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  1. Organizing pneumonia: chest HRCT findings*

    PubMed Central

    Faria, Igor Murad; Zanetti, Gláucia; Barreto, Miriam Menna; Rodrigues, Rosana Souza; Araujo-Neto, Cesar Augusto; Silva, Jorge Luiz Pereira e; Escuissato, Dante Luiz; Souza, Arthur Soares; Irion, Klaus Loureiro; Mançano, Alexandre Dias; Nobre, Luiz Felipe; Hochhegger, Bruno; Marchiori, Edson

    2015-01-01

    OBJECTIVE: To determine the frequency of HRCT findings and their distribution in the lung parenchyma of patients with organizing pneumonia. METHODS: This was a retrospective review of the HRCT scans of 36 adult patients (26 females and 10 males) with biopsy-proven organizing pneumonia. The patients were between 19 and 82 years of age (mean age, 56.2 years). The HRCT images were evaluated by two independent observers, discordant interpretations being resolved by consensus. RESULTS: The most common HRCT finding was that of ground-glass opacities, which were seen in 88.9% of the cases. The second most common finding was consolidation (in 83.3% of cases), followed by peribronchovascular opacities (in 52.8%), reticulation (in 38.9%), bronchiectasis (in 33.3%), interstitial nodules (in 27.8%), interlobular septal thickening (in 27.8%), perilobular pattern (in 22.2%), the reversed halo sign (in 16.7%), airspace nodules (in 11.1%), and the halo sign (in 8.3%). The lesions were predominantly bilateral, the middle and lower lung fields being the areas most commonly affected. CONCLUSIONS: Ground-glass opacities and consolidation were the most common findings, with a predominantly random distribution, although they were more common in the middle and lower thirds of the lungs. PMID:26176521

  2. Cocaine-induced pulmonary changes: HRCT findings *

    PubMed Central

    de Almeida, Renata Rocha; Zanetti, Gláucia; Souza, Arthur Soares; de Souza, Luciana Soares; Silva, Jorge Luiz Pereira e; Escuissato, Dante Luiz; Irion, Klaus Loureiro; Mançano, Alexandre Dias; Nobre, Luiz Felipe; Hochhegger, Bruno; Marchiori, Edson

    2015-01-01

    Abstract Objective: To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease. Methods: We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors. Results: In 8 patients (36.4%), the clinical and tomographic findings were consistent with "crack lung", those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%), barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each. Conclusions: Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings. PMID:26398752

  3. Acute hydrocarbon pneumonia after white spirit aspiration: sequential HRCT findings.

    PubMed

    Facon, David; Coumbaras, Jean; Bigot, Emmanuelle; Bahlouli, Fouad; Boissonnas, Alain; Bellin, Marie-France

    2005-01-01

    Hydrocarbon pneumonia is a very uncommon condition resulting from aspiration of mineral oil into the lung. We report the first description of early and sequential high-resolution computed tomographic (HRCT) findings of hydrocarbon pneumonia following attempted suicide by white spirit aspiration. Initial HRCT showed patchy opacities of coalescing masses with well-defined walls. They were visible in the middle lobe, lingula and lower lobes. Follow-up CT showed regression of the alveolar opacities, the presence of pneumatoceles and right asymptomatic pneumothorax. After 23 months of follow-up, the patient remained asymptomatic, and the follow-up CT scan was considered normal. The radiological features and a review of the relevant literature are briefly discussed. PMID:15252749

  4. Initial HRCT findings of novel influenza A (H1N1) infection

    PubMed Central

    Yuan, Ying; Tao, Xiao‐Feng; Shi, Yu‐Xin; Liu, Shi‐Yuan; Chen, Ji‐Quan

    2012-01-01

    Please cite this paper as: Yuan et al. (2012) Initial HRCT findings of novel influenza A (H1N1) infection. Influenza and Other Respiratory Viruses 6(601), e114–e119. Objectives  The aim of our study was to describe the presentation and illustrate the imaging features of chest high‐resolution computed tomography (HRCT) of patients with novel influenza A (H1N1) virus infection. Methods  Data were collected from 163 hospitalized patients between November 2009 and March 2011, who fulfilled the clinical criteria for H1N1 influenza infection and underwent HRCT examinations within 24 hours of admission. Results  Abnormal findings were observed in 40·5% of the patients. The patients with positive imaging findings were significantly older than patients with normal HRCT findings (P = 0·02). The most common finding was ground‐glass opacity (GGO) (n = 35). Interlobular septal thickening (n = 31) and centrilobular nodules (n = 30) were the second most frequent findings. Other common findings were consolidation, reticulation, and linear shadow. The most common imaging finding for lung involvement was GGO with a patchy pattern. Pulmonary involvement of the disease may be extensive and variable, but the total volume of affected lung was mostly <1 lobe. Conclusion  The baseline HRCT may be valuable and suggestive even for non‐severe H1N1 infections. When a severe case or a evolution is suspected, chest CT could be essential both for determining the precise extent of parenchymal damage and for monitoring its evolution. PMID:22551111

  5. [Ventilatory strategy for ARDS].

    PubMed

    Yoshida, Takeshi; Takegawa, Ryousuke; Ogura, Hiroshi

    2016-02-01

    Fifteen years have passed since lung protective strategy to the patients with acute respiratory distress syndrome (ARDS) established. Recently, the new Berlin Definition of ARDS has been developed and this classified ARDS into three stages (mild, moderate, and severe ARDS), depending on the PaO2/FiO2. After this new definition of ARDS, each treatment to the patients with ARDS should be considered, depending on the severity of lung injury, such as prone position to the patients with severe ARDS, muscle paralysis to the patients with severe ARDS. In this review article, we review the history of lung protective strategy and ARDS definition, discuss the novel physiological approaches to minimizing ventilator-induced lung injury, and highlight a numbers of experimental/clinical studies to support these concepts. PMID:26915253

  6. ARDS in pregnancy.

    PubMed

    Duarte, Alexander G

    2014-12-01

    Acute respiratory distress syndrome (ARDS) is an uncommon condition in pregnant patients. The causes of ARDS are associated with obstetric causes such as amniotic fluid embolism, preeclampsia, septic abortion, and retained products of conception or nonobstetric causes that include sepsis, aspiration pneumonitis, influenza pneumonia, blood transfusions, and trauma. An essential component in management of ARDS involves good communication between the obstetrics team and critical care specialist and a fundamental understanding of mechanical ventilatory support. Medical therapies such as nitric oxide and corticosteroids play a complimentary role. Extracorporeal life support is beneficial in the management of the parturient with severe ARDS. PMID:25314088

  7. ARDS (Acute Respiratory Distress Syndrome)

    MedlinePlus

    ... Twitter. What Is ARDS? ARDS, or acute respiratory distress syndrome, is a lung condition that leads to low oxygen levels in the blood. ARDS can be life threatening because your body's organs need oxygen-rich ...

  8. Pleural effusion in ARDS.

    PubMed

    Formenti, P; Umbrello, M

    2014-02-01

    Pleural effusion is a fluid collection within the pleural space and is a common finding in mechanically ventilated patients. It is frequently related to fluid overload, hyponcotic states, heart failure, and altered pleural pressure due to atelectasis or pneumonia. Recent literature has shown that its incidence within ARDS is increasing, even if, in most of cases, at least in the early phases, it seems of limited clinical relevance. Most of the knowledge of Pleural Effusion and of its interaction with lung/chest wall mechanics derives from a small number of experimental studies and from some clinical studies, in most of the cases performed with normal lung parenchyma. In ARDS, however, Pleural Effusion seems to have a little effect "per se" on tidal mechanics and oxygenation (increasing elastance and reducing PO2), that are already profoundly affected by the lung injury itself. To sum up all the observations, we can assume that Pleural Effusion alters regional transmural pressure, restricting more the inspiration phase, and creating an opening/closure effect that can be reverted by PEEP application in recruitable lungs. This restores volume and compliance only if the abdomen is normally expansible. Drainage of Pleural Effusion is frequently performed in ICU but the benefits and risks are not well established. Lung ultrasound is an effective technique with high sensitivity and specificity for both bedside diagnosis and drainage guidance. It may help to quantify and qualify the effusion and at the same time the grade of aeration of underling parenchyma. Aim of this review is to summarize the current evidence and opinions about the interaction between Pleural Effusion and positive pressure ventilation in the presence of ARDS, its impact on gas exchange and tidal mechanics, trying to figure out the best bedside management that is not available yet. The estimation of both lung and chest wall elastance may help in the clinical decision making whether to drain or not in

  9. OBESITY AND NUTRITION IN ARDS

    PubMed Central

    Stapleton, Renee D.; Suratt, Benjamin T.

    2014-01-01

    This chapter collectively discusses two important topics related to patients with ARDS: 1) obesity and its potential contribution to clinical outcomes through proposed biologic mechanisms and 2) current literature on provision of nutrition and micronutrients. The prevalence of obesity is rapidly increasing around the world, and more than one third of Americans are now obese. While obesity is associated with increased morbidity and mortality in the general population, recent literature suggests that among critically ill patients including those with ARDS, the relationship between obesity and outcomes is quite complex. Observational data demonstrate that obese patients may be at greater risk of developing ARDS and of having longer ICU and hospital lengths of stay compared to normal weight patients. However, obesity is also associated with improved survival. Therefore, in contrast to what might be assumed by clinicians, although obesity may confer greater ICU morbidity, it appears to simultaneously decrease mortality. The mechanisms for these findings are not yet clear, but recent biologic data may begin to provide an explanation. Critical illness, and more specifically the acute respiratory distress syndrome (ARDS), is a catabolic state where patients demonstrate a profound inflammatory response, multiple organ dysfunction, and hypermetabolism. This is often accompanied by malnutrition, which can lead to further impairment of immune function and increased morbidity and mortality in critically ill patients. Over the past decade or more, as we have come to better understand immunologic effects of nutrition in critical illness, nutrition has begun to be thought of as therapeutic, rather than purely supportive. Additionally, the concept of pharmaconutrition has emerged. Fortunately, several recent large studies about nutrition in critical care, with some investigations specifically in patients with ARDS, have provided valuable new evidence. PMID:25453416

  10. ARDS User Manual

    NASA Technical Reports Server (NTRS)

    Fleming, David P.

    2001-01-01

    Personal computers (PCs) are now used extensively for engineering analysis. their capability exceeds that of mainframe computers of only a few years ago. Programs originally written for mainframes have been ported to PCs to make their use easier. One of these programs is ARDS (Analysis of Rotor Dynamic Systems) which was developed at Arizona State University (ASU) by Nelson et al. to quickly and accurately analyze rotor steady state and transient response using the method of component mode synthesis. The original ARDS program was ported to the PC in 1995. Several extensions were made at ASU to increase the capability of mainframe ARDS. These extensions have also been incorporated into the PC version of ARDS. Each mainframe extension had its own user manual generally covering only that extension. Thus to exploit the full capability of ARDS required a large set of user manuals. Moreover, necessary changes and enhancements for PC ARDS were undocumented. The present document is intended to remedy those problems by combining all pertinent information needed for the use of PC ARDS into one volume.

  11. ARDS. The future.

    PubMed

    Wong, Hector R

    2002-01-01

    Improving the course and outcome of patients with ARDS presents a considerable challenge. An important component of meeting this challenge is a more comprehensive understanding of the heterogeneous pathophysiology of ARDS and the biologic response of the individual patient. This understanding may be developed through the power of genomics and its related technology. In particular, it will be crucial to characterize the immunophenotypes of individual patients with ARDS. By understanding the immune status of a given patient at a given point in the disease process, physicians can consider manipulating proinflammatory systems more rationally, such as the complement and chemokine cascades, or the anti-inflammatory arm of the immune system. Finally, a more refined molecular and genetic understanding of endogenous cytoprotective molecules and mechanisms, such as the heat shock response and HO-1, may provide further tools in the future armamentarium against ARDS. PMID:11910730

  12. Predicting Survival in ARDS.

    PubMed

    Karnik, Niteen D; Gupta, Anish V

    2015-11-01

    Acute respiratory distress syndrome (ARDS) is a fulminant clinical disorder of varied etiology, characterized by diffuse lung injury and severe hypoxemia. It is a leading cause of ICU admission and the associated high mortality has sparked a lot of research on etiology, outcome, scoring systems, mortality predictors, biomarkers including inflammatory cytokines and even genomics in ARDS. The previously used AECC (American European Consensus Conference) definition (1994) of ARDS was replaced by the recent Berlin definition (2012) so as to improve its validity and reliability.1,2 This would not only standardize patient enrollment into clinical trials but also help implement the results of these trials into clinical practice. Although various studies have shown a reduction in mortality due to ARDS, it has been largely attributed to the general improvement in critical care and the use of lung protection ventilation strategies.3-6 Hence focus on the etiology, co-morbidities, risk factors, complications and mortality predictors, is the need of the hour so as to improve survival. ARDS can occur secondary to multiple causes i.e. either due to direct lung involvement (pneumonia, lung contusion etc) or indirect alveolar damage by inflammatory cytokines (sepsis, trauma, burns, pancreatitis etc.). The causes of ARDS in tropical countries are varied with seasonal variation. Acute febrile illnesses (AFI) like malaria, leptospirosis and dengue usually predominate in the monsoons while H1N1 infection and pneumonias typically peak in the colder winter months. However, malaria, dengue and H1N1 have a potential to be perennial. PMID:27608777

  13. Soft tissue attenuation in middle ear on HRCT: Pictorial review

    PubMed Central

    Anbarasu, Arangasamy; Chandrasekaran, Kiruthika; Balakrishnan, Sivasubramanian

    2012-01-01

    Middle ear disease is a common clinical entity; imaging, especially High resolution Computed Tomography (HRCT), plays a crucial role in diagnosis and assessing the disease extent, helping to decide appropriate management. Temporal bone imaging is challenging and involves thorough understanding of the anatomy, especially in relation to HRCT imaging. Most of the middle ear pathologies appear as “soft tissue” on imaging. Careful analysis of the soft tissue on the HRCT is crucial in achieving the right diagnosis; clinical information is essential and the imaging findings need correlation with clinical presentation and otoscopic findings. The purpose of this pictorial essay is to enlist the pathologies that present as soft tissue in middle ear and to provide a structured and practical imaging approach that will serve as a guide for confident reporting in daily practice. PMID:23833422

  14. Aluminosis – Detection of an almost forgotten disease with HRCT

    PubMed Central

    Kraus, Thomas; Schaller, Karl Heinz; Angerer, Jürgen; Hilgers, Ralf-Dieter; Letzel, Stephan

    2006-01-01

    The aim of this study was to investigate whether it is possible to detect high-resolution computed tomography (HRCT) findings in aluminium powder workers, which are consistent with early stages of aluminosis. 62 male workers from 8 departments of two plants producing aluminium (Al) powder were investigated using a standardized questionnaire, physical examination, lung function analysis, biological monitoring of Al in plasma and urine, chest X-ray, HRCT and immunological tests. Chronic bronchitis was observed in 15 (24.2%) of the workers, and four workers (6.5%) reported shortness of breath during exercise. HRCT findings in 15 workers (24.2%) were characterized by ill-defined centrilobular nodular opacities. Workers with ill-defined centrilobular nodular opacities had a lower vital capacity than workers who had no such HRCT-findings (90.9 % pred. vs. 101.8 % pred., p = 0.01). Biological monitoring in plasma and urine revealed higher internal exposure to Al in affected workers (33.5 μg/l plasma to 15.4 μg/l plasma, p = 0.01) and (340.5 μg/g creat. to 135.1 μg/g creat., p = 0.007). Years of exposure and concentration of aluminum in urine and plasma appear to be the best predictors for HRCT findings. Age and decreased vital capacity show borderline significance. We conclude that aluminosis is still relevant in occupational medicine. With HRCT it is possible to detect early stages of aluminosis and biological monitoring can be used to define workers at high risk. PMID:16722569

  15. Definition of ALI/ARDS.

    PubMed

    Raghavendran, Krishnan; Napolitano, Lena M

    2011-07-01

    Although acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are caused by different injuries and conditions, their similar clinical picture makes a compelling case for them to be studied as a single entity. An array of potential specific targets for pharmacologic intervention can be applied to ALI/ARDS as one disease. Although a working definition of ALI/ARDS that includes pulmonary and extrapulmonary causes can have benefit in standardizing supportive care, it can also complicate assessments of the efficacy of therapeutic interventions. In this article, definitions that have been recently used for ALI/ARDS in various clinical studies are discussed individually. PMID:21742209

  16. Diagnostic workup for ARDS patients.

    PubMed

    Papazian, Laurent; Calfee, Carolyn S; Chiumello, Davide; Luyt, Charles-Edouard; Meyer, Nuala J; Sekiguchi, Hiroshi; Matthay, Michael A; Meduri, Gianfranco Umberto

    2016-05-01

    Acute respiratory distress syndrome (ARDS) is defined by the association of bilateral infiltrates and hypoxaemia following an initial insult. Although a new definition has been recently proposed (Berlin definition), there are various forms of ARDS with potential differences regarding their management (ventilator settings, prone positioning use, corticosteroids). ARDS can be caused by various aetiologies, and the adequate treatment of the responsible cause is crucial to improve the outcome. It is of paramount importance to characterize the mechanisms causing lung injury to optimize both the aetiological treatment and the symptomatic treatment. If there is no obvious cause of ARDS or if a direct lung injury is suspected, bronchoalveolar lavage (BAL) should be strongly considered to identify microorganisms responsible for pneumonia. Blood samples can also help to identify microorganisms and to evaluate biomarkers of infection. If there is no infectious cause of ARDS or no other apparent aetiology is found, second-line examinations should include markers of immunologic diseases. In selected cases, open lung biopsy remains useful to identify the cause of ARDS when all other examinations remain inconclusive. CT scan is fundamental when there is a suspicion of intra-abdominal sepsis and in some cases of pneumonia. Ultrasonography is important not only in evaluating biventricular function but also in identifying pleural effusions and pneumothorax. The definition of ARDS remains clinical and the main objective of the diagnostic workup should be to be focused on identification of its aetiology, especially a treatable infection. PMID:27007111

  17. How ARDS should be treated.

    PubMed

    Gattinoni, Luciano; Quintel, Michael

    2016-01-01

    The Berlin definition criteria applied at positive end-expiratory pressure (PEEP) 5 cm H2O reasonably predict lung edema and recruitabilty. To maintain viable gas exchange, the mechanical ventilation becomes progressively more risky going from mild to severe acute respiratory distress syndrome (ARDS). Tidal volume, driving pressure, flow, and respiratory rate have been identified as causes of ventilation-induced lung injury. Taken together, they represent the mechanical power applied to the lung parenchyma. In an inhomogeneous lung, stress risers locally increase the applied mechanical power. Increasing lung homogeneity by PEEP and prone position decreases the harm of mechanical ventilation, particularly in severe ARDS. PMID:27048605

  18. Biomarkers in Pediatric ARDS: Future Directions

    PubMed Central

    Orwoll, Benjamin E.; Sapru, Anil

    2016-01-01

    Acute respiratory distress syndrome (ARDS) is common among mechanically ventilated children and accompanies up to 30% of all pediatric intensive care unit deaths. Though ARDS diagnosis is based on clinical criteria, biological markers of acute lung damage have been extensively studied in adults and children. Biomarkers of inflammation, alveolar epithelial and capillary endothelial disruption, disordered coagulation, and associated derangements measured in the circulation and other body fluids, such as bronchoalveolar lavage, have improved our understanding of pathobiology of ARDS. The biochemical signature of ARDS has been increasingly well described in adult populations, and this has led to the identification of molecular phenotypes to augment clinical classifications. However, there is a paucity of data from pediatric ARDS (pARDS) patients. Biomarkers and molecular phenotypes have the potential to identify patients at high risk of poor outcomes, and perhaps inform the development of targeted therapies for specific groups of patients. Additionally, because of the lower incidence of and mortality from ARDS in pediatric patients relative to adults and lack of robust clinical predictors of outcome, there is an ongoing interest in biological markers as surrogate outcome measures. The recent definition of pARDS provides additional impetus for the measurement of established and novel biomarkers in future pediatric studies in order to further characterize this disease process. This chapter will review the currently available literature and discuss potential future directions for investigation into biomarkers in ARDS among children. PMID:27313995

  19. ARD1 Stabilization of TSC2 Suppresses Tumorigenesis Through the mTOR Signaling Pathway

    PubMed Central

    Kuo, Hsu-Ping; Lee, Dung-Fang; Chen, Chun-Te; Liu, Mo; Chou, Chao-Kai; Lee, Hong-Jen; Du, Yi; Xie, Xiaoming; Wei, Yongkun; Xia, Weiya; Weihua, Zhang; Yang, Jer-Yen; Yen, Chia-Jui; Huang, Tzu-Hsuan; Tan, Minjia; Xing, Gang; Zhao, Yingming; Lin, Chien-Hsing; Tsai, Shih-Feng; Fidler, Isaiah J.; Hung, Mien-Chie

    2010-01-01

    Mammalian target of rapamycin (mTOR) regulates various cellular functions, including tumorigenesis, and is inhibited by the tuberous sclerosis 1 (TSC1)–TSC2 complex. Here, we demonstrate that arrest-defective protein 1 (ARD1) physically interacts with, acetylates, and stabilizes TSC2, thereby repressing mTOR activity. The inhibition of mTOR by ARD1 inhibits cell proliferation and increases autophagy, thereby inhibiting tumorigenicity. Correlation between ARD1 and TSC2 abundance was apparent in multiple tumor types. Moreover, evaluation of loss of heterozygosity at Xq28 revealed allelic loss in 31% of tested breast cancer cell lines and tumor samples. Together, our findings suggest that ARD1 functions as an inhibitor of the mTOR pathway and that dysregulation of the ARD1-TSC2-mTOR axis may contribute to cancer development. PMID:20145209

  20. Mechanical Ventilation and ARDS in the ED

    PubMed Central

    Mohr, Nicholas M.; Miller, Christopher N.; Deitchman, Andrew R.; Castagno, Nicole; Hassebroek, Elizabeth C.; Dhedhi, Adam; Scott-Wittenborn, Nicholas; Grace, Edward; Lehew, Courtney; Kollef, Marin H.

    2015-01-01

    BACKGROUND: There are few data regarding mechanical ventilation and ARDS in the ED. This could be a vital arena for prevention and treatment. METHODS: This study was a multicenter, observational, prospective, cohort study aimed at analyzing ventilation practices in the ED. The primary outcome was the incidence of ARDS after admission. Multivariable logistic regression was used to determine the predictors of ARDS. RESULTS: We analyzed 219 patients receiving mechanical ventilation to assess ED ventilation practices. Median tidal volume was 7.6 mL/kg predicted body weight (PBW) (interquartile range, 6.9-8.9), with a range of 4.3 to 12.2 mL/kg PBW. Lung-protective ventilation was used in 122 patients (55.7%). The incidence of ARDS after admission from the ED was 14.7%, with a mean onset of 2.3 days. Progression to ARDS was associated with higher illness severity and intubation in the prehospital environment or transferring facility. Of the 15 patients with ARDS in the ED (6.8%), lung-protective ventilation was used in seven (46.7%). Patients who progressed to ARDS experienced greater duration in organ failure and ICU length of stay and higher mortality. CONCLUSIONS: Lung-protective ventilation is infrequent in patients receiving mechanical ventilation in the ED, regardless of ARDS status. Progression to ARDS is common after admission, occurs early, and worsens outcome. Patient- and treatment-related factors present in the ED are associated with ARDS. Given the limited treatment options for ARDS, and the early onset after admission from the ED, measures to prevent onset and to mitigate severity should be instituted in the ED. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01628523; URL: www.clinicaltrials.gov PMID:25742126

  1. Pulmonary changes on HRCT scans in nonsmoking females with COPD due to wood smoke exposure *

    PubMed Central

    Moreira, Maria Auxiliadora Carmo; Barbosa, Maria Alves; de Queiroz, Maria Conceição de Castro Antonelli Monteiro; Teixeira, Kim Ir Sen Santos; Torres, Pedro Paulo Teixeira e Silva; de Santana, Pedro José; Montadon, Marcelo Eustáquio; Jardim, José Roberto

    2013-01-01

    OBJECTIVE: To identify and characterize alterations seen on HRCT scans in nonsmoking females with COPD due to wood smoke exposure. METHODS: We evaluated 42 nonsmoking females diagnosed with wood smoke-related COPD and 31 nonsmoking controls with no history of wood smoke exposure or pulmonary disease. The participants completed a questionnaire regarding demographic data, symptoms, and environmental exposure. All of the participants underwent spirometry and HRCT of the chest. The COPD and control groups were adjusted for age (23 patients each). RESULTS: Most of the patients in the study group were diagnosed with mild to moderate COPD (83.3%). The most common findings on HRCT scans in the COPD group were bronchial wall thickening, bronchiectasis, mosaic perfusion pattern, parenchymal bands, tree-in-bud pattern, and laminar atelectasis (p < 0.001 vs. the control group for all). The alterations were generally mild and not extensive. There was a positive association between bronchial wall thickening and hour-years of wood smoke exposure. Centrilobular emphysema was uncommon, and its occurrence did not differ between the groups (p = 0.232). CONCLUSIONS: Wood smoke exposure causes predominantly bronchial changes, which can be detected by HRCT, even in patients with mild COPD. PMID:23670500

  2. Year in Review 2015: Pediatric ARDS.

    PubMed

    Cheifetz, Ira M

    2016-07-01

    Led by the work of the Pediatric Acute Lung Injury Consensus Conference, much was published on the topic of pediatric ARDS in 2015. Although the availability of definitive data to the pediatric practitioner for the management of infants and children with pediatric ARDS continues to lag behind that for the adult clinician, 2015 augmented the available medical literature with more information than had been seen for years. This article will review key pediatric ARDS publications with a focus on the Pediatric Acute Lung Injury Consensus Conference consensus definition, sedation management, use of high-frequency oscillatory ventilation, diagnosis of delirium, noninvasive respiratory support, lung-protective ventilation, and adjunct management therapies. Despite the recent progress, additional investigation in each of these areas is essential to the continued advancement of our knowledge and, more importantly, improvements in the outcome for pediatric patients with ARDS. PMID:27381701

  3. Surfactant Therapy of ALI and ARDS

    PubMed Central

    Raghavendran, K; Willson, D; Notter, RH

    2011-01-01

    This article examines exogenous lung surfactant replacement therapy and its utility in mitigating clinical acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS). Biophysical research has documented that lung surfactant dysfunction can be reversed or mitigated by increasing surfactant concentration, and multiple studies in animals with ALI/ARDS have shown that respiratory function and pulmonary mechanics in vivo can be improved by exogenous surfactant administration. Exogenous surfactant therapy is a routine intervention in neonatal intensive care, and is life-saving in preventing or treating the neonatal respiratory distress syndrome (NRDS) in premature infants. In applications relevant for lung injury-related respiratory failure and ALI/ARDS, surfactant therapy has been shown to be beneficial in term infants with pneumonia and meconium aspiration lung injury, and in children up to age 21 with direct pulmonary forms of ALI/ARDS. However, extension of exogenous surfactant therapy to adults with respiratory failure and clinical ALI/ARDS remains a challenge. Coverage here reviews clinical studies of surfactant therapy in pediatric and adult patients with ALI/ARDS, particularly focusing on its potential advantages in patients with direct pulmonary forms of these syndromes. Also discussed is the rationale for mechanism-based therapies utilizing exogenous surfactant in combination with agents targeting other aspects of the multifaceted pathophysiology of inflammatory lung injury. Additional factors affecting the efficacy of exogenous surfactant therapy in ALI/ARDS are also described, including the difficulty of effectively delivering surfactants to injured lungs and the existence of activity differences between clinical surfactant drugs. PMID:21742216

  4. Plasma Neutrophil Elastase and Elafin Imbalance Is Associated with Acute Respiratory Distress Syndrome (ARDS) Development

    PubMed Central

    Wang, Zhaoxi; Chen, Feng; Zhai, Rihong; Zhang, Lingsong; Su, Li; Lin, Xihong; Thompson, Taylor; Christiani, David C.

    2009-01-01

    Background We conducted an exploratory study of genome-wide gene expression in whole blood and found that the expression of neutrophil elastase inhibitor (PI3, elafin) was down-regulated during the early phase of ARDS. Further analyses of plasma PI3 levels revealed a rapid decrease during early ARDS development. PI3 and secretory leukocyte proteinase inhibitor (SLPI) are important low-molecular-weight proteinase inhibitors produced locally at neutrophil infiltration site in the lung. In this study, we tested the hypothesis that an imbalance between neutrophil elastase (HNE) and its inhibitors in blood is related to the development of ARDS. Methodology/Principal Findings PI3, SLPI, and HNE were measured in plasma samples collected from 148 ARDS patients and 63 critical ill patients at risk for ARDS (controls). Compared with the controls, the ARDS patients had higher HNE, but lower PI3, at the onset of ARDS, resulting in increased HNE/PI3 ratio (mean = 14.5; 95% CI, 10.9–19.4, P<0.0001), whereas plasma SLPI was not associated with the risk of ARDS development. Although the controls had elevated plasma PI3 and HNE, their HNE/PI3 ratio (mean = 6.5; 95% CI, 4.9–8.8) was not significantly different from the healthy individuals (mean = 3.9; 95% CI, 2.7–5.9). Before the onset (7-days period prior to ARDS diagnosis), we only observed significantly elevated HNE, but the HNE-PI3 balance remained normal. With the progress from prior to the onset of ARDS, the plasma level of PI3 declined, whereas HNE was maintained at a higher level, tilting the balance toward more HNE in the circulation as characterized by an increased HNE/PI3 ratio. In contrast, three days after ICU admission, there was a significant drop of HNE/PI3 ratio in the at-risk controls. Conclusions/Significance Plasma profiles of PI3, HNE, and HNE/PI3 may be useful clinical biomarkers in monitoring the development of ARDS. PMID:19197381

  5. [Update: standardized CT/HRCT classification of occupational and environmental thoracic diseases in Germany].

    PubMed

    Hering, K G; Hofmann-Preiß, K; Kraus, T

    2014-04-01

    The high-resolution computed tomography (HRCT) coding scheme of the international classification of occupational and environmental respiratory diseases (ICOERD) presented here is an instrument for a standardized semiquantitative description of occupation and environment-linked as well as other pulmonary and pleural diseases. Analogous to the International Labour Organization (ILO) classification, the ICOERD coding scheme should always be used when the CT/HRCT examination is employed for occupational medical investigations or expert opinions. After publication of the guidelines and recommendations on diagnostics and expert assessment of asbestos-linked diseases and silicosis, the application of a standardized investigation program and assessment with the ICOERD classification form are obligatory, at least for the initial assessment. Furthermore, its use in the field of follow-up assessments of occupational diseases should be encouraged in order to guarantee comparability between individual reports (interreader variability) and at least a semiquantitative assessment of disease progression in isolated cases. Because the anatomical structures in projection radiography and CT are not presented identically, a 1:1 transfer of the results of the ILO classification to the CT/HRCT coding scheme is not possible. An overview image of the thorax does not allow overlap-free reproduction of structures, in contrast to CT. These methodological differences can in cases of isolated assessment result in different opinions of projection and CT images mostly by different investigators. In cases of discrepant opinions an integrated report of findings by combination of all information from both procedures is necessary. PMID:24737105

  6. [Pathophysiology of gas exchange in ARDS].

    PubMed

    Fernández Fernández, R

    2006-11-01

    ARDS is produced in a pulmonary edema picture due to increased vascular patency. In this way, the initial alteration consists in an alveolar occupation due to protein rich edema. This occupation reduces the alveolar surface available for gas exchange, increasing the pulmonary areas with poor or null V/Q ratio. As ARDS progresses, vascular phenomena occur that affect the gas exchange differently, giving rise to heterogeneity in the V/Q ratio. This situation worsens due to the appearance of areas with null ventilation in relationship with the appearance of atelectasis in lung dependent zones. All these factors form the hypoxemia picture refractory to the increase of the inspired oxygen fraction characteristic of this clinical entity. In this article, we make a review of these physiological mechanisms and the effect on the oxygenation of different ventilatory and drug maneuvers. PMID:17129535

  7. Measles-induced respiratory distress, air-leak and ARDS.

    PubMed

    Piastra, M; Onesimo, R; De Luca, D; Lancella, L; Marzano, L; De Rosa, G; Pietrini, D; Valentini, P; Conti, G

    2010-02-01

    Young infants with measles requiring respiratory support have a significant risk for death and long-term complications. Even in developed countries, the occurrence of spontaneous air-leaks and acute respiratory distress syndrome (ARDS) still represent the most severe clinical presentation in early childhood, with a high fatality rate. A clinical series review from a tertiary university paediatric intensive care unit (PICU) was undertaken. During the 2006-2007 outbreak in Rome, Italy, a young infant presented with ARDS/spontaneous air-leak and needed aggressive ventilatory management and haemodynamic support. Both nebulised iloprost and intravenous pentoxifylline were administered during the acute hypoxaemic phase; the role of this pharmacologic approach in critically ill patients is still under debate. We observed four further cases of respiratory impairment requiring a non-invasive approach. Clinical-radiological findings ranged from interstitial pneumonia to bronchiolitis-like pictures. All patients were imported cases, representing an important epidemiological factor and future medical issue, though they were not malnourished nor affected by chronic diseases. We conclude that early respiratory assessment and timely PICU referral is of mainstem importance in the youngest infants with measles-induced respiratory failure. The protean nature of clinical presentation and the possibility of rapid respiratory deterioration should be highlighted, and infants from immigrant families may represent a susceptible high-risk group. PMID:20012881

  8. Mechanical Ventilation as a Therapeutic Tool to Reduce ARDS Incidence.

    PubMed

    Nieman, Gary F; Gatto, Louis A; Bates, Jason H T; Habashi, Nader M

    2015-12-01

    Trauma, hemorrhagic shock, or sepsis can incite systemic inflammatory response syndrome, which can result in early acute lung injury (EALI). As EALI advances, improperly set mechanical ventilation (MV) can amplify early injury into a secondary ventilator-induced lung injury that invariably develops into overt ARDS. Once established, ARDS is refractory to most therapeutic strategies, which have not been able to lower ARDS mortality below the current unacceptably high 40%. Low tidal volume ventilation is one of the few treatments shown to have a moderate positive impact on ARDS survival, presumably by reducing ventilator-induced lung injury. Thus, there is a compelling case to be made that the focus of ARDS management should switch from treatment once this syndrome has become established to the application of preventative measures while patients are still in the EALI stage. Indeed, studies have shown that ARDS incidence is markedly reduced when conventional MV is applied preemptively using a combination of low tidal volume and positive end-expiratory pressure in both patients in the ICU and in surgical patients at high risk for developing ARDS. Furthermore, there is evidence from animal models and high-risk trauma patients that superior prevention of ARDS can be achieved using preemptive airway pressure release ventilation with a very brief duration of pressure release. Preventing rather than treating ARDS may be the way forward in dealing with this recalcitrant condition and would represent a paradigm shift in the way that MV is currently practiced. PMID:26135199

  9. Human herpesviruses respiratory infections in patients with acute respiratory distress (ARDS).

    PubMed

    Bonizzoli, Manuela; Arvia, Rosaria; di Valvasone, Simona; Liotta, Francesco; Zakrzewska, Krystyna; Azzi, Alberta; Peris, Adriano

    2016-08-01

    Acute respiratory distress syndrome (ARDS) is today a leading cause of hospitalization in intensive care unit (ICU). ARDS and pneumonia are closely related to critically ill patients; however, the etiologic agent is not always identified. The presence of human herpes simplex virus 1, human cytomegalovirus and Epstein-Barr virus in respiratory samples of critically ill patients is increasingly reported even without canonical immunosuppression. The main aim of this study was to better understand the significance of herpesviruses finding in lower respiratory tract of ARDS patients hospitalized in ICU. The presence of this group of herpesviruses, in addition to the research of influenza viruses and other common respiratory viruses, was investigated in respiratory samples from 54 patients hospitalized in ICU, without a known microbiological causative agent. Moreover, the immunophenotype of each patient was analyzed. Herpesviruses DNA presence in the lower respiratory tract seemed not attributable to an impaired immunophenotype, whereas a significant correlation was observed between herpesviruses positivity and influenza virus infection. A higher ICU mortality was significantly related to the presence of herpesvirus infection in the lower respiratory tract as well as to impaired immunophenotype, as patients with poor outcome showed severe lymphopenia, affecting in particular T (CD3+) cells, since the first days of ICU hospitalization. In conclusion, these results indicate that herpesviruses lower respiratory tract infection, which occurs more frequently following influenza virus infection, can be a negative prognostic marker. An independent risk factor for ICU patients with ARDS is an impaired immunophenotype. PMID:27138606

  10. Induced hypothermia for trauma-related ARDS

    PubMed Central

    Dhillon, Gagandeep; Gopal, Palepu B.; Kamat, Akshata S.; Mulavisala, K.P.

    2015-01-01

    We report a case of 27-year-old male with lung contusions related acute respiratory distress syndrome (ARDS) managed by ARDSNet guidelines and additional hypothermia. On 4th day, post trauma partial pressure of oxygen dropped to 38 mm of mercury (Hg), not improving even on high positive end-expiratory pressure of 18 cm water (H2O), inverse ratio ventilation and fraction of inspired oxygen of 1. Extracorporeal membrane oxygenation was ruled out due to the risk of hemorrhage from trauma sites. Thereafter, hypothermia along with muscle paralysis was considered to reduce total body oxygen consumption. Patient's condition improved under hypothermia, and he was extubated and taken up for fracture fixation surgeries and discharged later in stable condition. PMID:26195862

  11. Is there still a role for the lung injury score in the era of the Berlin definition ARDS?

    PubMed Central

    2014-01-01

    outcomes, these findings suggest that the role of LIS in characterizing lung injury severity in the era of the Berlin definition ARDS may be limited. PMID:24533450

  12. [Inhaled nitric oxide: one modality in the treatment of ARDS].

    PubMed

    Carrillo-Esper, R; Ramírez-Hernández, J M; Gargallo-Hernández, J J; Hernández-Vásquez, R; Domínguez-Rodríguez, M I; Alemán-Alarcón, C E; Gallegos-Rodríguez, G

    1999-01-01

    We describe a patient with acute respiratory distress syndrome (ARDS), refractory to treatment with conventional mechanical ventilation. The hemodynamic parameters showed severe pulmonary hypertension with increased intrapulmonary shunt. Inhaled nitric oxide was administered and we observed a diminishing in pulmonary hypertension and intrapulmonary shunt with an important increase of oxygen exchange. We reviewed the literature and make a suggestion concerning use of inhaled nitric oxide in patients with ARDS. PMID:10491897

  13. Platelet Count Mediates the Contribution of a Genetic Variant in LRRC16A to ARDS Risk

    PubMed Central

    Wei, Yongyue; Wang, Zhaoxi; Su, Li; Chen, Feng; Tejera, Paula; Bajwa, Ednan K.; Wurfel, Mark M.; Lin, Xihong

    2015-01-01

    BACKGROUND: Platelets are believed to be critical in pulmonary-origin ARDS as mediators of endothelial damage through their interactions with fibrinogen and multiple signal transduction pathways. A prior meta-analysis identified five loci for platelet count (PLT): BAD, LRRC16A, CD36, JMJD1C, and SLMO2. This study aims to validate the quantitative trait loci (QTLs) of PLT within BAD, LRRC16A, CD36, JMJD1C, and SLMO2 among critically ill patients and to investigate the associations of these QTLs with ARDS risk that may be mediated through PLT. METHODS: ARDS cases and at-risk control subjects were recruited from the intensive care unit of the Massachusetts General Hospital. Exome-wide genotyping data of 629 ARDS cases and 1,026 at-risk control subjects and genome-wide gene expression profiles of 18 at-risk control subjects were generated for analysis. RESULTS: Single-nucleotide polymorphism (SNP) rs7766874 within LRRC16A was a significant locus for PLT among at-risk control subjects (β = −13.00; 95% CI, −23.22 to −2.77; P = .013). This association was validated using LRRC16A gene expression data from at-risk control subjects (β = 77.03 per 1 SD increase of log2-transformed expression; 95% CI, 27.26-126.80; P = .005). Further, rs7766874 was associated with ARDS risk conditioned on PLT (OR = 0.68; 95% CI, 0.51-0.90; P = .007), interacting with PLT (OR = 1.15 per effect allele per 100 × 103/μL of PLT; 95% CI, 1.03-1.30; P = .015), and mediated through PLT (indirect OR = 1.045; 95% CI, 1.007-1.085; P = .021). CONCLUSIONS: Our findings support the role of LRRC16A in platelet formation and suggest the importance of LRRC16A in ARDS pathophysiology by interacting with, and being mediated through, platelets. PMID:25254322

  14. Segmentation of interstitial lung disease patterns in HRCT images

    NASA Astrophysics Data System (ADS)

    Dash, Jatindra K.; Madhavi, Vaddepalli; Mukhopadhyay, Sudipta; Khandelwal, Niranjan; Kumar, Prafulla

    2015-03-01

    Automated segmentation of pathological bearing region is the first step towards the development of lung CAD. Most of the work reported in the literature related to automated analysis of lung tissue aims towards classification of fixed sized block into one of the classes. This block level classification of lung tissues in the image never results in accurate or smooth boundaries between different regions. In this work, effort is taken to investigate the performance of three automated image segmentation algorithms those results in smooth boundaries among lung tissue patterns commonly encountered in HRCT images of the thorax. A public database that consists of HRCT images taken from patients affected with Interstitial Lung Diseases (ILDs) is used for the evaluation. The algorithms considered are Markov Random Field (MRF), Gaussian Mixture Model (GMM) and Mean Shift (MS). 2-fold cross validation approach is followed for the selection of the best parameter value for individual algorithm as well as to evaluate the performance of all the algorithms. Mean shift algorithm is observed as the best performer in terms of Jaccard Index, Modified Hausdorff Distance, accuracy, Dice Similarity Coefficient and execution speed.

  15. Astilbin alleviates LPS-induced ARDS by suppressing MAPK signaling pathway and protecting pulmonary endothelial glycocalyx.

    PubMed

    Kong, Guiqing; Huang, Xiao; Wang, Lipeng; Li, Yan; Sun, Ting; Han, Shasha; Zhu, Weiwei; Ma, Mingming; Xu, Haixiao; Li, Jiankui; Zhang, Xiaohua; Liu, Xiangyong; Wang, Xiaozhi

    2016-07-01

    Acute respiratory distress syndrome (ARDS) is a devastating disorder that is characterized by increased vascular endothelial permeability and inflammation. Unfortunately, no effective treatment beyond supportive care is available for ARDS. Astilbin, a flavonoid compound isolated from Rhizoma Smilacis Glabrae, has been used for anti-hepatic, anti-arthritic, and anti-renal injury treatments. This study examined the effects of Astilbin on pulmonary inflammatory activation and endothelial cell barrier dysfunction caused by Gram-negative bacterial endotoxin lipopolysaccharide (LPS). Endothelial cells from human umbilical veins or male Kunming mice were pretreated with Astilbin 24h before LPS stimulation. Results showed that Astilbin significantly attenuated the pulmonary histopathological changes and neutrophil infiltration 6h after the LPS challenge. Astilbin suppressed the activities of myeloperoxidase and malondialdehyde, as well as the expression of tumor necrosis factor-α and interleukin-6 in vivo and in vitro. As indices of pulmonary edema, lung wet-to-dry weight ratios, were markedly decreased by Astilbin pretreatment. Western blot analysis also showed that Astilbin inhibited LPS-induced activation of mitogen-activated protein kinase (MAPK) pathways in lung tissues. Furthermore, Astilbin significantly inhibited the activity of heparanase and reduced the production of heparan sulfate in the blood serum as determined by ELISA. These findings indicated that Astilbin can alleviate LPS-induced ARDS, which potentially contributed to the suppression of MAPK pathway activation and the degradation of endothelial glycocalyx. PMID:27111514

  16. Sepsis and ARDS: The Dark Side of Histones

    PubMed Central

    Xu, Zhiheng; Huang, Yongbo; Mao, Pu; Zhang, Jianrong; Li, Yimin

    2015-01-01

    Despite advances in management over the last several decades, sepsis and acute respiratory distress syndrome (ARDS) still remain major clinical challenges and the leading causes of death for patients in intensive care units (ICUs) due to insufficient understanding of the pathophysiological mechanisms of these diseases. However, recent studies have shown that histones, also known as chromatin-basic structure proteins, could be released into the extracellular space during severe stress and physical challenges to the body (e.g., sepsis and ARDS). Due to their cytotoxic and proinflammatory effects, extracellular histones can lead to excessive and overwhelming cell damage and death, thus contributing to the pathogenesis of both sepsis and ARDS. In addition, antihistone-based treatments (e.g., neutralizing antibodies, activated protein C, and heparin) have shown protective effects and have significantly improved the outcomes of mice suffering from sepsis and ARDS. Here, we review researches related to the pathological role of histone in context of sepsis and ARDS and evaluate the potential value of histones as biomarkers and therapeutic targets of these diseases. PMID:26609197

  17. ARD remediation with limestone in a CO2 pressurized reactor

    USGS Publications Warehouse

    Sibrell, Philip L.; Watten, Barnaby J.; Friedrich, Andrew E.; Vinci, Brian J.

    2000-01-01

    We evaluated a new process for remediation of acid rock drainage (ARD). The process treats ARD with intermittently fluidized beds of granular limestone maintained within a continuous flow reactor pressurized with CO2. Tests were performed over a thirty day period at the Toby Creek mine drainage treatment plant, Elk County, Pennsylvania in cooperation with the Pennsylvania Department of Environmental Protection. Equipment performance was established at operating pressures of 0, 34, 82, and 117 kPa using an ARD flow of 227 L/min. The ARD had the following characteristics: pH, 3.1; temperature, 10 °C; dissolved oxygen, 6.4 mg/L; acidity, 260 mg/L; total iron, 21 mg/L; aluminum, 22 mg/L; manganese, 7.5 mg/L; and conductivity, 1400 μS/cm. In all cases tested, processed ARD was net alkaline with mean pH and alkalinities of 6.7 and 59 mg/L at a CO2 pressure of 0 kPa, 6.6 and 158 mg/L at 34 kPa, 7.4 and 240 mg/L at 82 kPa, and 7.4 and 290 mg/L at 117 kPa. Processed ARD alkalinities were correlated to the settled bed depth (p<0.001) and CO2 pressure (p<0.001). Iron, aluminum, and manganese removal efficiencies of 96%, 99%, and 5%, respectively, were achieved with filtration following treatment. No indications of metal hydroxide precipitation or armoring of the limestone were observed. The surplus alkalinity established at 82 kPa was successful in treating an equivalent of 1136 L/min (five-fold dilution) of the combined three ARD streams entering the Toby Creek Plant. This side-stream capability provides savings in treatment unit scale as well as flexibility in treatment effect. The capability of the system to handle higher influent acidity was tested by elevating the acidity to 5000 mg/L with sulfuric acid. Net alkaline effluent was produced, indicating applicability of the process to highly acidic ARD.

  18. Relationship between Concentrations of Lutein and StARD3 among Pediatric and Geriatric Human Brain Tissue

    PubMed Central

    Tanprasertsuk, Jirayu; Li, Binxing; Bernstein, Paul S.; Vishwanathan, Rohini; Johnson, Mary Ann; Poon, Leonard; Johnson, Elizabeth J.

    2016-01-01

    Lutein, a dietary carotenoid, selectively accumulates in human retina and brain. While many epidemiological studies show evidence of a relationship between lutein status and cognitive health, lutein’s selective uptake in human brain tissue and its potential function in early neural development and cognitive health have been poorly evaluated at a molecular level. The objective of this study was to evaluate the cross-sectional relationship between concentrations of brain lutein and StARD3 (identified as its binding protein in retinal tissue) among three age groups: infants (1–4 months, n = 10), older adults (55–86 years, n = 8), and centenarians (98–105 years, n = 10). Brain lutein concentrations were analyzed by high-performance liquid chromatography and StARD3 levels were analyzed by Western Blot analysis. The strong relationship in infant brains (r = 0.75, P < 0.001) suggests that lutein has a role in neural development. The relationship remained significant but weaker in older adults (r = 0.51, P < 0.05) and insignificant in centenarians (r = 0.08, P > 0.05), seven of whom had mild cognitive impairment (MCI) or dementia. These exploratory findings suggest an age-related decrease or abnormality of StARD3 activity in human brain. Given that StARD3 is also involved in cholesterol transportation, a process that is aberrant in neurodegenerative diseases, the potential protective function of lutein against these diseases remains to be explored. PMID:27205891

  19. Personalized medicine for ARDS: the 2035 research agenda.

    PubMed

    Beitler, Jeremy R; Goligher, Ewan C; Schmidt, Matthieu; Spieth, Peter M; Zanella, Alberto; Martin-Loeches, Ignacio; Calfee, Carolyn S; Cavalcanti, Alexandre B

    2016-05-01

    In the last 20 years, survival among patients with acute respiratory distress syndrome (ARDS) has increased substantially with advances in lung-protective ventilation and resuscitation. Building on this success, personalizing mechanical ventilation to patient-specific physiology for enhanced lung protection will be a top research priority for the years ahead. However, the ARDS research agenda must be broader in scope. Further understanding of the heterogeneous biology, from molecular to mechanical, underlying early ARDS pathogenesis is essential to inform therapeutic discovery and tailor treatment and prevention strategies to the individual patient. The ARDSne(x)t research agenda for the next 20 years calls for bringing personalized medicine to ARDS, asking simultaneously both whether a treatment affords clinically meaningful benefit and for whom. This expanded scope necessitates standard acquisition of highly granular biological, physiological, and clinical data across studies to identify biologically distinct subgroups that may respond differently to a given intervention. Clinical trials will need to consider enrichment strategies and incorporate long-term functional outcomes. Tremendous investment in research infrastructure and global collaboration will be vital to fulfilling this agenda. PMID:27040103

  20. A Comprehensive Review of Prone Position in ARDS.

    PubMed

    Kallet, Richard H

    2015-11-01

    Prone position (PP) has been used since the 1970s to treat severe hypoxemia in patients with ARDS because of its effectiveness at improving gas exchange. Compared with the supine position (SP), placing patients in PP effects a more even tidal volume distribution, in part, by reversing the vertical pleural pressure gradient, which becomes more negative in the dorsal regions. PP also improves resting lung volume in the dorsocaudal regions by reducing the superimposed pressure of both the heart and the abdomen. In contrast, pulmonary perfusion remains preferentially distributed to the dorsal lung regions, thus improving overall alveolar ventilation/perfusion relationships. Moreover, the larger tissue mass suspended from a wider dorsal chest wall effects a more homogeneous distribution of pleural pressures throughout the lung that reduces abnormal strain and stress development. This is believed to ameliorate the severity or development of ventilator-induced lung injury and may partly explain why PP reduces mortality in severe ARDS. Over 40 years of clinical trials have consistently reported improved oxygenation in approximately 70% of subjects with ARDS. Early initiation of PP is more likely to improve oxygenation than initiation during the subacute phase. Maximal oxygenation improvement occurs over a wide time frame ranging from several hours to several days. Meta-analyses of randomized controlled trials suggest that PP provides a survival advantage only in patients with relatively severe ARDS (PaO2 /FIO2 < 150 mm Hg). Moreover, survival is enhanced when patients are managed with a smaller tidal volume (≤ 8 mL/kg), higher PEEP (10-13 cm H2O), and longer duration of PP sessions (> 10-12 h/session). Combining adjunctive therapies (high PEEP, recruitment maneuvers, and inhaled vasodilators) with PP has an additive effect in improving oxygenation and may be particularly helpful in stabilizing gas exchange in very severe ARDS. PMID:26493592

  1. Findings

    MedlinePlus

    ... Issue All Issues Explore Findings by Topic Cell Biology Cellular Structures, Functions, Processes, Imaging, Stress Response Chemistry ... Glycobiology, Synthesis, Natural Products, Chemical Reactions Computers in Biology Bioinformatics, Modeling, Systems Biology, Data Visualization Diseases Cancer, ...

  2. A support vector machine classifier reduces interscanner variation in the HRCT classification of regional disease pattern in diffuse lung disease: Comparison to a Bayesian classifier

    SciTech Connect

    Chang, Yongjun; Lim, Jonghyuck; Kim, Namkug; Seo, Joon Beom; Lynch, David A.

    2013-05-15

    integrated ROI data obtained from both scanners, the classification accuracies with the SVM and Bayesian classifiers were 92% and 77%, respectively. The selected features resulting from the classification process differed by scanner, with more features included for the classification of the integrated HRCT data than for the classification of the HRCT data from each scanner. For the integrated data, consisting of HRCT images of both scanners, the classification accuracy based on the SVM was statistically similar to the accuracy of the data obtained from each scanner. However, the classification accuracy of the integrated data using the Bayesian classifier was significantly lower than the classification accuracy of the ROI data of each scanner. Conclusions: The use of an integrated dataset along with a SVM classifier rather than a Bayesian classifier has benefits in terms of the classification accuracy of HRCT images acquired with more than one scanner. This finding is of relevance in studies involving large number of images, as is the case in a multicenter trial with different scanners.

  3. Contemporary Ventilator Management in Patients With and at Risk of ALI/ARDS

    PubMed Central

    Chang, Steven Y; Dabbagh, Ousama; Gajic, Ognen; Patrawalla, Amee; Elie, Marie-Carmelle; Talmor, Daniel S; Malhotra, Atul; Adesanya, Adebola; Anderson, Harry L; Blum, James M; Park, Pauline K; Gong, Michelle Ng

    2013-01-01

    BACKGROUND Ventilator practices in patients at risk for acute lung injury (ALI) and ARDS are unclear. We examined factors associated with choice of set tidal volumes (VT), and whether VT < 8 mL/kg predicted body weight (PBW) relates to the development of ALI/ARDS. METHODS We performed a secondary analysis of a multicenter cohort of adult subjects at risk of lung injury with and without ALI/ARDS at onset of invasive ventilation. Descriptive statistics were used to describe ventilator practices in specific settings and ALI/ARDS risk groups. Logistic regression analysis was used to determine the factors associated with the use of VT < 8 mL/kg PBW and the relationship of VT to ALI/ARDS development and outcome. RESULTS Of 829 mechanically ventilated patients, 107 met the criteria for ALI/ARDS at time of intubation, and 161 developed ALI/ARDS after intubation (post-intubation ALI/ARDS). There was significant intercenter variability in initial ventilator settings, and in the incidence of ALI/ARDS and post-intubation ALI/ARDS. The median VT was 7.96 (IQR 7.14–8.94) mL/kg PBW in ALI/ARDS subjects, and 8.45 (IQR 7.50–9.55) mL/kg PBW in subjects without ALI/ARDS (P = .004). VT decreased from 8.40 (IQR 7.38–9.37) mL/kg PBW to 7.97 (IQR 6.90–9.23) mL/kg PBW (P < .001) in those developing post-intubation ALI/ARDS. Among subjects without ALI/ARDS, VT ≥ 8 mL/kg PBW was associated with shorter height and higher body mass index, while subjects with pneumonia were less likely to get ≥ 8 mL/kg PBW. Initial VT ≥ 8 mL/kg PBW was not associated with the post-intubation ALI/ARDS (adjusted odds ratio 1.30, 95% CI 0.74–2.29) or worse outcomes. Post-intubation ALI/ARDS subjects had mortality similar to subjects intubated with ALI/ARDS. CONCLUSIONS Clinicians seem to respond to ALI/ARDS with lower initial VT. Initial VT, however, was not associated with the development of post-intubation ALI/ARDS or other outcomes. PMID:22906363

  4. Rotordynamics on the PC: Transient Analysis With ARDS

    NASA Technical Reports Server (NTRS)

    Fleming, David P.

    1997-01-01

    Personal computers can now do many jobs that formerly required a large mainframe computer. An example is NASA Lewis Research Center's program Analysis of RotorDynamic Systems (ARDS), which uses the component mode synthesis method to analyze the dynamic motion of up to five rotating shafts. As originally written in the early 1980's, this program was considered large for the mainframe computers of the time. ARDS, which was written in Fortran 77, has been successfully ported to a 486 personal computer. Plots appear on the computer monitor via calls programmed for the original CALCOMP plotter; plots can also be output on a standard laser printer. The executable code, which uses the full array sizes of the mainframe version, easily fits on a high-density floppy disk. The program runs under DOS with an extended memory manager. In addition to transient analysis of blade loss, step turns, and base acceleration, with simulation of squeeze-film dampers and rubs, ARDS calculates natural frequencies and unbalance response.

  5. Predictive Criteria to Study the Pathogenesis of Malaria-Associated ALI/ARDS in Mice

    PubMed Central

    Ortolan, Luana S.; Sercundes, Michelle K.; Debone, Daniela; Hagen, Stefano C. F.; D' Império Lima, Maria Regina; Alvarez, José M.; Marinho, Claudio R. F.; Epiphanio, Sabrina

    2014-01-01

    Malaria-associated acute lung injury/acute respiratory distress syndrome (ALI/ARDS) often results in morbidity and mortality. Murine models to study malaria-associated ALI/ARDS have been described; we still lack a method of distinguishing which mice will develop ALI/ARDS before death. This work aimed to characterize malaria-associated ALI/ARDS in a murine model and to demonstrate the first method to predict whether mice are suffering from ALI/ARDS before death. DBA/2 mice infected with Plasmodium berghei ANKA developing ALI/ARDS or hyperparasitemia (HP) were compared using histopathology, PaO2 measurement, pulmonary X-ray, breathing capacity, lung permeability, and serum vascular endothelial growth factor (VEGF) levels according to either the day of death or the suggested predictive criteria. We proposed a model to predict malaria-associated ALI/ARDS using breathing patterns (enhanced pause and frequency respiration) and parasitemia as predictive criteria from mice whose cause of death was known to retrospectively diagnose the sacrificed mice as likely to die of ALI/ARDS as early as 7 days after infection. Using this method, we showed increased VEGF levels and increased lung permeability in mice predicted to die of ALI/ARDS. This proposed method for accurately identifying mice suffering from ALI/ARDS before death will enable the use of this model to study the pathogenesis of this disease. PMID:25276057

  6. Analyzing 3D xylem networks in Vitis vinifera using High Resolution Computed Tomography (HRCT)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Recent developments in High Resolution Computed Tomography (HRCT) have made it possible to visualize three dimensional (3D) xylem networks without time consuming, labor intensive physical sectioning. Here we describe a new method to visualize complex vessel networks in plants and produce a quantitat...

  7. Analysis of HRCT-derived xylem network reveals reverse flow in some vessels

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Flow in xylem vessels is modeled based on constructions of three dimensional xylem networks derived from High Resolution Computed Tomography (HRCT) images of grapevine (Vitis vinifera) stems. Flow in 6-14% of the vessels was found to be oriented in the opposite direction to the bulk flow under norma...

  8. Advanced Research Deposition System (ARDS) for processing CdTe solar cells

    NASA Astrophysics Data System (ADS)

    Barricklow, Keegan Corey

    CdTe solar cells have been commercialized at the Gigawatt/year level. The development of volume manufacturing processes for next generation CdTe photovoltaics (PV) with higher efficiencies requires research systems with flexibility, scalability, repeatability and automation. The Advanced Research Deposition Systems (ARDS) developed by the Materials Engineering Laboratory (MEL) provides such a platform for the investigation of materials and manufacturing processes necessary to produce the next generation of CdTe PV. Limited by previous research systems, the ARDS was developed to provide process and hardware flexibility, accommodating advanced processing techniques, and capable of producing device quality films. The ARDS is a unique, in-line process tool with nine processing stations. The system was designed, built and assembled at the Materials Engineering Laboratory. Final assembly, startup, characterization and process development are the focus of this research. Many technical challenges encountered during the startup of the ARDS were addressed in this research. In this study, several hardware modifications needed for the reliable operation of the ARDS were designed, constructed and successfully incorporated into the ARDS. The effect of process condition on film properties for each process step was quantified. Process development to achieve 12% efficient baseline solar cell required investigation of discrete processing steps, troubleshooting process variation, and developing performance correlations. Subsequent to this research, many advances have been demonstrated with the ARDS. The ARDS consistently produces devices of 12% +/-.5% by the process of record (POR). The champion cell produced to date utilizing the ARDS has an efficiency of 16.2% on low cost commercial sodalime glass and utilizes advanced films. The ARDS has enabled investigation of advanced concepts for processing CdTe devices including, Plasma Cleaning, Plasma Enhanced Closed Space Sublimation

  9. Pancreatitis-induced acute lung injury. An ARDS model.

    PubMed Central

    Guice, K S; Oldham, K T; Johnson, K J; Kunkel, R G; Morganroth, M L; Ward, P A

    1988-01-01

    Cerulein-induced acute pancreatitis in rats is associated with acute lung injury characterized by increased pulmonary microvascular permeability, increased wet lung weights, and histologic features of alveolar capillary endothelial cell and pulmonary parenchymal injury. The alveolar capillary permeability index is increased 1.8-fold after a 3-hour injury (0.30 to 0.54, p less than 0.05). Gravimetric analysis shows a similar 1.5-fold increase in wet lung weights at 3 hours (0.35% vs. 0.51% of total body weight, p less than 0.05). Histologic features assessed by quantitative morphometric analysis include significant intra-alveolar hemorrhage (0.57 +/- 0.08 vs. 0.12 +/- 0.02 RBC/alveolus at 6 hours, p less than 0.001); endothelial cell disruption (28.11% vs. 4.3%, p less than 0.001); and marked, early neutrophil infiltration (7.45 +/- 0.53 vs. 0.83 +/- 0.18 PMN/hpf at 3 hours, p less than 0.001). The cerulein peptide itself, a cholecystokinin (CCK) analog, is naturally occurring and is not toxic and in several in vitro settings including exposure to pulmonary artery endothelial cells, Type II epithelial cells, and an ex vivo perfused lung preparation. The occurrence of this ARDS-like acute lung injury with acute pancreatitis provides an excellent experimental model to investigate mechanisms and mediators involved in the pathogenesis of ARDS. Images Fig. 1. PMID:3389946

  10. Pancreatitis-induced acute lung injury. An ARDS model.

    PubMed

    Guice, K S; Oldham, K T; Johnson, K J; Kunkel, R G; Morganroth, M L; Ward, P A

    1988-07-01

    Cerulein-induced acute pancreatitis in rats is associated with acute lung injury characterized by increased pulmonary microvascular permeability, increased wet lung weights, and histologic features of alveolar capillary endothelial cell and pulmonary parenchymal injury. The alveolar capillary permeability index is increased 1.8-fold after a 3-hour injury (0.30 to 0.54, p less than 0.05). Gravimetric analysis shows a similar 1.5-fold increase in wet lung weights at 3 hours (0.35% vs. 0.51% of total body weight, p less than 0.05). Histologic features assessed by quantitative morphometric analysis include significant intra-alveolar hemorrhage (0.57 +/- 0.08 vs. 0.12 +/- 0.02 RBC/alveolus at 6 hours, p less than 0.001); endothelial cell disruption (28.11% vs. 4.3%, p less than 0.001); and marked, early neutrophil infiltration (7.45 +/- 0.53 vs. 0.83 +/- 0.18 PMN/hpf at 3 hours, p less than 0.001). The cerulein peptide itself, a cholecystokinin (CCK) analog, is naturally occurring and is not toxic and in several in vitro settings including exposure to pulmonary artery endothelial cells, Type II epithelial cells, and an ex vivo perfused lung preparation. The occurrence of this ARDS-like acute lung injury with acute pancreatitis provides an excellent experimental model to investigate mechanisms and mediators involved in the pathogenesis of ARDS. PMID:3389946

  11. Active Reading Documents (ARDs): A Tool to Facilitate Meaningful Learning through Reading

    ERIC Educational Resources Information Center

    Dubas, Justin M.; Toledo, Santiago A.

    2015-01-01

    Presented here is a practical tool called the Active Reading Document (ARD) that can give students the necessary incentive to engage with the text/readings. By designing the tool to incrementally develop student understanding of the material through reading using Marzano's Taxonomy as a framework, the ARD offers support through scaffolding as…

  12. Automated Lung Segmentation from HRCT Scans with Diffuse Parenchymal Lung Diseases.

    PubMed

    Pulagam, Ammi Reddy; Kande, Giri Babu; Ede, Venkata Krishna Rao; Inampudi, Ramesh Babu

    2016-08-01

    Performing accurate and fully automated lung segmentation of high-resolution computed tomography (HRCT) images affected by dense abnormalities is a challenging problem. This paper presents a novel algorithm for automated segmentation of lungs based on modified convex hull algorithm and mathematical morphology techniques. Sixty randomly selected lung HRCT scans with different abnormalities are used to test the proposed algorithm, and experimental results show that the proposed approach can accurately segment the lungs even in the presence of disease patterns, with some limitations in the apices and bases of lungs. The algorithm demonstrates a high segmentation accuracy (dice similarity coefficient = 98.62 and shape differentiation metrics dmean = 1.39 mm, and drms = 2.76 mm). Therefore, the developed automated lung segmentation algorithm is a good candidate for the first stage of a computer-aided diagnosis system for diffuse lung diseases. PMID:26961983

  13. CT detection of facial canal dehiscence and semicircular canal fistula: Comparison with surgical findings

    SciTech Connect

    Fuse, Takeo; Tada, Yuichiro; Aoyagi, Masaru; Sugai, Yukio

    1996-03-01

    The purpose of this study was to determine the accuracy of high resolution CT (HRCT) in the detection of facial canal dehiscence and semicircular canal fistula, the preoperative evaluation of both of which is clinically very important for ear surgery. We retrospectively reviewed the HRCT findings in 61 patients who underwent mastoidectomy at Yamagata University between 1989 and 1993. The HRCT images were obtained in the axial and semicoronal planes using 1 mm slice thickness and 1 mm intersection gap. In 46 (75%) of the 61 patients, the HRCT image-based assessment of the facial canal dehiscence coincided with the surgical findings. The data for the facial canal revealed sensitivity of 66% and specificity of 84%. For semicircular canal fistula. in 59 (97%) of the 61 patients, the HRCT image-based assessment and the surgical findings coincided. The image-based assessment in the remaining two patients, who both had massive cholesteatoma, was false-positive. HRCT is useful in the diagnosis of facial canal dehiscence and labyrinthine fistula, but its limitations should also be recognized. 12 refs., 3 figs., 6 tabs.

  14. Alternate retrieval technology demonstrations program - test report (ARD Environmental, Inc.)

    SciTech Connect

    Berglin, E.J.

    1997-07-31

    A prototype vehicle, control system, and waste and water scavenging system were designed and fabricated with essentially the full capabilities of the vehicle system proposed by ARD Environmental. A test tank mockup, including riser and decontamination chamber were designed and fabricated, and approximately 830 cubic feet of six varieties of waste simulants poured. The tests were performed by ARD Environmental personnel at its site in Laurel, Maryland, from 4/22/97 through 5/2/97. The capabilities tested were deployment and retrieval, extended mobility and productivity, the ability to operate the system using video viewing only, retrieval after simulated failure, and retrieval and decontamination. Testing commenced with deployment of the vehicle into the tank. Deployment was accomplished using a crane and auxiliary winch to position the vehicle and lower it through the decontamination chamber, into the 36`` diameter x 6` high riser, and touch down on the waste field in the tank. The initial mobility tests were conducted immediately after deployment, prior to sluicing, as the waste field exhibited the greatest amount of variation at this time. This test demonstrated the ability of the vehicle to maneuver over the simulated waste field, and the ability of the operator to work with only video viewing available. In addition, the ability of the vehicle to right itself after being turned on its side was demonstrated. The production rate was evaluated daily through the testing period by measuring the surface and estimating the amount of material removed. The test demonstrated the ability of the vehicle to reduce the waste surface using 400 psi (nominal) water jets, scavenge water and material from the work area, and move to any location, even in the relatively confined space of the 20` diameter test tank. In addition, the ability to sluice to a remote scavenging module was demonstrated. The failure mode test demonstrated the ability to retrieve a stuck vehicle by pulling

  15. Treatment of porcine Pseudomonas ARDS with combination drug therapy.

    PubMed

    Sielaff, T D; Sugerman, H J; Tatum, J L; Kellum, J M; Blocher, C R

    1987-12-01

    A combination drug therapy (Poly-5: ibuprofen 12.5 mg/kg, methylprednisolone 30 mg/kg, cimetidine 150 mg, diphenhydramine 10 mg/kg, and ketanserin 0.2 mg/kg) given at 20 and 120 minutes after starting continuous intravenous Pseudomonas (Ps, 5 X 10(8) CFU/20 kg/min) was studied in three groups of swine: saline control (C, n = 9), Ps alone (Ps, n = 8), and Ps plus Poly-5 (n = 5). PaO2, systemic (SAP) and pulmonary arterial (PAP) pressures, cardiac index (CI), thermal-cardiogreen extravascular lung water (EVLW), pulmonary albumin flux (slope index, SI), and arterial blood serotonin levels (5-HT) were measured. Ps produced significant (p less than 0.05) increases in PAP, EVLW, and SI with decreases in PaO2, CI, and SAP. 5-HT fell significantly compared to baseline. Poly-5 prevented (p less than 0.05) the rise in EVLW and SI and the fall in PaO2 and CI compared to Ps. PAP and SI were maintained at C until 90 and 150 minutes, respectively. SAP fell significantly from C at 30, 60, and 180 minutes. 5-HT was significantly lower than Ps throughout, and significantly lower than baseline at 180 minutes. Combined blockade of arachidonic acid metabolites, histamine, and serotonin receptors prevented hypoxemia, increased pulmonary capillary permeability, and cardiovascular deterioration in this porcine septic ARDS model. PMID:3694722

  16. Should PEEP Titration Be Based on Chest Mechanics in Patients With ARDS?

    PubMed

    Kallet, Richard H

    2016-06-01

    Functional residual capacity (FRC) is essentially the alveolar volume and a determinant of both oxygenation and respiratory system compliance (CRS). ARDS decreases FRC, and sufficient PEEP restores FRC; thus, assessments of PEEP by its impact on oxygenation and CRS are intimately linked. PEEP also can ameliorate or aggravate ventilator-induced lung injury. Therefore, it can be argued that PEEP should be titrated primarily by its impact on CRS The pro position argues that the heterogeneous nature of lung injury and its unique presentation in individual patients results in an uncoupling between oxygenation and CRS Therefore, relying upon oxygenation alone may enhance lung injury and mortality risk, particularly in those with severe ARDS. The con argument is that the preponderance of preclinical and clinical evidence suggests that a relatively narrow range of PEEP is required to manage all but the most severe cases of ARDS. In addition, pathological alterations in chest wall compliance confuse the interpretation of chest mechanics. Moreover, ambiguities and technical limitations in advanced techniques, such as esophageal manometry and pressure-volume curves, add a layer of complexity that renders its broader application in all ARDS patients both impractical and unnecessary. Whether sophisticated monitoring of chest mechanics in severe ARDS might improve outcomes further is open to question and should be studied further. However, it is highly improbable that we will ever discover a PEEP strategy that optimizes all aspects of cardiorespiratory function and chest mechanics for individual patients suffering from ARDS. PMID:27235320

  17. Prescribing Patterns of Drugs in Acute Respiratory Distress Syndrome (ARDS): An Observational Study

    PubMed Central

    Rao, Shobitha; Chogtu, Bharti

    2015-01-01

    Introduction: Acute respiratory distress syndrome (ARDS) is characterized by acute respiratory failure and is associated with wide range of clinical disorders. Controversy prevails over the pharmacological intervention in this disease. The aim of the study was to observe the prescribing pattern of drugs in patients with ARDS managed at a tertiary care hospital. Materials and Methods: This observational study was conducted at tertiary care hospital in India. Data of patients admitted from January 2010 to December 2012 was collected. Patients aged more than 18 years admitted in ICU, who were diagnosed to have ARDS during the study period, were included. A total of 150 patients of ARDS were selected. Data was collected as per the pre designed proforma and it included patients’ age, gender, clinical disorders precipitating ARDS, prescribing pattern of drugs and outcome. The data of the subjects was collected till discharge from hospital or death. Results: Infection was the cause of ARDS in 81.3% (n=122) of subjects. Antibiotics were prescribed in all the subjects and beta-lactams were prescribed in 97.3% (n=146). 41.3% (n=62) were prescribed corticosteroids, 39.3% (n=59) diuretics and 89.3% (n=134) intravenous fluids. Conclusion: The outcome of patients on different pharmacological treatment did not show any statistically significant difference. PMID:25859465

  18. Changes in lung composition and regional perfusion and tissue distribution in patients with ARDS

    PubMed Central

    Dakin, Jonathan; Jones, Andrew T; Hansell, David M; Hoffman, Eric A; Evans, Timothy W

    2011-01-01

    Background & objective ARDS is characterised by bilateral pulmonary infiltrates and refractory hypoxemia attributed to V/Q mismatch. We used dynamic CT to characterise changes in lung composition, regional perfusion and tissue distribution in patients with ARDS in comparison to healthy subjects. Methods The Fick principle was applied to serial attenuation measurements constructed from sequential CT images acquired during the passage of a bolus of iodinated contrast medium in healthy subjects (n=3) and patients with ARDS (n=11). Perfusion was calculated by the Mullani-Gould method and mapped throughout both lungs. Gradients of perfusion and tissue density against vertical height were constructed. Results In comparison to normal individuals, the tissue component of lungs from patients with ARDS was significantly increased (p<0.05). Blood fraction was unchanged. There was a discernable gradient in tissue density from non dependent to dependent regions in the patients with ARDS that was significantly different from controls. The proportion of perfusion applied to consolidated areas (ie shunt) correlated significantly (p<0.05) with the severity of hypoxaemia. Conclusions In patients with ARDS there are changes in both lung composition and the distribution of tissue and perfusion that may account in part for the physiological changes that define the syndrome. PMID:21883676

  19. Early airway pressure release ventilation prevents ARDS-a novel preventive approach to lung injury.

    PubMed

    Roy, Shreyas; Habashi, Nader; Sadowitz, Benjamin; Andrews, Penny; Ge, Lin; Wang, Guirong; Roy, Preyas; Ghosh, Auyon; Kuhn, Michael; Satalin, Joshua; Gatto, Louis A; Lin, Xin; Dean, David A; Vodovotz, Yoram; Nieman, Gary

    2013-01-01

    Acute respiratory distress syndrome (ARDS) afflicts 200,000 patients annually with a mortality rate of 30% to 60% despite wide use of low tidal volume (LTV) ventilation, the present standard of care. High-permeability alveolar edema and instability occur early in the development of ARDS, before clinical signs of lung injury, and represent potential targets for therapy. We hypothesize that early application of a protective ventilation strategy (airway pressure release ventilation [APRV]) will stabilize alveoli and reduce alveolar edema, preventing the development of ARDS. Yorkshire pigs (30-40 kg) were anesthetized and subjected to two-hit injury: (a) intestinal ischemia-reperfusion, (b) peritoneal sepsis, or sham surgery. Following surgery, pigs were randomized into APRV (n = 4), according to current published guidelines for APRV; LTV ventilation (n = 3), using the current published ARDS Network guidelines (6 mL/kg); or sham (n = 5). The clinical care of all pigs was administered per the Surviving Sepsis Campaign guidelines. Animals were killed, and necropsy performed at 48 h. Arterial blood gases were measured to assess for the development of clinical lung injury. Lung tissue epithelial cadherin (E-cadherin) was measured to assess alveolar permeability. Bronchoalveolar lavage fluid (BALF) surfactant protein A was measured to assess alveolar stability. Lung edema content and histopathology were analyzed at 48 h. Airway pressure release ventilation pigs did not develop ARDS. In contrast, pigs in the LTV ventilation met ARDS criteria (PaO2/FIO2 ratio) (APRV: baseline = 471 ± 16; 48 h = 392 ± 8; vs. LTV ventilation: baseline = 551 ± 28; 48 h = 138 ± 88; P < 0.001). Airway pressure release ventilation preserved alveolar epithelial integrity demonstrated by higher levels of E-cadherin in lung tissue as compared with LTV ventilation (P < 0.05). Surfactant protein A levels were higher in BALF from the APRV group, suggesting APRV preserved alveolar stability

  20. SNAKES manipulator and ARD sluicer testing -- April 1997

    SciTech Connect

    Berglin, E.J.

    1997-05-29

    Long reach arms represent one of the options available for deployment of end effectors which can be used in the retrieval of radioactive waste, from the Hanford single shell tanks. The versatility of an arm based deployment system is such that it has the potential to improve the performance of a wide range of end effectors compared with stand-alone or other deployment methods. The long term reliability and availability of the deployment system is central to the timely completion of a waste retrieval program. However, concerns have been expressed over the dynamic performance of long reach arms and it is essential that an arm based system can cope with operational dynamic loads generated by end effectors. The test program conducted set out to measure static and dynamic loads and responses from a representative arm and sluicer, with the objective of extrapolating the data to a long reach arm system, that can be used for in-tank waste retrieval. As an arm with an appropriate reach was not available, the test program was undertaken to measure dynamic characteristics of a Magnox Electric 18 ft multi-link, hydraulically actuated SNAKES manipulator. This is the longest reach unit in service, albeit only one third of the 50 ft length required for in-tank waste retrieval. In addition operational performance and loading measurements were obtained from a low pressure confined system sluicer under development by ARD Environmental, to add to the end effector data base. When subject to impulse loading, the arm was found to behave in a repeatable manner having fundamental natural frequencies in the vertical and transverse directions of 1 Hz. There were also a large number of higher natural frequencies measured up to 100 Hz.

  1. Predominant diffuse ground glass opacity in both lung fields: A case of sarcoidosis with atypical CT findings

    PubMed Central

    Ma, Chunmei; Zhao, Yadong; Wu, Taihua

    2016-01-01

    Sarcoidosis can cause fatal diffuse lung fibrosis in the end stage, so its early diagnosis and treatment can prevent the progression of fibrosis. Predominant ground glass opacity on high-resolution CT (HRCT) scans is a rare presentation of sarcoidosis. We report the case of a patient who presented with very few symptoms and signs of sarcoidosis; HRCT revealed large-scale ground glass opacity and minor lymphadenopathy. Bronchoalveolar lavage fluid contained turbid liquid. Sarcoidosis could be confirmed only based on pathological examination of the resected tissue. The patient was administrated prednisone at 40 mg/d orally with tapering of the dose. Lung HRCT scans taken 6 months after the prednisone treatment showed ablation of the ground glass opacity. This case report sheds light on an atypical HRCT presentation of sarcoidosis; the findings here will be useful for the early diagnosis of sarcoidosis and prevention of fatal complications.

  2. [SIRS and ARDS as a result of drug injection in the shoulder region].

    PubMed

    Konkel, T; Schaberg, T; Dölle, H; Schulte, M

    2008-06-01

    Bacterial infections with local inflammation or hematogenous spreading may occur after joint punctures and intra- or periarticular injections. The risk of severe infections increases in patients with diseases accompanied by low immunity, e.g., gout, alcoholism, rheumatoid arthritis, and diabetes mellitus. Cases of septic omarthritis after intra-articular injection with fatal outcome after delayed onset of therapy are known. In our clinic we treated a female patient who previously received an injection in the shoulder region in a different facility. On admission she was suffering from an abscess of the surrounding soft tissues, systemic inflammatory response syndrome (SIRS), and adult respiratory distress syndrome (ARDS). Because the clinical picture was recognized early, we were able to prevent severe progression with organ failure. Another female patient developed a postinjection bacterial acromioclavicular arthritis followed by septic inflammatory response syndrome (SIRS) and eventually multiple organ failure (MOF). With inconspicuous clinical findings in the initial shoulder examination the bacterial arthritis was detected as the cause of sepsis only after intensive investigations. PMID:18043902

  3. Relationship between elevated soluble CD74 and severity of experimental and clinical ALI/ARDS

    PubMed Central

    Wu, Guosheng; Sun, Yu; Wang, Kang’an; Chen, Zhengli; Wang, Xingtong; Chang, Fei; Li, Ting; Feng, Ping; Xia, Zhaofan

    2016-01-01

    CD74 is expressed on the cell surface of pulmonary macrophages and contributes to macrophage migration inhibitory factor (MIF)-induced inflammatory response in acute lung injury (ALI). A circulating form of CD74 (soluble CD74, sCD74) was recently discovered in autoimmune liver disease. Using two murine ALI models and cells culture, we examined the presence of sCD74 in circulation and alveolar space and preliminarily assessed the biological function of sCD74. The concentrations of sCD74 were increased in serum and bronchoalveolar lavage fluids (BALF) of murine ALI models. The elevated levels of sCD74 in BALF positively correlated with lung permeability and inflammation. In addition, sCD74 is secreted by macrophages in response to MIF stimulation and itself can stimulate the production of inflammatory cytokines. Our clinical study confirmed some findings of basic research. Moreover, we also found Day 3 serum sCD74 levels were associated with worse clinical outcomes. In conclusion, higher serum sCD74 levels may reflect more severe lung injury and may be used to help physicians determine prognosis of acute respiratory distress syndrome (ARDS). PMID:27444250

  4. Upright position mechanical ventilation: an alternative strategy for ALI/ARDS patients?

    PubMed

    Zhu, Min; Zhang, Wei; Wang, Jia-Ning; Yan, Hua; Li, Yang-Kai; Ai, Bo; Fu, Sheng-Lin; Fu, Xiang-Ning

    2009-11-01

    Use of body positioning to improve oxygenation in mechanically ventilated patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) has been well documented. However, neither prone position ventilation nor side lying ventilation has been reported to improve the survival. Whether there is a body position superior to routine supine position or other positions as therapeutic adjunct for ventilated patients with ALI and ARDS? We propose the hypothesis that upright position ventilation may be helpful to improve oxygenation and benefit patients with ALI/ARDS. According to the existing physiologic and pathophysiologic data of upright position investigation, we suppose that improvement of V/Q matching, increased functional residual capacity, alveolar recruitment, accelerated diaphragm recovery, early gastric emptying and enteric feeding may be a potential protect mechanism of upright position ventilation. Whether this can be translated into improvement in patient outcome should be further tested in clinical trial. PMID:19683402

  5. Survival Predictors for Severe ARDS Patients Treated with Extracorporeal Membrane Oxygenation: A Retrospective Study in China

    PubMed Central

    Liu, Xiaoqing; Xu, Yonghao; Zhang, Rong; Huang, Yongbo; He, Weiqun; Sang, Ling; Chen, Sibei; Nong, Lingbo; Li, Xi; Mao, Pu

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) is increasingly being applied as life support for acute respiratory distress syndrome (ARDS) patients. However, the outcomes of this procedure have not yet been characterized in severe ARDS patients. The aim of this study was to evaluate the outcomes of severe ARDS patients supported with ECMO and to identify potential predictors of mortality in these patients. A total of 38 severe ARDS patients (aged 51.39±13.27 years, 32 males) who were treated with ECMO in the specialized medical intensive care unit of Guangzhou Institute of Respiratory Diseases from July 2009 to December 2014 were retrospectively reviewed. The clinical data of the patients on the day before ECMO initiation, on the first day of ECMO treatment and on the day of ECMO removal were collected and analyzed. All patients were treated with veno-venous ECMO after a median mechanical ventilation duration of 6.4±7.6 days. Among the 20 patients (52.6%) who were successfully weaned from ECMO, 16 patients (42.1%) survived to hospital discharge. Of the identified pre-ECMO factors, advanced age, a long duration of ventilation before ECMO, a higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score, underlying lung disease, and pulmonary barotrauma prior to ECMO were associated with unsuccessful weaning from ECMO. Furthermore, multiple logistic regression analysis indicated that both barotrauma pre-ECMO and underlying lung disease were independent predictors of hospital mortality. In conclusion, for severe ARDS patients treated with ECMO, barotrauma prior to ECMO and underlying lung disease may be major predictors of ARDS prognosis based on multivariate analysis. PMID:27336170

  6. The Effect of Omega-3 Fatty Acids on ARDS: A Randomized Double-Blind Study

    PubMed Central

    Parish, Masoud; Valiyi, Farnaz; Hamishehkar, Hadi; Sanaie, Sarvin; Asghari Jafarabadi, Mohammad; Golzari, Samad EJ; Mahmoodpoor, Ata

    2014-01-01

    Purpose: The aim of this study was to evaluate the effect of an enteral nutrition diet, enriched with omega-3 fatty acids because of its anti-inflammatory effects on treatment of patients with mild to moderate ARDS. Methods: This randomized clinical trial was performed in two ICUs of Tabriz University of Medical Sciences from Jun 2011 until Sep 2013 in north west of Iran. Fifty-eight patients with mild to moderate ARDS were enroled in this clinical trial. All patients received standard treatment for ARDS based on ARDS network trial. In intervention group, patients received 6 soft-gels of omega-3/day in addition to the standard treatment. Results: Tidal volume, PEEP, pH, PaO2/FiO2 , SaO2, P platue and PaCO2 on the 7th and 14th days didn’t have significant difference between two groups. Indices of lung mechanics (Resistance, Compliance) had significant difference between the groups on the 14th day. Pao2 had significant difference between two groups on both 7th and 14th days. Trend of PaO2 changes during the study period in two groups were significant. We showed that adjusted mortality rate did not have significant difference between two groups. Conclusion: It seems that adding omega-3 fatty acids to enteral diet of patients with ARDS has positive results in term of ventilator free days, oxygenation, lung mechanic indices; however, we need more multi center trials with large sample size and different doses of omega-3 fatty acids for their routine usage as an adjuant for ARDS treatment. PMID:25671189

  7. Endogenous and Exogenous Cell-Based Pathways for Recovery from ARDS

    PubMed Central

    Gotts, Jeffrey E.; Matthay, Michael A.

    2014-01-01

    Synopsis Regenerative medicine has entered a rapid phase of discovery, and much has been learned in recent years about the lung’s response to injury. In this review, we first summarize the cellular and molecular mechanisms that damage the alveolar-capillary barrier, producing ARDS. We then turn our attention to the latest understanding of endogenous repair processes, highlighting the diversity of lung epithelial progenitor cell populations and their regulation in health and disease. Finally, we review the past, present and future of exogenous cell-based therapies for ARDS. PMID:25453426

  8. Structured multidisciplinary discussion of HRCT scans for IPF/UIP diagnosis may result in indefinite outcomes.

    PubMed

    Pezzuto, Gabriella; Claroni, Giulia; Puxeddu, Ermanno; Fusco, Armando; Cavalli, Francesco; Altobelli, Simone; Portalone, Silvia; Zompatori, Maurizio; Simonetti, Giovanni; Saltini, Cesare; Sergiacomi, Gianluigi

    2015-01-01

    Recent ATS/ERS/JRS/ALAT guidelines for the diagnosis and management of Idiopathic Pulmonary Fibrosis (IPF) have defined key features and specific high-resolution computerized tomography (HRCT) patterns for the diagnosis of UIP. The aim is the sorting of patients with suspected IPF into three subgroups, confident, possible or inconsistent with UIP patterns, after a multidisciplinary discussion (MDD). Specialists in respiratory diseases, radiologists and pathologists should reach IPF diagnosis based on either patients' clinical, radiological and laboratory data, either submitting patients to surgical biopsy. After ATS/ERS/JRS/ALAT recommendations have been applied, it has been identified a subgroup of patients showing uniform apical-basal distribution of honeycombing and reticular abnormalities that could not be categorized as confident, or possible nor inconsistent with UIP. These patients were subsequently diagnosed with IPF after MDD and lung biopsy. Inclusion of this pattern in the recommendation for IPF diagnosis would be worth considering. PMID:26237353

  9. Quantitative consensus of supervised learners for diffuse lung parenchymal HRCT patterns

    NASA Astrophysics Data System (ADS)

    Raghunath, Sushravya; Rajagopalan, Srinivasan; Karwoski, Ronald A.; Bartholmai, Brian J.; Robb, Richard A.

    2013-03-01

    Automated lung parenchymal classification usually relies on supervised learning of expert chosen regions representative of the visually differentiable HRCT patterns specific to different pathologies (eg. emphysema, ground glass, honey combing, reticular and normal). Considering the elusiveness of a single most discriminating similarity measure, a plurality of weak learners can be combined to improve the machine learnability. Though a number of quantitative combination strategies exist, their efficacy is data and domain dependent. In this paper, we investigate multiple (N=12) quantitative consensus approaches to combine the clusters obtained with multiple (n=33) probability density-based similarity measures. Our study shows that hypergraph based meta-clustering and probabilistic clustering provides optimal expert-metric agreement.

  10. Prone positioning improves survival in severe ARDS: a pathophysiologic review and individual patient meta-analysis.

    PubMed

    Gattinoni, L; Carlesso, E; Taccone, P; Polli, F; Guérin, C; Mancebo, J

    2010-06-01

    Prone positioning has been used for over 30 years in the management of patients with acute respiratory distress syndrome (ARDS). This maneuver has consistently proven capable of improving oxygenation in patients with acute respiratory failure. Several mechanisms can explain this observation, including possible intervening net recruitment and more homogeneously distributed alveolar inflation. It is also progressively becoming clear that prone positioning may reduce the nonphysiological stress and strain associated with mechanical ventilation, thus decreasing the risk of ventilator-induced lung injury, which is known to adversely impact patient survival. The available randomized clinical trials, however, have failed to demonstrate that prone positioning improves the outcomes of patients with ARDS overall. In contrast, the individual patient meta-analysis of the four major clinical trials available clearly shows that with prone positioning, the absolute mortality of severely hypoxemic ARDS patients may be reduced by approximately 10%. On the other hand, all data suggest that long-term prone positioning may expose patients with less severe ARDS to unnecessary complications. PMID:20473258

  11. Ventilator-Induced Lung Injury (VILI) in Acute Respiratory Distress Syndrome (ARDS): Volutrauma and Molecular Effects

    PubMed Central

    Carrasco Loza, R; Villamizar Rodríguez, G; Medel Fernández, N

    2015-01-01

    Acute Respiratory Distress Syndrome (ARDS) is a clinical condition secondary to a variety of insults leading to a severe acute respiratory failure and high mortality in critically ill patients. Patients with ARDS generally require mechanical ventilation, which is another important factor that may increase the ALI (acute lung injury) by a series of pathophysiological mechanisms, whose common element is the initial volutrauma in the alveolar units, and forming part of an entity known clinically as ventilator-induced lung injury (VILI). Injured lungs can be partially protected by optimal settings and ventilation modes, using low tidal volume (VT) values and high positive-end expiratory pressure (PEEP). The benefits in ARDS outcomes caused by these interventions have been confirmed by several prospective randomized controlled trials (RCTs) and are attributed to reduction in volutrauma. The purpose of this article is to present an approach to VILI pathophysiology focused on the effects of volutrauma that lead to lung injury and the ‘mechanotransduction’ mechanism. A more complete understanding about the molecular effects that physical forces could have, is essential for a better assessment of existing strategies as well as the development of new therapeutic strategies to reduce the damage resulting from VILI, and thereby contribute to reducing mortality in ARDS. PMID:26312103

  12. Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS

    PubMed Central

    Raymondos, Konstantinos; Ahrens, Jörg; Molitoris, Ulrich

    2015-01-01

    Objective. Tracheal intubation and positive-pressure ventilation as the current standard of care for the adult respiratory distress syndrome (ARDS) seem to have reached their limit in terms of a further relevant reduction of the still very high mortality. Case Presentation. A 75-year-old male patient developed ARDS after abscess drainage with deteriorating oxygenation, despite positive end-expiratory pressure (PEEP) values above 15 cm H2O. We applied external negative-pressure ventilation with a chamber respirator using −33 cm H2O at inspiration and −15 cm H2O at expiration, combined with conventional pressure support using a PEEP of about 8 cm H2O and a pressure support of 4–12 cm H2O. Alveolar infiltrates disappeared rapidly and PaO2/FiO2 values surpassed 300 mmHg after the first application and 500 mmHg after the second. Negative-pressure ventilation was used for 6–18 hours/day over five days. Now, 13 years later, the patient is still alive and has a good quality of life. Conclusion. Using this or similar concepts, not only in intubated patients but also as a noninvasive approach in patients with ARDS, offers new options that may genuinely differ from the present therapeutic approaches and may, therefore, have the potential to decrease the present high mortality from ARDS. PMID:26290758

  13. Prolonged Glucocorticoid Treatment in ARDS: Impact on Intensive Care Unit-Acquired Weakness

    PubMed Central

    Meduri, Gianfranco Umberto; Schwingshackl, Andreas; Hermans, Greet

    2016-01-01

    Systemic inflammation and duration of immobilization are strong independent risk factors for the development of intensive care unit-acquired weakness (ICUAW). Activation of the pro-inflammatory transcription factor nuclear factor-κB (NF-κB) results in muscle wasting during disuse-induced skeletal muscle atrophy (ICU bed rest) and septic shock. In addition, NF-κB-mediated signaling plays a significant role in mechanical ventilation-induced diaphragmatic atrophy and contractile dysfunction. Older trials investigating high dose glucocorticoid treatment reported a lack of a sustained anti-inflammatory effects and an association with ICUAW. However, prolonged low-to-moderate dose glucocorticoid treatment of sepsis and ARDS is associated with a reduction in NF-κB DNA-binding, decreased transcription of inflammatory cytokines, enhanced resolution of systemic and pulmonary inflammation, leading to fewer days of mechanical ventilation, and lower mortality. Importantly, meta-analyses of a large number of randomized controlled trials investigating low-to-moderate glucocorticoid treatment in severe sepsis and ARDS found no increase in ICUAW. Furthermore, while the ARDS network trial investigating methylprednisolone treatment in persistent ARDS is frequently cited to support an association with ICUAW, a reanalysis of the data showed a similar incidence with the control group. Our review concludes that in patients with sepsis and ARDS, any potential direct harmful neuromuscular effect of glucocorticoids appears outweighed by the overall clinical improvement and reduced duration of organ failure, in particular ventilator dependency and associated immobilization, which are key risk factors for ICUAW. PMID:27532030

  14. Acireductone Dioxygenase 1 (ARD1) Is an Effector of the Heterotrimeric G Protein β Subunit in Arabidopsis*

    PubMed Central

    Friedman, Erin J.; Wang, Helen X.; Jiang, Kun; Perovic, Iva; Deshpande, Aditi; Pochapsky, Thomas C.; Temple, Brenda R. S.; Hicks, Stephanie N.; Harden, T. Kendall; Jones, Alan M.

    2011-01-01

    Heterotrimeric G protein complexes are conserved from plants to mammals, but the complexity of each system varies. Arabidopsis thaliana contains one Gα, one Gβ (AGB1), and at least three Gγ subunits, allowing it to form three versions of the heterotrimer. This plant model is ideal for genetic studies because mammalian systems contain hundreds of unique heterotrimers. The activation of these complexes promotes interactions between both the Gα subunit and the Gβγ dimer with enzymes and scaffolds to propagate signaling to the cytoplasm. However, although effectors of Gα and Gβ are known in mammals, no Gβ effectors were previously known in plants. Toward identifying AGB1 effectors, we genetically screened for dominant mutations that suppress Gβ-null mutant (agb1-2) phenotypes. We found that overexpression of acireductone dioxygenase 1 (ARD1) suppresses the 2-day-old etiolated phenotype of agb1-2. ARD1 is homologous to prokaryotic and eukaryotic ARD proteins; one function of ARDs is to operate in the methionine salvage pathway. We show here that ARD1 is an active metalloenzyme, and AGB1 and ARD1 both control embryonic hypocotyl length by modulating cell division; they also may contribute to the production of ethylene, a product of the methionine salvage pathway. ARD1 physically interacts with AGB1, and ARD enzymatic activity is stimulated by AGB1 in vitro. The binding interface on AGB1 was deduced using a comparative evolutionary approach and tested using recombinant AGB1 mutants. A possible mechanism for AGB1 activation of ARD1 activity was tested using directed mutations in a loop near the substrate-binding site. PMID:21712381

  15. A study on the prediction of ARD generation in the hydrothermal alteration zone, in Korea

    NASA Astrophysics Data System (ADS)

    Yim, G.; Cheong, Y.; Ji, S.; Park, S.

    2006-05-01

    The aim of this study was to predict acid rock drainage (ARD) generation in the hydrothermal alteration zone in the vicinity of the Busan, Korea. Recently serious water quality problems have been happening at the large- scale construction areas including the hydrothermal alteration zone. Therefore, it is important to predict the ARD vulnerability for sustainable development. To decrease the potential hazard due to the ARD in the proposed development areas, it is necessary to secure the database for the ARD in the potential vulnerable areas and to develop the most suitable ARD reduction technologies. The eighty-three samples were collected based on the grid net which was divided at a regular interval on the geological map to minimize spatial bias in the sampling process. The mineralogical analysis for the study area revealed that pyrite was present in the several areas of pyrophylite mineralization and andesite. Then samples were treated by static test such as Acid Base Accounting (ABA) and etc. pH1:2 and EC1:2 ranged from 2.27 to 7.9 and 1.89 to 648 ¥ìS/cm, respectively. The Maximum Potential Acidity (MPA) of samples ranged from 0.0009 to 71.298 kg H2SO4/t. Through the plot result of NAPP versus NAGpH, rock samples could be classified into two categories; Potential Acid Forming (PAF) rock and Non-Acid Forming (NAF) rock. Seven samples (eight percent of those tested) were classified as the PAF. Samples of rocks with high Sulfur content display the Net Acid Generation (NAGpH) values below 4.5. Results of the ABA tests indicated that the MPA value reached up to 71.30kg H2SO4/t and maximum Acid Neutralising Capacity (ANC) was 106.4kg H2SO4/t. The plot result of total Sulfur content and the ANC data, collected at the residential area, showed the possibility of the ARD occurrence in this area. The results of this study are expected to provide a fundamental and useful database to the future researches and actions related to the preservation of water quality and the

  16. [Silicosis: computed tomography findings].

    PubMed

    González Vázquez, M; Trinidad López, C; Castellón Plaza, D; Calatayud Moscoso Del Prado, J; Tardáguila Montero, F

    2013-01-01

    Silicosis is an occupational lung disease, which is caused by the inhalation of silica and affects a wide range of jobs. There are many clinical forms of silicosis: acute silicosis, results from exposure to very large amounts of silica dust over a period of less than 2 years. Simple chronic silicosis, the most common type that we see today, results from exposure to low amounts of silica between 2 and 10 years. Chronic silicosis complicated, with silicotic conglomerates. In many cases the diagnosis of silicosis is made according to epidemiological and radiological data, without a histological confirmation. It is important to know the various radiological manifestations of silicosis to differentiate it from other lung diseases and to recognize their complications. The objective of this work is to describe typical and atypical radiological findings of silicosis and their complications in helical and high resolution (HRCT) thorax CT. PMID:22884889

  17. Performance comparison of classifiers for differentiation among obstructive lung diseases based on features of texture analysis at HRCT

    NASA Astrophysics Data System (ADS)

    Lee, Youngjoo; Seo, Joon Beom; Kang, Bokyoung; Kim, Dongil; Lee, June Goo; Kim, Song Soo; Kim, Namkug; Kang, Suk Ho

    2007-03-01

    The performance of classification algorithms for differentiating among obstructive lung diseases based on features from texture analysis using HRCT (High Resolution Computerized Tomography) images was compared. HRCT can provide accurate information for the detection of various obstructive lung diseases, including centrilobular emphysema, panlobular emphysema and bronchiolitis obliterans. Features on HRCT images can be subtle, however, particularly in the early stages of disease, and image-based diagnosis is subject to inter-observer variation. To automate the diagnosis and improve the accuracy, we compared three types of automated classification systems, naÃve Bayesian classifier, ANN (Artificial Neural Net) and SVM (Support Vector Machine), based on their ability to differentiate among normal lung and three types of obstructive lung diseases. To assess the performance and cross-validation of these three classifiers, 5 folding methods with 5 randomly chosen groups were used. For a more robust result, each validation was repeated 100 times. SVM showed the best performance, with 86.5% overall sensitivity, significantly different from the other classifiers (one way ANOVA, p<0.01). We address the characteristics of each classifier affecting performance and the issue of which classifier is the most suitable for clinical applications, and propose an appropriate method to choose the best classifier and determine its optimal parameters for optimal disease discrimination. These results can be applied to classifiers for differentiation of other diseases.

  18. Acute respiratory distress syndrome (ARDS) complicating influenza A/H1N1v infection--a clinical approach.

    PubMed

    Witczak, Agnieszka; Prystupa, Andrzej; Kurys-Denis, Ewa; Borys, Michał; Czuczwar, Mirosław; Niemcewicz, Marcin; Kocik, Janusz; Michalak, Anna; Pietrzak, Aldona; Chodorowska, Grażyna; Krupski, Witold; Mosiewicz, Jerzy; Tomasiewicz, Krzysztof

    2013-01-01

    ARDS is defined as an acute inflammatory syndrome characterized with bilateral parenchymal lung infiltrates on chest radiograph and PaO2/FiO2 ratio<200 resulting from causes other than acute left ventricular dysfunction. Inflammatory lung lesions may be induced by different disorders, with sepsis being the leading cause of ARDS. Other causes include infectious pneumonia, aspiration of gastric contents, drugs, severe trauma, fat embolism, surface burn, massive blood transfusion. Influenza A/H1N1 infection seems to be responsible for the development of extremely severe type of ARDS with poor response to routine treatment. Despite great progress in the management of ARDS with novel agents and sophisticated techniques, including antimicrobial drugs, extracorporeal membrane oxygenation, prostaglandins, nitric oxide, prostacyclin, exogenous surfactant administration and activated protein C, supportive treatment based mostly on advanced mechanical ventilation in the intensive care units seems to be the most important for the prognosis. PMID:24364461

  19. Should Airway Pressure Release Ventilation Be the Primary Mode in ARDS?

    PubMed

    Mireles-Cabodevila, Eduardo; Kacmarek, Robert M

    2016-06-01

    Airway pressure release ventilation (APRV) was originally described as a mode to treat lung-injured patients with the goal to maintain a level of airway pressure that would not depress the cardiac function, deliver mechanical breaths without excessive airway pressure, and to allow unrestricted spontaneous ventilation. Indeed, based on its design, APRV has technological features that serve the goals of safety and comfort. Animal studies suggest that APRV leads to alveolar stability and recruitment which result in less lung injury. These features are sought in patients at risk for lung injury or with ARDS. APRV allows unrestricted spontaneous ventilation, which is welcome in the era of less sedation and increased patient mobility (the effects in terms of lung injury remain to be explored). However, we must highlight that the performance of APRV is dependent on the operator-selected settings and the ventilator's performance. The clinician must select the appropriate settings in order to make effective the imputed benefits. This is a challenge when the ventilator's performance is not uniform, and the outcomes depend on high precision settings (very short expiratory time), where small variations can lead to undesired outcomes (de-recruitment or large tidal volumes leading to lung injury). Finally, we do not have evidence that APRV (as originally described) improves relevant clinical outcomes of patients with ARDS. For APRV to become the primary mode of ventilation for ARDS, it will require development of sound protocols and technological enhancements to ensure its performance and safety. For now, APRV does have a greater potential for adversely affecting patient outcome than improving it; unless definitive data are forthcoming demonstrating outcome benefits from the use of APRV in ARDS, there is no reason to consider this approach to ventilatory support. PMID:27235312

  20. Acute cor pulmonale in ARDS: rationale for protecting the right ventricle.

    PubMed

    Repessé, Xavier; Charron, Cyril; Vieillard-Baron, Antoine

    2015-01-01

    The ventilatory strategy for ARDS has been regularly amended over the last 40 years as knowledge of the pathophysiology of ARDS has increased. Initially focused mainly on the lung with the objectives of "opening the lung" and optimizing arterial oxygen saturation, this strategy now also takes into account pulmonary vascular injury and its effects on the right ventricle and on hemodynamics. Hemodynamic devices now available at the bedside, such as echocardiography, allow intensivists to evaluate respiratory settings according to right ventricular tolerance. Here, we review the pathophysiology of pulmonary vascular dysfunction in ARDS, consider the beneficial and deleterious effects of mechanical ventilation, describe the incidence and meaning of acute cor pulmonale based on recent studies in large series of patients, and propose a new, although not strictly validated, approach based on the protection of both the lung and right ventricle. One of our conclusions is that evaluating the right ventricle may help intensivists to assess the balance between recruitment and overdistension induced by the ventilatory strategy. Prone positioning with its beneficial effects on the lung and also on hemodynamics (the right ventricle) is a good illustration of this. Readers should be aware that most of the information given in this article reflects the point of view of the authors. Although based on clinical observations, clinical studies, and well-known pathophysiology, there is no evidence-based medicine to support this clinical commentary. Other approaches may be favored, in which case our article should be read as another attempt to help intensivists to improve management of ARDS. PMID:25560864

  1. [Pathophysiologic and therapeutic aspects of the adult respiratory distress syndrome (ARDS)].

    PubMed

    Thiel, M; Forst, H; Peter, K

    1991-02-01

    Since the first characterization of the adult respiratory distress syndrome (ARDS), knowledge of its aetiology and pathogenesis has grown considerably. In spite of this, mortality remains up to 50 to 90%, particularly if multiple organ failure is present. Because no causative clinical therapy is available up to now, significant attention is given to preventive measures like early operative stabilisation of long bone fractures, or prophylaxis of nosocomial infections. After clinical manifestation of ARDS, treatment focuses on functional disturbances of the cardiopulmonary system and on the underlying disease. The aim of this symptomatic therapy is to ensure oxygen supply according to the organisms demand. It is still unknown, however, whether the mortality of patients with ARDS can be reduced by optimising the oxygen supply. In general, oxygen supply can be enhanced by improving pulmonary gas exchange, cardiac output and blood oxygen transport capacity. For practical use the therapy often ends up with a therapeutical dilemma: On one hand, the improvement of the pulmonary gas exchange by application of PEEP can be associated with a critical decline in cardiac output, particularly if the afterload of the right ventricle is elevated. On the other hand, to increase cardiac output, both volume replacement and vasodilators can severely affect pulmonary gas exchange if the alveolo-capillary permeability is increased and pulmonary hypoxic vasoconstriction is disturbed. Thus, oxygen supply can be optimised only via invasive monitoring of the cardiorespiratory system. Although still experimental, the most promising approaches seem to be pharmacological interventions directed at suppressing the formation and effects of various humoral and cellular mediators. An improved understanding of the inflammatory processes might provide new insights in the pathophysiology of ARDS and the related therapeutic interventions. PMID:1863681

  2. ARD -- A Textual Language for Describing Regions within a Data Array

    NASA Astrophysics Data System (ADS)

    Berry, D. S.

    The ARD (ASCII Region Definition) system provides a textual language for describing regions within a data array, together with software for converting a textual description into a pixel mask, or plotting it on a graphics device. The textual language is based on a set of keywords identifying simple shapes (boxes, circles, lines, etc.). These keywords can be combined together using Boolean-style operators (AND, OR, NOT, etc.) to create more complex shapes. Data arrays can be multi-dimensional.

  3. Rationale for Prolonged Glucocorticoid Use in Pediatric ARDS: What the Adults Can Teach Us

    PubMed Central

    Schwingshackl, Andreas; Meduri, Gianfranco Umberto

    2016-01-01

    Based on molecular mechanisms and physiologic data, a strong association has been established between dysregulated systemic inflammation and progression of acute respiratory distress syndrome (ARDS). In ARDS patients, glucocorticoid receptor-mediated downregulation of systemic inflammation is essential to restore homeostasis, decrease morbidity and improve survival and can be significantly enhanced with prolonged low-to-moderate dose glucocorticoid treatment. A large body of evidence supports a strong association between prolonged glucocorticoid treatment-induced downregulation of the inflammatory response and improvement in pulmonary and extrapulmonary physiology. The balance of the available data from eight controlled trials (n = 622) provides consistent strong level of evidence for improving patient-centered outcomes and hospital survival. The sizable increase in mechanical ventilation-free days (weighted mean difference, 6.48 days; CI 95% 2.57–10.38, p < 0.0001) and intensive care unit-free days (weighted mean difference, 7.7 days; 95% CI, 3.13–12.20, p < 0.0001) by day 28 is superior to any investigated intervention in ARDS. For treatment initiated before day 14 of ARDS, the increased in hospital survival (70 vs. 52%, OR 2.41, CI 95% 1.50–3.87, p = 0.0003) translates into a number needed to treat to save one life of 5.5. Importantly, prolonged glucocorticoid treatment is not associated with increased risk for nosocomial infections (22 vs. 27%, OR 0.61, CI 95% 0.35–1.04, p = 0.07). Treatment decisions involve a tradeoff between benefits and risks, as well as costs. This low-cost, highly effective therapy is familiar to every physician and has a low risk profile when secondary prevention measures are implemented. PMID:27379217

  4. Clinical study on VATS combined mechanical ventilation treatment of ARDS secondary to severe chest trauma

    PubMed Central

    Qi, Yongjun

    2016-01-01

    The aim of the study was to investigate the clinical effects of microinvasive video-assisted thoracoscopic surgery (VATS) combined with mechanical ventilation in the treatment of acute respiratory distress syndrome (ARDS) secondary to severe chest trauma. A total of 62 patients with ARDS secondary to severe chest trauma were divided into the observation and control groups. The patients in the observation groups were treated with VATS combined with early mechanical ventilation while patients in the control group were treated using routine open thoracotomy combined with early mechanical ventilation. Compared to the controls, the survival rate of the observation group was significantly higher. The average operation time of the observation group was significantly shorter than that of the control group, and the incidence of complications in the perioperative period of the observation group was significantly lower than that of the control group (p<0.05). The average application time of the observation group was significantly shorter than that of the control group, and the incidence of ventilator-associated complications was significantly lower than that of the control group (p<0.05). In conclusion, a reasonable understanding of the indications and contraindications of VATS, combined with early mechanical treatment significantly improved the success rate of the treatment of ARDS patients secondary to severe chest trauma and reduced the complications. PMID:27446317

  5. Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers.

    PubMed

    Herridge, Margaret S; Moss, Marc; Hough, Catherine L; Hopkins, Ramona O; Rice, Todd W; Bienvenu, O Joseph; Azoulay, Elie

    2016-05-01

    Outcomes after acute respiratory distress syndrome (ARDS) are similar to those of other survivors of critical illness and largely affect the nerve, muscle, and central nervous system but also include a constellation of varied physical devastations ranging from contractures and frozen joints to tooth loss and cosmesis. Compromised quality of life is related to a spectrum of impairment of physical, social, emotional, and neurocognitive function and to a much lesser extent discrete pulmonary disability. Intensive care unit-acquired weakness (ICUAW) is ubiquitous and includes contributions from both critical illness polyneuropathy and myopathy, and recovery from these lesions may be incomplete at 5 years after ICU discharge. Cognitive impairment in ARDS survivors ranges from 70 to 100 % at hospital discharge, 46 to 80 % at 1 year, and 20 % at 5 years, and mood disorders including depression and post-traumatic stress disorder (PTSD) are also sustained and prevalent. Robust multidisciplinary and longitudinal interventions that improve these outcomes are still uncertain and data in our literature are conflicting. Studies are needed in family members of ARDS survivors to better understand long-term outcomes of the post-ICU family syndrome and to evaluate how it affects patient recovery. PMID:27025938

  6. Atomic Layer Etching of Silicon to Solve ARDE-Selectivity-Profile-Uniformity Trade-Offs

    NASA Astrophysics Data System (ADS)

    Wang, Mingmei; Ranjan, Alok; Ventzek, Peter; Koshiishi, Akira

    2014-10-01

    With shrinking critical dimensions, dry etch faces more and more challenges. Minimizing each of aspect ratio dependent etching (ARDE), bowing, undercut, selectivity, and within die uniformly across a wafer are met by trading off one requirement against another. At the root of the problem is that roles radical flux, ion flux and ion energy play may be both good and bad. Increasing one parameter helps meeting one requirement but hinders meeting the other. Self-limiting processes like atomic layer etching (ALE) promise a way to escape the problem of balancing trade-offs. ALE was realized in the mid-1990s but the industrial implementation has been slow. In recent years interest in ALE has revived. We present how ARDE, bowing/selectivity trade-offs may be overcome by varying radical/ion ratio, byproduct re-deposition. We overcome many of the practical implementation issues associated with ALE by precise passivation process control. The Monte Carlo Feature Profile Model (MCFPM) is used to illustrate realistic scenarios built around an Ar/Cl2 chemistry driven etch of Si masked by SiO2. We demonstrate that ALE can achieve zero ARDE and infinite selectivity. Profile control depends on careful management of the ion energies and angles. For ALE to be realized in production environment, tight control of IAD is a necessary. Experimental results are compared with simulation results to provide context to the work.

  7. Analysis of bronchoalveolar lavage fluid (Balf) from patients with adult respiratory distress syndrome (ARDS)

    SciTech Connect

    Henderson, R.F.; Baughman, R.P.; Waide, J.J.

    1995-12-01

    The pathogenesis of ARDS is largely unknown, but many factors are known to predispose one to ARDS: sepsis, aspiration of gastric contents, pneumonia, fracture, multiple transfusions, cardiopulmonary bypass, burn, dissemination intravascular coagulation, pulmonary contusion, near drowning, and pancreatitis. ARDS is characterized by severe hypoxemia, diffuse pulmonary infiltrates, and decreased pulmonary compliance. Current treatment methods still result in 50% mortality. Studies are underway at the University of Cincinnati to determine if treatment with a synthetic pulmonary surfactant, Exosurf{sup {reg_sign}} (contains dipalmitoyl phosphatidyl choline, Burroughs-Wellcome), improves the prognosis of these patients. BALF from these patients, before and after treatment, was analyzed to determine if the treatment resulted in an increase in disaturated phospholipids (surfactant phospholipids) in the epithelial lining fluid and if the treatments reduced the concentration of markers of inflammation and toxicity in the BALF. This study indicates that the method of administering Exosurf{sup {reg_sign}} did not lead to an increase in surfactant lipid or protein in the bronchoalveolar region of the respiratory tract.

  8. A model-based simulator for testing rule-based decision support systems for mechanical ventilation of ARDS patients.

    PubMed Central

    Sailors, R. M.; East, T. D.

    1994-01-01

    A model-based simulator was developed for testing rule-based decision support systems that manages ventilator therapy of patients with the Adult Respiratory Distress Syndrome (ARDS). The simulator is based on a multi-compartment model of the human body and mathematical models of the gas exchange abnormalities associated with ARDS. Initial testing of this system indicates that model-based simulators are a viable tool for testing rule-based expert systems used in health-care. PMID:7949849

  9. Analysis of HRCT-derived xylem network reveals reverse flow in some vessels.

    PubMed

    Lee, Eric F; Matthews, Mark A; McElrone, Andrew J; Phillips, Ronald J; Shackel, Kenneth A; Brodersen, Craig R

    2013-09-21

    Long distance water and nutrient transport in plants is dependent on the proper functioning of xylem networks, a series of interconnected pipe-like cells that are vulnerable to hydraulic dysfunction as a result of drought-induced embolism and/or xylem-dwelling pathogens. Here, flow in xylem vessels was modeled to determine the role of vessel connectivity by using three dimensional xylem networks derived from High Resolution Computed Tomography (HRCT) images of grapevine (Vitis vinifera cv. 'Chardonnay') stems. Flow in 4-27% of the vessel segments (i.e. any section of vessel elements between connection points associated with intervessel pits) was found to be oriented in the direction opposite to the bulk flow under normal transpiration conditions. In order for the flow in a segment to be in the reverse direction, specific requirements were determined for the location of connections, distribution of vessel endings, diameters of the connected vessels, and the conductivity of the connections. Increasing connectivity and decreasing vessel length yielded increasing numbers of reverse flow segments until a maximum value was reached, after which more interconnected networks and smaller average vessel lengths yielded a decrease in the number of reverse flow segments. Xylem vessel relays also encouraged the formation of reverse flow segments. Based on the calculated flow rates in the xylem network, the downward spread of Xylella fastidiosa bacteria in grape stems was modeled, and reverse flow was shown to be an additional mechanism for the movement of bacteria to the trunk of grapevine. PMID:23743143

  10. Multi-level classification of emphysema in HRCT lung images using delegated classifiers.

    PubMed

    Prasad, Mithun; Sowmya, Arcot

    2008-01-01

    Emphysema is a common chronic respiratory disorder characterized by the destruction of lung tissue. It is a progressive disease where the early stages are characterized by diffuse appearance of small air spaces and later stages exhibit large air spaces called bullae. A bullous region is a sharply demarcated region of emphysema. In this paper, we show that an automated texture-based system based on delegated classifiers is capable of achieving multiple levels of emphysema extraction in High Resolution Computed Tomography (HRCT) images. The key idea of delegation is that a cautious classifier makes predictions that meet a minimum level of confidence, and delegates the difficult or uncertain predictions to a more specialized classifier. In this paper, we design a two-step scenario where a first classifier chooses the examples to classify on and delegates the more difficult examples to a second classifier. We compare this technique to well known emphysema classification techniques and ensemble methods such as bagging and boosting. Comparison of the results shows that the techniques presented here are more accurate. From a medical standpoint, the classifiers built at different iterations appear to show an interesting correlation with different levels of emphysema. PMID:18979732

  11. Enhanced Classification of Interstitial Lung Disease Patterns in HRCT Images Using Differential Lacunarity

    PubMed Central

    Vasconcelos, Verónica; Barroso, João; Marques, Luis; Silvestre Silva, José

    2015-01-01

    The analysis and interpretation of high-resolution computed tomography (HRCT) images of the chest in the presence of interstitial lung disease (ILD) is a time-consuming task which requires experience. In this paper, a computer-aided diagnosis (CAD) scheme is proposed to assist radiologists in the differentiation of lung patterns associated with ILD and healthy lung parenchyma. Regions of interest were described by a set of texture attributes extracted using differential lacunarity (DLac) and classical methods of statistical texture analysis. The proposed strategy to compute DLac allowed a multiscale texture analysis, while maintaining sensitivity to small details. Support Vector Machines were employed to distinguish between lung patterns. Training and model selection were performed over a stratified 10-fold cross-validation (CV). Dimensional reduction was made based on stepwise regression (F-test, p value < 0.01) during CV. An accuracy of 95.8 ± 2.2% in the differentiation of normal lung pattern from ILD patterns and an overall accuracy of 94.5 ± 2.1% in a multiclass scenario revealed the potential of the proposed CAD in clinical practice. Experimental results showed that the performance of the CAD was improved by combining multiscale DLac with classical statistical texture analysis. PMID:26798638

  12. 3D cine magnetic resonance imaging of rat lung ARDS using gradient-modulated SWIFT with retrospective respiratory gating

    NASA Astrophysics Data System (ADS)

    Kobayashi, Naoharu; Lei, Jianxun; Utecht, Lynn; Garwood, Michael; Ingbar, David H.; Bhargava, Maneesh

    2015-03-01

    SWeep Imaging with Fourier Transformation (SWIFT) with gradient modulation and DC navigator retrospective gating is introduced as a 3D cine magnetic resonance imaging (MRI) method for the lung. In anesthetized normal rats, the quasi-simultaneous excitation and acquisition in SWIFT enabled extremely high sensitivity to the fast-decaying parenchymal signals (TE=~4 μs), which are invisible with conventional MRI techniques. Respiratory motion information was extracted from DC navigator signals and the SWIFT data were reconstructed to 3D cine images with 16 respiratory phases. To test this technique's capabilities, rats exposed to > 95% O2 for 60 hours for induction of acute respiratory distress syndrome (ARDS), were imaged and compared with normal rat lungs (N=7 and 5 for ARDS and normal groups, respectively). SWIFT images showed lung tissue density differences along the gravity direction. In the cine SWIFT images, a parenchymal signal drop at the inhalation phase was consistently observed for both normal and ARDS rats due to lung inflation (i.e. decrease of the proton density), but the drop was less for ARDS rats. Depending on the respiratory phase and lung region, the lungs from the ARDS rats showed 1-24% higher parenchymal signal intensities relative to the normal rat lungs, likely due to accumulated extravascular water (EVLW). Those results demonstrate that SWIFT has high enough sensitivity for detecting the lung proton density changes due to gravity, different phases of respiration and accumulation of EVLW in the rat ARDS lungs.

  13. Ex Vivo Effect of Varespladib on Secretory Phospholipase A2 Alveolar Activity in Infants with ARDS

    PubMed Central

    De Luca, Daniele; Minucci, Angelo; Piastra, Marco; Cogo, Paola E.; Vendittelli, Francesca; Marzano, Laura; Gentile, Leonarda; Giardina, Bruno; Conti, Giorgio; Capoluongo, Ettore D.

    2012-01-01

    Background Secretory phospholipase A2 (sPLA2) plays a pivotal role in acute respiratory distress syndrome (ARDS). This enzyme seems an interesting target to reduce surfactant catabolism and lung tissue inflammation. Varespladib is a specifically designed indolic sPLA2 inhibitor, which has shown promising results in animals and adults. No specific data in pediatric ARDS patients are yet available. Methods We studied varespladib in broncho-alveolar lavage (BAL) fluids obtained ex vivo from pediatric ARDS patients. Clinical data and worst gas exchange values during the ARDS course were recorded. Samples were treated with saline or 10–40–100 µM varespladib and incubated at 37°C. Total sPLA2 activity was measured by non-radioactive method. BAL samples were subjected to western blotting to identify the main sPLA isotypes with different sensitivity to varespladib. Results was corrected for lavage dilution using the serum-to-BAL urea ratio and for varespladib absorbance. Results Varespladib reduces sPLA2 activity (p<0.0001) at 10,40 and 100 µM; both sPLA2 activity reduction and its ratio to total proteins significantly raise with increasing varespladib concentrations (p<0.001). IC50 was 80 µM. Western blotting revealed the presence of sPLA2-IIA and –IB isotypes in BAL samples. Significant correlations exist between the sPLA2 activity reduction/proteins ratio and PaO2 (rho = 0.63;p<0.001), PaO2/FiO2 (rho = 0.7; p<0.001), oxygenation (rho = −0.6; p<0.001) and ventilation (rho = −0.4;p = 0.038) indexes. Conclusions Varespladib significantly inhibits sPLA2 in BAL of infants affected by post-neonatal ARDS. Inhibition seems to be inversely related to the severity of gas exchange impairment. PMID:23071714

  14. Mutations of the domain forming the dimeric interface of the ArdA protein affect dimerization and antimodification activity but not antirestriction activity

    PubMed Central

    Roberts, Gareth A; Chen, Kai; Bower, Edward K M; Madrzak, Julia; Woods, Arcadia; Barker, Amy M; Cooper, Laurie P; White, John H; Blakely, Garry W; Manfield, Iain; Dryden, David T F

    2013-01-01

    ArdA antirestriction proteins are encoded by genes present in many conjugative plasmids and transposons within bacterial genomes. Antirestriction is the ability to prevent cleavage of foreign incoming DNA by restriction-modification (RM) systems. Antimodification, the ability to inhibit modification by the RM system, can also be observed with some antirestriction proteins. As these mobile genetic elements can transfer antibiotic resistance genes, the ArdA proteins assist their spread. The consequence of antirestriction is therefore the enhanced dissemination of mobile genetic elements. ArdA proteins cause antirestriction by mimicking the DNA structure bound by Type I RM enzymes. The crystal structure of ArdA showed it to be a dimeric protein with a highly elongated curved cylindrical shape [McMahon SA et al. (2009) Nucleic Acids Res37, 4887–4897]. Each monomer has three domains covered with negatively charged side chains and a very small interface with the other monomer. We investigated the role of the domain forming the dimer interface for ArdA activity via site-directed mutagenesis. The antirestriction activity of ArdA was maintained when up to seven mutations per monomer were made or the interface was disrupted such that the protein could only exist as a monomer. The antimodification activity of ArdA was lost upon mutation of this domain. The ability of the monomeric form of ArdA to function in antirestriction suggests, first, that it can bind independently to the restriction subunit or the modification subunits of the RM enzyme, and second, that the many ArdA homologues with long amino acid extensions, present in sequence databases, may be active in antirestriction. Structured digital abstract ArdA and ArdA bind by molecular sieving (1, 2) ArdA and ArdA bind by cosedimentation in solution (1, 2) PMID:23910724

  15. Continuous distending pressure effects on variables contributing to oxygenation in healthy and ARDS model pigs during HFOV

    NASA Astrophysics Data System (ADS)

    Laviola, Marianna; Hajny, Ondrej; Roubik, Karel

    2014-10-01

    High frequency oscillatory ventilation (HFOV) is an alternative mode of mechanical ventilation. HFOV has been shown to provide adequate ventilation and oxygenation in acute respiratory distress syndrome (ARDS) patients and may represent an effective lung-protective ventilation in patients where conventional ventilation is failing. The aim of this study is to evaluate effects of continuous distending pressure (CDP) on variables that contribute to the oxygenation in healthy and ARDS lung model pigs. Methods. In order to simulate a lung disease, lung injury was induced by lavage with normal saline with detergent in three pigs. HFOV ventilation was applied before and after the lung lavage. CDP was stepwise increased by 2 cmH2O, until the maximum CDP (before the lung lavage 32 cmH2O and after the lung lavage 42 cmH2O) and then it was stepwise decreased by 2 cmH2O to the initial value. In this paper we analyzed the following parameters acquired during our experiments: partial pressure of oxygen in arterial blood (PaO2), cardiac output (CO) and mixed venous blood oxygen saturation (SvO2). In order to find how both PaO2 and CO affected SvO2 during the increase of CDP before and after lavage, a nonlinear regression fitting of the response in SvO2 on the predictors (PaO2 and CO) was implemented. Results. Before the lavage, with increasing of CDP, PaO2 remained constant, CO strongly decreased and SvO2 slightly decreased. After the lavage, with increasing of CDP, PaO2 strongly increased, CO decreased and SvO2 increased. So, development of SvO2 followed the PaO2 and CO trends. Changes in PaO2 and CO occur at decisive CDP step and it was much higher after the lung lavage compared to the healthy lungs. The implemented nonlinear model gives a good goodness of fitting in all three pigs. The values of PaO2 and CO estimated coefficients changed at the same decisive step of CDP identified by the trends. Also the algorithm identified a CDP step much higher after the lung lavage

  16. Polymyxin-B-immobilized-fiber column hemoperfusion with oseltamivir treatment for ARDS due to influenza H1N1/09

    PubMed Central

    Binh, Nguyen Gia; Manabe, Toshie; Co, Dao Xuan; Tuan, Nguyen Dang; Thach, Pham The; Kudo, Koichiro

    2015-01-01

    Acute respiratory distress syndrome (ARDS) is one of the severe complications of influenza H1N1/09 infection, resulting in high mortality. Effective treatment strategies for ARDS are needed. This report presents two cases of ARDS due to influenza in Vietnam. Both cases were similar in terms of starting symptoms, the rapid progression to ARDS, and the treatment strategy, direct hemoperfusion with a polymyxin-B-immobilized fiber column (PMX-DHP) and oseltamivir. However, the clinical course of disease and the outcomes were different. For case 1, treatment was initiated on day 4 following the onset of hypoxemia due to ARDS. Symptoms improved rapidly after treatment and the patient was discharged on day 12. For case 2, treatment was initiated on day 9 after the onset of symptoms. Despite intensive therapy, the patient died on day 18. In conclusion, treatment with PMX-DHP and oseltamivir is effective on ARDS due to influenza but only if initiated early. PMID:26090112

  17. Effect of various binning methods and ROI sizes on the accuracy of the automatic classification system for differentiation between diffuse infiltrative lung diseases on the basis of texture features at HRCT

    NASA Astrophysics Data System (ADS)

    Kim, Namkug; Seo, Joon Beom; Sung, Yu Sub; Park, Bum-Woo; Lee, Youngjoo; Park, Seong Hoon; Lee, Young Kyung; Kang, Suk-Ho

    2008-03-01

    To find optimal binning, variable binning size linear binning (LB) and non-linear binning (NLB) methods were tested. In case of small binning size (Q <= 10), NLB shows significant better accuracy than the LB. K-means NLB (Q = 26) is statistically significant better than every LB. To find optimal binning method and ROI size of the automatic classification system for differentiation between diffuse infiltrative lung diseases on the basis of textural analysis at HRCT Six-hundred circular regions of interest (ROI) with 10, 20, and 30 pixel diameter, comprising of each 100 ROIs representing six regional disease patterns (normal, NL; ground-glass opacity, GGO; reticular opacity, RO; honeycombing, HC; emphysema, EMPH; and consolidation, CONS) were marked by an experienced radiologist from HRCT images. Histogram (mean) and co-occurrence matrix (mean and SD of angular second moment, contrast, correlation, entropy, and inverse difference momentum) features were employed to test binning and ROI effects. To find optimal binning, variable binning size LB (bin size Q: 4~30, 32, 64, 128, 144, 196, 256, 384) and NLB (Q: 4~30) methods (K-means, and Fuzzy C-means clustering) were tested. For automated classification, a SVM classifier was implemented. To assess cross-validation of the system, a five-folding method was used. Each test was repeatedly performed twenty times. Overall accuracies with every combination of variable ROIs, and binning sizes were statistically compared. In case of small binning size (Q <= 10), NLB shows significant better accuracy than the LB. K-means NLB (Q = 26) is statistically significant better than every LB. In case of 30x30 ROI size and most of binning size, the K-means method showed better than other NLB and LB methods. When optimal binning and other parameters were set, overall sensitivity of the classifier was 92.85%. The sensitivity and specificity of the system for each class were as follows: NL, 95%, 97.9%; GGO, 80%, 98.9%; RO 85%, 96.9%; HC, 94

  18. Disease-specific dynamic biomarkers selected by integrating inflammatory mediators with clinical informatics in ARDS patients with severe pneumonia.

    PubMed

    Chen, Chengshui; Shi, Lin; Li, Yuping; Wang, Xiangdong; Yang, Shuanying

    2016-06-01

    Acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome that occurs as a result of various risk factors, including either direct or indirect lung injury, and systemic inflammation triggered also by severe pneumonia (SP). SP-ARDS-associated morbidity and mortality remains high also due to the lack of disease-specific biomarkers. The present study aimed at identifying disease-specific biomarkers in SP or SP-ARDS by integrating proteomic profiles of inflammatory mediators with clinical informatics. Plasma was sampled from the healthy as controls or patients with SP infected with bacteria or infection-associated SP-ARDS on the day of admission, day 3, and day 7. About 15 or 52 cytokines showed significant difference between SP and SP-ARDS patients with controls or 13 between SP-ARDS with SP alone and controls, including bone morphogenetic protein-15 (BMP-15), chemokine (C-X-C motif) ligand 16 (CXCL16), chemokine (C-X-C motif) receptor 3 (CXCR3), interleukin-6 (IL-6), protein NOV homolog (NOV/CCN3), glypican 3, insulin-like growth factor binding protein 4 (IGFBP-4), IL-5, IL-5 R alpha, IL-22 BP, leptin, MIP-1d, and orexin B with a significant correlation with Digital Evaluation Score System (DESS) scores. ARDS patients with overexpressed IL-6, CXCL16, or IGFBP-4 had significantly longer hospital stay and higher incidence of secondary infection. We also found higher levels of those mediators were associated with poor survival rates in patients with lung cancer and involved in the process of the epithelial mesenchymal transition of alveolar epithelial cells. Our preliminary study suggested that integration of proteomic profiles with clinical informatics as part of clinical bioinformatics is important to validate and optimize disease-specific and disease-staged biomarkers. PMID:27095254

  19. Detection and 3D representation of pulmonary air bubbles in HRCT volumes

    NASA Astrophysics Data System (ADS)

    Silva, Jose S.; Silva, Augusto F.; Santos, Beatriz S.; Madeira, Joaquim

    2003-05-01

    Bubble emphysema is a disease characterized by the presence of air bubbles within the lungs. With the purpose of identifying pulmonary air bubbles, two alternative methods were developed, using High Resolution Computer Tomography (HRCT) exams. The search volume is confined to the pulmonary volume through a previously developed pulmonary contour detection algorithm. The first detection method follows a slice by slice approach and uses selection criteria based on the Hounsfield levels, dimensions, shape and localization of the bubbles. Candidate regions that do not exhibit axial coherence along at least two sections are excluded. Intermediate sections are interpolated for a more realistic representation of lungs and bubbles. The second detection method, after the pulmonary volume delimitation, follows a fully 3D approach. A global threshold is applied to the entire lung volume returning candidate regions. 3D morphologic operators are used to remove spurious structures and to circumscribe the bubbles. Bubble representation is accomplished by two alternative methods. The first generates bubble surfaces based on the voxel volumes previously detected; the second method assumes that bubbles are approximately spherical. In order to obtain better 3D representations, fits super-quadrics to bubble volume. The fitting process is based on non-linear least squares optimization method, where a super-quadric is adapted to a regular grid of points defined on each bubble. All methods were applied to real and semi-synthetical data where artificial and randomly deformed bubbles were embedded in the interior of healthy lungs. Quantitative results regarding bubble geometric features are either similar to a priori known values used in simulation tests, or indicate clinically acceptable dimensions and locations when dealing with real data.

  20. The ATCA REXCESS Diffuse Emission Survey (ARDES) - I. Detection of a giant radio halo and a likely radio relic

    NASA Astrophysics Data System (ADS)

    Shakouri, S.; Johnston-Hollitt, M.; Pratt, G. W.

    2016-07-01

    We present the results of the radio halo survey of 16 REXCESS southern clusters up to a redshift of 0.2 with the Australia Telescope Compact Array (ATCA) at 1.4 and 2.1 GHz. This cluster sample called the ATCA REXCESS Diffuse Emission Survey (ARDES) includes clusters in a wide range of X-ray luminosities and is morphologically unbiased. We find two diffuse radio sources in the clusters RXCJ2234.5-3744 (Abell 3888) and RXCJ0225.1-2928. The diffuse radio emission in RXCJ2234.5-3744 is a giant radio halo and the diffuse emission in RXCJ0225.1-2928 is a peculiar radio relic candidate. The radio halo has a spectral index of α = -1.48 ± 0.14 and the K-corrected P1.4 is 1.9 ± 0.2 × 1024 W Hz-1. The properties of the detected halo are consistent with both the current P1.4-LX and P1.4-YSZ correlations. The putative radio relic is located approximately 1 Mpc from the cluster in a filament and has a physical extent of 346 ± 20 kpc and a power of P1.4 = 3.3 ± 0.8 × 1023 W Hz-1, which places it in the lower power region of currently known relics.

  1. The relationship between pulmonary function tests, thorax HRCT, and quantitative ventilation-perfusion scintigraphy in chronic obstructive pulmonary disease.

    PubMed

    Demir, Tunçalp; Ikitimur, Hande; Akpinar Tekgündüz, Sibel; Mutlu, Birsen; Yildirim, Nurhayat; Akman, Canan; Ozmen, Ozlem; Kanmaz, Bedii

    2005-01-01

    We have evaluated the relationship between pulmonary function tests (PFT), thorax high resolution computed tomography (HRCT) images and quantitative ventilation-perfusion (V/Q) scintigraphic studies in 16 male patients (mean age 65.6 +/- 5.5 years) with chronic obstructive pulmonary disease (COPD). The mean forced vital capacity (FVC) value of the patient group was 2352 +/- 642 mL (65.4 +/- 15.8%), whereas mean forced expiratory volume in one second (FEV(1)) was found to be 1150 +/- 442 mL (40.8 +/- 14.9%). The ratio of carbon monoxide diffusion capacity to alveolar ventilation (DLCO/VA) was 3.17 +/- 0.88 mL/min/mmHg/L, and the mean partial oxygen (PaO(2)) and carbon dioxide (PaCO(2)) pressures were 68.5 +/- 11.04 mmHg and 38.9 +/- 5.8 mmHg respectively. For each patient, thorax HRCT and V/Q scintigraphic images of both lungs were divided into upper, mid and lower zones during examination. Visual scoring for the assessment of emphysema on thorax HRCT were used and images were graded from mild to severe (< or = 25% - > or = 76%). Emphysema scores were found to be higher on upper zones with accompanying lowest V/Q ratios. DLCO/VA, DLCO, total emphysema scores, and individual emphysema scores of the upper, mid and lower zones were found to be correlated. As a conclusion, it can be stated that emphysematous changes in COPD patients are more apparent in the upper lung zones, which also have the lowest V/Q ratios. PMID:16456733

  2. The Ardón L6 ordinary chondrite: A long-hidden Spanish meteorite fall

    NASA Astrophysics Data System (ADS)

    Trigo-RodríGuez, Josep M.; Llorca, Jordi; Weyrauch, Mona; Bischoff, Addi; Moyano-Cambero, Carles E.; Keil, Klaus; Laubenstein, Matthias; Pack, Andreas; Madiedo, José MaríA.; Alonso-AzcáRate, Jacinto; Riebe, My; Wieler, Rainer; Ott, Uli; Tapia, Mar; Mestres, NarcíS.

    2014-08-01

    We report and describe an L6 ordinary chondrite fall that occurred in Ardón, León province, Spain (longitude 5.5605°W, latitude 42.4364°N) on July 9th, 1931. The 5.5 g single stone was kept hidden for 83 yr by Rosa González Pérez, at the time an 11 yr old who had observed the fall and had recovered the meteorite. According to various newspaper reports, the event was widely observed in Northern Spain. Ardón is a very well-preserved, fresh, strongly metamorphosed (petrologic type 6), and weakly shocked (S3) ordinary chondrite with well-equilibrated and recrystallized minerals. The mineral compositions (olivine Fa23.7±0.3, low-Ca pyroxene Fs20.4±0.2Wo1.5±0.2, plagioclase An10.3±0.5Ab84.3±1.2), magnetic susceptibility (log χ = 4.95 ± 0.05 × 10-9 m3 kg-1), bulk density (3.49 ± 0.05 g cm-3), grain density (3.58 ± 0.05 g cm-3), and porosity (2.5 vol%) are typical for L6 chondrites. Short-lived radionuclides confirm that the meteorite constitutes a recent fall. The 21Ne and 38Ar cosmic ray exposure ages are both about 20-30 Ma, similar to values for many other L chondrites. The cosmogenic 22Ne/21Ne ratio indicates that preatmospheric Ardón was a relatively large body. The fact that the meteorite was hidden in private hands for 83 yr makes one wonder if other meteorite falls may have experienced the same fate, thus possibly explaining the anomalously low number of falls reported in continental Spain in the 20th century.

  3. The Effects of Acid Rock Drainage (ARD) on Fluorescent Dissolved Organic Matter (DOM)

    NASA Astrophysics Data System (ADS)

    Lee, R. H.; Gabor, R. S.; SanClements, M.; McKnight, D. M.

    2011-12-01

    Located in the Rocky Mountains of central Colorado, the catchments drained by the headwaters of the Snake River are dominated by metal- and sulfide-rich bedrock. The breakdown of these minerals results in acidic metal-rich waters in the Snake (pH ~3) that persist until the confluence with Deer Creek (pH ~7). Previous research has been conducted examining the interactions of acid-rock drainage (ARD) and dissolved organic matter (DOM), but the effects of ARD on DOM production is not as well understood. In a synoptic study, samples of creek water were collected at evenly spaced intervals along the length of a tributary to the Snake River which drains an area with ARD. At each sampling location, water samples were collected and pH, conductivity, and temperature were measured. Water samples were analyzed for metal chemistry, and the DOM was analyzed with UV-Vis and fluorescence spectroscopy. The character of the DOM was described using PARAFAC and index calculations. This work demonstrates that the introduction of acid and dissolved metal species has notable effects on DOM composition. Preliminary data suggests that the introduction of acid drainage is responsible for the formation of a fluorophore not accounted for in the Cory and McKnight PARAFAC model. Both high concentrations of heavy metals (e.g. zinc) and the novel fluorophore are present downstream from a mining site, which indicates it as a possible source of both species. The data suggest a link between the introduction of fluorophores in acidic waters and acidophile populations at the source of the acid rock drainage.

  4. Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDS

    PubMed Central

    Rajasekaran, Surender; Sanfilippo, Dominic; Shoemaker, Allen; Curtis, Scott; Zuiderveen, Sandra; Ndika, Akunne; Stoiko, Michael; Hassan, Nabil

    2012-01-01

    Introduction. In the first 48 hours of ventilating patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), a multipronged approach including packed red blood cell (PRBC) transfusion is undertaken to maintain oxygen delivery. Hypothesis. We hypothesized children with ALI/ARDS transfused within 48 hours of initiating mechanical ventilation would have worse outcome. The course of 34 transfused patients was retrospectively compared to 45 nontransfused control patients admitted to the PICU at Helen DeVos Children's Hospital between January 1st 2008 and December 31st 2009. Results. Mean hemoglobin (Hb) prior to transfusion was 8.2 g/dl compared to 10.1 g/dl in control. P/F ratio decreased from 135.4 ± 7.5 to 116.5 ± 8.8 in transfused but increased from 148.0 ± 8.0 to 190.4 ± 17.8 (P < 0.001) in control. OI increased in the transfused from 11.7 ± 0.9 to 18.7 ± 1.6 but not in control. Ventilator days in the transfused were 15.6 ± 1.7 versus 9.5 ± 0.6 days in control (P < 0.001). There was a trend towards higher rates of MODS in transfused patients; 29.4% versus 17.7%, odds ratio 1.92, 95% CI; 0.6–5.6 Fisher exact P < 0.282. Conclusion. This study suggests that early transfusions of patients with ALI/ARDS were associated with increased ventilatory needs. PMID:22957223

  5. A PREGNANT WOMAN WITH AVIAN INFLUENZA A (H7N9) VIRUS PNEUMONIA AND ARDS MANAGED WITH EXTRACORPOREAL MEMBRANE OXYGENATION.

    PubMed

    Wang, Guyi; Zhou, Yanyan; Gong, Subo; Dong, Haiyun; Wu, Guobao; Xiang, Xudong; Tang, Jianjun

    2015-05-01

    We report a case of H7N9 avian influenza pneumonia in a pregnant woman who developed acute respiratory distress syndrome (ARDS) managed with extracorporeal membrane oxygenation (ECMO). A 29-year-old, 27 week pregnant woman developed rapidly progressive pneumonia with bilateral infiltrates on chest x-ray and was confirmed to have influenza A (H7N9) infection. Her condition deteriorated and she developed ARDS which was managed with veno-venous extracorporeal membrane oxygenation (V-V ECMO) and treated with antimicrobials. Her clinical symptoms and oxygenation gradually improved and the ECMO was discontinued on the 19t day. Unfortunately, she suddenly died a few days later, due to a presumed pulmonary embolism. Based on our experience, ECMO may be useful to manage pneumonia due to H7N9 avian influenza and ARDS in pregnant women. PMID:26521517

  6. New therapies for acute respiratory distress syndrome (ARDS):--a review.

    PubMed

    Reddy, V G

    1999-03-01

    Acute respiratory distress syndrome (ARDS) has been associated with high mortality. Improved understanding of the pathophysiology, recognition of precipitating events and improved management has decreased the mortality over the years. Mechanical ventilation is still the corner stone of the management of the disease. It is well recognised that high tidal volumes and airway pressures increase the morbidity, hence the need to use alternative modes of ventilation like pressure control with or without inverse ratio ventilation. Extracorporeal membrane oxygenation is still experimental and not easily available, whereas prone position to improve oxygenation is simple and inexpensive. The concept of pathological oxygen dependency and therapy aimed at supranormal values has failed to improve survival. Restricting the fluids to prevent further oedema formation in an already wet lung has improved the survival rate. Nitric oxide and surfactant have failed to produce desirable effect in large studies. Pharmacological support to inhibit inflammation with non steroidal anti-inflammatory drugs, antifungal agents, prostaglandin and corticosteroids have all failed. Interestingly corticosteroid rescue treatment in the late phase of ARDS has shown promise. Antiendotoxin and anticytokine studies which began with much enthusiasm is yet to produce desirable results. PMID:10972019

  7. Pharmacological therapies for pediatric and neonatal ALI/ARDS: an evidence-based review.

    PubMed

    De Luca, Daniele; Piastra, Marco; Tosi, Federica; Pulitanò, Silvia; Mancino, Aldo; Genovese, Orazio; Pietrini, Domenico; Conti, Giorgio

    2012-06-01

    Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are life-threating conditions still lacking a definite therapy and carrying a high mortality and morbidity, especially in children and infants. Albeit respiratory assistance and supportive therapies are crucial for ALI/ARDS, many drugs have been proposed to treat such syndromes through various mechanisms of action. On the whole the pharmacological therapy might play an important role in such a complex clinical situation but few evidence based data are available in pediatric and neonatal critical care. This review will focus on drugs directly available on the bedside, that is, medicines already administered in the practice or investigated in at least one clinical study. We will value the differences due to patient's age and the various causes of the syndrome, that may affect the response to the pharmacological therapy. A special attention will be given to the drugs directly deliverable into the lungs, as this strategy allows a total availability to the lung tissue. The experimental background behind each drug will be discussed and then clinical data in neonates and infants will be presented, if available. Data coming from adult critical care and thought to be somehow pertinent for the pediatric setting will otherwise be reviewed. Quality and evidence for or against each therapy will be evaluated according to the Scottish Intercollegiate Guidelines Network statement and practical reminders for clinicians will accordingly be provided. PMID:22512390

  8. Ulinastatin attenuates pulmonary endothelial glycocalyx damage and inhibits endothelial heparanase activity in LPS-induced ARDS.

    PubMed

    Wang, Lipeng; Huang, Xiao; Kong, Guiqing; Xu, Haixiao; Li, Jiankui; Hao, Dong; Wang, Tao; Han, Shasha; Han, Chunlei; Sun, Yeying; Liu, Xiangyong; Wang, Xiaozhi

    2016-09-16

    Acute respiratory distress syndrome (ARDS) is a syndrome of acute respiratory failure characterized by major pathologic mechanisms of increased microvascular permeability and inflammation. The glycocalyx lines on the endothelial surface, which determines the vascular permeability, and heparanase play pivotal roles in the degradation of heparan sulfate (HS). HS is the major component of the glycocalyx. The aim of this study is to examine the effects of Ulinastatin (UTI) on vascular permeability and pulmonary endothelial glycocalyx dysfunction induced by lipopolysaccharide (LPS). In our study, C57BL/6 mice and human umbilical vein endothelial cells were stimulated with LPS to induce injury models. After 6 h of LPS stimulation, pulmonary pathological changes, pulmonary edema, and vascular permeability were notably attenuated by UTI. UTI inhibited LPS-induced endothelial glycocalyx destruction and significantly decreased the production of HS as determined by ELISA and immunofluorescence. UTI also reduced the active form of heparanase (50 kDa) expression and heparanase activity. Moreover, lysosome pH was investigated because heparanase (65 kDa) can be reduced easily in its active form at 50 kDa in a low pH environment within lysosome. Results showed that UTI could inhibit LPS-induced pH elevation in lysosome. In conclusion, UTI protects pulmonary endothelial glycocalyx integrity and inhibits heparanase activity during LPS-induced ARDS. PMID:27498004

  9. Pediatric chest HRCT using the iDose4 Hybrid Iterative Reconstruction Algorithm: Which iDose level to choose?

    NASA Astrophysics Data System (ADS)

    Smarda, M.; Alexopoulou, E.; Mazioti, A.; Kordolaimi, S.; Ploussi, A.; Priftis, K.; Efstathopoulos, E.

    2015-09-01

    Purpose of the study is to determine the appropriate iterative reconstruction (IR) algorithm level that combines image quality and diagnostic confidence, for pediatric patients undergoing high-resolution computed tomography (HRCT). During the last 2 years, a total number of 20 children up to 10 years old with a clinical presentation of chronic bronchitis underwent HRCT in our department's 64-detector row CT scanner using the iDose IR algorithm, with almost similar image settings (80kVp, 40-50 mAs). CT images were reconstructed with all iDose levels (level 1 to 7) as well as with filtered-back projection (FBP) algorithm. Subjective image quality was evaluated by 2 experienced radiologists in terms of image noise, sharpness, contrast and diagnostic acceptability using a 5-point scale (1=excellent image, 5=non-acceptable image). Artifacts existance was also pointed out. All mean scores from both radiologists corresponded to satisfactory image quality (score ≤3), even with the FBP algorithm use. Almost excellent (score <2) overall image quality was achieved with iDose levels 5 to 7, but oversmoothing artifacts appearing with iDose levels 6 and 7 affected the diagnostic confidence. In conclusion, the use of iDose level 5 enables almost excellent image quality without considerable artifacts affecting the diagnosis. Further evaluation is needed in order to draw more precise conclusions.

  10. Insilico study of the A(2A)R-D (2)R kinetics and interfacial contact surface for heteromerization.

    PubMed

    Prakash, Amresh; Luthra, Pratibha Mehta

    2012-10-01

    G-protein-coupled receptors (GPCRs) are cell surface receptors. The dynamic property of receptor-receptor interactions in GPCRs modulates the kinetics of G-protein signaling and stability. In the present work, the structural and dynamic study of A(2A)R-D(2)R interactions was carried to acquire the understanding of the A(2A)R-D(2)R receptor activation and deactivation process, facilitating the design of novel drugs and therapeutic target for Parkinson's disease. The structure-based features (Alpha, Beta, SurfAlpha, and SurfBeta; GapIndex, Leakiness and Gap Volume) and slow mode model (ENM) facilitated the prediction of kinetics (K (off), K (on), and K (d)) of A(2A)R-D(2)R interactions. The results demonstrated the correlation coefficient 0.294 for K (d) and K (on) and the correlation coefficient 0.635 for K (d) and K (off), and indicated stable interfacial contacts in the formation of heterodimer. The coulombic interaction involving the C-terminal tails of the A(2A)R and intracellular loops (ICLs) of D(2)R led to the formation of interfacial contacts between A(2A)R-D(2)R. The properties of structural dynamics, ENM and KFC server-based hot-spot analysis illustrated the stoichiometry of A(2A)R-D(2)R contact interfaces as dimer. The propensity of amino acid residues involved in A(2A)R-D(2)R interaction revealed the presence of positively (R, H and K) and negatively (E and D) charged structural motif of TMs and ICL3 of A(2A)R and D(2)R at interface of dimer contact. Essentially, in silico structural and dynamic study of A(2A)R-D(2)R interactions will provide the basic understanding of the A(2A)R-D(2)R interfacial contact surface for activation and deactivation processes, and could be used as constructive model to recognize the protein-protein interactions in receptor assimilations. PMID:22278740

  11. Elucidating the molecular responses of apple rootstock resistant to ARD pathogens: Challenges and opportunities for development of genomics-assisted breeding tools

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Apple Replant Disease (ARD) is one of the major limitations to the establishment of an economically viable orchard on replant sites due to the buildup and long-term survival of pathogen inoculum. Infection by several soilborne necrotrophic fungi and oomycetes is primarily responsible for ARD and res...

  12. Does the simple dynamical systems approach provide useful information about catchment hydrological functioning in a Mediterranean context? Application to the Ardèche catchment (France)

    NASA Astrophysics Data System (ADS)

    Adamovic, M.; Braud, I.; Branger, F.; Kirchner, J. W.

    2014-09-01

    This study explores how catchment heterogeneity and variability can be summarized in simplified models, representing the dominant hydrological processes. It focuses on Mediterranean catchments, characterized by heterogeneous geology, pedology, and land use, as well as steep topography and a rainfall regime in which summer droughts contrast with high-rainfall periods in autumn. The Ardèche catchment (south-east France), typical of this environment, is chosen to explore the following questions: (1) can such a Mediterranean catchment be adequately characterized by simple dynamical systems approach and what are the limits of the method under such conditions? (2) What information about dominant predictors of hydrological variability can be retrieved from this analysis in such catchments? In this work we apply the data-driven approach of Kirchner (WRR, 2009) to estimate discharge sensitivity functions that summarize the behavior of four sub-catchments of the Ardèche, using non-vegetation periods (November-March) from 9 years of data (2000-2008) from operational networks. The relevance of the inferred sensitivity function is assessed through hydrograph simulations, and through estimating precipitation rates from discharge fluctuations. We find that the discharge-sensitivity function is downward-curving in double-logarithmic space, thus allowing further simulation of discharge and non-divergence of the model, only during non-vegetation periods. The analysis is complemented by a Monte-Carlo sensitivity analysis showing how the parameters summarizing the discharge sensitivity function impact the simulated hydrographs. The resulting discharge simulation results are good for granite catchments, found to be predominantly characterized by saturation excess runoff and sub-surface flow processes. The simple dynamical system hypothesis works especially well in wet conditions (peaks and recessions are well modeled). On the other hand, poor model performance is associated with

  13. Temporal hemodynamic effects of permissive hypercapnia associated with ideal PEEP in ARDS.

    PubMed

    Carvalho, C R; Barbas, C S; Medeiros, D M; Magaldi, R B; Lorenzi Filho, G; Kairalla, R A; Deheinzelin, D; Munhoz, C; Kaufmann, M; Ferreira, M; Takagaki, T Y; Amato, M B

    1997-11-01

    The associated use of permissive hypercapnia (PHY) and high PEEP levels (PEEP(IDEAL)) has been recently indicated as part of a lung-protective-approach (LPA) in acute respiratory distress syndrome (ARDS). However, the net hemodynamic effect produced by this association is not known. We analyzed the temporal hemodynamic effects of this combined strategy in 48 patients (mean age 34 +/- 13 yr) with ARDS, focusing on its immediate (after 1 h), early (first 36 h), and late (2nd-7th d) consequences. Twenty-five patients were submitted to LPA--with the combined use of permissive hypercapnia (PHY), VT < 6 ml/kg, distending pressures above PEEP < 20 cm H2O, and PEEP 2 cm H2O above the lower inflection point on the static inspiratory P-V curve (P(FLEX))- and 23 control patients were submitted to conventional mechanical ventilation. LPA was initiated at once, resulting in an immediate increase in heart rate (p = 0.0002), cardiac output (p = 0.0002), oxygen delivery (DO2l, p = 0.0003), and mixed venous Po2 (p = 0.0006), with a maintained systemic oxygen consumption (p = 0.52). The mean pulmonary arterial pressure markedly increased (mean increment 8.8 mm Hg; p < 0.0001), but the pulmonary vascular resistance did not change (p = 0.32). Cardiac filling pressures increased (p < 0.001) and the systemic vascular resistance fell (p = 0.003). All these alterations were progressively attenuated in the course of the first 36 h, despite persisting hypercapnia. Plasma lactate suffered a progressive decrement along the early period in LPA but not in control patients (p < 0.0001). No hemodynamic consequences of LPA were noticed in the late period and renal function was preserved. A multivariate analysis suggested that these acute hyperdynamic effects were related to respiratory acidosis, with no depressant effects ascribed to high PEEP levels. In contrast, high plateau pressures were associated with cardiovascular depression. Thus, as long as sufficiently low distending pressures are

  14. Evaluation of Temporal Bone Cholesteatoma and the Correlation Between High Resolution Computed Tomography and Surgical Finding

    PubMed Central

    Gomaa, Mohammed A.; Abdel Karim, Abdel Rahim A.; Abdel Ghany, Hosny S.; Elhiny, Ahmed A.; Sadek, Ahmed A.

    2013-01-01

    Background Acquired cholesteatomas are commonly seen in patients less than 30 years. There is a typical history of recurrent middle ear infections with tympanic membrane perforation. The diagnosis of cholesteatoma is usually made on otologic examination. Objective The aim of the work was to study the role of high resolution computed tomography (HRCT) in detecting, evaluating, and diagnosing middle ear cholesteatoma. Patients and methods This was a prospective study that included 56 consecutive patients with chronic suppurative otitis media, unsafe type cholesteatomas. Each patient was subjected to full clinical evaluation, and HRCT examination. Intravenous contrast media was used in some patients with suspected intracranial complication. Preoperative radiological data were correlated with data related to surgical findings. Results The study showed that a high incidence of cholesteatoma in the third decade of life. The scutum and lateral attic wall were the most common bony erosions in the middle ear bony wall (64.3%), and the incus was the most eroded ossicle in the middle ear (88.2%). Sclerosing of mastoid air cells were encountered in 60.7% of patients and the lateral semicircular canal was affected in 9%, while facial canal erosion was found in 21.4%. Temporal bone complications are more common than intracranial complications. HRCT findings were compared with operative features; the comparative study included the accuracy and sensitivity of HRCT in detecting cholesteatoma (92.8%), its location and extension (96.4%), ossicular chain erosion (98%), labyrinthine fistula and intracranial complications (100%). Conclusion The important role of HRCT scannig lies on the early detection of cholesteatoma, and more conservative surgical procedures can be used to eradicate the disease. PMID:24179410

  15. Omentin protects against LPS-induced ARDS through suppressing pulmonary inflammation and promoting endothelial barrier via an Akt/eNOS-dependent mechanism.

    PubMed

    Qi, Di; Tang, Xumao; He, Jing; Wang, Daoxin; Zhao, Yan; Deng, Wang; Deng, Xinyu; Zhou, Guoqi; Xia, Jing; Zhong, Xi; Pu, Shenglan

    2016-01-01

    Acute respiratory distress syndrome (ARDS) is characterized by increased pulmonary inflammation and endothelial barrier permeability. Omentin has been shown to benefit obesity-related systemic vascular diseases; however, its effects on ARDS are unknown. In the present study, the level of circulating omentin in patients with ARDS was assessed to appraise its clinical significance in ARDS. Mice were subjected to systemic administration of adenoviral vector expressing omentin (Ad-omentin) and one-shot treatment of recombinant human omentin (rh-omentin) to examine omentin's effects on lipopolysaccharide (LPS)-induced ARDS. Pulmonary endothelial cells (ECs) were treated with rh-omentin to further investigate its underlying mechanism. We found that a decreased level of circulating omentin negatively correlated with white blood cells and procalcitonin in patients with ARDS. Ad-omentin protected against LPS-induced ARDS by alleviating the pulmonary inflammatory response and endothelial barrier injury in mice, accompanied by Akt/eNOS pathway activation. Treatment of pulmonary ECs with rh-omentin attenuated inflammatory response and restored adherens junctions (AJs), and cytoskeleton organization promoted endothelial barrier after LPS insult. Moreover, the omentin-mediated enhancement of EC survival and differentiation was blocked by the Akt/eNOS pathway inactivation. Therapeutic rh-omentin treatment also effectively protected against LPS-induced ARDS via the Akt/eNOS pathway. Collectively, these data indicated that omentin protects against LPS-induced ARDS by suppressing inflammation and promoting the pulmonary endothelial barrier, at least partially, through an Akt/eNOS-dependent mechanism. Therapeutic strategies aiming to restore omentin levels may be valuable for the prevention or treatment of ARDS. PMID:27607575

  16. HrcT Is a Key Component of the Type III Secretion System in Xanthomonas spp. and Also Regulates the Expression of the Key hrp Transcriptional Activator HrpX

    PubMed Central

    Liu, Zhi-Yang; Zou, Li-Fang; Xue, Xiao-Bo; Cai, Lu-Lu; Ma, Wen-Xiu; Xiong, Li; Ji, Zhi-Yuan

    2014-01-01

    The type III secretion system (T3SS), encoded by hrp (hypersensitive response and pathogenicity) genes in Gram-negative phytopathogenic bacteria, delivers repertoires of T3SS effectors (T3SEs) into plant cells to trigger the hypersensitive response (HR) in nonhost or resistant-host plants and promote pathogenicity in susceptible plants. The expression of hrp genes in Xanthomonas is regulated by two key regulatory proteins, HrpG and HrpX. However, the interactions between hrp gene products in directing T3SE secretion are largely unknown. Here we demonstrated that HrcT of X. oryzae pv. oryzicola functions as a T3SS component and positively regulates the expression of hrpX. Transcription of hrcT occurs via two distinct promoters; one (T1) is with the hrpB operon and the second (T3) within hrpB7 Via either promoter T1 or T3, the defect in Hrp phenotype by hrcT deletion was corrected in the presence of hrcT only from Xanthomonas species but not from other phytopathogenic bacteria. An N-terminally truncated HrcT was able to bind the hrpX promoter and activate the expression of hrpX, supporting that HrcT is a positive regulator of hrpX. A revised model showing the regulatory interactions between HrcT, HrpX, and HrpG is proposed. PMID:24747909

  17. Treatment and prevention of ARD using silica micro encapsulation[Acid Rock Drainage

    SciTech Connect

    Mitchell, P.; Rybock, J.; Wheaton, A.

    1999-07-01

    In response to the known drawbacks of liming and the ever-increasing regulatory demands on the mining industry, KEECO has developed a silica micro encapsulation (SME) process. SME is a cost-effective, high performance reagent that is utilized in conjunction with simple chemical delivery systems. By encapsulating metals in a silica matrix formation and rapidly precipitating them into a sand-like sludge, it offers all the advantages of liming without the negative drawbacks. Utilizing an injection technique via a high shear mixing device, a slurry form of the SME product called KB-1{trademark} was applied to ARD at the Bunker Hill Mine in Idaho and to ARD pumped from collection ponds at a remote mine site in the Sierra Nevada Mountains. Flow rates at both sites ranged form 500 to 800 gallons per minute. Treated water from the Bunker Hill Mine operation achieved the site's NPDES criteria for all evaluated metals and US Drinking Water quality for arsenic, cadmium, chromium, lead and zinc with a dosage rate of 1.34 grams KB-1{trademark} per liter. Treated water from the Sierra Nevada project focused on the control of aluminum, arsenic, copper, iron and nickel. All water samples displayed a >99.5% reduction in these metals, as well as an 84%--87% reduction in the concentration of sulfate. Testing on sludge generated form both operations achieved TCLP Action Limits. The SME process is currently under evaluation as a means to coat the pyrite surfaces of newly generated mine tailings to prevent oxidation and future acid generation.

  18. Bronchial fistulae in ARDS patients: management with an extracorporeal lung assist device.

    PubMed

    Hommel, M; Deja, M; von Dossow, V; Diemel, K; Heidenhain, C; Spies, C; Weber-Carstens, S

    2008-12-01

    Patients with bronchial tree lesions feature, in particular, a high risk for developing bronchial fistulae after surgical repair when the clinical situation is complicated by acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and mechanical ventilation is needed. The current authors hypothesised that extracorporeal carbon dioxide removal would significantly decrease inspiratory airway pressures, thus promoting the protection of surgical bronchial reconstruction. Four patients were studied after surgical reconstruction of bronchial fistulae in whom ALI/ARDS developed and mechanical ventilation with positive end-expiratory pressure was required. Gas exchange, tidal volumes, airway pressures, respiratory frequency, vasopressor and sedation requirements were analysed before and after initiation of a pumpless extracorporeal lung assist device (pECLA; NovaLung, Talheim, Germany). Initiation of pECLA treatment enabled a reduction of inspiratory plateau airway pressures from 32.4 to 28.6 cmH(2)O (3.2 to 2.8 kPa), effectively treated hypercapnia (from 73.6 to 53.4 mmHg (9.8 to 7.1 kPa)) and abolished respiratory acidosis (from pH 7.24 to 7.41). All patients survived and were discharged to rehabilitation clinics. In patients after surgical bronchial reconstruction that was complicated by acute lung injury/acute respiratory distress syndrome, use of pumpless extracorporeal carbon dioxide removal was safe and efficient. Initiation of a pumpless extracorporeal lung assist device enabled a less invasive ventilator management, which may have contributed to healing of surgical bronchial repair. PMID:19043011

  19. [Antirestriction proteins ardA and Ocr as effective inhibitors of the type I restriction-modification enzymes].

    PubMed

    Zavil'gel'skiĭ, G B; Rastorguev, S M

    2009-01-01

    Genes encoding antirestriction proteins (antirestrictases, inasmuch as the antirestriction proteins inhibit the activity of restriction-modification systems, but have no proper enzyme activity, the name antirestrictase is only tentative) are included in the composition of conjugative plasmids (genes ardABC) and some bacteriophages (genes ocr and darA). Antirestriction proteins inhibit of the type I restriction-modification enzymes and thus protect unmodified DNA of plasmids and bacteriophages from degradation. Antirestriction proteins belong to the "protein mimicry of DNA" family: the spatial structure is like the B-form of DNA, and therefore the antirestriction proteins operated on the principle of concurrent inhibition replacing DNA in the complex with the restriction-modification enzyme. Based on the prepared in vitro mutant forms of ArdA and Ocr, and also on natural proteins ArdA selectively inhibiting restriction activity of the type I enzymes, but not affecting their methylase activity, we have developed a model of complex formation between the antirestriction proteins and the restriction-modification enzymes R2M2S. Antirestriction proteins are capable of competing displacement of the DNA strand from two sites which are situated as follows: 1) in S-subunit (enzyme contact with the specific DNA site) and 2) in R-subunit (through this unit translocation of the DNA strand occurs followed by its degradation). Analysis of estriction and antimodification activities of proteins ArdA and Ocr depending on the expression level of genes ardA and ocr was performed (the cloning of the genes was done under strictly regulated promoter). PMID:19425495

  20. Directional Multi-scale Modeling of High-Resolution Computed Tomography (HRCT) Lung Images for Diffuse Lung Disease Classification

    NASA Astrophysics Data System (ADS)

    Vo, Kiet T.; Sowmya, Arcot

    A directional multi-scale modeling scheme based on wavelet and contourlet transforms is employed to describe HRCT lung image textures for classifying four diffuse lung disease patterns: normal, emphysema, ground glass opacity (GGO) and honey-combing. Generalized Gaussian density parameters are used to represent the detail sub-band features obtained by wavelet and contourlet transforms. In addition, support vector machines (SVMs) with excellent performance in a variety of pattern classification problems are used as classifier. The method is tested on a collection of 89 slices from 38 patients, each slice of size 512x512, 16 bits/pixel in DICOM format. The dataset contains 70,000 ROIs of those slices marked by experienced radiologists. We employ this technique at different wavelet and contourlet transform scales for diffuse lung disease classification. The technique presented here has best overall sensitivity 93.40% and specificity 98.40%.

  1. Accelerated detection of intracranial space-occupying lesions with CUDA based on statistical texture atlas in brain HRCT.

    PubMed

    Liu, Wei; Feng, Huanqing; Li, Chuanfu; Huang, Yufeng; Wu, Dehuang; Tong, Tong

    2009-01-01

    In this paper, we present a method that detects intracranial space-occupying lesions in two-dimensional (2D) brain high-resolution CT images. Use of statistical texture atlas technique localizes anatomy variation in the gray level distribution of brain images, and in turn, identifies the regions with lesions. The statistical texture atlas involves 147 HRCT slices of normal individuals and its construction is extremely time-consuming. To improve the performance of atlas construction, we have implemented the pixel-wise texture extraction procedure on Nvidia 8800GTX GPU with Compute Unified Device Architecture (CUDA) platform. Experimental results indicate that the extracted texture feature is distinctive and robust enough, and is suitable for detecting uniform and mixed density space-occupying lesions. In addition, a significant speedup against straight forward CPU version was achieved with CUDA. PMID:19963990

  2. Neuronal acetylcholine receptors in Drosophila: the ARD protein is a component of a high-affinity alpha-bungarotoxin binding complex.

    PubMed Central

    Schloss, P; Hermans-Borgmeyer, I; Betz, H; Gundelfinger, E D

    1988-01-01

    The ard gene of Drosophila melanogaster encodes a structural homologue of vertebrate nicotinic acetylcholine receptors (AChR) and is expressed exclusively in nervous tissue. To study the nature of the ARD protein, antibodies were raised against fusion constructs containing two regions of this polypeptide. One segment is putatively extracellular (amino acids 65-212), the other domain is exposed to the cytoplasm (amino acids 305-444). The ARD antisera obtained served to investigate the physical relationship between the ARD protein and alpha-bungarotoxin (alpha-Btx) binding sites occurring in Drosophila. Two different high-affinity binding sites for [125I]alpha-Btx, a highly potent antagonist of vertebrate muscle AChR, were detected in fly head membranes. Equilibrium binding and kinetic studies revealed Kd values of approximately 0.1 nM (site 1) and approximately 4 nM (site 2). The estimated maximal binding (Bmax) was approximately 240 and 1080 fmol/mg protein respectively. Both sites exhibited a nicotinic-cholinergic pharmacology. Immunoprecipitation experiments with the ARD antisera indicated that the ARD protein is associated with the [125I]alpha-Btx binding site 1 only. These data support the previously postulated hypothesis that the ARD protein is part of an alpha-Btx binding neuronal AChR of Drosophila. Furthermore, they indicate heterogeneity in nicotinic-cholinergic binding sites in the insect nervous system. PMID:3141150

  3. Regorafenib assessment in refractory advanced colorectal cancer: RegARd-C study protocol

    PubMed Central

    Hendlisz, Alain; Deleporte, Amélie; Vandeputte, Caroline; Charette, Nicolas; Paesmans, Marianne; Guiot, Thomas; Garcia, Camilo; Flamen, Patrick

    2015-01-01

    Introduction Regorafenib was recently approved for patients with pretreated advanced colorectal cancer (aCRC), despite a moderate improvement of the patients’ outcome, and significant toxicities. Based on previous studies showing that early fluorodeoxyglucose-positron emission tomography (FDG-PET)-based metabolic response assessment (MRA) might adequately select patients unlikely to benefit from treatment, the RegARd-C trial uses early MRA to identify likely non-responders to regorafenib in a population of patients with aCRC and guide a comprehensive evaluation of genomic and epigenetic determinants of resistance to treatment. Methods and analysis RegARd-C is a multicentric prospective study. Its primary objective is to identify non-benefitters from regorafenib given at 160 mg/day, 3 weeks out of 4 in a population of patients with pretreated aCRC. Baseline PET is repeated at day 14 of the first treatment course. MRA is blinded for the investigators. Overall survival (OS) is the primary end point and will be correlated with metabolic parameters and (epi)genetic alterations assessed from tumour and serial blood samples. A target sample size of 105 evaluable patients (70 as derivation set and 35 as validation set), is considered as sufficient to validate an expected HR for OS of metabolic responders compared to metabolic non-responders significantly <1 (with 80% power and 1-sided 5% α in case of a true HR≤0.59 and a responders rate of 47%). Ethics and dissemination The study was approved by the Institut Jules Bordet's competent ethics committee and complies with the Helsinki declaration or the Belgian laws and regulations, whichever provides the greatest protection for the patient, and follows the International Conference on Harmonisation E 6 (R1) Guideline for Good Clinical Practice, reference number CPMP/ICH/135/95. The protocol and the trials results, even inconclusive, will be presented at international oncology congresses, and published in peer

  4. Scrub Typhus with Acute Respiratory Distress Syndrome (ARDS) and its Management in Intensive Care Unit: A Case Report.

    PubMed

    Sankuratri, Srinivas; Kalagara, Pavani; Samala, Kartika Balaji; Veledandi, Prabhakar Krishna; Atiketi, Srinadh Babu

    2015-05-01

    Scrub typhus is zoonotic disease caused by Orientia tsutsugamushi (O tsutsugamushi). It is transmitted to humans by the bite of trombiculid mite larvae (chiggers). It is a re-emerging infectious disease in India. Clinical manifestations include fever, headache, anorexia, myalgia, eschar, adenopathy and maculopapular rash. Complications of Scrub typhus develop after first week of illness. Complications include meningoencephalitis, jaundice, myocarditis, ARDS and renal failure. Eschar and rash may be unnoticed or absent. Thorough physical examination, identification of eschar/rash throws light in thinking about scrub typhus, treating and preventing further complications. Here, we report a case of scrub typhus with Acute Respiratory Distress Syndrome (ARDS) and its management with non invasive ventilation in the intensive care unit. PMID:26155511

  5. Impact of chemically-modified tetracycline 3 on intertwined physiological, biochemical, and inflammatory networks in porcine sepsis/ARDS

    PubMed Central

    Sadowsky, David; Nieman, Gary; Barclay, Derek; Mi, Qi; Zamora, Ruben; Constantine, Gregory; Golub, Lorne; Lee, Hsi-Ming; Roy, Shreyas; Gatto, Louis A; Vodovotz, Yoram

    2015-01-01

    Sepsis can lead to multiple organ dysfunction, including the Acute Respiratory Distress Syndrome (ARDS), due to intertwined, dynamic changes in inflammation and organ physiology. We have demonstrated the efficacy of Chemically-Modified Tetracycline 3 (CMT-3) at reducing inflammation and ameliorating pathophysiology in the setting of a clinically realistic porcine model of ARDS. Here, we sought to gain insights into the derangements that characterize sepsis/ARDS and the possible impact of CMT-3 thereon, by combined experimental and computational studies. Two groups of anesthetized, ventilated pigs were subjected to experimental sepsis via placement of a peritoneal fecal clot and intestinal ischemia/reperfusion by clamping the superior mesenteric artery for 30 min. The treatment group (n = 3) received CMT-3 at 1 hour after injury (T1), while the control group (n = 3) received a placebo. Multiple inflammatory mediators, along with clinically relevant physiologic and blood chemistry variables, were measured serially until death of the animal or T48. Principal Component Analysis (PCA) and Dynamic Bayesian Network (DBN) inference were used to relate these variables. PCA revealed a separation of cardiac and pulmonary physiologic variables by principal component, and a decreased rank of oxygen index and arterial PO2/FiO2 ratio in the treatment group compared to control. DBN suggested a conserved network structure in both control and CMT-3 animals: a response driven by positive feedback between interleukin-6 and lung dysfunction. Resulting networks further suggested that in control animals, acute kidney injury, acidosis, and respiratory failure play an increased role in the response to insult compared to CMT-3 animals. These combined in vivo and in silico studies in a high fidelity, clinically applicable animal model suggest a dynamic interplay between inflammatory, physiologic, and blood chemistry variables in the setting of sepsis and ARDS that may be dramatically altered

  6. Implementation Issues and Challenges for Computerized Clinical Protocols for Management of Mechanical Ventilation in ARDS Patients

    PubMed Central

    East, Thomas D.; Henderson, Susan; Morris, Alan H.; Gardner, Reed M.

    1989-01-01

    In the process of implementing complex computerized protocols for the management of ventilation in ARDS patients several unique problems were encountered in the areas of temporal dependency, testing, decision making architecture, data integrity, user interaction and order generation. The protocols are different from many of the applications previously developed in that they depend not only on the current status of the patient but the temporal sequence of events that led up to the present time. This necessitated timely charting which was not a small requirement in the demanding ICU environment. New testing tools had to be developed to simulate a temporal sequence of events so that all branches of the protocols could be thoroughly tested. The blackboard control architecture originally implemented had to be abandoned for the sake of data integrity. The inability to have interactive communication, during execution of the protocols required a thorough re-evaluation of the data which was routinely charted. The mechanism for triggering execution of the protocols had to be redesigned to provide shorter response time for the ICU environment. This new version of the protocols has been used in 16 patients for a total of 3553 therapy suggestions. It is now being generally accepted in the ICU and routinely used to treat a wide variety of respiratory failure patients.

  7. Ranitidine compared to cimetidine in multiagent pharmacological treatment of porcine Pseudomonas ARDS.

    PubMed

    Byrne, K; Sielaff, T D; Carey, P D; Tatum, J L; Blocher, C R; Vasquez, A; Hirsh, J I; Sugerman, H J

    1990-02-01

    The effects of two pharmacologically distinct histamine H2 receptor antagonists were studied in combination with ibuprofen (I) and diphenhydramine (D) in a porcine model of septic ARDS. Cimetidine (C) is reported as having direct oxygen radical scavenging abilities and is an inhibitor of cytochrome P-450, whereas ranitidine (R) acts solely by H2 receptor blockade. Four groups were studied: Group Ps (n = 8) received a continuous infusion of live Pseudomonas aeruginosa 5 x 10(8) CFU/ml at 0.3 ml/20kg/min, Group C (n = 6) received a control saline infusion, and the treatment groups received I (12.5 mg/kg) and D (10 mg/kg) in combination with either C (150 mg, CID, n = 6) or R (25 mg, RID, n = 5) given at 20 and 120 minutes after the onset of Ps. Pulmonary (PAP) and systemic (SAP) arterial pressures, cardiac index (CI), PaO2, thermal cardiogreen extravascular lung water (EVLW) and scintigraphically determined pulmonary albumin flux (slope index, SI) were measured. Ps infusion produced significant (p less than 0.05) cardiovascular collapse, hypoxemia and increased EVLW and SI. Both CID and RID temporarily reversed pulmonary arterial hypertension and maintained PaO2, EVLW, SAP and CI at control levels throughout the study, and significantly improved SI at 180 min. These results suggest that cimetidine and ranitidine act in this combination therapy primarily as H2 receptor antagonists. PMID:2311202

  8. BPD Following Preterm Birth: A Model for Chronic Lung Disease and a Substrate for ARDS in Childhood.

    PubMed

    Bhandari, Anita; Carroll, Christopher; Bhandari, Vineet

    2016-01-01

    It has been suggested that pediatric acute respiratory distress syndrome (PARDS) may be a different entity, vis-à-vis adult acute respiratory distress syndrome (ARDS), based on its epidemiology and outcomes. A more pediatric-specific definition of PARDS to include the subgroup of patients with underlying lung (and heart) disease has been proposed. Epidemiological data suggest that up to 13% of the children with ARDS have a history of prematurity and/or underlying chronic lung disease. However, the specific contribution of bronchopulmonary dysplasia (BPD), the most common chronic lung disease in infants, to the development of PARDS is not known. BPD leads to damaged lungs with long-term consequences secondary to disordered growth and immune function. These damaged lungs could potentially act as a substrate, which given the appropriate noxious stimuli, can predispose a child to PARDS. Interestingly, similar biomarkers [KL-6, interleukin (IL)-6, IL-8, sICAM-1, angiopoietin-2, and matrix metalloproteinase-8 and -9] of pulmonary injury have been associated both with BPD and ARDS. Recognition of a unique pattern of clinical symptomatology and/or outcomes of PARDS, if present, could potentially be useful for investigating targeted therapeutic interventions. PMID:27379219

  9. BPD Following Preterm Birth: A Model for Chronic Lung Disease and a Substrate for ARDS in Childhood

    PubMed Central

    Bhandari, Anita; Carroll, Christopher; Bhandari, Vineet

    2016-01-01

    It has been suggested that pediatric acute respiratory distress syndrome (PARDS) may be a different entity, vis-à-vis adult acute respiratory distress syndrome (ARDS), based on its epidemiology and outcomes. A more pediatric-specific definition of PARDS to include the subgroup of patients with underlying lung (and heart) disease has been proposed. Epidemiological data suggest that up to 13% of the children with ARDS have a history of prematurity and/or underlying chronic lung disease. However, the specific contribution of bronchopulmonary dysplasia (BPD), the most common chronic lung disease in infants, to the development of PARDS is not known. BPD leads to damaged lungs with long-term consequences secondary to disordered growth and immune function. These damaged lungs could potentially act as a substrate, which given the appropriate noxious stimuli, can predispose a child to PARDS. Interestingly, similar biomarkers [KL-6, interleukin (IL)-6, IL-8, sICAM-1, angiopoietin-2, and matrix metalloproteinase-8 and -9] of pulmonary injury have been associated both with BPD and ARDS. Recognition of a unique pattern of clinical symptomatology and/or outcomes of PARDS, if present, could potentially be useful for investigating targeted therapeutic interventions. PMID:27379219

  10. Structural analysis of the KRIT1 ankyrin repeat and FERM domains reveals a conformationally stable ARD-FERM interface

    SciTech Connect

    Zhang, Rong; Li, Xiaofeng; Boggon, Titus J.

    2015-10-14

    Cerebral cavernous malformations (CCM) are vascular dysplasias that usually occur in the brain and are associated with mutations in the KRIT1/CCM1, CCM2/MGC4607/OSM/Malcavernin, and PDCD10/CCM3/ TFAR15 genes. Here we report the 2.9 Å crystal structure of the ankyrin repeat domain (ARD) and FERM domain of the protein product of KRIT1 (KRIT1; Krev interaction trapped 1). The crystal structure reveals that the KRIT1 ARD contains 4 ankyrin repeats. There is also an unusual conformation in the ANK4 repeat that is stabilized by Trp-404, and the structure reveals a solvent exposed ankyrin groove. Domain orientations of the three copies within the asymmetric unit suggest a stable interaction between KRIT1 ARD and FERM domains, indicating a globular ARD–FERM module. It resembles the additional F0 domain found N-terminal to the FERM domain of talin. Structural analysis of KRIT1 ARD–FERM highlights surface regions of high evolutionary conservation, and suggests potential sites that could mediate interaction with binding partners. The structure therefore provides a better understanding of KRIT1 at the molecular level.

  11. Improved algorithm for computerized detection and quantification of pulmonary emphysema at high-resolution computed tomography (HRCT)

    NASA Astrophysics Data System (ADS)

    Tylen, Ulf; Friman, Ola; Borga, Magnus; Angelhed, Jan-Erik

    2001-05-01

    Emphysema is characterized by destruction of lung tissue with development of small or large holes within the lung. These areas will have Hounsfield values (HU) approaching -1000. It is possible to detect and quantificate such areas using simple density mask technique. The edge enhancement reconstruction algorithm, gravity and motion of the heart and vessels during scanning causes artefacts, however. The purpose of our work was to construct an algorithm that detects such image artefacts and corrects them. The first step is to apply inverse filtering to the image removing much of the effect of the edge enhancement reconstruction algorithm. The next step implies computation of the antero-posterior density gradient caused by gravity and correction for that. Motion artefacts are in a third step corrected for by use of normalized averaging, thresholding and region growing. Twenty healthy volunteers were investigated, 10 with slight emphysema and 10 without. Using simple density mask technique it was not possible to separate persons with disease from those without. Our algorithm improved separation of the two groups considerably. Our algorithm needs further refinement, but may form a basis for further development of methods for computerized diagnosis and quantification of emphysema by HRCT.

  12. Can chest high-resolution computed tomography findings diagnose pulmonary alveolar microlithiasis?*

    PubMed Central

    Francisco, Flávia Angélica Ferreira; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Escuissato, Dante Luiz; Araujo Neto, Cesar Augusto; Silva, Jorge Luiz Pereira e; Silva, Claudio S.; Hochhegger, Bruno; Souza Jr., Arthur Soares; Zanetti, Gláucia; Marchiori, Edson

    2015-01-01

    Objective The present study was aimed at retrospectively reviewing high-resolution computed tomography (HRCT) findings in patients with pulmonary alveolar microlithiasis in order to evaluate the frequency of tomographic findings and their distribution in the lung parenchyma. Materials and Methods Thirteen patients (9 females and 4 males; age, 9 to 59 years; mean age, 34.5 years) were included in the present study. The HRCT images were independently evaluated by two observers whose decisions were made by consensus. The inclusion criterion was the presence of abnormalities typical of pulmonary alveolar microlithiasis at HRCT, which precludes lung biopsy. However, in 6 cases lung biopsy was performed. Results Ground-glass opacities and small parenchymal nodules were the predominant tomographic findings, present in 100% of cases, followed by small subpleural nodules (92.3%), subpleural cysts (84.6%), subpleural linear calcifications (69.2%), crazy-paving pattern (69.2%), fissure nodularity (53.8%), calcification along interlobular septa (46.2%) and dense consolidation (46.2%). Conclusion As regards distribution of the lesions, there was preferential involvement of the lower third of the lungs. No predominance of distribution in axial and anteroposterior directions was observed. PMID:26379317

  13. Microscale Biogeochemical Controls on Manganese Oxyhydroxide Biomineral Formation and Associated Trace Metal Sequestration in ARD Biofilms

    NASA Astrophysics Data System (ADS)

    Haack, E. A.; Warren, L. A.

    2002-12-01

    Identifying the processes controlling reactive metal transport is a necessary prerequisite to the design of effective, mitigative, strategies for contaminated aqueous environments, such as acid rock drainage (ARD). Our research investigates the biogeochemical processes affecting trace metal fate in shallow tailings-associated seepage streams from a northern Ontario ARD environment (Onaping mine, Falconbridge Ltd., Sudbury, ON, Canada). Monthly, from June-Sept 2001, in situ characterization of biofilm geochemical parameters and quantification of biofilm-associated metal concentrations, by sequential extraction, was conducted on a diel scale. Results indicate that significant (p<0.05) seasonal accumulation of Mn, Ni, Co and Cr occurred within the biofilms (e.g. Ni, June: 3.60 mmol/kg; September: 25.7 mmol/kg). As much as 75%\\ of the total biofilm concentration of these elements was associated with the amorphous oxyhydroxide fraction. Further, trace metal concentrations were strongly and positively correlated to Mn concentrations in that fraction (R2 > 0.89), implying an important role for Mn oxyhydroxides as a sorbent phase in this system. On a diel basis, Mn concentrations in the amorphous oxyhydroxide fraction decreased significantly in the afternoon compared to morning or late evening values. The magnitude of the loss of Mn was correlated to shifts in the relative depth of the oxic/anoxic boundary. Fine-scale profiling of biofilm pH and O2, using microelectrodes, reflected photosynthesis and respiration; the oxic/anoxic boundary deepened and pH increased within the biofilm during daylight hours. Due to the low pH conditions of the biofilms (3.5-4.5) Mn oxyhydroxide formation is necessarily microbially-catalyzed. Therefore, although the exact mechanisms controlling Mn cycling in this fraction have yet to be elucidated, likely processes include microbially mediated Mn oxidation during non-photosynthetically active hours and abiotic dissolution during

  14. Targeting Abl Kinases to Regulate Vascular Leak During Sepsis and ARDS

    PubMed Central

    Rizzo, Alicia N.; Aman, Jurjan; van Nieuw Amerongen, Geerten P.; Dudek, Steven M.

    2015-01-01

    The vascular endothelium separates circulating fluid and inflammatory cells from the surrounding tissues. Vascular leak occurs in response to wide-spread inflammatory processes, such as sepsis and Acute Respiratory Distress Syndrome (ARDS), due to the formation of gaps between endothelial cells (EC). Although these disorders are leading causes of mortality in the ICU, no medical therapies exist to restore EC barrier function. Recent evidence highlights a key role for the Abl family of non-receptor tyrosine kinases in regulating vascular barrier integrity. These kinases have well-described roles in cancer progression and neuronal morphogenesis, but their functions in the vasculature have remained enigmatic until recently. The Abl family kinases, c-Abl (Abl1) and Abl related gene (Arg, Abl2), phosphorylate several cytoskeletal effectors that mediate vascular permeability, including myosin light chain kinase, cortactin, vinculin, and β-catenin. They also regulate cell-cell and cell-matrix junction dynamics, and the formation of actin-based cellular protrusions in multiple cell types. Additionally, both c-Abl and Arg are activated by hyperoxia and contribute to oxidant-induced EC injury. These numerous roles of Abl kinases in EC and the current clinical usage of imatinib and other Abl kinase inhibitors have spurred recent interest in repurposing these drugs for the treatment of vascular barrier dysfunction. This review will describe the structure and function of Abl kinases with an emphasis on their roles in mediating vascular barrier integrity. We will also provide a critical evaluation of the potential for exploiting Abl kinase inhibition as a novel therapy for inflammatory vascular leak syndromes. PMID:25814671

  15. Pulmonary talcosis: imaging findings.

    PubMed

    Marchiori, Edson; Lourenço, Sílvia; Gasparetto, Taisa Davaus; Zanetti, Gláucia; Mano, Cláudia Mauro; Nobre, Luiz Felipe

    2010-04-01

    Talc is a mineral widely used in the ceramic, paper, plastics, rubber, paint, and cosmetic industries. Four distinct forms of pulmonary disease caused by talc have been defined. Three of them (talcosilicosis, talcoasbestosis, and pure talcosis) are associated with aspiration and differ in the composition of the inhaled substance. The fourth form, a result of intravenous administration of talc, is seen in drug users who inject medications intended for oral use. The disease most commonly affects men, with a mean age in the fourth decade of life. Presentation of patients with talc granulomatosis can range from asymptomatic to fulminant disease. Symptomatic patients typically present with nonspecific complaints, including progressive exertional dyspnea, and cough. Late complications include chronic respiratory failure, emphysema, pulmonary arterial hypertension, and cor pulmonale. History of occupational exposure or of drug addiction is the major clue to the diagnosis. The high-resolution computed tomography (HRCT) finding of small centrilobular nodules associated with heterogeneous conglomerate masses containing high-density amorphous areas, with or without panlobular emphysema in the lower lobes, is highly suggestive of pulmonary talcosis. The characteristic histopathologic feature in talc pneumoconiosis is the striking appearance of birefringent, needle-shaped particles of talc seen within the giant cells and in the areas of pulmonary fibrosis with the use of polarized light. In conclusion, computed tomography can play an important role in the diagnosis of pulmonary talcosis, since suggestive patterns may be observed. The presence of these patterns in drug abusers or in patients with an occupational history of exposure to talc is highly suggestive of pulmonary talcosis. PMID:20155272

  16. Multiple Conformations of the Loop Region Confers Heat-Resistance on SsArd1, a Thermophilic NatA.

    PubMed

    Chang, Yu-Yung; Hsu, Chun-Hua

    2016-02-01

    Structural comparison indicates that the loop region between β3 and β4 of SsArd1 is extended relative to the corresponding region in mesophilic Nats, and forms a plastic hydrogen-bond network mainly at two serine residues. Strikingly, two single-point mutants showed ∼3 °C decrease in melting temperature, and two other variants showed ∼7 °C decrease; this correlated with significantly reduced enzymatic activity. To our knowledge, this is the first discovery of a loop region capable of remarkably improving protein thermostability. This provides a novel route to engineer heat-resistant proteins. PMID:26593285

  17. Automated Rotational Percussion Bed and Bronchoscopy Improves Respiratory Mechanics and Oxygenation in ARDS Patients Supported with Extracorporeal Membrane Oxygenation.

    PubMed

    Sharma, Nirmal S; Wille, Keith M; Bellot, S Christopher; Diaz-Guzman, Enrique

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) has been used to provide "lung rest" through the use of low tidal volume (6 ml/kg) and ultralow tidal volume (<6 ml/kg) ventilation in acute respiratory distress syndrome (ARDS). Low and ultralow tidal volume ventilation can result in low dynamic respiratory compliance and potentially increased retention of airway secretions. We present our experience using automated rotational percussion beds (ARPBs) and bronchoscopy in four ARDS patients to manage increased pulmonary secretions. These beds performed automated side-to-side tilt maneuver and intermittent chest wall percussion. Their use resulted in substantial reduction in peak and plateau pressures in two patients on volume control ventilation, while the driving pressures (inspiratory pressure) to attain the desired tidal volumes in patients on pressure control ventilation also decreased. In addition, mean partial pressure of oxygen in arterial blood (PaO2)/fraction of inspired oxygen (FiO2) ratio (109 pre-ARPB vs. 157 post-ARPB), positive end-expiratory pressure (10 cm H2O vs. 8 cm H2O), and FiO2 (0.88 vs. 0.52) improved after initiation of ARPB. The improvements in the respiratory mechanics and oxygenation helped us to initiate early ECMO weaning. Based on our experience, the use of chest physiotherapy, frequent body repositioning, and bronchoscopy may be helpful in the management of pulmonary secretions in patients supported with ECMO. PMID:26771392

  18. Pseudallescheria boydii with Aspergillus fumigatus and Aspergillus terreus in a Critically Ill Hematopoietic Stem Cell Recipient with ARDS.

    PubMed

    Lahmer, Tobias; Messer, Marlena; Ehmer, Ursula; Eser, Stefan; Beitz, Analena; Fekecs, Lisa; Schmid, Roland M; Huber, Wolfgang

    2016-04-01

    Pseudallescheria boydii is a fungal organism known to affect immunocompromised patients. This organism is known to cause, in severe cases, invasive infection of various organs such as the central nervous, cardiovascular, and respiratory systems. We report an unusual case of pulmonary P. boydii pneumonia in an immunocompromised critically ill patient with a co-infection of Aspergillus fumigatus and Aspergillus terreus with ARDS. This case highlights the importance of a high index of suspicion for superimposed fungal infections in patients who are critically ill and immunocompromised. Uncommon fungal pathogens should be considered in the differential diagnosis of respiratory failure, especially if diagnostic markers such as galactomannan (from BAL and serum) or 1,3-beta-D-glucan are elevated. Further diagnostic interventions are warranted when insufficient clinical improvement is observed to prevent treatment failure and adverse outcomes. PMID:26455910

  19. Development of community based model of Tawanchai Center: sufficiency economy principles for community Development an applicability at Bankhambong Community, Sa-ard Sub-district, Nampong District, Khon Kaen Province, Thailand.

    PubMed

    Kotrmaneetaweetong, Unchana; Choopen, Hhakuan; Chowchuen, Bowornsilp

    2012-11-01

    The objectives of the present study are 1) to study the application of sufficiency economy philosophy in community development as a model for future application of community health care program of Tawanchai Center, 2) study the administrative model for self sufficiency economy community in Bankhambong Community, Sa-ard Sub-district, Nampong District, Khon Kaen Province. The integrated study model included qualitative research by collecting data from documents, textbook, article, report, theory concept, researches and interviewing of relevant persons and the quantitative research by collecting data from questionnaires. The findings of study included objectives for development model of sufficiency economy for understanding of people, and use the philosophy of sufficiency economy model which compose of decrease expenditure, increase income activities, saving activities, learning activities and preservation of environment and sustainable natural resources activities. Decrease in expenditure activities included household gardening, and no allurements leading to ruin. Increase in income activities included supplement occupation and appropriate use of technology. Saving activities included creating saving group in household and community level. Learning activities included community use of local wisdom, and household learnt philosophy of sufficiency economy in daily living. Preservation of environment and sustainable natural resources activities included the use of sustainable raw materials in occupation. The generosity of one another activities included helping each other and solving problems for the poor and disable persons. The community development at in Bankhambong Community, Sa-ard Sub-district, Nampong District, Khon Kaen Province followed all of the above scope and guidelines and is the model for application of sufficiency community philosophy. We recommended method for successful implementation, including the starting from group process with capability of

  20. The performance improvement of automatic classification among obstructive lung diseases on the basis of the features of shape analysis, in addition to texture analysis at HRCT

    NASA Astrophysics Data System (ADS)

    Lee, Youngjoo; Kim, Namkug; Seo, Joon Beom; Lee, JuneGoo; Kang, Suk Ho

    2007-03-01

    In this paper, we proposed novel shape features to improve classification performance of differentiating obstructive lung diseases, based on HRCT (High Resolution Computerized Tomography) images. The images were selected from HRCT images, obtained from 82 subjects. For each image, two experienced radiologists selected rectangular ROIs with various sizes (16x16, 32x32, and 64x64 pixels), representing each disease or normal lung parenchyma. Besides thirteen textural features, we employed additional seven shape features; cluster shape features, and Top-hat transform features. To evaluate the contribution of shape features for differentiation of obstructive lung diseases, several experiments were conducted with two different types of classifiers and various ROI sizes. For automated classification, the Bayesian classifier and support vector machine (SVM) were implemented. To assess the performance and cross-validation of the system, 5-folding method was used. In comparison to employing only textural features, adding shape features yields significant enhancement of overall sensitivity(5.9, 5.4, 4.4% in the Bayesian and 9.0, 7.3, 5.3% in the SVM), in the order of ROI size 16x16, 32x32, 64x64 pixels, respectively (t-test, p<0.01). Moreover, this enhancement was largely due to the improvement on class-specific sensitivity of mild centrilobular emphysema and bronchiolitis obliterans which are most hard to differentiate for radiologists. According to these experimental results, adding shape features to conventional texture features is much useful to improve classification performance of obstructive lung diseases in both Bayesian and SVM classifiers.

  1. Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure ≤30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this

  2. Towards finding the linkage between metabolic and age-related disorders using semantic gene data network analysis

    PubMed Central

    Uzzal Hossain, Mohammad; Zaffar Shibly, Abu; Md. Omar, Taimur; Tous Zohora, Fatama; Sara Santona, Umme; Hossain, Md. Jakir; Hosen Khoka, Md. Sadek; Ara Keya, Chaman; Salimullah, Md.

    2016-01-01

    A metabolic disorder (MD) occurs when the metabolic process is disturbed. This process is carried out by thousands of enzymes participating in numerous inter-dependent metabolic pathways. Critical biochemical reactions that involve the processing and transportation of carbohydrates, proteins and lipids are affected in metabolic diseases. Therefore, it is of interest to identify the common pathways of metabolic disorders by building protein-protein interactions (PPI) for network analysis. The molecular network linkages between MD and age related diseases (ARD) are intriguing. Hence, we created networks of protein-protein interactions that are related with MD and ARD using relevant known data in the public domain. The network analysis identified known MD associated proteins and predicted genes and or its products of ARD in common pathways. The genes in the common pathways were isolated from the network and further analyzed for their co-localization and shared domains. Thus, a model hypothesis is proposed using interaction networks that are linked between MD and ARD. This data even if less conclusive finds application in understanding the molecular mechanism of known diseases in relation to observed molecular events PMID:27212841

  3. Towards finding the linkage between metabolic and age-related disorders using semantic gene data network analysis.

    PubMed

    Uzzal Hossain, Mohammad; Zaffar Shibly, Abu; Md Omar, Taimur; Tous Zohora, Fatama; Sara Santona, Umme; Hossain, Md Jakir; Hosen Khoka, Md Sadek; Ara Keya, Chaman; Salimullah, Md

    2016-01-01

    A metabolic disorder (MD) occurs when the metabolic process is disturbed. This process is carried out by thousands of enzymes participating in numerous inter-dependent metabolic pathways. Critical biochemical reactions that involve the processing and transportation of carbohydrates, proteins and lipids are affected in metabolic diseases. Therefore, it is of interest to identify the common pathways of metabolic disorders by building protein-protein interactions (PPI) for network analysis. The molecular network linkages between MD and age related diseases (ARD) are intriguing. Hence, we created networks of protein-protein interactions that are related with MD and ARD using relevant known data in the public domain. The network analysis identified known MD associated proteins and predicted genes and or its products of ARD in common pathways. The genes in the common pathways were isolated from the network and further analyzed for their co-localization and shared domains. Thus, a model hypothesis is proposed using interaction networks that are linked between MD and ARD. This data even if less conclusive finds application in understanding the molecular mechanism of known diseases in relation to observed molecular events. PMID:27212841

  4. High resolution spectroscopy of the Ar-D2O and Ar-HDO molecular complexes in the near-infrared range.

    PubMed

    Didriche, K; Földes, T

    2013-03-14

    Three rovibrational bands of Ar-D2O and two rovibrational bands of Ar-HDO were observed in the 1.5 μm range by continuous wave cavity ringdown spectroscopy. Their analyses led to the determination of rotational constants for the upper states and vibrational shifts indicating that the potential energy surface is only slightly affected by the vibrational excitation. Some Coriolis couplings were identified. The observed lines were fitted to retrieve a 3.5 ns lifetime of the upper state, showing that even with a triple or double excitation quanta in the water subunit, the Ar-D2O and Ar-HDO complexes are long-lived species. PMID:23514489

  5. High Tidal Volume Decreases ARDS, Atelectasis, and Ventilator Days Compared to Low Tidal Volume in Pediatric Burned Patients with Inhalation Injury

    PubMed Central

    Sousse, Linda E; Herndon, David N; Andersen, Clark R; Ali, Arham; Benjamin, Nicole C; Granchi, Thomas; Suman, Oscar E; Mlcak, Ronald P

    2015-01-01

    Background Inhalation injury, which is among the causes of acute lung injury and acute respiratory distress syndrome (ARDS), continues to represent a significant source of mortality in burned patients. Inhalation injury often requires mechanical ventilation, but the ideal tidal volume strategy is not clearly defined in burned pediatric patients. The aim of the present study is to determine the effects of low and high tidal volume on the number of ventilator days, ventilation pressures, and incidence of atelectasis, pneumonia and ARDS in pediatric burned patients with inhalation injury within one year post burn injury. Methods From 1986–2014, inhalation injury was diagnosed by bronchoscopy in pediatric burned patients (n=932). Patients were divided into three groups: (1) unventilated (n=241), (2) high tidal volume (HTV, 15 ± 3 ml/kg, n=190), and (3) low tidal volume (LTV, 9 ± 3 ml/kg, n = 501). Results HTV was associated with significantly decreased ventilator days (p<0.005) and maximum positive end expiratory pressure (p<0.0001) and significantly increased maximum peak inspiratory pressure (p<0.02) and plateau pressure (p<0.02) compared to patients with LTV. The incidence of atelectasis (p<0.0001) and ARDS (p<0.02) was significantly decreased with HTV compared to LTV. However, the incidence of pneumothorax was significantly increased in the HTV group compared with LTV (p<0.03). Conclusions HTV significantly decreases ventilator days and the incidence of both atelectasis and ARDS compared to low tidal volume in pediatric burned patients with inhalation injury. Thus, the use of HTV may interrupt sequences leading to lung injury in our patient population. PMID:25724604

  6. Beyond volutrauma in ARDS: the critical role of lung tissue deformation

    PubMed Central

    2011-01-01

    Ventilator-induced lung injury (VILI) consists of tissue damage and a biological response resulting from the application of inappropriate mechanical forces to the lung parenchyma. The current paradigm attributes VILI to overstretching due to very high-volume ventilation (volutrauma) and cyclic changes in aeration due to very low-volume ventilation (atelectrauma); however, this model cannot explain some research findings. In the present review, we discuss the relevance of cyclic deformation of lung tissue as the main determinant of VILI. Parenchymal stability resulting from the interplay of respiratory parameters such as tidal volume, positive end-expiratory pressure or respiratory rate can explain the results of different clinical trials and experimental studies that do not fit with the classic volutrauma/atelectrauma model. Focusing on tissue deformation could lead to new bedside monitoring and ventilatory strategies. PMID:21489320

  7. A computer-aided differential diagnosis between UIP and NSIP using automated assessment of the extent and distribution of regional disease patterns at HRCT: comparison with the radiologist's decision

    NASA Astrophysics Data System (ADS)

    Kim, Namkug; Seo, Joon Beom; Park, Sang Ok; Lee, Youngjoo; Lee, Jeongjin

    2009-02-01

    To evaluate the accuracy of computer aided differential diagnosis (CADD) between usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP) at HRCT in comparison with that of a radiologist's decision. A computerized classification for six local disease patterns (normal, NL; ground-glass opacity, GGO; reticular opacity, RO; honeycombing, HC; emphysema, EM; and consolidation, CON) using texture/shape analyses and a SVM classifier at HRCT was used for pixel-by-pixel labeling on the whole lung area. The mode filter was applied on the results to reduce noise. Area fraction (AF) of each pattern, directional probabilistic density function (pdf) (dPDF: mean, SD, skewness of pdf /3 directions: superior-inferior, anterior-posterior, central-peripheral), regional cluster distribution pattern (RCDP: number, mean, SD of clusters, mean, SD of centroid of clusters) were automatically evaluated. Spatially normalized left and right lungs were evaluated separately. Disease division index (DDI) on every combination of AFs and asymmetric index (AI) between left and right lung ((left-right)/left) were also evaluated. To assess the accuracy of the system, fifty-four HRCT data sets in patients with pathologically diagnosed UIP (n=26) and NSIP (n=28) were used. For a classification procedure, a CADD-SVM classifier with internal parameter optimization, and sequential forward floating feature selection (SFFS) were employed. The accuracy was assessed by a 5-folding cross validation with 20- times repetition. For comparison, two thoracic radiologists reviewed the whole HRCT images without clinical information and diagnose each case either as UIP or NSIP. The accuracies of radiologists' decision were 0.75 and 0.87, respectively. The accuracies of the CADD system using the features of AF, dPDF, AI of dPDF, RDP, AI of RDP, DDI were 0.70, 0.79, 0.77, 0.80, 0.78, 0.81, respectively. The accuracy of optimized CADD using all features after SFFS was 0.91. We developed the CADD

  8. Rock Finding

    ERIC Educational Resources Information Center

    Rommel-Esham, Katie; Constable, Susan D.

    2006-01-01

    In this article, the authors discuss a literature-based activity that helps students discover the importance of making detailed observations. In an inspiring children's classic book, "Everybody Needs a Rock" by Byrd Baylor (1974), the author invites readers to go "rock finding," laying out 10 rules for finding a "perfect" rock. In this way, the…

  9. Structure of the lutein-binding domain of human StARD3 at 1.74 Å resolution and model of a complex with lutein

    PubMed Central

    Horvath, Martin P.; George, Evan W.; Tran, Quang T.; Baumgardner, Kody; Zharov, Gabe; Lee, Sarah; Sharifzadeh, Hassan; Shihab, Saeed; Mattinson, Ty; Li, Binxing; Bernstein, Paul S.

    2016-01-01

    A crystal structure of the lutein-binding domain of human StARD3 (StAR-related lipid-transfer protein 3; also known as MLN64) has been refined to 1.74 Å resolution. A previous structure of the same protein determined to 2.2 Å resolution highlighted homology with StARD1 and shared cholesterol-binding character. StARD3 has since been recognized as a carotenoid-binding protein in the primate retina, where its biochemical function of binding lutein with specificity appears to be well suited to recruit this photoprotective molecule. The current and previous structures correspond closely to each other (r.m.s.d. of 0.25 Å), especially in terms of the helix-grip fold constructed around a solvent-filled cavity. Regions of interest were defined with alternate conformations in the current higher-resolution structure, including Arg351 found within the cavity and Ω1, a loop of four residues found just outside the cavity entrance. Models of the complex with lutein generated by rigid-body docking indicate that one of the ionone rings must protrude outside the cavity, and this insight has implications for molecular interactions with transport proteins and enzymes that act on lutein. Interestingly, models with the ∊-ionone ring characteristic of lutein pointing towards the bottom of the cavity were associated with fewer steric clashes, suggesting that steric complementarity and ligand asymmetry may play a role in discriminating lutein from the other ocular carotenoids zeaxanthin and meso-zeaxanthin, which only have β-ionone rings. PMID:27487925

  10. Structure of the lutein-binding domain of human StARD3 at 1.74 Å resolution and model of a complex with lutein.

    PubMed

    Horvath, Martin P; George, Evan W; Tran, Quang T; Baumgardner, Kody; Zharov, Gabe; Lee, Sarah; Sharifzadeh, Hassan; Shihab, Saeed; Mattinson, Ty; Li, Binxing; Bernstein, Paul S

    2016-08-01

    A crystal structure of the lutein-binding domain of human StARD3 (StAR-related lipid-transfer protein 3; also known as MLN64) has been refined to 1.74 Å resolution. A previous structure of the same protein determined to 2.2 Å resolution highlighted homology with StARD1 and shared cholesterol-binding character. StARD3 has since been recognized as a carotenoid-binding protein in the primate retina, where its biochemical function of binding lutein with specificity appears to be well suited to recruit this photoprotective molecule. The current and previous structures correspond closely to each other (r.m.s.d. of 0.25 Å), especially in terms of the helix-grip fold constructed around a solvent-filled cavity. Regions of interest were defined with alternate conformations in the current higher-resolution structure, including Arg351 found within the cavity and Ω1, a loop of four residues found just outside the cavity entrance. Models of the complex with lutein generated by rigid-body docking indicate that one of the ionone rings must protrude outside the cavity, and this insight has implications for molecular interactions with transport proteins and enzymes that act on lutein. Interestingly, models with the ℇ-ionone ring characteristic of lutein pointing towards the bottom of the cavity were associated with fewer steric clashes, suggesting that steric complementarity and ligand asymmetry may play a role in discriminating lutein from the other ocular carotenoids zeaxanthin and meso-zeaxanthin, which only have β-ionone rings. PMID:27487925

  11. Elucidating the molecular responses of apple rootstock resistant to ARD pathogens: challenges and opportunities for development of genomics-assisted breeding tools.

    PubMed

    Zhu, Yanmin; Fazio, Gennaro; Mazzola, Mark

    2014-01-01

    Apple replant disease (ARD) is a major limitation to the establishment of economically viable orchards on replant sites due to the buildup and long-term survival of pathogen inoculum. Several soilborne necrotrophic fungi and oomycetes are primarily responsible for ARD, and symptoms range from serious inhibition of growth to the death of young trees. Chemical fumigation has been the primary method used for control of ARD, and manipulating soil microbial ecology to reduce pathogen density and aggressiveness is being investigated. To date, innate resistance of apple rootstocks as a means to control this disease has not been carefully explored, partly due to the complex etiology and the difficulty in phenotyping the disease resistance. Molecular defense responses of plant roots to soilborne necrotrophic pathogens are largely elusive, although considerable progress has been achieved using foliar disease systems. Plant defense responses to necrotrophic pathogens consist of several interacting modules and operate as a network. Upon pathogen detection by plants, cellular signals such as the oscillation of Ca(2+) concentration, reactive oxygen species (ROS) burst and protein kinase activity, lead to plant hormone biosynthesis and signaling. Jasmonic acid (JA) and ethylene (ET) are known to be fundamental to the induction and regulation of defense mechanisms toward invading necrotrophic pathogens. Complicated hormone crosstalk modulates the fine-tuning of transcriptional reprogramming and metabolic redirection, resulting in production of antimicrobial metabolites, enzyme inhibitors and cell wall refortification to restrict further pathogenesis. Transcriptome profiling of apple roots in response to inoculation with Pythium ultimum demonstrated that there is a high degree of conservation regarding the molecular framework of defense responses compared with those observed with foliar tissues. It is conceivable that the timing and intensity of genotype-specific defense responses

  12. Elucidating the molecular responses of apple rootstock resistant to ARD pathogens: challenges and opportunities for development of genomics-assisted breeding tools

    PubMed Central

    Zhu, Yanmin; Fazio, Gennaro; Mazzola, Mark

    2014-01-01

    Apple replant disease (ARD) is a major limitation to the establishment of economically viable orchards on replant sites due to the buildup and long-term survival of pathogen inoculum. Several soilborne necrotrophic fungi and oomycetes are primarily responsible for ARD, and symptoms range from serious inhibition of growth to the death of young trees. Chemical fumigation has been the primary method used for control of ARD, and manipulating soil microbial ecology to reduce pathogen density and aggressiveness is being investigated. To date, innate resistance of apple rootstocks as a means to control this disease has not been carefully explored, partly due to the complex etiology and the difficulty in phenotyping the disease resistance. Molecular defense responses of plant roots to soilborne necrotrophic pathogens are largely elusive, although considerable progress has been achieved using foliar disease systems. Plant defense responses to necrotrophic pathogens consist of several interacting modules and operate as a network. Upon pathogen detection by plants, cellular signals such as the oscillation of Ca2+ concentration, reactive oxygen species (ROS) burst and protein kinase activity, lead to plant hormone biosynthesis and signaling. Jasmonic acid (JA) and ethylene (ET) are known to be fundamental to the induction and regulation of defense mechanisms toward invading necrotrophic pathogens. Complicated hormone crosstalk modulates the fine-tuning of transcriptional reprogramming and metabolic redirection, resulting in production of antimicrobial metabolites, enzyme inhibitors and cell wall refortification to restrict further pathogenesis. Transcriptome profiling of apple roots in response to inoculation with Pythium ultimum demonstrated that there is a high degree of conservation regarding the molecular framework of defense responses compared with those observed with foliar tissues. It is conceivable that the timing and intensity of genotype-specific defense responses

  13. Importance des algues Dasycladales révélée par la cathodoluminescence des évaporites triasiques (Trias des Forages GPF Ardèche, France). Role of Dasycladals algae displayed by the cathodoluminescence of Triassic evaporites (GPF deep bore holes, Ardèche, France)

    NASA Astrophysics Data System (ADS)

    Cros, Pierre; Arbey, François

    1999-06-01

    Two metastable minerals (the biogenic aragonite of Dasycladals algae and the diagenetic gypsum replaced by dolomite, anhydrite and quartz) appear to be significant for the diagenesis of Triassic evaporites of Ardèche, France (GPF cored deep drillings: Balazuc 1 and Morte-Mérie 1). The cathodoluminescence colours of dolomite, anhydrite and authigenic quartz, are digitally enhanced and compared with the high magnification pictures of SEM electron-excited cathodoluminescence (200-800 nm).

  14. Living with ARDS

    MedlinePlus

    ... can help you quit. Also, try to avoid secondhand smoke and other lung irritants, such as harmful fumes. ... see how other people who have the same symptoms have coped with them. Talk to your doctor ...

  15. How Is ARDS Treated?

    MedlinePlus

    ... blood flow through your body and to provide nutrition. Your doctor will make sure you get the right amount of fluids. Fluids usually are given through an IV ... National Institutes of Health Department of Health and Human Services USA.gov

  16. Tomographic and functional findings in severe COPD: comparison between the wood smoke-related and smoking-related disease *

    PubMed Central

    González-García, Mauricio; Gomez, Dario Maldonado; Torres-Duque, Carlos A.; Barrero, Margarita; Villegas, Claudia Jaramillo; Pérez, Juan Manuel; Varon, Humberto

    2013-01-01

    OBJECTIVE: Wood smoke exposure is a risk factor for COPD. For a given degree of airway obstruction, the reduction in DLCO is smaller in individuals with wood smoke-related COPD than in those with smoking-related COPD, suggesting that there is less emphysema in the former. The objective of this study was to compare HRCT findings between women with wood smoke-related COPD and women with smoking-related COPD. METHODS: Twenty-two women with severe COPD (FEV1/FVC ratio < 70% and FEV1 < 50%) were divided into two groups: those with wood smoke-related COPD (n = 12) and those with smoking-related COPD (n = 10). The two groups were compared regarding emphysema scores and airway involvement (as determined by HRCT); and functional abnormalities-spirometry results, DLCO, alveolar volume (VA), the DLCO/VA ratio, lung volumes, and specific airway resistance (sRaw). RESULTS: There were no significant differences between the two groups in terms of FEV1, sRaw, or lung hyperinflation. Decreases in DLCO and in the DLCO/VA ratio were greater in the smoking-related COPD group subjects, who also had higher emphysema scores, in comparison with the wood smoke-related COPD group subjects. In the wood smoke-related COPD group, HRCT scans showed no significant emphysema, the main findings being peribronchial thickening, bronchial dilation, and subsegmental atelectasis. CONCLUSIONS: Female patients with severe wood smoke-related COPD do not appear to develop emphysema, although they do show severe airway involvement. The reduction in DLCO and VA, with a normal DLCO/VA ratio, is probably due to severe bronchial obstruction and incomplete mixing of inspired gas during the determination of single-breath DLCO. PMID:23670499

  17. A 36,000-Year-Old Volcanic Eruption Depicted in the Chauvet-Pont d'Arc Cave (Ardèche, France)?

    PubMed

    Nomade, Sébastien; Genty, Dominique; Sasco, Romain; Scao, Vincent; Féruglio, Valérie; Baffier, Dominique; Guillou, Hervé; Bourdier, Camille; Valladas, Hélène; Reigner, Edouard; Debard, Evelyne; Pastre, Jean-François; Geneste, Jean-Michel

    2016-01-01

    Among the paintings and engravings found in the Chauvet-Pont d'Arc cave (Ardèche, France), several peculiar spray-shape signs have been previously described in the Megaloceros Gallery. Here we document the occurrence of strombolian volcanic activity located 35 km northwest of the cave, and visible from the hills above the cave entrance. The volcanic eruptions were dated, using 40Ar/39Ar, between 29 ± 10 ka and 35 ± 8 ka (2σ), which overlaps with the 14C AMS and thermoluminescence ages of the first Aurignacian occupations of the cave in the Megaloceros Gallery. Our work provides the first evidence of an intense volcanic activity between 40 and 30 ka in the Bas-Vivarais region, and it is very likely that Humans living in the Ardèche river area witnessed one or several eruptions. We propose that the spray-shape signs found in the Chauvet-Pont d'Arc cave could be the oldest known depiction of a volcanic eruption, predating by more than 34 ka the description by Pliny the Younger of the Vesuvius eruption (AD 79) and by 28 ka the Çatalhöyük mural discovered in central Turkey. PMID:26745626

  18. Alba from Thermoplasma volcanium belongs to α-NAT's: An insight into the structural aspects of Tv Alba and its acetylation by Tv Ard1.

    PubMed

    Ma, Chao; Pathak, Chinar; Lee, Sang Jae; Lee, Ki-Young; Jang, Sun-Bok; Nam, Minjoo; Im, Hookang; Yoon, Hye-Jin; Lee, Bong-Jin

    2016-01-15

    The Alba superfamily proteins have been regarded as a conserved group of proteins in archaea and eukarya, which have shown to be important in nucleic acid binding, chromatic organization and gene regulation. These proteins often belong to the N-acetyltransferase (NAT) category (N(α)-acetyltransferases or N(ε)-acetyltransferases) and undergo post-translational modifications. Here, we report the crystal structure of Alba from Thermoplasma volcanium (Tv Alba) at 2.4 Å resolution. The acetylation of Tv Alba was monitored and the N-terminal of Tv Alba has been shown to interact with acetyl coenzyme A (Ac-CoA). The chemical shift perturbation experiments of Tv Alba were performed in the presence of Ac-CoA and/or Tv Ard1, another T. volcanium protein that treats Tv Alba as a substrate. To examine the DNA binding capabilities of Tv Alba alone and in the presence of Ac-CoA and/or Tv Ard1, EMSA experiments were carried out. It is shown that although Tv Alba binds to Ac-CoA, the acetylation of Tv Alba is not related with its binding to dsDNA, and the involvement of the N-terminus in Ac-CoA binding demonstrates that Tv Alba belongs to the N(α)-acetyltransferase family. PMID:26657068

  19. A 36,000-Year-Old Volcanic Eruption Depicted in the Chauvet-Pont d’Arc Cave (Ardèche, France)?

    PubMed Central

    Nomade, Sébastien; Genty, Dominique; Sasco, Romain; Scao, Vincent; Féruglio, Valérie; Baffier, Dominique; Guillou, Hervé; Bourdier, Camille; Valladas, Hélène; Reigner, Edouard; Debard, Evelyne; Pastre, Jean–François; Geneste, Jean-Michel

    2016-01-01

    Among the paintings and engravings found in the Chauvet-Pont d’Arc cave (Ardèche, France), several peculiar spray-shape signs have been previously described in the Megaloceros Gallery. Here we document the occurrence of strombolian volcanic activity located 35 km northwest of the cave, and visible from the hills above the cave entrance. The volcanic eruptions were dated, using 40Ar/39Ar, between 29 ± 10 ka and 35 ± 8 ka (2σ), which overlaps with the 14C AMS and thermoluminescence ages of the first Aurignacian occupations of the cave in the Megaloceros Gallery. Our work provides the first evidence of an intense volcanic activity between 40 and 30 ka in the Bas-Vivarais region, and it is very likely that Humans living in the Ardèche river area witnessed one or several eruptions. We propose that the spray-shape signs found in the Chauvet-Pont d’Arc cave could be the oldest known depiction of a volcanic eruption, predating by more than 34 ka the description by Pliny the Younger of the Vesuvius eruption (AD 79) and by 28 ka the Çatalhöyük mural discovered in central Turkey. PMID:26745626

  20. Child Find

    ERIC Educational Resources Information Center

    Arizona Department of Education, 2006

    2006-01-01

    This brochure describes "Child Find," a component of the Individuals with Disabilities Education Act (IDEA) that requires states to identify, locate, and evaluate all children with disabilities, aged birth through 21, who are in need of early intervention or special education services.

  1. Evaluation of the relationship between smear positivity and high-resolution CT findings in children with pulmonary tuberculosis

    PubMed Central

    Bolursaz, Mohammad Reza; Mehrian, Payam; Aghahosseini, Farahnaz; Lotfian, Ferial; Khalilzadeh, Soheila; Baghaie, Nooshin; Hassanzad, Maryam; Velayati, Ali Akbar

    2014-01-01

    Summary Background The aim of this study is to find a relationship between the radiological manifestations of childhood tuberculosis on a high-resolution computed tomography (HRCT) and the results of sputum smear. This study aims to propose an alternative indicator of infectivity in terms of prevention of disease transmission through selective isolation policy in children whose clinical condition is highly suggestive of tuberculosis. Material/Methods This retrospective comparative study was performed on 95 children under 15 years of age diagnosed with tuberculosis based on both WHO criteria and positive sputum culture for mycobacterium Tuberculosis. The children were admitted for TB screening in the pediatric department of national research institute of tuberculosis and lung disease (NRITLD) between 2008–2012. Direct smear collected from sputum or gastric lavage, as well as HRCT were performed in all children prior to administration of medical therapy. Children were divided into 2 groups based on positive and negative smear results. HRCT abnormalities, as well as their anatomical distribution were compared between these 2 groups using multivariate analytic model. Results The most prevalent abnormalities in the positive smear group were consolidation, tree-in-bud pattern, upper lobe nodular infiltration and cavitation. The negative smear group featured lymphadenopathy, consolidation, collapse and nodular infiltration in the upper lobe. Cavity, tree- in-bud pattern and upper lobe nodular infiltration were highly associated with smear positivity in children. Conversely, lymphadenopathy and collapse had significant association with a negative smear. Conclusions This study revealed that cavity, tree-in-bud and upper lobe nodular infiltration has significant association with smear positivity in childhood tuberculosis. On the other hand, lymphadenopathy and collapse were closely associated with smear negativity in this age group. It was also demonstrated that children

  2. Repeated open endotracheal suctioning causes gradual desaturation but does not exacerbate lung injury compared to closed endotracheal suctioning in a rabbit model of ARDS

    PubMed Central

    2013-01-01

    Background Although endotracheal suctioning induces alveolar derecruitment during mechanical ventilation, it is not clear whether repeated endotracheal suctioning exacerbates lung injuries. The present study aimed to determine whether repeated open endotracheal suctioning (OS) exacerbates lung injury compared to closed endotracheal suctioning (CS) during mechanical ventilation in an animal model of acute respiratory distress syndrome (ARDS). Methods Briefly, thirty six Japanese white rabbits were initially ventilated in pressure-controlled mode with a constant tidal volume (6 mL/kg). Then, lung injury was induced by repeated saline lavage. The rabbits were divided into four groups, namely: a) OS; b) CS; c) control with ARDS only; d) and healthy control (HC) without ARDS. Animals in all the groups were then ventilated with positive end expiratory pressure (PEEP) at 10 cm H2O. CS was performed using 6 French-closed suctioning catheters connected to endotracheal tube under the following conditions: a) a suctioning time and pressure of 10 sec and 140 mm Hg, respectively; and b) a suction depth of 2 cm (length of adapter) plus tracheal tube. OS was performed using the same conditions described for CS, except the ventilator was disconnected from the animals. Each endotracheal suctioning was performed at an interval of 30 min. Results PaO2/FIO2 (P/F) ratio for CS, control and HC groups remained at >400 for 6 hours, whereas that of the OS group progressively declined to 300 (p < 0.05), with each suctioning. However, no difference was observed either in lung injury score (histology) or in the expression pattern of inflammatory cytokines (tumor necrosis factor-α and interleukin-6) after 6 hours between the OS and CS groups in the circulatory as well as the pulmonary tissues. Conclusions Progressive arterial desaturation under conditions of repeated endotracheal suctioning is greater in OS than in CS time-dependently. However, OS does not exacerbate lung injury

  3. Finding food

    PubMed Central

    Forsyth, Ann; Lytle, Leslie; Riper, David Van

    2011-01-01

    A significant amount of travel is undertaken to find food. This paper examines challenges in measuring access to food using Geographic Information Systems (GIS), important in studies of both travel and eating behavior. It compares different sources of data available including fieldwork, land use and parcel data, licensing information, commercial listings, taxation data, and online street-level photographs. It proposes methods to classify different kinds of food sales places in a way that says something about their potential for delivering healthy food options. In assessing the relationship between food access and travel behavior, analysts must clearly conceptualize key variables, document measurement processes, and be clear about the strengths and weaknesses of data. PMID:21837264

  4. The structure of the KlcA and ArdB proteins reveals a novel fold and antirestriction activity against Type I DNA restriction systems in vivo but not in vitro

    PubMed Central

    Serfiotis-Mitsa, Dimitra; Herbert, Andrew P.; Roberts, Gareth A.; Soares, Dinesh C.; White, John H.; Blakely, Garry W.; Uhrín, Dušan; Dryden, David T. F.

    2010-01-01

    Plasmids, conjugative transposons and phage frequently encode anti-restriction proteins to enhance their chances of entering a new bacterial host that is highly likely to contain a Type I DNA restriction and modification (RM) system. The RM system usually destroys the invading DNA. Some of the anti-restriction proteins are DNA mimics and bind to the RM enzyme to prevent it binding to DNA. In this article, we characterize ArdB anti-restriction proteins and their close homologues, the KlcA proteins from a range of mobile genetic elements; including an ArdB encoded on a pathogenicity island from uropathogenic Escherichia coli and a KlcA from an IncP-1b plasmid, pBP136 isolated from Bordetella pertussis. We show that all the ArdB and KlcA act as anti-restriction proteins and inhibit the four main families of Type I RM systems in vivo, but fail to block the restriction endonuclease activity of the archetypal Type I RM enzyme, EcoKI, in vitro indicating that the action of ArdB is indirect and very different from that of the DNA mimics. We also present the structure determined by NMR spectroscopy of the pBP136 KlcA protein. The structure shows a novel protein fold and it is clearly not a DNA structural mimic. PMID:20007596

  5. Mitochondrial Transfer via Tunneling Nanotubes is an Important Mechanism by Which Mesenchymal Stem Cells Enhance Macrophage Phagocytosis in the In Vitro and In Vivo Models of ARDS.

    PubMed

    Jackson, Megan V; Morrison, Thomas J; Doherty, Declan F; McAuley, Daniel F; Matthay, Michael A; Kissenpfennig, Adrien; O'Kane, Cecilia M; Krasnodembskaya, Anna D

    2016-08-01

    Mesenchymal stromal cells (MSC) have been reported to improve bacterial clearance in preclinical models of Acute Respiratory Distress Syndrome (ARDS) and sepsis. The mechanism of this effect is not fully elucidated yet. The primary objective of this study was to investigate the hypothesis that the antimicrobial effect of MSC in vivo depends on their modulation of macrophage phagocytic activity which occurs through mitochondrial transfer. We established that selective depletion of alveolar macrophages (AM) with intranasal (IN) administration of liposomal clodronate resulted in complete abrogation of MSC antimicrobial effect in the in vivo model of Escherichia coli pneumonia. Furthermore, we showed that MSC administration was associated with enhanced AM phagocytosis in vivo. We showed that direct coculture of MSC with monocyte-derived macrophages enhanced their phagocytic capacity. By fluorescent imaging and flow cytometry we demonstrated extensive mitochondrial transfer from MSC to macrophages which occurred at least partially through tunneling nanotubes (TNT)-like structures. We also detected that lung macrophages readily acquire MSC mitochondria in vivo, and macrophages which are positive for MSC mitochondria display more pronounced phagocytic activity. Finally, partial inhibition of mitochondrial transfer through blockage of TNT formation by MSC resulted in failure to improve macrophage bioenergetics and complete abrogation of the MSC effect on macrophage phagocytosis in vitro and the antimicrobial effect of MSC in vivo. Collectively, this work for the first time demonstrates that mitochondrial transfer from MSC to innate immune cells leads to enhancement in phagocytic activity and reveals an important novel mechanism for the antimicrobial effect of MSC in ARDS. Stem Cells 2016;34:2210-2223. PMID:27059413

  6. Mitochondrial Transfer via Tunneling Nanotubes is an Important Mechanism by Which Mesenchymal Stem Cells Enhance Macrophage Phagocytosis in the In Vitro and In Vivo Models of ARDS

    PubMed Central

    Jackson, Megan V.; Morrison, Thomas J.; Doherty, Declan F.; McAuley, Daniel F.; Matthay, Michael A.; Kissenpfennig, Adrien; O'Kane, Cecilia M.

    2016-01-01

    Abstract Mesenchymal stromal cells (MSC) have been reported to improve bacterial clearance in preclinical models of Acute Respiratory Distress Syndrome (ARDS) and sepsis. The mechanism of this effect is not fully elucidated yet. The primary objective of this study was to investigate the hypothesis that the antimicrobial effect of MSC in vivo depends on their modulation of macrophage phagocytic activity which occurs through mitochondrial transfer. We established that selective depletion of alveolar macrophages (AM) with intranasal (IN) administration of liposomal clodronate resulted in complete abrogation of MSC antimicrobial effect in the in vivo model of Escherichia coli pneumonia. Furthermore, we showed that MSC administration was associated with enhanced AM phagocytosis in vivo. We showed that direct coculture of MSC with monocyte‐derived macrophages enhanced their phagocytic capacity. By fluorescent imaging and flow cytometry we demonstrated extensive mitochondrial transfer from MSC to macrophages which occurred at least partially through tunneling nanotubes (TNT)‐like structures. We also detected that lung macrophages readily acquire MSC mitochondria in vivo, and macrophages which are positive for MSC mitochondria display more pronounced phagocytic activity. Finally, partial inhibition of mitochondrial transfer through blockage of TNT formation by MSC resulted in failure to improve macrophage bioenergetics and complete abrogation of the MSC effect on macrophage phagocytosis in vitro and the antimicrobial effect of MSC in vivo. Collectively, this work for the first time demonstrates that mitochondrial transfer from MSC to innate immune cells leads to enhancement in phagocytic activity and reveals an important novel mechanism for the antimicrobial effect of MSC in ARDS. Stem Cells 2016;34:2210–2223 PMID:27059413

  7. Fibroproliferative changes on high-resolution CT in the acute respiratory distress syndrome predict mortality and ventilator dependency: a prospective observational cohort study

    PubMed Central

    Muranaka, Hiroyuki; Gushima, Yasuhiro; Kotani, Toru; Nader, Habashi M; Fujimoto, Kiminori; Johkoh, Takeshi; Iwamoto, Norihiro; Kawamura, Kodai; Nagano, Junji; Fukuda, Koichiro; Hirata, Naomi; Yoshinaga, Takeshi; Ichiyasu, Hidenori; Tsumura, Shinsuke; Kohrogi, Hirotsugu; Kawaguchi, Atsushi; Yoshioka, Masakazu; Sakuma, Tsutomu; Suga, Moritaka

    2012-01-01

    Objectives To examine whether the extent of fibroproliferative changes on high-resolution CT (HRCT) scan influences prognosis, ventilator dependency and the associated outcomes in patients with early acute respiratory distress syndrome (ARDS). Design A prospective observational cohort study. Setting Intensive care unit in a teaching hospital. Participants 85 patients with ARDS who met American-European Consensus Conference Criteria and eligible criteria. Interventions HRCT scans were performed and prospectively evaluated by two independent observers on the day of diagnosis and graded into six findings according to the extent of fibroproliferation. An overall HRCT score was obtained by previously published method. Primary and secondary outcomes The primary outcome was 60-day mortality. Secondary outcomes included the number of ventilator-free days, organ failure-free days, the incidence of barotraumas and the occurrence of ventilator-associated pneumonia. Results Higher HRCT scores were associated with statistically significant decreases in organ failure-free days as well as ventilator-free days. Multivariate Cox proportional hazards model showed that the HRCT score remained an independent risk factor for mortality (HR 1.20; 95% CI 1.06 to 1.36; p=0.005). Multivariate analysis also revealed that the CT score had predictive value for ventilator weaning within 28 days (OR 0.63; 95% CI 0.48 to 0.82; p=0.0006) as well as for an incidence of barotraumas (OR 1.61; 95% CI 1.08 to 2.38; p=0.018) and for an occurrence of ventilator-associated pneumonia (OR 1.46; 95% CI 1.13 to 1.89; p=0.004). A HRCT score <210 enabled prediction of 60-day survival with 71% sensitivity and 72% specificity and of ventilator-weaning within 28 days with 75% sensitivity and 76% specificity. Conclusions Pulmonary fibroproliferation assessed by HRCT in patients with early ARDS predicts increased mortality with an increased susceptibility to multiple organ failure, including ventilator

  8. Determinants of diagnostic accuracy in pulmonary scintigraphy for pulmonary capillary protein leak associated with adult respiratory distress syndrome (ARDS): a technical note.

    PubMed

    Tatum, J; Sugerman, H; Perdikaris, N; Rehr, R; Burke, T; Fratkin, M

    1989-01-01

    Radionuclide assessment of pulmonary capillary protein leak using [99mTc] human serum albumin (99mTc-HSA) was first reported from our laboratory. In this study we investigated the impact of 1) sampling time post tracer injection, and 2) lung region assignment, on diagnostic accuracy between 2 groups (control n = 20 and ARDS n = 20). Each patient received 370 MBq 99mTc-HSA i.v. and was imaged for 45 min. The slope index (SI) [change in lung: heart activity ratio/min] was calculated from 11 computer assigned lung regions for intervals of 5-15 (early [E]) and 15-45 (late [L]) min. The diagnostic accuracy of E vs L SI calculations for the 11 regions was evaluated by stepwise logistic regression. E SI data and L SI data from the lower 1/3 of the lung did not achieve significance for inclusion in the discriminant model (P less than 0.05). In the nine remaining regions L SI was significant. Optimal discrimination was achieved from L SI data obtained from a region confined to the lateral half of the mid 3rd of the lung field (sensitivity 81%, specificity 85%, accuracy 83%). The results confirm that: 1) a late (15-45 min) sampling period and 2) proper region assignment are necessary to maximize accuracy of this technique. PMID:2920740

  9. The role of glutathione-S-transferase polymorphisms on clinical outcome of ALI/ARDS patient treated with N-acetylcysteine.

    PubMed

    Moradi, Mandana; Mojtahedzadeh, Mojtaba; Mandegari, Ali; Soltan-Sharifi, Mohammad Sadegh; Najafi, Atabak; Khajavi, Mohammad Reza; Hajibabayee, Molook; Ghahremani, Mohammad Hossein

    2009-03-01

    Oxidative stress has a proven role in pathophysiology of acute respiratory distress syndrome. The antioxidant drugs, especially N-acetylcysteine (NAC) have been used for years to overcome oxidative stress effects in patients. In the present study we have investigated the effects of NAC treatment (IV NAC in 150mg/kg at the first day followed by 50mg/kg/day for three days) on 27 ICU patients with ALI/ARDS considering the glutathione-S-transferase genetic variations, as an important enzyme contributing in oxidative stress pathways. The results indicated that NAC improved oxygenation (increase in PaO(2)/FiO(2)) and decreased mortality rate in treated patients compared to control group (p<0.05). Evaluation of three isoforms of glutathione-S-transferase (GST M1, P1 and T1), in these patients have showed an association between GST M1 null, and GST M1 and T1 double null polymorphisms with increased mortality in control group, suggesting antioxidant therapy critical for this group of patients. PMID:18993042

  10. Acute Respiratory Distress Syndrome (ARDS)

    MedlinePlus

    ABOUT US OUR INITIATIVES LUNG HEALTH & DISEASES SUPPORT & COMMUNITY STOP SMOKING GET INVOLVED DONATE - ABOUT US Mission, Impact & History Local Associations Our Leadership Scientific Advisors Financial Statements Media ...

  11. Comparison of Preoperative Temporal Bone CT with Intraoperative Findings in Patients with Cholesteatoma

    PubMed Central

    Rogha, Mehrdad; Hashemi, Sayyed Mostafa; Mokhtarinejad, Farhad; Eshaghian, Afrooz; Dadgostar, Alireza

    2014-01-01

    Introduction: Cholesteatoma is traditionally diagnosed by otoscopic examination and treated by surgery. The necessity for imaging in an uncomplicated case is controversial. This study was planned to investigate the usefulness of a preoperative high-resolution computed tomography (HRCT) scan in depicting the status of middle ear structures in the presence of cholesteatoma and also to compare the correspondence between pre- and intraoperative CT findings in patients with cholesteatoma. Materials and Methods: This prospective descriptive study was performed from January 2009 to May 2011 in 36 patients with cholesteatoma who were referred to the Kashani and Al-Zahra Clinics of Otolaryngology. Preoperative high-resolution temporal bone CT scans (axial and coronal views) were carried out and compared with intraoperative findings. Results: Evaluation of 36 patients and their CT scans revealed excellent correlation for sigmoid plate erosion, widening of aditus, and erosion of scutum; good correlation for erosion of malleus and tegmen; moderate correlation for lateral canal fistula (LCF) and erosion of mastoid air cells; and poor correlation for facial nerve dehiscence (FND), incus, and stapes erosion. Conclusion: A preoperative CT scan may be helpful in relation to diagnosis and decision making for surgery in cases of cholesteatoma and ossicular erosion. The CT scan can accurately predict the extent of disease and is helpful for detection of lateral canal fistula, erosions of dural plate, and ossicular erosions. However it is not able to distinguish between cholesteatoma and mucosal disease, facial nerve dehiscency, incus, and stapes erosion. PMID:24505568

  12. A randomised controlled trial and cost-effectiveness analysis of high-frequency oscillatory ventilation against conventional artificial ventilation for adults with acute respiratory distress syndrome. The OSCAR (OSCillation in ARDS) study.

    PubMed Central

    Lall, Ranjit; Hamilton, Patrick; Young, Duncan; Hulme, Claire; Hall, Peter; Shah, Sanjoy; MacKenzie, Iain; Tunnicliffe, William; Rowan, Kathy; Cuthbertson, Brian; McCabe, Chris; Lamb, Sallie

    2015-01-01

    BACKGROUND Patients with the acute respiratory distress syndrome (ARDS) require artificial ventilation but this treatment may produce secondary lung damage. High-frequency oscillatory ventilation (HFOV) may reduce this damage. OBJECTIVES To determine the clinical benefit and cost-effectiveness of HFOV in patients with ARDS compared with standard mechanical ventilation. DESIGN A parallel, randomised, unblinded clinical trial. SETTING UK intensive care units. PARTICIPANTS Mechanically ventilated patients with a partial pressure of oxygen in arterial blood/fractional concentration of inspired oxygen (P : F) ratio of 26.7 kPa (200 mmHg) or less and an expected duration of ventilation of at least 2 days at recruitment. INTERVENTIONS Treatment arm HFOV using a Novalung R100(®) ventilator (Metran Co. Ltd, Saitama, Japan) ventilator until the start of weaning. Control arm Conventional mechanical ventilation using the devices available in the participating centres. MAIN OUTCOME MEASURES The primary clinical outcome was all-cause mortality at 30 days after randomisation. The primary health economic outcome was the cost per quality-adjusted life-year (QALY) gained. RESULTS One hundred and sixty-six of 398 patients (41.7%) randomised to the HFOV group and 163 of 397 patients (41.1%) randomised to the conventional mechanical ventilation group died within 30 days of randomisation (p = 0.85), for an absolute difference of 0.6% [95% confidence interval (CI) -6.1% to 7.5%]. After adjustment for study centre, sex, Acute Physiology and Chronic Health Evaluation II score, and the initial P : F ratio, the odds ratio for survival in the conventional ventilation group was 1.03 (95% CI 0.75 to 1.40; p = 0.87 logistic regression). Survival analysis showed no difference in the probability of survival up to 12 months after randomisation. The average QALY at 1 year in the HFOV group was 0.302 compared to 0.246. This gives an incremental cost-effectiveness ratio (ICER) for the cost to

  13. Find a Surgeon

    MedlinePlus

    ... find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring teeth ... find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring teeth ...

  14. [Explosive "Roman find"].

    PubMed

    Stiel, Michael; Dettmeyer, Reinhard; Madea, Burkhard

    2006-01-01

    A case of a 40-year-old hobby archeologist is presented who searched for remains from Roman times. After finding an oblong, cylindrical object, he opened it with a saw to examine it, which triggered an explosion killing the man. The technical investigation of the remains showed that the find was actually a grenade from the 2nd World War. The autopsy findings and the results of the criminological investigation are presented. PMID:16529179

  15. Find a Midwife

    MedlinePlus

    ... The Find a Midwife practice locator is a web-based service that allows you to find midwifery practices in ... practice name, address, phone number, e-mail address, web site and a map of the ... reproductive health services, or gynecologic health, you may leave the birth ...

  16. Find an ACFAS Physician

    MedlinePlus

    ... Search Text Size Print Bookmark Find an ACFAS Physician Acceptance Policy By clicking on the "I Accept" ... Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Dem People's Rep Korea, Rebublic Of Kuwait Kyrgyzstan ...

  17. Find a Therapist

    MedlinePlus

    ... Facts Find Help News and Research Tips for Soldiers and Veterans Tips for Families and Friends Take ... questions to ask for yourself and for your child . If we can be of further assistance Contact ...

  18. Finding New Variable Stars

    NASA Astrophysics Data System (ADS)

    Joner, M. D.

    2016-06-01

    (Abstract only) Initial findings are presented for several new variable stars that have been identified using CCD photometry done with the 0.9-meter telescope located at the BYU West Mountain Observatory.

  19. ASGE: Find a Doctor

    MedlinePlus

    ... Join ASGE Event Calendar Cart LOG IN MEMBERS HEALTHCARE PROFESSIONALS PATIENTS ADVOCACY Advocacy Agenda Legislation Regulation Take Action ... New Members GI-Related Links MEMBERS Find A Doctor About ASGE Members ASGE physicians and surgeons have ...

  20. Find a Physical Therapist

    MedlinePlus

    ... physical therapists, physical therapist assistants, and students of physical therapy. Other Popular Resources: - Member Directory - Annual Reports Careers & Education Find Jobs Courses & Conferences About PT/PTA Careers Career Management ...

  1. Find a Cancer Doctor

    MedlinePlus

    ... Status message Locating you... The Find an Oncologist Database is made available by ASCO as an informational resource for patients and caregivers. The database includes the names of physicians and other health ...

  2. Find a Physical Therapist

    MedlinePlus

    ... There are numerous benefits to treatment by a physical therapist. Go There » For Patients Choosing Your PT Preparing ... need to know before your appointment with your physical therapist. Go There » Find a PT For Health Professionals ...

  3. Finding a Neurosurgeon

    MedlinePlus

    ... The first step in getting proper treatment for Chiari is to find the right doctor. While many ... neurologist, given that the only real treatment for Chiari is surgical, Conquer Chiari recommends that patients see ...

  4. Finding Your Voice

    ERIC Educational Resources Information Center

    Neugebauer, Bonnie

    2008-01-01

    In this article, the author offers ways on how to find a voice when telling or sharing stories in print or in person. To find a voice, someone must: (1) Trust themselves; (2) Trust their audience whether they know they can trust them or not; (3) Be respectful in their inventions; (4) Listen to and read the stories of others; (5) Make mistakes; (6)…

  5. Finding the engram.

    PubMed

    Josselyn, Sheena A; Köhler, Stefan; Frankland, Paul W

    2015-09-01

    Many attempts have been made to localize the physical trace of a memory, or engram, in the brain. However, until recently, engrams have remained largely elusive. In this Review, we develop four defining criteria that enable us to critically assess the recent progress that has been made towards finding the engram. Recent 'capture' studies use novel approaches to tag populations of neurons that are active during memory encoding, thereby allowing these engram-associated neurons to be manipulated at later times. We propose that findings from these capture studies represent considerable progress in allowing us to observe, erase and express the engram. PMID:26289572

  6. Tooth Tutoring: The Findings.

    ERIC Educational Resources Information Center

    Cone, Richard; And Others

    Findings are reported on a three year cross-age tutoring program in which undergraduate dental hygiene students and college students from other disciplines trained upper elementary students to tutor younger students in the techniques of dental hygiene. Data includes pre-post scores on the Oral Hygiene Index of plaque for both experimental and…

  7. Find a Periodontist

    MedlinePlus

    Search form Search Search form Search Select a Page Home About Us Vision and Mission AAP Membership Benefits of Membership AAP Benefits Details ... a Periodontist - Advanced Search Find a Periodontist - Advanced Search U.S. Zip Code Search The best way to ...

  8. Find a Massage Therapist

    MedlinePlus

    ... Workplace Options Business Finances Career Path Quiz Job Bank Job Bank AMTA's Customized Job Bank Works for You Search massage therapy jobs in ... open positions and resumes for free. AMTA Job Bank » Get Started Find Jobs Sign up for Job ...

  9. Find a Podiatrist

    MedlinePlus

    ... Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Zip / Postal Code: The closest podiatrist may not be in your zip code. Please use the mile radius search OR enter just the first 3 digits of your zip code to find the ...

  10. Finding Those Missing Links

    ERIC Educational Resources Information Center

    Gunn, Holly

    2004-01-01

    In this article, the author stresses not to give up on a site when a URL returns an error message. Many web sites can be found by using strategies such as URL trimming, searching cached sites, site searching and searching the WayBack Machine. Methods and tips for finding web sites are contained within this article.

  11. Find a Dentist

    MedlinePlus

    ... AGD. It shall not be used for any commercial purpose without the express, written permission, and consent of the AGD. Misuse of this service will result in prosecution to the fullest extent of all applicable law. Home | InfoBites | Find an AGD Dentist | Your Family's ...

  12. Comparison of hydrogeochemical logging of drilling fluid during coring with the results from geophysical logging and hydraulic testing Example of the Morte-Mérie scientific borehole, Ardèche-France, Deep Geology of France Programme

    NASA Astrophysics Data System (ADS)

    Aquilina, L.; Eberschweiler, C.; Perrin, J.; Deep Geology of France Team

    1996-11-01

    A 980-m-deep well was cored on the Ardèche border of the Southeastern basin of France as part of the Deep Geology of France (GPF) programme. Hydrogeochemical logging was carried out during drilling, which involved the monitoring of physico-chemical parameters (pH, Eh, temperature and conductivity), and chemical parameters (concentrations of He, Rn, CO 2, CH 4, O 2 Ca, Cl and SiO 2) of the drilling fluid permanently circulating in the well. This logging programme was complemented by geophysical logging and two hydraulic tests. The combination of these measurements enabled identification of a transmissive interval due to fractures in the Jurassic carbonates, and of fluid inflow both at the base of the porous and slightly permeable Triassic sandstones and from an open fracture in the Permian conglomerates. These intervals are marked by changes in the drilling-fluid chemistry, such as an increase in chemical species content, or a drop in pH. The degree of modification depends on the natural permeability of the fractures and the salinity of the fluids. The porous and permeable intervals are also marked by He anomalies, which act as a tracer for these zones. Comparison between the geophysical and hydrogeochemical logs reveals that the latter provide information on the liquid phase, whether the fractures are productive or not, whereas the geophysical logs are more directly related to the solid phase.

  13. CT findings in leukemia

    SciTech Connect

    Heiberg, E.; Wolverson, M.K.; Sundaram, M.; Shields, J.B.

    1984-12-01

    Review of 84 computed tomographic (CT) scans in leukemic patients demonstrate a wide spectrum of abnormalities. Findings caused by leukemia were lymphadenopathy, visceral enlargement, focal defects, and tissue infiltration. Hemorrhage was by far the most common complication and could usually be characterized on the noncontrast CT scan. The distinction between old hematomas, foci of infection, and leukemia infiltration could not be made with certainty without CT-guided aspiration. Unusual instances of sepsis, such as microabscesses of the liver and typhlitis, were seen.

  14. Sonographic Findings of Hydropneumothorax.

    PubMed

    Nations, Joel Anthony; Smith, Patrick; Parrish, Scott; Browning, Robert

    2016-09-01

    Ultrasound is increasingly being used in examination of the thorax. The sonographic features of normal aerated lung, abnormal lung, pneumothorax, and intrapleural fluid have been published. The sonographic features of uncommon intrathoracic syndromes are less known. Hydropneumothorax is an uncommon process in which the thoracic cavity contains both intrapleural air and water. Few published examples of the sonographic findings in hydropneumothorax exist. We present 3 illustrative cases of the sonographic features of hydropneumothorax with comparative imaging and a literature review of the topic. PMID:27556194

  15. MRI Findings in Neuroferritinopathy

    PubMed Central

    Ohta, Emiko; Takiyama, Yoshihisa

    2012-01-01

    Neuroferritinopathy is a neurodegenerative disease which demonstrates brain iron accumulation caused by the mutations in the ferritin light chain gene. On brain MRI in neuroferritinopathy, iron deposits are observed as low-intensity areas on T2WI and as signal loss on T2∗WI. On T2WI, hyperintense abnormalities reflecting tissue edema and gliosis are also seen. Another characteristic finding is the presence of symmetrical cystic changes in the basal ganglia, which are seen in the advanced stages of this disorder. Atrophy is sometimes noted in the cerebellar and cerebral cortices. The variety in the MRI findings is specific to neuroferritinopathy. Based on observations of an excessive iron content in patients with chronic neurologic disorders, such as Parkinson disease and Alzheimer disease, the presence of excess iron is therefore recognized as a major risk factor for neurodegenerative diseases. The future development of multimodal and advanced MRI techniques is thus expected to play an important role in accurately measuring the brain iron content and thereby further elucidating the neurodegenerative process. PMID:21808735

  16. Whole-genome Sequencing for Tracing the Transmission Link between Two ARD Outbreaks Caused by a Novel HAdV Serotype 7 Variant, China

    PubMed Central

    Qiu, Shaofu; Li, Peng; Liu, Hongbo; Wang, Yong; Liu, Nan; Li, Chengyi; Li, Shenlong; Li, Ming; Jiang, Zhengjie; Sun, Huandong; Li, Ying; Xie, Jing; Yang, Chaojie; Wang, Jian; Li, Hao; Yi, Shengjie; Wu, Zhihao; Jia, Leili; Wang, Ligui; Hao, Rongzhang; Sun, Yansong; Huang, Liuyu; Ma, Hui; Yuan, Zhengquan; Song, Hongbin

    2015-01-01

    From December 2012 to February 2013, two outbreaks of acute respiratory disease caused by HAdV-7 were reported in China. We investigated possible transmission links between these two seemingly unrelated outbreaks by integration of epidemiological and whole-genome sequencing (WGS) data. WGS analyses showed that the HAdV-7 isolates from the two outbreaks were genetically indistinguishable; however, a 12 bp deletion in the virus-associated RNA gene distinguished the outbreak isolates from other HAdV-7 isolates. Outbreak HAdV-7 isolates demonstrated increased viral replication compared to non-outbreak associated HAdV-7 isolate. Epidemiological data supported that the first outbreak was caused by introduction of the novel HAdV-7 virus by an infected recruit upon arrival at the training base. Nosocomial transmission by close contacts was the most likely source leading to onset of the second HAdV-7 outbreak, establishing the apparent transmission link between the outbreaks. Our findings imply that in-hospital contact investigations should be encouraged to reduce or interrupt further spread of infectious agents when treating outbreak cases, and WGS can provide useful information guiding infection-control interventions. PMID:26338697

  17. Finding the Next Earth

    NASA Astrophysics Data System (ADS)

    Batalha, Natalie M.; Kepler Team

    2013-01-01

    Twenty years ago, we knew of no planets orbiting other Sun-like stars, yet today, the roll call is nearly 1,000 strong. Statistical studies of exoplanet populations are possible, and words like "habitable zone" are heard around the dinner table. Theorists are scrambling to explain not only the observed physical characteristics but also the orbital and dynamical properties of planetary systems. The taxonomy is diverse but still reflects the observational biases that dominate the detection surveys. We've yet to find another planet that looks anything like home. The scene changed dramatically with the launch of the Kepler spacecraft in 2009 to determine, via transit photometry, the fraction of stars harboring earth-size planets in or near the Habitable Zone of their parent star. Early catalog releases hint that nature makes small planets efficiently: over half of the sample of 2,300 planet candidates discovered in the first two years are smaller than 2.5 times the Earth's radius. I will describe Kepler's milestone discoveries and progress toward an exo-Earth census. Humankind's speculation about the existence of other worlds like our own has become a veritable quest.

  18. Scintigraphic findings in schistosomiasis.

    PubMed

    Orduña, E; Silva, F

    1995-12-01

    Schistosomiasis mansoni is a tropical parasitic disease caused by a blood fluke which inhabits the portal system of humans. Fifteen pediatric patients with the acute disease were evaluated with liver and spleen scintigraphy (LSS). Clinical history, physical examination, and serum chemistries failed to reveal any other underlying systemic disease. Liver and spleen scintigraphies were performed before therapy, 7 months and 9 years after therapy with oxamniquine. LSS initially showed hepatomegaly in 93% of the patients. In the first follow up study a reactive spleen was evident in 78% of the cases, with an unchanged hepatic image. Long term follow up revealed that from the initially enlarged livers, 93% became normal. However, 47% of the spleens were abnormal. The scintigraphic changes observed in the liver over the years were those expected for an acute infection. The findings in the spleen might indicate the persistence of an immunologic reaction with a continuous trigger, probably an antibody. These observations suggest that the LSS can be used in the evaluation and follow-up of these patients. PMID:8637963

  19. The phylogenetic utility of acetyltransferase (ARD1) and glutaminyl tRNA synthetase (QtRNA) for reconstructing Cenozoic relationships as exemplified by the large Australian cicada Pauropsalta generic complex.

    PubMed

    Owen, Christopher L; Marshall, David C; Hill, Kathy B R; Simon, Chris

    2015-02-01

    The Pauropsalta generic complex is a large group of cicadas (72 described spp.; >82 undescribed spp.) endemic to Australia. No previous molecular work on deep level relationships within this complex has been conducted, but a recent morphological revision and phylogenetic analysis proposed relationships among the 11 genera. We present here the first comprehensive molecular phylogeny of the complex using five loci (1 mtDNA, 4 nDNA), two of which are from nuclear genes new to cicada systematics. We compare the molecular phylogeny to the morphological phylogeny. We evaluate the phylogenetic informativeness of the new loci to traditional cicada systematics loci to generate a baseline of performance and behavior to aid in gene choice decisions in future systematic and phylogenomic studies. Our maximum likelihood and Bayesian inference phylogenies strongly support the monophyly of most of the newly described genera; however, relationships among genera differ from the morphological phylogeny. A comparison of phylogenetic informativeness among all loci revealed that COI 3rd positions dominate the informativeness profiles relative to all other loci but exhibit some among taxon nucleotide bias. After removing COI 3rd positions, COI 1st positions dominate near the terminals, while the period intron has the most phylogenetic informativeness near the root. Among the nuclear loci, ARD1 and QtRNA have lower phylogenetic informativeness than period intron and elongation factor 1 alpha intron, but the informativeness increases at you move from the tips to the root. The increase in phylogenetic informativeness deeper in the tree suggests these loci may be useful for resolving older relationships. PMID:25091217

  20. Thoracic textilomas: CT findings*

    PubMed Central

    Machado, Dianne Melo; Zanetti, Gláucia; Araujo, Cesar Augusto; Nobre, Luiz Felipe; Meirelles, Gustavo de Souza Portes; Pereira e Silva, Jorge Luiz; Guimarães, Marcos Duarte; Escuissato, Dante Luiz; Souza, Arthur Soares; Hochhegger, Bruno; Marchiori, Edson

    2014-01-01

    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. PMID:25410842

  1. Recent advances in understanding and treating ARDS

    PubMed Central

    Baron, Rebecca M.; Levy, Bruce D.

    2016-01-01

    Acute respiratory distress syndrome represents a complex syndrome with considerable morbidity and mortality, for which there exist no targeted treatment strategies. However, recent advances in clinical care have improved outcomes, and we will review a number of these approaches here, as well as explore the mechanisms underlying the benefit of intervention that might point us in the direction toward future treatment and preventive strategies for this devastating syndrome. PMID:27158460

  2. Findings.

    ERIC Educational Resources Information Center

    Viadero, Debra; Coles, Adrienne D.

    1998-01-01

    Studies on race-based admissions, sports and sex, and religion and drugs suggest that: affirmative action policies were successful regarding college admissions; boys who play sports are more likely to be sexually active than their peers, with the opposite true for girls; and religion is a major factor in whether teens use cigarettes, alcohol, and…

  3. Going Local to Find Help

    MedlinePlus

    ... Home Current Issue Past Issues Cover Story: Traumatic Brain Injury Going Local to Find Help Past Issues / ... the time. From the MedlinePlus page on Traumatic Brain Injury, you can use Go Local to find ...

  4. Radiographic findings of Proteus Syndrome

    PubMed Central

    Gandhi, Nishant Mukesh; Davalos, Eric A.; Varma, Rajeev K.

    2015-01-01

    The extremely rare Proteus Syndrome is a hamartomatous congenital syndrome with substantial variability between clinical patient presentations. The diagnostic criteria consist of a multitude of clinical findings including hemihypertrophy, macrodactyly, epidermal nevi, subcutaneous hamartomatous tumors, and bony abnormalities. These clinical findings correlate with striking radiographic findings. PMID:27186241

  5. Histological findings in human brucellosis

    PubMed Central

    Hunt, A. C.; Bothwell, P. W.

    1967-01-01

    The histological findings in 14 cases of brucellosis are described. Unusual findings include the occurrence of brucellosis in a patient with Hodgkin's disease and in another with lymphosarcoma. A patient with hepatic cirrhosis apparently due to brucellosis is included in the series. Images PMID:5632572

  6. Empirical Findings and Educational Policies.

    ERIC Educational Resources Information Center

    Kotter, Ludwig

    1988-01-01

    Sketches relevant issues of the relationship between findings in the field of educational science and decisions to be taken in educational policy. Discusses possible interaction models, identifying factors relevant to their realization. States that the identification of factors determining the application of research findings remains an important…

  7. Finding the object'' proceedings addendum

    SciTech Connect

    Whiting, M.A.; Devaney, D.M.

    1990-10-01

    The purpose of this workshop was to discuss finding the object -- that is, how software engineers imagine, invent, design, or recycle objects and their behaviors for object-oriented software engineering. The workshop organizers (and, as we subsequently discovered, several of the workshop participants) felt that this issue is crucial to successful object-oriented software engineering (after all, finding objects is what the projects is all about, isn't it ). Unfortunately, when previous workshops have had the opportunity to review and discuss techniques practitioners use to find objects, too often the results were heated debates on what is an object '' which becomes all consuming. We believed that, given appropriate control over the question of which kind of object'' is being discussed (which meant tell us what object you are trying to find, then tell us your method), a workshop to concentrate on techniques for finding objects would be quite appropriate. 8 refs., 2 figs.

  8. Visual direction finding by fishes

    NASA Technical Reports Server (NTRS)

    Waterman, T. H.

    1972-01-01

    The use of visual orientation, in the absence of landmarks, for underwater direction finding exercises by fishes is reviewed. Celestial directional clues observed directly near the water surface or indirectly at an asymptatic depth are suggested as possible orientation aids.

  9. Finding an Eye Care Professional

    MedlinePlus

    ... article rating hospitals in the United States. Website: http://health.usnews.com/best-hospitals For More Information ... ophthalmologists in the United States and abroad. Website: https://secure.aao.org/aao/find-ophthalmologist The American ...

  10. A Family Finds Its Way

    MedlinePlus

    ... Cover Story: Traumatic Brain Injury A Family Finds Its Way Past Issues / Fall 2008 Table of Contents ... spoke recently with NIH MedlinePlus ' Christopher Klose. At its heart, TBI, hearing loss, any health condition is ...

  11. Going Local to Find Help

    MedlinePlus

    ... Bar Home Current Issue Past Issues Cover Story: Traumatic Brain Injury Going Local to Find Help Past Issues / Fall ... local health and social services for survivors of TBI is as important as knowing about the medical ...

  12. Find a NCCAOM Certified Practitioner

    MedlinePlus

    ... NCCAOM Certification Get Certified Get Recertified PDA Search Engine Find A Practitioner State Licensing Helpful NCCAOM Links ... My Status State Licensure Diplomates Recertification PDA Search Engine State Licensure Consumers Diplomate of Acupuncture Diplomate of ...

  13. Radiographic findings in liveborn triploidy.

    PubMed

    Silverthorn, K G; Houston, C S; Newman, D E; Wood, B J

    1989-01-01

    The detailed radiographic features of triploidy, a fatal congenital disorder with 69 chromosomes, have not previously been reported. Radiographs of ten liveborn infants with chromosomally confirmed triploidy showed six findings highly suggestive of this diagnosis: harlequin orbits, small anterior fontanelle, gracile ribs, diaphyseal overtubulation of long bones, upswept clavicles and antimongoloid pelvis. Sixteen other less specific findings showed many similarities to those found in trisomy 18. PMID:2748230

  14. Peak finding using biorthogonal wavelets

    SciTech Connect

    Tan, C.Y.

    2000-02-01

    The authors show in this paper how they can find the peaks in the input data if the underlying signal is a sum of Lorentzians. In order to project the data into a space of Lorentzian like functions, they show explicitly the construction of scaling functions which look like Lorentzians. From this construction, they can calculate the biorthogonal filter coefficients for both the analysis and synthesis functions. They then compare their biorthogonal wavelets to the FBI (Federal Bureau of Investigations) wavelets when used for peak finding in noisy data. They will show that in this instance, their filters perform much better than the FBI wavelets.

  15. CT findings of atrial myxoma

    SciTech Connect

    Tsuchiya, F.; Kohno, A.; Saitoh, R.; Shigeta, A.

    1984-04-01

    The computed tomographic (CT) appearance of six atrial myxomas was analyzed. Five of the myxomas were located in the left atrium and one was in the right atrium. The margin of the myxoma was at least slightly lobulated in five cases and the content was inhomogeneous in all. Calcification was demonstrated in three cases. The site of attachment of the myxoma was demonstrated by CT to be the arial septum in all cases. The CT finding correlated well with the operative findings. It is concluded that it is possible with CT to diagnose atrial myxoma by the location and nature of the intracardiac mass and to differentiate it from thrombus.

  16. Findings from ATSDR's Health Assessments.

    ERIC Educational Resources Information Center

    Susten, Allan S.

    1992-01-01

    Summarizes findings from the Agency for Toxic Substances and Disease Registry concerning the evaluation of data about hazardous substance release into the environment. Identifies the hazardous substances, exposure, health effects, and public health impact from 951 facilities identified on the National Priorities List (NPL) by the Environmental…

  17. Finding a Voice through Research

    ERIC Educational Resources Information Center

    Lobo, Jose; Vizcaino, Alida

    2006-01-01

    One question guided this experimental study: What impact does the change from teacher training to educational research have on university teachers' methodology and attitudes to teaching? To find answers to this question, the researchers selected five teachers of English as a Foreign Language (EFL) at the language centre of a private university on…

  18. Multi-Criteria Path Finding

    NASA Astrophysics Data System (ADS)

    Mohammadi, E.; Hunter, A.

    2012-07-01

    Path finding solutions are becoming a major part of many GIS applications including location based services and web-based GIS services. Most traditional path finding solutions are based on shortest path algorithms that tend to minimize the cost of travel from one point to another. These algorithms make use of some cost criteria that is usually an attribute of the edges in the graph network. Providing one shortest path limits user's flexibility when choosing a possible route, especially when more than one parameter is utilized to calculate cost (e.g., when length, number of traffic lights, and number of turns are used to calculate network cost.) K shortest path solutions tend to overcome this problem by providing second, third, and Kth shortest paths. These algorithms are efficient as long as the graphs edge weight does not change dynamically and no other parameters affect edge weights. In this paper we try to go beyond finding shortest paths based on some cost value, and provide all possible paths disregarding any parameter that may affect total cost. After finding all possible paths, we can rank the results by any parameter or combination of parameters, without a substantial increase in time complexity.

  19. MR imaging findings of endophthalmitis.

    PubMed

    Radhakrishnan, Rupa; Cornelius, Rebecca; Cunnane, Mary Beth; Golnik, Karl; Morales, Humberto

    2016-04-01

    Endophthalmitis is a sight-threatening ophthalmologic emergency. The clinical diagnosis is often challenging, and delayed diagnosis may exacerbate the poor visual prognosis. B-scan ultrasonography or spectral domain optical coherence tomography are imaging aids at the clinician's office. Cross-sectional imaging such as CT and particularly MRI can also help in the assessment of disease extent or complications. MR imaging findings are rarely described in the literature. Here, we discuss the spectrum of imaging findings of endophthalmitis and correlate them with key anatomic and pathophysiologic details of the globe. Early disease is often subtle on MR imaging with thick uveal enhancement, while advanced disease demonstrates retinal/choroidal detachment, vitreal exudates and peribulbar inflammation. Other noninfectious inflammatory diseases of the globe can show similar findings; however, MR diffusion-weighted images help identify infectious exudates and evaluate response to therapy. Knowledge of the spectrum of imaging findings of this disease is important for radiologists and help in the management decision process. PMID:26915896

  20. Writing audit findings: Be reasonable

    SciTech Connect

    Girvin, N.W.

    1992-05-01

    A customary approach to auditing and reporting deficiencies is to keep a running list of those that are found, evaluate the severity of each, and based on the evidence, document findings or observations or concerns in an audit report. The report is issued and the auditee is normally requested to address root cause'' as part of their corrective action. This paper describes a root problems'' approach to documenting audit findings that is designed not only to put the QA auditor in a more favorable light, but to more effectively enable the auditee to identify root cause and meaningful corrective action. The positive results of this approach are considerable. You will have fewer findings but those you do have will be substantial. You will cite requirements that sound reasonable and make arguments difficult. If some of the supporting deficiencies (examples) prove to be incorrect, you will still have ample support for the original finding. You will be seen as reasonable individual who can help lead the auditee towards identification of root cause without taking away part of the responsibility. You even have a fair chance of fostering a sense of commitment to quality improvement on the auditee's part. This in itself, is its own reward.

  1. Writing audit findings: Be reasonable!

    SciTech Connect

    Girvin, N.W.

    1992-05-01

    A customary approach to auditing and reporting deficiencies is to keep a running list of those that are found, evaluate the severity of each, and based on the evidence, document findings or observations or concerns in an audit report. The report is issued and the auditee is normally requested to address ``root cause`` as part of their corrective action. This paper describes a ``root problems`` approach to documenting audit findings that is designed not only to put the QA auditor in a more favorable light, but to more effectively enable the auditee to identify root cause and meaningful corrective action. The positive results of this approach are considerable. You will have fewer findings but those you do have will be substantial. You will cite requirements that sound reasonable and make arguments difficult. If some of the supporting deficiencies (examples) prove to be incorrect, you will still have ample support for the original finding. You will be seen as reasonable individual who can help lead the auditee towards identification of root cause without taking away part of the responsibility. You even have a fair chance of fostering a sense of commitment to quality improvement on the auditee`s part. This in itself, is its own reward.

  2. MEMS AO for Planet Finding

    NASA Technical Reports Server (NTRS)

    Rao, Shanti; Wallace, J. Kent; Shao, Mike; Schmidtlin, Edouard; Levine, B. Martin; Samuele, Rocco; Lane, Benjamin; Chakrabarti, Supriya; Cook, Timothy; Hicks, Brian; Jung, Paul

    2008-01-01

    This slide presentation reviews a method for planet finding using microelectromechanical systems (MEMS) Adaptive Optics (AO). The use of a deformable mirror (DM) is described as a part of the instrument that was designed with a nulling interferometer. The strategy that is used is described in detail.

  3. Finding Cryptography in Object Code

    SciTech Connect

    Jason L. Wright

    2008-10-01

    Finding and identifying Cryptography is a growing concern in the malware analysis community. In this paper, a heuristic method for determining the likelihood that a given function contains a cryptographic algorithm is discussed and the results of applying this method in various environments is shown. The algorithm is based on frequency analysis of opcodes that make up each function within a binary.

  4. 1980-1981 Evaluation Findings.

    ERIC Educational Resources Information Center

    Austin Independent School District, TX. Office of Research and Evaluation.

    This volume summarizes the results of evaluation and testing activities carried out in the Austin, Texas, Independent School District (AISD) during the 1980-81 school year. The text consists of five parts: Section one highlights important findings in the areas of Title I Schoolwide Projects, compensatory programs, early childhood programs,…

  5. Finding Geography Using Found Poetry

    ERIC Educational Resources Information Center

    Foster, Ellen J.

    2012-01-01

    Functional literacy is important in both English/language arts and geography. Using the "found poetry" strategy, students will summarize a piece of text, identify main ideas and find geographic connections. While using young adult literature is a great way to incorporate geography into English/language arts classroom, understanding of geography…

  6. [Typical findings of maltreated children].

    PubMed

    Rauch, E; Zinka, B; Schneider, K; Penning, R; Eisenmenger, W

    2006-06-15

    Childhood maltreatment manifests in a variety of forms and the underlying causes are manifold. In contrast to other offences involving physical injury, reporting behavior has, statistically speaking, remained unchanged. Patterns of injury must first be established and documented, and this involves a complete examination of the child's body. Depending on the constellation of findings, a radiological diagnosis is usually necessary. When all the findings have been collected, the further steps to be taken--where indicated a report to the police--must be discussed. All the evidence must be recorded, and photos obtained of all externally visible injuries before they fade. It is not the task of the physician to develop criminalistic ambitions, for example, by grilling (a parent) on the cause of the injuries. However, he/she has a duty to do everything necessary to protect the well-being of the child. PMID:16850804

  7. Radiological Findings of Michel Aplasia

    PubMed Central

    Umul, Ayse; Demirtas, Hakan; Celik, Ahmet Orhan

    2016-01-01

    Introduction: Congenital abnormalities of the inner ear is the most common cause of neurosensory hearing loss. Michel inner ear deformity is a rare developmental anomaly refers to the total aplasia of the inner ear. It is caused by developmental arrest of otic placode early during the third week of gestational age. Case report: We have discussed here that three year old girl diagnosed Michel aplasia with temporal bone computed tomography (CT) and temporal magnetic resonance imaging (MRI) findings. PMID:27482139

  8. Breast Ultrasound: Indications and Findings.

    PubMed

    Gundry, Kathleen R

    2016-06-01

    Breast ultrasound is a widely used adjuvant to mammography for the detection of breast cancer. This chapter will review some of the basic ultrasound technical factors and techniques, describe findings on ultrasound with an emphasis on the Breast Imaging Reporting and Data System terminology, and present the indications for breast ultrasound. New innovations in breast ultrasound, such as elastography, ultrasound contrast, 3-dimensional, and automated whole-breast ultrasound, will be reviewed. Ultrasound-guided breast procedures are also presented. PMID:26974219

  9. Angiographic Findings in Biliary Atresia

    SciTech Connect

    Uflacker, Renan Pariente, Daniele M.

    2004-09-15

    We present the angiographic findings of 46 patients with biliary atresia (BA). There were 25 males and 21 females, with a mean age of 22.5 months (range - 1.5 to 141 months). Hepatic and mesenteric angiography were obtained as part of a liver transplantation work-up or as part of the treatment of clinical events. All patients had a histological diagnosis of BA. The portal vein was patent in 43 patients, with a mean size of 4.1 mm, using the arterial catheter as comparison. Portal hepatopetal flow was observed in 20 patient and hepatofugal flow was observed in 21 patients. Presence of gastroesophageal varices was observed in 41 patients. The hepatic artery was enlarged in all patients. In all 46 patients studied, the intrahepatic peripheral hepatic artery branches presented with irregularities in contour, including encasement, strictures, dilatation and angulation, and images suggestive of peripheral occlusion. Angiographic vascular 'tuft-like' blush surrounding the irregular or occluded peripheral arterial segments was observed in 40 patients. The injection of Microfil (registered) in one case showed a marked vascular proliferation within the portal tract, apparently derived from arterial and portal connections, filling the entire portal space. We conclude that the presence of angiographically demonstrable perivascular arterial tufts in the periphery of the hepatic arterial circulation is a common finding in cases of BA, and may be a characteristic diagnostic angiographic finding.

  10. Adult Hirschprung disease: radiographic findings.

    PubMed

    Mindelzun, R E; Hicks, S M

    1986-09-01

    Hirschprung disease is usually diagnosed in infancy. Occasionally patients reach adulthood without diagnosis or treatment. Four cases of adult Hirschprung disease are described. The principal radiographic findings are a markedly dilated, feces-filled colon above the zone of transition; a narrowed rectum; a cone- or funnel-shaped zone of transition; and a mosaic colonic pattern caused by collapsed redundant mucosa after colonic cleansing. In an adult, identification on a barium enema examination of an abrupt, smooth transition zone in the rectum with proximal colonic dilatation, in conjunction with an appropriate clinical history, should suggest the diagnosis of adult Hirschprung disease. PMID:3737900

  11. ECHOCARDIOGRAPHIC FINDINGS IN BACTERIAL ENDOCARDITIS

    PubMed Central

    Ibrahim, M. Mohsen; El-Said, Galal M.

    1978-01-01

    Fifteen echocardiographic recordings in nine patients with bacterial endocarditis revealed vegetations in six cases. The vegetations appeared as uneven, irregular thickening of a valve, a mass of shaggy, dense echoes attached to a leaflet or cusp, or a mass of irregular dense echoes in the cavity or outflow tract of the left ventricle. Such findings were seen only on the echocardiograms of very sick patients with severe valvular lesions. Three patients had flail mitral valves. Echocardiography was not helpful in differentiating between active and healed lesions. Problems in the identification and differential diagnosis of vegetations shown on echocardiograms are discussed. Images PMID:15216037

  12. Imaging Findings of Congestive Hepatopathy.

    PubMed

    Wells, Michael L; Fenstad, Eric R; Poterucha, Joseph T; Hough, David M; Young, Phillip M; Araoz, Philip A; Ehman, Richard L; Venkatesh, Sudhakar K

    2016-01-01

    Congestive hepatopathy (CH) refers to hepatic abnormalities that result from passive hepatic venous congestion. Prolonged exposure to elevated hepatic venous pressure may lead to liver fibrosis and cirrhosis. Liver dysfunction and corresponding clinical signs and symptoms typically manifest late in the disease process. Recognition of CH at imaging is critical because advanced liver fibrosis may develop before the condition is suspected clinically. Characteristic findings of CH on conventional images include dilatation of the inferior vena cava and hepatic veins; retrograde hepatic venous opacification during the early bolus phase of intravenous contrast material injection; and a predominantly peripheral heterogeneous pattern of hepatic enhancement due to stagnant blood flow. Extensive fibrosis can be seen in chronic or severe cases. Hyperenhancing regenerative nodules that may retain hepatobiliary contrast agents are often present. Magnetic resonance (MR) elastography can show elevated liver stiffness and may be useful in evaluation of fibrosis in CH because it can be incorporated easily into routine cardiac MR imaging. Preliminary experience with MR elastography suggests its future use in initial evaluation of patients suspected of having CH, for monitoring of disease, and for assessment after therapy. To facilitate appropriate workup and treatment, radiologists should be familiar with findings suggestive of CH at radiography, ultrasonography, computed tomography, MR imaging, and MR elastography. In addition, knowledge of underlying pathophysiology, comparative histologic abnormalities, and extrahepatic manifestations is useful to avoid diagnostic pitfalls and suggest appropriate additional diagnostic testing. (©)RSNA, 2016. PMID:27284758

  13. Acquired immunodeficiency syndrome: neuroradiologic findings.

    PubMed

    Kelly, W M; Brant-Zawadzki, M

    1983-11-01

    Central nervous system complications depicted by CT in ten patients with acquired immunodeficiency syndrome are described. Three patients had multifocal intra-axial enhancing lesions representing atypical brain abscesses (two with toxoplasmosis, one with candidiasis). A fourth patient with multifocal "ring" lesions whose biopsy was interpreted as suggestive of toxoplasmosis responded poorly to treatment. Following his death three months later of Pneumocystis carinii pneumonia, autopsy revealed primary intracerebral immunoblastic lymphoma. One patient had Kaposi sarcoma involving the right frontal lobe (seen as an enhancing mass on the CT scan). CT findings in the remaining five patients revealed mild to moderate enlargement of cerebrospinal fluid spaces (including ventricles and basal cisternae) as a result of cryptococcal meningitis in three patients and "aseptic" meningitis in two. The two patients in whom early biopsy confirmed toxoplasmosis responded well to anti-infective therapy, resulting in dramatic clinical recoveries. PMID:6622693

  14. Research Findings on Overactive Bladder

    PubMed Central

    Patra, Phani B.; Patra, Sayani

    2015-01-01

    Several physiopathologic conditions lead to the manifestation of overactive bladder (OAB). These conditions include ageing, diabetes mellitus, bladder outlet obstruction, spinal cord injury, stroke and brain injury, Parkinson's disease, multiple sclerosis, interstitial cystitis, stress and depression. This review has discussed research findings in human and animal studies conducted on the above conditions. Several structural and functional changes under these conditions have not only been observed in the lower urinary tract, but also in the brain and spinal cord. Significant changes were observed in the following areas: neurotransmitters, prostaglandins, nerve growth factor, Rho-kinase, interstitial cells of Cajal, and ion and transient receptor potential channels. Interestingly, alterations in these areas showed great variation in each of the conditions of the OAB, suggesting that the pathophysiology of the OAB might be different in each condition of the disease. It is anticipated that this review will be helpful for further research on new and specific drug development against OAB. PMID:26195957

  15. Magellan: Principal Venus science findings

    NASA Technical Reports Server (NTRS)

    Saunders, R. Stephen

    1993-01-01

    This is a brief summary of the science findings of the Magellan mission, principally based on data from the radar system. Future plans for Magellan include acquisition of high resolution gravity data from a nearly circular orbit and atmospheric drag and occultation experiments. The Magellan science results represent the combined effort of more than 100 Magellan investigators and their students and colleagues. More extensive discussions can be found in the August and October, 1992 issues of the Journal of Geophysical Research, Planets. The Magellan mission's scientific objectives were to provide a global characterization of landforms and tectonic features; to distinguish and understand impact processes; to define and explain erosion, deposition, and chemical processes; and to model the interior density distribution. All but the last objective, which requires new global gravity data, have been accomplished, or we have acquired the data that are required to accomplish them.

  16. Finding and Not Finding Rat Perirhinal Neuronal Responses to Novelty.

    PubMed

    von Linstow Roloff, Eva; Muller, Robert U; Brown, Malcolm W

    2016-08-01

    There is much evidence that the perirhinal cortex of both rats and monkeys is important for judging the relative familiarity of visual stimuli. In monkeys many studies have found that a proportion of perirhinal neurons respond more to novel than familiar stimuli. There are fewer studies of perirhinal neuronal responses in rats, and those studies based on exploration of objects, have raised into question the encoding of stimulus familiarity by rat perirhinal neurons. For this reason, recordings of single neuronal activity were made from the perirhinal cortex of rats so as to compare responsiveness to novel and familiar stimuli in two different behavioral situations. The first situation was based upon that used in "paired viewing" experiments that have established rat perirhinal differences in immediate early gene expression for novel and familiar visual stimuli displayed on computer monitors. The second situation was similar to that used in the spontaneous object recognition test that has been widely used to establish the involvement of rat perirhinal cortex in familiarity discrimination. In the first condition 30 (25%) of 120 perirhinal neurons were visually responsive; of these responsive neurons 19 (63%) responded significantly differently to novel and familiar stimuli. In the second condition eight (53%) of 15 perirhinal neurons changed activity significantly in the vicinity of objects (had "object fields"); however, for none (0%) of these was there a significant activity change related to the familiarity of an object, an incidence significantly lower than for the first condition. Possible reasons for the difference are discussed. It is argued that the failure to find recognition-related neuronal responses while exploring objects is related to its detectability by the measures used, rather than the absence of all such signals in perirhinal cortex. Indeed, as shown by the results, such signals are found when a different methodology is used. © 2016 The Authors

  17. Finding and Not Finding Rat Perirhinal Neuronal Responses to Novelty

    PubMed Central

    Muller, Robert U.; Brown, Malcolm W.

    2016-01-01

    ABSTRACT There is much evidence that the perirhinal cortex of both rats and monkeys is important for judging the relative familiarity of visual stimuli. In monkeys many studies have found that a proportion of perirhinal neurons respond more to novel than familiar stimuli. There are fewer studies of perirhinal neuronal responses in rats, and those studies based on exploration of objects, have raised into question the encoding of stimulus familiarity by rat perirhinal neurons. For this reason, recordings of single neuronal activity were made from the perirhinal cortex of rats so as to compare responsiveness to novel and familiar stimuli in two different behavioral situations. The first situation was based upon that used in “paired viewing” experiments that have established rat perirhinal differences in immediate early gene expression for novel and familiar visual stimuli displayed on computer monitors. The second situation was similar to that used in the spontaneous object recognition test that has been widely used to establish the involvement of rat perirhinal cortex in familiarity discrimination. In the first condition 30 (25%) of 120 perirhinal neurons were visually responsive; of these responsive neurons 19 (63%) responded significantly differently to novel and familiar stimuli. In the second condition eight (53%) of 15 perirhinal neurons changed activity significantly in the vicinity of objects (had “object fields”); however, for none (0%) of these was there a significant activity change related to the familiarity of an object, an incidence significantly lower than for the first condition. Possible reasons for the difference are discussed. It is argued that the failure to find recognition‐related neuronal responses while exploring objects is related to its detectability by the measures used, rather than the absence of all such signals in perirhinal cortex. Indeed, as shown by the results, such signals are found when a different methodology is used.

  18. Lung segmentation from HRCT using united geometric active contours

    NASA Astrophysics Data System (ADS)

    Liu, Junwei; Li, Chuanfu; Xiong, Jin; Feng, Huanqing

    2007-12-01

    Accurate lung segmentation from high resolution CT images is a challenging task due to various detail tracheal structures, missing boundary segments and complex lung anatomy. One popular method is based on gray-level threshold, however its results are usually rough. A united geometric active contours model based on level set is proposed for lung segmentation in this paper. Particularly, this method combines local boundary information and region statistical-based model synchronously: 1) Boundary term ensures the integrality of lung tissue.2) Region term makes the level set function evolve with global characteristic and independent on initial settings. A penalizing energy term is introduced into the model, which forces the level set function evolving without re-initialization. The method is found to be much more efficient in lung segmentation than other methods that are only based on boundary or region. Results are shown by 3D lung surface reconstruction, which indicates that the method will play an important role in the design of computer-aided diagnostic (CAD) system.

  19. Knowledge translation of research findings

    PubMed Central

    2012-01-01

    Background One of the most consistent findings from clinical and health services research is the failure to translate research into practice and policy. As a result of these evidence-practice and policy gaps, patients fail to benefit optimally from advances in healthcare and are exposed to unnecessary risks of iatrogenic harms, and healthcare systems are exposed to unnecessary expenditure resulting in significant opportunity costs. Over the last decade, there has been increasing international policy and research attention on how to reduce the evidence-practice and policy gap. In this paper, we summarise the current concepts and evidence to guide knowledge translation activities, defined as T2 research (the translation of new clinical knowledge into improved health). We structure the article around five key questions: what should be transferred; to whom should research knowledge be transferred; by whom should research knowledge be transferred; how should research knowledge be transferred; and, with what effect should research knowledge be transferred? Discussion We suggest that the basic unit of knowledge translation should usually be up-to-date systematic reviews or other syntheses of research findings. Knowledge translators need to identify the key messages for different target audiences and to fashion these in language and knowledge translation products that are easily assimilated by different audiences. The relative importance of knowledge translation to different target audiences will vary by the type of research and appropriate endpoints of knowledge translation may vary across different stakeholder groups. There are a large number of planned knowledge translation models, derived from different disciplinary, contextual (i.e., setting), and target audience viewpoints. Most of these suggest that planned knowledge translation for healthcare professionals and consumers is more likely to be successful if the choice of knowledge translation strategy is informed by

  20. Somatosensory findings in postherpetic neuralgia.

    PubMed Central

    Nurmikko, T; Bowsher, D

    1990-01-01

    Somatic sensory perception thresholds (warm, cold, hot pain, touch, pinprick, vibration, two-point discrimination), allodynia and skin temperature were assessed in the affected area of 42 patients with unilateral postherpetic neuralgia (PHN) and 20 patients who had had unilateral shingles not followed by PHN (NoPHN), and in the mirror-image area on the other side. There was no difference between the two groups for age or length of time after the acute herpes zoster infection. The PHN group showed significant changes in all sensory threshold measurements when the affected area was compared with the mirror-image area on the unaffected side, while the NoPHN group exhibited no threshold changes. Mechanical allodynia was present in 87% of the PHN group; half of the 12 patients with ophthalmic PHN showed extension of allodynia to the maxillary distribution. No differences in skin temperature were recorded between affected and unaffected regions in either group. Our findings show a deficit of sensory functions mediated by both large and small primary afferent fibres and also suggest major central involvement in the pathophysiology of the condition. If PHN does not occur following acute herpes zoster, recovery of neural functions appears to be good. PMID:2313300

  1. Pollution! Find a STEM solution!

    NASA Astrophysics Data System (ADS)

    Takač, Danijela; Moćan, Marina

    2016-04-01

    Primary and secondary school Pantovčak is an innovative school in downtown Zagreb, Croatia. The school is involved in many projects concerning STEM education. Pollution! Find a STEM solution! is a two year long cross-curricular project that grew out of identified need to develop STEM and ICT skills more. Pisa results make evident that students' knowledge is poor and motivation for math and similar subjects is low. Implying priorities of European Commission, like e-learning, raises motivation and also develops basic skills and improves knowledge in science, math, physic, ICT. Main objectives are to increase students' interest in STEM education and careers and introduce them to all available new trends in technology, engineering and science in their region by visiting clean technology industries and strengthening links with them, to introduce some future digital jobs and prepare students for rapid technological changes by integrating ICT into classroom practice more, to highlight the importance of global environmental issues and improve the knowledge in the areas of sustainable development and renewable energy, to develop collaborative partnership between schools and the wider community in formal, non-formal and informal learning, to support multilingualism by publishing Open Educational Resources in 8 different languages and to strengthen the professional profile of the teaching profession. The project brings together 231 teachers and 2729 students from five different European countries in learning to think globally and work on activities that contribute to the community's well-being. There are altogether 33 activities, divided in 4 categories. STEM activities are focused on students building the devices for measuring air, light and noise pollution in their school and homes. They use the scientific method to analyze the data and compare the results with their peers to find a solution. Eskills, digital literacy and digital jobs are focused on introducing career

  2. Skin Findings in Williams Syndrome

    PubMed Central

    Kozel, Beth A.; Bayliss, Susan J.; Berk, David R.; Waxler, Jessica L; Knutsen, Russell H.; Danback, Joshua R.; Pober, Barbara R.

    2014-01-01

    Previous examination in a small number of individuals with Williams syndrome (also referred to as Williams-Beuren syndrome) has shown subtly softer skin and reduced deposition of elastin, an elastic matrix protein important in tissue recoil. No quantitative information about skin elasticity in individuals with Williams syndrome is available; nor has there been a complete report of dermatologic findings in this population. To fill this knowledge gap, 94 patients with Williams syndrome aged 7-50 years were recruited as part of the Skin and Vascular Elasticity (WS-SAVE) study. They underwent either a clinical dermatologic assessment by trained dermatologists (2010 WSA family meeting) or measurement of biomechanical properties of the skin with the DermaLab™ suction cup (2012 WSA family meeting). Clinical assessment confirmed that soft skin is common in this population (83%), as is premature graying of the hair (80% of those 20 years or older), while wrinkles (92%) and abnormal scarring (33%) were detected in larger than expected proportions. Biomechanical studies detected statistically significant differences in dP (the pressure required to lift the skin), dT (the time required to raise the skin through a prescribed gradient), VE (viscoelasticity) and E (Young’s modulus) relative to matched controls. The RT (retraction time) also trended longer but was not significant. The biomechanical differences noted in these patients did not correlate with the presence of vascular defects also attributable to elastin insufficiency (vascular stiffness, hypertension, and arterial stenosis) suggesting the presence of tissue specific modifiers that modulate the impact of elastin insufficiency in each tissue. PMID:24920525

  3. Regional Transmission Projects: Finding Solutions

    SciTech Connect

    The Keystone Center

    2005-06-15

    The Keystone Center convened and facilitated a year-long Dialogue on "Regional Transmission Projects: Finding Solutions" to develop recommendations that will help address the difficult and contentious issues related to expansions of regional electric transmission systems that are needed for reliable and economic transmission of power within and across regions. This effort brought together a cross-section of affected stakeholders and thought leaders to address the problem with the collective wisdom of their experience and interests. Transmission owners sat at the table with consumer advocates and environmental organizations. Representatives from regional transmission organizations exchanged ideas with state and federal regulators. Generation developers explored common interests with public power suppliers. Together, the Dialogue participants developed consensus solutions about how to begin unraveling some of the more intractable issues surrounding identification of need, allocation of costs, and reaching consensus on siting issues that can frustrate the development of regional transmission infrastructure. The recommendations fall into three broad categories: 1. Recommendations on appropriate institutional arrangements and processes for achieving regional consensus on the need for new or expanded transmission infrastructure 2. Recommendations on the process for siting of transmission lines 3. Recommendations on the tools needed to support regional planning, cost allocation, and siting efforts. List of Dialogue participants: List of Dialogue Participants: American Electric Power American Transmission Company American Wind Energy Association California ISO Calpine Corporation Cinergy Edison Electric Institute Environmental Defense Federal Energy Regulatory Commission Great River Energy International Transmission Company ISO-New England Iowa Public Utility Board Kanner & Associates Midwest ISO National Association of Regulatory Utility Commissioners National Association

  4. Skin findings in Williams syndrome.

    PubMed

    Kozel, Beth A; Bayliss, Susan J; Berk, David R; Waxler, Jessica L; Knutsen, Russell H; Danback, Joshua R; Pober, Barbara R

    2014-09-01

    Previous examination in a small number of individuals with Williams syndrome (also referred to as Williams-Beuren syndrome) has shown subtly softer skin and reduced deposition of elastin, an elastic matrix protein important in tissue recoil. No quantitative information about skin elasticity in individuals with Williams syndrome is available; nor has there been a complete report of dermatologic findings in this population. To fill this knowledge gap, 94 patients with Williams syndrome aged 7-50 years were recruited as part of the skin and vascular elasticity (WS-SAVE) study. They underwent either a clinical dermatologic assessment by trained dermatologists (2010 WSA family meeting) or measurement of biomechanical properties of the skin with the DermaLab™ suction cup (2012 WSA family meeting). Clinical assessment confirmed that soft skin is common in this population (83%), as is premature graying of the hair (80% of those 20 years or older), while wrinkles (92%), and abnormal scarring (33%) were detected in larger than expected proportions. Biomechanical studies detected statistically significant differences in dP (the pressure required to lift the skin), dT (the time required to raise the skin through a prescribed gradient), VE (viscoelasticity), and E (Young's modulus) relative to matched controls. The RT (retraction time) also trended longer but was not significant. The biomechanical differences noted in these patients did not correlate with the presence of vascular defects also attributable to elastin insufficiency (vascular stiffness, hypertension, and arterial stenosis) suggesting the presence of tissue specific modifiers that modulate the impact of elastin insufficiency in each tissue. PMID:24920525

  5. Transmyocardial laser revascularization: histopathological findings.

    PubMed

    Dedic, K; Klima, T; Cooley, D A; Frazier, O H; Kadipasaoglu, K A; Cihan, H B

    1998-01-01

    Transmyocardial laser revascularization (TMLR) is a new surgical technique clinically tested in patients with advanced severe coronary arteriosclerosis when classic routine treatment by medicaments, percutaneous transluminal coronary angioplasty (PTCA), or aorto-coronary bypass surgery does not improve symptoms of ischemic heart disease. During the procedure high-energy CO 2 laser performs 35-40 transmyocardial channels via left-sided thoracotomy. Channels are drilled from the epicardial side of the heart through the myocardium into the left ventricle cavity. Impulses are synchronized with EKG (diastole), the channel diameter is about 1 mm. Transmural laser penetration is confirmed by intraoperative transesophageal echocardiography (TEE). This technique is based on a theory that channels allow blood supply from left ventricle directly into the intramyocardial vessels (possibly capillaries) and so improve oxygenation of ischemic myocardium. Presented are gross and microscopic findings in a 75-year-old woman who suffered from classic class IV angina with shortness of breath. She had a history of an inferior myocardial infarct, ventricular tachyarrhythmia, aorto-coronary bypass, and mitral valvuloplasty. Her ejection fraction by echocardiography was 25%. Angiographically, she had multiple occlusions of native coronary arteries and diffuse distal stenosis in the graft of the left internal mammary artery (LIMA) to the left anterior descending coronary artery (LAD). Thirty six of forty laser pulses were confirmed by TEE as transmural. The patient died suddenly of ventricular fibrillation 5 days after TMLR surgery. The autopsy was performed 6 hours after death. After cross-sectioning of the heart all the laser-bored channels were found partially or completely filled by fibrin and cell infiltrate composed mainly of polymorphonuclear leukocytes. Patent channels were found within myocardial scars, channels performed through viable myocardium appeared to be partially

  6. Postmortem perianal findings in children.

    PubMed

    McCann, J; Reay, D; Siebert, J; Stephens, B G; Wirtz, S

    1996-12-01

    The postmortem finding of anal dilation or an exposed pectinate line in children who have died under suspicious circumstances continues to raise the concern of possible sexual abuse. The following multicenter, collaborative study was designed to help address that question. Sixty-five subjects, ranging in age from birth to 17 years, were autopsied at three different sites. A standard protocol along with 35-mm cameras were used to record the results. Thirty-eight (58%) subjects were boys, and 27 (42%) were girls. Forty-two (65%) were white, 10 (15%) African-American, five (8%) Asian, three (5%) white Hispanic and five (8%) other. Fifty-seven (88%) were in Tanner stage I of secondary sexual development. Thirty-four (52%) died of natural causes, 26 (40%) from accidental injuries, three (5%) from other causes, and four (6%) as a result of a homicide. Forty-eight subjects (74%) had some dilation of the anal sphincters. In 21 children (32%), the entire anal canal, including the rectal ampulla, could be visualized. In another 21 (32%) subjects, the pectinate line was exposed. Only the outer portion of the anal canal opened in six children (10%), whereas 17 (26%) had no dilatation of the anus. Anal laxity led to flattened skin folds in 50 (77%), a shallow anal canal in 40 (62%), the exposure of both the pectinate line in 38 (59%), and the anal mucosa in 24 (37%). Venous congestion was present in 14 (22%), venous pooling in three (5%), erythema in six (9%), and increased pigmentation in eight (12%). Funneling was found in two (3%). Blood was present in three (5%), and an abrasion was discovered in one (2%). No fissures, lacerations, hemorrhoids, or scars were found in any of the children. Anal orifice size varied with the age of the child, the amount of traction applied to the buttocks, and a history of a CNS injury at the time of death. It is suggested, finally, that anal dilatation alone cannot be used a marker for prior sexual abuse and the exposure of the pectinate line

  7. Researchers Find a Mechanism for Schizophrenia

    MedlinePlus

    ... exit disclaimer . Subscribe Researchers Find a Mechanism for Schizophrenia Scientists uncovered a mechanism behind genetic variations previously linked to schizophrenia. The findings may lead to new clinical approaches. ...

  8. Efficacy of a Web-Based, Tailored, Alcohol Prevention/Intervention Program for College Students: Initial Findings

    ERIC Educational Resources Information Center

    Bingham, C. Raymond; Barretto, Andrea Ippel; Walton, Maureen A.; Bryant, Christopher M.; Shope, Jean T.; Raghunathan, Trivellore E.

    2010-01-01

    Objective: Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called "Michigan Prevention and Alcohol Safety for Students" (M-PASS). Participants: Participants included 1,137 randomly sampled first-year college students, including 59% female, 80% white, and averaged age 18.1 years.…

  9. Cost Finding: Why It Is Important.

    ERIC Educational Resources Information Center

    Mielke, Linda

    1990-01-01

    Discusses the importance of cost finding for public libraries and the relationship of cost finding to output measures. A cost finding study conducted on the cost of gift books is described; several worksheets from the study are included. Suggestions are offered for beginning a cost-finding project. (three references) (MES)

  10. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Audit findings. 41.510... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule...

  11. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  12. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  13. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Audit findings. 41.510... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule...

  14. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Audit findings. 41.510... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule...

  15. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 1 2011-07-01 2011-07-01 false Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  16. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 1 2013-07-01 2013-07-01 false Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  17. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 1 2012-07-01 2012-07-01 false Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  18. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  19. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  20. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Audit findings. 41.510... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule...

  1. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  2. Americans Getting Adequate Water Daily, CDC Finds

    MedlinePlus

    ... medlineplus/news/fullstory_158510.html Americans Getting Adequate Water Daily, CDC Finds Men take in an average ... new government report finds most are getting enough water each day. The data, from the U.S. National ...

  3. Americans Getting Adequate Water Daily, CDC Finds

    MedlinePlus

    ... gov/news/fullstory_158510.html Americans Getting Adequate Water Daily, CDC Finds Men take in an average ... new government report finds most are getting enough water each day. The data, from the U.S. National ...

  4. CDC Study Finds Fecal Contamination in Pools

    MedlinePlus

    ... Communication (404) 639-3286 CDC study finds fecal contamination in pools A study of public pools done ... The E. coli is a marker for fecal contamination. Finding a high percentage of E. coli-positive ...

  5. National Assessment Findings and Educational Policy Questions.

    ERIC Educational Resources Information Center

    Brown, Rexford

    This paper addresses 11 commonly asked educational policy questions by referring to National Assessment of Educational Progress (NAEP) findings in five learning areas. The paper is organized for quick reference to the 63 findings, which are, in turn, indexed to the NAEP reports in which they originally appeared. Findings in reading, literature,…

  6. 10 CFR 1022.14 - Findings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... findings to the State in accordance with 10 CFR part 1005—Intergovernmental Review of Department of Energy... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.14 Findings. (a) If DOE finds that no...

  7. 10 CFR 1022.14 - Findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... findings to the State in accordance with 10 CFR part 1005—Intergovernmental Review of Department of Energy... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.14 Findings. (a) If DOE finds that no...

  8. 10 CFR 1022.14 - Findings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... findings to the State in accordance with 10 CFR part 1005—Intergovernmental Review of Department of Energy... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.14 Findings. (a) If DOE finds that no...

  9. 10 CFR 1022.14 - Findings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... findings to the State in accordance with 10 CFR part 1005—Intergovernmental Review of Department of Energy... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.14 Findings. (a) If DOE finds that no...

  10. 10 CFR 1022.14 - Findings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... findings to the State in accordance with 10 CFR part 1005—Intergovernmental Review of Department of Energy... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.14 Findings. (a) If DOE finds that no...

  11. Cutaneous findings of nutritional deficiencies in children.

    PubMed

    Goskowicz, M; Eichenfield, L F

    1993-08-01

    Nutritional deficiencies may be associated with a variety of cutaneous findings in children. This review emphasizes new developments relating to cutaneous findings of nutritional deficiencies. Zinc deficiency, acrodermatitis enteropathica, and acrodermatitis enteropathica-like eruptions are seen with a variety of conditions including cystic fibrosis, anorexia nervosa, and breastfeeding. Similar cutaneous findings not related to zinc deficiency may also occur with such metabolic disorders as methylmalonic aciduria, multiple carboxylase deficiency, essential fatty acid deficiency and other amino acid deficiencies. Vitamin K deficiency is associated with hemorrhagic disease of the newborn and coagulopathy. Vitamin A deficiency presents with a variety of systemic findings and distinctive dermatologic findings. Acute vitamin A deficiency may be seen in children infected with measles and is associated with more severe disease. The systemic and cutaneous findings of vitamin C deficiency, scurvy, are discussed. PMID:8374671

  12. 78 FR 941 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-07

    ... finds that the Respondent knowingly and intentionally: Falsely reported research experiments when the... in normal neurons, when the experiment was not conducted. Falsified Figure 3 of grant application...

  13. 3 CFR - Finding and Recapturing Improper Payments

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Finding and Recapturing Improper Payments Presidential Documents Other Presidential Documents Memorandum of March 10, 2010 Finding and Recapturing Improper Payments Memorandum for the Heads of Executive Departments and Agencies My Administration is committed to reducing payment errors and...

  14. Employment for Spouses Gets Harder to Find

    ERIC Educational Resources Information Center

    June, Audrey Williams

    2009-01-01

    Worries about a partner's finding a job are a major reason why colleges lose faculty and professional-staff recruits. Some institutions have hired people to focus largely on nonfaculty job searches. (Finding faculty jobs for spouses or partners is a more complex negotiation with the university.) But as the economy continues to dip into uncharted…

  15. 5 CFR 2638.504 - Director's finding.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Director's finding. 2638.504 Section 2638... Individual Executive Agency Employees § 2638.504 Director's finding. (a) In general. If the Director has reason to believe that an employee is violating or has violated an ethics provision, the Director...

  16. 5 CFR 2638.504 - Director's finding.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Director's finding. 2638.504 Section 2638... Individual Executive Agency Employees § 2638.504 Director's finding. (a) In general. If the Director has reason to believe that an employee is violating or has violated an ethics provision, the Director...

  17. Experimental interstellar organic chemistry - Preliminary findings

    NASA Technical Reports Server (NTRS)

    Khare, B. N.; Sagan, C.

    1973-01-01

    Review of the results of some explicit experimental simulation of interstellar organic chemistry consisting in low-temperature high-vacuum UV irradiation of condensed simple gases known or suspected to be present in the interstellar medium. The results include the finding that acetonitrile may be present in the interstellar medium. The implication of this and other findings are discussed.

  18. 16 CFR 1301.3 - Findings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Findings. 1301.3 Section 1301.3 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS BAN OF UNSTABLE REFUSE BINS § 1301.3 Findings. (a) Risk of injury. The Commission has studied 19 in-depth investigation reports of accidents associated with...

  19. 16 CFR 1305.5 - Findings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Findings. 1305.5 Section 1305.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS BAN OF ARTIFICIAL EMBERIZING MATERIALS (ASH AND EMBERS) CONTAINING RESPIRABLE FREE-FORM ASBESTOS § 1305.5 Findings. (a) The degree and nature of the risk of...

  20. 16 CFR 1304.5 - Findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Findings. 1304.5 Section 1304.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS BAN OF CONSUMER PATCHING COMPOUNDS CONTAINING RESPIRABLE FREE-FORM ASBESTOS § 1304.5 Findings. (a) The degree and nature of the risk of injury. The Commission...

  1. 16 CFR 1210.5 - Findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Findings. 1210.5 Section 1210.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR CIGARETTE LIGHTERS Requirements for Child Resistance § 1210.5 Findings. Section 9(f) of the Consumer...

  2. 16 CFR 1210.5 - Findings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Findings. 1210.5 Section 1210.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR CIGARETTE LIGHTERS Requirements for Child Resistance § 1210.5 Findings. Section 9(f) of the Consumer...

  3. 16 CFR 1204.6 - Findings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Findings. 1204.6 Section 1204.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS The Standard § 1204.6 Findings. As required by section 9 (b) and (c) of the Consumer...

  4. 16 CFR 1204.6 - Findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Findings. 1204.6 Section 1204.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR OMNIDIRECTIONAL CITIZENS BAND BASE STATION ANTENNAS The Standard § 1204.6 Findings. As required by section 9 (b) and (c) of the Consumer...

  5. Finding a Doctor for Your New Baby

    MedlinePlus

    ... About Zika & Pregnancy Finding a Doctor for Your New Baby KidsHealth > For Parents > Finding a Doctor for Your New Baby Print A A A Text Size What's ... recommendations. If you've recently moved to a new area, you may not have personal or social ...

  6. 34 CFR 300.111 - Child find.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Child find. 300.111 Section 300.111 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.111 Child find. (a) General. (1) The State...

  7. 34 CFR 300.111 - Child find.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Child find. 300.111 Section 300.111 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.111 Child find. (a) General. (1) The State...

  8. 34 CFR 300.111 - Child find.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Child find. 300.111 Section 300.111 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.111 Child find. (a) General. (1) The State...

  9. 34 CFR 300.111 - Child find.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Child find. 300.111 Section 300.111 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.111 Child find. (a) General. (1) The State...

  10. 34 CFR 300.111 - Child find.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Child find. 300.111 Section 300.111 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Other Fape Requirements § 300.111 Child find. (a) General. (1) The State...

  11. 16 CFR 1305.5 - Findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Findings. 1305.5 Section 1305.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS BAN OF ARTIFICIAL EMBERIZING MATERIALS (ASH AND EMBERS) CONTAINING RESPIRABLE FREE-FORM ASBESTOS § 1305.5 Findings. (a) The degree and nature of the risk of...

  12. 2 CFR 200.516 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Audit findings. 200.516 Section 200.516... MANAGEMENT AND BUDGET GUIDANCE Reserved UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS Audit Requirements Auditors § 200.516 Audit findings. (a) Audit...

  13. 16 CFR 1303.5 - Findings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Findings. 1303.5 Section 1303.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS BAN OF LEAD-CONTAINING PAINT AND CERTAIN CONSUMER PRODUCTS BEARING LEAD-CONTAINING PAINT § 1303.5 Findings. (a) The degree and nature of the risk of injury. (1)...

  14. 48 CFR 9903.201-6 - Findings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... STANDARDS CONTRACT COVERAGE CAS Program Requirements 9903.201-6 Findings. (a) Required change—(1) Finding... required to comply with a CAS, modification or interpretation thereof, that subsequently became applicable to the contract; or, for planned changes being made in order to remain CAS compliant, that the...

  15. 48 CFR 9903.201-6 - Findings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... STANDARDS CONTRACT COVERAGE CAS Program Requirements 9903.201-6 Findings. (a) Required change—(1) Finding... required to comply with a CAS, modification or interpretation thereof, that subsequently became applicable to the contract; or, for planned changes being made in order to remain CAS compliant, that the...

  16. 48 CFR 30.201-6 - Findings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Findings. 30.201-6 Section 30.201-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 30.201-6 Findings. See 48...

  17. 48 CFR 30.201-6 - Findings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Findings. 30.201-6 Section 30.201-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 30.201-6 Findings. See 48...

  18. 48 CFR 30.201-6 - Findings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Findings. 30.201-6 Section 30.201-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 30.201-6 Findings. See 48...

  19. 48 CFR 9903.201-6 - Findings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... STANDARDS CONTRACT COVERAGE CAS Program Requirements 9903.201-6 Findings. (a) Required change—(1) Finding... required to comply with a CAS, modification or interpretation thereof, that subsequently became applicable to the contract; or, for planned changes being made in order to remain CAS compliant, that the...

  20. 48 CFR 30.201-6 - Findings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Findings. 30.201-6 Section 30.201-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 30.201-6 Findings. See 48...

  1. 48 CFR 30.201-6 - Findings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Findings. 30.201-6 Section 30.201-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 30.201-6 Findings. See 48...

  2. 48 CFR 9903.201-6 - Findings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... STANDARDS CONTRACT COVERAGE CAS Program Requirements 9903.201-6 Findings. (a) Required change—(1) Finding... required to comply with a CAS, modification or interpretation thereof, that subsequently became applicable to the contract; or, for planned changes being made in order to remain CAS compliant, that the...

  3. Eye Examination Findings Among Children. United States.

    ERIC Educational Resources Information Center

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    Reported were extensive statistical data on the prevalence of abnormal eye conditions found on examination, heterophoria test results, and history of eye problems as well as extent of interrelationship of the eye examination and vision test findings among children aged 6 to 11 years in the United States, based on findings from the Health…

  4. 16 CFR 1633.8 - Findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Findings. 1633.8 Section 1633.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD FOR THE FLAMMABILITY (OPEN FLAME) OF MATTRESS SETS The Standard § 1633.8 Findings. (a) General. In order to issue a flammability standard under the FFA, the...

  5. Teacher Retirement Systems: Research Findings. Research Brief

    ERIC Educational Resources Information Center

    Hansen, Janet S.; Podgursky, Michael J.; Costrell, Robert M.

    2009-01-01

    This policy brief summarizes findings presented at a February 2009 research conference on teacher retirement systems hosted by the National Center on Performance Incentives (NCPI) at Vanderbilt University's Peabody College. The 2009 conference was the second in a series of NCPI events focusing on findings from recent research on issues related to…

  6. 5 CFR 2638.504 - Director's finding.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Director's finding. 2638.504 Section 2638... Individual Executive Agency Employees § 2638.504 Director's finding. (a) In general. If the Director has... under § 2638.503(c) and a determination by the Director under § 2638.503(d)(5) that the agency has...

  7. 16 CFR 1306.4 - Findings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Findings. 1306.4 Section 1306.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS BAN OF HAZARDOUS LAWN DARTS § 1306.4 Findings. (a) The Commission has found that lawn darts are being distributed in commerce and present an unreasonable risk...

  8. 76 FR 47589 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-05

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. SUMMARY: Notice is hereby given that the Office of Research Integrity (ORI) has... Research Center: Based on the Respondent's acceptance of ORI's research misconduct findings, ORI found...

  9. 16 CFR 1303.5 - Findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Findings. 1303.5 Section 1303.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS BAN OF LEAD-CONTAINING PAINT AND CERTAIN CONSUMER PRODUCTS BEARING LEAD-CONTAINING PAINT § 1303.5 Findings. (a) The degree and nature of the risk of injury. (1)...

  10. Ocular findings in conjoined (Siamese) twins.

    PubMed

    Mansour, A M; Mansour, N; Rosenberg, H S

    1991-01-01

    Conjoined twinning is a rare form of congenital anomaly. The ocular findings in six sets of conjoined twins as well as those reported elsewhere include abnormal optic nerve decussation, pseudosynophthalmos, microphthalmia, abnormal eyelids, orbital encephalocele, occipital encephalocele, and eyelid coloboma. These findings are interpreted as due to deformations from appositional fusion-related factors or malformations from developmental factors. PMID:1955960

  11. 20 CFR 617.33 - Findings required.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... FOR WORKERS UNDER THE TRADE ACT OF 1974 Job Search Allowances § 617.33 Findings required. (a) Findings by liable State. Before final payment of a job search allowance may be approved, the following... search allowance specified in § 617.32(a) (1) through (4); (2) The application for a job search...

  12. 20 CFR 617.33 - Findings required.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... FOR WORKERS UNDER THE TRADE ACT OF 1974 Job Search Allowances § 617.33 Findings required. (a) Findings by liable State. Before final payment of a job search allowance may be approved, the following... search allowance specified in § 617.32(a) (1) through (4); (2) The application for a job search...

  13. 20 CFR 617.33 - Findings required.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOR WORKERS UNDER THE TRADE ACT OF 1974 Job Search Allowances § 617.33 Findings required. (a) Findings by liable State. Before final payment of a job search allowance may be approved, the following... search allowance specified in § 617.32(a) (1) through (4); (2) The application for a job search...

  14. 20 CFR 617.33 - Findings required.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... FOR WORKERS UNDER THE TRADE ACT OF 1974 Job Search Allowances § 617.33 Findings required. (a) Findings by liable State. Before final payment of a job search allowance may be approved, the following... search allowance specified in § 617.32(a) (1) through (4); (2) The application for a job search...

  15. 20 CFR 617.33 - Findings required.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... FOR WORKERS UNDER THE TRADE ACT OF 1974 Job Search Allowances § 617.33 Findings required. (a) Findings by liable State. Before final payment of a job search allowance may be approved, the following... search allowance specified in § 617.32(a) (1) through (4); (2) The application for a job search...

  16. Joubert syndrome: the clinical and radiological findings.

    PubMed

    Karakas, Ekrem; Cullu, Nesat; Karakas, Omer; Calik, Mustafa; Boyaci, Fatima Nurefsan; Yildiz, Sema; Cece, Hasan; Akal, Ali

    2014-01-01

    Joubert syndrome is a rare disease characterised by clinical and radiological findings. Among the classic clinical findings of JS are hypotonia, ataxia, mental-motor retardation, respiratory and opthalmological findings. The paediatric cases included in the study comprised nine patients. There was familial consanguinty in seven cases. Clinically, all cases had mental-motor retardation and hypotonia. Episodic hyperpnoea attacks were observed in one case. Facial dysmorphism was the most common additional systemic anomaly and four cases had additional opthalmic findings. Brain MRI examination revealed that all cases had molar tooth sign, bat-wing appearance and vermian cleft. The majority of cases also had vermian hypoplasia. Cerebellar folial disorganisation was observed in approxiamtely half of the cases. Three cases had corpus callosum anomaly and atretic occipital encephalocoele. No pathology was determined in other organs. This study aimed to evaluate the clinical and radiological findings of 9 patients diagnosed with Joubert syndrome. PMID:24605724

  17. Family Finding Evaluations: A Summary of Recent Findings--Appendix. Publication #2015-01A

    ERIC Educational Resources Information Center

    Vandivere, Sharon; Malm, Karin

    2015-01-01

    This document was produced by the authors based on their research for the report, "Family Finding Evaluations: A Summary of Recent Findings. Publication #2015-01," and is an added resource for further information. The report reviews the results from 13 evaluations of Family Finding. The Family Finding model provides child welfare…

  18. Correlation between clinical characteristics, spirometric indices and high resolution computed tomography findings in patients of chronic obstructive pulmonary disease

    PubMed Central

    Singh, Anubhuti; Kumar, Santosh; Mishra, Ashwini Kumar; Kumar, Manoj; Kant, Surya; Verma, S K; Kushwaha, R A S; Garg, Rajiv

    2016-01-01

    Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease affecting the airways, leading to significant morbidity and mortality throughout the world. There is a need to have a holistic evaluation of COPD patients, other than just measuring the level of obstruction as performed by spirometry. High resolution computed tomography (HRCT) scan of thorax partly fulfills this requirement. Materials and Methods: Fifty patients of COPD (confirmed on spirometry as per the GOLD guidelines 2014 guidelines) were enrolled, out of which 35 patients got a HRCT done. Complete clinical evaluation was done. The Philips computer program for lung densitometry was used with these limits (−800/−1, 024 Hounsfield unit [HU]) to calculate densities, after validating densitometry values with phantoms. We established the area with a free hand drawing of the region of interest, then we established limits (in HUs) and the computer program calculated the attenuation as mean lung density (MLD) of the lower and upper lobes. Results: There was a significant correlation between smoking index and anteroposterior tracheal diameter (P = 0.036). Tracheal index was found to be decreasing with increasing disease severity which was statistically significant (P = 0.037). Mean upper lobe MLD was −839.27 HU, mean lower lobe MLD was −834.91 HU and the mean MLD was −837.08 HU. The lower lobes MLD were found to be decreasing with increasing disease severity. A mild linear correlation of pre forced expiratory volume in the first second (FEV1) was observed with lower lobe and total average MLD while a mild linear correlation of Post-FEV1 was observed with both coronal (P = 0.042) and sagittal (P = 0.001) lower lobes MLD. In addition, there was a linear correlation between both pre (P = 0.050) and post (P = 0.024) FEV1/forced vital capacity with sagittal lower lobe MLD. A predictive model can be derived to quantify obstruction severity (FEV1). Conclusion: HRCT may be an

  19. MRI findings in pediatric patients with scurvy.

    PubMed

    Gulko, Edwin; Collins, Lee K; Murphy, Robyn C; Thornhill, Beverly A; Taragin, Benjamin H

    2015-02-01

    In modern times scurvy is a rarely encountered disease caused by ascorbic acid (vitamin C) deficiency. However, sporadic cases of scurvy persist, particularly within the pediatric population. Recent individual case reports highlight an increased incidence of scurvy among patients with autism or developmental delay, with isolated case reports detailing the magnetic resonance imaging (MRI) findings of scurvy in these pediatric populations. We present the MRI findings of scurvy in four patients with autism or developmental delay, and review the literature on MRI findings in pediatric patients with scurvy. Despite its rarity, the radiologist must consider scurvy in a pediatric patient with a restricted diet presenting with arthralgia or myalgia. PMID:25109378

  20. Vertex finding with deformable templates at LHC

    NASA Astrophysics Data System (ADS)

    Stepanov, Nikita; Khanov, Alexandre

    1997-02-01

    We present a novel vertex finding technique. The task is formulated as a discrete-continuous optimisation problem in a way similar to the deformable templates approach for the track finding. Unlike the track finding problem, "elastic hedgehogs" rather than elastic arms are used as deformable templates. They are initialised by a set of procedures which provide zero level approximation for vertex positions and track parameters at the vertex point. The algorithm was evaluated using the simulated events for the LHC CMS detector and demonstrated good performance.

  1. MURCS association: ultrasonographic findings and pathologic correlation.

    PubMed

    Fernandez, C O; McFarland, R D; Timmons, C; Ramus, R; Twickler, D M

    1996-12-01

    MURCS association is a rare, lethal and unusual constellation of nonrandom findings that includes mullerian duct aplasia, renal aplasia, and cervicothoracic somite dysplasia.1-3 It has been described in 30 patients by Duncan and coworkers2 in 1979, in which report the authors proposed an embryologic cause for these defects.3 Antenatal ultrasonographic findings included a massive, cystic umbilical cord related to a patent urachus, enlarged bladder, single small kidney, and suspicion of urethral obstruction in a fetus of female phenotype. These findings are rare in a case of MURCS and were all confirmed on pathologic examination. PMID:8947863

  2. Delirium and hypovitaminosis D: neuroimaging findings.

    PubMed

    Bourgeois, James A; Hategan, Ana; Ford, Jennifer; Tisi, Daniel K; Xiong, Glen L

    2015-01-01

    The authors examined the frequency of neuroimaging findings of cortical atrophy and/or cerebrovascular disease in patients with delirium with hypovitaminosis D and normal vitamin D levels. Of 32 patients with delirium with hypovitaminosis D who were neuroimaged, 91.4% had neuroimaging findings, despite only five cases having a comorbid diagnosis of dementia. Similar frequencies of cortical atrophy and/or cerebrovascular disease were found in patients with delirium with normal vitamin D levels. Further research with a larger sample size is needed to compare neuroimaging findings between normal patients and patients with hypovitaminosis D with delirium. PMID:25111282

  3. Eosinophilic pneumonia presenting as life-threatening ARDS.

    PubMed

    Maia, José Miguel; Guedes, Fernando; Aragão, Irene; Cardoso, Teresa

    2015-01-01

    We present a case of a 25-year-old woman with sudden onset of shortness of breath, cough and malaise, 24 h after discharge from a psychiatric hospital. She had been there for 2 weeks after a suicide attempt with lye, and started treatment with paroxetin, alprazolam and valproic acid. She also started smoking 20 cigarettes/day during that hospital admission. Brought to the emergency department, she evolved in the first 24 h with respiratory failure and shock needing intensive care unit (ICU) admission, with mechanical ventilation and vasopressor support. Empiric antibiotic therapy was started (piperacillin-tazobactam and azithromycin) suspecting healthcare-associated pneumonia. The patient's chest radiography progressed with bilateral infiltrates. Peripheral blood eosinophilia was seen on the second day. A bronchoalveolar lavage was performed and had 50% of eosinophils. She was started on treatment with steroids and the next day no longer needed vasopressors; 4 days later she was extubated. PMID:26150613

  4. CASE STUDY OF AN INTEGRATED PASSIVE BIOLOGICAL ARD TREATMENT SYSTEM

    EPA Science Inventory

    Many active mine sites, mines in the closure stage and some abandoned mines are and have utilized cyanidation to remove and recover precious metals. Discharges from these sites normally contain significant amounts of metal cyanide complexes and concentrations of thiocyanate, solu...

  5. An Accelerated Radioactive Decay (ARD) Model for Type Ia Supernovae

    NASA Astrophysics Data System (ADS)

    Rust, Bert W.; Leventhal, Marvin

    2016-01-01

    In 1975, Leventhal and McCall [Nature, 255, 690-692] presented a radioactive decay model 56N i --> 56Co --> 56Fe for the post-peak luminosity decay of Type I supernovae light curves, in which the two decay rates are both accelerated by a common factor. In 1976, Rust, Leventhal and McCall [Nature, 262, 118-120] used sums of exponentials fitting to confirm the acceleration hypothesis, but their result was nevertheless rejected by the astronomical community. Here, we model Type Ia light curves with a system of ODEs (describing the nuclear decays) forced by a Ni-deposition pulse modelled by a 3-parameter Weibull pdf, with all of this occuring in the center of a pre-existing, optically thick, spherical shell which thermalizes the emitted gamma rays. Fitting this model to observed light curves routinely gives fits which account for 99.9+% of the total variance in the observed record. The accelerated decay rates are so stable, for such a long time, that they must occur in an almost unchanging environment -- not it a turbulent expanding atmosphere. The amplitude of the Ni-deposition pulse indicates that its source is the fusion of hydrogen. Carbon and oxygen could not supply the large energy/nucleon that is observed. The secondary peak in the infrared light curve can be easily modelled as a light echo from dust in the back side of the pre-existing shell, and the separation between the peaks indicates a radius of ≈15 light days for the shell. The long-term stability of the acceleration suggests that it is a kinematic effect arising because the nuclear reactions occur either on the surface of a very rapidly rotating condensed object, or in a very tight orbit around such an object, like the fusion pulse in a tokomak reactor.

  6. What Are the Signs and Symptoms of ARDS?

    MedlinePlus

    ... the Lungs Work Oxygen Therapy Pleurisy and Other Pleural Disorders Pneumonia Ventilator/Ventilator Support Send a link to ... puts you at higher risk for infections. A pneumothorax (collapsed lung). This is a condition in which ...

  7. Many COPD Patients Have Trouble Finding Care

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_158830.html Many COPD Patients Have Trouble Finding Care They can face ... first comprehensive look at chronic obstructive pulmonary disease (COPD) care in the United States. COPD is the ...

  8. Finding Good Health Information on the Internet

    MedlinePlus

    ... MedlinePlus Advantage Finding Good Health Information on the Internet Past Issues / Winter 2015 Table of Contents Millions ... get health information from magazines, TV, or the Internet. Some is reliable and up to date, some ...

  9. How to Find Insects Weathering the Winter.

    ERIC Educational Resources Information Center

    Brody, Jane

    1979-01-01

    Discusses how and where to find insects and other invertebrates in winter, as well as how to collect samples in order to watch those animals reappear in spring. Includes crickets, honey bees, mosquitoes, house flies, and butterflies and moths. (MA)

  10. Find a Hospice or Palliative Care Provider

    MedlinePlus

    ... Membership Regulatory Advocacy Quality Resources Education Press Room Facebook Twitter LinkedIn YouTube RSS NHPCO Member Menu Home My Profile My Transactions Upcoming Events My Committees Marketplace Find ...

  11. Anemia Boosts Stroke Death Risk, Study Finds

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160476.html Anemia Boosts Stroke Death Risk, Study Finds Blood condition ... 2016 (HealthDay News) -- Older stroke victims suffering from anemia -- a lack of red blood cells -- may have ...

  12. 16 CFR 1210.5 - Findings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... CIGARETTE LIGHTERS Requirements for Child Resistance § 1210.5 Findings. Section 9(f) of the Consumer Product... draft ASTM standard would not adequately reduce the unreasonable risk associated with lighters. (e)...

  13. Alberta Education's Clearinghouse: Functions and Findings.

    ERIC Educational Resources Information Center

    Wighton, David

    1984-01-01

    Discusses functions of the Alberta (Canada) Computer Technology Project's courseware clearinghouse, reviews findings on instructional software quality, identifies software development trends, and discusses need for support systems to facilitate the incorporation of computer assisted instruction in Canadian schools. (MBR)

  14. 16 CFR 1210.5 - Findings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... CIGARETTE LIGHTERS Requirements for Child Resistance § 1210.5 Findings. Section 9(f) of the Consumer Product... draft ASTM standard would not adequately reduce the unreasonable risk associated with lighters. (e)...

  15. 16 CFR 1210.5 - Findings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... CIGARETTE LIGHTERS Requirements for Child Resistance § 1210.5 Findings. Section 9(f) of the Consumer Product... draft ASTM standard would not adequately reduce the unreasonable risk associated with lighters. (e)...

  16. Finding Low-Cost Medical Care

    MedlinePlus

    ... costs and insurance requirements before you get care. Free and Low-Cost Clinics and Health Centers If ... in school), you may be able to find free or low-cost health clinics in your neighborhood. ...

  17. College Linemen Larger Than Ever, Study Finds

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159931.html College Linemen Larger Than Ever, Study Finds These athletes will need help adopting healthy lifestyles after their careers end, researcher says To use the sharing features ...

  18. [Omental infarction: CT findings (case report)].

    PubMed

    Yildiz, Seçil; Atasoy, Cetin; Yağci, Cemil; Akyar, Serdar

    2004-06-01

    Omental infarction, the end result of impaired perfusion of the greater omentum, is an uncommon cause of acute abdominal pain. Because its clinical symptoms are nonspecific, it is usually confused with more common conditions such as appendicitis or cholecystitis. Consequently, the diagnosis is generally made intraoperatively. However, computed tomography shows characteristic findings and allows a reliable preoperative diagnosis, preventing unnecessary laparotomy. We report two cases of omental infarction, and describe typical CT findings of this rare entitiy. PMID:15236134

  19. Distinction between forensic evidence and dermatological findings.

    PubMed

    Hammer, U; Boy, D; Rothaupt, D; Büttner, A

    2015-07-01

    The external examination after death requires knowledge in forensics/pathology, dermatology, as well as associated diseases and age-related alterations of the skin. This article highlights some findings with forensic evidence versus dermatological findings. The lectures in forensic medicine should be structured interdisciplinarily, especially to dermatology, internal medicine, surgery, pathology, and toxicology in order to train the overlapping skills required for external and internal postmortem examinations. PMID:26048487

  20. How to Find the Students' Inner Geek

    ERIC Educational Resources Information Center

    Zimmer, Marc

    2005-01-01

    As a chemistry professor at a liberal-arts college, the author believes it is his job to find the youthful awe in his students and draw it out so that they will be intrigued once again by science and nature, so that they want to learn about equilibria, pH, and redox reactions. He has to go fishing inside their brains, to find, hook, and reel in…

  1. Unusual Histopathological Findings in Childhood Appendectomy Specimens.

    PubMed

    Buyukbese Sarsu, Sevgi; Ucak, Ramazan; Buyukbese, Mehmet Akif; Karakus, Suleyman Cuneyt; Deniz, Hale

    2015-12-01

    The purpose of this study was to find the unusual findings in the childhood appendectomy specimens and their incidence. The clinicopathological data of 1,306 patients whose ages ranged from 3 to 16 were retrospectively collected. Histopathological findings in appendectomy specimens taken from patients who had a prediagnosis of appendicitis were obtained. Incidental appendectomies were not included in the research. Unusual findings were reevaluated in the histopathological assessment of appendectomy specimens. The number of patients whose pathological findings are considered unusual is 25 (1.91 %). Nine of the patients were girls and 16 of them were boys. Their ages ranged from 6 to 15. Pathological results revealed that there were 16 (1.22 %) cases of parasitosis, 3 (0.23 %) cases of granulomatosis, 3 (0.23 %) cases of eosinophilic appendicitis, 2 (0.15 %) cases of carcinoid tumors, and 1 (0.08 %) case of appendiceal non-Hodgkin's lymphoma. All patients underwent a standard appendectomy. Uncommon histopathological findings in childhood appendectomy specimens are more common than those in adulthood. This kind of certain unexpected lesions of the appendix may require advanced diagnostics, careful clinical care, follow-up for years, and a multidisciplinary approach. Therefore, histopathological examinations of appendectomy specimens must be performed routinely. PMID:26730070

  2. A survey of DNA motif finding algorithms

    PubMed Central

    Das, Modan K; Dai, Ho-Kwok

    2007-01-01

    Background Unraveling the mechanisms that regulate gene expression is a major challenge in biology. An important task in this challenge is to identify regulatory elements, especially the binding sites in deoxyribonucleic acid (DNA) for transcription factors. These binding sites are short DNA segments that are called motifs. Recent advances in genome sequence availability and in high-throughput gene expression analysis technologies have allowed for the development of computational methods for motif finding. As a result, a large number of motif finding algorithms have been implemented and applied to various motif models over the past decade. This survey reviews the latest developments in DNA motif finding algorithms. Results Earlier algorithms use promoter sequences of coregulated genes from single genome and search for statistically overrepresented motifs. Recent algorithms are designed to use phylogenetic footprinting or orthologous sequences and also an integrated approach where promoter sequences of coregulated genes and phylogenetic footprinting are used. All the algorithms studied have been reported to correctly detect the motifs that have been previously detected by laboratory experimental approaches, and some algorithms were able to find novel motifs. However, most of these motif finding algorithms have been shown to work successfully in yeast and other lower organisms, but perform significantly worse in higher organisms. Conclusion Despite considerable efforts to date, DNA motif finding remains a complex challenge for biologists and computer scientists. Researchers have taken many different approaches in developing motif discovery tools and the progress made in this area of research is very encouraging. Performance comparison of different motif finding tools and identification of the best tools have proven to be a difficult task because tools are designed based on algorithms and motif models that are diverse and complex and our incomplete understanding of

  3. Tympanometric findings in superior semicircular canal dehiscence syndrome.

    PubMed

    Castellucci, A; Brandolini, C; Piras, G; Modugno, G C

    2013-04-01

    The diagnostic role of audio-impedancemetry in superior semicircular canal dehiscence (SSCD) disease is well known. In particular, since the first reports, the presence of evoked acoustic reflexes has represented a determining instrumental exhibit in differential diagnosis with other middle ear pathologies that are responsible for a mild-low frequencies air-bone gap (ABG). Even though high resolution computed tomography (HRCT) completed by parasagittal reformatted images still represents the diagnostic gold standard, several instrumental tests can support a suspect of labyrinthine capsule dehiscence when "suggestive" symptoms occur. Objective and subjective audiometry often represents the starting point of the diagnostic course aimed at investigating the cause responsible for the so-called "intra-labyrinthine conductive hearing loss". The purpose of this study is to evaluate the role of tympanometry, in particular of the inter-aural asymmetry ratio in peak compliance as a function of different mild-low frequencies ABG on the affected side, in the diagnostic work-up in patients with unilateral SSCD. The working hypothesis is that an increase in admittance of the "inner-middle ear" conduction system due to a "third mobile window" could be detected by tympanometry. A retrospective review of the clinical records of 45 patients with unilateral dehiscence selected from a pool of 140 subjects diagnosed with SSCD at our institution from 2003 to 2011 was performed. Values of ABG amplitude on the dehiscent side and tympanometric measurements of both ears were collected for each patient in the study group (n = 45). An asymmetry between tympanometric peak compliance of the involved side and that of the contralateral side was investigated by calculating the inter-aural difference and the asymmetry ratio of compliance at the eardrum. A statistically significant correlation (p = 0.015 by Fisher's test) between an asymmetry ratio ≥ 14% in favour of the pathologic ear and an ABG

  4. Cytomegalovirus pneumonia in transplant patients: CT findings

    SciTech Connect

    Eun-Young Kang; Patz, E.F. Jr.; Mueller, N.L.

    1996-03-01

    Our goal was to assess the CT findings of cytomegalovirus (CMV) pneumonia in transplant patients. The study included 10 transplant patients who had chest CT scan and pathologically proven isolated pulmonary CMV infection. Five patients had bone marrow transplant and five had solid organ transplant. The CT scans were retrospectively reviewed for pattern and distribution of disease and the CT findings compared with the findings on open lung biopsy (n = 9) and autopsy (n = 1). Nine of 10 patients had parenchymal abnormalities apparent at CT and I had normal CT scans. The findings in the nine patients included small nodules (n = 6), consolidation (n = 4), ground-glass attenuation (n = 4), and irregular lines (n = 1). The nodules had a bilateral and symmetric distribution and involved all lung zones. The consolidation was most marked in the lower lung zones. The CT findings of CMV pneumonia in transplant patients are heterogeneous. The most common patterns include small nodules and areas of consolidation. 13 refs., 4 figs., 1 tab.

  5. Trichoscopic Findings of Hair Loss in Koreans

    PubMed Central

    Park, Jin; Kim, Joo-Ik; Kim, Han-Uk; Yun, Seok-Kweon

    2015-01-01

    Background Trichoscopic findings of hair loss have been well described for the differential diagnosis of alopecia; however, critical findings were not thoroughly investigated or compared among all ethnic groups, including Asians. Objective We aimed to find any characteristic trichoscopic findings in Korean alopecia patients and to verify whether those findings are closely related to previously reported observations. Methods Three hundred and twenty-seven patients with hair loss of various causes and 160 normal scalps were analyzed. Trichoscopic examination was performed with a polarized-light handheld dermoscope. Results A total of 35 patterns of trichoscopic features were represented, and certain features were significantly common or observed exclusively in a particular type of alopecia as follows: yellow dots, exclamation mark hairs, and proximal tapering hairs (alopecia areata), trichoptilosis and pointed hairs (trichotillomania), corkscrew hairs, septate hyphae hairs, and comma hairs (tinea capitis), diffuse white area, fibrotic white dots, and tufting hairs (primary cicatricial alopecia), hair diameter diversity and peripilar sign (androgenetic alopecia), and short nonvellus hairs (telogen effluvium). Conclusion The characteristic trichoscopic features for the differential diagnosis of alopecia in Koreans, shown as follicular, perifollicular, and hair shaft patterns, are similar to those of Caucasians; however, the frequencies of the pigment patterns are different between Koreans and Caucasians because of the contrast effect of the skin and hair color. Therefore, racial difference should be considered in the trichoscopic evaluation for differential diagnosis. PMID:26512168

  6. Acute pancreatitis: clinical vs. CT findings

    SciTech Connect

    Hill, M.C.; Barkin, J.; Isikoff, M.B.; Silver stein, W.; Kalser, M.

    1982-08-01

    In a prospective study of 91 patients with acute pancreatitis, computed tomographic (CT) findings were correlated with the clinical type of acute pancreatitis. In acute edematous pancreatitis (63 patients; 16 with repeat CT), CT was normal (28%) or showed inflammation limited to the pancreas (61%). Phlegmonous changes were present in 11%, including one patient with focal pancreatic hemorrhage, indicating that clinically unsuspected hemorrhagic pancreatitis can occur. In acute necrotizing (hemorrhagic, suppurative) pancreatitis (nine patients; eight with repeat CT), no patient had a normal CT scan and 89% had phlegmonous changes. One patient had hemorrhagic pancreatitis and three had abscesses. In acute exacerbation of chronic pancreatitis (10 patients; three with repeat CT), there were pancreatic calcifications (70%), a focal mass (40%), and pancreatic ductal dilation (30%). On follow-up CT, the findings of acute pancreatitis did not always disappear with resolution of the clinical symptons. This was especialy true of phlegmonous pancreatitis, where the CT findings could persist for months.

  7. Flow Cytometric Findings in Hemophagocytic Lymphohistiocytosis

    PubMed Central

    McCall, Chad M.; Mudali, Shiyama; Arceci, Robert J.; Small, Donald; Fuller, Shirley; Gocke, Christopher D.; Vuica-Ross, Milena; Burns, Kathleen H.; Borowitz, Michael J.; Duffield, Amy S.

    2016-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is an often fatal hyperinflammatory syndrome. HLH may be inherited, but it more commonly arises secondary to Epstein-Barr virus (EBV) or other infections, hematologic malignancies, or rheumatologic diseases. We identified 17 patients diagnosed with HLH who had flow cytometric analysis of peripheral blood or bone marrow performed at the time of diagnosis. Two patients had primary HLH, and the others had HLH secondary to EBV infection, hematologic malignancies, rheumatologic conditions, or tuberculosis. The marrow typically showed a reactive lymphocytosis and a marked left shift in myelopoiesis regardless of the etiology. Qualitative abnormalities were also found in several cases, including T-cell abnormalities in the majority of the EBV-associated HLH cases. While not specific, flow cytometric findings in HLH are different from the findings in uninvolved marrow samples, and care should be taken not to overinterpret immunophenotypic findings in these cases as indicative of a primary marrow disorder or lymphoma. PMID:22523218

  8. Ivory vertebra: imaging findings in different diagnoses*

    PubMed Central

    Braun, Richard Andreas; Milito, Carlos Felipe do Rego Barros; Goldman, Suzan Menasce; Fernandes, Eloy de Ávila

    2016-01-01

    Low back pain is often managed at all levels of healthcare. In general, diagnostic investigation begins with radiography of the lumbar spine. In addition to the most common findings, radiologists can identify increased density of a vertebral body, referred to as ivory vertebra. The objective of this study was to describe the main diseases that can present with this radiologic sign, such as Hodgkin lymphoma, Paget's disease, metastatic prostate cancer, breast cancer, and osteomyelitis. It is extremely important that radiologists be aware of this finding in order to inform the requesting physician of the possible etiologies, given that it can be the initial radiologic presentation for these diseases. PMID:27141135

  9. Ivory vertebra: imaging findings in different diagnoses.

    PubMed

    Braun, Richard Andreas; Milito, Carlos Felipe do Rego Barros; Goldman, Suzan Menasce; Fernandes, Eloy de Ávila

    2016-01-01

    Low back pain is often managed at all levels of healthcare. In general, diagnostic investigation begins with radiography of the lumbar spine. In addition to the most common findings, radiologists can identify increased density of a vertebral body, referred to as ivory vertebra. The objective of this study was to describe the main diseases that can present with this radiologic sign, such as Hodgkin lymphoma, Paget's disease, metastatic prostate cancer, breast cancer, and osteomyelitis. It is extremely important that radiologists be aware of this finding in order to inform the requesting physician of the possible etiologies, given that it can be the initial radiologic presentation for these diseases. PMID:27141135

  10. [Bioptic and autoptic findings in lymphogranulomatosis].

    PubMed

    Frege, J; Köhler, A H

    1978-05-15

    A reclassification of bioptical and autoptical findings in the lymphogranulomatosis according to the criteria of Lukes and co-workers resulted in an unambiguous prevailing of the mixed cellularity in bioptical preparations and of the form poor in lymphocytes in autoptical preparations. The comparison of bioptical and autoptical findings revealed the expected changing from the type rich in lymphocytes to the type poor in lymphocytes. The causes for this changing of the histological form might to be found in the deteriorating immunological defensive condition of the patient as well as in the influence on the histological picture by our modern therapy. PMID:685326

  11. Pathological findings in the Hawaiian monk seal.

    PubMed

    Banish, L D; Gilmartin, W G

    1992-07-01

    Postmortem examinations were performed on 45 Hawaiian monk seals (Monachus schauinslandi) collected during field research on the beaches of the Northwestern Hawaiian Islands (USA) from 1981 to 1985. Both males and females of all age groups, perinatal through adult, were examined. Frequent findings included parasites, trauma, cardiovascular disease (congenital and acquired), and respiratory infections. Emaciation was a common condition. All animals except neonates were infected with parasites; infection was severe in several cases. Splenic hematopoiesis was a universal histopathologic finding. Some cases exhibited lesions consistent with renal, gastrointestinal, and toxic disorders; ectopic tissue calcification; gallstones; and ophthalmologic and dental problems. PMID:1512875

  12. Finding Objects for Assisting Blind People

    PubMed Central

    Yi, Chucai; Flores, Roberto W.; Chincha, Ricardo; Tian, YingLi

    2013-01-01

    Computer vision technology has been widely used for blind assistance, such as navigation and wayfinding. However, few camera-based systems are developed for helping blind or visually-impaired people to find daily necessities. In this paper, we propose a prototype system of blind-assistant object finding by camera-based network and matching-based recognition. We collect a dataset of daily necessities and apply Speeded-Up Robust Features (SURF) and Scale Invariant Feature Transform (SIFT) feature descriptors to perform object recognition. Experimental results demonstrate the effectiveness of our prototype system. PMID:23894729

  13. [Ocular findings in leukemia in childhood].

    PubMed

    Rochels, R; Heiland, I

    1987-11-01

    Primary and therapy-induced ocular manifestations of leukemia in 25 of 103 children suffering from the disease (60 patients with ALL, eight with AML, two with CML, 33 with NHL) were kept under observation for an average period of five years. The lens was involved in 10%, the retina in 9%, the optic nerve in 7%, and the orbit in 4% of these cases. The present authors' findings concurred with those published in the literature to date, in that they could not find a pathognomonic combination or a specific frequency of ocular symptoms related to one of the four types of leukemia. PMID:3481001

  14. Radiographic findings in congenital lead poisoning

    SciTech Connect

    Pearl, M.; Boxt, L.M.

    1980-07-01

    Because lead crosses the placenta throughout pregnancy, the fetus is at risk for lead poisoning. A full term, asymptomatic child was born with congenital lead poisoning secondary to maternal pica. Radiographic findings of a dense cranial vault, lead lines, and delayed skeletal and deciduous dental development were noted at birth. After chelation therapy, when the patient was seven months old, radiographs revealed normal skeletal maturation. Tooth eruption did not occur until 15 months of age. Newborn infants with these radiographic findings should be screened for subclinical, congenital lead poisoning.

  15. Preliminary Airspace Operations Simulations Findings Report

    NASA Technical Reports Server (NTRS)

    2005-01-01

    Provides preliminary findings of the initial series (normal operations and contingency management) of airspace operations simulations. The key elements of this report discuss feedback from controller subjects for UAS flight above FL430. Findings provide initial evaluation of routine UAS operations above dense ARTCC airspace (ZOB), and identify areas of further research, policy direction and procedural development. This document further serves as an addendum to the detailed AOS simulation plan (Deliverable SIM001), incorporating feedback from FAA air traffic personnel and Access 5 IPTs.

  16. Computed tomographic findings in penetrating peptic ulcer

    SciTech Connect

    Madrazo, B.L.; Halpert, R.D.; Sandler, M.A.; Pearlberg, J.L.

    1984-12-01

    Four cases of peptic ulcer penetrating the head of the pancreas were diagnosed by computed tomography (CT). Findings common to 3 cases included (a) an ulcer crater, (b) a sinus tract, and (c) enlargement of the head of the pancreas. Unlike other modalities, the inherent spatial resolution of CT allows a convenient diagnosis of this important complication of peptic ulcer disease.

  17. 7 CFR 1794.43 - Agency finding.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Agency finding. 1794.43 Section 1794.43 Agriculture... (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Procedure for Environmental Assessments § 1794.43 Agency... quality of the human environment, RUS will prepare a FONSI. Upon authorization of RUS, the applicant...

  18. Changing Concepts and Findings on Autism

    ERIC Educational Resources Information Center

    Rutter, Michael

    2013-01-01

    New research findings provide major challenges regarding our understanding of the concept of autism. These are critically discussed in relation to research relevant to classification, genetics, environmental risk factors, gene-environment interplay, animal models, biomarkers, clinical features, neuropathology, pharmacotherapy, behavioral…

  19. Engineering Problem Finding in High School Students

    ERIC Educational Resources Information Center

    Franske, Benjamin James

    2009-01-01

    The purpose of this study was to explore the engineering problem finding ability of high school students at three high schools in Minnesota. Students at each of the three schools had differing backgrounds including pre-engineering coursework, traditional technology education coursework and advanced science coursework. Students were asked to find…

  20. 16 CFR 1202.2 - Findings. 1

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... increased. (3) The Commission estimates that manufacturing cost increases as a direct or indirect effect of... retail by consumers, some proportion of any manufacturing cost increases may be passed on to the consumer...) Effects on utility, cost, and availability. (1) The Commission finds that the public need for...

  1. 16 CFR 1202.2 - Findings. 1

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... increased. (3) The Commission estimates that manufacturing cost increases as a direct or indirect effect of... retail by consumers, some proportion of any manufacturing cost increases may be passed on to the consumer...) Effects on utility, cost, and availability. (1) The Commission finds that the public need for...

  2. World Fertility Survey: Major Findings and Implications.

    ERIC Educational Resources Information Center

    World Fertility Survey, London (England).

    A survey was conducted in 42 developing countries and in 20 developed countries to determine fertility practices and trends. Both individual and household questionnaires were used by interviewers to gather data. Findings concerning marriage patterns, contraception, reproductive motivation, childspacing, breastfeeding, maternal and child health,…

  3. Re-Establishing Broca's Initial Findings

    ERIC Educational Resources Information Center

    Richardson, Jessica D.; Fillmore, Paul; Rorden, Chris; LaPointe, Leonard L.; Fridriksson, Julius

    2012-01-01

    The importance of the left inferior pre-frontal cortex (LIPC) for speech production was first popularized by Paul Broca, providing a cornerstone of behavioral neurology and laying the foundation for future research examining brain-behavior relationships. Although Broca's findings were rigorously challenged, comprehensive contradictory evidence was…

  4. 77 FR 125 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-03

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. SUMMARY: Notice is hereby given that the Office of Research Integrity (ORI) has... conducted by ORI in its oversight review, ORI found that Dr. Mahesh Visvanathan, Research...

  5. Finding More Joy in Teaching Children

    ERIC Educational Resources Information Center

    Baumgartner, Jennifer J.; DiCarlo, Cynthia F.; Apavaloaie, Loredana

    2011-01-01

    Early childhood professionals are familiar with finding and appreciating daily moments of joy. Teachers smile inside and out when toddlers are able to pull up their own pants, preschoolers write their names for the first time, or kindergarteners figure out how to make complicated patterns with blocks. Working with young children can also be very…

  6. Assets and Barriers to Finding Employment

    ERIC Educational Resources Information Center

    Stolte, Michael

    2006-01-01

    In this intact-groups, quasi-experimental study, 115 unemployed job seekers who utilized federally funded labour market interventions were compared on program usage (long- or short-term), personality, personal meaning, employability skills, job search length, and pain and suffering. Results did not find significant differences in program usage or…

  7. Granuloma faciale: An unusual diascopic finding

    PubMed Central

    Ravikiran, Shilpashree P.; Jaiswal, Ashok Kumar; Syrti, Clarify; Madan Mohan, NT; Aradhya, Sujala S.

    2016-01-01

    Granuloma faciale (GF) is a benign, chronic inflammatory disorder, characterized by reddish brown plaques with prominent follicular orificesand telangeictasia, usually occurring over the face. The condition often presents a problem in differential diagnosis. Herein we describe a case of GF with an unusual diascopic finding of an apple jelly appearance on diascopy. PMID:27294051

  8. Granuloma faciale: An unusual diascopic finding.

    PubMed

    Ravikiran, Shilpashree P; Jaiswal, Ashok Kumar; Syrti, Clarify; Madan Mohan, N T; Aradhya, Sujala S

    2016-01-01

    Granuloma faciale (GF) is a benign, chronic inflammatory disorder, characterized by reddish brown plaques with prominent follicular orificesand telangeictasia, usually occurring over the face. The condition often presents a problem in differential diagnosis. Herein we describe a case of GF with an unusual diascopic finding of an apple jelly appearance on diascopy. PMID:27294051

  9. Find Your Voice: Eliminate Classroom Phobias

    ERIC Educational Resources Information Center

    Miranda, Michael V.

    2007-01-01

    The academically underprepared community college student may also be psychosocially underprepared for college, a condition contributing to the development of classroom-specific social phobia and to the high attrition rate at community colleges. The "Find Your Voice Program" uses individual and group cognitive-behavioral techniques to develop…

  10. Fact-Finding Prolongs Labor Disputes.

    ERIC Educational Resources Information Center

    Lieberman, Myron

    1979-01-01

    Fact finders should be called on the scene only when an impasse results in a disagreement over facts. Nevertheless, mediators typically recommend fact-finding regardless of the nature of the impasse. Such a move typically exacerbates the controversy instead of settling it. (Author/IRT)

  11. 75 FR 18837 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... senior scientist, Discovery Research, Women's Health, Wyeth Pharmaceuticals, engaged in research... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. SUMMARY: Notice is hereby given that the Office of Research Integrity (ORI)...

  12. Incidental finding of meningioma on bone scintigraphy.

    PubMed

    Thakorlal, A; Wong, D C; Anderson, R J

    2005-06-01

    An incidental finding of an intracranial posterior fossa meningioma detected by bone scintigraphy is presented. Most of the published literature on the diagnosis of meningioma is on the use of CT and MRI. There is limited published literature on the detection of meningioma with bone scintigraphy. PMID:15932468

  13. Curiosity Finds Calcium-Rich Deposits

    NASA Video Gallery

    NASA’s Curiosity rover finds calcium deposits on Mars similar to thoseseen on Earth when water circulates in cracks and rock fractures.Credit: NASA/JPL-Caltech    › Curiosity's mission site

  14. Staff Development: Finding the Right Fit

    ERIC Educational Resources Information Center

    Standerfer, Leslie

    2005-01-01

    Three years ago, when the author joined the staff of Agua Fria High School in Phoenix, Arizona, as an assistant principal, she was excited to find that the students' school day started an hour and a half later than normal each Wednesday to provide staff development time for the teaching staff. That first year, however, neither the principal, Bryce…

  15. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... for the purpose of reporting an audit finding is in relation to a type of compliance requirement for a major program or an audit objective identified in the compliance supplement. The auditor shall identify... type of compliance requirement for a major program or an audit objective identified in the...

  16. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... purpose of reporting an audit finding is in relation to a type of compliance requirement for a major program or an audit objective identified in the compliance supplement. The auditor shall identify... type of compliance requirement for a major program or an audit objective identified in the...

  17. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... for the purpose of reporting an audit finding is in relation to a type of compliance requirement for a major program or an audit objective identified in the compliance supplement. The auditor shall identify... type of compliance requirement for a major program or an audit objective identified in the...

  18. Finding Green in the Green Movement.

    ERIC Educational Resources Information Center

    Miller, Julie A.

    1997-01-01

    Looks at the history of the environmental industry since 1970. Suggests that, although job growth is not as high as it was, the growth rate is now about 2% and those with proper training can find opportunities in environmental fields. (JOW)

  19. 16 CFR 1301.3 - Findings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS BAN OF UNSTABLE REFUSE... reduce. (b) Products subject to this ban. (1) The Commission finds that the types of products subject to this ban are those manufactured metal receptacles known in the solid waste collection trade...

  20. Using Similarity to Find Length and Area.

    ERIC Educational Resources Information Center

    Sandefur, James T.

    1994-01-01

    Shows a way in which algebra and geometry can be used together to find the lengths and areas of spirals. This method develops better understanding of shapes, similarity, and mathematical connections in students. Discusses spirals embedded in triangles and squares, the Pythagorean theorem, and the area of regular polygons. (MKR)

  1. Another ``Find-the-Flaw'' Test

    NASA Astrophysics Data System (ADS)

    Grimvall, Göran

    2012-12-01

    Daniel F. Styer recently discussed physics problems where several different algebraic results are presented, and the task is to identify the correct result through reasoning based on a general understanding of physics principles. Here is a related, but more general, problem. A graph with several quite disparate captions is presented (Fig. 1). The task is to find the only caption that could be correct.

  2. 7 CFR 1735.51 - Required findings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 11 2011-01-01 2011-01-01 false Required findings. 1735.51 Section 1735.51 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GENERAL POLICIES, TYPES OF LOANS, LOAN REQUIREMENTS-TELECOMMUNICATIONS PROGRAM Basic Requirements For Loan Approval § 1735.51...

  3. 78 FR 67363 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. SUMMARY: Notice is hereby given that the Office of Research Integrity (ORI) has... Professor of Surgery and Pathology, Schulich School of Medicine and Dentistry, WU, engaged in...

  4. Questions That Science Teachers Find Difficult (II).

    ERIC Educational Resources Information Center

    Goodwin, Alan

    2003-01-01

    Presents some questions that science teachers find difficult. Focuses on three further questions relating to "simple" everyday situations that are normally explained in terms of the kinetic theory of matter. Identifies looking at the difference between chemical and physical changes as the most problematic question. (Author/YDS)

  5. The Pleasure of Finding Things out

    ERIC Educational Resources Information Center

    Loxley, Peter

    2005-01-01

    "The pleasure of finding things out" is a collection of short works by the Nobel Prize winning scientist Richard Feynman. The book provides insights into his infectious enthusiasm for science and his love of sharing ideas about the subject with anyone who wanted to listen. Feynman has been widely acknowledged as one of the greatest physicists of…

  6. Finding Strategic Solutions to Reduce Truancy

    ERIC Educational Resources Information Center

    Reid, Ken

    2010-01-01

    This article focuses on recent developments to find strategic solutions to the problem of truancy. It considers issues related to defining truancy and why reducing truancy matters before considering what causes truancy. The article concentrates upon seven areas where further work is needed: the role of parents (and carers); early intervention,…

  7. Pneumoconiosis: Comparison of imaging and pathologic findings

    SciTech Connect

    Chong, S.; Lee, K.S.; Chung, M.J.; Han, J.H.; Kwon, O.J.; Kim, T.S.

    2006-01-15

    Pneumoconiosis may be classified as either fibrotic or nonfibrotic, according to the presence or absence of fibrosis. Silicosis, coal worker pneumoconiosis, asbestosis, berylliosis, and talcosis are examples of fibrotic pneumoconiosis. Siderosis, stannosis, and baritosis are nonfibrotic forms of pneumoconiosis that result from inhalation of iron oxide, tin oxide, and barium sulfate particles, respectively. In an individual who has a history of exposure to silica or coal dust, a finding of nodular or reticulonodular lesions at chest radiography or small nodules with a perilymphatic distribution at thin-section computed tomography (CT), with or without eggshell calcifications, is suggestive of silicosis or coal worker pneumoconiosis. Magnetic resonance imaging is helpful for distinguishing between progressive massive fibrosis and lung cancer. CT and histopathologic findings in asbestosis are similar to those in idiopathic pulmonary fibrosis, but the presence of asbestos bodies in histopathologic specimens is specific for the diagnosis of asbestosis. Giant cell interstitial pneumonia due to exposure to hard metals is classified as a fibrotic form of pneumoconiosis and appears on CT images as mixed ground-glass opacities and reticulation. Berylliosis simulates pulmonary sarcoidosis on CT images. CT findings in talcosis include small centrilobular and subpleural nodules or heterogeneous conglomerate masses that contain foci of high attenuation indicating talc deposition. Siderosis is nonfibrotic and is indicated by a CT finding of poorly defined centrilobular nodules or ground-glass opacities.

  8. Pneumoconiosis: comparison of imaging and pathologic findings

    SciTech Connect

    Semin Chong; Kyung Soo Lee; Myung Jin Chung; Joungho Han; O. Jung Kwon; d Tae Sung Kim

    2006-01-15

    Pneumoconiosis may be classified as either fibrotic or nonfibrotic, according to the presence or absence of fibrosis. Silicosis, coal worker pneumoconiosis, asbestosis, berylliosis, and talcosis are examples of fibrotic pneumoconiosis. Siderosis, stannosis, and baritosis are nonfibrotic forms of pneumoconiosis that result from inhalation of iron oxide, tin oxide, and barium sulfate particles, respectively. In an individual who has a history of exposure to silica or coal dust, a finding of nodular or reticulonodular lesions at chest radiography or small nodules with a perilymphatic distribution at thin-section computed tomography (CT), with or without eggshell calcifications, is suggestive of silicosis or coal worker pneumoconiosis. Magnetic resonance imaging is helpful for distinguishing between progressive massive fibrosis and lung cancer. CT and histopathologic findings in asbestosis are similar to those in idiopathic pulmonary fibrosis, but the presence of asbestos bodies in histopathologic specimens is specific for the diagnosis of asbestosis. Giant cell interstitial pneumonia due to exposure to hard metals is classified as a fibrotic form of pneumoconiosis and appears on CT images as mixed ground-glass opacities and reticulation. Berylliosis simulates pulmonary sarcoidosis on CT images. CT findings in talcosis include small centrilobular and subpleural nodules or heterogeneous conglomerate masses that contain foci of high attenuation indicating talc deposition. Siderosis is nonfibrotic and is indicated by a CT finding of poorly defined centrilobular nodules or ground-glass opacities.

  9. Aetiology of Autism: Findings and Questions

    ERIC Educational Resources Information Center

    Rutter, M.

    2005-01-01

    Background Although there is good evidence that autism is a multifactorial disorder, an adequate understanding of the genetic and non-genetic causes has yet to be achieved. Methods Empirical research findings and conceptual reviews are reviewed with respect to evidence on possible causal influences. Results Much the strongest evidence concerns the…

  10. Independent Study Looks beyond Rhetoric, Finds Gains.

    ERIC Educational Resources Information Center

    Penning, Nick

    1991-01-01

    Last July, the New Initiatives Division of Sandia National Laboratory, a nuclear research center in Albuquerque, New Mexico, presented its findings on U.S. education to the U.S. Subcommittee on Elementary, Secondary, and Vocational Education. Current dropout rates, test scores, college attendance, educational expenditures, educator status, work…

  11. Finding the Genesis for a Thesis

    ERIC Educational Resources Information Center

    Caroll, Joyce Armstrong

    2013-01-01

    This article describes a prewriting heuristics strategy that can help students find the genesis of their thesis. The 3 functions of the heuristic procedure are that it aids in retrieving relevant information stored in the mind; draws attention to important information that can be further researched or accessed; and prepares the mind for the…

  12. 16 CFR 1212.5 - Findings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR... rule, the Consumer Product Safety Act (CPSA), 15 U.S.C. 2058(f)(1), requires the Commission to consider and make appropriate findings for inclusion in the rule with respect to: (1) The degree and nature...

  13. African Trypanosomes Find a Fat Haven

    PubMed Central

    Beverley, Stephen M.

    2016-01-01

    The African trypanosome was thought to primarily develop in the bloodstream and interstitial spaces of its mammalian host. In this issue of Cell Host & Microbe, Trindade et al. (2016) report the surprising finding that during ongoing persistent infections in mice, a major fraction of the parasites reside within fatty tissues. PMID:27281564

  14. 75 FR 18836 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. SUMMARY: Notice is hereby given that the Office of Research Integrity (ORI) and... graduate student, IU, engaged in research misconduct in research supported by National Center...

  15. 77 FR 46438 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-03

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. SUMMARY: Notice is hereby given that the Office of Research Integrity (ORI) has..., former Director of the Laboratory of Glycoimmunotheraphy, JWCI, engaged in research misconduct...

  16. 76 FR 64947 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-19

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. Notice is hereby given that the Office of Research Integrity (ORI) has taken..., Department of Chemistry, UP, engaged in research misconduct in research supported by National Institute...

  17. 76 FR 68460 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-04

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. SUMMARY: Notice is hereby given that the Office of Research Integrity (ORI) has... Resident Physician at UVA Medical Center, engaged in research misconduct by plagiarizing research...

  18. 78 FR 21125 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-09

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. SUMMARY: Notice is hereby given that the Office of Research Integrity (ORI) has... found by a preponderance of the evidence that Dr. Andrew Aprikyan, former Research Assistant...

  19. 77 FR 76491 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary, HHS. ACTION: Notice. SUMMARY: Notice is hereby given that the Office of Research Integrity (ORI) has..., engaged in research misconduct in research supported by National Institute of General Medical...

  20. Studies Find Vocabulary Instruction Is Falling Short

    ERIC Educational Resources Information Center

    Sparks, Sarah D.

    2013-01-01

    Children who enter kindergarten with a small vocabulary don't get taught enough words--particularly, sophisticated academic words--to close the gap, according to the latest in a series of studies by Michigan early-learning experts. The findings suggest many districts could be at a disadvantage in meeting the increased requirements for vocabulary…

  1. Child Find Practices in Christian Schools

    ERIC Educational Resources Information Center

    Lane, Julie M.; Jones, David R.

    2015-01-01

    The 1997 Amendments of the Individuals with Disabilities Education Act (IDEA) states that children placed in private schools by their parents are no longer afforded the right to special education services. However, IDEA does state that child find activities between public school representatives and private schools are to remain intact. This study…

  2. African Trypanosomes Find a Fat Haven.

    PubMed

    Beverley, Stephen M

    2016-06-01

    The African trypanosome was thought to primarily develop in the bloodstream and interstitial spaces of its mammalian host. In this issue of Cell Host & Microbe, Trindade et al. (2016) report the surprising finding that during ongoing persistent infections in mice, a major fraction of the parasites reside within fatty tissues. PMID:27281564

  3. Unusual pulmonary findings in mucolipidosis II.

    PubMed

    Ishak, Marleine; Zambrano, Eduardo V; Bazzy-Asaad, Alia; Esquibies, Americo E

    2012-07-01

    We report undescribed pulmonary findings in a child with mucolipidosis II (ML-II). Children with ML-II bear significant pulmonary morbidity that may include extensive pulmonary fibrosis, persistent hemosiderosis as well as pulmonary airway excrescences as they reach preschool age. PMID:22162509

  4. 77 FR 11538 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-27

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary..., which is critical to normal brain development. Specifically: a. In the VZ/SZ panel (upper row, right... that gestational alcohol exposure had an effect on brain development by affecting the way...

  5. 77 FR 38632 - Findings of Research Misconduct

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-28

    ... HUMAN SERVICES Office of the Secretary Findings of Research Misconduct AGENCY: Office of the Secretary... Exposure to the Widely Used Herbicide, Atrazine: Altered Function and Loss of Neurons in Brain Monamine... experiments carried out at UMDNJ between 2004 and 2006; Falsifying a bar graph representing brain...

  6. Fermat's Technique of Finding Areas under Curves

    ERIC Educational Resources Information Center

    Staples, Ed

    2004-01-01

    Perhaps next time teachers head towards the fundamental theorem of calculus in their classroom, they may wish to consider Fermat's technique of finding expressions for areas under curves, beautifully outlined in Boyer's History of Mathematics. Pierre de Fermat (1601-1665) developed some important results in the journey toward the discovery of the…

  7. Land and people: finding a balance

    USGS Publications Warehouse

    U.S. Geological Survey

    1998-01-01

    Land and People: Finding a Balance is an environmental study project that engages high school students in studying earth science resource issues. The project focuses on the interaction between people and the environment in three regions of the United States: Cape Cod, Los Angeles, and the Everglades. Each section of this project is devoted to one of the three regions.

  8. Morphosyntax in Children with Word Finding Difficulties

    ERIC Educational Resources Information Center

    Murphy, Victoria A.; Dockrell, Julie; Messer, David; Farr, Hannah

    2008-01-01

    Children with word finding difficulties (CwWFDs) are slower and less accurate at naming monomorphemic words than typically developing children (Dockrell, Messer & George, 2001), but their difficulty in naming morphologically complex words has not yet been investigated. One aim of this paper was to identify whether CwWFDs are similar to typically…

  9. Art Works ... when Students Find Inspiration

    ERIC Educational Resources Information Center

    Herberholz, Barbara

    2011-01-01

    Artworks are not produced in a vacuum, but by the interaction of experiences, and interrelationships of ideas, perceptions and feelings acknowledged and expressed in some form. Students, like mature artists, may be inspired and motivated by their memories and observations of their surroundings. Like adult artists, students may find that their own…

  10. Gallbladder Tuberculosis: CT Findings with Histopathologic Correlation

    PubMed Central

    Xu, Xiu-Fang; Qiu, Ling-Ling; Shen, Jian; Dong, Fei; Chen, Ying

    2011-01-01

    Objective We wanted to describe the computed tomography (CT) findings of gallbladder tuberculosis (TB) and to correlate them with pathologic findings. Materials and Methods There were seven patients (M:F = 3:4; mean age, 46.3 years; age range, 32 to 78 years) in whom gallbladder TB was eventually diagnosed. All of them underwent cross-sectional imaging with CT, a pathologic examination and a retrospective review. CT imaging evaluation was done in each case, including the findings of a mass versus nodule, wall thickening (uniform or irregular) and the enhancement patterns (homogeneous or heterogeneous). Results All the cases of gallbladder TB revealed the following three different CT findings: micronodular lesion of the gallbladder wall (n = 1), a thickened wall (n = 4) and a gallbladder mass (n = 2). There were three cases of homogeneous enhancement of the lesions, including homogeneous enhancement with nodular lesion, homogeneous uniform thickness enhancement and homogeneous thickness enhancement in one case each, and these cases pathology showed tuberculous granuloma with a little caseating necrosis in one case and tuberculous granuloma with rich fibrous tissue, but little or no evident caseating necrosis in two cases. Four cases of heterogeneous enhancement of the lesions, including heterogeneous uniform-thickness enhancement in two cases, heterogeneous enhancement with a local mass lesion in one case and heterogeneous enhancement with a mass that replaced the gallbladder in one case; in these cases, pathology showed tuberculous granuloma with marked caseation or liquefaction necrosis in three cases and tuberculous granuloma by fibrous and calcifications accompanied by caseating necrosis in one case. Among the seven cases of gallbladder TB, six cases were accompanied by abdominal extra-gallbladder TB, including abdominal lymph node TB in five cases and hepatic TB in four cases. Conclusion Gallbladder TB has various CT manifestations, and the enhanced CT findings

  11. Pulmonary involvement in lifelong non-smoking patients with rheumatoid arthritis and ankylosing spondylitis without respiratory symptoms.

    PubMed

    Ayhan-Ardic, F Figen; Oken, Oznur; Yorgancioglu, Z Rezan; Ustun, Nilgun; Gokharman, F Dilek

    2006-03-01

    Pulmonary involvement seen in rheumatoid arthritis (RA) and ankylosing spondylitis (AS) has been detected increasingly by using highly sensitive diagnostic techniques such as high-resolution computed tomography (HRCT). However, HRCT findings in healthy controls and the effects of smoking and drugs have not been well studied. The aim of this controlled study was to evaluate the relationships between disease-specific clinical, laboratory, HRCT and pulmonary function test (PFT) findings in 20 RA patients using methotrexate (MTX) and 20 AS patients using sulphasalazine who were non-smokers and exhibited asymptomatic respiratory signs. For this purpose, a total of 60 persons (40 patients and 20 healthy controls) were included in this study. A restrictive pattern on PFT was detected in four patients (20%) with AS, one patient with RA and one control (p<0.05). Fourteen patients (70%) with RA and ten patients (50%) with AS had positive HRCT findings. Only one patient (5%) in the control group had abnormal HRCT findings (p<0.05). Interstitial lung disease (ILD) was the most frequently seen HRCT finding in both the RA (35%) and AS (20%) groups. The chest expansion measurement, the score of the visual analogue scale (VAS) for pain and C-reactive protein (CRP) levels were statistically significantly better in patients with AS having normal HRCT than in those with abnormal findings (p<0.05). There was no correlation detected between HRCT and duration of disease, disease activity markers, functional indexes and PFT in patients with RA and AS. HRCT is a sensitive tool in detecting ILD in patients with RA and AS with no signs and symptoms of pulmonary involvement and may be an integral part of such work-up. However, future prospective studies are needed to better determine if HRCT is in fact a predictor of subsequent MTX toxicity. PMID:16091838

  12. Primary intracranial choriocarcinoma: MR imaging findings.

    PubMed

    Lv, X-F; Qiu, Y-W; Zhang, X-L; Han, L-J; Qiu, S-J; Xiong, W; Wen, G; Zhang, Y-Z; Zhang, J

    2010-11-01

    PICCC is the rarest, most malignant primary intracranial GCT. The purpose of this study was to describe and characterize the MR imaging findings in a series of 7 patients (6 males and 1 female; mean age, 11.9 years) with pathologically proved PICCC in our institution from 2004 to 2009. All tumors were located within the pineal (n = 6) or suprasellar (n = 1) regions. On T2-weighted MR imaging, the lesions appeared markedly heterogeneous with areas of both hypointensity and hyperintensity reflecting the histologic heterogeneity, including hemorrhage, fibrosis, cysts, or necrosis. Heterogeneous (n = 7), ringlike (n = 4), and/or intratumoral nodular (n = 3) enhancement was noted on T1-weighted images with gadolinium. These MR imaging findings, combined with patient age and serum β-HCG levels, may prove helpful in distinguishing PICCC from the more common primary brain tumors, thereby avoiding biopsy of this highly vascular tumor. PMID:20616180

  13. Interferometric direction finding with a metamaterial detector

    SciTech Connect

    Venkatesh, Suresh; Schurig, David; Shrekenhamer, David; Padilla, Willie; Xu, Wangren; Sonkusale, Sameer

    2013-12-16

    We present measurements and analysis demonstrating useful direction finding of sources in the S band (2–4 GHz) using a metamaterial detector. An augmented metamaterial absorber that supports magnitude and phase measurement of the incident electric field, within each unit cell, is described. The metamaterial is implemented in a commercial printed circuit board process with off-board back-end electronics. We also discuss on-board back-end implementation strategies. Direction finding performance is analyzed for the fabricated metamaterial detector using simulated data and the standard algorithm, MUtiple SIgnal Classification. The performance of this complete system is characterized by its angular resolution as a function of radiation density at the detector. Sources with power outputs typical of mobile communication devices can be resolved at kilometer distances with sub-degree resolution and high frame rates.

  14. SoFiA: Source Finding Application

    NASA Astrophysics Data System (ADS)

    Serra, Paolo; Westmeier, Tobias; Giese, Nadine; Jurek, Russell; Flöer, Lars; Popping, Attila; Winkel, Benjamin; van der Hulst, Thijs; Meyer, Martin; Koribalski, Bärbel; Staveley-Smith, Lister; Courtois, Hélène

    2014-12-01

    SoFiA is a flexible source finding pipeline designed to detect and parameterise sources in 3D spectral-line data cubes. SoFiA combines several powerful source finding and parameterisation algorithms, including wavelet denoising, spatial and spectral smoothing, source mask optimisation, spectral profile fitting, and calculation of the reliability of detections. In addition to source catalogues in different formats, SoFiA can also generate a range of output data cubes and images, including source masks, moment maps, sub-cubes, position-velocity diagrams, and integrated spectra. The pipeline is controlled by simple parameter files and can either be invoked on the command line or interactively through a modern graphical user interface.

  15. Neuropathologic findings in an aged albino gorilla.

    PubMed

    Márquez, M; Serafin, A; Fernández-Bellon, H; Serrat, S; Ferrer-Admetlla, A; Bertranpetit, J; Ferrer, I; Pumarola, M

    2008-07-01

    Pallido-nigral spheroids associated with iron deposition have been observed in some aged clinically normal nonhuman primates. In humans, similar findings are observed in neurodegeneration with brain iron accumulation diseases, which, in some cases, show associated mutations in pantothenate kinase 2 gene (PANK2). Here we present an aged gorilla, 40 years old, suffering during the last 2 years of life from progressive tetraparesis, nystagmus, and dyskinesia of the arms, hands, and neck, with accompanying abnormal behavior. The postmortem neuropathologic examination revealed, in addition to aging-associated changes in the brain, numerous corpora amylacea in some brain areas, especially the substantia nigra, and large numbers of axonal spheroids associated with iron accumulation in the internal globus pallidus. Sequencing of the gorilla PANK2 gene failed to detect any mutation. The clinical, neuropathologic, and genetic findings in this gorilla point to an age-related pallido-nigral degeneration that presented PKAN-like neurologic deficits. PMID:18587101

  16. Finding cycles and trees in sublinear time.

    SciTech Connect

    Czumaj, Artur; Goldreich, Oded; Seshadhri, Comandur; Sohler, Christian; Shapira, Asaf; Ron, Dana

    2010-10-01

    We present sublinear-time (randomized) algorithms for finding simple cycles of length at least k {ge} 3 and tree-minors in bounded-degree graphs. The complexity of these algorithms is related to the distance of the graph from being C{sub k}-minor-free (resp., free from having the corresponding tree-minor). In particular, if the graph is far (i.e., {Omega}(1)-far) from being cycle-free, i.e. if one has to delete a constant fraction of edges to make it cycle-free, then the algorithm finds a cycle of polylogarithmic length in time {tilde O}({radical}N), where N denotes the number of vertices. This time complexity is optimal up to polylogarithmic factors. The foregoing results are the outcome of our study of the complexity of one-sided error property testing algorithms in the bounded-degree graphs model. For example, we show that cycle-freeness of N-vertex graphs can be tested with one-sided error within time complexity {tilde O}(poly(1/{epsilon}) {center_dot} {radical}N). This matches the known {Omega}({radical}N) query lower bound, and contrasts with the fact that any minor-free property admits a two-sided error tester of query complexity that only depends on the proximity parameter {epsilon}. For any constant k {ge} 3, we extend this result to testing whether the input graph has a simple cycle of length at least k. On the other hand, for any fixed tree T, we show that T -minor-freeness has a one-sided error tester of query complexity that only depends on the proximity parameter {epsilon}. Our algorithm for finding cycles in bounded-degree graphs extends to general graphs, where distances are measured with respect to the actual number of edges. Such an extension is not possible with respect to finding tree-minors in o({radical}N) complexity.

  17. Neuroimaging findings in sickle cell disease

    PubMed Central

    Burke, C; Siddiqui, A

    2014-01-01

    At least 25% of individuals with sickle cell disease will have a neurological complication over their lifetime, often as early as in childhood. Neuroradiological findings in patients with sickle cell disease are common and include acute territorial infarction, silent ischaemia and intracranial haemorrhage. Imaging abnormalities are typically, but not always, manifestations of the underlying vasculopathy. Coexisting acute and chronic pathology may pose challenges to interpretation. PMID:24847772

  18. Primary hypertrophic osteoarthropathy: ultrasound and MRI findings.

    PubMed

    Adams, Brook; Amin, Tania; Leone, Valentina; Wood, Mark; Kraft, Jeannette K

    2016-05-01

    Primary hypertrophic osteoarthropathy is a rare genetic disorder related to failures in prostaglandin metabolism. Patients present with joint pain, limb enlargement, skin thickening and finger clubbing. Radiographs show characteristic periosteal reaction and thickening along the long bones. We present MRI and US findings in a child with the condition. Ultrasound showed echogenic tissue surrounding the long bones, presumably reflecting oedema and inflammatory tissue. Doppler sonograms demonstrated increased vascularity on the surface of some superficial bony structures. PMID:26939972

  19. Imaging findings of Gorlin-Goltz syndrome

    PubMed Central

    Hajalioghli, Parisa; Ghadirpour, Ali; Ataie-Oskuie, Reza; Kontzialis, Marinos

    2015-01-01

    A 15-year-old girl was referred to a dentist complaining of parageusia, bad taste in the mouth, which started 9 months ago. Panoramic X-ray and non-enhanced computed tomography scan revealed multiple bilateral unilocular cysts in the mandible and maxilla, along with calcification of anterior part of the falx cerebri. She was eventually diagnosed with Gorlin-Goltz syndrome based on imaging and histopathologic finding of keratocystic odontogenic tumor. PMID:25610614

  20. Scrotal angiokeratoma (Fordyce): histopathological and ultrastructural findings.

    PubMed

    Gioglio, L; Porta, C; Moroni, M; Nastasi, G; Gangarossa, I

    1992-01-01

    Bioptic findings related to four cases of scrotal angiokeratoma-Fordyce, were studied under light and electron microscopy. A particular heterogeneity of the structural and ultrastructural patterns typical of this lesion was thus observed. Light microscopy study pointed out, in particular, different degrees of dilation of papillary vessels, whereas ultrastructural study highlighted marked alterations of endothelial cells with structural and quantitative modifications of cytoplasmic organelles. PMID:1576434

  1. Finding and using best evidence for rehabilitation.

    PubMed

    Salmond, Susan W; Holly, Cheryl; Smith, Jane

    2014-12-01

    With the demands for improved experiences of care, improved outcomes, and greater efficiency/lower costs, the need for an evidence-based approach to care in rehabilitation settings has never been more urgent. This article guides practitioners in how to find the best available evidence for rehabilitation settings. It then discusses the use of evidence from systematic reviews through a high-impact case study: delirium in patients with postoperative hip fracture. PMID:25458135

  2. Current clinical findings on monosodium glutamate.

    PubMed

    Livingstone, V H

    1981-07-01

    Monosodium glutamate (MSG) is a common and widely used food additive which has been passed as GRAS (generally recognized as safe) by the American Food and Drug Administration. However, it may have a significant adverse effect on certain individuals; the physician must be able to recognize the symptoms of MSG sensitivity, otherwise known as "Chinese Restaurant Syndrome". This article reviews current findings on MSG. PMID:21289773

  3. CT Findings in Temporal Bone Osteoradionecrosis

    PubMed Central

    Ahmed, Salmaan; Gupta, Nakul; Hamilton, Jackson D.; Garden, Adam S.; Gidley, Paul W.; Ginsberg, Lawrence E.

    2014-01-01

    Purpose The goal of this study is to describe CT findings in patients with clinically proven temporal bone osteoradionecrosis (TB-ORN). Methods and materials CT scans of twenty patients were retrospectively evaluated for bony and soft tissue abnormalities. Clinical severity was graded based on level of therapy administered: mild (observation), moderate (antibiotics/hyperbaric oxygen), or severe (surgery). Results Radiation dose to the primary tumor ranged from 30 to 75.6 Gy. Time to onset of ORN from completion of radiation therapy was 2 to 22 years (median=7yrs). Clinical findings: Exposed bone=20/20, otorrhea=17/20, hearing loss=11/20, otalgia=10/20, facial nerve paralysis=2/20, gait imbalance=2/20. CT findings: EAC erosions=18/20, mastoid effusion=18/20, mastoid bony coalescence=5/20, enhancing soft tissue=6/20, soft tissue gas=6/20, temporomandibular joint/condylar erosion=3/20. 3 patients developed an abscess. Conclusion Mastoid effusion and EAC erosions are commonly seen with TB-ORN. Clinically moderate or severe cases of TB-ORN are more likely to demonstrate enhancing soft tissue (p=0.002), soft tissue gas (p=0.002), and temporomandibular joint involvement (p=0.07). PMID:24834883

  4. Transabdominal ultrasonographic findings in goats with paratuberculosis

    PubMed Central

    Tharwat, Mohamed; Al-Sobayil, Fahd; Hashad, Mahmoud; Buczinski, Sébastien

    2012-01-01

    This study describes the transabdominal ultrasonographic findings in 54 goats with confirmed Johne’s disease (JD). Compared with the control group (0.8 ± 0.4 mm thick), the test group presented with mild (2.8 ± 0.2 mm), moderate (4.2 ± 0.4 mm), and severe (6.9 ± 1.1 mm) thickening of the intestinal wall. The most outstanding ultrasonographic findings were pronounced enlargement of the mesenteric lymph nodes in 49 goats. In 36 goats, the enlarged lymph nodes showed a hypoechoic cortex and a hyperechoic medulla. In 7 goats, the cortex and medulla were hypoechoic. In 5 goats, the cortex and the medulla could not be differentiated. In the remaining cases, the cortex and medulla contained small hypoechoic lesions. Necropsy findings included enlarged mesenteric lymph nodes in 52 goats and thickening of the small intestinal wall in 30 goats. Compared with the postmortem results, the antemortem ultrasound sensitivity in detecting intestinal wall thickness and enlarged mesenteric lymph nodes was 80% and 94%, respectively. PMID:23543924

  5. Why most published research findings are false.

    PubMed

    Ioannidis, John P A

    2005-08-01

    There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research. PMID:16060722

  6. Imaging findings of mimickers of hepatocellular carcinoma

    PubMed Central

    Lee, Eunchae; Jang, Hyun-Jung

    2015-01-01

    Radiological imaging plays a crucial role in the diagnosis of hepatocellular carcinoma (HCC) as the noninvasive diagnosis of HCC in high-risk patients by typical imaging findings alone is widely adopted in major practice guidelines for HCC. While imaging techniques have markedly improved in detecting small liver lesions, they often detect incidental benign liver lesions and non-hepatocellular malignancy that can be misdiagnosed as HCC. The most common mimicker of HCC in cirrhotic liver is nontumorous arterioportal shunts that are seen as focal hypervascular liver lesions on dynamic contrast-enhanced cross-sectional imaging. Rapidly enhancing hemangiomas can be easily misdiagnosed as HCC especially on MR imaging with liver-specific contrast agent. Focal inflammatory liver lesions mimic HCC by demonstrating arterial-phase hypervascularity and subsequent washout on dynamic contrast-enhanced imaging. It is important to recognize the suggestive imaging findings for intrahepatic cholangiocarcinoma (CC) as the management of CC is largely different from that of HCC. There are other benign mimickers of HCC such as angiomyolipomas and focal nodular hyperplasia-like nodules. Recognition of their typical imaging findings can reduce false-positive HCC diagnosis. PMID:26770920

  7. Domain-Independent Scientific Function Finding

    NASA Astrophysics Data System (ADS)

    Schaffer, Cullen R.

    1990-01-01

    Programs such as Bacon, Abacus, Coper, Kepler and others are designed to find functional relationships of scientific significance in quantitative data without relying on the deep domain knowledge scientists normally bring to bear in analytic work. Whether these systems actually perform as intended is an open question, however. To date, they have been supported only by anecdotal evidence --reports that a desirable answer has been found in one or more selected and often artificial cases. In this dissertation, I thus attempt to develop, not only new approaches to domain -independent scientific function finding, but, equally, a rigorous methodology under which research into such methods can be conducted. A fundamental problem with previous work is that it has investigated scientific data analysis in the abstract --without referring to actual scientific data. By contrast, the work reported here is founded on a collection of 352 real scientific data sets. This empirical base supports a number of strong conclusions. First, while researchers working with artificial data have targeted complex multivariate relations, real data provides powerful evidence that even the simplest bivariate relationships are difficult to identify reliably. Second, despite its ubiquitous presence in previous work, the notion of heuristic search of a potentially explosive space of formulas appears to help very little with the problem of reliably identifying basic bivariate relationships. Instead, third, substantial performance improvement results from viewing function finding as a decision problem, the problem of classifying data sets reliably within a fixed--and quite limited--system of functional categories. This dissertation presents what I believe to be the strongest domain-independent scientific function-finding algorithm currently in existence and, certainly, the only one which has been rigorously demonstrated. At the same time, it suggests fundamental limitations in the power of such

  8. Chest imaging and lung function impairment after long-term occupational exposure to low concentrations of chrysotile.

    PubMed

    Spyratos, Dionisios; Chloros, Diamantis; Haidich, Bettina; Dagdilelis, Loukas; Markou, Stamatia; Sichletidis, Lazaros

    2012-01-01

    The aim of the present study was the investigation of radiographic findings in relation to lung function after occupational exposure to permissible levels of relatively pure chrysotile (0.5-3% amphiboles). We studied 266 out of the total 317 employees who have worked in an asbestos cement factory during the period 1968-2004 with chest x-ray, high-resolution computed tomography (HRCT) and lung function tests. Sensitivity of chest x-ray was 43% compared to HRCT. Abnormal HRCT findings were found in 75 subjects (67%) and were related to age, occupational exposure duration, and spirometric data. The presence of parenchymal or visceral pleural lesions (exclusively or as the predominant abnormality) was being accompanied by lower total lung capacity and diffusion capacity. HRCT was much more sensitive than chest x-ray for occupational chrysotile exposure. Lung function impairment was related with parenchymal but not with pleural HRCT abnormalities. PMID:22524648

  9. Finding apparent horizons in numerical relativity

    NASA Astrophysics Data System (ADS)

    Thornburg, Jonathan

    1996-10-01

    We review various algorithms for finding apparent horizons in 3+1 numerical relativity. We then focus on one particular algorithm, in which we pose the apparent horizon equation H≡∇ini+Kijninj-K=0 as a nonlinear elliptic (boundary-value) PDE on angular-coordinate space for the horizon shape function r=h(θ,φ), finite difference this PDE, and use Newton's method or a variant to solve the finite difference equations. We describe a method for computing the Jacobian matrix of the finite differenced H(h) sH (sh) function by symbolically differentiating the finite difference equations, giving the Jacobian elements directly in terms of the finite difference molecule coefficients used in computing sH (sh). Assuming the finite differencing scheme commutes with linearization, we show how the Jacobian elements may be computed by first linearizing the continuum H(h) equations, then finite differencing the linearized continuum equations. (This is essentially just the ``Jacobian part'' of the Newton-Kantorovich method for solving nonlinear PDEs.) We tabulate the resulting Jacobian coefficients for a number of different sH (sh) and Jacobian computation schemes. We find this symbolic differentiation method of computing the Jacobian to be much more efficient than the usual numerical-perturbation method, and also much easier to implement than is commonly thought. When solving the discrete sH (sh)=0 equations, we find that Newton's method generally shows robust convergence. However, we find that it has a small (poor) radius of convergence if the initial guess for the horizon position contains significant high-spatial-frequency error components, i.e., angular Fourier components varying as (say) cosmθ with m>~8. (Such components occur naturally if spacetime contains significant amounts of high-frequency gravitational radiation.) We show that this poor convergence behavior is not an artifact of insufficient resolution in the finite difference grid; rather, it appears to be caused

  10. Pediatric Stroke: Clinical Findings and Radiological Approach

    PubMed Central

    Lanni, Giuseppe; Catalucci, Alessia; Conti, Laura; Di Sibio, Alessandra; Paonessa, Amalia; Gallucci, Massimo

    2011-01-01

    This paper focuses on radiological approach in pediatric stroke including both ischemic stroke (Arterial Ischemic Stroke and Cerebral Sinovenous Thrombosis) and hemorrhagic stroke. Etiopathology and main clinical findings are examined as well. Magnetic Resonance Imaging could be considered as the first-choice diagnostic exam, offering a complete diagnostic set of information both in the discrimination between ischemic/hemorrhagic stroke and in the identification of underlying causes. In addition, Magnetic Resonance vascular techniques supply further information about cerebral arterial and venous circulation. Computed Tomography, for its limits and radiation exposure, should be used only when Magnetic Resonance is not available and on unstable patients. PMID:21603166

  11. Clinical and electrodiagnostic findings in cyhalothrine poisoning.

    PubMed

    Basiri, Keivan; Mohaghegh, Mohammad Reza; Teimouri, Somayyeh Sadat; Okhovat, Ali Asghar

    2016-01-01

    Acute onset bulbar symptoms with respiratory failure and descending paralysis may occur in several neuromuscular disorders including variants of Guillain-Barre syndrome (GBS), diphtheria, botulism and toxins. We present a 51-year-old man who presented with complains of ptosis and dyspnea following pyrethroids spraying in an enclosed area for eradication of flea. Within 5-6 days of admission limb weakness, dysphagia, dysarthria, blurred vision, diplopia, tremor and respiratory distress added to previous symptoms. Temporal profile of events after exposure, development of similar symptoms in patient's son, electrodiagnostic findings and exclusion of other etiologies confirms intoxication etiology. We reviewed the literature and provide an extensive electrodiagnostic overview. PMID:27099845

  12. Humoral Immunity in Bronchiectasis: Finding Good's Syndrome

    PubMed Central

    Pu, C.; Sukhal, S.; Fakhran, S.

    2015-01-01

    We present a case of a 37-year-old man with a past history of a surgically removed thymoma, who presented with recurrent pulmonary infections and bronchiectasis. On further testing, he was found to have low total immunoglobulin levels, a constellation of findings known as Good's syndrome. He responded well to immunoglobulin replacement, in addition to the usual treatments for bronchiectasis. We present this case to emphasize the association of bronchiectasis, low immunoglobulins, and thymomas and the role of immunoglobulin replacement as a treatment option. PMID:26839727

  13. Intracerebral pneumatoceles following facial trauma: CT findings

    SciTech Connect

    Mendelsohn, D.B.; Hertzanu, Y.

    1985-01-01

    Three patients with delayed frontal intracerebral pneumatoceles following facial injury are presented. In one patient an unusual appearance of bilateral and symmetrical frontal lobe pneumatoceles was demonstrated. While diagnosis is not difficult on routine radiographs, CT is valuable for determining effects on the brain and clearly delineating the fracture site; CT shows the location of the pneumatocele and may show an associated air-fluid level, mass effect or surrounding edema, or rim enhancement following administration of contrast material. The radiological appearances in conjunction with the clinical findings are highly characteristic and should not be mistaken for gas-forming cerebral abscesses.

  14. Castleman's disease of the kidney: Sonographic findings.

    PubMed

    Ooi, Chin Chin; Cheah, Foong Koon; Wong, Siew Kune

    2015-09-01

    We report a case of rare Castleman's disease of the kidney that mimicked a renal neoplasm with emphasis on the imaging and histologic findings. A 47-year-old man presented with dyspeptic symptoms. Ultrasound revealed a vascular, heterogeneous mass in the left kidney. Multiphasic CT scan confirmed an enhancing lesion with enlarged left para-aortic lymph nodes suspicious for nodal metastases. The provisional diagnosis was renal cell carcinoma. Percutaneous biopsy yielded a diagnosis of Castleman's disease of the hyaline-vascular type. Despite advancement in imaging modalities, differentiation of hyaline-vascular variant of Castleman's disease from hypervascular renal neoplasm remains difficult and the final diagnosis requires histopathological confirmation. PMID:24947075

  15. Chronic beryllium disease: computed tomographic findings.

    PubMed

    Sharma, Nidhi; Patel, Jeet; Mohammed, Tan-Lucien H

    2010-01-01

    Chronic beryllium disease is a rare multisystem granulomatous disease predominantly involving the lungs and resulting from an immunologic response to long-term occupational exposure. Computed tomography of the chest reveals important lung parenchymal and mediastinal findings and plays an important role in the diagnosis and follow-up assessment of patients with chronic beryllium disease. Its significance lies in the exact localization and evaluation of the extent of lesions. We present an overview of the subject and a pictorial review of the spectrum of computed tomographic features of beryllium disease. PMID:21084914

  16. Magnetic resonance imaging findings of intramammary metastases.

    PubMed

    Wienbeck, Susanne; Herzog, Aimee; Kinner, Sonja; Surov, Alexey

    2016-01-01

    The purpose of this study was to identify magnetic resonance imaging (MRI) findings of intramammary metastases (IM). We identified 8 cases with IM, which were investigated by breast MRI (1.5T). In every case, the diagnosis of IM was proven histopathologically on breast biopsy specimens. Overall, 187 IM were identified. IM had inconsistent MRI features, which cannot be clearly classify as benign or malignant. IM should be taken into consideration in the differential diagnosis of breast lesions to avoid possible misinterpretations. PMID:27133668

  17. Algebraic method for finding equivalence groups

    NASA Astrophysics Data System (ADS)

    Bihlo, Alexander; Dos Santos Cardoso-Bihlo, Elsa; Popovych, Roman O.

    2015-06-01

    The algebraic method for computing the complete point symmetry group of a system of differential equations is extended to finding the complete equivalence group of a class of such systems. The extended method uses the knowledge of the corresponding equivalence algebra. Two versions of the method are presented, where the first involves the automorphism group of this algebra and the second is based on a list of its megaideals. We illustrate the megaideal-based version of the method with the computation of the complete equivalence group of a class of nonlinear wave equations with applications in nonlinear elasticity.

  18. Clinical and electrodiagnostic findings in cyhalothrine poisoning

    PubMed Central

    Basiri, Keivan; Mohaghegh, Mohammad Reza; Teimouri, Somayyeh Sadat; Okhovat, Ali Asghar

    2016-01-01

    Acute onset bulbar symptoms with respiratory failure and descending paralysis may occur in several neuromuscular disorders including variants of Guillain-Barre syndrome (GBS), diphtheria, botulism and toxins. We present a 51-year-old man who presented with complains of ptosis and dyspnea following pyrethroids spraying in an enclosed area for eradication of flea. Within 5-6 days of admission limb weakness, dysphagia, dysarthria, blurred vision, diplopia, tremor and respiratory distress added to previous symptoms. Temporal profile of events after exposure, development of similar symptoms in patient's son, electrodiagnostic findings and exclusion of other etiologies confirms intoxication etiology. We reviewed the literature and provide an extensive electrodiagnostic overview. PMID:27099845

  19. [Identification of a body from dental findings].

    PubMed

    Spyropoulos, N

    1989-01-01

    The author starts by briefly reviewing the meaning and applications of Forensic Dentistry emphasizing the ethical and legal responsibility of the dentist who is called upon by the police and the Service of Forensic Medicine to contribute to the identification of a dead person. Next, the author describes an interesting case where the identification was possible by documenting more than ten points coinciding between the dental record of the person suspected to be the dead and the findings from the examination of the oral cavity of the body. PMID:2519155

  20. Imaging findings in patients with myelofibrosis.

    PubMed

    Guermazi, A; de Kerviler, E; Cazals-Hatem, D; Zagdanski, A M; Frija, J

    1999-01-01

    The purpose of this review is to illustrate the wide range of radiological abnormalities in myelofibrosis. Myelofibrosis, also called myeloid metaplasia, is a myeloproliferative disorder of unknown etiology. The common imaging findings in patients with myelofibrosis are osteosclerosis, hepatosplenomegaly, and lymphadenopathies. In addition, extramedullary hematopoiesis may develop in multiple sites such as chest, abdomen, pelvis, and central nervous system, simulating malignant disease. Selected plain-film, CT, and MR images in patients with myelofibrosis are shown as pictorial essay to allow ready recognition of the most common imaging abnormalities of the disease. PMID:10460376

  1. Radiologic findings in the Proteus syndrome.

    PubMed

    Azouz, E M; Costa, T; Fitch, N

    1987-01-01

    The radiological findings in two patients with the Proteus syndrome are described. Features in our two cases not previously mentioned or stressed include vertebral dysplasia and enlargement (megaspondylodysplasia), bilateral genu valgum, recurrent after surgery and intraabdominal and mesenteric lipomatosis. Emergency laparotomy was performed on the first patient who had a twisted necrotic portion of mesenteric fat. Macrodactyly, skeletal muscle atrophy and subcutaneous fat accumulation in the abdominal wall were present in both. In addition the second patient was mentally retarded and had frontal bony prominence of skull. Computed tomography was used for the specific diagnosis of the lipomatous tissues in both patients. PMID:3684361

  2. Cytogenetic findings in a large bowel adenocarcinoma.

    PubMed

    Ferti-Passantonopoulou, A; Panani, A; Avgerinos, A; Raptis, S

    1986-04-15

    Cytogenetic analysis of a biopsy specimen taken during sigmoidoscopy from an adenocarcinoma of the large bowel revealed a hypodiploid karyotype with numerical and structural abnormalities identified as trisomy 7, t(3;12), t(1;17), interstitial deletion of the long arm of a chromosome #5 and loss of the Y chromosome with double X chromosomes. The possibility of this karyotype being a further evolutionary step in a subgroup of large bowel cancers and the clinical value of the above findings are discussed. PMID:3456826

  3. Dermatoscopic findings of atrophic dermatofibrosarcoma protuberans

    PubMed Central

    Akay, Bengu Nisa; Unlu, Ezgi; Erdem, Cengizhan; Heper, Aylin Okcu

    2015-01-01

    Dermatofibrosarcoma protuberans (DFSP) is an uncommon locally aggressive mesenchymal tumor with a high local recurrence rate. Atrophic DFSP is a rare variant of DFSP characterized by a non-protuberant lesion. We report on a 23-year-old female, who presented with an atrophic, asymptomatic macule on the right side of her back 2 cm in diameter. Dermatoscopic examination revealed homogenous pigment network on a purplish erythematous background. The histopathological finding of the incisional biopsy material was consistent with DFSP. To our knowledge, this is the second case of atrophic DFSP discussing the dermatoscopic features of this relatively rare condition. PMID:25692086

  4. Framing and global health governance: key findings.

    PubMed

    McInnes, Colin; Lee, Kelley

    2012-01-01

    Despite widespread agreement that collective action to address shared health challenges across countries is desirable and necessary, the realm of global health governance has remained highly problematic. A key reason for this is the manner in which health issues are presented ('framed'). Because multiple frames are operating simultaneously, confusion and a range of competing policy recommendations and priorities result. Drawing on the previous articles published in this Special Supplement, these key findings explore how health issues are framed, what makes a framing successful, what frames are used for and what effects framing has. PMID:23088193

  5. Clinical findings among hard metal workers.

    PubMed Central

    Fischbein, A; Luo, J C; Solomon, S J; Horowitz, S; Hailoo, W; Miller, A

    1992-01-01

    In 1940, the first report appeared describing a pulmonary disorder associated with occupational exposures in the cemented tungsten carbide industry. The disease, known as "hard metal disease," has subsequently been characterised in detail and comprises a wide range of clinical signs and symptoms. In this report, clinical findings in a group of 41 hard metal workers employed until recently are described. A high prevalence of respiratory symptoms was found. Thirteen workers (31%) had abnormal chest radiographs indicative of interstitial lung disease. Fifty per cent of these had been employed in hard metal manufacturing for less than 10 years. Abnormalities of pulmonary function were also frequent and included a restrictive pattern of impairment and decrease in diffusing capacity (27%). Associations were found between diffusing capacity, chest radiographic abnormalities and right ventricular ejection fraction at exercise indicating cardiopulmonary effects. The findings show the continuous need to control excessive occupational exposures to prevent hard metal disease, the history of which now enters its sixth decade. PMID:1733452

  6. Electroencephalographic findings in workers exposed to benzene.

    PubMed

    Kellerová, V

    1985-01-01

    Preventive EEG examination was carried out in 40 workers significantly exposed to benzene. The EEG findings were compared with those of a control group of 48 healthy persons, a group of 110 workers significantly exposed to toluene and xylene and a group of 236 workers exposed to vinyl chloride. The individuals exposed to benzene exhibited 22.5% of abnormal and 45% threshold findings, the abnormalities being episodic, diffuse or a combination of the two. The effect of benzene entailed a frequent (32.5%) occurrence of a characteristic frequency lability. Sleep phenomena were found in a total of 60% cases (37.5% cases reached stage 1 B3 while 15% reached stage 2 according to Roth [14]). The rapid onset of deeper sleep stages (in 30% cases) is considered typical for benzene exposure. The photic driving response often had an extended frequency range (a total of 61.1%, to beta frequencies only in 30.55%, to both beta and theta frequencies also in 30.55% of cases). The different EEG features characteristic of the neurotoxic action of various types of organic solvents make possible a more efficient diagnostics of the effects of these chemicals on the CNS. PMID:4086812

  7. Oral and Dental Findings of Dyskeratosis Congenita

    PubMed Central

    Barlak, Pelin; Seymen, Figen

    2014-01-01

    Dyskeratosis congenital (DC) is a rare condition characterized by reticulate skin hyperpigmentation, mucosal leukoplakia, and nail dystrophy. More serious features are bone marrow involvement with pancytopenia and a predisposition to malignancy. The purpose of this case report is to describe the oral and dental findings in children with DC syndrome. A 10-year-old male diagnosed with DC was admitted because of extensive caries and toothache. Inadequate oral hygiene and extensive caries were observed in oral examination of the patient. Plaque accumulation was seen in gingival border of maxillary teeth. Papillary atrophy on the tongue was observed. Short and blunted roots of mandible incisors and upper and lower molars were determined on the radiographic examination. Dryness on the lips and commisuras, ectropion on his eyes, and epiphora were observed. Hematologic tests were performed and showed aplastic anemia at the age of 2. At the age of 4, the bone marrow transplantation was performed. Dermatological findings occurred after the bone marrow transplantation. The skin of the patient was thin, dry, and wrinkled in some areas. He had palmoplantar hyperkeratosis and syndactylia on his fingers. Endodontic treatment procedures were applied and other extensive caries are still being restored. The patient will be given full preventive care during regular follow-up. Oral hygiene was improved to the optimum level. PMID:25610666

  8. Otological findings in pediatric patients with hypogammaglobulinemia.

    PubMed

    Tavakol, Marzieh; Kouhi, Ali; Abolhassani, Hassan; Ghajar, Alireza; Afarideh, Mohsen; Shahinpour, Shervin; Aghamohammadi, Asghar

    2014-06-01

    The main clinical presentation of patients with primary antibody deficiency (PAD) incorporates upper respiratory tract infections comprising otitis media, sinusitis and pneumonia. This study was designed to investigate clinical and paraclinical otological complications in major types of PAD. A cross sectional study was conducted on 55 PAD patients with diagnosis of selective IgA deficiency, common variable immunodeficiency (CVID), X-linked agammaglobulinemia (XLA), and hyper IgM syndrome. All patients underwent otological examinations, audiometry, and auditory brain stem response. Otological complications were detected in 54.5% of PAD patients. Conductive hearing loss was the main finding amongst PID patients (73.3%) followed by sensorineural hearing loss which was present in 8 cases. Otitis media with effusion (21.8%), chronic otitis media (27.2%), tympanosclerosis with intact tympanic membrane (5.4%) and auditory neuropathy (3.6%) were most important found complications. CVID and XLA patients with prophylactic usage of antibiotics had lower rate of audiological complications (p=0.04) and otitis media with effusion (p=0.027). As our results showed, asymptomatic otological findings were not rare in PAD patients; therefore, a systematic otological investigation is recommended as an integral part of the management and follow-up of these patients. PMID:24659120

  9. ULTRASONOGRAPHIC FINDINGS IN 13 HORSES WITH LYMPHOMA.

    PubMed

    Janvier, Valentin; Evrard, Laurence; Cerri, Simona; Gougnard, Alexandra; Busoni, Valeria

    2016-01-01

    Ultrasonography and radiography are commonly used for staging of lymphoma in horses, however there is little published information on imaging characteristics for horses with confirmed disease. The purpose of this retrospective, case series study was to describe ultrasonographic and radiographic findings for a group of horses with a confirmed diagnosis of lymphoma. A total of 13 horses were sampled. Lymphadenopathy (8/13), peritoneal effusion (6/13), splenic (6/13), and hepatic (5/13) lesions were the most frequently identified. The predominant splenic and hepatic ultrasonographic lesions were hypoechoic nodules, organomegaly, and changes in echogenicity. Digestive tract lesions were detected in three horses and these included focal thickening and decreased echogenicity of the small (2/13) and large intestinal (2/13) wall. Thoracic lesions were predominantly pleural effusion (4/13), lymphadenopathy (4/13), and lung parenchymal changes (3/13). Enlarged lymph nodes were detected radiographically (4/13) and/or ultrasonographically (2/13) in the thorax and ultrasonographically in the abdomen (7/13) and in the caudal cervical region (4/13). Findings supported the use of abdominal and thoracic ultrasonography for lymphoma staging in horses. Ultrasound landmarks for localizing cecal and caudal deep cervical lymph nodes were also provided. PMID:26456541

  10. Clinicopathologic findings in Best vitelliform macular dystrophy

    PubMed Central

    Zhang, Qing; Small, Kent W.

    2012-01-01

    Purpose To correlate the clinical and histopathologic features of Best vitelliform macular dystrophy (BVMD). Methods Two eyes were obtained postmortem from a patient with BVMD. The patient’s clinical information was reviewed. Series sections of the globes were performed and sequentially stained with hematoxylin-eosin, periodic acid-Schiff or Masson trichrome. A section of the left macula was submitted for electron microscopic processing. Histopathologic findings were reconstructed in a scaled two-dimensional map and compared with fundus photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) images. Results The macular lesion of the right eye was identified as a well-demarcated region with pigment, elevated submacular yellow material and subretinal fluid. This corresponded histopathologically to a well-circumscribed area of RPE hyperplasia, accumulation of lipofuscin in the RPE, deposition of granular material in the photoreceptors, macrophages and drusen. The left eye displayed a 1 disc diameter chorioretinal scar with surrounding shallow fluid and submacular pigment. This corresponded to RPE changes and a fibrocellular proliferation in the choriocapillaris. Conclusion Histopathologic mapping revealed retinal edema, RPE abnormalities, drusen and a chorioretinal scar in BVMD that correlated with the fundus, FFA, FAF and OCT findings. PMID:21136072

  11. Unusual MRI Findings in a Polio Survivor

    PubMed Central

    Kubosawa, Hitoshi; Ishii, Takeshi

    2016-01-01

    A 63-year-old male consulted our institution due to worsening of right hip pain for approximately one month. The patient had no apparent functional disorders besides rigidity of the right ankle secondary to childhood poliomyelitis. Plain radiographs demonstrated narrowing of the right hip joint space. Magnetic resonance imaging (MRI) showed unusual findings in the right gluteus medius muscle, suspecting a malignant musculoskeletal tumor. Further examinations clarified acute inflammation caused by Staphylococcus aureus with no atypia. After treatment, serum inflammatory markers normalized and MRI showed homogeneous fat signal intensity in the muscle, which was consistent with poliomyelitis. Total hip arthroplasty was performed due to progression of osteoarthritis. Intraoperative findings showed flaccidity of the gluteus medius muscle, and histological examination of the specimen also was compatible with poliomyelitis. Postoperatively there was no hip instability and the patient has been able to resume his previous physical activity. To our knowledge, this is the first report regarding polio survivors combined with septic arthritis, and sole MRI examination was unable to lead to the diagnosis. The current patient demonstrates the possibility that the involved muscles in poliomyelitis exist even in asymptomatic regions, which will be helpful for accurate diagnosis and life guidance in polio survivors. PMID:27069705

  12. PLANTAR THROMBOPHLEBITIS: MAGNETIC RESONANCE IMAGING FINDINGS

    PubMed Central

    Miranda, Frederico Celestino; Carneiro, Renato Duarte; Longo, Carlos Henrique; Fernandes, Túlio Diniz; Rosemberg, Laércio Alberto; de Gusmão Funari, Marcelo Buarque

    2015-01-01

    Objective: Demonstrate the magnetic resonance imaging (MRI) findings in plantar thrombophlebitis. Methods: Retrospective review of twenty patients with pain in the plantar region of the foot, in which the MRI findings indicated plantar thrombophlebitis. Results: A total of fourteen men and six women, mean age 46.7 years were evaluated. Eight of these patients also underwent Doppler ultrasonography, which confirmed the thrombophlebitis. The magnetic resonance images were evaluated in consensus by two radiologists with experience in musculoskeletal radiology (more than 10 years each), showing perivascular edema in all twenty patients (100%) and muscle edema in nineteen of the twenty patients (95%). All twenty patients had intraluminal intermediate signal intensity on T2-weighted (100%) and venous ectasia was present in seventeen of the twenty cases (85%). Collateral veins were visualized in one of the twenty patients (5%). All fourteen cases (100%), in which intravenous contrast was administered, showed perivenular tissues enhancement and intraluminal filling defect. Venous ectasia, loss of compressibility and no flow on Doppler ultrasound were also observed in all eight cases examined by the method. Conclusion: MRI is a sensitive in the evaluation of plant thrombophlebitis in patients with plantar foot pain. PMID:27047898

  13. Fluoroscopic findings post-peroral esophageal myotomy.

    PubMed

    Harmath, Carla; Horowitz, Jeanne; Berggruen, Senta; Hammond, Nancy A; Hammond, Nancy; Nikolaidis, Paul; Miller, Frank H; Miller, Frank; Goodhartz, Lori A; Goodhartz, Lori; Teitelbaum, Ezra N; Teitlebaum, Erza; Hungness, Eric S; Hungness, Eric; Yaghmai, Vahid

    2015-02-01

    Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique that has been evolving rapidly. Endoscopic submucosal dissection was initiated in 1999, in Japan, for en-bloc resection of large lesions of the stomach (Zhou et al., World J Gastroenterol 19:6962-6968, 2013, ; Kobara et al., Clin Exp Gastroenterol 7:67-74, 2014). Since then, many additional therapies utilizing natural transluminal endoscopic approach have evolved. Peroral endoscopic myotomy (POEM) is a minimally invasive type of transluminal endoscopic surgery that was recently developed for the treatment of achalasia and esophageal motility disorders. The peroral endoscopic myotomy is a less invasive surgical treatment that is suitable for all types of achalasia and used as an alternate to the Heller myotomy. The radiographic findings of achalasia and surgical changes after Heller myotomy have been described, however, very little is available on the post-POEM esophagram appearance. The purpose of this article is to illustrate the anatomy, surgical procedure, and normal and abnormal findings seen on esophagrams in patients who have undergone a POEM. PMID:25128214

  14. Perceptual approaches to finding features in data

    NASA Astrophysics Data System (ADS)

    Rogowitz, Bernice E.

    2013-03-01

    Electronic imaging applications hinge on the ability to discover features in data. For example, doctors examine diagnostic images for tumors, broken bones and changes in metabolic activity. Financial analysts explore visualizations of market data to find correlations, outliers and interaction effects. Seismologists look for signatures in geological data to tell them where to drill or where an earthquake may begin. These data are very diverse, including images, numbers, graphs, 3-D graphics, and text, and are growing exponentially, largely through the rise in automatic data collection technologies such as sensors and digital imaging. This paper explores important trends in the art and science of finding features in data, such as the tension between bottom-up and top-down processing, the semantics of features, and the integration of human- and algorithm-based approaches. This story is told from the perspective of the IS and T/SPIE Conference on Human Vision and Electronic Imaging (HVEI), which has fostered research at the intersection between human perception and the evolution of new technologies.

  15. Audiological findings in aphasic patients after stroke

    PubMed Central

    Onoue, Solange Satie; Ortiz, Karin Zazo; Minett, Thaís Soares Cianciarullo; Borges, Alda Christina Lopes de Carvalho

    2014-01-01

    Objective To outline the audiological findings of aphasic patients after cerebrovascular accidents. Methods This is a cross-sectional study performed between March 2011 and August 2012 in the Speech, Language, and Hearing Pathology Department of the Universidade Federal de São Paulo. A total of 43 aphasic subjects (27 men) were referred for audiological evaluation after stroke, with mean age of 54.48 years. Basic audiological evaluation tests were performed, including pure tone audiometry, speech audiometry (speech recognition threshold and word recognition score), immittance measures (tympanometry and contralateral acoustic reflex), and transient otoacoustic emissions. Results Sensorineural hearing loss was prevalent (78.6%). Speech recognition threshold and word recognition score were not obtained in some patients because they were unable to perform the task. Hearing loss was a common finding in this population. Conclusion Comprehension and/or oral emission disruptions in aphasic patients after stroke compromised conventional speech audiometry, resulting in the need for changes in the evaluation procedures for these patients. PMID:25628193

  16. Unusual MRI Findings in a Polio Survivor.

    PubMed

    Sakamoto, Masaaki; Watanabe, Hitoshi; Kubosawa, Hitoshi; Ishii, Takeshi

    2016-01-01

    A 63-year-old male consulted our institution due to worsening of right hip pain for approximately one month. The patient had no apparent functional disorders besides rigidity of the right ankle secondary to childhood poliomyelitis. Plain radiographs demonstrated narrowing of the right hip joint space. Magnetic resonance imaging (MRI) showed unusual findings in the right gluteus medius muscle, suspecting a malignant musculoskeletal tumor. Further examinations clarified acute inflammation caused by Staphylococcus aureus with no atypia. After treatment, serum inflammatory markers normalized and MRI showed homogeneous fat signal intensity in the muscle, which was consistent with poliomyelitis. Total hip arthroplasty was performed due to progression of osteoarthritis. Intraoperative findings showed flaccidity of the gluteus medius muscle, and histological examination of the specimen also was compatible with poliomyelitis. Postoperatively there was no hip instability and the patient has been able to resume his previous physical activity. To our knowledge, this is the first report regarding polio survivors combined with septic arthritis, and sole MRI examination was unable to lead to the diagnosis. The current patient demonstrates the possibility that the involved muscles in poliomyelitis exist even in asymptomatic regions, which will be helpful for accurate diagnosis and life guidance in polio survivors. PMID:27069705

  17. Histopathologic findings in breast reduction specimens.

    PubMed

    Kececi, Yavuz; Tasli, Funda Alkan; Yagcı, Ayse; Sır, Emin; Canpolat, Selin; Vardar, Enver

    2014-04-01

    Reduction mammaplasty is a commonly performed operation for treatment of breast hypertrophy. It allows examination of specimens from a seemingly healthy population. Although there are many publications reporting the incidence of occult breast carcinomas, only a few studies have specifically examined the incidence of other breast lesions in reduction mammaplasty specimens. The authors conducted a single-centre retrospective chart review examining the incidence of benign and precancerous lesions in breast reduction specimens. Both age and the number of tissue sections were evaluated for the association with important pathologic findings. Of the 95 patients who underwent reduction mammaplasty, eight patients (8.4%) had atypical lesions. Fourteen patients (15%) had proliferative and 54 patients (57%) had non-proliferative breast lesions. No occult invasive breast cancer was identified in the breast reduction specimens. The existence of significant pathologic findings was not associated with age (p = 0.231, student t-test). On the other hand, it was found to be associated with the number of tissue sections (p = 0.046, Mann-Whitney U-test). This study reveals that breast reduction specimens should be analyzed histologically since a considerable amount of patients have breast lesions with increased cancer risk. Therefore, this analysis would guide the management of these patients in the follow-up period. PMID:23879776

  18. Diagnostic findings in 132 great horned owls

    USGS Publications Warehouse

    Franson, J.C.; Little, S.E.

    1996-01-01

    We reviewed diagnostic findings for 132 great horned owl (Bubo virginianus) carcasses that were submitted to the National Wildlife Health Center from 1975-93. The carcasses were collected in 24 states but most came from Colorado (N = 21), Missouri (N = 12), Oregon (N = 12), Wyoming (N = 11), Illinois (N = 10), and Wisconsin (N = 9). Forty-two birds were emaciated but presumptive causes of emaciation, including old injuries, chronic lesions in various organs, and exposure to dieldrin, were found in only 16. A greater proportion of juveniles (56%) than adults (29%) were emaciated. Twelve owls were shot and 35 died from other traumatic injuries. Poisonings were diagnosed in 11 birds, including five associated with hydrogen sulfide exposure in oil fields and six cases of agricultural pesticide poisonings. Electrocution killed nine birds and infectious diseases were found in six. Miscellaneous conditions, including egg impaction, drowning, and visceral gout were diagnosed in three of the birds and the cause of death was undetermined in 14 owls. While this review identifies major diagnostic findings in great horned owls, sample bias prevents definitive conclusions regarding actual proportional causes of mortality.

  19. An interim overview of LDEF materials findings

    SciTech Connect

    Stein, B.A.

    1992-12-01

    The flight and retrieval of the National Aeronautics and Space Administration's Long Duration Exposure Facility (LDEF) provided an opportunity for the study of the low-Earth orbit (LEO) environment and long-duration space environmental effects (SEE) on materials that is unparalleled in the history of the U.S. Space Program. The remarkable flight attitude stability of LDEF enables specific analyses of various individual and combined effects of LEO environmental parameters on identical materials on the same space vehicle. This paper provides an overview of the interim LDEF materials findings of the Principal Investigators and the Materials Special Investigation Group. In general, the LDEF data is remarkably consistent; LDEF will provide a benchmark for materials design data bases for satellites in low-Earth orbit. Some materials were identified to be encouragingly resistant to LEO SEE for 5.8 years; other space qualified materials displayed significant environmental degradation. Molecular contamination was widespread; LDEF offers an unprecedented opportunity to provide a unified perspective of unmanned LEO spacecraft contamination mechanisms. New material development requirements for long-term LEO missions have been identified and current ground simulation testing methods/data for new, durable materials concepts can be validated with LDEF results. LDEF findings are already being integrated into the design of Space Station Freedom.

  20. An interim overview of LDEF materials findings

    NASA Technical Reports Server (NTRS)

    Stein, Brad A.

    1992-01-01

    The flight and retrieval of the National Aeronautics and Space Administration's Long Duration Exposure Facility (LDEF) provided an opportunity for the study of the low-Earth orbit (LEO) environment and long-duration space environmental effects (SEE) on materials that is unparalleled in the history of the U.S. Space Program. The remarkable flight attitude stability of LDEF enables specific analyses of various individual and combined effects of LEO environmental parameters on identical materials on the same space vehicle. This paper provides an overview of the interim LDEF materials findings of the Principal Investigators and the Materials Special Investigation Group. In general, the LDEF data is remarkably consistent; LDEF will provide a 'benchmark' for materials design data bases for satellites in low-Earth orbit. Some materials were identified to be encouragingly resistant to LEO SEE for 5.8 years; other 'space qualified' materials displayed significant environmental degradation. Molecular contamination was widespread; LDEF offers an unprecedented opportunity to provide a unified perspective of unmanned LEO spacecraft contamination mechanisms. New material development requirements for long-term LEO missions have been identified and current ground simulation testing methods/data for new, durable materials concepts can be validated with LDEF results. LDEF findings are already being integrated into the design of Space Station Freedom.

  1. Virtual Exhibition and Fruition of Archaeological Finds

    NASA Astrophysics Data System (ADS)

    Manferdini, A. M.; Garagnani, S.

    2011-09-01

    During the last two decades, since digital technologies have become more sophisticated in acquiring real data and building faithful copies of them, their improvements have suggested interesting applications in the field of valorisation of Historical, Cultural and Artistic Heritage, with significant consequences in the share and widespread of knowledge. But although several technologies and methodologies for 3d digitization have recently been developed and improved, the lack of a standard procedure and the costs connected to their use still doesn't encourage the systematic digital acquisition of wide collections and heritage. The aim of this paper is to show the state of the art of a project whose aim is to provide a methodology and a procedure to create digital reproductions of artefacts for Institutions called to preserve, manage and enhance the fruition of archaeological finds inside museums or through digital exhibitions. Our project's aim is to find the most suitable procedure to digitally acquire archaeo logical artefacts that usually have small dimensions and have very complex and detailed surfaces. Within our methodology, particular attention has been paid to the use of widely shared and open-source visualization systems that enhance the involvement of the user by emphasizing three-dimensional characteristics of artefacts through virtual reality.

  2. Microbiological findings in prepubertal girls with vulvovaginitis.

    PubMed

    Sikanić-Dugić, Nives; Pustisek, Nives; Hirsl-Hećej, Vlasta; Lukić-Grlić, Amarela

    2009-01-01

    The aim of the study was to define the most common causes, symptoms and clinical features of vulvovaginitis in prepubertal girls, and to evaluate treatment success depending on the causative agent involved. The study included 115 girls aged 2-8 (mean 4.8) years, presenting with vulvovaginitis to the Outpatient Clinic for Pediatric and Adolescent Gynecology, Zagreb Children's Hospital, between September 2006 and July 2007. Medical history data were obtained from parents. Vaginal samples were collected for microbiological culture by using cotton-tipped swabs moistened with saline. All samples were referred to microbiology laboratory, where standard microbiological diagnostic procedures were performed. Selective and non-selective media were used. Of 115 study patients, 43 (37.4%) had received antibiotic therapy more than one month prior to their visit to the Clinic, mainly for upper respiratory tract infection. The most common presenting symptom was increased vaginal discharge usually noticed on the pants or diaper, found in 26 of 115 (22.6%) patients, followed by vulvar redness in 16 (13.9%), burning in seven (6.1%), itching in the vulvovaginal area in seven (6.1%), soreness in six (5.2%), odor in three (2.6%) patients, and two or more of these symptoms in another 50 (43.5%) patients. Fifty-nine of 115 children had normal clinical finding on gynecologic examination. Among the remaining 56 children, the most common finding was erythema observed in 19, vaginal discharge in ten, and a combination of discharge and erythema in 13 patients. Of 115 study patients, causative agents were isolated from vaginal culture in 38 (33%) cases. Of these, 21 grew group A beta hemolytic streptococcus, five patients Haemophilus influenzae, three Escherichia coli, two Enterococcus spp., and one each Staphylococcus aureus, Proteus mirabilis, and Streptococcus pneumoniae. Antibiotic therapy was administered in 31 of these 38 patients, except for those cases where intestinal bacteria and

  3. Food entrainment: major and recent findings

    PubMed Central

    Carneiro, Breno T. S.; Araujo, John F.

    2012-01-01

    Mammals exhibit daily anticipatory activity to cycles of food availability. Studies on such food anticipatory activity (FAA) have been conducted mainly in nocturnal rodents. They have identified FAA as the behavioral output of a food entrained oscillator (FEO), separate of the known light entrained oscillator (LEO) located in the suprachiasmatic nucleus (SCN) of hypothalamus. Here we briefly review the main characteristics of FAA. Also, we present results on four topics of food anticipation: (1) possible input signals to FEO, (2) FEO substrate, (3) the importance of canonical clock genes for FAA, and (4) potential practical applications of scheduled feeding. This mini review is intended to introduce the subject of food entrainment to those unfamiliar with it but also present them with relevant new findings on the issue. PMID:23205007

  4. Bone finds: a challenge to forensic science.

    PubMed

    Ganswindt, Melanie; Ehrlich, Edwin; Klostermann, Peter; Troike, Wolf-Gunther; Schneider, Volkmar

    2003-03-01

    The study presented here is based on 176 forensic dental reports compiled between 1993 and 2001. The bulk of the research took place in 1997, when major construction at Potsdamer Platz and Lehrter Bahnhof in central Berlin required the excavation of considerable quantities of earth. As building proceeded here, at 'Europe's biggest construction site', it revealed not only a large number of long bones, but also a great many skulls and skull fragments. In five instances, complete skeletons were unearthed. Many of the bones ultimately proved to be of animal origin. The police were not instructed to open a single criminal investigation. Identifying and piecing together the material in this context makes tremendous demands of forensic osteology. Establishing the nature of these finds beyond reasonable doubt, and putting a name and date to them, calls for interdisciplinary co-operation between experts in odontology, anthropology, anatomy, radiology and veterinary medicine, not to mention historians. PMID:12935638

  5. A Parallel VLSI Direction Finding Algorithm

    NASA Astrophysics Data System (ADS)

    van der Veen, Alle-Jan; Deprettere, Ed F.

    1988-02-01

    In this paper, we present a parallel VLSI architecture that is matched to a class of direction (frequency, pole) finding algorithms of type ESPRIT. The problem is modeled in such a way that it allows an easy to partition full parallel VLSI implementation, using unitary transformations only. The hard problem, the generalized Schur decomposition of a matrix pencil, is tackled using a modified Stewart Jacobi approach that improves convergence and simplifies parameter computations. The proposed architecture is a fixed size, 2-layer Jacobi iteration array that is matched to all sub-problems of the main problem: 2 QR-factorizations, 2 SVD's and a single GSD-problem. The arithmetic used is (pipelined) Cordic.

  6. Knee bone tumors: findings on conventional radiology*

    PubMed Central

    Andrade Neto, Francisco; Teixeira, Manuel Joaquim Diógenes; Araújo, Leonardo Heráclio do Carmo; Ponte, Carlos Eduardo Barbosa

    2016-01-01

    The knee is a common site for bone tumors, whether clinically painful or not. Conventional radiology has been established as the first line of investigation in patients with knee pain and can reveal lesions that often generate questions not only for the generalist physician but also for the radiologist or general orthopedist. History, image examination, and histopathological analysis compose the essential tripod of the diagnosis of bone tumors, and conventional radiology is an essential diagnostic tool in patients with knee pain. This pictorial essay proposes to depict the main conventional radiography findings of the most common bone tumors around the knee, including benign and malignant tumors, as well as pseudo-tumors. PMID:27403019

  7. Finding Good Elements for Focused Retrieval

    NASA Astrophysics Data System (ADS)

    Crouch, Carolyn J.; Crouch, Donald B.; Bapat, Salil; Mehta, Sarika; Paranjape, Darshan

    This paper describes the integration of our methodology for the dynamic retrieval of XML elements [2] with traditional article retrieval to facilitate the Focused and the Relevant-in-Context Tasks of the INEX 2008 Ad Hoc Track. The particular problems that arise for dynamic element retrieval in working with text containing both tagged and untagged elements have been solved [3]. The current challenge involves utilizing its ability to produce a rank-ordered list of elements in the context of focused retrieval. Our system is based on the Vector Space Model [8]; basic functions are performed using the Smart experimental retrieval system [7]. Experimental results are reported for the Focused, Relevant-in-Context, and Best-in-Context Tasks of both the 2007 and 2008 INEX Ad Hoc Tracks. These results indicate that the goal of our 2008 investigations—namely, finding good focused elements in the context of the Wikipedia collection-has been achieved.

  8. Computed tomography findings in bilateral perinephric lymphangiomatosis.

    PubMed

    Hakeem, Aijaz; Gojwari, Tariq A; Reyaz, Sheikh; Rasool, Shubana; Shafi, Hakim; Mufti, Shahida

    2010-01-01

    Perinephric lymphangioma is rare disorder that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic tissue to establish normal communication with the rest of lymphatic system. Once there is restricted drainage of lymphatic fluid the lymphatic channels dilate to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally .This condition presents with various signs and symptoms or can be just an incidental finding which in presence of misleading clinical history may be confused with other diseases. CT scan with delayed cuts and USG guided aspiration with biochemical analysis of fluid will help us in arriving to final diagnosis. PMID:20842254

  9. Some stimulus properties of inhalants: preliminary findings.

    PubMed

    Vila, J; Colotla, V A

    1981-01-01

    Water-deprived rats allowed access to 0.1% saccharin during 10 min followed by a 15-min (Exp. 1A) or a 30-min (Exp. 1B) exposure to lacquer thinner (6,360 ppm) failed to show a conditioned aversion to the saccharin solution. However, when the solvent odor was paired with water drinking followed by a 0.6 M LiCl injection (Exp. 2) the rats developed an aversion to water associated to lacquer thinner, drinking less than when water was presented alone. The findings suggest that whereas lacquer thinner does not appear to function as an unconditioned stimulus, it may acquire properties of conditioned stimulus in this paradigm of conditioned aversion. PMID:7335142

  10. Subacute Tension Hemopneumothorax with Novel Electrocardiogram Findings

    PubMed Central

    Saks, Mark A.; Griswold-Theodorson, Sharon; Shinaishin, Furkan; Demangone, Dawn

    2010-01-01

    This case report describes a patient with a subacute right-sided tension hemopneumothorax following an occult stab. The patient’s electrocardiogram (ECG), performed as part of a standardized triage process, demonstrated significant abnormalities that misguided initial resuscitation, but resolved following evacuation of the tension hemopneumothorax. Tension pneumothorax is typically regarded as an immediately life-threatening condition that requires emergent management with needle or tube thoracostomy. However, we believe that subacute tension pneumothorax may be a rarely observed clinical phenomenon and may lead to unique ECG findings. We believe that the ECG changes we observed provided an early clue to the eventual diagnosis of a subacute tension pneumothorax and have not been previously described in this setting. . PMID:20411085

  11. Lupus Nephritis: An Overview of Recent Findings

    PubMed Central

    de Zubiria Salgado, Alberto; Herrera-Diaz, Catalina

    2012-01-01

    Lupus nephritis (LN) is one of the most serious complications of systemic lupus erythematosus (SLE) since it is the major predictor of poor prognosis. In susceptible individuals suffering of SLE, in situ formation and deposit of immune complexes (ICs) from apoptotic bodies occur in the kidneys as a result of an amplified epitope immunological response. IC glomerular deposits generate release of proinflammatory cytokines and cell adhesion molecules causing inflammation. This leads to monocytes and polymorphonuclear cells chemotaxis. Subsequent release of proteases generates endothelial injury and mesangial proliferation. Presence of ICs promotes adaptive immune response and causes dendritic cells to release type I interferon. This induces maturation and activation of infiltrating T cells, and amplification of Th2, Th1 and Th17 lymphocytes. Each of them, amplify B cells and activates macrophages to release more proinflammatory molecules, generating effector cells that cannot be modulated promoting kidney epithelial proliferation and fibrosis. Herein immunopathological findings of LN are reviewed. PMID:22536486

  12. Some Findings Concerning Requirements in Agile Methodologies

    NASA Astrophysics Data System (ADS)

    Rodríguez, Pilar; Yagüe, Agustín; Alarcón, Pedro P.; Garbajosa, Juan

    Agile methods have appeared as an attractive alternative to conventional methodologies. These methods try to reduce the time to market and, indirectly, the cost of the product through flexible development and deep customer involvement. The processes related to requirements have been extensively studied in literature, in most cases in the frame of conventional methods. However, conclusions of conventional methodologies could not be necessarily valid for Agile; in some issues, conventional and Agile processes are radically different. As recent surveys report, inadequate project requirements is one of the most conflictive issues in agile approaches and better understanding about this is needed. This paper describes some findings concerning requirements activities in a project developed under an agile methodology. The project intended to evolve an existing product and, therefore, some background information was available. The major difficulties encountered were related to non-functional needs and management of requirements dependencies.

  13. A compilation of jet finding algorithms

    SciTech Connect

    Flaugher, B.; Meier, K.

    1992-12-31

    Technical descriptions of jet finding algorithms currently in use in p{anti p} collider experiments (CDF, UA1, UA2), e{sup +}e{sup {minus}} experiments and Monte-Carlo event generators (LUND programs, ISAJET) have been collected. For the hadron collider experiments, the clustering methods fall into two categories: cone algorithms and nearest-neighbor algorithms. In addition, UA2 has employed a combination of both methods for some analysis. While there are clearly differences between the cone and nearest-neighbor algorithms, the authors have found that there are also differences among the cone algorithms in the details of how the centroid of a cone cluster is located and how the E{sub T} and P{sub T} of the jet are defined. The most commonly used jet algorithm in electron-positron experiments is the JADE-type cluster algorithm. Five various incarnations of this approach have been described.

  14. Finding a New Home for Quantum States

    NASA Astrophysics Data System (ADS)

    Fuchs, Christopher A.; Appleby, D. Marcus; Zhu, Huangjun

    2015-03-01

    In the Quantum Bayesian interpretation of quantum mechanics, or QBism as it has come to be called, a significant effort has been made to find a good representation of quantum states, quantum measurement operators, and quantum time-evolution maps, all directly in terms of probabilities and conditional probabilities. The proposed means for doing this has involved a particularly interesting kind of fiducial quantum measurement called a symmetric informationally complete (SIC) measurement. If such objects exist for all finite-dimensional Hilbert spaces, then QBism will have all that it wants. But this suggests a natural follow-on question: Whether one might turn the tables and take the new formalism so developed as a foundation for quantum theory to begin with? This talk with describe a few recently discovered features of quantum theory when seen from this point of view.

  15. Incidental Finding and Management of Mesenteric Fibromatosis.

    PubMed

    Nicolas, Gregory; Kfoury, Tony; Shimlati, Rasha; Tohme, Maroon; Wakim, Raja

    2016-01-01

    BACKGROUND Mesenteric fibromatosis, also known as mesenteric desmoids, is part of the clinical-pathologic spectrum of deep fibromatosis, which encompasses a group of benign fibro-proliferative processes that are locally aggressive and have the capacity to infiltrate or recur without metastasis. CASE REPORT Case of a 45-year-old man, with a history of hypertension and lung fibrosis, presenting for a left abdominal mass, which was found incidentally during his lung fibrosis imaging. He complained of constipation due to pressure upon his bowel leading to difficulty in defecation. CONCLUSIONS Although there are many overlapping criteria between gastrointestinal stromal tumors and mesenteric fibromatosis, making it difficult to discriminate between the two, there are differences that are unique to mesenteric fibromatosis that should be noticed during the diagnosis. In this case, mesenteric fibromatosis was unusual as it is not associated with Gardner's syndrome, desmoid tumors, nor familial adenomatous polyposis, but was an incidental finding. PMID:27279600

  16. Cretaceous-Tertiary findings, paradigms and problems

    NASA Technical Reports Server (NTRS)

    Officer, C. B.; Drake, C. L.

    1988-01-01

    The asteroid hypothesis has stimulated numerous studies of the paleontological record at Cretaceous/Tertiary time as well as of geological indicators of environmental crisis preserved in the rock record. Both extinctions and geological anomalies often occur at times that do not appear to be synchronous or instantaneous. The record includes paleontological indicators of dinosaurs, terrestrial flora, marine planktonic organisms, and shallow water marine macrofauna and geological phenomena include occurrences of iridium and other platinum metals, trace elements, clay mineralogy, shocked minerals, soot, microspherules, and isotopes of osmium, strontium and carbon. These findings are reviewed in the context of the alternate hypotheses of an exogenic cause, involving either a single asteroid impact or multiple commentary impacts, and an endogenic cause, involving intense global volcanism and major sea level regression.

  17. [Phalloplethysmographic findings in homosexual pedophile offenders].

    PubMed

    Tichý, P

    1991-03-29

    Using phalloplethysmographic tests comprising 20 coloured slides of four categories the authors examined 50 homosexual pedophil delinquents and a matched group of heterosexual men. The findings of the two compared groups differed significantly on exposure to three categories of erotic stimuli--adult heterosexual and homosexual objects and child homosexual objects. Only on projection of child heterosexual objects there were no statistically significant differences in the number and magnitude of positive vasomotor reactions recorded in the two groups. Men in the control group responded more frequently and more positively to adult heterosexual objects than homosexual pedophil delinquents. The latter responded more frequently positively to adult and child homosexual objects. In more than one quarter of the delinquents (13 men) a preference of child objects was found, i.e. a deviant pedophil orientation. In seven men the preference of child objects was without sexual differentiation, six men preferred homosexual child objects. PMID:1868511

  18. [2012 literature findings in ambulatory internal medicine].

    PubMed

    Vu, F; Ceppi, M; Fasel, E; Dory, E; Amstutz, V; Monney, C; Nanchen, D; Willi, C Clair; Pasche, O; Vauthey, L; Bodenmann, P

    2013-01-23

    In 2012 several articles reported interesting findings for the ambulatory practice in internal general medicine. A negative rapid test for influenza does not rule out that diagnosis. A test assessing the walking speed in the elderly can help determining who would benefit from antihypertensive therapy. Antibiotic treatment has no benefit for acute uncomplicated rhinosinusitis and diverticulitis. Probiotics can reduce the risk of post-antibiotic diarrhea. Daily coffee intake could reduce mortality. Oral supplementation of calcium can be harmful to the cardiovascular system. Subclinical hyperthyroidism should be treated to prevent cardiovascular complications. Aspirin can prevent recurrences in case of a primary thromboembolic event. Local injection of corticosteroids under ultrasonographic guidance for plantar fasciitis can be a safe treatment. Ibuprofen can prevent acute mountain sickness. PMID:23413648

  19. The MOSO field experiment - Overview of findings

    NASA Astrophysics Data System (ADS)

    Ólafsson, Haraldur; Jonassen, Marius O.; Ágústsson, Hálfdán; Rögnvaldsson, Ólafur; Hjarðar, Bjarni G. Þ.; Rasol, Dubravka; Reuder, Joachim; Jónsson, Sigurður; Líf Kristinsdóttir, Birta

    2013-04-01

    In 2009 and 2011, the MOSO I and MOSO II meteorological field experiments took place in SW-Iceland. The main objectives were to describe the low level atmospheric coastal flows in the vicinity of mountains. The observations for the MOSO dataset were made using a large number of automatic weather stations, microbarographs, radiosoundings and a remotely piloted aircraft. The highlights of the findings include a four-dimensional description of the sea-breeze in Iceland, weak downslope acceleration, summer- and winter-time mountain wake flow, transition between wake flow and sea-breeze. The orographic drag force is explored and shown to be not so high most of the time in the predicted high-drag state. The observations from the remotely piloted aircraft have been used successfully to nudge simulations of the flow and are shown to be promising for operational use in numerical prediction of mesoscale coastal and orographic flows.

  20. Knuckle pads – a rare finding

    PubMed Central

    Gengenbacher, Michael; Bianchi, Stefano

    2012-01-01

    Knuckle pads are rare harmless subcutaneous nodules that must be differentiated from joint disease of the proximal interphalangeal or rarely of the metacarpophalangeal joints as well as from other masses of the paraarticular tissues. We present a case of an otherwise healthy 36-year-old woman presenting with bilateral knuckle pads located at the dorsal aspect of the proximal interphalangeal joints. No predisposition to a specific musculoskeletal disorder was noted. Ultrasound revealed well-delimited subcutaneous hypoechoic masses without internal flow signals at color Doppler. Histology showed proliferation of myofibroblasts with a decrease of elastic filaments in the deep dermis. The clinical picture, the family history in addition to the histology allowed us to make the diagnosis of knuckle pads. We present the ultrasound findings of knuckle pads and discuss the differential diagnosis of a “swelling” in the dorsal region of proximal interphalangeal joints and metacarpophalangeal joints. PMID:26672439

  1. Knee bone tumors: findings on conventional radiology.

    PubMed

    Andrade Neto, Francisco; Teixeira, Manuel Joaquim Diógenes; Araújo, Leonardo Heráclio do Carmo; Ponte, Carlos Eduardo Barbosa

    2016-01-01

    The knee is a common site for bone tumors, whether clinically painful or not. Conventional radiology has been established as the first line of investigation in patients with knee pain and can reveal lesions that often generate questions not only for the generalist physician but also for the radiologist or general orthopedist. History, image examination, and histopathological analysis compose the essential tripod of the diagnosis of bone tumors, and conventional radiology is an essential diagnostic tool in patients with knee pain. This pictorial essay proposes to depict the main conventional radiography findings of the most common bone tumors around the knee, including benign and malignant tumors, as well as pseudo-tumors. PMID:27403019

  2. Postmortem findings in the Nijmegen breakage syndrome.

    PubMed

    Van de Kaa, C A; Weemaes, C M; Wesseling, P; Schaafsma, H E; Haraldsson, A; De Weger, R A

    1994-01-01

    Autopsy findings for two patients with the Nijmegen breakage syndrome (NBS) are presented. This syndrome has the same type of immunologic and cytogenetic abnormalities as ataxia telangiectasia (AT). In NBS, however, microcephaly is found and progressive cerebellar ataxia and oculocutaneous telangiectasia are lacking. We demonstrate a clear neuropathologic difference between these two syndromes, as the diffuse cortical cerebellar degeneration characteristic of AT was absent in NBS. In the thymus the histologic picture was suggestive of simple dysplasia. Lymphoid tissues were slightly atrophic but otherwise structurally normal. In one of the two presented cases an extranodal diffuse large cell malignant non-Hodgkin lymphoma of B cell immunoblastic type was found in Waldeyer's ring, in the small and large intestines, and in the brain, whose sequelae had caused death. Six of the 19 patients known with certainty to have this syndrome have developed lymphoid malignancy, which indicates that these patients are prone to develop malignancies. PMID:7808977

  3. Finding missing proofs with automated reasoning.

    SciTech Connect

    Fitelson, B.; Wos, L.; Mathematics and Computer Science; Univ. of Wisconsin at Madison

    2001-08-01

    This article features long-sought proofs with intriguing properties (such as the absence of double negation and the avoidance of lemmas that appeared to be indispensable), and it features the automated methods for finding them. The theorems of concern are taken from various areas of logic that include two-valued sentential (or propositional) calculus and infinite-valued sentential calculus. Many of the proofs (in effect) answer questions that had remained open for decades, questions focusing on axiomatic proofs. The approaches we take are of added interest in that all rely heavily on the use of a single program that offers logical reasoning, William McCune's automated reasoning program OTTER. The nature of the successes and approaches suggests that this program offers researchers a valuable automated assistant. This article has three main components. First, in view of the interdisciplinary nature of the audience, we discuss the means for using the program in question (OTTER), which flags, parameters, and lists have which effects, and how the proofs it finds are easily read. Second, because of the variety of proofs that we have found and their significance, we discuss them in a manner that permits comparison with the literature. Among those proofs, we offer a proof shorter than that given by Meredith and Prior in their treatment of Lukasiewicz's shortest single axiom for the implicational fragment of two-valued sentential calculus, and we offer a proof for the Lukasiewicz 23-letter single axiom for the full calculus. Third, with the intent of producing a fruitful dialogue, we pose questions concerning the properties of proofs and, even more pressing, invite questions similar to those this article answers.

  4. Pedaudiologic findings after severe neonatal hyperbilirubinemia.

    PubMed

    Nickisch, Andreas; Massinger, Claudia; Ertl-Wagner, Birgit; von Voss, Hubertus

    2009-02-01

    Neonatal hyperbilirubinemia (NHB) above 20 mg/dl (NHB20) has been shown to increase the risk of hearing impairments. Up to now, audiological findings based on behavioural audiometry (BA), otoacoustic emissions (TEOAE) and auditory brainstem responses (ABR) from children after being diagnosed with NHB20 have not been thoroughly compared to those with lower NHB-levels. We, therefore, aimed to assess the presence and characteristics of auditory dysfunction in children with NHB20. The audiological data of 15 children aged 11 months to 9 years with a NHB level between 22.6 and 45.6 mg/dl and/or MRI-confirmed bilirubin encephalopathy (NHBG) were compared retrospectively to 15 children with NHB levels between 12.5 and 19.4 mg/dl (CG). After matching by weeks of gestation at birth, BA, TEOAE and ABR were performed in all the children. Subsequently the groups were compared. Only two children of the NHBG had consistently normal audiologic findings. Hearing function disorders were detected in 87% (13/15) of the NHBG-children, ranging from total deafness to normal BA, including unilateral and bilateral deafness as well as cochlear hearing loss. Auditory neuropathy/dys-synchrony (AN) was found in a total of eight children (53%) of the NHBG. In addition, it was found that after the occurrence of NHB20, initially detected TEOAE can disappear in some cases. In the comparison group (CG) only two children demonstrated a hearing dysfunction, both of which were cochlear hearing impairments, whereas no child had AN. A bias towards hearing impairments has to be taken into account for both groups. Detailed pedaudiologic testing should be mandatory for all children after the occurrence of NHB20 including follow-up during the first 12 months. Audiological diagnostic work-up in the affected children requires objective investigations of hearing functions, while BA is recommended to evaluate the adequate therapeutic procedure. PMID:18560867

  5. Intelligence: new findings and theoretical developments.

    PubMed

    Nisbett, Richard E; Aronson, Joshua; Blair, Clancy; Dickens, William; Flynn, James; Halpern, Diane F; Turkheimer, Eric

    2012-01-01

    We review new findings and new theoretical developments in the field of intelligence. New findings include the following: (a) Heritability of IQ varies significantly by social class. (b) Almost no genetic polymorphisms have been discovered that are consistently associated with variation in IQ in the normal range. (c) Much has been learned about the biological underpinnings of intelligence. (d) "Crystallized" and "fluid" IQ are quite different aspects of intelligence at both the behavioral and biological levels. (e) The importance of the environment for IQ is established by the 12-point to 18-point increase in IQ when children are adopted from working-class to middle-class homes. (f) Even when improvements in IQ produced by the most effective early childhood interventions fail to persist, there can be very marked effects on academic achievement and life outcomes. (g) In most developed countries studied, gains on IQ tests have continued, and they are beginning in the developing world. (h) Sex differences in aspects of intelligence are due partly to identifiable biological factors and partly to socialization factors. (i) The IQ gap between Blacks and Whites has been reduced by 0.33 SD in recent years. We report theorizing concerning (a) the relationship between working memory and intelligence, (b) the apparent contradiction between strong heritability effects on IQ and strong secular effects on IQ, (c) whether a general intelligence factor could arise from initially largely independent cognitive skills, (d) the relation between self-regulation and cognitive skills, and (e) the effects of stress on intelligence. PMID:22233090

  6. Histiocytic disorders of the chest: imaging findings.

    PubMed

    Ahuja, Jitesh; Kanne, Jeffrey P; Meyer, Cristopher A; Pipavath, Sudhakar N J; Schmidt, Rodney A; Swanson, Jonathan O; Godwin, J David

    2015-01-01

    Histiocytic disorders of the chest comprise a broad spectrum of diseases. The lungs may be involved in isolation or as part of systemic disease. Some of these disorders are primary and have unknown etiology, and others result from a histiocytic response to a known cause. Among primary histiocytic disorders, pulmonary Langerhans cell histiocytosis (PLCH) is the most common; others include Erdheim-Chester disease and Rosai-Dorfman disease. Adult PLCH occurs almost exclusively in adults aged 20-40 years who smoke. Pediatric PLCH is extremely rare and typically occurs as part of multisystemic disease. Erdheim-Chester disease affects middle-aged and older adults; thoracic involvement usually occurs as part of systemic disease. Rosai-Dorfman disease affects children and young adults and manifests as painless cervical lymphadenopathy. Examples of secondary histiocytic disorders are storage diseases such as Gaucher disease, Niemann-Pick disease, and Fabry disease; pneumoconiosis such as silicosis and coal workers' pneumoconiosis; and infections such as Whipple disease and malakoplakia. These disorders are characterized at histopathologic examination on the basis of infiltration of alveoli or the pulmonary interstitium by histiocytes, which are a group of cells that includes macrophages and dendritic cells. Dendritic cells are a heterogeneous group of nonphagocytic antigen-presenting immune cells. Immunohistochemical markers help to distinguish among various primary histiocytic disorders. Characteristic radiologic findings in the appropriate clinical context may obviate biopsy to establish a correct diagnosis. However, in the absence of these findings, integration of clinical, pathologic, and radiologic features is required to establish a diagnosis. PMID:25763722

  7. Key findings of the national weatherization evaluation

    SciTech Connect

    Brown, M.A.; Berry, L.G.

    1994-10-01

    In 1990, the U.S. Department of Energy sponsored a comprehensive evaluation of its Weatherization Assistance Program, the nation`s largest residential energy conservation program. The primary goal of the evaluation was to establish whether the Program meets the objectives of its enabling legislation and fulfills its mission statement, to reduce the heating and cooling costs for low-income families-particularly the elderly, persons with disabilities, and children by improving the energy-efficiency of their homes and ensuring their health and safety. Oak Ridge National Laboratory managed a five-part study which produced a series of documents evaluating the Program. The objective of this document is to summarize the findings of the five-part National Weatherization Evaluation. The five studies were as follows: (1) Network Study-this study characterized the weatherization network`s leveraging, capabilities, procedures, staff, technologies, and innovations; (2) Resources and Population Study-this study profiled low-income weatherization resources, the weatherized population, and the population remaining to be served; (3) Multifamily Study-this study described the nature and extent of weatherization activities in larger multifamily buildings; (4) Single-family Study-this study estimated the national savings and cost- effectiveness of weatherizing single-family and small multifamily dwellings that use natural gas or electricity for space heating; (5) Fuel-Oil Study-this study estimated the savings and cost-effectiveness of weatherizing single-family homes, located in nine northeastern states, that use fuel oil for space heating. This paper provides a brief overview of each study`s purposes, research methods and most important findings.

  8. Landfill aeration worldwide: Concepts, indications and findings

    SciTech Connect

    Ritzkowski, M.; Stegmann, R.

    2012-07-15

    Highlights: Black-Right-Pointing-Pointer Different landfill aeration concepts and accordant application areas are described. Black-Right-Pointing-Pointer Examples of full scale projects are provided for Europe, North-America and Asia. Black-Right-Pointing-Pointer Major project findings are summarised, including prospects and limitations. Black-Right-Pointing-Pointer Inconsistencies between laboratory and full scale results have been elaborated. Black-Right-Pointing-Pointer An explanatory approach in connection with the inconsistencies is provided. - Abstract: The creation of sustainable landfills is a fundamental goal in waste management worldwide. In this connection landfill aeration contributes towards an accelerated, controlled and sustainable conversion of conventional anaerobic landfills into a biological stabilized state associated with a minimised emission potential. The technology has been successfully applied to landfills in Europe, North America and Asia, following different strategies depending on the geographical region, the specific legislation and the available financial resources. Furthermore, methodologies for the incorporation of landfill aeration into the carbon trade mechanisms have been developed in recent years. This manuscript gives an overview on existing concepts for landfill aeration; their application ranges and specifications. For all of the described concepts examples from different countries worldwide are provided, including details regarding their potentials and limitations. Some of the most important findings from these aeration projects are summarised and future research needs have been identified. It becomes apparent that there is a great demand for a systematisation of the available results and implications in order to further develop and optimise this very promising technology. The IWWG (International Waste Working Group) Task Group 'Landfill Aeration' contributes towards the achievement of this goal.

  9. Astronomers Find Rare Beast by New Means

    NASA Astrophysics Data System (ADS)

    2010-01-01

    For the first time, astronomers have found a supernova explosion with properties similar to a gamma-ray burst, but without seeing any gamma rays from it. The discovery, using the National Science Foundation's Very Large Array (VLA) radio telescope, promises, the scientists say, to point the way toward locating many more examples of these mysterious explosions. "We think that radio observations will soon be a more powerful tool for finding this kind of supernova in the nearby Universe than gamma-ray satellites," said Alicia Soderberg, of the Harvard-Smithsonian Center for Astrophysics. The telltale clue came when the radio observations showed material expelled from the supernova explosion, dubbed SN2009bb, at speeds approaching that of light. This characterized the supernova, first seen last March, as the type thought to produce one kind of gamma-ray burst. "It is remarkable that very low-energy radiation, radio waves, can signal a very high-energy event," said Roger Chevalier of the University of Virginia. When the nuclear fusion reactions at the cores of very massive stars no longer can provide the energy needed to hold the core up against the weight of the rest of the star, the core collapses catastrophically into a superdense neutron star or black hole. The rest of the star's material is blasted into space in a supernova explosion. For the past decade or so, astronomers have identified one particular type of such a "core-collapse supernova" as the cause of one kind of gamma-ray burst. Not all supernovae of this type, however, produce gamma-ray bursts. "Only about one out of a hundred do this," according to Soderberg. In the more-common type of such a supernova, the explosion blasts the star's material outward in a roughly-spherical pattern at speeds that, while fast, are only about 3 percent of the speed of light. In the supernovae that produce gamma-ray bursts, some, but not all, of the ejected material is accelerated to nearly the speed of light. The superfast

  10. A review of MRI findings in schizophrenia

    PubMed Central

    Shenton, Martha E.; Dickey, Chandlee C.; Frumin, Melissa; McCarley, Robert W.

    2009-01-01

    After more than 100 years of research, the neuropathology of schizophrenia remains unknown and this is despite the fact that both Kraepelin (1919/1971: Kraepelin,E., 1919/1971. Dementia praecox. Churchill Livingston Inc., New York) and Bleuler (1911/1950: Bleuler, E., 1911/1950. Dementia praecox or the group of schizophrenias. International Universities Press, New York), who first described ‘dementia praecox’ and the ‘ schizophrenias’, were convinced that schizophrenia would ultimately be linked to an organic brain disorder. Alzheimer (1897: Alzheimer, A., 1897. Beitrage zur pathologischen anatomie der hirnrinde und zur anatomischen grundlage einiger psychosen. Monatsschrift fur Psychiarie und Neurologie. 2, 82–120) was the first to investigate the neuropathology of schizophrenia, though he went on to study more tractable brain diseases. The results of subsequent neuropathological studies were disappointing because of conflicting findings. Research interest thus waned and did not flourish again until 1976, following the pivotal computer assisted tomography (CT) finding of lateral ventricular enlargement in schizophrenia by Johnstone and colleagues. Since that time significant progress has been made in brain imaging, particularly with the advent of magnetic resonance imaging (MRI), beginning with the first MRI study of schizophrenia by Smith and coworkers in 1984 (Smith, R.C., Calderon, M., Ravichandran, G.K., et al. (1984). Nuclear magnetic resonance in schizophrenia: A preliminary study. Psychiatry Res. 12, 137–147). MR in vivo imaging of the brain now confirms brain abnormalities in schizophrenia. The 193 peer reviewed MRI studies reported in the current review span the period from 1988 to August, 2000. This 12 year period has witnessed a burgeoning of MRI studies and has led to more definitive findings of brain abnormalities in schizophrenia than any other time period in the history of schizophrenia research. Such progress in defining the

  11. Find Quality Resources: How Do I Know if I Can Trust the Informaton I Find Online?

    MedlinePlus

    ... Your Medical Record Support family caregivers Find Quality Resources How do I know if I can trust ... Food and Drug Administration . Are the tools or resources easily usable? On a web site, is it ...

  12. Finding organic vapors - a Monte Carlo approach

    NASA Astrophysics Data System (ADS)

    Vuollekoski, Henri; Boy, Michael; Kerminen, Veli-Matti; Kulmala, Markku

    2010-05-01

    Aerosols have an important role in regulating the climate both directly by absorbing and scattering solar radiation, as well as indirectly by acting as cloud condensation nuclei. While it is known that their net effect on radiative forcing is negative, several key aspects remain mysterious. There exist plenty of known primary sources of particles due to both natural and man-made origin - for example desert dust, volcanic activity and tire debris. On the other hand, it has been shown that the formation of secondary particles, by nucleation from precursor vapors, is a frequent, global phenomenon. However, the very earliest steps in new particle formation - nucleation and early growth by condensation - have many big question marks on them. While several studies have indicated the importance of a sufficient concentration of sulphuric acid vapor for the process, it has also been noted that this is usually not enough. Heads have therefore turned to organic vapors, which in their multitude could explain various observed characteristics of new particle formation. But alas, the vast number of organic compounds, their complex chemistry and properties that make them difficult to measure, have complicated the quantifying task. Nevertheless, evidence of organic contribution in particles of all size classes has been found. In particular, a significant organic constituent in the very finest particles suggests the presence of a high concentration of very low-volatile organic vapors. In this study, new particle formation in the boreal forest environment of Hyytiälä, Finland, is investigated in a process model. Our goal is to quantify the concentration, to find the diurnal profile and to get hints of the identity of some organic vapors taking part in new particle formation. Previous studies on the subject have relied on data analysis of the growth rate of the observed particles. However, due to the coarse nature of the methods used to calculate growth rates, this approach has its

  13. Findings from Project HeartBeat!

    PubMed Central

    Labarthe, Darwin R.; Dai, Shifan; Day, R. Sue; Fulton, Janet E.; Grunbaum, Jo Anne

    2015-01-01

    Project HeartBeat! was a longitudinal “growth” study of cardiovascular disease (CVD) risk factors and body composition in childhood and adolescence. Its findings demonstrate patterns of change from ages 8 to 18 years in anthropometric indicators of adiposity, blood lipid components, and blood pressure measurements, as well as the varying inter-relations among these patterns. Especially noteworthy are differences among associations between the two components of BMI (kg/m2)—the lean or fat-free mass index, and the fat mass index—and each of several CVD risk factors. Policy development and public health recommendations for CVD prevention beginning in childhood have evolved over 30 years or more. A new impetus to action is the recognized increase in the prevalence of childhood overweight and obesity. Intervention to prevent obesity can have a major impact in preventing CVD risk factors more broadly. Opportunities to strengthen interventions for CVD prevention in childhood and adolescence include updated algorithms for monitoring body composition, blood lipids, and blood pressure throughout childhood and adolescence through use of the Project HeartBeat! study results. PMID:19524150

  14. NASA Advisory Council: Fact-Finding Session

    NASA Technical Reports Server (NTRS)

    Cohen, Aaron; Martin, Franklin D.; Craig, Mark K.; Duke, Michael B.

    1992-01-01

    The principal agenda item for this fact-finding meeting of the NASA Advisory Council was NASA's preliminary planning of options to implement the President's initiative for establishing a base on the Moon and launching a human expedition to Mars. NASA's presentation (1) reviewed the key elements in the President's speech of July 20, 1989, summoning the Nation to launch a new exploration initiative to the Moon and Mars; (2) outlined five candidate options analyzed in terms of schedule and scale of effort (for a return to the Moon and for a voyage to Mars); (3) outlined tentative robotic mission milestones for both a 'vigorous deployment' option and a 'paced deployment' option; (4) reviewed Earth-to-orbit delivery requirements for a lunar heavy-lift launch vehicle, the National Space Transportation System, and a Mars heavy-lift launch vehicle; (5) summarized the associated Space Station Freedom requirements; (6) outlined the technology as well as human factors requirements for the candidate options; and (7) summarized the themes and approaches that could be employed for the science aspects of a national Moon/Mars exploration program.

  15. Space Situational Awareness (SSA) research findings

    NASA Astrophysics Data System (ADS)

    Richmond, D.

    Space Situational Awareness (SSA) is the foundation for space superiority and has become a national priority. Providing full SSA requires knowledge of space and ground assets along with communication links between these assets. It also requires an understanding of potential events and threats that may affect these assets. This paper summarizes the findings resulting from a research environment established to explore SSA issues. Non-traditional data sources available on the internet are identified along with methods to mine relevant data. Algorithms to augment this data with value added processing were evaluated and key features are presented. These include all-on-all conjunction analysis utilizing analytical distributed processing approaches and maneuver detection utilizing an approach described in the AMOS 2007 paper "Satellite Maneuver Detection Using Two-line Elements". Data fusion techniques are presented which were utilized to evaluate space launches, enhance maneuver detection capabilities, characterize events and determine possible intent. Several visualization approaches were explored and the key features/limitations are discussed to include performance consideration, event models between visualization components, and data needs at the tactical, operational, and strategic levels. Data dissemination approaches utilizing a Service Oriented Architecture (SOA) are highlighted along with challenges such as Multiple Levels of Security associated with the data. Dependencies between visualization and dissemination that impact the system's performance are discussed. Alternatives to balance system performance and application of a User Defined Operational Picture (UDOP) are explored.

  16. Mesozoic folds, fossil fields, and future finds ( )

    SciTech Connect

    Newman, G.W.; Witter, G.G.

    1988-02-01

    Drilling and surface geologic mapping have shown that pre-Tertiary, post-Triassic folds and upthrusted anticlines in an eastern Nevada fold-belt have accumulated major oil columns. This Mesozoic foldbelt involves a Cambrian through Triassic section, which has hundreds of feet of porosity in Ordovician sandstones, Silurian and Devonian carbonates, and Mississippian sandstones. In addition to the Devonian Pilot and Mississippian Chainman shales, source rocks are found in Cambrian and Ordovician shales and in some Paleozoic carbonates. The occurrence of live and dead oil shows in hundreds of vertical feet of porosity in wells drilled on several of these Mesozoic structures is interpreted as evidence that these structures were giant oil fields prior to being breached by Tertiary Basin and Range extensional faulting, which allowed vertical hydrocarbon leakage. Noting that undrilled Mesozoic structures still exist in the foldbelt and noting that natural processes are seldom 100% efficient - including, probably, the disruptive effects of Basin and range extensional faulting - the authors suggest that there is a very good chance of finding one or more giant fields in the remaining structures of this foldbelt.

  17. Finding Nonoverlapping Substructures of a Sparse Matrix

    SciTech Connect

    Pinar, Ali; Vassilevska, Virginia

    2005-08-11

    Many applications of scientific computing rely on computations on sparse matrices. The design of efficient implementations of sparse matrix kernels is crucial for the overall efficiency of these applications. Due to the high compute-to-memory ratio and irregular memory access patterns, the performance of sparse matrix kernels is often far away from the peak performance on a modern processor. Alternative data structures have been proposed, which split the original matrix A into A{sub d} and A{sub s}, so that A{sub d} contains all dense blocks of a specified size in the matrix, and A{sub s} contains the remaining entries. This enables the use of dense matrix kernels on the entries of A{sub d} producing better memory performance. In this work, we study the problem of finding a maximum number of nonoverlapping dense blocks in a sparse matrix, which is previously not studied in the sparse matrix community. We show that the maximum nonoverlapping dense blocks problem is NP-complete by using a reduction from the maximum independent set problem on cubic planar graphs. We also propose a 2/3-approximation algorithm that runs in linear time in the number of nonzeros in the matrix. This extended abstract focuses on our results for 2x2 dense blocks. However we show that our results can be generalized to arbitrary sized dense blocks, and many other oriented substructures, which can be exploited to improve the memory performance of sparse matrix operations.

  18. Cobalamin Deficiency: Clinical Picture and Radiological Findings

    PubMed Central

    Briani, Chiara; Dalla Torre, Chiara; Citton, Valentina; Manara, Renzo; Pompanin, Sara; Binotto, Gianni; Adami, Fausto

    2013-01-01

    Vitamin B12 deficiency causes a wide range of hematological, gastrointestinal, psychiatric and neurological disorders. Hematological presentation of cobalamin deficiency ranges from the incidental increase of mean corpuscular volume and neutrophil hypersegmentation to symptoms due to severe anemia, such as angor, dyspnea on exertion, fatigue or symptoms related to congestive heart failure, such as ankle edema, orthopnea and nocturia. Neuropsychiatric symptoms may precede hematologic signs and are represented by myelopathy, neuropathy, dementia and, less often, optic nerve atrophy. The spinal cord manifestation, subacute combined degeneration (SCD), is characterized by symmetric dysesthesia, disturbance of position sense and spastic paraparesis or tetraparesis. The most consistent MRI finding is a symmetrical abnormally increased T2 signal intensity confined to posterior or posterior and lateral columns in the cervical and thoracic spinal cord. Isolated peripheral neuropathy is less frequent, but likely overlooked. Vitamin B12 deficiency has been correlated negatively with cognitive functioning in healthy elderly subjects. Symptoms include slow mentation, memory impairment, attention deficits and dementia. Optic neuropathy occurs occasionally in adult patient. It is characterized by symmetric, painless and progressive visual loss. Parenteral replacement therapy should be started soon after the vitamin deficiency has been established. PMID:24248213

  19. Finding KBO flyby targets for New Horizons

    NASA Astrophysics Data System (ADS)

    Spencer, John; Trilling, David; Buie, Marc; Parker, Alex; Tholen, David; Stern, S. Alan

    2014-02-01

    We propose to continue the search for Kuiper Belt Objects (KBOs) that can be reached by the New Horizons spacecraft after its 2015 Pluto flyby. This first flyby of a small (~50 km) KBO would revolutionize our understanding of KBOs, providing information that can be extrapolated to hundreds of thousands of similar KBOs. Our 2011 search discovered three objects that could be targeted with only about twice the fuel that New Horizons has available during excellent seeing, but seeing was insufficient to achieve this depth over the entire search area in 2012 or 2013. Deepening the search in 2014, taking advantage of lower star density and the shrinking search area, has a good chance of finding a targetable object given sufficiently good seeing, especially with Hyper Suprime Cam. We expect about 2.5 targetable objects with R less 26.0 in the HSC field of view. We will also refine the orbits of previously discovered objects, including ones that can be observed from a distance by New Horizons on its passage through the Kuiper Belt.

  20. Finding KBO flyby targets for New Horizons

    NASA Astrophysics Data System (ADS)

    Spencer, John; Trilling, David; Buie, Marc; Parker, Alex; Tholen, David; Stern, S. Alan

    2014-08-01

    We propose to continue the search for Kuiper Belt Objects (KBOs) that can be reached by the New Horizons spacecraft after its 2015 Pluto flyby, by following up on KBOs discovered in 2014A. The first flyby of a small (~50 km) KBO would revolutionize our understanding of KBOs, providing information that can be extrapolated to hundreds of thousands of similar KBOs. Our 2011 search discovered two objects that could be targeted with less than twice the fuel that New Horizons has available, during excellent seeing, but seeing was insufficient to achieve this depth over the entire search area in 2012 or 2013. Deepening the search with time allocated in 2014A, taking advantage of lower star density and the shrinking search area, has a chance of finding a targetable object given sufficiently good seeing, especially with Hyper Suprime Cam. 2014B follow-up is essential to produce orbits good enough to determine targetability, and allow recovery in 2015. We will also continue to refine the orbits of other previously discovered objects, including ones that can be observed from a distance by New Horizons on its passage through the Kuiper Belt.