Durability of central aortic valve closure in patients with continuous flow left ventricular assist devices.

Science.gov (United States)

McKellar, Stephen H; Deo, Salil; Daly, Richard C; Durham, Lucian A; Joyce, Lyle D; Stulak, John M; Park, Soon J

2014-01-01

A competent aortic valve is essential to providing effective left ventricular assist device support. We have adopted a practice of central aortic valve closure by placing a simple coaptation stitch at left ventricular assist device implantation in patients with significant aortic insufficiency. We conducted a follow-up study to evaluate the efficacy and durability of this procedure. The study included patients who had undergone continuous flow left ventricular assist device implantation. The patients were divided into 2 groups, those who did not require any aortic procedure because the valve was competent and those who underwent central aortic valve closure for mild or greater aortic regurgitation. The clinical endpoints were mortality, progression or recurrence of aortic insufficiency, and reoperation for aortic valve pathologic features. Aortic insufficiency was measured qualitatively from mild to severe on a scale of 0 to 5. A total of 123 patients received continuous flow left ventricular assist devices from February 2007 to August 2011. Of those, 18 (15%) underwent central aortic valve closure at left ventricular assist device implantation because of significant aortic insufficiency (1.8 ± 1.4) and 105 who did not (competent aortic valve, 0.15 ± 0.43; P assist device-supported patients, with follow-up extending into 2 years. Although aortic insufficiency progressed over time in those with minimal native valve regurgitation initially, no such progression was noted in those with central aortic valve closure. Additional investigation is needed to evaluate whether prophylactic central aortic valve closure should be performed at left ventricular assist device implantation to avoid problematic aortic regurgitation developing over time, in particular in patients undergoing left ventricular assist device implantation for life-long (destination therapy) support. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights

Case report 373: Diametaphyseal chrondroblastoma of the upper portion of the left femur

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Sotelo-Avila, C.; Sundaram, M.; Graviss, E.R.; Kyriakos, M.; Tayob, A.A.

1986-06-01

In summary, a case has been presented of a chondroblastoma of the diametaphysis of the upper end of the left femur in an 11-year-old girl. Despite its atypical location, the tumor proved to be a characteristic chondroblastoma on microscopic examination. The literature was reviewed comprehensively and it was noted that 12 examples of chondroblastoma arising outside an epiphysis (or apophysis) were noted. (orig./SHA).

Rupture of the right upper pulmonary vein and left atrium caused by blunt chest trauma.

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Osaka, Motoo; Nagai, Ryo; Koishizawa, Tadashi

2017-11-01

A 49-year-old man was transferred to our hospital by ambulance due to blunt chest trauma sustained in a car accident. Echocardiography and enhanced computed tomography showed hemopericardium without other vital organ damage. Emergent surgery was performed under strong suspicion of traumatic cardiac rupture. Careful inspection showed a rupture of the right upper pulmonary vein at the junction of the left atrium, a laceration of the inferior vena cava, and a left-side pericardium rupture, and they were repaired with running 4-0 polypropylene suture. Postoperative hemodynamics were stable. The patient was discharged ambulatory on postoperative day 15.

[Left lateral gaze paresis due to subcortical hematoma in the right precentral gyrus].

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Sato, K; Takamori, M

1998-03-01

We report a case of transient left lateral gaze paresis due to a hemorrhagic lesion restricted in the right precentral gyrus. A 74-year-old female experienced a sudden clumsiness of the left upper extremity. A neurological examination revealed a left central facial paresis, distal dominant muscle weakness in the left upper limb and left lateral gaze paresis. There were no other focal neurological signs. Laboratory data were all normal. Brain CTs and MRIs demonstrated a subcortical hematoma in the right precentral gyrus. The neurological symptoms and signs disappeared over seven days. A recent physiological study suggested that the human frontal eye field (FEF) is located in the posterior part of the middle frontal gyrus (Brodmann's area 8) and the precentral gyrus around the precentral sulcus. More recent studies stressed the role of the precentral sulcus and the precentral gyrus. Our case supports those physiological findings. The hematoma affected both the FEF and its underlying white matter in our case. We assume the lateral gaze paresis is attributable to the disruption of the fibers from the FEF. It is likely that fibers for motor control of the face, upper extremity, and lateral gaze lie adjacently in the subcortical area.

Aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery arising from the right pulmonary artery: A case report

International Nuclear Information System (INIS)

Cho, Yong Seok; Kang, Mi Jin; Bae, Kyung Eun; Lee, Jin Hae; Lee, Han Bee; Kim, Jae Hyung; Jeong, Myeong Ja; Kang, Tae Kyung

2013-01-01

Aberrant origins of the pulmonary artery are rare anomalies, but are being reported several times in the world literature. Among them, pulmonary artery sling is the most well known anomaly, which is the left pulmonary artery arising from the right pulmonary artery. In case of pulmonary artery sling, the left pulmonary artery causes compression of the trachea and esophagus while it courses in between. In this case, we describe a case on incidentally found aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery without any compressions of the esophagus or trachea. In the world literature, aberrant origins of the left pulmonary artery without pulmonary artery sling was reported at one time, but currently, this is the first case of aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery arising from the right pulmonary artery.

Aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery arising from the right pulmonary artery: A case report

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Cho, Yong Seok; Kang, Mi Jin; Bae, Kyung Eun; Lee, Jin Hae; Lee, Han Bee; Kim, Jae Hyung; Jeong, Myeong Ja; Kang, Tae Kyung [Sanggye Paik Hospital, Inje University College of Medicine, Seoul, (Korea, Republic of)

2013-10-15

Aberrant origins of the pulmonary artery are rare anomalies, but are being reported several times in the world literature. Among them, pulmonary artery sling is the most well known anomaly, which is the left pulmonary artery arising from the right pulmonary artery. In case of pulmonary artery sling, the left pulmonary artery causes compression of the trachea and esophagus while it courses in between. In this case, we describe a case on incidentally found aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery without any compressions of the esophagus or trachea. In the world literature, aberrant origins of the left pulmonary artery without pulmonary artery sling was reported at one time, but currently, this is the first case of aberrant origin of the upper left lobe anterior and superior lingular segmental pulmonary artery arising from the right pulmonary artery.

Upper Mantle Discontinuities Underneath Central and Southern Mexico

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Perez-Campos, X.; Clayton, R. W.

2011-12-01

Central and southern Mexico are affected by the subduction of Cocos plate beneath North American plate. The MesoAmerican Subduction Experiment (MASE) and the Veracruz-Oaxaca (VEOX) project have mapped the geometry of the Cocos slab. It is characterized in central Mexico by a shallow horizontal geometry up to ~300 km from the trench, then it dives steeply (70°) into the mantle, to its apparent end at 500 km depth. In contrast, some 400 km to the south, the slab subducts smoothly, with a dip angle of ~26° to a depth of 150 km. We use receiver functions from teleseismic events, recorded at stations from MASE, VEOX, and the Servicio Sismológico Nacional (SSN, Mexican National Seismological Service) to map the upper mantle discontinuities and properties of the transition zone in central and southern Mexico. We also use data from the Mapping the Rivera Subduction Zone (MARS) Experiment to get a complete picture of the subduction regime in central Mexico and compare the mantle transition zone in a slab tear regime. The 410 discontinuity shows significant variation in topography in central Mexico, particularly where the slab is expected to reach such depth. The 660 discontinuity shows a smoother topography, indicating that the slab does not penetrate this far down. The results will be compared with a ridge regime in the Gulf of California.

Torque Control During Intrusion on Upper Central Incisor in Labial and Lingual bracket System - A 3D Finite Element Study.

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Pol, Tejas R; Vandekar, Meghna; Patil, Anuradha; Desai, Sanjana; Shetty, Vikram; Hazarika, Saptarshi

2018-01-01

The aim of present study was to investigate the difference of torque control during intrusive force on upper central incisors with normal, under and high torque in lingual and labial orthodontic systems through 3D finite element analysis. Six 3D models of an upper right central incisor with different torque were designed in Solid Works 2006. Software ANSYS Version 16.0 was used to evaluate intrusive force on upper central incisor model . An intrusive force of 0.15 N was applied to the bracket slot in different torque models and the displacements along a path of nodes in the upper central incisor was assessed. On application of Intrusive force on under torqued upper central incisor in Labial system produce labial crown movement but in Lingual system caused lingual movement in the apical and incisal parts. The same intrusive force in normal-torqued central incisor led to a palatal movement in apical and labial displacement of incisal edge in Lingual system and a palatal displacement in apical area and a labial movement in the incisal edge in Labial systemin. In overtorqued upper central incisor, the labial crown displacement in Labial system is more than Lingual system. In labial and lingual system on application of the same forces in upper central incisor with different inclinations showed different responses. The magnitudes of torque Loss during intrusive loads in incisors with normal, under and over-torque were higher in Labial system than Lingual orthodontic appliances. Key words: FEM, lingual orthodontics, intrusion, torque control, labial bracket systems.

[Successful One-lung Ventilation with a Right-sided Double-lumen Tube in a Patient with a Right Upper Tracheal Bronchus, who Underwent Left Pneumonectomy for Left Hilar Lung Cancer].

Science.gov (United States)

Kawagoe, Izumi; Kohchiyama, Tsukasa; Hayashida, Masakazu; Satoh, Daizoh; Suzuki, Kenji; Inada, Eiichi

2016-06-01

A 60-year-old male patient with left hilar lung cancer was scheduled to undergo left pneumonectomy or left sleeve lower lobectomy. Preoperative computer tomographic and bronchoscopic examinations revealed that the bronchus (B1) to the right apical segment (S1) was a tracheal bronchus (TB) originating from the trachea approximately 10 mm above the carina. Because the left main bronchus was to be dissected, a right-sided double-lumen tube (DLT) was selected to completely protect the right lung from spillage of secretions or cancer cells from the left lung. The right-sided DLT was placed so as to fit its lateral opening of the bronchial lumen to normal upper branches (B2, B3), while sacrificing ventilation of S1 with an abnormal branch (B1). However, one-lung ventilation (OLV) of the right lung could not be achieved, since a gas leakage from the opened tracheal lumen occurred, most probably due to intra-lobar micro-airway communications between S1 and S2/S3. The DLT was withdrawn until the blue bronchial cuff occluded the orifice of the TB (B1). Although the upper half of the blue bronchial cuff appeared above the tracheal carina, OLV through the two bronchial lumen openings could be achieved due to a specific, slanted doughnut shape of the blue bronchial cuff and the location of the abnormal branch (B1) approximate to the carina. Left pneumonectomy using successful OLV was completed safely without hypoxemia or hypercapnea. Our experience indicates that management of OLV for patients with a thoracheal bronchus needs special considerations of the exact location of the TB and intra-lobar micro-airway communications, in addition to types of scheduled surgical procedures.

Non-intubated uniportal left-lower lobe upper segmentectomy (S6).

Science.gov (United States)

Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Sesma, Julio; Lirio, Francisco; Galiana, Maria; Rivera, Maria Jesus

2017-01-01

Worldwide accepted indications of anatomical segmentectomies are mainly early stage primary adenocarcinomas, pulmonary metastasis and benign conditions. Their performance through uniportal VATS has become more and more popular due to the less invasiveness of the whole procedure under this approach. Recently, many efforts have focused on non-intubated spontaneously breathing management of lobectomies and anatomical segmentectomies, although specific selection criteria and main advantages are not completely standardized. In a 62-year-old thin man with two pulmonary residual metastasis from sigma adenocarcinoma, after chemotherapy plus antiangiogenic treatment, we indicated a single-incision video-assisted left-lower lobe (LLL) upper segmentectomy (S6) under spontaneous breathing and intercostal blockade. Total operation time was 240 minutes. Chest tube was removed at 24 hours and the patient was discharge on postoperative day 2 without any complication. Non-intubated uniportal VATS is a safe and reasonable approach for lung-sparing resections in selected patients, although more evidence is required for selecting which patients can benefit more over standard intubated procedures.

Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction

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Tae Hoon Kim

2015-12-01

Full Text Available A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction.

Science.gov (United States)

Kim, Tae Hoon; Shin, Yu Rim; Kim, Young Sam; Kim, Do Jung; Kim, Hyohyun; Shin, Hong Ju; Htut, Aung Thein; Park, Han Ki

2015-12-01

A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

(Mis)placed central venous catheter in the left superior intercostal vein

International Nuclear Information System (INIS)

Padovan, Ranka Stern; Paar, Maja Hrabak; Aurer, Igor

2010-01-01

Chest X-ray is routinely performed to check the position of the central venous catheter (CVC) inserted through the internal jugular or subclavian vein, while the further evaluation of CVC malfunction is usually performed by contrast venography. In patients with superior vena cava obstruction, the tip of the catheter is often seen in collateral mediastinal venous pathways, rather than in the superior vena cava. In such cases detailed knowledge of thoracic vessel anatomy is necessary to identify the exact location of the catheter. We report a case of 32-year-old female patient with relapsing mediastinal lymphoma and previous superior vena cava obstruction with collateral azygos-hemiazygos venous pathways. The patient had CVC inserted through the left subclavian vein and its position was detected by CT to be in the dilated left superior intercostal vein and accessory hemiazygos vein. Considering that dilated accessory hemiazygos vein can tolerate infusion, the CVC was left in place and the patient had no complaints related to CVC (mal)position. Furthermore, we present anatomical and radiological observations on the azygos-hemiazygos venous system with the special emphasis on the left superior intercostal vein. Non-contrast CT scans can be a valuable imaging tool in the detection of the CVC position, especially in patients with renal insufficiency and contrast media hypersensitivity

Fatal stroke after completion pneumonectomy for torsion of left upper lobe following left lower lobectomy

Directory of Open Access Journals (Sweden)

Apostolakis Efstratios

2006-09-01

Full Text Available Abstract Background The lobar torsion after lung surgery is a rare complication with an incidence of 0.09 to 0.4 %. It may occur after twisting of the bronchovascular pedicle of the remaining lobe after lobectomy, usually on the right side. The 180-degree rotation of the pedicle produces an acute obstruction of the lobar bronchus (atelectasis and of the lobar vessels as well. Without prompt treatment it progresses to lobar ischemia, pulmonary infarction and finally fatal gangrene. Case Presentation A 62 years old female patient was admitted for surgical treatment of lung cancer. She underwent elective left lower lobectomy for squamous cell carcinoma (pT2 N0. The operation was unremarkable, and the patient was extubated in the operating room. After eight hours the patient established decrease of pO2 and chest x-ray showed atelectasis of the lower lobe. To establish diagnosis, bronchoscopy was performed, demonstrating obstructed left lobar bronchus. The patient was re-intubated, and admitted to the operating room where reopening of the thoracotomy was performed. Lobar torsion was diagnosed, with the diaphragmatic surface of the upper lobe facing in an anterosuperior orientation. A completion pneumonectomy was performed. At the end of the procedure the patient developed a right pupil dilatation, presumably due to a cerebral embolism. A subsequent brain angio-CT scan established the diagnosis. She died at the intensive care unit 26 days later. Conclusion The thoracic surgeon should suspect this rare early postoperative complication after any thoracic operation in every patient with atelectasis of the neighboring lobe. High index of suspicion and prompt diagnosis may prevent catastrophic consequences, such as, infarction or gangrene of the pulmonary lobe. During thoracic operations, especially whenever the lung or lobe hilum is full mobilized, fixation of the remaining lobe may prevent this life threatening complication.

Divergent functions of the left and right central amygdala in visceral nociception.

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Sadler, Katelyn E; McQuaid, Neal A; Cox, Abigail C; Behun, Marissa N; Trouten, Allison M; Kolber, Benedict J

2017-04-01

The left and right central amygdalae (CeA) are limbic regions involved in somatic and visceral pain processing. These 2 nuclei are asymmetrically involved in somatic pain modulation; pain-like responses on both sides of the body are preferentially driven by the right CeA, and in a reciprocal fashion, nociceptive somatic stimuli on both sides of the body predominantly alter molecular and physiological activities in the right CeA. Unknown, however, is whether this lateralization also exists in visceral pain processing and furthermore what function the left CeA has in modulating nociceptive information. Using urinary bladder distension (UBD) and excitatory optogenetics, a pronociceptive function of the right CeA was demonstrated in mice. Channelrhodopsin-2-mediated activation of the right CeA increased visceromotor responses (VMRs), while activation of the left CeA had no effect. Similarly, UBD-evoked VMRs increased after unilateral infusion of pituitary adenylate cyclase-activating polypeptide in the right CeA. To determine intrinsic left CeA involvement in bladder pain modulation, this region was optogenetically silenced during noxious UBD. Halorhodopsin (NpHR)-mediated inhibition of the left CeA increased VMRs, suggesting an ongoing antinociceptive function for this region. Finally, divergent left and right CeA functions were evaluated during abdominal mechanosensory testing. In naive animals, channelrhodopsin-2-mediated activation of the right CeA induced mechanical allodynia, and after cyclophosphamide-induced bladder sensitization, activation of the left CeA reversed referred bladder pain-like behaviors. Overall, these data provide evidence for functional brain lateralization in the absence of peripheral anatomical asymmetries.

Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

International Nuclear Information System (INIS)

Gonsalves, Carin F.; Eschelman, David J.; Sullivan, Kevin L.; DuBois, Nancy; Bonn, Joseph

2003-01-01

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine catheter dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices

Potentiometric surface of the upper Floridan aquifer, west-central Florida, May 2011

Science.gov (United States)

Ortiz, Anita G.

2011-01-01

The Floridan aquifer system consists of the Upper and Lower Floridan aquifers separated by the middle confining unit. The middle confining unit and the Lower Floridan aquifer in west-central Florida generally contain highly mineralized water. The water-bearing units containing freshwater are herein referred to as the Upper Floridan aquifer. The Upper Floridan aquifer is the principal source of water in the Southwest Florida Water Management District and is used for major public supply, domestic use, irrigation, and brackish water desalination in coastal communities (Southwest Florida Water Management District, 2000). This map report shows the potentiometric surface of the Upper Floridan aquifer measured in May 2011. The potentiometric surface is an imaginary surface connecting points of equal altitude to which water will rise in tightly-cased wells that tap a confined aquifer system (Lohman, 1979). This map represents water-level conditions near the end of the dry season, when groundwater levels usually are at an annual low and withdrawals for agricultural use typically are high. The cumulative average rainfall of 45.74 inches for west-central Florida (from June 2010 through May 2011) was 6.85 inches below the historical cumulative average of 52.59 inches (Southwest Florida Water Management District, 2011). Historical cumulative averages are calculated from regional rainfall summary reports (1915 to most recent complete calendar year) and are updated monthly by the Southwest Florida Water Management District. This report, prepared by the U.S. Geological Survey in cooperation with the Southwest Florida Water Management District, is part of a semi-annual series of Upper Floridan aquifer potentiometric-surface map reports for west-central Florida. Potentiometric-surface maps have been prepared for January 1964, May 1969, May 1971, May 1973, May 1974, and for each May and September from 1975 through 2010. Water-level data are collected in May and September each year to

Incidence of upper limb venous thrombosis associated with peripherally inserted central catheters (PICC).

Science.gov (United States)

Abdullah, B J J; Mohammad, N; Sangkar, J V; Abd Aziz, Y F; Gan, G G; Goh, K Y; Benedict, I

2005-07-01

The objective of this study was to prospectively determine the incidence of venous thrombosis (VT) in the upper limbs in patients with peripherally inserted central catheters (PICC). We prospectively investigated the incidence of VT in the upper limbs of 26 patients who had PICC inserted. The inclusion criteria were all patients who had a PICC inserted, whilst the exclusion criterion was the inability to perform a venogram (allergies, previous contrast medium reaction and inability of gaining venous access). Both valved and non-valved catheters were evaluated. Prior to removal of the PICC, an upper limb venogram was performed. The number of segments involved with VT were determined. The duration of central venous catheterization was classified as; less than 6 days, between 6 days and 14 days and more than 14 days. VT was confirmed in 38.5% (10/26) of the patients. The majority 85.7% (12/14) were complete occlusive thrombi and the majority of VT only involved one segment. There was no statistical correlation between the site of insertion of the PICC and the location of VT. Neither was there any observed correlation between the occurrence of VT with the patient's history of hypertension, hypercholesterolaemia, coronary artery disease, diabetes mellitus, cardiac insufficiency, smoking or cancer. There was also no statistical correlation with the size of the catheter. In conclusion, PICCs are associated with a significant risk of upper extremity deep vein thrombosis (UEVT).

Potentiometric Surface of the Upper Floridan Aquifer, West-Central Florida, May 2006

Science.gov (United States)

Ortiz, A.G.

2007-01-01

Introduction Hydrologic Conditions in West-Central Florida The Floridan aquifer system consists of the Upper and Lower Floridan aquifers separated by the middle confining unit. The middle confining unit and the Lower Floridan aquifer in west-central Florida generally contain highly mineralized water. The water-bearing units containing fresh water are herein referred to as the Upper Floridan aquifer. The Upper Floridan aquifer is the principal source of water in the Southwest Florida Water Management District and is used for major public supply, domestic use, irrigation, and brackish water desalination in coastal communities (Southwest Florida Water Management District, 2000). This map report shows the potentiometric surface of the Upper Floridan aquifer measured in May 2006. The potentiometric surface is an imaginary surface connecting points of equal altitude to which water will rise in tightly-cased wells that tap a confined aquifer system (Lohman, 1979). This map represents water-level conditions near the end of the dry season, when ground-water levels usually are at an annual low and withdrawals for agricultural use typically are high. The cumulative average rainfall of 50.23 inches for west-central Florida (from June 2005 through May 2006) was 2.82 inches below the historical cumulative average of 53.05 inches (Southwest Florida Water Management District, 2006). Historical cumulative averages are calculated from regional rainfall summary reports (1915 to most recent complete calendar year) and are updated monthly by the Southwest Florida Water Management District. This report, prepared by the U.S. Geological Survey in cooperation with the Southwest Florida Water Management District, is part of a semi-annual series of Upper Floridan aquifer potentiometric-surface map reports for west-central Florida. Potentiometric-surface maps have been prepared for January 1964, May 1969, May 1971, May 1973, May 1974, and for each May and September since 1975. Water

Potentiometric Surface of the Upper Floridan Aquifer, West-Central Florida, September 2006

Science.gov (United States)

Ortiz, A.G.

2007-01-01

The Floridan aquifer system consists of the Upper and Lower Floridan aquifers separated by the middle confining unit. The middle confining unit and the Lower Floridan aquifer in west-central Florida generally contain highly mineralized water. The water-bearing units containing freshwater are herein referred to as the Upper Floridan aquifer. The Upper Floridan aquifer is the principal source of water in the Southwest Florida Water Management District and is used for major public supply, domestic use, irrigation, and brackish water desalination in coastal communities (Southwest Florida Water Management District, 2000). This map report shows the potentiometric surface of the Upper Floridan aquifer measured in September 2006. The potentiometric surface is an imaginary surface connecting points of equal altitude to which water will rise in tightly cased wells that tap a confined aquifer system (Lohman, 1979). This map represents water-level conditions near the end of the wet season, when ground-water levels usually are at an annual high and withdrawals for agricultural use typically are low. The cumulative average rainfall of 46.06 inches for west-central Florida (from October 2005 through September 2006) was 6.91 inches below the historical cumulative average of 52.97 inches (Southwest Florida Water Management District, 2006). Historical cumulative averages are calculated from regional rainfall summary reports (1915 to most recent complete calendar year) and are updated monthly by the Southwest Florida Water Management District. This report, prepared by the U.S. Geological Survey in cooperation with the Southwest Florida Water Management District, is part of a semi-annual series of Upper Floridan aquifer potentiometric-surface map reports for west-central Florida. Potentiometric-surface maps have been prepared for January 1964, May 1969, May 1971, May 1973, May 1974, and for each May and September since 1975. Water-level data are collected in May and September each

Potentiometric Surface of the Upper Floridan Aquifer, West-Central Florida, September 2007

Science.gov (United States)

Ortiz, A.G.

2008-01-01

The Floridan aquifer system consists of the Upper and Lower Floridan aquifers separated by the middle confining unit. The middle confining unit and the Lower Floridan aquifer in west-central Florida generally contain highly mineralized water. The water-bearing units containing fresh water are herein referred to as the Upper Floridan aquifer. The Upper Floridan aquifer is the principal source of water in the Southwest Florida Water Management District and is used for major public supply, domestic use, irrigation, and brackish water desalination in coastal communities (Southwest Florida Water Management District, 2000). This map report shows the potentiometric surface of the Upper Floridan aquifer measured in September 2007. The potentiometric surface is an imaginary surface connecting points of equal altitude to which water will rise in tightly-cased wells that tap a confined aquifer system (Lohman, 1979). This map represents water-level conditions near the end of the wet season, when ground-water levels usually are at an annual high and withdrawals for agricultural use typically are low. The cumulative average rainfall of 39.50 inches for west-central Florida (from October 2006 through September 2007) was 13.42 inches below the historical cumulative average of 52.92 inches (Southwest Florida Water Management District, 2007). Historical cumulative averages are calculated from regional rainfall summary reports (1915 to most recent complete calendar year) and are updated monthly by the Southwest Florida Water Management District. This report, prepared by the U.S. Geological Survey in cooperation with the Southwest Florida Water Management District, is part of a semi-annual series of Upper Floridan aquifer potentiometric-surface map reports for west-central Florida. Potentiometric-surface maps have been prepared for January 1964, May 1969, May 1971, May 1973, May 1974, and for each May and September since 1975. Water-level data are collected in May and September each

Potentiometric surface of the Upper Floridan aquifer, west-central Florida, September 2005

Science.gov (United States)

Ortiz, A.G.

2006-01-01

The Floridan aquifer system consists of the Upper and Lower Floridan aquifers separated by the middle confining unit. The middle confining unit and the Lower Floridan aquifer in west-central Florida generally contain highly mineralized water. The water-bearing units containing freshwater are herein referred to as the Upper Floridan aquifer. The Upper Floridan aquifer is the principal source of water in the Southwest Florida Water Management District and is used for major public-supply, domestic use, irrigation, and brackish-water desalination in coastal communities (Southwest Florida Water Management District, 2000).This map report shows the potentiometric surface of the Upper Floridan aquifer measured in September 2005. The potentiometric surface is an imaginary surface, connecting points of equal altitude to which water will rise in tightly cased wells that tap a confined aquifer system (Lohman, 1979). This map represents water-level conditions near the end of the wet season, when ground-water levels usually are at an annual high and withdrawals for agricultural use typically are low. The cumulative average rainfall of 55.19 inches for west-central Florida (from October 2004 through September 2005) was 2.00 inches above the historical cumulative average of 53.19 inches (Southwest Florida Water Management District, 2005). Historical cumulative averages are calculated from regional rainfall summary reports (1915 to most recent complete calendar year) and are updated monthly by the Southwest Florida Water Management District.This report, prepared by the U.S. Geological Survey in cooperation with the Southwest Florida Water Management District, is part of a semi-annual series of Upper Floridan aquifer potentiometric-surface map reports for west-central Florida. Potentiometric-surface maps have been prepared for January 1964, May 1969, May 1971, May 1973, May 1974, and for each May and September since 1975. Water-level data are collected in May and September each year

Potentiometric Surface of the Upper Floridan Aquifer, West-Central Florida, May 2007

Science.gov (United States)

Ortiz, A.G.

2008-01-01

The Floridan aquifer system consists of the Upper and Lower Floridan aquifers separated by the middle confining unit. The middle confining unit and the Lower Floridan aquifer in west-central Florida generally contain highly mineralized water. The water-bearing units containing fresh water are herein referred to as the Upper Floridan aquifer. The Upper Floridan aquifer is the principal source of water in the Southwest Florida Water Management District and is used for major public supply, domestic use, irrigation, and brackish water desalination in coastal communities (Southwest Florida Water Management District, 2000). This map report shows the potentiometric surface of the Upper Floridan aquifer measured in May 2007. The potentiometric surface is an imaginary surface connecting points of equal altitude to which water will rise in tightly-cased wells that tap a confined aquifer system (Lohman, 1979). This map represents water-level conditions near the end of the dry season, when ground-water levels usually are at an annual low and withdrawals for agricultural use typically are high. The cumulative average rainfall of 41.21 inches for west-central Florida (from June 2006 through May 2007) was 11.63 inches below the historical cumulative average of 52.84 inches (Southwest Florida Water Management District, 2007). Historical cumulative averages are calculated from regional rainfall summary reports (1915 to most recent complete calendar year) and are updated monthly by the Southwest Florida Water Management District. This report, prepared by the U.S. Geological Survey in cooperation with the Southwest Florida Water Management District, is part of a semi-annual series of Upper Floridan aquifer potentiometric-surface map reports for west-central Florida. Potentiometric-surface maps have been prepared for January 1964, May 1969, May 1971, May 1973, May 1974, and for each May and September since 1975. Water-level data are collected in May and September each year to show the

[Kinematics Modeling and Analysis of Central-driven Robot for Upper Limb Rehabilitation after Stroke].

Science.gov (United States)

Yi, Jinhua; Yu, Hongliu; Zhang, Ying; Hu, Xin; Shi, Ping

2015-12-01

The present paper proposed a central-driven structure of upper limb rehabilitation robot in order to reduce the volume of the robotic arm in the structure, and also to reduce the influence of motor noise, radiation and other adverse factors on upper limb dysfunction patient. The forward and inverse kinematics equations have been obtained with using the Denavit-Hartenberg (D-H) parameter method. The motion simulation has been done to obtain the angle-time curve of each joint and the position-time curve of handle under setting rehabilitation path by using Solid Works software. Experimental results showed that the rationality with the central-driven structure design had been verified by the fact that the handle could move under setting rehabilitation path. The effectiveness of kinematics equations had been proved, and the error was less than 3° by comparing the angle-time curves obtained from calculation with those from motion simulation.

Middle-to-Upper Palaeolithic site formation processes at the Bordes-Fitte rockshelter (Central France)

DEFF Research Database (Denmark)

Aubry, Thierry; Dimuccio, Luca Antonio; Buylaert, Jan-Pieter

2014-01-01

. In this article we use the Middle and Early Upper Palaeolithic archaeo-stratigraphic record from the Bordes-Fitte rockshelter (les Roches d'Abilly site, Central France), a Bayesian analysis of the ages obtained by accelerator mass spectrometry radiocarbon on ultrafiltered collagen and by luminescence on quartz...

Fracture resistance of upper central incisors restored with different posts and cores

Directory of Open Access Journals (Sweden)

Maryam Rezaei Dastjerdi

2015-08-01

Full Text Available Objectives To determine and compare the fracture resistance of endodontically treated maxillary central incisors restored with different posts and cores. Materials and Methods Forty-eight upper central incisors were randomly divided into four groups: cast post and core (group 1, fiber-reinforced composite (FRC post and composite core (group 2, composite post and core (group 3, and controls (group 4. Mesio-distal and bucco-lingual dimensions at 7 and 14 mm from the apex were compared to ensure standardization among the groups. Twelve teeth were prepared for crown restoration (group 4. Teeth in other groups were endodontically treated, decoronated at 14 mm from the apex, and prepared for posts and cores. Resin-based materials were used for cementation in groups 1 and 2. In group 3, composite was used directly to fill the post space and for core build-up. All samples were restored by standard metal crowns using glass ionomer cement, mounted at 135° vertical angle, subjected to thermomechanical aging, and then fractured using a universal testing machine. Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data. Results Fracture resistance of the groups was as follows: Control (group 4 > cast post and core (group 1 > fiber post and composite core (group 2 > composite post and core (group 3. All samples in groups 2 and 3 fractured in restorable patterns, whereas most (58% in group 1 were non-restorable. Conclusions Within the limitations of this study, FRC posts showed acceptable fracture resistance with favorable fracture patterns for reconstruction of upper central incisors.

Rodents from the Upper Miocene Tuğlu Formation (Çankırı Basin, Central Anatolia, Turkey)

NARCIS (Netherlands)

Joniak, Peter; de Bruijn, Hans

2015-01-01

The upper Miocene assemblages of rodents collected from two layers of the type section of the Tuğlu Formation (Çankırı Basin, Central Anatolia, Turkey) are described. The assemblage from the lower level is considerably less diverse than that from the upper level. It contains Progonomys together with

VARIATION IN THE OPENINGS (OSTIA OF LEFT PULMONARY VEINS INTO THE LEFT ATRIUM: A CASE REPORT

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Sesi

2015-03-01

Full Text Available During early embryonic development, absorption of pulmonary venous network by the left primitive atrial chamber results in opening of four pulmonary veins which drain independently into its chamber. The extent of absorption and hence, the number of pulmon ary veins which open into the left atrium, may vary. Here we report a variation in the opening of the Left upper (superior pulmonary vein into the Left atrium. A total of six openings observed

Additional Gigantoproductus species from the upper Visean-Namurian limestone of Kotaki, central Japan

OpenAIRE

Ibaraki, Yousuke; Tazawa, Jun-ichi; Nakamura, Yukio

2010-01-01

A large productid brachiopod species, Gigantoproductus aurita (Bolkhovitinova, 1938), is described from the Tsuchikurazawa Limestone (upper Visean-Namurian), a large limestone block within a Permian accretionary complex of Kotaki, Itoigawa City, Niigata Prefecture, central Japan. This is the fourth described Gigantoproductus species from the Tsuchikurazawa Limestone. The range of G. aurita may extend to late Visean on the basis of the previous fossil records of the limestone.

Rodents from the Upper Miocene Tuğlu Formation (Çankırı Basin, Central Anatolia, Turkey)

OpenAIRE

Joniak, Peter; de Bruijn, Hans

2015-01-01

The upper Miocene assemblages of rodents collected from two layers of the type section of the Tuğlu Formation (Çankırı Basin, Central Anatolia, Turkey) are described. The assemblage from the lower level is considerably less diverse than that from the upper level. It contains Progonomys together with Megacricetodon, which is a very unusual association. The assemblage from the upper layer shows a relatively high diversity with four species of Gliridae instead of only one in the lower layer. Apa...

Periglacial fires and trees in a continental setting of Central Canada, Upper Pleistocene.

Science.gov (United States)

Bélanger, N; Carcaillet, C; Padbury, G A; Harvey-Schafer, A N; Van Rees, K J C

2014-03-01

Fire is a key factor controlling global vegetation patterns and carbon cycling. It mostly occurs under warm periods during which fuel builds up with sufficient moisture, whereas such conditions stimulate fire ignition and spread. Biomass burning increased globally with warming periods since the last glacial era. Data confirming periglacial fires during glacial periods are very sparse because such climates are likely too cold to favour fires. Here, tree occurrence and fires during the Upper Pleistocene glacial periods in Central Canada are inferred from botanical identification and calibrated radiocarbon dates of charcoal fragments. Charcoal fragments were archived in sandy dunes of central Saskatchewan and were dated >50000-26600 cal BP. Fragments were mostly gymnosperms. Parallels between radiocarbon dates and GISP2-δ¹⁸O records deciphered relationships between fire and climate. Fires occurred either hundreds to thousands of years after Dansgaard-Oeschger (DO) interstadial warming events (i.e., the time needed to build enough fuel for fire ignition and spread) or at the onset of the DO event. The chronological uncertainties result from the dated material not precisely matching the fires and from the low residual ¹⁴C associated with old sample material. Dominance of high-pressure systems and low effective moisture during post-DO coolings likely triggered flammable periglacial ecosystems, while lower moisture and the relative abundance of fuel overshadowed lower temperatures for fire spread. Laurentide ice sheet (LIS) limits during DO events are difficult to assess in Central Canada due to sparse radiocarbon dates. Our radiocarbon data set constrains the extent of LIS. Central Saskatchewan was not covered by LIS throughout the Upper Pleistocene and was not a continental desert. Instead, our results suggest long-lasting periods where fluctuations of the northern tree limits and fires after interstadials occurred persistently. © 2014 John Wiley & Sons Ltd.

Anesthetic Management of Patients Undergoing Right Lung Surgery After Left Upper Lobectomy: Selection of Tubes for One-Lung Ventilation (OLV) and Oxygenation During OLV.

Science.gov (United States)

Kawagoe, Izumi; Hayashida, Masakazu; Suzuki, Kenji; Kitamura, Yoshitaka; Oh, Shiaki; Satoh, Daizoh; Inada, Eiichi

2016-08-01

To investigate anesthesia management in patients undergoing right lung surgery after a previous left upper lobectomy (LUL) that may require special precautions since angulation of the left bronchus can hamper correct placement of a left-sided double-lumen tube (DLT), and one-lung ventilation (OLV) depending solely on the left lower lobe may lead to inadequate oxygenation. A retrospective data analysis. Single university hospital. Patients underwent right lung surgery after previous LUL. None. Anesthesia management was investigated in 18 patients who underwent right lung surgery following LUL. All intubation procedures were performed under bronchoscopic guidance to prevent airway trauma. OLV could be achieved with a left-sided DLT in 12 patients, while tubes other than this were required in 6 patients, including a right-sided DLT (n = 3) and a bronchial blocker (n = 3). The presence or absence of remarkable bronchial angulation, characterized by a combination of a wide (>140°) angle between the trachea and left main bronchus and a narrow (right lung surgery after LUL. Copyright © 2016 Elsevier Inc. All rights reserved.

Central hemodynamics and left-ventricural contractility in patients with chronic obstructive pulmonary diseases and stable pulmonary hypertension: a radionuclide study

International Nuclear Information System (INIS)

Paleev, N.R.; Malov, G.A.; Cherejskaya, N.K.; Oblovatskaya, O.G.; Tsar'kova, L.N.; Zil'berman, E.Eh.; Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Serdechno-Sosudistoj Khirurgii)

1987-01-01

Systemic, central and intracardiac hemodynamics and left-ventricular contractility were studied radiocardiographically and radioventriculographically in 22 patients with stable pulmanory hypertension, developing in the presence of chronic obstructive pulmanory diseases. A tendency to increased circulating blood volume, significantly elevated end diastolic and end systolic indices, reduced total ejection fraction, and a tendency to decreased segmental ejection fractions were demonstrated. A significant reduction of the speed and percetage of left-ventricular myocardial circular fibre contraction is another evedence of incompetent left-ventricular contractility, in addition to the reduced ejection fraction

The influence of upper-crust lithology on topographic development in the central Coast Ranges of California

Science.gov (United States)

Garcia, A.F.; Mahan, S.A.

2012-01-01

A fundamental geological tenet is that as landscapes evolve over graded to geologic time, geologic structures control patterns of topographic distribution in mountainous areas such that terrain underlain by competent rock will be higher than terrain underlain by incompetent rock. This paper shows that in active orogens where markedly weak and markedly strong rocks are juxtaposed along contacts that parallel regional structures, relatively high topography can form where strain is localized in the weak rock. Such a relationship is illustrated by the topography of the central Coast Ranges between the Pacific coastline and the San Andreas fault zone (SAFZ), and along the length of the Gabilan Mesa (the "Gabilan Mesa segment" of the central Coast Ranges). Within the Gabilan Mesa segment, the granitic upper crust of the Salinian terrane is in contact with the accretionary-prism m??lange upper crust of the Nacimiento terrane along the inactive Nacimiento fault zone. A prominent topographic lineament is present along most of this lithologic boundary, approximately 50 to 65. km southwest of the SAFZ, with the higher topography formed in the m??lange on the southwest side of the Nacimiento fault. This paper investigates factors influencing the pattern of topographic development in the Gabilan Mesa segment of the central Coast Ranges by correlating shortening magnitude with the upper-crust compositions of the Salinian and Nacimiento terranes. The fluvial geomorphology of two valleys in the Gabilan Mesa, which is within the Salinian terrane, and alluvial geochronology based on optically-stimulated luminescence (OSL) age estimates, reveal that the magnitude of shortening accommodated by down-to-the-southwest tilting of the mesa since 400ka is less than 1 to 2m. Our results, combined with those of previous studies, indicate that at least 63% to 78% of late-Cenozoic, northeast-southwest directed, upper-crustal shortening across the Gabilan Mesa segment has been accommodated

CHAMBERED HEXACTINELLID SPONGES FROM UPPER TRIASSIC(NORIAN-RHAETIAN? REEFS OF NAYBAND FORMATION IN CENTRAL IRAN

Directory of Open Access Journals (Sweden)

B. SENOWBARI-DARYAN

2012-07-01

Full Text Available This paper describes several chambered hexactinellid sponges, including Casearia iranica n.sp., C. vezvanensis n. sp., C. delijanensis n. sp., Esfahanella magna gen. n. n. sp., and E. parva gen. n. n. sp. from reefs of the Upper Triassic (Norian-Rhaetian Nayband Formation exposed south of the town of Delijan in central Iran. The relative abundance of chambered and non-chambered hexactinellid sponges at this locality - as compared to hypercalcified representatives - highlight the importance of this group of sponges in reef and reefal limestones in central and east Tethys (China, Caucasia, Iran. 

Orthodontic-periodontic intervention of pathological migration of maxillary anterior teeth in advanced periodontal disease.

Science.gov (United States)

Panchal, Anita H; Patel, Vasumati G; Bhavsar, Neeta V; Mehta, Hardik V

2013-05-01

This case report presents a female patient whose chief complaint was of mobile and palatally drifted upper left central incisor which led to malalignment of upper anterior teeth. Orthodontic treatment of upper left central incisor was done with the help of 'Z' spring for the alignment of the upper anterior teeth. It was followed by splinting of upper anterior teeth to improve the stability and masticatory comfort. Regenerative periodontal surgery with Decalcified freeze dried bone allograft was done in relation to upper left central incisor.

Discontinuities Characteristics of the Upper Jurassic Arab-D Reservoir Equivalent Tight Carbonates Outcrops, Central Saudi Arabia

Science.gov (United States)

Abdlmutalib, Ammar; Abdullatif, Osman

2017-04-01

Jurassic carbonates represent an important part of the Mesozoic petroleum system in the Arabian Peninsula in terms of source rocks, reservoirs, and seals. Jurassic Outcrop equivalents are well exposed in central Saudi Arabia and which allow examining and measuring different scales of geological heterogeneities that are difficult to collect from the subsurface due to limitations of data and techniques. Identifying carbonates Discontinuities characteristics at outcrops might help to understand and predict their properties and behavior in the subsurface. The main objective of this study is to identify the lithofacies and the discontinuities properties of the upper Jurassic carbonates of the Arab D member and the Jubaila Formation (Arab-D reservoir) based on their outcrop equivalent strata in central Saudi Arabia. The sedimentologic analysis revealed several lithofacies types that vary in their thickness, abundances, cyclicity and vertical and lateral stacking patterns. The carbonates lithofacies included mudstone, wackestone, packstone, and grainstone. These lithofacies indicate deposition within tidal flat, skeletal banks and shallow to deep lagoonal paleoenvironmental settings. Field investigations of the outcrops revealed two types of discontinuities within Arab D Member and Upper Jubaila. These are depositional discontinuities and tectonic fractures and which all vary in their orientation, intensity, spacing, aperture and displacements. It seems that both regional and local controls have affected the fracture development within these carbonate rocks. On the regional scale, the fractures seem to be structurally controlled by the Central Arabian Graben System, which affected central Saudi Arabia. While, locally, at the outcrop scale, stratigraphic, depositional and diagenetic controls appear to have influenced the fracture development and intensity. The fracture sets and orientations identified on outcrops show similarity to those fracture sets revealed in the upper

An upper limb mathematical model of an oil palm harvester

Science.gov (United States)

Tumit, N. P.; Rambely, A. S.; BMT, Shamsul; Shahriman A., B.; Ng Y., G.; Deros, B. M.; Zailina, H.; Goh, Y. M.; Arumugam, Manohar; Ismail, I. A.; Abdul Hafiz A., R.

2014-09-01

The main purpose of this article is to develop a mathematical model of human body during harvesting via Kane's method. In this paper, a 2-D closed-kinematic biomechanical model that represents a harvesting movement is developed. The model of six segments consisted of upper right arm, right forearm, harvesting equipment, left forearm, upper left arm, and upper part of trunk. Finally, the inverse dynamic equations are represented in matrix form.

Video-assisted thoracic surgery for left upper lobectomy for complex lesions: how to extend the indication with optimal safety?

Science.gov (United States)

Bayard, Nathanaël Frank; Barnett, Stephen Arthur; Rinieri, Philippe; Melki, Jean; Peillon, Christophe; Baste, Jean Marc

2016-08-01

The feasibility of extending the VATS approach to locally advanced NSCLC has been described with good clinical outcome. These complex resections are still technically challenging and patient safety must remain the highest priority. In this article, we describe our routine VATS approach for left upper lobectomy in proximal, locally advanced lesions. Both surgical and anaesthesiology teams are trained during simulation sessions to respond rapidly in case of urgent thoracotomy. Encircling arterial and venous vessels allow control of inadvertent bleeding during difficult dissection. Also, whenever needed the double vessel control technique is a time saver waiting for conversion to thoracotomy.

Left bronchial artery arising from a replaced left hepatic artery in a patient with massive hemoptysis

Energy Technology Data Exchange (ETDEWEB)

Khil, Eun Kyung; Lee, Jae Myung [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

2015-09-15

A 70-year-old man with a 3-year history of bronchiectasis presented with massive hemoptysis that had lasted for 3 days. In our attempt to perform bronchial artery embolization, upper abdominal angiography was required to locate the left bronchial artery, which in this case was of anomalous origin, arising from a replaced left hepatic artery, which arose from the left gastric artery-a very unusual anatomical variant. We performed embolization with polyvinyl alcohol particles, and the patient's symptoms resolved completely, with no additional complications after conservative treatment.

[Left ventricular projectile migration after an accidental close-range gunshot wound].

Science.gov (United States)

Driessen, A; Tjardes, T; Eikermann, C; Trojan, S; Fröhlich, M; Grimaldi, G; Kosse, N

2016-07-01

We report the case of a 24-year-old female after sustaining a shotgun wound in the left upper extremity and chest. Initial emergency diagnostics revealed numerous shotgun pellets scattered throughout the left-side soft tissue, chest and upper lung lobe with one pellet having migrated into the left ventricle of the heart.Due to the devastating injury pattern, gunshot wounds are interdisciplinarily challenging and should include extended initial diagnostics, such as contrast agent CT. The potential toxicity of elevated lead blood levels have to be taken into further account.

Torquing an upper central incisor with aligners--acting forces and biomechanical principles.

Science.gov (United States)

Hahn, Wolfram; Zapf, Antonia; Dathe, Henning; Fialka-Fricke, Julia; Fricke-Zech, Susanne; Gruber, Rudolf; Kubein-Meesenburg, Dietmar; Sadat-Khonsari, Reza

2010-12-01

The forces delivered by aligners during torquing have still not been investigated. The purpose of this study was to measure the forces delivered to an upper central incisor during torquing with three different materials of the same thickness, and to describe the biomechanical principles of torquing with aligners. Five identical appliances were manufactured from each of three materials, all with a thickness of 1.0 mm (Ideal Clear®, Erkodur®, and Biolon®). An upper central incisor, as part of the measuring device, was torqued in defined steps in the vestibular and palatal directions with the respective appliance in place. For statistical analysis, the resulting forces, Fx (forces acting in the palatal and facial directions) and Fz (intrusive force as a side-effect) at a displacement of ±0.15 and ±0.8 mm from the tooth at the gingival margin were calculated. The mean Fx forces for ±0.15 mm displacement ranged from -1.89 N [standard deviation (SD) 0.48] to 0.11 N (SD 0.1). The mean Fz forces were between -0.97 N (SD 0.57) and -0.07 N (SD 0.22). The highest intrusive forces were measured during palatal displacement of the measuring tooth. An influence of direction of displacement on the levels of force was observed, especially for Fz at the greater displacement of ±0.8 mm. In relation to the intended amount of root movement during torquing, aligners tend to 'lift up' and therefore no effective force couple can be established for further root control. The force delivery properties are also influenced by the material used and the shape of the tooth.

Depositional architecture and sequence stratigraphy of the Upper Jurassic Hanifa Formation, central Saudi Arabia

Science.gov (United States)

El-Sorogy, Abdelbaset; Al-Kahtany, Khaled; Almadani, Sattam; Tawfik, Mohamed

2018-03-01

To document the depositional architecture and sequence stratigraphy of the Upper Jurassic Hanifa Formation in central Saudi Arabia, three composite sections were examined, measured and thin section analysed at Al-Abakkayn, Sadous and Maashabah mountains. Fourteen microfacies types were identified, from wackestones to boundstones and which permits the recognition of five lithofacies associations in a carbonate platform. Lithofacies associations range from low energy, sponges, foraminifers and bioclastic burrowed offshoal deposits to moderate lithoclstic, peloidal and bioclastic foreshoal deposits in the lower part of the Hanifa while the upper part is dominated by corals, ooidal and peloidal high energy shoal deposits to moderate to low energy peloidal, stromatoporoids and other bioclastics back shoal deposits. The studied Hanifa Formation exhibits an obvious cyclicity, distinguishing from vertical variations in lithofacies types. These microfacies types are arranged in two third order sequences, the first sequence is equivalent to the lower part of the Hanifa Formation (Hawtah member) while the second one is equivalent to the upper part (Ulayyah member). Within these two sequences, there are three to six fourth-order high frequency sequences respectively in the studied sections.

Altered Aortic Upper Wall TDI Velocity Is Inversely Related with Left Ventricular Diastolic Function in Operated Tetralogy of Fallot.

Science.gov (United States)

Bassareo, Pier Paolo; Saba, Luca; Marras, Andrea R; Mercuro, Giuseppe

2016-12-01

Postoperative tetralogy of Fallot (TOF) patients often develop progressive aortic root dilatation due to an impairment in aortic elastic properties. (1) to assess aortic elasticity at the level of the aortic upper wall by tissue Doppler imaging (TDI); (2) to evaluate the influence of aortic elasticity on left ventricular (LV) diastolic function in TOF patients. Twenty-eight postoperative TOF patients (14 males, 14 females. Mean age: 25.7 ± 1.6 years) and 28 age- and sex-matched normal subjects were examined. Aortic distensibility and stiffness index were calculated. Aortic wall systolic and diastolic velocities, LV systolic and diastolic parameters were assessed by TDI. Aortic distensibility was significantly lower (P = .024), and aortic stiffness index significantly higher (P = .036) in TOF patients compared to controls. E/E' was significantly higher in TOF than in control group (P < .001). Aortic upper wall early diastolic velocity (AWEDV) was significantly correlated with aortic stiffness index (r: -0.42; P < .03), aortic distensibility (r = 0.54; P < .004), left atrial volume (r = -0.62; P = .0004), and E/E' ratio (r = -0.87; P < .0001). The latter relationship remained significant even when excluding the influence of age at surgery (r = -0.60; P < .0007) and of previous palliative surgery (r = -0.53; P < .02). Aortic elastic properties can be directly assessed using TDI to measure AWEDV. Aortic elasticity is significantly lower in postoperative TOF patients, exerting a negative effect also on LV diastolic function, with a potential long-term influence on clinical status. © 2016 Wiley Periodicals, Inc.

Upper Palaeolithic genomes reveal deep roots of modern Eurasians

KAUST Repository

Jones, Eppie R.

2015-11-16

We extend the scope of European palaeogenomics by sequencing the genomes of Late Upper Palaeolithic (13,300 years old, 1.4-fold coverage) and Mesolithic (9,700 years old, 15.4-fold) males from western Georgia in the Caucasus and a Late Upper Palaeolithic (13,700 years old, 9.5-fold) male from Switzerland. While we detect Late Palaeolithic–Mesolithic genomic continuity in both regions, we find that Caucasus hunter-gatherers (CHG) belong to a distinct ancient clade that split from western hunter-gatherers ~45 kya, shortly after the expansion of anatomically modern humans into Europe and from the ancestors of Neolithic farmers ~25 kya, around the Last Glacial Maximum. CHG genomes significantly contributed to the Yamnaya steppe herders who migrated into Europe ~3,000 BC, supporting a formative Caucasus influence on this important Early Bronze age culture. CHG left their imprint on modern populations from the Caucasus and also central and south Asia possibly marking the arrival of Indo-Aryan languages.

Upper Palaeolithic genomes reveal deep roots of modern Eurasians

KAUST Repository

Jones, Eppie R.; Gonzalez-Fortes, Gloria; Connell, Sarah; Siska, Veronika; Eriksson, Anders; Martiniano, Rui; McLaughlin, Russell L.; Gallego Llorente, Marcos; Cassidy, Lara M.; Gamba, Cristina; Meshveliani, Tengiz; Bar-Yosef, Ofer; Mü ller, Werner; Belfer-Cohen, Anna; Matskevich, Zinovi; Jakeli, Nino; Higham, Thomas F. G.; Currat, Mathias; Lordkipanidze, David; Hofreiter, Michael; Manica, Andrea; Pinhasi, Ron; Bradley, Daniel G.

2015-01-01

We extend the scope of European palaeogenomics by sequencing the genomes of Late Upper Palaeolithic (13,300 years old, 1.4-fold coverage) and Mesolithic (9,700 years old, 15.4-fold) males from western Georgia in the Caucasus and a Late Upper Palaeolithic (13,700 years old, 9.5-fold) male from Switzerland. While we detect Late Palaeolithic–Mesolithic genomic continuity in both regions, we find that Caucasus hunter-gatherers (CHG) belong to a distinct ancient clade that split from western hunter-gatherers ~45 kya, shortly after the expansion of anatomically modern humans into Europe and from the ancestors of Neolithic farmers ~25 kya, around the Last Glacial Maximum. CHG genomes significantly contributed to the Yamnaya steppe herders who migrated into Europe ~3,000 BC, supporting a formative Caucasus influence on this important Early Bronze age culture. CHG left their imprint on modern populations from the Caucasus and also central and south Asia possibly marking the arrival of Indo-Aryan languages.

Relative incidence of phlebitis associated with peripheral intravenous catheters in the lower versus upper extremities.

Science.gov (United States)

Benaya, A; Schwartz, Y; Kory, R; Yinnon, A M; Ben-Chetrit, E

2015-05-01

Peripheral venous access in elderly, hospitalized patients is often challenging. The usual alternative is insertion of a central venous catheter, with associated risk for complications. The purpose of this investigation was to determine the relative incidence of phlebitis secondary to lower as compared to upper extremity intravenous catheters (IVCs) and associated risk factors. A non-randomized, observational, cohort-controlled study was carried out. Consecutive patients receiving a lower extremity IVC were enrolled and compared with patients receiving an upper extremity IVC. Patients were followed from insertion until removal of the IVC. The major endpoint was phlebitis. The incidence of phlebitis secondary to upper extremity IVCs was 3/50 (6 %) compared to 5/53 (9.4 %) in lower extremity IVCs (χ(2) Yates = 0.08, p = 0.776). Age, gender, obesity, diabetes mellitus, site (arm versus leg, left versus right), and size of needle were not found to be risk factors for phlebitis according to univariate analysis. None of the patients developed bloodstream infection. In elderly patients with poor venous access, lower extremity IVCs are a reasonable and low-risk alternative to central venous catheters.

Homonymous Central Quadrantanopia Caused by an Extrastriate (V2/V3 Infarction: A Case Report

Directory of Open Access Journals (Sweden)

Shu-Fang Lin

2008-08-01

Full Text Available A 66-year-old Taiwanese aboriginal male had complained of right-side blurred vision for 2 months, especially when reading. He had a 10-year history of hypertension and cardiovascular disease. His best-corrected visual acuity was 20/25 in each eye. Ophthalmoscopy revealed asymmetrical cupping, but a normal disc. Humphrey perimetry showed an upper homonymous para-central quadrantanopic defect. Brain magnetic resonance imaging showed an infarction in the left lower calcarine area over the extrastriate (V2/V3 cortical area and a narrowing of the left middle and posterior cerebral arteries due to severe arteriosclerosis.

A Constrained 3D Density Model of the Upper Crust from Gravity Data Interpretation for Central Costa Rica

Directory of Open Access Journals (Sweden)

Oscar H. Lücke

2010-01-01

Full Text Available The map of complete Bouguer anomaly of Costa Rica shows an elongated NW-SE trending gravity low in the central region. This gravity low coincides with the geographical region known as the Cordillera Volcánica Central. It is built by geologic and morpho-tectonic units which consist of Quaternary volcanic edifices. For quantitative interpretation of the sources of the anomaly and the characterization of fluid pathways and reservoirs of arc magmatism, a constrained 3D density model of the upper crust was designed by means of forward modeling. The density model is constrained by simplified surface geology, previously published seismic tomography and P-wave velocity models, which stem from wide-angle refraction seismic, as well as results from methods of direct interpretation of the gravity field obtained for this work. The model takes into account the effects and influence of subduction-related Neogene through Quaternary arc magmatism on the upper crust.

What's Left of the Left-Right Dimension? Why the Economic Policy Positions of Europeans Do Not Fit the Left-Right Dimension.

Science.gov (United States)

Otjes, Simon

2018-01-01

In political science the economic left-right dimension plays a central role. A growing body of evidence shows that the economic policy preferences of a large segment of citizens do not scale sufficiently. Using Mokken scale analysis, this study determines the causes of this phenomenon. Differences in the extent to which the economic policy preferences of citizens fit the left-right dimension can be explained in terms of the interaction between individual level and political system-level variables: citizens who spend more attention to politicians with views that conform to the left-right dimension, have views that conform to the left-right dimension. There is also a role for the legacy of communist dictatorship: citizens who were socialised in democratic countries have views that fit the left-right dimension better than those socialised during communism.

Migration of a Central Venous Catheter in a Hemodialysis Patient Resulted in Left Atrial Perforation and Thrombus Formation Requiring Open Heart Surgery.

Science.gov (United States)

Wong, Kevin; Marks, Barry A; Qureshi, Anwer; Stemm, Joseph J

2016-07-01

Central venous catheterization is widely used in patients on hemodialysis. A rare complication associated with the clinical use of central venous catheters is perforation of the heart or major vessels. We report a case of inadvertent perforation of the left atrium and thrombosis after the placement of a hemodialysis catheter in the right internal jugular vein. In such cases, surgical removal of the central venous catheter from perforation sites in the heart and vessel walls poses anesthetic challenges because of the high risk of pneumothorax, hemorrhage, arrhythmias, thrombosis, and death.

[Heparin-induced thrombocytopenia developed during the acute phase after left upper lobectomy for lung cancer].

Science.gov (United States)

Mitomo, Hideki; Miyamoto, Akira; Tabata, Toshiharu; Sugawara, Takafumi; Yabuki, Hiroshi; Fujimura, Shigefumi

2014-12-01

Heparin-induced thrombocytopenia (HIT) is a serious adverse effect of heparin administration. This must not be rarely encountered but is not often reported in Japan compared to Western countries. A 68-year-old woman underwent left upper lobectomy for lung cancer. Low-dose unfractionated heparin was administrated to prevent thromboembolism after the operation. Two days later, sudden dyspnea appeared and ultracardiosonography showing an extensive thromboembolus from the main trunk to both main branches of pulmonary artery indicated pulmonary embolization. After the establishment of percutaneous cardiopulmonary support (PCPS) support, the embolus was removed by emergent open heart surgery. However, despite further unfractionated heparin administration following embolization surgery, other thrombus was identified in both the bi-lateral internal jagular veins and inferior vena cava by ultrasonography and contrast computed tomography( CT). Her platelet count was decreased gradually despite platelet transfusion. Plate factor 4( PF4) antibody against heparin in her blood examination was found, and HIT II was diagnosed. Discontinuation of unfractionated heparin and administration of antithrombin agent improved platelet count, and no additional embolization was identified.

SOME INOZOID SPONGES FROM UPPER TRIASSIC (NORIAN-RHAETIAN NAYBAND FORMATION OF CENTRAL IRAN

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BABA SENOWBARI-DARYAN

1997-11-01

Full Text Available Some small-scaled Norian-Rhaetian reefs and reef mounds are imbedded within the shales, siltstones and siliciclastic-carbonate deposits of the Nayband Formation in central Iran. These deposits belong to the central Iranian plate as part of the Cimmerian Continent. Most of the biogenic rocks have a biostromal geometry, biohermal constructions are rare. Inozoid, sphinctozoid, and chaetetid sponges are, beside of corals and other reef builders, the most important reef organisms within these bioconstructions. In some reefs a variety of hexactinellid sponges also occur. The following inozoid sponges are described in this paper: Radiofibra norica n. sp., Permocorynella maxima n. sp., ?Sestrostomella robusta, Marawandia iranica, n. gen., n. sp. and Enaulofungia? triassica n. sp. The first four taxa are among the most abundant sponges within the Nayband Formation where it is exposed in several localities in central Iran. Enaulofungia? triassica, however, is not an abundant sponge there. These inozoid sponges have never been reported from the Triassic deposits of this region. Radiofibra, until now known only from the Upper Permian of Djebel Tebaga (Tunisia, is reported here for the first time from Triassic rocks. The stratigraphic as well as the paleogeographic distribution of all the genera are discussed.   

Left-sided portal hypertension revisited

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Antonio Manenti

2016-12-01

Conclusions: In every case of left-sided portal hypertension, upper digestive endoscopy and close follow-up are recommended. Besides, computed tomography can demonstrate particular conditions directly favoring gastroesophageal varices, and aid in selection of the appropriate therapeutic decisions. [Arch Clin Exp Surg 2016; 5(4.000: 211-215

Right Site, Wrong Route - Cannulating the Left Internal Jugular Vein.

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Paik, Peter; Arukala, Sanjay K; Sule, Anupam A

2018-01-09

Central venous catheters are placed in approximately five million patients annually in the US. The preferred site of insertion is one with fewer risks and easier access. Although the right internal jugular vein is preferred, on occasion, the left internal jugular may have to be accessed. A patient was admitted for septic shock, cerebrovascular accident, and non-ST-segment elevation myocardial infarction. A central venous line was needed for antibiotic and vasopressor administration. Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed. On chest radiography for confirmation, the left internal jugular central venous catheter was seen projecting down the left paraspinal region. It did not take the expected course across the midline toward the right and into the superior vena cava (SVC). A review of a computed tomography (CT) scan of the chest with contrast done on a prior admission revealed a duplicated SVC on the left side that had not been reported in the original CT scan interpretation. A left-sided SVC is present in approximately 0.3% to 0.5% of the population, with 90% of these draining into the coronary sinus. During placements of central venous lines and pacemakers, irritation of the coronary sinus may result in hypotension, arrhythmia, myocardial ischemia, or cardiac arrest. A widened mediastinum can be an indication of a duplicated SVC. When attempting a left internal jugular vein central venous catheter placement, it is important to be aware of venous anomalies in order to prevent complications.

Holocene volcanism of the upper McKenzie River catchment, central Oregon Cascades, USA

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Deligne, Natalia I.; Conrey, Richard M.; Cashman, Katharine V.; Champion, Duane E.; Amidon, William H.

2016-01-01

To assess the complexity of eruptive activity within mafic volcanic fields, we present a detailed geologic investigation of Holocene volcanism in the upper McKenzie River catchment in the central Oregon Cascades, United States. We focus on the Sand Mountain volcanic field, which covers 76 km2 and consists of 23 vents, associated tephra deposits, and lava fields. We find that the Sand Mountain volcanic field was active for a few decades around 3 ka and involved at least 13 eruptive units. Despite the small total volume erupted (∼1 km3 dense rock equivalent [DRE]), Sand Mountain volcanic field lava geochemistry indicates that erupted magmas were derived from at least two, and likely three, different magma sources. Single units erupted from one or more vents, and field data provide evidence of both vent migration and reoccupation. Overall, our study shows that mafic volcanism was clustered in space and time, involved both explosive and effusive behavior, and tapped several magma sources. These observations provide important insights on possible future hazards from mafic volcanism in the central Oregon Cascades.

Diagnosis and treatment of upper limb apraxia

OpenAIRE

Dovern, A.; Fink, G. R.; Weiss, P. H.

2012-01-01

Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients’ everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients’ prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed...

A chronological framework connecting the early Upper Palaeolithic across the Central Asian piedmont.

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Fitzsimmons, Kathryn E; Iovita, Radu; Sprafke, Tobias; Glantz, Michelle; Talamo, Sahra; Horton, Katharine; Beeton, Tyler; Alipova, Saya; Bekseitov, Galymzhan; Ospanov, Yerbolat; Deom, Jean-Marc; Sala, Renato; Taimagambetov, Zhaken

2017-12-01

Central Asia has delivered significant paleoanthropological discoveries in the past few years. New genetic data indicate that at least two archaic human species met and interbred with anatomically modern humans as they arrived into northern Central Asia. However, data are limited: known archaeological sites with lithic assemblages generally lack human fossils, and consequently identifying the archaeological signatures of different human groups, and the timing of their occupation, remains elusive. Reliable chronologic data from sites in the region, crucial to our understanding of the timing and duration of interactions between different human species, are rare. Here we present chronologies for two open air Middle to Upper Palaeolithic (UP) sequences from the Tien Shan piedmont in southeast Kazakhstan, Maibulak and Valikhanova, which bridge southern and northern Central Asia. The chronologies, based on both quartz optically stimulated luminescence (OSL) and polymineral post-infrared infrared luminescence (pIR-IRSL) protocols, demonstrate that technological developments at the two sites differ substantially over the ∼47-19 ka time span. Some of the innovations typically associated with the earliest UP in the Altai or other parts of northeast Asia are also present in the Tien Shan piedmont. We caution against making assumptions about the directionality of spread of these technologies until a larger, better defined database of transitional sites in the region is available. Connections between the timing of occupation of regions, living area setting and paleoenvironmental conditions, while providing hypotheses worth exploring, remain inconclusive. We cautiously suggest a trend towards increasing occupation of open air sites across the Central Asian piedmont after ∼40 ka, corresponding to more humid climatic conditions which nevertheless included pulses of dust deposition. Human occupation persisted into the Last Glacial Maximum, despite cooler, and possibly drier

Metastatic neuroblastoma presenting as refusal to use the left upper extremity in a six-year-old girl

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Casey Grover

2014-12-01

Full Text Available Neuroblastoma is the most common extracranial neoplasm in children, commonly presenting at an advanced stage. Despite the high prevalence of metastatic disease with neuroblastoma, metastases to the central nervous system are rare and predominantly involve the spinal cord. We present a case of neuroblastoma with metastases to the brain presenting as refusal to move the left arm. The lesion initially appeared to be both a subdural and epidural hematoma on computed tomography of the head, but upon magnetic resonance imaging, was found to represent metastatic neuroblastoma. In pediatric patients with systemic symptoms and neurologic deficits, metastatic disease, such as neuroblastoma, should be included in the differential diagnosis and appropriate imaging should be obtained.

The central retinal artery occlusion in the right eye followed by a branch retinal artery occlusion in the left eye four days later

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Cagatay Caglar

2013-01-01

Full Text Available A 65-year-old woman was admitted to our clinic with complaints of sudden, painless, decrease in vision, and sectoral visual field defect in the left eye and later presented to our clinic again with a history of sudden loss of vision in her right eye. In this case study we reported that the patient had branch retinal artery occlusion (BRAO in the left eye and at the same time progressing central retinal artery occlusion (CRAO in the right eye.

Primary angiitis of the central nervous system: an ante-mortem diagnosis.

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Singh S

2000-10-01

Full Text Available A rare case of primary angiitis of the central nervous system (PACNS is reported with its clinical and magnetic resonance imaging (MRI features. A 20-year-old girl presented with headache, projectile vomiting, unsteadiness of gait and urgency of micturition. She had left seventh nerve upper motor neuron type paresis, increased tone in all four limbs, exaggerated deep tendon reflexes, cerebellar signs, and papilloedema. Cerebrospinal fluid showed lymphocytosis with elevated protein and normal glucose level. Cerebral computerised tomographic scan and MRI showed bilateral diffuse asymmetric supra- and infra-tentorial lesions (predominantly in the supratentorial and left cerebrum. On MRI, the lesions were hyperintense on T2, and proton density-weighted images and hypointense on T1-weighted images. Based on the clinical findings of raised intracranial tension and MRI features, initial diagnoses of gliomatosis cerebrii, tuberculous meningitis, primary central nervous system lymphoma and chronic viral encephalitis were considered. PACNS was not included in the initial differentials and, an open brain biopsy was advised which established the definitive diagnosis.

Validity and reliability of central blood pressure estimated by upper arm oscillometric cuff pressure.

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Climie, Rachel E D; Schultz, Martin G; Nikolic, Sonja B; Ahuja, Kiran D K; Fell, James W; Sharman, James E

2012-04-01

Noninvasive central blood pressure (BP) independently predicts mortality, but current methods are operator-dependent, requiring skill to obtain quality recordings. The aims of this study were first, to determine the validity of an automatic, upper arm oscillometric cuff method for estimating central BP (O(CBP)) by comparison with the noninvasive reference standard of radial tonometry (T(CBP)). Second, we determined the intratest and intertest reliability of O(CBP). To assess validity, central BP was estimated by O(CBP) (Pulsecor R6.5B monitor) and compared with T(CBP) (SphygmoCor) in 47 participants free from cardiovascular disease (aged 57 ± 9 years) in supine, seated, and standing positions. Brachial mean arterial pressure (MAP) and diastolic BP (DBP) from the O(CBP) device were used to calibrate in both devices. Duplicate measures were recorded in each position on the same day to assess intratest reliability, and participants returned within 10 ± 7 days for repeat measurements to assess intertest reliability. There was a strong intraclass correlation (ICC = 0.987, P difference (1.2 ± 2.2 mm Hg) for central systolic BP (SBP) determined by O(CBP) compared with T(CBP). Ninety-six percent of all comparisons (n = 495 acceptable recordings) were within 5 mm Hg. With respect to reliability, there were strong correlations but higher limits of agreement for the intratest (ICC = 0.975, P difference 0.6 ± 4.5 mm Hg) and intertest (ICC = 0.895, P difference 4.3 ± 8.0 mm Hg) comparisons. Estimation of central SBP using cuff oscillometry is comparable to radial tonometry and has good reproducibility. As a noninvasive, relatively operator-independent method, O(CBP) may be as useful as T(CBP) for estimating central BP in clinical practice.

Seismic characteristics of central Brazil crust and upper mantle: A deep seismic refraction study

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Soares, J.E.; Berrocal, J.; Fuck, R.A.; Mooney, W.D.; Ventura, D.B.R.

2006-01-01

A two-dimensional model of the Brazilian central crust and upper mantle was obtained from the traveltime interpretation of deep seismic refraction data from the Porangatu and Cavalcante lines, each approximately 300 km long. When the lines were deployed, they overlapped by 50 km, forming an E-W transect approximately 530 km long across the Tocantins Province and western Sa??o Francisco Craton. The Tocantins Province formed during the Neoproterozoic when the Sa??o Francisco, the Paranapanema, and the Amazon cratons collided, following the subduction of the former Goia??s ocean basin. Average crustal VP and VP/VS ratios, Moho topography, and lateral discontinuities within crustal layers suggest that the crust beneath central Brazil can be associated with major geological domains recognized at the surface. The Moho is an irregular interface, between 36 and 44 km deep, that shows evidences of first-order tectonic structures. The 8.05 and 8.23 km s-1 P wave velocities identify the upper mantle beneath the Porangatu and Cavalcante lines, respectively. The observed seismic features allow for the identification of (1) the crust has largely felsic composition in the studied region, (2) the absence of the mafic-ultramafic root beneath the Goia??s magmatic arc, and (3) block tectonics in the foreland fold-and-thrust belt of the northern Brasi??lia Belt during the Neoproterozoic. Seismic data also suggested that the Bouguer gravimetric discontinuities are mainly compensated by differences in mass distribution within the lithospheric mantle. Finally, the Goia??s-Tocantins seismic belt can be interpreted as a natural seismic alignment related to the Neoproterozoic mantle domain. Copyright 2006 by the American Geophysical Union.

Multidisciplinary treatment of a fractured maxillary central incisor

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Praveen Kumar Neela

2017-01-01

Full Text Available Subgingivally fractured incisors are still a challenge to treat. Restoration of severely damaged teeth requires careful attention and comprehensive preplanned treatment. Here, a patient who had traumatic injury to the upper left central incisor which led to an oblique fracture involving enamel, dental and extending into the root below the gingival margin was saved from extraction by accelerated forced eruption of a root portion, allowing placement of crown, and eliminating the need for a fixed partial denture. A tooth otherwise would have gone for extraction routinely was thus saved and restored through a multidisciplinary approach by a combined orthodontic, periodontal and endodontic treatment.

Intermontane eolian sand sheet development, Upper Tulum Valley, central-western Argentina

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Patrick Francisco Fuhr Dal' Bó

Full Text Available ABSTRACTThe intermontane Upper Tulum eolian sand sheet covers an area of ca. 125 km² at north of the San Juan Province, central-western Argentina. The sand sheet is currently an aggrading system where vegetation cover, surface cementation and periodic flooding withhold the development of dunes with slipfaces. The sand sheet surface is divided into three parts according to the distribution of sedimentary features, which reflects the variation in sediment budget, water table level and periodic flooding. The central sand sheet part is the main area of eolian deposition and is largely stabilized by vegetation. The sedimentary succession is 4 m thick and records the vertical interbedding of eolian and subaqueous deposits, which have been deposited for at least 3.6 ky with sedimentation rates of 86.1 cm/ky. The construction of the sand sheet is associated with deflation of the sand-graded debris sourced by San Juan alluvial fan, which is available mainly in drier fall-winter months where water table is lower and wind speeds are periodically above the threshold velocity for sand transport. The accumulation of sedimentary bodies occurs in a stabilized eolian system where vegetation cover, thin mud veneers and surface cementation are the main agents in promoting accumulation. The preservation of the sand sheet accumulations is enabled by the progressive creation of the accommodation space in a tectonically active basin and the continuous burial of geological bodies favored by high rates of sedimentation.

Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

International Nuclear Information System (INIS)

Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja

2010-01-01

Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman

Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

Energy Technology Data Exchange (ETDEWEB)

Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

2010-02-15

Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman.

Distribution patterns and enrichment of lead, zinc and copper in surface sediments of the central Portuguese shelf and upper slope

NARCIS (Netherlands)

Jesus, C.C.; de Stigter, H.; Miranda, P.; Oliveira, A.; Rocha, F.

2013-01-01

Geographic patterns of Cu, Pb and Zn enrichment on the Lisbon-Setúbal-Sines continental shelf and upper slope (central Portuguese margin) were studied in this paper to gain insight into current pathways of trace metal dispersal. Our study is based on the analysis of elemental concentrations and

Bioerosion and encrustation: Evidences from the Middle ‒ Upper Jurassic of central Saudi Arabia

Science.gov (United States)

El-Hedeny, Magdy; El-Sabbagh, Ahmed; Al Farraj, Saleh

2017-10-01

The Middle ‒ Upper Jurassic hard substrates of central Saudi Arabia displayed considerable signs of bioerosion and encrustations. They include organic (oysters, other bivalves, gastropods, corals and brachiopods) and an inorganic carbonate hardground that marks the boundary between the Middle Jurassic Tuwaiq Mountain Limestone and the Upper Jurassic Hanifa Formation. Traces of bioerosion in organic substrates include seven ichnotaxa produced by bivalves (Gastrochaenolites Leymerie, 1842), polychaete annelids (Trypanites Mägdefrau, 1932; MaeandropolydoraVoigt, 1965 and CaulostrepsisClarke, 1908), sponges (Entobia Bronn, 1837), acrothoracican cirripedes (Rogerella Saint-Seine, 1951), gastropods (Oichnus Bromley, 1981) and probable ?Centrichnus cf. eccentricus. The encrusting epifauna on these substrates consist of several organisms, including oysters, serpulid worms, corals and foraminifera. In contrast, the carbonate hardground was only bioeroded by Gastrochaenolite, Trypanites and Entobia. Epibionts on this hardground include ;Liostrea Douvillé, 1904-type; oysters, Nanogyra nana Sowerby, 1822 and serpulids. In general, bioerosion and encrustation are less diversified in hardground than in organic substrates, indicating a long time of exposition of organic substrates with slow to moderate rate of deposition in a restricted marine environment. Both organic and inorganic commuinities are correlated with those of other equatorial, subtropical and temperate equivalents.

Nasolacrimal obstruction caused by root abscess of the upper canine in a cat.

Science.gov (United States)

Anthony, James M G; Sandmeyer, Lynne S; Laycock, Amanda R

2010-03-01

A 10-year-old, castrated male domestic short hair cat was presented to the Small Animal Clinic at the Western College of Veterinary Medicine with a presenting complaint of chronic, ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge but there were no apparent reasons for the ocular discharge, and nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease and a fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine and dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved. After 2 years, the epiphora has never reoccurred. This is a noteworthy case because a suspected root abscess resulted in extralumenal compression of the nasolacrimal duct, which shows the importance of a thorough oral examination when nasolacrimal obstruction is evident.

δ13C chemostratigraphy in the upper Tremadocian through lower Katian (Ordovician carbonate succession of the Siljan district, central Sweden

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Oliver Lehnert

2014-12-01

Full Text Available Based on δ13C data from two drillcores recovered from the Siljan district, we present a first continuous carbon isotope record of the upper Tremadocian–lower Katian limestone succession of central Sweden. New names for some isotopic carbon excursions from the Cambrian–Ordovician boundary through the basal Darriwilian are introduced. The Mora 001 core from the western part of the Siljan impact structure ranges through the Lower–Middle Ordovician, whereas the Solberga 1 core from its eastern part ranges through the Middle–lower Upper Ordovician. Upper Tremadocian and Floian units are extremely condensed and include extensive stratigraphic gaps. Multiple hardgrounds, sometimes with minor karstic overprint, imply recurrent periods of erosion and/or non-deposition. Like in other parts of Sweden, the Dapingian and Darriwilian succession is characterized by a relatively complete sedimentary record and low sedimentation rates.

Differences in graph theory functional connectivity in left and right temporal lobe epilepsy.

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Chiang, Sharon; Stern, John M; Engel, Jerome; Levin, Harvey S; Haneef, Zulfi

2014-12-01

To investigate lateralized differences in limbic system functional connectivity between left and right temporal lobe epilepsy (TLE) using graph theory. Interictal resting state fMRI was performed in 14 left TLE patients, 11 right TLE patients, and 12 controls. Graph theory analysis of 10 bilateral limbic regions of interest was conducted. Changes in edgewise functional connectivity, network topology, and regional topology were quantified, and then left and right TLE were compared. Limbic edgewise functional connectivity was predominantly reduced in both left and right TLE. More regional connections were reduced in right TLE, most prominently involving reduced interhemispheric connectivity between the bilateral insula and bilateral hippocampi. A smaller number of limbic connections were increased in TLE, more so in left than in right TLE. Topologically, the most pronounced change was a reduction in average network betweenness centrality and concurrent increase in left hippocampal betweenness centrality in right TLE. In contrast, left TLE exhibited a weak trend toward increased right hippocampal betweenness centrality, with no change in average network betweenness centrality. Limbic functional connectivity is predominantly reduced in both left and right TLE, with more pronounced reductions in right TLE. In contrast, left TLE exhibits both edgewise and topological changes that suggest a tendency toward reorganization. Network changes in TLE and lateralized differences thereof may have important diagnostic and prognostic implications. Published by Elsevier B.V.

Isolated primary lymphedema tarda of the upper limb.

Science.gov (United States)

Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

2013-03-01

Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

Ultrasound-guided catheterization of the left subclavian vein without recognition of persistent left superior vena cava

OpenAIRE

Park, Sun Young; Yoo, Jae Hwa; Kim, Mun Gyu; Kim, Sang Ho; Park, Byoung-Won; Oh, Hong Chul; Kim, Hojoon

2017-01-01

Abstract Rationale: A persistent left superior vena cava (PLSVC) is rare, but the most common thoracic venous anomaly. We report a case of PLSVC unrecognized during left subclavian vein catheterization using real-time ultrasound-guided supraclavicular approach. Patient concerns: A 79-year-old man with history of hypertension presented with traumatic subdural hemorrhage, subarachnoid hemorrhage, and epidural hemorrhage. Before the operation, a central venous catheter (CVC) was placed into the ...

Transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium.

Science.gov (United States)

Luciano, Debora; Laux, Daniela; Boudjemline, Younes; Hascoët, Sébastien; Lusson, Jean-René; Sorensen, Clio; Ovaert, Caroline; Kreitmann, Bernard; Van Praagh, Richard; Fraisse, Alain

2013-12-10

A persistent anastomosis between the pulmonary veins that connect with the left atrium and the systemic vein that drains into the right atrium has occasionally been reported. We report characteristics and transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium. We retrospectively studied such patients in 5 institutions. Ten patients (6 girls) presented at a median age of 8 (0.1 to 54) years with 2 anatomic types: 8 vertical vein types with drainage of the left upper lobe to the innominate vein via a large vertical vein (left superior cardinal vein) and to the left atrium via the left upper pulmonary vein; and 2 scimitar vein (SV) types with drainage of the right middle and lower pulmonary veins into the inferior vena cava and to the left atrium via an anomalous connecting vein. Associated malformations were aortic coarctation (n=2) and secundum atrial septal defects (n=3). Two patients of the vertical vein type were operated. Transcatheter occlusion of the abnormal pulmonary venous return was performed in 7 cases, associated with occlusion of systemic arterial supply (n=2), secundum atrial septal closure (n=2), left upper pulmonary vein stenosis stenting (n=1), and coarctation stenting (n=1). Including previously published cases, 18 patients (13 vertical veins and 5 scimitar veins) underwent transcatheter repair. Patients over 40 years of age tend to be symptomatic at presentation (p=0.056). In partially abnormal pulmonary venous return with dual drainage, transcatheter therapy can be offered in the majority of patients. © 2013.

New Paleomagnetic Data From Upper Gabbros Supports Limited Rotation of Central Semail Massif in Oman Ophiolite

Science.gov (United States)

Horst, A. J.; Sarah, T.; Hartley, E.; Martin, J.

2017-12-01

Paleomagnetic data from northern massifs of the Oman ophiolite demonstrate substantial clockwise rotations prior to or during obduction, yet data from southern massifs are recently suggested to be remagnetized during obduction and show subsequent smaller counterclockwise rotations. To better understand paleomagnetic data from the southern massifs, we conducted a detailed paleomagnetic and rock magnetic study of 21 sites in upper gabbros and 5 sites in lower crustal gabbros within the central Semail massif. Samples treated with progressive thermal demagnetization yield interpretable magnetizations with dominant unblocking between 500-580°C that implies characteristic remanent magnetization (ChRM) components carried by low-titanium magnetite and nearly pure magnetite. Rock magnetic and scanning electron microscopy data provide additional support of the carriers of magnetization. ChRMs from sites with samples containing partially-serpentinized olivine are similar to sites with samples lacking olivine, where the carriers appear to be fine magnetite intergrowths in pyroxene. The overall in situ and tilt-corrected mean directions from upper gabbros are distinct from the lower gabbros, from previous data within the massif, and also directions from similar crustal units in adjacent Rustaq and Wadi Tayin massifs. After tilt correction for 10-15° SE dip of the crust-mantle boundary, the mean direction from upper gabbros is nearly coincident with in situ lower gabbros. The tilt-corrected direction from upper gabbros is also consistent with an expected direction from the Late Cretaceous apparent polar wander path for Arabia at the age of crustal accretion ( 95Ma). These results suggest the upper crustal section in Semail has likely only experienced minor tilting since formation and acquisition of magnetization. Due to slow cooling of middle to lower gabbros in fast-spread crust, the lower gabbro sites likely cooled later or after obduction, and thus yield a distinct

Widening of mediastinum with persistent left superior Vena cava - CT diagnosis

International Nuclear Information System (INIS)

Neuwirth, J.; Kolar, J.

1992-01-01

Described in this paper are radiographic findings recorded from a case of persistent left superior vena cava which grew manifest by widening of the left contour of the upper mediastinal region. Contrast-enhanced computed tomography (CT) was undertaken to clear up suspicion of mediastinal tumour and revealed double superior vena cava. The diagnosis was then confirmed by digital subtraction venography. (orig.) [de

Uncrossed cortico-muscular projections in humans are abundant to facial muscles of the upper and lower face, but may differ between sexes.

Science.gov (United States)

Fischer, Urs; Hess, Christian W; Rösler, Kai M

2005-01-01

It is a popular concept in clinical neurology that muscles of the lower face receive predominantly crossed cortico-bulbar motor input, whereas muscles of the upper face receive additional ipsilateral, uncrossed input. To test this notion, we used focal transcranial magnetic brain stimulation to quantify crossed and uncrossed cortico-muscular projections to 6 different facial muscles (right and left Mm. frontalis, nasalis, and orbicularis oris) in 36 healthy right-handed volunteers (15 men, 21 women, mean age 25 years). Uncrossed input was present in 78% to 92% of the 6 examined muscles. The mean uncrossed: crossed response amplitude ratios were 0.74/0.65 in right/left frontalis, 0.73/0.59 in nasalis, and 0.54/0.71 in orbicularis oris; ANOVA p>0.05). Judged by the sizes of motor evoked potentials, the cortical representation of the 3 muscles was similar. The amount of uncrossed projections was different between men and women, since men had stronger left-to-left projections and women stronger right-to-right projections. We conclude that the amount of uncrossed pyramidal projections is not different for muscles of the upper from those of the lower face. The clinical observation that frontal muscles are often spared in central facial palsies must, therefore, be explained differently. Moreover, gender specific lateralization phenomena may not only be present for higher level behavioural functions, but may also affect simple systems on a lower level of motor hierarchy.

Total anomalous systemic venous drainage in left heterotaxy syndrome.

Science.gov (United States)

Khandenahally, Ravindranath S; Deora, Surender; Math, Ravi S

2013-04-01

Total anomalous systemic venous drainage is an extremely rare congenital heart defect. In this study we describe an 11-year-old girl who presented with a history of fatigue and central cyanosis that she had had since early childhood with unremarkable precordial examination results. Investigations revealed left heterotaxy with all systemic venous drainage to the left-sided atrium with non-compaction of the left ventricle.

Isolated left-sided partial anomalous pulmonary venous connection in a child.

Science.gov (United States)

Onan, İsmihan Selen; Sen, Onur; Gökalp, Selman; Onan, Burak

2017-09-01

Isolated left-sided partial anomalous pulmonary venous connection with intact interatrial septum is a rare diagnosis in childhood. In these cases, a vertical vein drains the left upper pulmonary lobe into the brachiocephalic vein and finally to the right atrium. Surgical treatment is performed to prevent right ventricular failure and pulmonary artery disease in advanced age. In this report, the rare entity of isolated left-sided anomalous pulmonary venous connection in a 14-year-old girl and successful minimally invasive surgery without cardiopulmonary bypass are described.

Anatomical variations of the thymus in relation to the left brachiocephalic vein, findings of necropsia.

Science.gov (United States)

Plaza, Oscar Alonso; Moreno, Freddy

2018-04-01

Two cases of anatomical variations of the thymus are presented with respect to the anatomical relations with the left brachiocephalic vein and found during the necropsy process. Less than 2 days after birth with Noonan Syndrome, when the left brachiocephalic vein was scanning behind the upper thymus horns, there were other adjacent lesions consisting of three supernumerary spleens and three hepatic veins. The second case was an 8-year-old infant with child malpractice who died from urinary sepsis due to obstructive uropathy, in which case the upper lobes of the thymus were fused and formed a ring through which the left brachiocephalic vein passed. Copyright © 2018 Elsevier B.V. All rights reserved.

Percutaneous endovascular therapy for symptomatic chronic total occlusion of the left subclavian artery.

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Akif Cakar, Mehmet; Tatli, Ersun; Tokatli, Alptug; Kilic, Harun; Gunduz, Huseyin; Akdemir, Ramazan

2018-03-16

Percutaneous endovascular therapy is an accepted and preferred procedure for symptomatic subclavian artery disease. However, the technical feasibility and effectiveness of treating chronic total occlusion of the subclavian artery with this approach is uncertain. We aimed to evaluate the initial and mid-term results of endovascular therapy for patients with symptomatic chronic total occlusion of the left subclavian artery. Consecutive patients who underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery between January 2010 and February 2014 were included. Overall, 16 patients (10 male, 6 female; mean age 56 ± 13 years) underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery - 6 (37.5%) had arm claudication, 8 (50.0%) had vertebrobasilar insufficiency and 2 (12.5%) had coronary steal. 18 balloon-expandable stents were implanted to 15 patients. The central luminal passage was not achieved in one patient because of the subintimal position of guidewire (procedural success rate 93.8%). There were no procedure-related complications. Mean preprocedural and postprocedural systolic blood pressure differences between the upper extremities were 37 ± 13 (range 25-60) mmHg and 11 ± 9 (range 5-38) mmHg, respectively; the improvement was statistically significant. Outpatient follow-up revealed one asymptomatic restenosis at two years. Patency rate at two years was 93.3%. Balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery is safe and effective, with good acute success rate and mid-term patency. Prospective randomised studies on larger patient populations would provide more precise results.

Community respiration/production and bacterial activity in the upper water column of the central Arctic Ocean

Science.gov (United States)

Sherr, Barry F.; Sherr, Evelyn B.

2003-04-01

Community metabolism (respiration and production) and bacterial activity were assessed in the upper water column of the central Arctic Ocean during the SHEBA/JOIS ice camp experiment, October 1997-September 1998. In the upper 50 m, decrease in integrated dissolved oxygen (DO) stocks over a period of 124 d in mid-winter suggested a respiration rate of ˜3.3 nM O 2 h -1 and a carbon demand of ˜4.5 gC m -2. Increase in 0-50 m integrated stocks of DO during summer implied a net community production of ˜20 gC m -2. Community respiration rates were directly measured via rate of decrease in DO in whole seawater during 72-h dark incubation experiments. Incubation-based respiration rates were on average 3-fold lower during winter (11.0±10.6 nM O 2 h -1) compared to summer (35.3±24.8 nM O 2 h -1). Bacterial heterotrophic activity responded strongly, without noticeable lag, to phytoplankton growth. Rate of leucine incorporation by bacteria (a proxy for protein synthesis and cell growth) increased ˜10-fold, and the cell-specific rate of leucine incorporation ˜5-fold, from winter to summer. Rates of production of bacterial biomass in the upper 50 m were, however, low compared to other oceanic regions, averaging 0.52±0.47 ngC l -1 h -1 during winter and 5.1±3.1 ngC l -1 h -1 during summer. Total carbon demand based on respiration experiments averaged 2.4±2.3 mgC m -3 d -1 in winter and 7.8±5.5 mgC m -3 d -1 in summer. Estimated bacterial carbon demand based on bacterial productivity and an assumed 10% gross growth efficiency was much lower, averaging about 0.12±0.12 mgC m -3 d -1 in winter and 1.3±0.7 mgC m -3 d -1 in summer. Our estimates of bacterial activity during summer were an order of magnitude less than rates reported from a summer 1994 study in the central Arctic Ocean, implying significant inter-annual variability of microbial processes in this region.

Post traumatic intra thoracic spleen presenting with upper GI bleed! – a case report

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Kinra Sonali

2006-11-01

Full Text Available Abstract Background Isolated splenic vein thrombosis with left sided portal hypertension is a rare cause of upper gastrointestinal bleed. Diagnosis is difficult and requires a high index of suspicion, especially in patients presenting with gastrointestinal bleed in the presence of splenomegaly and normal liver function tests. Case presentation A 64 year old male presented with haematemesis and melaena. An upper gastrointestinal endoscopy revealed the presence of antral erosions in the stomach and fundal varices. A computerised tomography scan of abdomen confirmed the presence of a diaphragmatic tear and the spleen to be lying in the left hemi thorax. The appearances of the splenic vein on the scan were consistent with thrombosis. Conclusion Left sided portal hypertension as a result of isolated splenic vein thrombosis secondary to trauma is rare. The unusual presentation of our case, splenic herniation into the left hemithorax, causing fundal varices leading to upper gastrointestinal bleed 28 years after the penetrating injury, makes this case most interesting. We believe that this has not been reported in literature before.

Extreme premature with persistent left superior vena cava.

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Aboitiz-Rivera, Carlos Manuel; Blachman-Braun, Ruben; Parra-Pérez, Mariana Yazmin

2017-10-01

Persistent left superior vena cava (PLSVC) is a congenital anomaly, that results when there is an absence of the normal regression of the left common precardinal vein during embryogenesis. Usually, this anomaly remains asymptomatic, however, when the PLSVC drains into the left atrium this could lead to a right-to-left shunt. Additionally, this can result in inadvertent delivery of air or thrombus into the systemic circulation with potential neurologic, cardiac and renal complications. In this article, we present a case of an extreme premature Mexican newborn in which the diagnosis was made after placement of a percutaneous central venues catheter.

Nonsustained Repetitive Upper Septal Idiopathic Fascicular Left Ventricular Tachycardia: Rare Type of VT

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Gokhan Aksan

2016-05-01

Full Text Available Upper septal fascicular ventricular tachycardia is a very rare form of idiopathic fascicular ventricular tachycardia. Upper septal fascicular tachycardia uses the posterior fascicle as the anterograde limb and the septal fascicle as the retrograde limb. When evaluating the electrocardiography for this form of tachycardia, the presence of narrow QRS morphology and normal axis may be misinterpreted as supraventricular tachycardia. Here, we report a very rare subtype of fascicular tachycardia that originates more proximally in the His-Purkinje system at the base of the heart.

Holothurian sclerites and conodonts in the Upper Carnian (Tuvalian and Norian Limestones in the Central Kanmik Alps

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Anton Ramovš

1992-12-01

Full Text Available Near Bivouac under the Skuta Mountain (locality 1 in the central Kamnik Alps Upper Carnian Limestones were determined with conodont Epigondolella nodosa Hayashi, holothurian sclerites Calclamnella consona Mostler and C. regularis Stefanov, ammonites and other fossils similar to deeper marine Hallstatt facies of Northern Limestone Alps.Conodonts Epigondolella abneptis (Huckriede and very rich holothurian fauna proved the Norian age for bedded limestones with very frequent large chert nodules on the south slope of the Skuta and on Sleme (loc. 2 and 3. They representdeeper marine facies and a distinct development of the Lower Norian

Clinical and endoscopic profile of the patients with upper gastrointestinal bleeding in central rural India: A hospital-based cross-sectional study

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Jyoti Jain

2018-01-01

Full Text Available Introduction: Acute Upper Gastrointestinal bleeding (UGIB is one of the common causes with which the patients present to emergency. The upper gastrointestinal (UGI endoscopy remains a crucial tool in identification of UGIB. The aim of the present study was to determine the endoscopic profile of UGIB in adult population of rural central India admitted with history of UGIB (hemetemesis and/or malena. Methods: This prospective, cross sectional study was conducted in rural hospital in central India and we enrolled all consecutive patients aged 18 years and above who were admitted in the hospital ward with the history of UGIB. After obtaining the demographic data, all patients underwent clinical examination, laboratory investigations and video-endoscopy. We used Student's t test to compare means, Chi-square test to compare proportions and Mann-Whitney test to compare medians. P value <0.05 will be considered significant. Results: The mean age of our study population (N = 118 was 46.2 years. Among 118 patients who underwent endoscopy, 47.4% had esophageal varices, 27.1% had portal hypertensive gastropathy, 14.4% had gastric erosions, 5.9% each had duodenal ulcers and esophagitis, 5% had gastric ulcer disease, 4.2% each had Mallory-Weiss tear and had gastric malignancy, 1.7% had esophageal malignancy and 16.1% had normal endoscopic findings. Conclusion: Esophageal varices were the most common cause of UGIB in the adult population of rural central India presenting with UGIB, when diagnosed by video-endoscopy.

Seismic imaging of the upper mantle beneath the northern Central Andean Plateau: Implications for surface topography

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Ward, K. M.; Zandt, G.; Beck, S. L.; Wagner, L. S.

2015-12-01

Extending over 1,800 km along the active South American Cordilleran margin, the Central Andean Plateau (CAP) as defined by the 3 km elevation contour is second only to the Tibetan Plateau in geographic extent. The uplift history of the 4 km high Plateau remains uncertain with paleoelevation studies along the CAP suggesting a complex, non-uniform uplift history. As part of the Central Andean Uplift and the Geodynamics of High Topography (CAUGHT) project, we use surface waves measured from ambient noise and two-plane wave tomography to image the S-wave velocity structure of the crust and upper mantle to investigate the upper mantle component of plateau uplift. We observe three main features in our S-wave velocity model including (1), a high velocity slab (2), a low velocity anomaly above the slab where the slab changes dip from near horizontal to a normal dip, and (3), a high-velocity feature in the mantle above the slab that extends along the length of the Altiplano from the base of the Moho to a depth of ~120 km with the highest velocities observed under Lake Titicaca. A strong spatial correlation exists between the lateral extent of this high-velocity feature beneath the Altiplano and the lower elevations of the Altiplano basin suggesting a potential relationship. Non-uniqueness in our seismic models preclude uniquely constraining this feature as an uppermost mantle feature bellow the Moho or as a connected eastward dipping feature extending up to 300 km in the mantle as seen in deeper mantle tomography studies. Determining if the high velocity feature represents a small lithospheric root or a delaminating lithospheric root extending ~300 km into the mantle requires more integration of observations, but either interpretation shows a strong geodynamic connection with the uppermost mantle and the current topography of the northern CAP.

Pattern of Nerve Blocks for Upper Limb Surgery at the University of ...

African Journals Online (AJOL)

Background: Central and peripheral neural blockade techniques are popular for lower and upper limb surgeries respectively. Lower limb surgery is amenable to central neural blockade techniques, anatomical and physiological imperatives makes peripheral neural blockade more suited for upper limb surgeries. We looked ...

Severe form of streptococcal necrotizing fasciitis of the upper limb - diagnostic and therapeutic challenge: A case report

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Mikić Dragan

2015-01-01

Full Text Available Introduction. Since delay in recognition and effective treatment of necrotizing fasciitis (NF caused by invasive group A streptococcus increases the mortality and disability, the early diagnosis and management of this disease are essential for a better outcome. We presented a patient with a severe form of streptococcal NF of the left upper limb in whom amputation was performed as a life saving procedure. Case report. A 65-year-old man, previously healthy, suffered an injury to his left hand by sting on a fish bone. Two days after that the patient got fever, redness, swelling and pain in his left hand. Clinical examination of the patient after admission indicated NF that spread quickly to the entire left upper limb, left armpit, and the left side of the chest and abdomen. Despite the use of aggressive antibiotic and surgical therapy severe destruction of the skin and subcutaneous tissues developed with the development of gangrene of the left upper limb. In this situation, the team of specialists decided that the patient must be operated on submited to amputation of the left arm, at the shoulder. After amputation and aggressive debridement of soft tissue on the left side of the trunk, the patient completely recovered. β-hemolytic streptococcus group A was isolated from the skin and tissue obtained during the surgery. Conclusion. In the most severe forms of streptococcal NF of the extremities, adequate multidisciplinary treatment, including limb amputation, can save the life of a patient.

Discoid Lupus Erythematosus Presenting as Upper Eyelid Edema and Erythema

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Abbas Darjani

2017-09-01

Full Text Available Discoid Lupus Erythematosus (DLE is an autoimmune disorder that usually occurs on sun exposed areas of head and neck. Infrequently it could be presented by palpebral involvement and rarely unilateral upper eye lid edema and erythema have been reported as the sole manifestation of DLE. We describe a 38-year-old woman with chronic left upper eye lid edema and erythema from one year ago which was induced by steroid injection for left eyebrow alopecia. Histopathologic and direct immunofluorescent studies were made on palpebral skin tissue and confirmed DLE diagnosis. Antinuclear antibody (ANA titer was 1/160 with speckled pattern. She was treated by oral hydroxychloroquine (400 mg daily with moderate improvement after three months. We should think about DLE in cases with chronic upper eye lid edema and erythema. The aim of this case report is to emphasize that ophthalmologist and dermatologists should be aware of different presentations of DLE in the periorbital area to prevent misdiagnosis.

Stereotactic radiosurgery with an upper partial denture

International Nuclear Information System (INIS)

Tayama, Shusaku; Kunieda, Etsuo; Takeda, Atsushi; Takeda, Toshiaki; Oku, Yohei

2009-01-01

A 54-year-old male with partial denture underwent stereotactic radiosurgery with an infrared camera-guided system for a metastatic brain tumor arising from lung cancer. Although this method utilizes a biteplate mounted on the upper jaw to detect head movement, the patient only had four teeth in his upper jaw. In order to stabilize the biteplate, the maxillary denture was fixed to the biteplate with an autopolymerizing resin. In addition, the rest-occlusal position of the lower jaw was impressed on the inferior surface of the biteplate with an autopolymerizing resin. To assess reproducibility and stability, the distance between the left and right incus and left and right markers was measured during pre-planning, as well as before and after stereotactic irradiation. Wearing the biteplate ensures the accuracy of radiotherapy planning for the implementation of radiosurgery in patients who have many maxillary teeth missing. However, a large degree of error was observed when the biteplate was removed. (author)

Immediate effects of plantar inputs on the upper half muscles and upright posture: a preliminary study.

Science.gov (United States)

Ciuffolo, Fabio; Ferritto, Anna L; Muratore, Filippo; Tecco, Simona; Testa, Mauro; D'Attilio, Michele; Festa, Felice

2006-01-01

This purpose of this study was to investigate the immediate effects of plantar inputs on both the upper half muscle activity (anterior temporal, masseter, digastric, sternocleidomastoid, upper and lower trapezius, cervical) and the body posture, by means of electromyography (EMG) and vertical force platform, respectively. Twenty four (24) healthy adults, between the ages of 24 and 31 years (25.3 +/- 1.9), with no history of craniomandibular disorder or systemic musculoskeletal dysfunction, were randomly divided into two groups: test group (fourteen subjects) and control group (ten subjects). A first recording session (TO) measured the baseline EMG and postural patterns of both groups. After this session, the test group wore test shoes with insoles that stimulated the plantar surfaces, while the control group wore placebo shoes. After one hour, a second set of measurements (T1) were performed. Significant differences between the groups at baseline were observed in the left anterior temporal, left cervical, and left upper trapezius, as well as at T1 in the left anterior temporal and right upper trapezius (p postural blindness in the test group compared to the control group was observed. Further studies are warranted to investigate the short and long-term effects of this type of insole, in patients with both craniomandibular-cervical and lower extremity disorders.

Conservative treatment of an ankylosed tooth after delayed replantation: a case report.

Science.gov (United States)

Díaz, Jaime Andrés; Sandoval, Hector Paulo; Pineda, Patricia Irene; Junod, Pablo Antonio

2007-10-01

An 8-year-old boy sustained avulsion of his upper right maxillary central incisor and lateral luxation of his upper left maxillary incisors. Subsequently, the upper right maxillary central incisor developed replacement resorption, and both upper left maxillary incisors developed pulpal canal obliteration. In the ankylosed tooth, decoronation procedure was performed, and in the 44-month follow-up period the involved alveolar site showed vertical apposition of bone and continuing replacement resorption. Decoronation is a surgical procedure that allows preservation of the bone volume for the future, avoiding aesthetic disturbances and more aggressive treatments in cases where other therapeutic alternatives are not feasible.

Quantitation of left ventricular dimensions and function by digital video subtraction angiography

International Nuclear Information System (INIS)

Higgins, C.B.; Norris, S.L.; Gerber, K.H.; Slutsky, R.A.; Ashburn, W.L.; Baily, N.

1982-01-01

Digital video subtraction angiography (DVSA) after central intravenous administration of contrast media was used in experimental animals and in patients with suspected coronary artery disease to quantitate left ventricular dimensions and regional and global contractile function. In animals, measurements of left ventricular (LV) volumes, wall thickness, ejection fraction, segmental contraction, and cardiac output correlated closely with sonocardiometry or thermodilution measurements. In patients, volumes and ejection fractions calculated from mask mode digital images correlated closely with direct left ventriculography. Global and segmental contractile function was displayed in patients by ejection shell images, stroke volume images, and time interval difference images. Central cardiovascular function was also quantitated by measurement of pulmonary transit time and calculation of pulmonary blood volume from digital fluoroscopic images. DVSA was shown to be useful and accurate in the quantitation of central cardiovascular physiology

Atypical temporal activation pattern and central-right brain compensation during semantic judgment task in children with early left brain damage.

Science.gov (United States)

Chang, Yi-Tzu; Lin, Shih-Che; Meng, Ling-Fu; Fan, Yang-Teng

In this study we investigated the event-related potentials (ERPs) during the semantic judgment task (deciding if the two Chinese characters were semantically related or unrelated) to identify the timing of neural activation in children with early left brain damage (ELBD). The results demonstrated that compared with the controls, children with ELBD had (1) competitive accuracy and reaction time in the semantic judgment task, (2) weak operation of the N400, (3) stronger, earlier and later compensational positivities (referred to the enhanced P200, P250, and P600 amplitudes) in the central and right region of the brain to successfully engage in semantic judgment. Our preliminary findings indicate that temporally postlesional reorganization is in accordance with the proposed right-hemispheric organization of speech after early left-sided brain lesion. During semantic processing, the orthography has a greater effect on the children with ELBD, and a later semantic reanalysis (P600) is required due to the less efficient N400 at the former stage for semantic integration. Copyright © 2018 Elsevier Inc. All rights reserved.

Thermal maturity and petroleum kitchen areas of Liassic Black Shales (Lower Jurassic) in the central Upper Rhine Graben, Germany

Science.gov (United States)

Böcker, Johannes; Littke, Ralf

2016-03-01

In the central Upper Rhine Graben (URG), several major oil fields have been sourced by Liassic Black Shales. In particular, the Posidonia Shale (Lias ɛ, Lower Toarcian) acts as excellent and most prominent source rock in the central URG. This study is the first comprehensive synthesis of Liassic maturity data in the URG area and SW Germany. The thermal maturity of the Liassic Black Shales has been analysed by vitrinite reflectance (VRr) measurements, which have been verified with T max and spore coloration index (SCI) data. In outcrops and shallow wells (oil window (ca. 0.50-0.60 % VRr). This maturity is found in Liassic outcrops and shallow wells in the entire URG area and surrounding Swabian Jura Mountains. Maximum temperatures of the Posidonia Shale before graben formation are in the order of 80-90 °C. These values were likely reached during Late Cretaceous times due to significant Upper Jurassic and minor Cretaceous deposition and influenced by higher heat flows of the beginning rift event at about 70 Ma. In this regard, the consistent regional maturity data (VRr, T max, SCI) of 0.5-0.6 % VRr for the Posidonia Shale close to surface suggest a major burial-controlled maturation before graben formation. These consistent maturity data for Liassic outcrops and shallow wells imply no significant oil generation and expulsion from the Posidonia Shale before formation of the URG. A detailed VRr map has been created using VRr values of 31 wells and outcrops with a structure map of the Posidonia Shale as reference map for a depth-dependent gridding operation. Highest maturity levels occur in the area of the Rastatt Trough (ca. 1.5 % VRr) and along the graben axis with partly very high VRr gradients (e.g. well Scheibenhardt 2). In these deep graben areas, the maximum temperatures which were reached during upper Oligocene to Miocene times greatly exceed those during the Cretaceous.

Influence of national centralization of oesophagogastric cancer on management and clinical outcome from emergency upper gastrointestinal conditions.

Science.gov (United States)

Markar, S R; Mackenzie, H; Wiggins, T; Askari, A; Karthikesalingam, A; Faiz, O; Griffin, S M; Birkmeyer, J D; Hanna, G B

2018-01-01

In England in 2001 oesophagogastric cancer surgery was centralized. The aim of this study was to evaluate whether centralization of oesophagogastric cancer to high-volume centres has had an effect on mortality from different emergency upper gastrointestinal conditions. The Hospital Episode Statistics database was used to identify patients admitted to hospitals in England (1997-2012). The influence of oesophagogastric high-volume cancer centre status (20 or more resections per year) on 30- and 90-day mortality from oesophageal perforation, paraoesophageal hernia and perforated peptic ulcer was analysed. Over the study interval, 3707, 12 441 and 56 822 patients with oesophageal perforation, paraoesophageal hernia and perforated peptic ulcer respectively were included. There was a passive centralization to high-volume cancer centres for oesophageal perforation (26·9 per cent increase), paraoesophageal hernia (19·5 per cent increase) and perforated peptic ulcer (23·0 per cent increase). Management of oesophageal perforation in high-volume centres was associated with a reduction in 30-day (HR 0·58, 95 per cent c.i. 0·45 to 0·74) and 90-day (HR 0·62, 0·49 to 0·77) mortality. High-volume cancer centre status did not affect mortality from paraoesophageal hernia or perforated peptic ulcer. Annual emergency admission volume thresholds at which mortality improved were observed for oesophageal perforation (5 patients) and paraoesophageal hernia (11). Following centralization, the proportion of patients managed in high-volume cancer centres that reached this volume threshold was 88·0 per cent for oesophageal perforation, but only 30·3 per cent for paraoesophageal hernia. Centralization of low incidence conditions such as oesophageal perforation to high-volume cancer centres provides a greater level of expertise and ultimately reduces mortality. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Relationship between the shape of the upper central incisors and the facial contour in dental students. Lima. Peru.

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Miguel Cabello

2015-06-01

Full Text Available Determine the relationship between the shape of the face and the shape of the upper right central incisor according to “The law of harmony” proposed by Williams. Materials and methods: This was an observational, analytic and cross-sectional study. A sample of 124 subjects, male and female students between 17 and 28 years old, was selected for the research. Their facial biotype and the shape of their upper right central incisor were determined by means of direct and photographic methods. Height and facial width were clinically evaluated using the direct method, and the proximal contours of the incisors were evaluated using a Vernier digital caliper. Images were downloaded to a computer and analyzed by means of the photographic method using Adobe Photoshop 5.0. Results: The relationship between the shape of the face and the shape of the incisor was positive in 43.5% of the sample (p=0.006 in the direct method. In the photographic method, the relationship between the shape of the face and the shape of the incisor was positive in 41.1% of the sample (p=0.037. The most frequent facial biotype in the direct and photographic methods was the dolichofacial with 61.3% and 71% respectively. The most frequent shape of the tooth with the direct and photographic methods was the ovoid with 55.6% and 51.6% respectively. Conclusion: Results do not confirm “The law of harmony” proposed by Williams, therefore when choosing the most suitable anterior tooth, experience and criteria of the dentist as well as the opinion of the patient should be taken in account in order to achieve a good aesthetic result.

Cerebral gas embolism due to upper gastrointestinal endoscopy.

Science.gov (United States)

ter Laan, Mark; Totte, Erik; van Hulst, Rob A; van der Linde, Klaas; van der Kamp, Wim; Pierie, Jean-Pierre E

2009-07-01

Cerebral gas embolism as a result of upper gastrointestinal endoscopy is a rare complication and bares a high morbidity. A patient is presented who underwent an upper endoscopy for evaluation of a gastric-mediastinal fistula after subtotal oesophagectomy and gastric tube reconstruction because of oesophageal cancer. During the procedure, cerebral gas emboli developed resulting in an acute left-sided hemiparesis. After hyperbaric oxygen therapy, the patient recovered almost completely. The aetiology and treatment is discussed based on the reviewed literature. Once cerebral gas emboli are recognized, patient outcome can be improved by hyperbaric oxygen therapy.

The ISOLDE experimental hall, wth the isotope separator in the upper left corner.

CERN Multimedia

CERN PhotoLab

1969-01-01

Beam tubes branch out from a switchyard, which by electrostatic deflectors direct beams of short-lived isotopes to various spectroscopic equipment. From left to right, Rudi Stoeckli at the separator control panel, Gilbert Droz and Henri Bersinger.

Analysis of 1997–2008 groundwater level changes in the upper Deschutes Basin, Central Oregon

Science.gov (United States)

Gannett, Marshall W.; Lite, Kenneth E.

2013-01-01

Groundwater-level monitoring in the upper Deschutes Basin of central Oregon from 1997 to 2008 shows water-level declines in some places that are larger than might be expected from climate variations alone, raising questions regarding the influence of groundwater pumping, canal lining (which decreases recharge), and other human influences. Between the mid-1990s and mid-2000s, water levels in the central part of the basin near Redmond steadily declined as much as 14 feet. Water levels in the Cascade Range, in contrast, rose more than 20 feet from the mid-1990s to about 2000, and then declined into the mid-2000s, with little or no net change. An existing U.S. Geological Survey regional groundwater-flow model was used to gain insights into groundwater-level changes from 1997 to 2008, and to determine the relative influence of climate, groundwater pumping, and irrigation canal lining on observed water-level trends. To utilize the model, input datasets had to be extended to include post-1997 changes in groundwater pumping, changes in recharge from precipitation, irrigation canal leakage, and deep percolation of applied irrigation water (also known as on-farm loss). Mean annual groundwater recharge from precipitation during the 1999–2008 period was 25 percent less than during the 1979–88 period because of drying climate conditions. This decrease in groundwater recharge is consistent with measured decreases in streamflow and discharge to springs. For example, the mean annual discharge of Fall River, which is a spring-fed stream, decreased 12 percent between the 1979–88 and 1999–2008 periods. Between the mid-1990s and late 2000s, groundwater pumping for public-supply and irrigation uses increased from about 32,500 to 52,000 acre-feet per year, partially because of population growth. Between 1997 and 2008, the rate of recharge from leaking irrigation canals decreased by about 58,000 acre-feet per year as a result of lining and piping of canals. Decreases in recharge

Upper airway resistance syndrome. Central electroencephalographic power and changes in breathing effort.

Science.gov (United States)

Black, J E; Guilleminault, C; Colrain, I M; Carrillo, O

2000-08-01

Upper airway resistance syndrome (UARS) is defined by excessive daytime sleepiness and tiredness, and is associated with increased breathing effort. Its polygraphic features involve progressive increases in esophageal pressure (Pes), terminated by arousal (AR) as defined by the American Sleep Disorders Association (ASDA). With the arousal there is an abrupt decrease in Pes, called Pes reversal. However, Pes reversal can be seen without the presence of an AR. We performed spectral analysis on electroencephalographic data from a central lead for both AR and nonarousal (N-AR) events obtained from 15 UARS patients (eight men and seven women). Delta band activity was increased before and surrounding Pes reversal regardless of the presence or absence of AR. In the period after Pes reversal, alpha, sigma, and beta activity showed a greater increase in AR events than in N-AR events. The Pes measures were identical leading up to the point of reversal, but showed a longer-lasting and significantly greater decrease in respiratory effort after an AR. The data indicate that substantial electroencephalographic changes can be identified in association with Pes events, even when ARs cannot be detected according to standard criteria; however, visually identifiable electroencephalographic arousals clearly have a greater impact on ongoing inspiratory effort.

An integrated rock-magnetic and geochemical approach to loess/paleosol sequences from Bohemia and Moravia (Czech Republic): Implications for the Upper Pleistocene paleoenvironment in central Europe

Czech Academy of Sciences Publication Activity Database

Hošek, J.; Hambach, U.; Lisá, Lenka; Matys Grygar, Tomáš; Horáček, I.; Meszner, S.; Knésl, I.

2015-01-01

Roč. 418, 15 January (2015), s. 344-358 ISSN 0031-0182 Institutional support: RVO:67985831 ; RVO:61388980 Keywords : loess/paleosols sequences * rock-magnetism * geochemical proxies * Upper Pleistocene * paleoclimate * Central Europe Subject RIV: DB - Geology ; Mineralogy; DD - Geochemistry (UACH-T) Impact factor: 2.525, year: 2015

Initial forces and moments delivered by removable thermoplastic appliances during rotation of an upper central incisor.

Science.gov (United States)

Hahn, Wolfram; Engelke, Benjamin; Jung, Klaus; Dathe, Henning; Fialka-Fricke, Julia; Kubein-Meesenburg, Dietmar; Sadat-Khonsari, Reza

2010-03-01

To determine the forces and moments delivered to a maxillary central incisor during rotation by three different thermoplastic appliances with identical thickness. Five identical appliances were manufactured from each of three materials (Ideal Clear 1.0 mm, Erkodur 1.0 mm, Biolon 1.0 mm). An upper central incisor fixed in a measuring device was rotated around its central axis in 0.5-degree steps to +/-2.5 degrees, +/-5 degrees, and +/-7.5 degrees (equivalent to an activation of +/-0.17 mm, +/-0.34 mm, and +/-0.51 mm of the incisor edge) in the clockwise and anticlockwise directions with the respective appliance fixed in place. For statistical analysis, the moments Tz (rotation) and forces Fz (intrusion) were tested. Means and standard deviations for Tz and median and 25% and 75% quantiles for Fz were calculated. An analysis of variance (ANOVA) was performed. The minimal moment was determined at a rotation of -0.17 mm (-7.3 Nmm, +/-0.8), and the maximal moment at a deflection of -0.51 mm (-71.8 Nmm. +/-2.5) was recorded. The minimal value for Fz was measured at an activation of -0.17 mm (0.0 N), and the highest intrusive forces were evaluated for a rotation of -0.51 mm (-5.8 N). The particular material sometimes had a significant (P aligners, an intrusive force can also be observed. The direction of rotation, and the materials used all exert an influence on the force delivery properties of the appliance.

Class II malocclusion with mutilated anterior segment: Treated with a rare approach-creating an apparent midline

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Abhishek Kshetrapal

2013-01-01

The following case report shows a 15-year-old male patient with Class II malocclusion who had missing central incisor and canine in the upper right quadrant, which were extracted around 4 years back. The case was treated by space closure involving movement of left central incisor into right central incisor position and conversion of the left lateral incisor into left central incisor. Overall an esthetic result was achieved saving the patient from the need for a prosthesis.

Use of the Amplatzer ASD Occluder for Closing a Persistent Left Vertical Vein

International Nuclear Information System (INIS)

Zanchetta, Mario; Zennaro, Marco; Zecchel, Roberto; Mancuso, Daniela; Pedon, Luigi

2009-01-01

We report the case of a very large anomalous connection of the veins draining the upper lobe of the left lung to both the left-sided vertical vein and the left atrium, associated with mild rheumatic mitral valve stenosis, in which the atrial septum was intact and the remaining venous system, including the coronary sinus, was otherwise normal (a variant of Lutembacher's syndrome). In order to abolish the left-to-right shunting, a transcatheter approach to close this venous structure was successfully attempted using an Amplatzer ASD Occluder device. The technical aspects and the alternative options of performing a procedure with a device for a purpose outside the scope of its approved label are discussed.

An objective assessment of safety to drive in an upper limb cast.

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Stevenson, H L; Peterson, N; Talbot, C; Dalal, S; Watts, A C; Trail, I A

2013-03-01

Patients managed with upper limb cast immobilization often seek advice about driving. There is very little published data to assist in decision making, and advice given varies between healthcare professionals. There are no specific guidelines available from the UK Drivers and Vehicles Licensing Agency, police, or insurance companies. Evidence-based guidelines would enable clinicians to standardize the advice given to patients. Six individuals (three male, three female; mean age 36 years, range 27-43 years) were assessed by a mobility occupational therapist and driving standards agency examiner while completing a formal driving test in six different types of upper limb casts (above-elbow, below-elbow neutral, and below-elbow cast incorporating the thumb [Bennett's cast]) on both left and right sides. Of the 36 tests, participants passed 31 tests, suggesting that most people were able to safely drive with upper limb cast immobilization. However, driving in a left above-elbow cast was considered unsafe.

Abnormal Degree Centrality of Bilateral Putamen and Left Superior Frontal Gyrus in Schizophrenia with Auditory Hallucinations: A Resting-state Functional Magnetic Resonance Imaging Study.

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Chen, Cheng; Wang, Hui-Ling; Wu, Shi-Hao; Huang, Huan; Zou, Ji-Lin; Chen, Jun; Jiang, Tian-Zi; Zhou, Yuan; Wang, Gao-Hua

2015-12-05

Dysconnectivity hypothesis of schizophrenia has been increasingly emphasized. Recent researches showed that this dysconnectivity might be related to occurrence of auditory hallucination (AH). However, there is still no consistent conclusion. This study aimed to explore intrinsic dysconnectivity pattern of whole-brain functional networks at voxel level in schizophrenic with AH. Auditory hallucinated patients group (n = 42 APG), no hallucinated patients group (n = 42 NPG) and normal controls (n = 84 NCs) were analyzed by resting-state functional magnetic resonance imaging. The functional connectivity metrics index (degree centrality [DC]) across the entire brain networks was calculated and evaluated among three groups. DC decreased in the bilateral putamen and increased in the left superior frontal gyrus in all the patients. However, in APG, the changes of DC were more obvious compared with NPG. Symptomology scores were negatively correlated with the DC of bilateral putamen in all patients. AH score of APG positively correlated with the DC in left superior frontal gyrus but negatively correlated with the DC in bilateral putamen. Our findings corroborated that schizophrenia was characterized by functional dysconnectivity, and the abnormal DC in bilateral putamen and left superior frontal gyrus might be crucial in the occurrence of AH.

Absence of Middle Hepatic Vein Combined with Retro-Aortic Left Renal Vein: a Very Rare Case Report

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Sezer Akçer

2012-06-01

Full Text Available The hepatic and renal veins drain into the inferior vena cava. The upper group of hepatic veins consists of three veins which extend to the posterior face of the liver to join the inferior cava. The left renal vein passes anterior to the aorta just below the origin of the superior mesenteric artery. We detected a variation in the hepatic and renal veins in a multislice CT angiogram of a nine-year-old male patient in the Radiology Department of Afyon Kocatepe University Medical School. The upper group hepatic veins normally drains into the inferior vena cava as three separate trunks, namely the right, left and middle. In our case, we found that only the right and left hepatic veins existed and the middle hepatic vein was absent. Furthermore, the left renal vein, which normally passes anterior to the abdominal aorta, was retro-aortic. Left renal vein variations are of great importance in planning retroperitoneal surgery and vascular interventions. Knowledge of a patient’s hepatic vein and renovascular anatomy and determining their variations and anomalies are of critical importance to abdominal operations, transplantations and preoperative evaluation of endovascular interventions.

Association between social capital and health-related quality of life among left behind and not left behind older people in rural China.

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Zhong, Yaqin; Schön, Pär; Burström, Bo; Burström, Kristina

2017-12-16

The association between social capital and health-related quality of life (HRQoL) has not been thoroughly studied among older persons in rural China, especially among those who were left behind or not. This study investigates the association between social capital and HRQoL and examines possible differences of this association between being left behind or not in rural China. A cross-sectional survey of 825 people aged 60 years and older, residing in three rural counties in Jiangsu Province in China, was conducted in 2013. Factor analysis was performed to measure social capital. EQ-5D was used to measure HRQoL. Tobit regression analysis with upper censoring was conducted to explore the association between social capital and EQ-5D index. After controlling for individual characteristics, low social capital and being left behind were significantly associated with low HRQoL. Old people with low social capital had 0.055 lower EQ-5D index compared to those with high social capital. Old people being left behind had 0.040 lower EQ-5D index compared to those who were not left behind. For different dimensions of social capital, the main effects came from the domain of trust and reciprocity. There was a significant interaction between low social capital and being left behind on HRQoL, suggesting that low social capital was associated with low HRQoL among persons left behind. Our findings indicate that the left behind old people with low social capital were a potentially vulnerable group in rural China. Formulating and implementing initiatives and strategies which increase social capital may foster better HRQoL, especially for old people who were left behind.

Headache and Central Positioning Vertigo in a Middle Aged Female-a Case of Solitary Cerebellar Tuberculoma Involving Left Cerebellar Hemisphere

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Shakya Bhattacharjee

2012-03-01

Full Text Available A 48 year old female presented with headache and an illusory sensation of spinning of head in respect to environment for last 8 weeks. Her head spinning or vertigo had no particular direction or not precipitated by any specific head posture. Headache is non- specific in nature and intensified in last few days.Her neurological examination revealed a central positional vertigo with horizontal gaze evoked nystagmus and ataxia. Her MRI scan brain showed the presence of a large solitary ring enhancing lesion in the left cerebellar hemisphere. The lesion was surgically excised and was examined histopathologicaliy that revealed a chronic inflammatory granuloma with caseation necrosis and multinucleated giant cells suggestive of tuberculosis

Non-bronchial collateral supply from the left gastric artery in massive haemoptysis

International Nuclear Information System (INIS)

Sellars, N.; Belli, A.M.

2001-01-01

Two patients presented with recurrent, massive haemoptysis. Arteriography, including thoracoabdominal aortograms, revealed in both cases large non-bronchial collaterals arising from the left gastric artery. In the first case the non-bronchial collateral supplied the upper left lobe and in the second case it supplied the middle right lobe. Percutaneous embolisation of bronchial and non-bronchial collateral branches has become an accepted procedure in controlling massive or recurrent haemoptysis. Accurate identification of the non-bronchial collateral arterial feeders is essential for successful embolotherapy. (orig.)

Unusual idiopathic normal pressure hydrocephalus patient with marked asymmetric and upper body parkinsonism

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Kyunghun Kang

2016-01-01

Full Text Available Asymmetry of parkinsonian symptoms is strong evidence toward the diagnosis of Parkinson's disease (PD. Lower body parkinsonism is characteristic in idiopathic normal pressure hydrocephalus (INPH. We report an unusual INPH patient with marked asymmetric and upper body parkinsonism. An 83-year-old man presented with gait impairment and asymmetric clumsiness of movement. According to the Unified Parkinson's Disease Rating Scale (UPDRS, the motor subscore was 12 in the left limb and 8 in the right. The score was 14 for both the upper and lower body. After the cerebrospinal fluid tap test (CSFTT, he showed marked improvement in the upper body score. A loss of asymmetry of parkinsonian signs, with greater improvement in the left limb, was presented. Fluorinated N-3-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl-nortropane (F-18 FP-CIT positron emission tomography (PET imaging was normal. In the differential diagnosis of elderly patients presenting with parkinsonism compatible with PD, we might need to consider a diagnosis of INPH.

Modulation of left primary motor cortex excitability after bimanual training and intermittent theta burst stimulation to left dorsal premotor cortex.

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Neva, Jason L; Vesia, Michael; Singh, Amaya M; Staines, W Richard

2014-03-15

Bimanual visuomotor movement training (BMT) enhances the excitability of human preparatory premotor and primary motor (M1) cortices compared to unimanual movement. This occurs when BMT involves mirror symmetrical movements of both upper-limbs (in-phase) but not with non-symmetrical movements (anti-phase). The neural mechanisms mediating the effect of BMT is unclear, but may involve interhemispheric connections between homologous M1 representations as well as the dorsal premotor cortices (PMd). The purpose of this study is to assess how intermittent theta burst stimulation (iTBS) of the left PMd affects left M1 excitability, and the possible combined effects of iTBS to left PMd applied before a single session of BMT. Left M1 excitability was quantified using transcranial magnetic stimulation (TMS) in terms of both the amplitudes and spatial extent of motor evoked potentials (MEPs) for the extensor carpi radialis (ECR) before and multiple time points following (1) BMT, (2) iTBS to left PMd or (3) iTBS to left PMd and BMT. Although there was not a greater increase in either specific measure of M1 excitability due to the combination of the interventions, iTBS applied before BMT showed that both the spatial extent and global MEP amplitude for the ECR became larger in parallel, whereas the spatial extent was enhanced with BMT alone and global MEP amplitude was enhanced with iTBS to left PMd alone. These results suggest that the modulation of rapid functional M1 excitability associated with BMT and iTBS of the left PMd could operate under related early markers of neuro-plastic mechanisms, which may be expressed in concurrent and distinct patterns of M1 excitability. Critically, this work may guide rehabilitation training and stimulation techniques that modulate cortical excitability after brain injury. Copyright © 2013 Elsevier B.V. All rights reserved.

Portable upper extremity robotics is as efficacious as upper extremity rehabilitative therapy: a randomized controlled pilot trial.

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Page, Stephen J; Hill, Valerie; White, Susan

2013-06-01

To compare the efficacy of a repetitive task-specific practice regimen integrating a portable, electromyography-controlled brace called the 'Myomo' versus usual care repetitive task-specific practice in subjects with chronic, moderate upper extremity impairment. Sixteen subjects (7 males; mean age 57.0 ± 11.02 years; mean time post stroke 75.0 ± 87.63 months; 5 left-sided strokes) exhibiting chronic, stable, moderate upper extremity impairment. Subjects were administered repetitive task-specific practice in which they participated in valued, functional tasks using their paretic upper extremities. Both groups were supervised by a therapist and were administered therapy targeting their paretic upper extremities that was 30 minutes in duration, occurring 3 days/week for eight weeks. One group participated in repetitive task-specific practice entirely while wearing the portable robotic, while the other performed the same activity regimen manually. The upper extremity Fugl-Meyer, Canadian Occupational Performance Measure and Stroke Impact Scale were administered on two occasions before intervention and once after intervention. After intervention, groups exhibited nearly identical Fugl-Meyer score increases of ≈2.1 points; the group using robotics exhibited larger score changes on all but one of the Canadian Occupational Performance Measure and Stroke Impact Scale subscales, including a 12.5-point increase on the Stroke Impact Scale recovery subscale. Findings suggest that therapist-supervised repetitive task-specific practice integrating robotics is as efficacious as manual practice in subjects with moderate upper extremity impairment.

Surgical management for upper urinary tract transitional cell carcinoma.

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Rai, Bhavan Prasad; Shelley, Mike; Coles, Bernadette; Biyani, Chandra S; El-Mokadem, Ismail; Nabi, Ghulam

2011-04-13

Upper tract transitional cell carcinomas (TCC) are uncommon and aggressive tumours. There are a number of surgical approaches to manage this condition including open radical nephroureterectomy and laparoscopic procedures. To determine the best surgical management option for upper tract transitional cell carcinoma. A sensitive search strategy was developed to identify relevant studies for inclusion in this review. The following databases were searched for randomised trials evaluating surgical approaches to the management of upper tract TCC: Medline EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, British Nursing Index, AMED, LILACS, Web of Science®, Scopus, Biosis, TRIP, Biomed Central, Dissertation Abstracts, and ISI Proceedings. The following criteria that were considered for this review.Types of studies - All randomised or quasi-randomised controlled trials comparing the various surgical methods and approaches for the management of localised upper tract transitional cell carcinoma. Types of participants - All adult patients with localised transitional cell carcinoma. Localised disease was defined as limited to the kidney or ureter with no gross regional lymph nodal enlargement on imaging. Types of interventions - Any surgical method or approach for managing localised upper tract transitional cell carcinoma. Types of outcome measures - Overall and cancer-specific survival were primary outcomes. Surgery-related morbidity. Quality of life and health economics outcomes were secondary outcomes. Two review authors examined the search results independently to identify trials for inclusion. We identified one randomised controlled trial that met our inclusion criteria. The trial showed that the laparoscopic approach had superior peri-operative outcomes compared to open approach. Laparoscopic was superior and statistically significant for blood loss (104 mL (millilitres) versus 430 mL, P management of upper tract transitional cell carcinoma

Multiple sclerosis: Left advantage for auditory laterality in dichotic tests of central auditory processing and relationship of psychoacoustic tests with the Multiple Sclerosis Disability Scale-EDSS.

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Peñaloza López, Yolanda Rebeca; Orozco Peña, Xóchitl Daisy; Pérez Ruiz, Santiago Jesús

2018-04-03

To evaluate the central auditory processing disorders in patients with multiple sclerosis, emphasizing auditory laterality by applying psychoacoustic tests and to identify their relationship with the Multiple Sclerosis Disability Scale (EDSS) functions. Depression scales (HADS), EDSS, and 9 psychoacoustic tests to study CAPD were applied to 26 individuals with multiple sclerosis and 26 controls. Correlation tests were performed between the EDSS and psychoacoustic tests. Seven out of 9 psychoacoustic tests were significantly different (P<.05); right or left (14/19 explorations) with respect to control. In dichotic digits there was a left-ear advantage compared to the usual predominance of RDD. There was significant correlation in five psychoacoustic tests and the specific functions of EDSS. The left-ear advantage detected and interpreted as an expression of deficient influences of the corpus callosum and attention in multiple sclerosis should be investigated. There was a correlation between psychoacoustic tests and specific EDSS functions. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Persistent Left Superior Vena Cava, The View of a Rare Case

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H.Volkan Kara

2013-10-01

Full Text Available The glenohumeral joint is the most commonly dislocated joint in the human body. Anterior dislocatin is the most common type and posterior dislocations account for <1% of shoulder dislocations.  A 68-yearold woman was brought to the emergency department by ambulance  with shoulder pain following a fall from stairs. On local physical examination, there was severe pain on the left proximal humerus. The left arm was in internal rotation in the adducted position. Active and passive movements of the left shoulder were painful and limited. The neurovascular examination of the left upper extremity revealed no deficit. Radiographs of her left shoulder were performed and no significant pathology was identified in the left shoulder anteroposterior (AP X-ray (Figure 1. Axillary radiography could not be performed because of painful arm movements. Therefore, CT was performed to clarify any existing shoulder pathology (Figure 2. Closed reduction under conscious sedation was performed with longitudinal and lateral traction on the arm to protect the humeral head. Control CT was performed and this revealed that reduction had improved the shoulder (Figure 3. She was then treated with an arm sling and discharged with an outpatient orthopaedic control visit.

Streamflow gain and loss and water quality in the upper Nueces River Basin, south-central Texas, 2008-10

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Banta, J. Ryan; Lambert, Rebecca B.; Slattery, Richard N.; Ockerman, Darwin J.

2012-01-01

The U.S. Geological Survey-in cooperation with the U.S. Army Corps of Engineers, The Nature Conservancy, the Real Edwards Conservation and Reclamation District, and the Texas Parks and Wildlife Department-investigated streamflow gain and loss and water quality in the upper Nueces River Basin, south-central Texas, specifically in the watersheds of the West Nueces, Nueces, Dry Frio, Frio, and Sabinal Rivers upstream from the Edwards aquifer outcrop. Streamflow in these rivers is sustained by groundwater contributions (for example, from springs) and storm runoff from rainfall events. To date (2012), there are few data available that describe streamflow and water-quality conditions of the rivers within the upper Nueces River Basin. This report describes streamflow gain-loss characteristics from three reconnaissance-level synoptic measurement surveys (hereinafter referred to as "surveys") during 2008-10 in the upper Nueces River Basin. To help characterize the hydrology, groundwater-level measurements were made, and water-quality samples were collected from both surface-water and groundwater sites in the study area from two surveys during 2009-10. The hydrologic (streamflow, springflow, and groundwater) measurements were made during three reconnaissance-level synoptic measurement surveys occurring in July 21-23, 2008; August 8-18, 2009; and March 22-24, 2010. These survey periods were selected to represent different hydrologic conditions. Streamflow gains and losses were based on streamflow and springflow measurements made at 74 sites in the study area, although not all sites were measured during each survey. Possible water chemistry relations among sample types (streamflow, springflow, or groundwater), between surveys, and among watersheds were examined using water-quality samples collected from as many as 20 sites in the study area.

Clinical comparison of automatic, noninvasive measurements of blood pressure in the forearm and upper arm.

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Schell, Kathleen; Bradley, Elisabeth; Bucher, Linda; Seckel, Maureen; Lyons, Denise; Wakai, Sandra; Bartell, Deborah; Carson, Elizabeth; Chichester, Melanie; Foraker, Teresa; Simpson, Kathleen

2005-05-01

When the upper arm (area from shoulder to elbow) is inaccessible and/or a standard-sized blood pressure cuff does not fit, some healthcare workers use the forearm to measure blood pressure. To compare automatic noninvasive measurements of blood pressure in the upper arm and forearm. A descriptive, correlational comparison study was conducted in the emergency department of a 1071-bed teaching hospital. Subjects were 204 English-speaking patients 6 to 91 years old in medically stable condition who had entered the department on foot or by wheelchair and who had no exclusions to using their left upper extremity. A Welch Allyn Vital Signs 420 series monitor was used to measure blood pressure in the left upper arm and forearm with the subject seated and the upper arm or forearm at heart level. Pearson r correlation coefficients between measurements in the upper arm and forearm were 0.88 for systolic blood pressure and 0.76 for diastolic blood pressure (P upper arm and forearm differed significantly (t = 2.07, P = .04). A Bland-Altman analysis indicated that the distances between the mean values and the limits of agreement for the 2 sites ranged from 15 mm Hg (mean arterial pressure) to 18.4 mm Hg (systolic pressure). Despite strict attention to correct cuff size and placement of the upper arm or forearm at heart level, measurements of blood pressure obtained noninvasively in the arm and forearm of seated patients in stable condition are not interchangeable.

Recurrent Upper Quadrant Pain: A Fish Bone Secondary to Gastric Perforation and Liver Abscess

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Hui Liang

2011-12-01

Full Text Available A 60-year-old male patient was admitted to our hospital for recurrent upper quadrant pain for 1 month. He had a past history of coronary artery disease. After admission, he repeatedly suffered from high-grade fever, chills and upper quadrant pain. Computed tomography (CT showed a round hypodense mass in the left lobe of the liver, approximately 2.7 × 2.2 cm in size, and a fish bone was confirmed by surgery in the left lobe of liver. The patient was cured completely after surgical removal of the fish bone and liver abscess. CT scan 1 month after discharge showed that the liver abscess had disappeared completely.

Left ventricular functions in children with newly diagnosed Graves' disease. A single-center study from Upper Egypt.

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Metwalley, Kotb Abbass; Farghaly, Hekma Saad; Abdelhamid, Abdelrahman

2018-01-01

This study aimed to evaluate the left ventricular (LV) functions in a cohort of children with Graves' disease (GD). This is a cross-sectional case-control study. It included 36 children with GD and 36 healthy children matched for age and gender. Thyroid hormones (TSH, FT4, and FT3) and anti-thyroid autoantibodies [anti-thyroid peroxidase (anti-TPO), thyrotropin receptor (TRAbs), and thyroglobulin antibodies] were measured. Conventional and tissue Doppler imaging (TDI) echocardiographies were used to assess left ventricular systolic and diastolic functions. LV mass index (LVMI) and myocardial performance index (MPI) were also measured. Compared to healthy children, conventional echocardiography of patients with GD revealed higher LVMI (P = 0.001) indicating LV hypertrophy but normal LV functions while TDI revealed lower Em/Am ratio indicating LV diastolic dysfunction (P = 0.001). Significant correlations were reported between FT4 with LVMI (P = 0.05), Em/Am (P = 0.01), and MPI (P = 0.01). In multivariate analysis, a positive correlation was identified between FT4 with MPI (OR = 1.17; 95% CI = 1.09-1.15; P = 0.001). Children with newly diagnosed GD may have significant subclinical changes in LV structure and function (diastolic and global). TDI is more sensitive than conventional Doppler in detecting LV dysfunction. These findings highlight the importance of early monitoring of children with GD for left ventricular mass index and diastolic function. What is Known: • There is an increased risk for cardiac abnormalities in children with Graves' disease (GD). • Limited studies assessed left ventricular function in patients with GD. What is New: • Children with newly diagnosed GD may have significant subclinical changes in left ventricular structure and functions. • Children with newly diagnosed GD should be monitored for left ventricular mass index and diastolic function.

On the perturbations of spectra of upper triangular operator matrices

International Nuclear Information System (INIS)

Barraa, Mohamed; Boumazgour, Mohamed

2003-07-01

In this paper we investigate perturbations of the left essential spectrum, right essential spectrum, essential spectrum and the regular spectrum of an upper triangular operator matrix such as M C - [A 11 C 12 O 21 B 22 ] acting on a Hilbert space H + K. (author)

Influence of Preadjusted Bracket Shape and Positioning Reference on Angulation of Upper Central Incisor.

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Topolski, Francielle; de O Accorsi, Mauricio A; Trevisi, Hugo J; Cuoghi, Osmar A; Moresca, Ricardo

2016-10-01

To verify the influence of different bracket shapes and placement references according to Andrews and MBT systems on the expression of angulation in upper central incisors (UCI). Bracket positioning and mesiodistal dental movement simulations were performed and the angulations produced in the dental crown were evaluated, based on computed tomography scan images of 30 UCI and AutoCAD software analysis. Rectangular (Andrews) and rhomboid (MBT) brackets were placed according to the references recommended by Andrews and MBT systems - long axis of the clinical crown (LACC) and incisal edge (IE) respectively. Data showed that the use of LACC as reference for bracket positioning produced 5° and 4° UCI angulations in Andrews and MBT brackets respectively. The use of IE produced a 1.2° mean angulation in UCI for both brackets. When the LACC was used as reference for bracket positioning, the UCI crown angulation corresponded to the angulation built into the brackets, regardless of shape, while the use of IE resulted in natural crown angulation, regardless of bracket shape. This research contributes to guide the orthodontist in relation to the different treatment techniques based on the use of preadjusted brackets.

Effects of upper-limb immobilisation on driving safety.

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Gregory, J J; Stephens, A N; Steele, N A; Groeger, J A

2009-03-01

Doctors are frequently asked by patients whether it is safe to drive with an upper limb immobilised in a cast. In the literature there are no objective measurements of the effects of upper-limb immobilisation upon driving performance. Eight healthy volunteers performed four 20-min driving circuits in a driving simulator (STISIM 400W), circuits 1 and 4 without immobilisation and circuits 2 and 3 with immobilisation. Immobilisation involved a lightweight below-elbow cast with the thumb left free. Volunteers were randomised to right or left immobilisation for circuit 2, and the contralateral wrist was immobilised for circuit 3. Circuits included urban and rural environments and specific hazards (pedestrians crossing, vehicles emerging from a concealed entrance, traffic lights changing suddenly, avoidance of an oncoming vehicle in the driver's carriageway). Limb immobilisation led to more cautious rural and urban driving, with less adjustment of speed and lateral road position than when unrestricted. However when responding to hazards immobilisation caused less safe driving, with higher speeds, a greater proximity to the hazard before action was taken and less steering adjustment. The effects of restriction upon performance were more prevalent and severe with right-arm immobilisation. Upper-limb immobilisation appears to have little effect on the ability to drive a car unchallenged, but to adversely affect responses to routine hazards. Advice on ability to drive safely should be cautious, as the impact of immobilisation appears to be more subtle and wide ranging than previously thought.

Repair of pectus excavatum in a toddler with Prune Belly syndrome and left bronchus compression

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Shawn T. Liechty

2017-01-01

Full Text Available A 2-year-old boy with prune-belly syndrome and severe pectus excavatum experienced recurrent pulmonary infections. A CT scan of the chest demonstrated compression of the left mainstem bronchus and leftward shift of the heart. The bronchial compression resulted in left upper lobe collapse and left lower lobe air-trapping requiring two hospitalizations for respiratory distress and pneumonia. The child underwent minimally invasive repair of his pectus excavatum and has not experienced any further pulmonary events. The pectus bar was removed 3 years post-operatively and at seven years following surgery he has a sustained repair.

Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

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Baoguo Xu

2011-09-01

Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot-assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three-dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot-assisted upper limb rehabilitation system, the patient's EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patient's motivation and attention and directly facilitate upper limb post-stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot-assisted training with motor imagery-based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

Coexisting contraction-extension consistent with buoyancy of the crust and upper mantle in North-Central Italy

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Aoudia, A; Ismail-Zadeh, A T; Panza, G F; Pontevivo, A

2002-01-01

The juxtaposed contraction and extension observed in the crust of the Italian Apennines and elsewhere has, for a long time, attracted the attention of geoscientists and is a long-standing enigmatic feature. Several models, invoking mainly external forces, have been put forward to explain the close association of these two end-member deformation mechanisms clearly observed by geophysical and geological investigations. These models appeal to interactions along plate margins or at the base of the lithosphere such as back-arc extension or shear tractions from mantle flow or to subduction processes such as slab roll back, retreat or pull and detachment. We present here a revisited crust and upper mantle model that supports delamination processes beneath North-Central Italy and provides a new background for the genesis and age of the recent magmatism in Tuscany. Although external forces must have been important in the building up of the Apennines, we show that internal buoyancy forces solely can explain the coexist...

Radiation Retinopathy Associated with Central Retinal Vein Occlusion

Institute of Scientific and Technical Information of China (English)

Yan; Liu; FengWen

2007-01-01

Purpose: To report a case of radiation retinopathy associated with central retinal vein occlusion.Methods: The clinical features and fundus fluorescein angiography of this case were analyzed.Results: The patient had been treated with radiotherapy for her nasopharyngeal carcinoma, and presented with sudden visual loss in the left eye. The funduscopic examination and fluorescein angiography showed the features of radiation retinopathy in both eyes, and central retinal vein occlusion in the left eye.Conclusions: Radiation retinopathy can be associated with central retinal vein occlusion in the same eye, and it seems that the endothelial cell loss caused by radiation retinopathy may lead to retinal vein occlusion.

Unusual metastasis of left colon cancer: considerations on two cases.

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Gubitosi, Adelmo; Moccia, Giancarlo; Malinconico, Francesca Antonella; Gilio, Francesco; Iside, Giovanni; Califano, Umberto G A; Foroni, Fabrizio; Ruggiero, Roberto; Docimo, Giovanni; Parmeggiani, Domenico; Agresti, Massimo

2009-04-01

Usually, left colon cancer metastasis concerns liver, abdominal lymph nodes and lungs. Other localizations are quite rare occurrences. In spite of this, some uncommon metastasis sites are reported in literature, such as: peritoneum, ovaries, uterus, kidney testis, bones, thyroid, oral cavity and central nervous system. We report two cases of unusual localizations of left colon cancer metastasis localization, one into the retroperitoneal space and the other at the left axillary lynphnodes and between liver and pancreas. In the first reported case the diffusion pathway may have been the lymphatic mesocolic vessels, partially left in place from the previous surgery. In the second case the alleged metastatic lane may have been through the periumbilical lymph nodes to the parasternal lymph nodes and then to the internal mammary ones, finally reaching the axillary limph nodes.

The Upper Permian in the Netherlands

NARCIS (Netherlands)

Visser, W.A.

1955-01-01

The Upper Permian in the Netherlands, as known from borehole data, is deposited in a mainly evaporitic facies north of the Brabant and Rhenish Massifs. In the extreme south (Belgian Campine, de Peel) a near-shore facies of reef dolomites and elastics occurs. In the western and central Netherlands

Left-colon antegrade continence enema (LACE) procedure for fecal incontinence.

Science.gov (United States)

Churchill, Bernard M; De Ugarte, Daniel A; Atkinson, James B

2003-12-01

Antegrade continence enemas (ACE) are an efficacious therapeutic option for patients with fecal incontinence. The authors review their institution's experience with a variation of the Monti-Malone ACE procedure using the left colon as a source of an intestinal conduit and enema reservoir. From 2000 to 2002, 18 patients with fecal incontinence or intractable constipation underwent left-colon ACE (LACE) procedure. Concomitant Mitrofanoff appendicovesicostomy was performed in 15 patients and bladder augmentation in 9. The majority of patients had neural tube defects. A segment of left colon was tubularized, tunneled into the muscular wall of the distal colon, and exteriorized through the left upper quadrant or midabdomen. Stomal catherization and enema installation were started one month postoperatively. Fifteen patients (83%) achieved fecal continence, 2 remain incontinent of stool, and 1 experienced stomal closure (mean follow-up was 24 +/- 9 months). Two patients had stomal stenosis that required revision. The mean enema volume in patient's achieving continence was 360 +/- 216 mL, and the mean transit time was 18 +/- 12 minutes. LACE is an efficacious procedure for fecal incontinence that can be performed safely at the time of major urologic reconstruction. Administration of enemas into the left colon has several physiologic advantages that result in predictable bowel evacuation.

Left Vocal Cord Paralysis Detected by PET/CT in a Case of Lung Cancer

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Ali Ozan Oner

2015-01-01

Full Text Available We report a patient with lung cancer. The first PET/CT imaging revealed hypermetabolic mass in the left aortopulmonary region and hypermetabolic nodule in the anterior segment of the upper lobe of the left lung. After completing chemotherapy and radiotherapy against the primary mass in the left lung, the patient underwent a second PET/CT examination for evaluation of treatment response. This test demonstrated, compared with the first PET/CT, an increase in the size and metabolic activity of the primary mass in the left lung in addition to multiple, pathologic-sized, hypermetabolic metastatic lymph nodes as well as multiple metastatic sclerotic areas in bones. These findings were interpreted as progressive disease. In addition, an asymmetrical FDG uptake was noticed at the level of right vocal cord. During follow-up, a laryngoscopy was performed, which demonstrated left vocal cord paralysis with no apparent mass. Thus, we attributed the paralytic appearance of the left vocal cord to infiltration of the left recurrent laryngeal nerve by the primary mass located in the apical region of the left lung. In conclusion, the knowledge of this pitfall is important to avoid false-positive PET results.

Left ventricular systolic dysfunction after transcatheter closure of a large patent ductus arteriosus.

Science.gov (United States)

Galal, Mohammed Omar; Arfi, Muhammed Amin; Nicole, Sekarski; Payot, Maurice; Hussain, Arif; Qureshi, Shakeel

2005-11-01

A 12-year-old boy reported in outpatient department with history of shortness of breath and dyspnoea on moderate exertion. Physical examination was significant for bounding pulses and for a continuous murmur III/VI, best heard at the left upper sternal border. Echocardiography confirmed a large patent arterial duct with shortening fraction of 33%. He underwent successful transcatheter closure of the patent arterial, using Amplatzer duct occluder 12/10. Few hours later echocardiography revealed an unexpected, yet important depression of left ventricular systolic function with shortening fraction decreasing to 24% and then two weeks later decreasing further to 20%. At a follow-up after four months, he had improved clinically but left ventricular dysfunction still persisted with shortening fraction of 24%.

Left atrium volume index is influenced by aortic stiffness and central pulse pressure in type 2 diabetes mellitus patients: a hemodynamic and echocardiographic study.

Science.gov (United States)

Zapolski, Tomasz; Wysokiński, Andrzej

2013-03-04

Left atrial volume index (LAVI) has recently emerged as a useful biomarker for risk stratification and risk monitoring in many clinical settings. Many hemodynamic factors such as preload and afterload have an effect on evaluating left atrium function. This study was performed to investigate the relationship between LAVI and aortic stiffness index (ASI) and selected markers characterizing hemodynamic state in patients with type 2 diabetes mellitus (DM2). The study population consisted of 100 patients (56 men, 44 women), 67.2 (±10.9) years old DM2, scheduled for routine coronary angiography. Standard transthoracic echocardiography was used to measure parameters needed for calculation of LAVI and ASI. During invasive procedures, central pulse pressure (CPP) in the ascendens aorta and left ventricle end-diastolic pressure (LVEDP) were recorded. Selected laboratory parameters were obtained, including lipidogram, serum uric acid, hs-CRP, fibrinogen, cTnT, myoglobin, BNP, HbA1C, creatinine, and GFR. Both LAVI and ASI were greater and CPP and LVEDP were markedly elevated in DM2 patients compared to controls. The independent predictors of LAVI were ASI (ß=0.331; p=0.011), CPP (ß=0.312; p=0.020), LVEDP (ß=0.381; p=0.006), HbA1C (ß=0.379; p=0.008), and BNP (ß=0,423; pDM2 patients.

Endovascular technique using a snare and suture for retrieving a migrated peripherally inserted central catheter in the left pulmonary artery

Science.gov (United States)

Teragawa, Hiroki; Sueda, Takashi; Fujii, Yuichi; Takemoto, Hiroaki; Toyota, Yasushi; Nomura, Shuichi; Nakagawa, Keigo

2013-01-01

We report a successful endovascular technique using a snare with a suture for retrieving a migrated broken peripherally inserted central catheter (PICC) in a chemotherapy patient. A 62-year-old male received monthly chemotherapy through a central venous port implanted into his right subclavian area. The patient completed chemotherapy without complications 1 mo ago; however, he experienced pain in the right subclavian area during his last chemotherapy session. Computed tomography on that day showed migration of a broken PICC in his left pulmonary artery, for which the patient was admitted to our hospital. We attempted to retrieve the ectopic PICC through the right jugular vein using a gooseneck snare, but were unsuccessful because the catheter was lodged in the pulmonary artery wall. Therefore, a second attempt was made through the right femoral vein using a snare with triple loops, but we could not grasp the migrated PICC. Finally, a string was tied to the top of the snare, allowing us to curve the snare toward the pulmonary artery by pulling the string. Finally, the catheter body was grasped and retrieved. The endovascular suture technique is occasionally extremely useful and should be considered by interventional cardiologists for retrieving migrated catheters. PMID:24109502

Chronology of fluvial terrace sequences for large Atlantic rivers in the Iberian Peninsula (Upper Tagus and Duero drainage basins, Central Spain)

Science.gov (United States)

Silva, Pablo G.; Roquero, Elvira; López-Recio, Mario; Huerta, Pedro; Martínez-Graña, Antonio M.

2017-06-01

This work analyses the chronology of fluvial terrace sequences of the two most important fluvial basins from central Spain draining to the Atlantic Ocean (Upper Tagus and Duero drainage basins). Both basins evolved under similar Mediterranean climatic conditions throughout the Pleistocene and present comparable number of fluvial terraces (16-17) after excluding the higher terrace levels of the Tagus (T1-T5) entrenched in the Raña surface. These higher ;rañizo terraces; was formed in response to fan-head trenching in this high alluvial piedmont (+220 m) and therefore not properly controlled by Quaternary fluvial downcutting. The study accomplishes the implementation of multiple regression analyses for terrace height-age relationships. To transform relative terrace heights above the present river thalwegs (i.e. +100 m) in numerical ages a ;height-age transference function; has been developed on the basis of preliminary statistical geochronological approaches proposed for Central Spain. The resultant height-age transference function gather 73 published geochronological data for terrace sequences, featuring a 3rd Order Polynomial Function (R2 0.90). This function describes the overall trend of valley downcutting for the last c. 2.3 Ma in Central Spain and is used to assign numerical ages to terrace levels at different relative elevation.

Terrane accumulation and collapse in central Europe: seismic and rheological constraints

Science.gov (United States)

Meissner, R.

1999-05-01

An attempt is made to compare the tectonic units and their evolution in central Europe with the deep seismic velocity structure and patterns of reflectivity. Caledonian and Variscan terrane accretion and orogenic collapse dominate the tectonic development in central and western Europe and have left their marks in a distinct velocity structure and crustal thickness as well as in the various reflectivity patterns. Whereas the memory of old collisional structures is still preserved in the rigid upper crust, collapse processes have formed and modified the lower crust. They have generally created rejuvenated, thin crusts with shallow Mohos. In the Variscan internides, the center of collision and post-orogenic heat pulses, the lower crust developed strong and thick seismic lamellae, the (cooler) externides show a thrust and shear pattern in the whole crust, and the North German Basin experienced large mafic intrusions in the lower crust and developed a high-velocity structure with only very thin lamellae on top of the Moho. The various kinds of reflectivity patterns in the lithosphere can be explained by a thermo-rheological model from terrane collision, with crustal thickening to collapse in a hot, post-orogenic setting.

Podemos and the New Political Cycle. Left-Wing Populism and Anti-Establishment Politics

DEFF Research Database (Denmark)

 Europe. The contributors address the multiples dynamics generated by Podemos as a new party developed out of the economic crisis, the structural crisis concerning social democracy and the incarnation of the welfare state project, and, more generally, out of the Left. It will appeal to upper-level students and scholars...

Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

Directory of Open Access Journals (Sweden)

Baoguo Xu

2011-09-01

Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

A new spiny species of Hypostomus Lacépède (Loricariidae: Hypostominae from thermal waters, upper rio Paraná basin, central Brazil

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Fernanda O. Martins

Full Text Available A new species of Hypostomus is described from the rio Quente, rio Paranaíba drainage, in the upper rio Paraná basin in central Brazil. The rio Quente is a peculiar small and shallow fast water stream with water temperatures around 34ºC. The new species is distinguished from all congeners by having the five lateral series of plates with hypertrophied odontodes not aligned in rows and more conspicuous on flanks of caudal peduncle of the larger specimens. The new species is only known from the rio Quente.

Time left in the mouse.

Science.gov (United States)

Cordes, Sara; King, Adam Philip; Gallistel, C R

2007-02-22

Evidence suggests that the online combination of non-verbal magnitudes (durations, numerosities) is central to learning in both human and non-human animals [Gallistel, C.R., 1990. The Organization of Learning. MIT Press, Cambridge, MA]. The molecular basis of these computations, however, is an open question at this point. The current study provides the first direct test of temporal subtraction in a species in which the genetic code is available. In two experiments, mice were run in an adaptation of Gibbon and Church's [Gibbon, J., Church, R.M., 1981. Time left: linear versus logarithmic subjective time. J. Exp. Anal. Behav. 7, 87-107] time left paradigm in order to characterize typical responding in this task. Both experiments suggest that mice engaged in online subtraction of temporal values, although the generalization of a learned response rule to novel stimulus values resulted in slightly less systematic responding. Potential explanations for this pattern of results are discussed.

Study of left ventricular diastolic dysfunction in recently diagnosed hypertensives in Central Nepal

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Shankar Laudari

2016-03-01

Full Text Available CORRECTION: The conclusion on the PDF of this article was replaced on 17th April 2016. The corrected PDF is now available by clicking on the link below.Background & Objectives: Ectopic Left ventricular diastolic dysfunction is now well established as a cause of left sided heart failure and as a powerful predictor of cardiovascular events. It is attributed mostly to systemic hypertension. The objective of the study was to determine the prevalence of left ventricular diastolic dysfunction in recently diagnosed hypertensives in Nepalese population using echocardiography. Materials & Methods: Two-dimensional echocardiography was performed on 120 newly diagnosed patients of systemic hypertension. Transmitral Doppler indexes of diastolic function, Valsalva maneuver applied to the same mitral inflow pattern, pulsed tissue Doppler of the mitral annulus, deceleration time, isovolumic relaxation time and pulmonary venous flow pattern.Results: The age of the patients in our study ranged from 20 to 84 years with mean age of 50years±14.13 years (standard deviation and male:female ratio being 1.35:1. Hypertensive patients were highest in age group 45-64 years followed by 25-44 years in both the genders. Majority of the patients had stage 1 hypertension (44.16% followed by stage 2 HTN in 34.17% and pre-hypertension in 21.67%. The majority of the patients in our study had Grade 1 LVDD (66.67%, 10.83% patients had Grade II LVDD, only 2.50% had non-restrictive Grade III LVDD and none had LVDD-IV. Stage II hypertensives had more LVDD(I+II+III: 39/41-95.12% than stage I hypertensives(39/53-73.58% and pre-hypertensives (8/26-30.77%. The association between stages of systemic HTN and LVDD was found to be highly statistically significant (p=0.002. Conclusion: Our study showed that left ventricular diastolic dysfunction is a common entity in Nepalese population with systemic hypertension.JCMS Nepal. 2016;12(1:14-18.

Chronology of the Middle to Upper Palaeolithic transition at Abric Romaní, Catalunya.

Science.gov (United States)

Camps, Marta; Higham, Thomas

2012-01-01

This paper presents new data from Abric Romaní, a key site in the region of Catalunya, northeastern Iberia, which is central to discussions of the transition between the Middle and Upper Palaeolithic in Europe. Until now, the Mid-Upper Paleolithic transition had been dated at the site through samples from the remaining baulk sections of levels A and B (typologically classified as 'earliest Aurignacian' and Mousterian, respectively) at the rear of the rockshelter, which were left from excavations in the late 1900s and early 1910s. We dated samples of bone and charcoal from these remnant sections with accelerator mass spectrometry (AMS) methods. We also analysed several humanly-modified artefacts (bone points and perforated shells) excavated from other areas of the same layers. From the initial series, we obtained ages of c. 20 ka BP (thousands of years before present); much younger than expected if they indeed dated to the early Upper Palaeolithic. We sampled additional material to test the robustness of these initial ages, and older determinations that were more comparable with the chronology outlined by Bischoff et al. (1988, 1994) resulted. All of the old and new results have been compared in a Bayesian model using the new INTCAL09 (14)C calibration dataset. The results appear to confirm the suggestion of some researchers (e.g., Zilhão and d'Errico, 1999) that there was no Aurignacian in the north of Iberia until c. 36,500 BP. The chronometric model shows a good level of agreement between the radiocarbon and U-series chronologies previously obtained, and the new results published in this paper. Copyright © 2011 Elsevier Ltd. All rights reserved.

Upper Limb Muscle and Brain Activity in Light Assembly Task on Different Load Levels

Science.gov (United States)

Zadry, Hilma Raimona; Dawal, Siti Zawiah Md.; Taha, Zahari

2010-10-01

A study was conducted to investigate the effect of load on upper limb muscles and brain activities in light assembly task. The task was conducted at two levels of load (Low and high). Surface electromyography (EMG) was used to measure upper limb muscle activities of twenty subjects. Electroencephalography (EEG) was simultaneously recorded with EMG to record brain activities from Fz, Pz, O1 and O2 channels. The EMG Mean Power Frequency (MPF) of the right brachioradialis and the left upper trapezius activities were higher on the high-load task compared to low-load task. The EMG MPF values also decrease as time increases, that reflects muscle fatigue. Mean power of the EEG alpha bands for the Fz-Pz channels were found to be higher on the high-load task compared to low-load task, while for the O1-O2 channels, they were higher on the low-load task than on the high-load task. These results indicated that the load levels effect the upper limb muscle and brain activities. The high-load task will increase muscle activities on the right brachioradialis and the left upper tapezius muscles, and will increase the awareness and motivation of the subjects. Whilst the low-load task can generate drowsiness earlier. It signified that the longer the time and the more heavy of the task, the subjects will be more fatigue physically and mentally.

Clinical Case of the Month: A 49 Year-Old Man Who Presents with Left Sided Weakness: An Update on Ischemic Stroke.

Science.gov (United States)

Masri, Najy; Weems, Rikki; Brown, Falon; Andres, Ben; Lopez, Fred

2016-01-01

A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness. On initial exam, the temperature was 99°F, the pulse was 93 beats per minute, the blood pressure was 191/100 mmHg, the respiratory rate was 22 breaths per minute, and the oxygen saturation was 100% while breathing room air. His neurological exam revealed diminished strength in the left upper extremity: 4/5 arm abduction and adduction of the left shoulder; 4/5 elbow and wrist extension and flexion; and 4/5 extension, abduction, and adduction of the digits. The patient also exhibited slight left upper extremity pronator drift. The strength was also diminished in the left lower extremity: 2/5 hip flexion, extension, and rotation; 3/5 knee flexion and extension; and 3/5 ankle dorsiflexion and plantar flexion. Initial NIH stroke scale score was 5, otherwise, there were no focal neurological deficits and the remainder of his exam was unremarkable. Initial computed tomography (CT) of the head was negative for any acute intracranial hemorrhage or infarct. A subsequent CT cerebral perfusion scan (Figure 1) was notable for areas of ischemia in the right cingulate gyrus as well as the medial frontal and parietal lobes. CT angiogram of the neck revealed bilateral atherosclerotic plaque in the carotid arteries; however, there was no evidence of any flow-limiting stenosis.

Rebuilding the US Health Left

Directory of Open Access Journals (Sweden)

Victor W. Sidel, MD

2010-02-01

Full Text Available With this issue Social Medicine begins a series of invited papers on the topic: “Rebuilding the US Health Left.” In this editorial we will outline our vision for this series. We undertake this project aware that our good friend and mentor, Dr. Walter Lear, one of the leading health activists of the 20th century, lies critically ill. Walter was the creator and custodian of the US Health Left Archives, a collection that is now with the University of Pennsylvania library. The collection reminds us of the important role left health care workers played in US history throughout the 20th century. They advocated for a national health program (Committee on the Costs of Medical Care, Physicians Forum, Medical Care Section/APHA, HealthPAC, Physicians for a National Health Program, National Physicians Alliance, provided international solidarity (American Soviet Medical Society, international brigades during the Spanish Civil War, Central American Solidarity Movement, Committee to Help Chilean Health Workers, Doctors for Global Health, traced the connections between disease and social class (Sigerist Circle, Spirit of 1848, APHA, fought for workers’ health (Councils for Occupational Safety and Health; Occupational Health and Safety Section, APHA participated in anti-war movements (Medical Committee for Human Rights, Physicians for Social Responsibility, International Physicians for the Prevention of Nuclear War, created new models of health care delivery (Health Cooperatives, Prepaid Health Maintenance Organizations, Community Health Centers, National Health Service Corps, Free Clinics, were central to the struggle for women’s rights (Planned Parenthood, Physicians for Reproductive Choice and Health, supported the civil rights movement both in medicine and in the broader society (National Medical Association, Medical Committee for Human Rights, played key roles in the movement for gay rights (ACT-UP, Gay & Lesbian Medical Association, Lesbian, Gay

Focal hot spot induced by a central subclavian line on bone scan.

Science.gov (United States)

Moslehi, Masood; Cheki, Mohsen; Dehghani, Tohid; Eftekhari, Mansoureh

2014-01-01

The diagnostic accuracy of nuclear medicine reporting can be improved by awareness of these instrument-related artifacts. Both awareness and experience are also important when it comes to detecting and identifying normal (and abnormal) variants. We present a case of hot spot on the upper right chest in the region of right subclavicular region resulting from injection of radiotracer from central subclavian line. A 52-year-old woman with a history of left breast cancer and recent bone pain was referred to our nuclear medicine department for skeletal survey. Anterior views of chest show a focus of increased radiotracer uptake corresponding to anterior arch of one of the right second rib. The nuclear physician reported it as a focal rib bony lesion and recommended radiological evaluation. As technician later explained, physicians realized that injection site was a central subclavian line on the right side and hot spot on that region is due to injection site. The appearance of both skeletal and soft-tissue uptake depends heavily on imaging technique (such as the route of radiotracer administration) and the interpreting physicians should be aware of the impact of technical factors on image quality.

Work-related upper limb “overuse” syndromes

DEFF Research Database (Denmark)

Jepsen, Jørgen Riis

2016-01-01

A previous review of historical descriptions and theories about the character and pathogenesis of writer’s cramp and other comparable chronic upper limb “overuse” work-related pain syndromes has indicated that somatic dysfunctions explain symptoms and findings. The first case studies and case...... series suggested that these conditions were caused by pathology affecting the peripheral nerves. The general perception gradually changed, however, with symptoms becoming attributed to central nervous system dysfunction and ultimately to represent a psychiatric condition. Work-related upper limb...... disorders remain diagnostically challenging to clinicians and there is still a tendency to see many patients’ pain as a psychiatric problem when a standard physical examination does not explain the condition. This article describes reports of writer’s cramp and comparable occupational upper limb “overuse...

Effect of One Carpet Weaving Workstation on Upper Trapezius Fatigue

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Neda Mahdavi

2016-03-01

Full Text Available Introduction: This study aimed to investigate the effect of carpet weaving at a proposed workstation on Upper Trapezius (UTr fatigue during a task cycle. Fatigue in the shoulder is one of the most important precursors for upper limb musculoskeletal disorders. One of the most prevalent musculoskeletal disorders between carpet weavers is disorder of the shoulder region. Methods: This cross-sectional study, included eight females and three males. During an 80-minute cycle of carpet weaving, Electromyography (EMG signals of right and left UTr were recorded by the surface EMG, continuously. After raw signals were processed, MPF and RMS were considered as EMG amplitude and frequency parameters. Time series model and JASA methods were used to assess and classify the EMG parameter changes during the working time. Results: According to the JASA method, 58%, 16%, 8% and 8% of the participants experienced fatigue, force increase, force decrease and recovery, respectively in the right UTr. Also, 50%, 25%, 8% and 16% of the participants experienced fatigue, force increase, force decrease and recovery, respectively in the left UTr. Conclusions: For the major portion of the weavers, dominant status in Left and right UTr was fatigue, at the proposed workstation during a carpet weaving task cycle. The results of the study provide detailed information for optimal design of workstations. Further studies should focus on fatigue in various muscles and time periods for designing an appropriate and ergonomics carpet weaving workstation

Non-compact left ventricle/hypertrabeculated left ventricle

International Nuclear Information System (INIS)

Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

2005-01-01

Non-compact left ventricle/hypertrabeculated left ventricle is a myocardiopatie produced by an arrest of the normal left ventricular compaction process during the early embryogenesis. It is associated to cardiac anomalies (congenital cardiopaties) as well as to extracardial conditions (neurological, facial, hematologic, cutaneous, skeletal and endocrinological anomalies). This entity is frequently unnoticed, being diagnosed only in centers with great experience in the diagnosis and treatment of myocardiopathies. Many cases of non-compact left ventricle have been initially misdiagnosed as hypertrophic myocardiopatie, endocardial fibroelastosis, dilated cardiomyopatie, restrictive cardiomyopathy and endocardial fibrosis. It is reported the case of a 74 years old man with a history of chronic arterial hypertension and diabetes mellitus, prechordial chest pain and mild dyspnoea. An echocardiogram showed signs of non-compact left ventricle with prominent trabeculations and deep inter-trabecular recesses involving left ventricular apical segment and extending to the lateral and inferior walls. Literature on this topic is reviewed

Use of 15N/14N Ratio to Evaluate the Sources of Nitrate Pollution in Surface and Groundwaters in the Upper Orontes Basin (Central Syria)

International Nuclear Information System (INIS)

Kattan, Z.

2004-01-01

This work represents the results of using of 15 N technique in the evaluation and interpretation of nitrate pollution sources of surface and groundwaters in the Upper Orontes Basin (Central Syria). Based on this method, it was possible to distinguish between two groups of water bodies: 1) the group of fresh and non polluted water, which effectively reflects natural mineralization in nitrogen, such as the waters in the Upper Orontes River, the Qattineh Lake in its western and southern parts, as well as the Al-Qoussier well; 2) the group of polluted water, such as the waters in the other sampling sites. The chemical and isotopic 15 N characteristics of this group reflect the impact of different intensities of pollution processes, which could mainly be derived from anthropogenic source. The intensity of this source was maximum in the Al-Domineh well, which was practically close to a sewage sink. (author)

Use of '15N/14N ratio to evaluate the anthropogenic source of nitrates in surface and groundwaters in the upper Orontes Basin (central Syria)

International Nuclear Information System (INIS)

Kattan, Z.

2002-01-01

The 15 N/ 14 N ratio of dissolved nitrogen species has long been used for the identification of the different sources of nitrate contamination of water systems. This study, which aims at providing a practical example of the utility of the 15 N stable isotope in identifying the natural and anthropogenic sources of nitrate in surface and groundwaters in the upper Orontes Basin, was implemented within the framework of the IAEA Regional technical project entitled 'Isotope Hydrology Techniques in Water Resources Management (RAW/8/002)'. The selected area for this work is located in the upper part of the Orontes River Basin, which occupies the central zone of the Syrian territories. This heavily populated region is characterized by intensive agricultural and industrial developments. Hence, the influence of the growing domestic activities is reflected by rapidly deteriorating of the surface and groundwaters qualities in this area

A study of tapping by the unaffected finger of patients presenting with central and peripheral nerve damage.

Science.gov (United States)

Zhang, Lingli; Han, Xiuying; Li, Peihong; Liu, Yang; Zhu, Yulian; Zou, Jun; Yu, Zhusheng

2015-01-01

Whether the unaffected function of the hand of patients presenting with nerve injury is affected remains inconclusive. We aimed to evaluate whether there are differences in finger tapping following central or peripheral nerve injury compared with the unaffected hand and the ipsilateral hand of a healthy subject. Thirty right brain stroke patients with hemiplegia, 30 left arm peripheral nerve injury cases, and 60 healthy people were selected. We tested finger tapping of the right hands, and each subject performed the test twice. Finger tapping following peripheral nerve injury as compared with the unaffected hand and the dominant hand of a healthy person was markedly higher than was found for central nerve injury (P tapping of the male peripheral group's unaffected hand and the control group's dominant hand was significantly higher than the central group (P tapping of the female control group's dominant hand was significantly higher than the central group's unaffected hand (P < 0.01, P = 0.002), the peripheral group's unaffected hand (P < 0.05, P = 0.034). The unaffected function of the hand of patients with central and peripheral nerve injury was different as compared with the ipsilateral hand of healthy individuals. The rehabilitation therapist should intensify the practice of normal upper limb fine activities and coordination of the patient.

A Study of Tapping by the Unaffected Finger of Patients Presenting with Central and Peripheral Nerve Damage

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Lingli eZhang

2015-05-01

Full Text Available Aim: Whether the unaffected function of the hand of patients presenting with nerve injury is affected remains inconclusive. We aimed to evaluate whether there are differences in finger tapping following central or peripheral nerve injury compared with the unaffected hand and the ipsilateral hand of a healthy subject.Methods: 30 right brain stroke patients with hemiplegia, 30 left arm peripheral nerve injury cases and 60 healthy people were selected. We tested finger tapping of the right hands, and each subject performed the test twice.Results: Finger tapping following peripheral nerve injury as compared with the unaffected hand and the dominant hand of a healthy person was significantly higher than was found for central nerve injury (P<0.05. Finger tapping of the male peripheral group’s unaffected hand and the control group’s dominant hand was significantly higher than the central group (P<0.001. However, finger tapping of the female control group’s dominant hand was markedly higher than the central group’s unaffected hand (P<0.01, P=0.002, the peripheral group’s unaffected hand (P<0.05, P=0.034. Conclusion: The unaffected function of the hand of patients with central and peripheral nerve injury was different as compared with the ipsilateral hand of healthy individuals. The rehabilitation therapist should intensify the practice of normal upper limb fine activities and coordination of the patient.

Endovascular Embolization of Bronchial Artery Originating from the Upper Portion of Aortic Arch in Patients with Massive Hemoptysis

International Nuclear Information System (INIS)

Jiang, Sen; Sun, Xi-Wen; Yu, Dong; Jie, Bing

2014-01-01

PurposeOur experience with endovascular embolization (EVE) of the bronchial artery (BA) originating from the upper portion of the aortic arch (AA) in six patients is described.MethodsAltogether, 818 patients with hemoptysis underwent multidetector row computed tomography angiography (MDCTA) before EVE or AA angiography during EVE. Aberrant BAs originating from the upper portion of the AA were the source of massive hemoptysis in six patients (0.73 %). MDCT angiograms and/or Digital subtraction angiograms were retrospectively reviewed. Selective catheterization and embolization were performed.ResultsThe ostia of the BAs were located on the superior surface of the AA between the brachiocephalic trunk and left common carotid artery in three patients, the junction of the aorta and medial surface of the left subclavian artery in two, and the posterior wall of the upper portion of the AA in one. The six BAs comprised two common trunks, three single right sides, and one single left side. The targeted vessels were successfully catheterized and embolized by a coaxial microcatheter system using polyvinyl alcohol particles. Other pathologic BAs and nonbronchial systemic arteries also were embolized. Bleeding was immediately controlled in all patients with no recurrence of hemoptysis. No procedure-related complications occurred.ConclusionsApplication of EVE of anomalous origin of BAs in patients with hemoptysis is important, as demonstrated in the six reported patients. MDCTA before EVE or AA angiography during EVE is critical to avoid missing a rare aberrant BA originating from the upper portion of the AA

Memory and a Hard Place: Revisiting Central Havana

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Marivic Wyndham

2008-02-01

Full Text Available Raul and Manolo are two Cuban men in their late sixties. Manolo left soon after Castro’s triumph to become a television celebrity in Miami. He returned in 1991 to make a clandestine film about the city which once was his. Raul never left his decaying city. He applauded the revolution, but little by little his enthusiasm soured. The paper examines the relationship of the two men to what was once the ultra modern Central Havana of the mid-1950s. Manolo’s froze on the day he left: his filmed city is silent, immobile, full of ghosts, almost empty, ugly, ruined. Manolo’s Central Havana processes and changes, it is noisy, busy, - but also it is ugly and ruined. Both lament the city as it once was. Only Raul sees hope of reconciliation.

Brachial versus central blood pressure and vascular stiffness

DEFF Research Database (Denmark)

Rasmussen, Susanne; Hansen, Tine; Frimodt-Møller, Marie

2010-01-01

Central blood pressure (BP) estimates the true load imposed on the left ventricle to a higher degree than does brachial BP. Increased aortic pulse wave velocity (aPWV) and central BP are risk markers for cardiovascular disease. Both can be measured by simple and noninvasive methods. Guidelines...

Brachial versus central blood pressure and vascular stiffness

DEFF Research Database (Denmark)

Rasmussen, Susanne; Hansen, Tine; Frimodt-Møller, Marie

2009-01-01

Central blood pressure (BP) estimates the true load imposed on the left ventricle to a higher degree than does brachial BP. Increased aortic pulse wave velocity (aPWV) and central BP are risk markers for cardiovascular disease. Both can be measured by simple and noninvasive methods. Guidelines...

Upper Limb Asymmetry in the Sense of Effort Is Dependent on Force Level

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Diane E. Adamo

2017-04-01

Full Text Available Previous studies have shown that asymmetries in upper limb sensorimotor function are dependent on the source of sensory and motor information, hand preference and differences in hand strength. Further, the utilization of sensory and motor information and the mode of control of force may differ between the right hand/left hemisphere and left hand/right hemisphere systems. To more clearly understand the unique contribution of hand strength and intrinsic differences to the control of grasp force, we investigated hand/hemisphere differences when the source of force information was encoded at two different force levels corresponding to a 20 and 70% maximum voluntary contraction or the right and left hand of each participant. Eleven, adult males who demonstrated a stronger right than left maximum grasp force were requested to match a right or left hand 20 or 70% maximal voluntary contraction reference force with the opposite hand. During the matching task, visual feedback corresponding to the production of the reference force was available and then removed when the contralateral hand performed the match. The matching relative force error was significantly different between hands for the 70% MVC reference force but not for the 20% MVC reference force. Directional asymmetries, quantified as the matching force constant error, showed right hand overshoots and left undershoots were force dependent and primarily due to greater undershoots when matching with the left hand the right hand reference force. Findings further suggest that the interaction between internal sources of information, such as efferent copy and proprioception, as well as hand strength differences appear to be hand/hemisphere system dependent. Investigations of force matching tasks under conditions whereby force level is varied and visual feedback of the reference force is available provides critical baseline information for building effective interventions for asymmetric (stroke

Upper Basalt-Confined Aquifer System in the Southern Hanford Site

International Nuclear Information System (INIS)

Thorne, P.

1999-01-01

The 1990 DOE Tiger Team Finding GW/CF-202 found that the hydrogeologic regime at the Hanford Site was inadequately characterized. This finding also identified the need for completing a study of the confined aquifer in the central and southern portions of the Hanford Site. The southern portion of the site is of particular interest because hydraulic-head patterns in the upper basalt-confined aquifer system indicate that groundwater from the Hanford central plateau area, where contaminants have been found in the aquifer, flows southeast toward the southern site boundary. This results in a potential for offsite migration of contaminants through the upper basalt-confined aquifer system. Based on the review presented in this report, available hydrogeologic characterization information for the upper basalt-confined aquifer system in this area is considered adequate to close the action item. Recently drilled offsite wells have provided additional information on the structure of the aquifer system in and near the southern part of the Hanford Site. Information on hydraulic properties, hydrochemistry, hydraulic heads and flow directions for the upper basalt-confined aquifer system has been re-examined and compiled in recent reports including Spane and Raymond (1993), Spane and Vermeul ( 1994), and Spane and Webber (1995)

Left regular bands of groups of left quotients

International Nuclear Information System (INIS)

El-Qallali, A.

1988-10-01

A semigroup S which has a left regular band of groups as a semigroup of left quotients is shown to be the semigroup which is a left regular band of right reversible cancellative semigroups. An alternative characterization is provided by using spinned products. These results are applied to the case where S is a superabundant whose set of idempotents forms a left normal band. (author). 13 refs

Effector-independent brain activity during motor imagery of the upper and lower limbs: an fMRI study.

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Mizuguchi, Nobuaki; Nakata, Hiroki; Kanosue, Kazuyuki

2014-10-03

We utilized functional magnetic resonance imaging (fMRI) to evaluate the common brain region of motor imagery for the right and left upper and lower limbs. The subjects were instructed to repeatedly imagined extension and flexion of the right or left hands/ankles. Brain regions, which included the supplemental motor area (SMA), premotor cortex and parietal cortex, were activated during motor imagery. Conjunction analysis revealed that the left SMA and inferior frontal gyrus (IFG)/ventral premotor cortex (vPM) were commonly activated with motor imagery of the right hand, left hand, right foot, and left foot. This result suggests that these brain regions are activated during motor imagery in an effector independent manner. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Observations of turbulent energy dissipation rate in the upper ocean of the central South China Sea

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Chen, G.

2016-02-01

Measurements of turbulent energy dissipation rate, velocity, temperature, and salinity were obtained in the upper ocean of the central South China Sea (14.5˚N, 117.0˚E) during an experimental campaign from May 11th to 13th 2010. Dissipation rate was elevated ( 10-7 Wkg-1) at night by convection mixing and was weakened ( 10-9 Wkg-1) in daytime due to the warming stratification. Thermocline dissipation rate varied with time ( 10-9 Wkg-1 to 10-8 Wkg-1) under the influence of internal waves. Energy was transferred from the diurnal internal tides to high frequency internal waves through nonlinear wave-wave interactions. This energy cascade process was accompanied by elevated shear and enhanced dissipation, which played an important role in the turbulent mixing in thermocline. Compare with the thermocline dissipation, dissipation below the thermocline was more stable and weak ( 10-10 Wkg-1). The observed dissipation rate during the measurement was well parameterized by the MacKinnon-Gregg parameterization (a model based on a reinterpretation of wave-wave interaction theory), whereas the Gregg-Henyey parameterization was not in good agreement with the observed dissipation rate.

Influence of Gluteus Maximus Inhibition on Upper Trapezius Overactivity in Chronic Mechanical Neck Pain with Radiculopathy

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Ghada Mohamed Koura

2017-03-01

Full Text Available Background: Mechanical neck pain is the most common type of neck pain and commonly to accompany with radiculopathy. Patients of neck pain exhibit greater activation of accessory muscles, (sternocleidomastoid, anterior scalene, and upper trapezius muscles and may also show changed patterns of motor control of other postural muscles as pelvic muscles for reducing activation of painful muscles of neck. Aim of the study: To determine if there is an association between gluteus maximus inhibition and overactivity of upper fibres of trapezius in patients with chronic mechanical neck pain with radiculopathy. Materials and Methods: Forty female patients participated in this study diagnosed as chronic mechanical neck pain with radiculopathy. Amplitude and onset of muscle activation were assessed by using the surface electromyography (EMG during prone hip extension test. Results: The results of this study demonstrated that there is no correlation between the amplitude of EMG activity of right and left gluteus maximus and the amplitude of EMG activity of right and left upper trapezius (P<0.05. Conclusion: It can be concluded that the overactivity of the upper trapezius muscle in patients with chronic mechanical neck pain with radiculopathy is not related to the inhibition of the gluteus maximus muscle during prone hip extension test.

A Geochemical Mass-Balance Method for Base-Flow Separation, Upper Hillsborough River Watershed, West-Central Florida, 2003-2005 and 2009

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Kish, G.R.; Stringer, C.E.; Stewart, M.T.; Rains, M.C.; Torres, A.E.

2010-01-01

Geochemical mass-balance (GMB) and conductivity mass-balance (CMB) methods for hydrograph separation were used to determine the contribution of base flow to total stormflow at two sites in the upper Hillsborough River watershed in west-central Florida from 2003-2005 and at one site in 2009. The chemical and isotopic composition of streamflow and precipitation was measured during selected local and frontal low- and high-intensity storm events and compared to the geochemical and isotopic composition of groundwater. Input for the GMB method included cation, anion, and stable isotope concentrations of surface water and groundwater, whereas input for the CMB method included continuous or point-sample measurement of specific conductance. The surface water is a calcium-bicarbonate type water, which closely resembles groundwater geochemically, indicating that much of the surface water in the upper Hillsborough River basin is derived from local groundwater discharge. This discharge into the Hillsborough River at State Road 39 and at Hillsborough River State Park becomes diluted by precipitation and runoff during the wet season, but retains the calcium-bicarbonate characteristics of Upper Floridan aquifer water. Field conditions limited the application of the GMB method to low-intensity storms but the CMB method was applied to both low-intensity and high-intensity storms. The average contribution of base flow to total discharge for all storms ranged from 31 to 100 percent, whereas the contribution of base flow to total discharge during peak discharge periods ranged from less than 10 percent to 100 percent. Although calcium, magnesium, and silica were consistent markers of Upper Floridan aquifer chemistry, their use in calculating base flow by the GMB method was limited because the frequency of point data collected in this study was not sufficient to capture the complete hydrograph from pre-event base-flow to post-event base-flow concentrations. In this study, pre-event water

Granuloma central de células gigantes Giant cells central granuloma

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Ayelén María Portelles Massó

2011-03-01

Full Text Available El granuloma reparativo central de células gigantes es una lesión proliferativa no neoplásica de etiología desconocida. Se presenta un paciente masculino de 40 años de edad, portador de prótesis parcial superior. Fue remitido al Servicio de Cirugía Maxilofacial del Hospital "V. I. Lenin" por presentar aumento de volumen en reborde alveolar superior, de color rojo grisáceo y que provocaba expansión de corticales óseas. Una vez analizados los exámenes clínicos, radiográficos e histopatológicos se diagnosticó un granuloma reparativo central de células gigantes Se realizó exéresis quirúrgica de la lesión y extracción de dientes adyacentes con una evolución satisfactoria sin señales de recidivas luego de tres años del tratamiento. El granuloma reparativo central de células gigantes se presentó como respuesta a un trauma. La correcta interpretación de los datos clínicos, radiográficos e histopatológicos nos permitió llegar al correcto diagnóstico y plan de tratamiento.Giant-cell central reparative granuloma is non neoplastic proliferative lesion of unknown etiology. We report a 40 years old male patient who was admitted at the Maxillofacial Service of the "V. I. Lenin" Hospital. The patient had partial upper prosthesis and was complaining of red-grey volume increase lesion in upper alveolar ridge which led to the expansion of cortical bone. Having analyzed clinical, radiographic and histopathological findings the case was concluded as a giant-cell central reparative granuloma. Surgical exeresis and adjunct tooth extraction were done. After three years of treatment, satisfactory follow up without recurrence is reported.

Left-Sided Catamenial Pneumothorax with Thoracic Endometriosis and Bullae in the Alveolar Wall.

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Takahashi, Ryo; Kurihara, Masatoshi; Mizobuchi, Teruaki; Ebana, Hiroki; Yamanaka, Sumitaka

2017-04-20

Catamenial pneumothorax (CP) is generally caused by intraperitoneal air leaking from the uterus into the thoracic cavity via a defect in the endometrial tissue of the diaphragm and is usually detected in the right thorax. We report a case of left-sided CP caused by endometriosis in the visceral pleura and with no abnormal findings in the diaphragm. A 33-year-old female patient presented at the end of a course of low-dose contraceptive pills for pelvic endometriosis, with spontaneous pneumothorax in the left chest. Chest CT revealed a bulla in the left upper lung lobe. The patient underwent partial resection of the lung. Immunohistochemistry confirmed the presence of endometrial stromal tissue in the visceral pleura and confirmed this as the cause of pneumothorax since there were no observable abnormalities in the diaphragm. This case suggests that immunohistochemical examination of patients with spontaneous pneumothorax can detect alternative endometrial lesions.

Spatial variations of earthquake occurrence and coseismic deformation in the Upper Rhine Graben, Central Europe

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Barth, A.; Ritter, J. R. R.; Wenzel, F.

2015-05-01

Seismic activity in the densely populated Upper Rhine Graben (URG) is an aspect in the public, political, and industrial decision making process. The spatial analysis of magnitude-frequency distributions provides valuable information about local seismicity patterns and regional seismic hazard assessment and can be used also as a proxy for coseismic deformation to explore the seismo-tectonic setting of the URG. We combine five instrumental and one historic earthquake bulletins to obtain for the first time a consistent database for events with local magnitudes ML ≥ 2.0 in the whole URG and use it for the determination of magnitude frequencies. The data processing results in a dataset with 274 Poisson distributed instrumentally recorded earthquakes within the URG between 01/1971 and 02/2012 and 34 historic events since the year 1250. Our analysis reveals significant b-value variations along the URG that allow us to differentiate four distinct sections (I-IV) with significant differences in earthquake magnitude distributions: I: Basel region in the Swiss-France-German border region (b = 0.83), II: region between Mulhouse and Freiburg in the southern URG (b = 1.42), III: central URG (b = 0.93), and IV: northern URG (b = 1.06). High b-values and thus a relatively low amount of high magnitude events in the Freiburg section are possibly a consequence of strongly segmented, small-scale structures that are not able to accumulate high stresses. We use the obtained magnitude-frequency distributions and representative source mechanisms for each section to determine coseismic displacement rates. A maximum horizontal displacement rate of 41 μm/a around Basel is found whereas only 8 μm/a are derived for the central and northern URG. A comparison with geodetic and geological constraints implies that the coseismic displacement rates cover less than 10% of the overall displacement rates, suggesting a high amount of aseismic deformation in the URG.

Comparison study of upper arm and forearm non-invasive blood pressures in adult Emergency Department patients.

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Schimanski, Karen; Jull, Andrew; Mitchell, Nancy; McLay, Jessica

2014-12-01

Forearm blood pressures have been suggested as an alternative site to measure blood pressures when the upper arm is unavailable. However there is little evidence utilising clinical populations to support this substitution. To determine agreement between blood pressures measured in the left upper arm and forearm using a singular oscillometric non-invasive device in adult Emergency Department patients. The secondary objective was to explore the relationship of blood pressure differences with age, sex, ethnicity, smoking history and obesity. Single centre comparison study. Adult Emergency Department, Tertiary Trauma Centre. Forty-four participants who met inclusion/exclusion criteria selected sequentially from the Emergency Department arrival board. A random assignment of order of measurement for left upper arm and forearm blood pressures was utilised. Participants were eligible if they were aged 18 years or older, had been assigned an Australasian Triage Scale code of 2, 3, 4, or 5, were able to consent, and able to have blood pressures measured on their left arm whilst lying at a 45° angle. The Bland-Altman method of statistical analysis was used, with the level of agreement for clinical acceptability for the systolic, diastolic and mean arterial pressure defined as ±10 mmHg. The forearm measure overestimated systolic (mean difference 2.2 mmHg, 95% limits of agreement ±19 mmHg), diastolic (mean difference 3.4 mmHg, 95% limits of agreement ±14.4 mmHg), and mean arterial pressures (mean difference 4.1 mmHg, 95% limits of agreement ±13.7 mmHg). The systolic measure was not significantly different from zero. Evidence of better agreement was found with upper arm/forearm systolic measures below 140 mmHg compared to systolic measures above 140 mmHg using the Levene's test (p=0.002, F-statistic=11.09). Blood pressure disparity was not associated with participant characteristics. Forearm measures cannot routinely replace upper arm measures for blood pressure measurement

Diagnosis and treatment of upper limb apraxia.

Science.gov (United States)

Dovern, A; Fink, G R; Weiss, P H

2012-07-01

Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients' prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed and ill-treated entity. Based on a systematic literature search, this review summarizes the current tools of diagnosis and treatment strategies for upper limb apraxia. It furthermore provides clinicians with graded recommendations. In particular, a short screening test for apraxia, and a more comprehensive diagnostic apraxia test for clinical use are recommended. Although currently only a few randomized controlled studies investigate the efficacy of different apraxia treatments, the gesture training suggested by Smania and colleagues can be recommended for the therapy of apraxia, the effects of which were shown to extend to activities of daily living and to persist for at least 2 months after completion of the training. This review aims at directing the reader's attention to the ecological relevance of apraxia. Moreover, it provides clinicians with appropriate tools for the reliable diagnosis and effective treatment of apraxia. Nevertheless, this review also highlights the need for further research into how to improve diagnosis of apraxia based on neuropsychological models and to develop new therapeutic strategies.

Primary central nervous system plasmablastic lymphoma presenting in human immunodeficiency virus-negative but Epstein-Barr virus-positive patient: A case report

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Zhang Li

2012-05-01

Full Text Available Abstract We report a 32-year-old Outer Mongolian man, with plasmablastic lymphoma (PBL primarily occured in the central nervous system and diagnosed by surgical resection. This patient appeared headache and Magnetic resonance imaging (MRI showed multiple lesions in the right cerebral hemisphere including the right frontal-parietal lobe and right basal ganglia and the left cerebellum, he was diagnosed as lymphoma by stereotactic biopsy in January 2009 in local hospital, and was given radiotherapy 33 times after the biopsy. The patient was admitted to The Military General Hospital of Beijing PLA., Beijing, P.R. China on March 9th, 2011, with chief complaints of right limbs convulsioned suddenly, then fell down and lose of his consciousness, then awoke after 4 to 5 minutes, with symptoms of angulus oris numbness and the right upper limb powerless ten days ago. MRI of the brain revealed a well-defined hyperdense and enhancing mass in the left frontal-parietal lobe, the meninges are closely related, there was extensive peritumoural edema noted with pressure effects, as evident by effacement of the left lateral ventricles and a 0.5 cm shift of the midline to the right side. Surgical resection showed markedly atypical, large singly dispersed or cohesive proliferation of plasmacytoid cells with frequent abnormal mitoses and binucleation, some neoplastic cells were large with round or oval nuclei and showed coarse chromatin and smaller or unapparent nucleoli, some neoplastic cells with prominent nucleoli, apoptosis and necrosis were often presented. Immunohistochemistry staining and gene rearrangement together with other supportive investigation confirmed the diagnosis of primary central nervous system plasmablastic lymphoma. A month later, he was started on chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, leurocristime and prednisone for a week. Other supportive treatment was provided for symptomatic epilepsy. The patient regained

A Brain-Machine Interface Based on ERD/ERS for an Upper-Limb Exoskeleton Control.

Science.gov (United States)

Tang, Zhichuan; Sun, Shouqian; Zhang, Sanyuan; Chen, Yumiao; Li, Chao; Chen, Shi

2016-12-02

To recognize the user's motion intention, brain-machine interfaces (BMI) usually decode movements from cortical activity to control exoskeletons and neuroprostheses for daily activities. The aim of this paper is to investigate whether self-induced variations of the electroencephalogram (EEG) can be useful as control signals for an upper-limb exoskeleton developed by us. A BMI based on event-related desynchronization/synchronization (ERD/ERS) is proposed. In the decoder-training phase, we investigate the offline classification performance of left versus right hand and left hand versus both feet by using motor execution (ME) or motor imagery (MI). The results indicate that the accuracies of ME sessions are higher than those of MI sessions, and left hand versus both feet paradigm achieves a better classification performance, which would be used in the online-control phase. In the online-control phase, the trained decoder is tested in two scenarios (wearing or without wearing the exoskeleton). The MI and ME sessions wearing the exoskeleton achieve mean classification accuracy of 84.29% ± 2.11% and 87.37% ± 3.06%, respectively. The present study demonstrates that the proposed BMI is effective to control the upper-limb exoskeleton, and provides a practical method by non-invasive EEG signal associated with human natural behavior for clinical applications.

Neurohormones as markers of right- and left-sided cardiac dimensions and function in patients with untreated chronic heart failure

DEFF Research Database (Denmark)

Kjaer, Andreas; Hildebrandt, Per; Appel, Jon

2005-01-01

and that neuroendocrine profiling could be of value. In order to study this, we investigated the relationship between hormones and cardiac dimensions and function of both the right and left ventricle. METHODS: Twenty-three patients with newly diagnosed, untreated CHF were included. Right (RVEF) and left ventricular...... was normal in all subjects as well as right ventricular volumes. Likewise, on average, the lung transit time (LTT) was normal. Brain natriuretic peptide (BNP) significantly correlated with LVEF, left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI...... ejection fractions (LVEF) and volumes were measured by means of first-pass and equilibrium radionuclide ventriculography. RESULTS: LVEF was 0.29 (range: 0.11-0.55). Two-thirds of the patients had dilated left ventricles with volumes above upper reference limit. Right ventricular ejection fraction...

MR urography versus retrograde pyelography/ureteroscopy for the exclusion of upper urinary tract malignancy

Energy Technology Data Exchange (ETDEWEB)

Lee, K.S., E-mail: kslee@bidmc.harvard.ed [Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Zeikus, E. [Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); DeWolf, W.C. [Department of Surgery, Division of Urology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Rofsky, N.M.; Pedrosa, I. [Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States)

2010-03-15

Aim: To evaluate the diagnostic performance of magnetic resonance urography (MRU) versus retrograde pyelography and/or ureteroscopy (RPU) in the detection of upper urinary tract neoplasms. Materials and methods: This retrospective study included 35 patients with suspected upper urinary tract malignancy who underwent MRU and RPU within 6-months in our institution during the study period (February 2002 to January 2007). MRU and RPU reports were reviewed and results recorded. For each patient, the urinary tract was sub-divided into four regions for analysis: left kidney/renal pelvis, left ureter, right kidney/renal pelvis, and right ureter. MRU and RPU results for each patient were compared to a reference standard and the diagnostic performance of both techniques was compared. Results: A total of 113 regions were analysed on MRU and 90 regions on RPU. Nineteen neoplasms were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for the detection of urinary tract neoplasms were 63, 91, 60, and 92% for MRU, respectively, and 53, 97, 83, and 88% for RPU, respectively. These differences were not statistically significant (p > 0.05). Conclusion: The high negative predictive value of MRU in the present series supports its use as a non-invasive screening examination for excluding the presence of upper urinary tract malignancy.

Observations of the turbulent kinetic energy dissipation rate in the upper central South China Sea

Science.gov (United States)

Liang, Chang-Rong; Chen, Gui-Ying; Shang, Xiao-Dong

2017-05-01

Measurements of the turbulent kinetic energy dissipation rate ( ɛ), velocity, temperature, and salinity were obtained for the upper ocean of the central South China Sea (14.5° N, 117.0° E) during an experimental campaign from May 11 to 13, 2010. Dissipation in the diurnal mixed layer showed a diurnal variability that was strongly affected by the surface buoyancy flux. Dissipation was enhanced ( ɛ ˜ 10-7 W kg-1) at night due to the convective mixing and was weakened ( ɛ ˜ 10-9 W kg-1) in daytime due to the stratification. Dissipation in the thermocline varied with time under the influence of internal waves. Shear from high-frequency internal waves (period ˜8 h) played an important role in enhancing the turbulent mixing in the thermocline. In the period of strong high-frequency internal waves, the shear from high-frequency internal waves became strong and the depth-averaged ɛ in the thermocline was elevated by almost one order of magnitude. Compared with the dissipation in the thermocline, dissipation below was weaker (the time-averaged ɛ ˜ 10-10 W kg-1). The observation indicates that the dissipation rates during the measurements can be parameterized by the MacKinnon-Gregg model that is widely used in the continental shelf but are not in agreement with the Gregg-Henyey model used for the open ocean.

“Anomalous right pulmonary artery left atrial fistula”: Growth in vain

Directory of Open Access Journals (Sweden)

Vishal Kumar Jain

2015-12-01

Full Text Available We report a case of direct communication between the right pulmonary artery and the left atrium; a rare cause of central cyanosis in 10 year old boy, emphasizing the role of multislice computed tomography scanner in delineating the complex vascular abnormality over more invasive conventional angiography.

5 February 2010: Romanian Former Minister of Justice V. Stoica (4th from left) visiting SM18 with, from left to right, University of Bucharest Faculty of Physics A. Costescu, DESY Hamburg C. Diaconu; Mrs Valeriu Stoica; Université de Montpellier II S. Ciulli; Technology Department Vacuum, Surfaces and Coatings group S. Ilie; Technology Department Head F. Bordry and Adviser for Russian Federation, Central and Eastern Europe T. Kurtyka.

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Maximilien Brice

2010-01-01

5 February 2010: Romanian Former Minister of Justice V. Stoica (4th from left) visiting SM18 with, from left to right, University of Bucharest Faculty of Physics A. Costescu, DESY Hamburg C. Diaconu; Mrs Valeriu Stoica; Université de Montpellier II S. Ciulli; Technology Department Vacuum, Surfaces and Coatings group S. Ilie; Technology Department Head F. Bordry and Adviser for Russian Federation, Central and Eastern Europe T. Kurtyka.

Three-dimensional Upper Crustal Velocity and Attenuation Structures of the Central Tibetan Plateau from Local Earthquake Tomography

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Zhou, B.; Liang, X.; Lin, G.; Tian, X.; Zhu, G.; Mechie, J.; Teng, J.

2017-12-01

A series of V-shaped conjugate strike-slip faults are the most spectacular geologic features in the central Tibetan plateau. A previous study suggested that this conjugate strike-slip fault system accommodates the east-west extension and coeval north-south contraction. Another previous study suggested that the continuous convergence between the Indian and Eurasian continents and the eastward asthenospheric flow generated lithospheric paired general-shear (PGS) deformation, which then caused the development of conjugate strike-slip faults in central Tibet. Local seismic tomography can image three dimensional upper-crustal velocity and attenuation structures in central Tibet, which will provide us with more information about the spatial distribution of physical properties and compositional variations around the conjugate strike-slip fault zone. Ultimately, this information could improve our understanding of the development mechanism of the conjugate strike-slip fault system. In this study, we collected 6,809 Pg and 2,929 Sg arrival times from 414 earthquakes recorded by the temporary SANDWICH and permanent CNSN networks from November 2013 to November 2015. We also included 300 P and 17 S arrival times from 12 shots recorded by the INDEPTH III project during the summer of 1998 in the velocity tomography. We inverted for preliminary Vp and Vp/Vs models using the SIMUL2000 tomography algorithm, and then relocated the earthquakes with these preliminary velocity models. After that, we inverted for the final velocity models with these improved source locations and origin times. After the velocity inversion, we performed local attenuation tomography using t* measurements from the same dataset with an already existing approach. There are correlated features in the velocity and attenuation structures. From the surface to 10 km depth, the study area is dominated by high Vp and Qp anomalies. However, from 10 km to 20 km depth, there is a low Vp and Qp zone distributed along the

[Femoral arteriovenous fistula: a late uncommon complication of central venous catheterization].

Science.gov (United States)

Conz, P A; Malagoli, A; Normanno, M; Munaro, D

2007-01-01

A 77-year-old woman was admitted due to AV graft thrombosis; given the technical impossibility of performing other native AV fistulas, we chose to insert a tunnelled central venous catheter. Considering the vascular history of the patient, the central venous catheter could not be placed into the internal jugular vein; it was therefore put into the left femoral vein. Following a 3-month-period of the catheter working properly, the patient was hospitalized due to sudden acute pain in the left thigh. In a few days the patient developed an important haematoma with serious anemization in the left lower limb. Ultrasonography showed the presence of a fistula between the left common femoral artery and the femoral vein, leading to the subsequent successful positioning of a stent into the common femoral artery through right trans-femoral access. Angiography examination showed the femoral vein patency along the proximal stretch with respect to the function of the tunnelled venous catheter.

Planktonic foraminiferal biostratigraphy of the Upper Barremian and Aptian of Crimea

Science.gov (United States)

Brovina, E. A.

2017-09-01

Reexamination of the Barremian-Aptian planktonic foraminifers from three sections (Verkhoirechie, mountain Krasnaya, and Marino) allowed the biostratigraphic scheme for Southwest and Central Crimea to be refined and updated. The following standard zones are recognized in the studied sections: Blowiella blowi (upper Barremian), Hedbergella excelsa (upper Barremian-lower Aptian), Leupoldina cabri (lower Aptian), H. luterbacheri, Globigerinelloides ferreolensis, Gl. barri, Gl. algerianus, Hedbergella trocoidea, Paraticinella rohri (upper Aptian). Beds with Hedbergella ruka are recognized in the B. blowi Zone. Foraminifers from the Partizanskoe section, representing the lower Aptian L. cabri and H. luterbacheri zones, are studied. The recognized strata are correlated with ammonite and nannoplankton zones and paleomagnetic data.

Left-right differences in ovarian volume and antral follicle count in 1423 women of reproductive age

DEFF Research Database (Denmark)

Korsholm, Anne-Sofie; Hvidman, Helene Westring; Bentzen, Janne Gasseholm

2017-01-01

The aim of this cross-sectional study was to investigate side differences in antral follicle count (AFC) and ovarian volume in left versus right ovaries in relation to chronological and "biological" age, the latter estimated by anti-Müllerian hormone (AMH) levels. The cohort comprised 1423 women...... ≤ 0.003). AFC was significantly higher in the right compared to the left ovary in the three upper AMH quartiles (p ≤ 0.005). The findings were similar when stratified in age quartiles. More than half (54.8%) had polycystic ovarian (PCO) morphology in at least one ovary. Of these women, 46.3% (n = 361......: 1014 fertile and 409 infertile. All were examined by transvaginal sonography and serum AMH. Overall the right ovary contained 8.1% more antral follicles (p = 0.002) and had 10.7% larger volume compared with the left (p right ovarian volume was larger than the left (p...

Biomechanical loading on the upper extremity increases from single key tapping to directional tapping.

Science.gov (United States)

Qin, Jin; Trudeau, Matthieu; Katz, Jeffrey N; Buchholz, Bryan; Dennerlein, Jack T

2011-08-01

Musculoskeletal disorders associated with computer use span the joints of the upper extremity. Computing typically involves tapping in multiple directions. Thus, we sought to describe the loading on the finger, wrist, elbow and shoulder joints in terms of kinematic and kinetic difference across single key switch tapping to directional tapping on multiple keys. An experiment with repeated measures design was conducted. Six subjects tapped with their right index finger on a stand-alone number keypad placed horizontally in three conditions: (1) on single key switch (the number key 5); (2) left and right on number key 4 and 6; (3) top and bottom on number key 8 and 2. A force-torque transducer underneath the keypad measured the fingertip force. An active-marker infrared motion analysis system measured the kinematics of the fingertip, hand, forearm, upper arm and torso. Joint moments for the metacarpophalangeal, wrist, elbow, and shoulder joints were estimated using inverse dynamics. Tapping in the top-bottom orientation introduced the largest biomechanical loading on the upper extremity especially for the proximal joint, followed by tapping in the left-right orientation, and the lowest loading was observed during single key switch tapping. Directional tapping on average increased the fingertip force, joint excursion, and peak-to-peak joint torque by 45%, 190% and 55%, respectively. Identifying the biomechanical loading patterns associated with these fundamental movements of keying improves the understanding of the risks of upper extremity musculoskeletal disorders for computer keyboard users. Copyright © 2010 Elsevier Ltd. All rights reserved.

Primary Meningeal Melanocytoma in the Left Temporal Lobe Associated with Nevus Ota

DEFF Research Database (Denmark)

Samadian, Mohammad; Nejad, Ali Mousavi; Bakhtevari, Mehrdad Hosseinzadeh

2015-01-01

BACKGROUND: Primary melanocytic neoplasms of the central nervous system are rare lesions arising from melanocytes of the leptomeninge that are found at highest density underneath the brain stem and along the upper cervical spinal cord. Thus most reported cases of meningeal melanocytomas are locat...

A Preliminary Observation of Weight Loss Following Left Gastric Artery Embolization in Humans

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Andrew J. Gunn

2014-01-01

Full Text Available Background/Objectives. Embolization of the left gastric artery (LGA, which preferentially supplies the gastric fundus, has been shown to produce weight loss in animal models. However, weight loss after LGA embolization in humans has not been previously established. The aim of this study was to evaluate postprocedural weight loss in patients following LGA embolization. Subjects/Methods. A retrospective analysis of the medical records of patients who underwent LGA embolization for upper gastrointestinal (GI bleeding was performed. Postprocedural weight loss in this group was compared to a control group of patients who had undergone embolization of other arteries for upper GI bleeding. Results. The experimental group (N=19 lost an average of 7.3% of their initial body weight within three months of LGA embolization, which was significantly greater than the 2% weight loss observed in the control group (N=28 (P=0.006. No significant differences were seen between the groups in preprocedural body mass index (BMI, age, postprocedural care in the intensive care unit, history of malignancy, serum creatinine, or left ventricular ejection fraction. Conclusions. The current data suggest that body weight in humans may be modulated via LGA embolization. Continued research is warranted with prospective studies to further investigate this phenomenon.

Repetitive transcranial magnetic stimulation of the left premotor/dorsolateral prefrontal cortex does not have analgesic effect on central poststroke pain.

Science.gov (United States)

de Oliveira, Rogério Adas Ayres; de Andrade, Daniel Ciampi; Mendonça, Melina; Barros, Rafael; Luvisoto, Tatiana; Myczkowski, Martin Luiz; Marcolin, Marco Antonio; Teixeira, Manoel Jacobsen

2014-12-01

Central poststroke pain (CPSP) is caused by an encephalic vascular lesion of the somatosensory pathways and is commonly refractory to current pharmacologic treatments. Repetitive transcranial magnetic stimulation (rTMS) of the premotor cortex/dorsolateral prefrontal cortex (PMC/DLPFC) can change thermal pain threshold toward analgesia in healthy subjects and has analgesic effects in acute postoperative pain as well as in fibromyalgia patients. However, its effect on neuropathic pain and in CPSP, in particular, has not been assessed. The aim of this prospective, double-blind, placebo-controlled study was to evaluate the analgesic effect of PMC/DLPFC rTMS in CPSP patients. Patients were randomized into 2 groups, active (a-) rTMS and sham (s-) rTMS, and were treated with 10 daily sessions of rTMS over the left PMC/DLPFC (10 Hz, 1,250 pulses/d). Outcomes were assessed at baseline, during the stimulation phase, and at 1, 2, and 4 weeks after the last stimulation. The main outcome was pain intensity changes measured by the visual analog scale on the last stimulation day compared to baseline. Interim analysis was scheduled when the first half of the patients completed the study. The study was terminated because of a significant lack of efficacy of the active arm after 21 patients completed the whole treatment and follow-up phases. rTMS of the left PMC/DLPFC did not improve pain in CPSP. The aim of this double-blind, placebo-controlled study was to evaluate the analgesic effects of rTMS to the PMC/DLPFC in CPSP patients. An interim analysis showed a consistent lack of analgesic effect, and the study was terminated. rTMS of the PMC/DLPFC is not effective in relieving CPSP. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

Physiopathological approach to infective endocarditis in chronic hemodialysis patients: left heart versus right heart involvement.

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Bentata, Yassamine

2017-11-01

Infectious endocarditis (IE), a complication that is both cardiac and infectious, occurs frequently and is associated with a heavy burden of morbidity and mortality in chronic hemodialysis patients (CHD). About 2-6% of chronic hemodialysis patients develop IE and the incidence is 50-60 times higher among CHD patients than in the general population. The left heart is the most frequent location of IE in CHD and the different published series report a prevalence of left valve involvement varying from 80% to 100%. Valvular and perivalvular abnormalities, alteration of the immune system, and bacteremia associated with repeated manipulation of the vascular access, particularly central venous catheters, comprise the main factors explaining the left heart IE in CHD patients. While left-sided IE develops in altered valves in a high-pressure system, right-sided IE on the contrary, generally develops in healthy valves in a low-pressure system. Right-sided IE is rare, with its incidence varying from 0% to 26% depending on the study, and the tricuspid valve is the main location. Might the massive influx of pathogenic and virulent germs via the central venous catheter to the right heart, with the tricuspid being the first contact valve, have a role in the physiopathology of IE in CHD, thus facilitating bacterial adhesion? While the physiopathology of left-sided IE entails multiple and convincing mechanisms, it is not the case for right-sided IE, for which the physiopathological mechanism is only partially understood and remains shrouded in mystery.

The Upper Danube Nature Park

International Nuclear Information System (INIS)

Dosedla, H.C.

1997-01-01

When in 1980 the Upper Danube Nature Park was founded as one of 65 nature sanctuaries in Germany there was great diversity of opinions concerning its intended character. The protected region consisting of a geologically outstanding landscape within central Europe is covering the first 80 km the upper Danube where the young river shortly after it's source in the Black Forest is breaking through the narrow canyons of the Jurassic rock plateau of the so-called Suebian Alps and also locates the subterranean passage where the stream is submerging from the surface for nearly ten miles. Since the purpose of nature preservation according to German las is closely combined with the rather contradicting aim of offering an attractive recreation area thus facing the immense impacts of modern mass tourism there are numerous problems which in the course of years have resulted in an intricate patterns of subtle management methods coping with the growing awareness of the ecological balance. (author)

Left-sided appendicitis: review of 95 published cases and a case report.

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Akbulut, Sami; Ulku, Abdullah; Senol, Ayhan; Tas, Mahmut; Yagmur, Yusuf

2010-11-28

To give an overview of the literature on left-sided acute appendicitis (LSAA) associated with situs inversus totalis (SIT) and midgut malrotation (MM). We present a new case of LSAA with SIT and a literature review of studies published in the English language on LSAA, accessed via PubMed and Google Scholar databases. Ninety-five published cases of LSAA were evaluated and a 25-year-old female, who presented to our clinic with left lower abdominal pain caused by LSAA, is reported. In the reviewed literature, fifty-seven patients were male and 38 were female with an age range of 8 to 82 years and a median age of 29.1 ± 15.9 years. Sixty-six patients had SIT, 23 had MM, three had cecal malrotation, and two had a previously unnoted congenital abnormality. Fifty-nine patients had presented to the hospital with left lower, 14 with right lower and seven with bilateral lower quadrant pain, and seven subjects complained of left upper quadrant pain. The diagnosis was established preoperatively in 49 patients, intraoperatively in 19, and during the postoperative period in five; 14 patients were aware of having this anomaly. The data of eight patients were not unavailable. Eleven patients underwent laparoscopic appendectomy, which was combined with cholecystectomy in two cases. Histopathological examination of the appendix specimens revealed adenocarcinoma in only two of 95 patients. The diagnosis of left lower quadrant pain is based on well-established clinical symptoms, physical examination and physician's experience.

A Brain-Machine Interface Based on ERD/ERS for an Upper-Limb Exoskeleton Control

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Zhichuan Tang

2016-12-01

Full Text Available To recognize the user’s motion intention, brain-machine interfaces (BMI usually decode movements from cortical activity to control exoskeletons and neuroprostheses for daily activities. The aim of this paper is to investigate whether self-induced variations of the electroencephalogram (EEG can be useful as control signals for an upper-limb exoskeleton developed by us. A BMI based on event-related desynchronization/synchronization (ERD/ERS is proposed. In the decoder-training phase, we investigate the offline classification performance of left versus right hand and left hand versus both feet by using motor execution (ME or motor imagery (MI. The results indicate that the accuracies of ME sessions are higher than those of MI sessions, and left hand versus both feet paradigm achieves a better classification performance, which would be used in the online-control phase. In the online-control phase, the trained decoder is tested in two scenarios (wearing or without wearing the exoskeleton. The MI and ME sessions wearing the exoskeleton achieve mean classification accuracy of 84.29% ± 2.11% and 87.37% ± 3.06%, respectively. The present study demonstrates that the proposed BMI is effective to control the upper-limb exoskeleton, and provides a practical method by non-invasive EEG signal associated with human natural behavior for clinical applications.

An elusive persistent left superior vena cava draining into left atrium

NARCIS (Netherlands)

A. Soward; F.J. ten Cate (Folkert); P.M. Fioretti (Paolo); P.W.J.C. Serruys (Patrick); J.R.T.C. Roelandt (Jos)

1986-01-01

textabstractA case report of a persistent left superior vena cava draining into left atrium with a fibromuscular left ventricular outflow tract obstruction and a small atrial septal defect. The anomalous vessel escaped detection during two right and left heart catheterizations from the right arm and

Moxonidine-induced central sympathoinhibition improves prognosis in rats with hypertensive heart failure.

Science.gov (United States)

Honda, Nobuhiro; Hirooka, Yoshitaka; Ito, Koji; Matsukawa, Ryuichi; Shinohara, Keisuke; Kishi, Takuya; Yasukawa, Keiji; Utsumi, Hideo; Sunagawa, Kenji

2013-11-01

Enhanced central sympathetic outflow is an indicator of the prognosis of heart failure. Although the central sympatholytic drug moxonidine is an established therapeutic strategy for hypertension, its benefits for hypertensive heart failure are poorly understood. In the present study, we investigated the effects of central sympathoinhibition by intracerebral infusion of moxonidine on survival in a rat model of hypertensive heart failure and the possible mechanisms involved. As a model of hypertensive heart failure, we fed Dahl salt-sensitive rats an 8% NaCl diet from 7 weeks of age. Intracerebroventricular (ICV) infusion of moxonidine (moxonidine-ICV-treated group [Mox-ICV]) or vehicle (vehicle-ICV-treated group [Veh-ICV]) was performed at 14-20 weeks of age, during the increased heart failure phase. Survival rates were examined, and sympathetic activity, left ventricular function and remodelling, and brain oxidative stress were measured. Hypertension and left ventricular hypertrophy were established by 13 weeks of age. At around 20 weeks of age, Veh-ICV rats exhibited overt heart failure concomitant with increased urinary norepinephrine (uNE) excretion as an index of sympathetic activity, dilated left ventricle, decreased percentage fractional shortening, and myocardial fibrosis. Survival rates at 21 weeks of age (n = 28) were only 23% in Veh-ICV rats, and 76% (n = 17) in Mox-ICV rats with concomitant decreases in uNE, myocardial fibrosis, collagen type I/III ratio, brain oxidative stress, and suppressed left ventricular dysfunction. Moxonidine-induced central sympathoinhibition attenuated brain oxidative stress, prevented cardiac dysfunction and remodelling, and improved the prognosis in rats with hypertensive heart failure. Central sympathoinhibition can be effective for the treatment of hypertensive heart failure.

Upper lip changes and gingival exposure on smiling: vertical dimension analysis.

Science.gov (United States)

Miron, Hagai; Calderon, Shlomo; Allon, Dror

2012-01-01

Our objectives were to evaluate and quantify upper lip soft-tissue changes in the vertical dimensions both at rest and at maximum smile, and to examine the correlation between upper labial vestibular attachment height and maxillary gingival exposure on smiling. Seventy-two volunteers (36 men, 36 women) aged 20 to 40 (mean, 30.49 years) were recruited for this study. For each subject, 9 measurements of upper lip position and maxillary incisor crown height at rest and in maximum smile were recorded. A statistically significant sexual dimorphism was apparent in most of the measured variables. Relaxed external upper lip length was 3.1 mm shorter in the women than in the men. The mean maxillary central incisor display at rest was 1.78 mm greater in the women than in the men. A high smile line was 2.5 times more prevalent in the women. The upper lip was shortened by 30% in subjects with a high smile line compared with 23% in subjects with a low smile line. The following findings were observed in subjects with a high smile pattern: (1) short upper lip length, (2) low smiling/resting upper lip length ratio, (3) inferior attachment of the upper labial vestibule, and (4) prominent upper lip vermilion. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Abnormal intrinsic functional hubs in alcohol dependence: evidence from a voxelwise degree centrality analysis

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Luo X

2017-07-01

Full Text Available Xiaoping Luo,1,2 Linghong Guo,1 Xi-Jian Dai,3 Qinglai Wang,2 Wenzhong Zhu,2 Xinjun Miao,2 Honghan Gong1 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 2Department of Radiology, Wenzhou Chinese Medicine Hospital, Wenzhou, Zhejiang, People’s Republic of China; 3Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, People’s Republic of China Objective: To explore the abnormal intrinsic functional hubs in alcohol dependence using voxelwise degree centrality analysis approach, and their relationships with clinical features.Materials and methods: Twenty-four male alcohol dependence subjects free of medicine (mean age, 50.21±9.62 years and 24 age- and education-matched male healthy controls (mean age, 50.29±8.92 years were recruited. The alcohol use disorders identification test and the severity of alcohol dependence questionnaire (SADQ were administered to assess the severity of alcohol craving. Voxelwise degree centrality approach was used to assess the abnormal intrinsic functional hubs features in alcohol dependence. Simple linear regression analysis was performed to investigate the relationships between the clinical features and abnormal intrinsic functional hubs.Results: Compared with healthy controls, alcohol dependence subjects exhibited significantly different degree centrality values in widespread left lateralization brain areas, including higher degree centrality values in the left precentral gyrus (BA 6, right hippocampus (BA 35, 36, and left orbitofrontal cortex (BA 11 and lower degree centrality values in the left cerebellum posterior lobe, bilateral secondary visual network (BA 18, and left precuneus (BA 7, 19. SADQ revealed a negative linear correlation with the degree centrality value in the left precentral gyrus (R2=0.296, P=0.006.Conclusion: The specific abnormal intrinsic functional hubs appear

Infection of the left sided gallbladder simulating liver abscess and gastric antral tumor

Energy Technology Data Exchange (ETDEWEB)

Kim, Jong Woo; Ahn, Jae Sung [St Mary' s Hospital Catholic Medical College, Seoul (Korea, Republic of)

1972-12-15

The left sided gallbladder, being a rare occurrence, may create diagnostic problem especially when it becomes infected. Recently, we have experienced 2 cases of infection of left sided gallbladder at the Department of Radiology, St Mary's Hospital, Catholic Medical College. Case I was a 32-year-old housewife with dyspepsia, epigastric pain and recurring bouts of high fever of 2 months duration. Under the provisional diagnosis of liver abscess liver scan was performed which revealed well defined cold area in the left lobe supporting the provisional diagnosis. Tender cystic mass was aspirated and pus was drained. The injected air at the occasion of aspiration outlined well defined cystic structure. Because aspiration failed to control the symptoms, laparotomy was performed. Surgeon found a left sided gallbladder which was empyematous. Case II was a 38 year old business man admitted to the hospital because of tender ill defined mass in mid epigastrium. The patient was febrile (39.4 .deg. C) and anemic. An upper GI series disclosed an irregular filling defect involving the antrum of the stomach. The mass was primarily extrinsic but was closely fixed to the gastric wall. Surgical intervention revealed chronic cholecystitis and pericholecystitis with thick adhesion to the distal stomach.

[An autopsied case of dominantly affecting upper motor neuron with atrophy of the frontal and temporal lobes--with special reference to primary lateral sclerosis].

Science.gov (United States)

Konagaya, M; Sakai, M; Iida, M; Hashizume, Y

1995-04-01

In this paper, the autopsy findings of a 78-year-old man mimicking primary lateral sclerosis (PLS) are reported. His clinical symptoms were slowly progressive spasticity, pseudobulbar palsy and character change. He died of sepsis 32 months after protracting the disease. The autopsy revealed severe atrophy of the frontal and temporal lobes. The histological findings were severe neuronal loss with gliosis in the precentral gyrus and left temporal lobe tip, loss of Betz cell, prominent demyelination throughout of the corticospinal tract, axonal swelling in the cerebral peduncule, severe degeneration of the amygdala, mild degeneration of the Ammon horn, normal substantia nigra, a few neuronal cells with central chromatolysis in the facial nerve nucleus and very mild neuronal cell loss in the spinal anterior horn. The anterior horn cell only occasionally demonstrated Bunina body by H & E and cystatin-C stainings, as well as, skein-like inclusion by ubiquitin staining. Thus, this is a case of uncommon amyotrophic lateral sclerosis (ALS) dominantly affecting the upper motor neuron including the motor cortex and temporal limbic system. In analysis of nine cases of putative primary lateral sclerosis in the literature, six cases showed loss of Betz cell in the precentral gyrus, and four cases very mild involvement of the lower motor neuron such as central chromatolysis and eosinophilic inclusion body. Degeneration of the limbic system was observed in two cases. We indicated a possible subgroup with concomitant involvement in the motor cortex and temporal lobe in motor neuron disease dominantly affecting the upper motor neuron.

Two new species of Hypostomus Lacépède (Teleostei: Loricariidae from the upper rio Paraná basin, Central Brazil

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Cláudio H. Zawadzki

Full Text Available Two new species of Hypostomus Lacépède (Teleostei: Loricariidae from the rio Paranaíba and rio Grande basins, both in the upper rio Paraná basin, central Brazil, are described herein. One of them is distinguished from all congeners, except H. albopunctatus, by having the pectoral-fin spine length equal to or smaller than the pelvic-fin spine. From H. albopunctatus, it is distinguished by having round dark spots (vs. pale on body and fins. The second species is distinguished from all congeners, except H. multidens and H. ternetzi, by having more than 115 teeth (vs. less than 109 per ramus on dentary and premaxilla. It is distinguished most readily from H. ternetzi by having teeth with two symmetrical (vs. asymmetrical cusps. It is distinguished from H. multidens by having round dark spots (vs. pale over body and fins.

Uranium minerals in Upper Carboniferous rocks in the Nowa Ruda region

International Nuclear Information System (INIS)

Bareja, E.

1981-01-01

Results of mineralogical studies on uranium in Upper Carboniferous rocks (Glinik Beds - Westphalian C - D and Ludwikowice Beds - Stephanian) in the vicinities of Nowa Ruda (Central Sudetic Depression) are presented. Uranium mineralization is here related to sandstones and polymictic conglomerates with clay and clay-carbonate cement. The major uranium-bearing horizon was found in middle part of the Glinik Beds, and some increase in uranium content - at the base of that unit. In the case of Stephanian rocks, points with uranium mineralization were found in various parts of the Ludwikowice Beds sequence: in basal conglomerate horizon and platy sandstones. Uranium minerals mainly occur in cement of sandstones and conglomerates. They were mainly identified as uranium blende and minerals of the sulfate group - zippeite and uranopilite. Mineralized uranium-bearing horizons display mineral paragenesis typical of Upper Carboniferous rocks of the Central Sudetic Depression: uranium blende, pyrite, chalcopyrite, sphalerite and galena. (author)

Bilateral generic working memory circuit requires left-lateralized addition for verbal processing.

Science.gov (United States)

Ray, Manaan Kar; Mackay, Clare E; Harmer, Catherine J; Crow, Timothy J

2008-06-01

According to the Baddeley-Hitch model, phonological and visuospatial representations are separable components of working memory (WM) linked by a central executive. The traditional view that the separation reflects the relative contribution of the 2 hemispheres (verbal WM--left; spatial WM--right) has been challenged by the position that a common bilateral frontoparietal network subserves both domains. Here, we test the hypothesis that there is a generic WM circuit that recruits additional specialized regions for verbal and spatial processing. We designed a functional magnetic resonance imaging paradigm to elicit activation in the WM circuit for verbal and spatial information using identical stimuli and applied this in 33 healthy controls. We detected left-lateralized quantitative differences in the left frontal and temporal lobe for verbal > spatial WM but no areas of activation for spatial > verbal WM. We speculate that spatial WM is analogous to a "generic" bilateral frontoparietal WM circuit we inherited from our great ape ancestors that evolved, by recruitment of additional left-lateralized frontal and temporal regions, to accommodate language.

Bedrock morphology and structure, upper Santa Cruz Basin, south-central Arizona, with transient electromagnetic survey data

Science.gov (United States)

Bultman, Mark W.; Page, William R.

2016-10-31

The upper Santa Cruz Basin is an important groundwater basin containing the regional aquifer for the city of Nogales, Arizona. This report provides data and interpretations of data aimed at better understanding the bedrock morphology and structure of the upper Santa Cruz Basin study area which encompasses the Rio Rico and Nogales 1:24,000-scale U.S. Geological Survey quadrangles. Data used in this report include the Arizona Aeromagnetic and Gravity Maps and Data referred to here as the 1996 Patagonia Aeromagnetic survey, Bouguer gravity anomaly data, and conductivity-depth transforms (CDTs) from the 1998 Santa Cruz transient electromagnetic survey (whose data are included in appendixes 1 and 2 of this report).Analyses based on magnetic gradients worked well to identify the range-front faults along the Mt. Benedict horst block, the location of possibly fault-controlled canyons to the west of Mt. Benedict, the edges of buried lava flows, and numerous other concealed faults and contacts. Applying the 1996 Patagonia aeromagnetic survey data using the horizontal gradient method produced results that were most closely correlated with the observed geology.The 1996 Patagonia aeromagnetic survey was used to estimate depth to bedrock in the upper Santa Cruz Basin study area. Three different depth estimation methods were applied to the data: Euler deconvolution, horizontal gradient magnitude, and analytic signal. The final depth to bedrock map was produced by choosing the maximum depth from each of the three methods at a given location and combining all maximum depths. In locations of rocks with a known reversed natural remanent magnetic field, gravity based depth estimates from Gettings and Houser (1997) were used.The depth to bedrock map was supported by modeling aeromagnetic anomaly data along six profiles. These cross sectional models demonstrated that by using the depth to bedrock map generated in this study, known and concealed faults, measured and estimated magnetic

Upper Limits on the Presence of Central Massive Black Holes in Two Ultra-compact Dwarf Galaxies in Centaurus A

Science.gov (United States)

Voggel, Karina T.; Seth, Anil C.; Neumayer, Nadine; Mieske, Steffen; Chilingarian, Igor; Ahn, Christopher; Baumgardt, Holger; Hilker, Michael; Nguyen, Dieu D.; Romanowsky, Aaron J.; Walsh, Jonelle L.; den Brok, Mark; Strader, Jay

2018-05-01

The recent discovery of massive black holes (BHs) in the centers of high-mass ultra-compact dwarf galaxies (UCDs) suggests that at least some are the stripped nuclear star clusters of dwarf galaxies. We present the first study that investigates whether such massive BHs, and therefore stripped nuclei, also exist in low-mass (M < 107 M ⊙) UCDs. We constrain the BH masses of two UCDs located in Centaurus A (UCD 320 and UCD 330) using Jeans modeling of the resolved stellar kinematics from adaptive optics data obtained with the SINFONI integral field spectrograph at the Very Large Telescope (VLT/SINFONI). No massive BHs are found in either UCD. We find a 3σ upper limit on the central BH mass in UCD 330 of M • < 1.0 × 105 M ⊙, which corresponds to 1.7% of the total mass. This excludes a high-mass fraction BH and would only allow low-mass BHs similar to those claimed to be detected in Local Group globular clusters. For UCD 320, poorer data quality results in a less constraining 3σ upper limit of M • < 1 × 106 M ⊙, which is equal to 37.7% of the total mass. The dynamical mass-to-light ratios of UCD 320 and UCD 330 are not inflated compared to predictions from stellar population models. The non-detection of BHs in these low-mass UCDs is consistent with the idea that elevated dynamical mass-to-light ratios do indicate the presence of a substantial BH. Although no massive BHs are detected, these systems could still be stripped nuclei. The strong rotation (v/σ of 0.3–0.4) in both UCDs and the two-component light profile in UCD 330 support the idea that these UCDs may be stripped nuclei of low-mass galaxies whose BH occupation fraction is not yet known.

Search for W(prime) → tb resonances with left- and right-handed couplings to fermions

International Nuclear Information System (INIS)

2011-01-01

We present a search for the production of a heavy gauge boson, W(prime), that decays to third-generation quarks, by the D0 Collaboration in p(bar p) collisions at √s = 1.96 TeV. We set 95% confidence level upper limits on the production cross section times branching fraction. For the first time, we set limits for arbitrary combinations of left- and right-handed couplings of the W(prime) boson to fermions. For couplings with the same strength as the standard model W boson, we set the following limits for M(W(prime)) > m(ν R ): M(W(prime)) > 863 GeV for purely left-handed couplings, M(W(prime)) > 885 GeV for purely right-handed couplings, and M(W(prime)) > 916 GeV if both left- and right-handed couplings are present. The limit for right-handed couplings improves for M(W(prime)) R ) to M(W(prime)) > 890 GeV.

[Chronic recurrent volvulus of the colonic splenic flexure associated with the eventration of left diaphragm].

Science.gov (United States)

Kim, Hee Sun; Yoo, Jeong Seon; Han, Seok Joo; Park, Hyojin

2007-01-01

The eventration of diaphragm is usually found incidentally on chest X-ray or sometimes presented as acute gastric volvulus. However, colonic volvulus on splenic flexure area complicated by diaphragmatic eventration is extremely rare. A 25 year old man complained of upper abdominal pain for three days. He had a history of brain injury during infant period, and had epilepsy and mental retardation. Plain chest X-ray showed left diaphragmatic eventration and marked dilatation of colon on splenic flexure area which had not been changed for last three years. Barium enema showed bird beak appearance on distal colon near the splenic flexure. Colonoscopic reduction failed. After decompression with rectal and nasogastric tubes, colonic volvulus was relieved. To prevent the recurrence of volvulus, we performed segmental resection of left colon including splenic flexure area and repaired the left diaphragmatic eventration. After the operation, the patient had no further recurrent episode of volvulus although ileus persisted.

Management of foreign object in the root canal of central incisor tooth

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Mothanna Alrahabi

2014-01-01

Full Text Available There are several reports describing the impaction of foreign objects into the exposed pulp chambers and canals by patients, especially children as they often have the habit of inserting foreign objects in the oral cavity. These objects will become a potent source of infection.This case report describes the retrieval of a foreign object impacted into the root canal of a 12-year-old male patient who was referred to the endodontic specialty clinic at Taibah University College of Dentistry. The patient′s chief complaint was a pain in the upper left central tooth. Clinical examination revealed a complicated enamel-dentin fracture with a large caries cavity. A periapical radiographic image showed a radiopaque object in the root canal system. Stainless steel Hedstrom files were used to retrieve the object from the canal. Following a proper cleaning and shaping of the root canal system, an intra-canal calcium hydroxide dressing was placed for 1 week. The root canal system was then filled with sealer and gutta-percha using the lateral compaction technique and the tooth received an aesthetic restoration.

Simplificação do índice CPO dos 18 aos 25 anos DMF Index simplification from 18 to 25 years

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Luiz O. C. Guimarães

1990-10-01

Full Text Available O índice CPO pode ser estimado pelo dobro do valor obtido pelo exame de dois hemiarcos (superior direito e inferior esquerdo, e pelo quádruplo do valor observado em seis dentes (primeiro molar e incisivo central superiores direitos, primeiro pré-molar superior esquerdo, segundo molar e incisivo lateral inferiores esquerdos e segundo pré-molar inferior direito. As estimativas foram feitas por métodos da estatística descritiva, em termos de média, composição percentual e coeficiente de prevalência de cárie, tendo-se levantado dados em 100 indivíduos de 18 a 25 anos.The DMF index can be estimated at double the value observed in the exam of two hemiarchs (Upper Right and Lower Left, or at four times the value obtained from six teeth (First Molar and Central Incisor Upper Right, first bicuspid upper left, second molar and lateral incisor lower left and second bicuspid lower right. The estimates were made by the use of methods of descriptive statistics, averages, percentages and the coefficient of the prevalence of caries, in a sample of 100 people, aged from 18 to 25 years.

New roles for mathematics in multi-disciplinary,upper secondary school projects

DEFF Research Database (Denmark)

Lindenskov, Lena; Andresen, Mette

2009-01-01

A new concept, compulsory multi-disciplinary courses, was introduced in upper secondary school curriculum as a central part of a recent reform. This paper reports from a case study of such a triple/four-disciplinary project in mathematics, physics, chemistry and ‘general study preparation...

Acute contained ruptured aortic aneurysm presenting as left vocal fold immobility.

Science.gov (United States)

Gnagi, Sharon H; Howard, Brittany E; Hoxworth, Joseph M; Lott, David G

2015-01-01

Objective. To recognize intrathoracic abnormalities, including expansion or rupture of aortic aneurysms, as a source of acute onset vocal fold immobility. Methods. A case report and review of the literature. Results. An 85-year-old female with prior history of an aortic aneurysm presented to a tertiary care facility with sudden onset hoarseness. On laryngoscopy, the left vocal fold was immobile in the paramedian position. A CT scan obtained that day revealed a new, large hematoma surrounding the upper descending aortic stent graft consistent with an acute contained ruptured aortic aneurysm. She was referred to the emergency department for evaluation and treatment by vascular surgery. She was counseled regarding surgical options and ultimately decided not to pursue further treatment. Her vocal fold immobility was subsequently treated via office-based injection medialization two weeks after presentation and again 5 months after the initial injection which dramatically improved her voice. Follow-up CT scan at 8 months demonstrated a reduction of the hematoma. The left vocal cord remains immobile to date. Conclusion. Ortner's syndrome, or cardiovocal syndrome, is hoarseness secondary to left recurrent laryngeal nerve palsy caused by cardiovascular pathology. It is a rare condition and, while typically presenting gradually, may also present with acute symptomatology.

Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility

Directory of Open Access Journals (Sweden)

Sharon H. Gnagi

2015-01-01

Full Text Available Objective. To recognize intrathoracic abnormalities, including expansion or rupture of aortic aneurysms, as a source of acute onset vocal fold immobility. Methods. A case report and review of the literature. Results. An 85-year-old female with prior history of an aortic aneurysm presented to a tertiary care facility with sudden onset hoarseness. On laryngoscopy, the left vocal fold was immobile in the paramedian position. A CT scan obtained that day revealed a new, large hematoma surrounding the upper descending aortic stent graft consistent with an acute contained ruptured aortic aneurysm. She was referred to the emergency department for evaluation and treatment by vascular surgery. She was counseled regarding surgical options and ultimately decided not to pursue further treatment. Her vocal fold immobility was subsequently treated via office-based injection medialization two weeks after presentation and again 5 months after the initial injection which dramatically improved her voice. Follow-up CT scan at 8 months demonstrated a reduction of the hematoma. The left vocal cord remains immobile to date. Conclusion. Ortner’s syndrome, or cardiovocal syndrome, is hoarseness secondary to left recurrent laryngeal nerve palsy caused by cardiovascular pathology. It is a rare condition and, while typically presenting gradually, may also present with acute symptomatology.

Analysis of reaching movements of upper arm in robot assisted exercises. Kinematic assessment of robot assisted upper arm reaching single-joint movements.

Science.gov (United States)

Iuppariello, Luigi; D'Addio, Giovanni; Romano, Maria; Bifulco, Paolo; Lanzillo, Bernardo; Pappone, Nicola; Cesarelli, Mario

2016-01-01

Robot-mediated therapy (RMT) has been a very dynamic area of research in recent years. Robotics devices are in fact capable to quantify the performances of a rehabilitation task in treatments of several disorders of the arm and the shoulder of various central and peripheral etiology. Different systems for robot-aided neuro-rehabilitation are available for upper limb rehabilitation but the biomechanical parameters proposed until today, to evaluate the quality of the movement, are related to the specific robot used and to the type of exercise performed. Besides, none study indicated a standardized quantitative evaluation of robot assisted upper arm reaching movements, so the RMT is still far to be considered a standardised tool. In this paper a quantitative kinematic assessment of robot assisted upper arm reaching movements, considering also the effect of gravity on the quality of the movements, is proposed. We studied a group of 10 healthy subjects and results indicate that our advised protocol can be useful for characterising normal pattern in reaching movements.

Studies on improvement of diagnostic ability of computed tomography (CT) in the parenchymatous organs in the upper abdomen, 1. Study on the upper abdominal compression method

Energy Technology Data Exchange (ETDEWEB)

Kawata, Ryo [Gifu Univ. (Japan). Faculty of Medicine

1982-07-01

1) The upper abdominal compression method was easily applicable for CT examination in practically all the patients. It gave no harm and considerably improved CT diagnosis. 2) The materials used for compression were foamed polystyrene, the Mix-Dp and a water bag. When CT examination was performed to diagnose such lesions as a circumscribed tumor, compression with the Mix-Dp was most useful, and when it was performed for screening examination of upper abdominal diseases, compression with a water bag was most effective. 3) Improvement in contour-depicting ability of CT by the compression method was most marked at the body of the pancreas, followed by the head of the pancreas and the posterior surface of the left lobe of the liver. Slight improvement was seen also at the tail of the pancreas and the left adrenal gland. 4) Improvement in organ-depicting ability of CT by the compression method was estimated by a 4-category classification method. It was found that the improvement was most marked at the body and the head of the pancreas. Considerable improvement was observed also at the left lobe of the liver and the both adrenal glands. Little improvement was obtained at the spleen. When contrast enhancement was combined with the compression method, improvement at such organs which were liable to be enhanced, as the liver and the adrenal glands, was promoted, while the organ-depicting ability was decreased at the pancreas. 5) By comparing the CT image under compression with that without compression, continuous infiltrations of gastric cancer into the body and the tail of the pancreas in 2 cases and a retroperitoneal infiltration of pancreatic tumor in 1 case were diagnosed preoperatively.

Primary Splenic Hydatid: A Case Report | Gul | East and Central ...

African Journals Online (AJOL)

Hydatid disease is a parasitic infection caused mainly by Echinococcus granulosus and is a common entity in this part of the world . However, primary hydatid disease of spleen is a rare entity. We are reporting a case of a massive primary splenic hydatid cyst in a 27 yr old female, who presented with left upper quadrant ...

Sternocostoclavicular Hyperostosis: An Insufficiently Recognized Clinical Entity

Directory of Open Access Journals (Sweden)

Taro Sugase

2017-04-01

Full Text Available A 79-year-old male chronic hemodialysis patient with no history of central venous catheterization was referred to our hospital with progressive swelling of the left upper limb ipsilateral to a forearm arteriovenous fistula. Radiological assessments revealed marked hyperostosis in the ribs, sternum, and clavicles with well-developed ossification of the sternocostoclavicular ligaments. Such characteristic structural abnormalities and our failure to identify the left subclavian vein with contrast material despite the abundant dilated collaterals in the left shoulder area encouraged us to diagnose our patient with sternocostoclavicular hyperostosis (SCCH complicated by central vein obstruction. The structural impact of the sternocostoclavicular region as a potential risk for inducing central vein obstruction and the diagnostic concerns of SCCH in this patient are also discussed.

Sedimentology of the Upper Maastrichtian chalk, Danish Central Graben. M-10X (Dan Field), E-5X (Tyra SE Field) facies and core logs

Energy Technology Data Exchange (ETDEWEB)

Ineson, J.R.

2004-07-01

Based on detailed logs presented here at 1:10, the cored Upper Maastrichtian succession of the M-10X (Dan Field) and E-5X (Tyra SE Field) wells in the southern Danish Central Graben is subdivided into eight lithofacies and five ichnofabrics. The dominant bioturbated or laminated chalk mudstones and subordinate sparse skeletal wackestones are largely the result of pelagic carbonate production, sedimented by suspension settling and small volume, low density turbidity currents. Evidence of winnowing/reduced sedimentation rates is yielded by rare incipient hardgrounds; a well-developed mature hardground profile is developed at the Cretaceous-Danian boundary (the ''Maastrichtian hardground''). Rare marl laminae are recorded and a discrete marly chalk bed associated with an interval of finegrained skeletal chalk wackestones near the top of the Maastrichtian is recognised in both wells. Comparison between the two wells demonstrates that the m-scale laminated-bioturbated chalk cycles described from the Dan Field area are both stratigraphically and areally restricted; this has implications for both cyclostratigraphic correlation and reconstruction of depositional environments and Late Maastrichtian evolution of the Danish Central Graben. (au)

The Effects of Individual Upper Alpha Neurofeedback in ADHD: An Open-Label Pilot Study

OpenAIRE

Escolano , Carlos; Navarro-Gil , Mayte; Garcia-Campayo , Javier; Congedo , Marco; Minguez , Javier

2014-01-01

International audience; Standardized neurofeedback (NF) protocols have been extensively evaluated in attention-deficit/hyperactivity disorder (ADHD). However, such protocols do not account for the large EEG heterogeneity in ADHD. Thus, individualized approaches have been suggested to improve the clinical outcome. In this direction, an open-label pilot study was designed to evaluate a NF protocol of relative upper alpha power enhancement in fronto-central sites. Upper alpha band was individual...

The Performance of the Upper Limb scores correlate with pulmonary function test measures and Egen Klassifikation scores in Duchenne muscular dystrophy.

Science.gov (United States)

Lee, Ha Neul; Sawnani, Hemant; Horn, Paul S; Rybalsky, Irina; Relucio, Lani; Wong, Brenda L

2016-01-01

The Performance of the Upper Limb scale was developed as an outcome measure specifically for ambulant and non-ambulant patients with Duchenne muscular dystrophy and is implemented in clinical trials needing longitudinal data. The aim of this study is to determine whether this novel tool correlates with functional ability using pulmonary function test, cardiac function test and Egen Klassifikation scale scores as clinical measures. In this cross-sectional study, 43 non-ambulatory Duchenne males from ages 10 to 30 years and on long-term glucocorticoid treatment were enrolled. Cardiac and pulmonary function test results were analyzed to assess cardiopulmonary function, and Egen Klassifikation scores were analyzed to assess functional ability. The Performance of the Upper Limb scores correlated with pulmonary function measures and had inverse correlation with Egen Klassifikation scores. There was no correlation with left ventricular ejection fraction and left ventricular dysfunction. Body mass index and decreased joint range of motion affected total Performance of the Upper Limb scores and should be considered in clinical trial designs. Copyright © 2016 Elsevier B.V. All rights reserved.

Hydrology, Water Quality, and Surface- and Ground-Water Interactions in the Upper Hillsborough River Watershed, West-Central Florida

Science.gov (United States)

Trommer, J.T.; Sacks, L.A.; Kuniansky, E.L.

2007-01-01

A study of the Hillsborough River watershed was conducted between October 1999 through September 2003 to characterize the hydrology, water quality, and interaction between the surface and ground water in the highly karstic uppermost part of the watershed. Information such as locations of ground-water recharge and discharge, depth of the flow system interacting with the stream, and water quality in the watershed can aid in prudent water-management decisions. The upper Hillsborough River watershed covers a 220-square-mile area upstream from Hillsborough River State Park where the watershed is relatively undeveloped. The watershed contains a second order magnitude spring, many karst features, poorly drained swamps, marshes, upland flatwoods, and ridge areas. The upper Hillsborough River watershed is subdivided into two major subbasins, namely, the upper Hillsborough River subbasin, and the Blackwater Creek subbasin. The Blackwater Creek subbasin includes the Itchepackesassa Creek subbasin, which in turn includes the East Canal subbasin. The upper Hillsborough River watershed is underlain by thick sequences of carbonate rock that are covered by thin surficial deposits of unconsolidated sand and sandy clay. The clay layer is breached in many places because of the karst nature of the underlying limestone, and the highly variable degree of confinement between the Upper Floridan and surficial aquifers throughout the watershed. Potentiometric-surface maps indicate good hydraulic connection between the Upper Floridan aquifer and the Hillsborough River, and a poorer connection with Blackwater and Itchepackesassa Creeks. Similar water level elevations and fluctuations in the Upper Floridan and surficial aquifers at paired wells also indicate good hydraulic connection. Calcium was the dominant ion in ground water from all wells sampled in the watershed. Nitrate concentrations were near or below the detection limit in all except two wells that may have been affected by

Sleep apnoea during upper respiratory infection and metabolic alkalosis in infancy.

Science.gov (United States)

Abreu e Silva, F A; MacFadyen, U M; Williams, A; Simpson, H

1986-01-01

Three to four hour polygraphic sleep studies were carried out in 10 infants, five with upper respiratory infection and five with metabolic alkalosis secondary to vomiting during and after recovery from illness. During upper respiratory infection, the main abnormality detected was brief (greater than 3 less than 6 seconds) or prolonged (greater than 6 seconds) attacks of obstructive apnoea. Other indices of apnoea were similar to recovery data. Gross body movements were also increased. In infants with metabolic alkalosis indices of central apnoea were significantly increased when compared with recovery or case control data. Prolonged (greater than 15 seconds) attacks of central apnoea and obstructive apnoea (greater than 6 seconds) were only observed during illness. Gross body movements and periodic breathing were also increased. These findings suggest that the functional consequences of apparently 'mild' illnesses in young infants may be greater than is generally suspected and perhaps relevant to mechanism(s) of death in sudden infant death syndrome. PMID:3789786

Isolated persistent left superior vena cava: A case report and its clinical implications

Directory of Open Access Journals (Sweden)

Samarjit Bisoyi

2017-01-01

Full Text Available The venous anomaly of a persistent left superior vena cava (PLSVC affects 0.3%-0.5% of the general population. PLSVC with absent right superior vena cava, also termed as "isolated PLSVC," is an extremely rare venous anomaly. Almost half of the patients with isolated PLSVC have cardiac anomalies in the form of atrial septal defect, endocardial cushion defects, or tetralogy of Fallot. Isolated PLSVC is usually innocuous. Its discovery, however, has important clinical implications. It can pose clinical difficulties with central venous access, cardiothoracic surgeries, and pacemaker implantation. When it drains to the left atrium, it may create a right to left shunt. In this case report, we present the incidental finding of isolated PLSVC in a patient who underwent aortic valve replacement. Awareness about this condition and its variations is important to avoid complications.

Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

DEFF Research Database (Denmark)

Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P

2013-01-01

Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation...... [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV)] in hypertensive patients....

Association between right-to-left shunts and brain lesions in sport divers.

Science.gov (United States)

Gerriets, Tibo; Tetzlaff, Kay; Hutzelmann, Alfred; Liceni, Thomas; Kopiske, Gerrit; Struck, Niklas; Reuter, Michael; Kaps, Manfred

2003-10-01

Recent studies suggest that healthy sport divers may develop clinically silent brain damage, based on the association between a finding of multiple brain lesions on MRI and the presence of right-to-left shunt, a pathway for venous gas bubbles to enter the arterial system. We performed echocontrast transcranial Doppler sonography in 42 sport divers to determine the presence of a right-to-left shunt. Cranial MRI was carried out using a 1.5 T magnet. A lesion was counted if it was hyperintense on both T2-weighted and T2-weighted fluid attenuated inversion recovery sequences. To test the hypothesis that the occurrence of postdive arterial gas emboli is related to brain lesions on MRI, we measured postdive intravascular bubbles in a subset of 15 divers 30 min after open water scuba dives. Echocontrast transcranial Doppler sonography revealed a right-to-left shunt in 16 of the divers (38%). Only one hyperintensive lesion of the central white matter was found and that was in a diver with no evidence of a right-to-left shunt. Postdive arterial gas emboli were detected in 3 out of 15 divers; they had a right-to-left shunt, but no pathologic findings on cranial magnetic resonance imaging. Our data support the theory that right-to-left shunts can serve as a pathway for venous gas bubbles into the arterial circulation. However, we could not confirm an association between brain lesions and the presence of a right-to-left shunt in sport divers.

Laparoscopic jejunostomy for obstructing upper gastrointestinal malignancies

Science.gov (United States)

TSUJIMOTO, HIRONORI; HIRAKI, SHUICHI; TAKAHATA, RISA; NOMURA, SHINSUKE; ITO, NOZOMI; KANEMATSU, KYOHEI; HORIGUCHI, HIROYUKI; AOSASA, SUEFUMI; YAMAMOTO, JUNJI; HASE, KAZUO

2015-01-01

The aim of this study was to describe a minimally invasive laparoscopic jejunostomy (Lap-J) technique for obstruction due to upper gastrointestinal malignancies and evaluate the nutritional benefit of Lap-J during neoadjuvant chemotherapy (NAC) in cases with obstructing esophageal cancer. Under general anesthesia, the jejunum 20–30 cm distant from the Treitz ligament was pulled out through an extended umbilical laparoscopic incision and a jejunal tube was inserted to 30 cm. The loop of bowel was gently returned to the abdomen and the feeding tube was drawn through the abdominal wall via the left lower incision. The jejunum was then laparoscopically sutured to the anterior abdominal wall. Lap-J was performed in 26 cases. The median operative time was 82 min. The postoperative course was uneventful. Lap-J prior to NAC was not associated with a decrease in body weight or serum total protein during NAC, compared with patients who received NAC without Lap-J. This minimally invasive jejunostomy technique may be particularly useful in patients in whom endoscopic therapy is not feasible due to obstruction from upper gastrointestinal malignancies. PMID:26807238

Angular (Gothic) aortic arch leads to enhanced systolic wave reflection, central aortic stiffness, and increased left ventricular mass late after aortic coarctation repair: evaluation with magnetic resonance flow mapping.

Science.gov (United States)

Ou, Phalla; Celermajer, David S; Raisky, Olivier; Jolivet, Odile; Buyens, Fanny; Herment, Alain; Sidi, Daniel; Bonnet, Damien; Mousseaux, Elie

2008-01-01

We sought to investigate the mechanism whereby a particular deformity of the aortic arch, an angulated Gothic shape, might lead to hypertension late after anatomically successful repair of aortic coarctation. Fifty-five normotensive patients with anatomically successful repair of aortic coarctation and either a Gothic (angulated) or a Romanesque (smooth and rounded) arch were studied with magnetic resonance angiography and flow mapping in both the ascending and descending aortas. Systolic waveforms, central aortic stiffness, and pulse velocity were measured. We hypothesized that arch angulation would result in enhanced systolic wave reflection with loss of energy across the aortic arch, as well as increased central aortic stiffness. Twenty patients were found to have a Gothic, and 35 a Romanesque, arch. Patients with a Gothic arch showed markedly augmented systolic wave reflection (12 +/- 6 vs 5 +/- 0.3 mL, P Gothic arch (5.6 +/- 1.1 vs 4.1 +/- 1 m/s, P Gothic aortic arch is associated with increased systolic wave reflection, as well as increased central aortic stiffness and left ventricular mass index. These findings explain (at least in part) the association between this pattern of arch geometry and late hypertension at rest and on exercise in subjects after coarctation repair.

40Ar/39Ar dates in the Central Cordillera of Colombia: Evidence for an upper triassic regional tecnomagmatic event

International Nuclear Information System (INIS)

Vinasco, C.J.; Cordani, U.G.; Vasconcelos, P

2001-01-01

The Coastal, Western, Central and the Eastern Cordilleras constitute four independent mountain ranges in the Northern Andes. The Coastal and Western Cordillera comprises allochthonous oceanic sequences of basic volcanic rocks and marine sediments of Cenozoic and Upper Cretaceous age (Aspden et al., 1987). The so-called Central Cordillera Polymetamorphic Complex (Restrepo and Toussaint, 1982), made up the pre-Mesozoic Central Cordillera basement, consists of low through high-grade metamorphic rocks intruded by Meso-Cenozoic batholiths. The Eastern Cordillera is a polydeformed continental mountain range consisting of Precambrian and Paleozoic metamorphic and igneous rocks overlain by Paleozoic to Mesozoic sedimentary covers. The northern part of the Central Cordillera has been described as a suspect terrain affected by several tectonometamorphic episodes. The most important of them have been always considered those related to the Hercynian orogeny, in Devonian and Carboniferous times, and those occurring at the beginning of the Andean Cycle in the Cretaceous (Restrepo and Toussaint, 1982). A possible Lower Paleozoic and even Precambrian age for the basement of the terrain has also been proposed. Although some indications of a Permo-Triassic event are already available, this period was not considered as of great importance for the geologic evolution of the region. The available radiometric dates in the 200-250 Ma interval, for the Central Cordillera, are as follows: 1. One K-Ar whole rock age for a Granulite of 251±21 Ma. (Restrepo et al, 1991) of the El Retiro group SE of Medellin. However, a K-Ar biotite age of 110±10 Ma. (Toussaint et al., 1978) was obtained for a migmatite rock associated with the same group. 2. A Sm/Nd garnet and whole rock age of 226±17 Ma in rocks associated to granulites, SE of Medellin, interpreted as metamorphic ages (Correa and Martins, 2001). 3. K-Ar biotite dates for the Puqui metamorphic complex, occurring north of Medellin, ranging

Examining the central and peripheral processes of written word production through meta-analysis

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Jeremy ePurcell

2011-10-01

Full Text Available Producing written words requires central cognitive processes (such as orthographic long-term and working memory as well as more peripheral processes responsible for generating the motor actions needed for producing written words in a variety of formats (handwriting, typing, etc.. In recent years, various functional neuroimaging studies have examined the neural substrates underlying the central and peripheral processes of written word production. This study provides the first quantitative meta-analysis of these studies by applying Activation Likelihood Estimation methods (Turkeltaub et al., 2002. For alphabet languages, we identified 11 studies (with a total of 17 experimental contrasts that had been designed to isolate central and/or peripheral processes of word spelling (total number of participants = 146. Three ALE meta-analyses were carried out. One involved the complete set of 17 contrasts; two others were applied to subsets of contrasts to distinguish the neural substrates of central from peripheral processes. These analyses identified a network of brain regions reliably associated with the central and peripheral processes of word spelling. Among the many significant results, is the finding that the regions with the greatest correspondence across studies were in the left inferior temporal/fusiform gyri and left inferior frontal gyrus. Furthermore, although the angular gyrus has traditionally been identified as a key site within the written word production network, none of the meta-analyses found it to be a consistent site of activation, identifying instead a region just superior/medial to the left angular gyrus in the left posterior intraparietal sulcus. In general these meta-analyses and the discussion of results provide a valuable foundation upon which future studies that examine the neural basis of written word production can build.

Central nervous system tuberculomata presenting as internuclear ...

African Journals Online (AJOL)

Central nervous system (CNS) tuberculoma can have variable presentation depending upon the site and number of tuberculomata. We are reporting a rare case of a 15 years old girl who presented to our hospital with binocular diplopia on right gaze. Clinical examination revealed left sided internuclear ophthalmoplegia ...

Long-term prognostic value of risk scores after drug-eluting stent implantation for unprotected left main coronary artery: A pooled analysis of the ISAR-LEFT-MAIN and ISAR-LEFT-MAIN 2 randomized clinical trials.

Science.gov (United States)

Xhepa, Erion; Tada, Tomohisa; Kufner, Sebastian; Ndrepepa, Gjin; Byrne, Robert A; Kreutzer, Johanna; Ibrahim, Tareq; Tiroch, Klaus; Valgimigli, Marco; Tölg, Ralf; Cassese, Salvatore; Fusaro, Massimiliano; Schunkert, Heribert; Laugwitz, Karl L; Mehilli, Julinda; Kastrati, Adnan

2017-01-01

To evaluate the long-term prognostic value of risk scores in the setting of drug-eluting stent (DES) implantation for uLMCA. Data on the prognostic value of novel risk scores developed to select the most appropriate revascularization strategy in patients undergoing DES implantation for uLMCA disease are relatively limited. The study represents a patient-level pooled analysis of the ISAR-LEFT-MAIN (607 patients randomized to paclitaxel-eluting or sirolimus-eluting stents) and the ISAR-LEFT-MAIN-2 (650 patients randomized to everolimus-eluting or zotarolimus-eluting stents) randomized trials. The Syntax Score (SxScore) as well the Syntax Score II (SS-II), the EuroSCORE and the Global Risk Classification (GRC) were calculated. The primary outcome was all-cause mortality. At a mean follow-up of 3 years there were 160 deaths (12.7%). The death-incidence was significantly higher in the upper tertiles than in the intermediate or lower ones for all risk scores (log-rank test P risk scores were able to stratify the mortality risk at long-term follow-up. EuroSCORE was the only risk score that significantly improved the discriminatory power of a multivariable model to predict long-term mortality. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Temporal evolution of fault systems in the Upper Jurassic of the Central German Molasse Basin: case study Unterhaching

Science.gov (United States)

Budach, Ingmar; Moeck, Inga; Lüschen, Ewald; Wolfgramm, Markus

2018-03-01

The structural evolution of faults in foreland basins is linked to a complex basin history ranging from extension to contraction and inversion tectonics. Faults in the Upper Jurassic of the German Molasse Basin, a Cenozoic Alpine foreland basin, play a significant role for geothermal exploration and are therefore imaged, interpreted and studied by 3D seismic reflection data. Beyond this applied aspect, the analysis of these seismic data help to better understand the temporal evolution of faults and respective stress fields. In 2009, a 27 km2 3D seismic reflection survey was conducted around the Unterhaching Gt 2 well, south of Munich. The main focus of this study is an in-depth analysis of a prominent v-shaped fault block structure located at the center of the 3D seismic survey. Two methods were used to study the periodic fault activity and its relative age of the detected faults: (1) horizon flattening and (2) analysis of incremental fault throws. Slip and dilation tendency analyses were conducted afterwards to determine the stresses resolved on the faults in the current stress field. Two possible kinematic models explain the structural evolution: One model assumes a left-lateral strike slip fault in a transpressional regime resulting in a positive flower structure. The other model incorporates crossing conjugate normal faults within a transtensional regime. The interpreted successive fault formation prefers the latter model. The episodic fault activity may enhance fault zone permeability hence reservoir productivity implying that the analysis of periodically active faults represents an important part in successfully targeting geothermal wells.

RUNOFF POTENTIAL OF MUREŞ RIVER UPPER BASIN TRIBUTARIES

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V. SOROCOVSCHI

2012-03-01

Full Text Available Runoff Potential of Mureş River Upper Basin Tributaries. The upper basin of the Mureş River includes a significant area of the Eastern Carpathians central western part with different runoff formation conditions. In assessing the average annual runoff potential we used data from six gauging stations and made assessments on three distinct periods. Identifying the appropriate areas of the obtained correlations curves (between specific average runoff and catchments mean altitude allowed the assessment of potential runoff at catchment level and on geographical units. The potential average runoff is also assessed on altitude intervals of the mentioned areas. The runoff potential analysis on hydrographic basins, geographical units and altitude intervals highlights the variant spatial distribution of this general water resources indicator in the different studied areas.

Extracting central places from the link structure in Wikipedia

DEFF Research Database (Denmark)

Kessler, Carsten

2017-01-01

of the German language edition of Wikipedia. The official upper and middle centers declared, based on German spatial laws, are used as a reference dataset. The characteristics of the link structure around their Wikipedia pages, which link to each other or mention each other, and how often, are used to develop...... a bottom-up method for extracting central places from Wikipedia. The method relies solely on the structure and number of links and mentions between the corresponding Wikipedia pages; no spatial information is used in the extraction process. The output of this method shows significant overlap...... with the official central place structure, especially for the upper centers. The results indicate that real-world relationships are in fact reflected in the link structure on the web in the case of Wikipedia....

Central haemodynamics in patients with severe postural hypotension

DEFF Research Database (Denmark)

Mehlsen, J; Haedersdal, C; Trap-Jensen, J

1991-01-01

Central haemodynamics in the supine and head-up tilted positions were studied in 24 patients with severe postural hypotension with and without supine hypertension. Results were compared with those obtained in eight normotensive and eight untreated hypertensive controls. In the supine position...... the patients had higher vascular resistances, lower stroke volumes and longer left ventricular ejection time indexes compared to controls, whereas left ventricular ejection fractions did not differ significantly. The patients with supine hypertension had significantly higher vascular resistance compared...... to those with supine normotension. The highest supine blood pressure levels were found in patients with multiple system atrophy. During tilt, vascular resistance and heart rates were increased and stroke volumes and left ventricular ejection time indexes were decreased in the controls. The patients were...

[Effects of acupuncture at left and right Hegu (LI 4) for cerebral function laterality].

Science.gov (United States)

Wang, Linying; Xu, Chunsheng; Zhu, Yifang; Li, Chuanfu; Yang, Jun

2015-08-01

To explore the cerebral function laterality of acupuncture at left and right Hegu (LI 4) by using functional magnetic resonance imaging (fMRI) and provide objective evidences for side selection of Hegu (LI 4) in the clinical application. Eighty healthy volunteers were randomly divided into a left-acupoint group and a right-acupoint group, and they were treated with acupuncture at left Hegu (LI 4) and right Hegu (LI 4) respectively. After the arrival of qi, the task-state fMRI data in both groups was collected, and analysis of functional neuroimages (AFNI) software was used to perform intra-group and between-group comparisons. After acupuncture, acupuncture feelings were recorded and MGH acupuncture sensation scale (MASS) was recorded. The difference of MASS between the two groups was not significant (P>0. 05). The result of left-acupoint group showed an increased signal on right cerebral hemisphere, while the right-acupoint group showed extensive signal changes in both cerebral hemispheres. The analysis between left-acupoint group and retroflex right-acupoint group showed differences in brain areas. The central effect of acupuncture at left and right Hegu (LI 4) is dissymmetry, indicating right hemisphere laterality. The right lobus insularis and cingulate gyrus may be the key regions in the acupuncture at Hegu (LI 4).

[Application of degree of portal systemic shunting in assessing upper gastrointestinal bleeding in patients with schistosomiasis cirrhosis].

Science.gov (United States)

Shuai, Ju; Ying, Li; Chang-Xue, Ji; Biao, Zhang

2017-03-27

To discuss the application of the degree of portal systemic shunting in assessing the upper gastrointestinal bleeding in patients with hepatic schistosomiasis. Thirty-three patients with upper gastrointestinal bleeding caused by hepatic schistosomiasis (a bleeding group) and 29 schistosomiasis cirrhosis patients without bleeding (a non-bleeding group) were enrolled as investigation subjects in Jinshan Hospital. The subjects were scanned by the 128 abdominal slice spiral CT. The portal systemic shunting vessels were reconstructed by using thin slab maximum intensity projection (TSMIP) and multiplanar reconstruction (MPR). The degrees of the shunting vessels of the subjects were evaluated and compared, and the relationship between upper gastrointestinal bleeding and the degree of the shunting was analyzed. In the bleeding group, the occurrence rates of the shunting vessels were found as follows: 86.4% in left gastric varices, 68.2% in short gastric varices, 50.0% in esophageal varices, 50.0% in para-esophageal varices, 37.9% in gastric varices, 69.7% in gastric-renal varices, 51.5% in spleen-renal varices, 25.8% in abdominal wall varices, 15.2% in omentum varices, 63.6% in para-splenic varices, 34.8% in umbilical varices, 40.9% in retroperitoneal-paravertebral varices, and 36.4% in mesenteric varices. In the bleeding group, the occurrence rates and the degree of shunt were significantly higher than those in the non-bleeding group in esophageal varices, esophageal vein, left gastric vein and gastric varices (all P upper gastrointestinal bleeding in patients with hepatic schistosomiasis. The patents with higher degree of the shunting vessels have a higher risk of gastrointestinal bleeding.

[Characteristics of pain syndrome in patients with upper limbs occupational polyneuropathies].

Science.gov (United States)

Kochetova, O A; Mal'kova, N Yu

2015-01-01

Pain syndrome accompanies various diseases of central and peripheral nervous system--that is one of the most important problems in contemporary neurology. Many scientists are in search for effective diagnostic and therapeutic tools. The article covers characteristics of the pain syndrome and its mechanisms in patients with upper limbs occupational polyneuropathies.

The ultimate determinants of central bank independence

NARCIS (Netherlands)

Eijffinger, S.C.W.; Schaling, E.

1995-01-01

Using a graphical method, a new way of determining the optimal degree of central bank conservativeness is developed in this paper. Unlike Lohmann (1992) and Rogoff (1985), we are able to express the upper and lower bounds of the interval containing the optimal degree of conservativeness in terms of

Upper-mantle velocity structure and its relation to topography across the Caledonides in Greenland and Norway

DEFF Research Database (Denmark)

Hejrani, Babak; Balling, N.; Jacobsen, B. H.

2015-01-01

This study investigates the upper-mantle P- and S-wave velocity structure as well as structure in the VP/VS ratio across the high topography areas of north Atlantic Caledonides, integrating data from a new East Greenland Caledonide Central Fjord Array (EGCFA) with results of recent studies...... strong upper-mantle velocity boundary under the East Greenland Caledonides. However, the contrast in the VP/VS ratio is not as clear at this location. A correlation study of topography versus upper-mantle velocity revealed positive correlation in southern Norway but negative or absent correlation...

Extraction of Maxillary Central Incisors: An Orthodontic-Restorative Treatment

Science.gov (United States)

Hedayati, Zohreh; Zare, Maryam; Bahramnia, Fateme

2014-01-01

Malformed central incisors with poor prognosis could be candidates for extraction especially in crowded dental arches. This case report refers to a 12-year-old boy who suffered from malformed upper central incisors associated with severe attrition. Upper lateral incisors were positioned palatally and canines were rotated and positioned in the high buccal area. The patient had class II malocclusion and space deficiency in both dental arches. Due to incisal wear and malformed short maxillary central incisors and the need for root canal therapy with a major crown build-up, these teeth were extracted. The maxillary lateral incisors were substituted. Thus the maxillary canines were substituted for lateral incisors and the first premolars were substituted for canines. In the lower dental arch the first bicuspids were extracted. Composite resin build-up was performed on the maxillary lateral incisors and canines. This allowed for the crowding and the malocclusion to be corrected. Subsequent gingivectomy improved the patient's gingival margins and smile esthetics one month after orthodontic therapy. PMID:25400954

Left-handedness and health

Directory of Open Access Journals (Sweden)

Milenković Sanja

2010-01-01

Full Text Available Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome, developmental disorders (autism, dislexia and sttutering and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about 'anomalous' cerebral domination, as a consequence of hormonal disbalance. .

[Left-handedness and health].

Science.gov (United States)

Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

2010-01-01

Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.

[High risk factors of upper gastrointestinal bleeding after neurosurgical procedures].

Science.gov (United States)

Zheng, Kang; Wu, Gang; Cheng, Neng-neng; Yao, Cheng-jun; Zhou, Liang-fu

2005-12-21

To analyze high risk factors of postoperative upper gastrointestinal (GI) bleeding after neurosurgery so as to give guidance for prevention of GI bleeding. A questionnaire was developed to investigate the medical records of 1500 patients who were hospitalized and underwent neurosurgical operations in 1997. Logistic regression analysis was made. 1430 valid questionnaires were obtained. Postoperative upper GI bleeding occurred in 75 patients (5.24%). The incidence of upper GI bleeding were 6.64% (54/813) in the male patients and 3.40% (21/617) in the female persons (P = 0.007); 9.88% (41/415) in those aged > 50 and 3.35% in those aged hematoma, intraventricular hemorrhage, subdural hematoma, and extradural hematoma were 15.7%, 10.0%, 6.00%, and 2.94% respectively (P = 0.02). The incidence of upper GI bleeding of the patients with tumors of fourth ventricle of cerebrum, brainstem, cerebral hemisphere, and sellar hypothalamus were 15.79% (3/19), 7.89%, 5.71%, and 3.74% respectively. In the emergent cases, the incidence of upper GI bleeding was higher in those with hypertension. The incidence of upper GI bleeding was 5.46% in the patients undergoing adrenocortical hormone treatment, significantly higher than that in those who did not receive such treatment (2.13%). Patients who are at high risk of developing postoperative upper GI bleeding including that: age greater than 50 years; male; Glasgow Coma Score less than 10 pre and post operation; The lesion was located in brain stem and forth ventricle; Hypertensive cerebral hemorrhage; Intracerebral and intraventricular hemorrhagic brain trauma; Postoperative pneumonia, brain edema, encephalic high pressure, pyogenic infection of the central nervous system and other postoperative complications. The mortality of patients with postoperative upper GI bleeding was evidently higher than that of the patients without postoperative upper GI bleeding.

Effect of sex on wasted left ventricular effort following maximal exercise.

Science.gov (United States)

Lane, A D; Ranadive, S M; Yan, H; Kappus, R M; Cook, M D; Sun, P; Woods, J A; Wilund, K; Fernhall, B

2013-09-01

Wasted left ventricular effort (∆Ew) refers to work required of the left ventricle to eject blood that does not result in increased stroke volume and is related to left ventricular hypertrophy. Literature shows that men and women have differing ventricular and vascular responses to and following exercise. Our purpose was to determine how ∆Ew changes post-exercise in men and women and examine potential mechanisms. We hypothesized a reduction in ∆Ew that would be greater in men and that central pulse wave velocity and wave intensity (WIA) would be related to ∆Ew. Blood pressures, central pulse wave velocity (cPWV), and WIA were obtained at rest, 15 and 30 min after maximal exercise. Both sexes reduced ∆Ew post-maximal exercise (p>0.05 for interaction), but women had higher ∆Ew at each time point (p<0.05). The first peak of WIA increased 15 min post-exercise only in women (p<0.05). cPWV was attenuated (p<0.05) in women at 15 min and men at 30 min (p<0.05) post-exercise with a significant time by sex interaction (p<0.05). WIA (1st peak) was correlated (p<0.05) to ∆Ew in both sexes before and 15 min post-exercise, but cPWV was only associated with ∆Ew in men at 30 min post-exercise. We conclude that both sexes decrease ∆Ew after maximal exercise, but vascular and ventricular changes associated with the attenuation of ∆Ew are not uniform between sexes. © Georg Thieme Verlag KG Stuttgart · New York.

Compensatory recombination phenomena of neurological functions in central dysphagia patients

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Xiao-dong Yuan

2015-01-01

Full Text Available We speculate that cortical reactions evoked by swallowing activity may be abnormal in patients with central infarction with dysphagia. The present study aimed to detect functional imaging features of cerebral cortex in central dysphagia patients by using blood oxygen level-dependent functional magnetic resonance imaging techniques. The results showed that when normal controls swallowed, primary motor cortex (BA4, insula (BA13, premotor cortex (BA6/8, supramarginal gyrus (BA40, and anterior cingulate cortex (BA24/32 were activated, and that the size of the activated areas were larger in the left hemisphere compared with the right. In recurrent cerebral infarction patients with central dysphagia, BA4, BA13, BA40 and BA6/8 areas were activated, while the degree of activation in BA24/32 was decreased. Additionally, more areas were activated, including posterior cingulate cortex (BA23/31, visual association cortex (BA18/19, primary auditory cortex (BA41 and parahippocampal cortex (BA36. Somatosensory association cortex (BA7 and left cerebellum in patients with recurrent cerebral infarction with central dysphagia were also activated. Experimental findings suggest that the cerebral cortex has obvious hemisphere lateralization in response to swallowing, and patients with recurrent cerebral infarction with central dysphagia show compensatory recombination phenomena of neurological functions. In rehabilitative treatment, using the favorite food of patients can stimulate swallowing through visual, auditory, and other nerve conduction pathways, thus promoting compensatory recombination of the central cortex functions.

The saw-tooth sign as a clinical clue for intrathoracic central airway obstruction

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Nakajima Akira

2012-07-01

Full Text Available Abstract Background The saw-tooth sign was first described by Sanders et al in patients with obstructive sleep apnea syndrome as one cause of extrathoracic central airway obstruction. The mechanism of the saw-tooth sign has not been conclusively clarified. The sign has also been described in various extrathoracic central airway diseases, such as in burn victims with thermal injury to the upper airways, Parkinson’s disease, tracheobronchomalacia, laryngeal dyskinesia, and pedunculated tumors of the upper airway. Case presentation A 61-year-old man was referred to our hospital with a two-month history of persistent dry cough and dyspnea. He was diagnosed with lung cancer located in an intrathoracic central airway, which was accompanied by the saw-tooth sign on flow-volume loops. This peculiar sign repeatedly improved and deteriorated, in accordance with the waxing and waning of central airway stenosis by anti-cancer treatments. Conclusion This report suggests that the so-called saw-tooth sign may be found even in intrathoracic central airway obstruction due to lung cancer.

New strict left bundle branch block criteria reflect left ventricular activation differences

DEFF Research Database (Denmark)

Emerek, Kasper Janus Grønn; Risum, Niels; Hjortshøj, Søren Pihlkjær

2015-01-01

AIMS: Pacing lead electrical delays and strict left bundle branch block (LBBB) criteria were assessed against cardiac resynchronization therapy (CRT) outcome. METHODS: Forty-nine patients with LBBB and QRS duration >130 milliseconds underwent CRT-implantation. Sensed right ventricular to left ven....... CONCLUSION: Interventricular electrical delay predicts left ventricular remodeling after CRT and new, strict ECG criteria of LBBB are superior in predicting remodeling.......AIMS: Pacing lead electrical delays and strict left bundle branch block (LBBB) criteria were assessed against cardiac resynchronization therapy (CRT) outcome. METHODS: Forty-nine patients with LBBB and QRS duration >130 milliseconds underwent CRT-implantation. Sensed right ventricular to left...... ventricular electrical delay (RV-LV-IED) was measured. Response to CRT was defined as ≥15% decrease in left ventricular end-systolic volume. RESULTS: Eighteen of 20 (90%) patients with non-ischemic dilated cardiomyopathy (DCM) and 18 of 29 (62%) with ischemic heart disease (IHD) responded to CRT, p

Influence of the vertical position of maxillary central incisors on the perception of smile esthetics among orthodontists and laypersons.

Science.gov (United States)

Machado, Andre Wilson; McComb, Ryan W; Moon, Won; Gandini, Luiz Gonzaga

2013-12-01

The purpose of this study was to determine the perception of smile esthetics among orthodontists and laypeople with respect to different upper central incisor vertical positions in a frontal smile analysis. A frontal close-up smile photo of an adult Caucasian woman was selected. The patient had healthy upper anterior dentition and had no history of orthodontic treatment. Images were altered in order to create six different central incisor vertical positions in 0.5-mm increments. All images were assessed in three different views: full smile, gingival close-up excluding incisal edges, and incisal close-up excluding gingival margins. Images were randomly assembled in an album, which was given to 120 judges: 60 orthodontists and 60 laypersons. Each rater was asked to evaluate the attractiveness of the images using the visual analog scale. The data collected were then statistically analyzed. The highest rated smiles showed two notable characteristics: the central-to-lateral incisal step was 1.5 mm; and the central incisor gingival margins matched the laterals, and both were 0.5 mm below the line of the canine gingival margins. The least attractive smile was the one with no step between the centrals and laterals, and with the central incisor gingival margins 1.0 mm above the canine gingival margins. The results of this study indicate that slightly extruded upper central incisors are more esthetically preferred than intruded. The upper central incisors are the key determinant in evaluating smile esthetics, and thus, the assessment of their ideal vertical positioning is an aspect of paramount importance. © 2013 Wiley Periodicals, Inc.

Peripheral cholangio carcimona with central abscess: one case report

International Nuclear Information System (INIS)

Rho, Taek Soo; Jung, Hoe Seok; Park, Cheol Min; Cha, In Ho

1993-01-01

The authors experienced one case of peripheral cholangio carcinoma with central abscess. CT and ultrasound demonstrate a well defined fluid collection with smooth wall in central portion of mass in left hepatic lobe.Needle aspiration revealed 150ml of pus with chocolate color. Follow-up ultrasound 2 weeks after antibiotics therapy showed fluid collection again. Fine needle aspiration biopsy was performed from a surrounding solid portion of a fluid collection area, and pathologic diagnosis was adenocarcinoma. In case of recurrent abscess or necrosis, we recommend fine needle aspiration biopsy from a central fluid collection area as well as surrounding solid portion of mass for the possibility of central abscess in peripheral cholangio carcinoma of the liver

Peripheral cholangio carcimona with central abscess: one case report

Energy Technology Data Exchange (ETDEWEB)

Rho, Taek Soo; Jung, Hoe Seok; Park, Cheol Min; Cha, In Ho [Korea University College of Medicine, Seoul (Korea, Republic of)

1993-12-15

The authors experienced one case of peripheral cholangio carcinoma with central abscess. CT and ultrasound demonstrate a well defined fluid collection with smooth wall in central portion of mass in left hepatic lobe.Needle aspiration revealed 150ml of pus with chocolate color. Follow-up ultrasound 2 weeks after antibiotics therapy showed fluid collection again. Fine needle aspiration biopsy was performed from a surrounding solid portion of a fluid collection area, and pathologic diagnosis was adenocarcinoma. In case of recurrent abscess or necrosis, we recommend fine needle aspiration biopsy from a central fluid collection area as well as surrounding solid portion of mass for the possibility of central abscess in peripheral cholangio carcinoma of the liver

Resedimented Limestones in Middle and Upper Jurassic Succession of the Slovenian Basin

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Boštjan Rožič

2006-12-01

Full Text Available The Middle and Upper Jurassic succession of the Slovenian Basin is characterized by pelagic sedimentation of siliceous limestones and radiolarian cherts. In the southern and central part of the basin two packages of resedimented limestones are interbedded within pelagic sediments. The Lower resedimented limestones are lower-middle Bajocian to lower Callovian in age. In the southern part of the basin they form laterally discontinuous sequences composed of limestone breccias, calcarenites and micritic limestone and in the central part of the basin calcarenite intercalations within pelagic beds. They were transported by turbidity currents from highly productive ooidal shoals of the Dinaric Carbonate Platform. The Lower resedimented carbonates correlate with the lower three members of the Travnik Formation in the Bovec Trough and similarly developed but much thicker Vajont Formation in the Belluno Basin. The difference in thickness is interpreted as a consequence of shallow-water and longshore currents on the Dinaric Carbonate Platform that transported platform material towards southwest in the direction of the Belluno Basin. The Upper resedimented limestones are upper Kimmeridgian to lower Tithonian and occur within radiolarian cherts in the upper part of the succession as calcarenite beds that originated by turbidity currents. Onset of resedimentation coincides with the emersion-related demise of barrier reef and following deposition of micritic and rare oolitic limestones on the Dinaric Carbonate Platform. Approximatelly coeval resedimented limestones occur in the fourth member of the Travnik Formation in the Bovec Trough, but are not reported from the Ammonitico Rosso Superiore Formation in the Belluno Basin.

Left atrial systolic force in hypertensive patients with left ventricular hypertrophy: the LIFE study

DEFF Research Database (Denmark)

Chinali, M.; Simone, G. de; Wachtell, K.

2008-01-01

In hypertensive patients without prevalent cardiovascular disease, enhanced left atrial systolic force is associated with left ventricular hypertrophy and increased preload. It also predicts cardiovascular events in a population with high prevalence of obesity. Relations between left atrial...... systolic force and left ventricular geometry and function have not been investigated in high-risk hypertrophic hypertensive patients. Participants in the Losartan Intervention For Endpoint reduction in hypertension echocardiography substudy without prevalent cardiovascular disease or atrial fibrillation (n...... = 567) underwent standard Doppler echocardiography. Left atrial systolic force was obtained from the mitral orifice area and Doppler mitral peak A velocity. Patients were divided into groups with normal or increased left atrial systolic force (>14.33 kdyn). Left atrial systolic force was high in 297...

Instream flow characterization of upper Salmon River Basin streams, Central Idaho, 2003

Science.gov (United States)

Maret, Terry R.; Hortness, Jon E.; Ott, Douglas S.

2004-01-01

Anadromous fish populations in the Columbia River Basin have plummeted in the last 100 years. This severe decline led to Federal listing of chinook salmon (Oncorhynchus tshawytscha) and steelhead trout (Oncorhynchus mykiss) stocks as endangered or threatened under the Endangered Species Act (ESA) in the 1990s. Historically, the upper Salmon River Basin (upstream from the confluence with the Pahsimeroi River) in Idaho provided migration corridors and significant habitat for these ESA-listed species, in addition to the federally listed bull trout (Salvelinus confluentus). Human development has modified the original streamflow conditions in many streams in the upper Salmon River Basin. Summer streamflow modifications, as a result of irrigation practices, have directly affected the quantity and quality of fish habitat and also have affected migration and (or) access to suitable spawning and rearing habitat for these fish. As a result of these ESA listings and Action 149 of the Federal Columbia River Power System Biological Opinion of 2000, the Bureau of Reclamation was tasked to conduct streamflow characterization studies in the upper Salmon River Basin to clearly define habitat requirements for effective species management and habitat restoration. These studies include the collection of habitat and streamflow information for the Physical Habitat Simulation (PHABSIM) model, a widely applied method to determine relations between habitat and discharge requirements for various fish species and life stages. Model results can be used by resource managers to guide habitat restoration efforts in the evaluation of potential fish habitat and passage improvements by increasing streamflow. Instream flow characterization studies were completed on Pole, Fourth of July, Elk, and Valley Creeks during 2003. Continuous streamflow data were collected upstream from all diversions on each stream. In addition, natural summer streamflows were estimated for each study site using regression

Beneficial effects of elevating cardiac preload on left-ventricular diastolic function and volume during heat stress

DEFF Research Database (Denmark)

Brothers, R M; Pecini, Redi; Dalsgaard, Morten

2014-01-01

via volume loading while heat stressed would 1) increase indices of left ventricular diastolic function, and 2) preserve left ventricular end-diastolic volume (LVEDV) during a subsequent simulated hemorrhagic challenge induced by lower-body negative pressure (LBNP). Indices of left ventricular......Volume loading normalizes tolerance to a simulated hemorrhagic challenge in heat-stressed individuals, relative to when these individuals are thermoneutral. The mechanism(s) by which this occurs is unknown. This project tested two unique hypotheses; that is, the elevation of central blood volume...... diastolic function were evaluated in nine subjects during the following conditions: thermoneutral, heat stress, and heat stress after acute volume loading sufficient to return ventricular filling pressures toward thermoneutral levels. LVEDV was also measured in these subjects during the aforementioned...

Progress of the ECRH Upper Launcher design for ITER

International Nuclear Information System (INIS)

Strauss, D.; Aiello, G.; Bruschi, A.; Chavan, R.; Farina, D.; Figini, L.; Gagliardi, M.; Garcia, V.; Goodman, T.P.; Grossetti, G.; Heemskerk, C.; Henderson, M.A.; Kasparek, W.; Krause, A.; Landis, J.-D.; Meier, A.; Moro, A.; Platania, P.; Plaum, B.; Poli, E.

2014-01-01

The design of the ITER ECRH system provides 20 MW millimeter wave power for central plasma heating and MHD stabilization. The system consists of an array of 24 gyrotrons with power supplies coupled to a set of transmission lines guiding the beams to the four upper and the equatorial launcher. The front steering upper launcher design described herein has passed successfully the preliminary design review, and it is presently in the final design stage. The launcher consists of a millimeter wave system and steering mechanism with neutron shielding integrated into an upper port plug with the plasma facing blanket shield module (in-vessel) and a set of ex-vessel waveguides connecting the launcher to the transmission lines. Part of the transmission lines are the ultra-low loss CVD torus diamond windows and a shutter valve, a miter bend section and the feedthroughs integrated in the plug closure plate. These components are connected by corrugated waveguides and form together the first confinement system (FCS). In-vessel, the millimeter-wave system includes a quasi-optical beam propagation system including four mirror sets and a front steering mirror. The millimeter wave system is integrated into a specifically optimized upper port plug providing structural stability to withstand plasma disruption forces and the high heat load from the plasma side with a dedicated blanket shield module. A recent update in the ITER interface definition has resulted in the recession of the upper port plug first wall panels, which is now integrated into the design. Apart from the millimeter wave system the upper port plug houses also a set of shield blocks which provide neutron shielding. An overview of the actual ITER ECRH Upper Launcher is given together with some highlights of the design

[The new potentials of magneto-laser therapy and electrostimulation in children with cleft palate and upper lip].

Science.gov (United States)

Gerasimenko, M Iu; Filatova, E V; Borisenko, O V; Levchenkova, V D; Grishina, N V; Spiridonova, N Z; Shevchenko, E Iu; Goncharenko, L L

2000-01-01

The paper presents rationale for design of new procedures of physiotherapy in children with expanded palate and upper lip; morphofunctional features of prenatal and early postnatal formation of central nervous system; a multilayer technique of magneto-laser radiation to the projection of the anterior central gyrus and the technique of electrostimulation by the system of the wink reflex which can influence central mechanisms of regulation and adaptation before and early after uranoplasty and cheiloplasty.

The effect of hand position on perceived finger orientation in left- and right-handers.

Science.gov (United States)

Fraser, Lindsey E; Harris, Laurence R

2017-12-01

In the absence of visual feedback, the perceived orientation of the fingers is systematically biased. In right-handers these biases are asymmetrical between the left and right hands in the horizontal plane and may reflect common functional postures for the two hands. Here we compared finger orientation perception in right- and left-handed participants for both hands, across various hand positions in the horizontal plane. Participants rotated a white line on a screen optically superimposed over their hand to indicate the perceived position of the finger that was rotated to one of seven orientations with the hand either aligned with the body midline, aligned with the shoulder, or displaced by twice the shoulder-to-midline distance from the midline. We replicated the asymmetric pattern of biases previously reported in right-handed participants (left hand biased towards an orientation ~30° inward, right hand ~10° inward). However, no such asymmetry was found for left-handers, suggesting left-handers may use different strategies when mapping proprioception to body or space coordinates and/or have less specialization of function between the hands. Both groups' responses rotated further outward as distance of the hand from the body midline increased, consistent with other research showing spatial orientation estimates diverge outward in the periphery. Finally, for right-handers, precision of responses was best when the hand was aligned with the shoulder compared to the other two conditions. These results highlight the unique role of hand dominance and hand position in perception of finger orientation, and provide insight into the proprioceptive position sense of the upper limbs.

THALAMID SPONGES FROM THE UPPER TRIASSIC (NORIAN-RHAETIAN NAYBAND FORMATION NEAR WALI-ABAD, SE ABADEH, CENTRAL IRAN(CONTRIBUTION TO TRIASSIC PALEONTOLOGY OF IRAN 4

Directory of Open Access Journals (Sweden)

BABA SENOWBARI-DARYAN

1999-03-01

Full Text Available An association of thalamid sponges including Amblysiphonella, Nevadathalamia, Stylothalamia, and Neoguadalupia, with the hexactinellid Casearia is described from the Upper Triassic (Norian-Rhaetian Nayband Formation of Hambast-Mts. near the small town of Wali-Abad (Abadeh region, central Iran. These Norian-Rhaetian (Neoguadalupia, Amblysiphonella, Nevadathalamia and Liassic (Stylothalamia columnaris Le Maitre thalamid sponge assemblages are exceptional associations, not previously reported from Iran nor from other localities in the world. The microfacies and organism associations in the sponge-bearing carbonates is discussed. Differences of macro- and microfaunal composition, as well as flora, support the recognition of Kristan-Tollmann et al. to classify the Nayband Formation in the Abadeh region as of a distinct unit, termed the "Wali-Abad-Faziesregion". Following thalamid sponge species are described as new: Nevadathalamia waliabadensis n. sp. and Stylothalamia hambastensis n. sp. 

Cortical disconnection of the ipsilesional primary motor cortex is associated with gait speed and upper extremity motor impairment in chronic left hemispheric stroke.

Science.gov (United States)

Peters, Denise M; Fridriksson, Julius; Stewart, Jill C; Richardson, Jessica D; Rorden, Chris; Bonilha, Leonardo; Middleton, Addie; Gleichgerrcht, Ezequiel; Fritz, Stacy L

2018-01-01

Advances in neuroimaging have enabled the mapping of white matter connections across the entire brain, allowing for a more thorough examination of the extent of white matter disconnection after stroke. To assess how cortical disconnection contributes to motor impairments, we examined the relationship between structural brain connectivity and upper and lower extremity motor function in individuals with chronic stroke. Forty-three participants [mean age: 59.7 (±11.2) years; time poststroke: 64.4 (±58.8) months] underwent clinical motor assessments and MRI scanning. Nonparametric correlation analyses were performed to examine the relationship between structural connectivity amid a subsection of the motor network and upper/lower extremity motor function. Standard multiple linear regression analyses were performed to examine the relationship between cortical necrosis and disconnection of three main cortical areas of motor control [primary motor cortex (M1), premotor cortex (PMC), and supplementary motor area (SMA)] and motor function. Anatomical connectivity between ipsilesional M1/SMA and the (1) cerebral peduncle, (2) thalamus, and (3) red nucleus were significantly correlated with upper and lower extremity motor performance (P ≤ 0.003). M1-M1 interhemispheric connectivity was also significantly correlated with gross manual dexterity of the affected upper extremity (P = 0.001). Regression models with M1 lesion load and M1 disconnection (adjusted for time poststroke) explained a significant amount of variance in upper extremity motor performance (R 2  = 0.36-0.46) and gait speed (R 2  = 0.46), with M1 disconnection an independent predictor of motor performance. Cortical disconnection, especially of ipsilesional M1, could significantly contribute to variability seen in locomotor and upper extremity motor function and recovery in chronic stroke. Hum Brain Mapp 39:120-132, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

A record of the last 460 thousand years of upper ocean stratification from the central Walvis Ridge, South Atlantic

NARCIS (Netherlands)

Scussolini, P.; Peeters, F.J.C.

2013-01-01

The upper branch of the Atlantic Meridional Overturning Circulation predominantly enters the Atlantic Ocean through the southeast, where the subtropical gyre is exposed to the influence of the Agulhas leakage (AL). To understand how the transfer of Indian Ocean waters via the AL affected the upper

Complications of central venous stenosis due to permanent central venous catheters in children on hemodialysis.

Science.gov (United States)

Rinat, Choni; Ben-Shalom, Efrat; Becker-Cohen, Rachel; Feinstein, Sofia; Frishberg, Yaacov

2014-11-01

Central venous catheters are frequently used as access for hemodialysis (HD) in children. One of the known complications is central venous stenosis. Although this complication is not rare, it is often asymptomatic and therefore unacknowledged. Superior vena cava (SVC) stenosis is obviously suspected in the presence of upper body edema, but several other signs and symptoms are often unrecognized as being part of this syndrome. We describe four patients with various manifestations of central venous stenosis and SVC syndrome. These sometimes life- or organ-threatening conditions include obstructive sleep apnea, unresolving stridor, increased intracranial pressure, increased intraocular pressure, right-sided pleural effusion, protein-losing enteropathy and lymphadenopathy. The temporal relationship of these complications associated with the use of central venous catheters and documentation of venous stenosis, together with their resolution after alleviation of high venous pressure, points to a causal role. We suggest pathophysiological mechanisms for the formation of each of these complications. In patients with occlusion of the SVC, various unexpected clinical entities can be caused by high central venous pressure. As often the etiology is not obvious, a high index of suspicion is needed as in some cases prompt alleviation of the high pressure is mandatory.

Age-dependent effects of brain stimulation on network centrality.

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Antonenko, Daria; Nierhaus, Till; Meinzer, Marcus; Prehn, Kristin; Thielscher, Axel; Ittermann, Bernd; Flöel, Agnes

2018-04-18

Functional magnetic resonance imaging (fMRI) studies have suggested that advanced age may mediate the effects of transcranial direct current stimulation (tDCS) on brain function. However, studies directly comparing neural tDCS effects between young and older adults are scarce and limited to task-related imaging paradigms. Resting-state (rs-) fMRI, that is independent of age-related differences in performance, is well suited to investigate age-associated differential neural tDCS effects. Three "online" tDCS conditions (anodal, cathodal, sham) were compared in a cross-over, within-subject design, in 30 young and 30 older adults. Active stimulation targeted the left sensorimotor network (active electrode over left sensorimotor cortex with right supraorbital reference electrode). A graph-based rs-fMRI data analysis approach (eigenvector centrality mapping) and complementary seed-based analyses characterized neural tDCS effects. An interaction between anodal tDCS and age group was observed. Specifically, centrality in bilateral paracentral and posterior regions (precuneus, superior parietal cortex) was increased in young, but decreased in older adults. Seed-based analyses revealed that these opposing patterns of tDCS-induced centrality modulation were explained from differential effects of tDCS on functional coupling of the stimulated left paracentral lobule. Cathodal tDCS did not show significant effects. Our study provides first evidence for differential tDCS effects on neural network organization in young and older adults. Anodal stimulation mainly affected coupling of sensorimotor with ventromedial prefrontal areas in young and decoupling with posteromedial areas in older adults. Copyright © 2018. Published by Elsevier Inc.

Serious Complication of Central Venous Catheterization Due to Hemothorax: Hemothorax

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Ümmügülsüm Gaygısız

2017-12-01

Full Text Available Central venous catheterization may cause life-threatening complications including pneumothorax and hemothorax. We report a case of multiple trauma complicated with an incidence of hemothorax due to a misplaced central venous catheter. Firstly, the tip of the guide-wire was ruptured in subcutaneous tissue and, secondly, the catheter came out of the vessel and caused hemothorax. During left subclavian catheterization, in this 47-years-old male patient, we could not advance the guide wire forward easily in the first attempt and tried to draw it back. In the second attempt, we inserted a new catheter without any difficulty. The blood gas analyses through the catheter for verification of location revealed its venous nature. After the catheterization, 500 mL hemorrhagic fluid was drained through the ipsilateral chest tube. Control chest X-ray showed that the catheter was in the left hemithorax and a piece of the guide wire was present below the left clavicle. Thorax computerized tomography showed that the catheter entered the thoracic cavity and extended to the paramediastinal region. An emergency surgery was performed to remove the piece of the guide wire and the catheter extending out of the vessel. A common method to check the intravenous insertion of a central catheter into a vein is to verify that the easily drawn blood has the nature of venous blood. This method, however, does not exclude the extravascular placement of the catheter in the presence of ipsilateral hemothorax.

Brachial index does not reflect upper extremity functionality following surgery for vascular trauma

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Erdal Simsek

2014-04-01

Full Text Available OBJECTIVES: Vascular injuries to the upper extremities requiring surgical repair are common after accidents. However, neither postoperative functionality nor hemodynamic status of the extremity are routinely described. We evaluated the postoperative functional and hemodynamic status of patients with vascular traumas in the upper extremities. METHODS: 26 patients who suffered penetrating vascular traumas in the upper extremities from November 2008 to December 2011 were retrospectively evaluated. Data on first approach, surgical technique employed and early postoperative outcomes were recorded. Further data on the post-discharge period, including clinical functional status of the arm, Doppler ultrasonography and brachial-brachial index were also evaluated. RESULTS: Average follow up was 33.5±10.8 months. Right (1.05±0.09 and left (1.04±0.08 brachial indexes were measured during follow up,. Doppler ultrasonography showed arterial occlusion in 4 patients (15%. Near-normal brachial-brachial indexes was observed in all four of these patients with occlusion of one of the upper extremity arteries, even though they exhibited limited arm function for daily work. CONCLUSIONS: Evaluation of the postoperative outcomes of this small series of patients with penetrating vascular traumas in the upper extremity revealed that 15% of them suffered occlusion of one artery of the upper extremity. Artery occlusion did not correlate with brachial-brachial Doppler index, probably due to rich collateral circulation, but occlusion was associated with an extremity that was dysfunctional for the purposes of daily work. The result of the brachial-brachial index does not therefore correlate with functionality.

Analysis of the relationship between myocardial viability and regional left ventricular wall motion

International Nuclear Information System (INIS)

Furutani, Yuhji; Ozaki, Masaharu; Yamamoto, Takeshi; Sato, Shinichi; Saiki, Atsushi; Kusukawa, Reizo

1993-01-01

Myocardial viability was determined by using postsystolic shortening (PSS) as an index, as obtained by cardiac blood pool scintigraphy with Tc-99m HSA. The findings were compared with those of thallium-201 myocardial SPECT. The study population was comparised of 41 patients with single blood vessel disease in the left anterior descending artery (34 with old myocardial infarction and 7 with effort angina pectoris). Left ventricular area was divided into 6 segments, and global and regional left ventricular blood volume curves were obtained. Delayed end-systole was the most common in the apex (41%), followed by the upper septum (37%) and lower septum (10%). PSS resulting from delayed end-systole was seen in 36 areas. PSS/end-diastolic volume (EDV) and PSS/systolic volume (SV) were obtained by adjusting end-diastolic and stroke counts, respectively. Thallium-201 myocardial SPECT images were divided into 5 segments to obtain defect score (DS) for visual Tl uptake. Both PSS/EDV and PSS/SV were greater in association with more delayed end-systole, greater DS, and lower reginal ejection fraction. Areas showing greater PSS were associated with less myocardial viability, as observed on Tl myocardial SPECT images. Thus, PSS seemed to reflect the degree of myocardial necrosis within the region of interest. (N.K.)

Vitamin K for upper gastrointestinal bleeding in people with acute or chronic liver diseases.

Science.gov (United States)

Martí-Carvajal, Arturo J; Solà, Ivan

2015-06-09

Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. Several treatments are used for upper gastrointestinal bleeding in people with liver diseases. One of them is vitamin K administration, but it is not known whether it benefits or harms people with acute or chronic liver disease and upper gastrointestinal bleeding. This is an update of this Cochrane review. To assess the beneficial and harmful effects of vitamin K for people with acute or chronic liver disease and upper gastrointestinal bleeding. We searched The Cochrane Hepato-Biliary Controlled Trials Register (February 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2 of 12, 2015), MEDLINE (Ovid SP) (1946 to February 2015), EMBASE (Ovid SP) (1974 to February 2015), Science Citation Index EXPANDED (1900 to February 2015), and LILACS (1982 to 25 February 2015). We sought additional randomised trials from two registries of clinical trials: the World Health Organization Clinical Trials Search Portal and the metaRegister of Controlled Trials. We looked through the reference lists of the retrieved publications and review articles. Randomised clinical trials irrespective of blinding, language, or publication status for assessment of benefits and harms. We considered observational studies for assessment of harms only. \\We aimed to summarise data from randomised clinical trials using Standard Cochrane methodology and assess them according to the GRADE approach. We found no randomised trials on vitamin K for upper gastrointestinal bleeding in people with liver diseases assessing benefits and harms of the intervention. We identified no quasi-randomised studies, historically controlled studies, or observational studies assessing harms. This updated review found no randomised clinical trials of vitamin K for upper gastrointestinal bleeding in people with liver diseases. The benefits and harms of vitamin K need to be tested

Brachial plexus injury management through upper extremity amputation with immediate postoperative prostheses.

Science.gov (United States)

Malone, J M; Leal, J M; Underwood, J; Childers, S J

1982-02-01

Management of patients with brachial plexus injuries requires a team approach so that all aspects of their care are addressed simultaneously. This report examines elective amputation and prosthetic rehabilitation in a patient with brachial plexus avulsion of the left arm. The best possibility for good prosthetic rehabilitation is the early application of prosthetic devices with intensive occupational therapy. Using this type of approach, we have achieved significant improvement in amputation rehabilitation of upper extremity amputees treated with immediate postoperative conventional electric and myoelectric prostheses.

Comparison of vascular width and accuracy of subjective assessment of pulmonary flow X-ray films of children with left-right shunt

International Nuclear Information System (INIS)

Hegenbarth, R.; Toeroek, M.; Hannover Medizinische Hochschule

1985-01-01

The authors established a comparative relationship between accuracy of measurement of pulmonary flow and extent of vascular widening in 72 children with Left-Right shunt vitiae; this accuracy of pulmonary flow measurement had been subjectively estimated by 4 investigators without knowing the diagnosis and in comparison to the haemodynamic values (percentage of correct findings). The following procedure was adopted: In a control group of 143 healthy children, we first determined the vascular diameter of the right descending pulmonary artery, of the right upper lobal vein, and of the peripheral vessels in the upper and lower pulmonary fields, at an accurately defined distance from the point of the hilus, and compared with the vascular diameters of the children with left-right shunt, employing the method of discrimination analysis. Comparison of the judgement by the 4 investigators with the degree of increase of the vascular diameters showed an accuracy of 65-100% if the right descending pulmonary artery became wider by 2.6 mm, and an accuracy of 79-95% if the mean vascular width in the right upper field increased by 0.7 mm. The accuracy was 83-94% if the mean vascular width in the right lower field increased by 0.6 mm. Statistical studies also showed that the judgement of the 4 investigators was influenced by different vessels. (orig.) [de

Repair of aorto-left ventricular tunnel arising from the left sinus of valsalva.

Science.gov (United States)

Nezafati, Mohammad Hassan; Maleki, Mahmood Hosseinzadeh; Javan, Hadi; Zirak, Nahid

2010-05-01

Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that bypasses the aortic valve via a para-valvular connection from the left ventricle to the aorta. In most cases, the tunnel arises from the right aortic sinus. In this case report, we are presenting a case of ALVT, of which the aortic orifice arose from the left aortic sinus, requiring special attention to avoid the left coronary artery injury at the time of surgical repair.

Comparison of CT findings with upper GI series and surgical findings

Energy Technology Data Exchange (ETDEWEB)

Hong, Jin Kyo; Suh, Soo Jhi; Kim, Soon Yong [School of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

1981-09-15

The authors made comparative studies of CT findings with upper GI series and surgical findings in 20 cases of histologically proven gastric cancers. The identification of chickening of gastric wall and local and remote metastasis by CT was thought to be great value in treatment planning and prediction of prognosis of the patients. The results were as follows: 1. Of 20 cases, 19 cases demonstrated thickening of gastric wall. Among 3 cases suggested as early cancer on upper GI series, 2 cases demonstrated thickened gastric wall on CT and it was proved to be advanced cancer at surgery. 2. Out of 8 cases showed no definite metastasis on CT, 4 cases had malignant infiltration histologically in the regional lymph nodes. But they were less than 1.5 cm in diameter. 3. The frequency order of remote metastasis found by CT was pancreas, liver, left adrenal gland and lung in organs and retroperitoneal, retrocrural and regional nodes in lymph nodes.

Anatomic relationship between left coronary artery and left atrium in patients undergoing atrial fibrillation ablation.

Science.gov (United States)

Anselmino, Matteo; Torri, Federica; Ferraris, Federico; Calò, Leonardo; Castagno, Davide; Gili, Sebastiano; Rovera, Chiara; Giustetto, Carla; Gaita, Fiorenzo

2017-07-01

Atrial fibrillation transcatheter ablation (TCA) is, within available atrial fibrillation rhythm control strategies, one of the most effective. To potentially improve ablation outcome in case of recurrent atrial fibrillation after a first procedure or in presence of structural myocardial disease, isolation of the pulmonary veins may be associated with extensive lesions within the left atrium. To avoid rare, but potentially life-threatening, complications, thorough knowledge and assessment of left atrium anatomy and its relation to structures in close proximity are, therefore, mandatory. Aim of the present study is to describe, by cardiac computed tomography, the anatomic relationship between aortic root, left coronary artery and left atrium in patients undergoing atrial fibrillation TCA. The cardiac computed tomography scan of 21 patients affected by atrial fibrillation was elaborated to segment left atrium, aortic root and left coronary artery from the surrounding structures and the following distances measured: left atrium and aortic root; left atrium roof and aortic root; left main coronary artery and left atrium; circumflex artery and left atrium appendage; and circumflex artery and mitral valve annulus. Above all, the median distance between left atrium and aortic root (1.9, 1.5-2.1 mm), and between circumflex artery and left atrium appendage ostium (3.0, 2.1-3.4 mm) were minimal (≤3 mm). None of measured distances significantly varied between patients presenting paroxysmal versus persistent atrial fibrillation. The anatomic relationship between left atrium and coronary arteries is extremely relevant when performing atrial fibrillation TCA by extensive lesions. Therefore, at least in the latter case, preablation imaging should be recommended to avoid rare, but potentially life-threatening, complications with the aim of an as well tolerated as possible procedure.

Hydrogeology, water quality, and potential for contamination of the Upper Floridan aquifer in the Silver Springs ground-water basin, central Marion County, Florida

Science.gov (United States)

Phelps, G.G.

1994-01-01

The Upper Floridan aquifer, composed of a thick sequence of very porous limestone and dolomite, is the principal source of water supply in the Silver Springs ground-water basin of central Marion County, Florida. The karstic nature of the local geology makes the aquifer susceptible to contaminants from the land surface. Contaminants can enter the aquifer by seepage through surficial deposits and through sinkholes and drainage wells. Potential contaminants include agricultural chemicals, landfill leachates and petroleum products from leaking storage tanks and accidental spills. More than 560 sites of potential contamination sources were identified in the basin in 1990. Detailed investigation of four sites were used to define hydrologic conditions at representative sites. Ground-water flow velocities determined from dye trace studies ranged from about 1 foot per hour under natural flow conditions to about 10 feet per hour under pumping conditions, which is considerably higher than velocities estimated using Darcy's equation for steady-state flow in a porous medium. Water entering the aquifer through drainage wells contained bacteria, elevated concentrations of nutrients, manganese and zinc, and in places, low concentrations of organic compounds. On the basis of results from the sampling of 34 wells in 1989 and 1990, and from the sampling of water entering the Upper Floridan aquifer through drainage wells, there has been no widespread degradation of water quality in the study area. In an area of karst, particularly one in which fracture flow is significant, evaluating the effects from contaminants is difficult and special care is required when interpolating hydrogeologic data from regional studies to a specific. (USGS)

Association Between Tangential Beam Treatment Parameters and Cardiac Abnormalities After Definitive Radiation Treatment for Left-Sided Breast Cancer

International Nuclear Information System (INIS)

Correa, Candace R.; Das, Indra J.; Litt, Harold I.; Ferrari, Victor; Hwang, W.-T.; Solin, Lawrence J.; Harris, Eleanor E.

2008-01-01

Purpose: To examine the association between radiation treatment (RT) parameters, cardiac diagnostic test abnormalities, and clinical cardiovascular diagnoses among patients with left-sided breast cancer after breast conservation treatment with tangential beam RT. Methods and Materials: The medical records of 416 patients treated between 1977 and 1995 with RT for primary left-sided breast cancer were reviewed for myocardial perfusion imaging and echocardiograms. Sixty-two patients (62/416, 15%) underwent these cardiac diagnostic tests for cardiovascular symptoms and were selected for further study. Central lung distance and maximum heart width and length in the treatment field were determined for each patient. Medical records were reviewed for cardiovascular diagnoses and evaluation of cardiac risk factors. Results: At a median of 12 years post-RT the incidence of cardiac diagnostic test abnormalities among symptomatic left-sided irradiated women was significantly higher than the predicted incidence of cardiovascular disease in the patient population, 6/62 (9%) predicted vs. 24/62 (39%) observed, p 0.001. As compared with patients with normal tests, patients with cardiac diagnostic test abnormalities had a larger median central lung distance (2.6 cm vs. 2.2 cm, p = 0.01). Similarly, patients with vs. without congestive heart failure had a larger median central lung distance (2.8 cm vs. 2.3 cm, p = 0.008). Conclusions: Contemporary RT for early breast cancer may be associated with a small, but potentially avoidable, risk of cardiovascular morbidity that is associated with treatment technique

Assessment of cardiac exposure in left-tangential breast irradiation

International Nuclear Information System (INIS)

Vees, H.; Bigler, R.; Gruber, G.; Bieri, S.

2011-01-01

Purpose. - To assess the value of treatment-planning related parameters namely, the breast volume; the distance of the inferior field border to diaphragm; and the cardio-thoracic ratio for left-tangential breast irradiation. Patients and methods. - Treatment plans of 27 consecutively left-sided breast cancer patients after breast conserving surgery were evaluated for several parameters concerning heart-irradiation. We measured the heart distance respective to the cardio-thoracic ratio and the distance of the inferior field border to diaphragm, as well as the breast volume in correlation with the irradiated heart volume. Results. - The mean heart and left breast volumes were 504 cm 3 and 672.8 cm 3 , respectively. The mean heart diameter was 13.4 cm; the mean cardio-thoracic ratio 0.51 and the mean distance of the inferior field border to diaphragm was 1.4 cm. Cardio-thoracic ratio (p = 0.01), breast volume (p = 0.0002), distance of the inferior field border to diaphragm (p = 0.02) and central lung distance (p = 0.02) were significantly correlated with the measured heart distance. A significant correlation was also found between cardio-thoracic ratio, breast volume and distance of the inferior field border to diaphragm with the irradiated heart volume measured by V10, V20 and V40. Conclusion. - The verification of parameters like cardio-thoracic ratio, distance of the inferior field border to diaphragm and breast volume in left-sided breast cancer patients may help in determining which patients could benefit from more complex planning techniques such as intensity-modulated radiotherapy to reduced risk of late cardiac injury. (authors)

Relationship between changes in the upper and lower tropospheric water vapor: A revisit

Science.gov (United States)

Yang, M.; Sun, D. Z.; Zhang, G. J.

2017-12-01

Upper tropospheric water vapor response to enhanced greenhouse gas forcing is as important as the lower tropospheric water vapor response in determining climate sensitivity. Early studies using older versions of climate models have suggested that the upper- and lower-troposphere water vapor changes are more strongly coupled in the climate models than in the observations. Here we reexamine this issue using a state-of-the-art climate model—the NCAR community model CAM5. Specifically, we have calculated the correlations between interannual variations of specific humidity in all levels of the troposphere with that at the surface in CAM5 and in the observations (as represented by the updated ERA-Interim and NCEP reanalysis). It is found that the previously noted biases in how strongly upper tropospheric water vapor and lower troposphere water vapor are linked still exist in CAM5—the change in the tropical averaged upper tropospheric water vapor is more strongly correlated with the change in the surface. However, this bias disappears in the averaged correlation obtained by averaging the point-by-point correlations over the tropics. The spatial pattern of the point-by-point correlations reveals that the better agreement between the model and the observations is related to the opposite model biases in different regions: the correlation is weaker in the model in the western Pacific, but stronger in the central and eastern Pacific. Further analysis of precipitation fields suggests that the weaker (stronger) coupling between tropospheric water vapor and surface moisture over western (central-eastern) Pacific in model is related to weaker (stronger) simulated convective activities in these regions. More specifically, during El Nino, the model has excessive deep convection in the central Pacific, but too littler deep convection in western Pacific. Implications of the results are discussed in the context of climate change as well as in the context of how to improve the model

Instream flow characterization of Upper Salmon River basin streams, central Idaho, 2005

Science.gov (United States)

Maret, Terry R.; Hortness, Jon E.; Ott, Douglas S.

2006-01-01

Anadromous fish populations in the Columbia River Basin have plummeted in the last 100 years. This severe decline led to Federal listing of Chinook salmon (Oncorhynchus tshawytscha) and steelhead trout (Oncorhynchus mykiss) stocks as endangered or threatened under the Endangered Species Act (ESA) in the 1990s. Historically, the upper Salmon River Basin (upstream of the confluence with the Pahsimeroi River) in Idaho provided migration corridors and significant habitat for these ESA-listed species, in addition to the ESA-listed bull trout (Salvelinus confluentus). Human development has modified the original streamflow conditions in many streams in the upper Salmon River Basin. Summer streamflow modifications resulting from irrigation practices, have directly affected quantity and quality of fish habitat and also have affected migration and (or) access to suitable spawning and rearing habitat for these fish. As a result of these ESA listings and Action 149 of the Federal Columbia River Power System Biological Opinion of 2000, the Bureau of Reclamation was tasked to conduct streamflow characterization studies in the upper Salmon River Basin to clearly define habitat requirements for effective species management and habitat restoration. These studies include collection of habitat and streamflow information for the Physical Habitat Simulation System (PHABSIM) model, a widely applied method to determine relations between habitat and discharge requirements for various fish species and life stages. Model simulation results can be used by resource managers to guide habitat restoration efforts by evaluating potential fish habitat and passage improvements by increasing or decreasing streamflow. In 2005, instream flow characterization studies were completed on Big Boulder, Challis, Bear, Mill, and Morgan Creeks. Continuous streamflow data were recorded upstream of all diversions on Big Boulder. Instantaneous measurements of discharge were also made at selected sites. In

Accessory left gastric artery: angiographic anatomy

Energy Technology Data Exchange (ETDEWEB)

Lee, Kang Soo; Lim, Hyung Guhn; Kim, Hong Soo; Jeon, Doo Sung [Presbyterian Medical Center, Chunju (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [College of Medicine and the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Song, Soon Young [Myongji Hospital, College of Medicine, Kwandong University, Seoul (Korea, Republic of)

2000-09-01

To evaluate the angiographic anatomy of the accessory left gastric artery (accLGA). We evaluated the angiographic findings of the accLGA in 50 patients (Angiostar; Siemens, Erlangen, Germany). Performing celiac and selective angiography in 50 and 34 patients, respectively. By means of celiac angiography, (1) site of origin, (2) anatomical course, (3) diameter, (4) degree of tortuosity, and (5) distal tapering were evaluated, while selective angiography was used to determine (1) arterial branching, (2) area of blood supply, and (3) patterns of gastric wall stain. Celiac angiography showed that the accLGA arose from the left hepatic artery (LHA) in 45 cases (90%) and from the proper hepatic artery in five (10%). If the accLGA arose from the LHA, its origin entirely depended on the branching pattern of the latter. It always arose from the lateral branch of the LHA furthest to the left and uppermost, and proximal to its umbilical point. The most common anatomical course of the accLGA, seen in 27 cases (54%), was between the S2 and S3 segmental branch. The diameter and degree of tortuosity of the accLGA were similar to those of adjacent intrahepatic branches in 21 (42%) and 33 cases (66%), respectively. The degree of tapering was less than that of adjacent intrahepatic vessel in 28 (56%). Selective angiography demonstrated esophageal branching of the acc LGA in 27 cases (79%), inferior phrenic arterial branching in three (9%), a mediastinal branch in one (3%), and hypervascularity of the lung in one (3%). In 15 cases (44%), bifurcation of the accLGA was recognized. The vascular territory of the accLGA was the gastric fundus together with the distal esophagus in 21 cases (62%), mainly the gastric fundus in six (18%), and mainly the distal esophagus in four (12%). The pattern of gastric mucosal stain was curvilinear wall in 31 cases (91%) and nodular in three (9%). A knowledge of the angiographic anatomy of the accLGA facilitates accurate recognition of this artery on

Decreased right heart blood volume determined by magnetic resonance imaging: evidence of central underfilling in cirrhosis

DEFF Research Database (Denmark)

Møller, S; Søndergaard, L; Møgelvang, J

1995-01-01

mL, NS), and left atrial volume (70 vs. 57 mL, P = .08) were normal or slightly increased. The right ejection fraction (68% vs. 53%, P fraction was slightly reduced (61% vs. 69%, NS). The central and arterial blood volume (CBV), assessed......Whether the central blood volume is reduced or expanded in cirrhosis is still under debate. Accordingly, the current study was undertaken to assess the volume of the heart cavities. Ten cirrhotic patients and matched controls had their right and left ventricular end-diastolic volumes (RVDV and LVDV...... as the cardiac output (CO) multiplied by the central circulation time, was significantly decreased (1.47 vs. 1.81 L, P blood volume (4.43 vs. 3.64 L, P

Detrital zircon provenance from three turbidite depocenters of the Middle-Upper Triassic Songpan-Ganzi complex, central China: Record of collisional tectonics, erosional exhumation, and sediment production

Science.gov (United States)

Weislogel, A.L.; Graham, S.A.; Chang, E.Z.; Wooden, J.L.; Gehrels, G.E.

2010-01-01

To test the idea that the voluminous upper Middle to Upper Triassic turbidite strata in the Songpan-Ganzi complex of central China archive a detrital record of Dabie ultrahigh-pressure (UHP) terrane unroofing, we report 2080 single detrital U-Pb zircon ages by sensitive high-resolution ion microprobe-reverse geometry (SHRIMP-RG) and laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) analysis from 29 eastern Songpan-Ganzi complex sandstone samples. Low (Th/U zircons, consistent with crystallization under UHP conditions, are rare in eastern Songpan-Ganzi complex zircon, and U-Pb ages of low Th/U zircons are incompatible with a Dabie terrane source. An unweighted pair group method with arithmetic mean nearest-neighbor analysis of Kolmogorov-Smirnov two-sample test results reveals that the eastern Songpan-Ganzi complex is not a single contiguous turbidite system but is instead composed of three subsidiary depocenters, each associated with distinct sediment sources. The northeastern depocenter contains zircon ages characterized by Paleozoic and bimodally distributed Precambrian zircon populations, which, together with south-to southeast-directed paleocurrent data, indicate derivation from the retro-side of the Qinling-Dabie (Q-D) collisional orogen wedge. In the central depocenter, the dominantly Paleozoic detrital zircon signature and south-to southwest-oriented paleocurrent indicators reflect a profusion of Paleozoic zircon grains. These data are interpreted to reflect an influx of material derived from erosion of Paleozoic supra-UHP rocks of the Dabie terrane in the eastern Qinling-Dabie orogen, which we speculate may have been enhanced by development of a monsoonal climate. This suggests that erosional unroofing played a significant role in the initial phase of UHP exhumation and likely influenced the petrotectonic and structural evolution of the Qinling-Dabie orogen, as evidenced by compressed Triassic isotherms/grads reported in the Huwan

The left IPL represents stored hand-postures for object use and action prediction

Directory of Open Access Journals (Sweden)

Michiel evan Elk

2014-04-01

Full Text Available Action semantics enables us to plan actions with objects and to predict others’ object-directed actions as well. Previous studies have suggested that action semantics are represented in a fronto-parietal action network that has also been implicated to play a role in action observation. In the present fMRI study it was investigated how activity within this network changes as a function of the predictability of an action involving multiple objects and requiring the use of action semantics. Participants performed an action prediction task in which they were required to anticipate the use of a centrally presented object that could be moved to an associated target object (e.g. hammer - nail. The availability of actor information (i.e. presenting a hand grasping the central object and the number of possible target objects (i.e. 0, 1 or 2 target objects were independently manipulated, resulting in different levels of predictability. It was found that making an action prediction based on actor information resulted in an increased activation in the extrastriate body area (EBA and the fronto-parietal action observation network (AON. Predicting actions involving a target object resulted in increased activation in the bilateral IPL and frontal motor areas. Within the AON, activity in the left inferior parietal lobe (IPL and the left premotor cortex (PMC increased as a function of the level of action predictability. Together these findings suggest that the left IPL represents stored hand-postures that can be used for planning object-directed actions and for predicting other’s actions as well.

Mapping of the left-sided phrenic nerve course in patients undergoing left atrial catheter ablations.

Science.gov (United States)

Huemer, Martin; Wutzler, Alexander; Parwani, Abdul S; Attanasio, Philipp; Haverkamp, Wilhelm; Boldt, Leif-Hendrik

2014-09-01

Catheter ablation of atrial fibrillation has been associated with left-sided phrenic nerve palsy. Knowledge of the individual left phrenic nerve course therefore is essential to prevent nerve injury. The aim of this study was to test the feasibility of an intraprocedural pace mapping and reconstruction of the left phrenic nerve course and to characterize which anatomical areas are affected. In patients undergoing left atrial catheter ablation, a three-dimensional map of the left atrial anatomical structures was created. The left-sided phrenic nerve course was determined by high-output pace mapping and reconstructed in the map. In this study, 40 patients with atrial fibrillation or atrial tachycardias were included. Left phrenic nerve capture was observed in 23 (57.5%) patients. Phrenic nerve was captured in 22 (55%) patients inside the left atrial appendage, in 22 (55%) in distal parts, in 21 (53%) in medial parts, and in two (5%) in ostial parts of the appendage. In three (7.5%) patients, capture was found in the distal coronary sinus and in one (2.5%) patient in the left atrium near the left atrial appendage ostium. Ablation target was changed due to direct spatial relationship to the phrenic nerve in three (7.5%) patients. No phrenic nerve palsy was observed. Left-sided phrenic nerve capture was found inside and around the left atrial appendage in the majority of patients and additionally in the distal coronary sinus. Phrenic nerve mapping and reconstruction can easily be performed and should be considered prior catheter ablations in potential affected areas. ©2014 Wiley Periodicals, Inc.

Plasticity within the Central Nervous System: A Case Report

Directory of Open Access Journals (Sweden)

Jun Hozumi

2011-01-01

Full Text Available Neural blockades are considered an alternative to pharmacotherapy for neuropathic pain although these blockades elicit limited effects. We encountered a patient with postbrachial plexus avulsion injury pain, which was refractory to conventional treatments but disappeared temporarily with the administration of the local anesthetic lidocaine around the left mandibular molar tooth during dental treatments. This analgesic effect on neuropathic pain by oral local anesthesia was reproducible. Under conditions of neuropathic pain, cerebral somatotopic reorganization in the sensorimotor cortices of the brain has been observed. Either expansion or shrinkage of the somatotopic representation of a deafferentated body part correlates with the degree of neuropathic pain. In our case, administration of an oral local anesthetic shrank the somatotopic representation of the mouth, which is next to the upper limb representation and thereby expanded the upper limb representation in a normal manner. Consequently, oral local anesthesia improved the pain in the upper limb. This case suggests that pain alleviation through neural plasticity within the brain is related to neural blockade.

Isolated persistent left-sided superior vena cava, giant coronary sinus, atrial tachycardia and heart failure in a child

Directory of Open Access Journals (Sweden)

Nagaraja Moorthy

2013-09-01

Full Text Available Persistence of a left-sided superior vena cava (PLSVC with absent right superior vena cava (isolated PLSVC is a very rare venous malformation and commonly associated with congenital heart disease or alterations of the cardiac situs. We describe an unusual case of a young boy presenting with persistent atrial tachycardia and congestive heart failure. He was detected to have unexplained grossly dilated right atrium, right ventricle with systolic dysfunction and a giant coronary sinus (CS. The dilated CS closely mimicked a pseudo cor-triatriatum on echocardiography. Contrast echocardiography from both arms revealed opacification of the CS before the right atrium. Bilateral upper limb venography confirmed the presence of absent right SVC and isolated persistent left SVC draining into the giant coronary sinus.

Studies on the microzooplankton from the central and eastern Arabian Sea

Digital Repository Service at National Institute of Oceanography (India)

Gauns, M; Mohanraju, R.; Madhupratap, M

Numerical abundance and composition of microzooplankton in the upper 200 m were studied from the central and eastern Arabian Sea during three seasons. Protozoans, comprising of ciliates (loricates and aloricates), flagellates and sarcodines were...

Central venous stenosis in haemodialysis patients without a previous history of catheter placement.

Science.gov (United States)

Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

2005-08-01

To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term.

Sternocostoclavicular Hyperostosis: An Insufficiently Recognized Clinical Entity

OpenAIRE

Taro Sugase; Tetsu Akimoto; Hidenori Kanazawa; Atsushi Kotoda; Daisuke Nagata

2017-01-01

A 79-year-old male chronic hemodialysis patient with no history of central venous catheterization was referred to our hospital with progressive swelling of the left upper limb ipsilateral to a forearm arteriovenous fistula. Radiological assessments revealed marked hyperostosis in the ribs, sternum, and clavicles with well-developed ossification of the sternocostoclavicular ligaments. Such characteristic structural abnormalities and our failure to identify the left subclavian vein with contras...

Advanced squamous cell carcinoma of the upper lip in an albino: A ...

African Journals Online (AJOL)

The early results appeared satisfactory both at rest and with lip animation. Conclusion: Near total loss of the upper lip can be reconstructed with bilateral cheek advancement for the lateral part and an Abbe flap for the central portion. The procedure is simple, can be performed under local anesthesia and is recommended for ...

PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

African Journals Online (AJOL)

GB

2017-03-01

Mar 1, 2017 ... heart, the central nervous system and the brain ... On history, she was born at term in a health ... line. Normal heart sounds with three out of six machinery murmur at the upper left .... al (18), during cardiac catheterization, the.

Pre-surgical evaluation of the cerebral tumor in the left language related areas by functional MRI

International Nuclear Information System (INIS)

Zou Zhitong; Ma Lin; Weng Xuchu

2010-01-01

Objective: To evaluate the application of combination of BOLD-fMRI and diffusion tensor tractography (DTT) in pre-operative evaluation of cerebral tumors located at the left language related areas. Methods: A non-vocal button pressing semantic judging paradigm was developed and validated in 10 right-handed volunteers at 3 T. After validation, this protocol combined with DTI were applied to 15 patients with left cerebral tumor prior to surgical resection, and 3 of them had aphasia. fMRI data analysis was on subject-specific basis by one-sampled t-test. The distance from the tumor to Broca area and pre-central 'hand-knot' area were measured separately. Functional language laterality index (LI) was calculated by taking out Broca area and Wernicke area. Three dimensional architecture of frontal lobe white matter fibers, especially arcuate fasciculus, were visualized using diffusion tensor tractography on Volume-one software. The images demonstrating relationship among tumor, language activation areas and white matter fibers were reviewed by neurosurgeons as part of pre-operative planning. One year after the operation, patients were followed up with MRI and language function test. Results: The non-vocal semantic judging paradigm successfully detect Broca area, Wernicke area and pre-central 'hand-knot' area. In 12 of 15 patients, the relationship of Broca area and pre-central motor area to the left brain tumor in language related areas was identified, which make the pre-operative neurosurgical plan applicable to minimize the disruption of language and motor. 8 patients had the left language dominant hemisphere, 3 patients with the right language dominant hemisphere and 1 patient with bilateral dominance. The other 3 patients' fMRI data were corrupted by patients' motion. Diffusion tensor images were corrupted by motion in 1 patient but demonstrated the impact of tumor on left accouter fasciculus in 14 patients. Diffusion tensor tractography showed disruption of left

Metabolic bone disease and central retinal degeneration in a kitten due to nutritional inadequacy of an all-meat raw diet

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Catherine Lenox

2015-05-01

Full Text Available A 5-month-old castrated male Sphynx kitten presented with left hindlimb lameness shortly after adoption. Prior to adoption, the breeder had fed the kitten an exclusively raw chicken diet. Radiographs revealed generalized osteopenia and a left tibia–fibula fracture. Ophthalmic examination revealed corneal vascularization and opacity in the right eye, and lesions suggestive of feline central retinal degeneration in the left eye. The patient’s diagnoses included metabolic bone disease and feline central retinal degeneration, which can result from taurine deficiency. The kitten’s nutritional diseases were managed with a complete and balanced canned diet designed for kitten growth and with taurine supplementation.

Intelligence related upper alpha desynchronization in a semantic memory task.

Science.gov (United States)

Doppelmayr, M; Klimesch, W; Hödlmoser, K; Sauseng, P; Gruber, W

2005-07-30

Recent evidence shows that event-related (upper) alpha desynchronization (ERD) is related to cognitive performance. Several studies observed a positive, some a negative relationship. The latter finding, interpreted in terms of the neural efficiency hypothesis, suggests that good performance is associated with a more 'efficient', smaller extent of cortical activation. Other studies found that ERD increases with semantic processing demands and that this increase is larger for good performers. Studies supporting the neural efficiency hypothesis used tasks that do not specifically require semantic processing. Thus, we assume that the lack of semantic processing demands may at least in part be responsible for the reduced ERD. In the present study we measured ERD during a difficult verbal-semantic task. The findings demonstrate that during semantic processing, more intelligent (as compared to less intelligent) subjects exhibited a significantly larger upper alpha ERD over the left hemisphere. We conclude that more intelligent subjects exhibit a more extensive activation in a semantic processing system and suggest that divergent findings regarding the neural efficiency hypotheses are due to task specific differences in semantic processing demands.

Orthodontic management of a dilacerated central incisor and partially impacted canine with unilateral extraction - A case report.

Science.gov (United States)

Felicita, A Sumathi

2017-10-01

To align a dilacerated maxillary central incisor and partially impacted canine with unilateral extraction in a young patient with skeletal deep bite. A 14 year old male patient reported to the hospital with skeletal deep bite (basal plane angle-17°), severe horizontal pattern of growth (Go-Gn to Sn -22°), upright maxillary incisors (U1 to NA -26°) and retroclined lower incisors (L1 to NB -11°). The maxillary left central incisor was dilacerated, and the maxillary left canine was partially impacted. Unilateral extraction of the left maxillary premolar and left mandibular central incisor was done. A canine disimpaction spring was used to align the impacted canine. An anterior bite plane was given to open the bite. Superimposition of lateral cephalogram (T1, T2) revealed bite opening, normal overjet and overbite. There was backward rotation of the mandible and increase in lower anterior facial height. There was no evidence of root resorption or loss of vitality in the dilacerated tooth. Clinically the canine was well aligned in the arch. Orthodontic management of a dilacerated incisor can be done without root resorption or loss of vitality. The partially impacted canine was well aligned in the arch. Unilateral extraction can produce good treatment results.

Clinical presentation of multiple cerebral emboli and central retinal artery occlusion (CRAO as signs of cardiac myxoma

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Alberto Galvez-Ruiz

2018-04-01

Full Text Available Cardiac myxomas are benign tumors of endocardial origin that usually occur in the left atrium. Trans-thoracic echocardiography is the diagnostic method of choice, and early surgical removal is the preferred method of treatment.We present a patient whose history of cerebral emboli and central retinal artery occlusion (CRAO led to a diagnosis of cardiac myxoma.Neuroimaging studies showed multiple infarcts in the region of the left middle and anterior cerebral arteries. Ophthalmic examination showed gross retinal pallor compatible with left central retinal artery occlusion (CRAO.The etiology of stroke was investigated by performing trans-thoracic echocardiography, which showed a mass in the left atrium compatible with cardiac myxoma. Complete removal of the cardiac tumor was performed by open-heart surgery.Fortunately, after a period of rehabilitation, the patient’s hemiparesis almost completely resolved, but the loss of vision OS remained unchanged.Many cases of myxoma are accompanied by constitutional symptoms, such as anemia, fever and weight loss, which allow for a diagnosis to made before serious complications such as embolism occur. Unfortunately, in some patients, such as ours, the absence of signs and symptoms allows the myxoma to pass completely unnoticed until the first embolic event occurs. Keywords: Cardiac myxoma, Central retinal artery occlusion, Cerebral emboli, Amaurosis

Extensional ductile tectonics of the Sioule metamorphic series (Variscan French Massif Central)

Science.gov (United States)

Faure, M.; Grolier, J.; Pons, J.

1993-09-01

In the Northern part of the Variscan French Massif Central, the Sioule series, from top to bottom, consists of a pre-Viséan granite, migmatite, gneiss and mica schist. Two ductile deformations have been recognized. The earlier phase is characterized by a north-east-south-west trending stretching lineation; the second phase, characterized by a north-west-south-east trending mineral, stretching and crenulation lineation, is better marked in the lower mica schist part than in the upper granito-gneissic part. This second phase occurred during retrogression of the metamorphic rocks; related shear criteria indicate a top to the south-west shear. The Namurian-Westphalian magmatic bodies such as the Echassières leucogranite, Pouzol-Servant microgranite and numerous north-east -south-west trending microgranite dykes are emplaced in extensional fractures related to the same north-west-south-east maximum stretching direction. The asymmetrical shapes of the two granitic massifs indicate that they intruded towards the south-east. The synkinematic retrogression of the metamorphic rocks, the shape of the magmatic bodies and a re-examination of the numerous available data support the interpretation that the deformation is due to the extensional tectonic regime related to the Variscan crustal re-quilibration. This interpretation is in agreement with the correlation of the Sioule series with the Chavanon series. The two series belong to a unique tectono-metamorphic unit left-laterally offset by the Stephanian motion of the Sillon Houiller fault. This study also shows that the Sillon Houiller did not play a significant part during the Namurian-Westphalian extensional tectonics of the Massif Central.

Clinico-anatomical correlations of left posterior cerebral artery occlusion

International Nuclear Information System (INIS)

Isono, Osamu; Shiota, Junichi; Kawamura, Mitsuru; Hirayama, Keizou; Maki, Toshiyuki.

1988-01-01

The relation between neurological signs and symptoms and computed tomography (CT) and magnetic resonance imaging (MRI) was examined in 11 cases of occlusion of the left posterior cerebral artery. All the patients were righthanded. Right homonimous hemianopia was noted in 8 cases, right upper quadrantanopia in 2 cases, and right lower quadrantanopia in 1 case. Of the 11 cases, alexia without agraphia was noted in 9 cases, all 9 of which showed lesions of inferior occipital cortex (lingual and fusiform gyri) and subjacent white matter. Lesions of splenium were found in only 5 of the cases of alexia without agraphia. In 2 cases with neither alexia nor agraphia, lesions were seen in the medial occipital cortex and the subjacent white matter but not in the inferior occipital lobe. Three patients had color anomia which was accompanied by memory disturbances and alexia without agraphia. In 2 of these 3, lesions were widespread in the region of the left posterior cerebral artery. Memory disturbances were observed in 6 cases, all of which also showed alexia without agraphia. The lesions extended not only of the inferior surface of the occipital lobe and along the interhemispheric fissure, but also of hippocampal and parahippocampal gyri. In 3 cases of alexia without agraphia in which no memory distrubance was found, the symptoms of alexia were slight and disappeared at an early stage. (J.P.N.)

Instream flow characterization of upper Salmon River basin streams, central Idaho, 2004

Science.gov (United States)

Maret, Terry R.; Hortness, Jon E.; Ott, Douglas S.

2005-01-01

Anadromous fish populations in the Columbia River Basin have plummeted in the last 100 years. This severe decline led to Federal listing of Chinook salmon (Oncorhynchus tshawytscha) and steelhead trout (Oncorhynchus mykiss) stocks as endangered or threatened under the Endangered Species Act (ESA) in the 1990s. Historically, the upper Salmon River Basin (upstream of the confluence with the Pahsimeroi River) in Idaho provided migration corridors and significant habitat for these ESA-listed species, in addition to the ESA-listed bull trout (Salvelinus confluentus). Human development has modified the original streamflow conditions in many streams in the upper Salmon River Basin. Summer streamflow modifications resulting from irrigation practices, have directly affected quantity and quality of fish habitat and also have affected migration and (or) access to suitable spawning and rearing habitat for these fish. As a result of these ESA listings and Action 149 of the Federal Columbia River Power System Biological Opinion of 2000, the Bureau of Reclamation was tasked to conduct streamflow characterization studies in the upper Salmon River Basin to clearly define habitat requirements for effective species management and habitat restoration. These studies include collection of habitat and streamflow information for the Physical Habitat Simulation System model, a widely applied method to determine relations between habitat and discharge requirements for various fish species and life stages. Model results can be used by resource managers to guide habitat restoration efforts by evaluating potential fish habitat and passage improvements by increasing streamflow. In 2004, instream flow characterization studies were completed on Salmon River and Beaver, Pole, Champion, Iron, Thompson, and Squaw Creeks. Continuous streamflow data were recorded upstream of all diversions on Salmon River and Pole, Iron, Thompson, and Squaw Creeks. In addition, natural summer streamflows were

New Data on Conodonts of the Upper Devonian of the Polar Urals (Ostantsovy Section, Malaya Usa River

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M.A. Soboleva

2016-09-01

Full Text Available The main features of the Upper Devonian sediments on the right side of the Ostantsovy Creek (the left tributary of the Malaya Usa River in the eastern part of the Bielsko-Eletskaya structural formational belt on the western slope of the Polar Urals have been considered. The late Frasnian age of these sediments has been determined on the basis of conodonts (the linguiformis zone of the standard conodont scale. The transition from clastic and organic limestones with massive stromatoporoid forms to limestones with fused (reservoir stromatoporoid forms and Palmatolepis biofacies is indicative of the transgressive shift of the linguiformis phase. This transgressive level is an indirect expression of the Upper Kellwasser global event.

Adenocarcinoma at Anastomotic Site of Ureterosigmoidostomy Potentially of Urothelial Origin Spreading to the Upper Urinary Tract

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Katsuhiro Makino

2015-01-01

Full Text Available Ureterosigmoidostomy is associated with the risk of several late complications including cancer development at anastomotic sites. We present an unusual case with adenocarcinoma of the anastomotic site associated with multiple adenocarcinoma lesions in the upper urinary tract. A 69-year-old man complained of persistent melena and hematuria. He had undergone radical cystectomy for high-grade bladder cancer and ureterosigmoidostomy 30 years before. Colonoscopy showed a tumor at the right ureterocolonic anastomosis, which was endoscopically resected and histologically diagnosed as adenocarcinoma. Seven years later, a tumor of the left ureterocolonic anastomosis associated with hydronephrosis was found. He underwent temporal percutaneous nephrostomy followed by sigmoidectomy and left ureterocutaneostomy. Eighteen months after the operation, computed tomography (CT detected left renal pelvic tumor with a mass along the former nephrostomy tract. Left nephroureterectomy and resection of the nephrostomy tract tumor revealed adenocarcinoma with multiple lesions of adenocarcinoma in the ureter. These tumors showed atypical immunohistochemistry as a colonic adenocarcinoma: positive for cytokeratin 7, negative for cytokeratin 20, and negative for β-catenin nuclear accumulation. Anastomotic site adenocarcinoma of the present case is potentially of urothelial origin because of unusual clinical manifestation and immunohistochemistry as a colon cancer.

Radiocarbon chronology of Manot Cave, Israel and Upper Paleolithic dispersals

Science.gov (United States)

Alex, Bridget; Barzilai, Omry; Hershkovitz, Israel; Marder, Ofer; Berna, Francesco; Caracuta, Valentina; Abulafia, Talia; Davis, Lauren; Goder-Goldberger, Mae; Lavi, Ron; Mintz, Eugenia; Regev, Lior; Bar-Yosef Mayer, Daniella; Tejero, José-Miguel; Yeshurun, Reuven; Ayalon, Avner; Bar-Matthews, Mira; Yasur, Gal; Frumkin, Amos; Latimer, Bruce; Hans, Mark G.; Boaretto, Elisabetta

2017-01-01

The timing of archeological industries in the Levant is central for understanding the spread of modern humans with Upper Paleolithic traditions. We report a high-resolution radiocarbon chronology for Early Upper Paleolithic industries (Early Ahmarian and Levantine Aurignacian) from the newly excavated site of Manot Cave, Israel. The dates confirm that the Early Ahmarian industry was present by 46,000 calibrated years before the present (cal BP), and the Levantine Aurignacian occurred at least between 38,000 and 34,000 cal BP. This timing is consistent with proposed migrations or technological diffusions between the Near East and Europe. Specifically, the Ahmarian could have led to the development of the Protoaurignacian in Europe, and the Aurignacian in Europe could have spread back to the Near East as the Levantine Aurignacian. PMID:29152566

Orthodontic Management of a Severely Rotated Maxillary Central Incisor in the Mixed Dentition: A Case Report

Directory of Open Access Journals (Sweden)

Arezoo Jahanbin

2014-06-01

Full Text Available The aim of this case report was to introduce an appliance for correcting severe rotation of anterior teeth in the mixed dentition period. A 9-year-old Iranian boy with a mixed dentition Class I malocclusion complained of a severely rotated of upper right central incisor. There was a mesiodens between the central incisors. The supernumerary tooth was first extracted and then a Whip appliance which is composed of a removable plate, a cantilever spring and a central bracket on the rotated tooth was utilized. After 8 months, the upper right central incisor was orthodontically brought into proper alignment. Circumferential supracrestal fibrotomy was performed on the overcorrected tooth. One week after surgery, the device was removed and the retention was started. The whip appliance is a removable appliance that can effectively correct severe rotation of anterior teeth especially during the mixed dentition period.

Evaluation of bone microstructure in CRPS-affected upper limbs by HR-pQCT.

Science.gov (United States)

Mussawy, Haider; Schmidt, Tobias; Rolvien, Tim; Rüther, Wolfgang; Amling, Michael

2017-01-01

Complex regional pain syndrome (CRPS) is a major complication after trauma, surgery, and/or immobilization of an extremity. The disease often starts with clinical signs of local inflammation and develops into a prolonged phase that is characterized by trophic changes and local osteoporosis and sometimes results in functional impairment of the affected limb. While the pathophysiology of CRPS remains poorly understood, increased local bone resorption plays an undisputed pivotal role. The aim of this retrospective clinical study was to assess the bone microstructure in patients with CRPS. Patients with CRPS type I of the upper limb whose affected and unaffected distal radii were analyzed by high-resolution peripheral quantitative computed tomography (HR-pQCT) were identified retrospectively. The osteology laboratory data and dual-energy X-ray absorptiometry (DXA) images of the left femoral neck and lumbar spine, which were obtained on the same day as HR-pQCT, were extracted from the medical records. Five patients were identified. The CRPS-affected upper limbs had significantly lower trabecular numbers and higher trabecular thicknesses than the unaffected upper limbs. However, the trabecular bone volume to total bone volume and cortical thickness values of the affected and unaffected sides were similar. Trabecular thickness tended to increase with time since disease diagnosis. CRPS associated with significant alterations in the bone microstructure of the affected upper limb that may amplify as the duration of disease increases.

Insights on surface-water/groundwater exchange in the upper Floridan aquifer, north-central Florida (USA), from streamflow data and numerical modeling

Science.gov (United States)

Sutton, James E.; Screaton, Elizabeth J.; Martin, Jonathan B.

2015-03-01

Surface-water/groundwater exchange impacts water quality and budgets. In karst aquifers, these exchanges also play an important role in dissolution. Five years of river discharge data were analyzed and a transient groundwater flow model was developed to evaluate large-scale temporal and spatial variations of exchange between an 80-km stretch of the Suwannee River in north-central Florida (USA) and the karstic upper Floridan aquifer. The one-layer transient groundwater flow model was calibrated using groundwater levels from 59 monitoring wells, and fluxes were compared to the exchange calculated from discharge data. Both the numerical modeling and the discharge analysis suggest that the Suwannee River loses water under both low- and high-stage conditions. River losses appear greatest at the inside of a large meander, and the former river water may continue across the meander within the aquifer rather than return to the river. In addition, the numerical model calibration reveals that aquifer transmissivity is elevated within this large meander, which is consistent with enhanced dissolution due to river losses. The results show the importance of temporal and spatial variations in head gradients to exchange between streams and karst aquifers and dissolution of the aquifers.

Left-Deviating Prism Adaptation in Left Neglect Patient: Reflexions on a Negative Result

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Jacques Luauté

2012-01-01

Full Text Available Adaptation to right-deviating prisms is a promising intervention for the rehabilitation of patients with left spatial neglect. In order to test the lateral specificity of prism adaptation on left neglect, the present study evaluated the effect of left-deviating prism on straight-ahead pointing movements and on several classical neuropsychological tests in a group of five right brain-damaged patients with left spatial neglect. A group of healthy subjects was also included for comparison purposes. After a single session of exposing simple manual pointing to left-deviating prisms, contrary to healthy controls, none of the patients showed a reliable change of the straight-ahead pointing movement in the dark. No significant modification of attentional paper-and-pencil tasks was either observed immediately or 2 hours after prism adaptation. These results suggest that the therapeutic effect of prism adaptation on left spatial neglect relies on a specific lateralized mechanism. Evidence for a directional effect for prism adaptation both in terms of the side of the visuomanual adaptation and therefore possibly in terms of the side of brain affected by the stimulation is discussed.

Scannographic appearance of increased colloid uptake in the left liver lobe (Case presentation)

International Nuclear Information System (INIS)

Tadzher, Isak S.; Josifovska, Tatjana; Popgjorcheva, Daniela

1996-01-01

Incidentally increased uptake of Tc-99m sulfur colloid was found in scannographic images in the whole left liver lobe in all positions (PA, AP, DL, LL). The patient, a 60-year-old woman, was three years earlier cholocystecomized and had since occasional pain in the right upper abdominal quadrant due to biliary dyskinesia. Accessory spleen tissue was seen as well in the inferior lineal pole, probably presenting Shurer's phenomenon of 'lienis in liene' thus augmenting the serendipity of the scanographic findings. Imaging of the accessory spleen with heat denaturated spherocytes - Tc-99m confirmed the lienal structure of the tissue with preserved red pulp trabecular trapping mechanism in addition to phagocytic function of lineal Kupffer cells (in white pulp). Mebrofenin-Tc-99m (IDA-agent) showed in our patient normal distribution in both liver lobes contrary to focal nodular hyperplasia and adenoma of the liver where IDA-radio- pharmaceuticals have delayed clearance due to abnormal biliary canaliculi. In our patient uptake, distribution, excretion and liver washout of mebrofenin-Tc-99m was found to be normal. This is in favor of an exclusive, solitary increase of the number of Kupffer cells confined to the whole left lobe of the liver. Increased colloid uptake in the left liver lobe is dependent on a greater number of Kupffer cells pro volume than in the right lobe. (Author)

An upper limit on hypertriton production in collisions of Ar(1.76 A GeV) + KCl

International Nuclear Information System (INIS)

Agakishiev, G.; Chernenko, S.; Fateev, O.; Zanevsky, Y.; Belver, D.; Cabanelas, P.; Castro, E.; Garzon, J.A.; Blanco, A.; Fonte, P.; Lopes, L.; Mangiarotti, A.; Boehmer, M.; Friese, J.; Gernhaeuser, R.; Jurkovic, M.; Kruecken, R.; Maier, L.; Weber, M.; Boyard, J.L.; Hennino, T.; Liu, T.; Moriniere, E.; Ramstein, B.; Destefanis, M.; Gilardi, C.; Kuehn, W.; Lange, J.S.; Metag, V.; Spruck, B.; Dohrmann, F.; Kaempfer, B.; Kotte, R.; Naumann, L.; Wendisch, C.; Wuestenfeld, J.; Dybczak, A.; Michalska, B.; Palka, M.; Przygoda, W.; Salabura, P.; Trebacz, R.; Wisniowski, M.; Epple, E.; Fabbietti, L.; Lapidus, K.; Siebenson, J.; Finocchiaro, P.; Schmah, A.; Spataro, S.; Froehlich, I.; Lorenz, M.; Markert, J.; Michel, J.; Muentz, C.; Pachmayer, Y.C.; Pechenova, O.; Rehnisch, L.; Rustamov, A.; Scheib, T.; Schuldes, H.; Stroebele, H.; Tarantola, A.; Teilab, K.; Galatyuk, T.; Gonzalez-Diaz, D.; Golubeva, M.; Guber, F.; Ivashkin, A.; Karavicheva, T.; Kurepin, A.; Reshetin, A.; Sadovsky, A.; Gumberidze, M.; Heinz, T.; Holzmann, R.; Koenig, I.; Koenig, W.; Kolb, B.W.; Lang, S.; Pechenov, V.; Pietraszko, J.; Schwab, E.; Sturm, C.; Traxler, M.; Yurevich, S.; Iori, I.; Krasa, A.; Krizek, F.; Kugler, A.; Sobolev, Yu.G.; Tlusty, P.; Wagner, V.; Kuc, H.; Mousa, J.; Tsertos, H.; Stroth, J.

2013-01-01

A high-statistic data sample of Ar(1.76 AGeV)+KCl events recorded with HADES is used to search for a hypertriton signal. An upper production limit per centrality-triggered event of 1.04 x 10 -3 on the 3 σ level is derived. Comparing this value with the number of successfully reconstructed Λ hyperons allows to determine an upper limit on the ratio N 3 Λ H /N Λ , which is confronted with statistical and coalescence-type model calculations. (orig.)

Neuromodulation therapy does not influence blood flow distribution or left-ventricular dynamics during acute myocardial ischemia.

Science.gov (United States)

Kingma, J G; Linderoth, B; Ardell, J L; Armour, J A; DeJongste, M J; Foreman, R D

2001-08-13

Electrical stimulation of the dorsal aspect of the upper thoracic spinal cord is used increasingly to treat patients with angina pectoris refractory to conventional therapeutic strategies. The purpose of this study was to determine whether spinal cord stimulation (SCS) in dogs affects regional myocardial blood flow and left-ventricular (LV) function before and during transient obstruction of the left anterior descending coronary artery (LAD). In anesthetized dogs, regional myocardial blood flow distribution was determined using radiolabeled microspheres and left-ventricular function was measured by impedance-derived pressure-volume loops. SCS was accomplished by stimulating the dorsal T1-T2 segments of the spinal cord using epidural bipolar electrodes at 90% of motor threshold (MT) (50 Hz, 0.2-ms duration). Effects of 5-min SCS were assessed under basal conditions and during 4-min occlusion of the LAD. SCS alone evoked no change in regional myocardial blood flow or cardiovascular indices. Transient LAD occlusion significantly diminished blood flow within ischemic, but not in non-ischemic myocardial tissue. Left ventricular pressure-volume loops were shifted rightward during LAD occlusion. Cardiac indices were altered similarly during LAD occlusion and concurrent SCS. SCS does not influence the distribution of blood flow within the non-ischemic or ischemic myocardium. Nor does it modify LV pressure-volume dynamics in the anesthetized experimental preparation.

Wine and the vine in Upper Moesia archaeological and epigraphic evidence

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Pilipović Sanja

2013-01-01

Full Text Available Vine-growing and winemaking in the area of the Roman province of Upper Moesia are looked at based on the information supplied by the ancient sources, and the archaeological and epigraphic evidence (inscriptions, artistic depictions, vinedressing and winemaking implements, drinking and transport vessels. Viniculture is associated with the Greco-Roman cultural orbit, while the native central-Balkan tribes typically consumed alcoholic beverages made from cereals. Therefore the goal of the research is to shed as much light as currently possible on the significance of vine-growing and wine in the life of the inhabitants of Upper Moesia. [Projekat Ministarstva nauke Republike Srbije, br. 177012: Society, spiritual and material culture and communications in prehistory and early history of the Balkans

Central venous stenosis in haemodialysis patients without a previous history of catheter placement

International Nuclear Information System (INIS)

Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

2005-01-01

Objective: To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Material and methods: Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Results: Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Conclusion: Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term

Prevalence of right-to-left shunts on transcranial Doppler in chronic migraine and medication-overuse headache

DEFF Research Database (Denmark)

Guo, Song; Shalchian, Sarvnaz; Gérard, Pascale

2014-01-01

BACKGROUND: It was suggested that right-to-left shunt (RLS) may be highly prevalent in chronic migraine (CM) patients, indicating that patent foramen ovale (PFO) might be an aggravating and chronifying factor of migraine. Since a high proportion of chronic migraineurs also have medication...... prevalence in CM is within the upper range of those reported in episodic migraine without aura or in the general population, and not higher in MOH. PFO is thus unlikely to have a significant causal role in these chronic headaches....

TMS over the Left Angular Gyrus Impairs the Ability to Discriminate Left from Right

Science.gov (United States)

Hirnstein, Marco; Bayer, Ulrike; Ellison, Amanda; Hausmann, Markus

2011-01-01

The underlying cognitive and neural mechanisms of the ability to discriminate left from right are hardly explored. Clinical studies from patients with impairments of left-right discrimination (LRD) and neuroimaging data suggest that the left angular gyrus is particularly involved in LRD. Moreover, it is argued that the often reported sex…

PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

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Hakan Tapar

2012-09-01

Full Text Available Successful peripheral blocks and selection of appropriate technique according to surgery is possible with a good knowledge of anatomy. Regional peripheral block anesthesia of upper extremity which applied by single injection to plexus brachialis is the most recommended method of anesthesia in daily surgical procedures. The most important advantages of peripheral nerve blocks which are type of regional anesthesia according to general anesthesia and central blocks are less effect to respiration and hemodynamics and shortness of recovery time. If a plexus brachialis catheter is placed, control of pain is provided without using systemic narcotic analgesic. With these advantages; rare life threatening potential complications can be seen which are pneumothorax, hematoma, neuritis, allergy, systemic and neurologic complications. In this compilation we aimed to review again the complications of upper extremity nerve blocks according to block type. [J Contemp Med 2012; 2(3.000: 195-200

Relationship between stress and pain in work-related upper extremity disorders: the hidden role of chronic multisymptom illnesses.

Science.gov (United States)

Clauw, Daniel J; Williams, David A

2002-05-01

Pain and fatigue are commonly associated with work-related upper extremity disorders. Occasionally these symptoms persist beyond a reasonable healing period. One potential explanation for prolonged symptom expression is the concurrent development of a stress-mediated illness or CMI (Chronic Multi-Symptom Illness). In such a scenario, the chronic regional pain and other symptoms that the individual is experiencing would be attributable to the CMI rather than to tissue damage or a biomechanical dysfunction of the upper-extremity. This article critically reviews the case definitions of the new class of CMI disorders and evaluates the existing evidence supporting centrally mediated physiological changes (e.g., sensory hypervigilance, dysautonomia) that manifest as symptoms of pain and fatigue in some individuals experiencing chronic stressors. While explanations for prolonged pain and fatigue have historically focused on mechanisms involving peripheral pathology or psychiatric explanations, ample evidences support the role of altered Central Nervous System function in accounting for symptom manifestation in CMI. A model is presented that unites seemingly disparate findings across numerous investigations and provides a framework for understanding how genetics, triggering events, stressors, and early life events can affect CNS activity. Resultant symptom expression (e.g., pain and fatigue) from central dysregulation would be expected to occur in a subset of individuals in the population, including a subset of individuals with work-related upper extremity disorders. Thus when symptoms such as pain and fatigue persist beyond a reasonable period, consideration of CMI and associated assessment and interventions focused on central mechanisms may be worthwhile.

Pulmonary and systemic blood flow contributions to upper airways in canine lung

International Nuclear Information System (INIS)

Barman, S.A.; Ardell, J.L.; Parker, J.C.; Perry, M.L.; Taylor, A.E.

1988-01-01

The blood flow contributions and drainage patterns of the pulmonary and systemic circulations in the upper airways (trachea and main bronchi) were assessed in anesthetized dogs by injecting 15-μm radiolabeled microspheres into the right and left heart, respectively. After the animals were killed, the tracheal cartilage, tracheal muscle-mucosa, and main bronchi were excised. The tracheal cartilage and tracheal muscle-mucosa were divided into lower, middle, and upper segments for blood flow determinations. The pulmonary contribution to tracheal blood flow was very small, being higher in the lower segments. The systemic contribution to these same tracheal regions was significantly higher, and higher in the upper segments. The pulmonary and systemic circulations each contributed ∼50% to the main bronchi blood flow. The pulmonary blood flow contribution alone to the trachea and main bronchi was also determined in subsequent experiments that utilized the isolated lung, and these blood flows were not significantly different from the pulmonary contribution measured in the intact lungs. The present results indicate that the systemic (bronchial) circulation is the primary source of tracheal blood flow and that both the pulmonary and systemic circulations may contribute ∼50% of the blood flow to the main bronchi in dog lungs

North Central regional environmental characterization report: executive summary - final

International Nuclear Information System (INIS)

1985-08-01

This Executive Summary of the final North Central Regional Environmental Characterization Report (RECR) is issued primarily for public information purposes and provides a general overview of the report. The complete RECR presents available regional environmental information pertinent to siting a repository for high-level nuclear waste in crystalline rock in Minnesota, Wisconsin, and the Upper Peninsula of Michigan. For each of the States within the North Central Region, information is provided on the environmental disqualifying factors and the environmental regional screening variables to be used in region-to-area screening

Architecture of an Upper Jurassic barrier island sandstone reservoir, Danish Central Graben:

DEFF Research Database (Denmark)

Johannessen, Peter N.; Nielsen, Lars H.; Nielsen, Lars

2010-01-01

An unusually thick (c. 88 m), transgressive barrier island and shoreface sandstone succession characterizes the Upper Jurassic Heno Formation reservoir of the Freja oil field situated on the boundary of Denmark and Norway. The development and preservation of such thick transgressive barrier island...... sands is puzzling since a barrier island typically migrates landwards during transgression and only a thin succession of back-barrier and shoreface sands is preserved. Investigation of the development and geometry of the Freja reservoir sandstones is problematic since the reservoir is buried c. 5 km...... and seismic resolution is inadequate for architectural analysis. Description of the reservoir sandstone bodies is thus based on sedimentological interpretation and correlation of seven wells, of which five were cored. Palaeotopography played a major role in the position and preservation of the thick reservoir...

The Monorail Technique to Overcome Difficult Anatomical Course During Implantation of Central Venous Port via the Left Internal Jugular Vein

Energy Technology Data Exchange (ETDEWEB)

Kim, Eu Hyun, E-mail: doorihyun6@gmail.com; Oh, Jung Suk; Chun, Ho Jong; Lee, Hae Giu; Choi, Byung Gil, E-mail: cbg@catholic.ac.kr [The Catholic University of Korea, Department of Radiology, Seoul St. Mary’s Hospital (Korea, Republic of)

2017-03-15

PurposeThe study aimed to introduce a monorail technique to overcome difficult anatomical course via left internal jugular vein in implantable port insertion.MethodsFrom 2007 to 2016, a total of 9346 patients were referred for implantable port insertion in our interventional unit, among which 79 cases were requested to insert on the left side. Our monorail technique was applied only when the technical challenge of the catheter tip entering the azygos vein instead of the superior vena cava occurred (n = 7). The technique consists of puncturing at the distal tip of the port catheter with a 21-gauge micropuncture needle and advancing a 0.018-in. hair-wire to guide and provide support for pre-assembled port.ResultsThe monorail technique was performed in seven patients and all but one case were technically successful, showing a technical success rate of 85.7%. There were no immediate or delayed complications.ConclusionsThe monorail technique is helpful to overcome the difficult anatomical course via left internal jugular vein in implantable port insertion.

The Monorail Technique to Overcome Difficult Anatomical Course During Implantation of Central Venous Port via the Left Internal Jugular Vein

International Nuclear Information System (INIS)

Kim, Eu Hyun; Oh, Jung Suk; Chun, Ho Jong; Lee, Hae Giu; Choi, Byung Gil

2017-01-01

PurposeThe study aimed to introduce a monorail technique to overcome difficult anatomical course via left internal jugular vein in implantable port insertion.MethodsFrom 2007 to 2016, a total of 9346 patients were referred for implantable port insertion in our interventional unit, among which 79 cases were requested to insert on the left side. Our monorail technique was applied only when the technical challenge of the catheter tip entering the azygos vein instead of the superior vena cava occurred (n = 7). The technique consists of puncturing at the distal tip of the port catheter with a 21-gauge micropuncture needle and advancing a 0.018-in. hair-wire to guide and provide support for pre-assembled port.ResultsThe monorail technique was performed in seven patients and all but one case were technically successful, showing a technical success rate of 85.7%. There were no immediate or delayed complications.ConclusionsThe monorail technique is helpful to overcome the difficult anatomical course via left internal jugular vein in implantable port insertion.

The Monorail Technique to Overcome Difficult Anatomical Course During Implantation of Central Venous Port via the Left Internal Jugular Vein.

Science.gov (United States)

Kim, Eu Hyun; Oh, Jung Suk; Chun, Ho Jong; Lee, Hae Giu; Choi, Byung Gil

2017-03-01

The study aimed to introduce a monorail technique to overcome difficult anatomical course via left internal jugular vein in implantable port insertion. From 2007 to 2016, a total of 9346 patients were referred for implantable port insertion in our interventional unit, among which 79 cases were requested to insert on the left side. Our monorail technique was applied only when the technical challenge of the catheter tip entering the azygos vein instead of the superior vena cava occurred (n = 7). The technique consists of puncturing at the distal tip of the port catheter with a 21-gauge micropuncture needle and advancing a 0.018-in. hair-wire to guide and provide support for pre-assembled port. The monorail technique was performed in seven patients and all but one case were technically successful, showing a technical success rate of 85.7%. There were no immediate or delayed complications. The monorail technique is helpful to overcome the difficult anatomical course via left internal jugular vein in implantable port insertion.

Acute Korsakoff-like amnestic syndrome resulting from left thalamic infarction following a right hippocampal hemorrhage.

Science.gov (United States)

Rahme, R; Moussa, R; Awada, A; Ibrahim, I; Ali, Y; Maarrawi, J; Rizk, T; Nohra, G; Okais, N; Samaha, E

2007-04-01

Korsakoff-like amnestic syndromes have been rarely described following structural lesions of the central nervous system. In this report, we describe a case of acute Korsakoff-like syndrome resulting from the combination of a left anteromedian thalamic infarct and a right hippocampal hemorrhage. We also review the literature relevant to the neuropathology and pathophysiology of Korsakoff syndrome and anterograde amnesia.

THE INFLUENCE OF LOWER LIMB MOVEMENT ON UPPER LIMB MOVEMENT SYMMETRY WHILE SWIMMING THE BREASTSTROKE

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M. Jaszczak

2011-09-01

Full Text Available This study 1 examined the influence of lower limb movement on upper limb movement symmetry, 2 determined the part of the propulsion phase displaying the greatest hand movement asymmetry, 3 diagnosed the range of upper limb propulsion phase which is the most prone to the influence of the lower limbs while swimming the breaststroke. Twenty-four participants took part in two tests. Half of them performed an asymmetrical leg movement. The propulsion in the first test was generated by four limbs while in the second one only by the upper limbs. The pressure differentials exerted by the water on the back and on the palm of the right and left hand were measured. Then, the asymmetry coefficient of the hand movement was determined. No changes in the level of the asymmetry index in participants performing correct (symmetrical lower limb movement were observed. Incorrect (asymmetrical leg motion resulted in an increase of hand asymmetry. It could be concluded that lower limb faults neutralize upper limb performance when swimming on a rectilinear path. However, most asymmetrical arm performance should be identified with the conversion of propulsion into recovery. Nevertheless, its proneness to influence improper leg performance might be expected at the beginning of arm propulsion.

An upper limit on hypertriton production in collisions of Ar(1.76 A GeV) + KCl

Energy Technology Data Exchange (ETDEWEB)

Agakishiev, G.; Chernenko, S.; Fateev, O.; Zanevsky, Y. [Joint Institute of Nuclear Research, Dubna (Russian Federation); Belver, D.; Cabanelas, P.; Castro, E.; Garzon, J.A. [Univ. de Santiago de Compostela, LabCAF. F. Fisica, Santiago de Compostela (Spain); Blanco, A.; Fonte, P.; Lopes, L.; Mangiarotti, A. [LIP-Laboratorio de Instrumentacao e Fisica Experimental de Particulas, Coimbra (Portugal); Boehmer, M.; Friese, J.; Gernhaeuser, R.; Jurkovic, M.; Kruecken, R.; Maier, L.; Weber, M. [Technische Universitaet Muenchen, Physik Department E12, Garching (Germany); Boyard, J.L.; Hennino, T.; Liu, T.; Moriniere, E.; Ramstein, B. [Universite Paris Sud, Institut de Physique Nucleaire (UMR 8608), CNRS/IN2P3, Orsay Cedex (France); Destefanis, M.; Gilardi, C.; Kuehn, W.; Lange, J.S.; Metag, V.; Spruck, B. [Justus Liebig Universitaet Giessen, II. Physikalisches Institut, Giessen (Germany); Dohrmann, F.; Kaempfer, B.; Kotte, R.; Naumann, L.; Wendisch, C.; Wuestenfeld, J. [Helmholtz-Zentrum Dresden-Rossendorf, Institut fuer Strahlenphysik, Dresden (Germany); Dybczak, A.; Michalska, B.; Palka, M.; Przygoda, W.; Salabura, P.; Trebacz, R.; Wisniowski, M. [Jagiellonian University of Cracow, Smoluchowski Institute of Physics, Krakow (Poland); Epple, E.; Fabbietti, L.; Lapidus, K.; Siebenson, J. [Excellence Cluster ' ' Origin and Structure of the Universe' ' , Garching (Germany); Finocchiaro, P.; Schmah, A.; Spataro, S. [Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare, Catania (Italy); Froehlich, I.; Lorenz, M.; Markert, J.; Michel, J.; Muentz, C.; Pachmayer, Y.C.; Pechenova, O.; Rehnisch, L.; Rustamov, A.; Scheib, T.; Schuldes, H.; Stroebele, H.; Tarantola, A.; Teilab, K. [Goethe-Universitaet, Institut fuer Kernphysik, Frankfurt (Germany); Galatyuk, T.; Gonzalez-Diaz, D. [Technische Universitaet Darmstadt, Darmstadt (Germany); Golubeva, M.; Guber, F.; Ivashkin, A.; Karavicheva, T.; Kurepin, A.; Reshetin, A.; Sadovsky, A. [Russian Academy of Science, Institute for Nuclear Research, Moscow (Russian Federation); Gumberidze, M. [Technische Universitaet Darmstadt, Darmstadt (Germany); Universite Paris Sud, Institut de Physique Nucleaire (UMR 8608), CNRS/IN2P3, Orsay Cedex (France); Heinz, T.; Holzmann, R.; Koenig, I.; Koenig, W.; Kolb, B.W.; Lang, S.; Pechenov, V.; Pietraszko, J.; Schwab, E.; Sturm, C.; Traxler, M.; Yurevich, S. [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, Darmstadt (Germany); Iori, I. [Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Milano (Italy); Krasa, A.; Krizek, F.; Kugler, A.; Sobolev, Yu.G.; Tlusty, P.; Wagner, V. [Academy of Sciences of Czech Republic, Nuclear Physics Institute, Rez (Czech Republic); Kuc, H. [Jagiellonian University of Cracow, Smoluchowski Institute of Physics, Krakow (Poland); Universite Paris Sud, Institut de Physique Nucleaire (UMR 8608), CNRS/IN2P3, Orsay Cedex (France); Mousa, J.; Tsertos, H. [University of Cyprus, Department of Physics, Nicosia (Cyprus); Stroth, J. [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, Darmstadt (Germany); Goethe-Universitaet, Institut fuer Kernphysik, Frankfurt (Germany); Collaboration: HADES Collaboration

2013-11-15

A high-statistic data sample of Ar(1.76 AGeV)+KCl events recorded with HADES is used to search for a hypertriton signal. An upper production limit per centrality-triggered event of 1.04 x 10{sup -3} on the 3 {sigma} level is derived. Comparing this value with the number of successfully reconstructed {Lambda} hyperons allows to determine an upper limit on the ratio N{sub 3{sub {Lambda}H}}/N{sub {Lambda}}, which is confronted with statistical and coalescence-type model calculations. (orig.)

Crowns to create esthetics for mal-aligned central incisors: a case report.

Science.gov (United States)

Savadi, Ravindra C; Savadi, Anupama R; Kumar, Preeti Satheesh

2011-06-01

This case report describes the smile design of crowded upper central anteriors in a female patient aged 25 years. The patient wanted the correction to be completed in a short period of time. A smile design schedule was drawn up involving root canal treatment of the central incisors and placing posts in both the teeth. All ceramic crowns were then fabricated to establish a very satisfactory and pleasing esthetics.

Crowns to Create Esthetics for Mal-Aligned Central Incisors: A Case Report

OpenAIRE

Savadi, Ravindra C.; Savadi, Anupama R.; Kumar, Preeti Satheesh

2011-01-01

This case report describes the smile design of crowded upper central anteriors in a female patient aged 25 years. The patient wanted the correction to be completed in a short period of time. A smile design schedule was drawn up involving root canal treatment of the central incisors and placing posts in both the teeth. All ceramic crowns were then fabricated to establish a very satisfactory and pleasing esthetics.

Delayed Migration and Perforation of the Jugular Vein by a Peripherally Inserted Central Catheter

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Joshua J. Oliver

2017-10-01

Full Text Available We report a case of peripherally inserted central catheter (PICC migration and perforation of the left internal jugular vein in a home health setting in an 80-year-old female. A left sided PICC was placed for treatment of diverticulitis following hospital discharge. She complained of sudden onset left sided neck pain immediately after starting an infusion of vancomycin. In the emergency department the injury was identified by portable chest radiograph and computed tomography of her neck. Following removal of the line, she had an uneventful course. Emergency physicians should be aware of this possible PICC line complication.

Six upper incisors: what's next?

Science.gov (United States)

Berneburg, Mirjam; Meller, Christian

2016-01-01

This case report describes our therapeutic approach taken in a girl with eruption disturbance of the upper anterior teeth. Two supernumerary teeth were involved, which required a combination of orthodontic and surgical treatment. The initial situation in the upper anterior segment was characterized by two supernumerary mesial incisors, ectopic eruption of the distally located lateral incisors, and crowded tooth buds in the canine areas. Key decisions had to be made as to whether any teeth needed to be extracted and, if so, regarding the timing and sites of extraction. Removing teeth too early would have preempted a complete assessment of tooth quality, whereas late extraction would have carried a risk of eruption disturbance. Once the distal lateral incisors had erupted, the supernumerary mesial incisors were extracted and the central incisors (initially located in between) mesialized with a bracket appliance. Following space closure and mesialization of the lateral incisors, a functional appliance was used. Tooth 13 was erupting, while tooth 23 was displaced and subsequently aligned as part of the final bracket treatment. To successfully treat eruption disturbances, a careful diagnostic workup is essential, including informative radiographs, personalized treatment planning, and correct decision-making as to whether teeth need to be extracted and regarding the timing and sites of extraction. Finally, the eruption of the canines should be monitored.

Dyscalculia, Dysgraphia, and Left-Right Confusion from a Left Posterior Peri-Insular Infarct

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S. Bhattacharyya

2014-01-01

Full Text Available The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation.

Dyscalculia, dysgraphia, and left-right confusion from a left posterior peri-insular infarct.

Science.gov (United States)

Bhattacharyya, S; Cai, X; Klein, J P

2014-01-01

The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI) showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation.

Apraxia in left-handers.

Science.gov (United States)

Goldenberg, Georg

2013-08-01

In typical right-handed patients both apraxia and aphasia are caused by damage to the left hemisphere, which also controls the dominant right hand. In left-handed subjects the lateralities of language and of control of the dominant hand can dissociate. This permits disentangling the association of apraxia with aphasia from that with handedness. Pantomime of tool use, actual tool use and imitation of meaningless hand and finger postures were examined in 50 consecutive left-handed subjects with unilateral hemisphere lesions. There were three aphasic patients with pervasive apraxia caused by left-sided lesions. As the dominant hand is controlled by the right hemisphere, they constitute dissociations of apraxia from handedness. Conversely there were also three patients with pervasive apraxia caused by right brain lesions without aphasia. They constitute dissociations of apraxia from aphasia. Across the whole group of patients dissociations from handedness and from aphasia were observed for all manifestations of apraxia, but their frequency depended on the type of apraxia. Defective pantomime and defective tool use occurred rarely without aphasia, whereas defective imitation of hand, but not finger, postures was more frequent after right than left brain damage. The higher incidence of defective imitation of hand postures in right brain damage was mainly due to patients who had also hemi-neglect. This interaction alerts to the possibility that the association of right hemisphere damage with apraxia has to do with spatial aptitudes of the right hemisphere rather than with its control of the dominant left hand. Comparison with data from right-handed patients showed no differences between the severity of apraxia for imitation of hand or finger postures, but impairment on pantomime of tool use was milder in apraxic left-handers than in apraxic right-handers. This alleviation of the severity of apraxia corresponded with a similar alleviation of the severity of aphasia as

Left hemisphere EEG coherence in infancy predicts infant declarative pointing and preschool epistemic language.

Science.gov (United States)

Kühn-Popp, N; Kristen, S; Paulus, M; Meinhardt, J; Sodian, B

2016-01-01

Pointing plays a central role in preverbal communication. While imperative pointing aims at influencing another person's behavior, declarative gestures serve to convey epistemic information and to share interest in an object. Further, the latter are hypothesized to be a precursor ability of epistemic language. So far, little is known about their underlying brain maturation processes. Therefore, the present study investigated the relation between brain maturation processes and the production of imperative and declarative motives as well as epistemic language in N = 32 infants. EEG coherence scores were measured at 14 months, imperative and declarative point production at 15 months and epistemic language at 48 months. Results of correlational analyses suggest distinct behavioral and neural patterns for imperative and declarative pointing, with declarative pointing being associated with the maturation of the left hemisphere. Further, EEG coherence measures of the left hemisphere at 14 months and declarative pointing at 15 months are related to individual differences in epistemic language skills at 48 months, independently of child IQ. In regression analyses, coherence measures of the left hemisphere prove to be the most important predictor of epistemic language skills. Thus, neural processes of the left hemisphere seem particularly relevant to social communication.

Functional influence of botulinum neurotoxin type A treatment (Xeomin® of multifocal upper and lower limb spasticity on chronic hemiparetic gait

Directory of Open Access Journals (Sweden)

Maurizio Falso

2012-05-01

Full Text Available This report describes the modification of hemiplegic shoulder pain and walking velocity through injections of Xeomin®, a new botulinum neurotoxin type A formulation, in a 67-year-old woman with chronic residual left hemiparesis and hemiparetic gait attributable to stroke. Clinical evaluation included upper and lower limb spasticity, upper and lower limb pain, trunk control, upper and lower limb motricity index, visual gait analysis, and gait velocity. Assessments were performed before, 1 week after, and 1 month after treatment. Improvement was observed in all clinical parameters assessed. Amelioration of spasticity of the upper and lower limbs and shoulder pain was observed after 1 month. Trunk postural attitude and paraxial muscle recruitment recovered. No adverse events were observed and the patient shows significant improvement of functional impairment derived from chronic spasticity after treatment with Xeomin®. We also provide a simple and useful protocol for clinical evaluation of the treatment.

Anatomical analysis of incidental left atrial diverticula in patients with suspected coronary artery disease using 64-channel multidetector CT

Energy Technology Data Exchange (ETDEWEB)

Shin, S.Y. [Department of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Kwon, S.H., E-mail: Kwon98@khu.ac.kr [Department of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Oh, J.H. [Department of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

2011-10-15

Aim: To describe and evaluate anatomical characterizations of incidental left atrial (LA) diverticula in patients with suspected coronary artery disease using 64-channel multidetector computed tomography (MDCT). Materials and methods: From October 2008 to June 2009, 2059 patients with suspected coronary artery disease underwent electrocardiogram-gated 64-channel MDCT. Five hundred and thirty-two LA diverticula were identified in 377 patients (18.3%, male to female ratio: 216:161, mean age 59 {+-} 10.89 years, range from 20 to 91 years). Two radiologists retrospectively analysed the number (single or multiple), size (diameter and length), shape (cystiform or tubiform), surface (smooth or irregular), and location (right or mid or left/upper or lower/lateral or posterior). If the length/diameter was <1.5, the diverticular shape was considered to be cystiform. Results: Among 532 LA diverticula, single (270/532, 51.1%), cystiform (411/532, 77.3%), and smooth (332/532, 62.4%) diverticula were found. The right upper region (255/532, 47.9%) was the most common location, followed by the left lateral area (172/532, 32.3%). The average diameter was 4.7 {+-} 2 mm (range from 1-19 mm), and the average length was 4.7 {+-} 2.1 mm (range 1-13 mm). The average ratio of length to diameter was 1.15 (range 0.25-1.45). The average number of diverticula was 2 {+-} 1.06 (range 1-5). Conclusion: Incidental LA diverticulum is not an uncommon finding in patients with suspected coronary artery disease. MDCT can provide anatomical details of LA diverticula. However, further studies are needed to determine their clinical significance.

Antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease.

Science.gov (United States)

Martí-Carvajal, Arturo J; Solà, Ivan

2015-06-09

Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. People with liver disease frequently have haemostatic abnormalities such as hyperfibrinolysis. Therefore, antifibrinolytic amino acids have been proposed to be used as supplementary interventions alongside any of the primary treatments for upper gastrointestinal bleeding in people with liver diseases. This is an update of this Cochrane review. To assess the beneficial and harmful effects of antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease. We searched The Cochrane Hepato-Biliary Controlled Trials Register (February 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2 of 12, 2015), MEDLINE (Ovid SP) (1946 to February 2015), EMBASE (Ovid SP) (1974 to February 2015), Science Citation Index EXPANDED (1900 to February 2015), LILACS (1982 to February 2015), World Health Organization Clinical Trials Search Portal (accessed 26 February 2015), and the metaRegister of Controlled Trials (accessed 26 February 2015). We scrutinised the reference lists of the retrieved publications. Randomised clinical trials irrespective of blinding, language, or publication status for assessment of benefits and harms. Observational studies for assessment of harms. We planned to summarise data from randomised clinical trials using standard Cochrane methodologies and assessed according to the GRADE approach. We found no randomised clinical trials assessing antifibrinolytic amino acids for treating upper gastrointestinal bleeding in people with acute or chronic liver disease. We did not identify quasi-randomised, historically controlled, or observational studies in which we could assess harms. This updated Cochrane review identified no randomised clinical trials assessing the benefits and harms of antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or

Post-Eocene tectonics of the Central Taurus Mountains

Directory of Open Access Journals (Sweden)

Ergün AKAY

1988-06-01

Full Text Available In post-Eocene time, the Central Taurus mountains have been subjected to four episodes of compression in probably Upper Eocene — Lower Oligocene, Langhian, Upper Tortonian, and Upper Pliocene to recent times. In the Upper Eocene — Lower Oligocene compressional period, Ecemiş, and Beyşehir conjugate faults which have both vertical and lateral components have been formed after an N - S compression. In the Langhian compression period, the Lycian nappes were emplaced from the NW to SE and this tectonic movement has also effected the Antalya and the Adana Miocene basins. In the Upper Tortonian compression period, firstly a WSW-ENE compression has resulted in the formation of Aksu thrust, Kırkkavak oblique reverse fault, Köprüçay syncline, Beşkonak anticline, Radyoring anticline, Taşağıl syncline and Kargı reverse faults. In this period a later phase of N — S compression has formed Çakallar folds, Gökçeler normal fault, the smooth anticline in Mut Karaman and the syncline in Ulukışla. In the latest compressional period from Upper Pliocene to recent, first on E — W compression which can be recognized by some mesoscopic faults has been developed and later a N — S compression resulted in the formation of the active faults on Ecemiş and Gökçeler faults, and the Antalya bay graben.

Left ventricular filling under elevated left atrial pressure

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Gaddam, Manikantam; Samaee, Milad; Santhanakrishnan, Arvind

2017-11-01

Left atrial pressure (LAP) is elevated in diastolic dysfunction, where left ventricular (LV) filling is impaired due to increase in ventricular stiffness. The impact of increasing LAP and LV stiffness on intraventricular filling hemodynamics remains unclear. We conducted particle image velocimetry and hemodynamics measurements in a left heart simulator (LHS) under increasing LAP and LV stiffness at a heart rate of 70 bpm. The LHS consisted of a flexible-walled LV physical model fitted within a fluid-filled chamber. LV wall motion was generated by a piston pump that imparted pressure fluctuations in the chamber. Resistance and compliance elements in the flow loop were adjusted to obtain bulk physiological hemodynamics in the least stiff LV model. Two LV models of increasing stiffness were subsequently tested under unchanged loop settings. LAP was varied between 5-20 mm Hg for each LV model, by adjusting fluid level in a reservoir upstream of the LV. For constant LV stiffness, increasing LAP lowered cardiac output (CO), while ejection fraction (EF) and E/A ratio were increased. For constant LAP, increasing LV stiffness lowered CO and EF, and increased E/A ratio. The implications of these altered hemodynamics on intraventricular filling vortex characteristics will be presented.

CT quantification of central airway in tracheobronchomalacia

Energy Technology Data Exchange (ETDEWEB)

Im, Won Hyeong; Jin, Gong Yong; Han, Young Min; Kim, Eun Young [Dept. of Radiology, Chonbuk National University Hospital, Jeonju (Korea, Republic of)

2016-05-15

To know which factors help to diagnose tracheobronchomalacia (TBM) using CT quantification of central airway. From April 2013 to July 2014, 19 patients (68.0 ± 15.0 years; 6 male, 13 female) were diagnosed as TBM on CT. As case-matching, 38 normal subjects (65.5 ± 21.5 years; 6 male, 13 female) were selected. All 57 subjects underwent CT with end-inspiration and end-expiration. Airway parameters of trachea and both main bronchus were assessed using software (VIDA diagnostic). Airway parameters of TBM patients and normal subjects were compared using the Student t-test. In expiration, both wall perimeter and wall thickness in TBM patients were significantly smaller than normal subjects (wall perimeter: trachea, 43.97 mm vs. 49.04 mm, p = 0.020; right main bronchus, 33.52 mm vs. 42.69 mm, p < 0.001; left main bronchus, 26.76 mm vs. 31.88 mm, p = 0.012; wall thickness: trachea, 1.89 mm vs. 2.22 mm, p = 0.017; right main bronchus, 1.64 mm vs. 1.83 mm, p = 0.021; left main bronchus, 1.61 mm vs. 1.75 mm, p = 0.016). Wall thinning and decreased perimeter of central airway of expiration by CT quantification would be a new diagnostic indicators in TBM.

Radioecological monitoring of transboundary rivers of the Central Asian Region

International Nuclear Information System (INIS)

Yuldashev, B.S.; Salikhbaev, U.S.; Kist, A.A.; Radyuk, D.S.; Vdovina, E.D.; Zhuk, L.I.

2005-01-01

Results of radioecological investigation of Central Asian rivers are presented. Investigation was done as part of the Navruz Project, a cooperative, transboundary river monitoring project involving rivers and institutions in Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan, and facilitated by Sandia National Laboratories in the United States. The study of waterborne radionuclides and metals concentrations in Central Asia is of particular interest because of the history of nuclear materials mining, fabrication, transport, and storage there, when it was part of the Soviet Union. This development left a legacy of radionuclides and metals contamination in some Central Asian regions, which poses a clear health hazard to populations who rely heavily upon surface water for agricultural irrigation and direct domestic consumption. (author)

The Analysis on Leading industries in Central Java Province

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Setyani Irmawati

2016-06-01

Full Text Available The purpose of this research is for identifying the types of industriesthat become leading industries in Central Java Province. The methods, used are LQ (SLQ and DLQ and Shift Share. The result of this research shows that the the leading industries in Central Java Province are beverage industry, tobacco processing industry, textile industry, apparel industry, wood industry, printing industry, furniture industry and other processing industries.In the future, the development of the industry should not only focus on the leading industries  but also onnon-leading industries, so that the non leading industries will not be left behind.

Right-sided dominance of the bilateral vestibular system in the upper brainstem and thalamus.

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Dieterich, Marianne; Kirsch, V; Brandt, T

2017-10-01

MRI diffusion tensor imaging tractography was performed on the bilateral vestibular brainstem pathways, which run from the vestibular nuclei via the paramedian and posterolateral thalamic subnuclei to the parieto-insular vestibular cortex. Twenty-one right-handed healthy subjects participated. Quantitative analysis revealed a rope-ladder-like system of vestibular pathways in the brainstem with crossings at pontine and mesencephalic levels. Three structural types of right-left fiber distributions could be delineated: (1) evenly distributed pathways at the lower pontine level from the vestibular nuclei to the pontine crossing, (2) a moderate, pontomesencephalic right-sided lateralization between the pontine and mesencephalic crossings, and (3) a further increase of the right-sided lateralization above the mesencephalic crossing leading to the thalamic vestibular subnuclei. The increasing lateralization along the brainstem was the result of an asymmetric number of pontine and mesencephalic crossing fibers which was higher for left-to-right crossings. The dominance of the right vestibular meso-diencephalic circuitry in right-handers corresponds to the right-hemispheric dominance of the vestibular cortical network. The structural asymmetry apparent in the upper brainstem might be interpreted in relation to the different functions of the vestibular system depending on their anatomical level: a symmetrical sensorimotor reflex control of eye, head, and body mediated by the lower brainstem; a lateralized right-sided upper brainstem-thalamic function as part of the dominant right-sided cortical/subcortical vestibular system that enables a global percept of body motion and orientation in space.

Periodontal probing of an impacted tooth recovered through a surgical-orthodontic approach: a case report.

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Dinoi, Maria Teresa; Lacarbonara, Mariano; Dimartino, Salvatore; Monaco, Annalisa; Marzo, Giuseppe

2014-01-27

The aim of this work was to assess the periodontal support of a central upper incisor recovered through a surgical-orthodontic approach compared to the spontaneously erupted contralateral incisor. This case study describes an 8-year-old Caucasian female with an impacted upper right central incisor. Surgical-orthodontic treatment was performed to reset the impacted dental element in the arch. Periodontal probing was performed of all sites (mesio-buccal, central-buccal, disto-buccal, mesio-palatal, central-palatal and disto-palatal) of the recovered impacted tooth and the contralateral tooth. The results were compared to determine whether the treated element showed signs of periodontal injury. Most of the probing results on both her right and left incisors gave values of approximately 3mm, which were not considered pathological. Both dental elements had adequate and physiological osseous attachments.

Estimation of eddy diffusivity coefficient of heat in the upper layers of equatorial Arabian Sea

Digital Repository Service at National Institute of Oceanography (India)

Zavialov, P.O.; Murty, V.S.N.

in the Central Equatorial Arabian Sea (CEAS). A comparison of the model computed K sub(h) values with those estimated from the heat balance of the upper layer (50 m) of the sea shows good agreement in the region of weak winds (CEAS) or low turbulent mixing regime...

A conservative approach to a thoracic duct injury caused by left subclavian vein catheterization

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Vedran Premuzic

2018-01-01

Full Text Available Thoracic duct injury is a rare complication of left subclavian vein catheterization. A significant injury could lead to chylothorax, a condition with high mortality rate if not treated. It is diagnosed with lymphography or by laboratory tests of pleural fluid aspirate. A 51 year old Caucasian male with a history of unregulated hypertension presented to our Emergency department (ED with anginous symptoms and increased serum creatinine level. After the placement of a temporary central venous catheter for hemodialysis in left subclavian vein, he developed lymph leakage on puncture site beside the catheter, at drainage rate of 75 ml/h. In the absence of more serious clinical symptoms, conservative treatment with close patient monitoring and diet changes was chosen, rather than more invasive treatment options.

Pucarilla-Cerro Tipillas volcanic complex: the oldest recognized caldera in the southeastern portion of central volcanic zone of Central Andes?

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Guzman, Silvina; Petrinovic, Ivan [CONICET -IBIGEO. Museo de Cs. Naturales, Universidad de Salta, Mendoza 2 (4400), Salta (Argentina)], E-mail: guzmansilvina@gmail.com

2008-10-01

We recognize the most eastern and oldest collapse caldera structure in the southern portion of the Central Volcanic Zone of the Andes. A description of Middle-Upper Miocene successions related to explosive- effusive events is presented. The location of this centre close to Cerro Galn Caldera attests a recurrence in the volcanism between 12 and 2 Ma in this portion of the Altiplano - Puna Plateau.

The impact of anthropogenic factors on the occurrence of molybdenum in stream and river sediments of central Upper Silesia (Southern Poland

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Pasieczna Anna

2017-12-01

Full Text Available In our study, a detailed survey was conducted with the aim to determine the distribution and possible anthropogenic sources of molybdenum in river and stream sediments in the central Upper Silesian Industrial Region (Southern Poland, where for many years, iron and zinc smelters as well as coking and thermal power plants were operating. At the same time, this has also been a residential area with the highest population density in the country. Sediments (1397 samples in total were collected from rivers and streams, and analysed for the content of molybdenum and 22 other elements. ICP-AES and CV-AAS methods were applied for the determination of the content of elements. The studies revealed molybdenum content in the range of 5 mg·kg−1. The spatial distribution of molybdenum demonstrated by the geochemical map has indicated that the principal factor determining its content in sediments is the discharge of wastewater from steelworks and their slag heaps. Another source of this element in sediments has been the waste of the historical mining of zinc ore and metallurgy of this metal. Additionally, molybdenum migration from landfills of power plants, coal combustion and Mo emission to the atmosphere and dust fall-out have been significant inputs of Mo pollution to the sediments.

Revascularization of an impacted, immature dilacerated permanent maxillary central incisor associated with odontoma and a supernumerary tooth

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Priya Subramaniam

2013-01-01

Full Text Available To intentionally replant an impacted immature permanent maxillary central incisor in the mixed dentition period followed by revascularization in order to achieve apical root closure. A 9-year-old boy presented with retained maxillary left primary incisors. Radiographic evaluation revealed the presence of a supernumerary tooth and an odontoma associated with an impacted permanent maxillary left central incisor, having root dilaceration. Treatment included surgical removal of mesiodens and odontoma. The impacted dilacerated permanent central incisor was removed and intentionally replanted, followed by revascularization of pulp. During the follow-up, root end closure with narrowing of canal space was observed, patient has been asymptomatic and the tooth remains vital. Revascularization of the immature reimplanted tooth showed continued root development and thickening of the lateral dentinal walls through deposition of new hard tissue and narrowing of the canal space.

[Morphometric features of the structure of the central nucleus of the amygdala in men and women].

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Antyukhov, A D

2015-01-01

To identify the interhemispheric asymmetry in the structure of the central nucleus of the amygdala in men and women. Morphometric features of the structure of neurons of the central nucleus amygdala complex were studied in histological sections of the brain of 6 men and 6 women (24 hemispheres), aged 19 to 55 years, with no lifetime diagnosis of mental or neurological disease. The value of the profile fields of neurons of the central nucleus amygdala complex in the left and right hemispheres of the brain were investigated. In women, the average value of neurons in the left hemisphere was somewhat greater than in the right hemisphere, while in men this value was greater in the right hemisphere. The interhemispheric morphometric differences were not significant regardless of gender. In addition, the quantity of relevant fields of neurons in the central nucleus of the amygdala in women was significantly larger than that of men in both hemispheres. The authors attempted to associate the results obtained in the study with emotional perception in men and women.

Topography of the accessory left gastric artery (ALGA) analyzed by CT angiography from the left hepatic artery

International Nuclear Information System (INIS)

Shioyama, Yasukazu; Takasaka, Isao; Onaya, Hiroaki

2003-01-01

To avoid gastric complications when we perform transcatheter treatment via left hepatic artery, we analyzed the topography of ALGA (accessory left gastric artery) by left hepatic arteriography and CT angiography from left hepatic artery. Six hundred seventy eight cases of CT angiography were performed between 1995 and 2000. Among them, selective left hepatic arteriography was done in 85 cases. We analyzed the frequency and the course of ALGA on the hepatic angiogram and CT angiogram. ALGA were identified in eighteen (21.2 %) of the 85 cases. We classified them into eleven cases of the proximal type and six cases of the distal type. When ALGA bifurcated from the left hepatic artery very close to the bifurcation of A2 (dorsolateral branch) and A3 (ventrolateral branch), we classified them as the distal type on hepatic angiogram. On the other hand, when ALGA bifurcated from the left hepatic artery apart from the bifurcation of A2 and A3 they were classified as the proximal type. In one rare case ALGA originated from the dorsolateral branch of the left hepatic artery. ALGA were classified as the distal and proximal types. Distal type of ALGA often overlapped dorsolateral branch of the left hepatic artery, and it was sometimes difficult to notice the existence of them. We should check the existence of ALGA on the arterial phase of dynamic CT before we plan to make a transcatheter treatment from the left hepatic artery. Then we can avoid gastric complications caused by a transcatheter treatment from the left hepatic artery. (author)

The "Geomorphologic Diagonal" of Central Europe - towards a new morphotectonic interpretation of macroforms in average mountains

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Zoeller, Ludwig

2016-04-01

Modern methods of low temperature thermochronology are able to throw light on the geomorphological development of macrorelief landforms. A rarely investigated problem concerns the orientation and morphotectonic evolution of Central European uplands (low to mid-elevation mountain ranges). A conspicuous NW-SE striking boundary takes course through Germany from the Osning and Teutoburg Forest in the NW to the Bavarian Forest in the SE. I call this line the "geomorphological diagonal". East of this line, more or less NW-SE striking morphotectonic features (e.g., Harz Mountains, Sudety) dominate the macrorelief up to the eastern border of Central Europe (Thornquist-Teysseire Lineament), with the exception of the Ohre Rift and Central Bohemia. West of this line, the macrorelief is either characterized by NNE-SSW to N-S oriented structures (e.g., Upper Rhine Rift) and, to a lesser extent, by (S)SW-(E)NE mountain ranges (southern Rhenish Slate Mountains and Ore Mountains) or by no predominance at all. In the Lower Rhine Embayment and along the Middle Rhine River, (N)NW-(S)SE directed morphotectonic features influence the low mountain ranges. In several cases geologists have proven that NW-SE morphotectonic structures are related to the Upper Cretaceous (Santonian to Campanian) "basin inversion" (e.g., von Eynatten et al. 2008). A compilation of low temperature thermochronological data (AFT, [U-Th]/He) from Central Europe clearly supports strong crustal cooling during the Upper Cretaceous and lowermost Tertiary in morphotectonically protruded crustal blocks east of the geomorphological diagonal, whereas west of it the age data available so far exhibit a much larger scatter from Upper Paleozoic to Tertiary without clear evidence of an outstanding Upper Cretaceous crustal cooling event. Based on this data I hypothesize that east of the diagonal macroforms of uplifted denudation surfaces ("peneplains" or "etchplains") may be inherited from the Cretaceous whereas west of it

Detection of Mg spinel lithologies on central peak of crater ...

Indian Academy of Sciences (India)

identified Fe bearing Mg-spinel-rich rock types are defined by their strong 2-μm ... The Modified Gaussian Modeling (MGM) analysis ... study the deep crustal and/or upper mantle composition and may lead to a fresh ... Lunar surface; Mg-spinel; central peak; Theophilus; remote sensing. .... The explanation of these spec-.

Left Atrial Decompression by Percutaneous Left Atrial Venting Cannula Insertion during Venoarterial Extracorporeal Membrane Oxygenation Support

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Ha Eun Kim

2016-06-01

Full Text Available Patients with venoarterial extracorporeal membrane oxygenation (ECMO frequently suffer from pulmonary edema due to left ventricular dysfunction that accompanies left heart dilatation, which is caused by left atrial hypertension. The problem can be resolved by left atrium (LA decompression. We performed a successful percutaneous LA decompression with an atrial septostomy and placement of an LA venting cannula in a 38-month-old child treated with venoarterial ECMO for acute myocarditis.

Social aspects of left-handedness

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Belojević Goran

2010-01-01

Full Text Available Throughout human history left-handedness has been considered as sinful. It has been associated with the devil, weakness, female gender, unhealthiness, evil, something that has to be turned to a “good” - right side by force. Left-handedness is being more and more acceptable at rational level, but in everyday life it is still considered to be unusual if someone writes with the left hand. Lessening of the number of lefthanders is associated with ageing. There are about 13% lefthanders among people in twenties and less than 1% lefthanders among those in eighties. This finding may be explaned with more pronounced socio-cultural pressure on left-handed people in the past, compared to nowadays. On the other hand, this may also support the hypothesis about a reduced life span of lefthanded people. With cross-exercising of left-handedness, certain typical characteristics and behavioral patterns appear in these people. This was a sort of provoked behavior and an attack on the integrity of an emotional attitude toward oneself. Stuttering may also appear as a consequence of unsuccessful cross-exercising of left-handedness. The hypothesis about left-handedness as an advantage is supported with the reports about relatively more lefthanders in some specific groups such as: mathematicians, sculptors, architects, painters, musicians, actors, tennis players, as well as famous army commanders and rulers.

North Central Regional Geologic Characterization Report. Executive summary. Final report

International Nuclear Information System (INIS)

1985-08-01

This Executive Summary of the final North Central Regional Geologic Characterization Report (RGCR) is issued primarily for public information purposes and provides a general overview of the report. The complete RGCR presents available regional geologic information pertinent to siting a repository for high-level nuclear waste in crystalline rock in Minnesota, Wisconsin, and the Upper Peninsula of Michigan. For each of the states within the North Central Region, information is provided on the geologic disqualifying factor and the geologic regional screening variables to be used in region-to-area screening

A left „theocracy“: The church and the state in revolutionary Nicaragua

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Jakopovich Daniel

2014-01-01

Full Text Available This paper analyses the antagonism between the established (Nicaraguan and global Catholic Church and the Sandinista movement and government, which was one of the focal points for the ascendancy of a continental and global liberation theology movement. The paper provides a critical overview of the Nicaraguan liberation theology movement, as well as Sandinista strategies, primarily in relation to the social functions of religion and religious institutions. The central focus of this essay is to identify how the left-theological and Sandinista understanding of the imperatives of the counter-hegemonic project, the „historical bloc“ (conceived as a system of political and social networks and alliances and the „national-popular“ strategy contributed to the tentative naissance of a novel state religion and a novel political project: a left-wing „theocratic“ social order. The Nicaraguan experience is useful for focusing the wider discussion about the importance of context-specific normative judgments about Church-state relations.

Left ventricular assist device implantation via left thoracotomy: alternative to repeat sternotomy.

Science.gov (United States)

Pierson, Richard N; Howser, Renee; Donaldson, Terri; Merrill, Walter H; Dignan, Rebecca J; Drinkwater, Davis C; Christian, Karla G; Butler, Javed; Chomsky, Don; Wilson, John R; Clark, Rick; Davis, Stacy F

2002-03-01

Repeat sternotomy for left ventricular assist device insertion may result in injury to the right heart or patent coronary grafts, complicating intraoperative and postoperative management. In 4 critically ill patients, left thoracotomy was used as an alternative to repeat sternotomy. Anastomosis of the outflow conduit to the descending thoracic aorta provided satisfactory hemodynamic support.

Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement

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Guilherme dos Santos Trento

2015-12-01

Full Text Available Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%. Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002. Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness.

Effect of left ventricular diastolic dysfunction on left atrial appendage function and thrombotic potential in nonvalvular atrial fibrillation.

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Demirçelik, Muhammed Bora; Çetin, Mustafa; Çiçekcioğlu, Hülya; Uçar, Özgül; Duran, Mustafa

2014-05-01

We aimed to investigate effects of left ventricular diastolic dysfunction on left atrial appendage functions, spontaneous echo contrast and thrombus formation in patients with nonvalvular atrial fibrillation. In 58 patients with chronic nonvalvular atrial fibrilation and preserved left ventricular systolic function, left atrial appendage functions, left atrial spontaneous echo contrast grading and left ventricular diastolic functions were evaluated using transthoracic and transoesophageal echocardiogram. Patients divided in two groups: Group D (n=30): Patients with diastolic dysfunction, Group N (n=28): Patients without diastolic dysfunction. Categorical variables in two groups were evaluated with Pearson's chi-square or Fisher's exact test. The significance of the lineer correlation between the degree of spontaneous echo contrast (SEC) and clinical measurements was evaluated with Spearman's correlation analysis. Peak pulmonary vein D velocity of the Group D was significantly higher than the Group N (p=0.006). However, left atrial appendage emptying velocity, left atrial appendage lateral wall velocity, peak pulmonary vein S, pulmonary vein S/D ratio were found to be significantly lower in Group D (p=0.028, patrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities respectively (r=-0.438, r=-0.328, r=-0.233, r=-0.447). Left atrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities were significantly lower in SEC 2-3-4 than SEC 1 (p=0.003, p=0.029, patrial fibrillation and preserved left ventricular ejection fraction, left atrial appendage functions are decreased in patients with left ventricular diastolic dysfunction. Left ventricular diastolic dysfunction may constitute a potential risk for formation of thrombus and stroke.

Searching pristine source of two gabbric plutons outcroping in Central Sierras Pampeanas Range, Argentina

International Nuclear Information System (INIS)

Daziano, C.; Ayala, R.

2010-01-01

This work is about the study of two gabbric plutons outcrop ing throughout Central Sierras Pampeanas range (Cordoba province, Argentina). San Lorenzo hill gabbric plutons is in the Upper proterozoic age whereas Cañada del Puerto belongs to the Early proterozoic.They are stock-type igneous bodies and they are intrusive s in an Upper Precambrian crystalline basement; it is mainly composed by gneisses, migmatites, schistes, marbles, amphibolite s, tact's, serpentinites and related rocks

Right colon cancer: Left behind.

Science.gov (United States)

Gervaz, P; Usel, M; Rapiti, E; Chappuis, P; Neyroud-Kaspar, I; Bouchardy, C

2016-09-01

Prognosis of colon cancer (CC) has steadily improved during the past three decades. This trend, however, may vary according to proximal (right) or distal (left) tumor location. We studied if improvement in survival was greater for left than for right CC. We included all CC recorded at the Geneva population-based registry between 1980 and 2006. We compared patients, tumor and treatment characteristics between left and right CC by logistic regression and compared CC specific survival by Cox models taking into account putative confounders. We also compared changes in survival between CC location in early and late years of observation. Among the 3396 CC patients, 1334 (39%) had right-sided and 2062 (61%) left-sided tumors. In the early 1980s, 5-year specific survival was identical for right and left CCs (49% vs. 48%). During the study period, a dramatic improvement in survival was observed for patients with left-sided cancers (Hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.29-0.62, p colon cancer patients, those with right-sided lesions have by far the worse prognosis. Change of strategic management in this subgroup is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

Oncoplastic Surgery for Upper/Upper Inner Quadrant Breast Cancer.

Science.gov (United States)

Lin, Joseph; Chen, Dar-Ren; Wang, Yu-Fen; Lai, Hung-Wen

2016-01-01

Tumors located in the upper/upper inner quadrant of the breast warrant more attention. A small lesion relative to the size of breast in this location may be resolved by performing a level I oncoplastic technique. However, a wide excision may significantly reduce the overall quality of the breast shape by distorting the visible breast line. From June 2012 to April 2015, 36 patients with breast cancer located in the upper/upper inner quadrant underwent breast-conservation surgery with matrix rotation mammoplasty. According to the size and location of the tumor relative to the nipple-areola complex, 11 patients underwent matrix rotation with periareolar de-epithelialization (donut group) and the other 25 underwent matrix rotation only (non-donut group). The cosmetic results were self-assessed by questionnaires. The average weights of the excised breast lumps in the donut and non-donut groups were 104.1 and 84.5 g, respectively. During the 3-year follow-up period, local recurrence was observed in one case and was managed with nipple-sparing mastectomy followed by breast reconstruction with prosthetic implants. In total, 31 patients (88.6%) ranked their postoperative result as either acceptable or satisfactory. The treated breasts were also self-evaluated by 27 patients (77.1%) to be nearly identical to or just slightly different from the untreated side. Matrix rotation is an easy breast-preserving technique for treating breast cancer located in the upper/upper inner quadrant of the breast that requires a relatively wide excision. With this technique, a larger breast tumor could be removed without compromising the breast appearance.

Doplervelocimetria das artérias oftálmica e central da retina em gestantes normais Dopplervelocimetry of ophthalmic and central retinal arteries in normal pregnancies

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Angélica Lemos Debs Diniz

2005-04-01

evaluate ophthalmic and retinal central artery Doppler indices during the second and third trimesters of normal pregnancy and to compare the right with left eye Doppler indices of normotensive women. METHODS: a cross-sectional study which evaluated central retinal and ophthalmic artery Doppler velocimetry values of 51 normal pregnant women, in the 20th to 38th week of gestation. The following values were analyzed: pulsatility and resistance indexes (PI, RI, peak systolic and end-diastolic flow velocity (PSV, EDFV and peak velocity ratio (PVR. The Doppler indices in the right and left eyes were studied by the median. The paired Student's t test was used to confront the right and left eye values and the Pearson linear correlation analysis was performed to study the value changes throughout the gestation, with the level of significance set at 5%. RESULTS: Doppler velocimetry indices of ophthalmic and central retinal arteries (median values were, respectively: PI=1.83; RI=0.78; PSV=34.20; EDFV=6.80; PVR=0.48 and PI=1.34; RI=0.70; PSV=7.40; EDFV=2.10. There was no significant difference between the right and left side Doppler values. Linear correlation analysis showed no association between the arterial values and pregnancy age. CONCLUSION: the unilateral analysis of ophthalmic and central retinal artery Doppler velocimetry values can be used in systemic maternal disease. There is no significant change in ophthalmic and central retinal artery Doppler velocimetry values throughout normal pregnancy.

Segmental omental infarction in childhood: an unusual case of left-sided location with extension into the pelvis

International Nuclear Information System (INIS)

Foscolo, Sylvain; Mandry, Damien; Galloy, Marie-Agnes; Claudon, Michel; Champigneulles, Jacqueline; Miscault, Godefroy de

2007-01-01

Segmental omental infarction (OI) is a rare cause of abdominal pain in children. It generally occurs in the right lower and upper quadrants of the abdomen and only a few cases of other locations have been described in adults. We report a unique paediatric case of OI with an unusual left-sided location extending into the pelvis in a 6-year-old non-obese girl. The diagnosis was suspected on US and CT based on imaging patterns previously described in adults and children. Laparoscopic resection should be balanced with nonsurgical management. (orig.)

The effect of percutaneous transcatheter occlusion of left atrial appendage on left atrium and adjacent anatomic structure in canine

International Nuclear Information System (INIS)

Yang Zhihong; Wu Hong; Qin Yongwen; Hu Jianqiang; Ding Zhongru; Liu Zongjun; Liu Biao; Zheng Xing

2009-01-01

Objective: To observe the effect of percutaneous transcatheter occlusion of left atrial appendage (LAA) with a new self-manufactured LAA occluder on left atrium and adjacent anatomic structure in canine. Methods: A new self-manufactured LAA occluder was implanted into the LAA through a transseptal catheter in 20 dogs. Before and after the procedure, the experimental dogs were anaesthetized and examined by transthoracic echocardiography (TTE) to measure the diameter and the volume of the left atrium, the left superior pulmonary vein flow velocity and the left atrioventricular valve flow velocity separately. The contrast radiography of the LAA and the left coronary arteriography were performed. Results: The new LAA occluder was implanted successfully in 14 dogs. No obvious changes in the diameter and the volume of the left atrium, in left superior pulmonary vein flow velocity and in left atrioventricular valve flow velocity were found. On arteriography, left circumflex artery was normally displayed after the procedure. No migration of the occluder was seen on TTE and angiography after procedure. Conclusion: Percutaneous transcatheter occlusion of left atrial appendage with a new self-manufactured LAA occluder has no obvious effect on left atrium and adjacent anatomic structure in experimental canine, which indicates that the new-type device is a safe and feasible occluder for LAA. (authors)

Asymmetric extractions in a patient with a hopeless maxillary central incisor, followed by treatment with mini-implant anchorage.

Science.gov (United States)

Jung, Min-Ho

2018-05-01

Premolar extraction is 1 option for treatment of patients with malocclusion and severe crowding or protrusion. When the patient has missing or hopeless teeth other than premolars, it is possible to consider removal of those teeth to use the space to decrease crowding. A 15-year-old girl sought treatment for severe crowding. She had already lost her maxillary right first premolar as a result of caries 1 year previously and had a hopeless maxillary right central incisor. Her mandibular left first molar still caused discomfort even after endodontic treatment. Extractions of the maxillary right central incisor and mandibular right first premolar and left first molar were chosen to resolve the occlusion problems. Orthodontic mini-implants were placed to translocate the maxillary left central incisor across the midpalatal suture to use the space in the maxillary right quadrant to relieve the crowding. Although a different extraction option was used in each quadrant, the final occlusion was acceptable. After debonding, porcelain crowns were placed on the anterior teeth to improve esthetics. The treatment result remained stable after 2 years of retention. Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Crustal and uppermost mantle structure and deformation in east-central China

Science.gov (United States)

Li, H.; Yang, X.; Ouyang, L.; Li, J.

2017-12-01

We conduct a non-linear joint inversion of receiver functions and Rayleigh wave dispersions to obtain the crustal and upper mantle velocity structure in east-central China. In the meanwhile, the lithosphere and upper mantle deformation beneath east-central China is also evaluated with teleseismic shear wave splitting measurements. The resulting velocity model reveals that to the east of the North-South Gravity Lineament, the crust and the lithosphere are significantly thinned. Furthermore, three extensive crustal/lithospheric thinning sub-regions are clearly identified within the study area. This indicates that the modification of the crust and lithosphere in central-eastern China is non-uniform due to the heterogeneity of the lithospheric strength. Extensive crustal and lithospheric thinning could occur in some weak zones such as the basin-range junction belts and large faults. The structure beneath the Dabie orogenic belt is complex due to the collision between the North and South China Blocks during the Late Paleozoic-Triassic. The Dabie orogenic belt is generally delineated by a thick crust with a mid-crust low-velocity zone and a two-directional convergence in the lithospheric scale. Obvious velocity contrast exhibits in the crust and upper mantle at both sides of the Tanlu fault, which suggests the deep penetration of this lithospheric-scale fault. Most of our splitting measurements show nearly E-W trending fast polarization direction which is slightly deviating from the direction of plate motion. The similar present-day lithosphere structure and upper mantle deformation may imply that the eastern NCC and the eastern SCB were dominated by a common dynamic process after late Mesozoic, i.e., the westward subduction of Pacific plate and the retreat of the subduction plate. The westward subduction of the Philippine plate and the long-range effects of the collision between the Indian plate and Eurasia plate during Cenozoic may have also contributed to the present

Methane anomalies in the oxygenated upper waters of the central Baltic Sea associated with zooplankton abundance

Science.gov (United States)

Schmale, Oliver; Wäge, Janine; Morholz, Volker; Rehder, Gregor; Wasmund, Norbert; Gräwe, Ulf; Labrenz, Matthias; Loick-Wilde, Natalie

2017-04-01

Apart from the sediment as the dominant source of methane in the aquatic realm the process of methane production in well-oxygenated waters has received considerable attention during the last years. The paradox of methane accumulation in these relatively shallow waters, commonly termed as "oceanic methane paradox", has been sporadically observed in lakes as well as in marine ecosystems like the Gulf of Mexico, the Black Sea, the Baltic Sea, Arctic waters or above the continental shelf off the coast of Spain and Africa. Even if this phenomenon has been described in the literature over the last decades, the potential sources of shallow methane accumulation are still controversially discussed. We report on methane enrichments that were observed during summer in the upper water column of the Gotland Basin, central Baltic Sea. In the eastern part of the basin methane concentrations just below the thermocline (in about 30 m water depth) varied between 15 and 77 nM, in contrast to the western part of the basin where no methane enrichments could be detected. Stable carbon isotope ratios of methane (delta 13C-CH4 of -67.6‰) clearly indicated its in situ biogenic origin. This is supported by clonal sequences from the depth with high methane concentrations in the eastern Gotland Basin, which cluster with the clade Methanomicrobiacea, a family of methanogenic Archaea. Hydroacoustic observation in combination with plankton net tows displayed a seston enrichment (size >100 micro meter) in a layer between 30-50 m depth. The dominant species in the phytoplankton, Dinophysis norvegica, was concentrated at 10-20 m depth, and showed higher concentrations in the eastern Gotland Basin in comparison with the western part of the basin. In contrast to the western Gotland Basin, the zooplankton community in the eastern part was dominated by the copepod species Temora longicornis. Laboratory incubations of a T. longicornis dominated seston fraction (>100 micro meter) sampled in the depth

Geochronology and geochemistry of upper proterozoic granites from Southern Benin

International Nuclear Information System (INIS)

Cordani, U.G.; Kawashita, K.; Vancini, K.R.B.; Cadoppi, P.; Sacchi, R.

1993-01-01

The Upper Proterozoic basement of Benin, like that of nearby Nigeria and like the polycyclic basement of Central Hoggar, belongs to the hinterland of the Pharusian Chain (Pan-African Trans-Saharan Belt) generated by the collision between the (passive) margin of the West African craton and the (reactivated) margin of the Tuareg Shield and its southern extension. Rb-Sr dating of sub alkaline, meta-aluminums, syn-Kinematic granite forming tabular bodies near Dassa-Zoume and near Save yielded two WR isochron ages of 650 ± 35 Ma (I.R. = 0.7043) and 705 ± 70 Ma (I.R. = 0.7045). Emplacement of these bodies was clearly controlled by trans current movements along the Kandi Fault System. The analyzed granites are comparable with those of Central Hoggar and North-Central Nigeria on the ground of field, geochronological and geochemical data; they also display some affinities with the late-tectonic granites of the Adrar des Iforas. They are expected to find their Brazilian continuation in the Chaval Granitoids west of Fortaleza, but data for comparison are inadequate. (author)

Upper crustal structure of Madeira Island revealed from ambient noise tomography

Science.gov (United States)

Matos, Catarina; Silveira, Graça; Matias, Luís; Caldeira, Rita; Ribeiro, M. Luísa; Dias, Nuno A.; Krüger, Frank; Bento dos Santos, Telmo

2015-06-01

We present the first image of the Madeira upper crustal structure, using ambient seismic noise tomography. 16 months of ambient noise, recorded in a dense network of 26 seismometers deployed across Madeira, allowed reconstructing Rayleigh wave Green's functions between receivers. Dispersion analysis was performed in the short period band from 1.0 to 4.0 s. Group velocity measurements were regionalized to obtain 2D tomographic images, with a lateral resolution of 2.0 km in central Madeira. Afterwards, the dispersion curves, extracted from each cell of the 2D group velocity maps, were inverted as a function of depth to obtain a 3D shear wave velocity model of the upper crust, from the surface to a depth of 2.0 km. The obtained 3D velocity model reveals features throughout the island that correlates well with surface geology and island evolution.

Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography.

Science.gov (United States)

Kaplanoglu, Hatice; Beton, Osman

2017-04-01

To evaluate the abnormalities and variations of the arterial system of upper extremities and superficial palmar arch with computed tomography angiography and to guide the clinician during this procedure. A total of 156 upper extremities of 78 cases were retrospectively analyzed using computed tomography angiography. The study was approved by the local ethics committee of the hospital. From the analysis of the computed tomography angiography images, the following information was recorded; the diameters and abnormalities of radial, ulnar and brachial arteries in both upper extremities, the presence of atherosclerotic changes or stenosis in these arteries, whether the superficial palmar arch was complete or incomplete, and arterial dominance. Also, the computed tomography angiography classification of superficial palmar arch distribution and anatomic configuration was performed. The mean baseline diameters of the radial, ulnar and brachial arteries of the cases were; 2.8 ± 0.6, 2.5 ± 0.7, and 4.7 ± 0.6 mm, respectively. A complete superficial palmar arch was observed in 69.2 % of the right hands and 70.5 % of the left hands. For the superficial palmar arches on the right side, the radial artery was dominant in two and the ulnar artery was dominant in 47 with the remaining showing codominance. On the left side, the radial artery was dominant in one hand, with the ulnar artery being dominant in 49 cases, and in 28 cases, there was codominance. In the superficial palmar arch classification, four of the arches (A-D) were defined as complete and the remaining three (E-G) as incomplete. The current study clarified different variations in palmar circulation and forearm arteries to aid the surgeon during trans-radial or trans-ulnar catheterization, hemodialysis, or coronary artery bypass grafting.

Pulmonary sequestrations of the upper lobe in children: Three presentations

International Nuclear Information System (INIS)

Hoeffel, J.C.; Bernard, C.; Didier, F.; Bretagne, M.C.; Gautry, P.; Olive, D.; Prevot, J.; Pernot, C.; Hopital des Enfants, 54 - Vandoeuvre-les-Nancy; Hopital des Enfants, 54 - Vandoeuvre-les-Nancy; Hopital des Enfants, 54 - Vandoeuvre-les-Nancy

1986-01-01

Pulmonary sequestrations are congenital abnormalities where nonfunctioning lung tissue receives its vascular supply from the systemic circulation (thoracic or abdominal aorta). It is necessary to establish the diagnosis in childhood when the lesions are uncomplicated. The authors present three cases of sequestration of the apex (2 extralobar and 1 atypical) with the main clinical and radiological features. Sequestrations in the upper lobe are rare, and the usual site is the left lower lobe. Plain X-rays show a dense opacity, sometimes with an air-fluid level: angiography is currently the best mean for definitive diagnosis; however, computed tomography will probably be very useful in the future. Differential diagnosis includes tumours of the superior mediastinum (neurogenic tumours, digestive duplication, bronchogenic cysts, pheochromocytoma and hydatid cysts). (orig.) [de

The New Left in the European Democracies: The Case of the German Radical Left

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Marco Damiani

2015-03-01

Full Text Available The new form of the social and political conflict cannot be explained by the traditional categories of right and left, but it articulates to them on two plans, that of the establishment, intended like plan of the structured political conflict from the traditional actors, and that of the anti-establishment, in which new representations of politics emerge. The New Left is characterized by type of intermittent participation and new perspectives on mobilization inside the parties and the social movements. This type of parties differs moreover from the traditional ones left of the socialist and social democratic left in not arranging of organizations collaterals placed under the direction of the leadership of the same party. The mobilization that spontaneously assumes not conventional forms of active participation of the citizens, or is primed by the action of an associative network of which the same parties take part, than however does not monopo-lize the collective action. In this regard, the attention will be dedicated to the study of Die Linke: an anti-establishment party of the non-socialist German left-wing, heir to the communist tradition. The choice was affected to the German model because: 1 Germany is a country with a strong social democratic tradition, but 25 years after the fall of the Berlin Wall the German political system identifies a new antagonist political party; 2 Die Linke represents an interesting case in the political landscape of the European radical left because is a one-party that gives up at the federation of parties to try to unify the political parties of German radical left-wing.

Local Upper Mantle Upwelling beneath New England: Evidence from Seismic Anisotropy.

Science.gov (United States)

Levin, V. L.; Long, M. D.; Lopez, I.; Li, Y.; Skryzalin, P. A.

2017-12-01

mantle fabric detected throughout the region. Figure 1. Splitting intensity (red circles) plotted over best-fitting sinusoidal functions (blue, parameters in upper right) and predictions based on average delays and fast polarizations (green, parameters in upper left). Outlines of the NAA at 200 km depth from tomographic studies using Earthscope data.

Bilateral chylothorax in a patient with chronic central vein thrombosis and chronic thromboembolic pulmonary hypertension

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Avdhesh Bansal

2015-01-01

Full Text Available The chylothorax is not a common presentation, and bilateral chylothorax in patients with chronically high central venous pressure secondary to venous thrombosis is a rare in incidence. We reported a case of bilateral chylothorax in a patient of chronic deep vein thrombosis (DVT in central veins with chronic thromboembolic pulmonary hypertension who presented with 2 weeks history of increased breathlessness, bilateral chest discomfort and weakness. Work-up with chest X-ray and ultrasonography-chest showed gross left sided and mild right sided pleural effusion, thoracocentesis was consistent with chylothorax. Contrast enhanced computed tomography-chest showed multiple collateral formation of left side subclavian vein, venous Doppler showed old DVT in right and left subclavian veins and two-dimensional echocardiogram showed finding of severe pulmonary hypertension. After 24 h of fasting and conservative management, pleural drain became clear and decreased in the amount. Patient′s video assisted thoracoscopic surgery was done, and thoracic duct was ligated and cut down at diaphragmatic level and bilateral talc pleurodesis done. Patient improved clinically and radiologically.

Vegetation Response to Upper Pliocene Glacial/Interglacial Cyclicity in the Central Mediterranean

Science.gov (United States)

Combourieu-Nebout, Nathalie

1993-09-01

New detailed pollen analysis of the lower part of the Upper Pliocene Semaforo section (Crotone, Italy) documents cyclic behavior of vegetation at the beginning of the Northern Hemisphere glaciations. The competition between four vegetation units (subtropical humid forest, deciduous temperate forest, altitudinal coniferous forest, and open xeric assemblage) probably reflects modifications of vegetation belts at this montane site. Several increases in herbaceous open vegetation regularly alternate with subtropical humid forest, which expresses rapid climatic oscillations. The complete temporal succession—deciduous forest (rich in Quercus), followed by subtropical humid forest (Taxodiaceae and Cathaya), then altitudinal coniferous forest ( Tsuga, Cedrus, Abies, and Picea), and finally herbaceous open vegetation (Graminae, Compositae, and Artemisia )—displays the climatic evolution from warm and humid interglaciation to cold and dry glaciation. It also suggests an independent variation of temperature and humidity, the two main climatic parameters. The vegetation history of southern Calabria recorded in the Semaforo section have been correlated with the ∂ 18O signal established in the Atlantic Ocean.

What is Beyond Right/Left?

DEFF Research Database (Denmark)

Dyrberg, Torben Bech

2009-01-01

The article looks at New Labour's move beyond right/left in the mid/late 1990s, which is an occasion to spell out the nature of right/left and what it means for democracy. In contrast to both defenders and critics of this move I argue in the first part that right/left is not an empty label bound up...... with the cleavage-lines of industrial society, but that it is an orientational metaphor which is articulated with others-in/out, up/down and front/back-and that we are in the process of moving beyond the industrial society right/left prototype. The second part looks at where New Labour is heading when moving beyond...... right/left. I argue that the new hegemonic orientation is that of front/back, which designs political renewal as a response to the social changes cutting across the outdated lines of contestation of partisan politics. The democratic problem of this move lies in squeezing politics between technocratic...

Diagnostic accuracy of ultrasound in upper and lower extremity long bone fractures of emergency department trauma patients.

Science.gov (United States)

Frouzan, Arash; Masoumi, Kambiz; Delirroyfard, Ali; Mazdaie, Behnaz; Bagherzadegan, Elnaz

2017-08-01

Long bone fractures are common injuries caused by trauma. Some studies have demonstrated that ultrasound has a high sensitivity and specificity in the diagnosis of upper and lower extremity long bone fractures. The aim of this study was to determine the accuracy of ultrasound compared with plain radiography in diagnosis of upper and lower extremity long bone fractures in traumatic patients. This cross-sectional study assessed 100 patients admitted to the emergency department of Imam Khomeini Hospital, Ahvaz, Iran with trauma to the upper and lower extremities, from September 2014 through October 2015. In all patients, first ultrasound and then standard plain radiography for the upper and lower limb was performed. Data were analyzed by SPSS version 21 to determine the specificity and sensitivity. The mean age of patients with upper and lower limb trauma were 31.43±12.32 years and 29.63±5.89 years, respectively. Radius fracture was the most frequent compared to other fractures (27%). Sensitivity, specificity, positive predicted value, and negative predicted value of ultrasound compared with plain radiography in the diagnosis of upper extremity long bones were 95.3%, 87.7%, 87.2% and 96.2%, respectively, and the highest accuracy was observed in left arm fractures (100%). Tibia and fibula fractures were the most frequent types compared to other fractures (89.2%). Sensitivity, specificity, PPV and NPV of ultrasound compared with plain radiography in the diagnosis of upper extremity long bone fractures were 98.6%, 83%, 65.4% and 87.1%, respectively, and the highest accuracy was observed in men, lower ages and femoral fractures. The results of this study showed that ultrasound compared with plain radiography has a high accuracy in the diagnosis of upper and lower extremity long bone fractures.

Central Sleep Apnea in Patients due to Severe Aortic Stenosis

Directory of Open Access Journals (Sweden)

Christian Prinz

2010-01-01

Full Text Available History. We report about the course of central sleep apnea (CSA in 3 patients (70.3±15.2 years with severe aortic stenosis (AS (AVA≤1.0 cm2, NYHA 2.7±1.4. Investigations. Every patient received echocardiography, left/right-heart catheterization, and cardiorespiratory polygraphy before and 6 months after surgical aortic valve replacement (without right-heart catheterization during follow up. Course. Preoperatively all patients demonstrated reduced systolic left ventricular function (EF <55%. They had elevated pulmoraryarterialy pressures and severe CSA. After valve replacement left ventricular function and exercise capacity improved, as well as the severity of CSA. Conclusion. Patients with severe AS can develop CSA, which seems to improve after surgery. Patients with severe AS should be screened for CSA, because CSA might be an additional risk factor and hint that myocardial adaptation is exhausting.

Rare cause of upper gastrointestinal bleeding owing to hepatic cancer invasion: a case report.

Science.gov (United States)

Wu, Wei-Ding; Wu, Jia; Yang, Hong-Guo; Chen, Yuan; Zhang, Cheng-Wu; Zhao, Da-Jian; Hu, Zhi-Ming

2014-09-21

Upper gastrointestinal bleeding refers to bleeding that arises from the gastrointestinal tract proximal to the ligament of Treitz. The primary reason for gastrointestinal bleeding associated with hepatocellular carcinoma is rupture of a varicose vein owing to pericardial hypotension. We report a rare case of gastrointestinal bleeding with hepatocellular carcinoma in a patient who presented with recurrent gastrointestinal bleeding. The initial diagnosis was gastric cancer with metastasis to the multiple lymph nodes of the lesser curvature. The patient underwent exploratory laparotomy, which identified two lesions in the gastric wall. Total gastrectomy and hepatic local excision was then performed. Pathological results indicated that the hepatocellular carcinoma had invaded the stomach directly, which was confirmed immunohistochemically. The patient is alive with a disease-free survival of 1 year since the surgery. Hepatocellular carcinoma with gastric invasion should be considered as a rare cause of upper gastrointestinal bleeding in hepatocellular carcinoma patients, especially with lesions located in the left lateral hepatic lobe. Surgery is the best solution.

A new species of Microglanis(Siluriformes: Pseudopimelodidae from the upper rio Tocantins basin, Goiás State, Central Brazil

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Oscar Akio Shibatta

Full Text Available A new species of Microglanis is described from the upper rio Tocantins basin, Barro Alto, Goiás State, Brazil. This species is distinguished from the others by presenting a unique color pattern, consisting of round spots in the flank between the larger dark brown blotches. Moreover, it can be distinguished by the combination of the following features: caudal fin emarginate, the upper lobe slightly larger than the lower, lateral line relatively long, reaching vertical through posterior margin of the pelvic fin, and light stripe on supra-occipital region absent or very narrow and with irregular shape.

Geometries of geoelectrical structures in central Tibetan Plateau from INDEPTH magnetotelluric data

Science.gov (United States)

Vozar, Jan; Jones, Alan G.; Le Pape, Florian

2013-04-01

Magnetotelluric (MT) data collected on N-S profiles crossing the Banggong-Nujiang Suture, which separates the Qiangtang and Lhasa Terranes in central Tibet, as a part of InterNational DEep Profiling of Tibet and the Himalaya project (INDEPTH) are modeled by 2D and 3D inversion codes. The 2D deep MT model of line 500 confirms previous observations concluding that the region is characterized to first-order by a resistive upper crust and a conductive, partially melted, middle to lower crust that extends from the Lhasa Terrane to the Qiangtang Terrane with varying depth. The same conductive structure setting, but in shallower depths is also present on the eastern 400 line. From deep electromagnetic sounding, supported by independent 1D integrated petro-physical investigation, we can estimate the next upper-mantle conductive layer at depths from 200 km to 250 km below the Lhasa Terrane and less resistive Tibetan lithosphere below the Qiangtang Terrane with conductive upper-mantle in depths about 120 km. The anisotropic 2D modeling reveals lower crustal anisotropy in Lhasa Terrane, which can interpreted as crustal channel flow. The 3D inversion models of all MT data from central Tibet show dominant 2D regional strike of mid and lower crustal structures equal N110E. This orientation is parallel to Shuanghu suture, BengCo Jiali strike-slip fault system and perpendicular to convergence direction. The lower crust conductor in central Lhasa Terrane can be interpreted more likely as 3D lower Indian crust structure, located to the east from line 500, than geoelectrical anisotropic crustal flow.

Oncoplastic Surgery for Upper/Upper Inner Quadrant Breast Cancer.

Directory of Open Access Journals (Sweden)

Joseph Lin

Full Text Available Tumors located in the upper/upper inner quadrant of the breast warrant more attention. A small lesion relative to the size of breast in this location may be resolved by performing a level I oncoplastic technique. However, a wide excision may significantly reduce the overall quality of the breast shape by distorting the visible breast line. From June 2012 to April 2015, 36 patients with breast cancer located in the upper/upper inner quadrant underwent breast-conservation surgery with matrix rotation mammoplasty. According to the size and location of the tumor relative to the nipple-areola complex, 11 patients underwent matrix rotation with periareolar de-epithelialization (donut group and the other 25 underwent matrix rotation only (non-donut group. The cosmetic results were self-assessed by questionnaires. The average weights of the excised breast lumps in the donut and non-donut groups were 104.1 and 84.5 g, respectively. During the 3-year follow-up period, local recurrence was observed in one case and was managed with nipple-sparing mastectomy followed by breast reconstruction with prosthetic implants. In total, 31 patients (88.6% ranked their postoperative result as either acceptable or satisfactory. The treated breasts were also self-evaluated by 27 patients (77.1% to be nearly identical to or just slightly different from the untreated side. Matrix rotation is an easy breast-preserving technique for treating breast cancer located in the upper/upper inner quadrant of the breast that requires a relatively wide excision. With this technique, a larger breast tumor could be removed without compromising the breast appearance.

Bilateral Pneumothoraces Following Central Venous Cannulation

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F. Pazos

2009-01-01

Full Text Available We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax.

Bilateral Pneumothoraces Following Central Venous Cannulation

Science.gov (United States)

Pazos, F.; Masterson, K.; Inan, C.; Robert, J.; Walder, B.

2009-01-01

We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax. PMID:19901997

Neurochemical Architecture of the Central Complex Related to Its Function in the Control of Grasshopper Acoustic Communication

Science.gov (United States)

Kunst, Michael; Pförtner, Ramona; Aschenbrenner, Katja; Heinrich, Ralf

2011-01-01

The central complex selects and coordinates the species- and situation-specific song production in acoustically communicating grasshoppers. Control of sound production is mediated by several neurotransmitters and modulators, their receptors and intracellular signaling pathways. It has previously been shown that muscarinic cholinergic excitation in the central complex promotes sound production whereas both GABA and nitric oxide/cyclic GMP signaling suppress its performance. The present immunocytochemical and pharmacological study investigates the question whether GABA and nitric oxide mediate inhibition of sound production independently. Muscarinic ACh receptors are expressed by columnar output neurons of the central complex that innervate the lower division of the central body and terminate in the lateral accessory lobes. GABAergic tangential neurons that innervate the lower division of the central body arborize in close proximity of columnar neurons and thus may directly inhibit these central complex output neurons. A subset of these GABAergic tangential neurons accumulates cyclic GMP following the release of nitric oxide from neurites in the upper division of the central body. While sound production stimulated by muscarine injection into the central complex is suppressed by co-application of sodium nitroprusside, picrotoxin-stimulated singing was not affected by co-application of this nitric oxide donor, indicating that nitric oxide mediated inhibition requires functional GABA signaling. Hence, grasshopper sound production is controlled by processing of information in the lower division of the central body which is subject to modulation by nitric oxide released from neurons in the upper division. PMID:21980504

A conservative approach to a thoracic duct injury caused by left subclavian vein catheterization

OpenAIRE

Vedran Premuzic; Ranko Smiljanic; Drazen Perkov

2018-01-01

Thoracic duct injury is a rare complication of left subclavian vein catheterization. A significant injury could lead to chylothorax, a condition with high mortality rate if not treated. It is diagnosed with lymphography or by laboratory tests of pleural fluid aspirate. A 51 year old Caucasian male with a history of unregulated hypertension presented to our Emergency department (ED) with anginous symptoms and increased serum creatinine level. After the placement of a temporary central venous c...

Right and left support feet of the Central Barrel Yoke of the CMS Detector

CERN Multimedia

Franz Leher, DWE

2000-01-01

Fully loaded the Central Barrel will weigh 3000 tonnes. Those feet have tosupport this weight. Therefore they are made of 120 mm thick steel plates.To guarantee a maximum coverage for the muon detctor they will house a muon detector just benaeth the top plate. Weight of 1 foot is 35 tonnes.Its height is 3.5 m and it is 2.5 m large

Sleep on the right side-Get cancer on the left?

Science.gov (United States)

Hallberg, Orjan; Johansson, Olle

2010-06-01

. Hallberg, A theory and model to explain the skin melanoma epidemic, Melanoma Res. 16 (2006) 115-118; O. Hallberg, A reduced repair efficiency can explain increasing melanoma rates, Eur. J. Cancer Prev. 17 (2008) 147-152; O. Hallberg, O. Johansson, Melanoma incidence and frequency modulation (FM) broadcasting, Arch. Environ. Health 57 (2002) 32-40; O. Hallberg, O. Johansson, FM broadcasting exposure time and malignant melanoma incidence, Electromagn. Biol. Med. 24 (2005) 1-8; O. Hallberg, Radio TV towers linked to increased risk of melanoma, Report, available at: http://foodconsumer.org/7777/8888/C_ancer_31/120907442007_Exclusive_report_Radio_TV_towers_linked_to_increased_risk_of_melanoma.shtml, 2007 (accessed 2007)]. Geographical areas covered by several transmitters show higher incidences of melanoma than areas covered by one transmitter. Here we show that a high prevalence of breast cancer and melanoma on the left side of the body may be a logical consequence of sleeping in beds having mattresses containing wave-reflecting metal springs. We found that people tend to sleep for longer periods on their right side, apparently to avoid disturbance by the heartbeat. This puts the left side farther away from the field-attenuating influence of the metal springs in the mattress; thus the left side will spend, on average, more time exposed to stronger combined fields from incident and reflected waves. This hypothesis may also explain why body parts farthest away from the mattress (trunk and upper arms for men; lower limbs and hips for women) have higher melanoma rates than the sun-exposed face area. The implications of this study should promote a critical consideration of population exposure to electromagnetic fields, especially during the night. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Pleural Effusion Resultant after Upper Abdominal Surgery: Analysis of 47 Cases

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Ufuk Cobanoglu

2011-09-01

Full Text Available Postoperative pulmonary complications, following upper abdominal surgery, occur at a rate which is higher, than lower abdominal surgery. One of these complications is pleural effusion. In this study, the frequency and causes of pleural effusions and the changes of the blood gas values and pulmonary functions of the patients with pleural effusions, occured after upper abdominal surgery are discussed in the accompaniment of the literature. Material and Methods:148 patients to whom upper adominal surgery is performed and in 47 of these patients pleural effusion is developed (31.75% , were examined restrospectivitely. Preoperative and postoperative pulmonary function tests (PFT and arterial blood gas (ABG results and the blood proteins, albumin values were recorded. The anesthesia type, the surgery properties, involving type of surgery and the surgical incision were determined. Results:Pleural effusion is detected bilaterally in 8 patients (17:02, at the rightside in 21 patients (44.69% ,and at the left side in 18 patients (38.29%.The 40.42% (19 cases of the patients who has pleural effusion in the postoperative period, had liver and gallbladder surgery, the %23.41 (11 Cases had spleen and pancreas surgery and the %36.17 (17 cases had the  other surgical procedures.Conclusions: While the upper abdominal surgery, impairment of the integrity of the diaphragm‘s peritoneum that covers the abdominal cavity where there is a highliquid pressure, may cause the liquid transition to the pleural space that has a negative pressure. Hypoalbuminemia and hipoproteinemia, that will occur due to the changes of oral intake and diet regulation in the postoperative period, may cause a reason for the pleural effusion. For this reason, doctors who performed these surgery procedures, should not ignore this complication, in the period of postoperative follow-ups of the patients.

Singularity-free static centrally symmetric solutions of some fourth order gravitational field equations

International Nuclear Information System (INIS)

Fiedler, B.; Schimming, R.

1983-01-01

The fourth order field equations proposed by TREDER with a linear combination of BACH's tensor and EINSTEIN's tensor on the left-hand side admit static centrally symmetric solutions which are analytical and non-flat in some neighborhood of the centre of symmetry. (author)

Central Venous Occlusion in the Hemodialysis Patient.

Science.gov (United States)

Krishna, Vinay Narasimha; Eason, Joseph B; Allon, Michael

2016-11-01

Central venous stenosis (CVS) is encountered frequently among hemodialysis patients. Prior ipsilateral central venous catheterization and cardiac rhythm device insertions are common risk factors, but CVS can also occur in the absence of this history. Chronic CVS can cause thrombosis with partial or complete occlusion of the central vein at the site of stenosis. CVS is frequently asymptomatic and identified as an incidental finding during imaging studies. Symptomatic CVS presents most commonly as an upper- or lower-extremity edema ipsilateral to the CVS. Previously unsuspected CVS may become symptomatic after placement of an ipsilateral vascular access. The likelihood of symptomatic CVS may be affected by the central venous catheter (CVC) location; CVC side; duration of CVC dependence; type, location, and blood flow of the ipsilateral access; and extent of collateral veins. Venous angiography is the gold standard for diagnosis. Percutaneous transluminal angioplasty and stent placement can improve the stenosis and alleviate symptoms, but CVS typically recurs frequently, requiring repeated interventions. Refractory symptomatic CVS may require ligation of the ipsilateral vascular access. Because no available treatment option is curative, the goal should be to prevent CVS by minimizing catheters and central vein instrumentation in patients with chronic kidney disease and dialysis patients. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Computer simulations of neural mechanisms explaining upper and lower limb excitatory neural coupling

Directory of Open Access Journals (Sweden)

Ferris Daniel P

2010-12-01

Full Text Available Abstract Background When humans perform rhythmic upper and lower limb locomotor-like movements, there is an excitatory effect of upper limb exertion on lower limb muscle recruitment. To investigate potential neural mechanisms for this behavioral observation, we developed computer simulations modeling interlimb neural pathways among central pattern generators. We hypothesized that enhancement of muscle recruitment from interlimb spinal mechanisms was not sufficient to explain muscle enhancement levels observed in experimental data. Methods We used Matsuoka oscillators for the central pattern generators (CPG and determined parameters that enhanced amplitudes of rhythmic steady state bursts. Potential mechanisms for output enhancement were excitatory and inhibitory sensory feedback gains, excitatory and inhibitory interlimb coupling gains, and coupling geometry. We first simulated the simplest case, a single CPG, and then expanded the model to have two CPGs and lastly four CPGs. In the two and four CPG models, the lower limb CPGs did not receive supraspinal input such that the only mechanisms available for enhancing output were interlimb coupling gains and sensory feedback gains. Results In a two-CPG model with inhibitory sensory feedback gains, only excitatory gains of ipsilateral flexor-extensor/extensor-flexor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 26%. In a two-CPG model with excitatory sensory feedback gains, excitatory gains of contralateral flexor-flexor/extensor-extensor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 100%. However, within a given excitatory sensory feedback gain, enhancement due to excitatory interlimb gains could only reach levels up to 20%. Interconnecting four CPGs to have ipsilateral flexor-extensor/extensor-flexor coupling, contralateral flexor-flexor/extensor-extensor coupling, and bilateral flexor-extensor/extensor-flexor coupling could enhance

An upper and lower bound of the Medication Possession Ratio

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Sperber CM

2017-08-01

Full Text Available Christian M Sperber, Suren R Samarasinghe, Grace P Lomax Patient Connect Limited, Guildford, UK Background: The Medication Possession Ratio (MPR is a ubiquitous and central measurement for adherence in the health care industry. However, attempts to standardize its calculation have failed, possibly due to the opacity of a single, static MPR, incapability of directly lending itself to a variety of studies, and challenges of comparing the value across studies. This work shows that the MPR strictly depends on the length of the time interval over which it is measured as well as on the dominant dispense quantity for short time intervals. Furthermore, removing a proportion of the patient cohort based on the number of acquisitions may also have a severe impact on the MPR. Therefore, it is suggested that the MPR is represented as a trend over a range of time intervals. To this end, an upper and lower bound of the MPR trend is developed with an upper bound acknowledging patients who change their treatment and the lower bound acknowledging patients who discontinue their treatment.Purpose: Introducing a representation of the MPR value as a trend rather than a static number by developing a quantitative description of an upper and lower bound of the MPR trend, while shedding light on the impacts on prefiltering the patient cohort.Patients and methods: Anonymized patient-level data was utilized as an example for a suggested calculation of an upper and lower bound of the MPR.Results: Representation of the MPR for a predefined time interval precludes a reliable MPR assessment. A quantitative approach is suggested to generate an upper and lower trend of the MPR while emphasizing the impact on removing patients with a limited number of acquisitions.Conclusion: An upper and lower trend makes the MPR more transparent and allows a better comparison across different studies. Removing patients with a limited number of acquisitions should be avoided. Keywords: MPR

Upper bound on the radii of black-hole photonspheres

International Nuclear Information System (INIS)

Hod, Shahar

2013-01-01

One of the most remarkable predictions of the general theory of relativity is the existence of black-hole “photonspheres”, compact null hypersurfaces on which massless particles can orbit the central black hole. We prove that every spherically-symmetric asymptotically flat black-hole spacetime is characterized by a photonsphere whose radius is bounded from above by r γ ⩽3M, where M is the total ADM mass of the black-hole spacetime. It is shown that hairy black-hole configurations conform to this upper bound. In particular, the null circular geodesic of the (bald) Schwarzschild black-hole spacetime saturates the bound

Investigation of geology and hydrology of the upper and middle Verde River watershed of central Arizona: a project of the Arizona Rural Watershed Initiative

Science.gov (United States)

Woodhouse, Betsy; Flynn, Marilyn E.; Parker, John T.C.; Hoffmann, John P.

2002-01-01

The upper and middle Verde River watershed in west-central Arizona is an area rich in natural beauty and cultural history and is an increasingly popular destination for tourists, recreationists, and permanent residents seeking its temperate climate. The diverse terrain of the region includes broad desert valleys, upland plains, forested mountain ranges, narrow canyons, and riparian areas along perennial stream reaches. The area is predominantly in Yavapai County, which in 1999 was the fastest-growing rural county in the United States (Woods and Poole Economics, Inc., 1999); by 2050, the population is projected to more than double. Such growth will increase demands on water resources. The domestic, industrial, and recreational interests of the population will need to be balanced against protection of riparian, woodland, and other natural areas and their associated wildlife and aquatic habitats. Sound management decisions will be required that are based on an understanding of the interactions between local and regional aquifers, surface-water bodies, and recharge and discharge areas. This understanding must include the influence of climate, geology, topography, and cultural development on those components of the hydrologic system. In 1999, the U.S. Geological Survey (USGS), in cooperation with the Arizona Department of Water Resources (ADWR), initiated a regional investigation of the hydrogeology of the upper and middle Verde River watershed. The project is part of the Rural Watershed Initiative (RWI), a program established by the State of Arizona and managed by the ADWR that addresses water supply issues in rural areas while encouraging participation from stakeholder groups in affected communities. The USGS is performing similar RWI investigations on the Colorado Plateau to the north and in the Mogollon Highlands to the east of the Verde River study area (Parker and Flynn, 2000). The objectives of the RWI investigations are to develop: (1) a single database

Evaluation of left-right asymmetry of pyramidal tracts in preterm neonates by diffusion tensor imaging and tractography

International Nuclear Information System (INIS)

Ogita, Kaori

2010-01-01

Diffusion Tensor Tractography (DTT) is a new noninvasive brain imaging technique to detect the neural tract and is expected to be instrumental in diagnosing diseases with white matter involvement. Assessing the pyramidal tract with DTT will be useful in diagnosing motor dysfunction. However, the pyramidal tract (PT) has not been fully investigated with this technique especially in neonates. The aim of this study is to clarify the normal characteristics, especially the latevility, of the PT in healthy neonates. Fourteen preterm neonates were examined with DTT before being discharged from the neonatal intensive care unit (NICU). Free software dTV and Volume-One were used to depict the PT and analyze the fractional anisotrophy (FA) value, a parameter used in Diffusion Tensor Imaging (DTI). In the beginning, the FA at the medulla oblongata as the initial region of interest was determined to be 0.18 or more to depict the PT by DTT. The FA values at the level of the posterior limb of the Internal Capsule (IC), the Corona Radiate (CR), and the Centrum Semiovale (CS) of the depicted PT were measured and compared with the contralateral. The upper limit of the level of the FA at the medulla oblongata value capable of depicting the PT was measured and compared with the contralateral. All data was analyzed using the Mann-Whitney test. A p-value of less than 0.05 was considered to indicate significant difference. The FA value of the left CS was higher than that of the right in all 14 cases, and the FA value of the left CA was higher than that of the right in 13 cases. The upper limit of the FA value of the medulla oblongata as the initial region of interest to depict the left side of the PT was higher than for the right side of the PT in all 14 cases. We clarified the laterality of the PT in healthy neonates using DTT. This laterality must be taken into consideration when involvement of the PT is diagnosed using this technique. (author)

Left auditory cortex gamma synchronization and auditory hallucination symptoms in schizophrenia

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Shenton Martha E

2009-07-01

Full Text Available Abstract Background Oscillatory electroencephalogram (EEG abnormalities may reflect neural circuit dysfunction in neuropsychiatric disorders. Previously we have found positive correlations between the phase synchronization of beta and gamma oscillations and hallucination symptoms in schizophrenia patients. These findings suggest that the propensity for hallucinations is associated with an increased tendency for neural circuits in sensory cortex to enter states of oscillatory synchrony. Here we tested this hypothesis by examining whether the 40 Hz auditory steady-state response (ASSR generated in the left primary auditory cortex is positively correlated with auditory hallucination symptoms in schizophrenia. We also examined whether the 40 Hz ASSR deficit in schizophrenia was associated with cross-frequency interactions. Sixteen healthy control subjects (HC and 18 chronic schizophrenia patients (SZ listened to 40 Hz binaural click trains. The EEG was recorded from 60 electrodes and average-referenced offline. A 5-dipole model was fit from the HC grand average ASSR, with 2 pairs of superior temporal dipoles and a deep midline dipole. Time-frequency decomposition was performed on the scalp EEG and source data. Results Phase locking factor (PLF and evoked power were reduced in SZ at fronto-central electrodes, replicating prior findings. PLF was reduced in SZ for non-homologous right and left hemisphere sources. Left hemisphere source PLF in SZ was positively correlated with auditory hallucination symptoms, and was modulated by delta phase. Furthermore, the correlations between source evoked power and PLF found in HC was reduced in SZ for the LH sources. Conclusion These findings suggest that differential neural circuit abnormalities may be present in the left and right auditory cortices in schizophrenia. In addition, they provide further support for the hypothesis that hallucinations are related to cortical hyperexcitability, which is manifested by

Kinetic analysis of the function of the upper body for elite race walkers during official men 20 km walking race.

Science.gov (United States)

Hoga-Miura, Koji; Ae, Michiyoshi; Fujii, Norihisa; Yokozawa, Toshiharu

2016-10-01

This study investigated the function of the upper extremities of elite race walkers during official 20 km races, focusing on the angular momentum about the vertical axis and other parameters of the upper extremities. Sixteen walkers were analysed using the three-dimensional direct linear transformation method during three official men's 20 km walking races. The subjects, included participants at the Olympics and World Championships, who finished without disqualification and had not been disqualified during the two years prior to or following the races analysed in the present study. The angular momenta of the upper and lower body were counterbalanced as in running and normal walking. The momentum of the upper body was mainly generated by the upper extremities. The joint force moment of the right shoulder and the joint torque at the left shoulder just before right toe-off were significantly correlated with the walking speed. These were counterbalanced by other moments and torques to the torso torque, which worked to obtain a large mechanical energy flow from the recovery leg to the support leg in the final phase of the support phase. Therefore, a function of the shoulder torque was to counterbalance the torso torque to gain a fast walking speed with substantial mechanical energy flow.

The Prognostic Value of Left Atrial Peak Reservoir Strain in Acute Myocardial Infarction Is Dependent on Left Ventricular Longitudinal Function and Left Atrial Size

DEFF Research Database (Denmark)

Ersbøll, Mads; Andersen, Mads J; Valeur, Nana

2013-01-01

of PALS and left ventricular longitudinal strain (global longitudinal strain) in large-scale populations in regard to prognosis. METHODS AND RESULTS: We prospectively included 843 patients (mean age 62.1+/-11.8; 74% male) with acute myocardial infarction and measured global longitudinal strain, left......BACKGROUND: Peak atrial longitudinal strain (PALS) during the reservoir phase has been proposed as a measure of left atrium function in a range of cardiac conditions, with the potential for added pathophysiological insight and prognostic value. However, no studies have assessed the interrelation...

A new species of Phrynopus (Amphibia, Anura, Craugastoridae from upper montane forests and high Andean grasslands of the Pui Pui Protected Forest in central Peru

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Edgar Lehr

2017-11-01

Full Text Available We describe a new species of Phrynopus from the upper montane forests and high Andean grasslands (puna of the Pui Pui Protected Forest and its close surroundings (Región Junín, central Peru and compare it morphologically and genetically with other species of Phrynopus. Phrynopus inti sp. n. is known from four localities outside and two localities inside the Pui Pui Protected Forest between 3350 and 3890 m a.s.l. Studied specimens of the new species are characterized by a snout-vent length of 27.2–35.2 mm in males (n = 6, and 40.4 mm in a single female, by having the skin on dorsum and flanks smooth with scattered tubercles, venter smooth, by lacking a tympanum, and males without vocal slits and nuptial pads. In life, the dorsum is pale grayish brown with or without dark brown blotches, or dorsum blackish brown with small yellow flecks, throat, chest and venter are pale grayish brown with salmon mottling, groin is pale grayish brown with salmon colored flecks, and the iris is golden orange with fine dark brown reticulations. The new species is morphologically most similar to Phrynopus kauneorum and P. juninensis. For the latter we describe the coloration in life for a specimen obtained at the type locality. A molecular phylogenetic analysis based on mitochondrial and nuclear DNA sequences inferred that the new species is most closely related to Phrynopus kauneorum, P. miroslawae, P. tautzorum, and an undescribed species distributed at high elevation in Región Pasco, central Peru.

A new species of Phrynopus (Amphibia, Anura, Craugastoridae) from upper montane forests and high Andean grasslands of the Pui Pui Protected Forest in central Peru.

Science.gov (United States)

Lehr, Edgar; von May, Rudolf; Moravec, Jiří; Cusi, Juan Carlos

2017-01-01

We describe a new species of Phrynopus from the upper montane forests and high Andean grasslands (puna) of the Pui Pui Protected Forest and its close surroundings (Región Junín, central Peru) and compare it morphologically and genetically with other species of Phrynopus . Phrynopus inti sp. n. is known from four localities outside and two localities inside the Pui Pui Protected Forest between 3350 and 3890 m a.s.l. Studied specimens of the new species are characterized by a snout-vent length of 27.2-35.2 mm in males (n = 6), and 40.4 mm in a single female, by having the skin on dorsum and flanks smooth with scattered tubercles, venter smooth, by lacking a tympanum, and males without vocal slits and nuptial pads. In life, the dorsum is pale grayish brown with or without dark brown blotches, or dorsum blackish brown with small yellow flecks, throat, chest and venter are pale grayish brown with salmon mottling, groin is pale grayish brown with salmon colored flecks, and the iris is golden orange with fine dark brown reticulations. The new species is morphologically most similar to Phrynopus kauneorum and P. juninensis . For the latter we describe the coloration in life for a specimen obtained at the type locality. A molecular phylogenetic analysis based on mitochondrial and nuclear DNA sequences inferred that the new species is most closely related to Phrynopus kauneorum , P. miroslawae , P. tautzorum , and an undescribed species distributed at high elevation in Región Pasco, central Peru.

Structural controllability and controlling centrality of temporal networks.

Science.gov (United States)

Pan, Yujian; Li, Xiang

2014-01-01

Temporal networks are such networks where nodes and interactions may appear and disappear at various time scales. With the evidence of ubiquity of temporal networks in our economy, nature and society, it's urgent and significant to focus on its structural controllability as well as the corresponding characteristics, which nowadays is still an untouched topic. We develop graphic tools to study the structural controllability as well as its characteristics, identifying the intrinsic mechanism of the ability of individuals in controlling a dynamic and large-scale temporal network. Classifying temporal trees of a temporal network into different types, we give (both upper and lower) analytical bounds of the controlling centrality, which are verified by numerical simulations of both artificial and empirical temporal networks. We find that the positive relationship between aggregated degree and controlling centrality as well as the scale-free distribution of node's controlling centrality are virtually independent of the time scale and types of datasets, meaning the inherent robustness and heterogeneity of the controlling centrality of nodes within temporal networks.

Aphasia following left thalamic hemorrhage

International Nuclear Information System (INIS)

Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro.

1984-01-01

We reported 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months), and described language disorders examined by Western Aphasia Battery (WAB) and measured cerebral blood flow by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in watershed area that involved the territory between posterior cerebral and middle cerebral arteries in the left temporooccipital region in addition to low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, whose score of repetition (8.4) was higher than that of comprehension (7.4), emission CT showed slight low flow area at the temporo-occipital region similarly as the case with transcortical sensory aphasia. In another case with anomic aphasia, scored 9 on both fluensy and comprehension subtests and 10 on repetition, there was wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. On the other hand, in all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus. (J.P.N.)

Transitional Cell Carcinoma of the Upper Ureter Metastatic to the Thoracic Spine Presenting as a Spinal Cord Compression

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J. O. Larkin

2008-01-01

Full Text Available We performed a left nephroureterectomy for a gentleman with transitional cell carcinoma of the upper ureter. Histological analysis revealed it to be a T1 lesion, but to be highly mitotically active. The gentleman defaulted on adjuvant therapy and defaulted on follow-up. He represented with symptoms of acute spinal cord compression and magnetic resonance imaging demonstrated a lesion at T6/7. Neurosurgical resection of the lesion showed it to be a metastatic deposit from the ureteric primary. Despite surgical debulking and subsequent radiotherapy to the lesion, the patient died secondary to metastatic complications. This case report is of interest to the surgeon as it demonstrates both the high metastatic potential of upper tract carcinomas and educates the surgeon on the presentation of acute spinal cord compression.

Brain structural network topological alterations of the left prefrontal and limbic cortex in psychogenic erectile dysfunction.

Science.gov (United States)

Chen, Jianhuai; Chen, Yun; Gao, Qingqiang; Chen, Guotao; Dai, Yutian; Yao, Zhijian; Lu, Qing

2018-05-01

Despite increasing understanding of the cerebral functional changes and structural abnormalities in erectile dysfunction, alterations in the topological organization of brain networks underlying psychogenic erectile dysfunction remain unclear. Here, based on the diffusion tensor image data of 25 patients and 26 healthy controls, we investigated the topological organization of brain structural networks and its correlations with the clinical variables using the graph theoretical analysis. Patients displayed a preserved overall small-world organization and exhibited a less connectivity strength in the left inferior frontal gyrus, amygdale and the right inferior temporal gyrus. Moreover, an abnormal hub pattern was observed in patients, which might disturb the information interactions of the remaining brain network. Additionally, the clustering coefficient of the left hippocampus was positively correlated with the duration of patients and the normalized betweenness centrality of the right anterior cingulate gyrus and the left calcarine fissure were negatively correlated with the sum scores of the 17-item Hamilton Depression Rating Scale. These findings suggested that the damaged white matter and the abnormal hub distribution of the left prefrontal and limbic cortex might contribute to the pathogenesis of psychogenic erectile dysfunction and provided new insights into the understanding of the pathophysiological mechanisms of psychogenic erectile dysfunction.

Central Retinal and Posterior Ciliary Artery Occlusion After Intralesional Injection of Sclerosant to Glabellar Subcutaneous Hemangioma

International Nuclear Information System (INIS)

Matsuo, Toshihiko; Fujiwara, Hiroyasu; Gobara, Hideo; Mimura, Hidefumi; Kanazawa, Susumu

2009-01-01

The aim of this study is to describe vision loss caused by central retinal artery and posterior ciliary artery occlusion as a consequence of sclerotherapy with a polidocanol injection to a glabellar hemangioma. An 18-year-old man underwent direct injection with a 23-gauge needle of 1 mL of a polidocanol-carbon dioxide emulsion into the glabellar subcutaneous hemangioma under ultrasound visualization of the needle tip by radiologists. He developed lid swelling the next day, and 3 days later at referral, the visual acuity in the left eye was no light perception. Funduscopy revealed central retinal artery occlusion and fluorescein angiography disclosed no perfusion at all in the left fundus, indicating concurrent posterior ciliary artery occlusion. The patient also showed mydriasis, blepharoptosis, and total external ophthalmoplegia on the left side. Magnetic resonance imaging demonstrated the swollen medial rectus muscle. In a month, blepharoptosis and ophthalmoplegia resolved but the visual acuity remained no light perception. Sclerosing therapy for facial hemangioma may develop a severe complication such as permanent visual loss.

Nonvariceal upper gastrointestinal bleeding

International Nuclear Information System (INIS)

Burke, Stephen J.; Weldon, Derik; Sun, Shiliang; Golzarian, Jafar

2007-01-01

Nonvariceal upper gastrointestinal bleeding (NUGB) remains a major medical problem even after advances in medical therapy with gastric acid suppression and cyclooxygenase (COX-2) inhibitors. Although the incidence of upper gastrointestinal bleeding presenting to the emergency room has slightly decreased, similar decreases in overall mortality and rebleeding rate have not been experienced over the last few decades. Many causes of upper gastrointestinal bleeding have been identified and will be reviewed. Endoscopic, radiographic and angiographic modalities continue to form the basis of the diagnosis of upper gastrointestinal bleeding with new research in the field of CT angiography to diagnose gastrointestinal bleeding. Endoscopic and angiographic treatment modalities will be highlighted, emphasizing a multi-modality treatment plan for upper gastrointestinal bleeding. (orig.)

Nonvariceal upper gastrointestinal bleeding

Energy Technology Data Exchange (ETDEWEB)

Burke, Stephen J.; Weldon, Derik; Sun, Shiliang [University of Iowa, Department of Radiology, Iowa, IA (United States); Golzarian, Jafar [University of Iowa, Department of Radiology, Iowa, IA (United States); University of Iowa, Department of Radiology, Carver College of Medicine, Iowa, IA (United States)

2007-07-15

Nonvariceal upper gastrointestinal bleeding (NUGB) remains a major medical problem even after advances in medical therapy with gastric acid suppression and cyclooxygenase (COX-2) inhibitors. Although the incidence of upper gastrointestinal bleeding presenting to the emergency room has slightly decreased, similar decreases in overall mortality and rebleeding rate have not been experienced over the last few decades. Many causes of upper gastrointestinal bleeding have been identified and will be reviewed. Endoscopic, radiographic and angiographic modalities continue to form the basis of the diagnosis of upper gastrointestinal bleeding with new research in the field of CT angiography to diagnose gastrointestinal bleeding. Endoscopic and angiographic treatment modalities will be highlighted, emphasizing a multi-modality treatment plan for upper gastrointestinal bleeding. (orig.)

Upper Gastrointestinal (GI) Series

Science.gov (United States)

... standard barium upper GI series, which uses only barium a double-contrast upper GI series, which uses both air and ... evenly coat your upper GI tract with the barium. If you are having a double-contrast study, you will swallow gas-forming crystals that ...

Transmural distribution of myocardial infarction: difference between the right and left ventricles in a canine model

International Nuclear Information System (INIS)

Ohzono, K.; Koyanagi, S.; Urabe, Y.; Harasawa, Y.; Tomoike, H.; Nakamura, M.

1986-01-01

The evolution of myocardial infarction 24 hours after ligating both the right coronary artery and the obtuse marginal branch of the left circumflex coronary artery was examined in 33 anesthetized dogs. Postmortem coronary angiography and a tracer microsphere technique were used to determine risk areas and their collateral blood flows, respectively. The mean weight of the risk areas was 11.3 +/- 0.5 g (mean +/- SEM) in the right ventricle and 10.5 +/- 0.9 g in the left ventricle (NS). The weight of infarcted tissue was 5.7 +/- 0.7 g in the right ventricle and 5.2 +/- 0.9 g in the left ventricle (NS). In both ventricles, infarct weight was linearly related to risk area size, and the percent of risk area necrosis was inversely correlated with the extent of collateral flow at 24 hours of coronary ligation, defined as the mean myocardial blood flow inside the central risk area. Ratios of infarct to risk area between the subendocardial and subepicardial layers were 0.76 +/- 0.06 and 0.28 +/- 0.05 in the right and left ventricles, respectively (p less than 0.01, between ventricles, n = 31), which coincided well with subendocardial-to-subepicardial-flow ratios at 24 hours, ie, 0.86 +/- 0.04 in the right ventricle and 0.32 +/- 0.06 in the left ventricle (p less than 0.01). The regional distribution of myocardial infarction correlated well with flow distribution inside the risk area; the slope of these relations was similar between the subendocardium and subepicardium in the right ventricle, whereas in the left ventricle it was larger in the subendocardium than in the subepicardium. Thus, in the dog, the inherent change in the regional distribution of coronary collateral blood flow is an important modifier in the evolution of myocardial infarction, especially in the left ventricle

Deployment of spatial attention to words in central and peripheral vision.

Science.gov (United States)

Ducrot, Stéphanie; Grainger, Jonathan

2007-05-01

Four perceptual identification experiments examined the influence of spatial cues on the recognition of words presented in central vision (with fixation on either the first or last letter of the target word) and in peripheral vision (displaced left or right of a central fixation point). Stimulus location had a strong effect on word identification accuracy in both central and peripheral vision, showing a strong right visual field superiority that did not depend on eccentricity. Valid spatial cues improved word identification for peripherally presented targets but were largely ineffective for centrally presented targets. Effects of spatial cuing interacted with visual field effects in Experiment 1, with valid cues reducing the right visual field superiority for peripherally located targets, but this interaction was shown to depend on the type of neutral cue. These results provide further support for the role of attentional factors in visual field asymmetries obtained with targets in peripheral vision but not with centrally presented targets.

Flexible endoscopic procedure in children with foreign bodies in their upper gastrointestinal system

Directory of Open Access Journals (Sweden)

Kaan Demirören

2014-03-01

Full Text Available Objective: Foreign body ingestion is an important public health problem. We pointed to this subject and aimed to determine the effectiveness of flexible endoscopic procedure in this study. Methods: We evaluated retrospectively fifty children having foreign body in their upper gastrointestinal system, who underwent flexible endoscopic procedure. Results: Of the patients, mean age was 5.5 ± 4 years old (range: 0.5-16 years, 64% was female. Ingested foreign bodies were coin (58%, pin (10%, battery (6%, nail (6%, necklace (6%, safety pin (4% and sewing pin, wire hairclip, ring, button and chicken skin. In endoscopic procedure, foreign bodies were seen in upper esophagus (32%, middle esophagus (26%, lower esophagus (8%, stomach (18%, bulbus (4% and second part of duodenum (8%, but were not seen in 4% of the cases. While 94% of foreign bodies were endoscopically removed, 6% of them were pushed to stomach with gastroscope from esophagus and left for spontaneous passage. Any important complication was developed. Conclusion: Flexible endoscopic procedure is an effective and safe method for removal of gastrointestinal system foreign bodies in children.

First record of Arapaima gigas (Schinz, 1822) (Teleostei: Osteoglossomorpha), the "pirarucu", in the upper Paraná River basin, Southeast Brazil

OpenAIRE

Carvalho, Fernando; Casatti, Lilian; Manzotti, Angelo; Ravazzi, Délcero

2015-01-01

Arapaima gigas (Schinz), the "pirarucu", is one of largest freshwater fish of the Neotropical region, naturally occurring in the Amazon, Essequibo, and Orinoco river basins. Herein, it is first recorded from the Grande River, in the upper Paraná River basin. This record is based on the finding of one dead specimen on the left margin of the Grande River, and in situ observation of juveniles and adults in the river.

Microsurgical anatomy of the central lobe.

Science.gov (United States)

Frigeri, Thomas; Paglioli, Eliseu; de Oliveira, Evandro; Rhoton, Albert L

2015-03-01

The central lobe consists of the pre- and postcentral gyri on the lateral surface and the paracentral lobule on the medial surface and corresponds to the sensorimotor cortex. The objective of the present study was to define the neural features, craniometric relationships, arterial supply, and venous drainage of the central lobe. Cadaveric hemispheres dissected using microsurgical techniques provided the material for this study. The coronal suture is closer to the precentral gyrus and central sulcus at its lower rather than at its upper end, but they are closest at a point near where the superior temporal line crosses the coronal suture. The arterial supply of the lower two-thirds of the lateral surface of the central lobe was from the central, precentral, and anterior parietal branches that arose predominantly from the superior trunk of the middle cerebral artery. The medial surface and the superior third of the lateral surface were supplied by the posterior interior frontal, paracentral, and superior parietal branches of the pericallosal and callosomarginal arteries. The venous drainage of the superior two-thirds of the lateral surface and the central lobe on the medial surface was predominantly through the superior sagittal sinus, and the inferior third of the lateral surface was predominantly through the superficial sylvian veins to the sphenoparietal sinus or the vein of Labbé to the transverse sinus. The pre- and postcentral gyri and paracentral lobule have a morphological and functional anatomy that differentiates them from the remainder of their respective lobes and are considered by many as a single lobe. An understanding of the anatomical relationships of the central lobe can be useful in preoperative planning and in establishing reliable intraoperative landmarks.

Evaluation of left ventricular function by cardiac CT

International Nuclear Information System (INIS)

Naito, Hiroaki; Kozuka, Takahiro

1982-01-01

Left ventricular function was evaluated by CT, which was compared with the data of left ventriculography for various cardiac diseases. The end diastolic volume of the left ventricle can be readily computed from CT, with a satisfactory correlation with that of left ventriculography (r = 0.95). The left ventricular ejection fraction, calculated from the areal ratio of the left ventricular lumen in end-diastolic imaging to that in end-sytolic imaging, also roughly reflects left ventricular contractile function, but shows correlation with left ventriculography by only r = 0.79. Although the cardiac output is not sensitive for functional evaluation, it can be directly calculated by means of dynamic scanning and shows a satisfactory correlation with the ear piece pigment dilution (r = 0.85). Evaluation of left ventricular function by CT shows a high precision in comparison with left ventriculography, but still lacks temporal resolving power. (Chiba, N.)

Robotic assessment of the influence of age on upper-limb sensorimotor function

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LLinares A

2013-07-01

Full Text Available Ana LLinares, Francisco Javier Badesa, Ricardo Morales, Nicolas Garcia-Aracil, JM Sabater, Eduardo Fernandez Biomedical Neuroengineering, Universidad Miguel Hernández de Elche, Elche, Spain Purpose: This paper examines the influence of age on several attributes of sensorimotor performance while performing a reaching task. Our hypothesis, based on previous studies, is that aged persons will show differences in one or more of the attributes of sensorimotor performance. Patients and methods: Fifty-one subjects (aged 20–80 years with no known neuromotor disorders of the upper limbs participated in the study. Subjects were asked to grasp the end-effector of a pneumatic robotic device with two degrees of freedom in order to reach peripheral targets (1.0 cm radius, "quickly and accurately", from a centrally located target (1.0 cm radius. Subjects began each trial by holding the hand within the central target for 2000 milliseconds. Afterwards, a peripheral target was illuminated. Then participants were given 3000 milliseconds to complete the movement. When a target was reached, the participant had to return to the central target in order to start a new trial. A total of 64 trials were completed and each peripheral target was illuminated in a random block design. Results: Subjects were divided into three groups according to age: group 1 (age 20–40 years, group 2 (age 41–60 years, and group 3 (age 61–80 years. The Kruskal–Wallis test showed significant differences (P < 0.05 between groups, except for the variables postural speed in the dominant arm, and postural speed and initial deviation in the non-dominant arm (P > 0.05. These results suggest that age introduces significant differences in upper-limb motor function. Conclusion: Our findings show that there are objective differences in sensorimotor function due to age, and that these differences are greater for the dominant arm. Therefore for the assessment of upper-limb function, we should

New Constraints on Upper Mantle Structure Underlying the Diamondiferous Central Slave Craton, Canada, from Teleseismic Body Wave Tomography

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Esteve, C.; Schaeffer, A. J.; Audet, P.

2017-12-01

Over the past number of decades, the Slave Craton (Canada) has been extensively studied for its diamondiferous kimberlites. Not only are diamonds a valuable resource, but their kimberlitic host rocks provide an otherwise unique direct source of information on the deep upper mantle (and potentially transition zone). Many of the Canadian Diamond mines are located within the Slave Craton. As a result of the propensity for diamondiferous kimberlites, it is imperative to probe the deep mantle structure beneath the Slave Craton. This work is further motivated by the increase in high-quality broadband seismic data across the Northern Canadian Cordillera over the past decade. To this end we have generated a P and S body wave tomography model of the Slave Craton and its surroundings. Furthermore, tomographic inversion techniques are growing ever more capable of producing high resolution Earth models which capture detailed structure and dynamics across a range of scale lengths. Here, we present preliminary results on the structure of the upper mantle underlying the Slave Craton. These results are generated using data from eight different seismic networks such as the Canadian National Seismic Network (CNSN), Yukon Northwest Seismic Network (YNSN), older Portable Observatories for Lithospheric Analysis and Reseach Investigating Seismicity (POLARIS), Regional Alberta Observatory for Earthquake Studies Network (RV), USArray Transportable Array (TA), older Canadian Northwest Experiment (CANOE), Batholith Broadband (XY) and the Yukon Observatory (YO). This regional model brings new insights about the upper mantle structure beneath the Slave Craton, Canada.

Effects of 12 days exposure to simulated microgravity on central circulatory hemodynamics in the rhesus monkey

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Convertino, V. A.; Koenig, S. C.; Krotov, V. P.; Fanton, J. W.; Korolkov, V. I.; Trambovetsky, E. V.; Ewert, D. L.; Truzhennikov, A.; Latham, R. D.

1998-01-01

Central circulatory hemodynamic responses were measured before and during the initial 9 days of a 12-day 10 degrees head-down tilt (HDT) in 4 flight-sized juvenile rhesus monkeys who were surgically instrumented with a variety of intrathoracic catheters and blood flow sensors to assess the effects of simulated microgravity on central circulatory hemodynamics. Each subject underwent measurements of aortic and left ventricular pressures, and aortic flow before and during HDT as well as during a passive head-up postural test before and after HDT. Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure were measured, and dP/dt and left ventricular elastance was calculated from hemodynamic measurements. The postural test consisted of 5 min of supine baseline control followed by 5 minutes of 90 degrees upright tilt (HUT). Heart rate, stroke volume, cardiac output, and left ventricular end-diastolic pressure showed no consistent alterations during HDT. Left ventricular elastance was reduced in all animals throughout HDT, indicating that cardiac compliance was increased. HDT did not consistently alter left ventricular +dP/dt, indicating no change in cardiac contractility. Heart rate during the post-HDT HUT postural test was elevated compared to pre-HDT while post-HDT cardiac output was decreased by 52% as a result of a 54% reduction in stroke volume throughout HUT. Results from this study using an instrumented rhesus monkey suggest that exposure to microgravity may increase ventricular compliance without alternating cardiac contractility. Our project supported the notion that an invasively-instrumented animal model should be viable for use in spaceflight cardiovascular experiments to assess potential changes in myocardial function and cardiac compliance.

[Influence of "prehistory" of sequential movements of the right and the left hand on reproduction: coding of positions, movements and sequence structure].

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Bobrova, E V; Liakhovetskiĭ, V A; Borshchevskaia, E R

2011-01-01

The dependence of errors during reproduction of a sequence of hand movements without visual feedback on the previous right- and left-hand performance ("prehistory") and on positions in space of sequence elements (random or ordered by the explicit rule) was analyzed. It was shown that the preceding information about the ordered positions of the sequence elements was used during right-hand movements, whereas left-hand movements were performed with involvement of the information about the random sequence. The data testify to a central mechanism of the analysis of spatial structure of sequence elements. This mechanism activates movement coding specific for the left hemisphere (vector coding) in case of an ordered sequence structure and positional coding specific for the right hemisphere in case of a random sequence structure.

[Hyperlexia in an adult patient with lesions in the left medial frontal lobe].

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Suzuki, K; Yamadori, A; Kumabe, T; Endo, K; Fujii, T; Yoshimoto, T

2000-04-01

A 69-year-old right-handed woman developed a transcortical motor aphasia with hyperlexia following resection of a glioma in the left medial frontal lobe. Neurological examination revealed grasp reflex in the right hand and underutilization of the right upper extremity. An MRI demonstrated lesions in the left medial frontal lobe including the supplementary motor area and the anterior part of the cingulate gyrus, which extended to the anterior part of the body of corpus callosum. Neuropsychologically she was alert and cooperative. She demonstrated transcortical motor aphasia. Her verbal output began with echolalia. Furthermore hyperlexia was observed in daily activities and during examinations. During conversation she suddenly read words written on objects around her which were totally irrelevant to the talk. When she was walking in the ward with an examiner she read words written on a trash bag that passed by and signboards which indicated a name of a room. Her conversation while walking was intermingled with reading words, which was irrelevant to the conversation. She also read time on analog clocks, which were hung on a wall in a watch store. In a naming task, she read words written on objects first and named them upon repeated question about their names. When an examiner opened a newspaper in front of her without any instructions she began reading until the examiner prohibited it. Then she began reading again when an examiner turned the page, although she remembered that she should not read it aloud. She showed mild ideomotor apraxia of a left hand. Utilization behavior, imitation behavior, hypergraphia, or compulsive use of objects was not observed throughout the course. Hyperlexic tendency is a prominent feature of this patient's language output. Hyperlexia was often reported in children with pervasive developmental disorders including autism. There are only a few reports about hyperlexia in adults and some of them were related to diffuse brain dysfunction

Aetiological factors in left-handedness

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Milenković Sanja M.

2005-01-01

Full Text Available Lateralisation associates the extremities and senses of one side of the body, which are connected by afferent and efferent pathways, with the primary motor and sensory areas of the hemisphere on the opposite side. Dominant laterality denotes the appearance of a dominant extremity or sense in the performance of complex psychomotor activities. Laterality is manifested both as right-handedness or left-handedness, which are functionally equivalent and symmetrical in the performance of activities. Right-handedness is significantly more common than left-handedness. Genetic theory is most widely accepted in explaining the onset of lateralisation. According to this theory, the models of brain organisation asymmetry (anatomical, functional, and biochemical are strongly, genetically determined. However, the inability to clearly demonstrate the association between genetic factors and left-handedness has led researchers to investigate the effects of the environment on left-handedness. Of particular interest are the intrauterine environment and the factors influencing foetal development, of which hormones and ultrasound exposure are the most significant. It has been estimated that an extra five cases of nonright-handed lateralisation can be expected in every 100 males who were exposed to ultrasound in utero compared to those who were not. Socio-cultural pressure on left-handed individuals was much more severe in the past, which is confirmed by scientific findings that left-handedness is present in 13% of individuals in their twenties, while in less than 1% of individuals in their eighties.

Left main percutaneous coronary intervention.

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Teirstein, Paul S; Price, Matthew J

2012-10-23

The introduction of drug-eluting stents and advances in catheter techniques have led to increasing acceptance of percutaneous coronary intervention (PCI) as a viable alternative to coronary artery bypass graft (CABG) for unprotected left main disease. Current guidelines state that it is reasonable to consider unprotected left main PCI in patients with low to intermediate anatomic complexity who are at increased surgical risk. Data from randomized trials involving patients who are candidates for either treatment strategy provide novel insight into the relative safety and efficacy of PCI for this lesion subset. Herein, we review the current data comparing PCI with CABG for left main disease, summarize recent guideline recommendations, and provide an update on technical considerations that may optimize clinical outcomes in left main PCI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Upper motor neuron predominant degeneration with frontal and temporal lobe atrophy.

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Konagaya, M; Sakai, M; Matsuoka, Y; Konagaya, Y; Hashizume, Y

1998-11-01

The autopsy findings of a 78-year-old man mimicking primary lateral sclerosis (PLS) are reported. He showed slowly progressive spasticity, pseudobulbar palsy and character change, and died 32 months after the onset of symptoms. Autopsy revealed severe atrophy of the frontal and temporal lobes, remarkable neuronal loss and gliosis in the precentral gyrus, left temporal lobe pole and amygdala, mild degeneration of the Ammon's horn, degeneration of the corticospinal tract, and very mild involvement of the lower motor neurons. The anterior horn cells only occasionally demonstrated Bunina body by cystatin-C staining, and skein-like inclusions by ubiquitin staining. This is a peculiar case with concomitant involvement in the motor cortex and temporal lobe in motor neuron disease predominantly affecting the upper motor neuron.

Large-scale brain networks are distinctly affected in right and left mesial temporal lobe epilepsy.

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de Campos, Brunno Machado; Coan, Ana Carolina; Lin Yasuda, Clarissa; Casseb, Raphael Fernandes; Cendes, Fernando

2016-09-01

Mesial temporal lobe epilepsy (MTLE) with hippocampus sclerosis (HS) is associated with functional and structural alterations extending beyond the temporal regions and abnormal pattern of brain resting state networks (RSNs) connectivity. We hypothesized that the interaction of large-scale RSNs is differently affected in patients with right- and left-MTLE with HS compared to controls. We aimed to determine and characterize these alterations through the analysis of 12 RSNs, functionally parceled in 70 regions of interest (ROIs), from resting-state functional-MRIs of 99 subjects (52 controls, 26 right- and 21 left-MTLE patients with HS). Image preprocessing and statistical analysis were performed using UF(2) C-toolbox, which provided ROI-wise results for intranetwork and internetwork connectivity. Intranetwork abnormalities were observed in the dorsal default mode network (DMN) in both groups of patients and in the posterior salience network in right-MTLE. Both groups showed abnormal correlation between the dorsal-DMN and the posterior salience, as well as between the dorsal-DMN and the executive-control network. Patients with left-MTLE also showed reduced correlation between the dorsal-DMN and visuospatial network and increased correlation between bilateral thalamus and the posterior salience network. The ipsilateral hippocampus stood out as a central area of abnormalities. Alterations on left-MTLE expressed a low cluster coefficient, whereas the altered connections on right-MTLE showed low cluster coefficient in the DMN but high in the posterior salience regions. Both right- and left-MTLE patients with HS have widespread abnormal interactions of large-scale brain networks; however, all parameters evaluated indicate that left-MTLE has a more intricate bihemispheric dysfunction compared to right-MTLE. Hum Brain Mapp 37:3137-3152, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. © 2016 The Authors Human Brain Mapping Published by

Thoracic aortic stent-graft placement combined with left subclavian artery 'chimney operation': therapeutic analysis of 15 cases with insufficient proximal anchor area

International Nuclear Information System (INIS)

Liu Jiayi; Huang Lianjun; Fan Zhanming; Zhang Zhaoqi

2012-01-01

Objective: To discuss the strategies for the management of insufficient proximal anchoring area during the performance of transluminal stent-graft placement (TSGP), and to evaluate the feasibility of intentional coverage of the left subclavian artery (LSA) together with left subclavian artery stent-graft placement by using 'chimney operation' technique. Methods: A total of 15 patients with thoracic aortic diseases complicated by insufficient proximal anchoring area, who were encountered in authors' hospital during the period from Dec. 2009 to April 2011, were enrolled in this study. The clinical data were retrospectively analyzed. The thoracic aortic diseases included aortic dissection (n=6), aortic pseudoaneurysm (n=1), aortic aneurysm (n=4) and penetrating ulcer (n=4). Of the 15 patients, the distance between the lesion and LSA anchoring site 15 mm in 2. TSGP was carried out. The ostium of LSA was intentionally and completely covered by thoracic aortic stent-graft and left subclavian artery stent-graft placement was subsequently performed. The patients were kept under observation for symptoms of cerebral and upper limb ischemia. The postoperative complications such as endoleak and the patency of LSA were assessed with angiography. Results: Thoracic aortic stent-graft placement was successfully carried out in all 15 patients. In addition, one 'chimney' stent was properly implanted in LSA in each patient. After the procedure, no complications of nervous system or severe ischemia of upper extremity occurred. Follow-up examinations performed between 5 days to 3 months after the treatment revealed that the aortic stent-graft remained in stable condition and no type Ⅰ endoleak occurred, meanwhile the blood flow in 'chimney' stent was unobstructed. Conclusion: Intentional LSA coverage with 'chimney operation' can expand the applicability of TSGP with high tolerability. It is especially useful for patients with left vertebral artery blood supply dominance or with

Revisions to the original extent of the Devonian Shale-Middle and Upper Paleozoic Total Petroleum System

Science.gov (United States)

Enomoto, Catherine B.; Rouse, William A.; Trippi, Michael H.; Higley, Debra K.

2016-04-11

Technically recoverable undiscovered hydrocarbon resources in continuous accumulations are present in Upper Devonian and Lower Mississippian strata in the Appalachian Basin Petroleum Province. The province includes parts of New York, Pennsylvania, Ohio, Maryland, West Virginia, Virginia, Kentucky, Tennessee, Georgia, and Alabama. The Upper Devonian and Lower Mississippian strata are part of the previously defined Devonian Shale-Middle and Upper Paleozoic Total Petroleum System (TPS) that extends from New York to Tennessee. This publication presents a revision to the extent of the Devonian Shale-Middle and Upper Paleozoic TPS. The most significant modification to the maximum extent of the Devonian Shale-Middle and Upper Paleozoic TPS is to the south and southwest, adding areas in Tennessee, Georgia, Alabama, and Mississippi where Devonian strata, including potential petroleum source rocks, are present in the subsurface up to the outcrop. The Middle to Upper Devonian Chattanooga Shale extends from southeastern Kentucky to Alabama and eastern Mississippi. Production from Devonian shale has been established in the Appalachian fold and thrust belt of northeastern Alabama. Exploratory drilling has encountered Middle to Upper Devonian strata containing organic-rich shale in west-central Alabama. The areas added to the TPS are located in the Valley and Ridge, Interior Low Plateaus, and Appalachian Plateaus physiographic provinces, including the portion of the Appalachian fold and thrust belt buried beneath Cretaceous and younger sediments that were deposited on the U.S. Gulf Coastal Plain.

Left-handedness and language lateralization in children.

Science.gov (United States)

Szaflarski, Jerzy P; Rajagopal, Akila; Altaye, Mekibib; Byars, Anna W; Jacola, Lisa; Schmithorst, Vincent J; Schapiro, Mark B; Plante, Elena; Holland, Scott K

2012-01-18

This fMRI study investigated the development of language lateralization in left- and righthanded children between 5 and 18 years of age. Twenty-seven left-handed children (17 boys, 10 girls) and 54 age- and gender-matched right-handed children were included. We used functional MRI at 3T and a verb generation task to measure hemispheric language dominance based on either frontal or temporo-parietal regions of interest (ROIs) defined for the entire group and applied on an individual basis. Based on the frontal ROI, in the left-handed group, 23 participants (85%) demonstrated left-hemispheric language lateralization, 3 (11%) demonstrated symmetric activation, and 1 (4%) demonstrated right-hemispheric lateralization. In contrast, 50 (93%) of the right-handed children showed left-hemispheric lateralization and 3 (6%) demonstrated a symmetric activation pattern, while one (2%) demonstrated a right-hemispheric lateralization. The corresponding values for the temporo-parietal ROI for the left-handed children were 18 (67%) left-dominant, 6 (22%) symmetric, 3 (11%) right-dominant and for the right-handed children 49 (91%), 4 (7%), 1 (2%), respectively. Left-hemispheric language lateralization increased with age in both groups but somewhat different lateralization trajectories were observed in girls when compared to boys. The incidence of atypical language lateralization in left-handed children in this study was similar to that reported in adults. We also found similar rates of increase in left-hemispheric language lateralization with age between groups (i.e., independent of handedness) indicating the presence of similar mechanisms for language lateralization in left- and right-handed children. Copyright © 2011 Elsevier B.V. All rights reserved.

Type of delta cycle in the Upper Westphalian of the Central coalfield (Spain)

Energy Technology Data Exchange (ETDEWEB)

Colmenero, J R; Barba Regidor, P

1985-01-01

The deltas were one of the main depositional systems in Westphalian sedimentation of the Central Asturian Coalfield. A prograding shallow fluvial dominated deltaic cycle is analyzed in this paper. The prograding coarsening-upward sequence consists mainly of sandstone lithofacies deposited by small-scale distributary fluvial channels and bars. Several widely distributed bituminous coal seams in the delta-plain lithofacies reflect inactive stages without sedimentation before its definitive abandonment.

[Effect of disease severity on upper extremity muscle strength, exercise capacity, and activities of daily living in individuals with pulmonary arterial hypertension].

Science.gov (United States)

Özcan Kahraman, Buse; Özsoy, İsmail; Acar, Serap; Özpelit, Ebru; Akdeniz, Bahri; Sevinç, Can; Savcı, Sema

2017-07-01

Pulmonary arterial hypertension (PAH) is a rare disease. Although muscle strength, exercise capacity, quality of life, and activities of daily living of patients with PAH are affected, it is not known how they are affected by disease severity. The purpose of the present study was to investigate effects of disease severity on upper extremity muscle strength, exercise capacity, and performance of activities of daily living in patients with PAH. Twenty-five patients with disease severity classified according to the New York Heart Association (NYHA) as functional class II (n=14) or class III (n=11) were included in the study. Upper-extremity exercise capacity and limitations in performing activities of daily living were assessed with 6-minute pegboard and ring test (6PBRT) and the Milliken activities of daily living scale (MAS), respectively. Shoulder flexion, elbow extension, elbow flexion muscle strength, and handgrip strength were measured with dynamometer. There were no significant differences in age, gender, body mass index, or mean pulmonary artery pressure between groups (p>0.05). The 6PBRT, MAS, and elbow flexion (right) and grip strength (right and left) results were significantly lower in NYHA III group than in NYHA II group (p=0.004, p=0.002, p=0.043, p=0.002 and p=0.003, respectively). There was no significant difference in shoulder flexion, elbow flexion (left), or elbow extension between groups (p>0.05). Results suggest that upper extremity exercise capacity, elbow flexion muscle strength (right), and handgrip strength decrease and that limitations in activities of daily living grow as disease severity increases in patients with PAH. When planning rehabilitation programs, disease severity should be considered and evaluations and treatments for the upper extremities should be included.

Reduction mammoplasty as a treatment for symptomatic central venous stenosis

Directory of Open Access Journals (Sweden)

Denise Seok Fun Fok

2018-03-01

Full Text Available Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to, inflammatory breast carcinoma, mastitis, lymphedema, and congestive heart failure. All reports of similar cases in the available literature have described improvement or resolution of the edema after treatment. Herein, we report and discuss the pathophysiology of breast edema formation in a patient who presented with massive left-sided breast edema 7 years after being diagnosed with central venous stenosis. Medical and minimally invasive therapy had not been successful, so she underwent reduction mammoplasty to relieve the symptoms.

Epigondolella abneptis and E. spatulata in the Lower Norian in the central Kamnik Alps, Slovenia

Directory of Open Access Journals (Sweden)

Anton Ramovš

1994-12-01

Full Text Available Epigondolella abneptis (Huckriede, 1958 and E. spatulata (Hayashi, 1968from the Lower Norian (Upper Triassic deeper marine micritic limestones with chert nodules and lenses in the locality Sleme, central Kamnik Alps, are presented.

Central venous stenosis among hemodialysis patients is often not associated with previous central venous catheters.

Science.gov (United States)

Kotoda, Atsushi; Akimoto, Tetsu; Kato, Maki; Kanazawa, Hidenori; Nakata, Manabu; Sugase, Taro; Ogura, Manabu; Ito, Chiharu; Sugimoto, Hideharu; Muto, Shigeaki; Kusano, Eiji

2011-01-01

It is widely assumed that central venous stenosis (CVS) is most commonly associated with previous central venous catheterization among the chronic hemodialysis (HD) patients. We evaluated the validity of this assumption in this retrospective study. The clinical records from 2,856 consecutive HD patients with vascular access failure during a 5-year period were reviewed, and a total of 26 patients with symptomatic CVS were identified. Combined with radiological findings, their clinical characteristics were examined. Only seven patients had a history of internal jugular dialysis catheterization. Diagnostic multidetector row computed tomography angiography showed that 7 of the 19 patients with no history of catheterization had left innominate vein stenosis due to extrinsic compression between the sternum and arch vessels. These patients had a shorter period from the time of creation of the vascular access to the initial referral (9.2 ± 7.6 months) than the rest of the patients (35.5 ± 18.6 months, p = 0.0017). Our findings suggest that cases without a history of central venous catheterization may not be rare among the HD patients with symptomatic CVS. However, those still need to be confirm by larger prospective studies of overall chronic HD patients with symptomatic CVS.

Hand preference and magnetic resonance imaging asymmetries of the central sulcus.

Science.gov (United States)

Foundas, A L; Hong, K; Leonard, C M; Heilman, K M

1998-04-01

Hand preference is perhaps the most evident behavioral asymmetry observed in humans. Anatomic brain asymmetries that may be associated with hand preference have not been extensively studied, and no clear relationship between asymmetries of the motor system and hand preference have been established. Therefore, using volumetric magnetic resonance imaging methodologies, the surface area of the hand representation was measured along the length of the central sulcus in 15 consistent right- and 15 left-handers matched for age and gender. There was a significant leftward asymmetry of the motor hand area of the precentral gyrus in the right-handers, but no directional asymmetry was found in the left-handers. When asymmetry quotients were computed to determine the distribution of interhemispheric asymmetries, the left motor bank was greater than the right motor bank in 9 of 15 right-handers, the right motor bank was greater than the left motor bank in 3 of 15 right-handers, and the motor banks were equal in 3 of 15 right-handers. In contrast, among left-handers, the left motor bank was greater than the right motor bank in 5 of 15, the right motor bank was greater than the left motor bank in 5 of 15, and the motor banks were equal in 5 of 15. Although no direct measure of motor dexterity and skill was performed, these data suggest that anatomic asymmetries of the motor hand area may be related to hand preference because of the differences in right-handers and left-handers. Furthermore, the predominant leftward asymmetry in right-handers and the random distribution of asymmetries in the left-handers support Annett's right-shift theory. It is unclear, however, whether these asymmetries are the result of preferential hand use or are a reflection of a biologic preference to use one limb over the other.

AngioVac Aspiration for Paradoxical Emboli Protection through a Fenestrated Fontan During Central Venous Thrombus Manipulation

Energy Technology Data Exchange (ETDEWEB)

Al-Hakim, Ramsey, E-mail: ralhakim@mednet.ucla.edu [University of California, Department of Radiology, Division of Interventional Radiology (United States); Patel, Komal, E-mail: kdpatel@mednet.ucla.edu [University of California, Department of Anesthesiology, Division of Cardiothoracic Anesthesiology (United States); Moriarty, John M., E-mail: jmoriarty@mednet.ucla.edu [University of California, Department of Radiology, Division of Interventional Radiology (United States)

2015-06-15

This case reports describes a 39-year-old female with a history of surgically repaired hypoplastic left heart syndrome who presented with a left peripherally inserted central catheter (PICC) with associated large volume subclavian and brachiocephalic vein thrombus. Due to the presence of a right-to-left shunt via a fenestrated Fontan, there was clinical concern for a paradoxical embolism during removal of the PICC. The AngioVac aspiration system was successfully utilized to aspirate thromboemboli from the level of the proximal Glenn shunt during manipulation and removal of the PICC. This is the first reported case to demonstrate the safe and effective use of the AngioVac aspiration system for protection of paradoxical emboli through a cardiac right-to-left shunt during a procedure at high risk for thromboembolism.

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

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

2014-11-06

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

A case report of central toxic keratopathy in a patient post TransPRK (followed by corneal collagen cross-linking).

Science.gov (United States)

Davey, Nicholas; Aslanides, Ioannis M; Selimis, Vasilis

2017-01-01

The purpose of this article is to report a case of central toxic keratopathy in a patient post transepithelial photorefractive keratectomy (TransPRK), followed immediately by corneal collagen cross-linking. This article describes the case of a 26-year-old male after bilateral aberration-free, TransPRK laser (Schwind Amaris 750S). The procedure was performed for compound myopic astigmatism in November 2015, followed immediately by accelerated corneal collagen cross-linking for early keratoconus. From day 3 post-op, tear film debris underneath both contact lenses with corneal haze and early, progressive central anterior stromal opacity formation only in the left eye were noted. At 2 weeks post-op, the left eye was noted to have a significant hyperopic shift with central corneal thinning in the anterior stroma. A central anterior stromal dense opacity had formed in the left eye with the surrounding superficial stromal haze. As of month 2, the opacity gradually started to improve in size and density. The hyperopic shift peaked at 2 months and continued to improve, largely due to epithelial compensation with a gradual recovery of stromal thickness. The question remains as to what provokes the typical central corneal necrosis/thinning in central toxic keratopathy. We hypothesize that the space between the contact lens and the corneal surface post TransPRK is prone to a "pseudo-interface pathology" that could mimic diffuse lamellar keratitis-like pathology. Suboptimal lid hygiene, resulting in tear film combinations of bacteria, inflammatory cells, matrix metalloproteinases and other proteolytic enzymes, contributes to the degradation of vulnerable, exposed collagen stromal tissue post TransPRK or any surface corneal ablation. Refractive surgeons should maintain a healthy lid margin and tear film, especially in contact lens wearers, to prevent potential complications in refractive surgery procedures.

A NEW LATE YPRESIAN SPECIES OF ASTERIGERINA AND THE FIRST RECORDS OF ORNATOROTALIA AND GRANOROTALIA FROM THE THANETIAN AND UPPER YPRESIAN OF TURKEY

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ERCÜMENT SİREL

2017-01-01

Full Text Available A new larger benthic foraminifer, Asterigerina cayrazensis n. sp., is described from the upper Ypresian (middle-upper Cuisian of the Çayraz section, N of Haymana, S Ankara, central Turkey, from which also the rotaliine species Ornatorotalia spinosa, O. granum and Granorotalia sublobata are first recorded. In addition, Ornatorotalia sp. is recorded from the Thanetian limestone of the Harabekayış section, W Elazığ, eastern Turkey.

Producing The New Regressive Left

DEFF Research Database (Denmark)

Crone, Christine

members, this thesis investigates a growing political trend and ideological discourse in the Arab world that I have called The New Regressive Left. On the premise that a media outlet can function as a forum for ideology production, the thesis argues that an analysis of this material can help to trace...... the contexture of The New Regressive Left. If the first part of the thesis lays out the theoretical approach and draws the contextual framework, through an exploration of the surrounding Arab media-and ideoscapes, the second part is an analytical investigation of the discourse that permeates the programmes aired...... becomes clear from the analytical chapters is the emergence of the new cross-ideological alliance of The New Regressive Left. This emerging coalition between Shia Muslims, religious minorities, parts of the Arab Left, secular cultural producers, and the remnants of the political,strategic resistance...

Acute traumatic central cord syndrome: analysis of clinical and radiological correlations.

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Miranda, P; Gomez, P; Alday, R

2008-12-01

In patients with traumatic spinal cord injury, several studies correlate neurological impairment and radiological findings. However, little information is available about this correspondence in the particular group of acute traumatic central cord syndrome. The object of the present work was to describe the clinical and radiological features of a series of patients presenting with acute traumatic central cord syndrome and to analyze clinical and radiological correlations on admission and at last follow-up. Retrospective review of 15 patients diagnosed of acute traumatic central cord syndrome between 1995 and 2005. Global motor score and motor score in upper extremities were determined on admission and at last follow-up (6 months-4 years, mean 16 months). Plain films, cervical computed tomography and magnetic resonance (MR) were performed in every patient and retrieved for the study. In seven patients, serial MR studies were performed during follow-up. Clinical and radiological correlations were statistically analyzed with non-parametric tests. Cervical spondylosis appeared associated with older age, falls, and absence of fracture. Spinal cord edema was the most common finding in MR studies but hemorrhage was also observed. The length of spinal cord edema significantly correlated with initial motor score. The decrease in T2-weighted hyperintensity in serial MR studies correlated with the gain of motor power in upper limbs at last follow-up. Elderly patients with more degenerated cervical spines commonly develop acute traumatic central cord syndrome after incidental falls. Length of spinal cord edema correlates with neurological impairment on admission and may provide significant prognostic information.

Bronchial compression by an enlarged left atrium in infants; a cause of hypovascularity of the left lung

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Corr, L.; Hallidie-Smith, K.A.; McCarthy, P.A.; Lavender, J.P.

1988-09-01

In three infants seen recently at our institution we noted signs of compression of the left main bronchus associated with enlarged left atria. None of our cases demonstrated the more usual signs of hyperinflation which are a hyperlucent lung field, depressed hemidiaphragm and mediastinal shift away from the affected side. In addition, hypoperfusion of the left lung was noted in each case. We believe that bronchial compression due to an enlarged left atrium, with consequent hypoxic vasoconstriction is a clinically significant entity, which is not well described and may be unappreciated in infants in whom the typical signs of hyperinflation are absent.

Petrographic Evidence of Microbial Mats in the Upper Cretaceous Fish-Bearing, Organic-Rich Limestone, Agua Nueva Formation, Central Mexico

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Blanco, A.; Maurrasse, F. J.; Hernández-Ávila, J.; Ángeles-Trigueros, S. A.; García-Cabrera, M. E.

2013-05-01

We document petrographic evidence of microbial mats in the Upper Cretaceous Agua Nueva Formation in the area of Xilitla (San Luis Potosí, Central Mexico), located in the southern part of the Tampico-Misantla basin. The sequence consists predominantly of alternating decimeter-thick beds of fossiliferous dark laminated limestone (C-org > 1.0wt%), and light gray, bioturbated limestone (C-org Duque-Botero and Maurrasse, 2005; 2008). These structures are also analogous to microbial mats in present environments, and Devonian deposits (Kremer, 2006). In addition, the laminae at Xilitla include filamentous bacterial structures, as thin and segmented red elements. In some thin sections, filaments appear to be embedded within the crinkly laminae and shreds showing the same pattern of folding, suggestive of biomorphic elements that represent the main producers of the organic matter associated with the laminae. Thus, exceptional bacterial activity characterizes sedimentation during the accumulation of the Agua Nueva Formation. Oxygen-deficient conditions related to the microbial mats were an important element in the mass mortality and preservation of the fish assemblages. Absence of bioturbation, pervasive framboidal pyrite, and the high concentration of organic matter (TOC ranges from 1.2% to 8wt%) in the dark limestones are consistent with persistent recurring dysoxic/anoxic conditions, and the light-gray bioturbated limestones represent relatively well-oxygenated episodes. Planktonic foraminifera (Rotalipora cushmani) and Inoceramu labiatus indicate a time interval from the latest Cenomanian through the earliest Turonian, thus this long interval of severe oxygen deficiency is coeval with Oceanic Anoxic Event 2 (OAE-2). [Duque-Botero and Maurrasse. 2005. Jour. Iberian Geology (31), 85-98; 2008. Cret. Res., 29, 957-964; Kremer. 2006. Acta Palaeontologica Polonica (51, 1), 143-154

Central hypothyroidism

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Vishal Gupta

2011-01-01

Full Text Available Central hypothyroidism is defined as hypothyroidism due to insufficient stimulation by thyroid stimulating hormone (TSH of an otherwise normal thyroid gland. It has an estimated prevalence of approximately 1 in 80,000 to 1 in 120,000. It can be secondary hypothyroidism (pituitary or tertiary hypothyroidism (hypothalamus in origin. In children, it is usually caused by craniopharyngiomas or previous cranial irradiation for brain tumors or hematological malignancies. In adults, it is usually due to pituitary macroadenomas, pituitary surgeries or post-irradiation. Fatigue and peripheral edema are the most specific clinical features. Diagnosis is established by the presence of normal to low-normal TSH on the background of low-normal thyroid hormones, confirmed by the thyrotropin releasing hormone stimulation test. Therapy includes use of levothyroxine titrated to improvement in symptomology and keeping free T4 in the upper limit of normal reference range.

Difference in Functional Performance on the Upper-Quarter Y-Balance Test Between High School Baseball Players and Wrestlers.

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Myers, Heather; Poletti, Mary; Butler, Robert J

2017-05-01

The Upper Quarter Y-Balance Test (YBT-UQ) is a unique movement test where individuals perform at the limits of their stability, requiring the coordination of balance, proprioception, range of motion, and stabilization. It is not yet clear if performance on the YBT-UQ differs between sports with dissimilar emphasis on upper-extremity performance. To compare performance on the YBT-UQ between wrestlers, whose sport requires some degree of closed-chain activity, and baseball players, whose sport is primarily open kinetic chain in nature. Cross-sectional. High school preparticipation physical assessment. 24 healthy high school male wrestlers (mean age 16.12 ± 1.24 y) and 24 healthy high school male baseball players (mean age 15.79 ± 1.25 y). All subjects performed the YBT-UQ, which requires reaching in 3 directions while maintaining a push-up position. The variables of interest include the maximum reach in each direction, as well as the composite score. In addition, asymmetries between limbs for each reach direction were compared. Wrestlers performed significantly better than baseball players in the medial direction, inferolateral direction, and in composite scores. In the medial direction, wrestlers exhibited greater scores (P < .01) on both left and right limbs, 10.5 ± 10.2%LL and 9.95 ± 10.2%LL, respectively. Significant differences (P < .01) were also observed in the inferolateral direction, with a difference of 11.3 ± 12.0%LL on the left and 8.7 ± 11.0%LL on the right. Composite scores were higher (P < .01) for the wrestlers, with a difference of 7.0% on the left and 7.1% on the right. This study suggests that wrestlers perform better on the YBT-UQ than baseball players. The findings may suggest sport-specific normative data for the YBT-UQ in high school athletes.

Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis

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Nodari Franco

2011-08-01

Full Text Available Abstract Background The ergotamine tartrate associated with certain categories of drugs can lead to critical ischemia of the extremities. Discontinuation of taking ergotamine is usually sufficient for the total regression of ischemia, but in some cases it could be necessary thrombolytic and anticoagulant therapy to avoid amputation. Case report A woman of 62 years presented with a severe pain left forearm appeared 10 days ago, with a worsening trend. The same symptoms appeared after 5 days also in the right forearm. Physical examination showed the right arm slightly hypothermic, with radial reduced pulse in presence of reduced sensitivity. The left arm was frankly hypothermic, pulse less on radial and with an ulnar humeral reduced pulse, associated to a decreased sensitivity and motility. Clinical history shows a chronic headache for which the patient took a daily basis for years Cafergot suppository (equivalent to 3.2 mg of ergotamine. From about ten days had begun therapy with itraconazole for vaginal candidiasis. The Color-Doppler ultrasound shown arterial thrombosis of the upper limbs (humeral and radial bilateral, with minimal residual flow to the right and no signal on the humeral and radial left artery. Results Angiography revealed progressive reduction in size of the axillary artery and right humeral artery stenosis with right segmental occlusions and multiple hypertrophic collateral circulations at the elbow joint. At the level of the right forearm was recognizable only the radial artery, decreased in size. Does not recognize the ulnar, interosseous artery was thin. To the left showed progressive reduction in size of the distal subclavian and humeral artery, determined by multiple segmental steno-occlusion with collateral vessels serving only a thin hypotrophic interosseous artery. Arteriographic findings were compatible with systemic drug-induced disease. The immediate implementation of thrombolysis, continued for 26 hours, with