Sample records for jugular um caso

  1. Idiopathic Bilateral External Jugular Vein Thrombosis.

    PubMed

    Hindi, Zakaria; Fadhel, Ehab

    2015-08-20

    Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchow's triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy. This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely. Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy.

  2. Endovascular Approach to Glomus Jugulare Tumors.

    PubMed

    Kocur, Damian; Ślusarczyk, Wojciech; Przybyłko, Nikodem; Hofman, Mariusz; Jamróz, Tomasz; Suszyński, Krzysztof; Baron, Jan; Kwiek, Stanisław

    2017-01-01

    Paragangliomas are benign neuroendocrine tumors derived from the glomus cells of the vegetative nervous system. Typically, they are located in the region of the jugular bulb and middle ear. The optimal management is controversial and can include surgical excision, stereotactic radiosurgery and embolization. We report the endovascular approach to three patients harboring glomus jugulare paragangliomas. In all cases incomplete occlusion of the lesions was achieved and recanalization in the follow-up period was revealed. Two patients presented no clinical improvement and the remaining one experienced a transient withdrawal of tinnitus. It is technically difficult to achieve complete obliteration of glomus jugulare tumors with the use of embolization and the subtotal occlusion poses a high risk of revascularization and is not beneficial in terms of alleviating clinical symptoms.

  3. Hiperplasia angiolinfoide com eosinofilia: um caso raro em cavidade oral

    PubMed Central

    Tenório, Jefferson da Rocha; Gonzaga, Amanda Katarinny Goes; Gonçalves, Patrícia Guerra Peixe; de Oliveira, Denise Hélen Imaculada Pereira; Queiroz, Lélia Maria Guedes

    2016-01-01

    Resumo A hiperplasia angiolinfoide com eosinofilia (HALE) é considerada uma lesão vascular benigna rara que acomete, principalmente, o tecido cutâneo e subcutâneo da região de cabeça e pescoço, mas incomum na cavidade oral. Sua etiopatogenia permanece indefinida, sendo descrita como proliferação vascular reacional, malformação vascular ou neoplasia. Tem como principal diagnóstico diferencial a doença de Kimura. Este trabalho relata um caso de um paciente do sexo masculino, de 50 anos, que exibia aumento de volume nodular na mucosa do lábio superior, com 3 cm de dimensão e 7 anos de evolução. Após a biópsia excisional, o exame histopatológico mostrou lesão bem encapsulada multilobulada com proliferação de capilares sanguíneos com células endoteliais de aspecto epitelioide, infiltrado inflamatório difuso com linfócitos, plasmócitos, inúmeros eosinófilos e presença de folículos linfoides. A análise imuno-histoquímica revelou positividade para CD34 e Ki-67, o que, juntamente com o exame morfológico, direcionou o diagnóstico para HALE. PMID:29930611

  4. Endovascular Approach to Glomus Jugulare Tumors

    PubMed Central

    Kocur, Damian; Ślusarczyk, Wojciech; Przybyłko, Nikodem; Hofman, Mariusz; Jamróz, Tomasz; Suszyński, Krzysztof; Baron, Jan; Kwiek, Stanisław

    2017-01-01

    Summary Background Paragangliomas are benign neuroendocrine tumors derived from the glomus cells of the vegetative nervous system. Typically, they are located in the region of the jugular bulb and middle ear. The optimal management is controversial and can include surgical excision, stereotactic radiosurgery and embolization. Case Report We report the endovascular approach to three patients harboring glomus jugulare paragangliomas. In all cases incomplete occlusion of the lesions was achieved and recanalization in the follow-up period was revealed. Two patients presented no clinical improvement and the remaining one experienced a transient withdrawal of tinnitus. Conclusions It is technically difficult to achieve complete obliteration of glomus jugulare tumors with the use of embolization and the subtotal occlusion poses a high risk of revascularization and is not beneficial in terms of alleviating clinical symptoms. PMID:28685005

  5. Radiosurgery of Glomus Jugulare Tumors: A Meta-Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Guss, Zachary D.; Batra, Sachin; Limb, Charles J.

    2011-11-15

    Purpose: During the past two decades, radiosurgery has arisen as a promising approach to the management of glomus jugulare. In the present study, we report on a systematic review and meta-analysis of the available published data on the radiosurgical management of glomus jugulare tumors. Methods and Materials: To identify eligible studies, systematic searches of all glomus jugulare tumors treated with radiosurgery were conducted in major scientific publication databases. The data search yielded 19 studies, which were included in the meta-analysis. The data from 335 glomus jugulare patients were extracted. The fixed effects pooled proportions were calculated from the data whenmore » Cochrane's statistic was statistically insignificant and the inconsistency among studies was <25%. Bias was assessed using the Egger funnel plot test. Results: Across all studies, 97% of patients achieved tumor control, and 95% of patients achieved clinical control. Eight studies reported a mean or median follow-up time of >36 months. In these studies, 95% of patients achieved clinical control and 96% achieved tumor control. The gamma knife, linear accelerator, and CyberKnife technologies all exhibited high rates of tumor and clinical control. Conclusions: The present study reports the results of a meta-analysis for the radiosurgical management of glomus jugulare. Because of its high effectiveness, we suggest considering radiosurgery for the primary management of glomus jugulare tumors.« less

  6. Flow Patterns in the Jugular Veins of Pulsatile Tinnitus Patients

    PubMed Central

    Kao, Evan; Kefayati, Sarah; Amans, Matthew R.; Faraji, Farshid; Ballweber, Megan; Halbach, Van; Saloner, David

    2017-01-01

    Pulsatile Tinnitus (PT) is a pulse-synchronous sound heard in the absence of an external source. PT is often related to abnormal flow in vascular structures near the cochlea. One vascular territory implicated in PT is the internal jugular vein (IJV). Using computational fluid dynamics (CFD) based on patient-specific Magnetic Resonance Imaging (MRI), we investigated the flow within the IJV of seven subjects, four symptomatic and three asymptomatic of PT. We found that there were two extreme anatomic types classified by the shape and position of the jugular bulbs: elevated and rounded. PT patients had elevated jugular bulbs that led to a distinctive helical flow pattern within the proximal internal jugular vein. Asymptomatic subjects generally had rounded jugular bulbs that neatly redirected flow from the sigmoid sinus directly into the jugular vein. These two flow patterns were quantified by calculating the length-averaged streamline curvature of the flow within the proximal jugular vein: 130.3 ± 8.1 m-1 for geometries with rounded bulbs, 260.7 ± 29.4 m-1 for those with elevated bulbs (P < 0.005). Our results suggest that variations in the jugular bulb geometry lead to distinct flow patterns that are linked to PT, but further investigation is needed to determine if the vortex pattern is causal to sound generation. PMID:28057349

  7. Malignant Jugular Paraganglioma: Unusual Presentation on 68Ga DOTANOC PET/CT.

    PubMed

    Jain, Tarun Kumar; Basher, Rajender Kumar; Shukla, Jaya; Mittal, Bhagwant Rai; Panda, Naresh K

    2016-02-01

    Metastatic jugular paraganglioma are rare tumors and account for less than 1% of the cases of head and neck tumors. We report a 40-year-old woman of jugular paraganglioma, presenting with right-sided neck swelling, hearing loss, and pulsatile tinnitus. Contrast-enhanced CT temporal bone revealed a mass in the right jugular foramina and extending inferiorly to internal jugular vein. Ga DOTANOC PET/CT was performed, which revealed somatostatin receptor expressing lesion in the right internal jugular vein and extension into sigmoid sinus and additional metastatic focus in the sacrum.

  8. Observations on the bony bridging of the jugular foramen in man.

    PubMed

    Dodo, Y

    1986-02-01

    The anatomical nature and pattern of incidence of bony bridging of the jugular foramen was investigated using 64 fetal crania aged nine months to term and 222 adult crania of Japanese. In addition, the region of the jugular foramen of an adult cadaver was carefully dissected in order to clarify the relationship between the cranial nerves passing through the jugular foramen and the intrajugular processes of the jugular foramen. The general conclusions concerning the anatomical nature of the bony bridging of the jugular foramen were as follows. (1) The intrajugular process of the temporal bone is situated posterior to the triangular depression (as described in Gray's Anatomy) of the petrous part. (2) The bony bridging of the jugular foramen is established by the contact of the intrajugular process of the temporal bone with the bony process of the occipital bone projecting either from just above the hypoglossal canal (Type I) or from posterior to the hypoglossal canal (Type III). (3) If both the processes of the occipital bone reach the intrajugular process of the temporal bone simultaneously, the jugular foramen is divided into three compartments. (4) In the case of Type I bridging, the anteromedial compartment transmits the glossopharyngeal nerve, while the posterolateral compartment gives passage to the vagus nerve, the accessory nerve and the internal jugular vein. (5) In the case of Type II bridging, the anteromedial compartment contains the glossopharyngeal, vagus and accessory nerves, and the posterolateral compartment transmits the internal jugular vein. (6) When tripartite division of the jugular foramen occurs, the anteromedial compartment transmits the glossopharyngeal nerve, the middle compartment contains the vagus and accessory nerves, and the posterolateral compartment transmits the internal jugular vein. Concerning the pattern of incidence of jugular foramen bridging in the Japanese fetal and adult cranial series, this is similar to that of the bony

  9. Observations on the bony bridging of the jugular foramen in man.

    PubMed Central

    Dodo, Y

    1986-01-01

    The anatomical nature and pattern of incidence of bony bridging of the jugular foramen was investigated using 64 fetal crania aged nine months to term and 222 adult crania of Japanese. In addition, the region of the jugular foramen of an adult cadaver was carefully dissected in order to clarify the relationship between the cranial nerves passing through the jugular foramen and the intrajugular processes of the jugular foramen. The general conclusions concerning the anatomical nature of the bony bridging of the jugular foramen were as follows. (1) The intrajugular process of the temporal bone is situated posterior to the triangular depression (as described in Gray's Anatomy) of the petrous part. (2) The bony bridging of the jugular foramen is established by the contact of the intrajugular process of the temporal bone with the bony process of the occipital bone projecting either from just above the hypoglossal canal (Type I) or from posterior to the hypoglossal canal (Type III). (3) If both the processes of the occipital bone reach the intrajugular process of the temporal bone simultaneously, the jugular foramen is divided into three compartments. (4) In the case of Type I bridging, the anteromedial compartment transmits the glossopharyngeal nerve, while the posterolateral compartment gives passage to the vagus nerve, the accessory nerve and the internal jugular vein. (5) In the case of Type II bridging, the anteromedial compartment contains the glossopharyngeal, vagus and accessory nerves, and the posterolateral compartment transmits the internal jugular vein. (6) When tripartite division of the jugular foramen occurs, the anteromedial compartment transmits the glossopharyngeal nerve, the middle compartment contains the vagus and accessory nerves, and the posterolateral compartment transmits the internal jugular vein. Concerning the pattern of incidence of jugular foramen bridging in the Japanese fetal and adult cranial series, this is similar to that of the bony

  10. Contemporary management of jugular paragangliomas.

    PubMed

    Wanna, George B; Sweeney, Alex D; Haynes, David S; Carlson, Matthew L

    2015-04-01

    Jugular paragangliomas are generally benign slow-growing tumors that can cause pulsatile tinnitus, hearing loss, and cranial nerves neuropathy. Progressive growth can also lead to intracranial extension. Historically, the treatment of choice for these lesions has been gross total resection. However, over the last 15 years, many groups have adopted less invasive management strategies including stereotactic radiation therapy, subtotal resection, and primary observation in order to reduce treatment-associated morbidity. The focus of this article is to review the modern management of jugular paraganglioma, highlighting the evolving treatment paradigm at the Otology Group of Vanderbilt. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. New treatment of vertigo caused by jugular bulb abnormalities.

    PubMed

    Hitier, Martin; Barbier, Charlotte; Marie-Aude, Thenint; Moreau, Sylvain; Courtheoux, Patrick; Patron, Vincent

    2014-08-01

    Jugular bulb abnormalities can induce tinnitus, hearing loss, or vertigo. Vertigo can be very disabling and may need surgical treatments with risk of hearing loss, major bleeding or facial palsy. Hence, we have developed a new treatment for vertigo caused by jugular bulb anomalies, using an endovascular technique. Three patients presented with severe vertigos mostly induced by high venous pressure. One patient showed downbeat vertical nystagmus during the Valsalva maneuver. The temporal-bone computed tomography scan showed a high rising jugular bulb or a jugular bulb diverticulum with dehiscence and compression of the vestibular aqueduct in all cases. We plugged the upper part of the bulb with coils, and we used a stent to maintain the coils and preserving the venous permeability. After 12- to 24-month follow-up, those patients experienced no more vertigo, allowing return to work. The 3-month arteriographs showed good permeability of the sigmoid sinus and jugular bulb through the stent, with complete obstruction of the upper part of the bulb in all cases. Disabling vertigo induced by jugular bulb abnormalities can be effectively treated by an endovascular technique. This technique is minimally invasive with a probable greater benefit/risk ratio compare with surgery. © The Author(s) 2013.

  12. The origin of mean arterial and jugular venous blood pressures in giraffes.

    PubMed

    Mitchell, Graham; Maloney, Shane K; Mitchell, Duncan; Keegan, D James

    2006-07-01

    Using a mechanical model of the giraffe neck and head circulation consisting of a rigid, ascending, 'carotid' limb, a 'cranial' circulation that could be rigid or collapsible, and a descending, 'jugular' limb that also could be rigid or collapsible, we have analyzed the origin of the high arterial and venous pressures in giraffe, and whether blood flow is assisted by a siphon. When the tubes were rigid and the 'jugular' limb exit was lower than the 'carotid' limb entrance a siphon operated, 'carotid' hydrostatic pressures became more negative, and flow was 3.3 l min(-1) but ceased when the 'cranial' and 'jugular' limbs were collapsible or when the 'jugular' limb was opened to the atmosphere. Pumping water through the model produced positive pressures in the 'carotid' limb similar to those found in giraffe. Applying an external 'tissue' pressure to the 'jugular' tube during pump flow produced the typical pressures found in the jugular vein in giraffe. Constriction of the lowest, 'jugular cuff', portion of the 'jugular' limb showed that the cuff may augment the orthostatic reflex during head raising. Except when all tubes were rigid, pressures were unaffected by a siphon. We conclude that mean arterial blood pressure in giraffes is a consequence of the hydrostatic pressure generated by the column of blood in the neck, that tissue pressure around the collapsible jugular vein produces the known jugular pressures, and that a siphon does not assist flow through the cranial circulation.

  13. Blood pressure normalization post-jugular venous balloon angioplasty.

    PubMed

    Sternberg, Zohara; Grewal, Prabhjot; Cen, Steven; DeBarge-Igoe, Frances; Yu, Jinhee; Arata, Michael

    2015-05-01

    This study is the first in a series investigating the relationship between autonomic nervous system dysfunction and chronic cerebrospinal venous insufficiency in multiple sclerosis patients. We screened patients for the combined presence of the narrowing of the internal jugular veins and symptoms of autonomic nervous system dysfunction (fatigue, cognitive dysfunction, sleeping disorders, headache, thermal intolerance, bowel/bladder dysfunction) and determined systolic and diastolic blood pressure responses to balloon angioplasty. The criteria for eligibility for balloon angioplasty intervention included ≥ 50% narrowing in one or both internal jugular veins, as determined by the magnetic resonance venography, and ≥ 3 clinical symptoms of autonomic nervous system dysfunction. Blood pressure was measured at baseline and post-balloon angioplasty. Among patients who were screened, 91% were identified as having internal jugular veins narrowing (with obstructing lesions) combined with the presence of three or more symptoms of autonomic nervous system dysfunction. Balloon angioplasty reduced the average systolic and diastolic blood pressure. However, blood pressure categorization showed a biphasic response to balloon angioplasty. The procedure increased blood pressure in multiple sclerosis patients who presented with baseline blood pressure within lower limits of normal ranges (systolic ≤ 105 mmHg, diastolic ≤ 70 mmHg) but decreased blood pressure in patients with baseline blood pressure above normal ranges (systolic ≥ 130 mmHg, diastolic ≥ 80 mmHg). In addition, gender differences in baseline blood pressure subcategories were observed. The coexistence of internal jugular veins narrowing and symptoms of autonomic nervous system dysfunction suggests that the two phenomena may be related. Balloon angioplasty corrects blood pressure deviation in multiple sclerosis patients undergoing internal jugular vein dilation. Further studies should investigate the

  14. Locating the optimal internal jugular target site for central venous line placement.

    PubMed

    Giordano, Chris R; Murtagh, Kevin R; Mills, Jaime; Deitte, Lori A; Rice, Mark J; Tighe, Patrick J

    2016-09-01

    Historically, the placement of internal jugular central venous lines has been accomplished by using external landmarks to help identify target-rich locations in order to steer clear of dangerous structures. This paradigm is largely being displaced, as ultrasound has become routine practice, raising new considerations regarding target locations and risk mitigation. Most human anatomy texts depict the internal jugular vein as a straight columnar structure that exits the cranial vault the same size that it enters the thoracic cavity. We dispute the notion that the internal jugulars are cylindrical columns that symmetrically descend into the thoracic cavity, and purport that they are asymmetric conical structures. The primary aim of this study was to evaluate 100 consecutive adult chest and neck computed tomography exams that were imaged at an inpatient hospital. We measured the internal jugular on the left and right sides at three different levels to look for differences in size as the internal jugular descends into the thoracic cavity. We revealed that as the internal jugular descends into the thorax, the area of the vessel increases and geometrically resembles a conical structure. We also reconfirmed that the left internal jugular is smaller than the right internal jugular. Understanding that the largest target area for central venous line placement is the lower portion of the right internal jugular vein will help to better target vascular access for central line placement. This is the first study the authors are aware of that depicts the internal jugular as a conical structure as opposed to the commonly depicted symmetrical columnar structure frequently illustrated in anatomy textbooks. This target area does come with additional risk, as the closer you get to the thoracic cavity, the greater the chances for lung injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Jugular veins in transient global amnesia: innocent bystanders.

    PubMed

    Baracchini, Claudio; Tonello, Simone; Farina, Filippo; Viaro, Federica; Atzori, Matteo; Ballotta, Enzo; Manara, Renzo

    2012-09-01

    Transient global amnesia (TGA) has been associated with an increased prevalence of internal jugular valve insufficiency and many patients report Valsalva-associated maneuvers before TGA onset. These findings have led to the assumption of hemodynamic alterations in intracranial veins inducing focal hippocampal ischemia. We investigated this hypothesis in patients with TGA and control subjects. Seventy-five patients with TGA and 75 age- and sex-matched healthy subjects were enrolled into a cross-sectional study. Extracranial and transcranial high-resolution venous echo-color-Doppler sonography was performed blindly in all patients and control subjects. Blood flow direction and velocities were recorded at the internal jugular veins, basal veins of Rosenthal, and vein of Galen, both at rest and during Valsalva-associated maneuvers. Mean age of patients with TGA was 60.3±8.0 years (median, 60 years; range, 44-78 years); 44 (59%) were female (female/male ratio: 1.42). Internal jugular valve insufficiency (left, right, or bilateral) was found to be more frequent in patients with TGA than in control subjects: 53 (70.7%) versus 22 (29.3%; P<0.05). Blood flow velocities in the deep cerebral veins of patients with TGA did not differ from control subjects both at rest and during Valsalva-associated maneuvers. Intracranial venous reflux was neither observed in patients with TGA nor in control subjects despite unilateral or bilateral internal jugular valve insufficiency during prolonged and maximal Valsalva-associated maneuvers. This study, although confirming the association between TGA and internal jugular valve insufficiency, challenges the hypothesis that cerebral venous congestion plays a significant role in the pathogenesis of TGA.

  16. Long-axis view for ultrasound-guided central venous catheter placement via the internal jugular vein.

    PubMed

    Mahan, Angel F; McEvoy, Matthew D; Gravenstein, Nikolaus

    2016-04-01

    In modern practice, real-time ultrasound guidance is commonly employed for the placement of internal jugular vein catheters. With a new tool, such as ultrasound, comes the opportunity to refine and further optimize the ultrasound view during jugular vein catheterization. We describe jugular vein access techniques and use the long-axis view as an alternative to the commonly employed short-axis cross-section view for internal jugular vein access and cannulation. The long-axis ultrasound-guided internal jugular vein approach for internal jugular vein cannulation is a useful alternative technique that can provide better needle tip and guidewire visualization than the more traditional short-axis ultrasound view.

  17. Noninvasive measurement of internal jugular venous oxygen saturation by photoacoustic imaging

    NASA Astrophysics Data System (ADS)

    Garcia-Uribe, Alejandro; Erpelding, Todd N.; Ke, Haixin; Reddy, Kavya; Sharma, Anshuman; Wang, Lihong V.

    2014-03-01

    The metabolic rate and oxygen consumption of the brain is reflected in jugular venous oxygen saturation. In many clinical conditions, such as head trauma, stroke, and low cardiac output states, the brain is at risk for hypoxic-ischemic injury. The current gold standard for monitoring brain oxygenation is invasive and requires jugular vein catheterization under fluoroscopic guidance; and therefore it is rarely used. Photo-acoustic tomography in combination with ultrasound can be used to estimate oxygen saturation of the internal jugular vein in real-time. This noninvasive method will enable earlier detection and prevention of impending hypoxic brain injury. A wavelength-tunable dye laser pumped by a Nd:YAG laser delivers light through an optical fiber bundle, and a modified commercial ultrasound imaging system (Philips iU22) detects both the pulse-echo ultrasound (US) and photoacoustic (PA) signals. A custom-built multichannel data acquisition system renders co-registered ultrasound and photoacoustic images at 5 frames per second. After the jugular vein was localized in healthy volunteers, dualwavelength PA images were used to calculate the blood hemoglobin oxygen saturation from the internal jugular vein in vivo. The preliminary results raise confidence that this emerging technology can be used clinically as an accurate, noninvasive indicator of cerebral oxygenation.

  18. Free Flap Survival Despite Internal Jugular Vein Thrombosis in Head and Neck Reconstruction

    PubMed Central

    Kiya, Koichiro; Seike, Shien; Hosokawa, Ko

    2018-01-01

    Summary: Microvascular free tissue transfer is one of the most common techniques of reconstruction for complex head and neck surgical defects. Generally, venous thrombosis is more likely to occur than arterial thrombosis in vascular anastomosis. Thus, recipient veins must be chosen carefully. Although the internal jugular vein is preferred as a recipient vein by many microsurgeons, internal jugular vein thrombosis is a potential complication, as shown in our report. Therefore, we consider that the external jugular vein still is an option as a recipient for venous anastomosis and that it is better to perform multiple vein anastomoses with 2 different venous systems, such as the internal and external jugular systems, than anastomoses within the same venous system. PMID:29464172

  19. Internal jugular vein blood flow in multiple sclerosis patients and matched controls.

    PubMed

    Mancini, Marcello; Lanzillo, Roberta; Liuzzi, Raffaele; Di Donato, Orlando; Ragucci, Monica; Monti, Serena; Salvatore, Elena; Morra, Vincenzo Brescia; Salvatore, Marco

    2014-01-01

    The aim of the study was to investigate the Internal Jugular Veins dynamics using contrast enhanced ultrasonography in Multiple Sclerosis patients, clinically isolated syndrome patients and healthy controls. Contrast enhanced ultrasonography imaging of the Internal Jugular Vein was performed in fifty-eight patients with Multiple Sclerosis, seven clinically isolated syndrome patients and in thirteen healthy controls. Time-intensity curves were quantified using a semi-automated method and compared with clinical disease outcomes. Wash-out parameters were calculated and six Time-intensity curves shapes were created. Significantly reduction of wash-out rate in Internal Jugular Veins was detected in Multiple Sclerosis patients compared to healthy controls [22.2% (2.7%-65.9%) vs. 33.4% (16.2%-76.8%); P<0.005]. Internal Jugular Vein enhancement was heterogeneous in patients with Multiple Sclerosis and consisted of slow wash-out Time-intensity curves shapes, compared with almost only one type of Time-intensity curves shape in control subjects that correspond to fast enhancement and fast wash-out. The vein wash-in parameters were similar in Multiple Sclerosis group compared with controls. A significant correlation was found between Internal Jugular Vein wash-out and level of disability (R =  -0.402, p<0.05). Contrast enhanced ultrasonography of the Internal Jugular Vein with time intensity curve analysis revealed alterations of cerebral venous outflow in Multiple Sclerosis patients, however mechanisms that determine this condition remains unclear.

  20. Correlations between anomalies of jugular veins and areas of vascular drainage of head and neck.

    PubMed

    Vaida, Monica-Adriana; Niculescu, V; Motoc, A; Bolintineanu, S; Sargan, Izabella; Niculescu, M C

    2006-01-01

    The study conducted on 60 human cadavers preserved in formalin, in the Anatomy Laboratory of the "Victor Babes" University of Medicine and Pharmacy Timisoara, during 2000-2006, observed the internal and external jugular veins from the point of view of their origin, course and affluents. The morphological variability of the jugular veins (external jugular that receives as affluents the facial and lingual veins and drains into the internal jugular, draining the latter's territory--3.33%; internal jugular that receives the lingual, upper thyroid and facial veins, independent--13.33%, via the linguofacial trunk--50%, and via thyrolinguofacial trunk--33.33%) made possible the correlation of these anomalies with disorders in the ontogenetic development of the veins of the neck. Knowing the variants of origin, course and drainage area of jugular veins is important not only for the anatomist but also for the surgeon operating at this level.

  1. Double external jugular vein and other rare venous variations of the head and neck.

    PubMed

    Shenoy, Varsha; Saraswathi, Perumal; Raghunath, Gunapriya; Karthik, Jayakumar Sai

    2012-12-01

    Superficial veins of the head and neck are utilised for central venous cannulation, oral reconstruction and parenteral nutrition in debilitated patients. Clinical and sonological examinations of these veins may provide clues toward underlying cardiac pathology. Hence, although variations in these vessels are common, a sound knowledge of such variations becomes clinically important to surgeons, radiologists and interventional anaesthetists. We report a rare case of a left-sided double external jugular vein where the common facial vein continued as the second external jugular vein, and where there was a communicating channel between the internal jugular vein on the same side and the anterior jugular vein.

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

    PubMed

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

    2018-01-09

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

  3. Percutaneous Catheterization of the Internal Jugular Vein for Hemodialysis

    PubMed Central

    Yeum, Chung Ho; Kim, Soo Wan; Nah, Myong Yun; Ma, Seong Kwon; Ko, Jung Hee; Kim, Nam Ho; Choi, Ki Chul

    2001-01-01

    Objectives The present study was aimed at evaluating the clinical experiences in the internal jugular venous catheterization for hemodialysis. Methods We retrospectively analyzed the data on internal jugular venous catheterization at Chonnam National University Hospital from May 2000 to Februrary 2001. Results There were 132 uremic patients with a total of 150 attempts of internal jugular cannulation. Overall success rate was 90.9% with average puncture trials of 2.3±2.1. 124 (82.7%) of the catheterization attempts were made on the right side and 26 (17.3%) were made on the left. The catheters were left in place from 2 to 87 days with an average of 19.5±15.3 days per catheter. The dialysis sessions per catheter were from 2 to 58 with an average of 11.3±6.8. The mean blood flow during hemodialysis immediately after catheterization was 213.4±42.2 ml/min. Thirty two (21.3%) patients had early complications. These included carotid artery puncture (11.3%), local bleeding (4.7%), local pain (3.3%), neck hematoma (0.7%) and malposition of the catheter (1.3%). Seventeen (11.3%) patients had late complications. These included fever or infection (11.3%), inadequate blood flow rate (3.3%) and inadvertent withdrawal (2.0%). There was no catheter-related mortality. Conclusions Our experiences revealed that the internal jugular vein catheterization is relatively safe and efficient for temporary vascular access for hemodialysis. PMID:11855153

  4. Ultrasound guidance for internal jugular vein cannulation: Continuing Professional Development.

    PubMed

    Ayoub, Christian; Lavallée, Catherine; Denault, André

    2010-05-01

    The objective of this continuing professional development module is to describe the role of ultrasound for central venous catheterization and to specify its benefits and limitations. Although ultrasound techniques are useful for all central venous access sites, the focus of this module is on the internal jugular vein approach. In recent years, several studies were published on the benefits of ultrasound use for central venous catheterization. This technique has evolved rapidly due to improvements in the equipment and technology available. Ultrasound helps to detect the anatomical variants of the internal jugular vein. The typical anterolateral position of the internal jugular vein with respect to the carotid is found in only 9-92% of cases. Ultrasound guidance reduces the rate of mechanical, infectious, and thrombotic complications by 57%, and it also reduces the failure rate by 86%. Cost-benefit analyses show that the cost of ultrasound equipment is compensated by the decrease in the expenses associated with the treatment of complications. In this article, we will review the history of ultrasound guidance as well as the reasons that account for its superiority over the classical anatomical landmark technique. We will describe the equipment needed for central venous catheterization as well as the various methods to visualize with ultrasound. To improve patient safety, we recommend the use of ultrasound for central venous catheterization using the internal jugular approach.

  5. Crouzon’s Syndrome with Life-Threatening Ear Bleed: Ruptured Jugular Vein Diverticulum Treated by Endovascular Embolization

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mondel, Prabath Kumar, E-mail: prabathmondel@gmail.com; Anand, Sunanda, E-mail: sunandaanand@gmail.com; Limaye, Uday S., E-mail: uslkem@gmail.com

    Crouzon’s syndrome is the commonest variety of syndromic craniosynostosis. Life-threatening ear bleed due to ruptured jugular venous diverticulum in Crouzon’s syndrome has not been described previously. In patients with syndromic craniosynostosis, definitive repair of jugular diverticulum by open surgery is fraught with high risk of bleeding, poor functional outcomes, and even death. A 24-year-old woman with Crouzon’s syndrome presented with conductive hearing loss and recurrent episodes of torrential bleeding from her left ear. On computed tomography, a defect in the roof of jugular fossa containing jugular venous diverticulum immediately inferior to the bony external auditory canal was seen. The clinicalmore » presentation, imaging features, and endovascular management of Crouzon’s syndrome due to a ruptured jugular venous diverticulum is described.« less

  6. A survey of the use of ultrasound guidance in internal jugular venous cannulation.

    PubMed

    McGrattan, T; Duffty, J; Green, J S; O'Donnell, N

    2008-11-01

    It has been that suggested the use of two dimensional (2D) ultrasound to facilitate placement of central venous cannulae in the internal jugular vein improves patient safety and reduces complications. Since the introduction of the National Institute for Clinical Excellence Technology Appraisal Guideline Number 49 in 2002, promoting the use of ultrasound in placement of internal jugular venous cannulae, utilisation of ultrasound has increased throughout the United Kingdom. We report the findings of a postal survey of 2000 senior anaesthetists in the United Kingdom which enquired about their use of ultrasound for internal jugular vein cannulae placement. Only 27% use 2D ultrasound as their first choice technique, although 35% use it as their first choice when teaching. There was no significant difference in practice between those working within a sub specialty in anaesthesia. There continues to be discrepancies between the application of the guideline and how senior anaesthetists both site and teach the placement of internal jugular vein central venous cannulae.

  7. Development of the jugular bulb: a radiologic study.

    PubMed

    Friedmann, David R; Eubig, Jan; McGill, Megan; Babb, James S; Pramanik, Bidyut K; Lalwani, Anil K

    2011-10-01

    Jugular bulb (JB) abnormalities such as JB diverticulum and high-riding JBs of the temporal bone can erode into the inner ear and present with hearing loss, vestibular disturbance, and pulsatile tinnitus. Their cause and potential to progress remain to be studied. This comprehensive radiologic study investigates the postnatal development of the venous system from transverse sinus to internal jugular vein (IJV). Academic medical center. PATIENTS, INTERVENTION, MAIN OUTCOME MEASURE: Measurements of the transverse and sigmoid sinus, the JB, IJV, and carotid artery were made from computed tomographic scans of the neck with intravenous contrast in infants (n = 5), children (n = 13), adults (n = 35), and the elderly (n = 15). Jugular bulbs were not detected in patients younger than 2 years, enlarged in adulthood, and remained stable in the elderly. The venous system was larger in men than in women. From transverse sinus to IJV, the greatest variation in size was just proximal and distal to the JB with greater symmetry observed as blood returned to the heart. Right-sided venous dominance was most common occurring in 70% to 80% of cases. The JB is a dynamic structure that forms after 2 years, and its size stabilizes in adulthood. The determinants in its exact position and size are multifactorial and may be related to blood flow. Improved understanding of this structure's development may help to better understand the cause of the high-riding JB and JB diverticulum, both of which may cause clinical symptoms.

  8. MR Elastography Can Be Used to Measure Brain Stiffness Changes as a Result of Altered Cranial Venous Drainage During Jugular Compression.

    PubMed

    Hatt, A; Cheng, S; Tan, K; Sinkus, R; Bilston, L E

    2015-10-01

    Compressing the internal jugular veins can reverse ventriculomegaly in the syndrome of inappropriately low pressure acute hydrocephalus, and it has been suggested that this works by "stiffening" the brain tissue. Jugular compression may also alter blood and CSF flow in other conditions. We aimed to understand the effect of jugular compression on brain tissue stiffness and CSF flow. The head and neck of 9 healthy volunteers were studied with and without jugular compression. Brain stiffness (shear modulus) was measured by using MR elastography. Phase-contrast MR imaging was used to measure CSF flow in the cerebral aqueduct and blood flow in the neck. The shear moduli of the brain tissue increased with the percentage of blood draining through the internal jugular veins during venous compression. Peak velocity of caudally directed CSF in the aqueduct increased significantly with jugular compression (P < .001). The mean jugular venous flow rate, amplitude, and vessel area were significantly reduced with jugular compression, while cranial arterial flow parameters were unaffected. Jugular compression influences cerebral CSF hydrodynamics in healthy subjects and can increase brain tissue stiffness, but the magnitude of the stiffening depends on the percentage of cranial blood draining through the internal jugular veins during compression—that is, subjects who maintain venous drainage through the internal jugular veins during jugular compression have stiffer brains than those who divert venous blood through alternative pathways. These methods may be useful for studying this phenomenon in patients with the syndrome of inappropriately low-pressure acute hydrocephalus and other conditions. © 2015 by American Journal of Neuroradiology.

  9. Transcatheter closure of a large patent ductus arteriosus using jugular access in an infant.

    PubMed

    Fernandes, Precylia; Assaidi, Anass; Baruteau, Alban-Elouen; Fraisse, Alain

    2018-03-01

    Trans-catheter device closure of patent ductus arteriosus (PDA) via femoral route is the commonly used, safe and effective procedure. Trans-jugular approach has been successfully used in older children with interrupted inferior vena cava. We report a case of successful occlusion of PDA using Amplatzer duct occluder (ADO) via trans-jugular approach following difficulties encountered in gaining femoral venous access. A 6-month-old male infant, weighing 8 kg was admitted for percutaneous catheter closure of PDA. Echocardiogram showed a 4.5 mm duct and left heart dilatation. Femoral venous access was not possible; therefore, we decided to use a trans-jugular approach. The duct was occluded using 8/6 mm ADO. Successful closure of the duct was confirmed with an aortogram. Post procedure echocardiogram showed no residual shunt across the duct. We highlight that trans-catheter closure of PDA using jugular venous access is safe and effective even in infants.

  10. Incidence of cranial nerve palsy after preoperative embolization of glomus jugulare tumors using Onyx.

    PubMed

    Gaynor, Brandon G; Elhammady, Mohamed Samy; Jethanamest, Daniel; Angeli, Simon I; Aziz-Sultan, Mohammad A

    2014-02-01

    The resection of glomus jugulare tumors can be challenging because of their inherent vascularity. Preoperative embolization has been advocated as a means of reducing operative times, blood loss, and surgical complications. However, the incidence of cranial neuropathy associated with the embolization of these tumors has not been established. The authors of this study describe their experience with cranial neuropathy following transarterial embolization of glomus jugulare tumors using ethylene vinyl alcohol (Onyx, eV3 Inc.). The authors retrospectively reviewed all cases of glomus jugulare tumors that had been treated with preoperative embolization using Onyx at their institution in the period from 2006 to 2012. Patient demographics, clinical presentation, grade and amount of Onyx used, degree of angiographic devascularization, and procedural complications were recorded. Over a 6-year period, 11 patients with glomus jugulare tumors underwent preoperative embolization with Onyx. All embolization procedures were completed in one session. The overall mean percent of tumor devascularization was 90.7%. No evidence of nontarget embolization was seen on postembolization angiograms. There were 2 cases (18%) of permanent cranial neuropathy attributed to the embolization procedures (facial nerve paralysis and lower cranial nerve dysfunction). Embolizing glomus jugulare tumors with Onyx can produce a dramatic reduction in tumor vascularity. However, the intimate anatomical relationship and overlapping blood supply between these tumors and cranial nerves may contribute to a high incidence of cranial neuropathy following Onyx embolization.

  11. Internal jugular thrombophlebitis caused by dermal infection.

    PubMed

    Yoshikawa, Hisao; Suzuki, Makoto; Nemoto, Naohiko; Hara, Hidehiko; Hashimoto, Go; Otsuka, Takenori; Moroi, Masao; Nakamura, Masato; Sugi, Kaoru

    2011-01-01

    A 29-year-old man presented with complaints of fever and pain and itching of his left neck with atopic dermatitis and abrasion. These symptoms had persisted for two days and dullness and fever developed, but the patient did not consult a physician. On the following day, he had a fever of 40°C and redness and swelling of the left neck. He visited a local clinic and was hospitalized with suspected cellulitis. A thrombus was detected in the internal jugular vein on MRI, and he was referred to our hospital. Neck ultrasonography showed the presence of an immovable thrombus in the area from the left internal jugular vein to the left brachiocephalic peripheral vein. Blood analysis indicated a major inflammatory response and juvenile idiopathic thrombophlebitis was suspected. A filter was carefully inserted into the superior vena cava, and anticoagulant therapy and medication with antibiotics led to remission. We present this case as a rare example of a condition mimicking Lemierre syndrome that was caused by dermal infection, and we include a review of the literature.

  12. Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb.

    PubMed

    Tirakotai, W; Benes, L; Kappus, C; Sure, U; Farhoud, A; Bien, S; Bertalanffy, H

    2007-01-01

    Dural arteriovenous fistulas located in the vicinity of the jugular foramen are complex vascular malformations and belong to the most challenging skull base lesions to treat. The authors comprehensively analyze multiple features in a series of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb. Four patients who underwent surgery via the transcondylar approach to treat dural arteriovenous fistulas around the jugular foramen were retrospectively reviewed. Previously, endovascular treatment was attempted in all patients. The success of the surgical treatment was examined with postoperative angiography. Complete obliteration of the dural arteriovenous fistulas (DAVFs) was achieved in three patients, and significant flow reduction in one individual. All patients had a good postoperative outcome, and only one experienced mild hypoglossal nerve palsy. Despite extensive bone drilling, an occipitocervical fusion was necessary in only one patient with bilateral lesions. The use of an individually tailored transcondylar approach to treat dural arteriovenous fistulas at the region of the jugular foramen is most effective. This approach allows for complete obliteration of the connecting arterial feeders, and removal of bony structures containing pathological vessels.

  13. In Vitro MRV-based Hemodynamic Study of Complex Helical Flow in a Patient-specific Jugular Model

    NASA Astrophysics Data System (ADS)

    Kefayati, Sarah; Acevedo-Bolton, Gabriel; Haraldsson, Henrik; Saloner, David

    2014-11-01

    Neurointerventional Radiologists are frequently requested to evaluate the venous side of the intracranial circulation for a variety of conditions including: Chronic Cerebrospinal Venous Insufficiency thought to play a role in the development of multiple sclerosis; sigmoid sinus diverticulum which has been linked to the presence of pulsatile tinnitus; and jugular vein distension which is related to cardiac dysfunction. Most approaches to evaluating these conditions rely on structural assessment or two dimensional flow analyses. This study was designed to investigate the highly complex jugular flow conditions using magnetic resonance velocimetry (MRV). A jugular phantom was fabricated based on the geometry of the dominant jugular in a tinnitus patient. Volumetric three-component time-resolved velocity fields were obtained using 4D PC-MRI -with the protocol enabling turbulence acquisition- and the patient-specific pulsatile waveform. Flow was highly complex exhibiting regions of jet, high swirling strength, and strong helical pattern with the core originating from the focal point of the jugular bulb. Specifically, flow was analyzed for helicity and the level of turbulence kinetic energy elevated in the core of helix and distally, in the post-narrowing region.

  14. Jugular vein phlebectasia in paediatric patients with vocal fold nodules.

    PubMed

    Liu, Xiang; Sun, Chang-zhi; Zou, Hua; Luo, Ren-zhong

    2013-08-01

    Jugular vein phlebectasia (JVP) may often be overlooked in clinical practice and the management for JVP include surgery and a conservative approach. We have studied the relationship between JVP and vocal fold nodules in paediatric patients as well as the effects of treatment. Twenty-three cases of paediatric vocal fold nodules with JVP were studied. All patients received voice therapy. After 6 months of treatment, hoarseness, neck appearance (subjective evaluation) and the degree of dilation of the jugular vein detected by Doppler ultrasonography were analysed. The follow-up period was 6 to 84 months. The hoarseness disappeared or lessened noticeably after treatment for 1-4 months. The neck masses also lessened (pre vs. post: 2.58 ± 0.40 vs. 1.60 ± 0.19) after treatment for 1-4 months. The visual analogue score of the post-treatment symptoms decreased significantly compared with pre-treatment (p <0.05). The degree of dilation of the post-treatment jugular vein also decreased significantly (p <0.05). Paediatric vocal fold nodules may be related to JVP. Voice changes may also be observed in cases of paediatric JVP. Voice therapy may offer another conservative treatment option for JVP accompanied by vocal fold nodules, and it may offer better results than simple observation of JVP.

  15. Syncopal episode as the presenting symptom of jugular vein thrombosis in pregnancy: a case report.

    PubMed

    Merhi, Zaher O; Haberman, Shoshana

    2007-06-01

    Jugular vein thrombosis has been reported to occur in pregnant women who conceived with assisted reproductive technology (ART). A 28-year-old woman at 17 weeks' gestation presented to the emergency room with a syncopal episode. She reported no arm pain or swelling, no neck pain or swelling, and no dyspnea or difficulty swallowing. Doppler sonography of the neck vasculature revealed acute bilateral internal jugular vein thromboses. Thrombophilia workup was normal. Intravenous anticoagulation with heparin was initiated, and the patient was discharged on low-molecular-weight heparin. Though rare, jugular vein thrombosis should be considered in the differential diagnosis of syncopal episodes even in women who conceive without ART.

  16. An Hybrid 2-Stage Technique to Treat a Post-Traumatic Internal Carotid-Jugular Fistula.

    PubMed

    Massara, Mafalda; Barillà, David; De Caridi, Giovanni; Serra, Raffaele; Volpe, Alberto; Cutrupi, Andrea; Alberti, Antonino; Volpe, Pietro

    2017-01-01

    Penetrating wounds of the neck involving the carotid arteries can lead to 2 possible and important late sequelae: pseudoaneurysm formation and arteriovenous fistula (AVF), if an artery and the adjacent jugular vein are simultaneously lacerated. Traumatic AVF of the neck are rare complications and if untreated may cause congestive heart failure, cerebral ischemia, thromboembolism, or even rupture complications. Current treatment options for carotid-jugular AVF include operative repair, detachable balloon, coiling, or stenting. We present a hybrid 2-stage technique to treat an internal carotid-jugular vein fistula in a young woman, based first on carotid stenting to reduce the bleeding and reestablish an adequate cerebral perfusion, followed by stent removal and safe vessels surgical reconstruction through carotid-to-carotid bypass and vein repair. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Endovascular Treatment of Carotid-Internal Jugular Venous Fistula in a Bomb Blast Victim.

    PubMed

    Ashraf, Tariq; Khan, Navedullah; Yousaf, K M; Yaqub, Maha Zainab Z.

    2017-02-01

    Carotid-internal jugular venous fistula is one of the rarest presentations among victims of bomb blast injuries. Treatment of such fistula is open surgery with high mortality and morbidity. Endovascular treatment with covered stent seems to have an optimal result with low complications. We present a case report of a bomb blast victim having carotid-jugular venous fistula with hemodynamic compromise. The patient was successfully managed with endovascular graft stent. There was an optimal result with no immediate and long-term complications.

  18. Non-contact hemodynamic imaging reveals the jugular venous pulse waveform

    NASA Astrophysics Data System (ADS)

    Amelard, Robert; Hughson, Richard L.; Greaves, Danielle K.; Pfisterer, Kaylen J.; Leung, Jason; Clausi, David A.; Wong, Alexander

    2017-01-01

    Cardiovascular monitoring is important to prevent diseases from progressing. The jugular venous pulse (JVP) waveform offers important clinical information about cardiac health, but is not routinely examined due to its invasive catheterisation procedure. Here, we demonstrate for the first time that the JVP can be consistently observed in a non-contact manner using a photoplethysmographic imaging system. The observed jugular waveform was strongly negatively correlated to the arterial waveform (r = -0.73 ± 0.17), consistent with ultrasound findings. Pulsatile venous flow was observed over a spatially cohesive region of the neck. Critical inflection points (c, x, v, y waves) of the JVP were observed across all participants. The anatomical locations of the strongest pulsatile venous flow were consistent with major venous pathways identified through ultrasound.

  19. Non-contact hemodynamic imaging reveals the jugular venous pulse waveform

    PubMed Central

    Amelard, Robert; Hughson, Richard L.; Greaves, Danielle K.; Pfisterer, Kaylen J.; Leung, Jason; Clausi, David A.; Wong, Alexander

    2017-01-01

    Cardiovascular monitoring is important to prevent diseases from progressing. The jugular venous pulse (JVP) waveform offers important clinical information about cardiac health, but is not routinely examined due to its invasive catheterisation procedure. Here, we demonstrate for the first time that the JVP can be consistently observed in a non-contact manner using a photoplethysmographic imaging system. The observed jugular waveform was strongly negatively correlated to the arterial waveform (r = −0.73 ± 0.17), consistent with ultrasound findings. Pulsatile venous flow was observed over a spatially cohesive region of the neck. Critical inflection points (c, x, v, y waves) of the JVP were observed across all participants. The anatomical locations of the strongest pulsatile venous flow were consistent with major venous pathways identified through ultrasound. PMID:28065933

  20. The search for valved conduit tissue grafts for adults (>22 mm): an ultrasonographic study of jugular vein diameters of horses and cattle

    PubMed Central

    Schwarzwald, Colin C; Jenni, Rolf

    2009-01-01

    Background Natural heterologous valved conduits with a diameter greater than 22 mm that can be used for right ventricular outflow tract reconstruction in adults are not commercially available. The purpose of this study was to measure by ultrasonography the maximum diameter of the distended jugular veins of horses and cattle, respectively, to identify a population of animals that would be suitable for post-mortem collection of jugular veins at sizes greater than 22 mm. Methods The study population included 60 Warmblood horses, 25 Freiberger horses, 20 Brown Swiss cows, and 20 Holstein cows (including 10 Holstein and 10 Red Holstein). The maximum cross-sectional diameter of the distended jugular veins was measured at a location half-way between the mandibular angle and the thoracic inlet. The thoracic circumference (heart girth length) was used as a surrogate of body size. The jugular vein diameters of the different populations were compared by analysis of variance and the association between heart girth length and jugular vein diameter was determined in each of the four study populations by linear regression analysis. Results There was considerable individual variation of jugular vein diameters within each of the four study populations. There was no statistically significant relationship between thoracic circumference and jugular vein diameter in any of the populations. The jugular vein diameters of Brown Swiss cows were significantly larger than those of any of the other populations. Warmblood horses had significantly larger jugular vein diameters compared to Freiberger horses. Conclusion The results of this study suggest that the production of bovine or equine xenografts with diameters of greater than 22 mm would be feasible. Differences between species and breeds need to be considered. However, prediction of the jugular vein diameter based on breed and heart girth length in an individual animal is inaccurate. PMID:19678940

  1. [Application of right jugular vessels to build extracorporeal membrane oxygenation for treating the critically ill children].

    PubMed

    Yan, X G; Lu, Z J; Zheng, J C; Zhang, W W; Lu, G P; Jia, B

    2016-07-01

    To summarize the experience in applying a technique of inserting a cannula through right internal jugular vein and common carotid artery to build extracorporeal membrane oxygenation (ECMO) for critically ill children. The data of critically ill patients received ECMO support through right internal jugular vein and common carotid artery between December 2011 and December 2015 from Children's Hospital of Fudan University were analyzed retrospectively.The data included diagnosis, age, body weight, time of cannula and ECMO running, complication and prognosis. In total 28 patients received ECMO support, 3 patients of post-cardiac surgery with transthoracic cannula were excluded.Twenty-five patients inserted cannula through neck vessels were enrolled, 15 boys and 10 girls, the median age was 1.8 years (range, 1 d-13 years), the median weight was 12.0 (2.8-50.0) kg.All the cannula sites were right internal jugular vein and right common carotid artery, before cannula use 5 patients had been inserted central vein tube and 3 patients with blood filter tube in right internal jugular vein, in one case cannula was applied during cardiopulmonary resuscitation.V-A ECMO had been built for all the cases successfully, the median operation time was (45±26) min.The pump flow was 80-150 ml/(kg·min), the median duration of ECMO support was 153(14-567) h. Sixteen (64%) patients weaned off ECMO successfully, 15(60%) survived to hospital discharge.About the complication of cannula, six patients developed cannula site bleeding, and two patients required re-fixation of cannula, one patient's external jugular vein had been hurt and sutured for bleeding. Application of right jugular vessels to build ECMO is easy and safe for treating the sick children. The skill should be proficient to assure ECMO run and reduce the complications.

  2. Concurrent Angioplasty Balloon Placement for Stent Delivery through Jugular Venous Bulb for Treating Cerebral Venous Sinus Stenosis. Technical Report.

    PubMed

    Qureshi, Adnan I; Khan, Asif A; Capistrant, Rachel; Qureshi, Mushtaq H; Xie, Kevin; Suri, M Fareed K

    2016-10-01

    To report upon technique of concurrent placement of angioplasty balloon at the internal jugular vein and sigmoid venous sinus junction to facilitate stent delivery in two patients in whom stent delivery past the jugular bulb was not possible. A 21-year-old woman and a 41-year-old woman with worsening headaches, visual obscuration or diplopia were treated for pseudotumor cerebri associated with transverse venous stenosis. Both patients had undergone primary angioplasty, which resulted in improvement in clinical symptoms followed by the recurrence of symptoms with restenosis at the site of angioplasty. After multiple attempts at stent delivery through jugular venous bulb were unsuccessful, a second guide catheter was placed in the ipsilateral internal jugular vein through contralateral femoral venous approach. A 6 mm × 20 mm (left) or 5 × 15 mm (right) angioplasty balloon was placed across the internal jugular vein and sigmoid sinus junction and partially inflated until the inflation and relative straightening of the junction was observed. In both patients, the internal jugular vein and sigmoid sinus junction was successfully traversed by the stent delivery system in a parallel alignment to inflated balloon. Balloon mounted stent was deployed at the site of restenosis with near complete resolution of lumen narrowing delivery and improvement in clinical symptoms. We report a technique for realignment and diameter change with concurrent placement and partial inflation of angioplasty balloon at the jugular venous bulb to facilitate stent delivery into the sigmoid and transverse venous sinuses in circumstances where multiple attempts at stent delivery are unsuccessful.

  3. Ultrasonographic finding of internal jugular vein during anti-G straining maneuver: is it associated with gravity-induced loss of consciousness?

    PubMed

    Choi, Hyun Seok; Sul, Jin Gon; Yi, Kyung Sik; Seo, Jeong-Min; Chung, Ki Young

    2010-07-01

    Gravity-induced loss of consciousness (G-LOC) is caused by loss of cerebral blood flow during high +Gz (head-to-foot inertial forces). The resistance of the jugular vein is a significant factor in decrease in cerebral blood flow. Ultrasonography of thoracic inlet veins, including internal jugular vein, is feasible to visualize the internal jugular vein and hemodynamic information. Anti-gravity straining maneuver (AGSM) was widely recognized as one of the important factors in preventing G-LOC. The purpose of this study was to evaluate the relationship between the ultrasonographic shape and size of internal jugular vein during AGSM and G-LOC. 47 trainee pilots who participated in human centrifuge education program were enrolled. They were all men, and their mean age was 23.9 +/- 1.38 years. Questionnaire sheets were used to collect information about well-being sensation, smoking, drinking, height, and weight. Using ultrasonography, we monitored shape and size of internal jugular vein during AGSM. After ultrasonographic examination, 47 subjects underwent human centrifuge on the same day. The protocol of human centrifuge training was maximal 6G with sustaining time of 30 s. G-LOC occurred to ten out of 47 subjects in human centrifuge. To find presumptive variable associated with G-LOC, we performed logistic regression analysis. Concave contour and smaller cross-sectional area of internal jugular vein during AGSM were associated with G-LOC.

  4. Single-stick tunneled central venous access using the jugular veins in infants weighing less than 5 kg.

    PubMed

    Lindquester, Will S; Hawkins, C Matthew; Monroe, Eric J; Gill, Anne E; Shivaram, Giridhar M; Seidel, F Glen; Lungren, Matthew P

    2017-11-01

    Despite the demonstrated feasibility of the single-stick technique in the femoral vein, its use in neonates and infants for placing central lines in internal and external jugular veins has not been reported. Describe and assess the safety and efficacy of tunneled jugular central venous catheter placement performed under ultrasound (US) and fluoroscopic guidance in neonates and infants weighing <5 kg using the single-stick technique at three tertiary pediatric hospitals. Thirty-three children weighing less than 5 kg received tunneled central venous access in either internal or external jugular veins using the single-stick technique. Patient history, procedural records and clinical follow-up documents were retrospectively reviewed. Complication rates were compared to those of 41 patients receiving single-stick femoral central lines. Technical complications occurred during one (3.0%) jugular placement with the patient having a failed right-side attempt with subsequent successful left-side placement. The catheters did not last the entire course of treatment in three (9.1%) patients with jugular lines. One patient had the catheter removed due to concern for infection, one catheter was accidentally removed during dressing changes, and one catheter was displaced and subsequently exchanged. Of patients receiving femoral central lines, 1 (2.4%) had a technical complication and 5 catheters (12.2%) did not last the entire course of treatment. The placement of tunneled central venous catheters in neonates/infants <5 kg is safe and technically feasible using the internal/external jugular vein via the single-stick technique. By theoretically reducing the risks of catheter infection by avoiding the diaper area and thrombosis by using larger veins, it may be preferable in certain patient populations.

  5. Comparison of subcutaneous central venous port via jugular and subclavian access in 347 patients at a single center

    PubMed Central

    ARIBAŞ, BILGIN KADRI; ARDA, KEMAL; ARIBAŞ, ÖZGE; ÇILEDAĞ, NAZAN; YOLOĞLU, ZEYNEL; AKTAŞ, ELIF; SEBER, TURGUT; KAVAK, ŞEYHMUS; COŞAR, YUSUF; KAYGUSUZ, HIDIR; TEKIN, EKREM

    2012-01-01

    The purpose of the present study was to examine whether patency times, including complications of subcutaneous venous chest port insertion using ultrasonography (US) guidance, differ between jugular and subclavian venous access. Between December 2008 and July 2010, subcutaneous venous chest ports were placed in 347 patients by an experienced team. All single-lumen port catheters were placed into jugular and subclavian veins under US and fluoroscopy guidance. Patency times and complication rates of ports via these routes were compared and the variables were age, gender, access, site of malignancy and coagulation parameters. The success of the jugular and subclavian groups was compared by univariate Kaplan-Meier survival analysis and the multivariable Cox regression test. A total of 15 patients underwent port removal due to complications. As a rate per 100 catheter days, ports were explanted in 7 (0.0092) due to thrombosis, 4 (0.0053) for catheter malposition, one each (0.0013) of port reservoir flip-over, bleeding, port pocket infection, skin necrosis and incision dehiscence, for a total of 15 patients (0.0197). Patency times were not different in the jugular and subclavian veins. Factors were not significant, with the exception of platelet count. There was no significant difference in patency times, including complications, between jugular vein access and subclavian vein access using US. This should be considered when selecting the access method. PMID:23170125

  6. A Randomized Controlled Comparison of the Internal Jugular Vein and the Subclavian Vein as Access Sites for Central Venous Catheterization in Pediatric Cardiac Surgery.

    PubMed

    Camkiran Firat, Aynur; Zeyneloglu, Pinar; Ozkan, Murat; Pirat, Arash

    2016-09-01

    To compare internal jugular vein and subclavian vein access for central venous catheterization in terms of success rate and complications. A 1:1 randomized controlled trial. Baskent University Medical Center. Pediatric patients scheduled for cardiac surgery. Two hundred and eighty children undergoing central venous catheterization were randomly allocated to the internal jugular vein or subclavian vein group during a period of 18 months. The primary outcome was the first-attempt success rate of central venous catheterization through either approach. The secondary outcomes were the rates of infectious and mechanical complications. The central venous catheterization success rate at the first attempt was not significantly different between the subclavian vein (69%) and internal jugular vein (64%) groups (p = 0.448). However, the overall success rate was significantly higher through the subclavian vein (91%) than the internal jugular vein (82%) (p = 0.037). The overall frequency of mechanical complications was not significantly different between the internal jugular vein (25%) and subclavian vein (31%) (p = 0.456). However, the rate of arterial puncture was significantly higher with internal jugular vein (8% vs 2%; p = 0.03) and that of catheter malposition was significantly higher with subclavian vein (17% vs 1%; p < 0.001). The rates per 1,000 catheter days for both positive catheter-tip cultures (26.1% vs 3.6%; p < 0.001) and central-line bloodstream infection (6.9 vs 0; p < 0.001) were significantly higher with internal jugular vein. There were no significant differences between the groups in the length of ICU and hospital stays or in-hospital mortality rates (p > 0.05 for all). Central venous catheterization through the internal jugular vein and subclavian vein was not significantly different in terms of success at the first attempt. Although the types of mechanical complications were different, the overall rate was similar between internal jugular vein and

  7. A metastatic glomus jugulare tumor. A temporal bone report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    El Fiky, F.M.; Paparella, M.M.

    The clinicopathologic findings in the temporal bone of a patient with a highly malignant metastasizing glomus jugulare tumor are reported. The patient exhibited all the symptoms of primary malignant tumors of the ear, including facial paralysis, otorrhea, pain, hearing loss, tinnitus, dizziness, and vertigo. He was treated with cobalt irradiation followed by radium implant in the ear canal for a residual tumor; then a left-sided radical mastoidectomy was performed.

  8. Femoral vs jugular venous catheterization and risk of nosocomial events in adults requiring acute renal replacement therapy: a randomized controlled trial.

    PubMed

    Parienti, Jean-Jacques; Thirion, Marina; Mégarbane, Bruno; Souweine, Bertrand; Ouchikhe, Abdelali; Polito, Andrea; Forel, Jean-Marie; Marqué, Sophie; Misset, Benoît; Airapetian, Norair; Daurel, Claire; Mira, Jean-Paul; Ramakers, Michel; du Cheyron, Damien; Le Coutour, Xavier; Daubin, Cédric; Charbonneau, Pierre

    2008-05-28

    Based on concerns about the risk of infection, the jugular site is often preferred over the femoral site for short-term dialysis vascular access. To determine whether jugular catheterization decreases the risk of nosocomial complications compared with femoral catheterization. A concealed, randomized, multicenter, evaluator-blinded, parallel-group trial (the Cathedia Study) of 750 patients from a network of 9 tertiary care university medical centers and 3 general hospitals in France conducted between May 2004 and May 2007. The severely ill, bed-bound adults had a body mass index (BMI) of less than 45 and required a first catheter insertion for renal replacement therapy. Patients were randomized to receive jugular or femoral vein catheterization by operators experienced in placement at both sites. Rates of infectious complications, defined as catheter colonization on removal (primary end point), and catheter-related bloodstream infection. Patient and catheter characteristics, including duration of catheterization, were similar in both groups. More hematomas occurred in the jugular group than in the femoral group (13/366 patients [3.6%] vs 4/370 patients [1.1%], respectively; P = .03). The risk of catheter colonization at removal did not differ significantly between the femoral and jugular groups (incidence of 40.8 vs 35.7 per 1000 catheter-days; hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.62-1.16; P = .31). A prespecified subgroup analysis demonstrated significant qualitative heterogeneity by BMI (P for the interaction term < .001). Jugular catheterization significantly increased incidence of catheter colonization vs femoral catheterization (45.4 vs 23.7 per 1000 catheter-days; HR, 2.10; 95% CI, 1.13-3.91; P = .017) in the lowest tercile (BMI <24.2), whereas jugular catheterization significantly decreased this incidence (24.5 vs 50.9 per 1000 catheter-days; HR, 0.40; 95% CI, 0.23-0.69; P < .001) in the highest tercile (BMI >28.4). The rate of catheter

  9. Patterns and Rates of Supplementary Venous Drainage to the Internal Jugular Veins.

    PubMed

    Qureshi, Adnan I; Ishfaq, Muhammad Fawad; Herial, Nabeel A; Khan, Asif A; Suri, M Fareed K

    2016-07-01

    Several studies have found supplemental venous drainage channels in addition to bilateral internal jugular veins for cerebral venous efflux. We performed this study to characterize the supplemental venous outflow patterns in a consecutive series of patients undergoing detailed cerebral angiography with venous phase imaging. The venographic phase of the arteriogram was reviewed to identify and classify supplemental cerebral venous drainage into anterior (cavernous venous sinus draining into pterygoid plexus and retromandibular vein) and posterior drainage pattern. The posterior drainage pattern was further divided into plexiform pattern (with sigmoid venous sinus draining into the paravertebral venous plexus), and solitary vein pattern (dominant single draining deep cervical vein) drainage. The posterior plexiform pattern was further divided into 2 groups: posterior plexiform with or without prominent solitary vein. Supplemental venous drainage was seen ipsilateral to internal jugular vein in 76 (43.7%) of 174 venous drainages (87 patients) analyzed. The patterns were anterior (n = 23, 13.2%), posterior plexiform without prominent solitary vein (n = 40, 23%), posterior plexiform with prominent solitary vein (n = 62, 35.6%), and posterior solitary vein alone (n = 3, 1.7%); occipital emissary veins and/or transosseous veins were seen in 1 supplemental venous drainage. Concurrent ipsilateral anterior and posterior supplemental drainage was seen in 6 of 174 venous drainages analyzed. We provide an assessment of patterns and rates of supplementary venous drainage to internal jugular veins to improve our understanding of anatomical and physiological aspects of cerebral venous drainage. Copyright © 2016 by the American Society of Neuroimaging.

  10. Subtotal resection for management of large jugular paragangliomas with functional lower cranial nerves.

    PubMed

    Wanna, George B; Sweeney, Alex D; Carlson, Matthew L; Latuska, Richard F; Rivas, Alejandro; Bennett, Marc L; Netterville, James L; Haynes, David S

    2014-12-01

    To evaluate tumor control following subtotal resection of advanced jugular paragangliomas in patients with functional lower cranial nerves and to investigate the utility of salvage radiotherapy for residual progressive disease. Case series with planned chart review. Tertiary academic referral center. Patients who presented with advanced jugular paragangliomas and functional lower cranial nerves were analyzed. Primary outcome measures included extent of resection, long-term tumor control, need for additional treatment, and postoperative lower cranial nerve function. Twelve patients (mean age, 46.2 years; 7 women, 58.3%) who met inclusion criteria were evaluated between 1999 and 2013. The mean postoperative residual tumor volume was 27.7% (range, 3.5%-75.0%) of the preoperative volume. When the residual tumor volume was less than 20% of the preoperative volume, no tumor growth occurred over an average of 44.6 months of follow-up (P < .01). Four tumors (33.3%) demonstrated serial growth at a mean of 23.5 months following resection, 2 of which were treated with salvage stereotactic radiotherapy providing control through the last recorded follow-up. No patient experienced permanent postoperative lower cranial neuropathy as a result of surgery. Subtotal resection of jugular paragangliomas with preservation of the lower cranial nerves is a viable management strategy. If more than 80% of the preoperative tumor volume is resected, the residual tumor seems less likely to grow. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  11. External jugular venous pressure as an alternative to conventional central venous pressure in right lobe donor hepatectomies.

    PubMed

    Abdullah, Mohamed Hussein; Soliman, Hossam El Deen; Morad, Wessam Saber

    2011-12-01

    Many centers have adopted central vein cannulation both for central venous pressure monitoring and fluid administration for right hepatectomy in living-liver donors. However, use of central venous catheters is associated with adverse events that are hazardous to patients and expensive to treat. This study sought to examine the use of external jugular venous pressure as an alternative to conventional central venous pressure in right lobe donor hepatectomies Forty ASA grade I adult living liver-donors without a known history of significant cardiac or pulmonary diseases were enrolled in this prospective observational study. Paired measurement of venous pressures (external jugular venous pressure and internal jugular venous pressure) were taken at the following times: after induction of anesthesia, 30 minutes after skin incision, during right lobe mobilization (every 15 minutes), during hepatic transaction (every 15 minutes), after right lobe resection (every 15 minutes), and after abdominal closure. Paired measurements were equal in 47.5%, 53.5%, 61.5%, 46.3%, and 52.5% for after induction, after skin incision, right lobe mobilization, right lobe transection, after resection, and before abdominal closure periods. However, all measurements were within acceptable limits of bias measurements (± 2 mm Hg). Central venous pressure catheter placement can be avoided and replaced by a less-invasive method such as external jugular venous pressure (which gave an acceptable estimate of central venous pressure in all phases of right lobe resection) in living-donor liver transplant and allowed equivalent monitor even during fluid restriction phases.

  12. Brain Slump Caused by Jugular Venous Stenoses Treated by Stenting: A Hypothesis to Link Spontaneous Intracranial Hypotension with Idiopathic Intracranial Hypertension

    PubMed Central

    Higgins, Nicholas; Trivedi, Rikin; Greenwood, Richard; Pickard, John

    2015-01-01

    Spontaneous intracranial hypotension, of which brain slump is an extreme expression, is caused by a cerebrospinal fluid leak. The reason the leak develops in the first place, however, is unknown, and some cases can be very difficult to manage. We describe a patient with severe symptoms of spontaneous intracranial hypotension and brain slump documented by magnetic resonance imaging whose clinical syndrome and structural brain anomaly resolved completely after treatment directed exclusively at improving cranial venous outflow. Diagnostics included computed tomography (CT) venography, catheter venography, and jugular venoplasty. CT venography showed narrowing of both internal jugular veins below the skull base. Catheter venography confirmed that these were associated with pressure gradients. Jugular venoplasty performed on two separate occasions as a clinical test gave temporary respite. Lasting remission (2 years of follow-up) was achieved by stenting the dominant internal jugular vein. These findings and this outcome suggest a mechanism for the development of spontaneous intracranial hypotension that would link it to idiopathic intracranial hypertension and have cranial venous outflow obstruction as the underlying cause. PMID:26251803

  13. Brain Slump Caused by Jugular Venous Stenoses Treated by Stenting: A Hypothesis to Link Spontaneous Intracranial Hypotension with Idiopathic Intracranial Hypertension.

    PubMed

    Higgins, Nicholas; Trivedi, Rikin; Greenwood, Richard; Pickard, John

    2015-07-01

    Spontaneous intracranial hypotension, of which brain slump is an extreme expression, is caused by a cerebrospinal fluid leak. The reason the leak develops in the first place, however, is unknown, and some cases can be very difficult to manage. We describe a patient with severe symptoms of spontaneous intracranial hypotension and brain slump documented by magnetic resonance imaging whose clinical syndrome and structural brain anomaly resolved completely after treatment directed exclusively at improving cranial venous outflow. Diagnostics included computed tomography (CT) venography, catheter venography, and jugular venoplasty. CT venography showed narrowing of both internal jugular veins below the skull base. Catheter venography confirmed that these were associated with pressure gradients. Jugular venoplasty performed on two separate occasions as a clinical test gave temporary respite. Lasting remission (2 years of follow-up) was achieved by stenting the dominant internal jugular vein. These findings and this outcome suggest a mechanism for the development of spontaneous intracranial hypotension that would link it to idiopathic intracranial hypertension and have cranial venous outflow obstruction as the underlying cause.

  14. Facial Nerve Paralysis after Onyx Embolization of a Jugular Paraganglioma: A Case Report with a Long-Term Follow Up

    PubMed Central

    Odat, Haitham; Alawneh, Khaled; Al-Qudah, Mohannad

    2018-01-01

    Jugular paragangliomas are slow growing highly vascular tumors arising from jugular paraganglia. The gold standard of treatment is complete surgical resection. Pre-operative embolization of these highly vascular tumors is essential to reduce intra-operative bleeding, allow safe dissection, and decrease operative time and post-operative complications. Onyx (ethylene-vinyl alcohol copolymer) has been widely used as permanent occluding material for vascular tumors of skull base because of its unique physical properties. We present the case of a 33-year-old woman who had left-sided facial nerve paralysis after Onyx embolization of jugular paraganglioma. The tumor was resected on the next day of embolization. The patient was followed up for 30 months with serial imaging studies and facial nerve assessment. The facial verve function improved from House–Brackmann grade V to grade II at the last visit. PMID:29518926

  15. Facial Nerve Paralysis after Onyx Embolization of a Jugular Paraganglioma: A Case Report with a Long-Term Follow Up.

    PubMed

    Odat, Haitham; Alawneh, Khaled; Al-Qudah, Mohannad

    2018-03-07

    Jugular paragangliomas are slow growing highly vascular tumors arising from jugular paraganglia. The gold standard of treatment is complete surgical resection. Pre-operative embolization of these highly vascular tumors is essential to reduce intra-operative bleeding, allow safe dissection, and decrease operative time and post-operative complications. Onyx (ethylene-vinyl alcohol copolymer) has been widely used as permanent occluding material for vascular tumors of skull base because of its unique physical properties. We present the case of a 33-year-old woman who had left-sided facial nerve paralysis after Onyx embolization of jugular paraganglioma. The tumor was resected on the next day of embolization. The patient was followed up for 30 months with serial imaging studies and facial nerve assessment. The facial verve function improved from House-Brackmann grade V to grade II at the last visit.

  16. Serum levels of S100B from jugular bulb as a biomarker of poor prognosis in patients with severe acute brain injury.

    PubMed

    Ballesteros, María A; Rubio-Lopez, María I; San Martín, María; Padilla, Ana; López-Hoyos, Marcos; Llorca, Javier; Miñambres, Eduardo

    2018-02-15

    To evaluate the correlation between protein S100B concentrations measured in the jugular bulb as well as at peripheral level and the prognostic usefulness of this marker. A prospective study of all patients admitted to the intensive care unit with acute brain damage was carried out. Peripheral and jugular bulb blood samples were collected upon admission and every 24h for three days. The endpoints were brain death diagnosis and the Glasgow Outcome Scale score after 6months. A total of 83 patients were included. Jugular protein S100B levels were greater than systemic levels upon admission and also after 24 and 72h (mean difference>0). Jugular protein S100B levels showed acceptable precision in predicting brain death both upon admission [AUC 0.67 (95% CI 0.53-0.80)] and after 48h [AUC 0.73 (95% CI 0.57-0.89)]. Similar results were obtained regarding the capacity of jugular protein S100B levels upon admission to predict an unfavourable outcome (AUC 0.69 (95% CI 0.56-0.79)). The gradient upon admission (jugular-peripheral levels) showed its capacity to predict the development of brain death [AUC 0.74 (95% CI 0.62-0.86)] and together with the Glasgow Coma Scale constituted the independent factors associated with the development of brain death. Regional protein S100B determinations are higher than systemic determinations, thus confirming the cerebral origin of protein S100B. The transcranial protein S100B gradient is correlated to the development of brain death. Copyright © 2017. Published by Elsevier B.V.

  17. The cephalic and external jugular veins: important alternative recipient vessels in left-sided microvascular breast reconstruction.

    PubMed

    Casey, William J; Rebecca, Alanna M; Smith, Anthony A; Craft, Randall O; Buchel, Edward W

    2007-01-01

    The internal mammary and thoracodorsal vessels are the standard recipient sites in microsurgical breast reconstruction. We review our series of venous outflow alternatives when these vessels are inadequate or unusable. A retrospective review of all free breast reconstructions was performed from July 2003 through December 2005. Outcomes were measured with regard to re-exploration, flap failure, and fat necrosis, with attention to the timing and side of reconstruction, as well as the presence or absence of radiation therapy. A total of 141 free breast reconstructions were performed during the study period. In seven cases (5%), alternative venous outflow vessels were selected (cephalic or external jugular vein). Nine anastamotic complications occurred, all of which involved the left internal mammary group (statistically significant for venous thrombosis, P = 0.0063) and three flaps failed. All cephalic and external jugular veins remained patent with no flap failures or fat necrosis within this group. The cephalic vein and external jugular vein are excellent alternatives for venous outflow in free breast reconstruction if neither the internal mammary nor thoracodorsal veins are sufficient, especially in left-sided reconstruction. 2007 Wiley-Liss, Inc.

  18. Technical considerations in continuous jugular venous oxygen saturation measurement.

    PubMed

    Dearden, N M; Midgley, S

    1993-01-01

    Fibreoptic reflection oximetry allows continuous in-vivo estimation of jugular venous oxygen saturation. In combination with pulse oximetry the oxygen extraction ratio SaO2-SjO2/SaO2 can be derived enabling identification of states of global luxury perfusion, normal coupling of global cerebral blood flow with global cerebral metabolism, global cerebral hypoperfusion and global cerebral ischemia. Several technical difficulties may arise affecting the accuracy of SjO2 recordings which must be recognised by the clinician before medical intervention is contemplated.

  19. Microsurgical Resection of Glomus Jugulare Tumors With Facial Nerve Reconstruction: 3-Dimensional Operative Video.

    PubMed

    Cândido, Duarte N C; de Oliveira, Jean Gonçalves; Borba, Luis A B

    2018-05-08

    Paragangliomas are tumors originating from the paraganglionic system (autonomic nervous system), mostly found at the region around the jugular bulb, for which reason they are also termed glomus jugulare tumors (GJT). Although these lesions appear to be histologically benign, clinically they present with great morbidity, especially due to invasion of nearby structures such as the lower cranial nerves. These are challenging tumors, as they need complex approaches and great knowledge of the skull base. We present the case of a 31-year-old woman, operated by the senior author, with a 1-year history of tinnitus, vertigo, and progressive hearing loss, that evolved with facial nerve palsy (House-Brackmann IV) 2 months before surgery. Magnetic resonance imaging and computed tomography scans demonstrated a typical lesion with intense flow voids at the jugular foramen region with invasion of the petrous and tympanic bone, carotid canal, and middle ear, and extending to the infratemporal fossa (type C2 of Fisch's classification for GJT). During the procedure the mastoid part of the facial nerve was identified involved by tumor and needed to be resected. We also describe the technique for nerve reconstruction, using an interposition graft from the great auricular nerve, harvested at the beginning of the surgery. We achieved total tumor resection with a remarkable postoperative course. The patient also presented with facial function after 6 months. The patient consented with publication of her images.

  20. Changes of jugular venous blood temperature associated with measurements of cerebral blood flow using the transcerebral double-indicator dilution technique.

    PubMed

    Mielck, F; Bräuer, A; Radke, O; Hanekop, G; Loesch, S; Friedrich, M; Hilgers, R; Sonntag, H

    2004-04-01

    The transcerebral double-indicator dilution technique is a recently developed method to measure global cerebral blood flow at bedside. It is based on bolus injection of ice-cold indocyanine green dye and simultaneous recording of resulting thermo- and dye-dilution curves in the aorta and the jugular bulb. However, with this method 40 mL of ice-cold solution is administered as a bolus. Therefore, this prospective clinical study was performed to elucidate the effects of repeated administration of indicator on absolute blood temperature and on cerebral blood flow and metabolism. The investigation was performed in nine male patients scheduled for elective coronary artery bypass grafting. Absolute blood temperature was measured in the jugular bulb and in the aorta before and after repeated measurements using the transcerebral double-indicator dilution technique. During the investigated time course, the blood temperature in the jugular bulb, compared to the aorta, was significantly higher with a mean difference of 0.21 degrees C. The administration of an ice-cold bolus reduced the mean blood temperature by 0.06 degrees C in the jugular bulb as well as in the aorta. After the transcerebral double-indicator dilution measurements a temperature recovery to baseline conditions was not observed during the investigated time period. Cerebral blood flow and cerebral metabolism did not change during the investigated time period. Repeated measurements with the transcerebral double-indicator dilution technique do not affect absolute jugular bulb blood temperatures negatively. Global cerebral blood flow and metabolism measurements remain unaltered. However, accuracy and resolution of this technique is not high enough to detect the effect of minor changes of physiological variables.

  1. Milrinone, a phosphodiesterase III inhibitor, prevents reduction of jugular bulb saturation during rewarming from hypothermic cardiopulmonary bypass.

    PubMed

    Iritakenishi, T; Hayashi, Y; Yamanaka, H; Kamibayashi, T; Ueda, K; Mashimo, T

    2012-01-01

    Inadequate cerebral oxygen balance during cardiopulmonary bypass may cause neuropsychological dysfunction. Milrinone, a phosphodiesterase III inhibitor, augments cerebral blood flow by direct vasodilatation. We conducted a prospective, randomized study in patients undergoing cardiac surgery with cardiopulmonary bypass to clarify the clinical efficacy of milrinone in the imbalance of cerebral oxygen supply and demand during the rewarming period of cardiopulmonary bypass. This is a prospective, randomized and placebo-controlled study. After anesthesia, a 5.5 F fiberoptic oximeter catheter was inserted into the right jugular bulb retrogradely for monitoring the jugular venous oxyhemoglobin saturation (SjO(2)). Patients were randomly assigned to two groups, one receiving a continuous infusion of milrinone, 0.5 µg/kg/min during hypothermic cardiopulmonary bypass, and the other receiving saline as control. Milrinone significantly prevented the reduction of the jugular venous oxyhemoglobin saturation at 10 minutes from the start of rewarming compared with the control group, but did not do so from 10 to 20 minutes after rewarming. Milrinone suppresses the reduction of SjO(2) and improves the balance of cerebral oxygen supply and demand during the early rewarming period of hypothermic cardiopulmonary bypass.

  2. Selective propensity of bovine jugular vein material to bacterial adhesions: An in-vitro study.

    PubMed

    Jalal, Zakaria; Galmiche, Louise; Lebeaux, David; Villemain, Olivier; Brugada, Georgia; Patel, Mehul; Ghigo, Jean-Marc; Beloin, Christophe; Boudjemline, Younes

    2015-11-01

    Percutaneous pulmonary valve implantation (PPVI) using Melody valve made of bovine jugular vein is safe and effective. However, infective endocarditis has been reported for unclear reasons. We sought to assess the impact of valvular substrates on selective bacterial adhesion. Three valved stents (Melody valve, homemade stents with bovine and porcine pericardium) were tested in-vitro for bacterial adhesion using Staphylococcus aureus and Streptococcus sanguinis strains. Bacterial adhesion was higher on bovine jugular venous wall for S. aureus and on Melody valvular leaflets for S. sanguinis in control groups and significantly increased in traumatized Melody valvular leaflets with both bacteria (traumatized vs non traumatized: p=0.05). Bacterial adhesion was lower on bovine pericardial leaflets. Selective adhesion of S. aureus and S. sanguinis pathogenic strains to Melody valve tissue was noted on healthy tissue and increased after implantation procedural steps. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Effective use of flow-spoiled FBI and time-SLIP methods in the diagnostic study of an aberrant vessel of the head and neck: "left jugular venous steal by the right jugular vein".

    PubMed

    Kogure, Taroh; Kogure, Kyuya; Iizuka, Mitsumasa; Ino, Azusa; Ishii, Masako

    2010-08-01

    Three-dimensional (3D) time-of-flight (TOF) is now commonly used in routine magnetic resonance angiography (MRA) studies of the head and neck. However, there are limits to its diagnostic abilities in the clinical field and, in some instances, a more invasive supplementary examination may be required. We incidentally discovered a patient with an aberrant vessel of the head and neck that ran alongside the left carotid artery and contained a constant, slowly pulsating efferent blood flow. 3D-TOF and carotid ultrasonography could not determine the nature and origin of this vessel. Additional studies using flow-spoiled fresh blood imaging (flow-spoiled FBI) and time spatial labeling inversion pulse (time-SLIP) methods were effective in determining that the vessel was the left jugular vein, and that the continuous venous reflux was a result of a venous steal by the right jugular vein. We show that by combining different MRA techniques we can effectively achieve diagnosis without resorting to more invasive examinations. 2010 Wiley-Liss, Inc.

  4. Internal jugular and vertebral vein volume flow in patients with clinically isolated syndrome or mild multiple sclerosis and healthy controls: results from a prospective sonographer-blinded study.

    PubMed

    Chambers, Brian; Chambers, Jayne; Churilov, Leonid; Cameron, Heather; Macdonell, Richard

    2014-09-01

    We evaluated internal jugular vein and vertebral vein volume flow using ultrasound, in patients with clinically isolated syndrome or mild multiple sclerosis and controls, to determine whether volume flow was different between the two groups. In patients and controls, internal jugular vein volume flow increased from superior to inferior segments, consistent with recruitment from collateral veins. Internal jugular vein and vertebral vein volume flow were greater on the right in supine and sitting positions. Internal jugular vein volume flow was higher in the supine posture. Vertebral vein volume flow was higher in the sitting posture. Regression analyses of cube root transformed volume flow data, adjusted for supine/sitting, right/left and internal jugular vein/vertebral vein, revealed no significant difference in volume flow in patients compared to controls. Our findings further refute the concept of venous obstruction as a causal factor in the pathogenesis of multiple sclerosis. Control volume flow data may provide useful normative reference values. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. A Randomized Parallel Study for Simulated Internal Jugular Vein Cannulation Using Simple Needle Guide Device

    ClinicalTrials.gov

    2017-08-14

    Doctors Attending a Central Line Insertion Training Courses for New Residents of a University Hospital From March 2017 to June 2017; Physicians Who Had Less Than 10 Ultrasound Guided Internal Jugular Vein Cannulation Participate in This Study

  6. Achondroplasia in children: correlation of ventriculomegaly, size of foramen magnum and jugular foramina, and emissary vein enlargement.

    PubMed

    Bosemani, Thangamadhan; Orman, Gunes; Hergan, Benedikt; Carson, Kathryn A; Huisman, Thierry A G M; Poretti, Andrea

    2015-01-01

    Achondroplasia is a skeletal dysplasia with diminished growth of the skull base secondary to defective enchondral bone formation. This leads to narrowing of the foramen magnum and jugular foramina, which further leads to ventricular dilatation and prominence of the emissary veins. The primary goal of our study was to determine a correlation between the degree of ventricular dilatation, jugular foramina and foramen magnum narrowing, as well as emissary vein enlargement. Conventional T2-weighted MR images were evaluated for surface area of the foramen magnum and jugular foramina, ventricular dilatation, and emissary veins enlargement in 16 achondroplasia patients and 16 age-matched controls. Ratios were calculated for the individual parameters using median values from age-matched control groups to avoid age as a confounder. Compared to age-matched controls, in children with achondroplasia, the surface area of the foramen magnum (median 0.50 cm(2), range 0.23-1.37 cm(2) vs. 3.14 cm(2), 1.83-6.68 cm(2), p < 0.001) and jugular foramina (median 0.02 cm(2), range 0-0.10 cm(2) vs. 0.21 cm(2), 0.03-0.61 cm(2), p < 0.001) were smaller, whereas ventricular dilatation (0.28, 0.24-0.4 vs. 0.26, 0.21-0.28, p < 0.001) and enlargement of emissary veins (6, 0-11 vs. 0, p < 0.001) were higher. Amongst the patients, Spearman correlation and multiple regression analysis did not reveal correlation for severity between the individual parameters. Our study suggests that in children with achondroplasia, (1) the variation in ventricular dilatation may be related to an unquantifiable interdependent relationship of emissary vein enlargement, venous channel narrowing, and foramen magnum compression and (2) stable ventricular size facilitated by interdependent factors likely obviates the need for ventricular shunt placement.

  7. Angiossarcoma mimetizando endoleak tardio pós-reparo endovascular de aneurisma de aorta infrarrenal: relato de caso

    PubMed Central

    de Almeida, Bruno Lorenção; Caria, Vinicius Pena; Cavalcante, Sthefanie Fauve Andrade; Ventin, Felipe Carvalho; Vieira, Eduardo Augusto Moreira; Darold, Eduardo Mulinari; de Souza, Rodrigo Américo Cunha; Araújo, Edmur Carlos

    2017-01-01

    Resumo Em todo paciente submetido a reparo endovascular do aneurisma de aorta abdominal (REVA) que se apresente subitamente com quadro de dor abdominal ou sinais de choque, a hipótese de endoleak ou vazamento, com expansão do aneurisma e ruptura deve ser aventada. Apresentamos o caso de um paciente em pós-operatório de REVA que apresentou uma neoplasia de duodeno mimetizando um endoleak. PMID:29930672

  8. Internal to external jugular vein bypass allowing for simultaneous bilateral radical neck dissection.

    PubMed

    Mourad, Moustafa; Saman, Masoud; Ducic, Yadranko

    2015-11-01

    The goal of the study was to determine the role of internal jugular vein (IJV) to external jugular vein (EJV) bypass grafting in the setting of bilateral radical neck dissection with IJV sacrifice. The study group consisted of eight patients who underwent bilateral radical neck dissection with IJV sacrifice. Demographic and oncologic parameters were defined for each patient, including age, gender, and pathology. Patients were monitored and evaluated for potential effects of increased intracranial pressure (ICP). Doppler ultrasonic evaluation was performed to assess patency of the site of anastamoses. In all, six patients underwent unilateral bypass grafting, whereas two patients underwent bilateral bypass grafts. Average age at time of surgery was 68.2 (range 56-71). Postoperatively, no sequelae of increased ICP were noted. Follow-up ultrasonic evaluation revealed patent vessels in all patients. We presently report on the use of EJV-to-IJV bypass grafting for all patients undergoing bilateral radical neck dissection for extensive neck disease. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Atypical Teratoid Rhabdoid Tumor in a Teenager with Unusual Infiltration Into the Jugular Foramen.

    PubMed

    Udaka, Yoko T; Yoon, Janet M; Malicki, Denise M; Khanna, Paritosh C; Levy, Michael L; Crawford, John R

    2015-12-01

    Atypical teratoid rhabdoid tumor is a rare malignant neoplasm that represents 1%-2% of all pediatric central nervous system tumors. Immunohistochemistry plays an important role in establishing the diagnosis with a loss of INI-1 staining in tumor cells. In this case report, we describe a teenager with an unusual presentation and pattern of infiltration of the tumor. A 13-year-old boy presented with a history over several months of progressive nausea, weight loss, and hoarseness of voice associated with multiple lower cranial nerve palsies on neurologic examination. Magnetic resonance imaging revealed a large heterogeneously enhancing extra-axial neoplasm with extension and bony expansion of the jugular foramen. After near total resection, neuropathology demonstrated the absence of INI-1 expression consistent with a diagnosis of atypical teratoid rhabdoid tumor. This case highlights the diverse clinical presentation and infiltrative potential of atypical teratoid rhabdoid tumors, thus expanding the differential diagnosis of extra-axial tumors invading the jugular foramen. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Iliopsoas abscess as a complication of tunneled jugular vein catheterization in a hemodialysis patient.

    PubMed

    Hsiao, Po-Jen; Tsai, Ming-Hsien; Leu, Jyh-Gang; Fang, Yu-Wei

    2015-04-01

    Iliopsoas abscess is a rare complication in hemodialysis patients that is mainly due to adjacent catheterization, local acupuncture, discitis, and bacteremia. Herein, we report a 47-year-old woman undergoing regular hemodialysis via a catheter in the internal jugular vein who presented with low back pain and dyspnea. A heart murmur suggested the presence of catheter-related endocarditis, and this was confirmed by an echocardiogram and a blood culture of methicillin-resistant Staphylococcus aureus. A computed tomography indicated a pulmonary embolism and an incidental finding of iliopsoas abscess. Following surgical intervention and intravenous daptomycin, the patient experienced full recovery and a return to usual activities. This case indicates that an iliopsoas abscess can be related to a jugular vein catheter, which is apparently facilitated by infective endocarditis. The possibility of iliopsoas abscess should be considered when a hemodialysis patient presents with severe low back pain, even when there is no history of adjacent mechanical intervention. © 2014 International Society for Hemodialysis.

  11. Evaluation of a Jugular Venipuncture Alpaca Model to Teach the Technique of Blood Sampling in Adult Alpacas.

    PubMed

    Rousseau, Marjolaine; Beauchamp, Guy; Nichols, Sylvain

    The effectiveness of teaching aids in veterinary medical education is not often assessed rigorously. The objective in the present study was to evaluate the effectiveness of a commercially available jugular venipuncture alpaca model as a complementary tool to teach veterinary students how to perform venipuncture in adult alpacas. We hypothesized that practicing on the model would allow veterinary students to draw blood in alpacas more rapidly with fewer attempts than students without previous practice on the model. Thirty-six third-year veterinary students were enrolled and randomly allocated to the model (group M; n=18) or the control group (group C; n=18). The venipuncture technique was taught to all students on day 0. Students in group M practiced on the model on day 2. On day 5, an evaluator blinded to group allocation evaluated the students' venipuncture skills during a practical examination using live alpacas. Success was defined as the aspiration of a 6-ml sample of blood. Measured outcomes included number of attempts required to achieve success (success score), total procedural time, and overall qualitative score. Success scores, total procedural time, and overall scores did not differ between groups. Use of restless alpacas reduced performance. The jugular venipuncture alpaca model failed to improve jugular venipuncture skills in this student population. Lack of movement represents a significant weakness of this training model.

  12. The safety and efficacy of gamma knife surgery in management of glomus jugulare tumor

    PubMed Central

    2010-01-01

    Background Glomus jugulare is a slowly growing, locally destructive tumor located in the skull base with difficult surgical access. The operative approach is, complicated by the fact that lesions may be both intra and extradural with engulfment of critical neurovascular structures. The tumor is frequently highly vascular, thus tumor resection entails a great deal of morbidity and not infrequent mortality. At timeslarge residual tumors are left behind. To decrease the morbidity associated with surgical resection of glomus jugulare, gamma knife surgery (GKS) was performed as an alternative in 13 patients to evaluate its safety and efficacy. Methods A retrospective review of 13 residual or unresectable glomus jagulare treated with GKS between 2004 and 2008.. Of these, 11 patients underwent GKS as the primary management and one case each was treated for postoperative residual disease and postembolization. The radiosurgical dose to the tumor margin ranged between 12-15 Gy. Results Post- gamma knife surgery and during the follow-up period twelve patients demonstrated neurological stability while clinical improvement was achieved in 5 patients. One case developed transient partial 7th nerve palsy that responded to medical treatment. In all patients radiographic MRI follow-up was obtained, the tumor size decreased in two cases and remained stable (local tumor control) in eleven patients. Conclusions Gamma knife surgery provids tumor control with a lowering of risk of developing a new cranial nerve injury in early follow-up period. This procedure can be safely used as a primary management tool in patients with glomus jugulare tumors, or in patients with recurrent tumors in this location. If long-term results with GKS are equally effective it will emerge as a good alternative to surgical resection. PMID:20819207

  13. Randomized comparison of three transducer orientation approaches for ultrasound guided internal jugular venous cannulation.

    PubMed

    Batllori, M; Urra, M; Uriarte, E; Romero, C; Pueyo, J; López-Olaondo, L; Cambra, K; Ibáñez, B

    2016-03-01

    Ultrasound-guided internal jugular venous access increases the rate of successful cannulation and reduces the incidence of complications, compared with the landmark technique. Three transducer orientation approaches have been proposed for this procedure: short-axis (SAX), long-axis (LAX) and oblique-axis (OAX). Our goal was to assess and compare the performance of these approaches. A prospective randomized clinical trial was conducted in one teaching hospital. Patients aged 18 yr or above, who were undergoing ultrasound-guided internal jugular cannulation, were randomly assigned to one of three intervention groups: SAX, LAX and OAX group. The main outcome measure was successful cannulation on first needle pass. Incidence of mechanical complications was also registered. Restricted randomization was computer-generated. In total, 220 patients were analysed (SAX n=73, LAX n=75, OAX n=72). Cannulation was successful on first needle pass in 51 (69.9%) SAX patients, 39 (52%) LAX patients and 53 (73.6%) OAX patients. First needle pass failure was higher in the LAX group than in the OAX group (adjusted OR 3.7, 95% CI 1.71-8.0, P=0.002). A higher mechanical complication rate was observed in the SAX group (15.1%) than in the OAX (6.9%) and LAX (4%) groups (P=0.047). As OAX showed a higher first needle pass success rate than LAX and a lower mechanical complications rate than SAX, we recommend it as the standard approach when performing ultrasound-guided internal jugular venous access. Further clinical studies are needed to confirm this conclusion. NCT 01966354. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Rapid methods for jugular bleeding of dogs requiring one technician.

    PubMed

    Frisk, C S; Richardson, M R

    1979-06-01

    Two methods were used to collect blood from the jugular vein of dogs. In both techniques, only one technician was required. A rope with a slip knot was placed around the base of the neck to assist in restraint and act as a tourniquet for the vein. The technician used one hand to restrain the dog by the muzzle and position the head. The other hand was used for collecting the sample. One of the methods could be accomplished with the dog in its cage. The bleeding techniques were rapid, requiring approximately 1 minute per dog.

  15. Effects of Moderate Hyperventilation on Jugular Bulb Gases under Propofol or Isoflurane Anesthesia during Supratentorial Craniotomy

    PubMed Central

    Meng, Lan; Li, Shu-Qin; Ji, Nan; Luo, Fang

    2015-01-01

    Background: The optimal ventilated status under total intravenous or inhalation anesthesia in neurosurgical patients with a supratentorial tumor has not been ascertained. The purpose of this study was to intraoperatively compare the effects of moderate hyperventilation on the jugular bulb oxygen saturation (SjO2), cerebral oxygen extraction ratio (O2ER), mean arterial blood pressure (MAP), and heart rate (HR) in patients with a supratentorial tumor under different anesthetic regimens. Methods: Twenty adult patients suffered from supratentorial tumors were randomly assigned to receive a propofol infusion followed by isoflurane anesthesia after a 30-min stabilization period or isoflurane followed by propofol. The patients were randomized to one of the following two treatment sequences: hyperventilation followed by normoventilation or normoventilation followed by hyperventilation during isoflurane or propofol anesthesia, respectively. The ventilation and end-tidal CO2 tension were maintained at a constant level for 20 min. Radial arterial and jugular bulb catheters were inserted for the blood gas sampling. At the end of each study period, we measured the change in the arterial and jugular bulb blood gases. Results: The mean value of the jugular bulb oxygen saturation (SjO2) significantly decreased, and the oxygen extraction ratio (O2ER) significantly increased under isoflurane or propofol anesthesia during hyperventilation compared with those during normoventilation (SjO2: t = −2.728, P = 0.011 or t = −3.504, P = 0.001; O2ER: t = 2.484, P = 0.020 or t = 2.892, P = 0.009). The SjO2 significantly decreased, and the O2ER significantly increased under propofol anesthesia compared with those values under isoflurane anesthesia during moderate hyperventilation (SjO2: t = −2.769, P = 0.012; O2ER: t = 2.719, P = 0.013). In the study, no significant changes in the SjO2 and the O2ER were observed under propofol compared with those values under isoflurane during

  16. Effects of Moderate Hyperventilation on Jugular Bulb Gases under Propofol or Isoflurane Anesthesia during Supratentorial Craniotomy.

    PubMed

    Meng, Lan; Li, Shu-Qin; Ji, Nan; Luo, Fang

    2015-05-20

    The optimal ventilated status under total intravenous or inhalation anesthesia in neurosurgical patients with a supratentorial tumor has not been ascertained. The purpose of this study was to intraoperatively compare the effects of moderate hyperventilation on the jugular bulb oxygen saturation (SjO 2 ), cerebral oxygen extraction ratio (O 2 ER), mean arterial blood pressure (MAP), and heart rate (HR) in patients with a supratentorial tumor under different anesthetic regimens. Twenty adult patients suffered from supratentorial tumors were randomly assigned to receive a propofol infusion followed by isoflurane anesthesia after a 30-min stabilization period or isoflurane followed by propofol. The patients were randomized to one of the following two treatment sequences: hyperventilation followed by normoventilation or normoventilation followed by hyperventilation during isoflurane or propofol anesthesia, respectively. The ventilation and end-tidal CO 2 tension were maintained at a constant level for 20 min. Radial arterial and jugular bulb catheters were inserted for the blood gas sampling. At the end of each study period, we measured the change in the arterial and jugular bulb blood gases. The mean value of the jugular bulb oxygen saturation (SjO 2 ) significantly decreased, and the oxygen extraction ratio (O 2 ER) significantly increased under isoflurane or propofol anesthesia during hyperventilation compared with those during normoventilation (SjO 2 : t = -2.728, P = 0.011 or t = -3.504, P = 0.001; O 2 ER: t = 2.484, P = 0.020 or t = 2.892, P = 0.009). The SjO 2 significantly decreased, and the O 2 ER significantly increased under propofol anesthesia compared with those values under isoflurane anesthesia during moderate hyperventilation (SjO 2 : t = -2.769, P = 0.012; O 2 ER: t = 2.719, P = 0.013). In the study, no significant changes in the SjO 2 and the O 2 ER were observed under propofol compared with those values under isoflurane during normoventilation. Our

  17. Usefulness of venous oxygen saturation in the jugular bulb for the diagnosis of brain death: report of 118 patients.

    PubMed

    Díaz-Regañón, Genaro; Miñambres, Eduardo; Holanda, Marisol; González-Herrera, Segundo; López-Espadas, Francisco; Garrido-Díaz, Carlos

    2002-12-01

    To assess the usefulness of venous oxygen saturation in the jugular bulb (SjO(2)) as a complementary test for the diagnosis of brain death. Prospective observational study. Polytrauma intensive care unit (ICU) of an acute-care teaching hospital in Santander, Spain. We studied 118 (44%) out of 270 patients with severe head injury and intracranial hemorrhage meeting criteria of brain death (lack of cardiac response to atropine, unresponsive apnea, and iso-electric EEG in the absence of shock, hypotension and treatment with muscle relaxants and/or central nervous system (CNS) depressant drugs). At the moment at which clinical diagnosis of brain death was made and an iso-electric EEG was obtained, simultaneous oxygen saturation in central venous blood (right atrium) (SvO(2)) and jugular venous bulb (SjO(2)) samples was measured. The ratio between SvO(2) and SjO(2), expressed as CvjO(2) (the so-called central venous-jugular bulb oxygen saturation rate; CvjO(2) = SvO(2)/SjO(2)) was calculated. CvjO(2) less than 1 was obtained in 114 patients [mean (SD): 0.89 (0.02)], whereas CvjO(2) greater than 1 was obtained in only 4 (3.38%). In the group of 152 survivors, a single patient was discharged from the ICU in a vegetative state in which CvjO(2) was below 1. CvjO(2)as a complementary test for the diagnosis of brain death showed 96.6% sensitivity, 99.3% specificity, and 99.1% and 97.4% positive and negative predictive values, respectively. Central venous-jugular bulb oxygen saturation rate below 1 together with accepted clinical criteria (unresponsive coma with brainstem areflexia) provides non-invasive assessment of cerebral circulatory arrest that can help to suspect brain death.

  18. The measurement of tissue interface pressures and changes in jugular venous parameters associated with cervical immobilisation devices: a systematic review

    PubMed Central

    2013-01-01

    Cervical immobilisation is commonly applied following trauma, particularly blunt head injury, but current methods of immobilisation are associated with significant complications. Semi-rigid disposable cervical collars are known to cause pressure ulcers, and impede effective airway management. These collars may also exacerbate a head injury by increasing intracranial pressure as a result of external compression of the jugular veins. There is a clear imperative to find ways of effectively immobilising the cervical spine whilst minimising complications, and any assessment of existing or new devices should include a standardized approach to the measurement of tissue interface pressures and their effect on jugular venous drainage from the brain. This systematic review summarises the research methods and technologies that have been used to measure tissue interface pressure and assess the jugular vein in the context of cervical immobilisation devices. 27 papers were included and assessed for quality. Laboratory investigations and biomechanical studies have gradually given way to methods that more accurately reflect clinical care. There are numerous accounts of skin ulceration associated with cervical collars, but no standardised approach to measuring tissue interface pressure. It is therefore difficult to compare studies and devices, but a pressure of less than 30 mmHg appears desirable. Cervical collars have been shown to have a compressive effect on the jugular veins, but it is not yet certain that this is the cause of the increased intracranial pressure observed in association with cervical collar use. This is the first review of its type. It will help guide further research in this area of trauma care, and the development and testing of new cervical immobilisation devices. PMID:24299024

  19. VENOUS SAMPLING FOR CUSHING DISEASE: COMPARISON OF INTERNAL JUGULAR VEIN AND INFERIOR PETROSAL SINUS SAMPLING.

    PubMed

    Radvany, Martin G; Quinones-Hinojosa, Alfredo; Gallia, Gary L; Wand, Gary S; Salvatori, Roberto

    2016-09-01

    Because magnetic resonance imaging (MRI) fails to detect many adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas, inferior petrosal sinus sampling (IPSS) is considered the gold standard to differentiate Cushing disease (CD) from ectopic ACTH secretion syndrome (EAS). Some authors have suggested internal jugular vein sampling (IJVS) as an alternative to IPSS. We simultaneously compared IJVS to IPSS in 30 consecutive patients referred for ACTH-dependent Cushing syndrome and equivocal MRI exams. Five sites were simultaneously sampled in each patient (right and left IPS, right and left IJV, and femoral vein) before and after the administration of corticotrophin-releasing hormone or desmopressin. The test was considered consistent with CD when the IPS to peripheral ratio was >2 at baseline or >3 after stimulus and the IJV to peripheral ratio was >1.7 at baseline or >2 after stimulus. In 27 of 30 patients, IPSS results were consistent with a central source of ACTH. Two of the other 3 patients had EAS (one lung carcinoid and one occult), and 1 patient had pathology-proven CD. The sensitivity of IPSS was 96.4%. Only 64.2% of these patients had results meeting criteria for a central source of ACTH by IJVS criteria. Twenty patients with centralizing IPPS have undergone pituitary surgery. Of these, the central origin of excessive ACTH was confirmed with certainty in 16 patients. Among these 16 patients, the IPSS sensitivity was 93.8%, whereas 5 patients had false-negative IJVS (68.7% sensitivity). These results do not support the routine use of IJVS in establishing if the pituitary is the source of excessive ACTH. ACTH = adrenocorticotropic hormone CD = Cushing disease CRH = corticotrophin-releasing hormone CS = Cushing syndrome DDAVP = desmopressin EAS = ectopic ACTH secretion IJVS = internal jugular vein sampling IPSS = inferior petrosal sinus sampling JVS = jugular venous sampling MRI = magnetic resonance imaging.

  20. Brightness of venous blood in South American camelids: implications for jugular catheterization.

    PubMed

    Grint, Nicola; Dugdale, Alexandra

    2009-01-01

    To compare the brightness of South American camelid venous blood to that of Equidae. Prospective clinical evaluation. Twelve South American camelids (eight llamas, four alpacas), eight horses and ponies (control group). Appropriately sized catheters were placed in the jugular vein of each animal under local anaesthesia. The blood spilt before the catheter was capped was caught on a white tile. A sample of blood was drawn for blood-gas analysis. The brightness of the blood (both on the tile and in the syringe) was matched to a colour chart (1 = darkest red, 8 = brightest red) by a single observer under bright light conditions. Packed cell volume (PCV) and partial pressure of oxygen (PvO(2)) in the blood were also measured on the syringe blood. Normally distributed data were compared using a two tailed t-test, and non-normally distributed data were compared using a Mann-Whitney U-test. Significance was set at p < 0.05. Camelid venous blood was significantly brighter red than that of horses and ponies both on the white tile (p = 0.0003) and in the syringe (p = 0.0001). PCV was significantly lower in camelids (32 +/- 4%) compared with horses (37 +/- 5%). Partial pressure of oxygen values were similar between groups. Jugular venous blood in alpacas and llamas is significantly brighter red than that of horses. Colour should not be used as a sole determinant of venous or arterial catheterization in this species.

  1. Complex Adaptive Systems of Systems (CASoS) engineering and foundations for global design.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brodsky, Nancy S.; Finley, Patrick D.; Beyeler, Walter Eugene

    2012-01-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which must be recognized and reckoned with to design a secure future for the nation and the world. Design within CASoS requires the fostering of a new discipline, CASoS Engineering, and the building of capability to support it. Towards this primary objective, we created the Phoenix Pilot as a crucible from which systemization of the new discipline could emerge. Using a wide range of applications, Phoenix has begun building both theoretical foundations and capability for: the integration of Applications to continuously build common understandingmore » and capability; a Framework for defining problems, designing and testing solutions, and actualizing these solutions within the CASoS of interest; and an engineering Environment required for 'the doing' of CASoS Engineering. In a secondary objective, we applied CASoS Engineering principles to begin to build a foundation for design in context of Global CASoS« less

  2. Early postnatal ozone exposure alters rat nodose and jugular sensory neuron development

    PubMed Central

    Zellner, Leor C.; Brundage, Kathleen M.; Hunter, Dawn D.; Dey, Richard D.

    2011-01-01

    Sensory neurons originating in nodose and jugular ganglia that innervate airway epithelium (airway neurons) play a role in inflammation observed following exposure to inhaled environmental irritants such as ozone (O3). Airway neurons can mediate airway inflammation through the release of the neuropeptide substance P (SP). While susceptibility to airway irritants is increased in early life, the developmental dynamics of afferent airway neurons are not well characterized. The hypothesis of this study was that airway neuron number might increase with increasing age, and that an acute, early postnatal O3 exposure might increase both the number of sensory airway neurons as well as the number SP-containing airway neurons. Studies using Fischer 344 rat pups were conducted to determine if age or acute O3 exposure might alter airway neuron number. Airway neurons in nodose and jugular ganglia were retrogradely labeled, removed, dissociated, and counted by means of a novel technique employing flow cytometry. In Study 1, neuron counts were conducted on postnatal days (PD) 6, 10, 15, 21, and 28. Numbers of total and airway neurons increased significantly between PD6 and PD10, then generally stabilized. In Study 2, animals were exposed to O3 (2 ppm) or filtered air (FA) on PD5 and neurons were counted on PD10, 15, 21, and 28. O3-exposed animals displayed significantly less total neurons on PD21 than FA controls. This study shows that age-related changes in neuron number occur, and that an acute, early postnatal O3 exposure significantly alters sensory neuron development. PMID:22140294

  3. Implementação de um algoritmo para a limpeza de mapas da RCFM

    NASA Astrophysics Data System (ADS)

    Souza, C. L.; Wuensche, C. A.

    2003-08-01

    A Radiação Cósmica de Fundo em Microondas (RCFM), descoberta por Penzias e Wilson em 1965, é uma das ferramentas mais poderosas para o estudo da cosmologia. Com a descoberta de flutuações de temperatura na RCFM, da ordem de uma parte em 105, pelo COBE (1992), uma nova era teve início. Nos últimos onze anos, diversos instrumentos fizeram novas medidas de alta precisão, refinando os resultados apresentados pelo COBE, culminando com os resultados recentes do satélite WMAP. A análise de dados da RCFM, especialmente no caso de experimentos com pequena cobertura do céu, apresenta uma série de dificuldades devido a emissões de contaminantes externos, tais como a emissão da Galáxia e de fontes pontuais, e de ruídos intrínsecos tanto ao sistema de detecção quanto à estratégia de observação do céu. Uma das soluções típicas para a filtragem de dados brutos de um experimento para medir flutuações de temperatura é aplicar um gabarito (template) e um filtro passa alta ao produzir mapas simplificados (sem considerar matrizes de correlação ou covariância). No caso de experimentos que utilizam detectores HEMT, essa combinação de filtros remove, satisfatoriamente, ruídos do tipo 1/f gerados pela instabilidade no ganho do detector acoplado ao movimento do instrumento, definido pela estratégia de observação. Entretanto, o sinal resultante medido, tanto em simulações quanto em séries temporais reais, sugere que parte do sinal cosmológico pode estar sendo removido junto com o ruído dos detectores. Este trabalho descreve as etapas para a produção de um mapa típico (simulado) e os testes preliminares de um algoritmo para remover ruídos do tipo 1/f introduzidos pela estratégia de observação sem prejudicar a qualidade do sinal cosmológico presente no mapa.

  4. Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients

    PubMed Central

    Karakitsos, Dimitrios; Labropoulos, Nicolaos; De Groot, Eric; Patrianakos, Alexandros P; Kouraklis, Gregorios; Poularas, John; Samonis, George; Tsoutsos, Dimosthenis A; Konstadoulakis, Manousos M; Karabinis, Andreas

    2006-01-01

    Introduction Central venous cannulation is crucial in the management of the critical care patient. This study was designed to evaluate whether real-time ultrasound-guided cannulation of the internal jugular vein is superior to the standard landmark method. Methods In this randomised study, 450 critical care patients who underwent real-time ultrasound-guided cannulation of the internal jugular vein were prospectively compared with 450 critical care patients in whom the landmark technique was used. Randomisation was performed by means of a computer-generated random-numbers table, and patients were stratified with regard to age, gender, and body mass index. Results There were no significant differences in gender, age, body mass index, or side of cannulation (left or right) or in the presence of risk factors for difficult venous cannulation such as prior catheterisation, limited sites for access attempts, previous difficulties during catheterisation, previous mechanical complication, known vascular abnormality, untreated coagulopathy, skeletal deformity, and cannulation during cardiac arrest between the two groups of patients. Furthermore, the physicians who performed the procedures had comparable experience in the placement of central venous catheters (p = non-significant). Cannulation of the internal jugular vein was achieved in all patients by using ultrasound and in 425 of the patients (94.4%) by using the landmark technique (p < 0.001). Average access time (skin to vein) and number of attempts were significantly reduced in the ultrasound group of patients compared with the landmark group (p < 0.001). In the landmark group, puncture of the carotid artery occurred in 10.6% of patients, haematoma in 8.4%, haemothorax in 1.7%, pneumothorax in 2.4%, and central venous catheter-associated blood stream infection in 16%, which were all significantly increased compared with the ultrasound group (p < 0.001). Conclusion The present data suggest that ultrasound

  5. Extra Luminal Entrapment of Guide Wire; A Rare Complication of Central Venous Catheter Placement in Right Internal Jugular Vein.

    PubMed

    Ansari, Md Abu Masud; Kumar, Naveen; Kumar, Shailesh; Kumari, Sarita

    2016-10-01

    Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV), closely abutting the wall of both vessels. The guide wire was coiled with end coursing behind the esophageal wall. Guide wire was removed under fluoroscopic guide manipulation under local anesthesia. We want to emphasize that even though CVC placement is common and simple procedure, serious complication can occur in hands of untrained operator. The procedure should be performed under supervision, if done by trainee. Force should never be applied to advance the guide wire if resistance is encountered.

  6. Rare malposition following left jugular vein catheterization: Case reports and a literature review.

    PubMed

    Wang, Lin; Liu, Zhangsuo; Wang, Changan; Liu, Dongwei; Yuan, Yiqiang

    2015-01-01

    The number of patients requiring chronic hemodialysis via a tunneled cuffed catheter is increasing. The right internal jugular vein (IJV) is generally the preferred site of percutaneous insertion. In certain situations, for example, in patients with a history of multiple access failures, catheterization of the left IJV is an important option. In this report, we present two rare cases of catheter malposition after left IJV catheterization; catheter adjustments, with the help of chest radiographs, resulted in a positive outcome in both cases. These cases exemplify the difficulties associated with left IJV catheterization, of which there are few reports in the published literature.

  7. Moderate hypothermia suppresses jugular venous superoxide anion radical, oxidative stress, early inflammation, and endothelial injury in forebrain ischemia/reperfusion rats.

    PubMed

    Koda, Yoichi; Tsuruta, Ryosuke; Fujita, Motoki; Miyauchi, Takashi; Kaneda, Kotaro; Todani, Masaki; Aoki, Tetsuya; Shitara, Masaki; Izumi, Tomonori; Kasaoka, Shunji; Yuasa, Makoto; Maekawa, Tsuyoshi

    2010-01-22

    The aim of this study was to assess the effect of moderate hypothermia (MH) on generation of jugular venous superoxide radical (O2-.), oxidative stress, early inflammation, and endothelial injury in forebrain ischemia/reperfusion (FBI/R) rats. Twenty-one Wistar rats were allocated to a control group (n=7, 37 degrees C), a pre-MH group (n=7, 32 degrees C before ischemia), and a post-MH group (n=7, 32 degrees C after reperfusion). MH was induced before induction of ischemia in the pre-MH group and just after reperfusion in the post-MH group. Forebrain ischemia was induced by occlusion of bilateral common carotid arteries with hemorrhagic hypotension for 10 min, followed by reperfusion. O(2)(-)(.) in the jugular vein was measured from the produced current using a novel O2-. sensor. The O2-. current showed a gradual increase during forebrain ischemia in the control and post-MH groups but was attenuated in the pre-MH group. Following reperfusion, the current showed a marked increase in the control group but was strongly attenuated in the pre- and post-MH groups. Concentrations of malondialdehyde, high-mobility group box 1 (HMGB1) protein, and intercellular adhesion molecule-1 (ICAM-1) in the brain and plasma 120 min after reperfusion in the pre- and post-MH groups were significantly lower than those in the control group, except for plasma HMGB1 in the post-MH group. In conclusion, MH suppressed O2-. measured in the jugular vein, oxidative stress, early inflammation, and endothelial injury in FBI/R rats. Copyright 2009 Elsevier B.V. All rights reserved.

  8. The Pitfalls and Important Distances in Temporal Bone HRCT of the Subjects with High Jugular Bulbs - Preliminary Report.

    PubMed

    Inal, Mikail; Muluk, Nuray B; Dağ, Ersel; Arıkan, Osman K; Kara, Simay A

    2015-01-01

    High jugular bulb (HJB) may be detected unilaterally or bilaterally in temporal bone high resolution computerized tomography (HRCT). In this retrospective study, we investigated the pitfalls and important surgical distances in patients with unilateral and bilateral HJB via temporal bone HRCT. In this preliminary report, the study group consisted of 20 adult patients (12 male, 8 female), or 40 ears, all of which underwent temporal bone HRCT. We divided them into groups that consisted of bilateral HJB (14 ears), unilateral HJB (13 ears), and control (No HJB, 13 ears). The anotomical relationships of the sigmoid sinus, jugular bulb, and carotid artery with several landmarks in the temporal bone were studied via temporal bone axial and coronal HRCT. The shortest distances between certain points were measured. These measurements were analyzed in respect to pneumatization. Dehiscence on the jugular bulb (JB) and internal carotid artery (ICA) and the dominance of JB were also evaluated for all of the groups. In the axial sections of the temporal bone HRCTs, the sigmois sinus (SS)-external auditory canal (EAC) distance of the bilateral HJB group (14.00±1.17 mm) was significantly lower than that of the control group (16.46±2.14 mm). The JB-posteromedial points of the umbo on the ear drum (ED) distance of the bilateral HJB (6.28±1.72 mm) and the unilateral HJB groups (7.23±2.00 mm) were significantly lower than that of the control group (11.15±2.30 mm). In the coronal sections of the temporal bone HRCT, the JB-F distance of the bilateral HJB group (5.42±2.10 mm) was significantly lower than that of the control group (8.30±2.28 mm). As the mastoid pneumatisation and mastoid volume increased, the percentage of ICA-dehiscence and the percentage of JB-dehiscence increased. In subjects with well-pneumatised mastoids, the doctors should be aware of the increased risk of ICA-dehiscence and JB-dehiscence. These measurements should be done in greater series to yield more

  9. Comparison of two blood sampling techniques for the determination of coagulation parameters in the horse: Jugular venipuncture and indwelling intravenous catheter.

    PubMed

    Mackenzie, C J; McGowan, C M; Pinchbeck, G; Carslake, H B

    2018-05-01

    Evaluation of coagulation status is an important component of critical care. Ongoing monitoring of coagulation status in hospitalised horses has previously been via serial venipuncture due to concerns that sampling directly from the intravenous catheter (IVC) may alter the accuracy of the results. Adverse effects such as patient anxiety and trauma to the sampled vessel could be avoided by the use of an indwelling IVC for repeat blood sampling. To compare coagulation parameters from blood obtained by jugular venipuncture with IVC sampling in critically ill horses. Prospective observational study. A single set of paired blood samples were obtained from horses (n = 55) admitted to an intensive care unit by direct jugular venipuncture and, following removal of a presample, via an indwelling IVC. The following coagulation parameters were measured on venipuncture and IVC samples: whole blood prothrombin time (PT), fresh plasma PT and activated partial thromboplastin time (aPTT) and stored plasma antithrombin activity (AT) and fibrinogen concentration. D-dimer concentration was also measured in some horses (n = 22). Comparison of venipuncture and IVC results was performed using Lin's concordance correlation coefficient. Agreement between paired results was assessed using Bland Altman analysis. Correlation was substantial and agreement was good between sample methods for all parameters except AT and D-dimers. Each coagulation parameter was tested using only one assay. Sampling was limited to a convenience sample and timing of sample collection was not standardised in relation to when the catheter was flushed with heparinised saline. With the exception of AT and D-dimers, coagulation parameters measured on blood samples obtained via an IVC have clinically equivalent values to those obtained by jugular venipuncture. © 2017 EVJ Ltd.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kim, Eu Hyun, E-mail: doorihyun6@gmail.com; Oh, Jung Suk; Chun, Ho Jong

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

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

    PubMed

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

    2017-03-01

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

  12. Ultrasound Monitoring of Jugular Venous Pulse during Space Missions: Proof of Concept.

    PubMed

    Zamboni, Paolo; Sisini, Francesco; Menegatti, Erica; Taibi, Angelo; Gadda, Giacomo; Tavoni, Valentina; Malagoni, Anna Maria; Tessari, Mirko; Gianesini, Sergio; Gambaccini, Mauro

    2018-03-01

    The jugular venous pulse (JVP) is one of the main parameters of cardiac function and is used by cardiologists in diagnosing heart failure. Its waveform comprises three positive waves (a, c and v) and two negative waves (x and y). Recently, it was found that JVP can be extrapolated from an ultrasound (US) video recording of the internal jugular vein (IJV), suggesting its application in space missions, on which US scanners are already widely used. To date, the feasibility of assessing JVP in microgravity (microG) has not been investigated. To verify the feasibility of JVP assessment in microG, we tested a protocol of self-performed B-mode ultrasound on the International Space Station (ISS). The protocol consisted of a video recording of IJV synchronized with electrocardiogram that produces a cross-sectional area time trace (JVP trace) (in cm 2 ). The scans were acquired in six experimental sessions; two pre-flight (BDC1 and -2), two in space (ISS1 and -2) and two post-flight (Houston PF1, Cologne PF2). We measured the mean and standard deviation of the JVP waves and the phase relationship between such waves and P and T waves on the electrocardiogram. We verified that such parameters had the same accuracy on Earth as they did under microG, and we compared their values. The sensitivity, specificity and accuracy of JVP trace in microgravity are higher than those on Earth. The sequence of (a, c, and v) ascents and (x and y) descents along the cardiac cycle in microG is the same as that on Earth. The cause-and-effect relationship between the P and T waves on the electrocardiogram and a and v waves, respectively, of JVP is also confirmed in microG. Our experiment indicated the feasibility of deriving a JVP trace from a B-mode US examination self-performed by an astronaut in microG. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

  13. Fístula arteriovenosa após termoablação com laser endovenoso 1470 nm: relato de caso

    PubMed Central

    de Araujo, Walter Junior Boim; Guimarães, Adriano Carvalho; Moreira, Ricardo Herkenhoff

    2016-01-01

    Resumo O tratamento tradicional da insuficiência da veia safena magna (VSM) inclui a ligadura alta na junção safeno-femoral combinada com a fleboextração. No entanto, a morbidade associada à insatisfação do paciente com esse tratamento tem conduzido ao desenvolvimento de técnicas alternativas, e a termoablação com laser endovenoso (EVLT) tornou-se uma alternativa minimamente invasiva à cirurgia. A formação de fístula arteriovenosa (FAV) durante o EVLT é extremamente rara. Neste estudo, relatamos um caso de identificação ecográfica de FAV entre um segmento da veia safena acessória lateral e a artéria femoral superficial. Optou-se inicialmente pela realização de duas tentativas de compressão com transdutor linear, sem sucesso, e alternativamente o procedimento cirúrgico foi realizado sem intercorrência e com resolução da FAV. Esse relato de caso evidencia a importância do seguimento de vigilância ecográfica após o EVLT tanto para o controle da efetividade do método como para o diagnóstico e tratamento precoce de suas complicações. PMID:29930599

  14. Venous compression syndrome of internal jugular veins prevalence in patients with multiple sclerosis and chronic cerebro-spinal venous insufficiency.

    PubMed

    Mandolesi, Sandro; Niglio, Tarcisio; Orsini, Augusto; De Sio, Simone; d'Alessandro, Alessandro; Mandolesi, Dimitri; Fedele, Francesco; d'Alessandro, Aldo

    2016-01-01

    Analysis of the incidence of Venous Compression Syndrome (VCS) with full block of the flow of the internal jugular veins (IJVs) in patients with Multiple Sclerosis and Chronic cerebro-spinal venous insufficiency. We included 769 patients with MS and CCSVI (299 males, 470 females) and 210 controls without ms and ccsvi (92 males, 118 females). each subject was investigated by echo-color-doppler (ecd). morphological and hemodynamic ecd data were recorded by a computerized mem-net maps of epidemiological national observatory on ccsvi and they were analyzed by mem-net clinical analysis programs. VCS of IJVs occurs in 240 subjects affected by CCSVI and MS (31% of total) and in 12 controls (6% of total). The differences between the two groups are statistical significant (X² = 36.64, p<0.0001). Up to day there are no longitudinal studies that allow us to identify the WC of jugular and/or vertebral veins as etiology of a chronic neurodegenerative disease, but we note that Venous Compression Syndrome of IJVs is strongly associated with MS and CCSVI. Chronic Cerebro-Spinal Venous Insufficiency, Multiple Sclerosis, Venous Compression Syndrome.

  15. Changes in Plasma Progesterone Levels in the Caudal Vena Cava and the Jugular Vein and Luteinizing Hormone Secretion Pattern After Feeding in Lactating and Non-lactating Dairy Cows

    PubMed Central

    ENDO, Natsumi; NAGAI, Kiyosuke; TANAKA, Tomomi; KAMOMAE, Hideo

    2012-01-01

    Abstract The present study was designed to assess progesterone profiles at the secreted (caudal vena cava) and circulating levels (jugular vein) and luteinizing hormone (LH) secretion pattern in lactating and non-lactating cows with reference to feeding. Four lactating and four non-lactating cycling Holstein cows were examined. Blood samples were collected simultaneously from the caudal vena cava (via a catheter inserted from the coccygeal vein) and the jugular vein every 15 min for 12 h (0500–1700 h) during the functional luteal phase. Cows were fed 50% of the daily diet 6 h after the start of blood sampling. During the 12-h sampling period, mean progesterone concentrations in the caudal vena cava did not differ between lactating and non-lactating cows (49.0 ± 2.9 and 53.3 ± 3.7 ng/ml; mean ± SE), whereas mean progesterone concentrations in the jugular vein in lactating cows were higher than those in non-lactating cows (6.4 ± 0.1 and 5.6 ± 0.1 ng/ml, P < 0.001). Lactating cows had a higher frequency of LH pulses than non-lactating cows (7.0 ± 0.7 and 4.3 ± 0.9 pulses/12 h, P<0.05). The influence of feeding was not observed on LH profiles but was observed on progesterone profiles in both veins. Progesterone concentrations in the caudal vena cava increased after feeding in both groups. Progesterone concentrations in the jugular vein decreased after feeding in lactating cows but not in non-lactating cows. These results indicate the difference in feeding-related changes in progesterone dynamics between lactating and non-lactating cows. PMID:23171608

  16. Gamma knife radiosurgery for glomus jugulare tumors: therapeutic advantages of minimalism in the skull base.

    PubMed

    Sharma, Manish S; Gupta, A; Kale, S S; Agrawal, D; Mahapatra, A K; Sharma, B S

    2008-01-01

    Glomus jugulare (GJ) tumors are paragangliomas found in the region of the jugular foramen. Surgery with/without embolization and conventional radiotherapy has been the traditional management option. To analyze the efficacy of gamma knife radiosurgery (GKS) as a primary or an adjunctive form of therapy. A retrospective analysis of patients who received GKS at a tertiary neurosurgical center was performed. Of the 1601 patients who underwent GKS from 1997 to 2006, 24 patients with GJ underwent 25 procedures. The average age of the cohort was 46.6 years (range, 22-76 years) and the male to female ratio was 1:2. The most common neurological deficit was IX, X, XI cranial nerve paresis (15/24). Fifteen patients received primary GKS. Mean tumor size was 8.7 cc (range 1.1-17.2 cc). The coverage achieved was 93.1% (range 90-97%) using a mean tumor margin dose of 16.4 Gy (range 12-25 Gy) at a mean isodose of 49.5% (range 45-50%). Thirteen patients (six primary and seven secondary) were available for follow-up at a median interval of 24 months (range seven to 48 months). The average tumor size was 7.9 cc (range 1.1-17.2 cc). Using a mean tumor margin dose of 16.3 Gy (range 12-20 Gy) 93.6% coverage (range 91-97%) was achieved. Six patients improved clinically. A single patient developed transient trigeminal neuralgia. Magnetic resonance imaging follow-up was available for 10 patients; seven recorded a decrease in size. There was no tumor progression. Gamma knife radiosurgery is a safe and effective primary and secondary modality of treatment for GJ.

  17. Patient Factors But Not the Use of Novel Anticoagulants or Warfarin Are Associated With Internal Jugular Vein Access-Site Hematoma After Right Heart Catheterization.

    PubMed

    Dasa, Osama; Shafiq, Qaiser; Ruzieh, Mohammed; Alhazmi, Luai; Al-Dabbas, Maen; Ammari, Zaid; Khouri, Samer; Moukarbel, George

    2017-12-01

    Right heart catheterization (RHC) is routinely performed to assess hemodynamics. Generally, anticoagulants are held prior to the procedure. At our center, anticoagulants are continued and ultrasound guidance is always used for internal jugular vein access. A micropuncture access kit is used to place a 5 or 6 Fr sheath using the modified Seldinger technique. Manual compression is applied for 10-15 min and the patient is observed for at least 2 hours after the procedure. In a retrospective analysis, we investigated the risk of bleeding complications associated with RHC via the internal jugular vein in patients with and without full anticoagulation. Our catheterization laboratory database was searched for adult patients who underwent RHC by a single operator between January 2012 and December 2015. A total of 571 patients were included in the analysis. Baseline characteristics, labs, relevant invasive hemodynamics, co-morbid conditions, and incidence of access-site hematoma are presented. Multivariable binary logistic regression was performed using IBM SPSS v. 23.0 software. Statistically significant associations with access-site hematoma were observed with body mass index (P=.02; 95% confidence interval [CI], 1.0-1.1), right atrial pressure (P=.03; 95% CI, 0.7-0.9), and dialysis dependence (P<.01; 95% CI, 0.1-0.6). There was no association of access-site hematoma with the use of anticoagulants (P>.99). The incidence of internal jugular vein access-site hematoma is small when using careful access techniques for RHC even with the continued use of novel oral anticoagulants and warfarin. Patient characteristics and co-morbid conditions are related to bleeding complications.

  18. Short-term tumor control and acute toxicity after stereotactic radiosurgery for glomus jugulare tumors.

    PubMed

    Poznanovic, Sheri A; Cass, Stephen P; Kavanagh, Brian D

    2006-03-01

    Glomus jugulare tumors (GJT) have traditionally been treated by surgery or fractionated external beam radiation therapy (XRT). This study evaluates acute toxicity and short-term efficacy of single-fraction stereotactic radiosurgery (SRS) for the treatment of GJT. Eight patients (age range 28-74) with GJT underwent SRS (Brainlab linear accelerator) as primary treatment. A nominal dose of 15-16 Gy was prescribed. After undergoing SRS, 7 of 8 patients (87.5%) reported complete resolution of presenting symptoms. Follow-up MRIs showed tumor stabilization in 100% of patients. Transient vertigo occurred in one patient. One patient suffered acute GI upset and transient lower cranial neuropathy. Stereotactic radiosurgery is an effective alternative for patients with GJT in achieving tumor control and resolution of symptoms. C-4.

  19. Ligation of the Jugular Veins Does Not Result in Brain Inflammation or Demyelination in Mice

    PubMed Central

    Wojtkiewicz, Gregory R.; Pulli, Benjamin; Iwamoto, Yoshiko; Ueno, Takuya; Waterman, Peter; Truelove, Jessica; Oklu, Rahmi; Chen, John W.

    2012-01-01

    An alternative hypothesis has been proposed implicating chronic cerebrospinal venous insufficiency (CCSVI) as a potential cause of multiple sclerosis (MS). We aimed to evaluate the validity of this hypothesis in a controlled animal model. Animal experiments were approved by the institutional animal care committee. The jugular veins in SJL mice were ligated bilaterally (n = 20), and the mice were observed for up to six months after ligation. Sham-operated mice (n = 15) and mice induced with experimental autoimmune encephalomyelitis (n = 8) were used as negative and positive controls, respectively. The animals were evaluated using CT venography and 99mTc-exametazime to assess for structural and hemodynamic changes. Imaging was performed to evaluate for signs of blood-brain barrier (BBB) breakdown and neuroinflammation. Flow cytometry and histopathology were performed to assess inflammatory cell populations and demyelination. There were both structural changes (stenosis, collaterals) in the jugular venous drainage and hemodynamic disturbances in the brain on Tc99m-exametazime scintigraphy (p = 0.024). In the JVL mice, gadolinium MRI and immunofluorescence imaging for barrier molecules did not reveal evidence of BBB breakdown (p = 0.58). Myeloperoxidase, matrix metalloproteinase, and protease molecular imaging did not reveal signs of increased neuroinflammation (all p>0.05). Flow cytometry and histopathology also did not reveal increase in inflammatory cell infiltration or population shifts. No evidence of demyelination was found, and the mice remained without clinical signs. Despite the structural and hemodynamic changes, we did not identify changes in the BBB permeability, neuroinflammation, demyelination, or clinical signs in the JVL group compared to the sham group. Therefore, our murine model does not support CCSVI as a cause of demyelinating diseases such as multiple sclerosis. PMID:22457780

  20. Ultrasound of Jugular Veins for Assessment of Acute Dyspnea in Emergency Departments and for the Assessment of Acute Heart Failure.

    PubMed

    Tzadok, Batsheva; Shapira, Shay; Tal-Or, Eran

    2018-05-01

    When a patient arrives at the emergency department (ED) presenting with symptoms of acute decompensated heart failure (ADHF), it is possible to reach a definitive diagnosis through many different venues, including medical history, physical examination, echocardiography, chest X-ray, and B-type natriuretic peptide (BNP) levels. Point-of-care ultrasound (POCUS) has become a mainstream tool for diagnosis and treatment in the field of emergency medicine, as well as in various other departments in the hospital setting. Currently, the main methods of diagnosis of ADHF using POCUS are pleural B-lines and inferior vena cava (IVC) width and respiratory variation. To examine the potential use and benefits of bedside ultrasound of the jugular veins in the evaluation of dyspneic patients for identification of ADHF. A blood BNP level was drawn from each participant at time of recruitment. The area and size of the internal jugular vein (IJV) during inspiration and expiration were examined. Our results showed that the respiratory area change of the IJVs had a specificity and sensitivity of nearly 70% accuracy rate in indentifying ADHF in our ED. Ultrasound of the IJV may be a useful tool for the diagnosis of ADHF because it is easy to measure and requires little skill. It is also not affected by patient body habitus.

  1. Bilateral chondrosarcoma of the jugular foramen: literature review and personal experience.

    PubMed

    Zanoletti, Elisabetta; Faccioli, Chiara; Cazzador, Diego; Mazzoni, Antonio; Martini, Alessandro

    2015-10-01

    Chondrosarcomas (CS) are slow-growing malignant cartilaginous tumors with locally invasive behavior. They account for only 0.15% head and neck neoplasia. There have been no reports in the management of bilateral skull base CS in the literature to date. The synchronous presentation of bilateral CS of the jugular foramen (JF) was diagnosed in a 22-year-old woman with right abducens nerve palsy. Once evaluated the collateral intracranial venous discharge, the lesions were removed in two surgical stages through a bilateral petro-occipital trans-sigmoid (POTS) approach performing a bilateral closure of sigmoid sinus. The patient is disease free 15 years after surgery. No complications occurred. Diplopia improved after excision of the tumor on the right side. A review of relevant English literature was performed. The POTS approach to the JF proved to be safe and effective. Staged radical surgery alone, assessing intracranial venous flow at all stages of surgery, was a valid strategy for bilateral CS, achieving long-term disease control, avoiding early adjuvant radiotherapy, and carrying no complications.

  2. [Comparison of transverse short-axis classic and oblique long-axis "Syringe-Free" approaches for internal jugular venous catheterization under ultrasound guidance].

    PubMed

    Ince, Ilker; Arı, Muhammet Ali; Sulak, Muhammet Mustafa; Aksoy, Mehmet

    There are different ultrasound probe positions used for internal jugular venous catheter placement. Also, in-plane or out of plane needle approach may be used for catheterization. Transverse short-axis classic approach is the most popular performed approach in literature. "Syringe-Free" is a new described technique that is performed with oblique long-axis approach. We aimed to compare performance of these two approaches. This study was conducted as a prospective and randomized study. 80 patients were included the study and divided into two groups that were named Group C (transverse short-axis classic approach) and Group SF (oblique long-axis syringe-free approach) by a computer-generated randomization. The primary outcome was mean time that guidewire is seen in the internal jugular vein (performing time). The secondary outcomes were to compare number of needle pass, number of skin puncture and complications between two groups. Demographic and hemodynamic data were not significantly different. The mean performing time was 54.9±19.1s in Group C and 43.9±15.8s in Group SF. Significant differences were found between the groups (p=0.006). Mean number of needle pass was 3.2(±2.1) in Group C and 2.1(±1.6) in Group SF. There were statistically significant differences between two groups (p=0.002). The number of skin puncture was 1.6(±0.8) and 1.2(±0.5) in Group C and SF, respectively (p=0.027). "Syringe-Free" technique has lower performing time, number of needle pass and skin puncture. Also, it allows to follow progress of guide-wire under continuous ultrasound visualization and the procedure does not need assistance during catheter insertion. Namely, "Syringe-Free" is effective, safe and fast technique that may be used to place internal jugular venous catheter. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  3. Point-of-Care Ultrasound for Jugular Venous Pressure Assessment: Live and Online Learning Compared.

    PubMed

    Socransky, Steve; Lang, Eddy; Bryce, Rhonda; Betz, Martin

    2017-06-08

    Point-of-care ultrasound (POCUS) is a novel technique for the assessment of jugular venous pressure. Distance education may allow for efficient dissemination of this technique. We compared online learning to a live course for teaching ultrasonography jugular venous pressure (u-JVP) to determine if these teaching methods yielded different levels of comfort with and use of u-JVP. This was an interventional trial of Canadian emergency physicians who had taken a basic POCUS course. The participants were in one of three Groups: online learning (Group OL), live teaching (Group LT), control (Group C). Group LT participants also took an advanced course prior to the study that included instruction in u-JVP. The participants who took the basic course were randomized to Group OL or Group C. Group OL was subject to the intervention, online learning. Group C only received an article citation regarding u-JVP. Questionnaires were completed before and after the intervention. The primary outcome was physician self-reported use and comfort with the technique of u-JVP after online learning compared to live teaching. Of the 287 advanced course participants, 42 completed the questionnaires (Group LT). Of the 3303 basic course participants, 47 who were assigned to Group OL completed the questionnaires and 47 from Group C completed the questionnaires. Use of u-JVP increased significantly in Group OL (from 15% to 55%) and Group C (from 21% to 47%) with the intervention. The comfort with use did not differ between Group LT and Group OL (p=0.14). The frequency of use remained higher in Group LT than Group OL (p=0.07). Online learning increases the use and comfort with performing u-JVP for emergency physicians with prior POCUS experience. Although the comfort with use of u-JVP was similar in Groups LT and OL, online learning appears to yield levels of use that are less than those of a live course.

  4. Long-term outcomes after radiosurgery for glomus jugulare tumors.

    PubMed

    Sallabanda, Kita; Barrientos, Hernan; Isernia Romero, Daniela Angelina; Vargas, Cristian; Gutierrez Diaz, Jose Angel; Peraza, Carmen; Rivin Del Campo, Eleonor; Praena-Fernandez, Juan Manuel; López-Guerra, José Luis

    2018-04-01

    The treatment of glomus jugulare tumors (GJT) remains controversial due to high morbidity. Historically, these tumors have primarily been managed surgically. The purpose of this retrospective review was to assess the tumor and clinical control rates as well as long-term toxicity of GJT treated with radiosurgery. Between 1993 and 2014, 30 patients with GJT (31 tumors) were managed with radiosurgery. Twenty-one patients were female and the median age was 59 years. Twenty-eight patients (93%) were treated with radiosurgery, typically at 14 Gy ( n = 26), and 2 patients (7%) with stereotactic radiosurgery. Sixteen cases (52%) had undergone prior surgery. The mean follow-up was 4.6 years (range 1.5-12). Crude overall survival, tumor control, clinical control, and long-term grade 1 toxicity rates were 97%, 97%, 97%, and 13% (4/30), respectively. No statistically significant risk factor was associated with lower tumor control in our series. Univariate analysis showed a statistically significant association between patients having 1 cranial nerve (CN) involvement before radiosurgery and a higher risk of lack of improvement of symptoms (odds ratio 5.24, 95% confidence interval 1.06-25.97, p = .043). Radiosurgery is an effective and safe treatment modality for GJT. Patients having 1 CN involvement before radiosurgery show a higher risk of lack of improvement of symptoms.

  5. Butyric acid retention in gingival tissue induces oxidative stress in jugular blood mitochondria.

    PubMed

    Cueno, Marni E; Imai, Kenichi; Matsukawa, Noriko; Tsukahara, Takamitsu; Kurita-Ochiai, Tomoko; Ochiai, Kuniyasu

    2013-09-01

    Butyric acid (BA) is a major extracellular metabolite produced by anaerobic periodontopathic bacteria and is commonly deposited in the gingival tissue. BA induces mitochondrial oxidative stress in vitro; however, its effects in vivo were never elucidated. Here, we determined the effects of butyric acid retention in the gingival tissues on oxidative stress induction in the jugular blood mitochondria. We established that BA injected in the rat gingival tissue has prolonged retention in gingival tissues. Blood taken at 0, 60, and 180 min after BA injection was used for further analysis. We isolated blood mitochondria, verified its purity, and measured hydrogen peroxide (H2O2), heme, superoxide (SOD), and catalase (CAT) to determine BA effects. We found that H2O2, heme, SOD, and CAT levels all increased after BA injection. This would insinuate that mitochondrial oxidative stress was induced ascribable to BA.

  6. Impalement brain injury from steel rod causing injury to jugular bulb: case report and review of the literature.

    PubMed

    Grossbach, Andrew J; Abel, Taylor J; Smietana, Janel; Dahdaleh, Nader; Severson, Meryl A; Hasan, David

    2014-01-01

    The management of impalement penetrating brain injuries (IPBI) from non-missile objects is extremely challenging, especially when vascular structures are involved. Cerebral angiography is a crucial tool in initial evaluation to assess for vascular injury as standard non-invasive imaging modalities are limited by foreign body artifact, especially for metallic objects. This study reports a case of an IPBI caused by a segment of steel rebar resulting in injury to the left jugular bulb and posterior temporal lobe. It describes the initial presentation, radiology, management and outcome in this patient and reviews the literature of similar injuries.

  7. [Prevalence of stenosis and thrombosis of central veins in hemodialysis after a tunneled jugular catheter].

    PubMed

    Jean, G; Vanel, T; Chazot, C; Charra, B; Terrat, J C; Hurot, J M

    2001-01-01

    Central venous stenosis (ST) and thrombosis (TB) related to catheter (KT) had been reported mostly for the subclavian vein. We performed a systematic cavographic study to evaluate the prevalence of these complications in 51 hemodialysis patients with present or previous history of tunneled internal jugular catheter. Each of them had used one or several KT (1.8 +/- 1.4 KT) for a mean 28 +/- 26 month cumulative time (i.e. 43,584 days total exposure time). Fifty percent of the KT were PermCath Quinton and 50% were Twincath (uncuffed) or CS 100 (cuffed) Medcomp. Twenty-seven had no ST (53%, group I), 24 had one or several significant ST (47%, group II) of superior Vena Cava (SVC, n = 4), inferior Vena Cava (IVC, n = 1), Brachio-cephalic Vein (BCV, n = 5) and subclavian vein (SC, n = 10), or a TB of SVC (n = 1), IVC (n = 3), BCV (n = 3), SC (n = 2). This accounts for an incidence of 0.55 ST or TB/1000 patient-days. Five of the twelve subclavian ST and TB had no history of previous subclavian catheter. Comparison between the two groups showed no differences according to age, time on dialysis, diabetes, hematocrit, CRP, cumulative time with catheter, catheter-related infections, type of catheter and anticoagulant treatment. IVC catheter tip's position is an important risk factor for TB and ST (4/6). Twelve group II patients had ST or TB-related symptoms, with a functional AV fistula in 9 cases. Eleven patients underwent repeated percutaneous angioplasty with 4 additional Wallstents and in 2 cases an AV fistula need to be closed. Central venous ST and TB after a jugular KT is extremely frequent, mostly without any symptoms. Consequences on peripheral or central vascular access, cost and poor long-term patency rate of angioplasty are of major importance. These results incite us to further reduce the catheter use in dialysis patients.

  8. Single jugular vein cannulated rats may not be suitable for intravenous pharmacokinetic screening of high logP compounds.

    PubMed

    Gaud, Nilesh; Kumar, Anoop; Matta, Muralikrishna; Kole, Prashant; Sridhar, Srikanth; Mandlekar, Sandhya; Holenarsipur, Vinay K

    2017-03-01

    Rat is commonly used for pharmacokinetic screening during pharmaceutical lead optimization. To handle the large number of compounds, rats with a single jugular vein cannulation are commonly utilized for intravenous pharmacokinetic studies, where the same cannula is used both for dose administration and blood sampling. We demonstrate that the single cannula method is not suitable for all compounds, especially for high logP compounds. We propose an alternative dual cannulation technique in which two cannulas are placed in the same jugular vein, thus avoiding an additional surgery. Compounds were administered orally or via intravenous infusion to compare PK parameters, including bioavailability, using both procedures. For itraconazole and amiodarone, known to bind to the cannula, the measured plasma exposures were substantially higher in the single cannulated rats than those from dual cannulated rats. Area under the plasma concentration time curve differed by 79% and 74% for itraconazole and amiodarone, respectively. When compared to the single cannulation approach, clearance, volume of distribution and bioavailability determined by dual cannulation were 39%, 60% and 38% higher for itraconazole, and 46%, 34% and 42% higher for amiodarone, respectively. In contrast, all pharmacokinetic parameters were similar between single and dual-cannulated rats for the hydrophilic compound atenolol. Based on these results, we recommend the use of dual cannulated rats for intravenous pharmacokinetic studies when testing a series of hydrophobic compounds that may be prone to non-specific binding to the cannula. If single cannulated model is selected for pharmacokinetic screening, we recommend a bridging study with dual cannulated rats with representative compounds of a given chemical series. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Delphi Method Validation of a Procedural Performance Checklist for Insertion of an Ultrasound-Guided Internal Jugular Central Line.

    PubMed

    Hartman, Nicholas; Wittler, Mary; Askew, Kim; Manthey, David

    2016-01-01

    Placement of ultrasound-guided central lines is a critical skill for physicians in several specialties. Improving the quality of care delivered surrounding this procedure demands rigorous measurement of competency, and validated tools to assess performance are essential. Using the iterative, modified Delphi technique and experts in multiple disciplines across the United States, the study team created a 30-item checklist designed to assess competency in the placement of ultrasound-guided internal jugular central lines. Cronbach α was .94, indicating an excellent degree of internal consistency. Further validation of this checklist will require its implementation in simulated and clinical environments. © The Author(s) 2014.

  10. ‘It’s learned on the job and it depends who you’re with.’ An observational qualitative study of how internal jugular cannulation is taught and learned

    PubMed Central

    Mort, Maggie M; Smith, Andrew F

    2017-01-01

    Internal jugular cannulation may lead to serious complications. Ultrasound guidance is advocated; however, procedural complications remain a concern. Inconsistent education may be in part responsible for this. This study examined how internal jugular cannulation is taught and learned. An ethnographic approach was used in two acute hospitals. Methods comprised interviews, observations and focus groups. An inductive thematic analysis was undertaken. Three themes were identified: apprenticeship, trust and reciprocity. In apprenticeship, a new form of apprenticeship learning, necessitated by the structure of training is described. In trust the strategies by which trainers assess trainees’ competence in order to allow them to gain experience is explored. In reciprocity the beneficial influence of trainees is illustrated. This study demonstrates how high-stakes procedures are learned. It provides insights into under-investigated topics such as the use of ‘permitted mistakes’ to stimulate reflection and the role played by trainees in promoting good practice. PMID:29456598

  11. External Carotid-Internal Jugular Fistula as a Late Complication After Carotid Endarterectomy: A Rare Case

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bakar, Bulent, E-mail: bulentbanrs@yahoo.com; Cekirge, Saruhan; Tekkok, Ismail Hakki

    2011-02-15

    A 66-year-old man presented with mild amnesia, progressive fatigue, ataxia, visual hallucinations, and debility. His past medical history included right-sided carotid endarterectomy performed elsewhere 6 years previously. Cranial magnetic resonance imaging showed left parieto-occipital arteriovenous malformation-like tortous vessels, venous congestion, and ischemic areas. Cerebral angiography showed right-sided compound external carotid artery-internal jugular vein (IJV) fistula, and distal occlusion of the right IJV. Transvenous embolization via contralateral IJV was performed, and the fistula, together with fistulous portion of the distal IJV, was sealed using coils. Two years later, patient is well with normal neurologic examination findings. The presence of an arteriovenousmore » communication after vascular surgery is a serious complication with potential long-term effects and therefore should be diagnosed and treated as promptly as possible.« less

  12. The internal jugular vein maintains its regional anatomy and patency after carotid endarterectomy: a prospective study.

    PubMed

    Khatri, V P; Wagner-Sevy, S; Espinosa, M H; Fisher, J B

    2001-02-01

    To validate the authors' published surface landmarks for gaining percutaneous access to the internal jugular vein (IJV), and to determine whether these surface landmarks were altered after neck surgery. Carotid puncture and pneumothorax continue to be the most frequent mechanical complications of percutaneous IJV venipuncture, particularly when the anterior or posterior approaches are used. The authors' modified technique of IJV venipuncture was associated with a 0.6% complication rate; notably, there were no instances of carotid artery puncture. Determining the accuracy of this method using duplex ultrasound would enhance the technique's applicability and safety. The authors also hypothesized that previous neck surgery would alter the regional anatomy in relation to these surface landmarks for IJV venipuncture. The authors prospectively evaluated 417 IJVs in 209 consecutive patients undergoing carotid duplex imaging before and after carotid endarterectomy (CEA). Patients who had undergone CEA were enrolled to investigate the effect of neck surgery on IJV anatomy. The opposite, nonoperated side of the neck served as a control for each patient. The position of the IJV in relation to the surface landmarks, the mobility of the IJV on neck rotation, and the size, patency, and relation of the IJV to the carotid artery were evaluated. Overall accuracy of the surface landmarks for locating the IJV percutaneously was 99% for the control group and 95% for the CEA group. With neck rotation, the IJV was located in a more lateral position in relation to the landmarks that would significantly reduce its accessibility. After neck rotation, it was also noted that the carotid artery moved behind the jugular vein in 85% of the patients in both groups. The mean size of the vein and its patency were similar in both groups. Duplex imaging validated the accuracy of the surface landmarks for IJV cannulation and documented the adverse effects of neck rotation. IJV anatomy is not altered

  13. The Internal Jugular Vein Maintains its Regional Anatomy and Patency After Carotid Endarterectomy: A Prospective Study

    PubMed Central

    Khatri, Vijay P.; Wagner-Sevy, Sam; Espinosa, Manuel H.; Fisher, Jay B.

    2001-01-01

    Objective To validate the authors’ published surface landmarks for gaining percutaneous access to the internal jugular vein (IJV), and to determine whether these surface landmarks were altered after neck surgery. Summary Background Data Carotid puncture and pneumothorax continue to be the most frequent mechanical complications of percutaneous IJV venipuncture, particularly when the anterior or posterior approaches are used. The authors’ modified technique of IJV venipuncture was associated with a 0.6% complication rate; notably, there were no instances of carotid artery puncture. Determining the accuracy of this method using duplex ultrasound would enhance the technique’s applicability and safety. The authors also hypothesized that previous neck surgery would alter the regional anatomy in relation to these surface landmarks for IJV venipuncture. Methods The authors prospectively evaluated 417 IJVs in 209 consecutive patients undergoing carotid duplex imaging before and after carotid endarterectomy (CEA). Patients who had undergone CEA were enrolled to investigate the effect of neck surgery on IJV anatomy. The opposite, nonoperated side of the neck served as a control for each patient. The position of the IJV in relation to the surface landmarks, the mobility of the IJV on neck rotation, and the size, patency, and relation of the IJV to the carotid artery were evaluated. Results Overall accuracy of the surface landmarks for locating the IJV percutaneously was 99% for the control group and 95% for the CEA group. With neck rotation, the IJV was located in a more lateral position in relation to the landmarks that would significantly reduce its accessibility. After neck rotation, it was also noted that the carotid artery moved behind the jugular vein in 85% of the patients in both groups. The mean size of the vein and its patency were similar in both groups. Conclusions Duplex imaging validated the accuracy of the surface landmarks for IJV cannulation and

  14. Perinatal autopsy findings in three cases of jugular lymphatic obstruction sequence and cardiac polyvalvular dysplasia.

    PubMed

    Bendon, Robert; Asamoah, Alexander

    2008-01-01

    Three infants with a prenatal diagnosis of Noonan's syndrome suffered fetal hydrops and immediate neonatal death. The infants all had the external appearance of jugular lymphatic obstruction sequence with wide-spaced nipples, redundant posterior nuchal skin, and edema of the dorsa of the feet and hands. All 3 demonstrated thick, redundant leaflets of all 4 cardiac valves, and 2 had a membranous ventricular septal defect. One female infant had a mutation of the PTPN11 gene. Two males had no common mutation of PTPN11. The males demonstrated other abnormalities in common, including small penis, testicular malformation, rosette-like appearance of the pituicytes, and an eosinophil infiltration of the pancreatic islets with islet cell hypertrophy. Detailed anatomy of cases of lymphatic obstruction sequence fetuses can be correlated with an increasing number of genetic mutations associated with Noonan's syndrome and related syndromes in mice and humans.

  15. Doença cística adventicial da artéria poplítea: relato de caso

    PubMed Central

    de Oliveira, Julio Cesar Peclat; Barreto, Fernando Tebet Ramos; Souza, Diogo Di Battista de Abreu e; Fonseca, João Marcos Fonseca e; Chimelli, Bernardo de Castro Abi Ramia; Peclat, Ana Paula Rolim Maia; Marques, Marcos Arêas; Fiorelli, Stenio Karlos Alvim

    2018-01-01

    Resumo A doença cística adventicial da artéria poplítea é uma doença pouco frequente, que deve ser considerada no diagnóstico diferencial de pacientes jovens com claudicação intermitente e sem fatores de risco para doença arterial periférica aterosclerótica. Apresentamos um caso de claudicação intermitente de membros inferiores em paciente masculino de 51 anos no qual essa doença foi diagnosticada. Foi submetido a ressecção do segmento de artéria comprometido e interposição de safena autóloga ipsilateral. Discutimos alternativas diagnósticas e terapêuticas. PMID:29930682

  16. Videothoracoscopic management of a perforated central vein and pleura after ultrasound-guided internal jugular vein cannulation: a case report

    PubMed Central

    Kim, Jeong-Eun; Jeon, Joon-Pyo; Kim, Yongsuk; Jeong, Su Ah

    2014-01-01

    A 23-year-old male underwent a left internal jugular vein catheterization during extended surgery for treatment of multiple fractures due to a traffic accident. Although the catheterization was performed under ultrasound (US) guidance, iatrogenic perforation of the central vein and pleura occurred. The catheter was removed, and the perforated site was addressed under thoracoscopy rather than an open thoracotomy. This case suggests that using US does not completely guarantee a complication-free outcome, and that catheter placement should be carefully confirmed. In addition, this case suggests that thoracoscopy may be an ideal method of resolving a perforation of the central vein and pleura. PMID:24851167

  17. Effects of Hypothermic Cardiopulmonary Bypass on Internal Jugular Bulb Venous Oxygen Saturation, Cerebral Oxygen Saturation, and Bispectral Index in Pediatric Patients Undergoing Cardiac Surgery: A Prospective Study.

    PubMed

    Hu, Zhiyong; Xu, Lili; Zhu, Zhirui; Seal, Robert; McQuillan, Patrick M

    2016-01-01

    The objective of this study was to evaluate the effect of hypothermic cardiopulmonary bypass (CPB) on cerebral oxygen saturation (rSO2), internal jugular bulb venous oxygen saturation (SjvO2), mixed venous oxygen saturation (SvO2), and bispectral index (BIS) used to monitor cerebral oxygen balance in pediatric patients.Sixty American Society of Anesthesiologists Class II-III patients aged 1 to 4 years old with congenital heart disease scheduled for elective cardiac surgery were included in this study. Temperature, BIS, rSO2, mean arterial pressure, central venous pressure, cerebral perfusion pressure (CPP), and hematocrit were recorded. Internal jugular bulb venous oxygen saturation and SvO2 were obtained from blood gas analysis at the time points: after induction of anesthesia (T0), beginning of CPB (T1), ascending aortic occlusion (T2), 20 minutes after initiating CPB (T3), coronary reperfusion (T4), separation from CPB (T5), and at the end of operation (T6). The effect of hypothermia or changes in CPP on rSO2, SjvO2, SvO2, and BIS were analyzed.Compared with postinduction baseline values, rSO2 significantly decreased at all-time points: onset of extracorporeal circulation, ascending aortic occlusion, 20 minutes after CPB initiation, coronary reperfusion, and separation from CPB (P < 0.05). Compared with measurements made following induction of anesthesia, SjvO2 significantly increased with initiation of CPB, ascending aortic occlusion, 20 minutes after initiating CPB, coronary reperfusion, and separation from CPB (P < 0.05). Compared with induction of anesthesia, BIS significantly decreased with the onset of CPB, aortic cross clamping, 20 minutes after initiating CPB, and coronary reperfusion (P < 0.05). Bispectral index increased following separation from CPB. There was no significant change in SvO2 during cardiopulmonary bypass (P > 0.05). Correlation analysis demonstrated that rSO2 was positively related to CPP (r = 0.687, P = 0

  18. How to deal with atrial septal defect closure from right internal jugular vein: Role of venous-arterial circuit for sizing and over-the-wire device implantation.

    PubMed

    Butera, Gianfranco; Lovin, Nicusor; Basile, Domenica Paola

    2017-01-01

    Secundum atrial septum defect (ASD) is the most common congenital heart disease. It is usually treated by a transcatheter approach using a femoral venous access. In case of bilateral femoral vein occlusion, the internal jugular venous approach for ASD closure is an option, in particular in cases where ASD balloon occlusion test and sizing is needed. Here, we report on a new technique for ASD closure using a venous-arterial circuit from the right internal jugular vein to the femoral artery. Two patients (females, 4 and 10 years of age) had occlusion of both femoral veins because of a previous history of pulmonary atresia and intact ventricular septum, for which they underwent percutaneous radiofrequency perforation and balloon angioplasty. These subjects needed balloon occlusion test of a residual ASD to size the hole and to check for hemodynamic suitability to ASD closure. After performing a venous-arterial circuit, a 24 mm St Jude ASD sizing balloon catheter was advanced over the circuit and the defect closed for 15 min to check hemodynamics and size the defect. ASD was closed is hemodinamically suitable. This technique was safe and reliable. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Dissecção aórtica de tipo B de Stanford: relato de caso e revisão de literatura

    PubMed Central

    Michaelis, Wilson; Santos, Antônio Lacerda; Yokohama, Rogério Akira; Andretta, Marianne Ariely; Delazari, Mariana Vieira; Vieira, Luciano; Seguro, Erick Fernando; Sarquis, Lucas Mansano

    2017-01-01

    Resumo O complexo tratamento de dissecção da aorta ainda apresenta controvérsias devido à gravidade do caso e à necessidade de individualização da terapêutica. A gravidade relaciona-se ao difícil diagnóstico pelas queixas inespecíficas e pelas graves complicações inerentes à evolução da doença (ruptura aórtica, síndrome de má perfusão, dissecção retrógrada, dor ou hipertensão refratária). Este relato apresenta um homem de 61 anos, tabagista e hipertenso mal controlado, que evoluiu para dissecção aórtica de tipo B de Stanford. Foi abordado através de técnica endovascular com uso de endoprótese com stent para tratamento do caso após falha do tratamento medicamentoso. O tratamento endovascular mostrou-se uma ferramenta eficaz para o tratamento definitivo, com boa taxa de sobrevida ao final do primeiro ano após o procedimento.

  20. Evaluation of pulsatility index and diameter of the jugular vein and superficial body temperature as physiological indices of temperament in weaned beef calves: relationship with serum cortisol concentrations, rectal temp..

    USDA-ARS?s Scientific Manuscript database

    The relationship between temperament, pulsatility index and diameter of the jugular vein, and body temperature was assessed in Angus crossbred calves (262±24.9 days old). Temperament scores were used to classify calves as calm (n=31), intermediate (n=32), or temperamental (n=28). Blood samples were ...

  1. [A case of lupus myocarditis and nephritis with transient foramen jugular syndrome].

    PubMed

    Kohro-Kawata, J; Nakamura, H; Yamamoto, T; Fukuta, S; Matsuzaki, M

    1997-10-01

    A 46-year-old man was admitted to our clinic because of acute heart failure. Six years before admission he was pointed out cardiomegary and hematuria. One year later, he was diagnosed as having jugular foramen syndrome. On admission, he had a fever and dyspnea. Pansystolic blowing murmur was audible at the apex. The chest ratio on his chest X-ray was 52.5%. An electrocardiogram showed left ventricular hypertrophy. An echocardiogram showed marked dilatation and severe dysfunction of left ventricle. Radionuclide scanning with technetium 99 m pyrophosphate identified inflammatory change in the apex. Myocardial biopsy showed fibrotic degeneration and IgG deposits in myocardium. Blood examination showed anemia, lymphopenia. positive anti-nuclear antibody (1000 times, shaggy pattern), positive anti ds-DNA antibody and hypocomplementemia. Furthermore, proteinuria was pointed out. Renal biopsy showed focal segmental glomerulonephritis with active necrotizing lesion (type III nephritis). Lupus myocarditis and nephritis was diagnosed. After prednisolone (80 mg/day) was administered. left ventricular function and hypocomplementemia improved. The ACE inhibitor was also used for proteinuria. In spite of a little amount of blood transfusion, he showed hepatic hemosiderosis. We suspect that the cause of hemosiderosis was related chronic inflammation of active lupus. It was treated with Erythropoietin.

  2. Pseudoaneurisma de aorta abdominal como complicação de pancreatite crônica: relato de caso

    PubMed Central

    Barbosa, Eduardo Carvalho Horta; Nóbrega, Leonardo Pires de Sá; Rodrigues, Daniel Augusto de Souza; Cunha, Josué Rafael Ferreira; Kalume, Claudio Eluan

    2017-01-01

    Resumo A pancreatite crônica é uma enfermidade associada a diversas complicações vasculares, como pseudocisto hemorrágico, trombose do sistema venoso portal e formações varicosas e pseudoaneurismáticas. O pseudoaneurisma de aorta abdominal secundário à pancreatite crônica é uma complicação rara, de difícil suspeição clínica, que requer tratamento complexo. A fisiopatologia dessa condição envolve a corrosão enzimática tecidual após a liberação e ativação de enzimas exócrinas proteolíticas das células acinares do pâncreas. O presente estudo relata o caso de um paciente de 52 anos, etilista crônico, internado com dor abdominal difusa, cuja propedêutica revelou se tratar de um pseudoaneurisma em aorta infrarrenal. Optou-se pelo tratamento cirúrgico convencional, levando-se em consideração a idade, as condições clínicas do paciente e a disponibilidade de endopróteses compatíveis com o diâmetro da aorta. PMID:29930654

  3. A descriptive comparison of ultrasound-guided central venous cannulation of the internal jugular vein to landmark-based subclavian vein cannulation.

    PubMed

    Theodoro, Daniel; Bausano, Brian; Lewis, Lawrence; Evanoff, Bradley; Kollef, Marin

    2010-04-01

    The safest site for central venous cannulation (CVC) remains debated. Many emergency physicians (EPs) advocate the ultrasound-guided internal jugular (USIJ) approach because of data supporting its efficiency. However, a number of physicians prefer, and are most comfortable with, the subclavian (SC) vein approach. The purpose of this study was to describe adverse event rates among operators using the USIJ approach, and the landmark SC vein approach without US. This was a prospective observational trial of patients undergoing CVC of the SC or internal jugular veins in the emergency department (ED). Physicians performing the procedures did not undergo standardized training in either technique. The primary outcome was a composite of adverse events defined as hematoma, arterial cannulation, pneumothorax, and failure to cannulate. Physicians recorded the anatomical site of cannulation, US assistance, indications, and acute complications. Variables of interest were collected from the pharmacy and ED record. Physician experience was based on a self-reported survey. The authors followed outcomes of central line insertion until device removal or patient discharge. Physicians attempted 236 USIJ and 132 SC cannulations on 333 patients. The overall adverse event rate was 22% with failure to cannulate being the most common. Adverse events occurred in 19% of USIJ attempts, compared to 29% of non-US-guided SC attempts. Among highly experienced operators, CVCs placed at the SC site resulted in more adverse events than those performed using USIJ (relative risk [RR] = 1.89, 95% confidence interval [CI] = 1.05 to 3.39). While limited by observational design, our results suggest that the USIJ technique may result in fewer adverse events compared to the landmark SC approach.

  4. Cross-sectional area variations of internal jugular veins during supine head rotation in multiple sclerosis patients with chronic cerebrospinal venous insufficiency: a prospective diagnostic controlled study with duplex ultrasound investigation

    PubMed Central

    2013-01-01

    Background Normally, chronic cerebrospinal venous insufficiency (CCSVI) has been studied using echo-colour Doppler (ECD). Subjects are examined in the supine and sitting positions, in accordance with a static protocol without rotation of the head. A dynamic approach, to assess venous sizes with different degrees of head rotation, has only been performed to improve jugular venous catheterisation. These echographic studies have suggested that head rotation to the contralateral side increases the cross-sectional area (CSA) of the internal jugular veins (IJVs) in supine subjects. Our goal was to evaluate the behaviour of CSA of the IJVs during supine head rotation in multiple sclerosis (MS) patients with CCSVI, compared to healthy controls (HCs). Methods The IJVs of 313 MS patients with CCSVI (male 43.8%, male/female 137/176; mean age 45 years old, range 19–77 years) and 298 HCs, matched by gender (male 43.6%, male/female 130/168) and age (mean age 46 years old, range 20–79 years), were compared using ECD. Their CSAs were evaluated with the subjects seated in a tiltable chair, first in the supine position at the level of the cricoid cartilage, with the head in a neutral position, and then after contralateral rotation to 90° from midline. Results Significant differences between the jugular CSAs before and after head rotation were observed only in the MS patients for the IJVs with wall collapse (F[6,1215] = 6414.57, p < 0.001), showing on longitudinal scans a typical “hourglass” aspect that we defined as “miopragic”. No significant difference was found in the distribution of these miopragic veins with regard to MS duration. There was a strong association between the CCSVI scores and the complexity of jugular morphological types (Χ2 [9, N = 313] = 75.183, p < 0.001). Wall miopragia was mainly observed in MS patients with SP (59.3%) and PP (70.0%) clinical forms, compared to RR (48.3%) forms (p = 0.015). Conclusion A dynamic ECD

  5. Central Venous Catheter Placement in the Left Internal Jugular Vein Complicated by Perforation of the Left Brachiocephalic Vein and Massive Hemothorax: A Case Report.

    PubMed

    Wetzel, Lindsay R; Patel, Priyesh R; Pesa, Nicholas L

    2017-07-01

    An elderly male presented for emergent repair of a ruptured abdominal aortic aneurysm. For anticipated volume resuscitation, vasopressor administration, and hemodynamic monitoring, a large-bore central venous catheter was placed in the left internal jugular vein under ultrasound guidance before surgical incision. Initially, there were no readily apparent signs of venous perforation. However, a massive left hemothorax developed because of perforation of the brachiocephalic vein and violation of the pleural space. This case report discusses both prevention and management of such a complication.

  6. Effects of Hypothermic Cardiopulmonary Bypass on Internal Jugular Bulb Venous Oxygen Saturation, Cerebral Oxygen Saturation, and Bispectral Index in Pediatric Patients Undergoing Cardiac Surgery: A Prospective Study

    PubMed Central

    Hu, Zhiyong; Xu, Lili; Zhu, Zhirui; Seal, Robert; McQuillan, Patrick M.

    2016-01-01

    Abstract The objective of this study was to evaluate the effect of hypothermic cardiopulmonary bypass (CPB) on cerebral oxygen saturation (rSO2), internal jugular bulb venous oxygen saturation (SjvO2), mixed venous oxygen saturation (SvO2), and bispectral index (BIS) used to monitor cerebral oxygen balance in pediatric patients. Sixty American Society of Anesthesiologists Class II-III patients aged 1 to 4 years old with congenital heart disease scheduled for elective cardiac surgery were included in this study. Temperature, BIS, rSO2, mean arterial pressure, central venous pressure, cerebral perfusion pressure (CPP), and hematocrit were recorded. Internal jugular bulb venous oxygen saturation and SvO2 were obtained from blood gas analysis at the time points: after induction of anesthesia (T0), beginning of CPB (T1), ascending aortic occlusion (T2), 20 minutes after initiating CPB (T3), coronary reperfusion (T4), separation from CPB (T5), and at the end of operation (T6). The effect of hypothermia or changes in CPP on rSO2, SjvO2, SvO2, and BIS were analyzed. Compared with postinduction baseline values, rSO2 significantly decreased at all-time points: onset of extracorporeal circulation, ascending aortic occlusion, 20 minutes after CPB initiation, coronary reperfusion, and separation from CPB (P < 0.05). Compared with measurements made following induction of anesthesia, SjvO2 significantly increased with initiation of CPB, ascending aortic occlusion, 20 minutes after initiating CPB, coronary reperfusion, and separation from CPB (P < 0.05). Compared with induction of anesthesia, BIS significantly decreased with the onset of CPB, aortic cross clamping, 20 minutes after initiating CPB, and coronary reperfusion (P < 0.05). Bispectral index increased following separation from CPB. There was no significant change in SvO2 during cardiopulmonary bypass (P > 0.05). Correlation analysis demonstrated that rSO2 was positively related to CPP (r = 0.687, P

  7. The Oscillating Component of the Internal Jugular Vein Flow: The Overlooked Element of Cerebral Circulation

    PubMed Central

    Sisini, Francesco; Toro, Eleuterio; Gambaccini, Mauro; Zamboni, Paolo

    2015-01-01

    The jugular venous pulse (JVP) provides valuable information about cardiac haemodynamics and filling pressures and is an indirect estimate of the central venous pressure (CVP). Recently it has been proven that JVP can be obtained by measuring the cross-sectional area (CSA) of the IJV on each sonogram of an ultrasound B-mode sonogram sequence. It has also been proven that during its pulsation the IJV is distended and hence that the pressure gradient drives the IJV haemodynamics. If this is true, then it will imply the following: (i) the blood velocity in the IJV is a periodic function of the time with period equal to the cardiac period and (ii) the instantaneous blood velocity is given by a time function that can be derived from a flow-dynamics theory that uses the instantaneous pressure gradient as a parameter. The aim of the present study is to confirm the hypothesis that JVP regulates the IJV blood flow and that pressure waves are transmitted from the heart toward the brain through the IJV wall. PMID:26783380

  8. Horner syndrome after unsuccessful venous port implantation by cannulation of the right internal jugular vein.

    PubMed

    Nowak, Łukasz R; Duda, Krzysztof; Mizianty, Marek; Wilczek, Małgorzata; Bieda, Tomasz

    2015-01-01

    Horner syndrome is a rare but likely underdiagnosed complication of internal jugular vein cannulation. We present a case of a young woman undergoing chemotherapy for gestational trophoblastic disease for whom venous port implantation was attempted due to poor peripheral vein access. Despite ultrasound guidance, the procedure was unsuccessful and complicated by a local haematoma, causing compression of the sympathetic nerves with Horner syndrome. The symptoms subsided within 3 weeks without treatment. The possible pathomechanisms of Horner syndrome after central venous cannulation are presented with suggested diagnostic and therapeutic approaches. Special emphasis must be placed on excluding carotid artery dissection because it carries the risk of subsequent cerebral vascular incidents. In the event of a carotid dissection, a multidisciplinary team must choose a pharmacological (antiplatelet drugs/anticoagulation) or interventional approach. Even with ultrasonography, central venous cannulation is not free of serious risks. In case of anisocoria following an uneventful procedure, diagnostic imaging of the vascular structures in the neck is mandatory for the exclusion of potentially serious complications, such as carotid dissection or venous thrombosis.

  9. The binary system K2SO4CaSO4

    USGS Publications Warehouse

    Rowe, J.J.; Morey, G.W.; Hansen, I.D.

    1965-01-01

    The binary system K2SO4CaSO4 was studied by means of heating-cooling curves, differential thermal analysis, high-temperature quenching technique and by means of a heating stage mounted on an X-ray diffractometer. Compositions and quench products were identified optically and by X-ray. Limited solid solution of CaSO4 in K2SO4 was found. There is a eutectic at 875??C and 34 wt. per cent CaSO4. Calcium langbeinite melts incongruently at 1011??C. The melting-point of CaSO4 (1462??C) was determined by the quenching technique using sealed platinum tubes. The only intermediate crystalline phase found in the system is K2SO4??2CaSO4 (calcium langbeinite). ?? 1965.

  10. Thermally stimulated luminescence studies of undoped, Cu- and Mn-doped CaSO4 compounds

    NASA Astrophysics Data System (ADS)

    Manam, J.; Das, S.

    Thermally stimulated luminescence (TSL) of undoped and doped CaSO4 with activators such as Cu and Mn has been investigated. The polycrystalline samples of undoped and doped CaSO4 are prepared by the melting method. The formation of CaSO4 compound is confirmed by X-ray diffraction and Fourier transform infrared studies. Scanning electron microscopic studies of CaSO4 are also carried out. The TSL glow curves of undoped CaSO4, Cu- and Mn-doped CaSO4 are studied. Comparison of the thermoluminescence (TL) intensity of the most intensive glow peak of Cu-doped CaSO4 compound with that of undoped CaSO4 shows that addition of Cu impurity in CaSO4 compound enhances the TL intensity by about four times. However, the addition of Mn impurity to undoped CaSO4 increases the TL intensity by about three times when compared with that of undoped CaSO4. The TL-dose dependence of all three samples was studied and was observed to be almost linear in the studied range of irradiation time. Among the samples studied, namely undoped CaSO4 and Cu- and Mn-doped CaSO4, Cu-doped CaSO4 is found to be the most sensitive. The trap parameters, namely order of kinetics (b), activation energy (E) and frequency factor (s) associated with the most intensive glow peaks of CaSO4:Mn, CaSO4:Cu and CaSO4 phosphors were determined using the glow curve shape (Chen's) method.

  11. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization.

    PubMed

    Brass, Patrick; Hellmich, Martin; Kolodziej, Laurentius; Schick, Guido; Smith, Andrew F

    2015-01-09

    Central venous catheters (CVCs) can help with diagnosis and treatment of the critically ill. The catheter may be placed in a large vein in the neck (internal jugular vein), upper chest (subclavian vein) or groin (femoral vein). Whilst this is beneficial overall, inserting the catheter risks arterial puncture and other complications and should be performed with as few attempts as possible. Traditionally, anatomical 'landmarks' on the body surface were used to find the correct place in which to insert catheters, but ultrasound imaging is now available. A Doppler mode is sometimes used to supplement plain 'two-dimensional' ultrasound. The primary objective of this review was to evaluate the effectiveness and safety of two-dimensional (imaging ultrasound (US) or ultrasound Doppler (USD)) guided puncture techniques for insertion of central venous catheters via the internal jugular vein in adults and children. We assessed whether there was a difference in complication rates between traditional landmark-guided and any ultrasound-guided central vein puncture.Our secondary objectives were to assess whether the effect differs between US and USD; whether the effect differs between ultrasound used throughout the puncture ('direct') and ultrasound used only to identify and mark the vein before the start of the puncture procedure (indirect'); and whether the effect differs between different groups of patients or between different levels of experience among those inserting the catheters. We searched the Central Register of Controlled Trials (CENTRAL) (2013, Issue 1), MEDLINE (1966 to 15 January 2013), EMBASE (1966 to 15 January 2013), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 15 January 2013 ), reference lists of articles, 'grey literature' and dissertations. An additional handsearch focused on intensive care and anaesthesia journals and abstracts and proceedings of scientific meetings. We attempted to identify unpublished or ongoing studies

  12. The ternary system K2SO4MgSO4CaSO4

    USGS Publications Warehouse

    Rowe, J.J.; Morey, G.W.; Silber, C.C.

    1967-01-01

    Melting and subsolidus relations in the system K2SO4MgSO4CaSO4 were studied using heating-cooling curves, differential thermal analysis, optics, X-ray diffraction at room and high temperatures and by quenching techniques. Previous investigators were unable to study the binary MgSO4CaSO4 system and the adjacent area in the ternary system because of the decomposition of MgSO4 and CaSO4 at high temperatures. This problem was partly overcome by a novel sealed-tube quenching method, by hydrothermal synthesis, and by long-time heating in the solidus. As a result of this study, we found: (1) a new compound, CaSO4??3MgSO4 (m.p. 1201??C) with a field extending into the ternary system; (2) a high temperature form of MgSO4 with a sluggishly reversible inversion. An X-ray diffraction pattern for this polymorphic form is given; (3) the inversion of ??-CaSO4 (anhydrite) to ??-CaSO4 at 1195??C, in agreement with grahmann; (1) (4) the melting point of MgSO4 is 1136??C and that of CaSO4 is 1462??C (using sealed tube methods to prevent decomposition of the sulphates); (5) calcium langbeinite (K2SO4??2CaSO4) is the only compound in the K2SO4CaSO4 binary system. This resolved discrepancies in the results of previous investigators; (6) a continuous solid solution series between congruently melting K2SOP4??2MgSO4 (langbeinite) and incongruently melting K2SO4??2CaSO4 (calcium langbeinite); (7) the liquidus in the ternary system consists of primary phase fields of K2SO4, MgSO4, CaSO4, langbeinite-calcium langbeinite solid solution, and CaSO4??3MgSO4. The CaSO4 field extends over a large portion of the system. Previously reported fields for the compounds (K2SO4??MgSO4??nCaSO4), K2SO4??3CaSO4 and K2SO4??CaSO4 were not found; (8) a minimum in the ternary system at: 740??C, 25% MgSO4, 6% CaSO4, 69% K2SO4; and ternary eutectics at 882??C, 49% MgSO4, 19% CaSO4, 32% K2SO4; and 880??, 67??5% MgSO4, 5% CaSO4, 27??5% K2SO4. ?? 1967.

  13. Studying CaSO4:Eu as an OSL phosphor

    NASA Astrophysics Data System (ADS)

    Guckan, Veysi; Altunal, Volkan; Nur, Necmettin; Depci, Tolga; Ozdemir, Adnan; Kurt, Kasim; Yu, Yan; Yegingil, Ihami; Yegingil, Zehra

    2017-09-01

    This study was carried out to investigate the properties of the OSL signal from Eu-doped calcium sulfate (CaSO4:Eu) phosphor and study on its thermal behavior as a function of temperature under a series of luminescence experiments. The suitability of its usage as an optically stimulated luminescence (OSL) dosimeter was also checked. CaSO4:Eu was synthesized using the precipitation method and prepared in pellet form. The dopant concentration value was performed as 0.1 mol%. The synthesized CaSO4:Eu was analyzed by X-ray diffraction (XRD) method to confirm the product. To have an idea about the crystallography and microstructure morphology of the material, scanning electron microscope (SEM) analysis were carried out. It was found that the OSL signal is a resultant signal having three components and exhibits thermal quenching above 150 °C. The excitation spectrum of CaSO4:Eu showed different peaks in the region 220-360 nm with the highest one at 269 nm. Thermoluminescence (TL) signals of CaSO4:Eu pellets were obtained and compared with the TL signals obtained after OSL measurements of the same pellets by blue light stimulation. The low temperature peak near 180 °C did not show any significant change in TL after OSL measurement whereas the high temperature peak at 240 °C was bleached with the blue light illumination and might be responsible for the observed OSL signal. The dosimetric properties such as dose response, minimum detectable dose, energy response, reusability, fading properties, thermal stability and effect of reading temperatures on OSL signals were examined. OSL signals of CaSO4:Eu pellets were decreased by approximately 8% at the end of the 24 h and by about 7% at the end of 28 days when compared with the first readout. The thermal stability of the ∼240 °C TL peak and OSL signal using isothermal decay measurements were used to determine the trap parameters. The CaSO4:Eu OSL dosimeter in accordance with the presented study allows a high

  14. Doença cística da adventícia na veia basílica: relato de caso

    PubMed Central

    Vasconcelos, Rafael Sampaio; Cherubim, Cesar Augusto; França, Felipe Mavignier Pereira; D'allacqua, Eduardo de Lucca; Dalio, Marcelo Bellini; Joviliano, Edwaldo Edner

    2016-01-01

    Resumo A doença cística da adventícia é uma entidade rara que acomete principalmente a artéria poplítea. A ocorrência em veias é muito rara, e sua etiologia é desconhecida. Clinicamente, apresenta-se como isquemia, trombose ou dor a depender do território acometido. Apresentamos o caso de um paciente masculino jovem referindo nódulo no braço esquerdo. A angiorressonância magnética do membro mostrou lesão cística em contato com a veia basílica, com conteúdo homogêneo e sem realce pós-contraste. Foi realizada ressecção da lesão em bloco com o segmento venoso envolvido. O estudo anatomopatológico foi sugestivo de cisto de adventícia de veia basílica.

  15. The progestin levonorgestrel induces endothelium-independent relaxation of rabbit jugular vein via inhibition of calcium entry and protein kinase C: role of cyclic AMP

    PubMed Central

    Herkert, Olaf; Kuhl, Herbert; Busse, Rudi; Schini-Kerth, Valérie B

    2000-01-01

    The progestin and oestrogen component of oral contraceptives have been involved in the development of venous thromboembolic events in women. In the present study we determined the vasoactive effects of sex steroids used in oral contraceptives in isolated preconstricted rabbit jugular veins in the presence of diclofenac and examined the underlying mechanisms.The natural hormone progesterone, the synthetic progestins levonorgestrel, 3-keto-desogestrel, gestodene and chlormadinone acetate, and the synthetic estrogen 17 α-ethinyloestradiol induced concentration-dependent relaxations of endothelium-intact veins constricted with U46619. Levonorgestrel also inhibited constrictions evoked by either a high potassium (K+) solution or phorbol myristate acetate (PMA) in the absence and presence of extracellular calcium (Ca2+). In addition, levonorgestrel depressed contractions evoked by Ca2+ and reduced 45Ca2+ influx in depolarized veins.Relaxations to levonorgestrel in U46619-constricted veins were neither affected by the presence of the endothelium nor by the inhibitor of soluble guanylyl cyclase, NS2028, but were significantly improved either by the selective cyclic AMP phosphodiesterase inhibitor rolipram or in the absence of diclofenac, and decreased by the protein kinase A inhibitor, Rp-8-CPT-cAMPS. Rolipram also potentiated relaxations to levonorgestrel in PMA-constricted veins in the presence, but not in the absence of extracellular Ca2+. Levonorgestrel increased levels of cyclic AMP and inhibited PMA-induced activation of protein kinase C in veins.These findings indicate that levonorgestrel caused endothelium-independent relaxations of jugular veins via inhibition of Ca2+ entry and of protein kinase C activation. In addition, the cyclic AMP effector pathway contributes to the levonorgestrel-induced relaxation possibly by depressing Ca2+ entry. PMID:10952682

  16. Comparison of the diameter, cross-sectional area, and position of the left and right internal jugular vein and carotid artery in adults using ultrasound.

    PubMed

    Bos, Michaël J; van Loon, Rick F H J; Heywood, Luke; Morse, Mitchell P; van Zundert, André A J

    2016-08-01

    Central venous access is indicated for transduction of central venous pressure and the administration of inotropes in the perioperative period. The right internal jugular vein (RIJV) is cannulated preferentially over the left internal jugular vein (LIJV). Cannulation of the LIJV is associated with a higher complication rate and a perceived increased level of difficulty when compared with cannulation of the RIJV. Possible explanations for the higher complication rate include a smaller diameter and more anterior position relative to the corresponding carotid artery (CA) of the LIJV compared with the RIJV. In this study, the RIJV and LIJV were examined in mechanically ventilated patients to determine the validity of these possible explanations. A prospective, nonrandomized cohort study. The operating room of a major teaching hospital. One hundred fifty-one patients scheduled for elective heart surgery. Ultrasound examination of the RIJV and LIJV at the level of the cricoid cartilage with a 12-MHz linear transducer in 151 anesthetized, mechanically ventilated patients in the Trendelenburg position. In 72% of patients, the RIJV was dominant over the LIJV. The diameter and cross-sectional area of the RIJV was larger than the LIJV (P < .001). An anterior position of the LIJV in relation to the left CA was detected more often when compared with the RIJV and right CA (15.1% vs 5.4%, P = .01). This study confirms the smaller diameter and increased frequency of anterior positioning relative to the corresponding CA of the LIJV when compared with the RIJV. This validates them as possible explanations for the higher complication rate of LIJV cannulation compared with RIJV cannulation. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Reconstruction of the cranial base in surgery for jugular foramen tumors.

    PubMed

    Ramina, Ricardo; Maniglia, Joao J; Paschoal, Jorge R; Fernandes, Yvens B; Neto, Mauricio Coelho; Honorato, Donizeti C

    2005-04-01

    The surgical removal of a jugular foramen (JF) tumor presents the neurosurgeon with a complex management problem that requires an understanding of the natural history, diagnosis, surgical approaches, and postoperative complications. Cerebrospinal fluid (CSF) leakage is one of the most common complications of this surgery. Different surgical approaches and management concepts to avoid this complication have been described, mainly in the ear, nose, and throat literature. The purpose of this study was to review the results of CSF leakage prevention in a series of 66 patients with JF tumors operated on by a multidisciplinary cranial base team using a new technique for cranial base reconstruction. We retrospectively studied 66 patients who had JF tumors with intracranial extension and who underwent surgical treatment in our institutions from January 1987 to December 2001. Paragangliomas were the most frequent lesions, followed by schwannomas and meningiomas. All patients were operated on using the same multidisciplinary surgical approach (neurosurgeons and ear, nose, and throat surgeons). A surgical strategy for reconstruction of the cranial base using vascularized flaps was carried out. The closure of the surgical wound was performed in three layers. A specially developed myofascial flap (temporalis fascia, cervical fascia, and sternocleidomastoid muscle) associated to the inferior rotation of the posterior portion of the temporalis muscle was used to reconstruct the cranial base with vascularized flaps. In this series of 66 patients, postoperative CSF leakage developed in three cases. These patients presented with very large or recurrent tumors, and the postoperative CSF fistulae were surgically closed. The cosmetic result obtained with this reconstruction was classified as excellent or good in all patients. Our results compare favorably with those reported in the literature. The surgical strategy used for cranial base reconstruction presented in this article has

  18. Ultrasound and Fluoroscopy-Guided Placement of Central Venous Ports via Internal Jugular Vein: Retrospective Analysis of 1254 Port Implantations at a Single Center

    PubMed Central

    Ahn, Se Jin; Chung, Jin Wook; An, Sang Bu; Yin, Yong Hu; Jae, Hwan Jun; Park, Jae Hyung

    2012-01-01

    Objective To assess the technical success and complication rates of the radiologic placement of central venous ports via the internal jugular vein. Materials and Methods We retrospectively reviewed 1254 central venous ports implanted at our institution between August 2002 and October 2009. All procedures were guided by using ultrasound and fluoroscopy. Catheter maintenance days, technical success rates, peri-procedural, as well as early and late complication rates were evaluated based on the interventional radiologic reports and patient medical records. Results A total of 433386 catheter maintenance days (mean, 350 days; range 0-1165 days) were recorded. The technical success rate was 99.9% and a total of 61 complications occurred (5%), resulting in a post-procedural complication rate of 0.129 of 1000 catheter days. Among them, peri-procedural complications within 24 hours occurred in five patients (0.4%). There were 56 post-procedural complications including 24 (1.9%, 0.055 of 1000 catheter days) early and 32 (2.6%, 0.074 of 1000 catheter days) late complications including, infection (0.6%, 0.018 of 10000 catheter days), thrombotic malfunction (1.4%, 0.040 of 1000 catheter days), nonthrombotic malfunction (0.9%, 0.025 of 1000 catheter days), venous thrombosis (0.5%, 0.014 of 1000 catheter days), as well as wound problems (1.1%, 0.032 of 1000 catheter days). Thirty six CVPs (3%) were removed due to complications. Bloodstream infections and venous thrombosis were the two main adverse events prolonging hospitalization (mean 13 days and 5 days, respectively). Conclusion Radiologic placement of a central venous port via the internal jugular vein is safe and efficient as evidenced by its high technical success rate and a very low complication rate. PMID:22563269

  19. The use of intermittent and continuous recordings of jugular venous bulb oxygen saturation in the unconscious patient.

    PubMed

    Garlick, R; Bihari, D

    1987-01-01

    Monitoring clinical signs in unconscious patients provides only late information about cerebral deterioration. Ischaemia and hypoxia are the mechanisms of much of the damage. Cerebral blood flow (CBF) measurements provide direct evidence of ischaemia but are intermittent values for what may be an unstable situation. Continuous recordings of CBF and oxygenation are more likely to reveal harmful tendencies to ischaemia and hypoxia at an early stage than intermittent readings. We report our experience with intermittent and also continuous recording of the jugular venous bulb oxygen saturation (JVO2Sat) obtained by fibreoptic oximetry in a group of 10 head injured and 7 septic patients. Simultaneous measurements of CBF by an isotopic xenon clearance method were also made. The JVO2Sat has been suggested to be a reliable indicator of cerebral oxygenation, a low value being indicative of ischaemia. We discuss whether our findings support this statement. There are also variations in JVO2Sat with mean arterial blood pressure and intracranial pressure. These variations have important implications in the interpretation that can be made of one single value of JVO2Sat.

  20. Metastatic Renal Cell Carcinoma Masquerading as Jugular Foramen Paraganglioma: A Role for Novel Magnetic Resonance Imaging.

    PubMed

    Thomas, Andrew J; Wiggins, Richard H; Gurgel, Richard K

    2017-08-01

    To describe a case of metastatic renal cell carcinoma (RCC) masquerading as a jugular foramen paraganglioma (JP). To compare imaging findings between skull base metastatic RCC and histologically proven paraganglioma. A case of unexpected metastatic skull base RCC is reviewed. Computed tomography (CT) and magnetic resonance imaging (MRI) were compared between 3 confirmed cases of JP and our case of metastatic RCC. Diffusion-weighted MRI (DW-MRI) sequences and computed apparent diffusion coefficient (ADC) values were compared between these entities. A 55-year-old man presents with what appears clinically and radiographically to be JP. The tumor was resected, then discovered on postoperative pathology to be metastatic RCC. Imaging was retrospectively compared between 3 histologically confirmed cases of JP and our case of skull base RCC. The RCC metastasis was indistinguishable from JP on CT and traditional MRI but distinct by ADC values calculated from DW-MRI. Metastatic RCC at the skull base may mimic the clinical presentation and radiographic appearance of JP. The MRI finding of flow voids is seen in both paraganglioma and metastatic RCC. Diffusion-weighted MRI is able to distinguish these entities, highlighting its potential utility in distinguishing skull base lesions.

  1. Internal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography.

    PubMed

    Lim, Byung Gun; Kim, Young Min; Kim, Heezoo; Lim, Sang Ho; Lee, Mi Kyoung

    2011-12-01

    A 41-year-old woman, who had no thrombotic risk factors and past history except congenital scoliosis, underwent central venous catheterization (CVC) before correction of the scoliosis. When internal jugular vein (IJV) catheterization using the anatomical landmark technique failed, CVC under ultrasound guidance was tried. As a consequence, thrombosis and hypoplasia of the right IJV were incidentally detected by ultrasonography. Central venous catheters were then successfully placed in other veins under ultrasound guidance. Also, after examinations to rule out the possibility of pulmonary embolism and to clarify the causes of the IJV thrombosis, the patient was found to have protein S deficiency. CVC under ultrasound guidance should be recommended to prevent the failure of cannulation and complications such as thromboembolism in patients who could possibly have anomalies of vessels as a result of anatomical deformities caused by severe scoliosis, even if patients do not have thrombotic risk factors such as a history of central catheter insertion or intravenous drug abuse, cancer, advanced age, cerebral infarction, and left ventricular dysfunction. Also, if venous thrombosis is found in patients without predisposing risk factors, one should ascertain the cause of the hypercoagulable state, for example protein S deficiency, and perform appropriate treatment and prevention of venous thromboembolism.

  2. The Accuracy of a Near-Infrared Spectroscopy Cerebral Oximetry Device and Its Potential Value for Estimating Jugular Venous Oxygen Saturation

    PubMed Central

    Ikeda, Keita; MacLeod, David B; Grocott, Hilary P.; Moretti, Eugene W.; Ames, Warwick; Vacchiano, Charles

    2014-01-01

    Background An intriguing potential clinical use of cerebral oximeter measurements (SctO2) is the ability to noninvasively estimate jugular bulb venous oxygen saturation (SjvO2). Our purpose in this study was to determine the accuracy of the FORE-SIGHT® (CAS Medical Systems; Branford, CT), which is calibrated to a weighted average of 70% (SjvO2) and 30% arterial saturation, for Food and Drug Administration pre-market approval 510 (k) certification by adapting an industry standard protocol, ISO 9919:2005 [www.ISO.org] (used for pulse oximeters) and to evaluate the use of SctO2 and SpO2 measurements to noninvasively estimate jugular venous oxygen saturation (SnvO2). Methods Paired blood gas samples from the radial artery and the jugular venous bulb were collected from 20 healthy volunteers undergoing progressive oxygen desaturation from 100 to 70%. The blood sample pairs were analyzed via co-oximetry and used to calculate the approximate mixed vascular cerebral blood oxygen saturation, or reference SctO2 values (refSctO2), during increasing hypoxia. These reference values were compared to bilateral FORE-SIGHT SctO2 values recorded simultaneously with the blood gas draws to determine its accuracy. Bilateral SctO2 and SpO2 measurements were then used to calculate SnvO2 values which were compared to SjvO2. Results Two hundred forty-six arterial and 253 venous samples from 18 subjects were used in the analysis. The ipsilateral FORE-SIGHT SctO2 values showed a tolerance interval (TI) of [−10.72 10.90] Lin’s concordance correlation coefficient (CCC) with standard error (SE) of 0.83 ± 0.073 with the refSctO2 values calculated using arterial and venous blood gases. The combined data had a CCC of 0. 81 + 0.059 with TI of [−9.22 9.40] with overall bias was 0.09% and amplitude of the root mean square of error after it was corrected with random effects analysis was 2.92%. The bias and variability values between the ipsilateral and the contralateral FORE-SIGHT SctO2

  3. The accuracy of a near-infrared spectroscopy cerebral oximetry device and its potential value for estimating jugular venous oxygen saturation.

    PubMed

    Ikeda, Keita; MacLeod, David B; Grocott, Hilary P; Moretti, Eugene W; Ames, Warwick; Vacchiano, Charles

    2014-12-01

    An intriguing potential clinical use of cerebral oximeter measurements (SctO2) is the ability to noninvasively estimate jugular bulb venous oxygen saturation (SjvO2). Our purpose in this study was to determine the accuracy of the FORE-SIGHT(®) (CAS Medical Systems, Branford, CT), which is calibrated to a weighted average of 70% (SjvO2) and 30% arterial saturation, for Food and Drug Administration pre-market approval 510(k) certification by adapting an industry standard protocol, ISO 9919:2005 (www.ISO.org) (used for pulse oximeters), and to evaluate the use of SctO2 and SpO2 measurements to noninvasively estimate jugular venous oxygen saturation (SnvO2). Paired blood gas samples from the radial artery and the jugular venous bulb were collected from 20 healthy volunteers undergoing progressive oxygen desaturation from 100% to 70%. The blood sample pairs were analyzed via co-oximetry and used to calculate the approximate mixed vascular cerebral blood oxygen saturation, or reference SctO2 values (refSctO2), during increasing hypoxia. These reference values were compared to bilateral FORE-SIGHT SctO2 values recorded simultaneously with the blood gas draws to determine its accuracy. Bilateral SctO2 and SpO2 measurements were then used to calculate SnvO2 values which were compared to SjvO2. Two hundred forty-six arterial and 253 venous samples from 18 subjects were used in the analysis. The ipsilateral FORE-SIGHT SctO2 values showed a tolerance interval (TI) of [-10.72 to 10.90] and Lin concordance correlation coefficient (CCC) with standard error (SE) of 0.83 ± 0.073 with the refSctO2 values calculated using arterial and venous blood gases. The ipsilateral data had a CCC of 0.81 + 0.059 with TI of [-9.22 to 9.40] with overall bias of 0.09%, and amplitude of the root mean square of error after it was corrected with random effects analysis was 2.92%. The bias and variability values between the ipsilateral and the contralateral FORE-SIGHT SctO2 measurements varied from

  4. Internal jugular vein sampling in adrenocorticotropic hormone-dependent Cushing's syndrome: a comparison with inferior petrosal sinus sampling.

    PubMed

    Erickson, Dana; Huston, John; Young, William F; Carpenter, Paul C; Wermers, Robert A; Bonelli, Frank S; Powell, Claudia C

    2004-04-01

    Distinguishing between pituitary-dependent Cushing's syndrome (CS) and occult ectopic ACTH syndrome can be extremely difficult. Bilateral inferior petrosal sinus sampling has been shown to have the highest diagnostic accuracy in this subtype evaluation. Internal jugular vein sampling (IJVS) has been reported as a potentially safer invasive alternative, but data are limited. Our objective was to compare the sensitivity and specificity of bilateral IJVS and bilateral inferior petrosal sinus sampling (IPSS) in patients with ACTH-dependent CS. We prospectively collected blood samples from the inferior petrosal sinus and internal jugular vein of consecutive patients with ACTH-dependent CS. The study group included 35 patients: 32 with pituitary-dependent CS (positive immunohistochemical findings for ACTH pituitary tumour or biochemical cure after pituitary surgery) and three with histologically proven ectopic ACTH syndrome. Inferior petrosal sinus sampling and bilateral IJVS were performed simultaneously before and after administration of corticotropin-releasing hormone (CRH), and ratios of central-to-peripheral ACTH concentrations were calculated. The basal IJVS central-to-peripheral ACTH ratios were diagnostic for pituitary-dependent CS (> 2) in 15 patients (46.9%), as were basal inferior petrosal sinus sampling central-to-peripheral ACTH ratios in 29 patients (90.6%). The post-CRH IJVS central-to-peripheral ACTH ratios were diagnostic for pituitary-dependent disease (> 3) in 24 patients (75%), as were post-CRH inferior petrosal sinus sampling central-to-peripheral ACTH ratios in 28 patients (87.5%). In the three patients with ectopic ACTH CS, the IJVS and inferior petrosal sinus sampling pre- and post-CRH ACTH ratios were correctly negative. The overall sensitivity of combined pre- or post-CRH was 81.3% for IJVS and 93.8% for inferior petrosal sinus sampling. Because of the difference between mean ratios in the two techniques, new criteria for IJVS were

  5. Hemodynamic effects of spiral ePTFE prosthesis compared with standard arteriovenous graft in a carotid to jugular vein porcine model.

    PubMed

    Jahrome, Ommid K; Hoefer, Imo; Houston, Graeme J; Stonebridge, Peter A; Blankestijn, Peter J; Moll, Frans L; de Borst, Gert J

    2011-01-01

    The primary patency rate of arteriovenous (AV) grafts is limited by distal venous anastomosis stenosis or occlusion due to intimal hyperplasia associated with distal graft turbulence. The normal blood flow in native arteries is spiral laminar flow. Standard vascular grafts do not produce spiral laminar flow at the distal anastomosis. Vascular grafts which induce a spiral laminar flow distally result in lower turbulence, particularly near the vessel wall. This initial study compares the hemodynamic effects of a spiral flow-inducing graft and a standard graft in a new AV carotid to jugular vein crossover graft porcine model. Four spiral flow grafts and 4 control grafts were implanted from the carotid artery to the contralateral jugular vein in 4 pigs. Two animals were terminated after 48 hours and 2 at 14 days. Graft patency was assessed by selective catheter digital angiography, and the flow pattern was assessed by intraoperative flow probe and color Doppler ultrasound (CDU) measurements. The spiral grafts were also assessed at enhanced flow rates using an external roller pump to simulate increased flow rates that may occur during dialysis using a standard dialysis needle cannulation. The method increased the flow rate through the graft by 660 ml/min. The graft distal anastomotic appearances were evaluated by explant histopathology. All grafts were patent at explantation with no complications. All anastomoses were found to be wide open and showed no significant angiographic stenosis at the distal anastomosis in both spiral and control grafts. CDU examinations showed a spiral flow pattern in the spiral graft and double helix pattern in the control graft. No gross histopathological effects were seen in either spiral or control grafts. This porcine model is robust and allows hemodynamic flow assessment up to 14 days postimplantation. The spiral flow-inducing grafts produced and maintained spiral flow at baseline and enhanced flow rates during dialysis needle

  6. Transpulmonary thermodilution using femoral indicator injection: a prospective trial in patients with a femoral and a jugular central venous catheter

    PubMed Central

    2010-01-01

    Introduction Advanced hemodynamic monitoring using transpulmonary thermodilution (TPTD) is established for measurement of cardiac index (CI), global end-diastolic volume index (GEDVI) and extra-vascular lung water index (EVLWI). TPTD requires indicator injection via a central venous catheter (usually placed via the jugular or subclavian vein). However, superior vena cava access is often not feasible due to the clinical situation. This study investigates the conformity of TPTD using femoral access. Methods This prospective study involved an 18-month trial at a medical intensive care unit at a university hospital. Twenty-four patients with both a superior and an inferior vena cava catheter at the same time were enrolled in the study. Results TPTD-variables were calculated from TPTD curves after injection of the indicator bolus via jugular access (TPTDjug) and femoral access (TPTDfem). GEDVIfem and GEDVIjug were significantly correlated (rm = 0.88; P < 0.001), but significantly different (1,034 ± 275 vs. 793 ± 180 mL/m2; P < 0.001). Bland-Altman analysis demonstrated a bias of +241 mL/m2 (limits of agreement: -9 and +491 mL/m2). GEDVIfem, CIfem and ideal body weight were independently associated with the bias (GEDVIfem-GEDVIjug). A correction formula of GEDVIjug after femoral TPTD, was calculated. EVLWIfem and EVLWIjug were significantly correlated (rm = 0.93; P < 0.001). Bland-Altman analysis revealed a bias of +0.83 mL/kg (limits of agreement: -2.61 and +4.28 mL/kg). Furthermore, CIfem and CIjug were significantly correlated (rm = 0.95; P < 0.001). Bland-Altman analysis demonstrated a bias of +0.29 L/min/m2 (limits of agreement -0.40 and +0.97 L/min/m2; percentage-error 16%). Conclusions TPTD after femoral injection of the thermo-bolus provides precise data on GEDVI with a high correlation, but a self-evident significant bias related to the augmented TPTD-volume. After correction of GEDVIfem using a correction formula, GEDVIfem shows high predictive capabilities

  7. [Thrombophlebitis in the central vein catheter (AVA3Xi) custody to the internal jugular vein: a case report].

    PubMed

    Morohashi, Toru; Ogura, Takahiro; Inamura, Rie; Kazama, Tomiei

    2012-06-01

    The central vein catheter-related infection and thrombosis are comparatively frequent and may cause a serious complication. AVA3Xi was taken into custody to the internal jugular vein, and the patient suffured from thrombophlebitis on the seventh day after the operation. A 73-year-old woman 151 cm tall and weighing 50 kg was scheduled for pancreatoduodenectomy under propofol-remifentanil anesthesia combined with epidural anesthesia (operating time 9 hours and 21 minutes, anesthetizing time 12 hours and 1 minute). The past history of the thrombosis was not present, and it was especially unquestionable for the trap including the preoperative testing and the central venous catheter insertion. The time course after the operation was also good. But the patient claimed the stiffness of the cervix on the postoperative seventh day; fever and shivering were also accompanied. S. epidermidis was identified by the blood culture. Thrombophlebitis was diagnosed with CT. It is necessary to choose an appropriate catheter and endeavor for the prevention and early detection of the blood clot formation to prevent catheter-related infection and thrombosis with cooperation with the surgeon.

  8. Constitutive modeling of jugular vein-derived venous valve leaflet tissues.

    PubMed

    Kaul, Nayyan; Huang, Hsiao-Ying Shadow

    2017-11-01

    Venous valve tissues, though used in vein reconstruction surgeries and bioprosthetic valves with moderate success, have not been extensively studied with respect to their structure. Their inherent anisotropic, non-linear behavior combined with severe diseases which affect veins, such as chronic venous insufficiency, warrant understanding the structure and material behavior of these tissues. Hence, before any bioprosthetic grafts may be used in place of tissues, it is of the utmost importance to understand the mechanical and structural properties of these tissues as this may lead to higher success rates for valve replacement surgeries. The longevity of the bioprosthetics may also increase if the manufactured grafts behave the same as native valves. Building on the scant information about the uniaxial and biaxial mechanical properties of jugular venous valves and wall tissues from previous studies, the current focus of our investigation lies in understanding the material behavior by establishing a phenomenological strain energy-based constitutive relation for the tissues. We used bovine veins to study the behavior of valve leaflet tissue and adjoining wall tissue (from the proximal and distal ends of the veins) under different biaxial testing protocols. We looked at the behavior of numerical partial derivatives of the strain energy to select a suitable functional form for the strain energy for wall and valve tissues. Using this strain energy descriptor, we determined the Cauchy stress and compared it with experimental results under additional sets of displacement-controlled biaxial testing protocols to find material specific model parameters by the Powell's method algorithm. Results show that whereas wall tissue strain energy can be explained using a polynomial non-linear function, the valve tissue, due to higher non-linearities, requires an exponential function. This study may provide useful information for the primary stages of bioprosthetic designs and replacement

  9. Hydroperoxide in internal jugular venous blood reflects occurrence of subarachnoid hemorrhage-induced delayed cerebral vasospasm.

    PubMed

    Uekusa, Hiroyuki; Miyazaki, Chikao; Kondo, Kosuke; Harada, Naoyuki; Nomoto, Jun; Sugo, Nobuo; Nemoto, Masaaki

    2014-10-01

    To investigate the association between subarachnoid hemorrhage-induced delayed cerebral vasospasm (DCVS) and oxidative stress, an oxidation product, hydroperoxide, was measured in 3 specimens: peripheral arterial blood, cerebrospinal fluid (CSF), and internal jugular venous blood (IJVB). Hydroperoxide was measured using the diacron reactive oxygen metabolites (d-ROMs) test. The hydroperoxide levels were evaluated based on the rate of change in the d-ROMs test value on day 6 relative with that on day 3 (d-ROMs change rate). The subjects were 20 patients. The d-ROMs change rate in IJVB was significantly higher in patients with DCVS on day 6 than in those without it (P < .01). When the patients were classified into the following 3 groups: Group A (no DCVS occurred throughout the clinical course); Group B (DCVS occurred, but no cerebral infarction [CI] was induced); and Group C (DCVS occurred and caused CI), the d-ROMs change rate in IJVB was the highest in Group C, followed by Group B then A (P < .01). The d-ROMs change rates in peripheral arterial blood and CSF were not related to the development of DCVS. It was concluded that the more severe DCVS occurs and is more likely to progress to CI as the IJVB hydroperoxide level rises early after the development of subarachnoid hemorrhage. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. Reconstruction of the right ventricular outflow tract with a bovine jugular vein graft fixed with a naturally occurring crosslinking agent (genipin) in a canine model.

    PubMed

    Chang, Y; Tsai, C C; Liang, H C; Sung, H W

    2001-12-01

    This study was designed to evaluate a newly developed biologic valved conduit fixed with genipin used to reconstruct the right ventricular outflow tract in a canine model. Fresh bovine jugular veins with a retained native valve procured from a slaughterhouse were used as raw materials to fabricate the valved conduits. A naturally occurring crosslinking agent, genipin, was used to fix the procured jugular veins. The glutaraldehyde-fixed counterpart was used as a control. A canine model was used in the study. Echocardiography revealed that the motion of the valvular leaflets in both the glutaraldehyde- and genipin-fixed conduits was satisfactory. The transvalvular pressure gradients of both studied groups were minimal. No endothelium-like cells were observed on the luminal surface of the conduit and the valvular leaflet for the glutaraldehyde-fixed group throughout the entire course of the study. In contrast, endothelium-like cells were observed on the entire surface of the genipin-fixed valved conduit retrieved at 6 months postoperatively in all the cases studied. There was no evidence of luminal fibrous peel in any the valved conduits studied. Degradation of valvular leaflet in one of the glutaraldehyde-fixed conduits was observed. In this particular case, thrombus formation was also observed on the surface of the valvular leaflet. On the other hand, no apparent degradation or thrombus formation was observed on the surfaces of the genipin-fixed valvular leaflet and conduit. A significantly more severe inflammatory reaction was observed for the glutaraldehyde-fixed conduit than for its genipin-fixed counterpart throughout the entire course of the study. The calcium contents of the samples before implantation and those retrieved at distinct implantation duration were minimal for both the glutaraldehyde- and genipin-fixed tissues. Although further studies are necessary, the genipin-fixed valved conduit appears to have great potential in helping mitigate the

  11. Escleroterapia de safena associada a enxerto de pele no tratamento de úlceras venosas

    PubMed Central

    de Oliveira, Alexandre Faraco; de Oliveira, Horácio

    2017-01-01

    Resumo Contexto Úlceras são a resultante final de varizes associadas a refluxo de veias safenas. Objetivo Demonstrar a possibilidade de associar dois procedimentos, a escleroterapia com espuma de veias safenas e o enxerto de pele parcial, para o tratamento de pacientes com úlceras venosas relacionadas a refluxo de veias safenas. Métodos Foram tratados 20 membros em 20 pacientes, todos com ulcerações relacionadas a refluxo de veias safenas. Realizamos o enxerto de pele expandida, seguido da escleroterapia ecoguiada com espuma de polidocanol nas veias associadas às úlceras, através de punção ou dissecção da veia. Resultados Em todos os casos, houve melhora dos sintomas relacionados à úlcera e cicatrização da lesão. Em 11 casos, obtivemos a viabilidade do enxerto de pele por completo; em quatro casos, houve cicatrização de cerca de 50% da lesão; e nos cinco casos restantes, houve cicatrização de aproximadamente 75% da lesão. A primeira ultrassonografia de controle revelou esclerose completa dos vasos tratados em 19 dos 20 casos e esclerose parcial sem refluxo detectável em um caso. Na segunda ultrassonografia, realizada após 45 dias, observamos esclerose completa de 15 casos; em cinco casos, houve esclerose parcial, dos quais três sem refluxo detectável e dois com refluxo em segmentos isolados associados a varizes. A complicação mais frequente foi a pigmentação nos trajetos venosos, observada em 13 pacientes. Um caso apresentou trombose assintomática de veias musculares da perna. Conclusão Essa associação de procedimentos consiste em uma opção válida com potencial para promover um tratamento mais breve e de menor custo. PMID:29930660

  12. Efficacy and safety of ultrasound-guided placement of central venous port systems via the right internal jugular vein in elderly oncologic patients: our single-center experience and protocol.

    PubMed

    Canfora, Alfonso; Mauriello, Claudio; Ferronetti, Antonio; Marte, Gianpaolo; Di Maio, Vittorio; Ciorra, Guido; Esposito, Maria Grazia; Giuliano, Maria Elena; Fregola, Giovanni; Barra, Luigi; Cuzzovaglia, Salvatore; Bottino, Vincenzo; Maida, Pietro

    2017-02-01

    Ultrasound-guidance has become the routine method for internal jugular vein (IJV) catheterization reducing dramatically failure and complication rates for central venous port (CVP) placement. The aim of this study was to determine the safety and efficacy of ultrasound-guided IJV CVP placement in elderly oncologic patients. Between January 2013 and December 2015, 101 elderly oncological patients underwent right IJV CVP placement under ultrasound-guidance. The length of catheter introduction ranged from 18 to 21 cm. Intraoperative fluoroscopy (IF) was always performed intraoperatively. Chest X-ray (CXR) was always performed 30 min after the end of the procedure. The morbidity rate was 1.98%; two arterial punctures were reported with one self-limiting hematoma. Two patients (1.98%) had catheter misplacements, recognized by intraoperative IF. No patients (0%) experienced pneumothorax (PNX), confirmed at CXR. Patients were all discharged at maximum 6 h from the procedure. The risk of catheter misplacement, PNX, and arterial/nerve puncture remains present with this technique. Lower rates of catheter misplacement have been reported after right IJV puncture, probably for its straight vertical course. Our results are in accordance with literature (1 counter-lateral subclavian vein and 1 counter-lateral internal jugular vein misplacements). All misplacements were detected intraoperatively. The PNX rates after cannulation of the IJV vary between 0.0 and 0.5%. We had no PNX occurrence. Ultrasonography (US) has improved safety and effectiveness of port system placements. While routine post-procedural CXR seems avoidable, IF should be considered mandatory.

  13. Recombination luminescence of CaSO4:Tb3+ and CaSO4:Gd3+phosphors

    NASA Astrophysics Data System (ADS)

    Kudryavtseva, Irina; Lushchik, Aleksandr; Maaroos, Aarne; Azmaganbetova, Zhannur; Nurakhmetov, Turlybek; Salikhoja, Zhussupbek

    2012-08-01

    A comparative study of the excitation of luminescence by VUV radiation as well as of thermally and photostimulated luminescence has been carried out for CaSO4:Tb3+ and CaSO4:Gd3+ phosphors, where Na+ or F- ions are used for charge compensation. The distinction in hole processes for the phosphors with Na+ or F- compensators is determined by the differing thermal stability of the holes localized at/near Tb3+Na+ and Gd3+Na+ (up to 100-160 K) or at/near Tb3+F- V Ca and Gd3+F- V Ca centers involving also a cation vacancy (up to 400-550 K). Tunnel luminescence in the pairs of localized electrons and holes nearby Tb3+ or Gd3+ has been detected. The mechanisms of electron-hole, hole-electron and tunnel recombination luminescence as well as a subsequent released energy transfer to RE3+ ions are considered.

  14. Preoperative ultrasonographic findings of internal jugular veins and carotid arteries in kidney transplant recipients.

    PubMed

    Choi, Ji Won; Kim, Gaab Soo; Lee, Seung Won; Park, Jeong Bo; Lee, Jeong Jin; Ko, Justin Sangwook

    2016-08-01

    Hemodialysis via the internal jugular vein (IJV) has been widely used for patients with end stage renal disease (ESRD) patients, as they have a higher risk of arterial diseases. We investigated the ultrasonographic findings of the IJV and carotid artery (CA) in recipients of kidney transplantation (KT) and identified factors influencing IJV/CA abnormalities. We enrolled 120 adult KT recipients. Patients in group A (n = 57) had a history of IJV hemodialysis, while those in group B (n = 63) were not yet on dialysis or undergoing dialysis methods not involving the IJV. The day before surgery, we evaluated the state of the IJV and CA using ultrasonography. We followed patients with IJV stenosis for six months after KT. Ultrasonography revealed that four patients (7%) in group A had IJV abnormalities, while no patients in group B had abnormalities (P = 0.118). Of the four patients with abnormalities, one with 57.4% stenosis normalized during follow- up. However, another patient with 90.1% stenosis progressed to occlusion, while the two patients with total occlusion remained the same. Twenty patients in group A (n = 11) and B (n = 9) had several CA abnormalities (P = 0.462). Upon multivariate analysis with stepwise selection, height and age were significantly correlated with IJV stenosis (P = 0.043, odds ratio = 0.9) and CA abnormality (P = 0.012, odds ratio = 1.1), respectively. IJV abnormalities (especially with a history of IJV hemodialysis) and CA abnormalities may be present in ESRD patients. Therefore, we recommend ultrasonographic evaluation before catheterization.

  15. Clinical spectrum of patients with erosion of the inner ear by jugular bulb abnormalities.

    PubMed

    Friedmann, David R; Le, B Thuy; Pramanik, Bidyut K; Lalwani, Anil K

    2010-02-01

    Anatomic variants of the jugular bulb (JB) are common; however, abnormalities such as large high riding JB and JB diverticulum (JBD) are uncommon. Rarely, the abnormal JB may erode into the inner ear. The goal of our study is to report a large series of patients with symptomatic JB erosion into the inner ear. Retrospective review in an academic medical center. Eleven patients with JB abnormality eroding into the inner ear were identified on computed tomography (CT) scan of the temporal bone. Age at presentation was from 5 years to 82 years with six males and five females. The large JB or JBD eroded into the vestibular aqueduct (n = 9) or the posterior semicircular canal (n = 4). The official radiology report usually identified the JB abnormality; however, erosion into these structures by the JB was not mentioned in all but one case. All patients were symptomatic with five having conductive hearing loss (CHL) and three complaining of pulsatile tinnitus. Those with pulsatile tinnitus and four of five with CHL had erosion into the vestibular aqueduct. Vestibular evoked myogenic potential (VEMP) findings in three of six patients were consistent with dehiscence of the inner ear. High riding large JB or JBD can erode into the inner ear and may be associated with CHL and/or pulsatile tinnitus. CT scan is diagnostic and should be examined specifically for these lesions. As patients with pulsatile tinnitus may initially undergo a magnetic resonance imaging scan, identification of JB abnormality should prompt CT scan or VEMP testing to evaluate for inner ear erosion.

  16. Calcification resistance for photooxidatively crosslinked acellular bovine jugular vein conduits in right-side heart implantation.

    PubMed

    Lü, Wei-Dong; Wang, An-Ping; Wu, Zhong-Shi; Zhang, Ming; Hu, Tie-Hui; Lei, Guang-Yan; Hu, Ye-Rong

    2012-10-01

    This study aimed to investigate the effect of decellularization plus photooxidative crosslinking and ethanol pretreatment on bioprosthetic tissue calcification. Photooxidatively crosslinked acellular (PCA) bovine jugular vein conduits (BJVCs) and their photooxidized controls (n = 5 each) were sterilized in a graded concentration of ethanol solutions for 4 h, and used to reconstruct dog right ventricular outflow tracts. At 1-year implantation, echocardiography showed similar hemodynamic performance, but obvious calcification for the photooxidized BJVC walls. Further histological examination showed intense calcium deposition colocalized with slightly degraded elastic fibers in the photooxidized BJVC walls, with sparsely distributed punctate calcification in the valves and other areas of walls. But PCA BJVCs had apparent degradation of elastic fibers in the walls, with only sparsely distributed punctate calcification in the walls and valves. Content assay demonstrated comparable calcium content for the two groups at preimplantation, whereas less calcium for the PCA group in the walls and similar calcium in the valvular leaflets compared with the photooxidized group at 1-year retrieval. Elastin content assay presented the conduit walls of PCA group had less elastin content at preimplantation, but similar content at 1-year retrieval compared with the photooxidized group. Phospholipid analysis showed phospholipid extraction by ethanol for the PCA group was more efficacious than the photooxidized group. These results indicate that PCA BJVCs resist calcification in right-side heart implantation owing to decellularization, further photooxidative crosslinking, and subsequent phospholipid extraction by ethanol at preimplantation. Copyright © 2012 Wiley Periodicals, Inc.

  17. Trans-jugular intrahepatic porto-systemic shunt placement for refractory ascites: a 'real-world' UK health economic evaluation.

    PubMed

    Parker, Matthew J; Guha, Neil; Stedman, Brian; Hacking, Nigel; Wright, Mark

    2013-07-01

    To assess the benefit of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement for refractory ascites. A retrospective observational study of all patients undergoing TIPS for refractory ascites in our hospital between 2003 and 2012. Secondary care. Cirrhotic patients with refractory ascites. We examined direct real-world (National Health Service) health related costs in the year before and after the TIPS procedure took place. Data were collected relating to the need for reintervention and hepatic encephalopathy. Data were available for 24 patients who underwent TIPS for refractory ascites (86% of eligible patients). TIPS was technically successful in all cases. Mean number of bed days in the year prior to TIPS was 30.3 and 14.3 in the year following (p=0.005). No patient had ascites at the end of the year after the TIPS with less requirement for paracentesis over the course of the year (p<0.001). Mean reduction in cost was £2759 per patient. TIPS was especially cost-effective in patients requiring between 6 and 12 drains per year with a mean saving of £9204 per patient. TIPS is both a clinically effective and economically advantageous therapeutic option for selected patients with refractory ascites.

  18. Adult Mouse Venous Hypertension Model: Common Carotid Artery to External Jugular Vein Anastomosis.

    PubMed Central

    Yang, Shun-Tai; Rodriguez-Hernandez, Ana; Walker, Espen J.; Young, William L.; Su, Hua; Lawton, Michael T.

    2015-01-01

    The understanding of the pathophysiology of brain arteriovenous malformations and arteriovenous fistulas has improved thanks to animal models. A rat model creating an artificial fistula between the common carotid artery (CCA) and the external jugular vein (EJV) has been widely described and proved technically feasible. This construct provokes a consistent cerebral venous hypertension (CVH), and therefore has helped studying the contribution of venous hypertension to formation, clinical symptoms, and prognosis of brain AVMs and dural AVFs. Equivalent mice models have been only scarcely described and have shown trouble with stenosis of the fistula. An established murine model would allow the study of not only pathophysiology but also potential genetic therapies for these cerebrovascular diseases. We present a model of arteriovenous fistula that produces a durable intracranial venous hypertension in the mouse. Microsurgical anastomosis of the murine CCA and EJV can be difficult due to diminutive anatomy and frequently result in a non-patent fistula. In this step-by-step protocol we address all the important challenges encountered during this procedure. Avoiding excessive retraction of the vein during the exposure, using 11-0 sutures instead of 10-0, and making a carefully planned end-to-side anastomosis are some of the critical steps. Although this method requires advanced microsurgical skills and a longer learning curve that the equivalent in the rat, it can be consistently developed. This novel model has been designed to integrate transgenic mouse techniques with a previously well-established experimental system that has proved useful to study brain AVMs and dural AVFs. By opening the possibility of using transgenic mice, a broader spectrum of valid models can be achieved and genetic treatments can also be tested. The experimental construct could also be further adapted to the study of other cerebrovascular diseases related with venous hypertension such as migraine

  19. Jugular venous valved conduit (Contegra) matches allograft performance in infant truncus arteriosus repair.

    PubMed

    Hickey, Edward J; McCrindle, Brian W; Blackstone, Eugene H; Yeh, Thomas; Pigula, Frank; Clarke, David; Tchervenkov, Christo I; Hawkins, John

    2008-05-01

    Limited availability and durability of allograft conduits require that alternatives be considered. We compared bovine jugular venous valved (JVV) and allograft conduit performance in 107 infants who survived truncus arteriosus repair. Children were prospectively recruited between 2003 and 2007 from 17 institutions. The median z-score for JVV (n=27, all 12 mm) was +2.1 (range +1.2 to +3.2) and allograft (n=80, 9-15mm) was +1.7 (range -0.4 to +3.6). Propensity-adjusted comparison of conduit survival was undertaken using parametric risk-hazard analysis and competing risks techniques. All available echocardiograms (n=745) were used to model deterioration of conduit function in regression equations adjusted for repeated measures. Overall conduit survival was 64+/-9% at 3 years. Conduit replacement was for conduit stenosis (n=16) and/or pulmonary artery stenosis (n=18) or regurgitation (n=1). The propensity-adjusted 3-year freedom from replacement for in-conduit stenosis was 96+/-4% for JVV and 69+/-8% for allograft (p=0.05). The risk of intervention or replacement for branch pulmonary artery stenosis was similar for JVV and allograft. Smaller conduit z-score predicted poor conduit performance (p<0.01) with best outcome between +1 and +3. Although JVV conduits were a uniform diameter, their z-score more consistently matched this ideal. JVV exhibited a non-significant trend towards slower progression of conduit regurgitation and peak right ventricular outflow tract (RVOT) gradient. In addition, catheter intervention was more successful at slowing subsequent gradient progression in children with JVV versus those with allograft (p<0.01). JVV does match allograft performance and may be advantageous. It is an appropriate first choice for repair of truncus arteriosus, and perhaps other small infants requiring RVOT reconstruction.

  20. CaSO4:DY,Mn: A new and highly sensitive thermoluminescence phosphor for versatile dosimetry

    NASA Astrophysics Data System (ADS)

    Bahl, Shaila; Lochab, S. P.; Kumar, Pratik

    2016-02-01

    With the advent of newer techniques for dose reduction coupled with the development of more sensitive detectors, the radiation doses in radiological medical investigation are decreasing. Nevertheless, keeping the tenet in mind that all radiation doses could entail risk, there is a need to develop more sensitive dosimeters capable of measuring low doses. This paper gives the account of the development of a new and sensitive phosphor CaSO4:Dy,Mn and its characterization. The standard production procedure based on the recrystallization method was used to prepare CaSO4:Dy,Mn. The Thermoluminescence (TL) studies were carried out by exposing it with gamma radiation (Cs-137) from 10 μGy to 100 Gy. The theoretical studies to determine the number of peaks and kinetic parameters related to the TL glow peaks in CaSO4:Dy,Mn was performed using the Computerized Glow Curve Deconvolution (CGCD) method. Experiments were performed to determine optimum concentration of the dopants Dysprosium (Dy) and Mangnese (Mn) in the host CaSO4 so that maximum sensitivity of the phosphor may be achieved. The optimum dopant concentration turned out to be 0.1 mol%. As there were two dopants Dy and Mn their relative ratio were varied in steps of 0.025 keeping the concentration of total dopant (Dy and Mn) 0.1 mol% always. The maximum TL intensity was seen in the CaSO4:Dy(0.025),Mn(0.075) combination. The TL sensitivity of this phosphor was found to be about 2 and 1.8 times higher than that of popular phosphor CaSO4:Dy and LiF:Mg,Cu,P (TLD-700H) respectively. This new phosphor CaSO4:Dy,Mn showed fading of 11% which is similar to that of the standard phosphor CaSO4:Dy. The paper concludes that the new, highly sensitive TL phosphor CaSO4:Dy,Mn has shown higher sensitivity and hence the potential to replace commonly used CaSO4:Dy.

  1. Feasibility study of CaSO4:Tb,Yb as a thermoluminescent dosimeter

    NASA Astrophysics Data System (ADS)

    Junot, Danilo O.; Santos, Max A.; Chagas, Marcos A. P.; Couto dos Santos, Marcos A.; Nunes, Luiz A. O.; Souza, Divanizia N.

    2014-02-01

    A new composite based on CaSO4, using terbium as dopant and ytterbium as co-dopant (CaSO4:Tb,Yb), was developed for employment as a thermoluminescent (TL) dosimeter. The crystals used in this work were grown using a production route based on the Yamashita method (Yamashita et al., 1968). Crystal powder was calcined at 600 °C for 1 h. Pellets were made by adding commercial and colorless glass to improve physical resistance and sintered at 700 °C for 6 h. All samples were irradiated by a beta source (90Sr/90Y) and received doses from 1 Gy to 5 Gy. TL analyses have been performed and characteristics such as sensitivity, reproducibility, linearity, and fading have been studied. The CaSO4:Tb,Yb pellets glow curves presented two peaks, the first at around 115 °C, and the second at around 200 °C. The highest intensity was shown for CaSO4:Tb,Yb with a concentration of 0.1 mol% of Tb and Yb together. In all the samples the TL response was proportional to the absorbed dose. Therefore, the CaSO4:Tb,Yb has potential to be used as a thermoluminescent dosimeter.

  2. Head rotation during internal jugular vein cannulation and the risk of carotid artery puncture.

    PubMed

    Sulek, C A; Gravenstein, N; Blackshear, R H; Weiss, L

    1996-01-01

    We undertook a prospective laboratory study to examine the effect of head position on the relative positions of the carotid artery and the internal jugular vein (IJV). Volunteers (n = 12) from departmental staff, 18-60 yr of age, who had never undergone cannulation of the IJV underwent imaging of their IJV and carotid artery. With the subject in a 15 degrees Trendelenburg position, two-dimensional ultrasound images of the IJV and the carotid artery were obtained on the left and right sides of the neck at 2 and 4 cm from the clavicle along the lateral border of the sternal head of the sternocleidomastoid muscle at 0 degrees, 40 degrees, and 80 degrees of head rotation from the midline. The percent overlap of the carotid artery and IJV increased significantly at 40 degrees and 80 degrees head rotation to both the right and left (P < 0.05). Data from 2 and 4 cm above the clavicle did not differ and were pooled. The percent overlap was larger on the left than the right only with 80 degrees of head rotation (P < 0.05). The increased overlap of carotid artery and IJV with head rotation > 40 degrees increases the risk of inadvertent puncture of the carotid artery associated with the common occurrence of transfixion of the IJV before it is identified during needle withdrawal. The IJV frequently collapses with needle insertion. This may result in puncture of the posterior wall of the vessel, and thus of the carotid artery when the two vessels overlap. To decrease this risk, the head should be kept in as neutral a position as possible, that is < 40 degrees rotation, during IJV cannulation.

  3. Vínculos sobre um modelo de quartessência de Chaplygin usando observações do satélite chandra da fração de massa de gás em aglomerados de galáxias

    NASA Astrophysics Data System (ADS)

    de Souza, R. S.

    2003-08-01

    Observações de Supernovas do tipo Ia mostram que a expansão do Universo está acelerando. Segundo as equações de Einstein uma componente com pressão negativa (energia escura) é necessária para explicar a aceleração cósmica. Além da energia escura é usualmente admitido que no Universo há também uma matéria exótica com pressão zero, que é chamada de matéria escura. Essa componente possui um papel fundamental na formação de estruturas no Universo. Recentemente tem se explorado a possibilidade de que matéria e energia escura poderiam ser unificadas através de uma única componente, que tem sido denominada de quartessência. Um exemplo de fluido com essas características é o Gás de Chaplygin Generalizado, que possui uma equação de estado da forma p = -A/ra. Inicialmente consideramos o caso especial a = 1 (gás de Chaplygin) e vinculamos parâmetros do modelo utilizando observações em raios-X do satélite Chandra da fração de massa de gás em aglomerados de galáxias. Uma comparação dos vínculos obtidos com esse teste com outros testes, tais como supernovas e idade do Universo, mostra que esse teste é bastante restritivo. Exibiremos ainda resultados para o caso em que a curvatura é nula e o parâmetro a está compreendido no intervalo -1 < a 1.

  4. Parylene supported 20um*20um uncooled thermoelectric infrared detector with high fill factor

    NASA Astrophysics Data System (ADS)

    Modarres-Zadeh, Mohammad J.; Carpenter, Zachary S.; Rockley, Mark G.; Abdolvand, Reza

    2012-06-01

    Presented is a novel design for an uncooled surface-micromachined thermoelectric (TE) infrared (IR) detector. The detector features a P-doped polysilicon/Nichrome (Cr20-Ni80) thermocouple, which is embedded into a thin layer of Parylene-N to provide structural support. The low thermal conductivity (~0.1W/m.K), chemical resistance, and ease of deposition/patterning of Parylene-N make it an excellent choice of material for use in MEMS thermal detectors. This detector also features an umbrella-like IR absorber composed of a three layer stack of NiCr/SiN/NiCr to optimize IR absorption. The total device area is 20 um * 20 um per pixel with an absorber area of ~19 um * 19 um resulting in a fill factor of 90%. At room temperature, a DC responsivity of ~170V/W with a rise time of less than 8 ms is measured from the fabricated devices in vacuum when viewing a 500K blackbody without any concentrating optics. The dominant source of noise in thermoelectric IR detectors is typically Johnson noise when the detectors are operating in an open circuit condition. The fabricated detectors have resistances about 85KOhm which results in Johnson noise of about 38nV/Hz^0.5. The D* is calculated to be 9 * 106 cm*Hz0.5/ W. Preliminary finite element analysis indicates that the thermal conduction from the hot junction to the substrate through the TE wires is dominant ( GTE >> Gparylene) considering the fabricated dimensions of the parylene film and the TE wires. Thus, by further reducing the size of the TE wires, GTE can be decreased and hence, responsivity can be improved while the parylene film sustains the structural integrity of the cell.

  5. Trans-jugular intrahepatic porto-systemic shunt placement for refractory ascites: a ‘real-world’ UK health economic evaluation

    PubMed Central

    Parker, Matthew J; Guha, Neil; Stedman, Brian; Hacking, Nigel; Wright, Mark

    2013-01-01

    Objective To assess the benefit of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement for refractory ascites. Design A retrospective observational study of all patients undergoing TIPS for refractory ascites in our hospital between 2003 and 2012. Setting Secondary care. Patients Cirrhotic patients with refractory ascites. Main outcome measures We examined direct real-world (National Health Service) health related costs in the year before and after the TIPS procedure took place. Data were collected relating to the need for reintervention and hepatic encephalopathy. Results Data were available for 24 patients who underwent TIPS for refractory ascites (86% of eligible patients). TIPS was technically successful in all cases. Mean number of bed days in the year prior to TIPS was 30.3 and 14.3 in the year following (p=0.005). No patient had ascites at the end of the year after the TIPS with less requirement for paracentesis over the course of the year (p<0.001). Mean reduction in cost was £2759 per patient. TIPS was especially cost-effective in patients requiring between 6 and 12 drains per year with a mean saving of £9204 per patient. Conclusions TIPS is both a clinically effective and economically advantageous therapeutic option for selected patients with refractory ascites. PMID:28839725

  6. Genome analysis of Daldinia eschscholtzii strains UM 1400 and UM 1020, wood-decaying fungi isolated from human hosts

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chan, Chai Ling; Yew, Su Mei; Ngeow, Yun Fong

    Background: Daldinia eschscholtzii is a wood-inhabiting fungus that causes wood decay under certain conditions. It has a broad host range and produces a large repertoire of potentially bioactive compounds. However, there is no extensive genome analysis on this fungal species. Results: Two fungal isolates (UM 1400 and UM 1020) from human specimens were identified as Daldinia eschscholtzii by morphological features and ITS-based phylogenetic analysis. Both genomes were similar in size with 10,822 predicted genes in UM 1400 (35.8 Mb) and 11,120 predicted genes in UM 1020 (35.5 Mb). A total of 751 gene families were shared among both UM isolates,more » including gene families associated with fungus-host interactions. In the CAZyme comparative analysis, both genomes were found to contain arrays of CAZyme related to plant cell wall degradation. Genes encoding secreted peptidases were found in the genomes, which encode for the peptidases involved in the degradation of structural proteins in plant cell wall. In addition, arrays of secondary metabolite backbone genes were identified in both genomes, indicating of their potential to produce bioactive secondary metabolites. Both genomes also contained an abundance of gene encoding signaling components, with three proposed MAPK cascades involved in cell wall integrity, osmoregulation, and mating/filamentation. Besides genomic evidence for degrading capability, both isolates also harbored an array of genes encoding stress response proteins that are potentially significant for adaptation to living in the hostile environments. In conclusion: Our genomic studies provide further information for the biological understanding of the D. eschscholtzii and suggest that these wood-decaying fungi are also equipped for adaptation to adverse environments in the human host.« less

  7. Genome analysis of Daldinia eschscholtzii strains UM 1400 and UM 1020, wood-decaying fungi isolated from human hosts

    DOE PAGES

    Chan, Chai Ling; Yew, Su Mei; Ngeow, Yun Fong; ...

    2015-11-18

    Background: Daldinia eschscholtzii is a wood-inhabiting fungus that causes wood decay under certain conditions. It has a broad host range and produces a large repertoire of potentially bioactive compounds. However, there is no extensive genome analysis on this fungal species. Results: Two fungal isolates (UM 1400 and UM 1020) from human specimens were identified as Daldinia eschscholtzii by morphological features and ITS-based phylogenetic analysis. Both genomes were similar in size with 10,822 predicted genes in UM 1400 (35.8 Mb) and 11,120 predicted genes in UM 1020 (35.5 Mb). A total of 751 gene families were shared among both UM isolates,more » including gene families associated with fungus-host interactions. In the CAZyme comparative analysis, both genomes were found to contain arrays of CAZyme related to plant cell wall degradation. Genes encoding secreted peptidases were found in the genomes, which encode for the peptidases involved in the degradation of structural proteins in plant cell wall. In addition, arrays of secondary metabolite backbone genes were identified in both genomes, indicating of their potential to produce bioactive secondary metabolites. Both genomes also contained an abundance of gene encoding signaling components, with three proposed MAPK cascades involved in cell wall integrity, osmoregulation, and mating/filamentation. Besides genomic evidence for degrading capability, both isolates also harbored an array of genes encoding stress response proteins that are potentially significant for adaptation to living in the hostile environments. In conclusion: Our genomic studies provide further information for the biological understanding of the D. eschscholtzii and suggest that these wood-decaying fungi are also equipped for adaptation to adverse environments in the human host.« less

  8. Puncture point-traction method: A novel method applied for right internal jugular vein catheterization

    PubMed Central

    WU, TIANLIANG; ZANG, HONGCHENG

    2016-01-01

    The ultrasound probe and advancement of the needle during real-time ultrasound-assisted guidance of catheterization of the right internal jugular vein (RIJV) tend to collapse the vein, which reduces the success rate of the procedure. We have developed a novel puncture point-traction method (PPTM) to facilitate RIJV cannulation. The present study examined whether this method facilitated the performance of RIJV catheterization in anesthetized patients. In this study, 120 patients were randomly assigned to a group in which PPTM was performed (PPTM group, n=60) or a group in which it was not performed (non-PPTM group, n=60). One patient was excluded because of internal carotid artery puncture and 119 patients remained for analysis. The cross-sectional area (CSA), anteroposterior diameter (AD) and transverse diameter (TD) of the RIJV at the cricoid cartilage level following the induction of anesthesia and during catheterization were measured, and the number with obvious loss of resistance (NOLR), the number with easy aspiration of blood into syringe (NEABS) during advancement of the needle, and the number of first-pass punctures (NFPP) during catheterization were determined. In the non-PPTM group, the CSA was smaller during catheterization compared with that following the induction of anesthesia (P<0.01). In the PPTM group compared with the non-PPTM group during catheterization, the CSA was larger (P<0.01) and the AD (P<0.01) and TD (P<0.05) were wider; NOLR (P<0.01), NEABS (P<0.01) and NFPP (P<0.01) increased significantly. The findings from this study confirmed that the PPTM facilitated catheterization of the RIJV and improved the success rate of RIJV catheterization in anesthetized patients in the supine position. PMID:27347054

  9. Gamma Knife radiosurgery for glomus jugulare tumors: a single-center series of 75 cases.

    PubMed

    Ibrahim, Ramez; Ammori, Mohannad B; Yianni, John; Grainger, Alison; Rowe, Jeremy; Radatz, Matthias

    2017-05-01

    OBJECTIVE Glomus jugulare tumors are rare indolent tumors that frequently involve the lower cranial nerves (CNs). Complete resection can be difficult and associated with lower CN injury. Gamma Knife radiosurgery (GKRS) has established its role as a noninvasive alternative treatment option for these often formidable lesions. The authors aimed to review their experience at the National Centre for Stereotactic Radiosurgery, Sheffield, United Kingdom, specifically the long-term tumor control rate and complications of GKRS for these lesions. METHODS Clinical and radiological data were retrospectively reviewed for patients treated between March 1994 and December 2010. Data were available for 75 patients harboring 76 tumors. The tumors in 3 patients were treated in 2 stages. Familial and/or hereditary history was noted in 12 patients, 2 of whom had catecholamine-secreting and/or active tumors. Gamma Knife radiosurgery was the primary treatment modality in 47 patients (63%). The median age at the time of treatment was 55 years. The median tumor volume was 7 cm 3 , and the median radiosurgical dose to the tumor margin was 18 Gy (range 12-25 Gy). The median duration of radiological follow-up was 51.5 months (range 12-230 months), and the median clinical follow-up was 38.5 months (range 6-223 months). RESULTS The overall tumor control rate was 93.4% with low CN morbidity. Improvement of preexisting deficits was noted in 15 patients (20%). A stationary clinical course and no progression of symptoms were noted in 48 patients (64%). Twelve patients (16%) had new symptoms or progression of their preexisting symptoms. The Kaplan-Meier actuarial tumor control rate was 92.2% at 5 years and 86.3% at 10 years. CONCLUSIONS Gamma Knife radiosurgery offers a risk-versus-benefit treatment option with very low CN morbidity and stable long-term results.

  10. Trombo flutuante em veia femoral

    PubMed Central

    Bertanha, Matheus; Pimenta, Rafael Elias Farres; Brandão, Gustavo Muçouçah Sampaio; Sobreira, Marcone Lima; Moura, Regina; Jaldin, Rodrigo Gibin; de Camargo, Paula Angeleli Bueno; Yoshida, Winston Bonetti

    2017-01-01

    Resumo O trombo venoso flutuante em veia femoral é um tipo de trombo com alto potencial de embolização pulmonar. Entretanto, ainda é controversa a conduta mais apropriada nesses casos. Tratamentos clínicos com anticoagulantes ou fibrinolíticos e trombectomias abertas ou por meio de dispositivos endovasculares vêm sendo empregados ainda sem um critério de indicação bem definido. Apresentamos três casos clínicos de trombos flutuantes em veia femoral, de etiologias distintas, cujos tratamentos e respectivas evoluções serão discutidos. PMID:29930666

  11. Morphological and positional relationships between the sigmoid sinus and the jugular bulb.

    PubMed

    Dai, Pei-Dong; Zhang, Hong-Qi; Wang, Zheng-Min; Sha, Yan; Wang, Ke-Qiang; Zhang, Tian-Yu

    2007-12-01

    The purpose of this study was to determine the quantitative relationships between the positions of the sigmoid sinus (SS) and jugular bulb (JB) and the influence of mastoid pneumatization upon these structures. The investigations were carried out on 116 healthy adult ears based on the axial images of computed tomography (CT). The reference system locating the displacements of the SS and JB was established and the shape and position of the SS and JB were measured. The volume of pneumatization was quantitatively measured based on the serial digital images of CT. The method of partial correlation analysis was used to find the real relationship of two variables from the complicated dependence relationships. There was a tendency for the SS in the males to be situated more laterally and more backwardly, and the JB in the males was situated more laterally with thicker lateral bone wall when compared to the females. When compared to the left side, the SS on the right side tended to protrude more deeply and was situated more laterally and with less thickness of the lateral bone wall. In male, the right SS was situated more anteriorly than the left SS. In female, the right JB was situated more posteriorly than the left JB. There was a tendency for the SS to be situated more medially, to have a thicker lateral bone wall, and to protrude more superficially in the well-pneumatized bones. When the pneumatization was well, the JB tended to be situated more backwards and have a thicker lateral bone wall. However, there was no significant difference of pneumatization between the high JB group and the low JB group. The SS position and JB position changed synchronously in forward-backward or medial-lateral directions. The results suggest that the factors that influence the shape and position of the SS and JB are multiple. The results suggest that the morphological and positional relationships between the SS and the JB are complicated but could be grasped. The development of the

  12. Impulsive excitation of mechanoluminescence in gamma-irradiated CaSO4:Eu phosphors

    NASA Astrophysics Data System (ADS)

    Kher, R. S.; Dhoble, S. J.; Pandey, R. K.; Upadhyay, A. K.; Khokhar, M. S. K.

    2011-01-01

    The mechanoluminescence (ML) and thermoluminescence (TL) of γ-irradiated CaSO4:Eu phosphor have been studied. CaSO4 samples having different concentrations of Eu were prepared by dissolving CaSO4.2H2O in sulphuric acid and evaporating the excess acid around 300 °C. ML was excited impulsively by dropping a load onto the sample. Three distinct peaks have been observed in the ML intensity versus time curve. The ML intensity increases with the increasing concentration of the dopant. The effect of temperature on the shape and peak of ML intensity was also recorded. Growth, saturation and broadening in an ML peak were observed. TL glow curves of CaSO4:Eu phosphors at different concentrations contain two TL peaks: the first peak was observed at around 110 °C and the other at 210 °C. Experimental results suggest that the ML excitation is related to the movement of dislocation with defect centres, the increase in ML with temperature is due to the enhancement in dislocation capture probability, and the reduction is due to the thermal bleaching of defect centres.

  13. The International Space Station Urine Monitoring System (UMS)

    NASA Technical Reports Server (NTRS)

    Feeback, Daniel L.; Cibuzar, Branelle R.; Milstead, Jeffery R.; Pietrzyk,, Robert A.; Clark, Mark S.F.

    2009-01-01

    A device capable of making in-flight volume measurements of single void urine samples, the Urine Monitoring System (UMS), was developed and flown on seven U.S. Space Shuttle missions. This device provided volume data for each urine void from multiple crewmembers and allowed samples of each to be taken and returned to Earth for post-flight analysis. There were a number of design flaws in the original instrument including the presence of liquid carry-over producing invalid "actual" micturition volumes and cross-contamination between successive users from residual urine in "dead" spots". Additionally, high or low volume voids could not be accurately measured, the on-orbit calibration and nominal use sequence was time intensive, and the unit had to be returned and disassembled to retrieve the volume data. These problems have been resolved in a new version, the International Space Station (ISS) UMS, that has been designed to provide real-time in-flight volume data with accuracy and precision equivalent to measurements made on Earth and the ability to provide urine samples that are unadulterated by the device. Originally conceived to be interfaced with a U.S.-built Waste Collection System (WCS), the unit now has been modified to interface with the Russian-supplied Sanitary Hygiene Device (ASY). The ISS UMS provides significant advantages over the current method of collecting urine samples into Urine Collection Devices (UCDs), from which samples are removed and returned to Earth for analyses. A significant future advantage of the UMS is that it can provide an interface to analytical instrumentation that will allow real-time measurement of urine bioanalytes allowing monitoring of crewmember health status during flight and the ability to provide medical interventions based on the results of these measurements. Currently, the ISS UMS is scheduled to launch along with Node-3 on STS-130 (20A) in December 2009. UMS will be installed and scientific/functional verification

  14. Experimental Comparison of Calcium Sulfate (CaSO(4)) Scale Deposition on Coated Carbon Steel and Titanium Surfaces

    NASA Astrophysics Data System (ADS)

    Al-Otaibi, Dhawi AbdulRahman

    Calcium Sulfate (CaSO4) deposit reduces heat exchange in heat transfer equipment which adversely affects the equipment performance and plant production. This experimental study was conducted by using the Rotating Cylinder Electrode (RCE) equipment available in the university's Center for Engineering Research (CER/RI) to study and compare the effect of solution hydrodynamics on Calcium Sulfate (CaSO4) scale deposition on coated carbon steel and titanium surfaces. In addition, the Scanning Electron Microscopic was used to examine the morphology and distribution of Calcium Sulfate (CaSO 4) crystals deposited on titanium metal surfaces. In this study, the rotational speed was varied from 100 to 2000 RPM to study the behavior of Calcium Sulfate (CaSO4) accumulation on both materials. Based on the experimental results, Calcium Sulfate (CaSO4) scale obtained in the present study was almost constant on coated carbon steel in which the rate of scale deposition is equal to the rate of scale removal. However, the deposition of Calcium Sulfate (CaSO4) observed on titanium material was increased as the speed increased.

  15. [Intracranial granulocytic sarcoma extending from the posterior fossa to the carotid space via the jugular foramen: a case report].

    PubMed

    Baba, Shiro; Matsuo, Takayuki; Ishizaka, Shunsuke; Morikawa, Minoru; Suyama, Kazuhiko; Nagata, Izumi

    2010-01-01

    Granulocytic sarcoma consists of neoplastic granulocytic precursors and myeloblasts. It is a focal lesion seen in 2-10.9% of acute myelogenous leukaemia (AML) patients. It usually develops either concurrently with the AML or after a remission. On rare occasions, it may be an initial manifestation of AML. Most common involvement sites are bone, periostium, soft tissue, lymph nodes and skin. Intracranial granulocytic sarcoma rarely occurs in meningeal or parenchymal form. We present an extremely rare case of intracranial granulocytic sarcoma extending from the posterior fossa to the carotid space via the jugular foramen in a 69 year old female. This form of involvement has not been previously reported. On MRI, the lesion appears isointense compared with normal grey matter in T1 and T2 weighted images and shows homogeneous contrast enhancement. With these findings, it is difficult to differentiate the lesion from other extraaxial tumours such as meningioma, paraganglioma, schwannoma, carcinoma, metastatic tumor, malignant lymphoma. However, granulocytic sarcoma, densely increased tumour cells restrict diffusion and reduce the extracellular volume fraction, tends to be markedly hyperintense on diffusion-weighted MR images and exhibits a marked decrease in ADC values. Therefore, DWI may be helpful in differentiating granulocytic sarcoma from other intracranial lesions.

  16. Recovery Act: Novel Kerf-Free PV Wafering that provides a low-cost approach to generate wafers from 150um to 50um in thickness

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fong, Theodore E.

    2013-05-06

    The technical paper summarizes the project work conducted in the development of Kerf-Free silicon wafering equipment for silicon solar wafering. This new PolyMax technology uses a two step process of implantation and cleaving to exfoliate 50um to 120um wafers with thicknesses ranging from 50um to 120um from a 125mm or 156mm pseudo-squared silicon ingot. No kerf is generated using this method of wafering. This method of wafering contrasts with the current method of making silicon solar wafers using the industry standard wire saw equipment. The report summarizes the activity conducted by Silicon Genesis Corporation in working to develop this technologymore » further and to define the roadmap specifications for the first commercial proto-type equipment for high volume solar wafer manufacturing using the PolyMax technology.« less

  17. The bovine jugular vein: a totally integrated valved conduit to repair the right ventricular outflow.

    PubMed

    Carrel, Thierry; Berdat, Pascal; Pavlovic, Mladen; Pfammatter, Jean-Pierre

    2002-07-01

    Current techniques to correct valvular anomalies of the right ventricular outflow tract (RVOT) include repair and replacement of the pulmonary valve. However, the performance of currently used conduits has been less than ideal because of unfavorable hemodynamics and mid- to long-term complications. An early experience with a totally integrated Contegra valved conduit derived from a bovine jugular vein is reported; this conduit has the advantage that there is no discontinuity between its lumen and the valve it incorporates. Between October 1999 and October 2001, a total of 22 Contegra valved conduits (12-22 mm) was implanted in 21 children aged <5 years, and in one patient aged 21 years. Diagnosis included tetralogy of Fallot (n = 13), pulmonary atresia (n = 3), double outlet right ventricle with pulmonary stenosis (PS) (n = 3), transposition of the great arteries, ventricular septal defect and PS (n = 2) and truncus arteriosus (n = 1). In 15 of these patients, distal and proximal anastomoses were performed on the beating heart. There was no mortality and no valved-conduit-related early morbidity. Intraoperative invasive assessment demonstrated excellent hemodynamic characteristics: mean peak pressure increase was 8.5+/-6.3 mmHg (varying between 4 mmHg in the 20-mm conduit and 18 mmHg in the 14-mm conduit). These values were confirmed by pre-discharge transthoracic pulsed-wave Doppler echocardiography. Because of endocarditis, one conduit was explanted after 11 months and replaced with a pulmonary homograft. Two patients required reintervention. The Contegra valved conduit is an excellent immediate substitute in the treatment of RVOT lesion when a pulmonary valve has to be inserted. Both systolic and diastolic valve functions are promising. Further data are required to confirm the favorable hemodynamics, as well as the durability and efficacy of this conduit in the long term.

  18. Uh and um revisited: are they interjections for signaling delay?

    PubMed

    O'Connell, Daniel C; Kowal, Sabine

    2005-11-01

    Clark and Fox Tree (2002) have presented empirical evidence, based primarily on the London-Lund corpus (LL; Svartvik & Quirk, 1980), that the fillers uh and um are conventional English words that signal a speaker's intention to initiate a minor and a major delay, respectively. We present here empirical analyses of uh and um and of silent pauses (delays) immediately following them in six media interviews of Hillary Clinton. Our evidence indicates that uh and um cannot serve as signals of upcoming delay, let alone signal it differentially: In most cases, both uh and um were not followed by a silent pause, that is, there was no delay at all; the silent pauses that did occur after um were too short to be counted as major delays; finally, the distributions of durations of silent pauses after uh and um were almost entirely overlapping and could therefore not have served as reliable predictors for a listener. The discrepancies between Clark and Fox Tree's findings and ours are largely a consequence of the fact that their LL analyses reflect the perceptions of professional coders, whereas our data were analyzed by means of acoustic measurements with the PRAAT software (www.praat.org). A comparison of our findings with those of O'Connell, Kowal, and Ageneau (2005) did not corroborate the hypothesis of Clark and Fox Tree that uh and um are interjections: Fillers occurred typically in initial, interjections in medial positions; fillers did not constitute an integral turn by themselves, whereas interjections did; fillers never initiated cited speech, whereas interjections did; and fillers did not signal emotion, whereas interjections did. Clark and Fox Tree's analyses were embedded within a theory of ideal delivery that we find inappropriate for the explication of these phenomena.

  19. Spitzer/IRS spectroscopy of the 12um Seyferts

    NASA Astrophysics Data System (ADS)

    Wu, Yanling; Charmandaris, V.; Huang, J.; Houck, J.

    2009-01-01

    The extended 12um galaxy sample is a flux-limited sample of 893 galaxies selected from the IRAS Faint Source Catalog 2. A total of 118 objects from this sample have been classified optically as Seyfert galaxies, providing one of the largest infrared selected unbiased sample of active galactic nuclei (AGN). We present our prelimary results from our analysis of mid-infrared Spitzer/IRS spectra of 102 12um Seyferts (that is 86 % of the 12um Seyfert sample) which have been observed by various Spitzer programs and are available in the Spitzer archive. A number of mid-infared diagnostics have been developed to study the nature of nuclear dust enshrouded emission from AGNs, in order to disentangle the starburst-AGN connection. Since PAH emission is a tracer of star formation activity we have measured the 11.3um PAH feature for our Seyfert sample. We find that as the strength of the radiation field in AGNs increases the PAH molecules are destroyed, while the PAH EWs increase with the IRAS f60/f25 ratios of the host galaxies. We further probe this warm/cold color diagnostic, by contrasting our findings with those of we starbust galaxies, ULIRGs, as well as blue compact dwarf galaxies.

  20. Time of flight MR angiography assessment casts doubt on the association between transient global amnesia and intracranial jugular venous reflux.

    PubMed

    Kang, Yeonah; Kim, Eunhee; Kim, Jae Hyoung; Choi, Byung Se; Jung, Cheolkyu; Bae, Yun Jung; Lee, Kyung Mi; Lee, Dong Hoon

    2015-03-01

    Evidence of intracranial venous reflux flow due to jugular venous reflux (JVR) on time of flight (TOF) MR angiography (MRA) is thought to be highly associated with transient global amnesia (TGA)-evidence that supports the venous congestion theory of TGA pathophysiology. However, recent studies indicate that intracranial JVR on TOF MRA is occasionally observed in normal elderly. Therefore, the purpose of this study was to compare the prevalence of intracranial JVR on TOF MRA in patients with TGA and two control groups. Three age- and sex-matched groups of subjects that received MRI and MRA were enrolled. The groups comprised 167 patients with TGA, 167 visitors to the emergency room (ER) and 167 visitors to a health promotion centre (HPC). Intracranial JVR was defined as abnormal venous signals in the inferior petrosal, sigmoid and/or transverse sinuses on TOF MRA. The prevalence of intracranial JVR was assessed across the three groups. Intracranial JVR was seen in seven (4.2 %) TGA patients, eight (4.8 %) ER visitors and three (1.8 %) HPC visitors, respectively. No statistically significant differences were observed among the three groups. TGA patients showed a low prevalence of intracranial JVR on TOF MRA, and no statistical differences were found in comparison with control groups.

  1. Success Rate and Complications of Internal Jugular Vein Catheterization With and Without Ultrasonography Guide

    PubMed Central

    Karimi-Sari, Hamidreza; Faraji, Mehrdad; Mohazzab Torabi, Saman; Asjodi, Gholamreza

    2014-01-01

    Background: Central venous catheterization (CVC) is an important procedure in emergency departments (EDs). Despite existence of ultrasonography (US) devices in every ED, CVC is done using anatomical landmarks in many EDs in Iran. Objectives: This study aimed to compare the traditional landmark method vs. US-guided method of CVC placement in terms of complications and success rate. Patients and Methods: In this randomized controlled trial, patients who were candidate for internal jugular vein catheterization, and referred to Baqiyatallah Hospital ED were randomly allocated into US-guided CVC and anatomical landmarks guided CVC groups. Central vein access time, number of attempts, success rate, and complications in each group were evaluated. Mann-Whitney U, chi-square and Fisher exact tests along with Pearson and Spearman correlation coefficients were used to analyze the data. Results: Out of 100 patients, 56 were male and 44 were female. No significant differences were found between the US-guided and traditional landmark methods of CVC insertion in terms of age, gender, BMI, and site of catheter insertion. The mean access time was significantly lower in the US-guided group (37.12 ± 17.33 s vs. 63.42 ± 35.19 s, P < 0.001). The mean number of attempts was also significantly lower in the US-guided group (1.12 ± 0.3 vs. 1.58 ± 0.64 times, P < 0.001). Eighty-eight percent of patients in the US-guided group were catheterized in the first attempt, while 50% of patients in the traditional landmark group were catheterized in the second or more attempts (P < 0.001). The success rate was 100% in the US-guided group, while it was 88% in the landmark group (P = 0.013). Moreover, the rate of complications was significantly lower in the US-guided group (4% vs. 24%, P = 0.004). Conclusions: The US-guided method for CVC placement was superior to the traditional landmark method in terms of access time, number of attempts, success rate, and fewer complications. PMID:25741514

  2. Success rate and complications of internal jugular vein catheterization with and without ultrasonography guide.

    PubMed

    Karimi-Sari, Hamidreza; Faraji, Mehrdad; Mohazzab Torabi, Saman; Asjodi, Gholamreza

    2014-12-01

    Central venous catheterization (CVC) is an important procedure in emergency departments (EDs). Despite existence of ultrasonography (US) devices in every ED, CVC is done using anatomical landmarks in many EDs in Iran. This study aimed to compare the traditional landmark method vs. US-guided method of CVC placement in terms of complications and success rate. In this randomized controlled trial, patients who were candidate for internal jugular vein catheterization, and referred to Baqiyatallah Hospital ED were randomly allocated into US-guided CVC and anatomical landmarks guided CVC groups. Central vein access time, number of attempts, success rate, and complications in each group were evaluated. Mann-Whitney U, chi-square and Fisher exact tests along with Pearson and Spearman correlation coefficients were used to analyze the data. Out of 100 patients, 56 were male and 44 were female. No significant differences were found between the US-guided and traditional landmark methods of CVC insertion in terms of age, gender, BMI, and site of catheter insertion. The mean access time was significantly lower in the US-guided group (37.12 ± 17.33 s vs. 63.42 ± 35.19 s, P < 0.001). The mean number of attempts was also significantly lower in the US-guided group (1.12 ± 0.3 vs. 1.58 ± 0.64 times, P < 0.001). Eighty-eight percent of patients in the US-guided group were catheterized in the first attempt, while 50% of patients in the traditional landmark group were catheterized in the second or more attempts (P < 0.001). The success rate was 100% in the US-guided group, while it was 88% in the landmark group (P = 0.013). Moreover, the rate of complications was significantly lower in the US-guided group (4% vs. 24%, P = 0.004). The US-guided method for CVC placement was superior to the traditional landmark method in terms of access time, number of attempts, success rate, and fewer complications.

  3. Kinetics Study on the Effect of NaCl on the CaSO4 Dissolution Behavior

    NASA Astrophysics Data System (ADS)

    Song, Jingyao; Shi, Peiyang; Wang, Yeguang; Jiang, Maofa

    2018-01-01

    The study of the dissolution kinetics of CaSO4 is essential for the control of the dissolution and recrystallization behavior of CaSO4. In this work, the kinetic behavior of CaSO4 dissolved in NaCl solution was investigated by means of conductivity meter. The results show that with the increase of concentration of NaCl, the temperature rise and the time prolonged, the dissolution rate of dihydrate CaSO4 gradually increases, and the dissolved apparent activation energy is gradually decreased. When the NaCl concentration is 1.8%, the dissolution kinetic equation is 1-(1-α) 1/3=5.46*10-4exp (-9147/RT) t; When the NaCl concentration is 3.0%, the dissolution kinetic equation is 1-(1-α) 1/3=2.81×10-4 exp (-6753/RT)t; When the NaCl concentration is 3.6%, the dissolution kinetic equation is 1-(1-α) 1/3=3.07×l0-4exp(-6103/RT)t.

  4. Volume reduction of the jugular foramina in Cavalier King Charles Spaniels with syringomyelia.

    PubMed

    Schmidt, Martin Jürgen; Ondreka, Nele; Sauerbrey, Maren; Volk, Holger Andreas; Rummel, Christoph; Kramer, Martin

    2012-09-06

    Understanding the pathogenesis of the chiari-like malformation in the Cavalier King Charles Spaniel (CKCS) is incomplete, and current hypotheses do not fully explain the development of syringomyelia (SM) in the spinal cords of affected dogs. This study investigates an unconventional pathogenetic theory for the development of cerebrospinal fluid (CSF) pressure waves in the subarachnoid space in CKCS with SM, by analogy with human diseases. In children with achondroplasia the shortening of the skull base can lead to a narrowing of the jugular foramina (JF) between the cranial base synchondroses. This in turn has been reported to cause a congestion of the major venous outflow tracts of the skull and consequently to an increase in the intracranial pressure (ICP). Amongst brachycephalic dog breeds the CKCS has been identified as having an extremely short and wide braincase. A stenosis of the JF and a consequential vascular compromise in this opening could contribute to venous hypertension, raising ICP and causing CSF jets in the spinal subarachnoid space of the CKCS. In this study, JF volumes in CKCSs with and without SM were compared to assess a possible role of this pathologic mechanism in the development of SM in this breed. Computed tomography (CT) scans of 40 CKCSs > 4 years of age were used to create three-dimensional (3D) models of the skull and the JF. Weight matched groups (7-10 kg) of 20 CKCSs with SM and 20 CKCSs without SM were compared. CKCSs without SM presented significantly larger JF -volumes (median left JF: 0.0633 cm3; median right JF: 0.0703 cm3; p < 0.0001) when compared with CKCSs with SM (median left JF: 0.0382 cm3; median right JF: 0.0434 cm3; p < 0.0001). There was no significant difference between the left and right JF within each group. Bland-Altman analysis revealed excellent reproducibility of all volume measurements. A stenosis of the JF and consecutive venous congestion may explain the aetiology of CSF pressure waves in the subarachnoid

  5. Volume reduction of the jugular foramina in Cavalier King Charles Spaniels with syringomyelia

    PubMed Central

    2012-01-01

    Background Understanding the pathogenesis of the chiari-like malformation in the Cavalier King Charles Spaniel (CKCS) is incomplete, and current hypotheses do not fully explain the development of syringomyelia (SM) in the spinal cords of affected dogs. This study investigates an unconventional pathogenetic theory for the development of cerebrospinal fluid (CSF) pressure waves in the subarachnoid space in CKCS with SM, by analogy with human diseases. In children with achondroplasia the shortening of the skull base can lead to a narrowing of the jugular foramina (JF) between the cranial base synchondroses. This in turn has been reported to cause a congestion of the major venous outflow tracts of the skull and consequently to an increase in the intracranial pressure (ICP). Amongst brachycephalic dog breeds the CKCS has been identified as having an extremely short and wide braincase. A stenosis of the JF and a consequential vascular compromise in this opening could contribute to venous hypertension, raising ICP and causing CSF jets in the spinal subarachnoid space of the CKCS. In this study, JF volumes in CKCSs with and without SM were compared to assess a possible role of this pathologic mechanism in the development of SM in this breed. Results Computed tomography (CT) scans of 40 CKCSs > 4 years of age were used to create three-dimensional (3D) models of the skull and the JF. Weight matched groups (7–10 kg) of 20 CKCSs with SM and 20 CKCSs without SM were compared. CKCSs without SM presented significantly larger JF -volumes (median left JF: 0.0633 cm3; median right JF: 0.0703 cm3; p < 0.0001) when compared with CKCSs with SM (median left JF: 0.0382 cm3; median right JF: 0.0434 cm3; p < 0.0001). There was no significant difference between the left and right JF within each group. Bland-Altman analysis revealed excellent reproducibility of all volume measurements. Conclusion A stenosis of the JF and consecutive venous congestion may explain the aetiology of CSF

  6. Nanophosphor CaSO4:Eu2+ for photoluminescence liquid crystal display (PLLCD)

    NASA Astrophysics Data System (ADS)

    Patle, Anita; Patil, R. R.; Moharil, S. V.

    2018-05-01

    In this work PL enhancement of CaSO4:Eu2+ nanophosphor which was synthesized with 0.01M molarity by co-precipitation method is presented. Synthesized phosphor was characterized by XRD, SEM, TEM and PL measurements. Average particle size is found to be in the range 80-100nm with Hexagonal morphology and PL studies showed emission peaks at 380nm, when samples were excited by 254nm. The observed PL emission is characteristic emission of Eu2+ similar to that observed in bulk CaSO4:Eu2. However under identical condition it is observed that intensity of emission get enhanced for 0.01M size which is doubled to that of 0.1M with similar emission at 380nm. A phosphor with narrow emission band around 390 nm is desirable, since at this wavelength the transmission of standard glass, polarizing plastic, other coating and LCD material is at acceptable level. Strong Eu2+ emission is observed in CaSO4:Eu nanophosphor which finds applications for PLLCD (photoluminescent liquid crystal display).

  7. The Contegra bovine valved jugular vein conduit for pediatric RVOT reconstruction: 4 years experience with 108 patients.

    PubMed

    Breymann, Thomas; Boethig, Dietmar; Goerg, Reiner; Thies, Wolf-Rüdiger

    2004-01-01

    Porcine xenografts for pediatric right ventricular outflow tractus (RVOT) reconstruction lack durability, homografts lack availability. The Contegra is a valve bearing bovine jugular vein. It is tear resistant, well pliable, and permits RVOT reconstruction without further foreign material. The 108 Contegras implanted in Bad Oeynhausen from May 1999 until January 2003 represent the largest single-center Contegra experience. The study gives the preliminary results from a controlled prospective multicenter trial aiming at FDA admission. The patients' diagnoses were truncus arteriosus (27%), double outlet right ventricle (14%), tetralogy of Fallot (48%), transposition of great arteries (6%), rare complex malformation (2%), and Ross procedure (1%). Fifty-eight were female. Age: 2 days to 20.1 years, mean: 4.3 +/- 5.2, median: 1.8 years. Thirty-three had primary implantations, 38 previous repairs, 37 conduit exchange. Total follow-up time: 227.7 years, mean: 2.1. About 848 echos were evaluated. Early mortality: 7.4% (8 patients); 1 late death. None was Contegra-related. Echocardiographic controls showed no relevant average valvular gradient development. Trace and mild-grade insufficiency is frequent, without tendency to increase. Average insufficiency is between trace and mild unless RV pressure remains under 100 mmHg. Average individual right/left ventricle length ratios did not increase over time. We saw no relevant conduit dilatation and no leaflet calcification. Pulmonary artery stenoses had mainly extrinsic reasons. At 4 years, freedom- from- event rates were: reoperation for Conduit inflow or valvular degeneration: 100%; reoperation for pulmonary artery branch stenoses (n = 10) 86%, explantation (n = 4): 92%. Survival: 91.7%. Contegra is worth being considered as an alternative to homografts.

  8. Jugular bulb oxygen saturation correlates with Full Outline of Responsiveness score in severe traumatic brain injury patients

    PubMed Central

    Senapathi, Tjokorda Gde Agung; Wiryana, Made; Sinardja, Ketut; Nada, Ketut Wibawa; Sutawan, Ida Bagus Krisna Jaya; Ryalino, Christopher; Alphonso, Aloysius

    2017-01-01

    Background Maintaining brain oxygenation status is the main goal of treatment in severe traumatic brain injury (TBI). Jugular venous oxygen saturation (SjvO2) monitoring is a technique to estimate global balance between cerebral oxygen supply and its metabolic requirement. Full Outline of Responsiveness (FOUR) score, a new consciousness measurement scoring, is expected to become an alternative for Glasgow Coma Scale (GCS) in evaluating neurologic status of patients with severe traumatic head injury, especially for those under mechanical ventilation. Methods A total of 63 patients with severe TBI admitted to emergency department (ED) were included in this study. SjvO2 sampling was taken every 24 hours, until 72 hours after arrival. The assessment of FOUR score was conducted directly after each blood sample for SjvO2 was taken. Spearman’s rank correlation was used to determine the correlation between SjvO2 and FOUR score. Regression analysis was used to determine mortality predictors. Results From the 63 patients, a weak positive correlation between SjvO2 and FOUR score (r=0.246, p=0.052) was found upon admission. Meanwhile, strong and moderate negative correlation values were found in 48 hours (r=−0.751, p<0.001) and 72 hours (r=−0.49, p=0.002) after admission. Both FOUR score (p<0.001) and SjvO2 (p=0.04) were found to be independent mortality predictors in severe TBI. Conclusion There was a negative correlation between the value of SjvO2 and FOUR score at 48 and 72 hours after admission. Both SjvO2 and FOUR score are independent mortality predictors in severe TBI. PMID:28919828

  9. "Uh" and "Um" Revisited: Are They Interjections for Signaling Delay?

    ERIC Educational Resources Information Center

    O'Connell, Daniel C.; Kowal, Sabine

    2005-01-01

    Clark and Fox Tree (2002) have presented empirical evidence, based primarily on the London-Lund corpus (LL; Svartvik & Quirk, 1980), that the fillers "uh" and "um" are conventional English words that signal a speaker's intention to initiate a minor and a major delay, respectively. We present here empirical analyses of "uh" and "um" and of silent…

  10. Effects of four different positive airway pressures on right internal jugular vein catheterisation.

    PubMed

    Zhou, Qinghe; Xiao, Wangpin; An, Erdan; Zhou, Hongmei; Yan, Min

    2012-05-01

    The right internal jugular vein (RIJV) is often used for central venous catheterisation in patients undergoing major surgery. The efficacy of this route correlates with the diameter of the vein which can be influenced by airway pressure. To investigate four positive airway pressures (PAPs) in mechanically ventilated patients and to determine the most suitable of these for RIJV catheterisation. Prospective, randomised, controlled study. Two Chinese medical centres. Two hundred and forty patients scheduled for gastrointestinal tract surgery under general anaesthesia (male-to-female ratio, 135 : 105; American Society of Anesthesiologists' physical status class, I-III; age range, 19-81 years); patients were excluded from the study if they had a history of haematological disease, external neck injury, RIJV catheterisation, severe cardiovascular disease, RIJV thrombosis, injection-site infection, pneumothorax and pulmonary bulla. They were randomised into four groups of 60, each to undergo RIJV catheterisation at a PAP of 0 (1 cmH2O = 0.098 kPa, group A); 15 (group B); 20 (group C); and 25 cmH2O (group D). Primary outcomes were central venous pressure (CVP) and RIJV cross-sectional area which were measured before and during PAP; the number of catheterisations completed in 30 s; the number of first pass punctures; heart rate and mean arterial pressure which were monitored continuously; and the incidence of complications which included local haematoma, pneumothorax and internal carotid artery (ICA) puncture. Two patients were excluded following ICA puncture, leaving 238 for analysis. In groups C and D, the CVP and the cross-sectional area of RIJV were significantly larger; the number completing catheterisation within 30 s and the number of first pass punctures increased significantly and was comparable between these two groups. Compared with groups A and B, the incidences of hypotension and bradycardia were significantly increased in groups C and D. The incidence of local

  11. An alternative method for immediate dose estimation using CaSO4:Dy based TLD badges

    NASA Astrophysics Data System (ADS)

    Singh, A. K.; Menon, S. N.; Dhabekar, Bhushan; Kadam, Sonal; Chougaonkar, M. P.; Babu, D. A. R.

    2014-11-01

    CaSO4:Dy based Thermoluminescence dosimeters (TLDs) are being used in country wide personnel monitoring program in India. The TL glow curve of CaSO4:Dy consists of a dosimetric peak at 220 °C and a low temperature peak at 120 °C which is unstable at room temperature. The TL integral counts in CaSO4:Dy reduces by 15% in seven days after irradiation due to the thermal fading of 120 °C TL peak. As the dosimetric procedure involves total integrated counts for dose conversion, the dosimeters are typically read about a week after receiving. However in the event of a suspected over exposure, where urgent processing is expected, this poses limitation. Post irradiation annealing treatment is used in such cases of immediate readout of cards. In this paper we report a new and easier to use technique based on optical bleaching for the urgent processing of TLD cards. Optical bleaching with green LED (∼555 nm photons) of 25,000 lux for one and half hour removes the low temperature TL peak without affecting the dosimetric peak. This method can be used for immediate dose estimation using CaSO4:Dy based TLD badges.

  12. STS-40 Exp. No. 192 urine monitoring system (UMS) on OV-102's middeck

    NASA Technical Reports Server (NTRS)

    1991-01-01

    STS-40 Experiment No. 192, Fluid-Electrolyte Regulation During Space Flight, urine monitoring system (UMS) is set up on the middeck of Columbia, Orbiter Vehicle (OV) 102, at the side hatch. The UMS is attached to OV-102's waste collection system (WCS). The urine specimen tray with sample tubes appears to the right of the UMS equipment.

  13. Long-term follow-up of saphenous vein, internal jugular vein, and knitted Dacron patches for carotid artery endarterectomy.

    PubMed

    Jacobowitz, G R; Kalish, J A; Lee, A M; Adelman, M A; Riles, T S; Landis, R

    2001-05-01

    To determine whether choice of material used for patch closure following carotid artery endarterectomy (CAE) influences rates of early or late restenosis, stroke, and death, 274 consecutive CAEs were retrospectively reviewed. Saphenous vein (SV) was used in 159 (58.0%) procedures; everted, double-thickness jugular vein (JV) was used in 25 (9.1%); and knitted Dacron (KD) was used in 90 (32.9%). Primary closure was not used in this series. There were four perioperative strokes: two (1.3%) in SV, one (4%) in JV, and one (1.1%) in KD (NS). Follow-up was obtained on 263 (96%) operated arteries (mean 41.5 months). Duplex scan results were available for 236 (89.7%) of these arteries (mean follow-up time 33.7 months). There were three (2%) late strokes in SV and two (2.2%) in KD (NS). In long-term follow-up, one patient (0.7%) in SV and two (2.4%) in KD developed > 80% stenosis (NS). One patient (0.7%) in SV, one (5.3%) in JV, and one (1.2%) in KD had total occlusion of the operated vessel (NS). Three procedures (2.2%) in SV, 1 (5.3%) in JV, and 7 (8.5%) in KD demonstrated moderate stenosis (50-79%) (NS). Three-year follow-up shows that choice of patch material does not affect early or late stroke rate, stroke-related death rate, rate of high-grade (> 80%) restenosis, or rate of total occlusion. There is a higher incidence of moderate stenosis in KD. Although our results and a review of the literature do not indicate that these patients are at increased risk for symptoms or progression of stenosis, they should be followed by duplex scanning to ensure that this is the case.

  14. High Frequency GaAs Bulk Acousto-Optic Devices For Modulators And Frequency Shifters At 1.3um And 1.5um In Fiber-Optics

    NASA Astrophysics Data System (ADS)

    Soos, J. I.; Rosemeier, R. G.

    1989-02-01

    The edge of a transmission window for a GaAs Bragg cell starts about lum, which allows this material to be used for infrared fiber-optic applications, especially at 1.3um and 1.5um. The single crystal of GaAs is acoustically anisotropic and has the highest figure of merit, M2, along <111> direction for a longitudinal mode sound wave. Recently, Brimrose has designed and fabricated an acousto-optic modulator from GaAs operating at a carrier frequency of 2.3 GHz with a diffraction efficiency of 4%/RF watt.

  15. X-ray absorption spectroscopy and X-ray photoelectron spectroscopy studies of CaSO 4:Dy thermoluminescent phosphors

    NASA Astrophysics Data System (ADS)

    Bakshi, A. K.; Jha, S. N.; Olivi, L.; Phase, D. M.; Kher, R. K.; Bhattacharyya, D.

    2007-11-01

    Extended X-ray absorption fine structure (EXAFS) measurements have been carried out on CaSO4:Dy phosphor samples at the Dy L3 edge with synchrotron radiation. Measurements were carried out on a set of samples which were subjected to post-preparation annealing at different temperatures and for different cycles. The EXAFS data have been analysed to find the Dy-S and Dy-O bond lengths in the neighbourhood of the Dy atoms in a CaSO4 matrix. The observations from EXAFS measurements were verified with XANES and XPS techniques. On the basis of these measurements, efforts were made to explain the loss of thermoluminescence sensitivity of CaSO4:Dy phosphors after repeated cycles of annealing at 400 °C in air for 1 h.

  16. Meningiomas del foramen magno: Reporte de 12 casos y revisión de la literatura

    PubMed Central

    Campero, Álvaro; Ajler, Pablo; Roman, Guillermo; Rivadeneira, Conrado

    2017-01-01

    Resumen Objetivo: El propósito del presente trabajo es presentar los resultados de 12 pacientes con diagnóstico de meningiomas del foramen magno (MFM), de localización anterior o lateral, operados con técnicas microquirúrgicas. Método: Desde Junio de 2005 a Diciembre de 2016, 12 pacientes con diagnóstico de MFM fueron intervenidos quirúrgicamente. Se evaluó: edad, sexo, localización de la lesión (anterior o lateral), sintomatología, tipo de abordaje utilizado y resultados postoperatorios. Resultados: De los pacientes intervenidos, 8 fueron mujeres y 4 varones. La edad promedio fue de 47 años. La localización fue anterior en 8 casos y lateral en 4 casos. La sintomatología más frecuente fue dolor occipito-cervical (8 casos), seguido de tetraparesia (3 casos). En los pacientes con MFM de localización anterior se realizó un abordaje extremo-lateral transcondilar (ELTC), mientras que en los tumores laterales el abordaje fue extremo-lateral retrocondilar (ELRC). En 10 casos la resección fue completa. En dos pacientes fue necesario dejar una pequeña lámina de meningioma sobre la arteria vertebral y a nivel del foramen yugular. Como complicaciones postoperatorias, 3 pacientes presentaron una paresia del XII nervio craneano y 2 pacientes paresia del XI nervio craneano; además, 1 paciente presentó una fístula de LCR. Conclusión: La cirugía de los MFM de localización anterior y lateral puede ser realizada de forma segura y efectiva. Es necesario: a) buen conocimiento anatómico de la región; b) disecar los músculos de la nuca en 2 planos, exponiendo el triángulo suboccipital y la arteria vertebral (AV); 3) realizar un abordaje ELRC en los tumores laterales, y ELTC en los tumores anteriores; y 4) buena técnica microquirúrgica. PMID:29142778

  17. Unit 5, STA. 50+00+RB, Orner Building, First U.M. Church Rectory, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Unit 5, STA. 50+00+RB, Orner Building, First U.M. Church Rectory, & First U.M. Church-context - Johnstown Local Flood Protection Project, Beginning on Conemaugh River approx 3.8 miles downstream from confluence of Little Conemaugh & Stony Creek Rivers at Johnstown, Johnstown, Cambria County, PA

  18. Numerical simulation of calcium sulfate (CaSO4) fouling in the plate heat exchanger

    NASA Astrophysics Data System (ADS)

    Xu, Zhiming; Zhao, Yu; Han, Zhimin; Wang, Jingtao

    2018-07-01

    Plate heat exchanger is a widely used apparatus in the industrial production processes. Through a numerical simulation method, this paper calculates the deposition rate of CaSO4 fouling on heat transfer surfaces of the plate heat exchanger under saturation in the bulk. The effects of CaSO4 concentration in the range 0.7 kg/m3 to 1.5 kg/m3, inlet flow velocity under turbulent flow, and the fluid's inlet temperature from 288 K to 328 K on the deposition rate, removal mass rate and fouling resistance are investigated. The simulation results are compared with the experimental results showing similar trend. The simulation results show that the concentration and the flow velocity affect significantly the fouling characteristics in the plate heat exchanger. The deposition mass rate, removal mass rate, and asymptotic value of fouling resistance all increase with the increase in CaSO4 concentration and the inlet temperature of the hot fluid, while the asymptotic value of fouling resistance decreases with the increasing of inlet flow velocity. The influence of the inlet temperature of cold fluid may be negligible.

  19. UM-PRS: An implementation of the procedural reasoning system for multirobot applications

    NASA Technical Reports Server (NTRS)

    Lee, Jaeho; Huber, Marcus J.; Durfee, Edmund H.; Kenny, Patrick G.

    1994-01-01

    The Procedural Reasoning System (PRS) is used in applications where predetermined situations might arise. The UM-PRS provides a reasoning system that represents robotic applications even in unpredictable domains, such as the robotic reconnaissance task domain outlined here. UM-PRS incorporates a changing context, rather than relying solely on a prearranged plan. The UM-PRS here provides representation important in the reasoning and interface between a mission plan and the executable map of an outdoor vehicle that changes its behavior based on what it comes in contact with in its environment. PRS is thus used in the dynamic control of such a vehicle, providing the basis for coordinating the joint task of multiple robotic vehicles by the their individual observations and representation.

  20. [Mesenteric-cava shunt's results with autologous jugular vein graft in children with pre-sinusoidal portal hypertension].

    PubMed

    Leal, N; López Santamaría, M; Gámez, M; Murcia, J; Andolfi, G; Berrocal, T; Frauca, E; Jara, P; Tovar, J

    2002-07-01

    Presinusoidal portal hypertension (PPH) in children evaluates without functional hepatic damage, and with the time, trends to compensate through the creation of spontaneous portosystemic shunts. Nevertheless, some patients suffer episodes of gastrointestinal bleeding (GIB) that because of its frequency or severity, force to propose the change of surgical treatment. To evaluate the results of the mesocaval shunt (MCS) with autologous jugular vein in children with PPH. Among the 32 children with PPH treated in our Hospital in the last 7 years, 10 had episodes of GIB that forced to perform a surgical shunt. The types of shunt were distal splenorenal in 3 patients and mesocaval in 7. These 7 cases are the material of this study. The origin of the PPH was a cavernomatosis transformation of the portal vein in 6 cases and a congenital hepatic fibrosis in 1. Before the surgery the average number of episodes of GIB was 9 (range 2-15); all the patients needed transfusion of blood products and variceal sclerosis. In 2 cases a tamponade with the Sengtaken balloon was required and 5 patients were treated with somatostatin and propranolol. The Doppler ultrasounds revealed and intense hepatofugal collateral circulation in all the cases. The initial flow through the shunt was adequate in all the patients except one who required a percutaneous balloon dilatation. Only this patient has suffered an episode of GIB. The hyperesplenism signs disappeared or improved in all the seven cases and the collateral circulation was significantly reduced. The pressure in the splenic territory decreased around 50% in the 4 patients that was measured. There were no cases of encephalopasty and only one child with congenital hepatic fibrosis shows signs of mild hepatic disfunction. The medium follow up post-shunt is 32 months (range 8 m-6 years). The MCS prevents the GIB in the PPH not responsive to the conservative treatment; its effectiveness is related with an adequate permeability though the graft

  1. VizieR Online Data Catalog: Draco nebula Herschel 250um map (Miville-Deschenes+, 2017)

    NASA Astrophysics Data System (ADS)

    Miville-Deschenes, M.-A.; Salome, Q.; Martin, P. G.; Joncas, G.; Blagrave, K.; Dassas, K.; Abergel, A.; Beelen, A.; Boulanger, F.; Lagache, G.; Lockman, F. J.; Marshall, D. J.

    2017-03-01

    Draco was observed with Herschel PACS (110 and 170um) and SPIRE (250, 350 and 500um) as part of the open-time program "First steps toward star formation: unveiling the atomic to molecular transition in the diffuse interstellar medium" (P.I. M-A Miville-Deschenes). A field of 3.85x3.85 was observed in parallel mode. Unfortunately, an error occurred during the acquisition of the PACS data making them unusable. Therefore, the results presented here are solely based on SPIRE data, especially the 250um map that has the highest angular resolution. (2 data files).

  2. Ultramicronized palmitoylethanolamide (PEA-um(®)) in the treatment of idiopathic pulmonary fibrosis.

    PubMed

    Di Paola, Rosanna; Impellizzeri, Daniela; Fusco, Roberta; Cordaro, Marika; Siracusa, Rosalba; Crupi, Rosalia; Esposito, Emanuela; Cuzzocrea, Salvatore

    2016-09-01

    Pulmonary fibrosis is a chronic condition characterized by progressive scarring of lung parenchyma. The aim of this study was to examine the effects of an ultramicronized preparation of palmitoylethanolamide (PEA-um(®)), an endogenous fatty acid amide, in mice subjected to idiopathic pulmonary fibrosis. Idiopathic pulmonary fibrosis was induced in male mice by a single intratracheal administration of saline with bleomycin sulphate (1mg/kg body weight) in a volume of 100μL. PEA-um(®) was injected intraperitoneally at 1, 3 or 10mg/kg 1h after bleomycin instillation and daily thereafter. Animals were sacrificed after 7 and 21days by pentobarbitone overdose. One cohort of mice was sacrificed after seven days of bleomycin administration, followed by bronchoalveloar lavage and determination of myeloperoxidase activity, lung edema and histopathology features. In the 21-day cohort, mortality was assessed daily, and surviving mice were sacrificed followed by the above analyses together with immunohistochemical localization of CD8, tumor necrosis factor-α, CD4, interleukin-1β, transforming growth factor-β, inducible nitric oxide synthase and basic fibroblast growth factor. Compared to bleomycin-treated mice, animals that received also PEA-um(®) (3 or 10mg/kg) had significantly decreased weight loss, mortality, inflammation, lung damage at the histological level, and lung fibrosis at 7 and 21days. PEA-um(®) (1mg/kg) did not significantly inhibit the inflammation response and lung fibrosis. This study demonstrates that PEA-um(®) (3 and 10mg/kg) reduces the extent of lung inflammation in a mouse model of idiopathic pulmonary fibrosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Human cerebral venous outflow pathway depends on posture and central venous pressure

    PubMed Central

    Gisolf, J; van Lieshout, J J; van Heusden, K; Pott, F; Stok, W J; Karemaker, J M

    2004-01-01

    Internal jugular veins are the major cerebral venous outflow pathway in supine humans. In upright humans the positioning of these veins above heart level causes them to collapse. An alternative cerebral outflow pathway is the vertebral venous plexus. We set out to determine the effect of posture and central venous pressure (CVP) on the distribution of cerebral outflow over the internal jugular veins and the vertebral plexus, using a mathematical model. Input to the model was a data set of beat-to-beat cerebral blood flow velocity and CVP measurements in 10 healthy subjects, during baseline rest and a Valsalva manoeuvre in the supine and standing position. The model, consisting of 2 jugular veins, each a chain of 10 units containing nonlinear resistances and capacitors, and a vertebral plexus containing a resistance, showed blood flow mainly through the internal jugular veins in the supine position, but mainly through the vertebral plexus in the upright position. A Valsalva manoeuvre while standing completely re-opened the jugular veins. Results of ultrasound imaging of the right internal jugular vein cross-sectional area at the level of the laryngeal prominence in six healthy subjects, before and during a Valsalva manoeuvre in both body positions, correlate highly with model simulation of the jugular cross-sectional area (R2 = 0.97). The results suggest that the cerebral venous flow distribution depends on posture and CVP: in supine humans the internal jugular veins are the primary pathway. The internal jugular veins are collapsed in the standing position and blood is shunted to an alternative venous pathway, but a marked increase in CVP while standing completely re-opens the jugular veins. PMID:15284348

  4. Phase relation of CaSO4 at high pressure and temperature up to 90 GPa and 2300 K

    NASA Astrophysics Data System (ADS)

    Fujii, Taku; Ohfuji, Hiroaki; Inoue, Toru

    2016-05-01

    Calcium sulfate (CaSO4), one of the major sulfate minerals in the Earth's crust, is expected to play a major role in sulfur recycling into the deep mantle. Here, we investigated the crystal structure and phase relation of CaSO4 up to ~90 GPa and 2300 K through a series of high-pressure experiments combined with in situ X-ray diffraction. CaSO4 forms three thermodynamically stable polymorphs: anhydrite (stable below 3 GPa), monazite-type phase (stable between 3 and ~13 GPa) and barite-type phase (stable up to at least 93 GPa). Anhydrite to monazite-type phase transition is induced by pressure even at room temperature, while monazite- to barite-type transition requires heating at least to 1500 K at ~20 GPa. The barite-type phase cannot always be quenched from high temperature and is distorted to metastable AgMnO4-type structure or another modified barite structure depending on pressure. We obtained the pressure-volume data and density of anhydrite, monazite- and barite-type phases and found that their densities are lower than those calculated from the PREM model in the studied P-T conditions. This suggests that CaSO4 is gravitationally unstable in the mantle and fluid/melt phase into which sulfur dissolves and/or sulfate-sulfide speciation may play a major role in the sulfur recycling into the deep Earth.

  5. A Systematic Review of Infective Endocarditis in Patients With Bovine Jugular Vein Valves Compared With Other Valve Types.

    PubMed

    Sharma, Ashutosh; Cote, Anita T; Hosking, Martin C K; Harris, Kevin C

    2017-07-24

    The aim of this study was to systematically evaluate the incidence of infective endocarditis (IE) in right ventricle-to-pulmonary artery conduits and valves, comparing bovine jugular vein (BJV) valves with all others. Recent evidence suggests that the incidence of IE is higher in patients with congenital heart disease who have undergone implantation of BJV valves in the pulmonary position compared with other valves. Systematic searches of published research were conducted using electronic databases (MEDLINE, Embase, and CINAHL) and citations cross-referenced current to April 2016. Included studies met the following criteria: patients had undergone right ventricle-to-pulmonary artery conduit or percutaneous pulmonary valve implantation, and investigators reported on the type of conduit or valve implanted, method of intervention (surgery or catheter based), IE incidence, and follow-up time. Fifty studies (Levels of Evidence: 2 to 4) were identified involving 7,063 patients. The median cumulative incidence of IE was higher for BJV compared with other valves (5.4% vs. 1.2%; p < 0.0001) during a median follow-up period of 24.0 and 35.5 months, respectively (p = 0.03). For patients with BJV valves, the incidence of IE was not different between surgical and catheter-based valve implantation (p = 0.83). There was a higher incidence of endocarditis with BJV valves than other types of right ventricle-to-pulmonary artery conduits. There was no difference in the incidence of endocarditis between catheter-based bovine valves and surgically implanted bovine valves, suggesting that the substrate for future infection is related to the tissue rather than the method of implantation. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. Right hepatic artery aneurysm.

    PubMed

    Bernal, Astrid Del Pilar Ardila; Loures, Paulo; Calle, Juan Cristóbal Ospina; Cunha, Beatriz; Córdoba, Juan Camilo

    2016-01-01

    We report a case of an aneurysm of the right hepatic artery and its multidisciplinary management by general surgery, endoscopy and radiology services. Being a case of extremely low incidence, it is important to show its diagnostic and therapeutic approach. RESUMO Relatamos um caso de aneurisma da artéria hepática direita conduzido de forma multidisciplinar pelos Serviços de Cirurgia Geral, Endoscopia e Radiologia. Em se tratando de caso de incidência baixíssima, é importante mostrar o enfoque diagnóstico e terapêutico usado em seu manejo.

  7. Thermoluminescence (TL) properties and x-ray diffraction (XRD) analysis of high purity CaSO4:Dy TL material

    NASA Astrophysics Data System (ADS)

    Kamarudin, Nadira; Abdullah, Wan Saffiey Wan; Hamid, Muhammad Azmi Abdul; Dollah, Mohd Taufik

    2014-09-01

    This paper presents the characterization and TL properties of dysprosium (Dy) doped calcium sulfate (CaSO4) TL material produced by co-precipitation technique with 0.5mol% concentration of dopant. The morphology of the produced TL material was studied using scanning electron microscope (SEM) and the micrograph shows that rectangular parallelepiped shaped crystal with the average of 150 μm in length were produced. The crystallinity of the produced powder was studied using x-ray powder diffraction (XRD). The XRD spectra show that the TL material produced is high purity anhydrite CaSO4 with average crystallite size of 74 nm with orthorhombic crystal system. The TL behavior of produced CaSO4:Dy was studied using a TLD reader after exposure to gamma ray by Co60 source with the doses of 1,5 and 10 Gy. The glow curve shows linear response with glow peak around 230°C which is desired development in the field of radiation dosimetry.

  8. Insights into water-mediated ion clustering in aqueous CaSO4 solutions: pre-nucleation cluster characteristics studied by ab initio calculations and molecular dynamics simulations.

    PubMed

    Li, Hui-Ji; Yan, Dan; Cai, Hou-Qin; Yi, Hai-Bo; Min, Xiao-Bo; Xia, Fei-Fei

    2017-05-10

    The molecular structure of growth units building crystals is a fundamental issue in the crystallization processes from aqueous solutions. In this work, a systematic investigation of pre-nucleation clusters and their hydration characteristics in aqueous CaSO 4 solutions was performed using ab initio calculations and molecular dynamics (MD) simulations. The results of ab initio calculations and MD simulations indicate that the dominant species in aqueous CaSO 4 solutions are monodentate ion-associated structures. Compared with charged ion clusters, neutral clusters are more likely to be present in an aqueous CaSO 4 solution. Neutral (CaSO 4 ) m clusters are probably the growth units involved in the pre-nucleation or crystallization processes. Meanwhile, hydration behavior around ion associated species in aqueous CaSO 4 solutions plays an important role in related phase/polymorphism selections. Upon ion clustering, the residence of some water molecules around Ca 2+ in ion-associated species is weakened while that of some bridging waters is enhanced due to dual interaction by Ca 2+ and SO 4 2- . Some phase/polymorphism selections can be achieved in aqueous CaSO 4 solutions by controlling the hydration around pre-nucleation clusters. Moreover, the association trend between calcium and sulfate is found to be relatively strong, which hints at the low solubility of calcium sulfate in water.

  9. Nano-fibrin stabilized CaSO4 crystals incorporated injectable chitin composite hydrogel for enhanced angiogenesis & osteogenesis.

    PubMed

    Arun Kumar, R; Sivashanmugam, A; Deepthi, S; Bumgardner, Joel D; Nair, Shantikumar V; Jayakumar, R

    2016-04-20

    Calcium sulfate (CaSO4), an excellent biodegradable bone forming agent that is an ideal choice as additive in gels, however, its disadvantage being poor gel rheology and angiogenesis. Here, we have synthesized chitin-CaSO4-nano-fibrin based injectable gel system which shows improved rheology and angiogenic potential. Rheological studies showed that the composite gel was a shear thinning gel with elastic modulus of 15.4±0.275kPa; a 1.67 fold increase over chitin control. SEM and XRD analyses revealed the effect of nano-fibrin (nFibrin) in transforming CaSO4 crystal shape from needle to hexagonal. It also masked the retarding effect of CaSO4 towards in vitro early cell attachment and angiogenesis using rabbit adipose derived mesenchymal stem cells (rASCs) and HUVECs, respectively. rASCs osteogenesis was confirmed by spectrophotometric endpoint assay, which showed 6-fold early increase in alkaline phosphatase levels and immuno-cytochemistry analysis. These in vitro results highlight the potential of injectable chitin-CaSO4-nFibrin gel for osteo-regeneration via enhanced angiogenesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Assessment of novel maleic anhydride copolymers prepared via nitroxide-mediated radical polymerization as CaSO4 crystal growth inhibitors.

    PubMed

    Al-Roomi, Yousef Mohammad; Hussain, Kaneez Fatema

    2017-04-01

    Calcium sulfate is one of the dominant scales which, unlike carbonate scale, are not easily removable by acid. To inhibit CaSO 4 scale formation in artificial cooling water systems, well-defined low molecular weight maleic anhydride and n-alkylacrylamide copolymers (YMR-S series) were synthesized via nitroxide-mediated radical polymerization initiated by benzoyl peroxide in the presence of 2,2,6,6-tetramethyl-1-piperidinyloxy at varying concentrations. These polymerizations exhibit living polymerization characteristics; that is, they show linear growth in chain length as a function of monomer conversion, and have narrow molecular weight distributions. Resultant polymers were characterized by means of 1 H-NMR and 13 C-NMR. The inhibition behavior of these YMR-S series polymers against CaSO 4 was evaluated using the static scale inhibition method and a dynamic tube block test. The inhibition ability on the CaSO 4 scale is 99.5% with 9 ppm dosage level at pH 10.45 and temperature 70°C. Scanning electronic microscope analysis proved the morphological changes of the CaSO 4 scales due to the strong inhibition action of YMR-S polymers. It is also observed that the antiscaling effect of the copolymers greatly depends on the molecular weight, and the optimum range is below 20,000 and approximately in the range 500-2000.

  11. VizieR Online Data Catalog: 24um excesses in clusters & membership of NGC2244 (Meng+, 2017)

    NASA Astrophysics Data System (ADS)

    Meng, H. Y. A.; Rieke, G. H.; Su, K. Y. L.; Gaspar, A.

    2017-09-01

    We re-measured the Spitzer/MIPS 24um photometry for all the clusters except for a few noted in Appendix A. We obtained the 24um data from the Spitzer Heritage Archive between 2004 Jan 28 and 2008 Oct 23. (3 data files).

  12. CT venography: use in selecting a surgical approach for the treatment of petrous apex cholesterol granulomas.

    PubMed

    Isaacson, Brandon; Kutz, Joe Walter; Mendelsohn, Dianne; Roland, Peter S

    2009-04-01

    To demonstrate the use of computed tomographic (CT) venography in selecting a surgical approach for cholesterol granulomas. Retrospective case review. Tertiary referral center. Three patients presented with symptomatic petrous apex cholesterol granulomas with extensive bone erosion involving the jugular fossa. Computed tomographic venography was performed on each patient before selecting a surgical approach for drainage. Localization of the jugular bulb in relation to the petrous carotid artery and basal turn of the cochlea was ascertained in each subject. Three patients with large symptomatic cholesterol granulomas were identified. Conventional CT demonstrated extensive bone erosion involving the jugular fossa in each patient. The location of the jugular bulb and its proximity to the petrous carotid artery and basal turn of the cochlea could not be determined with conventional temporal bone CT and magnetic resonance imaging. Computed tomographic venography provided the exact location of the jugular bulb in all 3 patients. The favorable position of the jugular bulb in all 3 cases permitted drainage of these lesions using an infracochlear approach. Computed tomographic venography provided invaluable information in 3 patients with large symptomatic cholesterol granulomas. All 3 patients were previously thought to be unsuitable candidates for an infracochlear or infralabyrinthine approach because of the unknown location of the jugular bulb.

  13. Protective Effects of Ultramicronized Palmitoylethanolamide (PEA-um) in Myocardial Ischaemia and Reperfusion Injury in VIVO.

    PubMed

    Di Paola, Rosanna; Cordaro, Marika; Crupi, Rosalia; Siracusa, Rosalba; Campolo, Michela; Bruschetta, Giuseppe; Fusco, Roberta; Pugliatti, Pietro; Esposito, Emanuela; Cuzzocrea, Salvatore

    2016-08-01

    Myocardial infarction is the leading cause of death, occurs after prolonged ischemia of the coronary arteries. Restore blood flow is the first intervention help against heart attack. However, reperfusion of the arteries leads to ischemia/reperfusion injury (I/R). The fatty acid amide palmitoylethanolamide (PEA) is an endogenous compound widely present in living organisms, with analgesic and anti-inflammatory properties. The present study evaluated the effect of ultramicronized palmitoylethanolamide (PEA-um) treatment on the inflammatory process associated with myocardial I/R. Myocardial ischemia reperfusion injury was induced by occlusion of the left anterior descending coronary artery for 30 min followed by 2 h of reperfusion. PEA-um, was administered (10 mg/kg) 15 min after ischemia and 1 h after reperfusion. In this study, we demonstrated that PEA-um treatment reduces myocardial tissue injury, neutrophil infiltration, adhesion molecules (ICAM-1, P-selectin) expression, proinflammatory cytokines (TNF-α, IL-1β) production, nitrotyrosine and PAR formation, nuclear factor kB expression, and apoptosis (Fas-L, Bcl-2) activation. In addition to study whether the protective effect of PEA-um on myocardial ischemia reperfusion injury is also related to the activation of PPAR-α, in a separate set of experiments it has been performed myocardial I/R in PPARα mice. Genetic ablation of peroxisome proliferator activated receptor (PPAR)-α in PPAR-αKO mice exacerbated Myocardial ischemia reperfusion injury when compared with PPAR-αWT mice. PEA-um induced cardioprotection in PPAR-α wild-type mice, but the same effect cannot be observed in PPAR-αKO mice. Our results have clearly shown a modulation of the inflammatory process, associated with myocardial ischemia reperfusion injury, following administration of PEA-um.

  14. Feasibility of the Use of Transesophageal Echocardiography as a Surface Probe for Puncturing and Catheterization of the Internal Jugular Vein: A Randomized Controlled Pilot Study.

    PubMed

    Teng, Yi; Ou, Mengchan; Yu, Hai

    2018-02-01

    To compare the transesophageal echocardiography (TEE) probe as a surface probe with the vascular probe for guiding internal jugular vein (IJV) catheterization. Prospective, randomized, controlled pilot study. University hospital. One hundred cardiac surgery patients, including 50 adult and 50 pediatric patients. Patients in the TEE probe group received right IJV catheterization using the TEE probe, while the vascular probe group used the vascular probe for catheterization. The puncture time, first-attempt success rate, quality of the imaging with needle tip positioning, wire positioning, and catheter positioning were recorded. The incidence of complication or any adverse event also was observed. Adult patients: In the vascular probe group, the success rate for first attempt IJV catheterization was 24/25 (96%), while in the TEE probe group, the success rate for first attempt IJV catheterization was 25/25 (100%). There was no statistical difference in the puncture time, image quality, needle tip positioning, wire positioning, and catheter positioning between groups (p > 0.05). Pediatric patients: The success rate for first-attempt IJV catheterization was 100% in both groups, and there were no statistical differences in the puncture time, image quality, and positioning between the 2 groups (p > 0.05). No complications or adverse events were observed in either group. The TEE probe, used as a surface probe, can be used to guide IJV puncturing and catheterization in cardiac surgery patients with favorable feasibility and safety. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. VizieR Online Data Catalog: A dust model for bet Pic from 0.58 to 870um (Ballering+, 2016)

    NASA Astrophysics Data System (ADS)

    Ballering, N. P.; Su, K. Y. L.; Rieke, G. H.; Gaspar, A.

    2016-08-01

    β Pic was imaged with the HST/STIS CCD in coronagraphic (50CORON) mode under program GO-12551 (PI: Apai), and the results of these observations were published in Apai et al. (2015ApJ...800..136A). The instrument bandpass is set by the response of the CCD and centered at 0.58um. We searched the HST archive and found previously unpublished observations of β Pic with the WFC3 instrument in the IR channel (filter F110W at ~1.16um) from program GO-11150 (PI: Graham). The Spitzer/MIPS observations of β Pic were taken under the Spitzer Guaranteed Time Observing Program 90 (PI: M. Werner). The data at all three bands (24, 70, and 160um) are published here for the first time. Two sets of 24um observations were obtained. The first set was obtained on 2004 March 20, the second set of data was obtained on 2004 April 11. Two sets of 70um observations were obtained. The first set was obtained on 2004 April 12. The second set was obtained on 2005 April 4. Herschel/PACS 70um scan map observations of β Pic (PI G. Olofsson, observation IDs 1342186612 and 1342186613) were published by Vandenbussche et al. (2010A&A...518L.133V). We used the ALMA 870um continuum image previously published by Dent et al. (2014Sci...343.1490D). (1 data file).

  16. Removal of Calcium from Scheelite Leaching Solution by Addition of CaSO4 Inoculating Crystals

    NASA Astrophysics Data System (ADS)

    Liu, Wenting; Li, Yongli; Zeng, Dewen; Li, Jiangtao; Zhao, Zhongwei

    2018-04-01

    In this work, the solubility behaviors of gypsum and anhydrite in the H2SO4-H3PO4-H2O system were investigated over the temperature range T = 30-80°C, and the results showed that the solubility of anhydrite was considerably lower than that of gypsum. On the basis of the differential solubilities of gypsum and anhydrite, a method was developed to remove calcium from the scheelite leaching solution by adding anhydrite as an inoculating crystal. The effects of the reaction time, concentration of the CaSO4 inoculating crystals, and temperature were investigated. With an addition of CaSO4 inoculating crystals at a concentration of 60 g/L, the Ca2+ concentration of the scheelite leaching solution decreased to a low level of approximately 0.76 g/L after 10 h at 70°C.

  17. A comparative study of magnetic resonance venography techniques for the evaluation of the internal jugular veins in multiple sclerosis patients☆

    PubMed Central

    Rahman, M. Tamizur; Sethi, Sean K.; Utriainen, David T.; Hewett, J. Joseph; Haacke, E. Mark

    2014-01-01

    Background and Purpose The use of magnetic resonance imaging (MRI) to assess the vascular nature of diseases such as multiple sclerosis (MS) is a growing field of research. This work reports on the application of MR angiographic (MRA) and venographic (MRV) techniques in assessing the extracranial vasculature in MS patients. Materials and Methods A standardized MRI protocol containing 2D TOF-MRV and dynamic 3D contrast-enhanced (CE) MRAV was run for 170 MS patients and 40 healthy controls (HC). The cross-sectional area (CSA) of the internal jugular veins (IJVs) was measured at three neck levels in all subjects for both MRV techniques to determine the presence of venous stenoses. All data were analyzed retrospectively. Results For the values where both methods showed signal, the 3D method showed larger CSA measurement values compared to 2D methods in both IJVs, in both MS and HC subjects which was confirmed with student paired t-tests. Of the 170 MS patients, 93 (55%) in CE-MRAV and 103 (61%) in TOF-MRV showed stenosis in at least one IJV. The corresponding numbers for the 40 HC subjects were 2 (5%) and 4 (10%), respectively. Carotid ectasias with IJV stenosis were seen in 26 cases (15%) with 3D CE-MRAV and were not observable with 2D TOF-MRV. Carotid ectasias were not seen in the HC group. In the 2D TOF-MRV data, banding of the IJVs related to slow flow was seen in 58 (34%) MS cases and in no HC cases. MS patients showed lower average CSAs than the HC subjects. Conclusion The 3D CE MRAV depicted the vascular anatomy more completely than the 2D TOF-MRV. However, the 3D CE MRAV does not provide any information about the flow characteristics which are indirectly available in the 2D TOF-MRV in those cases where there is slow flow. PMID:23850076

  18. Linfoma Nasal de Células T/Natural Killer Extranodal Refractario Mal Diagnosticado, Tratado de Manera Exitosa: Informe de Caso.

    PubMed

    Saavedra Ramírez, José Domingo

    2017-01-01

    El linfoma de células T/natural killer extranodal ("extranodal natural killer/T-cell lymphoma", ENKL) nasal es un linfoma no Hodgkin (LNH) agresivo y poco común para el cual no se ha establecido un tratamiento de referencia claro, especialmente en el escenario de la enfermedad recidivante/refractaria. Debido a su rareza, no se han llevado a cabo ensayos aleatorizados específicamente en ENKL nasal; sin embargo, los informes de caso y las series de caso pequeñas ofrecen un conocimiento importante sobre nuevos tratamientos potenciales. Presentamos el informe de caso de un paciente con ENKL nasal (previamente mal diagnosticado como una sinusitis crónica recidivante) en quien la enfermedad progresó durante la quimioterapia con múltiples agentes pero respondió al tratamiento de segunda línea con pralatrexato como agente único. Analizamos opciones de tratamiento para el ENKL nasal recidivante/refractario y sugerimos que el pralatrexato se evalúe más a fondo en este escenario clínico.

  19. Linfoma Nasal de Células T/Natural Killer Extranodal Refractario Mal Diagnosticado, Tratado de Manera Exitosa: Informe de Caso

    PubMed Central

    Saavedra Ramírez, José Domingo

    2017-01-01

    El linfoma de células T/natural killer extranodal (“extranodal natural killer/T-cell lymphoma”, ENKL) nasal es un linfoma no Hodgkin (LNH) agresivo y poco común para el cual no se ha establecido un tratamiento de referencia claro, especialmente en el escenario de la enfermedad recidivante/refractaria. Debido a su rareza, no se han llevado a cabo ensayos aleatorizados específicamente en ENKL nasal; sin embargo, los informes de caso y las series de caso pequeñas ofrecen un conocimiento importante sobre nuevos tratamientos potenciales. Presentamos el informe de caso de un paciente con ENKL nasal (previamente mal diagnosticado como una sinusitis crónica recidivante) en quien la enfermedad progresó durante la quimioterapia con múltiples agentes pero respondió al tratamiento de segunda línea con pralatrexato como agente único. Analizamos opciones de tratamiento para el ENKL nasal recidivante/refractario y sugerimos que el pralatrexato se evalúe más a fondo en este escenario clínico. PMID:29430232

  20. Electronic excitations and self-trapping of electrons and holes in CaSO4

    NASA Astrophysics Data System (ADS)

    Kudryavtseva, I.; Klopov, M.; Lushchik, A.; Lushchik, Ch; Maaroos, A.; Pishtshev, A.

    2014-04-01

    A first-principles study of the electronic properties of a CaSO4 anhydrite structural phase has been performed. A theoretical estimation for the fundamental band gap (p → s transitions) is Eg = 9.6 eV and a proper threshold for p → d transitions is Epd = 10.8 eV. These values agree with the data obtained for a set of CaSO4 doped with Gd3+, Dy3+, Tm3+ and Tb3+ ions using the methods of low-temperature highly sensitive luminescence and thermoactivation spectroscopy. The results are consistent with theoretical predictions of a possible low-temperature self-trapping of oxygen p-holes. The hopping diffusion of hole polarons starts above ˜40 K and is accompanied by a ˜50-60 K peak of thermally stimulated luminescence of RE3+ ions caused due to the recombination of hole polarons with the electrons localized at RE3+. There is no direct evidence of the self-trapping of heavy d-electrons, however, one can argue that their motion rather differs from that of conduction s-electrons.

  1. Effects of Partial Substitutions of NaCl with KCl, CaSO4 and MgSO4 on the Quality and Sensorial Properties of Pork Patties.

    PubMed

    Davaatseren, Munkhtugs; Chun, Ji-Yeon; Cho, Hyung-Yong; Min, Sang-Gi; Choi, Mi-Jung

    2014-01-01

    This study investigated the effects of NaCl replacers (KCl, CaSO4, and MgSO4) on the quality and sensorial properties of pork patty. In the characteristics of spray-dried salt particles, KCl showed the largest particle size with low viscosity in solution. Meanwhile CaSO4 treatment resulted in the smallest particle size and the highest viscosity (p<0.05). In comparison of the qualities of pork patties manufactured by varying level of Na replacers, MgSO4 treatment exhibited low cooking loss comparing to control (p<0.05). Textural properties of KCl and MgSO4 treatments showed similar pattern, i.e., low level of the replacers caused harder and less adhesive texture than those of control (p<0.05), whereas the hardness of these products was not different with control when the replacers were added more than 1.0%. The addition of CaSO4 also manifested harder and less adhesive than control (p<0.05), but the textural properties of CaSO4 treatment was not affected by level of Ca-salt. Eventually, sensorial properties indicated that KCl and CaSO4 influenced negative effects on pork patties. In contrast, MgSO4 showed better sensorial properties in juiciness intensity, tenderness intensity as well as overall acceptability than control, reflecting that MgSO4 was an effective Na-replacer in meat product formulation.

  2. Variability of the broad absorption lines in the QSO UM 232

    NASA Technical Reports Server (NTRS)

    Barlow, Thomas A.; Junkkarinen, Vesa T.; Burbidge, E. Margaret

    1989-01-01

    Low-resolution spectra of UM 232 taken in 1978, 1979, and 1988 at Lick Observatory are presented. Large changes in the Si IV lambda 1397, CIV lambda 1549, and Al III lambda 1857 broad absorption lines are apparent. The decrease in column density in all three ions and an observed brightening of the QSO suggests that these changes are due to an increase in the ionization level driven by an increase in the central source luminosity. This mechanism has been proposed by Smith and Penston to explain small changes in the absorption spectrum of the QSO 1246-057. The spectra of UM 232 show that the fractional decrease in optical depth is smaller at higher outflow velocies. The structure of the broad absorption-line region (BALR) is investigted by estimating an ionization parameter for each ion species as a function of velocity.

  3. Mild Jugular Compression Collar Ameliorated Changes in Brain Activation of Working Memory after One Soccer Season in Female High School Athletes.

    PubMed

    Yuan, Weihong; Dudley, Jonathan; Barber Foss, Kim D; Ellis, Jonathan D; Thomas, Staci; Galloway, Ryan T; DiCesare, Christopher A; Leach, James L; Adams, Janet; Maloney, Thomas; Gadd, Brooke; Smith, David; Epstein, Jeff N; Grooms, Dustin R; Logan, Kelsey; Howell, David R; Altaye, Mekibib; Myer, Gregory D

    2018-06-01

    Recent neuroimaging studies have suggested that repetitive subconcussive head impacts, even after only one sport season, may lead to pre- to post-season structural and functional alterations in male high school football athletes. However, data on female athletes are limited. In the current investigation, we aimed to (1) assess the longitudinal pre- to post-season changes in functional MRI (fMRI) of working memory and working memory performance, (2) quantify the association between the pre- to post-season change in fMRI of working memory and the exposure to head impact and working memory performance, and (3) assess whether wearing a neck collar designed to reduce intracranial slosh via mild compression of the jugular veins can ameliorate the changes in fMRI brain activation observed in the female high school athletes who did not wear collars after a full soccer season. A total of 48 female high school soccer athletes (age range: 14.00-17.97 years) were included in the study. These athletes were assigned to the non-collar group (n = 21) or to the collar group (n = 27). All athletes undewent MRI at both pre-season and post-season. In each session, a fMRI verbal N-Back task was used to engage working memory. A significant pre- to post-season increase in fMRI blood oxygen level dependent (BOLD) signal was demonstrated when performing the N-back working memory task in the non-collar group but not in the collar group, despite the comparable exposure to head impacts during the season between the two groups. The collar group demonstrated significantly smaller pre- to post-season change in fMRI BOLD signal than the non-collar group, suggesting a potential protective effect from the collar device. Significant correlations were also found between the pre- to post-season increase in fMRI brain activation and the decrease in task accuracy in the non-collar group, indicating an association between the compensatory mechanism in underlying neurophysiology and the alteration

  4. Paragangliomas of the Head & Neck: the KMC experience.

    PubMed

    Prasad, Sampath Chandra; Thada, Nikhil; Pallavi; Prasad, Kishore Chandra

    2011-01-01

    To determine the clinical features, investigations, intra-operative findings, surgical approaches used and the results of the treatment for paragangliomas of the head and neck. Retrospective study of 14 cases of paragangliomas in head and neck seen over a period of 10 years including five carotid body tumors, seven glomus jugulares and two glomus tympanicums. HRCT scans and bilateral carotid angiography were done in all cases of glomus jugulare. Pre-operative embolization was done in most cases. The trans-cervical approach was used for all cases of carotid body. In three cases of Type B jugulare tumors, a post-aural tympanotomy was used. A Fisch Type A approach was done for three cases of Type D jugulare tumors. Postaural tympanotomy approach was used for both patients with glomus tympanicum. In one case of extratympanic glomus jugulare tumor with hypoglossal palsy, a neck exploration was done to isolate and excise the tumor. Five patients with carotid body tumors presented as unilateral, painless, pulsatile swelling in the upper neck. Intra-operatively, three of the tumors were classified into Shamlin's Grade II and one each into Grade III and Grade I. A carotid blow-out occurred in one of the patients with Grade II disease, which was managed. ECA resection had to be done in one case. Seven patients were diagnosed to have glomus jugulare and two with glomus tympanicum. Six glomus jugulare tumors presented with hearing loss, ear discharge and obvious swelling. Glomus tympanicums presented with hearing loss but no bleeding from the ear. On examination, tumors presented with an aural polyp with no VII nerve deficits. Both tympanicums were classified as Fisch Type A, three of the jugulares classified as Type B, two as Type D2 and one as Type D1. Tumors were found to be supplied predominantly by the ascending pharyngeal artery. In three cases of Type B jugulare tumors, a post-aural tympanotomy was used. A Fisch Type A approach was done for three cases of Type D

  5. Neck Collar with Mild Jugular Vein Compression Ameliorates Brain Activation Changes during a Working Memory Task after a Season of High School Football.

    PubMed

    Yuan, Weihong; Leach, James; Maloney, Thomas; Altaye, Mekibib; Smith, David; Gubanich, Paul J; Barber Foss, Kim D; Thomas, Staci; DiCesare, Christopher A; Kiefer, Adam W; Myer, Gregory D

    2017-08-15

    Emerging evidence indicates that repetitive head impacts, even at a sub-concussive level, may result in exacerbated or prolonged neurological deficits in athletes. This study aimed to: 1) quantify the effect of repetitive head impacts on the alteration of neuronal activity based on functional magnetic resonance imaging (fMRI) of working memory after a high school football season; and 2) determine whether a neck collar that applies mild jugular vein compression designed to reduce brain energy absorption in head impact through "slosh" mitigation can ameliorate the altered fMRI activation during a working memory task. Participants were recruited from local high school football teams with 27 and 25 athletes assigned to the non-collar and collar group, respectively. A standard N-Back task was used to engage working memory in the fMRI at both pre- and post-season. The two study groups experienced similar head impact frequency and magnitude during the season (all p > 0.05). fMRI blood oxygen level dependent (BOLD) signal response (a reflection of the neuronal activity level) during the working memory task increased significantly from pre- to post-season in the non-collar group (corrected p < 0.05), but not in the collar group. Areas displaying less activation change in the collar group (corrected p < 0.05) included the precuneus, inferior parietal cortex, and dorsal lateral prefrontal cortex. Additionally, BOLD response in the non-collar group increased significantly in direct association with the total number of impacts and total g-force (p < 0.05). Our data provide initial neuroimaging evidence for the effect of repetitive head impacts on the working memory related brain activity, as well as a potential protective effect that resulted from the use of the purported brain slosh reducing neck collar in contact sports.

  6. Activation pathways of synovial T lymphocytes. Expression and function of the UM4D4/CDw60 antigen.

    PubMed Central

    Fox, D A; Millard, J A; Kan, L; Zeldes, W S; Davis, W; Higgs, J; Emmrich, F; Kinne, R W

    1990-01-01

    Accumulating evidence implicates a central role for synovial T cells in the pathogenesis of rheumatoid arthritis, but the activation pathways that drive proliferation and effector function of these cells are not known. We have recently generated a novel monoclonal antibody against a rheumatoid synovial T cell line that recognizes an antigen termed UM4D4 (CDw60). This antigen is expressed on a minority of peripheral blood T cells, and represents the surface component of a distinct pathway of human T cell activation. The current studies were performed to examine the expression and function of UM4D4 on T cells obtained from synovial fluid and synovial membranes of patients with rheumatoid arthritis and other forms of inflammatory joint disease. The UM4D4 antigen is expressed at high surface density on about three-fourths of synovial fluid T cells and on a small subset of synovial fluid natural killer cells; in synovial tissue it is present on more than 90% of T cells in lymphoid aggregates, and on approximately 50% of T cells in stromal infiltrates In addition, UM4D4 is expressed in synovial tissue on a previously undescribed population of HLA-DR/DP-negative non-T cells with a dendritic morphology. Anti-UM4D4 was co-mitogenic for both RA and non-RA synovial fluid mononuclear cells, and induced IL-2 receptor expression. The UM4D4/CDw60 antigen may represent a functional activation pathway for synovial compartment T cells, which could play an important role in the pathogenesis of inflammatory arthritis. Images PMID:2212003

  7. Luminescence properties of pure and doped CaSO4 nanorods irradiated by 15 MeV e-beam

    NASA Astrophysics Data System (ADS)

    Salah, Numan; Alharbi, Najlaa D.; Enani, Mohammad A.

    2014-01-01

    Calcium sulfate (CaSO4) doped with proper activators is a highly sensitive phosphor used in different fields mainly for radiation dosimetry, lighting and display applications. In this work pure and doped nanorods of CaSO4 were produced by the co-precipitation technique. Samples from this material doped with Ag, Cu, Dy, Eu and Tb were exposed to different doses of 15 MeV e-beam and studied for their thermoluminesence (TL) and photoluminescence (PL) properties. Color center formation leading to PL emissions were investigated before and after e-beam irradiation. The samples doped with rare earths elements (i.e. Dy, Eu and Tb) were observed to have thinner nanorods than the other samples and have higher absorption in the UV region. The Ag and Tb doped samples have poor TL response to e-beam, while those activated by Cu, Dy and Eu have strong glow peaks at around 123 °C. Quite linear response curves in the whole studied exposures i.e. 0.1-100 Gy were also observed in Cu and Dy doped samples. The PL results show that pure CaSO4 nanorods have active color centers without irradiation, which could be enriched/modified by these impurities mainly rare earths and further enhanced by e-beam irradiation. Eu3+ → Eu2+ conversion is clearly observed in Eu doped sample after e-beam irradiation. These results show that these nanorods might be useful in lighting and display devices development.

  8. Venous catheterization with ultrasound navigation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kasatkin, A. A., E-mail: ant-kasatkin@yandex.ru; Nigmatullina, A. R.; Urakov, A. L., E-mail: ant-kasatkin@yandex.ru

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization.more » We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient’s exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.« less

  9. Venous catheterization with ultrasound navigation

    NASA Astrophysics Data System (ADS)

    Kasatkin, A. A.; Urakov, A. L.; Nigmatullina, A. R.

    2015-11-01

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient's exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  10. Trombose induzida pelo calor endovenoso: relato de dois casos tratados com rivaroxabana e revisão da literatura

    PubMed Central

    de Araujo, Walter Junior Boim; Timi, Jorge Rufino Ribas; Erzinger, Fabiano Luiz; Caron, Filipe Carlos

    2016-01-01

    Resumo Define-se trombose induzida pelo calor endovenoso como a propagação do trombo a partir de uma veia superficial em direção a uma veia mais profunda. Em geral, é considerada clinicamente insignificante quando não há propagação do trombo para o sistema venoso profundo. Essa condição pode ser tratada com terapia anticoagulante, embora a observação pareça ser suficiente, principalmente para graus menores. Neste estudo, relatamos dois casos de trombose induzida pelo calor endovenoso que teriam indicação de heparina de baixo peso molecular até a resolução do quadro. Porém, optou-se pelo uso da rivaroxabana (15 mg de 12 em 12h), com resolução completa do trombo em 4 semanas (caso 1) e em 7 dias (caso 2). A rivaroxabana pode ser uma alternativa promissora no tratamento da trombose induzida pelo calor endovenoso avançada, pela simplicidade da posologia, sem comprometimento da eficácia ou da segurança. São necessários estudos prospectivos, randomizados e controlados que possibilitem melhor entendimento da condição e o desenvolvimento de recomendações mais definitivas sobre opções de prevenção e tratamento.

  11. Echocolor Doppler morpho-functional study of the jugulo-subclavian confluence in chronic cerebro-spinal venous insufficiency and multiple sclerosis patients.

    PubMed

    Mandolesi, Sandro; d'Alessandro, Aldo; Desogus, Antonello Ignazio; Ciccone, Marco Matteo; Zito, Annapaola; Stammegna, Immacolata; Niglio, Tarcisio; Orsini, Augusto; Mandolesi, Dimitri; d'Alessandro, Alessandro; Revelli, Luca

    2017-01-01

    The aim of this work is to measure the mean diameter of the confluence jugulo- subclavian, the impact of different types of jugular confluences and the correlation between the types of confluences and the Valsalva maneuver (jugular reflux) in subjects with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and Multiple Sclerosis. We investigated by Echo-Color-Doppler (ECD) 103 subjects (67 F 36M) of mean age 45 ± 12 years (a minimum of 22 to a maximum of 79 years, with a median of 44 and a modal value 42 years), mean EDSS of 4.7 and average disease duration of 12 years. The 103 right jugular veins investigated had an average diameter of 8.4 ± 2.4 mm (minimum 4.0, maximum 14.9 mm; median 7.9; modal value 7.6 mm). Three form types were found: 56 cylindrical, 29 conical and 18 funnel. Valsalva maneuver was positive in 30 patients. The 103 left jugular investigated had an average diameter of 8.9 ± 2.4 mm (minimum 2.8, maximum 14.4 mm; median of 8.8; modal value 8.7 mm). The form types were found: 42 cylindrical, 45 conical and 16 funnel. Valsalva maneuver was positive in 30 patients. The mean diameter of the jugular veins was 8.7 mm. Internal jugular veins with cylindrical morphology have a diameter smaller than other forms; this difference is statistically significant. The different morphology of the jugular vein confluence does not increase the possibility of a reflux because the positive Valsalva maneuvers are not statistically significant when compared to the various types. CCSVI, EchoColorDoppler Map, Jugulo-Subclavian Confluence Diameter.

  12. Impact-induced devolatilization of CaSO4 anhydrite and implications for K-T extinctions: Preliminary results

    NASA Technical Reports Server (NTRS)

    Tyburczy, James A.; Ahrens, Thomas J.

    1993-01-01

    The recent suggestions that the target area for the K-T bolide may have been a sulfate-rich evaporite and that the resulting sulfuric acid-rich aerosol was responsible for the subsequent cooling of the Earth and the resulting biological extinctions has prompted us to experimentally examine the impact-induced devolatization of the sulfate minerals anhydrite (CaSO4) and gypsum (CaSO4(2H2O)). Preliminary results for anhydrite are reported. Up to 42 GPa peak shock pressure, little or no devolatilization occurs, consistent with chemical thermodynamic calculations. Calculation of the influence of the partial pressure of the gas species on impact-induced devolatilization suggests that an even greater amount of sulfur than that proposed by Brett could have been released to the atmosphere by an impact into a sulfate-rich layer. Solid recovery, impact-induced devolatilization experiments were performed on the Caltech 20mm gun using vented, stainless steel sample assemblies.

  13. Healing bone lesion defects using injectable CaSO4 /CaPO4 -TCP bone graft substitute compared to cancellous allograft bone chips in a canine model.

    PubMed

    Hall, Deborah J; Turner, Thomas M; Urban, Robert M

    2018-04-16

    CaSO 4 /CaPO 4 -TCP bone graft substitute has been shown to be effective for treatment of bone lesion defects, but its mechanical, histological, and radiographic characteristics have not been studied in direct comparison with a conventional treatment such as cancellous allograft bone. Thirteen canines had a critical-size axial defect created bilaterally into the proximal humerus. CaSO 4 /CaPO 4 -TCP bone graft substitute (PRO-DENSE™, Wright Medical Technology) was injected into the defect in one humerus, and an equal volume of freeze-dried cancellous allograft bone chips was placed in the contralateral defect. The area fraction of new bone, residual graft, and fibrous tissue and the compressive strength and elastic modulus of bone within the defects were determined after 6, 13, or 26 weeks and correlated with radiographic changes. The data were analyzed using Friedman and Mann-Whitney tests. There was more bone in defects treated with the CaSO 4 /CaPO 4 -TCP bone graft substitute compared to defects treated with cancellous bone allograft at all three time points, and the difference at 13 weeks was significant (p = 0.025). The new bone was significantly stronger and stiffer in defects treated with the CaSO 4 /CaPO 4 -TCP bone graft substitute compared to defects treated with cancellous bone allograft at 13 (p = 0.046) and 26 weeks (p = 0.025). At 26 weeks, all defects treated with CaSO 4 /CaPO 4 -TCP bone graft substitute demonstrated complete healing with new bone, whereas healing was incomplete in all defects treated with cancellous allograft chips. The CaSO 4 /CaPO 4 -TCP bone graft substitute could provide faster and significantly stronger healing of bone lesions compared to the conventional treatment using freeze-dried cancellous allograft bone. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2018. © 2018 Wiley Periodicals, Inc.

  14. Use of "um" in the Deceptive Speech of a Convicted Murderer

    ERIC Educational Resources Information Center

    Villar, Gina; Arciuli, Joanne; Mallard, David

    2012-01-01

    Previous studies have demonstrated a link between language behaviors and deception; however, questions remain about the role of specific linguistic cues, especially in real-life high-stakes lies. This study investigated use of the so-called filler, "um," in externally verifiable truthful versus deceptive speech of a convicted murderer. The data…

  15. Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction.

    PubMed

    Esteves, Luiz Adriano; Joaquim, Andrei Fernandes; Tedeschi, Helder

    2016-01-01

    sexo masculino e a média de idade foi de 41,7 anos. Inicialmente 32% dos pacientes foram submetidos a tratamento cirúrgico, e 68% foram submetidos a tratamento conservador. Sete pacientes (29%) do grupo conservador foram submetidos posteriormente à cirurgia. No grupo cirúrgico, houve sete casos de fratura de odontóide tipo II, dois casos de fratura de elementos posteriores do áxis, um caso de luxação C1-C2, um caso de deslocamento occipito-cervical e um caso de fraturas de C1 e C2 e luxação facetária. Um paciente apresentava déficit neurológico, melhorando após o tratamento. Houve duas complicações pós-cirúrgicas, uma fístula liquórica e uma infecção de ferida operatória (reabordada). No grupo conservador, predominaram as fraturas do odontóide (oito) e dos elementos posteriores de C2 (cinco). Em dois casos, havia também fraturas em outros segmentos da coluna. Nenhum dos pacientes deste grupo apresentou deterioração neurológica. As lesões da junção craniocervical são raras, sendo mais frequentes as fraturas do odontóide e dos elementos posteriores do áxis. Nossos resultados recomendam o tratamento cirúrgico precoce para os pacientes com fraturas do odontóide tipo II e lesões ligamentares, e tratamento conservador para os demais pacientes.

  16. Uh and um in Children With Autism Spectrum Disorders or Language Impairment

    PubMed Central

    Gorman, Kyle; Olson, Lindsay; Presmanes Hill, Alison; Lunsford, Rebecca; Heeman, Peter A.; van Santen, Jan P. H.

    2016-01-01

    Atypical pragmatic language is often present in individuals with autism spectrum disorders (ASD), along with delays or deficits in structural language. This study investigated the use of the “fillers” uh and um by children ages 4–8 during the autism diagnostic observation schedule. Fillers reflect speakers’ difficulties with planning and delivering speech, but they also serve communicative purposes, such as negotiating control of the floor or conveying uncertainty. We hypothesized that children with ASD would use different patterns of fillers compared to peers with typical development or with specific language impairment (SLI), reflecting differences in social ability and communicative intent. Regression analyses revealed that children in the ASD group were much less likely to use um than children in the other two groups. Filler use is an easy-to-quantify feature of behavior that, in concert with other observations, may help to distinguish ASD from SLI. PMID:26800246

  17. The merging dwarf galaxy UM 448: chemodynamics of the ionized gas from VLT integral field spectroscopy

    NASA Astrophysics Data System (ADS)

    James, B. L.; Tsamis, Y. G.; Barlow, M. J.; Walsh, J. R.; Westmoquette, M. S.

    2013-01-01

    Using Very Large Telescope/Fibre Large Array Multi Element Spectrograph optical integral field unit observations, we present a detailed study of UM 448, a nearby blue compact galaxy (BCG) previously reported to have an anomalously high N/O abundance ratio. New Technology Telescope/Superb-Seeing Imager images reveal a morphology suggestive of a merger of two systems of contrasting colour, whilst our Hα emission maps resolve UM 448 into three separate regions that do not coincide with the stellar continuum peaks. UM 448 exhibits complex emission line profiles, with most lines consisting of a narrow [full width at half-maximum (FWHM) ≲ 100 km s-1], central component, an underlying broad component (FWHM ˜ 150-300 km s-1) and a third, narrow blueshifted component. Radial velocity maps of all three components show signs of solid body rotation across UM 448, with a projected rotation axis that correlates with the continuum morphology of the galaxy. A spatially resolved, chemodynamical analysis, based on the [O iii] λλ4363, 4959, [N ii] λ6584, [S ii] λλ6716, 6731 and [Ne iii] λ3868 line maps, is presented. Whilst the eastern tail of UM 448 has electron temperatures (Te) that are typical of BCGs, we find a region within the main body of the galaxy where the narrow and broad [O iii] λ4363 line components trace temperatures differing by 5000 K and oxygen abundances differing by 0.4 dex. We measure spatially resolved and integrated ionic and elemental abundances for O, N, S and Ne throughout UM 448, and find that they do not agree, possibly due the flux weighting of Te from the integrated spectrum. This has significant implications for abundances derived from long-slit and integrated spectra of star-forming galaxies in the nearby and distant universe. A region of enhanced N/O ratio is indeed found, extended over a ˜0.6 kpc2 region within the main body of the galaxy. Contrary to previous studies, however, we do not find evidence for a large Wolf-Rayet (WR

  18. Thermoluminescence and photoluminescence of cerium doped CaSO 4 nanosheets

    NASA Astrophysics Data System (ADS)

    Zahedifar, M.; Mehrabi, M.

    2010-12-01

    Thermoluminescence (TL) and photoluminescence (PL) characteristics of CaSO 4:Ce nanocrystalline prepared by hydrothermal method has been studied. Its TL glow curve contains three overlapping glow peaks at around 490, 505 and 521 K. Emission spectra band at 303 and 324 nm were observed for the orthorhombic phase of nanosheets. TL response of the prepared nanocrystalline to β and γ radiation was studied and the sensitivity of the nanosheets was found much more than that of analogous microcrystalline and is around 10 times higher than the well known high sensitive TL dosimeter LiF:Mg, Cu, P (GR-200) hot-pressed chips. TL kinetic parameters of this nanocrystalline are also presented.

  19. Observations of the new gravitational lens system UM 673 = Q 0142-100

    NASA Astrophysics Data System (ADS)

    Surdej, J.; Magain, P.; Swings, J.-P.; Borgeest, U.; Courvoisier, T. J.-L.; Kayer, R.; Kellermann, K. I.; Kuhr, H.; Refsdal, S.

    1988-06-01

    The authors have recently initiated a high resolution direct imaging survey of a selected sample of highly luminous quasars (HLQs). The observations are carried out with the 2.2 m telescope at ESO, and with the VLA at the NRAO, New Mexico. Following the first observing run at ESO, the authors have reported the discovery of a new gravitational lens system for the HLQ UM 673 = Q 0142-100. Additional observations supporting this interpretation are discussed here. Application of gravitational optometry to this system is given: a value of M0 = 2.4×1011M_sun; is derived for the mass of the lensing galaxy located between UM 673 A and B and a most likely estimate of Δt = 7 weeks is found for the expected delay between the arrival times of a similar variability event in the two lensed images of the quasar (H0 = 75 km s-1Mpc-1, q0 = 0).

  20. Como os Alunos do Ensino Médio da Rede Estadual de São Paulo obtém Conhecimentos Astronômicos?

    NASA Astrophysics Data System (ADS)

    da Cunha, W. S.; Voelzke, M. R.; Amaral, L. H.

    2005-08-01

    Atualmente vivencia-se um mundo globalizado onde os computadores e a internet permitiram um acesso rápido e seguro a todo tipo de informação e conhecimento. O presente trabalho visa analisar a maneira pela qual alunos de segundo grau da rede estadual da cidade de São Paulo obtiveram, caso tenham, conhecimentos básicos de astronomia quanto aos fenômenos celestes que os rodeiam, tais como a sucessão dos dias e das estações do ano, além de questioná~los sobre fatos genéricos tais como: o que vem a ser o Sol, o Big Bang, o que ocasionou a extinção dos dinossauros. Para tanto foi elaborado um formulário constando de questões de múltipla escolha, o qual foi aplicado no primeiro colegial diurno da Escola Estadual Guilherme de Almeida. Num espaço amostral de 44 alunos constatou-se que 41% dos alunos adquiriram seus conhecimentos astronômicos na escola e 59% através da mídia em geral. Neste mesmo espaço amostral apenas 11% dos alunos usaram computadores na escola, 41% na residência, 5% no trabalho e 43% não utilizaram. O presente estudo revelou também que para 50% dos alunos o professor jamais utilizou um programa de computador a respeito de astronomia ou fez alguma apresentação sobre o tema. Embora em sua fase inicial este estudo revela claramente que a maioria dos alunos não obtém na escola seus conhecimentos astronômicos, estes provém de fontes não especificamente didático-pedagógicas tais como filmes e revistas populares que não raramente geram conhecimentos incompletos e em muitos casos inclusive falhos.

  1. Carbon ions irradiation on nano- and microcrystalline CaSO4 : Dy

    NASA Astrophysics Data System (ADS)

    Salah, Numan

    2008-08-01

    Nanoparticles of CaSO4 : Dy phosphor with a particle size of around 30 nm have been prepared by the chemical co-precipitation technique. Pellet samples of the nanomaterials were irradiated by a 75 MeV C6+ ion beam at the fluence range 1 × 109-1 × 1013 ions cm-2. Thermoluminescence (TL) glow curves of the irradiated samples were recorded and studied. The microcrystalline form of this sample is also included in the study with the aim of reporting a comparative measurement. The TL analysis shows that the glow curve of the nanomaterial has two peaks at around 166 and 210 °C. These peaks are similar to those induced in the microcrystalline sample with a slight difference in their TL response. The second peak is more prominent in the case of the microcrystalline sample at low fluences, while the first one dominates in the nanostructured sample mainly at higher fluences. The TRIM code based on Monte Carlo simulation was also used for calculating some ion beam parameters. Dosimetric properties of the carbon ion beam irradiated materials show that the nanostructure material has excellent features such as a simple glow curve structure and a linear TL response over a wider range than the corresponding microcrystalline sample. These results show that the nanostructure form of CaSO4 : Dy might be useful for detecting the high doses of carbon ions used in radiotherapy. Thermal analysis of the prepared nano- and microcrystalline materials was also done in the range 50-500 °C using thermogravimetry analysis and differential thermal analysis. No phase transitions within this range of heating for both the materials are observed.

  2. Hemangioblastomas de fosa posterior: Reporte de 16 casos y revisión de la literatura

    PubMed Central

    Campero, Alvaro; Ajler, Pablo; Fernandez, Julio; Isolan, Gustavo; Paiz, Martin; Rivadeneira, Conrado

    2016-01-01

    Resumen Objetivo: El propósito del presente trabajo es presentar los resultados de 16 pacientes con diagnóstico de hemangioblastoma de fosa posterior (HBFP), operados con técnicas microquirúrgicas. Método: Desde junio de 2005 a diciembre de 2015, 16 pacientes con diagnóstico de HBFP fueron intervenidos quirúrgicamente. Se evaluó: sexo, edad, tipo de lesión (quística con nódulo, quística sin nódulo, sólida y sólida-quística), sintomatología y resultados postoperatorios. Resultados: De los 16 pacientes intervenidos, 11 fueron varones y 5 mujeres. La edad promedio fue de 44 años. La forma más frecuente fue quística con nódulo (57%), seguida por forma sólida (31%). Un solo caso presentó la forma quística sin nódulo (6%), y uno solo la forma sólido-quística (6%). La sintomatología más frecuente fue cefalea acompañada de síndrome cerebeloso (43%), seguido de síndrome de hipertensión endocraneana (25%). En todos los casos la resección fue completa, siendo necesario en un caso una embolización previa. Como complicaciones postoperatorias, 2 pacientes presentaron ataxia (mejoró al cabo de 3 meses), y 1 paciente presentó una fístula de LCR (se solucionó con un drenaje espinal externo). Se registró un óbito por complicaciones postoperatorias. Conclusión: Lo más frecuente de ver en pacientes con HBFP es la forma quística con nódulo, siendo su sintomatología predominante la cefalea acompañada de síndrome cerebeloso. La resección quirúrgica completa es posible, con una baja tasa de morbimortalidad. PMID:27999708

  3. Unit 5, STA. 50+00+RB, retaining wall at First U.M. Churchdetail ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Unit 5, STA. 50+00+RB, retaining wall at First U.M. Church-detail - Johnstown Local Flood Protection Project, Beginning on Conemaugh River approx 3.8 miles downstream from confluence of Little Conemaugh & Stony Creek Rivers at Johnstown, Johnstown, Cambria County, PA

  4. Microwave-Assisted Extraction, Chemical Structures, and Chain Conformation of Polysaccharides from a Novel Cordyceps Sinensis Fungus UM01.

    PubMed

    Cheong, Kit-Leong; Wang, Lan-Ying; Wu, Ding-Tao; Hu, De-Jun; Zhao, Jing; Li, Shao-Ping

    2016-09-01

    Cordyceps sinensis is a well-known tonic food with broad medicinal properties. The aim of the present study was to investigate the optimization of microwave-assisted extraction (MAE) and characterize chemical structures and chain conformation of polysaccharides from a novel C. sinensis fungus UM01. Ion-exchange and gel filtration chromatography were used to purify the polysaccharides. The chemical structure of purified polysaccharide was determined through gas chromatography-mass spectrometry. Moreover, high performance size exclusion chromatography combined with refractive index detector and multiangle laser light scattering were conducted to analyze the molecular weight (Mw ) and chain conformation of purified polysaccharide. Based on the orthogonal design L9 , optimal MAE conditions could be obtained through 1300 W of microwave power, with a 5-min irradiation time at a solid to water ratio of 1:60, generating the highest extraction yield of 6.20%. Subsequently, the polysaccharide UM01-S1 was purified. The UM01-S1 is a glucan-type polysaccharide with a (1→4)-β-d-glucosyl backbone and branching points located at O-3 of Glcp with a terminal-d-Glcp. The Mw , radius of gyration (Rg ) and hydrodynamic radius (Rh ) of UM01-S1 were determined as 5.442 × 10(6)  Da, 21.8 and 20.2 nm, respectively. Using the polymer solution theory, the exponent (ν) value of the power law function was calculated as 0.38, and the shape factor (ρ = Rg /Rh ) was 1.079, indicating that UM01-S1 has a sphere-like conformation with a branched structure in an aqueous solution. These results provide fundamental information for the future application of polysaccharides from cultured C. sinensis in health and functional food area. © 2016 Institute of Food Technologists®

  5. Analysis of head impact exposure and brain microstructure response in a season-long application of a jugular vein compression collar: a prospective, neuroimaging investigation in American football

    PubMed Central

    Myer, Gregory D; Yuan, Weihong; Barber Foss, Kim D; Thomas, Staci; Smith, David; Leach, James; Kiefer, Adam W; Dicesare, Chris; Adams, Janet; Gubanich, Paul J; Kitchen, Katie; Schneider, Daniel K; Braswell, Daniel; Krueger, Darcy; Altaye, Mekibib

    2016-01-01

    Background Historical approaches to protect the brain from outside the skull (eg, helmets and mouthpieces) have been ineffective in reducing internal injury to the brain that arises from energy absorption during sports-related collisions. We aimed to evaluate the effects of a neck collar, which applies gentle bilateral jugular vein compression, resulting in cerebral venous engorgement to reduce head impact energy absorption during collision. Specifically, we investigated the effect of collar wearing during head impact exposure on brain microstructure integrity following a competitive high school American football season. Methods A prospective longitudinal controlled trial was employed to evaluate the effects of collar wearing (n=32) relative to controls (CTRL; n=30) during one competitive football season (age: 17.04±0.67 years). Impact exposure was collected using helmet sensors and white matter (WM) integrity was quantified based on diffusion tensor imaging (DTI) serving as the primary outcome. Results With similar overall g-forces and total head impact exposure experienced in the two study groups during the season (p>0.05), significant preseason to postseason changes in mean diffusivity, axial diffusivity and radial diffusivity in the WM integrity were noted in the CTRL group (corrected p<0.05) but not in the collar group (p>0.05). The CTRL group demonstrated significantly larger preseason to postseason DTI change in multiple WM regions compared with the collar group (corrected p<0.05). Discussion Reduced WM diffusivity alteration was noted in participants wearing a neck collar after a season of competitive football. Collar wearing may have provided a protective effect against brain microstructural changes after repetitive head impacts. Trial registration number NCT02696200. PMID:27307271

  6. Long Distance Endovascular Growth of Jugulotympanic Paraganglioma Evident in 68Ga-DOTATATE PET but Concealed on CT.

    PubMed

    Avramovic, Nemanja; Weckesser, Matthias; Velasco, Aglaé; Stenner, Markus; Noto, Benjamin

    2017-02-01

    A 60-year-old woman was referred to contrast-enhanced CT for evaluation of jugular vein thrombosis incidentally detected by ultrasound. Contrast-enhanced CT showed an enhanced tumor of the right skull base highly suspicious of jugulotympanic paraganglioma. However, the jugular veins showed a nearly symmetric contrast enhancement without clear evidence of thrombosis. Consecutive Ga-DOTATATE PET/CT depicted high tumor uptake, which comprised the entire internal jugular vein. Endovascular growth of paraganglioma might be missed on contrast-enhanced CT because of high vascularization of the lesion. Ga-DOTATATE PET is suited for accurate determination of tumor extent.

  7. Effect of topical vapocoolant spray on response to arthrocentesis and intravenous catheterization in unsedated horses.

    PubMed

    Fjordbakk, Cathrine T; Haga, Henning A

    2011-06-01

    To assess the efficacy of a commercially available topical vapocoolant spray in reducing responses to arthrocentesis of the middle carpal (MC) and metacarpophalangeal (MCP) joints and jugular vein catheterization in unsedated horses. 8 healthy research horses. Arthrocentesis of both MC and MCP joints and bilateral jugular vein catheterization were performed in each horse. Immediately prior to skin penetration, 1 randomly selected MC joint, MCP joint, and jugular vein were sprayed with a vapocoolant liquid (intervention product), and the contralateral MC joint, MCP joint, and jugular vein were sprayed with water (placebo). An observer blinded to the type of spray treatment used evaluated the horses' responses to needle or catheter placement procedures by use of a 6-point categorical scale and a 100-mm visual analog scale. Responses evaluated via the visual analog scale were significantly reduced after application of the intervention product, compared with responses after application of the placebo, for the MC and MCP joints; no difference in responses to jugular vein catheterization was detected between the 2 treatments. Vapocoolant spray was safe and effective in reducing horses' responses to arthrocentesis. The use of such products prior to joint injections may reduce procedural nociception and pain anticipation in unsedated horses and may improve the safety of personnel performing such procedures.

  8. A teoria da percolação aplicada às galáxias aneladas peculiares

    NASA Astrophysics Data System (ADS)

    Poppe, P. C. R.; Martin, V. A. F.; de Medeiros, N. G. F.; Faúndez-Abans, M.; Oliveira-Abans, M.

    2003-08-01

    Formulado no final da década de 50, o modelo de percolação concentra-se em descrever o meio poroso, que será visto neste trabalho como uma rede de canais aleatórios, por onde escoa um fluido determinístico. Se o número de canais for suficientemente grande, então eles estarão ligados e o meio se tornará permeável à passagem do fluido. Neste caso, dizemos que houve a percolação do fluido. Reformulando o modelo acima, podemos escrever um código particularmente adaptado para simulações em Galáxias, onde iremos supor que os canais formam um reticulado, e que cada sítio da rede representa um poro que será interpretado como uma região ativa de formação estelar. Para cada elo teremos um pequeno canal ligando dois sítios vizinhos, que poderá, após um tempo "t", induzir ou não a formação de uma região ativa no poro vizinho. Para simular a passagem desta região ativa através dos poros, diremos que um elo está aberto com probabilidade p e fechado com probabilidade 1-p. Dessa forma, passamos a imaginar configurações de elos abertos e fechados, onde cada configuração ocorre com uma certa probabilidade, dada por p|A|(1-p)|F|, onde |A| é o número de elos abertos e |F| o número de elos fechados da configuração. A expressão anterior só tem importância física se |A| e |F| forem ambos finitos, pois, caso contrário, a probabilidade de ocorrência de uma dada configuração será sempre nula. Neste trabalho, foram considerados dados cinemáticos publicados na literatura bem como aqueles obtidos pelos autores a partir de observações fotométricas realizadas no Observatório de Las Campanãs, em 1994, para a Galáxia Anelada Peculiar HRG 03401. Mostraremos que para certos valores de p, situados entre 0,5 e 0,6, os clusters assim formados irão simular, de maneira coerente, o referido objeto.

  9. Resultados do desenvolvimento de um propulsor à plasma no Brasil

    NASA Astrophysics Data System (ADS)

    Ferreira, I. S.; Ferreira, J. L.

    2003-08-01

    Uma das partes mais importantes de um satélite é o controle de atitude do mesmo. E se tratando de um satélite científico, a atenção para este sistema deve ser redobrada. Uma possibilidade atraente para executar esta tarefa é a propulsão elétrica. Aqui, mostraremos resultados obtidos pelo propulsor à plasma PHALL-01, desenvolvido na Universidade de Brasília entre 2000 e 2003. Este é derivado do propulsor russo SPT-100 (Stationary Plasma Thruster), mas com o emprego inovador de um arranjo de imãs permanentes como fonte do campo magnético, este último o agente da aceleração do plasma. Esta alteração foi motivada pelo objetivo de que o mesmo operasse com o mínimo de potência elétrica. A partir da formulação teórica do mecanismo de aceleração, tendo como base as equações da magnetohidrodinâmica, pode-se obter vínculos sob os quais o propulsor pudesse ser construído. O mais forte destes é o que dita a topologia do campo magnético. Sendo assim, foram realizadas simulações computacionais, que definiram a geometria do propulsor. Após construído, este foi diagnosticado usando-se sondas de Langmuir e analisadores de energia. Como resultados, obtivemos a distribuição espacial da temperatura, densidade e potencial do plasma, bem como a distribuição angular do feixe produzido pelo mesmo em vários regimes de operação. O espectro de energia do feixe de plasma também foi medido, indicando íons de até 560eV. Combinando estes resultados, calculou-se o empuxo do propulsor: 84mN; e o impulso específico: 1083s. Estes demonstram que o mesmo estará qualificado, num futuro próximo, para o emprego no controle de atitude de satélites científicos, ou até mesmo como parte do conjunto propulsor primário, responsáveis pela transferência de órbitas.

  10. Simulação de ejeções de massa coronal

    NASA Astrophysics Data System (ADS)

    Corsini, M. A.; Silva, A. V. R.

    2003-08-01

    Ejeções de massa coronal (EMC) são bolhas gigantes de gás permeadas por campos magnéticos que são ejetadas do Sol durante um período de várias horas. Caso estas ejeções atinjam a Terra, geralmente, causam uma série de distúrbios às comunicações de longa distância e navegação, além de danos a satélites e transformadores. Portanto, é desejável que sejamos capazes de prever quando estas ejeções atingirão a Terra. Para tanto, é necessário um bom entendimento dos mecanismos causadores das ejeções e, principalmente, de como se dá a propagação das EMC e sua interação com o vento solar que permeia o meio interplanetário. Nesse sentido foi desenvolvido um programa computacional para resolver as equações MHD (Magneto-Hidro-Dinâmica) que regem a evolução das EMC. Primeiramente foram estabelecidas as condições necessárias para descrever o vento solar, no estado estacionário, que permeia todo o meio interplanetário. Num primeiro momento, resolveu-se o sistema de equações para o caso do vento isotérmico, conhecida como a solução de Parker, a fim de testarmos o modelo. Então, foi considerado o caso do vento solar com temperatura variável no meio interplanetário. Este resultado foi utilizado como a base de nosso sistema em seu instante inicial. Posteriormente foram feitas as considerações necessárias para descrever a propagação da Ejeção de Massa Coronal. As EMC foram simuladas como um aumento de densidade e temperatura local na coroa solar. A órbita e a posição da Terra foram incluídas no sistema. Os dados gerados possibilitaram uma análise da evolução da EMC pelo meio interplanetário até encontrar-se com a Terra. Os perfis de densidade e temperatura a 1 Unidade Astronômica são comparados com os dados de satélites reportados na literatura.

  11. Thermoluminesence of gamma rays irradiated CaSO4 nanorods doped with different elements

    NASA Astrophysics Data System (ADS)

    Salah, Numan

    2015-01-01

    Nanorods of calcium sulfate (CaSO4) activated by Ag, Cu, Dy, Eu and Tb were synthesized by the co-precipitation technique. They were irradiated by γ-rays in a wide range of exposures and studied for their thermoluminesence (TL) properties. The as-synthesized samples were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD) and photoluminescence (PL) emission spectra. SEM images show that the samples doped with rare earths elements (i.e. Dy, Eu and Tb) have thinner nanorods than the other samples, while XRD pattern shows a complete crystalline structures in a monoclinic phase. The TL glow curves of these samples show two components. The first one include low temperature glow peaks at around 125 °C, while the second component shows high temperature peaks in the range 230-270 °C. These glow peaks diver from sample to sample by their TL intensity. The TL results are promising, particularly that of Tb and Eu. Tb doped sample is found to be a highly TL sensitive with a prominent glow peak at around 270 °C, while Eu has created very active, high dense electron traps. The later shows quite linear response in the whole studied exposures i.e. 10 Gy-10 kGy. These results show that Eu or Tb doped CaSO4 nanorods might be proper candidates as dosimeters for high doses of ionizing radiations used in irradiation of foods and seeds.

  12. Which blood oxygen can sensitively indicate shock severity?

    NASA Astrophysics Data System (ADS)

    Pan, Boan; Li, Kai; Gao, Yuan; Ruan, Zhengshang; Li, Ting

    2016-03-01

    Clinical shock-monitoring mainly depends on measuring oxygen saturations from SVC blood samples invasively. The golden standard indicator is the central internal jugular vein oxygenation (SjvO2). Using near-infrared spectroscopy (NIRS) also can monitor shock in some papers published, but there is no discussion about which oxygen saturation (cerebral venous oxygen saturation, ScvO2; tissue oxygen saturation of internal jugular area; tissue oxygen saturation of extremities areas) can monitor shock patient more sensitively and accurately. The purpose of this paper is to examine which one is most effective. In order to discuss the problem, we continuously detected 56 critical patients who may be into shock state using NIRS oximeter at prefrontal, internal jugular vein area and forearm, and chose 24 patients who were into shock and then out of shock from the 56 critical patients. Combined with the patients' condition, the pulse oxygen saturation is most sensitively to monitoring shock than the others, and the internal jugular vein area oxygen saturation is most effective.

  13. Application and comparison of different implanted ports in malignant tumor patients.

    PubMed

    Li, Yanhong; Cai, Yonghua; Gan, Xiaoqin; Ye, Xinmei; Ling, Jiayu; Kang, Liang; Ye, Junwen; Zhang, Xingwei; Zhang, Jianwei; Cai, Yue; Hu, Huabin; Huang, Meijin; Deng, Yanhong

    2016-09-23

    The current study aims to compare the application and convenience of the upper arm port with the other two methods of implanted ports in the jugular vein and the subclavian vein in patients with gastrointestinal cancers. Currently, the standard of practice is placement of central venous access via an internal jugular vein approach. Perioperative time, postoperative complications, and postoperative comfort level in patients receiving an implanted venous port in the upper arm were retrospectively compared to those in the jugular vein and the subclavian vein from April 2013 to November 2014. Three hundred thirty-four patients are recruited for this analysis, consisting of 107 in the upper arm vein group, 70 in the jugular vein group, and 167 in the subclavian vein group. The occurrence of catheter misplacement in the upper arm vein is higher than that in the other two groups (13.1 vs. 2.9 vs. 5.4 %, respectively, P = 0.02), while the other complications in the perioperative period were not significantly different. The occurrence of transfusion obstacle of the upper arm vein group is significantly lower than that of the jugular and subclavian groups (0.9 vs. 7.1 vs. 7.2 %, P = 0.01). The occurrence of thrombus is also lower than that of other two groups (0.9 vs. 4.3 vs. 3.6 %, P = 0.03). Regarding the postoperative comfort, the influences of appearance (0 vs. 7.1 vs. 2.9 %, P = 0.006) and sleep (0.9 vs. 4.2 vs. 10.7 %, P = 0.003) are significantly better than those of the jugular and subclavian vein groups. Compared to the jugular and the subclavian vein groups, the implanted venous port in the upper arm vein has fewer complications and more convenience and comfort, and might be a superior novel choice for patients requiring long-term chemotherapy or parenteral nutrition.

  14. Fermentation optimization for the production of bioactive polysaccharides from Cordyceps sinensis fungus UM01.

    PubMed

    Wang, Lan-Ying; Cheong, Kit-Leong; Wu, Ding-Tao; Meng, Lan-Zhen; Zhao, Jing; Li, Shao-Ping

    2015-08-01

    The optimal fermentation conditions and medium for the production of bioactive polysaccharides from the mycelium of Cordyceps sinensis fungus UM01 were investigated by using orthogonal design and high performance size exclusion chromatography coupled with multi-angel laser light scattering and refractive index detector (HPSEC-MALLS-RID). Results showed that the optimal temperature, initial pH, rotation speed, medium capacity (ratio of medium volume to the volume of flask bottle) and inoculums volume for the mycelium growth were 15 °C, pH 6.0, 150 rpm, 2/5 (v/v), and 3% (v/v), respectively. Furthermore, bioactive polysaccharides from the mycelium of C. sinensis fungus UM01 were determined as polysaccharide fractions with the molecular weight above 10 kDa. The optimal fermentation medium was determined as a composition of glucose 30.0 g/L, sucrose 30.0 g/L, KH2PO4 1.0 g/L, CaCl2 0.5 g/L, yeast extract 3.0 g/L, and MgCl2 0.1g/L according to the maximum amount of the bioactive polysaccharides (486.16±19.60 mg/L) measured by HPSEC-MALLS/RID. Results are helpful to establish an efficient and controllable fermentation process for the industrial production of bioactive polysaccharides from C. sinensis UM01, and beneficial to develop a unique health and functional product in future. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Mental health problems of undocumented migrants (UMs) in the Netherlands: a qualitative exploration of help-seeking behaviour and experiences with primary care

    PubMed Central

    Teunissen, Erik; Sherally, Jamilah; van den Muijsenbergh, Maria; Dowrick, Chris; van Weel-Baumgarten, Evelyn; van Weel, Chris

    2014-01-01

    Objective To explore health-seeking behaviour and experiences of undocumented migrants (UMs) in general practice in relation to mental health problems. Design Qualitative study using semistructured interviews and thematic analysis. Participants 15 UMs in the Netherlands, varying in age, gender, country of origin and education; inclusion until theoretical saturation was reached. Setting 4 cities in the Netherlands. Results UMs consider mental health problems to be directly related to their precarious living conditions. For support, they refer to friends and religion first, the general practitioner (GP) is their last resort. Barriers for seeking help include taboo on mental health problems, lack of knowledge of and trust in GPs competencies regarding mental health and general barriers in accessing healthcare as an UM (lack of knowledge of the right to access healthcare, fear of prosecution, financial constraints and practical difficulties). Once access has been gained, satisfaction with care is high. This is primarily due to the attitude of the GPs and the effectiveness of the treatment. Reasons for dissatisfaction with GP care are an experienced lack of time, lack of personal attention and absence of physical examination. Expectations of the GP vary, medication for mental health problems is not necessarily seen as a good practice. Conclusions UMs often see their precarious living conditions as an important determinant of their mental health; they do not easily seek help for mental health problems and various barriers hamper access to healthcare for them. Rather than for medication, UMs are looking for encouragement and support from their GP. We recommend that barriers experienced in seeking professional care are tackled at an institutional level as well as at the level of GP. PMID:25416057

  16. Changes in plasma phenylalanine, isoleucine, leucine, and valine are associated with significant changes in intracranial pressure and jugular venous oxygen saturation in patients with severe traumatic brain injury.

    PubMed

    Vuille-Dit-Bille, Raphael N; Ha-Huy, Riem; Stover, John F

    2012-09-01

    Changes in plasma aromatic amino acids (AAA = phenylalanine, tryptophan, tyrosine) and branched chain amino acids (BCAA = isoleucine, leucine, valine) levels possibly influencing intracranial pressure (ICP) and cerebral oxygen consumption (SjvO(2)) were investigated in 19 sedated patients up to 14 days following severe traumatic brain injury (TBI). Compared to 44 healthy volunteers, jugular venous plasma BCAA were significantly decreased by 35% (p < 0.001) while AAA were markedly increased in TBI patients by 19% (p < 0.001). The BCAA to AAA ratio was significantly decreased by 55% (p < 0.001) which persisted during the entire study period. Elevated plasma phenylalanine was associated with decreased ICP and increased SjvO(2), while higher plasma isoleucine and leucine levels were associated with increased ICP and higher plasma leucine and valine were linked to decreased SjvO(2). The amount of enterally administered amino acids was associated with significantly increased plasma levels with the exception of phenylalanine. Contrary to the initial assumption that elevated AAA and decreased BCAA levels are detrimental, increased plasma phenylalanine levels were associated with beneficial signs in terms of decreased ICP and reduced cerebral oxygen consumption reflected by increased SjvO(2); concomitantly, elevated plasma isoleucine and leucine levels were associated with increased ICP while leucine and valine were associated with decreased SjvO(2) following severe TBI, respectively. The impact of enteral nutrition on this observed pattern must be examined prospectively to determine if higher amounts of phenylalanine should be administered to promote beneficial effects on brain metabolism and if normalization of plasma BCAA levels is without cerebral side effects.

  17. VizieR Online Data Catalog: SG1120-1202 members HST imaging & 24um fluxes (Monroe+, 2017)

    NASA Astrophysics Data System (ADS)

    Monroe, J. T.; Tran, K.-V. H.; Gonzalez, A. H.

    2017-09-01

    We employ HST imaging of an ~8'x12' mosaic across three filters: F390W (WFC3/UVIS), F606W (ACS/WFC), and F814W (ACS/WFC) for a total of 44 pointings (combined primary and parallels) during cycles 14 (GO 10499) and 19 (GO 12470). We use the Spitzer MIPS 24um fluxes from Saintonge+ (2008ApJ...685L.113S) and Tran+ (2009ApJ...705..809T). The 24um observations were retrieved from the Spitzer archive. For details on spectroscopy from multi-band ground-based observations using Magellan (in 2006), MMT, and VLT/VIMOS (in 2003), we refer the reader to Tran+ (2009ApJ...705..809T). (1 data file).

  18. Giant gastric lipossarcoma: case report and review of the literature.

    PubMed

    Matone, Jacques; Okazaki, Samuel; Maccapani, Gabriel Naman; Amancio, Thiago Trolez; Filippi, Renée Zon; Macedo, Antonio Luiz de Vasconcellos

    2016-01-01

    Liposarcoma is one of the most common soft tissue sarcomas in adults, occurring in 15 to 20% of all patients with sarcoma. Primary liposarcoma of the stomach is rare. We report a case of patient with giant gastric liposarcoma who underwent surgery after a gastrointestinal bleeding. Preoperative hystopathological diagnosis was not established, even after three biopsy attempts. We discuss differential diagnosis, genetic causes, diagnosis strategies and treatment. RESUMO O lipossarcoma é um tipo comum de sarcomas em adultos, com incidência entre 15 e 20% entre os sarcomas. No entanto, o acometimento do estômago é raro. Relatamos um caso de um lipossarcoma primário gástrico gigante com apresentação clínica de hemorragia digestiva. Foi submetido a tratamento cirúrgico sem diagnóstico definitivo, apesar de três biópsias realizadas. Revisamos diagnósticos diferenciais, influência genética e estratégias diagnósticas e terapêuticas.

  19. VizieR Online Data Catalog: 12um ISOCAM survey of the ESO-Sculptor field (Seymour+, 2007)

    NASA Astrophysics Data System (ADS)

    Seymour, N.; Rocca-Volmerange, B.; de Lapparent, V.

    2007-11-01

    We present a detailed reduction of a mid-infrared 12um (LW10 filter) ISOCAM open time observation performed on the ESO-Sculptor Survey field (Arnouts et al., 1997A&AS..124..163A). A complete catalogue of 142 sources (120 galaxies and 22 stars), detected with high significance (equivalent to 5{sigma}), is presented above an integrated flux density of 0.31mJy. Star/galaxy separation is performed by a detailed study of colour-colour diagrams. The catalogue is complete to 1mJy and, below this flux density, the incompleteness is corrected using two independent methods. The first method uses stars and the second uses optical counterparts of the ISOCAM galaxies; these methods yield consistent results. We also apply an empirical flux density calibration using stars in the field. For each star, the 12um flux density is derived by fitting optical colours from a multi-band {chi}2 to stellar templates (BaSel-2.0) and using empirical optical-IR colour-colour relations. This article is a companion analysis to our 2007 paper (Rocca-Volmerange et al. 2007A&A...475..801R) where the 12um faint galaxy counts are presented and analysed per galaxy type with the evolutionary code PEGASE.3. (1 data file).

  20. Analysis of head impact exposure and brain microstructure response in a season-long application of a jugular vein compression collar: a prospective, neuroimaging investigation in American football.

    PubMed

    Myer, Gregory D; Yuan, Weihong; Barber Foss, Kim D; Thomas, Staci; Smith, David; Leach, James; Kiefer, Adam W; Dicesare, Chris; Adams, Janet; Gubanich, Paul J; Kitchen, Katie; Schneider, Daniel K; Braswell, Daniel; Krueger, Darcy; Altaye, Mekibib

    2016-10-01

    Historical approaches to protect the brain from outside the skull (eg, helmets and mouthpieces) have been ineffective in reducing internal injury to the brain that arises from energy absorption during sports-related collisions. We aimed to evaluate the effects of a neck collar, which applies gentle bilateral jugular vein compression, resulting in cerebral venous engorgement to reduce head impact energy absorption during collision. Specifically, we investigated the effect of collar wearing during head impact exposure on brain microstructure integrity following a competitive high school American football season. A prospective longitudinal controlled trial was employed to evaluate the effects of collar wearing (n=32) relative to controls (CTRL; n=30) during one competitive football season (age: 17.04±0.67 years). Impact exposure was collected using helmet sensors and white matter (WM) integrity was quantified based on diffusion tensor imaging (DTI) serving as the primary outcome. With similar overall g-forces and total head impact exposure experienced in the two study groups during the season (p>0.05), significant preseason to postseason changes in mean diffusivity, axial diffusivity and radial diffusivity in the WM integrity were noted in the CTRL group (corrected p<0.05) but not in the collar group (p>0.05). The CTRL group demonstrated significantly larger preseason to postseason DTI change in multiple WM regions compared with the collar group (corrected p<0.05). Reduced WM diffusivity alteration was noted in participants wearing a neck collar after a season of competitive football. Collar wearing may have provided a protective effect against brain microstructural changes after repetitive head impacts. NCT02696200. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. The Athenæum Club, the Royal Society and the reform of dentistry in nineteenth-century Britain: A research report

    PubMed Central

    Bishop, Malcolm G. H.

    2017-01-01

    In 1978 M. J. Peterson examined the role played by the Royal College of Surgeons (RCS) in nineteenth-century dental reform, noting the establishment of its Licence in Dental Surgery (LDS) in 1859. In a paper published in Notes and Records in 2010, the present author described the influential role played by Fellows of the Royal Society during the nineteenth-century campaign for dental reform led by Sir John Tomes. Key players in this campaign, including the dentists Samuel Cartwright, Thomas Bell and James Salter, were, as well as being Fellows of the Royal Society, members of the Athenæum Club. The present research report indicates the roles played by those members of the Athenæum Club who were also Fellows of the Royal Society in the scientific and professional reform of nineteenth-century dentistry. Although it does not attempt to document meetings at the Club, it suggests the potential for a symbiotic effect between the Royal Society and the Athenæum. Where the previous paper proposed an active scientific role for the Royal Society in reforming dentistry, this paper presents the Athenæum as a significant extension of the sphere of influence into the cultural realm for those who did enjoy membership of both organizations.

  2. Utility of capillary microsampling for rat pharmacokinetic studies: Comparison of tail-vein bleed to jugular vein cannula sampling.

    PubMed

    Korfmacher, Walter; Luo, Yongyi; Ho, Stacy; Sun, Wei; Shen, Liduo; Wang, Jie; Wu, Zhongtao; Guo, Yang; Snow, Gregory; O'Shea, Thomas

    2015-01-01

    Serial sampling methods have been used for rat pharmacokinetic (PK) studies for over 20 years. Currently, it is still common to take 200-250 μL of blood at each timepoint when performing a PK study in rats and using serial sampling. While several techniques have been employed for collecting blood samples from rats, there is only limited published data to compare these methods. Recently, microsampling (≤ 50 μL) techniques have been reported as an alternative process for collecting blood samples from rats. In this report, five compounds were dosed orally into rats. For three proprietary compounds, jugular vein cannula (JVC) sampling was used to collect whole blood and plasma samples and capillary microsampling (CMS) was used to collect blood samples from the tail vein of the same animal. For the two other compounds, marketed drugs fluoxetine and glipizide, JVC sampling was used to collect both whole blood and blood CMS samples while tail-vein sampling from the same rats was also used to collect both whole blood and blood CMS samples. For the three proprietary compounds, the blood AUC as well as the blood concentration-time profile that were obtained from the tail vein were different from those obtained via JVC sampling. For fluoxetine, the blood total exposure (AUC) was not statistically different when comparing tail-vein sampling to JVC sampling, however the blood concentration-time profile that was obtained from the tail vein was different than the one obtained from JVC sampling. For glipizide, the blood AUC and concentration-time profile were not statistically different when comparing the tail-vein sampling to the JVC sampling. For both fluoxetine and glipizide, the blood concentration profiles obtained from CMS were equivalent to the blood concentration profiles obtained from the standard whole blood sampling, collected at the same sampling site. The data in this report provide strong evidence that blood CMS is a valuable small volume blood sampling approach

  3. VizieR Online Data Catalog: 70um-1.2mm and N2H+ maps of IRDC18454 (W43) (Beuther+,

    NASA Astrophysics Data System (ADS)

    Beuther, H.; Tackenberg, J.; Linz, H.; Henning, T.; Krause, O.; Ragan, S.; Nielbock, M.; Launhardt, R.; Schmiedeke, A.; Schuller, F.; Carlhoff, P.; Nguyen-Luong, Q.; Sakai, T.

    2011-11-01

    The cloud complex with a size of ~6'x6' was observed with PACS on Herschel on 2010 March 9. Maps at 250, 350, and 500um were obtained with SPIRE 2010) on 2010 March 11. We observed IRDC18454-1 with the Plateau de Bure Interferometer during five nights in October and November 2009 at 93GHz in the C and D configurations. The N2H+ data has been observed using the BEARS receiver at the NRO 45m telescope in Nobeyama, Japan. The different velocity components have been observed one in April 2010 with an average system temperature of Tsys=206K, the second in June, at slightly lower Tsys. The MIPS 24um data (from MIPSGAL) as well as the IRAC 8um observations (from GLIMPSE) are taken from the Spitzer archive. The 1.2mm continuum data were first presented in Beuther et al. (2002, Cat. J/ApJ/566/945) and the APEX 870um data are part of the ATLASGAL survey of the Galactic plane (Schuller et al., 2009A&A...504..415S). (2 data files).

  4. Determination of self attenuation coefficient and relative TL efficiency of CaSO 4 :Dy, LiF:Mg,Cu,P and LiF:Mg,Ti TLDs - An alternate approach

    NASA Astrophysics Data System (ADS)

    Bakshi, A. K.; Chatterjee, S.; Palani Selvam, T.; Joshi, V. J.; Chougaonkar, M. P.

    2011-10-01

    Self attenuation of TL and relative TL efficiency of polytetra fluoro ethylene (PTFE) embedded CaSO 4:Dy disc, LiF:Mg,Ti (MTS) disc and LiF:Mg,Cu,P (MCP-N) chip were determined in the present study for photons of energy 10-34 keV. The relative TL efficiency was determined using an alternative approach in which ratio of experimental response and corrected theoretical response was used instead of measuring the absolute TL emission in photon counting mode. For CaSO 4:Dy disc, it was found that with increasing the proportion of CaSO 4:Dy phosphor in the disc, the light attenuation coefficient increases. The light attenuation coefficient of MTS disc and MCP-N chip was found to be 23.4 and 45.5 cm -1, respectively. The relative TL efficiency in the photon energy range of 10-34 keV for MTS discs and MCP-N chips, evaluated in the present study matches well with the reported values in the literature.

  5. Soluble minerals in chemical evolution. I - Adsorption of 5-prime-AMP on CaSO4 - A model system

    NASA Technical Reports Server (NTRS)

    Orenberg, J. B.; Chan, S.; Calderon, J.; Lahav, N.

    1985-01-01

    The adsorption of 5-prime-AMP onto solid CaSO4-2H2O was studied in a saturated suspension as a function of pH and electrolyte concentration. The adsorption is pH-dependent and is directly correlated with the charge on the 5-prime-AMP molecule which is determined by the state of protonation of the N-1 nitrogen of the purine ring and the phosphate oxygens. It is proposed that the binding that occurs between the nucleotide and the salt is electrostatic in nature. The adsorption decreases with increasing ionic strength of the solution which means that in a fluctuating environment of wetting and drying cycles, a biomolecule similar to 5-prime-AMP could be expected to desorb during the drying phase. The results indicate that CaSO4-2H2O can serve as a concentrating surface for biomolecules. The significance of this is discussed with regard to the possible role of soluble minerals and their surfaces in a geochemical model consistent with the evolution of the earth and the origin of life.

  6. Evolution and Persistence of 5-um Hot Spots at the Galileo Probe entry Latitude

    NASA Technical Reports Server (NTRS)

    Fisher, B. M.

    1997-01-01

    We present a study on the longtudinal locations, morphology and evolution of the 5-um hot spots at 6.5 deg. N latitude (planetocentric), from an extensive IRTF-NSFCAM data set spanning more that 3 years, which includes the date of the Galileo Probe entry.

  7. The short form of the recombinant CAL-A-type lipase UM03410 from the smut fungus Ustilago maydis exhibits an inherent trans-fatty acid selectivity.

    PubMed

    Brundiek, Henrike; Saß, Stefan; Evitt, Andrew; Kourist, Robert; Bornscheuer, Uwe T

    2012-04-01

    The Ustilago maydis lipase UM03410 belongs to the mostly unexplored Candida antarctica lipase (CAL-A) subfamily. The two lipases with [corrected] the highest identity are a lipase from Sporisorium reilianum and the prototypic CAL-A. In contrast to the other CAL-A-type lipases, this hypothetical U. maydis lipase is annotated to possess a prolonged N-terminus of unknown function. Here, we show for the first time the recombinant expression of two versions of lipase UM03410: the full-length form (lipUMf) and an Nterminally truncated form (lipUMs). For comparison to the prototype, the expression of recombinant CAL-A in E. coli was investigated. Although both forms of lipase UM03410 could be expressed functionally in E. coli, the N-terminally truncated form (lipUMs) demonstrated significantly higher activities towards p-nitrophenyl esters. The functional expression of the N-terminally truncated lipase was further optimized by the appropriate choice of the E. coli strain, lowering the cultivation temperature to 20 °C and enrichment of the cultivation medium with glucose. Primary characteristics of the recombinant lipase are its pH optimum in the range of 6.5-7.0 and its temperature optimum at 55 °C. As is typical for lipases, lipUM03410 shows preference for long chain fatty acid esters with myristic acid ester (C14:0 ester) being the most preferred one.More importantly, lipUMs exhibits an inherent preference for C18:1Δ9 trans and C18:1Δ11 trans-fatty acid esters similar to CAL-A. Therefore, the short form of this U. maydis lipase is the only other currently known lipase with a distinct trans-fatty acid selectivity.

  8. Pneumatocele selar a tensión: Reporte de un caso y revisión de la literatura

    PubMed Central

    Campero, Álvaro; Ajler, Pablo; Goldschmidt, Ezequiel; Bendersky, Damián; Campero, Abraham

    2012-01-01

    Introducción: El neumoencéfalo a tensión luego de la cirugía transesfenoidal es poco común. En la literatura existen pocos casos reportados en los cuales el aire se encuentra localizado exclusivamente en las regiones selar y supraselar, constituyendo un pneumatocele selar. En este artículo se describe un caso inusual de pneumatocele selar a tensión de presentación tardía. Descripción del caso: Una mujer de 57 años consultó por hemianopsia bitemporal. Previamente, ya se le había realizado una cirugía transnasal por un adenoma hipofisario y se le había colocado una derivación lumbo-peritoneal por la presencia de una fístula de líquido cefalorraquídeo. Además, se le había realizado una resección transcraneal de un componente intracavernoso del tumor y radiocirugía debido a la agresividad del mismo. Se llevó a cabo una resonancia magnética que demostró un pneumatocele selar y supraselar. Intervención: Se realizó un abordaje transciliar. La región selar estaba encapsulada por tejido cicatrizal debido a los procedimientos previos. Se abrió la cicatriz y el aire fue evacuado. Posteriormente, el piso selar fue cerrado con grasa y cola de fibrina. Despuós del procedimiento, su campo visual retornó a la normalidad. Un año después de su última cirugía, continua asintomática. Conclusión: El pneumatocele selar y supraselar a tensión es un hallazgo extremadamente raro luego de una cirugía transesfenoidal. Su manifestaciónw clínica sería la alteración visual debida a la compresión inferior de la vía óptica. El pneumatocele selar a tensión debe ser evacuado en un corto plazo. PMID:23596554

  9. Recent transmission of drug-resistant Mycobacterium tuberculosis in a prison population in southern Brazil.

    PubMed

    Reis, Ana Julia; David, Simone Maria Martini de; Nunes, Luciana de Souza; Valim, Andreia Rosane de Moura; Possuelo, Lia Gonçalves

    2016-01-01

    We conducted a cross-sectional, retrospective study, characterized by classical and molecular epidemiology, involving M. tuberculosis isolates from a regional prison in southern Brazil. Between January of 2011 and August of 2014, 379 prisoners underwent sputum smear microscopy and culture; 53 (13.9%) were diagnosed with active tuberculosis. Of those, 8 (22.9%) presented with isoniazid-resistant tuberculosis. Strain genotyping was carried out by 15-locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat analysis; 68.6% of the patients were distributed into five clusters, and 87.5% of the resistant cases were in the same cluster. The frequency of drug-resistant tuberculosis cases and the rate of recent transmission were high. Our data suggest the need to implement an effective tuberculosis control program within the prison system. RESUMO Estudo transversal, retrospectivo, com isolados de M. tuberculosis de pacientes de um presídio regional no sul do Brasil, caracterizado através de epidemiologia clássica e molecular. Entre janeiro de 2011 e agosto de 2014, 379 detentos foram submetidos a baciloscopia e cultura, sendo 53 (13,9%) diagnosticados com tuberculose ativa. Desses, 8 (22,9%) apresentavam tuberculose resistente a isoniazida. A genotipagem das cepas foi realizada por 15-locus mycobacterial interspersed repetitive units-variable number of tandem repeat analysis; 68,6% dos pacientes estavam distribuídos em cinco clusters, e 87,5% dos casos resistentes estavam em um mesmo cluster. Verificou-se uma frequência elevada de casos de resistência e alta taxa de transmissão recente. Estes dados sugerem a necessidade da implantação de um programa efetivo de controle da tuberculose no sistema prisional.

  10. An Investigation of the Adsorption Characteristics of 5'ATP and 5'AMP onto the Surface of Caso4 x 2H2O

    NASA Technical Reports Server (NTRS)

    Calderon, J.; Sweeney, M. A.

    1984-01-01

    A model has been proposed in which solid surfaces can act as a site for cataletic activity of condensation reactions for certain biomolecules. From this model, the adsorption characteristics of 5'ATP and 5'AMP onto the surface of CaSO4.2H2O was chosen for study. It has been proven that 5'ATP and 5'AMP do adsorb onto the surface of CaSO4. Studies were then made to determine the dependence of absorption versus time, concentration, ionic strength and pH. It was found that the adsorption of the nucleotides is highly pH dependent, primarily determined by the phosphate acid groups of the nucleic acid molecule. From this investigation, the data obtained is discussed in relation to the model for the prebiotic earth.

  11. Mid-term sustained relief from headaches after balloon angioplasty of the internal jugular veins in patients with multiple sclerosis

    PubMed Central

    Giaquinta, Alessia; Veroux, Massimiliano; De Marco, Ester; Mociskyte, Dovile; Veroux, Pierfrancesco

    2018-01-01

    Objectives Multiple sclerosis (MS) patients frequently suffer from headaches and fatigue, and many reports have linked headaches with intracranial and/or extracranial venous obstruction. We therefore designed a study involving MS patients diagnosed with obstructive disease of internal jugular veins (IJVs), with the aim of evaluating the impact of percutaneous transluminal angioplasty (PTA) on headache and fatigue indicators. Methods 286 MS patients (175 relapsing remitting (RR), 75 secondary progressive (SP), and 36 primary progressive (PP)), diagnosed with obstructive disease of IJVs, underwent PTA of IJVs during the period 2011–2015. This included 113 headache positive patients (82 RR, 22 SP, and 9 PP) and 277 fatigue positive patients (167 RR, 74 SP, and 36 PP). Migraine Disability Assessment (MIDAS), and the Fatigue Severity Scale (FSS) were evaluated: before PTA; 3-months after PTA; and at final follow-up in 2017. Patients were evaluated with Doppler sonography of the IJVs at 1, 6 and 12 months after PTA and yearly thereafter. Non-parametric statistical analysis was performed using a combination of the Friedman test and Spearman correlation analysis. Results With the exception of the PP patients there were significant reductions (all p < 0.001) in the MIDAS and FSS scores in the 3-month following PTA. The improvement in MIDAS score following PTA was maintained throughout the follow-up period in both the RR (p < 0.001; mean of 3.55 years) and SP (p = 0.002; mean of 3.52 years) MS cohorts. With FSS, significant improvement was only observed at 2017 follow-up in the RR patients (p < 0.001; mean of 3.37 years). In the headache-positive patients, post-PTA MIDAS score was significantly negatively correlated with the change in the blood flow score in the left (r = -0.238, p = 0.031) and right (r = -0.250, p = 0.023) IJVs in the RR patients and left IJV (r = -0.727, p = 0.026) in the PP patients. In the fatigue-positive cohort, post-PTA FSS score was also

  12. Multifocal synchronous ipsilateral Warthin tumors: case report and review of the literature.

    PubMed

    Hall, Joseph E; Statham, Melissa McCarty; Sheridan, Rachel M; Wilson, Keith M

    2010-09-01

    We report a case of a 73-year-old woman who presented with an enlarging superficial parotid mass, a concomitant ipsilateral deep-lobe parotid mass, and associated upper jugular lymphadenopathy. The clinical presentation and radiographic imaging were suggestive of malignancy, and the patient was treated with total parotidectomy with upper jugular lymph node sampling. Pathologic examination revealed two distinct masses, one in the superficial lobe and one in the deep lobe of the parotid gland, both consistent with synchronous Warthin tumors. Analysis of the upper jugular lymph nodes was consistent with reactive lymphoid hyperplasia. Although the true incidence of multicentricity in ipsilateral Warthin tumors may be underappreciated and underreported, this entity should remain in the differential diagnosis for unilateral parotid masses.

  13. Solubility of Anhydrite (CaSO4) in NaCl-H2O Fluids at High T and P

    NASA Astrophysics Data System (ADS)

    Newton, R. C.; Manning, C. E.

    2003-12-01

    Weight losses of single crystals of a very pure natural anhydrite exposed to NaCl solutions of 0-0.3 mol fraction were measured at 600-800 \\deg C and 6-14 kbar. Experimental charges were contained in welded Pt capsules in 1.91 cm-diameter piston-cylinder apparatus with NaCl pressure medium for 5-72 hr. Measurements in initially pure H2O were made with HM, NNO, and MnO2 buffers, as well as without buffering. At 800 \\deg C and 10 kbar, CaSO4 molalities are: MnO2, 0.014 mol/kg H2O; HM, 0.017; NNO, 0.148; and unbuffered, 0.026. Variation in oxygen fugacity thus has a large effect on CaSO4 solubility, increasing with H2S/SO2 in the fluid. Unbuffered (self-buffered) charges gave solubilities much closer to HM than NNO. Melting occurred in the NNO experiment at this P and T. NaCl increases CaSO4 solubility enormously, with m(CaSO4) reaching 5.4, or 23.5 wt. %, at 800 \\deg C, 10 kbar and X(NaCl)=0.3. There is also a very large increase with temperature. Regression of all the data give: log(m-mo) = -1.533 + 0.00291T + (1.441 + 0.00016T)logX(NaCl) + 0.0413(P-10) where mo is molality in pure H2O, P is in kbar, and T is in Kelvins. The very large carrying capacity for sulfate in even mildly saline fluids at high P and T, together with the high oxygen potential generated when these solutions react with FeO in rocks to yield pyrrhotite, indicates that such fluids should be considered as principal agents in S-rich, highly oxidizing processes such as Pinatubo-type volcanic eruptions, certain deep-crustal granulite facies metamorphism, as in Bamble, Norway and Shevaroy Hills, S. India, and the anhydrite-related, oxidized Au ore deposits like Abitibi, Ontario, and Kalgoorlie, Australia.

  14. Preliminary Studies of Thermoluminescence Dosimeter (TLD) CaSO4:Dy Synthesis

    NASA Astrophysics Data System (ADS)

    Nuraeni, N.; Iskandar, F.; Waris, A.; Haryanto, F.

    2017-07-01

    Thermoluminescence dosimeter (TLD) CaSO4:Dy was synthesised by coprecipitation. The TLD was observed after radiation exposure to Strontium-90. The thermoluminescence intensity was read using a TLD Reader Harshaw 3500. The thermoluminescent response obtained was 59.29 nC. Then re-annealing was conducted with the temperature varied at 700, 800 and 900 °C. The thermoluminescent intensity obtained at temperatures of 700 °C, 800 °C and 900 °C was 66.12 nC, 169.45 nC, and 552.37 nC respectively. The sensitivity of the TLD increased in response to the re-annealing temperature rise. In addition to observing the thermoluminescence properties, a comparison was made between the TLD obtained from this experiment with an existing TLD in the market. Finally, also the glow-curve characteristics of the TLD were observed.

  15. Spatial distribution of tuberculosis in a municipality in the interior of São Paulo, 2008-2013.

    PubMed

    Fusco, Alcione Pereira Biffi; Arcêncio, Ricardo Alexandre; Yamamura, Mellina; Palha, Pedro Fredemir; Reis, Amanda Alessandra Dos; Alecrim, Tatiana Ferraz de Araújo; Protti, Simone Teresinha

    2017-06-05

    to describe the epidemiological clinical profile of tuberculosis and analyze the spatial distribution of cases in a municipality in the state of São Paulo. descriptive and ecological study of cases of tuberculosis through the records in an information system. Descriptive statistics were used to calculate central tendency (mean) and chi-square test, with Yates correction or Fisher exact test, when necessary. The Kernel technique was also used to calculate the occurrence densities of tuberculosis cases, using a radius of 1000 meters. Type I error was set at 5%. 299 cases of tuberculosis were identified, with 290 (96.98%) being geocoded. The majority of these were male (n = 212; 70.91%), median age 40 years, and the pulmonary clinical form was predominant (n = 244, 81.60%). The distribution occurred in a non-random manner, observing important areas of the municipality with a higher density of cases of the disease. the study evidenced an epidemiological profile of tuberculosis cases similar to those in the literature; however, their distribution does not occur in a random manner, pointing to specific population groups that require greater management and planning of health services for the control of tuberculosis. caracterizar o perfil clínico epidemiológico da tuberculose (TB) e analisar a distribuição espacial dos casos em município paulista. estudo descritivo e ecológico dos casos de tuberculose registrados em um sistema de informação. Recorreu-se à estatística descritiva com cálculo de medidas de tendência central (média) e aplicação do teste qui-quadrado, com correção de Yates ou teste exato de Fisher, quando necessários. Aplicou-se ainda a técnica de Kernel para o cálculo das densidades de ocorrência dos casos da TB, utilizando um raio de 1000 metros. Fixou-se o erro tipo I em 5%. identificou-se 299 casos de TB, sendo geocodificados 290 (96,98%). A maioria destes foi do sexo masculino (n=212; 70,91%), idade mediana 40 anos, sendo a forma cl

  16. Corticosterone and dehydroepiandrosterone in songbird plasma and brain: effects of season and acute stress

    PubMed Central

    Newman, Amy E. M.; Soma, Kiran K.

    2010-01-01

    Prolonged increases in plasma glucocorticoids can exacerbate neurodegeneration. In rats, these neurodegenerative effects can be reduced by dehydroepiandrosterone (DHEA), an androgen precursor with anti-glucocorticoid actions. In song sparrows, season and acute restraint stress affect circulating levels of corticosterone and DHEA, and the effects of stress differ in plasma collected from the brachial and jugular veins. Jugular plasma is an indirect index of the neural steroidal milieu. Here, we directly measured corticosterone and DHEA in several brain regions and jugular plasma, and examined the effects of season and acute restraint stress (30 min) (n = 571 samples). Corticosterone levels were up to 10× lower in brain than in jugular plasma. In contrast, DHEA levels were up to 5× higher in brain than in jugular plasma and were highest in the hippocampus. Corticosterone and DHEA concentrations were strongly seasonally regulated in plasma but, surprisingly, not seasonally regulated in brain. Acute stress increased corticosterone levels in plasma and brain, except during the molt, when stress unexpectedly decreased corticosterone levels in the hippocampus. Acute stress increased DHEA levels in plasma during the molt but had no effects on DHEA levels in brain. This is the first study to measure (i) corticosterone or DHEA levels in the brain of adult songbirds and (ii) seasonal changes in corticosterone or DHEA levels in the brain of any species. These results highlight several critical differences between systemic and local steroid concentrations and the difficulty of using circulating steroid levels to infer local steroid levels within the brain. PMID:19473242

  17. Tratamento endovascular de aneurisma de aorta abdominal com erosão de vértebra lombar associada à doença de Behçet: relato de caso

    PubMed Central

    de Souza, Nathalia Leslie Albanez Rodrigues; Siqueira, Daniel Emílio Dalledone; Cantador, Alex Aparecido; Rossetti, Leandro Pablos; Molinari, Giovani José Dal Poggetto; Guillaumon, Ana Terezinha

    2017-01-01

    Resumo A doença de Behçet é uma doença sistêmica, multifatorial e autoimune com diversas manifestações clínicas, entre elas o acometimento vascular. Aneurisma de aorta associado a erosão de vértebra lombar é condição rara na literatura, existindo apenas quatro relatos de caso nas bases de dados da PubMed. O presente artigo relata o caso de paciente do sexo feminino com diagnóstico de Doença de Behçet de longa data e aneurisma sacular de aorta abdominal infrarrenal com erosão de vértebra lombar. O caso foi tratado por meio de técnica endovascular com colocação de endoprótese monoilíaca e enxerto fêmoro-femoral cruzado, devido a limitações anatômicas da bifurcação aórtica. O artigo aborda a raridade desse tipo de apresentação da doença e o desfecho do tratamento e apresenta revisão da literatura sobre esse tema. PMID:29930640

  18. l-Arginine Pathway Metabolites Predict Need for Intra-operative Shunt During Carotid Endarterectomy.

    PubMed

    Szabo, P; Lantos, J; Nagy, L; Keki, S; Volgyi, E; Menyhei, G; Illes, Z; Molnar, T

    2016-12-01

    Asymmetric dimethylarginine (ADMA) inhibits nitric oxide (NO) synthesis and is a marker of atherosclerosis. This study examined the correlation between pre-operative l-arginine and ADMA concentration during carotid endarterectomy (CEA), and jugular lactate indicating anaerobic cerebral metabolism, jugular S100B reflecting blood-brain barrier integrity, and with factors of surgical intervention. The concentration of l-arginine, ADMA, and symmetric dimethylarginine was measured in blood taken under regional anaesthesia from the radial artery of 55 patients prior to CEA. Blood gas parameters, concentration of lactate, and S100B were also serially measured in blood taken from both the radial artery and the jugular bulb before and after carotid clamping, and after release of the clamp. To estimate anaerobic metabolism, the jugulo-arterial ratio of CO 2 gap/oxygen extraction was calculated. Positive correlation was found between pre-operative ADMA levels and the ratio of jugulo-arterial CO 2 gap/oxygen extraction during clamp and reperfusion (p = .005 and p = .01, respectively). An inverse correlation was found between the pre-operative l-arginine concentration and jugular lactate at each time point (both p = .002). The critical pre-operative level of l-arginine was determined by receiver operator curve analysis. If l-arginine was below the cutoff value of 35 μmol/L, jugular S100B concentration was higher 24 h post-operatively (p = .03), and jugular lactate levels were increased during reperfusion (p = .02). The median pre-operative concentration of l-arginine was lower in patients requiring an intra-operative shunt than in patients without need of shunt (median: 30.3 μmol/L [interquartile range 24.4-34.4 μmol/L] vs. 57.6 μmol/L [interquartile range 42.3-74.5 μmol/L]; p = .002). High pre-operative ADMA concentration predicts poor cerebral perfusion indicated by elevated jugulo-arterial CO 2 gap/oxygen extraction. Low pre-operative l

  19. Wissenschaft, die unsere Kultur verändert. Tiefenschichten des Streits um die Evolutionstheorie

    NASA Astrophysics Data System (ADS)

    Patzelt, Werner J.

    Die Evolutionstheorie ist eine der erfolgreichsten wissenschaftlichen Theorien. Sie erlaubt es, unsere Herkunft zu verstehen und riskante Merkmale gerade der menschlichen Spezies zu begreifen. Zugleich ist die Evolutionstheorie eine der umstrittensten Theorien. Das liegt nicht an ihrer empirischen Tragfähigkeit, sondern an ihrem Gegenstand. Sie handelt nämlich nicht nur - wie Hunderte andere wissenschaftliche Theorien - von der "Welt da draußen“, sondern vor allem auch von uns selbst und von unserem Platz in dieser Welt. Den einen gilt sie obendrein als Überwinderin religiösen Aberglaubens, den anderen als neuer Zugang zu Gott und seinem Wirken in der Welt. Ferner sehen die einen in der Evolution eine unbezweifelbare Tatsache gleich der Schwerkraft oder dem Holocaust, die anderen aber eine - noch oder dauerhaft - unbewiesene Hypothese oder gar eine falsche Schöpfungslehre. Und während die meisten Streitfragen solcher Art nach wechselseitig akzeptierten Regeln ‚normaler Wissenschaft‘ geklärt werden, wird bei der Frage nach dem Woher unserer Spezies und Kultur die intellektuelle Zuständigkeit von Wissenschaft mitunter überhaupt bezweifelt. Anscheinend geht es schon um recht tiefe Schichten unserer Kultur und nicht nur der wissenschaftlichen, wenn - wie seit 150 Jahren - um die Evolutionstheorie gestritten wird. Wie sehen diese Schichten aus?

  20. The resolution sensitivity of the Asian summer monsoon and its inter-model comparison between MRI-AGCM and MetUM

    NASA Astrophysics Data System (ADS)

    Ogata, Tomomichi; Johnson, Stephanie J.; Schiemann, Reinhard; Demory, Marie-Estelle; Mizuta, Ryo; Yoshida, Kohei; Osamu Arakawa

    2017-11-01

    In this study, we compare the resolution sensitivity of the Asian Summer Monsoon (ASM) in two Atmospheric General Circulation Models (AGCMs): the MRI-AGCM and the MetUM. We analyze the MetUM at three different resolutions, N96 (approximately 200-km mesh on the equator), N216 (90-km mesh) and N512 (40-km mesh), and the MRI-AGCM at TL95 (approximately 180-km mesh on the equator), TL319 (60-km mesh), and TL959 (20-km mesh). The MRI-AGCM and the MetUM both show decreasing precipitation over the western Pacific with increasing resolution, but their precipitation responses differ over the Indian Ocean. In MRI-AGCM, a large precipitation increase appears off the equator (5-20°N). In MetUM, this off-equatorial precipitation increase is less significant and precipitation decreases over the equator. Moisture budget analysis demonstrates that a changing in moisture flux convergence at higher resolution is related to the precipitation response. Orographic effects, intra-seasonal variability and the representation of the meridional thermal gradient are explored as possible causes of the resolution sensitivity. Both high-resolution AGCMs (TL959 and N512) can represent steep topography, which anchors the rainfall pattern over south Asia and the Maritime Continent. In MRI-AGCM, representation of low pressure systems in TL959 also contributes to the rainfall pattern. Furthermore, the seasonal evolution of the meridional thermal gradient appears to be more accurate at higher resolution, particularly in the MRI-AGCM. These findings emphasize that the impact of resolution is only robust across the two AGCMs for some features of the ASM, and highlights the importance of multi-model studies of GCM resolution sensitivity.

  1. CrpP Is a Novel Ciprofloxacin-Modifying Enzyme Encoded by the Pseudomonas aeruginosa pUM505 Plasmid.

    PubMed

    Chávez-Jacobo, Víctor M; Hernández-Ramírez, Karen C; Romo-Rodríguez, Pamela; Pérez-Gallardo, Rocío Viridiana; Campos-García, Jesús; Gutiérrez-Corona, J Félix; García-Merinos, Juan Pablo; Meza-Carmen, Víctor; Silva-Sánchez, Jesús; Ramírez-Díaz, Martha I

    2018-06-01

    The pUM505 plasmid, isolated from a clinical Pseudomonas aeruginosa isolate, confers resistance to ciprofloxacin (CIP) when transferred into the standard P. aeruginosa strain PAO1. CIP is an antibiotic of the quinolone family that is used to treat P. aeruginosa infections. In silico analysis, performed to identify CIP resistance genes, revealed that the 65-amino-acid product encoded by the orf131 gene in pUM505 displays 40% amino acid identity to the Mycobacterium smegmatis aminoglycoside phosphotransferase (an enzyme that phosphorylates and inactivates aminoglycoside antibiotics). We cloned orf131 (renamed crpP , for c iprofloxacin r esistance p rotein, p lasmid encoded) into the pUCP20 shuttle vector. The resulting recombinant plasmid, pUC- crpP , conferred resistance to CIP on Escherichia coli strain J53-3, suggesting that this gene encodes a protein involved in CIP resistance. Using coupled enzymatic analysis, we determined that the activity of CrpP on CIP is ATP dependent, while little activity against norfloxacin was detected, suggesting that CIP may undergo phosphorylation. Using a recombinant His-tagged CrpP protein and liquid chromatography-tandem mass spectrometry, we also showed that CIP was phosphorylated prior to its degradation. Thus, our findings demonstrate that CrpP, encoded on the pUM505 plasmid, represents a new mechanism of CIP resistance in P. aeruginosa , which involves phosphorylation of the antibiotic. Copyright © 2018 American Society for Microbiology.

  2. Room and low temperature luminescence properties of CaSO4: Dy , Tm codoped with Li

    NASA Astrophysics Data System (ADS)

    Can, N.; Karalı, T.; Wang, Y.; Townsend, P. D.; Prokic, M.; Canimoglu, A.

    2009-08-01

    Rare earths, especially Dy or Tm doped CaSO4 phosphors are actively studied. They have high sensitivity, a large dynamic range, thermal stability and ease of preparation. Nevertheless, they can be enhanced by inclusion of lithium and this study reports some effects of lithium co-dopant on the TL and radioluminescence (RL) emissions of two TL phosphors. Addition of Li as a co-dopant ion was made either during chemical preparation of the phosphors, or as a binder component mixed with the basic phosphors matrix during the process of pressing and sintering the TLD pellets.

  3. Long-Term Results of Surgery for Temporal Bone Paraganglioma

    PubMed Central

    Gjuric, Mislav; Seidinger, Lynda; Wigand, Malte Erik

    1996-01-01

    The only way to resolve the dispute about the effectiveness of surgery versus radiation therapy for glomus tympanicum and jugulare tumors is adequate long-term studies. In a retrospective study with an average follow-up period of 15 years (range 11 to 23 years) we reassessed 11 patients with glomus tympanicum tumors and 11 patients with glomus jugulare tumors. Ten of 11 patients with glomus tympanicum tumor were tumor-free after surgery. A temporary facial palsy and an external meatal wall defect were the only surgical complications. The air-bone gap postoperatively closed to within 10 dB in three patients, to within 20 dB in six patients, and to more than 30 dB in one patient. Nine of 10 patients with glomus jugulare tumor receiving complete resection were tumor-free. Less than half the patients experienced new-onset cranial nerve function loss, and all made satisfactory recovery, eliminating the need for tracheostomy or gastrostomy. In two patients, the hearing could be preserved on the preoperative level, but the majority already presented with deafness. In the long-term, surgery remains a treatment of choice for glomus tympanicum tumors. It is also an extremely effective treatment with low morbidity for glomus jugulare tumors, including those with intracranial extension. PMID:17170971

  4. RAAS and stress markers in acute ischemic stroke: preliminary findings.

    PubMed

    Back, C; Thiesen, K L; Skovgaard, K; Edvinsson, L; Jensen, L T; Larsen, V A; Iversen, H K

    2015-02-01

    Angiotensin II type 1 receptor blockade has neuroprotective effects in animal stroke models, but no effects in clinical stroke trials. We evaluated cerebral and peripheral changes in the renin angiotensin aldosterone system (RAAS) and stress responses in acute ischemic stroke patients. Blood from a jugular and cubital vein was collected within 48 h of stroke onset, after 24 and 48 h, and renin, angiotensin I, angiotensin II, aldosterone, norepinephrine, epinephrine, and cortisol were measured. Post-stroke cubital vein samples were collected after 8 (4.7-10) months. The acute systolic blood pressure was significantly increased, 148 (141-168) vs 140 (130-147) mmHg post-stroke. Angiotensin I, renin and aldosterone levels were significantly lower, angiotensin II was unchanged, and ACE activity was higher in the acute phase compared to post-stroke. No differences in RAAS were detected between jugular and cubital plasma levels. Jugular venous plasma levels of epinephrine and cortisol were elevated in the acute phase compared to cubital levels (P < 0.05). Increased epinephrine and cortisol levels in the jugular vein blood may reflect a higher peripheral turnover. The observed changes in RAAS in the acute stroke phase are consistent with responses to increased blood pressure. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Lemierre's syndrome (necrobacillosis)

    PubMed Central

    Golpe, R.; Marin, B.; Alonso, M.

    1999-01-01

    Lemierre's syndrome or postanginal septicaemia (necrobacillosis) is caused by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. Fusobacterium necrophorum is the most common pathogen isolated from the patients. The interval between the oropharyngeal infection and the onset of the septicaemia is usually short. The most common sites of septic embolisms are the lungs and joints, and other locations can be affected. A high degree of clinical suspicion is needed to diagnose the syndrome. Computed tomography of the neck with contrast is the most useful study to detect internal jugular vein thrombosis. Treatment includes intravenous antibiotic therapy and drainage of septic foci. The role of anticoagulation is controversial. Ligation or excision of the internal jugular vein may be needed in some cases.


Keywords: Lemierre's syndrome; Fusobacterium necrophorum; necrobacillosis; septicaemia; oropharynx PMID:10448489

  6. Magnetic removal of electron contamination for 60Co panoramic gamma ray exposure--Investigations with CaSO4:Dy and LiF based dosimeters.

    PubMed

    Kumar, Munish; Sahani, G; Chourasiya, G

    2010-06-01

    Electron contamination from a sealed (60)Co radiation source has been investigated comprehensively using a CaSO(4):Dy based TLD badge and LiF crystals. It has been found that due to electron contamination, the thermoluminescence (TL) detectors exhibit over response which can be corrected by applying a magnetic field. It has also been found that for a source-to-dosimeter distance of 50 cm, the ratio of the TL readouts of the third to first discs of the TLD badge reduces from approximately 1.5 to approximately 1.00 after applying a magnetic field. Hence detectors which are sensitive to electrons as well as photons, and are capable of distinguishing them, can lead to an erroneous measurement. This happens because the contribution due to electron contamination interferes with pure gamma calibration. The study is helpful in establishing accurate calibration and appropriate correction factors for personnel monitoring carried out using CaSO(4):Dy based TLD badge. Copyright 2009 Elsevier Ltd. All rights reserved.

  7. Um enfoque antropológico para o ensino de astronomia no nível médio

    NASA Astrophysics Data System (ADS)

    Costa, G. B.; Jafelice, L. C.

    2003-08-01

    Há uma enorme carência de materiais didático-pedagógicos em astronomia para professores do ensino médio, sobretudo materiais que explorem também aspectos humanísticos. A origem do Universo é um bom exemplo desta constatação central. Embora tal origem teve explicações culturais diversas, os professores não têm informações sobre isso e muito menos material que trabalhe diferentes visões de mundo e treinamento que os capacite a abordá-las devidamente. Conseqüentemente o ensino de astronomia costuma ser tecnicista e dissociado do aspecto humano que alimenta o grande interesse e curiosidade que esses temas despertam. Aqui apresentamos propostas visando contribuir para reverter esse quadro e trabalhamos distintas visões de Universo: espontâneas, autóctones e científicas. Desenvolvemos práticas, materiais instrucionais e textos para viabilizar a adoção de um enfoque antropológico para o ensino de astronomia no nível médio, no qual as culturas humanística e científica sejam integradas de uma maneira contextualizada e eficaz para aquele ensino. Estas propostas foram aplicadas em um curso de treinamento para professores da rede pública de diferentes disciplinas. A receptividade dos professores à abordagem proposta e os resultados alcançados foram muito estimulantes. Destes, destacamos: produção de roteiros de atividades; desenvolvimento de práticas didático-pedagógicas específicas (e.g., encenação de mitos; dança primordial guarani; "criação" de constelações e interpretações pluriculturais; etc.); e sugestões concretas para a efetiva realização de um ensino interdisciplinar contextualizado, onde questões cosmogônicas servem de mote para iniciar tal ensino. Discutimos estes resultados e como o enfoque adotado pode instrumentalizar os professores para leituras de mundo que incluem naturalmente aspectos culturais, sociais e históricos associados aos temas estudados. (PPGECNM/UFRN; PRONEX/FINEP; NUPA/USP; Temáticos/FAPESP)

  8. The U. S. Geological Survey, Digital Spectral Library: Version 1 (0.2 to 3.0um)

    USGS Publications Warehouse

    Clark, Roger N.; Swayze, Gregg A.; Gallagher, Andrea J.; King, Trude V.V.; Calvin, Wendy M.

    1993-01-01

    We have developed a digital reflectance spectral library, with management and spectral analysis software. The library includes 498 spectra of 444 samples (some samples include a series of grain sizes) measured from approximately 0.2 to 3.0 um . The spectral resolution (Full Width Half Maximum) of the reflectance data is <= 4 nm in the visible (0.2-0.8 um) and <= 10 nm in the NIR (0.8-2.35 um). All spectra were corrected to absolute reflectance using an NIST Halon standard. Library management software lets users search on parameters (e.g. chemical formulae, chemical analyses, purity of samples, mineral groups, etc.) as well as spectral features. Minerals from borate, carbonate, chloride, element, halide, hydroxide, nitrate, oxide, phosphate, sulfate, sulfide, sulfosalt, and the silicate (cyclosilicate, inosilicate, nesosilicate, phyllosilicate, sorosilicate, and tectosilicate) classes are represented. X-Ray and chemical analyses are tabulated for many of the entries, and all samples have been evaluated for spectral purity. The library also contains end and intermediate members for the olivine, garnet, scapolite, montmorillonite, muscovite, jarosite, and alunite solid-solution series. We have included representative spectra of H2O ice, kerogen, ammonium-bearing minerals, rare-earth oxides, desert varnish coatings, kaolinite crystallinity series, kaolinite-smectite series, zeolite series, and an extensive evaporite series. Because of the importance of vegetation to climate-change studies we have include 17 spectra of tree leaves, bushes, and grasses. The library and software are available as a series of U.S.G.S. Open File reports. PC user software is available to convert the binary data to ascii files (a separate U.S.G.S. open file report). Additionally, a binary data files are on line at the U.S.G.S. in Denver for anonymous ftp to users on the Internet. The library search software enables a user to search on documentation parameters as well as spectral features. The

  9. Accelerated Decompression from Saturation at 132 Feet of Sea Water With Isobaric oxygenation at 60 Feet of Sea Water

    DTIC Science & Technology

    2009-02-01

    catheterized with an external jugular catheter via the Seldinger technique and allowed to recover. Subjects were exposed to 132 feet of seawater (fsw) in...the external jugular vein of the animal was catheterized with a 16 gauge by 20.3 cm single lumen catheter (Braun Certofix; B. Braun Medical Inc... central cyanosis or the production of frothy white sputum. The onset of severe DCS (neurological or cardio-pulmonary dysfunction) and all behavioral

  10. VizieR Online Data Catalog: MIPS 24um nebulae (Gvaramadze+, 2010)

    NASA Astrophysics Data System (ADS)

    Gvaramadze, V. V.; Kniazev, A. Y.; Fabrika, S.

    2011-03-01

    Massive evolved stars lose a large fraction of their mass via copious stellar wind or instant outbursts. During certain evolutionary phases, they can be identified by the presence of their circumstellar nebulae. In this paper, we present the results of a search for compact nebulae (reminiscent of circumstellar nebulae around evolved massive stars) using archival 24um data obtained with the Multiband Imaging Photometer for Spitzer. We have discovered 115 nebulae, most of which bear a striking resemblance to the circumstellar nebulae associated with luminous blue variables (LBVs) and late WN-type (WNL) Wolf-Rayet (WR) stars in the Milky Way and the Large Magellanic Cloud (LMC). (1 data file).

  11. Integrando la historia clínica ambiental en el consejo prenatal y cuidado de 2 casos de gastrosquisis

    PubMed Central

    García, J.A. Ortega; Martín, M.; Lamas, A. Brea; De Paco-Matallana, C.; Jiménez, J.I. Ruiz; Soldin, O.P.

    2017-01-01

    Introducción La gastroquisis es una malformación de etiología desconocida en la que se han implicado factores de riesgo (FR) genéticos y medioambientales. El objetivo de este trabajo es desarrollar la historia clínica medioambiental pediátrica (HCMAP) de la gastroquisis en 2 pacientes. Pacientes y métodos Revisión bibliográfica en Pubmed y en el Developmental and Reproductive Toxicology Database. Búsqueda selectiva de sustancias con capacidad teratogénica en el Hazardous Substances Data Bank. Palabras clave utilizadas fueron: «gastroschisis» y «gastroschisis and risk factor». Resultados En ambos casos están presentes los siguientes FR descritos en la literatura: corta cohabitación, embarazos no planificados de madres relativamente jóvenes, cambio de pareja reciente, ingesta de alcohol, déficits nutricionales importantes, tabaquismo activo/pasivo. Un caso estuvo expuesto a cocaína, humo de cannabis y se realizó una ortopantografía durante el embarazo. Conclusiones 1) Es necesario obtener la HCMAP en todo paciente con gastroquisis; 2) una cuidadosa HCMAP requiere una adecuada revisión de los FR relacionados e instrucción básica para caracterizar y cuantificar las exposiciones medioambientales, y 3) siguiendo estos pasos, complementaremos nuestras labores asistenciales y preventivas. PMID:20122885

  12. "Um, I Can Tell You're Lying": Linguistic Markers of Deception versus Truth-Telling in Speech

    ERIC Educational Resources Information Center

    Arciuli, Joanne; Mallard, David; Villar, Gina

    2010-01-01

    Lying is a deliberate attempt to transmit messages that mislead others. Analysis of language behaviors holds great promise as an objective method of detecting deception. The current study reports on the frequency of use and acoustic nature of "um" and "like" during laboratory-elicited lying versus truth-telling. Results obtained using a…

  13. Geochemistry of hot springs in the Ie Seu’um hydrothermal areas at Aceh Besar district, Indonesia

    NASA Astrophysics Data System (ADS)

    Idroes, R.; Yusuf, M.; Alatas, M.; Subhan; Lala, A.; Saiful; Suhendra, R.; Idroes, G. M.; Marwan

    2018-03-01

    Indonesia geothermal resources are the largest in the world, about 40 percent of the total geothermal resources worldwide with a potential energy of 28,617 MW. Geothermal energy is one of the renewable energy in the world that can be developed sustainably. This kind of energy is not only environmentally friendly but also highly prospective compared to fossil energy. One of the potential geothermal energy in Indonesia is Seulawah Agam geothermal field with some manifestation areas. The fluid type of Ie Seu’um manifestation was chloride (Cl-) obtained from the ternary diagram Cl--SO4 2--HCO3 -, using UV-Vis spectrophotometry, argentometry and acidimetry method. The reservoir range temperature was 188,7 ± 9,3°C calculated using geothermometer Na-K-Ca, Na-K Fournier and Na-K Giggenbach by applying Atomic Absorption Spectroscopy method. This data processing was carried out using liquid chemistry plotting spreadsheet version 3 powell geoscience Ltd.3 September 2012 by Powell & Cumming. The potential in the geothermal manifestation of Ie Seu’um was estimated about 50-100 MW (medium enthalpy).

  14. Allergen challenge sensitizes TRPA1 in vagal sensory neurons and afferent C-fiber subtypes in guinea pig esophagus.

    PubMed

    Liu, Zhenyu; Hu, Youtian; Yu, Xiaoyun; Xi, Jiefeng; Fan, Xiaoming; Tse, Chung-Ming; Myers, Allen C; Pasricha, Pankaj J; Li, Xingde; Yu, Shaoyong

    2015-03-15

    Transient receptor potential A1 (TRPA1) is a newly defined cationic ion channel, which selectively expresses in primary sensory afferent nerve, and is essential in mediating inflammatory nociception. Our previous study demonstrated that TRPA1 plays an important role in tissue mast cell activation-induced increase in the excitability of esophageal vagal nodose C fibers. The present study aims to determine whether prolonged antigen exposure in vivo sensitizes TRPA1 in a guinea pig model of eosinophilic esophagitis (EoE). Antigen challenge-induced responses in esophageal mucosa were first assessed by histological stains and Ussing chamber studies. TRPA1 function in vagal sensory neurons was then studied by calcium imaging and by whole cell patch-clamp recordings in 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI)-labeled esophageal vagal nodose and jugular neurons. Extracellular single-unit recordings were performed in vagal nodose and jugular C-fiber neuron subtypes using ex vivo esophageal-vagal preparations with intact nerve endings in the esophagus. Antigen challenge significantly increased infiltrations of eosinophils and mast cells in the esophagus. TRPA1 agonist allyl isothiocyanate (AITC)-induced calcium influx in nodose and jugular neurons was significantly increased, and current densities in esophageal DiI-labeled nodose and jugular neurons were also significantly increased in antigen-challenged animals. Prolonged antigen challenge decreased esophageal epithelial barrier resistance, which allowed intraesophageal-infused AITC-activating nodose and jugular C fibers at their nerve endings. Collectively, these results demonstrated that prolonged antigen challenge sensitized TRPA1 in esophageal sensory neurons and afferent C fibers. This novel finding will help us to better understand the molecular mechanism underlying esophageal sensory and motor dysfunctions in EoE. Copyright © 2015 the American Physiological Society.

  15. Allergen challenge sensitizes TRPA1 in vagal sensory neurons and afferent C-fiber subtypes in guinea pig esophagus

    PubMed Central

    Liu, Zhenyu; Hu, Youtian; Yu, Xiaoyun; Xi, Jiefeng; Fan, Xiaoming; Tse, Chung-Ming; Myers, Allen C.; Pasricha, Pankaj J.; Li, Xingde

    2015-01-01

    Transient receptor potential A1 (TRPA1) is a newly defined cationic ion channel, which selectively expresses in primary sensory afferent nerve, and is essential in mediating inflammatory nociception. Our previous study demonstrated that TRPA1 plays an important role in tissue mast cell activation-induced increase in the excitability of esophageal vagal nodose C fibers. The present study aims to determine whether prolonged antigen exposure in vivo sensitizes TRPA1 in a guinea pig model of eosinophilic esophagitis (EoE). Antigen challenge-induced responses in esophageal mucosa were first assessed by histological stains and Ussing chamber studies. TRPA1 function in vagal sensory neurons was then studied by calcium imaging and by whole cell patch-clamp recordings in 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate (DiI)-labeled esophageal vagal nodose and jugular neurons. Extracellular single-unit recordings were performed in vagal nodose and jugular C-fiber neuron subtypes using ex vivo esophageal-vagal preparations with intact nerve endings in the esophagus. Antigen challenge significantly increased infiltrations of eosinophils and mast cells in the esophagus. TRPA1 agonist allyl isothiocyanate (AITC)-induced calcium influx in nodose and jugular neurons was significantly increased, and current densities in esophageal DiI-labeled nodose and jugular neurons were also significantly increased in antigen-challenged animals. Prolonged antigen challenge decreased esophageal epithelial barrier resistance, which allowed intraesophageal-infused AITC-activating nodose and jugular C fibers at their nerve endings. Collectively, these results demonstrated that prolonged antigen challenge sensitized TRPA1 in esophageal sensory neurons and afferent C fibers. This novel finding will help us to better understand the molecular mechanism underlying esophageal sensory and motor dysfunctions in EoE. PMID:25591867

  16. Reliability of temperatures measured at standard monitoring sites as an index of brain temperature during deep hypothermic cardiopulmonary bypass conducted for thoracic aortic reconstruction.

    PubMed

    Akata, Takashi; Setoguchi, Hidekazu; Shirozu, Kazuhiro; Yoshino, Jun

    2007-06-01

    It is essential to estimate the brain temperature of patients during deliberate deep hypothermia. Using jugular bulb temperature as a standard for brain temperature, we evaluated the accuracy and precision of 5 standard temperature monitoring sites (ie, pulmonary artery, nasopharynx, forehead deep-tissue, urinary bladder, and fingertip skin-surface tissue) during deep hypothermic cardiopulmonary bypass conducted for thoracic aortic reconstruction. In 20 adult patients with thoracic aortic aneurysms, the 5 temperature monitoring sites were recorded every 1 minute during deep hypothermic (<20 degrees C) cardiopulmonary bypass. The accuracy was evaluated by the difference from jugular bulb temperature, and the precision was evaluated by its standard deviation, as well as by the correlation with jugular bulb temperature. Pulmonary artery temperature and jugular bulb temperature began to change immediately after the start of cooling or rewarming, closely matching each other, and the other temperatures lagged behind these two temperatures. During either situation, the accuracy of pulmonary artery temperature measurement (0.3 degrees C-0.5 degrees C) was much superior to the other measurements, and its precision (standard deviation of the difference from jugular bulb temperature = 1.5 degrees C-1.8 degrees C; correlation coefficient = 0.94-0.95) was also best among the measurements, with its rank order being pulmonary artery > or = nasopharynx > forehead > bladder > fingertip. However, the accuracy and precision of pulmonary artery temperature measurement was significantly impaired during and for several minutes after infusion of cold cardioplegic solution. Pulmonary artery temperature measurement is recommended to estimate brain temperature during deep hypothermic cardiopulmonary bypass, even if it is conducted with the sternum opened; however, caution needs to be exercised in interpreting its measurements during periods of the cardioplegic solution infusion.

  17. Reproducibility of cerebrospinal venous blood flow and vessel anatomy with the use of phase contrast-vastly undersampled isotropic projection reconstruction and contrast-enhanced MRA.

    PubMed

    Schrauben, E M; Johnson, K M; Huston, J; Del Rio, A M; Reeder, S B; Field, A; Wieben, O

    2014-05-01

    The chronic cerebrospinal venous insufficiency hypothesis raises interest in cerebrospinal venous blood flow imaging, which is more complex and less established than in arteries. For accurate assessment of venous flow in chronic cerebrospinal venous insufficiency diagnosis and research, we must account for physiologic changes in flow patterns. This study examines day-to-day flow variability in cerebrospinal veins by use of 4D MR flow and contrast-enhanced MRA under typical, uncontrolled conditions in healthy individuals. Ten healthy volunteers were scanned in a test-retest fashion by use of a 4D flow MR imaging technique and contrast-enhanced MRA. Flow parameters obtained from phase contrast-vastly undersampled isotropic projection reconstruction and contrast-enhanced MRA scoring measurements in the head, neck, and chest veins were analyzed for internal consistency and interscan reproducibility. Internal consistency was satisfied at the torcular herophili, with an input-output difference of 2.2%. Percentages of variations in flow were 20.3%, internal jugular vein; 20.4%, azygos vein; 6.8%, transverse sinus; and 5.1%, common carotid artery. Retrograde flow was found in the lower internal jugular vein (4.8%) and azygos vein (7.2%). Contrast-enhanced MRA interscan κ values for the internal jugular vein (left: 0.474, right: 0.366) and azygos vein (-0.053) showed poor interscan agreement. Phase contrast-vastly undersampled isotropic projection reconstruction blood flow measurements are reliable and highly reproducible in intracranial veins and in the common carotid artery but not in veins of the neck (internal jugular vein) and chest (azygos vein) because of normal physiologic variation. Retrograde flow normally may be observed in the lower internal jugular vein and azygos vein. Low interrater agreement in contrast-enhanced MRA scans was observed. These findings have important implications for imaging diagnosis and experimental research of chronic cerebrospinal venous

  18. Interganglionic segregation of distinct vagal afferent fibre phenotypes in guinea-pig airways.

    PubMed Central

    Ricco, M M; Kummer, W; Biglari, B; Myers, A C; Undem, B J

    1996-01-01

    1. The present study addressed the hypothesis that jugular and nodose vagal ganglia contain the somata of functionally and anatomically distinct airway afferent fibres. 2. Anatomical investigations were performed by injecting guinea-pig airways with the neuronal tracer Fast Blue. The animals were killed 7 days later, and the ganglia were removed and immunostained with antisera against substance P (SP) and neurofilament protein (NF). In the nodose ganglion, NF-immunoreactive neurones accounted for about 98% of the Fast Blue-labelled cells while in the jugular ganglion they accounted for approximately 48%. SP and NF immunoreactivity was never (n = 100) observed in the same cell suggesting that the antisera labelled distinct populations. 3. Electrophysiological investigations were performed using an in vitro guinea-pig tracheal and bronchial preparation with intact afferent vagal pathways, including nodose and jugular ganglia. Action potentials arriving from single airway afferent nerve endings were monitored extracellularly using a glass microelectrode positioned near neuronal cell bodies in either ganglion. 4. The nodose ganglion contained the somata of mainly fast-conducting tracheal A delta fibres whereas the jugular ganglion contained equal numbers of C fibre and A delta fibre tracheal afferent somata. The nodose A delta neurones adapted rapidly to mechanical stimulation, had relatively low mechanical thresholds, were not activated by capsaicin and adapted rapidly to a hyperosmotic stimulus. By contrast, jugular A delta and C fibres adapted slowly to mechanical stimulation, were often activated by capsaicin, had higher mechanical thresholds and displayed a slow adaptation to a hyperosmotic stimulus. 5. The anatomical, physiological and pharmacological data provide evidence to support the contention that the vagal ganglionic source of the fibre supplying the airways ultimately dictates its neurochemical and physiological phenotype. Images Figure 1 PMID:8910234

  19. Um estudo espectrofotométrico da variável cataclísmica V3885 Sgr

    NASA Astrophysics Data System (ADS)

    Ribeiro, F. M. A.; Diaz, M. P.

    2003-08-01

    Variáveis Cataclísmicas são sistemas binários cerrados compostos de uma anã vermelha que transfere matéria para uma anã branca, em sistemas não magnéticos ocorre a formação de um disco de acresção em torno da anã branca. V3885 Sgr é uma variável cataclísmica classificada como sendo do tipo nova-like. É apresentado um estudo espectrofotométrico de V3885 Sgr de alta resolução temporal feito na região do visível. A região observada é centrada em Ha e abrange também a linha de HeI 6678. O primeiro resultado obtido neste estudo é a determinação do período orbital a partir de medidas da velocidade radial da linha de Ha como sendo 0,20716071(22) dias, resolvendo inconsistências quanto a esse valor na literatura e definindo uma efeméride a longo prazo para o sistema. Com este período e as medidas de velocidade radial do perfil de linha de Ha foi construído um diagrama de massas, através do qual restringimos as massas das componentes estelares do sistema e limitamos a inclinação orbital do sistema. Foram construídos diagramas de Greenstein para as linhas de Ha e HeI, onde os espectros médios em cada intervalo de fase são representados lado a lado em escala de cinza, indicando a existência de uma emissão intensa proveniente da parte posterior do disco. A partir da tomografia Doppler obtivemos perfis de emissividade radial para o disco tanto para a linha de Ha como para HeI. Os resultados obtidos são comparados com os de outros sistemas estudados com a mesma técnica. Serão apresentados também resultados da tomografia de flickering para o sistema.

  20. Injectable Shear-Thinning CaSO4/FGF-18-Incorporated Chitin-PLGA Hydrogel Enhances Bone Regeneration in Mice Cranial Bone Defect Model.

    PubMed

    Sivashanmugam, A; Charoenlarp, Pornkawee; Deepthi, S; Rajendran, Arunkumar; Nair, Shantikumar V; Iseki, Sachiko; Jayakumar, R

    2017-12-13

    For craniofacial bone regeneration, shear-thinning injectable hydrogels are favored over conventional scaffolds because of their improved defect margin adaptability, easier handling, and ability to be injected manually into deeper tissues. The most accepted method, after autografting, is the use of recombinant human bone morphogenetic protein-2 (BMP-2); however, complications such as interindividual variations, edema, and poor cost-efficiency in supraphysiological doses have been reported. The endogenous synthesis of BMP-2 is desirable, and a molecule which induces this is fibroblast growth factor-18 (FGF-18) because it can upregulate the BMP-2 expression  by supressing noggin. We developed a chitin-poly(lactide-co-glycolide) (PLGA) composite hydrogel by regeneration chemistry and then incorporated CaSO 4 and FGF-18 for this purpose. Rheologically, a 7-fold increase in the elastic modulus was observed in the CaSO 4 -incorporated chitin-PLGA hydrogels as compared to the chitin-PLGA hydrogel. Shear-thinning Herschel-Bulkley fluid nature was observed for both hydrogels. Chitin-PLGA/CaSO 4 gel showed sustained release of FGF-18. In vitro osteogenic differentiation showed an enhanced alkaline phosphatase (ALP) expression in the FGF-18-containing chitin-PLGA/CaSO 4 gel when compared to cells alone. Further, it was confirmed by studying the expression of osteogenic genes [RUNX2, ALP, BMP-2, osteocalcin (OCN), and osteopontin (OPN)], immunofluorescence staining of BMP-2, OCN, and OPN, and alizarin red S staining. Incorporation of FGF-18 in the hydrogel increased the endothelial cell migration. Further, the regeneration potential of the prepared hydrogels was tested in vivo, and longitudinal live animal μ-CT was performed. FGF-18-loaded chitin-PLGA/CaSO 4 showed early and almost complete bone healing in comparison with chitin-PLGA/CaSO 4 , chitin-PLGA/FGF-18, chitin-PLGA, and sham control systems, as confirmed by hematoxylin and eosin and osteoid tetrachrome stainings

  1. Embolização arterial superseletiva para tratamento de angiomiolipoma em paciente com rim único

    PubMed Central

    Góes, Adenauer Marinho de Oliveira; Jeha, Salim Abdon Haber; Salgado, José Rui Couto

    2016-01-01

    Resumo Os autores relatam o caso de uma paciente jovem previamente submetida a nefrectomia direita por apresentar angiomiolipomas renais (AMLRs) e portadora de dois volumosos angiomiolipomas no rim esquerdo remanescente. A paciente foi encaminhada pelo urologista para tratamento endovascular. Realizou-se embolização superseletiva de um dos tumores, localizado no polo renal inferior e em situação subcapsular; apesar de várias tentativas, não foi obtido um cateterismo seletivo suficiente para embolizar o segundo angiomiolipoma (localizado no polo renal superior) sem que um volume considerável de parênquima renal adjacente sofresse isquemia. O procedimento e a recuperação da paciente transcorreram sem complicações. A paciente recebeu alta no primeiro pós-operatório e vem sendo acompanhada ambulatorialmente há 9 meses sem intercorrências. É feita uma breve revisão sobre indicações, aspectos técnicos e complicações do tratamento endovascular dos AMLRs, além de serem discutidas vantagens dessa técnica quando comparada à ressecção cirúrgica dos tumores. PMID:29930580

  2. Discos de acresção em sistemas Be-X

    NASA Astrophysics Data System (ADS)

    Lopes de Oliveira, R.; Janot-Pacheco, E.

    2003-08-01

    Alguns fenômenos de outbursts em Be-X sugerem a existência, mesmo que temporária, de um disco de acresção quando da passagem do objeto compacto pelo periastro orbital. Neste trabalho avaliamos a possibilidade de formação do disco de acresção em sistemas Be+estrela de neutrons e Be+anã branca, e a influência da excentricidade orbital na ocorrência deste fenômeno. Utilizamos a expressão analítica para o momento angular específico da matéria constituinte de um meio em expansão lenta, como é o caso do disco circunstelar das estrelas Be, proposta por Wang(1981), sob a condição básica de que o raio de circularização deva ser maior do que o raio de Alfvén. Concluímos que existe um limite para o período orbital do sistema acima do qual não é possível a formação do disco de acresção, e que este valor aumenta para sistemas com excentricidade orbital maior.

  3. An investigation of the adsorption characteristics of 5 prime ATP and 5 prime AMP onto the surface of CaSO sub 4 x 2H sub 2 O

    NASA Technical Reports Server (NTRS)

    Calderon, J.; Sweeney, M. A.

    1986-01-01

    A model has been proposed (Lahev and Chans, 1982) in which solid surfaces can act as a site for catalytic activity of condensation reactions for certain biomolecules. From this model, the adsorption characteristics of 5'ATP and 5'AMP onto the surface of CaSO4 2H2O was chosen for study. It has been proven that 5'ATP and 5'AMP do adsorb onto the surface of CaSO4. Studies were then made to determine the dependence of adsorption versus time, concentration, ionic strength and pH. It was found that the adsorption of the nucleotides is highly pH dependent, primarily determined by the phosphate acid groups of the nucleic acid molecule. From this investigation, the data obtained are discussed in relation to the model for the prebiotic earth.

  4. Study of tibial nerve regeneration in Wistar rats in primary neurorrhaphy with and without gap, wrapped in vein segments.

    PubMed

    Bastos Dos Santos, Ewerton; Fernandes, Marcela; Gomes Dos Santos, João Baptista; Mattioli Leite, Vilnei; Valente, Sandra Gomes; Faloppa, Flávio

    2012-01-01

    This study compared nerve regeneration in Wistar rats, using epineural neurorrhaphy with a gap of 1.0 mm and without a gap, both wrapped with jugular vein tubes. Motor neurons in the spinal cord between L3 and S1 were used for the count, marked by exposure of the tibial nerve to Fluoro-Gold (FG). The tibial nerves on both sides were cut and sutured, with a gap on one side and no gap in the other. The sutures were wrapped with a jugular vein. Four months after surgery the tibial nerves were exposed to Fluoro-Gold and the motor neuron count performed in the spinal cord. The results were statistically analyzed by the paired Wilcoxon test. There was a statistical difference between the groups with and without gap in relation to the motor neuron count (p=0.013). The epineural neurorraphy without gap wrapped with jugular vein showed better results for nerve regeneration than the same procedure with gap. Experimental Study .

  5. Um satélite brasileiro para observação do diâmetro solar

    NASA Astrophysics Data System (ADS)

    Emilio, M.; Leister, N. V.; Benevides Soares, P.; Teixeira, R.; Kuhn, J.

    2003-08-01

    Propomos uma missão espacial para medir a forma e o diâmetro solar com o objetivo de ajudar a determinar o potencial gravitacional do Sol e a sua rotação com precisão, testar modelos teóricos de variação de energia e pela primeira vez medir os modos g de oscilação. As observações serão obtidas através do instrumento denominado APT (Astrometric and Photometric Telescope) descrito por Kuhn(1983). A sensibilidade do instrumento é de 0,2 mas em 27 dias para as observações do diâmetro solar feitas a cada minuto. Esta é uma missão de três anos de duração e pode complementar as medidas que serão feitas pelo satélite PICARD (a ser lançado em 2007). Outros parâmetros físicos podem ser obtidos com as mesmas imagens o que certamente interessará à comunidade de física solar. Um primeiro contato foi realizado com a agência espacial brasileira que pretende lançar um satélite científico a cada dois anos.

  6. UmUTracker: A versatile MATLAB program for automated particle tracking of 2D light microscopy or 3D digital holography data

    NASA Astrophysics Data System (ADS)

    Zhang, Hanqing; Stangner, Tim; Wiklund, Krister; Rodriguez, Alvaro; Andersson, Magnus

    2017-10-01

    We present a versatile and fast MATLAB program (UmUTracker) that automatically detects and tracks particles by analyzing video sequences acquired by either light microscopy or digital in-line holographic microscopy. Our program detects the 2D lateral positions of particles with an algorithm based on the isosceles triangle transform, and reconstructs their 3D axial positions by a fast implementation of the Rayleigh-Sommerfeld model using a radial intensity profile. To validate the accuracy and performance of our program, we first track the 2D position of polystyrene particles using bright field and digital holographic microscopy. Second, we determine the 3D particle position by analyzing synthetic and experimentally acquired holograms. Finally, to highlight the full program features, we profile the microfluidic flow in a 100 μm high flow chamber. This result agrees with computational fluid dynamic simulations. On a regular desktop computer UmUTracker can detect, analyze, and track multiple particles at 5 frames per second for a template size of 201 ×201 in a 1024 × 1024 image. To enhance usability and to make it easy to implement new functions we used object-oriented programming. UmUTracker is suitable for studies related to: particle dynamics, cell localization, colloids and microfluidic flow measurement. Program Files doi : http://dx.doi.org/10.17632/fkprs4s6xp.1 Licensing provisions : Creative Commons by 4.0 (CC by 4.0) Programming language : MATLAB Nature of problem: 3D multi-particle tracking is a common technique in physics, chemistry and biology. However, in terms of accuracy, reliable particle tracking is a challenging task since results depend on sample illumination, particle overlap, motion blur and noise from recording sensors. Additionally, the computational performance is also an issue if, for example, a computationally expensive process is executed, such as axial particle position reconstruction from digital holographic microscopy data. Versatile

  7. Different role of TTX-sensitive voltage-gated sodium channel (NaV 1) subtypes in action potential initiation and conduction in vagal airway nociceptors.

    PubMed

    Kollarik, M; Sun, H; Herbstsomer, R A; Ru, F; Kocmalova, M; Meeker, S N; Undem, B J

    2018-04-15

    The action potential initiation in the nerve terminals and its subsequent conduction along the axons of afferent nerves are not necessarily dependent on the same voltage-gated sodium channel (Na V 1) subunits. The action potential initiation in jugular C-fibres within airway tissues is not blocked by TTX; nonetheless, conduction of action potentials along the vagal axons of these nerves is often dependent on TTX-sensitive channels. This is not the case for nodose airway Aδ-fibres and C-fibres, where both action potential initiation and conduction is abolished by TTX or selective Na V 1.7 blockers. The difference between the initiation of action potentials within the airways vs. conduction along the axons should be considered when developing Na V 1 blocking drugs for topical application to the respiratory tract. The action potential (AP) initiation in the nerve terminals and its subsequent AP conduction along the axons do not necessarily depend on the same subtypes of voltage-gated sodium channels (Na V 1s). We evaluated the role of TTX-sensitive and TTX-resistant Na V 1s in vagal afferent nociceptor nerves derived from jugular and nodose ganglia innervating the respiratory system. Single cell RT-PCR was performed on vagal afferent neurons retrogradely labelled from the guinea pig trachea. Almost all of the jugular neurons expressed the TTX-sensitive channel Na V 1.7 along with TTX-resistant Na V 1.8 and Na V 1.9. Tracheal nodose neurons also expressed Na V 1.7 but, less frequently, Na V 1.8 and Na V 1.9. Na V 1.6 were expressed in ∼40% of the jugular and 25% of nodose tracheal neurons. Other Na V 1 α subunits were only rarely expressed. Single fibre recordings were made from the vagal nodose and jugular nerve fibres innervating the trachea or lung in the isolated perfused vagally-innervated preparations that allowed for selective drug delivery to the nerve terminal compartment (AP initiation) or to the desheathed vagus nerve (AP conduction). AP initiation in

  8. "Uh," "Um," and Autism: Filler Disfluencies as Pragmatic Markers in Adolescents with Optimal Outcomes from Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Irvine, Christina A.; Eigsti, Inge-Marie; Fein, Deborah A.

    2016-01-01

    Filler disfluencies--"uh" and "um"--are thought to serve distinct discourse functions. We examined fillers in spontaneous speech by youth with autism spectrum disorder (ASD), who struggle with pragmatic language, and by youth with ASD who have achieved an "optimal outcome" (OO), as well as in peers with typical…

  9. Rapamycin reduced pulmonary vascular remodelling by inhibiting cell proliferation via Akt/mTOR signalling pathway down-regulation in the carotid artery-jugular vein shunt pulmonary hypertension rat model.

    PubMed

    Ma, Xiaofan; Yao, Jianping; Yue, Yuan; Du, Shangming; Qin, Han; Hou, Jian; Wu, Zhongkai

    2017-08-01

    Pulmonary arterial hypertension (PAH) is a common complication of congenital heart disease. However, effective treatments for PAH are rare. This study aimed to investigate the inhibitory effects of rapamycin on PAH in the carotid artery-jugular vein (CA-JV) shunt PAH rat model as well as the mechanism underlying these effects. Twenty-four Sprague-Dawley rats were randomized into the following 3 groups: a control group, a CA-JV shunt group and a treatment group. Rapamycin (2 mg/kg/day) was administered to the treatment group, and placebo was administered to the CA-JV shunt group. Haemodynamic evaluations, pulmonary tissue samplings for morphometry and immunofluorescence and western blot analyses were performed to evaluate the effects of rapamycin on PAH. Rapamycin attenuated the increase of right ventricular systolic pressure (RVSP) and the right ventricular (RV) hypertrophy (RVSP: CA-JV vs CA-JV + rapamycin, P = 0.017; RV: CA-JV vs CA-JV + rapamycin, P = 0.022), as well as the intrapulmonary vessel thickening (thickness index: CA-JV vs CA-JV + rapamycin, P = 0.028; area index: CA-JV vs CA-JV + rapamycin, P = 0.014), induced by overcirculation of the pulmonary vasculature in the CA-JV shunt-induced PAH rat model. Rapamycin decreased the expression level of the indicated cell proliferation marker (α-smooth muscle actin) in the lung vessel and mechanistic target of rapamycin (mTOR) pathway components (p-mTOR: CA-JV vs CA-JV + rapamycin, P = 0.004; p-Raptor: CA-JV vs CA-JV + rapamycin, P = 0.000; p-S6K1: CA-JV vs CA-JV + rapamycin, P = 0.000; p-Akt: CA-JV vs CA-JV + rapamycin, P = 0.001; p-Rheb: CA-JV vs CA-JV + rapamycin, P = 0.000) in pulmonary tissue. Rapamycin reduced pulmonary vascular remodelling by inhibiting cell proliferation via Akt/mTOR signalling pathway down-regulation in the CA-JV shunt-induced PAH model in rats. Thus, rapamycin may be a novel candidate drug for the treatment of

  10. Low-Power Differential SRAM design for SOC Based on the 25-um Technology

    NASA Astrophysics Data System (ADS)

    Godugunuri, Sivaprasad; Dara, Naveen; Sambasiva Nayak, R.; Nayeemuddin, Md; Singh, Yadu, Dr.; Veda, R. N. S. Sunil

    2017-08-01

    In recent, the SOC styles area unit the vast complicated styles in VLSI these SOC styles having important low-power operations problems, to comprehend this we tend to enforced low-power SRAM. However these SRAM Architectures critically affects the entire power of SOC and competitive space. To beat the higher than disadvantages, during this paper, a low-power differential SRAM design is planned. The differential SRAM design stores multiple bits within the same cell, operates at minimum in operation low-tension and space per bit. The differential SRAM design designed supported the 25-um technology using Tanner-EDA Tool.

  11. Intravascular Food Reward

    PubMed Central

    Oliveira-Maia, Albino J.; Roberts, Craig D.; Walker, Q. David; Luo, Brooke; Kuhn, Cynthia; Simon, Sidney A.; Nicolelis, Miguel A. L.

    2011-01-01

    Consumption of calorie-containing sugars elicits appetitive behavioral responses and dopamine release in the ventral striatum, even in the absence of sweet-taste transduction machinery. However, it is unclear if such reward-related postingestive effects reflect preabsorptive or postabsorptive events. In support of the importance of postabsorptive glucose detection, we found that, in rat behavioral tests, high concentration glucose solutions administered in the jugular vein were sufficient to condition a side-bias. Additionally, a lower concentration glucose solution conditioned robust behavioral responses when administered in the hepatic-portal, but not the jugular vein. Furthermore, enteric administration of glucose at a concentration that is sufficient to elicit behavioral conditioning resulted in a glycemic profile similar to that observed after administration of the low concentration glucose solution in the hepatic-portal, but not jugular vein. Finally using fast-scan cyclic voltammetry we found that, in accordance with behavioral findings, a low concentration glucose solution caused an increase in spontaneous dopamine release events in the nucleus accumbens shell when administered in the hepatic-portal, but not the jugular vein. These findings demonstrate that the postabsorptive effects of glucose are sufficient for the postingestive behavioral and dopaminergic reward-related responses that result from sugar consumption. Furthermore, glycemia levels in the hepatic-portal venous system contribute more significantly for this effect than systemic glycemia, arguing for the participation of an intra-abdominal visceral sensor for glucose. PMID:21980372

  12. Transcutaneous regional venous oximetry: a feasibility study.

    PubMed

    Thiele, Robert H; Tucker-Schwartz, Jason M; Lu, Yao; Gillies, George T; Durieux, Marcel E

    2011-06-01

    The arterial pulse oximeter, which was introduced clinically in the 1970s, is a convenient, useful, and now ubiquitous anesthesia monitor. Unfortunately, although percent saturation of arterial hemoglobin is, along with cardiac output and concentration of hemoglobin, one of 3 components of oxygen delivery, it does not indicate whether oxygen delivery to a region of interest is adequate. Knowledge of peripheral or regional venous oxygen saturation (Sxvo₂) may lend insight into analysis of regional oxygen supply and demand. Our goal was to assess the suitability of 3 anatomic sites for the transcutaneous assessment of Sxvo₂. Using a Nonin reflectance oximetry probe (provided by Nonin Medical, Plymouth, MN) placed directly over the antecubital, external jugular, and internal jugular veins in 10 volunteers, we measured the absorbance of red and infrared electromagnetic radiation. We performed fast Fourier transformation on these absorbance waveforms. The ratio of pulsatile absorbance of red and infrared radiation at different frequencies was compared with nonpulsatile absorption, and Sxvo₂ was calculated based on previously derived empiric correlations. Estimates of transcutaneous Sxvo₂ ranged from 41% to 97%, with mean values of 75%, 80%, and 80% at the antecubital, external jugular, and internal jugular veins, respectively. Overall, 93% of predicted Sxvo₂ values were < 90%. Validation and subsequent improvement of this technique requires correlation of our results with venous blood gas measurements, followed by incorporation of technologies from related fields in oximetry (fetal reflectance oximetry and near-infrared spectroscopy), as well as the development of advanced signal processing techniques.

  13. Thermoluminescence Response of CaF2:Mn, CaFz:Dy and CaSO4:Tm to Protons and Alpha-Particles,

    DTIC Science & Technology

    1987-06-01

    TLD ) in diverse radiation fields, such as mixed neutron-gamma fields. TL responses of the detector may depend not only on the photon and neutron energy...response of three TLD materials: CaF 2 :Mn, CaF?:Dy and CaSO 4 :Tm. These three materials are commonly used in TLDs , because of their high sensitivities...and suitable readout temperatures. CaS04:Tm powder embedded in polyethylene was investiaged at DREO (Ref. (4)) as a combined neutron/gamma TLD , but

  14. Thermoluminescence of nanocrystalline CaSO4: Dy for gamma dosimetry and calculation of trapping parameters using deconvolution method

    NASA Astrophysics Data System (ADS)

    Mandlik, Nandkumar; Patil, B. J.; Bhoraskar, V. N.; Sahare, P. D.; Dhole, S. D.

    2014-04-01

    Nanorods of CaSO4: Dy having diameter 20 nm and length 200 nm have been synthesized by the chemical coprecipitation method. These samples were irradiated with gamma radiation for the dose varying from 0.1 Gy to 50 kGy and their TL characteristics have been studied. TL dose response shows a linear behavior up to 5 kGy and further saturates with increase in the dose. A Computerized Glow Curve Deconvolution (CGCD) program was used for the analysis of TL glow curves. Trapping parameters for various peaks have been calculated by using CGCD program.

  15. Management of the Facial Nerve in Lateral Skull Base Surgery Analytic Retrospective Study

    PubMed Central

    El Shazly, Mohamed A.; Mokbel, Mahmoud A.M.; Elbadry, Amr A.; Badran, Hatem S.

    2011-01-01

    Background: Surgical approaches to the jugular foramen are often complex and lengthy procedures associated with significant morbidity based on the anatomic and tumor characteristics. In addition to the risk of intra-operative hemorrhage from vascular tumors, lower cranial nerves deficits are frequently increased after intra-operative manipulation. Accordingly, modifications in the surgical techniques have been developed to minimize these risks. Preoperative embolization and intra-operative ligation of the external carotid artery have decreased the intraoperative blood loss. Accurate identification and exposure of the cranial nerves extracranially allows for their preservation during tumor resection. The modification of facial nerve mobilization provides widened infratemporal exposure with less postoperative facial weakness. The ideal approach should enable complete, one stage tumor resection with excellent infratemporal and posterior fossa exposure and would not aggravate or cause neurologic deficit. The aim of this study is to present our experience in handling jugular foramen lesions (mainly glomus jugulare) without the need for anterior facial nerve transposition. Methods: In this series we present our experience in Kasr ElEini University hospital (Cairo—Egypt) in handling 36 patients with jugular foramen lesions over a period of 20 years where the previously mentioned preoperative and operative rules were followed. The clinical status, operative technique and postoperative care and outcome are detailed and analyzed in relation to the outcome. Results: Complete cure without complications was achieved in four cases of congenital cholesteatoma and four cases with class B glomus. In advanced cases of glomus jugulare (28 patients) (C and D stages) complete cure was achieved in 21 of them (75%). The operative complications were also related to this group of 28 patients, in the form of facial paralysis in 20 of them (55.6%) and symptomatic vagal paralysis in 18 of

  16. Does acid-base equilibrium correlate with remnant liver volume during stepwise liver resection?

    PubMed

    Golriz, Mohammad; Abbasi, Sepehr; Fathi, Parham; Majlesara, Ali; Brenner, Thorsten; Mehrabi, Arianeb

    2017-10-01

    Small for size and flow syndrome (SFSF) is one of the most challenging complications following extended hepatectomy (EH). After EH, hepatic artery flow decreases and portal vein flow increases per 100 g of remnant liver volume (RLV). This causes hypoxia followed by metabolic acidosis. A correlation between acidosis and posthepatectomy liver failure has been postulated but not studied systematically in a large animal model or clinical setting. In our study, we performed stepwise liver resections on nine pigs to defined SFSF limits as follows: step 1: segment II/III resection, step 2: segment IV resection, step 3: segment V/VIII resection (RLV: 75, 50, and 25%, respectively). Blood gas values were measured before and after each step using four catheters inserted into the carotid artery, internal jugular vein, hepatic artery, and portal vein. The pH, [Formula: see text], and base excess (BE) decreased, but [Formula: see text] values increased after 75% resection in the portal and jugular veins. EH correlated with reduced BE in the hepatic artery. Pco 2 values increased after 75% resection in the jugular vein. In contrast, arterial Po 2 increased after every resection, whereas the venous Po 2 decreased slightly. There were differences in venous [Formula: see text], BE in the hepatic artery, and Pco 2 in the jugular vein after 75% liver resection. Because 75% resection is the limit for SFSF, these noninvasive blood evaluations may be used to predict SFSF. Further studies with long-term follow-up are required to validate this correlation. NEW & NOTEWORTHY This is the first study to evaluate acid-base parameters in major central and hepatic vessels during stepwise liver resection. The pH, [Formula: see text], and base excess (BE) decreased, but [Formula: see text] values increased after 75% resection in the portal and jugular veins. Extended hepatectomy correlated with reduced BE in the hepatic artery. Because 75% resection is the limit for small for size and flow

  17. Cumulative Evidence of Randomized Controlled and Observational Studies on Catheter-Related Infection Risk of Central Venous Catheter Insertion Site in ICU Patients: A Pairwise and Network Meta-Analysis.

    PubMed

    Arvaniti, Kostoula; Lathyris, Dimitrios; Blot, Stijn; Apostolidou-Kiouti, Fani; Koulenti, Despoina; Haidich, Anna-Bettina

    2017-04-01

    Selection of central venous catheter insertion site in ICU patients could help reduce catheter-related infections. Although subclavian was considered the most appropriate site, its preferential use in ICU patients is not generalized and questioned by contradicted meta-analysis results. In addition, conflicting data exist on alternative site selection whenever subclavian is contraindicated. To compare catheter-related bloodstream infection and colonization risk between the three sites (subclavian, internal jugular, and femoral) in adult ICU patients. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled trials, CINAHL, and ClinicalTrials.gov. Eligible studies were randomized controlled trials and observational ones. Extracted data were analyzed by pairwise and network meta-analysis. Twenty studies were included; 11 were observational, seven were randomized controlled trials for other outcomes, and two were randomized controlled trials for sites. We evaluated 18,554 central venous catheters: 9,331 from observational studies, 5,482 from randomized controlled trials for other outcomes, and 3,741 from randomized controlled trials for sites. Colonization risk was higher for internal jugular (relative risk, 2.25 [95% CI, 1.84-2.75]; I = 0%) and femoral (relative risk, 2.92 [95% CI, 2.11-4.04]; I = 24%), compared with subclavian. Catheter-related bloodstream infection risk was comparable for internal jugular and subclavian, higher for femoral than subclavian (relative risk, 2.44 [95% CI, 1.25-4.75]; I = 61%), and lower for internal jugular than femoral (relative risk, 0.55 [95% CI, 0.34-0.89]; I = 61%). When observational studies that did not control for baseline characteristics were excluded, catheter-related bloodstream infection risk was comparable between the sites. In ICU patients, internal jugular and subclavian may, similarly, decrease catheter-related bloodstream infection risk, when compared with femoral. Subclavian could be suggested as the most

  18. Management of the facial nerve in lateral skull base surgery analytic retrospective study.

    PubMed

    El Shazly, Mohamed A; Mokbel, Mahmoud A M; Elbadry, Amr A; Badran, Hatem S

    2011-01-01

    Surgical approaches to the jugular foramen are often complex and lengthy procedures associated with significant morbidity based on the anatomic and tumor characteristics. In addition to the risk of intra-operative hemorrhage from vascular tumors, lower cranial nerves deficits are frequently increased after intra-operative manipulation. Accordingly, modifications in the surgical techniques have been developed to minimize these risks. Preoperative embolization and intra-operative ligation of the external carotid artery have decreased the intraoperative blood loss. Accurate identification and exposure of the cranial nerves extracranially allows for their preservation during tumor resection. The modification of facial nerve mobilization provides widened infratemporal exposure with less postoperative facial weakness. The ideal approach should enable complete, one stage tumor resection with excellent infratemporal and posterior fossa exposure and would not aggravate or cause neurologic deficit. The aim of this study is to present our experience in handling jugular foramen lesions (mainly glomus jugulare) without the need for anterior facial nerve transposition. In this series we present our experience in Kasr ElEini University hospital (Cairo-Egypt) in handling 36 patients with jugular foramen lesions over a period of 20 years where the previously mentioned preoperative and operative rules were followed. The clinical status, operative technique and postoperative care and outcome are detailed and analyzed in relation to the outcome. Complete cure without complications was achieved in four cases of congenital cholesteatoma and four cases with class B glomus. In advanced cases of glomus jugulare (28 patients) (C and D stages) complete cure was achieved in 21 of them (75%). The operative complications were also related to this group of 28 patients, in the form of facial paralysis in 20 of them (55.6%) and symptomatic vagal paralysis in 18 of them (50%). Total anterior

  19. Validation of the A&D UM-201 device for office blood pressure measurement according to the European Society of Hypertension International Protocol Revision 2010.

    PubMed

    Fania, Claudio; Albertini, Federica; Palatini, Paolo

    2017-08-01

    The aim of this study was to determine the accuracy of the A&D UM-201 device coupled to several cuffs for different arm sizes for office blood pressure (BP) measurement according to the International Protocol of the European Society of Hypertension. Evaluation was carried out in 33 individuals. The mean age of the individuals was 59.3±13.2 years, systolic BP was 145.4±20.6 mmHg (range: 109-186 mmHg), diastolic BP was 87.3±18.0 mmHg (range: 50-124 mmHg), and arm circumference was 30.4±4.2 cm (range: 23-39 cm). The protocol requirements were followed precisely. The UM-201 monitor passed all requirements, fulfilling the standards of the protocol. On average, the device overestimated systolic BP by 3.0±2.1 mmHg and diastolic BP by 2.6±2.0 mmHg. These data show that the A&D UM-201 device coupled to several cuffs for different ranges of arm circumference fulfilled the requirements for validation by the International Protocol and can be recommended for clinical use in the adult population.

  20. Quiste neuroentérico intramedular: Reporte de caso y revisión bibliográfica

    PubMed Central

    Luque, Leopoldo Luciano; Marchetti, Maximo; Seclen, Daniel; Sainz, Ariel; Platas, Marcelo; Lambre, Jorge

    2018-01-01

    Resumen Los quistes neuroentéricos (QNE) son lesiones raras, congénitas y benignas, causadas por la comunicación persistente o anormal entre el neuroectodermo, la notocorda y el endodermo. Se presentan principalmente en pacientes pediátricos y adultos jóvenes, asociados a otras malformaciones vertebromedulares, gastrointestinales y respiratorias. Son lesiones intradurales extramedulares, siendo excepcional su presentación intramedular. El objetivo del presente artículo es reportar un caso de QNE intramedular cervical en un adulto joven, sin malformaciones concomitantes. El tratamiento quirúrgico es de elección según toda la bibliografía consultada, y por su alta tasa de recurrencia, el objetivo debe ser la resección total. El seguimiento con RMN es recomendado en resecciones subtotales. PMID:29900034

  1. Pull-Through Technique for Recanalization of Occluded Portosystemic Shunts (TIPS): Technical Note and Review of the Literature

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tanaka, Toshihiro, E-mail: toshihir@bf6.so-net.ne.jp; Guenther, Rolf W., E-mail: guenther@rad.rwth-aachen.de; Isfort, Peter, E-mail: isfort@hia.rwth-aachen.de

    Transjugular intrahepatic portosystemic shunt (TIPS) dysfunction is an important problem after creation of shunts. Most commonly, TIPS recanalization is performed via the jugular vein approach. Occasionally it is difficult to cross the occlusion. We describe a hybrid technique for TIPS revision via a direct transhepatic access combined with a transjugular approach. In two cases, bare metal stents or polytetrafluoroethylene (PTFE)-covered stent grafts had been placed in TIPS tract previously, and they were completely obstructed. The tracts were inaccessible via the jugular vein route alone. In each case, after fluoroscopy or computed tomography-guided transhepatic puncture of the stented segment of themore » TIPS, a wire was threaded through the shunt and snared into the right jugular vein. The TIPS was revised by balloon angioplasty and additional in-stent placement of PTFE-covered stent grafts. The patients were discharged without any complications. Doppler sonography 6 weeks after TIPS revision confirmed patency in the TIPS tract and the disappearance of ascites. We conclude that this technique is feasible and useful, even in patients with previous PTFE-covered stent graft placement.« less

  2. Study of tibial nerve regeneration in Wistar rats in primary neurorrhaphy with and without gap, wrapped in vein segments

    PubMed Central

    Bastos dos Santos, Ewerton; Fernandes, Marcela; Gomes dos Santos, João Baptista; Mattioli Leite, Vilnei; Valente, Sandra Gomes; Faloppa, Flávio

    2012-01-01

    Objective This study compared nerve regeneration in Wistar rats, using epineural neurorrhaphy with a gap of 1.0 mm and without a gap, both wrapped with jugular vein tubes. Motor neurons in the spinal cord between L3 and S1 were used for the count, marked by exposure of the tibial nerve to Fluoro-Gold (FG). Method The tibial nerves on both sides were cut and sutured, with a gap on one side and no gap in the other. The sutures were wrapped with a jugular vein. Four months after surgery the tibial nerves were exposed to Fluoro-Gold and the motor neuron count performed in the spinal cord. Results The results were statistically analyzed by the paired Wilcoxon test. There was a statistical difference between the groups with and without gap in relation to the motor neuron count (p=0.013). Conclusion The epineural neurorraphy without gap wrapped with jugular vein showed better results for nerve regeneration than the same procedure with gap. Level of Evidence: Experimental Study. PMID:24453597

  3. The Manifestation of Vortical and Secondary Flow in the Cerebral Venous Outflow Tract: An In Vivo MR Velocimetry Study

    PubMed Central

    Kefayati, Sarah; Amans, Matthew; Faraji, Farshid; Ballweber, Megan; Kao, Evan; Ahn, Sinyeob; Meisel, Karl; Halbach, Van; Saloner, David

    2016-01-01

    Aberrations in flow in the cerebral venous outflow tract (CVOT) have been implicated as the cause of several pathologic conditions including idiopathic intracranial hypertension (IIH), multiple sclerosis (MS), and pulsatile tinnitus (PT). The advent of 4D Flow magnetic resonance imaging (4D-Flow MRI) has recently allowed researchers to evaluate blood flow patterns in the arterial structures with great success. We utilized similar imaging techniques and found several distinct flow characteristics in the CVOT of subjects with and without lumenal irregularities. We present the flow patterns of 8 out of 38 subjects who have varying heights of the internal jugular bulb and varying lumenal irregularities including stenosis and diverticulum. In the internal jugular vein (IJV) with an elevated jugular bulb (JB), 4DFlow MRI revealed a characteristic spiral flow that was dependent on the level of JB elevation. Vortical flow was also observed in the diverticula of the venous sinuses and IJV. The diversity of flow complexity in the CVOT illustrates the potential importance of hemodynamic investigations in elucidating venous pathologies. PMID:27894675

  4. Changes in superior sagittal sinus blood velocities due to postural alterations and pressure on the head of the newborn infant.

    PubMed

    Cowan, F; Thoresen, M

    1985-06-01

    A pulsed Doppler bidirectional ultrasound system has been used to measure alterations in the blood velocities in the superior sagittal sinus of the healthy term newborn infant in response to unilateral and bilateral jugular venous occlusion. These maneuvers were performed with the baby lying in different positions: supine, prone, and on the side (both left and right), the neck flexed or extended, and with the head in the midline or turned 90 degrees to the side (both left and right). Transfontanel pressure was also measured in these positions during occlusions. Results show that turning the head effectively occludes the jugular vein on the side to which the head is turned and that occluding the other jugular vein does not force blood through this functional obstruction. The effect of different forms of external pressure to the head on the superior sagittal sinus velocities was also examined. Alterations in velocities were frequently profound although they varied considerably from baby to baby. This work shows how readily large fluctuations in cranial venous velocities and pressures can occur in the course of normal handling of babies.

  5. Trombose venosa profunda e vírus chicungunha

    PubMed Central

    Marques, Marcos Arêas; Adami de Sá, Fernanda Penza; Lupi, Otília; Brasil, Patricia; von Ristow, Arno

    2017-01-01

    Resumo Algumas infecções virais sistêmicas podem estar relacionadas ao desenvolvimento de trombose venosa profunda e/ou embolia pulmonar. Essa associação já está bem descrita em pacientes com infeções pelo vírus da imunodeficiência humana (HIV), hepatite C ou influenza. Recentemente introduzido no continente americano, o vírus chicungunha, agente etiológico da febre de chicungunha, ainda não tem essa relação bem sedimentada, mas com o aumento progressivo de sua incidência e pelo fato dessa infecção causar, muitas vezes, uma restrição severa da locomoção por poliartralgia e uma possível lesão endotelial direta, casos de tromboembolismo venoso podem começar a ser descritos. Neste relato de caso, descrevemos um paciente que desenvolveu trombose de veia poplítea direita durante internação para tratamento de febre por infecção por vírus chicungunha e poliartralgia severa. PMID:29930626

  6. CaSO4 Scale Formation on Vibrated Piping System in the Presence Citric Acid

    NASA Astrophysics Data System (ADS)

    Mangestiyono, W.; Jamari, J.; Muryanto, S.; Bayuseno, A. P.

    2018-02-01

    Vibration in many industries commonly generated by the operation mechanical equipment such as extruder, mixer, blower, compressor, turbine, generator etc. Vibration propagates into the floor and attacks the pipe around those mechanical equipment. In this paper, the influence of vibration in a pipe on the CaSO4 scale formation was investigated to understand the effect of vibration on the kinetics, mass of scale, crystal phases and crystal polymorph. To generate vibration force, mechanical equipment was prepared consisted of electrical motor, crankshaft, connecting rod and a vibration table at where test pipe section mounted. Deposition rate increased significantly when the vibration affected to the system i.e. 0.5997 and 1.6705 gr/hr for vibration frequency 4.00 and 8.00 Hz. The addition 10.00 ppm of citric acid declined the deposition rate of 8 Hz experiment from 3.4599 gr/hr to 2.2865 gr/hr.

  7. Short-term infection in cuffed versus noncuffed small bore central catheters: a randomized trial.

    PubMed

    Trerotola, Scott O; Patel, Aalpen A; Shlansky-Goldberg, Richard D; Solomon, Jeffrey A; Mondschein, Jeffrey I; Stavropoulos, S William; Soulen, Michael C; Itkin, Maxim; Chittams, Jesse

    2010-02-01

    To determine if a polyester cuff offered benefit in jugular small-bore central catheters (SBCCs). Eighty-four patients were randomly assigned to receive a 5-F single- or 6-F dual-lumen SBCC with (n = 42) or without (n = 42) a polyester cuff. Follow-up was performed at 2 weeks, 1 month, and 3 months or at catheter removal, whichever came first. At scheduled follow-up, catheter function, patient satisfaction, and infection were determined. At catheter removal, tip culture was performed to determine colonization and jugular vein patency was determined with ultrasonography (US). The overall infection rate was 0.4 per 1,000 catheter days. There was one clinical infection (noncuffed catheter). Colonization occurred in two noncuffed catheters and one cuffed catheter. There was one catheter dislodgment in the noncuffed group and none in the cuffed group. Cuffed catheters were no more difficult to insert but took slightly longer to remove (6 minutes +/- 4.7 vs 5 minutes +/- 3, P = .39) and often required local anesthesia for removal, whereas noncuffed catheters did not (41% vs 0%, P = .001). Partial (two cuffed, 0 noncuffed) or complete (two cuffed, one noncuffed) jugular thrombosis was seen on five of 58 completion US studies (8.6%). A polyester cuff on a SBCC confers no significant benefit in short-term colonization rates. Infection in SBCCs is uncommon. Despite their small diameters, SBCCs can result in jugular thrombosis, an important consideration in any patient requiring long-term venous access. Copyright (c) 2010 SIR. Published by Elsevier Inc. All rights reserved.

  8. Fast Track ultrasound protocol to detect acute complications after totally implantable venous access device placement.

    PubMed

    Wu, Chun-Yu; Lin, Feng-Sheng; Wang, Yi-Chia; Chou, Wei-Han; Lin, Wen-Ying; Sun, Wei-Zen; Lin, Chih-Peng

    2015-01-01

    The role of ultrasound examination in detection of postprocedure complications from totally implantable venous access devices (TIVAD) placement is still uncertain. In a cohort of 665 cancer outpatients, we assessed a quick ultrasound examination protocol in early detection of mechanical complications of catheterization. Immediately after TIVAD placement, an ultrasound examination and chest radiography were performed to detect hemothorax, pneumothorax, and catheter malposition. The two methods were compared. Of the 668 catheters inserted, 628 were placed into axillary veins and 40 into internal jugular veins. The ultrasound examination took 2.5 ± 1.1 min. No hemothorax was detected, and neither pneumothorax nor catheter malposition was evident among the 40 internal jugular vein cannulations. Ultrasound and chest radiography examinations of the 628 axillary vein cannulations detected five and four instances of pneumothorax, respectively. Ultrasound detected all six catheter malpositions into the internal jugular vein. However, ultrasound failed to detect two out of three malpositions in the contralateral brachiocephalic vein and one kinking inside the superior vena cava. Without revision surgery, the operating time was 34.1 ± 15.6 min. With revision surgery, the operating time was shorter when ultrasound detected catheter malposition than when chest radiography was used (96.8 ± 12.9 vs. 188.8 ± 10.3 min, p < 0.001). Postprocedure ultrasound examination is a quick and sensitive method to detect TIVAD-related pneumothorax. It also precisely detects catheter malposition to internal jugular vein thus reduces time needed for revision surgery while chest radiography remains necessary to confirm catheter final position.

  9. VizieR Online Data Catalog: Herschel SPIRE/FTS 194-671um survey of GOALS LIRGs (Lu+, 2017)

    NASA Astrophysics Data System (ADS)

    Lu, N.; Zhao, Y.; Diaz-Santos, T.; Xu, C. K.; Gao, Y.; Armus, L.; Isaak, K. G.; Mazzarella, J. M.; van der Werf, P. P.; Appleton, P. N.; Charmandaris, V.; Evans, A. S.; Howell, J.; Iwasawa, K.; Leech, J.; Lord, S.; Petric, A. O.; Privon, G. C.; Sanders, D. B.; Schulz, B.; Surace, J. A.

    2017-06-01

    In this paper we presented a Herschel SPIRE/FTS 194-671um spectroscopic survey of 121 galaxies belonging to a complete, flux-limited sample of 123 luminous infrared galaxies (LIRGs) down to a total IR flux of 6.5x10-13W/m2, selected from the Great Observatories All-Sky LIRG Survey (GOALS; Armus+ 2009PASP..121..559A). All 123 observed targets are listed in Table 1. (3 data files).

  10. Internal jugular vein aneurysm: A case report.

    PubMed

    Nasiri, Abdulrahman M; Rayes, Nora; Bakarman, Khaled A

    2018-01-01

    Aneurysm is a localized dilatation of an artery of at least 1.5 times the normal diameter that occurs when part of an artery wall weakens or is injured, allowing it to widen abnormally. In practice, an arterial aneurysm is more common in comparison to a venous aneurysm. Because of the rare incidence of venous aneurysms, treatment guidelines are not clearly established and thus treatment strategies vary. This is a case of a 57-year-old Saudi woman, with no significant medical history, who presented to Prince Sultan Military Hospital complaining of swelling in the right side of the neck that started 3 years ago. The patient reported that the swelling enlarged with coughing and straining, but there was no pain, change in skin color, dysphagia, change in voice, neurological defect, shortness of breath, history of any trauma to the neck, surgical intervention, or any lump. The condition can be diagnosed via ultrasonography, computed tomography, or magnetic resonance imaging. Despite the lack of guidelines, intervention was necessary because the patient was anxious regarding the increase in the size of the swelling, which she felt had a negative psychosocial impact. Moreover, because the sizable venous aneurysm harbored a mural thrombus that increased the risk of embolization and pulmonary embolism, surgery was offered.Indication for surgery includes pain, swelling, and cosmetic concerns. Conservative management of the condition is described in the literature. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  11. Detecting metal-poor gas accretion in the star-forming dwarf galaxies UM 461 and Mrk 600

    NASA Astrophysics Data System (ADS)

    Lagos, P.; Scott, T. C.; Nigoche-Netro, A.; Demarco, R.; Humphrey, A.; Papaderos, P.

    2018-06-01

    Using VIsible MultiObject Spectrograph (VIMOS)-integral field unit (IFU) observations, we study the interstellar medium (ISM) of two star-forming dwarf galaxies, UM 461 and Mrk 600. Our aim was to search for the existence of metallicity inhomogeneities that might arise from infall of nearly pristine gas feeding ongoing localized star formation. The IFU data allowed us to study the impact of external gas accretion on the chemical evolution as well as the ionized gas kinematics and morphologies of these galaxies. Both systems show signs of morphological distortions, including cometary-like morphologies. We analysed the spatial variation of 12 + log(O/H) abundances within both galaxies using the direct method (Te), the widely applied HII-CHI-mistry code, as well as by employing different standard calibrations. For UM 461, our results show that the ISM is fairly well mixed, at large scales; however, we find an off-centre and low-metallicity region with 12 + log(O/H) < 7.6 in the SW part of the brightest H II region, using the direct method. This result is consistent with the recent infall of a metal-poor H I cloud into the region now exhibiting the lowest metallicity, which also displays localized perturbed neutral and ionized gas kinematics. Mrk 600 in contrast, appears to be chemically homogeneous on both large and small scales. The intrinsic differences in the spatially resolved properties of the ISM in our analysed galaxies are consistent with these systems being at different evolutionary stages.

  12. Generation of narrow energy spread ion beams via collisionless shock waves using ultra-intense 1 um wavelength laser systems

    NASA Astrophysics Data System (ADS)

    Albert, Felicie; Pak, A.; Kerr, S.; Lemos, N.; Link, A.; Patel, P.; Pollock, B. B.; Haberberger, D.; Froula, D.; Gauthier, M.; Glenzer, S. H.; Longman, A.; Manzoor, L.; Fedosejevs, R.; Tochitsky, S.; Joshi, C.; Fiuza, F.

    2017-10-01

    In this work, we report on electrostatic collisionless shock wave acceleration experiments that produced proton beams with peak energies between 10-17.5 MeV, with narrow energy spreads between Δ E / E of 10-20%, and with a total number of protons in these peaks of 1e7-1e8. These beams of ions were created by driving an electrostatic collisionless shock wave in a tailored near critical density plasma target using the ultra-intense ps duration Titan laser that operates at a wavelength of 1 um. The near critical density target was produced through the ablation of an initially 0.5 um thick Mylar foil with a separate low intensity laser. A narrow energy spread distribution of carbon / oxygen ions with a similar velocity to the accelerated proton distribution, consistent with the reflection and acceleration of ions from an electrostatic field, was also observed. This work was supported by Lawrence Livermore National Laboratory's Laboratory Directed Research and Development program under project 15-LW-095, and the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA2734.

  13. A Case of Lemierre Syndrome Secondary to Otitis Media and Mastoiditis

    PubMed Central

    Turan, Aynur; Cam, Harun; Dadali, Yeliz; Korkmaz, Serdar; Özdek, Ali; Hekimoğlu, Baki

    2014-01-01

    Lemierre's syndrome is a rare clinical condition that generally develops secondary to oropharyngeal infection caused by Fusobacterium necrophorum, which is an anaerobic bacteria. A 62-year-old patient with diabetes mellitus presented with internal jugular vein and sigmoid sinus-transverse sinus thrombophlebitis, accompanying otitis media and mastoiditis that developed after an upper airway infection. Interestingly, there were air bubbles in both the internal jugular vein and transverse sinus. Vancomycin and meropenem were started and a right radical mastoidectomy was performed. The patient's clinical picture completely resolved in 14 days. High mortality and morbidity may be prevented with a prompt diagnosis of Lemierre's syndrome. PMID:25431696

  14. High-speed 1.3 -1.55 um InGaAs/InP PIN photodetector for microwave photonics

    NASA Astrophysics Data System (ADS)

    Kozyreva, O. A.; Solov'ev, Y. V.; Polukhin, I. S.; Mikhailov, A. K.; Mikhailovskiy, G. A.; Odnoblyudov, M. A.; Gareev, E. Z.; Kolodeznyi, E. S.; Novikov, I. I.; Karachinsky, L. Ya; Egorov, A. Yu; Bougrov, V. E.

    2017-11-01

    We have fabricated the 1.3-1.55 um PIN photodetector based on InGaAs/InP heterostructure. Measurement results of optical and electrical characteristics of PIN photodetector chip were the following: photoconductivity at 1550 nm was 0.65 A/W and internal capacitance was 0.025 pF. Microwave model of photodetector was developed and verified by measurements of scattering matrix. The implementation of broadband (up to 20 GHz) hybrid integrated matching and biasing circuit for high-speed photodetector is presented.

  15. Uma Visão do Universo Segundo um Grupo de Alunos do Ensino Médio de São Paulo

    NASA Astrophysics Data System (ADS)

    Elias, D. S.; Araújo, M.; Amaral, L. H.; Voelzke, M. R.; Araújo, M.

    2005-08-01

    A astronomia, embora seja uma ciência popular, com inúmeras descobertas de interesse público, ainda é apresentada desconsiderando-se os aspectos históricos e científicos relacionados ao seu desenvolvimento, sendo geralmente veiculada nos meios de comunicação de maneira pouco esclarecedora e não raro com imprecisões. Neste trabalho analisou-se a concepção de um grupo de estudantes de Ensino Médio sobre conceitos de astronomia, visando identificar sua visão de mundo a respeito do Universo, envolvendo idéias sobre espaço e tempo. Para issso, foi aplicado um questionário em três escolas da grande São Paulo em um espaço amostral de 270 alunos. Constatou-se que, embora o ensino de astronomia esteja previsto nos PCNEM, os resultados obtidos na pesquisa mostram que há grande deficiência no conhecimento dos temas investigados. Nesse sentido, verificou-se que apenas 20% dos alunos eram capazes de relacionar a sucessão das semanas com as fases da lua, enquanto 28% associaram as estações do ano à inclinação do eixo de rotação da Terra. Por outro lado, somente 23% dos alunos tinham noções das distâncias entre os objetos celestes próximos da Terra e 56% conseguiram relacionar o Big Bang com a origem do Universo. Finalmente, constatou-se que 37% reconheciam o ano-luz como uma unidade de distância e 60% reconheciam o Sol como sendo uma estrela. Apesar de 60% dos alunos indicarem que a escola é a principal fonte para aquisição dos conhecimentos de astronomia, conclui-se que seus conceitos nessa área ainda são inadequados, havendo necessidade de ampliação e aprimoramento da abordagem desses conteúdos nos ambientes escolares.

  16. Metamorphic Formation of Extraterrestrial Portlandite in the Sutter's Mill Meteorite (SM3)

    NASA Astrophysics Data System (ADS)

    Haberle, C. W.; Garvie, L. A.; Domanik, K. J.; Christensen, P. R.

    2013-12-01

    The Sutter's Mill meteorite fell on April 22nd, 2012. Only three small stones (totaling 14.6 g) were collected before heavy rains fell over the fall site, one of which (SM3, 5.0 g) was obtained by Arizona State University's Center for Meteorite Studies. Bulk powder X-ray diffraction (XRD) investigation of seven stones shows that SM3, 6, 8 and 9 are olivine-rich and SM38, 41 and 65 are clay-rich [Garvie 2013]. The olivine-rich stones are largely anhydrous, with mass losses of ~3 wt%, as measured by thermogravimetric analysis (TGA). SM3 also contains Fe-sulfides, magnetite, oldhamite, and minor enstatite. Reflected-light observations show a heterogeneous distribution of clasts, chondrules, sulfides and bluish-white grains embedded in a dark, fine-grained matrix. Three visually prominent bluish-white mineral grains were identified for study: Grain 1, 100 um surrounded by matrix; Grain 2, 200 x 100 um with a rim of ferrous olivine; and Grain 3, 350 x 150 um surrounded by a thick rim of microcrystalline Fe-Ni sulfides. Wavelength dispersive spectrometry (WDS) data of these grains are dominated by Ca and O exhibiting a 1:2 Ca:O ratio, with minor Cl and S. Secondary ion mass spectroscopy (SIMS) reveals abundant H. Compositional maps show an even distribution of Ca across the grains, with enrichments of S at the rims. The chemical data of these grains is consistent with portlandite, Ca(OH)2. This is the first indigenous report of meteoritic portlandite. Portlandite can form through the thermal decomposition of CaCO3 or via the carbothermic reduction of CaSO4 to CaO. CaCO3 decomposes to CO2 and CaO at temperatures >840° C. Carbothermic reduction of CaSO4 to CaO can occur at temperatures >700° C. Both reactions produce CaO which can then easily hydrate to Ca(OH)2, with a likely source of H from dehydroxylation of pre-existing serpentines. Dehydroxylation of serpentine occurs between 550° and 800° C with complete dehydration to olivine >800° C [Ivanova 2010, Gualtieri

  17. Solar Physics Topics in High School: Analysis of a Course with Practical Activities at Dietrich Schiel Observatory. (Spanish Title: Temas de Física Solar Para Estudiantes de Escuelas Secundarias: un Análisis de un Curso con Enfoque Práctico en el Observatorio Dietrich Schiel.) Tópicos de Física Solar no Ensino Médio: Análise de um Curso com Atividades Práticas no Observatório Dietrich Schiel

    NASA Astrophysics Data System (ADS)

    Calbo Aroca, Silvia; Donizete Colombo, Pedro, Jr.; Celestino Silva, Cibelle

    2012-12-01

    algunos estudiantes sabían que un espectro puede estar formado por un prisma o red de difracción, la mayor parte de ellos desconocía la naturaleza de las líneas espectrales. A lo largo del curso, esta cuestión fue trabajada con un enfoque práctico mediante la observación del espectro solar y de las lámparas durante clases expositivas/dialogadas. Los resultados obtenidos en el curso mustran la importancia de los centros de ciencia como un apoyo en la educación formal. En este caso en particular, la Sala Solar del Observatorio Dietrich Schiel se destaca como un entorno favorable para la enseñanza de la física moderna en la escuela secundaria. Este trabalho analisa resultados obtidos em um curso sobre física solar para alunos do ensino médio promovido pelo Observatório Dietrich Schiel da USP. O curso foi elaborado pelos autores com a intenção de investigar concepções sobre o Sol, ensinar tópicos de física moderna relacionados ao Sol e conhecimentos gerais sobre o astro rei. A metodologia de coleta de dados consistiu em gravação em áudio e vídeo das aulas e das entrevistas semi-estruturadas, e respostas a questionários escritos. Os resultados mostraram que a maioria dos participantes concebeu o Sol como constituído por fogo e as manchas solares como buracos na superfície solar. Embora alguns alunos soubessem que um espectro pode ser formado por um prisma ou rede de difração, a maior parte deles desconhecia a natureza das linhas espectrais. Ao longo do curso, este tema foi trabalhado com uma abordagem prática com observação do espectro solar e de lâmpadas e em aulas expositivo-dialogadas. Os resultados obtidos no curso apontam para a importância dos centros de ciências como parceiros da educação formal. Neste caso específico, a Sala Solar do Observatório Dietrich Schiel é um ambiente propício para o ensino de física moderna no ensino médio.

  18. Busca de estruturas em grandes escalas em altos redshifts

    NASA Astrophysics Data System (ADS)

    Boris, N. V.; Sodré, L., Jr.; Cypriano, E.

    2003-08-01

    A busca por estruturas em grandes escalas (aglomerados de galáxias, por exemplo) é um ativo tópico de pesquisas hoje em dia, pois a detecção de um único aglomerado em altos redshifts pode por vínculos fortes sobre os modelos cosmológicos. Neste projeto estamos fazendo uma busca de estruturas distantes em campos contendo pares de quasares próximos entre si em z Â3 0.9. Os pares de quasares foram extraídos do catálogo de Véron-Cetty & Véron (2001) e estão sendo observados com os telescópios: 2,2m da University of Hawaii (UH), 2,5m do Observatório de Las Campanas e com o GEMINI. Apresentamos aqui a análise preliminar de um par de quasares observado nos filtros i'(7800 Å) e z'(9500 Å) com o GEMINI. A cor (i'-z') mostrou-se útil para detectar objetos "early-type" em redshifts menores que 1.1. No estudo do par 131046+0006/J131055+0008, com redshift ~ 0.9, o uso deste método possibilitou a detecção de sete objetos candidatos a galáxias "early-type". Num mapa da distribuição projetada dos objetos para 22 < i' < 25 observou-se que estas galáxias estão localizadas próximas a um dos quasares e há indícios de que estejam aglomeradas dentro de um área de ~ 6 arcmin2. Se esse for o caso, estes objetos seriam membros de uma estrutura em grande escala. Um outro argumento em favor dessa hipótese é que eles obedecem uma relação do tipo Kormendy (raio equivalente X brilho superficial dentro desse raio), como a apresentada pelas galáxias elípticas em z = 0.

  19. Intensity variation study of the radiation field in a mammographic system using thermoluminescent dosimeters TLD-900 (CaSO4:Dy)

    NASA Astrophysics Data System (ADS)

    Corrêa, E. L.; Silva, J. O.; Vivolo, V.; Potiens, M. P. A.; Daros, K. A. C.; Medeiros, R. B.

    2014-02-01

    This study presents the results of the intensity variation of the radiation field in a mammographic system using the thermoluminescent dosimeter TLD-900 (CaSO4:Dy). These TLDs were calibrated and characterized in an industrial X-ray system used for instruments calibration, in the energy range used in mammography. They were distributed in a matrix of 19 lines and five columns, covering an area of 18 cm×8 cm in the center of the radiation field on the clinical equipment. The results showed a variation of the intensity probably explained by the non-uniformity of the field due to the heel effect.

  20. Rare case of nephrotic syndrome: Schimke syndrome.

    PubMed

    Pedrosa, Anna Kelly Krislane de Vasconcelos; Torres, Luiz Fernando Oliveira; Silva, Ana Corina Brainer Amorim da; Dantas, Adrianna Barros Leal; Zuntini, Káthia Liliane da Cunha Ribeiro; Aguiar, Lia Cordeiro Bastos

    2016-01-01

    Schimke syndrome corresponds to dysplasia of bone and immunity, associated with progressive renal disease secondary to nephrotic syndrome cortico-resistant, with possible other abnormalities such as hypothyroidism and blond marrow aplasia. It is a rare genetic disorder, with few reports in the literature. The most frequent renal involvement is nephrotic syndrome with focal segmental glomerulosclerosis and progressive renal failure. The objective of this study was to report a case of Schimke syndrome, diagnostic investigation and management of the case. Resumo A síndrome Schimke corresponde à displasia imuno-óssea, associada à doença renal progressiva secundária à síndrome nefrótica córtico-resistente, podendo haver outras anormalidades como hipotireoidismo e aplasia de medula óssea. Trata-se de uma patologia genética rara, com poucos relatos na literatura. O acometimento renal mais frequente é uma síndrome nefrótica por glomeruloesclerose segmentar e focal e falência renal progressiva. O objetivo deste estudo foi relatar um caso de síndrome de Schimke, investigação diagnóstica e condução do caso.

  1. An estimation of intracranial blood flow in the new-born infant.

    PubMed Central

    Cross, K W; Dear, P R; Hathorn, M K; Hyams, A; Kerslake, D M; Milligan, D W; Rahilly, P M; Stothers, J K

    1979-01-01

    1. A non-invasive method for the estimation of the intracranial blood flow of the new-born infant is described, and results obtained with it are presented. 2. The technique is a novel application of the principle of blood flow measurement by venous occlusion plethysmography. It is possible to apply a plethysmographic technique to the neonatal cranium because the presence of open sutures between the component bones permits small, but readily measurable, changes in intracranial volume to occur. 3. Skull volume changes are calculated from changes in the occipito-frontal circumference of the cranium as recorded and measured with a mercury-in-Silastic strain gauge. 4. The jugular veins in the baby's neck are occluded by finger pressure and there follows an increase in skull volume, which is rapid at first, but which decreases exponentially as venous drainage diverts to non-occluded channels such as the vertebral venous plexus. At the instant of jugular occlusion the rate of skull volume increase is representative of the rate of flow in the jugular vessels prior to occlusion, and so provides an index of the relative magnitude of the intracranial blood flow. The method thus allows changes in intracranial blood flow to be followed. When occlusion is released cranial volume decreases, initially rapidly, but slowing exponentially as resting volume is regained. 5. A theoretical model of the events occurring during the inflow and outflow phases has been developed, and a formula derived which allows an estimation to be made of the flow of blood through uncompressed channels. The measured value of jugular blood flow can then be augmented to an estimate of total intracranial flow. 6. The mean cerebral blood flow of sixteen normal babies was estimated to be 40 ml. 100 g-1.min-1 (S.D. = +/- 11.63). Images Fig. 2 Fig. 6 PMID:458665

  2. Topography of neurovascular structures in relation to round window and how it relates to cochlear implantation.

    PubMed

    Singla, Anjali; Gupta, Tulika; Sahni, Daisy; Gupta, Ashok Kumar; Aggarwal, Anjali

    2017-12-01

    The purpose of this investigation was to evaluate the distances and angles on basal turn of cochlea in relation to round window at which the jugular bulb, internal carotid artery and facial nerve are at maximal risk and their implications in cochlear implantation (CI). Fifty-four cadaveric temporal bones were microdissected to expose the basal turn of cochlea, the carotid canal, the facial canal and the jugular fossa. The points were marked on the basal turn of cochlea, where there was minimum distance of basal turn of cochlea from the roof of the jugular fossa (point a), carotid canal (point b) and facial canal (point c). The distances and angles of these points from the round window were measured. The points a, b and c were at mean (range) distances of 2.8 mm (1.3-4.1 mm), 8.4 mm (6.5-10.4 mm) and 16.4 mm (12.5-20.5 mm) and at mean angles of 30° (15°-45°), 111° (71°-136°) and 284° (255°-315°), respectively, from the round window. This study highlights that 2.8 ± 0.5 mm (30 ± 5.40), 8.4 ± 1 mm (111 ± 12.70) and 16.4 ± 1.7 mm (284 ± 13.5) from the round window are the high-risk points on the basal turn of the cochlea for the jugular bulb, internal carotid artery and facial nerve, respectively. A wide range found for each parameter indicates that it is mandatory to evaluate these distances in each CI patient on preoperative radiographs to avoid intraoperative injury to these vital structures.

  3. Cost effectiveness of different central venous approaches for port placement and use in adult oncology patients: evidence from a randomized three-arm trial.

    PubMed

    Biffi, Roberto; Pozzi, Simonetta; Bonomo, Guido; Della Vigna, Paolo; Monfardini, Lorenzo; Radice, Davide; Rotmensz, Nicole; Zampino, Maria Giulia; Fazio, Nicola; Orsi, Franco

    2014-11-01

    No randomized trials have so far investigated the cost effectiveness of different methods for implantation and use of central venous ports in oncology patients. Overall, 403 patients eligible for receiving intravenous chemotherapy for solid tumours were randomly assigned to implantation of a single type of port, either through a percutaneous landmark access to the internal jugular vein, an ultrasound (US)-guided access to the subclavian vein, or a surgical cut-down access through the cephalic vein at the deltoid-pectoralis groove. Insertion and maintenance costs were estimated by obtaining the charges for an average implant and use, while the costs of the management of complications were analytically assessed. The total cost was defined as the purchase cost plus the insertion cost plus the maintenance cost plus the cost of treatment of the complications, if any. A total of 401 patients were evaluable-132 with the internal jugular vein, 136 with the subclavian vein and 133 with the cephalic vein access. No differences were found for the rate of early complications. The US-guided subclavian insertion site had significantly lower failures. Infections occurred in 1, 3, and 3 patients (internal jugular, subclavian, and cephalic access, respectively; p = 0.464), whereas venous thrombosis was observed in 15, 8, and 11 patients, respectively (p = 0.272). Mean cost for purchase, implantation, diagnosis and treatment of complications in each patient was 2,167.85 for subclavian US-guided, 2,335.87 for cephalic, and 2,384.10 for internal jugular access, respectively (p = 0.0001). US real-time guidance to the subclavian vein resulted in the most cost-effective method of central venous port placement and use.

  4. An endovascular treatment of Chronic Cerebro-Spinal Venous Insufficiency in multiple sclerosis patients - 6 month follow-up results.

    PubMed

    Kostecki, Jacek; Zaniewski, Maciej; Ziaja, Krzysztof; Urbanek, Tomasz; Kuczmik, Waclaw; Krzystanek, Ewa; Ziaja, Damian; Korzeniowski, Tomasz; Majewski, Eugeniusz; Hartel, Marcin; Swiat, Maciej; Sioma-Markowska, Urszula

    2011-01-01

    In this study, the mid-term results (6 month follow-up) of the endovascular treatment in patients with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and multiple sclerosis (MS) were prospectively evaluated. Thirty-six patients with confirmed MS and CCSVI underwent endovascular treatment by the means of the uni- or bilateral jugular vein angioplasty with optional stent placement. All the patients completed 6 month follow-up. Their MS-related disability status and quality of life were evaluated 1, 3 and 6 months postoperatively by means of the following scales: Expanded Disability Status Scale (EDSS), Multiple Sclerosis Impact Scale (MSIS-29), Epworth Sleepiness Scale (ESS), Heat Intolerance scale (HIS) and Fatigue Severity Scale (FSS). For patency and restenosis rate assessment, the control US duplex Doppler examination was used. Six months after the procedure, restenosis in post-PTA jugular veins was found in 33% of cases. Among 17 patients who underwent stent implantation into the jugular vein, restenosis or partial in-stent thrombosis was identified in 55% of the cases. At the 6 month follow-up appointment, there was no significant improvement in the EDSS or the ESS. The endovascular treatment of the CCSVI improved the quality of life according to the MSIS-29 scale but only up to 3 months after the procedure (with no differences in the 6 month follow-up assessment). Six months after the jugular vein angioplasty (with or without stent placement), a statistically significant improvement was observed only in the FSS and the HIS. The endovascular treatment in patients with MS and concomitant CCSVI did not have an influence on the patient's neurological condition; however, in the mid-term follow-up, an improvement in some quality-of-life parameters was observed.

  5. Breast necrosis secondary to vasopressor extravasation: management using indocyanine green angiography and omental flap closure.

    PubMed

    Hagopian, Thomas M; Ghareeb, Paul A; Arslanian, Brian H; Moosavi, Benjamin L; Carlson, Grant W

    2015-01-01

    Extravasation is a rare but serious complication of vasopressor administration. A 60-year-old female who underwent ascending and hemiarch repair of the aorta along with aortic valve replacement developed extensive right breast and chest wall necrosis after vasopressor extravasation from an internal jugular vein central line. The patient underwent a total mastectomy due to deep tissue necrosis detected by laser-assisted indocyanine green dye angiography, and eventually required omental flap reconstruction to obtain adequate sternal coverage. This case represents a previously unreported complication of internal jugular central line extravasation of vasopressors with resultant breast and chest wall necrosis, and highlights the utility of the omentum in chest wall reconstruction. © 2015 Wiley Periodicals, Inc.

  6. Spontaneous ovarian hyper stimulation syndrome and deep vein thrombosis in a non pregnant woman: case report.

    PubMed

    Attia, Leila; Azzabi, Samira; Ben Hassine, Lamia; Chachia, Abdelatif; Koubâa, Abdelhamid; Khalfallah, Narjes

    2007-12-01

    To assess aetiological factors and complications in a patient with severe ovarian hyperstimulation syndrome (OHSS) and internal jugular vein thrombosis. A 27-year-old non pregnant woman with bilateral ovarian masses who had underwent laparotomy for suspicion of malignant tumor. The pathological examination disclosed malignancy and the diagnosis of OHSS were confirmed. The postoperative evolution was complicated by internal jugular, subclavian vein thrombosis and pulmonary embolism. All biological parameters were negative. The evolution was good. The incidence of thromboembolism in women with OHSS is low and the typical finding is deep venous thrombosis in the neck area. Preventive measure of OHSS is very important, and the patients must be treated timely and correctly once OHSS occurs.

  7. Papiloma invertido sinunasal con invasión intracraneal: Reporte de caso y revisión bibliográfica

    PubMed Central

    Di Pietrantonio, Andrés; Asmus, Humberto; Ingratta, Christian; Brennan, Walter; Schulz, Javier; Carballo, Leandro

    2018-01-01

    Resumen IntroducciÓn: El papiloma invertido es una neoplasia benigna de los senos paranasales localmente agresiva con alto potencial de recurrencia y de malignización. La extensión intracraneal es infrecuente y más aún, la penetración dural, asociándose a menudo a la recurrencia de la enfermedad o a su degeneración en carcinoma de células escamosas. Caso clínico: Presentamos el caso de una paciente de 32 años que consultó por lesión exofítica en fosa nasal derecha y exoftalmos, asociada a cefalea, anosmia y disgeusia. Se estudió con TC cerebro, macizo facial y RM de encéfalo que evidencian lesión en fosa nasal derecha con ocupación de senos aéreos, osteólisis de pared medial orbitaria y base de cráneo anterior e invasión intracraneal frontal derecha, con efecto de masa y compresión del parénquima encefálico adyacente. Intervención: Se realizó una nasofibroscopía en primer tiempo con diagnóstico anatomopatológico de papiloma invertido y posteriormente resección de la lesión mediante doble abordaje más reconstrucción de la fosa craneal anterior. Se obtuvo diagnóstico definitivo de papiloma invertido de tipo Schneideriano con áreas de transformación atípica in situ. La paciente evolucionó de forma favorable y sin complicaciones, con permeabilidad de vía aérea superior, sin signos de recidiva lesional luego de 4 años de seguimiento. Conclusión: La invasión intracraneal de esta patología es sumamente infrecuente. Cuando existe, es indicador de agresividad y potencial recidiva, por lo que la exéresis completa de la misma define el pronóstico de la enfermedad. PMID:29430328

  8. Descompresión microvascular en espasmo hemifacial: Reporte de 13 casos y revisión de la literatura

    PubMed Central

    Campero, Alvaro; Herreros, Isabel Cuervo-Arango; Barrenechea, Ignacio; Andjel, Germán; Ajler, Pablo; Rhoton, Albert

    2016-01-01

    Objetivo: El propósito del presente trabajo es presentar los resultados de 13 pacientes con diagnóstico de espasmo hemifacial (EHF), en los cuales se realizó una descompresión microvascular (DMV). Material y Método: Desde Junio de 2005 a Mayo de 2014, 13 pacientes con diagnóstico de EHF fueron intervenidos quirúrgicamente, realizando una DMV. Se evaluó: edad, sexo, tiempo de evolución de la sintomatología, hallazgos intraoperatorios y resultados postoperatorios. Resultados: De los 13 pacientes intervenidos, 7 fueron mujeres y 6 varones. La media de edad fue de 53 años. El tiempo medio entre el inicio de la sintomatología y la intervención quirúrgica osciló entre 3 y 9 años. En todos los casos el EHF era típico, uno de ellos con neuralgia trigeminal concomitante, observándose en todos compresión neurovascular intraoperatoria. Por orden decreciente de frecuencia la causa de la compresión fue arteria cerebelosa anteroinferior, arteria cerebelosa posteroinferior, arteria dolicomega basilar y arteria dolicomega vertebral. El seguimiento postoperatorio fue en promedio de 24 meses. El 62% presentó desaparición postquirúrgica inmediata de la sintomatología preoperatoria, el 30% desaparición tras un período de 3 semanas a 2 meses (8% con mejoría parcial), y en el 8% no hubo mejoría. En cuanto a las complicaciones postoperatorias: 3 pacientes presentaron paresia facial II-III en la escala de House-Brackman (se recuperaron en un período de 6 meses), y 1 paciente presentó fístula de líquido cefalorraquídeo. Ninguno de los pacientes de la serie presentaron hipoacusia transitorio o permanente. Conclusión: La DMV como tratamiento del EHF es un procedimiento efectivo y seguro, que permite la resolución completa de la patología en la mayoría de los casos. PMID:27127708

  9. La implantacion del enfoque constructivista en el aula de ciencia: Estudio de caso multiple

    NASA Astrophysics Data System (ADS)

    Arroyo Betancourt, Luz I.

    Esta investigacion estudia la implantacion del enfoque constructivista en tres aulas de ciencia del contexto puertorriqueno. Se auscultaron las practicas educativas que utilizan maestras consideradas constructivistas y la correspondencia de sus practicas educativas con los elementos esenciales de la didactica que proponen los teoricos de los planteamientos constructivistas. Se ausculto, ademas, a que vision del enfoque constructivista responden las expresiones de las maestras acerca de su practica educativa y como compara con su quehacer, a la luz de los elementos esenciales de las visiones constructivistas piagetiana, social y radical. Se utilizo el diseno de estudio descriptivo de caso multiple. El estudio se baso en entrevistas a profundidad, revision de documentos y observacion no participativa a la sala de clases. El contexto fueron tres escuelas publicas de la Region Educativa de San Juan, una elemental, una intermedia y una superior. Los resultados confirmaron que la transicion hacia el enfoque constructivista es un proceso que toma tiempo, dedicacion y la participacion en adiestramientos y readiestramientos acerca del nuevo enfoque. Las maestras coinciden en la mayoria de las practicas educativas que utilizan para implantar el enfoque constructivista de ensenanza y difieren en algunas debido, probablemente, a que han tenido que adaptarlas a los correspondientes niveles de ensenanza: elemental, intermedio y superior. Dos de las maestras planifican por conceptos generadores, mientras que una de ellas planifica siguiendo la guia que recibe del Departamento de Educacion. Difieren ademas, en el enfasis que confieren al inquirir cientifico. Con relacion a la correspondencia entre la vision manifestada por las maestras a la luz de las visiones piagetiana, social y radical, aparentemente, las preguntas del protocolo de entrevistas no lograron evocar la informacion con suficiente profundidad, por lo que la investigadora tuvo que inferir las visiones de las

  10. [Severe Bleeding from the Middle Ear Cavity after Myringotomy: Review Based on a Case Report].

    PubMed

    Hofmann, Veit M; Niehues, Stefan M; Albers, Andreas E; Pudszuhn, Annett

    2017-03-01

    Report of a rare case of severe bleeding from the middle ear cavity after myringotomy. On the basis of the case report, the procedure for such bleeding is discussed in the context of the literature. A 6-year-old boy received a revision myringotomy in an ambulant setting. During the procedure a severe bleeding occurred. The external auditory canal was adequately packed. The patient was extubated and transferred to the clinic as an emergency. Computer tomography of the temporal bone showed the anatomical variant of a dehiscent high jugular bulb, which had been injured. Because no rebleeding occurred, the packing of the ear canal was removed and an explorative tympanoscopy was performed on the third postoperative day. When the tympanomeatal flap was lifted, the defect in the jugular bulb was found. The lesion was covered with Tutopatch ® pads and fibrin glue and the auditory canal was packed again. After removal of the packing three weeks postoperatively a properly healed situs was found. No further measures were taken. The injury of a dehiscent jugular bulb in the course of ear surgeries leads to a massive hemorrhage. The case describes the diagnostic and therapeutic procedure for this relatively rare but severe complication. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Retrograde cerebral perfusion (RCP) in aortic arch surgery: efficacy and possible mechanisms of brain protection.

    PubMed

    Bavaria, J E; Pochettino, A

    1997-07-01

    Retrograde cerebral perfusion (RCP) was first introduced to treat air embolism during cardiopulmonary bypass (CPB). Its use was reintroduced to extend the safety of hypothermic circulatory arrest (HCA) during operations involving an open aortic arch. RCP seems to prevent cerebral rewarming during HCA. Both clinical and animal data suggest that RCP provides between 10% and 30% of baseline cerebral blood flow when administered through the superior vena cava (SVC) at jugular pressures of 20 to 25 mm Hg. RCP flows producing jugular venous pressures higher than 30 mm Hg may cause cerebral edema. Cerebral blood flow generated by RCP is able to sustain some cerebral metabolic activity, yet is not able to fully meet cerebral energy demands even at temperatures of 12 degrees to 18 degrees C. RCP may further prevent embolic events during aortic arch surgery when administered at moderate jugular vein pressures (< 40 mm Hg). Clinical results suggest that RCP, when applied during aortic arch reconstruction, may extend the safe HCA period and improve morbidity and mortality, especially when HCA times are more than 60 minutes. RCP applied in patients and severe carotid and brachiocephalic occlusive disease may be ineffective, and caution is in order when RCP times are greater than 90 minutes.

  12. Lesiones subcutáneas dolorosas en paciente con melanoma metastásico: un caso de paniculitis linfocítica asociado a vemurafenib.

    PubMed

    Benavente-Villegas, Felipe; Ferrando-Roca, Francisco; Dolz-Gaitón, Raquel; Royo-Peiró, María

    2017-10-15

    Vemurafenib ha probado ser una herramienta útil en el tratamiento de melanoma metastásico con mutación BRAF-V600E. Los efectos adversos incluyen artralgias, fatiga y toxicidad cutánea, siendo infrecuente la paniculitis. Presentamos el caso de una paciente de 43 años con melanoma metastásico que desarrolla lesiones subcutáneas dolorosas en miembros inferiores y superiores, asociadas a clínica sistémica después de 2 semanas de inicio de tratamiento con Vemurafenib + Cobimetinib. La histología demostró paniculitis linfocitaria septal y lobulillar. La paciente tuvo mala tolerancia al tratamiento anti diana a dosis plenas, requiriendo su ajuste, generando una corticodependencia para controlar sintomatología, y que finalmente obligó a la descontinuación de la terapia dirigida contra melanoma.  A la fecha, se han descrito 29 casos en la literatura de paniculitis asociada a vemurafenib, siendo la mayoría paniculitis neutrofílicas con adecuado control de sintomatología asociando antiinflamatorios no esteroidales y/o corticoides orales sin requerir en su mayoría modificación de la terapia contra melanoma; sin embargo hay que tener presente que pueden haber casos con mala evolución que obligan a la reducción de dosis de vemurafenib y descontinuar el tratamiento, como ha ocurrido en nuestro reporte.Vemurafenib has proven to be a useful tool in the treatment of metastatic melanoma with BRAF-V600E mutation. Adverse effects include arthralgia, fatigue, and skin toxicity; panniculitis is a rare complication. We present the case of a 43-year-old patient with metastatic melanoma who developed painful subcutaneous nodules of the lower and upper limbs and associated systemic clinical symptoms after 2 weeks of treatment with vemurafenib plus cobimetinib. Histology showed a septal and lobular lymphocytic panniculitis.The patient had poor tolerance of the full-dose treatment, requiring its adjustment. Systemic corticosteroids were required to control symptomatology

  13. Splenic artery aneurysm.

    PubMed

    Tcbc-Rj, Rui Antônio Ferreira; Ferreira, Myriam Christina Lopes; Ferreira, Daniel Antônio Lopes; Ferreira, André Gustavo Lopes; Ramos, Flávia Oliveira

    2016-01-01

    Splenic artery aneurysms - the most common visceral artery aneurysms - are found most often in multiparous women and in patients with portal hypertension. Indications for treatment of splenic artery aneurysm or pseudoaneurysm include specific symptoms, female gender and childbearing age, presence of portal hypertension, planned liver transplantation, a pseudoaneurysm of any size, and an aneurysm with a diameter of more than 2.5cm. Historically, the treatment of splenic artery aneurysm has been surgical ligation of the splenic artery, ligation of the aneurysm, or aneurysmectomy with or without splenectomy, depending on the aneurysm location. There are other percutaneous interventional techniques. The authors present a case of a splenic artery aneurysm in a 51-year-old woman, detected incidentally. RESUMO Aneurismas da artéria esplênica - os aneurismas arteriais viscerais mais comuns - são encontrados mais frequentemente em mulheres multíparas e em pacientes com hipertensão portal. As indicações para o seu tratamento incluem sintomas específicos, sexo feminino e idade fértil, presença de hipertensão portal, paciente em fila de transplante hepático, um pseudoaneurisma de qualquer tamanho, e um aneurisma com um diâmetro superior a 2,5cm. Historicamente, o tratamento do aneurisma da artéria esplênica tem sido a ligadura cirúrgica da artéria esplênica, a ligadura do aneurisma ou a aneurismectomia, com ou sem esplenectomia, dependendo do local do aneurisma. Existem outras técnicas intervencionistas percutâneas. Os autores apresentam o caso de um aneurisma de artéria esplênica em uma mulher de 51 anos de idade, diagnosticado incidentalmente.

  14. BIODEGRADABLE BILIARY STENTS: A NEW APPROACH FOR THE MANAGEMENT OF HEPATICOJEJUNOSTOMY STRICTURES FOLLOWING BILE DUCT INJURY. PROSPECTIVE STUDY.

    PubMed

    Giménez, Mariano E; Palermo, Mariano; Houghton, Eduardo; Acquafresca, Pablo; Finger, Caetano; Verde, Juan M; Cúneo, Jorge Cardoso

    2016-01-01

    áveis ​​foram colocados em 13 pacientes com estenose de hepaticojejunostomia secundárias usados para reparação do ductos biliares de lesão cirúrgica. A média de idade foi de 38,7 anos (23-67), nove pacientes eram homens e quatro mulheres. Todos os casos tiveram drenagem percutânea antes do momento da colocação de stent biodegradável. Em um caso, haemobilia temporária estava presente com necessidade de transfusão de sangue. Em outro, dor após a colocação do stent necessitou de medicação intravenosa. Nos outros 11 pacientes, alta hospitalar foi na manhã seguinte após o procedimento. Durante o seguimento, nenhum apresentou sintomas durante os primeiros nove meses. Um paciente apresentou significativa elevação da fosfatase alcalina por recidiva da estenose. Um caso teve recorrência de colangite 11 meses após a colocação do stent. Continuaram assintomáticos 84,6% com média de acompanhamento de 20 meses. A colocação de stents biodegradáveis ​​é técnica segura e viável. Não foram observadas restrições causadas pelo stent ou pela sua degradação. Stent pode substituir dilatação com balão na estenose de hepaticojejunostomia.

  15. Attitudes of Psychiatric Nurses about the Request for Euthanasia on the Basis of Unbearable Mental Suffering(UMS).

    PubMed

    De Hert, Marc; Van Bos, Liesbet; Sweers, Kim; Wampers, Martien; De Lepeleire, Jan; Correll, Christophe U

    2015-01-01

    When psychiatric patients express a wish for euthanasia, this should first and foremost be interpreted as a cry for help. Due to their close day-to-day relationship, psychiatric nurses may play an important and central role in responding to such requests. However, little is known about nurses' attitudes towards euthanasia motivated by unbearable mental suffering. The aim of this study was to provide insight into the attitudes and actions taken by psychiatric nurses when confronted with a patient's euthanasia request based on unbearable mental suffering (UMS). A questionnaire was sent to 11 psychiatric hospitals in the Flemish part of Belgium. The overall response rate was 70% (N = 627). Psychiatric nurses were frequently confronted with a request for euthanasia, either directly (N = 329, 53%) or through a colleague (N = 427, 69%). A majority (N = 536, 84%) did not object to euthanasia in a psychiatrically ill population with UMS. Confounding factors were the psychiatric diagnosis and the type of ward where the nurses were working. Most participants acknowledged a lack of knowledge and skills to adequately address the euthanasia request (N = 434, 71%). Nearly unanimously (N = 618, 99%), study participants indicated that dealing with euthanasia requests and other end-of-life issues should be part of the formal training of nurses. The results highlight the need for ethically sound and comprehensive provision of care. Psychiatric nurses play an important role in dealing with the complex issue of requests for euthanasia. There is also a need for education, training and clear guidelines on the level of health care organizations.

  16. On efeito do achatamento nos pontos de equilíbrio e na dinâmica de sistemas coorbitais

    NASA Astrophysics Data System (ADS)

    Mourão, D. C.; Winter, O. C.; Yokoyama, T.

    2003-08-01

    Neste trabalho analisamos o efeito do achatamento do corpo principal nos pontos de equilíbrio lagrangianos e na configuração de órbitas girino-ferradura. Enfatizamos os sistemas coorbitais de satélites de Saturno, pois se encontram em relativa proximidade com o planeta, em que o efeito do achatamento se torna mais evidente. O estudo é dividido em três etapas independentes. Na primeira fase analisamos as equações de movimento do problema restrito de três corpos considerando o efeito do achatamento, e através do balanceamento de forças buscamos a nova configuração dos pontos de equilíbrio lagrangianos. Concluímos, nesta etapa, que os pontos de equilíbrio estáveis apresentam um pequeno deslocamento definido pelo parâmetro de achatamento, não podendo ser mais representados por triângulos eqüiláteros. Aplicamos este resultado aos satélites coorbitais de Tetis e Dione, encontrando as posições de equilíbrio levemente deslocadas em relação ao caso sem achatamento. Na segunda fase visamos o sistema Saturno-Jano-Epimeteu, que por se tratar de um sistema de massas comparáveis, optamos por desenvolver as equações de Yoder et al (Icarus 53, pág 431-443, 1983), que permitem determinar os pontos de equilíbrio e a amplitude de oscilação angular das órbitas girino-ferradura para o problema não-restrito de três corpos, porém, no nosso estudo consideramos o efeito do achatamento do corpo principal nestas equações. Encontramos que a distância angular entre satélites, quando em posição de equilíbrio estável, diminui quanto maior for o parâmetro de achatamento do corpo principal. Além disso, a órbita de transição girino-ferradura possui largura angular menor em relação ao caso sem achatamento. Por fim, realizamos integrações numéricas para os casos reais de coorbitais de Saturno comparando com os resultados analíticos. Nestas integrações simulamos diversas órbitas girino-ferradura com diferentes parâmetros de achatamento

  17. [Integration of sex/gender into environmental health research. Results of the interdisciplinary research network Sex/Gender-Environment-Health (GeUmGe-NET)].

    PubMed

    Bolte, Gabriele; David, Madlen; Dębiak, Małgorzata; Fiedel, Lotta; Hornberg, Claudia; Kolossa-Gehring, Marike; Kraus, Ute; Lätzsch, Rebecca; Paeck, Tatjana; Palm, Kerstin; Schneider, Alexandra

    2018-06-01

    The comprehensive consideration of sex/gender in health research is essential to increase relevance and validity of research results. Contrary to other areas of health research, there is no systematic summary of the current state of research on the significance of sex/gender in environmental health. Within the interdisciplinary research network Sex/Gender-Environment-Health (GeUmGe-NET) the current state of integration of sex/gender aspects or, respectively, gender theoretical concepts into research was systematically assessed within selected topics of the research areas environmental toxicology, environmental medicine, environmental epidemiology and public health research on environment and health. Knowledge gaps and research needs were identified in all research areas. Furthermore, the potential for methodological advancements by using gender theoretical concepts was depicted. A dialogue between biomedical research, public health research, and gender studies was started with the research network GeUmGe-NET. This dialogue has to be continued particularly regarding a common testing of methodological innovations in data collection and data analysis. Insights of this interdisciplinary research are relevant for practice areas such as environmental health protection, health promotion, environmental justice, and environmental health monitoring.

  18. Attitudes of Psychiatric Nurses about the Request for Euthanasia on the Basis of Unbearable Mental Suffering(UMS)

    PubMed Central

    Wampers, Martien; De Lepeleire, Jan; Correll, Christophe U.

    2015-01-01

    Introduction When psychiatric patients express a wish for euthanasia, this should first and foremost be interpreted as a cry for help. Due to their close day-to-day relationship, psychiatric nurses may play an important and central role in responding to such requests. However, little is known about nurses’ attitudes towards euthanasia motivated by unbearable mental suffering. Objectives The aim of this study was to provide insight into the attitudes and actions taken by psychiatric nurses when confronted with a patient’s euthanasia request based on unbearable mental suffering (UMS). Method A questionnaire was sent to 11 psychiatric hospitals in the Flemish part of Belgium. Results The overall response rate was 70% (N = 627). Psychiatric nurses were frequently confronted with a request for euthanasia, either directly (N = 329, 53%) or through a colleague (N = 427, 69%). A majority (N = 536, 84%) did not object to euthanasia in a psychiatrically ill population with UMS. Confounding factors were the psychiatric diagnosis and the type of ward where the nurses were working. Most participants acknowledged a lack of knowledge and skills to adequately address the euthanasia request (N = 434, 71%). Nearly unanimously (N = 618, 99%), study participants indicated that dealing with euthanasia requests and other end-of-life issues should be part of the formal training of nurses. Conclusion The results highlight the need for ethically sound and comprehensive provision of care. Psychiatric nurses play an important role in dealing with the complex issue of requests for euthanasia. There is also a need for education, training and clear guidelines on the level of health care organizations. PMID:26700007

  19. Reconstruction of the pulmonary posterior wall using in situ autologous tissue for the treatment of pulmonary atresia with ventricular septal defect.

    PubMed

    Fan, Chengming; Yang, Yifeng; Xiong, Lian; Yin, Ni; Wu, Qin; Tang, Mi; Yang, Jinfu

    2017-02-23

    To evaluate the early and mid-term results of pulmonary trunk reconstruction using a technique in which autogenous tissue is preserved in situ in pulmonary atresia patients with a ventricular septal defect (PA-VSD). The pulmonary artery was reconstructed using autogenous tissue that had been preserved in situ and a bovine jugular venous patch in 24 patients who were diagnosed with PA-VSD (the observation group). The traditional operation using a bovine jugular venous conduit was performed in 40 other cases of PA-VSD (the control group). In the observation group, all patients survived and recovered successfully without complications. Follow-up echocardiography 2-10 years after the procedure showed that the reconstructed right ventricular outflow tract (RVOT) and pulmonary artery were patent, showing no evidence of flow obstruction. Only mild regurgitation of the bovine jugular vein valve was observed. In the control group, early postoperative death occurred in two cases. Another two patients had obstruction of the anastomotic stoma and underwent conduit replacement surgery within 2 weeks of the initial procedure. During the 2-10 years of follow-up care, six patients presented with valvular stenosis of the BJVC, with a pressure gradient of more than 50 mmHg. The technique for preserving autogenous tissue to reconstruct the pulmonary posterior wall is a satisfactory method for treating PA-VSD.

  20. Early and Late Retrieval of the ALN Removable Vena Cava Filter: Results from a Multicenter Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pellerin, O., E-mail: olivier.pellerin@egp.aphp.f; Barral, F. G.; Lions, C.

    Retrieval of removable inferior vena cava (IVC) filters in selected patients is widely practiced. The purpose of this multicenter study was to evaluate the feasibility and results of percutaneous removal of the ALN removable filter in a large patient cohort. Between November 2003 and June 2006, 123 consecutive patients were referred for percutaneous extraction of the ALN filter at three centers. The ALN filter is a removable filter that can be implanted through a femoral/jugular vein approach and extracted by the jugular vein approach. Filter removal was attempted after an implantation period of 93 {+-} 15 days (range, 6-722 days)more » through the right internal jugular vein approach using the dedicated extraction kit after control inferior vena cavography. Following filter removal, vena cavograms were obtained in all patients. Successful extraction was achieved in all but one case. Among these successful retrievals, additional manipulation using a femoral approach was needed when the apex of the filter was close to the IVC wall in two patients. No immediate IVC complications were observed according to the postimplantation cavography. Neither technical nor clinical differences between early and late filter retrieval were noticed. Our data confirm the safety of ALN filter retrieval up to 722 days after implantation. In infrequent cases, additional endovenous filter manipulation is needed to facilitate extraction.« less

  1. Food insecurity and health status in deprived populations, 2014: a multicentre survey in seven of the social and medical healthcare centres (CASOs) run by Doctors of the World, France.

    PubMed

    Laurence, S; Durand, E; Thomas, E; Chappuis, M; Corty, J F

    2017-02-01

    To document eating practices and socio-economic profiles of patients seen in the social and medical healthcare centres (CASOs in its French acronym) run by Doctors of the World (Médecins du Monde, MdM) in France and evaluate their nutritional and health status. The survey was carried out between April and May 2014 in seven CASOs in France. All the patients attending MdM clinics were given a nutrition and health questionnaire. Their anthropometric measurements were taken on site. 77.7% of the households surveyed were food insecure due to constrained resources. On average, the patients interviewed declared spending €2.5 per person per day on food. A total of 46.3% of adults declared not having eaten for a whole day at least once in the month preceding the survey. One third of the patients declared having lost weight over the last two weeks. A chronic pathology was diagnosed in more than one in two patients; 19% were obese and 34% were overweight. Constrained resources lead people living in very precarious conditions to eat without adequate nutrition, which could have consequences for their health, such as diabetes, obesity and cardiovascular disease. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  2. Fluid evolution of Au-Cu zones in Um Balad area, North Eastern Desert of Egypt: Implications from mineral chemistry and fluid inclusions

    NASA Astrophysics Data System (ADS)

    Abd El Monsef, Mohamed; Salem, Ibrahim; Slobodník, Marek; Ragab, Ahmed

    2018-07-01

    Scanning electron microscope (SEM), Electron microprobe (EMPA) and fluid inclusion studies of the ore body, as well as geochemical analyses of country rocks were performed to determine the nature and characteristics of the mineralizing fluid responsible for Au-Cu deposits in Um Balad area, Northern Eastern Desert of Egypt. The Um Balad Au-Cu deposits are confined to well developed-quartz veins and veinlets cutting through the hosting country rocks. Petrographic and geochemical investigations of the hosting rocks distinguished between two main rock units; 1) metagabbro-diorite rocks with tholeiitic nature derived in island arc/continental margin tectonic regime, and 2) granodiorite rocks formed from calc-alkaline magma in continental margin regime. Wallrock alterations are represented by propylitic and argillic types. The mineralized quartz veins are striking in NE-SW direction and dipping between (35°-45°) in SE direction, other mineralized mafic dykes enriched with auriferous quartz veinlets are trending NE-SW and dipping 70°/SE. The main ore minerals are represented by gold, chalcopyrite, pyrite, sphalerite, malachite, covellite and goethite. While, geffroyite, cuprite, chrysocolla, pseudomalachite, britholite, wolframite, scheelite, hematite and rutile are detected as minor constituents. Fluid inclusions microthermometry and isochore calculations combined with chlorite geothermometry revealed that the Um Balad deposits were formed at temperature ranging from 305 °C to 325 °C and pressure between (100-500 bar). The mineralization had been developed in the shallow levels, beneath the water table at depth of 350-1760 m, rather than common mesothermal vein-type deposits in Egypt. Magmatic water have been suggested as the main source for the mineralized fluid. The transportation of the gold metal seems to be happen as bisulfide complexes in moderately acidic environment. The deposition was resulted from combination of changes in physico-chemical parameters

  3. Transferências orbitais dentro do modelo quase bicircular no sistema Terra-Lua-Sol

    NASA Astrophysics Data System (ADS)

    Corrêa, A. A.; de Almeida Prado, A. F. B.; Stuchi, T. J.; Beaugé, C.

    2003-08-01

    O problema quase bicircular planar consiste na determinação da dinâmica de um corpo, de massa desprezível, que se move sob o campo gravitacional de três corpos. No caso estudado, o quarto corpo é considerado um satélite artificial e os demais são a Terra, a Lua e o Sol, formando o sistema de três corpos. Este modelo permite a construção de uma hamiltoniana similar a do problema restrito de três corpos (PRTC), incluindo termos periódicos não autônomos, provenientes da presença do Sol, portanto pode ser entendido como uma perturbação ao PRTC. Suas órbitas periódicas aparecem isoladas e possuem o mesmo período solar. Os pontos de equilíbrio colineares possuem o mesmo caráter de estabilidade linear dos pontos lagrangianos (L1, L2 e L3) do PRTC, sendo do tipo sela x centro x centro, instável na direção x e estáveis nas direções y e z. As órbitas periódicas tridimensionais ao redor do ponto colinear é chamada órbita Halo. O objetivo deste trabalho é determinar órbitas de transferências de baixo consumo de combustível para um veículo espacial partindo de uma órbita de estacionamento ao redor da Terra em direção a uma órbita Halo do ponto L1, situado entre a Terra e Lua. Esta tarefa pode ser transformada no problema de valor de contorno: dado um ponto inicial na órbita de estacionamento, um ponto final na órbita halo e o tempo de transferência, deseja-se obter a trajetória que liga estes dois pontos e que minimize os incrementos de velocidade do veículo. Essas transferências são realizadas baseadas no método de Lambert e analisadas de modo a fornecer um baixo consumo. Posteriormente, é feita uma comparação de consumo com as órbitas de transferência equivalentes do PRTC.

  4. Metabolic profiles and bile acid extraction rate in the liver of cows with fasting-induced hepatic lipidosis.

    PubMed

    Mohamed, T; Oikawa, S; Iwasaki, Y; Mizunuma, Y; Takehana, K; Endoh, D; Kurosawa, T; Sato, H

    2004-04-01

    This study was designed to monitor lipid profile in the portal and hepatic blood of cows with fasting-induced hepatic lipidosis, and to compare the results with those in the jugular blood. The work was also carried out to investigate bile acid (BA) in these vessels, and further to investigate BA extraction rate in the liver. Five cows were equipped with catheters in the portal, hepatic and jugular veins (day 0), fasted for 4 days (day 1-day 4) and then refed (day 5-day 11). Before morning feeding, blood was sampled before, during and after fasting from the catheterized vessels. In the portal blood, the concentration of non-esterified fatty acids (NEFA) showed a progressive increase and at day 5 there was an approximate twofold rise. Increased NEFA concentrations were also found similarly in the other two veins. At day 5, beta-hydroxybutyrate (BHBA) in the portal, hepatic and jugular blood rose to 197, 190 and 186% of the pre-fasting value, respectively. However, the concentrations of NEFA and BHBA in the three veins gradually returned to pre-fasting concentration during the refeeding period. Compared with the pre-fasting value at day 0, the content of liver triglyceride (TG) increased significantly at day 5 (P < 0.01). In the liver, the hepatic extraction rate of BA dropped from 3.1 times pre-fasting to 2.2 times during fasting. There were no significant differences in the concentrations of glucose, TG, total cholesterol, cholesterol esters, free cholesterol and phospholipids. The results of the current study show that metabolic alterations occur in the portal, hepatic and jugular veins during induction of hepatic lipidosis in cows, and mostly metabolites, with exception of BA concentration, run parallel. The decreased BA extraction rate in the liver of fasted cows was considered to reflect hepatic cell impairment caused by TG accumulation. Hopefully, the findings, at least in part, contribute to the explanation of the pathophysiology of hepatic lipidosis in dairy

  5. Estudo de soluções locais e cosmológicas em teorias do tipo tensor-escalar

    NASA Astrophysics Data System (ADS)

    Silva E Costa, S.

    2003-08-01

    Teorias do tipo tensor-escalar são a mais simples extensão possí vel da Relatividade Geral. Nessas teorias, cujo modelo padrão é a teoria de Brans-Dicke, a curvatura do espaço-tempo, descrita por componentes tensoriais, aparece acoplada a um campo escalar que, de certo modo, representa uma variação na constante de acoplamento da gravitação. Tais teorias apresentam soluções locais e cosmológicas que, em determinados limites, recaem nas apresentadas pela Relatividade Geral, mas que em outros limites trazem novidades, tais como conseqüências observacionais da evolução de flutuações primordiais distintas daquelas previstas pela Relatividade Geral (ver, por ex., Nagata et al., PRD 66, p. 103510 (2002)). Graças a esta possibilidade de trazer à luz novidades em relação à gravitação, teorias do tipo tensor-escalar podem ser vistas como um interessante campo alternativo de pesquisas para soluções dos problemas de massa faltante (ou escura) e/ou energia escura. Seguindo tal linha, este trabalho, ainda em sua fase inicial, apresenta soluções gerais de teorias do tipo tensor-escalar para diversas situações, verificando-se em que consiste a divergência dessas soluções dos casos tradicionais possí veis na Relatividade Geral. Como exemplos das soluções aqui apresentadas pode-se destacar uma expressão geral para diferentes soluções cosmológicas englobando diferentes tipos de matéria (representados por diferentes equações de estado), e a expressão para uma solução local representando um buraco negro com rotação, similar à solução de Kerr da Relatividade Geral. Por fim, é importante ressaltar que, embora aqui apresentem-se poucos resultados novos, na literatura sobre o assunto a maior parte das soluções apresentadas limita-se a uns poucos casos especí ficos, tal como soluções cosmológicas apenas com curvatura nula, e que mesmo as soluções disponí veis são, em geral, pouco divulgadas e, portanto, pouco conhecidas, e

  6. Tuberculosis recurrence in a priority city in the state of São Paulo, Brazil.

    PubMed

    Vieira, Amadeu Antonio; Leite, Danila Torres; Adreoni, Solange

    2017-01-01

    os casos novos de tuberculose pulmonar que completaram com sucesso o tratamento (com ou sem cura confirmada) foram selecionados e seguidos até 31 de dezembro de 2012. Dos 963 casos, RTB ocorreu em 47 (4,88%). O tempo médio transcorrido até o segundo episódio foi de 36,12 meses. Dos 47 casos de RTB, 16 (34,04%) ocorreram em até 18 meses da alta do primeiro tratamento (RTB recente), e 31 (65,96%) ocorreram após 18 meses (RTB tardia). Entre as variáveis investigadas, somente houve diferenças significativas entre os grupos RTB recente e tardia em relação ao ganho de peso na alta do primeiro tratamento (1,78 kg vs. 5,31 kg; p < 0,045) e nível de escolaridade (≤ 3 vs. > 3 anos de estudo; p < 0,004). A baixa escolaridade pode indicar uma menor adesão ao tratamento, dificultando a esterilização dos bacilos e facilitando sua sobrevivência em forma dormente, o que mascara a efetividade do tratamento. A ausência ou um reduzido aumento de peso na alta do tratamento poderá servir como um marcador biológico que pode ser utilizado pelos serviços de saúde que realizam o tratamento de tuberculose.

  7. Um Projeto de Intervenção nos Espaços de Exposições do Planetário do Parque do Ibirapuera

    NASA Astrophysics Data System (ADS)

    Elias, D. S.; Amaral, L. H.; de Araújo, C. F., Jr.; Matsuura, O. T.; Voelzke, M. R.

    2005-08-01

    Cada vez mais a humanidade, em sua imensa maioria, está alheia às próprias conquistas. A insatisfação com esta realidade tem levado muitos pesquisadores, instituições, empresas e governos a procurar formas alternativas de acompanhar e transmitir todo este acervo científico cultural à sociedade, buscando a melhoria da qualidade da divulgação científica e contribuindo para o processo de cultura e alfabetização científica. Não há tempo nem espaço nos limitados planos curriculares do ensino médio e mesmo nos programas de ensino que propiciem a cultura científica e o acompanhamento do vertiginoso progresso científico e tecnológico atual. Neste sentido, a educação formal escolar precisa ser complementada ou acrescida de uma educação informal, extra-escolar, que possa oferecer à sociedade o que a escola não pode oferecer. A interação do público com museus, feiras de ciências, planetários, exposições científicas e/ou culturais é de grande importância para a aquisição e difusão de conhecimentos relacionados ao mundo científico. Reconhecidamente como um modelo de alfabetização científica esses ambientes promovem uma interação social capaz de propiciar de forma efetiva uma melhor relação ensino-aprendizagem com o público. Partindo desta realidade a Universidade Cruzeiro do Sul e a Escola Municipal de Astronomia (EMA) vêm desenvolvendo um projeto de intervenção no espaço em torno do Planetário do Parque do Ibirapuera com o objetivo de se implantar um ambiente de aprendizagem motivador e desafiador que promova a popularização de conteúdos relacionados à astronomia, astrofísica e cosmologia. Busca-se, também, a aproximação e interação do público com exposições que estão sendo implementadas no planetário. Considerando que se trata de um projeto de mestrado em fase inicial o objetivo do presente trabalho é apresentar a concepção básica e os critérios que estão sendo utilizados do ponto de vista pedag

  8. Calculation of response matrix of CaSO 4:Dy based neutron dosimeter using Monte Carlo code FLUKA and measurement of 241Am-Be spectra

    NASA Astrophysics Data System (ADS)

    Chatterjee, S.; Bakshi, A. K.; Tripathy, S. P.

    2010-09-01

    Response matrix for CaSO 4:Dy based neutron dosimeter was generated using Monte Carlo code FLUKA in the energy range thermal to 20 MeV for a set of eight Bonner spheres of diameter 3-12″ including the bare one. Response of the neutron dosimeter was measured for the above set of spheres for 241Am-Be neutron source covered with 2 mm lead. An analytical expression for the response function was devised as a function of sphere mass. Using Frascati Unfolding Iteration Tool (FRUIT) unfolding code, the neutron spectrum of 241Am-Be was unfolded and compared with standard IAEA spectrum for the same.

  9. Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy - Case report.

    PubMed

    Tang, Jianlin; Abbas, Jihad; Hoetzl, Katherine; Allison, David; Osman, Mahamed; Williams, Mallory; Zelenock, Gerald B

    2014-12-01

    62 year old Caucasian female with pancreatic head mass abutting the superior mesenteric vein (SMV) presented with fine needle aspiration biopsy confirmed diagnosis of ductal adenocarcinoma. CT scan showed near complete obstruction of portal vein and large SMV collateral development. After 3 months of neoadjuvant therapy, her portal vein flow improved significantly, SMV collateral circulation was diminished. Pancreaticoduodenectomy (PD) and superior mesenteric portal vein (SMPV) confluence resection were performed; A saphenous vein interposition graft thrombosed immediately. The splenic vein remnant was distended and adjacent to the stump of the portal vein. Harvesting an internal jugular vein graft required extra time and using a synthetic graft posed a risk of graft thrombosis or infection. As a result, we chose to perform a direct anastomosis of the portal and splenic vein in a desperate situation. The anastomosis decompressed the mesenteric venous system, so we then ligated the SMV. The patient had an uneventful postoperative course, except transient ascites. She redeveloped ascites more than one year later. At that time a PET scan showed bilateral lung and right femur metastatic disease. She expired 15 months after PD. The lessons we learned are (1) Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2) Synthetic graft is an alternative for internal jugular vein graft. (3) Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4) It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival.

  10. Coexistence of calbindin D-28k and NADPH-diaphorase in vagal and glossopharyngeal sensory neurons of the rat.

    PubMed

    Ichikawa, H; Helke, C J

    1996-10-07

    The presence and coexistence of calbindin D-28k-immunoreactivity (ir) and nicotinamide adenosine dinucleotide phosphate (NADPH)-diaphorase activity (a marker of neurons that are presumed to convert L-arginine to L-citrulline and nitric oxide) were examined in the glossopharyngeal and vagal sensory ganglia (jugular, petrosal and nodose ganglia) of the rat. Calbindin D-28k-ir nerve cells were found in moderate and large numbers in the petrosal and nodose ganglia, respectively. Some calbindin D-28k-ir nerve cells were also observed in the jugular ganglion. NADPH-diaphorase positive nerve cells were localized to the jugular and nodose ganglia and were rare in the petrosal ganglion. A considerable portion (33-51%) of the NADPH-diaphorase positive neurons in these ganglia colocalized calbindin D-28k-ir. The presence and colocalization of calbindin D-28k-ir and NADPH-diaphorase activity in neurotransmitter-identified subpopulations of visceral sensory neurons were also studied. In all three ganglia, calcitonin gene-related peptide (CGRP)-ir was present in many NADPH-diaphorase positive neurons, a subset of which also contained calbindin D-28k-ir. In the nodose ganglion, many (42%) of tyrosine hydroxylase (TH)-ir neurons also contained NADPH diaphorase activity but did not contain calbindin D-28k-ir. These data are consistent with a potential co-operative role for calbindin D-28k and NADPH-diaphorase in the functions of a subpopulation of vagal and glossopharyngeal sensory neurons.

  11. Espectroscopia de candidatos a remanescentes de aglomerados abertos

    NASA Astrophysics Data System (ADS)

    Pavani, D. B.; Bica, E.; Ahumada, A. V.; Clariá, J. J.

    2003-08-01

    A pesquisa sobre remanescentes de aglomerados abertos tem despertado grande interesse. Seguindo esta tendência encontramos estudos teóricos e observacionais. Os primeiros baseiam-se em simulações numéricas buscando determinar fração de binárias e distâncias galatocêntricas, tempo de vida e conteúdo estelar. Estes estão relacionados à função inicial de massa e densidade de estrelas, ou seja, se ricos ou pobremente povoados, compactos ou esparsos. No caso observacional procuram-se identificar os remanescentes considerando-se que trazem estas assinaturas de seus percursores. No presente estudo empregamos espectroscopia para analisar oito concentrações pobremente povoadas, previamente classificadas como aglomerados abertos, sendo sete compactas e uma esparsa. As observações foram obtidas através do telescópio de 2,15 m do CASLEO em San Juan, Argentina, em turnos entre 2001 e 2003. Utilizamos uma câmara CCD contendo um chip Tektronics de 1024X1024 pixeis aliado a um espectrógrafo REOSC. O domínio espectral vai de 3700 a 7000 Å. As reduções foram realizadas no Observatório Astronômico de Córdoba (Argentina) usando pacotes IRAF padrões. Determinamos idades, avermelhamentos e tipos espectrais através de comparações com biblioteca de estrelas e de aglomerados. Em alguns casos nossos espectros estavam dominados por estrelas individuais às quais determinamos seus tipos espectrais. Aos oito objetos adicionamos mais cinco da literatura recente analisados via espectro ou diagrama cor-magnitude. O histograma resultante contém idades típicas entre 0.5 e 3 Ganos. Considerando que predominantemente estes objetos encontram-se na vizinhança solar e, portanto, não cruzaram muitas vezes o plano Galático esperamos que a diferença no tempo necessário para dissolução destes prováveis remanescentes seja em função de diferentes massas iniciais.

  12. Beware Swan-Ganz complications. Perioperative management.

    PubMed

    Asteri, T; Tsagaropoulou, I; Vasiliadis, K; Fessatidis, I; Papavasi-Liou, E; Spyrou, P

    2002-08-01

    Since the introduction of the pulmonary artery catheter (PAC) in 1970 by Swan et al., various complications are recognized with the insertion and the use of Swan-Ganz catheter. We present two different cases with rare but life threatening complications which had been successfully managed. The first case is a carotid cannulation with an 8.5 Fr introducer sheath, in an attempt to insert a pulmonary catheter via the right internal jugular vein. Two weeks later, the patient was re-admitted to the hospital and when an arteriovenous fistulae (carotid artery-internal jugular vein) was diagnosed, he was treated surgically. The second case presents the rupture of the right atrium in the conjunction with the superior vena cava. This serious cardiac complication was developed during the floatation of the PAC and the lesion was repaired while the mitral valve replacement was in progress.

  13. Properties of metallic glasses containing actinide metals. I. Thermal properties of U--M glasses (M = V, Cr, Mn, Fe, Co, and Ni)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Giessen, B.C.; Elliott, R.O.

    1978-01-01

    The results of a preparative and calorimetric study forming part of a continuing investigation of the new actinide glasses are reported. Specifically, lower bounds for the composition limits of glass formation (G.F.) at moderate cooling rates have been obtained for the U-M (M = Mn, Fe, Co, Ni) systems and the thermal stabilities of glasses in these four systems as well as for a U-V glass and a U-Cr glass have been surveyed.

  14. Ford/BASF/UM Activities in Support of the Hydrogen Storage Engineering Center of Excellence

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Veenstra, Mike; Purewal, Justin; Xu, Chunchuan

    Widespread adoption of hydrogen as a vehicular fuel depends critically on the development of low-cost, on-board hydrogen storage technologies capable of achieving high energy densities and fast kinetics for hydrogen uptake and release. As present-day technologies -- which rely on physical storage methods such as compressed hydrogen -- are incapable of attaining established Department of Energy (DOE) targets, development of materials-based approaches for storing hydrogen have garnered increasing attention. Material-based storage technologies have potential to store hydrogen beyond twice the density of liquid hydrogen. To hasten development of these ‘hydride’ materials, the DOE previously established three centers of excellence formore » materials storage R&D associated with the key classes of materials: metal hydrides, chemical hydrogen, and adsorbents. While these centers made progress in identifying new storage materials, the challenges associated with the engineering of the system around a candidate storage material are in need of further advancement. In 2009 the DOE established the Hydrogen Storage Engineering Center of Excellence with the objective of developing innovative engineering concepts for materials-based hydrogen storage systems. As a partner in the Hydrogen Storage Engineering Center of Excellence, the Ford-UM-BASF team conducted a multi-faceted research program that addresses key engineering challenges associated with the development of materials-based hydrogen storage systems. First, we developed a novel framework that allowed for a material-based hydrogen storage system to be modeled and operated within a virtual fuel cell vehicle. This effort resulted in the ability to assess dynamic operating parameters and interactions between the storage system and fuel cell power plant, including the evaluation of performance throughout various drive cycles. Second, we engaged in cost modeling of various incarnations of the storage systems. This analysis

  15. Project UM-HAUL: A self-unloading reusable lunar lander

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The establishment of a lunar base is technologically and financially challenging. Given the necessary resources and political support, it can be done. In addition to the geopolitical obstacles, however, there are logistical problems involved in establishing such bases that can only be overcome with the acquisition of a significant transportation and communications network in the Earth-Moon spatial region. Considering the significant number of payloads that will be required in this process, the mass-specific cost of launching these payloads, and the added risk and cost of human presence in space, it is clearly desirable to automate major parts of such an operation. One very costly and time-consuming factor in this picture is the delivery of payloads to the Moon. Foreseeable payloads would include atmospheric modules, inflatable habitat kits, energy and oxygen plant elements, ground vehicles, laboratory modules, crew supplies, etc. The duration of high-risk human presence on the Moon could be greatly reduced if all such payloads were delivered to the prospective base site in advance of crew arrival. In this view, the idea of a 'Self-Unloading Reusable Lunar Lander' (SURLL) arises naturally. The general scenario depicts the lander being brought to low lunar orbit (LLO) from Earth atop a generic Orbital Transfer Vehicle (OTV). From LLO, the lander shuttles payloads down to the lunar surface, where, by means of some resident, detachable unloading device, it deploys the payloads and returns to orbit. The general goal is for the system to perform with maximum payload capability, automation, and reliability, while also minimizing environmental hazards, servicing needs, and mission costs. Our response to this demand is UM-HAUL, or the UnManned Heavy pAyload Unloader and Lander. The complete study includes a system description, along with a preliminary cost analysis and a design status assessment.

  16. Project UM-HAUL: A self-unloading reusable lunar lander

    NASA Astrophysics Data System (ADS)

    The establishment of a lunar base is technologically and financially challenging. Given the necessary resources and political support, it can be done. In addition to the geopolitical obstacles, however, there are logistical problems involved in establishing such bases that can only be overcome with the acquisition of a significant transportation and communications network in the Earth-Moon spatial region. Considering the significant number of payloads that will be required in this process, the mass-specific cost of launching these payloads, and the added risk and cost of human presence in space, it is clearly desirable to automate major parts of such an operation. One very costly and time-consuming factor in this picture is the delivery of payloads to the Moon. Foreseeable payloads would include atmospheric modules, inflatable habitat kits, energy and oxygen plant elements, ground vehicles, laboratory modules, crew supplies, etc. The duration of high-risk human presence on the Moon could be greatly reduced if all such payloads were delivered to the prospective base site in advance of crew arrival. In this view, the idea of a 'Self-Unloading Reusable Lunar Lander' (SURLL) arises naturally. The general scenario depicts the lander being brought to low lunar orbit (LLO) from Earth atop a generic Orbital Transfer Vehicle (OTV). From LLO, the lander shuttles payloads down to the lunar surface, where, by means of some resident, detachable unloading device, it deploys the payloads and returns to orbit. The general goal is for the system to perform with maximum payload capability, automation, and reliability, while also minimizing environmental hazards, servicing needs, and mission costs. Our response to this demand is UM-HAUL, or the UnManned Heavy pAyload Unloader and Lander. The complete study includes a system description, along with a preliminary cost analysis and a design status assessment.

  17. Spattering activity at Halemáumáu in 2015 and the transition between Hawaiian and Strombolian eruptions

    NASA Astrophysics Data System (ADS)

    Mintz, B. G.; Houghton, B. F.; Orr, T. R.; Taddeucci, J.; Gaudin, D.; Kueppers, U.; Carey, R.; Scarlato, P.; Del Bello, E.

    2016-12-01

    Explosive activity in 2015 at the free surface of the Halemáumáu lava lake at Kīlauea showed features of both Hawaiian fountaining and Strombolian explosivity. Like low Hawaiian fountains, spattering events often persisted for tens of minutes or hours. However, like Strombolian explosions, the activity consisted of a series of bursting of discrete, meter-sized gas bubbles. Each bubble burst threw fluidal bombs, with meter to decimeter diameters, to elevations of meters to a few tens of meters above the collapsing bubble remnant. Initial velocities of the pyroclasts were lower than either Strombolian explosions or high Hawaiian fountains, typically only 7 to 14 meters/second on average.Although some events were triggered by short-lived rock falls that penetrated the crust of the lava lake, the resulting outgassing activity would become self-sustaining and persistent. Activity was at times, confined to a single point source, to several point sources, or along arcs extending tens of meters parallel to the lake margin.This activity represents another type of behavior exhibited by basaltic volcanoes and provides greater insight into the spectrum between Hawaiian fountaining and Strombolian explosivity. Consequently, this activity is highly instructive in terms of: (a) the diversity of degassing/outgassing possible at basaltic volcanoes and (b) the controls on mechanically coupled versus decoupled behavior of the exsolved bubbles. The 2015 Halemáumáu activity was often continuous over similar timescales to Hawaiian fountaining but was markedly less steady than high fountains. A significant portion of the gas phase was released as discrete bubble bursts, but with frequencies two or three orders of magnitude higher than at Stromboli, which permitted sustained but not steady events.

  18. Tratamento endovascular de aneurisma de tronco braquiocefálico em paciente com síndrome de Ehlers-Danlos tipo IV

    PubMed Central

    Belczak, Sergio Quilici; Klajner, Rafael Kogan; Ogawa, Lara Cote; Lucato, Laís Leite; Zeque, Bruna Stecca; de Macedo, Felipe Basso; da Silva, Ingredy Tavares; Atihe, Luís Felipe

    2016-01-01

    Resumo A síndrome de Ehlers-Danlos é uma doença genética que acarreta alteração na síntese de colágeno, causando extrema fragilidade do tecido conjuntivo. Tal fragilidade predispõe a uma série de doenças vasculares, como dissecções, aneurismas e pseudoaneurismas. Os autores relatam o histórico de um indivíduo de 19 anos com aneurisma de tronco braquiocefálico que foi submetido ao tratamento endovascular com implante de stents revestidos. O caso evoluiu com complicação do sítio de punção, que também foi tratada em caráter de emergência pela técnica endovascular com o implante de stent revestido.

  19. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

    PubMed Central

    Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rubén; Cervio, Andrés; Salvat, Jorge

    2015-01-01

    Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Caso clínico: Paciente masculino de 25 años con diagnóstico de leucemia linfática aguda en tratamiento quimioterápico que presentó neumonitis por metotrexate por lo que inicia tratamiento con corticoides. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada (TC) sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. fumigatus. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. La evacuación quirúrgica permite llegar rápidamente al diagnóstico mejorando la respuesta posterior al tratamiento antibiótico. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. PMID:26600985

  20. Risk factors for postpartum urinary incontinence.

    PubMed

    Leroy, Lígia da Silva; Lúcio, Adélia; Lopes, Maria Helena Baena de Moraes

    2016-04-01

    To investigate the risk factors for postpartum urinary incontinence (UI) and its characteristics. This was a case-control study with 344 puerperal women (77 cases and 267 controls) with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, p<0.0001), multiparity (OR 2.26, CI 95% 1.22 - 4.19, p=0.009), gestational age at birth greater or equal to 37 weeks (OR 2.52, CI 95% 1.16 - 5.46, p=0.02) and constipation (OR 1.94, CI 95% 1.05 - 5.46, p=0.035). Most often, UI first appeared during pregnancy and remained through the postpartum period. Urinary incontinence during pregnancy, multiparity, gestational age at birth greater or equal to 37 weeks, and constipation were presented as risk factors. In the studied group, stress UI was more frequent. Investigar os fatores de risco para a incontinência urinária (IU) no puerpério e as suas características. Trata-se de estudo caso-controle com 344 puérperas (77 casos e 267 controles), com até 90 dias pós-parto. Foi aplicado, em um único momento, um questionário para os dados sociodemográficos e clínicos, e dois outros para avaliar a perda urinária, situações de perda e o tipo de IU. Apresentaram IU de esforço 45,5%, perda urinária diversas vezes ao dia 44,2%, sendo 71,4% em pequena quantidade e 57,1% ao tossir ou espirrar. Em 70,1% dos casos a IU iniciou-se na gestação e permaneceu no puerpério. Ao ajustar-se um modelo de regressão logística bin

  1. Estudo de cavidade reentrante supercondutora a ser utilizada nos transdutores paramétricos do detector brasileiro de ondas gravitacionais Mario Schenberg

    NASA Astrophysics Data System (ADS)

    Ribeiro, K. L.; Furtado, S. R.; Aguiar, O. D.; Frajuca, C.

    2003-08-01

    Cavidades reentrantes de nióbio vêm sendo utilizadas pelo grupo Australiano nos transdutores eletromecânicos paramétricos do detector de ondas gravitacionais Niobè. Esses transdutores paramétricos são ativados por um sinal AC na faixa de microondas (banda X), que é modulado pelo sinal mecânico da vibração da antena esférica, com a variação de um parâmetro, que, no caso, é a capacitância da cavidade. Nós estudamos esse tipo de cavidade, com o objetivo de transformá-la de reentrante aberta para reentrante fechada, de forma a utilizá-la nos transdutores paramétricos do detector brasileiro Mario Schenberg. O desempenho do transdutor depende de alguns parâmetros da cavidade, como a sua Figura de Mérito (Q elétrico) e o seu acoplamento elétrico com o circuito externo. Neste trabalho mostramos a medida do Q elétrico como função do acoplamento, do acabamento superficial interno e do vazamento de microondas da cavidade, e mostramos o desempenho esperado para o detector Mario Schenberg usando uma cavidade supercondutora reentrante fechada de nióbio.

  2. FEASIBILITY STUDY FOR IDENTIFICATION OF STATIC AND DYNAMIC EXPOSURE USING CCD IMAGING TECHNIQUE FOR Caso4:Dy TL DOSEMETERS.

    PubMed

    Srivastava, Kshama; Soin, Seepika; Sapra, B K; Ratna, P; Datta, D

    2017-11-01

    The occupational exposure incurred by the radiation workers due to the external radiation is estimated using personal dosemeter placed on the human body during the monitoring period. In certain situations, it is required to determine whether the dosemeter alone was exposed accidentally/intentionally in radiation field (static exposure) or was exposed while being worn by a worker moving in his workplace (dynamic exposure). The present thermoluminscent (TL) based personnel monitoring systems are not capable of distinguishing between the above stated (static and dynamic) exposure conditions. The feasibility of a new methodology developed using the charge coupled device based imaging technique for identification of the static/dynamic exposure of CaSO4:Dy based TL detectors for low energy photons has been investigated. The techniques for the qualitative and the quantitative assessments of the exposure conditions are presented in this paper. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Hypertriglyceridemia: Is there a role for prophylactic apheresis? A case report.

    PubMed

    Francisco, Ana Rita; Gonçalves, Inês; Veiga, Fátima; Pedro, Mónica Mendes; Pinto, Fausto J; Brito, Dulce

    2016-01-01

    Severe hypertriglyceridemia has been consistently associated with an increased risk of cardiovascular disease and other complications, namely acute pancreatitis. We report a case of a 64 year-old woman with hypertrophic cardiomyopathy and metabolic syndrome with triglyceride level of 3260 mg/dL. Plasma exchange was performed with simultaneous medical treatment to achieve a rapid and effective lowering of triglycerides in order to prevent clinical complications. After three plasmapheresis sessions a marked reduction in triglyceride and total cholesterol levels was observed. Several cases have shown the importance of plasmapheresis in the treatment of acute pancreatitis. We intend to demonstrate the applicability of this technique as primary prophylaxis in the presence of extremely high serum triglyceridemia levels. Resumo A hipertrigliceridemia grave tem sido associada de forma consistente ao aumento do risco cardiovascular e a outras complicações, nomeadamente, pancreatite aguda. Descrevemos um caso de uma mulher de 64 anos, com miocardiopatia hipertrófica e síndrome metabólica com valor sérico de triglicerídeos de 3260 mg/dL. Foi efectuada plasmaferese e optimizado o tratamento médico para alcançar uma redução rápida e efectiva dos níveis dos triglicerídeos, prevenindo complicações clínicas. Após três sessões de plasmaferese, verificou-se uma redução marcada dos triglicerídeos e do colesterol total. Existem alguns casos descritos na literatura demonstrado a importância da plasmaferese no tratamento da pancreatite aguda em contexto de hipertrigliceridemia grave. Os autores pretendem com este caso demonstrar a aplicabilidade desta técnica em contexto de prevenção primária em doentes com níveis de triglicerídeos extremamente aumentados.

  4. Elevated brain serotonin turnover in patients with depression: effect of genotype and therapy.

    PubMed

    Barton, David A; Esler, Murray D; Dawood, Tye; Lambert, Elisabeth A; Haikerwal, Deepak; Brenchley, Celia; Socratous, Florentia; Hastings, Jacqueline; Guo, Ling; Wiesner, Glen; Kaye, David M; Bayles, Richard; Schlaich, Markus P; Lambert, Gavin W

    2008-01-01

    The biological basis for the development of major depressive disorder (MDD) remains incompletely understood. To quantify brain serotonin (5-hydroxytryptamine [5-HT]) turnover in patients with MDD. Patients with depression were studied both untreated and during administration of a selective serotonin reuptake inhibitor (SSRI) in an unblinded study of sequential design. Healthy volunteers were examined on only 1 occasion. Direct internal jugular venous blood sampling was used to directly quantify brain serotonin turnover. The effect of serotonin transporter (5-HTT) genotype on brain serotonin turnover was evaluated and the influence of SSRI therapy on serotonin turnover was investigated. Participants were recruited from the general community following media advertisement. Experimental procedures were performed in the research catheterization laboratory of a major training hospital and medical research institute. Studies were performed in 21 patients fulfilling the DSM-IV and International Statistical Classification of Diseases, 10th Revision diagnostic criteria for MDD and in 40 healthy volunteers. Treatment for patients consisted of SSRI administration for approximately 12 weeks. Brain serotonin turnover before and after SSRI therapy. Brain serotonin turnover was significantly elevated in unmedicated patients with MDD compared with healthy subjects (mean [SD] internal jugular venoarterial 5-hydroxyindoleacetic acid plasma concentration difference, 4.4 [4.3] vs 1.6 [2.4] nmol/L, respectively; P = .003). Analysis of the influence of the 5-HTT genotype in MDD indicated that carriage of the s allele compared with the l allele was associated with greater than a 2-fold increase in brain serotonin turnover (mean [SD] internal jugular venoarterial 5-hydroxyindoleacetic acid plasma concentration difference, 6.5 [4.7] vs 2.7 [2.9] nmol/L, respectively; P = .04). Following SSRI therapy, brain serotonin turnover was substantially reduced (mean [SD] internal jugular venoarterial

  5. Associations between endotoxin-induced metabolic changes and temperament in Brahman bulls

    USDA-ARS?s Scientific Manuscript database

    The influence of temperament on the alteration of metabolic parameters in response to a lipopolysaccharide (LPS) challenge was investigated. Brahman bulls were selected for this study based on temperament score. Bulls were fitted with indwelling jugular catheters for serial sampling to evaluate peri...

  6. Chromobacterium violaceum infection in chronic granulomatous disease: a case report and review of the literature.

    PubMed

    Meher-Homji, Zaal; Mangalore, Rekha Pai; D R Johnson, Paul; Y L Chua, Kyra

    2017-01-01

    Introduction. Chromobacterium violaceum is an opportunistic human pathogen, associated with significant mortality, and has been reported in patients with chronic granulomatous disease (CGD), a genetic condition causing impaired phagocytosis. Case presentation. A 28-year-old man with a history of CGD presented with fever, pharyngitis, cervical lymphadenopathy and internal jugular vein thrombosis, following travel to the rural Solomon Islands. C. violaceum was recovered from his blood. The patient recovered after treatment with meropenem and trimethoprim/sulfamethoxazole. Conclusion. To the best of our knowledge, this is the first case report of internal jugular vein thrombophlebitis (Lemierre's syndrome) caused by C. violaceum in a patient with CGD. A review of the literature demonstrated that the diagnosis of C. violaceum preceded the diagnosis of CGD in the majority of cases. This case emphasizes the importance of this organism in patients with CGD who live in or visit tropical areas.

  7. Chromobacterium violaceum infection in chronic granulomatous disease: a case report and review of the literature

    PubMed Central

    Mangalore, Rekha Pai; D. R. Johnson, Paul; Y. L. Chua, Kyra

    2017-01-01

    Introduction. Chromobacterium violaceum is an opportunistic human pathogen, associated with significant mortality, and has been reported in patients with chronic granulomatous disease (CGD), a genetic condition causing impaired phagocytosis. Case presentation. A 28-year-old man with a history of CGD presented with fever, pharyngitis, cervical lymphadenopathy and internal jugular vein thrombosis, following travel to the rural Solomon Islands. C. violaceum was recovered from his blood. The patient recovered after treatment with meropenem and trimethoprim/sulfamethoxazole. Conclusion. To the best of our knowledge, this is the first case report of internal jugular vein thrombophlebitis (Lemierre’s syndrome) caused by C. violaceum in a patient with CGD. A review of the literature demonstrated that the diagnosis of C. violaceum preceded the diagnosis of CGD in the majority of cases. This case emphasizes the importance of this organism in patients with CGD who live in or visit tropical areas. PMID:28348801

  8. Clival osteomyelitis and hypoglossal nerve palsy--rare complications of Lemierre's syndrome.

    PubMed

    He, Jingzhou; Lam, Jonathan Chun Leuk; Adlan, Tarig

    2015-08-30

    An increasingly reported entity, Lemierre's syndrome classically presents with a recent oropharyngeal infection, internal jugular vein thrombosis and the presence of anaerobic organisms such as Fusobacterium necrophorum. The authors report a normally fit and well 17-year-old boy who presented with severe sepsis following a 5-day history of a sore throat, myalgia and neck stiffness requiring intensive care admission. Blood cultures grew F. necrophorum and radiological investigations demonstrated left internal jugular vein, cavernous sinus and sigmoid sinus thrombus, left vertebral artery dissection and thrombus within the left internal carotid artery. Imaging also revealed two areas of acute ischaemia in the brain, consistent with septic emboli, skull base (clival) osteomyelitis and an extensive epidural abscess. The patient improved on meropenem and metronidazole and was warfarinised for his cavernous sinus thrombosis. He has an on-going left-sided hypoglossal (XIIth) nerve palsy. 2015 BMJ Publishing Group Ltd.

  9. Serial alterations in digital hemodynamics and endothelin-1 immunoreactivity, platelet-neutrophil aggregation, and concentrations of nitric oxide, insulin, and glucose in blood obtained from horses following carbohydrate overload.

    PubMed

    Eades, Susan C; Stokes, Ashley M; Johnson, Philip J; LeBlanc, Casey J; Ganjam, Venkataseshu K; Buff, Preston R; Moore, Rustin M

    2007-01-01

    To quantify changes in endothelium-derived factors and relate those changes to various aspects of digital hemodynamics during the prodromal stages of carbohydrate overload (CHO)-induced laminitis in horses. 20 adult horses without abnormalities of the digit. Digital and jugular venous blood samples were collected at 1-hour intervals (for assessment of endothelin-1 [ET-1] immunoreactivity and measurement of glucose, insulin, and nitric oxide [NO] concentrations) or 4-hour intervals (CBC and platelet-neutrophil aggregate assessment) for 8 hours or 16 hours after induction of CHO-associated laminitis in horses treated with an ET-1 antagonist. Effects of treatment, collection site, and time and the random effects of horse on each variable were analyzed by use of a repeated-measures model. Where treatment and collection site had no significant effect, data were combined. Compared with baseline values, CHO resulted in changes in several variables, including a significant increase from baseline in digital blood ET-like immunoreactivity at 11 hours; digital blood ET-like immunoreactivity was significantly greater than that in jugular venous blood at 8, 9, 11, and 12 hours. Digital and jugular venous blood concentrations of glucose increased from baseline significantly at 3, 4, and 5 hours; insulin concentration increased significantly at 5 hours; and the number of platelet-neutrophil aggregates increased significantly at 12 hours. In horses, concurrent increases in venous blood ET-1 immunoreactivity, insulin and glucose concentrations, and platelet-neutrophil aggregates support a role of endothelial dysfunction in the pathogenesis of CHO-induced laminitis.

  10. Detailed Anatomy of the Cranial Cervical Ganglion in the Dromedary Camel (Camelus dromedarius).

    PubMed

    Nourinezhad, Jamal; Mazaheri, Yazdan; Biglari, Zahra

    2015-08-01

    The detailed morphology and topography of the cranial cervical ganglion (CCG) with its surrounding structures were studied in 10 sides of five heads of adult one-humped camel to determine its general arrangement as well as its differences and similarities to other animals. The following detailed descriptions were obtained: (1) the bilateral CCG was constantly present caudal to cranial base at the rostroventral border of the occipital condyle over the caudolateral part of nasopharynx; (2) the CCG was always in close relations medially with the longus capitis muscle, rostrolaterally with the internal carotid artery, and caudally with the vagus nerve; and (3) the branches of the CCG were the internal carotid and external carotid nerves, jugular nerve, cervical interganglionic branch, laryngopharyngeal branch, carotid sinus branch and communicating branches to the vagus, and first spinal nerves. In conclusion, there was no variation regarding topography of dromedary CCG among the specimens, in spite of typical variations in number, and mainly in origin of nerve branches ramifying from the CCG. In comparative anatomy aspect, the close constant relations, and presence of major nerves (internal/external carotid and jugular nerves) of dromedary CCG exhibited a typical reported animal's pattern. However, the shape, structures lateral to the CCG, the origin and course pattern of external carotid and jugular nerves, the number of the major nerves branches, the communicating branches of the CCG to the spinal and cranial nerves, and the separation of most rostral parts of vagosympathetic trunk of dromedary were different from those of most reported animals. © 2015 Wiley Periodicals, Inc.

  11. Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy – Case report

    PubMed Central

    Tang, Jianlin; Abbas, Jihad; Hoetzl, Katherine; Allison, David; Osman, Mahamed; Williams, Mallory; Zelenock, Gerald B.

    2014-01-01

    62 year old Caucasian female with pancreatic head mass abutting the superior mesenteric vein (SMV) presented with fine needle aspiration biopsy confirmed diagnosis of ductal adenocarcinoma. CT scan showed near complete obstruction of portal vein and large SMV collateral development. After 3 months of neoadjuvant therapy, her portal vein flow improved significantly, SMV collateral circulation was diminished. Pancreaticoduodenectomy (PD) and superior mesenteric portal vein (SMPV) confluence resection were performed; A saphenous vein interposition graft thrombosed immediately. The splenic vein remnant was distended and adjacent to the stump of the portal vein. Harvesting an internal jugular vein graft required extra time and using a synthetic graft posed a risk of graft thrombosis or infection. As a result, we chose to perform a direct anastomosis of the portal and splenic vein in a desperate situation. The anastomosis decompressed the mesenteric venous system, so we then ligated the SMV. The patient had an uneventful postoperative course, except transient ascites. She redeveloped ascites more than one year later. At that time a PET scan showed bilateral lung and right femur metastatic disease. She expired 15 months after PD. Conclusion The lessons we learned are (1) Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2) Synthetic graft is an alternative for internal jugular vein graft. (3) Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4) It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival. PMID:25568802

  12. [Diagnosis and management of pulsatile tinnitus of venous origin].

    PubMed

    Zhang, Yibo; Wang, Wuqing; Dai, Chunfu; Chen, Liang

    2010-03-01

    To discuss the diagnosis and management of pulsatile tinnitus of venous origin. A retrospective study was conducted on 12 patients who were diagnosed with pulsatile tinnitus of venous origin and treated with ligation of internal jugular veins. We reevaluated the evidences of identifying pulsatile tinnitus of venous origin and reviewed the short-term and long-term postoperative effects and complications. We also reviewed associated articles in this report. Seven patients got relief of tinnitus in less than one week after the surgery, while the other 5 patients had no relief. Seven patients were inquired in this study and the other five lost to follow-up. According to the long review (from one to five years postoperatively), two patients who acquired immediate effect got relief of tinnitus, four including complained of no relief and the seventh aggravated into roaring. Three patients who got no immediate relief got no improvement at all. No one in our review complained of any complications. It's assumed that a history of pulsatile tinnitus, alleviation of tinnitus when pressing jugular veins, tinnitus changing with head position or posture and no occupying lesion in temporal CT scan or cranial MRI are inadequate in diagnosing pulsatile tinnitus of venous origin. Vascular imaging is also necessary to exclude other pathological changes like dura arteriovenous fistula, sigmoid diverticulum and so on. CT arteriography and venography are recommended preferentially. Ligation of internal jugular veins is controversial in patients who have no absence of transverse and sigmoid sinus and identified as pulsatile tinnitus of venous origin.

  13. Experience with the Cardiva Boomerang Catalyst system in pediatric cardiac catheterization.

    PubMed

    Seltzer, Sharon; Alejos, Juan Carlos; Levi, Daniel S

    2009-09-01

    We studied the safety and efficacy of the Cardiva Boomerang Catalyst vascular closure system in pediatric patients after cardiac catheterization with access in femoral and internal jugular vessels. Recurrent catheterization and advances in pediatric interventions increase the need for easy hemostasis without a residual foreign body that may prevent re-accessing the vessel. The Boomerang can be deployed in sheaths as small as 4Fr without residual foreign body, with minimal orientation needed, and few complications reported. In a two-month period, all patients between 18 months and 21 years old catheterized with 4-8Fr sheaths less than 15 cm long were eligible for Boomerang placement. These were compared retrospectively with control patients with manual hemostasis. Anthropomorphic measurements, procedure type, activated clotting time, and sheath size as well as total times of cases, intubation, hemostasis, and extubation were compared between the two groups. Forty-six Boomerangs were deployed in 31 patients and compared with 40 patients with manual hemostasis. Boomerangs were deployed in femoral vessels and the internal jugular vein. Device success with hemostasis was achieved in 39 patients (85%). There were no significant differences in time to hemostasis or extubation between the two groups. No major complications or operator error occurred, including hematoma, transfusion, retroperitoneal bleed, infection, vessel occlusion, or need for surgery. The Boomerang is a safe and easy means of achieving hemostasis in the pediatric population, in femoral vessels as well as internal jugular veins. Its times to hemostasis and extubation were not significantly different from manual hold. 2009 Wiley-Liss, Inc.

  14. One should avoid retro-orbital pharmacokinetic sample collections for intranasal dosing in rats: Illustration of spurious pharmacokinetics generated for anti-migraine drugs zolmitriptan and eletriptan.

    PubMed

    Patel, Harilal; Patel, Prakash; Modi, Nirav; Shah, Shaival; Ghoghari, Ashok; Variya, Bhavesh; Laddha, Ritu; Baradia, Dipesh; Dobaria, Nitin; Mehta, Pavak; Srinivas, Nuggehally R

    2017-08-30

    Because of the avoidance of first pass metabolic effects due to direct and rapid absorption with improved permeability, intranasal route represents a good alternative for extravascular drug administration. The aim of the study was to investigate the intranasal pharmacokinetics of two anti-migraine drugs (zolmitriptan and eletriptan), using retro-orbital sinus and jugular vein sites sampling. In a parallel study design, healthy male Sprague-Dawley (SD) rats aged between 8 and 12weeks were divided into groups (n=4 or 5/group). The animals of individual groups were dosed intranasal (~1.0mg/kg) and oral doses of 2.1mg/kg of either zolmitriptan or eletriptan. Serial blood sampling was performed from jugular vein or retro-orbital site and plasma samples were analyzed for drug concentrations using LC-MS/MS assay. Standard pharmacokinetics parameters such as T max , C max , AUC last , AUC 0-inf and T 1/2 were calculated and statistics of derived parameters was performed using unpaired t-test. After intranasal dosing, the mean pharmacokinetic parameters C max and AUC inf of zolmitriptan/eletriptan showed about 17-fold and 3-5-fold higher values for retro-orbital sampling as compared to the jugular vein sampling site. Whereas after oral administration such parameters derived for both drugs were largely comparable between the two sampling sites and statistically non-significant. In conclusion, the assessment of plasma levels after intranasal administration with retro-orbital sampling would result in spurious and misleading pharmacokinetics. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Energy response of CaSO4:Dy teflon TLD disk dosimeters to photons and electrons.

    PubMed

    Sharada, K S

    1983-01-01

    The photon energy response of CaSO4:Dy teflon disk dosimeters used widely in radiation dosimetry is computed using the energy absorption coefficient values for calcium, sulfur, oxygen, and carbon taken from J. H. Hubbell's tables. For fluorine, the energy absorption coefficients were obtained from the values given by F. H. Attix for CaF2 and Ca. The energy response of the radiation-monitoring disk for the range of 10 keV to 10 MeV, relative to air, is computed and plotted. The response is maximum between 20 and 30 keV and then gradually falls to a constant at 200 keV to 10 MeV. This computed response for different energies is compared with the experimental TL response of the dosimeter. The electron energy response of these TLD disks is computed using the stopping-power values for the different component elements. The electron stopping power for sulfur and calcium from 10 keV to 10 MeV is computed using the Bethe-Bloch formula. Those for oxygen and carbon are taken from the tables given by M. J. Berger and S. M. Seltzer. For fluorine, the values are computed from those for Li and LiF given in the same tables. This calculated response is compared with the experimental beta response of the TL dosimeter.

  16. A case report describing detection of Rhodoturola minuta fungemia in an ewe lamb

    USDA-ARS?s Scientific Manuscript database

    An eight-month-old crossbred ewe that was normal upon physical examination was humanely euthanized for tissue collection. Prior to euthanasia, whole blood was collected via jugular venipuncture into 60-ml syringes containing EDTA anticoagulant. After sacrifice, the brain was removed and the choroi...

  17. A importância da poeira e ondas de Alfvén na estabilidade de nuvens moleculares anãs

    NASA Astrophysics Data System (ADS)

    Falceta-Gonçalves, D.; de Juli, M. C.; Jatenco-Pereira, V.

    2003-08-01

    Nuvens moleculares anãs se apresentam dinamicamente estáveis, embora possuam massas muito maiores que a massa de Jeans. Por este motivo, a estabilidade destes objetos não pode ser explicada considerando-se apenas a pressão térmica. Campos magnéticos, aproximadamente uniformes e de ~mG, exercem um termo extra de pressão que sustenta a nuvem, mas somente na direção perpendicular às linhas de campo. Para a direção paralela, ondas de Alfvén geradas por turbulências no meio, por exemplo, têm sido utilizadas. Estas, sendo supostamente fracamente amortecidas, poderiam sustentar a nuvem nesta direção. Entretanto, estes meios contêm grandes quantidades de poeira carregada eletricamente. Estes grãos de poeira possuem frequências cíclotron, que podem entrar em ressonância com as ondas. Neste trabalho calculamos os efeitos que o amortecimento cíclotron da poeira teriam na propagação da onda, e consequentemente na estabilidade da nuvem. Considerando um fluxo de ondas, com um dado espectro de frequências, e uma população de grãos de poeira, com distribuição de tamanho observada, foi possível mostrar que o amortecimento é eficiente em uma larga banda de frequências. Neste caso as ondas seriam rapidamente amortecidas gerando pequenas condensações de alta densidade, e não poderiam ser utilizadas para explicar a estabilidade de uma nuvem inteira. Desta forma, rotação e turbulência seriam candidatos alternativos para garantir a estabilidade destes objetos.

  18. Uma análise do fenômeno “alternância de línguas” na fala de bilíngues intermodais (Libras e Português)

    PubMed Central

    de Sousa, Aline Nunes; de Quadros, Ronice Müller

    2013-01-01

    Um interessante fenômeno lingüístico presente nas interações das pessoas bilíngues é a alternância de línguas. Neste trabalho, estamos investigando a alternância entre a língua portuguesa oral e a língua de sinais brasileira – Libras, numa mesma cadeia enunciativa, com o objetivo de identificar e analisar o uso dessa alternância na fala de uma criança e de um adulto (ambos ouvintes, filhos de pais surdos), interagindo em uma situação de bilinguismo intermodal, com interlocutores surdos e ouvintes. A alternância de línguas, nesse caso, ocorre quando se para de falar em português e se alterna para sinalizar. O presente trabalho se caracteriza como um estudo inicial, com análise qualitativa de dados. Fazem parte do nosso corpus nove sessões de interações em Libras e em português oral, gravadas em vídeo, que fazem parte do Projeto Desenvolvimento Bilíngue Bimodal da UFSC. Os dados revelam que as características da alternância de línguas pelo adulto e pela criança parecem ter semelhanças e diferenças. O sujeito adulto parece ter feito um uso da alternância mais preocupado com o curso da interação. A criança, por sua vez, não parece tê-la usado com propósitos pragmáticos específicos. Quanto à extensão das alternâncias, pode-se perceber que tanto a criança quanto o adulto utilizaram enunciados maiores do que uma única palavra isolada. O papel dos interlocutores parece ter sido decisivo nas interações aqui investigadas – especialmente nas do adulto, já que a criança ainda está em processo de tomada de consciência do papel do interlocutor na interação. PMID:24379831

  19. Síndrome de Grisel en el adulto e inestabilidad cráneo cervical. Odontoidectomía endoscópica transnasal y fijación occípito-cervical. Reporte de caso y revisión de literatura

    PubMed Central

    Herrera, Roberto; Rojas, Héctor; Estramian, Ariel; Gómez, Julieta; Ledesma, José Luis; Pablo, José; Pastore, Julián

    2018-01-01

    Resumen Introducción: La patología de la unión cráneo-cervical es poco frecuente en la práctica neuroquirúrgica diaria. En general la mayor parte de estas lesiones son de origen traumático o reumatológico. La inestabilidad atlanto-axial de origen inflamatorio (Síndrome de Grisel) es una rara entidad de la que solo se han reportado 16 casos adultos en la literatura. Esta patología se caracteriza por el desarrollo de una lesión osteolítica a nivel de la articulación atlanto-axoidea posterior a un evento infeccioso, generalmente de las vías aéreas superiores. Descripción del caso: Presentamos el caso de una paciente de 76 años quien concurre en consulta por un cuadro clínico de inestabilidad cráneo espinal secundaria a una lesión osteolítica, con compromiso de C1 y C2. La sintomatología comenzó posteriormente a un proceso infeccioso respiratorio. Se realizó una fijación occípito-cervical posterior y una Odontoidectomía con descompresión anterior por vía endoscópica transnasal. La paciente evolucionó con resolución completa de los síntomas. Los cultivos fueron negativos y el estudio de anatomía patológica concluyó cambios inflamatorios inespecíficos. Conclusión: Hasta hace algunos pocos años la única opción para abordar esta patología era la vía transoral con técnica microquirúrgica. Hoy en día la endoscopía nos brinda muchas ventajas técnicas por lo que constituye una opción a tener en cuenta en la planificación de los abordajes a la unión cráneo-cervical. PMID:29430326

  20. Insulin-like growth factor-1 attenuates glucocorticoid suppression of pig lymphocyte function

    USDA-ARS?s Scientific Manuscript database

    The present study determined the effects of a synthetic glucocorticoid (dexamethasone, DEX) and IGF-1 on mitogen-induced proliferation and immunoglobulin (Ig) production by pig lymphocytes in vitro. Blood samples were obtained via jugular venipuncture from male, crossbred pigs (45 days of age, n=3/e...

  1. The French Muséum national d'histoire naturelle vascular plant herbarium collection dataset

    NASA Astrophysics Data System (ADS)

    Le Bras, Gwenaël; Pignal, Marc; Jeanson, Marc L.; Muller, Serge; Aupic, Cécile; Carré, Benoît; Flament, Grégoire; Gaudeul, Myriam; Gonçalves, Claudia; Invernón, Vanessa R.; Jabbour, Florian; Lerat, Elodie; Lowry, Porter P.; Offroy, Bérangère; Pimparé, Eva Pérez; Poncy, Odile; Rouhan, Germinal; Haevermans, Thomas

    2017-02-01

    We provide a quantitative description of the French national herbarium vascular plants collection dataset. Held at the Muséum national d'histoire naturelle, Paris, it currently comprises records for 5,400,000 specimens, representing 90% of the estimated total of specimens. Ninety nine percent of the specimen entries are linked to one or more images and 16% have field-collecting information available. This major botanical collection represents the results of over three centuries of exploration and study. The sources of the collection are global, with a strong representation for France, including overseas territories, and former French colonies. The compilation of this dataset was made possible through numerous national and international projects, the most important of which was linked to the renovation of the herbarium building. The vascular plant collection is actively expanding today, hence the continuous growth exhibited by the dataset, which can be fully accessed through the GBIF portal or the MNHN database portal (available at: https://science.mnhn.fr/institution/mnhn/collection/p/item/search/form). This dataset is a major source of data for systematics, global plants macroecological studies or conservation assessments.

  2. The French Muséum national d'histoire naturelle vascular plant herbarium collection dataset.

    PubMed

    Le Bras, Gwenaël; Pignal, Marc; Jeanson, Marc L; Muller, Serge; Aupic, Cécile; Carré, Benoît; Flament, Grégoire; Gaudeul, Myriam; Gonçalves, Claudia; Invernón, Vanessa R; Jabbour, Florian; Lerat, Elodie; Lowry, Porter P; Offroy, Bérangère; Pimparé, Eva Pérez; Poncy, Odile; Rouhan, Germinal; Haevermans, Thomas

    2017-02-14

    We provide a quantitative description of the French national herbarium vascular plants collection dataset. Held at the Muséum national d'histoire naturelle, Paris, it currently comprises records for 5,400,000 specimens, representing 90% of the estimated total of specimens. Ninety nine percent of the specimen entries are linked to one or more images and 16% have field-collecting information available. This major botanical collection represents the results of over three centuries of exploration and study. The sources of the collection are global, with a strong representation for France, including overseas territories, and former French colonies. The compilation of this dataset was made possible through numerous national and international projects, the most important of which was linked to the renovation of the herbarium building. The vascular plant collection is actively expanding today, hence the continuous growth exhibited by the dataset, which can be fully accessed through the GBIF portal or the MNHN database portal (available at: https://science.mnhn.fr/institution/mnhn/collection/p/item/search/form). This dataset is a major source of data for systematics, global plants macroecological studies or conservation assessments.

  3. The French Muséum national d’histoire naturelle vascular plant herbarium collection dataset

    PubMed Central

    Le Bras, Gwenaël; Pignal, Marc; Jeanson, Marc L.; Muller, Serge; Aupic, Cécile; Carré, Benoît; Flament, Grégoire; Gaudeul, Myriam; Gonçalves, Claudia; Invernón, Vanessa R.; Jabbour, Florian; Lerat, Elodie; Lowry, Porter P.; Offroy, Bérangère; Pimparé, Eva Pérez; Poncy, Odile; Rouhan, Germinal; Haevermans, Thomas

    2017-01-01

    We provide a quantitative description of the French national herbarium vascular plants collection dataset. Held at the Muséum national d’histoire naturelle, Paris, it currently comprises records for 5,400,000 specimens, representing 90% of the estimated total of specimens. Ninety nine percent of the specimen entries are linked to one or more images and 16% have field-collecting information available. This major botanical collection represents the results of over three centuries of exploration and study. The sources of the collection are global, with a strong representation for France, including overseas territories, and former French colonies. The compilation of this dataset was made possible through numerous national and international projects, the most important of which was linked to the renovation of the herbarium building. The vascular plant collection is actively expanding today, hence the continuous growth exhibited by the dataset, which can be fully accessed through the GBIF portal or the MNHN database portal (available at: https://science.mnhn.fr/institution/mnhn/collection/p/item/search/form). This dataset is a major source of data for systematics, global plants macroecological studies or conservation assessments. PMID:28195585

  4. [Sepsis caused by Fusobacterium necrophorum (Lemierre syndrome): a rare complication of acute pharyngotonsilitis].

    PubMed

    Perović, Marta; Maretić, Tomislav; Begovac, Josip

    2006-12-01

    Lemierre syndrome is defined as an acute pharyngotonsillar infection that has spread into the lateral pharyngeal space causing thrombophlebitis of the internal jugular vein with consecutive metastatic emboli. The syndrome is most often caused by Fusobacterium (F.) necrophorum and usually involves young, previously healthy people. We present a healthy 20-year-old man who suddenly developed with high fever and sore throat followed by dyspnea, tachypnea and cough on the third day of illness. His condition worsened despite outpatient intramuscular penicillin therapy (1600 000 IU/day). He was admitted to Dr. Fran Mihaljević University Hospital for Infectious Diseases, Zagreb, on the sixth day of his illness with clinical signs of sepsis. Chest radiograph showed bilateral multiple infiltrates. F. necrophorum was isolated from blood culture. Swelling of the neck was also observed on the fourteenth day of illness, however, thrombophlebitis of the jugular vein was not diagnosed on ultrasound examination. The patient was treated with clindamycin for five weeks and recovered completely.

  5. Cross sectional survey of ultrasound use for central venous catheter insertion among resident physicians.

    PubMed

    Nomura, Jason T; Sierzenski, Paul R; Nace, Jason E; Bollinger, Melissa

    2008-07-01

    Use of ultrasound guidance for Central Venous Catheter insertion has been associated with decreased complications and increased success rates. Previous reports show low rates of use among physicians. Evaluation of the frequency of Ultrasound Guidance use for Central Venous Catheter insertion among residents at a teaching institution. A cross sectional electronic survey of resident physicians at a tertiary care teaching hospital was conducted to evaluate use of Ultrasound Guidance for Central Venous Catheterization. Assessment included self reported frequency of ultrasound guidance use, and volume of central venous catheter placement. Attitudes toward the use of ultrasound were assessed using Likert scales. There is a high rate. over 90%, of ultrasound guidance use for Internal Jugular central venous catheters among residents. The majority of residents use sterile real-time imaging with a single operator with a reported success rate greater then 80%. Resident use of ultrasound guidance for Internal Jugular central venous catheter insertion can be much higher than previously reported in the literature.

  6. A peculiar case of suicide enacted through the ancient Japanese ritual of Jigai.

    PubMed

    Maiese, Aniello; Gitto, Lorenzo; dell'Aquila, Massimiliano; Bolino, Giorgio

    2014-03-01

    In the past, self-infliction of sharp force was a classic form of suicide, while in modern times it is quite rare, constituting only 2% to 3% of all self-inflicted deaths. In Japan, the jigai (Japanese characters: see text) ritual is a traditional method of female suicide, carried out by cutting the jugular vein using a knife called a tantō. The jigai ritual is the feminine counterpart of seppuku (well-known as harakiri), the ritual suicide of samurai warriors, which was carried out by a deep slash into the abdomen. In contrast to seppuku, jigai can be performed without assistance, which was fundamental for seppuku.The case we describe here involves an unusual case of suicide in which the victim was a male devotee of Japanese culture and weapons. He was found dead in his bathtub with a deep slash in the right lateral-cervical area, having cut only the internal jugular vein with a tantō knife, exactly as specified by the jigai ritual.

  7. Paraganglioma presenting as cholesterol granuloma of the petrous apex.

    PubMed

    Heman-Ackah, Selena E; Huang, Tina C

    2013-09-01

    We report the unique finding of a petrous apex cholesterol granuloma associated with a paraganglioma, also known as a glomus jugulare tumor, in a 52-year-old woman who presented to our department with pulsatile tinnitus, hearing loss, aural fullness, and disequilibrium. She had been treated for a petrous apex cholesterol granuloma 20 years earlier, at which time she had undergone drainage of the granuloma via subtotal petrous apicectomy. When she came to our facility approximately 20 years later, she had signs and symptoms consistent with a jugular paraganglioma, which was likely to have been present at the time of her initial presentation for the cholesterol granuloma. In fact, microscopic bleeding from the paraganglioma might have led to the formation of the cholesterol granuloma. The metachronous presentation of these two entities, which to our knowledge has not been reported previously in the literature, indicates the potential association of paragangliomas with the formation of cholesterol granulomas of the petrous apex.

  8. Asociación de la adherencia a la dieta mediterránea al inicio del embarazo y riesgo de gastrosquisis en la descendencia: un estudio de casos-controles

    PubMed Central

    Cánovas-Conesa, A.; Gomariz-Peñalver, V.; Sánchez-Sauco, M.F.; Vega, D.C. Jaimes; Ortega-García, J.A.; García, M.J. Aranda; Marín, J.L. Delgado; Ascanio, A. Trujillo; Hernández, F. López; Jimenez, J.I. Ruiz; de Paco Matallana, C.; Soldin, O.P.; Solís, M. Sánchez

    2016-01-01

    Resumen Objetivos El objetivo de este estudio fue estudiar la asociación de la adherencia a la dieta mediterránea materna al inicio del embarazo y el riesgo de gastrosquisis en la descendencia. Métodos Estudio de casos-control. 11 casos incidentes de gastrosquisis en la Región de Murcia de 2007 a 2012 y 34 controles concurrentes. Cuestionario validado de Frecuencia Alimentaria (CFA) sobre la dieta periconcepcional de 98 ítems realizado ‘cara a cara’ en el momento del diagnóstico. Factores confundidores: tabaquismo, expositión a cannabis/marihuana, edad materna y paterna, índice de masa corporal, ingresos económicos y nivel de estudios. Estudio descriptivo y regresión logística multivariable. Resultados Las madres de niños con gastrosquisis son más jóvenes (20,8 años; IC 95% 17,3–24,2) y su dieta tiene un menor aporte calórico, de grasas saturadas y monoinsaturadas y de proteínas que los controles. Odds Ratio (OR) en el modelo multivariable controlado por los factores confundidores: edad materna (años) 0,70 (IC95% 0,51–0,96); ácidos grasos monoinsaturados (oleico, g) 0,79 (IC95% 0,65–0,97) y consumo de vegetales (raciones/semana) 0,70 (IC95% 0,48–1,00). Conclusiones Una dieta materna rica en ácido oleico y productos vegetales podría contribuir a prevenir el riesgo de oclusión vascular de las arterias onfalomesentéricas, disminuyendo el riesgo de gastrosquisis. PMID:23833926

  9. Further studies on the new high sensitive CaSO4:Dy thermostimulated luminescence phosphor.

    PubMed

    Lakshmanan, A R; Tomita, A

    2002-01-01

    CaSO4:Dy phosphor prepared by a new recipe (denoted as N) is nearly 50% more sensitive than the presently used one (denoted as P). N consists of needle shaped crystals while P is mostly quadrilateral. In P most of the grains in as-grown condition are >75 microm in size while in N most of the grains are <75 microm. While the sensitivity of P increases with grain size, an exactly opposite trend is seen with N since higher sized grains (>105 microm) in N are agglomerates of particles and hence are opaque. The detection threshold of N (14.4 microGy) is nearly 4 times lower than that of P (54.2 microGy). The major glow peak(s) in both the phosphors occur in the 460-490 K (187-217 degrees C) region. But the low temperature peak near 390 K (117 degrees C) is very prominent in P while its presence is insignificant in N. The post-irradiation storage stability of N at approximately 30 degrees C was tested up to a period of 25 d and found to be better than that of P. The emission spectra of P and N are characteristic of Dy3+. In P, the 480 nm to 570 nm emission intensity ratio varies slightly with glow peak temperature, unlike that of N. The Dy concentration quenching effect in N is less serious than that in P. The intrinsic UV sensitivity of N is nearly a factor of 20 times lower than that of P.

  10. Performance of thin CaSO4:Dy pellets for calibration of a Sr90+Y90 source

    NASA Astrophysics Data System (ADS)

    Oliveira, M. L.; Caldas, L. V. E.

    2007-09-01

    Because of the radionuclide long half-life, Sr90+Y90, plane or concave sources, utilized in brachytherapy, have to be calibrated initially by the manufacturer and then routinely while they are utilized. Plane applicators can be calibrated against a conventional extrapolation chamber, but concave sources, because of their geometry, should be calibrated using relative dosimeters, as thermoluminescent (TL) materials. Thin CaSO4:Dy pellets are produced at IPEN specially for beta radiation detection. Previous works showed the feasibility of this material in the dosimetry of Sr90+Y90 sources in a wide range of absorbed dose in air. The aim of this work was to study the usefulness of these pellets for the calibration of a Sr90+Y90 concave applicator. To reach this objective, a special phantom was designed and manufactured in PTFE with semi spherical geometry. Because of the dependence of the TL response on the mass of the pellet, the response of each pellet was normalized by its mass in order to reduce the dispersion on TL response. Important characteristics of this material were obtained in reference of a standard Sr90+Y90 source, and the pellets were calibrated against a plane applicator; then they were utilized to calibrate the concave applicator.

  11. A rare case of lateral sinus thrombosis with carotid space abscess.

    PubMed

    Singh, Gautam Bir; Rai, Anil K; Singh, Sarvejeet; Sinha, Mukul

    2012-01-01

    This case report describes a case of carotid space abscess secondary to lateral sinus thrombosis associated with internal jugular vein thrombosis. With this case, we illustrate a rare entity that presented in an extremely rare manner. To the authors knowledge such a case has not been previously reported.

  12. Um supressor de fundo térmico para a câmara infravermelha CamIV

    NASA Astrophysics Data System (ADS)

    Jablonski, F.; Laporte, R.

    2003-08-01

    O ângulo sólido subtendido pelos pixels na câmara infravermelha do NexGal (CamIV) que operamos no OPD/LNA contém contribuições provenientes do sistema de coleta de fluxo propriamente dito - sendo esta a parte que interessa para as medidas astronômicas - e contribuições da obstrução central, sistema de suporte do espelho secundário e região exterior à pupila de entrada do telescópio. Estas últimas contribuições são devi-das à emissão de corpo negro à temperatura ambiente e aumentam exponencialmente para comprimentos de onda maiores que 2 micra (banda K, no infravermelho próximo). Embora a resultante pode ser quantificada e subtraída dos sinais relevantes, sua variância se adiciona à variância do sinal, e pode ser facilmente a contribuição domi-nante para a incerteza final das medidas, tornando ineficiente o processo de extração de informação e degradando a sensibilidade da câmara. A maneira clássica de resolver esse problema em sistemas ópticos que operam no infravermelho, onde os efeitos da emissão térmica do ambiente são importantes, é restringir o ângulo sólido subtendido pelos pixels individuais exclusivamente aos raios provenientes do sistema óptico. Para tanto, projeta-se uma imagem real, bastante reduzida, da pupila de entrada do sistema óptico num anteparo que transmita para o sistema de imageamento só o que interessa, bloqueando as contribuições das bordas externas à pupila de entrada, obstrução central do telescópio e sistema de suporte. Como a projeção é realizada em ambiente criogênico, a contribuição térmica espúria é efetivamente eliminada. Nós optamos por um sistema do tipo Offner para implementar na prática esta função. Trata-se de um sistema baseado em espelhos esféricos, bastante compacto e ajustado por construção. A opção por espelhos do mesmo material que o sistema de suporte (Alumínio) minimiza a dilatação diferencial, crítica nesse tipo de aplicação. Apresentamos as solu

  13. Tão perto de casa, tão longe de nós: etnografia das novas margens no centro da urbe

    PubMed Central

    Fernandes, Por Luís

    2011-01-01

    Philippe Bourgois é, desde 2007, “Richard Perry University professor” no Departamento de Antropologia e de Medicina Familiar e de Práticas Comunitárias na Universidade da Pensilvânia. Esteve durante largos anos ligado ao Departamento de Antropologia, História e Medicina Social da Universidade da Califórnia, São Francisco. A publicação, em 1995, de In Search of Respect: Selling Crack in El Barrio1 projectaria o seu nome muito para além dos Estados Unidos: uma etnografia no coração porto-riquenho do Harlem, em torno dos actores e dos ambientes da venda de crack. Seguir-se-ia um longo trabalho de terreno em acampamentos de dependentes de heroína em São Francisco, orientando o seu trabalho para as formas mais radicais da pobreza e da marginalidade nos EUA. É deste trabalho de terreno que sai o seu último livro, Righteous Dopefiend2. Em Junho de 2007 esteve em Lisboa para participar na 3.a edição do “Ethnografeast”. Foi então que aproveitámos a oportunidade para ouvir um percurso invulgar contado pelo próprio: uma longa conversa no Hotel Zurique, cujo nome só vem ao caso por evocar o país onde passou uma parte da infância. PMID:22013286

  14. Right atrial and right ventricular ultrasound-guided biopsy technique in standing horses.

    PubMed

    Decloedt, A; de Clercq, D; Ven, S; van der Vekens, N; Chiers, K; van Loon, G

    2016-05-01

    Endomyocardial biopsies could be a valuable tool in equine cardiology for diagnosing myocardial disease, which is probably underdiagnosed in horses because of lack of specific diagnostic measures and limitations of currently available diagnostic methods. To describe a technique for serial right atrial and right ventricular endomyocardial biopsy in standing horses using a percutaneous approach through the jugular vein. Prospective study. Biopsy was performed in 10 healthy standing horses sedated with detomidine, under continuous electrocardiography monitoring. A 10 cm (n = 6), 45 cm (n = 1) or 98 cm (n = 3) introducer sheath was inserted into the right jugular vein. Under echocardiographic guidance, a biopsy forceps was introduced through the sheath into the right ventricle and right atrium and endomyocardial biopsies were acquired. In all horses, 3 right ventricular biopsies were obtained from the right ventricular apex and 3 right atrial biopsies were obtained from the dorsal right atrial wall near the tuberculum intervenosum. The presence of myocardial tissue was confirmed by histology. All horses showed atrial and ventricular premature depolarisations associated with acquisition of the biopsies. In 9 horses, the arrhythmia disappeared after retraction of the forceps and introducer sheath. In one horse, ventricular premature depolarisations disappeared only after 8 h. No other complications were observed. Endomyocardial biopsy of the right atrium and right ventricle could be performed in standing horses using a percutaneous approach through the jugular vein and was not associated with complications other than temporary arrhythmias. This technique may be useful for research purposes or as a diagnostic tool, although further research is needed to establish the safety of the technique in clinical patients with myocardial disease. © 2015 EVJ Ltd.

  15. Imagens do céu ontem e hoje - um multimídia interativo de astronomia e uma nova exposição no MAST

    NASA Astrophysics Data System (ADS)

    Caretta, C. A.; Lima, F. P.; Requeijo, F.; Vieira, G. G.; Alves, F.; Valente, M. E. A.; de Almeida, R.; de Garcia, G. C.; Quixadá, A. C.

    2003-08-01

    "Imagens do Céu Ontem e Hoje" é o título de uma nova exposição que está sendo inaugurada no Museu de Astronomia e Ciências Afins (MCT), que inclui experimentos interativos, maquetes, réplicas e 8 terminais de computador com um multimídia interativo sobre Astronomia para consulta dos visitantes. O multimídia apresenta um conteúdo bastante extenso, que engloba quase todos os temas em Astronomia, consistindo numa fonte de divulgação e pesquisa para um público que vai das crianças até estudantes universitários. O conteúdo está distribuído em mais de 500 páginas de texto divididas em 4 módulos: "O Universo", "Espectroscopia", "Telescópios" e "Observando o Céu". Cada módulo é subdividido em 5 seções, em média, cada uma iniciada por uma animação que ilustra os temas a serem abordados na seção. Ao final da animação, uma lista de temas é apresentada sob o título "Saiba Mais". Para exemplificar, o módulo "O Universo" contém as seguintes seções: "O Universo visto pelo homem", "Conhecendo o Sistema Solar", "Indo além do Sistema Solar", "Nossa Galáxia, a Via-Láctea" e "Indo mais além, a imensidão do Universo". A seção "Conhecendo o Sistema Solar", por sua vez, tem os seguintes temas: "A origem do Sistema Solar", "O Sol", "Os planetas", "Satélites, asteróides, cometas e outros bichos..." e "O Sistema Solar em números". Cada texto é repleto de imagens, quadros, desenhos, esquemas, etc, além de passatempos ao final de cada seção, incluindo jogos interativos, quadrinhos e curiosidades, que auxiliam o aprendizado de forma divertida. Apresentamos neste trabalho as idéias gerais que permearam a produção da exposição, e uma viagem pelo multimídia para exemplificar sua estrutura e conteúdo. O multimídia será posteriormente disponibilizado para o público externo pela página eletrônica do MAst e/ou por intermédio de uma publicação comercial.

  16. A model for the extended studies of hepatic hemodynamics and metabolism in swine.

    PubMed

    Drougas, J G; Barnard, S E; Wright, J K; Sika, M; Lopez, R R; Stokes, K A; Williams, P E; Pinson, C W

    1996-12-01

    To our knowledge postoperative hepatic hemodynamics and hepatic metabolism have not been fully studied on a long-term basis. Our goal was to develop a large animal model that would permit the measurement of hepatic blood flow (BF), perihepatic pressures (P), and hepatic metabolism in a long-term setting. Catheters were inserted into the jugular vein, carotid artery, pulmonary artery, hepatic vein, and portal vein (PV) of 27 commercially bred pigs; ultrasonic transit time flowmeter probes were placed around the hepatic artery and PV. Daily postoperative measurements of jugular vein P, carotid artery P, pulmonary artery P, hepatic vein P, and PVP, as well as hepatic artery BF and PVBF, were recorded for 20 days. Hepatic carbohydrate metabolism was assessed by arteriovenous difference techniques. Jugular vein P, pulmonary artery P, hepatic vein P, PVP, and heart rate reached steady-state values during the first week, with a mean +/- SEM of 1.0 +/- 0.3 mm Hg for jugular vein P, 21.4 +/- 2.1 mm Hg for pulmonary artery P, 4.3 +/- 0.4 mm Hg for HVP, 7.8 +/- 0.5 mm Hg for PVP, and 116 +/- 4 beats per minute for heart rate. Mean carotid artery P increased from 65 +/- 3 mm Hg during surgery to 94 +/- 2 mm Hg on postoperative day 1 (P < 0.001) and to a mean 101 +/- 2 mm Hg thereafter. Total hepatic BF reached a steady-state value of 1,132 +/- 187 ml/min by postoperative day 7 (P = 0.19). Over week 1 hepatic artery BF measured as a percentage of total hepatic BF decreased from 35.0 +/- 3.0% to 15.5 +/- 2.7%, and PVBF increased from 65.0 +/- 3.0% to 84.5 +/- 2.7% (P < 0.005); both variables were steady thereafter. In the hemodynamic steady state the net hepatic balances of glucose, lactate, glycerol, and alanine in 5 pigs were 9.9 +/- 4.0, -4.2 +/- 0.4, -2.3 +/- 1.1, and -0.68 +/- 0.22 micromol/kg per min respectively. The net gut (portal-drained viscera) balances of glucose, lactate, alanine, and glycerol were -2.0 +/- 2.5, 1.1 +/- 0.5, 0.73 +/- 0.18, and -0.69 +/- 0

  17. Harvey: The Impact of a Cardiovascular Teaching Simulator on Student Skill Acquisition.

    ERIC Educational Resources Information Center

    Woolliscroft, James O.; And Others

    1987-01-01

    A life-sized cardiovascular patient simulator was used in medical education in a standard sophomore physical skills test. Significant gains were found in overall student scores and in assessment of interpretation of carotid pulses and precordial auscultation. Students did not make significant gains in jugular venous pulse or precordial motion…

  18. Chromium supplementation enhances the acute phase response of steers to a lipopolysaccharide (LPS) challenge

    USDA-ARS?s Scientific Manuscript database

    The study examined the effect of chromium supplementation on the response of steers to an LPS challenge. Twenty crossbred steers (235±4 kg BW) received 0 ppb (Control; C) or 200 ppb chromium propionate (CHR) for 55 days. Steers were fitted with jugular catheters and rectal temperature (RT) recording...

  19. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Moore, Thomas W.; Quach, Tu-Thach; Detry, Richard Joseph

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to pervasive interdependencies and attendant vulnerabilities to cascades in associated systems. Phoenix was initiated to address this high-impact problem space as engineers. Our overarching goals are maximizing security, maximizing health, and minimizing risk. We design interventions, or problem solutions, that influence CASoS to achieve specific aspirations. Through application to real-world problems, Phoenix is evolving the principles and discipline ofmore » CASoS Engineering while growing a community of practice and the CASoS engineers to populate it. Both grounded in reality and working to extend our understanding and control of that reality, Phoenix is at the same time a solution within a CASoS and a CASoS itself.« less

  20. Direct Generation and Detection of Quantum Correlated Photons with 3.2 um Wavelength Spacing.

    PubMed

    Sua, Yong Meng; Fan, Heng; Shahverdi, Amin; Chen, Jia-Yang; Huang, Yu-Ping

    2017-12-13

    Quantum correlated, highly non-degenerate photons can be used to synthesize disparate quantum nodes and link quantum processing over incompatible wavelengths, thereby constructing heterogeneous quantum systems for otherwise unattainable superior performance. Existing techniques for correlated photons have been concentrated in the visible and near-IR domains, with the photon pairs residing within one micron. Here, we demonstrate direct generation and detection of high-purity photon pairs at room temperature with 3.2 um wavelength spacing, one at 780 nm to match the rubidium D2 line, and the other at 3950 nm that falls in a transparent, low-scattering optical window for free space applications. The pairs are created via spontaneous parametric downconversion in a lithium niobate waveguide with specially designed geometry and periodic poling. The 780 nm photons are measured with a silicon avalanche photodiode, and the 3950 nm photons are measured with an upconversion photon detector using a similar waveguide, which attains 34% internal conversion efficiency. Quantum correlation measurement yields a high coincidence-to-accidental ratio of 54, which indicates the strong correlation with the extremely non-degenerate photon pairs. Our system bridges existing quantum technology to the challenging mid-IR regime, where unprecedented applications are expected in quantum metrology and sensing, quantum communications, medical diagnostics, and so on.

  1. Variação temporal do gradiente radial de o/h a partir de uma amostra de nebulosas planetárias

    NASA Astrophysics Data System (ADS)

    Maciel, W. J.; Costa, R. D. D.; Uchida, M. M. M.

    2003-08-01

    Gradientes radiais de abundância são observados no disco de nossa Galáxia e também em outras galáxias espirais. No caso da Galáxia, o principal problema relativo aos gradientes é sua variação temporal, que constitui um dos principais vínculos aos modelos de evolução química da Galáxia. As nebulosas planetárias são particularmente interessantes no estudo dos gradientes e suas variações, tanto espaciais como temporais. São objetos brilhantes, podendo ser observadas a grandes distâncias, e têm abundâncias relativamente precisas de diversos elementos químicos. Além disso, sendo originadas de estrelas com massas entre 0.8 e 8 massas solares na sequência principal, incluem objetos com idades e populações diferentes, o que as torna especialmente interessantes ao estudo da variação temporal dos gradientes. Neste trabalho, apresentamos resultados recentes sobre a variação temporal do gradiente de O/H a partir de uma amostra contendo cerca de 200 nebulosas, para as quais obtivemos distâncias por métodos estatísticos. As abundâncias foram parcialmente obtidas a partir de observações em Itajubá e La Silla, sendo as restantes obtidas da literatura. Os resultados mostram, pela primeira vez, evidências de um achatamento do gradiente de O/H, de -0.11 dex/kpc para -0.06 dex/kpc nos últimos 9 giga-anos ou de -0.08 dex/kpc para -0.06 dex/kpc nos últimos 5 giga-anos. Esses valores apresentam um bom acordo com alguns modelos recentes para a evolução química da Galáxia. (FAPESP/CNPq)

  2. Pleuroparenchymal fibroelastosis: report of two cases in Brazil.

    PubMed

    Gomes, Paula Silva; Shiang, Christina; Szarf, Gilberto; Coletta, Ester Nei Aparecida Martins; Pereira, Carlos Alberto de Castro

    2017-01-01

    Pleuroparenchymal fibroelastosis (PPFE) is a rare lung disease. It can be idiopathic or associated with any one of various conditions. To our knowledge, this is the first report of two cases of PPFE in Brazil. Our first patient presented with pleural and subpleural fibrosis in the upper lobes; a spiculated nodule in the left upper lobe; and a mild reticular pattern in the lower lobes. Surgical lung biopsy revealed PPFE in the upper lobes, including the nodule, and unclassified interstitial pneumonia in the left lower lobe. Our second patient had a history of exposure to domestic birds, indicating a risk of hypersensitivity pneumonitis, and presented with advanced lung disease, predominantly in the upper lobes, together with subpleural fibrosis.That patient underwent lung transplantation. In the explant specimen, PPFE and granulomas were identified, suggesting hypersensitivity pneumonitis as an associated cause. RESUMO A fibroelastose pleuroparenquimatosa (FEPP) é uma doença pulmonar rara, podendo ser idiopática ou associada a diversas condições. Pelo que sabemos, este é o primeiro relato de dois casos de FEPP no Brasil. Nosso primeiro paciente apresentava fibrose pleural e subpleural nos lobos superiores, um nódulo espiculado no lobo superior esquerdo e um padrão reticular discreto nos lobos inferiores. A biópsia pulmonar cirúrgica demonstrou FEPP nos lobos superiores, incluindo no nódulo, e pneumonia intersticial não classificada no lobo inferior esquerdo. Nosso segundo paciente tinha história de exposição a aves domésticas, indicando um risco de pneumonite de hipersensibilidade, e doença pulmonar avançada predominando em lobos superiores, com fibrose subpleural. Esse paciente foi submetido a transplante pulmonar. No espécime do explante, FEPP e granulomas foram identificados, sugerindo pneumonite de hipersensibilidade como causa associada.

  3. Infusion of butyrate affects plasma glucose, butyrate, and ß-hydroxybutyrate but not plasma insulin in lactating dairy cows

    USDA-ARS?s Scientific Manuscript database

    The objective of this research was to investigate the effects on plasma metabolites and rumen measures when butyrate was infused into the rumen or abomasum of lactating cows. Jugular catheters were inserted into 5 ruminally fistulated Holstein cows (94.2 ± 26.3 days in milk [DIM]; 717 ± 45 kg body w...

  4. Nursing Diagnoses of hospitalized patients with heart failure: a longitudinal study.

    PubMed

    Pereira, Juliana de Melo Vellozo; Flores, Paula Vanessa Peclat; Figueiredo, Lyvia da Silva; Arruda, Cristina Silva; Cassiano, Keila Mara; Vieira, Gláucia Cristina Andrade; Guerra, Thais de Rezende Bessa; Silva, Vanessa Alves da; Cavalcanti, Ana Carla Dantas

    2016-01-01

    , respectivamente. Fadiga apareceu somente em um paciente. Intolerância à atividade foi o diagnóstico que teve maior discordância entre os peritos. Débito cardíaco diminuído foi associado às características definidoras dispneia, edema, distensão da veia jugular e fração de ejeção diminuída nas três semanas de avaliação. Débito cardíaco diminuído esteve mais prevalente em pacientes com insuficiência cardíaca hospitalizados, sendo as características definidoras associadas determinantes para este diagnóstico de enfermagem.

  5. Precessão do jato de 3C120: simulações hidrodinâmicas 3D

    NASA Astrophysics Data System (ADS)

    Caproni, A.; de Gouveia dal Pino, E. M.; Abraham, Z.; Raga, A. C.

    2003-08-01

    Observações com técnicas de interferometria com longa linha de base têm mostrado a existência de um jato relativístico com componentes superluminais na região central de 3C 120. Estas componentes são ejetadas em distintas direções no plano do céu e com diferentes velocidades aparentes. Estas características foram interpretadas em trabalhos anteriores como efeitos da precessão do jato relativístico. Neste trabalho, realizamos simulações tri-dimensionais do jato de 3C 120 utilizando os parâmetros de precessão determinados em trabalhos anteriores e variando as características iniciais do jato e meio ambiente, tais como densidade numérica e temperatura. Todas as simulações foram feitas com o código hidrodinâmico YGUAZÚ-A, assumindo-se um jato adiabático descrito por uma equação de estado relativística. Pelo fato de estarmos utilizando um código hidrodinâmico, nós assumimos que a intensidade do campo magnético e a distribuição de partículas, necessários para se calcular a emissão sincrotron, são proporcionais à pressão hidrodinâmica. Comparação entre dois cenários distintos, nos quais o material do jato é ejetado com velocidade constante (jato contínuo) e com velocidade modulada por um padrão sinusoidal no tempo (jato intermitente), é apresentada e discutida. Para jatos que apresentam fenômenos de precessão e intermitência, com amplitude de variação na velocidade de injeção maior que dez por cento da velocidade média de injeção, a hipótese balística, controlada pela intermitencia, é mais provável. Por outro lado, para jatos com precessão mas sem intermitência (ou com amplitude de variabilidade em velocidade mais baixa que no caso anterior), o efeito da precessão na morfologia do jato não é desprezível. Portanto, de um modo geral, ambos efeitos (precessão e movimentos balísticos) devem estar concorrendo para afetar a morfologia dos jatos superluminais.

  6. Diagnosing the radiative and chemical contributions to future changes in tropical column ozone with the UM-UKCA chemistry-climate model

    NASA Astrophysics Data System (ADS)

    Keeble, James; Bednarz, Ewa M.; Banerjee, Antara; Abraham, N. Luke; Harris, Neil R. P.; Maycock, Amanda C.; Pyle, John A.

    2017-11-01

    Chemical and dynamical drivers of trends in tropical total-column ozone (TCO3) for the recent past and future periods are explored using the UM-UKCA (Unified Model HadGEM3-A (Hewitt et al., 2011) coupled with the United Kingdom Chemistry and Aerosol scheme) chemistry-climate model. A transient 1960-2100 simulation is analysed which follows the representative concentration pathway 6.0 (RCP6.0) emissions scenario for the future. Tropical averaged (10° S-10° N) TCO3 values decrease from the 1970s, reach a minimum around 2000 and return to their 1980 values around 2040, consistent with the use and emission of halogenated ozone-depleting substances (ODSs), and their later controls under the Montreal Protocol. However, when the ozone column is subdivided into three partial columns (PCO3) that cover the upper stratosphere (PCO3US), lower stratosphere (PCO3LS) and troposphere (PCO3T), significant differences in the temporal behaviour of the partial columns are seen. Modelled PCO3T values under the RCP6.0 emissions scenario increase from 1960 to 2000 before remaining approximately constant throughout the 21st century. PCO3LS values decrease rapidly from 1960 to 2000 and remain constant from 2000 to 2050, before gradually decreasing further from 2050 to 2100 and never returning to their 1980s values. In contrast, PCO3US values decrease from 1960 to 2000, before increasing rapidly throughout the 21st century and returning to 1980s values by ˜ 2020, and reach significantly higher values by 2100. Using a series of idealised UM-UKCA time-slice simulations with concentrations of well-mixed greenhouse gases (GHGs) and halogenated ODS species set to either year 2000 or 2100 levels, we examine the main processes that drive the PCO3 responses in the three regions and assess how these processes change under different emission scenarios. Finally, we present a simple, linearised model to describe the future evolution of tropical stratospheric column ozone values based on terms

  7. Under general anesthesia arginine vasopressin prevents hypotension but impairs cerebral oxygenation during arthroscopic shoulder surgery in the beach chair position.

    PubMed

    Cho, Soo Y; Kim, Seok J; Jeong, Cheol W; Jeong, Chang Y; Chung, Sung S; Lee, JongUn; Yoo, Kyung Y

    2013-12-01

    Patients undergoing surgery in the beach chair position (BCP) are at a risk of cerebral ischemia. We evaluated the effect of arginine vasopressin (AVP) on hemodynamics and cerebral oxygenation during surgery in the BCP. Thirty patients undergoing shoulder surgery in BCP under propofol-remifentanil anesthesia were randomly allocated either to receive IV AVP 0.07 U/kg (AVP group, N = 15) or an equal volume of saline (control group, N = 15) 2 minutes before taking BCP. Mean arterial blood pressure (MAP), heart rate (HR), jugular venous bulb oxygen saturation (SjvO2), and regional cerebral tissue oxygen saturation (SctO2) were measured after induction of anesthesia and before (presitting in supine position) and after patients took BCP. AVP itself given before the positioning increased MAP and decreased SjvO2 and SctO2 (P < 0.0001), with HR unaffected. Although MAP was decreased by BCP in both groups, it was higher in the AVP group (P < 0.0001). While in BCP, HR remained unaltered in the control and decreased in the AVP group. SjvO2 in BCP did not differ between the groups. SctO2 was decreased by BCP in both groups, which was more pronounced in the AVP group until the end of study. The incidence of hypotension (13% vs 67%; P = 0.003) was less frequent, and that of cerebral desaturation (>20% SctO2 decrease from presitting value) (80% vs 13%; P = 0.0003) was higher in the AVP group. The incidence of jugular desaturation (SjvO2 <50%) was comparable between the groups. A prophylactic bolus administration of AVP prevents hypotension associated with BCP in patients undergoing shoulder surgery under general anesthesia. However, it was associated with regional cerebral but not jugular venous oxygen desaturation on upright positioning.

  8. Evaluation of ultrasound-guided vascular access in dogs.

    PubMed

    Chamberlin, Scott C; Sullivan, Lauren A; Morley, Paul S; Boscan, Pedro

    2013-01-01

    To describe the technique and determine the feasibility, success rate, perceived difficulty, and time to vascular access using ultrasound guidance for jugular vein catheterization in a cardiac arrest dog model. Prospective descriptive study. University teaching hospital. Nine Walker hounds. A total of 27 jugular catheterizations were performed postcardiac arrest using ultrasound guidance. Catheterizations were recorded based on the order in which they were performed and presence/absence of a hematoma around the vein. Time (minutes) until successful vascular access and perceived difficulty in achieving vascular access (scale of 1 = easy to 10 = difficult) were recorded for each catheterization. Mean time to vascular access was 1.9 minutes (95% confidence interval, 1.1-3.4 min) for catheterizations without hematoma, versus 4.3 minutes (1.8-10.1 min) for catheterizations with hematoma (P = 0.1). Median perceived difficulty was 2 of 10 (range 1-7) for catheterizations without hematoma, versus 2 of 10 (range 1-8) for catheterizations with hematoma (P = 0.3). A learning curve was evaluated by comparing mean time to vascular access and perceived difficulty in initial versus subsequent catheterizations. Mean time to vascular access was 2.5 minutes (1.0-6.4 min) in the initial 13 catheterizations versus 3.3 minutes (1.5-7.5 min) in the subsequent 14 catheterizations (P = 0.6). Median perceived difficulty in the first 13 catheterizations (3, range 1-8) was significantly greater (P = 0.049) than median perceived difficulty in the subsequent 14 catheterizations (2, range 1-6). Ultrasound-guided jugular catheterization is associated with a learning curve but is successful in obtaining rapid vascular access in dogs. Further prospective studies are warranted to confirm the utility of this technique in a clinical setting. © Veterinary Emergency and Critical Care Society 2013.

  9. Increased brain serotonin turnover in panic disorder patients in the absence of a panic attack: reduction by a selective serotonin reuptake inhibitor.

    PubMed

    Esler, Murray; Lambert, Elisabeth; Alvarenga, Marlies; Socratous, Florentia; Richards, Jeff; Barton, David; Pier, Ciaran; Brenchley, Celia; Dawood, Tye; Hastings, Jacqueline; Guo, Ling; Haikerwal, Deepak; Kaye, David; Jennings, Garry; Kalff, Victor; Kelly, Michael; Wiesner, Glen; Lambert, Gavin

    2007-08-01

    Since the brain neurotransmitter changes characterising panic disorder remain uncertain, we quantified brain noradrenaline and serotonin turnover in patients with panic disorder, in the absence of a panic attack. Thirty-four untreated patients with panic disorder and 24 matched healthy volunteers were studied. A novel method utilising internal jugular venous sampling, with thermodilution measurement of jugular blood flow, was used to directly quantify brain monoamine turnover, by measuring the overflow of noradrenaline and serotonin metabolites from the brain. Radiographic depiction of brain venous sinuses allowed differential venous sampling from cortical and subcortical regions. The relation of brain serotonin turnover to serotonin transporter genotype and panic disorder severity were evaluated, and the influence of an SSRI drug, citalopram, on serotonin turnover investigated. Brain noradrenaline turnover in panic disorder patients was similar to that in healthy subjects. In contrast, brain serotonin turnover, estimated from jugular venous overflow of the metabolite, 5-hydroxyindole acetic acid, was increased approximately 4-fold in subcortical brain regions and in the cerebral cortex (P < 0.01). Serotonin turnover was highest in patients with the most severe disease, was unrelated to serotonin transporter genotype, and was reduced by citalopram (P < 0.01). Normal brain noradrenaline turnover in panic disorder patients argues against primary importance of the locus coeruleus in this condition. The marked increase in serotonin turnover, in the absence of a panic attack, possibly represents an important underlying neurotransmitter substrate for the disorder, although this point remains uncertain. Support for this interpretation comes from the direct relationship which existed between serotonin turnover and illness severity, and the finding that SSRI administration reduced serotonin turnover. Serotonin transporter genotyping suggested that increased whole brain

  10. Monitoring in traumatic brain injury.

    PubMed

    Matz, P G; Pitts, L

    1997-01-01

    In the past several years, improvements in technology have advanced the monitoring capabilities for patients with TBI. The primary goal of monitoring the patient with TBI is to prevent secondary insults to the brain, primarily cerebral ischemia. Cerebral ischemia may occur early and without clinical correlation and portends a poor outcome. Measurement of ICP is the cornerstone of monitoring in the patient with TBI. Monitoring of ICP provides a measurement of CPP and a rough estimation of CBF. However, with alterations in pressure autoregulation, measurement of CPP does not always allow for determination of CBF. To circumvent this problem, direct measurements of CBF can be performed using clearance techniques (133Xe, N2O, Xe-CT) or invasive monitoring techniques (LDF, TDF, NIRS). Although direct and quantitative, clearance techniques do not allow for continuous monitoring. Invasive CBF monitoring techniques are new, and artifactual results can be problematic. The techniques of jugular venous saturation monitoring and TCD are well established and are powerful adjuncts to ICP monitoring. They allow the clinician to monitor cerebral oxygen extraction and blood flow velocity, respectively, for any given CPP. Use of TCD may predict posttraumatic vasospasm before clinical sequelae. Jugular venous saturation monitoring may detect clinically occult episodes of cerebral ischemia and increased oxygen extraction. Jugular venous saturation monitoring optimizes the use of hyperventilation in the treatment of intracranial hypertension. Although PET and SPECT scanning allow direct measurement of CMRO2, these techniques have limited application currently. Similarly, microdialysis is in its infancy but has demonstrated great promise for metabolic monitoring. EEG and SEP are excellent adjuncts to the monitoring arsenal and provide immediate information on current brain function. With improvements in electronic telemetry, functional monitoring by EEG or SEP may become an important

  11. Ultrasonography-guided central venous catheterisation in haematological patients with severe thrombocytopenia

    PubMed Central

    Napolitano, Mariasanta; Malato, Alessandra; Raffaele, Francesco; Palazzolo, Manuela; Iacono, Giorgio Lo; Pinna, Roberto; Geraci, Girolamo; Modica, Giuseppe; Saccullo, Giorgia; Siragusa, Sergio; Cajozzo, Massimo

    2013-01-01

    Background Cannulation of the internal jugular vein (CVC) is a blind surface landmark-guided technique that could be potentially dangerous in patients with very low platelet counts. In such patients, ultrasonography (US)-guided CVC may be a valid approach. There is a lack of published data on the efficacy and safety of urgent US-guided CVC performed in haematological patients with severe thrombocytopenia. Materials and methods We retrospectively studied the safety of urgent CVC procedures in haematological patients including those with severe thrombocytopenia (platelet count <30×109/L). From January 1999 to June 2009, 431 CVC insertional procedures in 431 consecutive patients were evaluated. Patients were included in the study if they had a haematological disorder and required urgent CVC insertion. Patients were placed in Trendelenburg's position, an 18-gauge needle and guide-wire were advanced under real-time US guidance into the last part of the internal jugular vein; central venous cannulation of the internal jugular vein was performed using the Seldinger technique in all the procedures. Major and minor procedure-related complications were recorded. Results All 431 patients studied had haematological disorders: 39 had severe thrombocytopenia, refractory to platelet transfusion (group 1), while 392 did not have severe thrombocytopenia (group 2). The general characteristics of the patients in the two groups differed only for platelet count. The average time taken to perform the procedure was 4 minutes. Success rates were 97.4% and 97.9% in group 1 and group 2, respectively. No major complications occurred in either group. Discussion US-guided CVC is a safe and effective approach in haematological patients with severe thrombocytopenia requiring urgent cannulation for life support, plasma-exchange, chemotherapy and transfusion. PMID:23399356

  12. Minimally Invasive Monitoring of Chronic Central Venous Catheter Patency in Mice Using Digital Subtraction Angiography (DSA)

    PubMed Central

    Figueiredo, Giovanna; Fiebig, Teresa; Kirschner, Stefanie; Nikoubashman, Omid; Kabelitz, Lisa; Othman, Ahmed; Nonn, Andrea; Kramer, Martin; Brockmann, Marc A.

    2015-01-01

    Background Repetitive administration of medication or contrast agents is frequently performed in mice. The introduction of vascular access mini-ports (VAMP) for mice allows long-term vascular catheterization, hereby eliminating the need for repeated vessel puncture. With catheter occlusion being the most commonly reported complication of chronic jugular vein catheterization, we tested whether digital subtraction angiography (DSA) can be utilized to evaluate VAMP patency in mice. Methods Twenty-three mice underwent catheterization of the jugular vein and subcutaneous implantation of a VAMP. The VAMP was flushed every second day with 50 μL of heparinized saline solution (25 IU/ml). DSA was performed during injection of 100 μL of an iodine based contrast agent using an industrial X-ray inspection system intraoperatively, as well as 7±2 and 14±2 days post implantation. Results DSA allowed localization of catheter tip position, to rule out dislocation, kinking or occlusion of a microcatheter, and to evaluate parent vessel patency. In addition, we observed different ante- and retrograde collateral flow patterns in case of jugular vein occlusion. More exactly, 30% of animals showed parent vessel occlusion after 7±2 days in our setting. At this time point, nevertheless, all VAMPs verified intravascular contrast administration. After 14±2 days, intravascular contrast injection was verified in 70% of the implanted VAMPs, whereas at this point of time 5 animals had died or were sacrificed and in 2 mice parent vessel occlusion hampered intravascular contrast injection. Notably, no occlusion of the catheter itself was observed. Conclusion From our observations we conclude DSA to be a fast and valuable minimally invasive tool for investigation of catheter and parent vessel patency and for anatomical studies of collateral blood flow in animals as small as mice. PMID:26098622

  13. Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure).

    PubMed

    Caldentey, Guillem; Khairy, Paul; Roy, Denis; Leduc, Hugues; Talajic, Mario; Racine, Normand; White, Michel; O'Meara, Eileen; Guertin, Marie-Claude; Rouleau, Jean L; Ducharme, Anique

    2014-02-01

    This study sought to assess the prognostic value of physical examination in a modern treated heart failure population. The physical examination is the cornerstone of the evaluation and monitoring of patients with heart failure. Yet, the prognostic value of congestive signs (i.e., peripheral edema, jugular venous distension, a third heart sound, and pulmonary rales) has not been assessed in the current era. A post-hoc analysis was conducted on all 1,376 patients, 81% male, mean age 67 ± 11 years, with symptomatic left ventricular systolic dysfunction enrolled in the AF-CHF (Atrial Fibrillation and Congestive Heart Failure) trial. The prognostic value of baseline physical examination findings was assessed in univariate and multivariate Cox regression analyses. Peripheral edema was observed in 425 (30.9%), jugular venous distension in 297 (21.6%), a third heart sound in 207 (15.0%), and pulmonary rales in 178 (12.9%) patients. Death from cardiovascular causes occurred in 357 (25.9%) patients over a mean follow-up of 37 ± 19 months. All 4 physical examination findings were associated with cardiovascular mortality in univariate analyses (all p values <0.01). In multivariate analyses, taking all 4 signs as potential covariates, only rales (hazard ratio 1.41; 95% confidence interval: 1.07 to 1.86; p = 0.013) and peripheral edema (hazard ratio: 1.25; 95% confidence interval: 1.00 to 1.57; p = 0.048) were associated with cardiovascular mortality, independent of other variables. In the modern era, congestive signs on the physical examination (i.e., peripheral edema, jugular venous distension, a third heart sound, and pulmonary rales) continue to provide important prognostic information in patients with congestive heart failure. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  14. The distribution of TRPV1 and TRPV2 in the rat pharynx.

    PubMed

    Sasaki, Rika; Sato, Tadasu; Yajima, Takehiro; Kano, Mitsuhiro; Suzuki, Toshihiko; Ichikawa, Hiroyuki

    2013-07-01

    Immunohistochemistry for two nociceptive transducers, the transient receptor potential cation channel subfamily V members 1 (TRPV1) and 2 (TRPV2), was performed on the pharynx and its adjacent regions. TRPV1-immunoreactivity (IR) was detected in nerve fibers beneath and within the epithelium and/or taste bud-like structure. In the pharynx, these nerve fibers were abundant in the naso-oral part and at the border region of naso-oral and laryngeal parts. They were also numerous on the laryngeal side of the epiglottis and in the soft palate. TRPV2-IR was expressed by dendritic cells in the pharynx and epiglottis, as well as in the root of the tongue and soft palate. These cells were located in the epithelium and lamina propria. TRPV2-immunoreactive (IR) dendritic cells were numerous in the naso-oral part of the pharynx, epiglottis, and tongue. Abundance of TRPV2-IR dendritic processes usually obscured the presence of TRPV2-IR nerve fibers in these portions. However, some TRPV2-IR nerve fibers could be observed in the epithelium of the soft palate. Retrograde tracing method also revealed that sensory neurons which innervate the pharynx or soft palate were abundant in the jugular-petrosal ganglion complex and relatively rare in the nodose ganglion. In the jugular-petrosal ganglion complex, TRPV1- and TRPV2-IR were expressed by one-third of pharyngeal and soft palate neurons. TRPV2-IR was also detected in 11.5 % pharyngeal and 30.9 % soft palate neurons in the complex. Coexpression of TRPV1 and CGRP was frequent among pharyngeal and soft palate neurons. The present study suggests that TRPV1- and TRPV2-IR jugular-petrosal neurons may be associated with the regulation of the swallowing reflex.

  15. Bovine acute-phase response following different doses of corticotrophin-releasing hormone (CRH) challenge

    USDA-ARS?s Scientific Manuscript database

    Fourteen weaned, halter-trained Angus steers (BW = 191 ± 2.1 kg) were fitted with indwelling jugular catheter and rectal temperature monitoring device on d -1 of the study. On d 0, steers were ranked by body weight and randomly assigned to receive 1 of 3 infusion treatments (i.v.): 1) 0.1 micrograms...

  16. Care production for tuberculosis cases:analysis according to the elements of the Chronic Care Model.

    PubMed

    Silva, Daiane Medeiros da; Farias, Hérika Brito Gomes de; Villa, Tereza Cristina Scatena; Sá, Lenilde Duarte de; Brunello, Maria Eugênia Firmino; Nogueira, Jordana de Almeida

    2016-04-01

    To analyze the care provided to tuberculosis cases in primary health care services according to the elements of the Chronic Care Model. Cross-sectional study conducted in a capital city of the northeastern region of Brazil involving 83 Family Health Strategy professionals.A structured tool adapted to tuberculosis-related care in Brazil was applied.Analysis was based on the development of indicators with capacity to produce care varying between limited and optimum. The organization of care for tuberculosis and supported self-care presented reasonable capacity.In the coordination with the community, the presence of the community agent presented optimum capacity.Partnership with organizations of the community and involvement of experts presented limited capacity.The qualification of professionals, the system for scheduling and monitoring tuberculosis in the community, and the clinical information system presented basic capacity. The capacity of the primary health care services to produce tuberculosis-related care according to the elements of the Chronic Care Model is still limited.Overcoming the fragmentation of care and prioritizing a systemic operation between actions and services of the health care network remains as a major challenge. Analisar,segundo os elementos doChronicCareModel,a produção do cuidado aos casos de tuberculose nos serviços de Atenção Primária à Saúde. Estudo transversal, realizado em capital do nordeste brasileiro, envolvendo 83 profissionais da Estratégia Saúde da Família. Aplicou-se um instrumento estruturado, adaptado para atenção à tuberculose no Brasil. A análise pautou-se na construção de indicadores, cujacapacidade para produção de cuidados variou entre limitada a ótima. A organização da atenção à tuberculose e o autocuidado apoiado apresentaram capacidade razoável. Na articulação com a comunidade, a presençadoagente comunitário de saúde apresentou capacidade ótima. A parceria com organizações da

  17. [Semiotics of lesions of the cerebral venous collectors on application of noninvasive techniques of x-ray diagnosis].

    PubMed

    Semenov, S; Abalmasov, V

    2001-01-01

    The study included application of a complex of the noninvasive diagnostic techniques such as MR tomography, MR venography, duplex scanning of the internal jugular veins, and transcranial Doppler sonography. The authors provide a detailed description of the semiotics of the MR signs of cerebral venous collector lesion in patients with thrombosis, extravasal compression, aneurysms, and developmental anomalies. Present the quantitative ultrasound parameters of hemodynamics in the efferent vessels of the brain accessible to inspections describe the effect of spontaneous echo-opacification in the internal jugular veins, which is assumed to be a predictor of thrombosis. Intravenous injection of magnevist resulted in an appreciable refinement of visualization of small dural sinuses at MR venography thereby allowing for the diagnosis of their thrombosis. It is suggested that the use of the entire complex of the x-ray modalities under consideration may lead to a more complete and noninvasive evaluation of the nature of cerebral venous insufficiency and of the degree of hemodynamic significance. Moreover, this will make it possible to outline approaches to therapeutic or surgical correction of the disease.

  18. Necrotizing Lip Infection Causing Septic Thrombophlebitis of the Neck: A Rare Variant of Lemierre Syndrome.

    PubMed

    Cuddy, Karl; Saadat, Nariman; Khatib, Baber; Patel, Ashish

    2018-01-01

    Lemierre syndrome is an uncommon condition in which internal jugular vein thrombosis presents after recent oropharyngeal infection. Frequently, this is accompanied by septic emboli. This report outlines a variant of this disease process, with septic thrombophlebitis of the neck associated with a necrotizing skin infection of the lower lip and chin. A 25-year-old man with lower lip and chin swelling, initially managed with intravenous antibiotics, progressed to the development of a left facial vein thrombus, septic emboli to the lungs, and a necrotizing lower lip and chin infection that was managed with debridement, thrombectomy, and prolonged hemodynamic and pulmonary support. A necrotizing skin infection with thrombus of the jugular system and septic emboli is a very rare variant of Lemierre syndrome. Early recognition of an infection with septic emboli and/or necrotizing pathobiological findings allows for prompt antibiotic and surgical therapy, minimizing the mortality of these potentially lethal infections. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome.

    PubMed

    Benevides, Gabriel Núncio; Salgado, German Alcoba; Ferreira, Cristiane Rúbia; Felipe-Silva, Aloísio; Gilio, Alfredo Elias

    2015-01-01

    The symptoms of a previously healthy 14-year-old female with an initial history of tooth pain and swelling of the left maxillary evolved to a progressive headache and altered neurological findings characterized by auditory hallucinations, sleep disturbances, and aggressiveness. She was brought to the emergency department after 21 days of the initial symptoms. An initial computed tomography (CT) scan showed frontal subdural empyema with bone erosion. The symptoms continued to evolve to brain herniation 24 hours after admission. A second CT scan showed a left internal jugular vein thrombosis. The outcome was unfavorable and the patient died on the second day after admission. The autopsy findings depicted rarefaction of the cranial bone at the left side of the frontal sinus, and overt meningitis. The severe infection was further complicated by thrombophlebitis of the left internal jugular vein up to the superior vena cava with septic embolization to the lungs, pneumonia, and sepsis. This case report highlights the degree of severity that a trivial infection can reach. The unusual presentation of the sinusitis may have wrongly guided the approach of this unfortunate case.

  20. Endovascular Treatment of a Vertebral Artery Pseudoaneurysm in a Drug User

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mourikis, Dimitrios; Chatziioannou, Achilleas; Doriforou, Ortansia

    A 26-year-old drug abuser who presented with sepsis was found to have a pseudoaneurysm in the left vertebral artery. This aneurysm was presumed to be post-traumatic, since the patient reported multiple attempts to inject drugs in the left jugular vein 15 days prior to admission. The pseudoaneurysm was treated effectively with stent-graft placement.

  1. Interpretation of the microwave effect on induction time during CaSO4 primary nucleation by a cluster coagulation model

    NASA Astrophysics Data System (ADS)

    Guo, Zhichao; Li, Liye; Han, Wenxiang; Li, Jiawei; Wang, Baodong; Xiao, Yongfeng

    2017-10-01

    The effects of microwave on the induction time of CaSO4 are studied experimentally and theoretically. In the experiments, calcium sulfate is precipitated by mixing aqueous CaCl2 solution and Na2SO4 solution. The induction time is measured by recording the change of turbidity in solution. Various energy inputs are used to investigate the effect of energy input on nucleation. The results show that the induction time decreases with increasing supersaturation and increasing energy input. Employing the classical nucleation theory, the interfacial tension is estimated. In addition, the microwave effects on nucleation order (n) and nucleation coefficient (kN) are also investigated, and the corresponding values of homogeneous nucleation are compared with the values of heterogeneous nucleation in the microwave field. A cluster coagulation model, which brings together the classic nucleation models and the theories describing the behavior of colloidal suspension, was applied to estimate the induction time under various energy inputs. It is found that when nucleation is prominently homogeneous, the microwave energy input does not change the number of monomers in dominating clusters. And when nucleation is prominently heterogeneous, although the dominating cluster size increases with supersaturation increasing, at the same supersaturation level, the dominating cluster size remains constant in the microwave field.

  2. Shock induced reaction in Chicxulub target materials (CaSO4 and SiO2) and their relation to extinctions

    NASA Technical Reports Server (NTRS)

    Chen, Guangqing; Ahrens, Thomas J.

    1993-01-01

    The global platinum element rich layer, the presence of shocked quartz grains (in some cases with stishovite), and the observation of a tektite-rich layer, precisely at the K-T boundary, are the three major arguments for the extinction bolide impact hypothesis of Alvarez et al. Tektites (spherules) from Beloc in Haiti and Mimbral in Mexico received particular interest because of their geological proximity to the Chicxulub impact structure, which is a leading candidate for at least one of the K-T impact craters. Although in most localities the original glass has weathered to clay minerals, some shock-induced glass is found in outcrops and drill cores which is used for Ar-38/Ar-39 dating. The glassy tektites were found to be chemically similar and coeval at 65.0 Ma with Chicxulub melt rock. Two kinds of K-T spherules were discovered: (1) a silic black glass; and (2) a yellow glass, enriched in Ca, Mg, and S. The high sulfur content of the glass and the abundance of anhydrite (CaSO4) in the carbonate-evaporite sequence observed in Drill Holes Y-1 and Y-2 at Chicxulub prompted studies of calcium sulfate devolatization. Further discussion of our experiments is presented.

  3. Shock induced reaction in Chicxulub target materials (CaSO4 and SiO2) and their relation to extinctions

    NASA Astrophysics Data System (ADS)

    Chen, Guangqing; Ahrens, Thomas J.

    1993-03-01

    The global platinum element rich layer, the presence of shocked quartz grains (in some cases with stishovite), and the observation of a tektite-rich layer, precisely at the K-T boundary, are the three major arguments for the extinction bolide impact hypothesis of Alvarez et al. Tektites (spherules) from Beloc in Haiti and Mimbral in Mexico received particular interest because of their geological proximity to the Chicxulub impact structure, which is a leading candidate for at least one of the K-T impact craters. Although in most localities the original glass has weathered to clay minerals, some shock-induced glass is found in outcrops and drill cores which is used for Ar-38/Ar-39 dating. The glassy tektites were found to be chemically similar and coeval at 65.0 Ma with Chicxulub melt rock. Two kinds of K-T spherules were discovered: (1) a silic black glass; and (2) a yellow glass, enriched in Ca, Mg, and S. The high sulfur content of the glass and the abundance of anhydrite (CaSO4) in the carbonate-evaporite sequence observed in Drill Holes Y-1 and Y-2 at Chicxulub prompted studies of calcium sulfate devolatization. Further discussion of our experiments is presented.

  4. Cosmoeducação: uma proposta para o ensino de astronomia

    NASA Astrophysics Data System (ADS)

    Medeiros, L. A. L.; Jafelice, L. C.

    2003-08-01

    Entende-se por cosmoeducação o desenvolvimento vivencial da unidade homem-cosmo. Este conceito é norteado pela psicologia transpessoal, que estuda o ser humano em sua totalidade, onde suas relações ecológicas e cósmicas são de grande importância. Constata-se uma necessidade latente no ser humano moderno em resgatar uma relação holística com o Universo. Neste trabalho exploramos meios de cultivar a consciência de que o ser humano constitui parte integrante do cosmo e se relaciona com este com o objetivo de promover em si uma percepção ambiental mais ampla. Nossa hipótese de trabalho inicial foi que o ensino de conteúdos básicos em astronomia realizado através de uma abordagem holística, que incorpore práticas vivenciais correlacionadas àqueles conteúdos, pode despertar no indivíduo sua identidade cósmica. O método que utilizamos é o fenomenológico e o universo desta pesquisa é um grupo de estudantes da disciplina de Astronomia (Curso de Licenciatura em Geografia/UFRN), onde realizamos observação participante, entrevistas, depoimentos e as práticas vivenciais mencionadas. Neste caso estamos desenvolvendo e adaptando exercícios de algumas técnicas terapêuticas de psicologia transpessoal, que um de nós (LALM) tem aplicado no contexto clínico, para trabalhar aspectos cognitivos envolvidos naquele processo de conscientização cósmica. Resultados parciais claramente referendam a hipótese inicial. Um resultado a destacar é fruto de uma dinâmica de representação corporal interiorizada do eclipse lunar, envolvendo um pequeno grupo daqueles estudantes, na qual conteúdos míticos afloraram de maneira espontânea e contundente para todos, sugerindo ressonância, ou pelo menos isomorfismo, entre o macro e o microcosmo. Este e outros resultados são discutidos em detalhe neste trabalho. (PPGECNM/UFRN; PRONEX/FINEP; NUPA/USP; Temáticos/FAPESP).

  5. A distância e o conteúdo estelar da região HII gigante G333.1-0.4 - vínculos para a taxa de formação estelar da galáxia

    NASA Astrophysics Data System (ADS)

    Figuerêdo, E.; Damineli, A.; Blum, R.; Conti, P.

    2003-08-01

    Neste trabalho apresentamos imagens de alta resolução angular da região HII gigante G333.1-0.4 obtidas através dos filtros J, H e K no telescópio de 4-m do CTIO. Este trabalho faz parte de um estudo de regiões HII gigantes no infravermelho próximo que tem por objetivo estudar a natureza da formação de estrelas massivas e traçar a estrutura espiral de nossa galáxia. Nossa determinação da distância é baseada no método da paralaxe espectroscópica de estrelas OB localizadas na seqüência principal de idade zero (ZAMS) do Diagrama HR. No caso de G333.1-0.4, a magnitude aparente das estrelas localizadas na ZAMS indica que a distância não pode ser maior do que o limite inferior determinado por técnica rádio (2,8 kpc). Resultados semelhantes foram encontrados para regiões estudadas anteriormente, reforçando a idéia de que a taxa de formação estelar na Via Láctea é menor do que o determinado a partir de dados rádio. Nossos resultados mais recentes sobre o conteúdo estelar de G333.1-0.4 revelaram vários objetos que possuem cores bastante avermelhadas (H-K > 2,0). Nós identificamos estes objetos usando os diagramas cor-cor e cor-magnitude dos aglomerados. Estes objetos apresentam um forte excesso em emissão na banda K e possivelmente se tratam de estrelas do tipo OB envolvidas por um disco/envelope circumestelar espesso. O estudo da função de massa inical desta região, em conjunto com resultados de nossos trabalhos anteriores, aponta para uma IMF independente da posição galática. A contagem de estrelas nos fornece um valor para o número de fótons no contínuo de Lyman que corrobora com a afirmação de que G333.1-0.4 se encontra mais próxima da menor distância determinada por rádio.

  6. Outcome of renal transplantation from a donor with polycystic kidney disease.

    PubMed

    Migone, Silvia Regina da Cruz; Bentes, Camila Guerreiro; Nunes, Débora Bacellar Cruz; Nunes, Juliana Bacellar Cruz; Pinon, Rodolfo Marcial da Silva; Silva, Thales Xavit Souza E

    2016-01-01

    Faced with the long waiting list for a kidney transplant, the use of donors with expanded criteria, like polycystic kidneys, is an option that aims to increase in a short time the supply of kidneys for transplant. This report of two cases of transplants performed from a donor with polycystic kidneys showed promising results, and the receptors evolved with good renal function, serum creatinine measurements within the normal range and with adequate glomerular filtration rate, evaluated over a period of four years post transplant. This fact confirms that the option of using donors with polycystic kidneys is safe and gives good results. Resumo Diante da longa fila de espera por um transplante renal, a utilização de doadores com critério expandido, a exemplo de rins policísticos, torna-se uma opção que visa aumentar a oferta de rins para transplante a curto prazo. O presente relato de dois casos de transplantes realizados a partir de um doador com rins policísticos apresentou resultado promissor, tendo os receptores evoluído com boa função renal, dosagens de creatinina sérica dentro da faixa de normalidade e com taxa de filtração glomerular adequada, avaliados num período de quatro anos pós-transplante. Isto confirma que a opção da utilização de doadores com rins policísticos é segura e apresenta bons resultados.

  7. Surgical correction of ectopic penis and scrotum associated with bilateral orchidopexy.

    PubMed

    Sobral, Daniel Santos Rocha; Silva, Helder Damásio da; Damázio, Eulálio

    2017-01-01

    Ectopic penis is usually associated with penoscrotal transposition, and it is rarely observed in isolation. We report a surgical approach for an extremely rare case. A 10-year-old male patient with bilateral cryptorchidism and ectopic penis and scrotum in perineal area, with no penoscrotal transposition, representing an association not yet described in literature. A previous orchiopexy failed due to ectopic scrotum. By means of an inverted Y incision, the penis was mobilized and a perineal skin flap in form of a testicular sac was prepared. Finally orchiopexy was performed. The surgery was essential to treat cryptorchidism and to improve the self-image of the patient. RESUMO O pênis ectópico geralmente ocorre associado à transposição peno-escrotal, sendo raro isoladamente. Relatamos uma abordagem cirúrgica para um caso extremamente raro. Tratava-se de paciente do sexo masculino, 10 anos, com criptorquidia bilateral e pênis e escroto ectópicos, na região perineal, sem transposição peno-escrotal, representando uma associação ainda não descrita na literatura. Orquidopexia prévia sem sucesso, devido à ectopia do escroto. Por meio de uma incisão em Y invertido, mobilizou-se o pênis e preparou-se um retalho da pele perineal em forma de bolsa testicular. Por fim, realizou-se a orquidopexia. A cirurgia foi fundamental para tratar a criptorquidia e promover ganho na autoimagem do paciente.

  8. Surgical site infection in patients submitted to heart transplantation.

    PubMed

    Rodrigues, Jussara Aparecida Souza do Nascimento; Ferretti-Rebustini, Renata Eloah de Lucena; Poveda, Vanessa de Brito

    2016-08-29

    to analyze the occurrence and predisposing factors for surgical site infection in patients submitted to heart transplantation, evaluating the relationship between cases of infections and the variables related to the patient and the surgical procedure. retrospective cohort study, with review of the medical records of patients older than 18 years submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. the sample consisted of 86 patients, predominantly men, with severe systemic disease, submitted to extensive preoperative hospitalizations. Signs of surgical site infection were observed in 9.3% of transplanted patients, with five (62.5%) superficial incisional, two (25%) deep and one (12.5%) case of organ/space infection. There was no statistically significant association between the variables related to the patient and the surgery. there was no association between the studied variables and the cases of surgical site infection, possibly due to the small number of cases of infection observed in the sample investigated. analisar a ocorrência e os fatores predisponentes para infecção de sítio cirúrgico em pacientes submetidos a transplante cardíaco e verificar a relação entre os casos de infecção e as variáveis referentes ao paciente e ao procedimento cirúrgico. estudo de coorte retrospectivo, com exame dos prontuários médicos de pacientes maiores de 18 anos, submetidos a transplante cardíaco. A correlação entre variáveis foi realizada por meio dos testes exato de Fischer e de Mann-Whitney-Wilcoxon. a amostra foi constituída por 86 pacientes, predominantemente homens, com doença sistêmica grave, submetidos a internações pré-operatórias extensas. Apresentaram sinais de infecção do sítio cirúrgico 9,3% dos transplantados, sendo cinco (62,5%) incisionais superficiais, duas (25%) profundas e um (12,5%) caso de infecção de órgão/espaço. Não houve associa

  9. Cerebral Oxygen Saturation in Children With Congenital Heart Disease and Chronic Hypoxemia.

    PubMed

    Kussman, Barry D; Laussen, Peter C; Benni, Paul B; McGowan, Francis X; McElhinney, Doff B

    2017-07-01

    Increased hemoglobin (Hb) concentration accompanying hypoxemia is a compensatory response to maintain tissue oxygen delivery. Near infrared spectroscopy (NIRS) is used clinically to detect abnormalities in the balance of cerebral tissue oxygen delivery and consumption, including in children with congenital heart disease (CHD). Although NIRS-measured cerebral tissue O2 saturation (ScO2) correlates with arterial oxygen saturation (SaO2), jugular bulb O2 saturation (SjbO2), and Hb, little data exist on the interplay between these factors and cerebral O2 extraction (COE). This study investigated the associations of ScO2 and ΔSaO2-ScO2 with SaO2 and Hb and verified the normal range of ScO2 in children with CHD. Children undergoing cardiac catheterization for CHD were enrolled in a calibration and validation study of the FORE-SIGHT NIRS monitor. Two pairs of simultaneous arterial and jugular bulb samples were drawn for co-oximetry, calculation of a reference ScO2 (REF CX), and estimation of COE. Pearson correlation and linear regression were used to determine relationships between O2 saturation parameters and Hb. Data were also analyzed according to diagnostic group defined as acyanotic (SaO2 ≥ 90%) and cyanotic (SaO2 < 90%). Of 65 children studied, acceptable jugular bulb samples (SjbO2 absolute difference between samples ≤10%) were obtained in 57 (88%). The ΔSaO2-SjbO2, ΔSaO2-ScO2, and ΔSaO2-REF CX were positively correlated with SaO2 and negatively correlated with Hb (all P < .001). Although by diagnostic group ScO2 differed statistically (P = .002), values in the cyanotic patients were within the range considered normal (69% ± 6%). COE estimated by the difference between arterial and jugular bulb O2 content (ΔCaO2-CjbO2, mL O2/100 mL) was not different for cyanotic and acyanotic patients (P = .10), but estimates using ΔSaO2-SjbO2, ΔSaO2-ScO2, or ΔSaO2-ScO2/SaO2 were significantly different between the cyanotic and acyanotic children (P < .001). Children

  10. BSSDATA - um programa otimizado para filtragem de dados em radioastronomia solar

    NASA Astrophysics Data System (ADS)

    Martinon, A. R. F.; Sawant, H. S.; Fernandes, F. C. R.; Stephany, S.; Preto, A. J.; Dobrowolski, K. M.

    2003-08-01

    A partir de 1998, entrou em operação regular no INPE, em São José dos Campos, o Brazilian Solar Spectroscope (BSS). O BSS é dedicado às observações de explosões solares decimétricas com alta resolução temporal e espectral, com a principal finalidade de investigar fenômenos associados com a liberação de energia dos "flares" solares. Entre os anos de 1999 e 2002, foram catalogadas, aproximadamente 340 explosões solares classificadas em 8 tipos distintos, de acordo com suas características morfológicas. Na análise detalhada de cada tipo, ou grupo, de explosões solares deve-se considerar a variação do fluxo do sol calmo ("background"), em função da freqüência e a variação temporal, além da complexidade das explosões e estruturas finas registradas superpostas ao fundo variável. Com o intuito de realizar tal análise foi desenvolvido o programa BSSData. Este programa, desenvolvido em linguagem C++, é constituído de várias ferramentas que auxiliam no tratamento e análise dos dados registrados pelo BSS. Neste trabalho iremos abordar as ferramentas referentes à filtragem do ruído de fundo. As rotinas do BSSData para filtragem de ruído foram testadas nos diversos grupos de explosões solares ("dots", "fibra", "lace", "patch", "spikes", "tipo III" e "zebra") alcançando um bom resultado na diminuição do ruído de fundo e obtendo, em conseqüência, dados onde o sinal torna-se mais homogêneo ressaltando as áreas onde existem explosões solares e tornando mais precisas as determinações dos parâmetros observacionais de cada explosão. Estes resultados serão apresentados e discutidos.

  11. Descompresión microvascular en neuralgia del trigémino: Reporte de 36 casos y revisión de la literatura

    PubMed Central

    Campero, Alvaro; Ajler, Pablo; Campero, Abraham Agustín

    2014-01-01

    Objetivo: El propósito del presente trabajo es presentar los resultados de 36 pacientes con diagnóstico de neuralgia del trigémino (NT), en los cuales se realizó una descompresión microvascular (DMV). Material y Método: Desde junio de 2005 a mayo de 2012, 36 pacientes con diagnóstico de NT fueron operados por el primer autor (AC), realizando una DMV. Se evaluó: Edad, sexo, tiempo de sintomatología previo a la cirugía, hallazgos intraoperatorios (a través de los videos quirúrgicos), y resultados postoperatorios. Resultados: De los 36 pacientes operados, 25 fueron mujeres y 11 varones. El promedio de edad fue de 48 años. El seguimiento postoperatorio fue en promedio de 38 meses. De los 36 pacientes, 32 (88%) evolucionaron sin dolor hasta la fecha. De los 4 casos con recurrencia de dolor, en dos pacientes se observó como hallazgo intraoperatorio un conflicto venoso. Conclusión: La DMV como tratamiento de la NT es un procedimiento efectivo y seguro. El hallazgo intraoperatorio de una “compresión” venosa podría indicar una evolución postoperatoria desfavorable. PMID:25379343

  12. Annual Progress Report, Fiscal Year 1980

    DTIC Science & Technology

    1980-10-01

    Stress Rating Scales Heat Stroke Respiratory Control Hepatic Necrosis Survey Analysis Load Carriage Sustained/Continuous Operations Human Performances...wire placed percutaneously into one of the external jugular veins, under local anesthesia. Ventilatory measurements were made with the goat wearing a...electrical apparatus that produces positive air ions or in closed artificial environments which deplete negative air ions. Local positive ionization may

  13. [Cystic lesion of the dorsal mediastinum].

    PubMed

    Weinrich, M; Seidel, R; Graeter, T P; Schäfers, H-J; Lausberg, H F

    2005-09-01

    We present the case of a 52-year-old male who underwent thoracotomy for resection of a suspected bronchogenic cyst in the right posterior mediastinum. The size of the tumor had increased over years, according to repeated X-rays, and the cyst became symptomatic with obstruction of the right subclavian and jugular veins. To our surprise, histopathology revealed a hydatid cyst.

  14. CaSO4 Scale Inhibition by a Trace Amount of Zinc Ion in Piping System

    NASA Astrophysics Data System (ADS)

    Mangestiyono, W.; Sutrisno

    2017-05-01

    Usually, a small steam generator is not complemented by equipment such as demineralization and chlorination process apparatus since the economic aspect was a precedence. Such phenomenon was uncovered in a case study of green tea industrial process in which the boiler capacity was not more than 1 ton/hour. The operation of the small boiler affected the scaling process in its piping system. In a year operation, there was already a large scale of calcium attached to the inner surface of the pipe. Such large scale formed a layer and decreased the overall heat transfer coefficient, prolonged the process time and decreased the production. The aim of the current research was to solve the problem through a laboratory research to inhibit the CaSO4 scale formation by the addition of trace amounts of zinc ion. This research was conducted through a built in-house experimental rig which consisted of a dosing pump for controlling the flow rate and a thermocouple to control the temperature. Synthesis solution was prepared with 3,500 ppm concentration of CaCl2 and Na2SO4. The concentration of zinc was set at 0.00; 5.00 and 10.00 ppm. The data found were characterized by scanning electron microscopy (SEM) to analyze crystal polymorph as the influence of zinc ion addition. The induction time was also investigated to analyze the nucleation time, and it was found on the 9th, 13th, and 19th minute of the zinc ion addition of 0.00, 5.00 and 10.00 ppm. After running for a four-hour duration, the scale grow-rate was found to be 5.799; 5.501 and 4.950 × 10-3 gr/min for 0.00; 5.00 and 10.00 ppm of zinc addition at 50 °C.

  15. THE TYPES OF PALAEARCTIC HIPPORHININI (Coleoptera, Curculionidae, Cyclominae) CONSERVED AT THE MUSÉUM NATIONAL D'HISTOIRE NATURELLE, PARIS.

    PubMed

    Meregalli, Massimo; Perrin, Hélène

    2015-11-30

    The Palaearctic species of Curculionidae: Cyclominae: Hipporhinini conserved at the Muséum national d'Histoire Naturelle, Paris were critically revised in order to recognise the type specimens, select lectotypes or, where necessary, designate neotypes. Out of 135 species whose types were presumably preserved in the MNHN, original type specimens of 116 could be found. The holotypes of 21 species were available, either because originally designated as such, or because the species was unequivocally based on a single specimen; a paratype of another taxon, whose holotype is preserved in another collection, was also examined. The lectotypes of 93 species were designated, and a syntype of another species was also seen. Neotypes of 10 more species were designated, thus leading to a total number of species whose type is conserved at the MNHN to 126. Type specimens of five more species described by French authors, not present in the MNHN but conserved in other museums, were found as well and were included in the paper, with the further designation of three lectotypes. All types treated herein were labelled and photographed.

  16. Validation of the A&D UM-211 device for office blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Fania, Claudio; Albertini, Federica; Palatini, Paolo

    2017-10-01

    The aim of this study was to define the accuracy of UM-211, an automated oscillometric device for office use coupled to several cuffs for different arm sizes, according to the International Protocol of the European Society of Hypertension. The validation was performed in 33 individuals. Their mean age was 59.6±12.9 years, systolic blood pressure (BP) was 144.3±21.5 mmHg (range: 96-184 mmHg), diastolic BP was 86.8±18.5 mmHg (range: 48-124 mmHg), and arm circumference was 30.2±4.3 cm (range: 23-39 cm). Four sequential readings were taken by observers 1 and 2 using a double-headed stethoscope and a mercury sphygmomanometer, whereas three BP readings were taken by the supervisor using the test instrument. The differences between the readings provided by the device and the mean observer measurements were calculated. Therefore, each device measurement was compared with the previous and the next mean observer measurement. The validation results fulfilled all the 2010 European Society of Hypertension revision Protocol criteria for the general population and passed all validation grades. On average, the device overestimated systolic BP by 1.7±2.4 mmHg and diastolic BP by 1.7±2.5 mmHg. These data show that the UM-211 device coupled to several cuffs for different ranges of arm circumference met the requirements for validation according to the International Protocol and can be recommended for clinical use in the adult population. However, these results mainly apply to the use of the 22-32 and the 31-45 cm cuffs.

  17. The effect of adrenaline and noradrenaline on hormone secretion and blood flow from the thyroid vein in sheep with exteriorized thyroids.

    PubMed

    Falconer, I R

    1967-02-01

    1. Emotional stimulus to the sheep has previously been shown to cause increased thyroid hormone secretion; the influence of adrenaline and noradrenaline in this process has been investigated.2. Sheep bearing exteriorized thyroid glands on carotid artery-jugular vein loops were used. Thyroid vein blood was collected through a cannula in the jugular vein within the loop, and blood flow was measured by a plethysmographic technique.3. (131)I (50 muc) was injected intramuscularly (I.M.) into the sheep, and 4-7 days later the concentration of total and protein bound (131)I in thyroid vein blood was measured in samples taken every 10 min for 4 hr. Intracarotid injections of 1 mug, I.V. injections of 5 mug, or I.V. infusions at 10 mug/min for 10 min, of adrenaline or noradrenaline were administered 1.5 hr after commencement of sampling. Blood flow from the thyroid was measured in similar experiments.4. No significant changes in thyroid hormone secretion could be attributed to adrenaline or noradrenaline, and it was concluded that circulating catecholamines do not influence the release of thyroid hormone observed after brief emotional stimulus in the sheep.

  18. Reanalyzing the "far medial" (transcondylar-transtubercular) approach based on three anatomical vectors: the ventral posterolateral corridor.

    PubMed

    Chakravarthi, Srikant; Monroy-Sosa, Alejandro; Gonen, Lior; Fukui, Melanie; Rovin, Richard; Kojis, Nathaniel; Lindsay, Mark; Khalili, Sammy; Celix, Juanita; Corsten, Martin; Kassam, Amin B

    2018-06-01

    Endoscopic endonasal access to the jugular foramen and occipital condyle - the transcondylar-transtubercular approach - is anatomically complex and requires detailed knowledge of the relative position of critical neurovascular structures, in order to avoid inadvertent injury and resultant complications. However, access to this region can be confusing as the orientation and relationships of osseous, vascular, and neural structures are very much different from traditional dorsal approaches. This review aims at providing an organizational construct for a more understandable framework in accessing the transcondylar-transtubercular window. The region can be conceptualized using a three-vector coordinate system: vector 1 represents a dorsal or ventral corridor, vector 2 represents the outer and inner circumferential anatomical limits; in an "onion-skin" fashion, key osseous, vascular, and neural landmarks are organized based on a 360-degree skull base model, and vector 3 represents the final core or target of the surgical corridor. The creation of an organized "global-positioning system" may better guide the surgeon in accessing the far-medial transcondylar-transtubercular region, and related pathologies, and help understand the surgical limits to the occipital condyle and jugular foramen - the ventral posterolateral corridor - via the endoscopic endonasal approach.

  19. Difficulties of Distal Catheter Insertion of Ventriculoatrial Shunting in Infants and Little Children.

    PubMed

    Erdogan, Hakan; Altun, Adnan; Kuruoglu, Enis; Kaya, Ahmet Hilmi; Dagcinar, Adnan

    2017-09-26

    Ventriculoatrial (VA) shunting is a well-described cerebrospinal fluid diversion method for the treatment of hydrocephalus. However, it may be very challenging in infants and little children because of atrial catheter placement difficulties. This study aimed to create an algorithm to solve problems faced during open surgical procedures based on the present authors' experience. We conducted a retrospective analysis on 18 infants and children who underwent VA shunt insertion at the Department of Neurosurgery, Ondokuz Mayıs University School of Medicine Hospital between 2005 and 2012. Complications, clinical outcomes, revisions, and solutions for overcoming distal catheter placement difficulties were evaluated. Twenty-six VA shunt operations were performed in 18 patients. Six patients required eight VA shunt revisions. VA shunting was primarily performed from the internal jugular, facial, cephalic, and subclavian veins to the right atrium. In revision procedures, the internal jugular, cephalic, and subclavian veins were used. VA shunting in infants and little children requires careful surgical techniques. Neurosurgeons should necessarily have an appropriate strategy for VA shunting considering the complications and revisions. Our results suggest open surgical solutions to overcome distal catheter placement difficulties in this age group.

  20. Horner's syndrome in patients admitted to the intensive care unit that have undergone central venous catheterization: a prospective study.

    PubMed

    Butty, Z; Gopwani, J; Mehta, S; Margolin, E

    2016-01-01

    PurposeCentral venous catheterization (CVC) is estimated to be performed in millions of patients per year. Swan-Ganz catheters used for CVC are most often inserted into the internal jugular vein and during this procedure they may come into contact with the sympathetic chain. This study aims to determine the incidence of Horner's syndrome in patients admitted to intensive care unit that have undergone internal jugular CVC insertion during their admission and to determine whether ultrasonography-assisted insertion has decreased the frequency of this complication.Patients and methodsA total of 100 prospective patients admitted to the ICU were examined for the presence of anisocoria and ptosis after undergoing recent CVC. Presence of Horner's syndrome was confirmed by testing with 0.5% apraclonidine and looking for the reversal of anisocoria.ResultsFrequency of Horner's syndrome after CVC was 2% in a sample of 100 prospectively examined patients.ConclusionHorner's syndrome remains a relatively rare but definitive complication of CVC. ICU physicians should be educated about its existence and prevalence and ophthalmologists should inquire about any history of ICU admission necessitating CVC insertion in any patient presenting with Horner's syndrome.

  1. Association of the protein tyrosine phosphatase non-receptor 22 polymorphism (PTPN22) with endometriosis: a meta-analysis.

    PubMed

    Pabalan, Noel; Jarjanazi, Hamdi; Christofolini, Denise Maria; Bianco, Bianca; Barbosa, Caio Parente

    2017-01-01

    To evaluate PTPN22 C1858T polymorphism and the risk of endometriosis. A meta-analysis of 10 published case-control studies (from four articles), with a total sample of 971 cases and 1,181 controls, was performed. We estimated risk (odds ratio and 95% confidence intervals) of endometriosis associations with the C1858T polymorphism. A significant increased risk in all genetic models of the variant T allele with endometriosis (odds ratio: 3.14-5.55; p<0.00001-0.002) was found. The analysis without the study whose controls deviated from the Hardy-Weinberg equilibrium exacerbated these effects in the homozygous and recessive models (odds ratio: 7.19-9.45; p<0.00001-0.0002). In the Italian subgroup, a significant risk association was found in the homozygous and recessive models (odds ratio: 8.72-11.12; p=0.002). The associations observed between PTPN22 (C1858T) and the risk of endometriosis suggest this polymorphism might be a useful susceptibility marker for this disease. Avaliar o polimorfismo PTPN22 C1858T e o risco de endometriose. Foi realizada uma metanálise de 10 estudos caso-controle publicados (a partir de quatro artigos), com uma amostra total de 971 casos e 1.181 controles. O risco da associação da endometriose com o polimorfismo C1858T foi estimado em razão de chance e intervalo de confiança de 95%. Observou-se um aumento de risco significativo em todos os modelos genéticos com o alelo variante T e a endometriose (razão de chance: 3,14-5,55; p<0,00001-0,002). A análise sem incluir o estudo, em que os controles não estavam em equilíbrio de Hardy-Weinberg, mostrou aumento significativo nos modelos homozigotos e recessivos (razão de chance: 7,19-9,45; p<0,00001-0,0002). No subgrupo italiano, uma associação significativa foi encontrada considerando os modelos homozigoto e recessivo (razão de chance: 8,72-11,12; p=0,002). As associações observadas entre PTPN22 (C1858T) e o risco de endometriose sugerem que este polimorfismo pode ser um marcador de

  2. Journal of Special Operations Medicine, Volume 7, Edition 2, Spring 2007

    DTIC Science & Technology

    2007-01-01

    to help preclude dislodgement. Single-lumen central venous /jugular catheters are not difficult to place in an otherwise fit and well-conditioned MWD...progressively lost favor since the intro- duction of the Seldinger technique of central venous line placement. In fact, recent editions of the Advanced...latest advancements in medicine and the history of unconventional warfare medicine. Disclosure Statement: The JSOM presents both medical and nonmedical

  3. Journal of Special Operations Medicine, Volume 6, Edition 3

    DTIC Science & Technology

    2006-01-01

    between the lower leg muscular planes. These are often times located in multiple places and not radiographically detectable. Volume 6, Edition 3...tinged. Physical examination was remarkable for rales and rhonchi at the left base. There was no jugular venous distension or tracheal deviation... muscular or subcutaneous epinephrine are the first-line treatments for these rare but serious conditions; respi- ratory and intravascular fluid may

  4. [Lemierre's syndrome as differential diagnosis of lung cancer].

    PubMed

    Reinholdt Jensen, Jacob; Weinreich, Ulla Møller

    2012-05-28

    Lemierre's syndrome is a disseminated infection which is usually caused by Fusobacterium necrophorum. An oropharyngeal infection progresses to a septic thrombophlebitis of the internal jugular vein and later metastatic infections throughout the body occur. We present a clinical case in which a patient, initially presenting with symptoms characteristic of pulmonary cancer, turned out to have a rare variant of Lemierre's syndrome caused by Fusobacterium nucleatum.

  5. Telescópio de pequeno porte como suporte ao ensino em cidades com intensa poluição luminosa II

    NASA Astrophysics Data System (ADS)

    Pereira, P. C. R.; Santos-Júnior, J. M.; Cruz, W. S.

    2003-08-01

    Para a maioria dos estudantes, sua passagem pelo ensino formal fundamental envolve a transmissão de fatos que devem ser guardados para um exame, a habilidade para lembrar fórmulas e, eventualmente, a repetição de experimentos que devem produzir resultados exigidos pelo professor. O resultado deste modelo de ensino, ao longo dos anos, é conhecido por todos: desconhecimento e descontentamento, por parte dos estudantes, de temas relativos ao papel e aos processos da ciência. Acreditamos que a Astronomia, pelo seu caráter observacional, é uma das áreas do conhecimento que pode contribuir neste cenário. A Fundação Planetário da Cidade do Rio de Janeiro possui um telescópio Meade LX-200 (25cm) que, juntamente com as câmeras CCD ST-7E e ST8E, tem sido utilizado em projetos voltados aos estudantes do ensino médio desde o ano 2000. Tais projetos envolvem a condução de um projeto de pesquisa observacional num nível apropriado, e possibilitam o contato com técnicas e novas tecnologias: computador, software para manipulação de dados e gráficos, programas de tratamento e redução de dados, uso de equipamentos óptico-eletrônicos (telescópio e CCD), bem como o processo de aquisição de conhecimento. Dentro da proposta dos anos anteriores, priorizamos projetos de uma noite, ou seja, procuramos trabalhar com fenômenos que apresentem variabilidade com intervalo de recorrência relativamente curto. Em todos os casos, optamos pela fotometria diferencial, que tem se mostrado bastante eficiente para o céu luminoso como o da cidade do Rio de Janeiro. Neste painel, apresentamos alguns dos projetos desenvolvidos no último ano, com 25 estudantes. Apresentamos os resultados da observação da variável pulsante AI Vel (V = 6,6) e da variável cataclísmica FO Aqr (V = 13,5), e do monitoramento do trânsito da lua de Júpiter, Europa, ocorrido em 30 de abril de 2003. As curvas de luz produzidas para as primeiras estão concordantes com as da literatura, assim

  6. Brachial insertion of fully implantable venous catheters for chemotherapy: complications and quality of life assessment in 35 patients.

    PubMed

    Fonseca, Igor Yoshio Imagawa; Krutman, Mariana; Nishinari, Kenji; Yazbek, Guilherme; Teivelis, Marcelo Passos; Bomfim, Guilherme André Zottele; Cavalcante, Rafael Noronha; Wolosker, Nelson

    2016-01-01

    complicações pós-operatórias precoces, ocorridas em até 30 dias após o implante. A avaliação do grau de satisfação foi realizada com base na aplicação de um questionário específico já utilizado em estudos prévios. Em todos os casos, a punção ecoguiada da veia basílica foi possível, e o procedimento foi concluído com sucesso. As complicações precoces observadas incluíram um caso de tromboflebite de basílica e um de infecção de bolsa, ambos tratados clinicamente sem necessidade de retirada do dispositivo. Dos 35 pacientes interrogados, 33 (94,3%) recomendariam o dispositivo para outras pessoas. A implantação do port braquial é uma opção factível, com baixo risco intraoperatório e taxas semelhantes de complicações pós-operatórias imediatas quando comparada a dados já existentes da técnica convencional. Os pacientes estudados apresentaram-se satisfeitos com o dispositivo e recomendariam o procedimento para outras pessoas.

  7. Determinants of infant mortality in the Jequitinhonha Valley and in the North and Northeast regions of Brazil.

    PubMed

    Leal, Maria do Carmo; Bittencourt, Sonia Duarte de Azevedo; Torres, Raquel Maria Cardoso; Niquini, Roberta Pereira; Souza, Paulo Roberto Borges de

    2017-03-02

    das regiões Norte, Nordeste e Sudeste do Brasil. Trata-se de um estudo caso-controle com 803 casos de óbito de menores de um ano e 1.969 nascidos vivos (controles), cujas mães residiam em 2008 nos municípios selecionados. As listas nominais dos casos e do controles foram extraídas do Sistema de Informação sobre Mortalidade e do Sistema de Informação sobre Nascidos Vivos e completadas por dados obtidos pela pesquisa de "busca ativa de óbito e nascimento". A coleta de dados foi realizada em domicílio por meio de questionário semiestruturado, e a análise, por meio de regressão logística múltipla. O modelo final indicou que estão associadas positivamente e significativamente ao óbito infantil: a família trabalhar na agricultura, a mãe ter tido história de perdas fetais e infantis, não ter feito pré-natal ou ter tido um pré-natal inadequado e não estar vinculada à maternidade durante o pré-natal. Foram observadas interações significativas para explicar a ocorrência do óbito infantil entre cor de pele e escore socioeconômico e entre gestação classificada como de risco e peregrinação para o parto. O número excessivo de partos domiciliares e de peregrinação para o parto indica falhas na linha de cuidado da gestante e desarticulação entre os níveis de atenção ambulatorial e hospitalar. O estudo reforça a necessidade de uma gestão integrada das redes de atenção à saúde, potencializando as capacidades municipais em atender, com qualidade, à gestação, ao parto e ao nascimento.

  8. Life-cycle optimization model for distributed generation in buildings

    NASA Astrophysics Data System (ADS)

    Safaei, Amir

    afetado por perturbacoes relativas aos custos de combustivel. A aplicacao do modelo proposto foi testada num caso de estudo real, um edificio comercial localizado na cidade de Coimbra, em Portugal.

  9. Thermoluminescence, ESR and x-ray diffraction studies of CaSO4 : Dy phosphor subjected to post preparation high temperature thermal treatment

    NASA Astrophysics Data System (ADS)

    Bakshi, A. K.; Patwe, S. J.; Bhide, M. K.; Sanyal, B.; Natarajan, V.; Tyagi, A. K.; Kher, R. K.

    2008-01-01

    Thermoluminescence (TL), electron spin resonance (ESR) and x ray diffraction studies of CaSO4 : Dy phosphor subjected to post preparation high temperature treatment were carried out. Analysis of the TL glow curve indicated that the dosimetric glow peak at 240 °C reduces, whereas the low temperature satellite peak increases with the increase in the annealing temperature in the range 650-1000 °C. The influence of the annealing atmosphere on the TL glow curve structure was also observed. Reduction of the photoluminescence intensity of the annealed phosphor indicated that the environment of Dy3+ ions might have undergone some change due to high temperature treatment. Reduction in the ESR signal intensity corresponding to O_{3}^{-} and SO_{3}^{-} radicals was observed initially with the increase in the annealing temperaure; subsequently their intensity increased with temperature. Signals due to the SO_{4}^{-} radical vanished, when the phosphor was annealed beyond 800 °C. A signal corresponding to SH2- radicals was also observed in the ESR spectra for samples subjected to annealing in the temperature regime 800-1000 °C. XRD of the in situ annealed phosphor showed a change in the unit cell parameters. An endothermic peak at 860 °C in the DTA spectrum was observed.

  10. Effects of Ginkgo biloba extract on cerebral oxygen and glucose metabolism in elderly patients with pre-existing cerebral ischemia.

    PubMed

    Xu, Lili; Hu, Zhiyong; Shen, Jianjun; McQuillan, Patrick M

    2015-04-01

    Cerebral injury caused by hypoperfusion during the perioperative period is one of the main causes of disability and death in patients after major surgery. No effective protective or preventative strategies have been identified. This study was designed to evaluate the effects of Ginkgo biloba extract on cerebral oxygen and glucose metabolism in elderly patients with known, pre-existing cerebral ischemia. Sixty ASA (American Society of Anesthesiologists) II-III patients, diagnosed with vertebral artery ischemia by transcranial Doppler ultrasonography (TCD), and scheduled for elective total hip replacement surgery, were enrolled in the study. They were randomly allocated to receive either 1mg/kg Ginkgo biloba extract (G group n=30) or normal saline (D group n=30) after induction of anesthesia. Blood samples were collected from radial artery and jugular venous bulb catheters for blood gas analysis and determination of glucose and lactate concentrations preoperatively, before surgical incision, at the end of surgery, and on post-op day 1. Arterial O2 content (CaO2), jugular venous O2 content (CjvO2), arteriovenous O2 content difference (Da-jvO2), cerebral oxygen extraction rate (CEO2), and arteriovenous glucose and lactate content differences (Da-jvGlu and Da-jvLac) were calculated. There were no significant differences in CaO2 or Da-jvGlu during surgery between groups (p>0.05). However, the Ginkgo group had higher CjvO2, internal jugular venous oxygen saturation (SjvO2) and lower CEO2, Da-jvO2 and Da-jvLac at the end of surgery (T2) and on post-op day 1 (T3) than those in the control group (p<0.05). Ginkgo biloba extract can improve cerebral oxygen supply, decrease cerebral oxygen extraction rate and consumption, and help maintain the balance between cerebral oxygen supply and consumption. It has no effect, however, on cerebral glucose metabolism in elderly patients with known, pre-existing cerebral ischemia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Patterns of chronic venous insufficiency in the dural sinuses and extracranial draining veins and their relationship with white matter hyperintensities for patients with Parkinson's disease.

    PubMed

    Liu, Manju; Xu, Haibo; Wang, Yuhui; Zhong, Yi; Xia, Shuang; Utriainen, David; Wang, Tao; Haacke, E Mark

    2015-06-01

    Idiopathic Parkinson's disease (IPD) remains one of those neurodegenerative diseases for which the cause remains unknown. Many clinically diagnosed cases of IPD are associated with cerebrovascular disease and white matter hyperintensities (WMHs). The purpose of this study was to investigate the presence of transverse sinus and extracranial venous abnormalities in IPD patients and their relationship with brain WMHs. Twenty-three IPD patients and 23 age-matched normal controls were recruited in this study. They had conventional neurologic magnetic resonance structural and angiographic scans and, for blood flow, quantification of the extracranial vessels. Venous structures were evaluated with two-dimensional time of flight; flow was evaluated with two-dimensional phase contrast; and WMH volume was quantified with T2-weighted fluid-attenuated inversion recovery. The IPD and normal subjects were classified by both the magnetic resonance time-of-flight and phase contrast images into four categories: (1) complete or local missing transverse sinus and internal jugular veins on the time-of-flight images; (2) low flow in the transverse sinus and stenotic internal jugular veins; (3) reduced flow in the internal jugular veins; and (4) normal flow and no stenosis. Broken into the four categories with categories 1 to 3 combined, a significant difference in the distribution of the IPD patients and normal controls (χ(2) = 7.7; P < .01) was observed. Venous abnormalities (categories 1, 2, and 3) were seen in 57% of IPD subjects and in only 30% of controls. In IPD subjects, category type correlated with both flow abnormalities and WMHs. From this preliminary study, we conclude that a major fraction of IPD patients appear to have abnormal venous anatomy and flow on the left side of the brain and neck and that the flow abnormalities appear to correlate with WMH volume. Studies with a larger sample size are still needed to confirm these findings. Copyright © 2015 Society for Vascular

  12. Characterization of kinin receptors by bioassays.

    PubMed

    Gobeil, F; Regoli, D

    1994-08-01

    1. Using the classical pharmacological criteria recommended by Schild, namely the order of potency of selective agonists (e.g., bradykinin, desArg9-bradykinin, [Hyp3]BK and [Aib7]BK) and the apparent affinity of competitive antagonists (e.g., DArg[Hyp3,DPhe7,Leu8]BK and WIN 64338), we have attempted to characterize B2 receptor subtypes. It has been shown that vascular tissues (e.g., dog carotid and renal arteries, rabbit jugular vein and rabbit aorta) are very sensitive to kinin agonists and antagonists (pD2 and pA2 values for BK and HOE 140 on B2 receptors are 8.5-10.1 and 9.2-9.4, respectively, and for desArg9BK and desArg9[Leu8]BK on B1 receptors they are 7.3-8.6 and 7.3-7.8, respectively). Mechanisms of action of kinins differ between pharmacological preparations. Kinin may act directly on the smooth muscle (e.g., rabbit jugular vein and rabbit aorta) as well as indirectly through other endogenous mediators such as nitric oxide (EDRF) (e.g., dog carotid and renal arteries) and prostaglandins (e.g., dog renal artery). 2. Pharmacological analysis of rabbit jugular vein (RJV) and guinea pig ileum (GPI) has revealed different sensitivities to certain synthetic analogs of BK and to competitive B2 receptor antagonists between the two tissues. 3. Agonist order of potency ([Hyp3]BK > BK > [Aib7]BK) obtained for RJV differed from that obtained for GPI (BK > or = [Aib7]BK > [Hyp3]BK). Competitive antagonists such as DArg[Hyp3, DPhe7, Leu8]BK and WIN 64338 discriminate in favor of B2A (RJV) and B2B (GPI) receptor subtypes, respectively. These data demonstrate the existence of B2 receptor subtypes. Correlation between data obtained in the present study and those reported for binding to the human B2 receptor support the view that the human receptor is similar to that of the rabbit.

  13. Evaluating the effects of protective ventilation on organ-specific cytokine production in porcine experimental postoperative sepsis.

    PubMed

    Sperber, Jesper; Lipcsey, Miklós; Larsson, Anders; Larsson, Anders; Sjölin, Jan; Castegren, Markus

    2015-05-10

    Protective ventilation with lower tidal volume (VT) and higher positive end-expiratory pressure (PEEP) reduces the negative additive effects of mechanical ventilation during systemic inflammatory response syndrome. We hypothesised that protective ventilation during surgery would affect the organ-specific immune response in an experimental animal model of endotoxin-induced sepsis-like syndrome. 30 pigs were laparotomised for 2 hours (h), after which a continuous endotoxin infusion was started at 0.25 micrograms × kg(-1) × h(-1) for 5 h. Catheters were placed in the carotid artery, hepatic vein, portal vein and jugular bulb. Animals were randomised to two protective ventilation groups (n = 10 each): one group was ventilated with VT 6 mL × kg(-1) during the whole experiment while the other group was ventilated during the surgical phase with VT of 10 mL × kg(-1). In both groups PEEP was 5 cmH2O during surgery and increased to 10 cmH2O at the start of endotoxin infusion. A control group (n = 10) was ventilated with VT of 10 mL × kg(-1) and PEEP 5 cm H20 throughout the experiment. In four sample locations we a) simultaneously compared cytokine levels, b) studied the effect of protective ventilation initiated before and during endotoxemia and c) evaluated protective ventilation on organ-specific cytokine levels. TNF-alpha levels were highest in the hepatic vein, IL-6 levels highest in the artery and jugular bulb and IL-10 levels lowest in the artery. Protective ventilation initiated before and during endotoxemia did not differ in organ-specific cytokine levels. Protective ventilation led to lower levels of TNF-alpha in the hepatic vein compared with the control group, whereas no significant differences were seen in the artery, portal vein or jugular bulb. Variation between organs in cytokine output was observed during experimental sepsis. We see no implication from cytokine levels for initiating protective ventilation before endotoxemia. However, during endotoxemia

  14. Risk factors for acute adverse events during ultrasound-guided central venous cannulation in the emergency department.

    PubMed

    Theodoro, Daniel; Krauss, Missy; Kollef, Marin; Evanoff, Bradley

    2010-10-01

    Ultrasound (US) greatly facilitates cannulation of the internal jugular vein. Despite the ability to visualize the needle and anatomy, adverse events still occur. The authors hypothesized that the technique has limitations among certain patients and clinical scenarios. The purpose of this study was to identify characteristics of adverse events surrounding US-guided central venous cannulation (CVC). The authors assembled a prospective observational cohort of emergency department (ED) patients undergoing consecutive internal jugular CVC with US. The primary outcome of interest was a composite of acute mechanical adverse events including hematoma, arterial cannulation, pneumothorax, and unsuccessful placement. Physicians performing the CVC recorded anatomical site, reason for insertion, and acute complications. The patients with catheters were followed until the catheters were removed based on radiographic evidence or hospital nursing records. ED charts and pharmacy records contributed variables of interest. A self-reported online survey provided physician experience information. Logistic regression was used to calculate the odds of an adverse outcome.   Physicians attempted 289 CVCs on 282 patients. An adverse outcome occurred in 57 attempts (19.7%, 95% confidence interval [CI] = 15.5 to 24.7), the most common being 31 unsuccessful placements (11%, 95% CI = 7.7 to 14.8). Patients with a history of end-stage renal disease (odds ratio [OR] = 3.54, 95% CI = 1.59 to 7.89), and central lines placed by operators with intermediate experience (OR = 2.26, 95% CI = 1.19 to 4.32), were most likely to encounter adverse events. Previously cited predictors such as body mass index (BMI), coagulopathy, and pulmonary hyperinflation were not significant in our final model. Acute adverse events occurred in approximately one-fifth of US-guided internal jugular central line attempts. The study identified both patient (history of end-stage renal disease) and physician (intermediate

  15. Cerebral hypoxia during cardiopulmonary bypass: a magnetic resonance imaging study.

    PubMed

    Mutch, W A; Ryner, L N; Kozlowski, P; Scarth, G; Warrian, R K; Lefevre, G R; Wong, T G; Thiessen, D B; Girling, L G; Doiron, L; McCudden, C; Saunders, J K

    1997-09-01

    Neurocognitive deficits after open heart operations have been correlated to jugular venous oxygen desaturation on rewarming from hypothermic cardiopulmonary bypass (CPB). Using a porcine model, we looked for evidence of cerebral hypoxia by magnetic resonance imaging during CPB. Brain oxygenation was assessed by T2*-weighted imaging, based on the blood oxygenation level-dependent effect (decreased T2*-weighted signal intensity with increased tissue concentrations of deoxyhemoglobin). Pigs were placed on normothermic CPB, then cooled to 28 degrees C for 2 hours of hypothermic CPB, then rewarmed to baseline temperature. T2*-weighted, imaging was undertaken before CPB, during normothermic CPB, at 30-minute intervals during hypothermic CPB, after rewarming, and then 15 minutes after death. Imaging was with a Bruker 7.0 Tesla, 40-cm bore magnetic resonance scanner with actively shielded gradient coils. Regions of interest from the magnetic resonance images were analyzed to identify parenchymal hypoxia and correlated with jugular venous oxygen saturation. Post-hoc fuzzy clustering analysis was used to examine spatially distributed regions of interest whose pixels followed similar time courses. Attention was paid to pixels showing decreased T2* signal intensity over time. T2* signal intensity decreased with rewarming and in five of seven experiments correlated with the decrease in jugular venous oxygen saturation. T2* imaging with fuzzy clustering analysis revealed two diffusely distributed pixel groups during CPB. One large group of pixels (50% +/- 13% of total pixel count) showed increased T2* signal intensity (well-oxygenated tissue) during hypothermia, with decreased intensity on rewarming. Changes in a second group of pixels (34% +/- 8% of total pixel count) showed a progressive decrease in T2* signal intensity, independent of temperature, suggestive of increased brain hypoxia during CPB. Decreased T2* signal intensity in a diffuse spatial distribution indicates that

  16. Otimização de procedimento de manobra para indução de reentrada de um satélite retornável

    NASA Astrophysics Data System (ADS)

    Schulz, W.; Suarez, M.

    2003-08-01

    Veículos espaciais que retornam à Terra passam por regimes de velocidade e condições de vôo distintos. Estas diferenças dificultam sua concepção aerodinâmica e o planejamento de seu retorno. A partir de uma proposta de um veículo orbital retornável (satélite SARA, em desenvolvimento no IAE/CTA) para realização de experimentos científicos e tecnológicos em ambiente de baixa gravidade, surge a necessidade de realizarem-se estudos considerando-se os aspectos relativos à sua aerodinâmica. Após o lançamento, o veículo deve permanecer em órbita pelo tempo necessário para a condução de experimentos, sendo depois direcionado à Terra e recuperado em solo. A concepção aerodinâmica é de importância para o vôo em suas diversas fases e deve considerar aspectos relativos à estabilização Aerodinâmica e ao arrasto atmosférico, sendo este último de importância crucial na análise do aquecimento a ser enfrentado. A manobra de retorno inclui considerações sobre as condições atmosféricas e dinâmica de reentrada, devendo ser calculada de forma mais precisa possível. O trabalho proposto avalia estudos da dinâmica de vôo de um satélite recuperável considerando aspectos relativos à determinação orbital com GPS, técnica utilizada com sucesso na CONAE, e seu comportamento aerodinâmico em vôo balístico de retorno, com ênfase em sua fase de reentrada atmosférica. Busca-se otimizar a manobra de reentrada de tal forma que a utilização do sistema GPS garanta minimizar a área de impacto com o solo.

  17. Severe maternal morbidity: a case-control study in Maranhao, Brazil

    PubMed Central

    2013-01-01

    Background Maternal mortality and morbidity are among the top public health priorities in Brazil, being quite high, especially among the most disadvantage women. A case control study was developed to identify risk factors for severe maternal morbidity in Sao Luis, one of the poorest Brazilian State Capitals. Methods The case–control study was carried out between 01/03/2009 and 28/02/2010 in two public high-risk maternities facilities and in two intensive care units (ICUs) for referral of obstetric cases. All cases hospitalized due to complications during gestation period, childbirth or up to 42 days of puerperium and who fulfilled any of Mantel's and/or Waterstone's criteria were identified. Two controls per case were randomly selected among patients of the same clinics discharged for other reasons. Data were obtained through a structured interview as well as from medical charts and prenatal cards and included sociodemographic variables, clinical and obstetric histories, behavioral factors and exposure to stress factors during pregnancy, pre-natal assistance and obstetric complication and childbirth care. Results In the final model of the unconditional logistic regression analysis, being older than 35 years (OR=3.11; 95% CI:1.53-6.31), previous hypertension (OR=2.52; 95% CI:1.09-5.80), history of abortion (OR=1.61; 95% CI:0.97-2.68), 4–5 pre-natal consultations (OR=1.78; 95% CI:1.05-3.01) and 1–3 pre-natal consultations (OR=1.89; 95% CI:1.03-3.49) were independently associated with severe maternal morbidity. Conclusions The results corroborate the importance of reproductive healthcare, of identifying a high-risk pregnancy and of a qualified and complete prenatal care to prevent severe morbid events. Resumo Introdução A mortalidade e morbidade maternas estão entre os tópicos prioritários da Saúde Pública brasileira, especialmente na população de menor nível socioeconômico. Um estudo caso-controle foi desenvolvido para identificar os fatores de risco

  18. MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A CLINICAL UPDATE.

    PubMed

    Sobrado, Carlos Walter; Sobrado, Lucas Faraco

    2016-01-01

    azathioprine. A surgical procedure is indicated for selected cases. A colite aguda grave é emergência médica, potencialmente letal e o seu tratamento permanece ainda nos dias de hoje um desafio para o clínico e cirurgião. A corticoterapia intravenosa introduzida no arsenal terapêutico na década de 50 permanece como primeira linha de tratamento, e nos pacientes refratários a tal medida, a terapia de resgate pode ser com medidas clínicas ou colectomia de urgência. Avaliar os resultados da terapia de resgate medicamentosa (ciclosporina, infliximabe e tracolimus), suas indicações e resultados, e sugerir um guia prático para abordagem clínica. Foi realizada revisão na literatura utilizando as bases Medline/Pubmed, Cochrane Library, Scielo, e informações adicionais em sites institucionais de interesse cruzando os descritores: colite aguda grave, colite fulminante e tratamento. O tratamento da colite aguda grave tem evitado a colectomia em 60- 70% dos casos, desde que iniciado precocemente e com acompanhamento multidisciplinar. A ciclosporina intravenosa apesar de seus efeitos adversos, tem sido indicada naqueles casos mais graves com risco iminente de colectomia, pela sua rapidez de ação, meia-vida curta, e não aumentar os riscos de complicações cirúrgicas. A terapia com infliximabe tem sido reservada para os casos menos graves e naqueles em uso ou já expostos a imunossupressores (AZA/6-MP). A facilidade terapêutica, seus bons resultados a curto e médio prazo, a possibilidade de terapia de manutenção e também por agir como "ponte" para ação de imunossupressores (AZA/6-MP) tem recentemente favorecido a indicação de biológicos. A colectomia fica reservada para casos que não apresentaram resposta a terapia de resgate após cinco a sete dias de tratamento e nas complicações (megacólon tóxico, hemorragia profusa e perfuração). s: Os pacientes com boa resposta à terapia de resgate e não submetidos à operações de urgência, deverão ser

  19. STRATEGIES IN SEARCH FOR INTERNATIONAL PARTNERSHIPS.

    PubMed

    Freitas, Denise de

    2015-01-01

    Internationalization is the process which integrates universal, intercultural or global dimension in a program, in this case, postgraduate. It can be understood as the process of increasing participation in international operations. To offer design and motivational logistics on how to run a process of international scientific relationship. It is necessary to develop several different aspects to be reached internationalization: to know the fundamentals of internationalization; to have international vision; to promote strategy for internationalization; to know the characteristics of an institutional center of internationalization; and to understand the institutional advantages of internationalization. Internationalization is essential to aerate the Brazilian postgraduate and not mischaracterize or weakens the process. On the contrary, it contributes to increase its vitality and capacity for innovation. Today is not possible to imagine science without internationalization. A internacionalização é o processo no qual se integra dimensão universal, intercultural ou global em um programa, no caso, de pós-graduação. Ela pode ser compreendida como o processo de participação crescente em operações internacionais. Apresentar concepção logística e motivacional de como executar um processo de relações científicas internacionais. É necessário o desenvolvimento de vários e diferentes aspectos para ser alcançada a internacionalização: conhecer os grandes eixos da internacionalização; ter visão internacional; promover estratégia para a internacionalização; saber das características de um centro institucional de internacionalização; e conhecer as vantagens institucionais da internacionalização. A internacionalização é imprescindível para arejar a pós-graduação brasileira e não a descaracteriza, menospreza ou enfraquece. Ao contrário, contribui para aumentar sua vitalidade e capacidade de inovação. Na atualidade não dá para imaginar a ci

  20. Mineral chemistry and geochemistry of ophiolitic metaultramafics from Um Halham and Fawakhir, Central Eastern Desert, Egypt

    NASA Astrophysics Data System (ADS)

    Abdel-Karim, Abdel-Aal M.; Ali, Shehata; El-Shafei, Shaimaa A.

    2018-03-01

    This study is focused on ophiolitic metaultramafics from Um Halham and Fawakhir, Central Eastern Desert of Egypt. The rocks include serpentinized peridotites, serpentinites together with talc- and quartz-carbonates. The primary spinel relict is Al-chromite [Cr# > 60], which is replaced by Cr-magnetite during metamorphism. The high Cr# of Al-chromites resembles supra-subduction zone (SSZ) peridotites and suggests derivation from the deeper portion of the mantle section with boninitic affinity. These mantle rocks equilibrated with boninitic melt have been generated by high melting degrees. The estimated melting degrees ( 19-24%) lie within the range of SSZ peridotites. The high Cr# of spinel and Fo content of olivine together with the narrow compositional range suggest a mantle residual origin. Serpentinized peridotite and serpentinites have low Al2O3/SiO2 ratios (mostly < 0.03) like fore-arc mantle wedge serpentinites and further indicate that their mantle protolith had experienced partial melting before serpentinization process. Moreover, they have very low Nb, Ta, Zr and Hf concentrations along with sub-chondritic Nb/Ta (0.3-16) and Zr/Hf (mostly 1-20) ratios further confirming that their mantle source was depleted by earlier melting extraction event. The high chondrite normalized (La/Sm)N ratios (average 10) reflect input of subduction-related slab melts/fluids into their mantle source.

  1. Comparison of Venous Return Characteristics with Right Ventricular Mechanics During Cephalic Fluid Shift

    NASA Technical Reports Server (NTRS)

    Elliott, Morgan; Martin, David

    2015-01-01

    For my summer internship project, I organized a pilot study to analyze the effects of a cephalic fluid shift on venous return and right ventricular mechanics to increase right ventricular and venous knowledge. To accomplish this pilot study, I wrote a testing protocol, obtained Institutional Review Board (IRB) approval, completed subject payment forms, lead testing sessions, and analyzed the data. This experiment used -20deg head down tilt (20 HDT) as the ground based simulation for the fluid shift that occurs during spaceflight and compared it to data obtained from the seated and supine positions. Using echocardiography, data was collected for the right ventricle, hepatic vein, internal jugular vein, external jugular vein, and inferior vena cava. Additionally, non-invasive venous pressure measurements, similar to those soon to be done in-orbit, were collected. It was determined that the venous return from below the heard is increased during 20 HDT, which was supported by increased hepatic vein velocities, increased right ventricular inflow, and increased right ventricular strain at 20 HDT relative to seated values. Jugular veins in the neck undergo an increase in pressure and area, but no significant increase in flow, relative to seated values when a subject is tilted 20 HDT. Contrary to the initial expectations based on this jugular flow, there was no significant increase in central venous pressure, as evidenced by no change in Doppler indices for right arterial pressure or inferior vena cava diameter. It is suspected that these differences in pressure are due to the hydrostatic pressure indifference point shifting during tilt; there is a potential for a similar phenomenon with microgravity. This data will hopefully lead to a more in-depth understanding of the response of the body to microgravity and how those relate to the previously mentioned cardiovascular risk of fluid shift that is associated with spaceflight. These results were presented in greater detail

  2. Terapia fibrinolítica sistêmica no tromboembolismo pulmonar

    PubMed Central

    Ceresetto, José Manuel; Marques, Marcos Arêas

    2017-01-01

    Resumo O tromboembolismo pulmonar permanece como um grande desafio terapêutico para os médicos especialistas, pois, apesar de todo investimento e desenvolvimento em seu diagnóstico, profilaxia e tratamento, essa condição continua sendo a principal causa de morte evitável em ambiente hospitalar. Ainda restam muitas dúvidas em relação a qual perfil de paciente vai se beneficiar de fato da terapia fibrinolítica sistêmica, sem ficar exposto a um grande risco de sangramento. A estratificação de risco e a avaliação do prognóstico do evento, através de escores clínicos de insuficiência ventricular direita, marcadores de dilatação e disfunção do ventrículo direito e avaliação da massa trombótica, associados ou de forma isolada, são ferramentas que podem auxiliar na identificação do paciente que irá se beneficiar dessa terapia. Os únicos consensos em relação à terapia fibrinolítica no tratamento do tromboembolismo pulmonar são: não deve ser indicada de forma rotineira; nenhum dos escores ou marcadores, isoladamente, devem justificar seu uso; e os pacientes com instabilidade hemodinâmica são os mais beneficiados. Além disto, deve-se avaliar cada caso em relação ao risco de sangramento, especialmente no sistema nervoso central. PMID:29930636

  3. The Myriapoda and Onychophora collection (MY) of the Muséum national d’Histoire naturelle (MNHN, Paris)

    PubMed Central

    Bras, Gwenaël Le; Geoffroy, Jean-Jacques; Albenga, Laurent; Mauriès, Jean-Paul

    2015-01-01

    Abstract The Myriapoda and Onychophora collection dataset inventories the occurrence records of the collection of myriapods and onychophorans in the Muséum national d’Histoire naturelle, Paris. The dataset currently consists of 202 lots of onychophorans, representing all of those present, and almost ten thousand (9 795) lots of myriapods, representing 33 to 40% of the MNHN Myriapoda collection. This collection, which is of key historic importance, represents the results of two centuries of myriapod and onychophoran studies. The sources of the collection are worldwide, with a high representation for metropolitan France for the myriapods. None of the occurrences are yet georeferenced. Access to the dataset via the data portals of the MNHN and the GBIF has been made possible through the e-ReColNat project (ANR-11-INBS-0004). The Myriapoda and Onychophora collection of MNHN is actively expanding, hence both the collection and dataset are in continuous growth. The dataset can be accessed through the portals of GBIF at http://www.gbif.org/dataset/3287044c-8c48-4ad6-81d4-4908071bc8db and the MNHN at http://science.mnhn.fr/institution/mnhn/collection/my/item/search/form. PMID:26448704

  4. Astronomia cultural e meio ambiente segundo uma abordagem holística

    NASA Astrophysics Data System (ADS)

    Jafelice, L. C.

    2003-08-01

    Neste trabalho ampliamos a discussão da abordagem holística para o ensino de astronomia que temos desenvolvido nos últimos anos, analisamos novos resultados e apresentamos exemplos práticos para interessados em experimentá-la. A constatação básica a orientar este enfoque é que cursos introdutórios em astronomia costumam ser excessiva e prematuramente técnicos, além de assumirem uma visão tradicional, muito estreita, do que seja educação científica, herdada da era cartesiana e positivista da ciência. Fundamentamos porque é importante que elementos de astronomia cultural ofereçam o mote e constituam o eixo norteador daqueles cursos e porque é urgente revermos a visão que temos da relação entre astronomia e meio ambiente. Um ponto central nesta abordagem é explorar formas de reativar e atualizar uma relação orgânica com o meio e excitar a consciência de nossa inevitável e profunda interdependência com ele em nível cósmico. Neste trabalho exemplificamos a possibilidade de concretização desta proposta em três diferentes situações: disciplinas de cursos de licenciatura em geografia e em física; escolas de nível fundamental; e, neste caso ainda a ser implementada, comunidades carentes. Estes casos envolvem públicos e espaços diferenciados para educação formal e não-formal. Dos casos já implementados, destacamos os resultados alcançados pelos alunos: enriquecimento cultural, aprendizagem significativa de conteúdos astronômicos tradicionais; mudanças de comportamento, incorporando contato diário com o céu; e freqüentes vivências de sentimentos empáticos que redirecionam a relação com a natureza e a consciência ecológica global. Além disto, para interessados em aplicar esta proposta, também socializamos procedimentos e cuidados para a implementação de ações alternativas consonantes com a mesma. (PPGECNM/UFRN; PRONEX/FINEP; NUPA/USP; Temáticos/FAPESP)

  5. Geochemical and K Ar age constraints on the Late Neoproterozoic (?) gneisses at Um Tenassib area, north Eastern Desert, Egypt

    NASA Astrophysics Data System (ADS)

    Eliwa, Hassan A.

    2007-05-01

    Wadi Um Tenassib metamorphic rocks consist mainly of biotite gneiss and biotite-hornblende gneiss with subordinate intercalations of amphibolite, migmatitic gneiss, and aplitic granite. Biotite-hornblende gneiss, biotite gneiss, and aplitic granite are geochemically characterized and their cooling ages are determined by using the K-Ar method on biotite. The Um Tenassib gneisses (UTG) range in composition from quartz diorite/monzodiorite to granodiorite. They were derived from igneous rocks that pertain to calc alkaline and metaluminous to weakly peraluminous affinities and were generated in continental volcanic arc setting. REE patterns of the UTG are moderately fractionated (La N/Lu N = 5.9-7.5) relative to those of the aplitic granite (La N/Lu N = 33). The similarity in the geochemical characteristics and REE patterns of both gneiss types indicate their magmatic consanguinity. Amphiboles of the UTG biotite-hornblende gneisses are mainly hornblende, together with few paragasitic hornblende and edenite. Plagioclase composition is oligoclase to andesine (An 21-46) in the biotite-hornblende gneiss, and oligoclase (An 11-26) in the biotite gneiss. Mineral chemistry of amphibole and plagioclase indicate that the gneisses were metamorphosed under low- to medium-pressure of 2.6-6.4 kbar and at medium to high temperatures of 660-755 °C. The K-Ar biotite cooling ages (seven samples) range from 585 ± 12 Ma to 598 ± 12 Ma for the UTG, except one biotite-hornblende gneiss sample gives age of 577 ± 11 Ma. These ages suggest a latest metamorphic cooling event at ca. 585-600 Ma time span, which is consistent with the proposed cooling ages of ˜600 Ma for the Elat metamorphic rocks [Cosca, M.A., Shimron, A., Caby, R., 1999. Late Precambrian metamorphism and cooling in the Arabian-Nubian Shield: petrology and 40Ar/ 39Ar geochronology of metamorphic rocks of the Elat area (southern Israel). Precamb. Res. 98, 107-127]. It may indicate that the metamorphism of the UTG might have

  6. Aeromedical Evacuation Enroute Critical Care Validation Study

    DTIC Science & Technology

    2015-02-27

    finger pulse oximeter 6515-01-557-1136 Arrow International, Inc. jugular vein puncture kit 6515-01-262-7222 Argon Medical Corporation catheterization...patient 17 Administer oxygen 18 Measure a patients pulse oxygen saturation 19 Measure a patient’s blood pressure 20 Operate the Zoll M Series CCT... pulse 26 Measure a patient’s temperature 27 Advanced cardiac life support 28 Initiate treatment for hypovolemic shock 29 Initiate an IV infusion

  7. Lineage Analysis in Pulmonary Arterial Hypertension

    DTIC Science & Technology

    2012-06-01

    undergo pneunomectomy followed one week later by intravenous injection of monocrotaline pyrrole . The fate of GFP-expressing cells of endothelial lineage...pneumonectomy followed one week later by jugular vein injection of monocrotaline pyrrole in dimethyl formamide. Expression of smooth muscle alpha actin in...cells. We induced experimental pulmonary hypertension in SM22 Cre x mT/mG mice, by injecting monocrotaline pyrrole into the pulmonary circulation of

  8. Decompression from Saturation Using Oxygen: Its Effect on DCS and RNA in Large Swine

    DTIC Science & Technology

    2010-01-01

    mask. The external jugular vein was catheter- ized with a 14-Ga., 30-cm single lumen catheter ( Central Venous Catheterization Set; Arrow... venous catheterization for sequential blood sampling from the pig. J Invest Surg 1991; 4:103-7. 3. Behnke AR. The isobaric (oxygen window) principle of...pressures may lead to toxicity that involves the pulmonary system and/ or the central nervous system (CNS). There is evidence that 100% oxygen in

  9. Responses of Cholinergic and Noncholinergic Renshaw Cell Receptors After Acute and Chronic Exposure to Anticholinesterases.

    DTIC Science & Technology

    1983-07-01

    and above LD50 doses during the electrophysiological experiment by means of an indwelling catheter in the external jugular vein. All anaesthetized...the sequence of RUP responses during and subsequent to 60 secs of 20 Hz supra threshold antidromic stimulation of L-7 ventral roots. The control...admittedly the RFP in the spinal cord are complex, they are much less complicated than those found in the brain and therefore, correlations between

  10. Modeling the Biodynamical Response of the Human Thorax with Body Armor from a Bullet Impact

    DTIC Science & Technology

    2001-03-01

    inferior vena cava to the right auricle. From the right auricle, the blood is passed into the right ventricle. The right ventricle pumps the blood...the rib and vertebrae is modeled with two beam elements. To create the subcoastal angle, vertical cartilaginous connections at the inferior edge of...brachiocephalic aorta, the aorta, pulmonary arteries and veins, internal jugular veins, brachial veins, and superior vena cava . These vessels are modeled

  11. Thrombus in Transit: A Potentially Life-threatening Complication of Cerebral Sinus Thrombosis.

    PubMed

    Petracca, Martina; Calandrelli, Rosalinda; Broccolini, Aldobrando; Caliandro, Pietro; Della Marca, Giacomo; Frisullo, Giovanni; Morosetti, Roberta; Profice, Paolo; Lamendola, Priscilla; Pennestrì, Faustino; Pilato, Fabio

    2017-01-01

    We report the case of a 41-year-old, 7-weeks-pregnant patient, presenting with headache and generalized seizure due to cerebral venous thrombosis complicated by jugular thrombosis and thrombus dislocation into right cardiac cavities. The patient was treated with intravenous heparin, and underwent embolectomy in extracorporeal circulation. This case illustrates the variability of cerebral venous thrombosis progression and a potentially life-threatening condition even during anticoagulant therapy.

  12. Innominate Vein Stenosis in Association with Ipsilateral Hyperdynamic Brachiobasilic Fistula Causing Ipsilateral Limb and Hemifacial Swelling.

    PubMed

    Narendra, J B; Sreenivas, J; Karthikeyan, V S; Nagaraja, N H

    2017-01-01

    A 34-year-old hypertensive woman with a hyperdynamic, left brachiobasilic dialysis fistula presented with a long history of throbbing in her head and swelling of the left side of the face. Tight stenosis of left brachiocephalic vein was found to be causing retrograde flow into the left jugular vein which normalized after dilatation and stenting with resolution of all the symptoms and patient is asymptomatic for 1 year.

  13. Monorail system for percutaneous repositioning of the Greenfield vena caval filter.

    PubMed

    Guthaner, D F; Wyatt, J O; Mehigan, J T; Wright, A M; Breen, J F; Wexler, L

    1990-09-01

    The authors describe a technique for removing or repositioning a malpositioned Greenfield inferior vena caval filter. A "monorail" system was used, in which a wire was passed from the femoral vein through the apical hole in the filter and out the internal jugular vein; the wire was held taut from above and below and thus facilitated repositioning or removal of the filter. The technique was used successfully in two cases.

  14. Calcium-containing scaffolds induce bone regeneration by regulating mesenchymal stem cell differentiation and migration.

    PubMed

    Aquino-Martínez, Rubén; Angelo, Alcira P; Pujol, Francesc Ventura

    2017-11-16

    Osteoinduction and subsequent bone formation rely on efficient mesenchymal stem cell (MSC) recruitment. It is also known that migration is induced by gradients of growth factors and cytokines. Degradation of Ca 2+ -containing biomaterials mimics the bone remodeling compartment producing a localized calcium-rich osteoinductive microenvironment. The aim of our study was to determine the effect of calcium sulfate (CaSO 4 ) on MSC migration. In addition, to evaluate the influence of CaSO 4 on MSC differentiation and the potential molecular mechanisms involved. A circular calvarial bone defect (5 mm diameter) was created in the parietal bone of 35 Balb-C mice. We prepared and implanted a cell-free agarose/gelatin scaffold alone or in combination with different CaSO 4 concentrations into the bone defects. After 7 weeks, we determined the new bone regenerated by micro-CT and histological analysis. In vitro, we evaluated the CaSO 4 effects on MSC migration by both wound healing and agarose spot assays. Osteoblastic gene expression after BMP-2 and CaSO 4 treatment was also evaluated by qPCR. CaSO 4 increased MSC migration and bone formation in a concentration-dependent manner. Micro-CT analysis showed that the addition of CaSO 4 significantly enhanced bone regeneration compared to the scaffold alone. The histological evaluation confirmed an increased number of endogenous cells recruited into the cell-free CaSO 4 -containing scaffolds. Furthermore, MSC migration in vitro and active AKT levels were attenuated when CaSO 4 and BMP-2 were in combination. Addition of LY294002 and Wortmannin abrogated the CaSO 4 effects on MSC migration. Specific CaSO 4 concentrations induce bone regeneration of calvarial defects in part by acting on the host's undifferentiated MSCs and promoting their migration. Progenitor cell recruitment is followed by a gradual increment in osteoblast gene expression. Moreover, CaSO 4 regulates BMP-2-induced MSC migration by differentially activating the PI3

  15. Gypsum (CaSO4·2H2O) Scaling on Polybenzimidazole and Cellulose Acetate Hollow Fiber Membranes under Forward Osmosis

    PubMed Central

    Chen, Si Cong; Su, Jincai; Fu, Feng-Jiang; Mi, Baoxia; Chung, Tai-Shung

    2013-01-01

    We have examined the gypsum (CaSO4·2H2O) scaling phenomena on membranes with different physicochemical properties in forward osmosis (FO) processes. Three hollow fiber membranes made of (1) cellulose acetate (CA), (2) polybenzimidazole (PBI)/polyethersulfone (PES) and (3) PBI-polyhedral oligomeric silsesquioxane (POSS)/polyacrylonitrile (PAN) were studied. For the first time in FO processes, we have found that surface ionic interactions dominate gypsum scaling on the membrane surface. A 70% flux reduction was observed on negatively charged CA and PBI membrane surfaces, due to strong attractive forces. The PBI membrane surface also showed a slightly positive charge at a low pH value of 3 and exhibited a 30% flux reduction. The atomic force microscopy (AFM) force measurements confirmed a strong repulsive force between gypsum and PBI at a pH value of 3. The newly developed PBI-POSS/PAN membrane had ridge morphology and a contact angle of 51.42° ± 14.85° after the addition of hydrophilic POSS nanoparticles and 3 min thermal treatment at 95 °C. Minimal scaling and an only 1.3% flux reduction were observed at a pH value of 3. Such a ridge structure may reduce scaling by not providing a locally flat surface to the crystallite at a pH value of 3; thus, gypsum would be easily washed away from the surface. PMID:24957062

  16. Trombocitopenia induzida por heparina em paciente com oclusão arterial aguda

    PubMed Central

    Pimenta, Rafael Elias Farres; Yoshida, Winston Bonetti; Rollo, Hamilton Almeida; Sobreira, Marcone Lima; Bertanha, Matheus; Mariúba, Jamil Victor de Oliveira; Jaldin, Rodrigo Gibin; de Camargo, Paula Angeleli Bueno

    2016-01-01

    Resumo A trombocitopenia induzida por heparina é uma complicação grave da terapêutica anticoagulante com heparina e está associada à formação de anticorpos antifator IV plaquetário. Costuma surgir a partir do quinto dia do tratamento, com queda de pelo menos 50% da contagem plaquetária. Em decorrência da ativação plaquetária concomitante, pode ocorrer quadro de trombose, venosa ou arterial, com repercussões clínicas graves. Apresentamos um caso de paciente portador de síndrome do anticorpo antifosfolípide, com quadro de oclusão arterial aguda, que foi tratado cirurgicamente e recebeu heparina não fracionada no intra e pós-operatório. No quinto dia de tratamento anticoagulante, apresentou queda maior de 50% da contagem de plaquetas em relação à contagem pré-heparina. A suspeita de trombocitopenia induzida por heparina e seus aspectos diagnósticos e terapêuticos serão abordados neste desafio terapêutico.

  17. Intravenous and intratracheal mesenchymal stromal cell injection in a mouse model of pulmonary emphysema.

    PubMed

    Tibboel, Jeroen; Keijzer, Richard; Reiss, Irwin; de Jongste, Johan C; Post, Martin

    2014-06-01

    The aim of this study was to characterize the evolution of lung function and -structure in elastase-induced emphysema in adult mice and the effect of mesenchymal stromal cell (MSC) administration on these parameters. Adult mice were treated with intratracheal (4.8 units/100 g bodyweight) elastase to induce emphysema. MSCs were administered intratracheally or intravenously, before or after elastase injection. Lung function measurements, histological and morphometric analysis of lung tissue were performed at 3 weeks, 5 and 10 months after elastase and at 19, 20 and 21 days following MSC administration. Elastase-treated mice showed increased dynamic compliance and total lung capacity, and reduced tissue-specific elastance and forced expiratory flows at 3 weeks after elastase, which persisted during 10 months follow-up. Histology showed heterogeneous alveolar destruction which also persisted during long-term follow-up. Jugular vein injection of MSCs before elastase inhibited deterioration of lung function but had no effects on histology. Intratracheal MSC treatment did not modify lung function or histology. In conclusion, elastase-treated mice displayed persistent characteristics of pulmonary emphysema. Jugular vein injection of MSCs prior to elastase reduced deterioration of lung function. Intratracheal MSC treatment had no effect on lung function or histology.

  18. Elucidating the mechanism of posterior reversible encephalopathy syndrome: a case of transient blindness after central venous catheterization.

    PubMed

    Rao, Neal M; Raychev, Radoslav; Kim, Doojin; Liebeskind, David S

    2012-11-01

    Posterior reversible encephalopathy syndrome (PRES) is a condition characterized by reversible symptoms including headache, visual disturbances, focal neurological deficits, altered mentation, and seizures. It has been associated with circumstances that may affect the cerebrovascular system, such as hypertension, eclampsia, and immunosuppression with calcineurin inhibitors. The underlying etiology of PRES has remained unclear; however, cerebrovascular autoregulatory dysfunction, hyperperfusion, and endothelial activation have been implicated. We describe a case of a young patient with lung transplant, who presented with headache, acute binocular blindness, and seizure immediately after infusion of saline through a peripherally inserted central catheter line, which inadvertently terminated cephalad in the left internal jugular vein, near the jugular foramen. Subsequent brain magnetic resonance imaging revealed vasogenic edematous lesions in a pattern consistent with PRES--a diagnosis supported by his constellation of symptoms, history of lung transplantation on tacrolimus immunosuppression, and relative hypertension. This is the first reported case describing the development of PRES after the insertion of a peripherally inserted central catheter line. The development of PRES in a typical high-risk patient immediately after cerebral venous outflow obstruction implicates the role of the cerebral venous system and provides potential insight into the mechanism of this disorder that remains of unclear pathogenesis.

  19. Routine Chest Radiographs After Central Line Insertion: Mandatory Postprocedural Evaluation or Unnecessary Waste of Resources?

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lucey, Brian; Varghese, Jose C.; Haslam, Philip

    1999-09-15

    Purpose: To study the cost and impact on patient management of the routine performance of chest radiographs in patients undergoing imaged-guided central venous catheter insertion. Methods: Six hundred and twenty-one catheters placed in 489 patients over a 42-month period formed the study group. Catheters were placed in the right internal jugular vein (425), left internal jugular vein (133), and subclavian veins (63). At the end of the procedure fluoroscopy was used to assess catheter position and check for complications. A postprocedural chest radiograph was obtained in all patients. Results: Postprocedural chest fluoroscopy showed no evidence of pneumothorax, hemothorax, or mediastinalmore » hematoma. Inappropriate catheter tip position or catheter kinks were noted with 90 catheters. These problems were all corrected while the patient was on the interventional table. Postprocedural chest radiographs showed no complications but proximal catheter tip migration was noted in six of 621 catheters (1%). These latter six catheters required further manipulation. The total technical and related charges for the postprocedural chest radiographs in this series were estimated at Pounds 15,525. Conclusion: Postprocedural chest radiographs after image-guided central venous catheter insertion are not routinely required. A postprocedural chest radiograph can be performed on a case-by-case basis at the discretion of the interventional radiologist.« less

  20. Insertion of tunneled hemodialysis catheters without fluoroscopy.

    PubMed

    Motta Elias, Rosilene; da Silva Makida, Sonia Cristina; Abensur, Hugo; Martins Castro, Manuel Carlos; Affonso Moysés, Rosa Maria; Pereira, Benedito Jorge; Bueno de Oliveira, Rodrigo; Luders, Cláudio; Romão, João Egidio

    2010-01-01

    The tunneled cuffed catheter (TCC) is used as a bridge access for hemodialysis. Few prospective studies have been designed to evaluate conversion from non-tunneled to TCC without the use of fluoroscopy when performed by nephrologists. We performed an observational prospective cohort in incident patients receiving hemodialysis through a non-tunneled right jugular vein catheter. 130 procedures were performed in 122 patients (51+/-18 years). The success rate was 100%. There was a total of 26,546 catheter days. Ninety-one of the 130 catheters were removed during the study period. Life table analysis revealed primary patency rates of 92%, 82%, and 68% at 30, 60, and 120 days, respectively. Infection requiring catheter removal occurred at a frequency of 0.09 per 100 catheter days. Catheter malfunction requiring intervention occurred at a rate of 0.03 per 100 catheter days. Hypertension and duration of existing non-tunneled catheter of less than 2 weeks were independently associated with better TCC survival. The conversion from non-tunneled to TCC performed by nephrologists and without fluoroscopy may be safe by using the internal right jugular vein. The ideal time to do this procedure is within less than 2 weeks of existing non-tunneled catheter.