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Sample records for tee vikestest hingepiinadest

  1. Multiple-jet thermal mixing in a piping tee

    International Nuclear Information System (INIS)

    Lykoudis, P.S.; Hagar, R.C.

    1979-01-01

    Piping tees that are used to mix fluid streams at different temperatures are subjected to possibly severe thermal and mechanical stresses. There is reason to suspect that mixing in a piping tee could be improved by injecting the fluid streams into the tee through multiple jets. This paper reports the results of an experimental investigation of the effects of multiple-jet injection on mixing in a piping tee. The experimental work involves the measurement of the temperature fluctuation intensity with a hot-film sensor downstream of a simple 22.22-mm(7/8-in.)-diam tee with mixed multiple-jet injected hot and cold streams of water. The jets were provided by holes drilled in plates that partially blocked the inlet streams; 26 pairs of plates were investigated. The number of holes per plate varied from 1 to 51; the jet diameters ranged from 5 to 68% of the tee diameter. The inlet stream Reynolds number upstream of the jet plates was roughly 15 500 for each stream. The data indicated that the root mean square (rms) temperature fluctuation intensity measured at the tee outlet decreased dramatically as the jet plate cross-sectional area void fraction was decreased. When the jets emanating from the tee plates were misaligned, the reduction of the rms temperature fluctuation was not as high as when the jets were aligned. The rate of decay of the intensity downstream of the tee for most ofthe plates investigated was found to agree well with the -3/4 power decay law predicted by Corrsin's theory of scalar decay. However, unusual features in the intensity decay data were also observed, such as an increase of the intensity several diameters downstream before continuing to decay

  2. 21 CFR 868.5995 - Tee drain (water trap).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tee drain (water trap). 868.5995 Section 868.5995...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5995 Tee drain (water trap). (a) Identification. A tee drain (water trap) is a device intended to trap and drain water that collects in ventilator...

  3. TEE-Based Trusted Storage

    DEFF Research Database (Denmark)

    Gonzalez, Javier; Bonnet, Philippe

    Today, it is safe to assume that any program or data can be compromised, if they are not protected by hardware within a secure area. Systems based on crypto-processors (e.g., a trusted platform module, a smart card or a hardware security module) rely on the properties of tamper resistant hardware...... to establish a tight security parameter around a reduced set of predefined functionalities. Such systems are very secure, but they impose strong constraints on the functionalities, the connectivity or the resources available within the secure area. They have not proven versatile enough to provide mainstream...... trusted storage for personal data. We believe that this role can be taken over by systems equipped with Trusted Execution Environments (TEE), such as ARM’s TrustZone. Indeed, even if TEEs provide weaker security guarantees than crypto-processors, they already provide a secure area on many personal devices...

  4. Test report on experimental stress analysis of a 24 inch diameter tee (ORNL T-13)

    International Nuclear Information System (INIS)

    Henley, D.R.

    1975-03-01

    The experimental stress analysis and low cycle fatigue test of one 24 in. x 24 in. x 10 in. schedule 160 carbon steel, ANSI B16.9 tee performed by Combustion Engineering, Inc. are described. The tee was instrumented with 230 rectangular strain gage rosettes. Elastic data was obtained for 12 loading conditions consisting of internal pressure and orthogonal pure moments and orthogonal direct forces applied individually to the free branch and run ends of the tee. One of the run ends of the tee was ''built in'' throughout the test. All loads were applied through pipe extensions welded to the tee. The tee was tested to failure in a low cycle pressure fatigue test with a cyclic internal pressure between 100 psi and 7000 psi. A through-the-wall fatigue crack occurred at 15,084 cycles. Significant test results are summarized and compared with design values tabulated in the ASME Boiler and Pressure Vessel Code, Section III, 1971. (U.S.)

  5. Test report on experimental stress analysis of a 24 inch diameter tee (ORNL T-12)

    International Nuclear Information System (INIS)

    Henley, D.R.

    1975-04-01

    The experimental stress analysis and low cycle fatigue test of one 24'' x 24'' x 10'' schedule 40 carbon steel, ANSI B16.9 tee performed by Combustion Engineering, Inc. is described. The tee was instrumented with 230 rectangular strain gage rosettes. Elastic data was obtained for 12 loading conditions consisting of internal pressure and orthogonal pure moments and orthogonal direct forces applied individually to the free branch and run ends of the tee. One of the run ends of the tee was ''built in'' throughout the test. All loads were applied through pipe extensions welded to the tee. The tee was tested to failure in a low cycle pressure fatigue test with a cyclic internal pressure between 0 psi and 1800 psi. A through-the-wall fatigue crack occurred at 76620 cycles. Significant test results are summarized and compared with design values tabulated in the ASME Boiler and Pressure Vessel Code, Section III, 1971. (U.S.)

  6. Enhancing oil rate in solvent vapour extraction processes through tee-well pattern

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, F.; Knorr, K.D.; Wilton, R.R. [Society of Petroleum Engineers, Canadian Section, Calgary, AB (Canada)]|[Saskatchewan Research Council, Saskatoon, SK (Canada)

    2008-10-15

    In order for the vapour extraction (VAPEX) process to be considered commercially viable, the production flow rate in classical VAPEX must be increased. The low flow rate can be attributed to the fact that the classical VAPEX process uses forces of buoyancy to distribute the solvent and gravity to drain the diluted oil to the producer. This paper presented a new well pattern, referred to as the tee-SVX process, that may enhance the oil flow rate two to ten times over the classical approach. Additional horizontal injectors, perpendicular to the injector and the producer in classical VAPEX were placed in the top-most region of the reservoir in the new well pattern. The paper described the model development which involved conducting a series of simulation runs in order to evaluate the performance of the new well pattern. The paper also presented a comparison of the performance of the tee-SVX and the classical VAPEX and lateral-SVX. A sensitivity analysis was also performed to further evaluate the performance of tee-SVX and provide the boundaries of the application of the process. Two types of factors affecting the performance of tee-SVX were outlined, notably design factors; and formation and fluid uncertainties. The performance of tee-SVX in thinner reservoirs and in reservoirs with a gas cap were also examined. It was concluded that compared with the lateral-SVX process, the tee-SVX process could significantly reduce the time to solvent breakthrough. 12 refs., 2 tabs., 30 figs.

  7. Tee ajalugu / Maris Takk

    Index Scriptorium Estoniae

    Takk, Maris

    2006-01-01

    Eesti Maanteemuuseumi (Varbuse postijaam, Kanepi vald, Põlvamaa) näitus "Tee ajalugu". Sisekujundus: Krista Lepland, Malle Jürgenson, kaasautor Tea Tammelaan, OÜ Laika, Belka & Strelka. Ehitus: OÜ Bauvel. Postitõlla maalis Kai Kaljo. Eesti Sisearhitektide Liidu 2005. a. näituse kujunduse preemia. T. Tammelaanest, K. Leplandist ja M. Jürgensonist, OÜ Laika, Belka & Strelka tähtsamad tööd. Hedi Rootsist, tema tähtsamad tööd. Ill.: plaan, 28 värv. vaadet, 4 portreefotot

  8. Experimental stress analysis for four 24-in. ANSI standard B16.9 tees

    International Nuclear Information System (INIS)

    Hayes, J.K.; Moore, S.E.

    1976-01-01

    The experimental stress analysis and low cycle fatigue tests of four tees tested by Combustion Engineering, Inc. (E-E) under subcontract to Union Carbide Nuclear Division are described. These tests are part of the ORNL Design Criteria for Piping and Nozzles Program which is being conducted for the development of design criteria for nuclear power plant service piping components. The test assemblies were fabricated at C-E from commercially obtained ANSI B16.9 tees and matching diameter steel pipes welded to the tees, with suitable and closures and fixtures for applying the loads

  9. Thermal fatigue evaluation of piping system Tee-connections

    International Nuclear Information System (INIS)

    Metzner, K.J.; Braillard, O.; Faidy, C.; Marcelles, I.; Solin, J.; Stumpfrock, L.

    2004-01-01

    Thermal fatigue is one significant long-term degradation mechanism nuclear power plants (NPP), in particular, as operating plants become older and life time extension activities have been initiated. In general, the common thermal fatigue issues are understood and controlled by plant instrumentation systems. However, incidents in some plants indicate that certain piping system Tees are susceptible to turbulent temperature mixing effects that cannot be adequately monitored by common thermocouple instrumentation. The THERFAT project has been initiated to advance the accuracy and reliability of thermal fatigue load determination in engineering tools and research oriented approaches to outline a science based practical methodology for managing thermal fatigue risks in Tee-connections susceptible to high cyclic thermal fatigue. (orig.)

  10. Parametric CAD and Fea Model of a Saddle Tapping Tee

    DEFF Research Database (Denmark)

    A. Kristensen, Anders Schmidt; Lund Jepsen, Kristian

    2007-01-01

     Often it is necessary to branch of a pipe section on an oilrig. This operation is often performed by making a so-called "Hot Tapping", which involves welding a pipe and a flange on to the pipe section. A spherical valve and a gate are mounted on to the flange, i.e. weld-o-let. In order to perform...... the welding operations a so-called habitat must be constructed. This habitat encapsulates the "Hot Tapping" spot and is relatively costly. Thus, to avoid weld operations on to the pipeline, a solution with clamps has been developed, i.e. a Saddle Tapping Tee. The Saddle Tapping Tee is clamped on the pipe...... is determined from paragraph K302.3.2 in ASME B31.3. A full parametric 3D CAD model of the Saddle Tapping Tee is developed where a number of user-defined parameters are controlled from an Excel spreadsheet allowing parameter studies and technical documentation to be generated effectively. The same Excel spread...

  11. Insights into the Mechanism of Severe Mitral Regurgitation: RT-3D TEE Guided Management with Pathological Correlation.

    Science.gov (United States)

    Anand, Senthil; Hamoud, Naktal; Thompson, Jess; Janardhanan, Rajesh

    2015-01-01

    Mitral valve perforation is an uncommon but important complication of infective endocarditis. We report a case of a 65-year-old man who was diagnosed to have infective endocarditis of his mitral valve. Through the course of his admission he had a rapid development of hemodynamic instability and pulmonary edema secondary to acutely worsening mitral regurgitation. While the TEE demonstrated an increase in the size of his bacterial vegetation, Real Time 3D TEE was ultimately the imaging modality through which the valve perforation was identified. Through this case report we discuss the advantages that RT-3D TEE has over traditional 2D TEE in the management of valve perforation.

  12. Experimental stress analysis and fatigue tests of five 12-in. NPS ANSI Standard B16.9 tees

    International Nuclear Information System (INIS)

    Moore, S.E.; Grigory, S.C.; Weed, R.A.

    1984-04-01

    The tees, designated as ORNL tees T-4, T-6, T-7, T-8, and T-15, were tested under subcontract at Southwest Research Institute, and the data were analyzed at ORNL. Experimental stress analyses were conducted for 13 individual loadings on each tee, including internal pressure and 3 mutually perpendicular force and moment loads on the branch and on the run. Each test model was instrumented with approx. 220, 1/16-in. three-gage, 45 0 strain rosettes on the body of the tee, and approx. 10, 1/16-in. two-gage, strain rosettes on the pipe extensions. Dial indicators, mounted on a special nonflexible holding frame, were used to measure deflections and rotations of the pipe extensions. Normalized maximum stress intensities for each loading condition on each tee are summarized in the text. Complete sets of strain-gage data, normalized stresses, and displacement measurements for each tee are given on microfiche in the appendixes. Following completion of the strain-gage tests, each tee was tested to failure in a fully reversed displacement-controlled low-cycle fatigue test with an alternating transverse load applied to the branch pipe. The load was directed out of plane for T-4, T-6, T-8, and T-15; and in plane for T-7. A constant internal pressure equal to the nominal design pressure was maintained during the fatigue tests. Failure data from the fatigue tests are summarized in the text

  13. Insights into the Mechanism of Severe Mitral Regurgitation: RT-3D TEE Guided Management with Pathological Correlation

    Directory of Open Access Journals (Sweden)

    Senthil Anand

    2015-01-01

    Full Text Available Mitral valve perforation is an uncommon but important complication of infective endocarditis. We report a case of a 65-year-old man who was diagnosed to have infective endocarditis of his mitral valve. Through the course of his admission he had a rapid development of hemodynamic instability and pulmonary edema secondary to acutely worsening mitral regurgitation. While the TEE demonstrated an increase in the size of his bacterial vegetation, Real Time 3D TEE was ultimately the imaging modality through which the valve perforation was identified. Through this case report we discuss the advantages that RT-3D TEE has over traditional 2D TEE in the management of valve perforation.

  14. Experimental stress analysis and fatigue tests of five 24-in. NPS ANSI Standard B16.9 tees

    International Nuclear Information System (INIS)

    Moore, S.E.; Hayes, J.K.; Weed, R.A.

    1985-03-01

    Experimental stress analyses and low-cycle fatigue tests of five 24-in. nominal pipe size American National Standards Institute (ANSI) Standard B16.9 forged tees are documented in this report. The tees, designated as Oak Ridge National Laboratory tees T10, T11, T12, T13, and T16, were tested under subcontract at Combustion Engineering, Inc. in Chattanooga, Tennessee. Experimental stress analyses were conducted for 12 individual loadings on each tee. Each test model was instrumented with approx. 225, 1/8-in. three-gage, 45 0 strain rosettes on the inside and outside surfaces; and 6 linear variable differential transformers mounted on special nonflexible holding frames for measuring deflections and rotations of the pipe extensions. Following completion of the strain-gate tests, each tee was fatigue tested to failure with either a fully reversed displacement controlled in-plane bending moment on the branch or a cyclic internal pressure that ranged from a value slightly above zero to about 90% of the nominal yield pressure of the pipe extensions

  15. Pirita tee trepp = Pirita road stairway / Villem Tomiste

    Index Scriptorium Estoniae

    Tomiste, Villem, 1975-

    2011-01-01

    Artikkel lähtub Tallinna III linnafoorumist, kus vaatluse all oli Pirita tee alguse piirkond. Lauluväljaku ja Maarjamäe memoriaali vahelisest alast. Ettepanek ehitada Pirita teelt klindile trepistik, mis linna poolt külgneks elamute alaga. Näitusehallid võiksid kolida klindi peale Narva maantee äärde

  16. Palverännaku tee õpetab kogemuse kaudu / Katri Soe

    Index Scriptorium Estoniae

    Soe, Katri

    2006-01-01

    Camino de Santiago ehk Santiago tee juhtimiskoolitusest. Kommenteerivad koolituse läbinud Mistra-Autexi projektijuht Siiri Vaaderpass, AS-i Saare Finants juhataja Alar Tõru, AS-i Tobaccoland Eesti juhatuse esimees Mall Bakler ning koolituse organisaator ja läbiviija Aira Tammemäe

  17. Marek Strandberg - rohelise tee mees / Marek Strandberg ; interv. Toomas Jüriado

    Index Scriptorium Estoniae

    Strandberg, Marek, 1965-

    2004-01-01

    Euroopa Parlamendi saadikukandidaat Marek Strandberg propageerib kolmanda, rohelise tee valikut Eesti ja Euroopa jaoks, mis tähendab uute loodussõbralike tehnoloogiate rakendamist. Lisa: Eesti keskkonnaindikaatorid

  18. Thermal stress analysis for fatigue damage evaluation at a mixing tee

    International Nuclear Information System (INIS)

    Kamaya, Masayuki; Nakamura, Akira

    2011-01-01

    Highlights: → Thermal stress and fatigue damage have been analyzed for a mixing tee. → Fatigue damage was accumulated near boundaries of the cold spot. → It was found that fatigue damage was brought about by fluctuation of cold spot. → Simple one-dimensional analysis could derive stress for fatigue evaluation. - Abstract: Fatigue cracks have been found at mixing tees where fluids of different temperature flow in. In this study, the thermal stress at a mixing tee was calculated by the finite element method using temperature transients obtained by a fluid dynamics simulation. The simulation target was an experiment for a mixing tee, in which cold water flowed into the main pipe from a branch pipe. The cold water flowed along the main pipe wall and caused a cold spot, at which the membrane stress was relatively large. Based on the evaluated thermal stress, the magnitude of the fatigue damage was assessed according to the linear damage accumulation rule and the rain-flow procedure. Precise distributions of the thermal stress and fatigue damage could be identified. Relatively large axial stress occurred downstream from the branch pipe due to the cold spot. The variation ranges of thermal stress and fatigue damage became large near the position 20 o from the symmetry line in the circumferential direction. The position of the cold spot changed slowly in the circumferential direction, and this was the main cause of the fatigue damage. The fatigue damage was investigated for various differences in the temperature between the main and branch pipes. Since the magnitude of accumulated damage increased abruptly when the temperature difference exceeded the value corresponding to the fatigue limit, it was suggested that the stress amplitude should be suppressed less than the fatigue limit. In the thermal stress analysis for fatigue damage assessment, it was found that the detailed three-dimensional structural analysis was not required. Namely, for the current case, a one

  19. Establishment of a JSME code for the evaluation of high-cycle thermal fatigue in mixing tees

    International Nuclear Information System (INIS)

    Moriya, Shoichi; Fukuda, Toshihiko; Matsunaga, Tomoya; Hirayama, Hiroshi; Shiina, Kouji; Tanimoto, Koichi

    2004-01-01

    This paper describes a JSME code for high-cycle thermal fatigue evaluation by thermal striping in mixing tees with hot and cold water flows. The evaluation of thermal striping in a mixing tee has four steps to screen design parameters one-by-one according to the severity of the thermal load assessed from design conditions using several evaluation charts. In order to make these charts, visualization tests with acrylic pipes and temperature measurement tests with metal pipes were conducted. The influence of the configurations of mixing tees, flow velocity ratio, pipe diameter ratio and so on was examined from the results of the experiments. This paper makes a short mention of the process of providing these charts. (author)

  20. The use of TEE simulation in teaching basic echocardiography skills to senior anesthesiology residents.

    Science.gov (United States)

    Jelacic, Srdjan; Bowdle, Andrew; Togashi, Kei; VonHomeyer, Peter

    2013-08-01

    The authors evaluated the educational benefits of using a first-generation HeartWorks simulator to teach senior anesthesiology residents basic echocardiography skills. Prospective observational study. A single academic medical center (teaching hospital). Thirty-seven senior (fourth-year) anesthesiology residents participated in this study. Groups of 3 senior anesthesiology residents participated in a single 3-hour tutorial in the simulation laboratory in the authors' institution during their cardiothoracic anesthesiology rotation. A cardiothoracic anesthesiology faculty member demonstrated the use of the transesophageal echocardiography (TEE) simulator and instructed the residents on obtaining standard TEE views of normal anatomy. Prior to the laboratory session, the residents took an online multiple-choice pretest with 25 questions related to safety, probe manipulation, clinical application, and pathology, which was accompanied by echo images of normal cardiac anatomy and video clips of pathology. Three to four weeks after the TEE tutorial, the residents completed an online post-test and evaluation of the teaching session. There was a statistically significant increase in knowledge of normal echocardiographic anatomy (p = 0.04), with an average improvement in normal echocardiographic anatomy scores of 15%. Virtual reality TEE simulation technology was endorsed strongly by residents, produced a statistically significant improvement in knowledge of normal echocardiographic anatomy, and could be effective for teaching basic echocardiography to anesthesiology residents. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Experimental stress analysis and fatigue tests of five 24-in. NPS ANSI Standard B16. 9 tees. [PWR; BWR

    Energy Technology Data Exchange (ETDEWEB)

    Moore, S.E.; Hayes, J.K.; Weed, R.A.

    1985-03-01

    Experimental stress analyses and low-cycle fatigue tests of five 24-in. nominal pipe size American National Standards Institute (ANSI) Standard B16.9 forged tees are documented in this report. The tees, designated as Oak Ridge National Laboratory tees T10, T11, T12, T13, and T16, were tested under subcontract at Combustion Engineering, Inc. in Chattanooga, Tennessee. Experimental stress analyses were conducted for 12 individual loadings on each tee. Each test model was instrumented with approx. 225, 1/8-in. three-gage, 45/sup 0/ strain rosettes on the inside and outside surfaces; and 6 linear variable differential transformers mounted on special nonflexible holding frames for measuring deflections and rotations of the pipe extensions. Following completion of the strain-gate tests, each tee was fatigue tested to failure with either a fully reversed displacement controlled in-plane bending moment on the branch or a cyclic internal pressure that ranged from a value slightly above zero to about 90% of the nominal yield pressure of the pipe extensions.

  2. Use of real-time three-dimensional transesophageal echocardiography in type A aortic dissections: Advantages of 3D TEE illustrated in three cases

    Directory of Open Access Journals (Sweden)

    Cindy J Wang

    2015-01-01

    Full Text Available Stanford type A aortic dissections often present to the hospital requiring emergent surgical intervention. Initial diagnosis is usually made by computed tomography; however transesophageal echocardiography (TEE can further characterize aortic dissections with specific advantages: It may be performed on an unstable patient, it can be used intra-operatively, and it has the ability to provide continuous real-time information. Three-dimensional (3D TEE has become more accessible over recent years allowing it to serve as an additional tool in the operating room. We present a case series of three patients presenting with type A aortic dissections and the advantages of intra-operative 3D TEE to diagnose the extent of dissection in each case. Prior case reports have demonstrated the use of 3D TEE in type A aortic dissections to characterize the extent of dissection and involvement of neighboring structures. In our three cases described, 3D TEE provided additional understanding of spatial relationships between the dissection flap and neighboring structures such as the aortic valve and coronary orifices that were not fully appreciated with two-dimensional TEE, which affected surgical decisions in the operating room. This case series demonstrates the utility and benefit of real-time 3D TEE during intra-operative management of a type A aortic dissection.

  3. Comparison of the design rules for the end of the prestressed concrete double tee component between China and the United States

    Directory of Open Access Journals (Sweden)

    Meng Xian Hong

    2016-01-01

    Full Text Available Precast prestressed concrete double tee is an economic bearing component which can be made into a large span, large coverage area .From the angle of the design for the end of the precast prestressed concrete double tee component, flexure and axial tension in extended end, direct shear, diagonal tension at re-entrant corner, diagonal tension in extended end and the connection of the end of precast prestressed double tee component in China and the United States are compared. The comparative study provide the direction for the future development of China in the double tee,including strengthening the end reinforcement and increasing end connections.

  4. Study on flow phenomena at a mixing tee pipe in plants

    International Nuclear Information System (INIS)

    Maeda, Shogo; Kubota, Hiroki; Sugimoto, Katsumi; Takenaka, Nobuyuki; Miyoshi, Koji

    2016-01-01

    Thermal fatigue cracking may initiate at a tee pipe in plants where high and low temperature fluids flow in. The thermal stress fluctuation is caused by the wall temperature fluctuation due to heat transfer of the fluid temperature fluctuation near the wall. In order to elucidate the flow phenomena at a mixing tee pipe to cause temperature fluctuation, a visualization experiment of the flow in mixing section was conducted using a rectangular test section made of acrylic. As a result, the flow pattern was classified by momentum ratio M_R of the main and branch pipes, and it changed from wall jet to deflecting jet on M_R=3.70, and from deflecting jet to impinging jet on M_R=0.64. The jet flow from the branch pipe is swaying at a period of from about 5 s to 10 s. The relationship between the periods of fluctuation and M_R was investigated. The period decreased as M_R increased. (author)

  5. Numerical modelling of an isothermal flow in a mixing Tee using large eddy simulation

    International Nuclear Information System (INIS)

    Ndombo, Jean-Marc

    2013-01-01

    Thermal fatigue in Pressurized Water Reactor plants has been found to be very acute in some hot/cold Tee junction mixing zones (CIVAUX, 1998). Large Eddy Simulation (LES) can be used to capture the unsteadiness which is responsible for the large mechanical stresses associated with thermal fatigue. Firstly, we analyze some results obtained using the EDF R and D Code Saturne applied to the Vattenfall Tee junction benchmark (version 2006) and we look at the effect of including synthetic turbulence at the Tee junction pipe inlets. Then we analyze high-order turbulent statistics in the T-junction using LES, to gain a better understanding of the heat exchange near the junction walls. The configuration of the T-junction used is that of the MOTHER project. The bulk Reynolds number is 30,000. The study shows the structure of the mean flow, budgets of the kinetic energy, temperature variance and the thermal heat flux are made in the internal flow and near the walls. Two kinds of computations are made. One with an adiabatic condition and the other with a non adiabatic condition (steel walls). The EDF R and D Code Saturne is coupled with SYRTHES to analyze the temperature in the wall (SYRTHES is also developed by EDF R and D). (author)

  6. Theoretical modelling and experimental investigation of single-phase and two-phase flow division at a tee-junction

    International Nuclear Information System (INIS)

    Lemonnier, H.; Hervieu, E.

    1991-01-01

    Phase separation in a tee-junction is modelled in the particular case of bubbly-flow. The model is based on a two-dimensional approach and hence, uses local equations. The first step consists in modelling the single-phase flow in the tee-junction. The free streamline theory is used to predict the flow of the continuous phase. The two recirculation zones which are presented in this case are predicted by the model. The second step consists in predicting the gas bubble paths as a result of the actions of the single-phase flow. Finally, the trajectories of gas bubbles are used to predict the separation characteristics of the tee-junction. Each step of the modelling procedure has been carefully tested by an in-depth experimental investigation. Excellent quantitative agreement is obtained between experimental results and model predictions. Moreover, the phase separation phenomenon is found to be clearly described by the model. (orig.)

  7. Study on mixing behavior in a tee piping and numerical analyses for evaluation of thermal striping

    International Nuclear Information System (INIS)

    Kamide, H.; Igarashi, M.; Kawashima, S.; Kimura, N.; Hayashi, K.

    2009-01-01

    Water experiments were carried out for thermal hydraulic aspects of thermal striping in a mixing tee, which has main to branch diameter ratio of 3. Detailed temperature and velocity fields were measured by a movable thermocouple tree and particle image velocimetry. Flow patterns in the tee were classified into three groups; wall jet, deflecting jet, and impinging jet, which had their own temperature fluctuation profiles, depending on a momentum ratio between the main and branch pipes. Non-dimensional power spectrum density (PSD) of temperature fluctuation showed a unique profile, when the momentum ratio was identical. Numerical simulation based on finite difference method showed alternative vortex development, like Karman vortex series, behind the jet from the branch pipe in the wall jet case. The prominent frequency of the temperature fluctuation in the calculation was 0.2 of St number based on the branch pipe diameter and in good agreement with the experimental results. Mixing behavior in the tee was characterized by the relatively large vortex structures defined by the diameters and the velocities in the pipes

  8. Live 3D TEE demonstrates and guides the management of prosthetic mitral valve obstruction.

    Science.gov (United States)

    Chahal, Mangeet; Pandya, Utpal; Adlakha, Satjit; Khouri, Samer J

    2011-08-01

    A 43-year-old woman, with a remote history of rheumatic mitral stenosis and a St. Jude prosthetic mitral valve replacement, presented with shortness of breath and palpitations, shortly after a long flight. On admission, atrial fibrillation with a rapid ventricular response was noted in the setting of a long history of noncompliance with her anticoagulation. Transesophageal echocardiography (TEE) demonstrated multiple laminated thrombi in the left atrial appendage. Live three-dimensional (3D) TEE confirmed this diagnosis and demonstrated an immobile posterior leaflet of the mitral prosthesis, which had direct implications in her management. She successfully underwent surgery for mitral valve replacement, left atrial appendage ligation, and a Maze procedure on the following day. The multiple thrombi within the atrial appendage were confirmed intraoperatively and pannus formation was determined to be the etiology of the leaflet immobility. © 2011, Wiley Periodicals, Inc.

  9. Study of elasticity and limit analysis of joints and branch pipe tee connections

    International Nuclear Information System (INIS)

    Plancq, David

    1997-01-01

    The industrial context of this study is the behaviour and sizing the pipe joints in PWR and fast neutron reactors. Two aspects have been approached in this framework. The first issue is the elastic behaviour of the pipe joining with a plane or spherical surface or with another pipe in order to get a better understanding of this components usually modelled in classical calculations in a very simplified way. We focused our search on the bending of an intersecting pipe. In the case of the intersection with a plane surface we have conducted our study on the basis of literature results. In the case of intersection on a spherical surface we have also solved entirely the problem by using a sphere shell description different from that usually utilized. Finally, we give an approach to obtain a simple result for the bending of branch pipe tee joints allowing the formulation of a specific finite element. The second issue approached is the limit analysis which allows characterising the plastic failure of this structures and defining reference constraints. This constraints are used in numerous applications. We mention here the rules of pipe sizing and analyzing under primary load, the mechanics of cracks and the definition of global plasticity criteria. To solve this problem we concentrated our studies on the development of a new calculation techniques for the limit load called elastic compensation method (ECM). We have tested it on a large number of classical structures and on the branch pipe tee connections. We propose also a very simple result regarding the lower limit of the bending of a tee junction

  10. Crack growth from defects in tee intersections and nkzzles

    International Nuclear Information System (INIS)

    Burns, D.J.

    The general objective of the research summarized in this report was to investigate the application of the continuous monitoring immersion technique to curved surfaces. In particular, experiments were carried out on pipe sections to assess the accuracy of the immersion technique for curved surfaces, followed by a design study of its application to monitoring defects in the crotch of tee pipe intersections. It was concluded that an immersion ultrasonic technique based on the measurement of echo amplitude can be used to monitor the growth of a sawcut in a pipe at 260 0 C, but more effort is needed in time-domain studies

  11. Effect of particle diameter of porous media on flow and heat transfer in a mixing tee

    International Nuclear Information System (INIS)

    Wang, Yongwei; Lu, Tao; Wang, Kuisheng

    2012-01-01

    Highlights: ► Three particle diameter cases of 28 mm, 14 mm and 7 mm were simulated by LES. ► With the diameter decreasing, mixing scale tends to decrease in the mixing tee. ► With the diameter decreasing, thermal mixing is weakened. ► With the diameter decreasing, the thermal stratification is obvious. ► When the particle diameter ratio is 4:2:1, pressure drop ratio is 1:2:4. -- Abstract: Numerical simulations have been carried out to investigate flow and heat transfer in a mixing tee filled with periodic sintered copper spheres. Three particle diameter cases of 28 mm, 14 mm and 7 mm with the array of 4 × 4, 8 × 8 and 16 × 16 at the same porosity of 0.3 have been calculated using large-eddy simulations and the Smagorinsky–Lilly sub-grid scale model. With the particle diameter decreasing, the mixture scale of hot and cold fluid tends to decrease in the mixing tee; the pressure drop of fluid flow through porous media increases. When the particle diameter ratios are 4:2:1 and the specific surface ratios are 1:2:4, the pressure drop ratios are 1:2:4; the thermal mixing in porous media is weakened because the temperature fluctuation decreases and the stratification of hot and cold fluids is observed.

  12. Improving the coastal record of tsunamis in the ESI-07 scale: Tsunami Environmental Effects Scale (TEE-16 scale)

    Energy Technology Data Exchange (ETDEWEB)

    Lario, J.; Bardaji, T.; Silva, P.G.; Zazo, C.; Goy, J.L.

    2016-07-01

    This paper discusses possibilities to improve the Environmental Seismic Intensity Scale (ESI-07 scale), a scale based on the effects of earthquakes in the environment. This scale comprises twelve intensity degrees and considers primary and secondary effects, one of them the occurrence of tsunamis. Terminology and physical tsunami parameters corresponding to different intensity levels are often misleading and confusing. The present work proposes: i) a revised and updated catalogue of environmental and geological effects of tsunamis, gathering all the available information on Tsunami Environmental Effects (TEEs) produced by recent earthquake-tsunamis; ii) a specific intensity scale (TEE-16) for the effects of tsunamis in the natural environment at coastal areas. The proposed scale could be used in future tsunami events and, in historic and paleo-tsunami studies. The new TEE- 16 scale incorporates the size specific parameters already considered in the ESI-07 scale, such as wave height, run-up and inland extension of inundation, and a comprehensive and more accurate terminology that covers all the different intensity levels identifiable in the geological record (intensities VI-XII). The TEE-16 scale integrates the description and quantification of the potential sedimentary and erosional features (beach scours, transported boulders and classical tsunamites) derived from different tsunami events at diverse coastal environments (e.g. beaches, estuaries, rocky cliffs,). This new approach represents an innovative advance in relation to the tsunami descriptions provided by the ESI-07 scale, and allows the full application of the proposed scale in paleoseismological studies. The analysis of the revised and updated tsunami environmental damage suggests that local intensities recorded in coastal areas do not correlate well with the TEE-16 intensity (normally higher), but shows a good correlation with the earthquake magnitude (Mw). Tsunamis generated by earthquakes can then be

  13. Muelles pretensados en el estuario del río Tees

    Directory of Open Access Journals (Sweden)

    Halcrow, William

    1962-11-01

    Full Text Available Sobre las márgenes del río Tees, ya en su estuario, Middlesbrough (Inglaterra, se están terminando, actualmente, las obras de un muelle pretensado que permitirá atracar barcos de gran calado, puesto que se halla emplazado en aguas profundas, es decir, de unos 11 m de calado en mareas bajas de primavera. El muelle ha sido estudiado y proyectado por Sir William Halcrow & Partners, quienes, además de esta obra, se han encargado de otras también de tipo marítimo.

  14. Large Eddy Simulation and the effect of the turbulent inlet conditions in the mixing Tee

    International Nuclear Information System (INIS)

    Ndombo, Jean-Marc; Howard, Richard J.A.

    2011-01-01

    Highlights: → LES of Tee junctions can easily reproduce the bulk flow. → The presence or absence of a turbulent inlet condition has an affect on the wall heat transfer. → The maximum heat transfer moves 1 cm and reduces by 10% when a turbulent inlet is used. - Abstract: Thermal fatigue in Pressurized Water Reactor plants has been found to be very acute in some hot/cold Tee junction mixing zones. Large Eddy Simulation (LES) can be used to capture the unsteadiness which is responsible for the large mechanical stresses associated with thermal fatigue. Here one LES subgrid model is studied, namely the Dynamic Smagorinsky model. This paper has two goals. The first is to demonstrate some results obtained using the EDF R and D Code Saturne applied to the Vattenfall Tee junction benchmark (version 2006) and the second is to look at the effect of including synthetic turbulence at the Tee junction pipe inlets. The last goal is the main topic of this paper. The Synthetic Eddy Method is used to create the turbulent inlet conditions and is applied to two kinds of grids. One contains six million cells and the other ten million. The addition of turbulence at the inlet does not seem to have much effect on the bulk flow and all computations are in good agreement with the experimental data. However, the inlet turbulence does have an effect on the near wall flow. All cases show that the wall temperature fluctuation and the wall temperature/velocity correlation are not the same when a turbulent inlet condition is used. Inclusion of the turbulent inlet condition moves the downstream location of the maximum temperature/velocity correlation by 1 cm and reduces its magnitude by 10%. This result is very important because the temperature/velocity correlation is closely related to the turbulent heat transfer in the flow, which is in turn responsible for the mechanical stresses on the structure. Finally we have studied in detail the influence of the turbulent inlet condition just

  15. Study on heat transfer characteristics in a mixing tee pipe to evaluate for thermal fatigue

    International Nuclear Information System (INIS)

    Miyoshi, Koji; Nakamura, Akira; Utanohara, Yoichi

    2016-01-01

    Thermal fatigue racking may initiate at a tee pipe where high and low temperature fluids flow in from different directions and mix. Thermal stress fluctuations are caused by movement of a hot spot on the pipe inner surface. It is important to investigate the heat transfer from the fluid to the structure around the hot spot. The heat transfer characteristic in the mixing tee pipe was investigated by tests in this study. The unsteady heat transfer coefficients around the hot spot were estimated with the fluid and wall temperature, which were measured with thermocouples. The estimated heat transfer coefficient varied from 1.2 to 3.5 times of the steady state heat transfer coefficient. The heat transfer coefficient was 2.9 times of the steady state value at the position for the maximum stress fluctuation, which was calculated with the measured wall temperature distribution. (author)

  16. "Euroopa telligootika tee" : rahvusvahelised koostööprojektid / Ülle Jukk

    Index Scriptorium Estoniae

    Jukk, Ülle

    2005-01-01

    Euroopa Liidu programmi INTERREG IIIB raames ellu kutsutud projektist "European Route of Brick Gothic", milles osalemise lepingule kirjutas 2002. a. alla 27 linna ja maakonda ning kohalikku ja riigiasutust Saksamaalt, Poolast, Taanist, Rootsist, Leedust, Lätist ja Eestist (Muinsuskaitseamet, SA Tartumaa Turism). 1.-3. IX 2003 toimus seminar Tartus. Koostati käsiraamat "Kohalikud turundusstrateegiad kultuuripärandi innovaatiliseks kasutamiseks". Valminud on voldik "Euroopa tellisgootika tee", kõikide osalejate objekte tutvustav infobrozhüür ning veebileht (www.eurob.org)

  17. A descriptive study of step alignment and foot positioning relative to the tee by professional rugby union goal-kickers.

    Science.gov (United States)

    Cockcroft, John; Van Den Heever, Dawie

    2016-01-01

    This study describes foot positioning during the final two steps of the approach to the ball amongst professional rugby goal-kickers. A 3D optical motion capture system was used to test 15 goal-kickers performing 10 goal-kicks. The distance and direction of each step, as well as individual foot contact positions relative to the tee, were measured. The intra- and inter-subject variability was calculated as well as the correlation (Pearson) between the measurements and participant anthropometrics. Inter-subject variability for the final foot position was lowest (placed 0.03 ± 0.07 m behind and 0.33 ± 0.03 m lateral to the tee) and highest for the penultimate step distance (0.666 ± 0.149 m), performed at an angle of 36.1 ± 8.5° external to the final step. The final step length was 1.523 ± 0.124 m, executed at an external angle of 35.5 ± 7.4° to the target line. The intra-subject variability was very low; distances and angles for the 10 kicks varied per participant by 1.6-3.1 cm and 0.7-1.6°, respectively. The results show that even though the participants had variability in their run-up to the tee, final foot position next to the tee was very similar and consistent. Furthermore, the inter- and intra-subject variability could not be attributed to differences in anthropometry. These findings may be useful as normative reference data for coaching, although further work is required to understand the role of other factors such as approach speed and body alignment.

  18. Via Baltica : Eesti tee Hansaliidust Euroopa Liitu? = Via Baltica : Viron tie Hansaliitosta Euroopan Unioniin? / Hannu Eerikäinen

    Index Scriptorium Estoniae

    Eerikäinen, Hannu

    2004-01-01

    Via Baltica moodustab Läänemere regioonis tähtsaima arengutelje, mis avab Põhja-Euroopale tee EL-ist väljaspool olevatesse riikidesse. Tallinnast saab taas tähtis vahendaja Põhja- ja Kesk-Euroopa vahel

  19. Finite element analysis of elasto-plastic tee joints

    International Nuclear Information System (INIS)

    Powell, G.H.

    1974-09-01

    The theory and computational procedures used in the computer program B169TJ/EP for the analysis of elasto-plastic tee joints are described, and detailed user's guide is presented. The program is particularly applicable to joints conforming to the ANSI B16.9 Manufacturing Standard, but can also be applied to other joint geometries. The joint may be loaded by internal pressure and by arbitrary combinations of applied forces and moments at the ends of the branch and run pipes, and the loading sequence may be arbitrary. The joint material is assumed to yield according to the von Mises criterion, and to exhibit either linear kinematic hardening or nonlinear isotropic hardening after yield. The program makes use of the finite element and mesh generation procedures previously applied in the elastic stress analysis program B16.9TJ/ SA, with minor modifications. (U.S.)

  20. Fatigue crack growth studies on a tee junction using ultrasonic non-destructive methods

    International Nuclear Information System (INIS)

    Subramanian, C.V.; Thavasimuthu, M.; Ramesh, A.S.; Jayakumar, T.; Kalyanasundaram, P.; Baldev Raj

    1996-01-01

    Fatigue cracks need to be detected and sized to maintain structural integrity. The significance of cracks detected in service must also be assessed. This paper describes the on-line ultrasonic testing carried out on a Tee joint subjected to fatigue loading. The initiation and growth of the cracks were monitored for every 5,000 cycles up to 40,000 cycles. The study demonstrated the use of ultrasonic testing for fatigue crack growth detection and sizing. (author)

  1. Large-eddy simulations of velocity and temperature fluctuations in hot and cold fluids mixing in a tee junction with an upstream straight or elbow main pipe

    International Nuclear Information System (INIS)

    Lu, T.; Attinger, D.; Liu, S.M.

    2013-01-01

    Highlights: • Temperature and velocity fluctuations in a tee junction are predicted using LES. • The numerical results are in good agreement with the experimental data. • Upstream elbow pipe has significant influence on those fluctuations. -- Abstract: Thermal striping resulting in thermal fatigue is an important safety issue for nuclear power plants. In this work, temperature and velocity fluctuations in hot and cold fluids mixing in a tee junction with the main pipe connected either to an upstream straight or elbow pipe have been numerically predicted using large-eddy simulations (LES) on the FLUENT platform with the assumption of fully-developed velocity at both main and branch pipe inlets. The numerical results for the case with an upstream straight pipe were found to be in reasonable agreement with the available experimental data. The reason for the small discrepancy between the numerical results and experimental data can be attributed to the turbulence velocity being 10% of the fully-developed velocity at the main and branch pipe inlets in the LES calculations, while in the experiments the turbulence velocity was about 10% of the average velocity upstream of the tee junction. The simulated normalized mean and root-mean square (RMS) temperatures and the velocities at both straight and elbow tees were then compared, as well as the power spectrum densities (PSD) of the temperature fluctuations. The elbow pipe upstream of the main pipe has a significant influence on the mixing, resulting in increased temperature and velocity fluctuations. The flow pattern of the elbow tee deviates from the wall jet due to the secondary flow in the upstream elbow pipe

  2. 3D Assessment of Features Associated With Transvalvular Aortic Regurgitation After TAVR: A Real-Time 3D TEE Study.

    Science.gov (United States)

    Shibayama, Kentaro; Mihara, Hirotsugu; Jilaihawi, Hasan; Berdejo, Javier; Harada, Kenji; Itabashi, Yuji; Siegel, Robert; Makkar, Raj R; Shiota, Takahiro

    2016-02-01

    This study of 3-dimensional (3D) transesophageal echocardiography (TEE) aimed to demonstrate features associated with transvalvular aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) and to confirm the fact that a gap between the native aortic annulus and prosthesis is associated with paravalvular AR. The mechanism of AR after TAVR, particularly that of transvalvular AR, has not been evaluated adequately. All patients with severe aortic stenosis who underwent TAVR with the Sapien device (Edwards Lifesciences, Irvine, California) had 3D TEE of the pre-procedural native aortic annulus and the post-procedural prosthetic valve. In the 201 patients studied, the total AR was mild in 67 patients (33%), moderate in 21 patients (10%), and severe in no patients. There were 20 patients with transvalvular AR and 82 patients with paravalvular AR. Fourteen patients had both transvalvular and paravalvular AR. Patients with transvalvular AR had larger prosthetic expansion (p prosthetic shape at the prosthetic commissure level (p prosthetic commissures in relation to the native commissures, than the patients without transvalvular AR. Age (odds ratio [OR]: 1.05; 95% confidence interval [CI]: 1.01 to 1.09; p 3D TEE successfully demonstrated the features associated with transvalvular AR, such as large prosthetic expansion, elliptical prosthetic shape, and anti-anatomical position of prosthesis. Additionally, effective area oversizing was associated with paravalvular AR. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. Thermal load determination in the mixing TEE impacted by a turbulent flow generated by two fluids at large gap of temperature

    International Nuclear Information System (INIS)

    Braillard, O.

    2005-01-01

    A 304L mixing tee mock-up is instrumented to assess the fluctuating temperature in the mixing area generated by two fluids (water) at large gap of temperature meet. The turbulent mixing layer impacts the structure wall and creates stresses, which lead to the damages. The case studied in this paper corresponds to the 'swinging streak' within a flow rate ratio of 25 %. The instrumentation is specifically planned to measure the fluctuating temperature in the fluid close to the internal skin and inside the wall too. This experiment is performed using a new sensor 'fluxmeter' which is non intrusive and typically designed to catch the fluctuation without any signal attenuation, within a frequency range 0-25Hz. The facility called 'Fatherino' supplies an available delta T of 70 degree C in water at 4 m/s mixture velocity in a mixing tee mock-up 50 mm in diameter. The flow features generate a large turbulent flow in the mixing layer and favour the heat flux transfer to the wall. By applying an inverse heat conduction method applied to the output data given by the fluxmeter, both the heat flux is deduced and the temperature (mean and fluctuating values) at the internal surface can be accurately determined. In addition, a calculation using the Trio U code (thermal hydraulic code) within the large eddy simulation module is computed to assess the fluid temperature distribution in the mixing area close to the internal surface. The output data in mean and standard deviation are compared with the Fatherino measurements. The comparison consists in analysing the main parameters as the mean and standard deviation in the fluid along the main axis and in a circumferential view. The mixing layer geometry and the frequency of the fluctuation are also analysed. These experiments added to the calculation allow us improving the state of the knowledge in the mixing tees and the thermal load to be used in the industrial mixing tees in operating for the long lifetime assessment or for the

  4. Tension pneumomediastnum: A rare cause of acute intraoperative circulatory collapse in the setting of unremarkable TEE findings.

    Science.gov (United States)

    Weaver, Jonathan B; Kumar, Avinash B

    2017-02-01

    Case report. Operating room. 25YF, ASA IV E who underwent an emergent decompressive craniectomy for refractory intracranial hypertension secondary to acute intracranial hemorhage. A 25Y caucasian female presented with acute intracranial hemorrhage with intraventricular extension secondary to Moya Moya disease. Post admisison, she underwent an emergent decompressive craniectomy for medically refractory intracranial hypertension. Introperatively (post dural closure and bone flap removal) the patient developed acutely worsening peak and plateau pressures followed by pulseless electrical activity necessitating CPR with epinephrine and Vasopressin before return of circulation before return of circulation. Intraoperative TEE done during return of circulation, was essentially non diagnostic, the patient had normal breath sounds throughout, and non-contributory bronchoscopy findings. EKG, arterial blood pressure, heart rate, resp. rate, introperative tranesophageal echocardiogram (TEE), Pulse oximetry, serial arterial blood gases, introperative bronchoscopy, ventilatory peak pressures. A post operative chest CT revealed extensive pneumomediastinum with subcutaneous emphysema. The focussed introperative echocardiogram showed preserved left ventricular function and no evidence of tamponade physiology. Tension pneumomediastinum was the likely etiologic factor for the acute hemodynamic collapse and should be considered in the differential diagnosis of intraoperative circulatory arrest. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. A hydro-thermo-mechanics analyze of the thermal fatigue in the mixing tee junction

    International Nuclear Information System (INIS)

    Gourdin, C.; Chapuliot, S.; Magnaud, J.P.; Payen, T.

    2003-01-01

    Work presented here, has been achieved at Cea, and is related to the comprehension of the mechanisms leading to cracking under thermal loading in the zones of mixing. The main objective of this work is to analyze, by computation, the thermal loading induced by the turbulent mixing following a tee junction and to explain how it can create cracking, from the internal skin of the component to a leakage, as it was observed in Civaux Power Plant in 1998. The phenomenon is still today not completely understood. One of the principal reasons to this partial incomprehension undoubtedly resides in the multi-field aspect of the loading and of the associated damage, utilizing three different and complementary scientific disciplines: thermohydraulics, thermomechanics and material science. The presentation proposed here, consists in connecting the analyses resulting from these various fields. The first part concentrates on thermohydraulics simulations. The choice of an adequate modeling is discussed on the basis of observed cracking in order to highlight phenomena of large scale beats, which are supposed one of the major causes leading to the failure of the structures. The second part deals with the use of the temperature fields obtained in the first part in order to carry out thermomechanical simulations. All these simulations are 3-dimensional and represent the complex geometry of Civaux RRA piping line, including a tee junction and elbows, water flow velocity. Mean and temperatures variations, mean and stresses variations are also presented. As final results make it possible to determine a map of the damage associated with these complex thermal loading. (authors)

  6. Total Energy Expenditure (TEE) measured with the doubly labeled water technique in women from 60 to 70 years of age from Havana City, Cuba

    International Nuclear Information System (INIS)

    Hernandez-Triana, M.H.; Porrata, C.; Estrada, G.; Diaz, M.E.; Martin, I.; Bayley, H.; McCormack, B.A.; Jones, P.J.H.

    2002-01-01

    Aim: With the purpose to measure the Total Energy Expenditure (TEE) and to validate the Cuban Dietary Energy Allowance for elderly subjects, energy expenditure was assessed by the doubly labeled water technique in 11 women aged 65.9 ± 2.8 y with a mean BMI of 21.4 ± 4.2 kg/m2 during 14 days under free-living conditions in their own environment in Havana City. Materials and Methods: After taking a basal urine sample, the women received an oral dose of 2.5 g H218O (10%) and 0.12 g 2H2O (99.8%) body weight and samples of saliva and urine were collected 14 days after. Resting Metabolic Rate (RMR) was estimated by the Schofield equations proposed by the 1985 FAO/WHO/UNU Expert Committee Report and energy intake was measured by trained dietitians using the 3-day weighed dietary record. A mean value of the food quotient of 0.85 was used for the calculations of the CO2 production by the isotopic method. Results: In spite of the expected variability, the differences between TEE measured by the isotopic method (7.57 MJ/d) and estimated according to FAO/WHO/UNU, 1985 (7.24 MJ/d) were not significant (0.625). The recommended dietary allowance for energy valid for Cuban elderly subjects (7.66 MJ/d) was only slight over the value of the measured TEE. The value of energy expenditure measured in free-living elderly women from Havana City was in the range of acceptable values (6-8 MJ/d) for this group of age. Conclusions: The total energy expenditure of elderly women from Havana City was lower than reported values for women living in developed countries but coincident with those of women of the developing world. The differences between dietary energy intake and TEE measured by the isotopic method were around 27% and coincident with previous reports in elderly people. The Cuban allowance for dietary energy for elderly women was enough for covering their energy requirements

  7. Thermal fatigue crack growth in mixing tees nuclear piping - An analytical approach

    International Nuclear Information System (INIS)

    Radu, V.

    2009-01-01

    The assessment of fatigue crack growth due to cyclic thermal loads arising from turbulent mixing presents significant challenges, principally due to the difficulty of establishing the actual loading spectrum. So-called sinusoidal methods represent a simplified approach in which the entire spectrum is replaced by a sine-wave variation of the temperature at the inner pipe surface. The need for multiple calculations in this process has lead to the development of analytical solutions for thermal stresses in a pipe subject to sinusoidal thermal loading, described in previous work performed at JRC IE Petten, The Netherlands, during the author's stage as seconded national expert. Based on these stress distributions solutions, the paper presents a methodology for assessment of thermal fatigue crack growth life in mixing tees nuclear piping. (author)

  8. Thermal fatigue in mixing tees: A step by step simplified procedure

    International Nuclear Information System (INIS)

    Faidy, Claude

    2003-01-01

    Following the CIVAUX 1 incident of a leak on RHR system, EDF has developed a step by step procedure to screen and analyse similar locations: mixing tees with long duration at high ΔT between the 2 fluids. The paper present the procedure, the background of the methodology and few R and D work that support this procedure. The procedure is based on: screening criteria on maximum DT and minimum duration. screening criteria without any duration consideration, only DT and material. a simplified and conservative estimation of a usage factor. a detailed analysis of usage factor and crack growth rate, based on specific data collection of operating transients. Around that procedure EDF launched an R and D program on fatigue curves and fatigue reduction factors for high cycle fatigue. The procedure is compared with field experience and recent R and D fatigue tests. (author)

  9. Beyond the static image: Tee Corinne's roles as a pioneering lesbian artist and art historian.

    Science.gov (United States)

    Snider, Stefanie

    2013-01-01

    While Tee Corinne has been widely recognized as a preeminent lesbian and feminist artist of the last forty years, little has been written about her as an artist or art historian in any substantial way. This article attempts to shed light on Corinne's investment in creating explicitly sexual lesbian visual art and art historical writings that put pressure on the categories of artist and art historian between the 1970s and early 2000s. Corinne's work manages to fulfill feminist ideals while also working outside of the norms set up in both the lesbian and mainstream realms of art and art history.

  10. Study of elasticity and limit analysis of joints and branch pipe tee connections; Etude elastique et analyse limite des piquages et des tes

    Energy Technology Data Exchange (ETDEWEB)

    Plancq, David [Nantes Univ., 44 (France)

    1997-09-24

    The industrial context of this study is the behaviour and sizing the pipe joints in PWR and fast neutron reactors. Two aspects have been approached in this framework. The first issue is the elastic behaviour of the pipe joining with a plane or spherical surface or with another pipe in order to get a better understanding of this components usually modelled in classical calculations in a very simplified way. We focused our search on the bending of an intersecting pipe. In the case of the intersection with a plane surface we have conducted our study on the basis of literature results. In the case of intersection on a spherical surface we have also solved entirely the problem by using a sphere shell description different from that usually utilized. Finally, we give an approach to obtain a simple result for the bending of branch pipe tee joints allowing the formulation of a specific finite element. The second issue approached is the limit analysis which allows characterising the plastic failure of this structures and defining reference constraints. This constraints are used in numerous applications. We mention here the rules of pipe sizing and analyzing under primary load, the mechanics of cracks and the definition of global plasticity criteria. To solve this problem we concentrated our studies on the development of a new calculation techniques for the limit load called elastic compensation method (ECM). We have tested it on a large number of classical structures and on the branch pipe tee connections. We propose also a very simple result regarding the lower limit of the bending of a tee junction 111 refs., 88 figs., 8 tabs.

  11. Large Eddy Simulation of a thermal mixing tee in order to assess the thermal fatigue

    International Nuclear Information System (INIS)

    Galpin, J.; Simoneau, J.P.

    2011-01-01

    Highlights: → In this study, we perform a Large Eddy Simulation of a mixing tee, for which experimental thermal statistics are available. → A special methodology has been set up for comparing properly the fluctuations with the experiment. → A comparison between the Smagorinsky and the structure-function sub-grid scale model is achieved out. → Slight better predictions are obtained with the structure-function model. → The possibility to reduce the computational domain by prescribing synthetic turbulence at the inlet is tested. First results are encouraging and underline the advantage of considering this technique instead of a standard noise at the entrance of the domain. - Abstract: The present paper deals with thermal fatigue phenomenon, and more particularly with the numerical simulation using Large Eddy Simulation technique of a mixing tee, for which experimental thermal statistics are available. The sensitivity to the sub-grid scale closure is first evaluated by comparing the experimental statistics with the numerical results obtained via both the Smagorinsky and the structure-function models. Because of a difference of temporal resolution between the experiment and the simulation, the direct comparison of the fluctuations is not possible. Therefore, a methodology based on filtering the numerical results is proposed in order to achieve a proper comparison. The comparison of the numerical results with the experiment suggests that slight better predictions are obtained with the structure-function model even if the dependency of the results to the sub-grid scale model is low. Then, the possibility to reduce the fluid computational domain by prescribing synthetic turbulence at the inlet is tested. First results are encouraging and underline the advantage of considering this technique instead of a standard noise at the entrance of the domain. All the simulations are conducted with the commercial CFD code STAR-CD.

  12. Kundalini Yoga, Yogi Tee und das Wassermannzeitalter: Bibliografische Einblicke in die Healthy, Happy, Holy Organization (3HO) des Yogi Bhajan

    OpenAIRE

    Laue, Thorsten

    2008-01-01

    Obwohl seit 40 Jahren im Westen aktiv, ist die Healthy, Happy, Holy Organization (3HO) des Yogi Bhajan (1929-2004) von der deutschen wie internationalen Forschung weitestgehend übersehen worden. Um dieser Forschungslücke entgegenzuwirken, verfasste ich 2003 meine religionswissenschaftlich begründete Magisterarbeit Darstellung und Quellen der 3HO Deutschland e.V. Aus dem Darstellungsteil entstand die 2007 im Münsteraner LIT-Verlag publizierte Monographie Kundalini Yoga, Yogi Tee und das Wasser...

  13. Fatigue caused by temperature changes in mixing tees

    International Nuclear Information System (INIS)

    Rothenhoefer, Horst

    2010-01-01

    Unexpected damages at mixing tees in piping systems in the past, one of them in the French NPP Civaux, raised questions concerning the basic cause for these events. Assumptions lead to the postulation of a ''new'' degradation mechanism which was called ''striping'', mainly based on thermal fluctuations in the mixing zone of hot and cold fluid which would be transferred to the internal wall of the pipe resulting in High Cycle Fatigue (HCF). Experiments and CFD simulations have been performed to understand the degradation mechanism behind the damages in order to find adequate measures to control that mechanism in future. The knowledge and assessment of all relevant degradation mechanisms is prerequisite for the application of the Integrity Concept, part of the German KTA 3201.4. In this paper numerous publications concerning striping are reviewed and assessed. The published experiments and simulations are separated into two main groups. The first group should help to understand the details of the mixing fluid flow and the corresponding thermal fluctuations. The second group should verify the damage mechanism of local thermal cycles as a HCF load. Latest simulation results and a detailed assessment of the heat transfer between fluid and structure are explained to understand and describe the degradation mechanism of striping and to define adequate measures for failure prevention. It is shown that if the procedure of monitoring and assessment, including the optimization of operational modes, is applied, which some utilities have been practicing for many years, the ''new'' degradation mechanism of striping is covered as well. Finally the conclusions are validated by transferring them to real damages proving that with the new knowledge the damages can be explained and the Integrity Concept can still be applied if the guidelines are realized in practice. (orig.)

  14. Prosthetic valve endocarditis 7 months after transcatheter aortic valve implantation diagnosed with 3D TEE

    Directory of Open Access Journals (Sweden)

    Cenk Sarı

    2016-03-01

    Full Text Available Transcatheter aortic valve implantation (TAVI was introduced as an alternative treatment for patients with severe symptomatic aortic stenosis for whom surgery would be high-risk. Prosthetic aortic valve endocarditis is a serious complication of surgical AVR (SAVR with high morbidity and mortality. According to recent cases, post-TAVI prosthetic valve endocarditis (PVE seems to occur very rarely. We present the case of a 75-year-old woman who underwent TAVI (Edwards Saphien XT with an uneventful postoperative stay. She was diagnosed with endocarditis using three dimensional (3D echocardiography on the TAVI device 7 months later and she subsequently underwent surgical aortic valve replacement. Little experience of the interpretation of transoesophageal echocardiography (TEE and the clinical course and effectiveness of treatment strategies in post-TAVI endocarditis exists. We report a case of PVE in a TAVI patient which was diagnosed with three-dimensional transoesophageal echocardiography (3DTEE.

  15. Assessment of TEES{reg_sign} applications for Wet Industrial Wastes: Energy benefit and economic analysis report

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, D.C.; Scheer, T.H.

    1992-02-01

    Fundamental work is catalyzed biomass pyrolysis/gasification led to the Thermochemical Environmental Energy System (TEES{reg_sign}) concept, a means of converting moist biomass feedstocks to high-value fuel gases such as methane. A low-temperature (350{degrees}C), pressurized (3100 psig) reaction environment and a nickel catalyst are used to reduce volumes of very high-moisture wastes such as food processing byproducts while producing useful quantities of energy. A study was conducted to assess the economic viability of a range of potential applications of the process. Cases examined included feedstocks of cheese whey, grape pomace, spent grain, and an organic chemical waste stream. The analysis indicated that only the organic chemical waste process is economically attractive in the existing energy/economic environment. However, food processing cases will become attractive as alternative disposal practices are curtailed and energy prices rise.

  16. Assessment of TEES reg sign applications for Wet Industrial Wastes: Energy benefit and economic analysis report

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, D.C.; Scheer, T.H.

    1992-02-01

    Fundamental work is catalyzed biomass pyrolysis/gasification led to the Thermochemical Environmental Energy System (TEES{reg sign}) concept, a means of converting moist biomass feedstocks to high-value fuel gases such as methane. A low-temperature (350{degrees}C), pressurized (3100 psig) reaction environment and a nickel catalyst are used to reduce volumes of very high-moisture wastes such as food processing byproducts while producing useful quantities of energy. A study was conducted to assess the economic viability of a range of potential applications of the process. Cases examined included feedstocks of cheese whey, grape pomace, spent grain, and an organic chemical waste stream. The analysis indicated that only the organic chemical waste process is economically attractive in the existing energy/economic environment. However, food processing cases will become attractive as alternative disposal practices are curtailed and energy prices rise.

  17. Estrogenic alkylphenols in fish tissues, sediments, and waters from the U.K. Tyne and Tees estuaries

    Energy Technology Data Exchange (ETDEWEB)

    Lye, C.M.; Frid, C.L.J.; Gill, M.E. [Univ. of Newcastle upon Tyne, North Shields (United Kingdom). Dove Marine Lab.; Cooper, D.W.; Jones, D.M. [Univ. of Newcastle upon Tyne (United Kingdom)

    1999-04-01

    Nonylphenols and related compounds are common products of biodegradation of a large group of nonionic surfactants, the nonylphenol polyethoxylates. Many of these compounds are known to be environmentally persistent and to elicit estrogenic response in both mammals and fish. In this study, nonylphenol (NP), nonylphenol monoethoxylate (NP1EO), and octylphenol (OP) were found in tissues of mature male flounder, Platichthys flesus, and in tissues of juvenile flounder. These fish also showed detectable levels of the yolk protein vitellogenin in their plasma, indicative of estrogenic exposure. The compounds were also found in discharges from a major sewage treatment works and in sediments from two estuaries in north-east England; the highest levels from the highly industrialized Tees and lower levels from the industrialized/urbanized Tyne estuary. The implications of these findings for fish populations are discussed.

  18. Urbanistid ja keskkonnaeksperdid: iga muudatuse eest Reidi tee projektis oleme pidanud võitlema / Helen Sooväli-Sepping, Kristi Grišakov, Mari Jüssi ; intervjueerinud Mari Peegel ; kommenteerinud Taavi Aas

    Index Scriptorium Estoniae

    Sooväli-Sepping, Helen, 1974-

    2016-01-01

    TLÜ keskkonnakorralduse professor ja linnakorralduse õppekava juht Helen Sooväli-Sepping, TTÜ maastikuarhitektuuri õppekava juht ja linnaplaneerija-urbanist Kristi Grišakov ning Stockholmi keskkonnainstituudi Tallinna keskuse liikuvus- ja keskkonnaekspert Mari Jüssi kinnitavad, et Reidi tee projekt ei ole endiselt inimsõbralik

  19. Prosthetic valve endocarditis 7 months after transcatheter aortic valve implantation diagnosed with 3D TEE.

    Science.gov (United States)

    Sarı, Cenk; Durmaz, Tahir; Karaduman, Bilge Duran; Keleş, Telat; Bayram, Hüseyin; Baştuğ, Serdal; Özen, Mehmet Burak; Bayram, Nihal Akar; Bilen, Emine; Ayhan, Hüseyin; Kasapkara, Hacı Ahmet; Bozkurt, Engin

    2016-01-01

    Transcatheter aortic valve implantation (TAVI) was introduced as an alternative treatment for patients with severe symptomatic aortic stenosis for whom surgery would be high-risk. Prosthetic aortic valve endocarditis is a serious complication of surgical AVR (SAVR) with high morbidity and mortality. According to recent cases, post-TAVI prosthetic valve endocarditis (PVE) seems to occur very rarely. We present the case of a 75-year-old woman who underwent TAVI (Edwards Saphien XT) with an uneventful postoperative stay. She was diagnosed with endocarditis using three dimensional (3D) echocardiography on the TAVI device 7 months later and she subsequently underwent surgical aortic valve replacement. Little experience of the interpretation of transoesophageal echocardiography (TEE) and the clinical course and effectiveness of treatment strategies in post-TAVI endocarditis exists. We report a case of PVE in a TAVI patient which was diagnosed with three-dimensional transoesophageal echocardiography (3DTEE). Copyright © 2016 Hellenic Cardiological Society. Published by Elsevier B.V. All rights reserved.

  20. Structural reinforcement of a {theta}16 inches tee made during operation with composite material

    Energy Technology Data Exchange (ETDEWEB)

    Beim, Andre [Tresca Engenharia Ltda., Sao Paulo, SP (Brazil); Vilani, Eduardo Cesar [Rust Engenharia Ltda., Diadema, SP (Brazil)

    2009-07-01

    An industrial installation went through a turnaround to increase capacity. A tie-in line had to be made for this, and a 16 inches diameter branch was required to be made on an existing 16 inches pipe. The joining of these elements resulted in a 'tee' that was supposed to receive a reinforcement plate. This reinforcement plate was not installed before the plant start-up. Code calculations and a finite element stress analysis showed that reinforcement was necessary. The only viable solution was the application of a composite material reinforcement, designed to substitute the missing reinforcement plate, and reduce the stresses to allowable levels. A new finite element stress analysis was made to determine the required thickness of this reinforcement. The first part of this work shows the results of the finite element stress analysis. Figures with stress contours of the analyses show the results. The second part shows the details of the installation of the reinforcement, which was made during normal operation of the plant. Pictures illustrate the main steps of the installation procedure. (author)

  1. Large-eddy simulation in a mixing tee junction: High-order turbulent statistics analysis

    International Nuclear Information System (INIS)

    Howard, Richard J.A.; Serre, Eric

    2015-01-01

    Highlights: • Mixing and thermal fluctuations in a junction are studied using large eddy simulation. • Adiabatic and conducting steel wall boundaries are tested. • Wall thermal fluctuations are not the same between the flow and the solid. • Solid thermal fluctuations cannot be predicted from the fluid thermal fluctuations. • High-order turbulent statistics show that the turbulent transport term is important. - Abstract: This study analyses the mixing and thermal fluctuations induced in a mixing tee junction with circular cross-sections when cold water flowing in a pipe is joined by hot water from a branch pipe. This configuration is representative of industrial piping systems in which temperature fluctuations in the fluid may cause thermal fatigue damage on the walls. Implicit large-eddy simulations (LES) are performed for equal inflow rates corresponding to a bulk Reynolds number Re = 39,080. Two different thermal boundary conditions are studied for the pipe walls; an insulating adiabatic boundary and a conducting steel wall boundary. The predicted flow structures show a satisfactory agreement with the literature. The velocity and thermal fields (including high-order statistics) are not affected by the heat transfer with the steel walls. However, predicted thermal fluctuations at the boundary are not the same between the flow and the solid, showing that solid thermal fluctuations cannot be predicted by the knowledge of the fluid thermal fluctuations alone. The analysis of high-order turbulent statistics provides a better understanding of the turbulence features. In particular, the budgets of the turbulent kinetic energy and temperature variance allows a comparative analysis of dissipation, production and transport terms. It is found that the turbulent transport term is an important term that acts to balance the production. We therefore use a priori tests to evaluate three different models for the triple correlation

  2. The advantages of live/real time three-dimensional transesophageal echocardiography during assessments of pulmonary stenosis.

    Science.gov (United States)

    Kemaloğlu Öz, Tuğba; Özpamuk Karadeniz, Fatma; Akyüz, Şükrü; Ünal Dayı, Şennur; Esen Zencirci, Aycan; Atasoy, Işıl; Ösken, Altuğ; Eren, Mehmet

    2016-04-01

    This report sought to compare live/real-time three-dimensional transesophageal echocardiography (3D-TEE) with two-dimensional transesophageal echocardiography (2D-TEE) and to determine whether there are advantages to using 3D-TEE on patients with pulmonary stenosis (PS). Sixteen consecutive adult patients (50 % male and 50 % female; mean age 33 ± 13.4 years) with PS and indications of TEE were prospectively enrolled in this study. Following this, initial 2D-TEE and 3D-TEE examinations were performed, and 3D-TEE images were analyzed using an off-line Q-lab software system. Finally, the 2D-TEE and 3D-TEE findings were compared. In the present study, 3D-TEE allowed us to obtain the en face views of pulmonary valves (PVs) in all but one patient. While this patient was without a PV due to a previous tetralogy of Fallot operation, we could detect the type of PV in the other 15 (93.7 %) patients by using 3D-TEE. Due to poor image quality, the most stenotic area was not measurable in only one (6.2 %) of the patients. In eight (50 %) of the patients, severity and localization of stenosis were more precisely determined with 3DTEE than with 2D-TEE. The PVs' maximal annulus dimensions were found to be significantly larger when they were measured using 3D modalities. This study provides evidence of the incremental value of using 3D-TEE rather than 2D-TEE during assessments of PS, specifically in cases where special conditions (pregnancy, pulmonary regurgitation, and concomitant atrial septal defects) cause recordings of the transvalvular peak gradient to be inaccurate. Therefore, 3D-TEE should be used as a complementary imaging tool to 2D-TEE during routine echocardiographic examinations.

  3. "Miks, kägu, sa mäe peal seal kukkumas käid ..." ; "Pikk on tee. Küla taga, kus aas ...." ; "Milleks sulle mu armastust vaja on veel ..." ; "Terve päev nii möödub üha ..." ; "Väike tütarlaps mõnusalt suplemas jões ..." ; Maasikad ; Mesila

    Index Scriptorium Estoniae

    Romanov, Vladimir

    2004-01-01

    Sisu: "Miks, kägu, sa mäe peal seal kukkumas käid ..." ; "Pikk on tee. Küla taga, kus aas ...." ; "Milleks sulle mu armastust vaja on veel ..." ; "Terve päev nii möödub üha ..." ; "Väike tütarlaps mõnusalt suplemas jões ..." ; Maasikad ; Mesilaste keel. Eluloolisi andmeid autori kohta lk. 371. Luuletused paralleelselt udmurdi ja eesti keeles

  4. Added value of cardiac computed tomography for evaluation of mechanical aortic valve: Emphasis on evaluation of pannus with surgical findings as standard reference.

    Science.gov (United States)

    Suh, Young Joo; Lee, Sak; Im, Dong Jin; Chang, Suyon; Hong, Yoo Jin; Lee, Hye-Jeong; Hur, Jin; Choi, Byoung Wook; Chang, Byung-Chul; Shim, Chi Young; Hong, Geu-Ru; Kim, Young Jin

    2016-07-01

    The added value of cardiac computed tomography (CT) with transesophageal echocardiography (TEE) for evaluating mechanical aortic valve (AV) dysfunction has not yet been investigated. The purposes of this study were to investigate the added value of cardiac CT for evaluation of mechanical AVs and diagnoses of pannus compared to TEE, with surgical findings of redo-aortic valve replacement (AVR) used as a standard reference. 25 patients who underwent redo-AVR due to mechanical AV dysfunction and cardiac CT before redo-AVR were included. The presence of pannus, encroachment ratio by pannus, and limitation of motion (LOM) were evaluated on CT. The diagnostic performance of pannus detection was compared using TEE, CT, and CT+TEE, with surgical findings as a standard reference. The added value of CT for diagnosing the cause of mechanical AV dysfunction was assessed compared to TTE+TEE. In two patients, CT analysis was not feasible due to severe metallic artifacts. On CT, pannus and LOM were found in 100% (23/23) and 60.9% (14/23). TEE identified pannus in 48.0% of patients (12/25). CT, TEE, and CT+TEE correctly identified pannus with sensitivity of 92.0%, 48.0%, and 92.0%, respectively (P=0.002 for CT vs. TEE). In 11 of 13 cases (84.6%) with inconclusive or negative TEE results for pannus, CT detected the pannus. Among 13 inconclusive cases of TTE+TEE for the cause of mechanical AV dysfunction, CT suggested 6 prosthetic valve obstruction (PVO) by pannus, 4 low-flow low-gradient PVO, and one LOM without significant PVO. Cardiac CT showed added diagnostic value with TEE in the detection of pannus as the cause of mechanical AV dysfunction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Validity of a combined heart rate and motion sensor for the measurement of free-living energy expenditure in very active individuals.

    Science.gov (United States)

    Santos, Diana A; Silva, Analiza M; Matias, Catarina N; Magalhães, João P; Fields, David A; Minderico, Cláudia S; Ekelund, Ulf; Sardinha, Luís B

    2014-07-01

    The correct assessment of energy expenditure in very active individuals is important to ensure that dietary energy intake is sufficient. We aimed to validate a combined heart rate (HR) and motion sensor in estimating total (TEE) and activity energy expenditure (AEE) in males and females with high physical activity levels. Cross-sectional. Doubly-labelled water (DLW) was used to assess 7-day TEE in 12 male and female elite junior basketball players, aged 16-17 years. Resting energy expenditure (REE) was assessed with indirect calorimetry and AEE was calculated (AEE=TEE-RMR-0.1×TEE). Simultaneously, TEE and AEE were measured by combined HR and motion sensing. Individual HR calibration was performed with step-test. TEE and AEE were estimated from accelerometry and HR with individual (ACC+HRstep) and group calibration (ACC+HRgroup). No mean differences were found between TEE and AEE from the ACC+HRstep and ACC+HRgroup with DLW. TEE values (kJ/day) from ACC+HRgroup and ACC+HRstep explained TEE from DLW by ∼60% and 53%, respectively whereas AEE (kJ/day) estimated by ACC+HRgroup and ACC+HRstep explained 53% and 41% of the variability of AEE from the reference method. Concordance correlation coefficients for TEE and AEE using ACC+HRgroup were 0.74 and 0.69, correspondingly while for ACC+HRstep values of 0.69 and 0.45 were found. Large limits of agreement were found for TEE and AEE using both ACC+HRgroup and ACC+HRstep. ACC+HR models are a valid alternative to estimate TEE but not AEE in a group of highly active individuals however the considerable rate of equipment failure (∼50%) limits its usefulness. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN PATIENTS WITH CEREBRAL ISCHEMIA

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2010-12-01

    Full Text Available Abstract INTRODUCTION: Transesophageal echocardiography (TEE is superior to Transthoracic echocardiography (TTE in detection of atrial septal defects and aneurysm, aortic atheroma, left atrial thrombus and mitral valve abnormalities. TEE is indicated in young adults with cryptogenic ischemic stroke who are suspected of having cardioembolic mechanism despite non-diagnostic TTE. METHODS: A prospective clinical study was conducted in patients with ischemic stroke or TIA who had TTE done in Ghaem hospital, Mashhad during 2006-2007. Ischemic cerebrovascular events were detected by stroke neurologist. TEE was performed with VIPI3/GE device, USA and a 7 MHz transesophageal probe by an echocardiologist. Patients who did not have TTE before TEE were excluded. Comparison of TEE to TTE results was performed by the echocardiologist and stroke neurologist in each patient. Influence of TEE on therapeutic decisions in each patient was evaluated. RESULTS: Forty-seven patients (20 females, 27 males with a mean age of 42.6±7.3 years were studied. Cardiac and aortic abnormalities were detected in TEE of 35 cases (35/47; 74% with ischemic cerebrovascular events. Cardiac abnormalities of 17 cases (36% were only detectable by TEE. These seventeen cases included 7 patients with PFO, 1 case with ASD, 6 cases with aortic atheroma and 2 patients with clot in the left atrium. Comparing the preventive stroke strategies before and after TEE revealed that it was changed only in two cases (2/47; 4.3% due to performing TEE. These included one patient with a small high-risk PFO and another case with dehicense of mechanical mitral valve. CONCLUSION: TEE revealed cardiac or aortic abnormalities in one-third of the patients with cerebral ischemia and has not been detected by TEE previously. The influence of TEE in therapeutic decisions of patients with ischemic cerebrovascular events is very low.         Keywords: Transesophageal echocardiography, Stroke, Transient Ischemic

  7. Transesophageal echocardiography simulation is an effective tool in teaching psychomotor skills to novice echocardiographers.

    Science.gov (United States)

    Sohmer, Benjamin; Hudson, Christopher; Hudson, Jordan; Posner, Glenn D; Naik, Viren

    2014-03-01

    Performance of transesophageal echocardiography (TEE) requires the psychomotor ability to obtain interpretable echocardiographic images. The purpose of this study was to determine the effectiveness of a simulation-based curriculum in which a TEE simulator is used to teach the psychomotor skills to novice echocardiographers and to compare instructor-guided with self-directed online delivery of the curriculum. After institutional review board approval, subjects inexperienced in TEE completed an online review of TEE material prior to a baseline pre-test of TEE psychomotor skills using the simulator. Subjects were randomized to two groups. The first group received an instructor-guided lesson of TEE psychomotor skills with the simulator. The second group received a self-directed slide presentation of TEE psychomotor skills with the simulator. Both lessons delivered identical information. Following their respective training sessions, all subjects performed a post-test of their TEE psychomotor skills using the simulator. Two assessors rated the TEE performances using a validated scoring system for acquisition of images. Pre-test TEE simulator scores were similar between the two instruction groups (9.0 vs 5.0; P = 0.28). The scores in both groups improved significantly following training, regardless of the method of instruction (P psychomotor skills. There was no difference in improvement between the different modalities of instruction. Further research will examine the need for a faculty resource for a curriculum in which a simulator is used as an adjunct.

  8. Demonstration of infective endocarditis by cardiac CT and transoesophageal echocardiography: comparison with intra-operative findings.

    Science.gov (United States)

    Koo, Hyun Jung; Yang, Dong Hyun; Kang, Joon-Won; Lee, Joo Yeon; Kim, Dae-Hee; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae-Won; Lim, Tae-Hwan

    2018-02-01

    We aimed to compare imaging findings of infective endocarditis between computed tomography (CT) and transoesophageal echocardiography (TEE) using surgical inspection as a reference standard. Forty-nine patients (aged 54 ± 17 years, 69% men) who underwent pre-operative CT and TEE for infective endocarditis were included. Twelve of these patients had prosthetic valve endocarditis. Imaging findings of infective endocarditis were classified as vegetation, leaflet perforation, abscess/pseudoaneurysm, and paravalvular leakage. Diagnostic performances of CT and TEE were evaluated using surgical inspection as a reference standard. Interobserver agreements for CT findings were obtained using Cohen's κ test. The detection rates of infective endocarditis per patient with CT and TEE were 93.9% (46/49) and 95.9% (47/49), respectively. In per-imaging analysis, the sensitivities of CT and TEE were not significantly different for both native and prosthetic valve infective endocarditis (sensitivity: vegetation, 100% in TEE and 90.9% in CT; leaflet perforation, 87.5% in TEE and 50.0% in CT; abscess/pseudoaneurysm, 40.0% in TEE and 60.0% in CT; paravalvular leakage, 100% in TEE and 50.0% in CT). Interobserver agreements for CT findings were substantial or excellent (0.79-0.88). Cardiac CT can accurately demonstrate infective endocarditis in pre-operative patients with a similar diagnostic accuracy to TEE. The interobserver agreements for the CT findings of infective endocarditis were excellent. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  9. Real-time three-dimensional transesophageal echocardiography in the assessment of mechanical prosthetic mitral valve ring thrombosis.

    Science.gov (United States)

    Ozkan, Mehmet; Gürsoy, Ozan Mustafa; Astarcıoğlu, Mehmet Ali; Gündüz, Sabahattin; Cakal, Beytullah; Karakoyun, Süleyman; Kalçık, Macit; Kahveci, Gökhan; Duran, Nilüfer Ekşi; Yıldız, Mustafa; Cevik, Cihan

    2013-10-01

    Although 2-dimensional (2D) transesophageal echocardiography (TEE) is the gold standard for the diagnosis of prosthetic valve thrombosis, nonobstructive clots located on mitral valve rings can be missed. Real-time 3-dimensional (3D) TEE has incremental value in the visualization of mitral prosthesis. The aim of this study was to investigate the utility of real-time 3D TEE in the diagnosis of mitral prosthetic ring thrombosis. The clinical outcomes of these patients in relation to real-time 3D transesophageal echocardiographic findings were analyzed. Of 1,263 patients who underwent echocardiographic studies, 174 patients (37 men, 137 women) with mitral ring thrombosis detected by real-time 3D TEE constituted the main study population. Patients were followed prospectively on oral anticoagulation for 25 ± 7 months. Eighty-nine patients (51%) had thrombi that were missed on 2D TEE and depicted only on real-time 3D TEE. The remaining cases were partially visualized with 2D TEE but completely visualized with real-time 3D TEE. Thirty-seven patients (21%) had thromboembolism. The mean thickness of the ring thrombosis in patients with thromboembolism was greater than that in patients without thromboembolism (3.8 ± 0.9 vs 2.8 ± 0.7 mm, p 3D TEE during follow-up. There were no thrombi in 39 patients (25%); 45 (29%) had regression of thrombi, and there was no change in thrombus size in 68 patients (44%). Thrombus size increased in 3 patients (2%). Thrombosis was confirmed surgically and histopathologically in 12 patients (7%). In conclusion, real-time 3D TEE can detect prosthetic mitral ring thrombosis that could be missed on 2D TEE and cause thromboembolic events. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Complications of Intraoperative Transesophageal Echocardiography in Adult Cardiac Surgical Patients—Experience of Two Institutions in Taiwan

    Directory of Open Access Journals (Sweden)

    Chi-Hsiang Huang

    2007-01-01

    Full Text Available There is some safety concern about transesophageal echocardiography (TEE when it is used routinely during cardiac operations. The purpose of this investigation was to study the incidence of intraoperative TEE-associated complications in adult cardiac surgical patients. The study population comprised 6255 consecutive adult cardiac surgical patients with intraoperative TEE examinations. TEE-associated complications occurred in 25 patients (0.4%. Most of these complications consisted of oropharyngeal mucosal bleeding (15/25, 60%. Esophageal perforation occurred in one patient. Two patients experienced upper gastrointestinal bleeding. Seven patients experienced dental injuries, and TEE probe insertion failed in 10 patients. We conclude that intraoperative TEE-associated complications in cardiac operations is very low; the complication rate we found was comparable to previously reported values. [J Formos Med Assoc 2007; 106(1:92-95

  11. Manual Skill Acquisition During Transesophageal Echocardiography Simulator Training of Cardiology Fellows: A Kinematic Assessment.

    Science.gov (United States)

    Matyal, Robina; Montealegre-Gallegos, Mario; Mitchell, John D; Kim, Han; Bergman, Remco; Hawthorne, Katie M; O'Halloran, David; Wong, Vanessa; Hess, Phillip E; Mahmood, Feroze

    2015-12-01

    To investigate whether a transesophageal echocardiography (TEE) simulator with motion analysis can be used to impart proficiency in TEE in an integrated curriculum-based model. A prospective cohort study. A tertiary-care university hospital. TEE-naïve cardiology fellows. Participants underwent an 8-session multimodal TEE training program. Manual skills were assessed at the end of sessions 2 and 8 using motion analysis of the TEE simulator's probe. At the end of the course, participants performed an intraoperative TEE; their examinations were video captured, and a blinded investigator evaluated the total time and image transitions needed for each view. Results are reported as mean±standard deviation, or median (interquartile range) where appropriate. Eleven fellows completed the knowledge and kinematic portions of the study. Five participants were excluded from the evaluation in the clinical setting because of interim exposure to TEE or having participated in a TEE rotation after the training course. An increase of 12.95% in post-test knowledge scores was observed. From the start to the end of the course, there was a significant reduction (pcardiology fellows can be complemented with kinematic analyses to objectify acquisition of manual skills during simulator-based training. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Are novel non-invasive imaging techniques needed in patients with suspected prosthetic heart valve endocarditis? A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Habets, Jesse; Mali, Willem P.T.M. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Tanis, Wilco [Haga Teaching Hospital, Department of Cardiology, The Hague (Netherlands); Reitsma, Johannes B. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Brink, Renee B.A. van den [Academic Medical Center, Department of Cardiology, Amsterdam (Netherlands); Chamuleau, Steven A.J. [University Medical Center Utrecht, Department of Cardiology, Utrecht (Netherlands); Budde, Ricardo P.J. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands)

    2015-07-15

    Multimodal non-invasive imaging plays a key role in establishing a diagnosis of PHV endocarditis. The objective of this study was to provide a systematic review of the literature and meta-analysis of the diagnostic accuracy of TTE, TEE, and MDCT in patients with (suspected) PHV endocarditis. Studies published between 1985 and 2013 were identified via search and cross-reference of PubMed/Embase databases. Studies were included if (1) they reported on the non-invasive index tests TTE, TEE, or MDCT; (2) data was provided on PHV endocarditis as the condition of interest; and (3) imaging results were verified against either surgical inspection/autopsy or clinical follow-up reference standards, thereby enabling the extraction of 2-by-2 tables. Twenty articles (including 496 patients) met the inclusion criteria for PHV endocarditis. TTE, TEE, and MDCT + TEE had a pooled sensitivity/specificity for vegetations of 29/100 %; 82/95 %, and 88/94 %, respectively. The pooled sensitivity/specificity of TTE, TEE, and MDCT + TEE for periannular complications was 36/93 %, 86/98 %, and 100/94 %, respectively. TEE showed good sensitivity and specificity for establishing a diagnosis of PHV endocarditis. Although MDCT data are limited, this review showed that MDCT in addition to TEE may improve sensitivity in detecting life-threatening periannular complications. (orig.)

  13. Are novel non-invasive imaging techniques needed in patients with suspected prosthetic heart valve endocarditis? A systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Habets, Jesse; Mali, Willem P.T.M.; Tanis, Wilco; Reitsma, Johannes B.; Brink, Renee B.A. van den; Chamuleau, Steven A.J.; Budde, Ricardo P.J.

    2015-01-01

    Multimodal non-invasive imaging plays a key role in establishing a diagnosis of PHV endocarditis. The objective of this study was to provide a systematic review of the literature and meta-analysis of the diagnostic accuracy of TTE, TEE, and MDCT in patients with (suspected) PHV endocarditis. Studies published between 1985 and 2013 were identified via search and cross-reference of PubMed/Embase databases. Studies were included if (1) they reported on the non-invasive index tests TTE, TEE, or MDCT; (2) data was provided on PHV endocarditis as the condition of interest; and (3) imaging results were verified against either surgical inspection/autopsy or clinical follow-up reference standards, thereby enabling the extraction of 2-by-2 tables. Twenty articles (including 496 patients) met the inclusion criteria for PHV endocarditis. TTE, TEE, and MDCT + TEE had a pooled sensitivity/specificity for vegetations of 29/100 %; 82/95 %, and 88/94 %, respectively. The pooled sensitivity/specificity of TTE, TEE, and MDCT + TEE for periannular complications was 36/93 %, 86/98 %, and 100/94 %, respectively. TEE showed good sensitivity and specificity for establishing a diagnosis of PHV endocarditis. Although MDCT data are limited, this review showed that MDCT in addition to TEE may improve sensitivity in detecting life-threatening periannular complications. (orig.)

  14. Simultaneous measurement of free-living energy expenditure by the doubly labeled water method and heart-rate monitoring

    International Nuclear Information System (INIS)

    Livingstone, M.B.; Prentice, A.M.; Coward, W.A.; Ceesay, S.M.; Strain, J.J.; McKenna, P.G.; Nevin, G.B.; Barker, M.E.; Hickey, R.J.

    1990-01-01

    Total energy expenditure (TEE) was measured simultaneously in 14 free-living adults over 15 d by the doubly labeled water (DLW) method and for 2-4 separate days by heart-rate (HR) monitoring. Individual curves for HR vs oxygen consumption (VO2) were obtained and an HR (FLEX HR: 97 +/- 8 beats/min, range 84-113 beats/min) that discriminated between rest and activity was identified. Calibration curves were used to assign an energy value to daytime HR above FLEX HR. Below FLEX HR energy expenditure was taken as resting metabolism. Sleeping energy expenditure was assumed to be equal to basal metabolic rate. Average HR TEE (12.99 +/- 3.83 MJ/d) and average DLW TEE (12.89 +/- 3.80 MJ/d) were similar. HR TEE discrepancies ranged from -22.2% to +52.1%, with nine values lying within +/- 10% of DLW TEE estimates. The FLEX HR method provides a close estimation of the TEE of population groups. However, an increased number of sampling days may improve the precision of individual estimates of TEE

  15. Segmentation of multiple heart cavities in 3-D transesophageal ultrasound images

    NARCIS (Netherlands)

    Haak, A.; Vegas-Sanchez-Ferrero, G.; Mulder, H.W.; Ren, B.; Kirisli, H.A.; Metz, C.; van Burken, G.; van Stralen, M.; Pluim, J.P.W.; Steen, van der A.F.W.; Walsum, van T.; Bosch, J.G.

    Three-dimensional transesophageal echocardiography (TEE) is an excellent modality for real-time visualization of the heart and monitoring of interventions. To improve the usability of 3-D TEE for intervention monitoring and catheter guidance, automated segmentation is desired. However, 3-D TEE

  16. Comparison of left ventricular outflow geometry and aortic valve area in patients with aortic stenosis by 2-dimensional versus 3-dimensional echocardiography.

    Science.gov (United States)

    Saitoh, Takeji; Shiota, Maiko; Izumo, Masaki; Gurudevan, Swaminatha V; Tolstrup, Kirsten; Siegel, Robert J; Shiota, Takahiro

    2012-06-01

    The present study sought to elucidate the geometry of the left ventricular outflow tract (LVOT) in patients with aortic stenosis and its effect on the accuracy of the continuity equation-based aortic valve area (AVA) estimation. Real-time 3-dimensional transesophageal echocardiography (RT3D-TEE) provides high-resolution images of LVOT in patients with aortic stenosis. Thus, AVA is derived reliably with the continuity equation. Forty patients with aortic stenosis who underwent 2-dimensional transthoracic echocardiography (2D-TTE), 2-dimensional transesophageal echocardiography (2D-TEE), and RT3D-TEE were studied. In 2D-TTE and 2D-TEE, the LVOT areas were calculated as π × (LVOT dimension/2)(2). In RT3D-TEE, the LVOT areas and ellipticity ([diameter of the anteroposterior axis]/[diameter of the medial-lateral axis]) were evaluated by planimetry. The AVA is then determined using planimetry and the continuity equation method. LVOT shape was found to be elliptical (ellipticity of 0.80 ± 0.08). Accordingly, the LVOT areas measured by 2D-TTE (median 3.7 cm(2), interquartile range 3.1 to 4.1) and 2D-TEE (median 3.7 cm(2), interquartile range 3.1 to 4.0) were smaller than those by 3D-TEE (median 4.6 cm(2), interquartile range 3.9 to 5.3; p interquartile range 0.79 to 1.3, p interquartile range 0.64 to 0.94) and 2D-TEE (median 0.76 cm(2), interquartile range 0.62 to 0.95). Additionally, the continuity equation-based AVA by RT3D-TEE was consistent with the planimetry method. In conclusion, RT3D-TEE might allow more accurate evaluation of the elliptical LVOT geometry and continuity equation-based AVA in patients with aortic stenosis than 2D-TTE and 2D-TEE. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Assessment of left atrial appendage function by transthoracic pulsed Doppler echocardiography: Comparing against transesophageal interrogation and predicting echocardiographic risk factors for stroke.

    Science.gov (United States)

    Wai, Shin Hnin; Kyu, Kyu; Galupo, Mary Joyce; Songco, Geronica G; Kong, William K F; Lee, Chi Hang; Yeo, Tiong Cheng; Poh, Kian Keong

    2017-10-01

    Transesophageal echocardiographic (TEE) findings of left atrial appendage (LAA) thrombus, spontaneous echo contrast (SEC), and LAA dysfunction are established risk factors of cardioembolic stroke. The semi-invasive nature of TEE limits its utility as a routine risk stratification tool. We aim to correlate TEE and transthoracic echocardiography (TTE) pulsed Doppler measurements of LAA flow velocities and use TTE measurements to predict TEE findings. We prospectively measured pulsed Doppler LAA flow velocities in 103 consecutive patients on TEE and TTE. There was a strong correlation between TEE and TTE LAA emptying velocity (LAA E) (r = .88, P < .001) and a moderate correlation between LAA filling velocities (r = .50, P < .001). TTE LAA E predicted the presence of thrombus or SEC independent of atrial fibrillation (AF). To predict the presence of thrombus or SEC, the optimal TTE LAA E cutoff was ≤30 cm/s in all patients (75% sensitive, 90% specific) and ≤31 cm/s in AF patients (80% sensitive, 79% specific). To predict LAA dysfunction (TEE E ≤ 20 cm/s), the optimal TTE LAA E cutoff was ≤27 cm/s (100% sensitive, 89% specific in all patients and 100% sensitive, 74% specific in AF patients). TTE assessment of LAA function is feasible and correlates well with the more invasive TEE method. It predicts the presence of thrombus, SEC, and LAA dysfunction on TEE. TTE LAA assessment has incremental value in thromboembolic risk stratification and should be utilized more frequently. © 2017, Wiley Periodicals, Inc.

  18. Obstructed bi-leaflet prosthetic mitral valve imaging with real-time three-dimensional transesophageal echocardiography.

    Science.gov (United States)

    Shimbo, Mai; Watanabe, Hiroyuki; Kimura, Shunsuke; Terada, Mai; Iino, Takako; Iino, Kenji; Ito, Hiroshi

    2015-01-01

    Real-time three-dimensional transesophageal echocardiography (RT3D-TEE) can provide unique visualization and better understanding of the relationship among cardiac structures. Here, we report the case of an 85-year-old woman with an obstructed mitral prosthetic valve diagnosed promptly by RT3D-TEE, which clearly showed a leaflet stuck in the closed position. The opening and closing angles of the valve leaflets measured by RT3D-TEE were compatible with those measured by fluoroscopy. Moreover, RT3D-TEE revealed, in the ring of the prosthetic valve, thrombi that were not visible on fluoroscopy. RT3D-TEE might be a valuable diagnostic technique for prosthetic mitral valve thrombosis. © 2014 Wiley Periodicals, Inc.

  19. Comparison of aortic root dimensions and geometries before and after transcatheter aortic valve implantation by 2- and 3-dimensional transesophageal echocardiography and multislice computed tomography.

    NARCIS (Netherlands)

    Ng, A.C.; Delgado, V.; Kley, F. van der; Shanks, M.; Veire, N.R. van de; Bertini, M.; Nucifora, G.; Bommel, R.J. van; Tops, L.F.; Weger, A. de; Tavilla, G.; Roos, A. de; Kroft, L.J.; Leung, D.Y.; Schuijf, J.; Schalij, M.J.; Bax, J.J.

    2010-01-01

    BACKGROUND: 3D transesophageal echocardiography (TEE) may provide more accurate aortic annular and left ventricular outflow tract (LVOT) dimensions and geometries compared with 2D TEE. We assessed agreements between 2D and 3D TEE measurements with multislice computed tomography (MSCT) and changes in

  20. The value of transesophageal echocardiography for embolic strokes of undetermined source.

    Science.gov (United States)

    Katsanos, Aristeidis H; Bhole, Rohini; Frogoudaki, Alexandra; Giannopoulos, Sotirios; Goyal, Nitin; Vrettou, Agathi-Rosa; Ikonomidis, Ignatios; Paraskevaidis, Ioannis; Pappas, Konstantinos; Parissis, John; Kyritsis, Athanassios P; Alexandrov, Anne W; Triantafyllou, Nikos; Malkoff, Marc D; Voumvourakis, Konstantinos; Alexandrov, Andrei V; Tsivgoulis, Georgios

    2016-09-06

    Our aim was to evaluate the diagnostic yield of transesophageal echocardiography (TEE) in consecutive patients with ischemic stroke (IS) fulfilling the diagnostic criteria of embolic strokes of undetermined source (ESUS). We prospectively evaluated consecutive patients with acute IS satisfying ESUS criteria who underwent in-hospital TEE examination in 3 tertiary care stroke centers during a 12-month period. We also performed a systematic review and meta-analysis estimating the cumulative effect of TEE findings on therapeutic management for secondary stroke prevention among different IS subgroups. We identified 61 patients with ESUS who underwent investigation with TEE (mean age 44 ± 12 years, 49% men, median NIH Stroke Scale score = 5 points [interquartile range: 3-8]). TEE revealed additional findings in 52% (95% confidence interval [CI]: 40%-65%) of the study population. TEE findings changed management (initiation of anticoagulation therapy, administration of IV antibiotic therapy, and patent foramen ovale closure) in 10 (16% [95% CI: 9%-28%]) patients. The pooled rate of reported anticoagulation therapy attributed to abnormal TEE findings among 3,562 acute IS patients included in the meta-analysis (12 studies) was 8.7% (95% CI: 7.3%-10.4%). In subgroup analysis, the rates of initiation of anticoagulation therapy on the basis of TEE investigation did not differ (p = 0.315) among patients with cryptogenic stroke (6.9% [95% CI: 4.9%-9.6%]), ESUS (8.1% [95% CI: 3.4%-18.1%]), and IS (9.4% [95% CI: 7.5%-11.8%]). Abnormal TEE findings may decisively affect the selection of appropriate therapeutic strategy in approximately 1 of 7 patients with ESUS. © 2016 American Academy of Neurology.

  1. Transcranial Doppler and transesophageal echocardiography: comparison of both techniques and prospective clinical relevance of transcranial Doppler in patent foramen ovale detection.

    Science.gov (United States)

    Caputi, Luigi; Carriero, Maria Rita; Falcone, Chiara; Parati, Eugenio; Piotti, Patrizia; Materazzo, Carlo; Anzola, Gian Paolo

    2009-01-01

    Patent foramen ovale (PFO) has been investigated in several conditions apart from cryptogenic ischemic stroke. Contrast transesophageal echocardiography (cTEE) is the gold standard for the diagnosis, although it has some known limitations. Contrast transcranial Doppler (cTCD) allows a semiquantitative estimation of right-to-left shunt (RLS) volume. The aims of our study were to confirm the diagnostic accuracy of cTCD in PFO diagnosis and to compare the abilities of cTCD and cTEE to detect a RLS and PFO, respectively, under normal breathing. The latter could represent an important feature for its clinical significance. A total of 100 consecutive patients (59 women and 41 men, age 46 +/- 12 years) were evaluated after stabilized ischemic stroke/transient ischemic attack, migraine, and lacunae, and before neurosurgery in sitting position. All patients undertook cTEE and cTCD, at rest and under Valsalva maneuver (VM). cTEE under VM was the reference standard. A categorization of patients and a semiquantitative cTCD classification were proposed. In all, 63 of 100 patients had PFO diagnosed by cTEE. A general concordance of up to 90% between both techniques was found. cTCD sensitivity and specificity were 96.8% and 78.4%, respectively. In 17 of 100 patients with cTEE-proven PFO under VM, cTCD and cTEE detected RLS at rest in 75% (95% confidence interval [CI] 62%-85%) and 48% (95% CI 35%-61%) of cases, respectively (P < .001). cTEE disclosed RLS at rest in about 71% (95% CI 9%-42%) of cTCDs showing a "shower-curtain" pattern and only in about 22% (95% CI 52%-85%) of those cTCDs without that pattern. In diagnosing PFO, cTCD has a good accuracy compared with cTEE. To detect a RLS at rest, cTCD appears to be more sensitive than cTEE. The latter resulted positive under normal breathing, mostly in cases of significant RLS at cTCD. Our results point out the impact of cTCD in the evaluation of RLS volume, thus aiding, in association with the anatomic details by cTEE, in the

  2. Relation between holiday weight gain and total energy expenditure among 40- to 69-y-old men and women (OPEN study).

    Science.gov (United States)

    Cook, Chad M; Subar, Amy F; Troiano, Richard P; Schoeller, Dale A

    2012-03-01

    A significant proportion of the average annual body weight (BW) gain in US adults (~0.5-1 kg/y) may result from modest episodes of positive energy balance during the winter holiday season. We tested whether holiday BW gain was reduced in participants with high baseline total energy expenditure (TEE) or whether it varied by BMI (in kg/m(2)). In a secondary analysis of previously published data, ΔBW normalized over 90 d from mid-September/mid-October 1999 to mid-January/early March 2000 was analyzed by sex, age, and BMI in 443 men and women (40-69 y of age). TEE was measured by doubly labeled water. High or low energy expenditure was assessed as residual TEE after linear adjustment for age, height, and BW. No correlations between ΔBW and TEE or TEE residuals were found. Sixty-five percent of men and 58% of women gained ≥0.5 kg BW, with ~50% of both groups gaining ≥1% of preholiday BW. Obese men (BMI ≥30) gained more BW than did obese women. A high preholiday absolute TEE or residual TEE did not protect against BW gain during the winter holiday quarter. It is not known whether higher than these typical TEE levels would protect against weight gain or if the observed gain may be attributed to increased food consumption and/or reduced physical activity during the holiday quarter.

  3. [Usefullness of transesophageal echocardiography in early detection of coronary spasm].

    Science.gov (United States)

    Sagara, M; Haraguchi, M; Hamu, Y; Isowaki, S; Yoshimura, N

    1996-04-01

    Intraoperative transesophageal echocardiography (TEE) was performed on a 62-year-old man who underwent abdominal aortic replacement for abdominal aortic aneurysm under general anesthesia combined with epidural anesthesia. Coronary artery spasm occurred after unexpected massive hemorrhage, and TEE showed hypokinesis in the posterior-inferior left ventricular wall. The changes in TEE preceded the ST elevation in the ECG. Bolus infusion of isosorbide dinitrate and continuous infusion of nitroglycerin alleviated these changes. TEE enabled us to detect and evaluate coronary spasm before the appearance of ST changes in ECG.

  4. Use of Non-Invasive Phase Contrast Magnetic Resonance Imaging for Estimation of Atrial Septal Defect Size and Morphology: A Comparison with Transesophageal Echo

    International Nuclear Information System (INIS)

    Piaw, Chin Sze; Kiam, Ong Tiong; Rapaee, Annuar; Khoon, Liew Chee; Bang, Liew Houng; Ling, Chan Wei; Samion, Hasri; Hian, Sim Kui

    2006-01-01

    Background: Transesophageal echocardiography (TEE) is a trusted method of sizing atrial septal defect (ASD) prior to percutaneous closure but is invasive, uncomfortable, and may carry a small risk of morbidity and mortality. Magnetic resonance imaging (MRI) may be useful non-invasive alternative in such patients who refuse or are unable to tolerate TEE and may provide additional information on the shape of the A0SD. Purpose: To validate the accuracy of ASD sizing by MRI compared with TEE.Method: Twelve patients (mean age 30 years; range 11-60 years) scheduled for ASD closure underwent TEE, cine balanced fast field echo MRI (bFFE-MRI) in four-chamber and sagittal views and phase-contrast MRI (PC-MRI) with reconstruction using the two orthogonal planes of T2-weighted images as planning. The average of the three longest measurements for all imaging modalities was calculated for each patient. Results: Mean maximum ASD length on TEE was 18.8 ± 4.6 mm, mean length by bFFE-MRI was 20.0 ± 5.0 mm, and mean length by PC-MRI was 18.3 ± 3.6 mm. The TEE measurement was significantly correlated with the bFFE-MRI and PC-MRI measurements (Pearson r = 0.69, p = 0.02 and r = 0.59, p = 0.04, respectively). The mean difference between TEE and bFFE-MRI measurements was -1.2mm (95% CI: -3.7, 1.3) and between TEE and PC-MRI was 0.5 mm (95% CI: -1.9, 2.9). Bland-Altman analysis also determined general agreement between both MRI methods and TEE. The ASDs were egg-shaped in two cases, circular in 1 patient and oval in the remaining patients. Conclusion: ASD sizing by MRI using bFFE and phase-contrast protocols correlated well with TEE estimations. PC-MRI provided additional information on ASD shapes and proximity to adjacent structures

  5. The value of real-time three-dimensional transesophageal echocardiography in the assessment of paravalvular leak origin following prosthetic mitral valve replacement.

    Science.gov (United States)

    Yildiz, Mustafa; Duran, Nilüfer Ekşi; Gökdeniz, Tayyar; Kaya, Hasan; Ozkan, Mehmet

    2009-09-01

    Two-dimensional (2D) echocardiographic approaches are not sufficient to determine the origin of paravalvular leak (PVL) that occurs after prosthetic mitral valve replacement (MVR). In this study, we investigated the role of real-time three-dimensional transesophageal echocardiography (RT-3D TEE) in detecting the origin and size of PVL occurring after prosthetic MVR. The study included 13 patients (7 females; 6 males; mean age 56+/-10 years; range 37 to 71 years) who developed PVL within a mean of 8.3+/-3.8 years following mechanical prosthetic MVR. Nine patients (69.2%) had atrial fibrillation, and four patients (30.8%) had normal sinus rhythm. Four patients (30.8%) had hemolysis. Paravalvular leak was mild, moderate, and severe in two, six, and five patients, respectively. Real-time 3D TEE was performed using a 3D matrix-array TEE transducer immediately after detection of PVL on 2D TEE examination. Localization of PVL was made using a clock-wise format in relation to the aortic valve and the size of dehiscence was measured. The mean PVL width measured by 2D TEE was 3.00+/-0.92 mm. The mean length of dehiscence was 13.6+/-8.8 mm, and the mean width was 3.88+/-2.04 mm on RT-3D TEE. The PVLs were mainly localized in the posterior and anterior annular positions between 12 to 03 hours (n=7) and 06 to 09 hours (n=3) on RT-3D TEE, respectively, which corresponded to the posteromedial or anterolateral sectors of the posterior annulus. Considering that only the width of the PVL defect can be assessed by 2D TEE, delineation by RT-3D TEE includes the localization of PVL together with the length and width of the defect.

  6. Simultaneous Validation of Seven Physical Activity Questionnaires Used in Japanese Cohorts for Estimating Energy Expenditure: A Doubly Labeled Water Study.

    Science.gov (United States)

    Sasai, Hiroyuki; Nakata, Yoshio; Murakami, Haruka; Kawakami, Ryoko; Nakae, Satoshi; Tanaka, Shigeho; Ishikawa-Takata, Kazuko; Yamada, Yosuke; Miyachi, Motohiko

    2018-04-28

    Physical activity questionnaires (PAQs) used in large-scale Japanese cohorts have rarely been simultaneously validated against the gold standard doubly labeled water (DLW) method. This study examined the validity of seven PAQs used in Japan for estimating energy expenditure against the DLW method. Twenty healthy Japanese adults (9 men; mean age, 32.4 [standard deviation {SD}, 9.4] years, mainly researchers and students) participated in this study. Fifteen-day daily total energy expenditure (TEE) and basal metabolic rate (BMR) were measured using the DLW method and a metabolic chamber, respectively. Activity energy expenditure (AEE) was calculated as TEE - BMR - 0.1 × TEE. Seven PAQs were self-administered to estimate TEE and AEE. The mean measured values of TEE and AEE were 2,294 (SD, 318) kcal/day and 721 (SD, 161) kcal/day, respectively. All of the PAQs indicated moderate-to-strong correlations with the DLW method in TEE (rho = 0.57-0.84). Two PAQs (Japan Public Health Center Study [JPHC]-PAQ Short and JPHC-PAQ Long) showed significant equivalence in TEE and moderate intra-class correlation coefficients (ICC). None of the PAQs showed significantly equivalent AEE estimates, with differences ranging from -547 to 77 kcal/day. Correlations and ICCs in AEE were mostly weak or fair (rho = 0.02-0.54, and ICC = 0.00-0.44). Only JPHC-PAQ Short provided significant and fair agreement with the DLW method. TEE estimated by the PAQs showed moderate or strong correlations with the results of DLW. Two PAQs showed equivalent TEE and moderate agreement. None of the PAQs showed equivalent AEE estimation to the gold standard, with weak-to-fair correlations and agreements. Further studies with larger sample sizes are needed to confirm these findings.

  7. Longitudinal change in energy expenditure and effects on energy requirements of the elderly

    Science.gov (United States)

    2013-01-01

    Background Very little is known about the longitudinal changes in energy requirements in late life. The purposes of this study were to: (1) determine the energy requirements in late life and how they changed during a 7 year time-span, (2) determine whether changes in fat free mass (FFM) were related to changes in resting metabolic rate (RMR), and (3) determine the accuracy of predicted total energy expenditure (TEE) to measured TEE. Methods TEE was assessed via doubly labeled water (DLW) technique in older adults in both 1999 (n = 302; age: 74 ± 2.9 yrs) and again in 2006 (n = 87 age: 82 ± 3.1 yrs). RMR was measured with indirect calorimetry, and body composition was assessed with dual-energy x-ray absorptiometry. Results The energy requirements in the 9th decade of life were 2208 ± 376 kcal/d for men and 1814 ± 337 kcal/d for women. This was a significant decrease from the energy requirements in the 8th decade of life in men (2482 ± 476 kcal/d vs. 2208 ± 376 kcal/d) but not in women (1892 ± 271 kcal/d vs. 1814 ± 337 kcal/d). In addition to TEE, RMR, and activity EE (AEE) also decreased in men, but not women, while FFM decreased in both men and women. The changes in FFM were correlated with changes in RMR for men (r = 0.49, p < 0.05) but not for women (r = −0.08, ns). Measured TEE was similar to Dietary Reference Intake (DRI) predicted TEE for men (2208 ± 56 vs. 2305 ± 35 kcal/d) and women (1814 ± 42 vs. 1781 ± 20 kcal/d). However, measured TEE was different than the World Health Organization (WHO) predicted TEE in men (2208 ± 56 vs. 2915 ± 31 kcal/d (p < 0.05)) and women (1814 ± 42 vs. 2315 ± 21 kcal/d (p < 0.05)). Conclusions TEE, RMR and AEE decreased in men, but not women, from the 8th to 9th decade of life. The DRI equation to predict TEE was comparable to measured TEE, while the WHO equation over-predicted TEE in our elderly population

  8. Guidelines of the Indian Association of Cardiovascular and Thoracic Anaesthesiologists and Indian College of Cardiac Anaesthesia for perioperative transesophageal echocardiography fellowship examination

    Directory of Open Access Journals (Sweden)

    Kanchi Muralidhar

    2016-01-01

    Full Text Available During current medical care, perioperative transesophageal echocardiography (TEE has become a vital component of patient management, especially in cardiac operating rooms and in critical care medicine. Information derived from echocardiography has an important bearing on the patient′s outcome. The Indian Association of Cardiovascular and Thoracic Anaesthesiologists (IACTA has promoted the use of TEE during routine clinical care of patients undergoing cardiac surgery. An important mission of IACTA is to oversee training and certify anesthesiologists in the perioperative and intensive care use of TEE. The provision of "Fellowship" is by way of conducting IACTA - TEE fellowship (F-TEE examination. This has been done annually for the past 7 years using well-established curriculums by accredited national and international societies. Now, with the transformation and reconstitution of IACTA education and research cell into the newly formed Indian College of Cardiac Anaesthesia, F-TEE is bound to meet international standards. To ensure that the examinations are conducted in a transparent and foolproof manner, the guideline committee (formulated in 2010 of IACTA has taken the onus of formulating the guidelines for the same. These guidelines have been formally reviewed and updated since 2010 and are detailed here to serve as a guide to both the examinee and examiner ensuring standardization, efficiency, and competency of the IACTA F-TEE certification process.

  9. Patent foramen ovale: comparison among diagnostic strategies in cryptogenic stroke and migraine.

    Science.gov (United States)

    Zito, Concetta; Dattilo, Giuseppe; Oreto, Giuseppe; Di Bella, Gianluca; Lamari, Annalisa; Iudicello, Raffaella; Trio, Olimpia; Caracciolo, Giuseppe; Coglitore, Sebastiano; Arrigo, Francesco; Carerj, Scipione

    2009-05-01

    The aim of this study was to compare transthoracic echocardiography (TTE) and transcranial Doppler ultrasonography (TCD) with transesophageal echocardiography (TEE) in order to define the best clinical approach to patent foramen ovale (PFO) detection. In total, 72 consecutive patients (33 men) with a mean age of 49 +/- 13 years were prospectively enrolled. The TEE indication was cryptogenic stroke (36 patients) or migraine (36 patients, 22 with aura). All patients underwent standard TTE, TCD, and TEE examination. For any study, a contrast test was carried on using an agitated saline solution mixed with urea-linked gelatine (Haemaccel), injected as a rapid bolus via a right antecubital vein. A prolonged Valsalva maneuver was performed to improve test sensitivity. TEE identified a PFO in 65% of the whole population: 56.5% in the migraine cohort and 43.5% in the cryptogenic stroke cohort. TTE was able to detect a PFO in 55% of patients positive at TEE (54% negative predictive value, 100% positive predictive value, 55% sensitivity, and 100% specificity). TCD was able to identify a PFO in 97% of patients positive at TEE (89% negative predictive value, 98% positive predictive value, 94% sensitivity, and 96% specificity). In patients with cryptogenic stroke and migraine, there is a fair concordance (k = 0.89) between TCD and TEE in PFO recognition. Accordingly, TCD should be recommended as a simple, noninvasive, and reliable technique, whereas TEE indication should be restricted to selected patients. TTE is a very specific technique, whose major advantage is the ability to detect a large right-to-left shunt, particularly if associated with an atrial septal aneurysm.

  10. Energy expenditure and activity among Hadza hunter-gatherers.

    Science.gov (United States)

    Pontzer, Herman; Raichlen, David A; Wood, Brian M; Emery Thompson, Melissa; Racette, Susan B; Mabulla, Audax Z P; Marlowe, Frank W

    2015-01-01

    Studies of total energy expenditure, (TEE; kcal/day) among traditional populations have challenged current models relating habitual physical activity to daily energy requirements. Here, we examine the relationship between physical activity and TEE among traditional Hadza hunter-gatherers living in northern Tanzania. Hadza adults were studied at two camps, with minimal intervention so as to monitor energy expenditure and activity during normal daily life. We measured daily walking distance and walking speed using wearable GPS units for 41 adults. For a subset of 30 adults, we measured TEE using doubly labeled water, three indices of work load (foraging return rate, maternal status, and number of dependent children), and urinary biomarkers of metabolic activity and stress (8-hydroxydeoxyguanosine, cortisol, and testosterone). Fat-free mass was the single strongest predictor of TEE among Hadza adults (r(2)  = 0.66, P < 0.001). Hadza men used greater daily walking distances and faster walking speeds compared with that of Hadza women, but neither sex nor any measure of physical activity or work load were correlated with TEE in analyses controlling for fat-free mass. Compared with developed, industrial populations, Hadza adults had similar TEE but elevated levels of metabolic stress as measured by 8-hydroxydeoxyguanosine. Our results indicate that daily physical activity may not predict TEE within traditional hunter-gatherer populations like the Hadza. Instead, adults with high levels of habitual physical activity may adapt by reducing energy allocation to other physiological activity. © 2015 Wiley Periodicals, Inc.

  11. ECG-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Fagman, Erika; Flinck, Agneta; Lamm, Carl [Sahlgrenska University Hospital, Department of Radiology, Gothenburg (Sweden); Perrotta, Sossio [Sahlgrenska University Hospital, Department of Cardiovascular Surgery and Anaesthesia, Gothenburg (Sweden); Bech-Hanssen, Odd [Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Cardiology, Gothenburg (Sweden); Olaison, Lars [Sahlgrenska University Hospital, Department of Infectious Diseases, Gothenburg (Sweden); Svensson, Gunnar [Sahlgrenska University Hospital, Department of Cardiovascular Surgery and Anaesthesia, Gothenburg (Sweden); The Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg (Sweden)

    2012-11-15

    The aim of this prospective study was to investigate the agreement in findings between ECG-gated CT and transoesophageal echocardiography (TEE) in patients with aortic prosthetic valve endocarditis (PVE). Twenty-seven consecutive patients with PVE underwent 64-slice ECG-gated CT and TEE and the results were compared. Imaging was compared with surgical findings (surgery was performed in 16 patients). TEE suggested the presence of PVE in all patients [thickened aortic wall (n = 17), vegetation (n = 13), abscess (n = 16), valvular dehiscence (n = 10)]. ECG-gated CT was positive in 25 patients (93 %) [thickened aortic wall (n = 19), vegetation (n = 7), abscess (n = 18), valvular dehiscence (n = 7)]. The strength of agreement [kappa (95 % CI)] between ECG-gated CT and TEE was very good for thickened wall [0.83 (0.62-1.0)], good for abscess [0.68 (0.40-0.97)] and dehiscence [0.75 (0.48-1.0)], and moderate for vegetation [0.55 (0.26-0.88)]. The agreement was good between surgical findings (abscess, vegetation and dehiscence) and imaging for ECG-gated CT [0.66 (0.49-0.87)] and TEE [0.79 (0.62-0.96)] and very good for the combination of ECG-gated CT and TEE [0.88 (0.74-1.0)]. Our results indicate that ECG-gated CT has comparable diagnostic performance to TEE and may be a valuable complement in the preoperative evaluation of patients with aortic PVE. (orig.)

  12. ECG-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis

    International Nuclear Information System (INIS)

    Fagman, Erika; Flinck, Agneta; Lamm, Carl; Perrotta, Sossio; Bech-Hanssen, Odd; Olaison, Lars; Svensson, Gunnar

    2012-01-01

    The aim of this prospective study was to investigate the agreement in findings between ECG-gated CT and transoesophageal echocardiography (TEE) in patients with aortic prosthetic valve endocarditis (PVE). Twenty-seven consecutive patients with PVE underwent 64-slice ECG-gated CT and TEE and the results were compared. Imaging was compared with surgical findings (surgery was performed in 16 patients). TEE suggested the presence of PVE in all patients [thickened aortic wall (n = 17), vegetation (n = 13), abscess (n = 16), valvular dehiscence (n = 10)]. ECG-gated CT was positive in 25 patients (93 %) [thickened aortic wall (n = 19), vegetation (n = 7), abscess (n = 18), valvular dehiscence (n = 7)]. The strength of agreement [kappa (95 % CI)] between ECG-gated CT and TEE was very good for thickened wall [0.83 (0.62-1.0)], good for abscess [0.68 (0.40-0.97)] and dehiscence [0.75 (0.48-1.0)], and moderate for vegetation [0.55 (0.26-0.88)]. The agreement was good between surgical findings (abscess, vegetation and dehiscence) and imaging for ECG-gated CT [0.66 (0.49-0.87)] and TEE [0.79 (0.62-0.96)] and very good for the combination of ECG-gated CT and TEE [0.88 (0.74-1.0)]. Our results indicate that ECG-gated CT has comparable diagnostic performance to TEE and may be a valuable complement in the preoperative evaluation of patients with aortic PVE. (orig.)

  13. Total energy expenditure in burned children using the doubly labeled water technique

    International Nuclear Information System (INIS)

    Goran, M.I.; Peters, E.J.; Herndon, D.N.; Wolfe, R.R.

    1990-01-01

    Total energy expenditure (TEE) was measured in 15 burned children with the doubly labeled water technique. Application of the technique in burned children required evaluation of potential errors resulting from nutritional intake altering background enrichments during studies and from the high rate of water turnover relative to CO2 production. Five studies were discarded because of these potential problems. TEE was 1.33 +/- 0.27 times predicted basal energy expenditure (BEE), and in studies where resting energy expenditure (REE) was simultaneously measured, TEE was 1.18 +/- 0.17 times REE, which in turn was 1.16 +/- 0.10 times predicted BEE. TEE was significantly correlated with measured REE (r2 = 0.92) but not with predicted BEE. These studies substantiate the advantage of measuring REE to predict TEE in severely burned patients as opposed to relying on standardized equations. Therefore we recommend that optimal nutritional support will be achieved in convalescent burned children by multiplying REE by an activity factor of 1.2

  14. Mesure de la teneur en eau en continu durant le séchage du foin en balles

    OpenAIRE

    Cormier, Étienne

    2008-01-01

    Une mesure en continu et précise de la teneur en eau (TEE) permettrait d'optimiser le séchage du foin dans un séchoir commercial à grande échelle. Pour mesurer la précision des lectures dans ces conditions, un capteur électronique relié à 16 sondes a été utilisé pour estimer la TEE dans un séchoir expérimental. Deux sondes et un thermocouple étaient insérés dans huit couches de foin superposées, de 135 mm d'épaisseur chacune. Les TEE estimées par les sondes ont été comparées à des TEE exactes...

  15. Total Energy Expenditure, Energy Intake, and Body Composition in Endurance Athletes Across the Training Season: A Systematic Review.

    Science.gov (United States)

    Heydenreich, Juliane; Kayser, Bengt; Schutz, Yves; Melzer, Katarina

    2017-12-01

    Endurance athletes perform periodized training in order to prepare for main competitions and maximize performance. However, the coupling between alterations of total energy expenditure (TEE), energy intake, and body composition during different seasonal training phases is unclear. So far, no systematic review has assessed fluctuations in TEE, energy intake, and/or body composition in endurance athletes across the training season. The purpose of this study was to (1) systematically analyze TEE, energy intake, and body composition in highly trained athletes of various endurance disciplines and of both sexes and (2) analyze fluctuations in these parameters across the training season. An electronic database search was conducted on the SPORTDiscus and MEDLINE (January 1990-31 January 2015) databases using a combination of relevant keywords. Two independent reviewers identified potentially relevant studies. Where a consensus was not reached, a third reviewer was consulted. Original research articles that examined TEE, energy intake, and/or body composition in 18-40-year-old endurance athletes and reported the seasonal training phases of data assessment were included in the review. Articles were excluded if body composition was assessed by skinfold measurements, TEE was assessed by questionnaires, or data could not be split between the sexes. Two reviewers assessed the quality of studies independently. Data on subject characteristics, TEE, energy intake, and/or body composition were extracted from the included studies. Subjects were categorized according to their sex and endurance discipline and each study allocated a weight within categories based on the number of subjects assessed. Extracted data were used to calculate weighted means and standard deviations for parameters of TEE, energy intake, and/or body composition. From 3589 citations, 321 articles were identified as potentially relevant, with 82 meeting all of the inclusion criteria. TEE of endurance athletes was

  16. Transthoracic contrast echocardiography using vitamin B6 and sodium bicarbonate as contrast agents for the diagnosis of patent foramen ovale.

    Science.gov (United States)

    He, Jiang-Chun; Zheng, Jian-Yong; Li, Xin; Yang, Ye; Zhang, Bo-Yang; Chen, Yu; Li, Xian-Feng; Liu, Ying-Ming; Cao, Yi; Zhao, Li; Li, Tian-Chang

    2017-08-01

    To evaluate the utility of transthoracic contrast echocardiography (cTTE) using vitamin B6 and sodium bicarbonate as contrast agents for diagnosing right-to-left shunt (RLS) caused by patent foramen ovale (PFO) compared to that of transesophageal echocardiography (TEE). We investigated 125 patients admitted to our neurology department with unexplained cerebral infarction and migraine. All patients underwent cTTE using vitamin B6 and sodium bicarbonate as contrast agents, after which they underwent transthoracic echocardiography. The Doppler signal was recorded during the Valsalva maneuver, and TEE examinations were performed. The feasibility, diagnostic sensitivity, and safety of cTTE and TEE for PFO recognition were compared. Evidence of PFO was found in 49 (39.20%) patients with cTTE, more than were detected with TEE (39, 31.20%) (χ 2 =5.0625, P=0.0244). cTTE had a sensitivity of 92.31% and a specificity of 84.88% for diagnosing PFO, showing high concordance with TEE for PFO recognition (κ=0.72). Further, results of a semi-quantitative evaluation of PFO-RLS by cTTE were better than those with TEE (Z=-2.011, P=0.044). No significant adverse reaction was discovered during cTTE examination. cTTE using vitamin B6 and sodium bicarbonate as contrast agents has relatively good sensitivity and specificity for diagnosing RLS caused by PFO when compared with those for TEE. Using vitamin B6 and sodium bicarbonate as contrast agents to perform cTTE is recommended for detecting and diagnosing the PFO due to its simplicity, non-invasive character, low cost, and high feasibility.

  17. Villa Viimsis : Palumetsa tee 9 = Villa, Viimsi : Palumetsa tee 9 / Epp Lankots

    Index Scriptorium Estoniae

    Lankots, Epp, 1976-

    2005-01-01

    Hoone välisilme ning kuju määrab majasisene piki välisseina teisele korrusele tõusev trepp, mille kallet ning suunda markeerib fassaadil jooksev puitsõrestik. Maapinna-korruse ulatuses on fassaadil terasvõrku pakitud graniitkivid. Arhitektid: Andri Kirsima, Hannes Niineväli. Sisearhitekt: Raul Tiitus. Ill.: 3 välisvaadet

  18. Ära tee, tee! = Do not do it, do it! / Rebeka Põldsam

    Index Scriptorium Estoniae

    Põldsam, Rebeka, 1989-

    2016-01-01

    Margit Säde-Lehni kuraatorinäitus "DOings & kNOTs. Kunst ja/või instruktsioon" Tallinna Kunstihoones. Lähtepunktiks on Hans Ulrich Obristi 1993. a. algatatud projekt „Do it”. Kunstihoonesse on kutsutud 20 kunstnikku/rühmitust üle Euroopa, et tõlgendada kellegi teise jäetud instruktsioone ja teha nende järgi uusi teoseid

  19. Transesophageal echocardiography in the assessment of coronary arteries; Echokardiografia przezprzelykowa w ocenie proksymalnych odcinkow naczyn wiencowych

    Energy Technology Data Exchange (ETDEWEB)

    Adamek-Kosmider, A.; Kasprzak, J.; Kosmider, M.; Krzeminska-Pakula, M. [Akademia Medyczna, Lodz (Poland)

    1993-12-31

    The study was undertaken to assess the usefulness of TEE for evaluation of morphology and flow in coronary arteries. TEE (2D, spectral and color Doppler imaging) and coronary angiography were performed in 75 patients - 41 with valvular heart disease and 34 with ischemic heart disease. Proximal coronary artery stenosis was detected by coronarography in 11 pts (9-left main coronary artery, 2-right coronary artery). TEE visualization of proximal coronary arteries was possible in all pts. Echocardiographic features of artery stenosis were: the narrowing of the vessel in 2D image (9 pts), high flow velocity spectral Doppler (4 pts, mean 135 cm/s vs 55 cm/s in normal arteries) and mosaic, turbulent flow in color Doppler (10 pts). Sensitivity and specificity of TEE for coronary artery stenosis detection was respectively 81%/98% for 2D imaging and 90%/100% for color Doppler. TEE is a new, noninvasive and safe method for the evaluation of proximal coronary arteries. Detection of LMCA stenosis prior to atheterization may enhance the safety of coronary angiography. (author) 21 refs, 8 figs

  20. Transesophageal echocardiography in the assessment of coronary arteries

    International Nuclear Information System (INIS)

    Adamek-Kosmider, A.; Kasprzak, J.; Kosmider, M.; Krzeminska-Pakula, M.

    1993-01-01

    The study was undertaken to assess the usefulness of TEE for evaluation of morphology and flow in coronary arteries. TEE (2D, spectral and color Doppler imaging) and coronary angiography were performed in 75 patients - 41 with valvular heart disease and 34 with ischemic heart disease. Proximal coronary artery stenosis was detected by coronarography in 11 pts (9-left main coronary artery, 2-right coronary artery). TEE visualization of proximal coronary arteries was possible in all pts. Echocardiographic features of artery stenosis were: the narrowing of the vessel in 2D image (9 pts), high flow velocity spectral Doppler (4 pts, mean 135 cm/s vs 55 cm/s in normal arteries) and mosaic, turbulent flow in color Doppler (10 pts). Sensitivity and specificity of TEE for coronary artery stenosis detection was respectively 81%/98% for 2D imaging and 90%/100% for color Doppler. TEE is a new, noninvasive and safe method for the evaluation of proximal coronary arteries. Detection of LMCA stenosis prior to atheterization may enhance the safety of coronary angiography. (author)

  1. Energy requirement assessed by doubly-labeled water method in patients with advanced amyotrophic lateral sclerosis managed by tracheotomy positive pressure ventilation.

    Science.gov (United States)

    Ichihara, Noriko; Namba, Kazuyoshi; Ishikawa-Takata, Kazuko; Sekine, Kazunori; Takase, Mitsunori; Kamada, Yuko; Fujii, Seigo

    2012-10-01

    This study aimed to clarify the energy requirement in patients with amyotrophic lateral sclerosis (ALS) undergoing tracheostomy positive pressure ventilation with tracheostomy. Total energy expenditure (TEE) was measured in 10 hospitalized bedridden ALS patients using the doubly-labeled water (DLW) method. The mean TEE/day and TEE/fat- free mass estimated by DLW method were 934 ± 201 kcal/day and 34.8 ± 5.5 kcal/kg/day, respectively. The mean TEE/resting metabolic rate (RMR) was 0.85 when RMR was estimated by the Harris-Benedict equation, 0.91 by Dietary Reference Intake (DRI), and 0.97 by Ganpule's equation using fat-free mass (FFM). The ratios of TEE to measured RMR were 1.05, 1.15 and 1.23 in three patients. In conclusion, multiplying measured RMR by 1.1 to 1.2 is considered to be appropriate to estimate energy need. However, because it is difficult to measure RMR directly in a clinical setting, an appropriate equation for estimating RMR for ALS patient should be developed.

  2. One-stop shop assessment for atrial septal defect closure using 256-slice coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Yamasaki, Yuzo; Kamitani, Takeshi; Sagiyama, Koji; Yamanouchi, Torahiko; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan); Nagao, Michinobu; Kawanami, Satoshi [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Fukuoka (Japan); Sakamoto, Ichiro [Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Fukuoka (Japan); Yamamura, Kenichiro [Kyushu University, Department of Pediatrics, Graduate School of Medical Sciences, Fukuoka (Japan); Yabuuchi, Hidetake [Kyushu University, Department of Health Sciences, Graduate School of Medical Sciences, Fukuoka (Japan)

    2017-02-15

    To investigate the feasibility and accuracy of measurement of the pulmonary to systemic blood flow ratio (Qp/Qs) and defect and rim sizes in secundum atrial septal defects (ASDs) using 256-slice CT, compared to the reference transoesophageal echocardiography (TEE) and right heart catheterization (RHC) measurements. Twenty-three consecutive adult patients with secundum ASDs who underwent retrospective ECG-gated coronary CT angiography (CCTA), TEE and RHC were enrolled in this study. Right ventricular (RV) and left ventricular (LV) stroke volumes (SV) were calculated by biventricular volumetry of CCTA. Qp/Qs-CT was defined as RVSV/LVSV. The sizes of the defect and rim were measured by multi-planar reconstruction CT images. Correlations between Qp/Qs-CT and Qp/Qs-RHC and between the defect diameter obtained by CT and TEE were analyzed by Pearson's coefficient analysis. Rim sizes by CT and TEE were compared by paired t-test. Qp/Qs-CT was significantly correlated with Qp/Qs-RHC (r = 0.83, p < 0.0001), and the defect diameter by CT was significantly correlated with that by TEE (r = 0.95, p < 0.0001). There was no significant difference between CT and TEE in measurements of rim size. 256-slice CCTA allows measuring Qp/Qs and size of defects and rims in patients with secundum ASDs, accomplishing pretreatment evaluation non-invasively and comprehensively. (orig.)

  3. One-stop shop assessment for atrial septal defect closure using 256-slice coronary CT angiography

    International Nuclear Information System (INIS)

    Yamasaki, Yuzo; Kamitani, Takeshi; Sagiyama, Koji; Yamanouchi, Torahiko; Honda, Hiroshi; Nagao, Michinobu; Kawanami, Satoshi; Sakamoto, Ichiro; Yamamura, Kenichiro; Yabuuchi, Hidetake

    2017-01-01

    To investigate the feasibility and accuracy of measurement of the pulmonary to systemic blood flow ratio (Qp/Qs) and defect and rim sizes in secundum atrial septal defects (ASDs) using 256-slice CT, compared to the reference transoesophageal echocardiography (TEE) and right heart catheterization (RHC) measurements. Twenty-three consecutive adult patients with secundum ASDs who underwent retrospective ECG-gated coronary CT angiography (CCTA), TEE and RHC were enrolled in this study. Right ventricular (RV) and left ventricular (LV) stroke volumes (SV) were calculated by biventricular volumetry of CCTA. Qp/Qs-CT was defined as RVSV/LVSV. The sizes of the defect and rim were measured by multi-planar reconstruction CT images. Correlations between Qp/Qs-CT and Qp/Qs-RHC and between the defect diameter obtained by CT and TEE were analyzed by Pearson's coefficient analysis. Rim sizes by CT and TEE were compared by paired t-test. Qp/Qs-CT was significantly correlated with Qp/Qs-RHC (r = 0.83, p < 0.0001), and the defect diameter by CT was significantly correlated with that by TEE (r = 0.95, p < 0.0001). There was no significant difference between CT and TEE in measurements of rim size. 256-slice CCTA allows measuring Qp/Qs and size of defects and rims in patients with secundum ASDs, accomplishing pretreatment evaluation non-invasively and comprehensively. (orig.)

  4. Diagnostic accuracy of transesophageal echocardiogram for the detection of patent foramen ovale: a meta-analysis.

    Science.gov (United States)

    Mojadidi, Mohammad Khalid; Bogush, Nikolay; Caceres, Jose Diego; Msaouel, Pavlos; Tobis, Jonathan M

    2014-07-01

    Patent foramen ovale (PFO) is a remnant of the fetal circulation present in 20% of the population. Right-to-left shunting (RLS) through a PFO has been linked to the pathophysiology of stroke, migraine with aura, and hypoxemia. While different imaging modalities including transcranial Doppler, intra-cardiac echo, and transthoracic echo (TTE) have often been used to detect RLS, transesophageal echo (TEE) bubble study remains the gold standard for diagnosing PFO. The aim of this study was to determine the relative accuracy of TEE in the detection of PFO. A systematic review of Medline, using a standard approach for meta-analysis, was performed for all prospective studies assessing accuracy of TEE in the detection of PFO using confirmation by autopsy, cardiac surgery, and/or catheterization as the reference. Search results revealed 3105 studies; 4 met inclusion criteria. A total of 164 patients were included. TEE had a weighted sensitivity of 89.2% (95% CI: 81.1-94.7%) and specificity of 91.4% (95% CI: 82.3-96.8%) to detect PFO. The overall positive likelihood ratio (LR+) was 5.93 (95% CI: 1.30-27.09) and the overall negative likelihood ratio (LR-) was 0.22 (95% CI: 0.08-0.56). While TEE bubble study is considered to be the gold standard modality for diagnosing PFO, some PFOs may still be missed or misdiagnosed. It is important to understand the limitations of TEE and perhaps use other highly sensitive screening tests, such as transcranial doppler (TCD), in conjunction with TEE before scheduling a patient for transcatheter PFO closure. © 2013, Wiley Periodicals, Inc.

  5. Estimating activity energy expenditure: how valid are physical activity questionnaires?

    Science.gov (United States)

    Neilson, Heather K; Robson, Paula J; Friedenreich, Christine M; Csizmadi, Ilona

    2008-02-01

    Activity energy expenditure (AEE) is the modifiable component of total energy expenditure (TEE) derived from all activities, both volitional and nonvolitional. Because AEE may affect health, there is interest in its estimation in free-living people. Physical activity questionnaires (PAQs) could be a feasible approach to AEE estimation in large populations, but it is unclear whether or not any PAQ is valid for this purpose. Our aim was to explore the validity of existing PAQs for estimating usual AEE in adults, using doubly labeled water (DLW) as a criterion measure. We reviewed 20 publications that described PAQ-to-DLW comparisons, summarized study design factors, and appraised criterion validity using mean differences (AEE(PAQ) - AEE(DLW), or TEE(PAQ) - TEE(DLW)), 95% limits of agreement, and correlation coefficients (AEE(PAQ) versus AEE(DLW) or TEE(PAQ) versus TEE(DLW)). Only 2 of 23 PAQs assessed most types of activity over the past year and indicated acceptable criterion validity, with mean differences (TEE(PAQ) - TEE(DLW)) of 10% and 2% and correlation coefficients of 0.62 and 0.63, respectively. At the group level, neither overreporting nor underreporting was more prevalent across studies. We speculate that, aside from reporting error, discrepancies between PAQ and DLW estimates may be partly attributable to 1) PAQs not including key activities related to AEE, 2) PAQs and DLW ascertaining different time periods, or 3) inaccurate assignment of metabolic equivalents to self-reported activities. Small sample sizes, use of correlation coefficients, and limited information on individual validity were problematic. Future research should address these issues to clarify the true validity of PAQs for estimating AEE.

  6. Aortic intracardiac echocardiography-guided septal puncture during mitral valvuloplasty.

    Science.gov (United States)

    Akkaya, Emre; Vuruskan, Ertan; Zorlu, Ali; Sincer, Isa; Kucukosmanoglu, Mehmet; Ardic, Idris; Yilmaz, Mehmet Birhan

    2014-01-01

    Transoesophageal echocardiography (TEE) and venous intracardiac echocardiography (ICE) are traditionally used to visualize the interatrial septum (IAS) and the tenting effect of the fossa ovalis in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV). The aim of the present study was to assess the comparative efficacy and safety of arterial (intra-aortic) ICE and venous ICE, compared with TEE (traditional approach), in the patients undergoing PBMV. TEE, aortic ICE, and venous ICE were consecutively performed in 50 patients (40 ± 9 years, 86% female). The images of intracardiac structures were obtained from both aortic and right atrial loci. The IAS was visualized using TEE, aortic ICE, and venous ICE. The mean mitral valve area was 1.14 ± 0.2 cm(2), and the mean left atrial volume index was 57.5 ± 12 mL/m(2). The mean size of the visualized septal length was 48 ± 5 mm by TEE, 51 ± 5 mm by aortic ICE, and 33 ± 6 mm by venous ICE. The Bland-Altman test indicated that the 95% limits of agreement for the measurement of septal diameter ranged from -11.0 to +5.9 mm (mean -2.5 mm) between TEE and aortic ICE, -2.8 to +33.5 mm (mean +15.3 mm) between TEE and venous ICE, and -36.6 to +0.8 mm (mean -17.9 mm) between venous and aortic ICE. Standard venous ICE generally tended to yield smaller values compared with TEE and aortic ICE for the measurement of septal length. Furthermore, the view of fossa ovalis and 'tenting effect' was optimal in 11 patients on venous ICE; however, the fossa ovalis and tip of the needle were well visualized in all patients on aortic ICE (P < 0.001). There were no major complications with the use of aortic ICE. Aortic ICE is a superior alternative to venous ICE and facilitates trans-septal puncture in patients with mitral stenosis.

  7. Tallinna Tehnikaülikooli Raamatukogu = The Library of the Tallinn University of Technology / Margit Mutso

    Index Scriptorium Estoniae

    Mutso, Margit, 1966-

    2010-01-01

    Tallinnas Akadeemia tee 1 / Ehitajate tee 7 asuva raamatukoguhoone arhitektuursest lahendusest. Hoone on projekteerinud arhitektuuribüroo Agabus, Endjärv & Truverk Arhitektid. Žürii liikme Kalle Komissarovi hinnang kultuurkapitali aastapreemiale esitatud hoonele

  8. Dorogi, kotorõje nam võbirajut / Eteri Kekelidze

    Index Scriptorium Estoniae

    Kekelidze, Eteri, 1944-

    2005-01-01

    Eestis jätkub aktiivne elamu- ja tee-ehitus, suuri probleeme ehitusmaterjalide tarnimisega elamuehituse või tee-ehituse tarbeks sel aastal ei ole olnud. Ehitusmaterjalide tootmise probleemideks on kujunemas loodusressursside kaevandamise perspektiivid ja planeeritav keskkonnamaksude tõus

  9. "Tehisintellekti" pikk tee ekraanile

    Index Scriptorium Estoniae

    2001-01-01

    Mängufilmi "A.I. - Tehisintellekt" ("A.I. : Artificial Intelligence") ekraanile seadmise mõte sündis režissöör Stanley Kubrick'il 1969. aastal, kui ilmus Brian Aldissi ulmejutt "Supertoys Last All Summer Long". Ekraanile jõudis see 2001. a. Steven Spielbergi käe all

  10. ENERGY EXPENDITURE AND HABITUAL PHYSICAL ACTIVITIES IN ADOLESCENT SPRINT ATHLETES

    Directory of Open Access Journals (Sweden)

    Dirk Aerenhouts

    2011-06-01

    Full Text Available This study aimed to assess total energy expenditure (TEE and specific habitual physical activities in adolescent sprint athletes. Two methods used to estimate TEE, an activity diary (AD and SenseWear armband (SWA, were compared. Sixteen athletes (6 girls, 10 boys, mean age 16.5 ± 1.6 yr simultaneously wore a SWA and completed an AD and food diary during one week. Basal energy expenditure as given by the SWA when taken off was corrected for the appropriate MET value using the AD. TEE as estimated by the AD and SWA was comparable (3196 ± 590 kcal and 3012 ± 518 kcal, p = 0.113 without day-to-day variations in TEE and energy expended in activities of high intensity. Daily energy intake (2569 ± 508 kcal did not match TEE according to both the AD and SWA (respectively p < 0.001 and p = 0.007. Athletes were in a supine position for a longer time on weekend days than on week days and slept longer on Sundays. Athletes reported a longer time of high-intensive physical activities in the AD than registered by the SWA on 4 out of 7 days. In addition to specific sprint activities on 3 to 7 days per week, 11 out of 16 athletes actively commuted to school where they participated in sports once or twice per week. The AD and the SWA are comparable in the estimation of TEE, which appears realistic and sustainable. The SWA offers an appropriate and objective method in the assessment of TEE, sleeping and resting in adolescent athletes on the condition that detailed information is given for the times the armband is not worn. The AD offers activity specific information but relies on the motivation, compliance and subjectivity of the individual, especially considering high-intensive intermittent training

  11. Routine transesophageal echocardiography for the diagnosis of aortic disruption in trauma patients without enlarged mediastinum.

    Science.gov (United States)

    Vignon, P; Lagrange, P; Boncoeur, M P; Francois, B; Gastinne, H; Lang, R M

    1996-03-01

    To assess the value of routine transesophageal echocardiography (TEE) in diagnosing traumatic disruption of the aorta (TDA) in trauma patients presenting without enlarged mediastinum on chest x-ray films. Prospective study. TEE was routinely performed to exclude the presence of TDA in patients who sustained severe trauma secondary to abrupt deceleration collisions and presented with an upper mediastinum of fewer than 8 cm on supine chest x-ray films. Patients were divided into two groups according to the presence (group I) or absence (group II) of mediastinal hematoma diagnosed during TEE examination. Radiographic signs regarded as indicators of the presence of TDA were evaluated in both groups. Among the 40 consecutive patients studied, TEE demonstrated two cases of TDA associated with a mediastinal hematoma that were confirmed by both aortography and surgery. One of the patients had a normal mediastinum on presentation chest x-ray films, and the other only exhibited a blurred aortic knob. Radiographic mediastinal abnormalities suggestive of TDA were observed in 13 patients, but chest x-ray films were unremarkable in 12 patients. Twenty patients had multiple rib fractures. The frequency of chest radiographic abnormalities was not significantly higher in group I (n = 6) when compared with group II patients (n = 34). TEE examination demonstrated a normal thoracic aorta in 35 patients and was nondiagnostic in 3 patients (normal aortography). TEE should be routinely performed in victims of violent deceleration collisions, even in patients presenting apparently normal mediastinum on supine chest radiography.

  12. Association of energy intake and expenditure with obesity: A cross-sectional study of 150 pediatric patients following treatment for leukemia.

    Science.gov (United States)

    Srivastava, Richa; Batra, Atul; Dhawan, Deepa; Bakhshi, Sameer

    2017-02-01

    Increased obesity in leukemia survivors has been attributed to chemotherapy and radiation. Data on total energy intake (TEI) and total energy expenditure (TEE) are lacking in obese childhood leukemia patients after completion of therapy from India. We conducted a cross-sectional study in pediatric acute leukemia patients after completion of therapy wherein energy intake was assessed by 24-hour recall method. TEE was calculated using Harris-Benedict equation, by assessing the physical activity level using Physical Activity Questionnaire for children and basal metabolic rate by World Health Organization equation. Indian Academy of Pediatrics 2015 guidelines for BMI were used for defining overweight and obesity. Nutritional status was assessed in 150 leukemia patients after completion of therapy. Twenty-five percent of leukemia patients after completion of therapy were overweight and obese versus 11% of healthy controls (p = 0.042). The mean ratio of TEI/required energy intake (REI), TEE/required energy expenditure (REE), and (TEI:REI)/(TEE:REE) were significantly higher in overweight and obese group versus nonobese survivors (p obesity. Obesity in leukemia patients after completion of therapy is associated with increased energy intake, causing imbalance between energy intake and TEE in these patients.

  13. Dietary energy requirements of young adult men, determined by using the doubly labeled water method

    International Nuclear Information System (INIS)

    Roberts, S.B.; Heyman, M.B.; Evans, W.J.; Fuss, P.; Tsay, R.; Young, V.R.

    1991-01-01

    The autors examined the hypothesis that current recommendations on dietary energy requirements may underestimate the total energy needs of young adult men, by measuring total energy expenditure (TEE) and resting energy expenditure (REE) in 14 weight-maintaining healthy subjects leading unrestricted lives. TEE and body composition were measured by using 2H(2)18O, and REE was measured by using indirect calorimetry. All subjects had sedentary full-time occupations and participated in strenuous leisure activities for 34 ± 6 (SE) min/d. TEE and REE were 14.61 ± 0.76 and 7.39 ± 0.26 MJ/d, respectively, and 202 ± 2 and 122 ± 2 kJ.kg-1.d-1. There were significant relationships between TEE and both body fat-free mass (r = 0.732, P less than 0.005) and measured REE (r = 0.568, P less than 0.05). Measured TEE:REE values were significantly higher than the recommended energy requirement (1.98 ± 0.09, compared with 1.55 or 1.67, P less than 0.005). These results are consistent with the suggestion that the current recommended energy intake for young adult men may underestimate total energy needs

  14. Medline Plus

    Full Text Available ... Chicago Medical Center, Chicago, IL, 6/26/2014) Heart Diseases Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical Center, Merriam, ... Callahan Eye Hospital, Birmingham, AL, 3/17/2014) Heart Diseases Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical Center, Merriam, ...

  15. Measurement of energy expenditure in overweight men and women using [C-14]-bicarbonate-urea before and after weight loss

    International Nuclear Information System (INIS)

    Luscombe, N.; Kirkwood, I.D.; Bellon, M.; Tsopelas, C.; Wittert, G.A.

    2002-01-01

    Full text: Many studies have demonstrated significant declines in 24-hour energy expenditure (TEE) measured by whole body calorimetry with either the process of weight loss or the maintenance of reduced body weight. The aims of this study were to determine the effect of weight loss and two weeks of weight maintenance on TEE using [ 14 C]-bicarbonate-urea, Eleven subjects (6 males, 5 females), mean (±SE) age 50 ± 3 years, BMI 34.1 ± 2.1 kg/m2 and body fat 38.7 ± 3% were studied before and after a decrease in body weight of > 8% over a period of 8 weeks, followed by two weeks of weight maintenance. Weight loss was induced using the combination of Modifast and one small meal a day (∼3.34 MJ/day). Body composition (DEXA), resting energy expenditure (REE) and the thermic effect of a 2.7 MJ test meal (TEF) were measured in addition to TEE at week 2 and again at week 12. Diet was assessed using diaries and physical activity energy expenditure (PAEE) was calculated from the equation: 0.9 x TEE-REE, which assumes that 10% of TEE is accounted for by the TEE. Body weight decreased by 11.8 ± 1.0% from week 2 to 10, and remained stable thereafter. Total fat mass, abdominal fat mass and lean mass decreased by 19.7 ± 1.8%, 21.8 ± 2.3% and 6.0 ± 1.1 % respectively. At week 12, REE decreased by 5.7 ± 1.3% (p < 0.002). The decreases in TEF (13.3 ± 13.7%), PAEE (31 ± 57.5%) and TEE (0.18 + 3.68%) were not significant. There was a significant relationship between the change in REE and overall body weight (p < 0.026) but not lean mass. It is concluded that in free-living subjects, after weight loss and two weeks of weight maintenance, REE but not TEE decreases, although there is substantial variability between individuals.Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  16. Segmentation of multiple heart cavities in 3-D transesophageal ultrasound images.

    Science.gov (United States)

    Haak, Alexander; Vegas-Sánchez-Ferrero, Gonzalo; Mulder, Harriët W; Ren, Ben; Kirişli, Hortense A; Metz, Coert; van Burken, Gerard; van Stralen, Marijn; Pluim, Josien P W; van der Steen, Antonius F W; van Walsum, Theo; Bosch, Johannes G

    2015-06-01

    Three-dimensional transesophageal echocardiography (TEE) is an excellent modality for real-time visualization of the heart and monitoring of interventions. To improve the usability of 3-D TEE for intervention monitoring and catheter guidance, automated segmentation is desired. However, 3-D TEE segmentation is still a challenging task due to the complex anatomy with multiple cavities, the limited TEE field of view, and typical ultrasound artifacts. We propose to segment all cavities within the TEE view with a multi-cavity active shape model (ASM) in conjunction with a tissue/blood classification based on a gamma mixture model (GMM). 3-D TEE image data of twenty patients were acquired with a Philips X7-2t matrix TEE probe. Tissue probability maps were estimated by a two-class (blood/tissue) GMM. A statistical shape model containing the left ventricle, right ventricle, left atrium, right atrium, and aorta was derived from computed tomography angiography (CTA) segmentations by principal component analysis. ASMs of the whole heart and individual cavities were generated and consecutively fitted to tissue probability maps. First, an average whole-heart model was aligned with the 3-D TEE based on three manually indicated anatomical landmarks. Second, pose and shape of the whole-heart ASM were fitted by a weighted update scheme excluding parts outside of the image sector. Third, pose and shape of ASM for individual heart cavities were initialized by the previous whole heart ASM and updated in a regularized manner to fit the tissue probability maps. The ASM segmentations were validated against manual outlines by two observers and CTA derived segmentations. Dice coefficients and point-to-surface distances were used to determine segmentation accuracy. ASM segmentations were successful in 19 of 20 cases. The median Dice coefficient for all successful segmentations versus the average observer ranged from 90% to 71% compared with an inter-observer range of 95% to 84%. The

  17. Contrast transcranial Doppler ultrasound in the detection of right-to-left shunts: comparison of Echovist-200 and Echovist-300, timing of the Valsalva maneuver, and general recommendations for the performance of the test.

    Science.gov (United States)

    Droste, Dirk W; Jekentaite, Ruta; Stypmann, Jörg; Grude, Matthias; Hansberg, Tjark; Ritter, Martin; Nabavi, Darius; Nam, Eun-Mi; Dittrich, Ralf; Wichter, Thomas; Ringelstein, E Bernd

    2002-01-01

    Cardiac right-to-left shunts (RLS) can be identified by transesophageal echocardiography (TEE) as well as by transcranial Doppler ultrasound (TCD) using contrast agents, such as Echovist-200 or Echovist-300 in conjunction with a Valsalva maneuver (VM) as provocation procedure. Both Echovist preparations are in use. Currently, the appropriate timing of the VM is still under debate. Sixty-four patients were investigated by both TEE and bilateral TCD of the middle cerebral arteries. The following protocol was applied in a randomized way: (1) no VM, (2) VM for 5 s starting with the beginning of Echovist-300 injection, (3) VM for 5 s starting 5 s after the beginning of Echovist-300 injection, (4) VM for 5 s starting 10 s after the beginning of Echovist-300 injection, and (5) VM for 5 s starting 5 s after the beginning of Echovist-200 injection. In 27 patients, an RLS was demonstrated by both TEE and contrast TCD (shunt-positive). Twenty-two patients were negative in both investigations, no patient was positive on TEE but negative on TCD, 15 patients were only positive on at least one TCD investigation but negative on TEE. Tests 3 and 5 were the most appropriate ones; test 3 was slightly superior to test 5. TCD using Echovist-300 or Echovist-200 is a sensitive method to identify TEE-proven cardiac RLS. To achieve the best diagnostic accuracy, the VM should be performed for a duration of 5 s starting at 5 s following the beginning of contrast injection. Copyright 2002 S. Karger AG, Basel

  18. Atlas-based mosaicing of 3D transesophageal echocardiography images of the left atrium

    NARCIS (Netherlands)

    Mulder, H.W. (Harriët); Pluim, J.P.W.; Ren, B. (Ben); Haak, A. (Alexander); Viergever, M.A. (Max); Bosch, J.G. (Johan); Stralen, van M. (Marijn)

    2015-01-01

    3D transesophageal echocardiography (TEE) is routinely used for planning and guidance of cardiac interventions. However, the limited field-of-view dictates the compounding of multiple images for visualization of large structures, e.g. the left atrium (LA). Previously, we developed a TEE image

  19. Diagnosis of the prosthetic heart valve pannus formation with real-time three-dimensional transoesophageal echocardiography.

    Science.gov (United States)

    Ozkan, Mehmet; Gündüz, Sabahattin; Yildiz, Mustafa; Duran, Nilüfer Eksi

    2010-05-01

    Prosthetic heart valve obstruction (PHVO) caused by pannus formation is an uncommon but serious complication. Although two-dimensional transesophageal echocardiography (2D-TEE) is the method of choice in the evaluation of PHVO, visualization of pannus is almost impossible with 2D-TEE. While demonstrating the precise aetiology of PHVO is essential for guiding the therapy, either thrombolysis for valve thrombosis or surgery for pannus formation, more sophisticated imaging techniques are needed in patients with suspected pannus formation. We present real-time 3D-TEE imaging in a patient with mechanical mitral PHVO, clearly demonstrating pannus overgrowth.

  20. Pilot randomized crossover study comparing the efficacy of transnasal disposable endosheath with standard endoscopy to detect Barrett's esophagus.

    Science.gov (United States)

    Shariff, Mohammed K; Varghese, Sibu; O'Donovan, Maria; Abdullahi, Zarah; Liu, Xinxue; Fitzgerald, Rebecca C; di Pietro, Massimiliano

    2016-02-01

    The transnasal endosheath endoscope is a new disposable technology with potential applicability to the primary care setting. The aim of this study was to evaluate the efficacy of transnasal endosheath endoscopy (TEE) for the detection of Barrett's esophagus, by comparing the diagnostic accuracy of TEE with that of standard endoscopy. This was a prospective, randomized, crossover study performed in a single tertiary referral center. Consecutive patients undergoing surveillance for Barrett's esophagus or referred for diagnostic assessment were recruited. All patients were randomized to undergo TEE followed by standard endoscopy or the reverse. Endoscopy experiences and patient preferences were evaluated using a questionnaire. Endoscopic and histologic diagnosis of Barrett's esophagus, and optical image quality of both endoscopic procedures, were compared. A total of 21 of 25 patients completed the study. TEE had sensitivity and specificity of 100 % for an endoscopic diagnosis of Barrett's esophagus, and of 66.7 % and 100 %, respectively, for the histologic diagnosis of Barrett's esophagus. The mean optical quality of standard endoscopy was significantly better than that of TEE (7.11 ± 0.42 vs. 4.06 ± 0.27; P evaluation in primary care as an initial diagnostic tool. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Cooperative Studies in the Utilization and Storage of Excess Weapons-Grade Plutonium

    Energy Technology Data Exchange (ETDEWEB)

    Bolyatko, V. V. [Moscow Engineering Physics Institute (Russia)

    1998-01-29

    This technical report is a tangible and verifiable deliverable associated with the Nuclear Group subproject “Cooperative Studies in the Utilization and Storage of Excess Weapons-grade Plutonium.” This report is an assessment ofthe work performed by the Russian party from 1 October 1995 through 30 September 1996 regarding milestones defined in the contract between the Moscow Engineering Physics Institute (MEPhI) and the Texas Engineering Experiment Station (TEES). In these interactions, TEES serves as agent of the Amarillo National Resource Center for Plutonium (ANRCP) in the capacity oflead institution for the Nuclear Group of the ANRCP. The official Statement ofWork dated 8 April 1996 enumerates specific milestones and deliverables. In its present form, this report is an edited version ofthe translation submitted to TEES by MEPhI on 7 October 1996. The principal investigators for this subproject are Dr. Paul Nelson of TEES and Dr. Victor Bolyatko of the Moscow Engineering Physics Institute.

  2. An exercise in preferential unilateral breathing

    International Nuclear Information System (INIS)

    Cheong, D.; Tucker, B.; Jenkins, S.; Robinson, P.; Curtin University, Shenton Park, WA

    1999-01-01

    Full text: In preparation for major thoracic surgery, physiotherapists have traditionally taught unilateral breathing exercises. There are no studies that prove that these exercises are effective This study was undertaken to demonstrate the effects of unilateral thoracic expansion exercises (TEE) using 99 Tc m -Technegas Ten physiotherapists were taught unilateral TEE to increase ventilation to the right lower lobe. Each subject underwent two separate Technegas ventilation studies using a single-breath technique, one with normal deep inspiration and the other during a right TEE. Dynamic and static images were acquired in the seated position for each ventilation study. Analysis was undertaken by dividing the lungs into 6 zones of equal height and calculating the relative ventilation of each zone and each lung. Seven subjects (70%) achieved significantly increased ventilation to the right lower zone, while 9 (90%) achieved greater ventilation to the right lung. Total lung ventilation was reduced during right TEE when compared with normal deep inspiration

  3. Intraspecies variation in BMR does not affect estimates of early hominin total daily energy expenditure.

    Science.gov (United States)

    Froehle, Andrew W; Schoeninger, Margaret J

    2006-12-01

    We conducted a meta-analysis of 45 studies reporting basal metabolic rate (BMR) data for Homo sapiens and Pan troglodytes to determine the effects of sex, age, and latitude (a proxy for climate, in humans only). BMR was normalized for body size using fat-free mass in humans and body mass in chimpanzees. We found no effect of sex in either species and no age effect in chimpanzees. In humans, juveniles differed significantly from adults (ANCOVA: P BMR and body size, and used them to predict total daily energy expenditure (TEE) in four early hominin species. Our predictions concur with previous TEE estimates (i.e. Leonard and Robertson: Am J Phys Anthropol 102 (1997) 265-281), and support the conclusion that TEE increased greatly with H. erectus. Our results show that intraspecific variation in BMR does not affect TEE estimates for interspecific comparisons. Comparisons of more closely related groups such as humans and Neandertals, however, may benefit from consideration of this variation. 2006 Wiley-Liss, Inc.

  4. The transesophageal echocardiography simulator based on computed tomography images.

    Science.gov (United States)

    Piórkowski, Adam; Kempny, Aleksander

    2013-02-01

    Simulators are a new tool in education in many fields, including medicine, where they greatly improve familiarity with medical procedures, reduce costs, and, importantly, cause no harm to patients. This is so in the case of transesophageal echocardiography (TEE), in which the use of a simulator facilitates spatial orientation and helps in case studies. The aim of the project described in this paper is to simulate an examination by TEE. This research makes use of available computed tomography data to simulate the corresponding echocardiographic view. This paper describes the essential characteristics that distinguish these two modalities and the key principles of the wave phenomena that should be considered in the simulation process, taking into account the conditions specific to the echocardiography. The construction of the CT2TEE (Web-based TEE simulator) is also presented. The considerations include ray-tracing and ray-casting techniques in the context of ultrasound beam and artifact simulation. An important aspect of the interaction with the user is raised.

  5. Avoiding transthoracic echocardiography and transesophageal echocardiography for patients with variable body mass indexes in infective endocarditis

    Directory of Open Access Journals (Sweden)

    Robert Sogomonian

    2016-04-01

    Full Text Available Background: Echocardiography has been a popular modality used to aid in the diagnosis of infective endocarditis (IE with the modified Duke criteria. We evaluated the necessity between the uses of either a transthoracic echocardiography (TTE or transesophageal echocardiography (TEE in patients with a body mass index (BMI greater than or equal to 25 kg/m2 and less than 25 kg/m2. Methods: A single-centered, retrospective study of 198 patients between 2005 and 2012 diagnosed with IE based on modified Duke criteria. Patients, required to be above age 18, had undergone an echocardiogram study and had blood cultures to be included in the study. Results: Among 198 patients, two echocardiographic groups were evaluated as 158 patients obtained a TTE, 143 obtained a TEE, and 103 overlapped with TEE and TTE. Out of these patients, 167 patients were included in the study as 109 (65% were discovered to have native valve vegetations on TEE and 58 (35% with TTE. TTE findings were compared with TEE results for true negatives and positives to isolate valvular vegetations. Overall sensitivity of TTE was calculated to be 67% with a specificity of 93%. Patients were further divided into two groups with the first group having a BMI ≥25 kg/m2 and the subsequent group with a BMI <25 kg/m2. Patients with a BMI ≥25 kg/m2 who underwent a TTE study had a sensitivity and specificity of 54 and 92%, respectively. On the contrary, patients with a BMI < 25 kg/m2 had a TTE sensitivity and specificity of 78 and 95%, respectively. Conclusions: Patients with a BMI <25 kg/m2 and a negative TTE should refrain from further diagnostic studies, with TEE strong clinical judgment is warranted. Patients with a BMI ≥ 25 kg/m2 may proceed directly to TEE as the initial study, possibly avoiding an additional study with a TTE.

  6. Low-Power Receive-Electronics for a Miniature 3D Ultrasound Probe

    NARCIS (Netherlands)

    Yu, Z.

    2012-01-01

    This thesis describes the design of a front-end application-specific integrated circuit (ASIC), which will be put into the tip of a miniature ultrasound probe for 3D Trans-Esophageal Echocardiography (TEE). To enable 3D TEE, a matrix piezoelectric ultrasound transducer with more than 2000 elements

  7. SCF analysis of a pressurized vessel-nozzle intersection with wall thinning damage

    International Nuclear Information System (INIS)

    Qadir, M.; Redekop, D.

    2009-01-01

    A three-dimensional finite element analysis is carried out of a pressurized vessel-nozzle intersection (tee joint), with wall thinning damage. A convergence-validation study is first carried out for undamaged intersections, in which comparisons are made with previously published work for the stress concentration factor (SCF), and good agreement is observed. A study is then carried out for specific tee joints to examine the effect on the SCF of varying the extent of the wall thinning damage. Finally, a parametric study is conducted in which the SCF is computed for a wide range of tee joints, initially considered undamaged, and then with wall thinning damage.

  8. Intraoperative three-dimensional transesophageal echocardiography for assessing the defect geometries of mitral prosthetic paravalvular leak during transcatheter closure

    Directory of Open Access Journals (Sweden)

    Jeng Wei

    2015-03-01

    Conclusion: RT 3D TEE can clearly delineate the geometries of defects in their entirety, including shape, size, and location of the defect and track canal. It would also appear that RT 3D TEE is superior to 2D TEE in the process of guiding the wire through the difficult canal anatomy, facilitating the overall procedure. The small mitral PVLs can be completely occluded, but subsequent complications occurred with large defect closures because of embolization or releak. Therefore, transcatheter closure of PVLs seems to be an attractive alternative for these patients, but newer occluder designs that better conform to leak geometry will be required to improve outcomes.

  9. Three-dimensional transesophageal echocardiography: Principles and clinical applications

    Directory of Open Access Journals (Sweden)

    Annette Vegas

    2016-01-01

    Full Text Available A basic understanding of evolving 3D technology enables the echocardiographer to master the new skills necessary to acquire, manipulate, and interpret 3D datasets. Single button activation of specific 3D imaging modes for both TEE and transthoracic echocardiography (TTE matrix array probes include (a live, (b zoom, (c full volume (FV, and (d color Doppler FV. Evaluation of regional LV wall motion by RT 3D TEE is based on a change in LV chamber subvolume over time from altered segmental myocardial contractility. Unlike standard 2D TEE, there is no direct measurement of myocardial thickening or displacement of individual segments.

  10. Intraoperative three-dimensional transesophageal echocardiography for assessing the defect geometries of mitral prosthetic paravalvular leak during transcatheter closure.

    Science.gov (United States)

    Wei, Jeng; Yin, Wei-Hsian; Lee, Yung-Tsai; Hsiung, Ming C; Tsai, Shen-Kou; Chuang, Yi Cheng; Ou, Ching-Huei; Chou, Yi-Pen

    2015-03-01

    Paravalvular leaks (PVLs) are a common complication of prosthetic valve replacement. Use of the transcatheter intervention technique is a suitable alternative in high-risk patients who may not tolerate repeat surgery. Common reasons for failure of this demanding intervention include poor imaging quality and unsuitable anatomy. The purpose of this study was to assess the usefulness and the incremental value of real-time three-dimensional (RT 3D) transesophageal echocardiography (TEE) over two-dimensional (2D) TEE findings in the evaluation of the geometry and track of mitral PVLs during transcatheter closure. Five patients with six mitral PVLs at high risk for repeat surgery underwent transcatheter leak closure. Intraoperative RT 3DTEE was used to assess the location, shape, number, and size of the defects. Transapical approaches were used in all cases with fluoroscopic and RT 3D TEE guidance of the wire and catheter, device positioning, and assessment of residual leak after the procedure. In all of the cases, defects with irregular crescent shapes and distorted tracks were clearly delineated by RT 3D TEE. This was compared to those results obtained through 2D TEE, which was unable to characterize the defects. Three cases showed small leaks, which were completely occluded with a patent ductus arteriosus (PDA) device in two cases, and a muscular ventricular septal defect (mVSD) occluder combined with coil devices in one case. One case involved a large leak and early device embolization of the muscular VSD occluder, which was removed surgically, and demonstrated a crescent-shaped defect. One patient had two releaks 2 months subsequent to the procedure due to two new extended leaks at the tails of the crescent-shaped defect. RT 3D TEE can clearly delineate the geometries of defects in their entirety, including shape, size, and location of the defect and track canal. It would also appear that RT 3D TEE is superior to 2D TEE in the process of guiding the wire through the

  11. Impact of perioperative transesophageal echocardiography on tetralogy of fallot total repair

    Directory of Open Access Journals (Sweden)

    Yasmin Abdel Razek

    2014-03-01

    Conclusion: TEE imaging is a safe, feasible, and accurate tool for anatomical, hemodynamic, and functional assessment in patients with TOF during surgical repair. TEE offers the advantage of permitting visualization of the operative procedure in real time and provides guidance for the surgeon in making decisions inside the operating room.

  12. Tee teistele head, kuid tee seda hästi / Jeff Skoll ; interv. Des Dearlove

    Index Scriptorium Estoniae

    Skoll, Jeff

    2004-01-01

    Ilmunud ka: Delovõje Vedomosti : Karjera i obutshenije, 18. aug. 2004, lk. 6-7. Ameerika interneti-oksjonifirma eBay rajaja Jeff Skoll selgitab oma ettevõtte näitel sotsiaalse ettevõtluse olemust ning prognoosib selle populaarsuse kasvu tulevikus

  13. Tee bändi nagu kunstiteost, tee kunsti nagu jam session'it / Hanno Soans

    Index Scriptorium Estoniae

    Soans, Hanno, 1974-

    2009-01-01

    3. "NU Performance'i" festival "Recycle Pop" Kanuti gildis 11.-14. novembrini 2009. Kuraatorid Anders Härm ja Priit Raud. Norra Baktruppeni, rootslanna Catti Brandeliuse, prantslanna Carole Douillard'i, Andres Lõo, Maria Arusoo & Maria Juure, Erkki Luugi, Marco Laimre, Raul Kelleri, Kati Ilvese ja Killu Sukmiti esinemisest

  14. The effect of transesophageal echocardiography in the surgical treatment of tetralogy of Fallot.

    Science.gov (United States)

    Wang, L-C; Li, S-K; Zhu, F-T; Bian, T; Wang, H-Y

    2018-04-01

    To investigate the effect of transesophageal echocardiography (TEE) in the surgical treatment of tetralogy of Fallot. 98 patients with tetralogy of Fallot received and cured by Zhengzhou Cardiovascular Hospital (Zhengzhou No. 7 People's Hospital) from January 2015 to January 2017 were selected as the study objects. All patients were examined by TEE before surgery, and the pulmonary artery index (PAI) and pulmonary vein index (PVI) were measured, so as to analyze the effect of TEE in the surgical treatment of tetralogy of Fallot. Among the 98 patients, 12 patients were diagnosed with intensive care unit (ICU) retention, 23 patients were diagnosed with respirator assisted respiration extension, 8 patients were diagnosed with low cardiac output syndrome, and 10 patients were diagnosed with respiratory tract infection, which indicated that TEE could diagnose conditions after radical operation of tetralogy of Fallot. The calculation results showed that the PAI was (171.37±58.39) mm2/m2 and the PVI was (282.46±54.37) mm2/m2. The Pearson correlation analysis showed that the correlation between them was good (r=0.821, ptetralogy of Fallot. TEE can predict the occurrence of respirator assisted respiration extension, ICU retention and low cardiac output syndrome of patients after radical surgery by evaluating the PAI and PVI of patients with tetralogy of Fallot.

  15. In-vivo continuous monitoring of mixed venous oxygen saturation by photoacoustic transesophageal echocardiography (Conference Presentation)

    Science.gov (United States)

    Li, Li; Subramaniam, Balachundhar; Aguirre, Aaron D.; Andrawes, Michael N.; Tearney, Guillermo J.

    2016-02-01

    Mixed venous oxygen saturation (SvO2), measured from pulmonary arteries, is a gold-standard measure of the dynamic balance between the oxygen supply and demand in the body. In critical care, continuous monitoring of SvO2 plays a vital role in early detection of circulatory shock and guiding goal-oriented resuscitation. In current clinical practice, SvO2 is measured by invasive pulmonary artery catheters (PAC), which are associated with a 10% risk of severe complications. To address the unmet clinical need for a non-invasive SvO2 monitor, we are developing a new technology termed photoacoustic transesophageal echocardiography (PA-TEE). PA-TEE integrates transesophageal echocardiography with photoacoustic oximetry, and enables continuous assessment of SvO2 through an esophageal probe that can be inserted into the body in a minimally invasive manner. We have constructed a clinically translatable PA-TEE prototype, which features a mobile OPO laser, a modified ultrasonography console and a dual-modality esophageal probe. Comprised of a rotatable acoustic array detector, a flexible optical fiber bundle and a light-integrating acoustic lens, the oximetric probe has an outer diameter smaller than 15 mm and will be tolerable for most patients. Through custom-made C++/Qt software, our device acquires and displays ultrasonic and photoacoustic images in real time to guide the deployment of the probe. SvO2 is calculated on-line and updated every second. PA-TEE has now been used to evaluate SvO2 in living swine. Our findings show that changing the fraction of oxygen in the inspired gas modulates SvO2 measured by PA-TEE. Statistic comparison between SvO2 measurements from PA-TEE in vivo the gold-standard laboratorial analysis on blood samples drawn from PACs will be presented.

  16. Energy expenditure in professional flat jockeys using doubly labelled water during the racing season: Implications for body weight management.

    Science.gov (United States)

    Wilson, George; Lucas, Daloni; Hambly, Catherine; Speakman, John R; Morton, James P; Close, Graeme L

    2018-03-01

    To formulate individualized dietary strategies for jockeys, it is vital that energy requirements are quantified. We measured total energy expenditure (TEE) over two separate weeks in spring and summer using doubly labelled water in a group of male flat jockeys (n = 8, 36.9 ± 5.7 years, 164 ± 8 cm, 54.6 ± 2.5 kg). Total energy intake (TEI) was self-recorded, as were all riding and structured exercise activity. Mean daily TEE was 10.83 (±2.3) and 10.66 (±1.76) MJ, (p = .61) respectively. Self-reported TEI were 6.03 (±1.7) and 5.37 (±1.1) MJ (p = .40), respectively, and were significantly lower than TEE (p = .01). Mean race rides were 17 (±6) and 13 (±3; p = 0.37) and horses ridden at morning exercise were 8 (±6) and 7 (±4; p = .77) respectively. Additional structured exercise was 76.25 (±95.1) and 52.5 (±80.9) min per week (p = .35), respectively. At the individual level, TEE was related to body mass and the level of non-racing physical activity, but not riding. Physical activity levels for TEE were 1.76 (±0.37) and 1.69 (±0.27; p = .59) and appear modest when compared with other athletes, and similar to age-matched non-athletes, suggesting that conventional sport-specific nutritional recommendations do not appear applicable. The large discrepancy between TEE and TEI suggests significant under reporting of dietary intake. These data now provide an appropriate framework from which to formulate jockey nutritional guidelines to promote the ability to achieve the daily weight target and improve athlete welfare.

  17. A new therapeutic strategy for electrical cardioversion of atrial fibrillation.

    Science.gov (United States)

    de Luca, I; Sorino, M; Del Salvatore, B; de Luca, L

    2001-11-01

    The conventional approach to cardioversion of atrial fibrillation includes a period of anticoagulation with oral anticoagulant therapy (OAT) extending from 3 weeks precardioversion to 4 weeks postcardioversion. The protocol of rapid anticoagulation (such as that of the ACUTE study) consists of a precardioversion transesophageal echocardiography (TEE) followed by OAT for 4 weeks. In the last few years low-molecular-weight heparins have established themselves as a safe and efficacious alternative to traditional antithrombotic therapies. The aim of this study was to demonstrate that the exclusion of thrombi by precardioversion TEE together with the exclusion of atrial stunning by a second TEE performed after 1 week, to date not suggested in the literature, could reduce to 7 days the period of pericardioversion anticoagulation. This therapy would be carried out using low-molecular-weight heparins with no need for biological monitoring and with the possibility of self-administration. We have studied 57 consecutive patients who had atrial fibrillation or flutter with a history of atrial fibrillation lasting > 48 hours. All patients received enoxaparin at a dosage of 100 IU antiXa/kg twice daily before undergoing multiplane TEE. Previous informed consent and ethical committee authorization had been obtained. Twenty-four hours following TEE, in the absence of thrombi and/or spontaneous moderate/severe echocontrast in the atrial chambers, the patients underwent electrical cardioversion and were discharged within 24 hours of sinus rhythm restoration. These patients were prescribed enoxaparin at the indicated dosage twice daily until TEE, performed in an outpatients setting 7 days following cardioversion. In the absence of thrombi and/or atrial and/or left atrial appendage stunning, OAT was terminated. Enoxaparin was associated with OAT for the following 3 weeks if any of the following signs of stunning were present: A wave inferior to the normal value for age at transmitral

  18. The influence of lidocaine topical anesthesia during transesophageal echocardiography on blood methemoglobin level and risk of methemoglobinemia.

    Science.gov (United States)

    Filipiak-Strzecka, Dominika; Kasprzak, Jarosław D; Wiszniewska, Marta; Walusiak-Skorupa, Jolanta; Lipiec, Piotr

    2015-04-01

    Methemoglobinemia is a relatively rare, but potentially life-threating medical condition, which may be induced by application of topical anaesthetic agents commonly used during endoscopic procedure. The aim of our study was to assess the influence of lidocaine used prior to transesophageal echocardiography (TEE) on the blood level of methemoglobin in vivo. Additionally we attempted to establish the occurrence rate of clinically evident lidocaine-induced methemoglobinemia on the basis of data collected in our institution. We retrospectively analyzed patient records from 3,354 TEEs performed in our echocardiographic laboratory over the course of 13 years in search for clinically evident methemoglobinemia cases. Additionally, 18 consecutive patients referred for TEE were included in the prospective part of our analysis. Blood samples were tested before and 60 min after pre-TEE lidocaine anesthesia application. Information concerning concomitant conditions and pharmacotherapy were also obtained. In 3,354 patients who underwent TEE in our institution no cases of clinically evident methemoglobinemia occurred. In the prospective part of the study, none of 18 patients [16 (89 %) men, mean age 63 ± 13] was diagnosed with either clinical symptoms of methemoglobinemia or exceeded normal blood concentration of methemoglobin. Initial mean methemoglobin level was 0.5 ± 0.1 % with mild, statistically (but not clinically) significant rise to 0.6 ± 0.1 % after 60 min (p = 0.02). Among the analyzed factors only the relation between the proton pump inhibitors intake and methemoglobin blood level rise was identified as statistically relevant (p = 0.03). In adults, pre-TEE lidocaine anesthesia with recommended dosage results in significant increase in methemoglobin blood level, which however does not exceed normal values and does not result in clinically evident methemoglobinemia.

  19. Split-bolus single-phase cardiac multidetector computed tomography for reliable detection of left atrial thrombus. Comparison to transesophageal echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Staab, W.; Zwaka, P.A.; Sohns, J.M.; Schwarz, A.; Lotz, J. [University Medical Center Goettingen Univ. (Germany). Inst. for Diagnostic and Interventional Radiology; Sohns, C.; Vollmann, D.; Zabel, M.; Hasenfuss, G. [Goettingen Univ. (Germany). Dept. of Cardiology and Pneumology; Schneider, S. [Goettingen Univ. (Germany). Dept. of Medical Statistics

    2014-11-15

    Evaluation of a new cardiac MDCT protocol using a split-bolus contrast injection protocol and single MDCT scan for reliable diagnosis of LA/LAA thrombi in comparison to TEE, optimizing radiation exposure and use of contrast agent. A total of 182 consecutive patients with drug refractory AF scheduled for PVI (62.6% male, mean age: 64.1 ± 10.2 years) underwent routine diagnostic work including TEE and cardiac MDCT for the evaluation of LA/LAA anatomy and thrombus formation between November 2010 and March 2012. Contrast media injection was split into a pre-bolus of 30 ml and main bolus of 70 ml iodinated contrast agent separated by a short time delay. In this study, split-bolus cardiac MDCT identified 14 of 182 patients with filling defects of the LA/LAA. In all of these 14 patients, abnormalities were found in TEE. All 5 of the 14 patients with thrombus formation in cardiac MDCT were confirmed by TEE. MDCT was 100% accurate for thrombus, with strong but not perfect overall results for SEC equivalent on MDCT.

  20. Minimally invasive cardiac surgery and transesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Jha

    2014-01-01

    Full Text Available Improved cosmetic appearance, reduced pain and duration of post-operative stay have intensified the popularity of minimally invasive cardiac surgery (MICS; however, the increased risk of stroke remains a concern. In conventional cardiac surgery, surgeons can visualize and feel the cardiac structures directly, which is not possible with MICS. Transesophageal echocardiography (TEE is essential during MICS in detecting problems that require immediate correction. Comprehensive evaluation of the cardiac structures and function helps in the confirmation of not only the definitive diagnosis, but also the success of surgical treatment. Venous and aortic cannulations are not under the direct vision of the surgeon and appropriate positioning of the cannulae is not possible during MICS without the aid of TEE. Intra-operative TEE helps in the navigation of the guide wire and correct placement of the cannulae and allows real-time assessment of valvular pathologies, ventricular filling, ventricular function, intracardiac air, weaning from cardiopulmonary bypass and adequacy of the surgical procedure. Early detection of perioperative complications by TEE potentially enhances the post-operative outcome of patients managed with MICS.

  1. Transoesophageal echocardiography: What a neuroanaesthesiologist should know?

    Directory of Open Access Journals (Sweden)

    Minati Choudhury

    2015-01-01

    Full Text Available Transoesophageal echocardiography (TEE is a semi invasive imaging modality rapidly gained credence and popularity in the cardiothoracic centers worldwide by mid 1990s. It has also been found to be useful in some noncardiac surgical procedures, in particular in the management of neurosurgical patients and haemodynamically unstable patients in intensive care units (ICUs. The principal goal of basic transoesophageal echocardiographic examination encompass a broad range of anatomic imaging including the diagnosis of air embolism, causes of haemodynamic instability, ventricular size and function, volume status, and complications from invasive procedures, as well as the clinical impact or etiology of pulmonary dysfunction in ICU. TEE is relatively cheap and semi-invasive, but it should not be used as a stand-alone device but as a tool which provides data in addition to the data acquired from other forms of monitoring. The establishment of TEE in perioperative neuro anaesthetic care though recent, may result in a significant change in the role of the anaesthetsiologist who, using TEE can provide new information which may change the course and the outcome of surgical procedures.

  2. 15. Sensitivity in visualizing vegetations in cardiac lead-induced endocarditis: A comparative study between transesophageal vs. transthoracic echocardiography

    Directory of Open Access Journals (Sweden)

    A. AlFagih

    2016-07-01

    Full Text Available Despite advancement in sterile cardiac device implantation techniques, wound infections and/or bacteremia remain a significant problem. The presence of a vegetation in lead-induced endocarditis (LIE is a critical factor that determines the management. Transthoracic (TTE and Transesophageal (TEE Echocardiography are two different cardiac modalities that are used for the detection of lead vegetation. However, it is not yet clear which of the two has the highest diagnostic accuracy. We aim to identify which of the two has the highest sensitivity. In addition, we aim to correlate the existence of a vegetation with blood and wound culture results. We conducted a chart review in 113 patients whom underwent lead extraction at Prince Sultan Cardiac Center in Saudi Arabia during the period of Jan, 2002 to Jul, 2015. Six patients underwent lead extraction twice, increasing the number to be a total of 119 cases. Out of the study cohort, we include 38 patients who had both TTE and TEE done prior to lead extraction. Data regarding TTE, TEE, as well as blood and wound cultures were collected from echocardiography and microbiology lab reports using a well-structured case report form.Of the study population, 21 patients (55.3% had lead vegetations visualized either by TTE or TEE. Nineteen patients had vegetations detected by TEE, compared to 6 patients only when TTE was used. The sensitivity of TEE and TTE were 90.5% (CI: 69.6–98.8% and 28.5% (95% CI: 11.3–52.1%, respectively. Blood and wound culture results showed that in the presence of a vegetation, blood cultures were positive in 55% of the cases (P = 0.036 while only 44.4% of those with vegetations had a positive wound culture (P = 0.347. TEE has higher sensitivity in detecting vegetations compared to TTE in LIE. The presence of a vegetation is more likely to be associated with a positive blood culture than a positive wound culture. Further studies ought to measure the accuracy of different

  3. Total Energy Expenditure in Obese Kuwaiti Primary School Children Assessed by the Doubly-Labeled Water Technique

    Directory of Open Access Journals (Sweden)

    Lena Davidsson

    2016-10-01

    Full Text Available The aim of this pilot study was to assess body composition and total energy expenditure (TEE in 35 obese 7–9 years old Kuwaiti children (18 girls and 17 boys. Total body water (TBW and TEE were assessed by doubly-labeled water technique. TBW was derived from the intercept of the elimination rate of deuterium and TEE from the difference in elimination rates of 18O and deuterium. TBW was used to estimate fat-free mass (FFM, using hydration factors for different ages and gender. Fat mass (FM was calculated as the difference between body weight and FFM. Body weight was not statistically different but TBW was significantly higher (p = 0.018 in boys (44.9% ± 3.3% than girls (42.4% ± 3.0%, while girls had significantly higher estimated FM (45.2 ± 3.9 weight % versus 41.6% ± 4.3%; p = 0.014. TEE was significantly higher in boys (2395 ± 349 kcal/day compared with girls (1978 ± 169 kcal/day; p = 0.001. Estimated physical activity level (PAL was significantly higher in boys; 1.61 ± 0.167 versus 1.51 ± 0.870; p = 0.034. Our results provide the first dataset of TEE in 7–9 years old obese Kuwaiti children and highlight important gender differences to be considered during the development of school based interventions targeted to combat childhood obesity.

  4. Impact of electrocardiogram-gated multi-slice computed tomography-based aortic annular measurement in the evaluation of paravalvular leakage following transcatheter aortic valve replacement: the efficacy of the OverSized AortiC Annular ratio (OSACA ratio) in TAVR.

    Science.gov (United States)

    Maeda, Koichi; Kuratani, Toru; Torikai, Kei; Shimamura, Kazuo; Mizote, Isamu; Ichibori, Yasuhiro; Takeda, Yasuharu; Daimon, Takashi; Nakatani, Satoshi; Nanto, Shinsuke; Sawa, Yoshiki

    2013-07-01

    Even mild paravalvular leakage (PVL) after transcatheter aortic valve replacement (TAVR) is associated with increased late mortality. Electrocardiogram-gated multi-slice computed tomography (MSCT) enables detailed aortic annulus assessment. We describe the impact of MSCT for PVL following TAVR. Congruence between the prosthesis and annulus diameters affects PVL; therefore, we calculated the OverSized AortiC Annular ratio (OSACA ratio) and OSACA (transesophageal echocardiography, TEE) ratio as prosthesis diameter/annulus diameter on MSCT or TEE, respectively, and compared their relationship with PVL ≤ trace following TAVR. Of 36 consecutive patients undergoing TAVR (Group A), the occurrence of PVL ≤ trace (33.3%) was significantly related to the OSACA ratio (p = 0.00020). In receiver-operating characteristics analysis, the cutoff value of 1.03 for the OSACA ratio had the highest sum of sensitivity (75.0%) and specificity (91.7%; AUC = 0.87) with significantly higher discriminatory performance for PVL as compared to the OSACA (TEE) ratio (AUC = 0.69, p = 0.028). In nine consecutive patients (Group B) undergoing TAVR based on guidelines formulated from our experience with Group A, PVL ≤ trace was significantly more frequent (88.9%) than that in Group A (p = 0.0060). The OSACA ratio has a significantly higher discriminatory performance for PVL ≤ trace than the OSACA (TEE) ratio, and aortic annular measurement from MSCT is more accurate than that from TEE. © 2013 Wiley Periodicals, Inc.

  5. Anatomic characterization of cavotricuspid isthmus by 3D transesophageal echocardiography in patients undergoing radiofrequency ablation of typical atrial flutter.

    Science.gov (United States)

    Regoli, François; Faletra, Francesco; Marcon, Serena; Leo, Laura Anna; Dequarti, Maria Cristina; Caputo, Maria Luce; Conte, Giulio; Moccetti, Tiziano; Auricchio, Angelo

    2018-01-01

    Radiofrequency ablation (RFA) is the treatment of choice of cavotricuspid isthmus (CTI)-dependent atrial flutter. Procedural time is highly variable due to anatomical structures. This study aimed to characterize CTI anatomy by transesophageal 3D echocardiography imaging (3D-TEE) to identify anatomic structures related to longer ablation time. Thirty-one consecutive patients (mean age 67.3 ± 11.5 years, 22 males) underwent CTI-ablation procedure. Before ablation, TEE was performed and 3D-TEE images were acquired to evaluate CTI anatomy qualitatively as well as perform measures of CTI morphological features. The electrophysiologist performing RFA was blinded to 3D-TEE data. Bidirectional block of CTI was achieved in all patients without procedural complications after a median ablation time of 11 (IQR 7-14) min. Patients with RFA time ≥11 min (Group 2) presented lower left ventricular ejection fraction (51.1 ± 17.0 vs. 59.5 ± 6.6%, P 3D-TEE imaging is extremely helpful in qualitative and quantitative evaluation of CTI anatomy in patients undergoing RFA for symptomatic typical atrial flutter. Detection of a deep right atrial pouch was found to be associated with significantly prolonged CTI ablation time to achieve bidirectional block. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  6. Endoscopic ultrasound-guided biliary drainage using a newly designed metal stent with a thin delivery system: a preclinical study in phantom and porcine models.

    Science.gov (United States)

    Minaga, Kosuke; Kitano, Masayuki; Itonaga, Masahiro; Imai, Hajime; Miyata, Takeshi; Yamao, Kentaro; Tamura, Takashi; Nuta, Junya; Warigaya, Kenji; Kudo, Masatoshi

    2017-12-08

    This study was designed to evaluate the feasibility and safety of a newly designed self-expandable metal stent for endoscopic ultrasound-guided biliary drainage (EUS-BD) when it was delivered via three different stent delivery systems: a 7.5Fr delivery catheter with a bullet-shaped tip (7.5Fr-bullet), a 7Fr catheter with a bullet-shaped tip (7Fr-bullet), or a 7Fr catheter with a tee-shaped tip (7Fr-tee). This experimental study utilized a porcine model of biliary dilatation involving ten pigs. In the animal study, technical feasibility and clinical outcomes of the stent when placed with each of the delivery systems were examined. In addition, a phantom model was used to measure the resistance of these delivery systems to advancement. Phantom experiments showed that, compared with 7Fr-bullet, 7Fr-tee had less resistance force to the advancement of the stent delivery system. EUS-BD was technically successful in all ten pigs. Fistulous tract dilation was necessary in 100% (2/2), 75% (3/4), and 0% (0/4) of the pigs that underwent EUS-BD using 7.5Fr-bullet, 7Fr-bullet, and 7Fr-tee, respectively. There were no procedure-related complications. Our newly designed metal stent may be feasible and safe for EUS-BD, particularly when delivered by 7Fr-tee, because it eliminates the need for fistulous tract dilation.

  7. 3D-printed pediatric endoscopic ear surgery simulator for surgical training.

    Science.gov (United States)

    Barber, Samuel R; Kozin, Elliott D; Dedmon, Matthew; Lin, Brian M; Lee, Kyuwon; Sinha, Sumi; Black, Nicole; Remenschneider, Aaron K; Lee, Daniel J

    2016-11-01

    Surgical simulators are designed to improve operative skills and patient safety. Transcanal Endoscopic Ear Surgery (TEES) is a relatively new surgical approach with a slow learning curve due to one-handed dissection. A reusable and customizable 3-dimensional (3D)-printed endoscopic ear surgery simulator may facilitate the development of surgical skills with high fidelity and low cost. Herein, we aim to design, fabricate, and test a low-cost and reusable 3D-printed TEES simulator. The TEES simulator was designed in computer-aided design (CAD) software using anatomic measurements taken from anthropometric studies. Cross sections from external auditory canal samples were traced as vectors and serially combined into a mesh construct. A modified tympanic cavity with a modular testing platform for simulator tasks was incorporated. Components were fabricated using calcium sulfate hemihydrate powder and multiple colored infiltrants via a commercial inkjet 3D-printing service. All components of a left-sided ear were printed to scale. Six right-handed trainees completed three trials each. Mean trial time (n = 3) ranged from 23.03 to 62.77 s using the dominant hand for all dissection. Statistically significant differences between first and last completion time with the dominant hand (p 3D-printed simulator is feasible for TEES simulation. Otolaryngology training programs with access to a 3D printer may readily fabricate a TEES simulator, resulting in inexpensive yet high-fidelity surgical simulation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Tee uutele turgudele tugeva logistikapartneriga

    Index Scriptorium Estoniae

    2006-01-01

    Rahvusvahelise logistikaettevõtte Baltic Logistic System Eesti AS-i (BizPak/DPD) müügi- ja turundusjuhi Janek Kivimurru sõnul omab hästi läbi mõeldud logistikastrateegia võtmerolli edu saavutamisel uutel turgudel

  9. A mitral annulus tracking approach for navigation of off-pump beating heart mitral valve repair.

    Science.gov (United States)

    Li, Feng P; Rajchl, Martin; Moore, John; Peters, Terry M

    2015-01-01

    To develop and validate a real-time mitral valve annulus (MVA) tracking approach based on biplane transesophageal echocardiogram (TEE) data and magnetic tracking systems (MTS) to be used in minimally invasive off-pump beating heart mitral valve repair (MVR). The authors' guidance system consists of three major components: TEE, magnetic tracking system, and an image guidance software platform. TEE provides real-time intraoperative images to show the cardiac motion and intracardiac surgical tools. The magnetic tracking system tracks the TEE probe and the surgical tools. The software platform integrates the TEE image planes and the virtual model of the tools and the MVA model on the screen. The authors' MVA tracking approach, which aims to update the MVA model in near real-time, comprises of three steps: image based gating, predictive reinitialization, and registration based MVA tracking. The image based gating step uses a small patch centered at each MVA point in the TEE images to identify images at optimal cardiac phases for updating the position of the MVA. The predictive reinitialization step uses the position and orientation of the TEE probe provided by the magnetic tracking system to predict the position of the MVA points in the TEE images and uses them for the initialization of the registration component. The registration based MVA tracking step aims to locate the MVA points in the images selected by the image based gating component by performing image based registration. The validation of the MVA tracking approach was performed in a phantom study and a retrospective study on porcine data. In the phantom study, controlled translations were applied to the phantom and the tracked MVA was compared to its "true" position estimated based on a magnetic sensor attached to the phantom. The MVA tracking accuracy was 1.29 ± 0.58 mm when the translation distance is about 1 cm, and increased to 2.85 ± 1.19 mm when the translation distance is about 3 cm. In the study on

  10. Research on Synchronous Coordination Development of Tourism-Economy-Environment System in Qinghai Section of Silk Road

    Science.gov (United States)

    Xue, Huaju

    2018-01-01

    Using coupling theory in physics, the paper analyzed the relationship of coordinated development of tourism-economy-environment system (abbr. TEES) in Qinghai. Results showed the comprehensive evaluation of Qinghai TEES has been improved greatly from 2000 to 2014. However, coupling degree has still been in the running-in stage and coordination degree only arrives at the primary coordination level, the development of economy and tourism has exceeded the threshold of ecological environment after 2008, and the ecological environment has become the bottleneck restricting the further improvement of coupling coordination. In the future, Qinghai must change its mode of development and focus on industrial upgrading and transformation so as to promote the harmonious and sustainable development of TEES in the Silk Road.

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

    Science.gov (United States)

    Janardhanan, Rajesh; Pasha, Ahmed Khurshid

    2016-03-01

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

  12. Real-time 3D transesophageal echocardiography-guided closure of a complicated patent ductus arteriosus in a dog.

    Science.gov (United States)

    Doocy, K R; Nelson, D A; Saunders, A B

    2017-06-01

    Advanced imaging modalities are becoming more widely available in veterinary cardiology, including the use of transesophageal echocardiography (TEE) during occlusion of patent ductus arteriosus (PDA) in dogs. The dog in this report had a complex history of attempted ligation and a large PDA that initially precluded device placement thereby limiting the options for PDA closure. Following a second thoracotomy and partial ligation, the morphology of the PDA was altered and device occlusion was an option. Angiographic assessment of the PDA was limited by the presence of hemoclips, and the direction of ductal flow related to the change in anatomy following ligature placement. Intra-operative TEE, in particular real-time three-dimensional imaging, was pivotal for assessing the PDA morphology, monitoring during the procedure, selecting the device size, and confirming device placement. The TEE images increased operator confidence that the size and location of the device were appropriate before release despite the unusual position. This report highlights the benefit of intra-operative TEE, in particular real-time three-dimensional imaging, for successful PDA occlusion in a complicated case. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Loss of deuterium in faecal solids and by sequestration in reindeer: effect on doubly labelled water studies

    Directory of Open Access Journals (Sweden)

    Geir Gotaas

    2000-03-01

    Full Text Available An underlying assumption when estimating total energy expenditure (TEE using doubly labelled water (DLW is that the injected isotopes (lsO and 2H leave the body only in the form of CO, and H20. However, both isotopes have additional routes of loss. We quantified the loss of 2H (i attached to faecal solids and (ii by sequestration into newly synthesised fat in reindeer (Rangifer tarandus tarandus. Estimates of the errors caused by these processes were applied to data from DLW studies with reindeer in summer and in winter. Given the net rate of faecal dry matter output and lipid synthesis in the present study, ignoring both sources of error caused the TEE of reindeer to be underestimated by approximately 5% in winter and approximately 9% in summer. The separate effect of each source of error was evaluated in summer. If ignored, loss of 2H through sequestration alone caused TEE to be underestimated by approximately 3.7%. Similarly, if ignored, loss of 2H attached to faecal solids alone caused TEE to be underestimated by approximately 5.9%.

  14. Compensatory Changes in Energy Balance Regulation over One Athletic Season.

    Science.gov (United States)

    Silva, Analiza M; Matias, Catarina N; Santos, Diana A; Thomas, Diana; Bosy-Westphal, Anja; MüLLER, Manfred J; Heymsfield, Steven B; Sardinha, LUíS B

    2017-06-01

    Mechanisms in energy balance (EB) regulation may include compensatory changes in energy intake (EI) and metabolic adaption (MA), but information is unavailable in athletes who often change EB components. We aim to investigate EB regulation compensatory mechanisms over one athletic season. Fifty-seven athletes (39 males/18 females; handball, volleyball, basketball, triathlon, and swimming) were evaluated from the beginning to the competitive phase of the season. Resting and total energy expenditure (REE and TEE, respectively) were assessed by indirect calorimetry and doubly labeled water, respectively, and physical activity energy expenditure was determined as TEE - 0.1(TEE) - REE. Fat mass (FM) and fat-free mass (FFM) were evaluated by dual-energy x-ray absorptiometry and changed body energy stores was determined by 1.0(ΔFFM/Δtime) + 9.5(ΔFM/Δtime). EI was derived as TEE + EB. REE was predicted from baseline FFM, FM, sex, and sports. %MA was calculated as 100(measured REE/predicted REE-1) and MA (kcal) as %MA/100 multiplied by baseline measured REE. Average EI minus average physical activity energy expenditure was computed as a proxy of average energy availability, assuming that a constant nonexercise EE occurred over the season. Body mass increased by 0.8 ± 2.5 kg (P energy availability (r = 0.356 and r = 0.0644, respectively). TEE increased over the season without relevant mean changes in weight, suggesting that EI compensation likely occurred. The thrifty or spendthrift phenotypes observed among sports and the demanding workloads these athletes are exposed to highlight the need for sport-specific energy requirements.

  15. Under-reporting of food intake and body fatness in independent older people: a doubly labelled water study.

    Science.gov (United States)

    Pfrimer, Karina; Vilela, Mariana; Resende, Cristina Maria; Scagliusi, Fernanda Baeza; Marchini, Julio Sergio; Lima, Nereida K C; Moriguti, Julio Cesar; Ferriolli, Eduardo

    2015-01-01

    there are no accurate methods for the assessment of food intake in older populations, under-reporting of intake being highly prevalent. There is controversy about which dietary assessment method and what person's characteristics are associated with greater under-reporting rates. to assess the correlation between under-reporting of energy intake (EI) and different percentages of body fat in independent older people. cross-sectional study. area assisted by the Family Health Program of the Ribeirão Preto Medical School, University of São Paulo, Brazil. one hundred volunteers aged 60-70 years. all volunteers had their body composition assessed by dual-energy x-ray absorptiometry. In second phase, 41 volunteers were evaluated, representing the four quartiles of fat percentage. Total energy expenditure (TEE) was measured by the doubly labelled water method, and EI was assessed by 24-h recalls and a food frequency questionnaire (FFQ). TEE and EI values, EI-to-TEE ratios and EI-TEE values were compared. TEE was 2,220 ± 601 kcal, while the EI was 1,919 ± 602 kcal (24-h recall) and 2,119 ± 670 kcal (FFQ). The proportion of under-reporters was 31 and 40.5%, respectively. Under-reporting was more frequent in subjects with higher percentage of body fat and in females (P food intake. Older persons follow the same profile of under-reporting as younger adults. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Effect of Diet Composition on Energy Expenditure during Weight Loss: The POUNDS LOST Study

    Science.gov (United States)

    Bray, George A.; Smith, Steven R.; DeJonge, Lilian; de Souza, Russell; Rood, Jennifer; Champagne, Catherine M.; Laranjo, Nancy; Carey, Vincent; Obarzanek, Eva; Loria, Catherine M.; Anton, Stephen D.; Ryan, Donna H.; Greenway, Frank L.; Williamson, Donald; Sacks, Frank M.

    2011-01-01

    Background Weight loss reduces energy expenditure, but the contribution of different macronutrients to this change is unclear. Hypothesis We tested the hypothesis that macronutrient composition of the diet might affect the partitioning of energy expenditure during weight loss. Design A sub-study of 99 participants from the POUNDS LOST trial had total energy expenditure (TEE) measured by doubly labeled water and resting energy expenditure (REE) measured by indirect calorimetry at baseline and repeated at 6 months in 89 participants. Participants were randomly assigned to one of 4 diets with either 15% or 25% protein and 20% or 40% fat. Results TEE and REE were positively correlated with each other and with fat free mass and body fat, at baseline and 6 months. The average weight loss of 8.1±0.65 kg (LSmean±SE) reduced TEE by 120±56 kcal/d and REE by 136±18 kcal/d. A greater weight loss at 6 months was associated with a greater decrease in TEE and REE. Participants eating the high fat diet lost significantly more fat free mass (1.52±0.55 kg) than the low fat diet group (p<0.05). Participants eating the low fat diet had significantly higher measures of physical activity than the high fat group. Conclusion A greater weight loss was associated with a larger decrease in both TEE and REE. The low fat diet was associated with significant changes in fat free body mass and energy expenditure from physical activity compared to the high fat diet. PMID:21946707

  17. Jõekaldal Lasnamäel / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2006-01-01

    2006. aastal Berliini Tehnikaülikooli arhitektuurikateedri üheks edukamaks lõputööks osutunud Florian Bartholome ja Robert Ostmanni tööst "Tallinn - Lasnamäe", kus Laagna tee muudetakse jõeks, Laagna tee äärne ebasõbralik tsoon avalikuks puhkealaks jm. Projekt pälvis auhinna Rahvusvahelise Arhitektide Liidu (UIA) konkursil "Celebration of Cities 2" ja oli väljas Veneetsia arhitektuuribiennaalil

  18. Role of echocardiography for catheter-based management of valvular heart disease.

    Science.gov (United States)

    Shiota, Takahiro

    2017-01-01

    Catheter-based treatment of valvular heart disease, such as transvalvular aortic valve replacement (TAVR) or mitral clip procedure, has been increasingly accepted as a treatment choice for the past several years. Such new treatment options have been changing the management of patients with valvular heart disease drastically while socio-economic factors regarding their application need to be taken into consideration. The use of echocardiography, including transesophageal echocardiography (TEE), for such catheter-based treatments is essential for the success of the procedures. Severe hypotension after TAVR is a life-threatening emergency. Rapid assessment and diagnosis in the catheterization or hybrid laboratory is essential for safety and a positive outcome. Possible diagnoses in this critical situation would include severe left ventricular dysfunction due to coronary obstruction, cardiac tamponade, aortic rupture, acute severe aortic and/or mitral valve regurgitation, and hypovolemia due to bleeding. Although new types of TAVR valves reduce para-valvular aortic regurgitation (AR) significantly, it is still important to judge the severity of para-valvular AR correctly in the laboratory. As for mitral clip procedure, TEE is vital for guiding and monitoring the entire process. Accurate identification of the location and the geometry of the regurgitant orifice is necessary for proper placement of the clip. Real-time 3D TEE provides helpful en face view of the mitral valve and clip together to this end. Residual mitral regurgitation (MR) after the first clip is not uncommon. Quick and precise imaging of the residual MR (location and severity) with TEE is extremely important for the interventionist to place the second clip and possibly third clip properly. After the completion of the clip procedure, mitral valve stenosis and also iatrogenic atrial septal defect need to be checked by TEE. Echocardiography, especially TEE, is also vital for the success of other newer trans

  19. Intraoperative Diagnosis of Stanford Type A Dissection by Transesophageal Echocardiogram in a Patient Presenting for Renal Transplantation

    Directory of Open Access Journals (Sweden)

    William R. Hand

    2011-01-01

    Full Text Available A 48-year-old patient with hypertensive end-stage renal disease presented for cadaveric renal transplantation. On physical exam, a previously undocumented diastolic murmur was heard loudest at the left lower sternal border. The patient had a history of pericardial effusions and reported “a feeling of chest fullness” when lying flat. As such, a transesophageal echocardiogram (TEE was performed after induction of anesthesia to evaluate the pericardial space and possibly determine the etiology and severity of the new murmur. The TEE revealed a Stanford Type A aortic dissection. The renal transplant was cancelled (organ reassigned within region, and the patient underwent an urgent ascending and proximal hemiarch aortic replacement. This case demonstrates the importance of a thorough physical exam and highlights the utility of TEE for noncardiac surgical cases.

  20. Uued elamupiirkonnad / Lee Taal, Gea Velthut

    Index Scriptorium Estoniae

    Taal, Lee

    1998-01-01

    Lühiinfot: projektijuht, valmis elamud, infrastruktuur, arhitektuurne kontseptsioon, ehitajad, arhitektid jm. Maarjamäe elamupiirkond (AB Harmin, AB Urbel ja Peil, Alver Trummal Arhitektid), Vabaõhukooli tee asum (Künnapu & Padrik), Lepiku küla Kloostrimetsas /Lepiku Kinnisvarahooldus), Raudalu asum Viljandi mnt. ääres (R-Konsult, I. Raud), Kodu 2001 (Nordprojekt, Jaak Kruusmägi), Tiskre Haaberstis (Arhitektuuribüroo Alis), Randvere tee (Nordprojekt), Veskimöldre (Koot ja Koot).

  1. "Ülemiste" hotell Tallinnas : Lennujaama tee 2 = Ülemiste Hotel, Tallinn : Lennujaama tee 2 / Epp Lankots

    Index Scriptorium Estoniae

    Lankots, Epp, 1976-

    2005-01-01

    Arhitekt Martin Aunin, kes pälvis detailideni tervikliku ja peene materjalikäsitlusega arhitektuurse idee väljendamise eest "Ülemiste" hotelli loomisel Eesti Kultuurkapitali arhitektuuri sihtkapitali 2004. a. objektipreemia. 2004. a. parim betoonehitis. Ill.: 4 värv. välis- ja 4 sisevaadet

  2. Influence of the Quantity of Aortic Valve Calcium on the Agreement Between Automated 3-Dimensional Transesophageal Echocardiography and Multidetector Row Computed Tomography for Aortic Annulus Sizing.

    Science.gov (United States)

    Podlesnikar, Tomaz; Prihadi, Edgard A; van Rosendael, Philippe J; Vollema, E Mara; van der Kley, Frank; de Weger, Arend; Ajmone Marsan, Nina; Naji, Franjo; Fras, Zlatko; Bax, Jeroen J; Delgado, Victoria

    2018-01-01

    Accurate aortic annulus sizing is key for selection of appropriate transcatheter aortic valve implantation (TAVI) prosthesis size. The present study compared novel automated 3-dimensional (3D) transesophageal echocardiography (TEE) software and multidetector row computed tomography (MDCT) for aortic annulus sizing and investigated the influence of the quantity of aortic valve calcium (AVC) on the selection of TAVI prosthesis size. A total of 83 patients with severe aortic stenosis undergoing TAVI were evaluated. Maximal and minimal aortic annulus diameter, perimeter, and area were measured. AVC was assessed with computed tomography. The low and high AVC burden groups were defined according to the median AVC score. Overall, 3D TEE measurements slightly underestimated the aortic annulus dimensions as compared with MDCT (mean differences between maximum, minimum diameter, perimeter, and area: -1.7 mm, 0.5 mm, -2.7 mm, and -13 mm 2 , respectively). The agreement between 3D TEE and MDCT on aortic annulus dimensions was superior among patients with low AVC burden (AVC burden (≥3,025 arbitrary units). The interobserver variability was excellent for both methods. 3D TEE and MDCT led to the same prosthesis size selection in 88%, 95%, and 81% of patients in the total population, the low, and the high AVC burden group, respectively. In conclusion, the novel automated 3D TEE imaging software allows accurate and highly reproducible measurements of the aortic annulus dimensions and shows excellent agreement with MDCT to determine the TAVI prosthesis size, particularly in patients with low AVC burden. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  3. Patent foramen ovale: diagnosis with multidetector CT--comparison with transesophageal echocardiography.

    Science.gov (United States)

    Kim, Young Jin; Hur, Jin; Shim, Chi-Young; Lee, Hye-Jeong; Ha, Jong-Won; Choe, Kyu Ok; Heo, Ji Hoe; Choi, Eui-Young; Choi, Byoung Wook

    2009-01-01

    To evaluate the clinical feasibility and accuracy of 64-section multidetector computed tomography (CT) compared with transesophageal echocardiography (TEE) for diagnosis of a patent foramen ovale (PFO). Institutional review board approval was obtained for this retrospective study. The study included 152 consecutive stroke patients (mean age, 61.7 years; 98 men, 54 women) who underwent both cardiac multidetector CT and TEE. Electrocardiographically gated cardiac CT was performed with a 64-section CT scanner by using a saline-chaser contrast agent injection technique. A contrast agent jet from the contrast agent-filled left atrium (LA) to the saline-filled right atrium (RA) and channel-like appearance of the interatrial septum (IAS) were evaluated on axial and oblique sagittal CT images. Two-dimensional and Doppler TEE were performed to detect PFO. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT were obtained with TEE as the reference standard. A PFO was present in 26 patients at TEE. On CT images, a left-to-right contrast agent jet toward the inferior vena cava was noted in 21 patients (sensitivity, 73.1%; specificity, 98.4%; PPV, 90.5%; NPV, 94.7%). Channel-like appearance of the IAS was detected in 38 patients (sensitivity, 76.9%; specificity, 85.7%; PPV, 52.6%; NPV, 94.7%). Channel-like appearance of the IAS was noted in all patients who had a contrast agent jet. A contrast agent jet from LA to RA toward the inferior vena cava with channel-like appearance of the IAS on CT images confirms the presence of a PFO. (c) RSNA, 2008.

  4. A Mobile Phone App for Dietary Intake Assessment in Adolescents: An Evaluation Study.

    Science.gov (United States)

    Svensson, Åsa; Larsson, Christel

    2015-11-03

    There is a great need for dietary assessment methods that suit the adolescent lifestyle and give valid intake data. To develop a mobile phone app and evaluate its ability to assess energy intake (EI) and total energy expenditure (TEE) compared with objectively measured TEE. Furthermore, to investigate the impact of factors on reporting accuracy of EI, and to compare dietary intake with a Web-based method. Participants 14 to 16 years of age were recruited from year nine in schools in Gothenburg, Sweden. In total, 81 adolescents used the mobile phone app over 1 to 6 days. TEE was measured with the SenseWear Armband (SWA) during the same or proximate days. Individual factors were assessed with a questionnaire. A total of 15 participants also recorded dietary intake using a Web-based method. The mobile phone app underestimated EI by 29% on a group level (Pmobile phone app was 1.19 times the value of TEE measured by the SWA on a group level (Pmobile phone app stratified by gender showed that accuracy of the mobile phone app was higher among boys. EI, nutrients, and food groups assessed with the mobile phone app and Web-based method among 15 participants were not significantly different and several were significantly correlated, but strong conclusions cannot be drawn due to the low number of participants. By using a mobile phone dietary assessment app, on average 71% of adolescents' EI was captured. The accuracy of reported dietary intake was higher with lower BMI z-score and if a weekend day was included in the record. The daily question in the mobile phone app about physical activity could accurately rank the participants' TEE.

  5. A case difficult to diagnose in adults: High sinus venous atrial septal defect

    Directory of Open Access Journals (Sweden)

    Ozge Cetinarslan

    2018-01-01

    Full Text Available Sinus venous atrial septal defect (SVD is highly difficult to diagnose because of its location. Below, we report a case of SVD which is misdiagnosed as pulmonary hypertension and anomalous pulmonary venous return. A 57-year-old female patient was referred to congenital disease outpatient clinic of a tertiary center. She was admitted to the hospital with complaints of fatigue and exercise dyspnea which had started a year ago. She had transthoracic echocardiography (TTE examination done in another hospital which showed dilated right heart chambers and pulmonary hypertension. She underwent transesophageal echocardiography (TEE examination with the suspicion of atrial septal defect (ASD, but no defect was seen. As her symptoms persisted, we repeated the TTE and TEE examination in our center. TEE revealed 0.6 cm ASD on the upper side of the interatrial septum. All four pulmonary veins were draining into the left atrium. Right heart catheterization (RHC confirmed the diagnosis. A left-to-right shunt was detected and localized by a significant step-up in blood oxygen saturation found between mid and upper segments of the right atrium. According to our TEE and RHC results, we planned the surgical closure of the defect. Sinus venous ASD is deficiency of the superior portion of atrial septum adjacent to superior vena cava. Diagnosis of SVD is often more difficult than other forms of ASD and may require special imaging such as TEE, magnetic resonance imaging, or computed tomographic scanning. In conclusion, cardiologists must be aware about the possibility of SVD patients who have unexplained exertional dyspnea and fatigue, dilated right atrium and ventricle, pulmonary hypertension, paradoxical embolism, or atrial arrhythmias in their respective populations.

  6. A smartphone-driven methodology for estimating physical activities and energy expenditure in free living conditions.

    Science.gov (United States)

    Guidoux, Romain; Duclos, Martine; Fleury, Gérard; Lacomme, Philippe; Lamaudière, Nicolas; Manenq, Pierre-Henri; Paris, Ludivine; Ren, Libo; Rousset, Sylvie

    2014-12-01

    This paper introduces a function dedicated to the estimation of total energy expenditure (TEE) of daily activities based on data from accelerometers integrated into smartphones. The use of mass-market sensors such as accelerometers offers a promising solution for the general public due to the growing smartphone market over the last decade. The TEE estimation function quality was evaluated using data from intensive numerical experiments based, first, on 12 volunteers equipped with a smartphone and two research sensors (Armband and Actiheart) in controlled conditions (CC) and, then, on 30 other volunteers in free-living conditions (FLC). The TEE given by these two sensors in both conditions and estimated from the metabolic equivalent tasks (MET) in CC served as references during the creation and evaluation of the function. The TEE mean gap in absolute value between the function and the three references was 7.0%, 16.4% and 2.7% in CC, and 17.0% and 23.7% according to Armband and Actiheart, respectively, in FLC. This is the first step in the definition of a new feedback mechanism that promotes self-management and daily-efficiency evaluation of physical activity as part of an information system dedicated to the prevention of chronic diseases. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Early thromboembolic events ≤1week after fast-track total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    characteristics, complete follow-up through the Danish National Patient Register, and detailed evaluation on disposing factors and consequences of "early" TEEs through review of medical records. RESULTS: In 13,775 procedures with a median LOS of 2days, 43 (0.32%; 95% CI: 0.23-0.42) "early" and 90 (0.65%; 95% CI...... reduced by improving perioperative treatment of anemia. Further research is needed regarding interventions for prevention of "early" TEE in disposed patients....

  8. Diagnosis of cardiac tamponade with transesophageal echocardiography following the induction of anesthesia for suspected testicular torsion

    Directory of Open Access Journals (Sweden)

    Stephen M McHugh

    2015-01-01

    Full Text Available Transesophageal echocardiography (TEE is a valuable tool for evaluating hemodynamic instability in patients under general anesthesia. We present the case of a 28-year-old man who presented with complaints of testicular pain concerning for testicular torsion. After induction of general anesthesia for scrotal exploration and possible orchiopexy, the patient developed severe and persistent hypotension. Using intraoperative TEE, the diagnosis of pericardial tamponade was made, and an emergent pericardial window was performed.

  9. Tc-99m-HMPAO-Labeled leukocyte SPECT/CT in pediatrics: detecting Candida albicans tricuspid endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Calais, Jeremie; Edet-Sanson, Agathe; Gaucher, Stephane; Vera, Pierre; Cloirec, Joseph Le [Henri Becquerel Cancer Center and Rouen Univ. Hospital, Rouen (France)

    2015-12-15

    These results led to performing TEE, which showed tricuspid vegetation. Blood cultures were then positive to Candida albicans. Control blood cultures and TEE performed 6 weeks later after adapted antifungal therapy remained negative. In accordance with the results of Erba and al., this case illustrates the usefulness of late thoracic SPECT-CT acquisition of a WBC scan in a patient with high clinical suspicion of endocarditis and identified risk factors but inconclusive echocardiographic findings.

  10. Tc-99m-HMPAO-Labeled leukocyte SPECT/CT in pediatrics: detecting Candida albicans tricuspid endocarditis

    International Nuclear Information System (INIS)

    Calais, Jeremie; Edet-Sanson, Agathe; Gaucher, Stephane; Vera, Pierre; Cloirec, Joseph Le

    2015-01-01

    These results led to performing TEE, which showed tricuspid vegetation. Blood cultures were then positive to Candida albicans. Control blood cultures and TEE performed 6 weeks later after adapted antifungal therapy remained negative. In accordance with the results of Erba and al., this case illustrates the usefulness of late thoracic SPECT-CT acquisition of a WBC scan in a patient with high clinical suspicion of endocarditis and identified risk factors but inconclusive echocardiographic findings

  11. Comparing Methods for Cardiac Output: Intraoperatively Doppler-Derived Cardiac Output Measured With 3-Dimensional Echocardiography Is Not Interchangeable With Cardiac Output by Pulmonary Catheter Thermodilution.

    Science.gov (United States)

    Graeser, Karin; Zemtsovski, Mikhail; Kofoed, Klaus F; Winther-Jensen, Matilde; Nilsson, Jens C; Kjaergaard, Jesper; Møller-Sørensen, Hasse

    2018-01-09

    Estimation of cardiac output (CO) is essential in the treatment of circulatory unstable patients. CO measured by pulmonary artery catheter thermodilution is considered the gold standard but carries a small risk of severe complications. Stroke volume and CO can be measured by transesophageal echocardiography (TEE), which is widely used during cardiac surgery. We hypothesized that Doppler-derived CO by 3-dimensional (3D) TEE would agree well with CO measured with pulmonary artery catheter thermodilution as a reference method based on accurate measurements of the cross-sectional area of the left ventricular outflow tract. The primary aim was a systematic comparison of CO with Doppler-derived 3D TEE and CO by thermodilution in a broad population of patients undergoing cardiac surgery. A subanalysis was performed comparing cross-sectional area by TEE with cardiac computed tomography (CT) angiography. Sixty-two patients, scheduled for elective heart surgery, were included; 1 was subsequently excluded for logistic reasons. Inclusion criteria were coronary artery bypass surgery (N = 42) and aortic valve replacement (N = 19). Exclusion criteria were chronic atrial fibrillation, left ventricular ejection fraction below 0.40 and intracardiac shunts. Nineteen randomly selected patients had a cardiac CT the day before surgery. All images were stored for blinded post hoc analyses, and Bland-Altman plots were used to assess agreement between measurement methods, defined as the bias (mean difference between methods), limits of agreement (equal to bias ± 2 standard deviations of the bias), and percentage error (limits of agreement divided by the mean of the 2 methods). Precision was determined for the individual methods (equal to 2 standard deviations of the bias between replicate measurements) to determine the acceptable limits of agreement. We found a good precision for Doppler-derived CO measured by 3D TEE, but although the bias for Doppler-derived CO by 3D compared to

  12. Validity and reliability of GPS and LPS for measuring distances covered and sprint mechanical properties in team sports.

    Science.gov (United States)

    Hoppe, Matthias W; Baumgart, Christian; Polglaze, Ted; Freiwald, Jürgen

    2018-01-01

    This study aimed to investigate the validity and reliability of global (GPS) and local (LPS) positioning systems for measuring distances covered and sprint mechanical properties in team sports. Here, we evaluated two recently released 18 Hz GPS and 20 Hz LPS technologies together with one established 10 Hz GPS technology. Six male athletes (age: 27±2 years; VO2max: 48.8±4.7 ml/min/kg) performed outdoors on 10 trials of a team sport-specific circuit that was equipped with double-light timing gates. The circuit included various walking, jogging, and sprinting sections that were performed either in straight-lines or with changes of direction. During the circuit, athletes wore two devices of each positioning system. From the reported and filtered velocity data, the distances covered and sprint mechanical properties (i.e., the theoretical maximal horizontal velocity, force, and power output) were computed. The sprint mechanical properties were modeled via an inverse dynamic approach applied to the center of mass. The validity was determined by comparing the measured and criterion data via the typical error of estimate (TEE), whereas the reliability was examined by comparing the two devices of each technology (i.e., the between-device reliability) via the coefficient of variation (CV). Outliers due to measurement errors were statistically identified and excluded from validity and reliability analyses. The 18 Hz GPS showed better validity and reliability for determining the distances covered (TEE: 1.6-8.0%; CV: 1.1-5.1%) and sprint mechanical properties (TEE: 4.5-14.3%; CV: 3.1-7.5%) than the 10 Hz GPS (TEE: 3.0-12.9%; CV: 2.5-13.0% and TEE: 4.1-23.1%; CV: 3.3-20.0%). However, the 20 Hz LPS demonstrated superior validity and reliability overall (TEE: 1.0-6.0%; CV: 0.7-5.0% and TEE: 2.1-9.2%; CV: 1.6-7.3%). For the 10 Hz GPS, 18 Hz GPS, and 20 Hz LPS, the relative loss of data sets due to measurement errors was 10.0%, 20.0%, and 15.8%, respectively. This study shows that

  13. Estimation of Free-Living Energy Expenditure by Heart Rate and Movement Sensing: A Doubly-Labelled Water Study.

    Directory of Open Access Journals (Sweden)

    Søren Brage

    Full Text Available Accurate assessment of energy expenditure (EE is important for the study of energy balance and metabolic disorders. Combined heart rate (HR and acceleration (ACC sensing may increase precision of physical activity EE (PAEE which is the most variable component of total EE (TEE.To evaluate estimates of EE using ACC and HR data with or without individual calibration against doubly-labelled water (DLW estimates of EE.23 women and 23 men (22-55 yrs, 48-104 kg, 8-46%body fat underwent 45-min resting EE (REE measurement and completed a 20-min treadmill test, an 8-min step test, and a 3-min walk test for individual calibration. ACC and HR were monitored and TEE measured over 14 days using DLW. Diet-induced thermogenesis (DIT was calculated from food-frequency questionnaire. PAEE (TEE ÷ REE ÷ DIT and TEE were compared to estimates from ACC and HR using bias, root mean square error (RMSE, and correlation statistics.Mean(SD measured PAEE and TEE were 66(25 kJ·day(-1·kg(-1, and 12(2.6 MJ·day(-1, respectively. Estimated PAEE from ACC was 54(15 kJ·day(-1·kg(-1 (p<0.001, with RMSE 24 kJ·day(-1·kg(-1 and correlation r = 0.52. PAEE estimated from HR and ACC+HR with treadmill calibration were 67(42 and 69(25 kJ·day(-1·kg(-1 (bias non-significant, with RMSE 34 and 20 kJ·day(-1·kg(-1 and correlations r = 0.58 and r = 0.67, respectively. Similar results were obtained with step-calibrated and walk-calibrated models, whereas non-calibrated models were less precise (RMSE: 37 and 24 kJ·day(-1·kg(-1, r = 0.40 and r = 0.55. TEE models also had high validity, with biases <5%, and correlations r = 0.71 (ACC, r = 0.66-0.76 (HR, and r = 0.76-0.83 (ACC+HR.Both accelerometry and heart rate may be used to estimate EE in adult European men and women, with improved precision if combined and if heart rate is individually calibrated.

  14. Integrated Circuit Immunity

    Science.gov (United States)

    Sketoe, J. G.; Clark, Anthony

    2000-01-01

    This paper presents a DOD E3 program overview on integrated circuit immunity. The topics include: 1) EMI Immunity Testing; 2) Threshold Definition; 3) Bias Tee Function; 4) Bias Tee Calibration Set-Up; 5) EDM Test Figure; 6) EMI Immunity Levels; 7) NAND vs. and Gate Immunity; 8) TTL vs. LS Immunity Levels; 9) TP vs. OC Immunity Levels; 10) 7805 Volt Reg Immunity; and 11) Seventies Chip Set. This paper is presented in viewgraph form.

  15. Differentiation of thrombus from pannus as the cause of acquired mechanical prosthetic heart valve obstruction by non-invasive imaging: a review of the literature.

    Science.gov (United States)

    Tanis, Wilco; Habets, Jesse; van den Brink, Renee B A; Symersky, Petr; Budde, Ricardo P J; Chamuleau, Steven A J

    2014-02-01

    For acquired mechanical prosthetic heart valve (PHV) obstruction and suspicion on thrombosis, recently updated European Society of Cardiology guidelines advocate the confirmation of thrombus by transthoracic echocardiography, transesophageal echocardiography (TEE), and fluoroscopy. However, no evidence-based diagnostic algorithm is available for correct thrombus detection, although this is clinically important as fibrinolysis is contraindicated in non-thrombotic obstruction (isolated pannus). Here, we performed a review of the literature in order to propose a diagnostic algorithm. We performed a systematic search in Pubmed and Embase. Included publications were assessed on methodological quality based on the validated Quality Assessment of Diagnostic Accuracy Studies (QUADAS) II checklist. Studies were scarce (n = 15) and the majority were of moderate methodological quality. In total, 238 mechanical PHV's with acquired obstruction and a reliable reference standard were included for the evaluation of the role of fluoroscopy, echocardiography, or multidetector-row computed tomography (MDCT). In acquired PHV obstruction caused by thrombosis, mass detection by TEE and leaflet restriction detected by fluoroscopy were observed in the majority of cases (96 and 100%, respectively). In contrast, in acquired PHV obstruction free of thrombosis (pannus), leaflet restriction detected by fluoroscopy was absent in some cases (17%) and mass detection by TEE was absent in the majority of cases (66%). In case of mass detection by TEE, predictors for obstructive thrombus masses (compared with pannus masses) were leaflet restriction, soft echo density, and increased mass length. In situations of inconclusive echocardiography, MDCT may correctly detect pannus/thrombus based on the morphological aspects and localization. In acquired mechanical PHV obstruction without leaflet restriction and absent mass on TEE, obstructive PHV thrombosis cannot be confirmed and consequently, fibrinolysis

  16. Comparison of a web-based food record tool and a food-frequency questionnaire and objective validation using the doubly labelled water technique in a Swedish middle-aged population.

    Science.gov (United States)

    Nybacka, Sanna; Bertéus Forslund, Heléne; Wirfält, Elisabet; Larsson, Ingrid; Ericson, Ulrika; Warensjö Lemming, Eva; Bergström, Göran; Hedblad, Bo; Winkvist, Anna; Lindroos, Anna Karin

    2016-01-01

    Two web-based dietary assessment tools have been developed for use in large-scale studies: the Riksmaten method (4-d food record) and MiniMeal-Q (food-frequency method). The aim of the present study was to examine the ability of these methods to capture energy intake against objectively measured total energy expenditure (TEE) with the doubly labelled water technique (TEE DLW ), and to compare reported energy and macronutrient intake. This study was conducted within the pilot study of the Swedish CArdioPulmonary bioImage Study (SCAPIS), which included 1111 randomly selected men and women aged 50-64 years from the Gothenburg general population. Of these, 200 were enrolled in the SCAPIS diet substudy. TEE DLW was measured in a subsample ( n 40). Compared with TEE DLW , both methods underestimated energy intake: -2·5 (sd  2·9) MJ with the Riksmaten method; -2·3 (sd 3·6) MJ with MiniMeal-Q. Mean reporting accuracy was 80 and 82 %, respectively. The correlation between reported energy intake and TEE DLW was r 0·4 for the Riksmaten method ( P  < 0·05) and r 0·28 (non-significant) for MiniMeal-Q. Women reported similar average intake of energy and macronutrients in both methods whereas men reported higher intakes with the Riksmaten method. Energy-adjusted correlations ranged from 0·14 (polyunsaturated fat) to 0·77 (alcohol). Bland-Altman plots showed acceptable agreement for energy and energy-adjusted protein and carbohydrate intake, whereas the agreement for fat intake was poorer. According to energy intake data, both methods displayed similar precision on energy intake reporting. However, MiniMeal-Q was less successful in ranking individuals than the Riksmaten method. The development of methods to achieve limited under-reporting is a major challenge for future research.

  17. A Mobile Phone App for Dietary Intake Assessment in Adolescents: An Evaluation Study

    Science.gov (United States)

    Svensson, Åsa

    2015-01-01

    Background There is a great need for dietary assessment methods that suit the adolescent lifestyle and give valid intake data. Objective To develop a mobile phone app and evaluate its ability to assess energy intake (EI) and total energy expenditure (TEE) compared with objectively measured TEE. Furthermore, to investigate the impact of factors on reporting accuracy of EI, and to compare dietary intake with a Web-based method. Methods Participants 14 to 16 years of age were recruited from year nine in schools in Gothenburg, Sweden. In total, 81 adolescents used the mobile phone app over 1 to 6 days. TEE was measured with the SenseWear Armband (SWA) during the same or proximate days. Individual factors were assessed with a questionnaire. A total of 15 participants also recorded dietary intake using a Web-based method. Results The mobile phone app underestimated EI by 29% on a group level (Pphone app was 1.19 times the value of TEE measured by the SWA on a group level (Pphone app stratified by gender showed that accuracy of the mobile phone app was higher among boys. EI, nutrients, and food groups assessed with the mobile phone app and Web-based method among 15 participants were not significantly different and several were significantly correlated, but strong conclusions cannot be drawn due to the low number of participants. Conclusions By using a mobile phone dietary assessment app, on average 71% of adolescents’ EI was captured. The accuracy of reported dietary intake was higher with lower BMI z-score and if a weekend day was included in the record. The daily question in the mobile phone app about physical activity could accurately rank the participants’ TEE. PMID:26534783

  18. Tee või seek? / Andri Ksenofontov

    Index Scriptorium Estoniae

    Ksenofontov, Andri, 1962-

    1999-01-01

    Ajaloolise Jaani seegi kvartali saatusest ئ kas ehitada läbi selle Tartu maantee pikendus, mis säilitaks kvartalist vaid kiriku. Olukorda valgustab muinsuskaitseinspektor A. Ksenofontov, kes on läbimurde vastu ning leiab, et ajaloolise linnaosa ruumi lõhkumisega ei parane Tallinna liiklusolud. Tallinna seegi (Jaani hospidali) ajaloost.

  19. Eesti poiste Kolgata tee / Mati Mandel

    Index Scriptorium Estoniae

    Mandel, Mati, 1945-

    2008-01-01

    Rets. rmt.: Korpusepoisid : Eesti sõjamehed 22. eesti territoriaalkorpuses ja 8. eesti laskurkorpuses Teises maailmasõjas aastatel 1940-45. Tallinn : Eesti Akadeemiline Sõjaajaloo Selts : Sentinel, 2007

  20. Detection of left atrial thrombus in patients with mitral stenosis and atrial fibrillation: retrospective comparison of two-phase computed tomography, transoesophageal echocardiography and surgical findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Hwa; Ko, Sung Min [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Radiology, Research Institute of Medical Science, Seoul (Korea, Republic of); Hwang, Hweung Kon [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Cardiology, Seoul (Korea, Republic of); Song, Meong Gun; Shin, Je Kyoun [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Thoracic surgery, Seoul (Korea, Republic of); Kang, Woon Seok; Kim, Tae-Yop [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Anesthesiology, Seoul (Korea, Republic of)

    2013-11-15

    This retrospective study aims to assess the accuracy of two-phase computed tomography (CT) and transoesophageal echocardiography (TEE) for the detection of left atrial (LA) thrombus in patients with mitral stenosis (MS) and atrial fibrillation (AF), by using intraoperative findings as the reference standard. Preoperative two-phase CT and intraoperative TEE were performed in 106 patients with MS and AF. The ratio (LAA/AA{sub L}) of Hounsfield units (HU) in the LA appendage (LAA) to the ascending aorta (AA) was calculated on the late-phase CT image. LA echodense masses on TEE and LA filling defects on two-phase CT were observed in 29 and 39 patients, respectively. Thirty-five LA thrombi were identified at surgery in 27 patients. Compared with the intraoperative findings, per-patient sensitivity, specificity, positive and negative predictive values of two-phase CT were 100 %, 85 %, 69 % and 100 %, and those by using TEE were 93 %, 95 %, 86 % and 97 % in detecting LAA thrombus. After adopting the cut-off value of 0.5 for the LAA/AA{sub L} HU ratio, the specificity and positive predictive value of two-phase CT were increased to 96 % and 90 %, respectively. Two-phase CT with a cut-off value of LAA/AA{sub L} HU ratio of 0.5 provides high performance for the detection of LAA thrombus. (orig.)

  1. Novel imaging strategies for the detection of prosthetic heart valve obstruction and endocarditis.

    Science.gov (United States)

    Tanis, W; Budde, R P J; van der Bilt, I A C; Delemarre, B; Hoohenkerk, G; van Rooden, J-K; Scholtens, A M; Habets, J; Chamuleau, S

    2016-02-01

    Prosthetic heart valve (PHV) dysfunction remains difficult to recognise correctly by two-dimensional (2D) transthoracic and transoesophageal echocardiography (TTE/TEE). ECG-triggered multidetector-row computed tomography (MDCT), 18-fluorine-fluorodesoxyglucose positron emission tomography including low-dose CT (FDG-PET) and three-dimensional transoesophageal echocardiography (3D-TEE) may have additional value. This paper reviews the role of these novel imaging tools in the field of PHV obstruction and endocarditis.For acquired PHV obstruction, MDCT is of additional value in mechanical PHVs to differentiate pannus from thrombus as well as to dynamically study leaflet motion and opening/closing angles. For biological PHV obstruction, additional imaging is not beneficial as it does not change patient management. When performed on top of 2D-TTE/TEE, MDCT has additional value for the detection of both vegetations and pseudoaneurysms/abscesses in PHV endocarditis. FDG-PET has no complementary value for the detection of vegetations; however, it appears more sensitive in the early detection of pseudoaneurysms/abscesses. Furthermore, FDG-PET enables the detection of metastatic and primary extra-cardiac infections. Evidence for the additional value of 3D-TEE is scarce.As clinical implications are major, clinicians should have a low threshold to perform additional MDCT in acquired mechanical PHV obstruction. For suspected PHV endocarditis, both FDG-PET and MDCT have complementary value.

  2. Aortic annulus and ascending aorta: Comparison of preoperative and periooperative measurement in patients with aortic stenosis

    International Nuclear Information System (INIS)

    Smid, Michal; Ferda, Jiri; Baxa, Jan; Cech, Jakub; Hajek, Tomas; Kreuzberg, Boris; Rokyta, Richard

    2010-01-01

    Background: Precise determination of the aortic annulus size constitutes an integral part of the preoperative evaluation prior to aortic valve replacement. It enables the estimation of the size of prosthesis to be implanted. Knowledge of the size of the ascending aorta is required in the preoperative analysis and monitoring of its dilation enables the precise timing of the operation. Our goal was to compare the precision of measurement of the aortic annulus and ascending aorta using magnetic resonance (MR), multidetector-row computed tomography (MDCT), transthoracic echocardiography (TTE), and transoesophageal echocardiography (TEE) in patients with degenerative aortic stenosis. Methods and results: A total of 15 patients scheduled to have aortic valve replacement were enrolled into this prospective study. TTE was performed in all patients and was supplemented with TEE, CT and MR in the majority of patients. The values obtained were compared with perioperative measurements. For the measurement of aortic annulus, MR was found to be the most precise technique, followed by MDCT, TTE, and TEE. For the measurement of ascending aorta, MR again was found to be the most precise technique, followed by MDCT, TEE, and TTE. Conclusion: In our study, magnetic resonance was found to be the most precise technique for the measurement of aortic annulus and ascending aorta in patients with severe degenerative aortic stenosis.

  3. Oxyresveratrol, a Stilbene Compound from Morus alba L. Twig Extract Active Against Trichophyton rubrum.

    Science.gov (United States)

    Lu, Hai-Peng; Jia, Ya-Nan; Peng, Ya-Lin; Yu, Yan; Sun, Si-Long; Yue, Meng-Ting; Pan, Min-Hui; Zeng, Ling-Shu; Xu, Li

    2017-12-01

    Morus alba L. (mulberry) twig is known to have an inhibitory effect on pathogens in traditional Chinese medicine. In the present study, the dermophytic fungus, Trichophyton rubrum, was used to evaluate the inhibitory effect of total M. alba twig extract and extracts obtained using solvents with different polarities by the method of 96-well MTT colorimetry. The main active substance was isolated and identified by tracking its activity. In addition, the inhibitory effects of active extracts and a single active substance were investigated in combination with miconazole nitrate. Our data indicated that ethyl acetate extracts of mulberry twig (TEE) exhibited a desired inhibitory activity on T. rubrum with the minimum inhibitory concentration (MIC) of 1.000 mg/mL. With activity tracking, the main substance showing antimicrobial activity was oxyresveratrol (OXY), which was isolated from TEE. Its MIC for inhibiting the growth of T. rubrum was 0.500 mg/mL. The combined use of miconazole nitrate and OXY showed a synergistic inhibitory effect, as shown by a significant decrease in the MIC of both components. Based on the OXY content in TEE, the contribution rate of OXY to the inhibitory effect of TEE on T. rubrum was 80.52%, so it was determined to be the main antimicrobial substance in M. alba twig. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Noninvasive Hemodynamic Measurements During Neurosurgical Procedures in Sitting Position.

    Science.gov (United States)

    Schramm, Patrick; Tzanova, Irene; Gööck, Tilman; Hagen, Frank; Schmidtmann, Irene; Engelhard, Kristin; Pestel, Gunther

    2017-07-01

    Neurosurgical procedures in sitting position need advanced cardiovascular monitoring. Transesophageal echocardiography (TEE) to measure cardiac output (CO)/cardiac index (CI) and stroke volume (SV), and invasive arterial blood pressure measurements for systolic (ABPsys), diastolic (ABPdiast) and mean arterial pressure (MAP) are established monitoring technologies for these kind of procedures. A noninvasive device for continuous monitoring of blood pressure and CO based on a modified Penaz technique (volume-clamp method) was introduced recently. In the present study the noninvasive blood pressure measurements were compared with invasive arterial blood pressure monitoring, and the noninvasive CO monitoring to TEE measurements. Measurements of blood pressure and CO were performed in 35 patients before/after giving a fluid bolus and a change from supine to sitting position, start of surgery, and repositioning from sitting to supine at the end of surgery. Data pairs from the noninvasive device (Nexfin HD) versus arterial line measurements (ABPsys, ABPdiast, MAP) and versus TEE (CO, CI, SV) were compared using Bland-Altman analysis and percentage error. All parameters compared (CO, CI, SV, ABPsys, ABPdiast, MAP) showed a large bias and wide limits of agreement. Percentage error was above 30% for all parameters except ABPsys. The noninvasive device based on a modified Penaz technique cannot replace arterial blood pressure monitoring or TEE in anesthetized patients undergoing neurosurgery in sitting position.

  5. Role of Negative Trans-Thoracic Echocardiography in the Diagnosis of Infective Endocarditis.

    Science.gov (United States)

    Leitman, Marina; Peleg, Eli; Shmueli, Ruthie; Vered, Zvi

    2016-07-01

    The search for the presence of vegetations in patients with suspected infective endocarditis is a major indication for trans-esophageal echocardiographic (TEE) examinations. Advances in harmonic imaging and ongoing improvement in modern echocardiographic systems allow adequate quality of diagnostic images in most patients. To investigate whether TEE examinations are always necessary for the assessment of patients with suspected infective endocarditis. During 2012-2014 230 trans-thoracic echo (TTE) exams in patients with suspected infective endocarditis were performed at our center. Demographic, epidemiological, clinical and echocardiographic data were collected and analyzed, and the final clinical diagnosis and outcome were determined. Of 230 patients, 24 had definite infective endocarditis by clinical assessment. TEE examination was undertaken in 76 of the 230 patients based on the clinical decision of the attending physician. All TTE exams were classified as: (i) positive, i.e., vegetations present; (ii) clearly negative; or (iii) non-conclusive. Of the 92 with clearly negative TTE exams, 20 underwent TEE and all were negative. All clearly negative patients had native valves, adequate quality images, and in all 92 the final diagnosis was not infective endocarditis. Thus, the negative predictive value of a clearly negative TTE examination was 100%. In patients with native cardiac valves referred for evaluation for infective endocarditis, an adequate quality TTE with clearly negative examination may be sufficient for the diagnosis.

  6. The analysis of transesophageal oxygen saturation photoplethysmography from different signal sources.

    Science.gov (United States)

    Mou, Ling; Gong, Quan; Wei, Wei; Gao, Bo

    2013-06-01

    The photoplethysmography (PPG) signals detected by transesophageal oximetry sensor toward aorta arch (AA), descending aorta (DA), and left ventricle (LV) under the guidance of transesophageal echocardiography (TEE) were investigated, and the effects of filter application on PPG signals were evaluated. Eleven cardiac surgical patients were involved. After anesthesia was induced, the TEE probe with a modified pulse oximetry sensor was inserted. Under the guidance of TEE, the AA PPG, DA PPG and LV PPG were detected respectively when ventilator was on and off. The mean alternating current (AC) amplitudes and direct current (DC) values of original and filtered PPG signals were measured. The ratio of AC and DC value (AC/DC) and ventilation-induced AC variations were calculated. Satisfactory PPG waveforms were obtained in all patients under the guidance of TEE. The AC amplitude in LV PPG was significant larger than in AA and DA PPG, and both AC/DC and ventilation-induced AC variation in LV PPG were significantly higher than in AA PPG or DA PPG either. There were no significant differences of AC amplitude between filtered and ventilation off PPG signals. The AC amplitudes and AC/DC toward LV are significantly higher than transesophageal oximeter toward AA or DA, and the effect of mechanical ventilation on transesophageal PPG can be obviously reduced by filtering techniques.

  7. Temporo-mandibular joint dislocation: an unusual complication of transoesophageal echocardiography.

    Science.gov (United States)

    Anantharam, Brijesh; Chahal, Navtej; Stephens, Nigel; Senior, Roxy

    2010-03-01

    Temporo-mandibular joint (TMJ) dislocation is an unusual complication of transoesophageal echocardiography (TEE). We report a rare case of bilateral TMJ dislocation in an 84-year-old man prior to DC cardioversion (DCCV) for atrial flutter. Shortly after TEE and DCCV, the patient complained of bilateral facial pain. An orthopantomogram revealed bilateral TMJ dislocation. A closed reduction was performed by maxillo-facial surgeons under intravenous anaesthesia. Although very uncommon, the physician should be aware of the complication and its management.

  8. Measurement of energy expenditure in healthy male adults using [14C] bicarbonate

    International Nuclear Information System (INIS)

    Luscombe, N.; Tsopelas, C.; Kirkwood, I.; Bellon, M.; Wittert, G.; Royal Adelaide Hospital, Adelaide, SA

    2003-01-01

    Full text: The use of double-labelled water (3HH 18 O) to measure total energy expenditure (TEE) in free-living humans is expensive and requires access to a mass spectrometer. A 48-hour infusion of [ 14 C]-bicarbonate with the measurement of [ 14 C]-carbon dioxide ( 14 CO 2 ) after urease digestion of the urine, has been shown to produce comparable results to whole body calorimetry. We have used [ 14 C]-bicarbonate to measure TEE and determined (i) it's comparability with the Schofield equation and (ii) the reproducibility of repeated measurements within an individual. On two occasions ∼ 14 days apart, measurements of TEE, resting metabolic rate (RMR), respiratory quotient (RQ), energy intake, food quotient (FQ) and physical activity were made in eight healthy men (age 50 ± 3 yrs, wt 79 ± 3 kg, BMI 26 ± 1 kg/m2, fat mass 22.7 ± 2.5 kg, lean mass 56.5 ± 2.4 kg). Samples of each subjects' urine (collected for two consecutive 24 hour periods) were assayed in triplicate. RMR and RQ were determined by indirect calorimetry. Diet and activity patterns were recorded for four days during the infusion, and were analysed to determine energy intake and activity levels. There were no significant differences in any of the variables on the two study days. Data are expressed as mean ± SE. The coefficient of variation (CV) for the 14 CO 2 assay (within-assay CV) was 4.1 ± 0.4% (range 1.7 - 7.5%). The variation for the subjects between study days was 5.1 ± 0.9% (range 0.9 - 9.2%). TEE measured by 14 CO 2 (16,200 ± 780 KJ/day; range 13,400 - 19,387 KJ/day) was greater (14.7 ± 9% (% mean absolute difference ranged from -24.6 to 0.8%)) than the Schofield estimate of TEE (13,800 ± 710 KJ/day; range 12,100-15,500 KJ/day); the group means were significantly different (95% limits of agreement, T = 3.8, P = 0.007). Energy intake was 10,700 ± 535 KJ/day (range 7,970 - 12,600 KJ/day). Fasting RQ was 0.81 ± 0.01 (range 0.78 - 0.88), FQ was 0.84 ± 0.01 (range 0.78 - 0.87), and

  9. Prosthetic tricuspid valve dysfunction assessed by three-dimensional transthoracic and transesophageal echocardiography.

    Science.gov (United States)

    Yuasa, Toshinori; Takasaki, Kunitsugu; Mizukami, Naoko; Ueya, Nami; Kubota, Kayoko; Horizoe, Yoshihisa; Chaen, Hideto; Kuwahara, Eiji; Kisanuki, Akira; Hamasaki, Shuichi

    2013-09-01

    A 39-year-old male who had undergone tricuspid valve replacement for severe tricuspid regurgitation was admitted with palpitation and general edema. Two-dimensional (2D) echocardiography showed tricuspid prosthetic valve dysfunction. Additional three-dimensional (3D) transthoracic and transesophageal echocardiography (TEE) could clearly demonstrate the disabilities of the mechanical tricuspid valve. Particularly, 3D TEE demonstrated a mass located on the right ventricular side of the tricuspid prosthesis, which may have caused the stuck disk. This observation was confirmed by intra-operative findings.

  10. Feasibility of transesophageal echocardiography in birds without cardiac disease.

    Science.gov (United States)

    Beaufrère, Hugues; Pariaut, Romain; Nevarez, Javier G; Tully, Thomas N

    2010-03-01

    To establish a technique of transesophageal echocardiography (TEE) in birds without cardiac disease and describe the imaging planes obtained. Validation study. 18 birds including 3 pigeons (Columbia livia), 3 barred owls (Strix varia), 2 red-tailed hawks (Buteo jamaicensis), 1 goose (Anser anser), 1 mallard duck (Anas platyrhynchos), 1 Muscovy duck (Cairina moschata), 2 brown pelicans (Pelecanus occidentalis), 2 Hispaniolan Amazon parrots (Amazona ventralis), 2 red-fronted macaws (Ara rubrogenys), and 1 military macaw (Ara militaris). For each bird, anesthesia was induced and maintained by use of isoflurane. A pediatric, multiplane transesophageal ultrasound probe was passed into the esophagus and adjusted to the level of the heart for echocardiography. Probe positions were recorded via fluoroscopy, and associated imaging planes were described. TEE was performed successfully in all birds except the pelicans, 1 Hispaniolan Amazon parrot, and the red-fronted macaws. Five imaging planes of the heart were consistently viewed from 3 positions of the probe (identified as caudal, middle, and cranial positions relative to the cardiac silhouette). M-mode echocardiography of the left ventricle and the aortic root was performed. Color flow and spectral Doppler ultrasonographic images of in- and outflow regions were obtained. One Hispaniolan Amazon parrot died as a result of esophageal perforation. TEE examination of birds was feasible and provided a larger number of imaging planes with better resolution and details than those typically achieved via a transcoelomic approach. However, TEE should be performed with caution in psittacines.

  11. Patent foramen ovale and atrial septal aneurysm can cause ischemic stroke in patients with antiphospholipid syndrome.

    Science.gov (United States)

    Tanaka, Yasutaka; Ueno, Yuji; Miyamoto, Nobukazu; Shimada, Yoshiaki; Tanaka, Ryota; Hattori, Nobutaka; Urabe, Takao

    2013-01-01

    The purpose of the present study was to evaluate the contributions of embolic etiologies, patent foramen ovale (PFO) and atrial septal aneurysm (ASA) to the pathogenesis of ischemic stroke in patients with antiphospholipid syndrome (APS). We performed transesophageal echocardiography (TEE) examination for consecutive stroke patients who had been diagnosed with APS (APS group) to detect potential embolic sources. APS was diagnosed based on the modified Sapporo criteria. The control stroke group comprised age- and sex-matched cryptogenic stroke patients undergoing TEE. We assessed and compared the clinical characteristics and TEE findings between stroke patients with APS and control stroke groups. Among 582 patients, nine patients (nine women; mean age, 50 ± 18 years) were classified into the APS group. In 137 patients undergoing TEE, 41 age-matched female stroke patients were recruited to the control stroke group. Prevalences of PFO and ASA were significantly higher in the APS group than in the control stroke group (89 vs. 41 %, p = 0.027; 67 vs. 20 %, p = 0.015, respectively). Multiple logistic regression analysis showed that PFO (odds ratio (OR), 13.71; 95 % confidence interval (CI), 1.01-185.62; p = 0.049) and ASA (OR, 8.06; 95 % CI, 1.17-55.59; p = 0.034) were independently associated with the APS group. PFO and ASA were strongly associated with the APS group, and could thus represent potential embolic sources in ischemic stroke patients with APS.

  12. Total Energy Expenditure by the doubly labelled water method in rural pre-school children in Cuba

    International Nuclear Information System (INIS)

    Hernandez-Triana, M.H.; Gonzalez-Calderin, S.; Sanchez, V.; Basabe-Tuero, B.; Salazar, G.; Diaz, E.

    2002-01-01

    Aim: Total Energy Expenditure (TEE) was measured by the doubly labelled water method in nineteen 5 y old children of a rural mountain community in Cuba. Materials and Methods. Ten males and nine females (18.4 and 18.5 kg average weight) with mean BMI values of 16.3 and 16.1 kg/m2 were included in the study. RMR was previously measured in year 2000 by indirect calorimetry in a sample of 11 children and values correlated properly with the estimations using the proposed equations of Henry and Rees. This estimate was used then for the whole group. Energy intake measured by 3-day weighed dietary record was 3.73 MJ/day. Tee was measured by the doubly labelled water method. Results: TEE values of well nourished children were 7.15 and 5.77 MJ/d for boys and girls, respectively. These findings imply that well nourished boys and girls are having a moderate to heavy physical activity requiring 93 and 75 kcal/kg per day. Physical activity of normal Cuban boys and girls living in rural areas was 1.88 and 1.59 METS, which is much higher than those values reported for children from developed countries using DLW. Energy intake was 1639 ± 381 in boys and 1230 ± 355 kcal/d in girls. Conclusions: TEE and physical activity level of rural Cuban children was higher than reported values of children living in developed countries

  13. Warden repair for superior sinus venosus atrial septal defect and anomalous pulmonary venous drainage in children: Anesthesia and transesophageal echocardiography perspective

    Directory of Open Access Journals (Sweden)

    Neelam Aggarwal

    2016-01-01

    Full Text Available Objective: Review of intraoperative anesthetic challenges and the role of transesophageal echocardiography in children with sinus venosus atrial septal defect and partial anomalous pulmonary venous drainage undergoing Warden repair. Design: A retrospective observational case series. Methodolgy: Pediatric patients who underwent Warden repair between October 2011-September 2015 were recruited. Their preoperative clinical details, anesthetic techniques, intraoperative TEE findings and postoperative events were recorded from the medical records. The categorical variables and the continuous variables were expressed as number (percentages and mean ΁ SD respectively. Results: A total of 35 patients were operated for Warden repair during the study period. Anesthesia was induced with the aim to prevent any fall in pulmonary vascular resistance. The right internal jugular vein was cannulated under ultrasound guidance using a short length cannula to monitor right superior vena cava pressure. Intraoperative TEE revealed the drainage of PAPVC high into RSVC in 22 patients. Persistent LSVC was found in 9 patients. After repair, TEE imaging detected a high gradient at Warden anastomotic site in 5 patients and 3 of them required revision of surgery. Rerouted pulmonary veins required surgical correction in 2 patients in view of obstruction. None of them had pulmonary venous and SVC obstruction in the postoperative period. Conclusion: The primary aim of anesthesia is to avoid any fall in PVR. Right IJV cannulation can be beneficial. The intraoperative TEE can help in delineating the anatomy of lesion and detecting anastomotic site obstruction.

  14. Management issues during HeartWare left ventricular assist device implantation and the role of transesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Sanjay Orathi Patangi

    2013-01-01

    Full Text Available Left ventricular assist devices (LVAD are increasingly used for mechanical circulatory support of patients with severe heart failure, primarily as a bridge to heart transplantation. Transesophageal echocardiography (TEE plays a major role in the clinical decision making during insertion of the devices and in the post-operative management of these patients. The detection of structural and device-related mechanical abnormalities is critical for optimal functioning of assist device. In this review article, we describe the usefulness of TEE for optimal perioperative management of patients presenting for HeartWare LVAD insertion.

  15. Prosthesis-patient mismatch after transcatheter aortic valve implantation: impact of 2D-transthoracic echocardiography versus 3D-transesophageal echocardiography.

    Science.gov (United States)

    da Silva, Cristina; Sahlen, Anders; Winter, Reidar; Bäck, Magnus; Rück, Andreas; Settergren, Magnus; Manouras, Aristomenis; Shahgaldi, Kambiz

    2014-12-01

    To investigate the role of 2D-transthoracic echocardiography (2D-TTE) and 3D-transesophageal echocardiography (3D-TEE) in the determination of aortic annulus size prior transcatheter aortic valve implantation (TAVI) and its' impact on the prevalence of patient prosthesis mismatch (PPM). Echocardiography plays an important role in measuring aortic annulus dimension in patients undergoing TAVI. This has great importance since it determines both eligibility for TAVI and selection of prosthesis type and size, and can be potentially important in preventing an inadequate ratio between the prosthetic valvular orifice and the patient's body surface area, concept known as prosthesis-patient mismatch (PPM). A total of 45 patients were studied pre-TAVI: 20 underwent 3D-TEE (men/women 12/8, age 84.8 ± 5.6) and 25 2D-TTE (men/women 9/16, age 84.4 ± 5.4) in order to measure aortic annulus diameter. The presence of PPM was assessed before hospital discharge and after a mean period of 3 months. Moderate PPM was defined as indexed aortic valve area (AVAi) ≤ 0.85 cm(2)/m(2) and severe PPM as AVAi 3D-TEE and 2D-TTE respectively p value = n.s) and severe PPM occurred in 10 % of the patients who underwent 3D-TEE and in 20 % in those with 2D-TTE (p value = n.s). The echocardiographic evaluation 3 months post-TAVI showed 25 % moderate PPM in the 3D-TEE group compared with 24 % in the 2D-TTE group (p value = n.s) and no cases of severe PPM in the 3DTEE group comparing to 20 % in the 2D-TTE group (p = 0.032). Our results indicate a higher incidence of severe PPM in patients who performed 2DTTE compared to those performing 3DTEE prior TAVI. This suggests that the 3D technique should replace the 2DTTE analysis when investigating the aortic annulus diameter in patients undergoing TAVI.

  16. Computed tomography measurement of the left atrial appendage for optimal sizing of the Watchman device.

    Science.gov (United States)

    Xu, Bo; Betancor, Jorge; Sato, Kimi; Harb, Serge; Abdur Rehman, Karim; Patel, Kunal; Kumar, Arnav; Cremer, Paul C; Jaber, Wael; Rodriguez, L Leonardo; Schoenhagen, Paul; Wazni, Oussama

    Percutaneous left atrial appendage (LAA) occlusion is an emerging treatment option for patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation. The Watchman device (Boston Scientific Corporation, Natick, MA, USA) is deployed at the ostium of the LAA, and an appropriately sized device is critical for successful occlusion. However, standardized imaging protocols for device sizing have not been established. We investigated the clinical utility of a standardized imaging protocol, with pre-procedural multi-detector cardiac computed tomography (MDCT), and intra-procedural transesophageal echocardiography (TEE), for Watchman device sizing. Patients who underwent Watchman device implantation between 2010 and 2016 at our center, and who had pre-procedural MDCT and intra-procedural TEE were included. MDCT measurements (CTmax, CTmin, CTmean), and TEE measurement (TEEmax) of the LAA ostium were determined for each case, and correlated with the final size of the Watchman device implanted. Demographic data and clinical outcomes were collected. The study included 80 patients (mean age: 75 ± 9.6 years; male: 68%; mean CHA2DS2-VASc score: 4.5 ± 1.4). CTmax of the LAA ostium correlated strongly with the final deployed Watchman device size (Spearman's rho: 0.81, p < 0.001), while TEEmax of the LAA ostium showed only moderate correlation with the final deployed Watchman device size (Spearman's rho: 0.61, p < 0.001). Implantation success rate was 100%. At a mean duration of follow-up of 197 days, there were no device-related complications (device embolization, cardiac perforation and pericardial tamponade). At follow-up, the vast majority of patients (76 patients; 95%) had either no or trivial (≤3 mm) residual peri-device leak on TEE. A standardized imaging protocol for assessment of Watchman device implantation incorporating pre-procedural MDCT and intra-procedural TEE, was associated with excellent procedural outcomes at a mean duration

  17. Routine intraoperative transesophageal echocardiography for pediatric open heart surgery: Is it justifiable?

    International Nuclear Information System (INIS)

    Elgamal, Mohamed-Adel F.; Najm, Hani K.; Abid-Allah, M.; Omran, Ahmad S.

    2007-01-01

    The routine use of intraoperative transesophageal echocardiography (IO TEE) in children is still debatable. The aim of this study was to determine the safety, benefit and the possible risk of the routine use of IO TEE. It was performed in all children under the age of 14 years with a complex congenital heart defects undergoing open heart surgery, from July 2001 to December 2002. Simple lesions such as secundum atrial septal defects or simple perimembraneous ventricular septal defects (VSD) and neonates less than 2.7 kg were excluded. All children underwent a pre-repair and post-repair complete IO TEE study. There were 112 children, 65 males and 47 females. Ages ranged from 4 days to 156 month, a median of 9 months. A full study was not done in three neonates (3%) because the probe could not be inserted in one, and because of airway compression resulting in desaturation in another two. A pre-repair study confirmed the preoperative transthoracic echocardiographic findings in 105 children (95%). Diagnostic discrepancy or unexpected lesions not reported preoperative were found in six children (5%). Of the 109 children who had full post-repair studies, 67 (60%) showed optimum repair with no residual lesions and 26 (23%) showed trivial or mild residual lesions accepted by the team. Going back on pump to fix moderate or severe residual lesions occurred in 16 (14%) children. In all of these children, the decision for going back on pump was prompted by the IO TEE examination alone. Mild complications occurred in two children (2%). Based on our results, we recommend the routine use of IO TEE. It is safe, has a low complication rate, adds additional information and has a high impact on the diagnosis of residual lesions required in the operating room. However, careful monitoring of the ventilation and airway pressure, particularly during probe insertion and manipulation in small children, is very essential. (author)

  18. Echocardiographic Assessment of Heart Valve Prostheses

    Science.gov (United States)

    Sordelli, Chiara; Severino, Sergio; Ascione, Luigi; Coppolino, Pasquale; Caso, Pio

    2014-01-01

    Patients submitted to valve replacement with mechanical or biological prosthesis, may present symptoms related either to valvular malfunction or ventricular dysfunction from other causes. Because a clinical examination is not sufficient to evaluate a prosthetic valve, several diagnostic methods have been proposed to assess the functional status of a prosthetic valve. This review provides an overview of echocardiographic and Doppler techniques useful in evaluation of prosthetic heart valves. Compared to native valves, echocardiographic evaluation of prosthetic valves is certainly more complex, both for the examination and the interpretation. Echocardiography also allows discriminating between intra- and/or peri-prosthetic regurgitation, present in the majority of mechanical valves. Transthoracic echocardiography (TTE) requires different angles of the probe with unconventional views. Transesophageal echocardiography (TEE) is the method of choice in presence of technical difficulties. Three-dimensional (3D)-TEE seems to be superior to 2D-TEE, especially in the assessment of paravalvular leak regurgitation (PVL) that it provides improved localization and analysis of the PVL size and shape. PMID:28465917

  19. Clinical application of percutaneous balloon mitral valvuloplasty in patients with rheumatic mitral stenosis and left atrial thrombi

    International Nuclear Information System (INIS)

    Chen Junzhu; Zhang Furong; Tao Qianmin; Cheng Guanchang; Zheng Liangrong; Zhu Jianhua

    2002-01-01

    Objective: To evaluate safety and effect of percutaneous balloon mitral valvuloplasty (PBMV) for patients with rheumatic mitral stenosis and left atrial thrombi. Methods: PBMV was performed in 27 patients with rheumatic mitral stenosis and left atrial thrombi. 19 cases of left atrial fresh thrombi revealed by trans-esophageal echocardiography (TEE) received warfarin orally for 3-6 months before PBMV. Results: PBMV was successful in all cases of mitral stenosis and left atrial thrombi. Left atrial fresh thrombi was completely resolved in 9 cases and became smaller chronic organized thrombi in 10 cases after warfarin anticoagulation treatment among 19 cases of left atrial fresh thrombi revealed by TEE. In 5 cases of left atrial chronic organized thrombi shown only transthoracic echocardiography and without anticoagulation treatment, one case had cerebral embolism. No complication occurred in other cases. Conclusions: The study showed that patients with rheumatic mitral stenosis and atrial fibrillation should have routine TEE. PBMV for rheumatic mitral stenosis with left atrial thrombi after anticoagulation treatment is safe and effective

  20. Construction of a resonant loop with the ICRF antenna for KSTAR

    International Nuclear Information System (INIS)

    Bae, Young Dug; Jeong, Sung Un; Yoon, Jae Sung; Hong, Bong Geon

    2003-01-01

    The antenna of the KSTAR ICRF heating system consists of four current straps, each of which is grounded at the center, and has two coaxial ports, one at each end. The top and bottom ports of each strap are fed by one transmitter. The two ports are connected at tee connector to form a resonant loop, and the coaxial feed line from the transmitter is connected to the tee. One resonant loop with the proto-type antenna is built at the RF test stand in KAERI. It is composed with one current strap, one tee connector and two arms connecting them. Each arm consists of a 6-inch vacuum transmission line, a vacuum feed through, a part of pressurized 9-inch coaxial line, and an adjustable phase shifter to cover wide frequency range of 25-60 MHz. Total electrical length is changeable from 45 to 51 m. Many voltage probes and directional couplers are installed to measure RF voltage of the standing wave, power flow and phase difference. Resonant and matching conditions are investigated for various frequencies

  1. Echocardiography in Infective Endocarditis: State of the Art.

    Science.gov (United States)

    Afonso, Luis; Kottam, Anupama; Reddy, Vivek; Penumetcha, Anirudh

    2017-10-25

    In this review, we examine the central role of echocardiography in the diagnosis, prognosis, and management of infective endocarditis (IE). 2D transthoracic echocardiography (TTE) and transesophageal echocardiography TEE have complementary roles and are unequivocally the mainstay of diagnostic imaging in IE. The advent of 3D and multiplanar imaging have greatly enhanced the ability of the imager to evaluate cardiac structure and function. Technologic advances in 3D imaging allow for the reconstruction of realistic anatomic images that in turn have positively impacted IE-related surgical planning and intervention. CT and metabolic imaging appear to be emerging as promising ancillary diagnostic tools that could be deployed in select scenarios to circumvent some of the limitations of echocardiography. Our review summarizes the indispensable and central role of various echocardiographic modalities in the management of infective endocarditis. The complementary role of 2D TTE and TEE are discussed and areas where 3D TEE offers incremental value highlighted. An algorithm summarizing a contemporary approach to the workup of endocarditis is provided and major societal guidelines for timing of surgery are reviewed.

  2. Transesophageal Doppler measurement of renal arterial blood flow velocities and indices in children.

    Science.gov (United States)

    Zabala, Luis; Ullah, Sana; Pierce, Carol D'Ann; Gautam, Nischal K; Schmitz, Michael L; Sachdeva, Ritu; Craychee, Judith A; Harrison, Dale; Killebrew, Pamela; Bornemeier, Renee A; Prodhan, Parthak

    2012-06-01

    Doppler-derived renal blood flow indices have been used to assess renal pathologies. However, transesophageal ultrasonography (TEE) has not been previously used to assess these renal variables in pediatric patients. In this study, we (a) assessed whether TEE allows adequate visualization of the renal parenchyma and renal artery, and (b) evaluated the concordance of TEE Doppler-derived renal blood flow measurements/indices compared with a standard transabdominal renal ultrasound (TAU) in children. This prospective cohort study enrolled 28 healthy children between the ages of 1 and 17 years without known renal dysfunction who were undergoing atrial septal defect device closure in the cardiac catheterization laboratory. TEE was used to obtain Doppler renal artery blood velocities (peak systolic velocity, end-diastolic velocity, mean diastolic velocity, resistive index, and pulsatility index), and these values were compared with measurements obtained by TAU. Concordance correlation coefficient (CCC) was used to determine clinically significant agreement between the 2 methods. The Bland-Altman plots were used to determine whether these 2 methods agree sufficiently to be used interchangeably. Statistical significance was accepted at P ≤ 0.05. Obtaining 2-dimensional images of kidney parenchyma and Doppler-derived measurements using TEE in children is feasible. There was statistically significant agreement between the 2 methods for all measurements. The CCC between the 2 imaging techniques was 0.91 for the pulsatility index and 0.66 for the resistive index. These coefficients were sensitive to outliers. When the highest and lowest data points were removed from the analysis, the CCC between the 2 imaging techniques was 0.62 for the pulsatility index and 0.50 for the resistive index. The 95% confidence interval (CI) for pulsatility index was 0.35 to 0.98 and for resistive index was 0.21 to 0.89. The Bland-Altman plots indicate good agreement between the 2 methods; for the

  3. Anthelmintic effect of Psidium guajava and Tagetes erecta on wild-type and Levamisole-resistant Caenorhabditis elegans strains.

    Science.gov (United States)

    Piña-Vázquez, Denia M; Mayoral-Peña, Zyanya; Gómez-Sánchez, Maricela; Salazar-Olivo, Luis A; Arellano-Carbajal, Fausto

    2017-04-18

    Psidium guajava and Tagetes erecta have been used traditionally to treat gastrointestinal parasites, but their active metabolites and mechanisms of action remain largely unknown. To evaluate the anthelmintic potential of Psidium guajava and Tagetes erecta extracts on Levamisole-sensitive and Levamisole-resistant strains of the model nematode Caenorhabditis elegans. Aqueous extracts of Psidium guajava (PGE) and Tagetes erecta (TEE) were assayed on locomotion and egg-laying behaviors of the wild-type (N2) and Levamisole-resistant (CB193) strains of Caenorhabditis elegans. Both extracts paralyzed wild-type and Levamisole-resistant nematodes in a dose-dependent manner. In wild-type worms, TEE 25mg/mL induced a 75% paralysis after 8h of treatment and PGE 25mg/mL induced a 100% paralysis after 4h of treatment. PGE exerted a similar paralyzing effect on N2 wild-type and CB193 Levamisole-resistant worms, while TEE only partially paralyzed CB193 worms. TEE 25mg/mL decreased N2 egg-laying by 65% with respect to the untreated control, while PGE did it by 40%. Psidium guajava leaves and Tagetes erecta flower-heads possess hydrosoluble compounds that block the motility of Caenorhabditis elegans by a mechanism different to that of the anthelmintic drug Levamisole. Effects are also observable on oviposition, which was diminished in the wild-type worms. The strong anthelmintic effects in crude extracts of these plants warrants future work to identify their active compounds and to elucidate their molecular mechanisms of action. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  4. Evaluation of concordance among three cardiac output measurement techniques in adult patients during cardiovascular surgery postoperative care.

    Science.gov (United States)

    Muñoz, L; Velandia, A; Reyes, L E; Arevalo-Rodríguez, I; Mejía, C; Asprilla, D; Uribe, D V; Arevalo, J J

    2017-12-01

    The standard method for cardiac output measuring is thermodilution although it is an invasive technique. Transesophageal Echocardiography (TEE) offers a dynamic and functional alternative to thermodilution. Analyze concordance between two TEE methods and thermodilution for cardiac output assessment. Observational concordance study in cardiovascular surgery patients that required pulmonary artery catheter. TEE cardiac output measurement at both mitral annulus (MA) and left ventricle outflow tract (LVOT) were performed. Results were compared with thermodilution. Correlation was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. Statistical analysis was undertaken in STATA 13.0. Twenty-five patients were enrolled. Fifty two percent of patients were male, median age and ejection fraction was 63 years and 35% respectively. Median thermodilution, LVOT and MA -measured cardiac output was 3.25 L/min, 3.46 L/min and 8.4 L/min respectively. Different values between thermodilution and MA measurements were found (Lin concordance=0.071; Confidence Interval 95%=-0.009 to 0.151; Spearman's correlation=0.22) as values between thermodilution and LVOT (Lin concordance=0.232; Confidence Interval 95%=-0.12 a 0.537; Spearman's correlation 0.28). Bland-Altman analysis showed greater difference between MA measurements and thermodilution (DM=-0.408; Bland-Altman Limits=-0.809 to -0.007), than the other echocardiographic findings (DM=0.007; Bland-Altman Limits=-0.441 to 0.428). Results from cardiac output measurement by doppler and 2D-TEE on both MA and LVOT do not correlate with those obtained by thermodilution. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  5. Where does the pulmonary artery catheter float: Transesophageal echocardiography evaluation

    Directory of Open Access Journals (Sweden)

    Deepak K Tempe

    2015-01-01

    Full Text Available Background: Pulmonary artery (PA catheter provides a variety of cardiac and hemodynamic parameters. In majority of the patients, the catheter tends to float in the right pulmonary artery (RPA than the left pulmonary artery (LPA. We evaluated the location of PA catheter with the help of transesophageal echocardiography (TEE to know the incidence of its localization. Three views were utilized for this purpose; midesophageal ascending aorta (AA short-axis view, modified mid esophageal aortic valve long-axis view, and modified bicaval view. Methods: We enrolled 135 patients undergoing elective cardiac surgery where both the PA catheter and TEE were to be used; for this prospective observational study. PA catheter was visualized by TEE in the above mentioned views and the degree of clarity of visualization by three views was also noted. Position of the PA catheter was further confirmed by a postoperative chest radiograph. Results: One patient was excluded from the data analysis. PA catheter was visualized in RPA in 129 patients (96% and in LPA in 4 patients (3%. In 1 patient, the catheter was visualized in main PA in the chest radiograph. The midesophageal AA short-axis, modified aortic valve long-axis, and modified bicaval view provided good visualization in 51.45%, 57.4%, and 62.3% patients respectively. Taken together, PA catheter visualization was good in 128 (95.5% patients. Conclusion: We conclude that the PA catheter has a high probability of entering the RPA as compared to LPA (96% vs. 3% and TEE provides good visualization of the catheter in RPA.

  6. Misreporting of energy intake in the elderly using doubly labeled water to measure total energy expenditure and weight change.

    Science.gov (United States)

    Shahar, Danit R; Yu, Binbing; Houston, Denise K; Kritchevsky, Stephen B; Newman, Anne B; Sellmeyer, Deborah E; Tylavsky, Frances A; Lee, Jung Sun; Harris, Tamara B

    2010-02-01

    One of the major problems in dietary assessment is inaccuracy in reporting diet. To examine the association between self-reported energy intake (EI) by food frequency questionnaire (FFQ) and energy expenditure (EE), measured by doubly labeled water (DLW), among older persons. EE was assessed in 298 high-functioning, community-dwelling older adults (70-79 years of age) over a 2-week period using DLW. Dietary intake was assessed using a Block FFQ. The ratio between reported EI and total energy expenditure (TEE) was calculated. Misreporting was defined as follows: participants with an EI/TEE ratio of reporters, while participants with an EI/TEE ratio >1.28 were categorized as high energy reporters. Participants with an EI/TEE ratio of 0.77-1.28 were categorized as "true" energy reporters. One-year percent weight change prior to EE visit was used as another validation indicator. Participants who were low energy reporters but lost >2% of their body weight were categorized as undereaters. Two hundred ninety-six participants provided both FFQ and DLW measurements. Forty-three percent of participants were low energy reporters; among them, almost 30% lost weight and, therefore, were categorized as undereaters. The undereaters consumed significantly fewer calories. No difference in the frequency of low energy reporting was detected between genders or racial groups. Underreporters had significantly higher body weight than "true" or high reporters. Undereaters tended to have higher body mass index than the underreporters. Undereating is prevalent in the elderly and may be falsely perceived as underreporting. It should be further addressed and characterized in future studies.

  7. Tabletitervishoid meid tervemaks ei tee / Eugen Veges

    Index Scriptorium Estoniae

    Veges, Eugen, 1955-

    2009-01-01

    Autori hinnangul tuleks tervishoiu rahastamise aluseid muuta. Maksumäära langetamine koos omavastutusega mõjuks hinna ja kvaliteedi suhtele, muudaks teenindaja ja teenindatava suhted mõistetavamaks ning patsiendile vastuvõetavamaks

  8. Ärme tee majanduskasvust ebajumalat / Eugen Veges

    Index Scriptorium Estoniae

    Veges, Eugen, 1955-

    2011-01-01

    Endine ettevõtja on seisukohal, et majanduskasvu saavutamine ei ole eesmärk omaette, rõõmu tuleks tunda üleüldisest ja tasakaalustatud arengust, riigi valitsemises tuleks abstraktsete näitajate kõrval näha ka inimest

  9. Balti "Ungari tee" taotlus 1965 / Rein Taagepera

    Index Scriptorium Estoniae

    Taagepera, Rein, 1933-

    2010-01-01

    1965. aastal H. Raagi, H. Susi ja R. Taagepera poolt koostatud ja levitatud satelliitsusmemorandumist, milles toodi välja idee kehtestada Balti riikides rahvademokraatia; Zbigniew Brzezinski rollist memorandumi vahendajana ning selle avaldamisele järgnenud vastukajadest ja tegevustest kuni aastani 1973

  10. Pärnu, millise tee valid? / Asso Puidet

    Index Scriptorium Estoniae

    Puidet, Asso, 1977-

    2005-01-01

    Soome maineka turismieksperdi Pauli Santala hinnangul seisab Pärnu praegu teelahkmel, nüüd astutud sammudest oleneb, kus linn on 10 aasta pärast. Lisad: Helgemad hetked; Tumedad laigud; Mis päästaks Pärnu?

  11. Pikk tee märkamiseni / Katrin Saks

    Index Scriptorium Estoniae

    Saks, Katrin, 1956-

    2008-01-01

    Õpilaste koolisuhetest ning koolivägivallast. Ilmunud ka Vooremaa 9. okt. 2008, lk. 2 ; Võrumaa Teataja 11. okt. 2008, lk. 2 ; Koit 11. okt. 2008, lk. 6 ; Meie Maa 13. okt. 2008, lk. 2 ; Pärnu Postimees 10. okt. 2008, lk. 15 ; Virumaa Teataja 15. okt. 2008, lk. 11

  12. ) E STRYI) TEE~ I)IE VOOR()OST

    African Journals Online (AJOL)

    vyandelike voetsoldate op te tree. Volgens 5. SA Infanteriebrigadegroephoofkwartier se een ..... van hulle is kpl R. R. G. White, wat sy een oog verloor het. Sktr A. B. Cunningham van. 3 Transvaal Scottish se C ... toe hulle dit nader as 2000 tree van die sen- trale fortifikasies waag en slaag oak daarin am die pantserkarre aan ...

  13. Depth-resolved registration of transesophageal echo to x-ray fluoroscopy using an inverse geometry fluoroscopy system

    Energy Technology Data Exchange (ETDEWEB)

    Hatt, Charles R. [Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53705 (United States); Tomkowiak, Michael T.; Dunkerley, David A. P.; Slagowski, Jordan M. [Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin 53705 (United States); Funk, Tobias [Triple Ring Technologies, Inc., Newark, California 94560 (United States); Raval, Amish N. [Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53792 (United States); Speidel, Michael A., E-mail: speidel@wisc.edu [Departments of Medical Physics and Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53705 (United States)

    2015-12-15

    Purpose: Image registration between standard x-ray fluoroscopy and transesophageal echocardiography (TEE) has recently been proposed. Scanning-beam digital x-ray (SBDX) is an inverse geometry fluoroscopy system designed for cardiac procedures. This study presents a method for 3D registration of SBDX and TEE images based on the tomosynthesis and 3D tracking capabilities of SBDX. Methods: The registration algorithm utilizes the stack of tomosynthetic planes produced by the SBDX system to estimate the physical 3D coordinates of salient key-points on the TEE probe. The key-points are used to arrive at an initial estimate of the probe pose, which is then refined using a 2D/3D registration method adapted for inverse geometry fluoroscopy. A phantom study was conducted to evaluate probe pose estimation accuracy relative to the ground truth, as defined by a set of coregistered fiducial markers. This experiment was conducted with varying probe poses and levels of signal difference-to-noise ratio (SDNR). Additional phantom and in vivo studies were performed to evaluate the correspondence of catheter tip positions in TEE and x-ray images following registration of the two modalities. Results: Target registration error (TRE) was used to characterize both pose estimation and registration accuracy. In the study of pose estimation accuracy, successful pose estimates (3D TRE < 5.0 mm) were obtained in 97% of cases when the SDNR was 5.9 or higher in seven out of eight poses. Under these conditions, 3D TRE was 2.32 ± 1.88 mm, and 2D (projection) TRE was 1.61 ± 1.36 mm. Probe localization error along the source-detector axis was 0.87 ± 1.31 mm. For the in vivo experiments, mean 3D TRE ranged from 2.6 to 4.6 mm and mean 2D TRE ranged from 1.1 to 1.6 mm. Anatomy extracted from the echo images appeared well aligned when projected onto the SBDX images. Conclusions: Full 6 DOF image registration between SBDX and TEE is feasible and accurate to within 5 mm. Future studies will focus on

  14. Use of real time three-dimensional transesophageal echocardiography in intracardiac catheter based interventions.

    Science.gov (United States)

    Perk, Gila; Lang, Roberto M; Garcia-Fernandez, Miguel Angel; Lodato, Joe; Sugeng, Lissa; Lopez, John; Knight, Brad P; Messika-Zeitoun, David; Shah, Sanjiv; Slater, James; Brochet, Eric; Varkey, Mathew; Hijazi, Ziyad; Marino, Nino; Ruiz, Carlos; Kronzon, Itzhak

    2009-08-01

    Real-time three-dimensional (RT3D) echocardiography is a recently developed technique that is being increasingly used in echocardiography laboratories. Over the past several years, improvements in transducer technologies have allowed development of a full matrix-array transducer that allows acquisition of pyramidal-shaped data sets. These data sets can be processed online and offline to allow accurate evaluation of cardiac structures, volumes, and mass. More recently, a transesophageal transducer with RT3D capabilities has been developed. This allows acquisition of high-quality RT3D images on transesophageal echocardiography (TEE). Percutaneous catheter-based procedures have gained growing acceptance in the cardiac procedural armamentarium. Advances in technology and technical skills allow increasingly complex procedures to be performed using a catheter-based approach, thus obviating the need for open-heart surgery. The authors used RT3D TEE to guide 72 catheter-based cardiac interventions. The procedures included the occlusion of atrial septal defects or patent foramen ovales (n=25), percutaneous mitral valve repair (e-valve clipping; n=3), mitral balloon valvuloplasty for mitral stenosis (n=10), left atrial appendage obliteration (n=11), left atrial or pulmonary vein ablation for atrial fibrillation (n=5), percutaneous closures of prosthetic valve dehiscence (n=10), percutaneous aortic valve replacement (n=6), and percutaneous closures of ventricular septal defects (n=2). In this review, the authors describe their experience with this technique, the added value over multiplanar two-dimensional TEE, and the pitfalls that were encountered. The main advantages found for the use RT3D TEE during catheter-based interventions were (1) the ability to visualize the entire lengths of intracardiac catheters, including the tips of all catheters and the balloons or devices they carry, along with a clear depiction of their positions in relation to other cardiac structures, and

  15. Depth-resolved registration of transesophageal echo to x-ray fluoroscopy using an inverse geometry fluoroscopy system

    International Nuclear Information System (INIS)

    Hatt, Charles R.; Tomkowiak, Michael T.; Dunkerley, David A. P.; Slagowski, Jordan M.; Funk, Tobias; Raval, Amish N.; Speidel, Michael A.

    2015-01-01

    Purpose: Image registration between standard x-ray fluoroscopy and transesophageal echocardiography (TEE) has recently been proposed. Scanning-beam digital x-ray (SBDX) is an inverse geometry fluoroscopy system designed for cardiac procedures. This study presents a method for 3D registration of SBDX and TEE images based on the tomosynthesis and 3D tracking capabilities of SBDX. Methods: The registration algorithm utilizes the stack of tomosynthetic planes produced by the SBDX system to estimate the physical 3D coordinates of salient key-points on the TEE probe. The key-points are used to arrive at an initial estimate of the probe pose, which is then refined using a 2D/3D registration method adapted for inverse geometry fluoroscopy. A phantom study was conducted to evaluate probe pose estimation accuracy relative to the ground truth, as defined by a set of coregistered fiducial markers. This experiment was conducted with varying probe poses and levels of signal difference-to-noise ratio (SDNR). Additional phantom and in vivo studies were performed to evaluate the correspondence of catheter tip positions in TEE and x-ray images following registration of the two modalities. Results: Target registration error (TRE) was used to characterize both pose estimation and registration accuracy. In the study of pose estimation accuracy, successful pose estimates (3D TRE < 5.0 mm) were obtained in 97% of cases when the SDNR was 5.9 or higher in seven out of eight poses. Under these conditions, 3D TRE was 2.32 ± 1.88 mm, and 2D (projection) TRE was 1.61 ± 1.36 mm. Probe localization error along the source-detector axis was 0.87 ± 1.31 mm. For the in vivo experiments, mean 3D TRE ranged from 2.6 to 4.6 mm and mean 2D TRE ranged from 1.1 to 1.6 mm. Anatomy extracted from the echo images appeared well aligned when projected onto the SBDX images. Conclusions: Full 6 DOF image registration between SBDX and TEE is feasible and accurate to within 5 mm. Future studies will focus on

  16. Measurements of Daily Energy Intake and Total Energy Expenditure in People with Dementia in Care Homes: The Use of Wearable Technology.

    Science.gov (United States)

    Murphy, J; Holmes, J; Brooks, C

    2017-01-01

    To estimate daily total energy expenditure (TEE) using a physical activity monitor, combined with dietary assessment of energy intake to assess the relationship between daily energy expenditure and patterns of activity with energy intake in people with dementia living in care homes. A cross-sectional study in care homes in the UK. Twenty residents with confirmed dementia diagnosis were recruited from two care homes that specialised in dementia care. A physical activity monitor (SensewearTM Armband, Body Media, Pittsburgh, PA) was employed to objectively determine total energy expenditure, sleep duration and physical activity. The armband was placed around the left upper triceps for up to 7 days. Energy intake was determined by weighing all food and drink items over 4 days (3 weekdays and 1 weekend day) including measurements of food wastage. The mean age was 78.7 (SD ± 11.8) years, Body Mass Index (BMI) 23.0 (SD ± 4.2) kg/m2; 50% were women. Energy intake (mean 7.4; SD ± 2.6) MJ/d) was correlated with TEE (mean 7.6; SD ± 1.8 MJ/d; r=0.49, p<0.05). Duration of sleeping ranged from 0.4-12.5 (mean 6.1) hrs/d and time spent lying down was 1.3-16.0 (8.3) hrs/d. On average residents spent 17.9 (6.3-23.4) hrs/d undertaking sedentary activity. TEE was correlated with BMI (r=0.52, p<0.05) and body weight (r=0.81, p<0.001) but inversely related to sleep duration (r=-0.59, p<0.01) and time lying down (r=-0.62, p<0.01). Multiple linear regression analysis revealed that after taking BMI, sleep duration and time spent lying down into account, TEE was no longer correlated with energy intake. The results show the extent to which body mass, variable activity and sleep patterns may be contributing to TEE and together with reduced energy intake, energy requirements were not satisfied. Thus wearable technology has the potential to offer real-time monitoring to provide appropriate nutrition management that is more person-centred to prevent weight loss in dementia.

  17. Pilot Study: Estimation of Stroke Volume and Cardiac Output from Pulse Wave Velocity.

    Directory of Open Access Journals (Sweden)

    Yurie Obata

    Full Text Available Transesophageal echocardiography (TEE is increasingly replacing thermodilution pulmonary artery catheters to assess hemodynamics in patients at high risk for cardiovascular morbidity. However, one of the drawbacks of TEE compared to pulmonary artery catheters is the inability to measure real time stroke volume (SV and cardiac output (CO continuously. The aim of the present proof of concept study was to validate a novel method of SV estimation, based on pulse wave velocity (PWV in patients undergoing cardiac surgery.This is a retrospective observational study. We measured pulse transit time by superimposing the radial arterial waveform onto the continuous wave Doppler waveform of the left ventricular outflow tract, and calculated SV (SVPWV using the transformed Bramwell-Hill equation. The SV measured by TEE (SVTEE was used as a reference.A total of 190 paired SV were measured from 28 patients. A strong correlation was observed between SVPWV and SVTEE with the coefficient of determination (R2 of 0.71. A mean difference between the two (bias was 3.70 ml with the limits of agreement ranging from -20.33 to 27.73 ml and a percentage error of 27.4% based on a Bland-Altman analysis. The concordance rate of two methods was 85.0% based on a four-quadrant plot. The angular concordance rate was 85.9% with radial limits of agreement (the radial sector that contained 95% of the data points of ± 41.5 degrees based on a polar plot.PWV based SV estimation yields reasonable agreement with SV measured by TEE. Further studies are required to assess its utility in different clinical situations.

  18. Multiyear impacts of partial throughfall exclusion on Buxus sempervirens in a Mediterranean forest

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez-Calcerrada, J.; Letts, M. G.; Rolo, V.; Roset, S.; Rambal, S.

    2013-09-01

    Aim of study:We examined the impact of sustained partial throughfall exclusion on the functional performance of Buxus sempervirens L. in the understory of a Mediterranean evergreen forest. We further considered whether any impacts of throughfall exclusion were affected by light availability. Area of study: The study was conducted in the south of France. Material and methods: Several leaf physiological and branch structural traits were measured along a light gradient after seven years from the onset of a throughfall exclusion experiment (TEE). The results were analysed along with annual growth and survival data. Main results: Plant mortality was nil in both the throughfall exclusion and control treatments. Stem diameter growth was reduced by 39% in plants subjected to throughfall exclusion, but this difference was only significant at the p = 0.10 significance level. Leaf physiology remained unaffected by the TEE, but small changes were evident in branch structural traits in high light microsites following throughfall exclusion; branches had lower wood density in the TEE plot, and more biomass was partitioned to leaves relative to stems. Research highlights: These changes do not seem to reflect an acclimatory response that would enhance drought tolerance. Instead, we suggest that these drought effects might exacerbate vulnerability to xylem cavitation in the more open microsites. Reduced growth and increased vulnerability to drought may indicate an incipient decline in plant vitality following TEE. The extension of observations to the whole-plant level and longer periods will elucidate the consequences of these observations for plant fitness, and permit verification of the positive effect of shade on Buxus sempervirens under increased drought. (Author)

  19. Patent foramen ovale: detection with nongated multidetector CT.

    Science.gov (United States)

    Revel, Marie-Pierre; Faivre, Jean-Baptiste; Letourneau, Thierry; Henon, Hilde; Leys, Didier; Delannoy-Deken, Valérie; Remy-Jardin, Martine; Remy, Jacques

    2008-10-01

    To evaluate nongated multidetector computed tomography (CT) in the detection of patent foramen ovale (PFO) and atrial septal aneurysm (ASA) in comparison with transesophageal echocardiography (TEE). The study was approved by the institutional review board, and informed consent was obtained from all patients. One hundred five patients (57 men, 48 women; mean age, 53 years) with a recent stroke underwent TEE and multidetector CT on the same day. After injection of a diluted iodinated contrast material, a series of 2.4-mm-thick transverse images centered on the fossa ovalis were acquired in conjunction with release of the Valsalva maneuver. Two independent radiologists considered PFO present if left atrial enhancement was detected visually before enhancement of the pulmonary veins or if an early peak of left atrial enhancement was found at time-attenuation curve analysis. PFO was detected with 98% specificity (95% confidence interval [CI]: 0.91, 0.99). Overall sensitivity was 55% (95% CI: 0.38, 0.70), ranging from 28% for shunts classified as grade 1 at TEE to 91% for those classified as grade 4 at TEE. Interreader agreement was good (kappa = 0.81). Visual assessment was better than time-attenuation curve analysis, which enabled detection of only 15 of the 40 cases of PFO. Multidetector CT depicted only 22% of cases of ASA. The mean effective radiation dose was 2.3 mSv. Nongated multidetector CT can be used to diagnose high-grade shunts through a PFO, with 91% sensitivity and 98% specificity. Thus, PFO detection, in addition to routine CT evaluation of the lungs, could be indicated in patients with unexplained hypoxemia. (c) RSNA, 2008.

  20. Assessment of thermal fatigue damage caused by local fluid temperature fluctuation (part I: characteristics of constraint and stress caused by thermal striation and stratification)

    International Nuclear Information System (INIS)

    Kamaya, Masayuki

    2014-01-01

    Highlights: • The source of the membrane constraint due to local temperature fluctuation was shown. • Thermal fatigue that occurred at a mixing tee and branched elbow was analyzed. • Cracking occurrence was reasonably explained by the constraint and stress conditions. - Abstract: This study was aimed at identifying the constraint conditions under local temperature fluctuation by thermal striping at a mixing tee and by thermal stratification at an elbow pipe branched from the main pipe. Numerical and analytical approaches were made to derive the thermal stress and its fluctuation. It was shown that an inhomogeneous temperature distribution in a straight pipe caused thermal stress due to a membrane constraint even if an external membrane constraint did not act on the pipe. Although the membrane constraint increased the mean stress at the mixing tee, it did not contribute to fluctuation of the thermal stress. On the other hand, the membrane constraint played an important role in the fatigue damage accumulation near the stratification layer of the branched elbow. Based on the constraint and stress conditions analyzed, the characteristics of the cracking observed in actual nuclear power plants were reasonably explained. Namely, at the mixing tee, where thermal crazing has been found, the lack of contribution of the membrane constraint to stress fluctuation caused a stress gradient in the thickness direction and arrested crack growth. On the other hand, at the branched elbow, where axial through-wall cracks have been found, the relatively large hoop stress fluctuation was brought about by movement of the stratified layer together with the membrane constraint even under a relatively low frequency of stress fluctuation

  1. Front-end receiver electronics for a matrix transducer for 3-D transesophageal echocardiography.

    Science.gov (United States)

    Yu, Zili; Blaak, Sandra; Chang, Zu-yao; Yao, Jiajian; Bosch, Johan G; Prins, Christian; Lancée, Charles T; de Jong, Nico; Pertijs, Michiel A P; Meijer, Gerard C M

    2012-07-01

    There is a clear clinical need for creating 3-D images of the heart. One promising technique is the use of transesophageal echocardiography (TEE). To enable 3-D TEE, we are developing a miniature ultrasound probe containing a matrix piezoelectric transducer with more than 2000 elements. Because a gastroscopic tube cannot accommodate the cables needed to connect all transducer elements directly to an imaging system, a major challenge is to locally reduce the number of channels, while maintaining a sufficient signal-to-noise ratio. This can be achieved by using front-end receiver electronics bonded to the transducers to provide appropriate signal conditioning in the tip of the probe. This paper presents the design of such electronics, realizing time-gain compensation (TGC) and micro-beamforming using simple, low-power circuits. Prototypes of TGC amplifiers and micro-beamforming cells have been fabricated in 0.35-μm CMOS technology. These prototype chips have been combined on a printed circuit board (PCB) to form an ultrasound-receiver system capable of reading and combining the signals of three transducer elements. Experimental results show that this design is a suitable candidate for 3-D TEE.

  2. Simultaneous measurement of milk intake and total energy expenditure in mixed-fed infants: Methodological approach and prediction of total body water

    International Nuclear Information System (INIS)

    Wells, J.C.K.; Davies, P.S.W.; Coward, W.A.

    2000-01-01

    Evaluation of the energy metabolism that underlies the new WHO breast-fed growth reference requires simultaneous measurements of milk volume intake (MVI) and total energy expenditure (TEE) by stable isotope methodologies. In young infants, such data is collected without difficulty using the dose-to-the-infant method. In older infants, where breast-milk is supplemented with non-milk foods, MVI must be measured by dosing the mother instead of the infant. This procedure would interfere with a simple measurement of infant TEE using the standard dose-to-the-infant method. Theoretically, this difficulty can be resolved by dosing the mother with deuterium and the infant with 18-oxygen, and using curve-peeling methods to calculate the infant deuterium kinetics. We propose to ascertain whether such an approach is viable in practice, such that MVI, TEE and body composition could all be measured simultaneously in mixed-fed infants. Where MVI in older infants is measured on its own, there is a need to predict infant body water in order to estimate the deuterium dilution space. Using a database of 234 infants aged 1.5 to 12 months, we provide new predictive equations by which such values may be obtained. (author)

  3. Pre- and Postoperative Body Composition and Metabolic Characteristics in Patients with Acromegaly: A Prospective Study

    Science.gov (United States)

    Gao, Lu; Li, Hailong; Wang, Qiang; Wang, Zihao

    2018-01-01

    Objective To investigate the preoperative body composition, metabolic characteristics, and postoperative changes in patients with active acromegaly and analyze the effects of gender and age. Methods We included 36 patients with untreated acromegaly and 37 patients with nonfunctional pituitary adenomas. Adipose tissue (AT), the visceral fat index (VFI), sclerotin, protein, skeletal muscle, total body water (TBW), intracellular water (ICW), and extracellular water (ECW) were measured using bioelectrical impedance analysis (BIA). Total energy expenditure (TEE) and basal metabolism (BM) were measured with a cardiopulmonary and metabolic analyzer (CMA). Tricep skinfold thickness (TST), bicep circumference, waistline, hipline, and calf circumference were measured with a skinfold caliper and tape. These indices were measured before surgery and 3 months and 1 year after surgery. Results Overall, AT, VFI, and TST were lower, whereas sclerotin, protein, skeletal muscle, TBW, ICW, ECW, TEE, and BM were higher in acromegaly patients. Postoperatively, TST rose initially and then decreased, the waistline increased, and sclerotin, skeletal muscle, TEE, and BM decreased. Changes in these indices differed with gender and age in unique patterns. Conclusions Body composition and metabolism in acromegaly patients changed after surgery, and gender and age influenced these changes. PMID:29531529

  4. Compensation and trapping in CdZnTe radiation detectors studied by thermoelectric emission spectroscopy, thermally stimulated conductivity, and current-voltage measurements

    International Nuclear Information System (INIS)

    James, Ralph B.

    2000-01-01

    In today's commercially available counter-select-grade CdZnTe crystals for radiation detector applications, the thermal ionization energies of the traps and their types, whether electron or hole traps, were measured. The measurements were successfully done using thermoelectric emission spectroscopy (TEES) and thermally stimulated conductivity (TSC). For reliability, the electrical contacts to the sample were found to be very important and, instead of Au Schottky contacts, In Ohmic contacts had to be used. For the filling of the traps, photoexcitation was done at zero bias, at 20K and at wavelengths which gave the maximum bulk photoexcitation for the sample. Between the temperature range from 20 to 400 K, the TSC current was found to be on the order of ∼ 10,000 times or even larger than the TEES current, in agreement with theory, but only TEES could resolve the trap type and was sensitive to the deep traps. Large concentration of hole traps at 0.1 and 0.6 eV were observed and smaller contraction of electron traps at 0.4 eV was seen. These deep traps cause compensation in the material and also cause trapping that degrades the radiation detection measurement

  5. Gerbode defect and multivalvular dysfunction: Complex complications in adult congenital heart disease.

    Science.gov (United States)

    Ruivo, Catarina; Guardado, Joana; Montenegro Sá, Fernando; Saraiva, Fátima; Antunes, Alexandre; Correia, Joana; Morais, João

    2017-07-01

    We report a clinical case of a 40-year-old male with surgically corrected congenital heart disease (CHD) 10 years earlier: closure of ostium primum, mitral annuloplasty, and aortic valve and root surgery. The patient was admitted with acute heart failure. Transesophageal echocardiography (TEE) revealed a dysmorphic and severely incompetent aortic valve, a partial tear of the mitral valve cleft repair and annuloplasty ring dehiscence. A true left ventricular-to-right atrial shunt confirmed a direct Gerbode defect. The authors aim to discuss the diagnostic challenge of adult CHD, namely the key role of TEE on septal defects and valve regurgitations description. © 2017, Wiley Periodicals, Inc.

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... National Resource Directory Grants Management Services Veterans Service Organizations Office of ... Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports ...

  7. Draamateater võitis Poolas kaks preemiat / Tambet Kaugema

    Index Scriptorium Estoniae

    Kaugema, Tambet

    1999-01-01

    Eesti Draamateatri lavastus "Mao tee kalju peal" tõi Torunis toimunud rahvusvaheliselt festivalilt Kontakt kaks preemiat - Toruni Ülikooli preemia ja festivalile akrediteeritud teatrikriitikute preemia

  8. Kui ise ei tee, siis ei tee keegi : New Yorgi Storefronti galerii-platvormi töökorralduse kogemusi / Anu Lill

    Index Scriptorium Estoniae

    Lill, Anu

    2015-01-01

    Artikli autori kogemusi, olnud New Yorgi Storefront for Art and Architecture galeriis turunduse, suhtekorralduse ja arenduse osakonnas praktikal. Storefrontis tehakse näitusi, korraldatakse filmilinastusi, konverentse ning vestlusringe kunstnike ja arhitektidega

  9. Frequency of left atrial thrombus detected by transesophageal echocardiography in patients of tight mitral stenosis having negative trans-thoracic echocardiography at gulab devi cardiac complex

    International Nuclear Information System (INIS)

    Fayyaz, A.; Iqbal, M.W.

    2014-01-01

    Introduction: Patients with mitral stenosis (MS) having atrial fibrillation (AF) are more prone to develop left atrial (LA) thrombus. Systemic embolism, related to LA thrombus is a well-known risk of Percutaneous Mitral Balloon Valvotomy (PMBV) of the mitral valve. Therefore presence of LA thrombus is a contraindication to PMBV. Objective: Objective of this study was to detect the frequency of LA thrombus by transesophageal echocardiography (TEE) in patients of tight MS in whom transthoracic echocardiography (TTE) could not detect any LA thrombus. Patients and Methods: In this cross sectional study, we took 100 indoor patients with tight MS on non-probability consecutive sampling. Data was collected after meeting inclusion criteria. Patients were taken in this study after acquiring written informed consent. Symptoms were inquired from all patients and functional status was assessed by New York Heart Association class. Unstable patients were medically managed before the procedure. TEE was done on the same day before undergoing PMBV to look for clot in LA. Results: The mean age of the patients was 32.20 years and SD was 11.3 years. There were 36(36%) male patients and 64(64%) female patients. LA thrombus was present in 40% of patients on TEE out of which 19 were male patients (52.77%) and 21 were female patients (32.81%). Conclusion: Patients with mitral stenosis having AF are more prone to develop LA thrombus. In this study, the frequency of LA thrombus was 40% recorded, which is high. Due to the potential risk of embolization, it is strongly recommended to perform TEE in patients with normal TTE study before undergoing PMBV. The presence of a LA thrombus should be considered a contraindication to the PMBV of the mitral valve. (author)

  10. Transesophageal echocardiography in patients with cryptogenic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Dreger Henryk

    2009-03-01

    Full Text Available Abstract Background In about one third of all patients with cerebral ischemia, no definite cause can be identified (cryptogenic stroke. In many patients with initially suspected cryptogenic stroke, however, a cardiogenic etiology can eventually be determined. Hence, the aim of this study was to describe the prevalence of abnormal echocardiographic findings in a large number of these patients. Method Patients with cryptogenic cerebral ischemia (ischemic stroke, IS, and transient ischemic attack, TIA were included. The initial work-up included a neurological examination, EEG, cCT, cMRT, 12-lead ECG, Holter-ECG, Doppler ultrasound of the extracranial arteries, and transthoracic echocardiography. A multiplane transeophageal echocardiography (TEE, including i.v. contrast medium application [Echovist], Valsalva maneuver was performed in all patients Results 702 consecutive patients (380 male, 383 IS, 319 TIA, age 18–90 years were included. In 52.6% of all patients, TEE examination revealed relevant findings. Overall, the most common findings in all patients were: patent foramen ovale (21.7%, previously undiagnosed valvular disease (15.8%, aortic plaques, aortic valve sclerosis, atrial septal aneurysms, regional myocardial dyskinesia, dilated left atrium and atrial septal defects. Older patients (> 55 years, n = 291 and patients with IS had more relevant echocardiographic findings than younger patients or patients with TIA, respectively (p = 0.002, p = 0.003. The prevalence rates of PFO or ASD were higher in younger patients (PFO: 26.8% vs. 18.0%, p = 0.005, ASD: 9.6% vs. 4.9%, p = 0.014. Conclusion A TEE examination in cryptogenic stroke reveals contributing cardiogenic factors in about half of all patients. Younger patients had a higher prevalence of PFO, whereas older patients had more frequently atherosclerotic findings. Therefore, TEE examinations seem indicated in all patients with cryptogenic stroke – irrespective of age – because of

  11. Profound Obstructive Hypotension From Prone Positioning Documented by Transesophageal Echocardiography in a Patient With Scoliosis: A Case Report.

    Science.gov (United States)

    Abcejo, Arnoley S; Diaz Soto, Juan; Castoro, Courtney; Armour, Sarah; Long, Timothy R

    2017-08-01

    In a healthy 12-year-old female with scoliosis, prone positioning resulted in pressor-refractory cardiovascular collapse. Resumption of supine position immediately improved hemodynamics. Intraoperative transesophageal echocardiography (TEE) revealed a collapsed left atrium and biventricular failure. Repeat prone positioning resulted in a recurrence of hypotension. However, hemodynamic stabilization was restored and maintained by repositioning chest pads caudally. The patient successfully underwent a 6-hour scoliosis repair without perioperative morbidity. With this case, we aim to: (1) reintroduce awareness of this mechanical obstructive cause of reversible hypotension; (2) highlight the use of intraoperative TEE during prone hemodynamic collapse; and (3) suggest an alternative prone positioning technique if chest compression results in hemodynamic instability.

  12. Transesophageal echocardiography. 3. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Lambertz, Heinz; Lethen, Harald

    2013-01-01

    The book on transesophageal echocardiography covers the following issues: Development of transesophageal echocardiography, technical advances; indications and contraindication for transesophageal echocardiography; systematic of the medical examination process; cardiac valves and valve prostheses; mitral and aortic valvuloplasty, TAVI and interventional treatment of mitral regurgitation; infectious endocarditis; one-way and effluence disturbances of the left and right ventricle; diseases of the thoracic aorta; undefined right ventricle enlargement; lung embolism, acute infarct complications; TEE during anesthesia and perioperative intensive medicine, cardiac sources of embolism; cardiac tumors, mediastinal lymph nodes; pericardiac diseases; congenital heart diseases in childhood and adulthood; catheter interventions and heart valve reconstruction; surgically corrected congenital cardiac defects; intracavitary versus transesophageal echocardiography; three-dimensional TEE; coronary diagnostics; ischemia and vitality diagnostics.

  13. Anesthetic management for combined mitral valve replacement and aortic valve repair in a patient with osteogenesis imperfecta

    Directory of Open Access Journals (Sweden)

    Huang Jiapeng

    2011-01-01

    Full Text Available Osteogenesis imperfecta is a rare disorder of connective tissues and presents multiple challenges, including difficult airway, hyperthermia, coagulopathy and respiratory dysfunction, for anesthesiologists, especially during cardiac surgery. We present anesthetic management of a patient with osteogenesis impertecta during double valve surgery. Dexmedetomidine infusion minimized the risks of malignant hyperthermia. Glidescope and in-line stabilization facilitated endotracheal intubation and protected his oral structures and cervical spine. Transesophageal echocardiography (TEE diagnosed a flail A3 segment and redundant left coronary cusp causing mitral and aortic regurgitation. The mitral valve was replaced and the aortic valve repaired. Coagulopathy was corrected according to comprehensive coagulation analysis. Glidescope, dexmedetomidine, coagulation analysis and TEE could facilitate anesthetic management in these patients.

  14. [Fever, atrial fibrillation, and angina pectoris in a 58-year-old man].

    Science.gov (United States)

    Groebner, M; Südhoff, T; Doering, M; Kirmayer, M; Nitsch, T; Prügl, L; Römer, W; Wolf, H; Tacke, J; Massoudy, P; Nüsse, T; Elsner, D

    2014-05-01

    Primary cardiac lymphoma (PCL) respresents a very rare type of cardiac tumour. This report illustrates a case of PCL in an immunocompetent 58-year-old man presenting with atrial fibrillation and febrile syndrome. Comprehensive imaging [computer tomography (CT), cardiac magnetic resonance imaging (cMRI), 3-dimensional transesophageal echocardiography (3D-TEE)] identified a large right atrial tumour, leading to pericardial effusion. Isolated cardiac involvement was confirmed by positron emission tomography (PET)-CT. A diffuse large B-cell lymphoma (DLBCL) was diagnosed based on the results of a TEE-guided biopsy. A normalized PET scan (PETAL study) indicated complete remission following R-CHOP 14 immunochemotherapy. Thus, an interdisciplinary and multimodal approach avoided unnecessary cardiac surgery.

  15. Noninvasive diagnosis of suspected severe pulmonary embolism. Trans-esophageal echocardiography vs spiral CT

    International Nuclear Information System (INIS)

    Pruszczyk, P.; Torbicki, A.; Pacho, R.

    1998-01-01

    Patients with pulmonary embolism (PE) and echocardiographic signs of right ventricular over-lead have worse prognosis and may be require aggressive therapy. Unequivocal confirmation of PE is required before thrombolysis or embolectomy. This study compares the value of trans-esophageal echocardiography (TEE) and spiral CT (sCT) in direct visualization of pulmonary artery thrombo-emboli in patients with suspected PE and echocardiographic signs of right ventricular over-lead. Because of high prevalence of bilateral central pulmonary thrombo-emboli in patients with hemo-dynamically significant PE, both sCT and TEE allow its definitive confirmation in most cases. Thrombi reported by sCT distally to lobar arteries should be interpreted with caution. (author)

  16. Transesophageal echocardiography. 3. rev. and enl. ed.; Transoesophageale Echokardiografie. Lehrbuch und Altlas zur Untersuchungstechnik und Befundinterpretation

    Energy Technology Data Exchange (ETDEWEB)

    Lambertz, Heinz [ECHOECUCT-Akademie, Wiesbaden (Germany); Lethen, Harald (eds.) [Internistische Intensivmedizin, Wiesbaden (Germany). Innere Medizin/Kardiologie

    2013-02-01

    The book on transesophageal echocardiography covers the following issues: Development of transesophageal echocardiography, technical advances; indications and contraindication for transesophageal echocardiography; systematic of the medical examination process; cardiac valves and valve prostheses; mitral and aortic valvuloplasty, TAVI and interventional treatment of mitral regurgitation; infectious endocarditis; one-way and effluence disturbances of the left and right ventricle; diseases of the thoracic aorta; undefined right ventricle enlargement; lung embolism, acute infarct complications; TEE during anesthesia and perioperative intensive medicine, cardiac sources of embolism; cardiac tumors, mediastinal lymph nodes; pericardiac diseases; congenital heart diseases in childhood and adulthood; catheter interventions and heart valve reconstruction; surgically corrected congenital cardiac defects; intracavitary versus transesophageal echocardiography; three-dimensional TEE; coronary diagnostics; ischemia and vitality diagnostics.

  17. Vmesto Key Kaubamaja v Mustamjae mozhet bõt postrojeno novoje kommertsheskoje zdanije

    Index Scriptorium Estoniae

    2006-01-01

    Tallinna Mustamäe linnaosas Kadaka tee 70 asunud Key Kaubamaja asemele kavandatakse kahekorruselist kaubamaja ja kuuekorruselist büroohoonet. Detailplaneeringu eskiisprojekti koostas Ruum ja Maastik OÜ

  18. Restoran Noa Miidurannas = Noa Restaurant in the Miiduranna area of Tallinn / Peeter Loo, Jan Skolimowski, Kaspar Kruuse, Tarmo Piirmets ; kommenteerinud Raivo Kotov

    Index Scriptorium Estoniae

    2015-01-01

    Noa restoran Miidurannas Ranna tee 3, valminud 2014. Arhitektid Peeter Loo, Jan Skolimowski, Kaspar Kruuse (Kamp Arhitektid), sisearhitekt Tarmo Piirmets (Pink). Eesti Kultuurkapitali Arhitektuuri sihtkapitali arhitektuuripreemia 2014

  19. Maestro lahkub, edu retsept taskus / Tõnis Arnover

    Index Scriptorium Estoniae

    Arnover, Tõnis, 1952-

    2006-01-01

    USA keskpanga pikaaegse juhi Alan Greenspani tegevusest ja ametist tagasiastumisest. Vt. samas: Kõnekate vihjete suurmeister; Doktorikraad tuli alles keskeas; Alan Greenspani tee pooljumala seisusesse. Verstapostid keskpanga juhina

  20. Põhja-Eesti Regionaalhaigla X-korpus = North-Estonian Regional Hospital X-wing / Mari Kurismaa ; intervjueerinud Margit Mutso

    Index Scriptorium Estoniae

    Kurismaa, Mari, 1956-

    2011-01-01

    Tallinnas Sütiste tee 19 asuva haigla juurdeehitise sisekujundusest. Sisearhitekt Mari Kurismaa (Stuudio Kurismaa OÜ). Arhitektid Indrek Suigusaar, Vivian Oruvee (AB Pluss OÜ). Infograafika autor Mari Kaljuste

  1. Comparison of resting energy equations and total energy expenditure in haemodialysis patients and body composition measured by multi-frequency bioimpedance.

    Science.gov (United States)

    Oliveira, Ben; Sridharan, Sivakumar; Farrington, Ken; Davenport, Andrew

    2017-07-13

    Waste products of metabolism are retained in haemodialysis (HD) patients. Cellular metabolism generates energy, and patients with greater energy expenditure may therefore require more dialysis. To determine the amount of dialysis required, equations estimating resting and total energy expenditure (REE,TEE) are required. We compared estimates of REE in HD patients using established equations with a novel equation recently validated in HD patients (HD equation). TEE was derived from REE (HD equation) and estimates of physical activity obtained by questionnaire. REE and TEE relationships with bioimpedance measured body composition were then determined. We studied 317 HD patients; 195 males (61.5%), 123 diabetic (38.9%), mean age 65.0 ± 15.3 and weight 73.1 ± 16.8 kg. REE from HD Equation was 1509 ± 241 kcal/day, which was greater than for Mifflin St Joer 1384 ± 259, Harris-Benedict 1437 ± 244, Katch-McArdle 1345 ± 232 (all p employment (β 406.5, p appearance (β 2.7, p = 0.015), and negatively with age (β -7.9, p appearance, lower co-morbidity, age, and dialysis vintage, and the employed. More metabolically active patients may require greater dialytic clearances. This article is protected by copyright. All rights reserved.

  2. [Periprocedural and late complications after percutaneous closure of patent foramen ovale: a single centre experience].

    Science.gov (United States)

    Węglarz, Przemysław; Konarska Kuszewska, Ewa; Spisak Borowska, Katarzyna; Machowski, Jerzy; Drzewiecka-Gerber, Agnieszka; Kuszewski, Piotr; Jackson, Christopher L; Opala, Grzegorz; Trusz Gluza, Maria

    2012-01-01

    Patent foramen ovale (PFO) is a potential risk factor for ischaemic stroke in young individuals. An interventional method of secondary stroke prevention in PFO patients is its percutaneous closure. To assess safety and effectiveness (i.e. lack of residual shunt) of percutaneous PFO closure in patients with history of cryptogenic cerebrovascular event. 149 patients (56 men/93 women), aged 39 ± 12 years, underwent percutaneous PFO closure. The implantation was performed under local anaesthesia, guided by trans-oesophageal echocardiography (TEE) and fluoroscopy. Follow-up trans-thoracic echocardiography (TTE) was performed at 1 month and follow-up TEE at 6-months. In cases of residual shunt, additional TEE was performed after ensuing 6 months. Effective PFO closure (no residual shunt) was achieved in 91.3% patients at 6 months and 95.3% patients at 12 months. In 2 patients transient atrial fibrillation was observed during the procedure. In 2 patients, a puncture site haematoma developed and in 1 patient superficial thrombophlebitis was noted. In 1 patient a small pericardial effusion was observed, which resolved at day 3 post-procedurally, after administration of non-steroidal anti-inflammatory drugs. Percutaneous PFO closure seems to be a safe procedure when performed in a centre with adequate expertise with regard to these procedures.

  3. Patent foramen ovale in a large population of ischemic stroke patients: diagnosis, age distribution, gender, and race.

    Science.gov (United States)

    Gupta, Vishal; Yesilbursa, Dilek; Huang, Wen Ying; Aggarwal, Kul; Gupta, Vijaya; Gomez, Camilo; Patel, Vinod; Miller, Andrew P; Nanda, Navin C

    2008-02-01

    Patent foramen ovale (PFO) is a well-recognized risk factor for ischemic strokes. The true prevalence of PFO among stroke patients is still under debate. Transesophageal echocardiography (TEE) is the "gold standard" in diagnosing PFO but the physiology requires right-to-left atrial shunting. In this report, we evaluate the prevalence of PFO in a diverse group of ischemic stroke patients studied by TEE. TEE of 1,663 ischemic stroke patients were reviewed for cardiac source of embolism, including PFO and atrial septal aneurysm (ASA). Agitated saline bubble injection was performed to look for right to left atrial shunting. Success of maneuvers to elevate right atrial pressure (RAP) was noted by looking at the atrial septal bulge. Among 1,435 ischemic stroke patients analyzed, the presence or absence of PFO could not be determined in 32.1% because bulging of the septum could not be demonstrated in patients with negative contrast study despite aggressive maneuvers to elevate RAP. Of the remaining 974 patients, 294 patients (30.2%) had a PFO. The mean age was 61.5 years in both groups, with a bimodal distribution of PFO and the highest prevalence occurring in gender or racial difference in the prevalence of PFO, but there was a bimodal distribution in prevalence with age.

  4. Velocity encoded cardiovascular magnetic resonance to assess left atrial appendage emptying

    Directory of Open Access Journals (Sweden)

    Muellerleile Kai

    2012-06-01

    Full Text Available Abstract Background The presence of impaired left atrial appendage (LAA function identifies patients who are prone to thrombus formation in the LAA and therefore being at high risk for subsequent cardioembolic stroke. LAA function is typically assessed by measurements of LAA emptying velocities using transesophageal echocardiography (TEE in clinical routine. This study aimed at evaluating the feasibility of assessing LAA emptying by velocity encoded (VENC cardiovascular magnetic resonance (CMR. Methods This study included 30 patients with sinus rhythm (n = 18 or atrial fibrillation (n = 12. VENC-CMR velocity measurements were performed perpendicular to the orifice of the LAA. Peak velocities were measured of passive diastolic LAA emptying (e-wave in all patients. Peak velocities of active, late-diastolic LAA emptying (a-wave were assessed in patients with sinus rhythm. Correlation and agreement was analyzed between VENC-CMR and TEE measurements of e- and a-wave peak velocities. Results A significant correlation and good agreement was found between VENC-CMR and TEE measurements of maximal e-wave velocities (r = 0.61, P  Conclusions The assessment of active and passive LAA emptying by VENC-CMR is feasible. Further evaluation is required of potential future clinical applications such as risk stratification for cardioembolic stroke.

  5. Globanizatsija v miniature / Aleksandr Ikonnikov

    Index Scriptorium Estoniae

    Ikonnikov, Aleksandr

    2002-01-01

    St. Peterburgi 3000. a. ja Kaasani 1000. a. pühendatud rahvusvaheline konverents tõi meile erinevatest rahvustest, erinevate poliitiliste vaadetega inimesi erinevatest riikidest. Konverents "Suur Volga tee"

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic ... War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & ... War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters ...

  8. Kesk-Ameerika võitleb uimastimaffia vastu / Allan Espenberg

    Index Scriptorium Estoniae

    Espenberg, Allan

    2008-01-01

    USA parlament andis rohelise tee Merida initsiatiivile, mis näeb ette Mehhikole, Kesk-Ameerika riikidele ja Kariibi maadele organiseeritud kuritegevuse vastu võitlemiseks majanduslikku ja tehnilist abi

  9. Kak obraz vhodit v obraz / Mihhail Shemjakin

    Index Scriptorium Estoniae

    Shemjakin, Mihhail

    2004-01-01

    Vene kunstnik Mihhail Shemjakin endast (A. Ananitshevi intervjuu almanahhist "Mir Mihhaila Shemjakina") ja projekti "Mihhail Shemjakini näitus Tallinnas" autor Marina Tee Tallinna Linnagaleriis toimunud näitusest

  10. Eesti osaleb Riia teatrifestivalil kahe lavastusega

    Index Scriptorium Estoniae

    1999-01-01

    Riias algas 25. okt. rahvusvaheline teatrifestival Homo Novus '99,kus Eestit esindavad Eesti Draamateater Priit Pedajase lavastusega "Mao tee kalju peal" ja Theatrum Lembit Petersoni lavastusega "Pelleas ja Melisande"

  11. Draamateater ja Theatrum Riias festivalil / Andres Keil

    Index Scriptorium Estoniae

    Keil, Andres, 1974-

    1999-01-01

    Riias algas 25. okt. rahvusvaheline teatrifestival Homo Novus '99,kus Eestit esindavad Eesti Draamateater Priit Pedajase lavastusega "Mao tee kalju peal" ja Theatrum Lembit Petersoni lavastusega "Pelleas ja Melisande"

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games ...

  13. Kiviõli seikluskeskuse teenindushoone = Kiviõli adventure centre service building / Koit Ojaliiv

    Index Scriptorium Estoniae

    Ojaliiv, Koit, 1980-

    2015-01-01

    Kiviõli seikluskeskuse teenindushoone Mäepealse tee 1, valminud 2014. Hoone arhitekt Koit Ojaliiv (Kuu Arhitektid), sisekujundus Hannes Praks ja Eeva Masso (Kohvi OÜ). 2014. aasta Kultuurkapitali Arhitektuuripreemia kandidaat

  14. Laenu tagamisest munitsipaalmaaga ehk kuidagi ikka saab / Rein Tiivel

    Index Scriptorium Estoniae

    Tiivel, Rein, 1940-

    2006-01-01

    AS Kinnisvaratehingud ja Puulinna Linnavalitsus leppisid kokku linna omandis oleva kinnisasja koormamises kinnisvarafirma kasuks. Esitatud kaasus sisaldas mitmeid kokkuleppeid, mis seadsid kahtluse alla tehingu kehtivuse ja valitud tee otstarbekuse

  15. Intellektuaal Hernando de Soto hiilgav tee / Mihhail Lotman

    Index Scriptorium Estoniae

    Lotman, Mihhail, 1952-

    2005-01-01

    Artikkel kuulub maailma mõjukaimad intellektuaale tutvustavasse sarja. Autor tutvustab Peruu majanduseksperdi ja publitsisti, Vabaduse ja Demokraatia Instituudi looja ja juhataja Hernando de Soto tegevust, seisukohti ning leftistide kriitikat tema aadressil. Lisa: Hernando de Soto

  16. AS Balti Ameerika Auto Keskus Peterburi tee 50

    Index Scriptorium Estoniae

    1998-01-01

    Tallinna 'Chrysleri' ja 'Jeepi' autokeskuse hoonekompleksis on eristatavad kolm osa: kahekorruseline müügisalong, ühekorruseline töökoda ja hooldusruunid, ladu ning olmeplokk. Klaasfassaadiga automüügisaal ulatub hoonest välja sammastega ümbritsetud poolkaarest paadikujulise siiluna. Peatöövõtja: AS Feer Ehituse projektijuht: AS TSM. Projekteerija: Arhitektuuribüroo R. Puusepp. Arhitekt Aare Saks (FFNS, Rootsi). Sisekujundus Rein Nurmse. Projekt 1996, valmis 1997

  17. The TEES process cleans waste and produces energy

    International Nuclear Information System (INIS)

    Elliott, D.C.; Silva, L.J.

    1995-02-01

    A gasification system is under development that can be used with most types of wet organic wastes. The system operates at 350 degrees C and 205 atm using a liquid water phase as the processing medium. Since a pressurized system is used, the wet waste can be fed as a solution or slurry to the reactor without drying. Through the development of catalysts, a useful processing system has been produced. The system has utility both for direct conversion of high-moisture biomass to fuel gas or as a wastewater cleanup system for wet organic wastes including unconverted biomass from bioconversion processes. By the use of this system >99% conversions of organic waste to medium-Btu fuel gas can be achieved

  18. Viimsi Püha Jaakobi kirik = Jacob's Church in Viimsi / Margit Mutso

    Index Scriptorium Estoniae

    Mutso, Margit, 1966-

    2009-01-01

    Kirikuhoonest (Nurme tee 3, Pringi küla, Viimsi vald), mille arhitekt on Martin Aunin, kaasautor Erkki Ristoja ja konstruktor Kristjan Kaares. Žürii hinnang kultuurkapitali aastapreemiale esitatud hoonele

  19. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals ... from War Specific to Women Types of Trauma War Terrorism Violence and Abuse ...

  20. PTSD: National Center for PTSD

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    Full Text Available ... Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional Loan Centers Cemetery Locations Contact Us ...

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers ...

  2. Making three-dimensional echocardiography more tangible: a workflow for three-dimensional printing with echocardiographic data

    Directory of Open Access Journals (Sweden)

    Azad Mashari MD

    2016-12-01

    Full Text Available Three-dimensional (3D printing is a rapidly evolving technology with several potential applications in the diagnosis and management of cardiac disease. Recently, 3D printing (i.e. rapid prototyping derived from 3D transesophageal echocardiography (TEE has become possible. Due to the multiple steps involved and the specific equipment required for each step, it might be difficult to start implementing echocardiography-derived 3D printing in a clinical setting. In this review, we provide an overview of this process, including its logistics and organization of tools and materials, 3D TEE image acquisition strategies, data export, format conversion, segmentation, and printing. Generation of patient-specific models of cardiac anatomy from echocardiographic data is a feasible, practical application of 3D printing technology.

  3. Role of Echocardiography in the Management and Prognosis of Atrial Fibrillation

    Science.gov (United States)

    Silverman, David I; Ayirala, Srilatha R; Manning, Warren J

    2012-01-01

    Echocardiography plays a longstanding and vital role in the management of atrial fibrillation (AF). Advances in 2D imaging, Doppler echocardiography and strain imaging have all contributed to major progress in AF treatment. Echocardiographically measured left atrial (LA) volume is a powerful predictor of maintenance of sinus rhythm following cardioversion as well as risk of thrombus formation and thromboembolism. Doppler derived parameters of atrial mechanical function including atrial ejection force provide related prognostic information. Transesophageal echocardiocardiograpy (TEE) guided cardioversion of AF allows for rapid conversion to sinus rhythm without prolonged oral anticoagulation, and TEE serves as a useful tool during catheter ablation of AF and atrial flutter. Newer measures derived from speckle tracking offer great promise in further improving the care of patients with AF. PMID:28496715

  4. Viimsi Keevituse kontorihoone = Viimsi Keevitus office building / Madis Eek ; intervjueerinud Margit Mutso

    Index Scriptorium Estoniae

    Eek, Madis, 1966-

    2011-01-01

    Haabneemes Kaluri tee 13 asuva hoone rekonstrueerimisest ja sisekujundusest. Arhitekt Madis Eek, kaasautorid Kristi Põldme, Kristel Jaanus, klaasseinte joongraafika autor Reio Avaste (AB Eek & Mutso OÜ) . Keevislõvide autor Kalle Pruuden

  5. Liberaliseerime kapitalituru / Kenneth Rogoff

    Index Scriptorium Estoniae

    Rogoff, Kenneth

    2007-01-01

    IMF on ainus organisatsioon, mis võib leida tee riikidevahelise koostööni ka rahandusala üleilmastumise riskide vastu, tehes aktiivset lobitööd areneva maailma kiiremaks finantsiliseks avamiseks

  6. Marie N seisis pea peal / Helen Urbanik

    Index Scriptorium Estoniae

    Urbanik, Helen

    2002-01-01

    Tänavuse Eurovisiooni võitjast Marija Naumovast, tema heliplaatidest "Do svetlõh sljoz" ("Magusate pisarateni"), "Leskaties acis" ("Vaata mu silmadesse"), "Ma voix, ma vie" ("Minu hääl, minu tee")

  7. Tallinn pokupajet zemlju dlja prokladki shosse Põhjaväil

    Index Scriptorium Estoniae

    2007-01-01

    Seoses Russalkast Ahtri tänavani ulatuva tee-ehitusega seisab linnal ees 16 maaküsimuse lahendamine. Probleemidest seoses väila osaliselt merre ehitamisega. Kommenteerivad Alo Brandt ja Ain Valdmann

  8. Google ohverdab kasumit / Tarvo Vaarmets

    Index Scriptorium Estoniae

    Vaarmets, Tarvo

    2010-01-01

    Internetikontserni Google II kvartali puhaskasum osutus analüütikute prognoosidest väiksemaks. Google on kasumi hoogsa kasvatamise asemel valinud teise tee - otsida uusi võimalusi, uusi turge ja kasvuallikaid

  9. Jälitades vandlit / Bryan Christie ; fotod Brent Stirton

    Index Scriptorium Estoniae

    Christie, Bryan

    2015-01-01

    Osa Aafrika sõjategevuseks kasutatavast rahast saadakse vandliärist. Võltsvõhad, millesse on peidetud GPS-seadmed, paljastavad Aafrikas salakütitud vandli tee. Võitlusest salaküttimise vastu Aafrika riikides

  10. Karulaugu lasteaed-algkool = Karulaugu preschool and elementary school / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2009-01-01

    2009. a. Haabneemes Randvere tee 18 valminud Karulaugu lasteaed-algkoolist, mille arhitektid on Emil Urbel ja Indrek Erm, projekteerija AB Emil Urbel, sisekujundajad Taso Mähar ja Ines Haak. Projekt 2007

  11. Põhja-Eesti Regionaalhaigla uus korpus = New Block of the North Estonia Mrdical Centre

    Index Scriptorium Estoniae

    2010-01-01

    Tallinnas Sütiste tee 19 asuva haigla uue korpuse sisekujundusest. Sisearhitekt Mari Kurismaa, tema tähtsamate tööde loetelu. Haigla arhitektid Indrek Suigusaar ja Vivian Oruvee. Infograafika: Mari Kaljuste

  12. Svjaz : s obshtshestvennostju ili s korruptsijei? / Virkko Lepassalu

    Index Scriptorium Estoniae

    Lepassalu, Virkko, 1971-

    2008-01-01

    Randvere tee detailplaneeringu lugu ja selle võimalik seos Tallinna abilinnapea nõuniku Ivo Parbuse korruptsioonisüüdistusega. Piir korruptsiooni ja seadusliku tegevuse vahel võib olla eristamatu. Lisa: Spravka "DD"

  13. Wege der estnischen Musik von russischer Romantik zum Schamanentum. Lepo Sumera als prominenter Vertreter der Neuen Musik Estlands: seeine neue Sinfonie steht im Mittelpunkt von Konzerten der Staatskapelle

    Index Scriptorium Estoniae

    1992-01-01

    Eesti muusika tee vene romantismist £amanismini: Lepo Sumera kui eesti uue muusika silmapaistev esindaja/ Tema uus sümfoonia on Staatskapelle kontsertide keskpunktiks. Eesti kultuuripäevadelt Karlsruhes; Lepo Sumera muusikast

  14. Energy expenditure in caving.

    Directory of Open Access Journals (Sweden)

    Giorgia Antoni

    Full Text Available The aim of this study was to determine the energy expenditure of a group of cavers of both genders and different ages and experience during a 10 hour subterranean exploration, using portable metabolimeters. The impact of caving activity on body composition and hydration were also assessed through bioelectrical impedance, and nutritional habits of cavers surveyed. During cave activity, measured total energy expenditure (TEE was in the range 225-287 kcal/h for women-men (MET = 4.1, respectively; subjects had an energy intake from food in the range 1000-1200 kcal, thus inadequate to restore lost calories. Bayesian statistical analysis estimated the effect of predictive variables on TEE, revealing that experienced subjects had a 5% lower TEE than the less skilled ones and that women required a comparatively larger energy expenditure than men to perform the same task. BIVA (bioelectrical impedance vector analysis showed that subjects were within the range of normal hydration before and after cave activity, but bioelectrical changes indicated a reduction of extracellular water in men, which might result in hypo-osmolal dehydration in the case of prolonged underground exercise. All these facts should be considered when planning cave explorations, preparing training programs for subjects practising caving, and optimizing a diet for cavers. Further, information gathered through this study could be of value to reduce accidents in caves related to increase in fatigue.

  15. Energy expenditure in children with cerebral palsy and moderate / severe malnutrition during nutritional recovery.

    Science.gov (United States)

    García-Contreras, Andrea A; Vásquez-Garibay, Edgar M; Romero-Velarde, Enrique; Ibarra-Gutierrez, Ana I; Troyo-Sanroman, Rogelio

    2015-05-01

    To analyze the total energy expenditure (TEE) and resting energy expenditure (REE) in children with cerebral palsy (CP) and moderate or severe malnutrition during nutritional recovery. In an intervention study, thirteen subjects with CP (10 females and 3 males with a mean age of 9y11m ± 2y3m), level V of the Gross Motor Function Classification System and moderate or severe malnutrition were included. Eight were fed by nasogastric tube and five by gastrostomy. They were compared with 57 healthy participants (31 females and 26 males with mean age of 8y7m ± 10m). Anthropometric measurements, body composition and energy expenditure by bioelectrical impedance analysis (BIA) and indirect calorimetry (IC) were performed in both groups. TEE and REE were higher in healthy children than in children with CP in kcal/d and kcal/cm/d but were lower in kcal/kg/d (p children with CP produced a significant increase in energy expenditure. TEE and REE, in children with CP, are lower than in healthy children. Estimating the REE in children with CP and malnutrition is better performed in kcal/kg/d than in kcal/cm/d. Fat-free mass (FFM) is a good predictor of the REE in healthy children and children with CP. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. Vigdis Finnbogadottir / Vigdis Finnbogadottir ; interv. Astrid kannel

    Index Scriptorium Estoniae

    Finnbogadottir, Vigdis

    2007-01-01

    Maailma esimene valitud naispresident, Islandi Vabariigi president aastatel 1980-1996 Vigdis Finnbogadottir. Haridus, karjäär, tee teatridirektori toolilt presidendipostile, väikerahva keele olulisus, naised tipp-poliitikas, hariduse osatähtsus

  17. Kasvuvisioon 2018 - Eesti riigi järgmine juhtimisülesanne / Priit Põldoja

    Index Scriptorium Estoniae

    Põldoja, Priit, 1969-

    2010-01-01

    Ettevõtja hinnagul peab Eesti riigil olema aktiivne ettekujutus, kuidas positiivselt eristuda ja kuhu edasi liikuda. Arengufondi initsiatiiv Eesti kasvuvisiooni loomisel peaks leidma ühel või teisel viisil tee Eesti otsustajate tegevuskavva

  18. Draamateater napsas kaks auhinda

    Index Scriptorium Estoniae

    1999-01-01

    Draamateatri lavastus "Mao tee kalju peal" võitis Toruni rahvusvahelisel teatrifestivalil kaks auhinda. Priit Pedajase lavastus sai teatrikriitikute preemia ja eriauhinna Toruni Koperniku Ülikoolilt. Peaauhinda sel aastal välja ei antudki

  19. jfewr ©2016 - jfewr Publications

    African Journals Online (AJOL)

    user

    2016-09-03

    Sep 3, 2016 ... technique was used; where five local governments Areas (LGAs) were randomly selected, ... Key words: Kano metropolis, Nursery, Ornamental plants, Seedling, Unemployment. ..... Tee, N.T. and Labo, I. (2010): Inventory and.

  20. Nauding kehale ja meelele / Marika Aret ; tekst Inna Inanna

    Index Scriptorium Estoniae

    Aret, Marika

    2014-01-01

    Mustamäel Mustamäe tee 17 avatud Bliss majast, kus muude teenuste kõrval pakutakse buffeeerestoranis ja kohvikus taime- ja toortoitu. Intervjuu Blissi käivitustiimi ja restorani perenaise Marika Aretiga

  1. Routine cine-CMR for prosthesis-associated mitral regurgitation: a multicenter comparison to echocardiography.

    Science.gov (United States)

    Simprini, Lauren A; Afroz, Anika; Cooper, Mitchell A; Klem, Igor; Jensen, Christoph; Kim, Raymond J; Srichai, Monvadi B; Heitner, John F; Sood, Michael; Chandy, Elizabeth; Shah, Dipan J; Lopez-Mattei, Juan; Biederman, Robert W; Grizzard, John D; Fuisz, Anthon; Ghafourian, Kambiz; Farzaneh-Far, Afshin; Weinsaft, Jonathan

    2014-09-01

    Mitral regurgitation (MR) is an important complication after prosthetic mitral valve (PMV) implantation. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-cardiac magnetic resonance (CMR) holds the potential for the non-invasive assessment of regurgitant severity based on MR-induced inter-voxel dephasing. The study aim was to evaluate routine cine-CMR for the visual assessment of PMV-associated MR. Routine cine-CMR was performed at nine sites. A uniform protocol was used to grade MR based on jet size in relation to the left atrium (mild 2/3). MR was graded in each long-axis orientation, with overall severity based on cumulative grade. Cine-CMR was also scored for MR density and pulmonary vein systolic flow reversal (PVSFR). Visual interpretation was compared to quantitative analysis in a single-center (derivation) cohort, and to transesophageal echocardiography (TEE) in a multicenter (validation) cohort. The population comprised 85 PMV patients (59% mechanical valves, 41% bioprostheses). Among the derivation cohort (n = 25), quantitative indices paralleled visual scores, with stepwise increases in jet size and density in relation to visually graded MR severity (both p = 0.001). Patients with severe MR had an almost three-fold increase in quantitative jet area (p = 0.002), and a two-fold increase in density (p = 0.04) than did other patients. Among the multicenter cohort, cine-CMR and TEE (Δ =. 2 ± 3 days) demonstrated moderate agreement (κ = 0.44); 64% of discordances differed by ≤ 1 grade (Δ = 1.2 ± 0.5). Using a TEE reference, cine-CMR yielded excellent diagnostic performance for severe MR (sensitivity, negative predictive value = 100%). Patients with visually graded severe MR also had more frequent PVSFR (p cine-CMR. Cine-CMR is useful for the assessment of PMV-associated MR, which manifests concordant quantitative and qualitative changes in size and density of inter-voxel dephasing. Visual MR

  2. Routine Cine-CMR for Prosthesis Associated Mitral Regurgitation – A Multicenter Comparison to Echocardiography

    Science.gov (United States)

    Simprini, Lauren A.; Afroz, Anika; Cooper, Mitchell A.; Klem, Igor; Jensen, Christoph; Kim, Raymond J.; Srichai, Monvadi B.; Heitner, John F.; Sood, Michael; Chandy, Elizabeth; Shah, Dipan J.; Lopez-Mattei, Juan; Biederman, Robert W.; Grizzard, John D.; Fuisz, Anthon; Ghafourian, Kambiz; Farzaneh-Far, Afshin; Weinsaft, Jonathan

    2016-01-01

    Background/Aim MR is an important complication after PMV. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-CMR holds potential to non-invasively assess regurgitant severity based on MR-induced inter-voxel dephasing. This study evaluated routine cine-CMR for visual assessment of prosthetic mitral valve (PMV) associated mitral regurgitation (MR). Methods Routine cine-CMR was performed at 9 sites. A uniform protocol was used to grade MR based on jet size in relation to the left atrium (mild 2/3): MR was graded in each long axis orientation, with overall severity based on cumulative grade. Cine-CMR was also scored for MR density and pulmonary vein systolic flow reversal (PSFR). Visual interpretation was compared to quantitative analysis in a single center (derivation) cohort, and to transesophageal echocardiography (TEE) in a multicenter (validation) cohort. Results The population comprised 85 PMV patients (59% mechanical, 41% bioprosthetic). Among the derivation cohort (n=25), quantitative indices paralleled visual scores, with stepwise increases in jet size and density in relation to visually graded MR severity (both p=0.001): Patients with severe MR had nearly a 3-fold increase in quantitative jet area (p=0.002), and 2-fold increase in density (p=0.04) than did others. Among the multicenter cohort, cine-CMR and TEE (Δ=2±3 days) demonstrated moderate agreement (κ=0.44); 64% of discordances differed by ≤ 1 grade (Δ=1.2±0.5). Using a TEE reference, cine-CMR yielded excellent diagnostic performance for severe MR (sensitivity, negative predictive value=100%). Patients with visually graded severe MR also had more frequent PVSFR (pcine-CMR. Conclusions Cine-CMR is useful for assessment of PMV-associated MR, which manifests concordant quantitative and qualitative changes in size and density of inter-voxel dephasing. Visual MR assessment based on jet size provides an accurate non-invasive means of screening for

  3. Can contrast-enhanced multi-detector computed tomography replace transesophageal echocardiography for the detection of thrombogenic milieu and thrombi in the left atrial appendage. A prospective study with 124 patients; Kann die kontrastmittelverstaerkte Mehrzeilen-Computertomografie die transoesophageale Echokardiografie bei der Detektion von thrombogenem Milieu und Vorhofohrthromben ersetzen? Eine prospektive Studie mit 124 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Homsi, R.; Luetkens, J.A.; Schild, H.H.; Naehle, C.P. [Bonn Univ. (Germany). Dept. of Radiology; Nath, B. [SHG-KLliniken Voelklingen (Germany). Dept. of Medicine I - Cardiology; Schwab, J.O. [Bonn Univ. (Germany). Dept. of Medicine I - Cardiology

    2016-01-15

    To assess the diagnostic value of contrast-enhanced multi-detector computed tomography (MD-CT) for identifying patients with left atrial appendage (LAA) thrombus or circulatory stasis. 124 patients with a history of atrial fibrillation and/or cerebral ischemia (83 men, mean age 58.6 ± 12.4 years) and with a clinical indication for MD-CT of the heart and for transesophageal echocardiography (TEE) were included in the study. LAA thrombus or thrombogenic milieu was visually identified in TEE and MD-CT. In addition, MD-CT was analyzed quantitatively measuring the Hounsfield units (HU) of the left atrium (LA), the LAA and the ascending aorta (AA), and calculating the HU ratios LAA/AA (HU [LAA/AA]) und LAA/LA (HU [LAA/LA]). Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were calculated. The prevalence of a thrombus or thrombogenic milieu as assessed by TEE was 21.8 %. The HU ratio was lower in patients with thrombus or thrombogenic milieu (HU [LAA/AA]: 0.590 ± 0.248 vs. 0.909 ± 0.141; p < 0.001 und HU [LAA/LA] 0.689 ± 0.366 vs. 1.082 ± 0.228; p < 0.001). For the diagnosis of thrombus or a thrombogenic milieu, visual analysis yielded a sensitivity of 81.5 %, a specificity of 96.9 %, a PPV of 87.5 % and a NPV of 95.2 %. By combining visual and quantitative analysis with one criterion being positive, the specificity decreased to 91.8 %, the sensitivity to 77.8 %, the PPV to 72.4 %, and the NPV to 94.9 %. Visual analysis of the LAA in the evaluation of thrombus or thrombogenic milieu yields a high NPV of 95.1 % and may especially be useful to rule out LAA thrombi in patients with contraindications for TEE. Additional calculation of HU ratios did not improve the diagnostic performance of MD-CT.

  4. The effects of Ramadan fasting on activity and energy expenditure.

    Science.gov (United States)

    Lessan, Nader; Saadane, Ilham; Alkaf, Budour; Hambly, Catherine; Buckley, Adam J; Finer, Nick; Speakman, John R; Barakat, Maha T

    2018-01-01

    Fasting during the month of Ramadan entails abstinence from eating and drinking between dawn and sunset and a major shift in meal times and patterns with associated changes in several hormones and circadian rhythms; whether there are accompanying changes in energy metabolism is unclear. We have investigated the impact of Ramadan fasting on resting metabolic rate (RMR), activity, and total energy expenditure (TEE). Healthy nonobese volunteers (n = 29; 16 women) fasting during Ramadan were recruited. RMR was measured with the use of indirect calorimetry. In subgroups of participants, activity (n = 11; 5 women) and TEE (n = 10; 5 women) in free-living conditions were measured with the use of accelerometers and the doubly labeled water technique, respectively. Body composition was measured with the use of bioelectrical impedance. Measurements were repeated after a wash-out period of between 1 and 2 mo after Ramadan. Nonparametric tests were used for comparative statistics. Ramadan fasting did not result in any change in RMR (mean ± SD: 1365.7 ± 230.2 compared with 1362.9 ± 273.6 kcal/d for Ramadan and post-Ramadan respectively, P = 0.713, n = 29). However, controlling for the effects of age, sex, and body weight, RMR was higher in the first week of Ramadan than in subsequent weeks. During Ramadan, the total number of steps walked were significantly lower (n = 11, P = 0.001), while overall sleeping time was reduced and different sleeping patterns were seen. TEE did not differ significantly between Ramadan and post-Ramadan (mean ± SD: 2224.1 ± 433.7 compared with 2121.0 ± 718.5 kcal/d for Ramadan and post-Ramadan, P = 0.7695, n = 10). Ramadan fasting is associated with reduced activity and sleeping time, but no significant change in RMR or TEE. Reported weight changes with Ramadan in other studies are more likely to be due to differences in food intake. This trial is registered at clinicaltrials.gov as NCT02696421. © 2018 American Society for Nutrition. All rights

  5. Hours spent and energy expended in physical activity domains: Results from The Tomorrow Project cohort in Alberta, Canada

    Science.gov (United States)

    2011-01-01

    Background Knowledge of adult activity patterns across domains of physical activity is essential for the planning of population-based strategies that will increase overall energy expenditure and reduce the risk of obesity and related chronic diseases. We describe domain-specific hours of activity and energy expended among participants in a prospective cohort in Alberta, Canada. Methods The Past Year Total Physical Activity Questionnaire was completed by 15,591 Tomorrow Project® participants, between 2001 and 2005 detailing physical activity type, duration, frequency and intensity. Domain-specific hours of activity and activity-related energy expenditure, expressed as a percent of total energy expenditure (TEE) (Mean (SD); Median (IQR)) are reported across inactive (<1.4), low active (1.4 to 1.59), active (1.6 to 1.89) and very active (≥ 1.9) Physical Activity Level (PAL = TEE:REE) categories. Results In very active women and amongst all men except those classified as inactive, activity-related energy expenditure comprised primarily occupational activity. Amongst inactive men and women in active, low active and inactive groups, activity-related energy expenditure from household activity was comparable to, or exceeded that for occupational activity. Leisure-time activity-related energy expenditure decreased with decreasing PAL categories; however, even amongst the most active men and women it accounted for less than 10 percent of TEE. When stratified by employment status, leisure-time activity-related energy expenditure was greatest for retired men [mean (SD): 10.8 (8.5) percent of TEE], compared with those who were fully employed, employed part-time or not employed. Transportation-related activity was negligible across all categories of PAL and employment status. Conclusion For the inactive portion of this population, active non-leisure activities, specifically in the transportation and occupational domains, need to be considered for inclusion in daily routines

  6. Daily energy expenditure, cardiorespiratory fitness and glycaemic control in people with type 1 diabetes.

    Directory of Open Access Journals (Sweden)

    John Joseph Valletta

    Full Text Available Encouraging daily physical activity improves cardiorespiratory fitness and many cardiovascular risk factors. However, increasing physical activity often creates a challenge for people with type 1 diabetes, because of difficulties maintaining euglycemia in the face of altered food intake and adjustments to insulin doses. Our aim was to examine the triangular relationship between glucose control measured by continuous glucose monitoring system (CGMS, objective measures of total daily energy expenditure (TEE recorded by a multi-sensory monitoring device, and cardiorespiratory fitness (CRF, in free-living subjects with type 1 diabetes.Twenty-three individuals (12 women with type 1 diabetes who were free from micro- and macrovascular complications were recruited. TEE and glucose control were monitored simultaneously for up to 12 days, using a multi-sensory device and CGMS respectively. CRF was recorded as V02 max from a maximal treadmill test with the Bruce protocol.Subjects (mean±SD were aged 37±11 years, with BMI = 26.5±5.1 kg.m⁻², HbA1c = 7.7±1.3% (61±14 mmol/mol and V02 max (ml.min⁻¹.kg⁻¹  = 39.9±8.4 (range 22.4-58.6. TEE (36.3±5.5 kcal.kg⁻¹.day⁻¹ was strongly associated with CRF(39.9±8.4 ml.min⁻¹.kg⁻¹ independently of sex (r = 0.63, p<0.01. However, neither TEE (r = -0.20, p = 0.36 nor CRF (r = -0.20, p = 0.39; adjusted for sex, were significantly associated with mean glycaemia measured by CGMS.Higher levels of energy expenditure (due to a more active lifestyle are associated with increased cardiorespiratory fitness, but not necessarily better glycaemic control. Since increased levels of energy expenditure and good glycaemic control are both needed to protect against diabetes-related complications our data suggest they need to be achieved independently.

  7. Differentiation of thrombus from pannus as the cause of acquired mechanical prosthetic heart valve obstruction by non-invasive imaging: a review of the literature

    NARCIS (Netherlands)

    Tanis, Wilco; Habets, Jesse; van den Brink, Renee B. A.; Symersky, Petr; Budde, Ricardo P. J.; Chamuleau, Steven A. J.

    2014-01-01

    For acquired mechanical prosthetic heart valve (PHV) obstruction and suspicion on thrombosis, recently updated European Society of Cardiology guidelines advocate the confirmation of thrombus by transthoracic echocardiography, transesophageal echocardiography (TEE), and fluoroscopy. However, no

  8. Novel imaging strategies for the detection of prosthetic heart valve obstruction and endocarditis

    NARCIS (Netherlands)

    W. Tanis (Wilco); R.P.J. Budde (Ricardo); I.A.C. van der Bilt (Ivo); B. Delemarre; G. Hoohenker; J.-K. Van Rooden; A.M. Scholtens (Asbjørn M.); J. Habets; S.A.J. Chamuleau (Steven)

    2016-01-01

    textabstractProsthetic heart valve (PHV) dysfunction remains difficult to recognise correctly by two-dimensional (2D) transthoracic and transoesophageal echocardiography (TTE/TEE). ECG-triggered multidetector-row computed tomography (MDCT), 18-fluorine-fluorodesoxyglucose positron emission

  9. Thoughts on a road about roads / Margit Mutso

    Index Scriptorium Estoniae

    Mutso, Margit, 1966-

    2013-01-01

    Arhitekt Margit Mutso teede rekonstrueerimise ja planeerimise problemaatikast: autoteed, liiklussõlmed, liiklusmärgid, müratõkked, teeäärne arhitektuur, liiklusohutus, avalik kunst, linna sissesõidud, tänavad, inseneride haridus

  10. 14. VII avati Rael Arteli galerii fotoruumis...

    Index Scriptorium Estoniae

    2004-01-01

    Anu Allase kureeritud näitus "Juhitud reisid/Guided Tours". Näitusel osalevad Liisi Peets, Katrin Tees, Piret Räni, Anu Vahtra, Daisy Lappard, Tiit Sokk (Ulvi Tiit & Marili Sokk), Raivo Hool ja Rataplan

  11. Eesti elektrisüsteemi juhtimiskeskus = Estonian electrical system command centre

    Index Scriptorium Estoniae

    2010-01-01

    Tallinnas Kadaka tee 42B1asuva Eesti elektrisüsteemi juhtimiskeskuse sisekujundusest. Spetsiaalsed kaarjad lauad on sisearhitektide projekteeritud. Sisearhitektid: Priit Põldme, Reet Sepp (Joonprojekt), nende tähtsamate tööde loetelu

  12. Koda = Koda / Ülar Mark, Kariina Kristiina Kaufmann, Kadri Tonto ; kommenteerinud Katrin Koov

    Index Scriptorium Estoniae

    Mark, Ülar, 1968-

    2016-01-01

    Minimalistliku vormiga eramu KODA Tallinnas, Järvekalda tee 33. Autorid Ülar Mark, Taavi Jakobson, Hannes Tamjärv, Kalev Ramjalg, Marek Strandberg. Arhitektid Ülar Mark, Kariina Kristiina Kaufmann, Kadri Tonto, Hannes Praks

  13. Implementation and field evaluation of pretensioned concrete girder end crack control.

    Science.gov (United States)

    2016-05-01

    Wisconsin bulb tee pretensioned concrete girders are currently used for bridge construction. Their efficiency in load resistance has made them particularly desirable. To provide that efficiency, these girders are heavily prestressed. Cracking is evid...

  14. Carotid Angioplasty and Stenting

    Science.gov (United States)

    Carotid angioplasty and stenting Overview Carotid angioplasty (kuh-ROT-id AN-jee-o-plas-tee) and stenting ... to better see and examine the blood vessels. Food and medications You'll receive instructions on what ...

  15. Environmental Assessment - Demolish 934 of Grand Forks Air Force Base

    National Research Council Canada - National Science Library

    Strom, Diane

    2006-01-01

    .... Work includes removal of all plumbing, pumps and equipment, removal of the water lines from the water main into the building, replacement of the 14 tees on the water main with a straight piece...

  16. Slesers says spend, spend, spend

    Index Scriptorium Estoniae

    2011-01-01

    5. augustil kinnitas Läti Esimene Partei/Läti Tee parlamendivalimiste valimisplatvormi, mille peamine mõte seisneb selles, et raha tuleb teenida, mitte säästa. Zatlersi Reformierakond on samuti oma valimisplatvormi kinnitanud

  17. Prosthetic mitral valve obstruction: role of real-time three-dimensional transesophageal echocardiography in diagnosis.

    Science.gov (United States)

    Kannan, Arun; Jahan, Kahroba; Lotun, Kapildeo; Janardhanan, Rajesh

    2015-09-21

    Acute prosthetic valve thrombosis is a potentially serious complication with an incidence as high as 6% per patient-year for prostheses in the mitral position. Accurate diagnosis of the degree of obstruction and differentiation of pannus versus thrombus is critical in determination of the best mode of therapy. We discuss a case of a patient with multiple comorbidities who presented with mechanical mitral valve obstruction where both transthoracic and two-dimensional transesophageal echocardiography (TEE) were limited in making an accurate diagnosis regarding the mechanism of obstruction. Real-time 3D-TEE (RT-3DTEE) was critical in identifying a partial thrombus on the mechanical valve and guided the choice of thrombolysis as the most appropriate intervention, thus avoiding high-risk surgery in this patient with significant multiple comorbidities. 2015 BMJ Publishing Group Ltd.

  18. Esophageal Perforation due to Transesophageal Echocardiogram: New Endoscopic Clip Treatment

    Directory of Open Access Journals (Sweden)

    John Robotis

    2014-07-01

    Full Text Available Esophageal perforation due to transesophageal echocardiogram (TEE during cardiac surgery is rare. A 72-year-old female underwent TEE during an operation for aortic valve replacement. Further, the patient presented hematemesis. Gastroscopy revealed an esophageal bleeding ulcer. Endoscopic therapy was successful. Although a CT scan excluded perforation, the patient became febrile, and a second gastroscopy revealed a big perforation at the site of ulcer. The patient's clinical condition required endoscopic intervention with a new OTSC® clip (Ovesco Endoscopy, Tübingen, Germany. The perforation was successfully sealed. The patient remained on intravenous antibiotics, proton pump inhibitors and parenteral nutrition for few days, followed by enteral feeding. She was discharged fully recovered 3 months later. We clearly demonstrate an effective, less invasive treatment of an esophageal perforation with a new endoscopic clip.

  19. Novel imaging strategies for the detection of prosthetic heart valve obstruction and endocarditis

    NARCIS (Netherlands)

    Tanis, W; Budde, R P J; van der Bilt, I A C; Delemarre, B; Hoohenkerk, G; van Rooden, J-K; Scholtens, A M; Habets, J; Chamuleau, S

    Prosthetic heart valve (PHV) dysfunction remains difficult to recognise correctly by two-dimensional (2D) transthoracic and transoesophageal echocardiography (TTE/TEE). ECG-triggered multidetector-row computed tomography (MDCT), 18-fluorine-fluorodesoxyglucose positron emission tomography including

  20. Majandusminister kevadel 1940 : "Sööme praegu viimaseid reserve!" / Argo Ideon

    Index Scriptorium Estoniae

    Ideon, Argo, 1966-

    2009-01-01

    Arvustus : Faatum : Eesti tee hävingule 1939-1940 : riigikontrolör Karl Soonpää päevik Eesti Vabariigi saatuseaastatest 1939-1940 : Molotovi-Ribbentropi pakti tagamaad : dokumendid ja materjalid. Tallinn : SE & JS, 2009

  1. Joonised, tähendused ja unistused, ehk enklaavi eelised = From drawings to meanings and dreams: the advantage of remaining an enclave / Lilia del Rio

    Index Scriptorium Estoniae

    Rio, Lilia del

    2011-01-01

    Pirita tee alguse piirkonnast, mis oli vaatluse all 15. ja 16. juunil 2010. aastal toimunud Tallinna III linnafoorumil. Linnaruumi tegelikkusest ja Tallinna ruumilistest prioriteetidest. Rahvuspargist, rahvapargist, linnaparkidest. Plaanidest ja joonistest planeerimisprotsesside ja otstarveteni. Tallinna tulevikust

  2. Bürokraatia pidurdab teedeehitust / Silva Männik

    Index Scriptorium Estoniae

    Männik, Silva, 1974-

    2004-01-01

    Ilmunud ka: Delovõje Vedomosti 25. märts lk. 8. Eurobürokraatia tõttu jääb Eesti tee-ehitajatel sel aastal saamata ligi pool miljardit krooni. Diagramm: Teedeehitusprojektid 2004. aasta riigieelarves

  3. JUST Vol. 29 No. 1 April 2009

    African Journals Online (AJOL)

    Prince

    2009-04-01

    , this research investigates the impact of stool land revenue in ... The 'allodial' title holders are customary trus- tees only .... to collect quantitative information from a sample .... the fiduciary position of chiefs and therefore has a.

  4. Kubija Hotell-Loodusspaa = Kubija Hotel-Nature Spa

    Index Scriptorium Estoniae

    2012-01-01

    Võrus Männiku tee 43A asuva Kubija Hotell-Loodusspaa sisekujundusest. Sisearhitektid Tiiu Truus ja Birgit Jaanus (Stuudio Truus). Arhitektid Indrek Tiigi ja Helle-Triin Hansumäe. Loetletud Stuudio Truus tehtud töid

  5. Saja aasta asemel saaks maantee valmis ka kümnega / Jarno Laur

    Index Scriptorium Estoniae

    Laur, Jarno, 1975-

    2006-01-01

    Ilmunud ka: Järva Teataja 9. märts lk. 2. Riigikogu liige sotsiaaldemokraatide fraktsiooni poolt Riigikogu menetlusse antud Tallinna-Tartu-Luhamaa maantee ehitamise otsuse eelnõust, otsuse vastuvõtmise vajalikkusest ning tee-ehituse rahastamisest

  6. "U nih odna doroga - võiti iz etogo zdanija..." / Aleksei Poskatshev, Helle Kalda, Tõnis Kurrik

    Index Scriptorium Estoniae

    Poskatshev, Aleksei

    2003-01-01

    Akadeemia tee 46 ühiselamu elanike küsimust kommenteerivad hoone omaniku AS Capital Kinnisvara, Mustamäe Linnaosa Valitsuse ning Tallinna Säästva Arengu ja Planeerimise Ameti esindajad. Üles kirjutanud Nikolai Nortov

  7. The predictors of dislodgement and outcomes of transcatheter closure of complex atrial septal defects in adolescents and adults

    Directory of Open Access Journals (Sweden)

    Wei-Chieh Lee

    2015-11-01

    Conclusion: Eroded and floppy IAS or aneurysm formation post ASO implantation and peri-procedure arrhythmia could predict ASO dislodgement in complex ASD closure. Transcatheter closure of ASDs under TEE guidance is feasible in complex cases.

  8. Kuldkaru elutöö eest / Endel Link

    Index Scriptorium Estoniae

    Link, Endel

    2001-01-01

    Ameerika näitleja Kirk Douglas (1916), kellele seekordsel Berlinalel antakse elutöö eest Kuldkaru. Austamisõhtul näidatakse teda Stanley Kubricku kaua keelu all olnud filmis "Tee kuulsusele " ("Paths of Glory") : 1957

  9. Czeslaw Miloszi uusi raamatuid / Hendrik Lindepuu

    Index Scriptorium Estoniae

    Lindepuu, Hendrik

    1997-01-01

    Lühidalt C. Miloszi 1997. a. ilmunud raamatutest: lühiesseede kogumik 'Miloszi ABC' (Abecadlo Milosza), esseekogumik 'Elu saartel' (Zycie na wryspah) ning aforismide, proosaluule ja mõttekildude kogumik 'Koerake tee ääres' (Piesek przydrozny)

  10. Torunis kohtuvad naaberteatrid / Andres Laasik

    Index Scriptorium Estoniae

    Laasik, Andres, 1960-2016

    1999-01-01

    22. mail algas Poola väikelinnas Torunis rahvusvaheline teatrifestival "Kontakt". Eestist valis festivali juhtkond välja Priit Pedajase lavastuse "Mao tee kalju peal", mida mängitakse 27. mail ja 28. mail ka Varssavis

  11. F.F.F.F. / Pille Väljataga

    Index Scriptorium Estoniae

    Väljataga, Pille

    2001-01-01

    Rühmituse F.F.F.F. (Berit Teeäär, Maria Valdma, Ketli Tiitsar, Kaire Rannik, Kristi Paap) esinemisest 2000. a. suvel Leedus Niida kunstnike majas. Ehteid eksponeeriti kõrvuti nende 20-kordse suurendusega fotodega.

  12. Risk assessment as part of internal auditing in the government institutions of the Estonian Republic / Krisi Pungas

    Index Scriptorium Estoniae

    Pungas, Krisi

    2003-01-01

    Ülevaade sisekontrolli mõistest, eesmärkidest ja teostamisest Eesti Vabariigi valitsusasutustes. Sisekontrolli ülesandeks on välja selgitada kõige efektiivsem tee võimalike riskide juhtimiseks ühes organisatsioonis või tegevusvaldkonnas. Skeem

  13. Guantanamo vangilaagri üleelanute pihtimus : meid koheldi nagu loomi / Ruhal Ahmed, Shaliq Rasul ; interv. Külli-Riin Tigasson

    Index Scriptorium Estoniae

    Ahmed, Ruhal

    2006-01-01

    Kõnelevad kaks Michael Winterbottomi, Mat Whitecrossi dokumentaalse taustaga mängufilmi "Tee Guantanamosse" ("The Road to Guantanamo") prototüüpi, kelle kannatusi USA vangilaagris see film kujutab. Filmi näidatakse ka 10. PÖFFil

  14. Eesti Ajaloomuuseumi, Maarjamäe lossi tallihoone renoveerimine = Renovation of the Estonian History Museum's Maarjamäe palace stables / Jaak Huimerind, Tarmo Piirmets ; kommenteerinud Kaido Kivi

    Index Scriptorium Estoniae

    Huimerind, Jaak, 1957-

    2015-01-01

    Eesti Ajaloomuuseumi Maarjamäe lossi renoveeritud tallihoone Tallinnas Pirita tee 66, valminud 2014. Arhitekt Jaak Huimerind (Studio Paralleel OÜ), sisearhitekt ja näituse kujundaja Tarmo Piirmets (Pink OÜ). Eesti Kultuurkapitali Arhitektuuri sihtkapitali renoveerimispreemia 2014

  15. VENOUS AIR-EMBOLISM, PRESERVATION REPERFUSION INJURY, AND THE PRESENCE OF INTRAVASCULAR AIR COLLECTIONS IN HUMAN DONOR LIVERS - A RETROSPECTIVE CLINICAL-STUDY

    NARCIS (Netherlands)

    WOLF, RFE; SLUITER, WJ; BALLAST, A; VANDAM, RM; SLOOFF, MJH

    In human liver transplantation, air embolism is seldom encountered after graft reperfusion. Nevertheless, despite adequate flushing and clamping routines, air emboli have been reported in transesophageal echocardiography (TEE) studies performed during the reperfusion phase, We retrospectively

  16. SURVEY ON NON-TIMBER FOREST PRODUCTS IN BAUCHI ...

    African Journals Online (AJOL)

    User

    allow for the production of bush meats, rattan, bamboo, traditional medicines, honey and other forest food. ... marketed or have socio-cultural, religious significance (FAO, 1990; Tee ... most of which are consumed within the household of the.

  17. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... FAQs Ask a Question Toll Free Numbers Locator Hospitals and Clinics Vet Centers Regional Benefits Offices Regional ... TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional Loan ...

  18. Medline Plus

    Full Text Available ... New York, NY, 1/04/2012) Coronary Artery Disease Transradial Approach for Cardiac Catheterization: The New Frontier ... Medical Center, Chicago, IL, 6/26/2014) Heart Diseases Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical Center, Merriam, ...

  19. Medline Plus

    Full Text Available ... Center, New York, NY, 2/13/2008) Heart Health Tests Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical Center, ... Louis, St. Louis, MO, 05/11/2011) Sexual Health Issues Erectile Dysfunction Simultaneous Inflatable Penile Prosthesis (IPP) ...

  20. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) ... Topics For Veterans For Researchers Research Oversight Special Groups Caregivers Combat Veterans & their Families Readjustment Counseling (Vet ...

  1. Lavalood / Mihkel Mutt

    Index Scriptorium Estoniae

    Mutt, Mihkel, 1953-

    1999-01-01

    Tom Stoppardi "Midagi tõelist" Vanalinnastuudios, lav. Roman Baskin, Torgny Lindgreni "Mao tee kalju peal" Eesti Draamateatri väikeses saalis, lav. Priit Pedajas, Josef ja Karel Čapeki "Putukate elust" Pärnu Endlas, lavastaja Jaan Tooming

  2. Medline Plus

    Full Text Available ... of Chicago Medical Center, Chicago, IL, 6/26/2014) Aortic Aneurysm Hybrid Arch Debranching (University of Maryland ... of Chicago Medical Center, Chicago, IL, 6/26/2014) Heart Diseases Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical ...

  3. Medline Plus

    Full Text Available ... Intervention (University of Chicago Medical Center, Chicago, IL, 6/26/2014) Aortic Aneurysm Hybrid Arch Debranching (University ... Intervention (University of Chicago Medical Center, Chicago, IL, 6/26/2014) Heart Diseases Transesophageal Echocardiogram (TEE) (Shawnee ...

  4. Medline Plus

    Full Text Available ... Forest University Baptist Medical Center, Winston-Salem, NC, 12/16/13) Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical ... Broward Health Medical Center, Fort Lauderdale, FL, 5/12/2014) Total Ankle Replacement (Doctors Hospital, Coral Gables, ...

  5. Medline Plus

    Full Text Available ... to disable it to view the programs. Blood, Heart and Circulation Angioplasty Transradial Approach for Cardiac Catheterization: ... Chicago Medical Center, Chicago, IL, 6/26/2014) Heart Diseases Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical Center, ...

  6. Risk factors for placental malaria and associated adverse pregnancy ...

    African Journals Online (AJOL)

    ... suggest that, multigravida. African Health Sciences Vol 15 Issue 3, September 2015 .... Christian Medical University College Ethical Commit- tee (CRERC) on behalf of ..... Conroy AL, McDonald CR, Silver KL, et al. Com- plement activation: a ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Centers Regional Benefits Offices Regional Loan Centers Cemetery Locations Get help from Veterans Crisis Line Search Enter ... Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional ...

  8. Medline Plus

    Full Text Available ... Arch Debranching (University of Maryland Medical Center, Baltimore, MD, 2/16/2012) Transesophageal Echocardiogram (TEE) (Shawnee Mission ... Bypass Surgery (University of Maryland Medical Center, Baltimore, MD, 9/09/2013) Minimally Invasive Transcatheter Aortic Valve ...

  9. Vannisalong Coral pakub kvaliteeti soodsa hinna eest

    Index Scriptorium Estoniae

    2007-01-01

    Tallinnas A. H. Tammsaare tee 116 ja Tartus Teguri 45 asuvas vannisalongis Coral pakutakse põhiliselt vanne ja saunu, kuid müügil on ka dušikabiinid, segistid, valamud, vannitoamööbel, basseinid jm

  10. Left atrial appendage thrombosis during therapy with rivaroxaban in elective cardioversion for permanent atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Walter Serra

    2015-09-01

    Full Text Available Electric external cardioversion (EEC for permanent atrial fibrillation (AF carries a risk of thromboembolic events (TE. The use of transesophageal echocardiography (TEE to guide the management of atrial fibrillation may be considered a clinically effective alternative strategy to conventional therapy for patients in whom elective cardioversion is planned. Therapeutic anticoagulation with novel oral anticoagulants (NOAC is recommended for 3 to 4 weeks before and an anticoagulation life-long therapy is recommended after EEC to reduce TE, in patients with high CHA2DS2-VASc score; however, only few data are currently available about safety of shortterm anticoagulation with NOAC in the setting of EEC. Patients with increased risk of thromboembolism have not been adequately studied and the monitoring of anticoagulant effects can also have important benefits in case of drug interactions. We report a case of a 68-year old man with AF from September 2014. Moderate depression of global left ventricular systolic function was detected by echocardiographic exam. On the basis of a high thromboembolic risk, an anticoagulant therapy with rivaroxaban, at the dose of 20 mg/day, was started. TEE showed a thrombus in the left atrial appendage. This case demonstrates the utility of performing TEE prior than EEC in patients with hypokinetic cardiomyopathy other than AF in therapy with NOAC. We underline the presence of significant pharmacodynamic interference of rivaroxaban with other drugs such as oxcarbazepine.

  11. Diagnosis and treatment of shock due to massive pulmonary embolism: approach with transesophageal echocardiography and intrapulmonary thrombolysis.

    Science.gov (United States)

    Krivec, B; Voga, G; Zuran, I; Skale, R; Pareznik, R; Podbregar, M; Noc, M

    1997-11-05

    To evaluate the diagnostic value of transesophageal echocardiography (TEE) as an initial diagnostic tool in shocked patients. The second objective was to study therapeutic impact of intrapulmonary thrombolysis in patients with diagnosed massive pulmonary embolism. Prospective observational study. Medical ICU in 800-bed general hospital. Twenty-four consecutive patients with unexplained shock and distended jugular veins. In 18 patients, right ventricular dilatation with global or segmental hypokinesis was documented. In addition, central pulmonary thromboemboli (12 patients), reduced contrast flow in right pulmonary artery (one patient), and right ventricular free wall akinesis (one patient) were found. No additional echocardiographic findings were apparent in four patients. According to pulmonary scintigraphy or autopsy, sensitivity of TEE for diagnosis of massive pulmonary embolism (MPE) in patients with right ventricular dilatation was 92% and specificity was 100%. In patients without right ventricular dilatation, left ventricular dysfunction (four patients) or cardiac tamponade (two patients) was confirmed. Intrapulmonary thrombolysis was evaluated in 11 of 13 patients with MPE. Two patients died prior to attempted thrombolysis. Three patients received streptokinase and eight received urokinase. Twenty-four hours after beginning of treatment, total pulmonary resistance index significantly decreased for 59% and mean pulmonary artery pressure for 31%. Cardiac index increased for 74%. Nine of 11 patients receiving thrombolysis survived to hospital discharge. Bedside TEE is a valuable tool for diagnosis of MPE. It enables immediate intrapulmonary thrombolysis, which seems to be an effective therapeutic alternative in our group of patients with obstructive shock.

  12. Echocardiographic anatomy of the mitral valve: a critical appraisal of 2-dimensional imaging protocols with a 3-dimensional perspective.

    Science.gov (United States)

    Mahmood, Feroze; Hess, Philip E; Matyal, Robina; Mackensen, G Burkhard; Wang, Angela; Qazi, Aisha; Panzica, Peter J; Lerner, Adam B; Maslow, Andrew

    2012-10-01

    To highlight the limitations of traditional 2-dimensional (2D) echocardiographic mitral valve (MV) examination methodologies, which do not account for patient-specific transesophageal echocardiographic (TEE) probe adjustments made during an actual clinical perioperative TEE examination. Institutional quality-improvement project. Tertiary care hospital. Attending anesthesiologists certified by the National Board of Echocardiography. Using the technique of multiplanar reformatting with 3-dimensional (3D) data, ambiguous 2D images of the MV were generated, which resembled standard midesophageal 2D views. Based on the 3D image, the MV scallops visualized in each 2D image were recognized exactly by the position of the scan plane. Twenty-three such 2D MV images were created in a presentation from the 3D datasets. Anesthesia staff members (n = 13) were invited to view the presentation based on the 2D images only and asked to identify the MV scallops. Their responses were scored as correct or incorrect based on the 3D image. The overall accuracy was 30.4% in identifying the MV scallops. The transcommissural view was identified correctly >90% of the time. The accuracy of the identification of A1, A3, P1, and P3 scallops was <50%. The accuracy of the identification of A2P2 scallops was ≥50%. In the absence of information on TEE probe adjustments performed to acquire a specific MV image, it is possible to misidentify the scallops. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Vääna-Viti hoolekandeküla = Vääna-Viti community setting group home / Tõnu Laigu

    Index Scriptorium Estoniae

    Laigu, Tõnu, 1956-

    2015-01-01

    Vääna-Viti hoolekandeküla Harku vallas Aiba tee 8/7, valminud 2013. Hoonete arhitektid Tõnu Laigu, Koit Ojaliiv, Mari Rass (QP Arhitektid OÜ), sisearhitektid Andres Labi, Janno Roos (Ruumilabor OÜ). 2014. aasta Kultuurkapitali Arhitektuuripreemia kandidaat

  14. "Ekspeditsioon Wunderlich" = "Expedition Wunderlich" / Carl-Dag Lige, Hannes Praks ; kommenteerinud Triin Ojari

    Index Scriptorium Estoniae

    Lige, Carl-Dag, 1982-

    2016-01-01

    Näitus "Ekspeditsioon Wunderlich" Eesti Arhitektuurimuuseumis. Autorid Katrin Talvik, Merilin Tee, Sabine Suuster, Martin Saar, Karl Taul, Alden Jõgisuu, Tõnu Lensment, Aadam Kaarma, Cael-Dag Lige, Hannes Praks. Näitus on Eesti Kunstiakadeemia ja Eesti Arhitektuurimuuseumi ühisprojekt

  15. Liquid metal systems development: reactor vessel support structure evaluation

    International Nuclear Information System (INIS)

    McEdwards, J.A.

    1981-01-01

    Results of an evaluation of support structures for the reactor vessel are reported. The U ring, box ring, integral ring, tee ring and tangential beam supports were investigated. The U ring is the recommended vessel support structure configuration

  16. Mida vaadata pimedatel öödel? / Mati Sepping

    Index Scriptorium Estoniae

    Sepping, Mati

    2006-01-01

    Euroopa Filmiakadeemia liige tutvustab kuut filmi - Euroopa 2006.a. parima filmi nominenti, millest viis on ka 10. Pimedate Ööde Filmifestivali kavas : "Tee Guantanamosse", "Tuul, mis sasib odrapõldu", "Hommikusöök Pluutol", "Teiste elu", "Grbavica"

  17. Intra‑cardiac masses in adults: A review of echocardiogram records ...

    African Journals Online (AJOL)

    Background: Transthoracic echocardiography (TTE) is an excellent initial diagnostic technique used to evaluate and diagnose cardiac masses, even though transoesophageal echocardiography (TEE) provides superior image resolution and better visualization of cardiac masses, especially in patients with suboptimal ...

  18. Medline Plus

    Full Text Available ... New York, NY, 2/13/2008) Heart Health Tests Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical Center, Merriam, ... health care provider and does not provide medical diagnosis or treatment. BroadcastMed only provides visitors to the ...

  19. Measuring body composition and energy expenditure in children with severe neurologic impairment and intellectual disability

    NARCIS (Netherlands)

    Rieken, Rob; van Goudoever, Johannes B.; Schierbeek, Henk; Willemsen, Sten P.; Calis, Elsbeth A. C.; Tibboel, Dick; Evenhuis, Heleen M.; Penning, Corine

    2011-01-01

    Accurate prediction equations for estimating body composition and total energy expenditure (TEE) in children with severe neurologic impairment and intellectual disability are currently lacking. The objective was to develop group-specific equations to predict body composition by using

  20. Luik süüdistab Ragn-Sellsi / Peeter Raidla

    Index Scriptorium Estoniae

    Raidla, Peeter, 1955-

    2003-01-01

    Hans H. Luigega seotud plastifirma OÜ Starforte palub politseile esitatud avalduses kontrollida, kas AS-i Ragn-Sells käitumises lepingu ühepoolsel lõpetamisel esineb kuriteo tunnuseid. Kronoloogia: Tee OÜ Starforte ja AS-i Ragn-Sells kriminaalasjani

  1. Kõnnitee kindlusesse / Andres Kurg

    Index Scriptorium Estoniae

    Kurg, Andres, 1975-

    1998-01-01

    Arhitektid José Martinez Lapena ja Elias Torres Tur ääristasid siksakina mäekülge mööda Castelldefelsi kindlusse viiva jalakäijaste tee Barcelonas raudbetooni ja sakilise roostevärvi Corten terasega

  2. Meest sõnast, meeri sarvest! / Jürgen Rooste

    Index Scriptorium Estoniae

    Rooste, Jürgen, 1979-

    2006-01-01

    Tallinn saab 2011. a. Euroopa kultuuripealinnaks. Muutustest, mida autor usub Tallinnas toimuma hakkavat (Vabaduse väljakult kaob parkla, teatrid saavad juurdeehitused, peatatakse kõrghoonete ehitamine Pirita tee äärde, hoogustub kultuuritehase Polymer töö jm.)

  3. Comparison of evaluation results of piping thermal fatigue evaluation method based on equivalent stress amplitude

    International Nuclear Information System (INIS)

    Suzuki, Takafumi; Kasahara, Naoto

    2012-01-01

    In recent years, reports have increased about failure cases caused by high cycle thermal fatigue both at light water reactors and fast breeder reactors. One of the reasons of the cases is a turbulent mixing at a Tee-junction, where hot and cold temperature fluids are mixed, in a coolant system. In order to prevent thermal fatigue failures at Tee-junctions. The Japan Society of Mechanical Engineers published the guideline which is an evaluation method of high cycle thermal fatigue damage at nuclear pipes. In order to justify safety margin and make the procedure of the guideline concise, this paper proposes a new evaluation method of thermal fatigue damage with use of the 'equivalent stress amplitude.' Because this new method makes procedure of evaluation clear and concise, it will contribute to improving the guideline for thermal fatigue evaluation. (author)

  4. Comparing Methods for Cardiac Output

    DEFF Research Database (Denmark)

    Graeser, Karin; Zemtsovski, Mikhail; Kofoed, Klaus F

    2018-01-01

    of the left ventricular outflow tract. METHODS: The primary aim was a systematic comparison of CO with Doppler-derived 3D TEE and CO by thermodilution in a broad population of patients undergoing cardiac surgery. A subanalysis was performed comparing cross-sectional area by TEE with cardiac computed...... tomography (CT) angiography. Sixty-two patients, scheduled for elective heart surgery, were included; 1 was subsequently excluded for logistic reasons. Inclusion criteria were coronary artery bypass surgery (N = 42) and aortic valve replacement (N = 19). Exclusion criteria were chronic atrial fibrillation......, left ventricular ejection fraction below 0.40 and intracardiac shunts. Nineteen randomly selected patients had a cardiac CT the day before surgery. All images were stored for blinded post hoc analyses, and Bland-Altman plots were used to assess agreement between measurement methods, defined as the bias...

  5. Tehnoloogiafirma kontor Mustamäel. Skype'i Tallinna büroo / Skype'i Eesti kontor = Technology firm headquarters in Mustamäe. Skype's Tallinn offices / Skype's Estonia office

    Index Scriptorium Estoniae

    2007-01-01

    Tallinnas Akadeemia tee 21F asuva kontori ruumikujundus. Sisearhitekt Tarmo Piirmets (Pink OÜ), kes pälvis Skupe'i kontori sesekujunduse eest Eesti Kultuurkapitali arhitektuuri sihtkapitali aastapreemia. I-IV korruse plaan, 11 värv. vaadet, foto T. Piirmetsast

  6. Ruumikujundused eelmisel aastal / Tuuli Org

    Index Scriptorium Estoniae

    Org, Tuuli

    2007-01-01

    Kokkuvõtted Kuressaare linna 2006. aasta ilusamatest ruumikujundustest: Ereki kontorihoone Pihtla tee 28 (Vello Liiv), kohvik Classic Lossi 9 (Kai Laanmets, Liina Saabas), Kuressaare gümnaasium Nooruse 1 (Vello Liiv), Vinoteek Lossi 4 (Ülle Kiirend, Anne Olop)

  7. Nokia lõi tulemustega pahviks / Annika Matson

    Index Scriptorium Estoniae

    Matson, Annika, 1976-

    2005-01-01

    Ilmunud ka: Delovõje Vedomosti 2. veebr. lk. 29. Mobiiltelefonide tootja Nokia neljanda kvartali käive ja kasum tõukasid aktsia tõusule ning võideti tagasi ka turuosa. Diagramm: Aasta tagusele tasemele Nokia aktsial veel pikk tee

  8. How newness enters a country : reception of the "postcolonial" in Estonia / Ene-Reet Soovik

    Index Scriptorium Estoniae

    Soovik, Ene-Reet, 1968-

    2006-01-01

    Postkolonialistliku tõlkekirjanduse retseptsiooni Eestis vaadeldakse kolme romaani põhjal: Arundhati Roy "Väikeste Asjade Jumal" (eesti k. 1997 ja 2004), Salman Rushdie "Mauri viimane ohe" (eesti k. 2001 ja 2008), Ben Okri "Näljutatud tee" (eesti k. 1998)

  9. Blepharoplasty (Eyelid Surgery)

    Science.gov (United States)

    ... Blepharoplasty (BLEF-uh-roe-plas-tee) is a type of surgery that repairs droopy eyelids and may involve ... tobacco and drugs. Your expectations. An honest discussion of your hopes and motivation for surgery will help set the stage for ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional Loan ...

  11. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional Loan Centers ... Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen Service (VCS) Research Research ...

  12. 1000 krooni lapsele on ainuvõimalik tee / Mart Laar

    Index Scriptorium Estoniae

    Laar, Mart, 1960-

    2002-01-01

    Ilmunud ka: Põhjarannik ; Severnoje Poberezhje 13. august lk. 2, Meie Maa 14. august lk. 2, Virumaa Teataja 16. august lk. 7, Järva Teataja 16. august lk. 2, Koit 15. august lk. 6, Lääne-Harju Ekspress, Nädaline 17. august lk. 3,4, Hiiu Leht 16. august lk. 2, Pärnu Postimees 21. august lk. 18, Sillamjaeskii Vestnik 20. august lk. 2, Valgamaalane 17. august lk. 2, Vooremaa 27. august lk. 2, Lääne Elu 29. august lk. 4, Virumaa Nädalaleht nr. 10 lk. 5. Isamaaliit on lubanud tõsta toetused 1000 kroonini lapse kohta kuus. Autor: Isamaaliit. Parlamendisaadik

  13. Saksamaa frankofiilne välispoliitika - tupikus tee / Jeroen Bult

    Index Scriptorium Estoniae

    Bult, Jeroen

    2003-01-01

    Hollandi ajaloolane ja publitsist Jeroen Bult Saksamaa ja Prantsusmaa, Saksamaa ja USA suhetest. Autori sõnul on Saksamaa ühepoolne orientatsioon Prantsusmaale viinud Saksamaa kaugemale oma traditsioonilistest huvidest Ida-Euroopas

  14. Churchi-Pytagorase tees / Robert Rosen ; tõlk. Kalle Hein

    Index Scriptorium Estoniae

    Rosen, Robert

    2006-01-01

    Autori essee peamiseks mõtteks on põhjendada ühismõõdutuse tegelikkust ja näidata, kuidas matemaatika ja looduse vahekorra mõistmine on seotud matemaatika enda arendamise strateegiaga. Lisaks ka Kalevi Kulli märkused autori kohta

  15. LP-tee pikeneb Tartust Pärnuni / Sirje Pärismaa

    Index Scriptorium Estoniae

    Pärismaa, Sirje, 1958-

    2015-01-01

    Norrast pärit tõenduspõhist koostöökultuuri arendava LP-mudeliga (learning environment and pedagogical analysis) on liitumas seitse kooli Pärnust, Viljandist, Puhjast, Tartust ning kolm lasteaeda

  16. Eestil on Euroopas ka oma tee / Jürgen Ligi

    Index Scriptorium Estoniae

    Ligi, Jürgen, 1959-

    2004-01-01

    Ilmunud ka: Põhjarannik, 17. apr. 2004, lk. 2; Severnoje Poberezhje, 17. apr. 2004, lk. 2; Koit,17. apr. 2004, lk. 6; Meie Maa, 17. apr. 2004, lk. 2; Hiiu Leht, 20. apr. 2004, lk. 2; Virumaa Nädalaleht, 23. apr. 2004, lk. 2; Sakala, 23. apr. 2004, lk. 2; Valgamaalane, 8. mai 2004, lk. 2. Maksu- ja sotsiaalpoliitika otsustusõigusest ning kaitsmisest EL-i riikides

  17. Kohtuasi peatas Kõusaare "Magnuse" tee ka Riias / Mari Kodres

    Index Scriptorium Estoniae

    Kodres, Mari

    2008-01-01

    Kadri Kõusaare debüütfilmi "Magnus" linastamine Läti väärtfilmikinos Cinema Riga lõpetati, kuna kino juhtkond koos filmi levitajaga otsustasid linastamist jätkata alles peale kohtuvaidluse lõppu

  18. Problems of implementation the total quality management in the Lithuanian road building enterprises / Julius Christauskas

    Index Scriptorium Estoniae

    Christauskas, Julius

    2005-01-01

    Leedu tee-ehitusettevõtete juhtimine ei ole suunatud protsessi kui terviku kontrollile ja tulemuslikule meeskonnatööle, töötajad ei ole valmis võtma suuremat vastutust, puudu jääb efektiivsusest, loovusest ja innovatiivsusest. Tabelid. Graafikud

  19. Tallinna Tehnikaülikooli raamatukogu = Tallinn University of Technology library

    Index Scriptorium Estoniae

    2010-01-01

    Tallinnas Akadeemia tee 1 asuva raamatukoguhoone sisekujundusest. Sisearhitektid Kristi Lents, Hannelore Kääramees, hoone arhitektid Priit Pent ja Eero Endjärv (Agabus, Endjärv & Truverk Arhitektid). Sisearhitektide tähtsamate koos tehtud tööde loetelu

  20. V tesnote i v obide / Jekaterina Rodina

    Index Scriptorium Estoniae

    Rodina, Jekaterina

    2005-01-01

    EA Reng arhitekti Ilmar Jalase koostatud detailplaneering näeb ette Tallinna Õismäe elamurajoonis Paldiski mnt. 227 / Järveotsa tee 2 vahele 24, 14- ja 9-korruseliste hoonete ehitamist. Elanike protest peatas 24-korruselise elumaja planeeringu kinnitamise

  1. F.F.F.F. armastab mõtestada ennast / Reet Varblane

    Index Scriptorium Estoniae

    Varblane, Reet, 1952-

    2002-01-01

    Rühmituse F.F.F.F. (Kristi Paap, Kaire Rannik, Berit Teeäär, Ketli Tiitsar, Maria Valdma) näitus "Meie igapäevane leib" 9. novembrini Hansapanga galeriis ja näitus "Pentagramm" 26. X-1. XII Tarbekunstimuuseumis

  2. Kohtumised jõuga = Encouters with power / Vilen Künnapu

    Index Scriptorium Estoniae

    Künnapu, Vilen, 1948-

    2006-01-01

    Arhitekt mõtestab üht tahku oma loomingus - spirituaalset templiarhitektuuri. Budistlik keskus Jälgimäel, kontseptuaalne projekt "9 Mandala Templit Londonis, Thames'i jõel", ümartempel Tallinna vanglale, Valguse Tee kirik Tallinnas, kabel Huuksi mõisapargis, tempelelamu Suurupis

  3. Pole õige olla diktatuurisemu / Silver Meikar

    Index Scriptorium Estoniae

    Meikar, Silver, 1978-

    2008-01-01

    Ilmunud ka: Linnaleht : Tartu 21. mai 2008, lk. 4. Riigikogu liige kirjutab, et keskerakondlaste ja Jaan Kundla otsus luua Valgevene parlamendi sõprusrühm ja asuda seeläbi Lukashenka režiimiga sõprussuhetesse, ei tee riigile au

  4. Tallinn hakkab Põhjaväila tarvis maid ostma

    Index Scriptorium Estoniae

    2007-01-01

    Seoses Russalkast Ahtri tänavani ulatuva tee-ehitusega seisab linnal ees 16 maaküsimuse lahendamine. Probleemidest seoses väila osaliselt merre ehitamisega ja väila lõpuniehitamiseks lammutada tulevad hooned. Kommenteerivad Alo Brandt ja Ain Valdmann

  5. IFLA General Conference, 1986. Bibliographic Control Division. Section: Bibliography. Papers.

    Science.gov (United States)

    International Federation of Library Associations and Institutions, The Hague (Netherlands).

    Papers on bibliographic control presented at the 1986 International Federation of Library Associations (IFLA) conference include: (1) "Bibliographic Interchange/Coordination in Southeast Asia (Huck Tee Lim, Malaysia); (2) "Project for 'Chinese National Bibliography' and Its Progress" (Huang Jungui, China); (3) "Subject…

  6. Vabatrupp näitas meeleheite hiiglasi / Margit Tõnson

    Index Scriptorium Estoniae

    Tõnson, Margit, 1978-

    2005-01-01

    11. märtsil esietendus teatris NO98 ja Sine Loco (A. Türnpu projekt) koostöös lavastus "Inimese teekond", mille lähtematerjaliks on J. Bunyani religioosne teos "Palveränduri tee". Lavastaja ja kokkupanija A. Türnpu

  7. Pääsemine? / Andrus Norak

    Index Scriptorium Estoniae

    Norak, Andrus, 1958-2011

    2005-01-01

    11. märtsil esietendus teatris NO98 ja Sine Loco (A. Türnpu projekt) koostöös lavastus "Inimese teekond", mille lähtematerjaliks on J. Bunyani religioosne teos "Palveränduri tee". Lavastaja ja kokkupanija A. Türnpu

  8. Aitajaid sel teekonnal pole / Madli Pesti

    Index Scriptorium Estoniae

    Pesti, Madli, 1980-

    2005-01-01

    11. märtsil esietendus teatris NO98 ja Sine Loco (A. Türnpu projekt) koostöös lavastus "Inimese teekond", mille lähtematerjaliks on J. Bunyani religioosne teos "Palveränduri tee". Lavastaja ja kokkupanija A. Türnpu

  9. Inimese teekond valguses ja varjus / Karina Talts

    Index Scriptorium Estoniae

    Talts, Karina

    2005-01-01

    11. märtsil esietendus teatris NO98 ja Sine Loco (A. Türnpu projekt) koostöös lavastus "Inimese teekond", mille lähtematerjaliks on J. Bunyani religioosne teos "Palveränduri tee". Lavastaja ja kokkupanija A. Türnpu

  10. Eesti sõnum Kremlile : tunnistage ajaloofakte / Jaanus Piirsalu

    Index Scriptorium Estoniae

    Piirsalu, Jaanus, 1973-

    2007-01-01

    Moskvas tegutseva fondi Liberaalne Missioon ja Carnegie keskuse ümarlaual "Tee Euroopasse" käsitleti Eesti viimase 15 aasta arengut. Ümarlaual soovitas välisministeeriumi kantsler Matti Maasikas, et Kreml peaks tunnistama, et Eesti ei astunud vabatahtlikult NSVL-i

  11. Rikkad ja ilusad protestivad Maxima säästupoe vastu / Askur Alas

    Index Scriptorium Estoniae

    Alas, Askur, 1973-

    2008-01-01

    Tallinnas Pirital asuva Merivälja tee 80e kinnistu eskiisprojektist, mis ei vasta kehtestatud detailplaneeringule. Elanikud protestivad plaani vastu rajada elukohta lähedale Maxima säästuketi pood. Hoone arhitektuurse lahenduse autor on Tõnis Tarbe Arhitektuuribüroo

  12. Lipp lipi peal, lapp lapi peal / Valdo Randpere

    Index Scriptorium Estoniae

    Randpere, Valdo, 1958-

    2006-01-01

    IBM Eesti tegevdirektor teeb ettepaneku hakata Tallinna linnal tee- või ummikumaksu koguma, et linna tänavaid korras hoida ning liiklusummikuid hajutada. Ühtlasi soovitab autor teede-tänavate remondi planeerijail olla pisut mõistlikum ja ettenägelikum

  13. Dynamic Three-Dimensional Geometry of the Aortic Valve Apparatus-A Feasibility Study

    NARCIS (Netherlands)

    Khamooshian, Arash; Amador, Yannis; Hai, Ting; Jeganathan, Jelliffe; Saraf, Maria; Mahmood, Eitezaz; Matyal, Robina; Khabbaz, Kamal R.; Mariani, Massimo; Mahmood, Feroze

    OBJECTIVE: To provide (1) an overview of the aortic valve (AV) apparatus anatomy and nomenclature, and (2) data regarding the normal AV apparatus geometry and dynamism during the cardiac cycle obtained from three-dimensional transesophageal echocardiography (3D TEE). DESIGN: Retrospective

  14. Maintenance of primary cell cultures of immunocytes from Cacopsylla sp. psyllids: a new in vitrio tool for the study of pest insects

    Science.gov (United States)

    Psyllid species are major vectors of plant pathogens, such as phytoplasmas and Liberibacter bacteria, which threaten economic stability of fruit tee crops and vegetable production worldwide. Primary cell cultures of immunocytes have been developed from the three psyllid species, Cacopsylla melanone...

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... the Media Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament ...

  16. Cancer incidence in Bucaramanga Metropolitan Area, 2000-2004. First five years report from population based cancer registry of Metropolitan Area of Bucaramanga.

    Directory of Open Access Journals (Sweden)

    Erika Eliana Meza Durán

    2007-11-01

    diagnosis, control of duplicated cases, as well as code and typing quality. It was notpossible to include the cases obtained on the death certificate. Results: from 2000 to 2004, the Cancer Registry collecteddata on 5,939 new cases (without basal cell carcinoma, equivalent to diagnose 3.3 new cases per day. Every year, 858residents of the Metropolitan Area of Bucaramanga died by cancer (average of 2,3 cases per day; 57.0% of the casesaffected females (3,365 cases and 43.0% males (2,574 cases, the relation female:male is 1.3:1. The annual crudeincidence rate in male is 107.7/100,000 inhabitants, and in female is 128.2/ 100,000 inhabitants; the age-adjusted incidencerate (TEE it is 162.6 and 146.5 for 100,000 inhabitants, respectively. Excluding basal cell carcinoma, the most frequentcancer in males is prostate cancer (TEE 45.9/100,000 inh, followed by stomach cancer (TEE 18.3/100,000 inh and the skinsquamous cell carcinoma (14.7/100,000 hab; among women, the most frequent cancer is breast cancer (TEE 37.3/100,000hab, followed by cervical cancer (TEE 19.9/100,000 hab and colon and rectal cancer (TEE 9.8/100,000 hab. Conclusions:Compared with the GLOBOCAN 2002 data (A project that estimates the incidence, prevalence and mortality of 27 cancertypes for all the countries of the world in the year 2002, the breast cancer in this region is superior to that estimated for thecountry, while the rates on uterine cervix are very inferior to that estimated. The results of the other localizations in general aresimilar to expected.

  17. Self-Reported Interview-Assisted Diet Records Underreport Energy Intake in Maintenance Hemodialysis Patients.

    Science.gov (United States)

    Shapiro, Bryan B; Bross, Rachelle; Morrison, Gillian; Kalantar-Zadeh, Kamyar; Kopple, Joel D

    2015-07-01

    Studies suggest that maintenance hemodialysis (MHD) patients report dietary energy intakes (EIs) that are lower than what is actually ingested. Data supporting this conclusion have several important limitations. The present study introduces a novel approach of assessing underreporting of EI in MHD patients. Comparisons of EI of free-living MHD patients determined from food records to their measured energy needs. Metabolic research ward. Thirteen clinically stable MHD patients with unchanging weights whose EI was assessed by dietitian interview-assisted 3-day food records. EI was compared with (1) patients' resting energy expenditure (REE), measured by indirect calorimetry, and estimated total energy expenditure (TEE) and (2) patients' dietary energy requirements (DER) measured while patients underwent nitrogen balance studies and consumed a constant energy diet in a research ward for a mean duration of 89.5 days. DER was calculated as the actual EI during the research study corrected for changes in body fat and lean body mass measured by Dual X-Ray Absorptiometry. Underreporting of EI was determined by an EI:REE ratio <1.27 and an EI:TEE ratio or EI:DEE ratio <1.0. Seven of the 13 MHD patients studied were male. Patient's ages were 47.7 ± standard deviation 9.7 years; body mass index averaged 25.4 ± 2.8 kg/m2, and dialysis vintage was 53.3 ± 37.1 months. The EI:REE ratio (1.03 ± 0.23) was significantly less than the cutoff value for underreporting of 1.27 (P = .001); 12 of 13 patients had EI:REE ratios <1.27. The mean EI:TEE ratio was significantly less than the cutoff value of 1.0 (0.73 ± 0.17, P < .0001), and 12 MHD patients had EI:TEE ratios <1.0. The EI:DER ratio was also <1.0 (0.83 ± 0.25, P = .012), and 10 MHD had EI:DER ratios <1.0. Dietitian interview-assisted diet records by MHD patients substantially underestimate the patient's dietary EI. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  18. Conceptual design of a thermo-electrical energy storage system based on heat integration of thermodynamic cycles – Part A: Methodology and base case

    International Nuclear Information System (INIS)

    Morandin, Matteo; Maréchal, François; Mercangöz, Mehmet; Buchter, Florian

    2012-01-01

    The interest in large scale electricity storage (ES) with discharging time longer than 1 h and nominal power greater than 1 MW, is increasing worldwide as the increasing share of renewable energy, typically solar and wind energy, imposes severe load management issues. Thermo-electrical energy storage (TEES) based on thermodynamic cycles is currently under investigation at ABB corporate research as an alternative solution to pump hydro and compressed air energy storage. TEES is based on the conversion of electricity into thermal energy during charge by means of a heat pump and on the conversion of thermal energy into electricity during discharge by means of a thermal engine. The synthesis and the thermodynamic optimization of a TEES system based on hot water, ice storage and transcritical CO 2 cycles, is discussed in two papers. In this first paper a methodology for the conceptual design of a TEES system based on the analysis of the thermal integration between charging and discharging cycles through Pinch Analysis tools is introduced. According to such methodology, the heat exchanger network and temperatures and volumes of storage tanks are not defined a priori but are determined after the cycle parameters are optimized. For this purpose a heuristic procedure based on the interpretation of the composite curves obtained by optimizing the thermal integration between the cycles was developed. Such heuristic rules were implemented in a code that allows finding automatically the complete system design for given values of the intensive parameters of the charging and discharging cycles only. A base case system configuration is introduced and the results of its thermodynamic optimization are discussed here. A maximum roundtrip efficiency of 60% was obtained for the base case configuration assuming turbomachinery and heat exchanger performances in line with indications from manufacturers. -- Highlights: ► Energy storage based on water, ice, and transcritical CO 2 cycles is

  19. Guidelines for the definition of time-to-event end points in renal cell cancer clinical trials: results of the DATECAN project†.

    Science.gov (United States)

    Kramar, A; Negrier, S; Sylvester, R; Joniau, S; Mulders, P; Powles, T; Bex, A; Bonnetain, F; Bossi, A; Bracarda, S; Bukowski, R; Catto, J; Choueiri, T K; Crabb, S; Eisen, T; El Demery, M; Fitzpatrick, J; Flamand, V; Goebell, P J; Gravis, G; Houédé, N; Jacqmin, D; Kaplan, R; Malavaud, B; Massard, C; Melichar, B; Mourey, L; Nathan, P; Pasquier, D; Porta, C; Pouessel, D; Quinn, D; Ravaud, A; Rolland, F; Schmidinger, M; Tombal, B; Tosi, D; Vauleon, E; Volpe, A; Wolter, P; Escudier, B; Filleron, T

    2015-12-01

    In clinical trials, the use of intermediate time-to-event end points (TEEs) is increasingly common, yet their choice and definitions are not standardized. This limits the usefulness for comparing treatment effects between studies. The aim of the DATECAN Kidney project is to clarify and recommend definitions of TEE in renal cell cancer (RCC) through a formal consensus method for end point definitions. A formal modified Delphi method was used for establishing consensus. From a 2006-2009 literature review, the Steering Committee (SC) selected 9 TEE and 15 events in the nonmetastatic (NM) and metastatic/advanced (MA) RCC disease settings. Events were scored on the range of 1 (totally disagree to include) to 9 (totally agree to include) in the definition of each end point. Rating Committee (RC) experts were contacted for the scoring rounds. From these results, final recommendations were established for selecting pertinent end points and the associated events. Thirty-four experts scored 121 events for 9 end points. Consensus was reached for 31%, 43% and 85% events during the first, second and third rounds, respectively. The expert recommend the use of three and two endpoints in NM and MA setting, respectively. In the NM setting: disease-free survival (contralateral RCC, appearance of metastases, local or regional recurrence, death from RCC or protocol treatment), metastasis-free survival (appearance of metastases, regional recurrence, death from RCC); and local-regional-free survival (local or regional recurrence, death from RCC). In the MA setting: kidney cancer-specific survival (death from RCC or protocol treatment) and progression-free survival (death from RCC, local, regional, or metastatic progression). The consensus method revealed that intermediate end points have not been well defined, because all of the selected end points had at least one event definition for which no consensus was obtained. These clarified definitions of TEE should become standard practice in

  20. Tendencias e indicadores sociales de la mortalidad por cáncer de mama y cuello uterino: Antioquia, Colombia, 2000-2007 Trends and social indicators of both mortality breast cancer and cervical cancer in Antioquia, Colombia, 2000-2007

    Directory of Open Access Journals (Sweden)

    Armando Baena

    2011-12-01

    Full Text Available OBJETIVO: Estimar tasas estandarizadas por edad (TEE de mortalidad por cáncer de mama y cérvix 2000-2007 y explorar indicadores sociales que expliquen la variabilidad de las tasas. MATERIAL Y MÉTODOS: Las TEE de mortalidad se estimaron por el método directo y mediante regresión lineal se relacionaron con indicadores sociales por subregión. RESULTADOS: La TEE de cáncer de mama en Antioquia fue 11.3 por 100 000 mujeres-año y para cáncer cervical 9.1. En Medellín, la TEE de cáncer de mama fue 12.5, 1.8 veces la tasa de cáncer cervical. Se observó una disminución del cáncer cervical en Medellín (valor-p=0.03 entre 2000 y 2007, pero no en el resto de Antioquia. La mortalidad de cáncer cervical se relacionó con el porcentaje de miseria (valor-p=0.0003. CONCLUSIONES: La mortalidad por estas neoplasias ha permanecido constante en Antioquia, con una amplia variación de la mortalidad por cáncer cervical por subregión asociada con niveles de pobreza.OBJECTIVE: To estimate the mortality age-standardized rates (ASR for breast and cervical cancer from 2000-2007 and explore social indicators that explain the variability of rates in Antioquia. MATERIAL AND METHODS: The ASR was estimated by the direct method and linear regression was used to relate social indicators with rates by subregion. RESULTS: Breast and cervical cancer mortality ASRs in Antioquia were 11.3 and 9.1 per 100 000 woman-years respectively. In Medellin, the breast cancer mortality ASR was 12.5, 1.8 times the rate of cervical cancer. A decrease of cervical cancer ASR between 2000 and 2007 was observed in Medellin (p-value=0.03 but not in the rest of Antioquia. Cervical cancer mortality ASR was related to the percentage of poverty (p-value=0.0003. CONCLUSIONS: Mortality due to these neoplasms has remained constant in Antioquia. The wide variation in mortality from cervical cancer between regions seems to be associated with poverty.

  1. CT based 3D printing is superior to transesophageal echocardiography for pre-procedure planning in left atrial appendage device closure.

    Science.gov (United States)

    Obasare, Edinrin; Mainigi, Sumeet K; Morris, D Lynn; Slipczuk, Leandro; Goykhman, Igor; Friend, Evan; Ziccardi, Mary Rodriguez; Pressman, Gregg S

    2018-05-01

    Accurate assessment of the left atrial appendage (LAA) is important for pre-procedure planning when utilizing device closure for stroke reduction. Sizing is traditionally done with transesophageal echocardiography (TEE) but this is not always precise. Three-dimensional (3D) printing of the LAA may be more accurate. 24 patients underwent Watchman device (WD) implantation (71 ± 11 years, 42% female). All had complete 2-dimensional TEE. Fourteen also had cardiac computed tomography (CCT) with 3D printing to produce a latex model of the LAA for pre-procedure planning. Device implantation was unsuccessful in 2 cases (one with and one without a 3D model). The model correlated perfectly with implanted device size (R 2  = 1; p < 0.001), while TEE-predicted size showed inferior correlation (R 2  = 0.34; 95% CI 0.23-0.98, p = 0.03). Fisher's exact test showed the model better predicted final WD size than TEE (100 vs. 60%, p = 0.02). Use of the model was associated with reduced procedure time (70 ± 20 vs. 107 ± 53 min, p = 0.03), anesthesia time (134 ± 31 vs. 182 ± 61 min, p = 0.03), and fluoroscopy time (11 ± 4 vs. 20 ± 13 min, p = 0.02). Absence of peri-device leak was also more likely when the model was used (92 vs. 56%, p = 0.04). There were trends towards reduced trans-septal puncture to catheter removal time (50 ± 20 vs. 73 ± 36 min, p = 0.07), number of device deployments (1.3 ± 0.5 vs. 2.0 ± 1.2, p = 0.08), and number of devices used (1.3 ± 0.5 vs. 1.9 ± 0.9, p = 0.07). Patient specific models of the LAA improve precision in closure device sizing. Use of the printed model allowed rapid and intuitive location of the best landing zone for the device.

  2. Tuglas ja Ristikivi avavad prantslaste tõlkesarja

    Index Scriptorium Estoniae

    2010-01-01

    Prantsuse kirjastuselt "Editions Ameline" ilmus Friedebert Tuglase prantsuskeelne novellikogu L'Ombre d'un Homme ("Inimese vari"). Sarja nimi Le chemin du lézard tähendab tõlkes "Sisaliku tee", see Ristikivi luuletus on prantsuse kui eesti keeles ära toodud

  3. Randvere Kool = Randvere School / Kristi Lents

    Index Scriptorium Estoniae

    Lents, Kristi, 1981-

    2013-01-01

    Kristi Lents-Esnari ja Marita Mätase (Allianss Arhitektid) kujundatud Randvere Kooli (G.H. Schüdlöffeli tee 4, Randvere küla, Viimsi) interjöörist. Hoone arhitekt Inga Raukas. Lühidalt Kristi Lents-Esnarist ja Marita Mätasest

  4. Evaluation of prosthetic heart valves by transesophageal echocardiography: problems, pitfalls, and timing of echocardiography

    NARCIS (Netherlands)

    van den Brink, Renee B. A.

    2006-01-01

    Transesophageal echocardiography (TEE) is especially suitable for examination of prosthetic valves because of the proximity of the esophagus to the heart and absence of interference with lungs and ribs. This article reviews normal and abnormal morphologic characteristics of prosthetic valves such as

  5. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on Dietary Reference Values for energy

    DEFF Research Database (Denmark)

    Tetens, Inge

    Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived dietary reference values for energy, which are provided as average requirements (ARs) of specified age and sex groups. For children and adults, total energy expenditure (TEE...

  6. Kosovo elanikud ei malda enam iseseisvuse küsimusega oodata / Raimo Poom

    Index Scriptorium Estoniae

    Poom, Raimo

    2007-01-01

    Tee leidmine Kosovo iseseisvusele on praegu üks kõige valulikumaid rahvusvaheliste läbirääkimiste küsimusi. Vt. samas: ÜRO erisaadiku Ahtisaari plaan Kosovo jaoks; Eestlased teenivad kõige keerulisemas piirkonnas; Kosovo serblaste liider: iseseisvusel pole põhjendust

  7. Inimroti askeldused elegantses paberlabürindis / Silvia Soro

    Index Scriptorium Estoniae

    Soro, Silvia

    2005-01-01

    27. nov. esietendus Viljandi Kultuuriakadeemia black box'is Tallinna Ülikooli koreograafi-lavastaja eriala magistrandi H. Ehrenbuschi ja Kunstiakadeemia graafika eriala magistrantide J. Samma, A. Teeääre ja K. Ehala (paberlõige, lavakujundus) koostöös sündinud lavastus "!"

  8. Alternate Welding Processes for In-Service Welding

    Science.gov (United States)

    2009-04-24

    Conducting weld repairs and attaching hot tap tees onto pressurized pipes has the advantage of avoiding loss of service and revenue. However, the risks involved with in-service welding need to be managed by ensuring that welding is performed in a rep...

  9. Boys and Puberty (For Kids)

    Science.gov (United States)

    ... Videos for Educators Search English Español Boys and Puberty KidsHealth / For Kids / Boys and Puberty What's in this article? Why Are Girls Taller ... as you grow up, especially as you reach puberty (say: PYOO-bur-tee), the name for the ...

  10. Kohtumised jõuga = Encounters with power / Vilen Künnapu

    Index Scriptorium Estoniae

    Künnapu, Vilen, 1948-

    2010-01-01

    Arhitekt mõtestab oma loomingu spirituaalset ehk energeetilist arhitektuuri - Budistlik keskus Jälgimäel, kontseptuaalne projekt "9 Mandala Templit Londonis, Thames'i jõel", ümartempel Tallinna vanglale, Valguse Tee kirik Tallinnas, kabel Huuksi mõisapargis, tempelelamu Suurupis, Tigutorn Tartus jt.

  11. Männiku sotsiaalelamu = Social housing in Männiku / Peeter Pere

    Index Scriptorium Estoniae

    Pere, Peeter, 1957-

    2012-01-01

    2012. a. Tallinnas Männiku tee 92 valminud inva- ja peremajutamiseks mõeldud sotsiaalelamu, vana ühiselamu ümberprojekteerimine. Arhitektid: Siiri Vallner, Indrek Peil, Kaire Nõmm, kaasautorid: Ragnar Põllukivi, Andro Mänd, Kadri Klementi (Kavakava). Sisearhitekt Tarmo Piirmets (Pink). Projekt: 2010-2011

  12. Võru linnagaleriis avati kolm uut näitust

    Index Scriptorium Estoniae

    2009-01-01

    26. oktoobrist 20 novembrini on Võru Linnagaleriis avatud Ruti Jõgi joonistuste ja Aivar Rumvoldi maalide näitus "Koos. Omaette", Marek Hämmelbergi isikunäitus "Tuvi ämm" ning grupi Sigmund Freud (Liina Guiter, Katrin Tees, Helen Melesk) näitus "Keemia"

  13. Rail Baltic - дорогой и рискованный проект / Микк Салу

    Index Scriptorium Estoniae

    Салу, Микк, 1975-

    2011-01-01

    Rail Balticu puhul on tähtsaim küsimus, kas uut raudteeühendust on üldse vaja, mitte aga see, kas tee läheb läbi Tartu või Pärnu. Konsutatsioonifirma AECOM koostatud raportist Rail Balticu tasuvuse kohta

  14. Unistuste Rail Baltic - ilus ja kallis / Mikk Salu

    Index Scriptorium Estoniae

    Salu, Mikk, 1975-

    2011-01-01

    Rail Balticu puhul on tähtsaim küsimus, kas uut raudteeühendust on üldse vaja, mitte aga see, kas tee läheb läbi Tartu või Pärnu. Konsutatsioonifirma AECOM koostatud raportist Rail Balticu tasuvuse kohta

  15. Elutervik ja aeg : murdkem püramiidi võim / Sigmund Kvaloy ; tõlk. Tiiu Speek

    Index Scriptorium Estoniae

    Kvaloy, Sigmund

    2005-01-01

    Nüüdisaegsest ökofilosoofiast, tööstusliku kasvu ühiskonna ja eluliste vajaduste ühiskonna vastuoludest ning Norra ökopoliitikast. Lisatud lühiülevaade autori elukäigust. Vt. ka: David Rothenberg. Elutervik ja elulised vajadused: Eesti tee

  16. Müüdid ja mälestused mõttelennu meelevallas / Aita Kivi

    Index Scriptorium Estoniae

    Kivi, Aita, 1954-

    2000-01-01

    Sisu : Maimu Berg. Ära; Liam O'Flaherty. Must org; Victoria Holt. Menfreya; Tomás Eloy MartÍnez. Püha Evita; Ervin Õunapuu. Teie mälestuseks, kes iganes te olete ja kus asute; Anne Kahro. Viie kella tee

  17. Socio-economic and environmental factors influence energy utilization in Brazilian breast-fed infants

    NARCIS (Netherlands)

    Haisma, Hinke; Coward, W. Andrew; Visser, G. Henk; Vonk, Roel; Wells, Jonathan C. K.; Wright, A.; Victora, Cesar G.

    Energy intake recommendations for infants are based on data from industrialized countries. FAO/WHO/UNU expressed the need for studies on total energy expenditure (TEE) and basal metabolic rate from developing countries covering current and changing lifestyles. For this observational study, 65

  18. Transcatheter mitral valve implantation via transapical approach

    DEFF Research Database (Denmark)

    Sondergaard, Lars; Brooks, Matthew; Ihlemann, Nikolaj

    2015-01-01

    bypass surgery (n = 2), severe pulmonary hypertension (n = 1) and moderate to severe chronic renal failure (n = 3). A CardiAQ mitral valve was implanted using fluoroscopy and transoesophageal (TEE) guidance via a standard transapical approach. RESULTS: Accurate prosthesis positioning and deployment...

  19. Evaluation of aortic valve stenosis by cardiac multislice computed tomography compared with echocardiography: a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Sivertsen, Jacob; Kofoed, Klaus Fuglsang

    2009-01-01

    a systematic literature review and meta-analysis, was to explore whether MSCT is a reliable method for AVA quantification, and simultaneously to assess the coronary anatomy in patients with AVS. METHODS: A comprehensive systematic literature search and meta-analysis was conducted that included 14 studies...... totaling 470 patients. The meta-analysis was carried out to examine the reliability of MSCT compared to transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). Seven studies including 266 patients with AVS were also eligible for a secondary analysis to compare the accuracy of MSCT...... was concordant with planimetry by TEE, with a small bias of -0.02 (95% CI -0.16, 0.11) cm2 (p = 0.71). MSCT, when compared to invasive angiography for the detection of significant coronary stenosis, showed sensitivity, specificity and diagnostic odds ratio of 95.5% (95% CI 88-99), 81% (95% CI 75-86)%, and 53 (95...

  20. The Rise and Fall of the Concept of The Experience Economy in the Local Economic Development of Denmark

    DEFF Research Database (Denmark)

    Freire-Gibb, L. Carlos

    2011-01-01

    , nor to tourist attractions, which are also linked to TEE. However, it criticizes the implementation of an unorthodox idea to Local Economic Development, even though it may have useful principles to other disciplines. This article reflects the line of recent research which has questioned its......This article discusses the evolution of the concept of “The Experience Economy“ (TEE) in the Danish local economic policy. The term is rarely known worldwide; however, it has become quite popular among the Danes and other Scandinavians. Its origin comes from the American business-marketing field...... in the late 1990s, while in Denmark, it evolved as a multifaceted idea with notable effects for economic development at the local level. The concept is related to the cultural or creative economy, but in the Danish case, it became more diffuse. This article does not intend to be a critique of these two lines...

  1. Video Golf

    Science.gov (United States)

    1995-01-01

    George Nauck of ENCORE!!! invented and markets the Advanced Range Performance (ARPM) Video Golf System for measuring the result of a golf swing. After Nauck requested their assistance, Marshall Space Flight Center scientists suggested video and image processing/computing technology, and provided leads on commercial companies that dealt with the pertinent technologies. Nauck contracted with Applied Research Inc. to develop a prototype. The system employs an elevated camera, which sits behind the tee and follows the flight of the ball down range, catching the point of impact and subsequent roll. Instant replay of the video on a PC monitor at the tee allows measurement of the carry and roll. The unit measures distance and deviation from the target line, as well as distance from the target when one is selected. The information serves as an immediate basis for making adjustments or as a record of skill level progress for golfers.

  2. Tricuspid insufficiency after laser lead extraction.

    Science.gov (United States)

    Rodriguez, Yasser; Mesa, Julian; Arguelles, Eric; Carrillo, Roger G

    2013-08-01

    The use of laser lead extraction (LLE) to remove pacemaker and implantable cardiac defibrillator leads has become more prevalent in the past decade. Though the procedure is associated with a low rate of complications, LLE still poses some risks to patients. Some reports have suggested an increase in tricuspid insufficiency (TI) associated with LLE. We present a series of patients who underwent both LLE and complete evaluation for TI with echocardiographic techniques. From August 2008 to January 2010, 173 prospective, consecutive patients underwent LLE in a single center. All patients had transesophageal echocardiograms (TEE) during the extraction. Fifty-three patients had tricuspid valve function evaluated a day before the procedure with a transthoracic echocardiogram (TTE), during the procedure with a TEE and 2 days postoperatively with a TTE. All 173 patients experienced no change in tricuspid valve function during the procedure with TEE. Of the 53 patients who underwent a complete TI evaluation, 38 were males (72%) and 15 females (38%), with a mean age of 69.45 ± 14.08. Mean ejection fraction was 35.82 ± 14.72. Three (6%) patients experienced TI after the procedure (two mild and one severe, all with tricuspid valve endocarditis); 16 (30%) patients were found to have TI before LLE that returned to normal valve function during or after the procedure. Thirty-four (64%) patients did not experience any significant change of the tricuspid valve performance after LLE. LLE was not associated with increased TI. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  3. Under-reporting of food intake is frequent among Brazilian free-living older persons: a doubly labelled water study.

    Science.gov (United States)

    Ferriolli, Eduardo; Pfrimer, Karina; Moriguti, Julio C; Lima, Nereida K C; Moriguti, Eny K U; Formighieri, Paulo F; Scagliusi, Fernanda B; Marchini, Julio S

    2010-03-15

    The assessment of food intake is essential for the development of dietetic interventions. Accuracy is low when intake is assessed by questionnaires, the under-reporting of food intake being frequent. Most such studies, however, were performed in developed countries and there is little data about the older population of developing nations. This study aimed to verify the total energy expenditure (TEE) of independent older Brazilians living in an urban area, through the doubly labelled water (DLW) method and to compare it with the reported energy intake obtained through the application of a food frequency questionnaire (FFQ). Initially, 100 volunteers aged from 60 to 75 years had their body composition determined by dual-energy X-ray absorptiometry (DEXA). Five volunteers of each quartile of body fat percentage had their energy expenditure determined by DLW. The mean age of the subjects included in this phase of the study was 66.4 +/- 3.5 years, and ten of the subjects were men. The mean TEE was 2565 +/- 614 and 2154 +/- 339 kcal.day(-1) for men and women, respectively. The Physical Activity Level (PAL) was 1.58 +/- 0.31 and 1.52 +/- 0.22, respectively. Under-reporting of food intake was highly prevalent, with a mean percentage of reported intake in relation to measured TEE of -17.7%. Thus, under-reporting of food intake is highly prevalent among Brazilian independent older persons. The DLW method is an important tool in nutritional studies and its use is to be recommended in developing countries. Copyright 2010 John Wiley & Sons, Ltd.

  4. Reliability and validity of two frequently used self-administered physical activity questionnaires in adolescents

    Directory of Open Access Journals (Sweden)

    Kurtze Nanna

    2008-07-01

    Full Text Available Abstract Background To create and find accurate and reliable instruments for the measurement of physical activity has been a challenge in epidemiological studies. We investigated the reliability and validity of two different physical activity questionnaires in 71 adolescents aged 13–18 years; the WHO, Health Behaviour in Schoolchildren (HBSC questionnaire, and the International Physical Activity Questionnaire (IPAQ, short version. Methods The questionnaires were administered twice (8–12 days apart to measure reliability. Validity was assessed by comparing answers from the questionnaires with a cardiorespiratory fitness test (VO2peak and seven days activity monitoring with the ActiReg, an instrument measuring physical activity level (PAL and total energy expenditure (TEE. Results Intraclass correlation coefficients for reliability for the WHO HBSC questionnaire were 0.71 for frequency and 0.73 for duration. For the frequency question, there was a significant difference between genders; 0.87 for girls and 0.59 for boys (p 2peak were fair, ranging between 0.29 – 0.39. The WHO HBSC questionnaire measured against VO2peak for girls were acceptable, ranging between 0.30 – 0.55. Both questionnaires, except the walking question in IPAQ, showed a low correlation with PAL and TEE, ranging between 0.01 and 0.29. Conclusion These data indicate that the WHO HBSC questionnaire had substantial reliability and were acceptable instrument for measuring cardiorespiratory fitness, especially among girls. None of the questionnaires however seemed to be a valid instrument for measuring physical activity compared to TEE and PAL in adolescents.

  5. High incidence of echocardiographic abnormalities of the interatrial septum in patients undergoing ablation for atrial fibrillation.

    Science.gov (United States)

    Schernthaner, Christiana; Danmayr, Franz; Daburger, Apollonia; Eichinger, Jörg; Hammerer, Matthias; Strohmer, Bernhard

    2013-04-01

    Atrial fibrosis or fatty deposition is known to increase the propensity for the development of atrial fibrillation (AF). Apart from the pulmonic veins, the interatrial septum (IAS) might play a role in the maintenance of AF. In contrast to left atrial anatomy and adjacent veins, the IAS cannot be visualized in detail with computed tomography. Thus, preprocedural transesophageal echocardiography (TEE) may provide important morphologic information beyond exclusion from atrial thrombi. The study comprised 108 consecutive patients (mean age 60 ± 11 years; 98 men). AF was paroxysmal in 91 (84%) and persistent in 17 (16%) patients. We investigated the morphological characteristics of the IAS by TEE in patients who underwent radiofrequency ablation of AF. The IAS was structurally abnormal in 46 (43%) patients, showing the following echocardiograhic findings: atrial septal hypermobility or aneurysm (n = 27) associated with a patent foramen ovale (PFO) (n = 11) or with a small atrial septal defect (ASD) (n = 2), a septal flap associated with a PFO or an ASD (n = 8), and an abnormally thickened IAS (n = 12). A thrombus in the left atrial appendage was discovered in only 2 (2%) patients. A structurally abnormal IAS was diagnosed in nearly half of the patients undergoing ablation therapy for AF. The information obtained by TEE is mandatory to exclude left atrial thrombi prior the ablation procedure. Moreover, detailed knowledge of morphologic characteristics of the IAS facilitates an optimized and safe performance of the transseptal puncture using long sheaths with large diameters. © 2012, Wiley Periodicals, Inc.

  6. Interatrial septum thickness and difficulty with transseptal puncture during redo catheter ablation of atrial fibrillation.

    Science.gov (United States)

    Tomlinson, David R; Sabharwal, Nikant; Bashir, Yaver; Betts, Timothy R

    2008-12-01

    Patients undergoing catheter ablation for atrial fibrillation (AF) frequently require redo procedures, but there are no data reporting interatrial septum thickness (IAS) and difficulty during repeat transseptal puncture (TSP). Patients undergoing two separate AF ablation procedures had preprocedural fossa ovalis (FO) thickness measured using transesophageal echocardiography (TEE). "Difficult" TSP was defined by two observers as requiring excessive force, or conversion to TEE guidance. The study comprised 42 patients (37 male) with mean+/-SD age 55+/-9 years. Mean FO thickness was significantly greater at the time of redo TSP (2.2+/-1.6 mm vs 2.6+/-1.5 mm at redo, P=0.03); however, this finding was limited to those who underwent initial dual transseptal sheath procedures, FO thickness 2.0+/-1.5 mm and 2.5+/-1.4 mm for TEE 1 and 2, respectively (P=0.048). There was a trend for more frequent difficult redo TSP procedures, 7/42 (17%; 95% confidence interval [CI] 8-31) redo, versus 4/42 (10%; 95% CI 3-23) first TSP. On univariate analysis, FO thickness was not predictive of TSP difficulty; the only predictor of difficult redo TSP was diabetes. IAS thickness at the FO increased following catheter ablation of AF, yet on subgroup analysis this was limited to initial procedures utilizing dual transseptal sheaths. There was a trend toward more frequent difficulty during redo TSP, yet this was not associated with FO thickening. Diabetes may predispose to difficulty during redo TSP; this finding requires confirmation in a larger study population.

  7. Transcatheter closure of secundum atrial septal defect with cardio SEAL septal occluder. A preliminary result of clinical application

    International Nuclear Information System (INIS)

    Zhang Gejun; Dai Ruping; Liu Yanling; Jiang Shiliang; Zeng Zheng; Huang Lianjun; Xie Ruolan

    2001-01-01

    Objective: To evaluate the efficiency and preliminary results of transcatheter closure of secundum atrial septal defect (ASD) with CardioSEAL septal occluder. Methods: There were 12 patients in this study. Trans-esophageal echocardiography (TEE) before the interventions confirmed the ASDs with a mean diameter of *13.14 +- 3.48) mm (ranging from 8 to 20 mm). There were 11 isolated ASDs and 1 multi-defects ASD in the group. Each ASD was occluded with CardioSEAL septal occluder through the percutaneous procedure. The closure procedure was guided by fluoroscopy and trans-esophageal echocardiography. The TEE was done immediately after the procedure to find whether there was residual shunt. Trans-thoracic-echocardiography (TTE), ECG, and X-ray examination were done 24 hours, 1 month, 3 months, and 1 year after the procedures as follow-up to evaluate the efficiency. Results: The placements of the occluders were successful in 11 cases. There were no mortality and no emergent surgery during the procedures. TEE confirmed that there were trivial and small residual shunts in 3 cases immediately after the procedures. TTE confirmed small residual shunts in 2 cases 24 hour after the procedures, and in 1 case 1 month, 3 month, and 1 year after the procedures. Conclusion: Transcatheter closure of secundum ASD with CardioSEAL septal occluder was an efficient nonsurgical method. It could be the method of choice in treating the ASDs with special anatomic variations. It had a high successful rate of device placement and satisfied preliminary results, but the long-term follow-up was needed

  8. TCE REMOVAL FROM CONTAMINATED SOIL AND GROUND WATER

    Science.gov (United States)

    Widespread use of trichloroethylene (TEE) in the U.S. has resulted in its frequent detection in soil and groundwater. EE can become a health hazard after being processed in the human liver; or reductive dehalogenation in the environment may result in production of vinyl chloride,...

  9. The additional value of three-dimensional transesophageal echocardiography in complex aortic prosthetic heart valve endocarditis

    NARCIS (Netherlands)

    Tanis, Wilco; Teske, Arco J.; Van Herwerden, Lex A.; Chamuleau, Steven; Meijboom, Folkert; Budde, Ricardo P J; Cramer, MJ

    2015-01-01

    Background Two-dimensional transthoracic and transesophageal echocardiography (2DTTE and 2DTEE) may fail to detect signs of prosthetic heart valve (PHV) endocarditis due to acoustic shadowing. Three-dimensional (3D) TEE may have additional value; however, data are scarce. This study was performed to

  10. Rotermanni laudsepatöökoda = Rotermann cabinetmarker's workshop / Raivo Kotov, Andrus Kõresaar

    Index Scriptorium Estoniae

    Kotov, Raivo, 1976-

    2009-01-01

    Tallinna endise Rotermanni tööstuskvartali arhitektuuri kaasajastamine. Olemasoleva laudsepatöökoja kohale kavandati kolm eraldiseisvat majakat. Arhitektid Andrus Kõresaar ja Raivo Kotov (KOKO Arhitektid), konstruktorid Marti Sein ja Matis Teeäär, reklaamibüroo Brand Manuali kontori sisekujundaja Maarja Mikkin

  11. Problema Polshi / Dominique Moisi

    Index Scriptorium Estoniae

    Moisi, Dominique

    2007-01-01

    Autor võrdleb Hispaania ja Poola arengut ning leiab, et kuigi Euroopa Liidu liikmesriigina on Poola olnud märkimisväärselt edukas, seisab riik praegu teelahkmel: kas jätkata oma praegust poliitikat Saksamaa suhtes või loobuda minevikutaagast ja valida Hispaania tee

  12. Ausad vaesed, laiskus ja võitlev feminism / Hillar Padu

    Index Scriptorium Estoniae

    Padu, Hillar

    2002-01-01

    Inglise filosoof, loogik ja ühiskonnategelane Bertrand Russell (1872-1970) väitis, et usk töö moraalsusesse teeb tänapäeva maailmas palju kurja ja et tee õnnele ja jõukusele seisneb plaanipärase töö vähendamises

  13. Tom Olaf Urb / intervjueerinud Siim Õ. Ilves

    Index Scriptorium Estoniae

    Urb, Tom Olaf, 1985-

    2016-01-01

    Muusik, produtsent, kirjanik ja näitleja Tom-Olaf Urb, lavanimega Reket, arutleb disaini teemal ja nimetab kümme disainieset, mis teda elus köitnud on. Eesti Hip-Hop auhindade jagamisel valiti Reketi "Tuule tee" 2015.a. parimaks kodumaiseks hip-hop albumiks

  14. 46 CFR 50.25-1 - General.

    Science.gov (United States)

    2010-10-01

    ... subchapter. (b) Plate, bar stock, pipe, tube, pipe joining fittings (tees, elbows, reducers, etc.), bolting... or the cognizant Officer in Charge, Marine Inspection. (e) Components designed for hydraulic service... tested hydraulic components is granted by the Marine Safety Center or the cognizant Officer in Charge...

  15. I feel Slovenia(n) / Anzhe Logar

    Index Scriptorium Estoniae

    Logar, Anzhe

    2008-01-01

    Autor annab ülevaate poliitilistest arengutest ja võimuvõitlusest Sloveenias alates iseseisvumisest kuni 2008. aasta septembrini, perioodi sisse mahub ka Sloveenia esimene eesistumiskord Euroopa Liidus. Vt. samas: Berit Teeäär. Poriloopimisega saavutatud võit. Tabel: 21. septembril 2008 toimunud parlamendivalimiste tulemused

  16. Influence of transoesophageal echocardiography on therapy and prognosis in young patients with TIA or ischaemic stroke

    NARCIS (Netherlands)

    Rettig, T. C. D.; Bouma, B. J.; van den Brink, R. B. A.

    2009-01-01

    Objective. To determine the influence of transoesophageal echocardiography (TEE) on therapy and prognosis in patients with cryptogenic transient ischaemic attack (TIA) or ischaemic stroke under the age of 50 years.Methods and results. We evaluated all patients aged 50 and under who were referred to

  17. Twelve weeks of moderate aerobic exercise without dietary intervention or weight loss does not affect 24-h energy expenditure in lean and obese adolescents

    NARCIS (Netherlands)

    van der Heijden, Gert-Jan; Sauer, Pieter J. J.; Sunehag, Agneta L.

    Background: Exercise might have a persistent effect on energy expenditure and fat oxidation, resulting in increased fat loss. However, even without weight loss, exercise results in positive metabolic effects. The effect of an aerobic exercise program on 24-h total energy expenditure (TEE) and its

  18. Mäed, puud, rohukõrred : [luuletused] / Domokos Szil{u00E1gyi ; tlk. Tiiu Kokla

    Index Scriptorium Estoniae

    Szil{u00E1gyi, Domokos

    2004-01-01

    Sisu: Mäed, puud, rohukõrred ; Väiksed armuhümnid ; Nõid ; Katke kinni vanaisa ; Pööripäev ; Avaldus ; Kelles iseoma südametunnistusele koputad ; Süüdistus ; Tee nii, et armastaksin ; Circumdederunt ; Hädamaandumine. Eluloolisi andmeid autori kohta lk. 297-298

  19. One-dimensional calculation of flow branching using the method of characteristics

    International Nuclear Information System (INIS)

    Meier, R.W.; Gido, R.G.

    1978-05-01

    In one-dimensional flow systems, the flow often branches, such as at a tee or manifold. The study develops a formulation for calculating the flow through branch points with one-dimensional method of characteristics equations. The resultant equations were verified by comparison with experimental measurements

  20. Infotankistid ja Puhas Rõõm esitlevad : R.A.I.S.K. / Piret Räni

    Index Scriptorium Estoniae

    Räni, Piret

    2007-01-01

    Rühmitustest Infotankistid ja Puhas Rõõm. Näitusel R.A.I.S.K. (Radikaalne Agiteeriv Intrigeeriv Sotsiaalne Kunst) eksponeeritud töödest, autorid Mart Viljus, Katrin Tees, Ivika Kivi, Sulo Kallas, Piret Räni, Erki Kannus, Anu Vahtra, Maris Suits, Taavi Suits

  1. Elutervik ja aeg : murdkem püramiidi võim / Sigmund Kvaloy ; tõlk. Tiiu Speek

    Index Scriptorium Estoniae

    Kvaloy, Sigmund

    2005-01-01

    Nüüdisaegsest ökofilosoofiast, tööstusliku kasvu ühiskonna ja eluliste vajaduste ühiskonna vastuoludest ning Norra ökopoliitikast. Lisatud lühiülevaade autori elukäigust. Vt. ka: David Rothenberg. Elutervik ja elulised vajadused: Eesti tee. Lk. 549

  2. 296 kilomeetrit vabariigi presidendini ehk Kuidas Misso valla valijamees Ere Käis riigipea paika pani / Rainer Kerge

    Index Scriptorium Estoniae

    Kerge, Rainer, 1977-

    2006-01-01

    Kuigi Misso valla volikogu andis oma valijamehele, Misso Keskkooli direktorile Ere Käisele mandaadi hääletada president Arnold Rüütli poolt, ei avalikusta valijamees, kumba kandidaadi poolt ta oma hääle andis. Kaart: Misso valla valijamehe tee Estoniasse - 296 kilomeetrit

  3. Viis korrust klaasi ja betooni / Ell-Maaja Randküla

    Index Scriptorium Estoniae

    Randküla, Ell-Maaja, 1939-2016

    2005-01-01

    Hotell Ülemiste Tallinnas Lennujaama tee 2. Sisekujundus: Meelis Press ja Hillar Mänd, AS Meelis Pressi Arhitektuuribüroo. Ehitaja: AS FKSM. Arhitekt Martin Aunin. Meelis Pressist ja Hillar Männist, nende tähtsamad tööd. Ill.: 21 värv. vaadet

  4. Subacute Staphylococcus epidermidis Bacterial Endocarditis Complicated by Mitral-Aortic Intervalvular Fibrosa Pseudoaneurysm

    Science.gov (United States)

    2012-12-01

    compression, and thrombosis causing a cerebrovascular acci- dent or even death [2]. This is a case of an elderly male who initially underwent replacement...vascular accidents or other embolic events, and chest pain [3]. Case Reports in Cardiology 3 Figure 3: TEE depicting systolic ballooning of the

  5. Betti Alveri sünniaastapäeval kuulutatakse välja järjekordne Alveri kirjandusauhinna saaja...

    Index Scriptorium Estoniae

    2005-01-01

    Kirjandusauhinna nominendid: Sass Henno. Mina olin siin ; Andrei Hvostov. Lombakas Achilleus ; Mart Kangur, Jaak Rand ja Ivar Ravi. Jaak Rand ja teisi jutte ; Diana Leesalu. 2 grammi hämaruseni ; Jaan Pehk. Sisukord ; Linnar Priimägi. Kelle tee on varjul ; Leo de Sixtus. Skarabeuse tsivilisatsioon

  6. Tallinna Teletorn = Tallinn Television Tower

    Index Scriptorium Estoniae

    2015-01-01

    Rekonstrueeritud Tallinna Teletorn Kloostrimetsa tee 58a, valminud 2012. Eesti kultuurkapitali aastapreemia 2012. Arhitekt David Basiladze. Rekonstrueerimise projekti arhitektid Raivo Kotov, Andrus Kõresaar, Indrek Mikk, Margit Aule, Jaanus Männik, Lea Laidra, Karis Kahr (KOKO Arhitektid). Sisearhitektid Liis Lindvere, Raili Paling, Margit Argus (KOKO Arhitektid). Konstruktor Neoprojekt

  7. Managing phosphorus export from golf courses using industrial byproducts as filter materials

    Science.gov (United States)

    Golf courses, and in particular the tees, fairways, and putting greens, are vulnerable to loss of phosphorus (P) as dissolved reactive P (DRP) through sandy, porous grass rooting media and subsurface tile drainage. Excess levels of phosphorus (P) in surface waters promotes eutrophication, which in t...

  8. 75 FR 8346 - Proposed CERCLA Administrative Settlement; Anderson-Calhoun Mine and Mill Site, Leadpoint, WA

    Science.gov (United States)

    2010-02-24

    ...-Calhoun Mine and Mill Site, Leadpoint, WA AGENCY: Environmental Protection Agency (EPA). ACTION: Notice...-Calhoun Mine and Mill Site in Leadpoint, Washington, with settling party Blue Tee Corporation. The... Anderson-Calhoun Mine and Mill Site in Leadpoint, Washington, EPA Docket No. CERCLA-10-2010-0105 and should...

  9. Energy requirements of infants, children and adolescents

    Science.gov (United States)

    Energy requirements of infants, children and adolescents are defined as the amount of energy needed to balance total energy expenditure (TEE) at a desirable level of physical activity, and to support optimal growth and development consistent with long-term health. The latest FAO/WHO/UNU recommendati...

  10. Tartu Ülikool raamatukogus / Tiina Tammet

    Index Scriptorium Estoniae

    Tammet, Tiina, 1971-

    2005-01-01

    Kuni 13 II näitus "R.A.I.S.K." (Radikaalne Agiteeriv Intrigeeriv Sotsiaalne Kunst). Krutskilist ökokunsti teevad Infotankistid, Puhas Rõõm, Piret Räni, Maris Suits, Katrin Tees, Anu Vahtra, Mart Viljus, Ivika Kivi & Sulo Kallas, Taavi Suits, Kai Herkel ja Henry van Noordenburg

  11. 75 FR 25321 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2010-05-07

    ... Winter Sports Clinic Application, VA Form 0924a series. b. National Veterans Wheelchair Games Application.... National Veterans TEE Tournament Application, VA Form 0927a series. e. National Veterans Summer Sports... Form 0929a series. Type of Review: Existing collection in use without an OMB control number. Abstract...

  12. 75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2010-03-01

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

  13. Riigi valik - turvalisus või kaos / Kärt Anvelt

    Index Scriptorium Estoniae

    Anvelt, Kärt, 1973-

    2005-01-01

    2004. aastal lahkus Eesti politseist 382 inimest, 2005. aasta esimese kümne kuuga 360. Autor on seisukohal, et kui riik politseinike ja päästetöötajate palgatõusu osas kardinaalseid otsuseid ei tee, tekib riigil aasta-kahe pärast probleeme turvalisuse tagamisega

  14. 78 FR 55777 - Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event...

    Science.gov (United States)

    2013-09-11

    ... techniques or the use of other forms of information technology. Titles: a. National Disabled Veterans Winter... Form 0928h. m. Surfing Personnel Application, VA Form 0928i. n. Venue Personnel Application, VA Form... Creative Arts Festival, National Veterans TEE Tournament, National Disabled Veterans Winter Sports Clinic...

  15. Healed perivalvular abscess: Incidental finding on transthoracic echocardiography

    Directory of Open Access Journals (Sweden)

    Vishnu Datt

    2014-01-01

    Full Text Available A 36-year-old male patient presented with the complaints of palpitations and breathlessness. Preoperative transthoracic echocardiography (TTE revealed a bicuspid aortic valve; severe aortic regurgitation with dilated left ventricle (LV and mild LV systolic dysfunction (ejection fraction 50%. He was scheduled to undergo aortic valve replacement. History was not suggestive of infective endocarditis (IE. Preoperative TTE did not demonstrate any aortic perivalvular abscess. Intraoperative transesophageal echocardiography (TEE examination using the mid-esophageal (ME long-axis view, showed an abscess cavity affecting the aortic valve, which initially was assumed to be a dissection flap, but later confirmed to be an abscess cavity by color Doppler examination. The ME aortic valve short-axis view showed two abscesses; one was at the junction of the non-coronary and left coronary commissure and the other one above the right coronary cusp. Intraoperatively, these findings were confirmed by the surgeons. The case report demonstrates the superiority of TEE over TTE in diagnosing perivalvular abscesses.

  16. Structural modules in AP1000 plant design

    International Nuclear Information System (INIS)

    Prasad, N.; Tunon-Sanjur, L.

    2007-01-01

    Structural modules are extensively used in AP1000 plant design. The shop manufacturing of modules components improves the quality and reliability of plant structures. The application of modules has a positive impact on construction schedules, and results in substantial savings in the construction cost. This paper describes various types of structural modules used for AP1000 plant structures. CA structural wall modules are steel plate modules with concrete placed, on or within the module, after module installation. The layout and design of the largest CA wall modules, CA01 and CA20, is described in detail. General discussion of structural floor modules, such as the composite and finned floors, is also included. Steel form CB modules (liners) consist of plate reinforced with angle stiffeners and tee sections. The angles and the tee sections are on the concrete side of the plate. Design of CB20 has been included as an example of CB type modules. Design codes and structural concepts related to module designs are discussed. (authors)

  17. Noonan syndrome: An anesthesiologist′s perspective

    Directory of Open Access Journals (Sweden)

    Aggarwal Vikram

    2011-01-01

    Full Text Available Noonan syndrome (NS is one of the most common non chromosomal syndrome presenting to the cardiac anesthesiologist for the management of various cardiac lesions, predominantly pulmonary stenosis (PS (80% and hypertrophic obstructive cardiomyopathy (HOCM (30%. The presence of HOCM in NS makes these children susceptible to acute congestive heart failure due to hemodynamic fluctuations, thus necessitating optimization of drug and fluid therapy, careful conduct of anesthesia and providing adequate analgesia in the perioperative period. We describe a case of four year old boy with NS who presented to us for the management of PS and HOCM. In our case, transesophageal echocardiography (TEE played a major role in confirmation of the preoperative findings, detection of any new anomalies missed during the preoperative evaluation, intraoperative monitoring and assessment of the adequacy of repair in the immediate postoperative period. TEE provided invaluable help in taking critical surgical decisions, resulting in a favorable outcome.

  18. Design and analysis of reactor headers for Narora Atomic Power Project

    International Nuclear Information System (INIS)

    Danak, M.R.

    1975-01-01

    Reactor header for Narora Atomic Power Reactor is a 400 mm O.D. 10 metres long pressure vessel in the primary coolant circuit connecting 153 feeders to PHT pumps or steam generators. The vessel dimensions are restricted are by containment philosophy. The outlet connections for pumps or steam generators are to be of the size of vessel diameter and DO/t ratio for the vessel is approximately 10. The design and stresses induced meet the code requirements except that at times it is difficult to get precise stress values in absence of certain data and lack of code or available literature giving practical approach to the problem. It can be seen that the 400 mm equal tees used as part of the vessel cannot be penetrated in the light of code reinforcement requirements. However if the tees have to penetrated to retain established feeder layout, it should be established experimentally or by some detailed stress analysis that it will meet the intent of code. (author)

  19. Lemminkäinen valas vaidluses õli tulle / Katariina Krjutškova, Tea Taruste

    Index Scriptorium Estoniae

    Krjutškova, Katariina

    2010-01-01

    Lemminkäinen Eesti AS-i juhi Sven Pertens on arvamusel, et kui Aruvalla-Kose tee-ehituse riigihankes sõlmitakse leping Nordecon Infraga, aga kohtuvaidluses selgub hiljem, et hankeprotsessis on tehtud vigu, võib EL oma abiraha tagasi küsida. Lemminkäineni ja Nordeconi vaidlusest. Rahandusministeeriumi kommentaar

  20. JST Thesaurus Headwords and Synonyms: National Television System Committee [MeCab user dictionary for science technology term[Archive

    Lifescience Database Archive (English)

    Full Text Available MeCab user dictionary for science technology term National Television System Commit...tee 名詞 一般 * * * * NTSC NTSC エヌティーエスシー Thesaurus2015 200906068914886147 C EF11 UNKNOWN_2 National Television System Committee

  1. Aasta betoonehitis 2005

    Index Scriptorium Estoniae

    2006-01-01

    Aasta betoonehitiseks valiti TTP kontorihoone Tallinnas Pirital (Mähe tee 1), arhitekt Meelis Press. Eriauhinnad pälvisid arhitektuuribüroo QP Arhitektid (arhitektid Tõnu Laigu, Tõnu Laanemäe) AS Coal Terminal peahoone eest Muuga sadamas ja arhitektuuribüroo 3 + 1 Arhitektid eramu eest Magasini kvartalis Tallinnas

  2. Ny engelsk specialistuddannelse på ældreområdet

    DEFF Research Database (Denmark)

    Evron, Lotte Orr

    2016-01-01

    Naughton C, Hayes N, Zainab Z, Norton C, Lee G, Fitzpatrick JM, Crawford M, Tee S. The development of the Older Person’s Nurse Fellowship: Education concept to delivery. Nurse Education Today, 2016; (44): 1-7. doi: 10.1016/j.nedt.2016.04.022 Introduktion: Uddannelse af sundhedspersonale inden...

  3. Determinants of Perceived Health and Environmental Effects of ...

    African Journals Online (AJOL)

    USER

    physical land degeneration, and deforestation, environmental collapse associated with drought, flood and other extreme climatic changes. A study by. Tee et al, (2009) in Nigeria showed that excessive fuel wood harvesting led to massive soil erosion, decreased water quality and dam siltation. These changes lie at the heart ...

  4. Kennis en hantering van slangbyte deur algemene praktisyns op die ...

    African Journals Online (AJOL)

    antiserum en boomslang-antiserum. Daar is egter twee nadelige en po- tensieel ernstige komplikasies ver- bonde aan die gebruik van antise- rum, naamlik akute anafilaktiese reaksie, a.g.v. allergiese reaksie tee- noor perdeserum (waaruit poliva- lente antiserum voorberei word), en serumsiekte a.g.v. 'n vertraagde hi-.

  5. Measurements of cardiac output obtained with transesophageal echocardiography and pulmonary artery thermodilution are not interchangeable

    DEFF Research Database (Denmark)

    Møller-Sørensen, H; Graeser, K; Hansen, K L

    2014-01-01

    was placed in the following successive positions: supine, head-down tilt, head-up tilt, supine, supine with phenylephrine administration, pace heart rate 80 beats per minute (bpm), pace heart rate 110 bpm. TEE CO and PAC CO were measured simultaneously. The agreement was analysed by Bland-Altman plots...

  6. Sonnõi mir i jasnost snovideni / Jelena Skulskaja

    Index Scriptorium Estoniae

    Skulskaja, Jelena, 1950-

    2004-01-01

    PÖFFi mängufilme - "Tühi maja" ("Bin jip"), "Minu kasuvend Frankenstein" ("Moi svodnõi brat Frankenshtein"), "2046", "Tee maitse" ("Cha no aji"), "Allakäik" ("Der Untergang"), "Tütarlaps pärlkõrvarõngaga" ("Girl with a Pearl Earring"). Lisa : "Pimedate Ööde festival statistika peeglis"

  7. Kõik saab korda / Tamara Luuk

    Index Scriptorium Estoniae

    Luuk, Tamara, 1952-

    2010-01-01

    Rahvusvaheline videokunsti näitus "Kõik saab korda" Kumu Kunstimuuseumis 2. jaanuarini 2011. Kuraator Maria-Kristiina Soomre, kujundaja Berit Teeäär. Osalevad Marina Abramović (Serbia/USA), Eija-Liisa Ahtila (Soome), Kai Kaljo, Mike Marshall (Inglismaa), Ene-Liis Semper, Santeri Tuori (Soome), Guido van der Werve (Holland)

  8. Fulltext PDF

    Indian Academy of Sciences (India)

    M. Senthilkumar (Newgen Imaging) 1461 1996 Oct 15 13:05:22

    sented and the maps are presented in the appropri- ate scales, in user-friendly formats and with clarity. With the objective of working towards effective procedures for microzonation of urban centers, the Programme Advisory and Monitoring Commit- tee (PAMC) of Seismology Division, Department of Science and Technology ...

  9. Ääremaade pärispatt / Hardo Pajula

    Index Scriptorium Estoniae

    Pajula, Hardo, 1966-

    2006-01-01

    Sarnastest probleemidest Eesti ja Argentina rahanduses. Autor kirjutab, et Eesti ja Argentina on ühtemoodi rahakeskuste ääremaad, ainsaks lahenduseks on ääremaastaatusest välja kasvada või keskustega ühte sulada: Eesti rahasüsteemi lahustumine euroalas on ainus tee keskusesse. Lisa: Mis juhtus Argentinas?

  10. Echocardiography-based hemodynamic management of left ventricular diastolic dysfunction: a feasibility and safety study.

    Science.gov (United States)

    Shillcutt, Sasha K; Montzingo, Candice R; Agrawal, Ankit; Khaleel, Maseeha S; Therrien, Stacey L; Thomas, Walker R; Porter, Thomas R; Brakke, Tara R

    2014-11-01

    Patients with left ventricular diastolic dysfunction (LVDD) are at increased risk of postoperative adverse events. The primary aim of this study was to evaluate the safety and feasibility of using echocardiography-guided hemodynamic management (EGHEM) during surgery in subjects with LVDD compared to conventional management. The feasibility of using echocardiography to direct a treatment algorithm and clinical outcomes were compared for safety between groups. Subjects were screened for LVDD by preoperative transthoracic echocardiography (TTE) and randomized to the conventional or EGHEM group. Subjects in EGHEM received hemodynamic management based on left ventricular filling patterns on transesophageal echocardiography (TEE). Primary outcomes measured were the feasibility to obtain TEE images and follow a TEE-based treatment algorithm. Safety outcomes also compared the following clinical differences between groups: length of hospitalization, incidence of atrial fibrillation, congestive heart failure (CHF), myocardial infarction, cerebrovascular accident, transient ischemic attack and renal failure measured 30 days postoperatively. Population consisted of 28 surgical subjects (14 in conventional group and 14 in EGHEM group). Mean subject age was 73.4 ± 6.7 years (36% male) in conventional group and 65.9 ± 14.4 years (36% male) in EGHEM group. Procedures included orthopedic (conventional = 29%, EGHEM 36%), general (conventional = 50%, EGHEM = 36%), vascular (conventional = 7%, EGHEM = 21%), and thoracic (conventional = 14%, EGHEM = 7%). There was no statistically significant difference in adverse clinical events between the 2 groups. The EGHEM group had less CHF, atrial fibrillation, and shorter length of stay. Echocardiography-guided hemodynamic management of patients with LVDD during surgery is feasible and may be a safe alternative to conventional management. © 2014, Wiley Periodicals, Inc.

  11. Physical Activity Level and Physical Functionality in Nonagenarians Compared to Individuals Aged 60–74 Years

    Science.gov (United States)

    Frisard, Madlyn I.; Fabre, Jennifer M.; Russell, Ryan D.; King, Christina M.; DeLany, James P.; Wood, Robert H.; Ravussin, Eric

    2009-01-01

    Background Functional dependence and the risks of disability increase with age. The loss of independence is thought to be partially due to a decrease in physical activity. However, in populations, accurate measurement of physical activity is challenging and may not provide information on functional impairment. Methods This study therefore assessed physical functionality and physical activity level in a group of nonagenarians (11 men/11 women; 93 ± 1 years, 66.6 ± 2.4 kg, body mass index [BMI] = 24 ± 1 kg/m2) and a group of participants aged 60–74 years (17 men/15 women; 70 ± 1 years, 83.3 ± 3.0 kg, BMI = 29 ± 1 kg/m2) from the Louisiana Healthy Aging Study. Physical activity level was calculated from total energy expenditure (TEE) and resting metabolic rate (RMR). Physical functionality was assessed using the Reduced Continuous Scale Physical Functional Performance Test (CS-PFP10). Results Nonagenarians had lower absolute ( p < .001) and adjusted ( p < .007) TEE compared to participants aged 60–74 years which was attributed to a reduction in both RMR and physical activity level. Nonagenarians also had reduced functional performance ( p < .001) which was correlated with activity level (r = 0.68, p < .001). Conclusions When compared to individuals aged 60–74 years, 73% of the reduction in TEE in nonagenarians can be attributed to a reduction in physical activity level, the remaining being accounted for by a reduction in RMR. The reduced physical activity in nonagenarians is associated with less physical functionality. This study provides the first objective comparison of physical functionality and actual levels of physical activity in older individuals. PMID:17634327

  12. The validity of a web-based FFQ assessed by doubly labelled water and multiple 24-h recalls.

    Science.gov (United States)

    Medin, Anine C; Carlsen, Monica H; Hambly, Catherine; Speakman, John R; Strohmaier, Susanne; Andersen, Lene F

    2017-12-01

    The aim of this study was to validate the estimated habitual dietary intake from a newly developed web-based FFQ (WebFFQ), for use in an adult population in Norway. In total, ninety-two individuals were recruited. Total energy expenditure (TEE) measured by doubly labelled water was used as the reference method for energy intake (EI) in a subsample of twenty-nine women, and multiple 24-h recalls (24HR) were used as the reference method for the relative validation of macronutrients and food groups in the entire sample. Absolute differences, ratios, crude and deattenuated correlations, cross-classifications, Bland-Altman plot and plots between misreporting of EI (EI-TEE) and the relative misreporting of food groups (WebFFQ-24HR) were used to assess the validity. Results showed that EI on group level was not significantly different from TEE measured by doubly labelled water (0·7 MJ/d), but ranking abilities were poor (r -0·18). The relative validation showed an overestimation for the majority of the variables using absolute intakes, especially for the food groups 'vegetables' and 'fish and shellfish', but an improved agreement between the test and reference tool was observed for energy adjusted intakes. Deattenuated correlation coefficients were between 0·22 and 0·89, and low levels of grossly misclassified individuals (0-3 %) were observed for the majority of the energy adjusted variables for macronutrients and food groups. In conclusion, energy estimates from the WebFFQ should be used with caution, but the estimated absolute intakes on group level and ranking abilities seem acceptable for macronutrients and most food groups.

  13. Energy expenditure in adults living in developing compared with industrialized countries: a meta-analysis of doubly labeled water studies.

    Science.gov (United States)

    Dugas, Lara R; Harders, Regina; Merrill, Sarah; Ebersole, Kara; Shoham, David A; Rush, Elaine C; Assah, Felix K; Forrester, Terrence; Durazo-Arvizu, Ramon A; Luke, Amy

    2011-02-01

    There is an assumption that people in developing countries have a higher total energy expenditure (TEE) and physical activity level (PAL) than do people in developed nations, but few objective data for this assertion exist. We conducted a meta-analysis of TEE and PAL by using data from countries that have a low or middle human development index (HDI) compared with those with a high HDI to better understand how energy-expenditure variables are associated with development status and population differences in body size. We performed a literature search for studies in which energy expenditure was measured by using doubly labeled water. Mean data on age, weight, body mass index (BMI; in kg/m(2)), TEE, and PAL were extracted, and HDI status was assessed. Pooled estimates of the mean effect by sex were obtained, and the extent to which age, weight, HDI status, and year of publication explained heterogeneity was assessed. A total of 98 studies (14 studies from low- or middle-HDI countries) that represented 183 cohorts and 4972 individuals were included. Mean (±SE) BMI was lower in countries with a low or middle HDI than in those with a high HDI for both men and women (22.7 ± 1.0 compared with 26.0 ± 0.7, respectively, in men and 24.3 ± 0.7 compared with 26.6 ± 0.4, respectively, in women). In meta-regression models, there was an inverse association of age (P developing and industrialized countries, which calls into question the role of energy expenditure in the cause of obesity at the population level.

  14. Assessment of Pressure Fluctuation Effect for Thermal Fatigue in a T-junction Using Thermo-Hydro Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Pyo, Jaebum; Kim, Jungwoo; Huh, Namsu [Seoul National Univ. of Science and Technology, Seoul (Korea, Republic of); Kim, Sunhye [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2013-10-15

    As a result, when evaluating thermal fatigue for the mixing tee, temperature fluctuation is dominant for this phenomenon, it can be reasonably assumed that the pressure is constant on the pipe inner wall. Recently, thermal fatigue due to mixing of the fluids having different temperatures has been considered as an important issue on the fatigue evaluation of nuclear piping. Mainly, this phenomenon occurs in a T-junction operating with the fluids consisted of different temperatures. Because of the turbulent mixing of hot and cold water, the temperature on the inner wall of the pipe fluctuates rapidly, causing the variation of thermal stresses in the pipe and resulting in high cycle thermal fatigue. In practice, cracking by high cycle thermal fatigue is reported at a T-junction in the residual heat removal system at Civaux unit 1 in France. However, because of irregular flow inside the pipe, the pressure also fluctuates rapidly as well as temperature in the inner wall of the pipe. Therefore, in this paper, three-dimensional thermo-hydro analysis was performed for the mixing tee of the shutdown cooling system of the pressurized water reactor plant, examining the pressure variation at the pipe inner wall. Based on the analysis result, this study aims at assessing the pressure fluctuation effect on the thermal fatigue. In this paper, it is verified that there is pressure fluctuation as well as temperature on the inner wall of mixing tee operating with the fluids having different temperatures. However, since the amplitude of pressure is relatively smaller than design pressure of the shutdown cooling system, the effect wouldn't be important for the thermal fatigue.

  15. Energy expenditure evaluation in humans and non-human primates by SenseWear Armband. Validation of energy expenditure evaluation by SenseWear Armband by direct comparison with indirect calorimetry.

    Science.gov (United States)

    Casiraghi, Francesca; Lertwattanarak, Raweewan; Luzi, Livio; Chavez, Alberto O; Davalli, Alberto M; Naegelin, Terry; Comuzzie, Anthony G; Frost, Patricia; Musi, Nicolas; Folli, Franco

    2013-01-01

    The purpose of this study was to compare and validate the use of SenseWear Armband (SWA) placed on the arm (SWA ARM) and on the back (SWA BACK) in healthy humans during resting and a cycle-ergometer exercise and to evaluate the SWA to estimate Resting Energy Expenditure (REE) and Total Energy Expenditure (TEE) in healthy baboons. We studied 26 (15F/11M) human subjects wearing SWA in two different anatomical sites (arm and back) during resting and a cycle-ergometer test and directly compared these results with indirect calorimetry evaluation (IC), performed at the same time. We then inserted the SWA in a metabolic jacket for baboons and evaluated the TEE and REE in free living condition for 6 days in 21 (8F/13M) non-human primates. In humans we found a good correlation between SWA place on the ARM and on the BACK with IC during the resting experiment (1.1±0.3 SWAs, 1±0.2 IC kcal/min) and a slight underestimation in the SWAs data compared with IC during the cycle-ergometer exercise (5±1.9 SWA ARM, 4.5±1.5 SWA BACK and 5.4±2.1 IC kcal/min). In the non-human primate (baboons) experiment SWA estimated a TEE of 0.54±0.009 kcal/min during free living and a REE of 0.82±0.06 kcal/min. SWA, an extremely simple and inexpensive apparatus, provides quite accurate measurements of energy expenditure in humans and in baboons. Energy expenditure data obtained with SWA are highly correlated with the data obtained with "gold standard", IC, in humans.

  16. Catalytic destruction of organics and chlorinated organics with TEES II

    International Nuclear Information System (INIS)

    Baker, E.G.; Elliot, D.C.; Sealock, L.J. Jr.; Neuenschwander, G.G.

    1991-06-01

    A catalytic process is being developed at Pacific Northwest Laboratory (PNL) for destroying hazardous organics and chlorinated organics, including spent solvents, in aqueous waste streams. Experiments have been conducted in a batch reactor, a bench-scale continuous-stirred tank reactor (CSTR), and an continuous-flow tubular reactor. A 5-gal/h developmental unit is under construction and will be operational in 1991. The Thermochemical Environmental Energy System 2 can destroy a wide variety of organics and chlorinated organics by thermocatalytic treatment at 300 degrees C to 350 degrees C and 2000 to 3000 psig. This paper summarizes the batch reactor and CSTR results and presents new results obtained in the tubular reactor. The high levels of destruction achieved in the tubular reactor show that kinetic data obtained in CSTR can be used to design large-scale tubular reactors with little scaleup risk. Corrosion studies were completed, and it appears that less expensive materials of construction can be used in many applications, which will make the process more cost effective. Cost estimates for larger- scale facilities have been prepared by Onsite*Ofsite, Inc., who is working with PNL to transfer the technology to industry. 5 refs., 4 tabs., 1 fig

  17. Tee endale teene - saada kliendid konkurentide juurde / Frederick F. Reichheld

    Index Scriptorium Estoniae

    Reichheld, Frederick F.

    2003-01-01

    Autor leiab, et kulude vähendamiseks ja tulude suurendamiseks on vaja valida õigeid kliente. Vt. samas: Kuidas võita lojaalseid kliente ehk takjaid? ; Kuidas vältida ebalojaalseid kliente ehk liblikaid? ; Lojaalsus on kahesuunaline

  18. Experimental investigation of thermal mixing phenomena in a tee pipe

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Mei-Shiue; Hsieh, Huai-En; Zhang, Zhi-Yu; Pei, Bau-Shi [National Tsing Hua Univ., Taiwan (China). Inst. of Nuclear Engineering and Science

    2015-05-15

    T-pipe designs have been widely used in the industry. Among them, mixing of hot and cold water is a common application. In the mixing process, cold and hot fluids are respectively injected through main and branch pipes, and are mixed in the downstream area of T-tube. High temperature hot water flows through the main pipe for a long time; hence, the pipe wall is at high temperatures. The fluid injected into the branch pipe is a cooling fluid. After mixing, the wall of the main pipe is under high thermal fluctuations causing strong thermal stresses, which will eventually lead to pipe damage and water loss. Through flow rate adjustments of the branch and main pipes, when the branch/main velocity ratio was greater than 7.8, showing that cold water hit the bottom of the main pipe and created a reverse flow. This reverse flow created large thermal stresses on the wall. Hence, the branch/main velocity ratio and the hot-water-mixing phenomenon are the focus of this study.

  19. Kas Saudi Araabia naftatulu leiab tee Rootsi pangandusturule? / Romet Enok

    Index Scriptorium Estoniae

    Enok, Romet

    2008-01-01

    Autor vaatleb, kes võiks enim olla huvitatud Põhjala pangandusturu ümberkorraldamisest ja kellel oleks selleks kõige rohkem vahendeid. Autori hinnangul on võimalik, et Investori ja SEB juhtide kohtumisel Saudi Araabia printsi Alwaleed bin Saudiga oli kõne all Saudi printsi kaasamine strateegilise investorina SEB kõrvale Nordeat ostma

  20. Viimsi Keevituse büroo = Offices of Viimsi Keevitus

    Index Scriptorium Estoniae

    2010-01-01

    Viimsis Kaluri tee 13 asuva Viimsi Keevituse büroo sisekujundusest. Autorid: arhitektid Kristi Põldme, Madis Eek, Kristel Jaanus (AB Eek & Mutso), valik nende töödest. Büroo sissepääsu kõrval oleva lõvi autor on skulptor Kalle Pruuden. Klaasseinte 3D graafika: Reio Avaste

  1. Tshuzhoi Tanel Padar / Dmitri Babitshenko

    Index Scriptorium Estoniae

    Babitshenko, Dmitri

    2007-01-01

    Saksamaalt pärit, Eesti ülikoolides filmiteooria ja -ajaloo loenguid pidav ja filmi "Ring tee" valmimist režissöörina juhtinud Dirk Hoyeri mängufilm esilinastub 27. apr. kinos "Sõprus". Praeguseks on film ümber nimetatud "Võõraks", ühes peaosadest astub üles muusik Tanel Padar

  2. Arhitektuurikriitik Urmas Oja arvab nii / Urmas Oja

    Index Scriptorium Estoniae

    Oja, Urmas, 1981-2012

    2004-01-01

    Korterelamust Meriväljal Ranniku tee 2A (arhitekt Tiit Trummal), Kadriorus Poska t. 34 (OÜ Linnaprojekt, arhitekt Merle Kinks, valminud 1998), Poska t. 28 (OÜ Alver Trummal Arhitektid, valminud 2003), renoveeritud elamust Herne t. 9 (Casa Projekt, arhitekt Gert Sarv, valminud 2004), punasest kortermajast Kollane t. 5 (Arhitektuuriagentuur, valminud 2001)

  3. Toruni kandidaate kolm / Tambet Kaugema

    Index Scriptorium Estoniae

    Kaugema, Tambet

    1999-01-01

    10. korda Torunis toimuva Poola rahvusvahelise teatrifestivali Kontakt'99 kandidaatidena valis Eesti Kultuuriministeerium välja kolm lavastust: M. Kõivu "Omavahelisi jutuajamisi tädi Elliga" Vanemuisest (lav. A. Mäeots), Moskva lavastaja S. Pepeljaevi "Kodanikud" Von Krahli teatrist ning T. Lindgreni "Mao tee kalju peal" Eesti Draamateatrist (lav. P. Pedajas)

  4. Spinario - tornen i foden = Spinario : the thorn in the foot / Lise Gotfredsen

    Index Scriptorium Estoniae

    Gotfredsen, Lise

    2006-01-01

    Hellenistlikust skulptuurist "Okkatõmbaja" - "Spinario" ja selle hilisematest variantidest, mis sümboliseerivad ilu, edevust, aga ka pattu. Seda motiivi on kasutatud 12. sajandil ka Ojamaa, Taani ja Norra kirikutes ristimisastjatel, kujutades negatiivset, kahtlevat inimest, kes võib pääseda, kui ta valib õige tee ja vabastab end "okkast"

  5. Esiterrorist raputas moslemid ärkvele / Triin Oppi

    Index Scriptorium Estoniae

    Oppi, Triin

    2006-01-01

    Ilmunud ka: Postimees : na russkom jazõke 11. sept. lk. 4. Osama bin Ladeni eesmärgiks oligi USA ründamisega vallandada Lääne ja moslemite vaheline konflikt. Al-Qaeda tuumiku põgenemisest Pakistani ja Afganistani piirialadele ja Osama bin Ladeni otsingutest. Islamiterrorismi levikust. Lisa: Tee äärmusse

  6. Konfliktne ja soe Iisrael / Signe-Fideelia Roots

    Index Scriptorium Estoniae

    Roots, Fideelia-Signe, 1976-

    2008-01-01

    "Port Performance'i" workshop'ist Iisraelis 19. IV-6. V, performance'ite esitlusest Tel Avivi kaasaegse kunsti keskuses (CCAs) 4. V. Organiseerijad: performance'i-kunstnikud BBB Johannes Deimling ja Angelika Fojtuch. Osalesid Signe-Fideelia Roots ja Katrin Tees Eestist, Dinoys Damman Šveitsist ja Mara Maglione Itaaliast. Muljeid Iisraelist, sealsest kunstielust

  7. Tantsufestival Momentum 2008 : Alatskivi lossi tunded, mõtted, emotsioonid / Reet Kruup

    Index Scriptorium Estoniae

    Kruup, Reet

    2008-01-01

    25.-27. aprillini Alatskivi Kaunite Kunstide Kuu raames toimunud tantsufestivalist Momentum 2008. Festivalil osalesid Alatskivi vallas tegutsevate tantsurühmade kõrval ka tantsuteater Tee Kuubis, kontakttantsurühmitus Kontakt Tartust ja Tartu Ülikooli Viljandi Kultuuriakadeemia lavakunstide osakonna tudengid, kes esitasid improvisatsioonilise tantsuetenduse "Alatskivi lossi tunded, mõtted, emotsioonid..."

  8. Brain-Building Math Games.

    Science.gov (United States)

    Jung, Loretta Welk

    1983-01-01

    Index cards, masking tape, pizza shells, golf tees, and empty soda bottles can be used to make manipulative objects to be used in children's mathematics games. Twenty-two games that provide practice in number drills and problem solving are described, along with instructions for making objects needed for the games. (PP)

  9. Aasta tantsukunstnik on Kaja Kann

    Index Scriptorium Estoniae

    2006-01-01

    Rahvusvahelisel tantsupäeval pälvis Philip Morrise tantsuauhinna soolo eest "There are laika dogs living in Estonia" Kaja Kann. Läbilöögi preemia võitis Tallinna Ülikooli tantsutudengite teater Tee Kuubis ja tantsija preemia Alissa Shnaider Sasha Pepeljajevi trupi Apparatus lavastuse "Uksed" eest. Tseremoonia toimus KUMUs

  10. Scaling of energy confinement and poloidal beta in high density tokamaks

    NARCIS (Netherlands)

    Schram, D.C.; Schüller, F.C.

    1980-01-01

    A semi-empirical analysis of the heat balance of ohmically heated, high density Tokamak plasmas, shows that the observed heat transport can be explained by neoclassical (plateau) ion heat conduction in the central part of the plasma. Experimental values for Te, ß¿e, and tEe and the variation of

  11. Improving Teacher-Made Assessments in Technology and Engineering Education

    Science.gov (United States)

    White, Jesse W.; Moye, Johnny J.; Gareis, Christopher R.; Hylton, Sarah P.

    2018-01-01

    In the interest of learning how to effectively use the technological literacy standards and of adhering to education regulation, this article focuses on efforts to improve the professional teaching practices of Technology and Engineering Education (TEE) teachers by using the Gareis and Grant (2015) process with respect to "Standards for…

  12. Tornimäe kaksiktornid Tallinnas. Konkursi "Aasta betoonehitis 2007" nominent / Meeli Truu, Juhan Idnurm, Jaan Port...[jt.

    Index Scriptorium Estoniae

    2008-01-01

    AS Nord Projekt; konstruktorid: Juhan Idnurm, Jaan Port, Kaido Kuusiku (Nord Projekt AS), Indrek Heinloo (E-Inseneribüroo OÜ), Matis Teeäär (Neoprojekt OÜ), Kaido Pärl (TAA-Konsult); ehitajad: Lemminkäinen Eesti AS, AS Merko Ehitus; betooni ja betoonelementide tarnijad: AS Rudus Eesti, AS Betoneks

  13. Haabersti vaba aja keskus = Haabersti recreational centre

    Index Scriptorium Estoniae

    2008-01-01

    Haabersti vaba aja keskuse (Ehitajate tee 109A/2, Tallinn) sisekujundusest. Arhitektid: Peeter Pere ja Urmas Muru (AB Muru & Pere). Sisearhitekt: Katrin Kaevats (Salto AB). Katrin Kaevatsist, tema tähtsamad tööd. I-IV korruse plaan, värv. välisvaade, 11 sisevaadet, foto K. Kaevatsist

  14. 78 FR 62988 - Energy Conservation Program: Energy Conservation Standards for Certain Consumer Products and...

    Science.gov (United States)

    2013-10-23

    ....gov/cases/ee/tee0010.pdf ) (last accessed September 2010); 76 FR 37408, 37514, 37541-42 (June 27, 2011... rulemaking process. 68 FR 7990. DOE has made its procedures and policies available on the Office of the... requires agencies to examine the constitutional and statutory authority supporting any action that would...

  15. Möödus vaikselt / Tiina Käesel

    Index Scriptorium Estoniae

    Käesel, Tiina, 1943-

    2001-01-01

    Tallinna rakenduskunsti triennaalist 2000 "Omand" Tarbekunstimuuseumis. Kontseptsioon-kujundus: Ketli Tiitsar, Kaire Rannik, Berit Teeäär, Kristi Paap (F.F.F.F.). Paremaid esinejaid. Peaauhind - Eija Mustonen (Soome), auhinnad - Audrius Janushonis (Leedu), Claus Domine Hansen (Taani), Tarbekunstimuuseumi ostuauhind - Aigi Orav, grupi F.F.F.F. auhind - Monika Järg

  16. Kuidas finantseerida eksporditehinguid / Andrus Treier

    Index Scriptorium Estoniae

    Treier, Andrus, 1974-

    2005-01-01

    Enamik riike pakub oma ettevõtetele otseseid või kaudseid toetusi ekspordi edendamiseks. Lisaks sellele soovitab KredEx-i juhataja ettevõtetel teha ekspordikindlustus, millega erakindlustaja või riiklik ekspordikrediidiasutus kindlustab ettevõttele raha laekumise tehingu eest ka juhul, kui ostja teatud põhjusel seda ei tee. Lisa: Riikliku ekspordigarantii eelised

  17. Millal laps tööle panna? / Kristiina Illak

    Index Scriptorium Estoniae

    Illak, Kristiina

    2007-01-01

    Mõni hakkab raha teenima õige varakult, teine ajab tööl käimata ülikooli lõpuni läbi. Kumb tee on õigem? Lapse töötamise ja kooli kõrvalt töötamise üle arutlevad Katrin Peitre, Toomas Kibus, Lynn Veski ja Tiina Laanem

  18. 78 FR 26756 - Proposed Collection; Comment Request

    Science.gov (United States)

    2013-05-08

    ... in to a golf course or online when a tee-time is scheduled online. There are no forms that have been... daily business transactions difficult at the golf courses. Affected Public: Individuals or households... Collection Respondents are golf patrons who provide business to the Air Force Golf Courses. The information...

  19. Trombose de prótese biológica mitral: importância do ecocardiograma transesofágico no diagnóstico e acompanhamento pós-tratamento Bioprosthetic mitral valve thrombosis: importance of transesophageal echocardiography in the diagnosis and follow-up after treatment

    Directory of Open Access Journals (Sweden)

    Adelino Parro Jr

    2004-04-01

    Full Text Available OBJETIVO: Descrever os achados clínicos e ecocardiográficos de trombose em prótese biológica mitral e o valor do ecocardiograma transesofágico (ETE no diagnóstico e monitoração da lise do trombo. MÉTODOS: Foram estudados ao ETE 111 pacientes com prótese biológica mitral, e incluídos 4 de 7 com suspeita de trombo nestas próteses (idade média = 60,2±10,2 anos; 2 homens. O diagnóstico pôde ser confirmado pela realização seriada do ETE e pela evolução clínica. Investigaram-se os aspectos morfológicos dos folhetos da prótese, e presença e característica das massas ecogênicas anexas. Foram obtidos o gradiente médio pela prótese e a área valvar. RESULTADOS: O diagnóstico de trombo em prótese biológica mitral foi realizado 48,7±55,2 meses após a cirurgia. Dois pacientes apresentaram acidente vascular encefálico isquêmico no pós-operatório imediato. O gradiente médio global estava elevado (11,4±3 mmHg e a área valvar reduzida (1,24±0,3cm². Ao ETE, em todos foram evidenciadas massas ecogênicas em face ventricular esquerda da prótese biológica mitral, sugestivas de trombo. No ETE seriado (136±233 dias, houve desaparecimento do trombo em dois casos e redução do trombo nos outros dois, após tratamento. O gradiente médio reduziu para 6,2±3 mmHg (p=0,004; IC 95%, e a área valvar aumentou para 2,07±0,4 (p=ns. CONCLUSÃO: O ETE mostrou-se útil na detecção de trombo em prótese biológica mitral e eficaz na monitoração do tratamento, em todos casos.OBJECTIVE: To report the clinical and echocardiographic findings of bioprosthetic mitral valve thrombosis and the value of transesophageal echocardiography (TEE in its diagnosis and monitoring of thrombolysis. METHODS: One hundred and eleven patients with mitral bioprostheses underwent TEE, and 4 out of 7 suspected of having a thrombus on these prostheses were included in the study (mean age = 60.2±10.2 years; 2 men. The diagnosis was confirmed with serial

  20. British Nuclear Test Veterans' Association. Radiation exposure and subsequent health history of veterans and their children

    International Nuclear Information System (INIS)

    Urquhart, J.

    1993-01-01

    The present study of veterans' health carried out in association with Tyne Tees Television presents new and disturbing evidence of significant health effects in both veterans and their children, based on the health records of 1,454 members of the British Nuclear Test Veterans' Association, of whom 1,147 were fathers. (orig./MG)

  1. Asia Section. Regional Activities Division. Paper.

    Science.gov (United States)

    International Federation of Library Associations, The Hague (Netherlands).

    Two papers on library and information activities in developing nations, particularly in India and other Asian countries, were presented at the 1983 International Federation of Library Associations (IFLA) conference. In "IFLA in Asia: A Review of the Work of the Regional Section for Asia," Edward Lim Huck Tee (Malaysia) describes the low…

  2. Infant-Directed Speech Supports Phonetic Category Learning in English and Japanese

    Science.gov (United States)

    Werker, Janet F.; Pons, Ferran; Dietrich, Christiane; Kajikawa, Sachiyo; Fais, Laurel; Amano, Shigeaki

    2007-01-01

    Across the first year of life, infants show decreased sensitivity to phonetic differences not used in the native language [Werker, J. F., & Tees, R. C. (1984). Cross-language speech perception: evidence for perceptual reorganization during the first year of life. "Infant Behaviour and Development," 7, 49-63]. In an artificial language learning…

  3. Sadhana | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    This paper presents quick, easy design steps and methodology for obtaining the structure of a folded H plane tee at any given frequency of operation. Further, a scheme for the thermal management for high input power level(500 kW continuous wave) is presented. The proposed methodology is tested at various frequencies ...

  4. Res Publica nõuab veel üht abilinnapea kohta / Urmas Seaver

    Index Scriptorium Estoniae

    Seaver, Urmas, 1973-

    2005-01-01

    Tallinna linnapea Tõnis Palts on seisukohal, et Reformierakond surus koalitsiooni moodustamisel Res Publicale peale ebaõiglase vastutusvaldkondade jaotuse. Res Publica peasekretär Ott Lumi ei välista võimuliidu loomist Keskerakonnaga, kui Reformierakond järeleandmisi ei tee. ERL tegi ettepaneku kokku kutsuda erakondade ümarlaud. Vt. samas intervjuud Ott Lumiga

  5. High-Value Care in the Evaluation of Stroke.

    Science.gov (United States)

    Urja, Prakrity; Nippoldt, Eric H; Barak, Virginia; Valenta, Carrie

    2017-08-01

    Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs). The patient had a known history of patent foramen ovale (PFO) and occlusion of the right internal carotid artery. He was complicated by intracranial hemorrhage while on anticoagulation for pulmonary embolism. He was chronically on dual antiplatelet therapy (aspirin and clopidogrel) and statin.  Following the transfer, stroke protocol, including the activation of the stroke team, a computed tomography (CT) imaging study, and the rapid stabilization of the patient was initiated. His vitals were stable, and the physical examination was significant for the drooping of the left angle of the mouth, a nonreactive right pupil consistent with the previous stroke, a decreased strength in the left upper and lower extremities, and a faint systolic murmur. His previous stroke was shown to be embolic, involving both the right temporal and occipital regions, which was re-demonstrated in a CT scan. A magnetic resonance imaging (MRI) scan of the brain showed a new, restricted diffusion in the right pons that was compatible with an acute stroke as well as diffusely atherosclerotic vessels with a focal stenosis of the branch vessels. A transthoracic echocardiogram demonstrated no new thrombus in the heart. A transesophageal echocardiogram (TEE) showed known PFO, and repeat hypercoagulation evaluation was negative, as it was in his previous cerebrovascular accident (CVA

  6. Hereditary haemorrhagic telangiectasia: study of hepatic vascular alterations with multi-detector row helical CT and reconstruction programs; Telangiectasia emorragica ereditaria: TC multidetettore multifasica e programmi di ricostruzione nello studio delle alterazioni vascolari epatiche

    Energy Technology Data Exchange (ETDEWEB)

    Memeo, Maurizio; Stabile Ianora, Amato Antonio; Scaldapane, Arnaldo; Rotondo, Antonio; Angelelli, Giuseppe [Policlinico Universitario, Bari (Italy). DiMIMP Sezione di Diagnostica per Immagini; Suppressa, Patrizia; Cirulli, Anna; Sabba' , Carlo [Policlinico Universitario, Bari (Italy). Centro Interdipartimentale per lo studio dell' HHT

    2005-02-01

    Purpose: To evaluate hepatic alterations in patients affected by Hereditary Haemorrhagic Telangiectasia (HHT) by using multidetector row helical CT (MDCT) and new reconstruction programs. Materials and methods: An MDCT multiphasic study of the liver was performed in 105 consecutive patients: 89 considered to be affected by HHT and 16 with suspicion of disease alone. The scan delay was determined by using a test bolus of contrast material. The CT examination was performed with a triphasic technique (double arterial phase and portal venous phase). multiplanar and angiographic reconstructions were then obtained, and the images checked for the presence of shunts, hepatic perfusion disorders, vascular lesions (telangiectasis and large confluent vascular masses), indirect signs of portal hypertension, and anatomical vascular variants. Results: Hepatic vascular alterations were found in 78/105 cases (67/89) patients affected by HHT and 11/16 patients with clinical suspicion alone). Therefore HHT diagnosis was excluded in 5 patients. 78/100 (78%) patients with HHT had intrahepatic vascular alterations: arterioportal shunts in 40/78 (51.2%) arteriosystemic shunts in 16/78 (20.5%) and both shunt types in 22/78 (28.3%). Intraparenchymal perfusion disorders were found in 46/78 (58.9%) patients. Telangiectasis were recognised in 50/78 (64.1%) patients. Large confluent vascular masses (LCVMs) were identified in 20/78 (25.6%) patients. indirect signs of portal hypertension were found in 46/78 (58.9%) cases. Variant hepatic arterial anatomy was present in 38/100 cases (38%). Conclusions: Multiphasic MDCT and the new reconstruction programs enable the identification and characterisation of the complex vascular alterations typical of HHT. [Italian] Scopo: Valutare le alterazioni epatiche nei pazienti affetti da Telangiectasia Emorraica Ereditaria (TEE) utilizzando una TC multidetettore (TCMD) ed in nuovi programmi di ricostruzione. Materiale e metodi: E' stato eseguito uno

  7. Estimates of adherence and error analysis of physical activity data collected via accelerometry in a large study of free-living adults

    Directory of Open Access Journals (Sweden)

    Baer David J

    2008-06-01

    Full Text Available Abstract Background Activity monitors (AM are small, electronic devices used to quantify the amount and intensity of physical activity (PA. Unfortunately, it has been demonstrated that data loss that occurs when AMs are not worn by subjects (removals during sleeping and waking hours tend to result in biased estimates of PA and total energy expenditure (TEE. No study has reported the degree of data loss in a large study of adults, and/or the degree to which the estimates of PA and TEE are affected. Also, no study in adults has proposed a methodology to minimize the effects of AM removals. Methods Adherence estimates were generated from a pool of 524 women and men that wore AMs for 13 – 15 consecutive days. To simulate the effect of data loss due to AM removal, a reference dataset was first compiled from a subset consisting of 35 highly adherent subjects (24 HR; minimum of 20 hrs/day for seven consecutive days. AM removals were then simulated during sleep and between one and ten waking hours using this 24 HR dataset. Differences in the mean values for PA and TEE between the 24 HR reference dataset and the different simulations were compared using paired t-tests and/or coefficients of variation. Results The estimated average adherence of the pool of 524 subjects was 15.8 ± 3.4 hrs/day for approximately 11.7 ± 2.0 days. Simulated data loss due to AM removals during sleeping hours in the 24 HR database (n = 35, resulted in biased estimates of PA (p Conclusion Although estimated adherence was good, measurements of PA can be improved by relatively simple imputation of missing AM data.

  8. Low Rates of Major Complications for Radiofrequency Ablation of Atrial Fibrillation Maintained Over 14 Years: A Single Centre Experience of 2750 Consecutive Cases.

    Science.gov (United States)

    Voskoboinik, Aleksandr; Sparks, Paul B; Morton, Joseph B; Lee, Geoffrey; Joseph, Stephen A; Hawson, Joshua J; Kistler, Peter M; Kalman, Jonathan M

    2018-02-03

    Despite technological advances, studies continue to report high complication rates for atrial fibrillation (AF) ablation. We sought to review complication rates for AF ablation at a high-volume centre over a 14-year period and identify predictors of complications. We reviewed prospectively collected data from 2750 consecutive AF ablation procedures at our institution using radiofrequency energy (RF) between January 2004 and May 2017. All cases were performed under general anaesthetic with transoesophageal echocardiography (TEE), 3D-mapping and an irrigated ablation catheter. Double transseptal puncture was performed under TEE guidance. All patients underwent wide antral circumferential isolation of the pulmonary veins (30W anteriorly, 25W posteriorly) with substrate modification at operator discretion. Of 2255 initial and 495 redo procedures, ablation strategies were: pulmonary vein isolation (PVI) only 2097 (76.3%), PVI+lines 368 (13.4%), PVI+posterior wall 191 (6.9%), PVI+cavotricuspid isthmus 277 (10.1%). There were 23 major (0.84%) and 20 minor (0.73%) complications. Cardiac tamponade (five cases - 0.18%) and phrenic nerve palsy (one case - 0.04%) rates were very low. Major vascular complications necessitating surgery or blood transfusion occurred in five patients (0.18%). There were no cases of death, permanent disability, atrio-oesophageal fistulae or symptomatic pulmonary vein (PV) stenosis, although there were five TEE probe-related complications (0.18%). Female gender (OR 2.14; 95% CI 1.07-4.26) but not age >70 (OR 1.01) was the only multivariate predictor of complications. Atrial fibrillation ablation performed at a high-volume centre using RF can be achieved with a low major complication rate in a representative AF population over a sustained period of time. Copyright © 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights

  9. Study on mixing phenomena in T-pipe junction. Experimental analysis using DNS and investigation of mixing process

    International Nuclear Information System (INIS)

    Igarashi, Minoru; Tanaka, Masaaki; Kimura, Nobuyuki; Kamide, Hideki

    2003-02-01

    In the place where hot and cold fluids are mixed, a time and spatial temperature fluctuation occurs. When this temperature fluctuation amplitude is large, it causes high cycle thermal fatigue in surrounding structure (thermal striping phenomena). Mixing area of high and low temperature fluid exists not only in an atomic power plant but also in a general plant, then, it is significant to investigate this phenomena and also to establish an evaluation rule. In Japan Nuclear Cycle Development Institute, several experiments and the improvement of the analysis methods have been carried out to understand thermal striping phenomena and also to construct an evaluation rule, which can be applied to design. Water Experiment on Fluid Mixing in T-pipe with Long Cycle Fluctuation (WATLON), aiming at examining thermal striping phenomena in a mixing tee, is performed to investigate key factors of mixing phenomena. In this study, in order to investigate the fluid mixing phenomena, temperature and flow velocity distribution were measured by movable thermocouple tree and particle image velocimetry (PIV). And the analysis using a in-house direct numerical simulation (DNS) code, DINUS-3 was performed to understand applicability of the analytical method in mixing tee. The temperature and velocity fields obtained from the DINUS-3 were in good agreement with the experimental results. And the prominent frequency of temperature fluctuation was also in good agreement. The DINUS-3 calculation simulated vortex structure in the wake region behind the branch pipe jet. The results of analysis showed that a Karman vortex generated in the wake region behind the branch pipe jet influenced the temperature fluctuation behavior in the mixing tee. And the analytical results revealed that the vortex generated in the wake region behind the branch pipe jet showed the 3-dimensional behavior. (author)

  10. Triple-orifice valve repair in severe Barlow disease with multiple-jet mitral regurgitation: report of mid-term experience.

    Science.gov (United States)

    Fucci, Carlo; Faggiano, Pompilio; Nardi, Matilde; D'Aloia, Antonio; Coletti, Giuseppe; De Cicco, Giuseppe; Latini, Leonardo; Vizzardi, Enrico; Lorusso, Roberto

    2013-09-10

    Barlow disease represents a surgical challenge for mitral valve repair (MR) in the presence of mitral insufficiency (MI) with multiple regurgitant jets. We hereby present our mid-term experience using a modified edge-to-edge technique to address this peculiar MI. From March 2003 till December 2010, 25 consecutive patients (mean age 54 ± 7 years, 14 males) affected by severe Barlow disease with multiple regurgitant jets were submitted to MR. Preoperative transesophageal echo (TEE) in all the cases showed at least 2 regurgitant jets, involving one or both leaflets in more than one segment. In all the patients, a triple orifice valve (TOV) repair with annuloplasty was performed. Intra-operative TEE and postoperative transthoracic echocardiography (TTE) were carried out to evaluate results of the TOV repair. There was no in-hospital death and one late death (non-cardiac related). At intra-operative TEE, the three orifices showed a mean total valve area of 2.9 ± 0.1cm(2) (range 2.5-3.3 cm(2)) with no residual regurgitation (2 cases of trivial MI) and no sign of valve stenosis (mean transvalvular gradient 4.6 ± 1.5 mmHg). At follow up (mean 38 ± 22 months), TTE showed favourable MR and no recurrence of significant MI (6 cases of trivial and 1 of mild MI). Stress TTE was performed in 5 cases showing persistent effective valve function (2 cases of trivial MI at peak exercise). All the patients showed significant NYHA functional class improvement. This report indicates that the TOV technique is effective in correcting complex Barlow mitral valves with multiple jets. Further studies are required to confirm long-term applicability and durability in more numerous clinical cases. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. Estimates of adherence and error analysis of physical activity data collected via accelerometry in a large study of free-living adults.

    Science.gov (United States)

    Paul, David R; Kramer, Matthew; Stote, Kim S; Spears, Karen E; Moshfegh, Alanna J; Baer, David J; Rumpler, William V

    2008-06-09

    Activity monitors (AM) are small, electronic devices used to quantify the amount and intensity of physical activity (PA). Unfortunately, it has been demonstrated that data loss that occurs when AMs are not worn by subjects (removals during sleeping and waking hours) tend to result in biased estimates of PA and total energy expenditure (TEE). No study has reported the degree of data loss in a large study of adults, and/or the degree to which the estimates of PA and TEE are affected. Also, no study in adults has proposed a methodology to minimize the effects of AM removals. Adherence estimates were generated from a pool of 524 women and men that wore AMs for 13 - 15 consecutive days. To simulate the effect of data loss due to AM removal, a reference dataset was first compiled from a subset consisting of 35 highly adherent subjects (24 HR; minimum of 20 hrs/day for seven consecutive days). AM removals were then simulated during sleep and between one and ten waking hours using this 24 HR dataset. Differences in the mean values for PA and TEE between the 24 HR reference dataset and the different simulations were compared using paired t-tests and/or coefficients of variation. The estimated average adherence of the pool of 524 subjects was 15.8 +/- 3.4 hrs/day for approximately 11.7 +/- 2.0 days. Simulated data loss due to AM removals during sleeping hours in the 24 HR database (n = 35), resulted in biased estimates of PA (p Losing as little as one hour of data from the 24 HR dataset during waking hours results in significant biases (p sleep and imputing estimates for missing data during waking hours significantly improved the estimates of PA. Although estimated adherence was good, measurements of PA can be improved by relatively simple imputation of missing AM data.

  12. Hemodynamic and respiratory factors that influence the opening of patent foramen ovale in mechanically ventilated patients.

    Science.gov (United States)

    Vavlitou, A; Minas, G; Zannetos, S; Kyprianou, T; Tsagourias, M; Matamis, D

    2016-01-01

    Patent foramen ovale (PFO) is an anatomic variant that may lead to several pathological conditions, notably right to left shunt, paradoxical embolism, hypoxemia, and cerebral fat embolism. Mechanical positive pressure ventilation may increase the prevalence of PFO opening in Intensive Care Unit (ICU) patients; however, the respiratory and hemodynamic determinants of PFO opening have been poorly investigated. Contrast-enhanced transesophageal echocardiogram (ce-TEE) is considered the gold standard for PFO detection. We prospectively performed a multicenter study using ce-TEE in order to determine the respiratory and hemodynamic factors that may lead to PFO opening. One hundred and eight consecutive ICU adult patients under mechanical ventilation from three tertiary care hospitals, were included in the study. A standard multiplane ce-TEE was performed, and the dimensions and function of the right and left ventricle were studied. In each patient, the right ventricle (RV) end-diastolic area, RV end-systolic area, left ventricle (LV) end-diastolic area, and LV ejection fraction were measured using the modified Simpson's rule and the four-chamber view. At least three bubble tests were performed to detect PFO opening. Ventilatory parameters such as tidal volume, plateau pressure, static lung compliance, and positive end-expiratory pressure were recorded during the bubble test. Data for 81 men and 27 women were analyzed. PFO was detected in 27 % of the study population. Statistical significance was found between the presence of PFO and plateau pressure (odds ratio 3.421, 95 % CI: 1.2-9.4, p =0.017). Additionally, the presence of right ventricular dilatation (RV>LV) was strongly associated with PFO opening (odds ratio 3.163, 95 % CI: 1.2-8.075, p =0.018). In this group of mechanically ventilated, critically ill adult patients, right ventricular dilatation and plateau pressure above 26 mmHg were significantly associated with foramen ovale opening. Hippokratia 2016, 20

  13. Diet misreporting can be corrected: confirmation of the association between energy intake and fat-free mass in adolescents.

    Science.gov (United States)

    Vainik, Uku; Konstabel, Kenn; Lätt, Evelin; Mäestu, Jarek; Purge, Priit; Jürimäe, Jaak

    2016-10-01

    Subjective energy intake (sEI) is often misreported, providing unreliable estimates of energy consumed. Therefore, relating sEI data to health outcomes is difficult. Recently, Börnhorst et al. compared various methods to correct sEI-based energy intake estimates. They criticised approaches that categorise participants as under-reporters, plausible reporters and over-reporters based on the sEI:total energy expenditure (TEE) ratio, and thereafter use these categories as statistical covariates or exclusion criteria. Instead, they recommended using external predictors of sEI misreporting as statistical covariates. We sought to confirm and extend these findings. Using a sample of 190 adolescent boys (mean age=14), we demonstrated that dual-energy X-ray absorptiometry-measured fat-free mass is strongly associated with objective energy intake data (onsite weighted breakfast), but the association with sEI (previous 3-d dietary interview) is weak. Comparing sEI with TEE revealed that sEI was mostly under-reported (74 %). Interestingly, statistically controlling for dietary reporting groups or restricting samples to plausible reporters created a stronger-than-expected association between fat-free mass and sEI. However, the association was an artifact caused by selection bias - that is, data re-sampling and simulations showed that these methods overestimated the effect size because fat-free mass was related to sEI both directly and indirectly via TEE. A more realistic association between sEI and fat-free mass was obtained when the model included common predictors of misreporting (e.g. BMI, restraint). To conclude, restricting sEI data only to plausible reporters can cause selection bias and inflated associations in later analyses. Therefore, we further support statistically correcting sEI data in nutritional analyses. The script for running simulations is provided.

  14. Energy Balance over One Athletic Season.

    Science.gov (United States)

    Silva, Analiza M; Matias, Catarina N; Santos, Diana A; Thomas, Diana; Bosy-Westphal, Anja; Müller, Manfred J; Heymsfield, Steven B; Sardinha, Luís B

    2017-08-01

    Magnitude and variation in energy balance (EB) components over an athletic season are largely unknown. We investigated the longitudinal changes in EB over one season and explored the association between EB variation and change in the main fat-free mass (FFM) components in highly trained athletes. Eighty athletes (54 males; handball, volleyball, basketball, triathlete, and swimming) were evaluated from the beginning of the season to the main competition stage. Resting and total energy expenditure (REE and TEE, respectively) were assessed by indirect calorimetry and doubly labeled water, respectively. Physical activity energy expenditure was calculated as TEE - 0.1 TEE - REE. Fat mass (FM), FFM, and bone mineral were evaluated with dual-energy x-ray absorptiometry; changed body energy stores were calculated as 1.0(ΔFFM/Δtime) + 9.5(ΔFM/Δtime). Total-body water (TBW) and its compartments were assessed through dilution techniques, and total-body protein was calculated from a four-compartment model, with body volume assessed by air displacement plethysmography. Although a negative EB of -17.4 ± 72.7 kcal·d was observed (P sports and across sex groups resulting in a net weight increase (0.7 ± 2.3 kg) that is attributable to significant changes in FFM (1.2 ± 1.6 kg) and FM (-0.7 ± 1.5 kg) (P sports, and age. The mean negative EB observed over the season resulted from the rate of FM use and FFM accretion, but with a large variation by sex and sports. TBW, but not total-body protein or mineral balance, explained the magnitude of EB, which means that athletes under a positive or a negative EB showed a TBW expansion or shrinkage, respectively, specifically within the cells, over one athletic season.

  15. Energy Expenditure Evaluation in Humans and Non-Human Primates by SenseWear Armband. Validation of Energy Expenditure Evaluation by SenseWear Armband by Direct Comparison with Indirect Calorimetry

    Science.gov (United States)

    Casiraghi, Francesca; Chavez, Alberto O.; Davalli, Alberto M.; Naegelin, Terry; Comuzzie, Anthony G.; Frost, Patricia; Musi, Nicolas; Folli, Franco

    2013-01-01

    Introduction The purpose of this study was to compare and validate the use of SenseWear Armband (SWA) placed on the arm (SWA ARM) and on the back (SWA BACK) in healthy humans during resting and a cycle-ergometer exercise and to evaluate the SWA to estimate Resting Energy Expenditure (REE) and Total Energy Expenditure (TEE) in healthy baboons. Methods We studied 26 (15F/11M) human subjects wearing SWA in two different anatomical sites (arm and back) during resting and a cycle-ergometer test and directly compared these results with indirect calorimetry evaluation (IC), performed at the same time. We then inserted the SWA in a metabolic jacket for baboons and evaluated the TEE and REE in free living condition for 6 days in 21 (8F/13M) non-human primates. Results In humans we found a good correlation between SWA place on the ARM and on the BACK with IC during the resting experiment (1.1±0.3 SWAs, 1±0.2 IC kcal/min) and a slight underestimation in the SWAs data compared with IC during the cycle-ergometer exercise (5±1.9 SWA ARM, 4.5±1.5 SWA BACK and 5.4±2.1 IC kcal/min). In the non-human primate (baboons) experiment SWA estimated a TEE of 0.54±0.009 kcal/min during free living and a REE of 0.82±0.06 kcal/min. Conclusion SWA, an extremely simple and inexpensive apparatus, provides quite accurate measurements of energy expenditure in humans and in baboons. Energy expenditure data obtained with SWA are highly correlated with the data obtained with “gold standard”, IC, in humans. PMID:24069218

  16. Evaluation of a Mobile Phone Image-Based Dietary Assessment Method in Adults with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Megan E. Rollo

    2015-06-01

    Full Text Available Image-based dietary records have limited evidence evaluating their performance and use among adults with a chronic disease. This study evaluated the performance of a 3-day mobile phone image-based dietary record, the Nutricam Dietary Assessment Method (NuDAM, in adults with type 2 diabetes mellitus (T2DM. Criterion validity was determined by comparing energy intake (EI with total energy expenditure (TEE measured by the doubly-labelled water technique. Relative validity was established by comparison to a weighed food record (WFR. Inter-rater reliability was assessed by comparing estimates of intake from three dietitians. Ten adults (6 males, age: 61.2 ± 6.9 years old, BMI: 31.0 ± 4.5 kg/m2 participated. Compared to TEE, mean EI (MJ/day was significantly under-reported using both methods, with a mean ratio of EI:TEE 0.76 ± 0.20 for the NuDAM and 0.76 ± 0.17 for the WFR. Correlations between the NuDAM and WFR were mostly moderate for energy (r = 0.57, carbohydrate (g/day (r = 0.63, p < 0.05, protein (g/day (r = 0.78, p < 0.01 and alcohol (g/day (rs = 0.85, p < 0.01, with a weaker relationship for fat (g/day (r = 0.24. Agreement between dietitians for nutrient intake for the 3-day NuDAM (Intra-class Correlation Coefficient (ICC = 0.77–0.99 was lower when compared with the 3-day WFR (ICC = 0.82–0.99. These findings demonstrate the performance and feasibility of the NuDAM to assess energy and macronutrient intake in a small sample. Some modifications to the NuDAM could improve efficiency and an evaluation in a larger group of adults with T2DM is required.

  17. Hand-held indirect calorimeter offers advantages compared with prediction equations, in a group of overweight women, to determine resting energy expenditures and estimated total energy expenditures during research screening.

    Science.gov (United States)

    Spears, Karen E; Kim, Hyunsook; Behall, Kay M; Conway, Joan M

    2009-05-01

    To compare standardized prediction equations to a hand-held indirect calorimeter in estimating resting energy and total energy requirements in overweight women. Resting energy expenditure (REE) was measured by hand-held indirect calorimeter and calculated by prediction equations Harris-Benedict, Mifflin-St Jeor, World Health Organization/Food and Agriculture Organization/United Nations University (WHO), and Dietary Reference Intakes (DRI). Physical activity level, assessed by questionnaire, was used to estimate total energy expenditure (TEE). Subjects (n=39) were female nonsmokers older than 25 years of age with body mass index more than 25. Repeated measures analysis of variance, Bland-Altman plot, and fitted regression line of difference. A difference within +/-10% of two methods indicated agreement. Significant proportional bias was present between hand-held indirect calorimeter and prediction equations for REE and TEE (Pvalues and underestimated at higher values. Mean differences (+/-standard error) for REE and TEE between hand-held indirect calorimeter and Harris-Benedict were -5.98+/-46.7 kcal/day (P=0.90) and 21.40+/-75.7 kcal/day (P=0.78); between hand-held indirect calorimeter and Mifflin-St Jeor were 69.93+/-46.7 kcal/day (P=0.14) and 116.44+/-75.9 kcal/day (P=0.13); between hand-held indirect calorimeter and WHO were -22.03+/-48.4 kcal/day (P=0.65) and -15.8+/-77.9 kcal/day (P=0.84); and between hand-held indirect calorimeter and DRI were 39.65+/-47.4 kcal/day (P=0.41) and 56.36+/-85.5 kcal/day (P=0.51). Less than 50% of predictive equation values were within +/-10% of hand-held indirect calorimeter values, indicating poor agreement. A significant discrepancy between predicted and measured energy expenditure was observed. Further evaluation of hand-held indirect calorimeter research screening is needed.

  18. Multiline 3D beamforming using micro-beamformed datasets for pediatric transesophageal echocardiography

    Science.gov (United States)

    Bera, D.; Raghunathan, S. B.; Chen, C.; Chen, Z.; Pertijs, M. A. P.; Verweij, M. D.; Daeichin, V.; Vos, H. J.; van der Steen, A. F. W.; de Jong, N.; Bosch, J. G.

    2018-04-01

    Until now, no matrix transducer has been realized for 3D transesophageal echocardiography (TEE) in pediatric patients. In 3D TEE with a matrix transducer, the biggest challenges are to connect a large number of elements to a standard ultrasound system, and to achieve a high volume rate (>200 Hz). To address these issues, we have recently developed a prototype miniaturized matrix transducer for pediatric patients with micro-beamforming and a small central transmitter. In this paper we propose two multiline parallel 3D beamforming techniques (µBF25 and µBF169) using the micro-beamformed datasets from 25 and 169 transmit events to achieve volume rates of 300 Hz and 44 Hz, respectively. Both the realizations use angle-weighted combination of the neighboring overlapping sub-volumes to avoid artifacts due to sharp intensity changes introduced by parallel beamforming. In simulation, the image quality in terms of the width of the point spread function (PSF), lateral shift invariance and mean clutter level for volumes produced by µBF25 and µBF169 are similar to the idealized beamforming using a conventional single-line acquisition with a fully-sampled matrix transducer (FS4k, 4225 transmit events). For completeness, we also investigated a 9 transmit-scheme (3  ×  3) that allows even higher frame rates but found worse B-mode image quality with our probe. The simulations were experimentally verified by acquiring the µBF datasets from the prototype using a Verasonics V1 research ultrasound system. For both µBF169 and µBF25, the experimental PSFs were similar to the simulated PSFs, but in the experimental PSFs, the clutter level was ~10 dB higher. Results indicate that the proposed multiline 3D beamforming techniques with the prototype matrix transducer are promising candidates for real-time pediatric 3D TEE.

  19. Efficacy and safety of left atrial appendage closure with WATCHMAN in patients with or without contraindication to oral anticoagulation: 1-Year follow-up outcome data of the EWOLUTION trial.

    Science.gov (United States)

    Boersma, Lucas V; Ince, Hueseyin; Kische, Stephan; Pokushalov, Evgeny; Schmitz, Thomas; Schmidt, Boris; Gori, Tommaso; Meincke, Felix; Protopopov, Alexey Vladimir; Betts, Timothy; Foley, David; Sievert, Horst; Mazzone, Patrizio; De Potter, Tom; Vireca, Elisa; Stein, Kenneth; Bergmann, Martin W

    2017-09-01

    Left atrial appendage (LAA) occlusion with WATCHMAN has emerged as viable alternative to vitamin K antagonists in randomized controlled trials. EWOLUTION was designed to provide data in routine practice from a prospective multicenter registry. A total of 1025 patients scheduled for a WATCHMAN implant were prospectively and sequentially enrolled at 47 centers. Indication for LAA closure was based on European Society of Cardiology guidelines. Follow-up and transesophageal echocardiography (TEE) were performed per local practice. The baseline CHA 2 DS 2 -VASc score was 4.5 ± 1.6; the mean age was 73.4 ± 9 years; previous transient ischemic attack/ischemic stroke was present in 312 (30.5%), 155 (15.1%) had previous hemorrhagic stroke, and 320 (31.3%) had a history of major bleeding; and 750 (73%) were deemed unsuitable for oral anticoagulation therapy. WATCHMAN implant succeeded in 1005 (98.5%) of patients, without leaks >5 mm in 1002 (99.7%) with at least 1 TEE follow-up in 875 patients (87%). Antiplatelet therapy was used in 784 (83%), while vitamin K antagonists were used in only 75 (8%). At 1 year, mortality was 98 (9.8%), reflecting the advanced age and comorbidities in this population. Device thrombus was observed in 28 patients at routine TEE (3.7%) and was not correlated with the drug regimen (P = .14). Ischemic stroke rate was 1.1% (relative risk 84% vs estimated historical data); the major bleeding rate was 2.6% and was predominantly (2.3%) nonprocedure/device related. LAA closure with the WATCHMAN device has a high implant and sealing success. This method of stroke risk reduction appears to be safe and effective with an ischemic stroke rate as low as 1.1%, even though 73% of patients had a contraindication to and were not using oral anticoagulation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  20. The temporal response to drought in a Mediterranean evergreen tree: comparing a regional precipitation gradient and a throughfall exclusion experiment.

    Science.gov (United States)

    Martin-Stpaul, Nicolas K; Limousin, Jean-Marc; Vogt-Schilb, Hélène; Rodríguez-Calcerrada, Jesus; Rambal, Serge; Longepierre, Damien; Misson, Laurent

    2013-08-01

    Like many midlatitude ecosystems, Mediterranean forests will suffer longer and more intense droughts with the ongoing climate change. The responses to drought in long-lived trees differ depending on the time scale considered, and short-term responses are currently better understood than longer term acclimation. We assessed the temporal changes in trees facing a chronic reduction in water availability by comparing leaf-scale physiological traits, branch-scale hydraulic traits, and stand-scale biomass partitioning in the evergreen Quercus ilex across a regional precipitation gradient (long-term changes) and in a partial throughfall exclusion experiment (TEE, medium term changes). At the leaf scale, gas exchange, mass per unit area and nitrogen concentration showed homeostatic responses to drought as they did not change among the sites of the precipitation gradient or in the experimental treatments of the TEE. A similar homeostatic response was observed for the xylem vulnerability to cavitation at the branch scale. In contrast, the ratio of leaf area over sapwood area (LA/SA) in young branches exhibited a transient response to drought because it decreased in response to the TEE the first 4 years of treatment, but did not change among the sites of the gradient. At the stand scale, leaf area index (LAI) decreased, and the ratios of stem SA to LAI and of fine root area to LAI both increased in trees subjected to throughfall exclusion and from the wettest to the driest site of the gradient. Taken together, these results suggest that acclimation to chronic drought in long-lived Q. ilex is mediated by changes in hydraulic allometry that shift progressively from low (branch) to high (stand) organizational levels, and act to maintain the leaf water potential within the range of xylem hydraulic function and leaf photosynthetic assimilation. © 2013 John Wiley & Sons Ltd.