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Sample records for hypertrophic contaminated shallow

  1. Contamination of shallow wells in Nigeria from surface contaminant migration

    SciTech Connect

    Ademoroti, C.M.A. )

    1987-01-01

    Contaminated wells, located in six south/western and western states of Nigeria, were sampled and analyzed for pollution characteristics. Results of analysis indicated migration of contaminants into the wells from places where there was a potential source. There was a significant microbiological population in the wells placed near domestic waste sites. Also, there were excessive levels of trace heavy metals in those placed near metal dumping sites. On the other hand, the contaminants were minimal in wells that were not close to polluting sources. The studies revealed that groundwater contamination occurred primarily by dumping of wastes, wrong placement of waste disposal facilities, and improper construction of wells. The groundwater sources (wells, etc.) are used when pipe-borne water facilities are inadequate.

  2. Circumventing shallow air contamination in Mid Ocean Ridge Basalts

    NASA Astrophysics Data System (ADS)

    Mukhopadhyay, Sujoy; Parai, Rita; Tucker, Jonathan; Middleton, Jennifer; Langmuir, Charles

    2016-04-01

    Noble gases in mantle-derived basalts provide a rich portrait of mantle degassing and surface-interior volatile exchange. However, the ubiquity of shallow-level air contamination frequently obscures the mantle noble gas signal. In a majority of samples, shallow air contamination dominates the noble gas budget. As a result, reconstructing the variability in heavy noble gas mantle source compositions and inferring the history of deep recycling of atmospheric noble gases is difficult. For example, in the gas-rich popping rock 2ΠD43, 129Xe/130Xe ratios reach 7.7±0.23 in individual step-crushes, but the bulk composition of the sample is close to air (129Xe/130Xe of 6.7). Here, we present results from experiments designed to elucidate the source of shallow air contamination in MORBs. Step-crushes were carried out to measure He, Ne, Ar and Xe isotopic compositions on two aliquots of a depleted popping glass that was dredged from between the Kane and Atlantis Fracture Zones of the Mid-Atlantic Ridge in May 2012. One aliquot was sealed in ultrapure N2 after dredge retrieval, while the other aliquot was left exposed to air for 3.5 years. The bulk 20Ne/22Ne and 129Xe/130Xe ratios measured in the aliquot bottled in ultrapure N2 are 12.3 and 7.6, respectively, and are nearly identical to the estimated mantle source values. On the other hand, step crushes in the aliquot left exposed to air for several years show Ne isotopic compositions that are shifted towards air, with a bulk 20Ne/22Ne of 11.5; the bulk 129Xe/130Xe, however, was close to 7.6. These results indicate that lighter noble gases exchange more efficiently between the bubbles trapped in basalt glass and air, suggesting a diffusive or kinetic mechanism for the incorporation of the shallow air contamination. Importantly, in Ne-Ar or Ar-Xe space, step-crushes from the bottled aliquot display a trend that can be easily fit with a simple two-component hyperbolic mixing between mantle and atmosphere noble gases. Step

  3. Monitoring Potential Transport of Radioactive Contaminants in Shallow Ephemeral Channels

    SciTech Connect

    Miller, Julianne J.; Mizell, Steve A.; Nikolich, George; Campbell, Scott A.

    2012-02-01

    The U.S. Department of Energy (DOE) National Nuclear Security Administration (NNSA), Nevada Site Office (NSO), Environmental Restoration Soils Activity has authorized the Desert Research Institute (DRI) to conduct field assessments of potential sediment transport of contaminated soil from Corrective Action Unit (CAU) 550, Area 8 Smoky Contamination Area (CA), during precipitation runoff events. CAU 550 includes Corrective Action Sites (CASs) 08-23-03, 08-23-04, 08-23-06, and 08-23-07; these CASs are associated with tests designated Ceres, Smoky, Oberon, and Titania, respectively.

  4. Fecal Contamination of Shallow Tubewells in Bangladesh Inversely Related to Arsenic

    PubMed Central

    2011-01-01

    The health risks of As exposure due to the installation of millions of shallow tubewells in the Bengal Basin are known, but fecal contamination of shallow aquifers has not systematically been examined. This could be a source of concern in densely populated areas with poor sanitation because the hydraulic travel time from surface water bodies to shallow wells that are low in As was previously shown to be considerably shorter than for shallow wells that are high in As. In this study, 125 tubewells 6−36 m deep were sampled in duplicate for 18 months to quantify the presence of the fecal indicator Escherichia coli. On any given month, E. coli was detected at levels exceeding 1 most probable number per 100 mL in 19−64% of all shallow tubewells, with a higher proportion typically following periods of heavy rainfall. The frequency of E. coli detection averaged over a year was found to increase with population surrounding a well and decrease with the As content of a well, most likely because of downward transport of E. coli associated with local recharge. The health implications of higher fecal contamination of shallow tubewells, to which millions of households in Bangladesh have switched in order to reduce their exposure to As, need to be evaluated. PMID:21226536

  5. Brine contamination of shallow ground water and streams in the Brookhaven Oil Field, Lincoln County, Mississippi

    USGS Publications Warehouse

    Kalkhoff, S.J.

    1986-01-01

    A hydrologic investigation to define areas of brine contamination in shallow freshwater aquifers commonly used for streams that drain the Brookhaven Oil Field, was conducted from October 1983 to September 1984. The Brookhaven Oil Field covers approximately 15 sq mi in northwestern Lincoln County, Mississippi. Since 1943, disposal of approximately 544.2 million barrels of brine pumped from the oil producing zone (lower part of the Tuscaloosa Formation) has contaminated the Citronelle aquifer, the Hattiesburg aquifers, and streams that drain the oil field. Approximately 5 sq mi of the shallow Citronelle aquifer contain water with chloride concentrations higher than normal for this area ( > 20 mg/L). Brine contamination has moved from the source laterally through the Citronelle aquifer to discharge into nearby streams and vertically into the underlying Hattiesburg aquifers. Contamination is most noticeable in Shaws Creek when streamflow originates primarily from groundwater inflow (approximately 87% of the time during the study). Additional study is required to define contaminant plumes, rates of groundwater movement and geohydrochemical reactions between the contaminant and aquifer materials. These data would allow accurate predictions of location, extent and degree of contamination in the study area. (Author 's abstract)

  6. Factors affecting the distribution of hydrocarbon contaminants and hydrogeochemical parameters in a shallow sand aquifer.

    PubMed

    Lee, J Y; Cheon, J Y; Lee, K K; Lee, S Y; Lee, M H

    2001-07-01

    The distributions of hydrocarbon contaminants and hydrogeochemical parameters were investigated in a shallow sand aquifer highly contaminated with petroleum hydrocarbons leaked from solvent storage tanks. For these purposes, a variety of field investigations and studies were performed, which included installation of over 100 groundwater monitoring wells and piezometers at various depths, soil logging and analyses during well and piezometer installation, chemical analysis of groundwater, pump tests, and slug tests. Continuous water level monitoring at three selected wells using automatic data-logger and manual measuring at other wells were also conducted. Based on analyses of the various investigations and tests, a number of factors were identified to explain the distribution of the hydrocarbon contaminants and hydrogeochemical parameters. These factors include indigenous biodegradation, hydrostratigraphy, preliminary pump-and-treat remedy, recharge by rainfall, and subsequent water level fluctuation. The permeable sandy layer, in which the mean water table elevation is maintained, provided a dominant pathway for contaminant transport. The preliminary pump-and-treat action accelerated the movement of the hydrocarbon contaminants and affected the redox evolution pattern. Seasonal recharge by rain, together with indigenous biodegradation, played an important role in the natural attenuation of the petroleum hydrocarbons via mixing/dilution and biodegradation. The water level fluctuations redistributed the hydrocarbon contaminants by partitioning them into the soil and groundwater. The identified factors are not independent but closely inter-correlated. PMID:11475158

  7. Natural attenuation model and biodegradation for 1,1,1-trichloroethane contaminant in shallow groundwater.

    PubMed

    Lu, Qiang; Zhu, Rui-Li; Yang, Jie; Li, Hui; Liu, Yong-Di; Lu, Shu-Guang; Luo, Qi-Shi; Lin, Kuang-Fei

    2015-01-01

    Natural attenuation is an effective and feasible technology for controlling groundwater contamination. This study investigated the potential effectiveness and mechanisms of natural attenuation of 1,1,1-trichloroethane (TCA) contaminants in shallow groundwater in Shanghai by using a column simulation experiment, reactive transport model, and 16S rRNA gene clone library. The results indicated that the majority of the contaminant mass was present at 2-6 m in depth, the contaminated area was approximately 1000 m × 1000 m, and natural attenuation processes were occurring at the site. The effluent breakthrough curves from the column experiments demonstrated that the effectiveness of TCA natural attenuation in the groundwater accorded with the advection-dispersion-reaction equation. The kinetic parameter of adsorption and biotic dehydrochlorination of TCA was 0.068 m(3)/kg and 0.0045 d(-1). The contamination plume was predicted to diminish and the maximum concentration of TCA decreased to 280 μg/L. The bacterial community during TCA degradation in groundwater belonged to Trichococcus, Geobacteraceae, Geobacter, Mucilaginibacter, and Arthrobacter. PMID:26379629

  8. Natural attenuation model and biodegradation for 1,1,1-trichloroethane contaminant in shallow groundwater

    PubMed Central

    Lu, Qiang; Zhu, Rui-Li; Yang, Jie; Li, Hui; Liu, Yong-Di; Lu, Shu-Guang; Luo, Qi-Shi; Lin, Kuang-Fei

    2015-01-01

    Natural attenuation is an effective and feasible technology for controlling groundwater contamination. This study investigated the potential effectiveness and mechanisms of natural attenuation of 1,1,1-trichloroethane (TCA) contaminants in shallow groundwater in Shanghai by using a column simulation experiment, reactive transport model, and 16S rRNA gene clone library. The results indicated that the majority of the contaminant mass was present at 2–6 m in depth, the contaminated area was approximately 1000 m × 1000 m, and natural attenuation processes were occurring at the site. The effluent breakthrough curves from the column experiments demonstrated that the effectiveness of TCA natural attenuation in the groundwater accorded with the advection-dispersion-reaction equation. The kinetic parameter of adsorption and biotic dehydrochlorination of TCA was 0.068 m3/kg and 0.0045 d–1. The contamination plume was predicted to diminish and the maximum concentration of TCA decreased to 280 μg/L. The bacterial community during TCA degradation in groundwater belonged to Trichococcus, Geobacteraceae, Geobacter, Mucilaginibacter, and Arthrobacter. PMID:26379629

  9. Time-lapse 3-D seismic imaging of shallow subsurface contaminant flow.

    PubMed

    McKenna, J; Sherlock, D; Evans, B

    2001-12-01

    This paper presents a physical modelling study outlining a technique whereby buoyant contaminant flow within water-saturated unconsolidated sand was remotely monitored utilizing the time-lapse 3-D (TL3-D) seismic response. The controlled temperature and pressure conditions, along with the high level of acquisition repeatability attainable using sandbox physical models, allow the TL3-D seismic response to pore fluid movement to be distinguished from all other effects. TL3-D seismic techniques are currently being developed to monitor hydrocarbon reserves within producing reservoirs in an endeavour to improve overall recovery. However, in many ways, sandbox models under atmospheric conditions more accurately simulate the shallow subsurface than petroleum reservoirs. For this reason, perhaps the greatest application for analogue sandbox modelling is to improve our understanding of shallow groundwater and environmental flow mechanisms. Two fluid flow simulations were conducted whereby air and kerosene were injected into separate water-saturated unconsolidated sand models. In both experiments, a base 3-D seismic volume was recorded and compared with six later monitor surveys recorded while the injection program was conducted. Normal incidence amplitude and P-wave velocity information were extracted from the TL3-D seismic data to provide visualization of contaminant migration. Reflection amplitudes displayed qualitative areal distribution of fluids when a suitable impedance contrast existed between pore fluids. TL3-D seismic reflection tomography can potentially monitor the change in areal distribution of fluid contaminants over time, indicating flow patterns. However, other research and this current work have not established a quantifiable relationship between either normal reflection amplitudes and attenuation and fluid saturation. Generally, different pore fluids will have unique seismic velocities due to differences in compressibility and density. The predictable

  10. Phreatophyte influence on reductive dechlorination in a shallow aquifer contaminated with trichloroethene (TCE)

    USGS Publications Warehouse

    Lee, R.W.; Jones, S.A.; Kuniansky, E.L.; Harvey, G.; Lollar, B.S.; Slater, G.F.

    2000-01-01

    Phytoremediation uses the natural ability of plants to degrade contaminants in groundwater. A field demonstration designed to remediate aerobic shallow groundwater contaminated with trichloroethene began in April 1996 with the planting of cottonwood trees, a short-rotation woody crop, over an approximately 0.2-ha area at the Naval Air Station, Fort Worth, Texas. The project was developed to demonstrate capture of contaminated groundwater and degradation of contaminants by phreatophytes. Analyses from samples of groundwater collected from July 1997 to June 1998 indicate that tree roots have the potential to create anaerobic conditions in the groundwater that will facilitate degradation of trichloroethene by microbially mediated reductive dechlorination. Organic matter from root exudates and decay of tree roots probably stimulate microbial activity, consuming dissolved oxygen. Dissolved oxygen concentrations, which varied across the site, were smallest near a mature cottonwood tree (about 20 years of age and 60 meters southwest of the cottonwood plantings) where degradation products of trichloroethene were measured. Oxidation of organic matter is the primary microbially mediated reaction occurring in the groundwater beneath the planted trees whereas near the mature cottonwood tree, data indicate that methanogenesis is the most probable reaction occurring. Reductive dechlorination in groundwater either is not occurring or is not a primary process away from the mature tree. Carbon-13 isotope values for trichloroethene are nearly identical at locations away from the mature tree, further confirming that dechlorination is not occurring at the site.

  11. Biophysical mechanisms of trichloroethene uptake and loss in baldcypress growing in shallow contaminated groundwater

    USGS Publications Warehouse

    Nietch, C.T.; Morris, J.T.; Vroblesky, D.A.

    1999-01-01

    Wetland vegetation may be useful in the remediation of shallow contaminated aquifers. Mesocosm experiments were conducted to describe the regulatory mechanisms affecting trichloroethene (TCE) removal rates from groundwater by flood-adapted wetland trees at a contaminated site. TCE flux through baldcypress [Taxodium distichum (L) Rich] seedlings grown in glass- carboys decreased from day to night and from August to December. The diel fluctuation coincided with changes in leaf-level physiology, as the daytime flux was significantly correlated with net photosynthesis but not with respiration at night. A decrease in seedling water use from summer to winter explained the large seasonal difference in TCE flux. A simple model that simulates gas-phase diffusion through aerenchyma tested the importance of diffusion of TCE vapor from roots to the stem. The modeled diffusive flux was within 64% of the observed value during the winter but could only explain 8% of the summer flux. Seedling water use was a good estimator of flux during the summer. Hence, evapotranspiration (ET) in the summer may serve as a good predictor for the potential of TCE removal by baldcypress trees, while diffusive flux may better approximate potential contaminant loss in the winter.Wetland vegetation may be useful in the remediation of shallow contaminated aquifers. Mesocosm experiments were conducted to describe the regulatory mechanisms affecting trichloroethene (TCE) removal rates from groundwater by flood-adapted wetland trees at a contaminated site. TCE flux through baldcypress [Taxodium distichum (L) Rich] seedlings grown in glass-carboys decreased from day to night and from August to December. The diel fluctuation coincided with changes in leaf-level physiology, as the daytime flux was significantly correlated with net photosynthesis but not with respiration at night. A decrease in seedling water use from summer to winter explained the large seasonal difference in TCE flux. A simple model that

  12. Hypertrophic pachymeningitis.

    PubMed

    Hahn, Lewis D; Fulbright, Robert; Baehring, Joachim M

    2016-08-15

    Hypertrophic Pachymeningitis (HP) denotes inflammation and thickening of the dura mater that can be idiopathic or secondary to a wide variety of conditions. Clinically, HP can present as debilitating headaches and cranial nerve defects but in other cases may be completely asymptomatic. We aimed to determine the relative incidence of different etiologies of HP and compare their associated imaging findings. Additionally, we sought to compare the clinical features of the underlying syndromes. We retrospectively examined twenty-two consecutive cases of HP seen in a single practitioner neurology practice over a ten-year time period. The most common etiologies were idiopathic HP and neurosarcoidosis. No imaging features were completely specific to any etiology. Nonetheless, idiopathic HP typically demonstrated diffuse regular enhancement whereas neurosarcoidosis was more likely to display a nodular enhancement pattern. Headache and cranial neuropathies were the most common clinical presentation. HP symptoms were often responsive to steroids but complete responses were rare. HP is a diagnostic challenge without specific findings on minimally or non-invasive diagnostic studies. Biopsy is often required and serves as the basis for effective therapy. PMID:27423604

  13. Monitoring Potential Transport of Radioactive Contaminants in Shallow Ephemeral Channels: FY 2012

    SciTech Connect

    Miller, Julianne J.; Mizell, Steve A.; McCurdy, Greg; Campbell, Scott A.

    2012-09-01

    The US Department of Energy (DOE) National Nuclear Security Administration (NNSA), Nevada Site Office (NSO), Environmental Management’s Soils Activity has authorized the Desert Research Institute (DRI) to conduct field assessments of potential sediment transport of contaminated soil from Corrective Action Unit (CAU) 550, Smoky Contamination Area (CA), during precipitation runoff events. CAU 550 includes Corrective Action Sites (CASs) 08-23-03, 08-23-04, 08-23-06, and 08-23-07; these CASs are associated with tests designated Ceres, Smoky, Oberon, and Titania, respectively. Field measurements at the T-4 Atmospheric Test Site, CAU 370, suggest that radioactive material may have migrated along a shallow ephemeral drainage that traverses the site (NNSA/NSO, 2009). (It is not entirely clear how contaminated soils got into their present location at the T-4 Site, but flow to the channel has been redirected and the contamination does not appear to be migrating at present.) Although DRI initially looked at the CAU 370 site, given that it could not be confirmed that migration of contamination into the channel was natural, an alternate study site was selected at CAU 550. Aerial surveys in selected portions of the Nevada National Security Site (NNSS) also suggest that radioactivity may be migrating along ephemeral channels in Areas 3, 8, 11, 18, and 25 (Colton, 1999). Figure 1 shows the results of a low-elevation aerial survey (Colton, 1999) in Area 8. The numbered markers in Figure 1 identify ground zero for three safety experiments conducted in 1958 [Oberon (number 1), Ceres (number 2), and Titania (number 4)] and a weapons effects test conducted in 1964, Mudpack (number 3). This survey suggests contaminants may be migrating down the ephemeral channels that traverse CAU 550. Note particularly the lobe of higher concentration extending southeastward at the south end of the high concentration area marked as number 3 in Figure 1. CAU 550 in Area 8 of the NNSS was selected for

  14. Multidimensional spectrofluorometry characterization of dissolved organic matter in arsenic-contaminated shallow groundwater.

    PubMed

    Huang, Shuangbing; Wang, Yanxin; Cao, Ling; Pi, Kunfu; Yu, Mei; Even, Emilie

    2012-01-01

    Multidimensional spectrofluorometry was employed to characterize dissolved organic matter (DOM) in arsenic-contaminated shallow aquifers at Jianghan Plain (JHP), central China, to better understand the effect of biogeochemical processes on arsenic mobilization. The microbial humic quinone and amino acid components identified indicate the importance of microbially mediated processes in the reduction of iron oxyhydroxides. The relationship of quinone and amino acid-like components with Fe(2+) and S(2-) helps us understand the sequential redox transformation (SRT) in the high arsenic aquifer system and the origin of bicarbonate in groundwater. Correlation between DOM components and dissolved arsenic and Fe suggests that arsenic mobilization could be linked to the microbial reduction of iron oxyhydroxides with liable DOM as electron donors as well as to the electron shuttling function served by humic quinones. PMID:22571533

  15. Application of artificial neural networks to assess pesticide contamination in shallow groundwater

    USGS Publications Warehouse

    Sahoo, G.B.; Ray, C.; Mehnert, E.; Keefer, D.A.

    2006-01-01

    In this study, a feed-forward back-propagation neural network (BPNN) was developed and applied to predict pesticide concentrations in groundwater monitoring wells. Pesticide concentration data are challenging to analyze because they tend to be highly censored. Input data to the neural network included the categorical indices of depth to aquifer material, pesticide leaching class, aquifer sensitivity to pesticide contamination, time (month) of sample collection, well depth, depth to water from land surface, and additional travel distance in the saturated zone (i.e., distance from land surface to midpoint of well screen). The output of the neural network was the total pesticide concentration detected in the well. The model prediction results produced good agreements with observed data in terms of correlation coefficient (R = 0.87) and pesticide detection efficiency (E = 89%), as well as good match between the observed and predicted "class" groups. The relative importance of input parameters to pesticide occurrence in groundwater was examined in terms of R, E, mean error (ME), root mean square error (RMSE), and pesticide occurrence "class" groups by eliminating some key input parameters to the model. Well depth and time of sample collection were the most sensitive input parameters for predicting the pesticide contamination potential of a well. This infers that wells tapping shallow aquifers are more vulnerable to pesticide contamination than those wells tapping deeper aquifers. Pesticide occurrences during post-application months (June through October) were found to be 2.5 to 3 times higher than pesticide occurrences during other months (November through April). The BPNN was used to rank the input parameters with highest potential to contaminate groundwater, including two original and five ancillary parameters. The two original parameters are depth to aquifer material and pesticide leaching class. When these two parameters were the only input parameters for the BPNN

  16. Assessment of intrinsic bioremediation of jet fuel contamination in a shallow aquifer, Beaufort, South Carolina

    USGS Publications Warehouse

    Chapelle, Frank; Landmeyer, J.E.; Bradley, P.M.

    1995-01-01

    Field and laboratory studies show that microorganisms indigenous to the ground-water system underlying Tank Farm C, Marine Corps Air Station Beaufort, S.C., degrade petroleum hydrocarbons under aerobic and anaerobic conditions. Under aerobic conditions, sediments from the shallow aquifer underlying the site mineralized radiolabeled (14C) toluene to 14CO2 with first-order rate constants of about -0.29 per day. Sediments incubated under anaerobic conditions mineralized radiolabeled toluene more slowly, with first-order rate constants of -0.001 per day. Although anaerobic rates of biodegradation are low, they are significant in the hydrologic and geochemical context of the site. Because of low hydraulic conductivities (1.9-9.1 feet per day) and low hydraulic gradients (about 0.004 feet per feet), ground water flows slowly (approximately 20 feet per year) at this site. Furthermore, aquifer sediments contain organic-rich peat that has a high sorptive capacity. Under these conditions, hydrocarbon contaminants have moved no further than 10 feet downgradient of the jet fuel free product. Digital solute-transport simulations, using the range of model parameters measured at the site, show that dissolved contaminants will be completely degraded before they are discharged from the aquifer into adjacent surface-water bodies. These results show that natural attenuation processes are containing the migration of soluble hydrocarbons, and that intrinsic bioremediation is a potentially effective remedial strategy at this site.

  17. Arsenic concentrations and bacterial contamination in a pilot shallow dugwell program in West Bengal, India.

    PubMed

    Hira-Smith, Meera M; Yuan, Yan; Savarimuthu, Xavier; Liaw, Jane; Hira, Alpana; Green, Cynthia; Hore, Timir; Chakraborty, Protap; von Ehrenstein, Ondine S; Smith, Allan H

    2007-01-01

    Project Well has developed a pilot self-supporting community-based mitigation program to provide arsenic-safe water to the villagers of North 24 Parganas, West Bengal, India. Shallow concrete dugwells, less than 25 feet deep, that tap into an unconfined aquifer are constructed following stipulated guidelines. The design differs from the traditional dugwell in two major ways: (i) there is a layer of coarse sand in the annular space enveloping the outer wall of the concrete cylinder; and (ii) handpumps are used for water extraction to reduce the potential for bacterial contamination. Monitoring programs for arsenic and coliform bacteria in selected dugwells have been completed. In summer, when the water levels were low, the arsenic concentrations were measured. In 11 wells, measured over three years, the average water arsenic concentration was 29 micro gL-1. Two dugwells had high concentrations of arsenic (average 152 micro gL-1 and 61 micro gL-1), but the remaining nine dugwells had an overall average of 11 micro gL-1. Seasonal variation was assessed in five wells with monthly measurements and there was a direct relationship between increases in arsenic concentrations and decreases in the volume of water in the dugwells in the dry summer season. To control bacterial contamination, sodium hypochlorite solution containing 5% chlorine was applied once a month. In 2005, fecal coliform was undetected in 65% (n = 13) of the dugwells but detected at high levels in 35% (n = 7) of the dugwells. The program clearly reduced exposure to arsenic, but we conclude that further study of increases in arsenic concentrations in the dry season are warranted, as well as assessment of ways to more effectively control bacterial contamination such as more frequent chlorination, perhaps with lower doses on each occasion. PMID:17129953

  18. Use of tree rings to investigate the onset of contamination of a shallow aquifer by chlorinated hydrocarbons

    USGS Publications Warehouse

    Yanosky, T.M.; Hansen, B.P.; Schening, M.R.

    2001-01-01

    Oaks (Quercus velutina Lam.) growing over a shallow aquifer contaminated by chlorinated hydrocarbons were studied to determine if it was possible to estimate the approximate year that contamination began. The annual rings of some trees downgradient from the contaminant release site contained elevated concentrations of chloride possibly derived from dechlorination of contaminants. Additionally, a radial-growth decline began in these trees at approximately the same time that chloride became elevated. Growth did not decline in trees that contained smaller concentrations of chloride. The source of elevated chloride and the corresponding reductions in tree growth could not be explained by factors other than contamination. On the basis of tree-ring evidence alone, the release occurred in the late 1960s or early 1970s. Contaminant release at a second location apparently occurred in the mid- to late 1970s, suggesting that the area was used for disposal for at least 5 years and possibly longer. Copyright ?? 2001 Elsevier Science B.V.

  19. Contamination of vinyl chloride in shallow urban rivers in Osaka, Japan.

    PubMed

    Yamamoto, K; Fukushima, M; Kakutani, N; Tsuruho, K

    2001-02-01

    Vinyl chloride (VC) contamination had taken place in heavily polluted shallow rivers (Taishogawa and lower Hiranogawa Rivers) in Osaka, Japan. VC concentrations ranged from below detection limit to 55.6 micrograms l-1 (mean: 3.35 micrograms l-1, standard deviation: 5.96 micrograms l-1). Of 55 volatile organic compounds (VOCs) analyzed, concentrations of cis-1,2-dichloroethene (c-DCE), tetrachloroethene (PCE) and trichloroethene (TCE) were significantly correlated to VC concentrations in the rivers, indicating that they share common sources. The four VOCs were invariably present at approximate relative ratios of about 1:2.7:1.5:0.31 (VC: c-DCE: PCE: TCE). The similarity between sampling dates in the distribution pattern of the four VOCs concentrations were observed, but their concentrations were different between the dates. The concentrations of the four VOCs decreased with distance down the river. A sample from the upper Taishogawa River in July 1997 had 55.6 micrograms l-1 of VC, 152 micrograms l-1 of c-DCE, 86.2 micrograms l-1 of PCE and 18.4 micrograms l-1 of TCE, respectively. These values are about an order of magnitude higher than the other sites over the study period and are likely indicative of point source inputs. PMID:11229012

  20. Shallow Structure Characterization at a Groundwater Contamination Site: Seismic Processing and Tomographic Inversion

    NASA Astrophysics Data System (ADS)

    Fradelizio, G.; Gao, F.; Levander, A.; Zelt, C. A.

    2005-12-01

    In order to image the heterogeneities in a shallow (less then 20 meters) buried paleo-channel where groundwater is severely contaminated by trichloroethylene (TCE), two vertical seismic profiles (VSP) and a seismic profile between the two boreholes (VSP-surface) were acquired. The surficial lithology consists of a mix of Quaternary sands and gravels overlying an incised clay layer acting as structural/stratigraphic trap for the polluting DNAPLs (dense nonaqueous phase liquids). The high-resolution data were processed following a standard seismic processing scheme, and inverted using traveltime and waveform tomography methods. The tomographic velocity models were subsequently utilized to depth migrate the VSP-surface data, both post-stack and pre-stack using explicit finite-difference extrapolators. In addition, Q values were estimated for the area of interest, directly from the imaginary part of the tomographic velocities, and using spectral ratio methods on the VSP data. Since the shallow structures can be characterized mechanically to some degree in terms of physical properties such as seismic velocity, the reflection seismic migrated images can be directly compared to the waveform tomography velocity models, given that the two methods produce results with comparable resolution. Generally, a reasonably good agreement exists between the results of the two different methodologies, keeping in mind that the migrated image shows impedance contrasts, whereas the waveform tomography measures velocity fluctuations directly. Both seismic and tomography images suggest that the geological structure in the target area is considerably more complex and heterogeneous than a simple layer of alluvium over an eroded clay layer, as is also suggested by lithology logs. The heterogeneity in the target area suggests that a conventional reflection processing sequence including CMP stacking and post-stack migration may be compromised because of large lateral velocity variations. As we

  1. Occurrence of atrazine and degradates as contaminants of subsurface drainage and shallow groundwater

    SciTech Connect

    Jayachandran, K.; Steinheimer, T.R.; Moorman, T.B.

    1994-03-01

    Atrazine is a commonly used herbicide in corn (Zea mays L.) growing areas of the USA. Because of its heavy usage, moderate persistence, and mobility in soil, monitoring of atrazine movement under field conditions is essential to assess its potential to contaminate groundwater. Concentrations of atrazine, deisopropylatrazine (DIA), and deethlatraaine (DEA) were measured in subsurface drainage and shallow groundwater beneath continuous, no-till corn. Water samples were collected from the subsurface drain (tile) outlets and suction lysimeters in the growing seasons of 1990 and 1991, and analyzed for atrazine and two principle degradates won solid-phase extraction and HPLC. In 1990, atrazine concentration ranged from 1.3 to 5.1{mu}g L{sup -1} in tile-drain water and from 0.5 to 20.5 {mu}g L{sup -1} in lysimeter water. In general, concentrations of parent and degradates in solution were atrazine > DEA > DIA. Lesser levels of atrazine were measured in 1991 from Plots 2 and 4; however, greater concentrations of atrazine (6.0-8.4 {mu}g L{sup -1}) were measured from plot 5. Throughout the two growing seasons, atrazine concentration in Plot 5 tile-drain water was greater than that of Plots 2 and 4, suggesting a preferential movement of atrazine. Concentrations of DIA and DEA ranged from 0.1 to 2.2 and 0.9 to 3.2 {mu}g L{sup -1} respectively, indicating that the degradation products by themselves or in combination with parent atrazine can exceed the maximum contaminant level (mcl) of 3 {mu}g L{sup -1} even though atrazine by itself may be <3 {mu}g L{sup -1}. The deethylatrazine-to-atrazine ratio (DAR) is an indicator of residence time in soil during transport of atrazine to groundwater. In Plots 2 and 4, DAR values for tile-drain water ranged from 0.43 to 2.70 and 0.50 to 2.66 respectively. By comparison, a DAR of 0.38 to 0.60 was observed in Plot 5, suggesting less residence time in the soil. 38 refs., 5 figs., 4 tabs.

  2. Nitrate Contamination of Shallow Groundwater in The San Joaquin Valley - A Domestic Well Survey

    NASA Astrophysics Data System (ADS)

    Lockhart, K.; King, A.

    2011-12-01

    Groundwater quality has been, and continues to be, a major concern in agricultural areas where concentrated animal feeding operations (CAFO) exist or where fertilizers are applied. In the San Joaquin Valley, California, the majority of land-use is agricultural and groundwater contamination by nitrate is common in areas where many people rely on shallow domestic wells. Elevated levels of nitrate in drinking water have been linked to adverse health effects. This project sampled 200 domestic wells in Stanislaus, Merced, Tulare, and Kings Counties for nitrate as NO3-N. Wells were given a "dairy" or "non-dairy" designation depending on the distance to the nearest dairy corral or lagoon. This study found 46% of wells sampled in Tulare and Kings Counties and 42% of wells sampled in Stanislaus and Merced Counties exceeded the MCL for nitrate (10 mg/l). In Tulare and Kings Counties, non-dairy wells had a significantly greater mean nitrate value than dairy wells, and Tulare and Kings County non-dairy wells had a significantly greater mean nitrate value than Stanislaus and Merced non-dairy wells. Stanislaus and Merced County dairy wells had a significantly greater mean nitrate value than Tulare and Kings dairy wells. Tulare and Kings non-dairy wells may have greater nitrate values due to overlying row-crop and orchard land-use (commonly citrus) and the large quantities of fertilizers typically applied to these crops. Stanislaus and Merced Counties contain some of the densest CAFO areas of the state, possibly leading to Stanislaus and Merced dairy wells having higher nitrate concentrations than Tulare and Kings dairy wells.

  3. Microbial biomass in a shallow, urban aquifer contaminated with aromatic hydrocarbons: analysis by phospholipid fatty acid content and composition.

    PubMed

    Franzmann, P D; Patterson, B M; Power, T R; Nichols, P D; Davis, G B

    1996-06-01

    The city of Perth contains a number of sites that have been contaminated with hydrocarbons due to leakage from petroleum underground storage tanks. Microbial biomass in groundwater and sediment cores from above and below the water table, and from within and outside a plume of hydrocarbon contamination, was examined using phospholipid fatty acid methyl ester analysis. Microbial numbers, calculated from the phospholipid content, ranged from 0.9 x 10(6) to 7.8 x 10(6) 'Escherichia coli equivalent cells' g-1 dry wt of sediment. Over 96% of the microbial biomass was attached to the sediment and the proportion of attached cells did not decrease within the plume of contaminants. The amount of biomass within aquifer samples seemed to be related more to the proximity of the rhizosphere to the shallow aquifer, and other unknown urban inputs, rather than to the effects of the plume of contaminants. Fatty acids common to many bacterial groups dominated within the plume, and as such the analyses gave limited insight into microbial community structure. For site assessment of intrinsic remediation of shallow aquifers in urban areas, estimates of microbial biomass may not provide information that is readily applicable to plume management. PMID:8698663

  4. MODIS-derived spatiotemporal water clarity patterns in optically shallow FloridaKeys waters: A new approach to remove bottom contamination

    EPA Science Inventory

    Retrievals of water quality parameters from satellite measurements over optically shallow waters have been problematic due to bottom contamination of the signals. As a result, large errors are associated with derived water column properties. These deficiencies greatly reduce the ...

  5. [Hypertrophic cardiomyopathy. Arrhythmia in hypertrophic cardiomyopathy].

    PubMed

    Colín Lizalde, Luis de Jesús

    2003-01-01

    Hypertrophic cardiomyopathy is a relatively common genetic disorder with heterogeneity in mutations, forms of presentation, prognosis and treatment strategies. Hypertrophic cardiomyopathy is recognized as the most common cause of sudden cardiac death that occurs in young people, including athletes. The clinical diagnosis is complemented with the ecocardiographic study, in which an abnormal myocardial hypertrophy of the septum can be observed in the absence of a cardiac or systemic disease (arterial systemic hypertension, aortic stenosis). The annual sudden mortality rate is 1% and, in selected populations, it ranges between 3 and 6%. The therapeutic strategies depend on the different subsets of patients according to the morbidity and mortality, sudden cardiac death, obstructive symptoms, heart failure or atrial fibrillation and stroke. High risk patients for sudden death may effectively be treated with the automatic implantable cardioverter-defibrillator. PMID:12966640

  6. Sediment storage and severity of contamination in a shallow reservoir affected by historical lead and zinc mining

    USGS Publications Warehouse

    Juracek, K.E.

    2008-01-01

    A combination of sediment-thickness measurement and bottom-sediment coring was used to investigate sediment storage and severity of contamination in Empire Lake (Kansas), a shallow reservoir affected by historical Pb and Zn mining. Cd, Pb, and Zn concentrations in the contaminated bottom sediment typically exceeded baseline concentrations by at least an order of magnitude. Moreover, the concentrations of Cd, Pb, and Zn typically far exceeded probable-effects guidelines, which represent the concentrations above which toxic biological effects usually or frequently occur. Despite a pre-1954 decrease in sediment concentrations likely related to the end of major mining activity upstream by about 1920, concentrations have remained relatively stable and persistently greater than the probable-effects guidelines for at least the last 50 years. Cesium-137 evidence from sediment cores indicated that most of the bottom sediment in the reservoir was deposited prior to 1954. Thus, the ability of the reservoir to store the contaminated sediment has declined over time. Because of the limited storage capacity, Empire Lake likely is a net source of contaminated sediment during high-inflow periods. The contaminated sediment that passes through, or originates from, Empire Lake will be deposited in downstream environments likely as far as Grand Lake O' the Cherokees (Oklahoma). ?? 2007 Springer-Verlag.

  7. Numerical simulation of seasonal heat storage in a contaminated shallow aquifer - Temperature influence on flow, transport and reaction processes

    NASA Astrophysics Data System (ADS)

    Popp, Steffi; Beyer, Christof; Dahmke, Andreas; Bauer, Sebastian

    2015-04-01

    The energy market in Germany currently faces a rapid transition from nuclear power and fossil fuels towards an increased production of energy from renewable resources like wind or solar power. In this context, seasonal heat storage in the shallow subsurface is becoming more and more important, particularly in urban regions with high population densities and thus high energy and heat demand. Besides the effects of increased or decreased groundwater and sediment temperatures on local and large-scale groundwater flow, transport, geochemistry and microbiology, an influence on subsurface contaminations, which may be present in the urban surbsurface, can be expected. Currently, concerns about negative impacts of temperature changes on groundwater quality are the main barrier for the approval of heat storage at or close to contaminated sites. The possible impacts of heat storage on subsurface contamination, however, have not been investigated in detail yet. Therefore, this work investigates the effects of a shallow seasonal heat storage on subsurface groundwater flow, transport and reaction processes in the presence of an organic contamination using numerical scenario simulations. A shallow groundwater aquifer is assumed, which consists of Pleistoscene sandy sediments typical for Northern Germany. The seasonal heat storage in these scenarios is performed through arrays of borehole heat exchangers (BHE), where different setups with 6 and 72 BHE, and temperatures during storage between 2°C and 70°C are analyzed. The developing heat plume in the aquifer interacts with a residual phase of a trichloroethene (TCE) contamination. The plume of dissolved TCE emitted from this source zone is degraded by reductive dechlorination through microbes present in the aquifer, which degrade TCE under anaerobic redox conditions to the degradation products dichloroethene, vinyl chloride and ethene. The temperature dependence of the microbial degradation activity of each degradation step is

  8. MICROBIAL COMMUNITY STRUCTURE IN A SHALLOW HYDROCARBON-CONTAMINATED AQUIFER ASSOCIATED WITH HIGH ELECTRICAL CONDUCTIVITY

    EPA Science Inventory

    Little is known about the complex interactions between microbial communities and electrical properties in contaminated aquifers. In order to investigate possible connections between these parameters a study was undertaken to investigate the hypothesis that the degradation of hydr...

  9. Risk of diarrhoea from shallow groundwater contaminated with enteropathogens in the Kathmandu Valley, Nepal.

    PubMed

    Shrestha, Sadhana; Haramoto, Eiji; Malla, Rabin; Nishida, Kei

    2015-03-01

    Shallow groundwater is the main water source among many alternatives in the Kathmandu Valley, Nepal, which has a rapidly growing population and intermittent piped water supply. Although human pathogens are detected in groundwater, its health effects are unclear. We estimated risk of diarrhoea from shallow groundwater use using quantitative microbial risk assessment. Escherichia coli, Giardia cyst and Cryptosporidium oocyst levels were analysed in dug and tube wells samples. E. coli concentrations were converted to those of enteropathogenic E. coli (EPEC). Risks from EPEC in dug wells and from Cryptosporidium and Giardia in both dug and tube wells were higher than the acceptable limit (<10⁻⁴ infections/person-year) for both drinking and bathing exposures. Risk from protozoan enteropathogens increased the total risk 10,000 times, indicating that ignoring protozoans could lead to serious risk underestimation. Bathing exposure considerably increased risk, indicating that it is an important pathway. Point-of-use (POU) water treatment decreased the risk six-fold and decreased risk overestimation. Because removal efficiency of POU water treatment has the largest impact on total risk, increasing the coverage and efficiency of POU water treatment could be a practical risk management strategy in the Kathmandu Valley and similar settings. PMID:25719484

  10. STABLE CARBON ISOTOPE BIOGEOCHEMISTRY OF A SHALLOW SAND AQUIFER CONTAMINATED WITH FUEL HYDROCARBONS

    EPA Science Inventory

    Ground-water chemistry and the stable C isotope composition ( 13CDIC) of dissolved C (DIC) were measured in a sand aquifer contaminated with JP-4 fuel hydrocarbons. Results show that ground water in the upgradient zone was characterized by DIC content of 14-20 mg C/L and 13CDIC...

  11. Field note: successful establishment of a phytoremediation system at a petroleum hydrocarbon contaminated shallow aquifer: trends, trials, and tribulations.

    PubMed

    Cook, Rachel L; Landmeyer, James E; Atkinson, Brad; Messier, Jean-Pierre; Nichols, Elizabeth Guthrie

    2010-09-01

    We report the establishment of a mixed hybrid poplar (Populus spp.) and willow (Salix spp.) phytoremediation system at a fuel-contaminated site. Several approaches were used to balance competing goals of cost-effectiveness yet successful tree establishment without artificial irrigation or trenching. Bare root and unrooted cuttings were installed using either: (1) 1.2 m deep holes excavated with an 8 cm diameter auger using a direct-push rig and backfilled with the excavated, in situ soil; (2) 1.2 m deep holes created with a 23 cm diameter auger attached to a Bobcat rig and backfilled with clean topsoil from offsite; and (3) shallow holes between 15-30 cm deep that were created with a 1.3 cm diameter rod and no backfill. Tree mortality from initial plantings indicated contaminated zones not quantified in prior site investigations and remedial actions. Aquifer heterogeneity, underground utilities, and prior remediation infrastructure hampered the ability of the site to support a traditional experimental design. Total stem length and mortality were measured for all planted trees and were incorporated into a geographic information system. Planting early in the growing season, augering a larger diameter hole, and backfilling with clean, uncontaminated topsoil was cost effective and allowed for greater tree cutting growth and survival. PMID:21166278

  12. In-situ stabilization of radioactively contaminated low-level solid wastes buried in shallow trenches: an assessment

    SciTech Connect

    Arora, H.S.; Tamura, T.; Boegly, W.J.

    1980-09-01

    The potential effectiveness of materials for in-situ encapsulation of low-level, radioactively contaminated solid waste buried in shallow trenches is enumerated. Cement, clay materials, and miscellaneous sorbents, aqueous and nonaqueous gelling fluids and their combinations are available to solidify contaminated free water in trenches, to fill open voids, and to minimize radionuclide mobility. The success of the grouting technique will depend on the availability of reliable geohydrologic data and laboratory development of a mix with enhanced sorption capacity for dominant radionuclides present in the trenches. A cement-bentonite-based grout mix with low consistency for pumping, several hours controlled rate of hardening, negligible bleeding, and more than 170 kPa (25 psi) compressive strength are a few of the suggested parameters in laboratory mix development. Cost estimates of a cement-bentonite-based grout mix indicate that effective and durable encapsulation can be accomplished at a reasonable cost (about $113 per cubic meter). However, extensive implementation of the method suggests the need for a field demonstration of the method. 53 references.

  13. Saturated zone denitrification: potential for natural attenuation of nitrate contamination in shallow groundwater under dairy operations.

    PubMed

    Singleton, M J; Esser, B K; Moran, J E; Hudson, G B; McNab, W W; Harter, T

    2007-02-01

    We present results from field studies at two central California dairies that demonstrate the prevalence of saturated-zone denitrification in shallow groundwater with 3H/ 3He apparent ages of < 35 years. Concentrated animal feeding operations are suspected to be major contributors of nitrate to groundwater, but saturated zone denitrification could mitigate their impact to groundwater quality. Denitrification is identified and quantified using N and O stable isotope compositions of nitrate coupled with measurements of excess N2 and residual NO3(-) concentrations. Nitrate in dairy groundwater from this study has delta15N values (4.3-61 per thousand), and delta18O values (-4.5-24.5 per thousand) that plot with delta18O/delta15N slopes of 0.47-0.66, consistent with denitrification. Noble gas mass spectrometry is used to quantify recharge temperature and excess air content. Dissolved N2 is found at concentrations well above those expected for equilibrium with air or incorporation of excess air, consistent with reduction of nitrate to N2. Fractionation factors for nitrogen and oxygen isotopes in nitrate appear to be highly variable at a dairy site where denitrification is found in a laterally extensive anoxic zone 5 m below the water table, and at a second dairy site where denitrification occurs near the water table and is strongly influenced by localized lagoon seepage. PMID:17328180

  14. Near-surface seismic surveys at Rifle, Colorado for shallow groundwater contamination risk assessment

    NASA Astrophysics Data System (ADS)

    Chen, J.; Zelt, C. A.; Levander, A.

    2013-12-01

    In August 2012, we carried out a series of seismic surveys at a site located approximately 0.3 mile east of the city of Rifle in Garfield County, Colorado. The ground water beneath this site was contaminated by former vanadium and uranium ore-processing operations from 1924 through 1958. The site is on an alluvial terrace created by a flood-plain meander of the Colorado River. On the south side, the terrace is bounded by a steep descending slope to the Colorado River; on the other sides, it is bounded by ascending slopes of the more resistant sedimentary rocks of the Wasatch Formation. Although remedial actions have been taken to remove the contaminated surface materials, there are still potential risks from residual materials and redistribution of the contaminated water harming human health. This seismic project, funded by The U.S. Department of Energy, was designed to provide hydrogeologic information through sub-surface velocity model building and imaging of the water aquifer. A 3D compressional wave seismic survey covers an area that is 96 m in the N-S direction by 60 m in the E-W direction. An orthogonal, symmetric receiver and source template was used with 24 receiver lines, 96 channels per receiver line, and 2.5 m between lines. The inline shot and receiver spacing is 2 m and 1 m, respectively. The source was an accelerated weight drop striking a metal plate. The source has a dominant frequency at ~60 Hz, and is down by 20 db at 20 Hz and 150 Hz, providing data suitable for seismic tomography and seismic migration methods. Besides this 3D survey, three other seismic experiments were performed: (1) a 2D multi-component source and receiver survey, (2) a 3D surface wave experiment using 4.5 Hz geophones, and (3) an ambient noise experiment using 4.5 Hz geophones to record passing vehicles and trains. Preliminary results of the data analysis will be presented.

  15. Application of environmental tracers to delineate recharge patterns and nitrate contamination in shallow groundwater around a river

    NASA Astrophysics Data System (ADS)

    Kaown, Dugin; Koh, Eunhee; Park, Byeong-Hak; Lee, Kang-Kun

    2016-04-01

    Hydrogeochemical data, stable isotopes, chlorofluorocarbon (CFCs) and 3H-3He in groundwater were applied to characterize residence time, recharge patterns and nitrate contamination of groundwater in a small agricultural area, Yangpyung, Korea. The study area is located around a river and the measured groundwater table ranges from 1.5 to 2.65 m during the year. Most residents in the study area practice agriculture and potato, strawberry, and cabbage are the typical vegetables grown. Vegetable fields are mostly located in the upgradient area of the study area while forest and residence areas are located in the downgradient area. A lot of chemical and organic fertilizers are applied in the upgradient area. The concentration of NO3-N in groundwater showed 9.8-83.7 mg/L in the upgradient area and 0.1-22.6 mg/L in the downgradient area in 2014. It is necessary to monitor groundwater recharge patterns and transport processes of nitrate to protect surface water around the study area. The values of δ18O and δD showed that groundwater is recharged mainly from summer precipitation. The apparent groundwater ages using 3H-3He and CFCs ranged from 13 to 27 years in the upgradient area and from 25 to 35 years in the downgradient area. The NO3-N in more recently recharged groundwater showed higher concentrations while the NO3-N in older groundwater showed low concentrations. Some shallow wells in the downgradient area showed similar apparent groundwater age with that of the river water indicating groundwater-surface water interactions. A conceptual model of groundwater-surface water interactions using stable isotopes, apparent 3H-3He and CFCs age in groundwater will be useful to understand the hydrological processes and nitrate contamination of the study area.

  16. Shallow 3-D vertical seismic profiling around a contaminant withdrawal well on the Lawrence Livermore National Laboratory Site

    SciTech Connect

    Rector, J.; Bainer, R.; Milligan, P.; Tong, C.

    1997-01-30

    One of the major problems associated with ground water contaminant remediation is well placement. Optimal-placement of wells requires an accurate knowledge of geologic structure and stratigraphy in the near surface sediments and rock (0 to 100 m). Without the development of remote imaging provided by geophysical techniques, the required spacing between treatment wells may be less than 2 m in order to be confident that all contaminant reservoirs had been remediated. One method for characterizing geologic structure and stratigraphy in the near surface is vertical seismic profiling (VSP), a technique often used on deep exploration wells to calibrate surface seismic reflection data. For near-surface applications, VSP data can be acquired efficiently using an array of hydrophones lowered into a fluid-filled borehole (Milligan et al, 1997). In this paper we discuss the acquisition and processing of a 3-D VSP collected at a shallow remediation site located on the grounds of the Lawrence Livermore National Laboratory (LLNL) near Livermore, California. The site was used by the United States Navy as an air training base. At this time, initial releases of hazardous materials to the environment occurred in the form of solvents [volatile organic compounds (VOCs)] that were used for the cleaning of airplanes and their parts. Gasoline, diesel and other petroleum-based compounds are also known to have leaked into the ground. California Research and Development Company, a subsidy of Standard Oil, occupied the southeastern portion of the site from 1950 to 1954. The first releases of radioactive materials to the environment occurred at this time, with the beginning of testing of radioactive materials at the site. In 1952, LLNL acquired the site. Additional releases of VOCS, polychlorinated biphenyls (PCBs), metals, radionuclides (primarily tritium), gasoline and pesticides have occurred since. These releases were due to localized spills, landfills, surface impoundments, disposal pits

  17. Hypertrophic Cardiomyopathy: A Review

    PubMed Central

    Houston, Brian A; Stevens, Gerin R

    2014-01-01

    Hypertrophic cardiomyopathy (HCM) is a global disease with cases reported in all continents, affecting people of both genders and of various racial and ethnic origins. Widely accepted as a monogenic disease caused by a mutation in 1 of 13 or more sarcomeric genes, HCM can present catastrophically with sudden cardiac death (SCD) or ventricular arrhythmias or insidiously with symptoms of heart failure. Given the velocity of progress in both the fields of heart failure and HCM, we present a review of the approach to patients with HCM, with particular attention to those with HCM and the clinical syndrome of heart failure. PMID:25657602

  18. Update on hypertrophic scar treatment.

    PubMed

    Rabello, Felipe Bettini; Souza, Cleyton Dias; Farina Júnior, Jayme Adriano

    2014-08-01

    Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scars, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin. PMID:25141117

  19. Update on hypertrophic scar treatment

    PubMed Central

    Rabello, Felipe Bettini; Souza, Cleyton Dias; Júnior, Jayme Adriano Farina

    2014-01-01

    Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scars, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin. PMID:25141117

  20. Burns, hypertrophic scar and galactorrhea.

    PubMed

    Karimi, Hamid; Nourizad, Samad; Momeni, Mahnoush; Rahbar, Hosein; Momeni, Mazdak; Farhadi, Khosro

    2013-07-01

    An 18-year-old woman was admitted to Motahari Burn Center suffering from 30% burns. Treatment modalities were carried out for the patient and she was discharged after 20 days. Three to four months later she developed hypertrophic scar on her chest and upper limbs. At the same time she developed galactorrhea in both breasts and had a disturbed menstrual cycle four months post-burn. On investigation, we found hyperprolactinemia and no other reasons for the high level of prolactin were detected.She received treatment for both the hypertrophic scar and the severe itching she was experiencing. After seven months, her prolactin level had decreased but had not returned to the normal level. It seems that refractory hypertrophic scar is related to the high level of prolactin in burns patients. PMID:23456048

  1. Topical treatments for hypertrophic scars.

    PubMed

    Zurada, Joanna M; Kriegel, David; Davis, Ira C

    2006-12-01

    Hypertrophic scars represent an abnormal, exaggerated healing response after skin injury. In addition to cosmetic concern, scars may cause pain, pruritus, contractures, and other functional impairments. Therapeutic modalities include topical medications, intralesional corticosteroids, laser therapy, and cryosurgery. Topical therapies, in particular, have become increasingly popular because of their ease of use, comfort, noninvasiveness, and relatively low cost. This review will discuss the properties and effectiveness of these agents, including pressure therapy, silicone gel sheeting and ointment, polyurethane dressing, onion extract, imiquimod 5% cream, and vitamins A and E in the prevention and treatment of hypertrophic scars. PMID:17097399

  2. Contamination of shallow ground water in the area of building 95, Picatinny Arsenal, New Jersey, 1985-90

    USGS Publications Warehouse

    Sargent, B.P.; Storck, D.A.

    1994-01-01

    A zone of contaminated ground water at Picatinny Arsenal has resulted from the operation of a metal- plating facility in building 95 during 1960-81, and the wastewater-treatment system that is in and adjacent to the building. Thirty-two monitoring wells were installed in 1989 to supplement 12 previously installed wells. All wells were sampled in 1989 and 1990 for analysis of ground water for inorganic constituents, trace elements, volatile organic compounds, and nutrients. Four wells also were sampled for analysis for base/neutral- and acid-extractable compounds and pesticides, and soil gas from the unsaturated zone at eight sites was analyzed for volatile organic compounds. Concentrations of dissolved solids and sulfate in the study area were consistently above the U.S. Environmental Protection Agency's secondary drinking-water regulations. The areal distribution of sulfate differed from that of the volatile organic compounds. Concentrations of trace elements were not elevated downgradient from the source. The estimated average velocity of contaminant movement is 0.1 to 1.1 feet per day. The major organic contaminants identified in the study area are trichloroethylene, tetrachloroethylene, and 1,1,1-trichloroethane. Trichloroethylene was detected in wells upgradient from the wastewater- treatment site. Tetrachloroethylene and 1,1,1-trichloroethane might originate at tanks in the basement of building 95 rather than at the adjacent wastewater-treatment system. The pre- dominant gas-phase contaminant, 1,1,1- trichloroethane, was detected at a maximum con- centration of 15.7 micrograms per liter. Both trichoroethylene and tetrachloroethylene were detected in concentrations greater than 0.10 micrograms per liter in five of the eight soil- gas samples, indicating that volatilization and diffusion through the unsaturated zone could be a significant mechanism of contaminant loss from the aquifer.

  3. High-resolution geophysical imaging of shallow-water, contaminated wetlands: A novel application to Kearny freshwater marsh, New Jersey Meadowlands

    NASA Astrophysics Data System (ADS)

    Mansoor, Nasser M.

    The study investigated the transfer of state-of-the-art, geophysical technologies to permit effective characterization and monitoring of shallow-water wetlands. The innovative application was implemented in Kearney Marsh, NJ Meadowlands through three phases. Phase I (chapter 2) included laboratory-scale, induced polarization (IP) measurements conducted on marsh soils that were subsequently analyzed for heavy metal and physical properties. Phase II (chapter 3) included reconnaissance geophysical survey using terrain conductivity, magnetic gradiometry and surface water chemistry data from a shallow-draft paddleboat. Phase III (chapter 4) included continuous marine, electrical resistivity imaging (ERI) supported with rainfall and surface water data. Phase I revealed a linear relationship between the normalized chargeability and the estimated surface area to pore volume when the iron content is accounted for as a polarizable element of the soil. As the Fe concentration of soils is a critical biogeochemical parameter, IP measurements may provide a hitherto unrecognized approach to probing soil geochemistry, iron cycling and anaerobic microbial activity. The inverted sediment conductivity obtained from phase II resolved a contamination pattern probably attributable to leachate from adjacent landfills and/or salt water ingress from a partial tidal connection that is not obvious in the surface water data. Magnetic gradiometry and the in-phase component of the EM31 response both primarily reflect the distribution of junk metal associated with a legacy of illegal dumping. Historic aerial photographs suggest that this distribution reflects land-use history, defining the maximum previous extent of an adjacent landfill and a pattern of dumping correlated with historic roadways. The continuous ERI conducted during phase III is found to be an effective method for determining the resistivity structure of wetland sediments due to the shallow surface water layer. Temperature

  4. Carbon isotopic evidence for biodegradation of organic contaminants in the shallow vadose zone of the radioactive waste management complex

    SciTech Connect

    Conrad, Mark E.; DePaolo, Donald J.

    2003-09-04

    Waste material buried in drums in the shallow subsurface at the Radioactive Waste Management Facility (RWMC) of the Idaho National Engineering and Environmental Laboratory (INEEL) contained significant amounts of organic compounds including lubricating oils and chlorinated solvents. CO{sub 2} concentrations in pore gas samples from monitoring wells in the vicinity of the disposal pits are 3 to 5 times higher than the concentrations in nearby background wells. The stable carbon isotope ratios ({delta}{sup 13}C values) of CO{sub 2} from the disposal pits averaged 2.4. less than CO{sub 2} from the background wells, indicating that the elevated CO{sub 2} concentrations around the pits were derived from source materials with {delta}{sup 13}C values in the range of -24{per_thousand} to -29{per_thousand}. These {delta}{sup 13}C values are typical of lubricating oils, but higher than most solvents. The radiocarbon ({sup 14}C) contents of CO{sub 2} across most of the site were significantly elevated above modern concentrations due to reactor blocks buried in a subsurface vault at the site. However, several samples collected from the high-CO{sub 2} zone on the far side of the RWMC from the reactor blocks had very low {sup 14}C contents (less than 0.13 times modern), confirming production from lubricating oils manufactured from fossil hydrocarbons. The magnitude of the CO{sub 2} anomaly observed at the site is consistent with intrinsic biodegradation rates on the order of 0.5 to 3.0 metric tons of carbon per year.

  5. Experiments to determine the migration potential for water and contaminants in shallow land-burial facilities: design, emplacement, and preliminary results

    SciTech Connect

    DePoorter, G.L.; Abeele, W.V.; Burton, B.W.

    1982-01-01

    Although there have been many laboratory studies on water movement and contaminant transport, there is a need for more large scale field experiments. Large scale field experiments are necessary to (1) measure hydraulic conductivities on a scale typical of actual shallow land burial facilities and hazardous waste disposal facilities, (2) allow comparisons to be made between full scale and laboratory measurements, (3) verify the applicability of calculational methods for determining unsaturated hydraulic conductivities from water retention curves, and (4) for model validation. Experiments that will provide the information to do this are described in this paper. The results of these experiments will have applications for both the shallow land burial of low level radioactive wastes and the disposal of hazardous chemical wastes. These experiments will provide results that can be used in model verification for system performance. This type of data on experiments done at this scale has not been available, and are necessary for validating unsaturated transport models and other models used to predict long term system performance. Even though these experiments are done on crushed Bandelier Tuff, most models use physical properties of the backfill material such as density, porosity, and water retention curves. For this reason, once the models are validated in these experiments, they can be applied with confidence to other materials as long as the material properties are well characterized. In addition, from known water movement rates, calculable from the results of these experiments, requirements for other parts of the system such as liners, water diversion systems, and system cap requirements can be determined. Lastly, the results of these experiments and their use in model verification will provide a sound scientific basis on which to base decisions on system requirements and system design.

  6. Investigating the Sources of Nitrogen Contamination in the Shallow Aquifer of Jakarta using a Newly Developed Distributed River-Aquifer Flow and Transport Model

    NASA Astrophysics Data System (ADS)

    Costa, D.; Burlando, P.; Liong, S. Y.

    2015-12-01

    Recent observations in the shallow aquifer of Jakarta show a rise in nitrate (NO3-) levels. Groundwater is extensively used in the city to compensate for the limited public water supply network and therefore the risk to public health from a rise in NO3- concentration is high. NO3- has been identified as a cofactor for methemoglobinemia in infants, a disease which can lead to death in extreme cases. The NO3- levels detected are still below regulatory limits for drinking purposes but strategies are necessary to contain the growing problem. To this end, the main sources and pathways of inorganic compounds containing nitrogen (N) - i.e. nitrate, nitrite (NO2-) and ammonium (NH4+) - were investigated. We combined 3 years of field measurements in the Ciliwung River, the major river flowing through Jakarta, with a distributed river-aquifer interaction model to characterize the N-cycle in both systems and quantify the contribution of river infiltration in the overall groundwater N budget. The computed infiltration fluxes were compared to estimates of leaks from poorly maintained septic tanks, which are extensively used in the city, to identify the main source of groundwater contamination. Observations show a strong and interdependent spatial and seasonal variability in the levels of NO3-, NO2- and NH4+ in the river, which is caused by changes in nitrification/denitrification rates due to variations in dissolved oxygen concentrations. Simulation results suggest that such dynamics in the river cause river to aquifer contamination patterns to likewise change over space and time, which leads to heterogeneous vulnerability distributions. The estimated contribution of river-N infiltration to the observed NO3- groundwater levels is small if compared to that originating from all leaking septic tanks inside Jakarta. However, in the vicinity of the Ciliwung, river to groundwater N-loading can play an important role in the local NO3- groundwater levels because it is highly

  7. Laser application for hypertrophic rhinitis

    NASA Astrophysics Data System (ADS)

    Inouye, Tetsuzo; Tanabe, Tetsuya; Nakanoboh, Manabu; Ogura, Masami

    1995-05-01

    The CO2 and KTP/532 lasers have been used in the treatment of an allergic and hypertrophic rhinitis for the past several years. As we know, the laser enables a surgeon to perform the operation with minimum hemorrhage and minimized pain, during and after the procedure. Additionally many of these operations can be performed under local anesthesia instead of general anesthesia, on an outpatient basis. The laser is used to irradiate the mucous membranes of the inferior turbinates. Vaporization and cutting is easily done. Post operative management of the local operated area is easy. The advantages of laser surgery over regular surgical techniques are supreme for intranasal operations when performed under local anesthesia.

  8. Subaortic membrane mimicking hypertrophic cardiomyopathy.

    PubMed

    Anderson, Mark Joseph; Arruda-Olson, Adelaide; Gersh, Bernard; Geske, Jeffrey

    2015-01-01

    A 34-year-old man was referred for progressive angina and exertional dyspnoea refractory to medical therapy, with a presumptive diagnosis of hypertrophic cardiomyopathy (HCM). Transthoracic echocardiography (TTE) revealed asymmetric septal hypertrophy without systolic anterior motion of the mitral valve leaflet and with no dynamic left ventricular outflow tract (LVOT) obstruction. However, the LVOT velocity was elevated at rest as well as with provocation, without the characteristic late peaking obstruction seen in HCM. Focused TTE to evaluate for suspected fixed obstruction demonstrated a subaortic membrane 2.2 cm below the aortic valve. Coronary CT angiography confirmed the presence of the subaortic membrane and was negative for concomitant coronary artery disease. Surgical resection of the subaortic membrane and septal myectomy resulted in significant symptomatic relief and lower LVOT velocities on postoperative TTE. This case reminds the clinician to carefully evaluate for alternative causes of LVOT obstruction, especially subaortic membrane, as a cause of symptoms mimicking HCM. PMID:26538250

  9. Experimental Therapies in Hypertrophic Cardiomyopathy

    PubMed Central

    Marian, Ali J.

    2010-01-01

    The quintessential clinical diagnostic phenotype of human hypertrophic cardiomyopathy (HCM) is primary cardiac hypertrophy. Cardiac hypertrophy is also a major determinant of mortality and morbidity including the risk of sudden cardiac death (SCD) in patients with HCM. Reversal and attenuation of cardiac hypertrophy and its accompanying fibrosis is expected to improve morbidity as well as decrease the risk of SCD in patients with HCM. The conventionally used pharmacological agents in treatment of patients with HCM have not been shown to reverse or attenuate established cardiac hypertrophy and fibrosis. An effective treatment of HCM has to target the molecular mechanisms that are involved in the pathogenesis of the phenotype. Mechanistic studies suggest that cardiac hypertrophy in HCM is secondary to activation of various hypertrophic signaling molecules and, hence, is potentially reversible. The hypothesis is supported by the results of genetic and pharmacological interventions in animal models. The results have shown potential beneficial effects of angiotensin II receptor blocker losartan, mineralocorticoid receptor blocker spironolactone, 3-hydroxy-3-methyglutaryl-coenzyme A reductase inhibitors simvastatin and atorvastatin, and most recently, N-acetylcysteine (NAC) on reversal or prevention of hypertrophy and fibrosis in HCM. The most promising results have been obtained with NAC, which through multiple thiol-responsive mechanisms completely reversed established cardiac hypertrophy and fibrosis in three independent studies. Pilot studies with losartan and statins in humans have established the feasibility of such studies. The results in animal models have firmly established the reversibility of established cardiac hypertrophy and fibrosis in HCM and have set the stage for advancing the findings in the animal models to human patients with HCM through conducting large-scale efficacy studies. PMID:20560006

  10. Assessment of intrinsic bioremediation of gasoline contamination in the shallow aquifer, Laurel Bay Exchange, Marine Corps Air Station Beaufort, South Carolina

    USGS Publications Warehouse

    Landmeyer, J.E.; Chapelle, Francis; Bradley, P.M.

    1996-01-01

    Laboratory, field, and digital solute-transport- modeling studies demonstrate that microorganisms indigenous to the shallow ground-water system at Laurel Bay Exchange, Marine Corps Air Station Beaufort, South Carolina, can degrade petroleum hydrocarbons in gasoline released at the site. Microorganisms in aquifer sediments incubated in the laboratory under aerobic and anaerobic conditions mineralized radiolabeled carbon 14-toluene to 14C-carbon dioxide with first-order rate constants of Kbio = -0.640 per day and Kbio = -0.003 per day, respectively. Digital solute- transport modeling using the numerical code SUTRA revealed that anaerobic biodegradation of benzene occurs with a first-order rate constant near Kbio = -0.00025 per day. Sandy aquifer material beneath Laurel Bay Exchange is characterized by relatively high hydraulic conductivities (Kaq = 8.9 to 17.3 feet per day), average ground-water flow rate of about 60 feet per year, and a relatively uniform hydraulic gradient of 0.004 feet per foot. The sandy aquifer material also has low adsorptive potentials for toluene and benzene (both about Kad = 2.0 x 10-9 cubic feet per milligram), because of the lack of natural organic matter in the aquifer. The combination of this ground-water-flow rate and absence of significant adsorptive capacity in the aquifer permits toluene and benzene concentrations to be detected downgradient from the source area in monitoring wells, even though biodegradation of these compounds has been demonstrated. Solute-transport simulations, however, indicate that toluene and benzene will not reach the Broad River, the nearest point of contact with wildlife or human populations, about 3,600 feet west of the site boundary. These simulations also show that contamination will not be transported to the nearest Marine Corps property line about 2,400 feet south of the site. This is primarily because the source of contaminants has essentially been removed, and the low adsorptive capacity of the aquifer

  11. Hydrogeochemical and mineralogical effects of sustained CO2 contamination in a shallow sandy aquifer: A field-scale controlled release experiment

    NASA Astrophysics Data System (ADS)

    Cahill, Aaron G.; Marker, Pernille; Jakobsen, Rasmus

    2014-02-01

    A shallow aquifer CO2 contamination experiment was performed to investigate evolution of water chemistry and sediment alteration following leakage from geological storage by physically simulating a leak from a hypothetical storage site. In a carbonate-free aquifer, in western Denmark, a total of 1600 kg of gas phase CO2 was injected at 5 and 10 m depth over 72 days through four inclined injection wells into aeolian and glacial sands. Water chemistry was monitored for pH, EC, and dissolved element evolution through an extensive network of multilevel sampling points over 305 days. Sediment cores were taken pre and postinjection and analyzed to search for effects on mineralogy and sediment properties. Results showed the simulated leak to evolve in two distinct phases; an advective elevated ion pulse followed by increasing persistent acidification. Spatial and temporal differences in evolution of phases suggest separate chemical mechanisms and geochemical signatures. Dissolved element concentrations developed exhibiting four behaviors: (1) advective pulse (Ca, Mg, Na, Si, Ba, and Sr), (2) pH sensitive abundance dependent (Al and Zn), (3) decreasing (Mn and Fe), and (4) unaffected (K). Concentration behaviors were characterized by: (1) a maximal front moving with advective flow, (2) continual increase in close proximity to the injection plane, (3) removal from solution, and (4) no significant change. Only Al was observed to exceed WHO guidelines, however significantly so (10-fold excess). The data indicate that pH is controlled by equilibrium with gibbsite which is again coupled to cation exchange processes. Pre and postinjection sediment analysis indicated alteration of sediment composition and properties including depletion of reactive mineral species.

  12. Automating Shallow Seismic Imaging

    SciTech Connect

    Steeples, Don W.

    2004-12-09

    This seven-year, shallow-seismic reflection research project had the aim of improving geophysical imaging of possible contaminant flow paths. Thousands of chemically contaminated sites exist in the United States, including at least 3,700 at Department of Energy (DOE) facilities. Imaging technologies such as shallow seismic reflection (SSR) and ground-penetrating radar (GPR) sometimes are capable of identifying geologic conditions that might indicate preferential contaminant-flow paths. Historically, SSR has been used very little at depths shallower than 30 m, and even more rarely at depths of 10 m or less. Conversely, GPR is rarely useful at depths greater than 10 m, especially in areas where clay or other electrically conductive materials are present near the surface. Efforts to image the cone of depression around a pumping well using seismic methods were only partially successful (for complete references of all research results, see the full Final Technical Report, DOE/ER/14826-F), but peripheral results included development of SSR methods for depths shallower than one meter, a depth range that had not been achieved before. Imaging at such shallow depths, however, requires geophone intervals of the order of 10 cm or less, which makes such surveys very expensive in terms of human time and effort. We also showed that SSR and GPR could be used in a complementary fashion to image the same volume of earth at very shallow depths. The primary research focus of the second three-year period of funding was to develop and demonstrate an automated method of conducting two-dimensional (2D) shallow-seismic surveys with the goal of saving time, effort, and money. Tests involving the second generation of the hydraulic geophone-planting device dubbed the ''Autojuggie'' showed that large numbers of geophones can be placed quickly and automatically and can acquire high-quality data, although not under rough topographic conditions. In some easy-access environments, this device could

  13. Hypertrophic pachymeningitis accompanying neuromyelitis optica spectrum disorder: A case report.

    PubMed

    Kon, Tomoya; Nishijima, Haruo; Haga, Rie; Funamizu, Yukihisa; Ueno, Tatsuya; Arai, Akira; Suzuki, Chieko; Nunomura, Jin-ichi; Baba, Masayuki; Takahashi, Toshiyuki; Tomiyama, Masahiko

    2015-10-15

    We report a case of idiopathic cerebral hypertrophic pachymeningitis accompanying neuromyelitis optica spectrum disorder. No other identifiable cause of pachymeningitis was detected. Corticosteroid therapy was effective for both diseases. Hypertrophic pachymeningitis is closely related to autoimmune inflammatory disease of the central nervous system. This case supports the hypothesis that hypertrophic pachymeningitis can be a rare comorbidity of neuromyelitis optica spectrum disorder. PMID:26439957

  14. Aortic biomechanics in hypertrophic cardiomyopathy

    PubMed Central

    Badran, Hala Mahfouz; Soltan, Ghada; Faheem, Nagla; Elnoamany, Mohamed Fahmy; Tawfik, Mohamed; Yacoub, Magdi

    2015-01-01

    Background: Ventricular-vascular coupling is an important phenomenon in many cardiovascular diseases. The association between aortic mechanical dysfunction and left ventricular (LV) dysfunction is well characterized in many disease entities, but no data are available on how these changes are related in hypertrophic cardiomyopathy (HCM). Aim of the work: This study examined whether HCM alone is associated with an impaired aortic mechanical function in patients without cardiovascular risk factors and the relation of these changes, if any, to LV deformation and cardiac phenotype. Methods: 141 patients with HCM were recruited and compared to 66 age- and sex-matched healthy subjects as control group. Pulse pressure, aortic strain, stiffness and distensibility were calculated from the aortic diameters measured by M-mode echocardiography and blood pressure obtained by sphygmomanometer. Aortic wall systolic and diastolic velocities were measured using pulsed wave Doppler tissue imaging (DTI). Cardiac assessment included geometric parameters and myocardial deformation (strain and strain rate) and mechanical dyssynchrony. Results: The pulsatile change in the aortic diameter, distensibility and aortic wall systolic velocity (AWS') were significantly decreased and aortic stiffness index was increased in HCM compared to control (P < .001) In HCM AWS' was inversely correlated to age(r = − .32, P < .0001), MWT (r = − .22, P < .008), LVMI (r = − .20, P < .02), E/Ea (r = − .16, P < .03) LVOT gradient (r = − 19, P < .02) and severity of mitral regurg (r = − .18, P < .03) but not to the concealed LV deformation abnormalities or mechanical dyssynchrony. On multivariate analysis, the key determinant of aortic stiffness was LV mass index and LVOT obstruction while the role LV dysfunction in aortic stiffness is not evident in this population. Conclusion: HCM is associated with abnormal aortic mechanical properties. The severity of cardiac

  15. Infective endocarditis in hypertrophic cardiomyopathy

    PubMed Central

    Dominguez, Fernando; Ramos, Antonio; Bouza, Emilio; Muñoz, Patricia; Valerio, Maricela C.; Fariñas, M. Carmen; de Berrazueta, José Ramón; Zarauza, Jesús; Pericás Pulido, Juan Manuel; Paré, Juan Carlos; de Alarcón, Arístides; Sousa, Dolores; Rodriguez Bailón, Isabel; Montejo-Baranda, Miguel; Noureddine, Mariam; García Vázquez, Elisa; Garcia-Pavia, Pablo

    2016-01-01

    Abstract Infective endocarditis (IE) complicating hypertrophic cardiomyopathy (HCM) is a poorly known entity. Although current guidelines do not recommend IE antibiotic prophylaxis (IEAP) in HCM, controversy remains. This study sought to describe the clinical course of a large series of IE HCM and to compare IE in HCM patients with IE patients with and without an indication for IEAP. Data from the GAMES IE registry involving 27 Spanish hospitals were analyzed. From January 2008 to December 2013, 2000 consecutive IE patients were prospectively included in the registry. Eleven IE HCM additional cases from before 2008 were also studied. Clinical, microbiological, and echocardiographic characteristics were analyzed in IE HCM patients (n = 34) and in IE HCM reported in literature (n = 84). Patients with nondevice IE (n = 1807) were classified into 3 groups: group 1, HCM with native-valve IE (n = 26); group 2, patients with IEAP indication (n = 696); group 3, patients with no IEAP indication (n = 1085). IE episode and 1-year follow-up data were gathered. One-year mortality in IE HCM was 42% in our study and 22% in the literature. IE was more frequent, although not exclusive, in obstructive HCM (59% and 74%, respectively). Group 1 exhibited more IE predisposing factors than groups 2 and 3 (62% vs 40% vs 50%, P < 0.01), and more previous dental procedures (23% vs 6% vs 8%, P < 0.01). Furthermore, Group 1 experienced a higher incidence of Streptococcus infections than Group 2 (39% vs 22%, P < 0.01) and similar to Group 3 (39% vs 30%, P = 0.34). Overall mortality was similar among groups (42% vs 36% vs 35%, P = 0.64). IE occurs in HCM patients with and without obstruction. Mortality of IE HCM is high but similar to patients with and without IEAP indication. Predisposing factors, previous dental procedures, and streptococcal infection are higher in IE HCM, suggesting that HCM patients could benefit from IEAP. PMID:27368014

  16. Hypertrophic Cardiomyopathy in Athletes: Catching a Killer.

    ERIC Educational Resources Information Center

    Maron, Barry J.

    1993-01-01

    A leading cause of sudden death among young athletes, hypertrophic cardiomyopathy (HCM) does not always present cardiac signs and symptoms. Echocardiography offers the most effective means for diagnosis. Some patients require pharmaceutical or surgical intervention. Patients with HCM should not engage in organized competitive sports or…

  17. GIS Analysis of Available Data to Identify Regions in the US Where Shallow Ground Water Supplies are Particularly Vulnerable to Contamination by Releases to Biofuels from Underground Storage

    EPA Science Inventory

    In this slide presentation, GIS was used to perform a simple numerical and spatial analysis of shallow ground water drinkers and existing motor fuel service stations in the contiguous U.S. This analysis yielded an estimate of the probability of impact. "Vulnerability Indeces" w...

  18. Laparoscopic management of infantile hypertrophic pyloric stenosis.

    PubMed

    Gogolja, D; Visnjić, S; Maldini, B; Radesić, L; Roić, G; Zganjer, M; Fattorini, I

    2001-01-01

    Infantile hypertrophic pyloric stenosis is a common problem in pediatric surgery. Conventional management by the upper laparotomy was the method of choice over the last few decades. Advanced minimally invasive surgery allows successful endoscopic management of this entity too. We report on our initial experience with endoscopic surgery in the treatment of infantile hypertrophic pyloric stenosis with respect to some technical details. The operative procedure was well tolerated by the infant. After a short and uneventful postoperative course, the infant regained eating habits and was discharged from the hospital on the fifth postoperative day. Our favourable initial experience suggests that laparoscopic pyloromyotomy could be a safe and efficient alternative to the open surgery. PMID:11428282

  19. Apical hypertrophic cardiomyopathy presenting as acute coronary syndrome.

    PubMed

    Abdin, Amr; Eitel, Ingo; de Waha, Suzanne; Thiele, Holger

    2016-06-01

    Apical hypertrophic cardiomyopathy is a rare variant of hypertrophic cardiomyopathy. It is characterized by a local hypertrophy of the apical segments and displays typical electrocardiographic and imaging patterns. The clinical manifestations are variable and range from an asymptomatic course to sudden cardiac death. The most frequent symptom is chest pain and thus apical hypertrophic cardiomyopathy can mimic the symptoms and repolarization disturbances indicative of acute coronary syndrome. PMID:26628684

  20. 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

  1. Pathological features of hypertrophic obstructive cardiomyopathy

    PubMed Central

    Davies, M. J.; Pomerance, Ariela; Teare, R. D.

    1974-01-01

    The macroscopic features of hypertrophic obstructive cardiomyopathy are variable. The most easily recognized picture is of disproportionate and asymmetrical left ventricular hypertrophy with a small ventricular volume. Symmetrical ventricular hypertrophy also occurs and dilatation of the ventricular cavity may lead to a configuration more usually associated with congestive cardiomyopathy. Papillary muscle involvement leads to a bullet shape, often retained even when the ventricle dilates. Eighteen of the hearts showed a distinctive band of fibrous thickening below the aortic valve. This was a mirror image of the free edge of the anterior mitral cusp, had the microscopic features of an endocardial friction lesion, and was clearly the morphological expression of the systolic contact between cusp and septum seen on cineangiography. This band is characteristic of hypertrophic obstructive cardiomyopathy; it was more common in older patients and is of particular diagnostic value in cases with symmetrical hypertrophy, including those with dilated ventricular cavities. Sudden death was the commonest presentation in the younger cases but in several cases over 60 years at death hypertrophic obstructive cardiomyopathy was an incidental necropsy finding. Images PMID:4472994

  2. The embryological basis of subclinical hypertrophic cardiomyopathy.

    PubMed

    Captur, Gabriella; Ho, Carolyn Y; Schlossarek, Saskia; Kerwin, Janet; Mirabel, Mariana; Wilson, Robert; Rosmini, Stefania; Obianyo, Chinwe; Reant, Patricia; Bassett, Paul; Cook, Andrew C; Lindsay, Susan; McKenna, William J; Mills, Kevin; Elliott, Perry M; Mohun, Timothy J; Carrier, Lucie; Moon, James C

    2016-01-01

    Hypertrophic cardiomyopathy (HCM) is caused by mutations in sarcomeric proteins, the commonest being MYBPC3 encoding myosin-binding protein C. It is characterised by left ventricular hypertrophy but there is an important pre-hypertrophic phenotype with features including crypts, abnormal mitral leaflets and trabeculae. We investigated these during mouse cardiac development using high-resolution episcopic microscopy. In embryonic hearts from wildtype, homozygous (HO) and heterozygous (HET) Mybpc3-targeted knock-out (KO) mice we show that crypts (one or two) are a normal part of wildtype development but they almost all resolve by birth. By contrast, HO and HET embryos had increased crypt presence, abnormal mitral valve formation and alterations in the compaction process. In scarce normal human embryos, crypts were sometimes present. This study shows that features of the human pre-hypertrophic HCM phenotype occur in the mouse. In an animal model we demonstrate that there is an embryological HCM phenotype. Crypts are a normal part of cardiac development but, along with the mitral valve and trabeculae, their developmental trajectory is altered by the presence of HCM truncating Mybpc3 gene mutation. PMID:27323879

  3. The embryological basis of subclinical hypertrophic cardiomyopathy

    PubMed Central

    Captur, Gabriella; Ho, Carolyn Y.; Schlossarek, Saskia; Kerwin, Janet; Mirabel, Mariana; Wilson, Robert; Rosmini, Stefania; Obianyo, Chinwe; Reant, Patricia; Bassett, Paul; Cook, Andrew C.; Lindsay, Susan; McKenna, William J.; Mills, Kevin; Elliott, Perry M.; Mohun, Timothy J.; Carrier, Lucie; Moon, James C.

    2016-01-01

    Hypertrophic cardiomyopathy (HCM) is caused by mutations in sarcomeric proteins, the commonest being MYBPC3 encoding myosin-binding protein C. It is characterised by left ventricular hypertrophy but there is an important pre-hypertrophic phenotype with features including crypts, abnormal mitral leaflets and trabeculae. We investigated these during mouse cardiac development using high-resolution episcopic microscopy. In embryonic hearts from wildtype, homozygous (HO) and heterozygous (HET) Mybpc3-targeted knock-out (KO) mice we show that crypts (one or two) are a normal part of wildtype development but they almost all resolve by birth. By contrast, HO and HET embryos had increased crypt presence, abnormal mitral valve formation and alterations in the compaction process. In scarce normal human embryos, crypts were sometimes present. This study shows that features of the human pre-hypertrophic HCM phenotype occur in the mouse. In an animal model we demonstrate that there is an embryological HCM phenotype. Crypts are a normal part of cardiac development but, along with the mitral valve and trabeculae, their developmental trajectory is altered by the presence of HCM truncating Mybpc3 gene mutation. PMID:27323879

  4. Inflammation and cutaneous nervous system involvement in hypertrophic scarring

    PubMed Central

    Li, Shao-hua; Yang, Heng-lian; Xiao, Hu; Wang, Yi-bing; Wang, De-chang; Huo, Ran

    2015-01-01

    This study aimed to use a mouse model of hypertrophic scarring by mechanical loading on the dorsum of mice to determine whether the nervous system of the skin and inflammation participates in hypertrophic scarring. Results of hematoxylin-eosin and immunohistochemical staining demonstrated that inflammation contributed to the formation of a hypertrophic scar and increased the nerve density in scar tissue.Western blot assay verified that interleukin-13 expression was increased in scar tissue. These findings suggest that inflammation and the cutaneous nervous system play a role in hypertrophic scar formation. PMID:26692869

  5. Right ventricular obstruction in various types of hypertrophic cardiomyopathy.

    PubMed

    Stierle, U; Sheikhzadeh, A; Shakibi, J G; Langbehn, A F; Diederich, K W

    1987-01-01

    Hypertrophic cardiomyopathy (HCM) is most probably a genetically transmitted disease with different clinical and hemodynamic features. In hypertrophic obstructive cardiomyopathy (HOCM) the obstruction is predominantly in the left ventricular outflow tract (IHSS). In a minority of cases the obstruction is strictly located in midventricle (midventricular obstruction, MO). Hypertrophic nonobstructive cardiomyopathy (HNCM) includes asymmetric septal hypertrophy (ASH) and apical hypertrophy (AH). Right ventricular hypertrophic obstruction (RVHO) is an uncommon type of HCM and is almost always combined with other types of left ventricular HCM. We describe in the present report 1 case of RVHO with IHSS, 2 cases with MO and, to our knowledge, the first case with AH. PMID:3599397

  6. Rapid shallow breathing

    MedlinePlus

    Tachypnea; Breathing - rapid and shallow; Fast shallow breathing; Respiratory rate - rapid and shallow ... Shallow, rapid breathing has many possible medical causes, including: Asthma Blood clot in an artery in the lung Choking Chronic obstructive ...

  7. Hydrologic and Water-Quality Responses in Shallow Ground Water Receiving Stormwater Runoff and Potential Transport of Contaminants to Lake Tahoe, California and Nevada, 2005-07

    USGS Publications Warehouse

    Green, Jena M.; Thodal, Carl E.; Welborn, Toby L.

    2008-01-01

    Clarity of Lake Tahoe, California and Nevada has been decreasing due to inflows of sediment and nutrients associated with stormwater runoff. Detention basins are considered effective best management practices for mitigation of suspended sediment and nutrients associated with runoff, but effects of infiltrated stormwater on shallow ground water are not known. This report documents 2005-07 hydrogeologic conditions in a shallow aquifer and associated interactions between a stormwater-control system with nearby Lake Tahoe. Selected chemical qualities of stormwater, bottom sediment from a stormwater detention basin, ground water, and nearshore lake and interstitial water are characterized and coupled with results of a three-dimensional, finite-difference, mathematical model to evaluate responses of ground-water flow to stormwater-runoff accumulation in the stormwater-control system. The results of the ground-water flow model indicate mean ground-water discharge of 256 acre feet per year, contributing 27 pounds of phosphorus and 765 pounds of nitrogen to Lake Tahoe within the modeled area. Only 0.24 percent of this volume and nutrient load is attributed to stormwater infiltration from the detention basin. Settling of suspended nutrients and sediment, biological assimilation of dissolved nutrients, and sorption and detention of chemicals of potential concern in bottom sediment are the primary stormwater treatments achieved by the detention basins. Mean concentrations of unfiltered nitrogen and phosphorus in inflow stormwater samples compared to outflow samples show that 55 percent of nitrogen and 47 percent of phosphorus are trapped by the detention basin. Organic carbon, cadmium, copper, lead, mercury, nickel, phosphorus, and zinc in the uppermost 0.2 foot of bottom sediment from the detention basin were all at least twice as concentrated compared to sediment collected from 1.5 feet deeper. Similarly, concentrations of 28 polycyclic aromatic hydrocarbon compounds were

  8. Microbial Characterization of Nitrification in a Shallow, Nitrogen-Contaminated Aquifer, Cape Cod, Massachusetts and Detection of a Novel Cluster Associated with Nitrifying Betaproteobacteria

    Technology Transfer Automated Retrieval System (TEKTRAN)

    : Groundwater nitrification is a poorly characterized process affecting the speciation and transport of nitrogen. Cores from two sites in a sewage-contaminated groundwater plume were examined for microbial and molecular evidence of nitrification processes. The first, located beneath a sewage effl...

  9. A Longitudinal Study of Long-Term Change in Contamination Hazards and Shallow Well Quality in Two Neighbourhoods of Kisumu, Kenya

    PubMed Central

    Okotto-Okotto, Joseph; Okotto, Lorna; Price, Heather; Pedley, Steve; Wright, Jim

    2015-01-01

    Sub-Saharan Africa is experiencing rapid urbanisation and many urban residents use groundwater where piped supplies are intermittent or unavailable. This study aimed to investigate long-term changes in groundwater contamination hazards and hand-dug well water quality in two informal settlements in Kisumu city, Kenya. Buildings, pit latrines, and wells were mapped in 1999 and 2013–2014. Sanitary risk inspection and water quality testing were conducted at 51 hand-dug wells in 2002 to 2004 and 2014. Pit latrine density increased between 1999 and 2014, whilst sanitary risk scores for wells increased between 2002 to 2004 and 2014 (n = 37, Z = −1.98, p = 0.048). Nitrate levels dropped from 2004 to 2014 (n = 14, Z = −3.296, p = 0.001), but multivariate analysis suggested high rainfall in 2004 could account for this. Thermotolerant coliform counts dropped between 2004 and 2014, with this reduction significant in one settlement. Hand-dug wells had thus remained an important source of domestic water between 1999 and 2014, but contamination risks increased over this period. Water quality trends were complex, but nitrate levels were related to both sanitary risks and rainfall. Given widespread groundwater use by the urban poor in sub-Saharan Africa, the study protocol could be further refined to monitor contamination in hand-dug wells in similar settings. PMID:25898406

  10. A longitudinal study of long-term change in contamination hazards and shallow well quality in two neighbourhoods of Kisumu, Kenya.

    PubMed

    Okotto-Okotto, Joseph; Okotto, Lorna; Price, Heather; Pedley, Steve; Wright, Jim

    2015-04-01

    Sub-Saharan Africa is experiencing rapid urbanisation and many urban residents use groundwater where piped supplies are intermittent or unavailable. This study aimed to investigate long-term changes in groundwater contamination hazards and hand-dug well water quality in two informal settlements in Kisumu city, Kenya. Buildings, pit latrines, and wells were mapped in 1999 and 2013-2014. Sanitary risk inspection and water quality testing were conducted at 51 hand-dug wells in 2002 to 2004 and 2014. Pit latrine density increased between 1999 and 2014, whilst sanitary risk scores for wells increased between 2002 to 2004 and 2014 (n = 37, Z = -1.98, p = 0.048). Nitrate levels dropped from 2004 to 2014 (n = 14, Z = -3.296, p = 0.001), but multivariate analysis suggested high rainfall in 2004 could account for this. Thermotolerant coliform counts dropped between 2004 and 2014, with this reduction significant in one settlement. Hand-dug wells had thus remained an important source of domestic water between 1999 and 2014, but contamination risks increased over this period. Water quality trends were complex, but nitrate levels were related to both sanitary risks and rainfall. Given widespread groundwater use by the urban poor in sub-Saharan Africa, the study protocol could be further refined to monitor contamination in hand-dug wells in similar settings. PMID:25898406

  11. Muscular (hypertrophic) subaortic stenosis (hypertrophic obstructive cardiomyopathy): the evidence for true obstruction to left ventricular outflow.

    PubMed Central

    Wigle, E. D.; Henderson, M.; Rakowski, H.; Wilansky, S.

    1986-01-01

    The clinical and haemodynamic significance of the subaortic pressure gradient in patients with muscular (hypertrophic) subaortic stenosis (hypertrophic obstructive cardiomyopathy) has long been debated. In this report we summarize the evidence which indicates that true obstruction to left ventricular outflow exists in these patients. Rapid left ventricular ejection, through an outflow tract narrowed by ventricular septal hypertrophy, results in Venturi forces causing systolic anterior motion of the anterior (or posterior) mitral leaflets. Mitral leaflet-septal contact results in obstruction to outflow and the accompanying mitral regurgitation. The time of onset of mitral leaflet-septal contact determines the magnitude of the pressure gradient and the severity of the mitral regurgitation, as well as the degree of prolongation of left ventricular ejection time and the percentage of left ventricular stroke volume that is ejected in the presence of an obstructive pressure gradient. Early and prolonged mitral leaflet-septal contact results in a large pressure gradient, significant mitral regurgitation, as well as dramatic prolongation of the ejection time and a large percentage of left ventricular stroke volume being obstructed. Late and short mitral leaflet-septal contact results in little haemodynamic perturbation. Hypertrophic cardiomyopathy patients with obstructive pressure gradients are significantly more symptomatic than those without. Thus the obstructive pressure gradients in hypertrophic cardiomyopathy are of clinical as well as haemodynamic significance. To deny the existence of obstruction to outflow in patients with muscular subaortic stenosis is to deny these patients appropriate medical and surgical therapy. PMID:3774688

  12. End-stage hypertrophic cardiomyopathy in a cat

    PubMed Central

    White, Andrew J.M.

    2015-01-01

    A 14-year-old Persian cat was referred for evaluation of the progression of hypertrophic cardiomyopathy (HCM) after an acute episode of congestive heart failure. The diagnosis of HCM had been made almost 13 years ago. Echocardiography and electrocardiography revealed end-stage hypertrophic cardiomyopathy and multifocal atrial tachycardia. The patient was discharged on medical management with a grave prognosis. PMID:25969586

  13. End-stage hypertrophic cardiomyopathy in a cat.

    PubMed

    White, Andrew J M

    2015-05-01

    A 14-year-old Persian cat was referred for evaluation of the progression of hypertrophic cardiomyopathy (HCM) after an acute episode of congestive heart failure. The diagnosis of HCM had been made almost 13 years ago. Echocardiography and electrocardiography revealed end-stage hypertrophic cardiomyopathy and multifocal atrial tachycardia. The patient was discharged on medical management with a grave prognosis. PMID:25969586

  14. Atrioventricular Sequential Pacing for Hypertrophic Cardiomyopathy During Liver Transplantation.

    PubMed

    Ramos, Juan; Pai, Sher-Lu; Perry, Dana K; Blackshear, Joseph L; Aniskevich, Stephen

    2015-10-15

    Hypertrophic cardiomyopathy is a myocardial disorder that carries an increased risk of morbidity and mortality during liver transplantation. We describe the use of atrioventricular sequential pacing, placed preoperatively, to assist with intraoperative management of a patient with severe refractory hypertrophic cardiomyopathy undergoing orthotopic piggyback liver transplantation. We discuss the pathogenesis and treatment of this infrequent but serious comorbidity. PMID:26466305

  15. Hypertrophic osteopathy associated with hepatocellular carcinoma in a dog

    PubMed Central

    Randall, Victoria D.; Souza, Carlos; Vanderhart, Daniel; Boston, Sarah

    2015-01-01

    A 9-year-old spayed female dog diagnosed with hepatocellular carcinoma and hypertrophic osteopathy was negative for additional lesions on computed tomography of the thorax and abdomen. Resection of the affected liver lobe resulted in resolution of clinical signs. This is the first case of hypertrophic osteopathy secondary to hepatocellular carcinoma. PMID:26130837

  16. Topical modalities for treatment and prevention of postsurgical hypertrophic scars.

    PubMed

    Foo, Chong Wee; Tristani-Firouzi, Payam

    2011-08-01

    There is no universally accepted treatment regimen and no evidence-based literature to guide management of hypertrophic scars. This article summarizes the existing literature regarding topical treatments such as silicone gel sheeting and ointment, onion extract, vitamin E, pressure garment therapy, massage therapy, and topical imiquimod 5% cream in the management of hypertrophic scars. PMID:21856542

  17. Blepharoptosis and hypertrophic osteoarthropathy: A case report

    PubMed Central

    Doğan, Aysun Şanal; Acaroğlu, Gölge; Dikmetas, Ozlem

    2016-01-01

    A 52-year-old male patient presented to our hospital with a history of secondary hypertrophic osteoarthropathy (HOA) associated with an abdominal neoplasia and blepharoptosis. He had finger clubbing, hyperhidrosis, and hypertrichosis. He also had a recent history of extensive abdominal surgery with a pathology report of myelolipoma. Routine blood work was unremarkable. Upper eyelid reconstruction with blepharoplasty, upper eyelid wedge resection, and brow suspension was performed to address his eyelid concerns. By this case report, we would like to attract notice that the eyelid involvement may be a part of HOA and to emphasize the importance of systemic and pathologic evaluation in failed blepharoptosis surgery. PMID:27221686

  18. Hypertrophic Cardiomyopathy in Owl Monkeys (Aotus spp.)

    PubMed Central

    Knowlen, Grant G; Weller, Richard E; Perry, Ruby L; Baer, Janet F; Gozalo, Alfonso S

    2013-01-01

    Cardiac hypertrophy is a common postmortem finding in owl monkeys. In most cases the animals do not exhibit clinical signs until the disease is advanced, making antemortem diagnosis of subclinical disease difficult and treatment unrewarding. We obtained echocardiograms, electrocardiograms, and thoracic radiographs from members of a colony of owl monkeys that previously was identified as showing a 40% incidence of gross myocardial hypertrophy at necropsy, to assess the usefulness of these modalities for antemortem diagnosis. No single modality was sufficiently sensitive and specific to detect all monkeys with cardiac hypertrophy. Electrocardiography was the least sensitive method for detecting owl monkeys with hypertrophic cardiomyopathy. Thoracic radiographs were more sensitive than was electrocardiography in this context but cannot detect animals with concentric hypertrophy without an enlarged cardiac silhouette. Echocardiography was the most sensitive method for identifying cardiac hypertrophy in owl monkeys. The most useful parameters suggestive of left ventricular hypertrophy in our owl monkeys were an increased average left ventricular wall thickness to chamber radius ratio and an increased calculated left ventricular myocardial mass. Parameters suggestive of dilative cardiomyopathy were an increased average left ventricular myocardial mass and a decreased average ratio of left ventricular free wall thickness to left ventricular chamber radius. When all 4 noninvasive diagnostic modalities (physical examination, echocardiography, electrocardiography, and thoracic radiography) were used concurrently, the probability of detecting hypertrophic cardiomyopathy in owl monkeys was increased greatly. PMID:23759531

  19. Microbial characterization of nitrification in a shallow, nitrogen-contaminated aquifer, Cape Cod, Massachusetts and detection of a novel cluster associated with nitrifying Betaproteobacteria.

    PubMed

    Miller, Daniel N; Smith, Richard L

    2009-01-26

    Groundwater nitrification is a poorly characterized process affecting the speciation and transport of nitrogen. Cores from two sites in a plume of contamination were examined using culture-based and molecular techniques targeting nitrification processes. The first site, located beneath a sewage effluent infiltration bed, received treated effluent containing O2 (>300 microM) and NH4+ (51-800 microM). The second site was 2.5 km down-gradient near the leading edge of the ammonium zone within the contaminant plume and featured vertical gradients of O2, NH4+, and NO3- (0-300, 0-500, and 100-200 microM with depth, respectively). Ammonia- and nitrite-oxidizers enumerated by the culture-based MPN method were low in abundance at both sites (1.8 to 350 g(-1) and 33 to 35,000 g(-1), respectively). Potential nitrifying activity measured in core material in the laboratory was also very low, requiring several weeks for products to accumulate. Molecular analysis of aquifer DNA (nested PCR followed by cloning and 16S rDNA sequencing) detected primarily sequences associated with the Nitrosospira genus throughout the cores at the down-gradient site and a smaller proportion from the Nitrosomonas genus in the deeper anoxic, NH4+ zone at the down-gradient site. Only a single Nitrosospira sequence was detected beneath the infiltration bed. Furthermore, the majority of Nitrosospira-associated sequences represent an unrecognized cluster. We conclude that an uncharacterized group associated with Nitrosospira dominate at the geochemically stable, down-gradient site, but found little evidence for Betaproteobacteria nitrifiers beneath the infiltration beds where geochemical conditions were more variable. PMID:19059672

  20. Microbial characterization of nitrification in a shallow, nitrogen-contaminated aquifer, Cape Cod, Massachusetts and detection of a novel cluster associated with nitrifying Betaproteobacteria

    USGS Publications Warehouse

    Miller, D.N.; Smith, R.L.

    2009-01-01

    Groundwater nitrification is a poorly characterized process affecting the speciation and transport of nitrogen. Cores from two sites in a plume of contamination were examined using culture-based and molecular techniques targeting nitrification processes. The first site, located beneath a sewage effluent infiltration bed, received treated effluent containing O2 (> 300????M) and NH4+ (51-800????M). The second site was 2.5??km down-gradient near the leading edge of the ammonium zone within the contaminant plume and featured vertical gradients of O2, NH4+, and NO3- (0-300, 0-500, and 100-200????M with depth, respectively). Ammonia- and nitrite-oxidizers enumerated by the culture-based MPN method were low in abundance at both sites (1.8 to 350??g- 1 and 33 to 35,000??g- 1, respectively). Potential nitrifying activity measured in core material in the laboratory was also very low, requiring several weeks for products to accumulate. Molecular analysis of aquifer DNA (nested PCR followed by cloning and 16S rDNA sequencing) detected primarily sequences associated with the Nitrosospira genus throughout the cores at the down-gradient site and a smaller proportion from the Nitrosomonas genus in the deeper anoxic, NH4+ zone at the down-gradient site. Only a single Nitrosospira sequence was detected beneath the infiltration bed. Furthermore, the majority of Nitrosospira-associated sequences represent an unrecognized cluster. We conclude that an uncharacterized group associated with Nitrosospira dominate at the geochemically stable, down-gradient site, but found little evidence for Betaproteobacteria nitrifiers beneath the infiltration beds where geochemical conditions were more variable.

  1. Microbial characterization of nitrification in a shallow, nitrogen-contaminated aquifer, Cape Cod, Massachusetts and detection of a novel cluster associated with nitrifying Betaproteobacteria

    NASA Astrophysics Data System (ADS)

    Miller, Daniel N.; Smith, Richard L.

    2009-01-01

    Groundwater nitrification is a poorly characterized process affecting the speciation and transport of nitrogen. Cores from two sites in a plume of contamination were examined using culture-based and molecular techniques targeting nitrification processes. The first site, located beneath a sewage effluent infiltration bed, received treated effluent containing O 2 (> 300 µM) and NH 4+ (51-800 µM). The second site was 2.5 km down-gradient near the leading edge of the ammonium zone within the contaminant plume and featured vertical gradients of O 2, NH 4+, and NO 3- (0-300, 0-500, and 100-200 µM with depth, respectively). Ammonia- and nitrite-oxidizers enumerated by the culture-based MPN method were low in abundance at both sites (1.8 to 350 g - 1 and 33 to 35,000 g - 1 , respectively). Potential nitrifying activity measured in core material in the laboratory was also very low, requiring several weeks for products to accumulate. Molecular analysis of aquifer DNA (nested PCR followed by cloning and 16S rDNA sequencing) detected primarily sequences associated with the Nitrosospira genus throughout the cores at the down-gradient site and a smaller proportion from the Nitrosomonas genus in the deeper anoxic, NH 4+ zone at the down-gradient site. Only a single Nitrosospira sequence was detected beneath the infiltration bed. Furthermore, the majority of Nitrosospira-associated sequences represent an unrecognized cluster. We conclude that an uncharacterized group associated with Nitrosospira dominate at the geochemically stable, down-gradient site, but found little evidence for Betaproteobacteria nitrifiers beneath the infiltration beds where geochemical conditions were more variable.

  2. AUTOMATING SHALLOW SEISMIC IMAGING

    SciTech Connect

    Steeples, Don W.

    2003-09-14

    The current project is a continuation of an effort to develop ultrashallow seismic imaging as a cost-effective method potentially applicable to DOE facilities. The objective of the present research is to develop and demonstrate the use of a cost-effective, automated method of conducting shallow seismic surveys, an approach that represents a significant departure from conventional seismic-survey field procedures. Initial testing of a mechanical geophone-planting device suggests that large numbers of geophones can be placed both quickly and automatically. The development of such a device could make the application of SSR considerably more efficient and less expensive. The imaging results obtained using automated seismic methods will be compared with results obtained using classical seismic techniques. Although this research falls primarily into the field of seismology, for comparison and quality-control purposes, some GPR data will be collected as well. In the final year of th e research, demonstration surveys at one or more DOE facilities will be performed. An automated geophone-planting device of the type under development would not necessarily be limited to the use of shallow seismic reflection methods; it also would be capable of collecting data for seismic-refraction and possibly for surface-wave studies. Another element of our research plan involves monitoring the cone of depression of a pumping well that is being used as a proxy site for fluid-flow at a contaminated site. Our next data set will be collected at a well site where drawdown equilibrium has been reached. Noninvasive, in-situ methods such as placing geophones automatically and using near-surface seismic methods to identify and characterize the hydrologic flow regimes at contaminated sites support the prospect of developing effective, cost-conscious cleanup strategies for DOE and others.

  3. The molecular basis of hypertrophic scars.

    PubMed

    Zhu, Zhensen; Ding, Jie; Tredget, Edward E

    2016-01-01

    Hypertrophic scars (HTS) are caused by dermal injuries such as trauma and burns to the deep dermis, which are red, raised, itchy and painful. They can cause cosmetic disfigurement or contractures if craniofacial areas or mobile region of the skin are affected. Abnormal wound healing with more extracellular matrix deposition than degradation will result in HTS formation. This review will introduce the physiology of wound healing, dermal HTS formation, treatment and difference with keloids in the skin, and it also review the current advance of molecular basis of HTS including the involvement of cytokines, growth factors, and macrophages via chemokine pathway, to bring insights for future prevention and treatment of HTS. PMID:27574672

  4. Epidermolysis Bullosa with Hypertrophic Pyloric Stenosis in a Newborn

    PubMed Central

    Ben Dhaou, Mahdi; Ammar, Saloua; Louati, Hamdi; Zitouni, Hayet; Jallouli, Mohamed; Mhiri, Riadh

    2015-01-01

    Epidermolysis bullosa (EB) is an inherited blistering disorder characterized by the fragility of the skin and mucous membranes. Extracutaneous manifestations can be associated. We report a unique concomitant occurrence of EB and hypertrophic pyloric stenosis in a newborn. PMID:26500857

  5. Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM)

    MedlinePlus

    Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2016 BroadcastMed, Inc. All rights reserved.

  6. Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM)

    MedlinePlus

    Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM) You must have Javascript enabled in your web browser. View Program Transcript Click Here to view the OR-Live, Inc. Privacy Policy ...

  7. MRI and MR tractography in bilateral hypertrophic olivary degeneration

    PubMed Central

    Sen, Debraj; Gulati, Yoginder S.; Malik, Virender; Mohimen, Aneesh; Sibi, Eranki; Reddy, Deepak Chandra

    2014-01-01

    Hypertrophic olivary degeneration is a trans-synaptic neuronal degeneration associated with hypertrophy of the inferior olivary nucleus due to a lesion in the triangle of Guillain-Mollaret. Familiarity with this entity on magnetic resonance imaging (MRI) is essential to avoid other erroneous ominous diagnoses. We present a case of bilateral hypertrophic olivary degeneration and discuss the etiopathogenesis and MRI findings in this entity. The contributory role of MR tractography in the diagnosis is also highlighted. PMID:25489133

  8. Activated keratinocytes in the epidermis of hypertrophic scars.

    PubMed Central

    Machesney, M.; Tidman, N.; Waseem, A.; Kirby, L.; Leigh, I.

    1998-01-01

    The etiology of hypertrophic scarring, a pathological end point of wound healing, is unknown. The scars most commonly occur when epithelialization has been delayed during, for example, the healing of deep dermal burn wounds. Hypertrophic scars are conventionally described as a dermal pathology in which the epidermis has only a passive role. In this study, the expression of keratin intermediate filament proteins and filaggrin has been investigated in the epidermis of hypertrophic scars and site-matched controls from the same patients. Hypertrophic scar epidermis was found to express the hyperproliferative keratins K6 and K16 in interfollicular epidermis in association with K17 and precocious expression of filaggrin. K16 mRNA was localized by in situ hybridization using a highly specific cRNA probe. In contrast to the immunohistochemical location of K16 protein, the K16 mRNA was found to be expressed in the basal cell layer of normal skin. In hypertrophic scars the mRNA distribution corroborated the abnormal K16 protein distribution. These results suggest the keratinocytes in hypertrophic scar epidermis have entered an alternative differentiation pathway and are expressing an activated phenotype. Activated keratinocytes are a feature of the early stages of wound healing producing growth factors that influence fibroblasts, endothelial cells, and the inflammatory response. We propose that cellular mechanisms in the pathogenesis of hypertrophic scarring are more complex than isolated dermal phenomena. The persistence of activated keratinocytes in hypertrophic scar epidermis implicates abnormal epidermal-mesenchymal interactions. Images Figure 1 Figure 3 PMID:9588880

  9. Morphological and immunochemical differences between keloid and hypertrophic scar.

    PubMed Central

    Ehrlich, H. P.; Desmoulière, A.; Diegelmann, R. F.; Cohen, I. K.; Compton, C. C.; Garner, W. L.; Kapanci, Y.; Gabbiani, G.

    1994-01-01

    There are two types of excessive scarring, keloid and hypertrophic scar. Contrary to hypertrophic scars, keloids do not regress with time, are difficult to revise surgically, and do not provoke scar contractures. These two lesions require different therapeutic approaches but are often confused because of an apparent lack of morphological differences. We have investigated the collagen organization and the possible presence of alpha-smooth muscle (SM) actin-expressing myofibroblasts in these conditions. Keloids contain large, thick collagen fibers composed of numerous fibrils closely packed together. In contrast hypertrophic scars exhibit modular structures in which fibroblastic cells, small vessels, and fine, randomly organized collagen fibers are present. We confirm that such nodular structures are always present in hypertrophic scar and rarely in keloid. Furthermore, only nodules of hypertrophic scars contain alpha-SM actin-expressing myofibroblasts. Electron microscopic examination supports the above-mentioned differences in collagen organization and in fibroblastic features and shows the presence of an amorphous extracellular material surrounding fibroblastic cells in keloid. The presence in hypertrophic scar myofibroblasts of alpha-SM actin, the actin isoform typical of vascular SM cells, may represent an important element in the pathogenesis of contraction. Interestingly, when placed in culture fibroblasts from hypertrophic scars and keloid express similar amounts of alpha-SM actin, suggesting that local microenvironmental factors influence in vivo the expression of this protein. Thus several morphological and immunohistochemical differences exist between hypertrophic scar and keloid that are useful for the biological and pathological characterization of the two lesions. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:8030742

  10. MR Imaging in Hypertrophic Cardiomyopathy: From Magnet to Bedside.

    PubMed

    Bogaert, Jan; Olivotto, Iacopo

    2014-11-01

    Hypertrophic cardiomyopathy ( HCM hypertrophic cardiomyopathy ), the most common genetically transmitted cardiac disorder, has been the focus of extensive research over the past 50 years. HCM hypertrophic cardiomyopathy is a multifaceted disease with highly heterogeneous genetic background, phenotypic expression, clinical presentation, and long-term outcome. Though most patients have an indolent course with a life expectancy comparable to that of the general population, early diagnosis and accurate risk profiling are essential to identify the sizeable subset at increased risk of sudden cardiac death or disease progression and heart failure-related complications, requiring aggressive management options. Imaging has a central role in the diagnosis and prognostic assessment of HCM hypertrophic cardiomyopathy patients, as well as screening of potentially affected family members. In this context, magnetic resonance (MR) imaging has recently emerged as an ideal complement to transthoracic echocardiography. Its multiparametric approach, fusing spatial, contrast, and temporal resolution, provides the clinician with detailed characterization of the HCM hypertrophic cardiomyopathy phenotype and assessment of its functional consequences including causes and site of dynamic obstruction, presence and extent of myocardial perfusion abnormalities, and fibrosis. Moreover, MR is key in differentiating HCM hypertrophic cardiomyopathy from "phenocopies"-that is, hearts with similar morphology but profoundly different etiology, such as amyloid or Anderson-Fabry disease. Long term, the incremental information provided by MR is relevant to planning of septal reduction therapies, identification of the early stages of end-stage progression, and stratification of arrhythmic risk. The aim of this review is to depict the increasingly important role of MR imaging in relation to the complexity of HCM hypertrophic cardiomyopathy , highlighting its role in clinical decision making. PMID:25340269

  11. The impact of early sulfur saturation and calc-crustal contamination on ore-forming process in the Posan mafic-ultramafic complex: Derived from the shallow depleted mantle, Beishan region, NW China

    NASA Astrophysics Data System (ADS)

    Ma, Jian; Lü, Xinbiao; Liu, Yanrong; Cao, Xiaofeng; Liu, Yuegao; Ruan, Banxiao; Adam, Munir Mohammed Abdalla

    2016-03-01

    The Posan ultramafic intrusion is one of the ~280 Ma Pobei mafic-ultramafic complexes located in the Beishan rift, on the northeastern margin of the Tarim Craton. Given that three finished drill holes reveal less economic mineralization, it is necessary to understand the ore potential of this little ultramafic intrusion. Detailed fieldwork shows that it is comprised of five stages of magma events. Among them, stages I, II and III are the mafic bodies dominated by gabbro, gabbronorite and olivine gabbro, and stages IV and V are the ultramafic bodies characterized by layered intrusions. Theoretically, the Posan ultramafic intrusion meets the first requirement of ore mineralization because of its high MgO contents (14.76%) of the parental magma. Moreover, the low Ni content (less than 1900 ppm) in olivine and the paragenesis of sulfides and spinel demonstrate that the Posan intrusion experienced early sulfur saturation before or during the fractional crystallization of spinel and olivine. This part of the sulfide, which may contain Ni-Cu or PGE mineralization, deserves to be the focus of future work. In stage IV, the continuous decrease of Ni contents in olivine with the fractional crystallization, the calc-crustal contamination (irregular distributed plagioclase, high Th/Yb ratios, Nb and Zr depletion and K, Rb, Ba, U, Th and Pb enrichment) instead of sulfur-rich crustal contamination, and the high level of oxygen fugacity (+2.1 < fO2QFM < +3.0) result in no obvious disseminated sulfides created in this stage. A clinopyroxene TiO2-Alz diagram confirms that the Beishan mafic-ultramafic complexes were formed in a rift-related circumstance rather than the arc-related cumulus. Low TiO2/Yb and Nb/Yb ratios reflect that the Beishan complexes were derived from the shallow depleted mantle without garnet. Considering the temporal and spatial relationship of the Tarim large igneous province and the large numbers of mafic-ultramafic intrusions in the Beishan region, it is

  12. Paraneoplastic hypertrophic osteopathy in 30 dogs

    PubMed Central

    Withers, S. S.; Johnson, E. G.; Culp, W. T. N.; Rodriguez, C. O.; Skorupski, K. A.; Rebhun, R. B.

    2016-01-01

    Paraneoplastic hypertrophic osteopathy (pHO) is known to occur in both canine and human cancer patients. While the pathology of pHO is well-described in the dog, very little information exists regarding the true clinical presentation of dogs affected with pHO. The primary objective of this study was to provide a more comprehensive clinical picture of pHO. To this end, we retrospectively identified 30 dogs and recorded data regarding presenting complaints and physical examination (PE) findings on the date of pHO diagnosis. As a secondary objective, any blood test results were also collected from the computerized records. The most common clinical signs included leg swelling, ocular discharge and/or episcleral injection, lameness, and lethargy. The most common haematological and serum biochemical abnormalities included anaemia, neutrophilia and elevated alkaline phosphatase. In addition to presenting a more detailed clinical description of pHO in the dog, these data support the previously described haematological, serum biochemical and PE abnormalities published in individual case reports. PMID:23489591

  13. Treatment of hypertrophic obstructive cardiomyopathy with verapamil.

    PubMed Central

    Kaltenbach, M; Hopf, R; Kober, G; Bussmann, W D; Keller, M; Petersen, Y

    1979-01-01

    Twenty-two patients with hypertrophic obstructive cardiomyopathy were treated with the calcium inhibitor, verapamil, which was administered in a mean oral dose of 480 mg per day. After an average of 15 months of treatment (4 to 24 months), the QRS amplitude in the electrocardiogram was significantly reduced from 4.2 to 3.8 mV. Heart volume calculated from chest x-ray films in the supine position decreased significantly from 858 to 766 ml per 1.73 m2. In 10 patients, follow-up heart catheterisation showed a decrease in left ventricular muscle mass in 7 patients and a slight increase in 3 patients. Coronary artery diameter decreased in 7 patients, increased in 1, and was unchanged in 2. The reduction in coronary artery diameter is considered to be a consequence of a reduced heart muscle mass. From all available clinical data it is concluded that verapamil treatment is superior to beta-blocker therapy. Images PMID:573129

  14. Hypertrophic pachymeningitis: significance of myeloperoxidase anti-neutrophil cytoplasmic antibody.

    PubMed

    Yokoseki, Akiko; Saji, Etsuji; Arakawa, Musashi; Kosaka, Takayuki; Hokari, Mariko; Toyoshima, Yasuko; Okamoto, Kouichirou; Takeda, Shigeki; Sanpei, Kazuhiro; Kikuchi, Hirotoshi; Hirohata, Shunsei; Akazawa, Kouhei; Kakita, Akiyoshi; Takahashi, Hitoshi; Nishizawa, Masatoyo; Kawachi, Izumi

    2014-02-01

    The aim of this study was to elucidate the characteristics, pathogenesis and treatment strategy of hypertrophic pachymeningitis that is associated with myeloperoxidase anti-neutrophil cytoplasmic antibody (ANCA). We retrospectively investigated clinical, radiological, immunological and pathological profiles of 36 patients with immune-mediated or idiopathic hypertrophic pachymeningitis, including 17 patients with myeloperoxidase-ANCA, four patients with proteinase 3-ANCA, six patients with other immune-mediated disorders, and nine patients with 'idiopathic' variety. Myeloperoxidase-ANCA-positive hypertrophic pachymeningitis was characterized by: (i) an elderly female predominance; (ii) 82% of patients diagnosed with granulomatosis with polyangiitis (previously known as Wegener's granulomatosis) according to Watts' algorithm; (iii) a high frequency of patients with lesions limited to the dura mater and upper airways, developing headaches, chronic sinusitis, otitis media or mastoiditis; (iv) a low frequency of patients with the 'classical or generalized form' of granulomatosis with polyangiitis involving the entire upper and lower airways and kidney, or progressing to generalized disease, in contrast to proteinase 3-ANCA-positive hypertrophic pachymeningitis; (v) less severe neurological damage according to the modified Rankin Scale and low disease activity according to the Birmingham Vasculitis Activity Score compared with proteinase 3-ANCA-positive hypertrophic pachymeningitis; (vi) increased levels of CXCL10, CXCL8 and interleukin 6 in cerebrospinal fluids, and increased numbers of T cells, neutrophils, eosinophils, plasma cells and monocytes/macrophages in autopsied or biopsied dura mater with pachymeningitis, suggesting TH1-predominant granulomatous lesions in hypertrophic pachymeningitis, as previously reported in pulmonary or renal lesions of granulomatosis with polyangiitis; and (vii) greater efficacy of combination therapy with prednisolone and

  15. Medicinal Plants for the Treatment of Hypertrophic Scars

    PubMed Central

    Ye, Qi; Wang, Su-Juan; Chen, Jian-Yu; Xin, Hai-Liang; Zhang, Hong

    2015-01-01

    Hypertrophic scar is a complication of wound healing and has a high recurrence rate which can lead to significant abnormity in aesthetics and functions. To date, no ideal treatment method has been established. Meanwhile, the underlying mechanism of hypertrophic scarring has not been clearly defined. Although a large amount of scientific research has been reported on the use of medicinal plants as a natural source of treatment for hypertrophic scarring, it is currently scattered across a wide range of publications. Therefore, a systematic summary and knowledge for future prospects are necessary to facilitate further medicinal plant research for their potential use as antihypertrophic scar agents. A bibliographic investigation was accomplished by focusing on medicinal plants which have been scientifically tested in vitro and/or in vivo and proved as potential agents for the treatment of hypertrophic scars. Although the chemical components and mechanisms of action of medicinal plants with antihypertrophic scarring potential have been investigated, many others remain unknown. More investigations and clinical trials are necessary to make use of these medical plants reasonably and phytotherapy is a promising therapeutic approach against hypertrophic scars. PMID:25861351

  16. Familial spontaneous complete heart block in hypertrophic cardiomyopathy.

    PubMed Central

    Louie, E K; Maron, B J

    1986-01-01

    Two siblings with hypertrophic cardiomyopathy developed spontaneous complete heart block requiring permanent pacemaker implantation at similar ages (29 and 33 years). The clinical, morphological, and haemodynamic expressions of hypertrophic cardiomyopathy differed considerably in these two patients. The sister had severe functional limitation due to dyspnoea, pronounced and diffuse left ventricular hypertrophy (maximum ventricular septal thickness of 41 mm), and left ventricular outflow obstruction (peak subaortic gradient of 75 mm Hg under basal conditions). In contrast the brother was symptom free, had only modest left ventricular hypertrophy which was confined to the anterior ventricular septum (maximal thickness of 16 mm), and had no echocardiographic evidence of subaortic obstruction. These dissimilar findings in siblings with hypertrophic cardiomyopathy suggest that the predisposition to develop complete heart block was probably genetically transmitted, although it was unrelated to the phenotypic and clinical expression of the disease. Images Fig. 2 Fig. 3 PMID:3707787

  17. Phonoechocardiography and intracardiac phonocardiography in hypertrophic cardiomyopathy.

    PubMed Central

    Shaver, J. A.; Alvares, R. F.; Reddy, P. S.; Salerni, R.

    1986-01-01

    The salient phonoechocardiographic features of patients having hypertrophic cardiomyopathy (HCM) with or without left ventricular outflow tract (LVOT) gradients are reviewed. Intracardiac sound and pressure recordings from high fidelity catheter-tipped micromanometers have documented that the precordial murmur is the summation of both the systolic ejection murmur (SEM) arising from the LVOT, as well as the mitral regurgitant murmur recorded from the left atrium. The intensity of the precordial murmur varies directly with the LVOT gradient, which in turn is determined primarily by the contractility and loading conditions of the left ventricle. Reversed splitting of the second heart sound (S2) with paradoxical respiratory movement is a common finding in HCM, and when present, almost always denotes a significant LVOT gradient. It is due to marked lengthening of the left ventricular ejection time secondary to prolongation of the contraction and relaxation phases of left ventricular systole. The presence of a fourth heart sound (S4) is the rule in HCM when normal sinus rhythm is present, and is a reflection of a forceful left atrial contraction into a hypertrophied noncompliant left ventricle. A third heart sound (S3) is also common in HCM, and often the initial vibrations occur before the 0 point of the apexcardiogram (ACG) and continue giving the auscultatory impression of a diastolic rumble. When associated with a loud S1, which is frequently present, the clinical presentation may mimic mitral stenosis. This is particularly true when the patient has chronic atrial fibrillation. Careful attention to evidence of marked left ventricular hypertrophy as well as the typical echocardiographic findings of HCM preclude this diagnosis. In conclusion, phonoechocardiography is a simple non-invasive technique which almost always makes the definitive diagnosis of HCM. PMID:3774689

  18. Familial idiopathic hypertrophic osteoarthropathy and cranial suture defects in children

    SciTech Connect

    Reginato, A.J.; Schiapachasse, V.; Guerrero, R.

    1982-05-01

    Three children with idiopathic hypertrophic osteoarthropathy and cranial suture defects are reported. The syndrome was recognized after birth and in the two oldest siblings, the cranial defects and subperiosteal bone formation resolved almost completely by age 4 and 6 years. The joint swelling and clubbing persisted and mild bone reabsorption of the distal phalanges became apparent at an older age. Two siblings and both parents had normal bone X-rays and no clubbing. This study confirms the association of cranial sutural defects and familial idopathic hypertrophic osteoarthropathy.

  19. [Left ventricular hypertrophy in the cat - "when hypertrophic cardiomyopathy is not hypertrophic cardiomyopathy"].

    PubMed

    Glaus, T; Wess, G

    2010-07-01

    According to WHO classification hypertrophic cardiomyopathy (HCM) is a primary genetic cardiomyopathy. Echocardiographically HCM is characterized by symmetric, asymmetric or focal left ventricular hypertrophy (LVH) without recognizable underlying physical cause. However, echocardiographically HCM in cats may not be distinguishable from other causes of a thick appearing left ventricle. Hypovolemia can look like a hypertrophied ventricle but is basically only pseudohypertrophic. Well recognized and logical physical causes of LVH include systemic hypertension and outflow obstruction. LVH similar to HCM may also be found in feline hyperthyroidism. The context of the disease helps to differentiate these physical / physiological causes of LVH. Difficult to distinguish from HCM, particularly when based on a snapshot of a single echocardiographic exam, are myocarditis and . Only the clinical and echocardiographic course allow a reasonably confident etiological diagnosis and the differentiation between HCM and secondary LVH. PMID:20582898

  20. Hypertrophic osteoarthropathy presenting as unilateral cellulitis with successful treatment using pamidronate disodium.

    PubMed

    Bernardo, Sebastian G; Emer, Jason J; Burnett, Mark E; Gordon, Marsha

    2012-09-01

    Hypertrophic pulmonary osteoarthropathy is a paraneoplastic syndrome seen in patients with lung cancer. This condition is characterized by the presence of digital clubbing, periosteal thickening, synovial thickening, and severe pain of the affected joints. Other syndromes exhibiting clubbing may or may not have underlying diseases causing their manifestation. An example is primary hypertrophic osteoarthropathy, or pachydermoperiostosis. While clubbing makes up part of the clinical picture in both hypertrophic pulmonary osteoarthropathy and hypertrophic osteoarthropathy, the latter has no underlying disease associations. Rather, primary hypertrophic osteoarthropathy is familial, idiopathic, and has a chronic course often beginning during puberty in males. Secondary hypertrophic osteoarthropathy is an acquired form of clubbing that is classically associated with lung disease. However, it has also been associated with diseases of the heart, liver, and intestines. In the setting of pulmonary malignancy, secondary hypertrophic osteoarthropathy is known as hypertrophic pulmonary osteoarthropathy. Hypertrophic pulmonary osteoarthropathy has a distinct constellation of clinical findings that includes intractable pain often refractory to treatments other than resolution of the underlying disease process. The authors herein report a case of hypertrophic pulmonary osteoarthropathy masquerading as recurrent lower extremity cellulitis with chronic hand and foot pain in the setting of pulmonary malignancy that responded dramatically to intravenous pamidronate disodium (a bisphosphonate). Given the rarity of hypertrophic osteoarthropathy associated with lung cancer and the difficulty with pain management in such circumstances, the authors present the following case in which pain was mitigated by treatment with bisphosphonate therapy. PMID:23050033

  1. Red blood cell sodium heteroexchange in familial primary hypertrophic cardiomyopathy.

    PubMed

    Semplicini, A; Mozzato, M G; Bongiovi, S; Marzola, M; Macor, F; Ceolotto, G; Serena, L; Pessina, A C

    1994-03-01

    The hallmark of primary hypertrophic cardiomyopathy is an inappropriate myocardial hypertrophy, linked to myofibril disarray of the left ventricle. Its variable clinical expression may be due to genetic heterogeneity and variable penetrance. Since we have recently shown that abnormalities of cation transport in the erythrocytes are associated with cardiac hypertrophy in essential hypertensives and insulin-dependent diabetics, we have investigated the relationship between cardiac anatomy and function and red cell Li+/Na+ and Na+/H+ exchange in 33 relatives of a patient who died of cardiac failure and was found to have a primary hypertrophic cardiomyopathy at autopsy. According to echocardiographic examination, 11 members of the family also had a hypertrophic cardiomyopathy, with a family distribution compatible with autosomal dominant genetic transmission and variable penetrance. Red cell Li+/Na+ and Na+/H+ exchange were not significantly different in the affected members as compared to the unaffected, but in the former, after correction for potentially confounding variables, interventricular septum thickness was positively correlated to Na+/H+ exchange and diastolic function (Area E/Area A and Vmax E/Vmax A) negatively correlated to Li+/Na+ exchange. Since a generalized overactivity of the cell membrane Na+/H+ exchange, reflected by increased Na+/H+ and Li+/Na+ exchanges in the red cells, could favour cellular growth and diastolic dysfunction, our data suggest that abnormalities of cell membrane cation transport could play a role in the phenotypic expression of hypertrophic cardiomyopathy. PMID:8013504

  2. Hypertrophic Cardiomyopathy: Practical Steps for Preventing Sudden Death.

    ERIC Educational Resources Information Center

    Maron, Barry J.

    2002-01-01

    Hypertrophic cardiomyopathy (HCM) is a rare cause of death among athletes, with deaths occurring in young, apparently healthy people. Differentiating HCM from conditioning hypertrophy is challenging. Routine detection involves family history, physical examination, electrocardiography, and echocardiography. Keys to differential diagnosis include…

  3. Hypertrophic cardiomyopathy in infants: clinical features and natural history

    SciTech Connect

    Maron, B.J.; Tajik, A.J.; Ruttenberg, H.D.; Graham, T.P.; Atwood, G.F.; Victorica, B.E.; Lie, J.T.; Roberts, W.C.

    1982-01-01

    The clinical and morphologic features of hypertrophic cardiomyopathy in 20 patients recognized as having cardiac disease in the first year of life are described. Fourteen of these 20 infants were initially suspected of having heart disease solely because a heart murmur was identified. However, the infants showed a variety of clinical findings, including signs of marked congestive heart failure (in the presence of nondilated ventricular cavities and normal or increased left ventricular contractility) and substantial cardiac enlargement on chest radiograph. Other findings were markedly different from those usually present in older children and adults with hypertrophic cardiomyopathy (e.g., right ventricular hypertrophy on the ECG and cyanosis). Consequently, in 14 infants, the initial clinical diagnosis was congenital cardiac malformation other than hypertrophic cardiomyopathy. The clinical course was variable in these patients, but the onset of marked congestive heart failure in the first year of life appeared to be an unfavorable prognostic sign; nine of the 11 infants with congestive heart failure died within the first year of life. In infants with hypertrophic cardiomyopathy, unlike older children and adults with this condition, sudden death was less common (two patients) than death due to progressive congestive heart failure.

  4. Difficulty of diagnosing infected hypertrophic pseudarthrosis by radionuclide imaging

    SciTech Connect

    Hadjipavlou, A.; Lisbona, R.; Rosenthall, L.

    1983-02-01

    Hypertrophic pseudarthrosis was studied with /sup 99m/Tc MDP and /sup 67/Ga citrate in 11 patients. Two of the 11 pseudarthroses were complicated by infection. A high concentration of both radiopharmaceuticals was obtained at all 11 sites and their distribution patterns were identical. It was therefore impossible to distinguish the infected from the noninfected pseudarthroses by using /sup 67/Ga.

  5. Analysis of hypertrophic and normal scar gene expression with cDNA microarrays.

    PubMed

    Tsou, R; Cole, J K; Nathens, A B; Isik, F F; Heimbach, D M; Engrav, L H; Gibran, N S

    2000-01-01

    Hypertrophic scar is one form of abnormal wound healing. Previous studies have suggested that hypertrophic scar formation results from altered gene expression of extracellular matrix molecules. A broadscale evaluation of gene expression in hypertrophic scars has not been reported. To better understand abnormalities in hypertrophic scar gene expression, we compared messenger RNA expression in hypertrophic scars, normal scars, and uninjured skin with the use of complementary (c)DNA microarrays. Total RNA was extracted from freshly excised human hypertrophic scars, normal scars, or uninjured skin and reverse transcribed into cDNA with the incorporation of [33P] deoxycytidine triphosphate. The resulting radioactive cDNA probes were hybridized onto cDNA microarrays of 4000 genes. Hybridization signals were normalized and analyzed. In the comparison of tissue samples, mean intensities were calculated for each gene within each group (hypertrophic scars, normal scars, and uninjured skin). Ratios of the mean intensities of hypertrophic scars to normal scars, hypertrophic scars to uninjured skin, and normal scars to uninjured skin were generated. A ratio that was greater than 1 indicated upregulation of any particular gene and a ratio that was less than 1 indicated downregulation of any particular gene. Our data indicated that 142 genes were overexpressed and 50 genes were underexpressed in normal scars compared with uninjured skin, 107 genes were overexpressed and 71 were underexpressed in hypertrophic scars compared with uninjured skin, and 44 genes were overexpressed and 124 were underexpressed in hypertrophic scars compared with normal scars. Our analysis of collagen, growth factor, and metalloproteinase gene expression confirmed that our molecular data were consistent with published biochemical and clinical observations of normal scars and hypertrophic scars. cDNA microarray analysis provides a powerful tool for the investigation of differential gene expression in

  6. Hypertrophic Cardiomyopathy Registry (HCMR): The rationale and design of an international, observational study of hypertrophic cardiomyopathy

    PubMed Central

    Kramer, Christopher M.; Appelbaum, Evan; Desai, Milind Y.; Desvigne-Nickens, Patrice; DiMarco, John P.; Friedrich, Matthias G.; Geller, Nancy; Heckler, Sarahfaye; Ho, Carolyn Y.; Jerosch-Herold, Michael; Ivey, Elizabeth A.; Keleti, Julianna; Kim, Dong-Yun; Kolm, Paul; Kwong, Raymond Y.; Maron, Martin S.; Schulz-Menger, Jeanette; Piechnik, Stefan; Watkins, Hugh; Weintraub, William S.; Wu, Pan; Neubauer, Stefan

    2015-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common monogenic heart disease with a frequency as high as 1 in 200. In many cases, HCM is caused by mutations in genes encoding the different components of the sarcomere apparatus. HCM is characterized by unexplained left ventricular hypertrophy (LVH), myofibrillar disarray, and myocardial fibrosis. The phenotypic expression is quite variable. While the majority of patients with HCM are asymptomatic, serious consequences are experienced in a subset of affected individuals who present initially with sudden cardiac death (SCD) or progress to refractory heart failure (HF). The HCMR study is a National Heart Lung and Blood Institute (NHLBI)-sponsored 2750 patient, 41 site, international registry and natural history study designed to address limitations in extant evidence to improve prognostication in HCM (NCT01915615). In addition to collection of standard demographic, clinical, and echocardiographic variables, patients will undergo state-of-the-art cardiac magnetic resonance (CMR) for assessment of left ventricular (LV) mass and volumes as well as replacement scarring and interstitial fibrosis. In addition, genetic and biomarker analysis will be performed. HCMR has the potential to change the paradigm of risk stratification in HCM, using novel markers to identify those at higher risk. PMID:26299218

  7. Effects of Noscarna™ on hypertrophic scarring in the rabbit ear model: histopathological aspects.

    PubMed

    Lee, Dong Won; Ku, Sae Kwang; Cho, Hyuk Jun; Kim, Jeong Hwan; Hiep, Tran Tuan; Han, Sang Duk; Kim, Bo Gyun; Kang, Min Kyung; Do, Eui Seon; Jun, Joon Ho; Jang, Sun Woo; Son, Mi-Won; Sohn, Young Taek; Choi, Han-Gon; Yong, Chul Soon; Kim, Jong Oh

    2012-11-01

    In this study, we evaluated the effects of silicone-based gel on the healing of hypertrophic scars in the rabbit ear model. After 4-week application of silicone-based gel containing allantoin, dexpanthenol and heparin (Noscarna™) to scars in a rabbit ear model of hypertrophic scarring, significant improvements in hypertrophic scar healing and a great loss of skin pigment were observed compared to the non-treated control, base or silicone control-treated scars. Furthermore, histological analysis of Noscarna™-treated scars revealed a significant reduction in scar elevation index (SEI), anterior skin and epithelial thicknesses, inflammatory cells, vessels, collagen disorganization and fibroblasts compared to all control hypertrophic scars. Furthermore, Noscarna™ showed more favorable effects on hypertrophic scars than a commercial product, Contractubex®. Therefore, these results clearly demonstrated that the newly developed silicone-based gel, Noscarna™, could be a promising formulation as an effective therapeutic agent for hypertrophic scars. PMID:23212642

  8. Primary antiphospholipid syndrome, hypertrophic non-obstructive cardiomyopathy and hypotelorism.

    PubMed

    Kellermair, Joerg; Kammler, Juergen; Laubichler, Peter; Steinwender, Clemens

    2016-01-01

    Antiphospholipid syndrome (APS) is an autoimmune disorder associated with arterial/venous thrombosis. Cardiac manifestations of APS include valve stenosis/insufficiency, coronary artery disease and myocardial dysfunction presenting as dilated cardiomyopathy. In the following report, we present the case of a man with primary APS, hypertrophic non-obstructive cardiomyopathy and hypotelorism-a combination that has not yet been reported in the literature. PMID:27048398

  9. Hypertrophic osteopathy associated with a renal adenoma in a cat.

    PubMed

    Johnson, Robert L; Lenz, Stephen D

    2011-01-01

    Hypertrophic osteopathy is a hyperostotic syndrome of the appendicular skeleton that is most commonly associated with intrathoracic neoplasia or inflammation. The condition is rarely associated with intra-abdominal lesions. The majority of cases have occurred in dogs and human beings, with fewer cases reported in cats, horses, and other species. A 15-year-old male neutered Domestic Shorthair cat presented for swollen limbs and difficulty in ambulation. Radiographs and gross postmortem revealed severe periosteal hyperostosis of the diaphysis and metaphysis of all 4 limbs, including the humerus, radius, ulna, carpi, metacarpi, femur, tibia, tarsi, metatarsi, and phalanges. The axial skeleton was spared. Hyperostotic lesions were characterized microscopically by lamellar bony trabeculae separated by adipocytes and scant hematopoietic tissue. In several areas, fibrovascular connective tissue, woven bone, and islands of cartilage were also present. A 2.5 cm × 2.5 cm perirenal neoplasm compressed the left kidney and adrenal gland. This mass consisted of well-differentiated tubules of cuboidal epithelial cells and was most consistent with a renal tubular adenoma, because mitotic figures were rare, and no distant metastases were found. Thoracic pathology was absent. Hyperostosis was consistent with hypertrophic osteopathy secondary to the renal adenoma. The pathogenesis of hypertrophic osteopathy is uncertain, but predominant theories point to increased peripheral circulation and angiogenesis as a key initiating event. Recent literature highlights the potential role of vascular endothelial growth factor and platelet-derived growth factor in the human condition. The mechanism by which this renal adenoma caused hypertrophic osteopathy is unknown. PMID:21217054

  10. Hypertrophic neuropathy in Noonan syndrome with multiple lentigines.

    PubMed

    Maridet, Claire; Sole, Guilhem; Morice-Picard, Fanny; Taieb, Alain

    2016-06-01

    RASopathies comprise several genetic syndromes with mainly cardio-facial-cutaneous manifestations. We report a patient with Noonan syndrome with multiple lentigines (NSML) due to a PTPN11 (p.Thr468Met) mutation associated with hypertrophic neuropathy of lumbar plexus in an adult woman, initially referred for neuropathic pain. Differential diagnosis of neurofibromatosis type 1 (NF1) and other RASopathies is difficult without molecular testing. © 2016 Wiley Periodicals, Inc. PMID:26952712

  11. [The sonographic diagnosis of hypertrophic stenosis of the pylorus].

    PubMed

    Rodríguez, R I; Briceño de Rodríguez, J A; Urrutia, M

    1993-09-01

    The clinical records of 18 children were studied, between 15 and 60 days old. They were hospitalized due to vomiting and diagnosis of suspected pyloric hypertrophic stenosis (PHS). The sonography confirmed the diagnosis in 8 children, by the thickening of the muscular layer and enlargement of the pyloric canal. The surgery (pyloromyotomy) ratified the diagnosis in all 8 children. They all were in good health after being operated. PMID:8146343

  12. [The sonographic diagnosis of hypertrophic stenosis of the pylorus].

    PubMed

    Rodríguez, R I; Briceño de Rodríguez, J A; Urrutia, M

    1993-05-01

    The clinical records of 18 children were studied, between 15 and 60 days old. They were hospitalized due to vomiting and diagnosis of suspected pyloric hypertrophic stenosis (PHS). The sonography confirmed the diagnosis in 8 children, by the thickening of the muscular layer and enlargement of the pyloric canal. The surgery (pyloromyotomy) ratified the diagnosis in all 8 children. They all were in good health after being operated. PMID:8327749

  13. Nd:YAG Laser Treatment of Keloids and Hypertrophic Scars

    PubMed Central

    Akaishi, Satoshi; Koike, Sachiko; Dohi, Teruyuki; Kobe, Kyoko; Hyakusoku, Hiko; Ogawa, Rei

    2012-01-01

    Pathological cutaneous scars such as keloids and hypertrophic scars (HSs) are characterized by a diffuse redness that is caused by the overgrowth of capillary vessels due to chronic inflammation. Our group has been using long-pulsed, 1064-nm Nd:YAG laser in noncontact mode with low fluence and a submillisecond pulse duration to treat keloids and hypertrophic scars since 2006 with satisfactory results. The present study examined the efficacy of this approach in 22 Japanese patients with keloids (n = 16) or hypertrophic scars (n = 6) who were treated every 3 to 4 weeks. Treatment settings were as follows: 5 mm spot size diameter; 14 J/cm2 energy density; 300 μs exposure time per pulse; and 10 Hz repetition rate. The responses of the pathological scars to the treatment were assessed by measuring their erythema, hypertrophy, hardness, itching, and pain or tenderness. Moreover, skin samples from 3 volunteer patients were subjected to histological evaluation and 5 patients underwent thermography during therapy. The average total scar assessment score dropped from 9.86 to 6.34. Hematoxylin and eosin staining and Elastica Masson-Goldner staining showed that laser treatment structurally changed the tissue collagen. This influence reached a depth of 0.5 to 1 mm. Electron microscopy revealed plasma protein leakage, proteoglycan particles, and a change in the collagen fiber fascicles. Further analyses revealed that noncontact mode Nd:YAG laser treatment is highly effective for keloids and hypertrophic scars regardless of patient age, the origin and multiplicity of scarring, the location of the scar(s), or the tension on the scar. PMID:22259645

  14. Monomelic hypertrophic osteoarthropathy secondary to aortic prosthesis infection.

    PubMed

    Hernández, M V; Antonio del Olmo, J; Orellana, C; Mestres, C A; Mũnoz-Gómez, J

    1995-01-01

    We describe a case of hypertrophic osteoarthropathy (HOA), exclusively located in the left lower leg and secondary to vascular prosthesis infection. Four years before, the patient underwent aortofemoral bifurcation grafting because of a ruptured aortic aneurysm. The investigations revealed prosthesis infection by Pseudomona aeruginosa and Bacteroides thetaiotamicron. The onset of HOA in a patient with a vascular prosthesis can help to achieve an early diagnosis of graft infection. The literature on this uncommon association is reviewed. PMID:7699670

  15. Familial hypertrophic cardiomyopathy: vectorcardiographic findings in echocardiographically unaffected relative.

    PubMed Central

    Loperfido, F; Fiorilli, R; Digaetano, A; Di Gennaro, M; Santarelli, P; Bellocci, F; Coppola, E; Zecchi, P

    1982-01-01

    The electrocardiographic and vectorcardiographic (Frank system) features of the first degree relatives of subjects with documented familial hypertrophic cardiomyopathy were analysed. A total of nine affected members and 29 relatives were examined in four families. THe subjects were considered to be affected when the septal to free posterior wall thickness ratio exceeded 1.3 at M-mode echocardiography. Four relatives had asymmetric septal hypertrophy. Among 25 relatives without evidence of asymmetric septal hypertrophy, two over 20 years and 10 under 20 years of age showed increased voltage of QRS anterior forces (Qz amplitude greater than 0.80 mV) on the orthogonal electrocardiogram. The vectorcardiographic data of the relatives under 20 years of age without evidence of asymmetric septal hypertrophy (18 subjects) were compared with those of 38 normal control subjects of comparable age range. The young relatives without disproportionate septal hypertrophy had significantly greater Qz amplitude and Q/Rz ratio than the normal control subjects. In contrast, the echocardiographic data were not significantly different. We suggest that the electrocardiographic finding of abnormal anterior forces in one or more first degree relatives of subjects with documented hypertrophic cardiomyopathy may constitute a valuable aid in ascertaining the genetic transmission of the disease and in recognising affected members without echocardiographic evidence of hypertrophic cardiomyopathy. Images PMID:7200794

  16. Pregnancy related complications in women with hypertrophic cardiomyopathy

    PubMed Central

    Thaman, R; Varnava, A; Hamid, M S; Firoozi, S; Sachdev, B; Condon, M; Gimeno, J R; Murphy, R; Elliott, P M; McKenna, W J

    2003-01-01

    Objectives: To determine whether pregnancy is well tolerated in hypertrophic cardiomyopathy. Setting: Referral clinic. Design: The study cohort comprised 127 consecutively referred women with hypertrophic cardiomyopathy. Forty (31.5%) underwent clinical evaluation before pregnancy. The remaining 87 (68.5%) were referred after their first pregnancy. All underwent history, examination, electrocardiography, and echocardiography. Pregnancy related symptoms and complications were determined by questionnaire and review of medical and obstetric records where available. Results: There were 271 pregnancies in total. Thirty six (28.3%) women reported cardiac symptoms in pregnancy. Over 90% of these women had been symptomatic before pregnancy. Symptoms deteriorated during pregnancy in fewer than 10%. Of the 36 women with symptoms during pregnancy, 30 had further pregnancies. Symptoms reoccurred in 18 (60%); symptomatic deterioration was not reported. Heart failure occurred postnatally in two women (1.6%). No complications were reported in 19 (15%) women who underwent general anaesthesia and in 22 (17.4%) women who received epidural anaesthesia, three of whom had a significant left ventricular outflow tract gradient at diagnosis after pregnancy. Three unexplained intrauterine deaths occurred in women taking cardiac medication throughout pregnancy. No echocardiographic or clinical feature was a useful indicator of pregnancy related complications. Conclusions: Most women with hypertrophic cardiomyopathy tolerate pregnancy well. However, rare complications can occur and therefore planned delivery and fetal monitoring are still required for some patients. PMID:12807849

  17. A nude mouse model of hypertrophic scar shows morphologic and histologic characteristics of human hypertrophic scar.

    PubMed

    Momtazi, Moein; Kwan, Peter; Ding, Jie; Anderson, Colin C; Honardoust, Dariush; Goekjian, Serge; Tredget, Edward E

    2013-01-01

    Hypertrophic scar (HSc) is a fibroproliferative disorder that occurs following deep dermal injury. Lack of a relevant animal model is one barrier toward better understanding its pathophysiology. Our objective is to demonstrate that grafting split-thickness human skin onto nude mice results in survival of engrafted human skin and murine scars that are morphologically, histologically, and immunohistochemically consistent with human HSc. Twenty nude mice were xenografted with split-thickness human skin. Animals were euthanized at 30, 60, 120, and 180 days postoperatively. Eighteen controls were autografted with full-thickness nude mouse skin and euthanized at 30 and 60 days postoperatively. Scar biopsies were harvested at each time point. Blinded scar assessment was performed using a modified Manchester Scar Scale. Histologic analysis included hematoxylin and eosin, Masson's trichrome, toluidine blue, and picrosirius red staining. Immunohistochemistry included anti-human human leukocyte antigen-ABC, α-smooth muscle actin, decorin, and biglycan staining. Xenografted mice developed red, shiny, elevated scars similar to human HSc and supported by blinded scar assessment. Autograft controls appeared morphologically and histologically similar to normal skin. Xenografts survived up to 180 days and showed increased thickness, loss of hair follicles, adnexal structures and rete pegs, hypercellularity, whorled collagen fibers parallel to the surface, myofibroblasts, decreased decorin and increased biglycan expression, and increased mast cell density. Grafting split-thickness human skin onto nude mice results in persistent scars that show morphologic, histologic, and immunohistochemical consistency with human HSc. Therefore, this model provides a promising technique to study HSc formation and to test novel treatment options. PMID:23126488

  18. Role of verapamil in preventing and treating hypertrophic scars and keloids.

    PubMed

    Wang, Ru; Mao, Yu; Zhang, Zhenyu; Li, Zhengyong; Chen, Junjie; Cen, Ying

    2016-08-01

    Keloid and hypertrophic scars are difficult to manage and remain a therapeutic challenge. Verapamil has shown a great potential in the management of keloid and hypertrophic scars. Comparing with conventional corticosteroid injections, verapamil could improve the appearance of keloid and hypertrophic scars, and is associated with a lower incidence of adverse effects. Is verapamil an effective alternative modality in the prevention and treatment of keloid and hypertrophic scars? The aim of this study was to assess the effectiveness of verapamil in preventing and treating keloid and hypertrophic scars. Searches were conducted in Medline, EMbase and Cochrane databases from 1974 to January 2015. The selection of articles was limited to human subjects. Five randomised controlled trials (RCTs) or cluster-randomised trials or controlled clinical trials (CCTs) comparing the efficacy of verapamil with conventional treatments were identified. The results showed that verapamil could improve keloid and hypertrophic scars, and was not significantly different from conventional corticosteroid injections. Few adverse effects were observed. However, this result should be considered carefully, as most of the included studies have a high risk of bias because of issues with randomization, allocation concealment, blinding, incomplete outcomes and selective reporting. In conclusion, verapamil could act as an effective alternative modality in the prevention and treatment of keloid and hypertrophic scars. More high-quality, multiple-centre, large-sample (RCTs) are required to define the role of verapamil in preventing and treating keloid and hypertrophic scars. PMID:25968157

  19. Thallium-201 imaging in a patient with mid-ventricular hypertrophic obstructive cardiomyopathy

    SciTech Connect

    Wakasugi, S.; Shibata, N.; Kobayashi, T.; Fudemoto, Y.; Hasegawa, Y.; Nakano, S.

    1988-10-01

    Findings specific to mid-ventricular hypertrophic obstructive cardiomyopathy were obtained in a patient by means of /sup 201/Tl planar myocardial scintigraphy. Namely, a myocardial band-like image dividing the left ventricle into two chambers was clearly shown. This was identified as hypertrophic muscle with sphincter-like muscular stenosis at the mid portion of the left ventricle.

  20. A Novel Triple Medicine Combination Injection for the Resolution of Keloids and Hypertrophic Scars

    PubMed Central

    Gold, Michael H.

    2014-01-01

    Keloids and hypertrophic scars remain one of the more difficult treatment concerns for clinicians. A variety of therapies have been used in the past with moderate success. On occasion, combination therapy has been used to treat these lesion, in an attempt to lessen the symptoms of pain and pruritus that often accompanies keloids and hypertrophic scars, as well as treating the actual lesions themselves. A novel triple combination injection process is introduced here in an attempt to further reduce the signs and symptoms of these lesions. The combination includes 5-fluoruracil, triamcinolone acetonide, and hyaluronidase. All three work in concert to treat keloids and hypertrophic scars, and this is the first work at looking at these medicines given together, at the same time, in a series of recalcitrant keloids and hypertrophic scars. The positive results warrant further investigation and hope for those with keloids and hypertrophic scars. PMID:25489380

  1. Sports and Exercise in Athletes with Hypertrophic Cardiomyopathy.

    PubMed

    Alpert, Craig; Day, Sharlene M; Saberi, Sara

    2015-07-01

    Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease and one of the most common causes of sudden cardiac death (SCD). Current guidelines restrict the participation of patients with HCM in competitive sports, limiting the health benefits of exercise. However, many individuals with HCM have safely participated in sports, with a low incidence of SCD. Improved stratification of patients and desired activity may allow most individuals with HCM to engage in physical activity safely. Therefore, physicians should create an individualized approach in guiding each patient with HCM eager to enjoy the benefits of physical activity in a safe manner. PMID:26100424

  2. Pseudoidiopathic hypertrophic subaortic stenosis in a patient with cardiac tamponade.

    PubMed

    Pandi, A S; Kronik, G

    1987-04-01

    A 53-year-old woman with a large pericardial effusion and tamponade presented with signs of IHSS including a grade 4/6 apical systolic murmur, severe SAM, early systolic aortic valve closure and a small hypercontractile left ventricle but at most borderline left ventricular hypertrophy. Following pericardiocentesis, the clinical and echocardiographic signs of subvalvular obstruction resolved completely. One year later the patient died of bronchial carcinoma and no evidence of hypertrophic cardiomyopathy was found at autopsy. Pericardial tamponade should be added to the list of possible causes of dynamic subvalvular obstruction in a structurally normal heart. PMID:3829760

  3. Shallow, non-pumped wells: a low-energy alternative for cleaning polluted groundwater.

    PubMed

    Hudak, Paul F

    2013-07-01

    This modeling study evaluated the capability of non-pumped wells with filter media for preventing contaminant plumes from migrating offsite. Linear configurations of non-pumped wells were compared to permeable reactive barriers in simulated shallow homogeneous and heterogeneous aquifers. While permeable reactive barriers enabled faster contaminant removal and shorter distances of contaminant travel, non-pumped wells also prevented offsite contaminant migration. Overall, results of this study suggest that discontinuous, linear configurations of non-pumped wells may be a viable alternative to much more costly permeable reactive barriers for preventing offsite contaminant travel in some shallow aquifers. PMID:23609453

  4. Restrictive myocardium with an unusual pattern of apical hypertrophic cardiomyopathy.

    PubMed

    Sato, Takuma; Matsuyama, Taka-Aki; Seguchi, Osamu; Murata, Yoshihiro; Sunami, Haruki; Yanase, Masanobu; Fujita, Tomoyuki; Ishibashi-Ueda, Hatsue; Nakatani, Takeshi

    2015-01-01

    Loeffler endocarditis is a fibrous restrictive cardiomyopathy thought to be caused by persistent eosinophilia. It is difficult to diagnose, and the prognosis is often poor if the underlying eosinophilia is not promptly recognized and treated. We describe the case of a middle-aged woman treated for hypertrophic cardiomyopathy first detected during a routine check-up at age 35years but whose symptoms gradually progressed over the next 14years. Right ventricular biopsy showed extensive fibrosis of the endocardial tissue, and right heart catheterization revealed right heart failure and a low cardiac output state. Ultimately, she became reliant on inotropic and mechanical cardiovascular support, but we were not able to bridge her to transplant. Autopsy findings were typical of endocardial fibroelastosis, but she had not suffered from any tropical disease or traveled to high-risk areas. The presence of abnormal capillary proliferation suggested a diagnosis of Loeffler endocarditis. Nonetheless, apart from a 6-month period of eosinophilia 7years before her death, a history of well-controlled asthma and several drug sensitivities, we were unable to definitively identify the disease trigger. It is critical to diagnose and treat the underlying eosinophilia of Loeffler endocarditis to avoid a poor prognosis. This case highlights the importance of considering the diagnosis of eosinophilic endomyocarditis in patients with an unusual pattern of apical hypertrophic cardiomyopathy (or myocardial fibrosis of unknown etiology), even when there is no apparent history of eosinophilia. PMID:25804825

  5. ANCA-Associated Systemic Vasculitis Presenting With Hypertrophic Spinal Pachymeningitis

    PubMed Central

    Li, Xia; Zhao, Jiuliang; Wang, Qian; Fei, Yunyun; Zhao, Yan

    2015-01-01

    Abstract Reports of hypertrophic pachymeningitis associated with myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) localized exclusively in the spine were quite rare. Two cases of ANCA-associated systemic vasculitis (AASV) presenting with hypertrophic spinal pachymeningitis (HSP) causing low back pain and numbness are described. Two patients showed prominent systemic and local inflammatory reactions manifested as fever, elevated levels of erythrocyte sedimentation rate and C-reactive protein, and markedly increased levels of total protein of cerebrospinal fluid. The gadolinium (Gd)-enhanced T1-weighted magnetic resonance imaging scan of spinal cord demonstrated diffuse spinal dura matter thickening. Additionally, simple microscopic hematuria was found in 1 case suggestive of renal involvement and the other 1 complicated with interstitial lung disease. Then, a diagnosis of HSP secondary to AASV was made. Combination therapy of corticosteroids and cyclophosphamide produced a rapid improvement in the clinical symptoms and laboratory parameters. Followed up for 6 months, 1 case relapsed when the dosage of prednisone was tapered to 10 mg daily. Since the patient refused rituximab-based regimen, an immunosuppressive triple-therapy (corticosteroid, cyclophosphamide, and azathioprine) was initiated and brought control of the disease during the subsequent 6 months of follow-up. HSP is a relatively rare form of central nervous system involvement of AASV. Early recognition and intervention are of great significance since the pathogenesis of HSP starts with an inflammatory and fibrosing process. PMID:26579814

  6. Subaortic and midventricular obstructive hypertrophic cardiomyopathy with extreme segmental hypertrophy

    PubMed Central

    Efthimiadis, Georgios K; Giannakoulas, Georgios; Parcharidou, Despina G; Ziakas, Antonios G; Papadopoulos, Christodoulos E; Karoulas, Takis; Pliakos, Christodoulos; Parcharidis, Georgios

    2007-01-01

    Background Subaortic and midventricular hypertrophic cardiomyopathy in a patient with extreme segmental hypertrophy exceeding the usual maximum wall thickness reported in the literature is a rare phenomenon. Case Presentation A 19-year-old man with recently diagnosed hypertrophic cardiomyopathy (HCM) was referred for sudden death risk assessment. The patient had mild exertional dyspnea (New York Heart Association functional class II), but without syncope or chest pain. There was no family history of HCM or sudden death. A two dimensional echocardiogram revealed an asymmetric type of LV hypertrophy; anterior ventricular septum = 49 mm; posterior ventricular septum = 20 mm; anterolateral free wall = 12 mm; and posterior free wall = 6 mm. The patient had 2 types of obstruction; a LV outflow obstruction due to systolic anterior motion of both mitral leaflets (Doppler-estimated 38 mm Hg gradient at rest); and a midventricular obstruction (Doppler-estimated 43 mm Hg gradient), but without apical aneurysm or dyskinesia. The patient had a normal blood pressure response on exercise test and no episodes of non-sustained ventricular tachycardia in 24-h ECG recording. Cardiac MRI showed a gross late enhancement at the hypertrophied septum. Based on the extreme degree of LV hypertrophy and the myocardial hyperenhancement, an implantation of a cardioverter-defibrillator was recommended prophylactically for primary prevention of sudden death. Conclusion Midventricular HCM is an infrequent phenotype, but may be associated with an apical aneurysm and progression to systolic dysfunction (end-stage HCM). PMID:17349063

  7. The KCNE genes in hypertrophic cardiomyopathy: a candidate gene study

    PubMed Central

    2011-01-01

    Background The gene family KCNE1-5, which encode modulating β-subunits of several repolarising K+-ion channels, has been associated with genetic cardiac diseases such as long QT syndrome, atrial fibrillation and Brugada syndrome. The minK peptide, encoded by KCNE1, is attached to the Z-disc of the sarcomere as well as the T-tubules of the sarcolemma. It has been suggested that minK forms part of an "electro-mechanical feed-back" which links cardiomyocyte stretching to changes in ion channel function. We examined whether mutations in KCNE genes were associated with hypertrophic cardiomyopathy (HCM), a genetic disease associated with an improper hypertrophic response. Results The coding regions of KCNE1, KCNE2, KCNE3, KCNE4, and KCNE5 were examined, by direct DNA sequencing, in a cohort of 93 unrelated HCM probands and 188 blood donor controls. Fifteen genetic variants, four previously unknown, were identified in the HCM probands. Eight variants were non-synonymous and one was located in the 3'UTR-region of KCNE4. No disease-causing mutations were found and no significant difference in the frequency of genetic variants was found between HCM probands and controls. Two variants of likely functional significance were found in controls only. Conclusions Mutations in KCNE genes are not a common cause of HCM and polymorphisms in these genes do not seem to be associated with a propensity to develop arrhythmia PMID:21967835

  8. Family communication in a population at risk for hypertrophic cardiomyopathy.

    PubMed

    Batte, Brittany; Sheldon, Jane P; Arscott, Patricia; Huismann, Darcy J; Salberg, Lisa; Day, Sharlene M; Yashar, Beverly M

    2015-04-01

    Encouraging family communication is an integral component of genetic counseling; therefore, we sought to identify factors impacting communication to family members at risk for Hypertrophic Cardiomyopathy (HCM). Participants (N = 383) completed an online survey assessing: 1) demographics (gender, genetic test results, HCM family history, and disease severity); 2) illness representations; 3) family functioning and cohesiveness; 4) coping styles; 5) comprehension of HCM autosomal dominant inheritance; and 6) communication of HCM risk information to at-risk relatives. Participants were a national sample of individuals with HCM, recruited through the Hypertrophic Cardiomyopathy Association. Data from 183 participants were analyzed using a logistic regression analysis, with family communication as a dichotomous dependent variable. We found that female gender and higher comprehension of autosomal dominant inheritance were significant predictors of participants' communication of HCM risk information to all their siblings and children. Our results suggest that utilizing interventions that promote patient comprehension (e.g., a teaching-focused model of genetic counseling) are important and may positively impact family communication within families with HCM. PMID:25304619

  9. Smad ubiquitination regulatory factor 2 expression is enhanced in hypertrophic scar fibroblasts from burned children

    PubMed Central

    Finnerty, Celeste C; He, Jing; Herndon, David N

    2013-01-01

    Transforming growth factor-β1 (TGF-β1) plays a key role in hypertrophic scar formation. A lot of studies have shown that TGF-β1 stimulates fibroblast proliferation, collagen production, and α-smooth muscle actin (α-SMA) expression, inhibits matrix degradation and eventually leads to scar formation. Smad proteins are important intracellular mediators of TGF-β1 signaling, and Smad ubiquitination regulatory factor 2 (Smurf2), an ubiquitin ligase for Smads, plays critical roles in the regulation of TGF-β1/Smad signaling. It was reported that Smurf2 was abnormally expressed during the process of liver fibrosis and lung fibrosis. Hypertrophic scarring is a fibroproliferative disorder of the dermis that occurs following wounding. However, little is known about the expression of Smurf2 in hypertrophic scarring. We hypothesized that TGF-β1 signaling cannot be disrupted after wound epithelialization probably due to abnormal expression of Smurf2 in hypertrophic scar fibroblasts. In the present study, we found that hypertrophic scar fibroblasts exhibited increased Smurf2 protein and mRNA levels compared with normal fibroblasts, and the expression of Smurf2 gradually increased in hypertrophic scar fibroblasts after TGF-β1 stimulation. Furthermore, we transfected Smurf2 siRNA into hypertrophic scar fibroblasts, and we found that silencing the expression of Smurf2 in hypertrophic scar fibroblasts dramatically reduced TGF-β1 production, inhibited TGF-β1-induced α-SMA expression and inhibited TGF-β1-induced collagen I synthesis. Our results suggest that the enhanced expression of Smurf2 is involved in the progression of hypertrophic scarring. PMID:21920670

  10. Abnormalities of the Mitral Apparatus in Hypertrophic Cardiomyopathy: Echocardiographic, Pathophysiologic, and Surgical Insights.

    PubMed

    Silbiger, Jeffrey J

    2016-07-01

    Hypertrophic cardiomyopathy is a genetic disorder characterized by increased cardiac muscle mass. This disorder has broad phenotypic expression, including, among others, asymmetric septal hypertrophy, midcavity hypertrophy, and apical hypertrophy. In recent years, it has been recognized that hypertrophic cardiomyopathy is not characterized solely by ventricular hypertrophy but that a number of abnormalities of the mitral apparatus (papillary muscles, leaflets, chords, and annulus) may also occur. These figure prominently in the echocardiographic evaluation and surgical planning of patients with hypertrophic cardiomyopathy and serve as the focus of this review. PMID:27146120

  11. Hearing Profile in Patients with Dilated and Hypertrophic Cardiomyopathies

    PubMed Central

    El-Zarea, Gehan Abd El-Rahman; Hassan, Yasser Elsayed Mohamed; Mahmoud, Ahmed Mohamed Ahmed

    2016-01-01

    Introduction Cardiomyopathy may cause disruptions in the micro-vascular system of the stria vascularis in the cochlea, and, subsequently, may result in cochlear degeneration. Degeneration in the stria vascularis affects the physical and chemical processes in the organ of Corti, thereby causing a possible hearing impairment. The objective of this study was to assess the hearing profiles of patients with dilated and hypertrophic cardiomyopathies to determine the relationship between the degree of hearing loss and the degree and duration of the disease and to compare the dilated and hypertrophic cardiomyopathies as regards hearing profile. Methods In this case control study, we studied 21 patients (cases/study group/group 1) and 15 healthy individuals (controls/group 2). Six patients (group 1a) had hypertrophic cardiomyopathy (HCM), and 15 patients (group 1b) had dilated cardiomyopathy (DCM). The data were analyzed using the t-test, chi-squared test, Kruskal-Wallis test, and the Multiple Mann-Whitney test. Results The results of this study showed that 80% of those patients with DCM (group 1b) had bilateral sensorineural hearing loss (SNHL), and 100% of the patients with HCM (group 1a) had mild to severe bilateral sloping SNHL. Distortion Product Otoacoustic Emissions (DPOAEs) were present in 14% of the study group and in 100 % of the control group. The results of the measurements of auditory brainstem response (ABR) showed that 50% of the study group had abnormal latencies compared to the control group, and there was no correlation between the duration of the disease and the degree of hearing loss or DPOAE. Fifty percent of the patients with HCM and 35% of the patients with DCM had positive family histories of similar conditions, and 35% of those with HCM had a positive family history of sudden death. Conclusion The results of this study suggested that the link between heart disease and hearing loss and early identification of hearing loss in patients with

  12. GROUND-WATER SAMPLING BIAS OBSERVED IN SHALLOW, CONVENTIONAL WELLS

    EPA Science Inventory

    A previous field demonstration project on nitrate-based bioremediation of a fuel-contaminated aquifer used short-screened clustered well points in addition to shallow (10 foot), conventional monitoring wells to monitor the progress of remediation during surface application of rec...

  13. Distinguishing Hypertrophic Cardiomyopathy-Associated Mutations from Background Genetic Noise

    PubMed Central

    Kapplinger, Jamie D.; Landstrom, Andrew P.; Bos, J. Martijn; Salisbury, Benjamin A.; Callis, Thomas E.; Ackerman, Michael J.

    2014-01-01

    Despite the significant progress that has been made in identifying disease-associated mutations, the utility of the Hypertrophic Cardiomyopathy (HCM) genetic test is limited by a lack of understanding of the background genetic variation inherent to these sarcomeric genes in seemingly healthy subjects. This study represents the first comprehensive analysis of genetic variation in 427 ostensibly healthy individuals for the HCM genetic test using the “Gold Standard” Sanger sequencing method validating the background rate identified in the publically available exomes. While mutations are clearly over-represented in disease, a background rate as high as ~5% among healthy individuals prevents diagnostic certainty. To this end, we have identified a number of estimated predictive value-based associations including gene-specific, topology, and conservation methods generating an algorithm aiding in the probabilistic interpretation of an HCM genetic test. PMID:24510615

  14. Surgery Management of Rare Hypertrophic Frenum in an Infant

    PubMed Central

    Stroppa, Sheila de Carvalho; da Silva, Juliana Yassue Barbosa; Tavares, Maria Cristina Reis; Duda, João Gilberto; Losso, Estela Maris

    2014-01-01

    To report a rare case of a lateral frenum hypertrophy in an infant, this paper describes the case of a girl who came to a first dental appointment when she was 4 months old. A hypertrophic lateral frenum in the upper left canine region was detected. A great depression in the gingival rodet separated the anterior maxillary segment from the posterior one and also decreased the lip mobility in this region. A frenectomy was performed when the patient was 11 months old and the clinical follow-up was done up to the age of 30 months. There was normalization in the vestibular insertion of the lateral frenum, lip mobility, physiological development of the maxilla, and eruption of the upper incisors, canines, and first primary molars. Infants should go to a dental examination precociously in order to detect possible congenital and development alterations. PMID:25180104

  15. Cerebrovascular complications associated with idiopathic hypertrophic subaortic stenosis.

    PubMed

    Furlan, A J; Craciun, A R; Raju, N R; Hart, N

    1984-01-01

    One hundred fifty patients with idiopathic hypertrophic subaortic stenosis (IHSS) were followed-up for an average of 5.5 years. There were 95 males and 55 females with a mean age of 51 years. Patients usually presented with cardiac symptoms or syncope; no patient presented with stroke. Eight patients (5%) died during follow-up, all from cardiac causes. Eleven patients (7%) developed cerebrovascular complications; 5 (3%) had a stroke and 6 (4%) had TIA only. Patients with IHSS and atrial fibrillation have a much greater stroke risk. Mitral annulus calcification may also increase stroke risk in IHSS. However, stroke is almost never the presenting manifestation of IHSS, and the longterm risk of stroke for most patients with known IHSS is low. PMID:6538354

  16. Recent advances in diagnosis and management of hypertrophic cardiomyopathy

    PubMed Central

    Siswanto, B B; Aryani, R

    2009-01-01

    Hypertrophic cardiomyopathy (HCM) is characterised by a thickened but non-dilated left ventricle in the absence of another cardiac or systemic condition capable of producing the magnitude of hypertrophy evident. It is the most common familial genetic disease of the heart (1/500 to 1/1000), as well as the most common cause of sudden cardiac death in young people and athletes. Survival rates of patients with HCM have improved from the 1960s onwards. Natural history in patients with HCM might vary from developing severe heart failure or atrial fibrillation, some die suddenly, often at a young age and in the absence of previous symptoms. Because of its heterogeneous clinical course and expression, HCM frequently presents uncertainty and represents a management dilemma to cardiovascular specialists and other practitioners.

  17. Ehlers-Danlos Syndrome associated with cardiomyopathy hypertrophic obstructive.

    PubMed

    Pinto, Raimundo José Almeida de Oliveira; Santos, Adaílton Araújo dos; Azevedo, Mablo de Castro; Meira, Saulo Sacramento

    2015-01-01

    Ehlers-Danlos syndrome is a rare clinical condition caused by a genetic change that results in the formation of structurally or functionally altered collagen. The clinical manifestations are varied, being the most obvious skin hypermotility and increased joint flexibility, although other systems - such as cardiovascular, respiratory and neurological - may also be affected. This paper presents the report of a patient who sought medical attention with complaints of atypical chest pain. Clinical evaluation enabled hypothetical diagnosis of hypertrophic obstructive cardiomyopathy and Ehlers-Danlos syndrome. Initial electrocardiogram, echocardiogram and 24 hours holter allowed the confirmation of the first hypothesis. A skin biopsy performed later associated clinical data and confirmed the second hypothesis. PMID:26312722

  18. Pressure therapy for hypertrophic scarrings: preliminary communication1

    PubMed Central

    Robertson, J C; Druett, J E; Hodgson, B; Druett, Jane

    1980-01-01

    A six-point programme for the prevention and pressure therapy of hypertrophic scarring started in 1975 at Odstock Hospital. The work reported here includes a pressure calibration of batches of the material chosen for pressure bandaging; a pressure study of the bandages on volunteers' limbs; and the formation of a pressure therapy clinic. The clinic results were similar to those reported by Thomson (1974) and were considered sufficiently favourable to justify continuing the clinic and instituting a policy of close review and early therapy for all burns patients. The programme proved the accuracy of the pressure sensor and attempted to develop an objective method of recording progress. Arguments for pressure versus occlusion as the therapeutic agent are discussed and supported by a case report. It is suggested that a controlled trial of pressure therapy should be carried out. PMID:7241460

  19. Keloids and Hypertrophic Scars: A Spectrum of Clinical Challenges.

    PubMed

    Trace, Anthony P; Enos, Clinton W; Mantel, Alon; Harvey, Valerie M

    2016-06-01

    Since their earliest description, keloids and hypertrophic scars have beleaguered patients and clinicians alike. These scars can be aesthetically disfiguring, functionally debilitating, emotionally distressing, and psychologically damaging, culminating in a significant burden for patients. Our current understanding of keloid pathophysiology has grown and continues to advance while molecular biology, genetics, and technology provide ever-deepening insight into the nature of wound healing and the pathologic perturbations thereof. Greater understanding will lead to the development and application of refined therapeutic modalities. This article provides an overview of our current understanding of keloids, highlighting clinical characteristics and diagnostic criteria while providing a comprehensive summary of the many therapeutic modalities available. The proposed mechanism, application, adverse events, and reported efficacy of each modality is evaluated, and current recommendations are summarized. PMID:26894654

  20. Ehlers-Danlos Syndrome associated with cardiomyopathy hypertrophic obstructive*

    PubMed Central

    Pinto, Raimundo José Almeida de Oliveira; dos Santos, Adaílton Araújo; Azevedo, Mablo de Castro; Meira, Saulo Sacramento

    2015-01-01

    Ehlers-Danlos syndrome is a rare clinical condition caused by a genetic change that results in the formation of structurally or functionally altered collagen. The clinical manifestations are varied, being the most obvious skin hypermotility and increased joint flexibility, although other systems - such as cardiovascular, respiratory and neurological - may also be affected. This paper presents the report of a patient who sought medical attention with complaints of atypical chest pain. Clinical evaluation enabled hypothetical diagnosis of hypertrophic obstructive cardiomyopathy and Ehlers-Danlos syndrome. Initial electrocardiogram, echocardiogram and 24 hours holter allowed the confirmation of the first hypothesis. A skin biopsy performed later associated clinical data and confirmed the second hypothesis. PMID:26312722

  1. Hypertrophic osteoarthropathy in patient with Crohn's disease: a case report.

    PubMed

    Rhee, Sung-Min; Park, Ki Jeong; Ha, Yong-Chan

    2014-05-01

    Numerous causes of hypertrophic osteoarthropathy (HOA) have been reported. Commonly, secondary osteoarthropathy accompanies pulmonary diseases such as carcinoma of the lung, pleural tumors, lung abscesses, and bronchiectasis. However, HOA in inflammatory bowel disease is a rare complication. There are only a few reports of secondary HOA with Crohn's disease. Our purpose was to report another case of HOA in Crohn's disease. We describe a case of a 27-year-old man with underlying Crohn's disease presenting with 2 years of pain in multiple joints. Radiographic findings suggested HOA in extremities. We performed a conservative treatment including medication and rehabilitations. The patient's symptoms were much improved at the latest follow-up. Although numerous studies on HOA have been published, the pathogenesis of HOA is still unclear. Various treatment modalities were recommended but further studies to uncover the pathogenesis of HOA with Crohn's disease and to establish a treatment modality are needed. PMID:25025001

  2. Clinical utility of natriuretic peptides and troponins in hypertrophic cardiomyopathy.

    PubMed

    Kehl, Devin W; Buttan, Anshu; Siegel, Robert J; Rader, Florian

    2016-09-01

    The diagnosis of hypertrophic cardiomyopathy (HCM) is based on clinical, echocardiographic and in some cases genetic findings. However, prognostication remains limited except in the subset of patients with high-risk indicators for sudden cardiac death. Additional methods are needed for risk stratification and to guide clinical management in HCM. We reviewed the available data regarding natriuretic peptides and troponins in HCM. Plasma levels of natriuretic peptides, and to a lesser extent serum levels of troponins, correlate with established disease markers, including left ventricular thickness, symptom status, and left ventricular hemodynamics by Doppler measurements. As a reflection of left ventricular filling pressure, natriuretic peptides may provide an objective measure of the efficacy of a specific therapy. Both natriuretic peptides and troponins predict clinical risk in HCM independently of established risk factors, and their prognostic power is additive. Routine measurement of biomarker levels therefore may be useful in the clinical evaluation and management of patients with HCM. PMID:27236124

  3. Hypertrophic pulmonary osteoarthropathy demonstrated on SPECT/CT.

    PubMed

    Russo, Robert R; Lee, Allen; Mansberg, Robert; Emmett, Louise

    2009-09-01

    A 51-year-old man with a known history of hepatic cirrhosis and a right lung mass presented with hemoptysis and widespread bone pain. Sputum cytology demonstrated atypical cells. A CT scan of the chest demonstrated a 3-cm spiculating mass in the right lower lobe, in addition to nodules in both upper lobes and lymphadenopathy within the mediastinum and both hila. Skeletal scintigraphy was performed to assess for metastatic bone disease, and demonstrated increased tracer uptake along the cortex of the distal femurs bilaterally. There was also low-grade cortical uptake in the mid femur and tibia bilaterally on planar imaging. SPECT/CT was able to improve the specificity of the planar scintigraphic findings, by confirming tracer uptake was localized to the periosteum as expected for hypertrophic pulmonary osteoarthropathy, thereby excluding the presence of skeletal metastases. PMID:19692832

  4. Abnormal skeletal muscle bioenergetics in familial hypertrophic cardiomyopathy.

    PubMed Central

    Thompson, C. H.; Kemp, G. J.; Taylor, D. J.; Conway, M.; Rajagopalan, B.; O'Donoghue, A.; Styles, P.; McKenna, W. J.; Radda, G. K.

    1997-01-01

    OBJECTIVE: To determine the skeletal muscle metabolic manifestations of familial hypertrophic cardiomyopathy. DESIGN: A case-control study. SETTING: 31P magnetic resonance spectroscopy of the calf muscle was performed on volunteers from a centre specialising in familial hypertrophic cardiomyopathy. PATIENTS: Five patients with abnormal beta myosin heavy chain protein in cardiac and skeletal muscle and five patients with a troponin T abnormality in cardiac muscle were compared with healthy controls. RESULTS: High energy phosphate metabolism in vivo was examined in a non-invasive manner. In resting muscle, the beta myosin heavy chain group had a higher ratio of phosphocreatine to ATP concentration (4.51 (SD 0.17)) than either the troponin T group (3.88 (0.42)) or controls (n = 16; 4.04 (0.40)). Exercise duration was reduced compared to controls, and during the fourth minute of exercise phosphocreatine depletion and muscle acidification were greater in both patient groups. After exercise, the recovery of phosphocreatine-an index of oxidative metabolic capacity of the muscle-was slower in the beta myosin heavy chain group (mean half time 0.65 (0.08) minutes) than in the troponin T group (0.60 (0.17) minutes) or controls (0.48 (0.14) minutes). CONCLUSIONS: Exercise metabolism was abnormal in both groups of subjects, and the affected contractile protein determined the metabolic changes in muscle at rest and during recovery. In patients with abnormal beta myosin heavy chain protein, there was a decrease in oxidative capacity consistent with the reduction in mitochondria reported in muscle biopsy studies of similar patients. PMID:9326994

  5. Obstruction is unimportant in the pathophysiology of hypertrophic cardiomyopathy.

    PubMed Central

    Criley, J. M.; Siegel, R. J.

    1986-01-01

    There has been a longstanding controversy about the significance of intracavitary pressure gradients in hypertrophic cardiomyopathy (HCM). It has been generally assumed that the gradient is the result of an 'obstruction' that impedes left ventricular outflow and which can be relieved by operative intervention. In the first decade after the discovery of HCM (1957-66), the site of 'obstruction' was thought to be a muscular sphincter or contraction ring in the submitral region of the left ventricle, and operations designed to emulate pyloromyectomy (for hypertrophic pyloric stenosis) were developed. Following a challenge to the existence of the 'contraction ring' and an alternative non-obstructive explanation of the pressure gradient, the site of 'obstruction' was translocated to a point of apposition between the anterior mitral leaflet and the interventricular septum, a result of systolic anterior motion (SAM) of the mitral valve. Despite the translocation of the site and mechanism of 'obstruction', the operation for 'relief of obstruction' has not changed significantly. The newer site of 'obstruction' has been challenged on the grounds that the ventricle is not demonstrably impeded in its emptying; when a gradient is provoked, the ventricle empties more rapidly and more completely than it does without a gradient. In addition to a non-obstructive explanation of the gradient, other phenomena thought to be indicative of 'obstruction' can be explained by rapid and complete emptying of the ventricle (cavitary obliteration). Since the morbidity and mortality of symptomatic HCM patients without pressure gradients may exceed that of patients with pressure gradients, it is suggested that 'obstruction' may be unimportant in the pathophysiology of HCM and attention should be focused on abnormal diastolic function and life threatening arrhythmias. Images Figure 4 Figure 8b PMID:3534838

  6. DDD pacing in hypertrophic cardiomyopathy: a multicentre clinical experience.

    PubMed Central

    Slade, A. K.; Sadoul, N.; Shapiro, L.; Chojnowska, L.; Simon, J. P.; Saumarez, R. C.; Dodinot, B.; Camm, A. J.; McKenna, W. J.; Aliot, E.

    1996-01-01

    BACKGROUND--DDD pacing has been advocated as an effective treatment for drug refractory obstructive hypertrophic cardiomyopathy. This study reports the outcome of pacing in 56 patients with refractory symptoms referred to four tertiary centres. METHODS--Core data on symptoms, drug burden, and left ventricular outflow tract gradient were recorded. Patients underwent a temporary pacing study with optimisation of the atrioventricular (AV) delay for greatest gradient reduction without haemodynamic compromise. Patients were assessed after implantation in terms of changes in symptoms, drug load, and outflow tract gradient. RESULTS--56 patients underwent pacing assessment. The mean (SD) left ventricular outflow tract gradient before pacing was 78 (31) mm Hg. At temporary study the mean (SD) left ventricular outflow tract gradient was 38 (24) mm Hg with a median (range) optimised sensed AV delay of 65 (25-125) ms. Fifty three patients were implanted and followed up for a mean (SD) of 11 (11) months. The median (range) programmed sensed AV delay was 60 (31-200) ms. Left ventricular outflow tract gradient at follow up was 36 (25) mm Hg. Forty four patients had improved functional class. Although a correlation (r = 0.69) was shown between acute and chronic left ventricular outflow tract gradient reduction, there was no correlation between magnitude of gradient reduction and functional improvement, and no appreciable change in pharmacological burden. CONCLUSION--This series confirms symptomatic improvement after DDD pacing in hypertrophic cardiomyopathy. There remains, however, a discrepancy between perceived symptomatic benefit and modest objective improvement. Furthermore, the optimal outcome has been achieved only with continued pharmacological treatment. Current methods of temporary evaluation do not predict functional outcome which seems to be independent of the magnitude of gradient reduction. PMID:8624871

  7. Echo-guided transaortic left ventricular myotomy for idiopathic hypertrophic subaortic stenosis.

    PubMed

    Nitta, S; Yambe, T; Nitta, K; Katahira, Y; Saijo, Y; Sonobe, T; Naganuma, S; Kakinuma, Y; Tanaka, M; Miura, M

    1991-12-01

    Idiopathic hypertrophic subaortic stenosis (IHSS) is a progressive cardiac disease known to induce sudden death occasionally. The authors tested echocardiography as a method of guiding myotomy, and observed its clinical usefulness as a safe surgical procedure for IHSS. PMID:1843048

  8. Sudden death following AV node ablation in a man with Fabry disease mimicking hypertrophic cardiomyopathy.

    PubMed

    Rodda, Odette A; Lynch, Matthew; Parsons, Sarah

    2016-08-01

    We present a case of Fabry disease with an uncommon pattern of asymmetrical hypertrophy with septal prominence resulting in an erroneous diagnosis of hypertrophic cardilmyopathy clinically. The deceased presented for a medicolegal autopsy following his sudden death after an AV node ablation. Fabry disease continues to be an important misdiagnosis of hypertrophic cardiomyopathy in a clinical setting. Early diagnosis of Fabry disease is essential so that early treatment can be instituted. PMID:27213840

  9. Surgical Treatment of a 4-Year-Old Child with Hypertrophic Obstructive Cardiomyopathy: Case Report.

    PubMed

    Chen, Jin; Wu, Qingyu; Xu, Zhonghua; Kong, Xiangchen

    2016-01-01

    The incidence of pediatric hypertrophic obstructive cardiomyopathy is low. The lesions usually involve the left ventricle or ventricular septum, leading to either left or right ventricular outflow tract stenosis. However, combined left and right ventricular outflow tract stenosis is rare, and the surgical treatment is limited, especially in children. Surgery to release the obstruction was performed successfully in a 4-year-old child with right and left ventricular outflow tract obstruction together with a hypertrophic cardiomyopathy. The result was excellent. PMID:26913685

  10. Successful treatment of hypertrophic herpes simplex genitalis in HIV-infected patient with topical imiquimod.

    PubMed

    Deza, Gustavo; Martin-Ezquerra, Gemma; Curto-Barredo, Laia; Villar García, Judit; Pujol, Ramon M

    2015-12-01

    Hypertrophic herpes simplex genitalis is an atypical presentation of genital herpes described in the context of immunosuppression, particularly HIV-positive patients. This situation can become a diagnostic and therapeutic challenge. For this reason, alternative therapies are currently being discussed in the literature. We report a case of hypertrophic genital herpes in a HIV-positive patient who was successfully treated with topical 5% imiquimod after treatment failures with oral and i.v. antivirals. PMID:26074211

  11. Rapid shallow breathing index.

    PubMed

    Karthika, Manjush; Al Enezi, Farhan A; Pillai, Lalitha V; Arabi, Yaseen M

    2016-01-01

    Predicting successful liberation of patients from mechanical ventilation has been a focus of interest to clinicians practicing in intensive care. Various weaning indices have been investigated to identify an optimal weaning window. Among them, the rapid shallow breathing index (RSBI) has gained wide use due to its simple technique and avoidance of calculation of complex pulmonary mechanics. Since its first description, several modifications have been suggested, such as the serial measurements and the rate of change of RSBI, to further improve its predictive value. The objective of this paper is to review the utility of RSBI in predicting weaning success. In addition, the use of RSBI in specific patient populations and the reported modifications of RSBI technique that attempt to improve the utility of RSBI are also reviewed. PMID:27512505

  12. Rapid shallow breathing index

    PubMed Central

    Karthika, Manjush; Al Enezi, Farhan A.; Pillai, Lalitha V.; Arabi, Yaseen M.

    2016-01-01

    Predicting successful liberation of patients from mechanical ventilation has been a focus of interest to clinicians practicing in intensive care. Various weaning indices have been investigated to identify an optimal weaning window. Among them, the rapid shallow breathing index (RSBI) has gained wide use due to its simple technique and avoidance of calculation of complex pulmonary mechanics. Since its first description, several modifications have been suggested, such as the serial measurements and the rate of change of RSBI, to further improve its predictive value. The objective of this paper is to review the utility of RSBI in predicting weaning success. In addition, the use of RSBI in specific patient populations and the reported modifications of RSBI technique that attempt to improve the utility of RSBI are also reviewed. PMID:27512505

  13. MicroRNA-21 Regulates hTERT via PTEN in Hypertrophic Scar Fibroblasts

    PubMed Central

    Su, Lin-Lin; Liu, Jia-Qi; Li, Yan; Shi, Ji-Hong; Cai, Wei-Xia; Bai, Xiao-Zhi; Jia, Yan-Hui; Zhao, Bin; Wu, Xue; Li, Jun; Hu, Da-Hai

    2014-01-01

    Background As an important oncogenic miRNA, microRNA-21 (miR-21) is associated with various malignant diseases. However, the precise biological function of miR-21 and its molecular mechanism in hypertrophic scar fibroblast cells has not been fully elucidated. Methodology/Principal Findings Quantitative Real-Time PCR (qRT-PCR) analysis revealed significant upregulation of miR-21 in hypertrophic scar fibroblast cells compared with that in normal skin fibroblast cells. The effects of miR-21 were then assessed in MTT and apoptosis assays through in vitro transfection with a miR-21 mimic or inhibitor. Next, PTEN (phosphatase and tensin homologue deleted on chromosome ten) was identified as a target gene of miR-21 in hypertrophic scar fibroblast cells. Furthermore, Western-blot and qRT-PCR analyses revealed that miR-21 increased the expression of human telomerase reverse transcriptase (hTERT) via the PTEN/PI3K/AKT pathway. Introduction of PTEN cDNA led to a remarkable depletion of hTERT and PI3K/AKT at the protein level as well as inhibition of miR-21-induced proliferation. In addition, Western-blot and qRT-PCR analyses confirmed that hTERT was the downstream target of PTEN. Finally, miR-21 and PTEN RNA expression levels in hypertrophic scar tissue samples were examined. Immunohistochemistry assays revealed an inverse correlation between PTEN and hTERT levels in high miR-21 RNA expressing-hypertrophic scar tissues. Conclusions/Significance These data indicate that miR-21 regulates hTERT expression via the PTEN/PI3K/AKT signaling pathway by directly targeting PTEN, therefore controlling hypertrophic scar fibroblast cell growth. MiR-21 may be a potential novel molecular target for the treatment of hypertrophic scarring. PMID:24817011

  14. Involvement of impaired desmosome-related proteins in hypertrophic scar intraepidermal blister formation.

    PubMed

    Tan, Jianglin; He, Weifeng; Luo, Gaoxing; Wu, Jun

    2015-11-01

    Hypertrophic scar is one of the unique fibrotic diseases in human. Intraepidermal blister is a common clinical symptom following the hypertrophic scar formation. However, little is known about the reason of blister creation. In this study, we selected three patients with hypertrophic scar as manifested by raised, erythematous, pruritic, blister and thickened appearance undergoing scar resection. The first scar sample was 6 months after burn from the neck of a 3 years old male patient with 10 score by Vancouver Scar Scale (VSS). The second scar sample was 12 months after burn from the dorsal foot of a 16 years old female patient with 13 score by VSS. The third one was 9 months after burn from the elbow of a 34 years old male patients with 13 score by VSS. In order to understand the molecular mechanism of blister formation, we screened the different protein expression between hypertrophic scar and normal skin tissue by means of isobaric tags for relative and absolute quantitation (iTRAQ) labeling technology and high throughput 2D LC-MS/MS. There were 48 proteins found to be downregulated in hypertrophic scar. Among the downregulated ones, plakophilin1 (PKP1), plakophilin3 (PKP3) and desmoplakin (DSP) were the desmosome-related proteins which were validated by immunohistochemistry and western blotting assay. Transmission electron microscopy further showed the considerably reduced size and intensity of hemidesmosome and desmosome in hypertrophic scar tissue, compared to control normal skin. Our data indicted for the first time that downregulation of DSP, PKP1 and PKP3 in hypertrophic scar might be responsible for intraepidermal blister formation. PMID:25922301

  15. Accelerated shallow water modeling

    NASA Astrophysics Data System (ADS)

    Gandham, Rajesh; Medina, David; Warburton, Timothy

    2015-04-01

    ln this talk we will describe our ongoing developments in accelerated numerical methods for modeling tsunamis, and oceanic fluid flows using two dimensional shallow water model and/or three dimensional incompressible Navier Stokes model discretized with high order discontinuous Galerkin methods. High order discontinuous Galerkin methods can be computationally demanding, requiring extensive computational time to simulate real time events on traditional CPU architectures. However, recent advances in computing architectures and hardware aware algorithms make it possible to reduce simulation time and provide accurate predictions in a timely manner. Hence we tailor these algorithms to take advantage of single instruction multiple data (SIMD) architecture that is seen in modern many core compute devices such as GPUs. We will discuss our unified and extensive many-core programming library OCCA that alleviates the need to completely re-design the solvers to keep up with constantly evolving parallel programming models and hardware architectures. We will present performance results for the flow simulations demonstrating performance leveraging multiple different multi-threading APIs on GPU and CPU targets.

  16. Keloids and Hypertrophic Scars: Update and Future Directions

    PubMed Central

    Huang, Chenyu; Murphy, George F.; Akaishi, Satoshi

    2013-01-01

    Summary: The development of cutaneous pathological scars, namely, hypertrophic scars (HSs) and keloids, involves complex pathways, and the exact mechanisms by which they are initiated, evolved, and regulated remain to be fully elucidated. The generally held concepts that keloids and HSs represent “aberrant wound healing” or that they are “characterized by hyalinized collagen bundles” have done little to promote their accurate clinicopathological classification or to stimulate research into the specific causes of these scars and effective preventative therapies. To overcome this barrier, we review here the most recent findings regarding the pathology and pathogenesis of keloids and HSs. The aberrations of HSs and keloids in terms of the inflammation, proliferation, and remodeling phases of the wound healing process are described. In particular, the significant roles that the extracellular matrix and the epidermal and dermal layers of skin play in scar pathogenesis are examined. Finally, the current hypotheses of pathological scar etiology that should be tested by basic and clinical investigators are detailed. Therapies that have been found to be effective are described, including several that evolved directly from the aforementioned etiology hypotheses. A better understanding of pathological scar etiology and manifestations will improve the clinical and histopathological classification and treatment of these important lesions. PMID:25289219

  17. Idiopathic Hypertrophic Cranial Pachymeningitis Misdiagnosed as Acute Subtentorial Hematoma

    PubMed Central

    Park, Ik-Seong; Kim, Hoon; Chung, Eun Yong

    2010-01-01

    A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. During conservative treatment under the diagnosis of a subdural hematoma, left cranial nerve palsies were developed (3rd and 6th), followed by scleritis and uveitis involving both eyes. Magnetic resonance imaging (MRI) revealed an unusual tentorium-falx enhancement on gadolinium-enhanced T1-weighted images. Non-specific chronic inflammation of the pachymeninges was noticed on histopathologic examination following an open biopsy. Systemic steroid treatment was initiated, resulting in dramatic improvement of symptoms. A follow-up brain MRI showed total resolution of the lesion 2 months after steroid treatment. IHCP should be included in the differential diagnosis of subtentorial-enhancing lesions. PMID:20856672

  18. Current concepts related to hypertrophic scarring in burn injuries.

    PubMed

    Chiang, Ryan S; Borovikova, Anna A; King, Kassandra; Banyard, Derek A; Lalezari, Shadi; Toranto, Jason D; Paydar, Keyianoosh Z; Wirth, Garrett A; Evans, Gregory R D; Widgerow, Alan D

    2016-05-01

    Scarring following burn injury and its accompanying aesthetic and functional sequelae still pose major challenges. Hypertrophic scarring (HTS) can greatly impact patients' quality of life related to appearance, pain, pruritus and even loss of function of the injured body region. The identification of molecular events occurring in the evolution of the burn scar has increased our knowledge; however, this information has not yet translated into effective treatment modalities. Although many of the pathophysiologic pathways that bring about exaggerated scarring have been identified, certain nuances in burn scar formation are starting to be recognized. These include the effects of neurogenic inflammation, mechanotransduction, and the unique interactions of burn wound fluid with fat tissue in the deeper dermal layers, all of which may influence scarring outcome. Tension on the healing scar, pruritus, and pain all induce signaling pathways that ultimately result in increased collagen formation and myofibroblast phenotypic changes. Exposure of the fat domes in the deep dermis is associated with increased HTS, possibly on the basis of altered interaction of adipose-derived stem cells and the deep burn exudate. These pathophysiologic patterns related to stem cell-cytokine interactions, mechanotransduction, and neurogenic inflammation can provide new avenues of exploration for possible therapeutic interventions. PMID:27027596

  19. What Do Patients With Hypertrophic Cardiomyopathy Die from?

    PubMed

    Maron, Barry J; Rowin, Ethan J; Casey, Susan A; Garberich, Ross F; Maron, Martin S

    2016-02-01

    Hypertrophic cardiomyopathy (HC) has become a contemporary and treatable genetic heart disease, now with disease-related mortality reduced to as low as 0.5% per year, based largely on more effective risk stratification and the use of the implantable cardioverter-defibrillator for primary prevention of sudden death. This paradigm change in the natural history of HC has caused us to reconsider the overall mortality risk in this disease. We interrogated the databases of 2 HC referral centers, Minneapolis Heart Institute and Tufts Medical Center. Of 1,902 consecutive patients evaluated between 1992 and 2013, 1,653 patients (87%) have survived to the end of follow-up and 249 patients (13%) have died. Most deaths (178 of 249; 72%) were unrelated to HC, commonly because of cancer and predominantly in older patients. Non-HC mortality was significantly more common in adults presenting ≥ 60 years and least common in the youngest patients aged <30 years (p <0.001). Notably, deaths from non-HC causes substantially exceeded HC-related causes by 2.6-fold (p <0.001). In conclusion, only about 25% of patients with HC ultimately died of their disease, including predominantly those who were <30 years of age. These data allow patients with HC to develop a more realistic and reassured perception of their disease. PMID:26718233

  20. Private Mitochondrial DNA Variants in Danish Patients with Hypertrophic Cardiomyopathy

    PubMed Central

    Hagen, Christian M.; Aidt, Frederik H.; Havndrup, Ole; Hedley, Paula L.; Jensen, Morten K.; Kanters, Jørgen K.; Pham, Tam T.; Bundgaard, Henning; Christiansen, Michael

    2015-01-01

    Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease primarily caused by mutations in genes coding for sarcomeric proteins. A molecular-genetic etiology can be established in ~60% of cases. Evolutionarily conserved mitochondrial DNA (mtDNA) haplogroups are susceptibility factors for HCM. Several polymorphic mtDNA variants are associated with a variety of late-onset degenerative diseases and affect mitochondrial function. We examined the role of private, non-haplogroup associated, mitochondrial variants in the etiology of HCM. In 87 Danish HCM patients, full mtDNA sequencing revealed 446 variants. After elimination of 312 (69.9%) non-coding and synonymous variants, a further 109 (24.4%) with a global prevalence > 0.1%, three (0.7%) haplogroup associated and 19 (2.0%) variants with a low predicted in silico likelihood of pathogenicity, three variants: MT-TC: m.5772G>A, MT-TF: m.644A>G, and MT-CYB: m.15024G>A, p.C93Y remained. A detailed analysis of these variants indicated that none of them are likely to cause HCM. In conclusion, private mtDNA mutations are frequent, but they are rarely, if ever, associated with HCM. PMID:25923817

  1. Comprehensive Versus Targeted Genetic Testing in Children with Hypertrophic Cardiomyopathy.

    PubMed

    Bales, Nathan D; Johnson, Nicole M; Judge, Daniel P; Murphy, Anne M

    2016-06-01

    Hypertrophic cardiomyopathy (HCM) is a genetic disease of the sarcomere that can be found in both children and adults and is associated with many causative mutations. In children who are not the index case of HCM in their families, current recommendations call only for targeted genetic testing for familial mutations. However, clinical experience suggests that de novo mutations are possible, as are mutations inherited from apparently an unaffected parent. A chart review was conducted of all patients who received HCM genetic testing at Johns Hopkins from 2004 to 2013. In total, 239 patient charts were analyzed for personal and familial genetic findings. Eighty-one patients with sarcomere gene mutations were identified, of which 66 had a clinical diagnosis of HCM. Importantly, eight patients had >1 pathogenic or likely pathogenic mutation, including six patients who were diagnosed with HCM as children (18 or younger). In this analysis, when a sarcomere mutation is identified in a family, the likelihood of a child with HCM having >1 mutation is 25 % (6/24), compared to 4.8 % (2/42) for adults. The large number of children with multiple mutations suggests that broad panel rather than targeted genetic testing should be considered in HCM presenting during childhood even if the child is not the index case. PMID:26936621

  2. Echocardiographic diagnosis of the different phenotypes of hypertrophic cardiomyopathy.

    PubMed

    Parato, Vito Maurizio; Antoncecchi, Valeria; Sozzi, Fabiola; Marazia, Stefania; Zito, Annapaola; Maiello, Maria; Palmiero, Pasquale

    2016-01-01

    Hypertrophic Cardiomyopathy (HCM) is an inherited cardiovascular disorder of great genetic heterogeneity and has a prevalence of 0.1 - 0.2 % in the general population. Several hundred mutations in more than 27 genes, most of which encode sarcomeric structures, are associated with the HCM phenotype. Then, HCM is an extremely heterogeneous disease and several phenotypes have been described over the years. Originally only two phenotypes were considered, a more common, obstructive type (HOCM, 70 %) and a less common, non-obstructive type (HNCM, 30 %) (Maron BJ, et al. Am J Cardiol 48:418 -28, 1981). Wigle et al. (Circ 92:1680-92, 1995) considered three types of functional phenotypes: subaortic obstruction, midventricular obstruction and cavity obliteration. A leader american working group suggested that HCM should be defined genetically and not morphologically (Maron BJ, et al. Circ 113:1807-16, 2006). The European Society of Cardiology Working Group on Myocardial and Pericardial Diseases recommended otherwise a morphological classification (Elliott P, et al. Eur Heart J 29:270-6, 2008). Echocardiography is still the principal tool for the diagnosis, prognosis and clinical management of HCM. It is well known that the echocardiographic picture may have a clinical and prognostic impact. For this reason, in this article, we summarize the state of the art regarding the echocardiographic pattern of the HCM phenotypes and its impact on clinical course and prognosis. PMID:27519172

  3. Diastolic filling in a physical model of obstructive hypertrophic cardiomyopathy

    NASA Astrophysics Data System (ADS)

    Schovanec, Joseph; Samaee, Milad; Lai, Hong Kuan; Santhanakrishnan, Arvind

    2015-11-01

    Hypertrophic Cardiomyopathy (HCM) is an inherited heart disease that affects as much as one in 500 individuals, and is the most common cause of sudden death in young athletes. The myocardium becomes abnormally thick in HCM and deforms the internal geometry of the left ventricle (LV). Previous studies have shown that a vortex is formed during diastolic filling, and further that the dilated LV morphology seen in systolic heart failure results in altering the filling vortex from elliptical to spherical shape. We have also previously shown that increasing LV wall stiffness decreases the filling vortex circulation. However, alterations to intraventricular filling fluid dynamics due to an obstructive LV morphology and locally elevated wall stiffness (in the hypertrophied region) have not been previously examined from a mechanistic standpoint. We conducted an experimental study using an idealized HCM physical model and compared the intraventricular flow fields obtained from 2D PIV to a baseline LV physical model with lower wall stiffness and anatomical geometry. The obstruction in the HCM model leads to earlier breakdown of the filling vortex as compared to the anatomical LV. Intraventricular filling in both models under increased heart rates will be discussed.

  4. Idiopathic hypertrophic pachymeningitis mimicking prolactinoma with recurrent vision loss.

    PubMed

    Lok, Julie Y C; Yip, Nelson K F; Chong, Kelvin K L; Li, C L; Young, Alvin L

    2015-08-01

    Idiopathic hypertrophic pachymeningitis is a rare inflammatory condition with diffuse thickening of the dura mater, which may cause a compressive effect or vascular compromise. We report on a 28-year-old Chinese woman with a history of granulomatous mastitis 7 years previously and oligomenorrhoea, headache, blurred vision, and raised prolactin level 2 years previously, that was diagnosed as prolactinoma and treated conservatively with bromocriptine. However, she had recurrent bilateral vision loss when the bromocriptine was stopped. Her symptoms were resolved by high-dose steroid injection but remained steroid-dependent. Serial magnetic resonance imaging scan showed progressive diffuse thickening of the pachymeningitis with disappearance of pituitary apoplexy. Lumbar puncture showed lymphocytosis with no organisms. Open biopsy of the meninges was performed and histology showed features of inflammatory infiltrates and vasculitis. This is an unusual presentation of a rare condition in this age-group, with co-existing granulomatous mastitis and chronic otitis media, and is a diagnostic challenge mimicking pituitary macroadenoma and meningioma in initial magnetic resonance imaging scans. PMID:26238133

  5. Distinguishing ventricular septal bulge versus hypertrophic cardiomyopathy in the elderly.

    PubMed

    Canepa, Marco; Pozios, Iraklis; Vianello, Pier Filippo; Ameri, Pietro; Brunelli, Claudio; Ferrucci, Luigi; Abraham, Theodore P

    2016-07-15

    The burgeoning evidence of patients diagnosed with sigmoidal hypertrophic cardiomyopathy (HCM) later in life has revived the quest for distinctive features that may help discriminate it from more benign forms of isolated septal hypertrophy often labelled ventricular septal bulge (VSB). HCM is diagnosed less frequently than VSB at older ages, with a reversed female predominance. Most patients diagnosed with HCM at older ages suffer from hypertension, similar to those with VSB. A positive family history of HCM and/or sudden cardiac death and the presence of exertional symptoms usually support HCM, though they are less likely in older patients with HCM, and poorly investigated in individuals with VSB. A more severe hypertrophy and the presence of left ventricular outflow obstruction are considered diagnostic of HCM, though stress echocardiography has not been consistently used in VSB. Mitral annulus calcification is very prevalent in both conditions, whereas a restrictive filling pattern is found in a minority of older patients with HCM. Genetic testing has low applicability in this differential diagnosis at the current time, given that a causative mutation is found in less than 10% of elderly patients with suspected HCM. Emerging imaging modalities that allow non-invasive detection of myocardial fibrosis and disarray may help, but have not been fully investigated. Nonetheless, there remains a considerable morphological overlap between the two conditions. Comprehensive studies, particularly imaging based, are warranted to offer a more evidence-based approach to elderly patients with focal septal thickening. PMID:27122487

  6. Enteric neuronal plasticity and a reduced number of interstitial cells of Cajal in hypertrophic rat ileum

    PubMed Central

    Ekblad, E; Sjuve, R; Arner, A; Sundler, F

    1998-01-01

    Background—Partial obstruction of the ileum causes a notable hypertrophy of smooth muscle cells and enteric neurones in the proximally located intestine. 
Aims—To study the expression of neuromessengers in the hypertrophic ileum of rat as little is known about neuromessenger plasticity under these conditions. To investigate the presence of interstitial cells of Cajal (ICC) in hypertrophic ileum. 
Methods—Ileal hypertrophy was induced by circumferential application of a strip of plastic film for 18-24 days. Immunocytochemistry, in situ hybridisation, nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase histochemistry, and ethidium bromide staining were used to investigate the number of enteric neurones expressing neuropeptides and nitric oxide synthase, and the frequency of ICC. 
Results—In the hypertrophic ileum several neuronal populations showed changes in their expression of neuromessengers. Myenteric neurones expressing vasoactive intestinal peptide (VIP), pituitary adenylate cyclase activating peptide, and galanin were notably increased in number. In submucous ganglia the number of VIP immunoreactive neurones decreased while those expressing VIP mRNA increased. NADPH diaphorase positive submucous neurones increased dramatically while the number of neuronal type nitric oxide synthase expressing ones was unchanged. The number of ICC decreased notably in hypertrophic ileum. 
Conclusion—Enteric neurones change their levels of expression of neuromessengers in hypertrophic ileum. ICC are also affected. The changes are presumably part of an adaptive response to the increased work load. 

 Keywords: enteric nerves; interstitial cells of Cajal; hypertrophy; neuropeptides; nitric oxide; neuronal plasticity PMID:9691923

  7. Curative Effects of Oleanolic Acid on Formed Hypertrophic Scars in the Rabbit Ear Model

    PubMed Central

    Zhang, Hong; Zhang, Yan; Jiang, Yi-Ping; Zhang, Lan-Ke; Peng, Cheng; He, Kun; Rahman, Khalid; Qin, Lu-Ping

    2012-01-01

    Hypertrophic scarring is a common proliferative disorder of dermal fibroblasts characterized by collagen overproduction and excessive deposition of extracellular matrix (ECM). There is no consensus about the best therapeutics to produce complete and permanent improvement of scars with few side effects. To investigate the therapeutic effects of oleanolic acid (OA) on hypertrophic scars and explore the possible mechanism of action involved, a rabbit ear model with hypertrophic scars was established. OA (2.5%, 5%, and 10%) was given once daily to the scars for 28 consecutive days. As a result, OA significantly alleviated formed hypertrophic scars on rabbit ears. The levels of TGF-β1, MMP-1, TIMP-1, and collagens I and III were notably decreased, and the number of apoptosis cells and mRNA expression of MMP-2, caspase-3, and caspase-9 were markedly increased in the scar tissue. The scar elevation index (SEI) was also evidently reduced. Histological findings exhibited significant amelioration of the collagen tissue. These results suggest that OA has the favorable curative effects on formed hypertrophic scars in the rabbit ear model, and the possible mechanism of action is that OA decreases HSFs proliferation and increases HSFs apoptosis by reduction of P311 gene expression and TGF-β1 production, inhibition of TIMP-1 secretion, enhancement of MMP-2 activity, and subsequently facilitation of degradation of collagen types I and III. PMID:23326292

  8. The application of surface electrical and shallow geothermic methods in monitoring network design.

    USGS Publications Warehouse

    Gilkeson, R.H.; Cartwright, K.

    1983-01-01

    There are a variety of surface geophysical methods that are routinely used in geologic investigations. The three broad applications of these methods to evaluate the impact of waste disposal on shallow groundwater flow systems are: 1) evaluation of proposed waste disposal sites; 2) monitoring of site performance; and 3) investigation of contaminant migration at existing sites. Electrical and shallow geothermic are two surface geophysical methods that have application to waste disposal investigations. Of the electrical methods, electrical resistivity has the greatest application with a variety of techniques available. The distribution of temperature in shallow geologic materials (shallow geothermics) may define characteristics of shallow groundwater flow systems including zones of recharge and discharge and lithologic variation in the shallow geologic materials.-from Authors

  9. An Atypical Case of Apical Hypertrophic Cardiomyopathy: Absence of Giant T Waves in spite of Extreme Apical Wall Hypertrophy.

    PubMed

    Sanidas, Elias; Bonou, Maria; Anastasiadis, Georgios; Tzanis, Georgios; Barbetseas, John

    2015-01-01

    Apical hypertrophic cardiomyopathy is an uncommon variant of hypertrophic cardiomyopathy, with hypertrophy mainly affecting the apex of the left ventricle. We hereby describe a case of an octogenarian female patient who was randomly diagnosed with AHCM due to other comorbidities. PMID:26779351

  10. An Atypical Case of Apical Hypertrophic Cardiomyopathy: Absence of Giant T Waves in spite of Extreme Apical Wall Hypertrophy

    PubMed Central

    Sanidas, Elias; Bonou, Maria; Anastasiadis, Georgios; Tzanis, Georgios; Barbetseas, John

    2015-01-01

    Apical hypertrophic cardiomyopathy is an uncommon variant of hypertrophic cardiomyopathy, with hypertrophy mainly affecting the apex of the left ventricle. We hereby describe a case of an octogenarian female patient who was randomly diagnosed with AHCM due to other comorbidities. PMID:26779351

  11. Bimodal spectroscopy for in vivo characterization of hypertrophic skin tissue : pre-clinical experimentation, data selection and classification.

    PubMed

    Liu, H; Gisquet, H; Blondel, W; Guillemin, F

    2012-12-01

    This study aims at investigating the efficiency of bimodal spectroscopy in detection of hypertrophic scar tissue on a preclinical model. Fluorescence and Diffuse Reflectance spectra were collected from 55 scars deliberately created on ears of 20 rabbits, amongst which some received tacrolimus injection to provide non-hypertrophic scar tissue. The spectroscopic data measured on hypertrophic and non-hypertrophic scar tissues were used for developing our classification algorithm. Spectral features were extracted from corrected data and analyzed to classify the scar tissues into hypertrophic or non-hypertrophic. The Algorithm was developed using k-NN classifier and validated by comparing to histological classification result with Leave-One-Out cross validation. Bimodal spectroscopy showed promising results in detecting hypertrophic tissue (sensibility 90.5%, specificity 94.4%). The features used for classification were extracted from the autofluorescence spectra collected at 4 CEFS with excitations at 360, 410, and 420 nm. This indicates the hypertrophic process may involve change in concentration of several fluorophores (collagen, elastin and NADH) excited in this range, or modification in volume of explored tissue layers (epidermis and dermis) due to tissue thickening. PMID:23243577

  12. The presence of lysylpyridinoline in the hypertrophic cartilage of newly hatched chicks

    NASA Technical Reports Server (NTRS)

    Orth, M. W.; Martinez, D. A.; Cook, M. E.; Vailas, A. C.

    1993-01-01

    The presence of lysylpyridinoline (LP) as a nonreducible cross-link in appreciable quantities has primarily been limited to the mineralized tissues, bone and dentin. However, the results reported here show that LP is not only present in the hypertrophic cartilage of the tibiotarsus isolated from newly hatched broiler chicks, but it is approx. 4-fold as concentrated as hydroxylysylpyridinoline (HP). Bone and articular cartilage surrounding the hypertrophic cartilage do not contain measurable quantities of LP. Purified LP has a fluorescent scan similar to purified HP and literature values, confirming that we indeed were measuring LP. Also, the cartilage lesion produced by immature chondrocytes from birds with tibial dyschondroplasia had LP but the HP:LP ratio was > 1. Thus, the low HP:LP ratio could be a marker for hypertrophic cartilage in avians.

  13. Pak1 as a Novel Therapeutic Target for Anti-Hypertrophic Treatment in the Heart

    PubMed Central

    Liu, Wei; Zi, Min; Naumann, Ronald; Ulm, Susanne; Jin, Jiawei; Taglieri, Domenico M.; Prehar, Sukhpal; Gui, Junhong; Tsui, Hoyee; Xiao, Rui-Ping; Neyses, Ludwig; Solaro, R. John; Ke, Yunbo; Cartwright, Elizabeth J.; Lei, Ming; Wang, Xin

    2011-01-01

    Background Stress-induced hypertrophic remodeling is a critical pathogenetic process leading to heart failure. While many signal transduction cascades are demonstrated as important regulators to facilitate the induction of cardiac hypertrophy, the signaling pathways for suppressing hypertrophic remodeling remain largely unexplored. In this study, we identified p21-activated kinase 1 (Pak1) as a novel signaling regulator which antagonizes cardiac hypertrophy. Methods and Results Hypertrophic stress applied to primary neonatal rat cardiomyocytes (NRCMs), or murine hearts caused the activation of Pak1. Analysis of NRCMs expressing constitutively active Pak1 or in which Pak1 was silenced disclosed that Pak1 played an anti-hypertrophic role. To investigate the in vivo role of Pak1 in the heart, we generated mice with a cardiomyocyte-specific deletion of Pak1 (Pak1cko). When subject to 2 weeks of pressure overload, Pak1cko mice compared to controls, developed greater cardiac hypertrophy with attendant blunting of JNK activation, and these knockout mice underwent the transition into heart failure when prolonged stress was applied. In addition, chronic angiotensin II infusion also caused increased cardiac hypertrophy in Pak1cko mice. Moreover, we discovered that the Pak1 activator FTY720, a sphingosine-like analogue, was able to prevent pressure overload-induced hypertrophy in wild-type mice, without compromising their cardiac functions. Meanwhile FTY720 failed to exert such an effect on Pak1cko mice, suggesting that the anti-hypertrophic effect of FTY720 likely acts through Pak1 activation. Conclusions These results, for the first time, establish Pak1 as a novel anti-hypertrophic regulator and suggest that it may be a potential therapeutic target for the treatment of cardiac hypertrophy and heart failure. PMID:22082674

  14. Effect of lipopolysaccharide on the biological characteristics of human skin fibroblasts and hypertrophic scar tissue formation.

    PubMed

    Yang, Hongming; Hu, Chao; Li, Fengyu; Liang, Liming; Liu, Lingying

    2013-06-01

    Burn injury-mediated destruction of the skin barrier normally induces microbial invasion, in turn leading to the development of systemic infection and occasional septic shock by the release of endotoxins. The objective of this work was to study the influence of lipopolysaccharide (LPS) on the biological characteristics of normal skin fibroblasts and to elucidate the influence of LPS in the initial stage of skin wound healing. Twenty patients with hypertrophic scar in proliferative stage were selected randomly and primary cultures were established from fibroblasts derived from their hypertrophic scar tissue and normal skin. Normal skin fibroblasts of passage 3 were stimulated with different concentrations of LPS. LPS stimulated the proliferation and collagen synthesis of fibroblasts within a certain extent of concentrations (0.005-0.5 μg/mL) (P < 0.05), whereas at a concentration of 1 μg/mL inhibited the proliferation and collagen synthesis of fibroblasts (P < 0.05). Collagen synthesis by normal skin fibroblasts after LPS stimulation mimicked those derived from hypertrophic scar tissue. LPS of 0.1 μg/mL had significant effect on normal skin fibroblasts-continuous passage of these fibroblasts resulted in ultrastructural pattern similar to fibroblasts derived from hypertrophic scar tissue, and the findings was substantiated by hematoxylin and eosin staining and immunohistochemistry detection of proliferation cell nuclear antigen, type I procollagen and α-smooth muscle actin. Our results suggest that LPS might convert normal skin fibroblasts to hypertrophic scar tissue fibroblasts and participate in the formation of hypertrophic scar; hence, appropriate concentration of LPS may have no effect or be beneficial to skin wound healing, whereas excessive concentration of LPS may delay the time of wound healing. PMID:23653386

  15. Clinical significance of giant negative T waves in hypertrophic cardiomyopathy

    SciTech Connect

    Alfonso, F.; Nihoyannopoulos, P.; Stewart, J.; Dickie, S.; Lemery, R.; McKenna, W.J. )

    1990-04-01

    To assess the clinical significance of giant negative T waves in patients with hypertrophic cardiomyopathy from Western nations, clinical, echocardiographic, radionuclide and 48 h electrocardiographic (ECG) monitoring findings were compared in 27 patients with and 56 patients without giant negative T waves. Patients with giant negative T waves were older at diagnosis (43 +/- 15 versus 32 +/- 14 years, p less than 0.005), had greater ECG voltage (SV1 + RV5 = 57 +/- 20 versus 37 +/- 18 mm, p less than 0.001) and had a more vertical frontal plane axis (38.4 +/- 34 versus 13.4 +/- 45 degrees, p less than 0.05). Left ventricular wall thickness on two-dimensional echocardiography was similar at the mitral valve level (mean 16.5 +/- 4 versus 16.6 +/- 3 cm), but was greater at the papillary muscle level (mean 20.7 +/- 5 versus 17.6 +/- 3 mm, p less than 0.01) and apex (mean 23.3 +/- 5 versus 17.3 +/- 3 mm, p less than 0.001) in patients with giant negative T waves. Fewer patients with giant negative T waves had asymmetric septal hypertrophy (12 (44%) of 27 versus 36 (64%) of 56, p = 0.08) or systolic anterior motion of the mitral valve (4 (14%) of 27 versus 25 (45%) of 56, p less than 0.01), whereas left ventricular end-diastolic (44.1 +/- 6 versus 39.6 +/- 5 mm, p = 0.01) and end-systolic dimensions (27.8 +/- 4 versus 24 +/- 6 mm, p less than 0.05) were greater in this group. Nonsustained ventricular tachycardia was seen on ECG monitoring in 21% of patients in both groups.

  16. Operation for hypertrophic subaortic stenosis in the aged.

    PubMed

    Cooper, M M; McIntosh, C L; Tucker, E; Clark, R E

    1987-10-01

    To determine if operative palliation of idiopathic hypertrophic subaortic stenosis (IHSS) is worthwhile in the elderly, hemodynamic, cardiac conduction, symptomatological, functional, and survival data were examined in 52 patients (39 women) 65 years old and older (mean age, 69 years; range, 65 to 81 years) who had a left ventricular myotomy and myectomy (LVMM) (Morrow procedure) alone or with concomitant operations. Seventy-four percent of all operative survivors underwent catheterization an average of 6 months postoperatively. The mean follow-up was 54 months (range, 5 to 120 months). The population was divided for analyses into those with coronary artery disease (CAD) (N = 11,21%) and those without (N = 41). The peak resting left ventricular outflow tract gradient was reduced from 65 +/- 16 mm Hg to 3 +/- 1 mm Hg (p less than 0.01) in the group with CAD and from 95 +/- 13 mm Hg to 17 +/- 9 mm Hg (p less than 0.001) in the group without CAD. Significant reductions in peak gradients in response to provocation also occurred in both groups. New conduction abnormalities occurred in 72% of survivors, 85% of whom showed improvement in regard to symptoms. The overall average New York Heart Association Functional Class was 3.2 +/- 0.1 preoperatively and at latest follow-up, 1.9 +/- 0.1 (p less than 0.001). The hospital mortality for LVMM alone in the absence of CAD was 8% with a 5-year actuarial survival of 75 +/- 8%. LVMM in the presence of CAD resulted in an operative mortality of 27% (N = 3); all deaths were related to an acquired ventricular septal defect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3662685

  17. Quantitative measurement of hypertrophic scar: interrater reliability and concurrent validity.

    PubMed

    Nedelec, Bernadette; Correa, José A; Rachelska, Grazyna; Armour, Alexis; LaSalle, Léo

    2008-01-01

    Research into the pathophysiology and treatment of hypertrophic scar (HSc) remains limited by the heterogeneity of scar and the imprecision with which its severity is measured. The objective of this study was to test the interrater reliability and concurrent validity of the Cutometer measurement of elasticity, the Mexameter measurement of erythema and pigmentation, and total thickness measure of the DermaScan C relative to the modified Vancouver Scar Scale (mVSS) in patient-matched normal skin, normal scar, and HSc. Three independent investigators evaluated 128 sites (severe HSc, moderate or mild HSc, donor site, and normal skin) on 32 burn survivors using all of the above measurement tools. The intraclass correlation coefficient, which was used to measure interrater reliability, reflects the inherent amount of error in the measure and is considered acceptable when it is >0.75. Interrater reliability of the totals of the height, pliability, and vascularity subscales of the mVSS fell below the acceptable limit ( congruent with0.50). The individual subscales of the mVSS fell well below the acceptable level (< or =0.3). The Cutometer reading of elasticity provided acceptable reliability (>0.89) for each study site with the exception of severe scar. Mexameter and DermaScan C reliability measurements were acceptable for all sites (>0.82). Concurrent validity correlations with the mVSS were significant except for the comparison of the mVSS pliability subscale and the Cutometer maximum deformation measure comparison in severe scar. In conclusion, the Mexameter and DermaScan C measurements of scar color and thickness of all sites, as well as the Cutometer measurement of elasticity in all but the most severe scars shows high interrater reliability. Their significant concurrent validity with the mVSS confirms that these tools are measuring the same traits as the mVSS, and in a more objective way. PMID:18388576

  18. Hypertrophic Osteoarthropathy and Follicular Thyroid Cancer: A Rare Paraneoplastic Syndrome

    PubMed Central

    Tavarelli, Martina; Sarfati, Julie; De Gennes, Christian; Haroche, Julien; Buffet, Camille; Ghander, Cécile; Simon, Jean Marc; Ménégaux, Fabrice; Leenhardt, Laurence

    2015-01-01

    Background Hypertrophic osteoarthropathy (HOA) is a rare condition characterized by bone and joint pain and digital clubbing usually associated with bronchopulmonary diseases. Primary HOA is rare and the pathogenesis remains unclear. Objectives Cases of HOA as a paraneoplastic syndrome associated with thyroid carcinoma are very rare – only 2 cases have been described in the literature. Results We present the first case of a 40-year-old patient affected by HOA associated with invasive differentiated follicular thyroid carcinoma operated in 2 stages. Both operations were followed by radioiodine ablation, and then a rapid unresectable local recurrence developed requiring cervical radiotherapy (70 Gy). A second treatment with 100 mCi of 131I confirmed it was a refractory thyroid cancer. Further surgery confirmed a poorly differentiated follicular cancer and 12 cycles of chemotherapy by gemcitabine and oxaliplatin followed. During the 8 years of follow-up, cervical recurrence was stable, but severe episodes of hemoptysis occurred requiring iterative embolization of the bronchial and tracheal arteries. Other lung diseases were excluded. Digital clubbing appeared, which was associated with arthritis, bone pain and inflammatory syndrome. X-rays and magnetic resonance imaging found periosteal apposition in the long bones; bone scintigraphy confirmed the HOA diagnosis. Other causes of arthritis were eliminated. She was treated with colchicine, corticosteroids and nonsteroidal anti-inflammatory drugs, but only the combination of methotrexate and hydroxychloroquine reduced the morphine requirements. Conclusion HOA is exceptionally associated with thyroid cancer and we raised the hypothesis of the secretion of a circulating factor in a patient with invasive and recurrent follicular thyroid cancer, refractory to radioiodine. PMID:26835431

  19. Utilizing ECG-Based Heartbeat Classification for Hypertrophic Cardiomyopathy Identification.

    PubMed

    Rahman, Quazi Abidur; Tereshchenko, Larisa G; Kongkatong, Matthew; Abraham, Theodore; Abraham, M Roselle; Shatkay, Hagit

    2015-07-01

    Hypertrophic cardiomyopathy (HCM) is a cardiovascular disease where the heart muscle is partially thickened and blood flow is (potentially fatally) obstructed. A test based on electrocardiograms (ECG) that record the heart electrical activity can help in early detection of HCM patients. This paper presents a cardiovascular-patient classifier we developed to identify HCM patients using standard 10-second, 12-lead ECG signals. Patients are classified as having HCM if the majority of their recorded heartbeats are recognized as characteristic of HCM. Thus, the classifier's underlying task is to recognize individual heartbeats segmented from 12-lead ECG signals as HCM beats, where heartbeats from non-HCM cardiovascular patients are used as controls. We extracted 504 morphological and temporal features—both commonly used and newly-developed ones—from ECG signals for heartbeat classification. To assess classification performance, we trained and tested a random forest classifier and a support vector machine classifier using 5-fold cross validation. We also compared the performance of these two classifiers to that obtained by a logistic regression classifier, and the first two methods performed better than logistic regression. The patient-classification precision of random forests and of support vector machine classifiers is close to 0.85. Recall (sensitivity) and specificity are approximately 0.90. We also conducted feature selection experiments by gradually removing the least informative features; the results show that a relatively small subset of 264 highly informative features can achieve performance measures comparable to those achieved by using the complete set of features. PMID:25915962

  20. Abnormal Mitral Valve Dimensions in Pediatric Patients with Hypertrophic Cardiomyopathy.

    PubMed

    Schantz, Daryl; Benson, Lee; Windram, Jonathan; Wong, Derek; Dragulescu, Andreea; Yoo, Shi-Joon; Mertens, Luc; Friedberg, Mark; Al Nafisi, Bahiyah; Grosse-Wortmann, Lars

    2016-04-01

    The hearts of patients with hypertrophic cardiomyopathy (HCM) show structural abnormalities other than isolated wall thickening. Recently, adult HCM patients have been found to have longer mitral valve leaflets than control subjects. The aim of the current study was to assess whether children and adolescents with HCM have similar measureable differences in mitral valve leaflet dimensions when compared to a healthy control group. Clinical and echocardiographic data from 46 children with myocardial hypertrophy and a phenotype and/or genotype consistent with sarcomeric HCM were reviewed. Cardiac magnetic resonance imaging studies were evaluated. The anterior and posterior mitral valve leaflet lengths and myocardial structure were compared to 20 healthy controls. The anterior mitral valve was longer in the HCM group than in the control group (28.4 ± 4.9 vs. 25.2 ± 3.6 mm in control patients, p = 0.013) as was the posterior mitral valve leaflet (16.3 ± 3.0 vs. 13.1 ± 2.3 mm for controls <0.0001). There was no correlation between the resting left ventricular outflow tract gradient and anterior mitral valve leaflet length, nor was the anterior mitral valve leaflet longer in those with systolic anterior motion of the mitral valve compared to those without (28.9 ± 6.1 vs. 28.1 ± 4.5 mm, p = 0.61). Children and adolescents with HCM have abnormally long mitral valve leaflets when compared with healthy control subjects. These abnormalities do not appear to result in, or be due to, obstruction to left ventricular outflow. The mechanism of this mitral valve elongation is not clear but appears to be independent of hemodynamic disturbances. PMID:26961572

  1. Occurrence of Clinically Diagnosed Hypertrophic Cardiomyopathy in the United States.

    PubMed

    Maron, Martin S; Hellawell, Jennifer L; Lucove, Jaime C; Farzaneh-Far, Ramin; Olivotto, Iacopo

    2016-05-15

    Hypertrophic cardiomyopathy (HC) is the most common genetic heart disease and an important cause of sudden death and heart failure symptoms. The current prevalence for HC (1:500) is based on echocardiographic population studies in which a substantial proportion of affected subjects have not come to clinical recognition. Therefore, we sought to define the subset of patients with HC who are diagnosed in the US. A proprietary integrated claims database including medical condition International Classification of Diseases, Ninth Revision diagnostic codes for over 160 million individual patients in the US was interrogated for 2013 to identify the prevalence of clinically recognized HC. Patients with ≥1 claim for any of the HC International Classification of Diseases, Ninth Revision diagnosis codes from January to December 2013 were identified. The combined occurrence rate of HC was stratified by age and gender and multiplied by the 2013 United States population in the same age/gender categories to produce the final projected prevalence. The analysis was performed on 169,089,614 patients, of whom 59,009 unique patients were identified with ≥1 claim for HC. The projected estimated occurrence of diagnosed HC in the US in 2013 was 1:3,195 for a total of 98,958 subjects. Average age at HC diagnosis was in the fifth decade of life, with 43% of the cohort composed of women. In conclusion, leveraging a claims-based data analytic technique, about 100,000 patients are diagnosed clinically with HC in the US, an occurrence which is less than the prevalence reported in systematic population studies based on echocardiographic diagnosis. This observation supports the view that many patients with HC are undiagnosed throughout life and enhances our understanding of the burden of this genetic heart disease on the health care system. PMID:27006153

  2. Radiofrequency catheter septal ablation for hypertrophic obstructive cardiomyopathy in children

    PubMed Central

    Emmel, M.; Sreeram, N.

    2005-01-01

    Background The definitive therapeutic options for symptomatic obstructive cardiomyopathy in childhood are restricted. At present, extensive surgical myectomy is the only procedure that is of proven benefit. Patients and Methods Three patients, aged 5, 11 and 17 years, respectively, with progressive hypertrophic obstructive cardiomyopathy and increasing symptoms were considered for radiofrequency catheter septal ablation. The peak Doppler gradient recorded on several occasions ranged between 50 to 90mmHg. Via a femoral arterial approach, the His bundle was initially plotted and marked using the LocaLisa navigation system. Subsequently, using a cooled tip catheter a series of lesions were placed in the hypertrophied septum, taking care to stay away from the His bundle. A total of 17, 50 and 45 lesions were applied in the three patients. In one case, the procedure was complicated by two episodes of ventricular fibrillation requiring DC cardioversion but without any neurological sequelae. Results The preablation peak-to-peak gradient between left ventricle and aorta was 50 mmHg, 60 mmHg and 60 mmHg, respectively, and remained unchanged immediately after the procedure. All patients were discharged from hospital 48 hours later. Serial measurement of serum troponin T and CK-MB isoenzyme confirmed significant myocardial necrosis. Follow-up echocardiography both at seven days and at six weeks postablation confirmed a beneficial haemodynamic result, with reduction of left ventricular outflow obstruction and relief of symptoms. Conclusion In young children, in whom alcohol-induced septal ablation is not an option, radiofrequency catheter ablation offers an alternative to surgery, with the benefits of repeatability and a lower risk of procedure-related permanent AV block. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:25696442

  3. [Regional right ventricular hypertrophy in hypertrophic cardiomyopathy and hypertension].

    PubMed

    Seo, T; Yokota, Y; Kumaki, T; Takarada, A; Kubo, M; Kaku, K; Toh, S; Fukuzaki, H

    1985-06-01

    The mode of right ventricular hypertrophy was assessed by two-dimensional echocardiography (2DE) for 24 patients with hypertrophic cardiomyopathy (HCM), and the results were compared with those of 51 patients with hypertension (HT). The patients with HT were categorized in four groups depending on the thickness of the interventricular septum (IVST) and left ventricular posterior wall (PWT): HT-ASH with both left ventricular hypertrophy (LVH) (IVST greater than or equal to 13 mm) and asymmetric septal hypertrophy (ASH) (IVST/PWT greater than or equal to 1.3), severe HT with LVH and without ASH, and mild HT without LVH and ASH. Anterior wall thickness (AWT), posterior wall thickness (PWT), and diaphragmatic wall thickness (DWT) of the right ventricle were obtained from 2DE in the parasternal long-axis view, the short-axis view and subxiphoid view, respectively. These were recorded on video tape, and the measurements were made on the stop frames. Right ventricular hypertrophy (RVH) was estimated by the maximal right ventricular wall thickness (max RVWT), and the ratio of the maximal and minimal thickness (max RVWT/min RVWT) was calculated to evaluate asymmetrical hypertrophy (AH) of the right ventricle (RV). The incidence of RVH (Max RVWT greater than or equal to 5 mm) and asymmetrical hypertrophy (AH) (max RVWT/min RVWT greater than or equal to 1.3) of the RV in HCM, HT-ASH and mild HT were 67% and 41%, 57% and 45%, and 15% and 11%, respectively. The incidence of RVH with AH was more frequent in patients with HCM as well as HT with ASH than in patients with HT without ASH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4093619

  4. Differential expression of cyclooxygenases in hypertrophic scar and keloid tissues.

    PubMed

    Rossiello, Luigi; D'Andrea, Francesco; Grella, Roberto; Signoriello, Giuseppe; Abbondanza, Ciro; De Rosa, Caterina; Prudente, Mariaevelina; Morlando, Marianna; Rossiello, Raffaele

    2009-01-01

    Hypertrophic scar (HS) and keloid (KL) are two forms of an abnormal cutaneous scarring process, mainly characterized by excessive extracellular matrix deposition and fibroblast proliferation. Despite the increased understanding of the molecular and cellular events leading to HS and KL, the pathogenesis of these lesions remains poorly understood. A pivotal role in the formation of abnormal scars has been ascribed to transforming growth factor-beta, whose activity appears to be mediated through a link with pathways acting via cyclooxygenases (COX-1 and COX-2). To date, there is no report on the in vivo expression of COX-1 and COX-2 in human HS and KL tissues. Therefore, using immunohistochemistry and Western blot analysis, we investigated 36 cases of KL, 32 cases of HS, and 25 cases of normal skin in order to define the localization and distribution of COX-1 and COX-2 in the tissues of these scar lesions and the overlying epidermis. The results mainly show the following: (a) a significant overexpression of COX-1 in HS tissues and the overlying epidermis as compared with normal skin and KL tissues and (b) a significant overexpression of COX-2 in KL tissue and the overlying epidermis in contrast to normal skin and HS tissues. Our data support the hypothesis that both COXs are involved in the pathogenesis of scar lesions in different ways and, particularly, COX-1 in the formation of HS and COX-2 in the formation of KL. In addition, the overexpression of COX-1 and COX-2 in the epidermis overlying HS and KL tissues, respectively, underlines the importance of epithelial-mesenchymal interactions in the pathogenesis of scar lesions. PMID:19769727

  5. Hypertrophic lichen planus versus prurigo nodularis: a dermoscopic perspective

    PubMed Central

    Ankad, Balachandra S.; Beergouder, Savitha L.

    2016-01-01

    Background: Hypertrophic lichen planus (HLP) classically involves shin and ankles and is characterized by hyperkeratotic plaques and nodules. Prurigo nodularis (PN) is a chronic neurodermatitis that presents with intensely pruritic nodules. Histopathology of HLP and PN demonstrate epidermal hyperplasia, hypergranulosis, and compact hyperkeratosis. The dermis shows vertically arranged collagen fibers and an increased number of fibroblasts and capillaries in both conditions. Moreover, basal cell degeneration is confined to the tips of rete ridges, and band-like infiltration is conspicuously absent in HLP. Therefore, both conditions mimic each other clinically, which makes diagnosis difficult. Hence, there is a need for a diagnostic technique to differentiate both conditions. Objective: To evaluate dermoscopic patterns in HLP and PN and to study these patterns histopathologically. Materials and methods: The study was conducted at S. Nijalingappa Medical College in Bagalkot. It was an observational case series study. Ethical clearance and informed consent was obtained. A Dermlite 3 dermoscope (3Gen, San Juan Capistrano, CA, USA) attached to a Sony Cyber Shot camera DSC-W800 (Sony Electronics Inc., San Diego, California, USA) was employed. Histopathology was done to confirm the diagnosis. Results: There were 10 patients each with HLP and PN. HLP was seen in 8 males and 2 females. PN was observed in 7 females and 3 males. Dermoscopy of HLP demonstrated pearly white areas and peripheral striations (100%), gray-blue globules (60%), comedo-like openings (30%), red dots (40%), red globules (10%), brownish-black globules (30%), and yellowish structures (90%). In PN, red dots (70%), red globules (60%), and pearly white areas with peripheral striations (100%) were observed under dermoscopy. Conclusion: Both HLP and PN demonstrated specific dermoscopic patterns which can be demonstrated on histopathologic findings. The authors propose that these patterns are hallmarks of each

  6. Altered patterns of cardiac intercellular junction distribution in hypertrophic cardiomyopathy.

    PubMed Central

    Sepp, R.; Severs, N. J.; Gourdie, R. G.

    1996-01-01

    OBJECTIVE: To examine the distribution pattern of intercellular junctions (the mechanically coupling desmosomes and the electrically coupling gap junctions) in hypertrophic cardiomyopathy (HCM) hearts showing myofibre disarray. DESIGN: Samples from six necropsied hearts were studied, representing the interventricular septum and the free walls of the left and right ventricles. Immunohistochemical labelling of desmoplakin was used as a marker for desmosomes, and of connexin43 as a marker for gap junctions, in single and double stainings. The slides were examined by confocal laser scanning microscopy. RESULTS: Marked disorganisation of intercalated discs was observed in areas featuring myofibre disarray. Besides overall derangement, localised abnormalities in desmosome organisation were evident, which included: (1) the formation of abnormally enlarged megadiscs; (2) the presence of intersecting disc structures; and (3) aberrant side to side desmosomal connections. Gap junctional abnormalities included: (1) random distribution of gap junctions over the surface of myocytes, rather than localisation to intercalated discs; (2) abundant side to side gap junction connections between adjacent myocytes; and (3) formation of abnormally shaped gap junctions. Circles of myocytes continuously interconnected by gap junctions were also observed. Regions of the diseased hearts lacking myofibre disarray, and control hearts of normal patients and patients with other cardiac diseases, did not show these alterations. CONCLUSIONS: The disorganisation of the intercellular junctions associated with myofibre disarray in HCM may play an important role in the pathophysiological manifestations of the disease. The remodelling of gap junction distribution may underlie the formation of an arrhythmogenic substrate, thereby contributing to the generation and maintenance of cardiac arrhythmias associated with HCM. Images PMID:8944586

  7. Malalignment of the sarcomeric filaments in hypertrophic cardiomyopathy with cardiac myosin heavy chain gene mutation

    PubMed Central

    Muraishi, A; Kai, H; Adachi, K; Nishi, H; Imaizumi, T

    1999-01-01

    OBJECTIVE—To investigate changes in the alignment of the sarcomeric filaments in hypertrophic cardiomyopathy and the effects of cardiac β myosin heavy chain (β-MHC) mutation on the sarcomeric ultrastructure.
DESIGN—A retrospective analysis.
PATIENTS—Endomyocardial biopsy samples were examined by transmission electron microscopy in seven patients with hypertrophic cardiomyopathy and β-MHC mutation, six with hypertrophic cardiomyopathy but without the mutation, and five controls (with chest pain syndromes).
MAIN OUTCOME MEASURE—Alignment of the sarcomeric filaments and the distance between neighbouring thick myosin filaments.
RESULTS—In controls, cross sections of the sarcomere at the A band showed a highly organised orthohexagonal array with 6 thin actin filaments surrounding one thick myosin filament, whereas in hypertrophic cardiomyopathy the alignment of the sarcomeric filaments was sparse and disrupted. In hypertrophic cardiomyopathy with a mutation, the distance between neighbouring thick myosin filaments was greater than in controls (mean (SD) 45.3 (4.7) v 38.5 (3.5) nm, p < 0.05), and the variance of the distance was greater than in controls (8.0 (0.7) v 4.8 (1.0) nm, p < 0.001) or in patients with hypertrophic cardiomyopathy without a mutation (6.7 (0.6) nm, p < 0.05). In the latter, the variance of the distance was also greater than in the controls (p < 0.01). A significant correlation was found between the grade of the myocyte hypertrophy and the variance of the distance (r = 0.654; p < 0.01).
CONCLUSIONS—The alignment of the sarcomeric filaments is disrupted in hypertrophic cardiomyopathy, particularly when there is β-MHC mutation.


Keywords: hypertrophic cardiomyopathy; β myosin heavy chain; myosin filament; sarcomere PMID:10525522

  8. Identification and characterization of the novel Col10a1 regulatory mechanism during chondrocyte hypertrophic differentiation.

    PubMed

    Gu, J; Lu, Y; Li, F; Qiao, L; Wang, Q; Li, N; Borgia, J A; Deng, Y; Lei, G; Zheng, Q

    2014-01-01

    The majority of human skeleton develops through the endochondral pathway, in which cartilage-forming chondrocytes proliferate and enlarge into hypertrophic chondrocytes that eventually undergo apoptosis and are replaced by bone. Although at a terminal differentiation stage, hypertrophic chondrocytes have been implicated as the principal engine of bone growth. Abnormal chondrocyte hypertrophy has been seen in many skeletal dysplasia and osteoarthritis. Meanwhile, as a specific marker of hypertrophic chondrocytes, the type X collagen gene (COL10A1) is also critical for endochondral bone formation, as mutation and altered COL10A1 expression are often accompanied by abnormal chondrocyte hypertrophy in many skeletal diseases. However, how the type X collagen gene is regulated during chondrocyte hypertrophy has not been fully elucidated. We have recently demonstrated that Runx2 interaction with a 150-bp mouse Col10a1 cis-enhancer is required but not sufficient for its hypertrophic chondrocyte-specific reporter expression in transgenic mice, suggesting requirement of additional Col10a1 regulators. In this study, we report in silico sequence analysis of this 150-bp enhancer and identification of its multiple binding factors, including AP1, MEF2, NFAT, Runx1 and TBX5. Using this enhancer as bait, we performed yeast one-hybrid assay and identified multiple candidate Col10a1-interacting genes, including cyclooxygenase 1 (Cox-1) and Cox-2. We have also performed mass spectrometry analysis and detected EF1-alpha, Fus, GdF7 and Runx3 as components of the specific complex formed by the cis-enhancer and nuclear extracts from hypertrophic MCT (mouse chondrocytes immortalized with large T antigen) cells that express Col10a1 abundantly. Notably, some of the candidate genes are differentially expressed in hypertrophic MCT cells and have been associated with chondrocyte hypertrophy and Runx2, an indispensible Col10a1 regulator. Intriguingly, we detected high-level Cox-2 expression in

  9. Geotechnical characteristics of shallow ocean dredge spoil disposal mounds

    SciTech Connect

    Demars, K.R.; Dowling, J.J.; Long, R.P.; Morton, R.W.

    1984-05-01

    This paper summarizes the data obtained from site surveying and sediment sampling of dredge spoil disposal mounds at the Central Long Island Sound site. Emphasis is placed on the geotechnical and geological features of the mound and natural seabed. Since some of the spoil is contaminated, cappings of clean spoil have been used to isolate the spoil mounds from fauna and flora in the water column. Because of the contaminated spoil, improvements in the disposal techniques are needed and methodologies must be developed for evaluating short-term and long-term stability of these shallow ocean deposits which are subjected to loadings from waves, spoil disposal and capping operations.

  10. Redox buffering in shallow aquifers contaminated by leachate

    SciTech Connect

    Heron, G.; Bjerg, P.L.; Christensen, T.H.

    1995-12-31

    The redox conditions in two Danish landfill leachate-polluted aquifers (the Vejen and Grindsted) are discussed in terms of redox buffering. Dominant leachate contributors to reduction capacity (RDC) are dissolved organic matter and ammonium. Aquifer oxidation capacity is dominated by Fe(III) oxides, and the Vejen Landfill case shows that redox buffering by reduction of Fe(III) oxides may be important for plume development. Inorganic precipitates such as pyrite and other Fe(II) minerals may dramatically increase the oxygen demand of the aquifer. In mineral-poor aquifers such as the lower aquifer at Grindsted Landfill, redox buffering by solid electron acceptors is far less important, and smaller quantities of reduced species are formed.

  11. Contaminant Transport to Shallow Drainage Water in Pothole Topography

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Nutrient and herbicide losses from row crop agriculture represent potential environmental and human health hazards. In order to determine where nutrient and herbicide mitigation strategies can be targeted for optimum performance, levels of nutrients and herbicides were measured in an agricultural dr...

  12. Controlling Cyanobacterial Blooms in Hypertrophic Lake Taihu, China: Will Nitrogen Reductions Cause Replacement of Non-N2 Fixing by N2 Fixing Taxa?

    PubMed Central

    Paerl, Hans W.; Xu, Hai; Hall, Nathan S.; Zhu, Guangwei; Qin, Boqiang; Wu, Yali; Rossignol, Karen L.; Dong, Linghan; McCarthy, Mark J.; Joyner, Alan R.

    2014-01-01

    Excessive anthropogenic nitrogen (N) and phosphorus (P) inputs have caused an alarming increase in harmful cyanobacterial blooms, threatening sustainability of lakes and reservoirs worldwide. Hypertrophic Lake Taihu, China’s third largest freshwater lake, typifies this predicament, with toxic blooms of the non-N2 fixing cyanobacteria Microcystis spp. dominating from spring through fall. Previous studies indicate N and P reductions are needed to reduce bloom magnitude and duration. However, N reductions may encourage replacement of non-N2 fixing with N2 fixing cyanobacteria. This potentially counterproductive scenario was evaluated using replicate, large (1000 L), in-lake mesocosms during summer bloom periods. N+P additions led to maximum phytoplankton production. Phosphorus enrichment, which promoted N limitation, resulted in increases in N2 fixing taxa (Anabaena spp.), but it did not lead to significant replacement of non-N2 fixing with N2 fixing cyanobacteria, and N2 fixation rates remained ecologically insignificant. Furthermore, P enrichment failed to increase phytoplankton production relative to controls, indicating that N was the most limiting nutrient throughout this period. We propose that Microcystis spp. and other non-N2 fixing genera can maintain dominance in this shallow, highly turbid, nutrient-enriched lake by outcompeting N2 fixing taxa for existing sources of N and P stored and cycled in the lake. To bring Taihu and other hypertrophic systems below the bloom threshold, both N and P reductions will be needed until the legacy of high N and P loading and sediment nutrient storage in these systems is depleted. At that point, a more exclusive focus on P reductions may be feasible. PMID:25405474

  13. Prediction of Sarcomere Mutations in Subclinical Hypertrophic Cardiomyopathy

    PubMed Central

    Captur, Gabriella; Lopes, Luis R.; Mohun, Timothy J.; Patel, Vimal; Li, Chunming; Bassett, Paul; Finocchiaro, Gherardo; Ferreira, Vanessa M.; Esteban, Maite Tome; Muthurangu, Vivek; Sherrid, Mark V.; Day, Sharlene M.; Canter, Charles E.; McKenna, William J.; Seidman, Christine E.; Bluemke, David A.; Elliott, Perry M.; Ho, Carolyn Y.; Moon, James C.

    2014-01-01

    Background Sarcomere protein mutations in hypertrophic cardiomyopathy (HCM) induce subtle cardiac structural changes prior to the development of left ventricular hypertrophy (LVH). We have proposed that myocardial crypts are part of this phenotype and independently associated with the presence of sarcomere gene mutations. We tested this hypothesis in genetic HCM pre-LVH (G+LVH−). Methods and Results A multi-centre case-control study investigated crypts and 22 other cardiovascular magnetic resonance (CMR) parameters in subclinical HCM to determine their strength of association with sarcomere gene mutation carriage. The G+LVH− sample (n=73) was 29±13 years old and 51% male. Crypts were related to the presence of sarcomere mutations (for ≥1 crypt, β=2.5, 95% confidence interval [CI] 0.5-4.4, p=0.014; for ≥2 crypts, β=3.0, 95%CI 0.8-7.9, p=0.004). In combination with 3 other parameters: anterior mitral valve leaflet (AMVL) elongation (β=2.1, 95%CI 1.7-3.1, p<0.001), abnormal LV apical trabeculae (β=1.6, 95%CI 0.8-2.5, p<0.001), and smaller LV end-systolic volumes (β=1.4, 95%CI 0.5-2.3, p=0.001), multiple crypts indicated the presence of sarcomere gene mutations with 80% accuracy and an area under the curve of 0.85 (95%CI 0.8-0.9). In this G+LVH− population cardiac myosin-binding protein C mutation carriers had twice the prevalence of crypts when compared to the other combined mutations (47 vs. 23%; odds ratio, 2.9; 95%CI 1.1–7.9; p=0.045). Conclusions The subclinical HCM phenotype measured by CMR in a multi-center environment and consisting of crypts (particularly multiple), AMVL elongation, abnormal trabeculae and smaller LV systolic cavity, is indicative of the presence of sarcomere gene mutations and highlights the need for further study. PMID:25228707

  14. Clinical Utility of Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy

    PubMed Central

    2012-01-01

    Hypertrophic cardiomyopathy (HCM) is characterized by substantial genetic and phenotypic heterogeneity, leading to considerable diversity in clinical course including the most common cause of sudden death in young people and a determinant of heart failure symptoms in patients of any age. Traditionally, two-dimensional echocardiography has been the most reliable method for establishing a clinical diagnosis of HCM. However, cardiovascular magnetic resonance (CMR), with its high spatial resolution and tomographic imaging capability, has emerged as a technique particularly well suited to characterize the diverse phenotypic expression of this complex disease. For example, CMR is often superior to echocardiography for HCM diagnosis, by identifying areas of segmental hypertrophy (ie., anterolateral wall or apex) not reliably visualized by echocardiography (or underestimated in terms of extent). High-risk HCM patient subgroups identified with CMR include those with thin-walled scarred LV apical aneurysms (which prior to CMR imaging in HCM remained largely undetected), end-stage systolic dysfunction, and massive LV hypertrophy. CMR observations also suggest that the cardiomyopathic process in HCM is more diffuse than previously regarded, extending beyond the LV myocardium to include thickening of the right ventricular wall as well as substantial morphologic diversity with regard to papillary muscles and mitral valve. These findings have implications for management strategies in patients undergoing invasive septal reduction therapy. Among HCM family members, CMR has identified unique phenotypic markers of affected genetic status in the absence of LV hypertrophy including: myocardial crypts, elongated mitral valve leaflets and late gadolinium enhancement. The unique capability of contrast-enhanced CMR with late gadolinium enhancement to identify myocardial fibrosis has raised the expectation that this may represent a novel marker, which may enhance risk stratification. At

  15. Left Atrial Mechanical Function and Global Strain in Hypertrophic Cardiomyopathy

    PubMed Central

    Yoon, Yeonyee E.; Kim, Hack-Lyoung; Lee, Seung-Pyo; Kim, Hyung-Kwan; Kim, Yong-Jin; Cho, Goo-Yeong; Zo, Joo-Hee; Sohn, Dae-Won

    2016-01-01

    Background Atrial fibrillation is the most common arrhythmia and is associated with adverse outcomes in hypertrophic cardiomyopathy (HCM). Although left atrial (LA) remodeling and dysfunction are known to associate with the development of atrial fibrillation in HCM, the changes of the LA in HCM patients remain unclear. This study aimed to evaluate the changes in LA size and mechanical function in HCM patients compared to control subjects and to determine the characteristics of HCM associated with LA remodeling and dysfunction. Methods Seventy-nine HCM patients (mean age, 54 ± 11 years; 76% were men) were compared to 79 age- and sex-matched controls (mean age, 54 ± 11 years; 76% were men) and 20 young healthy controls (mean age, 33 ± 5 years; 45% were men). The LA diameter, volume, and mechanical function, including global strain (ε), were evaluated by 2D-speckle tracking echocardiography. The phenotype of HCM, maximal left ventricular (LV) wall thickness, LV mass, and presence and extent of late gadolinium enhancement (LGE) were evaluated with cardiac magnetic resonance imaging. Results HCM patients showed increased LA volume index, impaired reservoir function, and decreased LA ε compared to the control subjects. When we divided the HCM group according to a maximal LA volume index (LAVImax) of 38.7 ml/m2 or LA ε of 21%, no significant differences in the HCM phenotype and maximal LV wall thickness were observed for patients with LAVImax >38.7 ml/m2 or LA ε ≤21%. Conversely, the LV mass index was significantly higher both in patients with maximal LA volume index >38.7 ml/m2 and with LA ε ≤21% and was independently associated with LAVImax and LA ε. Although the LGE extent was increased in patients with LA ε ≤21%, it was not independently associated with either LAVImax or LA ε. Conclusions HCM patients showed progressed LA remodeling and dysfunction; the determinant of LA remodeling and dysfunction was LV mass index rather than LV myocardial fibrosis

  16. Relationship between Regional Fat Distribution and Hypertrophic Cardiomyopathy Phenotype

    PubMed Central

    Guglielmi, Valeria; Maresca, Luciano; Lanzillo, Chiara; Marinoni, Giorgia Michela; D’Adamo, Monica; Di Roma, Mauro; Preziosi, Paolo; Bellia, Alfonso; Calò, Leonardo; Sbraccia, Paolo

    2016-01-01

    Background Hypertrophic cardiomyopathy (HCM), the most common genetic heart disease, is characterized by heterogeneous phenotypic expression. Body mass index has been associated with LV mass and heart failure symptoms in HCM. The aim of our study was to investigate whether regional (trunk, appendicular, epicardial) fat distribution and extent could be related to hypertrophy severity and pattern in HCM. Methods Cardiovascular magnetic resonance was performed in 32 subjects with echocardiography-based diagnosis of HCM (22M/10F, 57.2±12.6 years) characterized by predominant hypertrophy at the interventricular septum (IVS). Regional fat distribution was assessed by dual-energy X-ray absorptiometry. Results Gender differences were detected in maximum IVS thickness (M: 18.3±3.8 mm vs. F: 14.3±4 mm, p = 0.012), right ventricle (RV) systolic function (M: 61.3±6.7%; F: 67.5±6.3%, p = 0.048), indexed RV end-diastolic (M: 64.8±16.3 ml/m2; F: 50.7±15.5 ml/m2, p = 0.04) and end-systolic volumes (M: 24.3±8.3 ml/m2; F: 16.7±7.4 ml/m2, p = 0.04). After adjusting for age and gender, maximum IVS thickness was associated with truncal fat (Tr-FAT) (β = 0.43, p = 0.02), but not with either appendicular or epicardial fat. Epicardial fat resulted independently associated with NT-proBNP levels (β = 0.63, p = 0.04). Late Gadolinium Enhancement-positive subjects displayed greater maximum IVS thickness (p = 0.02), LV mass index (p = 0.015) and NT-proBNP levels (p = 0.04), but no associations with fat amount or distribution were observed. Conclusion Truncal, but not appendicular or epicardial fat amount, seems to be related with maximum IVS thickness, the hallmark feature in our cohort of HCM patients. Further prospective researches are needed to assess a potential causative effect of central adiposity on HCM phenotype. PMID:27388274

  17. Hypertrophic scars and keloids in surgery: current concepts.

    PubMed

    Song, Colin

    2014-09-01

    Hypertrophic scars and keloids remain a challenge in surgery. We appreciate that our understanding of the process at cellular and molecular level, profound as it is, when it comes to the clinical evidence much is left to be desired. Although the bench to bedside conundrum remains, the science of translational research calls for an even higher level of cooperation between the scientist and the clinician for the impetus to succeed.The clinicians alerted us to the possible theories in the pathogenesis of keloid formation, inter alia, the ischemia theory, mast cell theory, immune theory, transforming growth factor β interaction, mechanical theory, and the melanocyte stimulating hormone theory. All of the above presupposed a stimulus that would result in an uncontrolled upregulation of collagen and extracellular matrix expression in the pathogenesis of the keloid. This bedside to bench initiative, as in true science, realized more ponderables than possibilities.By the same token, research into the epidermal-mesenchymal signaling, molecular biology, genomics, and stem cell research holds much promise in the bench top arena. To assess efficacy, many scar assessment scores exist in the literature. The clinical measurement of scar maturity can aid in determining end points for therapeutics. Tissue oxygen tension and color assessment of scars by standardized photography proved to be useful.In surgery, the use of dermal substitutes holds some promise as we surmise that quality scars that arise from dermal elements, molecular and enzyme behavior, and balance. Although a systematic review shows some benefit for earlier closure and healing of wounds, no such review exists at this point in time for the use of dermal substitutes in scars.Adipose-derived stem cell, as it pertains to scars, will hopefully realize the potential of skin regeneration rather than by repair in which we are familiar with as well as the undesirable scarring as a result of healing through the inflammatory

  18. Aortic Stiffness in Youth with Hypertrophic Cardiomyopathy Genotype.

    PubMed

    Zachariah, Justin P; Johnson, Philip K; Colan, Steven D

    2016-06-01

    Clinical events in hypertrophic cardiomyopathy (HCM) patients are related to the degree of hypertrophy. Aortic stiffness in adult HCM patients has been reported to be higher than control patients. Increased stiffness may cause more LV hypertrophy and thus lead to more clinical events. We sought to (a) noninvasively compare aortic structure and function between youth with sarcomeric HCM genotype versus control youth and (b) explore the relation between aortic function and degree of left ventricular (LV) hypertrophy. In a prospective study from a single referral center, clinical, anthropometric, and hemodynamic data were acquired on 28 consecutive pathogenic HCM gene mutation carriers and 26 unrelated controls (mean age 16.3, 50 % girls). Hemodynamic data included applanation tonometry measured central pulse pressure, carotid-femoral pulse wave velocity (CFPWV), reflected wave augmentation index (AIx). In the HCM gene carriers, LV mass-to-volume ratio was extracted from clinically indicated echocardiograms as an index of hypertrophy. Associations were assessed using multivariable adjusted linear regression. The HCM group was comprised of 14 myosin binding protein C3 carriers, 13 myosin heavy chain 7 carriers, and 1 child with both. HCM and control groups did not differ by age, sex, height, body mass index, heart rate, or blood pressure. HCM carriers had significantly lower CFPWV than controls (4.46 ± 0.88 vs. 4.97 ± 0.44 m/s, p = 0.01) and higher AIx magnitude (27 ± 19 vs. 18 ± 7 %, p = 0.04). These associations persisted after adjustment for age, sex, height, heart rate, mean pressure, and medication use. Within the HCM group, LV hypertrophy was related to AIx but not CFPWV. CFPWV nor AIx differed by genotype. Aortic stiffness appears lower, but wave reflection appears higher in youth carrying HCM gene mutations. The degree of wave reflection appears correlated with LV hypertrophy in this high-risk cohort, suggesting that mitigation of wave

  19. Back contamination.

    NASA Technical Reports Server (NTRS)

    Phillips, G. B.

    1971-01-01

    Discussion of the concept and implications of back contamination and of the ways and means for its prevention. Back contamination is defined as contamination of the terrestrial biosphere with organisms or materials returned from outer space that are capable of potentially harmful terrestrial activity. Since the question of whether or not life exists on other planets may, in reality, not be answered until many samples are returned to earth for detailed study, requirements for the prevention of back contamination are necessary. A review of methods of microbiologic contamination control is followed by a discussion of the nature of back contamination and its risk levels, contamination sources and locations, and possible defenses against back contamination. The U.S. lunar back contamination program is described and shown to provide a valuable basis for further refining the technology for the control of planetary back contamination.

  20. Comparison of proteomic datasets from hypertrophic chondrocytes in response to ER stress.

    PubMed

    Kudelko, Mateusz; Sharma, Rakesh; Cheah, Kathryn S E; Chan, Danny

    2016-06-01

    Cartilage proteomics is challenging due to the dominance of poorly soluble matrix components and limited available tissue. Using a "spatial" strategy coupled to MS/MS analysis we have specifically labeled and extracted hypertrophic chondrocytes within the growth plate providing thus a comprehensive proteomic map of normal hypertrophic chondrocytes. Furthermore our established 13del mouse model in which the activation of ER stress did not lead to apoptosis of the hypertrophic cells allowed us to address the natural consequences of ER stress in vivo. Thus our data provide also an overview of proteomic changes occurring in cells under ER stress. Associated with the published study [1] this dataset article provided the detailed information of experimental designing, methods, features as well as the raw data of mass spectrometry (MS) identification. Furthermore the data presented here allow the reader to assert the extent of proteomic changes occurring under ER stress in hypertrophic chondrocytes as well as address the data technical reproducibility in both wild type and stress condition. The mass spectrometry proteomics data can be fully accessed from the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifier PXD002125. PMID:27014728

  1. Enhanced in vivo delivery of 5-fluorouracil by ethosomal gels in rabbit ear hypertrophic scar model.

    PubMed

    Wo, Yan; Zhang, Zheng; Zhang, Yixin; Zhang, Zhen; Wang, Kan; Mao, Xiaohui; Su, Weijie; Li, Ke; Cui, Daxiang; Chen, Jun

    2014-01-01

    Applying Ethosomal Gels (EGs) in transdermal drug delivery systems has evoked considerable interest because of their good water-solubility and biocompatibility. However, there has not been an explicit description of applying EGs as a vehicle for hypertrophic scars treatment. Here, a novel transdermal EGs loaded with 5-fluorouracil (5-FU EGs) was successfully prepared and characterized. The stability assay in vitro revealed that 5-FU EGs stored for a period of 30 days at 4 ± 1 °C had a better size stability than that at 25 ± 1 °C. Furthermore, using confocal laser scanning microscopy, EGs labeled with Rhodamine 6 G penetrated into the deep dermis of the hypertrophic scar within 24 h in the rabbit ear hypertrophic model suggested that the EGs were an optional delivery carrier through scar tissues. In addition, the value of the Scar Elevation Index (SEI) of 5-FU EGs group in the rabbit ear scar model was lower than that of 5-FU Phosphate Buffered Saline gel and Control groups. To conclude, these results suggest that EGs delivery system loaded 5-fluorouracil is a perfect candidate drug for hypertrophic scars therapy in future. PMID:25501333

  2. Sudden cardiac death associated with occult hypertrophic cardiomyopathy in a dog under anesthesia

    PubMed Central

    2005-01-01

    Abstract A 6-year-old, 3.0 kg, neutered female, Yorkshire terrier was referred for orthopedic surgery. Cardiac arrest followed unsuccessful treatment of bradycardia and systemic arterial hypotension under general anesthesia. Postmortem examination revealed hypertrophic cardiomyopathy. A possible relationship between treatment of bradycardia, systemic arterial hypotension, and sudden cardiac death is described. PMID:16422064

  3. [Molecular targets and novel pharmacological options to prevent myocardial hypertrophic remodeling].

    PubMed

    Coppini, Raffaele; Ferrantini, Cecilia; Poggesi, Corrado; Mugelli, Alessandro; Olivotto, Iacopo

    2016-03-01

    Myocardial hypertrophic remodeling is a pathophysiological feature of several cardiac conditions and is the hallmark of hypertrophic cardiomyopathy (HCM), the most common monogenic inherited disease of the heart. In recent years, preclinical and clinical studies investigated the underlying molecular mechanisms and intracellular signaling pathways involved in pathologic cardiomyocyte hypertrophy and highlighted a number of possible molecular targets of therapy aimed at preventing its development. Early prevention of myocardial hypertrophic remodeling is particularly sought after in HCM, as current therapeutic strategies are unable to remove the primary cause of disease, i.e. the disease-causing gene mutation. Studies on transgenic animal models or human myocardial samples from patients with HCM identified intracellular calcium overload as a central mechanism driving pathological hypertrophy. In this review, we analyze recent preclinical and clinical studies on animal models and patients with HCM aimed at preventing or modifying hypertrophic myocardial remodeling. Mounting evidence shows that prevention of pathological hypertrophy is a feasible strategy in HCM and will enter the clinical practice in the near future. Considering the close mechanistic similarities between HCM and secondary hypertrophy, these studies are also relevant for the common forms of cardiac hypertrophy, such as hypertensive or valvular heart disease. PMID:27029877

  4. Assessing a murmur, saving a life: current trends in the management of hypertrophic cardiomyopathy.

    PubMed

    Katz, J R; Krafft, P; Fox, K

    1996-11-01

    Hypertrophic cardiomyopathy, formerly called idiopathic hypertrophic subaortic stenosis (IHSS), is the leading cause of sudden cardiac death in young people. Hypertrophic cardiomyopathy is a non-dilated cardiomyopathy primarily affecting the left ventricle, left atria, intraventricular septum, and mitral valve. It is an autosomal dominant genetic disorder that impairs diastolic and systolic function. Diagnosis is complex due to the heterogeneity of the disease. Symptoms and morphology are not always related and clinical signs may be absent or limited to a soft systolic murmur. The first symptom of hypertrophic cardiomyopathy is frequently sudden cardiac death. Echocardiogram is an accurate diagnostic tool. Asymptomatic patients are generally not treated. Treatment for symptomatic patients begins with beta or calcium channel blockers. Antiarrhythmics may be added to protect against sudden cardiac death. Surgical intervention is done if other treatments fall and involves removal of a portion of the obstructive septum. Operative mortality is 5% with a 60% reduction in symptoms. A promising alternative to surgery is dual-chamber pacemakers. Patient and family teaching is the emphasis of long-term management. PMID:8933537

  5. Videodensitometric time-density curve change after alcohol septal ablation of obstructive hypertrophic cardiomyopathy.

    PubMed

    Nemes, A; Kalapos, A; Sasi, V; Ungi, T; Ungi, I; Forster, T; Sepp, R

    2015-02-01

    A recently developed computerized method for estimation of myocardial perfusion, based on the analysis of the time-density curves, is demonstrated to assess myocardial blush over a selected myocardial region of interest in a patient with obstructive hypertrophic cardiomyopathy before and after alcohol septal ablation. PMID:23184598

  6. Enhanced in Vivo Delivery of 5-Fluorouracil by Ethosomal Gels in Rabbit Ear Hypertrophic Scar Model

    PubMed Central

    Wo, Yan; Zhang, Zheng; Zhang, Yixin; Zhang, Zhen; Wang, Kan; Mao, Xiaohui; Su, Weijie; Li, Ke; Cui, Daxiang; Chen, Jun

    2014-01-01

    Applying Ethosomal Gels (EGs) in transdermal drug delivery systems has evoked considerable interest because of their good water-solubility and biocompatibility. However, there has not been an explicit description of applying EGs as a vehicle for hypertrophic scars treatment. Here, a novel transdermal EGs loaded with 5-fluorouracil (5-FU EGs) was successfully prepared and characterized. The stability assay in vitro revealed that 5-FU EGs stored for a period of 30 days at 4 ± 1 °C had a better size stability than that at 25 ± 1 °C. Furthermore, using confocal laser scanning microscopy, EGs labeled with Rhodamine 6 G penetrated into the deep dermis of the hypertrophic scar within 24 h in the rabbit ear hypertrophic model suggested that the EGs were an optional delivery carrier through scar tissues. In addition, the value of the Scar Elevation Index (SEI) of 5-FU EGs group in the rabbit ear scar model was lower than that of 5-FU Phosphate Buffered Saline gel and Control groups. To conclude, these results suggest that EGs delivery system loaded 5-fluorouracil is a perfect candidate drug for hypertrophic scars therapy in future. PMID:25501333

  7. The Metabolome in Finnish Carriers of the MYBPC3-Q1061X Mutation for Hypertrophic Cardiomyopathy

    PubMed Central

    Heliö, Tiina; Jääskeläinen, Pertti; Laine, Mika; Hilvo, Mika; Nieminen, Markku S.; Laakso, Markku; Hyötyläinen, Tuulia; Orešič, Matej; Kuusisto, Johanna

    2015-01-01

    Aims Mutations in the cardiac myosin-binding protein C gene (MYBPC3) are the most common genetic cause of hypertrophic cardiomyopathy (HCM) worldwide. The molecular mechanisms leading to HCM are poorly understood. We investigated the metabolic profiles of mutation carriers with the HCM-causing MYBPC3-Q1061X mutation with and without left ventricular hypertrophy (LVH) and non-affected relatives, and the association of the metabolome to the echocardiographic parameters. Methods and Results 34 hypertrophic subjects carrying the MYBPC3-Q1061X mutation, 19 non-hypertrophic mutation carriers and 20 relatives with neither mutation nor hypertrophy were examined using comprehensive echocardiography. Plasma was analyzed for molecular lipids and polar metabolites using two metabolomics platforms. Concentrations of branched chain amino acids, triglycerides and ether phospholipids were increased in mutation carriers with hypertrophy as compared to controls and non-hypertrophic mutation carriers, and correlated with echocardiographic LVH and signs of diastolic and systolic dysfunction in subjects with the MYBPC3-Q1061X mutation. Conclusions Our study implicates the potential role of branched chain amino acids, triglycerides and ether phospholipids in HCM, as well as suggests an association of these metabolites with remodeling and dysfunction of the left ventricle. PMID:26267065

  8. Dietary copper supplementation reverses hypertrophic cardiomyopathy induced by chronic pressure overload in mice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Sustained pressure overload causes cardiac hypertrophy and the transition to heart failure. We show here that dietary supplementation with physiologically relevant levels of copper (Cu) reverses pre-established hypertrophic cardiomyopathy in the presence of pressure overload induced by ascending aor...

  9. An investigation of shallow ground-water quality near East Fork Poplar Creek, Oak Ridge, Tennessee

    USGS Publications Warehouse

    Carmichael, J.K.

    1989-01-01

    Alluvial soils of the flood plain of East Fork Poplar Creek in Oak Ridge, Tennessee, are contaminated with mercury and other metals, organic compounds, and radio-nuclides originating from the Y-12 Plant, a nuclear-processing facility located within the U.S. Department of Energy 's Oak Ridge Reservation. Observation wells were installed in the shallow aquifer of the flood plain, and water quality samples were collected to determine if contaminants are present in the shallow groundwater. Groundwater in the shallow aquifer occurs under water-table conditions. Recharge is primarily from precipitation and discharge is to East Fork Poplar Creek. Groundwater levels fluctuate seasonally in response to variations in recharge and evapotranspiration. During extremely dry periods, the water table drops below the base of the shallow aquifer in some flood-plain areas. Contaminants found in water samples from several of the wells in concentrations which equaled or exceeded drinking-water standards established by the U.S. Environmental Protection Agency are antimony, chromium, lead, mercury, selenium, phenols, and strontium-90. Total and dissolved uranium concentrations exceeded the analytical detection limit in nearly 70% of the wells in the flood plain. The results of water quality determinations demonstrate that elevated concentrations of most trace metals (and possibly organic compounds and radionuclides) were caused by contaminated sediments in the samples. The presence of contaminated sediment in samples is suspected to be the result of borehole contamination during well installation. (USGS)

  10. A new 4D trajectory-based approach unveils abnormal LV revolution dynamics in hypertrophic cardiomyopathy.

    PubMed

    Madeo, Andrea; Piras, Paolo; Re, Federica; Gabriele, Stefano; Nardinocchi, Paola; Teresi, Luciano; Torromeo, Concetta; Chialastri, Claudia; Schiariti, Michele; Giura, Geltrude; Evangelista, Antonietta; Dominici, Tania; Varano, Valerio; Zachara, Elisabetta; Puddu, Paolo Emilio

    2015-01-01

    The assessment of left ventricular shape changes during cardiac revolution may be a new step in clinical cardiology to ease early diagnosis and treatment. To quantify these changes, only point registration was adopted and neither Generalized Procrustes Analysis nor Principal Component Analysis were applied as we did previously to study a group of healthy subjects. Here, we extend to patients affected by hypertrophic cardiomyopathy the original approach and preliminarily include genotype positive/phenotype negative individuals to explore the potential that incumbent pathology might also be detected. Using 3D Speckle Tracking Echocardiography, we recorded left ventricular shape of 48 healthy subjects, 24 patients affected by hypertrophic cardiomyopathy and 3 genotype positive/phenotype negative individuals. We then applied Generalized Procrustes Analysis and Principal Component Analysis and inter-individual differences were cleaned by Parallel Transport performed on the tangent space, along the horizontal geodesic, between the per-subject consensuses and the grand mean. Endocardial and epicardial layers were evaluated separately, different from many ecocardiographic applications. Under a common Principal Component Analysis, we then evaluated left ventricle morphological changes (at both layers) explained by first Principal Component scores. Trajectories' shape and orientation were investigated and contrasted. Logistic regression and Receiver Operating Characteristic curves were used to compare these morphometric indicators with traditional 3D Speckle Tracking Echocardiography global parameters. Geometric morphometrics indicators performed better than 3D Speckle Tracking Echocardiography global parameters in recognizing pathology both in systole and diastole. Genotype positive/phenotype negative individuals clustered with patients affected by hypertrophic cardiomyopathy during diastole, suggesting that incumbent pathology may indeed be foreseen by these methods. Left

  11. A New 4D Trajectory-Based Approach Unveils Abnormal LV Revolution Dynamics in Hypertrophic Cardiomyopathy

    PubMed Central

    Madeo, Andrea; Piras, Paolo; Re, Federica; Gabriele, Stefano; Nardinocchi, Paola; Teresi, Luciano; Torromeo, Concetta; Chialastri, Claudia; Schiariti, Michele; Giura, Geltrude; Evangelista, Antonietta; Dominici, Tania; Varano, Valerio; Zachara, Elisabetta; Puddu, Paolo Emilio

    2015-01-01

    The assessment of left ventricular shape changes during cardiac revolution may be a new step in clinical cardiology to ease early diagnosis and treatment. To quantify these changes, only point registration was adopted and neither Generalized Procrustes Analysis nor Principal Component Analysis were applied as we did previously to study a group of healthy subjects. Here, we extend to patients affected by hypertrophic cardiomyopathy the original approach and preliminarily include genotype positive/phenotype negative individuals to explore the potential that incumbent pathology might also be detected. Using 3D Speckle Tracking Echocardiography, we recorded left ventricular shape of 48 healthy subjects, 24 patients affected by hypertrophic cardiomyopathy and 3 genotype positive/phenotype negative individuals. We then applied Generalized Procrustes Analysis and Principal Component Analysis and inter-individual differences were cleaned by Parallel Transport performed on the tangent space, along the horizontal geodesic, between the per-subject consensuses and the grand mean. Endocardial and epicardial layers were evaluated separately, different from many ecocardiographic applications. Under a common Principal Component Analysis, we then evaluated left ventricle morphological changes (at both layers) explained by first Principal Component scores. Trajectories’ shape and orientation were investigated and contrasted. Logistic regression and Receiver Operating Characteristic curves were used to compare these morphometric indicators with traditional 3D Speckle Tracking Echocardiography global parameters. Geometric morphometrics indicators performed better than 3D Speckle Tracking Echocardiography global parameters in recognizing pathology both in systole and diastole. Genotype positive/phenotype negative individuals clustered with patients affected by hypertrophic cardiomyopathy during diastole, suggesting that incumbent pathology may indeed be foreseen by these methods

  12. Hypertrophic stimuli induce transforming growth factor-beta 1 expression in rat ventricular myocytes.

    PubMed Central

    Takahashi, N; Calderone, A; Izzo, N J; Mäki, T M; Marsh, J D; Colucci, W S

    1994-01-01

    Transforming growth factor-beta 1 (TGF-beta 1) is a peptide growth factor that may play a role in the myocardial response to hypertrophic stimuli. However, the cellular distribution, mechanism of induction, and source of increased TGF-beta 1 in response to hypertrophic stimuli are not known. We tested the hypothesis that the cardiac myocyte responds to hypertrophic stimuli with the increased expression of TGF-beta 1. In adult rat ventricular myocardium freshly dissociated into myocyte and nonmyocyte cellular fractions, the preponderance of TGF-beta 1 mRNA visualized by Northern hybridization was in the nonmyocyte fraction. Abdominal aortic constriction (7 d) and subcutaneous norepinephrine infusion (36 h) each caused ventricular hypertrophy associated with 3.1-fold and 3.8-fold increases, respectively, in TGF-beta 1 mRNA in the myocyte fraction, but had no effect on the level of TGF-beta 1 mRNA in the nonmyocyte fraction. In ventricular myocytes, norepinephrine likewise caused a 4.1-fold increase in TGF-beta 1 mRNA associated with an increase in TGF-beta bioactivity. This induction of TGF-beta 1 mRNA occurred at norepinephrine concentrations as low as 1 nM and was blocked by prazosin, but not propranolol. NE did not increase the TGF-beta 1 mRNA level in nonmyocytes, primarily fibroblasts, cultured from neonatal rat ventricle. Thus, the cardiac myocyte responds to two hypertrophic stimuli, pressure overload and norepinephrine, with the induction of TGF-beta 1. These data support the view that TGF-beta 1, released by myocytes and acting in an autocrine and/or paracrine manner, is involved in myocardial remodeling by hypertrophic stimuli. Images PMID:7929822

  13. Dual pathways to endochondral osteoblasts: a novel chondrocyte-derived osteoprogenitor cell identified in hypertrophic cartilage

    PubMed Central

    Park, Jung; Gebhardt, Matthias; Golovchenko, Svitlana; Perez-Branguli, Francesc; Hattori, Takako; Hartmann, Christine; Zhou, Xin; deCrombrugghe, Benoit; Stock, Michael; Schneider, Holm; von der Mark, Klaus

    2015-01-01

    According to the general understanding, the chondrocyte lineage terminates with the elimination of late hypertrophic cells by apoptosis in the growth plate. However, recent cell tracking studies have shown that murine hypertrophic chondrocytes can survive beyond “terminal” differentiation and give rise to a progeny of osteoblasts participating in endochondral bone formation. The question how chondrocytes convert into osteoblasts, however, remained open. Following the cell fate of hypertrophic chondrocytes by genetic lineage tracing using BACCol10;Cre induced YFP-reporter gene expression we show that a progeny of Col10Cre-reporter labelled osteoprogenitor cells and osteoblasts appears in the primary spongiosa and participates – depending on the developmental stage – substantially in trabecular, endosteal, and cortical bone formation. YFP+ trabecular and endosteal cells isolated by FACS expressed Col1a1, osteocalcin and runx2, thus confirming their osteogenic phenotype. In searching for transitory cells between hypertrophic chondrocytes and trabecular osteoblasts we identified by confocal microscopy a novel, small YFP+Osx+ cell type with mitotic activity in the lower hypertrophic zone at the chondro-osseous junction. When isolated from growth plates by fractional enzymatic digestion, these cells termed CDOP (chondrocyte-derived osteoprogenitor) cells expressed bone typical genes and differentiated into osteoblasts in vitro. We propose the Col10Cre-labeled CDOP cells mark the initiation point of a second pathway giving rise to endochondral osteoblasts, alternative to perichondrium derived osteoprogenitor cells. These findings add to current concepts of chondrocyte-osteocyte lineages and give new insight into the complex cartilage-bone transition process in the growth plate. PMID:25882555

  14. miR-182 Modulates Myocardial Hypertrophic Response Induced by Angiogenesis in Heart

    PubMed Central

    Li, Na; Hwangbo, Cheol; Jaba, Irina M.; Zhang, Jiasheng; Papangeli, Irinna; Han, Jinah; Mikush, Nicole; Larrivée, Bruno; Eichmann, Anne; Chun, Hyung J.; Young, Lawrence H.; Tirziu, Daniela

    2016-01-01

    Myocardial hypertrophy is an adaptive response to hemodynamic demands. Although angiogenesis is critical to support the increase in heart mass with matching blood supply, it may also promote a hypertrophic response. Previously, we showed that cardiac angiogenesis induced by placental growth factor (PlGF), promotes myocardial hypertrophy through the paracrine action of endothelium-derived NO, which triggers the degradation of regulator of G protein signaling 4 (RGS4) to activate the Akt/mTORC1 pathways in cardiomyocytes. Here, we investigated whether miRNAs contribute to the development of hypertrophic response associated with myocardial angiogenesis. We show that miR-182 is upregulated concurrently with the development of hypertrophy in PlGF mice, but not when hypertrophy was blocked by concomitant expression of PlGF and RGS4, or by PlGF expression in eNOS−/− mice. Anti-miR-182 treatment inhibits the hypertrophic response and prevents the Akt/mTORC1 activation in PlGF mice and NO-treated cardiomyocytes. miR-182 reduces the expression of Bcat2, Foxo3 and Adcy6 to regulate the hypertrophic response in PlGF mice. Particularly, depletion of Bcat2, identified as a new miR-182 target, promotes AktSer473/p70-S6KThr389 phosphorylation and cardiomyocyte hypertrophy. LV pressure overload did not upregulate miR-182. Thus, miR-182 is a novel target of endothelial-cardiomyocyte crosstalk and plays an important role in the angiogenesis induced-hypertrophic response. PMID:26888314

  15. miR-182 Modulates Myocardial Hypertrophic Response Induced by Angiogenesis in Heart.

    PubMed

    Li, Na; Hwangbo, Cheol; Jaba, Irina M; Zhang, Jiasheng; Papangeli, Irinna; Han, Jinah; Mikush, Nicole; Larrivée, Bruno; Eichmann, Anne; Chun, Hyung J; Young, Lawrence H; Tirziu, Daniela

    2016-01-01

    Myocardial hypertrophy is an adaptive response to hemodynamic demands. Although angiogenesis is critical to support the increase in heart mass with matching blood supply, it may also promote a hypertrophic response. Previously, we showed that cardiac angiogenesis induced by placental growth factor (PlGF), promotes myocardial hypertrophy through the paracrine action of endothelium-derived NO, which triggers the degradation of regulator of G protein signaling 4 (RGS4) to activate the Akt/mTORC1 pathways in cardiomyocytes. Here, we investigated whether miRNAs contribute to the development of hypertrophic response associated with myocardial angiogenesis. We show that miR-182 is upregulated concurrently with the development of hypertrophy in PlGF mice, but not when hypertrophy was blocked by concomitant expression of PlGF and RGS4, or by PlGF expression in eNOS(-/-) mice. Anti-miR-182 treatment inhibits the hypertrophic response and prevents the Akt/mTORC1 activation in PlGF mice and NO-treated cardiomyocytes. miR-182 reduces the expression of Bcat2, Foxo3 and Adcy6 to regulate the hypertrophic response in PlGF mice. Particularly, depletion of Bcat2, identified as a new miR-182 target, promotes Akt(Ser473)/p70-S6K(Thr389) phosphorylation and cardiomyocyte hypertrophy. LV pressure overload did not upregulate miR-182. Thus, miR-182 is a novel target of endothelial-cardiomyocyte crosstalk and plays an important role in the angiogenesis induced-hypertrophic response. PMID:26888314

  16. SHALLOW GROUNDWATER USE BY ALFALFA

    Technology Transfer Automated Retrieval System (TEKTRAN)

    One proposal for drainage water disposal is to reuse drainage water for irrigation of salt tolerant crops until the volume has been reduced sufficiently to enable final disposal by evaporation. Part of this concept of serial biological concentration requires in-situ crop water reuse from shallow gr...

  17. Parameterization of precipitating shallow convection

    NASA Astrophysics Data System (ADS)

    Seifert, Axel

    2015-04-01

    Shallow convective clouds play a decisive role in many regimes of the atmosphere. They are abundant in the trade wind regions and essential for the radiation budget in the sub-tropics. They are also an integral part of the diurnal cycle of convection over land leading to the formation of deeper modes of convection later on. Errors in the representation of these small and seemingly unimportant clouds can lead to misforecasts in many situations. Especially for high-resolution NWP models at 1-3 km grid spacing which explicitly simulate deeper modes of convection, the parameterization of the sub-grid shallow convection is an important issue. Large-eddy simulations (LES) can provide the data to study shallow convective clouds and their interaction with the boundary layer in great detail. In contrast to observation, simulations provide a complete and consistent dataset, which may not be perfectly realistic due to the necessary simplifications, but nevertheless enables us to study many aspects of those clouds in a self-consistent way. Today's supercomputing capabilities make it possible to use domain sizes that not only span several NWP grid boxes, but also allow for mesoscale self-organization of the cloud field, which is an essential behavior of precipitating shallow convection. By coarse-graining the LES data to the grid of an NWP model, the sub-grid fluctuations caused by shallow convective clouds can be analyzed explicitly. These fluctuations can then be parameterized in terms of a PDF-based closure. The necessary choices for such schemes like the shape of the PDF, the number of predicted moments, etc., will be discussed. For example, it is shown that a universal three-parameter distribution of total water may exist at scales of O(1 km) but not at O(10 km). In a next step the variance budgets of moisture and temperature in the cloud-topped boundary layer are studied. What is the role and magnitude of the microphysical correlation terms in these equations, which

  18. Water and contaminant movement: migration barriers

    SciTech Connect

    Lane, L.J.; Nyhan, J.W.

    1984-11-01

    Migration barriers are used in shallow land burial facilities to slow or stop the movement of water and contaminants and are discussed here as a single component embedded in a complex environmental system. Analytical solutions to solute transport equations are used to approximate the behavior of migration barriers and to derive design criteria for control of subsurface water and contaminant migration. Various types of migration barriers are compared and design recommendations are made for shallow land burial trench caps and liners. Needed improvements and suggested field experiments for future designs of migration barriers are then discussed relative to the management of low-level radioactive wastes.

  19. Echocardiography Differences Between Athlete’s Heart Hearth and Hypertrophic Cardiomyopathy

    PubMed Central

    Kreso, Amir; Barakovic, Fahir; Medjedovic, Senad; Halilbasic, Amila; Klepic, Muhamed

    2015-01-01

    Introduction: Among long term athletes there is always present hypertrophy of the left ventricle walls as well as increased cardiac mass. These changes are the result of the heart muscle adaptation to load during the years of training, which should not be considered as pathology. In people suffering from hypertrophic cardiomyopathy (HCM), there is also present hypertrophy of the left ventricle walls and increased mass of the heart, but these changes are the result of pathological changes in the heart caused by a genetic predisposition for the development HCM of. Differences between myocardial hypertrophy in athletes and HCM are not clearly differentiated and there are always dilemmas between pathological and physiological hypertrophy. The goal of the study is to determine and compare the echocardiographic cardiac parameters of longtime athletes to patients with hypertrophic cardiomyopathy. Material and methods: The study included 60 subjects divided into two groups: active athletes and people with hypertrophic cardiomyopathy. Results: Mean values of IVSd recorded in GB is IVSd=17.5 mm (n=20, 95% CI, 16.00–19.00 mm), while a significantly smaller mean value is recorded in GA, IVSd=10.0 mm (n=40, 95% CI, 9.00-11.00 mm). The mean value of the left ventricle in diastole (LVDd) recorded in the GA is LVDd=51 mm (n=40; 95% CI, 48.00 to 52.00 mm), while in the group with hypertrophic cardiomyopathy (GB) mean LVDd value is 42 mm (n=20; 95% CI, 40.00 to 48.00 mm). The mean value of the rear wall of the left ventricle (LVPWd) recorded in the GA is LVDd=10 mm (n=40; 95% CI, 9.00-10.00 mm) while in the group with hypertrophic cardiomyopathy (GB) mean LVDd is 14 mm (n=20; 95% CI, 12.00 to 16.00 mm). The mean of the left ventricle during systole (LVSD) observed in GA is LVSD=34 mm (n=40; 95% CI, 32.00 to 36.00 mm), while in the group with hypertrophic cardiomyopathy (GB) mean LVSD is 28 mm (n=20; 95% CI, 24.00 to 28.83 mm). The mean ejection fraction (EF%) observed in GA is EF

  20. Idiopathic hypertrophic subaortic stenosis. By Irwin M. Freundlich, J. Thomas McMurray, J. Stauffer Lehman, 1967.

    PubMed

    Freundlich, I M; McMurray, J T; Lehman, J S

    1988-06-01

    In patients with a systolic ejection murmur and without a history of rheumatic fever, a probable diagnosis of idiopathic hypertrophic subaortic stenosis (IHSS) can be made from the roentgenologic findings. Left ventricular enlargement, associated at times with minimal left atrial enlargement, without intracardiac calcification and with a normal ascending aorta are the most frequent roentgen findings. For a positive diagnosis, a pressure gradient within the left ventricle and hypertrophic muscular obstruction should be demonstrated by angiocardiography. PMID:3285643

  1. Plasma Transglutaminase in Hypertrophic Chondrocytes: Expression and Cell-specific Intracellular Activation Produce Cell Death and Externalization

    PubMed Central

    Nurminskaya, Maria; Magee, Cordula; Nurminsky, Dmitry; Linsenmayer, Thomas F.

    1998-01-01

    We previously used subtractive hybridization to isolate cDNAs for genes upregulated in chick hypertrophic chondrocytes (Nurminskaya, M., and T.F. Linsenmayer. 1996. Dev. Dyn. 206:260–271). Certain of these showed homology with the “A” subunit of human plasma transglutaminase (factor XIIIA), a member of a family of enzymes that cross-link a variety of intracellular and matrix molecules. We now have isolated a full-length cDNA for this molecule, and confirmed that it is avian factor XIIIA. Northern and enzymatic analyses confirm that the molecule is upregulated in hypertrophic chondrocytes (as much as eightfold). The enzymatic analyses also show that appreciable transglutaminase activity in the hypertrophic zone becomes externalized into the extracellular matrix. This externalization most likely is effected by cell death and subsequent lysis—effected by the transglutaminase itself. When hypertrophic chondrocytes are transfected with a cDNA construct encoding the zymogen of factor XIIIA, the cells convert the translated protein to a lower molecular weight form, and they initiate cell death, become permeable to macromolecules and eventually undergo lysis. Non-hypertrophic cells transfected with the same construct do not show these degenerative changes. These results suggest that hypertrophic chondrocytes have a novel, tissue-specific cascade of mechanisms that upregulate the synthesis of plasma transglutaminase and activate its zymogen. This produces autocatalytic cell death, externalization of the enzyme, and presumably cross-linking of components within the hypertrophic matrix. These changes may in turn regulate the removal and/or calcification of this hypertrophic matrix, which are its ultimate fates. PMID:9722623

  2. Biological and Chemical Removal of Primary Cilia Affects Mechanical Activation of Chondrogenesis Markers in Chondroprogenitors and Hypertrophic Chondrocytes

    PubMed Central

    Deren, Matthew E.; Yang, Xu; Guan, Yingjie; Chen, Qian

    2016-01-01

    Chondroprogenitors and hypertrophic chondrocytes, which are the first and last stages of the chondrocyte differentiation process, respectively, are sensitive to mechanical signals. We hypothesize that the mechanical sensitivity of these cells depends on the cell surface primary cilia. To test this hypothesis, we removed the primary cilia by biological means with transfection with intraflagellar transport protein 88 (IFT88) siRNA or by chemical means with chloral hydrate treatment. Transfection of IFT88 siRNA significantly reduced the percentage of ciliated cells in both chondroprogenitor ATDC5 cells as well as primary hypertrophic chondrocytes. Cyclic loading (1 Hz, 10% matrix deformation) of ATDC5 cells in three-dimensional (3D) culture stimulates the mRNA levels of chondrogenesis marker Type II collagen (Col II), hypertrophic chondrocyte marker Type X collagen (Col X), and a molecular regulator of chondrogenesis and chondrocyte hypertrophy bone morphogenetic protein 2 (BMP-2). The reduction of ciliated chondroprogenitors abolishes mechanical stimulation of Col II, Col X, and BMP-2. In contrast, cyclic loading stimulates Col X mRNA levels in hypertrophic chondrocytes, but not those of Col II and BMP-2. Both biological and chemical reduction of ciliated hypertrophic chondrocytes reduced but failed to abolish mechanical stimulation of Col X mRNA levels. Thus, primary cilia play a major role in mechanical stimulation of chondrogenesis and chondrocyte hypertrophy in chondroprogenitor cells and at least a partial role in hypertrophic chondrocytes. PMID:26861287

  3. Shallow-water conservation laws

    NASA Astrophysics Data System (ADS)

    Ostapenko, V. V.

    2015-10-01

    The derivation of basic conservation laws in the shallow-water theory from the multidimensional integral laws of conservation of mass and total momentum describing the plane-parallel flow of an ideal incompressible fluid above a horizontal bottom is proposed. The restrictions on flow parameters arising in this case have the integral form and are much weaker in comparison with the requirement of flow potentiality and the condition of long-wavelength approximation. The last fact substantiates the use of the shallow-water model for the mathematical modeling of a much wider class of wave flows, the parameters of which are not related directly to the restrictions of the long-wavelength approximation.

  4. Shallow cells in directional solidification

    NASA Technical Reports Server (NTRS)

    Merchant, G. J.; Davis, S. H.

    1989-01-01

    The existing theory on two-dimensional transitions (appropriate to thin parallel-plate geometries) is presented in such a way that it is possible to identify easily conditions for the onset of shallow cells. Conditions are given under which succinonitrile-acetone mixtures should undergo supercritical bifurcation in experimentally accessible ranges. These results suggest a means for the quantitative test of the Mullins and Sekerka (1964) model and its weakly nonlinear extensions.

  5. Vortex Formation in Shallow Flows

    NASA Astrophysics Data System (ADS)

    Rockwell, Donald

    2006-11-01

    Vortical structures having a scale much larger than the depth of the flow, which arise in bluff body wakes, jets, and mixing layers generated in shallow layers, show distinctive features due to the influence of bed friction. Cinema techniques of high-image-density particle image velocimetry are employed to characterize quasi-two-dimensional and three-dimensional aspects of the vortex development in terms of: patterns of vorticity; flow topology involving definition of critical points; and global spectral and cross-spectral analyses, based on simultaneous time records at thousands of grid points of the cinema imaging. Taken together, these representations lead to an understanding of the relationship between coherent vortex development and unsteadiness along the bed and, furthermore, provide a basis for exploration of concepts generic to separated shear layers in shallow flows. These concepts include: suppression of a primary mode of vortex formation due to bed friction and emergence of another mode; resonant coupling between a gravity wave of the shallow layer and vortex formation, leading to large-scale vortices; and passive and active (open loop) control, which can either retard or enhance the onset of vortex formation. These studies suggest opportunities for further investigation on both experimental and numerical fronts. Collaboration with Haojun Fu, Alis Ekmekci, Jung-Chang Lin, and Muammer Ozgoren is gratefully acknowledged.

  6. 1982 THERMAL SHALLOW RESERVOIR TESTING

    SciTech Connect

    Mogen, P.; Pittinger, L.; Magers, M.

    1985-01-22

    An extensive study of the Thermal Shallow Reservoir at The Geysers was performed in 1982 to improve our understanding of the source and flow patterns of steam in the shallow anomaly and how they relate to the Thermal 4 blowout. This project included gathering and analyzing pressure transient, enthalpy, tracer and chemical data and developing a reservoir model that was consistent with this data. Following the pressure transient testing and analysis, a convection-plume with lateral-flow model was proposed. Subsequent analysis of enthalpy, tracer and chemical data corroborated this model. The high flowrate wells--Thermal 4, Thermal 10, Thermal 11 and Magma 1--produce from the high-pressure, high-permeability upflow zone. The source of this upflow is a limited fracture system connecting the shallow anomaly with the underlying main reservoir. The outlying low-pressure, low-permeability wells are supplied by lateral flow of steam from the central area. The pressure gradient from the core to the periphery is caused by condensation in the flanks.

  7. Alternative attractors of shallow lakes.

    PubMed

    Scheffer, M

    2001-07-17

    Ponds and shallow lakes can be very clear with abundant submerged plants, or very turbid due to a high concentration of phytoplankton and suspended sediment particles. These strongly contrasting ecosystem states have been found to represent alternative attractors with distinct stabilizing feedback mechanisms. In the turbid state, the development of submerged vegetation is prevented by low underwater light levels. The unprotected sediment frequently is resuspended by wave action and by fish searching for food causing a further decrease of transparency. Since there are no plants that could serve as refuges, zooplankton is grazed down by fish to densities insufficient to control algal blooms. In contrast, the clear state in eutrophic shallow lakes is dominated by aquatic macrophytes. The submerged macrophytes prevent sediment resuspension, take up nutrients from the water, and provide a refuge for zooplankton against fish predation. These processes buffer the impacts of increased nutrient loads until they become too high. Consequently, the response of shallow lakes to eutrophication tends to be catastrophic rather than smooth, and various lakes switch back and forth abruptly between a clear and a turbid state repeatedly without obvious external forcing. Importantly, a switch from a turbid to a stable clear state often can be invoked by means of biomanipulation in the form of a temporary reduction of the fish stock. PMID:12806081

  8. [Hypertrophic cardiomyopathy in the work of the cardiologist at a diagnostic center].

    PubMed

    Mandrusova, R V

    1991-01-01

    The author demonstrates a possibility of diagnosing hypertrophic cardiomyopathy (HCMP) at the diagnostic center where the main facilities required for examining cardiological patients are available. Provides the results of examining 23 patients with HCMP (according to sex, age, symptoms, clinical course, localization of myocardial hypertrophy, the presence of obstructive and nonobstructive forms, cases of familial diseases). Describes patients seen for HCMP during 6-10 years, in whom idiopathic hypertrophic subaortic stenosis (IHSS) transformed to symmetric HCMP with hypertrophy of the interventricular septum and free walls of the left and right ventricles associated with changes in the clinical picture of the disease. It is assumed that in some cases, IHSS may be a stage in the development of symmetric HCMP. In the course of the disease, the localization of myocardial hypertrophy, the presence of obstruction and the clinical picture are variable rather than permanent characteristics. PMID:1839469

  9. Myocardial stunning in hypertrophic cardiomyopathy: recovery predicted by single photon emission computed tomographic thallium-201 scintigraphy

    SciTech Connect

    Fine, D.G.; Clements, I.P.; Callahan, M.J.

    1989-05-01

    A young woman with hypertrophic cardiomyopathy confirmed by echocardiography and cardiac catheterization presented with chest pain and features of a large left ventricular aneurysm. The initial diagnosis was myocardial ischemia with either an evolving or an ancient myocardial infarction. Subsequently, verapamil therapy was associated with complete resolution of the extensive left ventricular wall motion abnormalities, normalization of left ventricular ejection fraction and a minimal myocardial infarction. Normal thallium uptake on single photon emission computed tomographic scintigraphy early in the hospital course predicted myocardial viability in the region of the aneurysm. Thus, orally administered verapamil may reverse spontaneous extensive myocardial ischemia in hypertrophic cardiomyopathy and possibly limit the extent of myocardial infarction in such circumstances.

  10. A small-molecule inhibitor of sarcomere contractility suppresses hypertrophic cardiomyopathy in mice

    PubMed Central

    Green, Eric M.; Wakimoto, Hiroko; Anderson, Robert L.; Evanchik, Marc J.; Gorham, Joshua M.; Harrison, Brooke C.; Henze, Marcus; Kawas, Raja; Oslob, Johan D.; Rodriguez, Hector M.; Song, Yonghong; Wan, William; Leinwand, Leslie A.; Spudich, James A.; McDowell, Robert S.; Seidman, J. G.; Seidman, Christine E.

    2016-01-01

    Hypertrophic cardiomyopathy (HCM) is an inherited disease of heart muscle that can be caused by mutations in sarcomere proteins. Clinical diagnosis depends on an abnormal thickening of the heart, but the earliest signs of disease are hyperdynamic contraction and impaired relaxation. Whereas some in vitro studies of power generation by mutant and wild-type sarcomere proteins are consistent with mutant sarcomeres exhibiting enhanced contractile power, others are not. We identified a small molecule, MYK-461, that reduces contractility by decreasing the adenosine triphosphatase activity of the cardiac myosin heavy chain. Here we demonstrate that early, chronic administration of MYK-461 suppresses the development of ventricular hypertrophy, cardiomyocyte disarray, and myocardial fibrosis and attenuates hypertrophic and profibrotic gene expression in mice harboring heterozygous human mutations in the myosin heavy chain. These data indicate that hyperdynamic contraction is essential for HCM pathobiology and that inhibitors of sarcomere contraction may be a valuable therapeutic approach for HCM. PMID:26912705

  11. Hypertrophic Cardiomyopathy (HCM): How Flow Analysis May Drive Medical Management and Surgical Approach

    NASA Astrophysics Data System (ADS)

    Abraham, Theodore P.

    2011-11-01

    Hypertrophic Cardiomyopathy (HCM) is the most common inherited heart disease and occurs in 1 in 500 persons worldwide regardless of race, age and gender. It is the most common cause of sudden death in the young and also causes heart failure and cardiac arrhythmias. The primary anatomic abnormality is thickening of certain walls, or sometimes global thickening of the left or right ventricle. The patterns of thickening along with increased ventricular stiffness lead to suboptimal ventricular filling and inefficient ejection of blood from the ventricle. Treatment for HCM can be medical or surgical. The choice of therapy is driven by the presence and severity of outflow obstruction. Flow analysis could provide sophisticated information about outflow and inflow ventricular dynamics. These flow dynamics features may enable better medical choices and provide information that would allow superior surgical planning. Associate Professor of Medicine & Director, Hypertrophic Cardiomyopathy Clinic

  12. Comparison of ventricular emptying with and without a pressure gradient in patients with hypertrophic cardiomyopathy.

    PubMed Central

    Siegel, R J; Criley, J M

    1985-01-01

    Thirty three patients with hypertrophic cardiomyopathy were studied to determine whether the presence of an intraventricular pressure gradient impaired left ventricular emptying. Patients with resting gradients had a higher mean left ventricular ejection fraction (92 (6.4)%) than patients without a resting or inducible pressure gradient (75.5 (9)%). The rate and degree of emptying increased when gradients greater than 85 mm Hg were induced in two patients with insignificant mitral regurgitation. If the induced gradients had been the result of obstruction a decrease in the rate or degree of ventricular emptying would be expected. Higher ejection fractions in patients with intracavitary pressure gradients as well as enhanced rate and degree of left ventricular emptying with induced gradients are inconsistent with outflow obstruction. These findings support the concept that cavity obliteration is responsible for the pressure gradient in these patients with hypertrophic cardiomyopathy. Images PMID:4038604

  13. Up-to-date approach to manage keloids and hypertrophic scars: A useful guide

    PubMed Central

    Arno, Anna I.; Gauglitz, Gerd G.; Barret, Juan P.; Jeschke, Marc G.

    2014-01-01

    Keloids and hypertrophic scars occur anywhere from 30 to 90% of patients, and are characterized by pathologically excessive dermal fibrosis and aberrant wound healing. Both entities have different clinical and histochemical characteristics, and unfortunately still represent a great challenge for clinicians due to lack of efficacious treatments. Current advances in molecular biology and genetics reveal new preventive and therapeutical options which represent a hope to manage this highly prevalent, chronic and disabling problem, with long-term beneficial outcomes and improvement of quality of life. While we wait for these translational clinical products to be marketed, however, it is imperative to know the basics of the currently existing wide array of strategies to deal with excessive scars: from the classical corticotherapy, to the most recent botulinum toxin and lasers. The main aim of this review paper is to offer a useful up-to-date guideline to prevent and treat keloids and hypertrophic scars. PMID:24767715

  14. A coordinate axis transformation study of spatial QRS loop in hypertrophic cardiomyopathy.

    PubMed

    Takimiya, A; Nakajima, S; Mugikura, M; Mutoh, K; Ibukiyama, C

    1991-01-01

    To obtain an overall view of the QRS loop on vectorcardiograms (VCG) of hypertrophic cardiomyopathy (HCM), the coordinate axis was transformed using the resolver method. The morphological features and planarity of the loop were compared with hypertrophic patterns and hypertensive heart disease (HHD). The subjects in the present study included 30 normal individuals, 40 patients with HCM and 30 with HHD. The HHD group was selected from patients showing left ventricular hypertrophy on VCG similar to that of HCM patients. The HCM group showed significantly greater values than the HHD group in the thickness/length ratio, which represents the planarity of the spatial QRS loop. The above finding suggests that the HCM group had greater deformation in the QRS loop than the HHD group. This may provide a useful indicator for the differential diagnosis of the two diseases. PMID:1920958

  15. A small-molecule inhibitor of sarcomere contractility suppresses hypertrophic cardiomyopathy in mice.

    PubMed

    Green, Eric M; Wakimoto, Hiroko; Anderson, Robert L; Evanchik, Marc J; Gorham, Joshua M; Harrison, Brooke C; Henze, Marcus; Kawas, Raja; Oslob, Johan D; Rodriguez, Hector M; Song, Yonghong; Wan, William; Leinwand, Leslie A; Spudich, James A; McDowell, Robert S; Seidman, J G; Seidman, Christine E

    2016-02-01

    Hypertrophic cardiomyopathy (HCM) is an inherited disease of heart muscle that can be caused by mutations in sarcomere proteins. Clinical diagnosis depends on an abnormal thickening of the heart, but the earliest signs of disease are hyperdynamic contraction and impaired relaxation. Whereas some in vitro studies of power generation by mutant and wild-type sarcomere proteins are consistent with mutant sarcomeres exhibiting enhanced contractile power, others are not. We identified a small molecule, MYK-461, that reduces contractility by decreasing the adenosine triphosphatase activity of the cardiac myosin heavy chain. Here we demonstrate that early, chronic administration of MYK-461 suppresses the development of ventricular hypertrophy, cardiomyocyte disarray, and myocardial fibrosis and attenuates hypertrophic and profibrotic gene expression in mice harboring heterozygous human mutations in the myosin heavy chain. These data indicate that hyperdynamic contraction is essential for HCM pathobiology and that inhibitors of sarcomere contraction may be a valuable therapeutic approach for HCM. PMID:26912705

  16. Exome Sequencing Identifies SLCO2A1 Mutations as a Cause of Primary Hypertrophic Osteoarthropathy

    PubMed Central

    Zhang, Zhenlin; Xia, Weibo; He, Jinwei; Zhang, Zeng; Ke, Yaohua; Yue, Hua; Wang, Chun; Zhang, Hao; Gu, Jiemei; Hu, Weiwei; Fu, Wenzhen; Hu, Yunqiu; Li, Miao; Liu, Yujuan

    2012-01-01

    By using whole-exome sequencing, we identified a homozygous guanine-to-adenine transition at the invariant −1 position of the acceptor site of intron 1 (c.97−1G>A) in solute carrier organic anion transporter family member 2A1 (SLCO2A1), which encodes a prostaglandin transporter protein, as the causative mutation in a single individual with primary hypertrophic osteoarthropathy (PHO) from a consanguineous family. In two other affected individuals with PHO from two unrelated nonconsanguineous families, we identified two different compound heterozygous mutations by using Sanger sequencing. These findings confirm that SLCO2A1 mutations inactivate prostaglandin E2 (PGE2) transport, and they indicate that mutations in SLCO2A1 are the pathogenic cause of PHO. Moreover, this study might also help to explain the cause of secondary hypertrophic osteoarthropathy. PMID:22197487

  17. A case of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome presenting with hypertrophic pachymeningitis.

    PubMed

    Shiraishi, Wataru; Hayashi, Shintaro; Iwanaga, Yasutaka; Murai, Hiroyuki; Yamamoto, Akifumi; Kira, Jun-ichi

    2015-02-15

    A 43-year-old woman with a 3-year history of headache, fever, and swelling of the forehead, presented to our hospital. A general examination revealed palmar and plantar pustules. Blood analyses showed an elevated white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate. Brain MRI revealed a partially thickened cranial bone with gadolinium enhancement, and also abnormally enhanced dura mater. Bone scintigraphy showed involvement of the cranial bone and bilateral sternoclavicular joints. Palmar skin biopsy indicated palmoplantar pustulosis. From these results, SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome with associated hypertrophic pachymeningitis was diagnosed. After corticosteroid therapy and tonsillectomy, the clinical symptoms and radiological abnormalities were improved. Clinicians should be aware of SAPHO as a potential unusual cause of hypertrophic pachymeningitis. PMID:25549534

  18. [Sporadic recurrent hypertrophic polyneuropathy. Clinical-histological contributions on differential diagnosis].

    PubMed

    Haferkamp, G; Regli, F

    1976-01-01

    The authors report about an own case of recurrent sporadic hypertrophic polyneuropathy and describe the clinical course and histologic picture with reference to the literature. The disease is characterized by recurrences of subacutely occurring polyradiculoneuropathy and sequent nearly complete remission. Clinical examination discloses preferentially symmetrically and distally occurring motor paresis while sensibility in most cases is less affected. The peripheral nerves may be enlarged after a few relapses and frequently painful to pressure during the bout. Excessive increase in CSF proteins is found only during the bout. Motor nerve conduction velocity is considerably reduced. Histological pictures typically present an onion bulb formation of the Schwann cells with marked proliferation of connective tissue. There frequently younger individuals are involved; the relation female to male is 3:1. Differentiation has to be made concerning hereditary and symptomatic forms of hypertrophic polyneuropathy. Etiological factors of the disease are discussed. PMID:185690

  19. Difficult anesthesia management in a case of living donor liver transplantation with hypertrophic obstructive cardiomyopathy.

    PubMed

    Kondo, Takashi; Kusunoki, Shinji; Kuroda, Masahiko; Kawamoto, Masashi

    2013-12-01

    Liver transplantation with hypertrophic obstructive cardiomyopathy is associated with acute hemodynamic changes, which can exacerbate left ventricular outflow tract obstruction during surgery. Therefore, selection of general anesthetic agents is important, as most can result in hemodynamic instability by reducing systemic vascular resistance and blood pressure. We report successful anesthetic management in a case of living donor liver transplantation with hypertrophic obstructive cardiomyopathy using ketamine, propofol, and fentanyl to avoid vasodilation by anesthetic agents. In addition, landiolol, phenylephrine, and low-dose dopamine were administered to prevent left ventricular outflow tract obstruction, and were found to be effective for improving acute hemodynamic changes during surgery. In the case of this patient, the combination of transesophageal echocardiography and a pulmonary artery catheter was beneficial for intraoperative hemodynamic monitoring. PMID:24597212

  20. Pregnancy outcome in a case of non-obstructive hypertrophic cardiomyopathy.

    PubMed

    Habib, A; Haque, T

    2013-07-01

    Hypertrophic cardiomyopathy (HCM) is a relatively common genetic disorder (1:500) inherited as an autosomal dominant trait. It is caused by mutations in any one of 10 genes encoding protein components of cardiac sarcomere. Some theoretically calculated risks exist when patients with HCM become pregnant. The physiologic increase of cardiac output and increased stroke volume may be impaired due to the non-compliant ventricular walls. In the first trimester, the physiologic hypervolemia of pregnancy to some extent counteracts the natural decrease in peripheral vascular resistance which would have otherwise provoked an obstruction gradientin systolic flow. As pregnancy advances, the vena caval compression may decrease venous return causing cardiac compromise, whereas the stress of labour may precipitate arrhythmia. We report our experience of a pregnancy with co-existant non-obstructive hypertrophic cardiomyopathy and nodal bradycardia ultimately resulting in pre-term delivery, neonatal death and maternal death in puerperium from overt cardiac failure after a relatively uneventful gestation. PMID:23982559

  1. The Mitral Valve in Obstructive Hypertrophic Cardiomyopathy: A Test in Context.

    PubMed

    Sherrid, Mark V; Balaram, Sandhya; Kim, Bette; Axel, Leon; Swistel, Daniel G

    2016-04-19

    Mitral valve abnormalities were not part of modern pathological and clinical descriptions of hypertrophic cardiomyopathy in the 1950s, which focused on left ventricular (LV) hypertrophy and myocyte fiber disarray. Although systolic anterior motion (SAM) of the mitral valve was discovered as the cause of LV outflow tract obstruction in the M-mode echocardiography era, in the 1990s structural abnormalities of the mitral valve became appreciated as contributing to SAM pathophysiology. Hypertrophic cardiomyopathy mitral malformations have been identified at all levels. They occur in the leaflets, usually elongating them, and also in the submitral apparatus, with a wide array of malformations of the papillary muscles and chordae, that can be detected by transthoracic and transesophageal echocardiography and by cardiac magnetic resonance. Because they participate fundamentally in the predisposition to SAM, they have increasingly been repaired surgically. This review critically assesses imaging and measurement of mitral abnormalities and discusses their surgical relief. PMID:27081025

  2. Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies

    PubMed Central

    Gauglitz, Gerd G; Korting, Hans C; Pavicic, Tatiana; Ruzicka, Thomas; Jeschke, Marc G

    2011-01-01

    Excessive scars form as a result of aberrations of physiologic wound healing and may arise following any insult to the deep dermis. By causing pain, pruritus and contractures, excessive scarring significantly affects the patient’s quality of life, both physically and psychologically. Multiple studies on hypertrophic scar and keloid formation have been conducted for decades and have led to a plethora of therapeutic strategies to prevent or attenuate excessive scar formation. However, most therapeutic approaches remain clinically unsatisfactory, most likely owing to poor understanding of the complex mechanisms underlying the processes of scarring and wound contraction. In this review we summarize the current understanding of the pathophysiology underlying keloid and hypertrophic scar formation and discuss established treatments and novel therapeutic strategies. PMID:20927486

  3. Microvascular Permeability Changes Might Explain Cardiac Tamponade after Alcohol Septal Ablation for Hypertrophic Cardiomyopathy

    PubMed Central

    Hsu, Jen-Te; Hsiao, Ju-Feng; Chang, Jung-Jung; Chung, Chang-Min; Chang, Shih-Tai; Pan, Kuo-Li

    2014-01-01

    Various sequelae of alcohol septal ablation for hypertrophic obstructive cardiomyopathy have been reported. Of note, some cases of cardiac tamponade after alcohol septal ablation cannot be well explained. We describe the case of a 78-year-old woman with hypertrophic obstructive cardiomyopathy in whom cardiac tamponade developed one hour after alcohol septal ablation, probably unrelated to mechanical trauma. At that time, we noted a substantial difference in the red blood cell-to-white blood cell ratio between the pericardial effusion (1,957.4) and the peripheral blood (728.3). In addition to presenting the patient's case, we speculate that a possible mechanism for acute tamponade—alcohol-induced changes in microvascular permeability—is a reasonable explanation for cases of alcohol septal ablation that are complicated by otherwise-unexplainable massive pericardial effusions. PMID:24808788

  4. Transcriptional Profiling of Rapamycin-Treated Fibroblasts From Hypertrophic and Keloid Scars

    PubMed Central

    Wong, Victor W.; You, Fanglei; Januszyk, Michael; Gurtner, Geoffrey C.; Kuang, Anna A.

    2016-01-01

    Excess scar formation after cutaneous injury can result in hypertrophic scar (HTS) or keloid formation. Modern strategies to treat pathologic scarring represent nontargeted approaches that produce suboptimal results. Mammalian target of rapamycin (mTOR), a central mediator of inflammation, has been proposed as a novel target to block fibroproliferation. To examine its mechanism of action, we performed genomewide microarray on human fibroblasts (from normal skin, HTS, and keloid scars) treated with the mTOR inhibitor, rapamycin. Hypertrophic scar and keloid fibroblasts demonstrated overexpression of collagen I and III that was effectively abrogated with rapamycin. Blockade of mTOR specifically impaired fibroblast expression of the collagen biosynthesis genes PLOD, PCOLCE, and P4HA, targets significantly overexpressed in HTS and keloid scars. These data suggest that pathologic scarring can be abrogated via modulation of mTOR pathways in procollagen and collagen processing. PMID:24835866

  5. Hypertrophic cardiomyopathy in a litter of five mixed-breed cats.

    PubMed

    Kraus, M S; Calvert, C A; Jacobs, G J

    1999-01-01

    A litter of five, 18-month-old, mixed-breed cats were determined to have hypertrophic cardiomyopathy (HCM). Although no overt clinical signs were present in any cat, systolic heart murmurs were present in each. Electrocardiograms were normal, while subjective interpretations of heart enlargement on radiographs were made on four cats. Echocardiographic analyses indicated abnormalities consistent with HCM. Overt clinical signs are absent two years following diagnosis. PMID:10416772

  6. Fatal infantile mitochondrial encephalomyopathy, hypertrophic cardiomyopathy and optic atrophy associated with a homozygous OPA1 mutation

    PubMed Central

    Spiegel, Ronen; Saada, Ann; Flannery, Padraig J; Burté, Florence; Soiferman, Devorah; Khayat, Morad; Eisner, Verónica; Vladovski, Eugene; Taylor, Robert W; Bindoff, Laurence A; Shaag, Avraham; Mandel, Hanna; Schuler-Furman, Ora; Shalev, Stavit A; Elpeleg, Orly; Yu-Wai-Man, Patrick

    2016-01-01

    Background Infantile-onset encephalopathy and hypertrophic cardiomyopathy caused by mitochondrial oxidative phosphorylation defects are genetically heterogeneous with defects involving both the mitochondrial and nuclear genomes. Objective To identify the causative genetic defect in two sisters presenting with lethal infantile encephalopathy, hypertrophic cardiomyopathy and optic atrophy. Methods We describe a comprehensive clinical, biochemical and molecular genetic investigation of two affected siblings from a consanguineous family. Molecular genetic analysis was done by a combined approach involving genome-wide autozygosity mapping and next-generation exome sequencing. Biochemical analysis was done by enzymatic analysis and Western blot. Evidence for mitochondrial DNA (mtDNA) instability was investigated using long-range and real-time PCR assays. Mitochondrial cristae morphology was assessed with transmission electron microscopy. Results Both affected sisters presented with a similar cluster of neurodevelopmental deficits marked by failure to thrive, generalised neuromuscular weakness and optic atrophy. The disease progression was ultimately fatal with severe encephalopathy and hypertrophic cardiomyopathy. Mitochondrial respiratory chain complex activities were globally decreased in skeletal muscle biopsies. They were found to be homozygous for a novel c.1601T>G (p.Leu534Arg) mutation in the OPA1 gene, which resulted in a marked loss of steady-state levels of the native OPA1 protein. We observed severe mtDNA depletion in DNA extracted from the patients’ muscle biopsies. Mitochondrial morphology was consistent with abnormal mitochondrial membrane fusion. Conclusions We have established, for the first time, a causal link between a pathogenic homozygous OPA1 mutation and human disease. The fatal multisystemic manifestations observed further extend the complex phenotype associated with pathogenic OPA1 mutations, in particular the previously unreported association

  7. Papillary Thyroid Carcinoma Treated with Radiofrequency Ablation in a Patient with Hypertrophic Cardiomyopathy: A Case Report

    PubMed Central

    Sun, Jianyi; Liu, Xiaosun; Zhang, Qing; Hong, Yanyun; Song, Bin; Teng, Xiaodong

    2016-01-01

    Standard therapy has not been established for thyroid cancer when a thyroidectomy is contraindicated due to systemic disease. Herein, we reported a patient who had hypertrophic cardiomyopathy and papillary thyroid carcinoma treated by radiofrequency ablation because of inability to tolerate a thyroidectomy. Radiofrequency ablation can be used to treat thyroid cancer when surgery is not feasible, although the long-term outcome needs further observation. PMID:27390548

  8. Hypertrophic Obstructive Cardiomyopathy in An Infant With Hemophagocytic Lymphohistiocytosis; Answer to a Riddle.

    PubMed

    Rabah, Fatma; Beshlawi, Ismail; Wali, Yasser; Al-Rawas, Abdulhakim; Al Senaidi, Khalfan

    2015-08-01

    Familial hemophagocytic lymphohistiocytosis (FHLH) is a hereditary hyperinflammatory condition with T-cell and macrophage activation. Treatment consists of immunosuppressive therapy plus bone marrow transplantation. Cardiac manifestations of FHLH were scarcely mentioned in the literature with conflicting pathophysiological explanations. We report a case of hypertrophic obstructive cardiomyopathy associated with FHLH. Guided by such a case, a clear vision regarding the real cause is thought to be obtained in the cloudy landscape of pathophysiology. PMID:25222062

  9. Systemic depletion of macrophages in the subacute phase of wound healing reduces hypertrophic scar formation.

    PubMed

    Zhu, Zhensen; Ding, Jie; Ma, Zengshuan; Iwashina, Takashi; Tredget, Edward E

    2016-07-01

    Hypertrophic scars are caused by trauma or burn injuries to the deep dermis and can cause cosmetic disfigurement and psychological issues. Studies suggest that M2-like macrophages are pro-fibrotic and contribute to hypertrophic scar formation. A previous study from our lab showed that M2 macrophages were present in developing hypertrophic scar tissues in vivo at 3-4 weeks after wounding. In this study, the effect of systemic macrophage depletion on scar formation was explored at subacute phase of wound healing. Thirty-six athymic nude mice that received human skin transplants were randomly divided into macrophage depletion group and control group. The former received intraperitoneal injections of clodronate liposomes while the controls received sterile saline injections on day 7, 10, and 13 postgrafting. Wound area, scar thickness, collagen abundance and collagen bundle structure, mast cell infiltration, myofibroblast formation, M1, and M2 macrophages together with gene expression of M1 and M2 related factors in the grafted skin were investigated at 2, 4, and 8 weeks postgrafting. The transplanted human skin from the control group developed contracted, elevated, and thickened scars while the grafted skin from the depletion group healed with significant less contraction and elevation. Significant reductions in myofibroblast number, collagen synthesis, and hypertrophic fiber morphology as well as mast cell infiltration were observed in the depletion group compared to the control group. Macrophage depletion significantly reduced M1 and M2 macrophage number in the depletion group 2 weeks postgrafting as compared to the control group. These findings suggest that systemic macrophage depletion in subacute phase of wound healing reduces scar formation, which provides evidence for the pro-fibrotic role of macrophages in fibrosis of human skin as well as insight into the potential benefits of specifically depleting M2 macrophages in vivo. PMID:27169512

  10. [Utility of cardiovascular magnetic resonance in hypertrophic cardiomyopathy: when is it superior to echocardiography?].

    PubMed

    Kammoun, I; Marrakchi, S; Zidi, A; Ibn ElHaj, Z; Naccache, S; Ben Amara, W; Jebri, F; Bennour, E; Kachboura, S

    2015-02-01

    The diagnosis of hypertrophic cardiomyopathy is usually established by echocardiography. Recently, there has been greatly increased use of cardiac magnetic resonance (CMR) because of its precise determination of myocardial anatomy and the depiction of myocardial fibrosis. In this review, we describe the role of echocardiography and magnetic resonance in the assessment of this complex disease. In conclusion, there is a complementarity between cardiovascular magnetic resonance imaging and echocardiography for the diagnosis and the management of HCM. PMID:24834991