WorldWideScience

Sample records for tulbid tee riidest

  1. 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

  2. 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...

  3. 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...

  4. 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

  5. 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

  6. 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

  7. 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.)

  8. 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.)

  9. 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

  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. 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.)

  12. 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

  13. 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.)

  14. 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.)

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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)

  1. 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.

  2. 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)

  3. 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.

  4. 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...

  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. 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

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. "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)

  13. 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

  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. 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.

  16. 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)

  17. 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.)

  18. 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)

  19. 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

  20. 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)

  1. 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.

  2. 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.

  3. 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)

  4. 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.

  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. 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.

  7. 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...

  8. 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.

  9. 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)

  10. 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.

  11. 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.

  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. 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

  14. 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.

  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. 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.

  17. 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

  18. 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.

  19. 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

  20. 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

  1. "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

  2. 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

  3. 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

  4. "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

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  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. 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

  15. 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

  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. 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

  18. 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

  19. 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

  20. 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?

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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

  7. ) 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 ...

  8. "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

  9. 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

  10. Inimese papilloomiviiruse vastane vaktsiin imet ei tee, aga kaitseb siiski / Marika Kusnets

    Index Scriptorium Estoniae

    Kusnets, Marika

    2006-01-01

    5. oktoobril korraldas ravimifirma Merck Sharp & Dohme koostöös erialaarstide, Eesti Vähiliidu ja Quattromediga ajakirjanikele ümarlaua, kus räägiti emakakaelavähi põhjustest ja ravist, HPV tüüpidest, nakatumis- ja kaitsemehhanismidest ning uuest Eesti turule jõudvast vaktsiinist

  11. Valitsus sel korral sügisest majandusennustust ei tee / Raimo Poom

    Index Scriptorium Estoniae

    Poom, Raimo

    2009-01-01

    Rahandusministeeriumi osakonnajuhataja Andrus Sääliku selgitusel on sügisese majandusprognoosi edasilükkamise taga EL-i otsus lükata sel aastal stabiilsus- ja konvergentsiprogrammide raportite esitamine kaks kuud edasi. Diagramm

  12. 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

  13. Pro Patria advised Rüütel to stay home / Berit Teeäär

    Index Scriptorium Estoniae

    Teeäär, Berit

    2005-01-01

    Isamaaliidu juhtpoliitiku, Europa Parlamendi saadiku Tunne Kelami arvates annab president Arnold Rüütli otsus mitte sõita 9. maiks Moskvasse Eestile hea võimaluse selgitada oma ajalugu tervele maailmale

  14. Tee idast läände viib läbi Leedu / Vladas Sturis

    Index Scriptorium Estoniae

    Sturis, Vladas

    2007-01-01

    Läänemere regioonis alustati uue transpordikoridori projekti "Ida-lääs", mis läbib Leedut, Venemaad, Rootsit ja Taanit, arendamist. Eesmärgiks on transiidi areng ja konkurentsivõime säilitamine regioonis

  15. Eesti porgand võib leida tee USA sõduri lauale Afganistanis / Gert D. Hankewitz

    Index Scriptorium Estoniae

    Hankewitz, Gert D.

    2010-01-01

    Lähiajal väisavad Eestit Ameerika Ühendriikide armee varustamisega tegeleva ameti US Defence Logistics Agency esindajad, kes otisvad oma vägedele Afganistanis köögiviljade, vee ja ehitusmaterjalidega varustajat

  16. Tee selgeks, mis sind segab / Hede Kerstin Luik ; interv. Aavo Kokk

    Index Scriptorium Estoniae

    Luik, Hede Kerstin

    2003-01-01

    Statoili turundusjuht Hede Kerstin Luik kirjeldab muutusi, mida Shelli bensiinijaamade ostmine ettevõttele ning selle töötajatele kaasa tõi ning kuidas pingelisel ajal tööstressiga võideldi. Kommenteerib Mihkel Reinsalu.

  17. Design data for quick development of folded H plane tee at high ...

    Indian Academy of Sciences (India)

    Harish V Dixit

    2018-03-14

    Mar 14, 2018 ... 2 Vidyavardhini's College of Engineering and Technology, Vasai 401202, India ... Further, a scheme for the thermal management for high input power level ..... waveguide walls for input time of 1000 s due to this power.

  18. Dokumentaalselt tõestatud: Paul Keresel suleti tee maailmameistri tiitlile / Paavo Kivine

    Index Scriptorium Estoniae

    Kivine, Paavo, 1939-

    2015-01-01

    Miks neli aastakümmet tipus püsinud suurmeister ei tulnud maailmameistriks. Lisatud dokument on pöördumine Venemaa Kommunistliku Partei II sekretäri ülesandeid täitnud Andrei Ždanovi poole ettepanekuga lubada Paul Keresel osaleda 1947. aasta maailmameistrivõistlustel (foto venekeelsest dokumendist ja tõlge)

  19. SCANIA müügi- ja teeninduskeskus. Tallinn, Peterburi tee 72 / Aivar Habakukk

    Index Scriptorium Estoniae

    Habakukk, Aivar

    1998-01-01

    Baltikumi suurima veokite ja busside müügi- ja hooldekeskuse projekteerimisel olid aluseks SCANIA teenindusjaamade tüüpsed ehituslikud lahendused ja firma teenindusjaamades eritöödele esitatavad nõuded. Hoone koosneb kolmest funktsionaalsest plokist : ühekorruseline kõrge remondi ja hooldeplokk ; varuosade ladu ning klienditeeninduse ja müügikeskus koosa bürooruumidega. Projekteerija : AS Arhitektibüroo Ehala & Irik. Arhitekt Priit Ehala. Sisekujundus : OÜ Stuudio Habakukk & Kivi. Peatöövõtkja : AS FCM. Projekt 1997, valmis 1998.

  20. Rail Baltica uus tee viiks rongid nelja tunniga Varssavisse / Tiina Rekand

    Index Scriptorium Estoniae

    Rekand, Tiina, 1985-

    2011-01-01

    Rail Baltica tasuvusuuringus on välja töötatud neli optimaalsemat marsruuti. Aecom Ltd Balti regiooni direktor Arnis Kakulis peab parimaks kiireimat ja lühimat teed, mis kulgeks Tallinnast Varssavisse Pärnu, Riia ja Kaunase kaudu

  1. Model-driven physiological assessment of the mitral valve from 4D TEE

    Science.gov (United States)

    Voigt, Ingmar; Ionasec, Razvan Ioan; Georgescu, Bogdan; Houle, Helene; Huber, Martin; Hornegger, Joachim; Comaniciu, Dorin

    2009-02-01

    Disorders of the mitral valve are second most frequent, cumulating 14 percent of total number of deaths caused by Valvular Heart Disease each year in the United States and require elaborate clinical management. Visual and quantitative evaluation of the valve is an important step in the clinical workflow according to experts as knowledge about mitral morphology and dynamics is crucial for interventional planning. Traditionally this involves examination and metric analysis of 2D images comprising potential errors being intrinsic to the method. Recent commercial solutions are limited to specific anatomic components, pathologies and a single phase of cardiac 4D acquisitions only. This paper introduces a novel approach for morphological and functional quantification of the mitral valve based on a 4D model estimated from ultrasound data. A physiological model of the mitral valve, covering the complete anatomy and eventual shape variations, is generated utilizing parametric spline surfaces constrained by topological and geometrical prior knowledge. The 4D model's parameters are estimated for each patient using the latest discriminative learning and incremental searching techniques. Precise evaluation of the anatomy using model-based dynamic measurements and advanced visualization are enabled through the proposed approach in a reliable, repeatable and reproducible manner. The efficiency and accuracy of the method is demonstrated through experiments and an initial validation based on clinical research results. To the best of our knowledge this is the first time such a patient specific 4D mitral valve model is proposed, covering all of the relevant anatomies and enabling to model the common pathologies at once.

  2. Mixing at double-Tee junctions with unequal pipe sizes in water distribution systems

    Data.gov (United States)

    U.S. Environmental Protection Agency — Pipe flow mixing with various solute concentrations and flow rates at pipe junctions is investigated. The degree of mixing affects the spread of contaminants in a...

  3. Peaminister Parts : "ei" seisukohaga Keskerakonnaga valitsust ei tee / Juhan Parts ; interv. Tuuli Koch

    Index Scriptorium Estoniae

    Parts, Juhan, 1966-

    2003-01-01

    Peaminister Juhan Parts tõdeb, et Keskerakonna juht Edgar Savisaar on selgelt väljendanud oma eitavat seisukohta Eesti EL-iga liitumise suhtes ning sellelt pinnalt on võimu jagamine Keskerakonnaga võimatu

  4. Tee It up!: Implementing a TPSR System in a High School Golf Unit

    Science.gov (United States)

    Busch, Nikki; Lavay, Barry

    2012-01-01

    Implementing Hellison's "Teaching Personal and Social Responsibility" (TPSR) system can help students take responsibility for their own behavior by helping students understand what it means to demonstrate appropriate behavior at various levels of responsibility. The levels range from zero through five and include: 0) irresponsibility, 1) respect,…

  5. Ekspert teeb Tallinna tee-ehituse maatasa / Väino Soonike ; interv. Priit Simson

    Index Scriptorium Estoniae

    Soonike, Väino

    2004-01-01

    Endine teede- ja sideministeeriumi asekantsler Tallinna teede korrashoiuks vajaminevast summast ja tegelikest kulutustest, tänavate halvast seiskorrast, selle põhjustest ning olukorra parandamise võimalustest. Tema sõnul on Tallinna tänavate remondi rahastamine poliitiliste vastuolude tõttu moonutatud

  6. Lühim tee iseendani läheb ümber maailma / Katrin Kaugver

    Index Scriptorium Estoniae

    Kaugver, Katrin, 1950-

    2007-01-01

    Euroopa Teadusraamatukogude Konsortsiumi (CERL) vanaraamatu seminarist Budapestis "Trükised ja omanikud : kirjeldades Euroopa kultuuri geograafiat" 2006. a. novembris. Esimest korda käis Eesti sel kokkusaamisel konsortsiumi täisliikme staatuses, TLÜ Akadeemiline Raamatukogu sai CERL-i täisliikmeks 2006. a.

  7. Rein Einasto : Eestis valitud ameerikalik valitsemise tee viib meid katastroofini / Rein Einasto ; interv. Kristi Leppik

    Index Scriptorium Estoniae

    Einasto, Rein, 1934-

    2008-01-01

    Kodanikuühiskonna edendamisest Eestis. Aasta missiooniinimese kandidaadiks esitatud professor Rein Einasto arvates päästaks meid avar mõtlemine, et viia inimkond tervikuna teisele teele. Praegune vaba turumajandus on pillamisele, raiskamisele ja kulutamisele üles ehitatud ummiktee. Lisa: Rein Einasto

  8. 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

  9. Training Effectiveness Evaluation (TEE) of the Advanced Fire Fighting Training System. Focus on the Trained Person.

    Science.gov (United States)

    Cordell, Curtis C.; And Others

    A training effectiveness evaluation of the Navy Advanced Fire Fighting Training System was conducted. This system incorporates simulated fires as well as curriculum materials and instruction. The fires are non-pollutant, computer controlled, and installed in a simulated shipboard environment. Two teams of 15 to 16 persons, with varying amounts of…

  10. Stephen Kingi tee tumeda tornini võttis 30 aastat / Raul Sulbi

    Index Scriptorium Estoniae

    Sulbi, Raul

    2007-01-01

    Stephen Kingi triloogiast "Tume torn" (Tallinn : Pegasus, 2006-2007) : Laskur : [romaan] / tõlkija Mart Kalvet ; Kolm saatusekaarti / [tõlkinud Kaido Haavandi] ; Ahermaad / [tõlkinud Matti Piirimaa] ;

  11. The effect of adiabatic and conducting wall boundary conditions on LES of a thermal mixing tee

    International Nuclear Information System (INIS)

    Howard, Richard J.A.; Pasutto, Thomas

    2009-01-01

    In this paper preliminary LES simulations are carried out of the FATHERINO mixing T junction experiment. In this experiment 80degC hot water enters a lateral steel pipe which has a diameter of D=0.054m, at a speed of 1.04m/s and meets 5degC cold water which enters a perpendicular steel pipe branch that also has a diameter D=0.054m but this time at a lower speed of 0.26m/s. The modelling of the steel pipe walls is tested by comparing adiabatic and 1D conducting wall boundary conditions. The numerical grid used contains approximately 440,000 hexahedral elements. The near wall refinement is not sufficient to resolve the near wall boundary layer (y + approx. = 32) and a standard logarithmic boundary condition is used. A method known as the synthetic eddy method is used to generate the turbulent flow at the pipe inlets. Three different LES models are used (Smagorinsky, dynamic Smagorinsky and wale) to resolve the subgrid turbulent motion beyond the wall grid. An additional test is carried out where no subgrid model is used with only the wall modelling being applied. The results show that the wale model generates much less resolved turbulence than the other cases and this model shows virtually no difference between the two methods of wall thermal modelling. The dynamic Smagorinsky model shows that, downstream of the mixing T, the lower wall remains at a lower temperature for longer when the adiabatic boundary condition is applied. The Smagorinsky model is found to produce the highest level of resolved temperature fluctuation. For this model the 1D thermal modelling approach increases the unsteadiness of both the velocity and temperature fields at the onset of the mixing and in the middle of the pipe downstream of the T junction. However near the lower wall the 1D thermal modelling approach tends to reduce the unsteadiness. The case with no subgrid modelling shows higher levels of turbulence kinetic energy but lower levels of temperature fluctuation than the cases with subgrid models. The absence of subgrid modelling generates temperature fluctuations just downstream of the T junction near the lower wall which are not present when a subgrid model is used. The results suggest that use of 1D wall modelling in LES becomes more important as the resolution of local flow unsteadiness increases. (author)

  12. Ei haukku haavaa tee : koiran vaikutus lapsen toimintaan ja toiminnallisuuden kehitykseen

    OpenAIRE

    Ansamaa, Katariina; Kaitila, Emmi

    2014-01-01

    Eläinten vaikutuksesta ihmisen terveyteen ja hyvinvointiin on olemassa paljon tutkimuksia. Myös eläinavusteisesta terapiasta on tutkimuksia, mutta koira-avusteisen terapian tutkimustieto on vielä vähäistä. Toimintaterapiassa koiran avulla voidaan pyrkiä löytämään ja mahdollistamaan asiakkaalle arjen merkityksellisiä toimintoja. Tämän opinnäytetyön tarkoituksena oli kerätä tietoa lasten koira-avusteisesta toimintaterapiasta. Teoreettinen viitekehys muodostuu eläin- ja koira-avusteisen terapian...

  13. Ülemiste järve esitlev elegantne hotell : Lennujaama tee 2, Tallinn = An Elegant Hotel that Presents Lake Ülemiste : Lennujaama tee 2, Tallinn / Urmas Oja

    Index Scriptorium Estoniae

    Oja, Urmas, 1981-2012

    2004-01-01

    Aerofloti hotelli kohale ja osalt vana maja konstruktsioonidele ehitatud Ülemiste hotellist. Hotelli ees on parkla ja purskkaevuga väljak. Projekteerija: EA Reng, projektijuht Taavi Turvas. Arhitekt Martin Aunin. Sisekujundus: Meelis Press, Hillar Mänd (M. Pressi Arhitektuuribüroo). Konstruktsioonid: Inseneribüroo Pike. Ehitaja: FKSM. I, II ja III korruse plaan, 3 välis- ja 5 sisevaadet

  14. Hotell 'Bernhard' Otepääl. Otepää aedlinn, Kolga tee 22a / Andres Lunge

    Index Scriptorium Estoniae

    Lunge, Andres

    1998-01-01

    Otepää aedlinnas asuva U. Tiirmaa poolt kuuekümnendatel projekteeritud Tartu Katseremonditehase puhkebaasi rekonstrueerimine. Kavandati uus peasissepääs, täiendav tubadekorrus, restoran, vastuvõtufuajee jm. ning juurdeehitusena osaliselt maaalune lisakorpus konverentsisaali jm. ruumidega. Tellija: AS Regel. Projekteerija: Tareke Projekt OÜ. Arhitekt Andres Lunge. Sisekujundaja Taisi Kadarik. Ehitus: AS Regel, 1996-1998. Projekt 1995, 1998, valmis 1998

  15. Computational fluid dynamic model for glycerol gasification in supercritical water in a tee junction shaped cylindrical reactor

    NARCIS (Netherlands)

    Yukananto, Riza; Pozarlik, Artur K.; Brem, Gerrit

    2018-01-01

    Gasification in supercritical water is a very promising technology to process wet biomass into a valuable gas. Providing insight of the process behavior is therefore very important. In this research a computational fluid dynamic model is developed to investigate glycerol gasification in

  16. Tee-junction of LMFR secondary circuit involving thermal, thermomechanical and fracture mechanics assessment on a striping phenomenon

    International Nuclear Information System (INIS)

    Lee, H.-Y.; Kim, J.-B.; Yoo, B.

    2002-01-01

    This paper presents the thermomechanical and fracture mechanics evaluation procedure of thermal striping damage on the secondary piping of LMFR using Green's function method and standard FEM. The thermohydraulic loading conditions used in the present analysis are simplified sinusoidal thermal loads and the random type thermal loads. The thermomechanical fatigue damage was evaluated according to ASME code subsection NH. The results of fatigue analysis for the sinusoidal and random type load cases showed that fatigue failure would occur at a welded joint during 90 000 hours of operation. The assessment for the fracture behavior of the welded joint showed that the crack would be initiated at an early stage of the operation. The fatigue crack was evaluated to propagate up to 5 mm along the thickness direction during the first 940.7 and 42 698.9 hours of operation for the sinusoidal and the random loading cases, respectively. However, it was evaluated that the crack would be arrested because of the low level of the primary stresses. The fatigue and crack propagation analyses for the random type loads were performed by Green's function method. (author)

  17. Meistrite tee 10 büroohoone Tallinnas = Meistrite St. 10 Office Building in Tallinn / Eero Palm

    Index Scriptorium Estoniae

    Palm, Eero, 1974-

    2005-01-01

    Kuubilaadne neljakorruseline hoone, parklapoolsel küljel evakuatsioonitrepp. Peamisteks materjalideks viimistlemata ja roostekarva betoonelement ning klaas. Projekteerija: Palm-E Arhitektibüroo OÜ. Arhitekt Eero Palm. Konstruktor: Randväli & Karema AS. Projekteeritud 2003, valminud 2004. Ill.: tüüpkorruse ja I korruse plaan, 5 värv. välisvaadet

  18. Evaluating poverty grass (Danthonia spicata L.) for use in tees, fairways, or rough areas in golf courses in the midwest

    Science.gov (United States)

    Nadia E. Navarrete-Tindall; Brad Fresenburg; J.W. Van Sambeek

    2007-01-01

    Poverty grass (Danthonia spicata L.), a native, cool-season perennial bunchgrass with wide distribution in the United States, is being evaluated for its suitability for use on golf courses. The goal is to identify practices to improve seed germination and successfully establish field plots as monocultures or with other native species to mimic natural...

  19. Magnumi-vendade tee rikkuseni käib läbi valguse ja varju / Villy Paimets

    Index Scriptorium Estoniae

    Paimets, Villy, 1972-

    2005-01-01

    Margus ja Aivar Linnamäele kuuluv Eesti suurim ravimimüügikontsern Magnum Medical on läbi aastate silma paistnud rohke offshore'ide, laenuskeemide ja esindusisikute kasutamisega. Vt. samas: Kultuurimetseen ja rallimees; Kuidas allesjäänud vara kolmeks kalliks sõiduautoks moondus; Magnum Medical tegutseb mitmes riigis ja hulga tütarfirmadega. Diagramm

  20. Johan Benadie : Eesti tööstusfirmadel maailmaklassini veel pikk tee astuda / Johan Benadie ; interv. Raul Kalev

    Index Scriptorium Estoniae

    Benadie, Johan

    2004-01-01

    Eesti tööstusettevõtteid külastas tööstusettevõtetele suunatud koolitusprogrammi "20 Keys" eestvedaja. "20 Keys" aitab Benadie sõnul tööstusettevõte tootlikkust suurendada. Lisa: Mis on "20 Keys"

  1. Evaluation of mixing downstream of tees in duct systems with respect to single point representative air sampling.

    Science.gov (United States)

    Kim, Taehong; O'Neal, Dennis L; Ortiz, Carlos

    2006-09-01

    Air duct systems in nuclear facilities must be monitored with continuous sampling in case of an accidental release of airborne radionuclides. The purpose of this work is to identify the air sampling locations where the velocity and contaminant concentrations fall below the 20% coefficient of variation required by the American National Standards Institute/Health Physics Society N13.1-1999. Experiments of velocity and tracer gas concentration were conducted on a generic "T" mixing system which included combinations of three sub ducts, one main duct, and air velocities from 0.5 to 2 m s (100 to 400 fpm). The experimental results suggest that turbulent mixing provides the accepted velocity coefficients of variation after 6 hydraulic diameters downstream of the T-junction. About 95% of the cases achieved coefficients of variation below 10% by 6 hydraulic diameters. However, above a velocity ratio (velocity in the sub duct/velocity in the main duct) of 2, velocity profiles were uniform in a shorter distance downstream of the T-junction as the velocity ratio went up. For the tracer gas concentration, the distance needed for the coefficients of variation to drop 20% decreased with increasing velocity ratio due to the sub duct airflow momentum. The results may apply to other duct systems with similar geometries and, ultimately, be a basis for selecting a proper sampling location under the requirements of single point representative sampling.

  2. Tee Kilkennysse läheb läbi... Liivalaia / William Elliott ; tõlk. Marek Laane

    Index Scriptorium Estoniae

    Elliott, William

    2005-01-01

    Suurbritannia diplomaat rõhutab vajadust tunda hästi olukorda selles riigis, mida hakatakse rajama või taas üles ehitama. Ta esitab kolm teesi, mida peaks silmas pidama riigi taasülesehitusel. Nn. riskiriikidega diplomaatiliste sidemete säilitamise tähtsusest. Lisa: Rumalaid diplomaatilistest suhetest loobumisi

  3. Kontorihoone : Järvevana tee 9g, Tallinn = Office Building : 9g Järvevana Str., Tallinn / Raivo Puusepp

    Index Scriptorium Estoniae

    Puusepp, Raivo

    2003-01-01

    Merko Ehituse 6-korruseline suletud kabinetsüsteemis büroohoone. Arhitekt Raivo Puusepp, kaasa töötasid Maike Heido ja Peeter Loo. Sisekujundaja Kaire Kemp (ArtAku). Konstruktiivne lahendus: Neoprojekt. Projekt 2001, valmis 2003. I korruse plaan, sise- ja 2 välisvaadet

  4. Pärnu filmifestivali rahva lemmik : laste haridus on ainus tee arenguks / Yoram Honig ; interv. Andris Feldmanis

    Index Scriptorium Estoniae

    Honig, Yoram

    2007-01-01

    XXI Pärnu rahvusvahelise dokumentaal- ja antropoloogiafilmide festivali lõputseremoonial kuulutati välja festivali võidufilmid. Parima filmi grand prix läks režissöör Wojciech Kasperski filmile "Seemned". Rahvahääletus valis parimaks Yoram Honigi filmi "Rahu esimene õppetund". Režissöör oma filmist. Lisatud "XXI Pärnu filmifestivali võitjad"

  5. Miks ohverdada veel üks põlvkond? / Christopher õBeazley ; interv. Berit Teeäär

    Index Scriptorium Estoniae

    õBeazley, Christopher

    2008-01-01

    Euroopa Parlamendi Balti-Euroopa tugirühma esimees Christopher Beazley vastab küsimustele, mis puudutavad tema huvi Balti riikide ja Läänemere regiooni vastu, Läänemere piirkonnas paiknevate Euroopa Liidu vanade ja uute liikmesriikide kontseptuaalsete erinevuste tõttu tekkida võivaid lahkhelisid, Euroopa Liidu ja Venemaa suhete seisu ja arenguperspektiive, liidu ühise välispoliitika kujunemise võimalikkust, Kaliningradi oblasti demilitariseerimist ning selle enklaavi muutmist Euroopa Liidu ja Venemaa vahelise vabakaubanduse pilootprojektiks, Läänemere ökoloogilise olukorra parandamist

  6. Andrew Smith: peame leidma tee majanduskasvuni, mis põhineb säästmisel, investeeringutel ja ekspordil / Andrew Smith

    Index Scriptorium Estoniae

    Smith, Andrew

    2010-01-01

    KPMG (UK) peaökonomist Andrew Smith vastab küsimustele, mis puudutavad majanduskriisi tekkimist, olukorra paranemist, majandusolukorda Suurbritannias, erinevusi Euroopa ja muude maailma piirkondade vahel, sarnasusi Eesti ja Suurbritannia majandusolukorra vahel ning prognoose edaspidiste arengute osas

  7. Spanish participation in the Benchmark of the OECD of CFDs applied to nuclear safety: the test of Tee Junction

    International Nuclear Information System (INIS)

    Abdelaziz Essa, M. A.; Chiva, S.; Munoz-Cobo, J. L.

    2011-01-01

    In this paper we show the main results obtained by the groups of the Universities UPV and UJI (GITH-Inter-Universitary Group on Thermal-Hidraulics), in the modeling of the OCDE Benchmark on the T-Junction performed during the year 2010. This benchmark consisted in predicting, using CFD codes the velocity and temperature distributions downstream the junction. Also was considered a important issue the prediction of the velocity and temperature fluctuations, especially the Power Spectral density of the temperature fluctuations. The results obtained in the Benchmark by the GITH group were very good.

  8. Mobility Analysis of AmpuTees (MAAT I): Quality of life and satisfaction are strongly related to mobility for patients with a lower limb prosthesis.

    Science.gov (United States)

    Wurdeman, Shane R; Stevens, Phillip M; Campbell, James H

    2017-10-01

    While rehabilitation professionals are historically trained to place emphasis on the restoration of mobility following lower limb amputation, changes in healthcare dynamics are placing an increased emphasis on the limb loss patient's quality of life and general satisfaction. Thus, the relationship between these constructs and mobility in the patient with lower limb loss warrants further investigation. To determine the relationship between mobility of the patient with lower limb loss and both (1) general (1) general satisfaction and (2) quality of life. Retrospective chart analysis. A retrospective chart review of the Prosthetic Limb Users Survey of Mobility and the Prosthesis Evaluation Questionnaire-Well-Being subsection. Pearson correlations were used to test relationships. Data from 509 patients with a lower limb prosthesis were included. Mobility was found to be positively correlated with quality of life ( r = 0.511, p mobility and both quality of life and general satisfaction. Thus, in the holistic care of a patient with lower limb loss, maximizing mobility would correlate with greater quality of life and general satisfaction. Clinical relevance There is growing emphasis on the quality of life and general satisfaction experienced by patients undergoing prosthetic rehabilitation. The results of this study underscore the importance of providing prosthetic rehabilitation that maximizes the patient's mobility, noting that these individuals also report greater quality of life and general satisfaction.

  9. Rahvalik ehitus : galeriimaja Harjumaal Peetris Uusmaa tee 1, 3, 5 = Construction for the people : gallery-accessed building in Peetri, Harju County / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2008-01-01

    Projekteerija: Arhitektuuribüroo Emil Urbel. Autorid: Emil Urbel, Ainar Luik, Ivar Lubjak. Konstruktor: OÜ Printsiip. Ehitaja: KMG Ehitus. Projekt: 2006, valmis: 2007. Emil Urbel ja Ainar Luik hoone arhitektuursest lahendusest, ehitusmaterjalidest, ökonoomsusest, ehitusest. Asendiplaan, I-III korruse plaan, 7 värv. välisvaadet

  10. Numerical investigation on thermal striping conditions for a tee junction of LMFBRE coolant pipes. 7. Effect of the 'Turbulence promoter' on the fluid mixing

    International Nuclear Information System (INIS)

    Tanaka, Masa-aki; Muramatsu, Toshiharu

    2004-06-01

    It is important to evaluate thermal-striping phenomena, which is the thermal fatigue issue in the structure generated by the temperature fluctuation due to the fluid mixing. Especially, the high amplitude and the high number of repetitions of the temperature fluctuation are needed to take into consideration. Moreover, it is necessary to consider the comparatively low frequency components of fluid temperature fluctuation, since the influence to structure material is large. Therefore, it is required to know the generating mechanism and conditions of the high amplitude and the low frequency component of fluid temperature fluctuation. In Japan Nuclear Cycle Development Institute, basic research on the promote system for fluid mixing is conducted, which system ('Turbulence promoter') is expected to reduce the large amplitude and low frequency components of fluid temperature fluctuation in T junction pipe. In this investigation, it is aimed to validate the effect and to generalize the mixing characteristics of 'Turbulence promoter' on the fluid mixing in T-junction pipe, and to contribute the knowledge to the rational design of LMFBR. In this report, numerical simulation for the existing experiment was conducted using a quasi-direct simulation code (DINUS-3). From the numerical simulation, the following results are obtained. (1) Numerical calculations could simulate well the flow patterns observed in the visualization experiment, in impinging jet case (Pattern-C) and deflecting jet cases (Pattern-B1 and Pattern-B). (2) By installing Turbulence promoter', cross-section area of main pipe after the mixing point is narrowed, and the fluid of main pipe is accelerated and flows along the slope of the promoter on the opposite side of branch pipe. this accelerated flow acts to prevent the collision of the branch pipe flow to the promoter. Therefore, the branch pipe flow conditions in deflecting jet category are extended. (3) At the throat of the main pipe, the flow was separated from the edge of the 'Turbulence promoter' and eddies were generated in downstream side of the promoter. And also the wake region was formed behind the promoter. By these eddies, fluid mixing is promoted. However, in the downstream side of the promoter, temperature fluctuation with large amplitude will be produced, since the flow attached to the main pipe wall as the main piping flow and the branch piping flow are mixed. (author)

  11. Elucidation of thermal hydraulic mixing mechanism in a mixing tee area with a 90-degree bend upstream and development of thermal-striping relaxation and control methods

    International Nuclear Information System (INIS)

    Sugawara, Yoshimasa; Yuki, Kazuhisa; Hashizume, Hidetoshi; Tanaka, Masa-aki; Muramatsu, Toshiharu

    2004-10-01

    In the region where two fluids with different temperatures mix, unstable fluid mixing like thermal striping occurs accompanying with unsteady temperature fluctuation of fluid. This temperature fluctuation is transported toward the surrounding area and becomes an important factor that induces thermal fatigue of structural materials, which sometimes results in crack generation of them. In fast breeder reactors that utilize liquid sodium as a coolant, the fluid temperature fluctuation could be easier to conduct toward the structural materials due to its high thermal conductivity, so that careful consideration for the thermal fatigue is required. In particular, since the low frequency band of temperature fluctuation strongly affects the thermal fatigue, evaluation and development of the relaxation and control methods for it become important issues. In this study, non-isothermal fluid mixing experiments in a T-junction area with a 90-degree bend upstream were carried out to estimate the fluid-temperature fluctuation in the vicinity of wall. The temperature fluctuations for various flow mixing conditions were measured, changing a velocity ratio and a pipe diameter ratio of a main pipe to a branch pipe to quantitatively evaluate the effect of a secondary flow on the temperature fluctuation. In addition, by analyzing both the visualization data taken by a PIV system and the temperature fluctuation data, it was attempted to construct a prediction formula for the temperature fluctuation. Our findings are summarized below. (1) Classifying the flow mixing pattern of jet flow running out from the branch pipe makes it possible to predict the maximum temperature fluctuation in the mixing area with higher accuracy by using the flow velocity ratio (0.2 -0.06 (d/D) 0.22 . Re-attachment Flow - deflecting Flow: Max(ΔTrms*)=0.64(v/V) -0.92 (d/D) 1.11 . (2) Prediction formulas for the maximum temperature fluctuation in the case of the curvature ratio of 1.0 are also constructed as follows. Stratified Flow: Max(ΔTrms*)=0.36(v/V) -0.06 (d/D) 0.34 . Re-attachment Flow - deflecting Flow: Max(ΔTrms*)=0.66(v/V) -0.86 (d/D) 0.95 . (3) Damping characteristics of the temperature fluctuation in the downstream direction are also evaluated and it is clarified that the temperature fluctuation damps rapidly in comparison with that in the case of no-bend system. (author)

  12. Pärnu mnt. ja Järvevana tee vahelise ala planeerimiskonkurss = Planning Competition of the Area between Järvevana and Pärnu Roads / Kalle Komissarov

    Index Scriptorium Estoniae

    Komissarov, Kalle, 1976-

    2002-01-01

    Konkursist, zürii koosseis, võidutöödest. Võistlusala oli AS-i "Kalev" ja Tallinna Piimatööstuse territoorium. Preemiad: I - Nikolai Volkov, Liis Sagadi, II - Tarmo Teedumäe, Renee Puusepp, Karli Luik, Toomas Tammis, Inga Raukas, III - Veronika Valk, ostupreemiad - Alver Trummal Arhitektid ja büroo Kosmos

  13. Ühehäälne Euroopa / Hans-Gert Pöttering ; interv. Berit Teeäär, Kaja Sõrg

    Index Scriptorium Estoniae

    Pöttering, Hans-Gert, 1945-

    2007-01-01

    Euroopa Parlamendi president räägib, kuivõrd paistab Eesti välja Euroopa poliitikas, vaeb Läänemere strateegiat ja Eesti-Vene kahepoolsete suhete arengut, Euroopa-Liidu ja Venemaa suhteid, sh seoses kavandatava Vene-Saksa gaasijuhtmega ning Euroopa Rahvapartei põhimõtteid ja tegevust. Lisad: Euroopa Parlamendi Euroopa Rahvapartei ja Euroopa Demokraatide (ERP-ED) fraktsioon; Mis on Euroopa Parlament?

  14. "Kes tööd ei tee, ei pea ka sööma!": ühe lootusetu võitluse lugu : Nõukogude töökohustuse ja parasiitide vaenamine Eesti NSV-s / Indrek Paavle

    Index Scriptorium Estoniae

    Paavle, Indrek, 1970-

    2015-01-01

    NSV Liidus kehtinud töökohustusest, töödistsipliini rikkumisest, distsipliinirikkumistega võitlemisest. Nõukogude võimu esimesest 20 aastast. Töötajate sunnismaisusest ja töödistsipliini rikkumise kriminaliseerimisest. Töödistsipliini seaduste rakendamise algusest Eestis. 1948. ja 1951. aasta parasiitide seadustest. Hruštšovi kampaaniast. Eesti NSV 1961. aasta parasiitidevastasest seadusest. Kampaania tulemustest. 1966. aasta seadusest. 1975. aasta seadusest. 1980. aastate kampaaniatest

  15. 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

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. 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 ...

  5. 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

  6. 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

  7. 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 ...

  8. [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.

  9. 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 ...

  10. 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

  11. 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

  12. Ka sisaliku tee kivil jätab jälje. Tantsuteatri uurimise metodoloogiast Rahel Olbrei pärandi näitel / Even a Lizard’s Path on Stone Leaves a Trace: Methodological Issues on Dance Research from the Example of Rahel Olbrei's Legacy

    Directory of Open Access Journals (Sweden)

    Heili Einasto

    2014-12-01

    Full Text Available The article is dedicated to dance research methodology, using Rahel Olbrei’s legacy as an example. Rahel Olbrei (1898—1983 was an Estonian choreographer and founder of the Estonia Theatre Dance Company. A choreographer’s work, when not on stage, becomes invisible, though it leaves its trace in the cultural memory. Olbrei’s legacy exists in the memory of the people who met her personally, but also of those who have obtained their memories from them – together they form a collective memory, Tamm and Halla (2008 present five major memory transmission channels: oral narratives, written (memoirs, diaries, autobiographies, history books, etc., visual (photos in Olbrei’s case, actional (the Rahel Olbrei Annual Award and spatial channels.  Memories are not fixed; they are records of how events have been experienced. We draw key elements out of our experience and save them, and later create or form that experience anew. Remembering as a process also needs information about how something is remembered: hints, directions and any triggers that wake up some of the information saved in the brain. Oral history is a process of relation building: relations are built between narrators and listeners, between past events and present dialogue – thus, when making oral history interviews, it is essential to also record aspects outside of the interview.  Choreography will stay alive only when it is being taught from one dancer to another. This paper describes the processes of making, saving and passing on movement texts using examples by Olbrei. In a situation where Olbrei’s choreography is lost forever, we can ask: what is her legacy in Estonia theatre and ballet? This legacy is perhaps strongest in dancers trained by her who were carriers of a pre-war work ethic and Olbrei’s vision of dancers as dancing actors. Olbrei’s views on dance education and art are alive today. She was convinced that a professional dancer should be able to perform anything. She deemed it important to have dancers as collaborators, not merely imitators of dance movements, and her vision of ballet as a meaningful dance drama was shared by choreographers who came after her. Only the challenges of the present century – commercialization of ballet as a genre and internationalisation of ballet companies – have started to crumble Olbrei’s artistic legacy and ideal of dance performance as a deeply felt art and the dancer as the choreographer’s collaborator.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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.)

  20. 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, ...

  1. 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.)

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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

  20. 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")

  1. 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.

  2. 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"

  3. 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

  4. 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 ...

  5. 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

  6. 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 ...

  7. 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 ...

  8. 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.

  9. 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

  10. 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 ...

  11. 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

  12. 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

  13. 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) ...

  14. 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

  15. 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, ...

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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 ...

  10. 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

  11. 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)

  12. 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.

  13. 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 ...

  14. 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 ...

  15. 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.

  16. 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 ...

  17. 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

  18. 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

  19. 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

  20. 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"

  1. 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"

  2. 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

  3. 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, ...

  4. 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"

  5. 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 ...

  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. 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

  8. PTSD: National Center for PTSD

    Medline Plus

    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 ...

  9. 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, ...

  10. 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 ...

  11. 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 ...

  12. 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...

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. 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

  17. 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 ...

  18. 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

  19. 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 ...

  20. 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...

  1. 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

  2. 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...

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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....

  14. 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.

  15. 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.

  16. 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.

  17. 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).

  18. 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.

  19. 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

  20. 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.

  1. 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.)

  2. 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.)

  3. 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

  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. 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.

  6. 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

  7. 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.

  8. 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.)

  9. 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.)

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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)

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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...

  1. Buddhist Pedagogy in Teacher Education: Cultivating Wisdom by Skillful Means

    Science.gov (United States)

    Ma Rhea, Zane

    2018-01-01

    This paper draws on research I have conducted about the cultivation of wisdom in Thailand and Australia. I examine the ancient pedagogy of pavi?aupaya skillful means investigating how this pedagogy can inform contemporary development of teacher educators and teachers. I examine the Panjaawi´tee Wisdom Method that has its foundations in the…

  2. Sadhana | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Home; Journals; Sadhana. VIKAS N GUPTA. Articles written in Sadhana. Volume 43 Issue 3 March 2018 pp 33. Design data for quick development of folded H plane tee at high average power level · HARISH V DIXIT AVIRAJ R JADHAV YOGESH M JAIN ALICE N CHEERAN VIKAS N GUPTA P K SHARMA · More Details ...

  3. 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

  4. 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.

  5. 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.

  6. 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...

  7. 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

  8. 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

  9. 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

  10. 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

  11. Selgusid Betti Alveri preemia nominendid

    Index Scriptorium Estoniae

    2005-01-01

    Betti Alveri kirjandusauhinna nominendid: Sass Henno "Mina olin siin", Andrei Hvostovi "Lombakas Achilleus", Mart Kanguri, Jaak Ranna ja Ivar Ravi "Jaak Rand ja teisi jutte", Diana Leesalu "2 grammi hämaruseni", Jaan Pehki "Sisukord", Linnar Priimäe "Kelle tee on varjul", Leo de Sixtuse "Skarabeuse tsivilisatsioon". Vt. ka Eesti Päevaleht, 16. nov., lk. 15

  12. 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

  13. Asia Beyond the Border: Physical Geography - Central and Northeastern Asia -

    Science.gov (United States)

    1961-03-21

    Shan: the kiang species ( Equus hemionus kiang). Forest hoofed animals are characteristic only for the western and northern mountain groups which are...severe winter olinate or its hot suremers» ’ „ ,, . •The Hwang Ho has a bread a»4>in S»*** a low vamy «»«»S tee sand and alluvial desert

  14. 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.

  15. 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

  16. 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

  17. "mina usun sõna..." : [luuletused] / Maarja Kangro, Mart Kangur, Lauri Kitsnik jt

    Index Scriptorium Estoniae

    2007-01-01

    Sisu: "mina usun sõna..." ; Tüdruk heitis mulle silma (Silmapartii) ; "Helista siis mulle. Hoolimata sellest, mis kell ma täna magama..." ; Tärkab ; Toad ; "Tee sees on augud. Maa sees on augud..." ; "Puuk on perses. Ai-ai, valus on..." ; Päärätik ; Pliidikütt ; "Ukrainlannast põetaja..." ; Stereonurr ; "Luuletused..."

  18. Development and implantation of application systems for reduction and analysis of experimental data in Nuclear Physics area

    International Nuclear Information System (INIS)

    Cardoso Junior, J.L.; Schelin, H.R.; Lemos, B.J.K.C.; Tanaka, E.H.; Castro, A.T.C.G.

    1984-01-01

    Several application systems for reduction and analysis of experimental data are described. These codes were development and/or implanted in tee IEAv/CTA CYBER 170/750 system. A brief description of the experimental data acquisition modes and the necessary reduction for analysis is given. Information on the purposes, uses and access of the codes are given [pt

  19. 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...

  20. Dave Benton laulab Peetri kirikus / Arvo Uustalu

    Index Scriptorium Estoniae

    Uustalu, Arvo, 1964-

    2004-01-01

    Poplaulja Dave Bentoni ja Eesti Televisiooni lastekoori kontserdist 20. dets. Tartu Peetri kirikus. Peetri kirikus heategevuskontserdil "Tee rõõmsaks mind, kui sul on aega" 28. dets. laulavad Katrin Pärn, Toomas Lunge, Kait Tamra ja Indrek Kalda. Rein Rannapi viisistatud kantaati "Ilus maa" esitab Kadri Leppoja juhatusel ja Urmas Taniloo saatel M. Härma gümnaasiumi segakoor

  1. 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,...

  2. 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"

  3. 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

  4. 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

  5. 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

  6. 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

  7. "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

  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. 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

  10. 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

  11. 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

  12. 14. II kell 14 esitletakse EKMi Rüütelkonna hoones...

    Index Scriptorium Estoniae

    2005-01-01

    Esitletakse raamatuid "Eesti kunst. 101 teost Eesti kunstimuuseumi kogudest" (autorid: Tiina Abel, Eha Komissarov, Hanno Soans, koostanud T. Abel, E. Komissarov, H. Soans ja Kädi Talvoja, kujundanud Anu Lemsalu), "Kunstnik ja tema kodu. C. T. von Neffi kunstikogu Piira ja Muuga mõisast" (koostanud Tiina Abel, kujundanud Andres Tali) ja Kiwa "Roboti tee on nihe. Salatühik"

  13. 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)

  14. 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.)

  15. 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)

  16. 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.

  17. 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

  18. 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

  19. 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)

  20. 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)

  1. 75 FR 32467 - Notice of a Regional Waiver of Section 1605 (Buy American Requirement) of the American Recovery...

    Science.gov (United States)

    2010-06-08

    ... the Clean Water State Revolving Fund to complete this project. The City was unable to find a supplier... joint reducer tee fitting, manufactured outside of the U.S. This is a project specific waiver and only applies to the use of the specified product for the ARRA project discussed in this notice. Any other ARRA...

  2. DIE MAPOCH.OORLOG,1882-1883

    African Journals Online (AJOL)

    Toe genl Joubert Nyabela teen November 1882 opdrag gegee' het om Mampuru te help op- spoor, het hy geweier, Hy het Mampuru trouens beskerming verleen, Gevolglik het Joubert en sy. 16 kommando direk tee'n die Ndzundza opgetrek, waarop 'n oorlog gevolg het wat net langer as agt maande geduur het en die ZAR ...

  3. 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

  4. 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.

  5. 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

  6. 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

  7. Sarri võttis Talleksiga taanlastelt Saksa Auto / Villy Paimets

    Index Scriptorium Estoniae

    Paimets, Villy, 1972-

    2005-01-01

    Andres Sarri poolt kontrollitav AS Talleks ostis Taani partnerilt Semler Holding välja 50-protsendilise osaluse AS-is Saksa Auto. Lisa: Viimastel aastatel eestlaste poolt välja ostetud ettevõtted. Diagramm: Saksa Auto tulemused paranesid mullu märgatavalt. Vt. samas: Sarri: me ei tee halbu tehinguid; Peeter Raidla. Tuleristsed 90ndate alguse võimuvõitlusest

  8. 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 ...

  9. 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

  10. 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 ...

  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. 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...

  13. 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...

  14. Perceptual Narrowing of Linguistic Sign Occurs in the 1st Year of Life

    Science.gov (United States)

    Palmer, Stephanie Baker; Fais, Laurel; Golinkoff, Roberta Michnick; Werker, Janet F.

    2012-01-01

    Over their 1st year of life, infants' "universal" perception of the sounds of language narrows to encompass only those contrasts made in their native language (J. F. Werker & R. C. Tees, 1984). This research tested 40 infants in an eyetracking paradigm and showed that this pattern also holds for infants exposed to seen language--American Sign…

  15. 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…

  16. 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

  17. 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

  18. 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

  19. 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...

  20. 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 ...

  1. 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"

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. Büroohoone kui elus mäng / Urmas Oja

    Index Scriptorium Estoniae

    Oja, Urmas, 1981-2012

    2005-01-01

    Arvutimämgust inspireeritud Martin Aunini projekteeritud büroohoonest Tetris Tallinnas Mustamäel Mustamäe tee 46. 2005. a. valminud hoone fassaadid teeb eriliseks lasuurvärvidega rohe-kollaseks värvitud betoon. Projekteerija: EA Reng. Konstruktor: IB Pike. Infograafika: Andres Rohtla. Kommenteerivad M. Aunin ja Värvistuudio Parem Sein juhataja Margus Pootsmaa

  9. Bjuro kak igrushka / Urmas Oja

    Index Scriptorium Estoniae

    Oja, Urmas, 1981-2012

    2005-01-01

    Arvutimämgust inspireeritud Martin Aunini projekteeritud büroohoonest Tetris Tallinnas Mustamäel Mustamäe tee 46. 2005. a. valminud hoone fassaadid teeb eriliseks lasuurvärvidega rohe-kollaseks värvitud betoon. Projekteerija: EA Reng. Konstruktor: IB Pike. Infograafika: Andres Rohtla. Kommenteerivad M. Aunin ja Värvistuudio Parem Sein juhataja Margus Pootsmaa

  10. 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

  11. 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.

  12. Marvelous Mud

    Science.gov (United States)

    Keeler, Rusty

    2011-01-01

    The author visited the Open Spaces Preschool in Whangarei, New Zealand and was surprised to see the most amazing natural preschool play. There were six preschoolers stripped down to tee shirts and underpants slipping, slopping, and sliding in the dirt spot which had now become the most lovely, silky-smooth deep-brown mud ever. Studies have…

  13. 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

  14. 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"

  15. 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

  16. 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..."

  17. 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)

  18. 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 "!"

  19. 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.

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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...

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. KGB methods suspected in eavesdropping affair

    Index Scriptorium Estoniae

    2011-01-01

    Läti Esimese Partei/Läti Tee esimees Ainars Slesers ütles telekanali LNT 5. mai saates 900 sekundit, et Läti hotellis Radisson Blu Ridzene on tõenäoliselt pealt kuulatud välismaiste ametiisikute kõnesid. Hotelli esindaja Aiga Lapina kinnitas, et hotell ei tea sellest midagi ja on nõus asja kontrollima

  15. 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

  16. 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

  17. 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-.

  18. 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

  19. 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

  20. 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...

  1. Disc Golf: Teaching a Lifetime Activity

    Science.gov (United States)

    Eastham, Susan L.

    2015-01-01

    Disc golf is a lifetime activity that can be enjoyed by students of varying skill levels and abilities. Disc golf follows the principles of ball golf but is generally easier for students to play and enjoy success. The object of disc golf is similar to ball golf and involves throwing a disc from the teeing area to the target in as few throws as…

  2. 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

  3. Lessons Learned from the Private Sector

    Energy Technology Data Exchange (ETDEWEB)

    Robichaud, Robert J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-07

    This session is focused on lessons learned from private sector energy projects that could be applied to the federal sector. This presentation tees up the subsequent presentations by outlining the differences between private and federal sectors in objectives, metrics for determining success, funding resources/mechanisms, payback and ROI evaluation, risk tolerance/aversion, new technology adoption perspectives, and contracting mechanisms.

  4. 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...

  5. 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...

  6. Triigi metskonnamaja = Triigi Forest Ranger Building / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2005-01-01

    Pikk postidel vundamendiga viilkatusega maja, milleni viib puidust tee. Sissepääsuhall on klaasseintega, laudis on metallist vaheosadega triibutatud, aknad kujutavad endast voodrilaua laiusi klaasist pilusid. Projekteerija AB Schults ja Partnerid. Autor Aivo Schults. Sisekujundaja Liis Raudsepp. Konstruktor: Inseneribüroo Peipman. Projekt 2003, valmis 2004. Ill.: I korruse plaan, 5 välisvaadet, sisevaade

  7. 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.

  8. 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…

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  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. 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"

  16. 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.

  17. Preliminary design of high-power wave-guide/transmission system

    Indian Academy of Sciences (India)

    ... CW klystron followed by wave-guide filter, dual directional coupler, high-power circulator, three 3 dB magic TEE power dividers to split the main channel into four equal channels of 250 kW each. Each individual channel has dual directional couplers, flexible wave-guide sections and high power ceramic vacuum window.

  18. 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…

  19. 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…

  20. 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.

  1. Teacher Candidate Fashion, Tattoos, and Piercings: Finding Balance and Common Sense

    Science.gov (United States)

    Colbert, Ron

    2008-01-01

    The season of new buds and blossoms also signals fashion changes in the college classroom. Shorts, short skirts, tees, muscle tops, underwear exposed by low-rise pants, hospital scrubs, and flip-flops appear. With the advent of warm weather, women's clothing style can be tight and/or revealing. Jewelry and accessories become more visible. Today,…

  2. 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

  3. 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

  4. 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

  5. 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...

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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)

  12. 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

  13. Ilon Wiklandi Imedemaa muudab tagasi lapseks / Janar Ala

    Index Scriptorium Estoniae

    Ala, Janar, 1979-

    2009-01-01

    Haapsalus avati 1. juulil 2009. a. lastepärane teemakeskus Iloni Imedemaa, kus saab tutvuda raamatuillustraatori Ilon Wiklandi kujutatud tegelastega. Avamisel viibis ka proua Evelin Ilves koos tütre Kadri Keiuga. Samal teemal ka "Pildi sisse: Iloni Imedemaa avab tee kunstniku loomingusse" lk. 1. Fotod sündmusest vt. ka: Postimees : Arter 4. juuli 2009, lk. 16, pealk.: Imedemaa Haapsalus

  14. 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.

  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. Kae kunstnikku! / Harry Liivrand, Margit Tõnson

    Index Scriptorium Estoniae

    Liivrand, Harry, 1961-

    2007-01-01

    Filmiajaloo kümme parimat filmi kunstnikest: Vincente Minnelli "Elujanu", Peter Webber "Tütarlaps pärlkõrvarõngaga", Andrei Tarkovski "Andrei Rubljov", Julie Taymor "Frida", James Ivory "Picasso: looja ja hävitaja", Ed Harris "Pollock", Julian Schnabel "Basquiat", Konrad Wolf "Goya ehk tunnetuse salakaval tee", Raoul Ruiz "Klimt", Oliver Hirschbiegel "Allakäik"

  17. 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

  18. 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

  19. 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

  20. 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...

  1. 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.

  2. 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...

  3. 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.

  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. 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...

  6. 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%.

  7. 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 ...

  8. 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.

  9. 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

  10. 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 ...

  11. 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.)

  12. 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?

  13. 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

  14. 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

  15. 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

  16. 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.

  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. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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)

  5. 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.

  6. 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.

  7. 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

  8. 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.

  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. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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...

  17. 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...

  18. 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)

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. 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.

  4. 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)

  5. [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.

  6. 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

  7. 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.

  8. 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.

  9. Information Technology and Development Series. Volume 2. Informatics and Industrial Development. Proceedings of the International Conference on Policies for Information Processing for Developing Countries Held at Dublin, Ireland on 9-13 March 1981,

    Science.gov (United States)

    1982-11-01

    phenomenon that is less ,han 20) years old. In spite of its recent history, we still do not fulls understand the sociological. psychological and economic...important for us to become aware of and to try to understand the socio- psychological and economic significance of the technologies that underlie the...officies: D~ atar processing tee hrolog% has become ain indispenisable tool iii goserment otfice,, anid coiriseluert ’l\\ there has been a steady increase in

  10. 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.

  11. George Soros : maailma hädad sünnivad avatuse ja suletuse vastuoludest / George Soros ; interv. Urmet Kook

    Index Scriptorium Estoniae

    Soros, George, 1930-

    2004-01-01

    George Soros vastab küsimustele, kas postkommunistlikel riikidel oleks olnud mõttekas ja võimalik valida veidi pehmem tee turumajandusele üleminekul, kas ta usub liberaalse demokraatia lõplikku võidukäiku maailmas, millised on suurimad ohud tänapäeva maailma ees, samuti küsimustele demokraatlike riikide alliansi otstarbe ja mahajäänud ühiskondade jaluleaitamise kohta

  12. 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.

  13. History of Special Operations Forces in Malaysia

    Science.gov (United States)

    2013-06-01

    volunteers at the “ Z ” experimental station outside Cairns, Australia. After nine months of training, the Jaywick party sailed from Exmouth Gulf, Western...57 Training was conducted in English. Lim Bo Seng translated instructions for the Chinese “ Dragon ” groups. During that period, Tan Choon Tee, a...and so of course everything is a balls -up. An imperial balls -up—the threat of interference in the running of the Malayan Section.”65 Talented

  14. 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

  15. Right-to-left shunts may be not uncommon cause of TIA in Japan.

    OpenAIRE

    Tateishi, Yohei; Iguchi, Yasuyuki; Kimura, Kazumi; Kobayashi, Kazuto; Shibazaki, Kensaku; Eguchi, Katsumi

    2009-01-01

    BACKGROUND AND PURPOSE: Although 30% to 60% of transient ischemic attacks (TIAs) have embolic sources, the etiology of the remaining TIAs is unknown. Right-to-left shunt (RLS) is one of the most important etiologies of cryptogenic stroke. The aim of this study was to determine whether RLS is related to transient ischemic attack (TIA) of unknown etiology. METHODS: We performed transesophageal echocardiography (TEE) and/or transcranial Doppler (TCD) studies for consecutive TIA patients in order...

  16. International Workshop on Millimeter Waves (1992) Held in Orvieto, Italy on April 22-24, 1992

    Science.gov (United States)

    1992-04-24

    1fillinmler4Vtlatri Circuits T. Yotwymatiat. Receott IDeehotnns. #of NRI)-;,.,s. Te, impIig It. 11. Jamset. Adv’anced Design Tee hnu jues fir Leiear... designed for the sky radiation measurement. - consideration of typical flight altitudes of 300m to Its output delivers a mean-value of the relevant...Electrolytic Processes: Anodic, Etching and Cathodic -increase of Surface to Volume Ratio metal deponition. Loca-Stuctre epoitin b pont- ikea ) no damage

  17. Gaya Hidup Remaja Pedesaan (Studi di Desa Sukaraya, Kecamatan Pancur Batu, Kabupaten Deli Serdang, Sumatera Utara)

    OpenAIRE

    Hastuti, Sri; Sudarwati, Lina

    2010-01-01

    Lifestyle can be identified with certain expressions and symbols to show who we are and in what group we relate to. Lifestyles nowadays have eliminated local and national boundaries, because the wave of lifestyles can easily spread through the media, even to village areas. Mass media and peer group has enormous effects to the lifestyle of teenagers nowadays. Luckily, there are still religious values and family values. Nevertheless, there is no doubt that the lifestyle of village tee...

  18. 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

  19. A Hybrid Approach to Composite Damage and Failure Analysis Combining Synergistic Damage Mechanics and Peridynamics

    Science.gov (United States)

    2017-12-31

    Composite Damage and Failure Analysis Combinin Synergistic Damage Mechanics and Peridynamics 6. AUTHOR(S) 5b. GRANT NUMBER N00014-16-1-2173 5c...NUMBER 8. PERFORMING ORGANIZATION REPORT NUMBER Texas A&M Engineering Experiment Station (TEES) 400 Harvey Mitchell Parkway, Suite 300 College...1.3 related to Synergistic Damage Mechanics and Tasks 2.2 and 2.4 related to Peridynamics, as described in the project proposal. The activities

  20. La Terapia de Aceptación y Compromiso (ACT) en el consumo de sustancias como estrategia de Evitación Experiencial

    OpenAIRE

    Carmen Luciano; Marisa Páez-Blarrina; Sonsoles Valdivia-Salas

    2010-01-01

    Numerosos estudios han corroborado que la regulación de los eventos privados focalizada en la evitación experiencial juega un papel fundamental, tanto en el desarrollo de las adicciones como en su mantenimiento, llegando a producir el patrón destructivo que caracteriza a las personas ancladas en el consumo desajustado de sustancias. Las contingencias a la base del comportamiento adictivo constituyen el Trastorno de Evitación Experiencial (TEE) que implica una estrategia inflexible, formada po...