Sample records for circumferential endocardial extent

  1. A Novel Microwave Catheter Can Perform Noncontact Circumferential Endocardial Ablation in a Model of Pulmonary Vein Isolation.

    PubMed

    Qian, Pierre; Barry, Michael Anthony; Nguyen, Trang; Ross, David; Kovoor, Pramesh; McEwan, Alistair; Thomas, Stuart; Thiagalingam, Aravinda

    2015-07-01

    Pulmonary vein isolation is an effective treatment for atrial fibrillation. Current endocardial ablation techniques require catheter contact for lesion formation. Inadequate or inconsistent catheter contact results in difficulty with achieving acute and long-term isolation and consequent atrial arrhythmia recurrence. Microwave energy produces radiant heating and therefore can be used for noncontact catheter ablation. We hypothesized that it is possible to design a microwave catheter to produce a circumferential transmural thermal lesion in an in vitro model of a pulmonary vein antrum. A monopole microwave catheter with a sideways firing axially symmetrical heating pattern was designed. Noncontact ablations were performed in a perfused pulmonary vein model constructed from microwave myocardial phantom embedded with a sheet of thermochromic liquid crystal to permit visualization and measurement of thermal lesions from color changes. 1200 J ablations were performed at 150 W for 80 seconds and 120 W for 100 seconds at high (0.8 L/min) and low (0.06 L/min) flow through the modeled pulmonary vein. Myocardial tissue was substituted for the phantom material and ablations repeated at 150 W for 180 seconds and stained with nitro-blue tetrazolium. The catheter was able to induce deep circumferential antral lesions in myocardial phantom and myocardial tissue. Higher power and shorter ablations delivering the same amount of microwave energy resulted in larger lesions with less surface sparing. A microwave catheter can be designed to produce a circumferential thermal lesion on noncontact ablation and may have possible applications for pulmonary vein isolation. © 2015 Wiley Periodicals, Inc.

  2. Interventional endocardial motion estimation from electroanatomical mapping data: application to scar characterization.

    PubMed

    Porras, Antonio R; Piella, Gemma; Berruezo, Antonio; Hoogendoorn, Corne; Andreu, David; Fernandez-Armenta, Juan; Sitges, Marta; Frangi, Alejandro F

    2013-05-01

    Scar presence and its characteristics play a fundamental role in several cardiac pathologies. To accurately define the extent and location of the scar is essential for a successful ventricular tachycardia ablation procedure. Nowadays, a set of widely accepted electrical voltage thresholds applied to local electrograms recorded are used intraoperatively to locate the scar. Information about cardiac mechanics could be considered to characterize tissues with different viability properties. We propose a novel method to estimate endocardial motion from data obtained with an electroanatomical mapping system together with the endocardial geometry segmented from preoperative 3-D magnetic resonance images, using a statistical atlas constructed with bilinear models. The method was validated using synthetic data generated from ultrasound images of nine volunteers and was then applied to seven ventricular tachycardia patients. Maximum bipolar voltages, commonly used to intraoperatively locate scar tissue, were compared to endocardial wall displacement and strain for all the patients. The results show that the proposed method allows endocardial motion and strain estimation and that areas with low-voltage electrograms also present low strain values.

  3. Differences in transient outward currents of feline endocardial and epicardial myocytes.

    PubMed

    Furukawa, T; Myerburg, R J; Furukawa, N; Bassett, A L; Kimura, S

    1990-11-01

    Whole-cell voltage-clamp experiments were performed on enzymatically dissociated single ventricular myocytes harvested from feline endocardial and epicardial surfaces. The studies were designed to test the hypothesis that the differences in the amplitude of transient outward current (Ito) contribute to the difference in action potential configuration between endocardial and epicardial myocytes. In the control state, action potentials recorded from epicardial cells demonstrated a prominent notch between phases 1 and 2, and membrane current recordings displayed a prominent Ito, whereas in endocardial cells the notch in action potentials and Ito were small. External application of 4-aminopyridine (2 mM) reduced the amplitudes of notch and Ito in epicardial cells but not in endocardial cells. After application of 4-aminopyridine (2 mM) and caffeine (5 mM), the notch and Ito were abolished completely in both endocardial and epicardial cells. The first component of Ito (Ito1) was present in all epicardial cells studied (n = 20); it was absent in 12 of the 20 endocardial cells, and a small Ito1 was present in the remaining eight endocardial cells. The mean amplitude of Ito1 was significantly greater in epicardial than in endocardial cells. At a test voltage of +80 mV, the amplitude of Ito1 was 102.0 +/- 47.7 pA/pF in epicardial cells and 3.3 +/- 3.3 pA/pF in endocardial cells (p less than 0.01). The second component of Ito (Ito2) was present in all endocardial (n = 30) and epicardial (n = 30) cells studied. The amplitude of Ito2 was significantly greater in epicardial than in endocardial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. The mechanism of endocardial lead-induced tricuspid regurgitation.

    PubMed

    Khoshbin, Espeed; Abdelbar, Abdelrahman; Allen, Stuart; Hasan, Ragheb

    2013-04-09

    Using this case report we attempt to define the mechanism of endocardial lead-induced tricuspid regurgitation (TR) in particular the direct effect of endocardial pacing leads on the competence of the tricuspid valve. We recommend a high index of suspicion and an early diagnostic strategy in order to reduce long-term morbidity which is associated with this condition and the need for a potentially avoidable surgery.

  5. The mechanism of endocardial lead-induced tricuspid regurgitation

    PubMed Central

    Khoshbin, Espeed; Abdelbar, Abdelrahman; Allen, Stuart; Hasan, Ragheb

    2013-01-01

    Using this case report we attempt to define the mechanism of endocardial lead-induced tricuspid regurgitation (TR) in particular the direct effect of endocardial pacing leads on the competence of the tricuspid valve. We recommend a high index of suspicion and an early diagnostic strategy in order to reduce long-term morbidity which is associated with this condition and the need for a potentially avoidable surgery. PMID:23576646

  6. Unipolar atrial electrogram morphology from an epicardial and endocardial perspective.

    PubMed

    van der Does, Lisette J M E; Knops, Paul; Teuwen, Christophe P; Serban, Corina; Starreveld, Roeliene; Lanters, Eva A H; Mouws, Elisabeth M J P; Kik, Charles; Bogers, Ad J J C; de Groot, Natasja M S

    2018-02-22

    Endo-epicardial asynchrony (EEA) and the interplay between the endocardial and epicardial layers could be important in the pathophysiology of atrial arrhythmias. The morphologic differences between epicardial and endocardial atrial electrograms have not yet been described, and electrogram morphology may hold information about the presence of EEA. The purpose of this study was to directly compare epicardial to endocardial unipolar electrogram morphology during sinus rhythm (SR) and to evaluate whether EEA contributes to electrogram fractionation by correlating fractionation to spatial activation patterns. In 26 patients undergoing cardiac surgery, unipolar electrograms were simultaneously recorded from the epicardium and endocardium at the inferior, middle, and superior right atrial (RA) free wall during SR. Potentials were analyzed for epi-endocardial differences in local activation time, voltage, RS ratio, and fractionation. The surrounding and opposite electrograms of fractionated deflections were evaluated for corresponding local activation times in order to determine whether fractionation originated from EEA. The superior RA was predisposed to delayed activation, EEA, and fractionation. Both epicardial and endocardial electrograms demonstrated an S-predominance. Fractionation was mostly similar between the 2 sides; however, incidentally deflections up to 4 mV on 1 side could be absent on the other side. Remote activation was responsible for most fractionated deflections (95%) in SR, of which 4% could be attributed to EEA. Local epi-endocardial differences in electrogram fractionation occur occasionally during SR but will likely increase during arrhythmias due to increasing EEA and (functional) conduction disorders. Electrogram fractionation can originate from EEA, and this study demonstrated that unipolar electrogram fractionation can potentially identify EEA. Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  7. Electrophysiological determinants of arrhythmic susceptibility upon endocardial and epicardial pacing in guinea-pig heart.

    PubMed

    Osadchii, O E

    2012-08-01

    Endocardial pacing instituted to treat symptomatic bradycardia may nevertheless promote tachyarrhythmia in some pacemaker-implanted patients. We sought to determine the contributing electrophysiological mechanisms. Left ventricular (LV) monophasic action potential duration (APD(90)) and effective refractory periods were determined in perfused guinea-pig hearts along with volume-conducted ECG recordings during epicardial and endocardial stimulations. Consistent with electrotonic modulation of repolarization, APD(90) at a given (either epicardial or endocardial) recording site tended to be longer while pacing from the ipsilateral LV site as compared to stimulations applied at the opposite side of ventricular wall. As a result, the intrinsic transmural repolarization gradient was amplified during endocardial pacing while being significantly reduced upon epicardial stimulations. The maximum slope of APD(90) restitution was greater upon endocardial than epicardial pacing. The excitability was found to recur at earlier repolarization time point at endocardium than epicardium, thereby contributing to increased endocardial critical intervals for re-excitation. Premature extrasystolic beats could have been elicited at shorter coupling stimulation intervals and propagated with greater transmural conduction delay upon endocardial than epicardial stimulations. Endocardial site exhibited lower ventricular fibrillation thresholds and greater inducibility of tachyarrhythmia upon extrasystolic stimulations as compared to epicardium. Arrhythmic susceptibility in guinea-pig heart is greater during endocardial than epicardial pacing because of greater transmural APD(90) dispersion, steeper electrical restitution slopes, greater critical intervals for LV re-excitation and slower transmural conduction of the earliest premature ectopic beats. Further studies are warranted to determine whether these effects may contribute to proarrhythmia in paced human patients. © 2012 The Author Acta

  8. Endocardial Energy Harvesting by Electromagnetic Induction.

    PubMed

    Zurbuchen, Adrian; Haeberlin, Andreas; Bereuter, Lukas; Pfenniger, Alois; Bosshard, Simon; Kernen, Micha; Philipp Heinisch, Paul; Fuhrer, Juerg; Vogel, Rolf

    2018-02-01

    cardiac pacemakers require regular medical follow-ups to ensure proper functioning. However, device replacements due to battery depletion are common and account for ∼25% of all implantation procedures. Furthermore, conventional pacemakers require pacemaker leads which are prone to fractures, dislocations or isolation defects. The ensuing surgical interventions increase risks for the patients and costs that need to be avoided. in this study, we present a method to harvest energy from endocardial heart motions. We developed a novel generator, which converts the heart's mechanical into electrical energy by electromagnetic induction. A mathematical model has been introduced to identify design parameters strongly related to the energy conversion efficiency of heart motions and fit the geometrical constraints for a miniaturized transcatheter deployable device. The implemented final design was tested on the bench and in vivo. the mathematical model proved an accurate method to estimate the harvested energy. For three previously recorded heart motions, the model predicted a mean output power of 14.5, 41.9, and 16.9 μW. During an animal experiment, the implanted device harvested a mean output power of 0.78 and 1.7 μW at a heart rate of 84 and 160 bpm, respectively. harvesting kinetic energy from endocardial motions seems feasible. Implanted at an energetically favorable location, such systems might become a welcome alternative to extend the lifetime of cardiac implantable electronic device. the presented endocardial energy harvesting concept has the potential to turn pacemakers into battery- and leadless systems and thereby eliminate two major drawbacks of contemporary systems.

  9. Circumferential distortion modeling of the TF30-P-3 compression system

    NASA Technical Reports Server (NTRS)

    Mazzawy, R. S.; Banks, G. A.

    1977-01-01

    Circumferential inlet pressure and temperature distortion testing of the TF30 P-3 turbofan engine was conducted. The compressor system at the test conditions run was modelled according to a multiple segment parallel compressor model. Aspects of engine operation and distortion configuration modelled include the effects of compressor bleeds, relative pressure-temperature distortion alignment and circumferential distortion extent. Model predictions for limiting distortion amplitudes and flow distributions within the compression system were compared with test results in order to evaluate predicted trends. Relatively good agreement was obtained. The model also identified the low pressure compressor as the stall-initiating component, which was in agreement with the data.

  10. Simultaneous epicardial and noncontact endocardial mapping of the canine right atrium: simulation and experiment.

    PubMed

    Sabouri, Sepideh; Matene, Elhacene; Vinet, Alain; Richer, Louis-Philippe; Cardinal, René; Armour, J Andrew; Pagé, Pierre; Kus, Teresa; Jacquemet, Vincent

    2014-01-01

    Epicardial high-density electrical mapping is a well-established experimental instrument to monitor in vivo the activity of the atria in response to modulations of the autonomic nervous system in sinus rhythm. In regions that are not accessible by epicardial mapping, noncontact endocardial mapping performed through a balloon catheter may provide a more comprehensive description of atrial activity. We developed a computer model of the canine right atrium to compare epicardial and noncontact endocardial mapping. The model was derived from an experiment in which electroanatomical reconstruction, epicardial mapping (103 electrodes), noncontact endocardial mapping (2048 virtual electrodes computed from a 64-channel balloon catheter), and direct-contact endocardial catheter recordings were simultaneously performed in a dog. The recording system was simulated in the computer model. For simulations and experiments (after atrio-ventricular node suppression), activation maps were computed during sinus rhythm. Repolarization was assessed by measuring the area under the atrial T wave (ATa), a marker of repolarization gradients. Results showed an epicardial-endocardial correlation coefficients of 0.80 and 0.63 (two dog experiments) and 0.96 (simulation) between activation times, and a correlation coefficients of 0.57 and 0.46 (two dog experiments) and 0.92 (simulation) between ATa values. Despite distance (balloon-atrial wall) and dimension reduction (64 electrodes), some information about atrial repolarization remained present in noncontact signals.

  11. Simultaneous Epicardial and Noncontact Endocardial Mapping of the Canine Right Atrium: Simulation and Experiment

    PubMed Central

    Sabouri, Sepideh; Matene, Elhacene; Vinet, Alain; Richer, Louis-Philippe; Cardinal, René; Armour, J. Andrew; Pagé, Pierre; Kus, Teresa; Jacquemet, Vincent

    2014-01-01

    Epicardial high-density electrical mapping is a well-established experimental instrument to monitor in vivo the activity of the atria in response to modulations of the autonomic nervous system in sinus rhythm. In regions that are not accessible by epicardial mapping, noncontact endocardial mapping performed through a balloon catheter may provide a more comprehensive description of atrial activity. We developed a computer model of the canine right atrium to compare epicardial and noncontact endocardial mapping. The model was derived from an experiment in which electroanatomical reconstruction, epicardial mapping (103 electrodes), noncontact endocardial mapping (2048 virtual electrodes computed from a 64-channel balloon catheter), and direct-contact endocardial catheter recordings were simultaneously performed in a dog. The recording system was simulated in the computer model. For simulations and experiments (after atrio-ventricular node suppression), activation maps were computed during sinus rhythm. Repolarization was assessed by measuring the area under the atrial T wave (ATa), a marker of repolarization gradients. Results showed an epicardial-endocardial correlation coefficients of 0.80 and 0.63 (two dog experiments) and 0.96 (simulation) between activation times, and a correlation coefficients of 0.57 and 0.46 (two dog experiments) and 0.92 (simulation) between ATa values. Despite distance (balloon-atrial wall) and dimension reduction (64 electrodes), some information about atrial repolarization remained present in noncontact signals. PMID:24598778

  12. Thrombo-embolic events in left ventricular endocardial pacing: long-term outcomes from a multicentre UK registry.

    PubMed

    Sawhney, Vinit; Domenichini, Giulia; Gamble, James; Furniss, Guy; Panagopoulos, Dimitrios; Lambiase, Pier; Rajappan, Kim; Chow, Anthony; Lowe, Martin; Sporton, Simon; Earley, Mark J; Dhinoja, Mehul; Campbell, Niall; Hunter, Ross J; Haywood, Guy; Betts, Tim R; Schilling, Richard J

    2018-06-01

    Endocardial left ventricular (LV) pacing is a viable alternative in patients with failed coronary sinus (CS) lead implantation. However, long-term thrombo-embolic risk remains unknown. Much of the data have come from a small number of centres. We examined the safety and efficacy of endocardial LV pacing to determine the long-term thrombo-embolic risk. Registries from four UK centres were combined to include 68 patients with endocardial leads with a mean follow-up of 20 months. These were compared to a matched 1:2 control group with conventional CS leads. Medical records were reviewed, and patients contacted for follow-up. Ischaemic stroke occurred in four patients (6%) in the endocardial arm providing an annual event rate (AER) of 3.6% over a 20 month follow-up; compared to 9 patients (6.6%) amongst controls with an AER of 3.4% over a 23-month follow-up. Regression analyses showed a significant association between sub-therapeutic international normalized ratio and stroke (P = 0.0001) in the endocardial arm. There was no association between lead material and mode of delivery (transatrial/transventricular) and stroke. Mortality rate was 12 and 15 per 100 patient years in the endocardial and control arm respectively with end-stage heart failure being the commonest cause. Endocardial LV lead in heart failure patients has a good success rate at 1.6 year follow-up. However, it is associated with a thrombo-embolic risk (which is not different from conventional CS leads) attributable to sub-therapeutic anticoagulation. Randomized control trials and studies on non-vitamin K antagonist oral anticoagulants are required to ascertain the potential of widespread clinical application of this therapeutic modality.

  13. Influence of Intramyocardial Adipose Tissue on the Accuracy of Endocardial Contact Mapping of the Chronic Myocardial Infarction Substrate.

    PubMed

    Samanta, Rahul; Kumar, Saurabh; Chik, William; Qian, Pierre; Barry, Michael A; Al Raisi, Sara; Bhaskaran, Abhishek; Farraha, Melad; Nadri, Fazlur; Kizana, Eddy; Thiagalingam, Aravinda; Kovoor, Pramesh; Pouliopoulos, Jim

    2017-10-01

    Recent studies have demonstrated that intramyocardial adipose tissue (IMAT) may contribute to ventricular electrophysiological remodeling in patients with chronic myocardial infarction. Using an ovine model of myocardial infarction, we aimed to determine the influence of IMAT on scar tissue identification during endocardial contact mapping and optimal voltage-based mapping criteria for defining IMAT dense regions. In 7 sheep, left ventricular endocardial and transmural mapping was performed 84 weeks (15-111 weeks) post-myocardial infarction. Spearman rank correlation coefficient was used to assess the relationship between endocardial contact electrogram amplitude and histological composition of myocardium. Receiver operator characteristic curves were used to derive optimal electrogram thresholds for IMAT delineation during endocardial mapping and to describe the use of endocardial mapping for delineation of IMAT dense regions within scar. Endocardial electrogram amplitude correlated significantly with IMAT (unipolar r =-0.48±0.12, P <0.001; bipolar r =-0.45±0.22, P =0.04) but not collagen (unipolar r =-0.36±0.24, P =0.13; bipolar r =-0.43±0.31, P =0.16). IMAT dense regions of myocardium reliably identified using endocardial mapping with thresholds of <3.7 and <0.6 mV, respectively, for unipolar, bipolar, and combined modalities (single modality area under the curve=0.80, P <0.001; combined modality area under the curve=0.84, P <0.001). Unipolar mapping using optimal thresholding remained significantly reliable (area under the curve=0.76, P <0.001) during mapping of IMAT, confined to putative scar border zones (bipolar amplitude, 0.5-1.5 mV). These novel findings enhance our understanding of the confounding influence of IMAT on endocardial scar mapping. Combined bipolar and unipolar voltage mapping using optimal thresholds may be useful for delineating IMAT dense regions of myocardium, in postinfarct cardiomyopathy. © 2017 American Heart Association, Inc.

  14. Acquired tricuspid valve stenosis associated with two ventricular endocardial pacing leads in a dog.

    PubMed

    Tompkins, Emily; Dulake, Michelle I; Ghaffari, Shadie; Nakamura, Reid K

    2015-01-01

    Acquired tricuspid valve stenosis (TVS) is a rare complication of endocardial pacing lead implantation in humans that has only been described once previously in the veterinary literature in a dog with excessive lead redundancy. A 12 yr old terrier presented with right-sided congestive heart failure 6 mo after implantation of a second ventricular endocardial pacing lead. The second lead was placed due to malfunction of the first lead, which demonstrated abnormally low impedance. Transthoracic echocardiography identified hyperechoic tissue associated with the pacing leads as they crossed the tricuspid valve annulus as well as a stenotic tricuspid inflow pattern via spectral Doppler interrogation. Medical management was ultimately unsuccessful and the dog was euthanized 6 wk after TVS was diagnosed. The authors report the first canine case of acquired TVS associated with two ventricular endocardial pacing leads.

  15. Phrenic nerve injury: An underrecognized and potentially preventable complication of pulmonary vein isolation using a wide-area circumferential ablation approach.

    PubMed

    Yong Ji, Sang; Dewire, Jane; Barcelon, Bernadette; Philips, Binu; Catanzaro, John; Nazarian, Saman; Cheng, Alan; Spragg, David; Tandri, Harikrishna; Bansal, Sandeep; Ashikaga, Hiroshi; Rickard, Jack; Kolandaivelu, Aravindan; Sinha, Sunil; Marine, Joseph E; Calkins, Hugh; Berger, Ronald

    2013-10-01

    Phrenic nerve injury (PNI) is a well-known, although uncommon, complication of pulmonary vein isolation (PVI) using radiofrequency energy. Currently, there is no consensus about how to avoid or minimize this injury. The purpose of this study was to determine how often the phrenic nerve, as identified using a high-output pacing, lies along the ablation trajectory of a wide-area circumferential lesion set. We also sought to determine if PVI can be achieved without phrenic nerve injury by modifying the ablation lesion set so as to avoid those areas where phrenic nerve capture (PNC) is observed. We prospectively enrolled 100 consecutive patients (age 61.7 ± 9.2 years old, 75 men) who underwent RF PVI using a wide-area circumferential ablation approach. A high-output (20 mA at 2 milliseconds) endocardial pacing protocol was performed around the right pulmonary veins and the carina where a usual ablation lesion set would be made. A total of 30% of patients had PNC and required modification of ablation lines. In the group of patients with PNC, the carina was the most common site of capture (85%) followed by anterior right superior pulmonary vein (RSPV) (70%) and anterior right inferior pulmonary vein (RIPV) (30%). A total of 25% of PNC group had capture in all 3 (RSPV, RIPV, and carina) regions. There was no difference in the clinical characteristics between the groups with and without PNC. RF PVI caused no PNI in either group. High output pacing around the right pulmonary veins and the carina reveals that the phrenic nerve lies along a wide-area circumferential ablation trajectory in 30% of patients. Modification of ablation lines to avoid these sites may prevent phrenic nerve injury during RF PVI. © 2013 Wiley Periodicals, Inc.

  16. Correlation between longitudinal, circumferential, and radial moduli in cortical bone: effect of mineral content.

    PubMed

    Macione, J; Depaula, C A; Guzelsu, N; Kotha, S P

    2010-07-01

    Previous studies indicate that changes in the longitudinal elastic properties of bone due to changes in mineral content are related to the longitudinal strength of bone tissue. Changes in mineral content are expected to affect bone tissue mechanical properties along all directions, albeit to different extents. However, changes in tissue mechanical properties along the different directions are expected to be correlated to one another. In this study, we investigate if radial, circumferential, and longitudinal moduli are related in bone tissue with varying mineral content. Plexiform bovine femoral bone samples were treated in fluoride ion solutions for a period of 3 and 12 days to obtain bones with 20% and 32% lower effective mineral contents. Transmission ultrasound velocities were obtained in the radial, circumferential, and longitudinal axes of bone and combined with measured densities to obtain corresponding tensorial moduli. Results indicate that moduli decreased with fluoride ion treatments and were significantly correlated to one another (r(2) radial vs. longitudinal = 0.80, r(2) circumferential vs. longitudinal = 0.90, r(2) radial vs. circumferential = 0.85). Densities calculated from using ultrasound parameters, acoustic impedance and transmission velocities, were moderately correlated to those measured by the Archimedes principle (r(2)=0.54, p<0.01). These results suggest that radial and circumferential ultrasound measurements could be used to determine the longitudinal properties of bone and that ultrasound may not be able to predict in vitro densities of bones containing unbonded mineral. Published by Elsevier Ltd.

  17. Ultrastructure of myocardial widened Z bands and endocardial cells in two teleostean species.

    PubMed

    Leknes, I L

    1981-01-01

    Widened myocardial Z bands and endocardial cells are described in two teleostean species Cichlasoma meeki and Corydoras aeneus. Widened Z bands containing mainly amorphous and electron-dense material were seen in a number of myocardial cells. Further, similar material may occur in large amounts beneath the sarcolemma and at intercellular junctions. Occasionally, we observed continuity between the latter material and that in expanded Z bands. In C. meeki the ventricular endocardial layer consists of two structurally different cell types, whereas in C. aeneus only one cell type was seen. The functional aspects of widened Z bands are discussed.

  18. Unipolar Endocardial Voltage Mapping in the Right Ventricle: Optimal Cutoff Values Correcting for Computed Tomography-Derived Epicardial Fat Thickness and Their Clinical Value for Substrate Delineation.

    PubMed

    Venlet, Jeroen; Piers, Sebastiaan R D; Kapel, Gijsbert F L; de Riva, Marta; Pauli, Philippe F G; van der Geest, Rob J; Zeppenfeld, Katja

    2017-08-01

    Low endocardial unipolar voltage (UV) at sites with normal bipolar voltage (BV) may indicate epicardial scar. Currently applied UV cutoff values are based on studies that lacked epicardial fat information. This study aimed to define endocardial UV cutoff values using computed tomography-derived fat information and to analyze their clinical value for right ventricular substrate delineation. Thirty-three patients (50±14 years; 79% men) underwent combined endocardial-epicardial right ventricular electroanatomical mapping and ablation of right ventricular scar-related ventricular tachycardia with computed tomographic image integration, including computed tomography-derived fat thickness. Of 6889 endocardial-epicardial mapping point pairs, 547 (8%) pairs with distance <10 mm and fat thickness <1.0 mm were analyzed for voltage and abnormal (fragmented/late potential) electrogram characteristics. At sites with endocardial BV >1.50 mV, the optimal endocardial UV cutoff for identification of epicardial BV <1.50 mV was 3.9 mV (area under the curve, 0.75; sensitivity, 60%; specificity, 79%) and cutoff for identification of abnormal epicardial electrogram was 3.7 mV (area under the curve, 0.88; sensitivity, 100%; specificity, 67%). The majority of abnormal electrograms (130 of 151) were associated with transmural scar. Eighty-six percent of abnormal epicardial electrograms had corresponding endocardial sites with BV <1.50 mV, and the remaining could be identified by corresponding low endocardial UV <3.7 mV. For identification of epicardial right ventricular scar, an endocardial UV cutoff value of 3.9 mV is more accurate than previously reported cutoff values. Although the majority of epicardial abnormal electrograms are associated with transmural scar with low endocardial BV, the additional use of endocardial UV at normal BV sites improves the diagnostic accuracy resulting in identification of all epicardial abnormal electrograms at sites with <1.0 mm fat. © 2017 American

  19. Systematic review and meta-analysis of left ventricular endocardial pacing in advanced heart failure: Clinically efficacious but at what cost?

    PubMed

    Graham, Adam J; Providenica, Rui; Honarbakhsh, Shohreh; Srinivasan, Neil; Sawhney, Vinit; Hunter, Ross; Lambiase, Pier

    2018-04-01

    Cardiac resynchronization using a left ventricular (LV) epicardial lead placed in the coronary sinus is now routinely used in the management of heart failure patients. LV endocardial pacing is an alternative when this is not feasible, with outcomes data sparse. To review the available evidence on the efficacy and safety of endocardial LV pacing via meta-analysis. EMBASE, MEDLINE, and COCHRANE databases with the search term "endocardial biventricular pacing" or "endocardial cardiac resynchronization" or "left ventricular endocardial" or "endocardial left ventricular." Comparisons of pre-and post-QRS width, LV ejection fraction (LVEF), and New York Heart Association (NYHA) functional classification was performed, and mean differences (and respective 95% confidence interval [CI]) applied as a measurement of treatment effect. Fifteen studies, including 362 patients, were selected. During a mean follow-up of 40 ± 24.5 months, death occurred in 72 patients (11 per 100 patient-years). Significant improvements in LVEF (mean difference 7.9%, 95% CI 5-10%, P < 0.0001; I 2  = 73%), QRS width (mean difference: -41% 95% -75 to -7%; P < 0.0001; I 2  = 94%), and NYHA class (mean difference: -1.06, 95% CI -1.2 to -0.9, P < 0.0001; I 2  = 60%), (all P < 0.0001) occurred. Stroke rate was 3.3-4.2 per 100 patient-years, which is higher than equivalent heart failure trial populations and recent meta-analysis that included small case series. LV endocardial lead implantation is a potentially efficacious alternative to CS lead placement, but preliminary data suggest a potentially higher risk of stroke during follow-up when compared to the expected incidence of stroke in similar cohorts of patients. © 2018 Wiley Periodicals, Inc.

  20. Loss of muscleblind-like 1 promotes invasive mesenchyme formation in endocardial cushions by stimulating autocrine TGFβ3

    PubMed Central

    2012-01-01

    Background Valvulogenesis and septation in the developing heart depend on the formation and remodeling of endocardial cushions in the atrioventricular canal (AVC) and outflow tract (OFT). These cushions are invaded by a subpopulation of endocardial cells that undergo an epithelial-mesenchymal transition in response to paracrine and autocrine transforming growth factor β (TGFβ) signals. We previously demonstrated that the RNA binding protein muscleblind-like 1 (MBNL1) is expressed specifically in the cushion endocardium, and knockdown of MBNL1 in stage 14 embryonic chicken AVC explants enhances TGFβ-dependent endocardial cell invasion. Results In this study, we demonstrate that the effect of MBNL1 knockdown on invasion remains dependent on TGFβ3 after it is no longer required to induce basal levels of invasion. TGFβ3, but not TGFβ2, levels are elevated in medium conditioned by MBNL1-depleted AVC explants. TGFβ3 is elevated even when the myocardium is removed, indicating that MBNL1 modulates autocrine TGFβ3 production in the endocardium. More TGFβ3-positive cells are observed in the endocardial monolayer following MBNL1 knockdown. Addition of exogenous TGFβ3 to AVC explants recapitulates the effects of MBNL1 knockdown. Time course experiments demonstrate that knockdown of MBNL1 induces precocious TGFβ3 secretion, and early exposure to excess TGFβ3 induces precocious invasion. MBNL1 expression precedes TGFβ3 in the AVC endocardium, consistent with a role in preventing precocious autocrine TGFβ3 signaling. The stimulatory effects of MBNL1 knockdown on invasion are lost in stage 16 AVC explants. Knockdown of MBNL1 in OFT explants similarly enhances cell invasion, but not activation. TGFβ is necessary and sufficient to mediate this effect. Conclusions Taken together, these data support a model in which MBNL1 negatively regulates cell invasion in the endocardial cushions by restricting the magnitude and timing of endocardial-derived TGFβ3 production. PMID

  1. Increased Regurgitant Flow Causes Endocardial Cushion Defects in an Avian Embryonic Model of Congenital Heart Disease

    PubMed Central

    Ford, Stephanie M; McPheeters, Matthew T; Wang, Yves T; Ma, Pei; Gu, Shi; Strainic, James; Snyder, Christopher; Rollins, Andrew M; Watanabe, Michiko; Jenkins, Michael W

    2017-01-01

    Background The relationship between changes in endocardial cushion and resultant congenital heart diseases (CHD) has yet to be established. It has been shown that increased regurgitant flow early in embryonic heart development leads to endocardial cushion defects, but it remains unclear how abnormal endocardial cushions during the looping stages might affect the fully septated heart. The goal of this study was to reproducibly alter blood flow in vivo and then quantify the resultant effects on morphology of endocardial cushions in the looping heart and on CHDs in the septated heart. Methods Optical pacing was applied to create regurgitant flow in embryonic hearts, and optical coherence tomography (OCT) was utilized to quantify regurgitation and morphology. Embryonic quail hearts were optically paced at 3 Hz (180bpm, well above intrinsic rate 60–110bpm) at stage 13 of development (3–4 wks human) for 5 min. Pacing fatigued the heart and led to at least 1 hr of increased regurgitant flow. Resultant morphological changes were quantified with OCT imaging at stage 19 (cardiac looping – 4–5 wks human) or stage 35 (4 chambered heart – 8 wks human). Results All paced embryos imaged at stage 19 displayed structural changes in cardiac cushions. The amount of regurgitant flow immediately after pacing was inversely correlated with cardiac cushion size 24-hrs post pacing (p-value < 0.01). The embryos with the most regurgitant flow and smallest cushions after pacing had a decreased survival rate at 8 days (p<0.05), indicating that those most severe endocardial cushion defects were lethal. Of the embryos that survived to stage 35, 17/18 exhibited CHDs including valve defects, ventricular septal defects, hypoplastic ventricles, and common AV canal. Conclusion The data illustrate a strong inverse relationship in which regurgitant flow precedes abnormal and smaller cardiac cushions, resulting in the development of CHDs. PMID:28211263

  2. Epicardial-endocardial breakthrough during stable atrial macroreentry: Evidence from ultra-high-resolution 3-dimensional mapping.

    PubMed

    Pathik, Bhupesh; Lee, Geoffrey; Sacher, Frédéric; Haïssaguerre, Michel; Jaïs, Pierre; Massoullié, Grégoire; Derval, Nicolas; Sanders, Prashanthan; Kistler, Peter; Kalman, Jonathan M

    2017-08-01

    Evidence for epicardial-endocardial breakthrough (EEB) is derived from mapping inferences in patients with atrial fibrillation who may also have focal activations. The purpose of this study was to investigate whether EEB could be discerned during stable right atrial (RA) macroreentry using high-density high-spatial resolution 3-dimensional mapping. Macroreentry was diagnosed using 3-dimensional mapping and entrainment. Bipolar maps were reviewed for EEB defined as (1) presence of focal endocardial activation with radial spread unaccounted for by an endocardial wavefront and (2) present with the same timing on every tachycardia cycle. The EEB site was always in proximity to a line of endocardial conduction slowing or block. Distance and conduction velocity from the line of block to the EEB site was calculated. Electrograms at EEB sites were individually analyzed for morphology and to confirm direction of activation. Entrainment was performed at EEB sites. Twenty-six patients were studied. Fourteen examples of EEB were seen: 11 at the posterior RA (4 at the superior portion of the posterior wall and 7 at the inferior section) and 1 each at the cavotricuspid isthmus postablation, RA septum, and inferolateral RA. The mean area of the EEB site was 0.6 ± 0.2 cm 2 . A mean of 79.5% ± 18.6% of unipolar electrograms at the EEB site demonstrated an rS morphology. The mean distance and conduction velocity from the line of endocardial block to the EEB site at the posterior RA was 13.6 ± 2.3 mm and 59.3 ± 12.3 cm/s, respectively. In 4 patients, entrainment demonstrated that EEB sites were within the circuit and in 1 of these patients critical to arrhythmia maintenance. Activation maps during tachycardia and coronary sinus pacing demonstrated EEB at the same anatomic site. EEB sites were demonstrated in stable atrial macroreentry supported by systematic entrainment confirmation and demonstration of the same phenomenon during pacing. Copyright © 2017 Heart Rhythm Society

  3. Qualitative and quantitative effects of harmonic echocardiographic imaging on endocardial edge definition and side-lobe artifacts

    NASA Technical Reports Server (NTRS)

    Rubin, D. N.; Yazbek, N.; Garcia, M. J.; Stewart, W. J.; Thomas, J. D.

    2000-01-01

    Harmonic imaging is a new ultrasonographic technique that is designed to improve image quality by exploiting the spontaneous generation of higher frequencies as ultrasound propagates through tissue. We studied 51 difficult-to-image patients with blinded side-by-side cineloop evaluation of endocardial border definition by harmonic versus fundamental imaging. In addition, quantitative intensities from cavity versus wall were compared for harmonic versus fundamental imaging. Harmonic imaging improved left ventricular endocardial border delineation over fundamental imaging (superior: harmonic = 71.1%, fundamental = 18.7%; similar: 10.2%; P <.001). Quantitative analysis of 100 wall/cavity combinations demonstrated brighter wall segments and more strikingly darker cavities during harmonic imaging (cavity intensity on a 0 to 255 scale: fundamental = 15.6 +/- 8.6; harmonic = 6.0 +/- 5.3; P <.0001), which led to enhanced contrast between the wall and cavity (1.89 versus 1.19, P <.0001). Harmonic imaging reduces side-lobe artifacts, resulting in a darker cavity and brighter walls, thereby improving image contrast and endocardial delineation.

  4. A left ventricular epicardial to right ventricular endocardial dominant frequency gradient exists in human ventricular fibrillation.

    PubMed

    Torres, Jose Luis; Shah, Bindi K; Greenberg, Richard M; Deger, Florin Titus; Gerstenfeld, Edward P

    2010-10-01

    We hypothesized that in patients with left ventricular dysfunction undergoing implant of a biventricular ICD, the local dominant frequency during early induced ventricular fibrillation would be higher at an epicardial left ventricular position compared to an endocardial right ventricular position. Patients undergoing implant of a biventricular ICD were studied. During ventricular fibrillation induction, bipolar electrograms were recorded from leads at an epicardial left ventricular position and an endocardial right ventricular position. Overlapping 2-s fast Fourier transforms were obtained for 6 s of ventricular fibrillation. The dominant frequency and organizational index were compared. Thirty-four patients (20 men, age 64 ± 11 years) underwent 57 inductions of ventricular fibrillation. Eighteen patients had non-ischemic dilated cardiomyopathy and 16 had ischemic dilated cardiomyopathy. The dominant frequency was higher at a lateral epicardial left ventricular position than an apical endocardial right ventricular position in 18 patients with non-ischemic dilated cardiomyopathy (LV epicardial 5.34 ± 0.37 Hz, RV endocardial 5.09 ± 0.41 Hz, p < 0.001), but not in 16 patients with ischemic dilated cardiomyopathy (LV epicardial 4.99 ± 0.57 Hz, RV epicardial 4.87 ± 0.65 Hz, p = 0.094). In patients with non-ischemic dilated cardiomyopathy, there is a dominant frequency gradient during early ventricular fibrillation induced at ICD testing from the lateral left ventricular epicardium to the apical right ventricular endocardium.

  5. 49 CFR 178.345-7 - Circumferential reinforcements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... stiffeners which prevent visual inspection of the cargo tank shell are prohibited on cargo tank motor... PACKAGINGS Specifications for Containers for Motor Vehicle Transportation § 178.345-7 Circumferential reinforcements. (a) A cargo tank with a shell thickness of less than 3/8 inch must be circumferentially...

  6. 49 CFR 178.345-7 - Circumferential reinforcements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... stiffeners which prevent visual inspection of the cargo tank shell are prohibited on cargo tank motor... PACKAGINGS Specifications for Containers for Motor Vehicle Transportation § 178.345-7 Circumferential reinforcements. (a) A cargo tank with a shell thickness of less than 3/8 inch must be circumferentially...

  7. 49 CFR 178.345-7 - Circumferential reinforcements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... stiffeners which prevent visual inspection of the cargo tank shell are prohibited on cargo tank motor... PACKAGINGS Specifications for Containers for Motor Vehicle Transportation § 178.345-7 Circumferential reinforcements. (a) A cargo tank with a shell thickness of less than 3/8 inch must be circumferentially...

  8. 49 CFR 178.345-7 - Circumferential reinforcements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... stiffeners which prevent visual inspection of the cargo tank shell are prohibited on cargo tank motor... PACKAGINGS Specifications for Containers for Motor Vehicle Transportation § 178.345-7 Circumferential reinforcements. (a) A cargo tank with a shell thickness of less than 3/8 inch must be circumferentially...

  9. 49 CFR 178.345-7 - Circumferential reinforcements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... stiffeners which prevent visual inspection of the cargo tank shell are prohibited on cargo tank motor... PACKAGINGS Specifications for Containers for Motor Vehicle Transportation § 178.345-7 Circumferential reinforcements. (a) A cargo tank with a shell thickness of less than 3/8 inch must be circumferentially...

  10. Axial-Loading Circumferential Dovetail Turbine-Blade Mount

    NASA Technical Reports Server (NTRS)

    Pierce, Martin J.; Ward, Steven D.; Eskridge, Ronald R.

    1992-01-01

    In new configuration, retaining ring holds base of blades in circumferential dovetail slot. Blades inserted axially via loading slots into circumferential dovetail slot. Ring placed over loading slots and fastened with split ring held by arm of disk. Blades less likely to be shaken loose during operation.

  11. Circumferential shaft seal

    NASA Technical Reports Server (NTRS)

    Ludwig, L. P. (Inventor)

    1981-01-01

    A circumferential shaft seal comprising two sealing rings held to a rotating shaft by means of a surrounding elastomeric band is disclosed. The rings are segmented and are of a rigid sealing material such as carbon or a polyimide and graphite fiber composite.

  12. Ethical considerations of transparency, informed consent, and nudging in a patient with paediatric aortic stenosis and symptomatic left ventricular endocardial fibroelastosis.

    PubMed

    Mavroudis, Constantine D; Cook, Thomas; Jacobs, Jeffrey P; Mavroudis, Constantine

    2016-12-01

    A 9-year-old boy who was born with bicuspid aortic stenosis underwent two unsuccessful aortic valvuloplasty interventions, and by 2 years of age he developed restrictive cardiomyopathy caused by left ventricular endocardial fibroelastosis and diastolic dysfunction. The attending cardiologist referred the patient to a high-volume, high-profile congenital cardiac surgical programme 1000 miles away that has a team with considerable experience with left ventricular endocardial fibroelastosis resection and a reputation of achieving good results. Owing to problems with insurance coverage, the parents sought other options for the care of their child in their home state. Dr George Miller is a well-respected local congenital and paediatric cardiac surgeon with considerable experience with the Ross operation as well as with right ventricular endocardial fibroelastosis resection. When talking with Dr Miller, he implied that there is little difference between right ventricular endocardial fibroelastosis and left ventricular endocardial fibroelastosis resection, and stated that he would perform the operation with low mortality based on his overall experience. Dr Miller stated that the local institution could provide an equivalent surgical procedure with comparable outcomes, without the patient and family having to travel out of state. A fundamental dilemma that often arises in clinical surgical practice concerns the conduct of assessing and performing new procedures, especially in rare cases, for which the collective global experience is scant. Although Dr Miller has performed right ventricular endocardial fibroelastosis resection, this procedure differs from left ventricular endocardial fibroelastosis resection, and he cannot be sure that he will indeed be able to perform the procedure better than the high-volume surgeon. This ethical situation is best understood in terms of the principles of respect for patient autonomy, beneficence, non-maleficence, and justice. The tension

  13. A Hybrid Method for Endocardial Contour Extraction of Right Ventricle in 4-Slices from 3D Echocardiography Dataset.

    PubMed

    Dawood, Faten A; Rahmat, Rahmita W; Kadiman, Suhaini B; Abdullah, Lili N; Zamrin, Mohd D

    2014-01-01

    This paper presents a hybrid method to extract endocardial contour of the right ventricular (RV) in 4-slices from 3D echocardiography dataset. The overall framework comprises four processing phases. In Phase I, the region of interest (ROI) is identified by estimating the cavity boundary. Speckle noise reduction and contrast enhancement were implemented in Phase II as preprocessing tasks. In Phase III, the RV cavity region was segmented by generating intensity threshold which was used for once for all frames. Finally, Phase IV is proposed to extract the RV endocardial contour in a complete cardiac cycle using a combination of shape-based contour detection and improved radial search algorithm. The proposed method was applied to 16 datasets of 3D echocardiography encompassing the RV in long-axis view. The accuracy of experimental results obtained by the proposed method was evaluated qualitatively and quantitatively. It has been done by comparing the segmentation results of RV cavity based on endocardial contour extraction with the ground truth. The comparative analysis results show that the proposed method performs efficiently in all datasets with overall performance of 95% and the root mean square distances (RMSD) measure in terms of mean ± SD was found to be 2.21 ± 0.35 mm for RV endocardial contours.

  14. Circumferential shaft seal

    NASA Technical Reports Server (NTRS)

    Ludwig, L. P. (Inventor)

    1980-01-01

    A circumferential shaft seal is described which comprises two sealing rings held to a rotating shaft by means of a surrounding elastomeric band. The rings are segmented and are of a rigid sealing material such as carbon or a polyimide and graphite fiber composite.

  15. Results of endocardial radiofrequency ablation of atrial fibrillation during mitral valve surgery.

    PubMed

    Demirkilic, U; Bolcal, C; Gunay, C; Doganci, S; Temizkan, V; Kuralay, E; Tatar, H

    2006-08-01

    The aim of the study is to evaluate the efficacy of thermocontrolled endocardial radiofrequency (RF) ablation for the patients with mitral valve disorder and associated chronic atrial fibrillation during mitral valve replacement operation. Between February 2002 and January 2004, 43 patients with mitral valve disease and associated chronic atrial fibrillation underwent mitral valve replacement and thermocontrolled endocardial RF ablation with Cobra RF system flexible probe at Gulhane Military Academy of Medicine, Department of Cardiovascular Surgery. Eighteen of the patients (41.8%) were males, while the remaining 25 (58.2%) were females. The average age of the patients was 44+/-14.21 (18-66) years. Functional capacity of the patients was class II in 15 (34. 9%), class III in 24 (55.8%), class IV in 4 (9.3%) according to the NYHA classification. At the preoperative period all of the patients were evaluated routinely by twelve-lead ECG, chest film and transthoracic echocardiography (TTE). For the patients over 40 years of age, we performed additional coronary angiography to delineate any coronary lesions. The patients were evaluated at months 1, 3, 6 and annually by twelve-lead ECG, TTE and holter monitoring after discharge. There were not any complications related to the performed technique. No operative and hospital mortality were recorded. At the follow-up period for 35 of 43 patients (81.4%) sinus rhythm was restored. The mean follow-up time was 24.3+/-11.2 (12-35) months. Endocardial RF ablation especially during mitral valve surgery is a simple technique to be performed. Early and midterm results of the cohort are satisfying.

  16. Endocardial fibrosarcoma in a reticulated python (Python reticularis).

    PubMed

    Gumber, Sanjeev; Nevarez, Javier G; Cho, Doo-Youn

    2010-11-01

    A female, reticulated python (Python reticularis) of unknown age was presented with a history of lethargy, weakness, and distended coelom. Physical examination revealed severe dystocia and stomatitis. The reticulated python was euthanized due to a poor clinical prognosis. Postmortem examination revealed marked distention of the reproductive tract with 26 eggs (10-12 cm in diameter), pericardial effusion, and a slightly firm, pale tan mass (3-4 cm in diameter) adhered to the endocardium at the base of aorta. Based on histopathologic and transmission electron microscopic findings, the diagnosis of endocardial fibrosarcoma was made.

  17. Infectious endocarditis in pacemaker endocardial leads: report of three cases.

    PubMed

    Cruz-Cruz, F; Espinola-Zavaleta, N; Hernández Lara, J; Iturralde-Torres, P; González-Hermosillo, J A; Romero-Cárdenas, A; Keirns, C; Vargas-Barrón, J

    1999-01-01

    Three cases of endocarditis affecting endocardial leads of permanent pacemakers are presented with a review of the literature. Vegetations were identified using transesophageal echocardiography. Infection of pacemaker leads is far less common than infection at the site of the pulse generator with greater morbidity and mortality and generally requiring surgical removal of both electrodes and power source. The most frequent infective agents are stahylococcus varieties.

  18. Postmortem analysis of encapsulation around long-term ventricular endocardial pacing leads.

    PubMed

    Candinas, R; Duru, F; Schneider, J; Lüscher, T F; Stokes, K

    1999-02-01

    To analyze the site and thickness of encapsulation around ventricular endocardial pacing leads and the extent of tricuspid valve adhesion, from today's perspective, with implications for lead removal and sensor location. Gross cardiac postmortem analysis was performed in 11 cases (8 female and 3 male patients; mean age, 78+/-7 years). None of the patients had died because of pacemaker malfunction. The mean implant time was 61+/-60 months (range, 4 to 184). The observations ranged from encapsulation only at the tip of the pacing lead to complete encapsulation along the entire length of the pacing lead within the right ventricle. Substantial areas of adhesion at the tricuspid valve apparatus were noted in 7 of the 11 cases (64%). The firmly attached leads could be removed only by dissection, and in some cases, removal was possible only by damaging the associated structures. No specific optimal site for sensor placement could be identified along the ventricular portion of the pacing leads; however, the fibrotic response was relatively less prominent in the atrial chamber. Extensive encapsulation is present in most long-term pacemaker leads, which may complicate lead removal. The site and thickness of encapsulation seem to be highly variable. Tricuspid valve adhesion, which is usually underestimated, may be severe. In contrast to earlier reports, our study demonstrates that the extent of fibrotic encapsulation may not be related to the duration since lead implantation. Moreover, we noted no ideal encapsulation-free site for sensors on the ventricular portion of long-term pacing leads.

  19. Longitudinal and Circumferential Strain of the Proximal Aorta

    PubMed Central

    Bell, Vanessa; Mitchell, William A.; Sigurðsson, Sigurður; Westenberg, Jos J. M.; Gotal, John D.; Torjesen, Alyssa A.; Aspelund, Thor; Launer, Lenore J.; de Roos, Albert; Gudnason, Vilmundur; Harris, Tamara B.; Mitchell, Gary F.

    2014-01-01

    Background Accurate assessment of mechanical properties of the proximal aorta is a requisite first step for elucidating the pathophysiology of isolated systolic hypertension. During systole, substantial proximal aortic axial displacement produces longitudinal strain, which we hypothesize causes variable underestimation of ascending aortic circumferential strain compared to values in the longitudinally constrained descending aorta. Methods and Results To assess effects of longitudinal strain, we performed magnetic resonance imaging in 375 participants (72 to 94 years old, 204 women) in the Age, Gene/Environment Susceptibility‐Reykjavik Study and measured aortic circumferential and longitudinal strain. Circumferential ascending aortic area strain uncorrected for longitudinal strain was comparable in women and men (mean [95% CI], 8.3 [7.8, 8.9] versus 7.9 [7.4, 8.5]%, respectively, P=0.3). However, longitudinal strain was greater in women (8.5±2.5 versus 7.0±2.5%, P<0.001), resulting in greater longitudinally corrected circumferential ascending aortic strain (14.4 [13.6, 15.2] versus 13.0 [12.4, 13.7]%, P=0.010). Observed circumferential descending aortic strain, which did not require correction (women: 14.0 [13.2, 14.8], men: 12.4 [11.6, 13.2]%, P=0.005), was larger than uncorrected (P<0.001), but comparable to longitudinally corrected (P=0.12) circumferential ascending aortic strain. Carotid‐femoral pulse wave velocity did not correlate with uncorrected ascending aortic strain (R=−0.04, P=0.5), but was inversely related to longitudinally corrected ascending and observed descending aortic strain (R=−0.15, P=0.004; R=−0.36, P<0.001, respectively). Longitudinal strain was also inversely related to carotid‐femoral pulse wave velocity and other risk factors for higher aortic stiffness including treated hypertension. Conclusions Longitudinal strain creates substantial and variable errors in circumferential ascending aortic area strain measurements

  20. The effect of circumferential distortion on fan performance at two levels of blade loading

    NASA Technical Reports Server (NTRS)

    Hartmann, M. J.; Sanger, N. L.

    1975-01-01

    Single stage fans designed for two levels of pressure ratio or blade loading were subjected to screen-induced circumferential distortions of 90-degree extent. Both fan rotors were designed for a blade tip speed of 425 m/sec, blade solidity of 1.3 and a hub-to-tip radius ratio of 0.5. Circumferential measurements of total pressure, temperature, static pressure, and flow angle were obtained at the hub, mean and tip radii at five axial stations. Rotor loading level did not appear to have a significant influence on rotor response to distorted flow. Losses in overall pressure ratio due to distortion were most severe in the stator hub region of the more highly loaded stage. At the near stall operating condition tip and hub regions of (either) rotor demonstrated different response characteristics to the distorted flow. No effect of loading was apparent on interactions between rotor and upstream distorted flow fields.

  1. Evaluating the roles of detailed endocardial structures on right ventricular haemodynamics by means of CFD simulations.

    PubMed

    Sacco, Federica; Paun, Bruno; Lehmkuhl, Oriol; Iles, Tinen L; Iaizzo, Paul A; Houzeaux, Guillaume; Vázquez, Mariano; Butakoff, Constantine; Aguado-Sierra, Jazmin

    2018-06-11

    Computational modelling plays an important role in right ventricular (RV) haemodynamic analysis. However, current approaches employ smoothed ventricular anatomies. The aim of this study is to characterise RV haemodynamics including detailed endocardial structures like trabeculae, moderator band and papillary muscles (PMs). Four paired detailed and smoothed RV endocardium models (two male and two female) were reconstructed from ex-vivo human hearts high-resolution magnetic resonance images (MRI). Detailed models include structures with ≥1 mm 2 cross-sectional area. Haemodynamic characterisation was done by computational fluid dynamics (CFD) simulations with steady and transient inflows, using high performance computing (HPC). The differences between the flows in smoothed and detailed models were assessed using Q-criterion for vorticity quantification, the pressure drop between inlet and outlet, and the wall shear stress (WSS). Results demonstrated that detailed endocardial structures increase the degree of intra-ventricular pressure drop, decrease the WSS and disrupt the dominant vortex creating secondary small vortices. Increasingly turbulent blood flow was observed in the detailed RVs. Female RVs were less trabeculated and presented lower pressure drops than the males. In conclusion, neglecting endocardial structures in RV haemodynamic models may lead to inaccurate conclusions about the pressures, stresses, and blood flow behaviour in the cavity. This article is protected by copyright. All rights reserved.

  2. An optically coupled system for quantitative monitoring of MRI gradient currents induced into endocardial leads.

    PubMed

    Mattei, E; Calcagnini, G; Triventi, M; Delogu, A; Del Guercio, M; Angeloni, A; Bartolini, P

    2013-01-01

    The time-varying gradient fields generated during Magnetic Resonance Imaging (MRI) procedures have the potential to induce electrical current on implanted endocardial leads. Whether this current can result in undesired cardiac stimulation is unknown. This paper presents an optically coupled system with the potential to quantitatively measure the currents induced by the gradient fields into endocardial leads during MRI procedures. Our system is based on a microcontroller that works as analog-to-digital (A/D) converter and sends the current signal acquired from the lead to an optical high-speed light-emitting-diode transmitter. Plastic fiber guides the light outside the MRI chamber, to a photodiode receiver and then to an acquisition board connected to a PC. The preliminary characterization of the performances of the system is also presented.

  3. Using Transmural Regularization and Dynamic Modeling for Non-Invasive Cardiac Potential Imaging of Endocardial Pacing with Imprecise Thoracic Geometry

    PubMed Central

    Erem, Burak; Coll-Font, Jaume; Orellana, Ramon Martinez; Štóvíček, Petr; Brooks, Dana H.

    2014-01-01

    Cardiac electrical imaging from body surface potential measurements is increasingly being seen as a technology with the potential for use in the clinic, for example for pre-procedure planning or during-treatment guidance for ventricular arrhythmia ablation procedures. However several important impediments to widespread adoption of this technology remain to be effectively overcome. Here we address two of these impediments: the difficulty of reconstructing electric potentials on the inner (endocardial) as well as outer (epicardial) surfaces of the ventricles, and the need for full anatomical imaging of the subject’s thorax to build an accurate subject-specific geometry. We introduce two new features in our reconstruction algorithm: a non-linear low-order dynamic parameterization derived from the measured body surface signals, and a technique to jointly regularize both surfaces. With these methodological innovations in combination, it is possible to reconstruct endocardial activation from clinically acquired measurements with an imprecise thorax geometry. In particular we test the method using body surface potentials acquired from three subjects during clinical procedures where the subjects’ hearts were paced on their endocardia using a catheter device. Our geometric models were constructed using a set of CT scans limited in axial extent to the immediate region near the heart. The catheter system provides a reference location to which we compare our results. We compare our estimates of pacing site localization, in terms of both accuracy and stability, to those reported in a recent clinical publication [1], where a full set of CT scans were available and only epicardial potentials were reconstructed. PMID:24595345

  4. Early development of the circumferential axonal pathway in mouse and chick spinal cord.

    PubMed

    Holley, J A

    1982-03-10

    The early development of the circumferential axonal pathway in the brachial and lumbar spinal cord of mouse and chick embryos was studied by scanning and transmission electron microscopy. The cellular processes which comprise this pathway grow in the transverse plane and along the lateral margin of the marginal zone (i.e., circumferentially oriented), as typified by the early embryonic commissural axons. The first formative event observed was in the ventrolateral margin of the primitive spinal cord ventricular zone. Cellular processes were found near the external limiting membrane that appeared to grow a variable distance either dorsally or ventrally. Later in development, presumptive motor column neurons migrated into the ventrolateral region, distal to these early circumferentially oriented processes. Concurrently, other circumferentially oriented perikarya and processes appeared along the dorsolateral margin. Due to their aligned sites of origin and parallel growth, the circumferential processes formed a more or less continuous line or pathway, which in about 10% of the scanned specimens could be followed along the entire lateral margin of the embryonic spinal cord. Several specimens later in development had two sets of aligned circumferential processes in the ventral region. Large numbers of circumferential axons were then found to follow the preformed pathway by fasciculation, after the primitive motor column had become established. Since the earliest circumferential processes appeared to differentiate into axons and were found nearly 24 hours prior to growth of most circumferential axons, their role in guidance as pioneering axons was suggested.

  5. Circumferentially aligned fibers guided functional neoartery regeneration in vivo.

    PubMed

    Zhu, Meifeng; Wang, Zhihong; Zhang, Jiamin; Wang, Lina; Yang, Xiaohu; Chen, Jingrui; Fan, Guanwei; Ji, Shenglu; Xing, Cheng; Wang, Kai; Zhao, Qiang; Zhu, Yan; Kong, Deling; Wang, Lianyong

    2015-08-01

    An ideal vascular graft should have the ability to guide the regeneration of neovessels with structure and function similar to those of the native blood vessels. Regeneration of vascular smooth muscle cells (VSMCs) with circumferential orientation within the grafts is crucial for functional vascular reconstruction in vivo. To date, designing and fabricating a vascular graft with well-defined geometric cues to facilitate simultaneously VSMCs infiltration and their circumferential alignment remains a great challenge and scarcely reported in vivo. Thus, we have designed a bi-layered vascular graft, of which the internal layer is composed of circumferentially aligned microfibers prepared by wet-spinning and an external layer composed of random nanofibers prepared by electrospinning. While the internal circumferentially aligned microfibers provide topographic guidance for in vivo regeneration of circumferentially aligned VSMCs, the external random nanofibers can offer enhanced mechanical property and prevent bleeding during and after graft implantation. VSMCs infiltration and alignment within the scaffold was then evaluated in vitro and in vivo. Our results demonstrated that the circumferentially oriented VSMCs and longitudinally aligned ECs were successfully regenerated in vivo after the bi-layered vascular grafts were implanted in rat abdominal aorta. No formation of thrombosis or intimal hyperplasia was observed up to 3 month post implantation. Further, the regenerated neoartery exhibited contraction and relaxation property in response to vasoactive agents. This new strategy may bring cell-free small diameter vascular grafts closer to clinical application. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Rapid high-amplitude circumferential slow wave propagation during normal gastric pacemaking and dysrhythmias

    PubMed Central

    O'Grady, Gregory; Du, Peng; Paskaranandavadivel, Nira; Angeli, Timothy R.; Lammers, Wim JEP; Asirvatham, Samuel J.; Windsor, John A.; Farrugia, Gianrico; Pullan, Andrew J.; Cheng, Leo K.

    2012-01-01

    Background Gastric slow waves propagate aborally as rings of excitation. Circumferential propagation does not normally occur, except at the pacemaker region. We hypothesized that: i) the unexplained high-velocity, high-amplitude activity associated with the pacemaker region is a consequence of circumferential propagation; ii) rapid, high-amplitude circumferential propagation emerges during gastric dysrhythmias; iii) the driving network conductance might switch between ICC-MP and circular ICC-IM during circumferential propagation; iv) extracellular amplitudes and velocities are correlated. Methods An experimental-theoretical study was performed. HR gastric mapping was performed in pigs during normal activation, pacing and dysrhythmia. Activation profiles, velocities and amplitudes were quantified. ICC pathways were theoretically evaluated in a bidomain model. Extracellular potentials were modelled as a function of membrane potentials. Key Results High-velocity, high-amplitude activation was only recorded in the pacemaker region when circumferential conduction occurred. Circumferential propagation accompanied dysrhythmia in 8/8 experiments, was faster than longitudinal propagation (8.9 vs 6.9 mm/s; p=0.004), and of higher amplitude (739 vs 528 μV; p=0.007). Simulations predicted that ICC-MP could be the driving network during longitudinal propagation, whereas during ectopic pacemaking, ICC-IM could outpace and activate ICC-MP in the circumferential axis. Experimental and modeling data demonstrated a linear relationship between velocities and amplitudes (p<0.001). Conclusions & Inferences The high-velocity and high-amplitude profile of the normal pacemaker region is due to localized circumferential propagation. Rapid circumferential propagation also emerges during a range of gastric dysrhythmias, elevating extracellular amplitudes and organizing transverse wavefronts. One possible explanation for these findings is bidirectional coupling between ICC-MP and circular

  7. Retinoic Acid Signaling Is Essential for Valvulogenesis by Affecting Endocardial Cushions Formation in Zebrafish Embryos.

    PubMed

    Li, Junbo; Yue, Yunyun; Zhao, Qingshun

    2016-02-01

    Retinoic acid (RA) plays important roles in many stages of heart morphogenesis. Zebrafish embryos treated with exogenous RA display defective atrio-ventricular canal (AVC) specification. However, whether endogenous RA signaling takes part in cardiac valve formation remains unknown. Herein, we investigated the role of RA signaling in cardiac valve development by knocking down aldh1a2, the gene encoding an enzyme that is mainly responsible for RA synthesis during early development, in zebrafish embryos. The results showed that partially knocking down aldh1a2 caused defective formation of primitive cardiac valve leaflets at 108 hpf (hour post-fertilization). Inhibiting endogenous RA signaling by 4-diethylaminobenzal-dehyde revealed that 16-26 hpf was a key time window when RA signaling affects the valvulogenesis. The aldh1a2 morphants had defective formation of endocardial cushion (EC) at 76 hpf though they had almost normal hemodynamics and cardiac chamber specification at early development. Examining the expression patterns of AVC marker genes including bmp4, bmp2b, nppa, notch1b, and has2, we found the morphants displayed abnormal development of endocardial AVC but almost normal development of myocardial AVC at 50 hpf. Being consistent with the reduced expression of notch1b in endocardial AVC, the VE-cadherin gene cdh5, the downstream gene of Notch signaling, was ectopically expressed in AVC of aldh1a2 morphants at 50 hpf, and overexpression of cdh5 greatly affected the formation of EC in the embryos at 76 hpf. Taken together, our results suggest that RA signaling plays essential roles in zebrafish cardiac valvulogenesis.

  8. Aerodynamic Inner Workings of Circumferential Grooves in a Transonic Axial Compressor

    NASA Technical Reports Server (NTRS)

    Hah, Chunill; Mueller, Martin; Schiffer, Heinz-Peter

    2007-01-01

    The current paper reports on investigations of the fundamental flow mechanisms of circumferential grooves applied to a transonic axial compressor. Experimental results show that the compressor stall margin is significantly improved with the current set of circumferential grooves. The primary focus of the current investigation is to advance understanding of basic flow mechanics behind the observed improvement of stall margin. Experimental data and numerical simulations of a circumferential groove were analyzed in detail to unlock the inner workings of the circumferential grooves in the current transonic compressor rotor. A short length scale stall inception occurs when a large flow blockage is built on the pressure side of the blade near the leading edge and incoming flow spills over to the adjacent blade passage due to this blockage. The current study reveals that a large portion of this blockage is created by the tip clearance flow originating from 20% to 50% chord of the blade from the leading edge. Tip clearance flows originating from the leading edge up to 20% chord form a tip clearance core vortex and this tip clearance core vortex travels radially inward. The tip clearance flows originating from 20% to 50% chord travels over this tip clearance core vortex and reaches to the pressure side. This part of tip clearance flow is of low momentum as it is coming from the casing boundary layer and the blade suction surface boundary layer. The circumferential grooves disturb this part of the tip clearance flow close to the casing. Consequently the buildup of the induced vortex and the blockage near the pressure side of the passage is reduced. This is the main mechanism of the circumferential grooves that delays the formation of blockage near the pressure side of the passage and delays the onset of short length scale stall inception. The primary effect of the circumferential grooves is preventing local blockage near the pressure side of the blade leading edge that

  9. Numerical investigation of a centrifugal compressor with circumferential grooves in vane diffuser

    NASA Astrophysics Data System (ADS)

    Chen, X. F.; Qin, G. L.; Ai, Z. J.

    2015-08-01

    Enhancing stall and surge margin has a great importance for the development of turbo compressors. The application of casing treatment is an effective measure to expand the stall margin and stable operation range. Numerical investigations were conducted to predict the performance of a low flow rate centrifugal compressor with circumferential groove casing treatment in vane diffuser. Numerical cases with different radial location, radial width and axial depth of a circumferential single groove and different numbers of circumferential grooves were carried out to compare the results. The CFD analyses results show that the centrifugal compressor with circumferential grooves in diffuser can extend stable range by about 9% while the efficiency over the whole operating range decreases by 0.2 to 1.7%. The evaluation based on stall margin improvement showed the optimal position for the groove to be located was indicated to exist near the leading edge of the diffuser, and a combination of position, width, depth and numbers of circumferential grooves that will maximize both surge margin range and efficiency.

  10. Demonstration of a Large-Scale Tank Assembly Via Circumferential Friction Stir Welds

    NASA Technical Reports Server (NTRS)

    Jones, Chip; Adams, Glynn; Colligan, Kevin; McCool, A. (Technical Monitor)

    2000-01-01

    Five (5) each 14-foot diameter circumferential FSWelds were conducted on the modified CWT, two (2) each pathfinder and three (3) each assembly welds Tapered circumferential welds were successfully demonstrated The use of a closeout anvil was successfully demonstrated during one of the pathfinder welds Considerable difficulty maintaining joint f it-up during the weld process Anvil deflections Hardware dimensional tolerances Inadequate clamping Variations in the heat sink characteristics of the circumferential anvil as compared to the test panel anvil

  11. Overlapping and differential localization of Bmp-2, Bmp-4, Msx-2 and apoptosis in the endocardial cushion and adjacent tissues of the developing mouse heart.

    PubMed

    Abdelwahid, E; Rice, D; Pelliniemi, L J; Jokinen, E

    2001-07-01

    The bone morphogenetic proteins BMP-2 and BMP-4 and the homeobox gene MSX-2 are required for normal development of many embryonic tissues. To elucidate their possible roles during the remodeling of the tubular heart into a fully septated four-chambered heart, we have localized the mRNA of Bmp-2, Bmp-4, Msx-2 and apoptotic cells in the developing mouse heart from embryonic day (E)11 to E17. mRNA was localized by in situ hybridization, and apoptotic cells by TUNEL (TDT-mediated dUTP-biotin nick end-labeling) as well as by transmission electron microscopy. By analyzing adjacent serial sections, we demonstrated that the expression of Msx-2 and Bmp-2 strikingly overlapped in the atrioventricular canal myocardium, in the atrioventricular junctional myocardium, and in the maturing myocardium of the atrioventricular valves. Bmp-4 was expressed in the outflow tract myocardium and in the endocardial cushion of the outflow tract ridges from E12 to E14. Msx-2 appeared in the mesenchyme of the atrioventricular endocardial cushion from E11 to E14, while Bmp-2 and Bmp-4 were detected between E11 and E14. Apoptotic cells were also detected in the mesenchyme of the endocardial cushion between E12 and E14. Our results suggest that BMP-2 and MSX-2 are tightly linked to the formation of the atrioventricular junction and valves and that BMP-4 is involved in the development of the outflow tract myocardium and of the endocardial cushion. In addition, BMP-2, BMP-4 and MSX-2 and apoptosis seem to be associated with differentiation of the endocardial cushion.

  12. On estimating intraventricular hemodynamic forces from endocardial dynamics: A comparative study with 4D flow MRI.

    PubMed

    Pedrizzetti, Gianni; Arvidsson, Per M; Töger, Johannes; Borgquist, Rasmus; Domenichini, Federico; Arheden, Håkan; Heiberg, Einar

    2017-07-26

    Intraventricular pressure gradients or hemodynamic forces, which are their global measure integrated over the left ventricular volume, have a fundamental importance in ventricular function. They may help revealing a sub-optimal cardiac function that is not evident in terms of tissue motion, which is naturally heterogeneous and variable, and can influence cardiac adaptation. However, hemodynamic forces are not utilized in clinical cardiology due to the unavailability of simple non-invasive measurement tools. Hemodynamic forces depend on the intraventricular flow; nevertheless, most of them are imputable to the dynamics of the endocardial flow boundary and to the exchange of momentum across the mitral and aortic orifices. In this study, we introduce a simplified model based on first principles of fluid dynamics that allows estimating hemodynamic forces without knowing the velocity field inside the LV. The model is validated with 3D phase-contrast MRI (known as 4D flow MRI) in 15 subjects, (5 healthy and 10 patients) using the endocardial surface reconstructed from the three standard long-axis projections. Results demonstrate that the model provides consistent estimates for the base-apex component (mean correlation coefficient r=0.77 for instantaneous values and r=0.88 for root mean square) and good estimates of the inferolateral-anteroseptal component (r=0.50 and 0.84, respectively). The present method represents a potential integration to the existing ones quantifying endocardial deformation in MRI and echocardiography to add a physics-based estimation of the corresponding hemodynamic forces. These could help the clinician to early detect sub-clinical diseases and differentiate between different cardiac dysfunctional states. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Self-Reacting Friction Stir Welding for Aluminum Alloy Circumferential Weld Applications

    NASA Technical Reports Server (NTRS)

    Bjorkman, Gerry; Cantrell, Mark; Carter, Robert

    2003-01-01

    Friction stir welding is an innovative weld process that continues to grow in use, in the commercial, defense, and space sectors. It produces high quality and high strength welds in aluminum alloys. The process consists of a rotating weld pin tool that plasticizes material through friction. The plasticized material is welded by applying a high weld forge force through the weld pin tool against the material during pin tool rotation. The high weld forge force is reacted against an anvil and a stout tool structure. A variation of friction stir welding currently being evaluated is self-reacting friction stir welding. Self-reacting friction stir welding incorporates two opposing shoulders on the crown and root sides of the weld joint. In self-reacting friction stir welding, the weld forge force is reacted against the crown shoulder portion of the weld pin tool by the root shoulder. This eliminates the need for a stout tooling structure to react the high weld forge force required in the typical friction stir weld process. Therefore, the self-reacting feature reduces tooling requirements and, therefore, process implementation costs. This makes the process attractive for aluminum alloy circumferential weld applications. To evaluate the application of self-reacting friction stir welding for aluminum alloy circumferential welding, a feasibility study was performed. The study consisted of performing a fourteen-foot diameter aluminum alloy circumferential demonstration weld using typical fusion weld tooling. To accomplish the demonstration weld, weld and tack weld development were performed and fourteen-foot diameter rings were fabricated. Weld development consisted of weld pin tool selection and the generation of a process map and envelope. Tack weld development evaluated gas tungsten arc welding and friction stir welding for tack welding rings together for circumferential welding. As a result of the study, a successful circumferential demonstration weld was produced leading

  14. Right ventricular outflow tract high-density endocardial unipolar voltage mapping in patients with Brugada syndrome: evidence for electroanatomical abnormalities.

    PubMed

    Letsas, Konstantinos P; Efremidis, Michael; Vlachos, Konstantinos; Georgopoulos, Stamatis; Karamichalakis, Nikolaos; Asvestas, Dimitrios; Valkanas, Kosmas; Korantzopoulos, Panagiotis; Liu, Tong; Sideris, Antonios

    2017-05-02

    Epicardial structural abnormalities at the right ventricular outflow tract (RVOT) may provide the arrhythmia substrate in Brugada syndrome (BrS). Electroanatomical endocardial unipolar voltage mapping is an emerging tool that accurately identifies epicardial abnormalities in different clinical settings. This study investigated whether endocardial unipolar voltage mapping of the RVOT detects electroanatomical abnormalities in patients with BrS. Ten asymptomatic patients (8 males, 34.5 ± 11.2 years) with spontaneous type 1 ECG pattern of BrS and negative late gadolinium enhancement-cardiac magnetic resonance imaging (LGE-c-MRI) underwent high-density endocardial electroanatomical mapping (>800 points). Using a cut-off of 1 mV and 4 mV for normal bipolar and unipolar voltage, respectively, derived from 20 control patients without structural heart disease established by LGE-c-MRI, the extend of low-voltage areas within the RVOT was estimated using a specific calculation software. The mean RVOT area presenting low-voltage bipolar signals in BrS patients was 3.4 ± 1.7 cm2 (range 1.5-7 cm2). A significantly greater area of abnormal unipolar signals was identified (12.6 ± 4.6 cm2 [range 7-22 cm2], P: 0.001). Both bipolar and unipolar electroanatomical abnormalities were mainly located at the free wall of the RVOT. The mean RVOT activation time was significantly prolonged in BrS patients compared to control population (86.4 ± 16.5 vs. 63.4 ± 9.7 ms, P < 0.001). Isochronal mapping demonstrated lines of conduction slowing within the RVOT in 8/10 BrS patients. Wide areas of endocardial unipolar voltage abnormalities that possibly reflect epicardial structural abnormalities are identified at the RVOT of BrS patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  15. A Novel Feature-Tracking Echocardiographic Method for the Quantitation of Regional Myocardial Function

    PubMed Central

    Pirat, Bahar; Khoury, Dirar S.; Hartley, Craig J.; Tiller, Les; Rao, Liyun; Schulz, Daryl G.; Nagueh, Sherif F.; Zoghbi, William A.

    2012-01-01

    Objectives The aim of this study was to validate a novel, angle-independent, feature-tracking method for the echocardiographic quantitation of regional function. Background A new echocardiographic method, Velocity Vector Imaging (VVI) (syngo Velocity Vector Imaging technology, Siemens Medical Solutions, Ultrasound Division, Mountain View, California), has been introduced, based on feature tracking—incorporating speckle and endocardial border tracking, that allows the quantitation of endocardial strain, strain rate (SR), and velocity. Methods Seven dogs were studied during baseline, and various interventions causing alterations in regional function: dobutamine, 5-min coronary occlusion with reperfusion up to 1 h, followed by dobutamine and esmolol infusions. Echocardiographic images were acquired from short- and long-axis views of the left ventricle. Segment-length sonomicrometry crystals were used as the reference method. Results Changes in systolic strain in ischemic segments were tracked well with VVI during the different states of regional function. There was a good correlation between circumferential and longitudinal systolic strain by VVI and sonomicrometry (r = 0.88 and r = 0.83, respectively, p < 0.001). Strain measurements in the nonischemic basal segments also demonstrated a significant correlation between the 2 methods (r = 0.65, p < 0.001). Similarly, a significant relation was observed for circumferential and longitudinal SR between the 2 methods (r = 0.94, p < 0.001 and r = 0.90, p < 0.001, respectively). The endocardial velocity relation to changes in strain by sonomicrometry was weaker owing to significant cardiac translation. Conclusions Velocity Vector Imaging, a new feature-tracking method, can accurately assess regional myocardial function at the endocardial level and is a promising clinical tool for the simultaneous quantification of regional and global myocardial function. PMID:18261685

  16. A novel feature-tracking echocardiographic method for the quantitation of regional myocardial function: validation in an animal model of ischemia-reperfusion.

    PubMed

    Pirat, Bahar; Khoury, Dirar S; Hartley, Craig J; Tiller, Les; Rao, Liyun; Schulz, Daryl G; Nagueh, Sherif F; Zoghbi, William A

    2008-02-12

    The aim of this study was to validate a novel, angle-independent, feature-tracking method for the echocardiographic quantitation of regional function. A new echocardiographic method, Velocity Vector Imaging (VVI) (syngo Velocity Vector Imaging technology, Siemens Medical Solutions, Ultrasound Division, Mountain View, California), has been introduced, based on feature tracking-incorporating speckle and endocardial border tracking, that allows the quantitation of endocardial strain, strain rate (SR), and velocity. Seven dogs were studied during baseline, and various interventions causing alterations in regional function: dobutamine, 5-min coronary occlusion with reperfusion up to 1 h, followed by dobutamine and esmolol infusions. Echocardiographic images were acquired from short- and long-axis views of the left ventricle. Segment-length sonomicrometry crystals were used as the reference method. Changes in systolic strain in ischemic segments were tracked well with VVI during the different states of regional function. There was a good correlation between circumferential and longitudinal systolic strain by VVI and sonomicrometry (r = 0.88 and r = 0.83, respectively, p < 0.001). Strain measurements in the nonischemic basal segments also demonstrated a significant correlation between the 2 methods (r = 0.65, p < 0.001). Similarly, a significant relation was observed for circumferential and longitudinal SR between the 2 methods (r = 0.94, p < 0.001 and r = 0.90, p < 0.001, respectively). The endocardial velocity relation to changes in strain by sonomicrometry was weaker owing to significant cardiac translation. Velocity Vector Imaging, a new feature-tracking method, can accurately assess regional myocardial function at the endocardial level and is a promising clinical tool for the simultaneous quantification of regional and global myocardial function.

  17. Segmental Analysis of Cardiac Short-Axis Views Using Lagrangian Radial and Circumferential Strain.

    PubMed

    Ma, Chi; Wang, Xiao; Varghese, Tomy

    2016-11-01

    Accurate description of myocardial deformation in the left ventricle is a three-dimensional problem, requiring three normal strain components along its natural axis, that is, longitudinal, radial, and circumferential strains. Although longitudinal strains are best estimated from long-axis views, radial and circumferential strains are best depicted in short-axis views. An algorithm that utilizes a polar grid for short-axis views previously developed in our laboratory for a Lagrangian description of tissue deformation is utilized for radial and circumferential displacement and strain estimation. Deformation of the myocardial wall, utilizing numerical simulations with ANSYS, and a finite-element analysis-based canine heart model were adapted as the input to a frequency-domain ultrasound simulation program to generate radiofrequency echo signals. Clinical in vivo data were also acquired from a healthy volunteer. Local displacements estimated along and perpendicular to the ultrasound beam propagation direction are then transformed into radial and circumferential displacements and strains using the polar grid based on a pre-determined centroid location. Lagrangian strain variations demonstrate good agreement with the ideal strain when compared with Eulerian results. Lagrangian radial and circumferential strain estimation results are also demonstrated for experimental data on a healthy volunteer. Lagrangian radial and circumferential strain tracking provide accurate results with the assistance of the polar grid, as demonstrated using both numerical simulations and in vivo study. © The Author(s) 2015.

  18. Segmental Analysis of Cardiac Short-Axis Views Using Lagrangian Radial and Circumferential Strain

    PubMed Central

    Ma, Chi; Wang, Xiao; Varghese, Tomy

    2016-01-01

    Accurate description of myocardial deformation in the left ventricle is a three-dimensional problem, requiring three normal strain components along its natural axis, that is, longitudinal, radial, and circumferential strains. Although longitudinal strains are best estimated from long-axis views, radial and circumferential strains are best depicted in short-axis views. An algorithm that utilizes a polar grid for short-axis views previously developed in our laboratory for a Lagrangian description of tissue deformation is utilized for radial and circumferential displacement and strain estimation. Deformation of the myocardial wall, utilizing numerical simulations with ANSYS, and a finite-element analysis–based canine heart model were adapted as the input to a frequency-domain ultrasound simulation program to generate radiofrequency echo signals. Clinical in vivo data were also acquired from a healthy volunteer. Local displacements estimated along and perpendicular to the ultrasound beam propagation direction are then transformed into radial and circumferential displacements and strains using the polar grid based on a pre-determined centroid location. Lagrangian strain variations demonstrate good agreement with the ideal strain when compared with Eulerian results. Lagrangian radial and circumferential strain estimation results are also demonstrated for experimental data on a healthy volunteer. Lagrangian radial and circumferential strain tracking provide accurate results with the assistance of the polar grid, as demonstrated using both numerical simulations and in vivo study. PMID:26578642

  19. Demonstration of a Large-Scale Tank Assembly via Circumferential Friction Stir Welds

    NASA Technical Reports Server (NTRS)

    Jones, Clyde S.; Adams, Glynn; Colligan, Kevin

    2000-01-01

    A collaborative effort between NASA/Marshall Space Flight Center and the Michoud Unit of Lockheed Martin Space Systems Company was undertaken to demonstrate assembly of a large-scale aluminum tank using circumferential friction stir welds. The hardware used to complete this demonstration was fabricated as a study of near-net- shape technologies. The tooling used to complete this demonstration was originally designed for assembly of a tank using fusion weld processes. This presentation describes the modifications and additions that were made to the existing fusion welding tools required to accommodate circumferential friction stir welding, as well as the process used to assemble the tank. The tooling modifications include design, fabrication and installation of several components. The most significant components include a friction stir weld unit with adjustable pin length capabilities, a continuous internal anvil for 'open' circumferential welds, a continuous closeout anvil, clamping systems, an external reaction system and the control system required to conduct the friction stir welds and integrate the operation of the tool. The demonstration was intended as a development task. The experience gained during each circumferential weld was applied to improve subsequent welds. Both constant and tapered thickness 14-foot diameter circumferential welds were successfully demonstrated.

  20. Electrical latency predicts the optimal left ventricular endocardial pacing site: results from a multicentre international registry.

    PubMed

    Sieniewicz, Benjamin J; Behar, Jonathan M; Sohal, Manav; Gould, Justin; Claridge, Simon; Porter, Bradley; Niederer, Steve; Gamble, James H P; Betts, Tim R; Jais, Pierre; Derval, Nicolas; Spragg, David D; Steendijk, Paul; van Gelder, Berry M; Bracke, Frank A; Rinaldi, Christopher A

    2018-04-23

    The optimal site for biventricular endocardial (BIVENDO) pacing remains undefined. Acute haemodynamic response (AHR) is reproducible marker of left ventricular (LV) contractility, best expressed as the change in the maximum rate of LV pressure (LV-dp/dtmax), from a baseline state. We examined the relationship between factors known to impact LV contractility, whilst delivering BIVENDO pacing at a variety of LV endocardial (LVENDO) locations. We compiled a registry of acute LVENDO pacing studies from five international centres: Johns Hopkins-USA, Bordeaux-France, Eindhoven-The Netherlands, Oxford-United Kingdom, and Guys and St Thomas' NHS Foundation Trust, London-UK. In all, 104 patients incorporating 687 endocardial and 93 epicardial pacing locations were studied. Mean age was 66 ± 11 years, mean left ventricular ejection fraction 24.6 ± 7.7% and mean QRS duration of 163 ± 30 ms. In all, 50% were ischaemic [ischaemic cardiomyopathy (ICM)]. Scarred segments were associated with worse haemodynamics (dp/dtmax; 890 mmHg/s vs. 982 mmHg/s, P < 0.01). Delivering BiVENDO pacing in areas of electrical latency was associated with greater improvements in AHR (P < 0.01). Stimulating late activating tissue (LVLED >50%) achieved greater increases in AHR than non-late activating tissue (LVLED < 50%) (8.6 ± 9.6% vs. 16.1 ± 16.2%, P = 0.002). However, the LVENDO pacing location with the latest Q-LV, was associated with the optimal AHR in just 62% of cases. Identifying viable LVENDO tissue which displays late electrical activation is crucial to identifying the optimal BiVENDO pacing site. Stimulating late activating tissue (LVLED >50%) yields greater improvements in AHR however, the optimal location is frequently not the site of latest activation.

  1. Usefulness of ventricular endocardial electric reconstruction from body surface potential maps to noninvasively localize ventricular ectopic activity in patients

    NASA Astrophysics Data System (ADS)

    Lai, Dakun; Sun, Jian; Li, Yigang; He, Bin

    2013-06-01

    As radio frequency (RF) catheter ablation becomes increasingly prevalent in the management of ventricular arrhythmia in patients, an accurate and rapid determination of the arrhythmogenic site is of important clinical interest. The aim of this study was to test the hypothesis that the inversely reconstructed ventricular endocardial current density distribution from body surface potential maps (BSPMs) can localize the regions critical for maintenance of a ventricular ectopic activity. Patients with isolated and monomorphic premature ventricular contractions (PVCs) were investigated by noninvasive BSPMs and subsequent invasive catheter mapping and ablation. Equivalent current density (CD) reconstruction (CDR) during symptomatic PVCs was obtained on the endocardial ventricular surface in six patients (four men, two women, years 23-77), and the origin of the spontaneous ectopic activity was localized at the location of the maximum CD value. Compared with the last (successful) ablation site (LAS), the mean and standard deviation of localization error of the CDR approach were 13.8 and 1.3 mm, respectively. In comparison, the distance between the LASs and the estimated locations of an equivalent single moving dipole in the heart was 25.5 ± 5.5 mm. The obtained CD distribution of activated sources extending from the catheter ablation site also showed a high consistency with the invasively recorded electroanatomical maps. The noninvasively reconstructed endocardial CD distribution is suitable to predict a region of interest containing or close to arrhythmia source, which may have the potential to guide RF catheter ablation.

  2. Endocardial left ventricle feature tracking and reconstruction from tri-plane trans-esophageal echocardiography data

    NASA Astrophysics Data System (ADS)

    Dangi, Shusil; Ben-Zikri, Yehuda K.; Cahill, Nathan; Schwarz, Karl Q.; Linte, Cristian A.

    2015-03-01

    Two-dimensional (2D) ultrasound (US) has been the clinical standard for over two decades for monitoring and assessing cardiac function and providing support via intra-operative visualization and guidance for minimally invasive cardiac interventions. Developments in three-dimensional (3D) image acquisition and transducer design and technology have revolutionized echocardiography imaging enabling both real-time 3D trans-esophageal and intra-cardiac image acquisition. However, in most cases the clinicians do not access the entire 3D image volume when analyzing the data, rather they focus on several key views that render the cardiac anatomy of interest during the US imaging exam. This approach enables image acquisition at a much higher spatial and temporal resolution. Two such common approaches are the bi-plane and tri-plane data acquisition protocols; as their name states, the former comprises two orthogonal image views, while the latter depicts the cardiac anatomy based on three co-axially intersecting views spaced at 600 to one another. Since cardiac anatomy is continuously changing, the intra-operative anatomy depicted using real-time US imaging also needs to be updated by tracking the key features of interest and endocardial left ventricle (LV) boundaries. Therefore, rapid automatic feature tracking in US images is critical for three reasons: 1) to perform cardiac function assessment; 2) to identify location of surgical targets for accurate tool to target navigation and on-target instrument positioning; and 3) to enable pre- to intra-op image registration as a means to fuse pre-op CT or MR images used during planning with intra-operative images for enhanced guidance. In this paper we utilize monogenic filtering, graph-cut based segmentation and robust spline smoothing in a combined work flow to process the acquired tri-plane TEE time series US images and demonstrate robust and accurate tracking of the LV endocardial features. We reconstruct the endocardial LV

  3. Status of the steam generator tube circumferential ODSCC degradation experienced at the Doel 4 plant

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

    Roussel, G.

    1997-02-01

    Since the 1991 outage, the Doel Unit 4 nuclear power plant is known to be affected by circumferential outside diameter intergranular stress corrosion cracking at the hot leg tube expansion transition. Extensive non destructive examination inspections have shown the number of tubes affected by this problem as well as the size of the cracks to have been increasing for the three cycles up to 1993. As a result of the high percentage of tubes found non acceptable for continued service after the 1993 in-service inspection, about 1,700 mechanical sleeves were installed in the steam generators. During the 1994 outage, allmore » the tubes sleeved during the 1993 outage were considered as potentially cracked to some extent at the upper hydraulic transition and were therefore not acceptable for continued service. They were subsequently repaired by laser welding. Furthermore all the tubes not sleeved during the 1993 outage were considered as not acceptable for continued service and were repaired by installing laser welded sleeves. During the 1995 outage, some unexpected degradation phenomena were evidenced in the sleeved tubes. This paper summarizes the status of the circumferential ODSCC experienced in the SG tubes of the Doel 4 plant as well as the other connected degradation phenomena.« less

  4. Structural and leakage integrity of tubes affected by circumferential cracking

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

    Hernalsteen, P.

    1997-02-01

    In this paper the author deals with the notion that circumferential cracks are generally considered unacceptable. He argues for the need to differentiate two facets of such cracks: the issue of the size and growth rate of a crack; and the issue of the structural strength and leakage potential of the tube in the presence of the crack. In this paper the author tries to show that the second point is not a major concern for such cracks. The paper presents data on the structural strength or burst pressure characteristics of steam generator tubes derived from models and data basesmore » of experimental work. He also presents a leak rate model, and compares the performance of circumferential and axial cracks as far as burst strength and leak rate. The final conclusion is that subject to improvement in NDE capabilities (sizing, detection, growth), that Steam Generator Defect Specific Management can be used to allow circumferentially degraded tubes to remain in service.« less

  5. [Pathomorphologic and ultrastructural characteristics of endocardial Cysticercus cellulosae].

    PubMed

    Grozdev, L J; Kaftandziev, D; Roganovic, D; Colanceski, V

    1980-01-01

    A case is presented of a solitary endocardial cysticercus of cellulose discovered at a biopsy in the left auricula of the heart, got by a 36-year old patient at the operation who had a mitral and aortal defect caused by a reumatic endocarditis. The cisticercus is implanted on the surface of an intact endothelium and the fibroelastic structure of the superficial part of the endocardium is preserved. Inflammation of the endocardium and the myocardium is presented by a perivascular infiltrates eosinophile granulocytes, plasms cells and lymphocytes, suggesting an allergic nature of inflammation. In histological preparates stained by selective methods of fungus according to Gridley and Crocott on the wall of the membrane of the cyst polymorphal Yeast-like elements are discovered at a size of 2-12 mil. mic. which ultrastructurally show degenerative forms of membranous structures suspected as immature primitive proglotids. In this paper, the objective difficulties are pointed out at the microscopic diagnosis of the cisticercus in the pathological material.

  6. Circumferential gap propagation in an anisotropic elastic bacterial sacculus

    NASA Astrophysics Data System (ADS)

    Taneja, Swadhin; Levitan, Benjamin A.; Rutenberg, Andrew D.

    2014-01-01

    We have modeled stress concentration around small gaps in anisotropic elastic sheets, corresponding to the peptidoglycan sacculus of bacterial cells, under loading corresponding to the effects of turgor pressure in rod-shaped bacteria. We find that under normal conditions the stress concentration is insufficient to mechanically rupture bacteria, even for gaps up to a micron in length. We then explored the effects of stress-dependent smart autolysins, as hypothesized by A. L. Koch [Adv. Microb. Physiol. 24, 301 (1983), 10.1016/S0065-2911(08)60388-4; Res. Microbiol. 141, 529 (1990), 10.1016/0923-2508(90)90017-K]. We show that the measured anisotropic elasticity of the peptidoglycan (PG) sacculus can lead to stable circumferential propagation of small gaps in the sacculus. This is consistent with the recent observation of circumferential propagation of PG-associated MreB patches in rod-shaped bacteria. We also find a bistable regime of both circumferential and axial gap propagation, which agrees with behavior reported in cytoskeletal mutants of B. subtilis. We conclude that the elastic anisotropies of a bacterial sacculus, as characterized experimentally, may be relevant for maintaining rod-shaped bacterial growth.

  7. Molecular Modeling of the Axial and Circumferential Elastic Moduli of Tubulin

    PubMed Central

    Zeiger, A. S.; Layton, B. E.

    2008-01-01

    Microtubules play a number of important mechanical roles in almost all cell types in nearly all major phylogenetic trees. We have used a molecular mechanics approach to perform tensile tests on individual tubulin monomers and determined values for the axial and circumferential moduli for all currently known complete sequences. The axial elastic moduli, in vacuo, were found to be 1.25 GPa and 1.34 GPa for α- and β-bovine tubulin monomers. In the circumferential direction, these moduli were 378 MPa for α- and 460 MPa for β-structures. Using bovine tubulin as a template, 269 homologous tubulin structures were also subjected to simulated tensile loads yielding an average axial elastic modulus of 1.10 ± 0.14 GPa for α-tubulin structures and 1.39 ± 0.68 GPa for β-tubulin. Circumferentially the α- and β-moduli were 936 ± 216 MPa and 658 ± 134 MPa, respectively. Our primary finding is that that the axial elastic modulus of tubulin diminishes as the length of the monomer increases. However, in the circumferential direction, no correlation exists. These predicted anisotropies and scale dependencies may assist in interpreting the macroscale behavior of microtubules during mitosis or cell growth. Additionally, an intergenomic approach to investigating the mechanical properties of proteins may provide a way to elucidate the evolutionary mechanical constraints imposed by nature upon individual subcellular components. PMID:18621829

  8. Endocardial Hippo signaling regulates myocardial growth and cardiogenesis.

    PubMed

    Artap, Stanley; Manderfield, Lauren J; Smith, Cheryl L; Poleshko, Andrey; Aghajanian, Haig; See, Kelvin; Li, Li; Jain, Rajan; Epstein, Jonathan A

    2018-08-01

    The Hippo signaling pathway has been implicated in control of cell and organ size, proliferation, and endothelial-mesenchymal transformation. This pathway impacts upon two partially redundant transcription cofactors, Yap and Taz, that interact with other factors, including members of the Tead family, to affect expression of downstream genes. Yap and Taz have been shown to regulate, in a cell-autonomous manner, myocardial proliferation, myocardial hypertrophy, regenerative potential, and overall size of the heart. Here, we show that Yap and Taz also play an instructive, non-cell-autonomous role in the endocardium of the developing heart to regulate myocardial growth through release of the paracrine factor, neuregulin. Without endocardial Yap and Taz, myocardial growth is impaired causing early post-natal lethality. Thus, the Hippo signaling pathway regulates cell size via both cell-autonomous and non-cell-autonomous mechanisms. Furthermore, these data suggest that Hippo may regulate organ size via a sensing and paracrine function in endothelial cells. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Usefulness of layer-specific strain for identifying complex CAD and predicting the severity of coronary lesions in patients with non-ST-segment elevation acute coronary syndrome: Compared with Syntax score.

    PubMed

    Zhang, Li; Wu, Wei-Chun; Ma, Hong; Wang, Hao

    2016-11-15

    Layer-specific strain allows the assessment of the function of every layer of myocardium. To evaluate the changes of non-ST-segment elevation acute coronary syndrome(NSTE-ACS) patients with and without complex coronary artery disease(CAD) by layer-specific strain and determine if myocardial strain can identify complex CAD and assess the severity of coronary lesions as defined by Syntax score (SS). A total of 139 patients undergoing coronary angiography due to suspected NSTE-ACS were prospectively enrolled. Echocardiography was performed 1h before angiography. Global longitudinal strain (GLS), territorial longitudinal strain (TLS), global circumferential strain (GCS) and territorial circumferential strain (TCS) of the three layers of LV wall were assessed by two-dimensional (2D) speckle tracking echocardiography (STE) with layer-specific myocardial deformation quantitative analysis based on the perfusion territories of the three major coronary arteries in an 18-segment model of LV. SS was used for predicting the severity of coronary lesions in patients with complex CAD. 78 had complex CAD, 32 had 1- or 2-vessel disease and 29 had no significant coronary stenosis confirmed by coronary angiography. According to SS value, 78 complex CAD subjects were subdivided into three groups, 24 in group SS 1 (SS≤22), 26 in group SS 2 (SS 23-32) and 28 in group SS 3 (SS≥33). Compared to the other two groups without complex CAD, patients with NSTE-ACS due to complex CAD had worse function in all 3 myocardial layers assessed by GLS, TLS, GCS and TCS. Endocardial GLS and TLS (all, P<0.01) were most affected. The absolute differences between endocardial and epicardial GLS and TLS were lower in magnitude in patients with complex CAD than in those without (all, P<0.001), and the more complex of coronary lesion, the lower magnitude of the parameters(all, P<0.001). Endocardial GLS and TLS were closely correlated with SS value(r=-0.751 and r=-0.753, respectively; P<0.001). By receiver

  10. Nickel-titanium wire in circumferential suture of a flexor tendon repair: a comparison to polypropylene.

    PubMed

    Karjalainen, T; He, M; Chong, A K S; Lim, A Y T; Ryhanen, J

    2010-07-01

    Nickel-titanium (NiTi) has been proposed as an alternative material for flexor tendon core suture. To our knowledge, its suitability as a circumferential suture of flexor tendon repair has not been investigated before. The purpose of this ex vivo study was to investigate the biomechanical properties of NiTi circumferential repairs and to compare them with commonly used polypropylene. Forty porcine flexor tendons were cut and repaired by simple running or interlocking mattress technique using 100 microm NiTi wire or 6-0 polypropylene. The NiTi circumferential repairs showed superior stiffness, gap resistance, and load to failure when compared to polypropylene repairs with both techniques. Nickel-titanium wire seems to be a potential material for circumferential repair of flexor tendons. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  11. Arthroscopic repair of circumferential lesions of the glenoid labrum: surgical technique.

    PubMed

    Tokish, John M; McBratney, Colleen M; Solomon, Daniel J; Leclere, Lance; Dewing, Christopher B; Provencher, Matthew T

    2010-09-01

    Symptomatic pan-labral or circumferential (360°) tears of the glenohumeral labrum are an uncommon injury. The purpose of the present study was to report the results of surgical treatment of circumferential lesions of the glenoid labrum with use of validated outcome instruments. From July 2003 to May 2006, forty-one shoulders in thirty-nine patients (thirty-four men and five women) with a mean age of 25.1 years were prospectively enrolled in a multicenter study and were managed for a circumferential (360°) lesion of the glenoid labrum. All patients had a primary diagnosis of pain and recurrent shoulder instability, and all underwent arthroscopic repair of the circumferential labral tear with a mean of 7.1 suture anchors. The outcomes for thirty-nine of the forty-one shoulders were assessed after a mean duration of follow-up of 31.8 months on the basis of the rating of pain and instability on a scale of 0 to 10, a physical examination, and three outcome instruments (the Single Assessment Numeric Evaluation score, the modified American Shoulder and Elbow Surgeons score, and the Short Form-12 score). Significant improvement was noted in terms of the mean pain score (from 4.3 to 1.1), the mean instability score (from 7.3 to 0.2), the mean modified American Shoulder and Elbow Surgeons score (from 55.5 to 89.6), the mean Short Form-12 score (from 75.7 to 90.0), and the mean Single Assessment Numeric Evaluation score (from 36.7 to 88.5). Six shoulders required revision surgery because of recurrent instability (two), recalcitrant biceps tendinitis (two), or postoperative tightness (two). All patients returned to their preinjury activity level. Pan-labral or circumferential lesions are an uncommon yet extensive injury of the glenohumeral joint that may result in recurrent instability and pain. The present study demonstrates that arthroscopic capsulolabral repair with suture anchor fixation can restore the stability of the glenohumeral joint and can provide a reliable

  12. Circumferential pressure probe

    NASA Technical Reports Server (NTRS)

    Holmes, Harlan K. (Inventor); Moore, Thomas C. (Inventor); Fantl, Andrew J. (Inventor)

    1989-01-01

    A probe for measuring circumferential pressure inside a body cavity is disclosed. In the preferred embodiment, a urodynamic pressure measurement probe for evaluating human urinary sphincter function is disclosed. Along the length of the probe are disposed a multiplicity of deformable wall sensors which typically comprise support tube sections with flexible side wall areas. These are arranged along the length of the probe in two areas, one just proximal to the tip for the sensing of fluid pressure inside the bladder, and five in the sensing section which is positioned within the urethra at the point at which the urinary sphincter constricts to control the flow of urine. The remainder of the length of the probe comprises multiple rigid support tube sections interspersed with flexible support tube sections in the form of bellows to provide flexibility.

  13. Speckle-Tracking Layer-Specific Analysis of Myocardial Deformation and Evaluation of Scar Transmurality in Chronic Ischemic Heart Disease.

    PubMed

    Tarascio, Michela; Leo, Laura Anna; Klersy, Catherine; Murzilli, Romina; Moccetti, Tiziano; Faletra, Francesco Fulvio

    2017-07-01

    Identification of the extent of scar transmurality in chronic ischemic heart disease is important because it correlates with viability. The aim of this retrospective study was to evaluate whether layer-specific two-dimensional speckle-tracking echocardiography allows distinction of scar presence and transmurality. A total of 70 subjects, 49 with chronic ischemic cardiomyopathy and 21 healthy subjects, underwent two-dimensional speckle-tracking echocardiography and late gadolinium-enhanced cardiac magnetic resonance. Scar extent was determined as the relative amount of hyperenhancement using late gadolinium-enhanced cardiac magnetic resonance in an 18-segment model (0% hyperenhancement = normal; 1%-50% = subendocardial scar; 51%-100% = transmural scar). In the same 18-segment model, peak systolic circumferential strain and longitudinal strain were calculated separately for the endocardial and epicardial layers as well as the full-wall myocardial thickness. All strain parameters showed cutoff values (area under the curve > 0.69) that allowed the discrimination of normal versus scar segments but not of transmural versus subendocardial scars. This was true for all strain parameters analyzed, without differences in efficacy between longitudinal and circumferential strain and subendocardial, subepicardial, and full-wall-thickness strain values. Circumferential and longitudinal strain in normal segments showed transmural and basoapical gradients (greatest values at the subendocardial layer and apex). In segments with scar, transmural gradient was maintained, whereas basoapical gradient was lost because the reduction of strain values in the presence of the scar was greater at the apex. The two-dimensional speckle-tracking echocardiographic values distinguish scar presence but not transmurality; thus, they are not useful predictors of scar segment viability. It remains unclear why there is a greater strain value reduction in the presence of a scar at the apical

  14. Optimization of the axial compressor flow passage to reduce the circumferential distortion

    NASA Astrophysics Data System (ADS)

    Popov, G.; Kolmakova, D.; Shklovets, A.; Ermakov, A.

    2015-08-01

    This work is motivated by the necessity to reduce the effects of the flow circumferential distortion in the flow passage of the aircraft gas turbine engine (GTE). In previous research, the authors have proposed the approaches to decrease of the flow circumferential distortion arising from the mid-support racks of GTE compressor and having a negative impact on the blade rows, located upstream. In particular, the idea of introducing the circumferentially non-uniform blade pitch and profile stagger angle of guide vanes located in front of the support was contributed in order to redistribute the flow and decrease the dynamic stresses in the rotor wheel of the same stage. During the research presented in this paper, another principal of reduction of the flow circumferential distortion was chosen. Firstly, the variants of upgrading the existing support racks were found. Secondly, the new design of support was offered. Both the first and the second version of the support design variation took into account the availability of technological and structural limitations associated with the location of oil pipes, springs and others elements in the support racks. Investigations of modified design showed that the support with altered racks provides a reduction of dynamic stresses by 20% at resonance with the most dangerous harmonic, and the new design of support can give the decrease of 30%.

  15. Scattering of circumferential waves in a cracked annulus

    NASA Astrophysics Data System (ADS)

    Valle, Christine; Qu, Jianmin; Jacobs, Laurence J.

    2000-05-01

    This paper considers guided waves propagating in the circumferential direction of an annulus with a radial crack, with the objective of developing an ultrasonic technique that can detect and characterize these cracks. Specifically, the finite element method is used to simulate the propagation and scattering of guided circumferential waves in a cracked annulus. This method fosters a better understanding of the wave fields, so that a transducer configuration used in the field can be optimized for crack detection/characterization. Both a point source (simulating laser generated ultrasound) and a distributed source (simulating a PZT transducer) are modeled and compared to corresponding experimental results. Animations (snapshots at different instants in time) of the strain energy field in the annulus are given for various combinations of load profiles, incident angles, and incident frequencies. Results of this paper provide the necessary design guidelines for developing nondestructive ultrasonic techniques for the detection/characterization of radial cracks in cylindrical pressure vessels, gas/oil pipes, and shaft/bearing systems.

  16. High-density collagen patch prevents stricture after endoscopic circumferential submucosal dissection of the esophagus: a porcine model.

    PubMed

    Aoki, Shigehisa; Sakata, Yasuhisa; Shimoda, Ryo; Takezawa, Toshiaki; Oshikata-Miyazaki, Ayumi; Kimura, Hiromi; Yamamoto, Mihoko; Iwakiri, Ryuichi; Fujimoto, Kazuma; Toda, Shuji

    2017-05-01

    Extensive excision of the esophageal mucosa by endoscopic submucosal dissection (ESD) frequently evokes a luminal stricture. This study aimed to determine the efficacy of a high-density collagen patch for the prevention of esophageal stricture in extensive ESD. Six pigs underwent circumferential esophageal ESD under general anesthesia. In 3 pigs, artificial ulcers were covered by 2 collagen patches. The other 3 pigs underwent circumferential ESD only. The 2 collagen patches were settled onto the ulcer surface using a general endoscope and instruments. The collagen patch-treated group showed significantly better patency rates on both the oral and anal sides of the wound area compared with the control group at day 14. The mucosal re-epithelization ratio was significantly promoted, and the extent of mucosal inflammation and fibrosis was significantly decreased with the collagen patch treatment in the wound area. The frequency of cells positive α-smooth muscle actin was significantly reduced in the collagen patch-treated group compared with the control group. We have established a high-density collagen device that can reduce the esophageal stricture associated with extensive ESD. This easy-to-handle device would be useful during superficial esophageal cancer treatment by ESD. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  17. An analytical model to design circumferential clasps for laser-sintered removable partial dentures.

    PubMed

    Alsheghri, Ammar A; Alageel, Omar; Caron, Eric; Ciobanu, Ovidiu; Tamimi, Faleh; Song, Jun

    2018-06-21

    Clasps of removable partial dentures (RPDs) often suffer from plastic deformation and failure by fatigue; a common complication of RPDs. A new technology for processing metal frameworks for dental prostheses based on laser-sintering, which allows for precise fabrication of clasp geometry, has been recently developed. This study sought to propose a novel method for designing circumferential clasps for laser-sintered RPDs to avoid plastic deformation or fatigue failure. An analytical model for designing clasps with semicircular cross-sections was derived based on mechanics. The Euler-Bernoulli elastic curved beam theory and Castigliano's energy method were used to relate the stress and undercut with the clasp length, cross-sectional radius, alloy properties, tooth type, and retention force. Finite element analysis (FEA) was conducted on a case study and the resultant tensile stress and undercut were compared with the analytical model predictions. Pull-out experiments were conducted on laser-sintered cobalt-chromium (Co-Cr) dental prostheses to validate the analytical model results. The proposed circumferential clasp design model yields results in good agreement with FEA and experiments. The results indicate that Co-Cr circumferential clasps in molars that are 13mm long engaging undercuts of 0.25mm should have a cross-section radius of 1.2mm to provide a retention of 10N and to avoid plastic deformation or fatigue failure. However, shorter circumferential clasps such as those in premolars present high stresses and cannot avoid plastic deformation or fatigue failure. Laser-sintered Co-Cr circumferential clasps in molars are safe, whereas they are susceptible to failure in premolars. Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.

  18. Feasibility study of negative lift circumferential type seal for helicopter transmissions

    NASA Technical Reports Server (NTRS)

    Goldring, E. N.

    1977-01-01

    A new seal concept, the negative lift circumferential type seal, was evaluated under simulated helicopter transmission conditions. The bore of the circumferential seal contains step type geometry which produces a negative lift that urges the sealing segments towards the shaft surface. The seal size was a 2.5 inch bore and the test speeds were 7000 and 14,250 rpm. During the 300 hour test at typical transmission seal pressure (to 2 psig) the leakage was within acceptable limits and generally less than 0.1 cc/hour during the last 150 hours of testing. The wear to the carbon segments during the 300 hours was negligible.

  19. Risk factors for esophageal stenosis after entire circumferential endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma.

    PubMed

    Miwata, Tomohiro; Oka, Shiro; Tanaka, Shinji; Kagemoto, Kenichi; Sanomura, Yoji; Urabe, Yuji; Hiyama, Toru; Chayama, Kazuaki

    2016-09-01

    Endoscopic submucosal dissection (ESD) is used to perform en block resection for esophageal squamous cell carcinoma, but it is strongly associated with postoperative stenosis, especially during entire circumferential resection. This study aimed to clarify the risk factors for refractory postoperative stenosis after entire circumferential esophageal ESD. Nineteen patients who underwent entire circumferential esophageal ESD from February 2006 to December 2013 at Hiroshima University Hospital were divided into two groups: refractory postoperative stenosis [≥6 endoscopic balloon dilation (EBD) procedures, 12 lesions in 12 patients] and non-refractory postoperative stenosis (≤5 EBD procedures, 7 lesions in 7 patients). We retrospectively examined the patient factors (age, sex, alcohol consumption, smoking index, and chemoradiation therapy history), tumor factors (location, macroscopic type, fibrosis, and depth), and treatment factors (mean procedure time, entire circumferential resection diameter, muscle layer damage, and steroid administration method) between the two groups. Muscle layer damage (p = 0.019) and ≥5 cm of longitudinal mucosal defect length after entire circumferential esophageal ESD (p = 0.010) were significant factors associated with the refractory group. Regarding the patient and tumor factors, there were no significant differences between the two groups. Our data suggest that refractory post-ESD stenosis occurs after entire circumferential esophageal ESD with muscle layer damage and ≥5 cm of longitudinal mucosal defect length.

  20. Risk Factors Associated With Circumferential Resection Margin Positivity in Rectal Cancer: A Binational Registry Study.

    PubMed

    Warrier, Satish K; Kong, Joseph Cherng; Guerra, Glen R; Chittleborough, Timothy J; Naik, Arun; Ramsay, Robert G; Lynch, A Craig; Heriot, Alexander G

    2018-04-01

    Rectal cancer outcomes have improved with the adoption of a multidisciplinary model of care. However, there is a spectrum of quality when viewed from a national perspective, as highlighted by the Consortium for Optimizing the Treatment of Rectal Cancer data on rectal cancer care in the United States. The aim of this study was to assess and identify predictors of circumferential resection margin involvement for rectal cancer across Australasia. A retrospective study from a prospectively maintained binational colorectal cancer database was interrogated. This study is based on a binational colorectal cancer audit database. Clinical information on all consecutive resected rectal cancer cases recorded in the registry from 2007 to 2016 was retrieved, collated, and analyzed. The primary outcome measure was positive circumferential resection margin, measured as a resection margin ≤1 mm. A total of 3367 patients were included, with 261 (7.5%) having a positive circumferential resection margin. After adjusting for hospital and surgeon volume, hierarchical logistic regression analysis identified a 6-variable model encompassing the independent predictors, including urgent operation, abdominoperineal resection, open technique, low rectal cancer, T3 to T4, and N1 to N2. The accuracy of the model was 92.3%, with an receiver operating characteristic of 0.783 (p < 0.0001). The quantitative risk associated with circumferential resection margin positivity ranged from <1% (no risk factors) to 43% (6 risk factors). This study was limited by the lack of recorded long-term outcomes associated with circumferential resection margin positivity. The rate of circumferential resection margin involvement in patients undergoing rectal cancer resection in Australasia is low and is influenced by a number of factors. Risk stratification of outcome is important with the increasing demand for publicly accessible quality data. See Video Abstract at http://links.lww.com/DCR/A512.

  1. Tks5-dependent formation of circumferential podosomes/invadopodia mediates cell-cell fusion.

    PubMed

    Oikawa, Tsukasa; Oyama, Masaaki; Kozuka-Hata, Hiroko; Uehara, Shunsuke; Udagawa, Nobuyuki; Saya, Hideyuki; Matsuo, Koichi

    2012-05-14

    Osteoclasts fuse to form multinucleated cells during osteoclastogenesis. This process is mediated by dynamic rearrangement of the plasma membrane and cytoskeleton, and it requires numerous factors, many of which have been identified. The underlying mechanism remains obscure, however. In this paper, we show that Tks5, a master regulator of invadopodia in cancer cells, is crucial for osteoclast fusion downstream of phosphoinositide 3-kinase and Src. Expression of Tks5 was induced during osteoclastogenesis, and prevention of this induction impaired both the formation of circumferential podosomes and osteoclast fusion without affecting cell differentiation. Tyrosine phosphorylation of Tks5 was attenuated in Src-/- osteoclasts, likely accounting for defects in podosome organization and multinucleation in these cells. Circumferential invadopodia formation in B16F0 melanoma cells was also accompanied by Tks5 phosphorylation. Co-culture of B16F0 cells with osteoclasts in an inflammatory milieu promoted the formation of melanoma-osteoclast hybrid cells. Our results thus reveal an unexpected link between circumferential podosome/invadopodium formation and cell-cell fusion in and beyond osteoclasts.

  2. Tks5-dependent formation of circumferential podosomes/invadopodia mediates cell–cell fusion

    PubMed Central

    Oyama, Masaaki; Kozuka-Hata, Hiroko; Uehara, Shunsuke; Udagawa, Nobuyuki; Saya, Hideyuki; Matsuo, Koichi

    2012-01-01

    Osteoclasts fuse to form multinucleated cells during osteoclastogenesis. This process is mediated by dynamic rearrangement of the plasma membrane and cytoskeleton, and it requires numerous factors, many of which have been identified. The underlying mechanism remains obscure, however. In this paper, we show that Tks5, a master regulator of invadopodia in cancer cells, is crucial for osteoclast fusion downstream of phosphoinositide 3-kinase and Src. Expression of Tks5 was induced during osteoclastogenesis, and prevention of this induction impaired both the formation of circumferential podosomes and osteoclast fusion without affecting cell differentiation. Tyrosine phosphorylation of Tks5 was attenuated in Src−/− osteoclasts, likely accounting for defects in podosome organization and multinucleation in these cells. Circumferential invadopodia formation in B16F0 melanoma cells was also accompanied by Tks5 phosphorylation. Co-culture of B16F0 cells with osteoclasts in an inflammatory milieu promoted the formation of melanoma–osteoclast hybrid cells. Our results thus reveal an unexpected link between circumferential podosome/invadopodium formation and cell–cell fusion in and beyond osteoclasts. PMID:22584907

  3. Nonlinear Analysis of Two-phase Circumferential Motion in the Ablation Circumstance

    NASA Astrophysics Data System (ADS)

    Xiao-liang, Xu; Hai-ming, Huang; Zi-mao, Zhang

    2010-05-01

    In aerospace craft reentry and solid rocket propellant nozzle, thermal chemistry ablation is a complex process coupling with convection, heat transfer, mass transfer and chemical reaction. Based on discrete vortex method (DVM), thermal chemical ablation model and particle kinetic model, a computational module dealing with the two-phase circumferential motion in ablation circumstance is designed, the ablation velocity and circumferential field can be thus calculated. The calculated nonlinear time series are analyzed in chaotic identification method: relative chaotic characters such as correlation dimension and the maximum Lyapunov exponent are calculated, fractal dimension of vortex bulbs and particles distributions are also obtained, thus the nonlinear ablation process can be judged as a spatiotemporal chaotic process.

  4. Automatic generation of endocardial surface meshes with 1-to-1 correspondence from cine-MR images

    NASA Astrophysics Data System (ADS)

    Su, Yi; Teo, S.-K.; Lim, C. W.; Zhong, L.; Tan, R. S.

    2015-03-01

    In this work, we develop an automatic method to generate a set of 4D 1-to-1 corresponding surface meshes of the left ventricle (LV) endocardial surface which are motion registered over the whole cardiac cycle. These 4D meshes have 1- to-1 point correspondence over the entire set, and is suitable for advanced computational processing, such as shape analysis, motion analysis and finite element modelling. The inputs to the method are the set of 3D LV endocardial surface meshes of the different frames/phases of the cardiac cycle. Each of these meshes is reconstructed independently from border-delineated MR images and they have no correspondence in terms of number of vertices/points and mesh connectivity. To generate point correspondence, the first frame of the LV mesh model is used as a template to be matched to the shape of the meshes in the subsequent phases. There are two stages in the mesh correspondence process: (1) a coarse matching phase, and (2) a fine matching phase. In the coarse matching phase, an initial rough matching between the template and the target is achieved using a radial basis function (RBF) morphing process. The feature points on the template and target meshes are automatically identified using a 16-segment nomenclature of the LV. In the fine matching phase, a progressive mesh projection process is used to conform the rough estimate to fit the exact shape of the target. In addition, an optimization-based smoothing process is used to achieve superior mesh quality and continuous point motion.

  5. Circumferential graben and the structural evolution of Alba Mons, Mars

    NASA Astrophysics Data System (ADS)

    Öhman, Teemu; McGovern, Patrick J.

    2014-05-01

    Alba Mons is a unique, very extensive but shallow volcanotectonic construct in northern Tharsis, Mars. Numerous models have been presented to explain the formation of Alba Mons and its most characteristic feature, a wristwatch-like pattern of radial and circumferential graben. We used a wide selection of topographic datasets to characterize the fault throw variation on nine topographic transects across the circumferential graben in order to provide observational constraints for the different formation models, and to gain further insight into the evolution of Alba Mons. In most of the transects, summed throws from outwards-facing (away from the center of the volcano) faults are larger than from the inwards-facing (towards the center) ones. Only the very gently sloping western transects show the opposite, emphasizing the east-west-asymmetry of Alba Mons. 10-40% of the observed topographic relief of Alba Mons along the nine transects can be accounted for by this throw difference between the inwards- and outwards-facing faults. These results are consistent with predictions of models suggesting an uplift mechanism to explain the formation of the circumferential graben, but not with models invoking central subsidence. Horizontal extensional strain along the transects varies between 0.5% and 2%, consistent with strain predictions of the late-stage sill complex inflation model of McGovern et al. (McGovern, P.J., Solomon, S.C., Head J.W. III, Smith, D.E., Zuber M.T., Neumann, G.A. [2001]. J. Geophys. Res. 106(E10), 23769-23809).

  6. MEMS-based non-rotatory circumferential scanning optical probe for endoscopic optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Xu, Yingshun; Singh, Janak; Siang, Teo Hui; Ramakrishna, Kotlanka; Premchandran, C. S.; Sheng, Chen Wei; Kuan, Chuah Tong; Chen, Nanguang; Olivo, Malini C.; Sheppard, Colin J. R.

    2007-07-01

    In this paper, we present a non-rotatory circumferential scanning optical probe integrated with a MEMS scanner for in vivo endoscopic optical coherence tomography (OCT). OCT is an emerging optical imaging technique that allows high resolution cross-sectional imaging of tissue microstructure. To extend its usage to endoscopic applications, a miniaturized optical probe based on Microelectromechanical Systems (MEMS) fabrication techniques is currently desired. A 3D electrothermally actuated micromirror realized using micromachining single crystal silicon (SCS) process highlights its very large angular deflection, about 45 degree, with low driving voltage for safety consideration. The micromirror is integrated with a GRIN lens into a waterproof package which is compatible with requirements for minimally invasive endoscopic procedures. To implement circumferential scanning substantially for diagnosis on certain pathological conditions, such as Barret's esophagus, the micromirror is mounted on 90 degree to optical axis of GRIN lens. 4 Bimorph actuators that are connected to the mirror on one end via supporting beams and springs are selected in this micromirror design. When actuators of the micromirror are driven by 4 channels of sinusoidal waveforms with 90 degree phase differences, beam focused by a GRIN is redirected out of the endoscope by 45 degree tilting mirror plate and achieve circumferential scanning pattern. This novel driving method making full use of very large angular deflection capability of our micromirror is totally different from previously developed or developing micromotor-like rotatory MEMS device for circumferential scanning.

  7. Biomechanical testing of circumferential instrumentation after cervical multilevel corpectomy.

    PubMed

    Hartmann, Sebastian; Thomé, Claudius; Keiler, Alexander; Fritsch, Helga; Hegewald, Aldemar Andres; Schmölz, Werner

    2015-12-01

    Biomechanical investigation. This study describes ex vivo evaluation of the range of motion (ROM) to characterize the stability and need for additional dorsal fixation after cervical single-level, two-level or multilevel corpectomy (CE) to elucidate biomechanical differences between anterior-only and supplemental dorsal instrumentation. Twelve human cervical cadaveric spines were loaded in a spine tester with pure moments of 1.5 Nm in lateral bending (LB), flexion/extension (FE), and axial rotation (AR), followed by two cyclic loading periods for three-level corpectomies. After each cyclic loading session, flexibility tests were performed for anterior-only instrumentation (group_1, six specimens) and circumferential instrumentation (group_2, six specimens). The flexibility tests for all circumferential instrumentations showed a significant decrease in ROM in comparison with the intact state and anterior-only instrumentations. In comparison with the intact state, supplemental dorsal instrumentation after three-level CE reduced the ROM to 12% (±10%), 9% (±12%), and 22% (±18%) in LB, FE, and AR, respectively. The anterior-only construct outperformed the intact state only in FE, with a significant ROM reduction to 57% (±35 %), 60% (±27%), and 62% (±35%) for one-, two- and three-level CE, respectively. The supplemental dorsal instrumentation provided significantly more stability than the anterior-only instrumentation regardless of the number of levels resected and the direction of motion. After cyclic loading, the absolute differences in stability between the two instrumentations remained significant while both instrumentations showed a comparable increase of ROM after cyclic loading. The large difference in the absolute ROM of anterior-only compared to circumferential instrumentations supports a dorsal support in case of three-level approaches.

  8. Severe fixed cervical kyphosis treated with circumferential osteotomy and pedicle screw fixation using an anterior-posterior-anterior surgical sequence.

    PubMed

    Yoshihara, Hiroyuki; Abumi, Kuniyoshi; Ito, Manabu; Kotani, Yoshihisa; Sudo, Hideki; Takahata, Masahiko

    2013-11-01

    Surgical treatment for severe circumferentially fixed cervical kyphosis has been challenging. Both anterior and posterior releases are necessary to provide the cervical mobility necessary for fusion in a corrected position. In two case reports, we describe the circumferential osteotomy of anterior-posterior-anterior surgical sequence, and the efficacy of this technique when cervical pedicle screw fixation for severe fixed cervical kyphosis is used. Etiology of fixed cervical kyphosis was unknown in one patient and neurofibromatosis in one patient. Both patients had severe fixed cervical kyphosis as determined by cervical radiographs and underwent circumferential osteotomy and fixation via an anterior-posterior-anterior surgical sequence and correction of kyphosis by pedicle screw fixation. Severe fixed cervical kyphosis was treated successfully by the use of circumferential osteotomy and pedicle screw fixation. The surgical sequence described in this report is a reasonable approach for severe circumferentially fixed cervical kyphosis and short segment fixation can be achieved using pedicle screws. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Circumferential optical coherence tomography angiography imaging of the swine esophagus using a micromotor balloon catheter.

    PubMed

    Lee, Hsiang-Chieh; Ahsen, Osman Oguz; Liang, Kaicheng; Wang, Zhao; Cleveland, Cody; Booth, Lucas; Potsaid, Benjamin; Jayaraman, Vijaysekhar; Cable, Alex E; Mashimo, Hiroshi; Langer, Robert; Traverso, Giovanni; Fujimoto, James G

    2016-08-01

    We demonstrate a micromotor balloon imaging catheter for ultrahigh speed endoscopic optical coherence tomography (OCT) which provides wide area, circumferential structural and angiographic imaging of the esophagus without contrast agents. Using a 1310 nm MEMS tunable wavelength swept VCSEL light source, the system has a 1.2 MHz A-scan rate and ~8.5 µm axial resolution in tissue. The micromotor balloon catheter enables circumferential imaging of the esophagus at 240 frames per second (fps) with a ~30 µm (FWHM) spot size. Volumetric imaging is achieved by proximal pullback of the micromotor assembly within the balloon at 1.5 mm/sec. Volumetric data consisting of 4200 circumferential images of 5,000 A-scans each over a 2.6 cm length, covering a ~13 cm(2) area is acquired in <18 seconds. A non-rigid image registration algorithm is used to suppress motion artifacts from non-uniform rotational distortion (NURD), cardiac motion or respiration. En face OCT images at various depths can be generated. OCT angiography (OCTA) is computed using intensity decorrelation between sequential pairs of circumferential scans and enables three-dimensional visualization of vasculature. Wide area volumetric OCT and OCTA imaging of the swine esophagus in vivo is demonstrated.

  10. Prognostic significance of positive circumferential resection margin in esophageal cancer: a systematic review and meta-analysis.

    PubMed

    Wu, Jie; Chen, Qi-Xun; Teng, Li-song; Krasna, Mark J

    2014-02-01

    To assess the prognostic significance of positive circumferential resection margin on overall survival in patients with esophageal cancer, a systematic review and meta-analysis was performed. Studies were identified from PubMed, EMBASE, and Web of Science. Survival data were extracted from eligible studies to compare overall survival in patients with a positive circumferential resection margin with patients having a negative circumferential resection margin according to the Royal College of Pathologists (RCP) criteria and the College of American Pathologists (CAP) criteria. Survival data were pooled with hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs). A random-effects model meta-analysis on overall survival was performed. The pooled HRs for survival were 1.510 (95% CI, 1.329-1.717; p<0.001) and 2.053 (95% CI, 1.597-2.638; p<0.001) according to the RCP and CAP criteria, respectively. Positive circumferential resection margin was associated with worse survival in patients with T3 stage disease according to the RCP (HR, 1.381; 95% CI, 1.028-1.584; p=0.001) and CAP (HR, 2.457; 95% CI, 1.902-3.175; p<0.001) criteria, respectively. Positive circumferential resection margin was associated with worse survival in patients receiving neoadjuvant therapy according to the RCP (HR, 1.676; 95% CI, 1.023-2.744; p=0.040) and CAP (HR, 1.847; 95% CI, 1.226-2.78; p=0.003) criteria, respectively. Positive circumferential resection margin is associated with poor prognosis in patients with esophageal cancer, particularly in patients with T3 stage disease and patients receiving neoadjuvant therapy. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. On guided circumferential waves in soft electroactive tubes under radially inhomogeneous biasing fields

    NASA Astrophysics Data System (ADS)

    Wu, Bin; Su, Yipin; Chen, Weiqiu; Zhang, Chuanzeng

    2017-02-01

    Soft electroactive (EA) tube actuators and many other cylindrical devices have been proposed recently in literature, which show great advantages over those made from conventional hard solid materials. However, their practical applications may be limited because these soft EA devices are prone to various failure modes. In this paper, we present an analysis of the guided circumferential elastic waves in soft EA tube actuators, which has potential applications in the in-situ nondestructive evaluation (NDE) or online structural health monitoring (SHM) to detect structural defects or fatigue cracks in soft EA tube actuators and in the self-sensing of soft EA tube actuators based on the concept of guided circumferential elastic waves. Both circumferential SH and Lamb-type waves in an incompressible soft EA cylindrical tube under inhomogeneous biasing fields are considered. The biasing fields, induced by the application of an electric voltage difference to the electrodes on the inner and outer cylindrical surfaces of the EA tube in addition to an axial pre-stretch, are inhomogeneous in the radial direction. Dorfmann and Ogden's theory of nonlinear electroelasticity and the associated linear theory for small incremental motion constitute the basis of our analysis. By means of the state-space formalism for the incremental wave motion along with the approximate laminate technique, dispersion relations are derived in a particularly efficient way. For a neo-Hookean ideal dielectric model, the proposed approach is first validated numerically. Numerical examples are then given to show that the guided circumferential wave propagation characteristics are significantly affected by the inhomogeneous biasing fields and the geometrical parameters. Some particular phenomena such as the frequency veering and the nonlinear dependence of the phase velocity on the radial electric voltage are discussed. Our numerical findings demonstrate that it is feasible to use guided circumferential

  12. Circumferential truncal contouring: the belt lipectomy.

    PubMed

    Aly, Al; Mueller, Melissa

    2014-10-01

    The primary goal of belt lipectomy surgery is to improve the contour of the inferior truncal circumferential unit and to place the resultant scar in natural junctions. Excessive intra-abdominal content is a contraindication for belt lipectomy. The higher the presenting patient's body mass index (BMI), the higher the risk of postoperative complications and the less impressive the results. The converse is also true: the lower the BMI, the lower the risk of complications and the better the results. The most common complications are small wound separations and seromas. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Metal Ir coatings on endocardial electrode tips, obtained by MOCVD

    NASA Astrophysics Data System (ADS)

    Vikulova, Evgeniia S.; Kal'nyi, Danila B.; Shubin, Yury V.; Kokovkin, Vasily V.; Morozova, Natalya B.; Hassan, Aseel; Basova, Tamara V.

    2017-12-01

    The present work demonstrates the application of the Metal-Organic Chemical Vapor Deposition technique to fabricate metal iridium coatings onto the pole tips of endocardial electrodes. Using iridium (III) acetylacetonate as a volatile precursor, the target coatings were successfully applied to the working surface of cathodes and anodes of pacemaker electrodes in the flow type reactor in hydrogen atmosphere at deposition temperature of 550 °C. The coating samples were characterized by means of XRD, SEM, Raman- and XPS-spectroscopies. The formation of non-textured coatings with fractal-like morphology and 7-24 nm crystallite size has been realized. The electrochemical properties of the coatings were investigated by cyclic voltammetry and electrochemical impedance spectroscopy. The charge storage capacity values of the electrochemically activated samples were 17.0-115 mC cm-2 and 14.4-76.5 mC cm-2 for measurements carried out in 0.1 M sulfuric acid and in phosphate buffer saline solutions, respectively. A comparison of some characteristics of the samples obtained with commercially available cathode of pacemaker electrodes is also presented.

  14. Releasing the circumferential fixation of the medial meniscus does not affect its kinematics.

    PubMed

    Vrancken, A C T; van Tienen, T G; Hannink, G; Janssen, D; Verdonschot, N; Buma, P

    2014-12-01

    Meniscal functioning depends on the fixation between the meniscal horns and the surrounding tissues. It is unknown, however, whether the integration between the outer circumference of the medial meniscus and the knee capsule/medial collateral ligament also influences the biomechanical behavior of the meniscus. Therefore, we aimed to determine whether detaching and resuturing the circumferential fixation of the medial meniscus influence its kinematic pattern. Human cadaveric knee joints were flexed (0°-30°-60°-90°) in a knee loading rig, in neutral orientation and under internal and external tibial torques. Roentgen stereophotogrammetric analysis was used to determine the motion of the meniscus in anteroposterior (AP) and mediolateral (ML) directions. Three fixation conditions were evaluated: (I) intact, (II) detached and (III) resutured. Detaching and resuturing the circumferential fixation did not alter the meniscal motion pattern in either the AP or ML direction. Applying an additional internal tibial torque caused the medial meniscus to move slightly anteriorly, and an external torque caused a little posterior translation with respect to the neutral situation. These patterns did not change when the circumferential fixation condition was altered. This study demonstrated that the motion pattern of the medial meniscus is independent of its fixation to the knee capsule and medial collateral ligament. The outcomes of this study can be deployed to design the fixation strategy of a permanent meniscus prosthesis. As peripheral fixation is a complicated step during meniscal replacement, the surgical procedure is considerably simplified when non-resorbable implants do not require circumferential fixation. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Circumferential optical coherence tomography angiography imaging of the swine esophagus using a micromotor balloon catheter

    PubMed Central

    Lee, Hsiang-Chieh; Ahsen, Osman Oguz; Liang, Kaicheng; Wang, Zhao; Cleveland, Cody; Booth, Lucas; Potsaid, Benjamin; Jayaraman, Vijaysekhar; Cable, Alex E.; Mashimo, Hiroshi; Langer, Robert; Traverso, Giovanni; Fujimoto, James G.

    2016-01-01

    We demonstrate a micromotor balloon imaging catheter for ultrahigh speed endoscopic optical coherence tomography (OCT) which provides wide area, circumferential structural and angiographic imaging of the esophagus without contrast agents. Using a 1310 nm MEMS tunable wavelength swept VCSEL light source, the system has a 1.2 MHz A-scan rate and ~8.5 µm axial resolution in tissue. The micromotor balloon catheter enables circumferential imaging of the esophagus at 240 frames per second (fps) with a ~30 µm (FWHM) spot size. Volumetric imaging is achieved by proximal pullback of the micromotor assembly within the balloon at 1.5 mm/sec. Volumetric data consisting of 4200 circumferential images of 5,000 A-scans each over a 2.6 cm length, covering a ~13 cm2 area is acquired in <18 seconds. A non-rigid image registration algorithm is used to suppress motion artifacts from non-uniform rotational distortion (NURD), cardiac motion or respiration. En face OCT images at various depths can be generated. OCT angiography (OCTA) is computed using intensity decorrelation between sequential pairs of circumferential scans and enables three-dimensional visualization of vasculature. Wide area volumetric OCT and OCTA imaging of the swine esophagus in vivo is demonstrated. PMID:27570688

  16. Complete 360° circumferential gonioscopic optical coherence tomography imaging of the iridocorneal angle

    PubMed Central

    McNabb, Ryan P.; Challa, Pratap; Kuo, Anthony N.; Izatt, Joseph A.

    2015-01-01

    Clinically, gonioscopy is used to provide en face views of the ocular angle. The angle has been imaged with optical coherence tomography (OCT) through the corneoscleral limbus but is currently unable to image the angle from within the ocular anterior chamber. We developed a novel gonioscopic OCT system that images the angle circumferentially from inside the eye through a custom, radially symmetric, gonioscopic contact lens. We present, to our knowledge, the first 360° circumferential volumes (two normal subjects, two subjects with pathology) of peripheral iris and iridocorneal angle structures obtained via an internal approach not typically available in the clinic. PMID:25909021

  17. Fabricated autologous epidermal cell sheets for the prevention of esophageal stricture after circumferential ESD in a porcine model.

    PubMed

    Kanai, Nobuo; Yamato, Masayuki; Ohki, Takeshi; Yamamoto, Masakazu; Okano, Teruo

    2012-10-01

    Endoscopic submucosal dissection (ESD) is an accepted treatment for early esophageal carcinoma. However, resection of a large mucosal area, as with circumferential ESD, induces severe stricture formation. To evaluate the efficacy of cultured autologous epidermal cell sheets to prevent severe esophageal constriction after circumferential ESD. Animal study. University institute. Eight pigs underwent circumferential esophageal ESD while under general anesthesia. In 4 pigs, fabricated autologous epidermal cell sheets were endoscopically transplanted to the central ESD sites immediately after the ESD. The other 4 pigs underwent circumferential ESD only. Necropsy and histological assessment were performed at 1 and 2 weeks post-ESD. Weight gain, degree of mucosal constriction, and histological assessments. All pigs in the control group showed severe esophageal constriction after 2 weeks. The control and transplanted groups had weight gains of -10.3% and 0.3% (P = .03), respectively, and the mean degrees of constriction were 88% and 56% (P < .01), respectively. Early re-epithelialization and mild fibrosis in the muscularis were observed in the transplanted group. Animal study, small sample size. Fabricated autologous skin epidermal cell sheets would be useful in preventing severe esophageal constriction after circumferential ESD. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  18. Analysis of the circumferential acoustic waves backscattered by a tube using the time-frequency representation of Wigner-Ville

    NASA Astrophysics Data System (ADS)

    Latif, R.; Aassif, E.; Maze, G.; Decultot, D.; Moudden, A.; Faiz, B.

    2000-01-01

    This paper presents a study of the group velocity dispersion of some circumferential waves propagating around an elastic tube. The dispersive character of the circumferential waves is theoretically known, but the experimental measurement of the group velocity in a dispersive medium is still a complex operation. We have determined the characteristics of the circumferential wave dispersion for aluminium and steel tubes using a time-frequency representation. Among these time-frequency techniques, the Wigner-Ville distribution (WVD) is used here for its interesting properties in terms of acoustic applications. The WVD is applied to the analysis of the dispersion of S0 symmetric and A1 antisymmetric circumferential waves propagating around a tube with a radii ratio equal to 0.95 (internal radius:external radius). This allowed us to determine their group velocities and reduced cutoff frequencies. The results obtained are in good agreement with the calculated values using the proper modes theory.

  19. Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion.

    PubMed

    Madan, S S; Boeree, N R

    2003-12-01

    Posterior lumbar interbody fusion (PLIF) restores disc height, the load bearing ability of anterior ligaments and muscles, root canal dimensions, and spinal balance. It immobilizes the painful degenerate spinal segment and decompresses the nerve roots. Anterior lumbar interbody fusion (ALIF) does the same, but could have complications of graft extrusion, compression and instability contributing to pseudarthrosis in the absence of instrumentation. The purpose of this study was to assess and compare the outcome of instrumented circumferential fusion through a posterior approach [PLIF and posterolateral fusion (PLF)] with instrumented ALIF using the Hartshill horseshoe cage, for comparable degrees of internal disc disruption and clinical disability. It was designed as a prospective study, comparing the outcome of two methods of instrumented interbody fusion for internal disc disruption. Between April 1994 and June 1998, the senior author (N.R.B.) performed 39 instrumented ALIF procedures and 35 instrumented circumferential fusion with PLIF procedures. The second author, an independent assessor (S.M.), performed the entire review. Preoperative radiographic assessment included plain radiographs, magnetic resonance imaging (MRI) and provocative discography in all the patients. The outcome in the two groups was compared in terms of radiological improvement and clinical improvement, measured on the basis of improvement of back pain and work capacity. Preoperatively, patients were asked to fill out a questionnaire giving their demographic details, maximum walking distance and current employment status in order to establish the comparability of the two groups. Patient assessment was with the Oswestry Disability Index, quality of life questionnaire (subjective), pain drawing, visual analogue scale, disability benefit, compensation status, and psychological profile. The results of the study showed a satisfactory outcome (score< or =30) on the subjective (quality of life

  20. Circumferential pressure distributions in a model labyrinth seal

    NASA Technical Reports Server (NTRS)

    Leong, Y. M. M. S.; Brown, R. D.

    1982-01-01

    A research program to isolate and study leakage flow through labyrinth glands was initiated. Circumferential pressure distributions were measured in the labyrinth glands with geometry appropriate to the high pressure labyrinths in large steam turbines. Knowledge of this pressure distribution is essential as it is this unequal pressure field that results in the destabilizing force. Parameters that are likely to affect the pressure distributions are incorporated into the test rig. Some preliminary pressure profiles are presented.

  1. Validation of the Predicted Circumferential and Radial Mode Sound Power Levels in the Inlet and Exhaust Ducts of a Fan Ingesting Distorted Inflow

    NASA Technical Reports Server (NTRS)

    Koch, L. Danielle

    2012-01-01

    Fan inflow distortion tone noise has been studied computationally and experimentally. Data from two experiments in the NASA Glenn Advanced Noise Control Fan rig have been used to validate acoustic predictions. The inflow to the fan was distorted by cylindrical rods inserted radially into the inlet duct one rotor chord length upstream of the fan. The rods were arranged in both symmetric and asymmetric circumferential patterns. In-duct and farfield sound pressure level measurements were recorded. It was discovered that for positive circumferential modes, measured circumferential mode sound power levels in the exhaust duct were greater than those in the inlet duct and for negative circumferential modes, measured total circumferential mode sound power levels in the exhaust were less than those in the inlet. Predicted trends in overall sound power level were proven to be useful in identifying circumferentially asymmetric distortion patterns that reduce overall inlet distortion tone noise, as compared to symmetric arrangements of rods. Detailed comparisons between the measured and predicted radial mode sound power in the inlet and exhaust duct indicate limitations of the theory.

  2. Right diaphragmatic paralysis following endocardial cryothermal ablation of inappropriate sinus tachycardia.

    PubMed

    Vatasescu, Radu; Shalganov, Tchavdar; Kardos, Attila; Jalabadze, Khatuna; Paprika, Dora; Gyorgy, Margit; Szili-Torok, Tamas

    2006-10-01

    Inappropriate sinus tachycardia (IST) is a rare disorder amenable to catheter ablation when refractory to medical therapy. Radiofrequency (RF) catheter modification/ablation of the sinus node (SN) is the usual approach, although it can be complicated by right phrenic nerve paralysis. We describe a patient with IST, who had symptomatic recurrences despite previous acutely successful RF SN modifications, including the use of electroanatomical mapping/navigation system. We decided to try transvenous cryothermal modification of the SN. We used 2 min applications at -85 degrees C at sites of the earliest atrial activation guided by activation mapping during isoprenaline infusion. Every application was preceded by high output stimulation to reveal phrenic nerve proximity. During the last application, heart rate slowly and persistently fell below 85 bpm despite isoprenaline infusion, but right diaphragmatic paralysis developed. At 6 months follow-up, the patient was asymptomatic and the diaphragmatic paralysis had partially resolved. This is the first report, we believe, of successful SN modification for IST by endocardial cryoablation, although this case also demonstrates the considerable risk of right phrenic nerve paralysis even with this ablation energy.

  3. Circumferential finger measurements utilizing a torque meter to increase reliability.

    PubMed

    King, T I

    1993-01-01

    The purpose of this study was to compare the reliabilities of two methods of measuring finger circumference. Traditionally, finger circumference is determined clinically by the use of a tape measure. In this study, a tape-measure device for recording finger circumference utilizing a torque meter was compared with the traditional method to determine reliability differences. Ninety-two occupational therapists and occupational therapy students obtained circumferential measurements of the author's left index finger at the middle of the proximal phalanx utilizing the two methods. The readings obtained for each method were analyzed to determine the coefficient of variation and to compare their variances. The coefficient of variation for the traditional method was 2.92 and for the device utilizing the torque meter was 0.75. The F ratio was 15.63, which is significant at the 0.01 level. The results of this study indicate greater interrater reliability using a device that can accurately measure torque and allow the therapist to control the amount of tension applied when obtaining circumferential measurements using a tape measure.

  4. Determination of the axial and circumferential mechanical properties of the skin tissue using experimental testing and constitutive modeling.

    PubMed

    Karimi, Alireza; Navidbakhsh, Mahdi; Haghighatnama, Maedeh; Haghi, Afsaneh Motevalli

    2015-01-01

    The skin, being a multi-layered material, is responsible for protecting the human body from the mechanical, bacterial, and viral insults. The skin tissue may display different mechanical properties according to the anatomical locations of a body. However, these mechanical properties in different anatomical regions and at different loading directions (axial and circumferential) of the mice body to date have not been determined. In this study, the axial and circumferential loads were imposed on the mice skin samples. The elastic modulus and maximum stress of the skin tissues were measured before the failure occurred. The nonlinear mechanical behavior of the skin tissues was also computationally investigated through a suitable constitutive equation. Hyperelastic material model was calibrated using the experimental data. Regardless of the anatomic locations of the mice body, the results revealed significantly different mechanical properties in the axial and circumferential directions and, consequently, the mice skin tissue behaves like a pure anisotropic material. The highest elastic modulus was observed in the back skin under the circumferential direction (6.67 MPa), while the lowest one was seen in the abdomen skin under circumferential loading (0.80 MPa). The Ogden material model was narrowly captured the nonlinear mechanical response of the skin at different loading directions. The results help to understand the isotropic/anisotropic mechanical behavior of the skin tissue at different anatomical locations. They also have implications for a diversity of disciplines, i.e., dermatology, cosmetics industry, clinical decision making, and clinical intervention.

  5. Esophageal circumferential en bloc endoscopic submucosal dissection: assessment of a new technique.

    PubMed

    Barret, Maximilien; Pratico, Carlos Alberto; Beuvon, Frédéric; Mangialavori, Luigi; Chryssostalis, Ariane; Camus, Marine; Chaussade, Stanislas; Prat, Frédéric

    2013-10-01

    Endoscopic esophageal piecemeal mucosectomy for high-grade dysplasia on Barrett's esophagus leads to suboptimal histologic evaluation, as well as recurrence on remaining mucosa. Circumferential en bloc mucosal resection would significantly improve the management of dysplastic Barrett's esophagus. Our aim was to describe a new method of esophageal circumferential endoscopic en bloc submucosal dissection (CESD) in a swine model. After submucosal injection, circumferential incision was performed at each end of the esophageal segment to be removed. Mechanical submucosal dissection was performed from the proximal to the distal incision, using a mucosectomy cap over the endoscope. The removed mucosal ring was retrieved. Clinical, endoscopic, and histologic data were prospectively collected. Esophageal CESD was conducted on 5 pigs. A median mucosal length of 6.5 cm (range, 4 to 8 cm) was removed in the lower third of the esophagus. The mean duration of the procedure was 36 minutes (range, 17 to 80 min). No procedure-related complication, including perforation, was observed. All animals exhibited a mild esophageal stricture at day 7, and a severe symptomatic stricture at day 14. Necropsy confirmed endoscopic findings with cicatricial fibrotic strictures. On histologic examination, an inflammatory cell infiltrate, diffuse fibrosis reaching the muscular layer, and incomplete reepithelialization were observed. CESD enables expeditious resection and thorough examination of large segments of esophageal mucosa in safe procedural conditions, but esophageal strictures occur in the majority of the cases. Efficient methods for stricture prevention are needed for this technique to be developed in humans.

  6. Circumferential Ciliary Body Cysts Presenting as Acute Pigment Dispersion and Ocular Hypertension.

    PubMed

    Sarıgül Sezenöz, Almila; Güngör, Sirel Gür; Kıratlı, Hayyam; Akman, Ahmet

    2017-09-15

    To report a case of circumferential neuroepithelial cyst of the ciliary body presenting with pigment dispersion (PD) and ocular hypertension. 48-year-old female patient presented with a complaint of pain in the left eye. On examination, visual acuity of the left eye was 0.9, and the intraocular pressure was 48 mmHg. Biomicroscopic anterior segment examination of the left eye revealed 4+ pigmented cells in the anterior chamber. Active PD from the pupillary region at 11 o'clock was noticed at the time of the examination. Ultrasound biomicroscopy demonstrated 360º cystic lesions of the ciliary body in the left eye. The patient was diagnosed as neuroepithelial cyst of the ciliary body. Our case is unique as it is the first case of circumferential neuroepithelial ciliary body cyst presenting with acute PD and ocular hypertension.

  7. Numerical simulation of transonic compressor under circumferential inlet distortion and rotor/stator interference using harmonic balance method

    NASA Astrophysics Data System (ADS)

    Wang, Ziwei; Jiang, Xiong; Chen, Ti; Hao, Yan; Qiu, Min

    2018-05-01

    Simulating the unsteady flow of compressor under circumferential inlet distortion and rotor/stator interference would need full-annulus grid with a dual time method. This process is time consuming and needs a large amount of computational resources. Harmonic balance method simulates the unsteady flow in compressor on single passage grid with a series of steady simulations. This will largely increase the computational efficiency in comparison with the dual time method. However, most simulations with harmonic balance method are conducted on the flow under either circumferential inlet distortion or rotor/stator interference. Based on an in-house CFD code, the harmonic balance method is applied in the simulation of flow in the NASA Stage 35 under both circumferential inlet distortion and rotor/stator interference. As the unsteady flow is influenced by two different unsteady disturbances, it leads to the computational instability. The instability can be avoided by coupling the harmonic balance method with an optimizing algorithm. The computational result of harmonic balance method is compared with the result of full-annulus simulation. It denotes that, the harmonic balance method simulates the flow under circumferential inlet distortion and rotor/stator interference as precise as the full-annulus simulation with a speed-up of about 8 times.

  8. Three-dimensional circumferential liposuction of the overweight or obese upper arm.

    PubMed

    Hong, Yoon Gi; Sim, Hyung Bo; Lee, Mu Young; Seo, Sang Won; Chang, Choong Hyun; Yeo, Kwan Koo; Kim, June-kyu

    2012-06-01

    Due to recent trends in liposuction, anatomic consideration of the body's fatty layers is essential. Based on this knowledge, a circumferential approach to achieving maximal aesthetic results is highlighted. In the upper arm, aspiration of fat from only the posterolateral region can result in skin flaccidity and disharmony of the overall balance of the upper arm contour. Different suction techniques were applied depending on the degree of fat accumulation. If necessary, the operation area was extended around the axillary and scapular regions to overcome the limitations of the traditional method and to achieve optimal effects. To maximize skin contracture and redraping, the authors developed three-dimensional circumferential liposuction (3D-CL) based on two concepts: circumferential aspiration of the upper arm, to which was applied different fluid infiltration and liposuction techniques in three anatomic compartments (anteromedial, anterolateral, and posterolateral), and extension of liposuction to the periaxillar and parascarpular areas. A total of 57 female patients underwent liposuction of their excess arm fat using this technique. The authors achieved their aesthetic goals of a straightened inferior brachial border and a more slender body contour. Complications occurred for five patients including irregularity, incision-site scar, and transient pigmentation. Through 3D-CL, the limitations of traditional upper arm liposuction were overcome, and a slender arm contour with a straightened inferior brachial border was produced. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at http://www.springer.com/00266.

  9. The pattern of circumferential and radial eruptive fissures on the volcanoes of Fernandina and Isabela islands, Galapagos

    USGS Publications Warehouse

    Chadwick, W.W.; Howard, K.A.

    1991-01-01

    Maps of the eruptive vents on the active shield volcanoes of Fernandina and Isabela islands, Galapagos, made from aerial photographs, display a distinctive pattern that consists of circumferential eruptive fissures around the summit calderas and radial fissures lower on the flanks. On some volcano flanks either circumferential or radial eruptions have been dominant in recent time. The location of circumferential vents outside the calderas is independent of caldera-related normal faults. The eruptive fissures are the surface expression of dike emplacement, and the dike orientations are interpreted to be controlled by the state of stress in the volcano. Very few subaerial volcanoes display a pattern of fissures similar to that of the Galapagos volcanoes. Some seamounts and shield volcanoes on Mars morphologically resemble the Galapagos volcanoes, but more specific evidence is needed to determine if they also share common structure and eruptive style. ?? 1991 Springer-Verlag.

  10. Single-ring ablation compared with standard circumferential pulmonary vein isolation using remote magnetic catheter navigation.

    PubMed

    Sohns, Christian; Bergau, Leonard; Seegers, Joachim; Lüthje, Lars; Vollmann, Dirk; Zabel, Markus

    2014-10-01

    In ablation of atrial fibrillation, the single-ring method aims for isolation of the posterior wall of the left atrium (LA) including the pulmonary veins (PVs) but avoiding posterior LA lesions. The aim of this randomized prospective study was to evaluate safety and efficacy of remote magnetic navigation (RMN)-guided single-ring ablation strategy as compared to standard RMN-guided circumferential PV ablation (PVA). Eighty consecutive patients undergoing PVA were enrolled prospectively and randomized equally into two study groups. RMN using the Stereotaxis system and open-irrigated 3.5-mm ablation catheters were used with a 3D mapping system in all procedures. Forty patients underwent RMN-guided single-ring ablation, and 40 patients received RMN-guided circumferential PVA. In the circumferential group, 3.3 ± 1.1 PVs were successfully isolated at the end of the procedure as compared to 3.1 ± 1.3 in the single-ring (box) group (p=0.38). All patients in the box group required additional posterior lesions in order to achieve electrical isolation of the PVs. Single-ring ablation was associated with longer procedure duration (p=0.01) and ablation time (p=0.001). After a single procedure, the proportion of patients free of any atrial tachycardia (AT)/atrial fibrillation (AF) episode at 12-month follow-up was 57 % in the box group and 58 % in the circ group. Using RMN, only minor complications have been observed. RMN-guided single-ring PVA provides comparable acute and long-term success rates as compared to RMN-guided circumferential PVA but requires additional posterior lesions to achieve PV isolation and increased procedure and ablation time. Procedural complication rates are low when using RMN.

  11. Expanded plug method for developing circumferential mechanical properties of tubular materials

    DOEpatents

    Hendrich, William Ray; McAfee, Wallace Jefferson; Luttrell, Claire Roberta

    2006-11-28

    A method for determining the circumferential properties of a tubular product, especially nuclear fuel cladding, utilizes compression of a polymeric plug within the tubular product to determine strain stress, yield stress and other properties. The process is especially useful in the determination of aging properties such as fuel rod embrittlement after long burn-down.

  12. Circumferential Trabeculotomy Versus Conventional Angle Surgery: Comparing Long-term Surgical Success and Clinical Outcomes in Children With Primary Congenital Glaucoma.

    PubMed

    Neustein, Rebecca F; Beck, Allen D

    2017-11-01

    This study compares the long-term efficacy of circumferential trabeculotomy to that of conventional angle surgeries in primary congenital glaucoma (PCG), as judged by glaucoma and visual outcomes. Retrospective observational case series. Setting: Emory Eye Center, Atlanta, Georgia. This was a single-institution retrospective study involving children with PCG who underwent circumferential trabeculotomy, standard trabeculotomy, or goniotomy with ≥2-year follow-up. Postoperative success (intraocular pressure [IOP] < 22 mm Hg ± glaucoma medications, without glaucoma progression/additional IOP-lowering surgery), Snellen-equivalent visual acuity (VA), and IOP at last follow-up. Kaplan-Meier method estimated the probability of glaucoma control vs time postoperatively, and values were compared between angle surgery cohorts using Wilcoxon signed rank tests, Mann-Whitney U tests, and Fisher exact tests. Included were 58 eyes (33 children) after circumferential trabeculotomy and 42 eyes (27 children) after standard trabeculotomy/goniotomy, with mean follow-up of 7.2 ± 4.0 and 8.2 ± 4.5 years, respectively. Postoperative success at last follow-up in the circumferential vs conventional cohorts was 81% (47 of 58 eyes) vs 31% (13 of 42 eyes) (P < .0001). At last follow-up, the circumferential cohort had better median VA than the conventional cohort (20/30 (interquartile range [IQR] 20/25 to 20/70) vs 20/70 (IQR 20/40 to 20/200), P = .009), required fewer glaucoma medications (0.55 ± 1.2 vs 1.61 ± 1.51, P < .0001), had lower IOP in first operated eye (15.2 ± 3.6 vs 18.2 ± 7.0, P = .048), and had comparable incidence of devastating complications (P = .065). In this retrospective study, circumferential trabeculotomy afforded better long-term success and visual outcomes than conventional angle surgery for children with PCG. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Improved circumferential shaft seal for aircraft gear transmissions

    NASA Technical Reports Server (NTRS)

    Ludwig, L. P.; Strom, T. N.

    1973-01-01

    Operation under simulated aircraft transmission conditions of speeds to 2850 m/min (9350 ft/min), lubricant temperatures to 394 K (250 F), shaft radial runouts to 0.254 mm (0.010 in.) F.I.R. (full indicator reading), and pressure differentials to 1.03 N/cm2 (1.5 psi) revealed that conventional circumferential seals leaked excessively. Modifying the conventional seal by adding helical grooves to the seal bore reduced leakage rates to within the acceptable level of 10 cm3/hr. The leakage rate of this modified seal was not significantly affected by lubricant flooding or by shaft radial runout.

  14. Circumferential resection margin positivity after preoperative chemoradiotherapy based on magnetic resonance imaging for locally advanced rectal cancer: implication of boost radiotherapy to the involved mesorectal fascia.

    PubMed

    Kim, Kyung Hwan; Park, Min Jung; Lim, Joon Seok; Kim, Nam Kyu; Min, Byung Soh; Ahn, Joong Bae; Kim, Tae Il; Kim, Ho Geun; Koom, Woong Sub

    2016-04-01

    To identify patients who are at a higher risk of pathologic circumferential resection margin involvement using preoperative magnetic resonance imaging. Between October 2008 and November 2012, 165 patients with locally advanced rectal cancer (cT4 or cT3 with <2 mm distance from tumour to mesorectal fascia) who received preoperative chemoradiotherapy were analysed. The morphologic patterns on post-chemoradiotherapy magnetic resonance imaging were categorized into five patterns from Pattern A (most-likely negative pathologic circumferential resection margin) to Pattern E (most-likely positive pathologic circumferential resection margin). In addition, the location of mesorectal fascia involvement was classified as lateral, posterior and anterior. The diagnostic accuracy of the morphologic criteria was calculated using receiver operating characteristic curve analysis. Pathologic circumferential resection margin involvement was identified in 17 patients (10.3%). The diagnostic accuracy of predicting pathologic circumferential resection margin involvement was 0.73 using the five-scale magnetic resonance imaging pattern. The sensitivity, specificity, positive predictive value and negative predictive value for predicting pathologic circumferential resection margin involvement were 76.5, 65.5, 20.3 and 96.0%, respectively, when cut-off was set between Patterns C and D. On multivariate logistic regression, the magnetic resonance imaging patterns D and E (P= 0.005) and posterior or lateral mesorectal fascia involvement (P= 0.017) were independently associated with increased probability of pathologic circumferential resection margin involvement. The rate of pathologic circumferential resection margin involvement was 30.0% when the patient had Pattern D or E with posterior or lateral mesorectal fascia involvement. Patients who are at a higher risk of pathologic circumferential resection margin involvement can be identified using preoperative magnetic resonance imaging although

  15. Complete 360° circumferential SSOCT gonioscopy of the iridocorneal angle

    NASA Astrophysics Data System (ADS)

    McNabb, Ryan P.; Kuo, Anthony N.; Izatt, Joseph A.

    2014-02-01

    The ocular iridocorneal angle is generally an optically inaccessible area when viewed directly through the cornea due to the high angle of incidence required and the large index of refraction difference between air and cornea (nair = 1.000 and ncornea = 1.376) resulting in total internal reflection. Gonioscopy allows for viewing of the angle by removing the aircornea interface through the use of a special contact lens on the eye. Gonioscopy is used clinically to visualize the angle directly but only en face. Optical coherence tomography (OCT) has been used to image the angle and deeper structures via an external approach. Typically, this imaging technique is performed by utilizing a conventional anterior segment OCT scanning system. However, instead of imaging the apex of the cornea, either the scanner or the subject is tilted such that the corneoscleral limbus is orthogonal to the optical axis of the scanner requiring multiple volumes to obtain complete circumferential coverage of the ocular angle. We developed a novel gonioscopic OCT (GOCT) system that images the entire ocular angle within a single volume via an "internal" approach through the use of a custom radially symmetric gonioscopic contact lens. We present, to our knowledge, the first complete 360° circumferential volumes of the iridocorneal angle from a direct, internal approach.

  16. Alterations in left ventricular curvature and principal strains in dilated cardiomyopathy with functional mitral regurgitation.

    PubMed

    Tibayan, Frederick A; Lai, David T M; Timek, Tomasz A; Dagum, Paul; Liang, David; Zasio, Mary K; Daughters, George T; Miller, D Craig; Ingels, Neil B

    2003-05-01

    Functional mitral regurgitation (FMR) is increasingly recognized as a left ventricular (LV) disease. Dilated cardiomyopathy (DCM) is commonly accompanied by FMR and reduction of LV torsion. Therapeutic targets for DCM include LV size reduction, altered LV shape, elimination of MR, and increasing LV torsion. It was hypothesized that, in addition to increasing LV size, DCM with FMR would alter normal LV shape and reduce and alter the direction of principal strains across the LV wall. This hypothesis was tested by measuring changes in epicardial and endocardial 2-D principal strains and regional radii of curvature accompanying tachycardia-induced cardiomyopathy in ovine hearts. Radio-opaque marker arrays were implanted into the left ventricle of eight sheep, including one subepicardial triangle and one subendocardial triangle in the anterior wall of the left ventricle. At one week postoperatively, biplane videofluoroscopy was used to determine marker dynamics. Rapid ventricular pacing was then instituted until FMR and signs of heart failure developed, and fluoroscopy was repeated. Circumferential LV radii of curvature were determined from marker triplets. DCM changed the normal epicardial oval LV cross-section to a more circular configuration. The endocardium maintained its normal circular shape as the left ventricle dilated. Deformations of the triangles from end-diastole to end-systole were determined, and the magnitude and direction of 2-D principal strains calculated. DCM was associated with decreased magnitude of both epicardial (-0.095 +/- 0.055 versus -0.040 +/- 0.032, p = 0.006) and endocardial (-0.117 +/- 0.047 versus -0.073 +/- 0.037, p = 0.023) principal strains. DCM reduced the angle of epicardial but not endocardial principal strain. DCM with FMR is associated with LV dilation, circularization of the normally oval equatorial circumferential LV epicardium, transmural reduction in principal strain, and decrease in angle of principal epicardial strain. These

  17. Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt.

    PubMed

    Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

    2013-08-13

    A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome.

  18. Saturn S-11 Production Operations Techniques, Production Welding. Volume 3: Circumferential Welding

    NASA Technical Reports Server (NTRS)

    Abel, D. G.

    1970-01-01

    Special processes and techniques are described for the circumferential welding of Saturn 2 cylinder and bulkhead assemblies to complete the LO2 and LH2 tankage and to maximize efficiency and personnel performance during S-2 follow-on or restart activities. The processes are only applicable to aluminum alloys within the 2000 series.

  19. Circumferential suture technique for esophageal transection to treat esophageal variceal bleeding.

    PubMed

    Jeng, L B; Chen, M F

    1993-01-01

    The EEA stapler has been used routinely for esophageal transection to treat esophageal variceal bleeding for some time. It carries the risk of postoperative leakage and is not suitable in those cases receiving recent sclerotherapy. The circumferential suture technique presented in this paper can be used in any situation requiring esophageal transection. It has been utilized by us in twenty-two emergent cases with good results.

  20. Snare coupling of the pre-pectoral pacing lead delivery catheter to the femoral transseptal apparatus for endocardial cardiac resynchronization therapy : mid-term results.

    PubMed

    Patel, Mehul B; Worley, Seth J

    2013-04-01

    Limitations imposed by the coronary sinus venous anatomy triggered the transseptal approach for endocardial LV lead placement. The alignment of the interatrial septum (IAS) and its neighborhood anatomy does not favor transseptal puncture from the pre-pectoral area. Locating and advancing a pre-pectoral LV lead delivery catheter (PDC) through an opening created in the IAS via femoral transseptal puncture (FTP) is time consuming and technically difficult. We describe a method where the PDC is snare coupled to the femoral transseptal apparatus (FTA). When the FTA is advanced into the left atrium (LA) the coupled PDC follows. The catheter of a 25-mm loop snare kit is replaced with the PDC (SelectSite®). The snare loop is positioned in the right common iliac vein from the pre-pectoral access. The PDC is coupled to the FTA by advancing the transseptal apparatus through the open snare loop. After conventional FTP, the FTA is withdrawn back into the right atrium (RA) over an extra support wire positioned in the LA. The PDC with open snare loop is pulled over the FTA up to the RA. The PDC is advanced to close the snare loop on the extra support wire immediately distal to the tip of the dilator close to the puncture site. The PDC is deflected to align with the FTA. The snare coupled catheters are gently advanced across the IAS into the LA. The PDC is released from the FTA by advancing the snare and opening the loop; the snare is then removed from the PDC. The PDC is deflected and advanced into the left ventricle (LV). After positioning the 4.1 Fr lumen less LV lead, the PDC is sliced and removed. The PDC snare coupled to the FTA was advanced into the LA in all five patients, however, access was lost during catheter manipulation in the one right-sided case. Endocardial LV lead was successfully positioned in all five patients. Snare coupling the pre-pectoral SelectSite® catheter to the FTA is technically simple, reliable and a safe method for transseptal endocardial LV lead

  1. A dual-reflective electrothermal MEMS micromirror for full circumferential scanning endoscopic imaging

    NASA Astrophysics Data System (ADS)

    Wu, Lei; Xie, Huikai

    2008-02-01

    This paper reports the design, fabrication and measurements of a dual-reflective, single-crystal silicon based micromirror that can perform full circumferential scanning (FCS) for endoscopic optical coherence tomography (EOCT). In the proposed FCS-EOCT probe, two optical fibers are used to deliver light beams to either surface of the micromirror, which can rotate +/-45° (or 90°) and thus a 180° optical scanning is obtained from each mirror surface, resulting in full circumferential scans. A novel surface- and bulk-combined micromachining process based on SOI wafers is developed for fabricating the dual reflective micromirror. The single-crystal-silicon device layer of SOI wafers is used for mirror flatness, and Al is coated on both sides for high reflectivity. With one light beam delivered to each mirror surface, full 360° scans have been observed. Other measured data include the resonant frequency: 328Hz, radius of curvatures: - 124 mm (front surface) and 127 mm (back surface), and the reflectances: 81.3% (front surface) and 79.0% (back surface).

  2. Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt

    PubMed Central

    Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

    2013-01-01

    A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome. PMID:23946511

  3. Circumferential and functional re-entry of in vivo slow-wave activity in the porcine small intestine.

    PubMed

    Angeli, T R; O'Grady, G; Du, P; Paskaranandavadivel, N; Pullan, A J; Bissett, I P; Cheng, L K

    2013-05-01

    Slow-waves modulate the pattern of small intestine contractions. However, the large-scale spatial organization of intestinal slow-wave pacesetting remains uncertain because most previous studies have had limited resolution. This study applied high-resolution (HR) mapping to evaluate intestinal pacesetting mechanisms and propagation patterns in vivo. HR serosal mapping was performed in anesthetized pigs using flexible arrays (256 electrodes; 32 × 8; 4 mm spacing), applied along the jejunum. Slow-wave propagation patterns, frequencies, and velocities were calculated. Slow-wave initiation sources were identified and analyzed by animation and isochronal activation mapping. Analysis comprised 32 recordings from nine pigs (mean duration 5.1 ± 3.9 min). Slow-wave propagation was analyzed, and a total of 26 sources of slow-wave initiation were observed and classified as focal pacemakers (31%), sites of functional re-entry (23%) and circumferential re-entry (35%), or indeterminate sources (11%). The mean frequencies of circumferential and functional re-entry were similar (17.0 ± 0.3 vs 17.2 ± 0.4 cycle min(-1) ; P = 0.5), and greater than that of focal pacemakers (12.7 ± 0.8 cycle min(-1) ; P < 0.001). Velocity was anisotropic (12.9 ± 0.7 mm s(-1) circumferential vs 9.0 ± 0.7 mm s(-1) longitudinal; P < 0.05), contributing to the onset and maintenance of re-entry. This study has shown multiple patterns of slow-wave initiation in the jejunum of anesthetized pigs. These results constitute the first description and analysis of circumferential re-entry in the gastrointestinal tract and functional re-entry in the in vivo small intestine. Re-entry can control the direction, pattern, and frequency of slow-wave propagation, and its occurrence and functional significance merit further investigation. © 2013 Blackwell Publishing Ltd.

  4. Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review

    PubMed Central

    Fan, Lihong; Ge, Zhaogang; Zhang, Chen; Li, Jia; Yu, Zefeng; Dang, Xiaoqian; Wang, Kunzheng

    2015-01-01

    The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p < 0.0001) and WOMAC Score (p = 0.0003) indicated that circumpatellarelectrocautery improved clinical outcomes compared with non-electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement. PMID:25801456

  5. Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review.

    PubMed

    Fan, Lihong; Ge, Zhaogang; Zhang, Chen; Li, Jia; Yu, Zefeng; Dang, Xiaoqian; Wang, Kunzheng

    2015-03-24

    The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p < 0.0001) and WOMAC Score (p = 0.0003) indicated that circumpatellarelectrocautery improved clinical outcomes compared with non-electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement.

  6. Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review

    NASA Astrophysics Data System (ADS)

    Fan, Lihong; Ge, Zhaogang; Zhang, Chen; Li, Jia; Yu, Zefeng; Dang, Xiaoqian; Wang, Kunzheng

    2015-03-01

    The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p < 0.0001) and WOMAC Score (p = 0.0003) indicated that circumpatellarelectrocautery improved clinical outcomes compared with non-electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement.

  7. Circumferential fusion is dominant over posterolateral fusion in a long-term perspective: cost-utility evaluation of a randomized controlled trial in severe, chronic low back pain.

    PubMed

    Soegaard, Rikke; Bünger, Cody E; Christiansen, Terkel; Høy, Kristian; Eiskjaer, Søren P; Christensen, Finn B

    2007-10-15

    Cost-utility evaluation of a randomized, controlled trial with a 4- to 8-year follow-up. To investigate the incremental cost per quality-adjusted-life-year (QALY) when comparing circumferential fusion to posterolateral fusion in a long-term, societal perspective. The cost-effectiveness of circumferential fusion in a long-term perspective is uncertain but nonetheless highly relevant as the ISSLS prize winner 2006 in clinical studies reported the effect of circumferential fusion superior to the effect of posterolateral fusion. A recent trial found no significant difference between posterolateral and circumferential fusion reporting cost-effectiveness from a 2-year viewpoint. A total of 146 patients were randomized to posterolateral or circumferential fusion and followed 4 to 8 years after surgery. The mean age of the cohort was 46 years (range, 20-65 years); 61% were females, 49% were smokers, 30% had primary diagnosis of isthmic spondylolisthesis, 35% had disc degeneration and no previous surgery, and 35% had disc degeneration and previous surgery. Eighty-two percent of patients have had symptoms for more than 2 years and 50% were out of the labor market due to sickness. The EQ-5D instrument was applied for the measurement of health-related quality of life and costs (2004 U.S. dollars) were measured in a full-scale societal perspective. Productivity costs were valued by the Friction Cost method, and both costs and effects were discounted. Arithmetic means and 95% bias-corrected, bootstrapped confidence intervals were reported. Nonparametric statistics were used for tests of statistical significance. Comprehensive sensitivity analysis was conducted and reported using cost-effectiveness acceptability curves. The circumferential group demonstrated clinical superiority over the posterolateral fusion group in functional outcome (P < 0.01), fusion rate (P < 0.04), and number of reoperations (P < 0.01) among others. Cost-utility analysis demonstrated circumferential fusion

  8. Non-invasive vascular radial/circumferential strain imaging and wall shear rate estimation using video images of diagnostic ultrasound.

    PubMed

    Wan, Jinjin; He, Fangli; Zhao, Yongfeng; Zhang, Hongmei; Zhou, Xiaodong; Wan, Mingxi

    2014-03-01

    The aim of this work was to develop a convenient method for radial/circumferential strain imaging and shear rate estimation that could be used as a supplement to the current routine screening for carotid atherosclerosis using video images of diagnostic ultrasound. A reflection model-based correction for gray-scale non-uniform distribution was applied to B-mode video images before strain estimation to improve the accuracy of radial/circumferential strain imaging when applied to vessel transverse cross sections. The incremental and cumulative radial/circumferential strain images can then be calculated based on the displacement field between consecutive B-mode images. Finally, the transverse Doppler spectra acquired at different depths along the vessel diameter were used to construct the spatially matched instantaneous wall shear values in a cardiac cycle. Vessel phantom simulation results revealed that the signal-to-noise ratio and contrast-to-noise ratio of the radial and circumferential strain images were increased by 2.8 and 5.9 dB and by 2.3 and 4.4 dB, respectively, after non-uniform correction. Preliminary results for 17 patients indicated that the accuracy of radial/circumferential strain images was improved in the lateral direction after non-uniform correction. The peak-to-peak value of incremental strain and the maximum cumulative strain for calcified plaques are evidently lower than those for other plaque types, and the echolucent plaques had higher values, on average, than the mixed plaques. Moreover, low oscillating wall shear rate values, found near the plaque and stenosis regions, are closely related to plaque formation. In conclusion, the method described can provide additional valuable results as a supplement to the current routine ultrasound examination for carotid atherosclerosis and, therefore, has significant potential as a feasible screening method for atherosclerosis diagnosis in the future. Copyright © 2014 World Federation for Ultrasound in

  9. Automated circumferential construction of first-order aqueous humor outflow pathways using spectral-domain optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Huang, Alex S.; Belghith, Akram; Dastiridou, Anna; Chopra, Vikas; Zangwill, Linda M.; Weinreb, Robert N.

    2017-06-01

    The purpose was to create a three-dimensional (3-D) model of circumferential aqueous humor outflow (AHO) in a living human eye with an automated detection algorithm for Schlemm's canal (SC) and first-order collector channels (CC) applied to spectral-domain optical coherence tomography (SD-OCT). Anterior segment SD-OCT scans from a subject were acquired circumferentially around the limbus. A Bayesian Ridge method was used to approximate the location of the SC on infrared confocal laser scanning ophthalmoscopic images with a cross multiplication tool developed to initiate SC/CC detection automated through a fuzzy hidden Markov Chain approach. Automatic segmentation of SC and initial CC's was manually confirmed by two masked graders. Outflow pathways detected by the segmentation algorithm were reconstructed into a 3-D representation of AHO. Overall, only <1% of images (5114 total B-scans) were ungradable. Automatic segmentation algorithm performed well with SC detection 98.3% of the time and <0.1% false positive detection compared to expert grader consensus. CC was detected 84.2% of the time with 1.4% false positive detection. 3-D representation of AHO pathways demonstrated variably thicker and thinner SC with some clear CC roots. Circumferential (360 deg), automated, and validated AHO detection of angle structures in the living human eye with reconstruction was possible.

  10. BIOPHYSICAL PARAMETERS DURING RADIOFREQUENCY CATHETER ABLATION OF SCAR-MEDIATED VENTRICULAR TACHYCARDIA: EPICARDIAL AND ENDOCARDIAL APPLICATIONS VIA MANUAL AND MAGNETIC NAVIGATION

    PubMed Central

    Bourke, Tara; Buch, Eric; Mathuria, Nilesh; Michowitz, Yoav; Yu, Ricky; Mandapati, Ravi; Shivkumar, Kalyanam; Tung, Roderick

    2014-01-01

    Background There is a paucity of data on biophysical parameters during radiofrequency ablation of scar-mediated ventricular tachycardia (VT). Methods and Results Data was collected from consecutive patients undergoing VT ablation with open-irrigation. Complete data was available for 372 lesions in 21 patients. The frequency of biophysical parameter changes were: >10Ω reduction (80%), bipolar EGM reduction (69%), while loss of capture was uncommon (32%). Unipolar injury current was seen in 72% of radiofrequency applications. Both EGM reduction and impedance drop were seen in 57% and a change in all 3 parameters was seen in only 20% of lesions. Late potentials were eliminated in 33%, reduced/modified in 56%, and remained after ablation in 11%. Epicardial lesions exhibited an impedance drop (90% vs 76%, p=0.002) and loss of capture (46% vs 27%, p<0.001) more frequently than endocardial lesions. Lesions delivered manually exhibited a >10Ω impedance drop (83% vs 71%, p=0.02) and an EGM reduction (71% vs 40%, p< 0.001) more frequently than lesions applied using magnetic navigation, although loss of capture, elimination of LPs, and a change in all 3 parameters were similarly observed. Conclusions VT ablation is inefficient as the majority of radiofrequency lesions do not achieve more than one targeted biophysical parameter. Only one-third of RF applications targeted at LPs result in complete elimination. Epicardial ablation within scar may be more effective than endocardial lesions and lesions applied manually may be more effective than lesions applied using magnetic navigation. New technologies directed at identifying and optimizing ablation effectiveness in scar are clinically warranted. PMID:24946895

  11. Biophysical parameters during radiofrequency catheter ablation of scar-mediated ventricular tachycardia: epicardial and endocardial applications via manual and magnetic navigation.

    PubMed

    Bourke, Tara; Buch, Eric; Mathuria, Nilesh; Michowitz, Yoav; Yu, Ricky; Mandapati, Ravi; Shivkumar, Kalyanam; Tung, Roderick

    2014-11-01

    There is a paucity of data on biophysical parameters during radiofrequency ablation of scar-mediated ventricular tachycardia (VT). Data were collected from consecutive patients undergoing VT ablation with open-irrigation. Complete data were available for 372 lesions in 21 patients. The frequency of biophysical parameter changes were: >10Ω reduction (80%), bipolar EGM reduction (69%), while loss of capture was uncommon (32%). Unipolar injury current was seen in 72% of radiofrequency applications. Both EGM reduction and impedance drop were seen in 57% and a change in all 3 parameters was seen in only 20% of lesions. Late potentials were eliminated in 33%, reduced/modified in 56%, and remained after ablation in 11%. Epicardial lesions exhibited an impedance drop (90% vs. 76%, P = 0.002) and loss of capture (46% vs. 27%, P < 0.001) more frequently than endocardial lesions. Lesions delivered manually exhibited a >10Ω impedance drop (83% vs. 71%, P = 0.02) and an EGM reduction (71% vs. 40%, P < 0.001) more frequently than lesions applied using magnetic navigation, although loss of capture, elimination of LPs, and a change in all 3 parameters were similarly observed. VT ablation is inefficient as the majority of radiofrequency lesions do not achieve more than one targeted biophysical parameter. Only one-third of RF applications targeted at LPs result in complete elimination. Epicardial ablation within scar may be more effective than endocardial lesions, and lesions applied manually may be more effective than lesions applied using magnetic navigation. New technologies directed at identifying and optimizing ablation effectiveness in scar are clinically warranted. © 2014 Wiley Periodicals, Inc.

  12. Expressions to Rayleigh circumferential phase velocity and dispersion relation for a cylindrical surface under mechanical pressure

    NASA Astrophysics Data System (ADS)

    Sebold, Jean Eduardo; de Lacerda, Luiz Alkimin

    2018-04-01

    This paper describes a substantiated mathematical theory for Rayleigh waves propagated on some types of metal cylinders. More specifically, it presents not only a new way to express the dispersion relation of Rayleigh waves propagated on the cylindrical surface, but also how it can be used to construct a mathematical equation showing that the applied static mechanical pressure affects the shear modulus of the metal cylinder. All steps, required to conclude the process, consider the equation of motion as a function of radial and circumferential coordinates only, while the axial component can be overlooked without causing any problems. Some numerical experiments are done to illustrate the changes in the Rayleigh circumferential phase velocity in a metal cylindrical section due to static mechanical pressure around its external surface.

  13. Left Ventricular Strain in Chemotherapy-Naive and Radiotherapy-Naive Patients With Cancer.

    PubMed

    Tadic, Marijana; Genger, Martin; Baudisch, Ana; Kelle, Sebastian; Cuspidi, Cesare; Belyavskiy, Evgeny; Burkhardt, Franziska; Venneri, Lucia; Attanasio, Philipp; Pieske, Burkert

    2018-03-01

    We sought to investigate left ventricular (LV) function and mechanics in patients with cancer before they received chemotherapy or radiotherapy, as well as the relationship between cancer and reduced LV multidirectional strain in the whole study population. The retrospective study involved 122 chemotherapy- and radiotherapy-naive patients with cancer and 45 age- and sex-matched controls with a cardiovascular risk profile similar to that of the patients with cancer. All the patients underwent echocardiographic examination before introduction of chemotherapy or radiotherapy. LV longitudinal (-19.1% ± 2.1% vs -17.8% ± 3.5%; P = 0.022), circumferential (-22.9% ± 3.5% vs -20.1% ± 4.1%; P < 0.001), and radial (40.5% ± 8.8% vs 35.2% ± 10.7%; P = 0.004) strain was significantly lower in the patients with cancer than in the control group. Endocardial and midmyocardial longitudinal LV strain was significantly reduced in the patients with cancer compared with the controls, whereas epicardial longitudinal strain was similar between these groups. Endocardial, midmyocardial, and epicardial circumferential strain was significantly lower in the chemotherapy- or radiotherapy-naive patients with cancer than in the controls. Cancer was associated with reduced longitudinal (odds ratio [OR], 9.0; 95% confidence interval [CI], 2.20-23.50; P < 0.001), reduced circumferential (OR, 7.1; 95% CI, 3.80-20.40; P < 0.001), and reduced radial strain (OR, 7.2; 95% CI, 3.41-25.10; P < 0.001) independent of age, sex, body mass index, diabetes, and hypertension. LV mechanics was impaired in the patients with cancer compared with the controls even before initiation of chemotherapy and radiotherapy. Cancer and hypertension were associated with reduced LV multidirectional strain independent of other clinical parameters. The present results indicate that cancer itself potentially induces cardiac remodelling independent of chemotherapy and radiotherapy. Copyright © 2017 Canadian

  14. Recent evaluations of crack-opening-area in circumferentially cracked pipes

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

    Rahman, S.; Brust, F.; Ghadiali, N.

    1997-04-01

    Leak-before-break (LBB) analyses for circumferentially cracked pipes are currently being conducted in the nuclear industry to justify elimination of pipe whip restraints and jet shields which are present because of the expected dynamic effects from pipe rupture. The application of the LBB methodology frequently requires calculation of leak rates. The leak rates depend on the crack-opening area of the through-wall crack in the pipe. In addition to LBB analyses which assume a hypothetical flaw size, there is also interest in the integrity of actual leaking cracks corresponding to current leakage detection requirements in NRC Regulatory Guide 1.45, or for assessingmore » temporary repair of Class 2 and 3 pipes that have leaks as are being evaluated in ASME Section XI. The objectives of this study were to review, evaluate, and refine current predictive models for performing crack-opening-area analyses of circumferentially cracked pipes. The results from twenty-five full-scale pipe fracture experiments, conducted in the Degraded Piping Program, the International Piping Integrity Research Group Program, and the Short Cracks in Piping and Piping Welds Program, were used to verify the analytical models. Standard statistical analyses were performed to assess used to verify the analytical models. Standard statistical analyses were performed to assess quantitatively the accuracy of the predictive models. The evaluation also involved finite element analyses for determining the crack-opening profile often needed to perform leak-rate calculations.« less

  15. Comparison of treadmill exercise stress cardiac MRI to stress echocardiography in healthy volunteers for adequacy of left ventricular endocardial wall visualization: A pilot study

    PubMed Central

    Thavendiranathan, Paaladinesh; Dickerson, Jennifer A.; Scandling, Debbie; Balasubramanian, Vijay; Pennell, Michael L.; Hinton, Alice; Raman, Subha V.; Simonetti, Orlando P.

    2013-01-01

    Purpose To compare exercise stress cardiac magnetic resonance (cardiac MR) to echocardiography in healthy volunteers with respect to adequacy of endocardial visualization and confidence of stress study interpretation. Materials and Methods 28 healthy volunteers (aged 28 ± 11 years, 15 males) underwent exercise stress echo and cardiac MR one week apart assigned randomly to one test first. Stress cardiac MR was performed using an MRI-compatible treadmill; stress echo was performed as per routine protocol. Cardiac MR and echo images were independently reviewed and scored for adequacy of endocardial visualization and confidence in interpretation of the stress study. Results Heart rate at the time of imaging was similar between the studies. Average time from cessation of exercise to start of imaging (21 vs. 31 seconds, p<0.001) and time to acquire stress images (20 vs. 51 seconds, p<0.001) was shorter for cardiac MR. The number of myocardial segments adequately visualized was significantly higher by cardiac MR at rest (99.8% versus 96.4%, p=0.002) and stress (99.8% versus 94.1%, p=0.001). The proportion of subjects in whom there was high confidence in the interpretation was higher for cardiac MR than echo (96% vs 60%, p=0.005). Conclusion Exercise stress cardiac MR to assess peak exercise wall motion is feasible and can be performed at least as rapidly as stress echo. PMID:24123562

  16. Numerical analysis of flow in a centrifugal compressor with circumferential grooves: influence of groove location and number on flow instability

    NASA Astrophysics Data System (ADS)

    Chen, X.; Qin, G.; Ai, Z.; Ji, Y.

    2017-08-01

    As an effective and economic method for flow range enhancement, circumferential groove casing treatment (CGCT) is widely used to increase the stall margin of compressors. Different from traditional grooved casing treatments, in which the grooves are always located over the rotor in both axial and radial compressors, one or several circumferential grooves are located along the shroud side of the diffuser passage in this paper. Numerical investigations were conducted to predict the performance of a low flow rate centrifugal compressor with CGCT in diffuser. Computational fluid dynamics (CFD) analysis is performed under stage environment in order to find the optimum location of the circumferential casing groove in consideration of stall margin enhancement and efficiency gain at design point, and the impact of groove number to the effect of this grooved casing treatment configuration in enhancing the stall margin of the compressor stage is studied. The results indicate that the centrifugal compressor with circumferential groove in vaned diffuser can obtain obvious improvement in the stall margin with sacrificing design efficiency a little. Efforts were made to study blade level flow mechanisms to determine how the CGCT impacts the compressor’s stall margin (SM) and performance. The flow structures in the passage, the tip gap, and the grooves as well as their mutual interactions were plotted and analysed.

  17. Automated circumferential construction of first-order aqueous humor outflow pathways using spectral-domain optical coherence tomography.

    PubMed

    Huang, Alex S; Belghith, Akram; Dastiridou, Anna; Chopra, Vikas; Zangwill, Linda M; Weinreb, Robert N

    2017-06-01

    The purpose was to create a three-dimensional (3-D) model of circumferential aqueous humor outflow (AHO) in a living human eye with an automated detection algorithm for Schlemm’s canal (SC) and first-order collector channels (CC) applied to spectral-domain optical coherence tomography (SD-OCT). Anterior segment SD-OCT scans from a subject were acquired circumferentially around the limbus. A Bayesian Ridge method was used to approximate the location of the SC on infrared confocal laser scanning ophthalmoscopic images with a cross multiplication tool developed to initiate SC/CC detection automated through a fuzzy hidden Markov Chain approach. Automatic segmentation of SC and initial CC’s was manually confirmed by two masked graders. Outflow pathways detected by the segmentation algorithm were reconstructed into a 3-D representation of AHO. Overall, only <1% of images (5114 total B-scans) were ungradable. Automatic segmentation algorithm performed well with SC detection 98.3% of the time and <0.1% false positive detection compared to expert grader consensus. CC was detected 84.2% of the time with 1.4% false positive detection. 3-D representation of AHO pathways demonstrated variably thicker and thinner SC with some clear CC roots. Circumferential (360 deg), automated, and validated AHO detection of angle structures in the living human eye with reconstruction was possible.

  18. Coupled, circumferential motions of the cell wall synthesis machinery and MreB filaments in B. subtilis.

    PubMed

    Garner, Ethan C; Bernard, Remi; Wang, Wenqin; Zhuang, Xiaowei; Rudner, David Z; Mitchison, Tim

    2011-07-08

    Rod-shaped bacteria elongate by the action of cell wall synthesis complexes linked to underlying dynamic MreB filaments. To understand how the movements of these filaments relate to cell wall synthesis, we characterized the dynamics of MreB and the cell wall elongation machinery using high-precision particle tracking in Bacillus subtilis. We found that MreB and the elongation machinery moved circumferentially around the cell, perpendicular to its length, with nearby synthesis complexes and MreB filaments moving independently in both directions. Inhibition of cell wall synthesis by various methods blocked the movement of MreB. Thus, bacteria elongate by the uncoordinated, circumferential movements of synthetic complexes that insert radial hoops of new peptidoglycan during their transit, possibly driving the motion of the underlying MreB filaments.

  19. Measurements of the Exerted Pressure by Pelvic Circumferential Compression Devices

    PubMed Central

    Knops, Simon P; van Riel, Marcel P.J.M; Goossens, Richard H.M; van Lieshout, Esther M.M; Patka, Peter; Schipper, Inger B

    2010-01-01

    Background: Data on the efficacy and safety of non-invasive Pelvic Circumferential Compression Devices (PCCDs) is limited. Tissue damage may occur if a continuous pressure on the skin exceeding 9.3 kPa is sustained for more than two or three hours. The aim of this study was to gain insight into the pressure build-up at the interface, by measuring the PCCD-induced pressure when applying pulling forces to three different PCCDs (Pelvic Binder® , SAM-Sling ® and T-POD® ) in a simplified model. Methods: The resulting exerted pressures were measured at four ‘anatomical’ locations (right, left, posterior and anterior) in a model using a pressure measurement system consisting of pressure cuffs. Results: The exerted pressure varied substantially between the locations as well as between the PCCDs. Maximum pressures ranged from 18.9-23.3 kPa and from 19.2-27.5 kPa at the right location and left location, respectively. Pressures at the posterior location stayed below 18 kPa. At the anterior location pressures varied markedly between the different PCCDs. Conclusion: The circumferential compression by the different PCCDs showed high pressures measured at the four locations using a simplified model. Difference in design and functional characteristics of the PCCDs resulted in different pressure build-up at the four locations. When following the manufacturer’s instructions, the exerted pressure of all three PCCDs tested exceeded the tissue damaging level (9.3 kPa). In case of prolonged use in a clinical situation this might put patients at risk for developing tissue damage. PMID:20361001

  20. Esophageal Motility after Extensive Circumferential Endoscopic Submucosal Dissection for Superficial Esophageal Cancer.

    PubMed

    Kuribayashi, Yasutaka; Iizuka, Toshiro; Nomura, Kosuke; Furuhata, Tsukasa; Yamashita, Satoshi; Matsui, Akira; Kikuchi, Daisuke; Mitani, Toshifumi; Kaise, Mitsuru; Hoteya, Shu

    2018-06-05

    Endoscopic submucosal dissection (ESD) for superficial esophageal cancer is sometimes extensive, and in our experience, patients not infrequently present with dysphagia after ESD even in the absence of esophageal stricture. The aim of this study was to evaluate esophageal motility using high-resolution manometry (HRM) in patients with and without dysphagia after extensive circumferential ESD. HRM was performed in a total of 52 patients who had undergone ESD for superficial esophageal cancer and a mucosal defect after ESD exceeded more than two-thirds of the esophageal circumference. The frequency and type of esophageal dysmotility and the relationship between esophageal motility and dysphagia were evaluated. Esophageal dysmotility was observed in 13 patients (25%): jackhammer esophagus in 4, esophagogastric junction outflow obstruction in 4, absent contractility in 2, and distal esophageal spasm, ineffective esophageal motility, and fragmented peristalsis in 1 patient each. Of the 22 patients with dysphagia after ESD, 9 (41%) had esophageal dysmotility. Of the 30 patients without dysphagia after ESD, 4 (13%) had esophageal dysmotility. The relationship between dysmotility and dysphagia was significant (p = 0.025). Esophageal dysmotility exists in approximately one-quarter of patients after extensive circumferential ESD, which is associated with dysphagia in the absence of esophageal stricture. © 2018 S. Karger AG, Basel.

  1. Association of left ventricular longitudinal and circumferential systolic dysfunction with diastolic function in hypertension: a nonlinear analysis focused on the interplay with left ventricular geometry.

    PubMed

    Ballo, Piercarlo; Nistri, Stefano; Cameli, Matteo; Papesso, Barbara; Dini, Frank Lloyd; Galderisi, Maurizio; Zuppiroli, Alfredo; Mondillo, Sergio

    2014-02-01

    The relationships of left ventricular (LV) longitudinal and circumferential systolic dysfunction with diastolic performance in hypertensive patients have never been compared. In 532 asymptomatic hypertensive patients, circumferential function was assessed with the use of midwall fractional shortening (mFS) and stress-corrected mFS (SCmFS), whereas longitudinal function was assessed with the use of left atrioventricular plane displacement (AVPD) and systolic mitral annulus velocity (s'). Early diastolic annular velocity (e') and the E/e' ratio were measured. Global longitudinal and circumferential strain were determined in a subset of 210 patients. e' was linearly related to all systolic indexes (AVPD: R = 0.40; s': R = 0.39; mFS: R = 0.16; SCmFS: R = 0.17; all P < .0001), but the correlations were stronger with longitudinal indexes than with circumferential ones (P < .0001). E/e' was nonlinearly related to AVPD (R = -0.49; P < .0001) and s' (R = -0.34; P < .0001) and showed no relationship with mFS and SCmFS. Longitudinal indexes were superior to circumferential ones in predicting e' <8 cm/s, E/e' <8, and E/e' ≥13. The effect of LV geometry on LV diastolic function was evident among patients with preserved systolic longitudinal function, but was blunted among patients with impaired longitudinal function. In multivariable analyses, only longitudinal indexes remained associated with e' and E/e'. Analyses using strains provided similar results. In asymptomatic hypertensive subjects, LV diastolic performance is independently associated with longitudinal systolic dysfunction, but not with circumferential systolic dysfunction. Subtle longitudinal systolic impairment plays a role in mediating the effect of LV geometry on diastolic performance. These findings may support the need of critically revising the concept of isolated diastolic dysfunction in these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Internal porosity of cast titanium removable partial dentures: influence of sprue direction and diameter on porosity in simplified circumferential clasps.

    PubMed

    Baltag, Ioana; Watanabe, Kouichi; Miyakawa, Osamu

    2005-06-01

    The behavior of molten titanium in molds of complicated shape is still insufficiently understood; consequently, definite spruing criteria are not yet available for titanium RPD frameworks. This study investigated the influence of sprue design on porosity in pressure-cast titanium circumferential clasps. The patterns of 90 circumferential clasps were sprued with three directions (0, 30 and 60 degrees , as measured between the sprue and the symmetry plane of the clasp assembly) and three sprue diameters (1.5, 2.0 and 2.5mm). CPTi was cast in a one-chamber pressure casting machine. Pore number and size were assessed on radiographs of the castings. Statistical analysis was done by two-way analysis of variance (ANOVA), followed by Fisher's PLSD post hoc test. The porosity in lingual arms increased significantly with increase of sprue diameter and sprue angle, while the porosity in minor connectors had an inversely proportional distribution. Very low porosity, uninfluenced by sprue design, was found in buccal arms. In conclusion, internal porosity in titanium circumferential clasp arms can be minimized through sprue design: the 0 degrees sprue direction produced the least porosity, while for the 30 and 60 degrees directions, 1.5mm diameter sprues produced lower porosity than 2.0 and 2.5mm diameter sprues. In this study, the lowest porosity in titanium circumferential clasp arms was obtained with sprues attached perpendicularly to the minor connectors, regardless of sprue diameter. Conventional sprue directions produced significantly higher porosity in clasp lingual arms, the amount of porosity increasing with sprue diameter.

  3. 46 CFR 52.05-45 - Circumferential joints in pipes, tubes and headers (modifies PW-41).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Circumferential joints in pipes, tubes and headers (modifies PW-41). 52.05-45 Section 52.05-45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Boilers Fabricated by Welding § 52.05-45...

  4. 46 CFR 52.05-45 - Circumferential joints in pipes, tubes and headers (modifies PW-41).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Circumferential joints in pipes, tubes and headers (modifies PW-41). 52.05-45 Section 52.05-45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Boilers Fabricated by Welding § 52.05-45...

  5. 46 CFR 52.05-45 - Circumferential joints in pipes, tubes and headers (modifies PW-41).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Circumferential joints in pipes, tubes and headers (modifies PW-41). 52.05-45 Section 52.05-45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Boilers Fabricated by Welding § 52.05-45...

  6. 46 CFR 52.05-45 - Circumferential joints in pipes, tubes and headers (modifies PW-41).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Circumferential joints in pipes, tubes and headers (modifies PW-41). 52.05-45 Section 52.05-45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Boilers Fabricated by Welding § 52.05-45...

  7. 46 CFR 52.05-45 - Circumferential joints in pipes, tubes and headers (modifies PW-41).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Circumferential joints in pipes, tubes and headers (modifies PW-41). 52.05-45 Section 52.05-45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Boilers Fabricated by Welding § 52.05-45...

  8. The elasticity problem for a thick-walled cylinder containing a circumferential crack

    NASA Technical Reports Server (NTRS)

    Nied, H. F.; Erdogan, F.

    1983-01-01

    The elasticity problem for a long hollow circular cylinder containing an axisymmetric circumferential crack subjected to general nonaxisymmetric external loads is considered. The problem is formulated in terms of a system of singular integral equations with the Fourier coefficients of the derivative of the crack surface displacement as density functions. The stress intensity factors and the crack opening displacement are calculated for a cylinder under uniform tension, bending by end couples, and self-equilibrating residual stresses.

  9. The elasticity problem for a thick-walled cylinder containing a circumferential crack

    NASA Technical Reports Server (NTRS)

    Nied, H. F.; Erdogan, F.

    1982-01-01

    The elasticity problem for a long hollow circular cylinder containing an axisymmetric circumferential crack subjected to general nonaxisymmetric external loads is considered. The problem is formulated in terms of a system of singular integral equations with the Fourier coefficients of the derivative of the crack surface displacement as density functions. The stress intensity factors and the crack opening displacement are calculated for a cylinder under uniform tension, bending by end couples, and self-equilibrating residual stresses.

  10. Regional effects of streptozotocin-induced diabetes on shortening and calcium transport in epicardial and endocardial myocytes from rat left ventricle.

    PubMed

    Smail, Manal M A; Qureshi, Muhammad A; Shmygol, Anatoliy; Oz, Murat; Singh, Jaipaul; Sydorenko, Vadym; Arabi, Alya; Howarth, Frank C; Al Kury, Lina

    2016-11-01

    In the heart, the left ventricle pumps blood at higher pressure than the right ventricle. Within the left ventricle, the electromechanical properties of ventricular cardiac myocytes vary transmurally and this may be related to the gradients of stress and strain experienced in vivo across the ventricular wall. Diabetes is also associated with alterations in hemodynamic function. The aim of this study was to investigate shortening and Ca 2+ transport in epicardial (EPI) and endocardial (ENDO) left ventricular myocytes in the streptozotocin (STZ)-induced diabetic rat. Shortening, intracellular Ca 2+ and L-type Ca 2+ current (I Ca,L ) were measured by video detection, fura-2 microfluorimetry, and whole-cell patch clamp techniques, respectively. Time to peak (TPK) shortening was prolonged to similar extents in ENDO and EPI myocytes from STZ-treated rats compared to ENDO and EPI myocytes from controls. Time to half (THALF) relaxation of shortening was prolonged in ENDO myocytes from STZ-treated rats compared to ENDO controls. TPK Ca 2+ transient was prolonged in ENDO myocytes from STZ-treated rats compared to ENDO controls. THALF decay of the Ca 2+ transient was prolonged in ENDO myocytes from STZ-treated rats compared to ENDO controls. Sarcoplasmic reticulum (SR) fractional release of Ca 2+ was reduced in EPI myocytes from STZ-treated rats compared to EPI controls. I C a,L activation, inactivation, and recovery from inactivation were not significantly altered in EPI and ENDO myocytes from STZ-treated rats or controls. Regional differences in Ca 2+ transport may partly underlie differences in ventricular myocyte shortening across the wall of the healthy and the STZ-treated rat left ventricle. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  11. The May 2005 eruption of Fernandina volcano, Galápagos: The first circumferential dike intrusion observed by GPS and InSAR

    USGS Publications Warehouse

    Chadwick, W.W.; Jonsson, Sigurjon; Geist, Dennis J.; Poland, M.; Johnson, Daniel J.; Batt, S.; Harpp, Karen S.; Ruiz, A.

    2011-01-01

    The May 2005 eruption of Fernandina volcano, Galápagos, occurred along circumferential fissures parallel to the caldera rim and fed lava flows down the steep southwestern slope of the volcano for several weeks. This was the first circumferential dike intrusion ever observed by both InSAR and GPS measurements and thus provides an opportunity to determine the subsurface geometry of these enigmatic structures that are common on Galápagos volcanoes but are rare elsewhere. Pre- and post- eruption ground deformation between 2002 and 2006 can be modeled by the inflation of two separate magma reservoirs beneath the caldera: a shallow sill at ~1 km depth and a deeper point-source at ~5 km depth, and we infer that this system also existed at the time of the 2005 eruption. The co-eruption deformation is dominated by uplift near the 2005 eruptive fissures, superimposed on a broad subsidence centered on the caldera. Modeling of the co-eruption deformation was performed by including various combinations of planar dislocations to simulate the 2005 circumferential dike intrusion. We found that a single planar dike could not match both the InSAR and GPS data. Our best-fit model includes three planar dikes connected along hinge lines to simulate a curved concave shell that is steeply dipping (~45–60°) toward the caldera at the surface and more gently dipping (~12–14°) at depth where it connects to the horizontal sub-caldera sill. The shallow sill is underlain by the deep point source. The geometry of this modeled magmatic system is consistent with the petrology of Fernandina lavas, which suggest that circumferential eruptions tap the shallowest parts of the system, whereas radial eruptions are fed from deeper levels. The recent history of eruptions at Fernandina is also consistent with the idea that circumferential and radial intrusions are sometimes in a stress-feedback relationship and alternate in time with one another.

  12. Instrumented circumferential fusion for tuberculosis of the dorso-lumbar spine. A single or double stage procedure?

    PubMed

    El-Sharkawi, Mohammad Mostafa; Said, Galal Zaki

    2012-02-01

    The purpose of this study was to present our experience in treating dorso-lumbar tuberculosis by one-stage posterior circumferential fusion and to compare this group with a historical group treated by anterior debridement followed by postero-lateral fusion and stabilization. Between 2003 and 2008, 32 patients with active spinal tuberculosis were treated by one-stage posterior circumferential fusion and prospectively followed for a minimum of two years. Pain severity was measured using Visual Analogue Scale (VAS). Neurological assessment was done using the Frankel scale. The operative data, clinical, radiological, and functional outcomes were also compared to a similar group of 25 patients treated with anterior debridement and fusion, followed 10-14 days later by posterior stabilization and postero-lateral fusion. The mean operative time and duration of hospital stay were significantly longer in the two-stage group. The mean estimated blood loss was also larger, though insignificantly, in the two-stage group. The incidence of complications was significantly lower in the one-stage group. At final follow-up, all 34 patients with pre-operative neurological deficits showed at least one Frankel grade of neurological improvement, all 57 patients showed significant improvement of their VAS back pain score, the mean kyphotic angle has significantly improved, all patients achieved solid fusion and 43 (75.4%) patients returned to their pre-disease activity level or work. Instrumented circumferential fusion, whether in one or two stages, is an effective treatment for dorso-lumbar tuberculosis. One-stage surgery, however, is advantageous because it has lower complication rate, shorter hospital stay, less operative time and blood loss.

  13. Single stage circumferential lingual mucosal graft urethroplasty in near obliterative bulbar urethra stricture: A novel technique.

    PubMed

    Sharma, Umesh; Yadav, Sher Singh; Tomar, Vinay; Garg, Amit

    2016-01-01

    This is a prospective study of the use and efficacy of a novel technique of circumferential tubularised lingual mucosal graft (LMG) in obliterative and near obliterative bulbar urethral stricture of >2 cm where excisional and augmented anastomotic urethroplasty are not feasible. The stenotic urethral segment was opened dorsally in midline and fibrosed urethra was excised taking care to preserve the healthy spongiosum tissue. LMG (av. Length 3 cm) was placed from one end of corporal body towards spongy tissue in a circumferential manner. Another LMG was placed in similar manner to deal with longer stricture. The urethra was tubularised over 14 Fr silicone catheter. A total of 12 men, of mean age 47 years underwent this procedure. The mean follow up period was 11 months starting from July 2014 till manuscript submission. Follow up included voiding cystourethrogram at 3 weeks, cystoscopy at 3 months (one patient didn't turned up) and subsequent follow up. Mean stricture length was 4.66 cm (range, 3-8.5 cm) and mean operative time was 195 min. (range, 160 to 200 min.). The technique was successful (normal voiding with no need for any post-operative procedure) in 11(91.6%) patients. One patient developed early recurrence at 4 month of surgery and had anastomotic stricture which was successfully managed by direct visual internal urethrotomy. Single stage circumferential tubularised graft urethroplasty is an excellent technique for strictures that include segments of obliterative and near obliterative diseased urethra. It provide a wider neourethra than patch graft urethroplasty.

  14. Transverse shear effect in a circumferentially cracked cylindrical shell

    NASA Technical Reports Server (NTRS)

    Delale, F.; Erdogan, F.

    1979-01-01

    The objectives of the paper are to solve the problem of a circumferentially-cracked cylindrical shell by taking into account the effect of transverse shear, and to obtain the stress intensity factors for the bending moment as well as the membrane force as the external load. The formulation of the problem is given for a specially orthotropic material within the framework of a linearized shallow shell theory. The particular theory used permits the consideration of all five boundary conditions as to moment and stress resultants on the crack surface. The effect of Poisson's ratio on the stress intensity factors and the nature of the out-of-plane displacement along the edges of the crack, i.e., bulging, are also studied.

  15. Experimental investigation on circumferential and axial temperature gradient over fuel channel under LOCA

    NASA Astrophysics Data System (ADS)

    Yadav, Ashwini Kumar; kumar, Ravi; Gupta, Akhilesh; Chatterjee, Barun; Mukhopadhyay, Deb; Lele, H. G.

    2014-06-01

    In a nuclear reactor temperature rises drastically in fuel channels under loss of coolant accident due to failure of primary heat transportation system. Present investigation has been carried out to capture circumferential and axial temperature gradients during fully and partially voiding conditions in a fuel channel using 19 pin fuel element simulator. A series of experiments were carried out by supplying power to outer, middle and center rods of 19 pin fuel simulator in ratio of 1.4:1.1:1. The temperature at upper periphery of pressure tube (PT) was slightly higher than at bottom due to increase in local equivalent thermal conductivity from top to bottom of PT. To simulate fully voided conditions PT was pressurized at 2.0 MPa pressure with 17.5 kW power injection. Ballooning initiated from center and then propagates towards the ends and hence axial temperature difference has been observed along the length of PT. For asymmetric heating, upper eight rods of fuel simulator were activated and temperature difference up-to 250 °C has been observed from top to bottom periphery of PT. Such situation creates steep circumferential temperature gradient over PT and could lead to breaching of PT under high pressure.

  16. Circumferential resection margin (CRM) positivity after MRI assessment and adjuvant treatment in 189 patients undergoing rectal cancer resection.

    PubMed

    Simpson, G S; Eardley, N; McNicol, F; Healey, P; Hughes, M; Rooney, P S

    2014-05-01

    The management of rectal cancer relies on accurate MRI staging. Multi-modal treatments can downstage rectal cancer prior to surgery and may have an effect on MRI accuracy. We aim to correlate the findings of MRI staging of rectal cancer with histological analysis, the effect of neoadjuvant therapy on this and the implications of circumferential resection margin (CRM) positivity following neoadjuvant therapy. An analysis of histological data and radiological staging of all cases of rectal cancer in a single centre between 2006 and 2011 were conducted. Two hundred forty-one patients had histologically proved rectal cancer during the study period. One hundred eighty-two patients underwent resection. Median age was 66.6 years, and male to female ratio was 13:5. R1 resection rate was 11.1%. MRI assessments of the circumferential resection margin in patients without neoadjuvant radiotherapy were 93.6 and 88.1% in patients who underwent neoadjuvant radiotherapy. Eighteen patients had predicted positive margins following chemoradiotherapy, of which 38.9% had an involved CRM on histological analysis. MRI assessment of the circumferential resection margin in rectal cancer is associated with high accuracy. Neoadjuvant chemoradiotherapy has a detrimental effect on this accuracy, although accuracy remains high. In the presence of persistently predicted positive margins, complete resection remains achievable but may necessitate a more radical approach to resection.

  17. Distinguishable circumferential inclined direction tilt sensor based on fiber Bragg grating with wide measuring range and high accuracy

    NASA Astrophysics Data System (ADS)

    Jiang, Shanchao; Wang, Jing; Sui, Qingmei

    2015-11-01

    One novel distinguishable circumferential inclined direction tilt sensor is demonstrated by incorporating two strain sensitivity fiber Bragg gratings (FBGs) with two orthogonal triangular cantilever beam and using one fiber Bragg grating (FBG) as temperature compensation element. According to spatial vector and space geometry, theory calculation model of the proposed FBG tilt sensor which can be used to obtain the azimuth and tile angle of the inclined direction is established. To obtain its measuring characteristics, calibration experiment on one prototype of the proposed FBG tilt sensor is carried out. After temperature sensitivity experiment data analysis, the proposed FBG tilt sensor exhibits excellent temperature compensation characteristics. In 2-D tilt angle experiment, tilt measurement sensitivities of these two strain sensitivity FBGs are 140.85°/nm and 101.01°/nm over a wide range of 60º. Further, azimuth and tile angle of the inclined direction can be obtained by the proposed FBG tilt sensor which is verified in circumferential angle experiment. Experiment data show that relative errors of azimuth are 0.55% (positive direction) and 1.14% (negative direction), respectively, and relative errors of tilt angle are all less than 3%. Experiment results confirm that the proposed distinguishable circumferential inclined direction tilt sensor based on FBG can achieve azimuth and tile angle measurement with wide measuring range and high accuracy.

  18. Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids.

    PubMed

    Lu, Ming; Shi, Guang-Ying; Wang, Guo-Qiang; Wu, Yan; Liu, Yang; Wen, Hao

    2013-08-14

    To identify a more effective treatment protocol for circumferential mixed hemorrhoids. A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group, where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection, or the control group, where traditional external dissection and internal ligation were performed. Postoperative recovery and complications were monitored. The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group. Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group; moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group. No edema rate was 70.8% in the treatment group higher than 43.8% in the control group; mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group. No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group; moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group. Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings.

  19. A rhythmic motor pattern activated by circumferential stretch in guinea-pig distal colon.

    PubMed

    Spencer, Nick J; Hennig, Grant W; Smith, Terence K

    2002-12-01

    Simultaneous intracellular recordings were made from pairs of circular muscle (CM) cells, at the oral and anal ends of a segment of guinea-pig distal colon, to investigate the neuronal mechanisms underlying faecal pellet propulsion. When a minimum degree of circumferential stretch was applied to sheet preparations of colon, recordings from CM cells revealed either no ongoing junction potentials, or alternatively, small potentials usually < 5 mV in amplitude. Maintained circumferential stretch applied to these preparations evoked an ongoing discharge of excitatory junction potentials (EJPs) at the oral recording site (range: 1-25 mV), which lasted for up to 6 h. The onset of each large oral EJP was time-locked with the onset of an inhibitory junction potential (IJP) at an anal recording electrode, located 2 cm from the oral recording. Similar results were obtained in isolated intact tube preparations of colon, when recordings were made immediately oral and anal of an artificial faecal pellet. The amplitudes of many large (> 5 mV) oral EJPs were linearly related to the amplitudes of anal IJPs occurring 20 mm apart. In the absence of an L-type Ca(2+) channel blocker, action potentials occurred on each large oral EJP. Synchronized discharges of stretch-activated EJPs and IJPs were preserved following pretreatment with capsaicin (10 microM), were unaffected by nifedipine (1 microM) and did not require the mucosa or submucous plexus. EJPs and IJPs were abolished by hexamethonium (300 microM) or tetrodotoxin (1 microM), but persisted in the presence of pyridoxal phosphate-6-azophenyl-2',4'-disulphonic acid (PPADS; 10 microM) or an NK(3) tachykinin receptor antagonist (Neurokinin A 4-10; 100 nM to 5 microM). In summary, maintained circumferential stretch of the distal colon activates a population of intrinsic mechanosensory neurons that generate repetitive firing of ascending excitatory and descending inhibitory pathways to CM. These mechanosensory neurons, which may be

  20. A rhythmic motor pattern activated by circumferential stretch in guinea-pig distal colon

    PubMed Central

    Spencer, Nick J; Hennig, Grant W; Smith, Terence K

    2002-01-01

    Simultaneous intracellular recordings were made from pairs of circular muscle (CM) cells, at the oral and anal ends of a segment of guinea-pig distal colon, to investigate the neuronal mechanisms underlying faecal pellet propulsion. When a minimum degree of circumferential stretch was applied to sheet preparations of colon, recordings from CM cells revealed either no ongoing junction potentials, or alternatively, small potentials usually < 5 mV in amplitude. Maintained circumferential stretch applied to these preparations evoked an ongoing discharge of excitatory junction potentials (EJPs) at the oral recording site (range: 1-25 mV), which lasted for up to 6 h. The onset of each large oral EJP was time-locked with the onset of an inhibitory junction potential (IJP) at an anal recording electrode, located 2 cm from the oral recording. Similar results were obtained in isolated intact tube preparations of colon, when recordings were made immediately oral and anal of an artificial faecal pellet. The amplitudes of many large (> 5 mV) oral EJPs were linearly related to the amplitudes of anal IJPs occurring 20 mm apart. In the absence of an L-type Ca2+ channel blocker, action potentials occurred on each large oral EJP. Synchronized discharges of stretch-activated EJPs and IJPs were preserved following pretreatment with capsaicin (10 μm), were unaffected by nifedipine (1 μm) and did not require the mucosa or submucous plexus. EJPs and IJPs were abolished by hexamethonium (300 μm) or tetrodotoxin (1 μm), but persisted in the presence of pyridoxal phosphate-6-azophenyl-2′,4′-disulphonic acid (PPADS; 10 μm) or an NK3 tachykinin receptor antagonist (Neurokinin A 4-10; 100 nm to 5 μm). In summary, maintained circumferential stretch of the distal colon activates a population of intrinsic mechanosensory neurons that generate repetitive firing of ascending excitatory and descending inhibitory pathways to CM. These mechanosensory neurons, which may be interneurons, are

  1. The role of infarct transmural extent in infarct extension: A computational study.

    PubMed

    Leong, Chin-Neng; Lim, Einly; Andriyana, Andri; Al Abed, Amr; Lovell, Nigel Hamilton; Hayward, Christopher; Hamilton-Craig, Christian; Dokos, Socrates

    2017-02-01

    Infarct extension, a process involving progressive extension of the infarct zone (IZ) into the normally perfused border zone (BZ), leads to continuous degradation of the myocardial function and adverse remodelling. Despite carrying a high risk of mortality, detailed understanding of the mechanisms leading to BZ hypoxia and infarct extension remains unexplored. In the present study, we developed a 3D truncated ellipsoidal left ventricular model incorporating realistic electromechanical properties and fibre orientation to examine the mechanical interaction among the remote, infarct and BZs in the presence of varying infarct transmural extent (TME). Localized highly abnormal systolic fibre stress was observed at the BZ, owing to the simultaneous presence of moderately increased stiffness and fibre strain at this region, caused by the mechanical tethering effect imposed by the overstretched IZ. Our simulations also demonstrated the greatest tethering effect and stress in BZ regions with fibre direction tangential to the BZ-remote zone boundary. This can be explained by the lower stiffness in the cross-fibre direction, which gave rise to a greater stretching of the IZ in this direction. The average fibre strain of the IZ, as well as the maximum stress in the sub-endocardial layer, increased steeply from 10% to 50% infarct TME, and slower thereafter. Based on our stress-strain loop analysis, we found impairment in the myocardial energy efficiency and elevated energy expenditure with increasing infarct TME, which we believe to place the BZ at further risk of hypoxia. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids

    PubMed Central

    Lu, Ming; Shi, Guang-Ying; Wang, Guo-Qiang; Wu, Yan; Liu, Yang; Wen, Hao

    2013-01-01

    AIM: To identify a more effective treatment protocol for circumferential mixed hemorrhoids. METHODS: A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group, where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection, or the control group, where traditional external dissection and internal ligation were performed. Postoperative recovery and complications were monitored. RESULTS: The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group. Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group; moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group. No edema rate was 70.8% in the treatment group higher than 43.8% in the control group; mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group. No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group; moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group. CONCLUSION: Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings. PMID:23946609

  3. Circumferential Esophageal Replacement by a Tissue-engineered Substitute Using Mesenchymal Stem Cells

    PubMed Central

    Catry, Jonathan; Luong-Nguyen, Minh; Arakelian, Lousineh; Poghosyan, Tigran; Bruneval, Patrick; Domet, Thomas; Michaud, Laurent; Sfeir, Rony; Gottrand, Frederic; Larghero, Jerome; Vanneaux, Valerie

    2018-01-01

    Tissue engineering appears promising as an alternative technique for esophageal replacement. Mesenchymal stem cells (MSCs) could be of interest for esophageal regeneration. Evaluation of the ability of an acellular matrix seeded with autologous MSCs to promote tissue remodeling toward an esophageal phenotype after circumferential replacement of the esophagus in a mini pig model. A 3 cm long circumferential replacement of the abdominal esophagus was performed with an MSC-seeded matrix (MSC group, n = 10) versus a matrix alone (control group, n = 10), which has previously been matured into the great omentum. The graft area was covered with an esophageal removable stent. A comparative histological analysis of the graft area after animals were euthanized sequentially is the primary outcome of the study. Histological findings after maturation, overall animal survival, and postoperative morbidity were also compared between groups. At postoperative day 45 (POD 45), a mature squamous epithelium covering the entire surface of the graft area was observed in all the MSC group specimens but in none of the control group before POD 95. Starting at POD 45, desmin positive cells were seen in the graft area in the MSC group but never in the control group. There were no differences between groups in the incidence of surgical complications and postoperative death. In this model, MSCs accelerate the mature re-epitheliazation and early initiation of muscle cell colonization. Further studies will focus on the use of cell tracking tools in order to analyze the becoming of these cells and the mechanisms involved in this tissue regeneration. PMID:29390879

  4. Influence of circumferential notch and fatigue crack on the mechanical integrity of biodegradable magnesium-based alloy in simulated body fluid.

    PubMed

    Bobby Kannan, M; Singh Raman, R K; Witte, F; Blawert, C; Dietzel, W

    2011-02-01

    Applications of magnesium alloys as biodegradable orthopaedic implants are critically dependent on the mechanical integrity of the implant during service. In this study, the mechanical integrity of an AZ91 magnesium alloy was studied using a constant extension rate tensile (CERT) method. The samples in two different geometries that is, circumferentially notched (CN), and circumferentially notched and fatigue cracked (CNFC), were tested in air and in simulated body fluid (SBF). The test results show that the mechanical integrity of the AZ91 magnesium alloy decreased substantially (∼50%) in both the CN and CNFC samples exposed to SBF. Fracture surface analysis revealed secondary cracks suggesting stress corrosion cracking susceptibility of the alloy in SBF. Copyright © 2010 Wiley Periodicals, Inc.

  5. Circumferential skin folds in a child: a case of Michelin tire baby syndrome.

    PubMed

    Palit, Aparna; Inamadar, Arun C

    2007-01-01

    A six-month-old girl who presented with dermatitis was found to have multiple, symmetric, deep, gyrate skin folds involving her trunk and similar circumferential lesions on her extremities since birth. She had a characteristic round face with hypertelorism, depressed nasal bridge, thin, down-turned vermillion border of upper lip and short neck. Skin biopsy demonstrated increased smooth muscle fibers in the deeper dermis. A diagnosis of Michelin tire baby syndrome was made. Clinical features, histopathology, differential diagnosis and prognosis of this rare disorder have been discussed.

  6. Mutations in Either TUBB or MAPRE2 Cause Circumferential Skin Creases Kunze Type

    PubMed Central

    Isrie, Mala; Breuss, Martin; Tian, Guoling; Hansen, Andi Harley; Cristofoli, Francesca; Morandell, Jasmin; Kupchinsky, Zachari A.; Sifrim, Alejandro; Rodriguez-Rodriguez, Celia Maria; Dapena, Elena Porta; Doonanco, Kurston; Leonard, Norma; Tinsa, Faten; Moortgat, Stéphanie; Ulucan, Hakan; Koparir, Erkan; Karaca, Ender; Katsanis, Nicholas; Marton, Valeria; Vermeesch, Joris Robert; Davis, Erica E.; Cowan, Nicholas J.; Keays, David Anthony; Van Esch, Hilde

    2015-01-01

    Circumferential skin creases Kunze type (CSC-KT) is a specific congenital entity with an unknown genetic cause. The disease phenotype comprises characteristic circumferential skin creases accompanied by intellectual disability, a cleft palate, short stature, and dysmorphic features. Here, we report that mutations in either MAPRE2 or TUBB underlie the genetic origin of this syndrome. MAPRE2 encodes a member of the microtubule end-binding family of proteins that bind to the guanosine triphosphate cap at growing microtubule plus ends, and TUBB encodes a β-tubulin isotype that is expressed abundantly in the developing brain. Functional analyses of the TUBB mutants show multiple defects in the chaperone-dependent tubulin heterodimer folding and assembly pathway that leads to a compromised yield of native heterodimers. The TUBB mutations also have an impact on microtubule dynamics. For MAPRE2, we show that the mutations result in enhanced MAPRE2 binding to microtubules, implying an increased dwell time at microtubule plus ends. Further, in vivo analysis of MAPRE2 mutations in a zebrafish model of craniofacial development shows that the variants most likely perturb the patterning of branchial arches, either through excessive activity (under a recessive paradigm) or through haploinsufficiency (dominant de novo paradigm). Taken together, our data add CSC-KT to the growing list of tubulinopathies and highlight how multiple inheritance paradigms can affect dosage-sensitive biological systems so as to result in the same clinical defect. PMID:26637975

  7. Prevalence and mechanism of tricuspid regurgitation following implantation of endocardial leads for pacemaker or cardioverter-defibrillator.

    PubMed

    Al-Mohaissen, Maha A; Chan, Kwan Leung

    2012-03-01

    Endocardial lead-induced tricuspid regurgitation has not been well recognized, either clinically or echocardiographically, and yet it is likely a preventable iatrogenic disease. In severe cases, it can lead to right ventricular failure and require tricuspid valve surgery. This complication will become increasingly important, because the numbers of permanent pacemakers and implantable cardioverter-defibrillators are expected to increase because of the aging population and the expanding capabilities of these devices. Published studies are largely retrospective, and serial studies to assess the time course of the development of tricuspid regurgitation are lacking. The mechanisms and severity of tricuspid regurgitation may not be well evaluated by two-dimensional echocardiography. Real-time three-dimensional echocardiography appears to be a promising technique to evaluate the mechanism of tricuspid regurgitation and may allow the early detection of patients who will develop severe lead-induced tricuspid regurgitation. A better understanding of the mechanism of lead-induced tricuspid regurgitation will be essential to the development of preventive strategies, which can then be tested in future clinical trials. Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

  8. Myocardial expression of the vascular endothelial growth factor (VEGF) after endocardial laser revascularization (ELR)

    NASA Astrophysics Data System (ADS)

    Rommerscheid, Jan; Theisen, Dirk; Schmuecker, G.; Brinkmann, Ralf; Broll, R.

    2001-10-01

    Background. Endocardial laser revascularization (ELR) is a new technique to treat patients with severe coronary artery disease (CAD) in a percutaneous approach. The results show a significant improvement of symptoms, but the mechanism of action is still unknown. One main theory is the angiogenesis for which Vascular Endothelial Growth Factor (VEGF) is the keypromotor. We investigated immunohistochemically the VEGF-expression after ELR in porcine hearts over a timeperiod of four weeks. Methods. ELR was performed with a single-pulse Thulium:YAG laser. 15 pigs were treated with ELR and the hearts were harvested at five timeperiods: directly (group I), 3 days (group II), 1 week (group III), 2 weeks (group IV) and 4 weeks (group V) after ELR. Each group consisted of three pigs. Immunohistochemically the VEGF-expression was assessed by staining with a polyclonal antibody against VEGF and cellcounting using an expression index (VEGF-EI) Results. A maximum of VEGF-expression was found three days (group II) after ELR with a VEGF-EI of 97%. At 1 week (group III) the VEGF-EI was similar high with 93%. Along the timecourse the index decreased to 22% at 4 weeks (groupV). Conclusions. Our findings show that ELR leads to an local upregulation of VEGF around the channels. The resulting angiogenesis could be the mechanism for the relief of angina.

  9. Transient thermal stress problem for a circumferentially cracked hollow cylinder

    NASA Technical Reports Server (NTRS)

    Nied, H. F.; Erdogan, F.

    1983-01-01

    The paper is concerned with the transient thermal stress problem for a long hollow circular cylinder containing an internal axisymmetric circumferential edge crack that is suddenly cooled from inside. It is assumed that the transient thermal stress problem is quasi-static, i.e., the inertial effects are negligible. Also, all thermoelastic coupling effects and the possible temperature dependence of the thermoelastic constants are neglected. The problem is considered in two parts. The first part is the evaluation of transient thermal stresses in an uncracked cylinder; the second part is the isothermal perturbation problem for the cracked cylinder in which the crack surface tractions, equal and opposite to the thermal stresses obtained from the first problem, are the only external loads. The superposition of the two solutions gives results for the cracked cylinder.

  10. Quantitative Differentiation of LV Myocardium with and without Layer-Specific Fibrosis Using MRI in Hypertrophic Cardiomyopathy and Layer-Specific Strain TTE Analysis.

    PubMed

    Funabashi, Nobusada; Takaoka, Hiroyuki; Ozawa, Koya; Kamata, Tomoko; Uehara, Masae; Komuro, Issei; Kobayashi, Yoshio

    2018-05-30

    To achieve further risk stratification in hypertrophic cardiomyopathy (HCM) patients, we localized and quantified layer-specific LVM fibrosis on MRI in HCM patients using regional layer-specific peak longitudinal strain (PLS) and peak circumferential strain (PCS) in LV myocardium (LVM) on speckle tracking transthoracic echocardiography (TTE). A total of 18 HCM patients (14 males; 58 ± 17 years) underwent 1.5T-MRI and TTE. PLS and PCS in each layer of the LVM (endocardium, epicardium, and whole-layer myocardium) were calculated for 17 AHA-defined lesions. MRI assessment showed that fibrosis was classified as endocardial, epicardial, or whole-layer (= either or both of these). Regional PLS was smaller in fibrotic endocardial lesions than in non-fibrotic endocardial lesions (P = 0.004). To detect LV endocardial lesions with fibrosis, ROC curves of regional PLS revealed an area under the curve (AUC) of 0.609 and a best cut-off point of 13.5%, with sensitivity of 65.3% and specificity of 54.3%. Regional PLS was also smaller in fibrotic epicardial lesions than in non-fibrotic epicardial lesions (P < 0.001). To detect LV epicardial lesions with fibrosis, ROC curves of PLS revealed an AUC of 0.684 and a best cut-off point of 9.5%, with sensitivity of 73.5% and specificity of 55.5%. Using whole-layer myocardium analysis, PLS was smaller in fibrotic lesions than in non-fibrotic lesions (P < 0.001). To detect whole-layer LV lesions with fibrosis, ROC curves of regional PLS revealed an AUC of 0.674 and a best cut-off point of 12.5%, with sensitivity of 79.0% and specificity of 50.7%. There were no significant differences in PCS of LV myocardium (endocardium, epicardium, and whole-layer) between fibrotic and non-fibrotic lesions. Quantitative regional PLS but not PCS in LV endocardium, epicardium, and whole-layer myocardium provides useful non-invasive information for layer-specific localization of fibrosis in HCM patients.

  11. Circumferentially oversewn inverted stapled anastomosis.

    PubMed

    Karam, Charbel; Lord, Sally; Gett, Rohan; Meagher, Alan P

    2018-04-01

    Leak rates of over 5% following anastomoses between the ileum and colon continue to be reported in large series and are associated with substantial morbidity and with mortality rates of 10-20%. In 1994, we began performing circumferentially oversewn inverted stapled anastomoses in patients undergoing ileo-colic anastomoses or ileostomy closure. It has become increasingly apparent that this method is associated with a low risk of leakage, which we should report. The anastomotic technique described was used in all patients undergoing ileo-colic anastomosis or closure of ileostomy by surgeon 1 (1994-2015) and in all ileo-colic anastomoses by surgeon 2 (2007-2015). All patients had a widely patent anastomosis constructed by two firings of a linear cutting stapler, as previously described. Additionally, the entire staple line was carefully oversewn with interrupted, inverting 4/0 polydioxanone sutures. Anastomotic leak was defined as a patient requiring re-operation or radiological drainage. One thousand and twelve patients underwent ileo-colic anastomosis and 685 patients underwent closure of ileostomy by surgeon 1, and 165 patients underwent ileo-colic anastomosis by surgeon 2. None of the 1862 patients required re-operation or radiological drainage for a leak (event rate 0%, 95% confidence interval 0-0.2%). However, there were three possible contained leaks treated successfully conservatively. The time taken to perform the actual anastomosis was measured in the last 30 ileo-colic resections. The median time was 42 min. While this method may well be too slow to gain widespread adoption, we hope this report encourages increased research into finding techniques with similar low leak rates. © 2016 Royal Australasian College of Surgeons.

  12. Propagation and radiation of sound from flanged circular ducts with circumferentially varying wall admittances. I Semi-infinite ducts. II - Finite ducts with sources

    NASA Technical Reports Server (NTRS)

    Fuller, C. R.

    1984-01-01

    Sound propagation in infinite, semiinfinite, and finite circular ducts with circumferentially varying wall admittances is investigated analytically. The infinite case is considered, and an example demonstrates the effects of wall-admittance distribution on dispersion characteristics and mode shapes. An exact solution is obtained for the semiinfinite case, a circular duct with a flanged opening: sidelobe suppression and circumferential-mode energy scattering leading to radiated-field asymmetry are found. A finite duct system with specified hard-walled pressure sources is examined in detail, evaluating reflection coefficients, transmission losses, and radiated-field directivity. Graphs and diagrams are provided, and the implications of the results obtained for the design of aircraft-turbofan inlet liners are discussed.

  13. Experimental study of flow distribution and pressure loss with circumferential inlet and outlet manifolds

    NASA Technical Reports Server (NTRS)

    Dittrich, R. T.

    1972-01-01

    Water flow tests with circumferential inlet and outlet manifolds were conducted to determine factors affecting fluid distribution and pressure losses. Various orifice sizes and manifold geometries were tested over a range of flow velocities. With inlet manifolds, flow distribution was related directly to orifice discharge coefficients. A correlation indicated that nonuniform distribution resulted when the velocity head ratio at the orifice was not in the range of constant discharge coefficient. With outlet manifolds, nonuniform flow was related to static pressure variations along the manifold. Outlet manifolds had appreciably greater pressure losses than comparable inlet manifolds.

  14. Growth behavior of surface cracks in the circumferential plane of solid and hollow cylinders

    NASA Technical Reports Server (NTRS)

    Forman, R. G.; Shivakumar, V.

    1986-01-01

    Experiments were conducted to study the growth behavior of surface fatigue cracks in the circumferential plane of solid and hollow cylinders. In the solid cylinders, the fatigue cracks were found to have a circular arc crack front with specific upper and lower limits to the arc radius. In the hollow cylinders, the fatigue cracks were found to agree accurately with the shape of a transformed semiellipse. A modification to the usual nondimensionalization expression used for surface flaws in flat plates was found to give correct trends for the hollow cylinder problem.

  15. Transient thermal stress problem for a circumferentially cracked hollow cylinder

    NASA Technical Reports Server (NTRS)

    Nied, H. F.; Erdogan, F.

    1982-01-01

    The transient thermal stress problem for a hollow elasticity cylinder containing an internal circumferential edge crack is considered. It is assumed that the problem is axisymmetric with regard to the crack geometry and the loading, and that the inertia effects are negligible. The problem is solved for a cylinder which is suddenly cooled from inside. First the transient temperature and stress distributions in an uncracked cylinder are calculated. By using the equal and opposite of this thermal stress as the crack surface traction in the isothermal cylinder the crack problem is then solved and the stress intensity factor is calculated. The numerical results are obtained as a function of the Fourier number tD/b(2) representing the time for various inner-to-outer radius ratios and relative crack depths, where D and b are respectively the coefficient of diffusivity and the outer radius of the cylinder.

  16. Nonlinear Local Bending Response and Bulging Factors for Longitudinal and Circumferential Cracks in Pressurized Cylindrical Shells

    NASA Technical Reports Server (NTRS)

    Young, Richard D.; Rose, Cheryl A.; Starnes, James H., Jr.

    2000-01-01

    Results of a geometrically nonlinear finite element parametric study to determine curvature correction factors or bulging factors that account for increased stresses due to curvature for longitudinal and circumferential cracks in unstiffened pressurized cylindrical shells are presented. Geometric parameters varied in the study include the shell radius, the shell wall thickness, and the crack length. The major results are presented in the form of contour plots of the bulging factor as a function of two nondimensional parameters: the shell curvature parameter, lambda, which is a function of the shell geometry, Poisson's ratio, and the crack length; and a loading parameter, eta, which is a function of the shell geometry, material properties, and the applied internal pressure. These plots identify the ranges of the shell curvature and loading parameters for which the effects of geometric nonlinearity are significant. Simple empirical expressions for the bulging factor are then derived from the numerical results and shown to predict accurately the nonlinear response of shells with longitudinal and circumferential cracks. The numerical results are also compared with analytical solutions based on linear shallow shell theory for thin shells, and with some other semi-empirical solutions from the literature, and limitations on the use of these other expressions are suggested.

  17. Traumatic elbow luxation in a free-ranging hedgehog (Erinaceus europaeus): surgical management using circumferential suture prostheses.

    PubMed

    Vallefuoco, Rosario; Pignon, Charly; Furst, Anna; Personne, Lauriane; Courreau, Jean-Francois; Moissonnier, Pierre

    2013-06-01

    A free-ranging adult female hedgehog (Erinaceus europaeus) was presented injured, presumably from vehicular trauma. Clinical and radiographic examination under general anesthesia revealed a lateral elbow luxation. Closed reduction was unsuccessful, so a surgical approach with circumferential suture prostheses was used to stabilize the elbow. Neither perioperative nor postoperative complications were recorded. The hedgehog regained good range of motion of the elbow and was fully able to run and to roll into a ball.

  18. Effects of Residual Stress, Axial Stretch, and Circumferential Shrinkage on Coronary Plaque Stress and Strain Calculations: A Modeling Study Using IVUS-Based Near-Idealized Geometries

    PubMed Central

    Wang, Liang; Zhu, Jian; Samady, Habib; Monoly, David; Zheng, Jie; Guo, Xiaoya; Maehara, Akiko; Yang, Chun; Ma, Genshan; Mintz, Gary S.; Tang, Dalin

    2017-01-01

    Accurate stress and strain calculations are important for plaque progression and vulnerability assessment. Models based on in vivo data often need to form geometries with zero-stress/strain conditions. The goal of this paper is to use IVUS-based near-idealized geometries and introduce a three-step model construction process to include residual stress, axial shrinkage, and circumferential shrinkage and investigate their impacts on stress and strain calculations. In Vivo intravascular ultrasound (IVUS) data of human coronary were acquired for model construction. In Vivo IVUS movie data were acquired and used to determine patient-specific material parameter values. A three-step modeling procedure was used to make our model: (a) wrap the zero-stress vessel sector to obtain the residual stress; (b) stretch the vessel axially to its length in vivo; and (c) pressurize the vessel to recover its in vivo geometry. Eight models were constructed for our investigation. Wrapping led to reduced lumen and cap stress and increased out boundary stress. The model with axial stretch, circumferential shrink, but no wrapping overestimated lumen and cap stress by 182% and 448%, respectively. The model with wrapping, circumferential shrink, but no axial stretch predicted average lumen stress and cap stress as 0.76 kPa and −15 kPa. The same model with 10% axial stretch had 42.53 kPa lumen stress and 29.0 kPa cap stress, respectively. Skipping circumferential shrinkage leads to overexpansion of the vessel and incorrect stress/strain calculations. Vessel stiffness increase (100%) leads to 75% lumen stress increase and 102% cap stress increase. PMID:27814429

  19. Nonuniformity of axial and circumferential remodeling of large coronary veins in response to ligation.

    PubMed

    Choy, Jenny Susana; Dang, Quang; Molloi, Sabee; Kassab, Ghassan S

    2006-04-01

    The pressure-induced remodeling of coronary veins is important in coronary venous retroperfusion. Our hypothesis is that the response of the large coronary veins to pressure overload will depend on the degree of myocardial support. Eleven normal Yorkshire swine from either sex, weighing 31-39 kg, were studied. Five pigs underwent ligation of the left anterior descending (LAD) vein, and six served as sham-operated controls. The ligation of the coronary vein caused an increase in pressure intermediate to arterial and venous values. After 2 wk of ligation, the animals were euthanized and the coronary vessels were perfusion-fixed with glutaraldehyde. The LAD vein was sectioned, and detailed morphometric measurements were made along its length from the point of ligation near the base down to the apex of the heart. The structural remodeling of the vein was circumferentially nonuniform because the vein is partially embedded in the myocardium; it was also axially nonuniform because it is tethered to the myocardium to different degrees along its axial length. The wall area was significantly larger in the experimental group, whereas luminal area in the proximal LAD vein was significantly smaller in the same group compared with sham-operated controls. The wall thickness-to-radius ratio was also significantly larger in the experimental group in proportion to the increase in pressure. The major conclusion of this study is that the response of the vein depends on the local wall stress, which is, in part, determined by the surrounding tissue. Furthermore, the geometric remodeling of the coronary vein restores the circumferential stress to the homeostatic value.

  20. Aerial ultrasound source with a circular vibrating plate attached to a rigid circumferential wall

    NASA Astrophysics Data System (ADS)

    Kuratomi, Ryo; Asami, Takuya; Miura, Hikaru

    2018-07-01

    We fabricate a transverse vibrating plate attached to a rigid wall integrated at the circumference of a circular vibrating plate that allows a strong sound wave field to be formed in the area encoded by the vibrating plate and rigid wall by installing a wall such as a reflective plate on the rigid wall. The design method for the circular vibrating plate attached to a rigid circumferential wall is investigated. A method of forming a strong standing wave field in an enclosed area constructed with a vibrating plate, cylindrical reflective plate, and parallel reflective plate is developed.

  1. Soil sampling device with latch assembly having a variable circumferential shape

    DOEpatents

    Meyer, Robert D.

    1996-01-01

    The invention relates to an improved sampler which can be operated in any orientation. The design features a positive gripping of the operating rod in a manner to reduce point loads so as to reduce any possibility of jamming of the rod on a retraction stroke until such time as it is positively retained in the fully withdrawn position. In the preferred embodiment, a pair of mating cylindrical latch pieces, held together by a circumferential spring, are used for positive actuation. The inner rod has an angular cut-out which provides the base for the latch when aligned with the latch. A release fixture can be used to free the latch from the cone rod after actuation. The latches are formed in such a manner as they may support themselves within the housing of the sampler until they engage the operating rod.

  2. The Aerodynamic Performance of an Over-the-Rotor Liner With Circumferential Grooves on a High Bypass Ratio Turbofan Rotor

    NASA Technical Reports Server (NTRS)

    Bozak, Richard F.; Hughes, Christopher E.; Buckley, James

    2013-01-01

    While liners have been utilized throughout turbofan ducts to attenuate fan noise, additional attenuation is obtainable by placing an acoustic liner over-the-rotor. Previous experiments have shown significant fan performance losses when acoustic liners are installed over-the-rotor. The fan blades induce an oscillating flow in the acoustic liners which results in a performance loss near the blade tip. An over-the-rotor liner was designed with circumferential grooves between the fan blade tips and the acoustic liner to reduce the oscillating flow in the acoustic liner. An experiment was conducted in the W-8 Single-Stage Axial Compressor Facility at NASA Glenn Research Center on a 1.5 pressure ratio fan to evaluate the impact of this over-the-rotor treatment design on fan aerodynamic performance. The addition of a circumferentially grooved over-the-rotor design between the fan blades and the acoustic liner reduced the performance loss, in terms of fan adiabatic efficiency, to less than 1 percent which is within the repeatability of this experiment.

  3. The Aerodynamic Performance of an Over-The-Rotor Liner with Circumferential Grooves on a High Bypass Ratio Turbofan Rotor

    NASA Technical Reports Server (NTRS)

    Bozak, Rick; Hughes, Christopher; Buckley, James

    2013-01-01

    While liners have been utilized throughout turbofan ducts to attenuate fan noise, additional attenuation is obtainable by placing an acoustic liner over-the-rotor. Previous experiments have shown significant fan performance losses when acoustic liners are installed over-the-rotor. The fan blades induce an oscillating flow in the acoustic liners which results in a performance loss near the blade tip. An over-the-rotor liner was designed with circumferential grooves between the fan blade tips and the acoustic liner to reduce the oscillating flow in the acoustic liner. An experiment was conducted in the W-8 Single-Stage Axial Compressor Facility at NASA Glenn Research Center on a 1.5 pressure ratio fan to evaluate the impact of this over-the-rotor treatment design on fan aerodynamic performance. The addition of a circumferentially grooved over-the-rotor design between the fan blades and the acoustic liner reduced the performance loss, in terms of fan adiabatic efficiency, to less than 1% which is within the repeatability of this experiment.

  4. Smooth muscle-like tissue constructs with circumferentially oriented cells formed by the cell fiber technology.

    PubMed

    Hsiao, Amy Y; Okitsu, Teru; Onoe, Hiroaki; Kiyosawa, Mahiro; Teramae, Hiroki; Iwanaga, Shintaroh; Kazama, Tomohiko; Matsumoto, Taro; Takeuchi, Shoji

    2015-01-01

    The proper functioning of many organs and tissues containing smooth muscles greatly depends on the intricate organization of the smooth muscle cells oriented in appropriate directions. Consequently controlling the cellular orientation in three-dimensional (3D) cellular constructs is an important issue in engineering tissues of smooth muscles. However, the ability to precisely control the cellular orientation at the microscale cannot be achieved by various commonly used 3D tissue engineering building blocks such as spheroids. This paper presents the formation of coiled spring-shaped 3D cellular constructs containing circumferentially oriented smooth muscle-like cells differentiated from dedifferentiated fat (DFAT) cells. By using the cell fiber technology, DFAT cells suspended in a mixture of extracellular proteins possessing an optimized stiffness were encapsulated in the core region of alginate shell microfibers and uniformly aligned to the longitudinal direction. Upon differentiation induction to the smooth muscle lineage, DFAT cell fibers self-assembled to coiled spring structures where the cells became circumferentially oriented. By changing the initial core-shell microfiber diameter, we demonstrated that the spring pitch and diameter could be controlled. 21 days after differentiation induction, the cell fibers contained high percentages of ASMA-positive and calponin-positive cells. Our technology to create these smooth muscle-like spring constructs enabled precise control of cellular alignment and orientation in 3D. These constructs can further serve as tissue engineering building blocks for larger organs and cellular implants used in clinical treatments.

  5. Smooth Muscle-Like Tissue Constructs with Circumferentially Oriented Cells Formed by the Cell Fiber Technology

    PubMed Central

    Hsiao, Amy Y.; Okitsu, Teru; Onoe, Hiroaki; Kiyosawa, Mahiro; Teramae, Hiroki; Iwanaga, Shintaroh; Kazama, Tomohiko; Matsumoto, Taro; Takeuchi, Shoji

    2015-01-01

    The proper functioning of many organs and tissues containing smooth muscles greatly depends on the intricate organization of the smooth muscle cells oriented in appropriate directions. Consequently controlling the cellular orientation in three-dimensional (3D) cellular constructs is an important issue in engineering tissues of smooth muscles. However, the ability to precisely control the cellular orientation at the microscale cannot be achieved by various commonly used 3D tissue engineering building blocks such as spheroids. This paper presents the formation of coiled spring-shaped 3D cellular constructs containing circumferentially oriented smooth muscle-like cells differentiated from dedifferentiated fat (DFAT) cells. By using the cell fiber technology, DFAT cells suspended in a mixture of extracellular proteins possessing an optimized stiffness were encapsulated in the core region of alginate shell microfibers and uniformly aligned to the longitudinal direction. Upon differentiation induction to the smooth muscle lineage, DFAT cell fibers self-assembled to coiled spring structures where the cells became circumferentially oriented. By changing the initial core-shell microfiber diameter, we demonstrated that the spring pitch and diameter could be controlled. 21 days after differentiation induction, the cell fibers contained high percentages of ASMA-positive and calponin-positive cells. Our technology to create these smooth muscle-like spring constructs enabled precise control of cellular alignment and orientation in 3D. These constructs can further serve as tissue engineering building blocks for larger organs and cellular implants used in clinical treatments. PMID:25734774

  6. Application of the line-spring model to a cylindrical shell containing a circumferential or axial part-through crack

    NASA Technical Reports Server (NTRS)

    Delale, F.; Erdogan, F.

    1981-01-01

    An approximate solution was obtained for a cylindrical shell containing a part-through surface crack. It was assumed that the shell contains a circumferential or axial semi-elliptic internal or external surface crack and was subjected to a uniform membrane loading or a uniform bending moment away from the crack region. A Reissner type theory was used to account for the effects of the transverse shear deformations. The stress intensity factor at the deepest penetration point of the crack was tabulated for bending and membrane loading by varying three dimensionless length parameters of the problem formed from the shell radius, the shell thickness, the crack length, and the crack depth. The upper bounds of the stress intensity factors are provided by the results of the elasticity solution obtained from the axisymmetric crack problem for the circumferential crack, and that found from the plane strain problem for a circular ring having a radial crack for the axial crack. The line-spring model gives the expected results in comparison with the elasticity solutions. Results also compare well with the existing finite element solution of the pressurized cylinder containing an internal semi-elliptic surface crack.

  7. Measurement of the longitudinal and circumferential muscular activity associated with peristalsis using a single fibre grating array

    NASA Astrophysics Data System (ADS)

    Arkwright, J. W.; Blenman, N. G.; Underhill, I. D.; Maunder, S. A.; Spencer, N. J.; Costa, M.; Brooks, S. J.; Szczesniak, M. M.; Dinning, P. G.

    2010-09-01

    Diagnostic catheters based on fibre Bragg gratings (FBG's) are proving to be highly effective for measurement of the muscular activity associated with peristalsis in the human gut. The primary muscular contractions that generate peristalsis are circumferential in nature; however, it has long been known that there is also a component of longitudinal contractility present, acting in harmony with the circumferential component to improve the overall efficiency of material movement. To date, there have been relatively few reports on the measurement or inference of longitudinal contractions in humans and all have been limited to detection at a single location only. This is due to the lack of a viable recording technique suitable for real-time in-vivo measurement of this type of activity over extended lengths of the gut. We report the detection of longitudinal motion in lengths of excised mammalian colon using an FBG technique that should be viable for similar detection in humans. The longitudinal sensors have been combined with our previously reported FBG pressure sensing elements to form a composite catheter that allows the relative phase between the two components to be detected. The catheter output has been validated using digital video mapping in an ex-vivo animal preparation using lengths of rabbit ileum.

  8. The degree of circumferential tumour involvement as a prognostic factor in oesophageal cancer.

    PubMed

    Sillah, Karim; Pritchard, Susan A; Watkins, Gillian R; McShane, James; West, Catharine M; Page, Richard; Welch, Ian M

    2009-08-01

    Tumour length is an adverse prognostic factor in oesophageal cancer. However, the prognostic role of the degree of oesophageal circumference (DOC) involved by tumour with or without resection margin invasion is not clear. This work assessed the relationship between DOC involved by tumour, clinico-pathological variables and prognosis. The clinico-pathological details of 320 patients who underwent potentially curative oesophagogastrectomy for cancer between 1994 and 2007 were analysed. The DOC involved with tumour measured macroscopically on the resected specimen was classified as small (<2.5 cm, n = 115), large (> or = 2.5 cm, n = 144) or circumferential (i.e. involving the whole circumference, n = 61). Univariate and multivariate survival analyses were carried out. The DOC with tumour was higher in ulcerating tumours than stenosing or polypoidal types (p = 0.017). Tumour length, T-stage, neoadjuvant chemotherapy and vascular invasion were independently associated with DOC with tumour on multivariate analysis (p < 0.05 for all). DOC > or = 2.5 cm was an adverse prognostic factor in univariate analysis (p = 0.002) with a hazard ratio of 1.52 [95% CI 1.13-2.04] compared with those <2.5 cm. Circumferential tumours had a similar prognosis to tumours > or = 2.5 cm (p = 0.60). The prognostic significance of DOC with tumour was lost in multivariate analysis where the factors retaining independence were patient age, T-stage, lymph node metastasis, vascular invasion and positive resection margins. However, when patients were stratified by use of neoadjuvant chemotherapy (n = 121), the DOC with tumour retained prognostic significance on multivariate analysis in the 199 patients who did not undergo neoadjuvant chemotherapy (p = 0.04). The DOC with tumour appears to provide prognostic information in oesophageal cancer surgery, especially in patients who do not undergo preoperative chemotherapy.

  9. Method and Apparatus for Determining Changes in Intracranial Pressure Utilizing Measurement of the Circumferential Expansion or Contraction of a Patient's Skull

    NASA Technical Reports Server (NTRS)

    Yos, William T. (Inventor); Cantrell, John H., Jr. (Inventor)

    2004-01-01

    A method and apparatus for measuring changes in intracranial pressure (ICP) utilizing the variation of the surface wave propagation parameters of the patient's skull to determine the change in ICP. In one embodiment, the method comprises the steps of transmitting an ultrasonic bulk compressional wave onto the surface of the skull at a predetermined angle with respect to the skull so as to produce a surface wave, receiving the surface wave at an angle with respect tn the skull which is substantially the same as the predetermined angle and at a location that is a predetermined distance from where the ultrasonic bulk compressional wave was transmitted upon the skull, determining the retardation or advancement in phase of the received surface wave with respect to a reference phase, and processing the determined retardation or advancement in phase to determine circumferential expansion or contraction of the skull and utilizing the determined circumferential change to determine the change in intracranial pressure.

  10. Soil sampling device with latch assembly having a variable circumferential shape

    DOEpatents

    Meyer, R.D.

    1996-12-24

    The invention relates to an improved sampler which can be operated in any orientation. The design features a positive gripping of the operating rod in a manner to reduce point loads so as to reduce any possibility of jamming of the rod on a retraction stroke until such time as it is positively retained in the fully withdrawn position. In the preferred embodiment, a pair of mating cylindrical latch pieces, held together by a circumferential spring, are used for positive actuation. The inner rod has an angular cut-out which provides the base for the latch when aligned with the latch. A release fixture can be used to free the latch from the cone rod after actuation. The latches are formed in such a manner as they may support themselves within the housing of the sampler until they engage the operating rod. 11 figs.

  11. The posterior transpedicular approach for circumferential decompression and instrumented stabilization with titanium cage vertebrectomy reconstruction for spinal tumors: consecutive case series of 50 patients.

    PubMed

    Metcalfe, Stephen; Gbejuade, Herbert; Patel, Nitin R

    2012-07-15

    A retrospective case series. To demonstrate the feasibility, safety, and results of the posterior transpedicular approach for circumferential decompression and instrumented reconstruction of thoracolumbar spinal tumors. Patients presenting with spinal tumor disease requiring 3-column instrumented stabilization are typically treated with a combined anterior and posterior surgical approach. However, circumferential decompression and instrumented stabilization may also be achieved through a single-stage, midline posterior transpedicular approach. Fifty consecutive patients (27 women and 23 men) underwent surgery between 2003 and 2010 at a single institution by the senior author. Mean age was 55.9 years (range, 25-79 yr).Single or multilevel, contiguous subtotal vertebrectomy was performed ranging from T1 to L4 (38 thoracic and 12 lumbar). Three-column spinal stabilization was achieved using posterior pedicle screw fixation and vertebral body reconstruction, with a titanium cage introduced through the posterior transpedicular route. The mean follow-up period was 17 months (range, 1-54 mo). The mean operating time was 4.2 hours. The mean estimated blood loss for a subgroup of 9 patients with hypervascular tumor pathology was 3933 mL (range, 2700-5800 mL). The mean blood loss in the remaining 41 patients was 1262 mL (range, 250-2500 mL).Postoperative neurological status was maintained or improved in all patients. Mean postoperative stay was 7.7 days (range, 3-12 d). At last review, 14 patients were alive, with a mean survival of 36 months (range, 13-71 mo). The mean survival for the 36 patients who died was 19 months (range, 2 weeks to 54 mo). This is the largest reported series of patients with spinal tumor disease undergoing circumferential decompression and 3-column instrumented stabilization through the posterior transpedicular approach.This surgical approach provides sufficient access for safe and effective circumferential decompression and stabilization, with

  12. Deficient Circumferential Growth Is the Primary Determinant of Aortic Obstruction Attributable to Partial Elastin Deficiency.

    PubMed

    Jiao, Yang; Li, Guangxin; Korneva, Arina; Caulk, Alexander W; Qin, Lingfeng; Bersi, Matthew R; Li, Qingle; Li, Wei; Mecham, Robert P; Humphrey, Jay D; Tellides, George

    2017-05-01

    Williams syndrome is characterized by obstructive aortopathy attributable to heterozygous loss of ELN , the gene encoding elastin. Lesions are thought to result primarily from excessive smooth muscle cell (SMC) proliferation and consequent medial expansion, although an initially smaller caliber and increased stiffness of the aorta may contribute to luminal narrowing. The relative contributions of such abnormalities to the obstructive phenotype had not been defined. We quantified determinants of luminal stenosis in thoracic aortas of Eln -/- mice incompletely rescued by human ELN . Moderate obstruction was largely because of deficient circumferential growth, most prominently of ascending segments, despite increased axial growth. Medial thickening was evident in these smaller diameter elastin-deficient aortas, with medial area similar to that of larger diameter control aortas. There was no difference in cross-sectional SMC number between mutant and wild-type genotypes at multiple stages of postnatal development. Decreased elastin content was associated with medial fibrosis and reduced aortic distensibility because of increased structural stiffness but preserved material stiffness. Elastin-deficient SMCs exhibited greater contractile-to-proliferative phenotypic modulation in vitro than in vivo. We confirmed increased medial collagen without evidence of increased medial area or SMC number in a small ascending aorta with thickened media of a Williams syndrome subject. Deficient circumferential growth is the predominant mechanism for moderate obstructive aortic disease resulting from partial elastin deficiency. Our findings suggest that diverse aortic manifestations in Williams syndrome result from graded elastin content, and SMC hyperplasia causing medial expansion requires additional elastin loss superimposed on ELN haploinsufficiency. © 2017 American Heart Association, Inc.

  13. Design and control of a novel gastroscope intervention mechanism with circumferentially pneumatic-driven clamping function.

    PubMed

    Li, Yanmin; Liu, Hao; Hao, Siwen; Li, Hongyi; Han, Jianda; Yang, Yunsheng

    2017-03-01

    Robot-assisted manipulation is promising for solving problems such as understaffing and the risk of infection in gastro-intestinal endoscopy. However, the commonly used friction rollers in few existing systems have a potential risk of deforming flexible endoscopes for non-uniform clamping. This paper presents a robotic system for a standard flexible endoscope and focuses on a novel gastroscope intervention mechanism (GIM), which provides circumferentially uniform clamping with an airbag. The GIM works with a relay-on mechanism in a way similar to manual operation. The shear stiffness of airbag and the critical slipping force (CSF) were analysed to determine the parameters of the airbag. A fuzzy PID controller was employed to realize a fast response and high accuracy of pneumatic actuation. Experiments were performed to evaluate the accuracy, stiffness and CSF. In vitro and in vivo animal experiments were also carried out. The GIM realized an accuracy of 0.025 ± 0.2 mm and -0.03 ± 0.25° for push-pull and rotation without delivery resistance. Under < 10 N delivery resistance, the error caused by the airbag stiffness was < 0.24 mm. A quadratic polynomial could be used to describe the relationship between the CSF and pneumatic pressure. The novel GIM could effectively deliver gastroscopes. The pneumatic-driven clamping method proposed could protect the gastroscope by circumferentially uniform clamping force and the CSF could be properly controlled to guarantee operating safety. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Ultrasound speckle tracking for radial, longitudinal and circumferential strain estimation of the carotid artery--an in vitro validation via sonomicrometry using clinical and high-frequency ultrasound.

    PubMed

    Larsson, Matilda; Heyde, Brecht; Kremer, Florence; Brodin, Lars-Åke; D'hooge, Jan

    2015-02-01

    Ultrasound speckle tracking for carotid strain assessment has in the past decade gained interest in studies of arterial stiffness and cardiovascular diseases. The aim of this study was to validate and directly contrast carotid strain assessment by speckle tracking applied on clinical and high-frequency ultrasound images in vitro. Four polyvinyl alcohol phantoms mimicking the carotid artery were constructed with different mechanical properties and connected to a pump generating carotid flow profiles. Gray-scale ultrasound long- and short-axis images of the phantoms were obtained using a standard clinical ultrasound system, Vivid 7 (GE Healthcare, Horten, Norway) and a high-frequency ultrasound system, Vevo 2100 (FUJIFILM, VisualSonics, Toronto, Canada) with linear-array transducers (12L/MS250). Radial, longitudinal and circumferential strains were estimated using an in-house speckle tracking algorithm and compared with reference strain acquired by sonomicrometry. Overall, the estimated strain corresponded well with the reference strain. The correlation between estimated peak strain in clinical ultrasound images and reference strain was 0.91 (p<0.001) for radial strain, 0.73 (p<0.001) for longitudinal strain and 0.90 (p<0.001) for circumferential strain and for high-frequency ultrasound images 0.95 (p<0.001) for radial strain, 0.93 (p<0.001) for longitudinal strain and 0.90 (p<0.001) for circumferential strain. A significant larger bias and root mean square error was found for circumferential strain estimation on clinical ultrasound images compared to high frequency ultrasound images, but no significant difference in bias and root mean square error was found for radial and longitudinal strain when comparing estimation on clinical and high-frequency ultrasound images. The agreement between sonomicrometry and speckle tracking demonstrates that carotid strain assessment by ultrasound speckle tracking is feasible. Copyright © 2014 The Authors. Published by Elsevier B

  15. Circumferential Peyronie's disease involving both the corpora cavernosa.

    PubMed

    Narita, T; Kudo, H; Matsumoto, K

    1995-05-01

    An extraordinary form of Peyronies disease is reported. The patient was a 52 year old male, who died of a malignant thymoma with multiple bone metastasis, extensive pleural carcinomatosis of the left lung and some metastatic nodules in the liver and the mesenterium. At autopsy, the proximal and middle portions of the penis were very hard. Macroscopically, the entire tunica albuginea of both the corpora cavernosa was markedly thickened, 2-4 mm; and calcified. Microscopically, the tunica albuginea showed extensive hyaline degeneration, calcification and ossifying foci with osteoblasts and osteoclasts. Inflammatory cells were frequently found beneath the thickened tunica albuginea. In the corpus cavernosum, cavernous arteries showed marked intimal thickening and medial muscular degeneration with a few inflammatory cells. Smooth muscles of the stroma were extensively atrophic and degenerative, and some of them were infiltrated with a few inflammatory cells. In the corpus spongiosum, the tunica albuginea was not thickened, but the smooth muscle in the stroma was atrophic and degenerative and a few inflammatory cells were also found. Surprisingly, there was no Littrés gland around the urethra. In Peyronies disease, the dorsal part of the penis is usually involved, and less frequently lateral or ventral sites are involved. The circumferential involvement of both the corpora cavernosa has not been reported until now, as far as the authors know.

  16. Effects of laser-aided circumferential supracrestal fiberotomy on root surfaces.

    PubMed

    Lee, Ji-Won; Park, Ki-Ho; Chung, Jong-Hyuk; Kim, Su-Jung

    2011-11-01

    To evaluate and compare the effects of circumferential supracrestal fiberotomy in vivo (using diode, CO(2), and Er∶YAG lasers) on the morphology and chemical composition of the root surface. Forty healthy premolar teeth, intended for extraction for orthodontic reasons, were used in this study. Root surfaces were treated using different laser methods, as follows: (1) control; (2) Er∶YAG laser (2.94 µm, 100 mJ, 10 Hz); (3) diode laser (808 nm, 1.2 W, continuous wave); and (4) CO(2) laser (10.6 µm, 3 W, continuous wave). Subsequently, the teeth were removed and subjected to scanning electron microscopic (SEM) examination and energy dispersive x-ray (EDX) spectrometric analysis. SEM analysis indicated that no thermal changes, including melting or carbonization, were observed following the lasing procedures. EDX analysis showed that the laser procedures resulted in similar mineral contents (weight % of calcium and phosphate) as compared to those in the control group. Based on these findings, we concluded that laser-aided procedures, when used at appropriate laser settings, preserve the original morphology and chemical composition of cementum.

  17. Variations in pelvic dimensions do not predict the risk of circumferential resection margin (CRM) involvement in rectal cancer.

    PubMed

    Salerno, G; Daniels, I R; Brown, G; Norman, A R; Moran, B J; Heald, R J

    2007-06-01

    The objective of this study was to assess the value of preoperative pelvimetry, using magnetic resonance imaging (MRI), in predicting the risk of an involved circumferential resection margin (CRM) in a group of patients with operable rectal cancer. A cohort of 186 patients from the MERCURY study was selected. These patients' histological CRM status was compared against 14 pelvimetry parameters measured from the preoperative MRI. These measurements were taken by one of the investigators (G.S.), who was blinded to the final CRM status. There was no correlation between the pelvimetry and the CRM status. However, there was a difference in the height of the rectal cancer and the positive CRM rate (p = 0.011). Of 61 patients with low rectal cancer, 10 had positive CRM at histology (16.4% with CI 8.2%-22.1%) compared with 5 of 110 patients with mid/upper rectal cancers (4.5% with CI 0.7%-8.4%). Magnetic resonance imaging can predict clear margins in most cases of rectal cancer. Circumferential resection margin positivity cannot be predicted from pelvimetry in patients with rectal cancer selected for curative surgery. The only predictive factor for a positive CRM in the patients studied was tumor height.

  18. Circumferential fit assessment of CAD/CAM single crowns--a pilot investigation on a new virtual analytical protocol.

    PubMed

    Matta, Ragai E; Schmitt, Johannes; Wichmann, Manfred; Holst, Stefan

    2012-10-01

    Techniques currently applied to determine the marginal accuracy of dental crown restorations yield inadequate information. This investigation aimed to test a new virtual approach for determining the precision of fit of single-crown copings. Zirconia single crown copings were manufactured on 10 gypsum, single-tooth master casts with two different established computer-aided design/computer-assisted manufacture (CAD/CAM) systems (groups A and B). After cementation, the circumferential fit was assessed with an industrial noncontact scanner and virtual 3D analysis, following a triple-scan protocol. Marginal fit was determined by virtual sectioning; each abutment-coping complex was digitally sliced in 360 vertical sections (1 degree per section). Standardized measurement distances for analyzing the marginal fit (z, xy, xyz) were selected, and a crosshair alignment was utilized to determine whether crowns were horizontally and/or vertically too large or small. The Mann-Whitney test was applied to test for differences between groups. Significant differences in the xy direction (P = .008) were measured between groups. Group A showed a greater number of horizontally overextended margins and a higher frequency of xy distances greater than 150 Μm, in addition to a tendency for excessive z distances (P = .095). The mean marginal gap values were clinically acceptable in the present investigation; however, a full circumferential analysis revealed significant differences in marginal coping quality.

  19. A comparison between Philips and Tomtec for left ventricular deformation and volume measurements in neonatal intensive care patients.

    PubMed

    de Waal, Koert; Phad, Nilkant

    2018-03-01

    Two-dimensional speckle tracking echocardiography is an emerging technique for analyzing cardiac function in newborns. Strain is a highly reliable and reproducible parameter, and reference values have been established for term and preterm newborns. Its implementation into clinical practice has been slow, partly due to lack of inter-vendor consistency. Our aim was to compare recent versions of Philips and Tomtec speckle tracking software for deformation and semiautomated volume and area measurements in neonatal intensive care patients. Longitudinal and circumferential deformation and cavity dimensions (volume, area) were determined off line from apical and short-axis images in 50 consecutive newborns with a median birthweight of 760 g (range 460-3200 g). Absolute mean endocardial global longitudinal strain measurements were similar between vendors, but with wide limits of agreement (Philips -18.9 [2.1]%, Tomtec -18.6 [2.5]%, bias -0.3 [1.7]%, and limits of agreement -3.6%-3.1%). Longitudinal strain rate and circumferential measurements showed poor correlation. All volume and area measurements correlated well between the vendors, but with significant bias. Global longitudinal strain measurements compared well between vendors but wide limits of agreement, suggesting that longitudinal measurements are preferred using similar hardware and software. © 2017, Wiley Periodicals, Inc.

  20. Id4 functions downstream of Bmp signaling to restrict TCF function in endocardial cells during atrioventricular valve development.

    PubMed

    Ahuja, Suchit; Dogra, Deepika; Stainier, Didier Y R; Reischauer, Sven

    2016-04-01

    The atrioventricular canal (AVC) connects the atrial and ventricular chambers of the heart and its formation is critical for the development of the cardiac valves, chamber septation and formation of the cardiac conduction system. Consequently, problems in AVC formation can lead to congenital defects ranging from cardiac arrhythmia to incomplete cardiac septation. While our knowledge about early heart tube formation is relatively comprehensive, much remains to be investigated about the genes that regulate AVC formation. Here we identify a new role for the basic helix-loop-helix factor Id4 in zebrafish AVC valve development and function. id4 is first expressed in the AVC endocardium and later becomes more highly expressed in the atrial chamber. TALEN induced inactivation of id4 causes retrograde blood flow at the AV canal under heat induced stress conditions, indicating defects in AV valve function. At the molecular level, we found that id4 inactivation causes misexpression of several genes important for AVC and AV valve formation including bmp4 and spp1. We further show that id4 appears to control the number of endocardial cells that contribute to the AV valves by regulating Wnt signaling in the developing AVC endocardium. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Biodegradable esophageal stent placement does not prevent high-grade stricture formation after circumferential mucosal resection in a porcine model.

    PubMed

    Pauli, Eric M; Schomisch, Steve J; Furlan, Joseph P; Marks, Andrea S; Chak, Amitabh; Lash, Richard H; Ponsky, Jeffrey L; Marks, Jeffrey M

    2012-12-01

    Advanced esophageal dysplasia and early cancers have been treated traditionally with esophagectomy. Endoscopic esophageal mucosectomy (EEM) offers less-invasive therapy, but high-degree stricture formation limits its applicability. We hypothesized that placement of a biodegradable stent (BD-stent) immediately after circumferential EEM would prevent stricturing. Ten pigs (five unstented controls, five BD-stent) were utilized. Under anesthesia, a flexible endoscope with a band ligator and snare was used to incise the mucosa approximately 20 cm proximal to the lower esophageal sphincter. A 10-cm, circumferential, mucosal segment was dissected and excised by using snare electrocautery. In the stented group, an 18-×120-mm, self-expanding, woven polydioxanone stent (ELLA-CS, Hradec-Kralove) was deployed. Weekly esophagograms evaluated for percent reduction in esophageal diameter, stricture length, and proximal esophageal dilation. Animals were euthanized when the stricture exceeded 80% and were unable to gain weight (despite high-calorie liquid diet) or at 14 weeks. The control group rapidly developed esophageal strictures; no animal survived beyond the third week of evaluation. At 2 weeks post-EEM, the BD-stent group had a significant reduction in esophageal diameter (77.7 vs. 26.6%, p < 0.001) and degree of proximal dilation (175 vs. 131%, p = 0.04) compared with controls. Survival in the BD-stent group was significantly longer than in the control group (9.2 vs. 2.4 weeks, p = 0.01). However, all BD-stent animals ultimately developed clinically significant strictures (range, 4-14 weeks). Comparison between the maximum reduction in esophageal diameter and stricture length (immediately before euthanasia) demonstrated no differences between the groups. Circumferential EEM results in severe stricture formation and clinical deterioration within 3 weeks. BD-stent placement significantly delays the time of clinical deterioration from 2.4 to 9.2 weeks, but does not affect the

  2. Amniotic membrane grafts for the prevention of esophageal stricture after circumferential endoscopic submucosal dissection.

    PubMed

    Barret, Maximilien; Pratico, Carlos Alberto; Camus, Marine; Beuvon, Frédéric; Jarraya, Mohamed; Nicco, Carole; Mangialavori, Luigi; Chaussade, Stanislas; Batteux, Frédéric; Prat, Frédéric

    2014-01-01

    The prevention of esophageal strictures following circumferential mucosal resection remains a major clinical challenge. Human amniotic membrane (AM) is an easily available material, which is widely used in ophthalmology due to its wound healing, anti-inflammatory and anti-fibrotic properties. We studied the effect of AM grafts in the prevention of esophageal stricture after endoscopic submucosal dissection (ESD) in a swine model. In this prospective, randomized controlled trial, 20 swine underwent a 5 cm-long circumferential ESD of the lower esophagus. In the AM Group (n = 10), amniotic membrane grafts were placed on esophageal stents; a subgroup of 5 swine (AM 1 group) was sacrificed on day 14, whereas the other 5 animals (AM 2 group) were kept alive. The esophageal stent (ES) group (n = 5) had ES placement alone after ESD. Another 5 animals served as a control group with only ESD. The prevalence of symptomatic strictures at day 14 was significantly reduced in the AM group and ES groups vs. the control group (33%, 40% and 100%, respectively, p = 0.03); mean esophageal diameter was 5.8±3.6 mm, 6.8±3.3 mm, and 2.6±1.7 mm for AM, ES, and control groups, respectively. Median (range) esophageal fibrosis thickness was 0.87 mm (0.78-1.72), 1.19 mm (0.28-1.95), and 1.65 mm (0.7-1.79) for AM 1, ES, and control groups, respectively. All animals had developed esophageal strictures by day 35. The anti-fibrotic effect of AM on esophageal wound healing after ESD delayed the development of esophageal stricture in our model. However, this benefit was of limited duration in the conditions of our study.

  3. Amniotic Membrane Grafts for the Prevention of Esophageal Stricture after Circumferential Endoscopic Submucosal Dissection

    PubMed Central

    Barret, Maximilien; Pratico, Carlos Alberto; Camus, Marine; Beuvon, Frédéric; Jarraya, Mohamed; Nicco, Carole; Mangialavori, Luigi; Chaussade, Stanislas; Batteux, Frédéric; Prat, Frédéric

    2014-01-01

    Background and Aims The prevention of esophageal strictures following circumferential mucosal resection remains a major clinical challenge. Human amniotic membrane (AM) is an easily available material, which is widely used in ophthalmology due to its wound healing, anti-inflammatory and anti-fibrotic properties. We studied the effect of AM grafts in the prevention of esophageal stricture after endoscopic submucosal dissection (ESD) in a swine model. Animals and Methods In this prospective, randomized controlled trial, 20 swine underwent a 5 cm-long circumferential ESD of the lower esophagus. In the AM Group (n = 10), amniotic membrane grafts were placed on esophageal stents; a subgroup of 5 swine (AM 1 group) was sacrificed on day 14, whereas the other 5 animals (AM 2 group) were kept alive. The esophageal stent (ES) group (n = 5) had ES placement alone after ESD. Another 5 animals served as a control group with only ESD. Results The prevalence of symptomatic strictures at day 14 was significantly reduced in the AM group and ES groups vs. the control group (33%, 40% and 100%, respectively, p = 0.03); mean esophageal diameter was 5.8±3.6 mm, 6.8±3.3 mm, and 2.6±1.7 mm for AM, ES, and control groups, respectively. Median (range) esophageal fibrosis thickness was 0.87 mm (0.78–1.72), 1.19 mm (0.28–1.95), and 1.65 mm (0.7–1.79) for AM 1, ES, and control groups, respectively. All animals had developed esophageal strictures by day 35. Conclusions The anti-fibrotic effect of AM on esophageal wound healing after ESD delayed the development of esophageal stricture in our model. However, this benefit was of limited duration in the conditions of our study. PMID:24992335

  4. Combined circumferential and longitudinal left ventricular systolic dysfunction in patients with asymptomatic aortic stenosis.

    PubMed

    Cioffi, Giovanni; Mazzone, Carmine; Barbati, Giulia; Rossi, Andrea; Nistri, Stefano; Ognibeni, Federica; Tarantini, Luigi; Di Lenarda, Andrea; Faggiano, Pompilio; Pulignano, Giovanni; Stefenelli, Carlo; de Simone, Giovanni; Devereux, Richard B

    2015-07-01

    Early detection of left ventricular (LV) systolic dysfunction is pivotal in the management of patients with aortic stenosis (AS). LV circumferential and/or longitudinal shortening may be impaired in these patients despite LV ejection fraction is preserved. We focused on prevalence and factors associated with combined impairment of circumferential and longitudinal shortening (C&L) in asymptomatic AS patients. Echocardiographic and clinical data from 200 patients with asymptomatic AS of any degree without history of heart failure and normal LV ejection fraction were analyzed. C&L were evaluated by mid-wall shortening (MS) and tissue Doppler mitral annular peak systolic velocity (S'), and classified low if <16.5% and if <8.5 cm/sec, respectively (10th percentiles of controls). Combined C&L dysfunction was detected in 72 patients (36%). The variables associated with this condition were higher LV mass (OR 1.02 [CI 1.01-1.04], P = 0.03), concentric LV geometry (OR 4.30 [CI 1.79-10.34], P = 0.001), increasing pulmonary artery wedge pressure (by E/e' ratio; OR 1.11 [CI 1.04-1.19], P = 0.001). The relation of MS and peak S' was linear and slightly significant in the whole population (r = 0.23; F statistic=0.001), absent in patients with C&L dysfunction (r = 0.04; F = ns), negative (linear model) in the subgroup of patients without C&L dysfunction (r = -0.22; F = 0.02). C&L dysfunction is present in more than one-third of patients with asymptomatic AS and is associated with concentric LV geometry and higher degree of diastolic dysfunction. The relation between MS and peak S' largely varies in the subgroups with different C&L function. © 2014, Wiley Periodicals, Inc.

  5. Comparative charge analysis of one- and two-level lumbar total disc arthroplasty versus circumferential lumbar fusion.

    PubMed

    Levin, David A; Bendo, John A; Quirno, Martin; Errico, Thomas; Goldstein, Jeffrey; Spivak, Jeffrey

    2007-12-01

    This is a retrospective, independent study comparing 2 groups of patients treated surgically for discogenic low back pain associated with degenerative disc disease (DDD) in the lumbosacral spine. To compare the surgical and hospitalization charges associated with 1- and 2-level lumbar total disc replacement and circumferential lumbar fusion. Reported series of lumbar total disc replacement have been favorable. However, economic aspects of lumbar total disc replacement (TDR) have not been published or studied. This information is important considering the recent widespread utilization of new technologies. Recent studies have demonstrated comparable short-term clinical results between TDR and lumbar fusion recipients. Relative charges may be another important indicator of the most appropriate procedure. We report a hospital charge-analysis comparing ProDisc lumbar disc replacement with circumferential fusion for discogenic low back pain. In a cohort of 53 prospectively selected patients with severe, disabling back pain and lumbar disc degeneration, 36 received Synthes ProDisc TDR and 17 underwent circumferential fusion for 1- and 2-level degenerative disc disease between L3 and S1. Randomization was performed using a 2-to-1 ratio of ProDisc recipients to control spinal fusion recipients. Charge comparisons, including operating room charges, inpatient hospital charges, and implant charges, were made from hospital records using inflation-corrected 2006 U.S. dollars. Operating room times, estimated blood loss, and length of stay were obtained from hospital records as well. Surgeon and anesthesiologist fees were, for the purposes of comparison, based on Medicare reimbursement rates. Statistical analysis was performed using a 2-tailed Student t test. For patients with 1-level disease, significant differences were noted between the TDR and fusion control group. The mean total charge for the TDR group was $35,592 versus $46,280 for the fusion group (P = 0.0018). Operating

  6. Stabilizing potential of anterior, posterior, and circumferential fixation for multilevel cervical arthrodesis: an in vitro human cadaveric study of the operative and adjacent segment kinematics.

    PubMed

    Dmitriev, Anton E; Kuklo, Timothy R; Lehman, Ronald A; Rosner, Michael K

    2007-03-15

    This is an in vitro biomechanical study. The current investigation was performed to evaluate the stabilizing potential of anterior, posterior, and circumferential cervical fixation on operative and adjacent segment motion following 2 and 3-level reconstructions. Previous studies reported increases in adjacent level range of motion (ROM) and intradiscal pressure following single-level cervical arthrodesis; however, no studies have compared adjacent level effects following multilevel anterior versus posterior reconstructions. Ten human cadaveric cervical spines were biomechanically tested using an unconstrained spine simulator under axial rotation, flexion-extension, and lateral bending loading. After intact analysis, all specimens were sequentially instrumented from C3 to C5 with: (1) lateral mass fixation, (2) anterior cervical plate with interbody cages, and (3) combined anterior and posterior fixation. Following biomechanical analysis of 2-level constructs, fixation was extended to C6 and testing repeated. Full ROM was monitored at the operative and adjacent levels, and data normalized to the intact (100%). All reconstructive methods reduced operative level ROM relative to intact specimens under all loading methods (P < 0.05). However, circumferential fixation provided the greatest segmental stability among 2 and 3-level constructs (P < 0.05). Moreover, anterior cervical plate fixation was least efficient at stabilizing operative segments following C3-C6 arthrodesis (P < 0.05). Supradjacent ROM was increased for all treatment groups compared to normal data during flexion-extension testing (P < 0.05). Similar trends were observed under axial rotation and lateral bending loading. At the distal level, flexion-extension and axial rotation testing revealed comparable intergroup differences (P < 0.05), while lateral bending loading indicated greater ROM following 2-level circumferential fixation (P < 0.05). Results from our study revealed greater adjacent level motion

  7. Investigation on inlet recirculation characteristics of double suction centrifugal compressor with unsymmetrical inlet

    NASA Astrophysics Data System (ADS)

    Yang, Ce; Wang, Yingjun; Lao, Dazhong; Tong, Ding; Wei, Longyu; Liu, Yixiong

    2016-08-01

    The inlet recirculation characteristics of double suction centrifugal compressor with unsymmetrical inlet structures were studied in numerical method, mainly focused on three issues including the amounts and differences of the inlet recirculation in different working conditions, the circumferential non-uniform distributions of the inlet recirculation, the recirculation velocity distributions of the upstream slot of the rear impeller. The results show that there are some differences between the recirculation of the front impeller and that of the rear impeller in whole working conditions. In design speed, the recirculation flow rate of the rear impeller is larger than that of the front impeller in the large flow range, but in the small flow range, the recirculation flow rate of the rear impeller is smaller than that of the front impeller. In different working conditions, the recirculation velocity distributions of the front and rear impeller are non-uniform along the circumferential direction and their non-uniform extents are quite different. The circumferential non-uniform extent of the recirculation velocity varies with the working conditions change. The circumferential non-uniform extent of the recirculation velocity of front impeller and its distribution are determined by the static pressure distribution of the front impeller, but that of the rear impeller is decided by the coupling effects of the inlet flow distortion of the rear impeller, the circumferential unsymmetrical distribution of the upstream slot and the asymmetric structure of the volute. In the design flow and small flow conditions, the recirculation velocities at different circumferential positions of the mean line of the upstream slot cross-section of the rear impeller are quite different, and the recirculation velocities distribution forms at both sides of the mean line are different. The recirculation velocity distributions in the cross-section of the upstream slot depend on the static pressure

  8. Spontaneous slip reduction of low-grade isthmic spondylolisthesis following circumferential release via bilateral minimally invasive transforaminal lumbar interbody fusion: technical note and short-term outcome.

    PubMed

    Pan, Jie; Li, Lijun; Qian, Lie; Zhou, Wei; Tan, Jun; Zou, Le; Yang, Mingjie

    2011-02-15

    STUDY DESIGN.: Retrospective clinical data analysis. OBJECTIVE.: To investigate and verify our philosophy of spontaneous slip reduction following circumferential release via bilateral minimally invasive transforaminal lumbar interbody fusion (Mini-TLIF) for treatment of low-grade symptomatic isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA.: Symptomatic isthmic spondylolisthesis usually requires surgical intervention, and the most currently controversial focus is on method and degree of reduction; and Mini-TLIF is an attractive surgical procedure for isthmic spondylolisthesis. METHODS.: Between February 2004 and June 2008, 21 patients with low-grade isthmic spondylolisthesis underwent Mini-TLIF in our institute. Total resection of the scar around the pars interarticularis liberated the nerve roots, achieving posterior release as well. The disc was thoroughly resected, and the disc space was gradually distracted and thoroughly released with sequential disc shavers until rupture of anulus conjunct with anterior longitudinal ligament, accomplishing anterior release, so as to insert Cages. Because of circumferential release, the slipped vertebrae would tend to obtain spontaneous reduction, and with pedicle screw fixation, additional reduction would be achieved without any application of posterior translation force. Radiographs, Visual Analogue Scale, and Oswestry Disability Index were documented. All the cases were followed up for 10 to 26 months. RESULTS.: Slip percentage was reduced from 24.2% ± 6.9% to 10.5% ± 4.0%, and foraminal area percentage increased from 89.1% ± 3.0% to 93.6% ± 2.1%. Visual Analogue Scale and Oswestry Disability Index decreased from 7.8 ± 1.5 to 2.1 ± 1.1 and from 53.3 ± 16.2 to 17.0 ± 7.8, respectively. No neurologic complications were encountered. There were no signs of instrumentation failure. The fusion rate approached 100%. CONCLUSION.: Slip reduction is based on circumferential release. The procedure can be well performed

  9. Circumferential targeted renal sympathetic nerve denervation with preservation of the renal arterial wall using intra-luminal ultrasound

    NASA Astrophysics Data System (ADS)

    Roth, Austin; Coleman, Leslie; Sakakura, Kenichi; Ladich, Elena; Virmani, Renu

    2015-03-01

    An intra-luminal ultrasound catheter system (ReCor Medical's Paradise System) has been developed to provide circumferential denervation of the renal sympathetic nerves, while preserving the renal arterial intimal and medial layers, in order to treat hypertension. The Paradise System features a cylindrical non-focused ultrasound transducer centered within a balloon that circulates cooling fluid and that outputs a uniform circumferential energy pattern designed to ablate tissues located 1-6 mm from the arterial wall and protect tissues within 1 mm. RF power and cooling flow rate are controlled by the Paradise Generator which can energize transducers in the 8.5-9.5 MHz frequency range. Computer simulations and tissue-mimicking phantom models were used to develop the proper power, cooling flow rate and sonication duration settings to provide consistent tissue ablation for renal arteries ranging from 5-8 mm in diameter. The modulation of these three parameters allows for control over the near-field (border of lesion closest to arterial wall) and far-field (border of lesion farthest from arterial wall, consisting of the adventitial and peri-adventitial spaces) depths of the tissue lesion formed by the absorption of ultrasonic energy and conduction of heat. Porcine studies have confirmed the safety (protected intimal and medial layers) and effectiveness (ablation of 1-6 mm region) of the system and provided near-field and far-field depth data to correlate with bench and computer simulation models. The safety and effectiveness of the Paradise System, developed through computer model, bench and in vivo studies, has been demonstrated in human clinical studies.

  10. Hemodynamic Deterioration in Lateral Compression Pelvic Fracture After Prehospital Pelvic Circumferential Compression Device Application.

    PubMed

    Garner, Alan A; Hsu, Jeremy; McShane, Anne; Sroor, Adam

    Increased fracture displacement has previously been described with the application of pelvic circumferential compression devices (PCCDs) in patients with lateral compression-type pelvic fracture. We describe the first reported case of hemodynamic deterioration temporally associated with the prehospital application of a PCCD in a patient with a complex acetabular fracture with medial displacement of the femoral head. Active hemorrhage from a site adjacent to the acetabular fracture was subsequently demonstrated on angiography. Caution in the application of PCCDs to patients with lateral compression-type fractures is warranted. Copyright © 2017 Air Medical Journal Associates. All rights reserved.

  11. Enhanced heat transfer with full circumferential ribs in helical pipe

    NASA Astrophysics Data System (ADS)

    Chang, S. W.; Su, L. M.; Yang, T. L.

    2002-08-01

    This paper describes an experimental study of heat transfers in the smooth-walled and rib-roughened helical pipes with reference to the design of enhanced cooling passages in the cylinder head and liner of a marine propulsive diesel engine. The manner in which the repeated ribs modify the forced heat convection in the helical pipe is considered for the case where the flow is turbulent upon entering the coil but laminar in further downstream. A selection of experimental results illustrates the individual and interactive effects of Dean vortices and rib-flows on heat transfer along the inner and outer helixes of coils. The experimental-based observations reveal that the centrifugal force modifies the heat transfer in a manner to generate circumferential heat transfer variation with better cooling performance on the outer edge relative to its inner counterpart even with the agitated flow field caused by the repeated ribs. Heat transfer augmentation factor in the range of 1.3 - 3 times of the smooth-walled level is achieved using the present ribbing geometry. A set of empirical correlations based on the experimental data has been developed to permit the evaluation of heat transfers along the inner and outer helixes of the smooth-walled and rib-roughened helical pipes.

  12. Development of circumferential seal for helicopter transmissions: Results of bench and flight tests

    NASA Technical Reports Server (NTRS)

    Strom, T. N.; Ludwig, L. P.

    1975-01-01

    A modified circumferential segmented ring seal was designed for direct replacement of a helicopter transmission elastomeric lip seal operating on a shaft diameter of 13.91 centimeters (5.481 in.) at sliding velocities to 52.48 m/sec (10 330 ft/min). The modifications involved the garter spring tension, shaft roundness, seal housing flatness, and pumping grooves to inhibit leakage. Operation of the seals in bench tests under simulated helicopter transmission conditions revealed that the seal leakage rate was within acceptable limits and that the wear rate was negligible. The low leakage and wear rates were confirmed in flight tests of 600 and 175 hours (sliding speed, 48.11 m/sec (9470 ft/min)). An additional 200 hours of air worthiness qualification testing (aircraft tie down) demonstrated that the seal can operate at the advanced sliding conditions of 52.48 m/sec (10 330 ft/min).

  13. Myocardial Tbx20 regulates early atrioventricular canal formation and endocardial epithelial-mesenchymal transition via Bmp2

    PubMed Central

    Cai, Xiaoqiang; Nomura-Kitabayashi, Aya; Cai, Weibin; Yan, Jianyun; Christoffels, Vincent M.; Cai, Chen-Leng

    2011-01-01

    During early embryogenesis, the formation of the cardiac atrioventricular canal (AVC) facilitates the transition of the heart from a linear tube into a chambered organ. However, the genetic pathways underlying this developmental process are poorly understood. The T-box transcription factor Tbx20 is expressed predominantly in the AVC of early heart tube. It was shown that Tbx20 activates Nmyc1 and suppresses Tbx2 expression to promote proliferation and specification of the atrial and ventricular chambers, yet it is not known if Tbx20 is involved in early AVC development. Here, we report that mice lacking Tbx20 in the AVC myocardium fail to form the AVC constriction, and the endocardial epithelial-mesenchymal transition (EMT) is severely perturbed. Tbx20 maintains expression of a variety of genes, including Bmp2, Tbx3 and Hand1 in the AVC myocardium. Intriguingly, we found Bmp2 downstream genes involved in the EMT initiation are also downregulated. In addition, re-expression of Bmp2 in the AVC myocardium substantially rescues the EMT defects resulting from the lack of Tbx20, suggesting Bmp2 is one of the key downstream targets of Tbx20 in AVC development. Our data support a complex signaling network with Tbx20 suppressing Tbx2 in the AVC myocardium but also indirectly promoting Tbx2 expression through Bmp2. The spatiotemporal expression of Tbx2 in the AVC appears to be balanced between these two opposing signals. Overall, our study provides genetic evidence that Tbx20 has essential roles in regulating AVC development that coordinate early cardiac chamber formation. PMID:21983003

  14. Myocardial Tbx20 regulates early atrioventricular canal formation and endocardial epithelial-mesenchymal transition via Bmp2.

    PubMed

    Cai, Xiaoqiang; Nomura-Kitabayashi, Aya; Cai, Weibin; Yan, Jianyun; Christoffels, Vincent M; Cai, Chen-Leng

    2011-12-15

    During early embryogenesis, the formation of the cardiac atrioventricular canal (AVC) facilitates the transition of the heart from a linear tube into a chambered organ. However, the genetic pathways underlying this developmental process are poorly understood. The T-box transcription factor Tbx20 is expressed predominantly in the AVC of early heart tube. It was shown that Tbx20 activates Nmyc1 and suppresses Tbx2 expression to promote proliferation and specification of the atrial and ventricular chambers, yet it is not known if Tbx20 is involved in early AVC development. Here, we report that mice lacking Tbx20 in the AVC myocardium fail to form the AVC constriction, and the endocardial epithelial-mesenchymal transition (EMT) is severely perturbed. Tbx20 maintains expression of a variety of genes, including Bmp2, Tbx3 and Hand1 in the AVC myocardium. Intriguingly, we found Bmp2 downstream genes involved in the EMT initiation are also downregulated. In addition, re-expression of Bmp2 in the AVC myocardium substantially rescues the EMT defects resulting from the lack of Tbx20, suggesting Bmp2 is one of the key downstream targets of Tbx20 in AVC development. Our data support a complex signaling network with Tbx20 suppressing Tbx2 in the AVC myocardium but also indirectly promoting Tbx2 expression through Bmp2. The spatiotemporal expression of Tbx2 in the AVC appears to be balanced between these two opposing signals. Overall, our study provides genetic evidence that Tbx20 has essential roles in regulating AVC development that coordinate early cardiac chamber formation. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Baseline asynchrony, assessed circumferentially using temporal uniformity of strain, besides coincidence between site of latest mechanical activation and presumed left ventricular lead position, predicts favourable prognosis after resynchronization therapy.

    PubMed

    Cavallino, Chiara; Rondano, Elisa; Magnani, Andrea; Leva, Lucia; Inglese, Eugenio; Dell'era, Gabriele; Occhetta, Eraldo; Bortnik, Miriam; Marino, Paolo N

    2012-06-01

    Traditional indexes of LV dyssynchrony (DYS) in pts to be resynchronized are sensitive to noise, while the concordance between LV lead position and site of latest mechanical activation is suggested to be, in these patients, clinically relevant. Both aspects, asynchrony and lead position have been addressed separately but unclear is their potential synergistic role in the clinical evolution of CRT patients. We assessed clinical and echocardiographic outcome, as well as mid-term prognosis, in a population of CHF patients submitted to CRT, stratified according to a novel asynchrony quantitation (temporal uniformity of strain: TUS) method and concordance or not between presumed LV lead position and site of latest mechanical activation. TUS was computed in 85 pts (QRS > 120 ms, EF < 0.35) in whom we measured circumferential and longitudinal strains using speckle-tracking 2D-echocardiography before and 3-6 months after CRT, together with triplane apical LV volumes. Optimal LV lead position in short axis view was defined as concordance of the segment with latest systolic circumferential strain prior-CRT and segment with assumed LV lead position. Assumed LV lead position was defined from a chest X-ray obtained 1 day after implantation and scored as anterior, lateral, posterior or inferior using 2 orthogonal views (antero-posterior and lateral). Following CRT, LV volume decreased (diastolic -8 ± 20%) and EF improved (+6 ± 9%, P < 0.001 for both). Two-way ANOVA revealed TUS improvement post-CRT (+22 ± 68%, P = 0.025), with a clear evidence for more marked asynchrony detectable at circumferential (from 0.53 ± 0.20 to 0.55 ± 0.19) as compared with longitudinal level (from 0.56 ± 0.14 to 0.62 ± 0.14) (P = 0.017). Multivariate analysis revealed that greater baseline asynchrony, as assessed circumferentially (P = 0.079), together with concordance between LV lead position and site of activation (P = 0.012), besides younger age (P = 0.051), longer QRS duration (P = 0

  16. A Steel Ball Surface Quality Inspection Method Based on a Circumferential Eddy Current Array Sensor.

    PubMed

    Zhang, Huayu; Xie, Fengqin; Cao, Maoyong; Zhong, Mingming

    2017-07-01

    To efficiently inspect surface defects on steel ball bearings, a new method based on a circumferential eddy current array (CECA) sensor was proposed here. The best probe configuration, in terms of the coil quality factor (Q-factor), magnetic field intensity, and induced eddy current density on the surface of a sample steel ball, was determined using 3-, 4-, 5-, and 6-coil probes, for analysis and comparison. The optimal lift-off from the measured steel ball, the number of probe coils, and the frequency of excitation current suitable for steel ball inspection were obtained. Using the resulting CECA sensor to inspect 46,126 steel balls showed a miss rate of ~0.02%. The sensor was inspected for surface defects as small as 0.05 mm in width and 0.1 mm in depth.

  17. 2-D Versus 3-D Cross-Correlation-Based Radial and Circumferential Strain Estimation Using Multiplane 2-D Ultrafast Ultrasound in a 3-D Atherosclerotic Carotid Artery Model.

    PubMed

    Fekkes, Stein; Swillens, Abigail E S; Hansen, Hendrik H G; Saris, Anne E C M; Nillesen, Maartje M; Iannaccone, Francesco; Segers, Patrick; de Korte, Chris L

    2016-10-01

    Three-dimensional (3-D) strain estimation might improve the detection and localization of high strain regions in the carotid artery (CA) for identification of vulnerable plaques. This paper compares 2-D versus 3-D displacement estimation in terms of radial and circumferential strain using simulated ultrasound (US) images of a patient-specific 3-D atherosclerotic CA model at the bifurcation embedded in surrounding tissue generated with ABAQUS software. Global longitudinal motion was superimposed to the model based on the literature data. A Philips L11-3 linear array transducer was simulated, which transmitted plane waves at three alternating angles at a pulse repetition rate of 10 kHz. Interframe (IF) radio-frequency US data were simulated in Field II for 191 equally spaced longitudinal positions of the internal CA. Accumulated radial and circumferential displacements were estimated using tracking of the IF displacements estimated by a two-step normalized cross-correlation method and displacement compounding. Least-squares strain estimation was performed to determine accumulated radial and circumferential strain. The performance of the 2-D and 3-D methods was compared by calculating the root-mean-squared error of the estimated strains with respect to the reference strains obtained from the model. More accurate strain images were obtained using the 3-D displacement estimation for the entire cardiac cycle. The 3-D technique clearly outperformed the 2-D technique in phases with high IF longitudinal motion. In fact, the large IF longitudinal motion rendered it impossible to accurately track the tissue and cumulate strains over the entire cardiac cycle with the 2-D technique.

  18. Lagrangian displacement tracking using a polar grid between endocardial and epicardial contours for cardiac strain imaging.

    PubMed

    Ma, Chi; Varghese, Tomy

    2012-04-01

    Accurate cardiac deformation analysis for cardiac displacement and strain imaging over time requires Lagrangian description of deformation of myocardial tissue structures. Failure to couple the estimated displacement and strain information with the correct myocardial tissue structures will lead to erroneous result in the displacement and strain distribution over time. Lagrangian based tracking in this paper divides the tissue structure into a fixed number of pixels whose deformation is tracked over the cardiac cycle. An algorithm that utilizes a polar-grid generated between the estimated endocardial and epicardial contours for cardiac short axis images is proposed to ensure Lagrangian description of the pixels. Displacement estimates from consecutive radiofrequency frames were then mapped onto the polar grid to obtain a distribution of the actual displacement that is mapped to the polar grid over time. A finite element based canine heart model coupled with an ultrasound simulation program was used to verify this approach. Segmental analysis of the accumulated displacement and strain over a cardiac cycle demonstrate excellent agreement between the ideal result obtained directly from the finite element model and our Lagrangian approach to strain estimation. Traditional Eulerian based estimation results, on the other hand, show significant deviation from the ideal result. An in vivo comparison of the displacement and strain estimated using parasternal short axis views is also presented. Lagrangian displacement tracking using a polar grid provides accurate tracking of myocardial deformation demonstrated using both finite element and in vivo radiofrequency data acquired on a volunteer. In addition to the cardiac application, this approach can also be utilized for transverse scans of arteries, where a polar grid can be generated between the contours delineating the outer and inner wall of the vessels from the blood flowing though the vessel.

  19. In vivo evaluation of virtual electrode mapping and ablation utilizing a direct endocardial visualization ablation catheter.

    PubMed

    Chik, William W B; Barry, M A; Malchano, Zach; Wylie, Bryan; Pouliopoulos, Jim; Huang, Kaimin; Lu, Juntang; Thavapalachandran, Sujitha; Robinson, David; Saadat, Vahid; Thomas, Stuart P; Ross, David L; Kovoor, Pramesh; Thiagalingam, Aravinda

    2012-01-01

    Radiofrequency (RF) ablation utilizing direct endocardial visualization (DEV) requires a "virtual electrode" to deliver RF energy while preserving visualization. This study aimed to: (1) examine the virtual electrode RF ablation efficacy; (2) determine the optimal power and duration settings; and (3) evaluate the utility of virtual electrode unipolar electrograms. The DEV catheter lesions were compared to lesions formed using a 3.5 mm open irrigated tip catheter within the right atria of 12 sheep. Generator power settings for DEV were titrated from 12W, 14W and 16W for 20, 30 and 40 seconds duration with 25 mL/min saline irrigation. Standard irrigated tip catheter settings of 30W, 50°C for 30 seconds and 30 mL/min were used. The DEV lesions were significantly greater in surface area and both major and minor axes compared to irrigated tip lesions (surface area 19.43 ± 9.09 vs 10.88 ± 4.72 mm, P<0.01) with no difference in transmurality (93/94 vs 46/47) or depth (1.86 ± 0.75 vs 1.85 ± 0.57 mm). Absolute electrogram amplitude reduction was greater for DEV lesions (1.89 ± 1.31 vs 1.49 ± 0.78 mV, P = 0.04), but no difference in percentage reduction. Pre-ablation pacing thresholds were not different between DEV (0.79 ± 0.36 mA) and irrigated tip (0.73 ± 0.25 mA) lesions. There were no complications noted during ablation with either catheter. Virtual electrode ablation consistently created wider lesions at lower power compared to irrigated tip ablation. Virtual electrode electrograms showed a comparable pacing and sensing efficacy in detecting local myocardial electrophysiological changes. © 2011 Wiley Periodicals, Inc.

  20. Underwater single beam circumferentially scanning detection system using range-gated receiver and adaptive filter

    NASA Astrophysics Data System (ADS)

    Tan, Yayun; Zhang, He; Zha, Bingting

    2017-09-01

    Underwater target detection and ranging in seawater are of interest in unmanned underwater vehicles. This study presents an underwater detection system that synchronously scans a collimated laser beam and a narrow field of view to circumferentially detect an underwater target. Hybrid methods of range-gated and variable step-size least mean squares (VSS-LMS) adaptive filter are proposed to suppress water backscattering. The range-gated receiver eliminates the backscattering of near-field water. The VSS-LMS filter extracts the target echo in the remaining backscattering and the constant fraction discriminator timing method is used to improve ranging accuracy. The optimal constant fraction is selected by analysing the jitter noise and slope of the target echo. The prototype of the underwater detection system is constructed and tested in coastal seawater, then the effectiveness of backscattering suppression and high-ranging accuracy is verified through experimental results and analysis discussed in this paper.

  1. The Influence of Hospital Volume on Circumferential Resection Margin Involvement: Results of the Dutch Surgical Colorectal Audit.

    PubMed

    Gietelink, Lieke; Henneman, Daniel; van Leersum, Nicoline J; de Noo, Mirre; Manusama, Eric; Tanis, Pieter J; Tollenaar, Rob A E M; Wouters, Michel W J M

    2016-04-01

    This population-based study evaluates the association between hospital volume and CRM (circumferential resection margin) involvement, adjusted for other confounders, in rectal cancer surgery. A low hospital volume (<20 cases/year) was independently associated with a higher risk of CRM involvement (odds ratio=1.54; 95% CI: 1.12-2.11). To evaluate the association between hospital volume and CRM (circumferential resection margin) involvement in rectal cancer surgery. To guarantee the quality of surgical treatment of rectal cancer, the Association of Surgeons of the Netherlands has stated a minimal annual volume standard of 20 procedures per hospital. The influence of hospital volume has been examined for different outcome variables in rectal cancer surgery. Its influence on the pathological outcome (CRM) however remains unclear. As long-term outcomes are best predicted by the CRM status, this parameter is of essential importance in the debate on the justification of minimal volume standards in rectal cancer surgery. Data from the Dutch Surgical Colorectal Audit (2011-2012) were used. Hospital volume was divided into 3 groups, and baseline characteristics were described. The influence of hospital volume on CRM involvement was analyzed, in a multivariate model, between low- and high-volume hospitals, according to the minimal volume standards. This study included 5161 patients. CRM was recorded in 86% of patients. CRM involvement was 11% in low-volume group versus 7.7% and 7.9% in the medium- and high-volume group (P≤0.001). After adjustment for relevant confounders, the influence of hospital volume on CRM involvement was still significant odds ratio (OR) = 1.54; 95% CI: 1.12-2.11). The outcomes of this pooled analysis support minimal volume standards in rectal cancer surgery. Low hospital volume was independently associated with a higher risk of CRM involvement (OR = 1.54; 95% CI: 1.12-2.11).

  2. Nuclear Membranes ETB Receptors Mediate ET-1-induced Increase of Nuclear Calcium in Human Left Ventricular Endocardial Endothelial Cells.

    PubMed

    Jules, Farah; Avedanian, Levon; Al-Khoury, Johny; Keita, Ramatoulaye; Normand, Alexandre; Bkaily, Ghassan; Jacques, Danielle

    2015-07-01

    In fetal human left ventricular endocardial endothelial cells (EECLs), both plasma membrane (PM) ET(A)R and ET(B)R were reported to mediate ET-1-induced increase of intracellular calcium [Ca](i); however, this effect was mediated by ET(A)R in right EECs (EECRs). In this study, we verified whether, as for the PM, nuclear membranes (NMs) ET-1 receptors activation in EECLs and EECRs induce an increase of nuclear calcium ([Ca](n)) and if this effect is mediated through the same receptor type as in PM. Using a plasmalemma-perforated technique and 3D confocal microscopy, our results showed that, as in PM intact cells, superfusion of nuclei of both cell types with cytosolic ET-1 induced a concentration-dependent sustained increase of [Ca](n). In EECRs, the ET(A)R antagonist prevented the effect of ET-1 on [Ca](n) without affecting EECLs. However, in both cell types, the effect of cytosolic ET-1 on [Ca](n) was prevented by the ETBR antagonist. In conclusion, both NMs' ET(A)R and ET(B)R mediated the effect of cytosolic ET-1 on [Ca](n) in EECRs. In contrast, only NMs' ET(B)R activation mediated the effect of cytosolic ET-1 in EECLs. Hence, the type of NMs' receptors mediating the effect of ET-1 on [Ca](n) are different from those of PM mediating the increase in [Ca](i).

  3. Statistical and Graphical Assessment of Circumferential and Radial Hardness Variation of AISI 4140, AISI 1020 and AA 6082 Aluminum Alloy

    PubMed Central

    Al-Khalid, Hamad; Alaskari, Ayman; Oraby, Samy

    2011-01-01

    Hardness homogeneity of the commonly used structural ferrous and nonferrous engineering materials is of vital importance in the design stage, therefore, reliable information regarding material properties homogeneity should be validated and any deviation should be addressed. In the current study the hardness variation, over wide spectrum radial locations of some ferrous and nonferrous structural engineering materials, was investigated. Measurements were performed over both faces (cross-section) of each stock bar according to a pre-specified stratified design, ensuring the coverage of the entire area both in radial and circumferential directions. Additionally the credibility of the apparatus and measuring procedures were examined through a statistically based calibration process of the hardness reference block. Statistical and response surface graphical analysis are used to examine the nature, adequacy and significance of the measured hardness values. Calibration of the apparatus reference block proved the reliability of the measuring system, where no strong evidence was found against the stochastic nature of hardness measures over the various stratified locations. Also, outlier elimination procedures were proved to be beneficial only at fewer measured points. Hardness measurements showed a dispersion domain that is within the acceptable confidence interval. For AISI 4140 and AISI 1020 steels, hardness is found to have a slight decrease trend as the diameter is reduced, while an opposite behavior is observed for AA 6082 aluminum alloy. However, no definite significant behavior was noticed regarding the effect of the sector sequence (circumferential direction). PMID:28817030

  4. Statistical and Graphical Assessment of Circumferential and Radial Hardness Variation of AISI 4140, AISI 1020 and AA 6082 Aluminum Alloy.

    PubMed

    Al-Khalid, Hamad; Alaskari, Ayman; Oraby, Samy

    2011-12-23

    Hardness homogeneity of the commonly used structural ferrous and nonferrous engineering materials is of vital importance in the design stage, therefore, reliable information regarding material properties homogeneity should be validated and any deviation should be addressed. In the current study the hardness variation, over wide spectrum radial locations of some ferrous and nonferrous structural engineering materials, was investigated. Measurements were performed over both faces (cross-section) of each stock bar according to a pre-specified stratified design, ensuring the coverage of the entire area both in radial and circumferential directions. Additionally the credibility of the apparatus and measuring procedures were examined through a statistically based calibration process of the hardness reference block. Statistical and response surface graphical analysis are used to examine the nature, adequacy and significance of the measured hardness values. Calibration of the apparatus reference block proved the reliability of the measuring system, where no strong evidence was found against the stochastic nature of hardness measures over the various stratified locations. Also, outlier elimination procedures were proved to be beneficial only at fewer measured points. Hardness measurements showed a dispersion domain that is within the acceptable confidence interval. For AISI 4140 and AISI 1020 steels, hardness is found to have a slight decrease trend as the diameter is reduced, while an opposite behavior is observed for AA 6082 aluminum alloy. However, no definite significant behavior was noticed regarding the effect of the sector sequence (circumferential direction).

  5. Assessment of circumferential angle-closure by the iris-trabecular contact index with swept-source optical coherence tomography.

    PubMed

    Baskaran, Mani; Ho, Sue-Wei; Tun, Tin A; How, Alicia C; Perera, Shamira A; Friedman, David S; Aung, Tin

    2013-11-01

    To evaluate the diagnostic performance of the iris-trabecular contact (ITC) index, a measure of the degree of angle-closure, using swept-source optical coherence tomography (SSOCT, CASIA SS-1000, Tomey Corporation, Nagoya, Japan) in comparison with gonioscopy. Prospective observational study. A total of 108 normal subjects and 32 subjects with angle-closure. The SSOCT 3-dimensional angle scans, which obtain radial scans for the entire circumference of the angle, were performed under dark conditions and analyzed using customized software by a single examiner masked to the subjects' clinical details. The ITC index was calculated as a percentage of the angle that was closed on SSOCT images. First-order agreement coefficient (AC1) statistics and area under the receiver operating characteristic curve (AUC) analyses were performed for angle-closure on the basis of the ITC index in comparison with gonioscopy. Angle-closure on gonioscopy was defined as nonvisibility of posterior trabecular meshwork for at least 2 quadrants. Agreement of the ITC index with gonioscopically defined angle-closure was assessed using the AC1 statistic. Study subjects were predominantly Chinese (95.7%) and female (70.7%), with a mean age of 59.2 (standard deviation, 8.9) years. The median ITC index was 15.24% for gonioscopically open-angle eyes (n = 108) and 48.5% for closed-angle eyes (n = 32) (P = 0.0001). The agreement for angle-closure based on ITC index cutoffs (>35% and ≥50%) and gonioscopic angle-closure was 0.699 and 0.718, respectively. The AUC for angle-closure detection using the ITC index was 0.83 (95% confidence interval, 0.76-0.89), with an ITC index >35% having a sensitivity of 71.9% and specificity of 84.3%. The ITC index is a summary measure of the circumferential extent of angle-closure as imaged with SSOCT. The index had moderate agreement and good diagnostic performance for angle-closure with gonioscopy as the reference standard. Copyright © 2013 American Academy of

  6. Transverse shear effects on the stress-intensity factor for a circumferentially cracked, specially orthotropic cylindrical shell

    NASA Technical Reports Server (NTRS)

    Delale, F.; Erdogan, F.

    1977-01-01

    The problem of a cylindrical shell containing a circumferential through crack is considered by taking into account the effect of transverse shear deformations. The formulation is given for a specially orthotropic material within the confines of a linearized shallow shell theory. The particular theory used permits the consideration of all five boundary conditions regarding moment and stress resultants on the crack surface. Consequently, aside from multiplicative constants representing the stress intensity factors, the membrane and bending components of the asymptotic stress fields near the crack tip are found to be identical. The stress intensity factors are calculated separately for a cylinder under a uniform membrane load, and that under a uniform bending moment. Sample results showing the nature of the out-of-plane crack surface displacement and the effect of the Poisson's ratio are presented.

  7. Sarcomere protein gene mutations and inherited heart disease: a beta-cardiac myosin heavy chain mutation causing endocardial fibroelastosis and heart failure.

    PubMed

    Kamisago, Mitsuhiro; Schmitt, Joachim P; McNamara, Dennis; Seidman, Christine; Seidman, J G

    2006-01-01

    Inherited human cardiomyopathies often lead to heart failure. A common feature of these conditions is that affected individuals can express the disease causing mutations for many years without showing clinical signs of the disease. Previous studies have demonstrated that sarcomere protein gene mutations can cause either dilated cardiomyopathy or hypertrophic cardiomyopathy. Here we demonstrate that the Arg442His missense mutation in beta-cardiac myosin heavy chain (betaMHC) causes dilated cardiomyopathy, endocardial fibroelastosis and heart failure at a very early age. Using standard genetic engineering tools we and others have made murine models by introducing human disease causing mutations into mice. The central hypothesis of these studies has been that by identifying the pathophysiological pathways activated by these mutations we can define enzymatic activities that are modified during the disease process and which may be involved in pathways that involve more common forms of cardiac disease. Murine models bearing different mutant myosins are being used to address whether each disease causing mutant betaMHC activates the same or different cellular pathways. Dissecting the molecular pathways modulated by mutations in sarcomere protein genes as well as other genes has already demonstrated that there are multiple pathways leading to cardiac remodelling and heart failure. Defining the mechanisms by which mutations in the same genes activate different cellular pathways remains an important question.

  8. In vitro investigation of the performance of different restorative materials under cast circumferential clasps for removable dental prostheses.

    PubMed

    Pospiech, Peter; Nagel, Florian; Gebhart, Florian; Nothdurft, Frank P; Mitov, Gergo

    2012-12-01

    The objective of this in vitro study was to investigate the behavior of different composite restorative materials under the load of cast circumferential clasps for removable dental prostheses (RDPs). In 60 human molars, standardized mesial-occlusal-distal cavities were prepared. The cavities were restored with the following materials: Definite, Tetric Ceram, SureFil, Heliomolar RO, Ariston pHc, and Oralloy, and provided with a rest seat. The rest seats were subjected to 5,000 cycles of thermal cycling and 1,200,000 masticatory cycles in a mastication simulator via cobalt-chromium circumferential clasps cast to standardized frameworks in a laboratory model designed to simulate the biomechanics of a free-end denture base. Fracture analysis of the restorations was performed by light microscopy. Before and after loading, material wear was measured with a 3D-laser scanner, and an analysis of the marginal quality was performed in an SEM at ×200 applying the replica technique. No significant differences in the fracture behavior among the composite materials were found; the amalgam control group showed a significantly higher fracture resistance. Regarding the wear of the materials, the composites Definite and SureFil exhibited a behavior similar to that of amalgam. The other composites demonstrated higher wear rates. The initial marginal quality was significantly worse for Ariston pHc. The marginal adaptation decreased significantly after thermal and mechanical loading for Definite and Ariston pHc. In terms of the investigated aspects of mechanical performance, the tested composites seemed to be inferior to amalgam. Further clinical studies are needed to evaluate the ability of composite restorations to provide support for RDP clasps. The use of composites as direct restoration materials should be avoided in teeth, which serve as abutments for clasp-retained RDPs.

  9. Contact forces during hybrid atrial fibrillation ablation: an in vitro evaluation.

    PubMed

    Lozekoot, Pieter W J; de Jong, Monique M J; Gelsomino, Sandro; Parise, Orlando; Matteucci, Francesco; Lucà, Fabiana; Kumar, N; Nijs, Jan; Czapla, Jens; Kwant, Paul; Bani, Daniele; Gensini, Gian Franco; Pison, Laurent; Crijns, Harry J G M; Maessen, Jos G; La Meir, Mark

    2016-03-01

    Data on epicardial contact force efficacy in dual epicardial-endocardial atrial fibrillation ablation procedures are lacking. We present an in vitro study on the importance of epicardial and endocardial contact forces during this procedure. The in vitro setup consists of two separate chambers, mimicking the endocardial and epicardial sides of the heart. A circuit, including a pump and a heat exchanger, circulates porcine blood through the endocardial chamber. A septum, with a cut out, allows the placement of a magnetically fixed tissue holder, securing porcine atrial tissue, in the middle of both chambers. Two trocars provide access to the epicardium and endocardium. Force transducers mounted on both catheter holders allow real-time contact force monitoring, while a railing system allows controlled contact force adjustment. We histologically assessed different combinations of epi-endocardial radiofrequency ablation contact forces using porcine atria, evaluating the ablation's diameters, area, and volume. An epicardial ablation with forces of 100 or 300 g, followed by an endocardial ablation with a force of 20 g did not achieve transmurality. Increasing endocardial forces to 30 and 40 g combined with an epicardial force ranging from 100 to 300 and 500 g led to transmurality with significant increases in lesion's diameters, area, and volumes. Increased endocardial contact forces led to larger ablation lesions regardless of standard epicardial pressure forces. In order to gain transmurality in a model of a combined epicardial-endocardial procedure, a minimal endocardial force of 30 g combined with an epicardial force of 100 g is necessary.

  10. Computerized Cuff Pressure Algometry as Guidance for Circumferential Tissue Compression for Wearable Soft Robotic Applications: A Systematic Review.

    PubMed

    Kermavnar, Tjaša; Power, Valerie; de Eyto, Adam; O'Sullivan, Leonard W

    2018-02-01

    In this article, we review the literature on quantitative sensory testing of deep somatic pain by means of computerized cuff pressure algometry (CPA) in search of pressure-related safety guidelines for wearable soft exoskeleton and robotics design. Most pressure-related safety thresholds to date are based on interface pressures and skin perfusion, although clinical research suggests the deep somatic tissues to be the most sensitive to excessive loading. With CPA, pain is induced in deeper layers of soft tissue at the limbs. The results indicate that circumferential compression leads to discomfort at ∼16-34 kPa, becomes painful at ∼20-27 kPa, and can become unbearable even below 40 kPa.

  11. Circumferential bone loss around splinted and nonsplinted immediately loaded implants retaining mandibular overdentures: A randomized controlled clinical trial using cone beam computed tomography.

    PubMed

    Elsyad, Moustafa Abdou; Khirallah, Ahmed Samir

    2016-11-01

    Circumferential marginal bone around 2 splinted and nonsplinted immediately loaded implants in the edentulous mandible has not been previously investigated. The purpose of this randomized controlled clinical trial was to assess circumferential bone loss around splinted and nonsplinted immediately loaded implants retaining mandibular overdentures, using cone beam computed tomography (CBCT). Thirty participants with complete edentulism were allocated to 2 groups and received 2 implants in the canine region of the mandible. Implants were either left nonsplinted (with ball attachment [BA]) or splinted (with bar attachment [RA]). Mandibular overdentures were connected to the implants 1 week later. CBCT was used to evaluate vertical bone loss (VBL) and horizontal bone loss (HBLo) bone loss at the distal (D), buccal (B), mesial (M), and lingual (L) sites of each implant upon overdenture insertion (baseline, T0), 1 year (T1) and 3 years (T3) after insertion. Repeated measures ANOVA was used for statistical analysis (α=.05). No significant difference in the survival rate (93.3% for BA and 100% for RA) was found between groups (P=.156). VBL and HBLo increased significantly at T3 compared with T1 for both groups (P<.005). After 3 years, VBL were 1.36 ±0.57 mm and 1.0 ±0.44 mm and HBLo were 0.88 ±0.48 mm for BA and 0.77 ±0.53 mm for RA. At T1 and T3, BA had more significant VBL than RA (P<.001), while HBLo did not differ significantly between groups. For both groups, a significant difference was found in VBL and HBLo between implant sites (P<.001). The B site recorded the highest VBL, and the L site recorded the lowest VBL. The M and D sites recorded the highest HBLo, and the B and L sites recorded the lowest HBLo. Two nonsplinted immediately loaded implants retaining mandibular overdentures were associated with significantly higher vertical and horizontal circumferential bone loss than those associated with splinted implants after a follow-up of 3 years. Copyright

  12. Ground Tests of a Radial Air-Cooled Engine to Correct a Poor Circumferential Pressure-Recovery Distribution

    NASA Technical Reports Server (NTRS)

    Gallagher, James J.

    1948-01-01

    This report presents the results of the tests of a power-plant installation to improve the circumferential pressure-recovery distribution at the face of the engine. An underslung "C" cowling was tested with two propellers with full cuffs and with a modification to one set of cuffs. Little improvement was obtained because the base sections of the cuffs were stalled. A set of guide vanes boosted the over-all pressures and helped the pressure recoveries for a few of the cylinders. Making the underslung cowling into a symmetrical "C" cowling evened the pressure distribution; however, no increases in front pressures were obtained. The pressures at the top cylinders remained low and the high pressures at the bottom cylinders were reduced. At higher powers and engine speeds, the symmetrical cowling appeared best from the standpoint of over-all cooling characteristics.

  13. Vascular Repair by Circumferential Cell Therapy Using Magnetic Nanoparticles and Tailored Magnets.

    PubMed

    Vosen, Sarah; Rieck, Sarah; Heidsieck, Alexandra; Mykhaylyk, Olga; Zimmermann, Katrin; Bloch, Wilhelm; Eberbeck, Dietmar; Plank, Christian; Gleich, Bernhard; Pfeifer, Alexander; Fleischmann, Bernd K; Wenzel, Daniela

    2016-01-26

    Cardiovascular disease is often caused by endothelial cell (EC) dysfunction and atherosclerotic plaque formation at predilection sites. Also surgical procedures of plaque removal cause irreversible damage to the EC layer, inducing impairment of vascular function and restenosis. In the current study we have examined a potentially curative approach by radially symmetric re-endothelialization of vessels after their mechanical denudation. For this purpose a combination of nanotechnology with gene and cell therapy was applied to site-specifically re-endothelialize and restore vascular function. We have used complexes of lentiviral vectors and magnetic nanoparticles (MNPs) to overexpress the vasoprotective gene endothelial nitric oxide synthase (eNOS) in ECs. The MNP-loaded and eNOS-overexpressing cells were magnetic, and by magnetic fields they could be positioned at the vascular wall in a radially symmetric fashion even under flow conditions. We demonstrate that the treated vessels displayed enhanced eNOS expression and activity. Moreover, isometric force measurements revealed that EC replacement with eNOS-overexpressing cells restored endothelial function after vascular injury in eNOS(-/-) mice ex and in vivo. Thus, the combination of MNP-based gene and cell therapy with custom-made magnetic fields enables circumferential re-endothelialization of vessels and improvement of vascular function.

  14. Cell lineage patterns in the shoot meristem of the sunflower embryo in the dry seed

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

    Jegla, D.E.; Sussex, I.M.

    1989-01-01

    We mapped the fate of cells in the shoot meristem of the dry-seed embryo of sunflower, Helianthus annuus L. cv. Peredovic, using irradiation-induced somatic sectors. We analyzed 249 chlorophyll-deficient or glabrous (hairless) sectors generated in 236 plants. Most sectors observed in the inflorescence extended into vegetative nodes. Thus cell lineages that ultimately gave rise to reproductive structures also contributed to vegetative structures. No single sector extended the entire length of the shoot. Thus the shoot is not derived from one or a few apical initials. Rather, the position, vertical extent, and width of the sectors at different levels of themore » shoot suggest that the shoot is derived from three to four circumferential populations of cells in each of three cell layers of the embryo meristem. Sectors had no common boundaries even in plants with two or three independent sectors, but varied in extent and overlapped along the length of the shoot. Thus individual cells in a single circumferential population behaved independently to contribute lineages of different vertical extents to the growing shoot. The predicted number of circumferential populations of cells as well as the apparent cell number in each population was consistent with the actual number of cells in the embryo meristem observed in histological sections.« less

  15. Performance of a 1.57 pressure-ratio transonic fan stage with a screen-induced 90 deg circumferential inlet flow distortion

    NASA Technical Reports Server (NTRS)

    Sanger, N. L.

    1976-01-01

    A transonic fan stage having a design pressure ratio of 1.57 was tested with a 90 degree circumferential distortion imposed on the inlet flow. The rotor diameter was approximately 50.8 cm, and the design pressure ratio was 1.60 at a tip speed of 425 m/sec. Overall performance at 70 and 100 percent of design speed showed a loss of stall pressure ratio and flow range at design speed and no significant loss in stall pressure ratio at 70 percent of design speed. Detailed flow measurements are presented to show the rotor-upstream flow interactions and the attenuation and amplification properties through the stage.

  16. Ecosystem extent and fragmentation

    USGS Publications Warehouse

    Sayre, Roger; Hansen, Matt

    2017-01-01

    One of the candidate essential biodiversity variable (EBV) groups described in the seminal paper by Pereira et al. (2014) concerns Ecosystem Structure. This EBV group is distinguished from another EBV group which encompasses aspects of Ecosystem Function. While the Ecosystem Function EBV treats ecosystem processes like nutrient cycling, primary production, trophic interactions, etc., the Ecosystem Structure EBV relates to the set of biophysical properties of ecosystems that create biophysical environmental context, confer biophysical structure, and occur geographically. The Ecosystem Extent and Fragmentation EBV is one of the EBVs in the Ecosystem Structure EBV group.Ecosystems are understood to exist at multiple scales, from very large areas (macro-ecosystems) like the Arctic tundra, for example, to something as small as a tree in an Amazonian rain forest. As such, ecosystems occupy space and therefore can be mapped across any geography of interest, whether that area of interest be a site, a nation, a region, a continent, or the planet. One of the most obvious and seemingly straightforward EBVs is Ecosystem Extent and Fragmentation. Ecosystem extent refers to the location and geographic distribution of ecosystems across landscapes or in the oceans, while ecosystem fragmentation refers to the spatial pattern and connectivity of ecosystem occurrences on the landscape.

  17. 46 CFR 172.235 - Extent of damage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... dimensions given in Table 172.235 except that, if the most disabling penetrations would be less than the... Damage Collision Penetration Longitudinal extent 0.495 L2/3 or 47.6 feet. (1/3 L2/3 or 14.5 m), whichever is less. Transverse extent 4 feet 2 inches (1.25 m).1 Vertical extent From the baseline upward...

  18. 46 CFR 172.235 - Extent of damage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... dimensions given in Table 172.235 except that, if the most disabling penetrations would be less than the... Damage Collision Penetration Longitudinal extent 0.495 L2/3 or 47.6 feet. (1/3 L2/3 or 14.5 m), whichever is less. Transverse extent 4 feet 2 inches (1.25 m).1 Vertical extent From the baseline upward...

  19. Laparoscopic transgastric circumferential stapler-assisted versus endoscopic esophageal mucosectomy in a porcine model

    PubMed Central

    Steinemann, Daniel C.; Zerz, Andreas; Müller, Philip C.; Sauer, Peter; Schaible, Anja; Lasitschka, Felix; Schwarz, Anne-Catherine; Müller-Stich, Beat P.; Linke, Georg R.

    2018-01-01

    Background and study aims Extensive endoscopic mucosal resection (EMR) for Barrett’s esophagus (BE) may lead to stenosis. Laparoscopic, transgastric, stapler-assisted mucosectomy (SAM) retrieving circumferential specimens is proposed. Methods SAM was evaluated in two phases. The feasibility of SAM and the quality of specimens was assessed in eight animals. The mucosal healing was evaluated in a 6-weeks survival experiment comparing SAM (n=6) and EMR (n=6). The ratio of the esophageal lumen width (REL) at the resection level measured in fluoroscopy after 6-weeks divided by the width immediately after resection was compared. Results In all animals a circular mucosectomy specimen was successfully obtained with an area of 492(426-573)mm2 and 941(813-1209)mm2 using a 21-mm and 25-mm stapler, respectively. In the survival experiments two animals developed symptomatic stenosis after EMR and none after SAM. The REL was 0.27[0.18-0.39] and 0.96[0.9-1.04] (p<0.0001) for EMR and SAM, respectively. Conclusions SAM provides a novel technique for en-bloc mucosectomy in BE. In contrast to EMR mucosal healing in SAM was not associated with stenosis up to six weeks after intervention. PMID:28301879

  20. 46 CFR 172.180 - Extent of damage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... penetrations having the dimensions given in Table 172.180 except that, if the most disabling penetrations would... 172.180—Extent of Damage Collision Penetration Longitudinal extent 0.495L2/3 or 47.6 feet ((1/3)L2/3 or 14.5m) whichever is shorter. Transverse extent 1 B/5 or 37.74 feet (11.5m) 2 whichever is shorter...

  1. 46 CFR 172.180 - Extent of damage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... penetrations having the dimensions given in Table 172.180 except that, if the most disabling penetrations would... 172.180—Extent of Damage Collision Penetration Longitudinal extent 0.495L2/3 or 47.6 feet ((1/3)L2/3 or 14.5m) whichever is shorter. Transverse extent 1 B/5 or 37.74 feet (11.5m) 2 whichever is shorter...

  2. 46 CFR 172.135 - Extent of damage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... penetrations having the dimensions given in Table 172.135 except that, if the most disabling penetrations would... 172.135—Extent of Damage Collision Penetration Longitudinal extent 0.495L 2/3 or 47.6 feet ((1/3)L 2/3 or 14.5m) whichever is shorter. Transverse extent 1 B/5 or 37.74 feet (11.5m) 2 whichever is shorter...

  3. 46 CFR 172.135 - Extent of damage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... penetrations having the dimensions given in Table 172.135 except that, if the most disabling penetrations would... 172.135—Extent of Damage Collision Penetration Longitudinal extent 0.495L 2/3 or 47.6 feet ((1/3)L 2/3 or 14.5m) whichever is shorter. Transverse extent 1 B/5 or 37.74 feet (11.5m) 2 whichever is shorter...

  4. Improvement of vascular function by magnetic nanoparticle-assisted circumferential gene transfer into the native endothelium.

    PubMed

    Vosen, Sarah; Rieck, Sarah; Heidsieck, Alexandra; Mykhaylyk, Olga; Zimmermann, Katrin; Plank, Christian; Gleich, Bernhard; Pfeifer, Alexander; Fleischmann, Bernd K; Wenzel, Daniela

    2016-11-10

    Gene therapy is a promising approach for chronic disorders that require continuous treatment such as cardiovascular disease. Overexpression of vasoprotective genes has generated encouraging results in animal models, but not in clinical trials. One major problem in humans is the delivery of sufficient amounts of genetic vectors to the endothelium which is impeded by blood flow, whereas prolonged stop-flow conditions impose the risk of ischemia. In the current study we have therefore developed a strategy for the efficient circumferential lentiviral gene transfer in the native endothelium under constant flow conditions. For that purpose we perfused vessels that were exposed to specially designed magnetic fields with complexes of lentivirus and magnetic nanoparticles thereby enabling overexpression of therapeutic genes such as endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF). This treatment enhanced NO and VEGF production in the transduced endothelium and resulted in a reduction of vascular tone and increased angiogenesis. Thus, the combination of MNPs with magnetic fields is an innovative strategy for site-specific and efficient vascular gene therapy. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Accessory atrioventricular pathways refractory to catheter ablation: role of percutaneous epicardial approach.

    PubMed

    Scanavacca, Maurício Ibrahim; Sternick, Eduardo Back; Pisani, Cristiano; Lara, Sissy; Hardy, Carina; d'Ávila, André; Correa, Frederico Soares; Darrieux, Francisco; Hachul, Denise; Marcial, Miguel Barbero; Sosa, Eduardo A

    2015-02-01

    Epicardial mapping and ablation of accessory pathways through a subxiphoid approach can be an alternative when endocardial or epicardial transvenous mapping has failed. We reviewed acute and long-term follow-up of 21 patients (14 males) referred for percutaneous epicardial accessory pathway ablation. There was a median of 2 previous failed procedures. All patients were highly symptomatic, 8 had atrial fibrillation (3 with cardiac arrest) and 13 had frequent symptomatic episodes of atrioventricular reentrant tachycardia. Six patients (28.5%) had a successful epicardial ablation. Five patients (23.8%) underwent a successful repeated endocardial mapping, and ablation after epicardial mapping yielded no early activation site. Epicardial mapping was helpful in guiding endocardial ablation in 2 patients (9.5%), showing that the earliest activation was simultaneous at the epicardium and endocardium. Four patients (19%) underwent successful open-chest surgery after failing epicardial/endocardial ablation. Two patients (9.5%) remained controlled under antiarrhythmic drugs after unsuccessful endocardial/epicardial ablation. Two patients had a coronary sinus diverticulum and one a right atrium to right ventricle diverticulum. Three patients acquired postablation coronary sinus stenosis. There was no major complication related to pericardial access. Percutaneous epicardial approach is an alternative when conventional endocardial or transvenous epicardial ablation fails in the elimination of the accessory pathway. A new attempt by endocardial approach was successful in a significant number of patients. Open-chest surgery may be required in symptomatic cases refractory to endocardial-epicardial approach. © 2014 American Heart Association, Inc.

  6. 27 CFR 4.2 - Territorial extent.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Territorial extent. 4.2 Section 4.2 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS LABELING AND ADVERTISING OF WINE Scope § 4.2 Territorial extent. This part...

  7. 27 CFR 10.2 - Territorial extent.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Territorial extent. 10.2 Section 10.2 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS COMMERCIAL BRIBERY Scope of Regulations § 10.2 Territorial extent. This part...

  8. Posterior transpedicular approach with circumferential debridement and anterior reconstruction as a salvage procedure for symptomatic failed vertebroplasty.

    PubMed

    Chiu, Yen-Chun; Yang, Shih-Chieh; Chen, Hung-Shu; Kao, Yu-Hsien; Tu, Yuan-Kun

    2015-02-10

    Complications and failure of vertebroplasty, such as cement dislodgement, cement leakage, or spinal infection, usually result in spinal instability and neural element compression. Combined anterior and posterior approaches are the most common salvage procedure for symptomatic failed vertebroplasty. The purpose of this study is to evaluate the feasibility and efficacy of a single posterior approach technique for the treatment of patients with symptomatic failed vertebroplasty. Ten patients with symptomatic failed vertebroplasty underwent circumferential debridement and anterior reconstruction surgery through a single-stage posterior transpedicular approach (PTA) from January 2009 to December 2011 at our institution. The differences of visual analog scale (VAS), neurologic status, and vertebral body reconstruction before and after surgery were recorded. The clinical outcomes of patients were categorized as excellent, good, fair, or poor based on modified Brodsky's criteria. The symptomatic failed vertebroplasty occurred between the T11 and L3 vertebrae with one- or two-level involvement. The average VAS score was 8.3 (range, 7 to 9) before surgery, significantly decreased to 3.2 (range, 2 to 4) after surgery (p < 0.01), and continued to decrease to 2.4 (range, 2 to 3) 1 year later (p < 0.01). The average correction of Cobb's angle after surgery was 17.3° (range, 4° to 35°) (p < 0.01). The mean loss of Cobb's angle correction after 1 year of follow-up was 2.7° (range, 0° to 5°). The average allograft subsidence at 1 year after surgery was 1 mm (range, 0 to 2). The neurologic status of Frankel's scale significantly improved after surgery (p = 0.014) and at 1 year after surgery (p = 0.046). No one experienced severe complications such as deep wound infection or neurologic deterioration. All patients achieved good or excellent outcomes after surgery based on modified Brodsky's criteria (p < 0.01). Single-stage PTA surgery with

  9. 27 CFR 25.2 - Territorial extent.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Territorial extent. 25.2 Section 25.2 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Scope of Regulations § 25.2 Territorial extent. This part applies to the...

  10. 27 CFR 25.2 - Territorial extent.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Territorial extent. 25.2 Section 25.2 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL BEER Scope of Regulations § 25.2 Territorial extent. This part applies to the...

  11. 27 CFR 25.2 - Territorial extent.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Territorial extent. 25.2 Section 25.2 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Scope of Regulations § 25.2 Territorial extent. This part applies to the...

  12. 27 CFR 25.2 - Territorial extent.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Territorial extent. 25.2 Section 25.2 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL BEER Scope of Regulations § 25.2 Territorial extent. This part applies to the...

  13. 27 CFR 25.2 - Territorial extent.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Territorial extent. 25.2 Section 25.2 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Scope of Regulations § 25.2 Territorial extent. This part applies to the...

  14. Integrated Assessment of Left Ventricular Electrical Activation and Myocardial Strain Mapping in Heart Failure Patients: A Holistic Diagnostic Approach for Endocardial Cardiac Resynchronization Therapy, Ablation of Ventricular Tachycardia, and Biological Therapy.

    PubMed

    Maffessanti, Francesco; Prinzen, Frits W; Conte, Giulio; Regoli, François; Caputo, Maria Luce; Suerder, Daniel; Moccetti, Tiziano; Faletra, Francesco; Krause, Rolf; Auricchio, Angelo

    2018-01-01

    This study sought to test the accuracy of strain measurements based on anatomo-electromechanical mapping (AEMM) measurements compared with magnetic resonance imaging (MRI) tagging, to evaluate the diagnostic value of AEMM-based strain measurements in the assessment of myocardial viability, and the additional value of AEMM over peak-to-peak local voltages. The in vivo identification of viable tissue, evaluation of mechanical contraction, and simultaneous left ventricular activation is currently achieved using multiple complementary techniques. In 33 patients, AEMM maps (NOGA XP, Biologic Delivery Systems, Division of Biosense Webster, a Johnson & Johnson Company, Irwindale, California) and MRI images (Siemens 3T, Siemens Healthcare, Erlangen, Germany) were obtained within 1 month. MRI tagging was used to determine circumferential strain (E cc ) and delayed enhancement to obtain local scar extent (%). Custom software was used to measure E cc and local area strain (LAS) from the motion field of the AEMM catheter tip. Intertechnique agreement for E cc was good (R 2  = 0.80), with nonsignificant bias (0.01 strain units) and narrow limits of agreement (-0.03 to 0.06). Scar segments showed lower absolute strain amplitudes compared with nonscar segments: E cc (median [first to third quartile]: nonscar -0.10 [-0.15 to -0.06] vs. scar -0.04 [-0.06 to -0.02]) and LAS (-0.20 [-0.27 to -0.14] vs. -0.09 [-0.14 to -0.06]). AEMM strains accurately discriminated between scar and nonscar segments, in particular LAS (area under the curve: 0.84, accuracy = 0.76), which was superior to peak-to-peak voltages (nonscar 9.5 [6.5 to 13.3] mV vs. scar 5.6 [3.4 to 8.3] mV; area under the curve: 0.75). Combination of LAS and peak-to-peak voltages resulted in 86% accuracy. An integrated AEMM approach can accurately determine local deformation and correlates with the scar extent. This approach has potential immediate application in the diagnosis, delivery of intracardiac therapies, and their

  15. Global Bi-ventricular endocardial distribution of activation rate during long duration ventricular fibrillation in normal and heart failure canines.

    PubMed

    Luo, Qingzhi; Jin, Qi; Zhang, Ning; Han, Yanxin; Wang, Yilong; Huang, Shangwei; Lin, Changjian; Ling, Tianyou; Chen, Kang; Pan, Wenqi; Wu, Liqun

    2017-04-13

    The objective of this study was to detect differences in the distribution of the left and right ventricle (LV & RV) activation rate (AR) during short-duration ventricular fibrillation (SDVF, <1 min) and long-duration ventricular fibrillation VF (LDVF, >1 min) in normal and heart failure (HF) canine hearts. Ventricular fibrillation (VF) was electrically induced in six healthy dogs (control group) and six dogs with right ventricular pacing-induced congestive HF (HF group). Two 64-electrode basket catheters deployed in the LV and RV were used for global endocardium electrical mapping. The AR of VF was estimated by fast Fourier transform analysis from each electrode. In the control group, the LV was activated faster than the RV in the first 20 s, after which there was no detectable difference in the AR between them. When analyzing the distribution of the AR within the bi-ventricles at 3 min of LDVF, the posterior LV was activated fastest, while the anterior was slowest. In the HF group, a detectable AR gradient existed between the two ventricles within 3 min of VF, with the LV activating more quickly than the RV. When analyzing the distribution of the AR within the bi-ventricles at 3 min of LDVF, the septum of the LV was activated fastest, while the anterior was activated slowest. A global bi-ventricular endocardial AR gradient existed within the first 20 s of VF but disappeared in the LDVF in healthy hearts. However, the AR gradient was always observed in both SDVF and LDVF in HF hearts. The findings of this study suggest that LDVF in HF hearts can be maintained differently from normal hearts, which accordingly should lead to the development of different management strategies for LDVF resuscitation.

  16. ALternate Site Cardiac ResYNChronization (ALSYNC): a prospective and multicentre study of left ventricular endocardial pacing for cardiac resynchronization therapy.

    PubMed

    Morgan, John M; Biffi, Mauro; Gellér, László; Leclercq, Christophe; Ruffa, Franco; Tung, Stanley; Defaye, Pascal; Yang, Zhongping; Gerritse, Bart; van Ginneken, Mireille; Yee, Raymond; Jais, Pierre

    2016-07-14

    The ALternate Site Cardiac ResYNChronization (ALSYNC) study evaluated the feasibility and safety of left ventricular endocardial pacing (LVEP) using a market-released pacing lead implanted via a single pectoral access by a novel atrial transseptal lead delivery system. ALSYNC was a prospective clinical investigation with a minimum of 12-month follow-up in 18 centres of cardiac resynchronization therapy (CRT)-indicated patients, who had failed or were unsuitable for conventional CRT. The ALSYNC system comprises the investigational lead delivery system and LVEP lead. Patients required warfarin therapy post-implant. The primary study objective was safety at 6-month follow-up, which was defined as freedom from complications related to the lead delivery system, implant procedure, or the lead ≥70%. The ALSYNC study enrolled 138 patients. The LVEP lead implant success rate was 89.4%. Freedom from complications meeting the definition of primary endpoint was 82.2% at 6 months (95% CI 75.6-88.8%). In the study, 14 transient ischaemic attacks (9 patients, 6.8%), 5 non-disabling strokes (5 patients, 3.8%), and 23 deaths (17.4%) were observed. No death was from a primary endpoint complication. At 6 months, the New York Heart Association class improved in 59% of patients, and 55% had LV end-systolic volume reduction of 15% or greater. Those patients enrolled after CRT non-response showed similar improvement with LVEP. The ALSYNC study demonstrates clinical feasibility, and provides an early indication of possible benefit and risk of LVEP. NCT01277783. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  17. Downscaling of inundation extents

    NASA Astrophysics Data System (ADS)

    Aires, Filipe; Prigent, Catherine; Papa, Fabrice

    2014-05-01

    The Global Inundation Extent from Multi-Satellite (GIEMS) provides multi-year monthly variations of the global surface water extent at about 25 kmx25 km resolution, from 1993 to 2007. It is derived from multiple satellite observations. Its spatial resolution is usually compatible with climate model outputs and with global land surface model grids but is clearly not adequate for local applications that require the characterization of small individual water bodies. There is today a strong demand for high-resolution inundation extent datasets, for a large variety of applications such as water management, regional hydrological modeling, or for the analysis of mosquitos-related diseases. This paper present three approaches to do downscale GIEMS: The first one is based on a image-processing technique using neighborhood constraints. The third approach uses a PCA representation to perform an algebraic inversion. The PCA-representation is also very convenient to perform temporal and spatial interpolation of complexe inundation fields. The third downscaling method uses topography information from Hydroshed Digital Elevation Model (DEM). Information such as the elevation, distance to river and flow accumulation are used to define a ``flood ability index'' that is used by the downscaling. Three basins will be considered for illustrative purposes: Amazon, Niger and Mekong. Aires, F., F. Papa, C. Prigent, J.-F. Cretaux and M. Berge-Nguyen, Characterization and downscaling of the inundation extent over the Inner Niger delta using a multi-wavelength retrievals and Modis data, J. of Hydrometeorology, in press, 2014. Aires, F., F. Papa and C. Prigent, A long-term, high-resolution wetland dataset over the Amazon basin, downscaled from a multi-wavelength retrieval using SAR, J. of Hydrometeorology, 14, 594-6007, 2013. Prigent, C., F. Papa, F. Aires, C. Jimenez, W.B. Rossow, and E. Matthews. Changes in land surface water dynamics since the 1990s and relation to population pressure

  18. Combined Circumferential and Longitudinal Left Ventricular Systolic Dysfunction in Patients with Rheumatoid Arthritis without Overt Cardiac Disease.

    PubMed

    Cioffi, Giovanni; Viapiana, Ombretta; Ognibeni, Federica; Dalbeni, Andrea; Gatti, Davide; Mazzone, Carmine; Faganello, Giorgio; Di Lenarda, Andrea; Adami, Silvano; Rossini, Maurizio

    2016-07-01

    Patients with rheumatoid arthritis have an increased risk for cardiovascular disease. Because of accelerated atherosclerosis and changes in left ventricular (LV) geometry, circumferential and longitudinal (C&L) LV systolic dysfunction (LVSD) may be impaired in these patients despite preserved LV ejection fraction. The aim of this study was to determine the prevalence of and factors associated with combined C&L LVSD in patients with rheumatoid arthritis. One hundred ninety-eight outpatients with rheumatoid arthritis without overt cardiac disease were prospectively analyzed from January through June 2014 and compared with 198 matched control subjects. C&L systolic function was evaluated by stress-corrected midwall shortening (sc-MS) and tissue Doppler mitral annular peak systolic velocity (S'). Combined C&L LVSD was defined if sc-MS was <86.5% and S' was <9.0 cm/sec (the 10th percentiles of sc-MS and S' derived in 132 healthy subjects). Combined C&L LVSD was detected in 56 patients (28%) and was associated with LV mass (odds ratio, 1.03; 95% CI, 1.01-1.06; P = .04) and concentric LV geometry (odds ratio, 2.76; 95% CI, 1.07-7.15; P = .03). By multiple logistic regression analysis, rheumatoid arthritis emerged as an independent predictor of combined C&L LVSD (odds ratio, 2.57; 95% CI, 1.06-6.25). The relationship between sc-MS and S' was statistically significant in the subgroup of 142 patients without combined C&L LVSD (r = 0.40, F < 0.001), having the best fitting by a linear function (sc-MS = 58.1 + 3.34 × peak S'; r(2) = 0.19, P < .0001), absent in patients with combined C&L LVSD. Combined C&L LVSD is detectable in about one fourth of patients with asymptomatic rheumatoid arthritis and is associated with LV concentric remodeling and hypertrophy. Rheumatoid arthritis predicts this worrisome condition, which may explain the increased risk for cardiovascular events in these patients. The aim of this "notice of clarification" is to analyze in brief

  19. ALIF and total disc replacement versus 2-level circumferential fusion with TLIF: a prospective, randomized, clinical and radiological trial.

    PubMed

    Hoff, Eike K; Strube, Patrick; Pumberger, Matthias; Zahn, Robert K; Putzier, Michael

    2016-05-01

    Prospective, randomized trial. The treatment of degenerative disc disease (DDD) with two-level fusion has been associated with a reasonable rate of complications. The aim of the present study was to compare (Hybrid) stand-alone anterior lumbar interbody fusion (ALIF) at L5/S1 with total disc replacement at L4/5 (TDR) as an alternative surgical strategy to (Fusion) 2-level circumferential fusion employing transforaminal lumbar interbody fusion (TLIF) with transpedicular stabilization at L4-S1. A total of 62 patients with symptomatic DDD of segments L5/S1 (Modic ≥2°) and L4/5 (Modic ≤2°; positive discography) were enrolled; 31 were treated with Hybrid and 31 with Fusion. Preoperatively, at 0, 12, and a mean follow-up of 37 months, clinical (ODI, VAS) and radiological evaluations (plain/extension-flexion radiographs evaluated for implant failure, fusion, global and segmental lordosis, and ROM) were performed. In 26 of 31 Hybrid and 24 of 31 Fusion patients available at the final follow-up, we found a significant clinical improvement compared to preoperatively. Hybrid patients had significantly lower VAS scores immediately postoperatively and at follow-up compared to Fusion patients. The complication rates were low and similar between the groups. Lumbar lordosis increased in both groups. The increase was mainly located at L4-S1 in the Hybrid group and at L1-L4 in the Fusion group. Hybrid patients presented with increased ROM at L4/5 and L3/4, and Fusion patients presented with increased ROM at L3/4, with significantly greater ROM at L3/4 compared to Hybrid patients at follow-up. Hybrid surgery is a viable surgical alternative for the presented indication. Approach-related inferior trauma and the balanced restoration of lumbar lordosis resulted in superior clinical outcomes compared to two-level circumferential fusion with TLIF.

  20. 27 CFR 6.2 - Territorial extent.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Territorial extent. 6.2 Section 6.2 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS âTIED-HOUSEâ Scope of Regulations § 6.2 Territorial extent. This part applies to the several States of the United States,...

  1. 27 CFR 6.2 - Territorial extent.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Territorial extent. 6.2 Section 6.2 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS âTIED-HOUSEâ Scope of Regulations § 6.2 Territorial extent. This part applies to the several States of the United States,...

  2. Measurement of oxygen tension in the ischemic myocardium using encased polargraphic oxygen electrodes.

    PubMed

    Barrett, J A; Lynch, V D; Balkon, J; Wolf, P S

    1986-06-01

    The ability to continuously monitor the delicate balance between blood flow and oxygen consumption would be a great asset in the study of myocardial ischemia. The present study was performed, in anesthetized dogs, to validate the use of encased polargraphic oxygen electrodes in the study of myocardial ischemia. Polargraphic oxygen electrodes were placed in the area to be rendered ischemic at fixed tissue depths of 3 mm (epicardium) and 9 mm (endocardium). Endocardial and epicardial oxygen tensions as well as the ratio of endocardial to epicardial oxygen tension and left circumflex coronary flow were monitored. Ischemia was induced by decreasing left circumflex coronary flow by 50%. Upon completion of a 20-min poststenotic period, endocardial pO2, endocardial/epicardial ratio, and coronary flow were significantly decreased (59 +/- 7, 52 +/- 7, and 55 +/- 4%, respectively) whereas epicardial pO2 was slightly decreased. Nitroglycerin (10 micrograms/kg, i.v.) markedly increased endocardial pO2 and endocardial/epicardial ratio above poststenotic control (13 +/- 5 mmHg and 64 +/- 10%, respectively) whereas epicardial pO2 was not significantly decreased. The increases in endocardial pO2 occurred at a point where coronary flow and mean arterial pressure were not significantly changed. Conversely, dipyridamole (125 micrograms/kg, i.v.) significantly increased coronary flow (26 +/- 2 ml/min/100 g) although it did not appreciably alter endocardial or epicardial pO2. It is concluded that encased polargraphic oxygen electrodes provide a quantitative method for determination of oxygen tension in the ischemic myocardium.

  3. Distribution analysis for F100(3) engine

    NASA Technical Reports Server (NTRS)

    Walter, W. A.; Shaw, M.

    1980-01-01

    The F100(3) compression system response to inlet circumferential distortion was investigated using an analytical compressor flow model. Compression system response to several types of distortion, including pressure, temperature, and combined pressure/temperature distortions, was investigated. The predicted response trends were used in planning future F100(3) distortion tests. Results show that compression system response to combined temperature and pressure distortions depends upon the relative orientation, as well as the individual amplitudes and circumferential extents of the distortions. Also the usefulness of the analytical predictions in planning engine distortion tests is indicated.

  4. Trend analysis of Arctic sea ice extent

    NASA Astrophysics Data System (ADS)

    Silva, M. E.; Barbosa, S. M.; Antunes, Luís; Rocha, Conceição

    2009-04-01

    The extent of Arctic sea ice is a fundamental parameter of Arctic climate variability. In the context of climate change, the area covered by ice in the Arctic is a particularly useful indicator of recent changes in the Arctic environment. Climate models are in near universal agreement that Arctic sea ice extent will decline through the 21st century as a consequence of global warming and many studies predict a ice free Arctic as soon as 2012. Time series of satellite passive microwave observations allow to assess the temporal changes in the extent of Arctic sea ice. Much of the analysis of the ice extent time series, as in most climate studies from observational data, have been focussed on the computation of deterministic linear trends by ordinary least squares. However, many different processes, including deterministic, unit root and long-range dependent processes can engender trend like features in a time series. Several parametric tests have been developed, mainly in econometrics, to discriminate between stationarity (no trend), deterministic trend and stochastic trends. Here, these tests are applied in the trend analysis of the sea ice extent time series available at National Snow and Ice Data Center. The parametric stationary tests, Augmented Dickey-Fuller (ADF), Phillips-Perron (PP) and the KPSS, do not support an overall deterministic trend in the time series of Arctic sea ice extent. Therefore, alternative parametrizations such as long-range dependence should be considered for characterising long-term Arctic sea ice variability.

  5. In-line inspection of unpiggable buried live gas pipes using circumferential EMAT guided waves

    NASA Astrophysics Data System (ADS)

    Ren, Baiyang; Xin, Junjun

    2018-04-01

    Unpiggable buried gas pipes need to be inspected to ensure their structural integrity and safe operation. The CIRRIS XITM robot, developed and operated by ULC Robotics, conducts in-line nondestructive inspection of live gas pipes. With the no-blow launching system, the inspection operation has reduced disruption to the public and by eliminating the need to dig trenches, has minimized the site footprint. This provides a highly time and cost effective solution for gas pipe maintenance. However, the current sensor on the robot performs a point-by-point measurement of the pipe wall thickness which cannot cover the whole volume of the pipe in a reasonable timeframe. The study of ultrasonic guided wave technique is discussed to improve the volume coverage as well as the scanning speed. Circumferential guided wave is employed to perform axial scanning. Mode selection is discussed in terms of sensitivity to different defects and defect characterization capability. To assist with the mode selection, finite element analysis is performed to evaluate the wave-defect interaction and to identify potential defect features. Pulse-echo and through-transmission mode are evaluated and compared for their pros and cons in axial scanning. Experiments are also conducted to verify the mode selection and detect and characterize artificial defects introduced into pipe samples.

  6. Postural changes may influence popliteal atherosclerosis by modifying local circumferential wall tension.

    PubMed

    Gemignani, Tiago; Matos-Souza, José R; Coelho, Otávio R; Franchini, Kleber G; Nadruz, Wilson

    2008-11-01

    Atherosclerosis of peripheral arteries typically affects vessels of the lower limbs, suggesting that local hemodynamic stimuli play a role in this process. Our study evaluated the effects of body postural changes on carotid and popliteal blood pressure, circumferential wall tension (CWT) and arterial strain, and investigated the relationship between such hemodynamic parameters and intima-media thickness (IMT) of these arteries. One hundred seventeen nondiabetic, nonhypertensive, nonsmoker subjects (48 men and 69 women) were enrolled and had their blood pressure measured in the arm and calf in supine and orthostatic positions. Echo-doppler analysis evaluated the common carotid and popliteal arteries after blood pressure measurements, while CWT was calculated according to Laplace's law. The results showed that changing from supine to orthostatic posture increased blood pressure and CWT in popliteal but not in carotid arteries. Partial correlation analysis adjusted for age and body mass index revealed no major relationship between IMT of the studied vessels and local blood pressure or arterial strain. Conversely, supine and orthostatic CWT exhibited comparable correlation coefficients with carotid IMT, while orthostatic CWT displayed a stronger relationship with popliteal IMT than with supine CWT. These results were confirmed by multiple linear regression analysis that included age, sex, body mass index, lipid fractions and glucose as independent variables. Overall, our results indicate that orthostatic CWT is a stronger hemodynamic predictor of popliteal IMT than supine CWT, suggesting that erectile posture may be a potential risk factor for popliteal atherosclerosis because it increases the local hemodynamic burden. (Hypertens Res 2008; 31: 2059-2064).

  7. A new method to estimate left ventricular circumferential midwall systolic function by standard echocardiography: Concordance between models and validation by speckle tracking.

    PubMed

    Ballo, Piercarlo; Nistri, Stefano; Bocelli, Arianna; Mele, Donato; Dini, Frank L; Galderisi, Maurizio; Zuppiroli, Alfredo; Mondillo, Sergio

    2016-01-15

    Assessment of left ventricular circumferential (LVcirc) systolic function by standard echocardiography can be performed by estimating midwall fractional shortening (mFS) and stress-corrected mFS (ScmFS). Their determination is based on spherical or cylindrical LV geometric models, which often yield discrepant values. We developed a new model based on a more realistic truncated ellipsoid (TE) LV shape, and explored the concordance between models among hypertensive patients. We also compared the relationships of different mFS and ScmFS estimates with indexes of LVcirc systolic strain. In 364 hypertensive subjects, mFS was determined using the spherical (mFSspher), cylindrical (mFScyl), and TE model (mFSTE). Corresponding values of ScmFSspher, ScmFScyl, and ScmFSTE were obtained. Global circumferential strain (GCS) and systolic strain rate (GCSR) were also measured by speckle tracking. The three models showed poor concordance for the estimation of mFS, with average differences ranging between 11% and 30% and wide limits of agreement. Similar results were found for ScmFS, where reclassification rates for the identification of abnormal LVcirc systolic function ranged between 18% and 29%. When tested against strain indexes, mFSTE and ScmFSTE showed the best correlations (R=0.81 and R=0.51, p<0.0001 for both) with GCS and GCSR. Multivariable analysis confirmed that mFSTE and ScmFSTE showed the strongest independent associations with LVcirc strain measures. Substantial discrepancies in LVcirc midwall systolic indexes exist between different models, supporting the need of model-specific normative data. The use of the TE model might provide indexes that show the best associations with established strain measures of LVcirc systolic function. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Tissue Motion and Assembly During Early Cardiovascular Morphogenesis

    NASA Astrophysics Data System (ADS)

    Rongish, Brenda

    2010-03-01

    Conventional dogma in the field of cardiovascular developmental biology suggests that cardiac precursor cells migrate to the embryonic midline to form a tubular heart. These progenitors are believed to move relative to their extracellular matrix (ECM); responding to stimulatory and inhibitory cues in their environment. The tubular heart that is formed by 30 hours post fertilization is comprised of two concentric layers: the muscular myocardium and the endothelial-like endocardium, which are separated by a thick layer of ECM believed to be secreted predominantly by the myocardial cells. Here we describe the origin and motility of fluorescently tagged endocardial precursors in transgenic (Tie1-YFP) quail embryos (R. Lansford, Caltech) using epifluorescence time-lapse imaging. To visualize the environment of migrating endocardial progenitors, we labeled two ECM components, fibronectin and fibrillin-2, via in vivo microinjection of fluorochrome-conjugated monoclonal antibodies. Dynamic imaging was performed at stages encompassing tubular heart assembly and early looping. We established the motion of endocardial precursor cells and presumptive cardiac ECM fibrils using both object tracking and particle image velocimetry (image cross correlation). We determined the relative importance of directed cell autonomous motility versus passive tissue movements in endocardial morphogenesis. The data show presumptive endocardial cells and cardiac ECM fibrils are swept passively into the anterior and posterior poles of the elongating tubular heart. These quantitative data indicate the contribution of cell autonomous motility displayed by endocardial precursors is limited. Thus, tissue motion drives most of the cell displacements during endocardial morphogenesis.

  9. Three-dimensional changes in left and right ventricular geometry in chronic mitral regurgitation.

    PubMed

    Young, A A; Orr, R; Smaill, B H; Dell'Italia, L J

    1996-12-01

    Regional three-dimensional (3-D) right (RV) and left ventricular (LV) geometry was studied in eight dogs before and 5-6 mo after induction of mitral regurgitation (MR). Ventricular shape changes were quantified with a 3-D finite-element model fitted to chamber contours traced on cardiac magnetic resonance images. MR increased LV end-diastolic volume (LVEDV; 99 vs. 57 ml; P < 0.001) and LV stroke volume (LVSV; 55 vs. 26 ml; P < 0.001). In contrast, RVEDV decreased (45 vs. 55 ml; P < 0.01), whereas SV was maintained. LV mass (free wall plus septum) increased (115 vs. 94 g; P < 0.05), whereas RV free-wall mass was relatively unchanged. Shape changes due to MR were characterized by a marked (7.4-mm) rightward shift of the septum relative to the lateral LV free wall at end diastole. In contrast, the distance from the RV free wall to the lateral LV free wall was relatively unchanged (2.7 mm). The distance between the LV lateral free wall and septum increased more than the distance between the anterior and posterior LV walls (22 vs. 15%; P = 0.04). During systole, the displacement of the septum into the LV increased significantly (7.3 vs. 2.9 mm; P < 0.01). Consistent with the end-diastolic dimension changes, LV endocardial circumferential curvature was decreased at end diastole to a greater extent in the anterior and posterior walls than in the septal and lateral walls (P < 0.01). Thus chronic MR produced an asymmetric LV dilatation with regional variation in geometry. The septum increased its contribution to the LVSV at the expense of RVEDV. RVSV was maintained, possibly by ventricular interaction.

  10. A critical role for the EphA3 receptor tyrosine kinase in heart development.

    PubMed

    Stephen, Lesley J; Fawkes, Amy L; Verhoeve, Adam; Lemke, Greg; Brown, Arthur

    2007-02-01

    Eph proteins are receptor tyrosine kinases that control changes in cell shape and migration during development. We now describe a critical role for EphA3 receptor signaling in heart development as revealed by the phenotype of EphA3 null mice. During heart development mesenchymal outgrowths, the atrioventricular endocardial cushions, form in the atrioventricular canal. This morphogenetic event requires endocardial cushion cells to undergo an epithelial to mesenchymal transformation (EMT), and results in the formation of the atrioventricular valves and membranous portions of the atrial and ventricular septa. We show that EphA3 knockouts have significant defects in the development of their atrial septa and atrioventricular endocardial cushions, and that these cardiac abnormalities lead to the death of approximately 75% of homozygous EphA3(-/-) mutants. We demonstrate that EphA3 and its ligand, ephrin-A1, are expressed in adjacent cells in the developing endocardial cushions. We further demonstrate that EphA3(-/-) atrioventricular endocardial cushions are hypoplastic compared to wildtype and that EphA3(-/-) endocardial cushion explants give rise to fewer migrating mesenchymal cells than wildtype explants. Thus our results indicate that EphA3 plays a crucial role in the development and morphogenesis of the cells that give rise to the atrioventricular valves and septa.

  11. Radiofrequency catheter ablation of idiopathic ventricular arrhythmias originating from intramural foci in the left ventricular outflow tract: efficacy of sequential versus simultaneous unipolar catheter ablation.

    PubMed

    Yamada, Takumi; Maddox, William R; McElderry, H Thomas; Doppalapudi, Harish; Plumb, Vance J; Kay, G Neal

    2015-04-01

    Idiopathic ventricular arrhythmias (VAs) originating from the left ventricular outflow tract (LVOT) sometimes require catheter ablation from the endocardial and epicardial sides for their elimination, suggesting the presence of intramural VA foci. This study investigated the efficacy of sequential and simultaneous unipolar radiofrequency catheter ablation from the endocardial and epicardial sides in treating intramural LVOT VAs. Fourteen consecutive LVOT VAs, which required sequential or simultaneous irrigated unipolar radiofrequency ablation from the endocardial and epicardial sides for their elimination, were studied. The first ablation was performed at the site with the earliest local ventricular activation and best pace map on the endocardial or epicardial side. When the first ablation was unsuccessful, the second ablation was delivered on the other surface. If this sequential unipolar ablation failed, simultaneous unipolar ablation from both sides was performed. The first ablation was performed on the epicardial side in 9 VAs and endocardial side in 5 VAs. The intramural LVOT VAs were successfully eliminated by the sequential (n=9) or simultaneous (n=5) unipolar catheter ablation. Simultaneous ablation was most likely to be required for the elimination of the VAs when the distance between the endocardial and epicardial ablation sites was >8 mm and the earliest local ventricular activation time relative to the QRS onset during the VAs of <-30 ms was recorded at those ablation sites. LVOT VAs originating from intramural foci could usually be eliminated by sequential unipolar radiofrequency ablation and sometimes required simultaneous ablation from both the endocardial and epicardial sides. © 2015 American Heart Association, Inc.

  12. 5-Year Outcome of Pulmonary Vein Isolation by Loss of Pace Capture on the Ablation Line Versus Electrical Circumferential Pulmonary Vein Isolation.

    PubMed

    Moser, Julia; Sultan, Arian; Lüker, Jakob; Servatius, Helge; Salzbrunn, Tim; Altenburg, Manuel; Schäffer, Benjamin; Schreiber, Doreen; Akbulak, Ruken Ö; Vogler, Julia; Hoffmann, Boris A; Willems, Stephan; Steven, Daniel

    2017-11-01

    This study sought to compare long-term arrhythmia-free survival between electrical circumferential pulmonary vein isolation (PVI) and PVI with the endpoint of unexcitability along the ablation line. PVI is the standard ablation strategy of paroxysmal atrial fibrillation, although arrhythmia recurrence in long-term follow-up (FU) is high. The endpoint of unexcitability along the ablation line results in decreased arrhythmia recurrence compared to electrical PVI in 1-year FU. Seventy-four consecutive patients (age 62.5 ± 10.6 years; 70.3% male) with de novo paroxysmal atrial fibrillation who were initially included in our randomized trial and underwent catheter ablation at our institution were analyzed. Patients who were randomized to either a conventional group (PVI, guided by circumferential catheter signals) or a pace-guided group (PG, anatomical ablation line encircling, ablation until loss of pace capture at 10 V, 2-ms pulse width on the ablation line) underwent long-term FU. The primary endpoint was recurrence of any atrial fibrillation or atrial tachycardia after a blanking period of 3 months. Sixty-nine patients completed a mean FU period of 5.14 ± 0.98 years. Arrhythmia-free survival without antiarrhythmic drug therapy was significantly higher in the PG group (71.05% vs. 25.81%, p = 0.002). Furthermore, multiple procedure success (1.29 ± 0.61 procedures in PG vs. 1.97 ± 1.06 procedures in conventional group, p < 0.001) was higher in the PG group compared to the conventional group (89.47% vs. 58.06%, p = 0.005). The endpoint of unexcitability along the PVI line improves success rates, resulting in a significant reduction of exposure to invasive procedures in 5-year FU. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. An abdominal active can defibrillator may facilitate a successful generator change when a lead failure is present.

    PubMed

    Solomon, A J; Moubarak, J B; Drood, J M; Tracy, C M; Karasik, P E

    1999-10-01

    Defibrillator generator changes are frequently performed on patients with an implantable cardioverter defibrillator in an abdominal pocket. These patients usually have epicardial patches or older endocardial lead systems. At the time of a defibrillator generator change defibrillation may be unsuccessful as a result of lead failure. We tested the hypothesis that an active can defibrillator implanted in the abdominal pocket could replace a non-functioning endocardial lead or epicardial patch. An abdominal defibrillator generator change was performed in 10 patients, (mean age = 67 +/- 13 years, nine men). Initially, a defibrillation threshold (DFT) was obtained using a passive defibrillator and the chronic endocardial or epicardial lead system. DFTs were then performed using an active can emulator and one chronic lead to simulate endocardial or epicardial lead failure. We tested 30 lead configurations (nine endocardial and 21 epicardial). Although a DFT of 7.3 +/- 4.2 joules was obtained with the intact chronic lead system, the active can emulator and one endocardial or epicardial lead still yielded an acceptable DFT of 19.9 +/- 6.1 joules. In addition, a successful implant (DFT < or = 24 joules) could have been accomplished in 28 of 30 (93%) lead configurations. An active can defibrillator in an abdominal pocket may allow for a successful generator change in patients with defibrillator lead malfunction. This would be simpler than abandoning the abdominal implant and moving to a new pectoral device and lead or tunnelling a new endocardial electrode. However, loss of defibrillation capability with a particular complex lead may be a warning of impending loss of other functions (eg. sensing and/or pacing).

  14. 32 CFR 536.56 - Negotiations-purpose and extent.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 true Negotiations-purpose and extent. 536.56 Section... CLAIMS AGAINST THE UNITED STATES Investigation and Processing of Claims § 536.56 Negotiations—purpose and extent. It is DA policy to settle meritorious claims promptly and fairly through direct negotiation at...

  15. 32 CFR 536.56 - Negotiations-purpose and extent.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 3 2013-07-01 2013-07-01 false Negotiations-purpose and extent. 536.56 Section... CLAIMS AGAINST THE UNITED STATES Investigation and Processing of Claims § 536.56 Negotiations—purpose and extent. It is DA policy to settle meritorious claims promptly and fairly through direct negotiation at...

  16. 32 CFR 536.56 - Negotiations-purpose and extent.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 true Negotiations-purpose and extent. 536.56 Section... CLAIMS AGAINST THE UNITED STATES Investigation and Processing of Claims § 536.56 Negotiations—purpose and extent. It is DA policy to settle meritorious claims promptly and fairly through direct negotiation at...

  17. 32 CFR 536.56 - Negotiations-purpose and extent.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Negotiations-purpose and extent. 536.56 Section... CLAIMS AGAINST THE UNITED STATES Investigation and Processing of Claims § 536.56 Negotiations—purpose and extent. It is DA policy to settle meritorious claims promptly and fairly through direct negotiation at...

  18. 32 CFR 536.56 - Negotiations-purpose and extent.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false Negotiations-purpose and extent. 536.56 Section... CLAIMS AGAINST THE UNITED STATES Investigation and Processing of Claims § 536.56 Negotiations—purpose and extent. It is DA policy to settle meritorious claims promptly and fairly through direct negotiation at...

  19. Probabilistic Forecasting of Arctic Sea Ice Extent

    NASA Astrophysics Data System (ADS)

    Slater, A. G.

    2013-12-01

    Sea ice in the Arctic is changing rapidly. Most noticeable has been the series of record, or near-record, annual minimums in sea ice extent in the past six years. The changing regime of sea ice has prompted much interest in seasonal prediction of sea ice extent, particularly as opportunities for Arctic shipping and resource exploration or extraction increase. This study presents a daily sea ice extent probabilistic forecast method with a 50-day lead time. A base projection is made from historical data and near-real-time sea ice concentration is assimilated on the issue date of the forecast. When considering the September mean ice extent for the period 1995-2012, the performance of the 50-day lead time forecast is very good: correlation=0.94, Bias = 0.14 ×106 km^2 and RMSE = 0.36 ×106 km^2. Forecasts for the daily minimum contains equal skill levels. The system is highly competitive with any of the SEARCH Sea Ice Outlook estimates. The primary finding of this study is that large amounts of forecast skill can be gained from knowledge of the initial conditions of concentration (perhaps more than previously thought). Given the simplicity of the forecast model, improved skill should be available from system refinement and with suitable proxies for large scale atmosphere and ocean circulation.

  20. 14 CFR 252.8 - Extent of smoking restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Extent of smoking restrictions. 252.8... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.8 Extent of smoking restrictions. The restrictions on smoking described in §§ 252.3 through 252.7 shall apply to all locations within the aircraft. ...

  1. 14 CFR 252.8 - Extent of smoking restrictions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Extent of smoking restrictions. 252.8... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.8 Extent of smoking restrictions. The restrictions on smoking described in §§ 252.3 through 252.7 shall apply to all locations within the aircraft. ...

  2. 14 CFR 252.8 - Extent of smoking restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Extent of smoking restrictions. 252.8... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.8 Extent of smoking restrictions. The restrictions on smoking described in §§ 252.3 through 252.7 shall apply to all locations within the aircraft. ...

  3. 14 CFR 252.8 - Extent of smoking restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Extent of smoking restrictions. 252.8... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.8 Extent of smoking restrictions. The restrictions on smoking described in §§ 252.3 through 252.7 shall apply to all locations within the aircraft. ...

  4. 14 CFR 252.8 - Extent of smoking restrictions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Extent of smoking restrictions. 252.8... PROCEEDINGS) ECONOMIC REGULATIONS SMOKING ABOARD AIRCRAFT § 252.8 Extent of smoking restrictions. The restrictions on smoking described in §§ 252.3 through 252.7 shall apply to all locations within the aircraft. ...

  5. Bi-ventricular finite element model of right ventricle overload in the healthy rat heart.

    PubMed

    Masithulela, Fulufhelo

    2016-11-25

    The recognition of RV overpressure is critical to human life, as this may signify morbidity and mortality. Right ventricle (RV) dysfunction is understood to have an impact on the performance of the left ventricle (LV), but the mechanisms remain poorly understood. It is understood that ventricular compliance has the ability to affect cardiac performance. In this study, a bi-ventricular model of the rat heart was used in preference to other, single-ventricle models. Finite element analysis (FEA) of the bi-ventricular model provides important information on the function of the healthy heart. The passive myocardium was modelled as a nearly incompressible, hyperelastic, transversely isotropic material using finite element (FE) methods. Bi-ventricular geometries of healthy rat hearts reconstructed from magnetic resonance images were imported in Abaqus©. In simulating the normal passive filling of the rat heart, pressures of 4.8 kPa and 0.0098 kPa were applied to the inner walls of the LV and RV respectively. In addition, to simulate the overpressure of the RV, pressures of 2.4 kPa and 4.8 kPa were applied to the endocardial walls of the LV and RV respectively. As boundary conditions, the circumferential and longitudinal displacements at the base were set to zero. The radial displacements at the base were left free. The results show that the average circumferential stress at the mid-wall in the overloaded model increased from 2.8 kPa to 18.2 kPa. The average longitudinal stress increased from 1.5 kPa to 9.7 kPa. Additionally, in the radial direction, the average stress increased from 0.1 kPa to 0.6 kPa in the mid-wall. The average circumferential strain was found to be 0.138 and 0.100 on the endocardium of the over pressured and healthy model respectively. The average circumferential stress at the epicardium, mid-wall and endocardium in the case of a normal heart is 10 times lower than in the overloaded heart model. The finite analysis method is able to provide

  6. A mathematical model of action potential heterogeneity in adult rat left ventricular myocytes.

    PubMed Central

    Pandit, S V; Clark, R B; Giles, W R; Demir, S S

    2001-01-01

    Mathematical models were developed to reconstruct the action potentials (AP) recorded in epicardial and endocardial myocytes isolated from the adult rat left ventricle. The main goal was to obtain additional insight into the ionic mechanisms responsible for the transmural AP heterogeneity. The simulation results support the hypothesis that the smaller density and the slower reactivation kinetics of the Ca(2+)-independent transient outward K(+) current (I(t)) in the endocardial myocytes can account for the longer action potential duration (APD), and more prominent rate dependence in that cell type. The larger density of the Na(+) current (I(Na)) in the endocardial myocytes results in a faster upstroke (dV/dt(max)). This, in addition to the smaller magnitude of I(t), is responsible for the larger peak overshoot of the simulated endocardial AP. The prolonged APD in the endocardial cell also leads to an enhanced amplitude of the sustained K(+) current (I(ss)), and a larger influx of Ca(2+) ions via the L-type Ca(2+) current (I(CaL)). The latter results in an increased sarcoplasmic reticulum (SR) load, which is mainly responsible for the higher peak systolic value of the Ca(2+) transient [Ca(2+)](i), and the resultant increase in the Na(+)-Ca(2+) exchanger (I(NaCa)) activity, associated with the simulated endocardial AP. In combination, these calculations provide novel, quantitative insights into the repolarization process and its naturally occurring transmural variations in the rat left ventricle. PMID:11720973

  7. Right Ventricular Strain, Torsion, and Dyssynchrony in Healthy Subjects using 3D Spiral Cine DENSE Magnetic Resonance Imaging

    PubMed Central

    Suever, Jonathan D; Wehner, Gregory J; Jing, Linyuan; Powell, David K; Hamlet, Sean M; Grabau, Jonathan D; Mojsejenko, Dimitri; Andres, Kristin N; Haggerty, Christopher M; Fornwalt, Brandon K

    2017-01-01

    Mechanics of the left ventricle (LV) are important indicators of cardiac function. The role of right ventricular (RV) mechanics is largely unknown due to the technical limitations of imaging its thin wall and complex geometry and motion. By combining 3D Displacement Encoding with Stimulated Echoes (DENSE) with a post-processing pipeline that includes a local coordinate system, it is possible to quantify RV strain, torsion, and synchrony. In this study, we sought to characterize RV mechanics in 50 healthy individuals and compare these values to their LV counterparts. For each cardiac frame, 3D displacements were fit to continuous and differentiable radial basis functions, allowing for the computation of the 3D Cartesian Lagrangian strain tensor at any myocardial point. The geometry of the RV was extracted via a surface fit to manually delineated endocardial contours. Throughout the RV, a local coordinate system was used to transform from a Cartesian strain tensor to a polar strain tensor. It was then possible to compute peak RV torsion as well as peak longitudinal and circumferential strain. A comparable analysis was performed for the LV. Dyssynchrony was computed from the standard deviation of regional activation times. Global circumferential strain was comparable between the RV and LV (−18.0% for both) while longitudinal strain was greater in the RV (−18.1% vs. −15.7%). RV torsion was comparable to LV torsion (6.2 vs. 7.1 degrees, respectively). Regional activation times indicated that the RV contracted later but more synchronously than the LV. 3D spiral cine DENSE combined with a post–processing pipeline that includes a local coordinate system can resolve both the complex geometry and 3D motion of the RV. PMID:28055859

  8. Real-time flood extent maps based on social media

    NASA Astrophysics Data System (ADS)

    Eilander, Dirk; van Loenen, Arnejan; Roskam, Ruud; Wagemaker, Jurjen

    2015-04-01

    During a flood event it is often difficult to get accurate information about the flood extent and the people affected. This information is very important for disaster risk reduction management and crisis relief organizations. In the post flood phase, information about the flood extent is needed for damage estimation and calibrating hydrodynamic models. Currently, flood extent maps are derived from a few sources such as satellite images, areal images and post-flooding flood marks. However, getting accurate real-time or maximum flood extent maps remains difficult. With the rise of social media, we now have a new source of information with large numbers of observations. In the city of Jakarta, Indonesia, the intensity of unique flood related tweets during a flood event, peaked at 8 tweets per second during floods in early 2014. A fair amount of these tweets also contains observations of water depth and location. Our hypothesis is that based on the large numbers of tweets it is possible to generate real-time flood extent maps. In this study we use tweets from the city of Jakarta, Indonesia, to generate these flood extent maps. The data-mining procedure looks for tweets with a mention of 'banjir', the Bahasa Indonesia word for flood. It then removes modified and retweeted messages in order to keep unique tweets only. Since tweets are not always sent directly from the location of observation, the geotag in the tweets is unreliable. We therefore extract location information using mentions of names of neighborhoods and points of interest. Finally, where encountered, a mention of a length measure is extracted as water depth. These tweets containing a location reference and a water level are considered to be flood observations. The strength of this method is that it can easily be extended to other regions and languages. Based on the intensity of tweets in Jakarta during a flood event we can provide a rough estimate of the flood extent. To provide more accurate flood extend

  9. How Infants Encode Spatial Extent

    ERIC Educational Resources Information Center

    Duffy, Sean; Huttenlocher, Janellen; Levine, Susan; Duffy, Renee

    2005-01-01

    This study explores how infants encode an object's spatial extent. We habituated 6.5-month-old infants to a dowel inside a container and then tested whether they dishabituate to a change in absolute size when the relation between dowel and container is held constant (by altering the size of both container and dowel) and when the relation changes…

  10. A randomized pilot study of optimization of cardiac resynchronization therapy in sinus rhythm patients using a peak endocardial acceleration sensor vs. standard methods.

    PubMed

    Ritter, Philippe; Delnoy, Peter Paul H M; Padeletti, Luigi; Lunati, Maurizio; Naegele, Herbert; Borri-Brunetto, Alberto; Silvestre, Jorge

    2012-09-01

    Non-response rate to cardiac resynchronization therapy (CRT) might be decreased by optimizing device programming. The Clinical Evaluation on Advanced Resynchronization (CLEAR) study aimed to assess the effects of CRT with automatically optimized atrioventricular (AV) and interventricular (VV) delays, based on a Peak Endocardial Acceleration (PEA) signal system. This multicentre, single-blind study randomized patients in a 1 : 1 ratio to CRT optimized either automatically by the PEA-based system, or according to centres' usual practices, mostly by echocardiography. Patients had heart failure (HF) New York Heart Association (NYHA) functional class III/IV, left ventricular ejection fraction (LVEF) <35%, QRS duration >150 or >120 ms with mechanical dyssynchrony. Follow-up was 1 year. The primary endpoint was the proportion of patients who improved their condition at 1 year, based on a composite of all-cause death, HF hospitalizations, NYHA class, and quality of life. In all, 268 patients in sinus rhythm (63% men; mean age: 73.1 ± 9.9 years; mean NYHA: 3.0 ± 0.3; mean LVEF: 27.1 ± 8.1%; and mean QRS duration: 160.1 ± 22.0 ms) were included and 238 patients were randomized, 123 to PEA and 115 to the control group. At 1 year, 76% of patients assigned to PEA were classified as improved, vs. 62% in the control group (P= 0.0285). The percentage of patients with improved NYHA class was significantly (P= 0.0020) higher in the PEA group than in controls. Fatal and non-fatal adverse events were evenly distributed between the groups. PEA-based optimization of CRT in HF patients significantly increased the proportion of patients who improved with therapy, mainly through improved NYHA class, after 1 year of follow-up.

  11. Zero-fluoroscopy cryothermal ablation of atrioventricular nodal re-entry tachycardia guided by endovascular and endocardial catheter visualization using intracardiac echocardiography (Ice&ICE Trial).

    PubMed

    Luani, Blerim; Zrenner, Bernhard; Basho, Maksim; Genz, Conrad; Rauwolf, Thomas; Tanev, Ivan; Schmeisser, Alexander; Braun-Dullaeus, Rüdiger C

    2018-01-01

    Stochastic damage of the ionizing radiation to both patients and medical staff is a drawback of fluoroscopic guidance during catheter ablation of cardiac arrhythmias. Therefore, emerging zero-fluoroscopy catheter-guidance techniques are of great interest. We investigated, in a prospective pilot study, the feasibility and safety of the cryothermal (CA) slow-pathway ablation in patients with symptomatic atrioventricular-nodal-re-entry-tachycardia (AVNRT) using solely intracardiac echocardiography (ICE) for endovascular and endocardial catheter visualization. Twenty-five consecutive patients (mean age 55.6 ± 12.0 years, 17 female) with ECG-documentation or symptoms suggesting AVNRT underwent an electrophysiology study (EPS) in our laboratory utilizing ICE for catheter navigation. Supraventricular tachycardia was inducible in 23 (92%) patients; AVNRT was confirmed by appropriate stimulation maneuvers in 20 (80%) patients. All EPS in the AVNRT subgroup could be accomplished without need for fluoroscopy, relying solely on ICE-guidance. CA guided by anatomical location and slow-pathway potentials was successful in all patients, median cryo-mappings = 6 (IQR:3-10), median cryo-ablations = 2 (IQR:1-3). Fluoroscopy was used to facilitate the trans-septal puncture and localization of the ablation substrate in the remaining 3 patients (one focal atrial tachycardia and two atrioventricular-re-entry-tachycardias). Mean EPS duration in the AVNRT subgroup was 99.8 ± 39.6 minutes, ICE guided catheter placement 11.9 ± 5.8 minutes, time needed for diagnostic evaluation 27.1 ± 10.8 minutes, and cryo-application duration 26.3 ± 30.8 minutes. ICE-guided zero-fluoroscopy CA in AVNRT patients is feasible and safe. Real-time visualization of the true endovascular borders and cardiac structures allow for safe catheter navigation during the ICE-guided EPS and might be an alternative to visualization technologies using geometry reconstructions. © 2017 Wiley Periodicals, Inc.

  12. Turbulent Swirling Flow Downstream of an Abrupt Pipe Expansion -- Modeling and Experimental Measurements.

    DTIC Science & Technology

    1982-07-01

    aerospace engineering um~Ŕ" eqe~vswse 0engiee amp snry stem englnerlag. enI~e so ISaCW , meterI scienc Turbulent Swirling Flow Dowstreas of an Abrupt...With the horizontal test section and circumferentially local measurements, the extent of the influence of gravity -induced convection can be determined

  13. Endocardial cushion defect

    MedlinePlus

    ... Philadelphia, PA: Elsevier; 2016:chap 426. Kouchoukos NT, Blackstone EH, Hanley FL, Kirklin JK. Atrioventricular septal defect. In: Kouchoukos NT, Blackstone EH, Hanley FL, Kirklin JK, eds. Kirklin/Barratt- ...

  14. Circumferential urinary sphincter surface electromyography: A novel diagnostic method for intrinsic sphincter deficiency.

    PubMed

    Heesakkers, John; Gerretsen, Reza; Izeta, Ander; Sievert, Karl-Dietrich; Farag, Fawzy

    2016-02-01

    The diagnosis of intrinsic sphincter deficiency (ISD) in patients with stress urinary incontinence (SUI) is not well established. We explored the possibility of applying a new tool: minimally invasive circumferential sphincter surface electromyography (CSS-EMG) to assess the muscular integrity of the urethral sphincter in patients with SUI/ISD. CSS-EMG of the urethral sphincter and urodynamic studies were performed in 44 women with SUI. A urethral pressure profile (UPP) was measured in four directions. Maximal urethral closure pressure (MUCP) <40 cm/H2 O or the presence of SUI without urethral hypermobility was used to define ISD. Twenty-one patients had urodynamic SUI, 23 had no SUI and 12 patients had ISD. The mean average rectified value (ARV) of the motor unit action potential (MUAP), an indicator of the strength of urethral rhabdosphincter, was estimated. ARV measured in the 12 o'clock quadrant during maximal contraction was the only CSS-EMG parameter that had significant predictive value for ISD. With an increase in the 12 o'clock ARV value, the likelihood of ISD decreases (Odds Ratio 0.36 95% confidence interval 0.67-0.92). In the ROC curve with ARV measured in the 12 o'clock quadrant during maximal contraction, the explained area was 0.794 (P = 0.02); implying that ARV measured at the 12 o'clock quadrant during maximal contraction was able to predict ISD significantly. Myogenic changes of the urethral sphincter that contribute to ISD can be assessed with CSS-EMG. This new concept for assessing the functionality of the female urethral sphincter may assist with better understanding of the pathophysiology, the diagnosis and the treatment of SUI. © 2014 Wiley Periodicals, Inc.

  15. Gonioscopy-assisted Transluminal Trabeculotomy: An Ab Interno Circumferential Trabeculotomy: 24 Months Follow-up.

    PubMed

    Grover, Davinder S; Smith, Oluwatosin; Fellman, Ronald L; Godfrey, David G; Gupta, Aditi; Montes de Oca, Ildamaris; Feuer, William J

    2018-05-01

    The purpose of this study was to provide 24-month follow-up on surgical success and safety of an ab interno circumferential 360-degree trabeculotomy. Chart review of patients who underwent a gonioscopy-assisted transluminal trabeculotomy (GATT) procedure was performed by 4 of the authors (D.S.G., O.S., R.L.F., and D.G.G.). The surgery was performed in adults with various types of open-angle glaucoma with preoperative intraocular pressures (IOPs) of ≥18 mm Hg. In total, 198 patients aged 24 to 89 years underwent the GATT procedure with at least 18 months follow-up. Patients with primary open-angle glaucoma had an average IOP decrease of 9.2 mm Hg at 24 months with an average decrease of 1.43 glaucoma medications. The mean percentage of IOP decrease in these primary open-angle glaucoma groups at 24 months was 37.3%. In secondary open-angle glaucoma, at 24 months there was an average decrease in IOP of 14.1 mm Hg on an average of 2.0 fewer medications. The mean percentage of IOP decrease in the secondary open-angle glaucoma groups at 24 months was 49.8%. The cumulative proportion of failure at 24 months ranged from 0.18 to 0.48, depending on the group. In all 6 study groups, at all 5 postoperative time points (3, 6, 12, 18, and 24 mo) the mean IOP and reduction in glaucoma medications was significantly reduced from baseline (P<0.001) with the exception of one time point. The 24-month results demonstrate that GATT is relatively safe and effective in treating various forms of open-angle glaucoma. The long-term results for GATT are relatively equivalent to those previously reported for GATT and ab externo trabeculotomy studies.

  16. A method for the measurement of dispersion curves of circumferential guided waves radiating from curved shells: experimental validation and application to a femoral neck mimicking phantom

    NASA Astrophysics Data System (ADS)

    Nauleau, Pierre; Minonzio, Jean-Gabriel; Chekroun, Mathieu; Cassereau, Didier; Laugier, Pascal; Prada, Claire; Grimal, Quentin

    2016-07-01

    Our long-term goal is to develop an ultrasonic method to characterize the thickness, stiffness and porosity of the cortical shell of the femoral neck, which could enhance hip fracture risk prediction. To this purpose, we proposed to adapt a technique based on the measurement of guided waves. We previously evidenced the feasibility of measuring circumferential guided waves in a bone-mimicking phantom of a circular cross-section of even thickness. The goal of this study is to investigate the impact of the complex geometry of the femoral neck on the measurement of guided waves. Two phantoms of an elliptical cross-section and one phantom of a realistic cross-section were investigated. A 128-element array was used to record the inter-element response matrix of these waveguides. This experiment was simulated using a custom-made hybrid code. The response matrices were analyzed using a technique based on the physics of wave propagation. This method yields portions of dispersion curves of the waveguides which were compared to reference dispersion curves. For the elliptical phantoms, three portions of dispersion curves were determined with a good agreement between experiment, simulation and theory. The method was thus validated. The characteristic dimensions of the shell were found to influence the identification of the circumferential wave signals. The method was then applied to the signals backscattered by the superior half of constant thickness of the realistic phantom. A cut-off frequency and some portions of modes were measured, with a good agreement with the theoretical curves of a plate waveguide. We also observed that the method cannot be applied directly to the signals backscattered by the lower half of varying thicknesses of the phantom. The proposed approach could then be considered to evaluate the properties of the superior part of the femoral neck, which is known to be a clinically relevant site.

  17. Spiral-wave dynamics in a mathematical model of human ventricular tissue with myocytes and Purkinje fibers.

    PubMed

    Nayak, Alok Ranjan; Panfilov, A V; Pandit, Rahul

    2017-02-01

    We present systematic numerical studies of the possible effects of the coupling of human endocardial and Purkinje cells at cellular and two-dimensional tissue levels. We find that the autorhythmic-activity frequency of the Purkinje cell in a composite decreases with an increase in the coupling strength; this can even eliminate the autorhythmicity. We observe a delay between the beginning of the action potentials of endocardial and Purkinje cells in a composite; such a delay increases as we decrease the diffusive coupling, and eventually a failure of transmission occurs. An increase in the diffusive coupling decreases the slope of the action-potential-duration-restitution curve of an endocardial cell in a composite. By using a minimal model for the Purkinje network, in which we have a two-dimensional, bilayer tissue, with a layer of Purkinje cells on top of a layer of endocardial cells, we can stabilize spiral-wave turbulence; however, for a sparse distribution of Purkinje-ventricular junctions, at which these two layers are coupled, we can also obtain additional focal activity and many complex transient regimes. We also present additional effects resulting from the coupling of Purkinje and endocardial layers and discuss the relation of our results to the studies performed in anatomically accurate models of the Purkinje network.

  18. Complex cardiac defects after ethanol exposure during discrete cardiogenic events in zebrafish: Prevention with folic acid

    PubMed Central

    Sarmah, Swapnalee; Marrs, James A.

    2014-01-01

    BACKGROUND Fetal alcohol spectrum disorder (FASD) describes a range of birth defects including various congenital heart defects (CHDs). Mechanisms of FASD-associated CHDs are not understood. Whether alcohol interferes with a single critical event or with multiple events in heart formation is not known. RESULTS Our zebrafish embryo experiments showed that ethanol interrupts different cardiac regulatory networks and perturbed multiple steps of cardiogenesis (specification, myocardial migration, looping, chamber morphogenesis and endocardial cushion formation). Ethanol exposure during gastrulation until cardiac specification or during myocardial midline migration did not produce severe or persistent heart development defects. However, exposure comprising gastrulation until myocardial precursor midline fusion or during heart patterning stages produced aberrant heart looping and defective endocardial cushions. Continuous exposure during entire cardiogenesis produced complex cardiac defects leading to severely defective myocardium, endocardium, and endocardial cushions. Supplementation of retinoic acid with ethanol partially rescued early heart developmental defects, but the endocardial cushions did not form correctly. In contrast, supplementation of folic acid rescued normal heart development, including the endocardial cushions. CONCLUSIONS Our results indicate that ethanol exposure interrupted divergent cardiac morphogenesis events causing heart defects. Folic acid supplementation was effective in preventing a wide spectrum of ethanol-induced heart developmental defects. PMID:23832875

  19. Spiral-wave dynamics in a mathematical model of human ventricular tissue with myocytes and Purkinje fibers

    NASA Astrophysics Data System (ADS)

    Nayak, Alok Ranjan; Panfilov, A. V.; Pandit, Rahul

    2017-02-01

    We present systematic numerical studies of the possible effects of the coupling of human endocardial and Purkinje cells at cellular and two-dimensional tissue levels. We find that the autorhythmic-activity frequency of the Purkinje cell in a composite decreases with an increase in the coupling strength; this can even eliminate the autorhythmicity. We observe a delay between the beginning of the action potentials of endocardial and Purkinje cells in a composite; such a delay increases as we decrease the diffusive coupling, and eventually a failure of transmission occurs. An increase in the diffusive coupling decreases the slope of the action-potential-duration-restitution curve of an endocardial cell in a composite. By using a minimal model for the Purkinje network, in which we have a two-dimensional, bilayer tissue, with a layer of Purkinje cells on top of a layer of endocardial cells, we can stabilize spiral-wave turbulence; however, for a sparse distribution of Purkinje-ventricular junctions, at which these two layers are coupled, we can also obtain additional focal activity and many complex transient regimes. We also present additional effects resulting from the coupling of Purkinje and endocardial layers and discuss the relation of our results to the studies performed in anatomically accurate models of the Purkinje network.

  20. 5 CFR 1.2 - Extent of the competitive service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Extent of the competitive service. 1.2... DEFINITIONS (RULE I) § 1.2 Extent of the competitive service. The competitive service shall include: (a) All... subject to the civil service laws by statute. OPM is authorized and directed to determine finally whether...

  1. 5 CFR 1.2 - Extent of the competitive service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Extent of the competitive service. 1.2... DEFINITIONS (RULE I) § 1.2 Extent of the competitive service. The competitive service shall include: (a) All... subject to the civil service laws by statute. OPM is authorized and directed to determine finally whether...

  2. klf2a couples mechanotransduction and zebrafish valve morphogenesis through fibronectin synthesis

    PubMed Central

    Steed, Emily; Faggianelli, Nathalie; Roth, Stéphane; Ramspacher, Caroline; Concordet, Jean-Paul; Vermot, Julien

    2016-01-01

    The heartbeat and blood flow signal to endocardial cell progenitors through mechanosensitive proteins that modulate the genetic program controlling heart valve morphogenesis. To date, the mechanism by which mechanical forces coordinate tissue morphogenesis is poorly understood. Here we use high-resolution imaging to uncover the coordinated cell behaviours leading to heart valve formation. We find that heart valves originate from progenitors located in the ventricle and atrium that generate the valve leaflets through a coordinated set of endocardial tissue movements. Gene profiling analyses and live imaging reveal that this reorganization is dependent on extracellular matrix proteins, in particular on the expression of fibronectin1b. We show that blood flow and klf2a, a major endocardial flow-responsive gene, control these cell behaviours and fibronectin1b synthesis. Our results uncover a unique multicellular layering process leading to leaflet formation and demonstrate that endocardial mechanotransduction and valve morphogenesis are coupled via cellular rearrangements mediated by fibronectin synthesis. PMID:27221222

  3. The role of surgery in the treatment of post-infarction ventricular tachycardia. A 5 year experience.

    PubMed

    Martinelli, L; Goggi, C; Graffigna, A; Salerno, J A; Chimienti, M; Klersy, C; Viganò, M

    1987-01-01

    The purpose of this report is to present a 5 year experience in electrophysiologically guided surgical treatment of post-infarction ventricular tachycardia (VT) in a consecutive series of 39 patients. In every case the arrhythmia was not responsive to pluripharmacological therapy. The diagnostic steps included preoperative endocardial, intraoperative epi- and endocardial mapping, automatically carried out when possible. Surgical techniques were: classic Guiraudon's encircling endocardial ventriculotomy (EEV), partial EEV, endocardial resection (ER), cryoablation or combined procedures. The hospital mortality was of 4 patients (10%). During the follow-up period (1-68 mo), 4 patients (11%) died of cardiac non-VT related causes. Among the survivors, 90% are in sinus rhythm. The authors consider electrophysiologically guided surgery a safe and reliable method for the treatment of post-infarction VT and suggest more extensive indications. They stress the importance of automatic mapping in pleomorphic and non-sustained VT, and the necessity of tailoring the surgical technique to the characteristics of each case.

  4. Global Warming and Northern Hemisphere Sea Ice Extent.

    PubMed

    Vinnikov; Robock; Stouffer; Walsh; Parkinson; Cavalieri; Mitchell; Garrett; Zakharov

    1999-12-03

    Surface and satellite-based observations show a decrease in Northern Hemisphere sea ice extent during the past 46 years. A comparison of these trends to control and transient integrations (forced by observed greenhouse gases and tropospheric sulfate aerosols) from the Geophysical Fluid Dynamics Laboratory and Hadley Centre climate models reveals that the observed decrease in Northern Hemisphere sea ice extent agrees with the transient simulations, and both trends are much larger than would be expected from natural climate variations. From long-term control runs of climate models, it was found that the probability of the observed trends resulting from natural climate variability, assuming that the models' natural variability is similar to that found in nature, is less than 2 percent for the 1978-98 sea ice trends and less than 0.1 percent for the 1953-98 sea ice trends. Both models used here project continued decreases in sea ice thickness and extent throughout the next century.

  5. Michelin tire baby syndrome: a review of the literature and a proposal for diagnostic criteria with adoption of the name circumferential skin folds syndrome.

    PubMed

    Rothman, Ilene L

    2014-01-01

    The term Michelin tire baby (MTB), named for the cartoon mascot of the Michelin Tire Company, has been used to describe babies with multiple symmetric circumferential rings of folded skin. In those reported with this phenotype who had skin biopsies, pathology has shown nevus lipomatosis, smooth muscle hamartoma, degenerative collagen, and scarring. Others did not undergo biopsy or had normal skin. Many individuals with the MTB phenotype have had a variety of other congenital anomalies. I review the literature on MTB and the history of the designation Michelin tire baby Syndrome (MTBS). Because the term MTBS has been poorly defined or not defined at all, I propose strict criteria for diagnosis. In doing so, it is recommended that the syndrome be renamed to avoid further confusion. © 2014 Wiley Periodicals, Inc.

  6. 46 CFR 56.95-10 - Type and extent of examination required.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Type and extent of examination required. 56.95-10 Section 56.95-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING PIPING SYSTEMS AND APPURTENANCES Inspection § 56.95-10 Type and extent of examination required. (a) General. The types and extent of nondestructive...

  7. 46 CFR 56.95-10 - Type and extent of examination required.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Type and extent of examination required. 56.95-10 Section 56.95-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING PIPING SYSTEMS AND APPURTENANCES Inspection § 56.95-10 Type and extent of examination required. (a) General. The types and extent of nondestructive...

  8. 46 CFR 56.95-10 - Type and extent of examination required.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Type and extent of examination required. 56.95-10 Section 56.95-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING PIPING SYSTEMS AND APPURTENANCES Inspection § 56.95-10 Type and extent of examination required. (a) General. The types and extent of nondestructive...

  9. 46 CFR 56.95-10 - Type and extent of examination required.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Type and extent of examination required. 56.95-10 Section 56.95-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING PIPING SYSTEMS AND APPURTENANCES Inspection § 56.95-10 Type and extent of examination required. (a) General. The types and extent of nondestructive...

  10. Observed Differences between North American Snow Extent and Snow Depth Variability

    NASA Astrophysics Data System (ADS)

    Ge, Y.; Gong, G.

    2006-12-01

    Snow extent and snow depth are two related characteristics of a snowpack, but they need not be mutually consistent. Differences between these two variables at local scales are readily apparent. However at larger scales which interact with atmospheric circulation and climate, snow extent is typically the variable used, while snow depth is often assumed to be minor and/or mutually consistent compared to snow extent, though this is rarely verified. In this study, a new regional/continental-scale gridded dataset derived from field observations is utilized to quantitatively evaluate the relationship between snow extent and snow depth over North America. Various statistical methods are applied to assess the mutual consistency of monthly snow depth vs. snow extent, including correlations, composites and principal components. Results indicate that snow depth variations are significant in their own rights, and that depth and extent anomalies are largely unrelated, especially over broad high latitude regions north of the snowline. In the vicinity of the snowline, where precipitation and ablation can affect both snow extent and snow depth, the two variables vary concurrently, especially in autumn and spring. It is also found that deeper winter snow translates into larger snow-covered area in the subsequent spring/summer season, which suggests a possible influence of winter snow depth on summer climate. The observed lack of mutual consistency at continental/regional scales suggests that snowpack depth variations may be of sufficiently large magnitude, spatial scope and temporal duration to influence regional-hemispheric climate, in a manner unrelated to the more extensively studied snow extent variations.

  11. Usefulness of Epicardial Area in the Short Axis to Identify Elevated Left Ventricular Mass in Men.

    PubMed

    Fitzpatrick, Jesse K; Cohen, Beth E; Rosenblatt, Andrew; Shaw, Richard E; Schiller, Nelson B

    2018-06-15

    Left ventricular (LV) hypertrophy is strongly associated with increased cardiovascular morbidity and mortality. The 2-dimensional LV mass algorithms suffer from measurement variability that can lead to misclassification of patients with LV hypertrophy as normal, or vice versa. Among the 4 echocardiographic measurements required by the 2-dimensional LV mass algorithms, epicardial and endocardial area have the lowest interobserver variation and could be used to corroborate LV mass calculations. We sought cut-off values that are able to discriminate between elevated and normal LV mass based on endocardial or epicardial area alone. Using data from 664 men enrolled in the Mind Your Heart Study, we calculated the correlation of LV mass index with epicardial area and endocardial area. We then used receiver operator characteristic curves to identify epicardial and endocardial area cut-points that could discriminate subjects with normal LV mass and LV hypertrophy. LV mass index was more strongly correlated with epicardial area compared with endocardial area, r = 0.70 versus r = 0.27, respectively. Epicardial area had a significantly higher area under the receiver operator characteristic curve (p <0.001) compared with endocardial area, 0.90 (95% confidence interval 0.86 to 0.93) versus 0.63 (95% confidence interval 0.57 to 0.71). An epicardial area cut-point of ≥38.0 cm 2 corresponded to a sensitivity of 95.0% and specificity of 54.4% for detecting LV hypertrophy. In conclusion, epicardial area showed promise as a method of rapid screening for LV hypertrophy and could be used to validate formal LV mass calculations. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Estimating the Extent of School Restructuring.

    ERIC Educational Resources Information Center

    Brief to Policymakers, 1992

    1992-01-01

    Findings of three studies that investigated the extent of school restructuring in American schools are presented in this paper. The data are combined from three different sources: (1) a national survey of 268 schools nominated for their successful restructuring programs; (2) a survey of 100 restructuring proposals submitted to a funding…

  13. Predictors of chronic pulmonary vein reconnections after contact force-guided ablation: importance of completing electrical isolation with circumferential lines and creating sufficient ablation lesion densities.

    PubMed

    Nakamura, Kohki; Naito, Shigeto; Sasaki, Takehito; Minami, Kentaro; Take, Yutaka; Shimizu, Satoru; Yamaguchi, Yoshiaki; Yano, Toshiaki; Senga, Michiharu; Yamashita, Eiji; Sugai, Yoshinao; Kumagai, Koji; Funabashi, Nobusada; Oshima, Shigeru

    2016-12-01

    We aimed to identify the predictors of chronic pulmonary vein reconnections (CPVRs) after contact force (CF)-guided circumferential PV isolation (CPVI) of atrial fibrillation (AF). Forty-nine consecutive patients undergoing second ablation procedures for recurrent AF after CF-guided ablation were retrospectively studied. The CPVI was performed by point-by-point ablation with a target CF of 15-20 g. The incidence of CPVRs was evaluated along the right- and left-sided anterior and posterior CPVI regions (Ant-RPVs, Post-RPVs, Ant-LPVs, and Post-LPVs). CPVRs were observed in 30.6, 22.4, 20.4, and 32.7 % of patients along the Ant-RPVs, Post-RPVs, Ant-LPVs, and Post-LPVs, respectively (P = 0.436). In the multivariate logistic analyses, completing a left atrium-PV conduction block with touch-up ablation inside the initially estimated CPVI lines (Ant-RPVs, Post-RPVs, Ant-LPVs, Post-LPVs; odds ratio [OR] 5.747, 15.000, 207.619, 7.940; P = 0.032, 0.004, 0.034, 0.021) and region length (Post-LPVs; OR 3.183, P = 0.027) were positive predictors of CPVRs, while the mean CF (Ant-RPVs; OR 0.861, P = 0.045) and number of radiofrequency applications per unit length (Ant-LPVs, Post-LPVs; OR 0.038, 0.122; P = 0.034, 0.029) were negative predictors. At optimal cutoffs of 5.8 cm for the region length, 14.2 g for the mean CF, and 1.97/cm (Ant-LPVs) and 2.01/cm (Post-LPVs) for the radiofrequency application density, the sensitivity and specificity were 93.8 and 63.6 %, 60.0 and 76.5 %, 90.0 and 64.1 %, and 75.0 and 63.6 %, respectively. Completing PVI with circumferential lines without touch-up ablation and creating a sufficient density of radiofrequency ablation lesions on the lines with a sufficient CF may be necessary to prevent CPVRs after a CF-guided CPVI.

  14. Biomechanics of the Chick Embryonic Heart Outflow Tract at HH18 Using 4D Optical Coherence Tomography Imaging and Computational Modeling

    PubMed Central

    Liu, Aiping; Yin, Xin; Shi, Liang; Li, Peng; Thornburg, Kent L.; Wang, Ruikang; Rugonyi, Sandra

    2012-01-01

    During developmental stages, biomechanical stimuli on cardiac cells modulate genetic programs, and deviations from normal stimuli can lead to cardiac defects. Therefore, it is important to characterize normal cardiac biomechanical stimuli during early developmental stages. Using the chicken embryo model of cardiac development, we focused on characterizing biomechanical stimuli on the Hamburger–Hamilton (HH) 18 chick cardiac outflow tract (OFT), the distal portion of the heart from which a large portion of defects observed in humans originate. To characterize biomechanical stimuli in the OFT, we used a combination of in vivo optical coherence tomography (OCT) imaging, physiological measurements and computational fluid dynamics (CFD) modeling. We found that, at HH18, the proximal portion of the OFT wall undergoes larger circumferential strains than its distal portion, while the distal portion of the OFT wall undergoes larger wall stresses. Maximal wall shear stresses were generally found on the surface of endocardial cushions, which are protrusions of extracellular matrix onto the OFT lumen that later during development give rise to cardiac septa and valves. The non-uniform spatial and temporal distributions of stresses and strains in the OFT walls provide biomechanical cues to cardiac cells that likely aid in the extensive differential growth and remodeling patterns observed during normal development. PMID:22844414

  15. Extent of reaction in open systems with multiple heterogeneous reactions

    USGS Publications Warehouse

    Friedly, John C.

    1991-01-01

    The familiar batch concept of extent of reaction is reexamined for systems of reactions occurring in open systems. Because species concentrations change as a result of transport processes as well as reactions in open systems, the extent of reaction has been less useful in practice in these applications. It is shown that by defining the extent of the equivalent batch reaction and a second contribution to the extent of reaction due to the transport processes, it is possible to treat the description of the dynamics of flow through porous media accompanied by many chemical reactions in a uniform, concise manner. This approach tends to isolate the reaction terms among themselves and away from the model partial differential equations, thereby enabling treatment of large problems involving both equilibrium and kinetically controlled reactions. Implications on the number of coupled partial differential equations necessary to be solved and on numerical algorithms for solving such problems are discussed. Examples provided illustrate the theory applied to solute transport in groundwater flow.

  16. A Spatial Method to Calculate Small-Scale Fisheries Extent

    NASA Astrophysics Data System (ADS)

    Johnson, A. F.; Moreno-Báez, M.; Giron-Nava, A.; Corominas, J.; Erisman, B.; Ezcurra, E.; Aburto-Oropeza, O.

    2016-02-01

    Despite global catch per unit effort having redoubled since the 1950's, the global fishing fleet is estimated to be twice the size that the oceans can sustainably support. In order to gauge the collateral impacts of fishing intensity, we must be able to estimate the spatial extent and amount of fishing vessels in the oceans. Methods that do currently exist are built around electronic tracking and log book systems and generally focus on industrial fisheries. Spatial extent for small-scale fisheries therefore remains elusive for many small-scale fishing fleets; even though these fisheries land the same biomass for human consumption as industrial fisheries. Current methods are data-intensive and require extensive extrapolation when estimated across large spatial scales. We present an accessible, spatial method of calculating the extent of small-scale fisheries based on two simple measures that are available, or at least easily estimable, in even the most data poor fisheries: the number of boats and the local coastal human population. We demonstrate this method is fishery-type independent and can be used to quantitatively evaluate the efficacy of growth in small-scale fisheries. This method provides an important first step towards estimating the fishing extent of the small-scale fleet, globally.

  17. Cyberbullying in Schools: Nature and Extent of Canadian Adolescents' Experience

    ERIC Educational Resources Information Center

    Li, Qing

    2005-01-01

    This study is an exploration of the cyberbullying issue. The primary focus is on the examination of the nature and extent of adolescents' cyberbullying experiences. Particularly, the following research questions guide this exploration: (1) To what extent do adolescents experience cyberbullying? (2) What are the characteristics of cyberbullying?…

  18. Deconvolution imaging of weak reflective pipe defects using guided-wave signals captured by a scanning receiver.

    PubMed

    Sun, Zeqing; Sun, Anyu; Ju, Bing-Feng

    2017-02-01

    Guided-wave echoes from weak reflective pipe defects are usually interfered by coherent noise and difficult to interpret. In this paper, a deconvolution imaging method is proposed to reconstruct defect images from synthetically focused guided-wave signals, with enhanced axial resolution. A compact transducer, circumferentially scanning around the pipe, is used to receive guided-wave echoes from discontinuities at a distance. This method achieves a higher circumferential sampling density than arrayed transducers-up to 72 sampling spots per lap for a pipe with a diameter of 180 mm. A noise suppression technique is used to enhance the signal-to-noise ratio. The enhancement in both signal-to-noise ratio and axial resolution of the method is experimentally validated by the detection of two kinds of artificial defects: a pitting defect of 5 mm in diameter and 0.9 mm in maximum depth, and iron pieces attached to the pipe surface. A reconstructed image of the pitting defect is obtained with a 5.87 dB signal-to-noise ratio. It is revealed that a high circumferential sampling density is important for the enhancement of the inspection sensitivity, by comparing the images reconstructed with different down-sampling ratios. A modified full width at half maximum is used as the criterion to evaluate the circumferential extent of the region where iron pieces are attached, which is applicable for defects with inhomogeneous reflection intensity.

  19. The extent of burning in African savanna

    NASA Technical Reports Server (NTRS)

    Cahoon, D. R. JR.; Levine, J. S.; Cofer, W. R. Iii; Stocks, B. J.

    1994-01-01

    The temporal and spatial distribution of African savanna grassland fires has been examined, and the areal extent of these fires has been estimated for the subequatorial African continent. African savanna fires have been investigated using remote sensing techniques and imagery collected by low-light sensors on Defense Meteorological Satellite Program (DMSP) satellites and by the Advanced Very High Resolution Radiometer (AVHRR) which is aboard polar orbiting National Oceanic and Atmospheric Administration (NOAA) satellites. DMSP imagery has been used to map the evolution of savanna burning over all of the African continent and the analysis of AVHRR imagery has been used to estimate the areal extent of the burning in the southern hemispheric African savannas. The work presented primarily reflects the analysiscompleted for the year 1987. However, comparisons have been made with other years and the representativeness of the 1987 analysis is discussed.

  20. Ventricular tachycardia in post-myocardial infarction patients. Results of surgical therapy.

    PubMed

    Viganò, M; Martinelli, L; Salerno, J A; Minzioni, G; Chimienti, M; Graffigna, A; Goggi, C; Klersy, C; Montemartini, C

    1986-05-01

    This report addresses the problems related to surgical treatment of post-infarction ventricular tachycardia (VT) and is based on a 5 year experience of 36 consecutive patients. In every case the arrhythmia was unresponsive to pharmacological therapy. All patients were operated on after the completion of a diagnostic protocol including preoperative endocardial, intra-operative epi-endocardial mapping, the latter performed automatically when possible. Surgical techniques were: classical Guiraudon's encircling endocardial ventriculotomy (EEV); partial EEV, endocardial resection (ER); cryoablation or a combination of these procedures. The in-hospital mortality (30 days) was 8.3% (3 patients). During the follow-up period (1-68 months), 3 patients (9%) died of cardiac but not VT related causes. Of the survivors, 92% are VT-free. We consider electrophysiologically guided surgery a safe and reliable method for the treatment of post-infarction VT and suggest its more extensive use. We stress the importance of automatic mapping in pleomorphic and non-sustained VT, and the necessity of tailoring the surgical technique to the characteristics of each case.

  1. Identification of Biokinetic Models Using the Concept of Extents.

    PubMed

    Mašić, Alma; Srinivasan, Sriniketh; Billeter, Julien; Bonvin, Dominique; Villez, Kris

    2017-07-05

    The development of a wide array of process technologies to enable the shift from conventional biological wastewater treatment processes to resource recovery systems is matched by an increasing demand for predictive capabilities. Mathematical models are excellent tools to meet this demand. However, obtaining reliable and fit-for-purpose models remains a cumbersome task due to the inherent complexity of biological wastewater treatment processes. In this work, we present a first study in the context of environmental biotechnology that adopts and explores the use of extents as a way to simplify and streamline the dynamic process modeling task. In addition, the extent-based modeling strategy is enhanced by optimal accounting for nonlinear algebraic equilibria and nonlinear measurement equations. Finally, a thorough discussion of our results explains the benefits of extent-based modeling and its potential to turn environmental process modeling into a highly automated task.

  2. Pain extent and function in youth with physical disabilities

    PubMed Central

    Miró, Jordi; de la Vega, Rocío; Tomé-Pires, Catarina; Sánchez-Rodríguez, Elisabet; Castarlenas, Elena; Jensen, Mark P; Engel, Joyce M

    2017-01-01

    Background The aim of this study was to increase our understanding of the role that spatial qualities of pain (location and extent) play in functioning, among youths with disabilities and chronic pain. Methods One-hundred and fifteen youths (mean age 14.4 years; SD ±3.3 years) with physical disabilities and chronic pain were interviewed and were asked to provide information about pain locations and their average pain intensity in the past week, and to complete measures of pain interference, psychological function and disability. Most of the participants in this sample were males (56%), Caucasian (68%), and had a cerebral palsy (34%) or muscular dystrophy (25%) problem. Most participants did not report high levels of disability ( X¯=12.7, SD ±9.5, range 0–60) or global pain intensity ( X¯=3.2, SD ±2.4, range 0–10). Results Pain at more than one body site was experienced by 91% of participants. There were positive associations between pain extent with pain interference (r = 0.30) and disability (r = 0.30), and a negative association with psychological function (r = –0.38), over and above average pain intensity. Additionally, pain intensity in the back (as opposed to other locations) was associated with more pain interference (r = 0.29), whereas pain intensity in the shoulders was associated with less psychological function (r = –0.18), and pain intensity in the bottom or hips was associated with more disability (r = 0.29). Conclusion The findings support the need to take into account pain extent in the assessment and treatment of youths with physical disabilities and chronic pain, call our attention about the need to identify potential risk factors of pain extent, and develop and evaluate the benefits of treatments that could reduce pain extent and target pain at specific sites. PMID:28115871

  3. Comparative analysis of glucagonergic cells, glia and the circumferential marginal zone in the reptilian retina

    PubMed Central

    Todd, Levi; Suarez, Lilianna; Squires, Natalie; Zelinka, Christopher Paul; Gribbins, Kevin; Fischer, Andy J.

    2015-01-01

    Retinal progenitors in the circumferential margin zone (CMZ) and Müller glia-derived progenitors have been well-described in the eyes of fish, amphibians and birds. However, there is no information regarding a CMZ and the nature of retinal glia in species phylogenetically bridging amphibians and birds. Thus, the purpose of this study was to examine the retinal glia and investigate whether a CMZ is present in the eyes of reptilian species. We used immuno-histochemical analyses to study retinal glia, neurons that could influence CMZ-progenitors, the retinal margin, and non-pigmented epithelium (NPE) of ciliary body of garter snakes, queen snakes, anole lizards, snapping turtles, and painted turtles. We compare our observations in reptile eyes to the CMZ and glia of fish, amphibians and birds. In all species, Sox9, Pax6 and the glucocorticoid receptor are expressed by Müller glia and cells at the retinal margin. However, proliferating cells were found only in the CMZ of turtles, but not in the eyes of anoles and snakes. Similar to eyes of chickens, the retinal margin in turtles contains accumulations of GLP1/glucagonergic neurites. We find that filamentous proteins, vimentin and GFAP, are expressed by Müller glia, but have different patterns of sub-cellular localization in the different species of reptiles. We provide evidence that the reptile retina may contain Non-astrocytic Inner Retinal Glial (NIRG) cells, similar to those described in the avian retina. We conclude that the retinal glia, glucagonergic neurons and CMZ of turtles appears to be the most similar to that of fish, amphibians and birds. PMID:26053997

  4. Forest extent and deforestation in tropical Africa since 1900.

    PubMed

    Aleman, Julie C; Jarzyna, Marta A; Staver, A Carla

    2018-01-01

    Accurate estimates of historical forest extent and associated deforestation rates are crucial for quantifying tropical carbon cycles and formulating conservation policy. In Africa, data-driven estimates of historical closed-canopy forest extent and deforestation at the continental scale are lacking, and existing modelled estimates diverge substantially. Here, we synthesize available palaeo-proxies and historical maps to reconstruct forest extent in tropical Africa around 1900, when European colonization accelerated markedly, and compare these historical estimates with modern forest extent to estimate deforestation. We find that forests were less extensive in 1900 than bioclimatic models predict. Resultantly, across tropical Africa, ~ 21.7% of forests have been deforested, yielding substantially slower deforestation than previous estimates (35-55%). However, deforestation was heterogeneous: West and East African forests have undergone almost complete decline (~ 83.3 and 93.0%, respectively), while Central African forests have expanded at the expense of savannahs (~ 1.4% net forest expansion, with ~ 135,270 km 2 of savannahs encroached). These results suggest that climate alone does not determine savannah and forest distributions and that many savannahs hitherto considered to be degraded forests are instead relatively old. These data-driven reconstructions of historical biome distributions will inform tropical carbon cycle estimates, carbon mitigation initiatives and conservation planning in both forest and savannah systems.

  5. Reduced Circumferential Resection Margin Involvement in Rectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit.

    PubMed

    Gietelink, Lieke; Wouters, Michel W J M; Tanis, Pieter J; Deken, Marion M; Ten Berge, Martijn G; Tollenaar, Rob A E M; van Krieken, J Han; de Noo, Mirre E

    2015-09-01

    The circumferential resection margin (CRM) is a significant prognostic factor for local recurrence, distant metastasis, and survival after rectal cancer surgery. Therefore, availability of this parameter is essential. Although the Dutch total mesorectal excision trial raised awareness about CRM in the late 1990s, quality assurance on pathologic reporting was not available until the Dutch Surgical Colorectal Audit (DSCA) started in 2009. The present study describes the rates of CRM reporting and involvement since the start of the DSCA and analyzes whether improvement of these parameters can be attributed to the audit. Data from the DSCA (2009-2013) were analyzed. Reporting of CRM and CRM involvement was plotted for successive years, and variations of these parameters were analyzed in a funnelplot. Predictors of CRM involvement were determined in univariable analysis and the independent influence of year of registration on CRM involvement was analyzed in multivariable analysis. A total of 12,669 patients were included for analysis. The mean percentage of patients with a reported CRM increased from 52.7% to 94.2% (2009-2013) and interhospital variation decreased. The percentage of patients with CRM involvement decreased from 14.2% to 5.6%. In multivariable analysis, the year of DSCA registration remained a significant predictor of CRM involvement. After the introduction of the DSCA, a dramatic improvement in CRM reporting and a major decrease of CRM involvement after rectal cancer surgery have occurred. This study suggests that a national quality assurance program has been the driving force behind these achievements. Copyright © 2015 by the National Comprehensive Cancer Network.

  6. Increased popliteal circumferential wall tension induced by orthostatic body posture is associated with local atherosclerotic plaques.

    PubMed

    Gemignani, Tiago; Azevedo, Renata C; Higa, Celina M; Coelho, Otávio R; Matos-Souza, José R; Nadruz, Wilson

    2012-09-01

    Lower limb arteries are exposed to higher hemodynamic burden in erectile posture. This study evaluated the effects of body posture on popliteal, carotid and brachial circumferential wall tension (CWT) and investigated the relationship between local CWT and atherosclerotic plaques in subjects with cardiovascular risk factors. Two hundred and three subjects (118 women and 85 men) with cardiovascular risk factors (smoking, hypertension or diabetes mellitus) underwent clinical and laboratory analysis and had their blood pressure measured in the arm and calf in supine and orthostatic positions. Arteries were evaluated by ultrasound analysis, while CWT was calculated according to Laplace's law. Among the enrolled participants, 47%, 29% and none presented popliteal, carotid and brachial plaques, respectively. Carotid CWT measurements were not associated with local plaques after adjustment for potential confounders. Conversely, general linear model and logistic regression analyses adjusted for potential confounders demonstrated that peak orthostatic CWT was the only local hemodynamic parameter showing significant relationship with popliteal plaques in the whole sample. In gender-specific analyses, although positively correlated with popliteal plaques in both genders, local peak orthostatic CWT exhibited an independent association with popliteal plaques after adjustment for potential confounders only in women. Popliteal CWT measured in orthostatic posture, rather than in supine position, is associated with popliteal atherosclerotic plaques, particularly in women. These findings suggest that erectile posture might play a role in the atherogenesis of leg arteries by modifying local hemodynamic forces and that there may be gender differences in this regard. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. A Model Assessment of Satellite Observed Trends in Polar Sea Ice Extents

    NASA Technical Reports Server (NTRS)

    Vinnikov, Konstantin Y.; Cavalieri, Donald J.; Parkinson, Claire L.

    2005-01-01

    For more than three decades now, satellite passive microwave observations have been used to monitor polar sea ice. Here we utilize sea ice extent trends determined from primarily satellite data for both the Northern and Southern Hemispheres for the period 1972(73)-2004 and compare them with results from simulations by eleven climate models. In the Northern Hemisphere, observations show a statistically significant decrease of sea ice extent and an acceleration of sea ice retreat during the past three decades. However, from the modeled natural variability of sea ice extents in control simulations, we conclude that the acceleration is not statistically significant and should not be extrapolated into the future. Observations and model simulations show that the time scale of climate variability in sea ice extent in the Southern Hemisphere is much larger than in the Northern Hemisphere and that the Southern Hemisphere sea ice extent trends are not statistically significant.

  8. 47 CFR 76.92 - Cable network non-duplication; extent of protection.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Cable network non-duplication; extent of... RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Network Non-duplication Protection, Syndicated Exclusivity and Sports Blackout § 76.92 Cable network non-duplication; extent of protection. (a...

  9. 47 CFR 76.92 - Cable network non-duplication; extent of protection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Cable network non-duplication; extent of... RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Network Non-duplication Protection, Syndicated Exclusivity and Sports Blackout § 76.92 Cable network non-duplication; extent of protection. (a...

  10. Flood inundation extent mapping based on block compressed tracing

    NASA Astrophysics Data System (ADS)

    Shen, Dingtao; Rui, Yikang; Wang, Jiechen; Zhang, Yu; Cheng, Liang

    2015-07-01

    Flood inundation extent, depth, and duration are important factors affecting flood hazard evaluation. At present, flood inundation analysis is based mainly on a seeded region-growing algorithm, which is an inefficient process because it requires excessive recursive computations and it is incapable of processing massive datasets. To address this problem, we propose a block compressed tracing algorithm for mapping the flood inundation extent, which reads the DEM data in blocks before transferring them to raster compression storage. This allows a smaller computer memory to process a larger amount of data, which solves the problem of the regular seeded region-growing algorithm. In addition, the use of a raster boundary tracing technique allows the algorithm to avoid the time-consuming computations required by the seeded region-growing. Finally, we conduct a comparative evaluation in the Chin-sha River basin, results show that the proposed method solves the problem of flood inundation extent mapping based on massive DEM datasets with higher computational efficiency than the original method, which makes it suitable for practical applications.

  11. Modeling of second-harmonic generation of circumferential guided wave propagation in a composite circular tube

    NASA Astrophysics Data System (ADS)

    Li, Mingliang; Deng, Mingxi; Gao, Guangjian; Xiang, Yanxun

    2018-05-01

    This paper investigated modeling of second-harmonic generation (SHG) of circumferential guided wave (CGW) propagation in a composite circular tube, and then analyzed the influences of interfacial properties on the SHG effect of primary CGW. Here the effect of SHG of primary CGW propagation is treated as a second-order perturbation to its linear wave response. Due to the convective nonlinearity and the inherent elastic nonlinearity of material, there are second-order bulk driving forces and surface/interface driving stresses in the interior and at the surface/interface of a composite circular tube, when a primary CGW mode propagates along its circumference. Based on the approach of modal expansion analysis for waveguide excitation, the said second-order driving forces/stresses are regarded as the excitation sources to generate a series of double-frequency CGW modes that constitute the second-harmonic field of the primary CGW propagation. It is found that the modal expansion coefficient of each double-frequency CGW mode is closely related to the interfacial stiffness constants that are used to describe the interfacial properties between the inner and outer circular parts of the composite tube. Furthermore, changes in the interfacial stiffness constants essentially influence the dispersion relation of CGW propagation. This will remarkably affect the efficiency of cumulative SHG of primary CGW propagation. Some finite element simulations have been implemented of response characteristics of cumulative SHG to the interfacial properties. Both the theoretical analyses and numerical simulations indicate that the effect of cumulative SHG is found to be much more sensitive to changes in the interfacial properties than primary CGW propagation. The potential of using the effect of cumulative SHG by primary CGW propagation to characterize a minor change in the interfacial properties is considered.

  12. Comparison of stapedotomy minus prosthesis, circumferential stapes mobilization, and small fenestra stapedotomy for stapes fixation.

    PubMed

    Acar, Gül Ozbilen; Kivekäs, Ilkka; Hanna, Bassem M; Huang, Lin; Gopen, Quinton; Poe, Dennis S

    2014-04-01

    To compare the outcomes of 3 surgical techniques for primary stapes fixation: stapedotomy minus prosthesis (STAMP), circumferential stapes mobilization (CSM), and small fenestra stapedotomy (SFS). Retrospective review of 277 primary cases operated for stapes fixation from 1997 to 2007. Tertiary academic center. Consecutive adult and pediatric cases operated for conductive hearing loss because of stapes fixation. STAMP was performed for otosclerosis limited to the anterior footplate, CSM was conducted for congenital stapes fixation, SFS was performed for more extensive otosclerosis or anatomic contraindications to STAMP/CSM. Pure-tone audiometry was performed preoperatively and postoperatively (3-6 wk) and the most recent long-term results (≥ 12 mo). Ninety-nine ears in 90 patients had audiologic follow-up data over 12 months. Sixty-seven ears (68%) underwent SFS, 16 (16%) STAMP, and 16 (16%) CSM. There was significant improvement in average air conduction (AC) thresholds and air-bone gap (ABG) for all techniques. Mean ABG for SFS closed from 29 to 7.1 dB (SD, 6.0), for STAMP from 29 to 3.8 dB (SD, 5.8 dB), and for CSM from 34 to 20 dB (SD, 8.2 dB). AC results were better in the STAMP than in the SFS group, especially in high frequencies. Bone conduction improvements were seen in all groups, highest in STAMP (4.3 dB) and CSM (3.8 dB) groups, but the differences between groups were not statistically significant. Satisfactory hearing results were achieved with all the techniques, and STAMP showed better hearing outcomes, especially in high frequencies. CSM is a good option for children and patients in whom it is desirable to avoid a footplate fenestration or prosthesis. CSM and STAMP had significantly higher rates of revision for refixation than SFS.

  13. Kinematics of a selectively constrained radiolucent anterior lumbar disc: comparisons to hybrid and circumferential fusion.

    PubMed

    Daftari, Tapan K; Chinthakunta, Suresh R; Ingalhalikar, Aditya; Gudipally, Manasa; Hussain, Mir; Khalil, Saif

    2012-10-01

    Despite encouraging clinical outcomes of one-level total disc replacements reported in literature, there is no compelling evidence regarding the stability following two-level disc replacement and hybrid constructs. The current study is aimed at evaluating the multidirectional kinematics of a two-level disc arthroplasty and hybrid construct with disc replacement adjacent to rigid circumferential fusion, compared to two-level fusion using a novel selectively constrained radiolucent anterior lumbar disc. Nine osteoligamentous lumbosacral spines (L1-S1) were tested in the following sequence: 1) Intact; 2) One-level disc replacement; 3) Hybrid; 4) Two-level disc replacement; and 5) Two-level fusion. Range of motion (at both implanted and adjacent level), and center of rotation in sagittal plane were recorded and calculated. At the level of implantation, motion was restored when one-level disc replacement was used but tended to decrease with two-level disc arthroplasty. The findings also revealed that both one-level and two-level disc replacement and hybrid constructs did not significantly change adjacent level kinematics compared to the intact condition, whereas the two-level fusion construct demonstrated a significant increase in flexibility at the adjacent level. The location of center of rotation in the sagittal plane at L4-L5 for the one-level disc replacement construct was similar to that of the intact condition. The one-level disc arthroplasty tended to mimic a motion profile similar to the intact spine. However, the two-level disc replacement construct tended to reduce motion and clinical stability of a two-level disc arthroplasty requires additional investigation. Hybrid constructs may be used as a surgical alternative for treating two-level lumbar degenerative disc disease. Published by Elsevier Ltd.

  14. Regional Mapping of Plantation Extent Using Multisensor Imagery

    NASA Astrophysics Data System (ADS)

    Torbick, N.; Ledoux, L.; Hagen, S.; Salas, W.

    2016-12-01

    Industrial forest plantations are expanding rapidly across the tropics and monitoring extent is critical for understanding environmental and socioeconomic impacts. In this study, new, multisensor imagery were evaluated and integrated to extract the strengths of each sensor for mapping plantation extent at regional scales. Three distinctly different landscapes with multiple plantation types were chosen to consider scalability and transferability. These were Tanintharyi, Myanmar, West Kalimantan, Indonesia, and southern Ghana. Landsat-8 Operational Land Imager (OLI), Phased Array L-band Synthetic Aperture Radar-2 (PALSAR-2), and Sentinel-1A images were fused within a Classification and Regression Tree (CART) framework using random forest and high-resolution surveys. Multi-criteria evaluations showed both L-and C-band gamma nought γ° backscatter decibel (dB), Landsat reflectance ρλ, and texture indices were useful for distinguishing oil palm and rubber plantations from other land types. The classification approach identified 750,822 ha or 23% of the Taninathryi, Myanmar, and 216,086 ha or 25% of western West Kalimantan as plantation with very high cross validation accuracy. The mapping approach was scalable and transferred well across the different geographies and plantation types. As archives for Sentinel-1, Landsat-8, and PALSAR-2 continue to grow, mapping plantation extent and dynamics at moderate resolution over large regions should be feasible.

  15. The extent of emphysema in patients with COPD.

    PubMed

    Shaker, Saher Burhan; Stavngaard, Trine; Hestad, Marianne; Bach, Karen Skjoelstrup; Tonnesen, Philip; Dirksen, Asger

    2009-01-01

    The global initiative for COPD (GOLD) adopted the degree of airway obstruction as a measure of the severity of the disease. The objective of this study was to apply CT to assess the extent of emphysema in patients with chronic obstructive pulmonary disease (COPD) and relate this extent to the GOLD stage of airway obstruction. We included 209 patients with COPD. COPD was defined as FEV(1)/FVC < 0.70 and no reversibility to beta(2)-agonists. All patients were current smokers with a smoking history of >or=20 pack-years. Patients were assessed by lung function measurement and visual and quantitative assessment of CT, from which the relative area of emphysema below -910 Hounsfield units (RA-910) was extracted. Mean RA-910 was 7.4% (n = 5) in patients with GOLD stage I, 17.0% (n = 119) in stage II, 24.2% (n = 79) in stage III and 33.9% (n = 6) in stage IV. Regression analysis showed a change in RA-910 of 7.8% with increasing severity according to GOLD stage (P < 0.001). Combined visual and quantitative assessment of CT showed that 184 patients had radiological evidence of emphysema, whereas 25 patients had no emphysema. The extent of emphysema increases with increasing severity of COPD and most patients with COPD have emphysema. Tissue destruction by emphysema is therefore an important determinant of disease severity in COPD.

  16. Extent of coterminous US rangelands: Quantifying implications of differing agency perspectives

    Treesearch

    Matthew Clark Reeves; John E. Mitchell

    2011-01-01

    Rangeland extent is an important factor for evaluating critical indicators of rangeland sustainability. Rangeland areal extent was determined for the coterminous United States in a geospatial framework by evaluating spatially explicit data from the Landscape Fire and Resource Management Planning Tools (LANDFIRE) project describing historic and current vegetative...

  17. Comparison of osmotic swelling influences on meniscal fibrocartilage and articular cartilage tissue mechanics in compression and shear.

    PubMed

    Nguyen, An M; Levenston, Marc E

    2012-01-01

    Although the contribution of the circumferential collagen bundles to the anisotropic tensile stiffness of meniscal tissue has been well described, the implications of interactions between tissue components for other mechanical properties have not been as widely examined. This study compared the effects of the proteoglycan-associated osmotic swelling stress on meniscal fibrocartilage and articular cartilage (AC) mechanics by manipulating the osmotic environment and tissue compressive offset. Cylindrical samples were obtained from the menisci and AC of bovine stifles, equilibrated in phosphate-buffered saline solutions ranging from 0.1× to 10×, and tested in oscillatory torsional shear and unconfined compression. Biochemical analysis indicated that treatments and testing did not substantially alter tissue composition. Mechanical testing revealed tissue-specific responses to both increasing compressive offset and decreasing bath salinity. Most notably, reduced salinity dramatically increased the shear modulus of both axially and circumferentially oriented meniscal tissue explants to a much greater extent than for cartilage samples. Combined with previous studies, these findings suggest that meniscal proteoglycans have a distinct structural role, stabilizing, and stiffening the matrix surrounding the primary circumferential collagen bundles. Copyright © 2011 Orthopaedic Research Society.

  18. 16 CFR 254.3 - Misrepresentation of extent or nature of accreditation or approval.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Misrepresentation of extent or nature of... extent or nature of accreditation or approval. (a) It is deceptive for an Industry Member to misrepresent, directly or indirectly, expressly or by implication, the nature, extent, or purpose of any Approval by a...

  19. 16 CFR 254.3 - Misrepresentation of extent or nature of accreditation or approval.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misrepresentation of extent or nature of... extent or nature of accreditation or approval. (a) It is deceptive for an industry member to misrepresent, directly or indirectly, the extent or nature of any approval by a State agency or accreditation by an...

  20. 16 CFR 254.3 - Misrepresentation of extent or nature of accreditation or approval.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Misrepresentation of extent or nature of... extent or nature of accreditation or approval. (a) It is deceptive for an industry member to misrepresent, directly or indirectly, the extent or nature of any approval by a State agency or accreditation by an...

  1. 16 CFR 254.3 - Misrepresentation of extent or nature of accreditation or approval.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Misrepresentation of extent or nature of... extent or nature of accreditation or approval. (a) It is deceptive for an industry member to misrepresent, directly or indirectly, the extent or nature of any approval by a State agency or accreditation by an...

  2. 16 CFR 254.3 - Misrepresentation of extent or nature of accreditation or approval.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Misrepresentation of extent or nature of... extent or nature of accreditation or approval. (a) It is deceptive for an industry member to misrepresent, directly or indirectly, the extent or nature of any approval by a State agency or accreditation by an...

  3. Computerized analysis of the 12-lead electrocardiogram to identify epicardial ventricular tachycardia exit sites.

    PubMed

    Yokokawa, Miki; Jung, Dae Yon; Joseph, Kim K; Hero, Alfred O; Morady, Fred; Bogun, Frank

    2014-11-01

    Twelve-lead electrocardiogram (ECG) criteria for epicardial ventricular tachycardia (VT) origins have been described. In patients with structural heart disease, the ability to predict an epicardial origin based on QRS morphology is limited and has been investigated only for limited regions in the heart. The purpose of this study was to determine whether a computerized algorithm is able to accurately differentiate epicardial vs endocardial origins of ventricular arrhythmias. Endocardial and epicardial pace-mapping were performed in 43 patients at 3277 sites. The 12-lead ECGs were digitized and analyzed using a mixture of gaussian model (MoG) to assess whether the algorithm was able to identify an epicardial vs endocardial origin of the paced rhythm. The MoG computerized algorithm was compared to algorithms published in prior reports. The computerized algorithm correctly differentiated epicardial vs endocardial pacing sites for 80% of the sites compared to an accuracy of 42% to 66% of other described criteria. The accuracy was higher in patients without structural heart disease than in those with structural heart disease (94% vs 80%, P = .0004) and for right bundle branch block (82%) compared to left bundle branch block morphologies (79%, P = .001). Validation studies showed the accuracy for VT exit sites to be 84%. A computerized algorithm was able to accurately differentiate the majority of epicardial vs endocardial pace-mapping sites. The algorithm is not region specific and performed best in patients without structural heart disease and with VTs having a right bundle branch block morphology. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  4. Remote magnetic versus manual catheter navigation for circumferential pulmonary vein ablation in patients with atrial fibrillation.

    PubMed

    Lüthje, Lars; Vollmann, Dirk; Seegers, Joachim; Dorenkamp, Marc; Sohns, Christian; Hasenfuss, Gerd; Zabel, Markus

    2011-11-01

    Only limited data exist on the clinical utility of remote magnetic navigation (RMN) for pulmonary vein (PV) ablation. Aim of this prospective study was to evaluate the safety and efficacy of RMN for PV isolation as compared to the manual (CON) approach. A total of 161 consecutive patients undergoing circumferential PV isolation were included. Open-irrigated 3.5 mm ablation catheters under the guidance of a mapping system were used. The catheter was navigated with the Stereotaxis Niobe II system in the RMN group (n = 107) and guided manually in the CON group (n = 54). Electrical isolation of all PVs was achieved in 90% of the patients in the RMN group and in 87% in the CON group (p = 0.6). All subjects were followed every 3 months by 7d Holter-ECG. At 12 months of follow-up, 53.5% (RMN) and 55.5% (CON) of the patients were free of any left atrial tachycardia/atrial fibrillation (AF) episode (p = 0.57). Free of symptomatic AF recurrence were 66.3% (RMN) and 62.1% (CON) of the subjects (p = 0.80). Use of RMN was associated with longer procedure duration (p < 0.0001), ablation times (p < 0.0001), and RF current application duration (p < 0.05). In contrast, fluoroscopy time was lower in the RMN group (p < 0.0001). Major complications occurred in 6 of 161 procedures (3.7%), with no significant difference between groups (p = 0.75). RMN-guided PV ablation provides comparable acute and long-term success rates as compared to manual navigation. Procedural complication rates are similar. The use of RMN is associated with markedly reduced fluoroscopy time, but prolonged ablation and procedure duration.

  5. Different bone regeneration patterns in periimplant circumferential gap defects grafted with two types of osteoconductive biomaterial.

    PubMed

    Lee, Jung-Seok; Sohn, Joo-Yeon; Lim, Hyun-Chang; Jung, Ui-Won; Choi, Seong-Ho

    2016-08-01

    This study aimed to determine healing patterns in periimplant gap defect grafted with demineralized bovine bone mineral (DBBM) and porous titanium granules (PTG), which are known to induce a minimal tissue reaction and to undergo minimal biodegradation in healing process. Experiments were performed using a standardized periimplant gap-defect model in dogs with two observational periods: 4 and 8 weeks. Circumferential defects were surgically induced around dental implants on unilateral mandibles in five dogs, and collagen barrier membranes were placed over the DBBM and PTG grafts at two experimental sites and over a nongrafted site. Four weeks later, the same procedures were performed on the contralateral mandible, and the animals allowed to heal for a further 4 weeks, after which they were sacrificed and their mandibles with graft/control sites harvested for histologic evaluation. Both types of grafted biomaterials significantly enhanced the defect fill with newly formed bone, but the bone-to-implant contact (BIC) was significantly increased only at sites that had been grafted with DBBM. The two experimental sites exhibited different healing patterns, with new bone formation being observed on the surface of the DBBM particles throughout the defect, while there was no de novo bone formation on the PTG surface, but rather appositional bone growth from the base and lateral walls of the defect. It has been suggested that gap-defect filling with DBBM around dental implants may enhance both BIC and defect fill; however, the present findings show that defect grafting with PTG enhances only defect fill and not BIC. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1202-1209, 2016. © 2015 Wiley Periodicals, Inc.

  6. Newborn infant with maternal anti-SSA antibody-induced complete heart block accompanying cardiomyopathy.

    PubMed

    Iida, Midori; Inamura, Noboru; Takeuchi, Makoto

    2006-01-01

    Newborn case of maternal anti-SSA antibody-induced congenital complete heart block (CCHB) accompanying cardiomyopathy is presented. Unexpectedly, she died of ventricular tachycardia, not bradycardia, 6 days after birth. Autopsy revealed left ventricular cardiomyopathy with endocardial fibroelastosis. Thus, when evaluating fetal cardiac performance in cases of maternal anti-SSA antibody-induced CCHB, it is necessary to pay attention to myocardial attributes such as endocardial hyperplasia.

  7. 27 CFR 24.158 - Extent of relief.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Extent of relief. 24.158 Section 24.158 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT..., until all tax is fully paid. (d) Wine vinegar plant bond. The surety will be relieved of liability for...

  8. Extent and determinants of patients' unvoiced needs.

    PubMed

    Low, Lee Lan; Sondi, Sararaks; Azman, Abu Bakar; Goh, Pik Pin; Maimunah, A Hamid; Ibrahim, Mohd Yusof; Hassan, Muhammad Radzi Abu; Letchuman, Ramanathan

    2011-09-01

    Patients with issues or health problems usually plan to discuss their concerns with their health care providers. If these concerns were not presented or voiced during the health care provider-patient encounter, the patients are considered to have unvoiced needs. This article examines the extent and possible determinants of patients' unvoiced needs in an outpatient setting. A cross-sectional study was conducted in 5 Ministry of Health Malaysia primary health facilities throughout the country. Of 1829 who participated, 5 did not respond to the question on planned issues. Of the 1824 respondents, 57.9% (95% confidence interval = 47.1-68.7) claimed to have issues/problems they planned to share, of whom 15.1% to 26.7% had unvoiced needs. Extent of unvoiced needs differed by employment status, perceived category of health care provider, and study center. Perceived category of health care provider, method of questionnaire administration, and study center were the only significant determinants of unvoiced needs. Unvoiced needs do exist in Malaysia and there is a need for health care providers to be aware and take steps to counter this.

  9. Extent, accuracy, and credibility of breastfeeding information on the Internet.

    PubMed

    Shaikh, Ulfat; Scott, Barbara J

    2005-05-01

    Our objective was to test and describe a model for evaluating Websites related to breastfeeding. Forty Websites most likely to be accessed by the public were evaluated for extent, accuracy, credibility, presentation, ease of use, and adherence to ethical and medical Internet publishing standards. Extent and accuracy of Website content were determined by a checklist of critical information. The majority of Websites reviewed provided accurate information and complied with the International Code of Marketing of Breast-milk Substitutes. Approximately half the Websites complied with standards of medical Internet publishing. While much information on breastfeeding on the Internet is accurate, there is wide variability in the extent of information, usability of Websites, and compliance with standards of medical Internet publishing. Results of this study may be helpful to health care professionals as a model for evaluating breastfeeding-related Websites and to highlight considerations when recommending or designing Websites.

  10. Probabilistic flood extent estimates from social media flood observations

    NASA Astrophysics Data System (ADS)

    Brouwer, Tom; Eilander, Dirk; van Loenen, Arnejan; Booij, Martijn J.; Wijnberg, Kathelijne M.; Verkade, Jan S.; Wagemaker, Jurjen

    2017-05-01

    The increasing number and severity of floods, driven by phenomena such as urbanization, deforestation, subsidence and climate change, create a growing need for accurate and timely flood maps. In this paper we present and evaluate a method to create deterministic and probabilistic flood maps from Twitter messages that mention locations of flooding. A deterministic flood map created for the December 2015 flood in the city of York (UK) showed good performance (F(2) = 0.69; a statistic ranging from 0 to 1, with 1 expressing a perfect fit with validation data). The probabilistic flood maps we created showed that, in the York case study, the uncertainty in flood extent was mainly induced by errors in the precise locations of flood observations as derived from Twitter data. Errors in the terrain elevation data or in the parameters of the applied algorithm contributed less to flood extent uncertainty. Although these maps tended to overestimate the actual probability of flooding, they gave a reasonable representation of flood extent uncertainty in the area. This study illustrates that inherently uncertain data from social media can be used to derive information about flooding.

  11. Sarcoidosis extent relates to molecular variability.

    PubMed

    Monast, C S; Li, K; Judson, M A; Baughman, R P; Wadman, E; Watt, R; Silkoff, P E; Barnathan, E S; Brodmerkel, C

    2017-06-01

    The molecular basis of sarcoidosis phenotype heterogeneity and its relationship to effective treatment of sarcoidosis have not been elucidated. Peripheral samples from sarcoidosis subjects who participated in a Phase II study of golimumab [anti-tumour necrosis factor (TNF)-α] and ustekinumab [anti-interleukin (IL)-12p40] were used to measure the whole blood transcriptome and levels of serum proteins. Differential gene and protein expression analyses were used to explore the molecular differences between sarcoidosis phenotypes as defined by extent of organ involvement. The same data were also used in conjunction with an enrichment algorithm to identify gene expression changes associated with treatment with study drugs compared to placebo. Our analyses revealed marked heterogeneity among the three sarcoidosis phenotypes included in the study cohort, including striking differences in enrichment of the interferon pathway. Conversely, enrichments of multiple pathways, including T cell receptor signalling, were similar among phenotypes. We also identify differences between treatment with golimumab and ustekinumab that may explain the differences in trends for clinical efficacy observed in the trial. We find that molecular heterogeneity is associated with sarcoidosis in a manner that may be related to the extent of organ involvement. These findings may help to explain the difficulty in identifying clinically efficacious sarcoidosis treatments and suggest hypotheses for improved therapeutic strategies. © 2017 British Society for Immunology.

  12. Exploring the Origin, Extent, and Future of Life

    NASA Astrophysics Data System (ADS)

    Bertka, Constance M.

    2009-09-01

    1. Astrobiology in societal context Constance Bertka; Part I. Origin of Life: 2. Emergence and the experimental pursuit of the origin of life Robert Hazen; 3. From Aristotle to Darwin, to Freeman Dyson: changing definitions of life viewed in historical context James Strick; 4. Philosophical aspects of the origin-of-life problem: the emergence of life and the nature of science Iris Fry; 5. The origin of terrestrial life: a Christian perspective Ernan McMullin; 6. The alpha and the omega: reflections on the origin and future of life from the perspective of Christian theology and ethics Celia Deane-Drummond; Part II. Extent of Life: 7. A biologist's guide to the Solar System Lynn Rothschild; 8. The quest for habitable worlds and life beyond the Solar System Carl Pilcher; 9. A historical perspective on the extent and search for life Steven J. Dick; 10. The search for extraterrestrial life: epistemology, ethics, and worldviews Mark Lupisella; 11. The implications of discovering extraterrestrial life: different searches, different issues Margaret S. Race; 12. God, evolution, and astrobiology Cynthia S. W. Crysdale; Part III. Future of Life: 13. Planetary ecosynthesis on Mars: restoration ecology and environmental ethics Christopher P. McKay; 14. The trouble with intrinsic value: an ethical primer for astrobiology Kelly C. Smith; 15. God's preferential option for life: a Christian perspective on astrobiology Richard O. Randolph; 16. Comparing stories about the origin, extent, and future of life: an Asian religious perspective Francisca Cho; Index.

  13. Pulmonary vein anatomy predicts freedom from atrial fibrillation using remote magnetic navigation for circumferential pulmonary vein ablation.

    PubMed

    Sohns, Christian; Sohns, Jan M; Bergau, Leonard; Sossalla, Samuel; Vollmann, Dirk; Lüthje, Lars; Staab, Wieland; Dorenkamp, Marc; Harrison, James L; O'Neill, Mark D; Lotz, Joachim; Zabel, Markus

    2013-08-01

    Multidetector computed tomography (MDCT) is frequently used to guide circumferential pulmonary vein ablation (PVA) for treatment of atrial fibrillation (AF) as it offers accurate visualization of the left atrial (LA) and pulmonary vein (PV) anatomy. This study aimed to identify if PV anatomy is associated with outcomes following PVA using remote magnetic navigation (RMN). We analysed data from 138 consecutive patients and 146 ablation procedures referred for PVA due to drug-refractory symptomatic AF (age 63 ± 11 years; 57% men; 69% paroxysmal AF). The RMN using the stereotaxis system and open-irrigated 3.5 mm ablation catheters was used in all procedures. Prior to PVA, all patients underwent electrocardiogram-gated 64-MDCT for assessment of LA dimensions, PV anatomy, and electro-anatomical image integration during the procedure. Regular PV anatomy was found in 68%, a common left PV ostium was detected in 26%, and variant anatomy of the right PVs was detected in 6%. After a mean follow-up of 337 ± 102 days, 63% of the patients maintained sinus rhythm after the initial ablation, and 83% when including repeat PVA. Although acutely successful PV isolation did not differ between anatomical subgroups (regular 3.5 ± 0.8 vs. variant 3.2 ± 1.3; P = 0.31), AF recurrence was significantly higher in patients with non-regular PV anatomy (P = 0.04, hazard ratio 1.72). Pulmonary vein anatomy did not influence complication rates. Pulmonary vein anatomy assessed by MDCT is a good predictor of AF recurrence after PVA using RMN.

  14. Extent of resection in temporal lobectomy for epilepsy. II. Memory changes and neurologic complications.

    PubMed

    Katz, A; Awad, I A; Kong, A K; Chelune, G J; Naugle, R I; Wyllie, E; Beauchamp, G; Lüders, H

    1989-01-01

    We present correlations of extent of temporal lobectomy for intractable epilepsy with postoperative memory changes (20 cases) and abnormalities of visual field and neurologic examination (45 cases). Postoperative magnetic resonance imaging (MRI) in the coronal plane was used to quantify anteroposterior extent of resection of various quadrants of the temporal lobe, using a 20-compartment model of that structure. The Wechsler Memory Scale-Revised (WMS-R) was administered preoperatively and postoperatively. Postoperative decrease in percentage of retention of verbal material correlated with extent of medial resection of left temporal lobe, whereas decrease in percentage of retention of visual material correlated with extent of medial resection of right temporal lobe. These correlations approached but did not reach statistical significance. Extent of resection correlated significantly with the presence of visual field defect on perimetry testing but not with severity, denseness, or congruity of the defect. There was no correlation between postoperative dysphasia and extent of resection in any quadrant. Assessment of extent of resection after temporal lobectomy allows a rational interpretation of postoperative neurologic deficits in light of functional anatomy of the temporal lobe.

  15. Atrial fibrillation driven by micro-anatomic intramural re-entry revealed by simultaneous sub-epicardial and sub-endocardial optical mapping in explanted human hearts.

    PubMed

    Hansen, Brian J; Zhao, Jichao; Csepe, Thomas A; Moore, Brandon T; Li, Ning; Jayne, Laura A; Kalyanasundaram, Anuradha; Lim, Praise; Bratasz, Anna; Powell, Kimerly A; Simonetti, Orlando P; Higgins, Robert S D; Kilic, Ahmet; Mohler, Peter J; Janssen, Paul M L; Weiss, Raul; Hummel, John D; Fedorov, Vadim V

    2015-09-14

    The complex architecture of the human atria may create physical substrates for sustained re-entry to drive atrial fibrillation (AF). The existence of sustained, anatomically defined AF drivers in humans has been challenged partly due to the lack of simultaneous endocardial-epicardial (Endo-Epi) mapping coupled with high-resolution 3D structural imaging. Coronary-perfused human right atria from explanted diseased hearts (n = 8, 43-72 years old) were optically mapped simultaneously by three high-resolution CMOS cameras (two aligned Endo-Epi views (330 µm2 resolution) and one panoramic view). 3D gadolinium-enhanced magnetic resonance imaging (GE-MRI, 80 µm3 resolution) revealed the atrial wall structure varied in thickness (1.0 ± 0.7-6.8 ± 2.4 mm), transmural fiber angle differences, and interstitial fibrosis causing transmural activation delay from 23 ± 11 to 43 ± 22 ms at increased pacing rates. Sustained AF (>90 min) was induced by burst pacing during pinacidil (30-100 µM) perfusion. Dual-sided sub-Endo-sub-Epi optical mapping revealed that AF was driven by spatially and temporally stable intramural re-entry with 107 ± 50 ms cycle length and transmural activation delay of 67 ± 31 ms. Intramural re-entrant drivers were captured primarily by sub-Endo mapping, while sub-Epi mapping visualized re-entry or 'breakthrough' patterns. Re-entrant drivers were anchored on 3D micro-anatomic tracks (15.4 ± 2.2 × 6.0 ± 2.3 mm2, 2.9 ± 0.9 mm depth) formed by atrial musculature characterized by increased transmural fiber angle differences and interstitial fibrosis. Targeted radiofrequency ablation of the tracks verified these re-entries as drivers of AF. Integrated 3D structural-functional mapping of diseased human right atria ex vivo revealed that the complex atrial microstructure caused significant differences between Endo vs. Epi activation during pacing and sustained AF driven by intramural re-entry anchored to fibrosis-insulated atrial bundles. Published on

  16. Capturing heterogeneity: The role of a study area's extent for estimating mean throughfall

    NASA Astrophysics Data System (ADS)

    Zimmermann, Alexander; Voss, Sebastian; Metzger, Johanna Clara; Hildebrandt, Anke; Zimmermann, Beate

    2016-11-01

    The selection of an appropriate spatial extent of a sampling plot is one among several important decisions involved in planning a throughfall sampling scheme. In fact, the choice of the extent may determine whether or not a study can adequately characterize the hydrological fluxes of the studied ecosystem. Previous attempts to optimize throughfall sampling schemes focused on the selection of an appropriate sample size, support, and sampling design, while comparatively little attention has been given to the role of the extent. In this contribution, we investigated the influence of the extent on the representativeness of mean throughfall estimates for three forest ecosystems of varying stand structure. Our study is based on virtual sampling of simulated throughfall fields. We derived these fields from throughfall data sampled in a simply structured forest (young tropical forest) and two heterogeneous forests (old tropical forest, unmanaged mixed European beech forest). We then sampled the simulated throughfall fields with three common extents and various sample sizes for a range of events and for accumulated data. Our findings suggest that the size of the study area should be carefully adapted to the complexity of the system under study and to the required temporal resolution of the throughfall data (i.e. event-based versus accumulated). Generally, event-based sampling in complex structured forests (conditions that favor comparatively long autocorrelations in throughfall) requires the largest extents. For event-based sampling, the choice of an appropriate extent can be as important as using an adequate sample size.

  17. A phase coherence approach to estimating the spatial extent of earthquakes

    NASA Astrophysics Data System (ADS)

    Hawthorne, Jessica C.; Ampuero, Jean-Paul

    2016-04-01

    We present a new method for estimating the spatial extent of seismic sources. The approach takes advantage of an inter-station phase coherence computation that can identify co-located sources (Hawthorne and Ampuero, 2014). Here, however, we note that the phase coherence calculation can eliminate the Green's function and give high values only if both earthquakes are point sources---if their dimensions are much smaller than the wavelengths of the propagating seismic waves. By examining the decrease in coherence at higher frequencies (shorter wavelengths), we can estimate the spatial extents of the earthquake ruptures. The approach can to some extent be seen as a simple way of identifying directivity or variations in the apparent source time functions recorded at various stations. We apply this method to a set of well-recorded earthquakes near Parkfield, CA. We show that when the signal to noise ratio is high, the phase coherence remains high well above 50 Hz for closely spaced M<1.5 earthquake. The high-frequency phase coherence is smaller for larger earthquakes, suggesting larger spatial extents. The implied radii scale roughly as expected from typical magnitude-corner frequency scalings. We also examine a second source of high-frequency decoherence: spatial variation in the shape of the Green's functions. This spatial decoherence appears to occur on a similar wavelengths as the decoherence associated with the apparent source time functions. However, the variation in Green's functions can be normalized away to some extent by comparing observations at multiple components on a single station, which see the same apparent source time functions.

  18. Arrhythmogenic substrate at the interventricular septum as a target site for radiofrequency catheter ablation of recurrent ventricular tachycardia in left dominant arrhythmogenic cardiomyopathy.

    PubMed

    Havranek, Stepan; Palecek, Tomas; Kovarnik, Tomas; Vitkova, Ivana; Psenicka, Miroslav; Linhart, Ales; Wichterle, Dan

    2015-03-10

    Left dominant arrhythmogenic cardiomyopathy (LDAC) is a rare condition characterised by progressive fibrofatty replacement of the myocardium of the left ventricle (LV) in combination with ventricular arrhythmias of LV origin. A thirty-five-year-old male was referred for evaluation of recurrent sustained monomorphic ventricular tachycardia (VT) of 200 bpm and right bundle branch block (RBBB) morphology. Cardiac magnetic resonance imaging showed late gadolinium enhancement distributed circumferentially in the epicardial layer of the LV free wall myocardium including the rightward portion of the interventricular septum (IVS). The clinical RBBB VT was reproduced during the EP study. Ablation at an LV septum site with absence of abnormal electrograms and a suboptimum pacemap rendered the VT of clinical morphology noninducible. Three other VTs, all of left bundle branch block (LBBB) pattern, were induced by programmed electrical stimulation. The regions corresponding to abnormal electrograms were identified and ablated at the mid-to-apical RV septum and the anteroseptal portion of the right ventricular outflow tract. No abnormalities were found at the RV free wall including the inferolateral peritricuspid annulus region. Histological examination confirmed the presence of abnormal fibrous and adipose tissue with myocyte reduction in endomyocardial samples taken from both the left and right aspects of the IVS. LDAC rarely manifests with sustained monomorphic ventricular tachycardia. In this case, several VTs of both RBBB and LBBB morphology were amenable to endocardial radiofrequency catheter ablation.

  19. The Extent of Reversibility of Polychlorinated Biphenyl Adsorption

    EPA Science Inventory

    The extent of reversibility of PCB bonding to sediments has been characterized in studies on the partitioning behavior of a hexachlorobiphenyl isomer. Linear non-singular isotherms have been observed for the adsorption and desorption of 2.4.5.2?,4?,5? hexachlorobiphenyl (HCBP) to...

  20. The extent of forest in dryland biomes

    Treesearch

    Jean-Francois Bastin; Nora Berrahmouni; Alan Grainger; Danae Maniatis; Danilo Mollicone; Rebecca Moore; Chiara Patriarca; Nicolas Picard; Ben Sparrow; Elena Maria Abraham; Kamel Aloui; Ayhan Atesoglu; Fabio Attore; Caglar Bassullu; Adia Bey; Monica Garzuglia; Luis G. GarcÌa-Montero; Nikee Groot; Greg Guerin; Lars Laestadius; Andrew J. Lowe; Bako Mamane; Giulio Marchi; Paul Patterson; Marcelo Rezende; Stefano Ricci; Ignacio Salcedo; Alfonso Sanchez-Paus Diaz; Fred Stolle; Venera Surappaeva; Rene Castro

    2017-01-01

    Dryland biomes cover two-fifths of Earth’s land surface, but their forest area is poorly known. Here, we report an estimate of global forest extent in dryland biomes, based on analyzing more than 210,000 0.5-hectare sample plots through a photo-interpretation approach using large databases of satellite imagery at (i) very high spatial resolution and (ii) very high...

  1. Profiling the Location and Extent of Musicians' Pain Using Digital Pain Drawings.

    PubMed

    Cruder, Cinzia; Falla, Deborah; Mangili, Francesca; Azzimonti, Laura; Araújo, Liliana S; Williamon, Aaron; Barbero, Marco

    2018-01-01

    According to existing literature, musicians are at risk of experiencing a range of painful musculoskeletal conditions. Recently, a novel digital technology was developed to investigate pain location and pain extent. The aim of this study was to describe pain location and pain extent in musicians using a digital method for pain drawing (PD) analysis. Additionally, the association between PD variables and clinical features were explored in musicians with pain. One hundred and fifty-eight musicians (90 women and 68 men; aged 22.4 ± 3.6 years) were recruited from Swiss and U.K. conservatories. Participants were asked to complete a survey including both background musical information and clinical features, the QuickDASH (QD) questionnaire, and the digital PDs. Of the 158 participants, 126 musicians (79.7%) reported having pain, with higher prevalence in the areas of the neck and shoulders, the lower back, and the right arm. The mean percentage of pain extent was 3.1% ± 6.5%. The mean QD score was higher for musicians with pain than for those without pain. Additionally, the results indicated a positive correlation between the QD score and pain extent, and there were significant correlations between age and pain intensity, as well as between pain extent and pain intensity. The high prevalence of pain among musicians has been confirmed using a digital technique for PD acquisition and analysis. In addition, positive correlations between pain extent and upper limb disability have been demonstrated. Our findings highlight the need for effective prevention and treatment strategies for musicians. © 2017 The Authors. Pain Practice published by Wiley Periodicals, Inc. on behalf of World Institute of Pain.

  2. A time series of urban extent in China using DSMP/OLS nighttime light data

    PubMed Central

    Chen, Dongsheng; Chen, Le; Wang, Huan; Guan, Qingfeng

    2018-01-01

    Urban extent data play an important role in urban management and urban studies, such as monitoring the process of urbanization and changes in the spatial configuration of urban areas. Traditional methods of extracting urban-extent information are primarily based on manual investigations and classifications using remote sensing images, and these methods have such problems as large costs in labor and time and low precision. This study proposes an improved, simplified and flexible method for extracting urban extents over multiple scales and the construction of spatiotemporal models using DMSP/OLS nighttime light (NTL) for practical situations. This method eliminates the regional temporal and spatial inconsistency of thresholding NTL in large-scale and multi-temporal scenes. Using this method, we have extracted the urban extents and calculated the corresponding areas on the county, municipal and provincial scales in China from 2000 to 2012. In addition, validation with the data of reference data shows that the overall accuracy (OA), Kappa and F1 Scores were 0.996, 0.793, and 0.782, respectively. We increased the spatial resolution of the urban extent to 500 m (approximately four times finer than the results of previous studies). Based on the urban extent dataset proposed above, we analyzed changes in urban extents over time and observed that urban sprawl has grown in all of the counties of China. We also identified three patterns of urban sprawl: Early Urban Growth, Constant Urban Growth and Recent Urban Growth. In addition, these trends of urban sprawl are consistent with the western, eastern and central cities of China, respectively, in terms of their spatial distribution, socioeconomic characteristics and historical background. Additionally, the urban extents display the spatial configurations of urban areas intuitively. The proposed urban extent dataset is available for download and can provide reference data and support for future studies of urbanization and urban

  3. Accuracy of determining preoperative cancer extent measured by automated breast ultrasonography.

    PubMed

    Tozaki, Mitsuhiro; Fukuma, Eisuke

    2010-12-01

    The aim of this study was to determine the accuracy of measuring preoperative cancer extent using automated breast ultrasonography (US). This retrospective study consisted of 40 patients with histopathologically confirmed breast cancer. All of the patients underwent automated breast US (ABVS; Siemens Medical Solutions, Mountain View, CA, USA) on the day before the surgery. The sizes of the lesions on US were measured on coronal multiplanar reconstruction images using the ABVS workstation. Histopathological measurement of tumor size included not only the invasive foci but also any in situ component and was used as the gold standard. The discrepancy of the tumor extent between automated breast US and the histological examination was calculated. Automated breast US enabled visualization of the breast carcinomas in all patients. The mean size of the lesions on US was 12 mm (range 4-62 mm). The histopathological diagnosis was ductal carcinoma in situ (DCIS) in seven patients and invasive ductal carcinoma in 33 patients (18 without an intraductal component, 15 with an intraductal component). Lesions ranged in diameter from 4 to 65 mm (mean 16 mm). The accuracy of determination of the tumor extent with a deviation in length of <2 cm was 98% (39/40). Automated breast US is thought to be useful for evaluating tumor extent preoperatively.

  4. 45 CFR 400.202 - Extent of Federal funding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Extent of Federal funding. 400.202 Section 400.202... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Federal Funding Federal Funding for Expenditures for Determining Eligibility and Providing Assistance and Services § 400...

  5. 45 CFR 400.202 - Extent of Federal funding.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 2 2011-10-01 2011-10-01 false Extent of Federal funding. 400.202 Section 400.202... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Federal Funding Federal Funding for Expenditures for Determining Eligibility and Providing Assistance and Services § 400...

  6. 45 CFR 400.202 - Extent of Federal funding.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 2 2014-10-01 2012-10-01 true Extent of Federal funding. 400.202 Section 400.202... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Federal Funding Federal Funding for Expenditures for Determining Eligibility and Providing Assistance and Services § 400...

  7. Radial and circumferential flow surveys at the inlet and exit of the Space Shuttle Main Engine High Pressure Fuel Turbine Model

    NASA Technical Reports Server (NTRS)

    Hudson, S. T.; Bordelon, W. J., Jr.; Smith, A. W.; Ramachandran, N.

    1995-01-01

    The main objective of this test was to obtain detailed radial and circumferential flow surveys at the inlet and exit of the SSME High Pressure Fuel Turbine model using three-hole cobra probes, hot-film probes, and a laser velocimeter. The test was designed to meet several objectives. First, the techniques for making laser velocimeter, hot-film probe, and cobra probe measurements in turbine flows were developed and demonstrated. The ability to use the cobra probes to obtain static pressure and, therefore, velocity had to be verified; insertion techniques had to be established for the fragile hot-film probes; and a seeding method had to be established for the laser velocimetry. Once the measurement techniques were established, turbine inlet and exit velocity profiles, temperature profiles, pressure profiles, turbulence intensities, and boundary layer thicknesses were measured at the turbine design point. The blockage effect due to the model inlet and exit total pressure and total temperature rakes on the turbine performance was also studied. A small range of off-design points were run to obtain the profiles and to verify the rake blockage effects off-design. Finally, a range of different Reynolds numbers were run to study the effect of Reynolds number on the various measurements.

  8. Factors influencing the spatial extent of mobile source air pollution impacts: a meta-analysis

    PubMed Central

    Zhou, Ying; Levy, Jonathan I

    2007-01-01

    Background There has been growing interest among exposure assessors, epidemiologists, and policymakers in the concept of "hot spots", or more broadly, the "spatial extent" of impacts from traffic-related air pollutants. This review attempts to quantitatively synthesize findings about the spatial extent under various circumstances. Methods We include both the peer-reviewed literature and government reports, and focus on four significant air pollutants: carbon monoxide, benzene, nitrogen oxides, and particulate matter (including both ultrafine particle counts and fine particle mass). From the identified studies, we extracted information about significant factors that would be hypothesized to influence the spatial extent within the study, such as the study type (e.g., monitoring, air dispersion modeling, GIS-based epidemiological studies), focus on concentrations or health risks, pollutant under study, background concentration, emission rate, and meteorological factors, as well as the study's implicit or explicit definition of spatial extent. We supplement this meta-analysis with results from some illustrative atmospheric dispersion modeling. Results We found that pollutant characteristics and background concentrations best explained variability in previously published spatial extent estimates, with a modifying influence of local meteorology, once some extreme values based on health risk estimates were removed from the analysis. As hypothesized, inert pollutants with high background concentrations had the largest spatial extent (often demonstrating no significant gradient), and pollutants formed in near-source chemical reactions (e.g., nitrogen dioxide) had a larger spatial extent than pollutants depleted in near-source chemical reactions or removed through coagulation processes (e.g., nitrogen oxide and ultrafine particles). Our illustrative dispersion model illustrated the complex interplay of spatial extent definitions, emission rates, background concentrations

  9. 46 CFR 287.24 - Extent of tax liability.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OPERATORS ESTABLISHMENT OF CONSTRUCTION RESERVE FUNDS § 287.24 Extent of tax liability. (a) Declared value... case of deposits in the construction reserve fund of amounts derived from sources other than those... regard to the provisions of section 511(c) of the Act. (c) Time for filing claim subsequent to election...

  10. 46 CFR 287.24 - Extent of tax liability.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OPERATORS ESTABLISHMENT OF CONSTRUCTION RESERVE FUNDS § 287.24 Extent of tax liability. (a) Declared value... case of deposits in the construction reserve fund of amounts derived from sources other than those... regard to the provisions of section 511(c) of the Act. (c) Time for filing claim subsequent to election...

  11. 46 CFR 287.24 - Extent of tax liability.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... OPERATORS ESTABLISHMENT OF CONSTRUCTION RESERVE FUNDS § 287.24 Extent of tax liability. (a) Declared value... case of deposits in the construction reserve fund of amounts derived from sources other than those... regard to the provisions of section 511(c) of the Act. (c) Time for filing claim subsequent to election...

  12. 46 CFR 287.24 - Extent of tax liability.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... OPERATORS ESTABLISHMENT OF CONSTRUCTION RESERVE FUNDS § 287.24 Extent of tax liability. (a) Declared value... case of deposits in the construction reserve fund of amounts derived from sources other than those... regard to the provisions of section 511(c) of the Act. (c) Time for filing claim subsequent to election...

  13. 46 CFR 174.315 - Extent and character of damage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... PERTAINING TO SPECIFIC VESSEL TYPES Hopper Dredges With Working Freeboard Assignments Calculations § 174.315 Extent and character of damage. (a) The calculations required by § 174.310 must show that the dredge can...

  14. 46 CFR 174.315 - Extent and character of damage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PERTAINING TO SPECIFIC VESSEL TYPES Hopper Dredges With Working Freeboard Assignments Calculations § 174.315 Extent and character of damage. (a) The calculations required by § 174.310 must show that the dredge can...

  15. Compressibility effects on rotor forces in the leakage path between a shrouded pump impeller and its housing

    NASA Technical Reports Server (NTRS)

    Cao, Nhai The

    1993-01-01

    A modified approach to Childs' previous work on fluid-structure interaction forces in the leakage path between an impeller shroud and its housing is presented in this paper. Three governing equations consisting of continuity, path-momentum, and circumferential-momentum equations were developed to describe the leakage path inside a pump impeller. Radial displacement perturbations were used to solve for radial and circumferential force coefficients. In addition, impeller-discharge pressure disturbances were used to obtain pressure oscillation responses due to precessing impeller pressure wave pattern. Childs' model was modified from an incompressible model to a compressible barotropic-fluid model (the density of the working fluid is a function of the pressure and a constant temperature only). Results obtained from this model yielded interaction forces for radial and circumferential force coefficients. Radial and circumferential forces define reaction forces within the impeller leakage path. An acoustic model for the same leakage path was also developed. The convective, Coriolis, and centrifugal acceleration terms are removed from the compressible model to obtain the acoustics model. A solution due to impeller discharge pressure disturbances model was also developed for the compressible and acoustics models. The results from these modifications are used to determine what effects additional perturbation terms in the compressible model have on the acoustic model. The results show that the additional fluid mechanics terms in the compressible model cause resonances (peaks) in the force coefficient response curves. However, these peaks only occurred at high values of inlet circumferential velocity ratios greater than 0.7. The peak pressure oscillation was shown to occur at the wearing ring seal. Introduction of impeller discharge disturbances with n = 11 diametral nodes showed that maximum peak pressure oscillations occurred at nondimensional precession frequencies of f

  16. Extent of resection and timing of surgery in adult low grade glioma.

    PubMed

    A Mirza, Farhan; Shamim, Muhammad Shahzad

    2017-06-01

    Low grade glioma is a group of WHO grade II tumours including diffuse astrocytoma, oligodendroglioma, and oligoastrocytoma. Strong evidence exists in literature now to support early surgery and higher extent of safe resection in improving outcomes. In this review, we are highlighting some of the important studies done in the last few years specifically addressing timing of surgery and extent of resection.

  17. [Contrast agent improves diagnostic value of dobutamine stress echocardiography].

    PubMed

    Uehara, H; Yamamoto, T; Hirano, Y; Ozasa, Y; Yamada, S; Ikawa, H; Ishikawa, K

    2001-03-01

    Suboptimal endocardial definition reduces the diagnostic value of stress echocardiography for coronary artery disease, but intravenous infusion of a left ventricular contrast agent (Albunex) may enhance endocardial border delineation and improve the diagnostic value of dobutamine stress echocardiography. Fifty-six patients, 38 with myocardial infarction, 16 with angina pectoris and two normal subjects, were enrolled in this study. Dobutamine was infused in scalar doses of 5 to 40 micrograms/kg/min. Intravenous infusion of Albunex (0.15 ml/kg) was administered at rest and during peak dobutamine stress during monitoring of the apical four-chamber view. The left ventricle in the apical four-chamber view was divided into six segments and an endocardial delineation score of 0 to 3 (none to excellent visualization) was given to each segment. Endocardial delineation score was increased after Albunex infusion from 2.0 to 2.3 in the basal-septal, 2.0 to 2.4 in the mid-septal, 1.1 to 1.8 in the apical-septal, 0.7 to 1.2 in the apical-lateral, 0.9 to 1.6 in the mid-lateral, and 1.2 to 1.9 in the basal-lateral segments during peak dobutamine administration. Endocardial border resolution in the lateral wall showed greater improvement than in the septal wall after Albunex infusion. Diagnostic values in the left anterior descending artery territory failed to improve with Albunex infusion (sensitivity 82% to 89%, specificity 94% to 89%, and accuracy 86% to 89%), whereas a higher diagnostic accuracy was noted in the left circumflex artery territory with Albunex compared to without Albunex (sensitivity 63% to 81%, specificity 88% to 98%, and accuracy 80% to 93%, p < 0.05). Contrast agent improves the diagnostic accuracy of dobutamine stress echocardiography in the left circumflex artery territory.

  18. Sequential Ligand-Dependent Notch Signaling Activation Regulates Valve Primordium Formation and Morphogenesis.

    PubMed

    MacGrogan, Donal; D'Amato, Gaetano; Travisano, Stanislao; Martinez-Poveda, Beatriz; Luxán, Guillermo; Del Monte-Nieto, Gonzalo; Papoutsi, Tania; Sbroggio, Mauro; Bou, Vanesa; Gomez-Del Arco, Pablo; Gómez, Manuel Jose; Zhou, Bin; Redondo, Juan Miguel; Jiménez-Borreguero, Luis J; de la Pompa, José Luis

    2016-05-13

    The Notch signaling pathway is crucial for primitive cardiac valve formation by epithelial-mesenchymal transition, and NOTCH1 mutations cause bicuspid aortic valve; however, the temporal requirement for the various Notch ligands and receptors during valve ontogeny is poorly understood. The aim of this study is to determine the functional specificity of Notch in valve development. Using cardiac-specific conditional targeted mutant mice, we find that endothelial/endocardial deletion of Mib1-Dll4-Notch1 signaling, possibly favored by Manic-Fringe, is specifically required for cardiac epithelial-mesenchymal transition. Mice lacking endocardial Jag1, Notch1, or RBPJ displayed enlarged valve cusps, bicuspid aortic valve, and septal defects, indicating that endocardial Jag1 to Notch1 signaling is required for post-epithelial-mesenchymal transition valvulogenesis. Valve dysmorphology was associated with increased mesenchyme proliferation, indicating that Jag1-Notch1 signaling restricts mesenchyme cell proliferation non-cell autonomously. Gene profiling revealed upregulated Bmp signaling in Jag1-mutant valves, providing a molecular basis for the hyperproliferative phenotype. Significantly, the negative regulator of mesenchyme proliferation, Hbegf, was markedly reduced in Jag1-mutant valves. Hbegf expression in embryonic endocardial cells could be readily activated through a RBPJ-binding site, identifying Hbegf as an endocardial Notch target. Accordingly, addition of soluble heparin-binding EGF-like growth factor to Jag1-mutant outflow tract explant cultures rescued the hyperproliferative phenotype. During cardiac valve formation, Dll4-Notch1 signaling leads to epithelial-mesenchymal transition and cushion formation. Jag1-Notch1 signaling subsequently restrains Bmp-mediated valve mesenchyme proliferation by sustaining Hbegf-EGF receptor signaling. Our studies identify a mechanism of signaling cross talk during valve morphogenesis involved in the origin of congenital heart

  19. Possible Extent of Ancient Lake in Gale Crater, Mars

    NASA Image and Video Library

    2013-12-09

    This illustration depicts a concept for the possible extent of an ancient lake inside Gale Crater. The base map combines image data from the Context Camera on NASA Mars Reconnaissance Orbiter and color information from Viking Orbiter imagery.

  20. Reaction Extrema: Extent of Reaction in General Chemistry

    ERIC Educational Resources Information Center

    Vandezande, Jonathon E.; Vander Griend, Douglas A.; DeKock, Roger L.

    2013-01-01

    Nearly 100 years ago de Donder introduced the term "extent of reaction", ?. We build on that work by defining the concept of reagent extrema for an arbitrary chemical reaction, aA + bB [reversible reaction] yY + zZ. The central equation is ?^[subscript i] = -n[subscript i,0]/?[subscript i]. The symbol ?^[subscript i] represents the…

  1. Successes and challenges from formation to implementation of eleven broad-extent conservation programs.

    PubMed

    Beever, Erik A; Mattsson, Brady J; Germino, Matthew J; Burg, Max Post Van Der; Bradford, John B; Brunson, Mark W

    2014-04-01

    Integration of conservation partnerships across geographic, biological, and administrative boundaries is increasingly relevant because drivers of change, such as climate shifts, transcend these boundaries. We explored successes and challenges of established conservation programs that span multiple watersheds and consider both social and ecological concerns. We asked representatives from a diverse set of 11 broad-extent conservation partnerships in 29 countries 17 questions that pertained to launching and maintaining partnerships for broad-extent conservation, specifying ultimate management objectives, and implementation and learning. Partnerships invested more funds in implementing conservation actions than any other aspect of conservation, and a program's context (geographic extent, United States vs. other countries, developed vs. developing nation) appeared to substantially affect program approach. Despite early successes of these organizations and benefits of broad-extent conservation, specific challenges related to uncertainties in scaling up information and to coordination in the face of diverse partner governance structures, conflicting objectives, and vast uncertainties regarding future system dynamics hindered long-term success, as demonstrated by the focal organizations. Engaging stakeholders, developing conservation measures, and implementing adaptive management were dominant challenges. To inform future research on broad-extent conservation, we considered several challenges when we developed detailed questions, such as what qualities of broad-extent partnerships ensure they complement, integrate, and strengthen, rather than replace, local conservation efforts and which adaptive management processes yield actionable conservation strategies that account explicitly for dynamics and uncertainties regarding multiscale governance, environmental conditions, and knowledge of the system? © 2014 Society for Conservation Biology.

  2. Reconstruction of past equilibrium line altitude using ice extent data

    NASA Astrophysics Data System (ADS)

    Visnjevic, Vjeran; Herman, Frederic; Podladchikov, Yuri

    2017-04-01

    With the end of the Last Glacial Maximum (LGM), about 20 000 years ago, ended the most recent long-lasting cold phase in Earth's history. This last glacial advance left a strong observable imprint on the landscape, such as abandoned moraines, trimlines and other glacial geomorphic features. These features provide a valuable record of past continental climate. In particular, terminal moraines reflect the extent of glaciers and ice-caps, which itself reflects past temperature and precipitation conditions. Here we present an inverse approach, based on a Tikhonov regularization, we have recently developed to reconstruct the LGM mass balance from observed ice extent data. The ice flow model is developed using the shallow ice approximation and solved explicitly using Graphical Processing Units (GPU). The mass balance field, b, is the constrained variable defined by the ice surface S, balance rate β and the spatially variable equilibrium line altitude field (ELA): b = min (β ṡ(S(x,y)- ELA (x,y)),c). (1) where c is a maximum accumulation rate. We show that such a mass balance, and thus the spatially variable ELA field, can be inferred from the observed past ice extent and ice thickness at high resolution and very efficiently. The GPU implementation allows us solve one 1024x1024 grid points forward model run under 0.5s, which significantly reduces the time needed for our inverse method to converge. We start with synthetic test to demonstrate the method. We then apply the method to LGM ice extents of South Island of New Zealand, the Patagonian Andes, where we can see a clear influence of Westerlies on the ELA, and the European Alps. These examples show that the method is capable of constraining spatial variations in mass balance at the scale of a mountain range, and provide us with information on past continental climate.

  3. Regional cardiac wall motion from gated myocardial perfusion SPECT studies

    NASA Astrophysics Data System (ADS)

    Smith, M. F.; Brigger, P.; Ferrand, S. K.; Dilsizian, V.; Bacharach, S. L.

    1999-06-01

    A method for estimating regional epicardial and endocardial wall motion from gated myocardial perfusion SPECT studies has been developed. The method uses epicardial and endocardial boundaries determined from four long-axis slices at each gate of the cardiac cycle. The epicardial and endocardial wall position at each time gate is computed with respect to stationary reference ellipsoids, and wall motion is measured along lines normal to these ellipsoids. An initial quantitative evaluation of the method was made using the beating heart from the dynamic mathematical cardiac torso (MCAT) phantom, with and without a 1.5-cm FWHM Gaussian blurring filter. Epicardial wall motion was generally well-estimated within a fraction of a 3.56-mm voxel, although apical motion was overestimated with the Gaussian filter. Endocardial wall motion was underestimated by about two voxels with and without the Gaussian filter. The MCAT heart phantom was modified to model hypokinetic and dyskinetic wall motion. The wall motion analysis method enabled this abnormal motion to be differentiated from normal motion. Regional cardiac wall motion also was analyzed for /sup 201/Tl patient studies. Estimated wall motion was consistent with a nuclear medicine physician's visual assessment of motion from gated long-axis slices for male and female study examples. Additional research is required for a comprehensive evaluation of the applicability of the method to patient studies with normal and abnormal wall motion.

  4. Fiber micro-architecture in the longitudinal-radial and circumferential-radial planes of ascending thoracic aortic aneurysm media

    PubMed Central

    Tsamis, Alkiviadis; Phillippi, Julie A.; Koch, Ryan G.; Pasta, Salvatore; D'Amore, Antonio; Watkins, Simon C.; Wagner, William R.; Gleason, Thomas G.; Vorp, David A.

    2013-01-01

    It was recently demonstrated by our group that the delamination strength of ascending thoracic aortic aneurysms (ATAA) was lower than that of control (CTRL, non-aneurysmal) ascending thoracic aorta (ATA), and the reduced strength was more pronounced among bicuspid (BAV) vs. tricuspid aortic valve (TAV) patients, suggesting a different risk of aortic dissection for BAV patients. We hypothesized that aortic valve morphologic phenotype predicts fiber micro-architectural anomalies in ATA. To test the hypothesis, we characterized the micro-architecture in the longitudinal-radial (Z-RAD) and circumferential-radial (Θ-RAD) planes of human ATA tissue that was artificially dissected medially. The outer and inner-media of CTRL-ATA, BAV-ATAA and TAV-ATAA were imaged using multi-photon microscopy in the Z-RAD and Θ-RAD planes to observe collagen and elastin. Micrographs were processed using an image-based tool to quantify several micro-architectural characteristics. In the outer-media of BAV-ATAA, elastin was more undulated and less aligned about the Θ-axis when compared with CTRL-ATA, which is consistent with increased tensile stretch at inflection point of Θ-strips of adventitial-medial half of BAV-ATAA (1.28) when compared with CTRL-ATA (1.13). With increasing age, collagen became more undulated about the Z-axis within the outer-media of TAV-ATAA, and elastin became more oriented in the Z-axis and collagen less radially-oriented within the inner-media of TAV-ATAA. This discrepancy in the micro-architecture with fibers in the inner layers being more stretched and with disrupted radially-oriented components than fibers in the outer layers may be associated with the development, progression and vascular remodeling in aneurysms arising in TAV patients. PMID:24075403

  5. Fiber micro-architecture in the longitudinal-radial and circumferential-radial planes of ascending thoracic aortic aneurysm media.

    PubMed

    Tsamis, Alkiviadis; Phillippi, Julie A; Koch, Ryan G; Pasta, Salvatore; D'Amore, Antonio; Watkins, Simon C; Wagner, William R; Gleason, Thomas G; Vorp, David A

    2013-11-15

    It was recently demonstrated by our group that the delamination strength of ascending thoracic aortic aneurysms (ATAA) was lower than that of control (CTRL, non-aneurysmal) ascending thoracic aorta (ATA), and the reduced strength was more pronounced among bicuspid (BAV) vs. tricuspid aortic valve (TAV) patients, suggesting a different risk of aortic dissection for BAV patients. We hypothesized that aortic valve morphologic phenotype predicts fiber micro-architectural anomalies in ATA. To test the hypothesis, we characterized the micro-architecture in the longitudinal-radial (Z-RAD) and circumferential-radial (Θ-RAD) planes of human ATA tissue that was artificially dissected medially. The outer and inner-media of CTRL-ATA, BAV-ATAA and TAV-ATAA were imaged using multi-photon microscopy in the Z-RAD and Θ-RAD planes to observe collagen and elastin. Micrographs were processed using an image-based tool to quantify several micro-architectural characteristics. In the outer-media of BAV-ATAA, elastin was more undulated and less aligned about the Θ-axis when compared with CTRL-ATA, which is consistent with increased tensile stretch at inflection point of Θ-strips of adventitial-medial half of BAV-ATAA (1.28) when compared with CTRL-ATA (1.13). With increasing age, collagen became more undulated about the Z-axis within the outer-media of TAV-ATAA, and elastin became more oriented in the Z-axis and collagen less radially-oriented within the inner-media of TAV-ATAA. This discrepancy in the micro-architecture with fibers in the inner layers being more stretched and with disrupted radially-oriented components than fibers in the outer layers may be associated with the development, progression and vascular remodeling in aneurysms arising in TAV patients. © 2013 Elsevier Ltd. All rights reserved.

  6. HOTEX: An Approach for Global Mapping of Human Built-Up and Settlement Extent

    NASA Technical Reports Server (NTRS)

    Wang, Panshi; Huang, Chengquan; Tilton, James C.; Tan, Bin; Brown De Colstoun, Eric C.

    2017-01-01

    Understanding the impacts of urbanization requires accurate and updatable urban extent maps. Here we present an algorithm for mapping urban extent at global scale using Landsat data. An innovative hierarchical object-based texture (HOTex) classification approach was designed to overcome spectral confusion between urban and nonurban land cover types. VIIRS nightlights data and MODIS vegetation index datasets are integrated as high-level features under an object-based framework. We applied the HOTex method to the GLS-2010 Landsat images to produce a global map of human built-up and settlement extent. As shown by visual assessments, our method could effectively map urban extent and generate consistent results using images with inconsistent acquisition time and vegetation phenology. Using scene-level cross validation for results in Europe, we assessed the performance of HOTex and achieved a kappa coefficient of 0.91, compared to 0.74 from a baseline method using per-pixel classification using spectral information.

  7. Monitoring the Extent of Forests on National to Global Scales

    NASA Astrophysics Data System (ADS)

    Townshend, J.; Townshend, J.; Hansen, M.; DeFries, R.; DeFries, R.; Sohlberg, R.; Desch, A.; White, B.

    2001-05-01

    Information on forest extent and change is important for many purposes, including understanding the global carbon cycle and managing natural resources. International statistics on forest extent are generated using many different sources often producing inconsistent results spatially and through time. Results will be presented comparing forest extent derived from the recent global Food and Agricultural Organization's (FAO) FRA 2000 report with products derived using wall-to-wall Landsat, AVHRR and MODIS data sets. The remotely sensed data sets provide consistent results in terms of total area despite considerable differences in spatial resolution. Although the location of change can be satisfactorily detected with all three remotely sensed data sets, reliable measurement of change can only be achieved through use of Landsat-resolution data. Contrary to the FRA 2000 results we find evidence of an increase in deforestation rates in the late 1990s in several countries. Also we have found evidence of considerable changes in some countries for which little or no change is reported by FAO. The results indicate the benefits of globally consistent analyses of forest cover based on multiscale remotely sensed data sets rather than a reliance on statistics generated by individual countries with very different definitions of forest and methods used to derive them.

  8. Extent of pyrolysis impacts on fast pyrolysis biochar properties.

    PubMed

    Brewer, Catherine E; Hu, Yan-Yan; Schmidt-Rohr, Klaus; Loynachan, Thomas E; Laird, David A; Brown, Robert C

    2012-01-01

    A potential concern about the use of fast pyrolysis rather than slow pyrolysis biochars as soil amendments is that they may contain high levels of bioavailable C due to short particle residence times in the reactors, which could reduce the stability of biochar C and cause nutrient immobilization in soils. To investigate this concern, three corn ( L.) stover fast pyrolysis biochars prepared using different reactor conditions were chemically and physically characterized to determine their extent of pyrolysis. These biochars were also incubated in soil to assess their impact on soil CO emissions, nutrient availability, microorganism population growth, and water retention capacity. Elemental analysis and quantitative solid-state C nuclear magnetic resonance spectroscopy showed variation in O functional groups (associated primarily with carbohydrates) and aromatic C, which could be used to define extent of pyrolysis. A 24-wk incubation performed using a sandy soil amended with 0.5 wt% of corn stover biochar showed a small but significant decrease in soil CO emissions and a decrease in the bacteria:fungi ratios with extent of pyrolysis. Relative to the control soil, biochar-amended soils had small increases in CO emissions and extractable nutrients, but similar microorganism populations, extractable NO levels, and water retention capacities. Corn stover amendments, by contrast, significantly increased soil CO emissions and microbial populations, and reduced extractable NO. These results indicate that C in fast pyrolysis biochar is stable in soil environments and will not appreciably contribute to nutrient immobilization. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  9. Comparison of simultaneous and sequential SPECT imaging for discrimination tasks in assessment of cardiac defects.

    PubMed

    Trott, C M; Ouyang, J; El Fakhri, G

    2010-11-21

    Simultaneous rest perfusion/fatty-acid metabolism studies have the potential to replace sequential rest/stress perfusion studies for the assessment of cardiac function. Simultaneous acquisition has the benefits of increased signal and lack of need for patient stress, but is complicated by cross-talk between the two radionuclide signals. We consider a simultaneous rest (99m)Tc-sestamibi/(123)I-BMIPP imaging protocol in place of the commonly used sequential rest/stress (99m)Tc-sestamibi protocol. The theoretical precision with which the severity of a cardiac defect and the transmural extent of infarct can be measured is computed for simultaneous and sequential SPECT imaging, and their performance is compared for discriminating (1) degrees of defect severity and (2) sub-endocardial from transmural defects. We consider cardiac infarcts for which reduced perfusion and metabolism are observed. From an information perspective, simultaneous imaging is found to yield comparable or improved performance compared with sequential imaging for discriminating both severity of defect and transmural extent of infarct, for three defects of differing location and size.

  10. The cardiac ultrastructure of Chimaera monstrosa L. (Elasmobranchii: Holocephali).

    PubMed

    Berge, P I

    1979-09-03

    The ultrastructure of the heart in Chimaera monstrosa L. is described. The endocardial and the epicardial cells are similar in the three cardiac regions. Myocardial cells show small variations. The myofibred, 4--6 microns thick, contains one or a few myofibrils. Each myosin filament is surrounded by six actin filaments. The sarcomere banding pattern includes the Z-, A-, I-, M-, N-, and H-band. End-to-end attachments between myofibres are composed of alternating desmosomes and fasciae adhaerentes. Desmosomes and nexuses occur between longitudinally oriented cell surfaces. The sarcoplasmic reticulum is poorly developed but well defined. Peripheral coupling-like structures are common, T-tubules are absent. Membrane bound dense bodies occur in all regions. Areas with ribosomes and single myosin filaments are often seen. The epicardial cells have a regular hexagonal surface and are much thicker than the endocardial cells. Numerous short and few longer cytoplasmic extensions face the pericardial cavity. The flat endocardial cells contain a large nucleus and small amounts of cytoplasm.

  11. Extent of hippocampal atrophy predicts degree of deficit in recall.

    PubMed

    Patai, Eva Zita; Gadian, David G; Cooper, Janine M; Dzieciol, Anna M; Mishkin, Mortimer; Vargha-Khadem, Faraneh

    2015-10-13

    Which specific memory functions are dependent on the hippocampus is still debated. The availability of a large cohort of patients who had sustained relatively selective hippocampal damage early in life enabled us to determine which type of mnemonic deficit showed a correlation with extent of hippocampal injury. We assessed our patient cohort on a test that provides measures of recognition and recall that are equated for difficulty and found that the patients' performance on the recall tests correlated significantly with their hippocampal volumes, whereas their performance on the equally difficult recognition tests did not and, indeed, was largely unaffected regardless of extent of hippocampal atrophy. The results provide new evidence in favor of the view that the hippocampus is essential for recall but not for recognition.

  12. Effect of Emphysema Extent on Serial Lung Function in Patients with Idiopathic Pulmonary Fibrosis.

    PubMed

    Cottin, Vincent; Hansell, David M; Sverzellati, Nicola; Weycker, Derek; Antoniou, Katerina M; Atwood, Mark; Oster, Gerry; Kirchgaessler, Klaus-Uwe; Collard, Harold R; Wells, Athol U

    2017-11-01

    Patients with idiopathic pulmonary fibrosis and emphysema may have artificially preserved lung volumes. In this post hoc analysis, we investigated the relationship between baseline emphysema and fibrosis extents, as well as pulmonary function changes, over 48 weeks. Data were pooled from two phase III, randomized, double-blind, placebo-controlled trials of IFN-γ-1b in idiopathic pulmonary fibrosis (GIPF-001 [NCT00047645] and GIPF-007 [NCT00075998]). Patients with Week 48 data, baseline high-resolution computed tomographic images, and FEV 1 /FVC ratios less than 0.8 or greater than 0.9 (<0.7 or >0.9 in GIPF-007), as well as randomly selected patients with ratios of 0.8-0.9 and 0.7-0.8, were included. Changes from baseline in pulmonary function at Week 48 were analyzed by emphysema extent. The relationship between emphysema and fibrosis extents and change in pulmonary function was assessed using multivariate linear regression. Emphysema was identified in 38% of patients. A negative correlation was observed between fibrosis and emphysema extents (r = -0.232; P < 0.001). In quartile analysis, patients with the greatest emphysema extent (28 to 65%) showed the smallest FVC decline, with a difference of 3.32% at Week 48 versus patients with no emphysema (P = 0.047). In multivariate analyses, emphysema extent greater than or equal to 15% was associated with significantly reduced FVC decline over 48 weeks versus no emphysema or emphysema less than 15%. No such association was observed for diffusing capacity of the lung for carbon monoxide or composite physiologic index. FVC measurements may not be appropriate for monitoring disease progression in patients with idiopathic pulmonary fibrosis and emphysema extent greater than or equal to 15%.

  13. Blending in: The Extent and Promise of Blended Education in the United States

    ERIC Educational Resources Information Center

    Allen, I. Elaine; Seaman, Jeff; Garrett, Richard

    2007-01-01

    "Blending In: The Extent and Promise of Blended Education in the United States" builds on the series of annual reports on the state of online education in U.S. Higher Education. This study, like the previous reports, is aimed at answering some of the fundamental questions about the nature and extent of education in the United States.…

  14. Effects of circumferential ankle pressure on ankle proprioception, stiffness, and postural stability: a preliminary investigation.

    PubMed

    You, Sung H; Granata, Kevin P; Bunker, Linda K

    2004-08-01

    Cross-sectional repeated-measures design. Determine the effects of circumferential ankle pressure (CAP) intervention on proprioceptive acuity, ankle stiffness, and postural stability. The application of CAP using braces, taping, and adaptive shoes or military boots is widely used to address chronic ankle instability (CAI). An underlying assumption is that the CAP intervention might improve ankle stability through increased proprioceptive acuity and stiffness in the ankle. METHOD AND MEASURES: A convenience sample of 10 subjects was recruited from the local university community and categorized according to proprioceptive acuity (high, low) and ankle stability (normal, CAI). Proprioceptive acuity was measured when blindfolded subjects were asked to accurately reproduce a self-selected target ankle position before and after the application of CAP. Proprioceptive acuity was determined in 5 different ankle joint position sense tests: neutral, inversion, eversion, plantar flexion, and dorsiflexion. Joint position angles were recorded electromechanically using a potentiometer. Passive ankle stiffness was computed from the ratio of applied static moment versus angular displacement. Active ankle stiffness was determined from biomechanical analyses of ankle motion following a mediolateral perturbation. Postural stability was quantified from the center of pressure displacement in the mediolateral and the anteroposterior directions in unipedal stance. All measurements were recorded with and without CAP applied by a pediatric blood pressure cuff. Data were analyzed using a separate mixed-model analysis of variance (ANOVA) for each dependent variable. Post hoc comparison using Tukey's honestly significant difference (HSD) test was performed if significant interactions were obtained. Significance level was set at P<.05 for all analyses. Significant group (high versus low proprioceptive acuity) x CAP interactions were identified for postural stability. Passive ankle stiffness was

  15. Automated Snow Extent Mapping Based on Orthophoto Images from Unmanned Aerial Vehicles

    NASA Astrophysics Data System (ADS)

    Niedzielski, Tomasz; Spallek, Waldemar; Witek-Kasprzak, Matylda

    2018-04-01

    The paper presents the application of the k-means clustering in the process of automated snow extent mapping using orthophoto images generated using the Structure-from-Motion (SfM) algorithm from oblique aerial photographs taken by unmanned aerial vehicle (UAV). A simple classification approach has been implemented to discriminate between snow-free and snow-covered terrain. The procedure uses the k-means clustering and classifies orthophoto images based on the three-dimensional space of red-green-blue (RGB) or near-infrared-red-green (NIRRG) or near-infrared-green-blue (NIRGB) bands. To test the method, several field experiments have been carried out, both in situations when snow cover was continuous and when it was patchy. The experiments have been conducted using three fixed-wing UAVs (swinglet CAM by senseFly, eBee by senseFly, and Birdie by FlyTech UAV) on 10/04/2015, 23/03/2016, and 16/03/2017 within three test sites in the Izerskie Mountains in southwestern Poland. The resulting snow extent maps, produced automatically using the classification method, have been validated against real snow extents delineated through a visual analysis and interpretation offered by human analysts. For the simplest classification setup, which assumes two classes in the k-means clustering, the extent of snow patches was estimated accurately, with areal underestimation of 4.6% (RGB) and overestimation of 5.5% (NIRGB). For continuous snow cover with sparse discontinuities at places where trees or bushes protruded from snow, the agreement between automatically produced snow extent maps and observations was better, i.e. 1.5% (underestimation with RGB) and 0.7-0.9% (overestimation, either with RGB or with NIRRG). Shadows on snow were found to be mainly responsible for the misclassification.

  16. Modulation of the Seasonal Cycle of Antarctic Sea Ice Extent Related to the Southern Annular Mode

    NASA Astrophysics Data System (ADS)

    Doddridge, Edward W.; Marshall, John

    2017-10-01

    Through analysis of remotely sensed sea surface temperature (SST) and sea ice concentration data, we investigate the impact of winds related to the Southern Annular Mode (SAM) on sea ice extent around Antarctica. We show that positive SAM anomalies in the austral summer are associated with anomalously cold SSTs that persist and lead to anomalous ice growth in the following autumn, while negative SAM anomalies precede warm SSTs and a reduction in sea ice extent during autumn. The largest effect occurs in April, when a unit change in the detrended summertime SAM is followed by a 1.8±0.6 ×105 km2 change in detrended sea ice extent. We find no evidence that sea ice extent anomalies related to the summertime SAM affect the wintertime sea ice extent maximum. Our analysis shows that the wind anomalies related to the negative SAM during the 2016/2017 austral summer contributed to the record minimum Antarctic sea ice extent observed in March 2017.

  17. Associations among body composition, inflammatory profile and disease extent in ulcerative colitis patients.

    PubMed

    Urbano, Ana Paula Signori; Sassaki, Ligia Yukie; Dorna, Mariana de Souza; Presti, Paula Torres; Carvalhaes, Maria Antonieta de Barros Leite; Martini, Ligia Araújo; Ferreira, Ana Lucia Anjos

    2018-02-01

    The aim of our study was to assess body composition status and its association with inflammatory profile and extent of intestinal damage in ulcerative colitis patients during clinical remission. This is a cross-sectional study in which body composition data (phase angle [PhA], fat mass [FM], triceps skin fold thickness [TSFt], mid-arm circumference [MAC], mid-arm muscle circumference [MAMC], adductor pollicis muscle thickness [APMt]), inflammatory profile (C-reactive protein [CRP], a1-acid glycoprotein, erythrocyte sedimentation rate [ESR]) and disease extent were recorded. The mean age of the 59 patients was 48.1 years; 53.3% were women. Most patients were in clinical remission (94.9%) and 3.4% was malnourished according to body mass index. PhA was inversely correlated with inflammatory markers such as CRP (R=-0.59; p<0.001) and ESR (R=-0.46; p<0.001) and directly correlated with lean mass: MAMC (R=0.31; p=0.01) and APMt (R=0.47; p<0.001). Lean mass was inversely correlated with non-specific inflammation marker (APMt vs. ESR) and directly correlated with hemoglobin values (MAMC vs. hemoglobin). Logistic regression analysis revealed that body cell mass was associated with disease extent (OR 0.92; 95CI 0.87-0.97; p<0.01). PhA was inversely correlated with inflammatory markers and directly correlated with lean mass. Acute inflammatory markers were correlated with disease extent. Body cell mass was associated with disease extent.

  18. Successes and challenges from formation to implementation of eleven broad-extent conservation programs

    USGS Publications Warehouse

    Beever, Erik A.; Bradford, John B.; Germino, Matthew J.; Mattsson, Brady J.; Post van der Burg, Max; Brunson, Mark

    2014-01-01

    Integration of conservation partnerships across geographic, biological, and administrative boundaries is increasingly relevant because drivers of change, such as climate shifts, transcend these boundaries. We explored successes and challenges of established conservation programs that span multiple watersheds and consider both social and ecological concerns. We asked representatives from a diverse set of 11 broadextent conservation partnerships in 29 countries 17 questions that pertained to launching and maintaining partnerships for broad-extent conservation, specifying ultimate management objectives, and implementation and learning. Partnerships invested more funds in implementing conservation actions than any other aspect of conservation, and a program’s context (geographic extent, United States vs. other countries, developed vs. developing nation) appeared to substantially affect program approach. Despite early successes of these organizations and benefits of broad-extent conservation, specific challenges related to uncertainties in scaling up information and to coordination in the face of diverse partner governance structures, conflicting objectives, and vast uncertainties regarding future system dynamics hindered long-term success, as demonstrated by the focal organizations. Engaging stakeholders, developing conservation measures, and implementing adaptive management were dominant challenges. To inform future research on broad-extent conservation, we considered several challenges when we developed detailed questions, such as what qualities of broad-extent partnerships ensure they complement, integrate, and strengthen, rather than replace, local conservation efforts and which adaptive management processes yield actionable conservation strategies that account explicitly for dynamics and uncertainties regarding multiscale governance, environmental conditions, and knowledge of the system?

  19. Integrating remotely sensed surface water extent into continental scale hydrology.

    PubMed

    Revilla-Romero, Beatriz; Wanders, Niko; Burek, Peter; Salamon, Peter; de Roo, Ad

    2016-12-01

    In hydrological forecasting, data assimilation techniques are employed to improve estimates of initial conditions to update incorrect model states with observational data. However, the limited availability of continuous and up-to-date ground streamflow data is one of the main constraints for large-scale flood forecasting models. This is the first study that assess the impact of assimilating daily remotely sensed surface water extent at a 0.1° × 0.1° spatial resolution derived from the Global Flood Detection System (GFDS) into a global rainfall-runoff including large ungauged areas at the continental spatial scale in Africa and South America. Surface water extent is observed using a range of passive microwave remote sensors. The methodology uses the brightness temperature as water bodies have a lower emissivity. In a time series, the satellite signal is expected to vary with changes in water surface, and anomalies can be correlated with flood events. The Ensemble Kalman Filter (EnKF) is a Monte-Carlo implementation of data assimilation and used here by applying random sampling perturbations to the precipitation inputs to account for uncertainty obtaining ensemble streamflow simulations from the LISFLOOD model. Results of the updated streamflow simulation are compared to baseline simulations, without assimilation of the satellite-derived surface water extent. Validation is done in over 100 in situ river gauges using daily streamflow observations in the African and South American continent over a one year period. Some of the more commonly used metrics in hydrology were calculated: KGE', NSE, PBIAS%, R 2 , RMSE, and VE. Results show that, for example, NSE score improved on 61 out of 101 stations obtaining significant improvements in both the timing and volume of the flow peaks. Whereas the validation at gauges located in lowland jungle obtained poorest performance mainly due to the closed forest influence on the satellite signal retrieval. The conclusion is that

  20. Integrating remotely sensed surface water extent into continental scale hydrology

    NASA Astrophysics Data System (ADS)

    Revilla-Romero, Beatriz; Wanders, Niko; Burek, Peter; Salamon, Peter; de Roo, Ad

    2016-12-01

    In hydrological forecasting, data assimilation techniques are employed to improve estimates of initial conditions to update incorrect model states with observational data. However, the limited availability of continuous and up-to-date ground streamflow data is one of the main constraints for large-scale flood forecasting models. This is the first study that assess the impact of assimilating daily remotely sensed surface water extent at a 0.1° × 0.1° spatial resolution derived from the Global Flood Detection System (GFDS) into a global rainfall-runoff including large ungauged areas at the continental spatial scale in Africa and South America. Surface water extent is observed using a range of passive microwave remote sensors. The methodology uses the brightness temperature as water bodies have a lower emissivity. In a time series, the satellite signal is expected to vary with changes in water surface, and anomalies can be correlated with flood events. The Ensemble Kalman Filter (EnKF) is a Monte-Carlo implementation of data assimilation and used here by applying random sampling perturbations to the precipitation inputs to account for uncertainty obtaining ensemble streamflow simulations from the LISFLOOD model. Results of the updated streamflow simulation are compared to baseline simulations, without assimilation of the satellite-derived surface water extent. Validation is done in over 100 in situ river gauges using daily streamflow observations in the African and South American continent over a one year period. Some of the more commonly used metrics in hydrology were calculated: KGE', NSE, PBIAS%, R2, RMSE, and VE. Results show that, for example, NSE score improved on 61 out of 101 stations obtaining significant improvements in both the timing and volume of the flow peaks. Whereas the validation at gauges located in lowland jungle obtained poorest performance mainly due to the closed forest influence on the satellite signal retrieval. The conclusion is that

  1. Extent of hippocampal atrophy predicts degree of deficit in recall

    PubMed Central

    Patai, Eva Zita; Gadian, David G.; Cooper, Janine M.; Dzieciol, Anna M.; Mishkin, Mortimer; Vargha-Khadem, Faraneh

    2015-01-01

    Which specific memory functions are dependent on the hippocampus is still debated. The availability of a large cohort of patients who had sustained relatively selective hippocampal damage early in life enabled us to determine which type of mnemonic deficit showed a correlation with extent of hippocampal injury. We assessed our patient cohort on a test that provides measures of recognition and recall that are equated for difficulty and found that the patients' performance on the recall tests correlated significantly with their hippocampal volumes, whereas their performance on the equally difficult recognition tests did not and, indeed, was largely unaffected regardless of extent of hippocampal atrophy. The results provide new evidence in favor of the view that the hippocampus is essential for recall but not for recognition. PMID:26417089

  2. Towards multispectral endoscopic imaging of cardiac lesion assessment and classification for cardiac ablation therapy

    NASA Astrophysics Data System (ADS)

    Park, Soo Young; Singh-Moon, Rajinder P.; Hendon, Christine P.

    2018-02-01

    Pulmonary vein (PV) isolation is a critical procedure for the treatment and termination of atrial fibrillation (AF). The success of such treatment depends on the extent of tissue damage, where partial lesions can allow abnormal electrical conduction and risk relapse of AF. Proper evaluation of lesion delivery and ablation line continuity remains challenging with current techniques and in part limit procedural efficacy. A tool for direct visualization of endo-myocardial lesions in vivo could potentially reduce ambiguity in treatment location and extent and improve the overall fidelity of lesion sets. In this work, we introduce a method for wide-field visualization of myocardial tissue including the discernment of ablated and non-ablated regions using an endoscopic multispectral imaging system (EMIS). The system was designed to fit the working channel of most commercial sheathes (<4 Fr) and supported quadruple-wavelength reflectance imaging through a flexible fiber-bundle. A total of 50 endocardial lesions were created and imaged on nine swine hearts, ex vivo in addition to 15 lesions on human LA samples near PV regions. A pixel-wise linear discriminant analysis algorithm was developed to classify regions of ablation treatment based on calibrated EMI maps. Results show good agreement of treatment severity and spatial extent compared to post-hoc tissue vital staining.

  3. Dofetilide promotes repolarization abnormalities in perfused Guinea-pig heart.

    PubMed

    Osadchii, Oleg E

    2012-12-01

    Dofetilide is class III antiarrhythmic agent which prolongs cardiac action potential duration because of selective inhibition of I (Kr), the rapid component of the delayed rectifier K(+) current. Although clinical studies reported on proarrhythmic risk associated with dofetilide treatment, the contributing electrophysiological mechanisms remain poorly understood. This study was designed to determine if dofetilide-induced proarrhythmia may be attributed to abnormalities in ventricular repolarization and refractoriness. The monophasic action potential duration and effective refractory periods (ERP) were assessed at distinct epicardial and endocardial sites along with volume-conducted ECG recordings in isolated, perfused guinea-pig heart preparations. Dofetilide was found to produce the reverse rate-dependent prolongation of ventricular repolarization, increased the steepness of action potential duration rate adaptation, and amplified transepicardial variability in electrical restitution kinetics. Dofetilide also prolonged the T peak-to-end interval on ECG, and elicited a greater prolongation of endocardial than epicardial ERP, thereby increasing transmural dispersion of refractoriness. At epicardium, dofetilide prolonged action potential duration to a greater extent than ERP, thus extending the critical interval for ventricular re-excitation. This change was associated with triangulation of epicardial action potential because of greater dofetilide-induced prolonging effect at 90 % than 30 % repolarization. Premature ectopic beats and spontaneous short-lasting episodes of monomorphic ventricular tachycardia were observed in 44 % of dofetilide-treated heart preparations. Proarrhythmic potential of dofetilide in guinea-pig heart is attributed to steepened electrical restitution, increased transepicardial variability in electrical restitution kinetics, amplified transmural dispersion of refractoriness, increased critical interval for ventricular re-excitation, and

  4. Left ventricular strain and its pattern estimated from cine CMR and validation with DENSE

    NASA Astrophysics Data System (ADS)

    Gao, Hao; Allan, Andrew; McComb, Christie; Luo, Xiaoyu; Berry, Colin

    2014-07-01

    Measurement of local strain provides insight into the biomechanical significance of viable myocardium. We attempted to estimate myocardial strain from cine cardiovascular magnetic resonance (CMR) images by using a b-spline deformable image registration method. Three healthy volunteers and 41 patients with either recent or chronic myocardial infarction (MI) were studied at 1.5 Tesla with both cine and DENSE CMR. Regional circumferential and radial left ventricular strains were estimated from cine and DENSE acquisitions. In all healthy volunteers, there was no difference for peak circumferential strain (- 0.18 ± 0.04 versus - 0.18 ± 0.03, p = 0.76) between cine and DENSE CMR, however peak radial strain was overestimated from cine (0.84 ± 0.37 versus 0.49 ± 0.2, p < 0.01). In the patient study, the peak strain patterns predicted by cine were similar to the patterns from DENSE, including the strain evolution related to recovery time and strain patterns related to MI scar extent. Furthermore, cine-derived strain disclosed different strain patterns in MI and non-MI regions, and regions with transmural and non-transmural MI as DENSE. Although there were large variations with radial strain measurements from cine CMR images, useful circumferential strain information can be obtained from routine clinical CMR imaging. Cine strain analysis has potential to improve the diagnostic yield from routine CMR imaging in clinical practice.

  5. Determining the ice seasons severity during 1982-2015 using the ice extents sum as a new characteristic

    NASA Astrophysics Data System (ADS)

    Rjazin, Jevgeni; Pärn, Ove

    2016-04-01

    Sea ice is a key climate factor and it restricts considerably the winter navigation in sever seasons on the Baltic Sea. So determining ice conditions severity and describing ice cover behaviour at severe seasons interests scientists, engineers and navigation managers. The present study is carried out to determine the ice seasons severity degree basing on the ice seasons 1982 to 2015. A new integrative characteristic is introduced to describe the ice season severity. It is the sum of ice extents of the ice season id est the daily ice extents of the season are summed. The commonly used procedure to determine the ice season severity degree by the maximal ice extent is in this research compared to the new characteristic values. The remote sensing data on the ice concentrations on the Baltic Sea published in the European Copernicus Programme are used to obtain the severity characteristic values. The ice extents are calculated on these ice concentration data. Both the maximal ice extent of the season and a newly introduced characteristic - the ice extents sum are used to classify the winters with respect of severity. The most severe winter of the reviewed period is 1986/87. Also the ice seasons 1981/82, 1984/85, 1985/86, 1995/96 and 2002/03 are classified as severe. Only three seasons of this list are severe by both the criteria. They are 1984/85, 1985/86 and 1986/87. We interpret this coincidence as the evidence of enough-during extensive ice cover in these three seasons. In several winters, for example 2010/11 ice cover extended enough for some time, but did not endure. At few other ice seasons as 2002/03 the Baltic Sea was ice-covered in moderate extent, but the ice cover stayed long time. At 11 winters the ice extents sum differed considerably (> 10%) from the maximal ice extent. These winters yield one third of the studied ice seasons. The maximal ice extent of the season is simple to use and enables to reconstruct the ice cover history and to predict maximal ice

  6. Investigation of temporal change in glacial extent of Chitral watershed using Landsat data.

    PubMed

    Naeem, Usman Ali; Shamim, Muhammad Ali; Ejaz, Naeem; Ur Rehman, Habib; Mustafa, Umer; Hashmi, Hashim Nisar; Ghumman, Abdul Razzaq

    2016-01-01

    Glaciers are also known as solid reservoirs, and in this regard, Pakistan is a blessed country to have enriched glaciers. The change in glacial extent becomes very crucial for rivers whose discharges are associated with glacier melt. Even a little change in the glacial extent may bring a significant change in the resulting river flows. Considering climate change scenarios, many researchers have predicted future flows in such catchments. But in almost all such studies, the reduction in the glaciers is not normally based on any rational. Therefore, research is needed in order to estimate how glaciers are actually behaving under the change of temperature and precipitations to better estimate the future flows. For this purpose, Chitral watershed was considered as the study area. The seasonal change in the snow extent was estimated by using MODIS data for various years that helped to identify the month with minimum glacial extent. With the help of remote sensing, unsupervised classification was performed to estimate the glacier area in Chitral watershed. The results show a definite receding trend with respect to time in the glaciers of the region for the past decade.

  7. Surgical Removal of Circumferentially Leaked Polymethyl Methacrylate in the Epidural Space of the Thoracic Spine after Percutaneous Vertebroplasty

    PubMed Central

    Kita, Kenichiro; Takata, Yoichiro; Higashino, Kosaku; Yamashita, Kazuta; Tezuka, Fumitake; Sakai, Toshinori; Nagamachi, Akihiro; Sairyo, Koichi

    2017-01-01

    Background  The major complication of percutaneous vertebroplasty (PVP) using polymethyl methacrylate (PMMA) is epidural leakage of PMMA that damages the spinal cord. Methods  This is a case report. Result  A 77-year-old man presented to our institution with a 6-month history of muscle weakness and an intolerable burning sensation of both lower limbs after PVP with PMMA for thoracic compression fracture at T7 at another hospital. His past medical history was significant for hypertension. He had no history of smoking and alcohol. Computed tomography revealed massive leakage of PMMA into the T6 and T7 spinal canal circumferentially surrounding the spinal cord that caused marked encroachment of the thecal sac. Magnetic resonance images revealed cord compression and intramedullary signal change from T6 to T7 level. After we verified that the leaked PMMA could be easily detached from the dura mater in the cadaveric lumbar spine, surgical decompression and removal of epidural PMMA was performed. The leaked PMMA was carefully thinned down with a high-speed diamond burr. Eight pieces of PMMA were detached from the dura mater easily without causing a dural tear. No neurologic deterioration was observed in the postoperative period. The burning sensation resolved, but the muscle weakness remained unchanged. One and a half years postoperatively, the muscle weakness has improved to ⅘ on the manual muscle strength test, but he could not walk without an aid because of spasticity. Conclusion  This report demonstrates the catastrophic epidural extrusion of PMMA following PVP. Extravasated PMMA can be removed through a working space created by means of laminectomy and subtraction of the affected pedicle. Spine surgeons should recognize the possible neurologic complications of PVP and be prepared to treat them using suitable approaches. PMID:28825011

  8. Lack of independent significance of a close (<1 mm) circumferential resection margin involvement in esophageal and junctional cancer.

    PubMed

    O'Farrell, N J; Donohoe, C L; Muldoon, C; Costelloe, J M; King, S; Ravi, N; Reynolds, J V

    2013-08-01

    For rectal cancer, an involved circumferential resection margin (CRM), defined as tumor cells within 1 mm of the CRM, is of established prognostic significance. This definition for the esophagus, however, is controversial, with the UK Royal College of Pathologists (RCP) recommending the 1 mm definition, while the College of American Pathologists (CAP) advises that only tumor cells at the cut margin (0 mm) define an incomplete (R1) resection. The aim of this study was to compare the clinical significance of both definitions in patients with pT3 tumors. CAP- and RCP-defined CRM status in patients treated by surgery only or by multimodal therapy was recorded prospectively in a comprehensive database from May 2003 to May 2011. Kaplan-Meier survival curves were generated, and factors affecting survival were assessed by univariate and multivariate analysis. A total of 157 of 340 patients had pT3 esophageal tumors, with RCP-positive CRM in 60 %, and 18 % by CAP. There were no significant differences between RCP-positive CRM and negative margins for node-positive disease, local recurrence, and survival. CAP-positive CRM was associated with positive nodes (P = 0.036) and poorer survival (P = 0.023). Multivariate analysis revealed nodal invasion to be the only independent prognostic variable (P = 0.004). A CRM margin of <1 mm is common in pT3 esophageal tumors, a finding consistent with other reports. The <1 mm definition was not associated with node positivity, local recurrence, or survival, in contrast to actual involvement at the margin, suggesting lack of independent prognostic significance of the RCP definition and possible superiority of the CAP criteria for prospective registration of CRM.

  9. 26 CFR 2.1-24 - Extent of tax liability.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) MARITIME CONSTRUCTION RESERVE FUND § 2.1-24 Extent of tax liability. (a) Declared value excess-profits tax... deposits in the construction reserve fund of amounts derived from sources other than those specified in... of section 511(c) of the Act. (c) Time for filing claim subsequent to election under section 511(c)(2...

  10. 26 CFR 2.1-24 - Extent of tax liability.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) MARITIME CONSTRUCTION RESERVE FUND § 2.1-24 Extent of tax liability. (a) Declared value excess-profits tax... deposits in the construction reserve fund of amounts derived from sources other than those specified in... of section 511(c) of the Act. (c) Time for filing claim subsequent to election under section 511(c)(2...

  11. 26 CFR 2.1-24 - Extent of tax liability.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) MARITIME CONSTRUCTION RESERVE FUND § 2.1-24 Extent of tax liability. (a) Declared value excess-profits tax... deposits in the construction reserve fund of amounts derived from sources other than those specified in... of section 511(c) of the Act. (c) Time for filing claim subsequent to election under section 511(c)(2...

  12. 26 CFR 2.1-24 - Extent of tax liability.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MARITIME CONSTRUCTION RESERVE FUND § 2.1-24 Extent of tax liability. (a) Declared value excess-profits tax... deposits in the construction reserve fund of amounts derived from sources other than those specified in... of section 511(c) of the Act. (c) Time for filing claim subsequent to election under section 511(c)(2...

  13. 26 CFR 2.1-24 - Extent of tax liability.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) MARITIME CONSTRUCTION RESERVE FUND § 2.1-24 Extent of tax liability. (a) Declared value excess-profits tax... deposits in the construction reserve fund of amounts derived from sources other than those specified in... of section 511(c) of the Act. (c) Time for filing claim subsequent to election under section 511(c)(2...

  14. Accuracy of planar reaching movements. I. Independence of direction and extent variability.

    PubMed

    Gordon, J; Ghilardi, M F; Ghez, C

    1994-01-01

    This study examined the variability in movement end points in a task in which human subjects reached to targets in different locations on a horizontal surface. The primary purpose was to determine whether patterns in the variable errors would reveal the nature and origin of the coordinate system in which the movements were planned. Six subjects moved a hand-held cursor on a digitizing tablet. Target and cursor positions were displayed on a computer screen, and vision of the hand and arm was blocked. The screen cursor was blanked during movement to prevent visual corrections. The paths of the movements were straight and thus directions were largely specified at the onset of movement. The velocity profiles were bell-shaped, and peak velocities and accelerations were scaled to target distance, implying that movement extent was also programmed in advance of the movement. The spatial distributions of movement end points were elliptical in shape. The major axes of these ellipses were systematically oriented in the direction of hand movement with respect to its initial position. This was true for both fast and slow movements, as well as for pointing movements involving rotations of the wrist joint. Using principal components analysis to compute the axes of these ellipses, we found that the eccentricity of the elliptical dispersions was uniformly greater for small than for large movements: variability along the axis of movement, representing extent variability, increased markedly but nonlinearly with distance. Variability perpendicular to the direction of movement, which results from directional errors, was generally smaller than extent variability, but it increased in proportion to the extent of the movement. Therefore, directional variability, in angular terms, was constant and independent of distance. Because the patterns of variability were similar for both slow and fast movements, as well as for movements involving different joints, we conclude that they result

  15. Left Atrial Appendage Closure for Stroke Prevention: Devices, Techniques, and Efficacy.

    PubMed

    Iskandar, Sandia; Vacek, James; Lavu, Madhav; Lakkireddy, Dhanunjaya

    2016-05-01

    Left atrial appendage closure can be performed either surgically or percutaneously. Surgical approaches include direct suture, excision and suture, stapling, and clipping. Percutaneous approaches include endocardial, epicardial, and hybrid endocardial-epicardial techniques. Left atrial appendage anatomy is highly variable and complex; therefore, preprocedural imaging is crucial to determine device selection and sizing, which contribute to procedural success and reduction of complications. Currently, the WATCHMAN is the only device that is approved for left atrial appendage closure in the United States. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Flood extent and water level estimation from SAR using data-model integration

    NASA Astrophysics Data System (ADS)

    Ajadi, O. A.; Meyer, F. J.

    2017-12-01

    Synthetic Aperture Radar (SAR) images have long been recognized as a valuable data source for flood mapping. Compared to other sources, SAR's weather and illumination independence and large area coverage at high spatial resolution supports reliable, frequent, and detailed observations of developing flood events. Accordingly, SAR has the potential to greatly aid in the near real-time monitoring of natural hazards, such as flood detection, if combined with automated image processing. This research works towards increasing the reliability and temporal sampling of SAR-derived flood hazard information by integrating information from multiple SAR sensors and SAR modalities (images and Interferometric SAR (InSAR) coherence) and by combining SAR-derived change detection information with hydrologic and hydraulic flood forecast models. First, the combination of multi-temporal SAR intensity images and coherence information for generating flood extent maps is introduced. The application of least-squares estimation integrates flood information from multiple SAR sensors, thus increasing the temporal sampling. SAR-based flood extent information will be combined with a Digital Elevation Model (DEM) to reduce false alarms and to estimate water depth and flood volume. The SAR-based flood extent map is assimilated into the Hydrologic Engineering Center River Analysis System (Hec-RAS) model to aid in hydraulic model calibration. The developed technology is improving the accuracy of flood information by exploiting information from data and models. It also provides enhanced flood information to decision-makers supporting the response to flood extent and improving emergency relief efforts.

  17. Estimating the extent of reporting to FDA: a case study of statin-associated rhabdomyolysis.

    PubMed

    McAdams, Mara; Staffa, Judy; Dal Pan, Gerald

    2008-03-01

    To estimate the extent of reporting to FDA through statin-associated rhabdomyolysis data. Data included incidence rates (IRs) of hospitalized rhabdomyolysis among statin users from a population-based study, and comparable reported AERS cases and national estimates of statin use from an AERS analysis. Using IRs, national estimates of statin use and average days supply per prescription, we estimated the number of US statin-associated cases of hospitalized rhabdomyolysis. We compared this estimate to the observed number of cases reported to FDA to evaluate the extent of reporting. We repeated this method for atorvastatin, cerivastatin, pravastatin, and simvastatin and statin combinations. We performed sensitivity analyses to check for biases such as misclassification of statin use and cohort selection bias. We evaluated potential time-dependent cerivastatin reporting by a "Dear Health Care Provider (DHCP)" letter. The estimated extent of reporting to FDA varied by statin (atorvastatin, 5.0%; cerivastatin, 31.2%; simvastatin, 14.2%; all four combined, 17.7%; and non-cerivastatin statins combined, 9.9%). No pravastatin-associated cohort cases occurred. Across a reasonable value range, sensitivity analyses did not significantly alter the results; overall the cohort was similar to national statin-users. There was a large increase in AERS reports after the cerivastatin DHCP letter and the estimated extent of reporting increased from 14.8 to 35.0%. The extent of reporting of adverse events to FDA varied by statin and may be influenced by publicity. For statins-associated rhabdomyolysis, the estimated extent of reporting appears to range from 5 to 30% but in the absence of stimulated reporting appears to be 5-15%. Copyright 2008 John Wiley & Sons, Ltd.

  18. Reliability and limits of agreement of circumferential, water displacement, and optoelectronic volumetry in the measurement of upper limb lymphedema.

    PubMed

    Deltombe, T; Jamart, J; Recloux, S; Legrand, C; Vandenbroeck, N; Theys, S; Hanson, P

    2007-03-01

    We conducted a reliability comparison study to determine the intrarater and inter-rater reliability and the limits of agreement of the volume estimated by circumferential measurements using the frustum sign method and the disk model method, by water displacement volumetry, and by infrared optoelectronic volumetry in the assessment of upper limb lymphedema. Thirty women with lymphedema following axillary lymph node dissection surgery for breast cancer surgery were enrolled. In each patient, the volumes of the upper limbs were estimated by three physical therapists using circumference measurements, water displacement and optoelectronic volumetry. One of the physical therapists performed each measure twice. Intraclass correlation coefficients (ICCs), relative differences, and limits of agreement were determined. Intrarater and interrater reliability ICCs ranged from 0.94 to 1. Intrarater relative differences were 1.9% for the disk model method, 3.2% for the frustum sign model method, 2.9% for water displacement volumetry, and 1.5% for optoelectronic volumetry. Intrarater reliability was always better than interrater, except for the optoelectronic method. Intrarater and interrater limits of agreement were calculated for each technique. The disk model method and optoelectronic volumetry had better reliability than the frustum sign method and water displacement volumetry, which is usually considered to be the gold standard. In terms of low-cost, simplicity, and reliability, we recommend the disk model method as the method of choice in clinical practice. Since intrarater reliability was always better than interrater reliability (except for optoelectronic volumetry), patients should therefore, ideally, always be evaluated by the same therapist. Additionally, the limits of agreement must be taken into account when determining the response of a patient to treatment.

  19. Value of Combined Circumferential and Longitudinal Left Ventricular Systolic Dysfunction to Predict Adverse Outcome in Patients with Asymptomatic Aortic Stenosis.

    PubMed

    Cioffi, Giovanni; Mazzone, Carmine; Barbati, Giulia; Rossi, Andrea; Nistri, Stefano; Ognibeni, Federica; Tarantini, Luigi; Di Lenarda, Andrea; Faggiano, Pompilio; Pulignano, Giovanni; Stefenelli, Carlo; de Simone, Giovanni

    2016-01-01

    BACKGROUND AND AIM OF THE STUDY: Patients with asymptomatic aortic stenosis (AS) may have left ventricular systolic dysfunction (LVSD) defined as an impairment of the circumferential and/or longitudinal (C&L) myocardial fibers, despite a preserved left ventricular ejection fraction (LVEF). An assessment was made as to whether the combined LVSD of C&L fibers has a prognostic impact in asymptomatic AS. METHODS: A total of 200 asymptomatic AS patients was analyzed. Midwall shortening and mitral annular peak systolic velocity were considered as indices of C&L function and classified as low if <16.5% and <8.5 cm/s, respectively. The primary outcome was a composite of major cardiovascular events (MACE), including aortic valve-related and ischemic cardiovascular-related events. RESULTS: During a 25-month follow up period, MACE occurred in 69 patients (35%),while 46 of 72 patients (64%) had C&L LVSD and 23 of 128 patients (18%) had not (p <0.001). Cox analysis identified C&L LVSD as an independent MACE predictor, together with aortic transvalvular peak gradient, E/E′ ratio and excessive left ventricular mass. C&L-LVSD also predicted the occurrence of aortic valve-related events and ischemic cardiovascular-related events analyzed separately. A receiver operating characteristic curve analysis showed that the area under the curve (AUC) for C&L LVSD in predicting MACE was 0.77, significantly higher (p = 0.002, z-statistic) than the AUCs of C&L fibers considered individually (0.64 and 0.63, respectively). CONCLUSION: C&L-LVSD provides additional prognostic information into traditional risk factors for patients with asymptomatic AS.

  20. Absence of Rapid Propagation through the Purkinje Network as a Potential Cause of Line Block in the Human Heart with Left Bundle Branch Block.

    PubMed

    Okada, Jun-Ichi; Washio, Takumi; Nakagawa, Machiko; Watanabe, Masahiro; Kadooka, Yoshimasa; Kariya, Taro; Yamashita, Hiroshi; Yamada, Yoko; Momomura, Shin-Ichi; Nagai, Ryozo; Hisada, Toshiaki; Sugiura, Seiryo

    2018-01-01

    Background: Cardiac resynchronization therapy is an effective device therapy for heart failure patients with conduction block. However, a problem with this invasive technique is the nearly 30% of non-responders. A number of studies have reported a functional line of block of cardiac excitation propagation in responders. However, this can only be detected using non-contact endocardial mapping. Further, although the line of block is considered a sign of responders to therapy, the mechanism remains unclear. Methods: Herein, we created two patient-specific heart models with conduction block and simulated the propagation of excitation based on a cellmodel of electrophysiology. In one model with a relatively narrow QRS width (176 ms), we modeled the Purkinje network using a thin endocardial layer with rapid conduction. To reproduce a wider QRS complex (200 ms) in the second model, we eliminated the Purkinje network, and we simulated the endocardial mapping by solving the inverse problem according to the actual mapping system. Results: We successfully observed the line of block using non-contact mapping in the model without the rapid propagation of excitation through the Purkinje network, although the excitation in the wall propagated smoothly. This model of slow conduction also reproduced the characteristic properties of the line of block, including dense isochronal lines and fractionated local electrocardiograms. Further, simulation of ventricular pacing from the lateral wall shifted the location of the line of block. By contrast, in the model with the Purkinje network, propagation of excitation in the endocardial map faithfully followed the actual propagation in the wall, without showing the line of block. Finally, switching the mode of propagation between the two models completely reversed these findings. Conclusions: Our simulation data suggest that the absence of rapid propagation of excitation through the Purkinje network is the major cause of the functional line

  1. Historical ecology with real numbers: past and present extent and biomass of an imperilled estuarine habitat

    PubMed Central

    Zu Ermgassen, Philine S. E.; Spalding, Mark D.; Blake, Brady; Coen, Loren D.; Dumbauld, Brett; Geiger, Steve; Grabowski, Jonathan H.; Grizzle, Raymond; Luckenbach, Mark; McGraw, Kay; Rodney, William; Ruesink, Jennifer L.; Powers, Sean P.; Brumbaugh, Robert

    2012-01-01

    Historic baselines are important in developing our understanding of ecosystems in the face of rapid global change. While a number of studies have sought to determine changes in extent of exploited habitats over historic timescales, few have quantified such changes prior to late twentieth century baselines. Here, we present, to our knowledge, the first ever large-scale quantitative assessment of the extent and biomass of marine habitat-forming species over a 100-year time frame. We examined records of wild native oyster abundance in the United States from a historic, yet already exploited, baseline between 1878 and 1935 (predominantly 1885–1915), and a current baseline between 1968 and 2010 (predominantly 2000–2010). We quantified the extent of oyster grounds in 39 estuaries historically and 51 estuaries from recent times. Data from 24 estuaries allowed comparison of historic to present extent and biomass. We found evidence for a 64 per cent decline in the spatial extent of oyster habitat and an 88 per cent decline in oyster biomass over time. The difference between these two numbers illustrates that current areal extent measures may be masking significant loss of habitat through degradation. PMID:22696522

  2. The regional extent of suppression: strabismics versus nonstrabismics.

    PubMed

    Babu, Raiju Jacob; Clavagnier, Simon R; Bobier, William; Thompson, Benjamin; Hess, Robert F

    2013-10-09

    Evidence is accumulating that suppression may be the cause of amblyopia rather than a secondary consequence of mismatched retinal images. For example, treatment interventions that target suppression may lead to better binocular and monocular outcomes. Furthermore, it has recently been demonstrated that the measurement of suppression may have prognostic value for patching therapy. For these reasons, the measurement of suppression in the clinic needs to be improved beyond the methods that are currently available, which provide a binary outcome. We describe a novel quantitative method for measuring the regional extent of suppression that is suitable for clinical use. The method involves a dichoptic perceptual matching procedure at multiple visual field locations. We compare a group of normal controls (mean age: 28 ± 5 years); a group with strabismic amblyopia (four with microesotropia, five with esotropia, and one with exotropia; mean age: 35 ± 10 years); and a group with nonstrabismic anisometropic amblyopia (mean age: 33 ± 12 years). The extent and magnitude of suppression was similar for observers with strabismic and nonstrabismic amblyopia. Suppression was strongest within the central field and extended throughout the 20° field that we measured. Suppression extends throughout the central visual field in both strabismic and anisometropic forms of amblyopia. The strongest suppression occurs within the region of the visual field corresponding to the fovea of the fixing eye.

  3. The Impact of Geothermal Heat on the Scandinavian Ice Sheet's LGM Extent

    NASA Astrophysics Data System (ADS)

    Szuman, Izabela; Ewertowski, Marek W.; Kalita, Jakub Z.

    2016-04-01

    The last Scandinavian ice sheet attained its most southern extent over Poland and Germany, protruding c. 200 km south of the main ice sheet mass. There are number of factors that may control ice sheet dynamics and extent. One of the less recognised is geothermal heat, which is heat that is supplied to the base of the ice sheet. A heat at the ice/bed interface plays a crucial role in controlling ice sheet stability, as well as impacting basal temperatures, melting, and ice flow velocities. However, the influence of geothermal heat is still virtually neglected in reconstructions and modelling of paleo-ice sheets behaviour. Only in a few papers is geothermal heat recalled though often in the context of past climatic conditions. Thus, the major question is if and how spatial differences in geothermal heat had influenced paleo-ice sheet dynamics and in consequence their extent. Here, we assumed that the configuration of the ice sheet along its southern margin was moderately to strongly correlated with geothermal heat for Poland and non or negatively correlated for Germany.

  4. Numerical Investigation of the Hydrogen Jet Flammable Envelope Extent with Account for Unsteady Phenomena

    NASA Astrophysics Data System (ADS)

    Chernyavsky, Boris; Benard, Pierre

    2010-11-01

    An important aspect of safety analysis in hydrogen applications is determination of the extent of flammable gas envelope in case of hydrogen jet release. Experimental investigations had shown significant disagreements between the extent of average flammable envelope predicted by steady-state numerical methods, and the region observed to support ignition, with proposed cause being non-steady jet phenomena resulting in significant variations of instantaneous gas concentration and velocity fields in the jet. In order to investigate the influence of these transient phenomena, a numerical investigation of hydrogen jet at low Mach number had been performed using unsteady Large Eddy Simulation. Instantaneous hydrogen concentration and velocity fields were monitored to determine instantaneous flammable envelope. The evolution of the instantaneous fields, including the development of the turbulence structures carrying hydrogen, their extent and frequency, and their relation with averaged fields had been characterized. Simulation had shown significant variability of the flammable envelope, with jet flapping causing shedding of large scale rich and lean gas pockets from the main jet core, which persist for significant times and substantially alter the extent of flammability envelope.

  5. Springtime atmospheric transport controls Arctic summer sea-ice extent

    NASA Astrophysics Data System (ADS)

    Kapsch, Marie; Graversen, Rune; Tjernström, Michael

    2013-04-01

    The sea-ice extent in the Arctic has been steadily decreasing during the satellite remote sensing era, 1979 to present, with the highest rate of retreat found in September. Contributing factors causing the ice retreat are among others: changes in surface air temperature (SAT; Lindsay and Zhang, 2005), ice circulation in response to winds/pressure patterns (Overland et al., 2008) and ocean currents (Comiso et al., 2008), as well as changes in radiative fluxes (e.g. due to changes in cloud cover; Francis and Hunter, 2006; Maksimovich and Vihma, 2012) and ocean conditions. However, large interannual variability is superimposed onto the declining trend - the ice extent by the end of the summer varies by several million square kilometer between successive years (Serreze et al., 2007). But what are the processes causing the year-to-year ice variability? A comparison of years with an anomalously large September sea-ice extent (HIYs - high ice years) with years showing an anomalously small ice extent (LIYs - low ice years) reveals that the ice variability is most pronounced in the Arctic Ocean north of Siberia (which became almost entirely ice free in September of 2007 and 2012). Significant ice-concentration anomalies of up to 30% are observed for LIYs and HIYs in this area. Focusing on this area we find that the greenhouse effect associated with clouds and water-vapor in spring is crucial for the development of the sea ice during the subsequent months. In years where the end-of-summer sea-ice extent is well below normal, a significantly enhanced transport of humid air is evident during spring into the region where the ice retreat is encountered. The anomalous convergence of humidity increases the cloudiness, resulting in an enhancement of the greenhouse effect. As a result, downward longwave radiation at the surface is larger than usual. In mid May, when the ice anomaly begins to appear and the surface albedo therefore becomes anomalously low, the net shortwave radiation

  6. Evolutionary history, immigration history, and the extent of diversification in community assembly.

    PubMed

    Knope, Matthew L; Forde, Samantha E; Fukami, Tadashi

    2011-01-01

    During community assembly, species may accumulate not only by immigration, but also by in situ diversification. Diversification has intrigued biologists because its extent varies even among closely related lineages under similar ecological conditions. Recent research has suggested that some of this puzzling variation may be caused by stochastic differences in the history of immigration (relative timing and order of immigration by founding populations), indicating that immigration and diversification may affect community assembly interactively. However, the conditions under which immigration history affects diversification remain unclear. Here we propose the hypothesis that whether or not immigration history influences the extent of diversification depends on the founding populations' prior evolutionary history, using evidence from a bacterial experiment. To create genotypes with different evolutionary histories, replicate populations of Pseudomonas fluorescens were allowed to adapt to a novel environment for a short or long period of time (approximately 10 or 100 bacterial generations) with or without exploiters (viral parasites). Each evolved genotype was then introduced to a new habitat either before or after a standard competitor genotype. Most genotypes diversified to a greater extent when introduced before, rather than after, the competitor. However, introduction order did not affect the extent of diversification when the evolved genotype had previously adapted to the environment for a long period of time without exploiters. Diversification of these populations was low regardless of introduction order. These results suggest that the importance of immigration history in diversification can be predicted by the immigrants' evolutionary past. The hypothesis proposed here may be generally applicable in both micro- and macro-organisms.

  7. Predictors of circumferential resection margin involvement in surgically resected rectal cancer: A retrospective review of 23,464 patients in the US National Cancer Database.

    PubMed

    Al-Sukhni, Eisar; Attwood, Kristopher; Gabriel, Emmanuel; Nurkin, Steven J

    2016-04-01

    The circumferential resection margin (CRM) is a key prognostic factor after rectal cancer resection. We sought to identify factors associated with CRM involvement (CRM+). A retrospective review was performed of the National Cancer Database, 2004-2011. Patients with rectal cancer who underwent radical resection and had a recorded CRM were included. Multivariable analysis of the association between clinicopathologic characteristics and CRM was performed. Tumor <1 mm from the cut margin defined CRM+. Of 23,464 eligible patients, 13.3% were CRM+. Factors associated with CRM+ were diagnosis later in the study period, lack of insurance, advanced stage, higher grade, undergoing APR, and receiving radiation. Nearly half of CRM+ patients did not receive neoadjuvant therapy. CRM+ patients who did not receive neoadjuvant therapy were more likely to be female, older, with more comorbidities, smaller tumors, earlier clinical stage, advanced pathologic stage, and CEA-negative disease compared to those who received it. Factors associated with CRM+ include features of advanced disease, undergoing APR, and lack of health insurance. Half of CRM+ patients did not receive neoadjuvant treatment. These represent cases where CRM status may be modifiable with appropriate pre-operative selection and multidisciplinary management. Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  8. 241-AY-101 Tank Construction Extent of Condition Review for Tank Integrity

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

    Barnes, Travis J.; Gunter, Jason R.

    2013-08-26

    This report provides the results of an extent of condition construction history review for tank 241-AY-101. The construction history of tank 241-AY-101 has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In tank 241-AY-101, the second double-shell tank constructed, similar issues as those with tank 241-AY-102 construction reoccurred. The overall extent of similary and affect on tank 241-AY-101 integrity is described herein.

  9. Using a filtering task to measure the spatial extent of selective attention

    PubMed Central

    Palmer, John; Moore, Cathleen M.

    2009-01-01

    The spatial extent of attention was investigated by measuring sensitivity to stimuli at to-be-ignored locations. Observers detected a stimulus at a cued location (target), while ignoring otherwise identical stimuli at nearby locations (foils). Only an attentional cue distinguished target from foil. Several experiments varied the contrast and separation of targets and foils. Two theories of selection were compared: contrast gain and a version of attention switching called an all-or-none mixture model. Results included large effects of separation, rejection of the contrast gain model, and the measurement of the size and profile of the spatial extent of attention. PMID:18405935

  10. Determining the relative extent of alteration in CM chondrites

    NASA Technical Reports Server (NTRS)

    Browning, Lauren B.; Mcsween, Harry Y., Jr.; Zolensky, Michael

    1993-01-01

    The aqueous alteration of CM chondrites provides a record of the processes attending the earliest stages of parent body evolution. However, resolving the alteration pathways of chondritic evolution requires a means for distinguishing the relative extent of alteration that individual samples have experienced. Three new indices for gauging the relative degree of alteration in CM chondrites based on modal and compositional analyses of 7 CM falls were proposed. The proposed alteration parameters are consistent with the basic tenets of several previous models and correlate with additional indices to produce an integrated method for determining the relative extent of alteration. The model predicts the following order of progressive alteration: Murchison (MC) is less than or equal to Bells (BL) is less than Murray (MY) is less than Cochabamba (CC) is less than Mighei (MI) is less than Nogoya (NG) is less than or equal to Cold Bokkeveld (CB). The broad range of CM phyllosilicate compositions observed within individual meteorites is fundamental to the characterization of the aqueous alteration process. Chemical analyses of CM phyllosilicates suggest that these phases became systematically enriched in Mg and depleted in Fe with increasing alteration.

  11. Left ventricular torsion and circumferential strain responses to exercise in patients with ischemic coronary artery disease.

    PubMed

    Peteiro, Jesus; Bouzas-Mosquera, Alberto; Broullon, Javier; Sanchez-Fernandez, Gabriel; Barbeito, Cayetana; Perez-Cebey, Lucia; Martinez, Dolores; Vazquez-Rodriguez, Jose M

    2017-01-01

    LV torsion during exercise in patients with coronary artery disease (CAD) is not well known. Circumferential strain (CS) and left ventricular (LV) torsion (Tor) have not been evaluated during ischemia in these patients. We aimed to assess the effect of ischemia during exercise echocardiography (ExE) on CS and Tor. We studied a group of 73 patients with true positive ExE results (Ischemic group: ischemia plus an abnormal coronary angiogram) and a matched control group of 66 patients with negative ExE and either normal coronary angiography or low post-test probability of CAD. Basal rotation (Rot) and apical rotation and basal and apical CS were studied by speckle tracking at rest and exercise. Apical CS and apical and basal Rot values were similar between groups at rest, except basal CS which was already worse in the ischemic group. At exercise, all rotational and CS parameters were impaired in the ischemic in comparison with the control group (basal CS: -18 ± 5 vs. -25 ± 7 %, p < 0.001; apical CS: -31 ± 11 vs. - 43 ± 9 %, p < 0.001; time to basal CS: 52 ± 6 vs. 48 ± 7 %, p = 0.001; time to apical CS: 55 ± 7 vs. 49 ± 6 %, p < 0.001; basal rotation: -0.7 ± 6.5° vs. -6.2 ± 8.5°, p < 0.001; LV twist 13.0 ± 10.4° vs.19.7 ± 11.5°, p < 0.001; LV-Tor 1.9 ± 1.6°/cm vs. 2.8 ± 1.7˚/cm, p = 0.001) with the exception of apical rotation which was similar (12.3 ± 7.4° vs. 13.4 ± 7.7°, p = NS). Basal and apical CS and basal rotation impair during exercise-induced ischemia. LV-Tor decreases with ischemia due to worsening of basal rotation, whereas apical rotation does not impair, suggesting the existence of an apical compensatory mechanism.

  12. Comparative study of circumferential clasp retention force for titanium and cobalt-chromium removable partial dentures.

    PubMed

    Rodrigues, Renata Cristina Silveira; Ribeiro, Ricardo Faria; de Mattos, Maria da Gloria Chiarello; Bezzon, Osvaldo Luiz

    2002-09-01

    The interest in using titanium to fabricate removable partial denture (RPD) frameworks has increased, but there are few studies to support its use. The objective of this study was to compare circumferential RPD clasps made of commercially pure titanium and identical clasps made of 2 different cobalt (Co)-chromium (Cr) alloys by testing insertion/removal and radiographically inspecting the casts for defects. On refractory casts that represent a partially edentulous mandibular right hemi-arch segment, 36 frameworks were cast from commercially pure titanium (n = 12) and 2 Co-Cr alloys (n = 12 each) with identical prefabricated patterns and the manufacturer-designated investment and casting technique. Each group was divided into 2 subgroups, corresponding to .25-mm and .50-mm undercuts, respectively. No polishing procedures were performed to ensure uniformity. Only nodules and burs were carefully removed with tungsten burs under magnification when necessary. The specimens were radiographed and subjected to an insertion/removal test simulating 5 years of framework use. The data were subjected to analysis of variance and the Tukey complementary test (P<.01) to compare the retentive forces of RPDs made with the different materials. The Student t test (P<.01) was used to compare the retentive forces of RPDs fabricated with the same alloy with different undercuts. A total of 20% of the titanium specimens demonstrated porosity, showing casting difficulties, and any defect detected on the clasps determined the sample replacement. For Co-Cr alloys, casting difficulties were not found. The data were subjected to analysis of variance and the Tukey complementary test to compare materials for the same undercut. For the .25-mm undercut, no significant difference was found between Magnum and Rematitan alloys; they were both different from the Remanium alloy (P<.01). For the.50-mm undercut, no significant difference was found between Co-Cr alloys; they were both different from

  13. The spatial extent of the effect of foreclosures on crime.

    PubMed

    Payton, Seth B; Stucky, Thomas D; Ottensmann, John R

    2015-01-01

    Although neighborhood stability has long been considered a substantial determinant of crime, foreclosures have not been the subject of concerted research among criminologists until recently. A number of recent studies have examined the linkage between home foreclosures and crime. Though generally finding a significant relationship, studies have used different approaches and units of analysis. This variation led us to examine the spatial extent to which foreclosures affect a relatively small surrounding area. In this paper, we consider the spatial extent of the foreclosure effect on crime by estimating fixed effect negative binomial models using geocoded UCR data for 2003-2008 and foreclosure data to predict crime counts using the number of foreclosures within various small area radii. Results show that, independently and jointly, foreclosures are a predictor of crime up to at least a distance of 2250 feet. Importantly, that effect declines with distance. We conclude with a discussion of the implications of those findings. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Arm-Positioning Accuracy as a Function of Direction, Extent, and Presentation

    ERIC Educational Resources Information Center

    Casher, Bonnie Berger; Stadulis, Robert E.

    1975-01-01

    Accuracy of horizontal arm-positioning toward the midline of the body was investigated, comparing two methods of presentation of the test position (verbal versus passive movement) and three extents of angular displacement. (RC)

  15. Validation of electromechanical wave imaging in a canine model during pacing and sinus rhythm.

    PubMed

    Grondin, Julien; Costet, Alexandre; Bunting, Ethan; Gambhir, Alok; Garan, Hasan; Wan, Elaine; Konofagou, Elisa E

    2016-11-01

    Accurate determination of regional areas of arrhythmic triggers is of key interest to diagnose arrhythmias and optimize their treatment. Electromechanical wave imaging (EWI) is an ultrasound technique that can image the transient deformation in the myocardium after electrical activation and therefore has the potential to detect and characterize location of triggers of arrhythmias. The objectives of this study were to investigate the relationship between the electromechanical and the electrical activation of the left ventricular (LV) endocardial surface during epicardial and endocardial pacing and during sinus rhythm as well as to map the distribution of electromechanical delays. In this study, 6 canines were investigated. Two external electrodes were sutured onto the epicardial surface of the LV. A 64-electrode basket catheter was inserted through the apex of the LV. Ultrasound channel data were acquired at 2000 frames/s during epicardial and endocardial pacing and during sinus rhythm. Electromechanical and electrical activation maps were synchronously obtained from the ultrasound data and the basket catheter, respectively. The mean correlation coefficient between electromechanical and electrical activation was 0.81 for epicardial anterior pacing, 0.79 for epicardial lateral pacing, 0.69 for endocardial pacing, and 0.56 for sinus rhythm. The electromechanical activation sequence determined by EWI follows the electrical activation sequence and more specifically in the case of pacing. This finding is of key interest in the role that EWI can play in the detection of the anatomical source of arrhythmias and the planning of pacing therapies such as cardiovascular resynchronization therapy. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  16. Validation of Electromechanical Wave Imaging in a canine model during pacing and sinus rhythm

    PubMed Central

    Grondin, Julien; Costet, Alexandre; Bunting, Ethan; Gambhir, Alok; Garan, Hasan; Wan, Elaine; Konofagou, Elisa E.

    2016-01-01

    Background Accurate determination of regional areas of arrhythmic triggers is of key interest to diagnose arrhythmias and optimize their treatment. Electromechanical wave imaging (EWI) is an ultrasound technique that can image the transient deformation in the myocardium following electrical activation and therefore has the potential to detect and characterize location of triggers of arrhythmias. Objectives The objectives of this study are to investigate the relationship between electromechanical and electrical activation of the left-ventricular (LV) endocardial surface during epicardial and endocardial pacing as well as during sinus rhythm and also to investigate the distribution of electromechanical delays. Methods In this study, six canines were investigated. Two external electrodes were sutured onto the epicardial surface of the left ventricle (LV). A 64-electrode basket catheter was inserted through the apex of the LV. Ultrasound channel data were acquired at 2000 frames/s during epicardial and endocardial pacing as well as during sinus rhythm. Electromechanical and electrical activation maps were synchronously obtained from the ultrasound data and the basket catheter respectively. Results The mean correlation coefficient between electromechanical and electrical activation was R=0.81 for epicardial anterior pacing, R=0.79 for epicardial lateral pacing, R=0.69 for endocardial pacing and R=0.56 for sinus rhythm. Conclusions The electromechanical activation sequence determined by EWI follows the electrical activation sequence and more specifically in the case of pacing. This finding is of key interest in the role that EWI can play in the detection of the anatomical source of arrhythmias and the planning of pacing therapies such as cardiovascular resynchronization therapy. PMID:27498277

  17. LEVEL AND EXTENT OF MERCURY CONTAMINATION IN OREGON LOTIC FISH

    EPA Science Inventory

    As part of the U.S. EPA's EMAP Oregon Pilot project, we conducted a probability survey of 154 Oregon streams and rivers to assess the spatial extent of mercury (Hg) contamination in fish tissue across the state. Samples consisted of whole fish analyses of both small (< 120 mm) a...

  18. Tropical forest extent and changes

    NASA Astrophysics Data System (ADS)

    Gwynne, M. D.; Torres, Cristina Boelcke; Croze, H. J.

    A UNEP/FAO assessment of the extent and rate of change of the tropical forest resources of 76 countries found that during the period 1976-1980 the amount of closed forest removed annually in the Americas, Asia and Africa was 4.1 million hectares, 1.8 million hectares and 1.3 million hectares respectively. Projections for 1981-1985 suggest that closed forest annual removal will remain at these same levels in Asia and Africa but will rise to 4.3 million hectares in the Americas thus giving a world removal total of 7.5 million hectares per year. No reliable information is available on the open forest areas cleared during 1975-1980 but annual open forest clearance during 1981-1985 is expected to be 2.3 million hectares for Africa, 1.2 million hectares for the Americas, and 0.19 million hectares for Asia. Shifting cultivation is the greatest single cause of deforestation. Removal of wood for energy purposes is a significant cause of deforestation in the drier tropics. If current removal rates are maintained, some 88 percent of the present world cover of tropical broad leaved forests will still remain at the end of the century.

  19. On the anisotropy of perceived ground extents and the interpretation of walked distance as a measure of perception

    PubMed Central

    Li, Zhi; Sun, Emily; Strawser, Cassandra J.; Spiegel, Ariana; Klein, Brennan; Durgin, Frank H.

    2012-01-01

    Two experiments are reported concerning the perception of ground extent in order to discover whether prior reports of anisotropy between frontal extents and extents in depth were consistent across different measures (visual matching and pantomime walking) and test environments (outdoor environments and virtual environments). In Experiment 1 it was found that depth extents of up to 7 m are indeed perceptually compressed relative to frontal extents in an outdoor environment, and that perceptual matching provided more precise estimates than did pantomime walking. In Experiment 2, similar anisotropies were found using similar tasks in a similar (but virtual) environment. In both experiments pantomime walking measures seemed to additionally compress the range of responses. Experiment 3 supported the hypothesis that range compression in walking measures of perceived distance might be due to proactive interference (memory contamination). It is concluded that walking measures are calibrated for perceived egocentric distance, but that pantomime walking measures may suffer range compression. Depth extents along the ground are perceptually compressed relative to frontal ground extents in a manner consistent with the angular scale expansion hypothesis. PMID:22889186

  20. Corticocortical feedback increases the spatial extent of normalization.

    PubMed

    Nassi, Jonathan J; Gómez-Laberge, Camille; Kreiman, Gabriel; Born, Richard T

    2014-01-01

    Normalization has been proposed as a canonical computation operating across different brain regions, sensory modalities, and species. It provides a good phenomenological description of non-linear response properties in primary visual cortex (V1), including the contrast response function and surround suppression. Despite its widespread application throughout the visual system, the underlying neural mechanisms remain largely unknown. We recently observed that corticocortical feedback contributes to surround suppression in V1, raising the possibility that feedback acts through normalization. To test this idea, we characterized area summation and contrast response properties in V1 with and without feedback from V2 and V3 in alert macaques and applied a standard normalization model to the data. Area summation properties were well explained by a form of divisive normalization, which computes the ratio between a neuron's driving input and the spatially integrated activity of a "normalization pool." Feedback inactivation reduced surround suppression by shrinking the spatial extent of the normalization pool. This effect was independent of the gain modulation thought to mediate the influence of contrast on area summation, which remained intact during feedback inactivation. Contrast sensitivity within the receptive field center was also unaffected by feedback inactivation, providing further evidence that feedback participates in normalization independent of the circuit mechanisms involved in modulating contrast gain and saturation. These results suggest that corticocortical feedback contributes to surround suppression by increasing the visuotopic extent of normalization and, via this mechanism, feedback can play a critical role in contextual information processing.

  1. EXTENT AND MAGNITUDE OF CATECHOLAMINE SURGE IN PEDIATRIC BURNED PATIENTS

    PubMed Central

    Kulp, Gabriela A; Herndon, David N.; Lee, Jong O.; Suman, Oscar E.; Jeschke, Marc G

    2009-01-01

    Increased catecholamine (CA) levels after severe burn are associated with stress, inflammation, hypermetabolism and impaired immune function. The CA secretion profiles in burned patients are not well described. Mechanisms, duration and extent of CA surge are unknown. The purpose of this large unicenter study was to evaluate the extent and magnitude of CA surge following severe burn in pediatric patients. Patients admitted between 1996 and 2008 were enrolled in this study. Twenty-four-hour urine collections were performed during acute hospitalization and up to 2 years post burn. Results from the samples collected from 12 normal, healthy volunteers were compared with the data from the burned patients. Relevant demographic and clinical information was obtained from Medical Records. Student’s t-test and one way ANOVA were used to analyze the data where appropriate. Significance was accepted at p<0.05. Four-hundred thirteen patients were enrolled in this study, 17 patients died during acute hospitalization. Burn caused a marked stress and inflammatory response, indicated by massive tachycardia and elevated pro-inflammatory cytokines. In burned patients, CA levels are consistently and significantly modulated after burn when compared to the levels in normal, healthy volunteers. CA levels were significantly higher in males compared to females, correlated with burn size in burns over 40% and were increased in older children. There were differences over time in survivors vs. non-survivors, with CA levels significantly higher in non-survivors at 2 time points. Inflammatory cytokines show a similar profile during the study period. Our study gives clinicians a useful insight into the extent and magnitude of CA elevation to better design treatment strategies. PMID:20407405

  2. Atrial Fibrillation in Hypertrophic Cardiomyopathy: Is the Extent of Septal Hypertrophy Important?

    PubMed

    Park, Kyoung-Min; Im, Sung Il; Kim, Eun Kyoung; Lee, Sang-Chol; Park, Seung-Jung; Kim, June Soo; On, Young Keun

    2016-01-01

    Hypertrophic cardiomyopathy (HCM) is a cardiac disease associated with a high incidence of atrial fibrillation (AF). Recent studies have suggested that interventricular septum thickness may influence the risk stratification of patients with AF. We evaluated the effects of septal hypertrophy on morbidity and mortality in patients with HCM. Patients were followed for a median of 6.1 years and were divided into two groups according to the extent of septal hypertrophy. A total of 1,360 HCM patients were enrolled: 482 (33%) apical or apicoseptal, 415 (28%) asymmetric septal, 388 (27%) basal septal, 38 (2.6%) concentric, and 37 (2.5%) diffuse and mixed type. Ninety-two all-cause deaths and 21 cardiac deaths occurred. The total event rates were significantly higher for patients with HCM with more extensive septal hypertrophy (group A) compared to those with HCM ± focal septal hypertrophy (group B), regardless of type (p<0.001). Arrhythmias occurred in 502 patients, with a significantly higher incidence in group A than in group B (p<0.001). Among patients with arrhythmias, the incidence of AF was significantly higher in group A than group B (p<0.001). In univariate Cox analysis, a greater extent of septal hypertrophy (p<0.001), E/E´ ratio (p = 0.011), and mitral regurgitation grade (p = 0.003) were significantly associated with developing AF. In multivariate Cox analyses, a greater extent of septal hypertrophy [odds ratio (OR) 5.44 (2.29-12.92), p<0.001] in patients with HCM was significantly associated with developing AF. In conclusion, a greater extent of septal hypertrophy is an independent predictor of progression to AF in patients with HCM.

  3. Remote magnetic navigation for circumferential pulmonary vein ablation: single-catheter technique or additional use of a circular mapping catheter?

    PubMed

    Vollmann, Dirk; Lüthje, Lars; Seegers, Joachim; Sohns, Christian; Sossalla, Samuel; Sohns, Jan; Röver, Christian; Hasenfuß, Gerd; Zabel, Markus

    2014-10-01

    Remote magnetic navigation (RMN) is utilized for catheter guidance during pulmonary vein ablation (PVA). We aimed to determine whether the additional use of a circular mapping catheter (CMC) influences efficacy and outcome of RMN-guided PVA. A total of 80 consecutive subjects (65 % male, age 62 ± 9 years) underwent circumferential PVA with a 3D mapping system and an RMN-guided irrigated catheter. Procedural endpoint was complete PV isolation (PVI), total radiofrequency (RF) time >60 min, or procedure duration >5 h. PVI was defined as an entrance and/or exit block, diagnosed with a CMC within the PV ostium or by pacing via the roving RMN-guided catheter (single-catheter technique). Prolonged Holter monitoring after 3 and 6 months was used to detect atrial tachyarrhythmia (AT/AF) recurrences. Complete PVI was achieved in 56 % (45/80) of all subjects (isolated PVs per patient, 3.1 ± 1.2; RF time, 56.3 ± 17.2 min; procedure duration, 3.8 ± 0.8 h). Prospective validation of the single-catheter technique for diagnosing PVI demonstrated high concordance (94 %) with blinded CMC results. CMC use in first-time PVA was associated with similar total RF and procedure times but higher PV isolation rate. Upon multivariate analysis, CMC use, female gender, left PV, smaller PV ostium and repeat PVA predicted PVI during RMN-guided ablation. Persistent AF and mitral regurgitation at baseline and the number of non-isolated PVs predicted AT/AF recurrence during follow-up. Concomitant CMC use for first-time, RMN-guided PVA is associated with similar procedure duration but higher PV isolation rates as compared to a single-catheter approach. Since the number of isolated PVs predicts freedom from AT/AF, CMC utilization appears advisable for first-time, RMN-guided PVA.

  4. Extent of resection in temporal lobectomy for epilepsy. I. Interobserver analysis and correlation with seizure outcome.

    PubMed

    Awad, I A; Katz, A; Hahn, J F; Kong, A K; Ahl, J; Lüders, H

    1989-01-01

    The extent of resection was assessed in 45 temporal lobectomies for medically intractable epilepsy with mapped temporal lobe foci. Postoperative magnetic resonance imaging (MRI) in the coronal plane was used to quantify the extent of resection of superior lateral, inferior lateral, basal, and medial structures, including the amygdalohippocampal complex. A new 20-compartment model of the temporal lobe was used for this assessment. Blinded interobserver variability was minimal. Intraoperative measurements and maps routinely overestimated the actual extent of resection, especially of medial structures. One year after surgery, 70% of patients remained seizure-free (except for auras). Seizure-free outcome was accomplished despite varying degrees of resection, but was more likely achieved with more extensive resections in all compartments. Among patients with mesiobasal foci, seizure-free outcome correlated significantly with extent of resection of amygdalohippocampal complex. We conclude that assessment of extent of resection by postoperative MRI provides an objective basis of evaluating outcome after temporal lobectomy. It allows a rational approach to understanding of operative failures and is potentially useful in comparing efficacy of various surgical approaches.

  5. 241-AW Tank Farm Construction Extent of Condition Review for Tank Integrity

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

    Barnes, Travis J.; Gunter, Jason R.; Reeploeg, Gretchen E.

    2013-11-19

    This report provides the results of an extent of condition construction history review for the 241-AW tank farm. The construction history of the 241-AW tank farm has been reviewed to identify issues similar to those experienced during tank AY-102 construction. Those issues and others impacting integrity are discussed based on information found in available construction records, using tank AY-102 as the comparison benchmark. In the 241-AW tank farm, the fourth double-shell tank farm constructed, similar issues as those with tank 241-AY-102 construction occured. The overall extent of similary and affect on 241-AW tank farm integrity is described herein.

  6. Inability to determine tissue health is main indication of allograft use in intermediate extent burns.

    PubMed

    Fletcher, John L; Cancio, Leopoldo C; Sinha, Indranil; Leung, Kai P; Renz, Evan M; Chan, Rodney K

    2015-12-01

    Cutaneous allograft is commonly used in the early coverage of excised burns when autograft is unavailable. However, allograft is also applied in intermediate-extent burns (25-50%), during cases in which it is possible to autograft. In this population, there is a paucity of data on the indications for allograft use. This study explores the indications for allograft usage in moderate size burns. Under an IRB-approved protocol, patients admitted to our burn unit between March 2003 and December 2010 were identified through a review of the burn registry. Data on allograft use, total burn surface area, operation performed, operative intent, number of operations, intensive care unit length of stay, and overall length of stay were collected and analyzed. Data are presented as means±standard deviations, except where noted. In the study period, 146 patients received allograft during their acute hospitalization. Twenty-five percent of allograft recipients sustained intermediate-extent burns. Patients with intermediate-extent burns received allograft later in their hospitalization than those with large-extent (50-75% TBSA) burns (6.8 days vs. 3.4 days, p=0.01). Allografted patients with intermediate-extent burns underwent more operations (10.8 vs. 6.1, p=0.002) and had longer hospitalizations (78.3 days vs. 40.9 days, p<0.001) than non-allografted patients, when controlled for TBSA. Clinical rationale for placement of allograft in this population included autograft failure, uncertain depth of excision, lack of autograft donor site, and wound complexity. When uncertain depth of excision was the indication, allograft was universally applied onto the face. In half of allografted intermediate-extent burn patients the inability to identify a viable recipient bed was the ultimate reason for allograft use. Unlike large body surface area burns, allograft skin use in intermediate-extent injury occurs later in the hospitalization and is driven by the inability to determine wound bed

  7. Is circumferential urethral mobilisation an overdo? A prospective outcome analysis of dorsal onlay and dorso - lateral onlay BMGU for anterior urethral strictures.

    PubMed

    Prakash, Gaurav; Singh, Bhupendra Pal; Sinha, Rahul Janak; Jhanwar, Ankur; Sankhwar, Satyanarayan

    2018-01-01

    For dorsal onlay graft placement, unilateral urethral mobilization is less invasive than standard circumferential urethral mobilization. Apart from success in terms of patency of urethra, other issues like sexual function, overall quality of life and patient satisfaction remain important issues while comparing outcomes of urethroplasty. To prospectively compare the objective as well as subjective outcomes of two approaches. Between July 2011 and January 2015, 136 adult males having anterior urethral stricture with urethral lumen ≥ 6 Fr. were prospectively assigned between two groups by alternate randomization. Operative time, complications, success rate (no obstructive symptoms, no need of any postoperative intervention, Q max > 15mL/sec), sexual functions (using Brief Male Sexual Function Inventory) were compared. Baseline parameters were similar in both groups (68 in each group). Overall success rate was similar in both groups (89 % and 91 % respectively). Improvement in total LUTS scores was similar in groups. Changes in overall health status (VAS and EQ 5D) was equal in both groups. Erectile function score was significantly decreased in DO than DL group while ejaculatory function and sexual desire remained stable after urethroplasty in both groups. In anterior urethral stricture buccal mucosa graft provides satisfactory results as onlay technique. No technique whether dorsolateral and dorsal techniques is superior to other. Dorsolateral technique needs minimal urethral mobilization and should be preferred whenever feasible. Copyright® by the International Brazilian Journal of Urology.

  8. Gonioscopy assisted transluminal trabeculotomy: an ab interno circumferential trabeculotomy for the treatment of primary congenital glaucoma and juvenile open angle glaucoma.

    PubMed

    Grover, Davinder S; Smith, Oluwatosin; Fellman, Ronald L; Godfrey, David G; Butler, Michelle R; Montes de Oca, Ildamaris; Feuer, William J

    2015-08-01

    To introduce a novel ab interno 360° trabeculotomy for treating primary congenital glaucoma (PCG) and juvenile open angle glaucoma (JOAG) and report preliminary results. A retrospective chart review of patients who underwent a gonioscopy assisted transluminal trabeculotomy (GATT) procedure by four of the authors (DSG, OS, RLF and DGG) between October 2011 and October 2013. The surgery was performed in patients ≤30 years old with a dysgenic anterior segment angle and uncontrolled PCG and JOAG. Fourteen eyes of 10 patients underwent GATT with follow-up >12 months (12-33 months; mean 20.4). Patients ranged in age from 17 months to 30 years (mean=18.4 years), and five (50%) were female patients. No complications occurred during or following surgery except for early postoperative hyphema in five (36%) of eyes, all cleared by 1 month. The mean intraocular pressure (IOP) decreased from 27.3 to 14.8 mm Hg and the mean number of medications required decreased from 2.6 to 0.86. Five eyes had a drop in IOP ≥15 mm Hg (range 15-39). The preliminary results and safety for GATT, a minimally invasive conjunctival sparing circumferential trabeculotomy, are promising and at least equivalent to previous results for ab externo trabeculotomy for the treatment of PCG and JOAG. All eyes in the study were considered a clinical success. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Comment on ``Canonical formalism for Lagrangians with nonlocality of finite extent''

    NASA Astrophysics Data System (ADS)

    Llosa, Josep

    2003-01-01

    The paper by Woodward [Phys. Rev. A 62, 052105 (2000)] claimed to have proved that Lagrangian theories with a nonlocality of finite extent are necessarily unstable. In this Comment we propose that this conclusion is false.

  10. 7 CFR 782.11 - Extent to which commodities are subject to end-use certificate regulations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Extent to which commodities are subject to end-use... (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS END-USE CERTIFICATE PROGRAM Implementation of the End-Use Certificate Program § 782.11 Extent to which commodities are subject to end-use...

  11. 7 CFR 782.11 - Extent to which commodities are subject to end-use certificate regulations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Extent to which commodities are subject to end-use... (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS END-USE CERTIFICATE PROGRAM Implementation of the End-Use Certificate Program § 782.11 Extent to which commodities are subject to end-use...

  12. 7 CFR 782.11 - Extent to which commodities are subject to end-use certificate regulations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Extent to which commodities are subject to end-use... (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS END-USE CERTIFICATE PROGRAM Implementation of the End-Use Certificate Program § 782.11 Extent to which commodities are subject to end-use...

  13. 7 CFR 782.11 - Extent to which commodities are subject to end-use certificate regulations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 7 2012-01-01 2012-01-01 false Extent to which commodities are subject to end-use... (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS END-USE CERTIFICATE PROGRAM Implementation of the End-Use Certificate Program § 782.11 Extent to which commodities are subject to end-use...

  14. 7 CFR 782.11 - Extent to which commodities are subject to end-use certificate regulations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 7 2013-01-01 2013-01-01 false Extent to which commodities are subject to end-use... (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS END-USE CERTIFICATE PROGRAM Implementation of the End-Use Certificate Program § 782.11 Extent to which commodities are subject to end-use...

  15. The Kinematic and Microphysical Control of Storm Integrated Lightning Flash Extent

    NASA Technical Reports Server (NTRS)

    Carey, Lawrence D.; Koshak, William J.; Peterson, Harold S.; Shultz, Elise; Matthee, Retha; Shultz, Christopher J.; Petersen, Walter A.; Bain, Lamont

    2013-01-01

    To investigate the kinematic and microphysical control of lightning properties, particularly those that may govern the production of nitrogen oxides (NO(x)) in thunderstorms, such as flash rate, type (intracloud (IC) vs. cloud-to-ground (CG)) and extent.

  16. Hadley circulation extent and strength in a wide range of simulated climates

    NASA Astrophysics Data System (ADS)

    D'Agostino, Roberta; Adam, Ori; Lionello, Piero; Schneider, Tapio

    2017-04-01

    Understanding the Hadley circulation (HC) dynamics is crucial because its changes affect the seasonal migration of the ITCZ, the extent of subtropical arid regions and the strength of the monsoons. Despite decades of study, the factors controlling its strength and extent have remained unclear. Here we analyse how HC strength and extent change over a wide range of climate conditions from the Last Glacial Maximum to future projections. The large climate change between paleoclimate simulations and future scenarios offers the chance to analyse robust HC changes and their link to large-scale factors. The HC shrinks and strengthens in the coldest simulation relative to the warmest. A progressive poleward shift of its edges is evident as the climate warms (at a rate of 0.35°lat./K in each hemisphere). The HC extent and strength both depend on the isentropic slope, which in turn is related to the meridional temperature gradient, subtropical static stability and tropopause height. In multiple robust regression analysis using these as predictors, we find that the tropical tropopause height does not add relevant information to the model beyond surface temperature. Therefore, primarily the static stability and secondarily the meridional temperature contrast together account for the bulk of the almost the total HC variance. However, the regressions leave some of the northern HC edge and southern HC strength variance unexplained. The effectiveness of this analysis is limited by the correlation among the predictors and their relationship with mean temperature. In fact, for all simulations, the tropical temperature explains well the variations of HC except its southern hemisphere intensity. Hence, it can be used as the sole predictor to diagnose the HC response to greenhouse-induced global warming. How to account for the evolution of the southern HC strength remains unclear, because of the large inter-model spread in this quantity.

  17. 32 CFR 21.460 - What is the extent of grants officers' and agreements officers' authority?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false What is the extent of grants officers' and... SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-GENERAL MATTERS Authorities and Responsibilities for Making and Administering Assistance Awards § 21.460 What is the extent of...

  18. 32 CFR 21.460 - What is the extent of grants officers' and agreements officers' authority?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false What is the extent of grants officers' and... SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-GENERAL MATTERS Authorities and Responsibilities for Making and Administering Assistance Awards § 21.460 What is the extent of...

  19. 2015 Arctic Sea Ice Maximum Annual Extent Is Lowest On Record

    NASA Image and Video Library

    2015-03-19

    The sea ice cap of the Arctic appeared to reach its annual maximum winter extent on Feb. 25, according to data from the NASA-supported National Snow and Ice Data Center (NSIDC) at the University of Colorado, Boulder. At 5.61 million square miles (14.54 million square kilometers), this year’s maximum extent was the smallest on the satellite record and also one of the earliest. Read more: 1.usa.gov/1Eyvelz Credit: NASA's Goddard Space Flight Center NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  20. A Global Geospatial Database of 5000+ Historic Flood Event Extents

    NASA Astrophysics Data System (ADS)

    Tellman, B.; Sullivan, J.; Doyle, C.; Kettner, A.; Brakenridge, G. R.; Erickson, T.; Slayback, D. A.

    2017-12-01

    A key dataset that is missing for global flood model validation and understanding historic spatial flood vulnerability is a global historical geo-database of flood event extents. Decades of earth observing satellites and cloud computing now make it possible to not only detect floods in near real time, but to run these water detection algorithms back in time to capture the spatial extent of large numbers of specific events. This talk will show results from the largest global historical flood database developed to date. We use the Dartmouth Flood Observatory flood catalogue to map over 5000 floods (from 1985-2017) using MODIS, Landsat, and Sentinel-1 Satellites. All events are available for public download via the Earth Engine Catalogue and via a website that allows the user to query floods by area or date, assess population exposure trends over time, and download flood extents in geospatial format.In this talk, we will highlight major trends in global flood exposure per continent, land use type, and eco-region. We will also make suggestions how to use this dataset in conjunction with other global sets to i) validate global flood models, ii) assess the potential role of climatic change in flood exposure iii) understand how urbanization and other land change processes may influence spatial flood exposure iv) assess how innovative flood interventions (e.g. wetland restoration) influence flood patterns v) control for event magnitude to assess the role of social vulnerability and damage assessment vi) aid in rapid probabilistic risk assessment to enable microinsurance markets. Authors on this paper are already using the database for the later three applications and will show examples of wetland intervention analysis in Argentina, social vulnerability analysis in the USA, and micro insurance in India.

  1. To What Extent Do Gestalt Grouping Principles Influence Tactile Perception?

    ERIC Educational Resources Information Center

    Gallace, Alberto; Spence, Charles

    2011-01-01

    Since their formulation by the Gestalt movement more than a century ago, the principles of perceptual grouping have primarily been investigated in the visual modality and, to a lesser extent, in the auditory modality. The present review addresses the question of whether the same grouping principles also affect the perception of tactile stimuli.…

  2. On the Anisotropy of Perceived Ground Extents and the Interpretation of Walked Distance as a Measure of Perception

    ERIC Educational Resources Information Center

    Li, Zhi; Sun, Emily; Strawser, Cassandra J.; Spiegel, Ariana; Klein, Brennan; Durgin, Frank H.

    2013-01-01

    Two experiments are reported concerning the perception of ground extent to discover whether prior reports of anisotropy between frontal extents and extents in depth were consistent across different measures (visual matching and pantomime walking) and test environments (outdoor environments and virtual environments). In Experiment 1 it was found…

  3. Bedrock Denudation on Titan: Estimates of Vertical Extent and Lateral Debris Dispersion

    NASA Technical Reports Server (NTRS)

    Moore, Jeffrey; Howard, A. D.; Schenk, Paul Michael

    2013-01-01

    Methane rainfall and runoff, along with aeolian activity, have dominated the sculpting of Titan s landscape. A knowledge of the vertical extent of bedrock erosion and the lateral extent of the resulting sediment is useful for several purposes [1]. For instance, what is the magnitude and expression of modification of constructional landforms (e.g., mountains)? Does highland denudation and the filling of basins with sediment cause adjustments (uplift and subsidence) in the crustal ice shell? Here we report preliminary findings of putative eroded craters and the results of landform evolution modeling (Fig. 1) that suggest that approx. 250 m of net bedrock erosion has at least locally taken place and approx.1 km of maximum local erosion.

  4. Validation of Forested Inundation Extent Revealed by L-Band Polarimetric and Interferometric SAR Data

    NASA Technical Reports Server (NTRS)

    Chapman, Bruce; Celi, Jorge; Hamilton, Steve; McDonald, Kyle

    2013-01-01

    UAVSAR, NASA's airborne Synthetic Aperture Radar (SAR), conducted an extended observational campaign in Central and South America in March 2013, primarily related to volcanic deformations along the Andean Mountain Range but also including a large number of flights studying other scientific phenomena. During this campaign, the L-Band SAR collected data over the Napo River in Ecuador. The objectives of this experiment were to acquire polarimetric and interferometric L-Band SAR data over an inundated tropical forest in Ecuador simultaneously with on-the-ground field work ascertaining the extent of inundation, and to then derive from this data a quantitative estimate for the error in the SAR-derived inundation extent. In this paper, we will first describe the processing and preliminary analysis of the SAR data. The polarimetric SAR data will be classified by land cover and inundation state. The interferometric SAR data will be used to identify those areas where change in inundation extent occurred, and to measure the change in water level between two observations separated by a week. Second, we will describe the collection of the field estimates of inundation, and have preliminary comparisons of inundation extent measured in the field field versus that estimated from the SAR data.

  5. On predicting the extent of magnetic aging in electrical steels

    NASA Astrophysics Data System (ADS)

    Ray, Santanu Kumar; Mohanty, Omkar Nath

    1989-02-01

    Magnetic aging of steels is essentially the result of an increase in coercive force, inhibition of ferrite domain wall movement by precipitated carbide particles being the main cause of this increase. In the present work, the nature of the carbides precipitating in four grades of electrical steels has been looked into. Existing postulations have been invoked to predict the extent of coercive force enhancement due to metastable (ɛ) and stable (cementite) carbides which have been observed to precipitate in these steels. The model of Drabecki and Wyslocki when applied to the case of metastable carbide predicts its contribution to the coercive force fairly accurately. None of the existing models, however, succeeds in suggesting the extent of the increases accruing from the presence of the stable carbide (cementite) particles. Each of the models takes into account only one or two of the isolated aspects of magnetic interaction between matrix and precipitate. It appears that for cementite, whose several magnetic characteristics are quite different from those of the ferrite matrix, all possible interaction parameters have to be taken into account to determine the actual mechanism.

  6. Corticocortical feedback increases the spatial extent of normalization

    PubMed Central

    Nassi, Jonathan J.; Gómez-Laberge, Camille; Kreiman, Gabriel; Born, Richard T.

    2014-01-01

    Normalization has been proposed as a canonical computation operating across different brain regions, sensory modalities, and species. It provides a good phenomenological description of non-linear response properties in primary visual cortex (V1), including the contrast response function and surround suppression. Despite its widespread application throughout the visual system, the underlying neural mechanisms remain largely unknown. We recently observed that corticocortical feedback contributes to surround suppression in V1, raising the possibility that feedback acts through normalization. To test this idea, we characterized area summation and contrast response properties in V1 with and without feedback from V2 and V3 in alert macaques and applied a standard normalization model to the data. Area summation properties were well explained by a form of divisive normalization, which computes the ratio between a neuron's driving input and the spatially integrated activity of a “normalization pool.” Feedback inactivation reduced surround suppression by shrinking the spatial extent of the normalization pool. This effect was independent of the gain modulation thought to mediate the influence of contrast on area summation, which remained intact during feedback inactivation. Contrast sensitivity within the receptive field center was also unaffected by feedback inactivation, providing further evidence that feedback participates in normalization independent of the circuit mechanisms involved in modulating contrast gain and saturation. These results suggest that corticocortical feedback contributes to surround suppression by increasing the visuotopic extent of normalization and, via this mechanism, feedback can play a critical role in contextual information processing. PMID:24910596

  7. A global map of urban extent from nightlights

    DOE PAGES

    Zhou, Yuyu; Smith, Steven J.; Zhao, Kaiguang; ...

    2015-05-13

    Urbanization, one of the major human induced land-cover and land-use changes, has a profound impact on the Earth system including biodiversity, the cycling of water and carbon and exchange of energy and water between Earth’s surface and atmosphere, all affecting weather and climate. Accurate information on urban areas and their spatial distribution at the regional and global scales is important for scientific understanding of their contribution to the changing Earth system, and for practical management and policy decisions. We developed a method to map the urban extent from the Defense Meteorological Satellite Program/Operational Linescan System (DMSP/OLS) nighttime stable-light data atmore » the global level and derived a new global map of 1-km urban extent for year 2000. Based on this map, we found that globally, urban land area is about 0.5% of total land area but ranges widely at regional level from 0.1% in Oceania to 2.3% in Europe. At the country level, urban land area varies from lower than 0.01% to higher than 10%, but is lower than 1% for most (70%) countries. Urbanization follows land mass distribution, as anticipated, with the highest concentration found between 30°N to 45°N latitude and the largest longitudinal peak around 80°W. Based on a sensitivity analysis and comparison with other global urban area products, we found that our global product of urban area provides a reliable estimate of global urban areas and offer the potential of capturing more accurately their spatial and temporal dynamics.« less

  8. Beyond the Storm: Comparison of Clinical Factors, Arrhythmogenic Substrate, and Catheter Ablation Outcomes in Structural Heart Disease Patients With versus Those Without a History of Ventricular Tachycardia Storm.

    PubMed

    Kumar, Saurabh; Fujii, Akira; Kapur, Sunil; Romero, Jorge; Mehta, Nishaki K; Tanigawa, Shinichi; Epstein, Laurence M; Koplan, Bruce A; Michaud, Gregory F; John, Roy M; Stevenson, William G; Tedrow, Usha B

    2017-01-01

    Catheter ablation can be lifesaving in ventricular tachycardia (VT) storm, but the underlying substrate in patients with storm is not well characterized. We sought to compare the clinical factors, substrate, and outcomes differences in patients with sustained monomorphic VT who present for catheter ablation with VT storm versus those with a nonstorm presentation. Consecutive ischemic (ICM; n = 554) or nonischemic cardiomyopathy patients (NICM; n = 369) with a storm versus nonstorm presentation were studied (ICM storm 186; NICM storm 101). In ICM, storm compared with nonstorm patients had significantly lower left ventricular (LV) ejection fraction (EF), greater number of antiarrhythmic drug (AAD) failures, slower VTs, greater number of scarred LV segments, higher incidence of anterior, septal, and apical endocardial LV scar (all P < 0.05). However, outcomes in follow-up were similar (12-month ventricular arrhythmia [VA]-free survival: 51% vs. 52%, P = 0.6; survival free of death/transplant 75% vs. 87%, P = 0.7). In addition to the above differences, NICM storm patients were also older; however, the extent and distribution of scar was similar except for a higher incidence of lateral endocardial scar in storm patients (P = 0.05). VA-free survival (36% vs. 47%, P = 0.004) and survival free of death/transplant, however, were worse in NICM storm than nonstorm patients (72% vs. 88%, P = 0.001). NICM storm patients had worse VA-free survival than ICM storm patients. There are differences in clinical factors and scar patterns in patients undergoing VT ablation who present with VT storm versus those with a nonstorm presentation. Clinical outcomes are worse in NICM storm patients. © 2016 Wiley Periodicals, Inc.

  9. A localizing circumferential compression device increases survival after coral snake envenomation to the torso of an animal model.

    PubMed

    Hack, Jason B; Deguzman, Jocelyn M; Brewer, Kori L; Meggs, William J; O'Rourke, Dorcas

    2011-07-01

    Pressure immobilization bandages have been shown to delay onset of systemic toxicity after Eastern coral snake (Micrurus fulvius) envenomation to the distal extremity. To assess the efficacy of a novel compression device in delaying onset of systemic toxicity after truncal envenomations with Eastern coral snake (Micrurus fulvius) venom in a porcine model. With University approval, nine juvenile pigs (11 kg to 22 kg) were sedated, anesthetized, and intubated but not paralyzed to ensure continuous spontaneous respirations in a university animal laboratory. Each animal was injected subcutaneously with 10 mg of M. fulvius venom in a pre-selected area of the trunk. After 1 min, six animals had the application of a novel, localizing circumferential compression (LoCC) device applied to the bite site (treatment group) and three animals had no treatment (control group). The device was composed of a rigid polymer clay form molded into a hollow fusiform shape with an internal dimension of 8 × 5 × 3 cm and an elastic belt wrapped around the animal securing the device in place. Vital signs were recorded at 30-min intervals. End points included a respiratory rate below 3 breaths/min, oxygen saturation < 80%, or survival to 8 h. Survival to 8 h was analyzed using Fisher's exact test, with p < 0.05 indicating significance. Survival analysis was performed using the Mantel-Cox test to assess time to death with outcomes represented in a Kaplan-Meier Cumulative survival plot. Five of the six pigs in the treatment group survived 8 h (293-480 min). None of the control pigs survived to 8 h (Fisher's exact p = 0.04), with mean time of respiratory failure 322 min (272-382 min). Survival analysis showed a significant delay in time to event in the treatment group compared to the control group (p = 0.04). The LoCC device used in this study delayed the onset of systemic toxicity and significantly increased survival time after artificial truncal envenomation by Eastern coral snake venom

  10. The Extent and Nature of Bullying in a Christian School

    ERIC Educational Resources Information Center

    Hazeltine, Brian

    2012-01-01

    Bullying is a problem that has been studied in schools worldwide, but there is little research on bullying within Christian schools, a dearth which may stem from the assumption that Christian schools teach character traits that are inimical to bullying. Yet understanding the extent and nature of bullying in Christian schools may lead to a better…

  11. The Extent and Nature of Bullying in a Christian School

    ERIC Educational Resources Information Center

    Hazeltine, Brian C.; Hernandez, David A.

    2015-01-01

    Bullying is a problem that has been studied in schools worldwide, but there is little research on bullying within Christian schools, a dearth which may stem from the assumption that Christian schools teach character traits that are inimical to bullying. Yet understanding the extent and nature of bullying in Christian schools may lead to a better…

  12. Circumferential resection margins and perineal complications after neoadjuvant long-course chemoradiotherapy followed by extralevator abdominoperineal excision of the rectum: Five years of activity at a single institution.

    PubMed

    Gravante, Gianpiero; Miah, Anur; Mann, Christopher D; Stephenson, James Andrews; Gani, Mohamed Akil Dilawar; Sharpe, David; Norwood, Michael; Boyle, Kirsten; Miller, Andrew; Hemingway, David

    2016-07-01

    Prone extralevator abdominoperineal excision of the rectum (ELAPE) has been introduced to improve the circumferential resection margins (CRM) compared with traditional APER. We present short-term results achieved with prone ELAPE preceded by neoadjuvant chemoradiotherapy during the last 5 years of activity. A retrospective review was conducted. Prone ELAPE operations performed between September 2010 and August 2014 at Leicester Royal Infirmary preceded by neoadjuvant chemoradiotherapy. Data regarding demographics, staging, neoadjuvant therapies, intraoperative perforations, and perineal complications were collected. Seventy-two patients were included. Pretreatment radiological T4 were 25.0%, histological T4 2.8%. Intraoperative perforations occurred in 2.8%, CRM was involved in 11.1%. Perineal complications consisted of superficial wound infections (20.8%), full thickness dehiscences (16.7%), hematomas (9.7%), pelvic collections (6.9%), and perineal hernias (5.6%). In our experience, prone ELAPE preceded by long-course chemoradiotherapy has been successfully used in the last 5 years to resect low rectal tumors. Perineal wound complications rates are similar to those presented in series using direct perineal closures. J. Surg. Oncol. 2016;114:86-90. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Change in extent of meadows and shrub fields in the central western cascade Range, Oregon

    Treesearch

    Sadao Takaoka; Frederick J. Swanson

    2008-01-01

    We examined change in areal extent of mountain meadows and fields of deciduous shrubs and conifer saplings in the central western Cascade Range of Oregon, based on analysis of aerial photographs taken in 1946 and 2000. These nonforest vegetation patches are distinctive habitats in dominantly forested landscapes, such as the Cascades, and change in extent of these...

  14. 12 CFR 157.11 - To what extent does Federal law preempt deposit-related state laws?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 1 2013-01-01 2013-01-01 false To what extent does Federal law preempt deposit-related state laws? 157.11 Section 157.11 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY DEPOSITS § 157.11 To what extent does Federal law preempt deposit-related state laws? State law...

  15. 12 CFR 157.11 - To what extent does Federal law preempt deposit-related state laws?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 1 2014-01-01 2014-01-01 false To what extent does Federal law preempt deposit-related state laws? 157.11 Section 157.11 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY DEPOSITS § 157.11 To what extent does Federal law preempt deposit-related state laws? State law...

  16. 12 CFR 157.11 - To what extent does Federal law preempt deposit-related state laws?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 1 2012-01-01 2012-01-01 false To what extent does Federal law preempt deposit-related state laws? 157.11 Section 157.11 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY DEPOSITS § 157.11 To what extent does Federal law preempt deposit-related state laws? State law...

  17. Is circumferential minimally invasive surgery effective in the treatment of moderate adult idiopathic scoliosis?

    PubMed

    Anand, Neel; Baron, Eli M; Khandehroo, Babak

    2014-06-01

    Outcomes for minimally invasive scoliosis correction surgery have been reported for mild adult scoliosis. Larger curves historically have been treated with open surgical procedures including facet resections or posterior column osteotomies, which have been associated with high-volume blood loss. Further, minimally invasive techniques have been largely reported in the setting of degenerative scoliosis. We describe the effects of circumferential minimally invasive surgery (cMIS) for moderate to severe scoliosis in terms of (1) operative time and blood loss, (2) overall health and disease-specific patient-reported outcomes, (3) deformity correction and fusion rate, and (4) frequency and types of complications. Between January 2007 and January 2012, we performed 50 cMIS adult idiopathic scoliosis corrections in patients with a Cobb angle of greater than 30° but less than 75° who did not have prior thoracolumbar fusion surgery; this series represented all patients we treated surgically during that time meeting those indications. Our general indications for this approach during that period were increasing back pain unresponsive to nonoperative therapy with cosmetic and radiographic worsening of curves. Surgical times and estimated blood loss were recorded. Functional clinical outcomes including VAS pain score, Oswestry Disability Index (ODI), and SF-36 were recorded preoperatively and postoperatively. Patients' deformity correction was assessed on pre- and postoperative 36-inch (91-cm) standing films and fusion was assessed on CT scan. Minimum followup was 24 months (mean, 48 months; range, 24-77 months). Mean blood loss was 613 mL for one-stage surgery and 763 mL for two-stage surgery. Mean operative time was 351 minutes for one-stage surgery and 482 minutes for two-stage surgery. At last followup, mean VAS and ODI scores decreased from 5.7 and 44 preoperatively to 2.9 and 22 (p < 0.001 and 0.03, respectively) and mean SF-36 score increased from 48 preoperatively to

  18. Intraoperative determination of the extent of corpus callosotomy for epilepsy: two simple techniques.

    PubMed

    Awad, I A; Wyllie, E; Luders, H; Ahl, J

    1990-01-01

    There is increasing interest in staged corpus callosotomy for intractable generalized epilepsy. At the first procedure, a portion (usually the anterior two-thirds) of the corpus callosum is sectioned. If seizures persist, completion of callosotomy or alternative treatment approaches can be considered. It is obviously important to ascertain that the desired extent of callosotomy was in fact accomplished at the time of initial operation. Our experience and the published literature indicate that the surgeon's impression at operation can be erroneous. We describe a technique of determining extent of corpus callosotomy during the procedure. The magnetic resonance imaging (MRI) scan in the midsagittal plane is used to select the desired extent of callosotomy. That point on the corpus callosum is characterized using simple planar geometry in relation to three anatomic landmarks in that same plane: the glabella, the inion, and the bregma (midline intersection of the coronal suture). The same point along the corpus callosum can then be located on a lateral skull x-ray using these same three anatomic landmarks. At surgery, an intraoperative lateral skull x-ray is obtained with a marking clip, thereby verifying the actual extent of callosotomy. We have verified the reliability of this scheme in 5 callosotomy procedures and have used this technique for intraoperative localization of midline and parasagittal targets in another 7 cases (3 tumors, 2 aneurysms, and 2 placements of interhemispheric subdural grids). In addition, we reviewed corpus callosum topography on 25 randomly selected MRI scans.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Rapid Estimates of Rupture Extent for Large Earthquakes Using Aftershocks

    NASA Astrophysics Data System (ADS)

    Polet, J.; Thio, H. K.; Kremer, M.

    2009-12-01

    The spatial distribution of aftershocks is closely linked to the rupture extent of the mainshock that preceded them and a rapid analysis of aftershock patterns therefore has potential for use in near real-time estimates of earthquake impact. The correlation between aftershocks and slip distribution has frequently been used to estimate the fault dimensions of large historic earthquakes for which no, or insufficient, waveform data is available. With the advent of earthquake inversions that use seismic waveforms and geodetic data to constrain the slip distribution, the study of aftershocks has recently been largely focused on enhancing our understanding of the underlying mechanisms in a broader earthquake mechanics/dynamics framework. However, in a near real-time earthquake monitoring environment, in which aftershocks of large earthquakes are routinely detected and located, these data may also be effective in determining a fast estimate of the mainshock rupture area, which would aid in the rapid assessment of the impact of the earthquake. We have analyzed a considerable number of large recent earthquakes and their aftershock sequences and have developed an effective algorithm that determines the rupture extent of a mainshock from its aftershock distribution, in a fully automatic manner. The algorithm automatically removes outliers by spatial binning, and subsequently determines the best fitting “strike” of the rupture and its length by projecting the aftershock epicenters onto a set of lines that cross the mainshock epicenter with incremental azimuths. For strike-slip or large dip-slip events, for which the surface projection of the rupture is recti-linear, the calculated strike correlates well with the strike of the fault and the corresponding length, determined from the distribution of aftershocks projected onto the line, agrees well with the rupture length. In the case of a smaller dip-slip rupture with an aspect ratio closer to 1, the procedure gives a measure

  20. A methodology to estimate the future extent of dryland salinity in the southwest of Western Australia.

    PubMed

    Caccetta, Peter; Dunne, Robert; George, Richard; McFarlane, Don

    2010-01-01

    In the southwestern agricultural region of Western Australia, the clearing of the original perennial vegetation for annual vegetation-based dryland agriculture has lead to rising saline groundwater levels. This has had effects such as reduced productivity of agricultural land, death of native vegetation, reduced stream water quality and infrastructure damage. These effects have been observed at many locations within the 18 million ha of cleared land. This has lead to efforts to quantify, in a spatially explicit way, the historical and likely future extent of the area affected, with the view to informing management decisions. This study was conducted to determine whether the likely future extent of the area affected by dryland salinity could be estimated by means of developing spatially explicit maps for use in management and planning. We derived catchment-related variables from digital elevation models and perennial vegetation presence/absence maps. We then used these variables to predict the salinity hazard extent by applying a combination of decision tree classification and morphological image processing algorithms. Sufficient objective data such as groundwater depth, its rate of rise, and its concentration of dissolved salts were generally not available, so we used regional expert opinion (derived from the limited existing studies on salinity hazard extent) as training and validation data. We obtained an 87% agreement in the salinity hazard extent estimated by this method compared with the validation data, and conclude that the maps are sufficient for planning. We estimate that the salinity hazard extent is 29.7% of the agricultural land.

  1. Ellis-van Creveld syndrome: prenatal diagnosis, molecular analysis and genetic counseling.

    PubMed

    Chen, Chih-Ping; Su, Yi-Ning; Hsu, Chin-Yuan; Chern, Schu-Rern; Tsai, Fuu-Jen; Wu, Pei-Chen; Chen, Po-Tsang; Wang, Wayseen

    2010-12-01

    To present the perinatal findings and molecular genetic analysis of two siblings with Ellis-van Creveld (EvC) syndrome. A 33-year-old woman, gravida 3, para 1, was referred for genetic counseling at 18 gestational weeks because of recurrent fetal skeletal dysplasia. Two years previously, she had delivered a 1,316-g dead male baby at 28 gestational weeks with a karyotype of 46,XY, postaxial polydactyly of the hands, thoracic narrowness, endocardial cushion defects, transposition of the great arteries, shortening of the long bones, malposition of the toes, and hypoplastic nails. During this pregnancy, prenatal ultrasound at 18 gestational weeks revealed shortening of the long bones (equivalent to 15 weeks), postaxial polydactyly of both hands, thoracic narrowness, and endocardial cushion defects. The pregnancy was subsequently terminated, and a 236-g female fetus was delivered with a karyotype of 46,XX, postaxial polydactyly of the hands, thoracic dysplasia, endocardial cushion defects, shortening of the long bones, and malposition of the toes and hypoplastic nails. The phenotype of each of the two siblings was consistent with EVC syndrome. Molecular analysis of the EVC and EVC2 genes revealed heterozygous mutations in the EVC2 gene. A heterozygous deletion mutation of a 26-bp deletion of c.871-2_894del26 encompassing the junction between intron 7 and exon 8 of the EVC2 gene was found in the mother and two siblings, and a heterozygous nonsense mutation of c.1195C >T, p.R399X in exon 10 of the EVC2 gene was found in the father and two siblings. Prenatal sonographic identification of endocardial cushion defects in association with shortening of the long bones should alert clinicians to the possibility of EvC syndrome and prompt a careful search of hexadactyly of the hands. Molecular analysis of the EVC and EVC2 genes is helpful in genetic counseling in cases with prenatally detected postaxial polydactyly, thoracic narrowness, short limbs and endocardial cushion defects

  2. Factors affecting basket catheter detection of real and phantom rotors in the atria: A computational study.

    PubMed

    Martinez-Mateu, Laura; Romero, Lucia; Ferrer-Albero, Ana; Sebastian, Rafael; Rodríguez Matas, José F; Jalife, José; Berenfeld, Omer; Saiz, Javier

    2018-03-01

    Anatomically based procedures to ablate atrial fibrillation (AF) are often successful in terminating paroxysmal AF. However, the ability to terminate persistent AF remains disappointing. New mechanistic approaches use multiple-electrode basket catheter mapping to localize and target AF drivers in the form of rotors but significant concerns remain about their accuracy. We aimed to evaluate how electrode-endocardium distance, far-field sources and inter-electrode distance affect the accuracy of localizing rotors. Sustained rotor activation of the atria was simulated numerically and mapped using a virtual basket catheter with varying electrode densities placed at different positions within the atrial cavity. Unipolar electrograms were calculated on the entire endocardial surface and at each of the electrodes. Rotors were tracked on the interpolated basket phase maps and compared with the respective atrial voltage and endocardial phase maps, which served as references. Rotor detection by the basket maps varied between 35-94% of the simulation time, depending on the basket's position and the electrode-to-endocardial wall distance. However, two different types of phantom rotors appeared also on the basket maps. The first type was due to the far-field sources and the second type was due to interpolation between the electrodes; increasing electrode density decreased the incidence of the second but not the first type of phantom rotors. In the simulations study, basket catheter-based phase mapping detected rotors even when the basket was not in full contact with the endocardial wall, but always generated a number of phantom rotors in the presence of only a single real rotor, which would be the desired ablation target. Phantom rotors may mislead and contribute to failure in AF ablation procedures.

  3. Use of C-band Sentinel-1 and L-band UAVSAR data for flood extent mapping during Hurricane Harvey

    NASA Astrophysics Data System (ADS)

    Lakshmi, V.; Kundu, S.; Torres, R.

    2017-12-01

    Hurricane Harvey was one of the most destructive storms that struck the Houston area in August 2017 causing loss of life and property. In this study, an estimation of flooding extent is done using two sets of microwave remote sensing data, Unmanned Aerial Vehicle Synthetic Aperture Radar (UAVSAR) and Sentinel-1. UAVSAR is an L-band SAR (Synthetic Aperture Radar) data which is an airborne repeat-pass interferometric observation system and has 16 km swath. Sentinel-1 is the C band microwave data developed by European Space Agency covering a large area (250 km). Data are analyzed to examine the flood extent over Houston during Harvey. Flood extent mapping is carried out using the Sentinel-1 data and UAVSAR using backscatter signatures which displays the extent of changes and destruction during the flood. Keywords: Harvey, UAVSAR, Sentinel-1, flood extent

  4. Real-time 3D visualization of cellular rearrangements during cardiac valve formation

    PubMed Central

    Pestel, Jenny; Ramadass, Radhan; Gauvrit, Sebastien; Helker, Christian; Herzog, Wiebke

    2016-01-01

    During cardiac valve development, the single-layered endocardial sheet at the atrioventricular canal (AVC) is remodeled into multilayered immature valve leaflets. Most of our knowledge about this process comes from examining fixed samples that do not allow a real-time appreciation of the intricacies of valve formation. Here, we exploit non-invasive in vivo imaging techniques to identify the dynamic cell behaviors that lead to the formation of the immature valve leaflets. We find that in zebrafish, the valve leaflets consist of two sets of endocardial cells at the luminal and abluminal side, which we refer to as luminal cells (LCs) and abluminal cells (ALCs), respectively. By analyzing cellular rearrangements during valve formation, we observed that the LCs and ALCs originate from the atrium and ventricle, respectively. Furthermore, we utilized Wnt/β-catenin and Notch signaling reporter lines to distinguish between the LCs and ALCs, and also found that cardiac contractility and/or blood flow is necessary for the endocardial expression of these signaling reporters. Thus, our 3D analyses of cardiac valve formation in zebrafish provide fundamental insights into the cellular rearrangements underlying this process. PMID:27302398

  5. A 3D Hermite-based multiscale local active contour method with elliptical shape constraints for segmentation of cardiac MR and CT volumes.

    PubMed

    Barba-J, Leiner; Escalante-Ramírez, Boris; Vallejo Venegas, Enrique; Arámbula Cosío, Fernando

    2018-05-01

    Analysis of cardiac images is a fundamental task to diagnose heart problems. Left ventricle (LV) is one of the most important heart structures used for cardiac evaluation. In this work, we propose a novel 3D hierarchical multiscale segmentation method based on a local active contour (AC) model and the Hermite transform (HT) for LV analysis in cardiac magnetic resonance (MR) and computed tomography (CT) volumes in short axis view. Features such as directional edges, texture, and intensities are analyzed using the multiscale HT space. A local AC model is configured using the HT coefficients and geometrical constraints. The endocardial and epicardial boundaries are used for evaluation. Segmentation of the endocardium is controlled using elliptical shape constraints. The final endocardial shape is used to define the geometrical constraints for segmentation of the epicardium. We follow the assumption that epicardial and endocardial shapes are similar in volumes with short axis view. An initialization scheme based on a fuzzy C-means algorithm and mathematical morphology was designed. The algorithm performance was evaluated using cardiac MR and CT volumes in short axis view demonstrating the feasibility of the proposed method.

  6. Real-time 3D visualization of cellular rearrangements during cardiac valve formation.

    PubMed

    Pestel, Jenny; Ramadass, Radhan; Gauvrit, Sebastien; Helker, Christian; Herzog, Wiebke; Stainier, Didier Y R

    2016-06-15

    During cardiac valve development, the single-layered endocardial sheet at the atrioventricular canal (AVC) is remodeled into multilayered immature valve leaflets. Most of our knowledge about this process comes from examining fixed samples that do not allow a real-time appreciation of the intricacies of valve formation. Here, we exploit non-invasive in vivo imaging techniques to identify the dynamic cell behaviors that lead to the formation of the immature valve leaflets. We find that in zebrafish, the valve leaflets consist of two sets of endocardial cells at the luminal and abluminal side, which we refer to as luminal cells (LCs) and abluminal cells (ALCs), respectively. By analyzing cellular rearrangements during valve formation, we observed that the LCs and ALCs originate from the atrium and ventricle, respectively. Furthermore, we utilized Wnt/β-catenin and Notch signaling reporter lines to distinguish between the LCs and ALCs, and also found that cardiac contractility and/or blood flow is necessary for the endocardial expression of these signaling reporters. Thus, our 3D analyses of cardiac valve formation in zebrafish provide fundamental insights into the cellular rearrangements underlying this process. © 2016. Published by The Company of Biologists Ltd.

  7. A Case of Loeffler Endocarditis That Showed Endomyocardial Systolic Dysfunction Detected by Layer Specific Strain Analysis.

    PubMed

    Jin, Xuanyi; Ma, Chunyan; Wang, Yonghuai; Yang, Jun

    2017-12-12

    Loeffler endocarditis is a rare comprehensive cardiac manifestation caused by eosinophilic cell infiltrations and is present in 50%-60% of patients with hypereosinophilic syndrome (HES). Left ventricle (LV) endocardial systolic dysfunction is a major cause of morbidity and mortality in HES and Loeffler endocarditis. We present a case of Loeffler endocarditis, whose left ventricular (LV) systolic dysfunction and endocardial systolic dysfunction were first neglected by conventional transthoracic echocardiography (TTE), but were later pointed out by layer-specific longitudinal strain analysis. With timely initial therapeutic management, the patient's outcome was remarkable. Thus, we strongly recommend strain analysis as a necessary supplementary test of conventional TTE in all patients with Loeffler endocarditis.

  8. Automated flood extent identification using WorldView imagery for the insurance industry

    NASA Astrophysics Data System (ADS)

    Geller, Christina

    2017-10-01

    Flooding is the most common and costly natural disaster around the world, causing the loss of human life and billions in economic and insured losses each year. In 2016, pluvial and fluvial floods caused an estimated 5.69 billion USD in losses worldwide with the most severe events occurring in Germany, France, China, and the United States. While catastrophe modeling has begun to help bridge the knowledge gap about the risk of fluvial flooding, understanding the extent of a flood - pluvial and fluvial - in near real-time allows insurance companies around the world to quantify the loss of property that their clients face during a flooding event and proactively respond. To develop this real-time, global analysis of flooded areas and the associated losses, a new methodology utilizing optical multi-spectral imagery from DigitalGlobe (DGI) WorldView satellite suite is proposed for the extraction of pluvial and fluvial flood extents. This methodology involves identifying flooded areas visible to the sensor, filling in the gaps left by the built environment (i.e. buildings, trees) with a nearest neighbor calculation, and comparing the footprint against an Industry Exposure Database (IE) to calculate a loss estimate. Full-automation of the methodology allows production of flood extents and associated losses anywhere around the world as required. The methodology has been tested and proven effective for the 2016 flood in Louisiana, USA.

  9. Number versus Extent in Newborns' Spontaneous Preference for Collections of Dots

    ERIC Educational Resources Information Center

    Turati, Chiara; Gava, Lucia; Valenza, Eloisa; Ghirardi, Valentina

    2013-01-01

    This study investigated processing of number and extent in newborns. Using visual preference, we showed that newborns discriminated between small sets of dot collections relying solely on implicit numerical information when non-numerical continuous variables were strictly controlled (Experiment 1), and solely on continuous information when…

  10. The extent to which core nursing textbooks inform holistic spiritual care.

    PubMed

    Timmins, Fiona; Murphy, Maryanne; Begley, Thelma; Neill, Freda; Sheaf, Greg

    2016-09-01

    National and international professional health and nursing guidelines recommend that attention should be given to the spiritual and religious needs of patients. This suggests that spiritual care is an important aspect of holistic patient care that needs to be considered and supported, if relevant, in a healthcare context. However, many nurses lack knowledge and awareness of the subject, and it is unclear to what extent core textbooks provide the information they need. This article reports on a study that explored the extent to which contemporary core nursing textbooks support and advocate the provision of spiritual care by nurses. Its findings suggest there is a lack of consistency in the inclusion of spirituality in these texts, and few refer specifically to the need for spiritual assessment tools or referral to chaplains. As more attention is given to patients' spiritual needs, the guidance given by nursing textbooks needs to be more substantive and consistent.

  11. Establishing water body areal extent trends in interior Alaska from multi-temporal Landsat data

    USGS Publications Warehouse

    Rover, Jennifer R.; Ji, Lei; Wylie, Bruce K.; Tieszen, Larry L.

    2012-01-01

    An accurate approach is needed for monitoring, quantifying and understanding surface water variability due to climate change. Separating inter- and intra-annual variances from longer-term shifts in surface water extents due to contemporary climate warming requires repeat measurements spanning a several-decade period. Here, we show that trends developed from multi-date measurements of the extents of more than 15,000 water bodies in central Alaska using Landsat Multispectral Scanner (MSS), Thematic Mapper (TM) and Enhanced Thematic Mapper Plus (ETM+) data (1979–2009) were highly influenced by the quantity and timing of the data. Over the 30-year period from 1979 to 2009, the study area had a net decrease (p < 0.05) in the extents of 3.4% of water bodies whereas 86% of water bodies exhibited no significant change. The Landsat-derived dataset provides an opportunity for additional research assessing the drivers of lake and wetland change in this region.

  12. To what extent is coherence lost in tissue?

    NASA Astrophysics Data System (ADS)

    Hode, Tomas; Jenkins, Peter; Jordison, Stefan; Hode, Lars

    2011-03-01

    In a series of experiments we investigated the extent to which coherence is preserved in tissue. We investigated whether the decrease in coherence length is dependent upon the coherence length of the illuminating light and possibly also if the light is polarized. We compared highly coherent light from a HeNe laser, and less coherent light from a semiconductor laser, in scattering media such as raw ground beef. We studied the laser speckle contrast after passing through 1 - 2 cm of meat. The conclusion is that the laser light is still coherent enough to form laser speckles after passing through a 2 cm thickness of meat.

  13. What controls the local time extent of flux transfer events?

    NASA Astrophysics Data System (ADS)

    Milan, S. E.; Imber, S. M.; Carter, J. A.; Walach, M.-T.; Hubert, B.

    2016-02-01

    Flux transfer events (FTEs) are the manifestation of bursty and/or patchy magnetic reconnection at the magnetopause. We compare two sequences of the ionospheric signatures of flux transfer events observed in global auroral imagery and coherent ionospheric radar measurements. Both sequences were observed during very similar seasonal and interplanetary magnetic field (IMF) conditions, though with differing solar wind speed. A key observation is that the signatures differed considerably in their local time extent. The two periods are 26 August 1998, when the IMF had components BZ≈-10 nT and BY≈9 nT and the solar wind speed was VX≈650 km s-1, and 31 August 2005, IMF BZ≈-7 nT, BY≈17 nT, and VX≈380 km s-1. In the first case, the reconnection rate was estimated to be near 160 kV, and the FTE signatures extended across at least 7 h of magnetic local time (MLT) of the dayside polar cap boundary. In the second, a reconnection rate close to 80 kV was estimated, and the FTEs had a MLT extent of roughly 2 h. We discuss the ramifications of these differences for solar wind-magnetosphere coupling.

  14. Update on the Greenland Ice Sheet Melt Extent: 1979-1999

    NASA Technical Reports Server (NTRS)

    Abdalati, Waleed; Steffen, Konrad

    2000-01-01

    Analysis of melt extent on the Greenland ice sheet is updated to span the time period 1979-1999 is examined along with its spatial and temporal variability using passive microwave satellite data. In order to acquire the full record, the issue of continuity between previous passive microwave sensors (SMMR, SSM/I F-8, and SSM/I F-11), and the most recent SSM/I F-13 sensor is addressed. The F-13 Cross-polarized gradient ratio (XPGR) melt-classification threshold is determined to be -0.0154. Results show that for the 21-year record, an increasing melt trend of nearly 1 %/yr is observed, and this trend is driven by conditions on in the western portion of the ice sheet, rather than the east, where melt appears to have decreased slightly. Moreover, the eruption of Mt. Pinatubo in 1991 is likely to have had some impact the melt, but not as much as previously suspected. The 1992 melt anomaly is 1.7 standard deviations from the mean. Finally, the relationship between coastal temperatures and melt extent suggest an increase in surface runoff contribution to sea level of 0.31 mm/yr for a 1 C temperature rise.

  15. The Role of Deposition in Limiting the Hazard Extent of Dense-Gas Plumes

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

    Dillon, M B

    2008-01-29

    Accidents involving release of large (multi-ton) quantities of toxic industrial chemicals often yield far fewer fatalities and causalities than standard, widely-used assessment and emergency response models predict. While recent work has suggested that models should incorporate the protection provided by buildings, more refined health effect methodologies, and more detailed consideration of the release process; investigations into the role of deposition onto outdoor surfaces has been lacking. In this paper, we examine the conditions under which dry deposition may significantly reduce the extent of the downwind hazard zone. We provide theoretical arguments that in congested environments (e.g. suburbs, forests), deposition tomore » vertical surfaces (such as building walls) may play a significant role in reducing the hazard zone extent--particularly under low-wind, stable atmospheric conditions which are often considered to be the worst-case scenario for these types of releases. Our analysis suggests that in these urban or suburban environments, the amount of toxic chemicals lost to earth's surface is typically a small fraction of overall depositional losses. For isothermal gases such as chlorine, the degree to which the chemicals stick to (or react with) surfaces (i.e. surface resistance) is demonstrated to be a key parameter controlling hazard extent (the maximum distance from the release at which hazards to human health are expected). This analysis does not consider the depositional effects associated with particulate matter or gases that undergo significant thermal change in the atmosphere. While no controlled experiments were available to validate our hypothesis, our analysis results are qualitatively consistent with the observed downwind extent of vegetation damage in two chlorine accidents.« less

  16. Not Extent of Telecommuting, But Job Characteristics as Proximal Predictors of Work-Related Well-Being.

    PubMed

    Vander Elst, Tinne; Verhoogen, Ronny; Sercu, Maarten; Van den Broeck, Anja; Baillien, Elfi; Godderis, Lode

    2017-10-01

    This study aimed to investigate the curvilinear relationship between extent of telecommuting and work-related well-being (ie, burnout, work engagement, and cognitive stress complaints), as well as to test whether job characteristics act as explanatory mechanisms underlying this relationship. A sample of 878 employees from an international telecommunication company with a long history of telecommuting participated in a survey on psychosocial risk factors and well-being at work. Mediation path analyses were conducted to test the hypotheses. Social support from colleagues, participation in decision-making, task autonomy, and work-to-family conflict, but not extent of telecommuting, were directly related to work-related well-being. Extent of telecommuting was indirectly related to well-being via social support. Employers should invest in creating good work environments in general, among both telecommuters and nontelecommuters.

  17. Individualized optimal surgical extent of the lateral neck in papillary thyroid cancer with lateral cervical metastasis.

    PubMed

    Park, Jae-Yong; Koo, Bon Seok

    2014-06-01

    Despite an excellent prognosis, cervical lymph node (LN) metastases are common in patients with papillary thyroid cancer (PTC). The presence of metastasis is associated with an increased risk of locoregional recurrence, which significantly impairs quality of life and may decrease survival. Therefore, it has been an important determinant of the extent of lateral LN dissection in the initial treatment of PTC patients with lateral cervical metastasis. However, the optimal extent of therapeutic lateral neck dissection (ND) remains controversial. Optimizing the surgical extent of LN dissection is fundamental for balancing the surgical morbidity and oncological benefits of ND in PTC patients with lateral neck metastasis. We reviewed the currently available literature regarding the optimal extent of lateral LN dissection in PTC patients with lateral neck metastasis. Even in cases with suspicion of metastatic LN at the single lateral level or isolated metastatic lateral LN, the application of ND including all sublevels from IIa and IIb to Va and Vb may be overtreatment, due to the surgical morbidity. When there is no suspicion of LN metastasis at levels II and V, or when multilevel aggressive neck metastasis is not found, sublevel IIb and Va dissection may not be necessary in PTC patients with lateral neck metastasis. Thus consideration of the individualized optimal surgical extent of lateral ND is important when treating PTC patients with lateral cervical metastasis.

  18. Tracking fine-scale seasonal evolution of surface water extent in Central Alaska and the Canadian Shield

    NASA Astrophysics Data System (ADS)

    Cooley, S. W.; Smith, L. C.; Pitcher, L. H.; Pavelsky, T.; Topp, S.

    2017-12-01

    Quantifying spatial and temporal variability in surface water storage at high latitudes is critical for assessing environmental sensitivity to climate change. Traditionally the tradeoff between high spatial and high temporal resolution space-borne optical imagery has limited the ability to track fine-scale changes in surface water extent. However, the recent launch of hundreds of earth-imaging CubeSats by commercial satellite companies such as Planet opens up new possibilities for monitoring surface water from space. In this study we present a comparison of seasonal evolution of surface water extent in two study areas with differing geologic, hydrologic and permafrost regimes, namely, the Yukon Flats in Central Alaska and the Canadian Shield north of Yellowknife, N.W.T. Using near-daily 3m Planet CubeSat imagery, we track individual lake surface area from break-up to freeze-up during summer 2017 and quantify the spatial and temporal variability in inundation extent. We validate our water delineation method and inundation extent time series using WorldView imagery, coincident in situ lake shoreline mapping and pressure transducer data for 19 lakes in the Northwest Territories and Alaska collected during the NASA Arctic Boreal Vulnerability Experiment (ABoVE) 2017 field campaign. The results of this analysis demonstrate the value of CubeSat imagery for dynamic surface water research particularly at high latitudes and illuminate fine-scale drivers of cold regions surface water extent.

  19. Moving beyond the total sea ice extent in gauging model biases

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

    Ivanova, Detelina P.; Gleckler, Peter J.; Taylor, Karl E.

    Here, reproducing characteristics of observed sea ice extent remains an important climate modeling challenge. This study describes several approaches to improve how model biases in total sea ice distribution are quantified, and applies them to historically forced simulations contributed to phase 5 of the Coupled Model Intercomparison Project (CMIP5). The quantity of hemispheric total sea ice area, or some measure of its equatorward extent, is often used to evaluate model performance. A new approach is introduced that investigates additional details about the structure of model errors, with an aim to reduce the potential impact of compensating errors when gauging differencesmore » between simulated and observed sea ice. Using multiple observational datasets, several new methods are applied to evaluate the climatological spatial distribution and the annual cycle of sea ice cover in 41 CMIP5 models. It is shown that in some models, error compensation can be substantial, for example resulting from too much sea ice in one region and too little in another. Error compensation tends to be larger in models that agree more closely with the observed total sea ice area, which may result from model tuning. The results herein suggest that consideration of only the total hemispheric sea ice area or extent can be misleading when quantitatively comparing how well models agree with observations. Further work is needed to fully develop robust methods to holistically evaluate the ability of models to capture the finescale structure of sea ice characteristics; however, the “sector scale” metric used here aids in reducing the impact of compensating errors in hemispheric integrals.« less

  20. Moving beyond the total sea ice extent in gauging model biases

    DOE PAGES

    Ivanova, Detelina P.; Gleckler, Peter J.; Taylor, Karl E.; ...

    2016-11-29

    Here, reproducing characteristics of observed sea ice extent remains an important climate modeling challenge. This study describes several approaches to improve how model biases in total sea ice distribution are quantified, and applies them to historically forced simulations contributed to phase 5 of the Coupled Model Intercomparison Project (CMIP5). The quantity of hemispheric total sea ice area, or some measure of its equatorward extent, is often used to evaluate model performance. A new approach is introduced that investigates additional details about the structure of model errors, with an aim to reduce the potential impact of compensating errors when gauging differencesmore » between simulated and observed sea ice. Using multiple observational datasets, several new methods are applied to evaluate the climatological spatial distribution and the annual cycle of sea ice cover in 41 CMIP5 models. It is shown that in some models, error compensation can be substantial, for example resulting from too much sea ice in one region and too little in another. Error compensation tends to be larger in models that agree more closely with the observed total sea ice area, which may result from model tuning. The results herein suggest that consideration of only the total hemispheric sea ice area or extent can be misleading when quantitatively comparing how well models agree with observations. Further work is needed to fully develop robust methods to holistically evaluate the ability of models to capture the finescale structure of sea ice characteristics; however, the “sector scale” metric used here aids in reducing the impact of compensating errors in hemispheric integrals.« less