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Sample records for upper thoracic region

  1. Palpation of the upper thoracic spine

    DEFF Research Database (Denmark)

    Christensen, Henrik Wulff; Vach, Werner; Vach, Kirstin

    2002-01-01

    procedure. RESULTS: Using an "expanded" definition of agreement that accepts small inaccuracies (+/-1 segment) in the numbering of spinal segments, we found--based on the pooled data from the thoracic spine--kappa values of 0.59 to 0.77 for the hour-to-hour and the day-to-day intraobserver reliability......OBJECTIVE: To assess the intraobserver reliability (in terms of hour-to-hour and day-to-day reliability) and the interobserver reliability with 3 palpation procedures for the detection of spinal biomechanic dysfunction in the upper 8 segments of the thoracic spine. DESIGN: A repeated....... INTERVENTION: Three types of palpation were performed: Sitting motion palpation and prone motion palpation for biomechanic dysfunction and paraspinal palpation for tenderness. Each dimension was rated as "absent" or "present" for each segment. All examinations were performed according to a standard written...

  2. Regional interdependence and manual therapy directed at the thoracic spine.

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    McDevitt, Amy; Young, Jodi; Mintken, Paul; Cleland, Josh

    2015-07-01

    Thoracic spine manipulation is commonly used by physical therapists for the management of patients with upper quarter pain syndromes. The theoretical construct for using thoracic manipulation for upper quarter conditions is a mainstay of a regional interdependence (RI) approach. The RI concept is likely much more complex and is perhaps driven by a neurophysiological response including those related to peripheral, spinal cord and supraspinal mechanisms. Recent evidence suggests that thoracic spine manipulation results in neurophysiological changes, which may lead to improved pain and outcomes in individuals with musculoskeletal disorders. The intent of this narrative review is to describe the research supporting the RI concept and its application to the treatment of individuals with neck and/or shoulder pain. Treatment utilizing both thrust and non-thrust thoracic manipulation has been shown to result in improvements in pain, range of motion and disability in patients with upper quarter conditions. Research has yet to determine optimal dosage, techniques or patient populations to which the RI approach should be applied; however, emerging evidence supporting a neurophysiological effect for thoracic spine manipulation may negate the need to fully answer this question. Certainly, there is a need for further research examining both the clinical efficacy and effectiveness of manual therapy interventions utilized in the RI model as well as the neurophysiological effects resulting from this intervention.

  3. Radiation therapy for the cervical and upper thoracic esophageal cancer

    International Nuclear Information System (INIS)

    Chatani, Masashi; Teshima, Teruki; Inoue, Toshihiko

    1990-01-01

    This is a retrospective analysis of 19 patients with carcinoma of the cervical esophagus (Ce) and 36 of the upper thoracic esophagus (Iu) treated with radiotherapy between September 1977 and December 1987. Three-year survival rates by Kaplan-Meier method were 18% in Ce cancer and 7% in Iu cancer. Two-year local tumor control was obtained in 3 Ce and 4 Iu cancer. Concerning the treatment methods for the above 7 patients, 3 patients with carcinoma of the Ce were treated with double wedged technique and 4 of Iu were treated with box-technique (2 patients), rotation technique (1) and double wedge technique (1). There were no 2-year local tumor control in patients who received less than 60 Gy of the tumor dose or whose tumor exceeded more than 10 cm in length. Double wedge technique is suitable for radiotherapy of Ce cancer, while further investigation of dose and compensation is necessary for Iu cancer. (author)

  4. UPPER THORACIC SPINE FRACTURE ASSOCIATED WITH FRACTURE OF THE STERNUM

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    JOAQUÍN VALERO

    Full Text Available ABSTRACT Objectives: The objectives of this presentation are to analyze the kinematics that causes this association, describe the impact of the injury, and evaluate the treatment performed Methods: Three cases are analyzed by quantifying the displacement and angulation of the sternum, the characteristics of the spinal injury and deformity, treatment, and complications Results: The mechanism that causes the injury is flexion-distraction, the component of the vertebral body presented is type A, and the most affected region was T5. Two patients had neurological picture E. Sternum injury was caused by direct trauma Conclusion: The association of these was observed in patients who have suffered from high-energy trauma in a car accident. There was no relationship between the angulation of the sternum and its displacement to the degree of kyphosis and displacement of the thoracic spine. It is important to carry out good radiographic studies that include the sternum when there is suspicion of this relationship.

  5. Upper thoracic-spine disc degeneration in patients with cervical pain.

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    Arana, Estanislao; Martí-Bonmatí, Luis; Mollá, Enrique; Costa, Salvador

    2004-01-01

    To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established. One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6 +/- 14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion. Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2-3 was the most commonly affected level of the upper thoracic spine, with 15 bulge/protrusions and one extrusion. Upper degenerative thoracic disc contour changes presented in older patients than the cervical levels (Student-Newman-Keuls test, P < 0.001). Degenerative disc contour changes at the C7-T1, T1-2, T2-3 and T3-4 levels were significantly correlated ( P = 0.001), but unrelated to any other disc disease, patient's gender or age. Degenerative cervical disc disease was closely related together ( P < 0.001), but not with any thoracic disc. A statistically significant relation was found within the upper thoracic discs, reflecting common pathoanatomical changes. The absence of relation to cervical segments is probably due to differences in their pathomechanisms.

  6. Upper thoracic-spine disc degeneration in patients with cervical pain

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    Arana, Estanislao; Marti-Bonmati, Luis; Costa, Salvador [Department of Radiology, Clinica Quiron, Avda Blasco Ibanez 14, 46010, Valencia (Spain); Molla, Enrique [Department of Radiology, Clinica Quiron, Avda Blasco Ibanez 14, 46010, Valencia (Spain); Department of Morphological Sciences, University of Valencia, Valencia (Spain)

    2004-01-01

    To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established. One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6{+-}14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion. Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2-3 was the most commonly affected level of the upper thoracic spine, with 15 bulge/protrusions and one extrusion. Upper degenerative thoracic disc contour changes presented in older patients than the cervical levels (Student-Newman-Keuls test, P<0.001). Degenerative disc contour changes at the C7-T1, T1-2, T2-3 and T3-4 levels were significantly correlated (P=0.001), but unrelated to any other disc disease, patient's gender or age. Degenerative cervical disc disease was closely related together (P<0.001), but not with any thoracic disc. A statistically significant relation was found within the upper thoracic discs, reflecting common pathoanatomical changes. The absence of relation to cervical segments is probably due to differences in their pathomechanisms. (orig.)

  7. Upper thoracic-spine disc degeneration in patients with cervical pain

    International Nuclear Information System (INIS)

    Arana, Estanislao; Marti-Bonmati, Luis; Costa, Salvador; Molla, Enrique

    2004-01-01

    To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established. One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6±14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion. Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2-3 was the most commonly affected level of the upper thoracic spine, with 15 bulge/protrusions and one extrusion. Upper degenerative thoracic disc contour changes presented in older patients than the cervical levels (Student-Newman-Keuls test, P<0.001). Degenerative disc contour changes at the C7-T1, T1-2, T2-3 and T3-4 levels were significantly correlated (P=0.001), but unrelated to any other disc disease, patient's gender or age. Degenerative cervical disc disease was closely related together (P<0.001), but not with any thoracic disc. A statistically significant relation was found within the upper thoracic discs, reflecting common pathoanatomical changes. The absence of relation to cervical segments is probably due to differences in their pathomechanisms. (orig.)

  8. The Flail and Pulseless Upper Limb: an Extreme Case of Traumatic Scapulo-thoracic Dissociation

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    Maria SW

    2015-07-01

    Full Text Available Scapulo-thoracic dissociation is an infrequent injury resulting from high energy trauma which is often associated with severe neurological and vascular injuries which may be unrecognised at the time of presentation. A 24 year-old female presented with bilateral rib fractures, pneumothorax, liver and kidney injuries following a road traffic accident. She also sustained fractures of her right scapula, odontoid, right transverse processes of the thoracic and lumbar vertebrae and a closed fracture of her right femur. Her right upper limb was later noted to be flail and pulseless, due to complete right brachial plexus injury, scapula-thoracic dissociation and subclavian artery avulsion. We managed the upper limb injuries non-operatively, and focused on resuscitation of the patient. Early exploration of the complete brachial plexus injury was not undertaken in spite of the possible associated poor functional outcome as there was no life-threatening indication.

  9. Upper gastrointestinal bleeding, aneurismatic dilatation of the thoracic aorta and filling defect on the esophagogram

    Energy Technology Data Exchange (ETDEWEB)

    Naschitz, J.E.; Bassan, H.; Lazarov, N.; Grishkan, A.

    1982-06-01

    A patient is described with an aneurysm of the thoracic aorta, which has ruptured into the esophagus. An esophageal X-ray contrast study has revealed a filling defect at the contact site of the esophagus and the aortic aneurysm. The filling defect was due to a clot protruding from the aorta into the esophagus. This unique case calls attention to a diagnostic triad: upper gastrointestinal bleeding, aneurysm of the thoracic aorta, and filling defect in the esophagus at its site of contact with the enlarged aorta. This triad suggested aortoesophageal fistula (AEF) in the patient and could help in the diagnosis of atypical cases of AEF, where thoracic aortography has not been performed initially.

  10. Upper gastrointestinal bleeding, aneurismatic dilatation of the thoracic aorta and filling defect on the esophagogram

    International Nuclear Information System (INIS)

    Naschitz, J.E.; Bassan, H.; Lazarov, N.; Grishkan, A.; Haifa Univ.; Haifa Univ.

    1982-01-01

    A patient is described with an aneurysm of the thoracic aorta, which has ruptured into the esophagus. An esophageal X-ray contrast study has revealed a filling defect at the contact site of the esophagus and the aortic aneurysm. The filling defect was due to a clot protruding from the aorta into the esophagus. This unique case calls attention to a diagnostic triad: upper gastrointestinal bleeding, aneurysm of the thoracic aorta, and filling defect in the esophagus at its site of contact with the enlarged aorta. This triad suggested aortoesophageal fistula (AEF) in the patient and could help in the diagnosis of atypical cases of AEF, where thoracic aortography has not been performed initially. (orig.) [de

  11. Approach to the irradiation of extensive cervical and upper thoracic spinal astrocytoma

    International Nuclear Information System (INIS)

    Dvorak, E.

    1981-01-01

    Intramedullary spinal cord tumors are relatively rare, especially to the extent presented in this report. A 31-year-old woman had been diagnosed as having an inoperable astrocytoma, grade I-II, involving the entire cervical spinal cord and two upper thoracic segments. After decompressive laminectomy, she was referred for a radical course of radiation therapy. An irradiation technique was devised which allowed treatment of a single cylindrical volume of tissue encompassing the known tumor. Field fractionation with undesirable gaps and/or excessive dose to overlying normal structures was avoided. To the cervical spinal cord she received 5590 cGy in 29 fractions over 42 days. By this schedule she received at the same time 4820 cGy to the medulla oblongata and 4880 cGy to the upper thoracic cord. Partial neurological improvement occurred at the end of the treatment. The treatment approach is discussed in the background of the literature data. (orig.) [de

  12. Bilateral Upper Extremity DVT in a 43-Year-Old Man: Is It Thoracic Outlet Syndrome?!

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    Hadoun Jabri

    2014-01-01

    Full Text Available Recurrent deep venous thrombosis, involving bilateral upper extremities, is an extremely rare phenomenon. We are presenting a 43-year-old man who was diagnosed with left upper extremity deep vein thrombosis (UEDVT and was treated with anticoagulation and surgical decompression in 2004. 9 years later, he presented with right arm swelling and was diagnosed with right UEDVT using US venous Doppler. Venogram showed compression of the subclavian vein by the first rib, diagnosing thoracic outlet syndrome (TOS. He was treated with anticoagulation and local venolysis and later by surgical decompression of the subclavian vein. Bilateral UEDVT, as mentioned above, is an extremely rare condition that is uncommonly caused by TOS. To our knowledge, we are reporting the first case of bilateral UEDVT due to TOS. Diagnosis usually starts with US venous Doppler to detect the thrombosis, followed by the gold standard venogram to locate the area of obstruction and lyse the thrombus if needed. The ultimate treatment for TOS remains surgical decompression of the vascular bundle at the thoracic outlet.

  13. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial.

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    Dunning, James R; Cleland, Joshua A; Waldrop, Mark A; Arnot, Cathy F; Young, Ian A; Turner, Michael; Sigurdsson, Gisli

    2012-01-01

    Randomized clinical trial. To compare the short-term effects of upper cervical and upper thoracic high-velocity low-amplitude (HVLA) thrust manipulation to nonthrust mobilization in patients with neck pain. Although upper cervical and upper thoracic HVLA thrust manipulation and nonthrust mobilization are common interventions for the management of neck pain, no studies have directly compared the effects of both upper cervical and upper thoracic HVLA thrust manipulation to nonthrust mobilization in patients with neck pain. Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized to receive either HVLA thrust manipulation or nonthrust mobilization to the upper cervical (C1-2) and upper thoracic (T1-2) spines. Patients were reexamined 48-hours after the initial examination and again completed the outcome measures. The effects of treatment on disability, pain, C1-2 passive rotation range of motion, and motor performance of the deep cervical flexors were examined with a 2-by-2 mixed-model analysis of variance (ANOVA). One hundred seven patients satisfied the eligibility criteria, agreed to participate, and were randomized into the HVLA thrust manipulation (n = 56) and nonthrust mobilization (n = 51) groups. The 2-by-2 ANOVA demonstrated that patients with mechanical neck pain who received the combination of upper cervical and upper thoracic HVLA thrust manipulation experienced significantly (Ppain (58.5%) than those of the nonthrust mobilization group (12.8% and 12.6%, respectively) following treatment. In addition, the HVLA thrust manipulation group had significantly (Pcervical flexor muscles as compared to the group that received nonthrust mobilization. The number needed to treat to avoid an unsuccessful outcome

  14. Treatment of carcinoma of the upper thoracic segment of the esophagus

    International Nuclear Information System (INIS)

    Stolyarov, V.I.; Berezkin, D.P.; Trishkin, V.A.; Ekimov, V.I.; Filatov, V.N.; Shulepov, A.V.; Feliz, P.

    1987-01-01

    Out of 350 hospitalized cases of esophageal carcinoma in the upper thoracic segment, stage 3-4 tumors were identified in 82.8%. A retarded seeking of medical advice was chiefly responsidle for the advancement of tumors. Radical surgery was performed in 32 (9.1%) patients only. The percentage of radically-treated cases could have been greater, if there had been fewer refusals to operate and to be operated on both on the part of patiens and doctors who would object to surgery on the grounds of concomitant pathology or the patient's age. Radiotherapy, used in 197 (72.7%) patients as a sole method of treatment, was followed by remission in 68%

  15. DIFFERENT TYPES OF INSPIRATORY MUSCLE TRAINING PROVIDES BETTERMENT IN ALTERED PULMONARY FUNCTIONS IN UPPER THORACIC SPINAL CORD INJURIES

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    Muruganandam Periyasamy

    2016-08-01

    Full Text Available Background: Respiratory problems are usual in upper thoracic spinal cord injuries when compared to Lower thoracic spinal cord injuries. Generally there are frequent respiratory complications in the individuals with spinal cord injuries. The complications of the respiratory system are severe and more prevalent source of morbidity and mortality after the spinal cord injury due to the inefficient breathing capacity including inspiratory and expiratory abilities. The present study represents the inspiratory muscle training especially in upper thoracic spinal cord injury patients to assess the improvement in the pulmonary functions. Methods: Twenty five patients with the age between 25 -40 years with the upper spinal cord injuries were selected in the present study in order to assess the efficacy of the training. Several types of exercises were practiced including diaphragmatic breathing exercises, incentive spirometry, active cycle of breathing technique and weight training. COPD Conditions, Chest wall deformities, Hypertensive patients, Cardio vascular problems were excluded in the study. Results: The results from the study showed that significant changes were found in the patients treated with all the above mentioned techniques. Axillary level, nipple level, Xiphisternum levels were analysed and the results found to be significant after the treatment. Incentive spirometry and peak flow meter observations were also found to be significant when compare to the pretreatment. Conclusion: The present study conclude that the combined effect of incentive spriometry, diaphragmatic breathing exercises, and active cycle of breathing technique is more effective in improving the pulmonary functions in upper thoracic spinal cord injuries than single method efficiency.

  16. Postoperative thoracic hemorrhage after right upper lobectomy with thoracic wall resection during rivaroxaban anticoagulant therapy for deep leg vein thrombosis: A case report

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    Taiji Kuwata

    Full Text Available Introduction: Postoperative pulmonary embolism (PE is the one of the most important complications after thoracic surgery. This complicatin after the surgery is often treated by new anticoaglant drug, such as rivaroxaban, which dose not need to the monitoring of blood coaglation system. We experienced postoperative bleeding case during anticoaglant therapy using rivaroxaban. Presentation of case: The patient underwent a right upper lobectomy with lung and chest wall resection for lung cancer. On postoperative day (POD 10, we started to use rivaroxaban to treat the deep vein thrombosis (DVT. Four days after starting the rivaroxaban treatment, severe surgical site hemorrhage occurred, which led to the need for the infusion of concentrated red cells (CRC. After stopping the rivaroxaban, the thoracic bleeding ceased. Because the event occurred so long after the surgery, and because the bleeding stopped after withdrawal of treatment, we believe that rivaroxaban induced the thoracic bleeding. Conclusion: Some reports in the field of orthopedics (Turpie et al., 2009 have noted that rivarxaban is effective to prevent postoperative DVT. However, there were few reports that invied the attention to postoperative bleeding be induced by rivarxaban. Thus, we describe this case in order to alert clinicians to the potential bleeding risks associated with the admistration of rivaroxaban postoperatively. Keywords: Revaroxaban, Anticoagulant, Surgical site bleeding

  17. Trial study on design of irradiated fields of radiotherapy in cervical and upper thoracic esophageal cancer

    International Nuclear Information System (INIS)

    Liu Hui; Zeng Zhifan; Cui Nianji; He Zhichun; Huang Shaomin

    2006-01-01

    Objective: To compare three kinds of irradiation treatment plans for cervical and upper thoracic esophageal cancer, in order to arrived at proper decision for the patient. Methods: From February 2001 to June 2004, 43 such patients were studied with three different simulated treatment plans made including conformal plan, conventional four-field plan and conventional two-field plan for every one. All plans were evaluated with iso- dose curve and dose-volume histogram. Results: GTV on 95% isodose curve was 99.5%, 98.2% and 87.4% in conformal plan, conventional four-field plan and conventional two-field plan, respectively; PTV 1 and PTV 2 on 95% isodose with 97.8%, 97.2%, 94.8% and 95.8%, 86.6%, 73.7%. The volume of > 20 Gy dose of left lung accepted was 18.6%, 17.2% and 32.3%, in conformal plan, conventional four-field plan and conventional two-field plan, respectively; the right lung received 20.5% ,19.9% and 35.5%. Conclusions: Conformal plan is the best in radiotherapy, as it can provide ideal dose distribution of irradiated target with adequate protection of the normal tissues. Conventional four-field plan, being easy to carry, out, can replace the conformal plan in most situations. Conventional two-field has the most uneven dose distribution and largest lung volume irradiated. (authors)

  18. Experimental human-like model to assess the part of viable Legionella reaching the thoracic region after nebulization.

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    Jérémie Pourchez

    Full Text Available The incidence of Legionnaires' disease (LD in European countries and the USA has been constantly increasing since 1998. Infection of humans occurs through aerosol inhalation. To bridge the existing gap between the concentration of Legionella in a water network and the deposition of bacteria within the thoracic region (assessment of the number of viable Legionella, we validated a model mimicking realistic exposure through the use of (i recent technology for aerosol generation and (ii a 3D replicate of the human upper respiratory tract. The model's sensitivity was determined by monitoring the deposition of (i aerosolized water and Tc99m radio-aerosol as controls, and (ii bioaerosols generated from both Escherichia coli and Legionella pneumophila sg 1 suspensions. The numbers of viable Legionella prior to and after nebulization were provided by culture, flow cytometry and qPCR. This study was designed to obtain more realistic data on aerosol inhalation (vs. animal experimentation and deposition at the thoracic region in the context of LD. Upon nebulization, 40% and 48% of the initial Legionella inoculum was made of cultivable and non-cultivable cells, respectively; 0.7% of both populations reached the filter holder mimicking the thoracic region in this setup. These results are in agreement with experimental data based on quantitative microbial risk assessment methods and bring new methods that may be useful for preventing LD.

  19. Clinical accuracy of three-dimensional fluoroscopy (IsoC-3D)-assisted upper thoracic pedicle screw insertion

    International Nuclear Information System (INIS)

    Sugimoto, Yoshihisa; Ito, Yasuo; Shimokawa, Tetsuya; Shiozaki, Yasuyuki; Mazaki, Tetsuro; Tomioka, Masao; Tanaka, Masato

    2010-01-01

    Correct screw placement is especially difficult in the upper thoracic vertebrae. At the cervicothoracic junction (C7-T2), problems can arise because of the narrowness of the pedicle and the difficulty of using a lateral image intensifier there. Other upper thoracic vertebrae (T3-6) pose a problem for screw insertion also because of the narrower pedicle. We inserted 154 pedicle screws into 78 vertebrae (C7 to T6) in 38 patients. Screws were placed using intraoperative data acquisition by an isocentric C-arm fluoroscope (Siremobile Iso-C3D) and computer navigation. Out of 90 pedicle screws inserted into 45 vertebrae between C7 and T2, 87 of the 90 (96.7%) screws were classified as grade 1 (no perforation). Of 64 pedicle screws inserted into 33 vertebrae between T3 and T6, 61 of 64 (95.3%) screws were classified as grade 1. In this study, we reduced pedicle screw misplacement at the level of the C7 and upper thoracic (T1-6) vertebrae using the three-dimensional fluoroscopy navigation system. (author)

  20. Evaluation of the value of ENI in radiotherapy for cervical and upper thoracic esophageal cancer: a retrospective analysis.

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    Liu, Mina; Zhao, Kuaile; Chen, Yun; Jiang, Guo-Liang

    2014-10-25

    A retrospective study to compare the failure patterns and effects of elective nodal irradiation (ENI) or involved field irradiation (IFI) for cervical and upper thoracic esophageal squamous cell carcinoma (SCC) patients. One hundred and sixty nine patients with the cervical and upper thoracic esophageal SCC were analyzed retrospectively; 99 patients (59%) underwent IFI and 70 patients (41%) received ENI. We defined "Out-PTVifi in-PTVeni metastasis" as lymph node metastasis occurring in the cervical prophylactic field of PTVeni thus out of PTVifi. Out-PTVifi in-PTVeni cervical node metastasis occurred in 8% of patients in the IFI group, all within 2 years after treatment. However, it occurred in 10% of patients in the ENI group, and these failures happened gradually since one year after treatments. No difference was found in OS and the incidences of Grade ≥ 3 treatment-related esophageal and lung toxicities between the two groups. ENI for cervical and upper thoracic esophageal SCC patients did not bring longer OS and better long-term control of cervical lymph nodes. Although ENI might delay cervical nodes progression in elective field; it could not decrease the incidence of these failures.

  1. Upper Limit for Regional Sea Level Projections

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    Jevrejeva, Svetlana; Jackson, Luke; Riva, Riccardo; Grinsted, Aslak; Moore, John

    2016-04-01

    With more than 150 million people living within 1 m of high tide future sea level rise is one of the most damaging aspects of warming climate. The latest Intergovernmental Panel on Climate Change report (AR5 IPCC) noted that a 0.5 m rise in mean sea level will result in a dramatic increase the frequency of high water extremes - by an order of magnitude, or more in some regions. Thus the flood threat to the rapidly growing urban populations and associated infrastructure in coastal areas are major concerns for society. Hence, impact assessment, risk management, adaptation strategy and long-term decision making in coastal areas depend on projections of mean sea level and crucially its low probability, high impact, upper range. With probabilistic approach we produce regional sea level projections taking into account large uncertainties associated with Greenland and Antarctica ice sheets contribution. We calculate the upper limit (as 95%) for regional sea level projections by 2100 with RCP8.5 scenario, suggesting that for the most coastlines upper limit will exceed the global upper limit of 1.8 m.

  2. Dosimetric comparison using different multileaf collimeters in intensity-modulated radiotherapy for upper thoracic esophageal cancer

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    Fu Yuchuan

    2010-07-01

    Full Text Available Abstract Purpose To study the impacts of multileaf collimators (MLC width [standard MLC width of 10 mm (sMLC and micro-MLC width of 4 mm (mMLC] in the intensity-modulated radiotherapy (IMRT planning for the upper thoracic esophageal cancer (UTEC. Methods and materials 10 patients with UTEC were retrospectively planned with the sMLC and the mMLC. The monitor unites (MUs and dose volume histogram-based parameters [conformity index (CI and homogeneous index (HI] were compared between the IMRT plans with sMLC and with mMLC. Results The IMRT plans with the mMLC were more efficient (average MUs: 703.1 ± 68.3 than plans with the sMLC (average MUs: 833.4 ± 73.8 (p p 5 (3260.3 ± 374.0 vs 3404.5 ± 374.4/gEUD (1815.1 ± 281.7 vs 1849.2 ± 297.6 of the spinal cord, the V10 (33.2 ± 6.5 vs 34.0 ± 6.7, V20 (16.0 ± 4.6 vs 16.6 ± 4.7, MLD (866.2 ± 174.1 vs 887.9 ± 172.1 and gEUD (938.6 ± 175.2 vs 956.8 ± 171.0 of the lungs were observed in the plans with the mMLC, respectively (p Conclusions Comparing to the sMLC, the mMLC not only demonstrated higher efficiencies and more optimal target coverage, but also considerably improved the dose sparing of OARs in the IMRT planning for UTEC.

  3. Regional aerosol deposition in human upper airways

    International Nuclear Information System (INIS)

    Swift, D.L.

    1989-01-01

    During the report period significant progress on the quantitative understanding of regional upper airway deposition of airborne particle has been realized. Replicate models of the human upper airways obtained from post-mortem casting of the nasal, oral, pharyngeal, laryngeal and upper tracheal regions and in vivo magnetic resonance imaging (MRI) of the same regions of adults and children have been employed to determine the overall and local deposition characteristics of aerosols in the ultrafine (1--100 μm diameter) and fine (0.8--12 μm diameter) region. Studies have been carried out for both nasal and oral breathing during inspiratory and expiratory flow at constant flow rates representative of rest and states of exercise. The results of these investigations indicate that particles in the size range of ''unattached'' radon progeny (1--3 nm) are deposited in both the nasal and oral passages with high efficiency (60--80%) for both inspiration and expiration, with the nasal deposition being somewhat greater (5--10%) than oral deposition. The effect of flow rate on upper airway deposition for both pathways is not great; data analysis indicates that the deposition for all flow rates from 4--50 liters/minute can be grouped by plotting deposition vs Q- 1/8 , where Q is flow rate, a far weaker dependency than observed for inertial deposition. Diffusional transport is the primary mechanism of deposition, and size dependence can be accounted for by plotting, deposition percent vs D n where D is particle diffusion coefficient and n ranges from 0.5--0.66. 2 refs

  4. Effect of different ways of intraoperative lymph node dissection on prognosis of patients with thoracic mid-upper esophageal carcinoma

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    Zhi Huang

    2016-02-01

    Full Text Available Objective: To analyze the effect of different ways of intraoperative lymph node dissection on prognosis of patients with thoracic mid-upper esophageal carcinoma. Methods: 106 cases of patients with thoracic mid-upper esophageal carcinoma were selected and according to different ways of lymph node dissection, divided into three-field group who received three-field lymph node dissection and two-field group who received two-field lymph node dissection, then serum lactate dehydrogenase (LDH, nitric oxide (NO, nitric oxide synthase (NOS and carcinoembryonic antigen (CEA as well as soluble interleukin-2 receptor (SIL- 2R, keratinized protein fragment 19 (Cyfra21-1 and squamous cell carcinoma antigen (SCC levels of two groups were compared, and postoperative follow-up was carried out to record disease-free survival rate and overall survival rate. Results: In three-field group, postoperative average serum LDH levels of patients with thoracic upper esophageal carcinoma and thoracic mid esophageal carcinoma were lower than LDH values of corresponding patients in two-field group (P<0.05; postoperative serum NO value of three-field group was higher than that of two-field group, and NOS, CEA and SIL-2R values were lower than those of two-field group (P<0.05; postoperative serum Cyfra21-1 and SCC values of three-field group were lower than those of two-field group (P<0.05; postoperative disease-free survival rate during the followup period of three-field group was higher than that of two-field group, and overall survival rate at corresponding points in time was also higher than that of two-field group (P<0.05. Conclusion: After patients with thoracic mid-upper esophageal carcinoma receive three-field lymph node dissection, levels of serum indexes with poor prognosis and tumor markers were optimized, long-term disease-free survival rate and overall survival rate are improved. It has positive clinical significance.

  5. 3D printing-assisted preoperative plan of pedicle screw placement for middle-upper thoracic trauma: a cohort study.

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    Xu, Wei; Zhang, Xuming; Ke, Tie; Cai, Hongru; Gao, Xiang

    2017-08-11

    This study aimed to evaluate the application of 3D printing in assisting preoperative plan of pedicle screw placement for treating middle-upper thoracic trauma. A preoperative plan was implemented in seven patients suffering from middle-upper thoracic (T3-T7) trauma between March 2013 and February 2016. In the 3D printing models, entry points of 56 pedicle screws (Magerl method) and 4 important parameters of the pedicle screws were measured, including optimal diameter (ϕ, mm), length (L, mm), inclined angle (α), head-tilting angle (+β), and tail-tilting angle (-β). In the surgery, bare-hands fixation of pedicle screws was performed using 3D printing models and the measured parameters as guidance. A total of seven patients were enrolled, including five men and two women, with the age of 21-62 years (mean age of 37.7 years). The position of the pedicle screw was evaluated postoperatively using a computerized tomography scan. Totally, 56 pedicle screws were placed, including 33 pieces of level 0, 18 pieces of level 1, 4 pieces of level 2 (pierced lateral wall), and 1 piece of level 3 (pierced lateral wall, no adverse consequences), with a fine rate of 91.0%. 3D printing technique is an intuitive and effective assistive technology to pedicle screw fixation for treating middle-upper thoracic vertebrae, which improve the accuracy of bare-hands screw placement and reduce empirical errors. The trial was approved by the Ethics Committee of the Fujian Provincial Hospital. It was registered on March 1st, 2013, and the registration number was K2013-03-001.

  6. Secondary Chondrosarcoma of the Upper Thoracic Costovertebral Junction with Neural Foraminal Extension and Compressing the Spinal Cord.

    Science.gov (United States)

    Bouali, Sofiene; Bouhoula, Asma; Maatar, Nidhal; Abderrahmen, Khansa; Boubaker, Adnen; Kallel, Jalel; Jemel, Hafedh

    2016-08-01

    Chondrosarcoma is a rare malignant tumor of bone. This family of tumors can be primary malignant tumors or a secondary malignant transformation of an underlying benign cartilage tumor. Secondary chondrosarcoma arising from a benign solitary costal osteochondroma is extremely rare. Data show that the reported incidence of costal osteochondroma is very low and they are usually found in the anterior region at the costochondral junction. To our knowledge, however, there have been no previous reports, in English literature, describing osteochondroma malignant transformation located in the thoracic costovertebral junction. We report the case of a man with chondrosarcoma arising from the malignant degeneration of an osteochondroma at the right first thoracic costovertebral junction with neural foraminal extension and compressing the spinal cord. Although it is rare in solitary osteochondromas of rib, malignant transformation must always be considered. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Dosimetric effect of beam arrangement for intensity-modulated radiation therapy in the treatment of upper thoracic esophageal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Fu, Yuchuan [Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Deng, Min; Zhou, Xiaojuan [Department of Thoracic Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Lin, Qiang; Du, Bin [Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Tian, Xue; Xu, Yong; Wang, Jin; Lu, You [Department of Thoracic Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Gong, Youling, E-mail: gongyouling@hotmail.com [Department of Thoracic Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu (China)

    2017-04-01

    To evaluate the lung sparing in intensity-modulated radiation therapy (IMRT) for patients with upper thoracic esophageal tumors extending inferiorly to the thorax by different beam arrangement. Overall, 15 patient cases with cancer of upper thoracic esophagus were selected for a retrospective treatment-planning study. Intensity-modulated radiation therapy plans using 4, 5, and 7 beams (4B, 5B, and 7B) were developed for each patient by direct machine parameter optimization (DMPO). All plans were evaluated with respect to dose volumes to irradiated targets and normal structures, with statistical comparisons made between 4B with 5B and 7B intensity-modulated radiation therapy plans. Differences among plans were evaluated using a two-tailed Friedman test at a statistical significance of p < 0.05. The maximum dose, average dose, and the conformity index (CI) of planning target volume 1 (PTV1) were similar for 3 plans for each case. No significant difference of coverage for planning target volume 1 and maximum dose for spinal cords were observed among 3 plans in present study (p > 0.05). The average V{sub 5}, V{sub 13}, V{sub 20}, mean lung dose, and generalized equivalent uniform dose (gEUD) for the total lung were significantly lower in 4B-plans than those data in 5B-plans and 7B-plans (p < 0.01). Although the average V{sub 30} for the total lung were significantly higher in 4B-plans than those in 5B-plans and 7B-plans (p < 0.05). In addition, when comparing with the 4B-plans, the conformity/heterogeneity index of the 5B- and 7B-plans were significantly superior (p < 0.05). The 4B-intensity-modulated radiation therapy plan has advantage to address the specialized problem of lung sparing to low- and intermediate-dose exposure in the thorax when dealing with relative long tumors extended inferiorly to the thoracic esophagus for upper esophageal carcinoma with the cost for less conformity. Studies are needed to compare the superiority of volumetric modulated arc therapy

  8. Dosimetric effect of beam arrangement for intensity-modulated radiation therapy in the treatment of upper thoracic esophageal carcinoma

    International Nuclear Information System (INIS)

    Fu, Yuchuan; Deng, Min; Zhou, Xiaojuan; Lin, Qiang; Du, Bin; Tian, Xue; Xu, Yong; Wang, Jin; Lu, You; Gong, Youling

    2017-01-01

    To evaluate the lung sparing in intensity-modulated radiation therapy (IMRT) for patients with upper thoracic esophageal tumors extending inferiorly to the thorax by different beam arrangement. Overall, 15 patient cases with cancer of upper thoracic esophagus were selected for a retrospective treatment-planning study. Intensity-modulated radiation therapy plans using 4, 5, and 7 beams (4B, 5B, and 7B) were developed for each patient by direct machine parameter optimization (DMPO). All plans were evaluated with respect to dose volumes to irradiated targets and normal structures, with statistical comparisons made between 4B with 5B and 7B intensity-modulated radiation therapy plans. Differences among plans were evaluated using a two-tailed Friedman test at a statistical significance of p < 0.05. The maximum dose, average dose, and the conformity index (CI) of planning target volume 1 (PTV1) were similar for 3 plans for each case. No significant difference of coverage for planning target volume 1 and maximum dose for spinal cords were observed among 3 plans in present study (p > 0.05). The average V 5 , V 13 , V 20 , mean lung dose, and generalized equivalent uniform dose (gEUD) for the total lung were significantly lower in 4B-plans than those data in 5B-plans and 7B-plans (p < 0.01). Although the average V 30 for the total lung were significantly higher in 4B-plans than those in 5B-plans and 7B-plans (p < 0.05). In addition, when comparing with the 4B-plans, the conformity/heterogeneity index of the 5B- and 7B-plans were significantly superior (p < 0.05). The 4B-intensity-modulated radiation therapy plan has advantage to address the specialized problem of lung sparing to low- and intermediate-dose exposure in the thorax when dealing with relative long tumors extended inferiorly to the thoracic esophagus for upper esophageal carcinoma with the cost for less conformity. Studies are needed to compare the superiority of volumetric modulated arc therapy with intensity

  9. EFFECT OF UPPER-LIMB AND THORACIC MUSCLE STRENGTH ON 6-MIN WALK DISTANCE IN COPD PATIENTS

    Directory of Open Access Journals (Sweden)

    D Varalakshmi

    2014-06-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD is the only cause of death from chronic disease that will increase worldwide until 2020 and it represents a big burden for patients and society. Patients with COPD characteristically show poor exercise performance indicated by a marked reduction in both peak pulmonary 02 uptake and work rate at peak exercise. The sequelae of exercise intolerance include increased difficulty in performing daily tasks, etc. The objective of the study is to investigate the influence of thoracic and upper limb muscle function on 6-min walk distance (6MWD in patients with COPD. Method: Thirty eight COPD patients were included if they fulfilled the criteria for COPD according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. Prospective, cross-sectional design with sample size of 38 patients. All patients performed 6MWD and 1RM exercises. Results: To study the correlation between variables, Pearson or Spearman coefficients of correlation were used with the level of statistical significance set at 5%.Results of this study suggested for the first time that thoracic muscle strength is a predictor of 6MWD in COPD patients. It also confirms the influence of respiratory muscle strength (Pimax, dyspnea, on the 6MWD of these patients. Conclusion: It is concluded that peripheral muscle strength, respiratory muscle strength, and the sensation of dyspnea all have an influence on the capacity of COPD patients to perform exercises.

  10. Continuous Thoracic Sympathetic Ganglion Block in Complex Regional Pain Syndrome Patients with Spinal Cord Stimulation Implantation

    Directory of Open Access Journals (Sweden)

    EungDon Kim

    2016-01-01

    Full Text Available The sympathetic block is widely used for treating neuropathic pain such as complex regional pain syndrome (CRPS. However, single sympathetic block often provides only short-term effect. Moreover, frequent procedures for sympathetic block may increase the risk of complications. The use of epidural route may be limited by concern of infection in case of previous implantation of the spinal cord stimulation (SCS. In contrast, a continuous sympathetic block can be administered without such concerns. The continuous thoracic sympathetic block (TSGB has been used to treat the ischemic disease and other neuropathic conditions such as postherpetic neuralgia. We administered continuous thoracic sympathetic block using catheter in CRPS patients who underwent SCS implantations and achieved desirable outcomes. We believe a continuous sympathetic block is a considerable option before performing neurolysis or radiofrequency rhizotomy and even after SCS implantation.

  11. Use of a Combination of Regional and General Anesthesia during Emergency Thoracic Surgery

    Directory of Open Access Journals (Sweden)

    V. Kh. Sharipova

    2015-01-01

    Full Text Available Objective: to elaborate multimodal anesthetic regimens and to evaluate their efficiency during emergency thoracic surgeries for varying injuries. Subjects and methods. A total of 116 patients emergently admitted to the Republican Research Center for Emergency Medical Care for chest traumatic injuries were examined and divided into 3 groups according to the mode of anesthesia. Results. Perioperative multimodal anesthetic regimens for emergency thoracic surgery, which involved all components of the pathogenesis of pain, were elaborated. Conclusion. The combination of regional and general anesthesia contributes to the smooth course of an intra operative period with minimal hemodynamic stress and it is cost effective in decreasing the use of narcotic anal gesics in the intraoperative period. 

  12. Repair of extensive radionecrosis of the thoracic wall using soft tissues from the paralyzed upper limb

    Energy Technology Data Exchange (ETDEWEB)

    Delacroix, R; Wallaert, C; Soulier, A; Delepoulle, E; Francois, C; Grignet, J P

    1975-04-01

    The authors report one case of extensive radionecrosis after postoperative radiotherapy for breast cancer, with overt pyothorax, deep axillary ulceration, and brachial paralysis. The plastic use of the musculo-aponeutrotic tissues of the paralysed upper limb resulted in spectacular success, complicated only by empyema of the hemithoracic cavity, for which treatment with neomycin is recommended.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Successful Recovery and Transplantation of 11 Organs Including Face, Bilateral Upper Extremities, and Thoracic and Abdominal Organs From a Single Deceased Organ Donor.

    Science.gov (United States)

    Tullius, Stefan G; Pomahac, Bohdan; Kim, Heung Bae; Carty, Matthew J; Talbot, Simon G; Nelson, Helen M; Delmonico, Francis L

    2016-10-01

    We report on the to date largest recovery of 11 organs from a single deceased donor with the transplantation of face, bilateral upper extremities, heart, 1 lung, liver (split for 2 recipients), kidneys, pancreas, and intestine. Although logistically challenging, this case demonstrates the feasibility and safety of the recovery of multiple thoracic and abdominal organs with multiple vascular composite allotransplants and tissues. Our experience of 8 additional successful multiple vascular composite allotransplants, thoracic, and abdominal organ recoveries suggests that such procedures are readily accomplishable from the same deceased donor.

  15. Thoracic posterior longitudinal ligament ossification in a fixed population; longitudinal radiological observations

    International Nuclear Information System (INIS)

    Ono, Minoru; Russell, W.J.; Kudo, Sho.

    1984-05-01

    All lateral chest radiographs of 34 persons with posterior longitudinal ligament ossification (PLLO) in the thoracic spine were reviewed for date of its onset and its progress. These observations spanned as long as 18 years. Upper mid-thoracic PLLO first appeared under the age of 40, then increased in extent in the vertical axis until the age of 50. Lower thoracic PLLO occurred later than upper mid-thoracic PLLO. In the lower thoracic and lumbar regions, degeneration of the vertebrae and discs apparently were focal factors which triggered the development of thoracic PLLO. PLLO apparently developed in a different way in the upper and mid-thoracic regions, where the vertebrae and discs were unremarkable at the time of its initial appearance, and degenerative abnormalities did not predispose to it. (author)

  16. Differences in the Thoracic Aorta by Region and Sex in a Murine Model of Marfan Syndrome

    Directory of Open Access Journals (Sweden)

    Francesc Jiménez-Altayó

    2017-11-01

    Full Text Available Marfan syndrome (MFS is a hereditary disorder of the connective tissue that causes life-threatening aortic aneurysm, which initiates at the aortic root and can progress into the ascending portion. However, analysis of ascending aorta reactivity in animal models of MFS has remained elusive. Epidemiologic evidence suggests that although MFS is equally prevalent in men and women, men are at a higher risk of aortic complications than non-pregnant women. Nevertheless, there is no experimental evidence to support this hypothesis. The aim of this study was to explore whether there are regional and sex differences in the thoracic aorta function of mice heterozygous for the fibrillin 1 (Fbn1 allele encoding a missense mutation (Fbn1C1039G/+, the most common class of mutation in MFS. Ascending and descending thoracic aorta reactivity was evaluated by wire myography. Ascending aorta mRNA and protein levels, and elastic fiber integrity were assessed by qRT-PCR, Western blotting, and Verhoeff-Van Gieson histological staining, respectively. MFS differently altered reactivity in the ascending and descending thoracic aorta by either increasing or decreasing phenylephrine contractions, respectively. When mice were separated by sex, contractions to phenylephrine increased progressively from 3 to 6 months of age in MFS ascending aortas of males, whereas contractions in females were unchanged. Endothelium-dependent relaxation was unaltered in the MFS ascending aorta of either sex; an effect related to augmented endothelium-dependent hyperpolarization-type dilations. In MFS males, the non-selective cyclooxygenase (COX inhibitor indomethacin prevented the MFS-induced enhancement of phenylephrine contractions linked to increased COX-2 expression. In MFS mice of both sexes, the non-selective nitric oxide synthase inhibitor L-NAME revealed negative feedback of nitric oxide on phenylephrine contractions, which was associated with upregulation of eNOS in females. Finally

  17. Differences in the Thoracic Aorta by Region and Sex in a Murine Model of Marfan Syndrome

    Science.gov (United States)

    Jiménez-Altayó, Francesc; Siegert, Anna-Maria; Bonorino, Fabio; Meirelles, Thayna; Barberà, Laura; Dantas, Ana P.; Vila, Elisabet; Egea, Gustavo

    2017-01-01

    Marfan syndrome (MFS) is a hereditary disorder of the connective tissue that causes life-threatening aortic aneurysm, which initiates at the aortic root and can progress into the ascending portion. However, analysis of ascending aorta reactivity in animal models of MFS has remained elusive. Epidemiologic evidence suggests that although MFS is equally prevalent in men and women, men are at a higher risk of aortic complications than non-pregnant women. Nevertheless, there is no experimental evidence to support this hypothesis. The aim of this study was to explore whether there are regional and sex differences in the thoracic aorta function of mice heterozygous for the fibrillin 1 (Fbn1) allele encoding a missense mutation (Fbn1C1039G/+), the most common class of mutation in MFS. Ascending and descending thoracic aorta reactivity was evaluated by wire myography. Ascending aorta mRNA and protein levels, and elastic fiber integrity were assessed by qRT-PCR, Western blotting, and Verhoeff-Van Gieson histological staining, respectively. MFS differently altered reactivity in the ascending and descending thoracic aorta by either increasing or decreasing phenylephrine contractions, respectively. When mice were separated by sex, contractions to phenylephrine increased progressively from 3 to 6 months of age in MFS ascending aortas of males, whereas contractions in females were unchanged. Endothelium-dependent relaxation was unaltered in the MFS ascending aorta of either sex; an effect related to augmented endothelium-dependent hyperpolarization-type dilations. In MFS males, the non-selective cyclooxygenase (COX) inhibitor indomethacin prevented the MFS-induced enhancement of phenylephrine contractions linked to increased COX-2 expression. In MFS mice of both sexes, the non-selective nitric oxide synthase inhibitor L-NAME revealed negative feedback of nitric oxide on phenylephrine contractions, which was associated with upregulation of eNOS in females. Finally, MFS ascending

  18. Regionalization of the Upper Tana Basin of Kenya Using Stream ...

    African Journals Online (AJOL)

    Regionalization of the Upper Tana Basin of Kenya Using Stream Flow Records. ... river gauge stations in the basin using the empirical orthogonal function analysis ... the study basin to be grouped into four homogenous hydrological zones that ...

  19. Regional aerosol deposition in human upper airways

    Energy Technology Data Exchange (ETDEWEB)

    Swift, D.L.

    1991-11-01

    During the current report experimental studies of upper respiratory deposition of radon progeny aerosols and stimulant aerosols were carried out in replicate casts of nasal and oral passages of adults and children. Additionally, preliminary studies of nasal passage deposition of unattached Po{sup 218} particles was carried out in four human subjects. Data on nasal inspiratory deposition in replicate models of adults and infants from three collaborating laboratories were compared and a best-fit curve of deposition efficiency for both attached and unattached particles was obtained, showing excellent inter-laboratory agreement. This curve demonstrates that nasal inspiratory deposition of radon progeny is weakly dependent upon flow rate over physiologically realistic ranges of flow, does not show a significant age effect, and is relatively independent of nasal passage dimensions for a given age range. Improved replicate models of the human adult oral passage extending to the mid-trachea were constructed for medium and higher flow mouth breathing states; these models were used to assess the deposition of unattached Po{sup 218} particles during oronasal breathing in the oral passage and demonstrated lower deposition efficiency than the nasal passage. Measurements of both Po{sup 218} particle and attached fraction particle size deposition were performed in replicate nasal passage of a four week old infant. 5 refs., 1 fig.

  20. Regional aerosol deposition in human upper airways

    Energy Technology Data Exchange (ETDEWEB)

    Swift, D.L.

    1992-11-01

    Laboratory experimental studies were carried out to investigate the factors influencing the deposition of aerosols ranging in size from 1 nm to 10 [mu]m in the human nasal, oral, pharyngeal and laryngeal airways. These experimental studies were performed in replicate upper airway physical models and in human volunteer subjects. New replicate models of the oral passage of an infant, the oral passage of an adult at two openings and the combined nasal and oral airways of an adult were constructed during the period, adding to the existing models of adult, child and infant nasal and oral airways models. Deposition studies in the adult oral and adult nasal models were performed under simulated cyclic flow conditions with 1 nm particles to compare with previously measured constant flow studies. Similar studies with inertial particles (1--10 [mu]m diameter) were performed with the adult nasal model; in both instances, results with cyclic flow were similar to constant flow results using a simple average flow rate based on inspiratory volume and time of inspiration. Human subject studies were performed with particle sizes 5--20 nm for nasal inspiration; preliminary analysis shows good agreement with model studies at several representative flow rates. Nasal inspiratory inertial deposition of 1--4 [mu]m diameter particles was measured in several adults as a function of airway dimensions; dimensional changes of the valve area by decongestion did not produce concomitant deposition changes.

  1. Regional aerosol deposition in human upper airways

    International Nuclear Information System (INIS)

    Swift, D.L.

    1991-01-01

    During the current report experimental studies of upper respiratory deposition of radon progeny aerosols and stimulant aerosols were carried out in replicate casts of nasal and oral passages of adults and children. Additionally, preliminary studies of nasal passage deposition of unattached Po 218 particles was carried out in four human subjects. Data on nasal inspiratory deposition in replicate models of adults and infants from three collaborating laboratories were compared and a best-fit curve of deposition efficiency for both attached and unattached particles was obtained, showing excellent inter-laboratory agreement. This curve demonstrates that nasal inspiratory deposition of radon progeny is weakly dependent upon flow rate over physiologically realistic ranges of flow, does not show a significant age effect, and is relatively independent of nasal passage dimensions for a given age range. Improved replicate models of the human adult oral passage extending to the mid-trachea were constructed for medium and higher flow mouth breathing states; these models were used to assess the deposition of unattached Po 218 particles during oronasal breathing in the oral passage and demonstrated lower deposition efficiency than the nasal passage. Measurements of both Po 218 particle and attached fraction particle size deposition were performed in replicate nasal passage of a four week old infant. 5 refs., 1 fig

  2. SU-E-T-125: Application of Jaw-Tracking Function in VMAT for Upper Thoracic Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, W; Chen, J; Zhai, T; Yan, L; Chen, C [Cancer Hospital of Shantou University Medical College, Shantou, Guangdong (China)

    2015-06-15

    Purpose: To explore the effect of the Jaw-tracking with RapidArc(JT-RapidArc) plans for upper thoracic esophageal cancer. Methods: Treatment planning was designed by using RapidArc and JT-RapidArc techniques for 11 consecutive patients. The dose-volume histogram parameters of PTV and the organs at risk(OAR), conformity index(CI), heterogeneity index(HI), low dose volume of normal tissue(B-P) and monitor units(MUs) were compared between the different techniques. Results: JT-RapidArc plans provided the better coverage of PTV1(64) D98 and HI(P<0.05), lower MLD, D2 of PTV1(64) and PTV2(54), but no statistically difference in CI(P>0.05), which comparison with RapidArc plans. Plans with JT- RapidArc had lower Lung of V5, V10, V13, V20, V30, MLD(P<0.05); heart of V20, MLD(P<0.05); and B-P of V5, V10, V15, V20, V30(P<0.05); but no significantly different in Spinal cord and SC-PRV as compared with RapidArc plans. JT-RapidArc plans increaseed the MUs by 1%(P>0.05) as compared with RapidArc plans. Conclusion: All of the plans had met the requirements of clinical dosimetry. JT-RapidArc plans as compared with RapidArc plans, showing better part of target coverage, part of OARS(lung and heart) and heart and B-P sparing, which MUs was slightly increased. This work was sponsored by Shantou University Medical College Clinical Research Enhancement Initiative(NO.201424)

  3. Dosimetric comparison between step-shoot intensity-modulated radiotherapy and volumetric-modulated arc therapy for upper thoracic and cervical esophageal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Min; Li, Qilin; Ning, Zhonghua; Gu, Wendong; Huang, Jin; Mu, Jinming; Pei, Honglei, E-mail: hongleipei@126.com

    2016-07-01

    To compare and analyze the dosimetric characteristics of volumetric modulated arc therapy (VMAT) vs step-shoot intensity-modulated radiation therapy (sIMRT) for upper thoracic and cervical esophageal carcinoma. Single-arc VMAT (VMAT1), dual-arc VMAT (VMAT2), and 7-field sIMRT plans were designed for 30 patients with upper thoracic or cervical esophageal carcinoma. Planning target volume (PTV) was prescribed to 50.4 Gy in 28 fractions, and PTV1 was prescribed to 60 Gy in 28 fractions. The parameters evaluated included dose homogeneity and conformality, dose to organs at risk (OARs), and delivery efficiency. (1) In comparison to sIMRT, VMAT provided a systematic improvement in PTV1 coverage. The homogeneity index of VMAT1 was better than that of VMAT2. There were no significant differences among sIMRT, VMAT1, and VMAT2 in PTV coverage. (2) VMAT1 and VMAT2 reduced the maximum dose of spinal cord as compared with sIMRT (p < 0.05). The rest dose-volume characteristics of OARs were similar. (3) Monitor units of VMAT2 and VMAT1 were more than sIMRT. However, the treatment time of VMAT1, VMAT2, and sIMRT was (2.0 ± 0.2), (2.8 ± 0.3), and (9.8 ± 0.8) minutes, respectively. VMAT1 was the fastest, and the difference was statistically significant. In the treatment of upper thoracic and cervical esophageal carcinoma by the AXESSE linac, compared with 7-field sIMRT, VMAT showed better PTV1 coverage and superior spinal cord sparing. Single-arc VMAT had similar target volume coverage and the sparing of OAR to dual-arc VMAT, with shortest treatment time and highest treatment efficiency in the 3 kinds of plans.

  4. Mapping Irrigation Potential in the Upper East Region of Ghana

    Science.gov (United States)

    Akomeah, E.; Odai, S. N.; Annor, F. O.; Adjei, K. A.; Barry, B.

    2009-04-01

    The Upper East Region together with the other two regions in Northern Ghana (Upper West and Northern Region) is seen as the locus of perennial food deficit (GPRS, 2003). Despite, the provision of over 200 small scale dams and various mechanisms aimed at poverty alleviation, the region is still plagued with poverty and yearly food shortages. To achieve food security and alleviate poverty in the region however, modernization of agriculture through irrigation is deemed inevitable. While it is true that considerable potential still exists for future expansion of irrigation, it cannot be refuted that water is becoming scarcer in the regions where the need for irrigation is most important, hence mapping the irrigation potential of the region will be the first step toward ensuring sound planning and sustainability of the irrigation developments. In this study, an attempt has been made to map out the irrigation potential of the Upper East Region. The river basin approach was used in assessing the irrigation potential. The catchments drained by The White Volta river, Red volta river, River Sissili and River Kulpawn were considered in the assessment. The irrigation potential for the sub basins was computed by combining information on gross irrigation water requirements for the selected cash crops, area of soil suitable for irrigation and available water resources. The capacity of 80%, 70%, 60% and 50% time of exceedance flow of the available surface water resources in the respective sub basins was estimated. The area that can be irrigated with this flow was computed with selected cropping pattern. Combining the results of the potential irrigable areas and the land use map of the respective sub basins, an irrigation potential map has been generated showing potential sites in the upper east region that can be brought under irrigation. Keywords: Irrigation potential, irrigation water requirement, land evaluation, dependable flow

  5. People, soil and manioc interactions in the upper Amazon region

    NARCIS (Netherlands)

    Peña Venegas, C.P.

    2015-01-01

    Abstract

    Clara Patricia Peña Venegas (2015). People, soil and manioc interactions in the upper Amazon region. PhD thesis, Wageningen University, The Netherlands, with summaries in English and Dutch, 210 pp.

    The presence of anthropogenic soils, or Amazonian Dark

  6. Wildlife in the Upper Great Lakes Region: a community profile.

    Science.gov (United States)

    Janine M. Benyus; Richard R. Buech; Mark D. Nelson

    1992-01-01

    Wildlife habitat data from seven Great Lakes National Forests were combined into a wildlife-habitat matrix named NORTHWOODS. The composite NORTHWOODS data base is summarized. Multiple queries of NORTHWOODS were used to profile the wildlife community of the Upper Great Lakes region.

  7. A preliminary study comparing the use of cervical/upper thoracic mobilization and manipulation for individuals with mechanical neck pain.

    Science.gov (United States)

    Griswold, David; Learman, Ken; O'Halloran, Bryan; Cleland, Josh

    2015-05-01

    Neck pain is routinely managed using manual therapy (MT) to the cervical and thoracic spines. While both mobilizations and manipulations to these areas have been shown to reduce neck pain, increase cervical range of motion, and reduce disability, the most effective option remains elusive. The purpose of this preliminary trial was to compare the pragmatic use of cervical and thoracic mobilizations vs. manipulation for mechanical neck pain. This trial included 20 patients with mechanical neck pain. Each patient was randomized to receive either mobilization or manipulation to both the cervical and thoracic spines during their plan of care. Within-group analyses were made with Wilcoxon signed-rank tests and between-group analyses were made with Mann-Whitney U. There were no between-group differences for any of the dependent variables including cervical active range of motion (CAROM) (P = 0.18), deep cervical flexion (DCF) endurance (P = 0.06), numerical pain rating scale (NPRS) (P = 0.26), the neck disability index (NDI, P = 0.33), patient-specific functional scale (PSFS, P = 0.20), or the global rating of change (GROC) scale (P = 0.94). Within-group results were significant for all outcome variables (Ppain.

  8. Demographic characteristics of MS patients in Poland's upper Silesia region.

    Science.gov (United States)

    Pierzchala, Krystyna; Adamczyk-Sowa, Monika; Dobrakowski, Pawel; Kubicka-Baczyk, Katarzyna; Niedziela, Natalia; Sowa, Pawel

    2015-05-01

    In Poland, no national registry of MS patients has yet been introduced. So far, no demographic studies have been conducted in patients with MS in Upper Silesia. The aim of the present study was to evaluate, for the first time, a selected demographic and clinical parameters in MS patients from the Upper Silesia region and compare these characteristics with previously published data from other regions of Poland. 640 patients with clinically defined MS, were prospectively and randomly selected for the study. Social, socio-economic, and demographic data were obtained through a questionnaire study. All subjects performed a self-assessment of their health condition using EQ-5D and EQ-VAS version questionnaires. The ratio of women to men was 2.18. The average age of onset was 29.6 ± 11.1 years; the disease duration was 7.9 ± 4.5 years. The relapsing-remitting form of MS was diagnosed in 73.12%. In 71.25% the onset was monofocal and in 28.75% multifocal disease onset was observed. Among the studied population 339 (52.97%) patients were still employed. A mean EQ-VAS score of 66.11 ± 20.12 was calculated. Results from our study identify for the first time the demographic and clinical characteristics of the Upper Silesia MS population.

  9. The effect of short-term upper thoracic self-mobilization using a Kaltenborn wedge on pain and cervical dysfunction in patients with neck pain.

    Science.gov (United States)

    Oh, Hyung-Taek; Hwangbo, Gak

    2018-04-01

    [Purpose] The aim of this study was to determine the effect of short-term self-joint mobilization of the upper spine using a Kaltenborn wedge on the pain and cervical dysfunction of patients with neck pain. [Subjects and Methods] Twenty-seven patients with neck pain were divided into two groups; the self-mobilization group (SMG, n=13) and the self-stretching group (SSG, n=14). The SMG performed upper thoracic self-mobilization and the SSG performed self-stretching exercises as a short-term intervention for a week. To assess the degree of neck pain, the visual analog scale (VAS) was utilized, and to measure the joint range of motion at the flexion-extension, it was compared and analyzed by using the goniometer. [Results] Both SMG and SSG show a significant decrease in the visual analog scale and a significant increase in joint range of motion within the group. In the comparison of groups, there was no significant difference, but it indicated effects on improving the range of motion of extension in SMG. [Conclusion] Self-mobilization of the upper spine, using a Kaltenborn wedge, was useful in alleviating pain in and dysfunction of the cervical spine, and in particular, in improving cervical spine extension in this study.

  10. Lithofacies palaeogeography of the Upper Permian Changxing Stage in the Middle and Upper Yangtze Region, China

    Directory of Open Access Journals (Sweden)

    He Youbin

    2013-04-01

    Full Text Available Based on the petrological study, according to single factor analysis and multifactor comprehensive mapping method, the quantitative lithofacies palaeogeography of the Upper Permian Changxing Stage of the Middle and Upper Yangtze Region was studied. The Changxing Stage in the Middle and Upper Yangtze Region is mainly composed of carbonate rocks; in addition, clastic and siliceous rocks occur with rare coals and pyroclastic rocks. Lithofacies can be divided into five types, including clastic rock assemblage, clastic rock–limestone assemblage, limestone assemblage, limestone–siliceous rock assemblage, and siliceous rock–clastic rock assemblage. Four fundamental ecological types and five fossil assemblages were recognized in the Changxing Stage. On the basis of the petrological and palaeoecological study, eight single factors were chosen including thickness, content of marine rocks, content of shallow water carbonate rocks, content of bioclasts with limemud matrix, content of bioclasts with sparry cement, distribution of reefs, content of thin bedded siliceous rocks and content of deep water sedimentary rocks. And eight single factor maps and one lithofacies paleogeographic map of the Changxing Stage were compiled. Paleoenvironments from west to east include an erosional area, fluvial plain, clastic platform, carbonate platform and reefs that developed there, slope and basin, low energy organic banks, and high energy organic banks. Sedimentary environments have an obvious control on the development of the source rocks, and the excellent source rocks are developed in the Dalong Formation. Changxing Stage reservoirs should be dominated by the reef and platform surrounding the Guangyuan–Liangping Basin rim area, and is the most favorable exploration area of the reef petroleum reservoirs of the Changxing Formation.

  11. At site and regional analysis of maximum annual and seasonal discharges and precipitation depths in the upper Hron region

    International Nuclear Information System (INIS)

    Kohnova, S.; Hlavcova, K.

    2004-01-01

    In this presentation authors deal with the regional analysis of maximum annual and seasonal discharges and precipitation depths in the upper Hron region (Slovak Republic). This work has two objectives: (1) At site and regional analysis of annual and seasonal maximum design discharges in the upper Hron region; (2) Analysis of annual and seasonal maximum design precipitations in the connection of extreme runoff condition in the upper Hron region

  12. Thoracic CT

    Science.gov (United States)

    ... through a vein (IV) in your hand or forearm. It may be given through the rectum using ... CT scan Vertebra, thoracic (mid back) Normal lung anatomy Thoracic organs References Gotway MB, Panse PM, Gruden ...

  13. Regional distribution of ventilation in patients with obstructive sleep apnea: the role of thoracic electrical impedance tomography (EIT) monitoring.

    Science.gov (United States)

    Bongiovanni, Filippo; Mura, Benedetta; Tagliaferri, Chiara; Bisanti, Alessandra; Testani, Elisa; Maviglia, Riccardo; Della Marca, Giacomo

    2016-12-01

    The aim of our study was to apply the electrical impedance tomography (EIT) technique to the study of ventilation during wake and NREM and REM sleep in patients with obstructive sleep apneas (OSA). This is a prospective, observational, monocentric, pilot study in a neurology department with a sleep disorder center. Inclusion criteria were age ≥18 years, both gender, and diagnosis of OSA. Exclusion criteria were the contraindications to the thoracic EIT. All patients underwent laboratory-based polysomnography (PSG) alongside thoracic EIT. Primary endpoint was to compare the global impedance (GI) among the conditions: "Wake" vs "Sleep," "NREM" vs "REM," and "OSA" vs "Non-OSA." Secondary endpoint was to measure the regional distribution of impedance in the four regions of interest (ROIs), in each condition. Of the 17 consecutive patients enrolled, two were excluded because of poor-quality EIT tracings. Fifteen were analyzed, 10 men and 5 women, mean age 51.6 ± 14.4 years. GI was higher in Wake vs Sleep (Wake 13.24 ± 11.23; Sleep 12.56 ± 13.36; p EIT can prove a valuable additional strategy for the evaluation of OSA patients.

  14. Transitional Cell Carcinoma of the Upper Ureter Metastatic to the Thoracic Spine Presenting as a Spinal Cord Compression

    Directory of Open Access Journals (Sweden)

    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.

  15. 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.

  16. 40 CFR 81.55 - Northeast Pennsylvania-Upper Delaware Valley Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Northeast Pennsylvania-Upper Delaware... Designation of Air Quality Control Regions § 81.55 Northeast Pennsylvania-Upper Delaware Valley Interstate Air Quality Control Region. The Northeast Pennsylvania-Upper Delaware Valley Interstate Air Quality Control...

  17. Crust and upper mantle structure in the Caribbean region by group velocity tomography and regionalization

    International Nuclear Information System (INIS)

    O'Leary, Gonzalez; Alvarez, L.; Chimera, G.; Panza, G.F.

    2004-04-01

    An overview of the crust and upper mantle structure of the Central America and Caribbean region is presented as a result of the processing of more than 200 seismograms recorded by digital broadband stations from SSSN and GSN seismic networks. By FTAN analysis of the fundamental mode of the Rayleigh waves, group velocity dispersion curves are obtained in the period range from 10 s to 40 s; the error of these measurements varies from 0.06 and 0.10 km/s. From the dispersion curves, seven tomographic maps at different periods and with average spatial resolution of 500 km are obtained. Using the logical combinatorial classification techniques, eight main groups of dispersion curves are determined from the tomographic maps and eleven main regions, each one characterized by one kind of dispersion curves, are identified. The average dispersion curves obtained for each region are extended to 150 s by adding data from the tomographic study of and inverted using a non-linear procedure. As a result of the inversion process, a set of models of the S-wave velocity vs. depth in the crust and upper mantle are found. In six regions, we identify a typically oceanic crust and upper mantle structure, while in the other two the models are consistent with the presence of a continental structure. Two regions, located over the major geological zones of the accretionary crust of the Caribbean region, are characterized by a peculiar crust and upper mantle structure, indicating the presence of lithospheric roots reaching, at least, about 200 km of depth. (author)

  18. Immediate and Short-Term Effects of Upper Thoracic Manipulation on Myoelectric Activity of Sternocleidomastoid Muscles in Young Women With Chronic Neck Pain: A Randomized Blind Clinical Trial.

    Science.gov (United States)

    Pires, Paulo Fernandes; Packer, Amanda Carine; Dibai-Filho, Almir Vieira; Rodrigues-Bigaton, Delaine

    2015-10-01

    The aim of this study was to assess the immediate and short-term effects of upper thoracic spine manipulation on pain intensity and myoelectric activity of the sternocleidomastoid muscles in young women with chronic neck pain. A randomized clinical trial was carried out involving 32 women with chronic neck pain (mean age, 24.8 ± 5.4 years) allocated to an experimental group and a placebo group. Three evaluations were carried out: baseline, immediate postintervention, and short-term postintervention (48-72 hours after intervention). Myoelectric activity of the right and left sternocleidomastoid muscles was assessed at rest and during isometric contractions for cervical flexion and elevation of the shoulder girdle. Neck pain intensity was assessed at rest using a visual analog scale. Comparisons of the data were performed using 2-way repeated-measures analysis of variance with the Bonferroni correction. The level of significance was set at P 0.40). No statistically significant differences were found for any of the variables analyzed in the intergroup comparisons at the different evaluation times (P > .05). No statistically significant differences were found in the intragroup or intergroup analyses of the experimental and placebo groups regarding myoelectric activity of the cervical muscles or the intensity of neck pain at rest in the immediate or short-term postintervention evaluations. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  19. Unstable ductile fracture conditions in upper shelf region

    International Nuclear Information System (INIS)

    Nakano, Yoshifumi; Kubo, Takahiro

    1985-01-01

    The phenomenon of unstability of ductile fracture in the upper shelf region of a forged steel for nuclear reactor pressure vessels A508 Cl. 3 was studied with a large compliance apparatus, whose spring constants were 100, 170 and 230 kgf/mm, at the test temperatures of 100, 200 and 300 0 C and at the loading rates of 2, 20 and 200 mm/min in the crosshead speed. The main results obtained are as follows: (1) The fracture modes of the specimens consisted of (a) stable fracture, (b) unstable fracture which leads to a complete fracture rapidly and (c) quasiunstable fracture which does not lead to a complete fracture though a rapid extension of ductile crack takes place. (2) Side groove, high temperature or small spring constant made a ductile crack more unstable. (3) High temperature or large spring constant made the occurrence of quasiunstable fracture easier. (4) Quasiunstable ductile fracture took place before the maximum load, that is, at the J integral value of about 10 kgf/mm. The initiation of a microscopic ductile crack, therefore, seems to lead to quasiunstable fracture. (5) The concept that unstable ductile fracture takes place when Tsub(app) exceeds Tsub(mat) seems applicable only to the case in which unstable ductile fracture takes place after the maximum load has been exceeded. (author)

  20. Regional anesthesia procedures for shoulder and upper arm surgery upper extremity update--2005 to present.

    Science.gov (United States)

    Sripada, Ramprasad; Bowens, Clifford

    2012-01-01

    This review of the literature since 2005 assesses developments of RA techniques commonly used for shoulder surgery, and their effectiveness for postoperative analgesia. Advantages of regional techniques include site-specific anesthesia and decreased postoperative opioid use. For shoulder surgeries, the ISB provides effective analgesia with minimal complications, whereas the impacts of IA single-injections remain unclear. When combined with GA, ISB can be used in lower volumes and reducing the complications for shoulder and proximal upper extremity. USG ISB and SCB are both effective and safe for shoulder surgery with a low incidence of complications, especially PONS.53 When compared with intravenous patient-controlled opioid analgesia, a perineural LA infusion using a disposable pump with patient-controlled LA bolus function has led to better pain relief and functional recovery while decreasing the need for rescue analgesics and the number of adverse events after ambulatory orthopedic surgery. The most remarkable advance in RA in the past 5 years is the increased usage of USG. Although there are no large-scale prospective studies to show the safety, efficacy, and success and complication rates for USG blocks, USG RA theoretically could have less risk for neurologic symptoms, except for those induced by LA (less likely perineurally, much more likely intraneurally). The next "quantum leap" lies in reducing LA concentrations and augmenting anesthetic-analgesic effects with perineural additives (including clonidine, buprenorphine, and likely low-dose dexamethasone). Since 2005, perineural catheters have been an analgesic option that offers improved pain relief among other benefits, and are now being used at home. It is clear that patients benefit greatly from a single injection and continuous nerve block for postoperative pain management,but the financial and logistical aspects need to be resolved, not to mention the phrenic hemiparesis coin toss. Whether combined

  1. Thoracic chordoma: CT and MR findings

    International Nuclear Information System (INIS)

    Cha, Yoo Mi; Hwang, Hee Young; Kim, Sang Joon; Chung, Hyo Sun; Han, Heon

    1993-01-01

    Chordoma arising from the notochordal remnants is a rare primary bone tumor in the cervicosacral region and is even more unusual in the thoracic region. The authors experienced a case of thoracic chordoma and reports its CT and MR findings

  2. Regional analgesia for video-assisted thoracic surgery – a systematic review

    DEFF Research Database (Denmark)

    Julia Steinthorsdottir, Kristin; Wildgaard, Lorna; Jessen Hansen, Henrik

    2013-01-01

    there is no gold standard for regional analgesia for VATS. This systematic review aimed to assess different regional techniques in regards to effect on acute post-operative pain following VATS, with emphasis on VATS lobectomy. The systematic review of the PubMed, Cochrane Library and Embase databases yielded...... be demonstrated, but a guide of factors to include in future studies on regional analgesia for VATS is presented....

  3. The effect of nodalization and temperature of reactor upper region: Sensitivity analysis for APR-1400 LBLOCA

    International Nuclear Information System (INIS)

    Kang, Dong Gu

    2017-01-01

    Highlights: • The nodalization of APR-1400 was modified to reflect the characteristic of upper region temperature. • The effect of nodalization and temperature of reactor upper region on LBLOCA consequence was evaluated. • The modification of nodalization is an essential prerequisite in APR-1400 LBLOCA analysis. - Abstract: In best estimate (BE) calculation, the definition of system nodalization is important step influencing the prediction accuracy for specific thermal-hydraulic phenomena. The upper region of reactor is defined as the region of the upper guide structure (UGS) and upper dome. It has been assumed that the temperature of upper region is close to average temperature in most large break loss of coolant accident (LBLOCA) analysis cases. However, it was recently found that the temperature of upper region of APR-1400 reactor might be little lower than or similar to hot leg temperature through the review of detailed design data. In this study, the nodalization of APR-1400 was modified to reflect the characteristic of upper region temperature, and the effect of nodalization and temperature of reactor upper region on LBLOCA consequence was evaluated by sensitivity analysis including best estimate plus uncertainty (BEPU) calculation. In basecase calculation, in case of modified version, the peak cladding temperature (PCT) in blowdown phase became higher and the blowdown quenching (or cooling) was significantly deteriorated as compared to original case, and as a result, the cladding temperature in reflood phase became higher and the final quenching was also delayed. In addition, thermal-hydraulic parameters were compared and analyzed to investigate the effect of change of upper region on cladding temperature. In BEPU analysis, the 95 percentile PCT used in current regulatory practice was increased due to the modification of upper region nodalization, and it occurred in the reflood phase unlike original case.

  4. Dilemma of diagnosing thoracic sarcoidosis in tuberculosis endemic regions: An imaging-based approach. Part 1

    Directory of Open Access Journals (Sweden)

    Ashu S Bhalla

    2017-01-01

    Full Text Available Sarcoidosis is a multi-systemic disorder of unknown etiology, although commonly believed to be immune-mediated. Histologically, it is characterized by noncaseating granuloma which contrasts against the caseating granuloma seen in tuberculosis (TB, an infectious disease that closely mimics sarcoidosis, both clinically as well as radiologically. In TB-endemic regions, the overlapping clinico-radiological manifestations create significant diagnostic dilemma, especially since the management options are markedly different in the two entities. Part 1 of this review aims to summarize the clinical, laboratory, and imaging features of sarcoidosis, encompassing both typical and atypical manifestations, in an attempt to distinguish between the two disease entities.

  5. Toward automatic regional analysis of pulmonary function using inspiration and expiration thoracic CT

    DEFF Research Database (Denmark)

    Murphy, Keelin; Pluim, Josien P. W.; Rikxoort, Eva M. van

    2012-01-01

    and its results; (b) verify that the quantitative, regional ventilation measurements acquired through CT are meaningful for pulmonary function analysis; (c) identify the most effective of the calculated measurements in predicting pulmonary function; and (d) demonstrate the potential of the system...... disorder). Lungs, fissures, airways, lobes, and vessels are automatically segmented in both scans and the expiration scan is registered with the inspiration scan using a fully automatic nonrigid registration algorithm. Segmentations and registrations are examined and scored by expert observers to analyze...... to have good correlation with spirometry results, with several having correlation coefficients, r, in the range of 0.85–0.90. The best performing kNN classifier succeeded in classifying 67% of subjects into the correct COPD GOLD stage, with a further 29% assigned to a class neighboring the correct one...

  6. Factors regulating collagen synthesis and degradation during second-intention healing of wounds in the thoracic region and the distal aspect of the forelimb of horses.

    Science.gov (United States)

    Schwartz, Anne J; Wilson, David A; Keegan, Kevin G; Ganjam, Venkataseshu K; Sun, Yao; Weber, Karl T; Zhang, Jiakun

    2002-11-01

    To determine significant molecular and cellular factors responsible for differences in second-intention healing in thoracic and metacarpal wounds of horses. 6 adult mixed-breed horses. A full-thickness skin wound on the metacarpus and another such wound on the pectoral region were created, photographed, and measured, and tissue was harvested from these sites weekly for 4 weeks. Gene expression of type-I collagen, transforming growth factor (TGF)-beta1, matrix metalloproteinase (MMP)-1, and tissue inhibitor of metalloproteinase (TIMP)-1 were determined by quantitative in situ hybridization. Myofibroblasts were detected by immunohistochemical labeling with alpha-smooth muscle actin (alpha-SMA). Collagen accumulation was detected by use of picrosirius red staining. Tissue morphology was examined by use of H&E staining. Unlike thoracic wounds, forelimb wounds enlarged during the first 2 weeks. Myofibroblasts, detected by week 1, remained abundant with superior organization in thoracic wounds. Type-I collagen mRNA accumulated progressively in both wounds. More type-I collagen and TGF-beta1 mRNA were seen in forelimb wounds. Volume of MMP-1 mRNA decreased from day 0 in both wounds. By week 3, TIMP-1 mRNA concentration was greater in thoracic wounds. Greater collagen synthesis in metacarpal than thoracic wounds was documented by increased concentrations of myofibroblasts, type-I collagen mRNA,TGF-beta1 mRNA, and decreased collagen degradation (ie, MMP-1). Imbalanced collagen synthesis and degradation likely correlate with development of exuberant granulation tissue, delaying healing in wounds of the distal portions of the limbs. Factors that inhibit collagen synthesis or stimulate collagenase may provide treatment options for horses with exuberant granulation tissue.

  7. Specialty Crop Profile: Blueberries for the Upper Piedmont and Mountain Regions

    OpenAIRE

    Bratsch, Tony

    2009-01-01

    Discusses blueberries as a small fruit crop for the upper Piedmont and mountain regions of Virginia. Provides information about best ways to plant the blueberries, mulching, irrigation, fertilization, pruning, harvesting and handling, marketing and more.

  8. Thoracic Trauma.

    Science.gov (United States)

    Dennis, Bradley M; Bellister, Seth A; Guillamondegui, Oscar D

    2017-10-01

    Management of chest trauma is integral to patient outcomes owing to the vital structures held within the thoracic cavity. Understanding traumatic chest injuries and appropriate management plays a pivotal role in the overall well-being of both blunt and penetrating trauma patients. Whether the injury includes rib fractures, associated pulmonary injuries, or tracheobronchial tree injuries, every facet of management may impact the short- and long-term outcomes, including mortality. This article elucidates the workup and management of the thoracic cage, pulmonary and tracheobronchial injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Parameters and functional analysis of the deep epaxial muscles in the thoracic, lumbar and sacral regions of the equine spine.

    Science.gov (United States)

    García Liñeiro, J A; Graziotti, G H; Rodríguez Menéndez, J M; Ríos, C M; Affricano, N O; Victorica, C L

    2018-04-30

    The epaxial muscles produce intervertebral rotation in the transverse, vertical and axial axes. These muscles also counteract the movements induced by gravitational and inertial forces and movements produced by antagonistic muscles and the intrinsic muscles of the pelvic limb. Their fascicles are innervated by the dorsal branch of the spinal nerve, which corresponds to the metamere of its cranial insertion in the spinous process. The structure allows the function of the muscles to be predicted: those with long and parallel fibres have a shortening function, whereas the muscles with short and oblique fibres have an antigravity action. In the horse, the multifidus muscle of the thoracolumbar region extends in multiple segments of two to eight vertebral motion segments (VMS). Functionally, the multifidus muscle is considered a spine stabiliser, maintaining VMS neutrality during spine rotations. However, there is evidence of the structural and functional heterogeneity of the equine thoracolumbar multifidus muscle, depending on the VMS considered, related to the complex control of the required neuromuscular activity. Osteoarticular lesions of the spine have been directly related to asymmetries of the multifidus muscle. The lateral (LDSM) and medial (MDSM) dorsal sacrocaudal muscles may be included in the multifidus complex, the function of which is also unclear in the lumbosacral region. The functional parameters of maximum force (F max ), maximum velocity of contraction (V max ) and joint moment (M) of the multifidus muscles inserted in the 4th, 9th, 12th and 17th thoracic and 3rd and 4th lumbar vertebrae of six horses were studied postmortem (for example: 4MT4 indicates the multifidus muscle that crosses four metameres with cranial insertion in the T4 vertebra). Furthermore, the structural and functional characteristics of LDSM and MDSM were determined. Data were analysed by analysis of variance (anova) in a randomised complete block design (P ≤ 0.05). For some

  10. The Role at Rehabilitation in Treatment of Thoracic Outlet Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Hosseinian

    2003-01-01

    Full Text Available Objective: Thoracic outlet syndrome is a complex disorder caused by neurovascular irritation in the region of the thoracic outlet. The syndrome have been said to be mainly due to anomalous structures in the thoracic outlet, treatment for thoracic outlet syndrome varies among different institutions, and there has not been any standard program. In general conservative and surgical treatment can be do if necessary. Materials & Methods: The rehabilitation program consists of exercise and physiotherapy and brace designed to hold the posture in which thoracic outlet is enlarged. Exercise program was designed simple enough to be performed in the daily living or during work after minimal training and isometric exercises of Serratus anterior, Levator Scapulae and Erector Spinae muscles to be performed in one posture: flexion and elevation of scapular girdle and correction position of upper-thoracic spine. During 7 years, 131 cases of (T.O.S. were evaluated that 26 cases (20% have operated and 84 cases (64% have treated with conservative treatment and 21 cases (16% have been candidate for surgery but they didn't accepted. Results: All of the cases have treated with conservative treatment for four months. 84 cases responded well and no further treatment was needed. 47 cases were not satisfied with. The outcome of their treatment, that 26 cases have operated and 21 cases have not accepted the operation and continued the conservative treatment, they have had pain and slightly disability. 23 cases of operated group responded well and they have resumed to work, one case has had neuropraxia for about one year. Conclusion: Most cases of thoracic outlet syndrome (T.O.S. can be treated conservatively. Surgically treatment is indicated only in cases severe enough to make them disable to work. It is better all the patients undergo conservative treatment for at least four months then will decided for surgical treatment.

  11. Thoracic outlet syndrome: Case report

    International Nuclear Information System (INIS)

    Marquez, Juan Camilo; Acosta, Mauricio Fernando; Uribe Jorge Ricardo

    2009-01-01

    We report a case of vascular thoracic outlet syndrome in a young man, diagnosed with upper limb arteriography, leading to repeated arterio-arterial emboli originating from a post-stenotic subclavian artery aneurysm. It is of our interest due to its low incidence and the small number of cases reported that have been diagnosed by arteriography. The thoracic outlet is the path through which vascular and neural structures goes from the neck to the axilla, and it has three anatomical strictures, that when pronounced, can compress the brachial plexus or subclavian vessels, leading to different symptoms and signs.

  12. Regional effects of agricultural conservation practices on nutrient transport in the Upper Mississippi River Basin

    Science.gov (United States)

    Garcia, Ana Maria.; Alexander, Richard B.; Arnold, Jeffrey G.; Norfleet, Lee; White, Michael J.; Robertson, Dale M.; Schwarz, Gregory E.

    2016-01-01

    Despite progress in the implementation of conservation practices, related improvements in water quality have been challenging to measure in larger river systems. In this paper we quantify these downstream effects by applying the empirical U.S. Geological Survey water-quality model SPARROW to investigate whether spatial differences in conservation intensity were statistically correlated with variations in nutrient loads. In contrast to other forms of water quality data analysis, the application of SPARROW controls for confounding factors such as hydrologic variability, multiple sources and environmental processes. A measure of conservation intensity was derived from the USDA-CEAP regional assessment of the Upper Mississippi River and used as an explanatory variable in a model of the Upper Midwest. The spatial pattern of conservation intensity was negatively correlated (p = 0.003) with the total nitrogen loads in streams in the basin. Total phosphorus loads were weakly negatively correlated with conservation (p = 0.25). Regional nitrogen reductions were estimated to range from 5 to 34% and phosphorus reductions from 1 to 10% in major river basins of the Upper Mississippi region. The statistical associations between conservation and nutrient loads are consistent with hydrological and biogeochemical processes such as denitrification. The results provide empirical evidence at the regional scale that conservation practices have had a larger statistically detectable effect on nitrogen than on phosphorus loadings in streams and rivers of the Upper Mississippi Basin.

  13. Regional Effects of Agricultural Conservation Practices on Nutrient Transport in the Upper Mississippi River Basin.

    Science.gov (United States)

    García, Ana María; Alexander, Richard B; Arnold, Jeffrey G; Norfleet, Lee; White, Michael J; Robertson, Dale M; Schwarz, Gregory

    2016-07-05

    Despite progress in the implementation of conservation practices, related improvements in water quality have been challenging to measure in larger river systems. In this paper we quantify these downstream effects by applying the empirical U.S. Geological Survey water-quality model SPARROW to investigate whether spatial differences in conservation intensity were statistically correlated with variations in nutrient loads. In contrast to other forms of water quality data analysis, the application of SPARROW controls for confounding factors such as hydrologic variability, multiple sources and environmental processes. A measure of conservation intensity was derived from the USDA-CEAP regional assessment of the Upper Mississippi River and used as an explanatory variable in a model of the Upper Midwest. The spatial pattern of conservation intensity was negatively correlated (p = 0.003) with the total nitrogen loads in streams in the basin. Total phosphorus loads were weakly negatively correlated with conservation (p = 0.25). Regional nitrogen reductions were estimated to range from 5 to 34% and phosphorus reductions from 1 to 10% in major river basins of the Upper Mississippi region. The statistical associations between conservation and nutrient loads are consistent with hydrological and biogeochemical processes such as denitrification. The results provide empirical evidence at the regional scale that conservation practices have had a larger statistically detectable effect on nitrogen than on phosphorus loadings in streams and rivers of the Upper Mississippi Basin.

  14. Investigation of the dispersion of airborne pollutants in the Upper Rhine and Lake Constance region

    International Nuclear Information System (INIS)

    Fiedler, F.; Adrian, G.; Kohler, M.

    1991-01-01

    The aim of the project is to calculate the regional flow and propagation conditions using the expensive three-dimensional meteorological model, the ''Karlsruher Atmosphaerisches Mesoskaliges Modell'' (KAMM) in order to derive the immission and the deposition of the conducting substance of pollutant matter, i.e., sulphur dioxide. In this report, calculations of the flowing field are described for the region Upper Rhine - Lake of Constance''. In the last part, the concentration fields for SO 2 are calculated for the region for typical large-area atmospheric conditions with disclosure of sources. An appraising discussion of the results concludes this work. (orig.) [de

  15. Tourniquet Deflation Prior to 20 Minutes in Upper Extremity Intravenous Regional Anesthesia.

    Science.gov (United States)

    Gurich, Richard W; Langan, Justin W; Teasdall, Robert J; Tanner, Stephanie L; Sanders, John L

    2018-03-01

    Bier blocks, or intravenous regional anesthesia (IVRA), are a method of anesthesia for upper extremity surgeries. This study reports our experience with tourniquet deflation prior to 20 minutes with upper extremity IVRA. This study was designed as a retrospective cohort analysis. Records, including intraoperative and immediate postoperative anesthesia notes, of 430 patients who underwent IVRA with an upper extremity Bier block and a corresponding tourniquet time of less than 20 minutes were reviewed. Patient demographics, procedure(s) performed, American Society of Anesthesiologists scores, volume of lidocaine used in Bier block, tourniquet time, and any complications were recorded. This cohort consisted of 127 males and 303 females. The 3 most common procedures performed were carpal tunnel release (315), trigger finger release (47), and excision of masses (34). The average tourniquet time for this cohort was 16 minutes (range, 9-19 minutes), and the average volume of lidocaine (0.5% plain) injected was 44 mL (range, 30-70 mL). A tourniquet time of 17 minutes or less was observed in 339 patients, and 170 patients had tourniquet times of 15 minutes or less. Five complications were recorded: intraoperative vomiting, mild postoperative nausea/vomiting, severe postoperative nausea and vomiting, and transient postoperative hypotension that responded to a fluid bolus. No major complications were observed in our cohort of upper extremity IVRA and tourniquet times of less than 20 minutes. Several variables play a role in the safety of upper extremity IVRA.

  16. Three-dimensional P velocity structure of the crust and upper mantle under Beijing region

    Energy Technology Data Exchange (ETDEWEB)

    Quan, A.; Liu, F.; Sun, Y.

    1980-04-01

    By use of the teleseismic P arrival times at 15 stations of the Beijing network for 120 events distributed over various azimuths, we studied the three-dimensional P velocity structure under the Beijing region. In calculating the theoretic travel time, we adopted the source parameters given in BISC, and used the J-B model as the standard model of earth. On inversion, we adopted singular value decomposition as a generalized inversion package, which can be used for solving very large over-determined systems of equations Gm = t without resorting to normal equations G/sup T/Gm = G/sup T/t. The results are that within the crust and upper mantle under the Beijing region there are clear lateral differences. In the results obtained by use of data from 1972 to 1975, it can be seen that there are three different zones of P-velocity. In the southeast Beijing region, P velocity is lower than that of the normal model by 10 to 14% within the crust, and by 8 to 9% within the upper mantle. The northwest Beijing region is a higher-velocity zone, within which the average P-velocity is faster than that of the normal model by about 9%. It disappears after entering into the upper mantle. The central part of this region is a normal zone. On the surface, the distribution of these P velocity variations corresponds approximately to the distribution of the over-burden. But in the deeper region, the distribution of velocity variation agrees with the distribution of seismicity. It is interesting to note that the hypocenters of several major earthquakes in this region, e.g., the Sanhe-Pinggu earthquake (1679, M = 8), the Shacheng earthquake (1730, M = 6-3/4) and the Tangshan earthquake (1976, M = 7.8), are all located very close to this boundary of these P-velocity variation zones.

  17. Regionalization of Crustal and Upper Mantle Q Structure in Eastern Eurasia Using Multiple Regional Waves

    National Research Council Canada - National Science Library

    Gaherty, James; Lerner-Lam, Arthur

    2007-01-01

    We have mapped lateral variations in seismic Q in eastern Eurasia, including continental China, central Asia, Mongolia and Siberia, using high-frequency regional phases Lg and Pn, as well as long-period Rayleigh waves...

  18. SPURS: Salinity Processes in the Upper-Ocean Regional Study: THE NORTH ATLANTIC EXPERIMENT

    Science.gov (United States)

    Lindstrom, Eric; Bryan, Frank; Schmitt, Ray

    2015-01-01

    In this special issue of Oceanography, we explore the results of SPURS-1, the first part of the ocean process study Salinity Processes in the Upper-ocean Regional Study (SPURS). The experiment was conducted between August 2012 and October 2013 in the subtropical North Atlantic and was the first of two experiments (SPURS come in pairs!). SPURS-2 is planned for 20162017 in the tropical eastern Pacific Ocean.

  19. Pattern of relapse in surgical treated patients with thoracic esophageal squamous cell carcinoma and its possible impact on target delineation for postoperative radiotherapy

    International Nuclear Information System (INIS)

    Cai Wenjie; Xin Peiling

    2010-01-01

    Objective: To provide a reference for determination of the postoperative radiotherapy target volume for thoracic esophageal squamous cell carcinoma. Background data: The irradiation target volume is important for effective postoperative treatment of thoracic esophageal squamous cell carcinoma. Methods: One hundred forty patients with recurrent or metastatic thoracic esophageal squamous cell carcinoma who had been treated with radical surgery but not with postoperative radiotherapy were enrolled in this study. The information of locoregional recurrence and distant metastasis for these patients was analyzed. Results: The median time to progression in the 140 patients with recurrence or metastasis was 18.3 months (range 15.4-21.1 months). Anastomotic recurrence accounted for 13.6% of treatment failures. The supraclavicular and station 1-5 and 7 lymph nodes had high metastasis rates for esophageal squamous cell carcinomas in all locations. The order from highest to lowest metastasis rate for the station 3 and 4 lymph nodes was middle, upper and lower thoracic esophageal regions and the order for upper abdominal lymph nodes was lower, middle, and upper thoracic esophageal regions. Locoregional recurrence was the most common type of recurrence. Conclusions: For upper and middle thoracic esophageal squamous cell carcinomas, the anastomosis, supraclavicular, and station 1-5 and 7 lymph nodes should be delineated as the postoperative prophylactic irradiation target volume with upper abdominal lymph nodes excluded; for lower thoracic esophageal squamous cell carcinomas, anastomosis, supraclavicular, station 1-5 and 7 lymph nodes and upper abdominal lymph nodes should be delineated as the postoperative prophylactic irradiation target volume.

  20. Large mammals from the Upper Neopleistocene reference sections in the Tunka rift valley, southwestern Baikal Region

    Science.gov (United States)

    Shchetnikov, A. A.; Klementiev, A. M.; Filinov, I. A.; Semeney, E. Yu.

    2015-03-01

    This work presents the data on new finds of fossil macrotheriofauna in the reference sections of the Upper Neopleistocene sediments in the Tunka rift valley (southwestern Baikal Region). The osteological material of a number of Late Neopleistocene mammals including extinct species rare for the Baikal region such as Crocuta spelaea, Panthera spelaea, and Spirocerus kiakhtensis (?) was directly dated with a radiocarbon (AMS) method. The obtained 14C data (18000-35000 years) allow one to rejuvenate significantly the upper limit of the common age interval of habitat of these animals in southern part of Eastern Siberia. Cave hyena and spiral-horned antelope lived in the Tunka rift valley in the Baikal region in Late Kargino time (37-24 ka), and cave lion survived the maximum in the Sartan cryochron in the region (21-20 ka). The study of collected paleontological collections provides a basis for selection of independent Kargino (MIS 3) faunal assemblages to use them for regional biostratigraphic analysis of Pleistocene deposits. Radiocarbon age dating of samples allows one to attribute confidently all paleofaunal remains available to the second half of the Late Pleistocene.

  1. Local extirpations and regional declines of endemic upper beach invertebrates in southern California

    Science.gov (United States)

    Hubbard, D. M.; Dugan, J. E.; Schooler, N. K.; Viola, S. M.

    2014-10-01

    Along the world's highly valued and populous coastlines, the upper intertidal zones of sandy beach ecosystems and the biodiversity that these zones support are increasingly threatened by impacts of human activities, coastal development, erosion, and climate change. The upper zones of beaches typically support invertebrates with restricted distributions and dispersal, making them particularly vulnerable to habitat loss and fragmentation. We hypothesized that disproportionate loss or degradation of these zones in the last century has resulted in declines of upper shore macroinvertebrates in southern California. We identified a suite of potentially vulnerable endemic upper beach invertebrates with direct development, low dispersal and late reproduction. Based on the availability of printed sources and museum specimens, we investigated historical changes in distribution and abundance of two intertidal isopod species (Tylos punctatus, Alloniscus perconvexus) in southern California. Populations of these isopods have been extirpated at numerous historically occupied sites: T. punctatus from 16 sites (57% decrease), and A. perconvexus from 14 sites (64% decrease). During the same period, we found evidence of only five colonization events. In addition, the northern range limit of the southern species, T. punctatus, moved south by 31 km (8% of range on California mainland) since 1971. Abundances of T. punctatus have declined on the mainland coast; only three recently sampled populations had abundances >7000 individuals m-1. For A. perconvexus populations, abundances >100 individuals m-1 now appear to be limited to the northern part of the study area. Our results show that numerous local extirpations of isopod populations have resulted in regional declines and in greatly reduced population connectivity in several major littoral cells of southern California. Two of the six major littoral cells (Santa Barbara and Zuma) in the area currently support 74% of the remaining isopod

  2. [Improvement in health care quality for patients from the thoracic/chest pain unit in a regional hospital].

    Science.gov (United States)

    Castellano Ortega, M A; Romero de Castilla, R J; Rus Mansilla, C; Cortez Quiroga, G A; Bayona Gómez, A J; Duran Torralba, M C

    2011-01-01

    The evaluation of an improvement cycle in patients suffering thoracic/chest pain in hospital emergencies, especially in those who could benefit from the early Bruce Treadmill Test. A multidisciplinary group care protocol was designed, which identified improvement opportunities and gave priority to the fact that «an early Bruce Treadmill Test was carried out on fewer occasions than recommended». Causes were analysed (Ishikawa diagram) and six quality criteria were defined. These criteria were evaluated in a random sample of 30 patients out of the total of 180 who used the ergometer at the Hospital in the first six months of 2007, as well as questionnaire for the doctors. Corrective measures were introduced: circulation, accessibility through intranet and explicit information for new employees (doctors). The second evaluation was carried out during the first six-months of 2008 using another random sample of 30 patients from a total of 120. In the first evaluation, the classification of the risk according to the protocol was very low (100% non-compliance) and patients whose admission to the Chest Pain Unit was recommended and an early Bruce Treadmill Test (74% criteria failure) were referred to cardiology clinics. After implementation of the corrective measures, we obtain a general improvement in all the criteria, but very significant from the previous ones, with non-compliances being reduced to 17% in classification and to the 23% in referrals. The structured cycle has helped resolve the priority problem in the short-term. The adopted measures have mainly been organisational, dependent on the professionals involved, and at a very low cost. Simple but organised methodological approaches should be taken into account before the incorporation of higher cost technologies. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

  3. Ultrasound-Guided Regional Anesthesia for Procedures of the Upper Extremity

    Directory of Open Access Journals (Sweden)

    Farheen Mirza

    2011-01-01

    Full Text Available Anesthesia options for upper extremity surgery include general and regional anesthesia. Brachial plexus blockade has several advantages including decreased hemodynamic instability, avoidance of airway instrumentation, and intra-, as well as post-operative analgesia. Prior to the availability of ultrasound the risks of complications and failure of regional anesthesia made general anesthesia a more desirable option for anesthesiologists inexperienced in the practice of regional anesthesia. Ultrasonography has revolutionized the practice of regional anesthesia. By visualizing needle entry throughout the procedure, the relationship between the anatomical structures and the needle can reduce the incidence of complications. In addition, direct visualization of the spread of local anesthesia around the nerves provides instant feedback regarding the likely success of the block. This review article outlines how ultrasound has improved the safety and success of brachial plexus blocks. The advantages that ultrasound guidance provides are only as good as the experience of the anesthesiologist performing the block. For example, in experienced hands, with real time needle visualization, a supraclavicular brachial plexus block has changed from an approach with the highest risk of pneumothorax to a block with minimal risks making it the ideal choice for most upper extremity surgeries.

  4. Automated segmentation of blood-flow regions in large thoracic arteries using 3D-cine PC-MRI measurements.

    Science.gov (United States)

    van Pelt, Roy; Nguyen, Huy; ter Haar Romeny, Bart; Vilanova, Anna

    2012-03-01

    Quantitative analysis of vascular blood flow, acquired by phase-contrast MRI, requires accurate segmentation of the vessel lumen. In clinical practice, 2D-cine velocity-encoded slices are inspected, and the lumen is segmented manually. However, segmentation of time-resolved volumetric blood-flow measurements is a tedious and time-consuming task requiring automation. Automated segmentation of large thoracic arteries, based solely on the 3D-cine phase-contrast MRI (PC-MRI) blood-flow data, was done. An active surface model, which is fast and topologically stable, was used. The active surface model requires an initial surface, approximating the desired segmentation. A method to generate this surface was developed based on a voxel-wise temporal maximum of blood-flow velocities. The active surface model balances forces, based on the surface structure and image features derived from the blood-flow data. The segmentation results were validated using volunteer studies, including time-resolved 3D and 2D blood-flow data. The segmented surface was intersected with a velocity-encoded PC-MRI slice, resulting in a cross-sectional contour of the lumen. These cross-sections were compared to reference contours that were manually delineated on high-resolution 2D-cine slices. The automated approach closely approximates the manual blood-flow segmentations, with error distances on the order of the voxel size. The initial surface provides a close approximation of the desired luminal geometry. This improves the convergence time of the active surface and facilitates parametrization. An active surface approach for vessel lumen segmentation was developed, suitable for quantitative analysis of 3D-cine PC-MRI blood-flow data. As opposed to prior thresholding and level-set approaches, the active surface model is topologically stable. A method to generate an initial approximate surface was developed, and various features that influence the segmentation model were evaluated. The active surface

  5. Asphyxiating thoracic dysplasia

    International Nuclear Information System (INIS)

    Franzcr, J.; Kozlowski, K.

    2008-01-01

    Asphyxiating Thoracic Dysplasia is the most frequent form of Small Thorax - Short Rib Syndromes. Asphyxiating Thoracic Dysplasia in two patients with different clinical course is reported. Radiographic examination is the only method to diagnose Asphyxiating Thoracic Dysplasia with certainty. The correct diagnosis is important for prognostication and genetic counseling. It also excludes the necessity of further, often expensive investigations. (author)

  6. Lithofacies palaeogeography of the Late Permian Wujiaping Age in the Middle and Upper Yangtze Region, China

    Directory of Open Access Journals (Sweden)

    Jin-Xiong Luo

    2014-10-01

    Full Text Available The lithofacies palaeogeography of the Late Permian Wujiaping Age in Middle and Upper Yangtze Region was studied based on petrography and the “single factor analysis and multifactor comprehensive mapping” method. The Upper Permian Wujiaping Stage in the Middle and Upper Yangtze Region is mainly composed of carbonate rocks and clastic rocks, with lesser amounts of siliceous rocks, pyroclastic rocks, volcanic rocks and coal. The rocks can be divided into three types, including clastic rock, clastic rock–limestone and limestone–siliceous rock, and four fundamental ecological types and four fossil assemblages are recognized in the Wujiaping Stage. Based on a petrological and palaeoecological study, six single factors were selected, namely, thickness (m, content (% of marine rocks, content (% of shallow water carbonate rocks, content (% of biograins with limemud, content (% of thin-bedded siliceous rocks and content (% of deep water sedimentary rocks. Six single factors maps of the Wujiaping Stage and one lithofacies palaeogeography map of the Wujiaping Age were composed. Palaeogeographic units from west to east include an eroded area, an alluvial plain, a clastic rock platform, a carbonate rock platform where biocrowds developed, a slope and a basin. In addition, a clastic rock platform exists in the southeast of the study area. Hydrocarbon source rock and reservoir conditions were preliminarily analyzed based on lithofacies palaeogeography. Sedimentary environments have obvious controls over the development of the resource rocks. With regard to the abundance of organic matter, the hydrocarbon potential of the coastal swamp environment is the best, followed by the basin environment and the carbonate rock platform. The gas reservoir types of the Wujiaping Stage can be classified as conventional and unconventional gas reservoirs, like coal bed gas and shale gas; all of them have well exploration prospects.

  7. Reconstruction of the mid-Hirnantian palaeotopography in the Upper Yangtze region, South China

    Directory of Open Access Journals (Sweden)

    Linna Zhang

    2014-12-01

    Full Text Available Reconstruction of the Hirnantian (Late Ordovician palaeotopography in South China is important for understanding the distribution pattern of the Hirnantian marine depositional environment. In this study, we reconstructed the Hirnantian palaeotopography in the Upper Yangtze region based on the rankings of the palaeo-water depths, which were inferred according to the lithofacies and biofacies characteristics of the sections. Data from 374 Hirnantian sections were collected and standardized through the online Geobiodiversity Database. The Ordinary Kriging interpolation method in the ArcGIS software was applied to create the continuous surface of the palaeo-water depths, i.e. the Hirnantian palaeotopography. Meanwhile, the line transect analysis was used to further observe the terrain changes along two given directions.The reconstructed palaeotopographic map shows a relatively flat and shallow epicontinental sea with three local depressions and a submarine high on the Upper Yangtze region during the Hirnantian. The water depth is mostly less than 60 m and the Yangtze Sea gradually deepens towards the north.

  8. Review of meningitis surveillance data, upper West Region, Ghana 2009-2013.

    Science.gov (United States)

    Nuoh, Robert Domo; Nyarko, Kofi Mensah; Nortey, Priscilla; Sackey, Samuel Oko; Lwanga, Noora Charles; Ameme, Donne Kofi; Nuolabong, Culbert; Abdulai, Marijanatu; Wurapa, Fredrick; Afari, Edwin

    2016-01-01

    The Upper West region of Ghana is within the meningitis belt. Analysis of long term surveillance data is necessary for understanding changes in the disease occurrence. We analyzed five years of surveillance data to describe by person, place and time and to determine trends in meningitis. Meningitis surveillance data from Ghana Health Service in the Upper West Region, from 2009 to 2013 were reviewed. Data was obtained from District-Health Information Management System and line list from the Disease Control Unit. Population figures (denominators) and rainfall data were also analyzed. Within the period 980 cases of meningitis were reported in the region, 507(52%) females and 473(48%) males. The mean age of cases was 20.1years and standard deviation 18.8 years with, 77.6 %( 761/980) cases occurring in persons aged under 30 years. Children under five years were 19.3% (190/980). Attack rates ranged from 6.1/100,000 population in the Daffiama-bussei-Issa-district to 47.5/100,000 in Jirapa. Overall case fatality rate of meningitis was 12.2% with 14deaths/100,000 population. Bacterial agents were isolated from 35% (245/702) of CSF. Majority were Streptococcus pneumonia 48.2 % ( 122/258), and N. meningitides Y/W 135 40.3% (102/258). Meningitis was found to be seasonal with peaks in the dry season. Meningitis in the region is seasonal, and showed a decreasing trend. Jirapa, Lawra, Nadowli and Wa West districts had the highest burden. Control effort of the disease should focus on vaccination against streptococcus pneumonia and N. meningitis W135 especially within crowded settlements such as boarding schools.

  9. CT and MRI characteristics of ossification of the ligamenta flava in the thoracic spine

    Energy Technology Data Exchange (ETDEWEB)

    Xiong, L. [Dept. of Radiology, University of Texas Health Science Center, San Antonio, TX (United States); Zeng, Q.Y. [Dept. of Radiology, General Coal Hospital, Beijing (China); Jinkins, J.R. [Dept. of Radiology, School of Medicine, Philadelphia, PA (United States)

    2001-09-01

    The purpose of this study was to compare MRI findings with CT findings of mass-forming calcification/ossification of the thoracic ligamenta flava (OTLF). Twenty-one Chinese patients presented with clinical evidence of chronic and progressive thoracic spinal cord compression which included: difficulty in walking; weakness; and/or numbness of the extremities, back pain, and lower extremity paresthesias. Axial and sagittal T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) were performed through the thoracic spine on a 1.0-T Impact unit (Siemens, Erlangen, Germany). Axial CT was obtained with 5-mm contiguous sections through the thoracic region. Decompressive surgery with resection of the OTLF were carried out in all patients. Low signal intensity of the mass-forming OTLF was demonstrated at a single level (n=1) or at multiple levels (n=20) on both T1WI and T2WI. The distribution of OTLF was bilateral at all levels identified in 6 cases, unilateral at all levels in 5 patients, and both unilateral and bilateral at different levels in 10 cases. Ossification of the thoracic ligamenta flava involved the upper thoracic spine (T1-4) in 3 cases, midthoracic spine (T5-8) in 3 cases, lower thoracic spine (T9-12) in 10 cases, and more than one thoracic spinal subregion in 5 cases. Computed tomography confirmed the MR findings regarding the location and distribution of OTLF in all cases, as well as the associated evidence of central spinal canal stenosis. In addition, 5 patients revealed associated ossification of the posterior longitudinal ligament. All patients demonstrated gradual, but incomplete, clinical improvement of the radiculomyelopathy following decompressive surgery. Ossification of the posterior longitudinal ligament resulting in thoracic central spinal canal stenosis and clinical radiculomyelopathy is not uncommon in the Asian people. Ossification of the thoracic ligamenta flava can be accurately evaluated equally well by CT and MR with regard to level

  10. CT and MRI characteristics of ossification of the ligamenta flava in the thoracic spine

    International Nuclear Information System (INIS)

    Xiong, L.; Zeng, Q.Y.; Jinkins, J.R.

    2001-01-01

    The purpose of this study was to compare MRI findings with CT findings of mass-forming calcification/ossification of the thoracic ligamenta flava (OTLF). Twenty-one Chinese patients presented with clinical evidence of chronic and progressive thoracic spinal cord compression which included: difficulty in walking; weakness; and/or numbness of the extremities, back pain, and lower extremity paresthesias. Axial and sagittal T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) were performed through the thoracic spine on a 1.0-T Impact unit (Siemens, Erlangen, Germany). Axial CT was obtained with 5-mm contiguous sections through the thoracic region. Decompressive surgery with resection of the OTLF were carried out in all patients. Low signal intensity of the mass-forming OTLF was demonstrated at a single level (n=1) or at multiple levels (n=20) on both T1WI and T2WI. The distribution of OTLF was bilateral at all levels identified in 6 cases, unilateral at all levels in 5 patients, and both unilateral and bilateral at different levels in 10 cases. Ossification of the thoracic ligamenta flava involved the upper thoracic spine (T1-4) in 3 cases, midthoracic spine (T5-8) in 3 cases, lower thoracic spine (T9-12) in 10 cases, and more than one thoracic spinal subregion in 5 cases. Computed tomography confirmed the MR findings regarding the location and distribution of OTLF in all cases, as well as the associated evidence of central spinal canal stenosis. In addition, 5 patients revealed associated ossification of the posterior longitudinal ligament. All patients demonstrated gradual, but incomplete, clinical improvement of the radiculomyelopathy following decompressive surgery. Ossification of the posterior longitudinal ligament resulting in thoracic central spinal canal stenosis and clinical radiculomyelopathy is not uncommon in the Asian people. Ossification of the thoracic ligamenta flava can be accurately evaluated equally well by CT and MR with regard to level

  11. Analysis of chosen urban bioclimatic conditions in Upper Silesian Industrial Region, Poland

    Science.gov (United States)

    Zimnol, Jan

    2013-04-01

    Due to the increasing urbanization, people spend more and more time in cities. Because of that fact during the last century the human bioclimatological approach had an important influence on the applied urban bioclimatology. The aim of the study was to analyze chosen thermal bioclimatic conditions in urban area of Upper Silesian Industrial Region in connection with the atmospheric circulation and air masses. The study was focused on the thermal conditions that are important for the bioclimatological research on human thermal comfort. They were the basis for making study on how to show the influence of the air masses and circulations types on frequency and variability of the chosen bioclimate indexes. That research was based on data (2004 - 2008) acquired by the Silesian University (Faculty of Earth Sciences) meteorological station located in the city of Sosnowiec (50°17'N, 19°08'E, h=263 m a.s.l.). The temperature measurements were made automatically every 10 minutes on the 2 meters above the ground level. Previous research showed that the station is a good representation of the local urban climate conditions in Upper Silesian Industrial Region. In the study the following air temperatures were taken into consideration: average day temperature, maximum day temperature, minimum day temperature and the average air temperature at 12 UTC. They were associated with atmospheric circulation types and masses typical for the region. Using the data mentioned above I conducted a classification to divide days into following objective categories: cool, cold, comfortable, hot, warm and very hot in the seasonal depiction. The final stage of the work was to find the answer to the following question: "When and how do the strong air masses and air circulations types modify bioclimatic conditions in the study area?" Answer to that question together with further results of the research will be presented on my poster.

  12. Habitat capacity for cougar recolonization in the Upper Great Lakes region.

    Science.gov (United States)

    O Neil, Shawn T; Rahn, Kasey C; Bump, Joseph K

    2014-01-01

    Recent findings indicate that cougars (Puma concolor) are expanding their range into the midwestern United States. Confirmed reports of cougar in Michigan, Minnesota, and Wisconsin have increased dramatically in frequency during the last five years, leading to speculation that cougars may re-establish in the Upper Great Lakes (UGL) region, USA. Recent work showed favorable cougar habitat in northeastern Minnesota, suggesting that the northern forested regions of Michigan and Wisconsin may have similar potential. Recolonization of cougars in the UGL states would have important ecological, social, and political impacts that will require effective management. Using Geographic Information Systems (GIS), we extended a cougar habitat model to Michigan and Wisconsin and incorporated primary prey densities to estimate the capacity of the region to support cougars. Results suggest that approximately 39% (>58,000 km2) of the study area could support cougars, and that there is potential for a population of approximately 500 or more animals. An exploratory validation of this habitat model revealed strong association with 58 verified cougar locations occurring in the study area between 2008 and 2013. Spatially explicit information derived from this study could potentially lead to estimation of a viable population, delineation of possible cougar-human conflict areas, and the targeting of site locations for current monitoring. Understanding predator-prey interactions, interspecific competition, and human-wildlife relationships is becoming increasingly critical as top carnivores continue to recolonize the UGL region.

  13. Habitat capacity for cougar recolonization in the Upper Great Lakes region.

    Directory of Open Access Journals (Sweden)

    Shawn T O Neil

    Full Text Available BACKGROUND: Recent findings indicate that cougars (Puma concolor are expanding their range into the midwestern United States. Confirmed reports of cougar in Michigan, Minnesota, and Wisconsin have increased dramatically in frequency during the last five years, leading to speculation that cougars may re-establish in the Upper Great Lakes (UGL region, USA. Recent work showed favorable cougar habitat in northeastern Minnesota, suggesting that the northern forested regions of Michigan and Wisconsin may have similar potential. Recolonization of cougars in the UGL states would have important ecological, social, and political impacts that will require effective management. METHODOLOGY/PRINCIPAL FINDINGS: Using Geographic Information Systems (GIS, we extended a cougar habitat model to Michigan and Wisconsin and incorporated primary prey densities to estimate the capacity of the region to support cougars. Results suggest that approximately 39% (>58,000 km2 of the study area could support cougars, and that there is potential for a population of approximately 500 or more animals. An exploratory validation of this habitat model revealed strong association with 58 verified cougar locations occurring in the study area between 2008 and 2013. CONCLUSIONS/SIGNIFICANCE: Spatially explicit information derived from this study could potentially lead to estimation of a viable population, delineation of possible cougar-human conflict areas, and the targeting of site locations for current monitoring. Understanding predator-prey interactions, interspecific competition, and human-wildlife relationships is becoming increasingly critical as top carnivores continue to recolonize the UGL region.

  14. Evolution of thoracic surgery in Canada.

    Science.gov (United States)

    Deslauriers, Jean; Pearson, F Griffith; Nelems, Bill

    2015-01-01

    Canada's contributions toward the 21st century's practice of thoracic surgery have been both unique and multilayered. Scattered throughout are tales of pioneers where none had gone before, where opportunities were greeted by creativity and where iconic figures followed one another. To describe the numerous and important achievements of Canadian thoracic surgeons in the areas of surgery for pulmonary tuberculosis, thoracic oncology, airway surgery and lung transplantation. Information was collected through reading of the numerous publications written by Canadian thoracic surgeons over the past 100 years, interviews with interested people from all thoracic surgery divisions across Canada and review of pertinent material form the archives of several Canadian hospitals and universities. Many of the developments occurred by chance. It was the early and specific focus on thoracic surgery, to the exclusion of cardiac and general surgery, that distinguishes the Canadian experience, a model that is now emerging everywhere. From lung transplantation in chimera twin calves to ex vivo organ preservation, from the removal of airways to tissue regeneration, and from intensive care research to complex science, Canadians have excelled in their commitment to research. Over the years, the influence of Canadian thoracic surgery on international practice has been significant. Canada spearheaded the development of thoracic surgery over the past 100 years to a greater degree than any other country. From research to education, from national infrastructures to the regionalization of local practices, it happened in Canada.

  15. Principles for the establishment of upper bounds to doses to individuals from global and regional sources

    International Nuclear Information System (INIS)

    1989-01-01

    The IAEA Safety Guide, Safety Series No. 77 (1986), Principles for Limiting Releases of Radioactive Effluents into the Environment, identifies the concept of upper bounds to individual dose. They are the fractions of the dose limit for members of the public allocated to the various different sources and practices which can give rise to individual exposure. This Guide is concerned with the contributions to individual dose which may arise from other sources in the same region and also from sources which are far away but which, because of the nature of the radionuclides involved, give rise to a global component of dose. Consideration is given to the need for control of such exposures and the means by which it could be achieved. The text may be seen as providing expansion of the guidance given in Safety Series No. 77. 24 refs

  16. Risk of contamination of wild berries from upper Orava region by cadmium

    Directory of Open Access Journals (Sweden)

    Stanislav Zupka

    2016-01-01

    Full Text Available The upper Orava region is located at the North Slovakia, near of potential sources of environmental contamination due by mining of coal, zinc and lead ores. The aim of the study was to evaluate the risk of consumption of wild forest fruit from Upper Orava region from the aspect of cadmium content. Ten sampling points were found by random search. From these points samples of soil, leaves and fruits of wild berries (9 samples of blueberries Vaccinium Myrtillus and 1 sample of strawberries Fragaria Vesca were collected. In soil samples the active soil reaction (pH/H2O ranged from 3.53 (strong acidity to 4.56 (extremly strong acidity, and the determined percentage of humus ranged from 1.66 (low humic soil to 4.90 (high humic soil.  In two soil samples the total content of cadmium determinated in soil extracts by aqua regia exceeded limit 0.70 mg.kg-1 given by the legislation in tne Slovak Republic. In three soil samples the determined content of cadmium mobile forms determined in soil extracts by NH4NO3 exceeded the limit 0.10 mg.kg-1. The content of Cd determined in leaves as well as in fruits was evaluated according to Food Codex of the Slovak Republic. Only in one sample of leaf samples the limit 1.00 mg.kg-1 was exceeded. The other leaf samples are safely when used as an ingredient in tea mixtures. On the other hand even in 7 fruit samples the limit 0.05 mg.kg-1 was exceeded. This fruit can pose a risk for the human organism when is directly consumed as well as may negatively affect the human health when is used as raw materials in the food industry. 

  17. Temporary occipital fixation in young children with severe cervical-thoracic spinal deformity.

    Science.gov (United States)

    Kelley, Brian J; Minkara, Anas A; Angevine, Peter D; Vitale, Michael G; Lenke, Lawrence G; Anderson, Richard C E

    2017-10-01

    OBJECTIVE The long-term effects of instrumentation and fusion of the occipital-cervical-thoracic spine on spinal growth in young children are poorly understood. To mitigate the effects of this surgery on the growing pediatric spine, the authors report a novel technique used in 4 children with severe cervical-thoracic instability. These patients underwent instrumentation from the occiput to the upper thoracic region for stabilization, but without bone graft at the craniovertebral junction (CVJ). Subsequent surgery was then performed to remove the occipital instrumentation, thereby allowing further growth and increased motion across the CVJ. METHODS Three very young children (15, 30, and 30 months old) underwent occipital to thoracic posterior segmental instrumentation due to cervical or upper thoracic dislocation, progressive kyphosis, and myelopathy. The fourth child (10 years old) underwent similar instrumentation for progressive cervical-thoracic scoliosis. Bone graft was placed at and distal to C-2 only. After follow-up CT scans demonstrated posterior arthrodesis without unintended fusion from the occiput to C-2, 3 patients underwent removal of the occipital instrumentation. RESULTS Follow-up cervical spine flexion/extension radiographs demonstrated partial restoration of motion at the CVJ. One patient has not had the occipital instrumentation removed yet, because only 4 months have elapsed since her operation. CONCLUSIONS Temporary fixation to the occiput provides increased biomechanical stability for spinal stabilization in young children, without permanently eliminating motion and growth at the CVJ. This technique can be considered in children who require longer instrumentation constructs for temporary stabilization, but who only need fusion in more limited areas where spinal instability exists.

  18. Vegetation Dynamics in the Upper Guinean Forest Region of West Africa from 2001 to 2015

    Directory of Open Access Journals (Sweden)

    Zhihua Liu

    2016-12-01

    Full Text Available The Upper Guinea Forest (UGF region of West Africa is one of the most climatically marginal and human-impacted tropical forest regions in the world. Research on the patterns and drivers of vegetation change is critical for developing strategies to sustain ecosystem services in the region and to understand how climate and land use change will affect other tropical forests around the globe. We compared six spectral indices calculated from the 2001–2015 MODIS optical-infrared reflectance data with manually-interpreted measurements of woody vegetation cover from high resolution imagery. The tasseled cap wetness (TCW index was found to have the strongest association with woody vegetation cover, whereas greenness indices, such as the enhanced vegetation index (EVI, had relatively weak associations with woody cover. Trends in woody vegetation cover measured with the TCW index were analyzed using Mann–Kendall statistics and were contrasted with trends in vegetation greenness measured with EVI. In the drier West Sudanian Savanna and Guinean Forest-Savanna Mosaic ecoregions, EVI trends were primarily positive, and TCW trends were primarily negative, suggesting that woody vegetation cover was decreasing, while herbaceous vegetation cover is increasing. In the wettest tropical forests in the Western Guinean Lowland Forest ecoregion, declining trends in both TCW and EVI were indicative of widespread forest degradation resulting from human activities. Across all ecoregions, declines in woody cover were less prevalent in protected areas where human activities were restricted. Multiple lines of evidence suggested that human land use and resource extraction, rather than climate trends or short-term climatic anomalies, were the predominant drivers of recent vegetation change in the UGF region of West Africa.

  19. MRI of thoracic outlet syndrome in children

    Energy Technology Data Exchange (ETDEWEB)

    Chavhan, Govind B.; Batmanabane, Vaishnavi [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Toronto, ON (Canada); Muthusami, Prakash [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Division of Image Guided Therapy, Department of Diagnostic Imaging, Toronto, ON (Canada); Towbin, Alexander J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology and Medical Imaging, Cincinnati, OH (United States); Borschel, Gregory H. [The Hospital for Sick Children and University of Toronto, Division of Plastic Surgery, Department of Pediatric Surgery, Toronto, ON (Canada)

    2017-09-15

    Thoracic outlet syndrome is caused by compression of the neurovascular bundle as it passes from the upper thorax to the axilla. The neurovascular bundle can be compressed by bony structures such as the first rib, cervical ribs or bone tubercles, or from soft-tissue abnormalities like a fibrous band, muscle hypertrophy or space-occupying lesion. Thoracic outlet syndrome commonly affects young adults but can be seen in the pediatric age group, especially in older children. Diagnosis is based on a holistic approach encompassing clinical features, physical examination findings including those triggered by various maneuvers, electromyography, nerve conduction studies and imaging. Imaging is performed to confirm the diagnosis, exclude mimics and classify thoracic outlet syndrome into neurogenic, arterial, venous or mixed causes. MRI and MR angiography are useful in this process. A complete MRI examination for suspected thoracic outlet syndrome should include the assessment of anatomy and any abnormalities using routine sequences, vessel assessment with the arms in adduction by MR angiography and assessment of dynamic compression of vessels with abduction of the arms. The purpose of this paper is to describe the anatomy of the thoracic outlet, causes of thoracic outlet syndrome, the MR imaging techniques used in its diagnosis and the principles of image interpretation. (orig.)

  20. MRI of thoracic outlet syndrome in children

    International Nuclear Information System (INIS)

    Chavhan, Govind B.; Batmanabane, Vaishnavi; Muthusami, Prakash; Towbin, Alexander J.; Borschel, Gregory H.

    2017-01-01

    Thoracic outlet syndrome is caused by compression of the neurovascular bundle as it passes from the upper thorax to the axilla. The neurovascular bundle can be compressed by bony structures such as the first rib, cervical ribs or bone tubercles, or from soft-tissue abnormalities like a fibrous band, muscle hypertrophy or space-occupying lesion. Thoracic outlet syndrome commonly affects young adults but can be seen in the pediatric age group, especially in older children. Diagnosis is based on a holistic approach encompassing clinical features, physical examination findings including those triggered by various maneuvers, electromyography, nerve conduction studies and imaging. Imaging is performed to confirm the diagnosis, exclude mimics and classify thoracic outlet syndrome into neurogenic, arterial, venous or mixed causes. MRI and MR angiography are useful in this process. A complete MRI examination for suspected thoracic outlet syndrome should include the assessment of anatomy and any abnormalities using routine sequences, vessel assessment with the arms in adduction by MR angiography and assessment of dynamic compression of vessels with abduction of the arms. The purpose of this paper is to describe the anatomy of the thoracic outlet, causes of thoracic outlet syndrome, the MR imaging techniques used in its diagnosis and the principles of image interpretation. (orig.)

  1. Epidemiology and pathogenesis of thoracic outlet syndrome

    Directory of Open Access Journals (Sweden)

    Wojcik Gustaw

    2015-03-01

    Full Text Available The superior thoracic aperture is a place particularly vulnerable to the occurrence of tissue conflict and the development of a number of neurovascular changes carrying a risk of upper limb dysfunction. The triggering factor in this case is the pressure on the nerve vascular elements brought about by too large muscles of the chest and neck, clavicle fracture and dislocation of the upper ribs, anomalies in the form of ribs, in the neck, or by apex of the lung tumors. Each anatomical anomaly may be a cause of a number of lesions and lead to the development of the disease. Due to the nature of the oppressed structures, there are two basic groups: neurogenic and vascular. The most common variant giving clinical symptoms is neurogenic thoracic outlet syndrome. In this, the compression ratio, the brachial plexus, and for this reason, the vascular surface of the upper limb dysfunction is often overlooked. However, the vascular variant, and especially arterial sub-variant, is very dangerous because it can give complications even in the form of aneurysms, and even upper limb ischemia. The aim of the study is to present the most common changes in the thoracic outlet causing functional disorders of the upper limb.

  2. Thoracic myelopathy with alkaptonuria.

    Science.gov (United States)

    Akeda, Koji; Kasai, Yuichi; Kawakita, Eiji; Matsumura, Yoshihiro; Kono, Toshibumi; Murata, Tetsuya; Uchida, Atsumasa

    2008-01-15

    A case of thoracic myelopathy with alkaptonuria (ochronotic spondyloarthropathy) is presented. To present and review the first reported case of an alkaptonuric patient with concomitant thoracic myelopathy. Alkaptonuria, a rare hereditary metabolic disease, is characterized by accumulation of homogentistic acid, ochronosis, and destruction of connective tissue resulting in degenerative spondylosis and arthritis. Despite the high incidence of intervertebral disc diseases among patients with alkaptonuria, neurologic symptoms caused by spinal disease are rare. Thoracic myelopathy in a patient with alkaptonuria has not been previously reported. The clinical course, radiologic features, pathology, and treatment outcome of an alkaptonuria patient with thoracic myelopathy was documented. Myelopathy of the patient was caused by rupture of a thoracic intervertebral disc. The neurologic symptoms of the patient were markedly improved after surgery. We have reported for the first time, that an alkaptonuria patient showed thoracic myelopathy caused by rupture of a thoracic intervertebral disc. Decompression followed by the instrumented fusion of the thoracic spine was effective for improving the neurologic symptoms.

  3. Thoracic spine pain

    Directory of Open Access Journals (Sweden)

    Aleksey Ivanovich Isaikin

    2013-01-01

    Full Text Available Thoracic spine pain, or thoracalgia, is one of the common reasons for seeking for medical advice. The epidemiology and semiotics of pain in the thoracic spine unlike in those in the cervical and lumbar spine have not been inadequately studied. The causes of thoracic spine pain are varied: diseases of the cardiovascular, gastrointestinal, pulmonary, and renal systems, injuries to the musculoskeletal structures of the cervical and thoracic portions, which require a thorough differential diagnosis. Facet, costotransverse, and costovertebral joint injuries and myofascial syndrome are the most common causes of musculoskeletal (nonspecific pain in the thoracic spine. True radicular pain is rarely encountered. Traditionally, treatment for thoracalgia includes a combination of non-drug and drug therapies. The cyclooxygenase 2 inhibitor meloxicam (movalis may be the drug of choice in the treatment of musculoskeletal pain.

  4. Regional-scale controls on dissolved nitrous oxide in the Upper Mississippi River

    Science.gov (United States)

    Turner, P.A.; Griffis, T.J.; Baker, J.M.; Lee, X.; Crawford, John T.; Loken, Luke C.; Venterea, R.T.

    2016-01-01

    The U.S. Corn Belt is one of the most intensive agricultural regions of the world and is drained by the Upper Mississippi River (UMR), which forms one of the largest drainage basins in the U.S. While the effects of agricultural nitrate (NO3-) on water quality in the UMR have been well documented, its impact on the production of nitrous oxide (N2O) has not been reported. Using a novel equilibration technique, we present the largest data set of freshwater dissolved N2O concentrations (0.7 to 6 times saturation) and examine the controls on its variability over a 350 km reach of the UMR. Driven by a supersaturated water column, the UMR was an important atmospheric N2O source (+68 mg N2ONm-2 yr-1) that varies nonlinearly with the NO3-concentration. Our analyses indicated that a projected doubling of the NO3-concentration by 2050 would cause dissolved N2O concentrations and emissions to increase by about 40%.

  5. Study on 3-D velocity structure of crust and upper mantle in Sichuan-yunnan region, China

    Science.gov (United States)

    Wang, C.; Mooney, W.D.; Wang, X.; Wu, J.; Lou, H.; Wang, F.

    2002-01-01

    Based on the first arrival P and S data of 4 625 regional earthquakes recorded at 174 stations dispersed in the Yunnan and Sichuan Provinces, the 3-D velocity structure of crust and upper mantle in the region is determined, incorporating with previous deep geophysical data. In the upper crust, a positive anomaly velocity zone exists in the Sichuan basin, whereas a negative anomaly velocity zone exists in the western Sichuan plateau. The boundary between the positive and negative anomaly zones is the Longmenshan fault zone. The images of lower crust and upper mantle in the Longmenshan fault, Xianshuihe fault, Honghe fault and others appear the characteristic of tectonic boundary, indicating that the faults litely penetrate the Moho discontinuity. The negative velocity anomalies at the depth of 50 km in the Tengchong volcanic area and the Panxi tectonic zone appear to be associated with the temperature and composition variations in the upper mantle. The overall features of the crustal and the upper mantle structures in the Sichuan-Yunnan region are the lower average velocity in both crust and uppermost mantle, the large crustal thickness variations, and the existence of high conductivity layer in the crust or/and upper mantle, and higher geothermal value. All these features are closely related to the collision between the Indian and the Asian plates. The crustal velocity in the Sichuan-Yunnan rhombic block generally shows normal.value or positive anomaly, while the negative anomaly exists in the area along the large strike-slip faults as the block boundary. It is conducive to the crustal block side-pressing out along the faults. In the major seismic zones, the seismicity is relative to the negative anomaly velocity. Most strong earthquakes occurred in the upper-mid crust with positive anomaly or normal velocity, where the negative anomaly zone generally exists below.

  6. UPPER JURASSIC OUTCROPS ALONG THE CALDAS DA RAINHA DIAPIR, WEST CENTRAL PORTUGAL: A REGIONAL GEOHERITAGE OVERVIEW

    Directory of Open Access Journals (Sweden)

    JORGE DINIS

    2004-03-01

    Full Text Available The Mesozoic Portuguese geological heritage is very rich and varied, a legacy of the position in the western margin of Iberia and its relationship with the evolution of the North Atlantic, with an interesting tectonic history since the Late Triassic. Regarding the Upper Jurassic several connections can be established between the tectonics and the stratigraphic record in the area surrounding the Caldas da Rainha structure: the basement and salt pillow control on deposition; the beginning of a diapiric and magmatic cycle associated to the on-set of sea-floor and the exhumation of both Jurassic deposits and the core of their controlling diapirs. The nature of the outcrops and richness in sedimentary environments, related with the different phases of rifting, is a remarkable case for extensional basin studies. Geological sites can be of regional, national or international importance due to scientific, educational, economical, social or historical reasons. The present proposal can be considered as a model for the establishment of tourist/educational routes with a strong component in communication on Earth Sciences, integrating social and historical aspects at a regional level. The recognition of those sites as geoheritage may contribute to a more sustainable management, in particular because it allows the achievement of a critical dimension for the investment in human resources and marketing. In Portugal, recent legal evolution might be considered promising. Nevertheless, since implementation of the concept of protected site depends on the approval of detailed management programs, there are frequent delays, misinterpretations and disrespect of legislation. The strategy to be adopted must integrate conservation, scientific studies and science communication in projects with economic and social interest.

  7. Density heterogeneity of the upper mantle beneath Siberia from satellite gravity and a new regional crustal model

    DEFF Research Database (Denmark)

    Herceg, Matija; Thybo, Hans; Artemieva, Irina

    2013-01-01

    We present a new regional model for the density structure of the upper mantle below Siberia. The residual mantle gravity anomalies are based on gravity data derived from the GOCE gravity gradients and geopotential models, with crustal correction to the gravity field being calculated from a new...... on regional and global crustal models. We analyze how uncertainties and errors in the crustal model propagate from crustal densities to mantle residual gravity anomalies and the density model of the upper mantle. The new regional density model for the Siberian craton and the West Siberian Basin complements...... regional crustal model. This newly compiled database on the crustal seismic structure, complemented by additional constraints from petrological analysis of near-surface rocks and lower crustal xenoliths, allows for a high-resolution correction of the crustal effects as compared to previous studies based...

  8. A pilot application of regional scale risk assessment to the forestry management of the upper Grand Ronde watershed, Oregon

    Science.gov (United States)

    Suzanne M. Anderson; Wayne G. Landis

    2012-01-01

    An issue in forestry management has been the integration of a variety of different information into a threat analysis or risk assessment. In this instance, regional scale risk assessment was applied to the Upper Grande Ronde watershed in eastern Oregon to examine the potential of risk assessment for use in the management of broad landscapes. The site was a focus of...

  9. Evaluation of Sugar Maple Dieback in the Upper Great Lakes Region and Development of a Forest Health Youth Education Program

    Science.gov (United States)

    Bal, Tara L.

    2013-01-01

    Sugar Maple, "Acer saccharum" Marsh., is one of the most valuable trees in the northern hardwood forests. Severe dieback was recently reported by area foresters in the western Upper Great Lakes Region. Sugar Maple has had a history of dieback over the last 100 years throughout its range and different variables have been identified as…

  10. Versatality of supraclavicular flap in neck, face, and upper chest region coverage

    International Nuclear Information System (INIS)

    Almas, D.; Masood, T.; Dar, M.F.; Noman, B.

    2015-01-01

    The objective is to analyze the utility of the island supraclavicular flap in a region where skin graft cannot be used and free flap is not feasible. We assessed complications and functional outcomes. Study Design: Prospective descriptive study. Place and Duration of Study: The study was done at plastic and reconstructive surgery department CMH Rawalpindi during the period of 03 year from October 2011 to October 2014. Material and Patients: An island supraclavicular artery flap was used to reconstruct oncologic, and post burn neck contractures release defects. 30 patients were included in the study. Doppler probe was used to help with localization of vascular pedicle. All the patients with scarring in both shoulder regions, history of radiation to neck and undergoing radical neck dissection were excluded. Results: A total of 30 patients were included 20 (66.6%) male and 10 (33.3%) were female. Oncologicre section was followed by immediate reconstruction with island supraclavicular artery flap. Post burn contractures were released and covered by a pedicled supraclavicular artery flap. The recipient sites were neck, face, oral and upper chest region. The average harvest time was 1 and half hour. Donor site was closed primarily in 22 (73.3%) while 8 (26.6%) require skin grafting. Post burn contractures needed scar management with intralesional steroid, pressure garments and scar revision with Z-plasty in 4(13.3%) cases. 1 (3.3%) flap failed completely and the defect was covered with a skin graft. We had 01 (3.3%) mortality due to respiratory obstruction, despite adequate flap perfusion for 24 hours. Minor complications included, partial flap loss, seroma, and haematoma formation. In addition hypertrophied scar, spreading scar and keloid formation occurred at the donor site 18 (60%). Conclusion: Island supraclavicular artery flap with an easy learning curve is a reliable flap. It has a good colour and texture match with minimal donor site morbidity. It is an excellent

  11. Using isotope techniques to assess groundwater resources in the upper Jezireh region

    International Nuclear Information System (INIS)

    Kattan, Z.; Abou Zakhem, B.; Al-Charideh, A.; Kadkoy, N

    2008-07-01

    This work discuses in details the hydrochemical and environmental isotopes ( 2 H, 3 H, 13 C, 14 C, 18 O and 34 S) characteristics of groundwaters resources in the Palaeogene aquifer in the Upper Syrian Jezireh Region in order to evaluate these resources in terms of recharge zones and water ages in such an aquifer system that undergone during the last decades to intensive exploitation as a consequence of sever pumping in both Syria and Turkey. The results show that the main recharge zones for the Palaeogene aquifer exists in Turkey within lands of more than 700 m.a.s.l, and effectively coincide well with the exposure of the Karstified Nummulitic limestone in Mardin uplift. The chemical and isotopic behaviors of groundwaters, together with the radiometric 14 C ages reflect the existence of three different groundwater groups: (1) the fresh and cold water, percolating in short and shallow flow paths, such as the case of the major cold springs in Ras Al-Ain and Ain El-Arous areas and most wells located in the vicinity of the Syrian-Turkish borders, for which the main replenishment processes were occurred after the palaeoclimatic humid conditions of the Holocene period, placed between 4.5-6 ka BP; (2) the brackish and thermal waters containing certain amounts of H 2 S gas, that percolate in longer and deeper flow paths, for which the main replenishment processes were occurred during the palaeoclimatic humid conditions of the Pleistocene time, placed at 9-18 ka BP; (3) the brackish and admixed thermal groundwaters with intermediate 14 C ages, which seem to be formed as a result of mixing between the previous two groups. (Authors)

  12. Spatial and socio-demographic determinants of contraceptive use in the Upper East region of Ghana.

    Science.gov (United States)

    Achana, Fabian Sebastian; Bawah, Ayaga A; Jackson, Elizabeth F; Welaga, Paul; Awine, Timothy; Asuo-Mante, Eric; Oduro, Abraham; Awoonor-Williams, John Koku; Phillips, James F

    2015-04-02

    This paper presents results of baseline data on the determinants of contraceptive use in 7 districts in northern Ghana where there is an ongoing integrated primary health care systems strengthening projectknown as the Ghana Essential Health Intervention Project (GEHIP). We used a household survey data conducted within 66 randomly sampled census enumeration areas in seven rural districts of the Upper East Region of northern Ghana where health systems strengthening interventions are currently ongoing in three of the districts with four of the districts serving as comparison districts. This survey was conducted prior to the introduction of interventions. Data was collected on various indices included geographic information systems (GIS) and contraceptive use. The data was analyzed using survey design techniques that accounts for correct variance estimation. Categorical variables were summarized as proportions and associations between these variables and contraceptive use tested using Chi-square test. Uni-variable and multivariable logistic regression techniques were used to assess the effects of the selected covariates on contraceptive use. All tests were deemed to be statistically significant at 5% level statistical significance. Results show that contraceptive use is generally low (about 13 per cent) and use is nearly evenly for spacing and stopping purposes. Factors associated with the use of contraceptives include exposure to integrated primary healthcare services, the level of education, and socioeconomic status, couple fertility preference, marital status, and parity. For instance, the odds of contraceptive use among 15-45 year old women who live 2 km or more from a CHPS compound is 0.74 compared to women who live less than 2 km from a CHPS compound (p-value = 0.035). The findings suggest that rapid scale up of the Community based Health Planning and Services (CHPS) program accompanied with improved door-to-door health services would kindle uptake of modern

  13. On transient events in the upper atmosphere generated away of thunderstorm regions

    Science.gov (United States)

    Morozenko, V.; Garipov, G.; Khrenov, B.; Klimov, P.; Panasyuk, M.; Sharakin, S.; Zotov, M.

    2011-12-01

    Experimental data on transient events in UV and Red-IR ranges obtained in the MSU missions "Unversitetsky-Tatiana" (wavelengths 300-400 nm) and "Unversitetsky-Tatiana-2" (wavelengths 300-400 nm and 600-800 nm), published by Garipov et al, in 2010 at COSPAR session http://www.cospar2010.org, at TEPA conference http://www.aragats.am/Conferences/tepa2010 and in 2011 by Sadovnichy et al, Solar System Research, 45, #1, 3-29 (2011); Vedenkin et al, JETP, v. 140, issue 3(9), 1-11 (2011) demonstrated existence of transients at large distances (up to thousands km) away of cloud thunderstorm regions. Those "remote" transients are short (1-5 msec) and are less luminous than the transients above thunderstorm regions. The ratio of Red-IR to UV photon numbers in those transients indicates high altitude of their origin (~70 km). Important observation facts are also: 1. a change of the exponent in transient distribution on luminosity Q ("-1" for photon numbers Q=1020 -1023 to "-2" for Q>1023), 2. a change of global distribution of transient with their luminosity (transients with Q>1023 are concentrated in equatorial range above continents, while transients with low luminosity are distributed more uniformly), 3. a phenomenon of transient sequences in one satellite orbit which is close to geomagnetic meridian. In the present paper phenomenological features of transients are explained in assumption that the observed transients have to be divided in two classes: 1. transients related to local, lower in the atmosphere, lightning at distance not more than hundreds km from satellite detector field of view in the atmosphere and 2. transients generated by far away lightning. Local transients are luminous and presumably are events called "transient luminous events" (TLE). In distribution on luminosity those events have some threshold Q~1023 and their differential luminosity distribution is approximated by power law exponent "-2". Remote transients have to be considered separately. Their

  14. Vertical field MR imaging of upper thorax and spine in small children

    International Nuclear Information System (INIS)

    Brockstedt, S.; Malmgren, N.; Malmgren, L.; Ivarsson, M.L.; Larsson, E.M.; Holtaas, S.; Staahlberg, F.

    1993-01-01

    To improve image quality in a vertical field MR imaging unit, operating at low field strength (0.3 T), we have designed a half-elliptical coil for use in the upper thoracic region of small children. Our intention was also to shorten the examination time, which until now has been long, because several scans with different coils have been necessary to cover the thoracic region. The experimental coil is designed so that a child's shoulders fit into the central region. The coil consists of 2 serially connected cable-loops, mounted on a foam rubber vest. The coil performance was tested in a phantom and improvements relative to standard coils were demonstrated in in vivo studies. The results indicate that by using the half-elliptical coil, the signal-to-noise (S/N) ratio can be improved by a factor of 2 to 3 in the thoracic region of a child. (orig.)

  15. Thoracic and abdominopelvic actinomycosis

    African Journals Online (AJOL)

    thoracic disease.1,2,4 The chronic progressive suppurative infection ... venous Penicillin G for 4 - 6 weeks being the treatment of ... pathology was demonstrated in the liver. (Figs 7a and b ). .... ulceration (may resemble Crohn's disease).3. 2.

  16. Society of Thoracic Surgeons

    Science.gov (United States)

    ... Apply for Membership Membership Directory Pay Your Dues Industry Mailing List License & eBlast Communications Programs Advertise on ... Hotel Discount Copyright © 2017 The Society of Thoracic Surgeons. ...

  17. Cervical Epidural Anaesthesia for Radical Mastectomy and Chronic Regional Pain Syndrome of Upper Limb - A Case Report

    Directory of Open Access Journals (Sweden)

    Ashok Jadon

    2009-01-01

    Full Text Available A 47-yrs-female patient presented with carcinoma right breast, swelling and allodynia of right upper limb. radical mastectomy with axillary clearance and skin grafting was done under cervical epidural anaesthesia through 18G epidural catheter placed at C6/C7 level. Postoperative analgesia and rehabilitation of affected right upper limb was managed by continuous epidural infusion of 0.125% bupivacaine and 2.5 µg/ml -1 clonidine solution through epidu-ral catheter for 5 days and physiotherapy. This case report highlights the usefulness of cervical epidural analgesia in managing a complex situation of carcinoma breast with associated periarthitis of shoulder joint and chronic regional pain syndrome (CRPS of right upper limb.

  18. Movement coordination and differential kinematics of the cervical and thoracic spines in people with chronic neck pain.

    Science.gov (United States)

    Tsang, Sharon M H; Szeto, Grace P Y; Lee, Raymond Y W

    2013-07-01

    Research on the kinematics and inter-regional coordination of movements between the cervical and thoracic spines in motion adds to our understanding of the performance and interplay of these spinal regions. The purpose of this study was to examine the effects of chronic neck pain on the three-dimensional kinematics and coordination of the cervical and thoracic spines during active movements of the neck. Three-dimensional spinal kinematics and movement coordination between the cervical, upper thoracic, and lower thoracic spines were examined by electromagnetic motion sensors in thirty-four individuals with chronic neck pain and thirty-four age- and gender-matched asymptomatic subjects. All subjects performed a set of free active neck movements in three anatomical planes in sitting position and at their own pace. Spinal kinematic variables (angular displacement, velocity, and acceleration) of the three defined regions, and movement coordination between regions were determined and compared between the two groups. Subjects with chronic neck pain exhibited significantly decreased cervical angular velocity and acceleration of neck movement. Cross-correlation analysis revealed consistently lower degrees of coordination between the cervical and upper thoracic spines in the neck pain group. The loss of coordination was most apparent in angular velocity and acceleration of the spine. Assessment of the range of motion of the neck is not sufficient to reveal movement dysfunctions in chronic neck pain subjects. Evaluation of angular velocity and acceleration and movement coordination should be included to help develop clinical intervention strategies to promote restoration of differential kinematics and movement coordination. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Average Potential Temperature of the Upper Mantle and Excess Temperatures Beneath Regions of Active Upwelling

    Science.gov (United States)

    Putirka, K. D.

    2006-05-01

    The question as to whether any particular oceanic island is the result of a thermal mantle plume, is a question of whether volcanism is the result of passive upwelling, as at mid-ocean ridges, or active upwelling, driven by thermally buoyant material. When upwelling is passive, mantle temperatures reflect average or ambient upper mantle values. In contrast, sites of thermally driven active upwellings will have elevated (or excess) mantle temperatures, driven by some source of excess heat. Skeptics of the plume hypothesis suggest that the maximum temperatures at ocean islands are similar to maximum temperatures at mid-ocean ridges (Anderson, 2000; Green et al., 2001). Olivine-liquid thermometry, when applied to Hawaii, Iceland, and global MORB, belie this hypothesis. Olivine-liquid equilibria provide the most accurate means of estimating mantle temperatures, which are highly sensitive to the forsterite (Fo) contents of olivines, and the FeO content of coexisting liquids. Their application shows that mantle temperatures in the MORB source region are less than temperatures at both Hawaii and Iceland. The Siqueiros Transform may provide the most precise estimate of TpMORB because high MgO glass compositions there have been affected only by olivine fractionation, so primitive FeOliq is known; olivine thermometry yields TpSiqueiros = 1430 ±59°C. A global database of 22,000 MORB show that most MORB have slightly higher FeOliq than at Siqueiros, which translates to higher calculated mantle potential temperatures. If the values for Fomax (= 91.5) and KD (Fe-Mg)ol-liq (= 0.29) at Siqueiros apply globally, then upper mantle Tp is closer to 1485 ± 59°C. Averaging this global estimate with that recovered at Siqueiros yields TpMORB = 1458 ± 78°C, which is used to calculate plume excess temperatures, Te. The estimate for TpMORB defines the convective mantle geotherm, and is consistent with estimates from sea floor bathymetry and heat flow (Stein and Stein, 1992), and

  20. The thoracic paraspinal shadow: normal appearances.

    Science.gov (United States)

    Lien, H H; Kolbenstvedt, A

    1982-01-01

    The width of the right and left thoracic paraspinal shadows were measured at all levels in 200 presumably normal individuals. The paraspinal shadow could be identified in nearly all cases on the left side and in approximately one-third on the right. The range of variation was greater on the left side than one the right. The left paraspinal shadow was wider at the upper levels and in individuals above 40 years of age.

  1. Geologic map of the upper Arkansas River valley region, north-central Colorado

    Science.gov (United States)

    Kellogg, Karl S.; Shroba, Ralph R.; Ruleman, Chester A.; Bohannon, Robert G.; McIntosh, William C.; Premo, Wayne R.; Cosca, Michael A.; Moscati, Richard J.; Brandt, Theodore R.

    2017-11-17

    This 1:50,000-scale U.S. Geological Survey geologic map represents a compilation of the most recent geologic studies of the upper Arkansas River valley between Leadville and Salida, Colorado. The valley is structurally controlled by an extensional fault system that forms part of the prominent northern Rio Grande rift, an intra-continental region of crustal extension. This report also incorporates new detailed geologic mapping of previously poorly understood areas within the map area and reinterprets previously studied areas. The mapped region extends into the Proterozoic metamorphic and intrusive rocks in the Sawatch Range west of the valley and the Mosquito Range to the east. Paleozoic rocks are preserved along the crest of the Mosquito Range, but most of them have been eroded from the Sawatch Range. Numerous new isotopic ages better constrain the timing of both Proterozoic intrusive events, Late Cretaceous to early Tertiary intrusive events, and Eocene and Miocene volcanic episodes, including widespread ignimbrite eruptions. The uranium-lead ages document extensive about 1,440-million years (Ma) granitic plutonism mostly north of Buena Vista that produced batholiths that intruded an older suite of about 1,760-Ma metamorphic rocks and about 1,700-Ma plutonic rocks. As a result of extension during the Neogene and possibly latest Paleogene, the graben underlying the valley is filled with thick basin-fill deposits (Dry Union Formation and older sediments), which occupy two sub-basins separated by a bedrock high near the town of Granite. The Dry Union Formation has undergone deep erosion since the late Miocene or early Pliocene. During the Pleistocene, ongoing steam incision by the Arkansas River and its major tributaries has been interrupted by periodic aggradation. From Leadville south to Salida as many as seven mapped alluvial depositional units, which range in age from early to late Pleistocene, record periodic aggradational events along these streams that are

  2. The Rock Art of Upper Tibet and Ladakh: Inner Asian cultural adaptation, regional differentiation and the Western Tibetan Plateau Style

    OpenAIRE

    Bruneau , Laurianne; Bellezza , John V.

    2013-01-01

    International audience; This paper examines common thematic and esthetic features discernable in the rock art of the western portion of the Tibetan plateau. This rock art is international in scope; it includes Ladakh (La-dwags) (under Indian jurisdiction), Tö (Stod) and the Changthang (Byang-thang) (under Chinese administration) hereinafter called Upper Tibet. This work sets out the relationship of this art to other regions of Inner Asia and defines what we call the 'Western Tibetan Plateau S...

  3. Regional patterns of major nonnative invasive plants and associated factors in upper Midwest forests

    Science.gov (United States)

    Zhaofei Fan; W. Keith Moser; Mark H. Hansen; Mark D. Nelson

    2013-01-01

    Nonnative invasive plants (IPs) are rapidly spreading into natural ecosystems (e.g., forests and grasslands). Potential threats of IP invasion into natural ecosystems include biodiversity loss, structural and environmental change, habitat degradation, and economic losses. The Upper Midwest of the United States encompasses the states of Illinois, Indiana, Iowa, Michigan...

  4. Pain in the lumbar, thoracic or cervical regions: do age and gender matter? A population-based study of 34,902 Danish twins 20-71 years of age

    DEFF Research Database (Denmark)

    Leboeuf-Yde, Charlotte; Nielsen, Jan; Kyvik, Kirsten O

    2009-01-01

    , aged 20 to 71 years, representative of the general Danish population. Identical questions on pain were asked for the lumbar, thoracic and cervical regions. RESULTS: Low back pain was most common, followed by neck pain with thoracic pain being least common. Pain for at least 30 days in the past year......BACKGROUND: It is unclear to what extent spinal pain varies between genders and in relation to age. It was the purpose of this study to describe the self-reported prevalence of 1) pain ever and pain in the past year in each of the three spinal regions, 2) the duration of such pain over the past...... year, 3) pain radiating from these areas, and 4) pain in one, two or three areas. In addition, 5) to investigate if spinal pain reporting is affected by gender and 6) to see if it increases gradually with increasing age. METHOD: A cross-sectional survey was conducted in 2002 on 34,902 twin individuals...

  5. Centennial- to decadal-scale monsoon precipitation variations in the upper Hanjiang River region, China over the past 6650 years

    Science.gov (United States)

    Tan, Liangcheng; Cai, Yanjun; Cheng, Hai; Edwards, Lawrence R.; Gao, Yongli; Xu, Hai; Zhang, Haiwei; An, Zhisheng

    2018-01-01

    The upper Hanjiang River region is the recharge area of the middle route of South-to-North Water Transfer Project. The region is under construction of the Hanjiang-Weihe River Water Transfer Project in China. Monsoon precipitation variations in this region are critical to water resource and security of China. In this study, high-resolution monsoon precipitation variations were reconstructed in the upper Hanjiang River region over the past 6650 years from δ18O and δ13C records of four stalagmites in Xianglong cave. The long term increasing trend of stalagmite δ18O record since the middle Holocene is consistent with other speleothem records from monsoonal China. This trend follows the gradually decreasing Northern Hemisphere summer insolation, which indicates that solar insolation may control the orbital-scale East Asian summer monsoon (EASM) variations. Despite the declined EASM intensity since the middle Holocene, local precipitation may not have decreased remarkably, as revealed by the δ13C records. A series of centennial- to decadal-scale cyclicity was observed, with quasi-millennium-, quasi-century-, 57-, 36- and 22-year cycles by removing the long-term trend of stalagmite δ18O record. Increased monsoon precipitation during periods of 4390-3800 a BP, 3590-2960 a BP, 2050-1670 a BP and 1110-790 a BP had caused four super-floods in the upper reach of Hanjiang River. Dramatically dry climate existed in this region during the 5.0 ka and 2.8 ka events, coinciding with notable droughts in other regions of monsoonal China. Remarkably intensified and southward Westerly jet, together with weakened summer monsoon, may delay the onset of rainy seasons, resulting in synchronous decreasing of monsoon precipitation in China during the two events. During the 4.2 ka event and the Little Ice Age, the upper Hanjiang River region was wet, which was similar to the climate conditions in central and southern China, but was the opposite of drought observed in northern China. We

  6. Imaging of thoracic trauma

    International Nuclear Information System (INIS)

    Uffmann, M.; Herold, C.J.; Fuchs, M.

    1998-01-01

    Blunt trauma to the chest results from transfer of kinetic energy to the human body. It may cause a wide range of mostly life-threatening injuries, including fractures of the thoracic skeleton, disintegration of the pleural space, contusion or laceration of pulmonary parenchyma and damage to the mediastinal structures. For a systematic approach it may be helpful to follow an organ-based evaluation of thoracic trauma. However, it should be borne in mind that subtle injuries may be associated with serious complications. Trauma to the chest may affect different anatomic compartments at the same time, requiring and extending diagnostic approach. Conventional radiography plays a major role in diagnosting thoracic trauma, complemented by ultrasound examination of the pleura and abdomen. It is well documented that CT scanning represents a major technological improvement for assessment of thoracic trauma. With the advent of fast helical CT scanning this method becomes more applicable for severly traumatized patients and potentially replaces other time-consuming procedures. State-of-the-art imaging of both projection and cross-sectional techniques provides useful information for immediate and appropriate treatment mandatory in patients with thoracic trauma. (orig.) [de

  7. Newborn hearing screening: analysis and outcomes after 100,000 births in Upper-Normandy French region.

    Science.gov (United States)

    Caluraud, Sophie; Marcolla-Bouchetemblé, Aurore; de Barros, Angélique; Moreau-Lenoir, Florence; de Sevin, Emmanuel; Rerolle, Stéphane; Charrière, Elisabeth; Lecler-Scarcella, Véronique; Billet, François; Obstoy, Marie-Françoise; Amstutz-Montadert, Isabelle; Marie, Jean-Paul; Lerosey, Yannick

    2015-06-01

    Neonatal hearing impairment is a common disorder with a prevalence of 1 to 2‰ worldwide, with significant consequences on overall development when rehabilitated too late. New-born hearing screening has been implemented in the 1990s in most European countries and the USA. The Upper-Normandy region of France has been conducting a pilot program since 1999. The aim of this prospective study was to evaluate and critically analyse it. The Upper-Normandy universal new-born hearing screening program is performed in two steps. Between 1999 and 2004, first, we administered a Transient Evoked Oto Acoustic Emission (TEOAE) test was administered a few days after birth for healthy newborns without risk factors. For newborns admitted to a neonatal intensive care unit (NICU) or presenting risk factors, was administered an automated auditory brainstem response (AABR) test prior to discharge. Second, newborns who failed the initial hearing screening were retested as outpatients using TEOAE. Since 2004, infants who failed the initial screen were tested with AABR 3 to 4 weeks later as outpatients, providing an opportunity to compare the two protocols. Overall screening coverage in the Upper-Normandy region is 99.8%. First step coverage is 99.58% in well-infant nurseries and 97.09% in the NICU. The test-retest procedure during the first step and the use of AABR for the second resulted in higher follow-up rates and lower false positive rates. The Upper-Normandy region universal newborn hearing screening program facilitated diagnosis and rehabilitation of infants before age of 9 months, most notably when severe to profound hearing impairment was found. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. 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)

  9. UPPER JURASSIC OUTCROPS ALONG THE CALDAS DA RAINHA DIAPIR, WEST CENTRAL PORTUGAL: A REGIONAL GEOHERITAGE OVERVIEW

    OpenAIRE

    DINIS, JORGE; BERNARDES, CRISTINA

    2004-01-01

    The Mesozoic Portuguese geological heritage is very rich and varied, a legacy of the position in the western margin of Iberia and its relationship with the evolution of the North Atlantic, with an interesting tectonic history since the Late Triassic. Regarding the Upper Jurassic several connections can be established between the tectonics and the stratigraphic record in the area surrounding the Caldas da Rainha structure: the basement and salt pillow control on deposition; the beginning of a ...

  10. Thoracic surgical resident education: a costly endeavor.

    Science.gov (United States)

    Calhoon, John H; Baisden, Clint; Holler, Ben; Hicks, George L; Bove, Ed L; Wright, Cameron D; Merrill, Walter H; Fullerton, Dave A

    2014-12-01

    We sought to define an accurate measure of thoracic surgical education costs. Program directors from six distinct and differently sized and geographically located thoracic surgical training programs used a common template to provide estimates of resident educational costs. These data were reviewed, clarifying questions or discrepancies when noted and using best estimates when exact data were unavailable. Subsequently, a composite of previously published cost-estimation products was used to capture accurate cost data. Data were then compiled and averaged to provide an accurate picture of all costs associated with thoracic surgical education. Before formal accounting was performed, the estimated average for all programs was approximately $250,000 per year per resident. However, when formal evaluations by the six programs were performed, the annual cost of resident education ranged from $330,000 to $667,000 per year per resident. The average cost of $483,000 per year was almost double the initial estimates. Variability was noted by region and size of program. Faculty teaching costs varied from $208,000 to $346,000 per year. Simulation costs ranged from $0 to $80,000 per year. Resident savings to program ranged from $0 to $135,000 per year and averaged $37,000 per year per resident. Thoracic surgical education costs are considerably higher than initial estimates from program directors and probably represent an unappreciated source of financial burden for cardiothoracic surgical educational programs. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Acetylene C2H 2 retrievals from MIPAS data and regions of enhanced upper tropospheric concentrations in August 2003

    Directory of Open Access Journals (Sweden)

    V. P. Kanawade

    2011-10-01

    Full Text Available Acetylene (C2H2 volume mixing ratios (VMRs have been successfully retrieved from the Michelson Interferometer for Passive Atmospheric Sounding (MIPAS Level 1B radiances during August 2003, providing the first global map of such data and ratios to CO in the literature. The data presented here contain most information between 300 hPa and 100 hPa with systematic errors less than 10% at the upper levels. Random errors per point are less than 15% at lower levels and are closer to 30% at 100 hPa. Global distributions of the C2H2 and C2H2/CO ratio confirm significant features associated with both the Asian monsoon anticyclone and biomass burning for this important hydrocarbon in a characteristic summer month (August 2003, showing tight correlations regionally, particularly at lower to medium values, but globally emphasising the differences between sources and lifetimes of CO and C2H2. The correlations are seen to be particularly disturbed in the regions of highest C2H2 concentrations, indicating variability in the surface emissions or fast processing. A strong isolation of C2H2 within the Asian monsoon anticyclone is observed, evidencing convective transport into the upper troposphere, horizontal advection within the anticyclone at 200 hPa, distinct gradients at the westward edge of the vortex and formation of a secondary dynamical feature from the eastward extension of the anticyclone outflow over the Asian Pacific. Ratios of C2H2/CO are consistent with the evidence from the cross-sections that the C2H2 is uplifted rapidly in convection. Observations are presented of enhanced C2H2 associated with the injection from biomass burning into the upper troposphere and the outflow from Africa at 200 hPa into both the Atlantic and Indian Oceans. In the biomass burning regions, C2H2 and CO are well correlated, but the uplift is less marked and peaks at lower altitudes compared to the strong effects observed in the Asian monsoon anticyclone. Ratios of C2H2/CO

  12. Hydrologic Conditions that Influence Streamflow Losses in a Karst Region of the Upper Peace River, Polk County, Florida

    Science.gov (United States)

    Metz, P.A.; Lewelling, B.R.

    2009-01-01

    The upper Peace River from Bartow to Fort Meade, Florida, is described as a groundwater recharge area, reflecting a reversal from historical groundwater discharge patterns that existed prior to the 1950s. The upper Peace River channel and floodplain are characterized by extensive karst development, with numerous fractures, crevasses, and sinks that have been eroded in the near-surface and underlying carbonate bedrock. With the reversal in groundwater head gradients, river water is lost to the underlying groundwater system through these karst features. An investigation was conducted to evaluate the hydrologic conditions that influence streamflow losses in the karst region of the upper Peace River. The upper Peace River is located in a basin that has been altered substantially by phosphate mining and increases in groundwater use. These alterations have changed groundwater flow patterns and caused streamflow declines through time. Hydrologic factors that have had the greatest influence on streamflow declines in the upper Peace River include the lowering of the potentiometric surfaces of the intermediate aquifer system and Upper Floridan aquifer beneath the riverbed elevation due to below-average rainfall (droughts), increases in groundwater use, and the presence of numerous karst features in the low-water channel and floodplain that enhance the loss of streamflow. Seepage runs conducted along the upper Peace River, from Bartow to Fort Meade, indicate that the greatest streamflow losses occurred along an approximate 2-mile section of the river beginning about 1 mile south of the Peace River at Bartow gaging station. Along the low-water and floodplain channel of this 2-mile section, there are about 10 prominent karst features that influence streamflow losses. Losses from the individual karst features ranged from 0.22 to 16 cubic feet per second based on measurements made between 2002 and 2007. The largest measured flow loss for all the karst features was about 50 cubic

  13. Assessment of multimodal freight bottlenecks and alleviation strategies for upper Midwest region.

    Science.gov (United States)

    2010-05-01

    The freight that passes through the Mississippi Valley Region is high volume and has a substantial impact on the economy of the : region. According to the BTS-sponsored Commodity Flow Survey, trucks carried almost 2.5 billion tons of freight across t...

  14. Use of thoracic spine thrust manipulation for neck pain and headache in a patient following multiple-level anterior cervical discectomy and fusion: a case report.

    Science.gov (United States)

    Salvatori, Renata; Rowe, Robert H; Osborne, Raine; Beneciuk, Jason M

    2014-06-01

    Case report. Thoracic spine thrust manipulation has been shown to be an effective intervention for individuals experiencing mechanical neck pain. The patient was a 46-year-old woman referred to outpatient physical therapy 2 months following multiple-level anterior cervical discectomy and fusion. At initial evaluation, primary symptoms consisted of frequent headaches, neck pain, intermittent referred right elbow pain, and muscle fatigue localized to the right cervical and upper thoracic spine regions. Initial examination findings included decreased passive joint mobility of the thoracic spine, limited cervical range of motion, and limited right shoulder strength. Outcome measures consisted of the numeric pain rating scale, the Neck Disability Index, and the global rating of change scale. Treatment consisted of a combination of manual therapy techniques aimed at the thoracic spine, therapeutic exercises for the upper quarter, and patient education, including a home exercise program, over a 6-week episode of care. Immediate reductions in cervical-region pain (mean ± SD, 2.0 ± 1.1) and headache (2.0 ± 1.3) intensity were reported every treatment session immediately following thoracic spine thrust manipulation. At discharge, the patient reported 0/10 cervical pain and headache symptoms during all work-related activities. From initial assessment to discharge, Neck Disability Index scores improved from 46% to 16%, with an associated global rating of change scale score of +7 ("a very great deal better"). This case report describes the immediate and short-term clinical outcomes for a patient presenting with symptoms of neck pain and headache following anterior cervical discectomy and fusion surgical intervention. Clinical rationale and patient preference aided the decision to incorporate thoracic spine thrust manipulation as a treatment for this patient. Level of Evidence Therapy, level 4.

  15. Geologic framework of the regional ground-water flow system in the Upper Deschutes Basin, Oregon

    Science.gov (United States)

    Lite, Kenneth E.; Gannett, Marshall W.

    2002-12-10

    Ground water is increasingly relied upon to satisfy the needs of a growing population in the upper Deschutes Basin, Oregon. Hydrogeologic studies are being undertaken to aid in management of the ground-water resource. An understanding of the geologic factors influencing ground-water flow is basic to those investigations. The geology of the area has a direct effect on the occurrence and movement of ground water. The permeability and storage properties of rock material are influenced by the proportion, size, and degree of interconnection of open spaces the rocks contain. These properties are the result of primary geologic processes such as volcanism and sedimentation, as well as subsequent processes such as faulting, weathering, or hydrothermal alteration. The geologic landscape in the study area evolved during about 30 million years of volcanic activity related to a north-south trending volcanic arc, the current manifestation of which are today’s Cascade Range volcanoes.

  16. Impacts of using reformulated and oxygenated fuel blends on the regional air quality of the upper Rhine valley

    Directory of Open Access Journals (Sweden)

    J.-F. Vinuesa

    2006-01-01

    Full Text Available The effects of using three alternative gasoline fuel blends on regional air quality of the upper Rhine valley have been investigated. The first of the tested fuels is oxygenated by addition of ethyl-tertio-butyl ether (ETBE, the second is based on a reformulation of its composition and the third on is both oxygenated and reformulated. The upper Rhine valley is a very sensitive region for pollution episodes and several meteorological and air quality studies have already been performed. High temporal and spatial emission inventories are available allowing relevant and realistic modifications of the emission inventories. The calculation period, i.e., 11 May 1998, corresponds to a regional photochemical ozone pollution episode during which ozone concentrations exceeded several times the information threshold of the ozone directive of the European Union (180 μg m-3 as 1 hourly average. New emission inventories are set up using specific emission factors related to the alternative fuels by varying the fraction of gasoline passenger cars (from 50% to 100% using the three fuel blends. Then air quality modeling simulations are performed using these emission inventories over the upper Rhine valley. The impact of alternative fuels on regional air quality is evaluated by comparing these simulations with the one using a reference emission inventory, e.g., where no modifications of the fuel composition are included. The results are analyzed by focusing on peak levels and daily averaged concentrations. The use of the alternative fuels leads to general reductions of ozone and volatile organic compounds (VOC and increases of NOx levels. We found different behaviors related to the type of the area of concern i.e. rural or urban. The impacts on ozone are enhanced in urban areas where 15% reduction of the ozone peak and daily averaged concentrations can be reached. This behavior is similar for the NOx for which, in addition, an increase of the levels can be noted

  17. Comparative study between ultrasound guided TAP block and paravertebral block in upper abdominal surgeries

    Directory of Open Access Journals (Sweden)

    Ruqaya M Elsayed Goda

    2017-01-01

    Conclusion: We concluded that ultrasound guided transverses abdominis plane block and thoracic paravertebral block were safe and effective anesthetic technique for upper abdominal surgery with longer and potent postoperative analgesia in thoracic paravertebral block than transverses abdominis block.

  18. NACP MCI: CO2 Emissions Inventory, Upper Midwest Region, USA., 2007

    Data.gov (United States)

    National Aeronautics and Space Administration — ABSTRACT: This data set provides a bottom-up CO2 emissions inventory for the mid-continent region of the United States for the year 2007. The study was undertaken as...

  19. NACP MCI: CO2 Emissions Inventory, Upper Midwest Region, USA., 2007

    Data.gov (United States)

    National Aeronautics and Space Administration — This data set provides a bottom-up CO2 emissions inventory for the mid-continent region of the United States for the year 2007. The study was undertaken as part of...

  20. Vestas Pinaria Region: Original Basaltic Achondrite Material Derived from Mixing Upper and Lower Crust

    Science.gov (United States)

    Mcfadden, L. A.; Combe, Jean-Philippe; Ammannito, Eleonora; Frigeri, Alessandro; Stephan, Katrin; Longobardo, Andrea; Palomba, Ernesto; Tosi, Federico; Zambon, Francesca; Krohn, Katrin; hide

    2015-01-01

    Analysis of data from the Dawn mission shows that the Pinaria region of Vesta spanning a portion of the rim of the Rheasilvia basin is bright and anhydrous. Reflectance spectra, absorption band centers, and their variations, cover the range of pyroxenes from diogenite-rich to howardite and eucrite compositions, with no evidence of olivine in this region. By examining band centers and depths of the floor, walls and rims of six major craters in the region, we find a lane of diogenite-rich material next to howardite-eucrite material that does not follow the local topography. The source of this material is not clear and is probably ejecta from post-Rheasilvia impacts. Material of a howardite-eucrite composition originating from beyond the Rheasilvia basin is evident on the western edge of the region. Overall, the Pinaria region exposes the complete range of basaltic achondrite parent body material, with little evidence of contamination of non-basaltic achondrite material. With both high reflectance and low abundance of hydrated material, this region of Vesta may be considered the "Pinaria desert".

  1. Solving the Upper Valley's housing needs: how a coalition of public and private organizations joined forces to develop housing in a region with inadequate stock and prohibitive prices

    OpenAIRE

    Dan French

    2004-01-01

    Like many communities, New Hampshire and Vermont's Upper Valley region is facing a serious housing shortage. Dan French reveals how an innovative housing coalition is working to find solutions that provide housing and protect the area's quality of life.

  2. Does regional anesthesia influence early outcome of upper arm arteriovenous fistula?

    International Nuclear Information System (INIS)

    Mohamed A Elsharawy; Roshdi Al-metwalli

    2010-01-01

    To assess the effect of regional anesthesia on the outcome of elbow arteriovenous fistula (AVF), prospectively studied consecutive patients with end-stage renal disease referred for permanent vascular access to the Vascular Unit of King Fahd University Hospital between September 2004 and September 2007. The patients were divided into 2 groups: Group 1: patients who underwent the construction of the AVF under regional anesthesia and Group 2: patients who were operated under general anesthesia, indicated by their preferences or failure of regional anesthesia. Data including patient characteristics and type of AVF were recorded. The internal diameter of the vein and the artery and intra-operative blood flow were measured. The complications of both types of anesthesia were recorded. The patients were followed up for three months. Eighty four cases were recruited in this study. Complete brachial plexus block was achieved in 57 (68%) patients. Seven patients were converted to general anesthesia and 20 patients had AVF under general anesthesia from the start. There were no significant differences between the 2 groups with regard to basic characteristics or operative data. There were no instances of systemic toxicity, hematomas, or nerve injury from the regional block. No major complications were reported from the general anesthesia. There was no significant difference between both groups regarding early failure of AVF (Group 1, 14% vs. Group2; 11%. P= 0.80). No significant advantage of regional over general anesthesia in terms of early outcome of AVF was seen in this study (Author).

  3. Palms and Palm Communities in the Upper Ucayali River Valley - a Little-Known Region in the Amazon Basin

    DEFF Research Database (Denmark)

    Balslev, Henrik; Eiserhardt, Wolf L.; Kristiansen, Thea

    2010-01-01

    The Amazon region and its palms are inseparable. Palms make up such an important part of the rain forest ecosystem that it is impossible to imagine the Amazon basin without them. Palms are visible in the canopy and often fill up the forest understory. Palms – because of their edible fruits...... – are cornerstone species for the survival of many animals, and palms contribute substantially to forest inventories in which they are often among the ten most important families. Still, the palms and palm communities of some parts of the Amazon basin remain poorly studied and little known. We travelled to a little......-explored corner of the western Amazon basin, the upper Ucayali river valley. There, we encountered 56 different palms, 18 of which had not been registered for the region previously, and 21 of them were found 150–400 km beyond their previously known limits....

  4. [Examination of upper abdominal region in high spatial resolution diffusion-weighted imaging using 3-Tesla MRI].

    Science.gov (United States)

    Terada, Masaki; Matsushita, Hiroki; Oosugi, Masanori; Inoue, Kazuyasu; Yaegashi, Taku; Anma, Takeshi

    2009-03-20

    The advantage of the higher signal-to-noise ratio (SNR) of 3-Tesla magnetic resonance imaging (3-Tesla) has the possibility of contributing to the improvement of high spatial resolution without causing image deterioration. In this study, we compared SNR and the apparent diffusion coefficient (ADC) value with 3-Tesla as the condition in the diffusion-weighted image (DWI) parameter of the 1.5-Tesla magnetic resonance imaging (1.5-Tesla) and we examined the high spatial resolution images in the imaging method [respiratory-triggering (RT) method and breath free (BF) method] and artifact (motion and zebra) in the upper abdominal region of DWI at 3-Tesla. We have optimized scan parameters based on phantom and in vivo study. As a result, 3-Tesla was able to obtain about 1.5 times SNR in comparison with the 1.5-Tesla, ADC value had few differences. Moreover, the RT method was effective in correcting the influence of respiratory movement in comparison with the BF method, and image improvement by the effective acquisition of SNR and reduction of the artifact were provided. Thus, DWI of upper abdominal region was a useful sequence for the high spatial resolution in 3-Tesla.

  5. The Austrian social festival Keep the Ball Rolling in a peripheral region of Upper Styria

    Directory of Open Access Journals (Sweden)

    Gstach Isabell

    2014-03-01

    Full Text Available The “Steirische Eisenstraße” is a region located in the province of Styria in Austria, which has been struggling with a massive shift in population and age structure for some time. In 2012/13 the Austrian social festival Keep the Ball Rolling is taking place in this region. Over a period of 18 months, the social festival is providing opportunities to think of their own environment. Consequently, they can develop and implement ideas for good cohabitation and put these into practice. The main focus of this article is the demographic presentation of the “Steirische Eisenstraße” region, according to population, employment and age structure. The introduction of the social festival is fundamental in initiating successful change processes.

  6. Regional aerosol deposition in human upper airways. Progress report, March 1, 1992--February 28, 1993

    Energy Technology Data Exchange (ETDEWEB)

    Swift, D.L.

    1992-11-01

    Laboratory experimental studies were carried out to investigate the factors influencing the deposition of aerosols ranging in size from 1 nm to 10 {mu}m in the human nasal, oral, pharyngeal and laryngeal airways. These experimental studies were performed in replicate upper airway physical models and in human volunteer subjects. New replicate models of the oral passage of an infant, the oral passage of an adult at two openings and the combined nasal and oral airways of an adult were constructed during the period, adding to the existing models of adult, child and infant nasal and oral airways models. Deposition studies in the adult oral and adult nasal models were performed under simulated cyclic flow conditions with 1 nm particles to compare with previously measured constant flow studies. Similar studies with inertial particles (1--10 {mu}m diameter) were performed with the adult nasal model; in both instances, results with cyclic flow were similar to constant flow results using a simple average flow rate based on inspiratory volume and time of inspiration. Human subject studies were performed with particle sizes 5--20 nm for nasal inspiration; preliminary analysis shows good agreement with model studies at several representative flow rates. Nasal inspiratory inertial deposition of 1--4 {mu}m diameter particles was measured in several adults as a function of airway dimensions; dimensional changes of the valve area by decongestion did not produce concomitant deposition changes.

  7. Managment of thoracic empyema.

    Science.gov (United States)

    Sherman, M M; Subramanian, V; Berger, R L

    1977-04-01

    Over a ten year period, 102 patients with thoracic empyemata were treated at Boston City Hospital. Only three patients died from the pleural infection while twenty-six succumbed to the associated diseases. Priniciples of management include: (1) thoracentesis; (2) antibiotics; (3) closed-tube thoracostomy; (4) sinogram; (5) open drainage; (6) empyemectomy and decortication in selected patients; and (7) bronchoscopy and barium swallow when the etiology is uncertain.

  8. Thoracic textilomas: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Machado, Dianne Melo; Zanetti, Glaucia; Araujo Neto, Cesar Augusto; Nobre, Luiz Felipe; Meirelles, Gustavo de Souza Portes; Silva, Jorge Luiz Pereira e; Guimaraes, Marcos Duarte; Escuissato, Dante Luiz; Souza Junior, Arthur Soares; Hochhegger, Bruno; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Hospital Universitario Antonio Pedro (HUAP/UFF), Niteroi, RJ (Brazil)

    2014-09-15

    Objective: the aim of this study was to analyze chest CT scans of patients with thoracic textiloma. Methods: this was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. Results: the majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). Conclusions: it is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication. (author)

  9. Mountains Under Pressure: Evaluating Ecosystem Services and Livelihoods in the Upper Himalayan Region of Nepal

    NARCIS (Netherlands)

    Bhusal, Jagat K.; Chapagain, Prem Sagar; Regmi, Santosh; Gurung, Praju; Zulkafli, Zed; Karpouzoglou, T.D.; Pandeya, Bhopal; Buytaert, Wouter; Clark, Julian

    2016-01-01

    Natural resource-based livelihoods in mountainous regions are subject to new types of development as well as climate related pressures and vulnerabilities. On one hand, the integrity of the mountainous landscape is under pressure from the melting of glaciers, changes in water availability, rainfall

  10. Probabilistic full waveform inversion based on tectonic regionalization - development and application to the Australian upper mantle

    NARCIS (Netherlands)

    Käufl, P.; Fichtner, A.; Igel, H.

    2013-01-01

    We present a first study to investigate the feasibility of a probabilistic 3-D full waveform inversion based on spectral-element simulations of seismic wave propagation and Monte Carlo exploration of the model space. Through a tectonic regionalization we reduce the dimension of the model space to

  11. Fetal development of deep back muscles in the human thoracic region with a focus on transversospinalis muscles and the medial branch of the spinal nerve posterior ramus

    Science.gov (United States)

    Sato, Tatsuo; Koizumi, Masahiro; Kim, Ji Hyun; Kim, Jeong Hyun; Wang, Bao Jian; Murakami, Gen; Cho, Baik Hwan

    2011-01-01

    Fetal development of human deep back muscles has not yet been fully described, possibly because of the difficulty in identifying muscle bundle directions in horizontal sections. Here, we prepared near-frontal sections along the thoracic back skin (eight fetuses) as well as horizontal sections (six fetuses) from 14 mid-term fetuses at 9–15 weeks of gestation. In the deep side of the trapezius and rhomboideus muscles, the CD34-positive thoracolumbar fascia was evident even at 9 weeks. Desmin-reactivity was strong and homogeneous in the superficial muscle fibers in contrast to the spotty expression in the deep fibers. Thus, in back muscles, formation of the myotendinous junction may start from the superficial muscles and advance to the deep muscles. The fact that developing intramuscular tendons were desmin-negative suggested little possibility of a secondary change from the muscle fibers to tendons. We found no prospective spinalis muscle or its tendinous connections with other muscles. Instead, abundant CD68-positive macrophages along the spinous process at 15 weeks suggested a change in muscle attachment, an event that may result in a later formation of the spinalis muscle. S100-positive intramuscular nerves exhibited downward courses from the multifidus longus muscle in the original segment to the rotatores brevis muscles in the inferiorly adjacent level. The medial cutaneous nerve had already reached the thoracolumbar fascia at 9 weeks, but by 15 weeks the nerve could not penetrate the trapezius muscle. Finally, we propose a folded myotomal model of the primitive transversospinalis muscle that seems to explain a fact that the roofing tile-like configuration of nerve twigs in the semispinalis muscle is reversed in the multifidus and rotatores muscles. PMID:21954879

  12. Structural Heterogeneities in Southeast Tibet: Implications for Regional Flow in the Lower Crust and Upper Mantle

    Directory of Open Access Journals (Sweden)

    Zhi Wang

    2012-01-01

    Full Text Available Our seismic study together with the MT analysis reveal a “R-shape” flow existing in both the lower crust and uppermost mantle, which suggests the crustal deformation along the deep, large sutures (such as the Longmen Shan fault and the Anninghe Fault under the southeastern Tibetan Plateau is maintained by dynamic pressure from the regional flow intermingled with the hot upwelling asthenosphere. The material in the lower crust and uppermost mantle flowing outward from the center of the plateau is buttressed by the old, strong lithosphere that underlies the Sichuan basin, pushing up on the crust above and maintaining steep orogenic belt through dynamic pressure. We therefore consider that the “R-shape” regional flow played a key role in the crustal deformation along the deep suture zones of the Bangong-Nujiang, the Longmen-Shan faults, and other local heavily faulted zones beneath the southeastern Tibetan Plateau.

  13. Adjoint tomography of the crust and upper mantle structure beneath the Kanto region using broadband seismograms

    KAUST Repository

    Miyoshi, Takayuki; Obayashi, Masayuki; Peter, Daniel; Tono, Yoko; Tsuboi, Seiji

    2017-01-01

    A three-dimensional seismic wave speed model in the Kanto region of Japan was developed using adjoint tomography for application in the effective reproduction of observed waveforms. Starting with a model based on previous travel time tomographic results, we inverted the waveforms obtained at seismic broadband stations from 140 local earthquakes in the Kanto region to obtain the P- and S-wave speeds Vp and Vs. Additionally, all centroid times of the source solutions were determined before the structural inversion. The synthetic displacements were calculated using the spectral-element method (SEM) in which the Kanto region was parameterized using 16 million grid points. The model parameters Vp and Vs were updated iteratively by Newton’s method using the misfit and Hessian kernels until the misfit between the observed and synthetic waveforms was minimized. Computations of the forward and adjoint simulations were conducted on the K computer in Japan. The optimized SEM code required a total of 6720 simulations using approximately 62,000 node hours to obtain the final model after 16 iterations. The proposed model reveals several anomalous areas with extremely low-Vs values in comparison with those of the initial model. These anomalies were found to correspond to geological features, earthquake sources, and volcanic regions with good data coverage and resolution. The synthetic waveforms obtained using the newly proposed model for the selected earthquakes showed better fit than the initial model to the observed waveforms in different period ranges within 5–30 s. This result indicates that the model can accurately predict actual waveforms.

  14. Adjoint tomography of the crust and upper mantle structure beneath the Kanto region using broadband seismograms

    KAUST Repository

    Miyoshi, Takayuki

    2017-10-04

    A three-dimensional seismic wave speed model in the Kanto region of Japan was developed using adjoint tomography for application in the effective reproduction of observed waveforms. Starting with a model based on previous travel time tomographic results, we inverted the waveforms obtained at seismic broadband stations from 140 local earthquakes in the Kanto region to obtain the P- and S-wave speeds Vp and Vs. Additionally, all centroid times of the source solutions were determined before the structural inversion. The synthetic displacements were calculated using the spectral-element method (SEM) in which the Kanto region was parameterized using 16 million grid points. The model parameters Vp and Vs were updated iteratively by Newton’s method using the misfit and Hessian kernels until the misfit between the observed and synthetic waveforms was minimized. Computations of the forward and adjoint simulations were conducted on the K computer in Japan. The optimized SEM code required a total of 6720 simulations using approximately 62,000 node hours to obtain the final model after 16 iterations. The proposed model reveals several anomalous areas with extremely low-Vs values in comparison with those of the initial model. These anomalies were found to correspond to geological features, earthquake sources, and volcanic regions with good data coverage and resolution. The synthetic waveforms obtained using the newly proposed model for the selected earthquakes showed better fit than the initial model to the observed waveforms in different period ranges within 5–30 s. This result indicates that the model can accurately predict actual waveforms.

  15. TU-G-BRA-04: Changes in Regional Lung Function Measured by 4D-CT Ventilation Imaging for Thoracic Radiotherapy

    International Nuclear Information System (INIS)

    Nakajima, Y; Kadoya, N; Kabus, S; Loo, B; Keall, P; Yamamoto, T

    2015-01-01

    Purpose: To test the hypothesis: 4D-CT ventilation imaging can show the known effects of radiotherapy on lung function: (1) radiation-induced ventilation reductions, and (2) ventilation increases caused by tumor regression. Methods: Repeat 4D-CT scans (pre-, mid- and/or post-treatment) were acquired prospectively for 11 thoracic cancer patients in an IRB-approved clinical trial. A ventilation image for each time point was created using deformable image registration and the Hounsfield unit (HU)-based or Jacobian-based metric. The 11 patients were divided into two subgroups based on tumor volume reduction using a threshold of 5 cm 3 . To quantify radiation-induced ventilation reduction, six patients who showed a small tumor volume reduction (<5 cm 3 ) were analyzed for dose-response relationships. To investigate ventilation increase caused by tumor regression, two of the other five patients were analyzed to compare ventilation changes in the lung lobes affected and unaffected by the tumor. The remaining three patients were excluded because there were no unaffected lobes. Results: Dose-dependent reductions of HU-based ventilation were observed in a majority of the patient-specific dose-response curves and in the population-based dose-response curve, whereas no clear relationship was seen for Jacobian-based ventilation. The post-treatment population-based dose-response curve of HU-based ventilation demonstrated the average ventilation reductions of 20.9±7.0% at 35–40 Gy (equivalent dose in 2-Gy fractions, EQD2), and 40.6±22.9% at 75–80 Gy EQD2. Remarkable ventilation increases in the affected lobes were observed for the two patients who showed an average tumor volume reduction of 37.1 cm 3 and re-opening airways. The mid-treatment increase in HU-based ventilation of patient 3 was 100.4% in the affected lobes, which was considerably greater than 7.8% in the unaffected lobes. Conclusion: This study has demonstrated that 4D-CT ventilation imaging shows the known

  16. Complex regional pain syndrome type I in the upper extremity - how efficient physical therapy and rehabilitation are.

    Science.gov (United States)

    Zečević Luković, Tanja; Ristić, Branko; Jovanović, Zorica; Rančić, Nemanja; Ignjatović Ristić, Dragana; Cuković, Saša

    2012-08-01

    To evaluate the effects of early started combined therapy in Complex Regional Pain Syndrome-1 (CRPS-1) on the upper extremities. The study included 36 patients in the first stadium of CRPS-1 on the upper extremities The mean age of patients was 42.6±14.6, the majority of them (26 of 36) were females. The right side of the upper extremity was affected much more then the left side. They were treated by combined therapy including analgetics, electrotherapy, magneto therapy and kinesitherapy. The average length of observation was 172.1 days (from 90 to 250 days). The average length of treatment was 91.5±42.16 days. Intensity of pain, swelling of the extremity, the change in skin coloration and cutaneous manifestations were assessed three times, at the beginning of the treatment, after 6 weeks and at the end of the treatment. The pain was registered in all patients at visit 1 (average pain intensity was 5.70 ±1.44 on 100 mm visual analogue scale), and it was progressively decreased during the treatment from 3.60±1.22 at the second visit to 0.34±0.68 at the third visit. Vasodilatation was registered in 30 (83.33%) patients and skin temperature asymmetries was found in 21 (58.33%) patients. The difference of size was detected in 30 (83.33%) patients at the first visit compared to four (11.11%) patients at the end of the treatment. There were six (16.66%) patients without swelling at the beginning compared to 26 (72.22%) at the end of the treatment (p less than 0.000). Complete healing was achieved in 32 patients (88.88%). The carefully chosen physical agents in combination with analgesic and non-steroidal anti-inflammatory drugs may benefit in patients with CRPS-1 on the upper extremity if the treatment starts as soon as possible.

  17. Environmental changes and human work in the region of the Upper Paraná River floodplain: processes and interactions

    Directory of Open Access Journals (Sweden)

    EA. Tomanik

    Full Text Available The environment and society constitute a complex of elements and interactions. Thus, an understanding of the processes in which the environment and psychosocial elements are involved may not be gained from knowledge of just one isolated variable. Based on such premises, the present paper, which summarizes the results of a series of studies, adopts work relationships as its main focus, but in addition, it has two complementary objectives. One is to present some analyses on the interaction between human actions and the environmental changes that have been taking place in the region of the Upper Paraná River floodplain and in its boundaries. A secondary aim is to show how those two factors have been changing people's working and living conditions and the identity configuration of some of the human groups that live at that site.

  18. Patterns of failure after complete resection of thoracic esophageal squamous cell carcinoma: implications for postoperative radiation therapy volumes

    International Nuclear Information System (INIS)

    Zhang Wencheng; Wang Qifeng; Xiao Zefen; Yang Longhai; Liu Xiangyang

    2012-01-01

    Objective: To analyze intrathoracic or extrathoracic recurrence pattern after surgical resection of thoracic esophageal squamous cell carcinoma (TESCC) and its help for further modify and improvement on the target of postoperative radiation therapy. Methods: One hundred and ninety-five patients who had undergone resection of TESCC at the Cancer Hospital, Chinese Academy of Medical Sciences enrolled from April 1999 to July 2007. Sites of failure on different primary location of esophageal cancer were documented. Results: Patients with upper or middle thoracic esophageal cancer had higher proportion of intrathoracic recurrence. Patients with lower thoracic esophageal cancer had more intrathoracic recurrence and abdominal lymph node metastatic recurrence. Histological lymph node status has nothing to do with intrathoracic recurrence, supraclavicular lymph node (SLN) metastasis or distant metastasis (χ 2 =1.58, 0.06, 0.04, P =0.134, 0.467, 0.489, respectively), whereas the chance of abdominal lymph node metastases in N positive patients was significantly higher than that in N 0 patients (28.7%: 10.6%, χ 2 =9.94, P =0.001), and so did in middle thoracic esophageal cancer (20.0%: 5.6%, χ 2 =5.67, P =0.015). Anatomic recurrence rate of patients with proximal resection margin no more than 3 cm was significantly higher compared to those more than 3 cm (25.0%: 11.3%, χ 2 =5.65, P=0.019). Conclusions: Mediastinum is the most common recurrence site.According to recurrence site, the following radiation targets are recommended: when tumor was located at the upper or middle thoracic esophagus with negative N status, the mediastinum, the tumor bed and the supraclavicular region should be included as postoperative RT target; when tumor was located at the middle thoracic esophagus with positive N or located at the lower thoracic esophagus, the abdominal lymph node should be added.If the proximal resection margin was no more than 3 cm, the anastomotic-stoma should be included

  19. Decadal oscillation of lakes and aquifers in the upper Great Lakes region of North America: hydroclimatic implications

    Science.gov (United States)

    Watras, C.J.; Read, J.S.; Holman, K.D.; Liu, Z.; Song, Y.-Y.; Watras, A.J.; Morgan, S.; Stanley, E.H.

    2014-01-01

    We report a unique hydrologic time-series which indicates that water levels in lakes and aquifers across the upper Great Lakes region of North America have been dominated by a climatically-driven, near-decadal oscillation for at least 70 years. The historical oscillation (~13y) is remarkably consistent among small seepage lakes, groundwater tables and the two largest Laurentian Great Lakes despite substantial differences in hydrology. Hydrologic analyses indicate that the oscillation has been governed primarily by changes in the net atmospheric flux of water (P-E) and stage-dependent outflow. The oscillation is hypothetically connected to large-scale atmospheric circulation patterns originating in the mid-latitude North Pacific that support the flux of moisture into the region from the Gulf of Mexico. Recent data indicate an apparent change in the historical oscillation characterized by a ~12y downward trend beginning in 1998. Record low water levels region-wide may mark the onset of a new hydroclimatic regime.

  20. Spatial gradients in freshwater fish diversity, abundance and current pattern in the Himalayan region of Upper Ganges Basin, India

    Directory of Open Access Journals (Sweden)

    AJEY KUMAR PATHAK

    2014-10-01

    Full Text Available Pathak AK, Sarkar UK, Singh SP. 2014. Spatial gradients in freshwater fish diversity, abundance and current pattern in the Himalayan region of Upper Ganges Basin, India. Biodiversitas 15: 186-194.The present study describes the analysis and mapping of the different measurements of freshwater fish biodiversity of the Upper Ganges basin in the Himalayan region using spatial interpolation methods of Geographical Information System. The diversity, richness and abundance of fishes for each sampling location were determined and Kriging interpolation was applied on each fisheries measurement to predict and produce semivariogram. The semivariogarms produced were cross validated and reclassified. The reclassified maps for richness, abundance and diversity of fishes, occurrence of cold water threatened fish and abundance of important genera like Tor, Schziothorax and species were produced. The result of the Kriging produced good results and overall error in the estimation process was found significant. The cross validation of semovariograms also provided a better result with the observed data sets. Moreover, weighted overlay analysis of the reclassified raster maps of richness and abundance of fishes produced the classified raster map at different evaluation scale (0-10 qualitatively describing the gradient of species richness and abundance compositely. Similarly, the classified raster map at same evaluation scale qualitatively describing the gradient of species abundance and diversity compositely was produced and published. Further, basin wise analysis between Alaknanda/Pindar and Ganga1 sub basins showed 0.745 disparities at 0.745 distances in 2 dimensional spaces. The richness, diversity and abundance of threatened fishes among the different sampling locations were not significant (p = 0.9.

  1. Maternal health care initiatives: Causes of morbidities and mortalities in two rural districts of Upper West Region, Ghana.

    Directory of Open Access Journals (Sweden)

    Joshua Sumankuuro

    Full Text Available Maternal and neonatal morbidities and mortalities have received much attention over the years in sub-Saharan Africa; yet addressing them remains a profound challenge, no more so than in the nation of Ghana. This study focuses on finding explanations to the conditions which lead to maternal and neonatal morbidities and mortalities in rural Ghana, particularly the Upper West Region.Mixed methods approach was adopted to investigate the medical and non-medical causes of maternal and neonatal morbidities and mortalities in two rural districts of the Upper West Region of Ghana. Survey questionnaires, in-depth interviews and focus group discussions were employed to collect data from: a 80 expectant mothers (who were in their second and third trimesters, excluding those in their ninth month, b 240 community residents and c 13 healthcare providers (2 district directors of health services, 8 heads of health facilities and 3 nurses.Morbidity and mortality during pregnancy is attributed to direct causes such urinary tract infection (48%, hypertensive disorders (4%, mental health conditions (7%, nausea (4% and indirect related sicknesses such as anaemia (11%, malaria, HIV/AIDS, oedema and hepatitis B (26%. Socioeconomic and cultural factors are identified as significant underlying causes of these complications and to morbidity and mortality during labour and the postnatal period. Birth asphyxia and traditional beliefs and practices were major causes of neonatal deaths.These findings provide focused targets and open a window of opportunity for the community-based health services run by Ghana Health Service to intensify health education and promotion programmes directed at reducing risky economic activities and other cultural beliefs and practices affecting maternal and neonatal morbidity and mortality.

  2. Thoracic solitary pedunculated osteochondroma in a child: a case report

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    Wali Z

    2013-10-01

    Full Text Available Zubair Wali,1 Khalid I Khoshhal21Department of Orthopedic Surgery, King Fahd Hospital, Almadinah Almunawwarah, Saudi Arabia; 2Department of Orthopedic Surgery, College of Medicine, Taibah University, Almadinah Almunawwarah, Saudi ArabiaObjective: This case report describes the rare presentation of a thoracic pedunculated osteochondroma in a child, arising from the lamina of the fourth thoracic vertebra.Clinical features: A 7-year-old girl was referred for the evaluation of a swelling in her back. The patient was suffering from atraumatic, progressive painless back swelling, of approximately 2 years duration. The physical examination showed a healthy child, with a well-defined mass, about 4 × 6 cm, located around the midline of the upper thoracic spine. No clinical signs of hereditary multiple exostoses were detected. Plain radiographs and computerized tomography were suggestive of a pedunculated osteochondroma arising from the lamina of the fourth thoracic vertebra.Intervention and outcome: The patient underwent surgical excision of the mass. The pathologist confirmed the diagnosis. Follow up for 2 years did not show any evidence of clinical or radiological recurrence.Conclusion: The current report describes a rare case and the management of a solitary pedunculated osteochondroma arising from the lamina of the fourth thoracic vertebra in a child below the age of 10 years.Keywords: benign tumors, hereditary multiple exostoses, spine column tumors, thoracic vertebra

  3. Renewable energy in the heating sector in Austria with particular reference to the region of Upper Austria

    International Nuclear Information System (INIS)

    Kranzl, Lukas; Kalt, Gerald; Müller, Andreas; Hummel, Marcus; Egger, Christiane; Öhlinger, Christine; Dell, Gerhard

    2013-01-01

    The heating sector has been neglected in energy policies for quite some time, especially on the European level. Only recently, with the implementation of the European directive 2009/28/EC the sector has gained higher attention. The objective of this paper is to provide an overview of the heat market in Austria and of the current status and future prospects of renewable energy in the heat sector (RES-H) up to 2030. Despite the growing energy demand, the share of renewable energy in the total energy demand for space heating and hot water increased from about 20% in 1970 to about 34% in 2008. This is mainly due to ambitious RES-H support instruments and regional policy targets. For example, the government of the region of Upper Austria has implemented a target of 100% RES-H share in the space heating and hot water sector until the year 2030. However, the National Renewable Energy Action Plan for 2020 foresees only moderate growth rates for RES-H compared to recent market growth and scenarios in literature. Due to the ambitious targets and support schemes of regional governments it seems likely that RES-H deployment could growstronger than stated in the action plan. - Highlights: ► Overview on Austrian heat sector and RES-H development. ► Growing RES-H market mainly due to regional promotion schemes. ► Austrian NREAP foresees only moderate growth of RES-H up to 2020. ► Targets and policies on the regional level might lead to stronger RES-H deployment

  4. Radiologic findings of thoracic trauma

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    Akgul Ozmen C

    2017-08-01

    Full Text Available Cihan Akgul Ozmen,1 Serdar Onat,2 Delal Aycicek3 1Department of Radiology, 2Department of Chest Surgery, Dicle University School of Medicine, Diyarbakir, 3Radiology Unit, Siirt State Hospital, Siirt, Turkey Introduction: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. Methods: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included. Most of the patients were male (83.3% and victims of a blunt chest trauma. The images were analyzed with respect to the presence of fractures of bony structures, hemothorax, pneumothorax, mediastinal organ injury, and pulmonary and vascular injuries. Results: MDCT images of the 240 patients yielded a prevalence of 41.7% rib fractures, 11.2% scapular fractures, and 7.5% clavicle fractures. The prevalence of thoracic vertebral fracture was 13.8% and that of sternal fracture was 3.8%. The prevalence of hemothorax, pneumothorax, pneumomediastinum, and subcutaneous emphysema was 34.6%, 62.1%, 9.6%, and 35.4%, respectively. The prevalence of rib, clavicle, and thoracic vertebral fractures and pulmonary contusion was higher in the blunt trauma group, whereas the prevalence of hemothorax, subcutaneous emphysema, diaphragmatic injury, and other vascular lacerations was significantly higher in the penetrating trauma group than in the blunt trauma group (p<0.05. Conclusion: MDCT images may yield a high prevalence of fracture of bony structures, soft tissue lacerations, and vascular lesions, which should be well understood by

  5. Sedimentology of the Essaouira Basin (Meskala Field) in context of regional sediment distribution patterns during upper Triassic pluvial events

    Science.gov (United States)

    Mader, Nadine K.; Redfern, Jonathan; El Ouataoui, Majid

    2017-06-01

    Upper Triassic continental clastics (TAGI: Trias Argilo-Greseux Inferieur) in the Essaouira Basin are largely restricted to the subsurface, which has limited analysis of the depositional environments and led to speculation on potential provenance of the fluvial systems. Facies analysis of core from the Meskala Field onshore Essaouira Basin is compared with tentatively time-equivalent deposits exposed in extensive outcrops in the Argana Valley, to propose a process orientated model for local versus regional sediment distribution patterns in the continuously evolving Moroccan Atlantic rift during Carnian to Norian times. The study aims to unravel the climatic overprint and improve the understanding of paleo-climatic variations along the Moroccan Atlantic margin to previously recognised Upper Triassic pluvial events. In the Essaouira Basin, four facies associations representing a progressive evolution from proximal to distal facies belts in a continental rift were established. Early ephemeral braided river systems are succeeded by a wet aeolian sandflat environment with a strong arid climatic overprint (FA1). This is followed by the onset of perennial fluvial deposits with extensive floodplain fines (FA2), accompanied by a distinct shift in fluvial style, suggesting increase in discharge and related humidity, either locally or in the catchment area. The fluvial facies transitions to a shallow lacustrine or playa lake delta environment (FA3), which exhibits cyclical abandonment. The delta is progressively overlain by a terminal playa with extensive, mottled mudstones (FA4), interpreted to present a return from cyclical humid-arid conditions to prevailing aridity in the basin. In terms of regional distribution and sediment source provenance, paleocurrent data from Carnian to Norian deposits (T5 to T8 member) in the Argana Valley suggest paleoflow focused towards the S and SW, not directed towards the Meskala area in the NW as previously suggested. A major depo

  6. Chronology and ancient feeding ecology of two upper Pleistocene megamammals from the Brazilian Intertropical Region

    Science.gov (United States)

    de Melo França, Lucas; Trindade Dantas, Mário André; Bocchiglieri, Adriana; Cherckinsky, Alexander; de Souza Ribeiro, Adauto; Bocherens, Hervé

    2014-09-01

    In Brazilian Intertropical Region (BIR) fossil remains of the giant ground sloth Eremotherium laurillardi (Lund, 1842) and of the proboscidean Notiomastodon platensis (Ameghino, 1888) are the most abundant among megaherbivores. However, the paleoecology of both species needs to be better understood to enlighten why these species disappear in the end of the Pleistocene, an issue that is still debated. During the last decades, the carbon and oxygen stable isotopes have been increasingly being used to obtain paleoecological information about extinct animals, although this information is in most cases dissociated from chronological data. Thus, the main objective of this study is to contribute to the knowledge about feeding ecology and chronology of E. laurillardi and N. platensis within BIR. For each fossil sample we performed stable isotopes analyses (δ13C/δ18O) and radiocarbon dating (14C with AMS). The results showed that N. platensis occurred between 12,125 and 19,594 cal yr BP and exhibited a grazer diet (δ13C = -1.1‰-1.3‰), while E. laurillardi lived between 11,084 and 27,690 cal yr BP, with a mixed feeder diet (C3/C4 plants; values ratio δ13C = -7.7‰ to -3.3‰). The δ18O values of N. platensis ranged between 2.20‰ and 3.60‰, while the values of E. laurillardi ranged between -3.10‰ and -1.10‰. Neither species did exhibit differences in its diet through time, which suggests that the vegetational composition of this locality did not vary in the late Pleistocene. Both species were living in an open environment, rich in herbaceous plants (C4 plants) and with tree and shrub with disjoint distribution, maybe similar to some parts of recent Caatinga, where they have partitioned the spatial and feeding niches.

  7. Thoracic organ transplantation.

    Science.gov (United States)

    Pierson, Richard N; Barr, Mark L; McCullough, Keith P; Egan, Thomas; Garrity, Edward; Jessup, Mariell; Murray, Susan

    2004-01-01

    This article presents an overview of factors associated with thoracic transplantation outcomes over the past decade and provides valuable information regarding the heart, lung, and heart-lung waiting lists and thoracic organ transplant recipients. Waiting list and post-transplant information is used to assess the importance of patient demographics, risk factors, and primary cardiopulmonary disease on outcomes. The time that the typical listed patient has been waiting for a heart, lung, or heart-lung transplant has markedly increased over the past decade, while the number of transplants performed has declined slightly and survival after transplant has plateaued. Waiting list mortality, however, appears to be declining for each organ and for most diseases and high-severity subgroups, perhaps in response to recent changes in organ allocation algorithms. Based on perceived inequity in organ access and in response to a mandate from Health Resources and Services Administration, the lung transplant community is developing a lung allocation system designed to minimize deaths on the waiting list while maximizing the benefit of transplant by incorporating post-transplant survival and quality of life into the algorithm. Areas where improved data collection could inform evolving organ allocation and candidate selection policies are emphasized.

  8. Thoracic damage control surgery.

    Science.gov (United States)

    Gonçalves, Roberto; Saad, Roberto

    2016-01-01

    The damage control surgery came up with the philosophy of applying essential maneuvers to control bleeding and abdominal contamination in trauma patients who are within the limits of their physiological reserves. This concept was extended to thoracic injuries, where relatively simple maneuvers can shorten operative time of in extremis patients. This article aims to revise the various damage control techniques in thoracic organs that must be known to the surgeon engaged in emergency care. RESUMO A cirurgia de controle de danos surgiu com a filosofia de se aplicar manobras essenciais para controle de sangramento e contaminação abdominal, em doentes traumatizados, nos limites de suas reservas fisiológicas. Este conceito se estendeu para as lesões torácicas, onde manobras relativamente simples, podem abreviar o tempo operatório de doentes in extremis. Este artigo tem como objetivo, revisar as diversas técnicas de controle de dano em órgãos torácicos, que devem ser de conhecimento do cirurgião que atua na emergência.

  9. Comparative study between ultrasound guided tap block and paravertebral block in upper abdominal surgeries. Randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ruqaya M. Elsayed

    2017-01-01

    Conclusion: We concluded that ultrasound guided transversus abdominis plane block and thoracic paravertebral block were safe and effective anesthetic technique for upper abdominal surgery with longer and potent postoperative analgesia in thoracic paravertebral block than transversus abdominis block.

  10. Strategic Location and Territorial Integrity: The Role of Subsidiary Sites in the Classic Maya Kingdoms of the Upper Usumacinta Region

    Directory of Open Access Journals (Sweden)

    Armando Anaya Hernández

    2006-03-01

    Full Text Available The Upper Usumacinta region was the scene of an intense interaction between the different kingdoms of the Classic Maya Period. This interaction took the form of political and marriage alliances as well as warfare and is well attested in the inscribed monuments of the region, especially towards the Late Classic Period (c. AD 600-900. Through this interaction the Maya rulers would not only assert their claim to power but also ensure the boundaries of their kingdoms, with an eye to accruing a vaster domain. The definition of the political organisation and territorial extent of the Maya Lowland kingdoms is an issue that has attracted the attention of various scholars (Adams 1981; Adams and Jones 1981; Ball and Taschek 1991; Flannery 1972; Freidel 1981; Hammond 1974; 1981; Inomata and Aoyama 1996; Mathews 1988; 1991; Sanders 1981. Like these scholars, I have presented a model aimed at estimating the territorial extent of the kingdoms of the Upper Usumacinta region, taking into account the physical characteristics of the terrain (Anaya Hernández 2001. In this article I approach this issue again, focusing this time on the importance that the subsidiary centres located at strategic locations across the landscape had for the maintenance of the territorial integrity of the kingdoms of Pomoná and Piedras Negras. The political importance of these sites is reflected in the efforts that the kings of these polities went through to warrant the loyalty of the rulers of these secondary centres, as can be attested by the presence of a sculptured stela at the site of Panhalé, in the vicinity of Pomoná, and an inscribed wooden box found within the Redención del Campesino Valley that makes reference to a Piedras Negras ruler. To address this issue I took advantage of the capabilities that GIS offers to model movement across the physical setting in order to define the potential boundaries between the aforementioned kingdoms in the light of the available

  11. Regional paleohydrologic and paleoclimatic settings of wetland/lacustrine depositional systems in the Morrison Formation (Upper Jurassic), Western Interior, USA

    Science.gov (United States)

    Dunagan, S.P.; Turner, C.E.

    2004-01-01

    During deposition of the Upper Jurassic Morrison Formation, water that originated as precipitation in uplands to the west of the Western Interior depositional basin infiltrated regional aquifers that underlay the basin. This regional groundwater system delivered water into the otherwise dry continental interior basin where it discharged to form two major wetland/lacustrine successions. A freshwater carbonate wetland/lacustrine succession formed in the distal reaches of the basin, where regional groundwater discharged into the Denver-Julesburg Basin, which was a smaller structural basin within the more extensive Western Interior depositional basin. An alkaline-saline wetland/lacustrine complex (Lake T'oo'dichi') formed farther upstream, where shallower aquifers discharged into the San Juan/Paradox Basin, which was another small structural basin in the Western Interior depositional basin. These were both wetlands in the sense that groundwater was the major source of water. Input from surface and meteoric water was limited. In both basins, lacustrine conditions developed during episodes of increased input of surface water. Inclusion of wetlands in our interpretation of what had previously been considered largely lacustrine systems has important implications for paleohydrology and paleoclimatology. The distal carbonate wetland/lacustrine deposits are well developed in the Morrison Formation of east-central Colorado, occupying a stratigraphic interval that is equivalent to the "lower" Morrison but extends into the "upper" Morrison Formation. Sedimentologic, paleontologic, and isotopic evidence indicate that regional groundwater discharge maintained shallow, hydrologically open, well oxygenated, perennial carbonate wetlands and lakes despite the semi-arid climate. Wetland deposits include charophyte-rich wackestone and green mudstone. Lacustrine episodes, in which surface water input was significant, were times of carbonate and siliciclastic deposition in scarce deltaic

  12. Thoracic spine x-ray

    Science.gov (United States)

    Vertebral radiography; X-ray - spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films ... There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most ...

  13. Chest x-ray as a screening tool for blunt thoracic trauma in children.

    Science.gov (United States)

    Yanchar, Natalie L; Woo, Kenneth; Brennan, Maureen; Palmer, Cameron S; Zs Ee, Michael; Sweeney, Brian; Crameri, Joe

    2013-10-01

    With the increasing use of thoracic computed tomography (CT) to screen for injuries in pediatric blunt thoracic trauma (BTT), we determined whether chest x-ray (CXR) and other clinical and epidemiologic variables could be used to predict significant thoracic injuries, to inform the selective use of CT in pediatric BTT. We further queried if these were discrepant from factors associated with the decision to obtain a thoracic CT. This retrospective cohort study included cases of BTT from three Level I pediatric trauma centers between April 1999 and March 2008. Pre-CT epidemiologic, clinical, and radiologic variables associated with CT findings of any thoracic injury or a significant thoracic injury as well as the decision to obtain a thoracic CT were determined using logistic regression. Of 425 patients, 40% patients had a significant thoracic injury, 49% had nonsignificant thoracic injury, and 11% had no thoracic injury at all. Presence of hydrothorax and/or pneumothorax on CXR significantly increased the likelihood of significant chest injury visualized by CT (adjusted odds ratio 10.8; 95% confidence interval, 6.5-18), as did the presence of isolated subcutaneous emphysema (adjusted odds ratio, 19.8; 95% confidence interval, 2.3-168). Although a normal CXR finding was not statistically associated with a reduced risk of significant thoracic injury, 8 of the 9 cases with normal CXR findings and significant injuries involved occult pneumothoraces or hemothoraces not requiring intervention. Converse to features suggesting increased risk of significant injury, the decision to obtain a thoracic CT was only associated with later period in the study and obtaining a CT scan of another body region. CXR can be used to screen for significant thoracic injuries and direct the selective use of thoracic CT in pediatric BTT. Prospective studies are needed to validate these findings and develop guidelines that include CXR to define indications for thoracic CT in pediatric BTT

  14. Relationship between geohydrology and Upper Pleistocene-Holocene evolution of the eastern region of the Province of Buenos Aires, Argentina

    Science.gov (United States)

    Capítulo, Leandro Rodrigues; Kruse, Eduardo E.

    2017-07-01

    The Upper Pleistocene-Holocene geological evolution, which is characterized by its landscape-forming energy and is related to geological and geomorphological complexity, has an impact on the groundwater dynamics of coastal aquifers. The geological configuration of a sector of the east coast of the Province of Buenos Aires was analyzed, as well as its connection with the geological and geomorphological history of the region during the Late Pleistocene and Holocene, and its influence on the regional and local geohydrological behaviour. This analysis was based on the application of the concept of hydrofacies. Boreholes were drilled and sampled (with depths of up to 40 m), and vertical electrical sounding, electrical tomography and pumping tests were undertaken. The description of the cutting samples by means of a stereo microscope, the interpretation of satellite images, and the construction of lithological and hydrogeological profiles and flow charts were carried out in the laboratory, and then integrated in a GIS. The identification of the lithological units and their distribution in the area allowed the construction of an evolutionary geological model for the Late Pleistocene and Holocene. Three aquifer units can be recognized: one of Late Pleistocene age (hydrofacies E) and the other two of Holocene age (hydrofacies A and C); their hydraulic connection depends on the occurrence and thickness variation of the aquitard units (hydrofacies B and D). The approach adopted allows the examination of the possibilities for groundwater exploitation and constitutes an applied conceptual framework to be taken into consideration when developing conceptual and numerical models at the local and regional scales.

  15. Regional and temporal variations in coding of hospital diagnoses referring to upper gastrointestinal and oesophageal bleeding in Germany

    Directory of Open Access Journals (Sweden)

    Garbe Edeltraut

    2011-08-01

    Full Text Available Abstract Background Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM. Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. Methods We analysed hospitalisation diagnoses for oesophageal bleeding (OB and upper gastrointestinal bleeding (UGIB from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided or "unspecific" (origin of bleeding not provided coding. We studied regional (former East versus West Germany differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Results Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32 for specific and 0.67 (95% CI 0.60-0.74 for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51 for specific and 0.83 (95% CI 0.80-0.87 for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. Conclusions During the study

  16. Anesthesia for thoracic surgery: A survey of middle eastern practice

    Science.gov (United States)

    Eldawlatly, Abdelazeem; Turkistani, Ahmed; Shelley, Ben; El-Tahan, Mohamed; Macfie, Alistair; Kinsella, John

    2012-01-01

    Purpose: The main objective of this survey is to describe the current practice of thoracic anesthesia in the Middle Eastern (ME) region. Methods: A prospective online survey. An invitation to participate was e-mailed to all members of the ME thoracic-anaesthesia group. A total of 58 members participated in the survey from 19 institutions in the Middle East. Questions concerned ventilation strategies during one-lung ventilation (OLV), anesthesia regimen, mode of postoperative analgesia, use of lung isolation techniques, and use of i.v. fluids. Results: Volume-controlled ventilation was favored over pressure-controlled ventilation (62% vs 38% of respondents, Panesthesia practice. Failure to pass a DLT and difficult airway are the most commonly cited indications for BB use. Regarding postoperative analgesia, the majority 61.8% favor thoracic epidural analgesia over other techniques (P<0.05). Conclusions: Our survey provides a contemporary snapshot of the ME thoracic anesthetic practice. PMID:23162388

  17. Food as a social determinant of mental health among household heads in the Upper West Region of Ghana.

    Science.gov (United States)

    Atuoye, Kilian Nasung; Luginaah, Isaac

    2017-05-01

    According to the World Health Organization, mental distress and related illnesses are becoming leading causes of morbidity and mortality in developing countries. Despite the influence of food insecurity on mental health, empirical understanding of this relationship in sub-Saharan Africa, where incidence of food insecurity is relatively high, is almost non-existent. This study contributes to the literature by examining the association between food insecurity and mental health in the Upper West Region of Ghana. We used Ordinary Least Square (OLS) to analyze cross-sectional data collected on household heads (n = 1438) in 2014 using the Household Food Insecurity Access Scale and the DUKE Health Profile. The results show that heads of severely food insecure (β = 0.934, p ≤ 0.001) and moderately food secure households (β = 0.759, p ≤ 0.001) were more likely to report elevated mental distress compared to those from food secure households. We also found that female household heads were more likely to report elevated mental distress (β = 0.164, p ≤ 0.05) compared to their male counterparts. Our findings suggest the need to improve food security as a strategy targeted at improving overall mental health in the Ghanaian context. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Change in frozen soils and its effect on regional hydrology, upper Heihe basin, northeastern Qinghai-Tibetan Plateau

    Science.gov (United States)

    Gao, Bing; Yang, Dawen; Qin, Yue; Wang, Yuhan; Li, Hongyi; Zhang, Yanlin; Zhang, Tingjun

    2018-02-01

    Frozen ground has an important role in regional hydrological cycles and ecosystems, particularly on the Qinghai-Tibetan Plateau (QTP), which is characterized by high elevations and a dry climate. This study modified a distributed, physically based hydrological model and applied it to simulate long-term (1971-2013) changes in frozen ground its the effects on hydrology in the upper Heihe basin, northeastern QTP. The model was validated against data obtained from multiple ground-based observations. Based on model simulations, we analyzed spatio-temporal changes in frozen soils and their effects on hydrology. Our results show that the area with permafrost shrank by 8.8 % (approximately 500 km2), predominantly in areas with elevations between 3500 and 3900 m. The maximum depth of seasonally frozen ground decreased at a rate of approximately 0.032 m decade-1, and the active layer thickness over the permafrost increased by approximately 0.043 m decade-1. Runoff increased significantly during the cold season (November-March) due to an increase in liquid soil moisture caused by rising soil temperatures. Areas in which permafrost changed into seasonally frozen ground at high elevations showed especially large increases in runoff. Annual runoff increased due to increased precipitation, the base flow increased due to changes in frozen soils, and the actual evapotranspiration increased significantly due to increased precipitation and soil warming. The groundwater storage showed an increasing trend, indicating that a reduction in permafrost extent enhanced the groundwater recharge.

  19. Role of the Land Valuation Division in Property Rating by District Assemblies in Ghana's Upper East Region

    Directory of Open Access Journals (Sweden)

    Maxwell Kwotua Petio

    2013-05-01

    Full Text Available District Assemblies in Ghana are charged with the responsibility of developing their areas of jurisdiction mainly through internally mobilised revenue. As a consequence, the assemblies are empowered by various pieces of legislation to impose local taxes within their jurisdiction. The local taxes include property rates which are a form of tax that only the District Assemblies may levy. The study therefore looked at the levying of property rates in the Upper East Region and assessed the role and institutional capacity of the Land Valuation Division of the Lands Commission in the tax administration. Findings included limited coverage of the tax, use of flat rates due to absence of up-to-date property values, inadequate technical personnel and logistics for the Land Valuation Division (LVD and lack of political will to levy the rates fully. Relevant suggestions are made, such as the need to introduce mass valuation, widen the tax coverage, establish a fund for revaluation and revive the Valuation Training School, as well as provide requisite logistics for efficient performance of the LVD.

  20. Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey.

    Science.gov (United States)

    Kyei-Onanjiri, Minerva; Carolan-Olah, Mary; Awoonor-Williams, John Koku; McCann, Terence V

    2018-03-15

    Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies. The aim of this study was to examine the availability of emergency obstetric care interventions in the Upper East Region of Ghana. A cross-sectional survey of 120 health facilities was undertaken. Status of emergency obstetric care was assessed through an interviewer administered questionnaire to directors/in-charge officers of maternity care units in selected facilities. Data were analysed using descriptive statistics. Eighty per cent of health facilities did not meet the criteria for provision of emergency obstetric care. Comparatively, private health facilities generally provided EmOC interventions less frequently than public health facilities. Other challenges identified include inadequate skill mix of maternity health personnel, poor referral processes, a lack of reliable communication systems and poor emergency transport systems. Multiple factors combine to limit women's access to a range of essential maternal health services. The availability of EmOC interventions was found to be low across the region; however, EmOC facilities could be increased by nearly one-third through modest investments in some existing facilities. Also, the key challenges identified in this study can be improved by enhancing pre-existing health system structures such as Community-based Health Planning and Services (CHPS), training more midwifery personnel, strengthening in-service training and implementation of referral audits as part of health service

  1. Simulation of river plume behaviors in a tropical region: Case study of the Upper Gulf of Thailand

    Science.gov (United States)

    Yu, Xiaojie; Guo, Xinyu; Morimoto, Akihiko; Buranapratheprat, Anukul

    2018-02-01

    River plumes are a general phenomenon in coastal regions. Most previous studies focus on river plumes in middle and high latitudes with few studies examining those in low latitude regions. Here, we apply a numerical model to the Upper Gulf of Thailand (UGoT) to examine a river plume in low latitudes. Consistent with observational data, the modeled plume has seasonal variation dependent on monsoon conditions. During southwesterly monsoons, the plume extends northeastward to the head of the gulf; during northeasterly monsoons, it extends southwestward to the mouth of the gulf. To examine the effects of latitude, wind and river discharge on the river plume, we designed several numerical experiments. Using a middle latitude for the UGoT, the bulge close to the river mouth becomes smaller, the downstream current flows closer to the coast, and the salinity in the northern UGoT becomes lower. The reduction in the size of the bulge is consistent with the relationship between the offshore distance of a bulge and the Coriolis parameter. Momentum balance of the coastal current is maintained by advection, the Coriolis force, pressure gradient and internal stresses in both low and middle latitudes, with the Coriolis force and pressure gradient enlarged in the middle latitude. The larger pressure gradient in the middle latitude is induced by more offshore freshwater flowing with the coastal current, which induces lower salinity. The influence of wind on the river plume not only has the advection effects of changing the surface current direction and increasing the surface current speed, but also decreases the current speed due to enhanced vertical mixing. Changes in river discharge influence stratification in the UGoT but have little effect on the behavior of the river plume.

  2. Fungi occurring on forests injured by air pollutants in the Upper Silesia and Cracow industrial regions. Pt. 10. Mycoflora of dying young trees of Alnus incana

    Energy Technology Data Exchange (ETDEWEB)

    Domanski, S.; Kowalski, T.

    1987-01-01

    The results of a 10-year study on the mortality of Alnus incana in the Upper Silesia industrial region (Poland) are presented in this paper. Fungi which infected the trees at different stages of the disease were identified. The most common were: Cryptosphora suffusa, Hypoxylon fuscum, Peniophora cinerea, P. erikssonii, Pezicula cinnamomea, Tymipanis alnea, and Valsa diatrypa.

  3. Practices and constraints in Bambara Groundnut’s production, marketing and consumption in the Brong Ahafo and Upper East Regions of Ghana

    NARCIS (Netherlands)

    Berchie, J.N.; Adu-Dapaah, H.K.; Dankyi, A.A.; Plahar, W.A.; Nelson-Quartey, F.; Haleegoah, J.

    2010-01-01

    A study was undertaken to understand the practices and major constraints in bambara groundnut production, marketing and consumption in the Brong Ahafo (Transition) and Upper East (Guinea Savannah) Regions of Ghana. A total of 200 bambara producers, 33 marketers and 68 consumers were randomly chosen

  4. The evolution of thoracic anesthesia.

    Science.gov (United States)

    Brodsky, Jay B

    2005-02-01

    The specialty of thoracic surgery has evolved along with the modem practice of anesthesia. This close relationship began in the 1930s and continues today. Thoracic surgery has grown from a field limited almost exclusively to simple chest wall procedures to the present situation in which complex procedures, such as lung volume reduction or lung transplantation, now can be performed on the most severely compromised patient. The great advances in thoracic surgery have followed discoveries and technical innovations in many medical fields. One of the most important reasons for the rapid escalation in the number and complexity of thoracic surgical procedures now being performed has been the evolution of anesthesia for thoracic surgery. There has been so much progress in this area that numerous books and journals are devoted entirely to this subject. The author has been privileged to work with several surgeons who specialized in noncardiac thoracic surgery. As a colleague of 25 years, the noted pulmonary surgeon James B.D. Mark wrote, "Any operation is a team effort... (but) nowhere is this team effort more important than in thoracic surgery, where near-choreography of moves by all participants is essential. Exchange of information, status and plans are mandatory". This team approach between the thoracic surgeon and the anesthesiologist reflects the history of the two specialties. With new advances in technology, such as continuous blood gas monitoring and the pharmacologic management of pulmonary circulation to maximize oxygenation during one-lung ventilation, in the future even more complex procedures may be able to be performed safely on even higher risk patients.

  5. A reappraisal of pediatric thoracic surface anatomy.

    Science.gov (United States)

    Fischer, Nicholas J; Morreau, Jonty; Sugunesegran, Ramanen; Taghavi, Kiarash; Mirjalili, S Ali

    2017-09-01

    Accurate knowledge of surface anatomy is fundamental to safe clinical practice. A paucity of evidence in the literature regarding thoracic surface anatomy in children was identified. The associations between surface landmarks and internal structures were meticulously analyzed by reviewing high quality computed tomography (CT) images of 77 children aged from four days to 12 years. The results confirmed that the sternal angle is an accurate surface landmark for the azygos-superior vena cava junction in a plane through to the level of upper T4 from birth to age four, and to lower T4 in older children. The concavity of the aortic arch was slightly below this plane and the tracheal and pulmonary artery bifurcations were even lower. The cardiac apex was typically at the 5 th intercostal space (ICS) from birth to age four, at the 4 th ICS and 5 th rib in 4-12 year olds, and close to the midclavicular line at all ages. The lower border of the diaphragm was at the level of the 6 th or 7 th rib at the midclavicular line, the 7 th ICS and 8 th rib at the midaxillary line, and the 11 th thoracic vertebra posteriorly. The domes of the diaphragm were generally flatter and lower in children, typically only one rib level higher than its anterior level at the midclavicular line. Diaphragm apertures were most commonly around the level of T9, T10, and T11 for the IVC, esophagus and aorta, respectively. This is the first study to provide an evidence-base for thoracic surface anatomy in children. Clin. Anat. 30:788-794, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. Land cover in Upper Egypt assessed using regional and global land cover products derived from MODIS imagery.

    Science.gov (United States)

    Fuller, Douglas O; Parenti, Michael S; Gad, Adel M; Beier, John C

    2012-01-01

    Irrigation along the Nile River has resulted in dramatic changes in the biophysical environment of Upper Egypt. In this study we used a combination of MODIS 250 m NDVI data and Landsat imagery to identify areas that changed from 2001-2008 as a result of irrigation and water-level fluctuations in the Nile River and nearby water bodies. We used two different methods of time series analysis -- principal components (PCA) and harmonic decomposition (HD), applied to the MODIS 250 m NDVI images to derive simple three-class land cover maps and then assessed their accuracy using a set of reference polygons derived from 30 m Landsat 5 and 7 imagery. We analyzed our MODIS 250 m maps against a new MODIS global land cover product (MOD12Q1 collection 5) to assess whether regionally specific mapping approaches are superior to a standard global product. Results showed that the accuracy of the PCA-based product was greater than the accuracy of either the HD or MOD12Q1 products for the years 2001, 2003, and 2008. However, the accuracy of the PCA product was only slightly better than the MOD12Q1 for 2001 and 2003. Overall, the results suggest that our PCA-based approach produces a high level of user and producer accuracies, although the MOD12Q1 product also showed consistently high accuracy. Overlay of 2001-2008 PCA-based maps showed a net increase of 12 129 ha of irrigated vegetation, with the largest increase found from 2006-2008 around the Districts of Edfu and Kom Ombo. This result was unexpected in light of ambitious government plans to develop 336 000 ha of irrigated agriculture around the Toshka Lakes.

  7. Productivity of Stored Water in Some Selected Multiple Use Small Reservoirs in the Upper East Region of Ghana

    Science.gov (United States)

    Annor, F. O.; Yamoah-Antwi, D.; Odai, S. N.; Adjei, K. A.; van de Giesen, N. C.

    2009-04-01

    The Upper East Region (UER) of Ghana is a water stressed area with agriculture as the main occupation of the inhabitants. The importance of small reservoirs for the sustenance of the livelihood of the people in this part of the country during the dry season cannot be over emphasized. Most of these small reservoirs were constructed, in the 1960s, mainly with the aim of providing water for domestic use and livestock watering during the dry periods of the year. Over the years, however, these small reservoirs have been put to a variety of uses, some of which accelerate the depletion of the stored water. The reservoirs are therefore most times, unable to serve the purposes for which they were constructed. To address this situation, a study was conducted to determine the productivity of stored water in small reservoirs to better inform policy makers and water managers in the allocation of water especially in the dry season. Water productivity can be thought of as the output (product) that can be obtained per unit volume of water used or applied for either crop or livestock production. Data on crops and livestock were obtained through questionnaire administration, interviews, focus group discussions, physical measurements as well as field observations from nine reservoirs in the UER. The research findings show that donkeys have the highest productivity of about US90 followed by cattle with US70. These high productivity values are as a result of the variety of products and services rendered by donkeys and cattle. For crop, tomatoes have the highest productivity value compared with pepper and leafy vegetables. Despite the fact that donkeys had the highest productivity and hence priority over all uses, it is prudent to note that, inhabitants of the study area aside the sale of livestock for money (income) keep livestock for prestige. Therefore in the allocation of stored water in small multiple use reservoirs, the allocation criteria should consider the views, values and

  8. Identification of fish nursery areas in a free tributary of an impoundment region, upper Uruguay River, Brazil

    Directory of Open Access Journals (Sweden)

    Patrícia Alves da Silva

    Full Text Available This study aims to determine the importance of different environments of the Ligeiro River (upper Uruguay River, Brazil in fish reproduction. For this purpose, three environments (sampling sites were selected: rapids, a pool, and the mouth of the Ligeiro River. Ichthyoplankton, zooplankton, and benthos were sampled six times per month from September, 2006 to March, 2007. Zooplankton and ichthyoplankton samples were collected early in the evening with plankton nets (64 µm and 500 µm, respectively. Benthos samples were also collected early in the evening with a Van Veen dredge. Local abiotic variables (temperature, dissolved oxygen, pH, electrical conductivity, water speed, alkalinity, water hardness, and water transparency were measured simultaneously with the biotic data sampling and were complemented by regional variables (water flow and precipitation. A total of 43,475 eggs and 2,269 larvae were captured. Of these larvae, 80.1% were in the pre-flexion and larval yolk stages. Digestive tract content showed that the greatest degree of repletion among the larvae in more advanced phases occurred in the pool environment. Water speed was the main characteristic used to differentiate the river's rapids and mouth from the pool. The abundance of zooplankton and benthos was not related to the distribution of densities among the different components of the ichthyoplankton. A greater abundance of eggs and larvae with yolk was found in the rapids and river mouth. Ordination analyses showed a connection between the advanced stage larvae and the pool environment. In conclusion, the rapids and river mouth of the Ligeiro River's are important locations for fish reproduction, particularly in regard to spawning and drifting of the ichthyoplankton's initial stages, whereas the pool represents a nursery place for larval growth.

  9. Hydrothermal dolomitization of the Bekhme formation (Upper Cretaceous), Zagros Basin, Kurdistan Region of Iraq: Record of oil migration and degradation

    Science.gov (United States)

    Mansurbeg, Howri; Morad, Daniel; Othman, Rushdy; Morad, Sadoon; Ceriani, Andrea; Al-Aasm, Ihsan; Kolo, Kamal; Spirov, Pavel; Proust, Jean Noel; Preat, Alain; Koyi, Hemin

    2016-07-01

    The common presence of oil seepages in dolostones is widespread in Cretaceous carbonate successions of the Kurdistan Region of Iraq. This integrated field, petrographic, chemical, stable C, O and Sr isotopes, and fluid inclusion study aims to link dolomitization to the origin and geochemical evolution of fluids and oil migration in the Upper Cretaceous Bekhme carbonates. Flux of hot basinal (hydrothermal) brines, which is suggested to have occurred during the Zagros Orogeny, resulted in dolomitization and cementation of vugs and fractures by coarse-crystalline saddle dolomite, equant calcite and anhydrite. The saddle dolomite and host dolostones have similar stable isotopic composition and formed prior to oil migration from hot (81-115 °C) basinal NaCl-MgCl2-H2O brines with salinities of 18-22 wt.% NaCl eq. The equant calcite cement, which surrounds and hence postdates saddle dolomite, has precipitated during oil migration from cooler (60-110 °C) NaCl-CaCl2-H2O brines (14-18 wt.% NaCl eq). The yellowish fluorescence color of oil inclusions in the equant calcite indicates that the oil had API gravity of 15-25° composition, which is lighter than present-day oil in the reservoirs (API of 10-17°). This difference in oil composition is attributed to oil degradation by the flux of meteoric water, which is evidenced by the low δ13C values (- 8.5‰ to - 3.9‰ VPDB) as well as by nil salinity and low temperature in fluid inclusions of late columnar calcite cement. This study demonstrates that linking fluid flux history and related diagenesis to the tectonic evolution of the basin provides important clues to the timing of oil migration, degradation and reservoir evolution.

  10. Investigation of Temperature Dynamics in Small and Shallow Reservoirs, Case Study: Lake Binaba, Upper East Region of Ghana

    Directory of Open Access Journals (Sweden)

    Ali Abbasi

    2016-03-01

    Full Text Available An unsteady fully three-dimensional model of Lake Binaba (a shallow small reservoir in semi-arid Upper East Region of Ghana has been developed to simulate its temperature dynamics. The model developed is built on the Reynolds Averaged Navier–Stokes (RANS equations, utilizing the Boussinesq approach. As the results of the model are significantly affected by the physical conditions on the boundaries, allocating appropriate boundary conditions, particularly over a water surface, is essential in simulating the lake’s thermal structure. The thermal effects of incoming short-wave radiation implemented as a heat source term in the temperature equation, while the heat fluxes at the free water surface, which depend on wind speed, air temperature, and atmospheric stability conditions are considered as temperature boundary condition. The model equations were solved using OpenFOAM CFD toolbox. As the flow is completely turbulent, which is affected by the complex boundary conditions, a new heat transfer solver and turbulence model were developed to investigate the spatial and temporal distribution of temperature in small and shallow inland water bodies using improved time-dependent boundary conditions. The computed temperature values were compared with four days of observed field data. Simulated and observed temperature profiles show reasonable agreement where the root mean square error (RMSE over the simulation period ranges from 0.11 to 0.44 °C in temporal temperature profiles with an average value of 0.33 °C. Results indicate that the model is able to simulate the flow variables and the temperature distribution in small inland water bodies with complex bathymetry.

  11. Parameterization of the middle and upper tropospheric water vapor from ATOVS observations over a tropical climate region

    Science.gov (United States)

    Makama, Ezekiel Kaura; Lim, Hwee San; Abdullah, Khiruddin

    2018-01-01

    Precipitable water vapor (PWV) is a highly variable, but important greenhouse gas that regulates the radiation budget of the earth. Its variability in time and space makes it difficult to quantify. Knowledge of its vertical distribution, in particular, is crucial for many reasons. In this study, empirical relationships between isobaric layers of PWV over Peninsular Malaysia are examined. Analysis of variance (ANOVA) technique on Advanced Television and Infrared Observation Satellite Operational Vertical Sounder (ATOVS) observations, from 2005 to 2011, has been used to propose a relationship of the form, W=α(WL)β for the middle (MW) and upper (UW) layers PWV. W is either MW or UW with α and β as regression coefficients, which are functions of latitude. Coefficients of determination (R2) and root mean square error (RMSE) of respective values between 0.75-0.86 and 1.65-2.38 mm, across the zones, were obtained for both the MW and UW predictions, with a mean bias (MB) below ±1 mm.The predicted and observed PWV presented a better agreement northerly. Initial predictability test for each model was done on two independent data sets: ATOVS (2012-2015), and radiosonde (2010-2011) at Penang, Kuantan and Sepang stations, with very good outcomes. The results of the tests revealed remarkable performances, when compared with two previously reported models. The inclusion of variable regression coefficients, and the utilization of satellite-derived data, which provide soundings of data-void regions between radiosonde networks, proved to have optimized the results.

  12. Altered spinal kinematics and muscle recruitment pattern of the cervical and thoracic spine in people with chronic neck pain during functional task.

    Science.gov (United States)

    Tsang, Sharon M H; Szeto, Grace P Y; Lee, Raymond Y W

    2014-02-01

    Knowledge on the spinal kinematics and muscle activation of the cervical and thoracic spine during functional task would add to our understanding of the performance and interplay of these spinal regions during dynamic condition. The purpose of this study was to examine the influence of chronic neck pain on the three-dimensional kinematics and muscle recruitment pattern of the cervical and thoracic spine during an overhead reaching task involving a light weight transfer by the upper limb. Synchronized measurements of the three-dimensional spinal kinematics and electromyographic activities of cervical and thoracic spine were acquired in thirty individuals with chronic neck pain and thirty age- and gender-matched asymptomatic controls. Neck pain group showed a significantly decreased cervical velocity and acceleration while performing the task. They also displayed with a predominantly prolonged coactivation of cervical and thoracic muscles throughout the task cycle. The current findings highlighted the importance to examine differential kinematic variables of the spine which are associated with changes in the muscle recruitment in people with chronic neck pain. The results also provide an insight to the appropriate clinical intervention to promote the recovery of the functional disability commonly reported in patients with neck pain disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. A P-wave velocity model of the upper crust of the Sannio region (Southern Apennines, Italy

    Directory of Open Access Journals (Sweden)

    M. Cocco

    1998-06-01

    Full Text Available This paper describes the results of a seismic refraction profile conducted in October 1992 in the Sannio region, Southern Italy, to obtain a detailed P-wave velocity model of the upper crust. The profile, 75 km long, extended parallel to the Apenninic chain in a region frequently damaged in historical time by strong earthquakes. Six shots were fired at five sites and recorded by a number of seismic stations ranging from 41 to 71 with a spacing of 1-2 km along the recording line. We used a two-dimensional raytracing technique to model travel times and amplitudes of first and second arrivals. The obtained P-wave velocity model has a shallow structure with strong lateral variations in the southern portion of the profile. Near surface sediments of the Tertiary age are characterized by seismic velocities in the 3.0-4.1 km/s range. In the northern part of the profile these deposits overlie a layer with a velocity of 4.8 km/s that has been interpreted as a Mesozoic sedimentary succession. A high velocity body, corresponding to the limestones of the Western Carbonate Platform with a velocity of 6 km/s, characterizes the southernmost part of the profile at shallow depths. At a depth of about 4 km the model becomes laterally homogeneous showing a continuous layer with a thickness in the 3-4 km range and a velocity of 6 km/s corresponding to the Meso-Cenozoic limestone succession of the Apulia Carbonate Platform. This platform appears to be layered, as indicated by an increase in seismic velocity from 6 to 6.7 km/s at depths in the 6-8 km range, that has been interpreted as a lithological transition from limestones to Triassic dolomites and anhydrites of the Burano formation. A lower P-wave velocity of about 5.0-5.5 km/s is hypothesized at the bottom of the Apulia Platform at depths ranging from 10 km down to 12.5 km; these low velocities could be related to Permo-Triassic siliciclastic deposits of the Verrucano sequence drilled at the bottom of the Apulia

  14. A vertical hydroclimatology of the Upper Indus Basin and initial insights to potential hydrological change in the region

    Science.gov (United States)

    Forsythe, Nathan; Kilsby, Chris G.; Fowler, Hayley J.; Archer, David R.

    2010-05-01

    The water resources of the Upper Indus Basin (UIB) are of the utmost importance to the economic wellbeing of Pakistan. The irrigated agriculture made possible by Indus river runoff underpins the food security for Pakistan's nearly 200 million people. Contributions from hydropower account for more than one fifth of peak installed electrical generating capacity in a country where widespread, prolonged load-shedding handicaps business activity and industrial development. Pakistan's further socio-economic development thus depends largely on optimisation of its precious water resources. Confident, accurate projections of future water resource availability and variability are urgent insights needed by development planners and infrastructure managers at all levels. Correctly projecting future hydrological conditions depends first and foremost on a thorough understanding of the underlying mechanisms and processes of present hydroclimatology. The vertical and horizontal spatial variations in key climate parameters (temperature, precipitation) govern the contributions of the various elevation zones and subcatchments comprising the UIB. Trends in this complex mountainous region are highly varied by season and parameter. Observed changes here often do not match general global trends or even necessarily those found in neighbouring regions. This study considers data from a variety sources in order to compose the most complete picture possible of the vertical hydroclimatology of the UIB. The study presents the observed climatology and trends for precipitation and temperature from local observations at long-record meteorological stations (Pakistan Meteorological Department). These data are compared to characterisations of additional water cycle parameters (humidity, cloud, snow cover and snow-water-equivalent) derived from local short-record automatic weather stations, the ECMWF ‘ERA' reanalysis projects and satellite based observations (AVHRR, MODIS, etc). The potential

  15. Details of recurrence sites after elective nodal irradiation (ENI) using 3D-conformal radiotherapy (3D-CRT) combined with chemotherapy for thoracic esophageal squamous cell carcinoma--a retrospective analysis.

    Science.gov (United States)

    Yamashita, Hideomi; Okuma, Kae; Wakui, Reiko; Kobayashi-Shibata, Shino; Ohtomo, Kuni; Nakagawa, Keiichi

    2011-02-01

    To describe patterns of recurrence of elective nodal irradiation (ENI) in definitive chemoradiotherapy (CRT) for thoracic esophageal squamous cell carcinoma (SqCC) using 3D-conformal radiotherapy. One hundred and twenty-six consecutive patients with stages I-IVB thoracic esophageal SqCC newly diagnosed between June 2000 and July 2009 and treated with 3D-CRT in our institution were recruited from our database. Definitive CRT consisted of two cycles of nedaplatin/5FU repeated every 4 weeks, with concurrent radiation therapy of 50-50.4 Gy in 25-28 fractions. Until completion, radiotherapy was delivered to the N1 and M1a lymph nodes as ENI in addition to gross tumor volume. All 126 patients were included in this analysis, and their tumors were staged as follows: T1/T2/T3/T4, 28/18/54/26; N0/N1, 50/76; M0/M1a/M1b, 91/5/30. The mean follow-up period for the 63 surviving patients was 28.3 (±22.8) months. Eighty-seven patients (69%) achieved complete response (CR) without any residual tumor at least once after completion of CRT. After achieving CR, each of 40 patients experienced failures (local=20 and distant=20) and no patient experienced elective nodal failure without having any other site of recurrence. The upper thoracic esophageal carcinoma showed significantly more (34%) relapses at the local site than the middle (9%) or lower thoracic (11%) carcinomas. The 2-year and 3-year overall survival was 56% and 43%, respectively. The 1-year, 2-year and 3-year disease-free survival was 46%, 38% and 33%, respectively. In CRT for esophageal SqCC, ENI was effective for preventing regional nodal failure. The upper thoracic esophageal carcinomas had significantly more local recurrences than the middle or lower thoracic sites. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  16. The association between incentive spirometry performance and pain in postoperative thoracic epidural analgesia.

    Science.gov (United States)

    Harris, David J; Hilliard, Paul E; Jewell, Elizabeth S; Brummett, Chad M

    2015-01-01

    Effective use of postoperative incentive spirometry improves patient outcomes but is limited by pain after thoracic and upper abdominal surgery. Thoracic epidurals are frequently used to provide analgesia and attenuate postoperative pulmonary dysfunction. We hypothesized that, in patients with thoracic epidurals for thoracic and abdominal surgery, high pain scores would be associated with poorer incentive spirometry performance, even when accounting for other variables. Retrospective study of 468 patients who underwent upper abdominal or thoracic surgery using postoperative thoracic epidural analgesia between June 1, 2009, and August 31, 2013, at a single tertiary academic center. The association between incentive spirometry performance and pain was assessed as the primary outcome. Other independent predictors of incentive spirometry performance were also identified. Postoperative incentive spirometry performance was found to be inversely proportional to pain score, which correlated significantly stronger with deep breathing pain compared with pain at rest (-0.33 vs -0.14 on postoperative day 1; -0.23 vs -0.12 on postoperative day 2). Pain with deep breathing was independently associated with poorer incentive spirometry performance in the multivariable linear regression model (P spirometry performance could be used as another indicator of thoracic epidural efficacy. This may be particularly useful in patients reporting high pain scores postoperatively.

  17. A study for a guide chart of lower and upper boundary regions to avoid the condensation-induced water hammer in a long horizontal pipe

    International Nuclear Information System (INIS)

    Lee, Byung Jin

    1995-02-01

    Effects of the key system parameters such as the pipe length, the pipe diameter, the feedwater temperature and the system pressure on the critical flow rates of both the upper and the lower boundaries have been examined for long horizontal pipes. The upper and lower critical flow rates are sensitive to the pipe diameter, the pipe length and the system pressure, but not to the feedwater temperature over the practical operating ranges. Guide charts of the CIWH region boundary have been developed to be used in the system design and operation to predict the operating conditions vulnerable to the CIWH. The charts illustrate a series of the operating ranges bounded by the lower and the upper limiting curves where the water hammer is very likely to occur. A design and operational procedure has also been provided to help the designer and the operator to avoid the CIWH

  18. Regional hardening of Upper Cretaceous Chalk in eastern England, UK: trace element and stable isotope patterns in the Upper Cenomanian and Turonian Chalk and their significance

    Science.gov (United States)

    Jeans, Christopher V.; Long, Dee; Hu, Xiu-Fang; Mortimore, Rory N.

    2014-12-01

    The regional hardening of the Late Cenomanian to Early Turonian Chalk of the Northern Province of eastern England has been investigated by examining the pattern of trace elements and stable carbon and oxygen isotopes in the bulk calcite of two extensive and stratigraphically adjacent units each 4 to 5 m thick of hard chalk in Lincolnshire and Yorkshire. These units are separated by a sequence, 0.3-1.3 m thick, of variegated marls and clayey marls. Modelling of the geochemistry of the hard chalk by comparison with the Standard Louth Chalk, combined with associated petrographic and geological evidence, indicates that (1) the hardening is due to the precipitation of a calcite cement, and (2) the regional and stratigraphical patterns of geochemical variation in the cement are largely independent of each other and have been maintained by the impermeable nature of the thin sequence of the clay-rich marls that separate them. Two phases of calcite cementation are recognised. The first phase was microbially influenced and did not lithify the chalk. It took place predominantly in oxic and suboxic conditions under considerable overpressure in which the Chalk pore fluids circulated within the units, driven by variations in compaction, temperature, pore fluid pressure and local tectonics. There is evidence in central and southern Lincolnshire of the loss of Sr and Mgenriched pore fluids to the south during an early part of this phase. The second phase of calcite precipitation was associated with the loss of overpressure in probably Late Cretaceous and in Cenozoic times as the result of fault movement in the basement penetrating the overlying Chalk and damaging the seal between the two chalk units. This greatly enhanced grain pressures, resulting in grain welding and pressure dissolution, causing lithification with the development of stylolites, marl seams, and brittle fractures. Associated with this loss of overpressure was the penetration of the chalk units by allochthonous

  19. Comparison of sediment pollution in the rivers of the Hungarian Upper Tisza Region using non-destructive analytical techniques

    International Nuclear Information System (INIS)

    Osan, Janos; Toeroek, Szabina; Alfoeldy, Balint; Alsecz, Anita; Falkenberg, Gerald; Baik, Soo Yeun; Van Grieken, Rene

    2007-01-01

    The rivers in the Hungarian Upper Tisza Region are frequently polluted mainly due to mining activities in the catchment area. At the beginning of 2000, two major mining accidents occurred in the Romanian part of the catchment area due to the failure of a tailings dam releasing huge amounts of cyanide and heavy metals to the rivers. Surface sediment as well as water samples were collected at six sites in the years 2000-2003, from the northeast-Hungarian section of the Tisza, Szamos and Tur rivers. The sediment pollution of the rivers was compared based on measurements of bulk material and selected single particles, in order to relate the observed compositions and chemical states of metals to the possible sources and weathering of pollution. Non-destructive X-ray analytical methods were applied in order to obtain different kinds of information from the same samples or particles. In order to identify the pollution sources, their magnitude and fate, complementary analyses were carried out. Heterogeneous particulate samples were analyzed from a large geographical territory and a 4-year time period. Individual particles were analyzed only from the 'hot' samples that showed elevated concentrations of heavy metals. Particles that were classified as anthropogenic were finally analyzed to identify trace concentrations and chemical states of heavy metals. Although the Tisza river was affected by water pollution due to the two major mining accidents at the beginning of 2000, the concentration of heavy metals in sediments decreased to the mineral background level 1 year after the pollution event. In the tributaries Szamos and Tur, however, no significant decrease of the heavy metal concentrations was observed in the recent years, indicating a continuous pollution. Among the water suspended particles collected from river Tur, fibers of unknown origin were observed by electron microscopy; these particles were aluminosilicates enriched in Zn and Mn. Cd was also concentrated in

  20. Indoor radon measurement in some adobe houses in the Kassena Nankana area of the Upper East Region

    International Nuclear Information System (INIS)

    Quashie, F. K.

    2010-06-01

    Inhalation of radon and its daughter products is the major contributor to the total exposure of the population to natural radiation. The present study has measured radon gas concentration in some Adobe houses and the soil radon gas around these houses in the Kassena Nankana Area of the Upper East Region by using passive radon indoor dosimeter containing solid-state nuclear track detector (SSNTD) commercially known as LR - 115 (type II, pelliculable). Fifty (50) indoor radon dosimeters were placed in the various Adobe houses in the study area. Additionally, thirty (30) dosimeters were placed in the soil around some of the houses at a depth of 75 cm. Soil radon dosimeters were retrieved after two (2) weeks while the indoor radon dosimeters were retrieved after 78 to 82 days. The detectors were then chemically etched. The digital laser optic system and the spark counter coupled with microfiche reader were used in counting both the indoor and soil detectors respectively. Indoor radon concentration in the study area range from 35.28 Bq/m 3 to 244.22 Bq/m 3 . An active dosimeter known as the radon scout plus which gives instantaneous readings between 1 to 3 hours was also used in nineteen of the adobe houses in the study area and a total average radon concentration of 56.90 Bq/m3 was obtained. The soil radon concentration was also found to range from 2.12 kBq/m 3 to 15.03 kBq/m 3 . A good correlation was found to exist between the soil radon concentration and that of the indoor radon concentration with a correlation coefficient of about 0.61. The mean radon emanation coefficient of some fifteen (15) soil samples monitored was 0.46. The average annual effective dose was estimated to be about 1.66 mSv/y and that of the average annual effective dose using the equilibrium equivalent factor (F) was 1.00 mSv/y

  1. Isolated thoracic perfusion with chemofiltration for progressive malignant pleural mesothelioma

    Directory of Open Access Journals (Sweden)

    Aigner KR

    2017-06-01

    Full Text Available Karl Reinhard Aigner, Emir Selak, Sabine Gailhofer Department of Surgical Oncology, Medias Klinikum, Burghausen, Germany Introduction: Therapy of malignant pleural mesothelioma and especially the adequate role of surgery in this context remain the subject of controversial discussions. Radical surgery in particular, which is associated with substantial morbidity, failed to translate into a definite survival advantage. We report on interim results of an ongoing Phase II study of regional chemotherapy in terms of isolated thoracic perfusion with chemofiltration (ITP-F.Patients and methods: Twenty-eight patients (25 male, 3 female, mean age 63.4 years with advanced pleural mesothelioma were included in this study. Isolation of the chest was achieved by insertion of a venous and arterial stop-flow balloon catheter via a femoral access. The aorta and inferior vena cava were blocked at the level of the diaphragm and the upper arms were blocked by pneumatic cuffs. Chemotherapy, consisting of 60 mg/m² cisplatin and 15 mg/m² mitoxantrone, was administered directly into the aorta. The isolated circuit was maintained for 15 minutes followed by ~45 minutes of chemofiltration with a hemoprocessor until 5 L of filtrate were reached. The endpoints of the study were overall survival and quality of life (QoL.Results: Out of 28 patients enrolled in the study, 5 had prior surgeries, 10 patients had systemic chemotherapy, and 5 patients additional irradiation. In all patients in restaging, clinical progress was noted. In all, 162 cycles were administered. Due to chemofiltration, toxicity was within tolerable limits, revealing World Health Organization grade I leucopenia and thrombocytopenia in 9 patients and mucositis grade I in 6 patients. The major surgical complication was inguinal lymphatic fistula in 40% of the cases. Gastrointestinal toxicity and/or neurotoxicity were never observed. One-year survival was 49%, 2-year and 3-year survival was 31%, and 5

  2. 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

  3. Automated extraction of pleural effusion in three-dimensional thoracic CT images

    Science.gov (United States)

    Kido, Shoji; Tsunomori, Akinori

    2009-02-01

    It is important for diagnosis of pulmonary diseases to measure volume of accumulating pleural effusion in threedimensional thoracic CT images quantitatively. However, automated extraction of pulmonary effusion correctly is difficult. Conventional extraction algorithm using a gray-level based threshold can not extract pleural effusion from thoracic wall or mediastinum correctly, because density of pleural effusion in CT images is similar to those of thoracic wall or mediastinum. So, we have developed an automated extraction method of pulmonary effusion by use of extracting lung area with pleural effusion. Our method used a template of lung obtained from a normal lung for segmentation of lungs with pleural effusions. Registration process consisted of two steps. First step was a global matching processing between normal and abnormal lungs of organs such as bronchi, bones (ribs, sternum and vertebrae) and upper surfaces of livers which were extracted using a region-growing algorithm. Second step was a local matching processing between normal and abnormal lungs which were deformed by the parameter obtained from the global matching processing. Finally, we segmented a lung with pleural effusion by use of the template which was deformed by two parameters obtained from the global matching processing and the local matching processing. We compared our method with a conventional extraction method using a gray-level based threshold and two published methods. The extraction rates of pleural effusions obtained from our method were much higher than those obtained from other methods. Automated extraction method of pulmonary effusion by use of extracting lung area with pleural effusion is promising for diagnosis of pulmonary diseases by providing quantitative volume of accumulating pleural effusion.

  4. Thoracic complications of rheumatoid disease

    International Nuclear Information System (INIS)

    Massey, H.; Darby, M.; Edey, A.

    2013-01-01

    Rheumatoid arthritis is a relatively common multisystem disease associated with significant mortality and morbidity. Thoracic disease, both pleural and pulmonary, is a frequent extra-articular manifestation of rheumatoid arthritis and responsible for approximately 20% of rheumatoid-associated mortality. Rheumatoid disease and its associated therapies can affect all compartments of the lung inciting a range of stereotyped pathological responses and it is not infrequent for multiple disease entities to co-exist. In some instances, development of pulmonary complications may precede typical rheumatological presentation of the disease and be the first indication of an underlying connective tissue disease. The spectrum of thoracic disease related to rheumatoid arthritis is reviewed

  5. Paleogeographic and paleo-oceanographic influences on carbon isotope signatures: Implications for global and regional correlation, Middle-Upper Jurassic of Saudi Arabia

    Science.gov (United States)

    Eltom, Hassan A.; Gonzalez, Luis A.; Hasiotis, Stephen T.; Rankey, Eugene C.; Cantrell, Dave L.

    2018-02-01

    Carbon isotope data (δ13C) can provide an essential means for refining paleogeographic and paleo-oceanographic reconstructions, and interpreting stratigraphic architecture within complex carbonate strata. Although the primary controls on global δ13C signatures of marine carbonates are well understood, understanding their latitudinal and regional variability is poor. To better constrain the nature and applications of δ13C stratigraphy, this study: 1) presents a new high-resolution δ13C stratigraphic curve from Middle to Upper Jurassic carbonates in the upper Tuwaiq Mountain, Hanifa, and lower Jubaila formations in central Saudi Arabia; 2) explores their latitudinal and regional variability; and 3) discusses their implications for stratigraphic correlations. Analysis of δ13C data identified six mappable units with distinct δ13C signatures (units 1-6) between up-dip and down-dip sections, and one unit (unit 7) that occurs only in the down-dip section of the study succession. δ13C data from the upper Tuwaiq Mountain Formation and the lower Hanifa Formation (units 1, 2), which represent Upper Callovian to Middle Oxfordian strata, and record two broad positive δ13C excursions. In the upper part of the Hanifa Formation (units 3-6, Early Oxfordian-Late Kimmeridgian), δ13C values decreased upward to unit 7, which showed a broad positive δ13C excursion. Isotopic data suggest similar δ13C trends between the southern margin of the Tethys Ocean (Arabian Plate; low latitude, represented by the study succession) and northern Tethys oceans (high latitude), despite variations in paleoclimatic, paleogeographic, and paleoceanographic conditions. Variations in the δ13C signal in this succession can be attributed to the burial of organic matter and marine circulation at the time of deposition. Our study uses δ13C signatures to provide independent data for chronostratigraphic constraints which help in stratigraphic correlations within heterogeneous carbonate successions.

  6. The Askin tumour. Neuroactodermic tumour of the thoracic wall

    International Nuclear Information System (INIS)

    Velazquez, P.; Nicolas, A. I.; Vivas, I.; Damaso Aquerreta, J.; Martinez-Cuesta, A.

    1999-01-01

    The Askin tumours is an extremely rare and malignant process in the thoracic pulmonary region during infancy and youth. The differential diagnosis has to be considered with other thoracic wall tumours that are more common in pediatrics like the undifferentiated neuroblastoma, the embionic rabdomiosarcoma, the Ewing sarcoma and the linfoma. A retrospective examination was carried out on 473 thoracic wall tumours from 1994 to 1997 at our centre, resulting in 4 patients with an anatomopathologically tested Askin tumour (ages from 13-21). All the cases were studied using simple radiography and CT. In two cases MRI was also used. The most common clinical manifestation was a palpable painful mass in the thoracic wall. In the simple radiograph the main finding was a large mass of extrapleural soft material, with costal destruction ( n=3) and a pleural effusion (n=2). In the CT study the mass was heterogeneous, with internal calcifications in one case. CT and MRI showed invasion in the mediastinum (n=1), medular channel (n=1) and phrenic and sulphrenic extension (n=1). The Askin tumour should be included in the differential diagnosis of thoracic wall masses in infant-youth ages. There are no specific morphological characteristics. Both CT and MRI are useful for the diagnosis, staging and follow up. (Author) 11 refs

  7. Extrapleural Inner Thoracic Wall Lesions: Multidetector CT Findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Soo; Kim, Young Tong; Jou, Sung Shik [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of)

    2010-06-15

    The extrapleural space is external to the parietal pleura in the thorax. The structures within and adjacent to this region include the fat pad, endothoracic fascia, intercostal muscles, connective tissue, nerves, vessels, and ribs. Further, the space is divided into the inner and outer thoracic wall by the innermost intercostal muscle. Extrapleural lesions in the inner thoracic wall are classified as air-containing lesions, fat-containing lesions, and soft tissue-containing lesions according on their main component. Air-containing lesions include extrapleural air from direct chest trauma and extrapleural extension from pneumomediastinum. Prominent extrapleural fat is seen in decreased lung volume conditions, and can also be seen in normal individuals. Soft tissue-containing lesions include extrapleural extensions from a pleural or chest wall infection as well as tumors and extrapleural hematoma. We classify extrapleural lesions in the inner thoracic wall and illustrate their imaging findings

  8. Chondrosarcoma of a thoracic vertebra

    International Nuclear Information System (INIS)

    Abdelwahab, I.F.; Casden, A.M.; Klein, M.J.; Spollman, A.

    1991-01-01

    Central chondrosarcoma is an uncommon primary malignancy of the axial skeleton which usually affects the posterior elements or the posterior part of a vertebral body. The authors present an unusual case of chondrosarcoma involving the anterior part of a thoracic vertebra with massive extravertebral extension into the posterior mediastinum. The roles of computed tomography and magnetic resonance imaging in identifying this pathology are emphasized

  9. Nanotechnology applications in thoracic surgery.

    Science.gov (United States)

    Hofferberth, Sophie C; Grinstaff, Mark W; Colson, Yolonda L

    2016-07-01

    Nanotechnology is an emerging, rapidly evolving field with the potential to significantly impact care across the full spectrum of cancer therapy. Of note, several recent nanotechnological advances show particular promise to improve outcomes for thoracic surgical patients. A variety of nanotechnologies are described that offer possible solutions to existing challenges encountered in the detection, diagnosis and treatment of lung cancer. Nanotechnology-based imaging platforms have the ability to improve the surgical care of patients with thoracic malignancies through technological advances in intraoperative tumour localization, lymph node mapping and accuracy of tumour resection. Moreover, nanotechnology is poised to revolutionize adjuvant lung cancer therapy. Common chemotherapeutic drugs, such as paclitaxel, docetaxel and doxorubicin, are being formulated using various nanotechnologies to improve drug delivery, whereas nanoparticle (NP)-based imaging technologies can monitor the tumour microenvironment and facilitate molecularly targeted lung cancer therapy. Although early nanotechnology-based delivery systems show promise, the next frontier in lung cancer therapy is the development of 'theranostic' multifunctional NPs capable of integrating diagnosis, drug monitoring, tumour targeting and controlled drug release into various unifying platforms. This article provides an overview of key existing and emerging nanotechnology platforms that may find clinical application in thoracic surgery in the near future. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  10. Thoracic periaortal fibrosis and Ormond's disease

    International Nuclear Information System (INIS)

    Kacl, G.M.; Bino, M.; Salomon, F.; Risti, B.; Marincek, B.

    1995-01-01

    Two cases of thoracic periaortal fibrosis as a manifestation of retroperitoneal fibrosis (Ormond's disease) are shown on CT and MRI. Thoracic periaortal fibrosis can result in an inflammatory aneurysmo with chronic dissection. Manifestation of thoracic periaortal fibrosis may typically occur intermittently over decades. (orig.) [de

  11. Thoracic trauma in newborn foals

    International Nuclear Information System (INIS)

    Jean, D.; Laverty, S.; Halley, J.; Hannigan, D.; Leveille, R.

    1999-01-01

    In a report describing life ending fractures (255 horses) from the Livestock Disease Diagnostic Center, Kentucky (1993 and 1994), 32 foals had rib fractures. The purpose of our study was to examine the incidence of rib fractures in newborn foals on a Thoroughbred studfarm by physical and radiographic examination, to determine factors which may contribute to the problem and to document any clinical consequences. All foals (263) included were examined within 3 days of birth. The thoracic cage was palpated externally for abnormalities and all foals were placed in dorsal recumbency to evaluate thoracic cage symmetry. Radiographs were used to diagnose foals with thoraciccage asymmetry (TCA) and rib fracture (RF). A diagnosis of costochondral dislocation (CD) was made when no radiographic evidence of fracture was present but there was severe TCA, Fifty-five foals (20.1%) had TCA (9 RF), One to 5 ribs were fractured on 9 of 40 radiographic studies. No consequences of the thoracic trauma was detected clinically, radiographically or ultrasonographically in this group of foals or at a 2- and 4-week follow-up examination. The percentage of foals with a history of abnormal parturition was higher in the TCA foals (15%) compared to the normal foals (6.8%). There weremore primiparous dams in the TCA group than in the normal foal group. Fillies (56.6%) had a higher incidence of birth trauma than colts (43.4%), Thisstudy demonstrates that thoracic trauma is often present in newborn foals and may not always be of clinical significance. Dystocia foals and foals from primiparous mares should be considered high risk for thoracic trauma

  12. Main factors controlling the sedimentation of high-quality shale in the Wufeng–Longmaxi Fm, Upper Yangtze region

    Directory of Open Access Journals (Sweden)

    Yuman Wang

    2017-09-01

    Full Text Available In this paper, the shale of Upper Ordovician Wufeng Fm–Lower Silurian Longmaxi Fm was taken as an example to reveal the distribution patterns and the main sedimentation controlling factors of high-quality shale in the Upper Yangtze region. This study was made from the aspects of plate movement, fluctuation of sea level, palaeo-productivity, deposition rate and paleogeographic environment, based on the field outcrop sections and drilling data of the southern Sichuan Basin, together with geochemical element testing and biostratigraphical analysis results. The following findings were obtained. First, the collision and joint of Yangtze Plate and its periphery plates and the intra-plate deformation were gentle in the early stage, strong in the late stage, gentle in northwest and strong in southeast, so the sedimentation center in the Upper Yangtze region migrated to the northwest and the closure of sea area in the southern Sichuan Basin changed from weak in early stages to strong in late stages. Second, at the turning period from Ordovician to Silurian, sea levels presented the cycle change of deep–shallow–deep–shallow. Due to the combination of high sea levels and a stable ocean basin in early stages, an extensive anoxic tectonic sedimentary space favorable for organic matters preservation was formed in the sea floor. Third, due to the effect of tectonic movements and sea closure, palaeo-productivity of sea areas in the southern Sichuan Basin presented a trend of being high in the early stage and low in the late stage, and the deposition rate was also low in the early stage and high in the late stage. And fourth, extensive deposition and distribution of shale rich in organic matters and silica was mainly controlled by a stable sea basin with a low subsidence rate, a relatively high sea level, semi-closed waters and low deposition rates. To sum up, the high-quality shale in the Upper Yangtze region is characterized by multiphase

  13. Rule of lymph node metastasis and proper target of postoperative radiotherapy for thoracic esophageal carcinoma

    International Nuclear Information System (INIS)

    Xiao Zefen; Zhou Zongmei; Lv Jima; Liang Jun; Ou Guangfei; Jin Jing; Song Yongwen; Zhang Shiping; Yin Weibo

    2008-01-01

    Objective: To analyze the rule of lymph node metastasis in thoracic esophageal carcinoma, and to study the proper radiation target. Methods: From September 1986 to December 1997,549 patients with esophageal carcinoma who had undergone radical resection were divided into surgery alone group (S,275 patients) or surgery plus radiotherapy group(S + R,274 patients). Radiotherapy was begun 3 to 4 weeks after operation. The radiation target included both supra-clavicular areas and the entire mediastinum. The total dose was 50 Gy in 25 fractions over 5 weeks for the supra-clavicular areas and 60 Gy in 30 fractions over 6 weeks for the entire mediastinum. Results: The 5-year overall survival of patients with lymph node metastasis in one anatomic site and two anatomic sites was 31.5% and 13.9% (P=0.013), respectively. For patients with > 2 positive nodes metastasis receiving surgery alone, the corresponding 5-year survival was 24.8% and 4.9% (P=0.046), respectively. The median number of dissected lymph nodes of the upper-, middle-and lower-segment esophageal carcinoma was 13, 17 and 20, respectively. The rate of metastatic lymph node in the para-esophagus region was the highest(61.5%-64.9%), which was not different among the different primary sites (P=0.922). The anastomotic stoma recurrence rate of the upper-segment esophageal carcinoma was higher than that of the middle- or lower-segment carcinomas (16.7%, 3.1%, and 7.7%, χ 2 =9.02,P<0.05). Conclusions: For the thoracic esophageal carcinoma, the number of anatomic sites of lymph node metastasis is an important factor affecting the survival. The lower rate of lymph node metastasis of the upper segment esophageal carcinoma may be corrected with the less lymph node dissected. The rate of lymph node metastasis in para-esophageal region is not related with the lesion segment. The anastomotic stoma is an important radiotherapy target for upper segment esophageal carcinoma. (authors)

  14. [Biomedicine in thoracic surgery: state of the art].

    Science.gov (United States)

    Leistner, M; Steinke, M; Walles, T

    2013-06-01

    Biomedicine represents a new scientific field at the interface of human, molecular and cell biology and medicine. Comprising the diverse disciplines of stem cell research, tissue engineering and material sciences, biomedicine gives rise to new approaches in research and therapy for - to date - unmet medical issues. Biomedical research is currently conducted in many medical, especially surgical subspecialties, and a number of successful developments have already been brought to clinical application. Concerning thoracic surgery, biomedical approaches are pursued primarily for tissue and organ replacement of the upper airways, lung and thoracic wall. In spite of a comparatively small research foundation, five different concepts have been clinically implemented worldwide, due to a lack of established treatment options in the case of extensive disease of the greater airways. In this review, the clinical background and the tissue-specific basics of tracheobronchial biomedicine are presented. Georg Thieme Verlag KG Stuttgart · New York.

  15. Identification of fish nursery areas in a free tributary of an impoundment region, upper Uruguay River, Brazil

    Directory of Open Access Journals (Sweden)

    Patrícia Alves da Silva

    2012-01-01

    Full Text Available This study aims to determine the importance of different environments of the Ligeiro River (upper Uruguay River, Brazil in fish reproduction. For this purpose, three environments (sampling sites were selected: rapids, a pool, and the mouth of the Ligeiro River. Ichthyoplankton, zooplankton, and benthos were sampled six times per month from September, 2006 to March, 2007. Zooplankton and ichthyoplankton samples were collected early in the evening with plankton nets (64 µm and 500 µm, respectively. Benthos samples were also collected early in the evening with a Van Veen dredge. Local abiotic variables (temperature, dissolved oxygen, pH, electrical conductivity, water speed, alkalinity, water hardness, and water transparency were measured simultaneously with the biotic data sampling and were complemented by regional variables (water flow and precipitation. A total of 43,475 eggs and 2,269 larvae were captured. Of these larvae, 80.1% were in the pre-flexion and larval yolk stages. Digestive tract content showed that the greatest degree of repletion among the larvae in more advanced phases occurred in the pool environment. Water speed was the main characteristic used to differentiate the river's rapids and mouth from the pool. The abundance of zooplankton and benthos was not related to the distribution of densities among the different components of the ichthyoplankton. A greater abundance of eggs and larvae with yolk was found in the rapids and river mouth. Ordination analyses showed a connection between the advanced stage larvae and the pool environment. In conclusion, the rapids and river mouth of the Ligeiro River's are important locations for fish reproduction, particularly in regard to spawning and drifting of the ichthyoplankton's initial stages, whereas the pool represents a nursery place for larval growth.O presente estudo visa determinar a importância de diferentes ambientes do rio Ligeiro (alto rio Uruguai/Brasil na reprodução dos

  16. Regional diagenesis of sandstone in the Upper Jurassic Morrison Formation, San Juan Basin, New Mexico and Colorado

    International Nuclear Information System (INIS)

    Hansley, P.L.

    1990-01-01

    The author reports that early authigenic mineral assemblages and vitroclastic textures are very well preserved in upper sandstones of the Upper Jurassic Morrison Formation. The distributions of the authigenic minerals were controlled, in part, by chemical gradients in a large saline, alkaline lake (Lake T'oo'dichi) that existed in late Morrison time. Sandstones on lake margins were cemented by smectite and silica, whereas sandstones nearer the lake center, in which waters were most saline and alkaline, were cemented by zeolites. Diagenetic alterations in sandstones were promoted by alkaline interstitial waters that emanated from adjacent fine-grained, tuffaceous lake beds. Metastable phases that precipitated first were replaced relatively quickly by more stable, ordered phases in the geochemically favorable environment of the closed basin setting. Elevation of temperatures above the geothermal gradient was proved by the influx of warm, deep-basin waters that locally modified early diagenetic assemblages during burial diagenesis. In organic- (and commonly also uranium ore-) bearing sandstones located primarily in the southern part of the basin, complex diagenetic assemblages resulted from water/rock reactions involving soluble organic complexes

  17. EFFECT OF SITTING POSTURE ON THORACIC CONFIGURATION AND CHANGES IN VOLUME OF HEMITHORACES

    Directory of Open Access Journals (Sweden)

    Shōbo A

    2017-06-01

    Full Text Available Background: Poor posture is detrimental to breathing. Our purpose was to investigate the effect of upright and hunchbacked sitting on thoracic configuration and changes in the volume of the thorax during quiet and volitional deep breathing. Methods: The participants were 11 healthy men with a mean age of 21.6 years, mean body mass of 59.8 kg, mean height of 169.7 cm and a body mass index of 20.7 kg/m2. Eighty-four reflective markers were placed on the trunk. Three-dimensional motion analysis measured the volume within the hemithoraces. To calculate upper and lower thoracic volumes, six imaginary hexahedra were visualized using four reflective markers for each on both aspects of the thorax. Each hexahedron was divided into three imaginary triangular pyramids to calculate positional vectors. Finally, the volume for the hexahedra and triangular pyramids was calculated. Upper thoracic volume encompassed a space from the sternal notch to a midpoint on the ventral aspect of the third rib and the lower thoracic volume from the xiphoid process to the midpoint on tenth rib’s dorsal aspect. Results: In hunchbacked sitting during quiet breathing the left lower hemithorax yielded a significantly larger volume (p=0.003, and both breathing patterns during inspiration and expiration yielded a significantly greater change in thoracic configuration (p=0.01, p=0.016. Conclusion: Findings suggested that, in a hunchbacked sitting, there was decreased thoracic asymmetry with re-establishment of thoracic vertebral alignment, consequently stabilizing the sitting position, but breathing was suppressed and tidal volume decreased. Physiotherapy should aim at ensuring correction of hunchbacked posture and maintenance of thoracic symmetry.

  18. New simple mathematical model to help evaluating the extent of the late-Quaternary valley glacier in the Upper Soča Region (NW Slovenia

    Directory of Open Access Journals (Sweden)

    Miloš Bavec

    2002-06-01

    Full Text Available A simple mathematical model was developed that enables an evaluation of a valley glacier extent independently of any geological data. Based on glaciological criteria and on quantitative analysis of the glacier’s accumulation-, and ablation-areas the modeloffers an opportunity for an independent test of paleoenvironmental interpretations that are traditionally based on (often vague and difficult-to-interpret geomorphological and sedimentological information. The model is presented here through a case study from theUpper Soča River Region.

  19. A Methology for Assessing the Regional Transportation Energy Demands of Different Spatial Residential Development Scenarios: a Case Study for the Upper Housatonic River Basin, Massachusetts

    Science.gov (United States)

    Oski, J. A.; Fabos, J. G.; Gross, M.

    1982-01-01

    A method is suggested whereby regional landscape planning efforts can be aided by the use of a geographic information system to determine sites for more energy efficient residential and mixed use developments within a study area. The location of land parcels suited for residential and mixed land use developments in the Upper Housatonic River Basin Study Area in Berkshire County, Massachusetts is described as well as the three development options. Significant steps in the procedure are discussed and the computation of the transportation energy requirement is elaborated.

  20. CT-guided stellate ganglion blockade vs. radiofrequency neurolysis in the management of refractory type I complex regional pain syndrome of the upper limb

    Energy Technology Data Exchange (ETDEWEB)

    Kastler, Adrian [University Hospital CHU Gabriel Montpied, Radiology Department, Clermont-Ferrand (France); Franche Comte University, I4S Laboratory-EA 4268-IFR 133, Besancon (France); CHU Clermont-Ferrand, Hopital Gabriel Montpied, Clermont-Ferrand (France); Aubry, Sebastien; Kastler, Bruno [University Hospital CHU Jean Minjoz, Radiology and Interventional Pain Unit, Besancon (France); Franche Comte University, I4S Laboratory-EA 4268-IFR 133, Besancon (France); Sailley, Nicolas; Michalakis, Demosthene [University Hospital CHU Jean Minjoz, Radiology and Interventional Pain Unit, Besancon (France); Siliman, Gaye [University Hospital CHU St Jacques, Clinical Investigation Center, Besancon (France); Gory, Guillaume [Franche Comte University, I4S Laboratory-EA 4268-IFR 133, Besancon (France); Lajoie, Jean-Louis [University Hospital CHU Jean Minjoz, Pain evaluation and Management Unit, Besancon (France)

    2013-05-15

    To describe and evaluate the feasibility and efficacy of CT-guided radiofrequency neurolysis (RFN) vs. local blockade of the stellate ganglion in the management of chronic refractory type I complex regional pain syndrome (CRPS) of the upper limb. Sixty-seven patients were included in this retrospective study between 2000 and 2011. All suffered from chronic upper limb type I CRPS refractory to conventional pain therapies. Thirty-three patients underwent stellate ganglion blockade and 34 benefited from radiofrequency neurolysis of the stellate ganglion. CT guidance was used in both groups. The procedure was considered effective when pain relief was {>=}50 %, lasting for at least 2 years. Thirty-nine women (58.2 %) and 28 men (41.8 %) with a mean age of 49.5 years were included in the study. Univariate analysis performed on the blockade and RFN groups showed a significantly (P < 0.0001) higher success rate in the RFN group (67.6 %, 23/34) compared with the blockade group (21.2 %, 7/33) with an odds ratio of 7.76. CT-guided radiofrequency neurolysis of the stellate ganglion is a safe and successful treatment of chronic refractory type I CRPS of the upper limb. It appears to be more effective than stellate ganglion blockade. (orig.)

  1. Ultrasonographyin diagnosis of thoracic diseases

    OpenAIRE

    Stević Ruža; Jaković Radoslav; Mašulović Dragan; Nagorni-Obradović Ljudmila; Mujović Nataša; Jovanović Dragana

    2010-01-01

    Introduction. Chest sonography was used until recently mainly for diagnosis of pleural diseases. High resolution ultrasound machines enable ultrasound application not only in pleural diseases detection, but in diagnosing peripheral lung and mediastinal lesions. Ultrasonography can define the origin and structure of the lesion of thoracic wall, pleural and peripheral lung lesions and mediastinal lesions. Pleural lesions. Ultrasonography is very useful in diagnosing pleural effusion and disting...

  2. Radiofrequency Denervation Improves Health-Related Quality of Life in Patients with Thoracic Zygapophyseal Joint Pain.

    Science.gov (United States)

    Hambraeus, Johan; Hambraeus, Kjerstin S; Persson, Jan

    2018-05-01

    To describe a practical approach for the diagnosis and treatment of thoracic zygapophyseal joint pain and to present preliminary clinical data on the effects of this treatment approach on health-related quality of life. An observational study. Specialist outpatient pain clinic in northern Sweden. Patients with long-term thoracic pain. We describe a method of radiofrequency denervation of thoracic zygapophyseal joints. We compared health-related quality of life between patients who underwent radiofrequency denervation of thoracic zygapophyseal joints and patients who underwent radiofrequency denervation for lumbar and cervical zygapophyseal joint pain. Treatment according to the Spine Intervention Society Guidelines was performed on the lumbar region in 178 patients and in the cervical region in 55 patients. Another 82 patients were treated in the thoracic region with our proposed technique. A survival plot of improvements in health-related quality of life revealed that all three treatments were effective in 65% or more of patients. The improvement in health-related quality of life was maintained for 12 or more months after treatment in 47% to 51% of patients. Our results suggest that radiofrequency denervation of thoracic zygapophyseal joint pain is as effective as radiofrequency denervation, the standard treatment, for lumbar and cervical zygapophyseal joint pain. If these results can be confirmed by other centers, radiofrequency denervation is likely to become more widely available for the treatment of thoracic zygapophyseal joint pain.

  3. Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions

    International Nuclear Information System (INIS)

    Hao, D.J.; He, B.R.; Liu, T.J.; Zhao, Q.P.; Sun, H.H.; Jiang, Y.H.

    2011-01-01

    Background. Inconsistent accuracies of CT-guided thoracic spinal biopsies have been reported in previous studies. Purpose. To determine the accuracy of CT-guided thoracic spinal biopsy, to compare the results with those previously reported, and to determine if there are any factors that influence the accuracy of CT-guided thoracic spinal biopsy. Material and Methods. In total, 158 consecutive CT-guided percutaneous thoracic spine procedures (performed at the Dept. of Spinal Surgery, Xian Red Cross Hospital between April 2000 and July 2010) were reviewed. The 158 lesions were categorized by location and radiographic features. Pathological and clinical follow-up were used to determine accuracy. Results. The diagnostic accuracy of CT-guided thoracic spinal biopsy was 90.5% overall. Biopsy of metastatic bone disease (98.2%) was significantly more accurate than biopsies of primary tumors (80.9%) and of hematological malignancies (47.0%) (P < 0.05 and P < 0.005, respectively). The diagnostic accuracy of CT-guided thoracic spinal biopsy was significantly higher for the lower thoracic spine (97.6%) than for the middle (90.0%) or upper thoracic spine (80.4%) (P < 0.05 and P < 0.025, respectively). The diagnostic accuracy was significantly higher for lytic lesions (96.4%) than for sclerotic lesions (81.3%) (P < 0.010). The accuracy of biopsies performed using the transpedicular approach (91.0%) was not significantly different from that of biopsies performed using posterolateral approaches (91.5%) (0.25 < P < 0.5). Conclusion. Percutaneous CT-guided thoracic spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was not affected by any of the variables except for lesion level, histology, and radiographic features

  4. Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hao, D.J.; He, B.R.; Liu, T.J.; Zhao, Q.P. (Dept. of Spinal Surgery, Xian Red Cross Hospital, Xian Shaanxi (China)), email: zqpddn1@gmail.com; Sun, H.H. (Dept. of Orthopaedic, Tangdu Hospital, Fourth Military Medical Univ., Xian Shaanxi (China)); Jiang, Y.H. (Dept. of Radiology, Xian Red Cross Hospital, Xian Shaanxi (China))

    2011-11-15

    Background. Inconsistent accuracies of CT-guided thoracic spinal biopsies have been reported in previous studies. Purpose. To determine the accuracy of CT-guided thoracic spinal biopsy, to compare the results with those previously reported, and to determine if there are any factors that influence the accuracy of CT-guided thoracic spinal biopsy. Material and Methods. In total, 158 consecutive CT-guided percutaneous thoracic spine procedures (performed at the Dept. of Spinal Surgery, Xian Red Cross Hospital between April 2000 and July 2010) were reviewed. The 158 lesions were categorized by location and radiographic features. Pathological and clinical follow-up were used to determine accuracy. Results. The diagnostic accuracy of CT-guided thoracic spinal biopsy was 90.5% overall. Biopsy of metastatic bone disease (98.2%) was significantly more accurate than biopsies of primary tumors (80.9%) and of hematological malignancies (47.0%) (P < 0.05 and P < 0.005, respectively). The diagnostic accuracy of CT-guided thoracic spinal biopsy was significantly higher for the lower thoracic spine (97.6%) than for the middle (90.0%) or upper thoracic spine (80.4%) (P < 0.05 and P < 0.025, respectively). The diagnostic accuracy was significantly higher for lytic lesions (96.4%) than for sclerotic lesions (81.3%) (P < 0.010). The accuracy of biopsies performed using the transpedicular approach (91.0%) was not significantly different from that of biopsies performed using posterolateral approaches (91.5%) (0.25 < P < 0.5). Conclusion. Percutaneous CT-guided thoracic spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was not affected by any of the variables except for lesion level, histology, and radiographic features

  5. Recent changes in sediment redistribution in the upper parts of the fluvial system of European Russia: regional aspects

    Directory of Open Access Journals (Sweden)

    O. P. Yermolaev

    2015-03-01

    Full Text Available Quantitative assessments of soil loss from cultivated land and sediment redistribution along pathways from cultivated fields to river channels have been undertaken using a range of different methods and techniques, including erosion models, detailed studies of sediment redistribution in representative catchments, monitoring of gully head retreat and evaluation of sediment deposition in ponds and small reservoirs. Most of the sediment eroded from arable land is deposited between the lower portions of the cultivated slopes and the river channels. Less than 15% of the eroded sediment is delivered to the river channels. Sediment redistribution rates in the upper parts of the fluvial system have declined during the last 25 years in both the western and eastern parts of the Russian Plain, because of a major reduction of surface runoff during snowmelt and a reduction of the area of arable land in some parts of the study area.

  6. Thoracic manual therapy is not more effective than placebo thoracic manual therapy in patients with shoulder dysfunctions: A systematic review with meta-analysis.

    Science.gov (United States)

    Bizzarri, Paolo; Buzzatti, Luca; Cattrysse, Erik; Scafoglieri, Aldo

    2018-02-01

    Manual treatments targeting different regions (shoulder, cervical spine, thoracic spine, ribs) have been studied to deal with patients complaining of shoulder pain. Thoracic manual treatments seem able to produce beneficial effects on this group of patients. However, it is not clear whether the patient improvement is a consequence of thoracic manual therapy or a placebo effect. To compare the efficacy of thoracic manual therapy and placebo thoracic manual treatment for patients with shoulder dysfunction. Electronic databases (MEDLINE, CENTRAL, PEDro, CINAHL, WoS, EMBASE, ERIC) were searched through November 2016. Randomized Controlled Trials assessing pain, mobility and function were selected. The Cochrane bias estimation tool was applied. Outcome results were either extracted or computed from raw data. Meta-analysis was performed for outcomes with low heterogeneity. Four studies were included in the review. The methodology of the included studies was generally good except for one study that was rated as high risk of bias. Meta-analysis showed no significant effect for "pain at present" (SMD -0.02; 95% CI: -0.35, 0.32) and "pain during movement" (SMD -0.12; 95% CI: -0.45, 0.21). There is very low to low quality of evidence that a single session of thoracic manual therapy is not more effective than a single session of placebo thoracic manual therapy in patients with shoulder dysfunction at immediate post-treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. The chemical effects on the summertime ozone in the upper troposphere and lower stratosphere over the Tibetan Plateau and the South Asian monsoon region

    Science.gov (United States)

    Gu, Yixuan; Liao, Hong; Xu, Jianming; Zhou, Guangqiang

    2018-01-01

    We use the global three-dimensional Goddard Earth Observing System chemical transport model with the Universal tropospheric-stratospheric Chemistry eXtension mechanism to examine the contributions of the chemical processes to summertime O3 in the upper troposphere and lower stratosphere (UTLS) over the Tibetan Plateau and the South Asian monsoon region (TP/SASM). Simulated UTLS O3 concentrations are evaluated by comparisons with Microwave Limb Sounder products and net chemical production of O3 (NPO3) are evaluated by comparisons with model results in previous studies. Simulations show that the chemical processes lead to an increase in O3 concentration, which is opposite to the effect of O3 transport in the UTLS over the TP/SASM region throughout the boreal summer. NPO3 in UTLS over the TP/SASM region is the largest in summer. Elevated values (0.016-0.020 Tg year-1) of the seasonal mean NPO3 are simulated to locate at 100 hPa in the TP/SASM region, where the mixing ratios of O3 are low and those of O3 precursors (NO x , VOCs, and CO) are high. The high concentrations of O3 precursors (NO x , VOCs, and CO) together with the active photochemical reactions of NO2 in the UTLS over the TP/SASM region during summertime could be important reasons for the enhancement of {NP}_{{{O}3 }} over the studied region.

  8. The vectoral role of several blackfly species (Diptera: Simuliidae) in relation to human onchocerciasis in the Sierra Parima and Upper Orinoco regions of Venezuela.

    Science.gov (United States)

    Basáñez, M G; Yarzábal, L; Takaoka, H; Suzuki, H; Noda, S; Tada, I

    1988-12-01

    Experimental and natural infections with Onchocerca volvulus were studied in several anthropophilic blackfly species present in the endemic area of the Upper Orinoco region of Venezuela. When fed on four different Yanomami volunteers in the Sierra Parima, the total infection rate was 31.4% for Simulium guianense in comparison with 7.5% for S. limbatum. The proportion of ingested microfilariae that entered the thorax during the first 24 hours and completed development to the infective stage was also much lower in the latter than in the former species. There was no larval development of O. volvulus in S. antillarum, but one female harboured in its head six infective larvae of a zoonotic filaria. When S. oyapokense s.l. was fed on an infected volunteer in the Upper Orinoco most flies ingested few microfilariae, and further development reached only the L1 stage. Natural infection and infectivity rates for S. guianense in two localities of the Sierra Parima were 0.2-4.0% and 1.3-10.2%, respectively, more than 50% of the L3 larvae being in the head. The corresponding data for S. oyapockense s.l. in the Upper Orinoco were 0.1-0.5%, although the only L3 larva found did not correspond to O. volvulus. It is suggested that S. guianense is the main vector of onchocerciasis in the Sierra Parima and that S. limbatum could play a secondary role. Simulium oyapockense s.l. replaces them in the Upper Orinoco and may maintain a degree of transmission, but its epidemiological importance remains to be assessed.

  9. Thoracic aortic aneurysms and dissections: endovascular treatment.

    Science.gov (United States)

    Baril, Donald T; Cho, Jae S; Chaer, Rabih A; Makaroun, Michel S

    2010-01-01

    The treatment of thoracic aortic disease has changed radically with the advances made in endovascular therapy since the concept of thoracic endovascular aortic repair was first described 15 years ago. Currently, there is a diverse array of endografts that are commercially available to treat the thoracic aorta. Multiple studies, including industry-sponsored and single-institution reports, have demonstrated excellent outcomes of thoracic endovascular aortic repair for the treatment of thoracic aortic aneurysms, with less reported perioperative morbidity and mortality in comparison with conventional open repair. Additionally, similar outcomes have been demonstrated for the treatment of type B dissections. However, the technology remains relatively novel, and larger studies with longer term outcomes are necessary to more fully evaluate the role of endovascular therapy for the treatment of thoracic aortic disease. This review examines the currently available thoracic endografts, preoperative planning for thoracic endovascular aortic repair, and outcomes of thoracic endovascular aortic repair for the treatment of both thoracic aortic aneurysms and type B aortic dissections. Mt Sinai J Med 77:256-269, 2010. (c) 2010 Mount Sinai School of Medicine.

  10. Reconstruction of cervical scar contracture using axial thoracic flap based on the thoracic branch of the supraclavicular artery.

    Science.gov (United States)

    Ma, Xianjie; Li, Yang; Wang, Lu; Li, Weiyang; Dong, Liwei; Xia, Wei; Su, Yingjun

    2014-09-01

    Cervical scar contracture causes both physical and psychological distress for burn patients. Many pedicle flaps or skin grafting have been suggested for reconstruction of cervical scar contracture with variable results in the literature. The authors present the axial thoracic flap based on the thoracic branch of the supraclavicular artery (TBSA) for reconstruction of cervical scar contracture. Postburn scar contractures in anterior neck region of 66 patients had been reconstructed with the axial pattern thoracic flaps based on the TBSA, including 1 expanded and 10 nonexpanded pedicle flaps, and 9 expanded and 46 nonexpanded island pedicle flaps, during 1988 through 2012. After removing and releasing the cervical scar contracture, the flap was designed in the thoracic region. The axial artery of the flap is the TBSA bifurcating from the intersection point of sternocleidomastoid muscle and omohyoid muscle with several concomitant veins as the axial veins. The flap can be designed in a large area within the borders of the anterior border of the trapezius muscle superiorly, the middle part of the deltoid muscle laterally, the midsternal line medially, and the level 3 to 4 cm below nipples inferiorly. After incisions were made along the medial, inferior, and lateral border, dissection was performed toward the pedicle. Donor site was closed directly in expanded cases and with skin grafting in nonexpanded cases. Cervical scar contractures were repaired with good functional and cosmetic results in 64 cases among this cohort. Flap tip necrosis in other 2 cases, caused by postoperative hematoma, was repaired by skin grafting. The color and texture of all flaps were fitted with those of the surrounding skin. The donor sites all healed primarily. The flap sensation in the thoracic region regained in the early stage postoperatively and that in cervical area recovered completely after 6 months according to the report of the patients. With reliable blood supply based on the

  11. Regional variations in upper mantle compressional velocities beneath southern California 1. Post-shock temperatures: Their experimental determination, calculation, and implications, 2.. Ph.D. Thesis

    Science.gov (United States)

    Raikes, S. A.

    1978-01-01

    The compressional velocity within the upper mantle beneath Southern California is investigated through observations of the dependence of teleseismic P-delays at all stations of the array on the distance and azimuth to the event. The variation of residuals with azimuth was found to be as large as 1.3 sec at a single station; the delays were stable as a function of time, and no evidence was found for temporal velocity variations related to seismic activity in the area. These delays were used in the construction of models for the upper mantle P-velocity structure to depths of 150 km, both by ray tracing and inversion techniques. The models exhibit considerable lateral heterogeneity including a region of low velocity beneath the Imperial Valley, and regions of increased velocity beneath the Sierra Nevada and much of the Transverse Ranges. The development is described of a technique for the experimental determination of post-shock temperatures, and its application to several metals and silicates shocked to pressures in the range 5 to 30 GPa. The technique utilizes an infra-red radiation detector to determine the brightness temperature of the free surface of the sample after the shock wave has passed through it.

  12. Transient Upper Crustal Tear Illuminated by the Chi Chi Earthquake: Results from Strain Inversions in the Luliao Region, Taiwan

    Science.gov (United States)

    Lamont, E. A.; Lewis, J.; Byrne, T. B.; Crespi, J. M.; Rau, R.

    2010-12-01

    Modeling of earthquake focal mechanisms and coseismic GPS data from an area at the southern tip of the 1999 Chi Chi rupture suggests the existence of an evolving upper plate tear. The earthquakes occur in what we refer to as the Luliao seismic zone and define a steeply northeast-dipping tabular volume that extends from the surface to approximately 11 km. We find that the focal mechanisms from the six-month period following the 1999 Chi-Chi Earthquake yield best-fitting strain tensors that suggest the dominance of strike-slip faulting. Our strain inversions, using a micropolar continuum model, reveal orogen-perpendicular (NW-SE) minimum stretching (i.e., shortening) and orogen-parallel (NE-SW) maximum stretching. Additionally, our inversions indicate plane strain with positive, non-zero relative vorticity values, suggestive of counter-clockwise (map view) block rotations. Published coseismic GPS data provide additional evidence that this tabular volume of crust is the locus of strike-slip faulting accompanied by block rotation. Preliminary 2D strain inversions for GPS stations that span the inverted focal mechanisms reveal negative (counterclockwise) rotation values and principal strain axes that are generally consistent with our focal mechanism inversions. We interpret our findings to reflect an accommodation zone that is activated by differential westward expansion of the foreland fold and thrust belt. In particular, this zone separates an area of greater westward propagation near Taichung from an area of lesser propagation to the south near Chiayi. Differential expansion of the orogen appears to be influenced by an eastward pointing, lower-plate promontory south of the Sanyi-Puli seismic zone. Unlike the Luliao events, the Sanyi-Puli seismic zone extends from the near surface to approximately 30 km and we have interpreted it as a reactivated continental margin fracture zone inherited from South China Sea rifting. The lower-plate promontory is coincident with the

  13. Streamflow in the upper Mississippi river basin as simulated by SWAT driven by 20{sup th} century contemporary results of global climate models and NARCCAP regional climate models

    Energy Technology Data Exchange (ETDEWEB)

    Takle, Eugene S.; Jha, Manoj; Lu, Er; Arritt, Raymond W.; Gutowski, William J. [Iowa State Univ. Ames, IA (United States)

    2010-06-15

    We use Soil and Water Assessment Tool (SWAT) when driven by observations and results of climate models to evaluate hydrological quantities, including streamflow, in the Upper Mississippi River Basin (UMRB) for 1981-2003 in comparison to observed streamflow. Daily meteorological conditions used as input to SWAT are taken from (1) observations at weather stations in the basin, (2) daily meteorological conditions simulated by a collection of regional climate models (RCMs) driven by reanalysis boundary conditions, and (3) daily meteorological conditions simulated by a collection of global climate models (GCMs). Regional models used are those whose data are archived by the North American Regional Climate Change Assessment Program (NARCCAP). Results show that regional models correctly simulate the seasonal cycle of precipitation, temperature, and streamflow within the basin. Regional models also capture interannual extremes represented by the flood of 1993 and the dry conditions of 2000. The ensemble means of both the GCM-driven and RCM-driven simulations by SWAT capture both the timing and amplitude of the seasonal cycle of streamflow with neither demonstrating significant superiority at the basin level. (orig.)

  14. Simulation of Runoff Changes Caused by Cropland to Forest Conversion in the Upper Yangtze River Region, SW China

    Science.gov (United States)

    Yu, Pengtao; Wang, Yanhui; Coles, Neil; Xiong, Wei; Xu, Lihong

    2015-01-01

    The "Grain for Green Project" is a country-wide ecological program to converse marginal cropland to forest, which has been implemented in China since 2002. To quantify influence of this significant vegetation change, Guansihe Hydrological (GSH) Model, a validated physically-based distributed hydrological model, was applied to simulate runoff responses to land use change in the Guansihe watershed that is located in the upper reaches of the Yangtze River basin in Southwestern China with an area of only 21.1 km2. Runoff responses to two single rainfall events, 90 mm and 206 mm respectively, were simulated for 16 scenarios of cropland to forest conversion. The model simulations indicated that the total runoff generated after conversion to forest was strongly dependent on whether the land was initially used for dry croplands without standing water in fields or constructed (or walled) paddy fields. The simulated total runoff generated from the two rainfall events displayed limited variation for the conversion of dry croplands to forest, while it strongly decreased after paddy fields were converted to forest. The effect of paddy terraces on runoff generation was dependent on the rainfall characteristics and antecedent moisture (or saturation) conditions in the fields. The reduction in simulated runoff generated from intense rainfall events suggested that afforestation and terracing might be effective in managing runoff and had the potential to mitigate flooding in southwestern China. PMID:26192181

  15. Active monitoring with lichens in the Linz region (Upper Austria); Aktives Monitoring mit Flechten in der Landeshauptstadt Linz (Oberoesterreich, Oesterreich)

    Energy Technology Data Exchange (ETDEWEB)

    Heber, I; Heber, W; Tuerk, R

    1993-12-31

    A bio-monitoring project to asses air quality was run in the city of Linz (Upper Austria) between October 1990 and November 1991. The project used Hypogymnia physodes samples which were exposed according to VDI specifications (No. 3799). The climatic conditions of October 1990 resulted in a high atmospheric pollution load which caused almost all of the lichens exposed (82 plates) to die within four weeks. New samples were exposed in November 1990 and their damage rates indicated a clear zoning of emission input loads of the city of Linz in the period December 1990 to March 1991. (orig.) [Deutsch] In der Landeshauptstadt Linz (Oesterreich, Oberoesterreich) wurde im Zeitraum von Oktober 1990 bis November 1991 ein Biomonitoring-Projekt zur Bewertung der Luftguete durchgefuehrt. Dabei wurden Proben von Hypogymnia physodes entsprechend den Anleitungen des VDI (Nr. 3799) exponiert. Bereits waehrend des Oktober 1990 fuehrten die klimatischen Gegebenheiten zu einer hohen Belastung der Atmosphaere mit Schadstoffen, so dass fast alle exponierten Flechten (82 Tafeln) innerhalb von vier Wochen vollstaendig abstarben. Die im November 1990 neu exponierten Proben liessen fuer den Zeitraum Dezember 1990 bis Maerz 1991 bereits eine deutliche Zonierung der Immissionsbelastung in der Stadt Linz aufgrund der Schaedigungsraten der Flechten erkennen. (orig.)

  16. November 2015 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-11-01

    Full Text Available No abstract available. Article truncated after 150 words. The November 2015 Arizona Thoracic Society meeting was held on Wednesday, November 18, 2015 at the Scottsdale Shea Hospital beginning at 6:30 PM. This was a dinner meeting with case presentations. There were 14 in attendance representing the pulmonary, critical care, sleep, and radiology communities. There were 3 case presentations: 1. Dr. Gerald Schwartzberg presented a case of a 56-year-old man with a history of diabetes, alcoholism and tobacco abuse who has a history of Mycobacterium avium-intracellulare (MAI with a residual thin-walled cavity in his right upper lobe (RUL. After quitting drinking and smoking and years of being asymptomatic, he presented with hemoptysis. Chest x-ray showed increasing density in the RUL. CT scan showed an intracavitary density in his previous cavity presumably a fungus ball. Sputum cultures are pending. Discussion followed on management of fungus balls. Bronchoscopy was recommended to view the bronchial anatomy to exclude other diagnosis as well ...

  17. A rare malformation of urinary system: Right ectopic thoracic kidney

    Directory of Open Access Journals (Sweden)

    Musab Ilgi

    2017-01-01

    Full Text Available An ectopic kidney is a common developmental anomaly of the urinary system. However, the thoracic kidney (TK is the rarest state form of an aberrant kidney. The aim of this case report is defining the symptoms in TK diagnosis and constructing a treatment model will promote the best outcomes. These patients come to the physician with the various symptoms, and they could be diagnosed incidentally. In our case, we describe 40 years female patient with severe respiratory problems and upper back pain. In the pulmonary clinic, suspected mass was diagnosed with chest X-ray, and computerized tomography detected nontraumatic nonhernia associated, a truly ectopic TK. Moreover, the thoracic surgeon and urologist team decided to exploration and reconstructed the right ectopic kidney. The 1st month of the control of patient symptoms was disappeared. Overall, TK should be kept in mind in the differential diagnosis of thoracic tumors. Surgical exploration and reconstruction should be thought in patients who have severe respiratory symptoms.

  18. Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition

    Directory of Open Access Journals (Sweden)

    Fu-Tai Wang

    2015-07-01

    Full Text Available Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD can decompose a signal into several intrinsic mode functions (IMFs that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method.

  19. Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition.

    Science.gov (United States)

    Wang, Fu-Tai; Chan, Hsiao-Lung; Wang, Chun-Li; Jian, Hung-Ming; Lin, Sheng-Hsiung

    2015-07-07

    Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD) can decompose a signal into several intrinsic mode functions (IMFs) that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method.

  20. Quantitative controls on location and architecture of carbonate depositional sequences: upper miocene, cabo de gata region, se Spain

    Science.gov (United States)

    Franseen, E.K.; Goldstein, R.H.; Farr, M.R.

    1998-01-01

    Sequence stratigraphy, pinning-point relative sea-level curves, and magnetostratigraphy provide the quantitative data necessary to understand how rates of sea-level change and different substrate paleoslopes are dominant controls on accumulation rate, carbonate depositional sequence location, and internal architecture. Five third-order (1-10 my) and fourth-order (0.1-1.0 my) upper Miocene carbonate depositional sequences (DS1A, DS1B, DS2, DS3, TCC) formed with superimposed higher-frequency sea-level cycles in an archipelago setting in SE Spain. Overall, our study indicates when areas of high substrate slope (> 15??) are in shallow water, independent of climate, the location and internal architecture of carbonate deposits are not directly linked to sea-level position but, instead, are controlled by location of gently sloping substrates and processes of bypass. In contrast, if carbonate sediments are generated where substrates of low slope ( 15.6 cm/ky to ??? 2 cm/ky and overall relative sea level rose at rates of 17-21.4 cm/ky. Higher frequency sea-level rates were about 111 to more than 260 cm/ky, producing onlapping, fining- (deepening-) upward cycles. Decreasing accumulation rates resulted from decreasing surface area for shallow-water sediment production, drowning of shallow-water substrates, and complex sediment dispersal related to the archipelago setting. Typical systems tract and parasequence development should not be expected in "bypass ramp" settings; facies of onlapping strata do not track base level and are likely to be significantly different compared to onlapping strata associated with coastal onlap. Basal and upper DS2 reef megabreccias (indicating the transition from cool to warmer climatic conditions) were eroded from steep upslope positions and redeposited downslope onto areas of gentle substrate during rapid sea-level falls (> 22.7 cm/ky) of short duration. Such rapid sea-level falls and presence of steep slopes are not conducive to formation of

  1. Seismic Velocity Structure of the Pacific Upper Mantle in the NoMelt Region from Finite-Frequency Traveltime Tomography

    Science.gov (United States)

    Hung, S. H.; Lin, P. Y.; Gaherty, J. B.; Russell, J. B.; Jin, G.; Collins, J. A.; Lizarralde, D.; Evans, R. L.; Hirth, G.

    2017-12-01

    Surface wave dispersion and magnetotelluric survey from the NoMelt Experiment conducted on 70 Ma central Pacific seafloor revealed an electrically resistive, high shear wave velocity lid of 80 km thick underlain by a non-highly conductive, low-velocity layer [Sarafian et al., 2015; Lin et al., 2016]. The vertical structure of the upper mantle consistent with these observational constraints suggests a plausible convection scenario, where the seismically fast, dehydrated lithosphere preserving very strong fossil spreading fabric moves at a constant plate speed over the hydrated, melt-free athenospheric mantle with the presence of either pressure-driven return flow or thermally-driven small scale circulation. To explore 3-D variations in compressional shear wave velocities related to the lithospheric and asthenospheric mantle dynamics, we employ a multichannel cross correlation method to measure relative traveltime residuals based on the vertical P and traverse S waveforms filtered at 10-33 s from telseismic earthquakes at epicentral distance between 30 and 98 degrees. The obtained P and S residuals show on average peak-to-peak variations of ±0.5 s and ±1 s, respectively, across the NoMelt OBS array. Particularly, the P residuals for most of the events display an asymmetrical pattern with respect to an axis oriented nearly N-S to NE-SW through the array. Preliminary ray-based P tomography results reveal similar asymmetric variations in the uppermost 100 km mantle. To verify the resulting structural features, we will further perform both the P and S traveltime tomography and resolution tests based on a multiscale finite-frequency approach which properly takes into account both the 3D off-path sensitivities of the measured residuals and data-adaptive resolution of the model.

  2. Etiology and outcome in patients with upper gastrointestinal bleeding: Study on 4747 patients in the central region of Iran.

    Science.gov (United States)

    Minakari, Mohammad; Badihian, Shervin; Jalalpour, Pooyan; Sebghatollahi, Vahid

    2017-04-01

    Upper gastrointestinal bleeding (UGIB) is a threatening condition leading to urgent hospitalization. This study aims to investigate etiology and outcome in UGIB patients in Iran. Medical records of GIB patients admitted to Alzahra referral hospital (in Isfahan) during 2010-2015 were retrospectively reviewed for demographic data, comorbidities, history of smoking and taking non-steroidal anti-inflammatory drugs (NSAIDs), presenting symptoms, endoscopic findings, therapeutic endoscopy, blood products' infusion, surgical intervention, rebleeding, and mortality. A total of 4747 patients were enrolled in the study (69.2% men, mean age = 55.46 ± 21.98 years). Hematemesis was the most frequent presenting symptom (63.5%). Peptic ulcer (duodenal ulcer in most cases) was seen as the main reason for UGIB (42.4%). Rebleeding (present in 16.5% of patients) was found to be more frequent in patients with older age, presenting sign of hematochezia and hypotension, history of taking NSAIDs and smoking, presence of comorbidities, history of bleeding because of UGI tract neoplasm and esophageal varices, history of needing blood products' infusion, and history of therapeutic endoscopy or surgical intervention (P < 0.005). We found that mortality (5.5% in total) was also higher in the same group of patients that were seen to have a higher tendency for rebleeding (P < 0.005). Peptic ulcers are the most common cause of UGIB. Comorbidities, hemodynamic instability, high-risk endoscopic stigmata, history of smoking and taking NSAIDs, gastric and esophageal malignancies, may be important predisposing factors for rebleeding and mortality in patients with UGIB. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  3. Classification and Use of Natural and Anthropogenic Soils by Indigenous Communities of the Upper Amazon Region of Colombia

    OpenAIRE

    Peña-Venegas, C.P.; Stomph, T.J.; Verschoor, G.; Echeverri, J.A.; Struik, P.C.

    2016-01-01

    Outsiders often oversimplify Amazon soil use by assuming that abundantly available natural soils are poorly suited to agriculture and that sporadic anthropogenic soils are agriculturally productive. Local perceptions about the potentials and limitations of soils probably differ, but information on these perceptions is scarce. We therefore examined how four indigenous communities in the Middle Caquetá River region in the Colombian Amazon classify and use natural and anthropogenic soils. The st...

  4. Appearance and chronology of Textile ceramics in the Middle and Upper Volga region: critical comparison of conventional 14C-, AMS- and typological chronologies

    Directory of Open Access Journals (Sweden)

    Lavento Mika T.

    2015-06-01

    Full Text Available The article offers a comparison of three different methods of chronology construction – conventional 14C (radiocarbon dating, AMS (accelerator mass-spectrometry dating and the so called typological chronology – to date the textile ceramics of the Bronze – Early Iron Age in the Northern Coniferous Zone of Europe, from the Upper and Middle Volga and Kama Rivers to the Baltic region and Scandinavia. The Textile Ceramics Culture (also known as “Net”, “Pseudo-textile”, “Spun-and-speckled” is often associated with a Finnish-speaking community from the Bronze – beginning of the Iron Age. The earliest date of the Textile Ceramics sites on the Middle Oka River is presumably considered to be the 18 th century BC. Datings of the reference sites in the Middle Volga region were fixed within the 15 th – 8 th centuries BC. Comparing these data with the AMS chronology available for the materials from Finland and Estonia, the authors conclude that appearance of the Textile Ceramics was almost synchronous in the Volga and the Baltic regions, although chronology of the early tradition of the Textile Ceramics seems to be different in these areas. The results of yet a small number of AMS dates should be treated only as preliminary. However, AMS-dating seems to be the most efficient tool for further refining of the Textile Ceramics chronology over a vast territory, including in the Volga region.

  5. Their grass is greener but ours is sweeter - thoroughbred breeding and water management in the Upper Hunter region of New South Wales, Australia

    Energy Technology Data Exchange (ETDEWEB)

    McManus, P. [University of Sydney, Sydney, NSW (Australia). School for Geoscience

    2008-05-15

    The Upper Hunter region (in New South Wales (NSW) around Scone is reputed to be the second most significant thoroughbred breeding region in the world after the Bluegrass region of Kentucky. This article identifies the importance and cultural constructions of grass, and hence water, in the thoroughbred breeding industry in this region. Thoroughbred stud managers attempt to produce environments attractive to potential horse purchasers and owners with mares to be mated. These environments are constructed from perceptions of how a thoroughbred stud should appear, and from the physical conditions of specific locations. One perception is that the grass should be green. There are differing opinions in the thoroughbred breeding industry about the nutritional value of irrigated grasses, the role of these grasses in horse development and the associated access to, cost of and efficacy of water used for this purpose. The paper concludes that effective water management in this industry is only possible if various cultures of nature are understood, where necessary challenged, and subsequently included in policy and planning.

  6. Pneumothorax in severe thoracic traumas

    International Nuclear Information System (INIS)

    Camassa, N.W.; Boccuzzi, F.; Diettorre, E.; Troilo, A.

    1988-01-01

    The authors reviewed CT scans and supine chest X-ray of 47 patients affected by severe thoracic trauma, examined in 1985-86. The sensibility of the two methodologies in the assessment of pneumothorax was compared. CT detected 25 pneumothorax, whereas supine chest X-ray allowed a diagnosis in 18 cases only. In 8 of the latter (44.4%) the diagnosis was made possible by the presence of indirect signs of pneumothorax only - the most frequent being the deep sulcus sign. The characterization of pneumothorax is important especially in the patients who need to be treated with mechanical ventilation therapy, or who are to undergo surgery in total anaesthesia

  7. The disappearance of Picea at the end of Upper Pleistocene in the Basque-Cantabrian region: climatic and anthropogenic factors

    International Nuclear Information System (INIS)

    Uzquiano, P.

    1995-01-01

    Charcoal analysis from archaeological sites in Cantabrian region (North of Spain) has yielded evidence of Picea charcoal in Late-Wurmian sediments. Taking into account the behaviour of this taxon in Quaternary climatic cycles, data suggest the presence of small localities of low-density populations near each catchment area of prehistoric settlements. The different function of each site and hunter-gatherers'logistical moves closer to the economic resources are responsible for the presence or absence of Picea, and for the disappearance of its last localities. (author). 16 refs., 4 figs

  8. Radionuclide content in the Upper Vistula River sediments in a coal mining region in Poland (east-central Europe)

    International Nuclear Information System (INIS)

    Jasinska, M.; Mietelski, J.W.; Pociask-Karteczka, J.

    1998-01-01

    Hard coal mining activity is one of the Technologically Enhanced Natural Radiation sources introduced more than a hundred years ago in the southern part of Poland. This study of radionuclides (K-40, Ra-226, Ra-228) in river sediments showed the principal factors determining the specific activity of radionuclides are distance from mines and sorption by clay particles in river sediments. The K-40 specific activity varies between 185 and 595 Bq/kg. The highest Ra-228 and Ra-226 specific activities, 280-610 and 205-415 Bq/kg, respectively, were detected in sediments of the Vistula in the vicinity of Silesia region. 7 refs., 1 fig., 3 tabs

  9. Thoracic dysfunction in whiplash associated disorders: A systematic review

    Science.gov (United States)

    Smith, Richard; Tyros, Isaak; Falla, Deborah; Rushton, Alison

    2018-01-01

    Background Research investigating Whiplash Associated Disorder (WAD) has largely focused on the cervical spine yet symptoms can be widespread. Thoracic spine pain prevalence is reported ~66%; perhaps unsurprising given the forceful stretch/eccentric loading of posterior structures of the spine, and the thoracic spine’s contribution to neck mobility/function. Approximately 50% WAD patients develop chronic pain and disability resulting in high levels of societal and healthcare costs. It is time to look beyond the cervical spine to fully understand anatomical dysfunction in WAD and provide new directions for clinical practice and research. Purpose To evaluate the scope and nature of dysfunction in the thoracic region in patients with WAD. Methods A systematic review and data synthesis was conducted according to a pre-defined, registered (PROSPERO, CRD42015026983) and published protocol. All forms of observational study were included. A sensitive topic-based search strategy was designed from inception to 1/06/16. Databases, grey literature and registers were searched using a study population terms and key words derived from scoping search. Two reviewers independently searched information sources, assessed studies for inclusion, extracted data and assessed risk of bias. A third reviewer checked for consistency and clarity. Extracted data included summary data: sample size and characteristics, outcomes, and timescales to reflect disorder state. Risk of bias was assessed using the Newcastle-Ottawa Scale. Data were tabulated to allow enabling a semi-qualitative comparison and grouped by outcome across studies. Strength of the overall body of evidence was assessed using a modified GRADE. Results Thirty eight studies (n>50,000) which were conducted across a range of countries were included. Few authors responded to requests for further data (5 of 9 contacted). Results were reported in the context of overall quality and were presented for measures of pain or dysfunction and

  10. Segmental thoracic spinal anesthesia in patient with Byssinosis undergoing nephrectomy.

    Science.gov (United States)

    Patel, Kiran; Salgaonkar, Sweta

    2012-01-01

    Byssinosis is an occupational disease occurring commonly in cotton mill workers; it usually presents with features of chronic obstructive pulmonary disease (COPD). The management of patients with COPD presents a significant challenges to the anesthetist. Regional anesthesia is preferred in most of these patients to avoid perioperative and postoperative complications related to general anesthesia. We report a known case of Byssinosis who underwent nephrectomy under segmental spinal anesthesia at the low thoracic level.

  11. A regional composite-face effect for species-specific recognition: Upper and lower halves play different roles in holistic processing of monkey faces.

    Science.gov (United States)

    Wang, Zhe; Quinn, Paul C; Jin, Haiyang; Sun, Yu-Hao P; Tanaka, James W; Pascalis, Olivier; Lee, Kang

    2018-04-25

    Using a composite-face paradigm, we examined the holistic processing induced by Asian faces, Caucasian faces, and monkey faces with human Asian participants in two experiments. In Experiment 1, participants were asked to judge whether the upper halves of two faces successively presented were the same or different. A composite-face effect was found for Asian faces and Caucasian faces, but not for monkey faces. In Experiment 2, participants were asked to judge whether the lower halves of the two faces successively presented were the same or different. A composite-face effect was found for monkey faces as well as for Asian faces and Caucasian faces. Collectively, these results reveal that own-species (i.e., own-race and other-race) faces engage holistic processing in both upper and lower halves of the face, but other-species (i.e., monkey) faces engage holistic processing only when participants are asked to match the lower halves of the face. The findings are discussed in the context of a region-based holistic processing account for the species-specific effect in face recognition. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. A Habitat-based Wind-Wildlife Collision Model with Application to the Upper Great Plains Region

    Energy Technology Data Exchange (ETDEWEB)

    Forcey, Greg, M.

    2012-08-28

    Most previous studies on collision impacts at wind facilities have taken place at the site-specific level and have only examined small-scale influences on mortality. In this study, we examine landscape-level influences using a hierarchical spatial model combined with existing datasets and life history knowledge for: Horned Lark, Red-eyed Vireo, Mallard, American Avocet, Golden Eagle, Whooping Crane, red bat, silver-haired bat, and hoary bat. These species were modeled in the central United States within Bird Conservation Regions 11, 17, 18, and 19. For the bird species, we modeled bird abundance from existing datasets as a function of habitat variables known to be preferred by each species to develop a relative abundance prediction for each species. For bats, there are no existing abundance datasets so we identified preferred habitat in the landscape for each species and assumed that greater amounts of preferred habitat would equate to greater abundance of bats. The abundance predictions for bird and bats were modeled with additional exposure factors known to influence collisions such as visibility, wind, temperature, precipitation, topography, and behavior to form a final mapped output of predicted collision risk within the study region. We reviewed published mortality studies from wind farms in our study region and collected data on reported mortality of our focal species to compare to our modeled predictions. We performed a sensitivity analysis evaluating model performance of 6 different scenarios where habitat and exposure factors were weighted differently. We compared the model performance in each scenario by evaluating observed data vs. our model predictions using spearmans rank correlations. Horned Lark collision risk was predicted to be highest in the northwestern and west-central portions of the study region with lower risk predicted elsewhere. Red-eyed Vireo collision risk was predicted to be the highest in the eastern portions of the study region and in

  13. Thoracic organ transplantation: laboratory methods.

    Science.gov (United States)

    Patel, Jignesh K; Kobashigawa, Jon A

    2013-01-01

    Although great progress has been achieved in thoracic organ transplantation through the development of effective immunosuppression, there is still significant risk of rejection during the early post-transplant period, creating a need for routine monitoring for both acute antibody and cellular mediated rejection. The currently available multiplexed, microbead assays utilizing solubilized HLA antigens afford the capability of sensitive detection and identification of HLA and non-HLA specific antibodies. These assays are being used to assess the relative strength of donor specific antibodies; to permit performance of virtual crossmatches which can reduce the waiting time to transplantation; to monitor antibody levels during desensitization; and for heart transplants to monitor antibodies post-transplant. For cell mediated immune responses, the recent development of gene expression profiling has allowed noninvasive monitoring of heart transplant recipients yielding predictive values for acute cellular rejection. T cell immune monitoring in heart and lung transplant recipients has allowed individual tailoring of immunosuppression, particularly to minimize risk of infection. While the current antibody and cellular laboratory techniques have enhanced the ability to manage thoracic organ transplant recipients, future developments from improved understanding of microchimerism and graft tolerance may allow more refined allograft monitoring techniques.

  14. Imaging of thoracic aortic dissection

    International Nuclear Information System (INIS)

    Vu, F.H.; Young, N.; Soo, Y.S.

    1994-01-01

    Acute thoracic aortic dissection has a high mortality rate if untreated, so the diagnosis must be rapidly made. Multiple imaging techniques are often used. This retrospective study from 1988 to 1993 assesses the usefulness in diagnosis of chest X-rays, computed tomography (CT) scanning, aortography, magnetic resonance imaging (MRI), trans-thoracic (TTE) and trans-oesophageal (TOE) echocardiography. Forty-two patients with a final clinical diagnosis of dissection were studied. The diagnosis was confirmed in 16 (13 at surgery and three at autopsy). Three died with dissection given as the only cause of death. Chest X-ray abnormalities were seen in all 19 patients with surgery or death from dissection, with a widened mediastinum and/or dilated aorta being present in 17. In the group of 16 patients with surgery or autopsy proof, CT scans found dissections in 9 out of 12 patients studied and correctly classified the type in only five. Aortography was preformed in five, with accurate depiction of dissection and type in all. TTE found dissections in three of eight patients imaged by this method. MRI and TOE were preformed each on two patients, with accurate depiction of dissection and type in each. Because of the relatively low sensitivity of CT scanning in defining aortic dissections Westmead Hospital is currently assessing the use of TOE as the prime imaging modality prior to surgical intervention. 17 refs., 4 tabs., 4 figs

  15. Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia: A Feasible Economical Alternative

    OpenAIRE

    Kejriwal, Aditya Kumar; Begum, Shaheen; Krishan, Gopal; Agrawal, Richa

    2017-01-01

    Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml?1 mixed with 0.5 ml of fentanyl 50 ?g ml?1. Other drugs we...

  16. Thoracic spinal anesthesia is safe for patients undergoing abdominal cancer surgery

    OpenAIRE

    Ellakany, Mohamed Hamdy

    2014-01-01

    Aim: A double-blinded randomized controlled study to compare discharge time and patient satisfaction between two groups of patients submitted to open surgeries for abdominal malignancies using segmental thoracic spinal or general anesthesia. Background: Open surgeries for abdominal malignancy are usually done under general anesthesia, but many patients with major medical problems sometimes can’t tolerate such anesthesia. Regional anesthesia namely segmental thoracic spinal anesthesia may be b...

  17. Classification and Use of Natural and Anthropogenic Soils by Indigenous Communities of the Upper Amazon Region of Colombia.

    Science.gov (United States)

    Peña-Venegas, C P; Stomph, T J; Verschoor, G; Echeverri, J A; Struik, P C

    Outsiders often oversimplify Amazon soil use by assuming that abundantly available natural soils are poorly suited to agriculture and that sporadic anthropogenic soils are agriculturally productive. Local perceptions about the potentials and limitations of soils probably differ, but information on these perceptions is scarce. We therefore examined how four indigenous communities in the Middle Caquetá River region in the Colombian Amazon classify and use natural and anthropogenic soils. The study was framed in ethnopedology: local classifications, preferences, rankings, and soil uses were recorded through interviews and field observations. These communities recognized nine soils varying in suitability for agriculture. They identified anthropogenic soils as most suitable for agriculture, but only one group used them predominantly for their swiddens. As these communities did not perceive soil nutrient status as limiting, they did not base crop-site selection on soil fertility or on the interplay between soil quality and performance of manioc genetic resources.

  18. Regional stratigraphy and its dependency on tectonic movements (case study: Upper Cretaceous and Paleogene stages in Western Siberia)

    International Nuclear Information System (INIS)

    Podobina, V

    2015-01-01

    Multiscale and divergent tectonic movements have been identified in Western Siberia of which first - order movements caused transgressions and regressions, as well as the partial formation of sediments. As a result of tectonic movement direction turn, no transgression was observed in the cross-sections of Campanian and Danian central section and in the Priabonian top section. During second-order tectonic movements and undirectional transgression insignificant bed thicknesses and channels were formed. Such movements could have included different tectonic activities within the western and eastern parts of the region limited by the Koltogorsk-Urengoy Rift. Third-order tectonic movement of moderate amplitude promoted either extension, contraction or even depth variations of the marine basin itself

  19. Satellite and ground measurements of latitude distribution of upper ionosphere parameters in the region of the main trough of ionization

    International Nuclear Information System (INIS)

    Filippov, V.M.; Alekseev, V.N.; Afonin, V.V.

    1988-01-01

    Results of simultaneous complex measurements of subauroral ionosphere structure at observations of charged-particle precipitation at Interkosmos-19 satellite, electron concentration and temperature at Kosmos-900 satellite, ionosphere parameters and plasma convection at Zhigansk (L∼4) and Jakutsk (L∼3) stations and 630.0 mm line luminescence by scanning photometer at Zhigansk station, carried out on the 26 - 27.03.1979, are presented. It is found, that the through polar edge is formed by low-energy electron precipitations in diffuse auroral zone. It is confirmed by spatial coincidence of diffuse precipitations equatorial boundary, determined by satellite and ground optical measurements, with the ionization main through polar edge, determined by ground ionospherical observation and satellite measurements Ne at Kosmos-900 satellite. Results of these complex experiments show as well, that one of the main mechanisms of main ionospherical through formation may be plasma convection peculiarities within F region at subauroral zone widthes

  20. Constraining controls on carbonate sequences with high-resolution chronostratigraphy: Upper Miocene, Cabo de Gata region, SE Spain

    Science.gov (United States)

    Montgomery, P.; Farr, M.R.; Franseen, E.K.; Goldstein, R.H.

    2001-01-01

    A high-resolution chronostratigraphy has been developed for Miocene shallow-water carbonate strata in the Cabo de Gata region of SE Spain for evaluation of local, regional and global factors that controlled platform architecture prior to and during the Messinian salinity crisis. Paleomagnetic data were collected from strata at three localities. Mean natural remanent magnetization (NRM) ranges between 1.53 ?? 10-8 and 5.2 ?? 10-3 Am2/kg. Incremental thermal and alternating field demagnetization isolated the characteristic remanent magnetization (ChRM). Rock magnetic studies show that the dominant magnetic mineral is magnetite, but mixtures of magnetite and hematite occur. A composite chronostratigraphy was derived from five stratigraphic sections. Regional stratigraphic data, biostratigraphic data, and an 40Ar/39Ar date of 8.5 ?? 0.1 Ma, for an interbedded volcanic flow, place the strata in geomagnetic polarity Chrons C4r to C3r. Sequence-stratigraphic and diagenetic evidence indicate a major unconformity at the base of depositional sequence (DS)3 that contains a prograding reef complex, suggesting that approximately 250 000 yr of record (Subchrons C3Br.2r to 3Br.1r) are missing near the Messinian-Tortonian boundary. Correlation to the GPTS shows that the studied strata represent five third- to fourth-order DSs. Basal units are temperate to subtropical ramps (DS1A, DS1B, DS2); these are overlain by subtropical to tropical reefal platforms (DS3), which are capped by subtropical to tropical cyclic carbonates (Terminal Carbonate Complex, TCC). Correlation of the Cabo de Gata record to the Melilla area of Morocco, and the Sorbas basin of Spain indicate that early - Late Tortonian ramp strata from these areas are partially time-equivalent. Similar strata are extensively developed in the Western Mediterranean and likely were influenced by a cool climate or influx of nutrients during an overall rise in global sea-level. After ramp deposition, a sequence boundary (SB3) in

  1. Advancements in robotic-assisted thoracic surgery.

    Science.gov (United States)

    Steenwyk, Brad; Lyerly, Ralph

    2012-12-01

    Advancements in robotic-assisted thoracic surgery present potential advantages for patients as well as new challenges for the anesthesia and surgery teams. This article describes the major aspects of the surgical approach for the most commonly performed robotic-assisted thoracic surgical procedures as well as the pertinent preoperative, intraoperative, and postoperative anesthetic concerns. Copyright © 2012. Published by Elsevier Inc.

  2. Thoracic duct lymphography by subcutaneous contrast agent ...

    African Journals Online (AJOL)

    A second lymphography revealed a collateral thoracic duct that was not detected during the first lymphography. The collateral duct was ligated and chylothorax was resolved after the second surgery. The lymphography applied in this study was minimally-invasive and easily provided images of the thoracic duct in a dog with ...

  3. Visualization of the thoracic duct by lymphoscintigraphy

    International Nuclear Information System (INIS)

    Baulieu, F.; Baulieu, J.L.; Itti, R.; Tours Univ., 37

    1987-01-01

    Imaging of the thoracic duct is usually performed by radiological lymphography. However, this procedure, which uses an oil based dye injected directly into the lymph channels, has some adverse effects. In this paper we note that lymphoscintigraphy, a physiological and non invasive method, may visualize thoracic duct abnormalities, and might be particularly usefull when radiological lymphography is contraindicated. (orig.)

  4. Bilateral locked facets in the thoracic spine

    NARCIS (Netherlands)

    M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)

    1984-01-01

    textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

  5. Rare thoracic cancers, including peritoneum mesothelioma

    NARCIS (Netherlands)

    Siesling, Sabine; van der Zwan, Jan Maarten; Izarzugaza, Isabel; Jaal, Jana; Treasure, Tom; Foschi, Roberto; Ricardi, Umberto; Groen, Harry; Tavilla, Andrea; Ardanaz, Eva

    Rare thoracic cancers include those of the trachea, thymus and mesothelioma (including peritoneum mesothelioma). The aim of this study was to describe the incidence, prevalence and survival of rare thoracic tumours using a large database, which includes cancer patients diagnosed from 1978 to 2002,

  6. Rare thoracic cancers, including peritoneum mesothelioma

    NARCIS (Netherlands)

    Siesling, Sabine; Zwan, J.M.V.D.; Izarzugaza, I.; Jaal, J.; Treasure, T.; Foschi, R.; Ricardi, U.; Groen, H.; Tavilla, A.; Ardanaz, E.

    2012-01-01

    Rare thoracic cancers include those of the trachea, thymus and mesothelioma (including peritoneum mesothelioma). The aim of this study was to describe the incidence, prevalence and survival of rare thoracic tumours using a large database, which includes cancer patients diagnosed from 1978 to 2002,

  7. Upper mantle structure of shear-waves velocities and stratification of anisotropy in the Afar Hotspot region

    Science.gov (United States)

    Sicilia, D.; Montagner, J.-P.; Cara, M.; Stutzmann, E.; Debayle, E.; Lépine, J.-C.; Lévêque, J.-J.; Beucler, E.; Sebai, A.; Roult, G.; Ayele, A.; Sholan, J. M.

    2008-12-01

    The Afar area is one of the biggest continental hotspots active since about 30 Ma. It may be the surface expression of a mantle "plume" related to the African Superswell. Central Africa is also characterized by extensive intraplate volcanism. Around the same time (30 Ma), volcanic activity re-started in several regions of the African plate and hotspots such as Darfur, Tibesti, Hoggar and Mount Cameroon, characterized by a significant though modest volcanic production. The interactions of mantle upwelling with asthenosphere, lithosphere and crust remain unclear and seismic anisotropy might help in investigating these complex interactions. We used data from the global seismological permanent FDSN networks (GEOSCOPE, IRIS, MedNet, GEO- FON, etc.), from the temporary PASSCAL experiments in Tanzania and Saudi Arabia and a French deployment of 5 portable broadband stations surrounding the Afar Hotspot. A classical two-step tomographic inversion from surface waves performed in the Horn of Africa with selected Rayleigh wave and Love wave seismograms leads to a 3D-model of both S V velocities and azimuthal anisotropy, as well as radial SH/ SV anisotropy, with a lateral resolution of 500 km. The region is characterized by low shear-wave velocities beneath the Afar Hotspot, the Red Sea, the Gulf of Aden and East of the Tanzania Craton to 400 km depth. High velocities are present in the Eastern Arabia and the Tanzania Craton. The results of this study enable us to rule out a possible feeding of the Central Africa hotspots from the "Afar plume" above 150-200 km. The azimuthal anisotropy displays a complex pattern near the Afar Hotspot. Radial anisotropy, although poorly resolved laterally, exhibits S H slower than S V waves down to about 150 km depth, and a reverse pattern below. Both azimuthal and radial anisotropies show a stratification of anisotropy at depth, corresponding to different physical processes. These results suggest that the Afar hotspot has a different and

  8. Seismological observations at the Northern Andean region of Colombia: Evidence for a shallowly subducting Caribbean Slab and an extensional regime in the upper plate

    Science.gov (United States)

    Monsalve, G.; Cardona, A.; Yarce, J.; Alvira, D.; Poveda, E.

    2013-05-01

    A number of seismological observations, among which we can mention teleseismic travel time residuals, P to S receiver functions and Pn velocity quantification, suggest a clear distinction between the seismic structure of the crust and uppermost mantle between the plains on the Caribbean coast of Colombia and the mountains at the Northern Andean region. Absolute and relative travel time residuals indicate the presence of a seismically fast material in the upper mantle beneath northern Colombia; preliminary results of Pn studies show a region of relatively slow Pn velocities (between 7.8 and 7.9 km/s) underneath the Caribbean coast, contrasting with values greater than 8 km/s beneath the Central and Western cordilleras of Colombia, and the Pacific coast; receiver functions suggest a significantly thinner crust beneath the Caribbean coast, with a crustal thickness between 25 and 30 km, than beneath the Northern Andean zone at the cordilleras of Colombia, where it exceeds 40 km and reaches about 57 km at the location of Bogota. Besides the obviuos discrepancies that appear in response to different topography, we think that the seismological observations are a consequence of the presence of two very distinct slab segments beneath Colombia and contrasting behaviors of the upper plate, which correspond to Caribbean and Nazca subductions. Our seismic observations can be explained by a shallowly subducting Caribbean Plate, in the absence of an asthenospheric wedge, that steepens at about the location of the Bucaramanga nest, and a thinned continental crust that reflects an extensional component linked to oblique convergence of the Caribbean, which contrasts with the crustal thickening in the Andean Cordillera linked to crustal shortening and Nazca plate subuction. These new data are consistent with the idea of of a relatively warm Nazca slab of Neogene age which seems to have a relatively frontal convergence, and a colder, more buoyant Caribbean slab which represents an

  9. Suitability of selected bioindicators of atmospheric pollution in the industrialised region of Ostrava, Upper Silesia, Czech Republic.

    Science.gov (United States)

    Francová, Anna; Chrastný, Vladislav; Šillerová, Hana; Kocourková, Jana; Komárek, Michael

    2017-08-29

    This study is a continuation of our preceding research identifying suitable environmental samples for the tracing of atmospheric pollution in industrial areas. Three additional types of environmental samples were used to characterise contamination sources in the industrial area of Ostrava city, Czech Republic. The region is known for its extensive metallurgical and mining activities. Fingerprinting of stable Pb isotopes was applied to distinguish individual sources of anthropogenic Pb. A wide range of 206 Pb/ 207 Pb ratios was observed in the investigated samples: 206 Pb/ 207 Pb = 1.168-1.198 in mosses; 206 Pb/ 207 Pb = 1.167-1.215 in soils and 206 Pb/ 207 Pb = 1.158-1.184 in tree cores. Black and brown coal combustion, as well as metallurgical activities, is the two main sources of pollution in the area. Fossil fuel burning in industry and households seems to be a stronger source of Pb emissions than from the metallurgical industry. Concentration analyses of tree rings showed that a significant increase in As concentrations occurred between 1999 and 2016 (from 0.38 mg kg -1 to 13.8 mg kg -1 ). This shift corresponds to the use of brown coal from Bílina, Czech Republic, with an increased As concentration. The burning of low-quality fuels in households remains a problem in the area, as small ground sources have a greater influence on the air quality than do industrial sources.

  10. Lower thoracic degenerative spondylithesis with concomitant lumbar spondylosis.

    Science.gov (United States)

    Hsieh, Po-Chuan; Lee, Shih-Tseng; Chen, Jyi-Feng

    2014-03-01

    Degenerative spondylolisthesis of the spine is less common in the lower thoracic region than in the lumbar and cervical regions. However, lower thoracic degenerative spondylolisthesis may develop secondary to intervertebral disc degeneration. Most of our patients are found to have concomitant lumbar spondylosis. By retrospective review of our cases, current diagnosis and treatments for this rare disease were discussed. We present a series of 5 patients who experienced low back pain, progressive numbness, weakness and even paraparesis. Initially, all of them were diagnosed with lumbar spondylosis at other clinics, and 1 patient had even received prior decompressive lumbar surgery. However, their symptoms continued to progress, even after conservative treatments or lumbar surgeries. These patients also showed wide-based gait, increased deep tendon reflex (DTR), and urinary difficulty. All these clinical presentations could not be explained solely by lumbar spondylosis. Thoracolumbar spinal magnetic resonance imaging (MRI), neurophysiologic studies such as motor evoked potential (MEP) or somatosensory evoked potential (SSEP), and dynamic thoracolumbar lateral radiography were performed, and a final diagnosis of lower thoracic degenerative spondylolisthesis was made. Bilateral facet effusions, shown by hyperintense signals in T2 MRI sequence, were observed in all patients. Neurophysiologic studies revealed conduction defect of either MEP or SSEP. One patient refused surgical management because of personal reasons. However, with the use of thoracolumbar orthosis, his symptoms/signs stabilized, although partial lower leg myelopathy was present. The other patients received surgical decompression in association with fixation/fusion procedures performed for managing the thoracolumbar lesions. Three patients became symptom-free, whereas in 1 patient, paralysis set in before the operation; this patient was able to walk with assistance 6 months after surgical decompression

  11. Shoulder Pain After Thoracic Surgery

    DEFF Research Database (Denmark)

    Blichfeldt-Eckhardt, Morten R; Andersen, Claus; Ørding, Helle

    2017-01-01

    OBJECTIVES: To study the time course of ipsilateral shoulder pain after thoracic surgery with respect to incidence, pain intensity, type of pain (referred versus musculoskeletal), and surgical approach. DESIGN: Prospective, observational cohort study. SETTING: Odense University Hospital, Denmark...... for musculoskeletal involvement (muscle tenderness on palpation and movement) with follow-up 12 months after surgery. Clinically relevant pain was defined as a numeric rating scale score>3. Of the 60 patients included, 47 (78%) experienced ipsilateral shoulder pain, but only 25 (42%) reported clinically relevant...... shoulder pain. On postoperative day 4, 19 patients (32%) still suffered shoulder pain, but only 4 patients (7%) had clinically relevant pain. Four patients (8%) still suffered shoulder pain 12 months after surgery. In 26 patients (55%), the shoulder pain was classified as referred versus 21 patients (45...

  12. Carcinoma of the thoracic esophagus

    International Nuclear Information System (INIS)

    Herskovic, A.M.; Leichman, L.; Lattin, P.B.

    1987-01-01

    The authors analyzed all cases of thoracic esophagel carcinoma seen from 1980 to 1984 inclusive, plus an additional 22 cases from a pilot study at Wayne State University. Most patients received preoperative combination radiation and chemotherapy. Eighty-nine patients completed treatment (5-fluorouracil, cisplatin, and radiation therapy) as in both the RTOG and SWOG national studies. Of these 89, 39 refused or were not offered planned surgery. Four patients are still alive and well. Fifty patients underwent esophagectomy; 12 patients were free of tumor at esophagectomy, and four of these are alive and well. One patient with a tumor in the resected esophagus alone is still alive. Twenty-two patients were enrolled in the pilot study in which surgery was reserved for salvage, the initial radiation volume was increased, the tumor dose was increased to 5,000 rad give continuously, and chemotherapy was increased to four courses

  13. Radiation therapy of thoracic and abdominal tumors

    International Nuclear Information System (INIS)

    LaRue, S.M.; Gillette, S.M.; Poulson, J.M.

    1995-01-01

    Until recently, radiotherapy of thoracic and abdominal tumors in animals has been limited. However, the availability of computerized tomography and other imaging techniques to aid in determining the extent of tumor, an increase in knowledge of dose tolerance of regional organs, the availability of isocentrically mounted megavoltage machines, and the willingness of patients to pursue more aggressive treatment is making radiation therapy of tumors in these regions far more common. Tumor remission has been reported after radiation therapy of thymomas. Radiation therapy has been used to treat mediastinal lymphoma refractory to chemotherapy, and may be beneficial as part of the initial treatment regimen for this disease. Chemodectomas are responsive to radiation therapy in human patients, and favorable response has also been reported in dogs. Although primary lung tumors in dogs are rare, in some cases radiation therapy could be a useful primary or adjunctive therapy. Lung is the dose-limiting organ in the thorax. Bladder and urethral tumors in dogs have been treated using intraoperative and external-beam radiation therapy combined with chemotherapy. These tumors are difficult to control locally with surgery alone, although the optimal method of combining treatment modalities has not been established. Local control of malignant perianal tumors is also difficult to achieve with surgery alone, and radiation therapy should be used. Intraoperative radiation therapy combined with external-beam radiation therapy has been used for the management of metastatic carcinoma to the sublumbar lymph nodes. Tolerance of retroperitoneal tissues may be decreased by disease or surgical manipulation

  14. Geological analysis and petrographic training Tarata in careers (Upper Paleozoic)-test paleoclimatic interpretation in the light of the glacial episode devono-carboniferous (Arlit region, northern Niger)

    International Nuclear Information System (INIS)

    El Hamet, Mai Ousmane

    1983-01-01

    I - Lower Carboniferous glacial Designed west of the Air (northern Niger), it consists mainly of coarse sandstone with few pebbles scattered or polygenic conglomerate matrix abundant silty-clay sandstone. The ice structures, such as eskers, kames and Pingo are very well represented, but are smaller. The glacial facies are characterized by rapid lateral variations and fall into a narrow submeridional. The small extension of these facies and the position of this region at about 50 degrees south latitude in the Carboniferous period Devono-lead to believe that these phenomena related to valley glaciers mountain, but not necessarily requiring very high altitude at this latitude. II - Formation of Tarat:1-Stratigraphy. The sedimentological and petrographic study of tarat in the quarries in the region SOMAIR Arlit shows that this training has three distinct lithostratigraphic units separated by erosive surfaces of discontinuities with a major tarat located between the middle and upper Tarat . Biostratigraphy made from pollen analysis and paleobotanical studies confirm that major lithologic discontinuity between the deposition of Lower Carboniferous and Upper Permian those with a gap in the Upper Carboniferous and Lower Permian, it will be specified by further studies.2-Paleoclimatology. The new observations in the same career and the existence of glacial phenomena mentioned above before submitting the formation of tarat, led to consider the latter assuming a palaeoenvironment periglacial hypothesis that, in light periglacial seems to reject. Indeed, many characters observed (solifluction, grooves and ridges possible, relatively fresh feldspar) can also be observed in temperate and cold at that time, the region was located approximately 40 degrees south latitude.3-Volcanism.The existence of volcanism contemporaneous with deposition of Tarat was highlighted on one hand with the study of elements vitroclastiques, other hand with the cluster analysis of zircon, the zirconium

  15. Comparison of muscle and joint pressure-pain thresholds in patients with complex regional pain syndrome and upper limb pain of other origin.

    Science.gov (United States)

    Mainka, Tina; Bischoff, Florian S; Baron, Ralf; Krumova, Elena K; Nicolas, Volkmar; Pennekamp, Werner; Treede, Rolf-Detlef; Vollert, Jan; Westermann, Andrea; Maier, Christoph

    2014-03-01

    Pain localized in the deep tissues occurs frequently in complex regional pain syndrome (CRPS). In addition, hyperalgesia to blunt pressure over muscles is common in CRPS, but it often appears in limb pain of other origin as well. Considering that 3-phase bone scintigraphy (TPBS) reveals periarticular enhanced bone metabolism in CRPS, joint-associated hyperalgesia to blunt pressure might be a more specific finding than hyperalgesia over muscles. In 34 patients with upper limb pain (18 CRPS, 16 non-CRPS; diagnosed in accordance to the Budapest criteria) and in 18 healthy controls, pressure-pain thresholds (PPT) were assessed bilaterally over the thenar (PPTThenar), the metacarpophalangeal (PPTMCP), and the proximal interphalangeal (PPTPIP) joints using a pressure algometer (Somedic, Sweden). Beforehand, all patients had received TPBS for diagnostic purposes independently of the study. Region-of-interest (ROI) ratios (mineralization phase) for the MCP and PIP, excluding fracture sites, were correlated with the PPT. In CRPS, all ROI ratios were significantly increased and all PPT of the affected hand were decreased compared to non-CRPS (PPTThenar: 243±150kPa vs 358±197kPa, PPTMCP: 80±67kPa vs 159±93kPa, PPTPIP: 80±56kPa vs 184±110kPa; PPain. Published by Elsevier B.V. All rights reserved.

  16. Wireless peripheral nerve stimulation for complex regional pain syndrome type I of the upper extremity: a case illustration introducing a novel technology.

    Science.gov (United States)

    Herschkowitz, Daniel; Kubias, Jana

    2018-04-13

    Complex regional pain syndrome (CRPS) is a debilitating painful disorder, cryptic in its pathophysiology and refractory condition with limited therapeutic options. Type I CRPS with its variable relationship to trauma has often no discernible fractures or nerve injuries and remains enigmatic in its response to conservative treatment as well as the other limited interventional therapies. Neuromodulation in the form of spinal cord and dorsal root ganglion stimulation (SCS, DRGS) has shown encouraging results, especially of causalgia or CRPS I of lower extremities. Upper extremity CRPS I is far more difficult. To report a case of upper extremity CRPS I treated by wireless peripheral nerve stimulation (WPNS) for its unique features and minimally invasive technique. The system does not involve implantation of battery or its connections. A 47 year old female patient presented with refractory CRPS I following a blunt trauma to her right forearm. As interventional treatment in the form of local anesthetics (Anesthesia of peripheral branches of radial nerve) and combined infusions of ketamine/lidocaine failed to provide any significant relief she opted for WPNS treatment. Based on the topographic distribution, two electrodes (Stimwave Leads: FR4A-RCV-A0 with tines, Generation 1 and FR4A-RCV-B0 with tines, Generation 1), were placed along the course of radial and median nerves under ultrasonography monitoring and guided by intraoperative stimulation. This procedure did not involve implantation of extension cables or the power source. At a frequency of 60 Hz and 300 μs the stimulation induced paresthesia along the distribution of the nerves. Therapeutic relief was observed with high frequency (HF) stimulation (HF 10 kHz/32 μs, 2.0 mA) reducing her pain from a visual analogue scale (VAS) score of 7-4 postoperatively. Three HF stimulations programs were provided at the time of discharge, as she improved in her sensory impairment to touch, pressure and temperature at her first

  17. Assessment of impact of mass movements on the upper Tayyah valley's bridge along Shear escarpment highway, Asir region (Saudi Arabia) using remote sensing data and field investigation

    Science.gov (United States)

    Youssef, A. M.; Al-Kathery, M.; Pradhan, B.

    2015-01-01

    Escarpment highways, roads and mountainous areas in Saudi Arabia are facing landslide hazards that are frequently occurring from time to time causing considerable damage to these areas. Shear escarpment highway is located in the north of the Abha city. It is the most important escarpment highway in the area, where all the light and heavy trucks and vehicle used it as the only corridor that connects the coastal areas in the western part of the Saudi Arabia with the Asir and Najran Regions. More than 10 000 heavy trucks and vehicles use this highway every day. In the upper portion of Tayyah valley of Shear escarpment highway, there are several landslide and erosion potential zones that affect the bridges between tunnel 7 and 8 along the Shear escarpment Highway. In this study, different types of landslides and erosion problems were considered to access their impacts on the upper Tayyah valley's bridge along Shear escarpment highway using remote sensing data and field investigation. These landslides and erosion problems have a negative impact on this section of the highway. Results indicate that the areas above the highway and bridge level between bridge 7 and 8 have different landslides including planar, circular, rockfall failures and debris flows. In addition, running water through the gullies cause different erosional (scour) features between and surrounding the bridge piles and culverts. A detailed landslides and erosion features map was created based on intensive field investigation (geological, geomorphological, and structural analysis), and interpretation of Landsat image 15 m and high resolution satellite image (QuickBird 0.61 m), shuttle radar topography mission (SRTM 90 m), geological and topographic maps. The landslides and erosion problems could exhibit serious problems that affect the stability of the bridge. Different mitigation and remediation strategies have been suggested to these critical sites to minimize and/or avoid these problems in the future.

  18. Embolization for Thoracic Duct Collateral Leakage in High-Output Chylothorax After Thoracic Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp; Ueno, Yutaka, E-mail: uenoyut@hirakata.kmu.ac.jp; Komemushi, Atsushi, E-mail: komemush@takii.kmu.ac.jp; Tanigawa, Noboru, E-mail: tanigano@hirakata.kmu.ac.jp [Kansai Medical University, Department of Radiology (Japan)

    2017-01-15

    PurposeThis study was designed to investigate thoracic duct collateral leakage and the supply route of lymphatic fluid by lymphangiography and transcatheter thoracic ductography and to evaluate the results of embolization for thoracic duct collateral leakage performed to cut off this supply route.MethodsData were retrospectively collected from five patients who underwent embolization for thoracic duct collateral leakage in persistent high-output chylothorax after thoracic surgery. Extravasation of lipiodol at the ruptured thoracic duct collaterals was confirmed in all patients on lymphangiography. Transcatheter thoracic ductography was used to identify extravasation of iodinated contrast agent and to identify communication between the thoracic duct and leakage site. Thoracic duct embolization (TDE) was performed using the percutaneous transabdominal approach to cut off the supply route using N-butyl cyanoacrylate (NBCA) mixed with lipiodol (1:5–1:20).ResultsClinical success (drainage volume ≤10 mL/kg/day within 7 days after TDE) was achieved in all patients. The collateral routes developed as consequence of surgical thoracic duct ligation. In three patients, NBCA-Lipiodol reached the leakage site through direct communication between the thoracic duct and the ruptured lymphatic duct. In the other two patients, direct communication and extravasation was not detected on thoracic ductography, and NBCA-Lipiodol did not reach the leakage site. However, NBCA-Lipiodol did reach the cisterna chyli, lumbar trunks, and some collateral routes via the cisterna chyli or lumbar lymphatics. As a result, leakage was stopped.ConclusionsTDE was effective for the management of leakage of the collaterals in high-output chylothorax after thoracic surgery.

  19. Embolization for Thoracic Duct Collateral Leakage in High-Output Chylothorax After Thoracic Surgery

    International Nuclear Information System (INIS)

    Kariya, Shuji; Nakatani, Miyuki; Yoshida, Rie; Ueno, Yutaka; Komemushi, Atsushi; Tanigawa, Noboru

    2017-01-01

    PurposeThis study was designed to investigate thoracic duct collateral leakage and the supply route of lymphatic fluid by lymphangiography and transcatheter thoracic ductography and to evaluate the results of embolization for thoracic duct collateral leakage performed to cut off this supply route.MethodsData were retrospectively collected from five patients who underwent embolization for thoracic duct collateral leakage in persistent high-output chylothorax after thoracic surgery. Extravasation of lipiodol at the ruptured thoracic duct collaterals was confirmed in all patients on lymphangiography. Transcatheter thoracic ductography was used to identify extravasation of iodinated contrast agent and to identify communication between the thoracic duct and leakage site. Thoracic duct embolization (TDE) was performed using the percutaneous transabdominal approach to cut off the supply route using N-butyl cyanoacrylate (NBCA) mixed with lipiodol (1:5–1:20).ResultsClinical success (drainage volume ≤10 mL/kg/day within 7 days after TDE) was achieved in all patients. The collateral routes developed as consequence of surgical thoracic duct ligation. In three patients, NBCA-Lipiodol reached the leakage site through direct communication between the thoracic duct and the ruptured lymphatic duct. In the other two patients, direct communication and extravasation was not detected on thoracic ductography, and NBCA-Lipiodol did not reach the leakage site. However, NBCA-Lipiodol did reach the cisterna chyli, lumbar trunks, and some collateral routes via the cisterna chyli or lumbar lymphatics. As a result, leakage was stopped.ConclusionsTDE was effective for the management of leakage of the collaterals in high-output chylothorax after thoracic surgery.

  20. Emergency Anaesthetic Management of Extensive Thoracic Trauma

    Directory of Open Access Journals (Sweden)

    H C Chandola

    2007-01-01

    Full Text Available High speed vehicles, drug abuse, alcohol and easy availability of handguns are the main reasons of increasing number of trauma especially thoracic trauma. Anaesthesiologist plays an important role in the management of extensive thoracic trauma. Thoracic trauma, penetrating or blunt, may cause damage to organs suspended in thorax viz. pleura, lungs, heart, great vessels, trachea and oesophagus. It may lead to pneumothorax, cardiac tamponade or life threatening haemorrhage. With aggressive care and management of these factors, majority of patients can survive and return to normal life.

  1. Radiologic-anatomic correlation of thoracic vertebrae and rib shadows in chest digital radiograph

    International Nuclear Information System (INIS)

    Yamaguchi, Isao; Itoh, Harumi

    2007-01-01

    The purpose of this study was to provide an introduction to parsing the radiologic appearance of thoracic vertebrae and ribs. In the study, the radiologic-anatomic correlation technique was applied to promote further understanding of normal chest radiographs. The thoracic vertebrae and ribs of chest radiographs were compared with each macroscopic radiologic and computed tomography (CT) image. The rib parsed the linear shadow of the body of the rib. The macroscopic and radiologic images of thoracic vertebrae and ribs were evaluated to explain their normal radiologic findings. The results of such correlation were summarized as follows: The lamina of the vertebral arch was visualized due to anterior rotation of the upper thoracic vertebrae. The density ratio of the thoracic-vertebrae shadow was almost the same in the vertebral body and vertebral arch. The linear shadow superimposed on the rib corresponded to the inferior margin of the rib. The radiologic-anatomic correlation technique was useful to evaluate normal radiologic findings, and the study was useful to radiological technologists. (author)

  2. Thoracic and respirable particle definitions for human health risk assessment.

    Science.gov (United States)

    Brown, James S; Gordon, Terry; Price, Owen; Asgharian, Bahman

    2013-04-10

    Particle size-selective sampling refers to the collection of particles of varying sizes that potentially reach and adversely affect specific regions of the respiratory tract. Thoracic and respirable fractions are defined as the fraction of inhaled particles capable of passing beyond the larynx and ciliated airways, respectively, during inhalation. In an attempt to afford greater protection to exposed individuals, current size-selective sampling criteria overestimate the population means of particle penetration into regions of the lower respiratory tract. The purpose of our analyses was to provide estimates of the thoracic and respirable fractions for adults and children during typical activities with both nasal and oral inhalation, that may be used in the design of experimental studies and interpretation of health effects evidence. We estimated the fraction of inhaled particles (0.5-20 μm aerodynamic diameter) penetrating beyond the larynx (based on experimental data) and ciliated airways (based on a mathematical model) for an adult male, adult female, and a 10 yr old child during typical daily activities and breathing patterns. Our estimates show less penetration of coarse particulate matter into the thoracic and gas exchange regions of the respiratory tract than current size-selective criteria. Of the parameters we evaluated, particle penetration into the lower respiratory tract was most dependent on route of breathing. For typical activity levels and breathing habits, we estimated a 50% cut-size for the thoracic fraction at an aerodynamic diameter of around 3 μm in adults and 5 μm in children, whereas current ambient and occupational criteria suggest a 50% cut-size of 10 μm. By design, current size-selective sample criteria overestimate the mass of particles generally expected to penetrate into the lower respiratory tract to provide protection for individuals who may breathe orally. We provide estimates of thoracic and respirable fractions for a variety of

  3. Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles

    International Nuclear Information System (INIS)

    Briggs, A.M.; Greig, A.M.; Wrigley, T.V.; Tully, E.A.; Adams, P.E.; Bennell, K.L.

    2007-01-01

    Several measures can quantify thoracic kyphosis from radiographs, yet their suitability for people with osteoporosis remains uncertain. The aim of this study was to examine the validity and reliability of the vertebral centroid and Cobb angles in people with osteoporosis. Lateral radiographs of the thoracic spine were captured in 31 elderly women with osteoporosis. Thoracic kyphosis was measured globally (T1-T12) and regionally (T4-T9) using Cobb and vertebral centroid angles. Multisegmental curvature was also measured by fitting polynomial functions to the thoracic curvature profile. Canonical and Pearson correlations were used to examine correspondence; agreement between measures was examined with linear regression. Moderate to high intra- and inter-rater reliability was achieved (SEM = 0.9-4.0 ). Concurrent validity of the simple measures was established against multisegmental curvature (r = 0.88-0.98). Strong association was observed between the Cobb and centroid angles globally (r = 0.84) and regionally (r 0.83). Correspondence between measures was moderate for the Cobb method (r 0.72), yet stronger for the centroid method (r = 0.80). The Cobb angle was 20% greater for regional measures due to the influence of endplate tilt. Regional Cobb and centroid angles are valid and reliable measures of thoracic kyphosis in people with osteoporosis. However, the Cobb angle is biased by endplate tilt, suggesting that the centroid angle is more appropriate for this population. (orig.)

  4. Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles

    Energy Technology Data Exchange (ETDEWEB)

    Briggs, A.M.; Greig, A.M. [University of Melbourne, Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, Victoria (Australia); University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Victoria (Australia); Wrigley, T.V.; Tully, E.A.; Adams, P.E.; Bennell, K.L. [University of Melbourne, Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, Victoria (Australia)

    2007-08-15

    Several measures can quantify thoracic kyphosis from radiographs, yet their suitability for people with osteoporosis remains uncertain. The aim of this study was to examine the validity and reliability of the vertebral centroid and Cobb angles in people with osteoporosis. Lateral radiographs of the thoracic spine were captured in 31 elderly women with osteoporosis. Thoracic kyphosis was measured globally (T1-T12) and regionally (T4-T9) using Cobb and vertebral centroid angles. Multisegmental curvature was also measured by fitting polynomial functions to the thoracic curvature profile. Canonical and Pearson correlations were used to examine correspondence; agreement between measures was examined with linear regression. Moderate to high intra- and inter-rater reliability was achieved (SEM = 0.9-4.0 ). Concurrent validity of the simple measures was established against multisegmental curvature (r = 0.88-0.98). Strong association was observed between the Cobb and centroid angles globally (r = 0.84) and regionally (r = 0.83). Correspondence between measures was moderate for the Cobb method (r = 0.72), yet stronger for the centroid method (r = 0.80). The Cobb angle was 20% greater for regional measures due to the influence of endplate tilt. Regional Cobb and centroid angles are valid and reliable measures of thoracic kyphosis in people with osteoporosis. However, the Cobb angle is biased by endplate tilt, suggesting that the centroid angle is more appropriate for this population. (orig.)

  5. Catamenial pneumothorax caused by thoracic endometriosis

    Directory of Open Access Journals (Sweden)

    Paolo Maniglio, MD

    2018-02-01

    Conclusion: The diagnosis of thoracic endometriosis is challenging. The first line of treatment is medical, whereas the surgical treatment is performed secondly. Moreover, surgical treatment can lead to a significant rate of recurrence, often reduced by a coadjutant medical treatment.

  6. Surgical treatment of double thoracic adolescent idiopathic scoliosis with a rigid proximal thoracic curve.

    Science.gov (United States)

    Sudo, Hideki; Abe, Yuichiro; Abumi, Kuniyoshi; Iwasaki, Norimasa; Ito, Manabu

    2016-02-01

    There is limited consensus on the optimal surgical strategy for double thoracic adolescent idiopathic scoliosis (AIS). Recent studies have reported that pedicle screw constructs to maximize scoliosis correction cause further thoracic spine lordosis. The objective of this study was to apply a new surgical technique for double thoracic AIS with rigid proximal thoracic (PT) curves and assess its clinical outcomes. Twenty one consecutive patients with Lenke 2 AIS and a rigid PT curve (Cobb angle ≥30º on side-bending radiographs, flexibility ≤30 %) treated with the simultaneous double-rod rotation technique (SDRRT) were included. In this technique, a temporary rod is placed at the concave side of the PT curve. Then, distraction force is applied to correct the PT curve, which reforms a sigmoid double thoracic curve into an approximate single thoracic curve. As a result, the PT curve is typically converted from an apex left to an apex right curve before applying the correction rod for PT and main thoracic curve. All patients were followed for at least 2 years (average 2.7 years). The average main thoracic and PT Cobb angle correction rate at the final follow-up was 74.7 and 58.0 %, respectively. The average preoperative T5-T12 thoracic kyphosis was 9.3°, which improved significantly to 19.0° (p corrected using SDRRT for Lenke 2 AIS with a rigid PT curve.

  7. A History of Thoracic Aortic Surgery.

    Science.gov (United States)

    McFadden, Paul Michael; Wiggins, Luke M; Boys, Joshua A

    2017-08-01

    Ancient historical texts describe the presence of aortic pathology conditions, although the surgical treatment of thoracic aortic disease remained insurmountable until the 19th century. Surgical treatment of thoracic aortic disease then progressed along with advances in surgical technique, conduit production, cardiopulmonary bypass, and endovascular technology. Despite radical advances in aortic surgery, principles established by surgical pioneers of the 19th century hold firm to this day. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Rare earth elements in fly ashes created during the coal burning process in certain coal-fired power plants operating in Poland - Upper Silesian Industrial Region

    International Nuclear Information System (INIS)

    Smolka-Danielowska, Danuta

    2010-01-01

    The subject of the study covered volatile ashes created during hard coal burning process in ash furnaces, in power plants operating in the Upper Silesian Industrial Region, Southern Poland. Coal-fired power plants are furnished with dust extracting devices, electro precipitators, with 99-99.6% combustion gas extracting efficiency. Activity concentrations ofTh-232, Ra-226, K-40, Ac-228, U-235 and U-238 were measured with gamma-ray spectrometer. Concentrations of selected rare soil elements (La, Ce, Nd, Sm, Y, Gd, Th, U) were analysed by means of instrumental neutron activation analysis (INAA). Mineral phases of individual ash particles were identified with the use of scanning electron microscope equipped with EDS attachment. Laser granulometric analyses were executed with the use of Analyssette analyser. The activity of the investigated fly-ash samples is several times higher than that of the bituminous coal samples; in the coal, the activities are: 226Ra - 85.4 Bq kg -1 , 40 K-689 Bq kg -1 , 232Th - 100.8 Bq kg -1 , 235U-13.5 Bq kg -1 , 238U-50 Bq kg -1 and 228Ac - 82.4 Bq kg -1 .

  9. A uranium-bearing coalificated wood remain from the Upper Carboniferous uranium ore deposit in the Baden-Baden region of the Black Forest

    International Nuclear Information System (INIS)

    Kirchheimer, F.

    1981-01-01

    From the 1973 discovered Upper Carboniferous uranium ore sandstone deposit in the Baden-Baden region (Black Forest) a uranium-bearing coalificated wood remain derived, probably the relic of a Cordaites-trunk. The chemical determinated whole uranium content of this amounts about to 40 wght.-%. Pitchblende of the collomorphic type is embedded in the vitrinite of the fossil and imitates the nearly destroyed former wood-structure. The aggregates of this mineral, surrounded by zones of contact, consist of at least two modifications of different reflectance and hardness. Radiometric analyses reveale a different disturbed radioactive equilibrium, which indicated partly loss and re-enrichment of the uranium-content in recent time. A part of the fossil is completely mineralized by pitchblende of high reflectance and associated galena. For this paragenesis the radiometric investigations proved an approached equilibrium of radioactive substances. Therefore it is to be estimated, that the pitchblende is not alterated substantially, in contrast to the embeddings in the vitrinite, rich in little reflecting and soft nasturanium. The inhomogenic mineralization of the highly coalificated fossil, also to recognise microscopically, is set in relation to the controverse genetic interpretation of the deposit. Final remarks are concerned to other uranium-enriched fossils, especially remains of bones of different origin and age. (orig.) [de

  10. Rare earth elements in fly ashes created during the coal burning process in certain coal-fired power plants operating in Poland - Upper Silesian Industrial Region.

    Science.gov (United States)

    Smolka-Danielowska, Danuta

    2010-11-01

    The subject of the study covered volatile ashes created during hard coal burning process in ash furnaces, in power plants operating in the Upper Silesian Industrial Region, Southern Poland. Coal-fired power plants are furnished with dust extracting devices, electro precipitators, with 99-99.6% combustion gas extracting efficiency. Activity concentrations ofTh-232, Ra-226, K-40, Ac-228, U-235 and U-238 were measured with gamma-ray spectrometer. Concentrations of selected rare soil elements (La, Ce, Nd, Sm, Y, Gd, Th, U) were analysed by means of instrumental neutron activation analysis (INAA). Mineral phases of individual ash particles were identified with the use of scanning electron microscope equipped with EDS attachment. Laser granulometric analyses were executed with the use of Analyssette analyser. The activity of the investigated fly-ash samples is several times higher than that of the bituminous coal samples; in the coal, the activities are: 226Ra - 85.4 Bq kg(-1), 40 K-689 Bq kg(-1), 232Th - 100.8 Bq kg(-1), 235U-13.5 Bq kg(-1), 238U-50 Bq kg(-1) and 228Ac - 82.4 Bq kg(-1).

  11. Complex Regional Pain Syndrome type I of the upper limb - treatment based on Stress Loading Program: a case study

    Directory of Open Access Journals (Sweden)

    Aline Sarturi Ponte

    2015-03-01

    Full Text Available The daily life of an individual suffering from Complex Regional Pain Syndrome type I (CPRS I becomes limited, because this syndrome causes signs and symptoms located in the affected limb, and may occur in other parts. From this premise, this study aims to present the contributions of Occupational Therapy and the Rehabilitation Stress Loading Program for a subject with CRPS I in the upper limb, attended by the Group of Pain from the University Hospital of Santa Maria (HUSM, Rio Grande do Sul state. This research is characterized as a case study, experimental, which deals with pre and post occupational therapy intervention. The instruments used for data collection were the protocols of Disabilities of the Arm, Shoulder and Hand (DASH, the International Classification of Disability, Functioning and Health (ICF, the Canadian Occupational Performance Measure (COPM, the Visual Analogue Scale, and goniometry (EVA. After assessment, the subject was exposed to the treatment of compressive active resistive exercises; after this treatment was completed, the subject was reassessed. It was observed that the treatment applied has contributed to the reduction of the pain and to the improvement in the Range of Motion (ROM of the subject. The use of the stress protocol and active compression contributed significantly to the reduction of pain, ADM gain and occupational performance improvement.

  12. Airborne differential absorption lidar for water vapour measurements in the upper troposphere and lower stratosphere in the spectral region around 940 nm

    Energy Technology Data Exchange (ETDEWEB)

    Poberaj, G.

    2000-07-01

    Two all-solid-state laser systems were developed and studied in detail to optimise their performance for an airborne water vapour differential absorption lidar (DIAL). Their special features are high average output powers and excellent spectral properties in the 940-nm spectral region relevant for monitoring very low water vapour contents in the upper troposphere and lower stratosphere. One system is an injection-seeded pulsed Ti:sapphire ring laser with a spectral bandwidth of 105 MHz and an average power of 1.1 W. The other system is an injection-seeded optical parametric oscillator (OPO) in a ring configuration. Using KTP as nonlinear crystal, a signal output with a spectral bandwidth of 140 MHz and an average power of 1.2 W was achieved. Both systems, the Ti:sapphire ring laser and the KTP OPO, possess spectral purity values higher than 99%. The pump source for these systems is a frequency doubled diode-pumped Nd:YAG laser operating at a repetition rate of 100 Hz. The KTP OPO system has been used as a transmitter in a new airborne water vapour DIAL instrument. For the first time, measurements of two-dimensional water vapour distributions with a high vertical (500 m) and horizontal (20 km) resolution across several potential vorticity streamers were performed. Very low water vapour mixing ratios (10-50 ppmv) and strong gradients were observed in the tropopause region. The sensitivity of the DIAL instrument in the centre of a stratospheric intrusion ranges from 3% in the near field to 12% in the far field (4 km). The first comparison experiments with in situ measuring instruments show a good agreement. Considerable differences are found between DIAL measurements and data obtained from the ECMWF operational analyses and a mesoscale numerical model. (orig.)

  13. Giant thoracic schwannoma presenting with abrupt onset of abdominal pain: a case report

    Science.gov (United States)

    2009-01-01

    Introduction Giant intradural extramedullary schwannomas of the thoracic spine are not common. Schwannomas, that is, tumors derived from neoplastic Schwann cells, and neurofibromas represent the most common intradural extramedullary spinal lesions. We report the case of a patient with a giant thoracic schwannoma presenting unusually with acute abdominal pain and with delayed neurological impairment. Case presentation A 26-year-old Hispanic man with no previous medical problems presented with acute periumbilical pain. After extensive work-up including an exploratory laparotomy for appendectomy, magnetic resonance imaging scans of the lumbar and thoracic spine revealed a giant intradural extramedullary thoracic schwannoma within the spinal canal posterior to the T9, T10, and T11 vertebral bodies. Magnetic resonance imaging signal prolongation was noted in the spinal cord both rostral and caudal to the schwannoma. The patient underwent an urgent laminectomy from T8 to L1. After sacrificing the T10 root, the tumor was removed en bloc. Postoperatively, the patient improved significantly gaining antigravity strength in both lower extremities. Conclusion The T10 dermatome is represented by the umbilical region. This referred pain may represent a mechanism by which a giant thoracic schwannoma may present as acute abdominal pain. Acute, intense abdominal pain with delayed neurologic deficit is a rare presentation of a thoracic schwannoma but should be considered as a possible cause of abdominal pain presenting without clear etiology. Although these lesions may be delayed in their diagnosis, early diagnosis and treatment may lead to an improved clinical outcome. PMID:19946504

  14. Giant thoracic schwannoma presenting with abrupt onset of abdominal pain: a case report

    Directory of Open Access Journals (Sweden)

    Yang Isaac

    2009-10-01

    Full Text Available Abstract Introduction Giant intradural extramedullary schwannomas of the thoracic spine are not common. Schwannomas, that is, tumors derived from neoplastic Schwann cells, and neurofibromas represent the most common intradural extramedullary spinal lesions. We report the case of a patient with a giant thoracic schwannoma presenting unusually with acute abdominal pain and with delayed neurological impairment. Case presentation A 26-year-old Hispanic man with no previous medical problems presented with acute periumbilical pain. After extensive work-up including an exploratory laparotomy for appendectomy, magnetic resonance imaging scans of the lumbar and thoracic spine revealed a giant intradural extramedullary thoracic schwannoma within the spinal canal posterior to the T9, T10, and T11 vertebral bodies. Magnetic resonance imaging signal prolongation was noted in the spinal cord both rostral and caudal to the schwannoma. The patient underwent an urgent laminectomy from T8 to L1. After sacrificing the T10 root, the tumor was removed en bloc. Postoperatively, the patient improved significantly gaining antigravity strength in both lower extremities. Conclusion The T10 dermatome is represented by the umbilical region. This referred pain may represent a mechanism by which a giant thoracic schwannoma may present as acute abdominal pain. Acute, intense abdominal pain with delayed neurologic deficit is a rare presentation of a thoracic schwannoma but should be considered as a possible cause of abdominal pain presenting without clear etiology. Although these lesions may be delayed in their diagnosis, early diagnosis and treatment may lead to an improved clinical outcome.

  15. Thoracic trauma: analysis of 100 consecutive cases

    Directory of Open Access Journals (Sweden)

    Maíra Benito Scapolan

    2010-09-01

    Full Text Available Objective: To analyze thoracic trauma assisted by the EmergencyService of Hospital da Irmandade da Santa Casa de Misericórdia deSão Paulo. Methods: One hundred patients with thoracic trauma wereassisted throughout six months in 2006. Data from their records werecollected and a protocol of thoracic trauma was fulfilled. The RevisedTrauma Score was used to evaluate gravity of injury and to calculatethe survival index. Results: Prevalence of trauma injury in male from20 to 29 years old was observed. Out of all patients, 44 had blunttrauma and 56 penetrating trauma (78.6% presented stab woundsand 21.4% gun shots. Up to the settings of injuries, 23% were in thethoracoabdominal transition, 7% in the precordium and 70% in theremainder thoracic area. In those with the thoracoabdominal transitioninjury, 22.7% were hemodynamically unstable and 77.3% stable.Thoracoabdominal injury patients presented 40.9% of diaphragmwound and all were stable. Of those with precordium wound, 37.5%presented cardiac injury. In cardiac onset, 66.7% presented stableand 33.3% unstable. Thoracic drainage was the most accomplishedsurgical procedure (71%. Conclusions: The thoracic trauma patientis most prevalently young male with stab wound penetrating injury,without associated injuries, hemodynamically stable, presentinghemothorax, with high probability of survival.

  16. Initial thoracic involvement in lymphoma. CT assessment

    International Nuclear Information System (INIS)

    Bustos, A.; Corredoira, J.; Ferreiros, J.; Cabeza, B.; Jorquera, M.; Pedrosa, I.; Martinez, R.; Fernandez, C.

    2002-01-01

    To analyze the initial thoracic involvement by CT in a consecutive series of patients with lymphoma. A retrospective analysis was made of thoracic CT studies made at the time of diagnosis of 259 patients with lymphoma. Mediastinal pulmonary, pleural, pericardial and chest wall involvement was assessed by CT. Of 259 patients (129 men y 130 women), 56 had Hodgkin's disease (HD) and 203 had non-Hodgkin lymphoma (NHL). Forty-two percent (42.5%, 110/259) of the patients had chest involvement on CT: 33 of 56 patients with HD (58.9%) and 77 of 203 patients with NHL (37.9%). All the patients with thoracic HD) and 71.4% of patients with thoracic NHL, had mediastinal lymph node involvement. of the patients with thoracic involvement 12.1% (4/33) of the patient with HD and 23.3% (18/77) of the patients with NHL had pulmonary involvement. Thoracic involvement on CT was more frequent in HD. Mediastinal lymph node involvement was the most common finding fundamentally in HD. Pulmonary disease always occurred in the presence of mediastinal lymph node involvement in HD but could occur as an isolated finding in NHL. (Author) 24 refs

  17. Pleural puncture with thoracic epidural: A rare complication?

    Directory of Open Access Journals (Sweden)

    Rachna Wadhwa

    2011-01-01

    Full Text Available Freedom from pain has almost developed to be a fundamental human right. Providing pain relief via epidural catheters in thoracic and upper abdominal surgeries is widely accepted. Pain relief through this technique not only provides continuous analgesia but also reduces post-operative pulmonary complications and also hastens recovery. But being a blind procedure it is accompanied by certain complications. Hypotension, dura puncture, high epidural, total spinal, epidural haematoma, spinal cord injury and infection are some of the documented side effects of epidural block. There are case reports eliciting neurological complications, catheter site infections, paresthesias, radicular symptoms and worsening of previous neurological conditions. Few technical problems related to breakage of epidural catheter are also mentioned in the literature. The patient had no sequelae on long term follow up even when a portion of catheter was retained. We present a case report where epidural catheter punctured pleura in a patient undergoing thoracotomy for carcinoma oesophagus.

  18. Emergency thoracic surgery in elderly patients

    Science.gov (United States)

    Limmer, Stefan; Unger, Lena; Czymek, Ralf; Kujath, Peter; Hoffmann, Martin

    2011-01-01

    Objectives Emergency thoracic surgery in the elderly represents an extreme situation for both the surgeon and patient. The lack of an adequate patient history as well as the inability to optimize any co-morbidities, which are the result of the emergent situation, are the cause of increased morbidity and mortality. We evaluated the outcome and prognostic factors for this selected group of patients. Design Retrospective chart review. Setting Academic tertiary care referral center. Participants Emergency patients treated at the Department of Thoracic Surgery, University Hospital of Luebeck, Germany. Main outcome measures Co-morbidities, mortality, risk factors and hospital length of stay. Results A total of 124 thoracic procedures were performed on 114 patients. There were 79 men and 36 women (average age 72.5 ±6.4 years, range 65–94). The overall operative mortality was 25.4%. The most frequent indication was thoracic/mediastinal infection, followed by peri- or postoperative thoracic complications. Risk factors for hospital mortality were a high ASA score, pre-existing diabetes mellitus and renal insufficiency. Conclusions Our study documents a perioperative mortality rate of 25% in patients over 65 who required emergency thoracic surgery. The main indication for a surgical intervention was sepsis with a thoracic/mediastinal focus. Co-morbidities and the resulting perioperative complications were found to have a significant effect on both inpatient length of stay and outcome. Long-term systemic co-morbidities such as diabetes mellitus are difficult to equalize with respect to certain organ dysfunctions and significantly increase mortality. PMID:21369531

  19. Thoracic CT in the ED: a study of thoracic computed tomography utilisation.

    LENUS (Irish Health Repository)

    Williams, E

    2010-02-01

    The aim of this retrospective study was to investigate the use of thoracic Computed Tomography (CT) in the Emergency Department of a Dublin Academic Teaching Hospital over a six month period. Data was retrieved using the hospital\\'s computerised information system. There were 202 referrals in total for thoracic CT from the Emergency Department during this time period. The most common indication for thoracic CT referral was for the investigation of pulmonary embolism with 127 (63%) referrals. There were 40 (25%) referrals for suspected malignancy and lung disease, whilst 8 (4%) of the referrals were for investigation of thoracic aortic dissection, 8 (4%) for infection, and 6 (3%) were for investigation of thoracic injury. Only 8 (4%) of all referrals were for investigation of injury as a result of chest trauma.

  20. Detecting Precontact Anthropogenic Microtopographic Features in a Forested Landscape with Lidar: A Case Study from the Upper Great Lakes Region, AD 1000-1600.

    Science.gov (United States)

    Howey, Meghan C L; Sullivan, Franklin B; Tallant, Jason; Kopple, Robert Vande; Palace, Michael W

    2016-01-01

    Forested settings present challenges for understanding the full extent of past human landscape modifications. Field-based archaeological reconnaissance in forests is low-efficiency and most remote sensing techniques are of limited utility, and together, this means many past sites and features in forests are unknown. Archaeologists have increasingly used light detection and ranging (lidar), a remote sensing tool that uses pulses of light to measure reflecting surfaces at high spatial resolution, to address these limitations. Archaeology studies using lidar have made significant progress identifying permanent structures built by large-scale complex agriculturalist societies. Largely unaccounted for, however, are numerous small and more practical modifications of landscapes by smaller-scale societies. Here we show these may also be detectable with lidar by identifying remnants of food storage pits (cache pits) created by mobile hunter-gatherers in the upper Great Lakes during Late Precontact (ca. AD 1000-1600) that now only exist as subtle microtopographic features. Years of intensive field survey identified 69 cache pit groups between two inland lakes in northern Michigan, almost all of which were located within ~500 m of a lakeshore. Applying a novel series of image processing techniques and statistical analyses to a high spatial resolution DTM we created from commercial-grade lidar, our detection routine identified 139 high potential cache pit clusters. These included most of the previously known clusters as well as several unknown clusters located >1500 m from either lakeshore, much further from lakeshores than all previously identified cultural sites. Food storage is understood to have emerged regionally as a risk-buffering strategy after AD 1000 but our results indicate the current record of hunter-gatherer cache pit food storage is markedly incomplete and this practice and its associated impact on the landscape may be greater than anticipated. Our study also

  1. Endocrine disrupting alkylphenolic chemicals and other contaminants in wastewater treatment plant effluents, urban streams, and fish in the Great Lakes and Upper Mississippi River Regions

    Science.gov (United States)

    Barber, Larry B.; Loyo-Rosales, Jorge E.; Rice, Clifford P.; Minarik, Thomas A.; Oskouie, Ali K.

    2015-01-01

    Urban streams are an integral part of the municipal water cycle and provide a point of discharge for wastewater treatment plant (WWTP) effluents, allowing additional attenuation through dilution and transformation processes, as well as a conduit for transporting contaminants to downstream water supplies. Domestic and commercial activities dispose of wastes down-the-drain, resulting in wastewater containing complex chemical mixtures that are only partially removed during treatment. A key issue associated with WWTP effluent discharge into streams is the potential to cause endocrine disruption in fish. This study provides a long-term (1999-2009) evaluation of the occurrence of alkylphenolic endocrine disrupting chemicals (EDCs) and other contaminants discharged from WWTPs into streams in the Great Lakes and Upper Mississippi River Regions (Indiana, Illinois, Michigan, Minnesota, and Ohio). The Greater Metropolitan Chicago Area Waterways, Illinois, were evaluated to determine contaminant concentrations in the major WWTP effluents and receiving streams, and assess the behavior of EDCs from their sources within the sewer collection system, through the major treatment unit processes at a WWTP, to their persistence and transport in the receiving stream. Water samples were analyzed for alkylphenolic EDCs and other contaminants, including 4-nonylphenol (NP), 4-nonylphenolpolyethoxylates (NPEO), 4-nonylphenolethoxycarboxylic acids (NPEC), 4-tert-octylphenol (OP), 4-tert-octylphenolpolyethoxylates (OPEO), bisphenol A, triclosan, ethylenediaminetetraacetic acid (EDTA), and trace elements. All of the compounds were detected in all of the WWTP effluents, with EDTA and NPEC having the greatest concentrations. The compounds also were detected in the WWTP effluent dominated rivers. Multiple fish species were collected from river and lake sites and analyzed for NP, NPEO, NPEC, OP, and OPEO. Whole-body fish tissue analysis indicated widespread occurrence of alkylphenolic compounds

  2. Inspecting the transformation of Roman settlements in the Upper Potenza Valley (Marche region across Late Antiquity and into the Early Medieval era

    Directory of Open Access Journals (Sweden)

    Francesca Carboni

    2015-12-01

    Full Text Available The following analysis shows the changes occurred in the settlement patterns in the upper Potenza river valley (MC, Marche region during the transition period between Late Antiquity and Early Middle Ages. This analysis is mainly based on the results of a geoarchaeological project, which has been carried out by a team from Ghent University since 2000. The review of the pottery collected during the fi eld survey has allowed for a better defined chronology of the last phase of occupation of the rural sites identifi ed in the sample zone, located within an intermediate basin between the Umbria-Marche Apennines and a lateral dorsal ridge, in areas dominated by the hilltops of Monte Primo and Monte Castel Santa Maria. For some of these sites, it is now possible to ascertain a continuity of life up to the end of the seventh century and further into the Middle Ages. La presente analisi illustra le trasformazioni delle modalità insediative avvenute nel periodo di transizione fra la tarda antichità e il medioevo nell’alta valle del fi ume Potenza (MC, Marche. Essa si basa sui risultati del progetto condotto con metodo geo-archeologico da un gruppo di ricerca dell’Università di Ghent, dal 2000. La revisione del materiale ceramico raccolto nel corso delle ricognizioni ha consentito di defi nire meglio le ultime fasi di occupazione dei siti rurali identifi cati nella zona campione in questione, posizionata all’interno del bacino intramontano posto fra l’Appennino umbro-marchigiano e una dorsale montuosa laterale, dominata dalle cime del Monte Primo e del Monte Santa Maria. Per alcuni di questi siti è stato, infatti, possibile accertare una continuità di occupazione estesa fi no al VII secolo e oltre, in età medievale.

  3. Endocrine disrupting alkylphenolic chemicals and other contaminants in wastewater treatment plant effluents, urban streams, and fish in the Great Lakes and Upper Mississippi River Regions.

    Science.gov (United States)

    Barber, Larry B; Loyo-Rosales, Jorge E; Rice, Clifford P; Minarik, Thomas A; Oskouie, Ali K

    2015-06-01

    Urban streams are an integral part of the municipal water cycle and provide a point of discharge for wastewater treatment plant (WWTP) effluents, allowing additional attenuation through dilution and transformation processes, as well as a conduit for transporting contaminants to downstream water supplies. Domestic and commercial activities dispose of wastes down-the-drain, resulting in wastewater containing complex chemical mixtures that are only partially removed during treatment. A key issue associated with WWTP effluent discharge into streams is the potential to cause endocrine disruption in fish. This study provides a long-term (1999-2009) evaluation of the occurrence of alkylphenolic endocrine disrupting chemicals (EDCs) and other contaminants discharged from WWTPs into streams in the Great Lakes and Upper Mississippi River Regions (Indiana, Illinois, Michigan, Minnesota, and Ohio). The Greater Metropolitan Chicago Area Waterways, Illinois, were evaluated to determine contaminant concentrations in the major WWTP effluents and receiving streams, and assess the behavior of EDCs from their sources within the sewer collection system, through the major treatment unit processes at a WWTP, to their persistence and transport in the receiving stream. Water samples were analyzed for alkylphenolic EDCs and other contaminants, including 4-nonylphenol (NP), 4-nonylphenolpolyethoxylates (NPEO), 4-nonylphenolethoxycarboxylic acids (NPEC), 4-tert-octylphenol (OP), 4-tert-octylphenolpolyethoxylates (OPEO), bisphenol A, triclosan, ethylenediaminetetraacetic acid (EDTA), and trace elements. All of the compounds were detected in all of the WWTP effluents, with EDTA and NPEC having the greatest concentrations. The compounds also were detected in the WWTP effluent dominated rivers. Multiple fish species were collected from river and lake sites and analyzed for NP, NPEO, NPEC, OP, and OPEO. Whole-body fish tissue analysis indicated widespread occurrence of alkylphenolic compounds

  4. Atrophy and Primary Somatosensory Cortical Reorganization after Unilateral Thoracic Spinal Cord Injury: A Longitudinal Functional Magnetic Resonance Imaging Study

    Directory of Open Access Journals (Sweden)

    Jia-Sheng Rao

    2013-01-01

    Full Text Available The effects of traumatic spinal cord injury (SCI on the changes in the central nervous system (CNS over time may depend on the dynamic interaction between the structural integrity of the spinal cord and the capacity of the brain plasticity. Functional magnetic resonance imaging (fMRI was used in a longitudinal study on five rhesus monkeys to observe cerebral activation during upper limb somatosensory tasks in healthy animals and after unilateral thoracic SCI. The changes in the spinal cord diameters were measured, and the correlations among time after the lesion, structural changes in the spinal cord, and primary somatosensory cortex (S1 reorganization were also determined. After SCI, activation of the upper limb in S1 shifted to the region which generally dominates the lower limb, and the rostral spinal cord transverse diameter adjacent to the lesion exhibited obvious atrophy, which reflects the SCI-induced changes in the CNS. A significant correlation was found among the time after the lesion, the spinal cord atrophy, and the degree of contralateral S1 reorganization. The results indicate the structural changes in the spinal cord and the dynamic reorganization of the cerebral activation following early SCI stage, which may help to further understand the neural plasticity in the CNS.

  5. Outcomes from the Delphi process of the Thoracic Robotic Curriculum Development Committee.

    Science.gov (United States)

    Veronesi, Giulia; Dorn, Patrick; Dunning, Joel; Cardillo, Giuseppe; Schmid, Ralph A; Collins, Justin; Baste, Jean-Marc; Limmer, Stefan; Shahin, Ghada M M; Egberts, Jan-Hendrik; Pardolesi, Alessandro; Meacci, Elisa; Stamenkovic, Sasha; Casali, Gianluca; Rueckert, Jens C; Taurchini, Mauro; Santelmo, Nicola; Melfi, Franca; Toker, Alper

    2018-06-01

    As the adoption of robotic procedures becomes more widespread, additional risk related to the learning curve can be expected. This article reports the results of a Delphi process to define procedures to optimize robotic training of thoracic surgeons and to promote safe performance of established robotic interventions as, for example, lung cancer and thymoma surgery. In June 2016, a working panel was spontaneously created by members of the European Society of Thoracic Surgeons (ESTS) and European Association for Cardio-Thoracic Surgery (EACTS) with a specialist interest in robotic thoracic surgery and/or surgical training. An e-consensus-finding exercise using the Delphi methodology was applied requiring 80% agreement to reach consensus on each question. Repeated iterations of anonymous voting continued over 3 rounds. Agreement was reached on many points: a standardized robotic training curriculum for robotic thoracic surgery should be divided into clearly defined sections as a staged learning pathway; the basic robotic curriculum should include a baseline evaluation, an e-learning module, a simulation-based training (including virtual reality simulation, Dry lab and Wet lab) and a robotic theatre (bedside) observation. Advanced robotic training should include e-learning on index procedures (right upper lobe) with video demonstration, access to video library of robotic procedures, simulation training, modular console training to index procedure, transition to full-procedure training with a proctor and final evaluation of the submitted video to certified independent examiners. Agreement was reached on a large number of questions to optimize and standardize training and education of thoracic surgeons in robotic activity. The production of the content of the learning material is ongoing.

  6. Occupational and environmental mercury exposure among small-scale gold miners in the Talensi-Nabdam District of Ghana's Upper East region.

    Science.gov (United States)

    Paruchuri, Yasaswi; Siuniak, Amanda; Johnson, Nicole; Levin, Elena; Mitchell, Katherine; Goodrich, Jaclyn M; Renne, Elisha P; Basu, Niladri

    2010-11-15

    Mercury use in small-scale gold mining is ubiquitous across Ghana but little is known about the extent to which such activities have contaminated community residents and miners. Here, occupational exposures to elemental mercury (via urine sampling) and dietary exposures to methylmercury (via hair sampling) were assessed among 120 participants recruited from a mining community located in the Talensi-Nabdam District of Ghana's Upper East region during summer 2009. More than one-fifth of the participants had moderately high levels of urinary mercury (>10μg/L) and 5% had urine mercury levels that exceeded the WHO guideline value of 50μg/L. When participants were stratified according to occupation, those active in the mining industry had the highest mercury levels. Specifically, individuals that burned amalgam had urine mercury levels (median: 43.8μg/L; mean ± SD: 171.1±296.5μg/L; n=5) significantly higher than median values measured in mechanical operators (11.6μg/L, n=4), concession managers/owners (5.6μg/L, n=11), excavators that blast and chisel ore (4.9μg/L, n=33), individuals that sift and grind crushed ore (2.2μg/L, n=47), support workers (0.5μg/L, n=14), and those with no role in the mining sector (2.5μg/L, n=6). There was a significant positive Spearman correlation between fish consumption and hair mercury levels (r=0.30) but not with urine mercury (r=0.18) though further studies are needed to document which types of fish are consumed as well as portion sizes. Given that 200,000 people in Ghana are involved in the small-scale gold mining industry and that the numbers are expected to grow in Ghana and many other regions of the world, elucidating mercury exposure pathways in such communities is important to help shape policies and behaviors that may minimize health risks. Copyright © 2010 Elsevier B.V. All rights reserved.

  7. Occupational and environmental mercury exposure among small-scale gold miners in the Talensi-Nabdam District of Ghana’s Upper East region

    Science.gov (United States)

    Paruchuri, Yasaswi; Siuniak, Amanda; Johnson, Nicole; Levin, Elena; Mitchell, Katherine; Goodrich, Jaclyn M.; Renne, Elisha P.; Basu, Niladri

    2014-01-01

    Mercury use in small-scale gold mining is ubiquitous across Ghana but little is known about the extent to which such activities have contaminated community residents and miners. Here, occupational exposures to elemental mercury (via urine sampling) and dietary exposures to methylmercury (via hair sampling) were assessed among 120 participants recruited from a mining community located in the Talensi-Nabdam District of Ghana’s Upper East region during summer 2009. More than one-fifth of the participants had moderately high levels of urinary mercury (>10 µg/L) and 5% had urine mercury levels that exceeded the WHO guideline value of 50 µg/L. When participants were stratified according to occupation, those active in the mining industry had the highest mercury levels. Specifically, individuals that burned amalgam had urine mercury levels (median: 43.8 µg/L; mean ± SD: 171.1 ± 296.5 µg/L; n=5) significantly higher than median values measured in mechanical operators (11.6 µg/L, n=4), concession managers/owners (5.6 µg/L, n=11), excavators that blast and chisel ore (4.9 µg/L, n=33), individuals that sift and grind crushed ore (2.2 µg/L, n=47), support workers (0.5 µg/L, n=14), and those with no role in the mining sector (2.5 µg/L, n=6). There was a significant positive spearman correlation between fish consumption and hair mercury levels (r = 0.30) but not with urine mercury (r = 0.18) though further studies are needed to document which types of fish are consumed as well as portion sizes. Given that 200,000 people in Ghana are involved in the small-scale gold mining industry and that the numbers are expected to grow in Ghana and many other regions of the world, elucidating mercury exposure pathways in such communities is important to help shape policies and behaviors that may minimize health risks. PMID:20875913

  8. Thoracic CT findings at hypovolemic shock

    International Nuclear Information System (INIS)

    Rotondo, A.; Angelelli, G.; Catalano, O.; Grassi, R.; Scialpi, M.

    1998-01-01

    Purpose: To describe and discuss the thoracic CT features of hypovolemic shock. Material and Methods: From a group of 18 patients with signs of hypovolemia on contrast-enhanced abdominal CT, 11 were selected for our study as having also undergone a complete chest examination. Pulse rate, blood pressure, trauma score value, Glasgow coma scale value, surgical result, and final outcome were retrospectively evaluated. The CT features analyzed were: decreased cardiac volume, reduced caliber of the thoracic aorta, aortic branches and caval venous system, increased enhancement of the aorta, and increased enhancement of the pulmonary collapses/contusions. Results: All 11 subjects presented severe injuries and hemodynamic instability; 7 were stable enough to undergo surgery; only 1 of the 11 survived. Two patients showed none of the features of thoracic hypovolemia. All the other patients presented at least two signs: reduced caliber of the thoracic aorta in 7 cases; decreased volume of the cardiac chambers and increased aortic enhancement in 6; decreased caliber of the aortic vessels in 4; decreased caliber of the caval veins in 3; and increased enhancement of the pulmonary collapses/contusions in 3. Conclusions: In patients with hypovolemia, CT may show several thoracic findings in addition to abdominal ones. Knowledge of these features is important for distinguishing them from traumatic injuries. (orig.)

  9. Thoracic radiotherapy and breath control: current prospects

    International Nuclear Information System (INIS)

    Reboul, F.; Mineur, L.; Paoli, J.B.; Bodez, V.; Oozeer, R.; Garcia, R.

    2002-01-01

    Three-dimensional conformal radiotherapy (3D CRT) is adversely affected by setup error and organ motion. In thoracic 3D CRT, breathing accounts for most of intra-fraction movements, thus impairing treatment quality. Breath control clearly exhibits dosimetric improvement compared to free breathing, leading to various techniques for gated treatments. We review benefits of different breath control methods -i.e. breath-holding or beam gating, with spirometric, isometric or X-ray respiration sensor- and argument the choice of expiration versus inspiration, with consideration to dosimetric concerns. All steps of 3D-CRT can be improved with breath control. Contouring of organs at risk (OAR) and target are easier and more accurate on breath controlled CT-scans. Inter- and intra-fraction target immobilisation allows smaller margins with better coverage. Lung outcome predictors (NTCP, Mean Dose, LV20, LV30) are improved with breath-control. In addition, inspiration breath control facilitates beam arrangement since it widens the distance between OAR and target, and leaves less lung normal tissue within the high dose region. Last, lung density, as of CT scan, is more accurate, improving dosimetry. Our institutions choice is to use spirometry driven, patient controlled high-inspiration breath-hold; this technique gives excellent immobilization results, with high reproducibility, yet it is easy to implement and costs little extra treatment time. Breath control, whatever technique is employed, proves superior to free breathing treatment when using 3D-CRT. Breath control should then be used whenever possible, and is probably mandatory for IMRT. (authors)

  10. MRI findings in thoracic outlet syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Aralasmak, Ayse; Sharifov, Rasul; Kilicarslan, Rukiye; Alkan, Alpay [Bezmialem Vakif University, Department of Radiology, Fatih/Istanbul (Turkey); Cevikol, Can; Karaali, Kamil; Senol, Utku [Akdeniz University, Department of Radiology, Antalya (Turkey)

    2012-11-15

    We discuss MRI findings in patients with thoracic outlet syndrome (TOS). A total of 100 neurovascular bundles were evaluated in the interscalene triangle (IS), costoclavicular (CC), and retropectoralis minor (RPM) spaces. To exclude neurogenic abnormality, MRIs of the cervical spine and brachial plexus (BPL) were obtained in neutral. To exclude compression on neurovascular bundles, sagittal T1W images were obtained vertical to the longitudinal axis of BPL from spinal cord to the medial part of the humerus, in abduction and neutral. To exclude vascular TOS, MR angiography (MRA) and venography (MRV) of the subclavian artery (SA) and vein (SV) in abduction were obtained. If there is compression on the vessels, MRA and MRV of the subclavian vessels were repeated in neutral. Seventy-one neurovascular bundles were found to be abnormal: 16 arterial-venous-neurogenic, 20 neurogenic, 1 arterial, 15 venous, 8 arterial-venous, 3 arterial-neurogenic, and 8 venous-neurogenic TOS. Overall, neurogenic TOS was noted in 69%, venous TOS in 66%, and arterial TOS in 39%. The neurovascular bundle was most commonly compressed in the CC, mostly secondary to position, and very rarely compressed in the RPM. The cause of TOS was congenital bone variations in 36%, congenital fibromuscular anomalies in 11%, and position in 53%. In 5%, there was unilateral brachial plexitis in addition to compression of the neurovascular bundle. Severe cervical spondylosis was noted in 14%, contributing to TOS symptoms. For evaluation of patients with TOS, visualization of the brachial plexus and cervical spine and dynamic evaluation of neurovascular bundles in the cervicothoracobrachial region are mandatory. (orig.)

  11. A discussion for the evolution model of Pb isotope of the upper mantle in western Yunnan and its interpretation to the lead isotopic compositions of the regional alkali-rich porphyries and their related rocks

    International Nuclear Information System (INIS)

    Wu Kaixing; Hu Ruizhong; Bi Xianwu; Zhang Qian; Peng Jiantang

    2003-01-01

    Thirty Pb isotope data of the upper mantle in the area of western Yunnan have the similar trends with the Stacey-Kramers' two stage model growth curves but apparently deviate from it on the lead isotope composition programs, which may suggest Pb isotope of the upper mantle in the area of western Yunnan might have two stage evolution history though not fit very well to the Stacey-Kramers' two stage model growth curves. In this paper, a two-stage growth curves which can better fit the Pb isotope data was constructed based on the lead isotope data of the upper mantle in western Yunnan and the principle that Stacey and Kramers constructed the two-stage model and a reasonable interpretation was given to the lead isotopic compositions of the regional alkali-rich porphyries and their related rocks using the model. (authors)

  12. A comparison of oblique subcostal transversus abdominis plane block versus thoracic paravertebral block for postoperative analgesia after open cholecystectomy

    Directory of Open Access Journals (Sweden)

    Ghada Kamhawy

    2017-10-01

    Full Text Available Background: A major challenge in the postoperative period is pain management which, if not adequately controlled, may contribute to patient discomfort and decreased patient satisfaction, and possibly increased morbidity and mortality. Both Thoracic paravertebral block and oblique subcostal transversus abdominis plane block can be used as analgesic techniques for abdominal surgeries. Our aim in this research was comparison of cumulative 24-h post-operative morphine consumption between ultrasound-guided oblique subcostal transversus abdominis plane block and ultrasound-guided thoracic paravertebral block in patients who underwent an open cholecystectomy under general anesthesia. Patients and methods: This study was performed on 46 patients who underwent open cholecystectomy under general anesthesia. All patients were randomly allocated alternatively to one of two equal groups to either undergo ultrasound-guided unilateral oblique subcostal transversus abdominis plane block Group (I or to undergo ultrasound-guided unilateral thoracic paravertebral block Group (II. Both groups were subjected to a similar analgesic regimen in the immediate post-operative period that involved intravenous patient-controlled morphine analgesia which was used in both groups. Results: The total morphine consumption in the first postoperative 24 h was lower in thoracic paravertebral block Group (II (9.9 mg in thoracic paravertebral block group vs. 15.4 mg in oblique subcostal transversus abdominis plane block Group (I with p < 0.001. The mean time of first request of analgesia in Group (I was 248.7 min compared to 432.1 for Group (II with p < 0.001. Conclusions: Both ultrasound-guided oblique subcostal transversus abdominis plain block and single injection ultrasound guided thoracic paravertebral block are effective analgesic techniques for upper abdominal surgeries and reduces postoperative opioid requirements. However, thoracic paravertebral block is more

  13. Enhanced Recovery in Thoracic Surgery: A Review

    Directory of Open Access Journals (Sweden)

    Vesna D. Dinic

    2018-02-01

    Full Text Available The main goal of enhanced recovery program after thoracic surgery is to minimize stress response, reduce postoperative pulmonary complications, and improve patient outcome, which will in addition decrease hospital stay and reduce hospital costs. As minimally invasive technique, video-assisted thoracoscopic surgery represents an important element of enhanced recovery program in thoracic surgery. Anesthetic management during preoperative, intraoperative and postoperative period is essential for the enhanced recovery. In the era of enhanced recovery protocols, non-intubated thoracoscopic procedures present a step forward. This article focuses on the key elements of the enhanced recovery program in thoracic surgery. Having reviewed recent literature, the authors highlight potential procedures and techniques that might be incorporated into the program.

  14. A Case of Fatal Pulmonary Hypoplasia with Congenital Diaphragmatic Hernia, Thoracic Myelomeningocele, and Thoracic Dysplasia.

    Science.gov (United States)

    Ito, Ai; Fujinaga, Hideshi; Matsui, Sachiko; Tago, Kumiko; Iwasaki, Yuka; Fujino, Shuhei; Nagasawa, Junko; Amari, Shoichiro; Kaneshige, Masao; Wada, Yuka; Takahashi, Shigehiro; Tsukamoto, Keiko; Miyazaki, Osamu; Yoshioka, Takako; Ishiguro, Akira; Ito, Yushi

    2017-10-01

    Background  Congenital diaphragmatic hernia (CDH) is fatal in severe cases of pulmonary hypoplasia. We experienced a fatal case of pulmonary hypoplasia due to CDH, thoracic myelomeningocele (MMC), and thoracic dysplasia. This constellation of anomalies has not been previously reported. Case Report  A male infant with a prenatal diagnosis of thoracic MMC with severe hydrocephalus and scoliosis was born at 36 weeks of gestation. CDH was found after birth and the patient died of respiratory failure due to pulmonary hypoplasia and persistent pulmonary hypertension of the newborn at 30 hours of age despite neonatal intensive care. An autopsy revealed a left CDH without herniation of the liver or stomach into the thoracic cavity, severe hydrocephalus, Chiari malformation type II, MMC with spina bifida from Th4 to Th12, hemivertebrae, fused ribs, deformities of the thoracic cage and legs, short trunk, and agenesis of the left kidney. Conclusion  We speculate that two factors may be associated with the severe pulmonary hypoplasia: decreased thoracic space due to the herniation of visceral organs caused by CDH and thoracic dysplasia due to skeletal deformity and severe scoliosis.

  15. A RARE CASE OF THORACIC ACTINOMYCOSIS

    Directory of Open Access Journals (Sweden)

    Priyanka Das

    2017-10-01

    Full Text Available PRESENTATION OF CASE Actinomycetes are branching gram-positive anaerobic bacteria belonging to Actinomycetaceae family and are commensals in human oropharynx, gastrointestinal tract and female genitalia. Thoracic or pulmonary actinomycosis is an uncommon bacterial infection. The diagnosis of pulmonary or thoracic actinomycosis is often confounding because of its shared clinical features with malignant lung diseases and chronic suppurative lung diseases. However, chest physicians should be aware of actinomycosis being a differential diagnosis in persistent shadows in lung as early diagnosis leads to good prognosis. 1

  16. Failures and complications of thoracic drainage

    Directory of Open Access Journals (Sweden)

    Đorđević Ivana

    2006-01-01

    Full Text Available Background/Aim. Thoracic drainage is a surgical procedure for introducing a drain into the pleural space to drain its contents. Using this method, the pleura is discharged and set to the physiological state which enables the reexpansion of the lungs. The aim of the study was to prove that the use of modern principles and protocols of thoracic drainage significantly reduces the occurrence of failures and complications, rendering the treatment more efficient. Methods. The study included 967 patients treated by thoracic drainage within the period from January 1, 1989 to June 1, 2000. The studied patients were divided into 2 groups: group A of 463 patients treated in the period from January 1, 1989 to December 31, 1994 in whom 386 pleural drainage (83.36% were performed, and group B of 602 patients treated form January 1, 1995 to June 1, 2000 in whom 581 pleural drainage (96.51% were performed. The patients of the group A were drained using the classical standards of thoracic drainage by the general surgeons. The patients of the group B, however, were drained using the modern standards of thoracic drainage by the thoracic surgeons, and the general surgeons trained for this kind of the surgery. Results. The study showed that better results were achieved in the treatment of the patients from the group B. The total incidence of the failures and complications of thoracic drainage decreased from 36.52% (group A to 12.73% (group B. The mean length of hospitalization of the patients without complications in the group A was 19.5 days versus 10 days in the group B. The mean length of the treatment of the patients with failures and complications of the drainage in the group A was 33.5 days versus 17.5 days in the group B. Conclusion. The shorter length of hospitalization and the lower morbidity of the studied patients were considered to be the result of the correct treatment using modern principles of thoracic drainage, a suitable surgical technique, and a

  17. Thoracic pain in a collegiate runner.

    Science.gov (United States)

    Austin, G P; Benesky, W T

    2002-08-01

    This case study describes the process of examination, re-examination, and intervention for a collegiate runner with mechanical thoracic pain preventing athletic participation and limiting daily function. Unimpaired function fully returned in less than 3 weeks with biweekly sessions to re-establish normal and painfree thoracic mechanics via postural hygiene, exercise, mobilization, and manipulation. The outcome of this case study supports the original hypothesis that the pattern of impairments was in fact responsible for the functional limitations and disability in this athlete. At the time of publication the athlete was without functional limitations and had fully returned to competitive sprinting for the university track team.

  18. Idiopathic thoracic transdural intravertebral spinal cord herniation

    Directory of Open Access Journals (Sweden)

    Mazda K Turel

    2017-01-01

    Full Text Available Idiopathic spinal cord herniation is a rare and often missed cause of thoracic myelopathy. The clinical presentation and radiological appearance is inconsistent and commonly confused with a dorsal arachnoid cyst and often is a misdiagnosed entity. While ventral spinal cord herniation through a dural defect has been previously described, intravertebral herniation is a distinct entity and extremely rare. We present the case of a 70-year old man with idiopathic thoracic transdural intravertebral spinal cord herniation and discuss the clinico-radiological presentation, pathophysiology and operative management along with a review the literature of this unusual entity.

  19. Lungs, pleura, thoracal wall. 7. rev. ed.

    International Nuclear Information System (INIS)

    Stender, H.S.

    1988-01-01

    The book describes the anatomy of the lungs, as well as X-ray, computerized tomography, nuclear magnetic resonance, and nuclear-medical imaging techniques. Following a discussion of the general symptomatology of pulmonary diseases verifiable by X-ray, the individual diseases including inhalation damage from inorganic dusts and gases are dealt with. Traumatic thoracal conditions, the image of the thorax after operations, alterations of the thoracal wall, as well as pleural diseases are also discussed. (MG) With 1776 figs., 52 tabs [de

  20. Chest physiotherapy with positive expiratory pressure breathing after abdominal and thoracic surgery: a systematic review.

    Science.gov (United States)

    Orman, J; Westerdahl, E

    2010-03-01

    A variety of chest physiotherapy techniques are used following abdominal and thoracic surgery to prevent or reduce post-operative complications. Breathing techniques with a positive expiratory pressure (PEP) are used to increase airway pressure and improve pulmonary function. No systematic review of the effects of PEP in surgery patients has been performed previously. The purpose of this systematic review was to determine the effect of PEP breathing after an open upper abdominal or thoracic surgery. A literature search of randomised-controlled trials (RCT) was performed in five databases. The trials included were systematically reviewed by two independent observers and critically assessed for methodological quality. We selected six RCT evaluating the PEP technique performed with a mechanical device in spontaneously breathing adult patients after abdominal or thoracic surgery via thoracotomy. The methodological quality score varied between 4 and 6 on the Physiotherapy Evidence Database score. The studies were published between 1979 and 1993. Only one of the included trials showed any positive effects of PEP compared to other breathing techniques. Today, there is scarce scientific evidence that PEP treatment is better than other physiotherapy breathing techniques in patients undergoing abdominal or thoracic surgery. There is a lack of studies investigating the effect of PEP over placebo or no physiotherapy treatment.

  1. Unsustainability of water resources in the Upper Laja River Basin, Mexico: Social-hydrology interactions in a regional overexploited aquifer with increasing concentrations of fluoride, arsenic and sodium

    Science.gov (United States)

    Ortega, A.

    2013-05-01

    The Upper Laja River Basin, also known as the Independence Basin (IB), with an area of 7,000 km2 and a population near to 500,000 inhabitants is part of the regional Lerma-Chapala Basin in Central Mexico. Groundwater is the main source for drinking water supply, agriculture and industrial uses. Total groundwater extraction is in the order of 1,000 million of m3/a, through near to 3,000 wells in the basin, from which about 85% is for agriculture production, mainly for exportation. Historical hydrologic information in the basin showed the existence of numerous streams, rivers and lakes within the catchments in addition to thousands of springs in the discharge area. At present there is not permanent runoff in the main river and most of the springs and associated ecosystems have disappeared. Water table in the aquifer is between 100 and 200 m depth with decreasing rates between 2 m/a and 10 m/a, while 60 years ago water tables was near ground surface. Dissolved concentration of arsenic and fluoride in groundwater is increasing with time, causing severe health effects in rural villages and more recently in the main urban centers. Increasing concentration of sodium is affecting soil productivity and plant grow, where several hectares of land are been abandoned. There are several pieces of evidence that show the unsustainability of water resources in the IB creating complex social-hydrology interactions: Human actions are impairing the long-term renewability of freshwater stocks and flows. Basic water requirement are not been guaranteed to all inhabitants to maintain human health, neither to restore nor to maintain the remaining ecosystems. Water quality does not meet certain minimum standards in most of the basin. Water-planning and decision making are not democratic, the COTAS, a representation of water users is controlled by farmers with political power; therefore, limiting the participation of other parties and fostering direct participation of affected interests

  2. Possible radiation induced cancer of the thoracic esophagus after postoperative irradiation for the breast cancer

    International Nuclear Information System (INIS)

    Ueda, Mamoru; Matsubara, Toshiki; Kasumi, Fujio; Nishi, Mitsumasa; Kajitani, Tamaki

    1991-01-01

    We report 11 patients with cancer of the thoracic esophagus developing after postoperative irradiation therapy for breast cancer. Irradiation was done immediately after mastectomy in these patients and the irradiation field included the unilateral or bilateral parasternal region. They received a total dose ranging from 35 Gy to 60 Gy and the dose received to the thoracic esophagus was estimated from 10 Gy to 48 Gy. All cancer sites were involved in the irradiation field. The latent intervals of 10 patients from radiation to the manifest of cancer ranged from 10 to 19 years. Among 4777 women undergoing mastectomy for breast cancer between 1946 and 1980 in our hospital, 8 women (0.17%) developed cancer of the thoracic esophagus, whereas 5 (0.335%) out of 1534 women treated with mastectomy and radiotherapy with Linac between 1964 and 1980 developed cancer of the thoracic esophagus. Higher incidence of esophageal cancer in patients treated with surgery and radiation suggests that these cancers might be induced by radiation. Eight patients had esophagectomy and 4 patients of them received postoperative irradiation. They have survived from 9 months to 13 years. Two patients were controlled well by the irradiation alone. It is interesting that radiation therapy is sensitive to the possible radiation induced cancer of the thoracic esophagus. Follow up study should be directed to the possible development of second malignancy in patients who survive for a long time after radiation therapy. (author)

  3. Evolution of Thoracic Surgery in Canada

    Directory of Open Access Journals (Sweden)

    Jean Deslauriers

    2015-01-01

    Full Text Available BACKGROUND: Canada’s contributions toward the 21st century’s practice of thoracic surgery have been both unique and multilayered. Scattered throughout are tales of pioneers where none had gone before, where opportunities were greeted by creativity and where iconic figures followed one another.

  4. Thoracic endometriosis syndrome: Current concept in ...

    African Journals Online (AJOL)

    Background: Thoracic endometriosis is a rare pathology. The diagnosis is often delayed or missed, however recently, there has been significant advances in the knowledge of this condition and hence, an improvement in the diagnosis and treatment. Objective: To review the current concepts in the pathophysiology and ...

  5. Thoracic Ectopia Cordis in an Ethiopian Neonate

    African Journals Online (AJOL)

    GB

    2017-03-01

    Mar 1, 2017 ... Thoracic Ectopia Cordis in an Ethiopian Neonate. Henok Tadele*. 1 ... the chest wall. Initial treatment included covering the heart with sterile-saline soaked dressing, starting systemic antibiotics and supportive care. A staged ... of thoracoabdominal EC, anterior diaphragmatic hernia, lower sternal defect and ...

  6. April 2014 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-04-01

    Full Text Available No abstract available. Article truncated at 150 words. The April 2014 Arizona Thoracic Society meeting was held on Wednesday, 4/23/2014 at Scottsdale Shea Hospital beginning at 6:30 PM. There were 15 in attendance representing the pulmonary, critical care, sleep, pathology and radiology communities. It was announced that there will be a wine tasting with the California, New Mexico and Colorado Thoracic Societies at the American Thoracic Society International Meeting. The tasting will be led by Peter Wagner and is scheduled for the Cobalt Room in the Hilton San Diego Bayfront on Tuesday, May 20, from 4-8 PM. Guideline development was again discussed. The consensus was to await publication of the IDSA Cocci Guidelines and respond appropriately. George Parides, Arizona Chapter Representative, gave a presentation on Hill Day. Representatives of the Arizona, New Mexico and Washington Thoracic Societies met with their Congressional delegations, including Rep. David Schweikert, to discuss the Cigar Bill, NIH funding, and the Medicare Sustainable Growth ...

  7. November 2017 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2017-11-01

    Full Text Available No abstract available. Article truncated after 150 words. The November 2017 Arizona Thoracic Society meeting was held on Wednesday, November 15, 2017 at the HonorHealth Rehabilitation Hospital beginning at 6:30 PM. This was a dinner meeting with a lecture followed by case presentations. There were 15 in attendance representing the pulmonary, critical care, sleep, allergy, infectious disease and radiology communities. At the beginning of the meeting several issues were discussed: 1. CME offered by the Southwest Journal of Pulmonary and Critical Care Medicine (SWJPCC is currently offered to only the Southwest state thoracic societies and the Mayo Clinic. After discussion it was felt that this restriction of access was no longer appropriate and CME credits should be available to all. 2. Efforts continue to obtain CME for the Arizona Thoracic Society meetings. Our Chapter Representative, Dr. Gerry Schwartzberg, is approaching this with the American Thoracic Society. Locally, HonorHealth sent out a survey on CME needs. Members were encouraged …

  8. Thoracic trauma: presentation and management outcome

    International Nuclear Information System (INIS)

    Saaiq, M.; Shah, S. A.

    2008-01-01

    To determine the presentation and management outcome of thoracic trauma in a tertiary care setting. A total of 143 patients, who presented with chest trauma, were included in the study. All the patients were assessed by the history, physical examination and ancillary investigations. Appropriate managements were instituted as required. Data was described in percentages. out of 143 patients, 119 (83)% were males and 24 (17)% were females. Most of the patients belonged to the age group of 21-50 years. Ninety seven (66)% patients were admitted for indoor management. Blunt injury was found in 125 (87.4%) patients, while penetrating injuries in only 18 (12.6%) patients. Road Traffic Accidents (RTAs) were the commonest cause of trauma (n=103, 72%). Rib fracture was the commonest chest injury (74% patients). Head injury was the most frequently associated injury (18% of the patients). Tube thoracostomy was the commonest intervention undertaken in 65 (45%) patients. Seventeen (11.88%) patients were managed with mechanical ventilation. there were 17 deaths with a mortality rate of 11.88%. Thoracic trauma is an important cause of hospitalization, morbidity and mortality in the younger population. RTAs constitute the leading cause of thoracic trauma in our setup. Tube thoracostomy is the most frequent and at times the only invasive procedure required as a definitive measure in thoracic trauma patients. A policy of selective hospitalization helps to avoid unnecessary hospital admissions. (author)

  9. Thoracic epidural anaesthesia for major abdominal surgeries ...

    African Journals Online (AJOL)

    The pulse rate, blood pressure and oxygen saturation were monitored throughout the procedure and recorded. Data were obtained from the ... In a previous study, Consani et al.3 documented the feasibility of thoracic epidural ... thoracostomy and mastectomy in high-risk patients.2,6 Since TEA places less demand on drugs, ...

  10. Thoracic and abdominopelvic actinomycosis | Spiegel | SA Journal ...

    African Journals Online (AJOL)

    intervention it is worthwhile including actinomycosis infection in the differential diagnosis. We present radiological findings for 4 patients presenting with different forms of thoracic and abdominopelvic actinomycosis infection, and a short review of the documented literature findings. South African Journal of Radiology Vol.

  11. Acquired intrathoracic kidney in thoracic kyphosis

    International Nuclear Information System (INIS)

    Murayama, Sadayuki; Kawashima, Akira; Ohuchida, Toshiyuki; Russell, W.J.

    1986-12-01

    Two cases of acquired intrathoracic kidney associated with thoracic kyphosis are reported, with emphasis on the radiographic manifestations. A search of the scientific literature disclosed that the acquired type of this abnormality is rare. The importance of recognizing this entity from a differential diagnostic standpoint is underscored. (author)

  12. Tonganoxichnus, a new insect trace from the Upper Carboniferous of eastern Kansas

    Science.gov (United States)

    Mangano, M.G.; Buatois, L.A.; Maples, C.G.; Lanier, Wendy E.

    1997-01-01

    Upper Carboniferous tidal rhythmites of the Tonganoxie Sandstone Member (Stranger Formation) at Buildex Quarry, eastern Kansas, USA, host a relatively diverse arthropod-dominated ichnofauna. Bilaterally symmetrical traces displaying unique anterior and posterior sets of morphological features are well represented within the assemblage. A new ichnogenus, Tonganoxichnus, is proposed for these traces. T. buildexensis, the type ichnospecies, has an anterior region characterized by the presence of a frontal pair of maxillary palp impressions, followed by a head impression and three pairs of conspicuous thoracic appendage imprints symmetrically opposite along a median axis. The posterior region commonly exhibits numerous delicate chevron-like markings, recording the abdominal appendages, and a thin, straight, terminal extension. T. buildexensis is interpreted as a resting trace. A second ichnospecies, T. ottawensis, is characterized by a fan-like arrangement of mostly bifid scratch marks at the anterior area that records the head- and thoracic-appendage backstrokes against the substrate. The posterior area shows chevron-like markings or small subcircular impressions that record the abdominal appendages of the animal, also ending in a thin, straight, terminal extension. Specimens display lateral repetition, and are commonly grouped into twos or threes with a fix point at the posteriormost tail-like structure. T. ottawensis is interpreted as a jumping structure, probably in connection with feeding purposes. The two ichnospecies occur in close association, and share sufficient morphologic features to support the same type of arthropod producer. T. buildexensis closely mimics the ventral anatomy of the tracemaker, whereas T. ottawensis records the jumping abilities of the animal providing significant ethologic and paleoecologic information. The presence of well-differentiated cephalic, thoracic, and abdominal features, particularly in T. buildexensis, resembles the

  13. Temperature oscillations in the upper thermocline region- A case study on internal waves off Kalpeni Island in the southern Arabian Sea

    Digital Repository Service at National Institute of Oceanography (India)

    Charyulu, R.J.K.; Sarma, Y.V.B.; Sarma, M.S.S.; Rao, L.V.G.

    characteristics of the temperature oscillations. The power spectra of temperature fluctuations at 11 depths in the upper thermocline from 80 to 100 m with 2 m interval, were computed for studying the short period internal waves. Power spectra density was higher...

  14. Optimal geophysical complex and methods for investigation of peleogene and upper cretaceous deposits in search and exploratory wells in the northern areas of Tumen region

    International Nuclear Information System (INIS)

    Nelepchenko, O.M.; Akhiyarov, V.Kh.

    1975-01-01

    A number of geophysical studies of the Paleogene and upper Cretaceous deposits in prospecting and exploration boreholes in the northern part of the Tyumen field are described. The studies include, besides the essential ones, neutron logging with thermal neutrons (NKT-50), infrared logging, and lateral logging

  15. Postradiation motor neuron syndrome of the upper cervical region - a manifestation of the combined effect of cranial irradiation and intrathecal chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tan, S.V.; Pye, I.F. (Leicester Royal Infirmary (United Kingdom))

    1991-05-01

    The authors present a brief case report of neurogenic amyotropy apparently resulting from damage to the anterior horn cells of the upper cervical cord and lower brainstem during cranial irradiation which occurred as part of the patient's treatment for acute leukaemia. (Author).

  16. Right thoracic curvature in the normal spine

    Directory of Open Access Journals (Sweden)

    Masuda Keigo

    2011-01-01

    Full Text Available Abstract Background Trunk asymmetry and vertebral rotation, at times observed in the normal spine, resemble the characteristics of adolescent idiopathic scoliosis (AIS. Right thoracic curvature has also been reported in the normal spine. If it is determined that the features of right thoracic side curvature in the normal spine are the same as those observed in AIS, these findings might provide a basis for elucidating the etiology of this condition. For this reason, we investigated right thoracic curvature in the normal spine. Methods For normal spinal measurements, 1,200 patients who underwent a posteroanterior chest radiographs were evaluated. These consisted of 400 children (ages 4-9, 400 adolescents (ages 10-19 and 400 adults (ages 20-29, with each group comprised of both genders. The exclusion criteria were obvious chest and spinal diseases. As side curvature is minimal in normal spines and the range at which curvature is measured is difficult to ascertain, first the typical curvature range in scoliosis patients was determined and then the Cobb angle in normal spines was measured using the same range as the scoliosis curve, from T5 to T12. Right thoracic curvature was given a positive value. The curve pattern was organized in each collective three groups: neutral (from -1 degree to 1 degree, right (> +1 degree, and left ( Results In child group, Cobb angle in left was 120, in neutral was 125 and in right was 155. In adolescent group, Cobb angle in left was 70, in neutral was 114 and in right was 216. In adult group, Cobb angle in left was 46, in neutral was 102 and in right was 252. The curvature pattern shifts to the right side in the adolescent group (p Conclusions Based on standing chest radiographic measurements, a right thoracic curvature was observed in normal spines after adolescence.

  17. CT morphometry of adult thoracic intervertebral discs.

    Science.gov (United States)

    Fletcher, Justin G R; Stringer, Mark D; Briggs, Christopher A; Davies, Tilman M; Woodley, Stephanie J

    2015-10-01

    Despite being commonly affected by degenerative disorders, there are few data on normal thoracic intervertebral disc dimensions. A morphometric analysis of adult thoracic intervertebral discs was, therefore, undertaken. Archival computed tomography scans of 128 recently deceased individuals (70 males, 58 females, 20-79 years) with no known spinal pathology were analysed to determine thoracic disc morphometry and variations with disc level, sex and age. Reliability was assessed by intraclass correlation coefficients (ICCs). Anterior and posterior intervertebral disc heights and axial dimensions were significantly greater in men (anterior disc height 4.0±1.4 vs 3.6±1.3 mm; posterior disc height 3.6±0.90 vs 3.4±0.93 mm; p<0.01). Disc heights and axial dimensions at T4-5 were similar or smaller than at T2-3, but thereafter increased caudally (mean anterior disc height T4-5 and T10-11, 2.7±0.7 and 5.4±1.2 mm, respectively, in men; 2.6±0.8 and 5.1±1.3 mm, respectively, in women; p<0.05). Except at T2-3, anterior disc height decreased with advancing age and anteroposterior and transverse disc dimensions increased; posterior and middle disc heights and indices of disc shape showed no consistent statistically significant changes. Most parameters showed substantial to almost perfect agreement for intra- and inter-rater reliability. Thoracic disc morphometry varies significantly and consistently with disc level, sex and age. This study provides unique reference data on adult thoracic intervertebral disc morphometry, which may be useful when interpreting pathological changes and for future biomechanical and functional studies.

  18. Evaluation of lung volumes, vital capacity and respiratory muscle strength after cervical, thoracic and lumbar spinal surgery.

    Science.gov (United States)

    Oliveira, Marcio Aparecido; Vidotto, Milena Carlos; Nascimento, Oliver Augusto; Almeida, Renato; Santoro, Ilka Lopes; Sperandio, Evandro Fornias; Jardim, José Roberto; Gazzotti, Mariana Rodrigues

    2015-01-01

    Studies have shown that physiopathological changes to the respiratory system can occur following thoracic and abdominal surgery. Laminectomy is considered to be a peripheral surgical procedure, but it is possible that thoracic spinal surgery exerts a greater influence on lung function. The aim of this study was to evaluate the pulmonary volumes and maximum respiratory pressures of patients undergoing cervical, thoracic or lumbar spinal surgery. Prospective study in a tertiary-level university hospital. Sixty-three patients undergoing laminectomy due to diagnoses of tumors or herniated discs were evaluated. Vital capacity, tidal volume, minute ventilation and maximum respiratory pressures were evaluated preoperatively and on the first and second postoperative days. Possible associations between the respiratory variables and the duration of the operation, surgical diagnosis and smoking status were investigated. Vital capacity and maximum inspiratory pressure presented reductions on the first postoperative day (20.9% and 91.6%, respectively) for thoracic surgery (P = 0.01), and maximum expiratory pressure showed reductions on the first postoperative day in cervical surgery patients (15.3%; P = 0.004). The incidence of pulmonary complications was 3.6%. There were reductions in vital capacity and maximum respiratory pressures during the postoperative period in patients undergoing laminectomy. Surgery in the thoracic region was associated with greater reductions in vital capacity and maximum inspiratory pressure, compared with cervical and lumbar surgery. Thus, surgical manipulation of the thoracic region appears to have more influence on pulmonary function and respiratory muscle action.

  19. Preoperative diagnosis of lymph node metastasis in thoracic esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Eguchi, Reiki; Yamada, Akiyoshi; Ueno, Keiko; Murata, Yoko [Tokyo Women`s Medical Coll. (Japan)

    1996-10-01

    From 1994 to 1995, to evaluate the utility of preoperative CT, EUS (endoscopic ultrasonography) and US in the diagnosis of lymph node metastasis in thoracic esophageal cancer, 94 patients with thoracic esophageal cancer who underwent esophagectomy were studied clinicopathologically. The sensitivity of EUS diagnosis of upper mediastinal lymph node metastasis (85%), left-sided paragastrin lymph node metastasis (73-77%), and especially lower paraesophageal lymph node metastasis (100%) were good. But due to their low-grade specificity in EUS diagnosis, their overall accuracy was not very good. On the other hand, the overall accuracy of the CT diagnosis of lymph node metastasis was fine. However, sensitivity, the most important clinical factor in the CT diagnosis of lymph node metastasis was considerably inferior to EUS. The assessment of the diagnosis of lymph node metastasis around the tracheal bifurcation and the pulmonary hilum and the left para-cardial lesion by CT or EUS was poor. It was concluded that lymph node metastasis of these area must be the pitfall in preoperative diagnosis. The average diameter of the lymph nodes and the proportion of cancerous tissue in the lymph nodes diagnosed as metastatic lymph nodes by CT was larger than that of the false negative lymph nodes. However, the lymph nodes diagnosed as true positives by EUS showed no such tendency. This must be the reason the sensitivity of the EUS diagnosis and specificity of the CT diagnosis were favorable, but the specificity of the EUS diagnosis and especially the sensitivity of the CT diagnosis were not as good. (author)

  20. Preoperative diagnosis of lymph node metastasis in thoracic esophageal cancer

    International Nuclear Information System (INIS)

    Eguchi, Reiki; Yamada, Akiyoshi; Ueno, Keiko; Murata, Yoko

    1996-01-01

    From 1994 to 1995, to evaluate the utility of preoperative CT, EUS (endoscopic ultrasonography) and US in the diagnosis of lymph node metastasis in thoracic esophageal cancer, 94 patients with thoracic esophageal cancer who underwent esophagectomy were studied clinicopathologically. The sensitivity of EUS diagnosis of upper mediastinal lymph node metastasis (85%), left-sided paragastrin lymph node metastasis (73-77%), and especially lower paraesophageal lymph node metastasis (100%) were good. But due to their low-grade specificity in EUS diagnosis, their overall accuracy was not very good. On the other hand, the overall accuracy of the CT diagnosis of lymph node metastasis was fine. However, sensitivity, the most important clinical factor in the CT diagnosis of lymph node metastasis was considerably inferior to EUS. The assessment of the diagnosis of lymph node metastasis around the tracheal bifurcation and the pulmonary hilum and the left para-cardial lesion by CT or EUS was poor. It was concluded that lymph node metastasis of these area must be the pitfall in preoperative diagnosis. The average diameter of the lymph nodes and the proportion of cancerous tissue in the lymph nodes diagnosed as metastatic lymph nodes by CT was larger than that of the false negative lymph nodes. However, the lymph nodes diagnosed as true positives by EUS showed no such tendency. This must be the reason the sensitivity of the EUS diagnosis and specificity of the CT diagnosis were favorable, but the specificity of the EUS diagnosis and especially the sensitivity of the CT diagnosis were not as good. (author)

  1. An evaluation of in-plane shields during thoracic CT.

    Science.gov (United States)

    Foley, S J; McEntee, M F; Rainford, L A

    2013-08-01

    The object of this study was to compare organ dose and image quality effects of using bismuth and barium vinyl in-plane shields with standard and low tube current thoracic CT protocols. A RANDO phantom was scanned using a 64-slice CT scanner and three different thoracic protocols. Thermoluminescent dosemeters were positioned in six locations to record surface and absorbed breast and lung doses. Image quality was assessed quantitatively using region of interest measurements. Scanning was repeated using bismuth and barium vinyl in-plane shields to cover the breasts and the results were compared with standard and reduced dose protocols. Dose reductions were most evident in the breast, skin and anterior lung when shielding was used, with mean reductions of 34, 33 and 10 % for bismuth and 23, 18 and 11 % for barium, respectively. Bismuth was associated with significant increases in both noise and CT attenuation values for all the three protocols, especially anteriorly and centrally. Barium shielding had a reduced impact on image quality. Reducing the overall tube current reduced doses in all the locations by 20-27 % with similar increases in noise as shielding, without impacting on attenuation values. Reducing the overall tube current best optimises dose with minimal image quality impact. In-plane shields increase noise and attenuation values, while reducing anterior organ doses primarily. Shielding remains a useful optimisation tool in CT and barium is an effective alternative to bismuth especially when image quality is of concern.

  2. The European educational platform on thoracic surgery.

    Science.gov (United States)

    Massard, Gilbert; Rocco, Gaetano; Venuta, Federico

    2014-05-01

    As the largest scientific organisation world-wide exclusively dedicated to general thoracic surgery (GTS), the European Society of Thoracic Surgeons (ESTS) recognized that one of its priorities is education. The educational platform designed ESTS addresses not only trainees, but also confirmed thoracic surgeons. The two main aims are (I) to prepare trainees to graduation and to the certification by the European Board of Thoracic Surgery and (II) to offer opportunities for continuous medical education in the perspective of life-long learning and continuous professional development to certified thoracic surgeons. It is likely that recertification will become an obligation during the coming decade. At its inception, the platform differentiated two different events. A 6-day course emphasizing on theoretic knowledge was created in Antalya in 2007. The same year, a 2-day school oriented to practical issues with hands-on in the animal lab was launched in Antalya. These two teaching tracks need further development. In the knowledge track, we intend to organize highly specialized 2-day courses to deepen insight into theoretical questions. The skill track will be implemented by specialized courses for high technology such as tracheal surgery, ECMO, robotics or chest wall reconstruction. In order to promote tomorrows' leadership, we created an academic competence track giving an insight into medical communication, methodology and management. We also had to respond to an increasing demand from the Russian speaking countries, where colleagues may face problems to attend western meetings, and where the language bareer may be a major impediment. We initiated a Russian school with three events yearly in 2012. Contemporary teaching must be completed with an e-learning platform, which is currently under development. The school activities are organized by the educational committee, which is headed by the ESTS Director of Education, assisted by coordinators of the teaching tracks and

  3. Magnetic resonance-thoracic ductography. Imaging aid for thoracic surgery and thoracic duct depiction based on embryological considerations

    International Nuclear Information System (INIS)

    Okuda, Itsuko; Udagawa, Harushi; Takahashi, Junji; Yamase, Hiromi; Kohno, Tadasu; Nakajima, Yasuo

    2009-01-01

    We describe the optimal protocol of magnetic resonance-thoracic ductography (MRTD) and provide examples of thoracic ducts (TD) and various anomalies. The anatomical pathway of the TD was analyzed based on embryological considerations. A total of 78 subjects, consisting of noncancer adults and patients with esophageal cancer and lung cancer, were enrolled. The MRTD protocol included a long echo time and was based on emphasizing signals from the liquid fraction and suppressing other signals, based on the principle that lymph flow through the TD appears hyperintense on T2-weighted images. The TD configuration was classified into nine types based on location [right and/or left side(s) of the descending aorta] and outflow [right and/or left venous angle(s)]. MRTD was conducted in 78 patients, and the three-dimensional reconstruction was considered to provide excellent view of the TD in 69 patients, segmentalization of TD in 4, and a poor view of the TD in 5. MRTD achieved a visualization rate of 94%. Most of the patients had a right-side TD that flowed into the left venous angle. Major configuration variations were noted in 14% of cases. Minor anomalies, such as divergence and meandering, were frequently seen. MRTD allows noninvasive evaluation of TD and can be used to identify TD configuration. Thus, this technique is considered to contribute positively to safer performance of thoracic surgery. (author)

  4. Anatomical landmarks and skin markers are not reliable for accurate labeling of thoracic vertebrae on MRI

    International Nuclear Information System (INIS)

    Shabshin, Nogah; Schweitzer, Mark E.; Carrino, John A.

    2010-01-01

    Background: Numbering of the thoracic spine on MRI can be tedious if C2 and L5-S1 are not included and may lead to errors in lesion level. Purpose: To determine whether anatomic landmarks or external markers are reliable as an aid for accurate numbering of thoracic vertebrae on MRI. Material and Methods: Sixty-seven thoracic spine MR studies of 67 patients (30 males, 37 females, age range 18-83 years) were studied, composed of 52 consecutive MR studies and an additional 15 MRI in which vitamin E markers were placed over the skin. In the 52 thoracic MR examinations potential numbering aids such as the level of the sternal apex, pulmonary artery, aortic arch, and osseous or disc abnormalities were numbered on both cervical localizer (standard of reference) and thoracic sagittal images. The additional 15 examinations in which vitamin E markers were placed over the skin were evaluated for consistency in the level of the markers on different sequences in the same exam. Results: The sternal apex level ranged from T2 to T5 [T3 in 28/51 patients (55%), T2 in 10/51 (20%)]. The aortic arch level ranged from T2 to T4 [T4 in 18/48 (38%) and T3 in 17 (35%)]. Pulmonary artery level ranged from T4 to T6-7 disc [T5 in 20/52 patients (38%) and T6 in 14/52 (27%)]. In 3 of 12 patients who had abnormalities in a vertebral body or disc as definite point reference, the non-localizer image mislabelled the level. In 11/15 (73%) patients with vitamin E markers that were placed over the upper thoracic spine, the results showed consistency in the level of the markers in relation to the reference points or consistent inter-marker gap between the sequences. Conclusion: There are only two reliable ways to accurately define the levels if no landmarking feature is available on the magnet. The first is by including C2 in the thoracic sequence of a diagnostic quality, and the second is by using an abnormality in the discs or vertebral bodies as a point of reference

  5. Anatomical landmarks and skin markers are not reliable for accurate labeling of thoracic vertebrae on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Shabshin, Nogah (Dept. of Diagnostic Imaging, Chaim Sheba Medical Center, Tel-HaShomer (Israel)), e-mail: shabshin@gmail.com; Schweitzer, Mark E. (Dept. of Diagnostic Imaging, Ottawa Hospital and Univ. of Ottawa, Ottawa (Canada)); Carrino, John A. (Dept. of Radiology, Johns Hopkins Univ. School of Medicine, Baltimore, MD (United States))

    2010-11-15

    Background: Numbering of the thoracic spine on MRI can be tedious if C2 and L5-S1 are not included and may lead to errors in lesion level. Purpose: To determine whether anatomic landmarks or external markers are reliable as an aid for accurate numbering of thoracic vertebrae on MRI. Material and Methods: Sixty-seven thoracic spine MR studies of 67 patients (30 males, 37 females, age range 18-83 years) were studied, composed of 52 consecutive MR studies and an additional 15 MRI in which vitamin E markers were placed over the skin. In the 52 thoracic MR examinations potential numbering aids such as the level of the sternal apex, pulmonary artery, aortic arch, and osseous or disc abnormalities were numbered on both cervical localizer (standard of reference) and thoracic sagittal images. The additional 15 examinations in which vitamin E markers were placed over the skin were evaluated for consistency in the level of the markers on different sequences in the same exam. Results: The sternal apex level ranged from T2 to T5 [T3 in 28/51 patients (55%), T2 in 10/51 (20%)]. The aortic arch level ranged from T2 to T4 [T4 in 18/48 (38%) and T3 in 17 (35%)]. Pulmonary artery level ranged from T4 to T6-7 disc [T5 in 20/52 patients (38%) and T6 in 14/52 (27%)]. In 3 of 12 patients who had abnormalities in a vertebral body or disc as definite point reference, the non-localizer image mislabelled the level. In 11/15 (73%) patients with vitamin E markers that were placed over the upper thoracic spine, the results showed consistency in the level of the markers in relation to the reference points or consistent inter-marker gap between the sequences. Conclusion: There are only two reliable ways to accurately define the levels if no landmarking feature is available on the magnet. The first is by including C2 in the thoracic sequence of a diagnostic quality, and the second is by using an abnormality in the discs or vertebral bodies as a point of reference

  6. Society of Thoracic Surgeons Risk Score predicts hospital charges and resource use after aortic valve replacement.

    Science.gov (United States)

    Arnaoutakis, George J; George, Timothy J; Alejo, Diane E; Merlo, Christian A; Baumgartner, William A; Cameron, Duke E; Shah, Ashish S

    2011-09-01

    The impact of Society of Thoracic Surgeons predicted mortality risk score on resource use has not been previously studied. We hypothesize that increasing Society of Thoracic Surgeons risk scores in patients undergoing aortic valve replacement are associated with greater hospital charges. Clinical and financial data for patients undergoing aortic valve replacement at The Johns Hopkins Hospital over a 10-year period (January 2000 to December 2009) were reviewed. The current Society of Thoracic Surgeons formula (v2.61) for in-hospital mortality was used for all patients. After stratification into risk quartiles, index admission hospital charges were compared across risk strata with rank-sum and Kruskal-Wallis tests. Linear regression and Spearman's coefficient assessed correlation and goodness of fit. Multivariable analysis assessed relative contributions of individual variables on overall charges. A total of 553 patients underwent aortic valve replacement during the study period. Average predicted mortality was 2.9% (±3.4) and actual mortality was 3.4% for aortic valve replacement. Median charges were greater in the upper quartile of patients undergoing aortic valve replacement (quartiles 1-3, $39,949 [interquartile range, 32,708-51,323] vs quartile 4, $62,301 [interquartile range, 45,952-97,103], P < .01]. On univariate linear regression, there was a positive correlation between Society of Thoracic Surgeons risk score and log-transformed charges (coefficient, 0.06; 95% confidence interval, 0.05-0.07; P < .01). Spearman's correlation R-value was 0.51. This positive correlation persisted in risk-adjusted multivariable linear regression. Each 1% increase in Society of Thoracic Surgeons risk score was associated with an added $3000 in hospital charges. This is the first study to show that increasing Society of Thoracic Surgeons risk score predicts greater charges after aortic valve replacement. As competing therapies, such as percutaneous valve replacement, emerge to

  7. Extent of postoperative prophylactic radiotherapy after radical surgery of thoracic esophageal squamous cell carcinoma

    International Nuclear Information System (INIS)

    Lu Jincheng; Tao Hua; Zha Wenwu; Xu Kangxiong

    2007-01-01

    Objective: To determine the extent of postoperative prophylactic radiotherapy after radical surgery of thoracic esophageal squamous cell carcinoma. Should the entire mediastinum (M), bilateral supraclavicular areas(S) and the left gastric area(L) be all included in the irradiation field. Methods The clinical data of 204 such patients treated from 1996 through 1999 were retrospectively reviewed. They were classified into four groups: group A, 26 patients given irradiation to the mediastinum M alone; group B, 139 patients given irradiation to the mediastinum and bilateral supraclavicular areas M + S; group C, 10 patients irradiation to the mediastinum plus left gastric area M + L; and group D, 29 patients irradiation to all these three areas ( M + S + L). The overall and disease-free survival rates were calculated using the Kaplan- Meier method and comparison of these groups was done with the Logrank test. Prognostic variables were entered into a Cox regression model controlling the age, gender, length, site, pT, pN, and treatment received. Results: The 1-, 3- and 5-year overall and disease-free survival rates of all 204 patients were 83.8%, 53.2%, 34.1% and 77.8%, 51.6%, 33.8% , respectively. The 5-year disease-free survival rates for patients in group A, group B, group C, and group D were 36.3%, 30.7%, 40.0% and 43.6% (χ 2 = 3.05, P=0.385), respectively. Multivariate analysis showed that the pT and pN were independent risk factors for disease-free survival rate, whereas treatment arm gave no significant difference (χ 2 =2.77, P=0.096). None of the 43 patents without irradiation to the L had abdominal lymph node metastasis from lesions in the upper and upper-middle third (located middle third but invasion to the upper third) thoracic esophagus. The data of supraclavicular lymph node metastasis between patients with and without irradiation showed that S in lesion in the lower and middle-lower third (located middle third but invasion to the lower third) thoracic

  8. Management of an ingested fish bone in the lung using video-assist thoracic surgery: a case report.

    Science.gov (United States)

    Tan, Sichuang; Tan, Sipin; Peng, Muyun; Yu, Fenglei

    2015-06-01

    We report a case of lung abscess caused by an ingested fish bone that was successfully treated by minimally invasive surgery. Although cases of ingested foreign body abscess are well reported, lung abscess caused by ingested fish bone is extremely rare. To date, less than 10 similar cases have been reported in the literature. To the best of our knowledge, the case presented in this case report is the first report of this kind that was successfully treated by video-assist thoracic surgery (VATS). A 47-year-old man was admitted to department of thoracic surgery with the complaint of continues dry cough and fever. The patient accidentally swallowed a long sharp-blade-shaped fish bone 20 days before, which perforated the upper thoracic esophagus on the right and embedded in the right upper lobe.The diagnosis was verified by computed tomography scan and a video-assist thoracic surgery procedure was successfully performed to treat the patient. The patient survived the esophageal perforation fortunately without involvement of great vessel injury and probable mediastinitis. This report may provide additional experience on lung abscess caused by ingested fish bones. However, it is also important to educate the public of the risks of trying to force an ingested object down into the stomach.

  9. Focal Anterior Displacement of the Thoracic Spinal Cord without Evidence of Spinal Cord Herniation or an Intradural Mass

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Yoon; Lee, Joon Woo; Lee, Guen Young; Kang, Heung Sik [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of)

    2014-07-01

    We report magnetic resonance imaging (MRI) findings on focal anterior displacement of the thoracic spinal cord in asymptomatic patients without a spinal cord herniation or intradural mass. We identified 12 patients (male:female = 6:6; mean age, 51.7; range, 15-83 years) between 2007 and 2011, with focal anterior displacement of the spinal cord and without evidence of an intradural mass or spinal cord herniation. Two radiologists retrospectively reviewed the MRI findings in consensus. An asymmetric spinal cord deformity with a focal dented appearance was seen on the posterior surface of the spinal cord in all patients, and it involved a length of 1 or 2 vertebral segments in the upper thoracic spine (thoracic vertebrae 1-6). Moreover, a focal widening of the posterior subarachnoid space was also observed in all cases. None of the patients had myelopathy symptoms, and they showed no focal T2-hyperintensity in the spinal cord with the exception of one patient. In addition, cerebrospinal fluid (CSF) flow artifacts were seen in the posterior subarachnoid space of the affected spinal cord level. Computed tomography myelography revealed preserved CSF flow in the two available patients. Focal anterior spinal cord indentation can be found in the upper thoracic level of asymptomatic patients without a spinal cord herniation or intradural mass.

  10. Focal Anterior Displacement of the Thoracic Spinal Cord without Evidence of Spinal Cord Herniation or an Intradural Mass

    International Nuclear Information System (INIS)

    Lee, Jong Yoon; Lee, Joon Woo; Lee, Guen Young; Kang, Heung Sik

    2014-01-01

    We report magnetic resonance imaging (MRI) findings on focal anterior displacement of the thoracic spinal cord in asymptomatic patients without a spinal cord herniation or intradural mass. We identified 12 patients (male:female = 6:6; mean age, 51.7; range, 15-83 years) between 2007 and 2011, with focal anterior displacement of the spinal cord and without evidence of an intradural mass or spinal cord herniation. Two radiologists retrospectively reviewed the MRI findings in consensus. An asymmetric spinal cord deformity with a focal dented appearance was seen on the posterior surface of the spinal cord in all patients, and it involved a length of 1 or 2 vertebral segments in the upper thoracic spine (thoracic vertebrae 1-6). Moreover, a focal widening of the posterior subarachnoid space was also observed in all cases. None of the patients had myelopathy symptoms, and they showed no focal T2-hyperintensity in the spinal cord with the exception of one patient. In addition, cerebrospinal fluid (CSF) flow artifacts were seen in the posterior subarachnoid space of the affected spinal cord level. Computed tomography myelography revealed preserved CSF flow in the two available patients. Focal anterior spinal cord indentation can be found in the upper thoracic level of asymptomatic patients without a spinal cord herniation or intradural mass

  11. [Digital thoracic radiology: devices, image processing, limits].

    Science.gov (United States)

    Frija, J; de Géry, S; Lallouet, F; Guermazi, A; Zagdanski, A M; De Kerviler, E

    2001-09-01

    In a first part, the different techniques of digital thoracic radiography are described. Since computed radiography with phosphore plates are the most commercialized it is more emphasized. But the other detectors are also described, as the drum coated with selenium and the direct digital radiography with selenium detectors. The other detectors are also studied in particular indirect flat panels detectors and the system with four high resolution CCD cameras. In a second step the most important image processing are discussed: the gradation curves, the unsharp mask processing, the system MUSICA, the dynamic range compression or reduction, the soustraction with dual energy. In the last part the advantages and the drawbacks of computed thoracic radiography are emphasized. The most important are the almost constant good quality of the pictures and the possibilities of image processing.

  12. Comminuted fracture of the thoracic spine.

    LENUS (Irish Health Repository)

    Cashman, J P

    2012-02-03

    BACKGROUND: Road deaths fell initially after the introduction of the penalty points but despite this, the rate of spinal injuries remained unchanged. AIMS: We report a patient with a dramatic spinal injury, though without neurological deficit. We discuss the classification, management and economic impact of these injuries. METHODS: We describe the management of a patient with a comminuted thoracic spinal fracture without neurological injury. We conducted a literature review with regard to the availability of literature of the management of these injuries. RESULTS: This 17-year-old female was managed surgically and had a good functional outcome. There is no clear consensus in the published literature on the management of these injuries. CONCLUSIONS: Comminuted thoracic spinal factures are potentially devastating. Such a patient presents challenges in determining the appropriate treatment.

  13. Incidental Cardiac Findings on Thoracic Imaging.

    LENUS (Irish Health Repository)

    Kok, Hong Kuan

    2013-02-07

    The cardiac structures are well seen on nongated thoracic computed tomography studies in the investigation and follow-up of cardiopulmonary disease. A wide variety of findings can be incidentally picked up on careful evaluation of the pericardium, cardiac chambers, valves, and great vessels. Some of these findings may represent benign variants, whereas others may have more profound clinical importance. Furthermore, the expansion of interventional and surgical practice has led to the development and placement of new cardiac stents, implantable pacemaker devices, and prosthetic valves with which the practicing radiologist should be familiar. We present a collection of common incidental cardiac findings that can be readily identified on thoracic computed tomography studies and briefly discuss their clinical relevance.

  14. March 2014 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-04-01

    Full Text Available No abstract available. Article truncated after 150 words. The March 2014 Arizona Thoracic Society meeting was a special meeting. In conjunction with the Valley Fever Center for Excellence and the Arizona Respiratory Center the Eighteenth Annual Farness Lecture was held in the Sonntag Pavilion at St. Joseph's Hospital at 6 PM on Friday, April 4, 2014. The guest speaker was Antonio "Tony" Catanzaro, MD from the University of California San Diego and current president of the Cocci Study Group. There were 57 in attendance representing the pulmonary, critical care, sleep, and infectious disease communities. After opening remarks by Arizona Thoracic Society president, Lewis Wesselius (a former fellow under Dr. Catanzaro at UCSD, John Galgiani, director of the Valley Fever Center for Excellence, gave a brief history of the Farness lecture before introducing Dr. Catanzaro. The lecture is named for Orin J. Farness, a Tucson physician, who was the first to report culture positive coccidioidomycosis (cocci or Valley Fever. ...

  15. Thoracic endometriosis syndrome: CT and MRI features

    International Nuclear Information System (INIS)

    Rousset, P.; Rousset-Jablonski, C.; Alifano, M.; Mansuet-Lupo, A.; Buy, J.-N.; Revel, M.-P.

    2014-01-01

    Thoracic endometriosis is considered to be rare, but is the most frequent form of extra-abdominopelvic endometriosis. Thoracic endometriosis syndrome affects women of reproductive age. Diagnosis is mainly based on clinical findings, which can include catamenial pneumothorax and haemothorax, non-catamenial endometriosis-related pneumothorax, catamenial haemoptysis, lung nodules, and isolated catamenial chest pain. Symptoms are typically cyclical and recurrent, with a right-sided predominance. Computed tomography (CT) is the first-line imaging method, but is poorly specific; therefore, its main role is to rule out other pulmonary diseases. However, in women with a typical clinical history, some key CT findings may help to confirm this often under-diagnosed syndrome. MRI can also assist with the diagnosis, by showing signal changes typical of haemorrhage within diaphragmatic or pleural lesions

  16. Comparison of caudal ropivacaine-morphine and paravertebral catheter for major upper abdominal surgery in infants.

    Science.gov (United States)

    Sato, Makoto; Iida, Takafumi; Kikuchi, Chika; Sasakawa, Tomoki; Kunisawa, Takayuki

    2017-05-01

    The caudal epidural block is one of the most commonly used regional anesthetic techniques in children. Administration of morphine via caudal injection enables analgesia, even for upper abdominal surgery. The thoracic paravertebral block has also been successfully used to treat perioperative pain during upper abdominal procedures in pediatric patients. In the current study, we compared the two regional techniques for upper abdominal surgery in infants to determine whether one of them was preferable to the other. Consecutive patients under 12 months of age who underwent upper abdominal surgery were retrospectively divided according to the chosen postoperative analgesia: Group C, caudal ropivacaine-morphine; Group P, paravertebral catheter. We analyzed the following outcomes: requirement for additional analgesics, pain scores, need for mechanical ventilation and oxygen dosage, postoperative blood pressure and heart rate, time to pass first stool, time until first full meal, and complications. Twenty-one consecutive patients were included: 10 in Group C and 11 in Group P. Median age at surgery was 80 (47.5-270.0) and 84.5 (34.3-287.5) days, respectively. No difference was found between the two groups in requirement for additional analgesics at 24 h after surgery (median 1 in Group C vs 1 in Group P, P = 0.288, 95% CI: -2 to 1). BOPS pain scores were only lower in Group P when compared to Group C at 24 h after surgery (median 1 vs 2, P = 0.041, 95% CI: -2 to 0). None of the patients had perioperative complications. In this small series, there was no significant difference between caudal ropivacaine-morphine and paravertebral catheter for postoperative care in infants undergoing upper abdominal surgery. Further prospective studies are needed to compare the efficacy and incidence of complications of caudal block and paravertebral catheter for postoperative analgesia. © 2017 John Wiley & Sons Ltd.

  17. The reduction of image noise and streak artifact in the thoracic inlet during low dose and ultra-low dose thoracic CT

    International Nuclear Information System (INIS)

    Paul, N S; Prezelj, E; Burey, P; Menezes, R J; Blobel, J; Ursani, A; Kashani, H; Siewerdsen, J H

    2010-01-01

    Increased pixel noise and streak artifact reduce CT image quality and limit the potential for radiation dose reduction during CT of the thoracic inlet. We propose to quantify the pixel noise of mediastinal structures in the thoracic inlet, during low-dose (LDCT) and ultralow-dose (uLDCT) thoracic CT, and assess the utility of new software (quantum denoising system and BOOST3D) in addressing these limitations. Twelve patients had LDCT (120 kV, 25 mAs) and uLDCT (120 kV, 10 mAs) images reconstructed initially using standard mediastinal and lung filters followed by the quantum denoising system (QDS) to reduce pixel noise and BOOST3D (B3D) software to correct photon starvation noise as follows: group 1 no QDS, no B3D; group 2 B3D alone; group 3 QDS alone and group 4 both QDS and B3D. Nine regions of interest (ROIs) were replicated on mediastinal anatomy in the thoracic inlet, for each patient resulting in 3456 data points to calculate pixel noise and attenuation. QDS reduced pixel noise by 18.4% (lung images) and 15.8% (mediastinal images) at 25 mAs. B3D reduced pixel noise by ∼8% in the posterior thorax and in combination there was a 35.5% reduction in effective radiation dose (E) for LDCT (1.63-1.05 mSv) in lung images and 32.2% (1.55-1.05 mSv) in mediastinal images. The same combination produced 20.7% reduction (0.53-0.42 mSv) in E for uLDCT, for lung images and 17.3% (0.51-0.42) for mediastinal images. This quantitative analysis of image quality confirms the utility of dedicated processing software in targeting image noise and streak artifact in thoracic LDCT and uLDCT images taken in the thoracic inlet. This processing software potentiates substantial reductions in radiation dose during thoracic LDCT and uLDCT.

  18. Thoracic empyema caused by Campylobacter rectus.

    Science.gov (United States)

    Ogata, Tomoyuki; Urata, Teruo; Nemoto, Daisuke; Hitomi, Shigemi

    2017-03-01

    We report a case of thoracic empyema caused by Campylobacter rectus, an organism considered as a periodontal pathogen but rarely recovered from extraoral specimens. The patient fully recovered through drainage of purulent pleural fluid and administration of antibiotics. The present case illustrates that C. rectus can be a cause of not only periodontal disease but also pulmonary infection. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. March 2014 Arizona thoracic society notes

    OpenAIRE

    Robbins RA

    2014-01-01

    No abstract available. Article truncated after 150 words. The March 2014 Arizona Thoracic Society meeting was a special meeting. In conjunction with the Valley Fever Center for Excellence and the Arizona Respiratory Center the Eighteenth Annual Farness Lecture was held in the Sonntag Pavilion at St. Joseph's Hospital at 6 PM on Friday, April 4, 2014. The guest speaker was Antonio "Tony" Catanzaro, MD from the University of California San Diego and current president of the Cocci Study Group. T...

  20. Emergency thoracic surgery in elderly patients

    OpenAIRE

    Limmer, Stefan; Unger, Lena; Czymek, Ralf; Kujath, Peter; Hoffmann, Martin

    2011-01-01

    Objectives Emergency thoracic surgery in the elderly represents an extreme situation for both the surgeon and patient. The lack of an adequate patient history as well as the inability to optimize any co-morbidities, which are the result of the emergent situation, are the cause of increased morbidity and mortality. We evaluated the outcome and prognostic factors for this selected group of patients. Design Retrospective chart review. Setting Academic tertiary care referral center. Participants ...

  1. One-stage sequential bilateral thoracic expansion for asphyxiating thoracic dystrophy (Jeune syndrome).

    Science.gov (United States)

    Muthialu, Nagarajan; Mussa, Shafi; Owens, Catherine M; Bulstrode, Neil; Elliott, Martin J

    2014-10-01

    Jeune syndrome (asphyxiating thoracic dystrophy) is a rare disorder characterized by skeletal dysplasia, reduced diameter of the thoracic cage and extrathoracic organ involvement. Fatal, early respiratory insufficiency may occur. Two-stage lateral thoracic expansion has been reported, addressing each side sequentially over 3-12 months. While staged repair theoretically provides less invasive surgery in a small child with respiratory distress, we utilized a single stage, bilateral procedure aiming to rapidly maximize lung development. Combined bilateral surgery also offered the chance of rapid recovery, and reduced hospital stay. We present our early experience of this modification of existing surgical treatment for an extremely rare condition, thought to be generally fatal in early childhood. Nine children (6 males, 3 females; median age 30 months [3.5-75]) underwent thoracic expansion for Jeune syndrome in our centre. All patients required preoperative respiratory support (5 with tracheostomy, 8 requiring positive pressure ventilation regularly within each day/night cycle). Two children underwent sequential unilateral (2-month interval between stages) and 7 children bilateral thoracic expansion by means of staggered osteotomies of third to eighth ribs and plate fixation of fourth to fifth rib and sixth to seventh rib, leaving the remaining ribs floating. There was no operative mortality. There were 2 deaths within 3 months of surgery, due to pulmonary hypertension (1 following two-stage and 1 following single-stage thoracic expansion). At the median follow-up of 11 months (1-15), 3 children have been discharged home from their referring unit and 2 have significantly reduced respiratory support. One child remains on non-invasive ventilation and another is still ventilated with a high oxygen requirement. Jeune syndrome is a difficult condition to manage, but bilateral thoracic expansion offers an effective reduction in ventilator requirements in these children

  2. Effectiveness of a specific manual approach to the suboccipital region in patients with chronic mechanical neck pain and rotation deficit in the upper cervical spine: study protocol for a randomized controlled trial.

    Science.gov (United States)

    González Rueda, Vanessa; López de Celis, Carlos; Barra López, Martín Eusebio; Carrasco Uribarren, Andoni; Castillo Tomás, Sara; Hidalgo García, Cesar

    2017-09-05

    Mechanical neck pain is a highly prevalent problem in primary healthcare settings. Many of these patients have restricted mobility of the cervical spine. Several manual techniques have been recommended for restoring cervical mobility, but their effectiveness in these patients is unknown. The aim of the present study is to compare the effectiveness of two types of specific techniques of the upper neck region: the pressure maintained suboccipital inhibition technique (PMSIT) and the translatory dorsal glide mobilization (TDGM) C0-C1 technique, as adjuncts to a protocolized physiotherapy treatment of the neck region in subjects with chronic mechanical neck pain and rotation deficit in the upper cervical spine. A randomized, prospective, double-blind (patient and evaluator) clinical trial. The participants (n = 78) will be randomly distributed into three groups. The Control Group will receive a protocolized treatment for 3 weeks, the Mobilization Group will receive the same protocolized treatment and 6 sessions (2 per week) of the TDGM C0-C1 technique, and the Pressure Group will receive the same protocolized treatment and 6 sessions (2 per week) of the PMSIT technique. The intensity of pain (VAS), neck disability (NDI), the cervical range of motion (CROM), headache intensity (HIT-6) and the rating of clinical change (GROC scale) will be measured. The measurements will be performed at baseline, post-treatment and 3 months after the end of treatment, by the same physiotherapist blinded to the group assigned to the subject. We believe that an approach including manual treatment to upper cervical dysfunction will be more effective in these patients. Furthermore, the PMSIT technique acts mostly on the musculature, while the TDGM technique acts on the joint. We expect to clarify which component is more effective in improving the upper cervical mobility. ClinicalTrials.gov NCT02832232 . Registered on July 13th, 2016.

  3. CT findings in severe thoracic sarcoidosis

    International Nuclear Information System (INIS)

    Hennebicque, Anne-Sophie; Brillet, Pierre-Yves; Moulahi, Hassen; Brauner, Michel W.; Nunes, Hilario; Valeyre, Dominique

    2005-01-01

    Severe thoracic sarcoidosis includes manifestations with significant clinical and functional impairment and a risk of mortality. Severe thoracic sarcoidosis can take on various clinical presentations and is associated with increased morbidity. The purpose of this article was to describe the CT findings in severe thoracic sarcoidosis and to explain some of their mechanisms. Subacute respiratory insufficiency is a rare and early complication due to a high profusion of pulmonary lesions. Chronic respiratory insufficiency due to pulmonary fibrosis is a frequent and late complication. Three main CT patterns are identified: bronchial distortion, honeycombing and linear opacities. CT can be helpful in diagnosing some mechanisms of central airway obstruction such as bronchial distortion due to pulmonary fibrosis or an extrinsic bronchial compression by enlarged lymph nodes. An intrinsic narrowing of the bronchial wall by endobronchial granulomatous lesions may be suggested by CT when it shows evidence of bronchial mural thickening. Pulmonary hypertension usually occurs in patients with end-stage pulmonary disease and is related to fibrotic destruction of the distal capillary bed and to the resultant chronic hypoxemia. Several other mechanisms may contribute to the development of pulmonary hypertension including extrinsic compression of major pulmonary arteries by enlarged lymph nodes and secondary pulmonary veno-occlusive disease. Aspergilloma colonization of a cavity is the main cause of hemoptysis in sarcoidosis. Other rare causes are bronchiesctasis, necrotizing bronchial aspergillosis, semi-invasive pulmonary aspergillosis, erosion of a pulmonary artery due to a necrotic sarcoidosis lesion, necrosis of parenchymal sarcoidosis lesions and specific endobronchial macroscopic lesions. (orig.)

  4. [Thoracic surgery for patients with bronchial asthma].

    Science.gov (United States)

    Iyoda, A; Satoh, Y

    2012-07-01

    Thoracic surgery poses a risk for complications in the respiratory system. In particular, for patients with bronchial asthma, we need to care for perioperative complications because it is well known that these patients frequently have respiratory complications after surgery, and they may have bronchial spasms during surgery. If we can get good control of their bronchial asthma, we can usually perform surgery for these patients without limitations. For safe postoperative care, it is desirable that these patients have stable asthma conditions that are well-controlled before surgery, as thoracic surgery requires intrabronchial intubation for anesthesia and sometimes bronchial resection. These stimulations to the bronchus do not provide for good conditions because of the risk of bronchial spasm. Therefore, we should use the same agents that are used to control bronchial asthma if it is already well controlled. If it is not, we have to administer a β₂ stimulator, aminophylline, or steroidal agents for good control. Isoflurane or sevoflurane are effective for the safe control of anesthesia during surgery, and we should use a β₂ stimulator, with or without inhalation, or steroidal agents after surgery. It is important to understand that we can perform thoracic surgery for asthma patients if we can provide perioperative control of bronchial asthma, although these patients still have severe risks.

  5. Endovascular repair of traumatic thoracic aortic tears.

    Science.gov (United States)

    Mansour, M Ashraf; Kirk, Jeffrey S; Cuff, Robert F; Banegas, Shonda L; Ambrosi, Gavin M; Liao, Timothy H; Chambers, Christopher M; Wong, Peter Y; Heiser, John C

    2012-03-01

    Patients with thoracic aorta injuries (TAI) present a unique challenge. The purpose of this study was to review the outcomes of thoracic endovascular aortic repair (TEVAR) in patients with TAI. A retrospective chart review of all patients admitted for TEVAR for trauma was performed. In a 5-year period, 19 patients (6 women and 13 men; average age, 42 y) were admitted to our trauma center with TAI. Mechanism of injury was a motor vehicle crash in 12 patients, motorcycle crash in 2 patients, automobile-pedestrian accident in 2 patients, 1 fall, 1 crush injury, and 1 stab wound to the back. A thoracic endograft was used in 6 patients and proximal aortic cuffs were used in 13 patients (68%). One patient (5%) died. There were no strokes, myocardial infarctions, paraplegia, or renal failure. TEVAR for TAI appears to be a safe option for patients with multiple injuries. TEVAR in young patients is still controversial because long-term endograft behavior is unknown. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. October 2012 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2012-10-01

    Full Text Available No abstract available. Article truncated at 150 words. A dinner meeting was held on 10/24/2012 at Scottsdale Shea beginning at 6:30 PM. There were 23 in attendance representing the pulmonary, critical care, sleep, infectious disease, pathology, and radiology communities. An announcement was made that the Colorado Thoracic Society has accepted an invitation to partner with the Arizona and New Mexico Thoracic Societies in the Southwest Journal of Pulmonary and Critical Care Medicine. Discussions continue to be held regarding a combined Arizona Thoracic Society meeting with Tucson either in Casa Grande or electronically. Six cases were presented: Dr. Tim Kuberski, chief of Infectious Disease at Maricopa Medical Center, presented a 48 year old female who had been ill for 2 weeks. A CT of the chest revealed a left lower lobe nodule and a CT of the abdomen showed hydronephrosis and a pelvic mass. Carcinoembryonic antigen (CEA was elevated. All turned out to be coccidioidomycosis on biopsy. CEA decreased …

  7. Robotics in general thoracic surgery procedures.

    Science.gov (United States)

    Latif, M Jawad; Park, Bernard J

    2017-01-01

    The use of robotic technology in general thoracic surgical practice continues to expand across various institutions and at this point many major common thoracic surgical procedures have been successfully performed by general thoracic surgeons using the robotic technology. These procedures include lung resections, excision of mediastinal masses, esophagectomy and reconstruction for malignant and benign esophageal pathologies. The success of robotic technology can be attributed to highly magnified 3-D visualization, dexterity afforded by 7 degrees of freedom that allow difficult dissections in narrow fields and the ease of reproducibility once the initial set up and instruments become familiar to the surgeon. As the application of robotic technology trickle downs from major academic centers to community hospitals, it becomes imperative that its role, limitations, learning curve and financial impact are understood by the novice robotic surgeon. In this article, we share our experience as it relates to the setup, common pitfalls and long term results for more commonly performed robotic assisted lung and thymic resections using the 4 arm da Vinci Xi robotic platform (Intuitive Surgical, Inc., Sunnyvale, CA, USA) to help guide those who are interested in adopting this technology.

  8. Endoscopic Transforaminal Thoracic Foraminotomy and Discectomy for the Treatment of Thoracic Disc Herniation

    Science.gov (United States)

    Nie, Hong-Fei; Liu, Kai-Xuan

    2013-01-01

    Thoracic disc herniation is a relatively rare yet challenging-to-diagnose condition. Currently there is no universally accepted optimal surgical treatment for symptomatic thoracic disc herniation. Previously reported surgical approaches are often associated with high complication rates. Here we describe our minimally invasive technique of removing thoracic disc herniation, and report the primary results of a series of cases. Between January 2009 and March 2012, 13 patients with symptomatic thoracic disc herniation were treated with endoscopic thoracic foraminotomy and discectomy under local anesthesia. A bone shaver was used to undercut the facet and rib head for foraminotomy. Discectomy was achieved by using grasper, radiofrequency, and the Holmium-YAG laser. We analyzed the clinical outcomes of the patients using the visual analogue scale (VAS), MacNab classification, and Oswestry disability index (ODI). At the final follow up (mean: 17 months; range: 6–41 months), patient self-reported satisfactory rate was 76.9%. The mean VAS for mid back pain was improved from 9.1 to 4.2, and the mean ODI was improved from 61.0 to 43.8. One complication of postoperative spinal headache occurred during the surgery and the patient was successfully treated with epidural blood patch. No other complications were observed or reported during and after the surgery. PMID:24455232

  9. Comparing the radiosensitivity of cervical and thoracic spinal cord using the relative seriality model

    International Nuclear Information System (INIS)

    Adamus-Gorka, M.; Lind, B.K.; Brahme, A.

    2003-01-01

    Spinal cord is one of the most important normal tissues that are aimed to be spared during radiation therapy of cancer. This organ has been known for its strongly serial character and its high sensitivity to radiation. In order to compare the sensitivity of different parts of spinal cord, the early data (1970's) for radiation myelopathy available in the literature could be used. In the present study the relative seriality model (Kallman et al. 1992) has been fitted to two different sets of clinical data for spinal cord irradiation: radiation myelitis of cervical spinal cord after treating 248 patients for malignant disease of head and neck (Abbatucci et al. 1978) and radiation myelitis of thoracic spinal cord after radiation treating 43 patients with lung carcinoma (Reinhold et al. 1976). The maximum likelihood method was applied for the fitting and the corresponding parameters together with their 68% confidence intervals calculated for each of the datasets respectively. The alpha-beta ratio for the thoracic survival was also obtained. On the basis of the present study the following conclusions can be drawn: 1. radiation myelopathy is a strongly serial endpoint, 2. it appears to be differences in radiosensitivity between the cervical and thoracic region of spinal cord, 3. thoracic spinal cord revealed very serial characteristic of dose response, while the cervical myelopathy seems to be a bit less serial endpoint, 4. the dose-response curve is much steeper in case of myelopathy of cervical spinal cord, due to the much higher gamma value for this region. This work compares the fitting of NTCP model to the cervical and thoracic regions of the spinal cord and shows quite different responses. In the future more data should be tested for better understanding the mechanism of spinal cord sensitivity to radiation

  10. Regional scheme for the connection to the grid of renewable energies: for the Hauts-de-France region, for the Nord-Pas-de-Calais region, for the Picardy region, the Alsace region, the Aquitaine region, the Auvergne region, the Lower-Normandy region, the Burgundy region, the Brittany region, the Centre-Val-de-Loire region, the Champagne-Ardennes region, the Franche-Comte region, the Upper Normandy region, the Ile-de-France region, the Languedoc-Roussillon region, the Lorraine region, the Midi-Pyrenees region, the Provence-Alps-Cote d'Azur region, the Pays-de-la-Loire region, the Poitou-Charentes region, the Rhone-Alps region. Technical and financial status of the scheme implementation

    International Nuclear Information System (INIS)

    2017-01-01

    This document gathers reports related to all French regions. Each one addresses the elaboration of the concerned regional scheme of connection of renewable energies to the distribution network (French acronym: S3REnR) which aims at anticipating and planning evolutions of electrical networks which are necessary for the integration of renewable energies. Illustrated by maps, tables and graphs, these reports propose indications of energy production locations, an identification of planned works, a presentation of the concerned region, of its existing grid and projects, an overview of the scheme content (initial status, results of consultations, adopted strategies, planned works), and an overview of the scheme implementation status

  11. Trunk muscle activation in a person with clinically complete thoracic spinal cord injury.

    Science.gov (United States)

    Bjerkefors, Anna; Carpenter, Mark G; Cresswell, Andrew G; Thorstensson, Alf

    2009-04-01

    The aim of this study was to assess if, and how, upper body muscles are activated in a person with high thoracic spinal cord injury, clinically classified as complete, during maximal voluntary contractions and in response to balance perturbations. Data from one person with spinal cord injury (T3 level) and one able-bodied person were recorded with electromyography from 4 abdominal muscles using indwelling fine-wire electrodes and from erector spinae and 3 upper trunk muscles with surface electrodes. Balance perturbations were carried out as forward or backward support surface translations. The person with spinal cord injury was able to activate all trunk muscles, even those below the injury level, both in voluntary efforts and in reaction to balance perturbations. Trunk movements were qualitatively similar in both participants, but the pattern and timing of muscle responses differed: upper trunk muscle involvement and occurrence of co-activation of ventral and dorsal muscles were more frequent in the person with spinal cord injury. These findings prompt further investigation into trunk muscle function in paraplegics, and highlight the importance of including motor tests for trunk muscles in persons with thoracic spinal cord injury, in relation to injury classification, prognosis and rehabilitation.

  12. Computed tomography in radiation therapy planning: Thoracic region

    International Nuclear Information System (INIS)

    Seydel, H.G.; Zingas, A.; Haghbin, M.; Mondalek, P.; Smereka, R.

    1983-01-01

    With the explosive spread of computed tomographic (CT) scanning throughout the United States, one of the main applications has been in patients who are treated for cancer by surgery, radiation therapy, or chemotherapy. For the radiation oncologist, the desire to provide local tumor control and avoid geographic misses to achieve an expected prolongation of survival has led to the use of large radiation fields in the treatment of intrathoracic cancer, including bronchogenic carcinoma, cancer of the esophagus, and other malignant tumors. The optimal radiation therapy plan is a balance between local tumor control and the necessity to preserve normal structures by the use of directed and limited fields for bulk disease. CT scanning has been employed to accurately demonstrate the extent of tumor as well as to determine the isodose distribution of radiation, including the spatial distribution of radiation portals in single planar and three-dimensional aspects as well as consideration of tissue inhomogeneities. The accurate planning of the distribution of therapeutic irradiation includes both the tumor-bearing target volume and the critical normal tissues. This chapter provides information regarding these aspects of the application of CT scanning to radiation therapy for bronchogenic carcinoma and carcinoma of the esophagus

  13. Thoracic cavity segmentation algorithm using multiorgan extraction and surface fitting in volumetric CT

    Energy Technology Data Exchange (ETDEWEB)

    Bae, JangPyo [Interdisciplinary Program, Bioengineering Major, Graduate School, Seoul National University, Seoul 110-744, South Korea and Department of Radiology, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul 138-736 (Korea, Republic of); Kim, Namkug, E-mail: namkugkim@gmail.com; Lee, Sang Min; Seo, Joon Beom [Department of Radiology, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul 138-736 (Korea, Republic of); Kim, Hee Chan [Department of Biomedical Engineering, College of Medicine and Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 110-744 (Korea, Republic of)

    2014-04-15

    Purpose: To develop and validate a semiautomatic segmentation method for thoracic cavity volumetry and mediastinum fat quantification of patients with chronic obstructive pulmonary disease. Methods: The thoracic cavity region was separated by segmenting multiorgans, namely, the rib, lung, heart, and diaphragm. To encompass various lung disease-induced variations, the inner thoracic wall and diaphragm were modeled by using a three-dimensional surface-fitting method. To improve the accuracy of the diaphragm surface model, the heart and its surrounding tissue were segmented by a two-stage level set method using a shape prior. To assess the accuracy of the proposed algorithm, the algorithm results of 50 patients were compared to the manual segmentation results of two experts with more than 5 years of experience (these manual results were confirmed by an expert thoracic radiologist). The proposed method was also compared to three state-of-the-art segmentation methods. The metrics used to evaluate segmentation accuracy were volumetric overlap ratio (VOR), false positive ratio on VOR (FPRV), false negative ratio on VOR (FNRV), average symmetric absolute surface distance (ASASD), average symmetric squared surface distance (ASSSD), and maximum symmetric surface distance (MSSD). Results: In terms of thoracic cavity volumetry, the mean ± SD VOR, FPRV, and FNRV of the proposed method were (98.17 ± 0.84)%, (0.49 ± 0.23)%, and (1.34 ± 0.83)%, respectively. The ASASD, ASSSD, and MSSD for the thoracic wall were 0.28 ± 0.12, 1.28 ± 0.53, and 23.91 ± 7.64 mm, respectively. The ASASD, ASSSD, and MSSD for the diaphragm surface were 1.73 ± 0.91, 3.92 ± 1.68, and 27.80 ± 10.63 mm, respectively. The proposed method performed significantly better than the other three methods in terms of VOR, ASASD, and ASSSD. Conclusions: The proposed semiautomatic thoracic cavity segmentation method, which extracts multiple organs (namely, the rib, thoracic wall, diaphragm, and heart

  14. Microfacies, Depositional environment and Sequence Stratigraphy of Upper Carboniferous- Lower Permian rocks from Ozbak-Kuh region (Zaladou Section, East Central Iran

    Directory of Open Access Journals (Sweden)

    Ali Ahmadi

    2016-01-01

    Full Text Available Zaladou section is located in Ozbak-Kuh mountains in the nourthen part of Tabas block and consist of shale, limy sandstone, limestone and dolomite. Continous relationship of Upper Carboniferous and Lower Permian deposits, is quite evident in Zaladou section. The lower boundry of this section is located on the Absheni formation of Sardar Group with disconformity surface, and upper boundry’s is covered by disconformity surface and bauxite horizon of Bagh-e-Vang formation. According to the lithological Characters and microscopic studies, tidal flat, lagoon, bar, tidal inlet and open marine sub-environment are identified for Zaladou section. Results of this study show that Zaladou section was deposited in silisiclastic-carbonate mix homoclinal ramp in late Carboniferous and in carbonate homoclinal ramp in early Permian. Field study, microfacies and analysis through the sequence led to recognition of main sequence surface, such as: sequence boundry, maximum flooding surface, marine flooding surface, system tracts and two depositional sequences.

  15. Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation

    Energy Technology Data Exchange (ETDEWEB)

    Courtney, Malachi; Ayyagari, Raj R. [Yale School of Medicine, Yale New Haven Hospital, New Haven, CT (United States); Division of Interventional Radiology, Department of Radiology, 789 Howard Avenue, P.O. Box 208042, New Haven, CT (United States)

    2015-06-15

    Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails. (orig.)

  16. Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation

    International Nuclear Information System (INIS)

    Courtney, Malachi; Ayyagari, Raj R.

    2015-01-01

    Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails. (orig.)

  17. Assessing Readmission After General, Vascular, and Thoracic Surgery Using ACS-NSQIP

    Science.gov (United States)

    Lucas, Donald J.; Haider, Adil; Haut, Elliot; Dodson, Rebecca; Wolfgang, Christopher L.; Ahuja, Nita; Sweeney, John; Pawlik, Timothy M.

    2015-01-01

    Objective In 2012, Medicare began cutting reimbursement for hospitals with high readmission rates. We sought to define the incidence and risk factors associated with readmission after surgery. Methods A total of 230,864 patients discharged after general, upper gastrointestinal (GI), small and large intestine, hepatopancreatobiliary (HPB), vascular, and thoracic surgery were identified using the 2011 American College of Surgeons National Surgical Quality Improvement Program. Readmission rates and patient characteristics were analyzed. A predictive model for readmission was developed among patients with length of stay (LOS) 10 days or fewer and then validated using separate samples. Results Median patient age was 56 years; 43% were male, and median American Society of Anesthesiologists (ASA) class was 2 (general surgery: 2; upper GI: 3; small and large intestine: 2; HPB: 3; vascular: 3; thoracic: 3; P readmission was 7.8% (general surgery: 5.0%; upper GI: 6.9%; small and large intestine: 12.6%; HPB: 15.8%; vascular: 11.9%; thoracic: 11.1%; P readmission included ASA class, albumin less than 3.5, diabetes, inpatient complications, nonelective surgery, discharge to a facility, and the LOS (all P readmission. A simple integer-based score using ASA class and the LOS predicted risk of readmission (area under the receiver operator curve 0.702). Conclusions Readmission among patients with the LOS 10 days or fewer occurs at an incidence of at least 5% to 16% across surgical subspecialties. A scoring system on the basis of ASA class and the LOS may help stratify readmission risk to target interventions. PMID:24022435

  18. Thoracic mobilisation and periscapular soft tissue manipulations in the management of chronic Prolapsed Intervertebral Disc (PIVD - An innovative manual therapy approach

    Directory of Open Access Journals (Sweden)

    Raj Kiran

    2017-10-01

    Full Text Available Background The most common cause of CLBP is discogenic lower back pain. Researches haveshown that connective tissue remodelling occurs in CLBP and thoracic spinal mobility and thoracolumbar mobility have higher correlations with LBP. Aims To see the effect of upper back fascia and periscapular muscles stretching and thoracic mobilisation to reduce symptoms in subjects with CLBP due to lumbar disk herniation. Methods A total of 40 subjects with CLBP due to Prolapsed Intervertebral Disc (PIVD were recruited and randomly distributed in two groups. Group 1 was given stretching of upper back fascia and periscapular muscles and thoracic mobilization along with conventional exercises (Cyriax listing correction -I followed by repeated McKenzie back extension exercise and Core muscle strengthening. Group 2 received only conventional exercises. Outcome Measures: visual analog scale, Oswestry Disability Index and Modified Schober's Test. Measurements were taken before and after three weeks of treatment, for five days/week. Results Overall results of the study, both Group 1 and Group 2 showed improvement in pain, function and lumbar Range of Motion (ROM after three weeks of intervention. However, Group 1 improved significantly to a greater extent in pain, ROM and function than the Group 2. Conclusion Stretching of periscapular muscles and fascia of the upper back and mobilisation of upper thoracic spine is found to be effective for the management of chronic low back pain due to PIVD.

  19. Study on the impact of sudden stratosphere warming in the upper mesosphere-lower thermosphere regions using satellite and HF radar measurements [Conference paper

    CSIR Research Space (South Africa)

    Mbatha, N

    2009-07-01

    Full Text Available Neutral atmosphere (including the MLT) and ionosphere are linked by energy and momentum transfer. Thus, this whole region forms a coupled system in which influences that originates at one height or in one region can have profound influence elsewhere...

  20. Nuclear Energy Center: upper St. Lawrence region. Part I. Siting. Part II. Fort Drum surrogate site, description and impact assessment. Part III. Dispersed sites impact assessment and comparison with the NEC

    Energy Technology Data Exchange (ETDEWEB)

    Merry, P.A.; Luner, C.; Hong, S.W.; Canham, H.O.; Boggs, J.F.; McCool, T.P.

    1976-12-01

    This report is one of many supporting documents used by the Nuclear Regulatory commission in the preparation of the Nuclear Energy Center Site Survey (NECSS) mandated by Congress. While the overall study focuses on the feasibility and practicability of nuclear energy centers (NECs), this report is directed towards choosing a suitable surrogate site in the upper St. Lawrence region of New York State, assessing the probable impacts associated with construction and operation of the NEC, and comparing these impacts with those associated with small dispersed nuclear power stations. The upper St. Lawrence region is surveyed to identify a specific site that might be suitable for a surrogate NEC. Several assumptions about the basic design of an NEC are delineated, and a general overview of the characteristics of the region is given. The Fort Drum Military Reservation is chosen as a suitable surrogate site. Fort Drum and the surrounding area are described in terms of land use and population patterns, terrestrial and aquatic ecology, water use and quality, meteorology, institutional framework, and socioeconomic structure. The impacts associated with NEC development are assessed. Then the impacts associated with smaller dispersed nuclear power stations located throughout New York State are assessed and compared with the impacts associated with the NEC. Finally, the impacts due to development of the transmission line networks associated with the NEC and with the dispersed power stations are assessed and compared.

  1. Geologic framework for the assessment of undiscovered oil and gas resources in sandstone reservoirs of the Upper Jurassic-Lower Cretaceous Cotton Valley Group, U.S. Gulf of Mexico region

    Science.gov (United States)

    Eoff, Jennifer D.; Dubiel, Russell F.; Pearson, Ofori N.; Whidden, Katherine J.

    2015-01-01

    The U.S. Geological Survey (USGS) is assessing the undiscovered oil and gas resources in sandstone reservoirs of the Upper Jurassic–Lower Cretaceous Cotton Valley Group in onshore areas and State waters of the U.S. Gulf of Mexico region. The assessment is based on geologic elements of a total petroleum system. Four assessment units (AUs) are defined based on characterization of hydrocarbon source and reservoir rocks, seals, traps, and the geohistory of the hydrocarbon products. Strata in each AU share similar stratigraphic, structural, and hydrocarbon-charge histories.

  2. Ranking of conventional X-ray diagnosis and phlebography in the thoracic outlet syndrome (TOS)

    International Nuclear Information System (INIS)

    Vahlensieck, M.; Beltz, L.

    1991-01-01

    The compression of the neurovascular bundle of the upper limb (thoracic outlet syndrome, TOS) can be caused by osseous, muscular, fibrous, tumorous and habitual abnormalities of the cervicothoracic junction. Osseous causes can be shown in a conventional x-ray of the cervi cothoracic junction. In about 40% of the cases there is a venous stenosis which can be proved by means of phlebography in a special patient position (provocation position). The type of stenosis and location provides information on the cause of it. We examined 34 patients. (orig.) [de

  3. Rates of thoracic trauma and mortality due to accidents in Brazil

    International Nuclear Information System (INIS)

    Cury, Francisco; Baitello, Andre Luciano; Echeverria, Rodrigo Florencio; Espada, Paulo Cesar; Godoy, Jose Maria Pereira de

    2009-01-01

    To report on the causes of trauma, indexes of trauma, and mortality related to thoracic trauma in one region of Brazil. This prospective study was performed at the Regional Trauma Center in Syo Josi do Rio Preto over a 1-year period, from 1 st July 2004 to 30 th June 2005. We included all patients attending the center's emergency room with thoracic trauma and an anatomic injury scale (AIS) > - 2. We collected data using a protocol completed on arrival in hospital utilizing the AIS. We studied the types of accidents as well as the mortality and the AIS scores. Prevalence rates were calculated and the paired t-test and logistic regression were employed for the statistical analysis.There were a total of 373 casualties with AIS > - 2 and there were 45 (12%) deaths. The causes of thoracic trauma among the 373 casualties were as follows: 91 (24.4%) car crashes, 75 (20.1%) falls, 46 (12.3%) motorbike accidents, 40 (10.7%) stabbings, 22 (5.9%) accidents involving pedestrians, 21 (5.6%) bicycle accidents, 17 (4.6%) shootings, and 54 (14.5%) other types of accident. The severity of the injuries was classified according to the AIS: 224 (60%) were grade 2, 101 (27%) were grade 3, 27 (7.2%) were grade 4, 18 (4.9%) were grade 5, and 3 were (0.8%) grade 6. With respect to thoracic trauma, pedestrians involved in accidents and victims of shootings had mortality rates that were significantly higher than that of those involved in other types of accidents. Road accidents are the main cause of thoracic injury, with accidents involving pedestrians and shootings being associated with a greater death rate. (author)

  4. Thoracic Pneumorrhachis in Patient with Lumbar Fractures; a Case Report

    Directory of Open Access Journals (Sweden)

    Amir Ghafarzad

    2014-03-01

    Full Text Available 800x600 Pneumorrhachis as a relatively rare condition may be an indication of substantial intra-spinal column injury. Here we report a 39-year-old man was admitted because of low back pain and dyspenea after locating between motor vehicle and wall three days before admission. On arrival, physical exams and vital signs were normal. Computed tomography (CT scan showed bilateral pleural effusion, fracture of ribs number 8, 9 and 10 in lower left side of thorax, fracture of vertebra in L2-L4, and air bubbles in upper thoracic spinal canal.  Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:Arial;}

  5. Thoracic aortic aneurysm: A rare cause of elevated hemidiaphragm

    Directory of Open Access Journals (Sweden)

    Md Arshad Ejazi

    2016-01-01

    Full Text Available Phrenic nerve palsy causing hemidiaphragm paralysis is a very uncommon feature of thoracic aortic aneurysm. In one case, a 30 year male complained of chronic dull aching chest pain, and hoarseness of voice; posteroanterior view chest radiograph revealed large spherical radiopacity on the left upper lung zone with smooth lobulated margin with elevated left hemidiaphragm. On Colour Doppler sonography, lesion was anechoic on gray scale sonography but on Doppler analysis revealed intense internal vascularity within it with characteristic "Ying Yang" sign. The finding favor the vascular origin of the lesion and a diagnosis of an arterial aneurysm was made Contrast-enhanced computed tomography (CT of the thorax revealed a large well defined spherical lesion of 8 × 10 cm size with smooth well defined margin arising from the aortic arch and attenuation of impending rupture or dissection were lesion on immediate post contrast and delayed scan was similar to that of aorta. Left hemidiaphragm elevation was explained by the gross mass effect of the aneurysm causing right phrenic nerve palsy.

  6. A Regional Guidebook for Applying the Hydrogeomorphic Approach to Assessing Wetland Functions of Depression Wetlands in the Upper Des Plaines River Basin

    National Research Council Canada - National Science Library

    Lin, Jeff P

    2006-01-01

    .... The HGM approach is a collection of concepts and methods used to develop functional indices to assess the capacity of a particular wetland to perform functions relative to similar wetlands in a region...

  7. Thoracic fistulas of the pancreas and their complications in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Fritsch, R; Schirg, E; Buerger, D

    1981-08-01

    The article reports on two thoracic fistulas of the pancreas in infants. Anamnesis revealed that recurring abdominal pain had occured in those children for years; at the time of their admission to hospital there was considerable dyspnoea with thoracic pain depending on the respiration. Fistulas of the pancreas with thoracic connection were identified as the cause. The article goes into the details of genesis, differential diagnosis and course of the disease.

  8. Treatment outcomes of extended-field radiation therapy for thoracic superficial esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Doo Yeul; Moon, Sung Ho; Cho, Kwan Ho; Kim, Tae Hyun; Kim, Moon Soo; Lee, Jong Yeul; Suh, Yang Gun [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    2017-09-15

    To evaluate the efficacy and safety of extended-field radiation therapy for patients with thoracic superficial esophageal cancer (SEC). From May 2007 to October 2016, a total of 24 patients with thoracic SEC (T1a and T1b) who underwent definitive radiotherapy and were analyzed retrospectively. The median total radiotherapy dose was 64 Gy (range, 54 to 66 Gy) in conventional fractionation. All 24 patients received radiotherapy to whole thoracic esophagus and 23 patients received elective nodal irradiation. The supraclavicular lymph nodes, the celiac lymph nodes, and both of those nodal areas were included in 11, 3, and 9 patients, respectively. The median follow-up duration was 28.7 months (range 7.9 to 108.0 months). The 3-year overall survival, local control, and progression-free survival rates were 95.2%, 89.7%, and 78.7%, respectively. There were 5 patients (20.8%) with progression of disease, 2 local failures (8.3%) and 3 (12.5%) regional failures. Three patients also experienced distant metastasis and had died of disease progression. There were no treatment-related toxicities of grade 3 or higher. Definitive extended-field radiotherapy for thoracic SEC showed durable disease control rates in medically inoperable and endoscopically unfit patients. Even extended-field radiotherapy with elective nodal irradiation was safe without grade 3 or 4 toxicities.

  9. Comparison between cranial thoracic intervertebral disc herniations in German Shepherd dogs and other large breed dogs.

    Science.gov (United States)

    Gaitero, Luis; Nykamp, Stephanie; Daniel, Rob; Monteith, Gabrielle

    2013-01-01

    Cranial thoracic intervertebral disc herniations have been reported to be rare in dogs due to the presence of the intercapital ligament, however some studies have proposed they may not be uncommon in German Shepherd dogs. The purpose of this retrospective study was to compare cranial thoracic intervertebral disc herniations in German Shepherd dogs and other large breed dogs (control group). Medical records at the Ontario Veterinary College were searched for German Shepherd dogs and other large breed dogs that had magnetic resonance imaging studies including the T1-T9 region. For each dog and each disc space from T1-T9, three variables (compression, disc degeneration, and herniation) were recorded and graded based on review of sagittal T2-weighted images. Twenty-three German Shepherd dogs and 47 other large breed dogs met inclusion criteria. The German Shepherd dog group had higher scores than the control group for compression (P = 0.0099) and herniation (P dog group, intervertebral discs T2-T3 and T4-T5 had an increased risk for compression and T3-T4 had an increased risk for compression and herniation. Findings from this study indicated that German Shepherd dogs may be more likely than other large breed dogs to have spinal cord compression due to cranial thoracic disc herniations. Imaging of the cranial thoracic spine, including T2-T3, is recommended for German Shepherd dogs with T3-L3 neurological signs. © 2012 Veterinary Radiology & Ultrasound.

  10. Treatment outcomes of extended-field radiation therapy for thoracic superficial esophageal cancer

    International Nuclear Information System (INIS)

    Lee, Doo Yeul; Moon, Sung Ho; Cho, Kwan Ho; Kim, Tae Hyun; Kim, Moon Soo; Lee, Jong Yeul; Suh, Yang Gun

    2017-01-01

    To evaluate the efficacy and safety of extended-field radiation therapy for patients with thoracic superficial esophageal cancer (SEC). From May 2007 to October 2016, a total of 24 patients with thoracic SEC (T1a and T1b) who underwent definitive radiotherapy and were analyzed retrospectively. The median total radiotherapy dose was 64 Gy (range, 54 to 66 Gy) in conventional fractionation. All 24 patients received radiotherapy to whole thoracic esophagus and 23 patients received elective nodal irradiation. The supraclavicular lymph nodes, the celiac lymph nodes, and both of those nodal areas were included in 11, 3, and 9 patients, respectively. The median follow-up duration was 28.7 months (range 7.9 to 108.0 months). The 3-year overall survival, local control, and progression-free survival rates were 95.2%, 89.7%, and 78.7%, respectively. There were 5 patients (20.8%) with progression of disease, 2 local failures (8.3%) and 3 (12.5%) regional failures. Three patients also experienced distant metastasis and had died of disease progression. There were no treatment-related toxicities of grade 3 or higher. Definitive extended-field radiotherapy for thoracic SEC showed durable disease control rates in medically inoperable and endoscopically unfit patients. Even extended-field radiotherapy with elective nodal irradiation was safe without grade 3 or 4 toxicities

  11. [Animal experiment study of anastomosis healing after partial resection of the pre-irradiated thoracic esophagus].

    Science.gov (United States)

    Engel, C; Nilles-Schendera, A; Frommhold, H

    2000-01-01

    Multimodal therapeutic concepts in cases of neoplasms of the intestinal tract entail the risk of undesirable complications with respect to healing of wounds and anastomoses. The separate steps of a combined treatment consisting radiation therapy and partial resection of the thoracic esophagus were performed in animal experiments to study the effect of radiation therapy on the healing of anastomoses. Adult non-purebred dogs were irradiated in a defined thoracic field with a Betatron (42 MeV) and subsequently underwent esophagectomy. After resection of a 2 cm segment of the esophagus end-to-end anastomosis was performed. Different methods of irradiation and postoperative observation times resulted in a total of 8 groups of 3 animals each. Fractionated irradiation was definitely better tolerated than irradiation with a high single doses. The temporary delay of the anastomotic healing was documented histologically. Only one case of anastomotic leakage occurred, and impaired wound healing was observed in only one animal. The mode of irradiation must be regarded as important for the clinical course. Fractionated preoperative irradiation in the area of the thoracic esophagus does not lead to any relevant disturbance of wound and anastomotic healing with meticulous surgical technique and adequate intensive postoperative care. The basic feasibility of surgical therapy combined with preoperative radiotherapy in tumors of the upper digestive tract was confirmed by our experimental work.

  12. Internal Thoracic Artery Encircled by an Unusual Phrenic Nerve Loop

    Directory of Open Access Journals (Sweden)

    Robert Fu-Chean Chen

    2007-12-01

    Full Text Available We report an anatomic variation of the phrenic nerve. During a routine gross anatomical dissection course at our medical university, we found an unusual loop of the left phrenic nerve around the internal thoracic artery, about 1 cm from the take-off of the left subclavian artery. The phrenic nerve is close to the internal thoracic artery and is easily injured when dissecting the internal thoracic artery for coronary artery bypass conduit. Therefore, we suggest that the anatomic relationship of the phrenic nerve and internal thoracic artery is important in preventing incidental injury of the phrenic nerve.

  13. The reported thoracic injuries in Homer's Iliad

    Directory of Open Access Journals (Sweden)

    Apostolaki Mary

    2010-11-01

    Full Text Available Abstract Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%, the stones (7.4%, the arrow (5.5% and the sword (5.5%. We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim, medium (those which cause the victim to abandon the battlefield, and severe (those which cause death of the victim. According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95% and the remaining 8 an Achaean (21.05%. The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield.

  14. The reported thoracic injuries in Homer's Iliad.

    Science.gov (United States)

    Apostolakis, Efstratios; Apostolaki, Georgia; Apostolaki, Mary; Chorti, Maria

    2010-11-19

    Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%), the stones (7.4%), the arrow (5.5%) and the sword (5.5%). We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim), medium (those which cause the victim to abandon the battlefield), and severe (those which cause death of the victim). According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95%) and the remaining 8 an Achaean (21.05%). The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield.

  15. A "conservative" method of thoracic wall dissection: a proposal for teaching human anatomy.

    Science.gov (United States)

    Barberini, Fabrizio; Brunone, Francesca

    2008-01-01

    The common methods of dissection exposing the thoracic organs include crossing of the wall together with wide resection of its muscular planes. In order to preserve these structures, a little demolishing technique of the thoracic wall is proposed, entering the thoracic cavity without extensive resection of the pectoral muscles. This method is based on the fact that these muscles rise up from the wall, like a bridge connecting the costal plane with the upper limb, and that the pectoralis major shows a segmental constitution. SUPERIOR LIMIT: Resect the sternal manubrium transversely between the 1st and the 2nd rib. The incision is prolonged along the 1st intercostal space, separating the first sterno-costal segment of the pectoralis major from the second one, and involving the intercostal muscles as far as the medial margin of the pectoralis minor. This muscle must be raised up, and the transverse resection continued below its medial margin latero-medially along the 1st intercostal space, to rejoin the cut performed before. Then, the incision of the 1st intercostal space is prolonged below the lateral margin of the pectoralis minor, which must be kept raised up, medio-laterally as far as the anterior axillary line. INFERIOR LIMIT: It corresponds to the inferior border of the thoracic cage, resected from the xiphoid process to the anterior axillary line, together with the sterno-costal insertions of the diaphragm. Then, an incision of the sterno-pericardial ligaments and a median sternotomy from the xiphoid process to the transverse resection of the manubrium should be performed. LATERAL LIMIT: From the point of crossing of the anterior axillary line with the inferior limit, resect the ribs from the 10th to the 2nd one. The lateral part of the pectoralis major must be raised up, so that the costal resection may be continued below it. Then, at the lateral extremity of the superior incision, the first and the second sternocostal segment of the pectoralis major must be

  16. Integrated diagnostic imaging of primary thoracic rhabdomyosarcoma

    International Nuclear Information System (INIS)

    Almberger, M.; Iannicelli, E.; Matrunola, M.; Schiavetti, A.; Capocaccia, P.

    2001-01-01

    We report a rare case of primary thoracic rhabdomyosarcoma in a girl who was referred with acute chest pain, hacking cough, and wheezing. A chest X-ray revealed a complete opacity of the right hemithorax. Ultrasound revealed a right-sided pleural effusion and a solid mass above the liver dome, suggesting a neoplastic disease, which quickly led to further specific examination. Use of CT and MRI together with bone scintigraphy completed the investigation. The biopsy specimen showed a pattern of alveolar rhabdomyosarcoma. This case was reported to emphasize the role of US in the evaluation of a child with hemithorax opacity. (orig.)

  17. Digital subtraction angiography of the thoracic aorta

    International Nuclear Information System (INIS)

    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.

    1984-01-01

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram

  18. Integrated diagnostic imaging of primary thoracic rhabdomyosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Almberger, M.; Iannicelli, E. [Dept. of Radiology, University ' ' La Sapienza' ' , Rome (Italy); Matrunola, M.; Schiavetti, A.; Capocaccia, P. [Dept. of Pediatric Radiology, University ' ' La Sapienza' ' , Rome (Italy)

    2001-03-01

    We report a rare case of primary thoracic rhabdomyosarcoma in a girl who was referred with acute chest pain, hacking cough, and wheezing. A chest X-ray revealed a complete opacity of the right hemithorax. Ultrasound revealed a right-sided pleural effusion and a solid mass above the liver dome, suggesting a neoplastic disease, which quickly led to further specific examination. Use of CT and MRI together with bone scintigraphy completed the investigation. The biopsy specimen showed a pattern of alveolar rhabdomyosarcoma. This case was reported to emphasize the role of US in the evaluation of a child with hemithorax opacity. (orig.)

  19. Digital subtraction angiography of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.

    1984-02-01

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram.

  20. Temporary quadriplegia following continuous thoracic paravertebral block.

    Science.gov (United States)

    Calenda, Emile; Baste, Jean Marc; Danielou, Eric; Michelin, Paul

    2012-05-01

    A case of temporary quadriplegia following a continuous thoracic paravertebral block in an adult patient scheduled for video-assisted thoracoscopy is presented. An 18-gauge Tuohy needle was inserted under direct vision by the surgeon but the tip of the catheter was not localized. Postoperatively, the patient developed temporary quadriplegia 90 minutes after the start of a continuous infusion of ropivacaine 0.2%. Imaging studies showed that the catheter was localized in the intrathecal space. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. [Surgical treatment of thoracic disc herniation].

    Science.gov (United States)

    Hrabálek, L; Kalita, O; Langová, K

    2010-08-01

    The aim of this study was to compare the efficiency of different surgical approaches to thoracic disc herniation, and to show the role of segmental fusion and selection of an appropriate microsurgical decompression technique for the successful outcome of surgery. A group of 27 patients, 10 men and 17 women, between 31 and 70 years (average age, 49.33 years) were included in this prospective study. They underwent surgery for thoracic degeneration disc disease in the period from June 1994 to August 2008. In all patients, the severity of myelopathy was assessed using the grading Frankel system and JOA score, axial and radicular pain intensity was evaluated with VAS and ODI rating systems. The diagnosis was established on the basis of thoracic spine radiography, thoracic spine MRI and a CT scan of the segment. A total of 30 thoracic segments, in the range of Th4/Th5 to Th12/L1, were indicated for surgery. Localisation of the hernia was medial at 19 segments, mediolateral at three and lateral at eight segments. Soft disc herniation was found in 17 cases and hard disc protrusion at the remaining 13 segments. Surgery for significant myelopathy was carried out in 23 patients and for pain in four patients. According to the surgical procedure used, the patients were allocated to two groups: group A comprised 10 patients treated without disc replacement through a laminectomy or a costotransversectomy exposure, and group B consisted of 17 patients undergo- ing intersomatic fusion via a thoracotomy. Clinical and radiographic examinations were made at regular intervals for at least 1 year of follow-up. The results of clinical assessment, including JOA scores, JOA Recovery Rate, VAS scores at rest and after exercise and ODI, were statistically analysed for each group and compared. There was a statistically significant difference in JOA evaluation of myelopathy between the groups in group A, the mean JOA score declined from 7.9 to 7.0, i.e., -0.9 point, while in group B it

  2. Operativ behandling af thoracic outlet syndrome

    DEFF Research Database (Denmark)

    Birkeland, Peter; Stiasny, Jerzy

    2012-01-01

    of the brachial plexus. At surgery, we found and severed a fibrous band that compressed the inferior trunk. Postoperatively, the pain subsided and fine hand movements improved. One patient had no cervical rib, however, in the two other cases we found rudimentary cervical ribs. Magnetic resonance imaging......We present three cases with longstanding true neurogenic thoracic outlet syndrome. All patients had aching pain in the shoulder, arm and ulnar border of the hand. On examination, we found atrophy of the hand muscles. Electromyography revealed signs of compromised function of the inferior trunk...

  3. Volume distribution for particles between 3.5 to 2000 μm in the upper 200 m region of the South Pacific Gyre

    Directory of Open Access Journals (Sweden)

    L. Stemmann

    2008-03-01

    border of the SPG to the ultra-oligotrophy of the center in the upper 200 m depth. We expect large particles to play a major role in the trophic interaction in the upper waters of the South Pacific Gyre.

  4. Non-volant mammals from the Upper Paraná River Basin: a data set from a critical region for conservation in Brazil.

    Science.gov (United States)

    Gonçalves, Fernando; Hannibal, Wellington; Godoi, Mauricio N; Martins, Fernando I; Oliveira, Roniel F; Figueiredo, Valquiria V; Casella, Janaina; de Sá, Érica F G G

    2018-02-01

    The data set represents the first attempt at a large-scale inventory of non-volant mammals, with potential applications to performing macroecological studies, developing conservation strategies, and undertaking population and community ecology research, but also to evaluate the ecological consequences of fragmentation and defaunation. Our objectives for compiling these data were to summarize information about inventories of non-volant mammals in the critically important area of the Upper Paraná River Basin by focusing on species richness and index of frequency of occurrence and to identify gaps in knowledge regarding non-volant mammal communities in order to guide future sampling efforts. The data set comprises studies on communities of non-volant mammals from 52 locations covering more than 1,000 km 2 and comprises portion of four Brazilian states in the Upper Paraná River Basin. We listed 81 species of non-volant mammals distributed among 58 genera, 22 families, and 9 orders. Rodentia (28 species) was the richest order, followed by Carnivora (17 spp.) and Didelphimorphia (15 spp.). The richest family was Cricetidae (20 spp.), followed by Didelphidae (15 spp.), and Dasypodidae and Felidae (six spp.). Considering national conservation status, one species are considered endangered and 16 vulnerable. Considering global conservation status, 7 species are considered vulnerable, 10 are considered near threatened, and 6 are data deficient. According to the index of frequency of occurrence, Myrmecophaga tridactyla was the most frequent species, occurring at 88.64% of all sites, while 25 species were considered very restricted, occurring in just 2.56% of all sites. In general, the non-volant mammal fauna was composed of mainly very restricted (VR, 25 species) and localized species (L, 25 species), which account for 61.7% of the known species, while 38.3% are restricted (R, 8 species), common (C, 16 species), and widespread (W, 7 species). Seven marsupials and five

  5. Analysis of spatial pattern Change of LU/LC over the upper Tarim River region since 1990 using remote sensing data

    Science.gov (United States)

    Bai, L. Y.; Feng, J. Z.; Ma, Y. X.; Ran, Q. Y.; Wang, K.; Zhao, Y.

    2017-02-01

    The upper reaches of Tarim River (URTR) is an important port of trade between China and central Asia. The development of the URTR is thus significant for the SREB initiative. The LU/LC data in the URTR from 1990 to 2015 were used to quantitatively explore the dynamics of LU/LC changes, and its driving force was discussed from two aspects of nature and human. Results showed that the unused land and grassland were the main land use types in this area, accounting for more than 79%. Compared with the data of 1990, the areas of woodland, water, farmland, and building land of 2015 increased with 3.24%, 6.53%, 10.57%, and 0.40%, respectively, and the areas of unused land and grassland decreased, which accounted for 53.25% and 26.01%, respectively. The increases of the woodland and farmland areas mainly is originated from grassland and unused land. The woodland increased sharply around 2000 due to the abundant water during the period between 1998 and 2000. Subsequently, part of the woodland was shifted into the farmland. The extension of building land wasn’t obvious, but showed a salient feature of population urbanization. It was essential that the LU/LC patterns of the URTR were deeply influenced by human farming and living activities.

  6. Spontaneous combustion of the Upper Paleocene Cerrejon Formation coal and generation of clinker in La Guajira Peninsula (Caribbean Region of Colombia)

    Energy Technology Data Exchange (ETDEWEB)

    Quintero, J.A. [Carbones del Cerrejon Limited., Cl. 100 No. 19-54 piso 12, Bogota D.C. (Colombia); Candela, S.A. [ECOPETROL S.A. Edificio Principal Cr. 7 No. 37-65, Bogota D.C. (Colombia); Rios, C.A. [Escuela de Geologia, Universidad Industrial de Santander, Cr 27 Cl 9, Ciudad Universitaria, Bucaramanga (Colombia); Montes, C. [Smithsonian Tropical Research Institute, Roosvelt Ave., Tupper Building - 401, Balboa, Ancon, Panama (Panama); Uribe, C. [Tubos Moore S.A. Cll 99 No. 57-74, Bogota (Colombia)

    2009-12-01

    Clinker referred here as red and brick-looking burnt rocks found interbedded in the Upper Paleocene Cerrejon Formation is the result of spontaneous and natural combustion of coal seams in the recent geologic past. These rocks have been mapped, measured and characterized in the Cerrejon Coal Mine at La Guajira Peninsula (Colombia). These burnt rocks usually outcrop in irregular patterns as almost tabular bodies up to 100 m thick, thinning and pinching out below ground surface to depths up to 448 m. Mapping revealed that clinker is usually found near deformed zones, either faults or tight folds. Timing of spontaneous combustion seems to predate folding and faulting, but seems to postdate the development of the Cerrejon thrust fault and alluvial fan proceeding from the Perija Range. Clinker covers an area of around 2.9 x 10{sup 6} m{sup 2} with a volume of approximately 1.4 x 10{sup 8} m{sup 3}. The calculation of the amount of heat released through coal burning indicates that complete combustion of 6.4 Mt of 26.4 x 10{sup 6} J/kg coal would yield 17 x 10{sup 13} J. (author)

  7. Are antibiotics over-prescribed in Poland? Management of upper respiratory tract infections in primary health care region of Warszawa, Wola.

    Science.gov (United States)

    Windak, A; Tomasik, T; Jacobs, H M; de Melker, R A

    1996-10-01

    Concern about the increasing numbers of multiple resistant strains resulting from over- and misuse of antibiotics is growing world-wide. A questionnaire based on two cases related to respiratory tract infections for which antibiotic prescription was disputable was sent to primary care physicians in the health care district of Warszawa, Wola, Poland. The prescription percentage for both cases was high, with a large variety in choice of antibiotic therapy made by the doctors. This finding was striking when compared with the more restrictive prescription behaviour of Dutch general practitioners. Moreover, this high prescription percentage was combined with other abundant activities. In the case of the patient with acute tonsillitis, 53% of the primary care physicians would have ordered additional tests, 94% would have advised bed-rest and 9% would have referred. In the sinusitis case, these figures were 88, 74 and 54% respectively. No correlations were found between choice of antibiotics and characteristics of the physicians such as age, gender, experience with working in primary health care or degree of specialization. In conclusion, the results of this small pilot study indicate that Polish first-contact doctors have an inadequate prescription behaviour in cases with upper respiratory tract infections. Our results underline the need for courses in pharmacotherapy within the postgraduate education course in family medicine recently introduced in Poland.

  8. Modified Graded Motor Imagery for Complex Regional Pain Syndrome Type 1 of the Upper Extremity in the Acute Phase: A Patient Series

    Science.gov (United States)

    Lagueux, Emilie; Charest, Joelle; Lefrancois-Caron, Eve; Mauger, Marie-Eve; Mercier, Emilie; Savard, Kim; Tousignant-Laflamme, Yannick

    2012-01-01

    Complex regional pain syndrome (CRPS) is a pathologic condition in which the painful experience is disproportionate in time and intensity in comparison with the inciting event. At present, the pathophysiology of CRPS is not well understood. Several studies have indicated that cortical reorganization plays a role in the persistence of the symptoms.…

  9. Global Coupled Model Studies of The Jovian Upper Atmosphere In Response To Electron Precipitation and Ionospheric Convection Within The Auroral Region.

    Science.gov (United States)

    Millward, G. H.; Miller, S.; Aylward, A. D.

    The Jovian Ionospheric Model (JIM) is a global three-dimensional model of Jupiter's coupled ionosphere and thermosphere, developed at University College London. Re- cently, the model has been used to investigate the atmospheric response to electron precipitation within the high-latitude auroral region. A series of simulations have been performed in which the model atmosphere is subjected to monochromatic precipitat- ing electrons of varying number flux and initial energy and, in addition, to various degrees of ionospheric convection. The auroral ionospheric conductivity which re- sults is shown to be strongly non-linear with respect to the incoming electron energy, with a maximum observed for incident particles of initial energy 60 KeV. Electrons with higher energies penetrate the thermospheric region completely, whilst electrons of lower energy (say 10 keV) produce ionisation at higher levels in the atmosphere which are less less condusive to the creation of ionospheric conductivity. Studies of the thermospheric winds with the auroral region show that zonal winds (around the auroral oval) can attain values of around 70% of the driving zonal ion velocity. Also the results show that these large neutral winds are limited in vertical extent to the region of large ionospheric conductivity, tailing off markedly at altitudes above this. The latest results from this work will be presented, and the implications for Jovian magnetospheric-ionospheric coupling will be discussed.

  10. Single injection thoracic paravertebral block (TPVB for breast surgery in morbidly obese patient

    Directory of Open Access Journals (Sweden)

    Anita Kulkarni

    2017-01-01

    Full Text Available Morbidly obese (MO patients with associated restrictive airway disease, obstructive sleep apnea, and coronary artery disease pose challenge to an anesthesiologist. Regional block combined with general anesthesia (GA is the anesthetic technique of choice as it will decrease the requirement of opioids, anesthetics, and postoperative respiratory depression. A MO patient for modified radical mastectomy was successfully managed with single-injection thoracic paravertebral block and conventional GA.

  11. September 2017 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2017-09-01

    Full Text Available No abstract available. Article truncated at 150 words. The September 2017 Arizona Thoracic Society meeting was held on Wednesday, September 27, 2017 at the HonorHealth Rehabilitation Hospital beginning at 6:30 PM. This was a dinner meeting with case presentations. There were 16 in attendance representing the pulmonary, critical care, sleep, and radiology communities. There was a discussion of the Tobacco 21 bill which had been introduced the last session in the Arizona State Legislature. Since it seems likely that the bill will be reintroduced, the Arizona Thoracic Society will support the bill in the future. Dr. Rick Robbins announced that the SWJPCC has applied to be included in PubMed. In addition, Dr. Robbins was assigned the task of tracking down the campaign contributions to congressional members from the tobacco PAC before the next election. There were 7 case presentations: 1.\tAshley L. Garrett, MD, pulmonary fellow at Mayo, presented an elderly man with insulin-dependent diabetes who felt he …

  12. October 2013 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2013-10-01

    Full Text Available No abstract available. Article truncated after 150 words. The October Arizona Thoracic Society meeting was held on Wednesday, 10/23/2013 at Shea Hospital beginning at 6:30 PM. There were 21 in attendance representing the pulmonary, critical care, sleep, and thoracic surgery communities. A proposal was made to decrease the number of meetings from 10 to 8 per year. After a brief discussion, this was adopted. Dr. Parides will try and coordinate these changes with Tucson. Meetings were announced for December in Tucson, January in Carmel, February in Albuquerque, and April in Phoenix. A suggestion was made to have a separate area for meetings on the SWJPCC website. There were 2 cases presented-both by Nick Sparacino, a first year fellow at Good Samaritan/VA. 1. The first case was a 48 year old man admitted to podiatry for chronic diabetic foot ulcers. His preoperative chest x-ray revealed multiple pulmonary nodules. Importantly, he had a history of working in a brake pad …

  13. Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis

    Directory of Open Access Journals (Sweden)

    Paul Singh

    2014-05-01

    Full Text Available Introduction - Most often, ganglioneuromas affect older pediatric and adult patients. They are typically slow growing tumors that remain clinically silent until they become large enough to cause symptoms by compression of adjacent structures. Case - We report a case of a 22-year-old Hispanic gravida 2 para 1 female patient who was found to have massive hydrops fetalis at 20 completed gestational weeks. Fetal echocardiography revealed a narrowed distal ductal arch and proximal descending aorta. Cesarean delivery was undertaken at 29 completed gestational weeks for refractory labor and nonreassuring fetal status. The neonate expired at 47 minutes of life despite aggressive resuscitation. At autopsy, multiple thoracic masses were found adjacent to a compressed proximal descending aorta. Histological and immunohistochemical analysis confirmed the diagnosis of a ganglioneuroma, a rare type of neural crest tumor. Discussion - A variety of intrathoracic masses have previously been reported to cause hydrops fetalis including teratomas, fibrosarcomas, and lymphangiomas. To our knowledge, this case is the first description of hydrops fetalis caused by ganglioneuromas. We propose that multiple thoracic ganglioneuromas led to biventricular distal outflow tract obstruction and hydrops fetalis.

  14. Retrospective evaluation of thoracic computed tomography findings in dogs naturally infected by Angiostrongylus vasorum.

    Science.gov (United States)

    Coia, Mark E; Hammond, Gawain; Chan, Daniel; Drees, Randi; Walker, David; Murtagh, Kevin; Stone, Janine; Bexfield, Nicholas; Reeve, Lizzie; Helm, Jenny

    2017-09-01

    Angiostrongylus vasorum (A. vasorum) is an important emerging disease of canidae. Cardiorespiratory signs are common in affected dogs, therefore thoracic imaging is critical for diagnosing and monitoring disease. Descriptions of thoracic computed tomography (CT) findings in dogs naturally infected with A. vasorum are currently lacking. Aims of this multicenter, retrospective study were to describe thoracic CT findings in a group of dogs with confirmed disease, determine whether any changes were consistent among dogs, and propose standardized terms for describing thoracic CT findings. Nine UK-based referral centers' clinical and imaging databases were searched for dogs that had a confirmed diagnosis of A. vasorum, and had undergone thoracic CT examination. Eighteen dogs, from seven of the centers, fulfilled the inclusion criteria. The lung lobes were divided into the following three zones and the CT changes described in each: pleural (zone 1), subpleural (zone 2), and peribronchovascular (zone 3). The predominent abnormality was increased lung attenuation due to poorly defined ground-glass opacity or consolidation. There were regions of mosaic attenuation due to peripheral bronchiectasis. Nine/18 (50%) dogs showed hyperattenuating nodules of varying sizes with ill-defined margins. The distribution always affected zones 1 and 2 with varied involvement of zone 3; this resulted in clear delineation between zones 2 and 3. Tracheobronchial lymphadenomegaly was frequently noted. Findings were nonspecific and there was considerable overlap with other pulmonary conditions. However, authors recommend that A. vasorum be considered a likely differential diagnosis for dogs with a predominantly peripheral distribution of lung changes. © 2017 American College of Veterinary Radiology.

  15. Exposure to 100% Oxygen Abolishes the Impairment of Fracture Healing after Thoracic Trauma.

    Directory of Open Access Journals (Sweden)

    Julia Kemmler

    Full Text Available In polytrauma patients a thoracic trauma is one of the most critical injuries and an important trigger of post-traumatic inflammation. About 50% of patients with thoracic trauma are additionally affected by bone fractures. The risk for fracture malunion is considerably increased in such patients, the pathomechanisms being poorly understood. Thoracic trauma causes regional alveolar hypoxia and, subsequently, hypoxemia, which in turn triggers local and systemic inflammation. Therefore, we aimed to unravel the role of oxygen in impaired bone regeneration after thoracic trauma. We hypothesized that short-term breathing of 100% oxygen in the early post-traumatic phase ameliorates inflammation and improves bone regeneration. Mice underwent a femur osteotomy alone or combined with blunt chest trauma 100% oxygen was administered immediately after trauma for two separate 3 hour intervals. Arterial blood gas tensions, microcirculatory perfusion and oxygenation were assessed at 3, 9 and 24 hours after injury. Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma. Bone healing was assessed on day 7, 14 and 21. Thoracic trauma induced pulmonary and systemic inflammation and impaired bone healing. Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury. These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

  16. Penetrating abdomino-thoracic injury with an iron rod: An anaesthetic challenge

    Directory of Open Access Journals (Sweden)

    Kiranpreet Kaur

    2014-01-01

    Full Text Available Penetrating abdomino-thoracic injuries are potentially life-threatening due to the associated haemorrhagic shock and visceral injury. The management of these injuries poses specific challenges in pre-hospital care, transport, and management strategies. We report a 35-year-old male having impalement injury of the left thorax and left upper arm with a metallic rod used for construction of the house after a fall from height. One rod penetrated thorax from left shoulder and exit point was present just above the iliac crest and second rod was seen piercing left upper arm. Patient was successfully managed without any intraoperative, post-operative surgical complications, neurological damage or permanent injuries.

  17. A Regional Guidebook for Applying the Hydrogeomorphic Approach to Assessing Wetland Functions of Depression Wetlands in the Upper Des Plaines River Basin

    Science.gov (United States)

    2006-05-01

    Wetlands and Coastal Ecology Branch; Dr. David J. Tazik, Chief, Eco- system Evaluation and Engineering Division; and Dr. Edwin A. Theriot, Direc- tor, EL...wetlands (Euliss and Mushet 1996, Azous and Horner 2001, Bhaduri et al. 1997) and nutrient loading into those wetlands. The overall LU score is...Euliss, N. H., and Mushet , D. M. (1996). “Water-level fluctuation in wetlands as a function of landscape condition in the prairie pothole region

  18. Comparison of histopathologic changes following X-irradiation of mid-thoracic and lumbosacral levels of neonatal rat spinal cord

    International Nuclear Information System (INIS)

    Heard, J.K.; Gilmore, S.A.

    1985-01-01

    Light microscopic changes were studied in the dorsal funiculi of spinal cords from rats irradiated (4000 R) at 3 days of age and killed from 9-60 days postirradiation (P-I). The irradiated site was limited to a 5-mm length of mid-thoracic spinal cord (T only) in one group of rats, to a 5-mm length of lumbosacral spinal cord (L only) in a second group, and to 5-mm lengths of both mid-thoracic and lumbosacral spinal cord (T/L) in the third group. Changes in the lumbosacral regions were essentially the same in both L only and T/L irradiated groups. These changes included a decreased neuroglial population and a concurrent state of hypomyelination from 9-30 days P-I. In contrast, in the mid-thoracic regions of T only and T/L irradiated groups the decrease in the neuroglial population was obvious only through 13 days P-I, and by 30 days this population resembled that of the controls. The irradiated mid-thoracic areas were hypomyelinated, with the fasciculus gracilis showing a greater degree of hypomyelination than the fasciculus cuneatus. By 25 days P-I, myelination appeared to be normal in these areas. Scattered hemorrhages were noted in both lumbosacral and mid-thoracic regions, but necrotic areas occurred only at the lumbosacral level. In general, the mid-thoracic area appeared to be less sensitive to x-radiation at 3 days of age than the lumbosacral area. These data suggest that there may be marked differences in the developmental states of cells at these two levels at 3 days of age

  19. Menstruation in an unusual place: A case of thoracic endometriosis ...

    African Journals Online (AJOL)

    While pelvic endometriosis is relatively common, thoracic menstruation is rare. A report of what is believed to be the first case of thoracic endometriosis in Uganda is given. A 34 year old female was complaining of on and off chest pain mainly on the right side. Clinically she had signs of pleural effusion and 500 mls of altered ...

  20. State of the art thoracic ultrasound: intervention and therapeutics

    NARCIS (Netherlands)

    Corcoran, John P.; Tazi-Mezalek, Rachid; Maldonado, Fabien; Yarmus, Lonny B.; Annema, Jouke T.; Koegelenberg, Coenraad F. N.; St Noble, Victoria; Rahman, Najib M.

    2017-01-01

    The use of thoracic ultrasound outside the radiology department and in everyday clinical practice is becoming increasingly common, having been incorporated into standards of care for many specialties. For the majority of practitioners, their experience of, and exposure to, thoracic ultrasound will

  1. An unusual renal accessory artery originating from the thoracic aorta and its potential clinical implications

    Directory of Open Access Journals (Sweden)

    Elvira Talović

    2013-05-01

    Full Text Available We report a case of an unsual anatomical vascular blood supply to the right kidney. In an analysis of kidneys, by dissection of 39 foetuses, additional renal arteries were found in 18 cases (46.15%. In only one case (2.5% was it noticed that the right kidney was supplied with blood by three renal arteries, one main and two additional arteries. One of the additional arteries, marked as the upper pole artery of aortic origin, separated from the thoracic aorta at the level of T11 (the eleventh thoracic rib, 1.5 cm above the truncus coeliacus. This artery, after passing through the diaphragm, entered the renal hilus at its upper part and served to vasculate that part of the kidney. Conclusion. The importance of this study is seen in the fact that anatomic knowledge of variations in the vascularization of the kidneys is of exceptional practical importance. Also, this information may concern transplant surgeons involved in living donor nephrectomies.

  2. Mid-Upper Arm Circumference Based Nutrition Programming: Evidence for a New Approach in Regions with High Burden of Acute Malnutrition

    Science.gov (United States)

    Goossens, Sylvie; Bekele, Yodit; Yun, Oliver; Harczi, Géza; Ouannes, Marie; Shepherd, Susan

    2012-01-01

    Background In therapeutic feeding programs (TFP), mid-upper arm circumference (MUAC) shows advantages over weight-for-height Z score (WHZ) and is recommended by the World Health Organization (WHO) as an independent criterion for screening children 6–59 months old. Here we report outcomes and treatment response from a TFP using MUAC ≤118 mm or oedema as sole admission criteria for severe acute malnutrition (SAM). Methods Patient data from September 2007 to March 2009 for children admitted by MUAC ≤118 mm or oedema to a Médecins Sans Frontières (MSF) TFP in Burkina Faso were retrospectively analyzed. Analysis included anthropometric measurements at admission and discharge, program outcomes and treatment response. Results Of 24,792 patient outcomes analyzed, nearly half (48.8%; n = 12,090) were admitted with MUAC 116–118 mm. Most patients (88.7%; n = 21,983) were 6–24 months old. At admission, 52.7% (n = 5,041) of those with MUAC 116–118 mm had a WHZ <−3 SD. At discharge, 89.1% (n = 22,094) recovered (15% weight gain or oedema resolution), 7.9% (n = 1,961) defaulted, 1.5% (n = 384) failed to respond to treatment, and 1.0% (n = 260) died. Average weight gain was 5.4 g/kg/day, and average MUAC gain was 0.42 mm/day. Patients with MUAC ≤114 mm at admission had higher average daily weight and MUAC gains at discharge compared to those admitted with MUAC 116–118 mm, but those in the latter category required longer lengths of stay to achieve recovery (P<0.001). Conclusion This analysis suggests that MUAC ≤118 mm as TFP admission criterion is a useful alternative to WHZ. Regarding treatment response, rates of weight and MUAC gain were acceptable. Applying 15% weight gain as discharge criterion resulted in longer lengths of stay for less malnourished children. Since MUAC gain parallels weight gain, it may be feasible to use MUAC as both an admission and discharge criterion. PMID:23189140

  3. Serological evidence for Saint Louis encephalitis virus in free-ranging New World monkeys and horses within the upper Paraná River basin region, Southern Brazil

    Directory of Open Access Journals (Sweden)

    Walfrido Kühl Svoboda

    2014-06-01

    Full Text Available Introduction Saint Louis encephalitis virus (SLEV primarily occurs in the Americas and produces disease predominantly in humans. This study investigated the serological presence of SLEV in nonhuman primates and horses from southern Brazil. Methods From June 2004 to December 2005, sera from 133 monkeys (Alouatta caraya, n=43; Sapajus nigritus, n=64; Sapajus cay, n=26 trap-captured at the Paraná River basin region and 23 blood samples from farm horses were obtained and used for the serological detection of a panel of 19 arboviruses. All samples were analyzed in a hemagglutination inhibition (HI assay; positive monkey samples were confirmed in a mouse neutralization test (MNT. Additionally, all blood samples were inoculated into C6/36 cell culture for viral isolation. Results Positive seroreactivity was only observed for SLEV. A prevalence of SLEV antibodies in sera was detected in Alouatta caraya (11.6%; 5/43, Sapajus nigritus (12.5%; 8/64, and S. cay (30.8%; 8/26 monkeys with the HI assay. Of the monkeys, 2.3% (1/42 of A. caraya, 6.3% 94/64 of S. nigritus, and 15.4% (4/26 of S. cay were positive for SLEV in the MNT. Additionally, SLEV antibodies were detected by HI in 39.1% (9/23 of the horses evaluated in this study. Arboviruses were not isolated from any blood sample. Conclusions These results confirmed the presence of SLEV in nonhuman primates and horses from southern Brazil. These findings most likely represent the first detection of this virus in nonhuman primates beyond the Amazon region. The detection of SLEV in animals within a geographical region distant from the Amazon basin suggests that there may be widespread and undiagnosed dissemination of this disease in Brazil.

  4. Kharlamova, N. F. Climate Changes over the 20th and 21st Centuries in the Upper Basin of the Ob and Irtysh Rivers (Altai Region)

    Science.gov (United States)

    Fedorovna, K. N., II

    2015-12-01

    The Russian climate is more sensitive to global warming than the climate in many other parts of the world. According to the Second Climate Change National Assessment, since the mid-1970s, the average temperature has been rising with rate of 0.43 ° C / 10 years, which is more than two times higher than the rate of global warming. In the Altai region, the rate of temperature change is higher than the average for Russia with an annual surface air temperature increase equal to 1.8°C the 20th century. The maximum value of this increase the past 50 years (1963-2013) was found in the intermountain basins of Altai (+ 2.6°C) mainly due to the winter and spring warming with changes in the summer season being considerably smaller. This warming is accompanied with negative tendencies in annual precipitation over the entire Altai Krai. The mountain ranges of Altai are called the "water tower" of Northern Eurasia. The northward flow of numerous rivers streaming down from these ranges in the Basin of the Ob and the Irtysh Rivers is formed by melting of Altai glaciers and snowfields. Since the middle of the 19th century the largest glaciers in the Altai have retreated by 1.5-2 km and the thickness of their tails decreased by 50-70 m. The reduction of mountain glaciers poses a threat of depletion of water flow to major agricultural regions downstream affecting human activity and even the drinking water availability. Permafrost in the Altai Mountains is actively degraded (thawing), which represents a danger for infrastructure (first of all for roads and pipelines) and increases risk of catastrophic events (landslides, mudflows). Continued warming could contribute to a significant reduction of water resources, biodiversity and other negative processes in the region.The reported study was partially supported by the Russian Foundation for Baseline Research (project No. 15-45-04450).

  5. Effect of ion entry acceptance conditions on the performance of a quadrupole mass spectrometer operated in upper and lower stability regions

    International Nuclear Information System (INIS)

    Turner, P.; Taylor, S.; Gibson, J.R.

    2005-01-01

    Computer simulation of ion motion in a quadrupole mass spectrometer has been used to examine the effect of initial ion conditions on performance when operated in the first and third zones of the Mathieu stability diagram. Commercial instruments frequently use round electrodes instead of the better-performing hyperbolic electrodes because the cost of manufacturing is lower. However, adverse features are seen when using round electrodes. Here further insight is provided and a possible method of correction is suggested. For the first time, ion origin for the first stability region for a round electrode quadrupole has been reported

  6. Adjacent-segment disease after thoracic pedicle screw fixation.

    Science.gov (United States)

    Agarwal, Nitin; Heary, Robert F; Agarwal, Prateek

    2018-03-01

    OBJECTIVE Pedicle screw fixation is a technique widely used to treat conditions ranging from spine deformity to fracture stabilization. Pedicle screws have been used traditionally in the lumbar spine; however, they are now being used with increasing frequency in the thoracic spine as a more favorable alternative to hooks, wires, or cables. Although safety concerns, such as the incidence of adjacent-segment disease (ASD) after cervical and lumbar fusions, have been reported, such issues in the thoracic spine have yet to be addressed thoroughly. Here, the authors review the literature on ASD after thoracic pedicle screw fixation and report their own experience specifically involving the use of pedicle screws in the thoracic spine. METHODS Select references from online databases, such as PubMed (provided by the US National Library of Medicine at the National Institutes of Health), were used to survey the literature concerning ASD after thoracic pedicle screw fixation. To include the authors' experience at Rutgers New Jersey Medical School, a retrospective review of a prospectively maintained database was performed to determine the incidence of complications over a 13-year period in 123 consecutive adult patients who underwent thoracic pedicle screw fixation. Children, pregnant or lactating women, and prisoners were excluded from the review. By comparing preoperative and postoperative radiographic images, the occurrence of thoracic ASD and disease within the surgical construct was determined. RESULTS Definitive radiographic fusion was detected in 115 (93.5%) patients. Seven incidences of instrumentation failure and 8 lucencies surrounding the screws were observed. One patient was observed to have ASD of the thoracic spine. The mean follow-up duration was 50 months. CONCLUSIONS This long-term radiographic evaluation revealed the use of pedicle screws for thoracic fixation to be an effective stabilization modality. In particular, ASD seems to be less of a problem in the

  7. The Askin tumour. Neuroactodermic tumour of the thoracic wall; Tumor de Askin: tumor neuroectodermico de la pared toracica

    Energy Technology Data Exchange (ETDEWEB)

    Velazquez, P.; Nicolas, A. I.; Vivas, I.; Damaso Aquerreta, J.; Martinez-Cuesta, A. [Clinica Universitaria de Navarra. Pamplona (Spain)

    1999-07-01

    The Askin tumours is an extremely rare and malignant process in the thoracic pulmonary region during infancy and youth. The differential diagnosis has to be considered with other thoracic wall tumours that are more common in pediatrics like the undifferentiated neuroblastoma, the embionic rabdomiosarcoma, the Ewing sarcoma and the linfoma. A retrospective examination was carried out on 473 thoracic wall tumours from 1994 to 1997 at our centre, resulting in 4 patients with an anatomopathologically tested Askin tumour (ages from 13-21). All the cases were studied using simple radiography and CT. In two cases MRI was also used. The most common clinical manifestation was a palpable painful mass in the thoracic wall. In the simple radiograph the main finding was a large mass of extrapleural soft material, with costal destruction ( n=3) and a pleural effusion (n=2). In the CT study the mass was heterogeneous, with internal calcifications in one case. CT and MRI showed invasion in the mediastinum (n=1), medular channel (n=1) and phrenic and sulphrenic extension (n=1). The Askin tumour should be included in the differential diagnosis of thoracic wall masses in infant-youth ages. There are no specific morphological characteristics. Both CT and MRI are useful for the diagnosis, staging and follow up. (Author) 11 refs.

  8. Associations between psychological stress and smoking, drinking, obesity, and high blood pressure in an upper middle-income country in the African region.

    Science.gov (United States)

    Chamik, Tanja; Viswanathan, Bharathi; Gedeon, Jude; Bovet, Pascal

    2018-02-01

    The direction and magnitude of the associations between cardiovascular risk factors (CVRFs) and psychological stress continue to be debated, and no data are available from surveys in the African region. In this study, we examine the associations between CVRFs and psychological stress in the Seychelles, a rapidly developing small island state in the African region. A survey was conducted in 1,240 adults aged 25-64 years representative of the Seychelles. Participants were asked to rank psychological stress that they had experienced during the past 12 months in four domains: work, social life, financial situation, and environment around home. CVRFs (high blood pressure, tobacco use, alcohol drinking, and obesity) were assessed using standard procedures. Psychological stress was associated with age, sex, and socioeconomic status. Overall, there were only few consistent associations between psychological stress and CVRFs, adjusting for age, sex, and socioeconomic status. Social stress was associated with smoking, drinking, and obesity, and there were marginal associations between stress at work and drinking, and between financial stress, and smoking and drinking. Psychological stress was not associated with high blood pressure. These findings suggest that psychological stress should be considered in cardiovascular disease prevention and control strategies. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Enriched and depleted characters of the Amnay Ophiolite upper crustal section and the regionally heterogeneous nature of the South China Sea mantle

    Science.gov (United States)

    Perez, Americus d. C.; Faustino-Eslava, Decibel V.; Yumul, Graciano P.; Dimalanta, Carla B.; Tamayo, Rodolfo A.; Yang, Tsanyao Frank; Zhou, Mei-Fu

    2013-03-01

    The volcanic section of the Middle Oligocene Amnay Ophiolite in Mindoro, Philippines has previously been shown to be of normalmid-oceanic ridge basalt (NMORB) composition. Here we report for the first time an enriched mantle component that is additionally recorded in this crustal section. New whole rock major and trace element data are presented for nine mafic volcanic rocks from a section of the ophiolite that has not been previously examined. These moderately evolved tholeiitic basalts were found to have resulted from the bulk mixing of ˜10% ocean island basalt components with depleted mantle. Drawing together various geochemical characteristics reported for different rock suites taken as representatives of the South China Sea crust, including the enriched MORB (EMORB) and NMORB of the East Taiwan Ophiolite, the NMORB from previous studies of the Amnay Ophiolite and the younger ocean floor eruptives of the Scarborough Seamount-Reed Bank region, a veined mantle model is proposed for the South China Sea mantle. The NMORB magmatic products are suggested to have been derived from the more depleted portions of the mantle whereas the ocean island basalt (OIB) and EMORB-type materials from the mixing of depleted and veined/enriched mantle regions.

  10. Geothermal development promotion survey report. No. 29. Upper reach region of Oita river; 1988-1990 chinetsu kaihatsu sokushin chosa hokokusho. No. 29 Oitagawa joryu chiiki

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1991-03-01

    The results of surveys conducted in the Oita river region, Oita Prefecture, in fiscal 1988-1989 are compiled in this report. Conducted were a geological/alteration zone survey, geochemical survey, electric prospecting (Schlumberger method), electromagnetic surveillance (simplified magnetotelluric method), electromagnetic surveillance (EMAP - Environmental Monitoring and Assessment Program method), heat flow rate survey, test boring, environmental impact survey, and so forth. Conclusions are mentioned below. It is inferred that the geothermal fluid results from groundwater originating in meteoric water, that the meteoric water takes many years to flow from the mountainous region into the ground where it is stored mainly in the Shonai stratum, that the stored water is warmed by heat from rocks in the neighborhood for development into a geothermal fluid, and that the geothermal fluid finally forms a hot spring water reservoir. Hot spring water reservoirs are found widely distributed in the basin of the Oita river. In view of the ground temperature distribution and the hot spring water geochemical temperature determined by structure boring, it is concluded that possibilities are quite low that there exists a high-temperature geothermal fluid usable for power generation. (NEDO)

  11. Magnetic resonance imaging of thoracic hydatid disease

    International Nuclear Information System (INIS)

    Sinner, W.N. von; Rifal, A.; Te Strake, L.; Sieck, J.; King Faisal Specialist Hospital and Research Centre, Riyadh; Michigan Univ., Ann Arbor

    1990-01-01

    Two patients with thoracic manifestations of hydatid disease (HD) are discussed; one patient had recurrent HD of the chest wall and the other, intrapulmonary HD after rupture and intrathoracic extension of an infradiaphragmatic cyst. At magnetic resonance (MR) imaging the manifestations of HD in the thorax are similar to previously reported MR findings in HD in the liver. The presence of a low signal intensity rim on T2 weighted images representing the cyst wall was confirmed. On T1 weighted images cysts with heterogeneous low and intermediate signal intensity contents and a relatively high signal intensity wall were seen. ''Folded parasitic membranes'' previously not described on MR were noted. Daughter cysts may have a low or high signal intensity depending on contents. Reactive changes in the lung may be quite marked compared with the liver, due to reaction to the parasite or simply because the lung is more easily compressed leading to secondary atelectasis. (orig.)

  12. Evaluation of registration methods on thoracic CT

    DEFF Research Database (Denmark)

    Murphy, K.; van Ginneken, B.; Reinhardt, J.

    2011-01-01

    method and the evaluation is independent, using the same criteria for all participants. All results are published on the EMPIRE10 website (http://empire10.isi.uu.nl). The challenge remains ongoing and open to new participants. Full results from 24 algorithms have been published at the time of writing......EMPIRE10 (Evaluation of Methods for Pulmonary Image REgistration 2010) is a public platform for fair and meaningful comparison of registration algorithms which are applied to a database of intra-patient thoracic CT image pairs. Evaluation of non-rigid registration techniques is a non trivial task....... This article details the organisation of the challenge, the data and evaluation methods and the outcome of the initial launch with 20 algorithms. The gain in knowledge and future work are discussed....

  13. Motion correction in thoracic positron emission tomography

    CERN Document Server

    Gigengack, Fabian; Dawood, Mohammad; Schäfers, Klaus P

    2015-01-01

    Respiratory and cardiac motion leads to image degradation in Positron Emission Tomography (PET), which impairs quantification. In this book, the authors present approaches to motion estimation and motion correction in thoracic PET. The approaches for motion estimation are based on dual gating and mass-preserving image registration (VAMPIRE) and mass-preserving optical flow (MPOF). With mass-preservation, image intensity modulations caused by highly non-rigid cardiac motion are accounted for. Within the image registration framework different data terms, different variants of regularization and parametric and non-parametric motion models are examined. Within the optical flow framework, different data terms and further non-quadratic penalization are also discussed. The approaches for motion correction particularly focus on pipelines in dual gated PET. A quantitative evaluation of the proposed approaches is performed on software phantom data with accompanied ground-truth motion information. Further, clinical appl...

  14. Idiopathic Thoracic Spontaneous Spinal Epidural Hematoma

    Directory of Open Access Journals (Sweden)

    Abdurrahman Aycan

    2016-01-01

    Full Text Available A 33-year-old male patient experienced temporary sensory loss and weakness in the right lower extremity one month prior to admission. The patient was admitted to a private clinic with a three-day history of acute onset of sensory loss and weakness in both lower extremities and was treated and followed up with a prediagnosis of transverse myelitis and the Guillain-Barre syndrome (GBS. The patient was subsequently transferred to our clinic and the neurologic examination revealed paraplegia in both lower extremities, positive bilateral Babinski signs, and hypesthesia below the T10 dermatome with saddle anesthesia. The patient had urinary incontinence and thoracic magnetic resonance imaging (MRI showed an image of a mass compressing the medulla.

  15. An Official American Thoracic Society Research Statement

    DEFF Research Database (Denmark)

    Slatore, Christopher G; Horeweg, Nanda; Jett, James R

    2015-01-01

    BACKGROUND: Pulmonary nodules are frequently detected during diagnostic chest imaging and as a result of lung cancer screening. Current guidelines for their evaluation are largely based on low-quality evidence, and patients and clinicians could benefit from more research in this area. METHODS......: In this research statement from the American Thoracic Society, a multidisciplinary group of clinicians, researchers, and patient advocates reviewed available evidence for pulmonary nodule evaluation, characterized six focus areas to direct future research efforts, and identified fundamental gaps in knowledge...... demographic and nodule characteristics with patient-level outcomes. Methods to share data from registries are also necessary. CONCLUSIONS: This statement may help researchers to develop impactful and innovative research projects and enable funders to better judge research proposals. We hope...

  16. Thoracic manifestations of ovarian hyperstimulation syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Levin, M.F.; Hutton, L.C.; Kaplan, B.R. [University of Western Ontario, London, ON (Canada)

    1995-02-01

    In order to determine the thoracic manifestations of severe ovarian hyperstimulation syndrome, the medical records and available images of 771 patients who had received gonadotropins to induce superovulation, were reviewed. In 22 patients (3%) severe hyperstimulation syndrome was diagnosed clinically and confirmed with ultrasonography (US). Pleural effusion occurred in five of these (23%), one of whom required thoracentesis. Atelectasis and internal jugular vein thrombosis developed in one patient, and ventilation-perfusion mismatch occurred in another. The study concluded that respiratory distress in patients with ovarian hyperstimulation syndrome was most likely due to lung restriction. Pulmonary manifestations formed an important part of this syndrome, and radiologic input were considered necessary for assessment, monitoring and management. 10 refs., 2 figs., 1 tab.

  17. Strontium and argon isotopic homogenization of pelitic sediments during low-grade regional metamorphism: the Pan-African Upper Damara Sequence of northern Namibia (South West Africa)

    International Nuclear Information System (INIS)

    Clauer, N.

    1979-01-01

    The fine mineral fractions 0 C and pressures up to 2 kbar. These events are dated at about 535 m.y. and 455 m.y. respectively (with lambda( 87 Rb) = 1.42 X 10 -11 yr -1 ). Anomalously high K-Ar ages on samples from specific stratigraphic horizons can be related to open system behaviour and K migration during the formation of stilpnomelane from ferromagnesian illites. This study shows that age dating of sedimentary rocks subjected to low-grade regional metamorphism can only yield meaningful results if the interpretation of isotopic analyses is based on a clear understanding of the mineralogical processes that led to the formation of these parageneses which characterize the rock unit dated. (Auth.)

  18. Causes of childhood blindness in Ghana: results from a blind school survey in Upper West Region, Ghana, and review of the literature.

    Science.gov (United States)

    Huh, Grace J; Simon, Judith; Grace Prakalapakorn, S

    2017-06-13

    Data on childhood blindness in Ghana are limited. The objectives of this study were to determine the major causes of childhood blindness and severe visual impairment (SVI) at Wa Methodist School for the Blind in Northern Ghana, and to compare our results to those published from other studies conducted in Ghana. In this retrospective study, data from an eye screening at Wa Methodist School in November 2014 were coded according to the World Health Organization/Prevention of Blindness standardized reporting methodology. Causes of blindness/SVI were categorized anatomically and etiologically, and were compared to previously published studies. Of 190 students screened, the major anatomical causes of blindness/SVI were corneal scar/phthisis bulbi (CS/PB) (n = 28, 15%) and optic atrophy (n = 23, 12%). The major etiological causes of blindness/SVI were unknown (n = 114, 60%). Eighty-three (44%) students became blind before age one year. Of four published blind school surveys conducted in Ghana, CS/PB was the most common anatomical cause of childhood blindness. Over time, the prevalence of CS/PB within blind schools decreased in the north and increased in the south. Measles-associated visual loss decreased from 52% in 1987 to 10% in 2014 at Wa Methodist School. In a blind school in northern Ghana, CS/PB was the major anatomical cause of childhood blindness/SVI. While CS/PB has been the most common anatomical cause of childhood blindness reported in Ghana, there may be regional changes in its prevalence over time. Being able to identify regional differences may guide future public health strategies to target specific causes.

  19. Benchmarking in Thoracic Surgery. Third Edition.

    Science.gov (United States)

    Freixinet Gilart, Jorge; Varela Simó, Gonzalo; Rodríguez Suárez, Pedro; Embún Flor, Raúl; Rivas de Andrés, Juan José; de la Torre Bravos, Mercedes; Molins López-Rodó, Laureano; Pac Ferrer, Joaquín; Izquierdo Elena, José Miguel; Baschwitz, Benno; López de Castro, Pedro E; Fibla Alfara, Juan José; Hernando Trancho, Florentino; Carvajal Carrasco, Ángel; Canalís Arrayás, Emili; Salvatierra Velázquez, Ángel; Canela Cardona, Mercedes; Torres Lanzas, Juan; Moreno Mata, Nicolás

    2016-04-01

    Benchmarking entails continuous comparison of efficacy and quality among products and activities, with the primary objective of achieving excellence. To analyze the results of benchmarking performed in 2013 on clinical practices undertaken in 2012 in 17 Spanish thoracic surgery units. Study data were obtained from the basic minimum data set for hospitalization, registered in 2012. Data from hospital discharge reports were submitted by the participating groups, but staff from the corresponding departments did not intervene in data collection. Study cases all involved hospital discharges recorded in the participating sites. Episodes included were respiratory surgery (Major Diagnostic Category 04, Surgery), and those of the thoracic surgery unit. Cases were labelled using codes from the International Classification of Diseases, 9th revision, Clinical Modification. The refined diagnosis-related groups classification was used to evaluate differences in severity and complexity of cases. General parameters (number of cases, mean stay, complications, readmissions, mortality, and activity) varied widely among the participating groups. Specific interventions (lobectomy, pneumonectomy, atypical resections, and treatment of pneumothorax) also varied widely. As in previous editions, practices among participating groups varied considerably. Some areas for improvement emerge: admission processes need to be standardized to avoid urgent admissions and to improve pre-operative care; hospital discharges should be streamlined and discharge reports improved by including all procedures and complications. Some units have parameters which deviate excessively from the norm, and these sites need to review their processes in depth. Coding of diagnoses and comorbidities is another area where improvement is needed. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

  20. Paravertebral and Brachial plexus block for Abdominal flap to cover the upper limb wound

    Directory of Open Access Journals (Sweden)

    Narendra kumar

    2011-08-01

    Full Text Available We present a case report where thoracic paravertebral block and brachial plexus block were used in a sick elderly patient with poor cardiopulmonary reserve, to cover a post traumatic raw area of the upper limb by raising flap from lateral abdominal wall. The residual raw area of abdomen was then covered with the split skin graft taken from thigh.

  1. Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols.

    Science.gov (United States)

    Piccioni, Federico; Segat, Matteo; Falini, Stefano; Umari, Marzia; Putina, Olga; Cavaliere, Lucio; Ragazzi, Riccardo; Massullo, Domenico; Taurchini, Marco; Del Naja, Carlo; Droghetti, Andrea

    2018-03-01

    Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies. Thoracic paravertebral block is considered the first-line loco-regional technique for VATS. Other techniques include intercostal nerve block and serratus anterior plane block. Nonsteroidal anti-inflammatory drugs and paracetamol are essential part of the multimodal treatment of pain. Also, adjuvant drugs can be useful as opioid-sparing agents. Nevertheless, the treatment of postoperative pain must take into account opioid agents too, if necessary. All above is useful for careful planning and execution of a multimodal analgesic treatment to enhance the recovery of patients. This article summarizes the most recent evidences from literature and authors' experiences on perioperative multimodal analgesia principles for implementing an ERAS program after VATS lobectomy.

  2. Thoracic Cavernoma with Intraosseous and Extradural Component Mimicking Metastasis: Case Presentation

    Directory of Open Access Journals (Sweden)

    Kocaman Umit

    2016-09-01

    Full Text Available Spinal epidural cavernomas are quite rare lesions and only 5% of all cavernomas are located in the spine. The lesions are most commonly localized in the thoracic region. The differential diagnosis includes neurogenic tumors, lymphoma, schwannoma, meningioma, multiple myeloma, Ewing's sarcoma and metastasis. A 40- year-old male patient presented with paraplegia and MR images revealed an epidural soft tissue constricting the right posterolateral of the cord at the T6 level. Pathology showed cavernous hemangioma. A literature search revealed no other case that so closely mimicked metastasis by invading all components of the thoracic vertebra and also expanding to the epidural distance. We therefore present the case emphasizing these features.

  3. Report on the inquiry into sale price fluctuations of gasoline and diesel fuel in the regions of Abitibi-Temiscamingue, Saguenay-Lac Saint Jean and the Upper Mauricie, October 1998 to 31 December 1999

    International Nuclear Information System (INIS)

    Lambert, L.; Dumais, M. A.

    2000-01-01

    An inquiry was initiated by the President of the Quebec Energy Board (Regie de l'energie) on October 7, 1999 to review the reasons for the wide fluctuations in the retail sale prices of gasoline and diesel fuel in the regions of Abitibi-Temiscamingue, Saguenay/Lac-Saint-Jean and the Upper Mauricie, although the Board has no jurisdiction over the prices charged for petroleum products or anti-competitive practices. Consequently, the inquiry confined itself to an analysis of the information pertaining to the structure and forces driving the petroleum products market, and an examination of price mechanisms and consumer reactions in these regions. The inquiry reviewed the relevant legislation and regulation, the social, economic and energy situations in the affected regions, and the structure and functioning of the market for gasoline and diesel fuel. The inquiry came to the conclusion that the price fluctuations during the period under review reflected the wholesale prices recorded at Montreal and Quebec, which are determined by national and international market forces over which Quebec has no significant control. Furthermore, the inquiry concluded that although market forces are present and functioning in the regions, there are relatively few outlets affiliated with major oil companies, and a large number of independent retail outlets with relatively small volumes of annual sales. They essentially set their own prices at a level that reflect their cost of operation. Appendices contain the Inquiry's mandate, a list of those who testified before the Inquiry, a map showing the geographic profile of the regions surveyed and a list of figures and tables. 18 tabs., 31 figs

  4. [Flexible endoscope in thoracic surgery: CITES or cVATS?].

    Science.gov (United States)

    Assouad, J; Fénane, H; Masmoudi, H; Giol, M; Karsenti, A; Gounant, V; Grunenwald, D

    2013-10-01

    Early pain and persistent parietal disorders remains a major unresolved problem in thoracic surgery. Thoracotomy and the use of multiple ports in most Video Assisted Thoracic Surgery (VATS) procedures are the major cause of this persistent pain. For the last decade, a few publications describing the use of either single incision VATS and cervical thoracic approaches have been reported without significant results in comparison with current used techniques. Intercostals compression during surgery and early after by intercostals chest tube placement, are probably the major cause of postoperative pain. Flexible endoscope is currently used in several surgeries and will take more and more importance in our daily use in thoracic surgery. Instrument flexibility allows its use through minimally invasive approaches and offers a very interesting intra-thoracic navigation. We describe here the first use in France of a flexible endoscope in thoracic surgery through a single cervical incision to perform simultaneous exploration and biopsies of the mediastinum and right pleura using the original approach of Cervical Incision Thoracic Endoscopic Surgery (CITES). Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  5. Detecting and quantifying the extent of desertification and its impact in the semi-arid Sub-Saharan Africa: A case study of the Upper East Region, Ghana

    Science.gov (United States)

    Owusu, Alex B.

    The semi-arid Sub-Saharan region of Africa is in a state of permanent instability at a variety of spatio-temporal momentum. Efforts at sustaining and managing this fragile but all-important ecosystem and its processes require collecting, storing and analyzing multispatial and temporal data that are accurate and continuously updated in terms of changes (degradation), types and magnitude of change. Remote sensing techniques based on multispectral satellite-acquired data (AVHRR, Landsat TM and ETM+) have demonstrated an immense potential as a means to detect, quantify, monitor and map these changes. However, much of what satellite sensors can detect and capture, especially in the form of vegetation index (NDVI), do not tell the entire story about land degradation. This research used multispectral remote sensing data from three sensors (AVHRR, Landsat TM, and ETM+ and IKONOS) to detect and quantify the spatio-temporal land degradation (desertification) to validate the local observation and perception of desertification. The study also analyzes data on crop production in search of evidence proving or disproving degradation in the semi-arid sahel-sudan savannah transitional vegetation zone of the UER, Ghana. Multispectral satellite-acquired NDVI, from AVHRR, Landsat TM & ETM+, show that vegetation greenness is on the ascendancy, although there are pockets (localized degradation) signs of severe land degradation; field evidence suggests that the increasing NDVI is caused by vegetation succession where locally adapted horsetail grasses have been displaced by environmentally efficient, short-lived, quick maturing and dense grasses due to excessive burning, rapid population growth and inappropriate development policies. Local people's perceptions, supported by crop production data, suggest extensive land degradation. Other evidence includes food insecurity, diseases, rainfall variability and land extensification to marginal lands. Convergence of evidence suggests that

  6. Gemini long-slit observations of luminous obscured quasars: Further evidence for an upper limit on the size of the narrow-line region

    International Nuclear Information System (INIS)

    Hainline, Kevin N.; Hickox, Ryan C.; Greene, Jenny E.; Myers, Adam D.; Zakamska, Nadia L.; Liu, Guilin; Liu, Xin

    2014-01-01

    We examine the spatial extent of the narrow-line regions (NLRs) of a sample of 30 luminous obscured quasars at 0.4 < z < 0.7 observed with spatially resolved Gemini-N GMOS long-slit spectroscopy. Using the [O III] λ5007 emission feature, we estimate the size of the NLR using a cosmology-independent measurement: the radius where the surface brightness falls to 10 –15 erg s –1 cm –2 arcsec –2 . We then explore the effects of atmospheric seeing on NLR size measurements and conclude that direct measurements of the NLR size from observed profiles are too large by 0.1-0.2 dex on average, as compared to measurements made to best-fit Sérsic or Voigt profiles convolved with the seeing. These data, which span a full order of magnitude in IR luminosity (log (L 8 μm /erg s –1 ) = 44.4-45.4), also provide strong evidence that there is a flattening of the relationship between NLR size and active galactic nucleus luminosity at a seeing-corrected size of ∼7 kpc. The objects in this sample have high luminosities which place them in a previously under-explored portion of the size-luminosity relationship. These results support the existence of a maximal size of the NLR around luminous quasars; beyond this size, there is either not enough gas or the gas is over-ionized and does not produce enough [O III] λ5007 emission.

  7. Robotic thoracic surgery: The state of the art

    Science.gov (United States)

    Kumar, Arvind; Asaf, Belal Bin

    2015-01-01

    Minimally invasive thoracic surgery has come a long way. It has rapidly progressed to complex procedures such as lobectomy, pneumonectomy, esophagectomy, and resection of mediastinal tumors. Video-assisted thoracic surgery (VATS) offered perceptible benefits over thoracotomy in terms of less postoperative pain and narcotic utilization, shorter ICU and hospital stay, decreased incidence of postoperative complications combined with quicker return to work, and better cosmesis. However, despite its obvious advantages, the General Thoracic Surgical Community has been relatively slow in adapting VATS more widely. The introduction of da Vinci surgical system has helped overcome certain inherent limitations of VATS such as two-dimensional (2D) vision and counter intuitive movement using long rigid instruments allowing thoracic surgeons to perform a plethora of minimally invasive thoracic procedures more efficiently. Although the cumulative experience worldwide is still limited and evolving, Robotic Thoracic Surgery is an evolution over VATS. There is however a lot of concern among established high-volume VATS centers regarding the superiority of the robotic technique. We have over 7 years experience and believe that any new technology designed to make minimal invasive surgery easier and more comfortable for the surgeon is most likely to have better and safer outcomes in the long run. Our only concern is its cost effectiveness and we believe that if the cost factor is removed more and more surgeons will use the technology and it will increase the spectrum and the reach of minimally invasive thoracic surgery. This article reviews worldwide experience with robotic thoracic surgery and addresses the potential benefits and limitations of using the robotic platform for the performance of thoracic surgical procedures. PMID:25598601

  8. Robert R. Shaw, MD: thoracic surgical hero, Afghanistan medical pioneer, champion for the patient, never a surgical society president.

    Science.gov (United States)

    Urschel, Harold C; Urschel, Betsey Bradley

    2012-06-01

    Dr Robert R. Shaw arrived in Dallas to practice Thoracic Surgery in 1937, as John Alexander's 7th Thoracic Surgical Resident from Michigan University Medical Center. Dr Shaw's modus operandi was, "You can accomplish almost anything, if you don't care who gets the credit." He was a remarkable individual who cared the most about the patient and very little about getting credit for himself. From 1937 to 1970, Dr Shaw established one of the largest lung cancer surgical centers in the world in Dallas, Texas. It was larger than M.D. Anderson and Memorial Sloan-Kettering Hospitals put together regarding the surgical treatment of lung cancer patients. To accomplish this, he had the help of Dr Donald L. Paulson, who trained at the Mayo Clinic and served as Chief of Thoracic Surgery at Brook Army Hospital during the Second World War. Following the War, because of his love for Texas, he ended up as a partner of Dr Shaw in Dallas. Together, they pursued the development of this very large surgical lung cancer center. Dr Shaw and his wife Ruth went to Afghanistan with Medico multiple times to teach men modern cardiac and thoracic surgery. They also served as consultants on Medico's Ship of Hope in Africa. Dr Shaw initiated multiple new operations including: 1) resection of Pancoast's cancer of the lung after preoperative irradiation; 2) upper lobe of the lung bronchoplasty, reattaching (and saving) the lower lobe to prevent the "disabling" pneumonectomy; and 3) resections of pulmonary mucoid impaction of the lung in asthmatics. Because of his humility and giving "the credit to others," Dr Shaw was never President of a major medical or surgical association. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs.

    Science.gov (United States)

    Osarogiagbon, Raymond U; Freeman, Richard K; Krasna, Mark J

    2015-08-01

    Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed.

  10. Right main bronchial fracture resolution by digital thoracic drainage system.

    Science.gov (United States)

    Cortés Julián, Gildardo; Mier, José M; Iñiguez, Marco A; Guzmán de Alba, Enrique

    2016-03-01

    Tracheobronchial stenosis is common in the thoracic surgery service, and iatrogenic injury of the airway after manipulation is not infrequent. When a digital thoracic drainage system came onto the market, many advantages were evident. A 24-year-old woman with critical right main bronchial stenosis underwent airway dilation that was complicated by a tear with a massive air leak, resulting in a total right pneumothorax. We employed a pleural drain connected to a digital thoracic drainage system. The drain was removed 2 days after successful resolution of the air leak. © The Author(s) 2015.

  11. Magnetic resonance in prenatal diagnosis of thoracic anomalies

    International Nuclear Information System (INIS)

    Pietrani, M.; Elias, D.; Wojakowski, A.; Fataljaef, V.; Carcano, M.; Otano, L.

    2007-01-01

    The objective of this article is to communicate the experience in the evaluation of fetal anomalies thoracic by means of magnetic resonance. Between January, 2001 - March, 2007 16 fetus were evaluated by means of magnetic resonance with echographic diagnosis of thoracic anomalies. An equipment of 1.5 TESLA was used. The thoracic anatomy was valued in general. At the presence of discovering pulmonary mass, their size, volume and intensity of sign were determined. The echographic and magnetic resonance findings were checked against the perinatal results [es

  12. Fetal magnetic resonance imaging of thoracic and abdominal malformations

    International Nuclear Information System (INIS)

    Woitek, R.; Asenbaum, U.; Furtner, J.; Prayer, D.; Brugger, P.C.

    2013-01-01

    Diagnosis and differential diagnosis of fetal thoracic and abdominal malformations. Ultrasound and magnetic resonance imaging (MRI). In cases of suspected pathologies based on fetal ultrasound MRI can be used for more detailed examinations and can be of assistance in the differential diagnostic process. Improved imaging of anatomical structures and of the composition of different tissues by the use of different MRI sequences. Fetal MRI has become a part of clinical routine in thoracic and abdominal malformations and is the basis for scientific research in this field. In cases of thoracic or abdominal malformations fetal MRI provides important information additional to ultrasound to improve diagnostic accuracy, prognostic evaluation and surgical planning. (orig.) [de

  13. The Upper Atmosphere; Threshold of Space.

    Science.gov (United States)

    Bird, John

    This booklet contains illustrations of the upper atmosphere, describes some recent discoveries, and suggests future research questions. It contains many color photographs. Sections include: (1) "Where Does Space Begin?"; (2) "Importance of the Upper Atmosphere" (including neutral atmosphere, ionized regions, and balloon and investigations); (3)…

  14. [Segmental cut-off bridge and local floating technology for the treatment of ossification of ligamentum flavum in thoracic spine].

    Science.gov (United States)

    Liang, Wei-dong; Zhang, Jian; Sheng, Wei-bin

    2013-10-08

    To explore the efficacy and safety of segmental cut-off bridge and local floating technology for the treatment of ossification of ligamentum flavum (OLF) in thoracic spine. Retrospective study was performed in 98 patients with thoracic OLF who under went operation. There was 56 males and 42 females with an average age of 45.8 (35-73) years. The average duration of onset was 17 (3-51) months. The main clinical symptoms were numbness and paraesthesia (n = 90), lower limb weakness and walking trouble (n = 46), positive pyramidal tract signs (n = 33) and sphincter function obstacle (n = 9). OLF was screened and diagnosed by radiology, magnetic resonance imaging (MRI), computed tomography (CT) or CT myelography (CTM). A total of 142 OLF nidus were spotted. The lesions involved single segment (n = 32), double segments (n = 56), three segments (n = 6) and ≥ four segments (n = 4). And the locations were at upper thoracic segment (T1-4) (n = 34), middle thoracic segment (T5-8) (n = 23) and lower thoracic segment (T9-12) (n = 42). The OLF nidus were removed by local floating technology oft windowing at cephalic and caudal ends and a cut-off bridge at both sides of involved segments. Pre- and post-operative Japanese Orthopedic Association (JOA) scores and Epstein grades were recorded to evaluate the outcomes. The mean loss volume of blood was 320 ml and operative duration 155 min. All cases recovered independent activities. The mean follow-up period was 28 (13-48) months. The mean preoperative JOA score was 4.3 (1-8) points and the mean postoperative JOA score 9.7 (5-11) points. The recovery rate was 78.8%. According to Epstein grade, the excellent and good rate was 86.7%. As a common cause of thoracic spinal cord compression, OLF should be operated as early as possible. Based upon clinical and imaging findings, the application of segmental cut-off bridge and local floating technology is both safe and efficacious in the treatment of OLF in thoracic spine.

  15. Extended replacement of the thoracic aorta.

    Science.gov (United States)

    Hino, Yutaka; Okada, Kenji; Oka, Takanori; Inoue, Takeshi; Tanaka, Akiko; Omura, Atsushi; Kano, Hiroya; Okita, Yutaka

    2013-01-01

    We present our experience of total aortic arch replacement. Twenty-nine patients (21 males and 8 females; mean age 63.3 ± 13.3 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was non-dissecting aneurysm in 11 patients, including one aortitis and aortic dissection in 18 patients (acute type A: one, chronic type A: 11, chronic type B: six). Five patients had Marfan syndrome. In their previous operation, two patients had undergone the Bentall procedure, three had endovascular stenting, one had aortic root replacement with valve sparing and 12 had hemi-arch replacement for acute type A dissection. Approaches to the aneurysm were as follows: posterolateral thoracotomy with rib-cross incision in 16, posterolateral thoracotomy extended to the retroperitoneal abdominal aorta in seven, mid-sternotomy and left pleurotomy in three, anterolateral thoracotomy with partial lower sternotomy in two and clam-shell incision in one patient. Extension of aortic replacement was performed from the aortic root to the descending aorta in 4, from the ascending aorta to the descending aorta in 17 and from the ascending to the abdominal aorta in eight patients. Arterial inflow for cardiopulmonary bypass consisted of the femoral artery in 15 patients, ascending aorta and femoral artery in seven, descending or abdominal aorta in five and ascending aorta in two. Venous drainage site was the femoral vein in 10, pulmonary artery in eight, right atrium in five, femoral artery with right atrium/pulmonary artery in four and pulmonary artery with right atrium in two patients. The operative mortality, 30-day mortality and hospital mortality was one (cardiac arrest due to aneurysm rupture), one (rupture of infected aneurysm) and one (brain contusion), respectively. Late mortality occurred in three patients due to pneumonia, ruptured residual aneurysm and intracranial bleeding. Actuarial survival at 5 years after the operations was 80.6

  16. Characterization of upper thoracic spinal neurons responding to esophageal distension in diabetic rats

    DEFF Research Database (Denmark)

    Qin, Chao; Ghorbani, Marie L M; Wu, Mingyuan

    2008-01-01

    The aim of this study was to examine spinal neuronal processing of innocuous and noxious mechanical inputs from the esophagus in diabetic rats. Streptozotocin (50 mg/kg, ip) was used to induce diabetes in 15 male Sprague-Dawley rats, and vehicle (10 mM citrate buffer) was injected into 15 rats...

  17. Calcium activity of upper thoracic dorsal root ganglion neurons in zucker diabetic Fatty rats

    DEFF Research Database (Denmark)

    Ghorbani, Marie Louise; Nyborg, Niels C B; Fjalland, Bjarne

    2013-01-01

    The aim of the present study was to examine the calcium activity of C8-T5 dorsal root ganglion (DRG) neurons from Zucker diabetic fatty rats. In total, 8 diabetic ZDF fatty animals and 8 age-matched control ZDF lean rats were employed in the study. C8-T5 dorsal root ganglia were isolated bilatera......The aim of the present study was to examine the calcium activity of C8-T5 dorsal root ganglion (DRG) neurons from Zucker diabetic fatty rats. In total, 8 diabetic ZDF fatty animals and 8 age-matched control ZDF lean rats were employed in the study. C8-T5 dorsal root ganglia were isolated...... in calcium activity of the DRG neurons were found, potentially indicating altered neuronal responses during myocardial ischemia....

  18. Radiology of the diaphragm, pleura, thoracic cage, and upper air passages (excluding the larynx)

    International Nuclear Information System (INIS)

    Meschan, I.

    1987-01-01

    1. Abnormalities in function. 2. Abnormalities in position. 3. Abnormalities in shape (configuration). 4. Abnormalities in size or integrity. 5. Abnormalities in density and architecture (both internal and external). 6. Abnormalities in number. 7. Changes in respect to time. 8. Changes as a result of treatment, surgery, or medication. They are described in this chapter

  19. Geologic framework, regional aquifer properties (1940s-2009), and spring, creek, and seep properties (2009-10) of the upper San Mateo Creek Basin near Mount Taylor, New Mexico

    Science.gov (United States)

    Langman, Jeff B.; Sprague, Jesse E.; Durall, Roger A.

    2012-01-01

    The U.S. Geological Survey, in cooperation with the U.S. Forest Service, examined the geologic framework, regional aquifer properties, and spring, creek, and seep properties of the upper San Mateo Creek Basin near Mount Taylor, which contains areas proposed for exploratory drilling and possible uranium mining on U.S. Forest Service land. The geologic structure of the region was formed from uplift of the Zuni Mountains during the Laramide Orogeny and the Neogene volcanism associated with the Mount Taylor Volcanic Field. Within this structural context, numerous aquifers are present in various Paleozoic and Mesozoic sedimentary formations and the Quaternary alluvium. The distribution of the aquifers is spatially variable because of the dip of the formations and erosion that produced the current landscape configuration where older formations have been exhumed closer to the Zuni Mountains. Many of the alluvial deposits and formations that contain groundwater likely are hydraulically connected because of the solid-matrix properties, such as substantive porosity, but shale layers such as those found in the Mancos Formation and Chinle Group likely restrict vertical flow. Existing water-level data indicate topologically downgradient flow in the Quaternary alluvium and indiscernible general flow patterns in the lower aquifers. According to previously published material and the geologic structure of the aquifers, the flow direction in the lower aquifers likely is in the opposite direction compared to the alluvium aquifer. Groundwater within the Chinle Group is known to be confined, which may allow upward migration of water into the Morrison Formation; however, confining layers within the Chinle Group likely retard upward leakage. Groundwater was sodium-bicarbonate/sulfate dominant or mixed cation-mixed anion with some calcium/bicarbonate water in the study area. The presence of the reduction/oxidation-sensitive elements iron and manganese in groundwater indicates reducing

  20. Detection of thoracic vascular structures by electrical impedance tomography: a systematic assessment of prominence peak analysis of impedance changes.

    Science.gov (United States)

    Wodack, K H; Buehler, S; Nishimoto, S A; Graessler, M F; Behem, C R; Waldmann, A D; Mueller, B; Böhm, S H; Kaniusas, E; Thürk, F; Maerz, A; Trepte, C J C; Reuter, D A

    2018-02-28

    Electrical impedance tomography (EIT) is a non-invasive and radiation-free bedside monitoring technology, primarily used to monitor lung function. First experimental data shows that the descending aorta can be detected at different thoracic heights and might allow the assessment of central hemodynamics, i.e. stroke volume and pulse transit time. First, the feasibility of localizing small non-conductive objects within a saline phantom model was evaluated. Second, this result was utilized for the detection of the aorta by EIT in ten anesthetized pigs with comparison to thoracic computer tomography (CT). Two EIT belts were placed at different thoracic positions and a bolus of hypertonic saline (10 ml, 20%) was administered into the ascending aorta while EIT data were recorded. EIT images were reconstructed using the GREIT model, based on the individual's thoracic contours. The resulting EIT images were analyzed pixel by pixel to identify the aortic pixel, in which the bolus caused the highest transient impedance peak in time. In the phantom, small objects could be located at each position with a maximal deviation of 0.71 cm. In vivo, no significant differences between the aorta position measured by EIT and the anatomical aorta location were obtained for both measurement planes if the search was restricted to the dorsal thoracic region of interest (ROIs). It is possible to detect the descending aorta at different thoracic levels by EIT using an intra-aortic bolus of hypertonic saline. No significant differences in the position of the descending aorta on EIT images compared to CT images were obtained for both EIT belts.

  1. Recent clinical innovations in thoracic surgery in Hong Kong.

    Science.gov (United States)

    Zhao, Ze-Rui; Li, Zheng; Situ, Dong-Rong; Ng, Calvin S H

    2016-08-01

    The concept of personalized medicine, which aims to provide patients with targeted therapies while greatly reducing surgical trauma, is gaining popularity among Asian clinicians. Single port video-assisted thoracic surgery (VATS) has rapidly gained popularity in Hong Kong for major lung resections, despite bringing new challenges such as interference between surgical instruments and insertion of the optical source through a single incision. Novel types of endocutters and thoracoscopes can help reduce the difficulties commonly encountered during single-port VATS. Our region has been the testing ground and has led the development of many of these innovations. Performing VATS, in particular single-port VATS in hybrid operating theatre helps to localise small pulmonary lesions with real-time images, thus increasing surgical accuracy and pushes the boundaries in treating subcentimeter diseases. Such approach may be assisted by use of electromagnetic navigational bronchoscopy in the same setting. In addition, sublobar resection can also be more individualised according to pathologic tumour subtype that require rapid intraoperative diagnostic test to guide appropriate surgical therapy. A focus on technology and innovation for large tumours that require chest wall resection and reconstructions have also been on going, with new materials and prostheses that may be tailored to each individual needs. The current paper reviews the literature pertaining to the above topics and discusses recent related innovations in Hong Kong, highlighting the study results and future perspectives.

  2. Geology and sequence stratigraphy of undiscovered oil and gas resources in conventional and continuous petroleum systems in the Upper Cretaceous Eagle Ford Group and related strata, U.S. Gulf Coast Region

    Science.gov (United States)

    Dubiel, Russell F.; Pearson, Ofori N.; Pitman, Janet K.; Pearson, Krystal M.; Kinney, Scott A.

    2012-01-01

    The U.S. Geological Survey (USGS) recently assessed the technically recoverable undiscovered oil and gas onshore and in State waters of the Gulf Coast region of the United States. The USGS defined three assessment units (AUs) with potential undiscovered conventional and continuous oil and gas resources in Upper Cretaceous (Cenomanian to Turonian) strata of the Eagle Ford Group and correlative rocks. The assessment is based on geologic elements of a total petroleum system, including hydrocarbon source rocks (source rock maturation, hydrocarbon generation and migration), reservoir rocks (sequence stratigraphy and petrophysical properties), and traps (formation, timing, and seals). Conventional oil and gas undiscovered resources are in updip sandstone reservoirs in the Upper Cretaceous Tuscaloosa and Woodbine Formations (or Groups) in Louisiana and Texas, respectively, whereas continuous oil and continuous gas undiscovered resources reside in the middip and downdip Upper Cretaceous Eagle Ford Shale in Texas and the Tuscaloosa marine shale in Louisiana. Conventional resources in the Tuscaloosa and Woodbine are included in the Eagle Ford Updip Sandstone Oil and Gas AU, in an area where the Eagle Ford Shale and Tuscaloosa marine shale display vitrinite reflectance (Ro) values less than 0.6%. The continuous Eagle Ford Shale Oil AU lies generally south of the conventional AU, is primarily updip of the Lower Cretaceous shelf edge, and is defined by thermal maturity values within shales of the Eagle Ford and Tuscaloosa that range from 0.6 to 1.2% Ro. Similarly, the Eagle Ford Shale Gas AU is defined downdip of the shelf edge where source rocks have Ro values greater than 1.2%. For undiscovered oil and gas resources, the USGS assessed means of: 1) 141 million barrels of oil (MMBO), 502 billion cubic feet of natural gas (BCFG), and 4 million barrels of natural gas liquids (MMBNGL) in the Eagle Ford Updip Sandstone Oil and Gas AU; 2) 853 MMBO, 1707 BCFG, and 34 MMBNGL in the

  3. Character of the contact and biostratigraphical feature of distribution of the microfauna on border between productive series (PS) and underlying upper Miocene sediments of Absheron oil and gas bearing region

    International Nuclear Information System (INIS)

    Shikhlinsky, S.A.

    2002-01-01

    Full text: Productive Series (PS) is a basic hydrocarbon object and has a wide distribution in the Absheron Oil and Gas Bearing Region (AOGBR).In the normal stratigraphic sequences PS lays between Akchagylian and Pontian Regiostages (Pontian).From microfauna point of view, PS contains rare native ostracods , fish teeth, otolithes and forams.In situ, in PS, there are 34 of microfauna species present and more than half of them are transitional, which appear in the Upper Miocene and finish the existence in the Akchagylian-Apsheronian sediments.Others taxons are having the strict stratigraphical distribution and very important for the definition of the age of different lithostratones inside PS.Stratigraphical distribution of these species has been tested in numerous natural outcrops and well sections.The large interest for geologists is the boundary between PS and underlying Upper Miocene.The stratigraphic character of the given intermediate complex of sediments depends on paleotectonic conditions and different sections on the way it is expressed differently.In one section, in other-the gradual transition from Pontian to Kalinskaya Suite (KaS).The detailed study of the samples from the numerous old explorationwells drilled before 1972 and from new contract areas located in the Caspian sea, such as Karabakh, Dan Ulduzu, Ashrafi, where sampling was made very detailed, allowed us to discover the characteristic biomarkers and to specify the character of distribution of the microfauna on the Pontian-KaS boundary.The similar contact between KaC and Pontian is observed in the Karabakh field too.KaS here is represented by monotonous carbonated shale, clay and claystone, almost not distinguished from the black Potian shale, with increase at the contact with water.Despite of it, the boundary is precisely beaten by microfauna.In the Pontian sediments we have discovered a characteristic complex of Ostracoda and microscopic Pelecypoda.

  4. Thoracic splenosis as a differential diagnosis of juxtapleural nodules

    Directory of Open Access Journals (Sweden)

    B. Lopes

    2014-01-01

    Full Text Available Thoracic splenosis is rare and consists of ectopic implantation of splenic tissue into the chest after concomitant thoracic and abdominal trauma with diaphragm injury. It occurs in about 18% of cases of splenic ruptures. In almost all cases, diagnosis is given incidentally once patients are usually asymptomatic. Thoracic splenosis should be considered as a differential diagnosis in all patients with history of trauma presenting with juxtapleural nodules in chest computed tomography. However, malignant conditions should be ruled out firstly. Biopsy is not essential for the diagnosis once nuclear medicine can confirm splenosis in patients with pertinent history of trauma and suggestive tomographic image. We present a typical case of thoracic splenosis whose diagnosis was made by nuclear medicine and no invasive procedures were required.

  5. Left Sided Trans-thoracic Esophagectomy for Resectable ...

    African Journals Online (AJOL)

    ADMIN

    Background: Surgery is the main stay of treatment for Esophageal Cancer but there is no .... patients and a nasogastric tube positioned in the gastric tube in all. .... infection, thorough drainage of the thoracic cavity, maintenance of nutrition and ...

  6. “Clavicular Duplication Causing Thoracic Outlet Obstruction ...

    African Journals Online (AJOL)

    and left shoulder pain radiating to hand, and associated with paresthesia and .... results in fracture instead of acromioclavicular joint sprain and a “new” clavicle ... such as anomalous cervical ribs, hypoplastic first thoracic rib, exostoses of the ...

  7. variations in dimensions and shape of thoracic cage with aging

    African Journals Online (AJOL)

    the rib cage dimensions, the shape and cross- ..... Figure 6: CT axial section of thorax, showing the internal thoracic dimensions and shape at different age .... Dean J, Koehler R, Schleien C, Michael J, Chantarojanasiri T, Rogers M, Traystman ...

  8. Sampling Efficiency and Performance of Selected Thoracic Aerosol Samplers.

    Science.gov (United States)

    Görner, Peter; Simon, Xavier; Boivin, Alexis; Bau, Sébastien

    2017-08-01

    Measurement of worker exposure to a thoracic health-related aerosol fraction is necessary in a number of occupational situations. This is the case of workplaces with atmospheres polluted by fibrous particles, such as cotton dust or asbestos, and by particles inducing irritation or bronchoconstriction such as acid mists or flour dust. Three personal and two static thoracic aerosol samplers were tested under laboratory conditions. Sampling efficiency with respect to particle aerodynamic diameter was measured in a horizontal low wind tunnel and in a vertical calm air chamber. Sampling performance was evaluated against conventional thoracic penetration. Three of the tested samplers performed well, when sampling the thoracic aerosol at nominal flow rate and two others performed well at optimized flow rate. The limit of flow rate optimization was found when using cyclone samplers. © The Author 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

  9. Thoracic meningocele, non-associated with neurofibromatosis: a case report

    International Nuclear Information System (INIS)

    Abdala, N.; Nalli, D.R.; Carrete Junior, H.; Rodrigues, W.M.; Nogueira, R.G.; Carri, J.M.

    1993-01-01

    A case of thoracic meningocele, not associated with neurofibromatosis, in a 30 year-old woman is reported. The importance of imaging diagnostic methods in the differential diagnosis of posterior mediastinal masses is discussed. (author)

  10. Graft-Sparing Strategy for Thoracic Prosthetic Graft Infection.

    Science.gov (United States)

    Uchino, Gaku; Yoshida, Takeshi; Kakii, Bunpachi; Furui, Masato

    2018-04-01

    Thoracic prosthetic graft infection is a rare but serious complication with no standard management. We reported our surgical experience on graft-sparing strategy for thoracic prosthetic graft infection.  This study included patients who underwent graft-sparing surgery for thoracic prosthetic graft infection at Matsubara Tokushukai Hospital in Japan from January 2000 to October 2017.  There were 17 patients included in the analyses, with a mean age at surgery of 71.0 ± 10.5 years; 11 were men. In-hospital mortality was observed in five patients (29.4%).  Graft-sparing surgery for thoracic prosthetic graft infection is an alternative option particularly for early graft infection after hemiarch replacement. Georg Thieme Verlag KG Stuttgart · New York.

  11. Anaesthetic and critical care management of thoracic injuries.

    Science.gov (United States)

    Round, J A; Mellor, A J

    2010-09-01

    Thoracic wounding has been a relatively common presentation of military wounds throughout modern conflict. When civilian casualties are included the incidence has remained constant at around 10%, although the frequency and severity of wounds to combatants has been altered by modern body armour. Whilst thoracic injury has a high initial mortality on the battlefield, those surviving to reach hospital frequently have injuries that only require simple management. In addition to penetrating ballistic injury, blunt chest trauma frequently occurs on operations as a result of road traffic collisions or tertiary blast injury. The physiological impact of thoracic wounds, however, is often great and survivors often require intensive care management and, where available, complex strategies to ensure oxygenation and carbon dioxide removal. This review examines the incidence and patterns of thoracic trauma and looks at therapeutic options for managing these complex cases.

  12. Biomechanical properties of human thoracic spine disc segments

    Directory of Open Access Journals (Sweden)

    B D Stemper

    2010-01-01

    Full Text Available Background : The objective was to determine the age-dependent compressive and tensile properties of female and male thoracic spine segments using postmortem human subjects (PMHS. Materials and Methods : Forty-eight thoracic disc segments at T4-5, T6-7, T8-9, and T10-11 levels from 12 PMHS T3-T11 spinal columns were divided into groups A and B based on specimen age and loaded in compression and tension. Stiffness and elastic modulus were computed. Stiffness was defined as the slope in the linear region of the force-displacement response. Elastic modulus was defined as the slope of the stress strain curve. Analysis of Variance (ANOVA was used to determine significant differences (P< 0.05 in the disc cross-sectional area, stiffness, and elastic modulus based on gender, spinal level, and group. Results : Specimen ages in group A (28 ± 8 years were significantly lower than in group B (70 ± 7 years. Male discs had significantly greater area (7.2 ± 2.0 sq cm than female discs (5.9 ± 1.8 sq cm. Tensile and compressive stiffness values were significantly different between the two age groups, but not between gender and level. Specimens in group A had greater tensile (486 ± 108 N/mm and compressive (3300 ± 642 N/mm stiffness values compared to group B specimens (tension: 397 ± 124 N/mm, compression: 2527 ± 734 N/mm. Tensile and compressive elastic modulus values depended upon age group and gender, but not on level. Group A specimens had significantly greater tensile and compressive moduli (2.9 ± 0.8 MPa, 19.5 ± 4.1 MPa than group B specimens (1.7 ± 0.6 MPa, 10.6 ± 3.4 MPa. Female specimens showed significantly greater tensile and compressive moduli (2.6 ± 1.0 MPa, 16.6 ± 6.4 MPa than male specimens (2.0 ± 0.7 MPa, 13.7 ± 5.0 MPa. Discussion: Using the two groups to represent "young" and "old" specimens, this study showed that the mechanical response decreases in older specimens, and the decrease is greater in compressive than distractive

  13. Elective nodal irradiation (ENI) in definitive chemoradiotherapy (CRT) for squamous cell carcinoma of the thoracic esophagus.

    Science.gov (United States)

    Onozawa, Masakatsu; Nihei, Keiji; Ishikura, Satoshi; Minashi, Keiko; Yano, Tomonori; Muto, Manabu; Ohtsu, Atsushi; Ogino, Takashi

    2009-08-01

    There are some reports indicating that prophylactic three-field lymph node dissection for esophageal cancer can lead to improved survival. But the benefit of ENI in CRT for thoracic esophageal cancer remains controversial. The purpose of the present study is to retrospectively evaluate the efficacy of elective nodal irradiation (ENI) in definitive chemoradiotherapy (CRT) for thoracic esophageal cancer. Patients with squamous cell carcinoma (SCC) of the thoracic esophagus newly diagnosed between February 1999 and April 2001 in our institution was recruited from our database. Definitive chemoradiotherapy consisted of two cycles of cisplatin/5FU repeated every 5 weeks, with concurrent radiation therapy of 60 Gy in 30 fractions. Up to 40 Gy radiation therapy was delivered to the cervical, periesophageal, mediastinal and perigastric lymph nodes as ENI. One hundred two patients were included in this analysis, and their characteristics were as follows: median age, 65 years; male/female, 85/17; T1/T2/T3/T4, 16/11/61/14; N0/N1, 48/54; M0/M1, 84/18. The median follow-up period for the surviving patients was 41 months. Sixty patients achieved complete response (CR). After achieving CR, only one (1.0%; 95% CI, 0-5.3%) patient experienced elective nodal failure without any other site of recurrence. In CRT for esophageal SCC, ENI is effective for preventing regional nodal failure. Further evaluation of whether ENI leads to an improved overall survival is needed.

  14. Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia: A Feasible Economical Alternative.

    Science.gov (United States)

    Kejriwal, Aditya Kumar; Begum, Shaheen; Krishan, Gopal; Agrawal, Richa

    2017-01-01

    Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml -1 mixed with 0.5 ml of fentanyl 50 μg ml -1 . Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery. The patient was reviewed 2 days postoperatively in ward. The thoracic spinal anesthetia was performed easily in the patient. Some discomfort which was readily treated with 1mg midazolam and 20 mg ketamine intravenously. There was no neurological deficit and hemodynamic parameters were in normal range intra and post-operatively and recovery was uneventful. We used a narrow gauze (26G) spinal needle which minimized the trauma to the patient and the chances of PDPH, which was more if 16 or 18G epidural needle had been used and could have increased further if there have been accidental dura puncture. Also using spinal anesthesia was economical although it should be done cautiously as we are giving spinal anesthesia above the level of termination of spinal cord.

  15. Concomitant lower thoracic spine disc disease in lumbar spine MR imaging studies.

    Science.gov (United States)

    Arana, Estanislao; Martí-Bonmatí, Luis; Dosdá, Rosa; Mollá, Enrique

    2002-11-01

    Our objective was to study the coexistence of lower thoracic-spine disc changes in patients with low back pain using a large field of view (FOV) in lumbar spine MR imaging. One hundred fifty patients with low back pain were referred to an MR examination. All patients were studied with a large FOV (27 cm), covering from the coccyx to at least the body of T11. Discs were coded as normal, protrusion, and extrusion (either epiphyseal or intervertebral). The relationship between disc disease and level was established with the Pearson chi(2) test. The T11-12 was the most commonly affected level of the lower thoracic spine with 58 disc cases rated as abnormal. Abnormalities of T11-12 and T12-L1 discs were significantly related only to L1-L2 disease ( p=0.001 and p=0.004, respectively) but unrelated to other disc disease, patient's gender, and age. No correlation was found between other discs. Magnetic resonance imaging of the lumbar spine can detect a great amount of lower thoracic disease, although its clinical significance remains unknown. A statistically significant relation was found within the thoracolumbar junctional region (T11-L2), reflecting common pathoanatomical changes. The absence of relation with lower lumbar spine discs is probably due to differences in their pathomechanisms.

  16. Concomitant lower thoracic spine disc disease in lumbar spine MR imaging studies

    International Nuclear Information System (INIS)

    Arana, Estanislao; Marti-Bonmati, Luis; Dosda, Rosa; Molla, Enrique

    2002-01-01

    Our objective was to study the coexistence of lower thoracic-spine disc changes in patients with low back pain using a large field of view (FOV) in lumbar spine MR imaging. One hundred fifty patients with low back pain were referred to an MR examination. All patients were studied with a large FOV (27 cm), covering from the coccyx to at least the body of T11. Discs were coded as normal, protrusion, and extrusion (either epiphyseal or intervertebral). The relationship between disc disease and level was established with the Pearson χ 2 test. The T11-12 was the most commonly affected level of the lower thoracic spine with 58 disc cases rated as abnormal. Abnormalities of T11-12 and T12-L1 discs were significantly related only to L1-L2 disease (p=0.001 and p=0.004, respectively) but unrelated to other disc disease, patient's gender, and age. No correlation was found between other discs. Magnetic resonance imaging of the lumbar spine can detect a great amount of lower thoracic disease, although its clinical significance remains unknown. A statistically significant relation was found within the thoracolumbar junctional region (T11-L2), reflecting common pathoanatomical changes. The absence of relation with lower lumbar spine discs is probably due to differences in their pathomechanisms. (orig.)

  17. External validation of the Society of Thoracic Surgeons General Thoracic Surgery Database.

    Science.gov (United States)

    Magee, Mitchell J; Wright, Cameron D; McDonald, Donna; Fernandez, Felix G; Kozower, Benjamin D

    2013-11-01

    The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) reports outstanding results for lung and esophageal cancer resection. However, a major weakness of the GTSD has been the lack of validation of this voluntary registry. The purpose of this study was to perform an external, independent audit to assess the accuracy of the data collection process and the quality of the database. An independent firm was contracted to audit 5% of sites randomly selected from the GTDB in 2011. Audits were performed remotely to maximize the number of audits performed and reduce cost. Auditors compared lobectomy cases submitted to the GTSD with the hospital operative logs to evaluate completeness of the data. In addition, 20 lobectomy records from each site were audited in detail. Agreement rates were calculated for 32 individual data elements, 7 data categories pertaining to patient status or care delivery, and an overall agreement rate for each site. Six process variables were also evaluated to assess best practice for data collection and submission. Ten sites were audited from the 222 participants. Comparison of the 559 submitted lobectomy cases with operative logs from each site identified 28 omissions, a 94.6% agreement rate (discrepancies/site range, 2 to 27). Importantly, cases not submitted had no mortality or major morbidity, indicating a lack of purposeful omission. The aggregate agreement rates for all categories were greater than 90%. The overall data accuracy was 94.9%. External audits of the GTSD validate the accuracy and completeness of the data. Careful examination of unreported cases demonstrated no purposeful omission or gaming. Although these preliminary results are quite good, it is imperative that the audit process is refined and continues to expand along with the GTSD to insure reliability of the database. The audit results are currently being incorporated into educational and quality improvement processes to add further value. Copyright

  18. Increased interleukin-11 levels in thoracic aorta and plasma from patients with acute thoracic aortic dissection.

    Science.gov (United States)

    Xu, Yao; Ye, Jing; Wang, Menglong; Wang, Yuan; Ji, Qingwei; Huang, Ying; Zeng, Tao; Wang, Zhen; Ye, Di; Jiang, Huimin; Liu, Jianfang; Lin, Yingzhong; Wan, Jun

    2018-06-01

    Interleukin (IL) 11 is closely related to tumor and hematological system diseases. Recent studies have demonstrated that IL-11 also participates in cardiovascular diseases, including ischemia-reperfusion mediated heart injury and acute myocardial infarction. This study aimed to investigate whether IL-11 is involved in acute thoracic aortic dissection (TAD). Aortic tissue samples from normal donors and acute TAD patients were collected, and the expression of IL-11 in all aortic tissue was analyzed. In addition, blood samples from patients with chest pain were collected and divided into a non-AD (NAD) group and a TAD group according to the results of computed tomography angiography of the thoracic aorta. The plasma IL-11, IL-17 and interferon (IFN) γ in all blood samples were measured. Compared with aortic tissue of normal controls, IL-11 was significantly increased in aortic tissue of acute TAD patients, especially in the torn section. The IL-11 was derived from aorta macrophages in TAD. In addition, the plasma IL-11, IL-17 and IFN-γ were significantly higher in acute TAD patients than in NAD patients, and the correlation analysis showed that IL-11 levels were positively correlated with levels of IFN-γ, IL-17, glucose, systolic blood pressure, diastolic blood pressure, white blood cells, C-reactive proteins and D-dimers. Binary logistic regression analyses showed that elevated IL11 in patients who may have diagnostic value of TAD, but less that D-dimer. IL-11 was increased in thoracic aorta and plasma of TAD patients and may be a promising biomarker for diagnosis in patients with TAD. Copyright © 2018. Published by Elsevier B.V.

  19. Cardiovascular complications following thoracic radiotherapy in patients with cancer

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Melgaard; Borchsenius, Julie I Helene; Offersen, Birgitte Vrou

    2016-01-01

    Cardiovascular complications following thoracic radiotherapy in patients with cancer are well described. Advancements in surgery, radiotherapy and systemic treatments have led to an increasing number of cancer survivors and thus an increasing number of patients with long-term side effects...... of their cancer treatments. This article describes the short- and long-term cardiovascular morbidity and mortality following thoracic radiotherapy and further, optimal cardiovascular assessments and diagnostic tools in asymptomatic and symptomatic patients....

  20. Video-assisted thoracic surgery mediastinal germ cell metastasis resection.

    Science.gov (United States)

    Nardini, Marco; Jayakumar, Shruti; Migliore, Marcello; Dunning, Joel

    2017-07-01

    Thoracoscopy can be safely used for dissection of masses in the visceral mediastinum. We report the case of a 31-year-old man affected by metastatic germ cell tumo