Immediate and Long-Term Outcome of Acute H2S Intoxication Induced Coma in Unanesthetized Rats: Effects of Methylene Blue

PubMed Central

Sonobe, Takashi; Chenuel, Bruno; Cooper, Timothy K.; Haouzi, Philippe

2015-01-01

Background Acute hydrogen sulfide (H2S) poisoning produces a coma, the outcome of which ranges from full recovery to severe neurological deficits. The aim of our study was to 1- describe the immediate and long-term neurological effects following H2S-induced coma in un-anesthetized rats, and 2- determine the potential benefit of methylene blue (MB), a compound we previously found to counteract acute sulfide cardiac toxicity. Methods NaHS was administered IP in un-sedated rats to produce a coma (n = 34). One minute into coma, the rats received MB (4 mg/kg IV) or saline. The surviving rats were followed clinically and assigned to Morris water maze (MWM) and open field testing then sacrificed at day 7. Results Sixty percent of the non-treated comatose rats died by pulseless electrical activity. Nine percent recovered with neurological deficits requiring euthanasia, their brain examination revealed major neuronal necrosis of the superficial and middle layers of the cerebral cortex and the posterior thalamus, with variable necrosis of the caudate putamen, but no lesions of the hippocampus or the cerebellum, in contrast to the typical distribution of post-ischemic lesions. The remaining animals displayed, on average, a significantly less effective search strategy than the control rats (n = 21) during MWM testing. Meanwhile, 75% of rats that received MB survived and could perform the MWM test (P<0.05 vs non-treated animals). The treated animals displayed a significantly higher occurrence of spatial search than the non-treated animals. However, a similar proportion of cortical necrosis was observed in both groups, with a milder clinical presentation following MB. Conclusion In conclusion, in rats surviving H2S induced coma, spatial search patterns were used less frequently than in control animals. A small percentage of rats presented necrotic neuronal lesions, which distribution differed from post-ischemic lesions. MB dramatically improved the immediate survival and spatial search strategy in the surviving rats. PMID:26115032

Immediate and Long-Term Outcome of Acute H2S Intoxication Induced Coma in Unanesthetized Rats: Effects of Methylene Blue.

PubMed

Sonobe, Takashi; Chenuel, Bruno; Cooper, Timothy K; Haouzi, Philippe

2015-01-01

Acute hydrogen sulfide (H2S) poisoning produces a coma, the outcome of which ranges from full recovery to severe neurological deficits. The aim of our study was to 1--describe the immediate and long-term neurological effects following H2S-induced coma in un-anesthetized rats, and 2--determine the potential benefit of methylene blue (MB), a compound we previously found to counteract acute sulfide cardiac toxicity. NaHS was administered IP in un-sedated rats to produce a coma (n = 34). One minute into coma, the rats received MB (4 mg/kg i.v.) or saline. The surviving rats were followed clinically and assigned to Morris water maze (MWM) and open field testing then sacrificed at day 7. Sixty percent of the non-treated comatose rats died by pulseless electrical activity. Nine percent recovered with neurological deficits requiring euthanasia, their brain examination revealed major neuronal necrosis of the superficial and middle layers of the cerebral cortex and the posterior thalamus, with variable necrosis of the caudate putamen, but no lesions of the hippocampus or the cerebellum, in contrast to the typical distribution of post-ischemic lesions. The remaining animals displayed, on average, a significantly less effective search strategy than the control rats (n = 21) during MWM testing. Meanwhile, 75% of rats that received MB survived and could perform the MWM test (P<0.05 vs non-treated animals). The treated animals displayed a significantly higher occurrence of spatial search than the non-treated animals. However, a similar proportion of cortical necrosis was observed in both groups, with a milder clinical presentation following MB. In conclusion, in rats surviving H2S induced coma, spatial search patterns were used less frequently than in control animals. A small percentage of rats presented necrotic neuronal lesions, which distribution differed from post-ischemic lesions. MB dramatically improved the immediate survival and spatial search strategy in the surviving rats.

[Comatose states: etiopathogenesis, experimental studies, treatment of hepatic coma].

PubMed

Strekalova, O S; Uchaĭkin, V F; Ipatova, O M; Torkhovskaia, T I; Medvedeva, N V; Storozhakov, G I; Archakov, A I

2009-01-01

The review presents the modern concepts on biochemical mechanisms of processes, that result in comatose states (CS), with emphasis on the search of new therapeutic approaches. CS of various origin causes severe suppression of brain cells functioning and stable unconsciousness. Numerous reasons of various CS are classified into two main groups: primary brain damages (ischemia, tumor, trauma) and secondary damages originating from system injuries in the body (endocrine, toxic e. c.). The most often primary CS is the hypoxic-ischemic one, as result of corresponding encephalopathy. Its mechanism is the brain cells "energy crisis"--because of decreased blood supply or its deficiency by energy substrates or/and by oxygen. Among secondary CS the substantial place takes hepatic coma as a consequence of hepatic encephalopathy in severe liver diseases--cirrhosis, acute liver failure, sharp intoxication. Its main reason is associated with exess of ammonia entering the brain tissue (it accumulates in blood because of lack of its removing by damaged hepatocytes). Ammonia reacts with glutamate in brain astrocytes and the product of this reaction, glutamine, induced osmotic imbalance, that results in change of form and functions of these important brain cells. It induces, in turn, neurons functions damages, changes in neurotransmission and cerebral blood flow and all these may give rise CS. The most of CS studies are carried out in human. Experimental models ofhepatic CS are reproduced mainly in rats, the most often by surgery methods. Other models included administration of thioacetamide or D-galactosamine, sometimes in combination with lipopolysaccharide. In earlier studies ammonia administration together with liver damages by ligation or by CCl4 was used. The main principles of hepatic coma treatment include the care of encephalopathy, detoxification, and liver treatment. Elaboration of new nanodrugs with increased penetration into tissues and cells, in particular, on the base of phospholipid nanoparticles, may increase substantially the therapeuti efficiency. One of such drug is thought to be a new hepatoprotective preparation phosphogliv--nanoparticles of soy phosphatidylcholine with glycyrrhizic acid. It is supposed, that the further development of phospholipid nanoforms, with minimal particle sizes, may reveal the more action in CS treatment.

Reestablishment of ion homeostasis during chill-coma recovery in the cricket Gryllus pennsylvanicus

PubMed Central

MacMillan, Heath A.; Williams, Caroline M.; Staples, James F.; Sinclair, Brent J.

2012-01-01

The time required to recover from cold-induced paralysis (chill-coma) is a common measure of insect cold tolerance used to test central questions in thermal biology and predict the effects of climate change on insect populations. The onset of chill-coma in the fall field cricket (Gryllus pennsylvanicus, Orthoptera: Gryllidae) is accompanied by a progressive drift of Na+ and water from the hemolymph to the gut, but the physiological mechanisms underlying recovery from chill-coma are not understood for any insect. Using a combination of gravimetric methods and atomic absorption spectroscopy, we demonstrate that recovery from chill-coma involves a reestablishment of hemolymph ion content and volume driven by removal of Na+ and water from the gut. Recovery is associated with a transient elevation of metabolic rate, the time span of which increases with increasing cold exposure duration and closely matches the duration of complete osmotic recovery. Thus, complete recovery from chill-coma is metabolically costly and encompasses a longer period than is required for the recovery of muscle potentials and movement. These findings provide evidence that physiological mechanisms of hemolymph ion content and volume regulation, such as ion-motive ATPase activity, are instrumental in chill-coma recovery and may underlie natural variation in insect cold tolerance. PMID:23184963

Assessment of refractive astigmatism and simulated therapeutic refractive surgery strategies in coma-like-aberrations-dominant corneal optics.

PubMed

Zhou, Wen; Stojanovic, Aleksandar; Utheim, Tor Paaske

2016-01-01

The aim of the study is to raise the awareness of the influence of coma-like higher-order aberrations (HOAs) on power and orientation of refractive astigmatism (RA) and to explore how to account for that influence in the planning of topography-guided refractive surgery in eyes with coma-like-aberrations-dominant corneal optics. Eleven eyes with coma-like-aberrations-dominant corneal optics and with low lenticular astigmatism (LA) were selected for astigmatism analysis and for treatment simulations with topography-guided custom ablation. Vector analysis was used to evaluate the contribution of coma-like corneal HOAs to RA. Two different strategies were used for simulated treatments aiming to regularize irregular corneal optics: With both strategies correction of anterior corneal surface irregularities (corneal HOAs) were intended. Correction of total corneal astigmatism (TCA) and RA was intended as well with strategies 1 and 2, respectively. Axis of discrepant astigmatism (RA minus TCA minus LA) correlated strongly with axis of coma. Vertical coma influenced RA by canceling the effect of the with-the-rule astigmatism and increasing the effect of the against-the-rule astigmatism. After simulated correction of anterior corneal HOAs along with TCA and RA (strategies 1 and 2), only a small amount of anterior corneal astigmatism (ACA) and no TCA remained after strategy 1, while considerable amount of ACA and TCA remained after strategy 2. Coma-like corneal aberrations seem to contribute a considerable astigmatic component to RA in eyes with coma-like-aberrations dominant corneal optics. If topography-guided ablation is programmed to correct the corneal HOAs and RA, the astigmatic component caused by the coma-like corneal HOAs will be treated twice and will result in induced astigmatism. Disregarding RA and treating TCA along with the corneal HOAs is recommended instead.

Hyperosmolar nonketotic coma precipitated by lithium-induced nephrogenic diabetes insipidus.

PubMed Central

Azam, H.; Newton, R. W.; Morris, A. D.; Thompson, C. J.

1998-01-01

A 45-year-old man, with a 10-year history of manic depression treated with lithium, was admitted with hyperosmolar, nonketotic coma. He gave a five-year history of polyuria and polydipsia, during which time urinalysis had been negative for glucose. After recovery from hyperglycaemia, he remained polyuric despite normal blood glucose concentrations; water deprivation testing indicated nephrogenic diabetes insipidus, likely to be lithium-induced. We hypothesize that when this man developed type 2 diabetes, chronic polyuria due to nephrogenic diabetes insipidus was sufficient to precipitate hyperosmolar dehydration. PMID:9538487

Double deflection system for an electron beam device

DOEpatents

Parker, Norman W.; Golladay, Steven D.; Crewe, Albert V.

1978-01-01

A double deflection scanning system for electron beam instruments is provided embodying a means of correcting isotropic coma, and anisotropic coma aberrations induced by the magnetic lens of such an instrument. The scanning system deflects the beam prior to entry into the magnetic lens from the normal on-axis intersection of the beam with the lens according to predetermined formulas and thereby reduces the aberrations.

Dust in Cometary Comae: Present Understanding of the Structure and Composition of Dust Particles

NASA Technical Reports Server (NTRS)

Levasseur-Regourd, A. C.; Zolensky, M.; Lasue, J.

2007-01-01

In situ probing of a very few cometary comae has shown that dust particles present a low albedo and a low density, and that they consist of both rocky material and refractory organics. Remote observations of solar light scattered by cometary dust provide information on the properties of dust particles in the coma of a larger set of comets. The observations of the linear polarization in the coma indicate that the dust particles are irregular, with a size greater (on the average) than about one micron. Besides, they suggest, through numerical and experimental simulations, that both compact grains and fluffy aggregates (with a power law of the size distribution in the -2.6 to -3 range), and both rather transparent silicates and absorbing organics are present in the coma. Recent analysis of the cometary dust samples collected by the Stardust mission provide a unique ground truth and confirm, for comet 81P/Wild 2, the results from remote sensing observations. Future space missions to comets should, in the next decade, lead to a more precise characterization of the structure and composition of cometary dust particles.

Cold adaptation shapes the robustness of metabolic networks in Drosophila melanogaster

PubMed Central

Williams, CM; Watanabe, M; Guarracino, MR; Ferraro, MB; Edison, AS; Morgan, TJ; Boroujerdi, AFB; Hahn, DA

2015-01-01

When ectotherms are exposed to low temperatures, they enter a cold-induced coma (chill coma) that prevents resource acquisition, mating, oviposition, and escape from predation. There is substantial variation in time taken to recover from chill coma both within and among species, and this variation is correlated with habitat temperatures such that insects from cold environments recover more quickly. This suggests an adaptive response, but the mechanisms underlying variation in recovery times are unknown, making it difficult to decisively test adaptive hypotheses. We use replicated lines of Drosophila melanogaster selected in the laboratory for fast (hardy) or slow (susceptible) chill-coma recovery times to investigate modifications to metabolic profiles associated with cold adaptation. We measured metabolite concentrations of flies before, during, and after cold exposure using NMR spectroscopy to test the hypotheses that hardy flies maintain metabolic homeostasis better during cold exposure and recovery, and that their metabolic networks are more robust to cold-induced perturbations. The metabolites of cold-hardy flies were less cold responsive and their metabolic networks during cold exposure were more robust, supporting our hypotheses. Metabolites involved in membrane lipid synthesis, tryptophan metabolism, oxidative stress, energy balance, and proline metabolism were altered by selection on cold tolerance. We discuss the potential significance of these alterations. PMID:25308124

Resolution of electroconvulsive therapy refractory major depressive disorder with unintentional hypoglycemic seizure: a case report.

PubMed

Rosenblat, Joshua D; Devarajan, Sivakumaran

2013-09-01

We report a 74-year-old white woman with type 1 diabetes and major depressive disorder refractory to multiple medications who received 15 electroconvulsive therapy treatments with minimal improvement. After an accidental hypoglycemic seizure, the patient's symptoms completely resolved. In conclusion, the present case reveals an instance where electroconvulsive therapy-induced seizures appeared to be minimally effective, whereas a single accidental hypoglycemia-induced seizure was incredibly effective for the resolutions of depressive symptoms. Although this case presents a single efficacious use of accidental insulin coma therapy, the applicability is limited because of the known risks of insulin coma therapy.

Amiodarone-induced myxoedema coma.

PubMed

Hassan, Syed; Ayoub, Walaa; Hassan, Mona; Wisgerhof, Max

2014-04-12

A 62-year-old man was found to have bradycardia, hypothermia and respiratory failure 3 weeks after initiation of amiodarone therapy for atrial fibrillation. Thyroid-stimulating hormone was found to be 168 μIU/mL (nl. 0.3-5 μIU/mL) and free thyroxine (FT4) was <0.2 ng/dL (nl. 0.8-1.8 ng/dL). He received intravenous fluids, vasopressor therapy and stress dose steroids; he was intubated and admitted to the intensive care unit. He received 500 μg of intravenous levothyroxine in the first 18 h of therapy, and 150 µg intravenous daily thereafter. Haemodynamic improvement, along with complete recovery of mental status, occurred after 48 h. Twelve hours after the initiation of therapy, FT4 was 0.96 ng/dL. The patient was maintained on levothyroxine 175 (g POorally daily. A thyroid ultrasound showed diffuse heterogeneity. The 24 hour excretion of iodine was 3657 (mcg (25-756 ( mcg). The only two cases of amiodarone-induced myxoedema coma in the literature report patient death despite supportive therapy and thyroid hormone replacement. This case represents the most thoroughly investigated case of amiodarone-induced myxoedema coma with a history significant for subclinical thyroid disease.

N-Acetylcysteine Use in Non-Acetaminophen-Induced Acute Liver Failure.

PubMed

McPheeters, Chelsey M; VanArsdale, Vanessa M; Weant, Kyle A

2016-01-01

This article will review the available evidence related to the management of non-acetaminophen induced acute liver failure with N-acetylcysteine. Randomized controlled trials and a meta-analysis were included in this review. The efficacy of N-acetylcysteine in the treatment of acute liver failure from causes other than acetaminophen toxicity was evaluated. The efficacy of N-acetylcysteine in non-acetaminophen-induced acute liver failure is limited to specific patient populations. Patients classified as Coma Grade I or II are more likely to benefit from the use of this agent. The use of N-acetylcysteine is associated with improved transplant-free survival, not overall survival, in adults. N-Acetylcysteine does not improve the overall survival of patients with non-acetaminophen-induced acute liver failure but may be beneficial in those patients with Coma Grades I-II. Liver transplantation remains the only definitive therapy in advanced disease.

Amiodarone induced myxedema coma: Two case reports and literature review.

PubMed

Hawatmeh, Amer; Thawabi, Mohammad; Abuarqoub, Ahmad; Shamoon, Fayez

2018-05-21

Amiodarone is a benzofuran derivative that contains 37% iodine by weight and is structurally similar to the thyroid hormones. Amiodarone has a complex effect on the thyroid gland, ranging from abnormalities of thyroid function tests to overt thyroid dysfunction, with either thyrotoxicosis or hypothyroidism. Myxedema coma secondary to amiodarone use has been rarely reported in the literature. Our two case reports are an add on to the literature, and illustrate that amiodarone is an important cause of thyroid dysfunction including hypothyroidism and myxedema coma. Hence, healthcare providers should have a high index of suspicion for these conditions while treating patients who are taking amiodarone therapy as early recognition and management are essential to optimize outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

Peripheral myopization and visual performance with experimental rigid gas permeable and soft contact lens design.

PubMed

Pauné, J; Queiros, A; Quevedo, L; Neves, H; Lopes-Ferreira, D; González-Méijome, J M

2014-12-01

To evaluate the performance of two experimental contact lenses (CL) designed to induce relative peripheral myopic defocus in myopic eyes. Ten right eyes of 10 subjects were fitted with three different CL: a soft experimental lens (ExpSCL), a rigid gas permeable experimental lens (ExpRGP) and a standard RGP lens made of the same material (StdRGP). Central and peripheral refraction was measured using a Grand Seiko open-field autorefractometer across the central 60° of the horizontal visual field. Ocular aberrations were measured with a Hartman-Shack aberrometer, and monocular contrast sensitivity function (CSF) was measured with a VCTS6500 without and with the three contact lenses. Both experimental lenses were able to increase significantly the relative peripheral myopic defocus up to -0.50 D in the nasal field and -1.00 D in the temporal field (p<0.05). The ExpRGP induced a significantly higher myopic defocus in the temporal field compared to the ExpSCL. ExpSCL induced significantly lower levels of Spherical-like HOA than ExpRGP for the 5mm pupil size (p<0.05). Both experimental lenses kept CSF within normal limits without any statistically significant change from baseline (p>0.05). RGP lens design seems to be more effective to induce a significant myopic change in the relative peripheral refractive error. Both lenses preserve a good visual performance. The worsened optical quality observed in ExpRGP was due to an increased coma-like and spherical-like HOA. However, no impact on the visual quality as measured by CSF was observed. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Amiodarone-induced myxoedema coma

PubMed Central

Hassan, Syed; Ayoub, Walaa; Hassan, Mona; Wisgerhof, Max

2014-01-01

A 62-year-old man was found to have bradycardia, hypothermia and respiratory failure 3 weeks after initiation of amiodarone therapy for atrial fibrillation. Thyroid-stimulating hormone was found to be 168 μIU/mL (nl. 0.3–5 μIU/mL) and free thyroxine (FT4) was <0.2 ng/dL (nl. 0.8–1.8 ng/dL). He received intravenous fluids, vasopressor therapy and stress dose steroids; he was intubated and admitted to the intensive care unit. He received 500 μg of intravenous levothyroxine in the first 18 h of therapy, and 150 µg intravenous daily thereafter. Haemodynamic improvement, along with complete recovery of mental status, occurred after 48 h. Twelve hours after the initiation of therapy, FT4 was 0.96 ng/dL. The patient was maintained on levothyroxine 175 (g POorally daily. A thyroid ultrasound showed diffuse heterogeneity. The 24 hour excretion of iodine was 3657 (mcg (25–756 ( mcg). The only two cases of amiodarone-induced myxoedema coma in the literature report patient death despite supportive therapy and thyroid hormone replacement. This case represents the most thoroughly investigated case of amiodarone-induced myxoedema coma with a history significant for subclinical thyroid disease. PMID:24729111

Clinical analysis of penehyclidine hydrochloride combined with hemoperfusion in the treatment of acute severe organophosphorus pesticide poisoning.

PubMed

Liang, M J; Zhang, Y

2015-05-11

This study aimed to observe the clinical curative effect of penehyclidine hydrochloride (PHC) combined with hemoperfusion in treating acute severe organophosphorus pesticide poisoning. We randomly divided 61 patients with severe organophosphorus pesticide poisoning into an experimental group (N = 31) and a control group (N = 30), and we compared the coma-recovery time, mechanical ventilation time, healing time, hospital expenses, and mortality between the two groups. The coma-recovery time, mechanical ventilation time, and healing time were lower in the experimental group than in the control group (P < 0.05), while the hospitalization expenses were higher in the experimental group than in the control group (P < 0.01); moreover, no significant difference was observed in the mortality rate between the two groups. Thus, PHC combined with hemoperfusion exerts a better therapeutic effect in acute severe organophosphorus pesticide poisoning than PHC alone.

Factors predisposing to coma and delirium: fentanyl and midazolam exposure; CYP3A5, ABCB1, and ABCG2 genetic polymorphisms; and inflammatory factors.

PubMed

Skrobik, Yoanna; Leger, Caroline; Cossette, Mariève; Michaud, Veronique; Turgeon, Jacques

2013-04-01

Delirium and sedative-induced coma are described as incremental manifestations of cerebral dysfunction. Both may be associated with sedative or opiate doses and pharmacokinetic or pharmacogenetic variables, such as drug plasma levels (exposure), drug metabolism, and/or their transport across the blood-brain barrier. To compare biological and drug treatment characteristics in patients with coma and/or delirium while in the ICU. In 99 patients receiving IV fentanyl, midazolam, or both, we evaluated drug doses, covariates likely to influence drug effects (age, body mass index, and renal and hepatic dysfunction); delirium risk factors; concomitant administration of CYP3A and P-glycoprotein substrates/inhibitors; ABCB1, ABCG2, and CYP3A5 genetic polymorphisms; and fentanyl and midazolam plasma levels. Delirium and coma were evaluated daily. In patients with only coma (n=15), only delirium (n=7), and neither ever (n=14), we measured plasma levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-1RA, IL-6, IL-8, IL-10, IL-17,macrophage inflammatory protein-1β, and monocyte chemotactic protein-1. Time to first coma was associated with fentanyl and midazolam doses (p=0.03 and p=0.01, respectively). The number of days in coma was associated with the number of days of coadministration of CYP3A inhibitors (r=0.30; p=0.006). Plasma levels of fentanyl were higher in patients with clinical coma (3.7±4.7 vs. 2.0±1.8 ng/mL, p=0.0001) as were midazolam plasma levels (1050±2232 vs. 168±249 ng/mL, p=0.0001). Delirium occurrence was unrelated to midazolam administration, cumulative doses, or serum levels. Days with delirium were associated with days of coadministration of P-glycoprotein inhibitor (r=0.35; p=0.0004). Delirious patients had higher levels of the inflammatory mediator IL-6 than comatose patients (129.3 vs. 35.0 pg/mL, p=0.05). Coma is associated with fentanyl and midazolam exposure; delirium is unrelated to midazolam and may be linked to inflammatory status. These data suggest that iatrogenic coma and delirium are not mechanistically linked.

Self-induced drug intoxication in baclofen: of the calm hypotonic coma in the status epilepticus.

PubMed

Thill, Chloé; Di Constanzo, Laurence; Pessey, François; Aries, Philippe; Montelescaut, Étienne; Sapin, Jeanne; Vaillant, Catherine; Drouillard, Isabelle

2016-06-01

Baclofen is an agonist of peripheral and central B gamma-aminobutyric acid receptors, whose activation causes a myorelaxation and a powerfull depression of the central nervous system. Moreover, it has an action against addiction, in reducing craving. Commercialized since 1975 in France, to control muscle spasticity due to medullar affection or multiple sclerosis, it receives a temporary recommendation of use in march 2014, as a last-line adjuvant treatment in alcohol withdrawal. Beyond its therapeutic use, baclofen is involved in many self-induced intoxications. We report the case of a patient who develops, after a massive ingestion of baclofen (supposed dose ingested: 1 200 mg), a hypotonic and calm coma, requiring her admission in our intensive care unit, and then a status epilepticus.

Cold tolerance is unaffected by oxygen availability despite changes in anaerobic metabolism

NASA Astrophysics Data System (ADS)

Boardman, Leigh; Sørensen, Jesper G.; Koštál, Vladimír; Šimek, Petr; Terblanche, John S.

2016-09-01

Insect cold tolerance depends on their ability to withstand or repair perturbations in cellular homeostasis caused by low temperature stress. Decreased oxygen availability (hypoxia) can interact with low temperature tolerance, often improving insect survival. One mechanism proposed for such responses is that whole-animal cold tolerance is set by a transition to anaerobic metabolism. Here, we provide a test of this hypothesis in an insect model system (Thaumatotibia leucotreta) by experimental manipulation of oxygen availability while measuring metabolic rate, critical thermal minimum (CTmin), supercooling point and changes in 43 metabolites in moth larvae at three key timepoints (before, during and after chill coma). Furthermore, we determined the critical oxygen partial pressure below which metabolic rate was suppressed (c. 4.5 kPa). Results showed that altering oxygen availability did not affect (non-lethal) CTmin nor (lethal) supercooling point. Metabolomic profiling revealed the upregulation of anaerobic metabolites and alterations in concentrations of citric acid cycle intermediates during and after chill coma exposure. Hypoxia exacerbated the anaerobic metabolite responses induced by low temperatures. These results suggest that cold tolerance of T. leucotreta larvae is not set by oxygen limitation, and that anaerobic metabolism in these larvae may contribute to their ability to survive in necrotic fruit.

Long-term outcomes after immediate aortic repair for acute type A aortic dissection complicated by coma.

PubMed

Tsukube, Takuro; Haraguchi, Tomonori; Okada, Yasushi; Matsukawa, Ritsu; Kozawa, Shuichi; Ogawa, Kyoichi; Okita, Yutaka

2014-09-01

The management of acute type A aortic dissection complicated by coma remains controversial. We previously reported an excellent rate of recovery of consciousness provided aortic repair was performed within 5 hours of the onset of symptoms. This study evaluates the early and long-term outcomes using this approach. Between August 2003 and July 2013, of the 241 patients with acute type A aortic dissection brought to the Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, 30 (12.4%) presented with coma; Glasgow Coma Scale was less than 11 on arrival. Surgery was performed in 186 patients, including 27 (14.5%) who were comatose. Twenty-four comatose patients underwent successful aortic repair immediately (immediate group). Their mean age was 71.0 ± 11.1 years, Glasgow Coma Scale was 6.5 ± 2.4, and prevalence of carotid dissection was 79%. For brain protection, deep hypothermia with antegrade cerebral perfusion was used, and postoperative induced hypothermia was performed. Neurologic evaluations were performed using the Glasgow Coma Scale, National Institutes of Health Stroke Scale, and modified Rankin Scale. In the immediate group, the time from the onset of symptoms to arrival in the operating theater was 222 ± 86 minutes. Hospital mortality was 12.5%. Full recovery of consciousness was achieved in 79% of patients in up to 30 days. Postoperative Glasgow Coma Scale and National Institutes of Health Stroke Scale improved significantly when compared with the preoperative score (P < .05), and postoperative activities of daily living independence (modified Rankin Scale <3) was achieved in 50% of patients. The mean follow-up period was 56.5 months, and the cumulative survival was 48.2% after 10 years. Cox proportional hazards regression analysis indicated that immediate repair (hazard ratio, 4.3; P = .007) was the only significant predictor of postoperative survival over a 5-year period. The early and long-term outcomes as a result of immediate aortic repair for acute type A aortic dissection complicated by coma were satisfactory. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Axisymmetric Optical Membrane Modeling Based on Experimental Results

DTIC Science & Technology

2004-03-01

polymers; one such was NASA’s Inflatable Antenna Experiment (IAE), which is a pressurized lenticular about 14 meters in diameter. It was designed...2cos2θ Astigmatism with axis at +/- 45 deg 5 ρ 2sin2θ Astigmatism with axis at +/- 0 or 90 deg 6 (3 ρ 2-2) ρ cosθ Primary coma along y axis...7 (3 ρ 2-2) ρ sinθ Primary coma along x axis 51 8 6 ρ 4-6 ρ 2+1 Primary spherical aberration 9 ρ 3cos(3θ ) Triangular astigmatism , base on y axis

A closed-loop anesthetic delivery system for real-time control of burst suppression

NASA Astrophysics Data System (ADS)

Liberman, Max Y.; Ching, ShiNung; Chemali, Jessica; Brown, Emery N.

2013-08-01

Objective. There is growing interest in using closed-loop anesthetic delivery (CLAD) systems to automate control of brain states (sedation, unconsciousness and antinociception) in patients receiving anesthesia care. The accuracy and reliability of these systems can be improved by using as control signals electroencephalogram (EEG) markers for which the neurophysiological links to the anesthetic-induced brain states are well established. Burst suppression, in which bursts of electrical activity alternate with periods of quiescence or suppression, is a well-known, readily discernible EEG marker of profound brain inactivation and unconsciousness. This pattern is commonly maintained when anesthetics are administered to produce a medically-induced coma for cerebral protection in patients suffering from brain injuries or to arrest brain activity in patients having uncontrollable seizures. Although the coma may be required for several hours or days, drug infusion rates are managed inefficiently by manual adjustment. Our objective is to design a CLAD system for burst suppression control to automate management of medically-induced coma. Approach. We establish a CLAD system to control burst suppression consisting of: a two-dimensional linear system model relating the anesthetic brain level to the EEG dynamics; a new control signal, the burst suppression probability (BSP) defining the instantaneous probability of suppression; the BSP filter, a state-space algorithm to estimate the BSP from EEG recordings; a proportional-integral controller; and a system identification procedure to estimate the model and controller parameters. Main results. We demonstrate reliable performance of our system in simulation studies of burst suppression control using both propofol and etomidate in rodent experiments based on Vijn and Sneyd, and in human experiments based on the Schnider pharmacokinetic model for propofol. Using propofol, we further demonstrate that our control system reliably tracks changing target levels of burst suppression in simulated human subjects across different epidemiological profiles. Significance. Our results give new insights into CLAD system design and suggest a control-theory framework to automate second-to-second control of burst suppression for management of medically-induced coma.

Galaxy Interactions, Tidal Debris, and the Origin of Intracluster Light in the Coma Cluster

NASA Astrophysics Data System (ADS)

Gregg, Michael

1999-07-01

We propose to obtain deep WFPC2 and parallel STIS images of low surface brightness tidal debris that we have recently discovered in the Coma cluster; the material is being stripped from its parent galaxy and added to the general cluster background. These images will enable direct study of the brightest blue and red supergiants, globular clusters, and star forming regions which may be present, or will place strong limits on the numbers of such objects and any recent star formation. We also propose similar observations of the parent spiral, NGC4911, in the core of Coma; it is losing its ISM to the hot cluster gas and as well as the low surface brightness tidal debris. By imaging this galaxy, we will get a high resolution look at the interaction between the galaxy and interstellar medium, as well as any ram-pressure induced star formation. The tidal features in Coma appear to be adding material to the background light and cD galaxy envelopes at a significant rate; determining the nature of the added stellar population and the interactions which produce it are critical to understanding the formation and evolution of cD galaxies and clusters.

[Could it be a little less? Let the dose of thiopental in euthanasia depend on the body weight].

PubMed

Sprij, Bram

2010-01-01

The Dutch 'euthanasia and assisted suicide' practice guideline advises using 2000 mg thiopental to induce coma, followed by a muscle relaxant to cause death by respiratory paralysis. However, when a doctor administers such a high dose of thiopental as a bolus injection to a cachectic patient, there is a high likelihood of immediate death and other side effects, which can be distressing for the family. Doctors who administered less than 2000 mg have been reprimanded for not working according to current standards. Arguments are given concerning in which circumstances it is reasonable to use the advised dose of 2000 mg of thiopental and when to use less thiopental to induce coma by direct intravenous injection. The author suggests that it may be better to adjust the dose of thiopental according to the body weight of the patient. The current practice guideline needs revision.

Hyperammoniemic coma in a patient with ureterosigmoidostomy and normal liver function.

PubMed

Van Laethem, J L; Gay, F; Franck, N; Van Gossum, A

1992-11-01

Hyperammoniemic encephalopathy has been reported after ureterosigmoidostomy. Its development is related to a problem of bacterial overgrowth and, most often, is favored by the presence of an underlying liver dysfunction. We report the case of a 43-year-old woman with a ureterosigmoidostomy done 28 years earlier who developed hyperammoniemic coma induced by an acute rectocolitis and in the absence of any detectable liver dysfunction. Neither administration of Lactilol and neomycin nor rectal tube drainage were effective; systemic antimicrobial therapy effective against the urease-producing gram-negative bacilli was required and led to a decrease in serum ammonia levels and a dramatic clinical improvement.

Human Brain Activity Patterns beyond the Isoelectric Line of Extreme Deep Coma

PubMed Central

Kroeger, Daniel; Florea, Bogdan; Amzica, Florin

2013-01-01

The electroencephalogram (EEG) reflects brain electrical activity. A flat (isoelectric) EEG, which is usually recorded during very deep coma, is considered to be a turning point between a living brain and a deceased brain. Therefore the isoelectric EEG constitutes, together with evidence of irreversible structural brain damage, one of the criteria for the assessment of brain death. In this study we use EEG recordings for humans on the one hand, and on the other hand double simultaneous intracellular recordings in the cortex and hippocampus, combined with EEG, in cats. They serve to demonstrate that a novel brain phenomenon is observable in both humans and animals during coma that is deeper than the one reflected by the isoelectric EEG, and that this state is characterized by brain activity generated within the hippocampal formation. This new state was induced either by medication applied to postanoxic coma (in human) or by application of high doses of anesthesia (isoflurane in animals) leading to an EEG activity of quasi-rhythmic sharp waves which henceforth we propose to call ν-complexes (Nu-complexes). Using simultaneous intracellular recordings in vivo in the cortex and hippocampus (especially in the CA3 region) we demonstrate that ν-complexes arise in the hippocampus and are subsequently transmitted to the cortex. The genesis of a hippocampal ν-complex depends upon another hippocampal activity, known as ripple activity, which is not overtly detectable at the cortical level. Based on our observations, we propose a scenario of how self-oscillations in hippocampal neurons can lead to a whole brain phenomenon during coma. PMID:24058669

Peripheral Refraction Validity of the Shin-Nippon SRW5000 Autorefractor.

PubMed

Osuagwu, Uchechukwu Levi; Suheimat, Marwan; Wolffsohn, James S; Atchison, David A

2016-10-01

To investigate the operation of the Shin-Nippon/Grand Seiko autorefractor and whether higher-order aberrations affect its peripheral refraction measurements. Information on instrument design, together with parameters and equations used to obtain refraction, was obtained from a patent. A model eye simulating the operating principles was tested with an optical design program. Effects of induced defocus and astigmatism on the retinal image were used to calibrate the model eye to match the patent equations. Coma and trefoil were added to assess their effects on the image. Peripheral refraction of a physical model eye was measured along four visual field meridians with the Shin-Nippon/Grand Seiko autorefractor SRW-5000 and a Hartmann-Shack aberrometer, and simulated autorefractor peripheral refraction was derived using the Zernike coefficients from the aberrometer. In simulation, the autorefractor's square image was changed in size by defocus, into rectangles or parallelograms by astigmatism, and into irregular shapes by coma and trefoil. In the presence of 1.0 D oblique astigmatism, errors in refraction were proportional to the higher-order aberrations, with up to 0.8 D sphere and 1.5 D cylinder for ±0.6 μm of coma or trefoil coefficients with a 5-mm-diameter pupil. For the physical model eye, refraction with the aberrometer was similar in all visual field meridians, but refraction with the autorefractor changed more quickly along one oblique meridian and less quickly along the other oblique meridian than along the horizontal and vertical meridians. Simulations predicted that higher-order aberrations would affect refraction in oblique meridians, and this was supported by the experimental measurements with the physical model eye. The autorefractor's peripheral refraction measurements are valid for horizontal and vertical field meridians, but not for oblique field meridians. Similar instruments must be validated before being adopted outside their design scope.

The Three Sources of Gas in the Comae of Comets

NASA Technical Reports Server (NTRS)

Huebner, W. F.

1995-01-01

Surface water ice on a comet nucleus is the major source of coma gas. Dust, entrained by coma gas, fragments and vaporizes, forming a second, distributed source of coma gas constituents. Ice species more volatile than water ice below the surface of the nucleus are a third source of coma gas. Vapors from these ices, produced by heat penetrating into the nucleus, diffuse through pores outward into the coma. The second and third sources provide minor, but sometimes easily detectible, gaseous species in the coma. We present mixing ratios of observed minor coma constituents relative to water vapor as a function of heliocentric and cometocentric distances and compare these ratios with model predictions, assuming the sources of the minor species are either coma dust or volatile ices in the nucleus.

Solar-insolation-induced changes in the coma morphology of comet 67P/Churyumov-Gerasimenko. Optical monitoring with the Nordic Optical Telescope

NASA Astrophysics Data System (ADS)

Zaprudin, B.; Lehto, H. J.; Nilsson, K.; Somero, A.; Pursimo, T.; Snodgrass, C.; Schulz, R.

2017-07-01

Context. 67P/Churyumov-Gerasimenko (67P/C-G) is a short-period Jupiter family comet with an orbital period of 6.55 yr. Being the target comet of ESA's Rosetta mission, 67P/C-G has become one of the most intensively studied minor bodies of the solar system. The Rosetta Orbiter and the Philae Lander have brought us unique information about the structure and activity of the comet nucleus, as well as its activity along the orbit, composition of gas, and dust particles emitted into the coma. However, as Rosetta stayed in very close proximity to the cometary nucleus (less than 500 km with a few short excursions reaching up to 1500 km), it could not see the global picture of a coma at the scales reachable by telescopic observations (103 - 105 km). Aims: In this work we aim to connect in-situ observations made by Rosetta with the morphological evolution of the coma structures monitored by the ground-based observations. In particular, we concentrate on causal relationships between the coma morphology and evolution observed with the Nordic Optical Telescope (NOT) in the Canary Islands, and the seasonal changes of the insolation and the activity of the comet observed by the Rosetta instruments. Methods: Comet 67P/C-G was monitored with the NOT in imaging mode in two colors. Imaging optical observations were performed roughly on a weekly basis, which provides good coverage of short- and long-term variability. With the three dimensional modeling of the coma produced by active regions on the southern hemisphere, we aim to qualify the observed morphology by connecting it to the activity observed by Rosetta. Results: During our monitoring program, we detected major changes in the coma morphology of comet 67P/C-G. These were long-term and long-lasting changes. They do not represent any sudden outburst or short transient event, but are connected to seasonal changes of the surface insolation and the emergence of new active regions on the irregular shaped comet nucleus. We have also found significant deviations in morphological changes from the prediction models based on previous apparitions of 67P/C-G, like the time delay of the morphology changes and the reduced activity in the northern hemisphere. According to our modeling of coma structures and geometry of observations, the changes are clearly connected with the activity in the southern hemisphere observed by the Rosetta spacecraft.

Structural Basis of Rap Phosphatase Inhibition by Phr Peptides

PubMed Central

Gallego del Sol, Francisca; Marina, Alberto

2013-01-01

Two-component systems, composed of a sensor histidine kinase and an effector response regulator (RR), are the main signal transduction devices in bacteria. In Bacillus, the Rap protein family modulates complex signaling processes mediated by two-component systems, such as competence, sporulation, or biofilm formation, by inhibiting the RR components involved in these pathways. Despite the high degree of sequence homology, Rap proteins exert their activity by two completely different mechanisms of action: inducing RR dephosphorylation or blocking RR binding to its target promoter. However the regulatory mechanism involving Rap proteins is even more complex since Rap activity is antagonized by specific signaling peptides (Phr) through a mechanism that remains unknown at the molecular level. Using X-ray analyses, we determined the structure of RapF, the anti-activator of competence RR ComA, alone and in complex with its regulatory peptide PhrF. The structural and functional data presented herein reveal that peptide PhrF blocks the RapF-ComA interaction through an allosteric mechanism. PhrF accommodates in the C-terminal tetratricopeptide repeat domain of RapF by inducing its constriction, a conformational change propagated by a pronounced rotation to the N-terminal ComA-binding domain. This movement partially disrupts the ComA binding site by triggering the ComA disassociation, whose interaction with RapF is also sterically impaired in the PhrF-induced conformation of RapF. Sequence analyses of the Rap proteins, guided by the RapF-PhrF structure, unveil the molecular basis of Phr recognition and discrimination, allowing us to relax the Phr specificity of RapF by a single residue change. PMID:23526880

Effect of quinine and artesunate combination therapy on platelet count of children with severe malaria.

PubMed

Gupta, Parul; Narang, Manish; Gomber, Sunil; Saha, Rumpa

2017-05-01

There are several case reports of quinine-induced thrombocytopenia but no clinical trials to ascertain its incidence and significance in severe malaria. The primary objective was to assess the effect of quinine on the platelet count in children with severe malaria and to compare it with artesunate combination therapy (ACT), and the secondary objective was to assess outcome of treatment with quinine and ACT. An open-labelled, randomised, controlled trial was undertaken in 100 children aged 6 months to 12 years who were diagnosed with malaria by microscopy and/or rapid diagnostic test kits with at least one WHO clinical or laboratory criterion for severe malaria. All subjects were commenced on either quinine or ACT. Clindamycin was added to artesunate as a combination drug (ACT). It was also given to patients on quinine to avoid its confounding effect on the results. Platelet counts were undertaken every 24 hours for 7 consecutive days, temperature and coma score (Blantyre coma score ≥3 in children <4 years or Glasgow coma score ≥13 in children >4 years) was recorded 6-hourly and peripheral smears were taken 12-hourly until two consecutively negative smears were obtained. The primary outcome was a fall in the platelet count by ≥20% from the time of drug initiation until day 7. The secondary outcome was comparison of the efficacy, parasite clearance time, fever clearance time, coma recovery time and adverse effects of quinine vs ACT. 30.4% patients in the quinine group (n = 48) had ≥20% fall in platelet count and 10.8% of patients in the ACT group (n = 46) (P = 0.02). Despite the fall in platelet count, there was no bleeding. The efficacy of ACT was significantly better than quinine but the other treatment outcomes showed insignificant difference. Quinine should be used with caution in patients with severe malaria because of the potential risk of quinine-induced thrombocytopenia.

The effects of hypoglycemic and alcoholic coma on the blood-brain barrier permeability

PubMed Central

Yorulmaz, Hatice; Seker, Fatma Burcu; Oztas, Baria

2011-01-01

In this investigation, the effects of hypoglycemic coma and alcoholic coma on the blood-brain barrier (BBB) permeability have been compared. Female adult Wistar albino rats weighing 180-230 g were divided into three groups: Control group (n=8), Alcoholic Coma Group (n=18), and Hypoglycemic Coma group (n=12). The animals went into coma approximately 3-4 hours after insulin administration and 3-5 minutes after alcohol administration. Evans blue (4mL/kg) was injected intravenously as BBB tracer. It was observed that the alcoholic coma did not significantly increase the BBB permeability in any of the brain regions when compared to control group. Changes in BBB permeability were significantly increased by the hypoglycemic coma in comparison to the control group values (p<0.01). Our findings suggest that hypoglycemic and alcoholic coma have different effects on the BBB permeability depending on the energy metabolism. PMID:21619558

Homeopathic treatment for prolonged postoperative coma: a case report.

PubMed

Vithoulkas, G; Văcăraș, V; Kavouras, J; Buzoianu, A D; Mărginean, M; Văcăraș, D; Cozma, S

2017-01-01

Coma is the state of unrousable unconsciousness. There are variations in the degree of coma and the findings and signs found on the patient's clinical examination depend on the underlying cause of the disorder. The Glasgow Coma scale evaluates the best motor, verbal and eye answers of the patient. A patient is considered to be in a coma if his Glasgow Coma Scale is below 8 points. The progress that we have made throughout the years has also led to complications that can culminate in a major catastrophe like death, permanent brain damage, coma. A study performed reached the conclusion that prior comorbidity, older age, intraoperative hypotension, and cardiovascular surgery may predispose patients to postoperative coma. The article presents a case of postoperative coma treated successfully with homeopathy. Although a rare complication, postoperative coma is a severe, death-leading condition, causing immense suffering on both the patient and the patient's family. A multidisciplinary and thorough approach is necessary for these patients, but even after a well-conducted therapy, this condition leads to the death of the patient.

Homeopathic treatment for prolonged postoperative coma: a case report

PubMed Central

Vithoulkas, G; Văcăraș, V; Kavouras, J; Buzoianu, AD; Mărginean, M; Văcăraș, D; Cozma, S

2017-01-01

Coma is the state of unrousable unconsciousness. There are variations in the degree of coma and the findings and signs found on the patient’s clinical examination depend on the underlying cause of the disorder. The Glasgow Coma scale evaluates the best motor, verbal and eye answers of the patient. A patient is considered to be in a coma if his Glasgow Coma Scale is below 8 points. The progress that we have made throughout the years has also led to complications that can culminate in a major catastrophe like death, permanent brain damage, coma. A study performed reached the conclusion that prior comorbidity, older age, intraoperative hypotension, and cardiovascular surgery may predispose patients to postoperative coma. The article presents a case of postoperative coma treated successfully with homeopathy. Although a rare complication, postoperative coma is a severe, death-leading condition, causing immense suffering on both the patient and the patient’s family. A multidisciplinary and thorough approach is necessary for these patients, but even after a well-conducted therapy, this condition leads to the death of the patient. PMID:28616086

Pathophysiology of cerebral oedema in acute liver failure.

PubMed

Scott, Teresa R; Kronsten, Victoria T; Hughes, Robin D; Shawcross, Debbie L

2013-12-28

Cerebral oedema is a devastating consequence of acute liver failure (ALF) and may be associated with the development of intracranial hypertension and death. In ALF, some patients may develop cerebral oedema and increased intracranial pressure but progression to life-threatening intracranial hypertension is less frequent than previously described, complicating less than one third of cases who have proceeded to coma since the advent of improved clinical care. The rapid onset of encephalopathy may be dramatic with the development of asterixis, delirium, seizures and coma. Cytotoxic and vasogenic oedema mechanisms have been implicated with a preponderance of experimental data favouring a cytotoxic mechanism. Astrocyte swelling is the most consistent neuropathological finding in humans with ALF and ammonia plays a definitive role in the development of cytotoxic brain oedema. The mechanism(s) by which ammonia induces astrocyte swelling remains unclear but glutamine accumulation within astrocytes has led to the osmolyte hypothesis. Current evidence also supports an alternate 'Trojan horse' hypothesis, with glutamine as a carrier of ammonia into mitochondria, where its accumulation results in oxidative stress, energy failure and ultimately astrocyte swelling. Although a complete breakdown of the blood-brain barrier is not evident in human ALF, increased permeation to water and other small molecules such as ammonia has been demonstrated resulting from subtle alterations in the protein composition of paracellular tight junctions. At present, there is no fully efficacious therapy for cerebral oedema other than liver transplantation and this reflects our incomplete knowledge of the precise mechanisms underlying this process which remain largely unknown.

THE HST/ACS COMA CLUSTER SURVEY. VIII. BARRED DISK GALAXIES IN THE CORE OF THE COMA CLUSTER

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

Marinova, Irina; Jogee, Shardha; Weinzirl, Tim

2012-02-20

We use high-resolution ({approx}0.''1) F814W Advanced Camera for Surveys (ACS) images from the Hubble Space Telescope ACS Treasury survey of the Coma cluster at z {approx} 0.02 to study bars in massive disk galaxies (S0s), as well as low-mass dwarf galaxies in the core of the Coma cluster, the densest environment in the nearby universe. Our study helps to constrain the evolution of bars and disks in dense environments and provides a comparison point for studies in lower density environments and at higher redshifts. Our results are: (1) we characterize the fraction and properties of bars in a sample ofmore » 32 bright (M{sub V} {approx}< -18, M{sub *} > 10{sup 9.5} M{sub Sun }) S0 galaxies, which dominate the population of massive disk galaxies in the Coma core. We find that the measurement of a bar fraction among S0 galaxies must be handled with special care due to the difficulty in separating unbarred S0s from ellipticals, and the potential dilution of the bar signature by light from a relatively large, bright bulge. The results depend sensitively on the method used: the bar fraction for bright S0s in the Coma core is 50% {+-} 11%, 65% {+-} 11%, and 60% {+-} 11% based on three methods of bar detection, namely, strict ellipse fit criteria, relaxed ellipse fit criteria, and visual classification. (2) We compare the S0 bar fraction across different environments (the Coma core, A901/902, and Virgo) adopting the critical step of using matched samples and matched methods in order to ensure robust comparisons. We find that the bar fraction among bright S0 galaxies does not show a statistically significant variation (within the error bars of {+-}11%) across environments which span two orders of magnitude in galaxy number density (n {approx} 300-10,000 galaxies Mpc{sup -3}) and include rich and poor clusters, such as the core of Coma, the A901/902 cluster, and Virgo. We speculate that the bar fraction among S0s is not significantly enhanced in rich clusters compared to low-density environments for two reasons. First, S0s in rich clusters are less prone to bar instabilities as they are dynamically heated by harassment and are gas poor as a result of ram pressure stripping and accelerated star formation. Second, high-speed encounters in rich clusters may be less effective than slow, strong encounters in inducing bars. (3) We also take advantage of the high resolution of the ACS ({approx}50 pc) to analyze a sample of 333 faint (M{sub V} > -18) dwarf galaxies in the Coma core. Using visual inspection of unsharp-masked images, we find only 13 galaxies with bar and/or spiral structure. An additional eight galaxies show evidence for an inclined disk. The paucity of disk structures in Coma dwarfs suggests that either disks are not common in these galaxies or that any disks present are too hot to develop instabilities.« less

Prognostic value of EEG in different etiological types of coma.

PubMed

Khaburzania, M; Beridze, M

2013-06-01

Study aimed at evaluation of prognostic value of standard EEG in different etiology of coma and the influence of etiological factor on the EEG patterns and coma outcome. Totally 175 coma patients were investigated. Patients were evaluated by Glasgow Coma Scale (GCS), clinically and by 16 channel electroencephalography. Auditory evoked potentials studied by EEG -regime for evoked potentials in patients with vegetative state (VS). Patients divided in 8 groups according to coma etiology. All patients were studied for photoreaction, brainstem reflexes, localization of sound and pain, length of coma state and outcome. Brain injury visualized by conventional CT. Outcome defined as death, VS, recovery with disability and without disability. Disability was rated by Disability Rating Scale (DRS). Recovered patients assessed by Mini Mental State Examination (MMSE) scale. Statistics performed by SPSS-11.0. From 175 coma patients 55 patients died, 23 patients found in VS, 97 patients recovered with and without disability. In all etiological groups of coma the background EEG patterns were established. Correspondence analysis of all investigated factors revealed that sound localization had the significant association with EEG delta and theta rhythms and with recovery from coma state (Chi-sqr. =31.10493; p= 0.000001). Among 23 VS patients 9 patients had the signs of MCS and showed the long latency waves (p300) after binaural stimulation. The high amplitude theta frequencies in frontal and temporal lobes significantly correlated with prolongation of latency of cognitive evoked potentials (r=+0.47; p<0.01). Etiological factor had the significant effect on EEG patterns' association with coma outcome only in hemorrhagic and traumatic coma (chi-sqr.=12.95; p<0.005; chi-sqr.=7.92; p<0.03 respectively). Significant correlations established between the delta and theta EEG patterns and coma outcome. Low amplitude decreased power delta and theta frequencies correlated with SND in survived coma patients (r=+0.21; p<0.001; r=+0.27; p<0.001 respectively). Standard EEG is the useful tool for elucidation of coma patients with a high probability to recover as well as those patients, who are at high risk of SND in case of recovery from coma state.

H2S induced coma and cardiogenic shock in the rat: Effects of phenothiazinium chromophores

PubMed Central

SONOBE, TAKASHI; HAOUZI, PHILIPPE

2015-01-01

Context Hydrogen sulfide (H2S) intoxication produces an acute depression in cardiac contractility-induced circulatory failure, which has been shown to be one of the major contributors to the lethality of H2S intoxication or to the neurological sequelae in surviving animals. Methylene blue (MB), a phenothiazinium dye, can antagonize the effects of the inhibition of mitochondrial electron transport chain, a major effect of H2S toxicity. Objectives We investigated whether MB could affect the immediate outcome of H2S-induced coma in unanesthetized animals. Second, we sought to characterize the acute cardiovascular effects of MB and two of its demethylated metabolites—azure B and thionine—in anesthetized rats during lethal infusion of H2S. Materials and methods First, MB (4 mg/kg, intravenous [IV]) was administered in non-sedated rats during the phase of agonal breathing, following NaHS (20 mg/kg, IP)-induced coma. Second, in 4 groups of urethane-anesthetized rats, NaHS was infused at a rate lethal within 10 min (0.8 mg/min, IV). Whenever cardiac output (CO) reached 40% of its baseline volume, MB, azure B, thionine, or saline were injected, while sulfide infusion was maintained until cardiac arrest occurred. Results Seventy-five percent of the comatose rats that received saline (n = 8) died within 7 min, while all the 7 rats that were given MB survived (p = 0.007). In the anesthetized rats, arterial, left ventricular pressures and CO decreased during NaHS infusion, leading to a pulseless electrical activity within 530 s. MB produced a significant increase in CO and dP/dtmax for about 2 min. A similar effect was produced when MB was also injected in the pre-mortem phase of sulfide exposure, significantly increasing survival time. Azure B produced an even larger increase in blood pressure than MB, while thionine had no effect. Conclusion MB can counteract NaHS-induced acute cardiogenic shock; this effect is also produced by azure B, but not by thionine, suggesting that the presence of methyl groups is a prerequisite for producing this protective effect. PMID:25965774

EEG in connection with coma.

PubMed

Wilson, John A; Nordal, Helge J

2013-01-08

Coma is a dynamic condition that may have various causes. Important changes may take place rapidly, often with consequences for treatment. The purpose of this article is to provide a brief overview of EEG patterns in comas with various causes, and indicate how EEG contributes in an assessment of the prognosis for coma patients. The article is based on many years of clinical and research-based experience of EEG used for patients in coma. A self-built reference database was supplemented by searches for relevant articles in PubMed. EEG reveals immediate changes in coma, and can provide early information on cause and prognosis. It is the only diagnostic tool for detecting a non-convulsive epileptic status. Locked-in- syndrome may be overseen without EEG. Repeated EEG scans increase diagnostic certainty and make it possible to monitor the development of coma. EEG reflects brain function continuously and therefore holds a key place in the assessment and treatment of coma.

Incidence, predictors and outcomes of postoperative coma: an observational study of 858,606 patients.

PubMed

Newman, Jessica; Blake, Kathryn; Fennema, Jordan; Harris, David; Shanks, Amy; Avidan, Michael S; Kelz, Max B; Mashour, George A

2013-08-01

Coma is a state of profound unresponsiveness that can occur as a serious perioperative complication. The study of risk factors for, and sequelae of, postoperative coma has been limited due to the rarity of the event. To determine the incidence, risk factors and impact of postoperative coma in a large patient population. Observational study using a prospectively gathered national dataset. Data from 858 606 patients were analysed. The incidence of postoperative coma of more than 24-h duration was identified. Logistic regression was used to identify independent predictors and develop a risk model of postoperative coma in derivation and validation cohorts; 30-day mortality was also analysed. The incidence of postoperative coma was 0.06%. Multivariate analysis revealed the following independent predictors: liver disease, systemic sepsis, age at least 63 years, renal disease, emergency operation, cardiac disease, hypertension, prior neurological disease, diabetes mellitus and BMI 25 to 29.99 kg m (protective). These predictors were incorporated into a risk index classification; odds ratios for postoperative coma increased from 2.5 with one risk factor to 18.4 with three. Coma was associated with 74.2% all-cause mortality; coma associated with cardiac arrest had a 1.9-fold higher mortality. This is the largest study of postoperative coma ever reported and will be useful for determining risk of coma of more than 24 h duration when evaluating an unresponsive patient following surgery. Data on prognosis will aid medical and ethical decision-making for the comatose surgical patient.

The coma cluster after lunch: Has a galaxcy group passed through the cluster core?

NASA Technical Reports Server (NTRS)

Burns, Jack O.; Roettiger, Kurt; Ledlow, Michael; Klypin, Anatoly

1994-01-01

We propose that the Coma cluster has recently undergone a collision with the NGC 4839 galaxy group. The ROSAT X-ray morphology, the Coma radio halo, the presence of poststarburst galaxies in the bridge between Coma and NGC 4839, the usually high velocity dispersion for the NGC 4839 group, and the position of a large-scale galaxy filament to the NE of Coma are all used to argue that the NGC 4839 group passed through the core of Coma approximately 2 Gyr ago. We present a new Hydro/N-body simulation of the merger between a galaxy group and a rich cluster that reproduces many of the observed X-ray and optical properties of Coma/NGC 4839.

The portrayal of coma in contemporary motion pictures.

PubMed

Wijdicks, Eelco F M; Wijdicks, Coen A

2006-05-09

Coma has been a theme of screenplays in motion pictures, but there is no information about its accuracy. The authors reviewed 30 movies from 1970 to 2004 with actors depicting prolonged coma. Accurate depiction of comatose patients was defined by appearance, the complexity of care, accurate cause of coma and probability of awakening, and appropriate compassionate discussion between the physician and family members. Twenty-two key scenes from 17 movies were rated for accuracy by a panel of neurointensivists and neuroscience nurses and then were shown to 72 nonmedical viewers. Accuracy of the scenes was assessed using a Likert Scale. Coma was most often caused by motor vehicle accidents or violence (63%). The time in a comatose state varied from days to 10 years. Awakening occurred in 18 of 30 motion pictures (60%). Awakening was sudden with cognition intact, even after prolonged time in a coma. Actors personified "Sleeping Beauty" (eyes closed, beautifully groomed). Physicians appeared as caricatures. Only two movies had a reasonable accurate representation (Dream Life of Angels and Reversal of Fortune). The majority of the surveyed viewers identified inaccuracy of representation of coma, awakenings, and conversations on the experience of being in a coma, except in 8 of the 22 scenes (36%). Twenty-eight of the 72 viewers (39%) could potentially allow these scenes to influence decisions in real life. Misrepresentation of coma and awakening was common in motion pictures and impacted on the public perception of coma. Neurologic advice regarding prolonged coma is needed.

Determination of injection molding process windows for optical lenses using response surface methodology.

PubMed

Tsai, Kuo-Ming; Wang, He-Yi

2014-08-20

This study focuses on injection molding process window determination for obtaining optimal imaging optical properties, astigmatism, coma, and spherical aberration using plastic lenses. The Taguchi experimental method was first used to identify the optimized combination of parameters and significant factors affecting the imaging optical properties of the lens. Full factorial experiments were then implemented based on the significant factors to build the response surface models. The injection molding process windows for lenses with optimized optical properties were determined based on the surface models, and confirmation experiments were performed to verify their validity. The results indicated that the significant factors affecting the optical properties of lenses are mold temperature, melt temperature, and cooling time. According to experimental data for the significant factors, the oblique ovals for different optical properties on the injection molding process windows based on melt temperature and cooling time can be obtained using the curve fitting approach. The confirmation experiments revealed that the average errors for astigmatism, coma, and spherical aberration are 3.44%, 5.62%, and 5.69%, respectively. The results indicated that the process windows proposed are highly reliable.

The inter-rater reliability and prognostic value of coma scales in Nepali children with acute encephalitis syndrome.

PubMed

Ray, Stephen; Rayamajhi, Ajit; Bonnett, Laura J; Solomon, Tom; Kneen, Rachel; Griffiths, Michael J

2018-02-01

Background Acute encephalitis syndrome (AES) is a common cause of coma in Nepali children. The Glasgow coma scale (GCS) is used to assess the level of coma in these patients and predict outcome. Alternative coma scales may have better inter-rater reliability and prognostic value in encephalitis in Nepali children, but this has not been studied. The Adelaide coma scale (ACS), Blantyre coma scale (BCS) and the Alert, Verbal, Pain, Unresponsive scale (AVPU) are alternatives to the GCS which can be used. Methods Children aged 1-14 years who presented to Kanti Children's Hospital, Kathmandu with AES between September 2010 and November 2011 were recruited. All four coma scales (GCS, ACS, BCS and AVPU) were applied on admission, 48 h later and on discharge. Inter-rater reliability (unweighted kappa) was measured for each. Correlation and agreement between total coma score and outcome (Liverpool outcome score) was measured by Spearman's rank and Bland-Altman plot. The prognostic value of coma scales alone and in combination with physiological variables was investigated in a subgroup (n = 22). A multivariable logistic regression model was fitted by backward stepwise. Results Fifty children were recruited. Inter-rater reliability using the variables scales was fair to moderate. However, the scales poorly predicted clinical outcome. Combining the scales with physiological parameters such as systolic blood pressure improved outcome prediction. Conclusion This is the first study to compare four coma scales in Nepali children with AES. The scales exhibited fair to moderate inter-rater reliability. However, the study is inadequately powered to answer the question on the relationship between coma scales and outcome. Further larger studies are required.

ULTRA-COMPACT DWARFS IN THE COMA CLUSTER

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

Chiboucas, Kristin; Tully, R. Brent; Marzke, R. O.

2011-08-20

We have undertaken a spectroscopic search for ultra-compact dwarf galaxies (UCDs) in the dense core of the dynamically evolved, massive Coma cluster as part of the Hubble Space Telescope/Advanced Camera for Surveys (HST/ACS) Coma Cluster Treasury Survey. UCD candidates were initially chosen based on color, magnitude, degree of resolution within the ACS images, and the known properties of Fornax and Virgo UCDs. Follow-up spectroscopy with Keck/Low-Resolution Imaging Spectrometer confirmed 27 candidates as members of the Coma cluster, a success rate >60% for targeted objects brighter than M{sub R} = -12. Another 14 candidates may also prove to be Coma members,more » but low signal-to-noise spectra prevent definitive conclusions. An investigation of the properties and distribution of the Coma UCDs finds these objects to be very similar to UCDs discovered in other environments. The Coma UCDs tend to be clustered around giant galaxies in the cluster core and have colors/metallicity that correlate with the host galaxy. With properties and a distribution similar to that of the Coma cluster globular cluster population, we find strong support for a star cluster origin for the majority of the Coma UCDs. However, a few UCDs appear to have stellar population or structural properties which differentiate them from the old star cluster populations found in the Coma cluster, perhaps indicating that UCDs may form through multiple formation channels.« less

The Influence of the Aspheric Profiles for Transition Zone on Optical Performance of Human Eye After Conventional Ablation

NASA Astrophysics Data System (ADS)

Fang, L.

2014-12-01

The analysis in the impact of transition zone on the optical performance of human eye after laser refractive surgery is important for improving visual correction technology. By designing the ablation profiles of aspheric transition zone and creating the ablation profile for conventional refractive surgery in optical zone, the influence of aspheric transition zone on residual aberrations was studied. The results indicated that the ablation profiles of transition zone had a significant influence on the residual wavefront aberrations. For a hyperopia correction, the profile #9 shows a larger induced coma and spherical aberration when the translation of the centre of pupil remains constant. However, for a myopia astigmatism correction, the induced coma and spherical aberration in profile #1 shows relatively larger RMS values than those in other profiles. Therefore, the residual higher order aberrations may be decreased by optimizing ablation profiles of transition zone, but they cannot be eliminated. In order to achieve the best visual performance, the design of ablation pattern of transition zone played a crucial role.

Successful management of drug-induced hypercapnic acidosis with naloxone and noninvasive positive pressure ventilation.

PubMed

Agrafiotis, Michalis; Tryfon, Stavros; Siopi, Demetra; Chassapidou, Georgia; Galanou, Artemis; Tsara, Venetia

2015-02-01

A 74-year-old man was referred to our hospital due to deteriorating level of consciousness and desaturation. His Glasgow Coma Scale was 6, and his pupils were constricted but responded to light. Chest radiograph was negative for significant findings. Arterial blood gas evaluation on supplemental oxygen revealed severe acute on chronic respiratory acidosis: pH 7.15; PCO2, 133 mm Hg; PO2,64 mm Hg; and HCO3, 31 mmol/L. He regained full consciousness (Glasgow Coma Scale, 15) after receiving a 0.4 mg dose of naloxone, but because of persistent severe respiratory acidosis (pH 7.21; PCO2, 105 mm Hg), he was immediately commenced on noninvasive positive pressure ventilation (NIV) displaying a remarkable improvement in arterial blood gas values within the next few hours. However, in the days that followed, he remained dependent on NIV, and he was finally discharged on a home mechanical ventilation prescription. In cases of drug-induced respiratory depression, NIV should be regarded as an acceptable treatment, as it can provide ventilatory support without the increased risks associated with invasive mechanical ventilation.

Immediate coma and poor outcome in subarachnoid haemorrhage are independently associated with an aneurysmal origin.

PubMed

Tsermoulas, Georgios; Flett, Lisa; Gregson, Barbara; Mitchell, Patrick

2013-08-01

Subarachnoid haemorrhage (SAH) may present with coma and this is known to be associated with aneurysmal origin and blood load. Aneurysmal origin is associated with increased blood load and existing data do not allow us to determine if the association between coma and aneurysmal SAH is wholly due to blood load or if aneurysmal origin has an additional independent effect. The objective of our study is to find if an aneurysmal origin is a predictor of acute onset of coma independent of blood load. A series of consecutive patients with spontaneous SAH were divided into two groups: aneurysmal (aSAH) and non-aneurysmal--angiographically negative SAH (naSAH). Blood load was quantified so that the effect of aneurysmal origin could be resolved from the effect of the amount of blood spilled. Non-parametric regression was used to relate blood load to coma and poor outcome rates for aneurysmal bleeds. We analysed a total of 421 patients presenting during the period 2009-2011. Ninety aneurysmal cases presented with coma, seventy immediately in the early phase and seven shortly after rebleeding. None of the naSAH cases presented with immediate coma and 1 developed delayed coma. Delayed coma was associated with acute hydrocephalus in both groups. Aneurysmal origin was found to be an independent determinant of immediate coma (p=0.02) and poor outcome (p<0.001). Immediate coma and poor outcome in SAH are associated with an aneurysmal origin and do not characterize naSAH. Copyright © 2013 Elsevier B.V. All rights reserved.

EEG and Coma.

PubMed

Ardeshna, Nikesh I

2016-03-01

Coma is defined as a state of extreme unresponsiveness, in which a person exhibits no voluntary movement or behavior even to painful stimuli. The utilization of EEG for patients in coma has increased dramatically over the last few years. In fact, many institutions have set protocols for continuous EEG (cEEG) monitoring for patients in coma due to potential causes such as subarachnoid hemorrhage or cardiac arrest. Consequently, EEG plays an important role in diagnosis, managenent, and in some cases even prognosis of coma patients.

Effect of Iris registration on visual outcome in wavefront-guided LASEK for myopic astigmatism.

PubMed

Lee, Jong Joo; Kim, Mee Kum; Wee, Won Ryang

2018-04-01

This study aimed to investigate the effect of iris registration (IR) on visual outcomes in wavefront-guided LASEK for myopic astigmatism. The retrospective chart review was performed for wavefront-guided LASEK using VISX Star S4 in patients with myopic astigmatism (cylinder ≥ 1.00 diopter[D]). Eyes were divided into IR group (LASEK with IR at the time of surgery) and Non-IR group (LASEK without IR system + failed-IR engagement during LASEK). Visual acuity (VA), astigmatism, higher-order aberration (HOA), and contrast sensitivity were assessed preoperatively and 3 months postoperatively. The IR and Non-IR groups were subcategorized depending on the spherical equivalent (lower myopia ≤-5.00 D vs. higher myopia >-5.00 D) for the comparison of HOA changes. Postoperative uncorrected VAs showed no differences between IR (n = 30) and Non-IR (n = 46). In astigmatic vector analyses, no differences were noted in the mean magnitude of error and the mean angle of error between two groups. There were no differences in postoperative total HOA, spherical aberration (SA), coma, and trefoil between the groups, either. The total HOA and SA increased in both groups, while coma increased only in Non-IR. In higher myopia, ΔRMS of coma was smaller in IR. Preoperative and postoperative total HOA were linearly correlated in Non-IR, but not for IR. Contrast sensitivity of 12 cycles per degree improved in both groups. IR had similar outcomes to conventional trackers in wavefront-guided LASEK, with less tendency of inducing coma, especially in higher myopia.

Changes in accommodation and ocular aberration with simultaneous vision multifocal contact lenses.

PubMed

Ruiz-Alcocer, Javier; Madrid-Costa, David; Radhakrishnan, Hema; Ferrer-Blasco, Teresa; Montés-Micó, Robert

2012-09-01

The aim of this study was to evaluate ocular aberration changes through different simultaneous vision multifocal contact lenses (CLs). Eighteen young-adult subjects with a mean age of 29.8±2.11 years took part. Changes in accommodative response, spherical aberration (C(4)(0)), horizontal coma (C(3)(1)), vertical coma (C(3)(-1)), and root mean square (RMS) of higher-order aberrations (HOAs, third to sixth orders) were evaluated. Measurements were obtained with a distance-single vision CL and 2 aspheric multifocal CLs of simultaneous focus center-near design (PureVision Low Add and PureVision High Add) for 2 accommodative stimuli (-2.50 and -4.00 D). All measurements were performed monocularly with a Hartmann-Shack aberrometer (IRX-3; Imagine Eyes, Orsay, France). No statistically significant differences were found in accommodative responses to -2.50- and -4.00-D stimuli between the single vision CL and the 2 multifocal CLs. Spherical aberration was found to decrease and become more negative with accommodation for both stimuli with all three CLs. Horizontal coma decreased significantly with accommodation (-2.5- and -4.00-D stimuli) for the distance-single vision CLs (P=0.002 and P=0.003). No differences were found in vertical coma Zernike coefficients. The RMS of HOAs was found to decrease only with the single vision CLs for both stimuli (P<0.01). Data obtained in this study suggest that in young subjects, the multifocal CLs studied do not induce large changes in accommodative response compared with the distance-single vision CLs. Spherical aberration reduced significantly with accommodation.

A patient with acute liver failure and extreme hypoglycaemia with lactic acidosis who was not in a coma: causes and consequences of lactate-protected hypoglycaemia.

PubMed

Oldenbeuving, G; McDonald, J R; Goodwin, M L; Sayilir, R; Reijngoud, D J; Gladden, L B; Nijsten, M W N

2014-07-01

Lactate can substitute for glucose as a metabolic substrate. We report a patient with acute liver failure who was awake despite a glucose level of 0.7 mmol/l with very high lactate level of 25 mmol/l. The hypoglycaemia+hyperlactataemia combination may be considered paradoxical since glucose is the main precursor of lactate and lactate is reconverted into glucose by the Cori cycle. Literature relevant to the underlying mechanism of combined deep hypoglycaemia and severe hyperlactataemia was assessed. We also assessed the literature for evidence of protection against deep hypoglycaemia by hyperlactataemia. Four syndromes demonstrating hypoglycaemia+hyperlactataemia were found: 1) paracetamol-induced acute liver failure, 2) severe malaria, 3) lymphoma and 4) glucose-6-phosphatase deficiency. An impaired Cori cycle is a key component in all of these metabolic states. Apparently the liver, after exhausting its glycogen stores, loses the gluconeogenic pathway to generate glucose and thereby its ability to remove lactate as well. Several patients with lactic acidosis and glucose levels below 1.7 mmol/l who were not in a coma have been reported. These observations and other data coherently indicate that lactate-protected hypoglycaemia is, at least transiently, a viable state under experimental and clinical conditions. Severe hypoglycaemia+hyperlactataemia reflects failure of the gluconeogenic pathway of lactate metabolism. The existence of lactate-protected hypoglycaemia implies that patients who present with this metabolic state should not automatically be considered to have sustained irreversible brain damage. Moreover, therapies that aim to achieve hypoglycaemia might be feasible with concomitant hyperlactataemia.

Pathophysiology of cerebral oedema in acute liver failure

PubMed Central

Scott, Teresa R; Kronsten, Victoria T; Hughes, Robin D; Shawcross, Debbie L

2013-01-01

Cerebral oedema is a devastating consequence of acute liver failure (ALF) and may be associated with the development of intracranial hypertension and death. In ALF, some patients may develop cerebral oedema and increased intracranial pressure but progression to life-threatening intracranial hypertension is less frequent than previously described, complicating less than one third of cases who have proceeded to coma since the advent of improved clinical care. The rapid onset of encephalopathy may be dramatic with the development of asterixis, delirium, seizures and coma. Cytotoxic and vasogenic oedema mechanisms have been implicated with a preponderance of experimental data favouring a cytotoxic mechanism. Astrocyte swelling is the most consistent neuropathological finding in humans with ALF and ammonia plays a definitive role in the development of cytotoxic brain oedema. The mechanism(s) by which ammonia induces astrocyte swelling remains unclear but glutamine accumulation within astrocytes has led to the osmolyte hypothesis. Current evidence also supports an alternate ‘Trojan horse’ hypothesis, with glutamine as a carrier of ammonia into mitochondria, where its accumulation results in oxidative stress, energy failure and ultimately astrocyte swelling. Although a complete breakdown of the blood-brain barrier is not evident in human ALF, increased permeation to water and other small molecules such as ammonia has been demonstrated resulting from subtle alterations in the protein composition of paracellular tight junctions. At present, there is no fully efficacious therapy for cerebral oedema other than liver transplantation and this reflects our incomplete knowledge of the precise mechanisms underlying this process which remain largely unknown. PMID:24409052

Myxedema coma leading to respiratory depression in a dog.

PubMed

Atkinson, Kathryn; Aubert, Isabelle

2004-04-01

A 10-year-old, intact male, cocker spaniel was presented with hypothermia, without shivering, and progressive stupor leading to coma. Myxedema coma, potentially precipitated by diuretic therapy, was tentatively diagnosed and treatment initiated, but progressive respiratory depression led to the decision to euthanize. Postmortem findings supported the diagnosis of myxedema coma.

Myxedema coma leading to respiratory depression in a dog

PubMed Central

2004-01-01

Abstract A 10-year-old, intact male, cocker spaniel was presented with hypothermia, without shivering, and progressive stupor leading to coma. Myxedema coma, potentially precipitated by diuretic therapy, was tentatively diagnosed and treatment initiated, but progressive respiratory depression led to the decision to euthanize. Postmortem findings supported the diagnosis of myxedema coma. PMID:15144105

Severe angioedema in myxedema coma: a difficult airway in a rare endocrine emergency.

PubMed

Lee, Christopher H; Wira, Charles R

2009-10-01

Myxedema coma is the most lethal manifestation of hypothyroidism. It is a true medical emergency and can result in profound hemodynamic instability and airway compromise. Myxedema coma currently remains a diagnostic challenge due to the rarity of cases seen today, and failure to promptly initiate therapy with replacement thyroid hormone can be fatal. As thyroid hormone therapy can take days or weeks to reverse the manifestations of myxedema coma, interim supportive therapy is critical while awaiting clinical improvement. Some patients will require endotracheal intubation in the emergency department (ED), and physicians should be aware that unanticipated posterior pharyngeal edema in myxedema coma could severely complicate airway management. Although mechanical ventilation is a well-described adjunctive therapy for myxedema coma, reports of the potential difficulty in securing a definitive airway in these patients are rare. We describe a case of an unidentified woman who presented to the ED with myxedema coma requiring urgent endotracheal intubation and was found to have extensive posterior pharyngeal angioedema inconsistent with her relatively benign external examination. This case highlights the typical features of myxedema coma and discusses our necessity for a rescue device in definitive endotracheal tube placement. Emergency physicians should anticipate a potentially difficult airway in all myxedema coma patients regardless of the degree of external facial edema present.

Characterization of the warm-hot intergalactic medium near the Coma cluster through high-resolution spectroscopy of X Comae

NASA Astrophysics Data System (ADS)

Bonamente, M.; Ahoranta, J.; Tilton, E.; Tempel, E.; Morandi, A.

2017-08-01

We have analysed all available archival XMM-Newton observations of X Comae, a bright X-ray quasar behind the Coma cluster, to study the properties of the warm-hot intergalactic medium (WHIM) in the vicinity of the nearest massive galaxy cluster. The reflection grating spectrometer observations confirm the possible presence of a Ne ix K α absorption line at the redshift of Coma, although with a limited statistical significance. This analysis is therefore in line with the earlier analysis by Takei et al. based on a sub-set of these data. Its large column density and optical depth, however, point to implausible conditions for the absorbing medium, thereby casting serious doubts to its reality. Chandra has never observed X Comae and therefore cannot provide additional information on this source. We combine upper limits to the presence of other X-ray absorption lines (notably from O vii and O viii) at the redshift of Coma with positive measurements of the soft excess emission from Coma measured by ROSAT (Bonamente et al.). The combination of emission from warm-hot gas at kT ˜ 1/4 keV and upper limits from absorption lines provide useful constraints on the density and the sightline length of the putative WHIM towards Coma. We conclude that the putative warm-hot medium towards Coma is consistent with expected properties, with a baryon overdensity δb ≥ 10 and a sightline extent of order of tens of Mpc.

Childhood acute non-traumatic coma: aetiology and challenges in management in resource-poor countries of Africa and Asia.

PubMed

Gwer, Samson; Chacha, Clifford; Newton, Charles R; Idro, Richard

2013-08-01

This review examines the best available evidence on the aetiology of childhood acute non-traumatic coma in resource-poor countries (RPCs), discusses the challenges associated with management, and explores strategies to address them. Publications in English and French which reported on studies on the aetiology of childhood non-traumatic coma in RPCs are reviewed. Primarily, the MEDLINE database was searched using the keywords coma, unconsciousness, causality, aetiology, child, malaria cerebral, meningitis, encephalitis, Africa, Asia, and developing countries. 14 records were identified for inclusion in the review. Cerebral malaria (CM) was the commonest cause of childhood coma in most of the studies conducted in Africa. Acute bacterial meningitis (ABM) was the second most common known cause of coma in seven of the African studies. Of the studies in Asia, encephalitides were the commonest cause of coma in two studies in India, and ABM was the commonest cause of coma in Pakistan. Streptococcus pneumoniae was the most commonly isolated organism in ABM. Japanese encephalitis, dengue fever and enteroviruses were the viral agents most commonly isolated. Accurate diagnosis of the aetiology of childhood coma in RPCs is complicated by overlap in clinical presentation, limited diagnostic resources, disease endemicity and co-morbidity. For improved outcomes, studies are needed to further elucidate the aetiology of childhood coma in RPCs, explore simple and practical diagnostic tools, and investigate the most appropriate specific and supportive interventions to manage and prevent infectious encephalopathies.

'Is she alive? Is she dead?' Representations of chronic disorders of consciousness in Douglas Coupland's Girlfriend in a Coma.

PubMed

Colbeck, Matthew

2016-09-01

Depictions of coma have come to dominate literary and filmic texts over the last half century, a phenomenon coinciding with advancements in medical technology that have led to remarkable increases in the survival rates of patients with chronic disorders of consciousness. Authors of coma fiction are preoccupied with the imagined subjective experience of coma, often creating complex, dream-like worlds from which the protagonist must escape if survival is to be achieved. However, such representations appear to conflict with medical case studies and patient narratives that reveal that most often survivors of coma have no recollection of the coma itself. Providing a close reading of Douglas Coupland's Girlfriend in a Coma (1998) against the context of medical literature and diagnoses, this article examines how the coma patient is represented, often depicting the realities of a prolonged vegetative state, in contrast with other popular representations of coma. It explores how the author develops a work of 'fantastic' fiction (a genre defined by the structuralist critic Tzvetan Todorov), using the condition of coma as a metaphor for a postmodern existential crisis, while simultaneously employing mimetic techniques that raise important medical, ethical and philosophical questions surrounding the ontological status of the comatose patient. It is argued that coma fiction, even in its misrepresentation of the condition, can help us to engage with and interrogate how we think about chronic disorders of consciousness, thereby providing a valuable insight into our attitudes towards illness and mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Brain function recovery after prolonged posttraumatic coma].

PubMed

Klimash, A V; Zhanaidarov, Z S

2016-01-01

To explore the characteristics of brain function recovery in patients after prolonged posttraumatic coma and with long-unconscious states. Eighty-seven patients after prolonged posttraumatic coma were followed-up for two years. An analysis of a clinical/neurological picture after a prolonged episode of coma was based on the dynamics of vital functions, neurological status and patient's reactions to external stimuli. Based on the dynamics of the clinical/neurological picture that shows the recovery of functions of the certain brain areas, three stages of brain function recovery after a prolonged episode of coma were singled out: brain stem areas, diencephalic areas and telencephalic areas. These functional/anatomic areas of brain function recovery after prolonged coma were compared to the present classifications.

Changing pattern of drugs used for self-poisoning.

PubMed Central

Proudfoot, A T; Park, J

1978-01-01

In 1967-76 the annual number of admissions to a poisoning treatment centre rose from 964 to 2134. The proportion of admissions caused by taking barbiturate hypnotics and methaqualone fell considerably while that caused by taking benzodiazepines and tricyclic antidepressants increased. As a result the proportion of patients admitted unconscious fell from 23% to 15%. The declining contributions of barbiturates and methaqualone and increased importance of tricyclic antidepressants were significant in all grades of coma. The change in drugs taken, however, has not yet reduced the percentage of unconscious patients needing endotracheal intubation or assisted ventilation, and hypothermia remains as common. Only hypotension has become less frequent as antidepressants replace barbiturates as the main cause of drug-induced coma. The use of salicylates for self-poisoning is declining slowly, and paracetamol poisoning is now as common. PMID:620215

Accuracy of self-reported length of coma and posttraumatic amnesia in persons with medically verified traumatic brain injury.

PubMed

Sherer, Mark; Sander, Angelle M; Maestas, Kacey Little; Pastorek, Nicholas J; Nick, Todd G; Li, Jingyun

2015-04-01

To determine the accuracy of self-reported length of coma and posttraumatic amnesia (PTA) in persons with medically verified traumatic brain injury (TBI) and to investigate factors that affect self-report of length of coma and PTA duration. Prospective cohort study. Specialized rehabilitation center with inpatient and outpatient programs. Persons (N=242) with medically verified TBI who were identified from a registry of persons who had previously participated in TBI-related research. Not applicable. Self-reported length of coma and self-reported PTA duration. Review of medical records revealed that the mean medically documented length of coma and PTA duration was 6.9±12 and 19.2±22 days, respectively, and the mean self-reported length of coma and PTA duration was 16.7±22 and 106±194 days, respectively. The average discrepancy between self-report and medical record for length of coma and PTA duration was 8.2±21 and 64±176 days, respectively. Multivariable regression models revealed that time since injury, performance on cognitive tests, and medical record values were associated with self-reported values for both length of coma and PTA duration. In this investigation, persons with medically verified TBI showed poor accuracy in their self-report of length of coma and PTA duration. Discrepancies were large enough to affect injury severity classification. Caution should be exercised when considering self-report of length of coma and PTA duration. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS).

PubMed

Dixit, Siddharth; Dutta, Manoj Kumar; Namdeo, Mayank

2015-05-01

Myxedema coma or hypothyroid crisis is an endocrine emergency and needs ICU management. Neuroleptic malignant syndrome (NMS) is another medical emergency which needs high degree of clinical suspicion else mortality can be high. There is a paradox in co existence of myxedema coma and NMS. While one is hypometabolic state another is hypermetabolic state and both can be precipitated by antipsychotics use. Hypothermia and flaccidity commonly expected in myxedema coma may mask fever and rigidity of classical NMS contributing to diagnostic problem and treatment delay. Scientific literature on coexistance of myxedema coma and NMS is sparse. We hereby report first case with coexisting myxedema coma and NMS in a patient of schizophrenia treated with antipsychotic, where classical symptoms of NMS were masked by myxedema coma. Prompt diagnosis and effective management by a team resulted in favourable outcome in our patient. This case is reported to alert intensive care physicians to atypical manifestations of NMS in presence of hypothyroidism.

A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS)

PubMed Central

Dutta, Manoj Kumar; Namdeo, Mayank

2015-01-01

Myxedema coma or hypothyroid crisis is an endocrine emergency and needs ICU management. Neuroleptic malignant syndrome (NMS) is another medical emergency which needs high degree of clinical suspicion else mortality can be high. There is a paradox in co existence of myxedema coma and NMS. While one is hypometabolic state another is hypermetabolic state and both can be precipitated by antipsychotics use. Hypothermia and flaccidity commonly expected in myxedema coma may mask fever and rigidity of classical NMS contributing to diagnostic problem and treatment delay. Scientific literature on coexistance of myxedema coma and NMS is sparse. We hereby report first case with coexisting myxedema coma and NMS in a patient of schizophrenia treated with antipsychotic, where classical symptoms of NMS were masked by myxedema coma. Prompt diagnosis and effective management by a team resulted in favourable outcome in our patient. This case is reported to alert intensive care physicians to atypical manifestations of NMS in presence of hypothyroidism. PMID:26155541

Mild decentration measured by a Scheimpflug camera and its impact on visual quality following SMILE in the early learning curve.

PubMed

Li, Meiyan; Zhao, Jing; Miao, Huamao; Shen, Yang; Sun, Ling; Tian, Mi; Wadium, Elizabeth; Zhou, Xingtao

2014-05-20

To measure decentration following femtosecond laser small incision lenticule extraction (SMILE) for the correction of myopia and myopic astigmatism in the early learning curve, and to investigate its impact on visual quality. A total of 55 consecutive patients (100 eyes) who underwent the SMILE procedure were included. Decentration was measured using a Scheimpflug camera 6 months after surgery. Uncorrected and corrected distance visual acuity (UDVA, CDVA), manifest refraction, and wavefront errors were also measured. Associations between decentration and the preoperative spherical equivalent were analyzed, as well as the associations between decentration and wavefront aberrations. Regarding efficacy and safety, 40 eyes (40%) had an unchanged CDVA; 32 eyes (32%) gained one line; and 11 eyes (11%) gained two lines. Fifteen eyes (15%) lost one line of CDVA, and two eyes (2%) lost two lines. Ninety-nine of the treated eyes (99%) had a postoperative UDVA better than 1.0, and 100 eyes (100%) had a UDVA better than 0.8. The mean decentered displacement was 0.17 ± 0.09 mm. The decentered displacement of all treated eyes (100%) was within 0.50 mm; 70 eyes (70%) were within 0.20 mm; and 90 eyes (90%) were within 0.30 mm. The vertical coma showed the greatest increase in magnitude. The magnitude of horizontal decentration was found to be associated with an induced horizontal coma. This study suggests that, although mild decentration occurred in the early learning curve, good visual outcomes were achieved after the SMILE surgery. Special efforts to minimize induced vertical coma are necessary. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Myxedema coma associated with combination aripiprazole and sertraline therapy.

PubMed

Church, Chelsea O; Callen, Erin C

2009-12-01

To describe a case of myxedema coma (MC) associated with combination aripiprazole and sertraline therapy. A 41-year-old male presented to the emergency department with confusion, right-sided numbness and tingling, slurred speech, dizziness, and facial edema. His blood pressure was 160/113 mm Hg, with a pulse of 56 beats/min and temperature of 35.4 degrees C. Initial abnormal laboratory values included creatine kinase (CK) 439 U/L; serum creatinine 1.6 mg/dL; aspartate aminotransferase 85 U/L; and alanine aminotransferase 35 U/L. Repeat cardiac markers revealed an elevated CK level of 3573 U/L with a CK-MB of 24 ng/mL. Thyroid function tests showed thyroid-stimulating hormone 126.4 microIU/mL and free thyroxine 0.29 ng/dL. Home medications of unknown duration were sertraline 200 mg and aripiprazole 20 mg daily. He was admitted to the intensive care unit and initially treated with intravenous levothyroxine and dexamethasone. By hospital day 4, the patient was clinically stable and discharged to home. Myxedema coma, the most significant form of hypothyroidism (HT), is a rare but potentially fatal condition. The known precipitating causes of MC were ruled out in this patient, which left his home medications as the likely cause. Cases of HT caused by certain atypical antipsychotics and antidepressants are found in the literature, but none was reported with aripiprazole therapy. There are also no reported cases of sertraline or aripiprazole inducing MC. Use of the Naranjo probability scale indicates that the combination of aripiprazole and sertraline was a probable inducer of MC in this patient. Due to the widespread use of psychotropic medications, clinicians should be reminded of the rare, yet life-threatening, occurrence of MC when treating patients, especially with combination therapies such as sertraline and aripiprazole.

The combination of exercise training and alpha-lipoic acid treatment has therapeutic effects on the pathogenic phenotypes of Alzheimer's disease in NSE/APPsw-transgenic mice.

PubMed

Cho, Joon Y; Um, Hyun S; Kang, Eun B; Cho, In H; Kim, Chul H; Cho, Jung S; Hwang, Dae Y

2010-03-01

Exercise training was suggested as a practical therapeutic strategy for human subjects suffering from Alzheimer's disease (AD) in our previous study. Therefore, the purpose of this study was to investigate the effects of combining exercise training with the administration of antioxidants on the pathological phenotype of AD. To accomplish this, non-transgenic mice (Non-Tg) and NSE/APPsw Tg mice were treated with alpha-lipoic acid and treadmill exercised for 16 weeks, after which their brains were evaluated to determine whether any changes in the pathological phenotype-related factors occurred. The results indicated that (i) the combination-applied (COMA) Tg group with exercise training (ET) and alpha-lipoic acid administration (LA) showed ameliorated spatial learning and memory compared to the sedentary (SED)-Tg and single-treatment groups; (ii) there were no differences in the level of Abeta-42 peptides across groups; (iii) the level of glucose transporter-1 and brain-derived neurotrophic factor proteins were highly increased in the COMA group, (iv) ET and LA did not induce a synergistic effect on the expression of heat shock protein-70 and apoptotic proteins including Bax and caspase-3; (v) the levels of SOD-1 and CAT suppressing oxidative stress were extensively higher in the COMA than in the single-treated groups and (vi) there were no significant differences across groups regarding these serum characteristics, although these levels were lower than the SED-Tg group. Taken together, these results suggest that the combination with ET and LA may contribute to protect the neuron injury induced by Abeta peptides and may be considered an effective therapeutic strategy for human subjects suffering from AD.

Monte Carlo Particle Trajectory Models for Neutral Cometary Gases. II. The Spatial Morphology of the Lyman-Alpha Coma

NASA Astrophysics Data System (ADS)

Combi, Michael R.; Smyth, William H.

1988-04-01

The Monte Carlo particle-trajectory model (MCPTM) developed in Paper 1 is applied to explain the observed morphology of the spatially extended Lyα comae of comets. The physical processes and assumptions used in the model as they relate to the photodissociation of H2O and OH and the solar radiation pressure acceleration are presented herein. For this first application, the rocket and Skylab images of the Lyα coma of comet Kohoutek were chosen for study. The self-consistent modeling analysis of these data consisted of two parts. The first part entailed using a steady state spherically symmetric inner coma MCPTM coupled with a simple gas-dynamic model to calculate the physical development of the coma, i.e., the dependence of coma temperature and outflow speed on radial distance to the center of the nucleus, as a function of the (time) heliocentric distance of the comet. The inner coma MCPTM was used to calculate correctly the photo-chemical heating of the coma due to the partial collisional thermalization of the hot hydrogen atoms produced in the photodissociation of water molecules. In the second part of the analysis the results from the first part were used in a fully time-dependent and three-dimensional extended coma MCPTM which includes the explicit calculation of partial thermalization of the H atoms by multiple collisions with coma molecules. The same physical model yielded very good matches between the modeled Lycα isophotes and those observed in both of the two very different images of comet Kohoutek. The production rate was varied in time as implied by the shape of the visual light curve. All other physical parameters were varied only according to their naturally expected heliocentric distance and velocity dependencies. The complete physical description of the inner coma provided by the coupled gas-dynamic/MCPTM calculation was needed to obtain a good fit to the data. The correct inner coma description is important since it provides not only the initial conditions for the photodissociated H atoms but also (and most importantly) the collisional targets for the H atoms produced in the innermost regions of the coma. Simplistic descriptions for the coma (single speed and perfectly radial molecular motion) do not yield realistic isophote contours. The implications of the model results as they apply to other comets, species, and a variety of conditions are also discussed.

Genetic and Anatomical Basis of the Barrier Separating Wakefulness and Anesthetic-Induced Unresponsiveness

PubMed Central

Hung, Hsiao-Tung; Koh, Kyunghee; Sowcik, Mallory; Sehgal, Amita; Kelz, Max B.

2013-01-01

A robust, bistable switch regulates the fluctuations between wakefulness and natural sleep as well as those between wakefulness and anesthetic-induced unresponsiveness. We previously provided experimental evidence for the existence of a behavioral barrier to transitions between these states of arousal, which we call neural inertia. Here we show that neural inertia is controlled by processes that contribute to sleep homeostasis and requires four genes involved in electrical excitability: Sh, sss, na and unc79. Although loss of function mutations in these genes can increase or decrease sensitivity to anesthesia induction, surprisingly, they all collapse neural inertia. These effects are genetically selective: neural inertia is not perturbed by loss-of-function mutations in all genes required for the sleep/wake cycle. These effects are also anatomically selective: sss acts in different neurons to influence arousal-promoting and arousal-suppressing processes underlying neural inertia. Supporting the idea that anesthesia and sleep share some, but not all, genetic and anatomical arousal-regulating pathways, we demonstrate that increasing homeostatic sleep drive widens the neural inertial barrier. We propose that processes selectively contributing to sleep homeostasis and neural inertia may be impaired in pathophysiological conditions such as coma and persistent vegetative states. PMID:24039590

The "near-death experience" during comas: psychotraumatic suffering or the taming of reality?

PubMed

Auxéméry, Y

2013-09-01

An near death experience (NDE) is the experience of an atypical state of consciousness that is induced by the neuropsychological consequences of a passage near death. Far from being a psychologically traumatic event, these experiences never cause flashbacks and can even eliminate the fear of death. Listening to patients who have shared their near death sensations has encouraged the reevaluation of the medical standards associated with NDEs. Over several decades, the patient has been positioned at the center of management decisions, with his or her will taken into account. Certain patients can be revived following neurological events, but their resuscitation is performed with the possibility of serious neurological sequelae, which might prevent a return to normal life. The patient may also remain unconscious, either transiently or in a more long term coma or persistent vegetative state. Nonetheless, several works have demonstrated the presence of neuronal activity, however little, in patients suffering from prolonged comas. The medical team then does not act as if the patient were not there but, on the contrary, considers the patient to be the subject, although unable to speak directly, to whom one speaks and of whom one speaks between caregivers. Copyright © 2013 Elsevier Ltd. All rights reserved.

Split high-dose oral levothyroxine treatment as a successful therapy option in myxedema coma.

PubMed

Charoensri, Suranut; Sriphrapradang, Chutintorn; Nimitphong, Hataikarn

2017-10-01

High-dose intravenous thyroxine (T4) is the preferable treatment for myxedema coma. We describe the clinical course of a 69-year-old man who presented with myxedema coma and received oral levothyroxine (LT4) therapy (1 mg) in a split dose. This suggests split high-dose oral LT4 as a therapeutic option in myxedema coma.

Particle Sizes in the Coma of Comet 45P/Honda-Mrkos-Pajdušáková from Arecibo Radar Observations

NASA Astrophysics Data System (ADS)

Springmann, Alessondra; Howell, Ellen S.; Harmon, John K.; Lejoly, Cassandra; Rivera-Valentin, Edgard G.; Virkki, Anne; Zambrano-Marin, Luisa F.; Taylor, Patrick A.; Harris, Walter M.; Mueller, Beatrice E. A.; Samarasinha, Nalin H.; Rodriguez Sanchez-Vahamonde, Carolina

2017-10-01

Radar observations of cometary comae can provide information about not only the cross-section of the coma, but also constraints on the particle sizes comprising the coma. Harmon et al. (2011) described analysis of radar observations of comet 103P/Hartley 2 to constrain the sizes of its coma particles, as well as modeling to analyze the particle velocity distribution in the coma and orientation with respect to the sun. Arecibo Observatory planetary radar system observations of comet 45P/Honda-Mrkos-Pajdušáková were obtained 9-16 February 2017 by transmitting a continuous wave of polarized radio waves at the comet. By examining the polarization ratios of the returned signal (whether it has the same sense or opposite sense of the transmitted signal), we can look for non-zero same sense polarization signal. Detectable same sense signal indicates the presence of particles with sizes larger than the Rayleigh transition size criteria, a = λ/2π ≈ 2 cm (for the Arecibo wavelength of 12.6 cm).The observations show strong opposite sense signal return from the comet nucleus, as well as a larger ‘skirt’ of surrounding grains in the coma. Preliminary analysis of this data indicates at least a weak same sense polarized signal, implying a population of grains larger than 2 cm in the coma. The sizes of particles in the coma, compared with the area of the coma, can help us constrain the minimum mass for particles at the Rayleigh size limit in the 45P coma. Further, a detectable grain halo of large particles around 45P would imply significant lofting of grains from the comet nucleus.ReferencesHarmon, John K., et al. "Radar observations of comet 103P/Hartley 2." The Astrophysical Journal Letters 734.1 (2011): L2.

The effect of electron collisions on rotational populations of cometary water

NASA Technical Reports Server (NTRS)

Xie, Xingfa; Mumma, Michael J.

1992-01-01

The e-H2O collisional rate for exciting rotational transitions in cometary water is evaluated for conditions found in Comet Halley during the Giotto spacecraft encounter. In the case of the 0(00)-1(11) rotational transition, the e-H2O collisional rate exceeds that for excitation by neutral-neutral collisions at distances exceeding 3000 km from the cometary nucleus. The estimates are based on theoretical and experimental studies of e-H2O collisions, on ion and electron parameters acquired in situ by instruments on the Giotto and Vega spacecraft, and on results obtained from models of the cometary ionosphere. Thus, the rotational temperature of the water molecule in the intermediate coma may be controlled by collisions with electrons rather than with neutral molecules, and the rotational temperature retrieved from high-resolution IR spectra of water in Comet Halley may reflect electron temperatures rather than neutral gas temperatures in the intermediate coma.

Observational data needs useful for modeling the coma

NASA Technical Reports Server (NTRS)

Huebner, W. F.; Giguere, P. T.

1981-01-01

A computer model of comet comae is described; results from assumed composition of frozen gases are summarized and compared to coma observations. Restrictions on relative abundance of some frozen constituents are illustrated. Modeling, when tightly coupled to observational data, can be important for comprehensive analysis of observations, for predicting undetected molecular species and for improved understanding of coma and nucleus. To accomplish this, total gas production rates and relative elemental abundances of H:C:N:O:S are needed as a function of heliocentric distance of the comet. Also needed are relative column densitites and column density profiles with well defined diaphragm range and pointing position on the coma. Production rates are less desirable since they are model dependent. Total number (or upper limits) of molecules in the coma and analysis of unidentified spectral lines are needed also.

VizieR Online Data Catalog: HST/ACS Coma Cluster Survey. VI. (den Brok+, 2011)

NASA Astrophysics Data System (ADS)

den Brok, M.; Peletier, R. F.; Valentijn, E. A.; Balcells, M.; Carter, D.; Erwin, P.; Ferguson, H. C.; Goudfrooij, P.; Graham, A. W.; Hammer, D.; Lucey, J. R.; Trentham, N.; Guzman, R.; Hoyos, C.; Verdoes Kleijn, G.; Jogee, S.; Karick, A. M.; Marinova, I.; Mouhcine, M.; Weinzirl, T.

2018-01-01

We have used the data from the HST/ACS Coma Cluster Survey, a deep two-passband imaging survey of the Coma cluster. A full description of the observations and data reduction can be found in Paper I (Carter et al., 2008ApJS..176..424C). We have derived colour gradients for a sample of confirmed or very likely Coma cluster members. (2 data files).

[The diagnosis and treatment of myxedema coma].

PubMed

Aoki, Chie; Kasai, Kikuo

2012-11-01

Myxedema coma is defined as severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related to dysfunction in multiple organs. It is very rare disease with high mortality rate. Early recognition and therapy of myxedema coma are essential, and treatment should be begun on the basis of clinical suspection. However, regimen of myxedema is not well established even now, especially about thyroid hormone supplementation. Japan Thyroid Association is drawing up "The diagnostic criteria of myxedema coma (3rd draft) and preliminary guide to treatment of it". According to this criteria and preliminary guide, the clinical presentation, diagnosis, and treatment of myxedema coma will be reviewed here.

Development and Preliminary Validation of the Coma Arousal Communication Scale.

PubMed

Garin, Julie; Reina, Margot; DeiCas, Paula; Rousseaux, Marc

To develop a Coma Arousal Communication Scale and perform preliminary validation. A group of experts developed a questionnaire to assess communication between patients emerging from coma and caregiver (participation, communication modes, and themes) and the strategies used to facilitate communication. To assess the scale's psychometric characteristics, it was presented to the caregivers of 40 inpatients admitted to 5 coma units and (to obtain reference data) to 29 control participants. The Coma Arousal Communication Scale displayed good intra- and interrater reliability as judged by intraclass correlation coefficients (between 0.76 and 0.98) and Bland and Altman plots. Cohen κ coefficient revealed moderate to almost perfect levels of agreement for most individual items and slight levels for a few items dealing with compensatory strategies. We observed good internal consistency, relations with the Wessex Head Injury Matrix, and sensitivity to change for patients who had sustained brain injury in the previous 6 months. The Coma Arousal Communication Scale provides accurate information about communication skills of individuals emerging from coma. However, some compensatory strategies adopted by caregivers are difficult to characterize.

The relation between persistent coma and brain ischemia after severe brain injury.

PubMed

Cheng, Quan; Jiang, Bing; Xi, Jian; Li, Zhen Yan; Liu, Jin Fang; Wang, Jun Yu

2013-12-01

To investigate the relation between brain ischemia and persistent vegetative state after severe traumatic brain injury. The 66 patients with severe brain injury were divided into two groups: The persistent coma group (coma duration ≥10 d) included 51 patients who had an admission Glasgow Coma Scale (GCS) of 5-8 and were unconscious for more than 10 d. There were 15 patients in the control group, their admission GCS was 5-8, and were unconscious for less than 10 d. The brain areas, including frontal, parietal, temporal, occipital lobes and thalamus, were measured by Single Photon Emission Computed Tomography (SPECT). In the first SPECT scan, multiple areas of cerebral ischemia were documented in all patients in both groups, whereas bilateral thalamic ischemia were presented in all patients in the persistent coma group and were absented in the control group. In the second SPECT scan taken during the period of analepsia, with an indication that unilateral thalamic ischemia were persisted in 28 of 41 patients in persistent coma group(28/41,68.29%). Persistent coma after severe brain injury is associated with bilateral thalamic ischemia.

Dawn-dusk asymmetry induced by the Parker spiral angle in the plasma dynamics around comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Behar, E.; Tabone, B.; Nilsson, H.

2018-05-01

When interacting, the solar wind and the ionised atmosphere of a comet exchange energy and momentum. Our aim is to understand the influence of the average Parker spiral configuration of the solar wind magnetic field on this interaction. We compare the theoretical expectations of an analytical generalised gyromotion with Rosetta observations at comet 67P/Churyumov-Gerasimenko. A statistical approach allows one to overcome the lack of upstream solar wind measurement. We find that additionally to their acceleration along (for cometary pick-up ions) or against (for solar wind ions) the upstream electric field orientation and sense, the cometary pick-up ions are drifting towards the dawn side of the coma, while the solar wind ions are drifting towards the dusk side of the coma, independent of the heliocentric distance. The dynamics of the interaction is not taking place in a plane, as often assumed in previous works.

Prolonged hypernatremia triggered by hyperglycemic hyperosmolar state with coma: A case report.

PubMed

Vigil, Darlene; Ganta, Kavitha; Sun, Yijuan; Dorin, Richard I; Tzamaloukas, Antonios H; Servilla, Karen S

2015-05-06

A man with past lithium use for more than 15 years, but off lithium for two years and not carrying the diagnosis of diabetes mellitus or nephrogenic diabetes insipidus (NDI), presented with coma and hyperglycemic hyperosmolar state (HHS). Following correction of HHS, he developed persistent hypernatremia accompanied by large volumes of urine with low osmolality and no response to desmopressin injections. Urine osmolality remained < 300 mOsm/kg after injection of vasopressin. Improvement in serum sodium concentration followed the intake of large volumes of water plus administration of amiloride and hydrochlorothiazide. Severe hyperglycemia may trigger symptomatic lithium-induced NDI years after cessation of lithium therapy. Patients with new-onset diabetes mellitus who had been on prolonged lithium therapy in the past require monitoring of their serum sodium concentration after hyperglycemic episodes regardless of whether they do or do not carry the diagnosis of NDI.

Prolonged hypernatremia triggered by hyperglycemic hyperosmolar state with coma: A case report

PubMed Central

Vigil, Darlene; Ganta, Kavitha; Sun, Yijuan; Dorin, Richard I; Tzamaloukas, Antonios H; Servilla, Karen S

2015-01-01

A man with past lithium use for more than 15 years, but off lithium for two years and not carrying the diagnosis of diabetes mellitus or nephrogenic diabetes insipidus (NDI), presented with coma and hyperglycemic hyperosmolar state (HHS). Following correction of HHS, he developed persistent hypernatremia accompanied by large volumes of urine with low osmolality and no response to desmopressin injections. Urine osmolality remained < 300 mOsm/kg after injection of vasopressin. Improvement in serum sodium concentration followed the intake of large volumes of water plus administration of amiloride and hydrochlorothiazide. Severe hyperglycemia may trigger symptomatic lithium-induced NDI years after cessation of lithium therapy. Patients with new-onset diabetes mellitus who had been on prolonged lithium therapy in the past require monitoring of their serum sodium concentration after hyperglycemic episodes regardless of whether they do or do not carry the diagnosis of NDI. PMID:25949947

Dust grains in the coma of 67P/Churyumov-Gerasimenko - link with surface properties and cometary activity

NASA Astrophysics Data System (ADS)

Capria, M. T.; Ivanovski, S.; Zakharov, W.; Capaccioni, F.; Filacchione, G.; De Sanctis, M. C.; Rotundi, A.; Della Corte, V.; Longobardo, A.; Palomba, E.; Colangeli, L.; Bockelee-Morvan, D.; Erard, S.; Leyrat, C.

2016-11-01

The imaging spectrometer VIRTIS and the dust analyzer GIADA, onboard Rosetta, made an extensive observation of the dust particles in the coma of the comet 67P/Churyumov-Gerasimenko. From the analysis of GIADA data, two different kind of particles have been revealed, compact and fluffy with different compositions and dynamical properties. Compact particles are characterized by densities of about 10E3 kg/m3, while fluffy particles have an almost fractal nature, with densities less than 1 kg/m3. In this work we present the initial results of a model linking the dust flux distribution, as obtained from a theoretical thermal nucleus model, with a model describing the dynamics of aspherical grains in the coma. The results are discussed in the context of the latest observations from VIRTIS and GIADA instruments. The 2D nucleus thermal model, when applied to the real shape of the comet, provides the size distribution and physical properties of the emitted grains at different times and location on the surface. The thermal model can simulate grains of various size distribution, composition and physical properties. This information is used as an input for the dust dynamical model that follows the emitted particles in the coma. The main source of heating is the solar illumination. In the dust dynamical model, the grain trajectory of emitted particles remains in a plane perpendicular to the rotational axis and the direction of illumination is taken to be in the same plane (i.e. does not cause transversal forces). The dust particles are assumed to be isothermal convex bodies and temperature changes only induce modest changes in the aerodynamic force (twice higher temperature changes aerodynamic force less than 30%). This study reviews the theoretical values at which temperature difference starts to play a role on the dynamics. We discuss to what extent the particle's temperature affects the terminal velocities of the dust grains in the 67P coma in dependence on their mass and temperature constrained by the observations.

Dust grains in the coma of 67P/Churyumov-Gerasimenko - link with surface properties and cometary activity

NASA Astrophysics Data System (ADS)

Capria, Maria Teresa; Ivanovski, Stavro; Zakharov, Vladimir; Capaccioni, Fabrizio; Filacchione, Gianrico; De Sanctis, Maria Cristina; rotundi, alessandra; della corte, vincenzo; Longobardo, Andrea; Palomba, Ernesto; colangeli, luigi; Bockelee-Morvan, Dominique; Érard, Stéphane; Leyrat, Cedric; VIRTIS, GIADA

2016-10-01

The imaging spectrometer VIRTIS and the dust analyzer GIADA, onboard Rosetta, made an extensive observation of the dust particles in the coma of the comet 67P/Churyumov-Gerasimenko. From the analysis of GIADA data, two different kind of particles have been revealed, compact and fluffy with different compositions and dynamical properties. Compact particles are characterized by densities of about 103 kg/m3, while fluffy particles have an almost fractal nature, with densities less than 1 kg/m3.In this work we present the initial results of a model linking the dust flux distribution, as obtained from a theoretical thermal nucleus model, with a model describing the dynamics of aspherical grains in the coma. The results are discussed in the context of the latest observations from VIRTIS and GIADA instruments.The 2D nucleus thermal model, when applied to the real shape of the comet, provides the size distribution and physical properties of the emitted grains at different times and location on the surface. The thermal model can simulate grains of various size distribution, composition and physical properties. This information is used as an input for the dust dynamical model that follows the emitted particles in the coma. The main source of heating is the solar illumination. In the dust dynamical model, the grain trajectory of emitted particles remains in a plane perpendicular to the rotational axis and the direction of illumination is taken to be in the same plane (i.e. does not cause transversal forces). The dust particles are assumed to be isothermal convex bodies and temperature changes only induce modest changes in the aerodynamic force (twice higher temperature changes aerodynamic force less than ~30%). This study reviews the theoretical values at which temperature difference starts to play a role on the dynamics. We discuss to what extent the particle's temperature affects the terminal velocities of the dust grains in the 67P coma in dependence on their mass and temperature constrained by the observations.

Spectroscopic Observations of Comet C/2013 A1 (Siding Spring) from Mars using ChemCam, OMEGA and SPICAM.

NASA Astrophysics Data System (ADS)

Lasue, J.; Gondet, B.; Bertaux, J. L.; Barraclough, B. L.; Beck, P.; Bender, S.; Bibring, J. P.; Bridges, N. T.; Chaufray, J. Y.; Gasnault, O.; Herkenhoff, K. E.; Langevin, Y.; Le Mouelic, S.; Lemmon, M. T.; Lewin, E.; McConnochie, T. H.; Martín-Torres, J.; Maurice, S.; Meslin, P. Y.; Ming, D. W.; Montmessin, F.; Owen, T. C.; Rapin, W.; Rocard, F.; Wiens, R. C.; Zorzano, M. P.

2014-12-01

Comet Siding Spring will graze Mars on Oct. 19th 2014. Its closest approach from the centre of the planet will be 135,000 km, and its predicted visual magnitude as low as -5.3 (JPL Horizons web site). The observing conditions will be ideal to attempt spectroscopic measurements of the inner coma from the UV to the IR at an unprecedented spectral resolution from the instruments located on and around Mars. ChemCam is a Laser-Induced Breakdown Spectroscopy instrument operating on-board the Mars Science Laboratory rover to analyse the chemical composition of rocks and can be used for passive spectroscopy. ChemCam is equipped with high resolution spectrometers covering the optical range (240-850 nm) with a pixel resolution of 0.05nm up to 470nm and 0.2nm in the near-IR range. The ChemCam passive spectroscopy field of view is 0.65 mrad wide and covers several 100km projected on the coma. Based on predicted magnitude and inner coma intensity variations, we expect to retrieve spectral signatures around the nucleus. Simultaneously the 7 instruments on board Mars Express will take measurements in nadir and limb modes. We will merge the results obtained with ChemCam with those of the 2 imaging spectrometers SPICAM (110-310 nm resolution of 0.6nm and 1-1.7 μm resolution of 1.5 nm) and OMEGA (457-910 nm resolution of 1.5 nm and 2.5-5.1 μm resolution of 15 nm) to obtain the composition and spatial variation of emitting molecules in the different parts of the coma. The instruments will also monitor the atmosphere before and after the encounter to detect any change. We will report on the preparations for the observations and the spectroscopy results, with emphasis on the detection of complex organic molecules and the spatial distribution of H2O and OH in the inner coma. A decision will be made on the adequacy of risk reduction activities for the spacecraft, and planned science operations may need to be cancelled by ESOC.This work is supported by NASA, ESA and CNES.

Myxoedema coma presenting in status epilepticus.

PubMed Central

Woods, K. L.; Holmes, G. K.

1977-01-01

A 71-year-old woman with myxoedema coma presenting in status epilepticus is reported. Although this complication of myxoedema coma is considered to be fatal the patient described responded dramatically to treatment and remains in good health. PMID:876913

Anions in Cometary Comae

NASA Technical Reports Server (NTRS)

Charnley, Steven B.

2011-01-01

The presence of negative ions (anions) in cometary comae is known from Giotto mass spectrometry of IP/Halley. The anions 0-, OH-, C-, CH- and CN- have been detected, as well as unidentified anions with masses 22-65 and 85-110 amu (Chaizy et al. 1991). Organic molecular anions are known to have a significant impact on the charge balance of interstellar clouds and circumstellar envelopes and have been shown to act as catalysts for the gas-phase synthesis of larger hydrocarbon molecules in the ISM, but their importance in cometary comae has not yet been explored. We present details of the first attempt to model the chemistry of anions in cometary comae. Based on the combined chemical and hydro dynamical model of Rodgers & Charnley (2002), we investigate the role of large carbon-chain anions in cometary coma chemistry. We calculate the effects of these anions on coma thermodynamics, charge balance and examine their impact on molecule formation.

Gas Dynamics and Kinetics in the Cometary Coma: Theory and Observations

NASA Technical Reports Server (NTRS)

Combi, Michael R.; Harris, Walter M.; Smyth, William H.

2005-01-01

Our ability to describe the physical state of the expanding coma affects fundamental areas of cometary study both directly and indirectly. In order to convert measured abundances of gas species in the coma to gas production rates, models for the distribution and kinematics of gas species in the coma are required. Conversely, many different types of observations, together with laboratory data and theory, are still required to determine coma model attributes and parameters. Accurate relative and absolute gas production rates and their variations with time and from comet to comet are crucial to our basic understanding of the composition and structure of cometary nuclei and their place in the solar system. We review the gas dynamics and kinetics of cometary comae from both theoretical and observational perspectives, which are important for understanding the wide variety of physical conditions that are encountered.

Analysis of Risk Factors for Hypoglycemic Coma in 194 Patients with Type 2 Diabetes

PubMed Central

Lu, Zefen; Liu, Jianfeng; He, Qing; Chakraborty, Anindita; Zhu, Tiehong

2017-01-01

Background The present study was conducted to analyze possible risk factors in patients with type 2 diabetes who are in hypoglycemic coma. Material/Methods A total of 194 patients with type 2 diabetic hypoglycemic coma who were admitted to our hospital between January 2010 and January 2016 were included. The patients were all in coma on admission, and their blood glucose levels were lower than 2.8 mmol/L. None of the patients had type I diabetes, specific types of diabetes, or gestational diabetes. Multiple linear regression analysis was used to determine possible factors associated with hypoglycemic coma. Results Among the patients, 82 were male and 112 were female (mean age, 66.88±10.62 years). In addition, 72 patients lived in urban areas and 122 lived in rural areas. Occurrence of hypoglycemic coma was correlated with difference between urban and rural residence, glycosylated hemoglobin (HbA1c) level, combined hypertension, and combined neural complications. Self-purchased drugs resulted in significantly lower blood glucose level at the onset of hypoglycemic coma than insulin, secretagogue, or non-secretagogue drugs. Blood glucose level at onset was correlated with season. Patients living in rural areas or with combined macrovascular or microvascular complications had prolonged hospital stay and poor prognosis. Conclusions Our results demonstrate that rural residence, higher HbA1c level, combined hypertension, and combined neural complications increase the incidence of hypoglycemic coma. Use of self-purchased drugs and colder seasons may result in lower blood glucose levels in patients with hypoglycemic coma. PMID:29180613

The Complex Outgassing of Comets and the Resulting Coma, a Direct Simulation Monte-Carlo Approach

NASA Astrophysics Data System (ADS)

Fougere, Nicolas

During its journey, when a comet gets within a few astronomical units of the Sun, solar heating liberates gases and dust from its icy nucleus forming a rarefied cometary atmosphere, the so-called coma. This tenuous atmosphere can expand to distances up to millions of kilometers representing orders of magnitude larger than the nucleus size. Most of the practical cases of coma studies involve the consideration of rarefied gas flows under non-LTE conditions where the hydrodynamics approach is not valid. Then, the use of kinetic methods is required to properly study the physics of the cometary coma. The Direct Simulation Monte-Carlo (DSMC) method is the method of choice to solve the Boltzmann equation, giving the opportunity to study the cometary atmosphere from the inner coma where collisions dominate and is in thermodynamic equilibrium to the outer coma where densities are lower and free flow conditions are verified. While previous studies of the coma used direct sublimation from the nucleus for spherically symmetric 1D models, or 2D models with a day/night asymmetry, recent observations of comets showed the existence of local small source areas such as jets, and extended sources via sublimating icy grains, that must be included into cometary models for a realistic representation of the physics of the coma. In this work, we present, for the first time, 1D, 2D, and 3D models that can take into account the full effects of conditions with more complex sources of gas with jets and/or icy grains. Moreover, an innovative work in a full 3D description of the cometary coma using a kinetic method with a realistic nucleus and outgassing is demonstrated. While most of the physical models used in this study had already been developed, they are included in one self-consistent coma model for the first time. The inclusion of complex cometary outgassing processes represents the state-of-the-art of cometary coma modeling. This provides invaluable information about the coma by refining the understanding of the material that constitutes comets. This helps us to comprehend the process of the Solar System formation, one of the top priority questions in the 2013-2022 Planetary Science Decadal survey.

[Myxedema coma].

PubMed

Rizzo, Leonardo F L; Mana, Daniela L; Bruno, Oscar D; Wartofsky, Leonard

2017-01-01

Hypothyroidism is a frequently diagnosed and simply treated disease. If not recognised, however, in time it may develop into the most severe manifestation of hypothyroidism known as myxedema coma. The term "myxedema coma" is generally seen as misleading since most patients do not initially present in a coma. The typical progression is lethargy evolving into stupor and, eventually, into coma with respiratory failure and hypothermia. It mainly affects elderly women, often occurring in winter and is relatively rare. It can be considered a form of decompensated hypothyroidism often triggered by a variety of non-thyroid conditions or diseases provoking an extremely severe condition of multiple system failure with lethal consequences unless an early diagnosis is made and an aggressive treatment is administered.

Effects of pregabalin on brain edema, neurologic and histologic outcomes in experimental traumatic brain injury.

PubMed

Shamsi Meymandi, Manzumeh; Soltani, Zahra; Sepehri, Gholamreza; Amiresmaili, Sedigheh; Farahani, Fatemeh; Moeini Aghtaei, Mohammadmehdi

2018-05-03

Brain edema and increased intracranial pressure (ICP) are among the main causes of neurological disturbance and mortality following traumatic brain injury (TBI). Since pregabalin neuroprotective effects have been shown, this study was performed to evaluate the possible neuroprotective effects of pregabalin in experimental TBI of male rats. Adult male Wistar rats were divided into 4 groups: sham, vehicle, pregabalin 30 mg/kg and pregabalin 60 mg/kg. TBI was induced in vehicle and pregabalin groups by Marmarou method. Pregabalin was administered 30 min after TBI. Sham and vehicle groups received saline. Brain water and Evans blue content and histopathological changes were evaluated 24, 5 and 24 h after TBI, respectively. The ICP and neurological outcomes (veterinary coma scale, VCS) were recorded before, 1 h and 24 h post TBI. The results showed a significant reduction in brain water content and ICP, and a significant increase in VCS of pregabalin group (60 mg/kg) as compared to vehicle group (P < 0.05). Also, pregabalin reduced brain edema and apoptosis score as compared to vehicle group. Post TBI pregabalin administration revealed a delayed but significant improvement in ICP and neurological outcomes in experimental TBI. The underlying mechanism(s) was not determined and needs further investigation. Copyright © 2018 Elsevier Inc. All rights reserved.

Coma Associated with Microscopy-Diagnosed Plasmodium vivax: A Prospective Study in Papua, Indonesia

PubMed Central

Hardianto, Setiawan O.; Tjitra, Emiliana; Kenangalem, Enny; Sugiarto, Paulus; Price, Ric N.; Anstey, Nicholas M.

2011-01-01

Background Coma complicates Plasmodium falciparum infection but is uncommonly associated with P. vivax. Most series of vivax coma have been retrospective and have not utilized molecular methods to exclude mixed infections with P. falciparum. Methods We prospectively enrolled patients hospitalized in Timika, Indonesia, with a Glasgow Coma Score (GCS) ≤10 and P. vivax monoinfection on initial microscopy over a four year period. Hematological, biochemical, serological, radiological and cerebrospinal fluid (CSF) examinations were performed to identify other causes of coma. Repeat microscopy, antigen detection and polymerase chain reaction (PCR) were performed to exclude infections with other Plasmodium species. Results Of 24 patients fulfilling enrolment criteria, 5 had clear evidence for other non-malarial etiologies. PCR demonstrated 10 mixed infections and 3 P. falciparum monoinfections. 6 (25%) patients had vivax monoinfection and no apparent alternative cause, with a median GCS of 9 (range 8–10) and a median coma duration of 42 (range 36–48) hours. CSF leukocyte counts were <10/ul (n = 3); 2 of the 3 patients without CSF examination recovered with antimalarial therapy alone. One patient had a tremor on discharge consistent with a post-malarial neurological syndrome. No patient had other organ dysfunction. The only death was associated with pure P. falciparum infection by PCR. Vivax monoinfection-associated risk of coma was estimated at 1 in 29,486 clinical vivax infections with no deaths. In comparison, the risk of falciparum-associated coma was estimated at 1 in 1,276 clinical infections with an 18.5% mortality rate. Conclusions P. vivax-associated coma is rare, occurring 23 times less frequently than that seen with falciparum malaria, and is associated with a high proportion of non-malarial causes and mixed infections using PCR. The pathogenesis of coma associated with vivax malaria, particularly the role of comorbidities, is uncertain and requires further investigation. PMID:21666785

Which EEG patterns in coma are nonconvulsive status epilepticus?

PubMed

Trinka, Eugen; Leitinger, Markus

2015-08-01

Nonconvulsive status epilepticus (NCSE) is common in patients with coma with a prevalence between 5% and 48%. Patients in deep coma may exhibit epileptiform EEG patterns, such as generalized periodic spikes, and there is an ongoing debate about the relationship of these patterns and NCSE. The purposes of this review are (i) to discuss the various EEG patterns found in coma, its fluctuations, and transitions and (ii) to propose modified criteria for NCSE in coma. Classical coma patterns such as diffuse polymorphic delta activity, spindle coma, alpha/theta coma, low output voltage, or burst suppression do not reflect NCSE. Any ictal patterns with a typical spatiotemporal evolution or epileptiform discharges faster than 2.5 Hz in a comatose patient reflect nonconvulsive seizures or NCSE and should be treated. Generalized periodic diacharges or lateralized periodic discharges (GPDs/LPDs) with a frequency of less than 2.5 Hz or rhythmic discharges (RDs) faster than 0.5 Hz are the borderland of NCSE in coma. In these cases, at least one of the additional criteria is needed to diagnose NCSE (a) subtle clinical ictal phenomena, (b) typical spatiotemporal evolution, or (c) response to antiepileptic drug treatment. There is currently no consensus about how long these patterns must be present to qualify for NCSE, and the distinction from nonconvulsive seizures in patients with critical illness or in comatose patients seems arbitrary. The Salzburg Consensus Criteria for NCSE [1] have been modified according to the Standardized Terminology of the American Clinical Neurophysiology Society [2] and validated in three different cohorts, with a sensitivity of 97.2%, a specificity of 95.9%, and a diagnostic accuracy of 96.3% in patients with clinical signs of NCSE. Their diagnostic utility in different cohorts with patients in deep coma has to be studied in the future. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015. Published by Elsevier Inc.

Succinate and artificial maintenance of normal body temperature synergistically correct lethal disorders in thiopental coma rat.

PubMed

Ivnitsky, Jury Ju; Rejniuk, Vladimir L; Schäfer, Timur V; Malakhovsky, Vladimir N

2006-01-20

Under modeling of thiopental coma influence of sodium succinate and (or) external warming for the support of normal body temperature (isothermal regimen) on the gas exchange, blood gas content, acid-base status and survival rate was studied in rats. In the absence of therapy hypothermia was developed (-9.4 degrees C), O(2) consumption decreased by a factor 5, oxygenation of arterial blood (pO(2)) did not change while that of venous blood increased, where with arteriovenous oxygen tension gradient decreased by half. Blood tension of carbon dioxide (pCO(2)) increased twice, respiratory and metabolic acidosis was developed. Survival rate under absence of a therapy was 42%, with isolated use of isothermal regimen or succinate therapy alike-50%; with their use in combination drastically increased up to 92%. Succinate increased arteriovenous gradient of pO(2), decreased deficit of buffer bases, increased bicarbonate concentration. At isothermal regimen accumulation of CO(2) in the blood was diminished, its excretion was increased, pH of blood approached normal values. Combined use of both therapy agents increased O(2) consumption and potentiated their positive influence on acid-base status. The implication is that hypothermia restrains effect of succinate in barbiturate coma; prevention of hypothermia in combination with succinate administration is highly effective method of experimental therapy of barbiturate intoxication.

An Atypical Case of Myxedema Coma with Concomitant Nonconvulsive Seizure.

PubMed

Patel, Pratik; Bekkerman, Mikhael; Varallo-Rodriguez, Cristina; Rampersaud, Rajendra

2016-01-01

Hypothyroidism is a prevalent condition in the general population that is treatable with appropriately dosed thyroid hormone replacement medication. Infrequently, patients will present with myxedema coma, characterized by hypothermia, hypotension, bradycardia, and altered mental status in the setting of severe hypothyroidism. Myxedema coma has also been known to manifest in a number of unusual and dangerous forms. Here, we present the case of a woman we diagnosed with an uncharacteristic expression of myxedema coma and nonconvulsive seizure complicated by a right middle cerebral artery infarct.

The child in coma

NASA Technical Reports Server (NTRS)

Lewinn, E. B.

1978-01-01

Children in coma continue to pose medical, social, economic, ethical, moral, and legal problems. Modern life-support technology has aggravated these problems. Coma is viewed as a pathological state of unconsciousness from which the patient has not achieved arousal, and which calls for vigorous action to help him regain consciousness. There are two variables that have an especially important bearing on the ability to achieve arousal. These are: the character of the brain injury that caused the coma, and environmental factors that affect the patient after the injury.

[Evaluation of prognosis in purulent meningitis-myelitis based on the Glasgow Coma Scale].

PubMed

Garlicki, A; Caban, J; Bociaga, M; Krukowiecki, J; Warunek, W; Skwara, P

1996-01-01

We presented data from the investigation of the usefulness of the Glasgow Coma Scale in predicting the outcome of bacterial meningitis. Patients who aggregated high Glasgow Coma Scale scores had a good prognosis, whereas those patients with low scores had a very poor prognosis, inspite of this limitation the Glasgow Coma Scale seems to be a valuable supplement to the physical examination of patients with bacterial meningitis and may help in predicting the outcome of the disease.

Initial Diagnosis and Management of Coma.

PubMed

Traub, Stephen J; Wijdicks, Eelco F

2016-11-01

Coma represents a true medical emergency. Drug intoxications are a leading cause of coma; however, other metabolic disturbances and traumatic brain injury are also common causes. The general emergency department approach begins with stabilization of airway, breathing, and circulation, followed by a thorough physical examination to generate a limited differential diagnosis that is then refined by focused testing. Definitive treatment is ultimately disease-specific. This article presents an overview of the pathophysiology, causes, examination, and treatment of coma. Copyright © 2016 Elsevier Inc. All rights reserved.

Neuroanatomical Predictors of Awakening in Acutely Comatose Patients

PubMed Central

Kowalski, Robert G.; Buitrago, Manuel M.; Duckworth, Josh; Chonka, Zachary D.; Puttgen, H. Adrian; Stevens, Robert D.; Geocadin, Romergryko G.

2016-01-01

Objective Lateral brain displacement has been associated with loss of consciousness and poor outcome in a range of acute neurologic disorders. We studied the association between lateral brain displacement and awakening from acute coma. Methods This prospective observational study included all new onset coma patients admitted to the Neurosciences Critical Care Unit (NCCU) over 12 consecutive months. Head computed tomography (CT) scans were analyzed independently at coma onset, after awakening, and at follow-up. Primary outcome measure was awakening, defined as the ability to follow commands before hospital discharge. Secondary outcome measures were discharge Glasgow Coma Scale (GCS), modified Rankin Scale, Glasgow Outcome Scale, and hospital and NCCU lengths of stay. Results Of the 85 patients studied, the mean age was 58 ± 16 years, 51% were female, and 78% had cerebrovascular etiology of coma. Fifty-one percent of patients had midline shift on head CT at coma onset and 43 (51%) patients awakened. In a multivariate analysis, independent predictors of awakening were younger age (odds ratio [OR] = 1.039, 95% confidence interval [CI] = 1.002–1.079, p = 0.040), higher GCS score at coma onset (OR = 1.455, 95% CI = 1.157–1.831, p = 0.001), nontraumatic coma etiology (OR = 4.464, 95% CI = 1.011–19.608, p = 0.048), lesser pineal shift on follow-up CT (OR = 1.316, 95% CI = 1.073–1.615, p = 0.009), and reduction or no increase in pineal shift on follow-up CT (OR = 11.628, 95% CI = 2.207–62.500, p = 0.004). Interpretation Reversal and/or limitation of lateral brain displacement are associated with acute awakening in comatose patients. These findings suggest objective parameters to guide prognosis and treatment in patients with acute onset of coma. PMID:25628166

Acute Kidney Injury as a Risk Factor for Delirium and Coma during Critical Illness.

PubMed

Siew, Edward D; Fissell, William H; Tripp, Christina M; Blume, Jeffrey D; Wilson, Matthew D; Clark, Amanda J; Vincz, Andrew J; Ely, E Wesley; Pandharipande, Pratik P; Girard, Timothy D

2017-06-15

Acute kidney injury may contribute to distant organ dysfunction. Few studies have examined kidney injury as a risk factor for delirium and coma. To examine whether acute kidney injury is associated with delirium and coma in critically ill adults. In a prospective cohort study of intensive care unit patients with respiratory failure and/or shock, we examined the association between acute kidney injury and daily mental status using multinomial transition models adjusting for demographics, nonrenal organ failure, sepsis, prior mental status, and sedative exposure. Acute kidney injury was characterized daily using the difference between baseline and peak serum creatinine and staged according to Kidney Disease Improving Global Outcomes criteria. Mental status (normal vs. delirium vs. coma) was assessed daily with the Confusion Assessment Method for the ICU and Richmond Agitation-Sedation Scale. Among 466 patients, stage 2 acute kidney injury was a risk factor for delirium (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.07-2.26) and coma (OR, 2.04; 95% CI, 1.25-3.34) as was stage 3 injury (OR for delirium, 2.56; 95% CI, 1.57-4.16) (OR for coma, 3.34; 95% CI, 1.85-6.03). Daily peak serum creatinine (adjusted for baseline) values were also associated with delirium (OR, 1.35; 95% CI, 1.18-1.55) and coma (OR, 1.44; 95% CI, 1.20-1.74). Renal replacement therapy modified the association between stage 3 acute kidney injury and daily peak serum creatinine and both delirium and coma. Acute kidney injury is a risk factor for delirium and coma during critical illness.

VizieR Online Data Catalog: ETGs sample for the Coma cluster (Riguccini+, 2015)

NASA Astrophysics Data System (ADS)

Riguccini, L.; Temi, P.; Amblard, A.; Fanelli, M.; Brighenti, F.

2017-10-01

For the Coma Cluster, we utilize the work of Mahajan et al. (2010, J/MNRAS/404/1745) to build our ETG sample. Mahajan et al. (2010, J/MNRAS/404/1745) used a combination of MIPS 24 μm observations and SDSS photometry and spectra to investigate the star formation history of galaxies in the Coma supercluster. All of their galaxies from the SDSS data in the Coma supercluster region are brighter than r~17.77, the completeness limit of the SDSS spectroscopic galaxy catalog. Their 24 μm fluxes are obtained from archival data covering 2x2 deg2 for Coma Cluster. Our final sample of 124 sources is composed of 49 ellipticals and 75 lenticulars. (1 data file).

Myxedema coma with cardiac tamponade and severe cardiomyopathy.

PubMed

Majid-Moosa, Abdulla; Schussler, Jeffrey M; Mora, Adan

2015-10-01

Myxedema coma is an infrequent but potentially fatal complication of hypothyroidism. We present a rare case of previously undiagnosed hypothyroidism presenting in cardiogenic shock from pericardial tamponade and depressed myocardial contractility in myxedema coma. Here, we focus on cardiovascular complications associated with the condition.

Modeling the coma of 2060 Chiron

NASA Technical Reports Server (NTRS)

Boice, D. C.; Konno, I.; Stern, S. Alan; Huebner, W. F.

1991-01-01

Observations of comet-like activity and a resolved coma have established that 2060 Chiron is a comet. Determinations of its radius range from 65 to 200 km. This unusually large size for a comet suggests that the atmosphere of Chiron is intermediate to the tightly bound, thin atmospheres typical of planets and satellite and the greatly extended atmospheres in free expansion typical of cometary comae. Under certain conditions it may gravitationally bind an atmosphere that is thick compared to its size, while a significant amount of gas escapes to an extensive exosphere. These attributes coupled with reports of sporadic outbursts at large heliocentric distances and the identification of CN in the coma make Chiron a challenging object to model. Simple models of gas production and the dusty coma were recently presented but a general concensus on many basic features has not emerged. Development was begun on a more complete coma model of Chiron. The objectives are to report progress on this model and give the preliminary results for understanding Chiron.

Spectroscopic characterisation of the stellar content of ultra diffuse galaxies

NASA Astrophysics Data System (ADS)

Ruiz-Lara, T.; Beasley, M. A.; Falcón-Barroso, J.; Román, J.; Pinna, F.; Brook, C.; Di Cintio, A.; Martín-Navarro, I.; Trujillo, I.; Vazdekis, A.

2018-05-01

Understanding the peculiar properties of Ultra Diffuse Galaxies (UDGs) via spectroscopic analysis is a challenging task requiring very deep observations and exquisite data reduction. In this work we perform one of the most complete characterisations of the stellar component of UDGs to date using deep optical spectroscopic data from OSIRIS at GTC. We measure radial and rotation velocities, star formation histories (SFH) and mean population parameters, such as ages and metallicities, for a sample of five UDG candidates in the Coma cluster. From the radial velocities, we confirm the Coma membership of these galaxies. We find that their rotation properties, if detected at all, are compatible with dwarf-like galaxies. The SFHs of the UDG are dominated by old (˜ 7 Gyr), metal-poor ([M/H] ˜ -1.1) and α-enhanced ([Mg/Fe] ˜ 0.4) populations followed by a smooth or episodic decline which halted ˜ 2 Gyr ago, possibly a sign of cluster-induced quenching. We find no obvious correlation between individual SFH shapes and any UDG morphological properties. The recovered stellar properties for UDGs are similar to those found for DDO 44, a local UDG analogue resolved into stars. We conclude that the UDGs in our sample are extended dwarfs whose properties are likely the outcome of both internal processes, such as bursty SFHs and/or high-spin haloes, as well as environmental effects within the Coma cluster.

A continued program of planetary study at the University of Texas McDonald Observatory

NASA Technical Reports Server (NTRS)

Smith, H. J.; Barker, E. S.; Cochran, W. D.; Trafton, L. M.

1986-01-01

The beginning of eclipses of the Pluto-Charon system was detected. The onset of coma formation of P/Halley at 5.4 au was detected and evidence of sublimation at 4.8 au when CN emission was detected. Extensive spatial maps of the gas in the comae of comets Halley and Giacobini-Zinner were obtained in fall 1985. Halley was time variable, and Giacobini-Zinner was depleted in C2 and C3 relative to CN. Comet Kopff was shown to have a pre-perihelion brightness maximum of its gas, consistent with mantle development if the comet is a high obliquity object. New Haser model scale lengths for CN, C3, and C2 were determined using results from the Faint Comet Survey. Spectra of 12 asteroids in unusual orbits showed no evidence of any comet-like emission features. In particular, 3200 Phaethon (1983 TB) has no gas or dust coma, in spite of the similarity of its orbit with the Geminid meteor stream. Data were analyzed on Saturn's H2 and CH4 bands for the recent southern summer using a Tomasko-Doose type of haze distribution. This haze model fits the data moderately well, giving a CH4 mixing ratio of (4.2 + or 0.4)x003. Simple functions were found to approximate the collision-induced rotation-translation thermal opacity of H2.

ORIGIN OF MOLECULAR OXYGEN IN COMET 67P/CHURYUMOV–GERASIMENKO

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

Mousis, O.; Ronnet, T.; Brugger, B.

2016-06-01

Molecular oxygen has been detected in the coma of comet 67P/Churyumov–Gerasimenko with abundances in the 1%–10% range by the Rosetta Orbiter Spectrometer for Ion and Neutral Analysis-Double Focusing Mass Spectrometer instrument on board the Rosetta spacecraft. Here we find that the radiolysis of icy grains in low-density environments such as the presolar cloud may induce the production of large amounts of molecular oxygen. We also show that molecular oxygen can be efficiently trapped in clathrates formed in the protosolar nebula (PSN), and that its incorporation as crystalline ice is highly implausible, because this would imply much larger abundances of Armore » and N{sub 2} than those observed in the coma. Assuming that radiolysis has been the only O{sub 2} production mechanism at work, we conclude that the formation of comet 67P/Churyumov–Gerasimenko is possible in a dense and early PSN in the framework of two extreme scenarios: (1) agglomeration from pristine amorphous icy grains/particles formed in ISM and (2) agglomeration from clathrates that formed during the disk’s cooling. The former scenario is found consistent with the strong correlation between O{sub 2} and H{sub 2}O observed in comet 67P/Churyumov-Gerasimenko’s coma while the latter scenario requires that clathrates formed from ISM icy grains that crystallized when entering the PSN.« less

Energy expenditure during barbiturate coma.

PubMed

Ashcraft, Christine M; Frankenfield, David C

2013-10-01

Barbiturate coma may have a significant effect on metabolic rate, but the phenomenon is not extensively studied. The primary purpose of the current study was to compare the metabolic rate of general critical care patients with those requiring barbiturate coma. A secondary purpose was to evaluate the accuracy of the Penn State prediction equation between these 2 groups of patients. Indirect calorimetry was used to measure the resting metabolic rate of mechanically ventilated, critically ill patients in a barbiturate coma and those of similar height, weight, and age but not in a barbiturate coma. Measurements of resting metabolic rate were compared with predictions using the Penn State equation accounting for body size, body temperature, and minute ventilation. The barbiturate coma group had a lower resting metabolic rate than the control group that remained lower even after adjustment for predicted healthy metabolic rate and maximum body temperature (1859 ± 290 vs 2037 ± 289 kcal/d, P = .020). When minute ventilation was also included in the analysis, the resting metabolic rate between the groups became statistically insignificant (1929 ± 229 vs 2023 ± 226 kcal/d, P = .142). The Penn State equation, which uses these variables, was accurate in 73% of the control patients and also the barbiturate coma patients. Resting metabolic rate is moderately reduced in barbiturate coma, but the decrease is out of proportion with changes in body temperature. However, if both body temperature and minute ventilation are considered, then the change is predictable.

Physical properties of dust particles in different comets inferred from observations and experimental simulations

NASA Astrophysics Data System (ADS)

Hadamcik, E.; Levasseur-Regourd, A. C.

2007-08-01

1.Introduction Remote observations of solar light scattered by cometary dust particles provide information on the dust properties for a large variety of comets, in complement to the exceptional in-situ observations (with or without sample returns). The scattered light is partially linearly polarized, with a polarization degree depending on the geometry of observations (phase angle ?) and on the physical properties of the particles. Differences in polarization have been found in cometary comae, pointing to different physical properties of the dust (e.g. sizes of the grains, of the aggregates, structures and porosities, complex refractive indices) [1, 2]. Such differences, as well as an observed polarimetric wavelength effect, tend to show that large aggregates made of submicron-sized grains could be present in some cometary comae regions [3, 4]. On the opposite, more compact particles seem to be present in other comae regions and/or comets [5, 6]. 2. Results We will present observations of different comets. The variations of the dust properties in the coma and their evolution will be discussed. The results will be compared to the results obtained by other observational techniques. On the images of comet 9P/Tempel 1 (at ?=41°) some hours after Deep Impact, two kinds of dust particles are detected: more compact particles with small velocities and fluffy particles ejected by the impact with larger velocities. On the images of comet 73P/Schwassmann-Wachmann 3, in the tail direction of fragment B, a disruption is observed. The dust coma around fragment C is more symmetric. For both A and B, important dust jets are ejected by the nucleus, which are visible on the intensity images in the solar and antisolar directions, and on the polarization maps. 3. Interpretation and conclusion Numerical (7,8,9) and experimental simulations provide an interpretation of the observations in terms of the physical properties of the particles. Experimental simulations have been performed on numerous levitating samples (compact and fluffy) with the PROGRA2 experiment, either in reduced gravity conditions (parabolic flights) [10,11], or lifted by an air-draught (laboratory conditions) [12,13]. The variations of the polarization are correlated to variations in the size of the grains and aggregates and are a function of the complex refractive index and its evolution. The correlation between the variations of the scattered intensity and the linear polarization maps allows us to disentangle different physical properties of the dust. The results are compared to results obtained from previous observations by the same methods. References [1] E. Hadamcik and A.C. Levasseur-Regourd, JQSRT 79-80, 661-678 (2003) [2] A.C. Levasseur-Regourd, E. Hadamcik, JQSRT 79-80, 903-910 (2003) [3] E. Hadamcik, A.C. Levasseur-Regourd, A&A 403, 757- 768 (2003) [4] L. Kolokolova et al., In: Comets II, M.C. Festou et al. (eds), pp 577 (2004) [5] E. Hadamcik, A.C. Levasseur-Regourd, Icarus 166, 188-194 (2003) [6] E. Hadamcik et al., Icarus, accepted. [7] J. Lasue, A.C. Levasseur-Regourd, JQSRT 100, 220-236 (2006) [8] H. Kimura et al., A&A 449, 1243-1254 (2006) [9] A.C. Levasseur-Regourd et al., PSS, in press, available on line (2007) [10] J.-B. Renard et al. Appl. Opt 41, 609-618 (2002) [11] J.-B. Renard et al., Adv. Space Res. 31, 2511-2518 (2003) [12] E. Hadamcik et al., JQSRT 100, 143-156 (2006) [13] E. Hadamcik et al., Icarus, in press, available on line (2007)

Improving cognitive outcome in cerebral malaria: insights from clinical and experimental research.

PubMed

de Miranda, Aline Silva; Brant, Fátima; Machado, Fabiana Simão; Rachid, Milene Alvarenga; Teixeira, Antônio Lúcio

2011-12-01

Cerebral Malaria (CM) is a clinical syndrome defined by the World Health Organization (WHO) as a potentially reversible diffuse encephalopathy characterized mainly by coma and the presence of asexual forms of Plasmodium falciparum parasites in peripheral blood smears in the absence of other causes of encephalopathy. A wide range of clinical manifestations follows the disease including cognitive, behavioral and motor dysfunctions, seizures and coma. The underlying mechanisms of CM pathogenesis remain incompletely understood although vascular, immunological and metabolic changes have been described. The classical treatment of CM is based on the administration of antimalarial drugs, especially chloroquine and artemisinin derivates as artesunate. Even with treatment, 15 to 20% of children with CM die and approximately 10 to 17% of those who survive remain with significant long-term cognitive impairment. In this context, neuroprotective and adjuvant therapies have been recently investigated in clinical and experimental studies of CM in an attempt to improve cognitive outcome. A poor understanding of pathophysiological mechanisms, properties of compounds used and patient selection have contributed to the lack of success of these interventions. This review discusses clinical aspects of cognitive sequelae, possible mechanisms involved in the brain injury, perspectives and limitations regarding the pharmacological strategies to improve cognitive outcome in CM.

Diagnosis of myxedema coma complicated by renal failure: a case report.

PubMed

Takamura, Akiteru; Sangen, Ryusho; Furumura, Yoshiki; Usuda, Daisuke; Kasamaki, Yuji; Kanda, Tsugiyasu

2017-04-01

Myxedema coma, caused by severe lack of thyroid hormone, is characterized by deterioration of mental status, hypothermia, hypotension, hyponatremia, and hypoventilation. We describe an 84-year-old woman who presented with renal failure and new onset severe hypothyroidism leading to challenges in the recognition of myxedema coma.

Myxedema coma in a patient with Down's syndrome.

PubMed

Bansal, Darpan; Nanda, Ashish; Gupta, Ekta; Croker, Mary; Williams, Misty L; Bacchus, Amy; Simmons, Debra; Erbland, Marcia

2006-11-01

hyroid dysfunction is common in Down's syndrome, most common being hypothyroidism. Longstanding, untreated hypothyroidism can lead to myxedema coma. Here we report a patient with Down's syndrome who presented with myxedema coma. The three essential elements for the diagnosis of myxedema coma include altered mental status, defective thermoregulation and a precipitating event or illness; all of these were present in our patient. Also, very high TSH, low T3 and T4, and the rapid response to the treatment with levothyroxine confirmed the diagnosis. Patients with Down's syndrome should have regular screening for thyroid dysfunction.

Thyroid gland disorder emergencies: thyroid storm and myxedema coma.

PubMed

Hampton, Jessica

2013-01-01

Although thyroid dysfunction will develop in more than 12% of the US population during their lifetimes, true thyroid emergencies are rare. Thyroid storm and myxedema coma are endocrine emergencies resulting from thyroid hormone dysregulation, usually coupled with an acute illness as a precipitant. Careful assessment of risk and rapid action, once danger is identified, are essential for limiting morbidity and mortality related to thyroid storm and myxedema coma. This article reviews which patients are at risk, explains thyroid storm and myxedema coma, and describes pharmacological treatment and supportive cares.

An Atypical Case of Myxedema Coma with Concomitant Nonconvulsive Seizure

PubMed Central

Patel, Pratik; Varallo-Rodriguez, Cristina

2016-01-01

Hypothyroidism is a prevalent condition in the general population that is treatable with appropriately dosed thyroid hormone replacement medication. Infrequently, patients will present with myxedema coma, characterized by hypothermia, hypotension, bradycardia, and altered mental status in the setting of severe hypothyroidism. Myxedema coma has also been known to manifest in a number of unusual and dangerous forms. Here, we present the case of a woman we diagnosed with an uncharacteristic expression of myxedema coma and nonconvulsive seizure complicated by a right middle cerebral artery infarct. PMID:27872766

Time variability and heterogeneity in the coma of 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Hässig, M.; Altwegg, K.; Balsiger, H.; Bar-Nun, A.; Berthelier, J. J.; Bieler, A.; Bochsler, P.; Briois, C.; Calmonte, U.; Combi, M.; De Keyser, J.; Eberhardt, P.; Fiethe, B.; Fuselier, S. A.; Galand, M.; Gasc, S.; Gombosi, T. I.; Hansen, K. C.; Jäckel, A.; Keller, H. U.; Kopp, E.; Korth, A.; Kührt, E.; Le Roy, L.; Mall, U.; Marty, B.; Mousis, O.; Neefs, E.; Owen, T.; Rème, H.; Rubin, M.; Sémon, T.; Tornow, C.; Tzou, C.-Y.; Waite, J. H.; Wurz, P.

2015-01-01

Comets contain the best-preserved material from the beginning of our planetary system. Their nuclei and comae composition reveal clues about physical and chemical conditions during the early solar system when comets formed. ROSINA (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) onboard the Rosetta spacecraft has measured the coma composition of comet 67P/Churyumov-Gerasimenko with well-sampled time resolution per rotation. Measurements were made over many comet rotation periods and a wide range of latitudes. These measurements show large fluctuations in composition in a heterogeneous coma that has diurnal and possibly seasonal variations in the major outgassing species: water, carbon monoxide, and carbon dioxide. These results indicate a complex coma-nucleus relationship where seasonal variations may be driven by temperature differences just below the comet surface.

Burst Suppression on Processed Electroencephalography as a Predictor of Post-Coma Delirium in Mechanically Ventilated ICU Patients

PubMed Central

Andresen, Jennifer M.; Girard, Timothy D.; Pandharipande, Pratik P.; Davidson, Mario A.; Ely, E. Wesley; Watson, Paula L.

2015-01-01

Objectives Many patients, due to a combination of illness and sedatives, spend a considerable amount of time in a comatose state that can include time in burst suppression. We sought to determine if burst suppression measured by processed electroencephalography (pEEG) during coma in sedative-exposed patients is a predictor of post-coma delirium during critical illness. Design Observational convenience sample cohort Setting Medical and surgical ICUs in a tertiary care medical center Patients Cohort of 124 mechanically ventilated ICU patients Measurements and Main Results Depth of sedation was monitored twice daily using the Richmond Agitation-Sedation Scale and continuously monitored by pEEG. When non-comatose, patients were assessed for delirium twice daily using Confusion Assessment Method for the ICU (CAM-ICU). Multiple logistic regression and Cox proportional hazards regression were used to assess associations between time in burst suppression and both incidence and time to resolution of delirium, respectively, adjusting for time in deep sedation and a principal component score consisting of APACHE II score and cumulative doses of sedatives while comatose. Of the 124 patients enrolled and monitored, 55 patients either never had coma or never emerged from coma yielding 69 patients for whom we performed these analyses; 42 of these 69 (61%) had post-coma delirium. Most patients had burst-suppression during coma, though often short-lived [ median (intraquartile range) time in burst suppression, 6.4 (1-58) minutes]. After adjusting for covariates, even this short time in burst suppression independently predicted a higher incidence of post-coma delirium [odds ratio 4.16; 95% confidence interval (CI) 1.27-13.62; p=0.02] and a lower likelihood (delayed) resolution of delirium (hazard ratio 0.78; 95% CI 0.53-0.98; p=0.04). Conclusions Time in burst suppression during coma, as measured by processed EEG, was an independent predictor of incidence and time to resolution of post-coma/post-deep sedation delirium. These findings of this single center investigation support lighter sedation strategies. PMID:25072756

Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan.

PubMed

Ono, Yosuke; Ono, Sachiko; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Tanaka, Yuji

2017-03-01

Myxedema coma is a life-threatening and emergency presentation of hypothyroidism. However, the clinical features and outcomes of this condition have been poorly defined because of its rarity. We conducted a retrospective observational study of patients diagnosed with myxedema coma from July 2010 through March 2013 using a national inpatient database in Japan. We investigated characteristics, comorbidities, treatments, and in-hospital mortality of patients with myxedema coma. We identified 149 patients diagnosed with myxedema coma out of approximately 19 million inpatients in the database. The mean (standard deviation) age was 77 (12) years, and two-thirds of the patients were female. The overall proportion of in-hospital mortality among cases was 29.5%. The number of patients was highest in the winter season. Patients treated with steroids, catecholamines, or mechanical ventilation showed higher in-hospital mortality than those without. Variations in type and dosage of thyroid hormone replacement were not associated with in-hospital mortality. The most common comorbidity was cardiovascular diseases (40.3%). The estimated incidence of myxedema coma was 1.08 per million people per year in Japan. Multivariable logistic regression analysis revealed that higher age and use of catecholamines (with or without steroids) were significantly associated with higher in-hospital mortality. The present study identified the clinical characteristics and outcomes of patients with myxedema coma using a large-scale database. Myxedema coma mortality was independently associated with age and severe conditions requiring treatment with catecholamines. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Development of an objective tool for the diagnosis of myxedema coma.

PubMed

Chiong, Yien V; Bammerlin, Elaine; Mariash, Cary N

2015-09-01

Myxedema coma, a rare entity, with a reported 25%-65% mortality had no objective criteria for making the diagnosis when we began our study. We developed an objective screening tool for myxedema coma to more easily identify patients and examine the best treatment method in future prospective studies to reduce the mortality of this entity. We conducted a retrospective chart review to find all patients aged ≥18 years admitted with myxedema coma from January 1, 2005 through June 13, 2010 at Indiana University Health Methodist Hospital. On the basis of both our retrospective chart review and on literature accounts, we identified 6 criteria to diagnose myxedema coma. We identified 10 patients initially diagnosed with myxedema coma and established a control group consisting of 13 patients identified with altered mental status and increased thyroid-stimulating hormone (TSH) levels. The 6 variables we created for the screening tool were heart rate, temperature, Glasgow coma scale, TSH, free thyroxine, and precipitating factors. The screening tool has a sensitivity and specificity of about 80%. We ran a logistic regression model using the 10 study patients and 13 controls with the 6 variables. No variables alone significantly contributed to the model. However, the overall model was highly significant (P = 0.012), providing strong support for a scoring system that uses these variables simultaneously. This screening tool enables physicians to rapidly diagnose myxedema coma to expedite treatment. A more refined diagnostic tool may be used in future clinical studies designed to determine the optimal treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores.

PubMed

Sattin, Davide; Lovaglio, Piergiorgio; Brenna, Greta; Covelli, Venusia; Rossi Sebastiano, Davide; Duran, Dunja; Minati, Ludovico; Giovannetti, Ambra Mara; Rosazza, Cristina; Bersano, Anna; Nigri, Anna; Ferraro, Stefania; Leonardi, Matilde

2017-09-01

The study compared the metric characteristics (discriminant capacity and factorial structure) of two different methods for scoring the items of the Coma Recovery Scale-Revised and it analysed scale scores collected using the standard assessment procedure and a new proposed method. Cross sectional design/methodological study. Inpatient, neurological unit. A total of 153 patients with disorders of consciousness were consecutively enrolled between 2011 and 2013. All patients were assessed with the Coma Recovery Scale-Revised using standard (rater 1) and inverted (rater 2) procedures. Coma Recovery Scale-Revised score, number of cognitive and reflex behaviours and diagnosis. Regarding patient assessment, rater 1 using standard and rater 2 using inverted procedures obtained the same best scores for each subscale of the Coma Recovery Scale-Revised for all patients, so no clinical (and statistical) difference was found between the two procedures. In 11 patients (7.7%), rater 2 noted that some Coma Recovery Scale-Revised codified behavioural responses were not found during assessment, although higher response categories were present. A total of 51 (36%) patients presented the same Coma Recovery Scale-Revised scores of 7 or 8 using a standard score, whereas no overlap was found using the modified score. Unidimensionality was confirmed for both score systems. The Coma Recovery Scale Modified Score showed a higher discriminant capacity than the standard score and a monofactorial structure was also supported. The inverted assessment procedure could be a useful evaluation method for the assessment of patients with disorder of consciousness diagnosis.

Thermal Model of Laser-Induced Eye Damage

DTIC Science & Technology

1974-10-08

Identify by. block ntber) Ocular Damage Laser Effect3 Thermal Model Temperature Rise Prediction Retinal, Corneal, Lenticular Damage 20. ABSTR ACT (CoIfn...routine available to predict retinal or lenticular beam characteristics based on beam de- scripton at the cornea and distance of the last beam waist 5...used are selected for minimal aberrations of the astigmatic kind and that coma is negligible because of nearly axial "illumination. Secondly, the thermal

Memory disorder related to coma duration after head injury.

PubMed Central

Vilkki, J; Poropudas, K; Servo, A

1988-01-01

The relationship of memory and intelligence test performances to coma duration was studied in 51 head injured patients who had not been operated on for intracranial haematoma. Memory defect was related to coma duration, and was not secondary to impaired perceptual or conceptual analysis of the material to be remembered. PMID:3236022

[Coma in France today].

PubMed

Do, Chung Hi

2015-01-01

Comas result from acute life-threatening neurological failure. To understand coma, it is firstly necessary to define it, to cite the aetiologies and their epidemiology and to describe the chronic disorders of consciousness. It is also important to address the challenges and principles of treatment during the acute phase. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Hypoglycemic neuronal death is triggered by glucose reperfusion and activation of neuronal NADPH oxidase

PubMed Central

Suh, Sang Won; Gum, Elizabeth T.; Hamby, Aaron M.; Chan, Pak H.; Swanson, Raymond A.

2007-01-01

Hypoglycemic coma and brain injury are potential complications of insulin therapy. Certain neurons in the hippocampus and cerebral cortex are uniquely vulnerable to hypoglycemic cell death, and oxidative stress is a key event in this cell death process. Here we show that hypoglycemia-induced oxidative stress and neuronal death are attributable primarily to the activation of neuronal NADPH oxidase during glucose reperfusion. Superoxide production and neuronal death were blocked by the NADPH oxidase inhibitor apocynin in both cell culture and in vivo models of insulin-induced hypoglycemia. Superoxide production and neuronal death were also blocked in studies using mice or cultured neurons deficient in the p47phox subunit of NADPH oxidase. Chelation of zinc with calcium disodium EDTA blocked both the assembly of the neuronal NADPH oxidase complex and superoxide production. Inhibition of the hexose monophosphate shunt, which utilizes glucose to regenerate NADPH, also prevented superoxide formation and neuronal death, suggesting a mechanism linking glucose reperfusion to superoxide formation. Moreover, the degree of superoxide production and neuronal death increased with increasing glucose concentrations during the reperfusion period. These results suggest that high blood glucose concentrations following hypoglycemic coma can initiate neuronal death by a mechanism involving extracellular zinc release and activation of neuronal NADPH oxidase. PMID:17404617

IL-1 or TNF receptor gene deletion delays onset of encephalopathy and attenuates brain edema in experimental acute liver failure.

PubMed

Bémeur, Chantal; Qu, Hong; Desjardins, Paul; Butterworth, Roger F

2010-01-01

Previous reports suggested that brain-derived proinflammatory cytokines are involved in the pathogenesis of hepatic encephalopathy (HE) and brain edema in acute liver failure (ALF). To further address this issue, expression of interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) mRNAs were measured in the brains of mice with acute liver failure resulting from exposure to azoxymethane. In addition, time to severe encephalopathy (coma) was assessed in mice lacking genes coding for interferon-gamma, the tumor necrosis factor receptor-1 or the interleukin-1 type 1 receptor. Interleukin-1beta, tumor necrosis factor-alpha and interferon-gamma expression were quantified using RT-PCR. Significant increases in interleukin-1beta and tumor necrosis factor-alpha mRNA were observed in the frontal cortex of azoxymethane-treated wild-type mice at coma stages of encephalopathy. Interferon-gamma, however, could not be detected in the brains of these animals. Onset of severe encephalopathy (coma) and brain edema in ALF mice were significantly delayed in interleukin-1 type 1 receptor or tumor necrosis factor receptor-1 knockout mice. Deletion of the interferon-gamma gene, on the other hand, had no significative effect on the neurological status or brain water content of acute liver failure mice. These results demonstrate that toxic liver injury resulting from exposure to azoxymethane is associated with selective induction of proinflammatory cytokines in the brain and that deletion of tumor necrosis factor receptor-1 or interlukin-1 type 1 receptor delays the onset of coma and brain edema in this model of acute liver failure. These findings further support a role for selective brain-derived cytokines in the pathogenesis of the cerebral complications in acute liver failure and suggest that anti-inflammatory strategies could be beneficial in their prevention. Copyright 2009 Elsevier Ltd. All rights reserved.

Between My Body and My "Dead Body": Narratives of Coma.

PubMed

Meoded Danon, Limor

2016-01-01

This article is based on narrative research that focuses on corporeal experience during coma and during the rehabilitation process. Seventeen participants from different areas of Israel who had been in various kinds of coma states reveal what the corporeal experience of coma is. The participants are divided into three types of narrative protagonists--"dead-alive," "rational," and "emissaries." Each of the participants redefined the boundaries of the body, especially in cases when they spoke of experiences they did not understand as corporeal, for example, out-of-body experiences, near-death experiences, or experiences of being between the earthly and unearthly. Their struggle to find suitable words to tell their coma stories emphasizes these boundaries between experiencing and telling, which crossed the normative discursive border of the medical establishment and illustrates the ambiguous nature of human existence. © The Author(s) 2015.

Myxedema coma: diagnosis and treatment.

PubMed

Wall, C R

2000-12-01

Myxedema coma, the extreme manifestation of hypothyroidism, is an uncommon but potentially lethal condition. Patients with hypothyroidism may exhibit a number of physiologic alterations to compensate for the lack of thyroid hormone. If these homeostatic mechanisms are overwhelmed by factors such as infection, the patient may decompensate into myxedema coma. Patients with hypothyroidism typically have a history of fatigue, weight gain, constipation and cold intolerance. Physicians should include hypothyroidism in the differential diagnosis of every patient with hyponatremia. Patients with suspected myxedema coma should be admitted to an intensive care unit for vigorous pulmonary and cardiovascular support. Most authorities recommend treatment with intravenous levothyroxine (T4) as opposed to intravenous liothyronine (T3). Hydrocortisone should be administered until coexisting adrenal insufficiency is ruled out. Family physicians are in an important position to prevent myxedema coma by maintaining a high level of suspicion for hypothyroidism.

Models for Cometary Comae Containing Negative Ions

NASA Technical Reports Server (NTRS)

Cordiner, M. A.; Charnley, S. B.

2012-01-01

The presence of negative ions (anions) in cometary comae is known from Giotto mass spectrometry of IP/Halley. The anions O(-), OH(-), C(-), CH(-) and CN(-) have been detected, as well as unidentified anions with masses 22-65 and 85-110 amu [I]. Organic molecular anions such as C4H(-) and C6H(-) are known to have a significant impact on the charge balance of interstellar clouds and circumstellar envelopes and have been shown to act as catalysts for the gas phase synthesis of larger hydrocarbon molecules in the ISM, but their importance in cometary comae has not yet been fully explored. We present details of our new models for the chemistry of cometary comae that include atomic and molecular anions. We calculate the impact of these anions on the charge balance and examine their importance for cometary coma chemistry.

A Study of the Effects of Faint Dust Comae on the Spectra of Asteroids

NASA Astrophysics Data System (ADS)

Rondón, E.; Carvano, J.; Lorenz-Martins, S.

2017-09-01

The presence of dust comae on asteroids and centaurs is a phenomenon that became accepted in the last decades and which challenges the traditional definitions of asteroids and comets. A possible way of improving the chances of discovery of Active Asteroids is to use large multi-colour surveys or catalogs, like SDSS Moving Object Catalog. In this work we analyze the effects of faint dust comae on asteroid spectra and then use it to investigate the effects that a faint dust comae would have over the spectrum, magnitude, and radial profile of asteroids.

Balance of corneal horizontal coma by internal optics in eyes with intraocular artificial lenses: evidence of a passive mechanism.

PubMed

Marcos, Susana; Rosales, Patricia; Llorente, Lourdes; Barbero, Sergio; Jiménez-Alfaro, I

2008-01-01

It is well known that the aberrations of the cornea are partially compensated by the aberrations of the internal optics of the eye (primarily the crystalline lens) in young subjects. This effect has been found not only for the spherical aberration, but also for horizontal coma. It has been debated whether the compensation of horizontal coma is the result of passive mechanism [Artal, P., Benito, A., & Tabernero, J. (2006). The human eye is an example of robust optical design. Journal of Vision, 6 (1), 1-7] or through an active developmental feedback process [Kelly, J. E., Mihashi, T., & Howland, H. C. (2004). Compensation of corneal horizontal/vertical astigmatism, lateral coma, and spherical aberration by internal optics of the eye. Journal of Vision, 4 (4), 262-271]. In this study we investigate the active or passive nature of the horizontal coma compensation using eyes with artificial lenses, where no active developmental process can be present. We measured total and corneal aberrations, and lens tilt and decentration in a group of 38 eyes implanted with two types of intraocular lenses designed to compensate the corneal spherical aberration of the average population. We found that spherical aberration was compensated by 66%, and horizontal coma by 87% on average. The spherical aberration is not compensated at an individual level, but horizontal coma is compensated individually (coefficients of correlation corneal/internal aberration: -0.946, p<0.0001). The fact that corneal (but not total) horizontal coma is highly correlated with angle lamda (computed from the shift of the 1st Purkinje image from the pupil center, for foveal fixation) indicates that the compensation arises primarily from the geometrical configuration of the eye (which generates horizontal coma of opposite signs in the cornea and internal optics). The amount and direction of tilts and misalignments of the lens are comparable to those found in young eyes, and on average tend to compensate (rather than increase) horizontal coma. Computer simulations using customized model eyes and different designs of intraocular lenses show that, while not all designs produce a compensation of horizontal coma, a wide range of aspheric biconvex designs may produce comparable compensation to that found in young eyes with crystalline lenses, over a relatively large field of view. These findings suggest that the lens shape, gradient index or foveal location do not need to be fine-tuned to achieve a compensation of horizontal coma. Our results cannot exclude a fine-tuning for the orientation of the crystalline lens, since cataract surgery seems to preserve the position of the capsule.

Chemical and Hydrodynamical Models of Cometary Comae

NASA Technical Reports Server (NTRS)

Charnley, Steven

2012-01-01

Multi-fluid modelling of the outflowing gases which sublimate from cometary nuclei as they approach the Sun is necessary for understanding the important physical and chemical processes occurring in this complex plasma. Coma chemistry models can be employed to interpret observational data and to ultimately determine chemical composition and structure of the nuclear ices and dust. We describe a combined chemical and hydrodynamical model [1] in which differential equations for the chemical abundances and the energy balance are solved as a function of distance from the cometary nucleus. The presence of negative ions (anions) in cometary comae is known from Giotto mass spectrometry of 1P/Halley. The anions O(-), OH(-), C(-), CH(-) and CN(-) have been detected, as well as unidentified anions with masses 22-65 and 85-110 amu [2]. Organic molecular anions such as C4H(-) and C6H(-) are known to have a significant impact on the charge balance of interstellar clouds and circumstellar envelopes and have been shown to act as catalysts for the gas-phase synthesis of larger hydrocarbon molecules in the ISM, but their importance in cometary comae has not yet been fully explored. We present details of new models for the chemistry of cometary comae that include atomic and molecular anions and calculate the impact of these anions on the coma physics and chemistry af the coma.

Jet Morphology and Coma Analysis of Comet 103P/Hartley 2

NASA Astrophysics Data System (ADS)

Vaughan, Charles M.; Pierce, Donna M.; Cochran, Anita L.

2017-12-01

Spectral data for the coma of Hartley 2 were acquired across four nights in late 2010 using an integral field spectrometer at McDonald Observatory. For the 30 observations during these four nights, we detected five radical species in the coma: C2, C3, CH, CN, and NH2. Using division by azimuthal mean and division by radial profile, we enhanced 150 images of the coma to reveal subtle coma structure. These images revealed noticeable temporal evolution and spatial variations between species. To quantify the observed variation between species, we partitioned the coma and used analysis of variance (ANOVA) techniques to provide a statistical basis for heterogeneity. Nearly every ANOVA test indicated a spatially diverse distribution in the coma when considering all species collectively. To examine the temporal behavior, we used the works by Belton et al., Thomas et al., and Bruck Syal et al. to predict nucleus orientation and active jet directions at our observation times. Several of these reported jet sites correlated to high radical concentrations, and the sites on the smaller lobe are more closely associated with high radical concentrations. Lastly, we provide constraints for the suspect parent molecules of the detected radicals, and we propose that photolysis reactions occurring at or near extended icy grains are a source for the more enigmatic radicals, such as C3.

Central diabetes insipidus in pediatric severe traumatic brain injury.

PubMed

Alharfi, Ibrahim M; Stewart, Tanya Charyk; Foster, Jennifer; Morrison, Gavin C; Fraser, Douglas D

2013-02-01

To determine the occurrence rate of central diabetes insipidus in pediatric patients with severe traumatic brain injury and to describe the clinical, injury, biochemical, imaging, and intervention variables associated with mortality. Retrospective chart and imaging review. Children's Hospital, level 1 trauma center. Severely injured (Injury Severity Score ≥ 12) pediatric trauma patients (>1 month and <18 yr) with severe traumatic brain injury (presedation Glasgow Coma Scale ≤ 8 and head Maximum Abbreviated Injury Scale ≥ 4) that developed acute central diabetes insipidus between January 2000 and December 2011. Of 818 severely injured trauma patients, 180 had severe traumatic brain injury with an overall mortality rate of 27.2%. Thirty-two of the severe traumatic brain injury patients developed acute central diabetes insipidus that responded to desamino-8-D-arginine vasopressin and/or vasopressin infusion, providing an occurrence rate of 18%. At the time of central diabetes insipidus diagnosis, median urine output and serum sodium were 6.8 ml/kg/hr (interquartile range = 5-11) and 154 mmol/L (interquartile range = 149-159), respectively. The mortality rate of central diabetes insipidus patients was 87.5%, with 71.4% declared brain dead after central diabetes insipidus diagnosis. Early central diabetes insipidus onset, within the first 2 days of severe traumatic brain injury, was strongly associated with mortality (p < 0.001), as were a lower presedation Glasgow Coma Scale (p = 0.03), a lower motor Glasgow Coma Scale (p = 0.01), an occurrence of fixed pupils (p = 0.04), and a prolonged partial thromboplastin time (p = 0.04). Cerebral edema on the initial computed tomography, obtained in the first 24 hrs after injury, was the only imaging finding associated with death (p = 0.002). Survivors of central diabetes insipidus were more likely to have intracranial pressure monitoring (p = 0.03), have thiopental administered to induce coma (p = 0.04) and have received a decompressive craniectomy for elevated intracranial pressure (p = 0.04). The incidence of central diabetes insipidus in pediatric patients with severe traumatic brain injury is 18%. Mortality was associated with early central diabetes insipidus onset and cerebral edema on head computed tomography. Central diabetes insipidus nonsurvivors were less likely to have received intracranial pressure monitoring, thiopental coma and decompressive craniectomy.

Intranasal post-cardiac arrest treatment with orexin-A facilitates arousal from coma and ameliorates neuroinflammation.

PubMed

Modi, Hiren R; Wang, Qihong; Gd, Sahithi; Sherman, David; Greenwald, Elliot; Savonenko, Alena V; Geocadin, Romergryko G; Thakor, Nitish V

2017-01-01

Cardiac arrest (CA) entails significant risks of coma resulting in poor neurological and behavioral outcomes after resuscitation. Significant subsequent morbidity and mortality in post-CA patients are largely due to the cerebral and cardiac dysfunction that accompanies prolonged whole-body ischemia post-CA syndrome (PCAS). PCAS results in strong inflammatory responses including neuroinflammation response leading to poor outcome. Currently, there are no proven neuroprotective therapies to improve post-CA outcomes apart from therapeutic hypothermia. Furthermore, there are no acceptable approaches to promote cortical or cognitive arousal following successful return of spontaneous circulation (ROSC). Hypothalamic orexinergic pathway is responsible for arousal and it is negatively affected by neuroinflammation. However, whether activation of the orexinergic pathway can curtail neuroinflammation is unknown. We hypothesize that targeting the orexinergic pathway via intranasal orexin-A (ORXA) treatment will enhance arousal from coma and decrease the production of proinflammatory cytokines resulting in improved functional outcome after resuscitation. We used a highly validated CA rat model to determine the effects of intranasal ORXA treatment 30-minute post resuscitation. At 4hrs post-CA, the mRNA levels of proinflammatory markers (IL1β, iNOS, TNF-α, GFAP, CD11b) and orexin receptors (ORX1R and ORX2R) were examined in different brain regions. CA dramatically increased proinflammatory markers in all brain regions particularly in the prefrontal cortex, hippocampus and hypothalamus. Post-CA intranasal ORXA treatment significantly ameliorated the CA-induced neuroinflammatory markers in the hypothalamus. ORXA administration increased production of orexin receptors (ORX1R and ORX2R) particularly in hypothalamus. In addition, ORXA also resulted in early arousal as measured by quantitative electroencephalogram (EEG) markers, and recovery of the associated behavioral neurologic deficit scale score (NDS). Our results indicate that intranasal delivery of ORXA post-CA has an anti-inflammatory effect and accelerates cortical EEG and behavioral recovery. Beneficial outcomes from intranasal ORXA treatment lay the groundwork for therapeutic clinical approach to treating post-CA coma.

Electron impact excitation of carbon monoxide in comet Hale-Bopp

NASA Astrophysics Data System (ADS)

Campbell, L.; Brunger, M. J.

2009-02-01

The fourth positive emissions of carbon monoxide in the coma of comet Hale-Bopp have been assumed to be due mainly to fluorescence induced by sunlight. Based on this assumption they were used to deduce the abundance of carbon monoxide in the comet, giving a value higher than in other comets. Emissions produced by electron impact excitation of CO were not considered. Recent measurements and theoretical calculations of integral cross sections for electron impact excitation of CO allow the contribution of electron impact to be calculated, giving about 40% of the total. This implies that the abundance of CO in the outer coma of comet Hale-Bopp was only 60% of that previously deduced. However, as the high proportion of CO in comet Hale-Bopp was also seen in some other measurements, alternative explanations are considered. The method of calculation is tested by successfully predicting the O I emission at 1356 Å, supporting the belief that this line is due to electron impact excitation.

[Post-traumatic coma and pre-traumatic memory].

PubMed

Malacrida, R; Piazza, J; Abraham, G

1990-01-01

Instead of thinking that it is impossible to enter in the internal world of a comatose patient, we are now put before a new and encouraging prospective, that of the possibility, even though minimal, of influencing the vital residual organisation of the patient and to induce him perhaps to accept again external stimulations, which previously were too intense. As loss of conscience often causes loss of memory, our intention was to examine the problem of memory loss in comatose patients after accidents. The analysis of 50 questionnaires distributed to trauma-patients awakening from a comatose state and interviews give clear indications that: 1) the patients remember absolutely nothing during the time of the coma; 2) in the majority of cases (34) the patients remember in the moment preceding the accident a clear autodestructive tendency especially if they were the cause of the accident; and 3) almost all patients (41) agree to have benefited greatly from the trauma itself and from its memory.

Comet 81p/Wild 2: The Updated Stardust Coma Dust Fluence Measurement for Smaller (Sub 10-Micrometre) Particles

NASA Technical Reports Server (NTRS)

Price, M. C.; Kearsley, A. T.; Burchell, M. J.; Horz, Friedrich; Cole, M. J.

2009-01-01

Micrometre and smaller scale dust within cometary comae can be observed by telescopic remote sensing spectroscopy [1] and the particle size and abundance can be measured by in situ spacecraft impact detectors [2]. Initial interpretation of the samples returned from comet 81P/Wild 2 by the Stardust spacecraft [3] appears to show that very fine dust contributes not only a small fraction of the solid mass, but is also relatively sparse [4], with a low negative power function describing grain size distribution, contrasting with an apparent abundance indicated by the on-board Dust Flux Monitor Instrument (DFMI) [5] operational during the encounter. For particles above 10 m diameter there is good correspondence between results from the DFMI and the particle size inferred from experimental calibration [6] of measured aerogel track and aluminium foil crater dimensions (as seen in Figure 4 of [4]). However, divergence between data-sets becomes apparent at smaller sizes, especially submicrometre, where the returned sample data are based upon location and measurement of tiny craters found by electron microscopy of Al foils. Here effects of detection efficiency tail-off at each search magnification can be seen in the down-scale flattening of each scale component, but are reliably compensated by sensible extrapolation between segments. There is also no evidence of malfunction in the operation of DFMI during passage through the coma (S. Green, personal comm.), so can the two data sets be reconciled?

Asymmetric Spherical Coupled Escape Probability: Model and Results for Optically Thick Cometary Comae

NASA Astrophysics Data System (ADS)

Gersch, Alan; A'Hearn, M. F.

2012-05-01

We have adapted the Coupled Escape Probability method of radiative transfer calculations for use in asymmetrical spherical situations and applied it to modeling molecular emission spectra of potentially optically thick cometary comae. Recent space missions (e.g. Deep Impact & EPOXI) have provided spectra from comets of unprecedented spatial resolution of the regions of the coma near the nucleus, where the coma may be optically thick. Currently active missions (e.g. Rosetta) and hopefully more in the future will continue the trend and demonstrate the need for better modeling of comae with optical depth effects included. Here we present a brief description of our model and results of interest for cometary studies, especially for space based observations. Although primarily motivated by the need for comet modeling, our (asymmetric spherical) radiative transfer model could be used for studying other astrophysical phenomena as well.

Cometary science. Time variability and heterogeneity in the coma of 67P/Churyumov-Gerasimenko.

PubMed

Hässig, M; Altwegg, K; Balsiger, H; Bar-Nun, A; Berthelier, J J; Bieler, A; Bochsler, P; Briois, C; Calmonte, U; Combi, M; De Keyser, J; Eberhardt, P; Fiethe, B; Fuselier, S A; Galand, M; Gasc, S; Gombosi, T I; Hansen, K C; Jäckel, A; Keller, H U; Kopp, E; Korth, A; Kührt, E; Le Roy, L; Mall, U; Marty, B; Mousis, O; Neefs, E; Owen, T; Rème, H; Rubin, M; Sémon, T; Tornow, C; Tzou, C-Y; Waite, J H; Wurz, P

2015-01-23

Comets contain the best-preserved material from the beginning of our planetary system. Their nuclei and comae composition reveal clues about physical and chemical conditions during the early solar system when comets formed. ROSINA (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) onboard the Rosetta spacecraft has measured the coma composition of comet 67P/Churyumov-Gerasimenko with well-sampled time resolution per rotation. Measurements were made over many comet rotation periods and a wide range of latitudes. These measurements show large fluctuations in composition in a heterogeneous coma that has diurnal and possibly seasonal variations in the major outgassing species: water, carbon monoxide, and carbon dioxide. These results indicate a complex coma-nucleus relationship where seasonal variations may be driven by temperature differences just below the comet surface. Copyright © 2015, American Association for the Advancement of Science.

A Case of Myxedema Coma Presenting as a Brain Stem Infarct in a 74-Year-Old Korean Woman

PubMed Central

Ahn, Ji Yun; Kwon, Hyuk-Sool; Ahn, Hee Chol

2010-01-01

Myxedema coma is the extreme form of untreated hypothyroidism. In reality, few patients present comatose with severe myxedema. We describe a patient with myxedema coma which was initially misdiagnosed as a brain stem infarct. She presented to the hospital with alteration of the mental status, generalized edema, hypothermia, hypoventilation, and hypotension. Initially her brain stem reflexes were absent. After respiratory and circulatory support, her neurologic status was not improved soon. The diagnosis of myxedema coma was often missed or delayed due to various clinical findings and concomitant medical condition and precipitating factors. It is more difficult to diagnose when a patient has no medical history of hypothyroidism. A high index of clinical suspicion can make a timely diagnosis and initiate appropriate treatment. We report this case to alert clinicians considering diagnosis of myxedema coma in patients with severe decompensated metabolic state including mental change. PMID:20808690

A case of myxedema coma presenting as a brain stem infarct in a 74-year-old Korean woman.

PubMed

Ahn, Ji Yun; Kwon, Hyuk-Sool; Ahn, Hee Chol; Sohn, You Dong

2010-09-01

Myxedema coma is the extreme form of untreated hypothyroidism. In reality, few patients present comatose with severe myxedema. We describe a patient with myxedema coma which was initially misdiagnosed as a brain stem infarct. She presented to the hospital with alteration of the mental status, generalized edema, hypothermia, hypoventilation, and hypotension. Initially her brain stem reflexes were absent. After respiratory and circulatory support, her neurologic status was not improved soon. The diagnosis of myxedema coma was often missed or delayed due to various clinical findings and concomitant medical condition and precipitating factors. It is more difficult to diagnose when a patient has no medical history of hypothyroidism. A high index of clinical suspicion can make a timely diagnosis and initiate appropriate treatment. We report this case to alert clinicians considering diagnosis of myxedema coma in patients with severe decompensated metabolic state including mental change.

The origin of low mass particles within and beyond the dust coma envelopes of Comet Halley

NASA Technical Reports Server (NTRS)

Simpson, J. A.; Rabinowitz, D.; Tuzzolino, A. J.; Ksanfomality, L. V.; Sagdeev, R. Z.

1987-01-01

Measurements from the Dust Counter and Mass Analyzer (DUCMA) instruments on VEGA-1 and -2 revealed unexpected fluxes of low mass (up to 10 to the minus 13th power g) dust particles at very great distances from the nucleus (300,000 to 600,000 km). These particles are detected in clusters (10 sec duration), preceded and followed by relatively long time intervals during which no dust is detected. This cluster phenomenon also occurs inside the envelope boundaries. Clusters of low mass particles are intermixed with the overall dust distribution throughout the coma. The clusters account for many of the short-term small-scale intensity enhancements previously ascribed to microjets in the coma. The origin of these clusters appears to be emission from the nucleus of large conglomerates which disintegrate in the coma to yield clusters of discrete, small particles continuing outward to the distant coma.

[Prognostic value of EEG in acute posttraumatic coma (author's transl)].

PubMed

Walser, H; Friedli, W; Glinz, W

1981-12-01

To evaluate the prognostic power of a single EEG-record, the recordings of 50 patients with posttraumatic coma performed within 48 hours after the injury were compared with the outcome after 6 months. A 5-point scale comprising 2 EEG-patterns being notorious for their dismal prognostic significance (suppression bursts, alpha-coma) and changes of vigilance were used as a mean of visual assessment of the recordings. In 24 out of the 28 patients with a bad outcome, the EEG had shown the patterns of category I, II and III (suppression bursts, alpha coma, no changes of vigilance). Of the 22 patients with a good outcome, the EEG had been classified as IV or V (clearly discernible changes of vigilance, sleep patterns). Further findings of particular dismal prognostic significance were focal epileptic discharges, as 9 out of the 11 patients with this EEG pattern had not survived the posttraumatic coma for more than 6 months.

Streaming Clumps Ejection Model and the Heterogeneous Inner Coma of Comet Wild 2

NASA Technical Reports Server (NTRS)

Clark, B. C.; Economou, T. E.; Green, S. F.; Sandford, S. A.; Zolensky, M. E.

2004-01-01

The conventional concept of cometary comae is that they are dominated by fine particulates released individually by sublimation of surface volatiles and subsequent entrainment in the near-surface gas. It has long been recognized that such particulates could be relatively large, with early estimates that objects perhaps up to one meter in size may be levitated from the surface of the typical cometary nucleus. However, the general uniformity and small average particulate size of observed comae and the relatively smooth, monotonic increases and decreases in particle density during the Giotto flythrough of comet Halley s coma in 1986 reinforced the view that the bulk of the particles are released at the surface, are fine-sized and inert. Jets have been interpreted as geometrically constrained release of these particulates. With major heterogeneities observed during the recent flythrough of the inner coma of comet Wild 2, these views deserve reconsideration.

The distribution of early- and late-type galaxies in the Coma cluster

NASA Technical Reports Server (NTRS)

Doi, M.; Fukugita, M.; Okamura, S.; Turner, E. L.

1995-01-01

The spatial distribution and the morohology-density relation of Coma cluster galaxies are studied using a new homogeneous photmetric sample of 450 galaxies down to B = 16.0 mag with quantitative morphology classification. The sample covers a wide area (10 deg X 10 deg), extending well beyond the Coma cluster. Morphological classifications into early- (E+SO) and late-(S) type galaxies are made by an automated algorithm using simple photometric parameters, with which the misclassification rate is expected to be approximately 10% with respect to early and late types given in the Third Reference Catalogue of Bright Galaxies. The flattened distribution of Coma cluster galaxies, as noted in previous studies, is most conspicuously seen if the early-type galaxies are selected. Early-type galaxies are distributed in a thick filament extended from the NE to the WSW direction that delineates a part of large-scale structure. Spiral galaxies show a distribution with a modest density gradient toward the cluster center; at least bright spiral galaxies are present close to the center of the Coma cluster. We also examine the morphology-density relation for the Coma cluster including its surrounding regions.

Origins of ultra-diffuse galaxies in the Coma cluster - I. Constraints from velocity phase-space

NASA Astrophysics Data System (ADS)

Alabi, Adebusola; Ferré-Mateu, Anna; Romanowsky, Aaron J.; Brodie, Jean; Forbes, Duncan A.; Wasserman, Asher; Bellstedt, Sabine; Martín-Navarro, Ignacio; Pandya, Viraj; Stone, Maria B.; Okabe, Nobuhiro

2018-06-01

We use Keck/DEIMOS spectroscopy to confirm the cluster membership of 16 ultra-diffuse galaxies (UDGs) in the Coma cluster, bringing the total number of spectroscopically confirmed UDGs from the Yagi et al. (Y16) catalog to 25. We also identify a new cluster background UDG, confirming that most (˜95 per cent) of the UDGs in the Y16 catalog belong to the Coma cluster. In this pilot study of Coma UDGs in velocity phase-space, we find evidence of a diverse origin for Coma cluster UDGs, similar to normal dwarf galaxies. Some UDGs in our sample are consistent with being late infalls into the cluster environment while some may have been in the cluster for ≥8 Gyr. The late infallen UDGs have higher absolute relative line-of-sight velocities, bluer optical colors, and within the projected cluster core, are smaller in size, compared to the early infalls. The early infall UDGs, which may also have formed in-situ, have been in the cluster environment for as long as the most luminous galaxies in the Coma cluster and they may be failed galaxies which experienced star formation quenching at earlier epochs.

Abundant molecular oxygen in the coma of comet 67P/Churyumov-Gerasimenko.

PubMed

Bieler, A; Altwegg, K; Balsiger, H; Bar-Nun, A; Berthelier, J-J; Bochsler, P; Briois, C; Calmonte, U; Combi, M; De Keyser, J; van Dishoeck, E F; Fiethe, B; Fuselier, S A; Gasc, S; Gombosi, T I; Hansen, K C; Hässig, M; Jäckel, A; Kopp, E; Korth, A; Le Roy, L; Mall, U; Maggiolo, R; Marty, B; Mousis, O; Owen, T; Rème, H; Rubin, M; Sémon, T; Tzou, C-Y; Waite, J H; Walsh, C; Wurz, P

2015-10-29

The composition of the neutral gas comas of most comets is dominated by H2O, CO and CO2, typically comprising as much as 95 per cent of the total gas density. In addition, cometary comas have been found to contain a rich array of other molecules, including sulfuric compounds and complex hydrocarbons. Molecular oxygen (O2), however, despite its detection on other icy bodies such as the moons of Jupiter and Saturn, has remained undetected in cometary comas. Here we report in situ measurement of O2 in the coma of comet 67P/Churyumov-Gerasimenko, with local abundances ranging from one per cent to ten per cent relative to H2O and with a mean value of 3.80 ± 0.85 per cent. Our observations indicate that the O2/H2O ratio is isotropic in the coma and does not change systematically with heliocentric distance. This suggests that primordial O2 was incorporated into the nucleus during the comet's formation, which is unexpected given the low upper limits from remote sensing observations. Current Solar System formation models do not predict conditions that would allow this to occur.

Local cortical dynamics of burst suppression in the anaesthetized brain.

PubMed

Lewis, Laura D; Ching, Shinung; Weiner, Veronica S; Peterfreund, Robert A; Eskandar, Emad N; Cash, Sydney S; Brown, Emery N; Purdon, Patrick L

2013-09-01

Burst suppression is an electroencephalogram pattern that consists of a quasi-periodic alternation between isoelectric 'suppressions' lasting seconds or minutes, and high-voltage 'bursts'. It is characteristic of a profoundly inactivated brain, occurring in conditions including hypothermia, deep general anaesthesia, infant encephalopathy and coma. It is also used in neurology as an electrophysiological endpoint in pharmacologically induced coma for brain protection after traumatic injury and during status epilepticus. Classically, burst suppression has been regarded as a 'global' state with synchronous activity throughout cortex. This assumption has influenced the clinical use of burst suppression as a way to broadly reduce neural activity. However, the extent of spatial homogeneity has not been fully explored due to the challenges in recording from multiple cortical sites simultaneously. The neurophysiological dynamics of large-scale cortical circuits during burst suppression are therefore not well understood. To address this question, we recorded intracranial electrocorticograms from patients who entered burst suppression while receiving propofol general anaesthesia. The electrodes were broadly distributed across cortex, enabling us to examine both the dynamics of burst suppression within local cortical regions and larger-scale network interactions. We found that in contrast to previous characterizations, bursts could be substantially asynchronous across the cortex. Furthermore, the state of burst suppression itself could occur in a limited cortical region while other areas exhibited ongoing continuous activity. In addition, we found a complex temporal structure within bursts, which recapitulated the spectral dynamics of the state preceding burst suppression, and evolved throughout the course of a single burst. Our observations imply that local cortical dynamics are not homogeneous, even during significant brain inactivation. Instead, cortical and, implicitly, subcortical circuits express seemingly different sensitivities to high doses of anaesthetics that suggest a hierarchy governing how the brain enters burst suppression, and emphasize the role of local dynamics in what has previously been regarded as a global state. These findings suggest a conceptual shift in how neurologists could assess the brain function of patients undergoing burst suppression. First, analysing spatial variation in burst suppression could provide insight into the circuit dysfunction underlying a given pathology, and could improve monitoring of medically-induced coma. Second, analysing the temporal dynamics within a burst could help assess the underlying brain state. This approach could be explored as a prognostic tool for recovery from coma, and for guiding treatment of status epilepticus. Overall, these results suggest new research directions and methods that could improve patient monitoring in clinical practice.

Wave aberrations in rhesus monkeys with vision-induced ametropias

PubMed Central

Ramamirtham, Ramkumar; Kee, Chea-su; Hung, Li-Fang; Qiao-Grider, Ying; Huang, Juan; Roorda, Austin; Smith, Earl L.

2007-01-01

The purpose of this study was to investigate the relationship between refractive errors and high-order aberrations in infant rhesus monkeys. Specifically, we compared the monochromatic wave aberrations measured with a Shack-Hartman wavefront sensor between normal monkeys and monkeys with vision-induced refractive errors. Shortly after birth, both normal monkeys and treated monkeys reared with optically induced defocus or form deprivation showed a decrease in the magnitude of high-order aberrations with age. However, the decrease in aberrations was typically smaller in the treated animals. Thus, at the end of the lens-rearing period, higher than normal amounts of aberrations were observed in treated eyes, both hyperopic and myopic eyes and treated eyes that developed astigmatism, but not spherical ametropias. The total RMS wavefront error increased with the degree of spherical refractive error, but was not correlated with the degree of astigmatism. Both myopic and hyperopic treated eyes showed elevated amounts of coma and trefoil and the degree of trefoil increased with the degree of spherical ametropia. Myopic eyes also exhibited a much higher prevalence of positive spherical aberration than normal or treated hyperopic eyes. Following the onset of unrestricted vision, the amount of high-order aberrations decreased in the treated monkeys that also recovered from the experimentally induced refractive errors. Our results demonstrate that high-order aberrations are influenced by visual experience in young primates and that the increase in high-order aberrations in our treated monkeys appears to be an optical byproduct of the vision-induced alterations in ocular growth that underlie changes in refractive error. The results from our study suggest that the higher amounts of wave aberrations observed in ametropic humans are likely to be a consequence, rather than a cause, of abnormal refractive development. PMID:17825347

Coma morphology of comet 67P controlled by insolation over irregular nucleus

NASA Astrophysics Data System (ADS)

Shi, X.; Hu, X.; Mottola, S.; Sierks, H.; Keller, H. U.; Rose, M.; Güttler, C.; Fulle, M.; Fornasier, S.; Agarwal, J.; Pajola, M.; Tubiana, C.; Bodewits, D.; Barbieri, C.; Lamy, P. L.; Rodrigo, R.; Koschny, D.; Barucci, M. A.; Bertaux, J.-L.; Bertini, I.; Boudreault, S.; Cremonese, G.; Da Deppo, V.; Davidsson, B.; Debei, S.; De Cecco, M.; Deller, J.; Groussin, O.; Gutiérrez, P. J.; Hviid, S. F.; Ip, W.-H.; Jorda, L.; Knollenberg, J.; Kovacs, G.; Kramm, J.-R.; Kührt, E.; Küppers, M.; Lara, L. M.; Lazzarin, M.; Lopez-Moreno, J. J.; Marzari, F.; Naletto, G.; Oklay, N.; Toth, I.; Vincent, J.-B.

2018-05-01

While the structural complexity of cometary comae is already recognizable from telescopic observations1, the innermost region, within a few radii of the nucleus, was not resolved until spacecraft exploration became a reality2,3. The dust coma displays jet-like features of enhanced brightness superposed on a diffuse background1,4,5. Some features can be traced to specific areas on the nucleus, and result conceivably from locally enhanced outgassing and/or dust emission6-8. However, diffuse or even uniform activity over topographic concavity can converge to produce jet-like features9,10. Therefore, linking observed coma morphology to the distribution of activity on the nucleus is difficult11,12. Here, we study the emergence of dust activity at sunrise on comet 67P/Churyumov-Gerasimenko using high-resolution, stereo images from the OSIRIS camera onboard the Rosetta spacecraft, where the sources and formation of the jet-like features are resolved. We perform numerical simulations to show that the ambient dust coma is driven by pervasive but non-uniform water outgassing from the homogeneous surface layer. Physical collimations of gas and dust flows occur at local maxima of insolation and also via topographic focusing. Coma structures are projected to exhibit jet-like features that vary with the perspective of the observer. For an irregular comet such as 67P/Churyumov-Gerasimenko, near-nucleus coma structures can be concealed in the shadow of the nucleus, which further complicates the picture.

MMN and novelty P3 in coma and other altered states of consciousness: a review.

PubMed

Morlet, Dominique; Fischer, Catherine

2014-07-01

In recent decades, there has been a growing interest in the assessment of patients in altered states of consciousness. There is a need for accurate and early prediction of awakening and recovery from coma. Neurophysiological assessment of coma was once restricted to brainstem auditory and primary cortex somatosensory evoked potentials elicited in the 30 ms range, which have both shown good predictive value for poor coma outcome only. In this paper, we review how passive auditory oddball paradigms including deviant and novel sounds have proved their efficiency in assessing brain function at a higher level, without requiring the patient's active involvement, thus providing an enhanced tool for the prediction of coma outcome. The presence of an MMN in response to deviant stimuli highlights preserved automatic sensory memory processes. Recorded during coma, MMN has shown high specificity as a predictor of recovery of consciousness. The presence of a novelty P3 in response to the subject's own first name presented as a novel (rare) stimulus has shown a good correlation with coma awakening. There is now a growing interest in the search for markers of consciousness, if there are any, in unresponsive patients (chronic vegetative or minimally conscious states). We discuss the different ERP patterns observed in these patients. The presence of novelty P3, including parietal components and possibly followed by a late parietal positivity, raises the possibility that some awareness processes are at work in these unresponsive patients.

MMN and Novelty P3 in Coma and Other Altered States of Consciousness: A Review

PubMed Central

Morlet, Dominique; Fischer, Catherine

2014-01-01

In recent decades, there has been a growing interest in the assessment of patients in altered states of consciousness. There is a need for accurate and early prediction of awakening and recovery from coma. Neurophysiological assessment of coma was once restricted to brainstem auditory and primary cortex somatosensory evoked potentials elicited in the thirty millisecond range, which have both shown good predictive value for poor coma outcome only. In this paper, we review how passive auditory oddball paradigms including deviant and novel sounds have proved their efficiency in assessing brain function at a higher level, without requiring the patient’s active involvement, thus providing an enhanced tool for the prediction of coma outcome. The presence of an MMN in response to deviant stimuli highlights preserved automatic sensory memory processes. Recorded during coma, MMN has shown high specificity as a predictor of recovery of consciousness. The presence of a novelty P3 in response to the subject’s own first name presented as a novel (rare) stimulus has shown a good correlation with coma awakening. There is now a growing interest in the search for markers of consciousness, if there are any, in unresponsive patients (chronic vegetative or minimally conscious states). We discuss the different ERP patterns observed in these patients. The presence of novelty P3, including parietal components and possibly followed by a late parietal positivity, raises the possibility that some awareness processes are at work in these unresponsive patients. PMID:24281786

A new method to detect and correct sample tilt in scanning transmission electron microscopy bright-field imaging.

PubMed

Brown, H G; Ishikawa, R; Sánchez-Santolino, G; Lugg, N R; Ikuhara, Y; Allen, L J; Shibata, N

2017-02-01

Important properties of functional materials, such as ferroelectric shifts and octahedral distortions, are associated with displacements of the positions of lighter atoms in the unit cell. Annular bright-field scanning transmission electron microscopy is a good experimental method for investigating such phenomena due to its ability to image light and heavy atoms simultaneously. To map atomic positions at the required accuracy precise angular alignment of the sample with the microscope optical axis is necessary, since misalignment (tilt) of the specimen contributes to errors in position measurements of lighter elements in annular bright-field imaging. In this paper it is shown that it is possible to detect tilt with the aid of images recorded using a central bright-field detector placed within the inner radius of the annular bright-field detector. For a probe focus near the middle of the specimen the central bright-field image becomes especially sensitive to tilt and we demonstrate experimentally that misalignment can be detected with a precision of less than a milliradian, as we also confirm in simulation. Coma in the probe, an aberration that can be misidentified as tilt of the specimen, is also investigated and it is shown how the effects of coma and tilt can be differentiated. The effects of tilt may be offset to a large extent by shifting the diffraction plane detector an amount equivalent to the specimen tilt and we provide an experimental proof of principle of this using a segmented detector system. Copyright © 2016 Elsevier B.V. All rights reserved.

Predictors of Stroke and Coma After Neurosurgery: An ACS-NSQIP Analysis.

PubMed

Larsen, Alexandra M G; Cote, David J; Karhade, Aditya V; Smith, Timothy R

2016-09-01

The American College of Surgeons National Surgical Quality Improvement Program database aims to reduce 30-day postoperative complications. Reduction of postoperative stroke and coma can decrease length and cost of hospitalization, improve patient functional status, and decrease morbidity and mortality. We performed a search of the American College of Surgeons National Surgical Quality Improvement Program database for all patients from 2006 to 2013 undergoing an operation with a surgeon whose primary specialty was neurologic surgery. Of 94,546 neurosurgical patients reported, there were 687 (0.73%) cases of postoperative stroke and coma. The annual rate of coma longer than 24 hours decreased from 0.90% in 2006 to 0.002% in 2013 (P < 0.001), and the annual rate of stroke decreased from 1.2% in 2006 to 0.5% in 2013 (P = 0.013). Multivariate analysis showed that inpatient status (P = 0.001; odds ratio [OR], 30.3), age (P = 0.005; OR, 1.012), history of diabetes (P = 0.017; OR, 1.515), ventilator dependence (P < 0.001; OR, 4.379), impaired sensorium (P < 0.001; OR, 2.314), history of coma longer than 24 hours (P < 0.001; OR, 2.655), hemiparesis (P = 0.022; OR, 1.492), cerebrovascular accident/stroke with neurologic deficit (P < 0.001; OR, 2.091), cerebrovascular accident/stroke without neurologic deficit (P = 0.001; OR, 2.44), and tumor involving central nervous system (P < 0.001; OR, 2.928) are significant risk factors for developing postneurosurgical stroke and coma. The rate of postneurosurgical stroke decreased from 1.2% in 2006 to 0.5% in 2013 and the rate of postneurosurgical coma greater than 24 hours decreased from 0.9% in 2006 to 0.002% in 2013. Ten risk factors for developing postneurosurgical stroke and coma were identified using multivariable analysis. These risk factors should be assessed preoperatively and incorporated into clinical decision making so that individuals who are at higher risk for the development of stroke and coma can be appropriately monitored during the postoperative period. Copyright © 2016 Elsevier Inc. All rights reserved.

Experimental Concussion

PubMed Central

Brown, W. Jann; Yoshida, N.; Canty, T.; Verity, M. Anthony

1972-01-01

Ultrastructural and biochemical alterations were studied in the brainstem reticular formation of animals in which transient coma had been induced by controlled blows to the head. After a period of 7-10 days, animals that did not show obvious injury were artificially respired and sacrificed by perfusion with buffered formalin and glutaraldehyde. Histochemistry and light microscopy revealed chromatolysis of 10-15% of the neurons of pertinent segments of the nucleus giganto cellularis. There was much PAS-positive, diastase-sensitive material in the associated neuropil. Electron miscroscopy of the region confirmed the polysaccharide accumulation in dendrites, presynaptic boutons and preterminal axons. Similar material was found in some astrocytes. A longitudinal microchemical investigation with suitable controls of glycogen concentration in the brainstem demonstrated peak values at 5-7 days after concussion. No significant change in phosphorylase activity was demonstrated. The significance of glycogen accumulation in postconcussive injury and possible mechanisms for its accumulation in relation to changes in electrolyte balance and alterations in Kreb's cycle intermediates are discussed. ImagesFig 9Fig 10Fig 1Fig 2Fig 3Fig 11Fig 4Fig 5Fig 6Fig 7Fig 8 PMID:5045878

Yellow fever

MedlinePlus

... the heart, liver, and kidney. Bleeding disorders, seizures, coma, and delirium may also occur. Symptoms may include: ... heartbeats (arrhythmias) Bleeding (may progress to hemorrhage) Seizures Coma

[Myxedema coma. A case reported].

PubMed

Rebollo-Gómez, Héctor

2010-01-01

Myxedema coma is a life-threatening condition; it is a complication of untreated hypothyroidism and an endocrine emergency. Most patients are elderly women with a previous history of long-standing hypothyroidism which presents during the winter. The myxedema coma has an insidious onset and it is very rare; its recognition can be quite difficult. Once suspected, treatment can be lifesaving and should be start promptly in anticipation of confirmation of the diagnosis by laboratory test. The mortality rate is high. I presented a case of an old woman with myxedema coma with an undiagnosed hypothyroidism, with altered mental status, normal temperature, pneumonia, hyponatremia and high level of creatine phosphokinase, who presented in the emergency room.

A CO2-rich coma model applied to the neutral coma of Comet West

NASA Technical Reports Server (NTRS)

Mitchell, G. F.; Swift, M. B.; Huntress, W. T.

1982-01-01

Models of the cometary coma in which the dominant volatile is CO2 have been constructed for a range of heliocentric distances. Model coma abundances of C2, C3, and CN are compared with the abundances observed in Comet West and are found to be in good agreement. Furthermore, the variation with heliocentric distance of C2, C3, and CN model abundances agree well with the observed variation in Comet West. The present work lends detailed support to a previous suggestion that a substance more volatile than water, such as CO2, controls the evaporation of the nucleus of Comet West. The implications for cometary formation are briefly discussed.

The dust distribution within the inner coma of comet P/Halley 1982i - Encounter by Giotto's impact detectors

NASA Technical Reports Server (NTRS)

Mcdonnell, J. A. M.; Evans, G. C.; Evans, S. T.; Alexander, W. M.; Burton, W. M.; Firth, J. G.; Bussoletti, E.; Grard, R. J. L.; Hanner, M. S.; Sekanina, Z.

1987-01-01

Analyses are presented of Giotto's Dust Impact Detection System experiment measurements of dust grains incident on the Giotto dust shield along its trajectory through the coma of comet P/Halley on March 13 and 14, 1986. Ground-based CCD imagery of the inner coma dust continuum at the time of the encounter are used to derive the area of grains intercepted by Giotto. Data obtained at large masses show clear evidence of a decrease in the mass distribution index at these masses within the coma; it is shown that such a value of the mass index can furnish sufficient mass for consistency with an observed deceleration.

Theophylline-Induced Seizures: Clinical and Pathophysiologic Aspects

PubMed Central

Nakada, Tsutomu; Kwee, Ingrid L.; Lerner, Alfred M.; Remler, Michael P.

1983-01-01

The clinical features and management of theophylline-induced seizures are not well appreciated in spite of their unique aspects. These seizures tend to occur in neurologically intact patients and leave no or only minor neurologic sequelae if controlled early. They begin with focal motor seizures with or without secondary generalization and are followed by stupor or coma. They are responsive only to adjustment of theophylline dosage. Should the motor phenomenon persist, it takes the form of epilepsia partialis continua. Extensive workup for a structural brain lesion may be unrewarding. The electroencephalogram typically shows periodic lateralized epileptiform discharges, which may provide a diagnostic clue. PMID:6858124

Fatal encephalopathy after an isolated overdose of cocaine

PubMed Central

Kondziella, D; Danielsen, E R; Arlien-Soeborg, P

2009-01-01

Cocaine induced brain damage can be divided into primary neurotoxic effects causing toxic encephalopathy, secondary effects of compromised cerebral blood flow in ischaemic and haemorrhagic stroke, cerebral vasculitis and vasospasm, and tertiary effects due to hypoxia as a result of cardiopulmonary collapse. Toxic leucoencephalopathy mainly affects white matter (WM) tracts serving higher cerebral function, thereby leading to altered personality, attention deficits and memory impairment in mild cases and to dementia, coma and brain death in severe cases. Here we describe the case of a 21-year-old man who committed suicide by injecting cocaine. The cocaine induced a toxic leucoencephalopathy, which was proven at autopsy. PMID:21731586

Dynamic accommodation with simulated targets blurred with high order aberrations

PubMed Central

Gambra, Enrique; Wang, Yinan; Yuan, Jing; Kruger, Philip B.; Marcos, Susana

2010-01-01

High order aberrations have been suggested to play a role in determining the direction of accommodation. We have explored the effect of retinal blur induced by high order aberrations on dynamic accommodation by measuring the accommodative response to sinusoidal variations in accommodative demand (1–3 D). The targets were blurred with 0.3 and 1 μm (for a 3-mm pupil) of defocus, coma, trefoil and spherical aberration. Accommodative gain decreased significantly when 1-μm of aberration was induced. We found a strong correlation between the relative accommodative gain (and phase lag) and the contrast degradation imposed on the target at relevant spatial frequencies. PMID:20600230

Induction of burst suppression or coma using intravenous anesthetics in refractory status epilepticus.

PubMed

Kang, Bong Su; Jung, Keun-Hwa; Shin, Jeong-Won; Moon, Jang Sup; Byun, Jung-Ick; Lim, Jung-Ah; Moon, Hye Jin; Kim, Young-Soo; Lee, Soon-Tae; Chu, Kon; Lee, Sang Kun

2015-05-01

General anesthetic-induced coma therapy has been recommended for the treatment of refractory status epilepticus (RSE). However, the influence of electroencephalographic (EEG) burst suppression (BS) on outcomes still remains unclear. This study investigated the impact of intravenous anesthetic-induced BS on the prognosis of RSE using a retrospective analysis of all consecutive adult patients who received intravenous anesthetic treatment for RSE at the Seoul National University Hospital between January 2006 and June 2011. Twenty-two of the 111 episodes of RSE were enrolled in this study. Of the 22 RSE patients, 12 (54.5%) were women and 18 (81.4%) exhibited generalized convulsive status epilepticus. Sixteen patients (72.7%) were classified as having acute symptomatic etiology, including three patients with anoxic encephalopathy, and others with remote symptomatic etiology. Only two patients (9.1%) had a favorable Status Epilepticus Severity Score (0-2) at admission. All patients received midazolam (MDZ) as a primary intravenous anesthetic drug for RSE treatment; three (13.6%) received MDZ and propofol, and one (4.5%) received MDZ and pentobarbital. The rates of mortality and poor outcome at discharge were 13.6% (n=3) and 54.5% (n=12), respectively. While BS was achieved in six (27.5%) patients, it was not associated with mortality or poor outcome. Induced BS was associated with prolonged hospital stay in subgroup analysis when excluding anoxic encephalopathy. Our results suggest that induction of BS for treating RSE did not affect mortality or outcome at discharge and may lead to an increased length of hospital stay. Copyright © 2014 Elsevier Ltd. All rights reserved.

Thermal modeling of cometary nuclei

NASA Astrophysics Data System (ADS)

Weissman, P. R.; Kieffer, H. H.

1981-09-01

A model of the sublimation of volatile ices from a cometary nucleus is presented which includes the effects of (1) diurnal heating and cooling, (2) rotation period and pole orientation, (3) the thermal properties of the ice and subsurface layers, and (4) the contributions from coma opacity, scattering and thermal emission where the properties of the coma are derived from the integrated rate of volatile production by the nucleus. In applying the model to the case of the 1986 apparition of Halley's comet, it is found that the generation of a cometary dust coma increases the total energy reaching the Halley nucleus due to the greater geometrical cross-section of the coma as compared with the bare nucleus. The calculated coma opacity of Halley is about 0.2 at 1 AU from the sun and 1.2 at perihelion. Possible consequences of the results obtained for the generation of nongravitational forces, volatile production rates for comets and cometary lifetimes against sublimation are discussed.

Coma Morphology Due to an Extended Active Region and Implications for the Spin State of Comet Hale-Bopp

NASA Technical Reports Server (NTRS)

Samarasinha, Nalin H.

2000-01-01

We show that the circular character of continuum structures observed in the coma of comet Hale-Bopp around the perihelion passage is most likely due to a dust jet from a large extended active region on the surface. Coma morphology due to a wide jet is different from that due to a narrow jet. The latter shows foreshortening effects due to observing geometry, wider jet produces more circular features. This circularization effect provides a self-consistent explanation for the evolution of near-perihelion coma morphology. No changes in the direction of the rotational angular momentum vector are required during this period in contrast to the models of Schleicher et al. This circularization effect also enables us to produce near-circular coma features in the S-E quadrant during 1997 late February and therefore questions the basic premise on which Sekanina bases his morphological arguments for a gravitationally bound satellite nucleus.

[The coma awakening unit, between intensive care and rehabilitation].

PubMed

Mimouni, Arnaud

2015-01-01

After intensive care and before classic neurological rehabilitation is possible, patients in an altered state of consciousness are cared for at early stages in so-called coma awakening units. The care involves, on the one hand, the complex support of the patient's awakening from coma as a neurological and existential process, and on the other, support for their families. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Midazolam fails to prevent neurological damage in children with convulsive refractory febrile status epilepticus.

PubMed

Nagase, Hiroaki; Nishiyama, Masahiro; Nakagawa, Taku; Fujita, Kyoko; Saji, Yohsuke; Maruyama, Azusa

2014-07-01

We conducted a retrospective study to compare the outcome of intravenous midazolam infusion without electroencephalography or targeted temperature management and barbiturate coma therapy with electroencephalography and targeted temperature management for treating convulsive refractory febrile status epilepticus. Of 49 consecutive convulsive refractory febrile status epilepticus patients admitted to the pediatric intensive care unit of our hospital, 29 were excluded because they received other treatments or because of various underlying illnesses. Thus, eight patients were treated with midazolam and 10 with barbiturate coma therapy using thiamylal. Midazolam-treated patients were intubated only when necessary, whereas barbiturate coma therapy patients were routinely intubated. Continuous electroencephalography monitoring was utilized only for the barbiturate coma group. The titration goal for anesthesia was clinical termination of status epilepticus in the midazolam group and suppression or burst-suppression patterns on electroencephalography in the barbiturate coma group. Normothermia was maintained using blankets and neuromuscular blockade in the barbiturate coma group and using antipyretics in the midazolam group. Prognoses were measured at 1 month after onset; children were classified into poor and good outcome groups. Good outcome was achieved in all the barbiturate coma group patients and 50% of the midazolam group patients (P = 0.02, Fisher's exact test). Although the sample size was small and our study could not determine which protocol element is essential for the neurological outcome, the findings suggest that clinical seizure control using midazolam without continuous electroencephalography monitoring or targeted temperature management is insufficient in preventing neurological damage in children with convulsive refractory febrile status epilepticus. Copyright © 2014 Elsevier Inc. All rights reserved.

Contemporary approach to neurologic prognostication of coma after cardiac arrest.

PubMed

Ben-Hamouda, Nawfel; Taccone, Fabio S; Rossetti, Andrea O; Oddo, Mauro

2014-11-01

Coma after cardiac arrest (CA) is an important cause of admission to the ICU. Prognosis of post-CA coma has significantly improved over the past decade, particularly because of aggressive postresuscitation care and the use of therapeutic targeted temperature management (TTM). TTM and sedatives used to maintain controlled cooling might delay neurologic reflexes and reduce the accuracy of clinical examination. In the early ICU phase, patients' good recovery may often be indistinguishable (based on neurologic examination alone) from patients who eventually will have a poor prognosis. Prognostication of post-CA coma, therefore, has evolved toward a multimodal approach that combines neurologic examination with EEG and evoked potentials. Blood biomarkers (eg, neuron-specific enolase [NSE] and soluble 100-β protein) are useful complements for coma prognostication; however, results vary among commercial laboratory assays, and applying one single cutoff level (eg, > 33 μg/L for NSE) for poor prognostication is not recommended. Neuroimaging, mainly diffusion MRI, is emerging as a promising tool for prognostication, but its precise role needs further study before it can be widely used. This multimodal approach might reduce false-positive rates of poor prognosis, thereby providing optimal prognostication of comatose CA survivors. The aim of this review is to summarize studies and the principal tools presently available for outcome prediction and to describe a practical approach to the multimodal prognostication of coma after CA, with a particular focus on neuromonitoring tools. We also propose an algorithm for the optimal use of such multimodal tools during the early ICU phase of post-CA coma.

Outcome in patients with bacterial meningitis presenting with a minimal Glasgow Coma Scale score

PubMed Central

Lucas, Marjolein J.; Brouwer, Matthijs C.; van der Ende, Arie

2014-01-01

Objective: In bacterial meningitis, a decreased level of consciousness is predictive for unfavorable outcome, but the clinical features and outcome in patients presenting with a minimal score on the Glasgow Coma Scale are unknown. Methods: We assessed the incidence, clinical characteristics, and outcome of patients with bacterial meningitis presenting with a minimal score on the Glasgow Coma Scale from a nationwide cohort study of adults with community-acquired bacterial meningitis in the Netherlands from 2006 to 2012. Results: Thirty of 1,083 patients (3%) presented with a score of 3 on the Glasgow Coma Scale. In 22 of 30 patients (73%), the minimal Glasgow Coma Scale score could be explained by use of sedative medication or complications resulting from meningitis such as seizures, cerebral edema, and hydrocephalus. Systemic (86%) and neurologic (47%) complications occurred frequently, leading to a high proportion of patients with unfavorable outcome (77%). However, 12 of 30 patients (40%) survived and 7 patients (23%) had a good functional outcome, defined as a score of 5 on the Glasgow Outcome Scale. Patients presenting with a minimal Glasgow Coma Scale score on admission and bilaterally absent pupillary light responses, bilaterally absent corneal reflexes, or signs of septic shock on admission all died. Conclusions: Patients with community-acquired bacterial meningitis rarely present with a minimal score on the Glasgow Coma Scale, but this condition is associated with high rates of morbidity and mortality. However, 1 out of 5 of these severely ill patients will make a full recovery, stressing the continued need for aggressive supportive care in these patients. PMID:25340065

Pre- and Post-equinox ROSINA production rates calculated using a realistic empirical coma model derived from AMPS-DSMC simulations of comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Hansen, Kenneth; Altwegg, Kathrin; Berthelier, Jean-Jacques; Bieler, Andre; Calmonte, Ursina; Combi, Michael; De Keyser, Johan; Fiethe, Björn; Fougere, Nicolas; Fuselier, Stephen; Gombosi, Tamas; Hässig, Myrtha; Huang, Zhenguang; Le Roy, Lena; Rubin, Martin; Tenishev, Valeriy; Toth, Gabor; Tzou, Chia-Yu

2016-04-01

We have previously used results from the AMPS DSMC (Adaptive Mesh Particle Simulator Direct Simulation Monte Carlo) model to create an empirical model of the near comet coma (<400 km) of comet 67P for the pre-equinox orbit of comet 67P/Churyumov-Gerasimenko. In this work we extend the empirical model to the post-equinox, post-perihelion time period. In addition, we extend the coma model to significantly further from the comet (~100,000-1,000,000 km). The empirical model characterizes the neutral coma in a comet centered, sun fixed reference frame as a function of heliocentric distance, radial distance from the comet, local time and declination. Furthermore, we have generalized the model beyond application to 67P by replacing the heliocentric distance parameterizations and mapping them to production rates. Using this method, the model become significantly more general and can be applied to any comet. The model is a significant improvement over simpler empirical models, such as the Haser model. For 67P, the DSMC results are, of course, a more accurate representation of the coma at any given time, but the advantage of a mean state, empirical model is the ease and speed of use. One application of the empirical model is to de-trend the spacecraft motion from the ROSINA COPS and DFMS data (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis, Comet Pressure Sensor, Double Focusing Mass Spectrometer). The ROSINA instrument measures the neutral coma density at a single point and the measured value is influenced by the location of the spacecraft relative to the comet and the comet-sun line. Using the empirical coma model we can correct for the position of the spacecraft and compute a total production rate based on the single point measurement. In this presentation we will present the coma production rate as a function of heliocentric distance both pre- and post-equinox and perihelion.

Compressed spectral arrays of patients with fulminant hepatic failure in hepatic coma undergoing liver transplantation.

PubMed

Takeichi, Takayuki; Asonuma, Katsuhiro; Kim, Ildeok; Inomata, Yukihiro; Kasahara, Mureo; Ohwada, Susumu; Morishita, Yasuo; Tanaka, Koichi

2002-08-01

Assessing the coma status of patients with fulminant hepatic failure (FHF) is important for determining the reversibility of brain damage and for properly timing liver transplantation. The compressed spectral array (CSA) method is a frequency analysis technique that processes electroencephalogram signals by computer to facilitate on-line interpretation. This method has been used to monitor the consciousness levels of neurointensive care unit patients. In this study, we determined whether CSA could be used to assess the coma status of patients with FHF, and whether CSA provided information that was useful in deciding when to proceed with liver transplantation. CSA recording was carried out in 17 FHF patients with encephalopathy (coma grade III-IV) who underwent living-related liver transplantation between August 1997 and May 1999. Recording was performed with a Neuromonitor OEE-72044 (NIHON KOHDEN, Osaka, Japan) every 24 h before and after transplantation, until the patients regained consciousness. The CSAs of healthy controls were distributed almost equally between 0 and 16 Hz. The CSAs of FHF patients in hepatic coma were classified into three patterns. Eight of the 17 patients showed very prominent slow waves of about 2 Hz (group A), and seven patients showed strongly suppressed rapid waves between 8 and 16 Hz (group B). The remaining two patients showed CSA patterns that were similar to those of healthy controls, even though these patients were comatose (group C). Abnormal CSA patterns were observed in 15 of the 17 patients (88%). Group B patients seemed to have higher coma grades than did group A patients. Sixteen patients underwent liver transplantation, completely recovered from hepatic encephalopathy, and subsequently showed CSA patterns similar to those of healthy controls. One patient died without regaining consciousness. These results suggest that CSA is useful in assessing the coma status of FHF patients and in evaluating electrophysiological recovery from hepatic coma after liver transplantation.

Analysis of IUE Observations of Hydrogen in Comets

NASA Technical Reports Server (NTRS)

Combi, Michael R.; Feldman, Paul D.

1998-01-01

The 15-years worth of hydrogen Lyman-alpha observations of cometary comae obtained with the International Ultraviolet Explorer (IUE) satellite had gone generally unanalyzed because of two main modeling complications. First, the inner comae of many bright (gas productive) comets are often optically thick to solar Lyman-alpha radiation. Second, even in the case of a small comet (low gas production) the large IUE aperture is quite small as compared with the immense size of the hydrogen coma, so an accurate model which properly accounts for the spatial distribution of the coma is required to invert the infrared brightnesses to column densities and finally to H atom production rates. Our Monte Carlo particle trajectory model (MCPTM), which for the first time provides the realistic full phase space distribution of H atoms throughout the coma has been used as the basis for the analysis of IUE observations of the inner coma. The MCPTM includes the effects of the vectorial ejection of the H atoms upon dissociation of their parent species (H2O and OH) and of their partial collisional thermalization. Both of these effects are crucial to characterize the velocity distribution of the H atoms. This combination of the MCPTM and spherical radiative transfer code had already been shown to be successful in understanding the moderately optically thick coma of comet P/Giacobini-Zinner and the coma of comet Halley that varied from being slightly to very optically thick. Both of these comets were observed during solar minimum conditions. Solar activity affects both the photochemistry of water and the solar Lyman-alpha radiation flux. The overall plan of this program here was to concentrate on comets observed by IUE at other time during the solar cycle, most importantly during the two solar maxima of 1980 and 1990. Described herein are the work performed and the results obtained.

Delirium and coma evaluated in mechanically ventilated patients in the intensive care unit in Japan: a multi-institutional prospective observational study.

PubMed

Tsuruta, Ryosuke; Oda, Yasutaka; Shintani, Ayumi; Nunomiya, Shin; Hashimoto, Satoru; Nakagawa, Takashi; Oida, Yasuhisa; Miyazaki, Dai; Yabe, Shigemi

2014-06-01

The object of this study is to evaluate the prevalence and effects of delirium on 28-day mortality in critically ill patients on mechanical ventilation in Japan. Prospective cohort study was conducted in medical and surgical intensive care units (ICUs) of 24 medical centers. Patients were followed up daily for delirium during ICU stay after enrollment. Coma was defined with the Richmond Agitation Sedation Scale score of -4 or -5. Delirium was diagnosed using the Confusion Assessment Method for the ICU. The Cox proportional hazards regression model was used to assess the effects of delirium and coma on 28-day mortality, time to extubation, and time to ICU discharge; delirium and coma were included as time-varying covariates after controlling for age, Acute Physiology and Chronic Health Evaluation II score, ventilator-associated pneumonia, and the reason for intubation with infection. Of 180 patients, 115 patients (64%) developed delirium. Moreover, 15 patients (8%) died within 28 days after ICU admission, including 7 patients who experienced coma and 8 patients who experienced both coma and delirium. There were no deaths among patients who did not experience coma. Delirium was associated with a shorter time to extubation (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.65-3.85; P<.001) and a shorter ICU length of stay in comatose patients (HR, 1.59; 95% CI, 1.04-2.44; P=.034), whereas delirium appeared with prolonged time to ICU discharge among patients without coma, although statistical significance was not detected due to limited analytical power (HR, 0.62; 95% CI, 0.34-1.12; P=.114). Delirium during ICU stay was not associated with higher mortality. Further study is needed to investigate the discrepancy between these and previous data. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in predicting mortality in critically ill patients*.

PubMed

Wijdicks, Eelco F M; Kramer, Andrew A; Rohs, Thomas; Hanna, Susan; Sadaka, Farid; O'Brien, Jacklyn; Bible, Shonna; Dickess, Stacy M; Foss, Michelle

2015-02-01

Impaired consciousness has been incorporated in prediction models that are used in the ICU. The Glasgow Coma Scale has value but is incomplete and cannot be assessed in intubated patients accurately. The Full Outline of UnResponsiveness score may be a better predictor of mortality in critically ill patients. Thirteen ICUs at five U.S. hospitals. One thousand six hundred ninety-five consecutive unselected ICU admissions during a six-month period in 2012. Glasgow Coma Scale and Full Outline of UnResponsiveness score were recorded within 1 hour of admission. Baseline characteristics and physiologic components of the Acute Physiology and Chronic Health Evaluation system, as well as mortality were linked to Glasgow Coma Scale/Full Outline of UnResponsiveness score information. None. We recruited 1,695 critically ill patients, of which 1,645 with complete data could be linked to data in the Acute Physiology and Chronic Health Evaluation system. The area under the receiver operating characteristic curve of predicting ICU mortality using the Glasgow Coma Scale was 0.715 (95% CI, 0.663-0.768) and using the Full Outline of UnResponsiveness score was 0.742 (95% CI, 0.694-0.790), statistically different (p = 0.001). A similar but nonsignificant difference was found for predicting hospital mortality (p = 0.078). The respiratory and brainstem reflex components of the Full Outline of UnResponsiveness score showed a much wider range of mortality than the verbal component of Glasgow Coma Scale. In multivariable models, the Full Outline of UnResponsiveness score was more useful than the Glasgow Coma Scale for predicting mortality. The Full Outline of UnResponsiveness score might be a better prognostic tool of ICU mortality than the Glasgow Coma Scale in critically ill patients, most likely a result of incorporating brainstem reflexes and respiration into the Full Outline of UnResponsiveness score.

Right median nerve electrical stimulation for acute traumatic coma (the Asia Coma Electrical Stimulation trial): study protocol for a randomised controlled trial.

PubMed

Wu, Xiang; Zhang, Chao; Feng, Junfeng; Mao, Qing; Gao, Guoyi; Jiang, Jiyao

2017-07-10

Traumatic brain injury (TBI) has become the most common cause of death and disability in persons between 15 and 30 years of age, and about 10-15% of patients affected by TBI will end up in a coma. Coma caused by TBI presents a significant challenge to neuroscientists. Right median nerve electrical stimulation has been reported as a simple, inexpensive, non-invasive technique to speed recovery and improve outcomes for traumatic comatose patients. This multicentre, prospective, randomised (1:1) controlled trial aims to demonstrate the efficacy and safety of electrical right median nerve stimulation (RMNS) in both accelerating emergence from coma and promoting long-term outcomes. This trial aims to enrol 380 TBI comatose patients to partake in either an electrical stimulation group or a non-stimulation group. Patients assigned to the stimulation group will receive RMNS in addition to standard treatment at an amplitude of 15-20 mA with a pulse width of 300 μs at 40 Hz ON for 20 s and OFF for 40 s. The electrical treatment will last for 8 h per day for 2 weeks. The primary endpoint will be the percentage of patients regaining consciousness 6 months after injury. The secondary endpoints will be Extended Glasgow Outcome Scale, Coma Recovery Scale-Revised and Disability Rating Scale scores at 28 days, 3 months and 6 months after injury; Glasgow Coma Scale, Glasgow Coma Scale Motor Part and Full Outline of Unresponsiveness scale scores on day 1 and day 7 after enrolment and 28 days, 3 months and 6 months after injury; duration of unconsciousness and mechanical ventilation; length of intensive care unit and hospital stays; and incidence of adverse events. Right median nerve electrical stimulation has been used as a safe, inexpensive, non-invasive therapy for neuroresuscitation of coma patients for more than two decades, yet no trial has robustly proven the efficacy and safety of this treatment. The Asia Coma Electrical Stimulation (ACES) trial has the following novel features compared with other major RMNS trials: (1) the ACES trial is an Asian multicentre randomised controlled trial; (2) RMNS therapy starts at an early stage 7-14 days after the injury; and (3) various assessment scales are used to evaluate the condition of patients. We hope the ACES trial will lead to optimal use of right median nerve electrical treatment. ClinicalTrials.gov, NCT02645578 . Registered on 23 December 2015.

The Coma Cluster Luminosity Function from Ultraviolet to Near-Infrared

NASA Astrophysics Data System (ADS)

Andreon, S.; Cuillandre, J.-C.; Pello, R.

The Coma cluster luminosity function (LF) from ultraviolet (2000 AA ) to the near-infrared (H band) is summarized. In the UV the LF is very steep, much steeper than in the optical. The steep Coma UV LF implies that faint and bright galaxies give similar contributions to the total UV flux and to the total metal production rate. The ComaUV LF is dominated in number and luminosity by blue galaxies, which are often faint in the optical. Therefore the Coma UV LF is dominated by star forming galaxies, not by massive and large galaxies. The optical Coma LF is relatively steep (alpha=-1.4) over the 11 magnitudes sampled, but its slope and shape depend on considered filter and magnitude. We found a clear steeping of the FL going from B to R bands, indicative of the presence of a large number of red dwarfs, as faint as three bright globular clusters. Furthermore, using Hubble Space Telescope images, we discover that blends of globular clusters, not resolved in individual components due to seeing, look like dwarf galaxies when observed from the ground and are numerous and bright. The existence of these fake extended sources increases the steepness of the LF at faint magnitudes, if not deal on. This concern affects previous deep probing of the luminosity function, but not the present work. The near-infrared LF wa s computed on a near-infrared selected sample of galaxies which photometry is complete down to the typical dwarf (M* +5) luminosity. The Coma LF can be described by a Schechter function with intermediate slope (alpha sim-1.3), plus a dip at MH~-22 mag. The shape of the Coma LF in H band is quite similar to th e one found in the B band. The similarity of the LF in the optical and H bands implies that in the central region of Coma there is no new population of galaxies which is too faint to be observed in the optical band (because dust enshrouded, for instance), down to the magnitudes of dwarfs. The exponential cut of the LF at the bright end is in good agreement with the one derived from shallower near-infrared samples o f galaxies, both in clusters and in the field. The faint end of the LF, reaching MH~-19 mag (roughly MB~ -15), is steep, but less than previously suggested from shallower near-infrared observations of an adjacent region in the Coma cluster.

Neuroimmunological Blood Brain Barrier Opening in Experimental Cerebral Malaria

PubMed Central

Baer, Kerstin; Mikolajczak, Sebastian A.; Kappe, Stefan H. I.; Frevert, Ute

2012-01-01

Plasmodium falciparum malaria is responsible for nearly one million annual deaths worldwide. Because of the difficulty in monitoring the pathogenesis of cerebral malaria in humans, we conducted a study in various mouse models to better understand disease progression in experimental cerebral malaria (ECM). We compared the effect on the integrity of the blood brain barrier (BBB) and the histopathology of the brain of P. berghei ANKA, a known ECM model, P. berghei NK65, generally thought not to induce ECM, P. yoelii 17XL, originally reported to induce human cerebral malaria-like histopathology, and P. yoelii YM. As expected, P. berghei ANKA infection caused neurological signs, cerebral hemorrhages, and BBB dysfunction in CBA/CaJ and Swiss Webster mice, while Balb/c and A/J mice were resistant. Surprisingly, PbNK induced ECM in CBA/CaJ mice, while all other mice were resistant. P. yoelii 17XL and P. yoelii YM caused lethal hyperparasitemia in all mouse strains; histopathological alterations, BBB dysfunction, or neurological signs were not observed. Intravital imaging revealed that infected erythrocytes containing mature parasites passed slowly through capillaries making intimate contact with the endothelium, but did not arrest. Except for relatively rare microhemorrhages, mice with ECM presented no obvious histopathological alterations that would explain the widespread disruption of the BBB. Intravital imaging did reveal, however, that postcapillary venules, but not capillaries or arterioles, from mice with ECM, but not hyperparasitemia, exhibit platelet marginalization, extravascular fibrin deposition, CD14 expression, and extensive vascular leakage. Blockage of LFA-1 mediated cellular interactions prevented leukocyte adhesion, vascular leakage, neurological signs, and death from ECM. The endothelial barrier-stabilizing mediators imatinib and FTY720 inhibited vascular leakage and neurological signs and prolonged survival to ECM. Thus, it appears that neurological signs and coma in ECM are due to regulated opening of paracellular-junctional and transcellular-vesicular fluid transport pathways at the neuroimmunological BBB. PMID:23133375

[Thyroid Storm and Myxedema Coma].

PubMed

Milkau, Malte; Sayk, Friedhelm

2018-03-01

Thyroid storm and myxedema coma are the most severe clinical forms of thyroid dysfunction. While both hyper- and hypothyroidsm are common diseases, thyroid storm and myxedema coma are rare. Due to their unspecific signs and symptoms they are often difficult to diagnose. Both disorders are medical emergencies, which still show a significant mortality. The following article summarizes diagnostic tools and treatment options for these disorders. © Georg Thieme Verlag KG Stuttgart · New York.

Intravenous administration of levothyroxine for treatment of suspected myxedema coma complicated by severe hypothermia in a dog.

PubMed

Henik, R A; Dixon, R M

2000-03-01

A 7-year-old male English Coonhound with suspected myxedema coma complicated by severe hypothermia and metabolic abnormalities was treated with a combination of active external and core rewarming techniques, i.v. and oral administration of levothyroxine, supplemental oxygen, and administration of fluids (0.9% NaCl solution). Myxedema coma develops as a consequence of severe hypothyroidism and is characterized by a hypometabolic, stuporous state. Myxedema coma is associated with a high mortality rate, and most reported cases have involved Doberman Pinschers. Intravenous administration of levothyroxine can be used successfully in combination with oral administration to restore normal metabolic function and assist in warming and thermoregulation, although dosages should be conservative to avoid adverse cardiovascular effects.

Sources of the monochromatic aberrations induced in human eyes after laser refractive surgery

NASA Astrophysics Data System (ADS)

Porter, Jason

Laser in-situ keratomileusis (LASIK) procedures correct the eye's defocus and astigmatism but also introduce higher order monochromatic aberrations. Little is known about the origins of these induced aberrations. The advent of wavefront sensor technology has made it possible to measure accurately and quickly the aberrations of normal and postoperative LASIK eyes. The goal of this thesis was to exploit this technology to better understand some of the potential mechanisms by which aberrations could be introduced during LASIK. A first step towards investigating these sources was to characterize the aberration changes in post-LASIK eyes. Higher order rms wavefront error increased after conventional and customized LASIK surgery. On average, spherical aberration approximately doubled, and significant changes in vertical and horizontal coma were observed. We examined two sources of postoperative aberrations: the creation of a microkeratome flap and the subsequent laser ablation. Higher order rms increased slightly and there was a wide variation in the response of individual Zernike modes after cutting a flap. The majority of induced spherical aberration was due to the laser ablation and not the flap-cut. Aberrations are also induced by static and dynamic decentrations of the patient's pupil. We found that ablations were typically decentered in the superotemporal direction due to shifts in pupil center location between aberration measurement (dilated) and surgical (undilated) conditions in customized LASIK eyes. There was a weak correlation between the horizontal coma theoretically induced by this offset and that measured postoperatively. Finally, dynamic eye movements during the procedure induce higher order aberrations. We found that the most problematic decentrations during LASIK are relatively slow drifts in eye position. An eye-tracking system with a 2-Hz closed-loop bandwidth could compensate for most eye movements during LASIK. One solution for reducing the aberrations induced by static and dynamic shifts in pupil center location is to reference the aberration measurement and treatment with respect to fixed features on the eye. Several other sources of aberration induction in LASIK, such as the efficiency of laser pulses striking the cornea perpendicularly versus obliquely, must still be investigated to optimize postoperative optical quality after LASIK.

Volume Phase Masks in Photo-Thermo-Refractive Glass

DTIC Science & Technology

2014-10-06

development when forming the nanocrystals. Fig. 1.1 shows the refractive index change curves for some common glass melts when exposed to a beam at 325 nm...integral curve to the curve for the ideal phase mask. If there is a deviation in the experimental curve from the ideal curve , whether the overlap...redevelopments of the sample. Note that the third point on the spherical curve and the third and fourth points on the coma y curve have larger error bars than

Comet 67P/Churyumov-Gerasimenko during the Rosetta mission: numerical simulation of dusty gas coma

NASA Astrophysics Data System (ADS)

Tenishev, Valeriy; Combi, Michael; Rubin, Martin; Hansen, Kenneth; Gombosi, Tamas

The Rosetta spacecraft is en route to comet 67P/Churyumov-Gerasimenko for a rendezvous, landing, and extensive orbital phase beginning in 2014. Having a limited amount of information regarding its coma, interpretation of measurements and safety consideration of the spacecraft will require modeling of the comet's environment. Such models should be able to simulate both the gas and dust phases of the coma as well as the interaction between them in a self-consistent manner. The relevant physical processes in the coma include photolytic reactions and interaction with the nucleus for the gas phase and drag by the gas, gravity of the nucleus, solar gravity and radiation pressure, and charging by the ambient plasma for the dust phase. Developing of such modeling capabilities will be able to link measurements obtained by different instruments onboard of spacecraft. Some examples of cometary comae simulations can be found in [1-3]. In this work we present our kinetic model of a dusty gas coma [4] with results of its application to the case of comet Churyumov-Gerasimenko at conditions corresponding to some stages the during the Rosetta mission. Based on the surface properties and local production rates obtained by MIRO, RSI and VIRTIS the model will be able to propagate the injected gas and dust into the coma linking the measurements to those obtained by ALICE, MIDAS and ROSINA for the gas phase and COSIMA and GIADA for the dust phase of the coma. A simultaneous simulation of the major components of the multi-phase coma will allow us to link observations of the gas and dust phases. In this work we present results of a numerical study of neutral/ionized multispecies gaseous and electrically charged dust environment of the comet Churyumov-Gerasimenko at a helio-centric distance of 1.3 AU. The simulation is performed in fully 3D geometry with a realistic nucleus model that describes its topological features and source distribution. Both, neutral and ionized components of the gas phase of the coma are simulated kinetically. Photolytic reactions are taken into account. Parameters of the ambient plasma as well as the distribution of electric/magnetic fields are obtained from an MHD simulation [5] of the coma connected to the solar wind. Those parameters are used for calculation of the electric charge of dust grains. Trajectories of ions and electrically charged dust grains are simulated by accounting for the gas drag, Lorentz force, nucleus gravity and radiation pressure. REFFERENCES [1] M.R. Combi, Icarus, 123, 207-226 (1996) [2] Y. Skorov, G.N. Markelov, H.U. Keller, Solar Sys. Res. 38, 455-475 (2004) [3] V.V. Zakharov, A.V. Rodionov, G. A. Lukianov, J.F. Crifo, Icarus 201, 358-380 (2009) [4] V. Tenishev, M. R. Combi, B. Davidsson, Astrophysical Journal, 685, 659-677 (2008) [5] M. Rubin, K. C. Hansen, T. Gombosi, M. R. Combi, K. Altwegg, H. Balsiger, Icarus, 199, 505-519 (2009)

Repeatability of the Dust and Gas Morphological Structures in the Coma of Comet

NASA Astrophysics Data System (ADS)

Lejoly, Cassandra; Samarasinha, N. H.; Ojha, L.; Schleicher, D. G.

2013-10-01

Comet 1P/Halley is the most famous comet in history and has been observed for over two millennia, making it one of the most extensively studied comets. The morphology in the coma of comet 1P/Halley originates due to the activity at the nucleus and could be used as a probe of the nuclear rotation and the activity. We will present the results from a study summarizing the evolution of coma morphology of comet 1P/Halley observed from ground between October 1985 and June 1986. The results to be presented include analysis of dust features as well as gas (CN) features in the coma and comparisons will be made between their spatial and temporal evolution. About 80 CN images and 300 continuum images from the Small Bodies Node of the NASA Planetary Data System were analyzed using image enhancement techniques that were not available n the 1980s. This enables us to see coma structure never observed before in comet 1P/Halley. Because of the comet's proximity to Earth, most of our best signal-to-noise images were taken in the March-April interval of 1986. Despite the limited coverage of preceding and following months, there is a sufficient number of images to monitor morphological evolution over many months. The initial synodic periods as a function of time used to phase the images together were extrapolated from the lightcurves of the active coma (Schleicher et al. 1990, AJ, 100, 896-912). We will present the periods of repeatability of individual coma features measured using the position angle at different spatial distances from the nucleus in adjacent cycles. Separate features appear to have slightly different periods of repeatability, perhaps depending on the corresponding source regions on the nucleus and/or projection effects. The periods of repeatability of coma morphologies will be presented as a function of time from the perihelion. These results will ultimately be used in detailed modeling of the coma morphologies of comet 1P/Halley over the 1985-1986 apparition in order to characterize the activity of the comet. This work is supported by NASA Planetary Atmospheres grant NNX11AD85G and C.L.'s participation at the meeting is supported by a gift to the Lunar and Planetary Laboratory at the University of Arizona.

Combining DSMC Simulations and ROSINA/COPS Data of Comet 67P/Churyumov-Gerasimenko to Develop a Realistic Empirical Coma Model and to Determine Accurate Production Rates

NASA Astrophysics Data System (ADS)

Hansen, K. C.; Fougere, N.; Bieler, A. M.; Altwegg, K.; Combi, M. R.; Gombosi, T. I.; Huang, Z.; Rubin, M.; Tenishev, V.; Toth, G.; Tzou, C. Y.

2015-12-01

We have previously published results from the AMPS DSMC (Adaptive Mesh Particle Simulator Direct Simulation Monte Carlo) model and its characterization of the neutral coma of comet 67P/Churyumov-Gerasimenko through detailed comparison with data collected by the ROSINA/COPS (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis/COmet Pressure Sensor) instrument aboard the Rosetta spacecraft [Bieler, 2015]. Results from these DSMC models have been used to create an empirical model of the near comet coma (<200 km) of comet 67P. The empirical model characterizes the neutral coma in a comet centered, sun fixed reference frame as a function of heliocentric distance, radial distance from the comet, local time and declination. The model is a significant improvement over more simple empirical models, such as the Haser model. While the DSMC results are a more accurate representation of the coma at any given time, the advantage of a mean state, empirical model is the ease and speed of use. One use of such an empirical model is in the calculation of a total cometary coma production rate from the ROSINA/COPS data. The COPS data are in situ measurements of gas density and velocity along the ROSETTA spacecraft track. Converting the measured neutral density into a production rate requires knowledge of the neutral gas distribution in the coma. Our empirical model provides this information and therefore allows us to correct for the spacecraft location to calculate a production rate as a function of heliocentric distance. We will present the full empirical model as well as the calculated neutral production rate for the period of August 2014 - August 2015 (perihelion).

Characteristics of Near-Death Experiences Memories as Compared to Real and Imagined Events Memories

PubMed Central

Brédart, Serge; Dehon, Hedwige; Ledoux, Didier; Laureys, Steven; Vanhaudenhuyse, Audrey

2013-01-01

Since the dawn of time, Near-Death Experiences (NDEs) have intrigued and, nowadays, are still not fully explained. Since reports of NDEs are proposed to be imagined events, and since memories of imagined events have, on average, fewer phenomenological characteristics than real events memories, we here compared phenomenological characteristics of NDEs reports with memories of imagined and real events. We included three groups of coma survivors (8 patients with NDE as defined by the Greyson NDE scale, 6 patients without NDE but with memories of their coma, 7 patients without memories of their coma) and a group of 18 age-matched healthy volunteers. Five types of memories were assessed using Memory Characteristics Questionnaire (MCQ – Johnson et al., 1988): target memories (NDE for NDE memory group, coma memory for coma memory group, and first childhood memory for no memory and control groups), old and recent real event memories and old and recent imagined event memories. Since NDEs are known to have high emotional content, participants were requested to choose the most emotionally salient memories for both real and imagined recent and old event memories. Results showed that, in NDE memories group, NDE memories have more characteristics than memories of imagined and real events (p<0.02). NDE memories contain more self-referential and emotional information and have better clarity than memories of coma (all ps<0.02). The present study showed that NDE memories contained more characteristics than real event memories and coma memories. Thus, this suggests that they cannot be considered as imagined event memories. On the contrary, their physiological origins could lead them to be really perceived although not lived in the reality. Further work is needed to better understand this phenomenon. PMID:23544039

A SUZAKU SEARCH FOR NONTHERMAL EMISSION AT HARD X-RAY ENERGIES IN THE COMA CLUSTER

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

Wik, Daniel R.; Sarazin, Craig L.; Finoguenov, Alexis

2009-05-10

The brightest cluster radio halo known resides in the Coma cluster of galaxies. The relativistic electrons producing this diffuse synchrotron emission should also produce inverse Compton emission that becomes competitive with thermal emission from the intracluster medium (ICM) at hard X-ray energies. Thus far, claimed detections of this emission in Coma are controversial. We present a Suzaku HXD-PIN observation of the Coma cluster in order to nail down its nonthermal hard X-ray content. The contribution of thermal emission to the HXD-PIN spectrum is constrained by simultaneously fitting thermal and nonthermal models to it and a spatially equivalent spectrum derived frommore » an XMM-Newton mosaic of the Coma field. We fail to find statistically significant evidence for nonthermal emission in the spectra which are better described by only a single- or multitemperature model for the ICM. Including systematic uncertainties, we derive a 90% upper limit on the flux of nonthermal emission of 6.0 x 10{sup -12} erg s{sup -1} cm{sup -2} (20-80 keV, for {gamma} = 2.0), which implies a lower limit on the cluster-averaged magnetic field of B>0.15 {mu}G. Our flux upper limit is 2.5 times lower than the detected nonthermal flux from RXTE and BeppoSAX. However, if the nonthermal hard X-ray emission in Coma is more spatially extended than the observed radio halo, the Suzaku HXD-PIN may miss some fraction of the emission. A detailed investigation indicates that {approx}50%-67% of the emission might go undetected, which could make our limit consistent with that of Rephaeli and Gruber and Fusco-Femiano et al. The thermal interpretation of the hard Coma spectrum is consistent with recent analyses of INTEGRAL and Swift data.« less

Which clinical variable influences health-related quality of life the most after spontaneous subarachnoid hemorrhage? Hunt and Hess scale, Fisher score, World Federation of Neurosurgeons score, Brussels coma score, and Glasgow coma score compared.

PubMed

Kapapa, Thomas; Tjahjadi, Martin; König, Ralph; Wirtz, Christian Rainer; Woischneck, Dieter

2013-12-01

To determine the strength of the correlation between the Hunt and Hess scale, Fisher score, Brussels coma score, World Federation of Neurosurgeons score, and Glasgow coma score and health-related quality of life. Evaluable questionnaires from 236 patients (5.6 years [± standard deviation, 2.854 years] on average after hemorrhage) were included in the analysis. Quality of life was documented using the MOS-36 item short form health survey. Because of the ordinal nature of the variables, Kendall tau was used for calculation. Significance was established as P ≤ 0.05. Weak and very weak correlations were found in general (r ≤ 0.28). The strongest correlations were found between the Glasgow coma score and quality of life (r = 0.236, P = 0.0001). In particular, the "best verbal response" achieved the strongest correlations in the comparison, at r = 0.28/P = 0.0001. The Fisher score showed very weak correlations (r = -0.148/P = 0.012). The Brussels coma score (r = -0.216/P = 0.0001), Hunt and Hess scale (r = -0.197/P = 0.0001), and the World Federation of Neurosurgeons score (r = -0.185/P = 0.0001) revealed stronger correlations, especially in terms of the physical aspects of quality of life. The Glasgow coma scale revealed the strongest, and the Fisher score showed the weakest correlations. Thus the Fisher score, as an indicator of the severity of a hemorrhage, has little significance in terms of health-related quality of life. Copyright © 2013 Elsevier Inc. All rights reserved.

Prognosis of patients in coma after acute subdural hematoma due to ruptured intracranial aneurysm.

PubMed

Torné, Ramon; Rodríguez-Hernández, Ana; Romero-Chala, Fabián; Arikan, Fuat; Vilalta, Jordi; Sahuquillo, Juan

2016-04-01

Acute subdural hematomas (aSDH) secondary to intracranial aneurysm rupture are rare. Most patients present with coma and their functional prognosis has been classically considered to be very poor. Previous studies mixed good-grade and poor-grade patients and reported variable outcomes. We reviewed our experience by focusing on patients in coma only and hypothesized that aSDH might worsen initial mortality but not long-term functional outcome. Between 2005 and 2013, 440 subarachnoid hemorrhage (SAH) patients were admitted to our center. Nineteen (4.3%) were found to have an associated aSDH and 13 (2.9%) of these presented with coma. Their prospectively collected clinical and outcome data were reviewed and compared with that of 104 SAH patients without aSDH who presented with coma during the same period. Median aSDH thickness was 10mm. Four patients presented with an associated aneurysmal cortical laceration and only one had good recovery. Overall, we observed good long-term outcomes in both SAH patients in coma with aSDH and those without aSDH (38.5% versus 26.4%). Associated aSDH does not appear to indicate a poorer long-term functional prognosis in SAH patients presenting with coma. Anisocoria and brain herniation are observed in patients with aSDH thicknesses that are smaller than those observed in trauma patients. Despite a high initial mortality, early surgery to remove the aSDH results in a good outcome in over 60% of survivors. Aneurysmal cortical laceration appears to be an independent entity which shows a poorer prognosis than other types of aneurysmal aSDH. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dark energy and the structure of the Coma cluster of galaxies

NASA Astrophysics Data System (ADS)

Chernin, A. D.; Bisnovatyi-Kogan, G. S.; Teerikorpi, P.; Valtonen, M. J.; Byrd, G. G.; Merafina, M.

2013-05-01

Context. We consider the Coma cluster of galaxies as a gravitationally bound physical system embedded in the perfectly uniform static dark energy background as implied by ΛCDM cosmology. Aims: We ask if the density of dark energy is high enough to affect the structure of a large and rich cluster of galaxies. Methods: We base our work on recent observational data on the Coma cluster, and apply our theory of local dynamical effects of dark energy, including the zero-gravity radius RZG of the local force field as the key parameter. Results: 1) Three masses are defined that characterize the structure of a regular cluster: the matter mass MM, the dark-energy effective mass MDE (<0), and the gravitating mass MG (=MM + MDE). 2) A new matter-density profile is suggested that reproduces the observational data well for the Coma cluster in the radius range from 1.4 Mpc to 14 Mpc and takes the dark energy background into account. 3) Using this profile, we calculate upper limits for the total size of the Coma cluster, R ≤ RZG ≈ 20 Mpc, and its total matter mass, MM ≲ MM(RZG) = 6.2 × 1015 M⊙. Conclusions: The dark energy antigravity affects the structure of the Coma cluster strongly at large radii R ≳ 14 Mpc and should be considered when its total mass is derived.

Jet Morphology and Coma Analysis of 103P/Hartley 2: Temporal Evolution and Interspecies Comparisons

NASA Astrophysics Data System (ADS)

Vaughan, Charles M.; Pierce, Donna M.; Cochran, Anita L.

2014-11-01

We present our results on an expanded study of the jet and coma behavior of comet 103P/Hartley 2 (a continuation of original results presented in Vaughan et al. 2012). We observed Hartley 2 pre- and post-perihelion in 2010 using the George and Cynthia Mitchell Spectrograph on the 2.7 m telescope at McDonald Observatory. Data for CN, C2, C3, CH, and NH2 were collected over six nights from 15 July to 10 November. The spectral data were used to create coma maps for each of the observed species, and the maps were processed using radial and azimuthal division techniques to create enhanced images of the coma to examine coma morphological features. To compliment the ongoing investigation of Hartley 2 as studied by the EPOXI flyby mission, we use findings from other researchers (Belton et al. 2012; Syal et al. 2012; Thomas et al. 2012) to identify dust jet locations on the nucleus and compare the computed jet directions to the radical densities in the coma at our observation times. We also calculate production rates and mixing ratios with water for suspected parent species. This work was funded by the National Science Foundation Graduate K-12 (GK-12) STEM Fellows program (Award No. DGE-0947419) and NASA’s Planetary Atmospheres program (Award No. NNX14AH18G).

Chemistry in the Dusty Coma of Comet Hale-Bopp

NASA Astrophysics Data System (ADS)

Boice, D. C.; Cochran, A. L.; Disanti, M. A.; Huebner, W. F.

1998-09-01

Recent progress on a multifluid, hydrodynamic model is presented for the dusty gas flow in the inner coma of comet Hale-Bopp at several heliocentric distances. The simulations are based on a 1-D neutral coma model with detailed photo and gas-phase chemistry and dust entrainment by the gas, a separate energy balance for the electrons, separate flow of the neutral gas, fast neutral atomic and molecular hydrogen, and dust entrainment with fragmentation. The model accounts for three sources of gas release: sublimation from surface ices, transport of gas from subsurface regions through the surface, and release of gas from dust in the coma. This permits a consistent study of the importance and strength of each possible source for a variety of gas-phase species. The simulations allow a study of the changes with heliocentric distance of features within a cometary coma, e.g., spatial distributions of gas-phase species and dust of various sizes and the velocity and temperature profiles. In particular, the model is used to probe spatial distributions of gas-phase species (e.g., CN, CH, C_3, C_2, HCN, HNC, CO) and dust, and the velocity and temperature structure to understand the complex gas-phase chemistry that occurs in the inner coma. Comparisons with observations are made where available to characterize the environment surrounding comet Hale-Bopp and to aid in assimilating a variety of diverse observations of this unique comet.

Bacteriology of aspiration pneumonia in patients with acute coma.

PubMed

Lauterbach, Enise; Voss, Frederik; Gerigk, Roland; Lauterbach, Michael

2014-12-01

Loss of protective airway reflexes in patients with acute coma puts these patients at risk of aspiration pneumonia complicating the course of the primary disease. Available data vary considerably with regard to bacteriology, role of anaerobic bacteria, and antibiotic treatment. Our objective was to research the bacteriology of aspiration pneumonia in acute coma patients who were not pre-treated with antibiotics or hospitalized within 30 days prior to the event. We prospectively analyzed 127 patient records from adult patients admitted, intubated and ventilated to a tertiary medical intensive care unit with acute coma. Bacteriology and antibiotic resistance testing from tracheal aspirate sampled within 24 h after admission, blood cultures, ICU scores (APACHE II, SOFA), hematology, and clinical chemistry were assessed. Patients were followed up until death or hospital discharge. The majority of patients with acute coma suffered from acute cardiovascular disorders, predominantly myocardial infarction, followed by poisonings, and coma of unknown cause. In a majority of our patients, microaspiration resulted in overt infection. Most frequently S. aureus, H. influenzae, and S. pneumoniae were isolated. Anaerobic bacteria (Bacteroides spec., Fusobacteria, Prevotella spec.) were isolated from tracheal aspirate in a minority of patients, and predominantly as part of a mixed infection. Antibiotic monotherapy with a 2nd generation cephalosporin, or a 3rd generation gyrase inhibitor, was most effective in our patients regardless of the presence of anaerobic bacteria.

A Dozen New Galaxies Caught in the Act: Gas Stripping and Extended Emission Line Regions in the Coma Cluster

NASA Astrophysics Data System (ADS)

Yagi, Masafumi; Yoshida, Michitoshi; Komiyama, Yutaka; Kashikawa, Nobunari; Furusawa, Hisanori; Okamura, Sadanori; Graham, Alister W.; Miller, Neal A.; Carter, David; Mobasher, Bahram; Jogee, Shardha

2010-12-01

We present images of extended Hα clouds associated with 14 member galaxies in the Coma cluster obtained from deep narrowband imaging observations with the Suprime-Cam at the Subaru Telescope. The parent galaxies of the extended Hα clouds are distributed farther than 0.2 Mpc from the peak of the X-ray emission of the cluster. Most of the galaxies are bluer than g - r ≈ 0.5 and they account for 57% of the blue (g - r < 0.5) bright (r < 17.8 mag) galaxies in the central region of the Coma cluster. They reside near the red- and blueshifted edges of the radial velocity distribution of Coma cluster member galaxies. Our findings suggest that most of the parent galaxies were recently captured by the Coma cluster potential and are now infalling toward the cluster center with their disk gas being stripped off and producing the observed Hα clouds. Based on data collected at the Subaru Telescope, which is operated by the National Astronomical Observatory of Japan.

The Spatial Distribution of C2, C3, and NH in Comet 2P/Encke

NASA Astrophysics Data System (ADS)

Dorman, Garrett; Pierce, Donna M.; Cochran, Anita L.

2013-12-01

We examine the spatial distribution of C2, C3, and NH radicals in the coma of comet Encke in order to understand their abundances and distributions in the coma. The observations were obtained from 2003 October 22-24, using the 2.7 m telescope at McDonald Observatory. Building on our original study of CN and OH, we have used our modified version of the vectorial model, which treats the coma as one large cone, in order to reproduce Encke's highly aspherical and asymmetric coma. Our results suggest that NH can be explained by the photodissociation of NH2, assuming that NH2 is produced rapidly from NH3 in the innermost coma. Our modeling of C2 and C3 suggests a multi-generational photodissociation process may be required for their production. Using the results of our previous study, we also obtain abundance ratios with respect to OH and CN. Overall, we find that Encke exhibits typical carbon-chain abundances, and the results are consistent with other studies of comet Encke.

Hyperosmolar diabetic non-ketotic coma, hyperkalaemia and an unusual near death experience.

PubMed

Ting, J Y

2001-03-01

Generally, cardiac arrest due to pulseless electrical activity has a poor outcome, except when reversible factors such as acute hyperkalaemia are identified and managed early. Hyperosmolar diabetic non-ketotic coma may lead to acute hyperkalaemia. Hyperosmolar diabetic non-ketotic coma is a metabolic emergency usually seen in elderly non-insulin dependent diabetics, characterized by severe hyperglycaemia, volume depletion, altered consciousness, confusion and less frequently neurological deficit. Cerebrovascular accident or transient ischaemic attack may be mistakenly diagnosed, particularly if the patient has no history of diabetes mellitus. Delays in diagnosis and management of glycaemic emergencies presenting as a constellation of neurological abnormalities can be avoided by routine early measurement of blood glucose. Hyperosmolar diabetic non-ketotic coma should be considered in any patient with altered consciousness or neurologic deficit in conjunction with hyperglycaemia. As hyperosmolar diabetic non-ketotic coma results in severe fluid depletion, electrolyte disturbance, profound hyperglycaemia and an altered mental state, the guiding principles of therapy include aggressive rehydration, insulin therapy, correction of electrolyte abnormalities and treatment of any underlying illnesses. Treatment of acute hyperkalaemia includes calcium ions, insulin with dextrose, salbutamol and haemodialysis.

A Dusty Coma Model of Comet Hyakutake

NASA Astrophysics Data System (ADS)

Boice, D. C.; Benkhoff, J.

1996-09-01

We present a multifluid, hydrodynamic model for the gas, dust, and plasma flow in a cometary coma appropriate for Comet Hyakutake. The model accounts for three sources of gas release: sublimation from surface ices, transport of gas from subsurface regions through the surface, and release of gas from dust in the coma. The simulations are based on a spherically symmetric neutral coma model with detailed photo and gas-phase chemistry and dust entrainment by the gas. The model includes a separate energy balance for the electrons, separate flow of the neutral gas, fast neutral atomic and molecular hydrogen, and dust entrainment with fragmentation. The simulations allow a study of how certain features of a cometary coma, e.g., spatial distributions of gas-phase species and dust of various sizes, change with heliocentric distance. Special attention is given to observations of hydrocarbon and sulphur species. In comparison with observations, the model can be used to characterize the environment surrounding Hyakutake and aid in assimilating a variety of diverse observations of this bright comet. A complete description of the model and more extensive results with comparisons to observations where possible will be presented.

Urea cycle pathway targeted therapeutic action of naringin against ammonium chloride induced hyperammonemic rats.

PubMed

Ramakrishnan, Arumugam; Vijayakumar, Natesan

2017-10-01

Ammonia is a well-known neurotoxin that causes liver disease and urea cycle disorder. Excessive ammonia content in the blood leads to hyperammonemic condition and affects both excitatory and inhibitory neurotransmission including brain edema and coma. Naringin, a plant bioflavonoid present in various citrus fruits and mainly extracted from the grape fruit. This study was designed to assess the protective effect of naringin on ammonium chloride (NH 4 Cl) induced hyperammonemic rats. Experimental hyperammonemia was induced by intraperitoneal injections (i.p) of NH 4 Cl (100mg/kg body weight (b.w.)) thrice a week for 8 consecutive weeks. Hyperammonemic rats were treated with naringin (80mg/kg b.w.) via oral gavage. Naringin administration significantly augmented the level of blood ammonia and plasma urea. Naringin also upregulate the expression of urea cycle enzymes such as carbamoyl phosphate synthase I (CPS I) and ornithine transcarbamylase (OTC), arininosuccinate synthase (ASS), argininosuccinate lyase (ASL) and arginase I (ARG) and metabotropic glutamate receptors (mGluRs) such as mGluRs I and mGluRs V and down regulate the expression of inflammatory markers like tumor necrosis factor (TNF-α), nuclear factor kappa B (NF-kB), Interleukin-6 (IL-6), inducible nitric oxide synthase (iNOS). In addition, to this, the protective effect of naringin was also revealed through the immunohistochemical changes in tissues. Thus our present study result suggest that naringin modulates the expression of proteins involved in urea cycle pathway and suppresses the expression of inflammatory markers and acts as a potential agent to treat condition in rats. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Challenges in the Management of a Patient with Myxoedema Coma in Ghana: A Case Report.

PubMed

Akpalu, Josephine; Atiase, Yacoba; Yorke, Ernest; Fiscian, Henrietta; Kootin-Sanwu, Cecilia; Akpalu, Albert

2017-03-01

Myxoedema coma is a rare life-threatening disease, and it is essential that it is managed appropriately to reduce the associated high mortality. However, in the setting where efficient healthcare delivery is hampered by inadequacies, the management of such cases may pose a significant challenge. We present the case of a middle-aged woman diagnosed with myxoedema coma and severe hyponatremia. The case report highlights some of the challenges that may be encountered during the management of myxoedema coma in similar settings and outlines the management strategies undertaken to overcome them in the absence of national guidelines. It also brings to the fore the need for clinicians to look out for clinical features suggestive of hypothyroidism particularly among high risk individuals for early diagnosis and treatment. None declared.

Spectroscopic Profiles of Comets Garradd and McNaught

NASA Astrophysics Data System (ADS)

Harris, Ien; Pierce, Donna M.; Cochran, Anita L.

2017-10-01

We have used the integral-field unit spectrograph (the George and Cynthia Mitchell Spectrograph) on the 2.7m Harlan J. Smith telescope at McDonald Observatory to obtain spectroscopic images of the comae of several comets. The images were obtained for various radical species (C2, C3, CN, NH2). Radial and azimuthal average profiles of the radical species were created to enhance any observed cometary coma morphological features. We compare the observed coma features across the observed species and over the different observation periods in order to constrain possible rotational states of the observed comets, as well as determine possible source differences in the coma between the observed radical species. We will present results for several comets, including C/2009 P1 (Garradd) and 260P (McNaught).

[Thyrotoxic storm and myxedema coma].

PubMed

Takasu, N

1999-08-01

Thyrotoxic or hyperthyroid storm is a grave, life-threatening, but relatively infrequent medical emergency. Immediate causes of death in this emergency are severe hyperpyrexia and pulmonary edema associated with arrhythmias, shock, and coma. This emergency is found in Graves' patients most frequently. Myxedema coma is an emergency clinical state caused by severe deficiency of thyroid hormones. This crisis represents the extreme expression of hypothyroidism. While it is quite useful to elicit a history of previous hypothyroidism, thyroid surgery, or radioactive iodine treatment, it is not obtainable.

Perioperative management of a patient with myxedema coma and septicemic shock.

PubMed

Baduni, Neha; Sinha, Sunil Kumar; Sanwal, Manoj K

2012-10-01

Myxedema coma is a life-threatening but uncommon complication of long-standing, neglected hypothyroidism. It was first reported by Ord in 1879. Till date only around 200 cases have been reported in literature. The incidence in European countries is 0.22 per million per year. No epidemiological data is available from the Indian subcontinent. We are reporting the case of an elderly lady who went into life-threatening myxedema coma along with septicemic shock, and was successfully treated with oral thyroxine.

[Hyperammonemia type II as an example of urea cycle disorder].

PubMed

Hawrot-Kawecka, Anna M; Kawecki, Grzegorz P; Duława, Jan

2006-01-01

Ornithine transcarbamylase deficiency is the most common inherited urea cycle disorder. Its clinical manifestations as lethargy, vomites, coma and cerebral edema are the effect of the higher concentration of the ammonia in plasma. Hyperammonemia, caused by mutation in ornithine transcarbamylase gene, is often considered as a reason of coma by pediatricians but skipped by internist, although it is the third reason of hepatic coma in adults. This article is the recapitulation of published studies and their implication on everyday clinical practice.

Hypothyroidism-induced myocardial damage and heart failure: an overlooked entity.

PubMed

Shuvy, Mony; Shifman, Oshrat E Tayer; Nusair, Samir; Pappo, Orit; Lotan, Chaim

2009-01-01

Hypothyroid state may induce cardiac muscle impairment such as diastolic dysfunction and abnormal relaxation time. Advanced heart failure in hypothyroid patients has been described only in severe symptomatic cases, mostly during myxedematous coma. We describe an unusual case of asymptomatic patient with hypothyroidism who presented with severely reduced cardiac function with elevated cardiac enzymes reflecting significant myocardial injury. Comprehensive evaluation for heart failure was suggestive only for long-standing untreated hypothyroidism. Endomyocadial biopsy demonstrated unique histological findings of mucopolysaccharide accumulation attributed to hypothyroid state. Asymptomatic hypothyroidism may cause severe reduction in cardiac function accompanied with elevated cardiac enzymes. To our knowledge, this is the first description of human myocardial biopsy revealing mucopolysaccharide accumulation attributed to hypothyroid state.

End-of-mission ROSINA/COPS measurements as a probe of the innermost coma of comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Tenishev, V.; Fougere, N.; Rubin, M.; Tzou, C. Y.; Combi, M. R.; Altwegg, K.; Gombosi, T. I.; Shou, Y.; Huang, Z.; Hansen, K. C.; Toth, G.

2017-12-01

A cometary coma is a unique phenomenon in the Solar system that represents an example of a planetary atmosphere influenced by little or no gravity. Due to the negligible gravity of a comet's nucleus, a coma has a characteristic size that exceeds that of the nucleus itself by many orders of magnitude. An extended dusty gas cloud that forms a coma is affected mainly by molecular collisions, radiative cooling, and photolytic, charge-exchange, and impact-ionization reactions. Such an environment has been extensively observed during the recent Rosetta mission, which was the first mission that escorts a comet along its way through the Solar system for an extended amount of time with the main scientific objectives of characterizing comet's nucleus, determining the surface composition, and studying the comet's activity development. The ROSINA (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) Comet Pressure Sensor (COPS) onboard the Rosetta spacecraft has performed one of the most exciting observations of the innermost coma during the spacecraft descend maneuver during the last ten hours of the mission when the random and outflow directed pressures in the coma have been measured all the way down to the comet's surface. Performed at such close proximity to the nucleus, these observations can help to characterize effects due to topological features and/or the gas local conditions at the surface of the nucleus. The major focus of the presented study is analyzing of the end-of-mission pressure measurements by the ROSINA/COPS instrument. Because the coma at a heliocentric distance of 3.8 AU was in a collisionless regime, it can be described by solving the Liouville equation, as we have done in our analysis. We have used the SHAP5 nucleus model to account for the topology of the volatile source. Spacecraft trajectory and the instrument pointing with respect to the comet's nucleus have been obtained with the SPICE library. Here, we present results of our analysis and discuss the effects of the surface topology and that of the local surface volatile injection on the distribution of gas in the innermost coma of comet 67P/Churyumov-Gerasimenko.

Analysis of the ROSINA/COPS end-of-mission measurements of the coma of comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Tenishev, Valeriy; Combi, Michael R.; Fougere, Nicolas; Rubin, Martin; Tzou, Chia-Yu; Shou, Yinsi; Gombosi, T. I.; Altwegg, Kathrin; Huang, Zhenguang; Toth, Gabor; Hansen, Kenneth C.

2017-10-01

A cometary coma is a unique phenomenon in the Solar system that represents an example of a planetary atmosphere influenced by little or no gravity. Due to the negligible gravity of a comet’s nucleus, a coma has a characteristic size that exceeds that of the nucleus itself by many orders of magnitude. An extended dusty gas cloud that forms a coma is affected mainly by molecular collisions, radiative cooling, and photolytic, charge-exchange, and impact-ionization reactions.Such an environment has been extensively observed during the recent Rosetta mission, which was the first mission that escorts a comet along its way through the Solar system for an extended amount of time with the main scientific objectives of characterizing comet’s nucleus, determining the surface composition, and studying the comet’s activity development.The ROSINA (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) Comet Pressure Sensor (COPS) onboard the Rosetta spacecraft has performed one of the most exciting observations of the innermost coma during the spacecraft descend maneuver during the last ten hours of the mission when the random and outflow directed pressures in the coma have been measured all the way down to the comet’s surface. Performed at such close proximity to the nucleus, these observations can help to characterize effects due to topological features and/or the gas local conditions at the surface of the nucleus.The major focus of the presented study is analyzing of the end-of-mission pressure measurements by the ROSINA/COPS instrument. Because the coma at a heliocentric distance of 3.8 AU was in a collisionless regime, it can be described by solving the Liouville equation, as we have done in our analysis. We have used the SHAP5 nucleus model to account for the topology of the volatile source. Spacecraft trajectory and the instrument pointing with respect to the comet’s nucleus have been obtained with the SPICE library. Here, we present results of our analysis and discuss the effects of the surface topology and that of the local surface volatile injection on the distribution of gas in the innermost coma of comet 67P/Churyumov-Gerasimenko.

Chemical Recycling of HCN in Cometary Comae

NASA Astrophysics Data System (ADS)

Boice, Daniel C.; Kawakita, Hideyo; Shinnaka, Yoshiharu; Mumma, Michael J.; Kobayashi, Hitomi; Ogawa, Sayuri

2014-11-01

Modeling is essential to understand the important physical and chemical processes that occur in cometary comae, especially the relationship between putative parent and daughter molecules, such as, HCN and CN. Photochemistry is a major source of ions and electrons that further initiate key gas-phase reactions, contributing to the plethora of molecules and atoms observed in comets. The effects of photoelectrons that interact via impacts are important to the overall excitation and dissociation processes in the inner coma. We consider the relevant processes in the collision-dominated, inner coma of a comet within a global modeling framework to understand observations of HCN and CN. The CN source(s) must be able to produce highly collimated jets, be consistent with the observed CN parent scale length, and have a production rate consistent with the observed CN production. HCN fulfills these conditions in some comets (e.g., 1P/Halley, Hale-Bopp) while it does not in others (e.g., 8P/Tuttle, 6P/d’Arrest, 73P/S-W3, 2P/Encke, 9P/Temple 1 and C/2007 W1).We investigate the chemistry of HCN with our chemical kinetics coma model including a network with other possible CN parents, as well as a dust component that may be a potential source of CN. It is seen that the major destruction pathways of HCN are via photo dissociation (into H and CN) and protonation with water group ions - primarily H3O+. We point out the intriguing “recycling” of HCN via protonation reactions with H3O+, H2O+, OH+, and subsequent dissociative recombination. It seems that HCN molecules observed in the coma can consist of those initially released from the nucleus and those that are freshly formed at different locations in the coma via these protonation/dissociation reactions. We will investigate implications for reconciling discrepancies between observations of HCN and CN in cometary comae.Acknowledgements: We appreciate support from the NSF Planetary Astronomy Program. This program is partially supported by the MEXT Supported Program for the Strategic Research Foundation at Private Universities, 2014-2018.

The Meteoroid Fluence at Mars Due to Comet C/2013 A1 (Siding Spring)

NASA Technical Reports Server (NTRS)

Moorhead, A.; Wiegert, P.; Blaauw, R.; McCarty, C.; Kingery, A.; Cooke, W.

2014-01-01

Long-period comet C/2013 A1 (Siding Spring) will experience a close encounter with Mars on 2014 Oct 19. A collision between the comet and the planet has been ruled out, but the comet's coma may envelop Mars and its man-made satellites. By the time of the close encounter, five operational spacecraft will be present near Mars. Characterizing the coma is crucial for assessing the risk posed to these satellites by meteoroid impacts. We present an analytic model of cometary comae that describes the spatial and size distributions of cometary dust and meteoroids. This model correctly reproduces, to within an order of magnitude, the number of impacts recorded by Giotto near 1P/Halley [1] and by Stardust near comet 81P/Wild 2 [2]. Applied to Siding Spring, our model predicts a total particle fluence near Mars of 0.02 particles per square meter. In order to determine the degree to which Siding Spring's coma deviates from a sphere, we perform numerical simulations which take into account both gravitational effects and radiative forces. We take the entire dust component of the coma and tail continuum into account by simulating the ejection and evolution of dust particles from comet Siding Spring. The total number of particles simulated is essentially a free parameter and does not provide a check on the total fluence. Instead, these simulations illustrate the degree to which the coma of Siding Spring deviates from the perfect sphere described by our analytic model (see Figure). We conclude that our analytic model sacrifices less than an order of magnitude in accuracy by neglecting particle dynamics and radiation pressure and is thus adequate for order-of-magnitude fluence estimates. Comet properties may change unpredictably and therefore an analytic coma model that enables quick recalculation of the meteoroid fluence is highly desirable. NASA's Meteoroid Environment Office is monitoring comet Siding Spring and taking measurements of cometary brightness and dust production. We will discuss our coma model and nominal fluence taking the latest observations into account.

Dwarf galaxies in the coma cluster: Star formation properties and evolution

NASA Astrophysics Data System (ADS)

Hammer, Derek M.

The infall regions of galaxy clusters are unique laboratories for studying the impact of environment on galaxy evolution. This intermediate region links the low-density field environment and the dense core of the cluster, and is thought to host recently accreted galaxies whose star formation is being quenched by external processes associated with the cluster. In this dissertation, we measure the star formation properties of galaxies at the infall region of the nearby rich cluster of galaxies, Coma. We rely primarily on Ultraviolet (UV) data owing to its sensitivity to recent star formation and we place more emphasis on the properties of dwarf galaxies. Dwarf galaxies are good tracers of external processes in clusters but their evolution is poorly constrained as they are intrinsically faint and hence more challenging to detect. We make use of deep GALEX far-UV and near-UV observations at the infall region of the Coma cluster. This area of the cluster has supporting photometric coverage at optical and IR wavelengths in addition to optical spectroscopic data that includes deep redshift coverage of dwarf galaxies in Coma. Our GALEX observations were the deepest exposures taken for a local galaxy cluster. The depth of these images required alternative data analysis techniques to overcome systematic effects that limit the default GALEX pipeline analysis. Specifically, we used a deblending method that improved detection efficiency by a factor of ˜2 and allowed reliable photometry a few magnitudes deeper than the pipeline catalog. We performed deep measurements of the total UV galaxy counts in our field that were used to measure the source confusion limit for crowded GALEX fields. The star formation properties of Coma members were studied for galaxies that span from starbursts to passive galaxies. Star-forming galaxies in Coma tend to have lower specific star formation rates, on average, as compared to field galaxies. We show that the majority of these galaxies are likely in the process of being quenched or were only recently quenched. We modeled the quenching timescales for transition galaxies, or “green valley” objects, and found that the majority are quenched in less than 1 Gyr. This timescale is consistent with rapid dynamical processes that are active in the cluster environment as opposed to the more gradual quenching mechanisms that exist in the group environment. For the passive galaxy population, we have measured an average stellar age of 6-8 Gyr for the red sequence which is consistent with previous studies based on spectroscopic observations. We note that the star formation properties of Coma member galaxies were established from photometry alone, as opposed to using spectroscopic data which are more challenging to obtain for dwarf galaxies. We have measured the faintest UV luminosity functions (LFs) presented for a rich galaxy cluster thus far. The Coma UV LFs are 3.5 mag fainter than previous studies in Coma, and are sufficiently deep that we reach the dwarf passive galaxy population for the first time. We have introduced a new technique for measuring the LF which avoids color selection effects associated with previous methods. The UV LFs constructed separately for star-forming and passive galaxies follow a similar distribution at faint magnitudes, which suggests that the recent quenching of infalling dwarf star-forming galaxies is sufficient to build the dwarf passive population in Coma. The Coma UV LFs show a turnover at faint magnitudes as compared to the field, owing to a deficit of dwarf galaxies with stellar masses below M∗ = 108 M⊙ . We show that the UV LFs for the field behind the Coma cluster are nearly identical to the average field environment, and do not show evidence for a turnover at faint magnitudes. We suspect that the missing dwarf galaxies in Coma are severely disrupted by tidal processes as they are accreted onto the cluster, just prior to reaching the infall region studied here.

Neurosurgical management of L-asparaginase induced haemorrhagic stroke

PubMed Central

Ogbodo, Elisha; Kaliaperumal, Chandrasekaran; O’Sullivan, Michael

2012-01-01

The authors describe a case of L-asparaginase induced intracranial thrombosis and subsequent haemorrhage in a newly diagnosed 30-year-old man with acute lymphoblastic leukaemia who was successfully managed by surgical intervention. At presentation, he had a Glasgow Coma Score of 7/15, was aphasic and had dense right hemiplegia. Neuroimaging revealed an acute anterior left middle cerebral artery infarct with parenchymal haemorrhagic conversion, mass effect and subfalcine herniation. He subsequently underwent left frontal craniotomy and evacuation of large frontal haematoma and decompressive craniectomy for cerebral oedema. Six months postoperatively he underwent titanium cranioplasty. He had made good clinical recovery and is currently mobilising independently with mild occasional episodes of expressive dysphasia, difficulty with fine motor movement on the right side, and has remained seizure free. This is the first documented case of L-asparaginase induced haemorrhagic stroke managed by neurosurgical intervention. The authors emphasise the possible role of surgery in managing chemotherapy induced intracranial complications. PMID:22605598

Synthesis of formamide and isocyanic acid after ion irradiation of frozen gas mixtures

NASA Astrophysics Data System (ADS)

Kaňuchová, Z.; Urso, R. G.; Baratta, G. A.; Brucato, J. R.; Palumbo, M. E.; Strazzulla, G.

2016-01-01

Context. Formamide (NH2HCO) and isocyanic acid (HNCO) have been observed as gaseous species in several astronomical environments such as cometary comae and pre- and proto-stellar objects. A debate is open on the formation route of those molecules, in particular if they are formed by chemical reactions in the gas phase and/or on grains. In this latter case it is relevant to understand if the formation occurs through surface reactions or is induced by energetic processing. Aims: We present arguments that support the formation of formamide in the solid phase by cosmic-ion-induced energetic processing of ices present as mantles of interstellar grains and on comets. Formamides, along with other molecules, are expelled in the gas phase when the physical parameters are appropriate to induce the desorption of ices. Methods: We have performed several laboratory experiments in which ice mixtures (H2O:CH4:N2, H2O:CH4:NH3, and CH3OH:N2) were bombarded with energetic (30-200 keV) ions (H+ or He+). FTIR spectroscopy was performed before, during, and after ion bombardment. In particular, the formation of HNCO and NH2HCO was measured quantiatively. Results: Energetic processing of ice can quantitatively reproduce the amount of NH2HCO observed in cometary comae and in many circumstellar regions. HNCO is also formed, but additional formation mechanisms are requested to quantitatively account for the astronomical observations. Conclusions: We suggest that energetic processing of ices in the pre- and proto-stellar regions and in comets is the main mechanism to produce formamide, which, once it is released in the gas phase because of desorption of ices, is observed in the gas phase in these astrophysical environments.

Prediction of Recovery from Coma After CPR

MedlinePlus

... to pain. There is good evidence* that myoclonus status epilepticus within the first day after CPR accurately predicts poor recovery from coma. Myoclonus status epilepticus is a constant twitching of muscles, including the ...

Using an integral-field unit spectrograph to study radical species in cometary coma

NASA Astrophysics Data System (ADS)

Lewis, Benjamin; Pierce, Donna M.; Vaughan, Charles M.; Cochran, Anita

2015-01-01

We have observed several comets using an integral-field unit spectrograph (the George and Cynthia Mitchell Spectrograph) on the 2.7m Harlan J. Smith telescope at McDonald Observatory. Full-coma spectroscopic images were obtained for various radical species (C2, C3, CN, NH2). Various coma enhancements were used to identify and characterize coma morphological features. The azimuthal average profiles and the Haser model were used to determine production rates and possible parent molecules. Here, we present the work completed to date, and we compare our results to other comet taxonomic surveys. This work was funded by the National Science Foundation Graduate K-12 (GK-12) STEM Fellows program (Award No. DGE-0947419), NASA's Planetary Atmospheres program (Award No. NNX14AH18G), and the Fund for Astrophysical Research, Inc.

Using an integral-field unit spectrograph to study radical species in cometary coma

NASA Astrophysics Data System (ADS)

Lewis, Benjamin; Pierce, Donna; Cochran, Anita; Vaughan, Charles

2014-11-01

We have observed several comets using an integral-field unit spectrograph (the George and Cynthia Mitchell Spectrograph) on the 2.7m Harlan J. Smith telescope at McDonald Observatory. Full-coma spectroscopic images were obtained for various radical species (C2, C3, CN, NH2). Various coma enhancements were used to identify and characterize coma morphological features. The azimuthal average profiles and the Haser model were used to determine production rates and possible parent molecules. Here, we present the work completed to date, and we compare our results to other comet taxonomic surveys. This work was funded by the National Science Foundation Graduate K-12 (GK-12) STEM Fellows program (Award No. DGE-0947419), NASA’s Planetary Atmospheres program (Award No. NNX14AH18G), and the Fund for Astrophysical Research, Inc.

Postoperative myxoedema coma.

PubMed

James, Robert; James, Jessie; Vij, Amarjit Singh; Vij, Kamaljeet Kaur

2014-02-13

Hypothyroidism is a commonly diagnosed endocrine disorder in medicine. Hyponatraemia is reported in up to 10% of hypothyroid patients, although it is usually mild and rarely causes symptoms. Myxoedema coma is a rare manifestation of hypothyroidism and it can be lethal if it goes undiagnosed and untreated. Our patient presented with an acute manifestation of probable long-standing, but undiagnosed, hypothyroidism. She was asymptomatic but when subjected to surgery (identifiable stress factor) it precipitated as myxoedema coma. Stressful situations such as surgery or infection are the usual precipitating factors for myxoedema coma. The patient responded well to treatment with levothyroxin, 0.9% saline infusion and other general supportive measures. Judicious use of intravenous saline to correct hyponatraemia is important. Correction with 3% normal saline should be carried out with great caution, as rapid correction with 3% normal saline can lead to central pontine demyelination.

Postoperative myxoedema coma

PubMed Central

James, Robert; James, Jessie; Vij, Amarjit Singh; Vij, Kamaljeet Kaur

2014-01-01

Hypothyroidism is a commonly diagnosed endocrine disorder in medicine. Hyponatraemia is reported in up to 10% of hypothyroid patients, although it is usually mild and rarely causes symptoms. Myxoedema coma is a rare manifestation of hypothyroidism and it can be lethal if it goes undiagnosed and untreated. Our patient presented with an acute manifestation of probable long-standing, but undiagnosed, hypothyroidism. She was asymptomatic but when subjected to surgery (identifiable stress factor) it precipitated as myxoedema coma. Stressful situations such as surgery or infection are the usual precipitating factors for myxoedema coma. The patient responded well to treatment with levothyroxin, 0.9% saline infusion and other general supportive measures. Judicious use of intravenous saline to correct hyponatraemia is important. Correction with 3% normal saline should be carried out with great caution, as rapid correction with 3% normal saline can lead to central pontine demyelination. PMID:24526192

A human brain network derived from coma-causing brainstem lesions.

PubMed

Fischer, David B; Boes, Aaron D; Demertzi, Athena; Evrard, Henry C; Laureys, Steven; Edlow, Brian L; Liu, Hesheng; Saper, Clifford B; Pascual-Leone, Alvaro; Fox, Michael D; Geerling, Joel C

2016-12-06

To characterize a brainstem location specific to coma-causing lesions, and its functional connectivity network. We compared 12 coma-causing brainstem lesions to 24 control brainstem lesions using voxel-based lesion-symptom mapping in a case-control design to identify a site significantly associated with coma. We next used resting-state functional connectivity from a healthy cohort to identify a network of regions functionally connected to this brainstem site. We further investigated the cortical regions of this network by comparing their spatial topography to that of known networks and by evaluating their functional connectivity in patients with disorders of consciousness. A small region in the rostral dorsolateral pontine tegmentum was significantly associated with coma-causing lesions. In healthy adults, this brainstem site was functionally connected to the ventral anterior insula (AI) and pregenual anterior cingulate cortex (pACC). These cortical areas aligned poorly with previously defined resting-state networks, better matching the distribution of von Economo neurons. Finally, connectivity between the AI and pACC was disrupted in patients with disorders of consciousness, and to a greater degree than other brain networks. Injury to a small region in the pontine tegmentum is significantly associated with coma. This brainstem site is functionally connected to 2 cortical regions, the AI and pACC, which become disconnected in disorders of consciousness. This network of brain regions may have a role in the maintenance of human consciousness. © 2016 American Academy of Neurology.

The Dependence of the Circumnuclear Coma Structure on the Properties of the Nucleus. IV. Structure of the Night-Side Gas Coma of a Strongly Sublimating Nucleus

NASA Astrophysics Data System (ADS)

Crifo, J. F.; Rodionov, A. V.

2000-12-01

The structure of the nightside coma in the vicinity of a strongly active comet nucleus of pure ice is investigated by solving gasdynamic equations for the flow of water vapour sublimated from—or condensed onto—the nucleus surface. To guarantee the physical validity of the solution, both Euler and Navier-Stokes Equations are solved, and the solutions are compared. A spherical nucleus is considered first and then a triaxial ellipsoidal nucleus. The results show that (1) a fluid coma of significant extent and very complicated physical structure is formed; (2) for low heat conduction transfer across the nucleus from the dayside to the nightside surface, a narrow conical weak shock appears near to the antisolar axis; the whole nightside surface acts as a cold trap for the vapor, part of which recondenses onto it; (3) for intermediate heat conduction, part of the nightside surface becomes weakly sublimating, and a different weak shock pattern is formed; and (4) at high heat conduction, the whole nightside surface is weakly sublimating, and the resulting flow pattern becomes similar to that existing in a coma formed by diffusion from the nucleus interior (see Crifo, Rodionov and Bockelée-Morvan, 1999, Icarus138, 83-106). The results are compared to related model results by other authors, and a discussion is made of their relevance to the 1996 observation of the near-nucleus nightside coma of Comet C/1996 B2 Hyakutake.

Functional coma.

PubMed

Ludwig, L; McWhirter, L; Williams, S; Derry, C; Stone, J

2016-01-01

Functional coma - here defined as a prolonged motionless dissociative attack with absent or reduced response to external stimuli - is a relatively rare presentation. In this chapter we examine a wide range of terms used to describe states of unresponsiveness in which psychologic factors are relevant to etiology, such as depressive stupor, catatonia, nonepileptic "pseudostatus," and factitious disorders, and discuss the place of functional or psychogenic coma among these. Historically, diagnosis of functional coma has sometimes been reached after prolonged investigation and exclusion of other diagnoses. However, as is the case with other functional disorders, diagnosis should preferably be made on the basis of positive findings that provide evidence of inconsistency between an apparent comatose state and normal waking nervous system functioning. In our review of physical signs, we find some evidence for the presence of firm resistance to eye opening as reasonably sensitive and specific for functional coma, as well as the eye gaze sign, in which patients tend to look to the ground when turned on to one side. Noxious stimuli such as Harvey's sign (application of high-frequency vibrating tuning fork to the nasal mucosa) can also be helpful, although patients with this disorder are often remarkably unresponsive to usually painful stimuli, particularly as more commonly applied using sternal or nail bed pressure. The use of repeated painful stimuli is therefore not recommended. We also discuss the role of general anesthesia and other physiologic triggers to functional coma. © 2016 Elsevier B.V. All rights reserved.

The effect of brain death and coma on gastric myoelectrical activity.

PubMed

Bor, Canan; Bordin, Dmitry; Demirag, Kubilay; Uyar, Mehmet

2016-05-01

Gastrointestinal motility problems and delayed gastric emptying in patients admitted to intensive care units are important because they can contribute to different problems. Herein we aimed to measure the changes in gastric myoelectrical activity with electrogastrography (EGG) following brain death (BD) and compare the results to those from patients in a deep coma without BD. Fifteen patients with BD and nine in a deep coma with a Glasgow Coma Score from 3 to 8 were included. An enteral nutrition solution was given via a nasogastric tube between 45 min of fasting and the postprandial periods. The mean dominant frequency (MnDF), normal gastric slow wave ratio (%), tachygastria and bradygastria (%), power ratio (PR: dominant power after test meal/fasting), and dominant frequency instability coefficient were evaluated. The median of MnDF was determined 3.20±0.6 (BD) vs 3.05±0.5 (control), p>0.05. Patients with BD displayed tachygastria, particularly during the fasting state, with this disturbance decreasing during the postprandial period (from 41% to 15%). However, none of the differences between the groups were statistically significant. PR was pathologic in 4/15 (26.7%) patients in the BD group and 4/9 (44.4%) patients in the control group (p=0.288). Patients with coma or BD bouth might have gastric myoelectrical activity disturbances. BD does not show more severe disturbance than coma wihouth BD. EGG might be useful as a non-invasive and easy-to-use technology; however, it needs further improvement.

A human brain network derived from coma-causing brainstem lesions

PubMed Central

Boes, Aaron D.; Demertzi, Athena; Evrard, Henry C.; Laureys, Steven; Edlow, Brian L.; Liu, Hesheng; Saper, Clifford B.; Pascual-Leone, Alvaro; Geerling, Joel C.

2016-01-01

Objective: To characterize a brainstem location specific to coma-causing lesions, and its functional connectivity network. Methods: We compared 12 coma-causing brainstem lesions to 24 control brainstem lesions using voxel-based lesion-symptom mapping in a case-control design to identify a site significantly associated with coma. We next used resting-state functional connectivity from a healthy cohort to identify a network of regions functionally connected to this brainstem site. We further investigated the cortical regions of this network by comparing their spatial topography to that of known networks and by evaluating their functional connectivity in patients with disorders of consciousness. Results: A small region in the rostral dorsolateral pontine tegmentum was significantly associated with coma-causing lesions. In healthy adults, this brainstem site was functionally connected to the ventral anterior insula (AI) and pregenual anterior cingulate cortex (pACC). These cortical areas aligned poorly with previously defined resting-state networks, better matching the distribution of von Economo neurons. Finally, connectivity between the AI and pACC was disrupted in patients with disorders of consciousness, and to a greater degree than other brain networks. Conclusions: Injury to a small region in the pontine tegmentum is significantly associated with coma. This brainstem site is functionally connected to 2 cortical regions, the AI and pACC, which become disconnected in disorders of consciousness. This network of brain regions may have a role in the maintenance of human consciousness. PMID:27815400

Production, Outflow Velocity, and Radial Distribution of H2O and OH in the Coma of Comet C/1995 O1 [Hale-Bopp] from Wide Field Imaging of OH

NASA Technical Reports Server (NTRS)

Harris, Walter M.; Scherb, Frank; Mierkiewicz, Edwin; Oliverson, Ronald; Morgenthaler, Jeffrey

2003-01-01

Observations of OH are a useful proxy of the water production rate (Q(sub H2O)) and outflow velocity (V(sub out)) in comets. From wide field images taken on 03/28/1997 and 04/08/1997 that capture the entire scale length of the OH coma of comet C/1995 O1 (Hale-Bopp), we obtain Q(sub H2O) from the model-independent method of aperture summation. With an adaptive ring summation algorithm, we extract the radial brightness distribution of OH 0-0 band emission out to cometocentric distances of up to 10(exp 6) km, both as azimuthal averages and in quadrants covering different position angles relative to the comet-Sun line. These profiles are fit using both fixed and variable velocity 2-component spherical expansion models to estimate V(sub OH) with increasing distance from the nucleus. The OH coma of Hale-Bopp was more spatially extended than previous comets, and this extension is best matched by a variable acceleration of H2O and OH that acted across the entire coma, but was strongest within 1-2 x 10(exp 4) km from the nucleus. Our models indicate that V(sub OH) at the edge of our detectable field of view (10(exp 6) km) was approx. 2-3 times greater in Hale-Bopp than for a 1P/Halley-class comet at 1 AU, which is consistent with the results of more sophisticated gas-kinetic models, extrapolation from previous observations of OH in comets with Q(sub H2O) greater than 10(exp 29)/s , and direct radio measurements of the outer coma Hale-Bopp OH velocity. The most probable source of this acceleration is thermalization of the excess energy of dissociation of H2O and OH over an extended collisional coma. When the coma is broken down by quadrants in position angle, we find an azimuthal asymmetry in the radial distribution that is characterized by an increase in the spatial extent of OH in the region between the orbit-trailing and anti-sunward directions. Model fits specific to this area and comparison with radio OH measurements suggest greater acceleration here, with V(sub OH) approx. 1.5 times greater at a 10(exp 6) km cometocentric distance than elsewhere in the coma. We discuss several mechanisms that may have acted within the coma to produce the observed effect.

New red jewels in Coma Berenices

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

Terrien, Ryan C.; Mahadevan, Suvrath; Deshpande, Rohit

2014-02-20

We have used Sloan Digital Sky Survey-III (SDSS-III) Apache Point Observatory Galactic Evolution Experiment (APOGEE) radial velocity observations in the near-infrared H-band to explore the membership of the nearby (86.7 ± 0.9 pc) open cluster Coma Berenices (Melotte 111), concentrating on the poorly populated low-mass end of the main sequence. Using SDSS-III APOGEE radial velocity measurements, we confirm the membership of eight K/M dwarf members, providing the first confirmed low-mass members of the Coma Berenices cluster. Using R ∼ 2000 spectra from IRTF-SpeX, we confirm the independently luminosity classes of these targets, and find their metallicities to be consistent withmore » the known solar mean metallicity of Coma Berenices and of M dwarfs in the solar neighborhood. In addition, the APOGEE spectra have enabled measurement of vsin i for each target and detection for the first time of the low-mass secondary components of the known binary systems Melotte 111 102 and Melotte 111 120, as well as identification of the previously unknown binary system 2MASS J12214070+2707510. Finally, we use Kilodegree Extremely Little Telescope photometry to measure photometric variability and rotation periods for a subset of the Coma Berenices members.« less

Post-coma persons with multiple disabilities use assistive technology for their leisure engagement and communication.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Oliva, Doretta; Buonocunto, Francesca; Sacco, Valentina; D'Amico, Fiora; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa

2014-01-01

Interventions for post-coma persons, who have emerged from a minimally conscious state but present with extensive neuro-motor impairment and lack of or minimal verbal skills, need to promote occupation and communication through the use of assistive technology. These two studies were aimed at assessing two technology-aided programs to promote leisure engagement and communication for three post-coma participants with multiple disabilities. Study I assessed a program to allow a woman and a man with extensive neuro-motor impairment and lack of speech to switch on music and videos, make requests to caregivers, and send messages to (communicate with) relevant partners and receive messages from those partners. Study II assessed a program to allow a post-coma woman with extensive motor impairment and reduced verbal behavior to activate music, videos and requests, send and receive messages, and make telephone calls. Data showed that both programs were successful. The participants of Study I managed leisure engagement, requests, as well as text messaging. The participant of Study II showed consistent leisure engagement, text messaging, and telephone calls. Assistive technology can be profitably used to provide post-coma persons with multiple disabilities relevant leisure and communication opportunities.

[Myxedema coma in a patient with type 1 neurofibromatosis: rare association].

PubMed

Sasazawa, Denise Tieko; Tsukumo, Daniela Miti; Lalli, Cristina Alba

2013-12-01

Myxedema coma, a rare but fatal emergency, is an extreme expression of hypothyroidism. We describe a 51-year-old male patient who has discontinued hypothyroidism treatment 10 months earlier and developed lethargy, edema, and cold intolerance symptoms. He also had a previous diagnosis of neurofibromatosis. After admission, he progressed to respiratory insufficiency and coma. The prompt recognition of the condition, thyroid hormone replacement, and management of the complications (hypoventilation, cardiogenic shock associated with swinging heart, adrenal and renal insufficiency and sepsis), resulted in a favorable evolution.

Analysis of hydrogen H-alpha observations of the coma of Comet P/Halley

NASA Technical Reports Server (NTRS)

Smyth, William H.; Marconi, M. L.; Scherb, Frank; Roesler, Fred L.

1993-01-01

The Monte Carlo Particle Trajectory Model of Combi and Smyth (1988) is used here to analyze observations of the H-alpha coma of Comet Halley. The solar excitation mechanism for the H-alpha emissions line is described. The H2O production rates derived for the H-alpha brightness measurements are shown to be very consistent with the H2O production rates determined from other Comet Halley observations of the H, O, and OH comae. Revised H2O production rates determined from 6300 A brightness measurements are presented.

Period change of a contact binary system RW Comae Berenices

NASA Astrophysics Data System (ADS)

Maithong, Wiraporn; Phao-ai, Parinda

2017-08-01

In this work, we studied about the period change of a contact binary system RW Comae Berenices. The binary system was observed on March 9th, 2016 by the 105 mm diameter of a refraction telescope with the DSLR digital camera at the Regional Observatory for the Public Nakhon Ratchasima, Thailand. The photometry used the IRIS program. The period change was analyzed by used the O-C diagram. The result shows that the period of the RW Comae Berenices is increasing with 1.89×10-3 seconds/year.

VizieR Online Data Catalog: Coma clusters and filaments galaxies FIR survey (Fuller+, 2016)

NASA Astrophysics Data System (ADS)

Fuller, C.; Davies, J. I.; Smith, M. W. L.; Valiante, E.; Eales, S.; Bourne, N.; Dunne, L.; Dye, S.; Furlanetto, C.; Ibar, E.; Ivison, R.; Maddox, S.; Sansom, A.; Michalowski, M. J.; Davis, T.

2017-05-01

We have undertaken a Herschel FIR survey of the Coma cluster and the galaxy filament it resides within. Our survey covers an area of ~150 deg2 observed in five bands at 100, 160, 250, 350 and 500um. We have used the SDSS spectroscopic survey to define an area and redshift selected sample of 744 Coma cluster galaxies - the CCC. For comparison, we also define in a similar way a sample of 951 galaxies in the connecting filament - the CFC. (2 data files).

DEEP ULTRAVIOLET LUMINOSITY FUNCTIONS AT THE INFALL REGION OF THE COMA CLUSTER

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

Hammer, D. M.; Hornschemeier, A. E.; Jenkins, L.

2012-02-01

We have used deep GALEX observations at the infall region of the Coma cluster to measure the faintest ultraviolet (UV) luminosity functions (LFs) presented for a rich galaxy cluster thus far. The Coma UV LFs are measured to M{sub UV} = -10.5 in the GALEX FUV and NUV bands, or 3.5 mag fainter than previous studies, and reach the dwarf early-type galaxy population in Coma for the first time. The Schechter faint-end slopes ({alpha} Almost-Equal-To -1.39 in both GALEX bands) are shallower than reported in previous Coma UV LF studies owing to a flatter LF at faint magnitudes. A Gaussian-plus-Schechtermore » model provides a slightly better parameterization of the UV LFs resulting in a faint-end slope of {alpha} Almost-Equal-To -1.15 in both GALEX bands. The two-component model gives faint-end slopes shallower than {alpha} = -1 (a turnover) for the LFs constructed separately for passive and star-forming galaxies. The UV LFs for star-forming galaxies show a turnover at M{sub UV} Almost-Equal-To -14 owing to a deficit of dwarf star-forming galaxies in Coma with stellar masses below M{sub *} = 10{sup 8} M{sub Sun }. A similar turnover is identified in recent UV LFs measured for the Virgo cluster suggesting this may be a common feature of local galaxy clusters, whereas the field UV LFs continue to rise at faint magnitudes. We did not identify an excess of passive galaxies as would be expected if the missing dwarf star-forming galaxies were quenched inside the cluster. In fact, the LFs for both dwarf passive and star-forming galaxies show the same turnover at faint magnitudes. We discuss the possible origin of the missing dwarf star-forming galaxies in Coma and their expected properties based on comparisons to local field galaxies.« less

The Inner Coma Physical Environments of Ecliptic Comets 45P/Honda-Mrkos-Pajdusakova, 2P/Encke, and 41P/Tuttle-Giacobini-Kresak Revealed Through Long-Slit Spectroscopy at NASA IRTF

NASA Astrophysics Data System (ADS)

Bonev, Boncho P.; DiSanti, Michael A.; Roth, Nathan; Dello Russo, Neil; Vervack, Ronald J.; Gibb, Erika L.; Villanueva, Geronimo Luis; Combi, Michael R.; Fougere, Nicolas; Kawakita, Hideyo; McKay, Adam J.; Saki, Mohammad; Cordiner, Martin; Protopapa, Silvia; de Val-Borro, Miguel

2017-10-01

Understanding the physical processes in the inner regions of cometary atmospheres is vital for interpretation of molecular cometary emission at all wavelengths. Furthermore, because ecliptic comets are continuously evaluated as space mission targets, understanding their coma environments is a central theme in both enhancing the science return of past missions (EPOXI, Rosetta) and in selecting future mission targets. With this motivation, we report long-slit high-resolution observations of H2O emission in the comae of three ecliptic comets observed in early 2017: 45P/Honda-Mrkos-Pajdusakova, 2P/Encke, and 41P/Tuttle-Giacobini-Kresak. Using the new crossed-dispersed spectrograph iSHELL at NASA IRTF, we detected a suite of water rovibrational emission lines from these comets and measured the spatial distributions of H2O rotational temperatures and molecular column densities. Both parameters are highly diagnostic of the physical environment in cometary comae, the competition between cooling and heating processes in these environments, and the presence (or lack thereof) of extended coma sources of gas-phase H2O. Comets 2P and 45P allowed a rare glimpse into coma physics at small (< 0.6 AU) heliocentric distances, where photochemical heating is particularly important, but direct H2O observations have been sparse. Our results add to the small sample of spatial-spectral measurements of this type. They will be discussed in the context of coma physics models along with prospects for investigations during the upcoming favorable apparitions of ecliptic comets 21P/Giacobini-Zinner and 46P/Wirtanen. We gratefully acknowledge support from the NASA Solar System Workings, Planetary Atmospheres, Earth and Space Science Fellowship, Solar System Observations, Emerging Worlds, and Astrobiology Programs, and NSF Solar and Planetary Research Grants. We are grateful to the entire IRTF staff for their help with these challenging observations, most of which were done during daytime.

Deep UV Luminosity Functions at the Infall Region of the Coma Cluster

NASA Technical Reports Server (NTRS)

Hammer, D. M.; Hornschemeier, A. E.; Salim, S.; Smith, R.; Jenkins, L.; Mobasher, B.; Miller, N.; Ferguson, H.

2011-01-01

We have used deep GALEX observations at the infall region of the Coma cluster to measure the faintest UV luminosity functions (LFs) presented for a rich galaxy cluster thus far. The Coma UV LFs are measured to M(sub uv) = -10.5 in the GALEX FUV and NUV bands, or 3.5 mag fainter than previous studies, and reach the dwarf early-type galaxy population in Coma for the first time. The Schechter faint-end slopes (alpha approximately equal to -1.39 in both GALEX bands) are shallower than reported in previous Coma UV LF studies owing to a flatter LF at faint magnitudes. A Gaussian-plus-Schechter model provides a slightly better parametrization of the UV LFs resulting in a faint-end slope of alpha approximately equal to -1.15 in both GALEX bands. The two-component model gives faint-end slopes shallower than alpha = -1 (a turnover) for the LFs constructed separately for passive and star forming galaxies. The UV LFs for star forming galaxies show a turnover at M(sub UV) approximately equal to -14 owing to a deficit of dwarf star forming galaxies in Coma with stellar masses below M(sub *) = 10(sup 8) solar mass. A similar turnover is identified in recent UV LFs measured for the Virgo cluster suggesting this may be a common feature of local galaxy clusters, whereas the field UV LFs continue to rise at faint magnitudes. We did not identify an excess of passive galaxies as would be expected if the missing dwarf star forming galaxies were quenched inside the cluster. In fact, the LFs for both dwarf passive and star forming galaxies show the same turnover at faint magnitudes. We discuss the possible origin of the missing dwarf star forming galaxies in Coma and their expected properties based on comparisons to local field galaxies.

Observation of CO2 in Comet C/2012 K5 LINEAR

NASA Astrophysics Data System (ADS)

McKay, Adam; Kelley, Michael; DiSanti, Michael; Chanover, Nancy

2012-12-01

The study of cometary composition is important to understanding the formation and evolution of our solar system. Comets have undergone very little thermal evolution in their lifetimes, which results in their near pristine composition. The nucleus of a comet is very rarely detected directly. Instead, we observe the coma that surrounds the nucleus. Physical and chemical processes in the coma affect its composition, and therefore coma composition is not a direct representation of nuclear composition. An important trend is the observed variation of coma composition with heliocentric distance, most likely influenced by the volatility of the main surface ices, H2O, CO2, and CO. Infrared studies of these molecules are complicated by telluric features, so often daughter molecules of these species such as OH are observed instead. A potentially effective tracer for these primary ices is atomic oxygen in the coma. However, the relationship between these ices and atomic oxygen is only understood at a qualitative level. We propose to use Spitzer observations in IRAC's 4.5 micron band pass to observe the CO2 v3 band at 4.26 microns in comet C/2012 K5 LINEAR. These observations will be coordinated with observations of atomic oxygen obtained at Apache Point Observatory and observations of H2O at Keck. These near simultaneous observations of H2O, CO2, and atomic oxygen in a cometary coma will increase our understanding of the link between these primary ices and atomic oxygen. With a complete understanding of the relationship between atomic oxygen and the primary ices on the nucleus, observations of atomic oxygen can serve as a powerful proxy for the production of these primary volatiles and aid our understanding of the variation in coma composition as a function of heliocentric distance, and therefore the composition of the nucleus and how our solar system was formed.

Long-lasting functional disabilities in patients who recover from coma after cardiac operations.

PubMed

Rodriguez, Rosendo A; Nair, Shona; Bussière, Miguel; Nathan, Howard J

2013-03-01

Uncertainty regarding the long-term functional outcome of patients who awaken from coma after cardiac operations is difficult for families and physicians and may delay rehabilitation. We studied the long-term functional status of these patients to determine if duration of coma predicted outcome. We followed 71 patients who underwent cardiac operations; recovered their ability to respond to verbal commands after coma associated with postoperative stroke, encephalopathy, and/or seizures; and were discharged from the hospital. The Glasgow Outcome Scale Extended (GOSE) was used to assess functional disability 2 to 4 years after discharge. Outcomes were classified as favorable (GOSE scores 7 and 8) and unfavorable (GOSE scores 1-6). Of 71 patients identified, 39 were interviewed, 15 died, 1 refused to be interviewed, and 16 were lost to follow-up. Of the 54 patients with completed GOSE evaluations, only 15 (28%) had favorable outcomes. Among patients with unfavorable outcomes, 15 (28%) died, 14 (26%) survived with moderate disabilities, and 10 (18%) had severe disabilities. Factors associated with unfavorable outcomes were increases in duration of coma (p = 0.007), time in intensive care (p = 0.006), length of hospitalization (p = 0.004), and postoperative serum creatine kinase levels (p = 0.006). Only duration of coma was an independent predictor of unfavorable outcome (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.008-1.537; p = 0.042). Patients with durations of coma greater than 4 days were more likely to have unfavorable outcomes (OR, 5.1; 95% CI, 1.3-21.3; p = 0.02). Two thirds of comatose patients who survived to discharge after cardiac operations had unfavorable long-term functional outcomes. A longer duration of unconsciousness is a predictor of unfavorable outcome. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Insights into the nature of cometary organic matter from terrestrial analogues

NASA Astrophysics Data System (ADS)

Court, Richard W.; Sephton, Mark A.

2012-04-01

The nature of cometary organic matter is of great interest to investigations involving the formation and distribution of organic matter relevant to the origin of life. We have used pyrolysis-Fourier transform infrared (FTIR) spectroscopy to investigate the chemical effects of the irradiation of naturally occurring bitumens, and to relate their products of pyrolysis to their parent assemblages. The information acquired has then been applied to the complex organic matter present in cometary nuclei and comae. Amalgamating the FTIR data presented here with data from published studies enables the inference of other comprehensive trends within hydrocarbon mixtures as they are progressively irradiated in a cometary environment, namely the polymerization of lower molecular weight compounds; an increased abundance of polycyclic aromatic hydrocarbon structures; enrichment in 13C; reduction in atomic H/C ratio; elevation of atomic O/C ratio and increase in the temperature required for thermal degradation. The dark carbonaceous surface of a cometary nucleus will display extreme levels of these features, relative to the nucleus interior, while material in the coma will reflect the degree of irradiation experienced by its source location in the nucleus. Cometary comae with high methane/water ratios indicate a nucleus enriched in methane, favouring the formation of complex organic matter via radiation-induced polymerization of simple precursors. In contrast, production of complex organic matter is hindered in a nucleus possessing a low methane/water ration, with the complex organic matter that does form possessing more oxygen-containing species, such as alcohol, carbonyl and carboxylic acid functional groups, resulting from reactions with hydroxyl radicals formed by the radiolysis of the more abundant water. These insights into the properties of complex cometary organic matter should be of particular interest to both remote observation and space missions involving in situ analyses and sample return of cometary materials.

Brain Connectivity in Pathological and Pharmacological Coma

PubMed Central

Noirhomme, Quentin; Soddu, Andrea; Lehembre, Rémy; Vanhaudenhuyse, Audrey; Boveroux, Pierre; Boly, Mélanie; Laureys, Steven

2010-01-01

Recent studies in patients with disorders of consciousness (DOC) tend to support the view that awareness is not related to activity in a single brain region but to thalamo-cortical connectivity in the frontoparietal network. Functional neuroimaging studies have shown preserved albeit disconnected low-level cortical activation in response to external stimulation in patients in a “vegetative state” or unresponsive wakefulness syndrome. While activation of these “primary” sensory cortices does not necessarily reflect conscious awareness, activation in higher-order associative cortices in minimally conscious state patients seems to herald some residual perceptual awareness. PET studies have identified a metabolic dysfunction in a widespread frontoparietal “global neuronal workspace” in DOC patients including the midline default mode network (“intrinsic” system) and the lateral frontoparietal cortices or “extrinsic system.” Recent studies have investigated the relation of awareness to the functional connectivity within intrinsic and extrinsic networks, and with the thalami in both pathological and pharmacological coma. In brain damaged patients, connectivity in all default network areas was found to be non-linearly correlated with the degree of clinical consciousness impairment, ranging from healthy controls and locked-in syndrome to minimally conscious, vegetative, coma, and brain dead patients. Anesthesia-induced loss of consciousness was also shown to correlate with a global decrease in cortico-cortical and thalamo-cortical connectivity in both intrinsic and extrinsic networks, but not in auditory, or visual networks. In anesthesia, unconsciousness was also associated with a loss of cross-modal interactions between networks. These results suggest that conscious awareness critically depends on the functional integrity of thalamo-cortical and cortico-cortical frontoparietal connectivity within and between “intrinsic” and “extrinsic” brain networks. PMID:21191476

Neuronal damage and cognitive impairment associated with hypoglycemia: An integrated view.

PubMed

Languren, Gabriela; Montiel, Teresa; Julio-Amilpas, Alberto; Massieu, Lourdes

2013-10-01

The aim of the present review is to offer a current perspective about the consequences of hypoglycemia and its impact on the diabetic disorder due to the increasing incidence of diabetes around the world. The main consequence of insulin treatment in type 1 diabetic patients is the occurrence of repetitive periods of hypoglycemia and even episodes of severe hypoglycemia leading to coma. In the latter, selective neuronal death is observed in brain vulnerable regions both in humans and animal models, such as the cortex and the hippocampus. Cognitive damage subsequent to hypoglycemic coma has been associated with neuronal death in the hippocampus. The mechanisms implicated in selective damage are not completely understood but many factors have been identified including excitotoxicity, oxidative stress, zinc release, PARP-1 activation and mitochondrial dysfunction. Importantly, the diabetic condition aggravates neuronal damage and cognitive failure induced by hypoglycemia. In the absence of coma prolonged and severe hypoglycemia leads to increased oxidative stress and discrete neuronal death mainly in the cerebral cortex. The mechanisms responsible for cell damage in this condition are still unknown. Recurrent moderate hypoglycemia is far more common in diabetic patients than severe hypoglycemia and currently important efforts are being done in order to elucidate the relationship between cognitive deficits and recurrent hypoglycemia in diabetics. Human studies suggest impaired performance mainly in memory and attention tasks in healthy and diabetic individuals under the hypoglycemic condition. Only scarce neuronal death has been observed under moderate repetitive hypoglycemia but studies suggest that impaired hippocampal synaptic function might be one of the causes of cognitive failure. Recent studies have also implicated altered mitochondrial function and mitochondrial oxidative stress. Copyright © 2013 Elsevier Ltd. All rights reserved.

Application of ERPs neuromarkers for assessment and treatment of a patient with chronic crossed aphasia after severe TBI and long-term coma - Case Report.

PubMed

Chantsoulis, Marzena; Półrola, Paweł; Góral-Półrola, Jolanta; Hajdukiewicz, Anna; Supiński, Jan; Kropotov, Juri D; Pachalska, Maria

2017-03-31

 Objective. The study aimed to evaluate the application of ERPs neuromarkers for the assessment and treatment of a patient with chronic crossed aphasia after severe TBI and a long-term coma. An ambidextrous female patient, aged 29, suffered from posttraumatic chronic crossed aphasia, severe TBI and a prolonged coma after a car accident. The patient took part in two differentiated rehabilitation programmes of neurotherapy included 20 sessions of relative beta training and 20 sessions of rTMS; both programmes were combined with behavioural training. The patient was tested 3 times: before the experiment, after completion of programme A, and after completion of programme B. In the 1st recording, the neuromarker of aphasia was found - an excess of the P2 wave over the left temporal area. There was a cognitive control deficit - an excess of omission errors and an increase of RT variability - all indexes of sporadic ADHD. In the 2nd recording, slight improvements in cognitive control, and language functions were found. In the 3rd recording, after the rTMS sessions most of her cognitive dysfunctions had been resolved, including language functions. It should be stressed that the activation (especially the increase in the ERP potential of the right side over the frontal lobe) was found. The neuromarker of aphasia did not change, only the location had slightly moved frontally. The application of ERP neuromarkers assists in the diagnosis, treatment, and academic success of an ambidextrous patient with chronic posttraumatic aphasia and sporadic ADHD. ERPs can be used to assess the functional brain changes induced by neurotherapeutical programmes.

Dust emission from comets at large heliocentric distances. I - The case of comet Bowell /1980b/

NASA Technical Reports Server (NTRS)

Houpis, H. L. F.; Mendis, D. A.

1981-01-01

Alternative processes of dust emission from comets at large heliocentric distances are considered, in order to explain the dust coma observed in comet Bowell (1980b) at a heliocentric distance as large as 7.17 AU. It is shown that the electrostatic blow-off of dust from a charged, H2O-dominated nucleus having a layer of loose, fine dust may be the formation process of the dust coma, with the coma size expected from the process being comparable to the observed value and the dust grain size being equal to or less than 0.4 microns in size. The upper limit for the total mass in the coma is 3.9 x 10 to the 8th g, and the spatial extension less than 10,000 km. The observed activity may alternatively be due to dust entrainment by the sublimating gas from a CO2-dominated nucleus.

Diagnostic Simulations of the Lunar Exosphere using Coma and Tail

NASA Astrophysics Data System (ADS)

Lee, Dong Wook; Kim, Sang J.

2017-10-01

The characteristics of the lunar exosphere can be constrained by comparing simulated models with observational data of the coma and tail (Lee et al., JGR, 2011); and thus far a few independent approaches on this issue have been performed and presented in the literature. Since there are two-different observational constraints for the lunar exosphere, it is interesting to find the best exospheric model that can account for the observed characteristics of the coma and tail. Considering various initial conditions of different sources and space weather, we present preliminary time-dependent simulations between the initial and final stages of the development of the lunar tail. Based on an updated 3-D model, we are planning to conduct numerous simulations to constrain the best model parameters from the coma images obtained from coronagraph observations supported by a NASA monitoring program (Morgan, Killen, and Potter, AGU, 2015) and future tail data.

[Myxedema coma as a rare differential diagnosis of severe consciousness disturbance].

PubMed

Kollmar, R; Schellinger, P D; Bardutzky, J; Meisel, F; Schwaninger, M

2002-12-01

Myxedema coma is a rare and life-threatening complication of untreated hypothyroidism. Therefore, it must be part of the differential diagnosis in comatose patients. We report one patient who presented with CO(2) narcosis,hypothermia, bradycardia,hyporeflexia, tetraparesis, ascitis, pleural effusions, and heart insufficiency. Examination of the CSF, cranial CT, MRI, and MR angiography were normal. In suspicion of myxedema coma,the patient was treated with high dose L-thyroxine and hydrocortisone for preventing secondary adrenal insufficiency. A fast clinical recovery, decreased T4 (7.2 ng/l) and T3 (0.93 ng/l), and increased TSH (20.19 mU/l) together with the following anamnesis of radio iodine therapy and insufficient thyroxine intake confirmed the diagnosis. In conclusion, treatment of the myxedema coma must be started as soon as the laboratory results are confirmatory, since its course depends on the time of initiation of treatment.

Numerical simulations of particle orbits around 2060 Chiron

NASA Technical Reports Server (NTRS)

Stern, S. A.; Jackson, A. A.; Boice, D. C.

1994-01-01

Scattered light from orbiting or coorbiting dust is a primary signature by which Earth-based observers study the activity and atmosphere of the unusual outer solar system object 2060 Chiron. Therefore, it is important to understand the lifetime, dynamics, and loss rates of dust in its coma. We report here dynamical simulations of particles in Chiron's collisionless coma. The orbits of 17,920 dust particles were numerically integrated under the gravitational influence of Chiron, the Sun, and solar radiation pressure. These simulations show that particles ejected from Chiron are more likely to follow suborbital trajectories, or to escape altogether, than to enter quasistable orbits. Significant orbital lifetimes can only be achieved for very specific launch conditions. These results call into question models of a long-term, bound coma generated by discrete outbursts, and instead suggest that Chiron's coma state is closely coupled to the nearly instantaneous level of Chiron's surface activity.

Postoperative Conversion Disorder in Elderly Oral Cancer Patient.

PubMed

Yakushiji, Takashi; Hayashi, Kamichika; Morikawa, Takamichi; Migita, Masashi; Ogane, Satoru; Muramatsu, Kyotaro; Kamio, Takashi; Shibahara, Takahiko; Takano, Nobuo

2016-01-01

Conversion disorder is a condition in which psychological stress in response to difficult situations manifests as physical symptoms. Here, we report a case of postoperative coma due to conversion disorder in an elderly oral cancer patient. An 82-year-old woman was referred to Tokyo Dental College Chiba Hospital with a mass lesion on the tongue. A biopsy revealed a well-differentiated squamous cell carcinoma. Surgical treatment was performed for the tongue carcinoma and tracheotomy for management of the airway. On postoperative day 5, the patient exhibited loss of consciousness (Glasgow Coma Scale: E1, VT, M1; Japan Coma Scale: III-300). The patient's vital signs were all normal, as were the results of a full blood count, brain-CT, MRI, and MRA. Only the arm dropping test was positive. Therefore, the cause of the coma was diagnosed as conversion disorder. Seven hours later, the patient showed a complete recovery.

Therapeutic options to enhance coma arousal after traumatic brain injury: state of the art of current treatments to improve coma recovery.

PubMed

Cossu, Giulia

2014-04-01

Traumatic brain injury is a leading cause of death and disability. Optimizing the recovery from coma is a priority in seeking to improve patients' functional outcomes. Standards of care have not been established: pharmacological interventions, right median nerve and sensory stimulation, dorsal column stimulation (DCS), deep brain stimulation, transcranial magnetic stimulation, hyperbaric oxygen therapy and cell transplantation have all been utilized with contrasting results. The aim of this review is to clarify the indications for the various techniques and to guide the clinical practice towards an earlier coma arousal. A systematic bibliographic search was undertaken using the principal search engines (Pubmed, Embase, Ovid and Cochrane databases) to locate the most pertinent studies. Traumatic injury is a highly individualized process, and subsequent impairments are dependent on multiple factors: this heterogeneity influences and determines therapeutic responses to the various interventions.

EEG as an Indicator of Cerebral Functioning in Postanoxic Coma.

PubMed

Juan, Elsa; Kaplan, Peter W; Oddo, Mauro; Rossetti, Andrea O

2015-12-01

Postanoxic coma after cardiac arrest is one of the most serious acute cerebral conditions and a frequent cause of admission to critical care units. Given substantial improvement of outcome over the recent years, a reliable and timely assessment of clinical evolution and prognosis is essential in this context, but may be challenging. In addition to the classic neurologic examination, EEG is increasingly emerging as an important tool to assess cerebral functions noninvasively. Although targeted temperature management and related sedation may delay clinical assessment, EEG provides accurate prognostic information in the early phase of coma. Here, the most frequently encountered EEG patterns in postanoxic coma are summarized and their relations with outcome prediction are discussed. This article also addresses the influence of targeted temperature management on brain signals and the implication of the evolution of EEG patterns over time. Finally, the article ends with a view of the future prospects for EEG in postanoxic management and prognostication.

Therapeutic burst-suppression coma in pediatric febrile refractory status epilepticus.

PubMed

Lin, Jainn-Jim; Chou, Cheng-Che; Lan, Shih-Yun; Hsiao, Hsiang-Ju; Wang, Yu; Chan, Oi-Wa; Hsia, Shao-Hsuan; Wang, Huei-Shyong; Lin, Kuang-Lin

2017-09-01

Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013. The clinical characteristics were analyzed. Thirty-five patients (23 boys; age range: 1-18years) were enrolled, of whom 28 (80%) developed super-refractory status epilepticus. All of the patients received the continuous administration of intravenous antiepileptic drugs for febrile refractory status epilepticus, and 26 (74.3%) achieved therapeutic burst-suppression coma. All of the patients received mechanical ventilatory support, and 26 (74.3%) received inotropic agents. Eight (22.9%) patients died within 1month. The neurologically functional outcomes at 6months were good in six (27.3%) of the 22 survivors, of whom two returned to clinical baseline. The patients with therapeutic burst-suppression coma were significantly associated with hemodynamic support than the patients with electrographic seizures control (p=0.03), and had a trend of higher 1-month mortality rate, worse 6months outcomes, and a longer duration of hospitalization. Our results suggest that therapeutic burst-suppression coma to treat febrile refractory status epilepticus may lead to an increased risk of hemodynamic instability and a trend of worse outcomes. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Near-UV OH Prompt Emission in the Innermost Coma of 103P/Hartley 2

NASA Astrophysics Data System (ADS)

La Forgia, Fiorangela; Bodewits, Dennis; A'Hearn, Michael F.; Protopapa, Silvia; Kelley, Michael S. P.; Sunshine, Jessica; Feaga, Lori; Farnham, Tony

2017-11-01

The Deep Impact spacecraft flyby of comet 103P/Hartley 2 occurred on 2010 November 4, 1 week after perihelion with a closest approach (CA) distance of about 700 km. We used narrowband images obtained by the Medium Resolution Imager on board the spacecraft to study the gas and dust in the innermost coma. We derived an overall dust reddening of 15%/100 nm between 345 and 749 nm and identified a blue enhancement in the dust coma in the sunward direction within 5 km from the nucleus, which we interpret as a localized enrichment in water ice. OH column density maps show an anti-sunward enhancement throughout the encounter, except for the highest-resolution images, acquired at CA, where a radial jet becomes visible in the innermost coma, extending up to 12 km from the nucleus. The OH distribution in the inner coma is very different from that expected for a fragment species. Instead, it correlates well with the water vapor map derived by the HRI-IR instrument on board Deep Impact. Radial profiles of the OH column density and derived water production rates show an excess of OH emission during CA that cannot be explained with pure fluorescence. We attribute this excess to a prompt emission process where photodissociation of H2O directly produces excited OH*(A 2Σ+) radicals. Our observations provide the first direct imaging of near-UV prompt emission of OH. We therefore suggest the use of a dedicated filter centered at 318.8 nm to directly trace the water in the coma of comets.

Thermal modeling of cometary nuclei

USGS Publications Warehouse

Weissman, P.R.; Kieffer, H.H.

1981-01-01

A new model of the sublimation of volatile ices from a cometary nucleus has been developed which includes the effects of diurnal heating and cooling, rotation period and pole orientation, and thermal properties of the ice and subsurface layers. The model also includes the contribution from coma opacity, scattering, and thermal emission, where the properties of the coma are derived from the integrated rate of volatile production by the nucleus. The model is applied to the specific case of the 1986 apparition of Halley's comet. It is found that the generation of a cometary dust coma actually increases the total energy reaching the Halley nucleus. This results because of the significantly greater geometrical cross section of the coma as compared with the bare nucleus, and because the coma provides an essentially isotropic source of multiply scattered sunlight and thermal emission over the entire nucleus surface. For Halley, the calculated coma opacity is approximately 0.2 at 1 AU from the Sun, and 1.2 at perihelion (0.587 AU). At 1 AU this has little effect on dayside temperatures (maximum ???200??K) but raises nightside temperatures (minimum ???150??K) by about 40??K. At perihelion the higher opacity results in a nearly isothermal nucleus with only small diurnal and latitudinal temperature variations. The general surface temperature is 205??K with a maximum of 209??K at local noon on the equator. Some possible consequences of the results with respect to the generation of nongravitational forces, observed volatile production rates for comets, and cometary lifetimes against sublimation are discussed. ?? 1981.

Prolonged dystonic reaction to chlorpromazine in myxoedema coma.

PubMed Central

Wood, G. M.; Waters, A. K.

1980-01-01

A case of myxoedema coma is reported where the administration of chlorpromazine resulted in a prolonged dystonic reaction. A similar challenge with a butyrophenone when the patient was on thyroxine caused a similar but much abbreviated response. PMID:7393810

Coma cluster of galaxies

NASA Image and Video Library

1999-12-02

Atlas Image mosaic, covering 34 x 34 on the sky, of the Coma cluster, aka Abell 1656. This is a particularly rich cluster of individual galaxies over 1000 members, most prominently the two giant ellipticals, NGC 4874 right and NGC 4889 left.

Water ice grains in comet C/2013 US10 (Catalina)

NASA Astrophysics Data System (ADS)

Protopapa, Silvia; Kelley, Michael S. P.; Yang, Bin; Woodward, Charles E.; Sunshine, Jessica M.

2017-10-01

Knowledge of the the physical properties of water ice in cometary nuclei is critical in determining how the Solar System was formed. While it is difficult to directly study the properties of water ice in comet nuclei, we can study comet interiors through their comae. Cometary activity makes the interiors of these objects available for characterization. However, the properties (grain size, abundance, purity, chemical state) of water-ice grains detected in the coma do not necessarily represent the characteristics of the water ice on the surface and/or in the interior of the nucleus. This is due to the potential physical and chemical evolution of the emitted material. Once in the coma, water-ice grains are heated by sunlight, and if temperatures are warm enough, they sublime. In this case, their sizes and potentially their ice-to-dust fractions are reduced.We present IRTF/SpeX measurements of the Oort cloud comet C/2013 US10 (Catalina), which reached perihelion in Nov 2015 at a heliocentric distance Rh=0.822 AU. Observations of US10 were acquired on UT 2014-08-13, 2016-01-12, and 2016-08-13 (Rh=5.9, 1.3, and 3.9 AU). This set of measurements, spanning a broad range in Rh, are rare and fundamental for estimating how ice grains evolve in the coma. The spectrum obtained close to perihelion is featureless and red sloped, which is consistent with a dust-dominated coma. Conversely, the spectra acquired on August 2014 and 2016 display neutral slopes and absorption bands at 1.5 and 2.0 μm, consistent with the presence of water-ice grains. These variations in water ice with heliocentric distance are correlated with sublimation rates. Additionally, the measurements obtained at 5.8 AU and 3.9 AU are nearly identical, suggesting that water-ice grains, once in the coma, do not sublime significantly. Therefore, the properties of these long-lived water-ice grains may represent their state in the nucleus or immediately after insertion into the coma. We will present radiative transfer models of the data and interpret the results in the context of spacecraft data of cometary nuclei, and of our on-going compositional survey of water-ice grain halos in cometary comae.This work was funded by NASA SSO, NASA PAST and NASA SOFIA grants.

CONSTRAINTS ON COSMIC RAYS, MAGNETIC FIELDS, AND DARK MATTER FROM GAMMA-RAY OBSERVATIONS OF THE COMA CLUSTER OF GALAXIES WITH VERITAS AND FERMI

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

Arlen, T.; Aune, T.; Bouvier, A.

2012-10-01

Observations of radio halos and relics in galaxy clusters indicate efficient electron acceleration. Protons should likewise be accelerated and, on account of weak energy losses, can accumulate, suggesting that clusters may also be sources of very high energy (VHE; E > 100 GeV) gamma-ray emission. We report here on VHE gamma-ray observations of the Coma galaxy cluster with the VERITAS array of imaging Cerenkov telescopes, with complementing Fermi Large Area Telescope observations at GeV energies. No significant gamma-ray emission from the Coma Cluster was detected. Integral flux upper limits at the 99% confidence level were measured to be on themore » order of (2-5) Multiplication-Sign 10{sup -8} photons m {sup -2} s {sup -1} (VERITAS, >220 GeV) and {approx}2 Multiplication-Sign 10{sup -6} photons m {sup -2} s {sup -1} (Fermi, 1-3 GeV), respectively. We use the gamma-ray upper limits to constrain cosmic rays (CRs) and magnetic fields in Coma. Using an analytical approach, the CR-to-thermal pressure ratio is constrained to be <16% from VERITAS data and <1.7% from Fermi data (averaged within the virial radius). These upper limits are starting to constrain the CR physics in self-consistent cosmological cluster simulations and cap the maximum CR acceleration efficiency at structure formation shocks to be <50%. Alternatively, this may argue for non-negligible CR transport processes such as CR streaming and diffusion into the outer cluster regions. Assuming that the radio-emitting electrons of the Coma halo result from hadronic CR interactions, the observations imply a lower limit on the central magnetic field in Coma of {approx}(2-5.5) {mu}G, depending on the radial magnetic field profile and on the gamma-ray spectral index. Since these values are below those inferred by Faraday rotation measurements in Coma (for most of the parameter space), this renders the hadronic model a very plausible explanation of the Coma radio halo. Finally, since galaxy clusters are dark matter (DM) dominated, the VERITAS upper limits have been used to place constraints on the thermally averaged product of the total self-annihilation cross section and the relative velocity of the DM particles, ({sigma}v).« less

Constraints on Cosmic Rays, Magnetic Fields, and Dark Matter from Gamma-ray Observations of the Coma Cluster of Galaxies with VERITAS and FERMI

NASA Technical Reports Server (NTRS)

Arlen, T.; Aune, T.; Beilicke, M.; Benbow, W.; Bouvier, A.; Buckley, J. H.; Bugaev, V.; Byrum, K.; Cannon, A.; Cesarini, A.;

[Biochemical measurements of glucose metabolism in relation to cause of death and postmortem effects].

PubMed

Kernbach, G; Püschel, K; Brinkmann, B

1986-01-01

This study was performed to examine the relationship between postmortem biochemical values and cause of death. The follow samples were taken from 399 corpses: cerebrospinal fluid (CSF; n = 376, suboccipital), blood (n = 158, femoral vein), and urine (n = 101, at autopsy). (See Table 1 for causes of death) All samples were stored at -80 degrees C. A further 100 samples of blood were later taken and stored at +4 degrees C before testing. Biochemical determinations made were: glucose in CSF, blood, and urine (hexokinase method); lactate (LDH/GPT) and free acetone (HS-gas chromatography) in CSF; hemoglobin A1 in blood (microcolumn technique). In 34 cases fatal diabetic coma was considered verified by morphological and chemical findings. One hundred cases of sudden cardiac death were chosen as the main control group. In 32 of the 34 cases defined above, the value of the formula of Traub (glucose + lactate in CSF) exceeded 415 mg/dl. It is not influenced significantly by hyperglycemia or hyperlactatemia due to factors other than diabetes (i.e., carbon monoxide, asphyxia). After death the value rose till the 30th hpm, then remained stable for at least 1 week. Fatal coma was defined as the ketoacidotic form if free acetone in CSF ranged above 21 mg/l. In these cases, CSF glucose and free acetone correlated positively. Hemoglobin A1 remained stable after death. Its amount was independent from postmortem blood glucose, postmortem interval and total hemoglobin. Furthermore, the manner of storage (-80 degrees or +4 degrees C) had no significant influence on its values. In 29 of 34 cases of fatal coma, Hb A1 exceeded 12.1%. Analysis of urine glucose showed elevated levels (over 500 mg/dl) in diabetic comas. On conclusion, fatal diabetic coma seems indicated as the cause of death if measured values of postmortem biochemistry exceed the following limits: CSF-Traub 415 mg/dl, free acetone (CSF) 21 mg/l; Hb A1 12.1%; urine glucose 500 mg/dl. Most important are the Traub formula and hemoglobin A1. Usually, in fatal coma both values are elevated. If both of them are normal, diabetic coma can nearly be excluded. Combined evaluation of all values is absolutely necessary. Morphology must also always be taken into account. Consequently, a diagnosis of fatal coma can be obtained by a process of elimination.

Epidemiology, pathophysiology and putative genetic basis of carbamazepine- and oxcarbazepine-induced hyponatremia.

PubMed

Berghuis, B; de Haan, G-J; van den Broek, M P H; Sander, J W; Lindhout, D; Koeleman, B P C

2016-09-01

The use of carbamazepine (CBZ) and oxcarbazepine (OXC) as first-line antiepileptic drugs in the treatment of focal epilepsy is limited by hyponatremia, a known adverse effect. Hyponatremia occurs in up to half of people taking CBZ or OXC and, although often assumed to be asymptomatic, it can lead to symptoms ranging from unsteadiness and mild confusion to seizures and coma. Hyponatremia is probably due to the antidiuretic properties of CBZ and OXC that are, at least partly, explained by stimulation of the vasopressin 2 receptor/aquaporin 2 pathway. No known genetic risk variants for CBZ- and OXC-induced hyponatremia exist, but likely candidate genes are part of the vasopressin water reabsorption pathway. © 2016 EAN.

Phencyclidine-induced malignant hyperthermia causing submassive liver necrosis.

PubMed

Armen, R; Kanel, G; Reynolds, T

1984-07-01

This report describes three male patients arrested for aggressive and combative behavior, characteristic of phencyclidine intoxication, in whom severe hyperthermia, respiratory failure, and coma developed. Two days after the malignant hyperthermic event, serum transaminase levels rose acutely to extremely high levels with concomitant elevations in bilirubin levels and a fall in prothrombin activity. Liver biopsy specimens in two patients showed marked perivenular necrosis and collapse. No specific treatment was directed at the phencyclidine intoxication. Two of the three patients survived. Submassive liver necrosis caused by malignant hyperthermia is an unusual complication of phencyclidine abuse.

Introduccion al estudio de la coma (Final) [Introduction to the Study of the Coma (Final Part)].

ERIC Educational Resources Information Center

Amilcar Cipriano, Nestor

1979-01-01

This concluding article in a series concerning the use of the comma in Spanish gives specific examples of its use from Spanish literature. Concluding remarks outline the major purposes of the comma. (NCR)

Transport and Distribution of Hydroxyl Radicals and Oxygen Atoms from H2O Photodissociation in the Inner Coma of Comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Lai, Ian-Lin; Su, Cheng-Chin; Ip, Wing-Huen; Wei, Chen-En; Wu, Jong-Shinn; Lo, Ming-Chung; Liao, Ying; Thomas, Nicolas

2016-03-01

With a combination of the Direct Simulation Monte Carlo (DSMC) calculation and test particle computation, the ballistic transport process of the hydroxyl radicals and oxygen atoms produced by photodissociation of water molecules in the coma of comet 67P/Churyumov-Gerasimenko is modelled. We discuss the key elements and essential features of such simulations which results can be compared with the remote-sensing and in situ measurements of cometary gas coma from the Rosetta mission at different orbital phases of this comet.

Sudden cardiac arrest as a rare presentation of myxedema coma: case report.

PubMed

Salhan, Divya; Sapkota, Deepak; Verma, Prakash; Kandel, Saroj; Abdulfattah, Omar; Lixon, Antony; Zwenge, Deribe; Schmidt, Frances

2017-01-01

Myxedema coma is a decompensated hypothyroidism which occurs due to long-standing, undiagnosed, or untreated hypothyroidism. Untreated hypothyroidism is known to affect almost all organs including the heart. It is associated with a decrease in cardiac output, stroke volume due to decreased myocardial contractility, and an increase in systemic vascular resistance. It can cause cardiac arrhythmias and the most commonly seen conduction abnormalities are sinus bradycardia, heart block, ventricular tachycardia, and torsade de pointes. The authors report a case of an elderly man who presented with sudden cardiac arrest and myxedema coma and who was successfully revived.

Complete recovery after severe myxoedema coma complicated by status epilepticus

PubMed Central

Fjølner, Jesper; Søndergaard, Esben; Kampmann, Ulla; Nielsen, Søren

2015-01-01

We report a case of life-threatening myxoedema presenting with hypothermia, hypotension, bradycardia, pericardial effusion and deep coma. The condition was complicated by prolonged status epilepticus. The optimal treatment strategy has been debated over the years and the literature is briefly reviewed. Treatment with l-thyroxine (LT4) monotherapy without initial loading dose and with no l-triiodothyronine (LT3) treatment was successful with full recovery after hospitalisation for more than a month. Myxoedema coma is a rare, reversible condition with a high mortality and should be considered as a differential diagnosis in medical emergencies. PMID:25809434

Myxedema coma after esophagectomy.

PubMed

Yuan, Yong; Hu, Yang; Xie, Tianpeng; Zhao, Yongfan

2010-07-01

For most patients with esophageal cancer, esophagectomy is an effective therapy. Perioperative management is critical for clinical outcomes after the operation. Great efforts should be made to avoid postoperative complications. We report myxedema coma, an emergency condition caused by severe hypothyroidism, after a patient underwent esophagectomy for esophageal cancer. The patient was successfully treated with intravenous levothyroxine. We strongly recommend that physicians test the thyroid hormone levels in patients with risk factors. If myxedema coma occurs, immediate use of intravenous levothyroxine is effective for this lethal complication. Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Complete recovery after severe myxoedema coma complicated by status epilepticus.

PubMed

Fjølner, Jesper; Søndergaard, Esben; Kampmann, Ulla; Nielsen, Søren

2015-03-25

We report a case of life-threatening myxoedema presenting with hypothermia, hypotension, bradycardia, pericardial effusion and deep coma. The condition was complicated by prolonged status epilepticus. The optimal treatment strategy has been debated over the years and the literature is briefly reviewed. Treatment with l-thyroxine (LT4) monotherapy without initial loading dose and with no l-triiodothyronine (LT3) treatment was successful with full recovery after hospitalisation for more than a month. Myxoedema coma is a rare, reversible condition with a high mortality and should be considered as a differential diagnosis in medical emergencies. 2015 BMJ Publishing Group Ltd.

Spectroscopic Investigations of Fragment Species in the Coma

NASA Technical Reports Server (NTRS)

Feldman, Paul D.; Cochran, Anita L.; Combi, Michael R.

2004-01-01

The content of the gaseous coma of a comet is dominated by fragment species produced by photolysis of the parent molecules issuing directly from the icy nucleus of the comet. Spectroscopy of these species provides complementary information on the physical state of the coma to that obtained from observations of the parent species. Extraction of physical parameters requires detailed molecular and atomic data together with reliable high-resolution spectra and absolute fluxes of the primary source of excitation, the Sun. The large database of observations, dating back more than a century, provides a means to assess the chemical and evolutionary diversity of comets.

Morfología de la Coma del Cometa Hale - Bopp

NASA Astrophysics Data System (ADS)

Gil-Hutton, R.; Caballero, M.; Coldwell, G.; Cañada, M.; Godoy, G.; Trozzo, C.; Gómez, G.

Para lograr comprender plenamente los procesos físicos que se desarrollan en los núcleos cometarios y obtener un modelo que explique, no sólo su actividad, sino también sus efectos sobre la coma, es necesario obtener información detallada para el mayor número de cometas posible, siendo las características más interesantes para estudiar la ubicación de las regiones activas, la presencia de jets, las tasas de producción de gas y polvo y la interacción de la coma con el viento solar. En la actualidad, con técnicas de procesamiento de imágenes y tecnología CCD se pueden obtener este tipo de datos para cometas que ingresan al sistema solar interior y estudiar, de esta manera, la morfología de sus comas, tratando de correlacionar la actividad detectada con algún modelo teórico. En este trabajo se presenta un estudio parcial de la actividad desarrollada por el cometa Hale-Bopp, y sus efectos sobre la morfología de su coma, desde agosto de 1995 hasta la fecha en base a imágenes adquiridas con el telescopio de 0.76 m. de la Estación Astronómica Dr. Carlos Ulrrico Cesco.

Map-based trigonometric parallaxes of open clusters: Coma

NASA Technical Reports Server (NTRS)

Gatewood, George

1995-01-01

This is the fourth study in a series to determine the direct trigonometric parallaxes of four of the nearest open star clusters, the Hyades, the Pleiades, the Praesepe, and the nearby cluster in Coma (Gatewood et al. 1990; Gatewood et al. 1992); Gatewood & Kiewiet de Jonge 1994). The results for the open star cluster in Coma are compared with those of the other three clusters, and the members are found to be significantly subluminous. The trigonometric parallax of the cluster is estimated from that of three members studied with the Multichannel Astrometric Photometer (MAP) at the Thaw Refractor of the University of Pittsburgh's Allegheny Observatory. The weighted mean parallax of the cluster is +13.53 +/- 0.54 mass (0.00054 min), corresponding to a distance modulus of 4.34 +/- 0.09 mag. The U-B excess of the Coma cluster members may be used to adjust the observed absolute magnitudes and the B-V measurements as suggested by Sandage & Eggen (1959). The agreement obtained in this manner suggests that, like subdwarf stars, the stars of the Coma cluster appear subluminous because of line blanketing. One of the three members observed in this study was recognized as a member by its parallax and is the faintest known member of the cluster.

Coma Patient Monitoring System Using Image Processing

NASA Astrophysics Data System (ADS)

Sankalp, Meenu

2011-12-01

COMA PATIENT MONITORING SYSTEM provides high quality healthcare services in the near future. To provide more convenient and comprehensive medical monitoring in big hospitals since it is tough job for medical personnel to monitor each patient for 24 hours.. The latest development in patient monitoring system can be used in Intensive Care Unit (ICU), Critical Care Unit (CCU), and Emergency Rooms of hospital. During treatment, the patient monitor is continuously monitoring the coma patient to transmit the important information. Also in the emergency cases, doctor are able to monitor patient condition efficiently to reduce time consumption, thus it provides more effective healthcare system. So due to importance of patient monitoring system, the continuous monitoring of the coma patient can be simplified. This paper investigates about the effects seen in the patient using "Coma Patient Monitoring System" which is a very advanced product related to physical changes in body movement of the patient and gives Warning in form of alarm and display on the LCD in less than one second time. It also passes a sms to a person sitting at the distant place if there exists any movement in any body part of the patient. The model for the system uses Keil software for the software implementation of the developed system.

Map-based trigonometric parallaxes of open clusters: Coma

NASA Astrophysics Data System (ADS)

Gatewood, George

1995-06-01

This is the fourth study in a series to determine the direct trigonometric parallaxes of four of the nearest open star clusters, the Hyades, the Pleiades, the Praesepe, and the nearby cluster in Coma (Gatewood et al. 1990; Gatewood et al. 1992); Gatewood & Kiewiet de Jonge 1994). The results for the open star cluster in Coma are compared with those of the other three clusters, and the members are found to be significantly subluminous. The trigonometric parallax of the cluster is estimated from that of three members studied with the Multichannel Astrometric Photometer (MAP) at the Thaw Refractor of the University of Pittsburgh's Allegheny Observatory. The weighted mean parallax of the cluster is +13.53 +/- 0.54 mass (0.00054 min), corresponding to a distance modulus of 4.34 +/- 0.09 mag. The U-B excess of the Coma cluster members may be used to adjust the observed absolute magnitudes and the B-V measurements as suggested by Sandage & Eggen (1959). The agreement obtained in this manner suggests that, like subdwarf stars, the stars of the Coma cluster appear subluminous because of line blanketing. One of the three members observed in this study was recognized as a member by its parallax and is the faintest known member of the cluster.

The distribution of gas and ions in the inner coma of 67P/Churyumov-Gerasimenko between 3 AU before and after its perihelion

NASA Astrophysics Data System (ADS)

Bodewits, Dennis; Lara, Luisa; La Forgia, Fiorangela; A'Hearn, Michael F.; Knollenberg, Jörg; Lazzarin, Monica; Li, Zhong-Yi; Osiris Team

2016-10-01

Rosetta explored a regime not accessible before: the inner coma of a low-activity comet at a large range of heliocentric distances. The Wide Angle Camera (WAC) of the OSIRIS instrument on board the Rosetta spacecraft is equipped with several narrowband filters that are centered on the emission lines and bands of various molecules and ions. These filters center on fragment species that are relatively bright and that have been used for numerous comet studies from the ground (e.g. A'Hearn et al. 1995). Surprisingly, we found that outside 2 AU pre-perihelion, the emission in the filters was dominated by emission from dissociative electron impact excitation (Bodewits et al. 2016). Closer to perihelion, higher gas densities reduced electron temperatures in the inner coma and photo-processes drove much if not most of the emission from the comet. Our observations allowed us to study changes in the physical environment of the inner coma, and Rosetta's excursions as far as 1000 km from the surface allowed us to study different regions of the coma.In this contribution, we will summarize the results of our OSIRIS observations from approximately 3 AU before to 3 AU after perihelion.

Abnormal intra-aural pressure waves associated with death in African children with acute nontraumatic coma.

PubMed

Gwer, Samson; Kazungu, Michael; Chengo, Eddie; Ohuma, Eric O; Idro, Richard; Birch, Tony; Marchbanks, Robert; Kirkham, Fenella J; Newton, Charles R

2015-07-01

We explored the relationship between tympanic membrane displacement (TMD) measurements, a tool to monitor intracranial pressure noninvasively, and clinical features and death in children with acute coma in Kilifi, Kenya. Between November 2007 and September 2009, we made serial TMD measurements and clinical observations on children with acute coma (Blantyre coma score (BCS) ≤ 2) on the pediatric high dependency unit of Kilifi District Hospital, and on well children presenting to the hospital's outpatient department for routine follow-up. We examined middle ear function using tympanometry and measured cardiac pulse (CPA) and respiratory pulse pressure amplitudes (RPA) using the TMD analyzer. We recruited 75 children (32 (43%) females; median age 3.3 (IQR: 2.0, 4.3) years). Twenty-one (28%) children died. Higher TMD measurements predicted death. Adjusting for diagnosis, every 50 nl rise in both semirecumbent and recumbent CPA was associated with increased odds of death associated with intracranial herniation (OR: 1.61, 95% confidence interval (CI): 1.07, 2.41; P = 0.02 and OR: 1.35, 95% CI: 1.10, 1.66; P ≤ 0.01 respectively). Raised TMD pulse pressure measurements are associated with death and may be useful in detecting and monitoring risk of intracranial herniation and intracranial pressure in childhood coma.

Comparison of Aberrations After Standard and Customized Refractive Surgery

NASA Astrophysics Data System (ADS)

Fang, L.; He, X.; Wang, Y.

2013-09-01

To detect possible differences in residual wavefront aberrations between standard and customized laser refractive surgery based onmathematical modeling, the residual optical aberrations after conventional and customized laser refractive surgery were compared accordingto the ablation profile with transition zone. The results indicated that ablation profile has a significant impact on the residual aberrations.The amount of residual aberrations for conventional correction is higher than that for customized correction. Additionally, the residualaberrations for high myopia eyes are markedly larger than those for moderate myopia eyes. For a 5 mm pupil, the main residual aberrationterm is coma and yet it is spherical aberration for a 7 mm pupil. When the pupil diameter is the same as optical zone or greater, themagnitudes of residual aberrations is obviously larger than that for a smaller pupil. In addition, the magnitudes of the residual fifth orsixth order aberrations are relatively large, especially secondary coma in a 6 mm pupil and secondary spherical aberration in a 7 mm pupil.Therefore, the customized ablation profile may be superior to the conventional correction even though the transition zone and treatmentdecentration are taken into account. However, the customized ablation profile will still induce significant amount of residual aberrations.

The capacity to maintain ion and water homeostasis underlies interspecific variation in Drosophila cold tolerance

PubMed Central

MacMillan, Heath A.; Andersen, Jonas L.; Davies, Shireen A.; Overgaard, Johannes

2015-01-01

Many insects, including Drosophila, succumb to the physiological effects of chilling at temperatures well above those causing freezing. Low temperature causes a loss of extracellular ion and water homeostasis in such insects, and chill injuries accumulate. Using an integrative and comparative approach, we examined the role of ion and water balance in insect chilling susceptibility/ tolerance. The Malpighian tubules (MT), of chill susceptible Drosophila species lost [Na+] and [K+] selectivity at low temperatures, which contributed to a loss of Na+ and water balance and a deleterious increase in extracellular [K+]. By contrast, the tubules of chill tolerant Drosophila species maintained their MT ion selectivity, maintained stable extracellular ion concentrations, and thereby avoided injury. The most tolerant species were able to modulate ion balance while in a cold-induced coma and this ongoing physiological acclimation process allowed some individuals of the tolerant species to recover from chill coma during low temperature exposure. Accordingly, differences in the ability to maintain homeostatic control of water and ion balance at low temperature may explain large parts of the wide intra- and interspecific variation in insect chilling tolerance. PMID:26678786

Numerical simulations of the radiance from the limb measurements of dusty coma of the Comet 67P/Churyumov Gerasimenko

NASA Astrophysics Data System (ADS)

Błęcka, M. I.; Rinaldi, G.; Fink, U.; Capacioni, F.; Tozzi, G. P.

2013-09-01

The work we present deals with the spectrometric measurements of the VIRTIS instrument part of the payload of the Rosetta mission to the Comet 67P/Churyumov-Gerasimenko. This spectrometer will monitor (VIRTIS M channel: 0.25μm - 0.98μm; Δκ=20cm-1 ; 0.980 - 5.0 μm; Δκ=5cm-1; VIRTIS H channel: 2.0 μm- 5.0 μm ; Δκ=5cm-1) the nucleus and the coma in order to provide a picture of coma's composition, the production of gas and dust, and the structure and variation of mineralogy of the nucleus surface. The dust is an important constituent of cometary environment and is always present on the surface of the nucleus and in the coma. The cometary spectra are strongly affected by the processes taking place in the coma and by the structure, composition and the spatial distribution of cometary solid particles. The particles of the dust, illuminated by solar light, scatter, absorb and emit radiation. The reflected and emitted radiation are transmitted through the coma region before being collected by instruments such as VIRTIS. The reflection, absorption, scattering, and emission processes in the coma depend on the Comet-Sun geometry. In the VIRTIS team we have initiated and effort to simulate the dust radiance using several radiative transfer models (see Rinaldi et al, this issue). In the present paper, which is the continuation of our previous works (e.g. AGU fall meeting 2011, EGU 2012, EPSC2012 -abstracts), we are mainly concentrated on the influence of optical parameters of dust on spectra we expect from the VIRTIS/Rosetta measurements. To this purposes the equation of radiative transfer in limb geometry through the assembly of various dust grains and gases is solved. The number density distribution of the dust grains around the coma and their size distribution are drawn from recent theoretical models (e.g.Tenishev et.al.2011). A few phenomenological scattering phase functions are taken into account. We have assumed in the simulation the presence on the surface of H2O ice, in which are embedded dust grains of various mineralogies. These grains, when freed by the gas sublimation, were considered as the main constituent of the dusty coma. At the beginning the particles are spherical. Such an assumption would be reasonable in many cases. We have confined ourselves to the compact dust particles only. But it should be noted here that fluffy grains would have different optical properties and their presence would lead to different conclusions. The main purposes of the paper are: 1) discussion of the influence of the mineralogical composition of cometary dust including mixtures with ices, the size distributions and optical parameters - using the various possible phase functions, extinction and symmetry factors 2) influence of cometary activity on parameters of the coma and then the signal to be measured by the VIRTIS spectrometer at various distances from the Sun (3.7AU; 3.5AU; 3.0AU; 1.24AU).

Structure of Cometary Dust Particles

NASA Astrophysics Data System (ADS)

Levasseur-Regourd, A. C.; Hadamcik, E.; Lasue, J.

2004-11-01

The recent encounter of Stardust with comet 81P/Wild 2 has provided highly spatially resolved data about dust particles in the coma. They show intense swarms and bursts of particles, suggest the existence of fragmenting low-density particles formed of higher density sub-micrometer components [1], and definitely confirm previous results (inferred from Giotto encounter with comet Grigg-Skjellerup [2] and remote light scattering observations [3]). The light scattering properties (mostly polarization, which does not depend upon disputable normalizations) of dust in cometary comae will be summarized, with emphasis on the spatial changes and on the wavelength and phase angle dependence. Experimental and numerical simulations are needed to translate these observed light scattering properties in terms of physical properties of the dust particles (e.g. size, morphology, albedo, porosity). New experimental simulations (with fluffy mixtures of sub-micron sized silica and carbon grains) and new numerical simulations (with fractal aggregates of homogeneous or core-mantled silicate and organic grains) will be presented. The results are in favor of highly porous particles built up (by ballistic-cluster-cluster agglomeration) from grains of interstellar origin. The perspectives offered by laboratory simulations with aggregates built under conditions representative of the early solar system on board the International Space Station will be presented, together with the perspectives offered by future experiments on board the Rosetta cometary probe. Supports from CNES and ESA are acknowledged [1] Tuzzolino et al., Science, 304, 1776, 2004, [2] N. McBride et al., Mon. Not. R. Astron. Soc., 289, p. 535-553, 1997, [3] Levasseur-Regourd and Hadamcik, J. Quant. Spectros. Radiat. Transfer, 79-80, 903-910, 2003.

Extending technology-aided leisure and communication programs to persons with spinal cord injury and post-coma multiple disabilities.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Ricciuti, Riccardo A; Trignani, Roberto; Oliva, Doretta; Signorino, Mario; D'Amico, Fiora; Sasanelli, Giovanni

2015-01-01

These two studies extended technology-aided programs to promote leisure and communication opportunities to a man with cervical spinal cord injury and a post-coma man with multiple disabilities. The studies involved the use of ABAB designs, in which A and B represented baseline and intervention phases, respectively. The programs focused on enabling the participants to activate songs, videos, requests, text messages, and telephone calls. These options were presented on a computer screen and activated through a small pressure microswitch by the man with spinal cord injury and a special touch screen by the post-coma man. To help the latter participant, who had no verbal skills, with requests and telephone calls, series of words and phrases were made available that he could activate in those situations. Data showed that both participants were successful in managing the programs arranged for them. The man with spinal cord injury activated mean frequencies of above five options per 10-min session. The post-coma man activated mean frequencies of about 12 options per 20-min session. Technology-aided programs for promoting leisure and communication opportunities might be successfully tailored to persons with spinal cord injury and persons with post-coma multiple disabilities. Implications for Rehabilitation Technology-aided programs may be critical to enable persons with pervasive motor impairment to engage in leisure activities and communication events independently. Persons with spinal cord injury, post-coma extended brain damage, and forms of neurodegenerative disease, such as amyotrophic lateral sclerosis, may benefit from those programs. The programs could be adapted to the participants' characteristics, both in terms of technology and contents, so as to improve their overall impact on the participants' functioning and general mood.

Near-UV OH Prompt Emission in the Innermost Coma of 103P/Hartley 2

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

La Forgia, Fiorangela; Bodewits, Dennis; A’Hearn, Michael F.

The Deep Impact spacecraft flyby of comet 103P/Hartley 2 occurred on 2010 November 4, 1 week after perihelion with a closest approach (CA) distance of about 700 km. We used narrowband images obtained by the Medium Resolution Imager on board the spacecraft to study the gas and dust in the innermost coma. We derived an overall dust reddening of 15%/100 nm between 345 and 749 nm and identified a blue enhancement in the dust coma in the sunward direction within 5 km from the nucleus, which we interpret as a localized enrichment in water ice. OH column density maps show an anti-sunwardmore » enhancement throughout the encounter, except for the highest-resolution images, acquired at CA, where a radial jet becomes visible in the innermost coma, extending up to 12 km from the nucleus. The OH distribution in the inner coma is very different from that expected for a fragment species. Instead, it correlates well with the water vapor map derived by the HRI-IR instrument on board Deep Impact . Radial profiles of the OH column density and derived water production rates show an excess of OH emission during CA that cannot be explained with pure fluorescence. We attribute this excess to a prompt emission process where photodissociation of H{sub 2}O directly produces excited OH*( A {sup 2}Σ{sup +}) radicals. Our observations provide the first direct imaging of near-UV prompt emission of OH. We therefore suggest the use of a dedicated filter centered at 318.8 nm to directly trace the water in the coma of comets.« less

Food deprivation and prior anoxic coma have opposite effects on the activity of a visual interneuron in the locust.

PubMed

Cross, Kevin P; Britton, Samantha; Mangulins, Rebecca; Money, Tomas G A; Robertson, R Meldrum

2017-04-01

We compared how different metabolic stressors, anoxic coma and food deprivation, affected signaling in neural tissue. We used the locust's Descending Contralateral Movement Detector (DCMD) interneuron because its large axon, high firing frequencies, and rapid conduction velocity make it energetically expensive. We exposed locusts to a 30min anoxic coma or 1day of food deprivation and found contrasting effects on signaling within the axon. After a prior anoxic coma, the DCMD fired fewer high-frequency (>200Hz) action potentials (APs) (Control: 12.4±1.6; Coma: 6.3±0.9) with a reduction in axonal conduction velocity (CV) at all frequencies (∼4-8%) when presented with a standard looming visual stimulus. Prior anoxic coma was also associated with a loss of supernormal conduction by reducing both the number of supernormal APs and the firing frequency with the highest CV. Initially, food deprivation caused a significant increase in the number of low- and high-frequency APs with no differences observed in CV. After controlling for isolation, food deprivation resulted in an increase in high-frequency APs (>200Hz: Control: 17.1±1.7; Food-deprived: 19.9±1.3) and an increase in relative conduction velocity for frequencies >150Hz (∼2%). Action potentials of food-deprived animals had a smaller half-width (Control: 0.45±0.02ms; Food-deprived: 0.40±0.01ms) and decay time (Control: 0.62±0.03ms; Food-deprived: 0.54±0.02ms). Our data indicate that the effects of metabolic stress on neural signaling can be stressor-dependent. Copyright © 2017 Elsevier Ltd. All rights reserved.

DARK MATTER SUBHALOS AND THE X-RAY MORPHOLOGY OF THE COMA CLUSTER

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

Andrade-Santos, Felipe; Nulsen, Paul E. J.; Kraft, Ralph P.

2013-04-01

Structure formation models predict that clusters of galaxies contain numerous massive subhalos. The gravity of a subhalo in a cluster compresses the surrounding intracluster gas and enhances its X-ray emission. We present a simple model, which treats subhalos as slow moving and gasless, for computing this effect. Recent weak lensing measurements by Okabe et al. have determined masses of {approx}10{sup 13} M{sub Sun} for three mass concentrations projected within 300 kpc of the center of the Coma Cluster, two of which are centered on the giant elliptical galaxies NGC 4889 and NGC 4874. Adopting a smooth spheroidal {beta}-model for themore » gas distribution in the unperturbed cluster, we model the effect of these subhalos on the X-ray morphology of the Coma Cluster, comparing our results to Chandra and XMM-Newton X-ray data. The agreement between the models and the X-ray morphology of the central Coma Cluster is striking. With subhalo parameters from the lensing measurements, the distances of the three subhalos from the Coma Cluster midplane along our line of sight are all tightly constrained. Using the model to fit the subhalo masses for NGC 4889 and NGC 4874 gives 9.1 Multiplication-Sign 10{sup 12} M{sub Sun} and 7.6 Multiplication-Sign 10{sup 12} M{sub Sun }, respectively, in good agreement with the lensing masses. These results lend strong support to the argument that NGC 4889 and NGC 4874 are each associated with a subhalo that resides near the center of the Coma Cluster. In addition to constraining the masses and 3-d location of subhalos, the X-ray data show promise as a means of probing the structure of central subhalos.« less

A New 3D Multi-fluid Model: A Study of Kinetic Effects and Variations of Physical Conditions in the Cometary Coma

NASA Astrophysics Data System (ADS)

Shou, Y.; Combi, M.; Toth, G.; Tenishev, V.; Fougere, N.; Jia, X.; Rubin, M.; Huang, Z.; Hansen, K.; Gombosi, T.; Bieler, A.

2016-12-01

Physics-based numerical coma models are desirable whether to interpret the spacecraft observations of the inner coma or to compare with the ground-based observations of the outer coma. In this work, we develop a multi-neutral-fluid model based on the BATS-R-US code of the University of Michigan, which is capable of computing both the inner and outer coma and simulating time-variable phenomena. It treats H2O, OH, H2, O, and H as separate fluids and each fluid has its own velocity and temperature, with collisions coupling all fluids together. The self-consistent collisional interactions decrease the velocity differences, re-distribute the excess energy deposited by chemical reactions among all species, and account for the varying heating efficiency under various physical conditions. Recognizing that the fluid approach has limitations in capturing all of the correct physics for certain applications, especially for very low density environment, we applied our multi-fluid coma model to comet 67P/Churyumov-Gerasimenko at various heliocentric distances and demonstrated that it yields comparable results to the Direct Simulation Monte Carlo (DSMC) model, which is based on a kinetic approach that is valid under these conditions. Therefore, our model may be a powerful alternative to the particle-based model, especially for some computationally intensive simulations. In addition, by running the model with several combinations of production rates and heliocentric distances, we characterize the cometary H2O expansion speeds and demonstrate the nonlinear dependencies of production rate and heliocentric distance. Our results are also compared to previous modeling work and remote observations, which serve as further validation of our model.

A preliminary model of the coma of 2060 Chiron

NASA Technical Reports Server (NTRS)

Boice, Daniel C.; Konno, I.; Stern, S. Alan; Huebner, Walter F.

1992-01-01

We have included gravity in our fluid dynamic model with chemical kinetics of dusty comet comae and applied it with two dust sizes to 2060 Chiron. A progress report on the model and preliminary results concerning gas/dust dynamics and chemistry is given.

Dynamic molecular oxygen production in cometary comae.

PubMed

Yao, Yunxi; Giapis, Konstantinos P

2017-05-08

Abundant molecular oxygen was discovered in the coma of comet 67P/Churyumov-Gerasimenko. Its origin was ascribed to primordial gaseous O 2 incorporated into the nucleus during the comet's formation. This thesis was put forward after discounting several O 2 production mechanisms in comets, including photolysis and radiolysis of water, solar wind-surface interactions and gas-phase collisions. Here we report an original Eley-Rideal reaction mechanism, which permits direct O 2 formation in single collisions of energetic water ions with oxidized cometary surface analogues. The reaction proceeds by H 2 O + abstracting a surface O-atom, then forming an excited precursor state, which dissociates to produce O 2 - . Subsequent photo-detachment leads to molecular O 2 , whose presence in the coma may thus be linked directly to water molecules and their interaction with the solar wind. This abiotic O 2 production mechanism is consistent with reported trends in the 67P coma and raises awareness of the role of energetic negative ions in comets.

Modeling of the illumination driven coma of 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Bieler, André

2015-04-01

In this paper we present results modeling 67P/Churyumov-Gerasimenko's (C-G) neutral coma properties observed by the Rosetta ROSINA experiment with 3 different model approaches. The basic assumption for all models is the idea that the out-gassing properties of C-G are mainly illumination driven. With this assumption all models are capable of reproducing most features in the neutral coma signature as detected by the ROSINA-COPS instrument over several months. The models include the realistic shape model of the nucleus to calculate the illumination conditions over time which are used to define the boundary conditions for the hydrodynamic (BATS-R-US code) and the Direct Simulation Monte Carlo (AMPS code) simulations. The third model finally computes the projection of the total illumination on the comet surface towards the spacecraft. Our results indicate that at large heliocentric distances (3.5 to 2.8 AU) most gas coma structures observed by the in-situ instruments can be explained by uniformly distributed activity regions spread over the whole nucleus surface.

Radical formation in the coma from photodissociation of ice grains

NASA Technical Reports Server (NTRS)

Jackson, William M.; Gerth, Christopher

1990-01-01

Long ago visual observations of comets suggested that there are jets in comets but it has only been recently that A'Hearn et al. have proven that some of these jets are due to emission from the CN radical. Recent studies in the lab have shown that CN radicals can be ejected directly into the gas phase from the photolysis of frozen vapors if the parent molecular has been excited to repulsive excited state. This later observation suggests that the jets that have been observed may be due to photodissociation of icy grains in the coma. A theory of radical formation from icy grains is presented. It is shown that direct formation of free radicals in the coma is an effective way to produce radicals from icy grains in the coma. The model predicts that icy grains could produce from 6 to 800,000 OH radicals/s per grain depending upon whether the radius of the grain is 0.3 to 100 micron.

ALP conversion and the soft X-ray excess in the outskirts of the Coma cluster

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

Kraljic, David; Rummel, Markus; Conlon, Joseph P., E-mail: David.Kraljic@physics.ox.ac.uk, E-mail: Markus.Rummel@physics.ox.ac.uk, E-mail: j.conlon1@physics.ox.ac.uk

2015-01-01

It was recently found that the soft X-ray excess in the center of the Coma cluster can be fitted by conversion of axion-like-particles (ALPs) of a cosmic axion background (CAB) to photons. We extend this analysis to the outskirts of Coma, including regions up to 5 Mpc from the center of the cluster. We extract the excess soft X-ray flux from ROSAT All-Sky Survey data and compare it to the expected flux from ALP to photon conversion of a CAB. The soft X-ray excess both in the center and the outskirts of Coma can be simultaneously fitted by ALP tomore » photon conversion of a CAB. Given the uncertainties of the cluster magnetic field in the outskirts we constrain the parameter space of the CAB. In particular, an upper limit on the CAB mean energy and a range of allowed ALP-photon couplings are derived.« less

Coma measurement by use of an alternating phase-shifting mask mark with a specific phase width

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

Qiu Zicheng; Wang Xiangzhao; Yuan Qiongyan

2009-01-10

The correlation between the coma sensitivity of the alternating phase-shifting mask (Alt-PSM) mark and the mark's structure is studied based on the Hopkins theory of partially coherent imaging and positive resist optical lithography (PROLITH) simulation. It is found that an optimized Alt-PSM mark with its phase width being two-thirds its pitch has a higher sensitivity to coma than Alt-PSM marks with the same pitch and the different phase widths. The pitch of the Alt-PSM mark is also optimized by PROLITH simulation, and the structure of p=1.92{lambda}/NA and pw=2p/3 proves to be with the highest sensitivity. The optimized Alt-PSM mark ismore » used as a measurement mark to retrieve coma aberration from the projection optics in lithographic tools. In comparison with an ordinary Alt-PSM mark with its phase width being a half its pitch, the measurement accuracies of Z7 and Z14 apparently increase.« less

Myxedema Coma with Reversible Cardiopulmonary Failure: a Rare Entity in 21St Century.

PubMed

Dhakal, Prajwal; Pant, Manisha; Acharya, Pranab Sharma; Dahal, Sumit; Bhatt, Vijaya Raj

2015-09-01

Myxedema coma, a rare entity in 21st century in developed nations, is a decompensated phase of hypothyroidism with high mortality rates. We describe a young woman with myxedema, who developed respiratory failure, congestive heart failure and significant pericardial effusion, some of the uncommon manifestations. Decreased cardiac contractility can result in cardiomyopathy and heart failure. As illustrated by this case, myxedema can also result in significant pericardial effusion due to increased vascular permeability. Myxedema can further be complicated by alveolar hypoventilation and respiratory failure secondary to the lack of central drive as well as respiratory muscle weakness. Prompt therapy with thyroid hormone replacement, glucocorticoid therapy, aggressive supportive care and management of the precipitating event can save lives and reverse the cardiopulmonary symptoms, as in our patient. Hence, physicians should have a high index of suspicion for myxedema coma in patients with unexplained cardiopulmonary failure. Our report is, therefore, aimed at bringing awareness about the rare but fatal manifestations of myxedema coma.

Rapid reduction of acute subdural hematoma and redistribution of hematoma: case report.

PubMed

Watanabe, Arata; Omata, Tomohiro; Kinouchi, Hiroyuki

2010-01-01

An 88-year-old woman presented with acute subdural hematoma (ASDH) which showed rapid resolution on computed tomography (CT) and magnetic resonance (MR) imaging. She was transferred to our hospital after falling out of bed. On admission, she was comatose with Japan Coma Scale score of 200 and Glasgow Coma Scale score of E1V1M2. Brain CT showed a thick left frontotemporal ASDH. Conservative treatment consisted of 200 ml of glycerol administered intravenously twice a day, and maintenance in the approximately 20 degree head-up position to reduce intracranial pressure. Three days later, her consciousness recovered to Japan Coma Scale score of 30 and Glasgow Coma Scale score of E2V4M5. CT showed obvious reduction of the hematoma without brain or scalp swelling. Spinal MR imaging detected no redistribution of hematoma to the spine. The present case illustrates that rapid spontaneous reduction of ASDH may occur by redistribution of hematoma, mainly to the supratentorial subdural space because of brain atrophy.

Coma and vegetative states: state of the art and proposal of a novel approach combining existing coma scales.

PubMed

Bonsignore, Luca Tommaso; Macrì, Simone; Orsi, Paolo; Chiarotti, Flavia; Alleva, Enrico

2014-01-01

Brain damage of various aetiologies can lead to different disorders of consciousness (DOC), varying from coma to vegetative, to minimally conscious states. Each state is characterised by a different degree of wakefulness, awareness, pain sensitivity and is differentially handled with respect to treatment, ethical considerations and end-oflife decisions. Thus, its correct identification is crucial while devising or modulating appropriate treatment strategies. Actually, the main coma scales cannot always accurately determine the state of consciousness of an individual, while other tools (e.g. imaging techniques) present a certain degree of uncertainty. A complementary approach may be constituted by a 24-hour observation of patients, for a sufficient period of days, using an ad hoc behavioural scale, further correlated with physiological and pharmacological parameters measured on patients. The method herein described might help recognising the presence of consciousness of the different DOC patients, and thus discerning a vegetative from a minimally conscious state.

Cometary MHD and chemistry

NASA Technical Reports Server (NTRS)

Wegmann, R.; Schmidt, H. U.; Huebner, W. F.; Boice, D. C.

1987-01-01

An MHD and chemical comet-coma model was developed, applying the computer program of Huebner (1985) for the detailed chemical evolution of a spherically expanding coma and the program of Schmidt and Wegman (1982) and Wegman (1987) for the MHD flow of plasma and magnetic field in a comet to the Giotto-mission data on the ion abundances measured by the HIS ion mass spectrometer. The physics and chemistry of the coma are modeled in great detail, including photoprocesses, gas-phase chemical kinetics, energy balance with a separate electron temperature, multifluid hydrodynamics with a transition to free molecular flow, fast-streaming atomic and molecular hydrogen, counter and cross streaming of the ionized species relative to the neutral species in the coma-solar wind interaction region with momentum exchange by elastic collisions, mass-loading through ion pick-up, and Lorentz forces of the advected magnetic field. The results, both inside and outside of the contact surface, are discussed and compared with the relevant HIS ion mass spectra.

Composition/Structure/Dynamics of comet and planetary satellite atmospheres

NASA Technical Reports Server (NTRS)

Combi, Michael R. (Principal Investigator)

1995-01-01

This research program addresses two cases of tenuous planetary atmospheres: comets and Io. The comet atmospheric research seeks to analyze a set of spatial profiles of CN in comet Halley taken in a 7.4-day period in April 1986; to apply a new dust coma model to various observations; and to analyze observations of the inner hydrogen coma, which can be optically thick to the resonance scattering of Lyman-alpha radiation, with the newly developed approach that combines a spherical radiative transfer model with our Monte Carlo H coma model. The Io research seeks to understand the atmospheric escape from Io with a hybrid-kinetic model for neutral gases and plasma given methods and algorithms developed for the study of neutral gas cometary atmospheres and the earth's polar wind and plasmasphere. Progress is reported on cometary Hydrogen Lyman-alpha studies; time-series analysis of cometary spatial profiles; model analysis of the dust comae of comets; and a global kinetic atmospheric model of Io.

Dynamic molecular oxygen production in cometary comae

NASA Astrophysics Data System (ADS)

Yao, Yunxi; Giapis, Konstantinos P.

2017-05-01

Abundant molecular oxygen was discovered in the coma of comet 67P/Churyumov-Gerasimenko. Its origin was ascribed to primordial gaseous O2 incorporated into the nucleus during the comet's formation. This thesis was put forward after discounting several O2 production mechanisms in comets, including photolysis and radiolysis of water, solar wind-surface interactions and gas-phase collisions. Here we report an original Eley-Rideal reaction mechanism, which permits direct O2 formation in single collisions of energetic water ions with oxidized cometary surface analogues. The reaction proceeds by H2O+ abstracting a surface O-atom, then forming an excited precursor state, which dissociates to produce O2-. Subsequent photo-detachment leads to molecular O2, whose presence in the coma may thus be linked directly to water molecules and their interaction with the solar wind. This abiotic O2 production mechanism is consistent with reported trends in the 67P coma and raises awareness of the role of energetic negative ions in comets.

Diagnosis of reversible causes of coma.

PubMed

Edlow, Jonathan A; Rabinstein, Alejandro; Traub, Stephen J; Wijdicks, Eelco F M

2014-12-06

Because coma has many causes, physicians must develop a structured, algorithmic approach to diagnose and treat reversible causes rapidly. The three main mechanisms of coma are structural brain lesions, diffuse neuronal dysfunction, and, rarely, psychiatric causes. The first priority is to stabilise the patient by treatment of life-threatening conditions, then to use the history, physical examination, and laboratory findings to identify structural causes and diagnose treatable disorders. Some patients have a clear diagnosis. In those who do not, the first decision is whether brain imaging is needed. Imaging should be done in post-traumatic coma or when structural brain lesions are probable or possible causes. Patients who do not undergo imaging should be reassessed regularly. If CT is non-diagnostic, a checklist should be used use to indicate whether advanced imaging is needed or evidence is present of a treatable poisoning or infection, seizures including non-convulsive status epilepticus, endocrinopathy, or thiamine deficiency. Copyright © 2014 Elsevier Ltd. All rights reserved.

A case report on near manual strangulation and glasgow coma scale.

PubMed

Meel Banwari, L

2015-09-01

Glasgow Coma Scale (GCS) is considered as a gold standard in estimating the prognosis of the comatose patient. The management of the patient relies heavily on this scale. The mechanism of injury must also be included in scoring of the GCS. Survival from strangulation is uncommon, and if it occurs, it is often associated with various complications such as neurological consequences. To highlight a poor correlation with low GCS and ultimate outcome in cases of manual strangulation. This is a case report of young female adult who was raped and manually strangulated by a colleague during a training course for traditional healers. She was admitted with very low (3/15) Glasgow Coma Scale (GCS) and presumed to have a poor prognosis. She was rigorously ventilated in Intensive Care Unit (ICU), and was discharged from hospital after a week without any complications. The neck and genital injuries are described. This report discusses. A low Glasgow Coma Scale is not a predictive of poor prognosis in cases of manual strangulation.

Modeling the Thermodynamic Properties of the Inner Comae of Comets

NASA Astrophysics Data System (ADS)

Boice, Daniel C.

2017-10-01

Introduction: Modeling is central to understand the important properties of the cometary environment. We have developed a comet model, SUISEI, that self-consistently includes the relevant physicochemical processes within a global modeling framework, from the porous subsurface layers of the nucleus to the interaction with the solar wind. Our goal is to gain valuable insights into the intrinsic properties of cometary nuclei so we can better understand observations and in situ measurements. SUISEI includes a multifluid, reactive gas dynamics simulation of the dusty coma (ComChem) and a suite of other coupled numerical simulations. This model has been successfully applied to a variety of comets in previous studies over the past three decades. We present results from a quantitative study of the thermodynamic properties and chemistry of cometary comae as a function of cometocentric and heliocentric distance to aid in interpretation of observations and in situ measurements of comets.Results and Discussion: ComChem solves the fluid dynamic equations for the mass, momentum, and energy of three neutral fluids (H, H2, and the heavier bulk fluid), ions, and electrons. In the inner coma, the gas expands, cools, accelerates, and undergoes many photolytic and gas-phase chemical reactions tracking hundreds of sibling species. The code handles the transition to free molecular flow and describes the spatial distribution of species in the coma of a comet. Variations of neutral gas temperature and velocity with cometocentric distance and heliocentric distance for a comet approaching the Sun from 2.5 to 0.3 AU are presented. Large increases in the gas temperatures (>400 K) due to photolytic heating in the coma within ~0.5 AU are noted, with dramatic effects on the chemistry, optical depth, and other coma properties. Results are compared to observations when available.Conclusions: SUISEI has proven to be a unique and valuable model to understand the relevant physical processes and properties of small Solar System bodies, including near-Sun comets and asteroids.Acknowledgments: This work was supported by FAPESP under Grant No. 2015/03176-8 and the National Science Foundation Planetary Astronomy Program Grant No. 0908529.

An empirical model of H2O, CO2 and CO coma distributions and production rates for comet 67P/Churyumov-Gerasimenko based on ROSINA/DFMS measurements and AMPS-DSMC simulations

NASA Astrophysics Data System (ADS)

Hansen, Kenneth C.; Altwegg, Kathrin; Bieler, Andre; Berthelier, Jean-Jacques; Calmonte, Ursina; Combi, Michael R.; De Keyser, Johan; Fiethe, Björn; Fougere, Nicolas; Fuselier, Stephen; Gombosi, T. I.; Hässig, Myrtha; Huang, Zhenguang; Le Roy, Léna; Rubin, Martin; Tenishev, Valeriy; Toth, Gabor; Tzou, Chia-Yu; ROSINA Team

2016-10-01

We have previously used results from the AMPS DSMC (Adaptive Mesh Particle Simulator Direct Simulation Monte Carlo) model to create an empirical model of the near comet water (H2O) coma of comet 67P/Churyumov-Gerasimenko. In this work we create additional empirical models for the coma distributions of CO2 and CO. The AMPS simulations are based on ROSINA DFMS (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis, Double Focusing Mass Spectrometer) data taken over the entire timespan of the Rosetta mission. The empirical model is created using AMPS DSMC results which are extracted from simulations at a range of radial distances, rotation phases and heliocentric distances. The simulation results are then averaged over a comet rotation and fitted to an empirical model distribution. Model coefficients are then fitted to piecewise-linear functions of heliocentric distance. The final product is an empirical model of the coma distribution which is a function of heliocentric distance, radial distance, and sun-fixed longitude and latitude angles. The model clearly mimics the behavior of water shifting production from North to South across the inbound equinox while the CO2 production is always in the South.The empirical model can be used to de-trend the spacecraft motion from the ROSINA COPS and DFMS data. The ROSINA instrument measures the neutral coma density at a single point and the measured value is influenced by the location of the spacecraft relative to the comet and the comet-sun line. Using the empirical coma model we can correct for the position of the spacecraft and compute a total production rate based on single point measurements. In this presentation we will present the coma production rates as a function of heliocentric distance for the entire Rosetta mission.This work was supported by contracts JPL#1266313 and JPL#1266314 from the US Rosetta Project and NASA grant NNX14AG84G from the Planetary Atmospheres Program.

Production, Outflow Velocity, and Radial Distribution of H2O and OH in the Coma of Comet C/1995 O1 [Hale-Bopp] from Wide Field Imaging of OH

NASA Technical Reports Server (NTRS)

Harris, Walter M.; Scherb, Frank; Mierkiewicz, Edwin; Oliversen, Ronald; Morgenthaler, Jeffrey

2001-01-01

Observations of OH are a useful proxy of the water production rate (Q(sub H2O)) and outflow velocity (V(sub out)) in comets. We use wide field images taken on 03/28/1997 and 04/08/1997 that capture the entire scale length of the OH coma of comet C/1995O1 (Hale-Bopp) to obtain Q(sub H2O) from the model-independent method of aperture summation. We also extract the radial brightness profile of OH 3080 angstroms out to cometocentric distances of up to 10(exp 6) km using an adaptive ring summation algorithm. Radial profiles are obtained as azimuthal averages and in quadrants covering different position angles relative to the comet-Sun line. These profiles are fit using both fixed and variable velocity two-component spherical expansion models to determine VOH with increasing distance from the nucleus. The OH coma of Hale-Bopp was more spatially extended than in previous comets, and this extension is best matched by a variable acceleration of H2O and OH that acted across the entire coma, but was strongest within 1-2 x 10(exp 4) km from the nucleus. This acceleration led to VOH at 10(exp 6) km that was 2-3 times greater than that obtained from a 1P/Halleytype comet at 1 AU, a result that is consistent with gas-kinetic models, extrapolation from previous observations of OH in comets with Q(sub H2O) > 10(exp 29)/s, and radio measurements of the outer coma Hale-Bopp OH velocity profile. When the coma is broken down by quadrant, we find an azimuthal asymmetry in the radial distribution that is characterized by an increase in the spatial extent of OH in the region between the orbit-trailing and anti-sunward directions. Model fits to this area and comparison with radio OH measurements suggest greater acceleration in this region, with VOH UP to 1.5 times greater at 10(exp 6) km radial distance than elsewhere in the coma.

Up-regulation of brain cytokines and chemokines mediates neurotoxicity in early acute liver failure by a mechanism independent of microglial activation.

PubMed

Faleiros, Bruno E; Miranda, Aline S; Campos, Alline C; Gomides, Lindisley F; Kangussu, Lucas M; Guatimosim, Cristina; Camargos, Elizabeth R S; Menezes, Gustavo B; Rachid, Milene A; Teixeira, Antônio L

2014-08-26

The neurological involvement in acute liver failure (ALF) is characterized by arousal impairment with progression to coma. There is a growing body of evidence that neuroinflammatory mechanisms play a role in this process, including production of inflammatory cytokines and microglial activation. However, it is still uncertain whether brain-derived cytokines and glial cells are crucial to the pathophysiology of ALF at the early stage, before coma development. Here, we investigated the influence of cytokines and microglia in ALF-induced encephalopathy in mice as soon as neurological symptoms were identifiable. Behavior was assessed at 12, 24, 36 and 48 h post-injection of thioacetamide, a hepatotoxic drug, through locomotor activity by an open field test. Brain concentration of cytokines (TNF-α and IL-1β) and chemokines (CXCL1, CCL2, CCL3 and CCL5) were assessed by ELISA. Microglial activation in brain sections was investigated through immunohistochemistry, and cellular ultrastructural changes were observed by transmission electron microscopy. We found that ALF-induced animals presented a significant decrease in locomotor activity at 24 h, which was accompanied by an increase in IL-1β, CXCL1, CCL2, CCL3 and CCL5 in the brain. TNF-α level was significantly increased only at 36 h. Despite marked morphological changes in astrocytes and brain endothelial cells, no microglial activation was observed. These findings suggest an involvement of brain-derived chemokines and IL-1β in early pathophysiology of ALF by a mechanism independent of microglial activation. Copyright © 2014 Elsevier B.V. All rights reserved.

Hco+ in the Coma of Comet Hale-Bopp

NASA Astrophysics Data System (ADS)

Lovell, A. J.; Schloerb, F. P.; Bergin, E. A.; Dickens, J. E.; De Vries, C. H.; Senay, M. C.; Irvine, W. M.

1997-05-01

Maps of comet C/1995 O1 (Hale-Bopp) in the millimeter-wave emission of the ion HCO^+ revealed a local minimum near the nucleus position, with a maximum about 100,000 km in the antisolar direction. These observed features of the HCO^+ emission require a low abundance of HCO^+ due to enhanced destruction in the inner coma of the comet, within a region of low electron temperature (T_e). To set constraints on the formation of HCO^+ in the coma, as well as the location and magnitude of the transition to higher T_e, the data are compared with the results of ion-molecule chemistry models.

Status epilepticus caused by a myxoedema coma.

PubMed

Jansen, H J; Doebé, S R Oedit; Louwerse, E S; van der Linden, J C; Netten, P M

2006-06-01

The case of a 63-year-old woman who presented with status epilepticus, coma and hypoventilation is reported. A primary neurological cause was considered. Hypothermia led to further investigations and a diagnosis of severe hypothyroidism. The neurological complications of hyperthyriodism include alteration in mental status with slowness, decreased concentration and lethargy, headache, cranial nerve palsies, dysarthria, hoarseness, myopathy, neuropathy, reflex changes, ataxia, and psychotic episodes. Our patient suffered from a rare consequence of severe hypothyroidism presenting with status epilepticus and she died despite treatment. To our knowledge this is the second patient to be reported with myxoedema coma with this kind of presentation. Despite therapeutic options, there is a high mortality rate.

Myxedema coma.

PubMed

Wartofsky, Leonard

2006-12-01

Myxedema coma is the term given to the most severe presentation of profound hypothyroidism and is often fatal in spite of therapy. Decompensation of the hypothyroid patient into a coma may be precipitated by a number of drugs, systemic illnesses (eg, pneumonia), and other causes. It typically presents in older women in the winter months and is associated with signs of hypothyroidism, hypothermia, hyponatremia, hypercarbia, and hypoxemia. Treatment must be initiated promptly in an intensive care unit setting. Although thyroid hormone therapy is critical to survival, it remains uncertain whether it should be administered as thyroxine, triiodothyronine, or both. Adjunctive measures, such as ventilation, warming, fluids, antibiotics, pressors, and corticosteroids, may be essential for survival.

HCO+ in the coma of comet Hale-Bopp

NASA Technical Reports Server (NTRS)

Lovell, A. J.; Schloerb, F. P.; Bergin, E. A.; Dickens, J. E.; Devries, C. H.; Senay, M. C.; Irvine, W. M.; Ferris, J. P. (Principal Investigator)

1997-01-01

Maps of comet C/1995 O1 (Hale-Bopp) in the millimeter-wave emission of the ion HCO+ revealed a local minimum near the nucleus position, with a maximum about 100,000 km in the antisolar direction. These observed features of the HCO+ emission require a low abundance of HCO+ due to enhanced destruction in the inner coma of the comet, within a region of low electron temperature (Te). To set constraints on the formation of HCO+ in the coma, as well as the location and magnitude of the transition to higher Te, the data are compared with the results of ion-molecule chemistry models.

Another collision for the Coma cluster

NASA Technical Reports Server (NTRS)

Vikhlinin, A.; Forman, W.; Jones, C.

1996-01-01

The wavelet transform analysis of the Rosat position sensitive proportional counter (PSPC) images of the Coma cluster are presented. The analysis shows, on small scales, a substructure dominated by two extended sources surrounding the two bright clusters NGC 4874 and NGC 4889. On scales of about 2 arcmin to 3 arcmin, the analysis reveals a tail of X-ray emission originating near the cluster center, curving to the south and east for approximately 25 arcmin and ending near the galaxy NGC 4911. The results are interpreted in terms of a merger of a group, having a core mass of approximately 10(exp 13) solar mass, with the main body of the Coma cluster.

Rosetta/Alice Measurements of Atomic and Molecular Abundances in the Coma of 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Vervack, R. J., Jr.; Weaver, H. A., Jr.; Knight, M. M.; Feldman, P.; Stern, A.; Parker, J. W.; Feaga, L. M.; Steffl, A.; Bertaux, J. L.; A'Hearn, M. F.; Keeney, B. A.

2017-12-01

During the Rosetta orbital phase from August 2014 through September 2016, the Alice far-ultraviolet (FUV) imaging spectrograph routinely monitored the FUV emission from the coma of 67P/Churyumov-Gerasimenko (67P). These data, spanning 700-2050 Å, provide both spatial and temporal information on the evolution of the coma composition throughout the encounter. Emissions from hydrogen (Lyman beta at 1025 Å), oxygen (1304 Å triplet, 1356 Å), sulfur (1429 Å and 1479 Å multiplets, 1814 Å triplet), and carbon (1561 Å, 1657 Å) were regularly observed, as well as emission from the CO Fourth Positive and Cameron bands. We present a preliminary analysis of these emissions with a focus on the abundances in the coma and a mapping of the temporal and spatial variations. Both short-term (days) and long-term (months) variations will be discussed in the context of rotational and seasonal timeframes. We also present ratios among various species with the goal of identifying the dominant processes at work in the coma as a function of time. Rosetta is an ESA mission with contributions from its member states and NASA. The Alice team acknowledges continuing support from NASA's Jet Propulsion Laboratory through contract 1336850 to the Southwest Research Institute. RJV's work was supported by a subcontract from Southwest Research Institute to the Johns Hopkins University Applied Physics Laboratory.

Myxedema coma of both primary and secondary origin, with non-classic presentation and extremely elevated creatine kinase.

PubMed

Benvenga, S; Squadrito, S; Saporito, F; Cimino, A; Arrigo, F; Trimarchi, F

2000-09-01

Myxedema coma is a rare, often fatal endocrine emergency that concerns elderly patients with long-standing primary hypothyroidism; myxedema coma of central origin is exceedingly rare. Here, we report a 37-year-old woman in whom classical symptoms of hypothyroidism had been absent. Six years earlier, she had severe obstetric hemorrhage and, shortly after, two subsequent episodes of pericardial effusion. On the day of admission, pericardiocentesis was performed for the third episode of pericardial effusion. Because of the subsequent grave arrhythmias and unconsciousness, she was transferred to our ICU. Prior to the endocrine consultation, a silent myocardial infarction had been suspected, based on the extremely high serum levels of creatine kinase (CK) and isoenzyme CK-MB. However, based on thyroid sonography, pituitary computed tomography, elevated titers of antithyroid antibodies and pituitary stimulation tests, the final diagnosis was myxedema coma of dual origin: an atrophic variant of Hashimoto's thyroiditis and post-necrotic pituitary atrophy (Sheehan syndrome). Substitutive therapy caused a prompt clinical amelioration and normalization of CK levels. Our patient is the first case of myxedema coma of double etiology, and illustrates how its presentation deviates markedly from the one endocrinologists and physicians at ICU are prepared to encounter. In addition, cardiac problems as those of our patient should not discourage from substitutive treatment (using L-thyroxine and the gastrointestinal route of absorption), if the age is relatively low.

Ultraviolet and optical view of galaxies in the Coma Supercluster

NASA Astrophysics Data System (ADS)

Mahajan, Smriti; Singh, Ankit; Shobhana, Devika

2018-05-01

The Coma supercluster (100h-1Mpc) offers an unprecedented contiguous range of environments in the nearby Universe. In this paper we present a catalogue of spectroscopically confirmed galaxies in the Coma supercluster detected in the ultraviolet (UV) wavebands. We use the arsenal of UV and optical data for galaxies in the Coma supercluster covering ˜500 square degrees on the sky to study their photometric and spectroscopic properties as a function of environment at various scales. We identify the different components of the cosmic-web: large-scale filaments and voids using Discrete Persistent Structures Extractor, and groups and clusters using Hierarchical Density-based spatial clustering of applications with noise, respectively. We find that in the Coma supercluster the median emission in Hα inclines, while the g - r and FUV - NUV colours of galaxies become bluer moving further away from the spine of the filaments out to a radius of ˜1 Mpc. On the other hand, an opposite trend is observed as the distance between the galaxy and centre of the nearest cluster or group decreases. Our analysis supports the hypothesis that properties of galaxies are not just defined by its stellar mass and large-scale density, but also by the environmental processes resulting due to the intrafilament medium whose role in accelerating galaxy transformations needs to be investigated thoroughly using multi-wavelength data.

Epidemiology and prognosis of coma in daytime television dramas

PubMed Central

Casarett, David; Fishman, Jessica M; MacMoran, Holly Jo; Pickard, Amy; Asch, David A

2005-01-01

Objective To determine how soap operas portray, and possibly misrepresent, the likelihood of recovery for patients in coma. Design Retrospective cohort study. Setting Nine soap operas in the United States reviewed between 1 January 1995 and 15 May 2005. Subjects 64 characters who experienced a period of unconsciousness lasting at least 24 hours. Their final status at the end of the follow-up period was compared with pooled data from a meta-analysis. Results Comas lasted a median of 13 days (interquartile range 7-25 days). Fifty seven (89%) patients recovered fully, five (8%) died, and two (3%) remained in a vegetative state. Mortality for non-traumatic and traumatic coma was significantly lower than would be predicted from the meta-analysis data (non-traumatic 4% v 53%; traumatic 6% v 67%; Fisher's exact test both P < 0.001). On the day that patients regained consciousness, most (49/57; 86%) had no evidence of limited function, cognitive deficit, or residual disability needing rehabilitation. Compared with meta-analysis data, patients in this sample had a much better than expected chance of returning to normal function (non-traumatic 91% v 1%; traumatic 89% v 7%; both P < 0.001). Conclusions The portrayal of coma in soap operas is overly optimistic. Although these programmes are presented as fiction, they may contribute to unrealistic expectations of recovery. PMID:16373744

PCA/HEXTE Observations of Coma and A2319

NASA Technical Reports Server (NTRS)

Rephaeli, Yoel

1998-01-01

The Coma cluster was observed in 1996 for 90 ks by the PCA and HEXTE instruments aboard the RXTE satellite, the first simultaneous, pointing measurement of Coma in the broad, 2-250 keV, energy band. The high sensitivity achieved during this long observation allows precise determination of the spectrum. Our analysis of the measurements clearly indicates that in addition to the main thermal emission from hot intracluster gas at kT=7.5 keV, a second spectral component is required to best-fit the data. If thermal, it can be described with a temperature of 4.7 keV contributing about 20% of the total flux. The additional spectral component can also be described by a power-law, possibly due to Compton scattering of relativistic electrons by the CMB. This interpretation is based on the diffuse radio synchrotron emission, which has a spectral index of 2.34, within the range allowed by fits to the RXTE spectral data. A Compton origin of the measured nonthermal component would imply that the volume-averaged magnetic field in the central region of Coma is B =0.2 micro-Gauss, a value deduced directly from the radio and X-ray measurements (and thus free of the usual assumption of energy equipartition). Barring the presence of unknown systematic errors in the RXTE source or background measurements, our spectral analysis yields considerable evidence for Compton X-ray emission in the Coma cluster.

An Integrated Modeling Study for Coordinated Observations of H, O, OH, and H2O(+) Emissions in the Coma and Ion Tail of the Comet Hale-Bopp

NASA Technical Reports Server (NTRS)

Smyth, William H.

2001-01-01

This project has two overall objectives. One objective is to advance our general understanding of both the comet neutral atmosphere and the cometary plasma in the atmosphere and ion tall. The other objective is to obtain specific key information about comet Hale-Bopp that is generally important for Hale-Bopp studies. The primary emphasis in this project is to analyze, in a self-consistent manner, excellent quality high resolution image and line profile observations obtained by the University of Wisconsin for H, O, OH, and H2O+ emissions from the inner coma, outer coma, and ion tail of Hale-Bopp. The information on the spatial and velocity distributions of H2O neutral and ionized photo-products in the inner coma, outer coma, and in the H2O+ ion tail is of substantial and direct importance in the development of an integrated understanding of the complex structure and dynamics of the neutral and plasma species in the atmosphere of Hale-Bopp in particular and comets in general. The H2O production rate of Hale-Bopp is determined and, together with the other information related to the structure and dynamics of the neutral and plasma atmospheres obtained in this study, provide critical information important for a wide variety of research conducted by other groups.

[Sepsis associated encephalopathy is an independently risk factor for nosocomial coma in patients with supratentorial intracerebral hemorrhage: a retrospective cohort study of 261 patients].

PubMed

Wang, Guangsheng; Wang, Shaodan; Zhou, Yeting; Chen, Xiaodong; Ma, Xiaobo; Tong, Daoming

2016-08-01

To investigate whether the presence of sepsis associated encephalopathy (SAE) would predict nosocomial coma (NC) and poor outcome in patients with supratentorial intracerebral hemorrhage (SICH). A retrospective cohort study was conducted. The adult acute SICH patients with or without coma admitted to intensive care unit (ICU) of Shuyang People' Hospital Affiliated to Xuzhou Medical University from December 2012 to December 2015 were enrolled. Brain computed tomography (CT) scans were analyzed and the patients were divided into pre-hospital coma (PC) and NC groups. The clinical data and the incidence of SAE of patients in two groups were compared, and the 30-day prognosis was followed up. Univariate and Cox regression analyses were performed to analyze whether SAE would predict NC and poor outcome in patients with SICH. A total of 330 patients with acute SICH and coma were enrolled, excluding 60 cases of infratentorial cerebral hemorrhage, 3 cases of primary intraventricular hemorrhage, and 6 cases of unknown volume hematoma. Finally, 261 patients were included, with 111 patients of NC events, and 150 patients of PC events. 69 (62.2%) SAE in SICH with NC and 33 (22.2%) SAE in SICH with PC was diagnosed, and the incidence of SAE between two groups was statistically significant (P < 0.01). Compared with PC group, SICH patients in the NC group had lower incidence of hypertension (81.1% vs. 96.0%), longer time from onset to NC [days: 2.3 (23.9) vs. 0 (0.5)] and length of ICU stay [days: 5.0 (34.0) vs. 3.0 (12.0)], higher initial Glasgow coma score (GCS, 10.2±1.5 vs. 6.6±1.6) and sequential organ failure assessment (SOFA) score [4.0 (6.0) vs. 3.0 (3.0)], lower initial National Institutes of Health Stroke Scale (NIHSS) score (19.4±6.6 vs. 30.2±6.8), as well as more frequent sepsis (78.4% vs. 38.0%), vegetative state (24.3% vs. 14.0%), acute respiratory failure (24.3% vs. 10.0%), pneumonia (37.8% vs. 24.0%), septic shock (8.1% vs. 0), acute liver failure (5.4% vs. 0), hypernatremia (8.1% vs. 0), CT indicating that more frequent vasogenic edema (64.9% vs. 16.0%) and white matter lesion (13.5% vs. 2.0%), and less mannitol usage (94.6% vs. 100.0%), and less brain midline shift (32.4% vs. 68.0%) and hematoma enlargement (8.1% vs. 30.0%), less hematoma volume (mL: 28.0±18.8 vs. 38.3±24.4) in CT, and higher 30-day mortality (54.1% vs. 26.0%) with statistical differences (all P < 0.05). It was shown by Cox regression analyses that SAE [hazard ratio (HR) = 3.5, 95% confidence interval (95%CI) = 1.346-6.765, P = 0.000] and SOFA score (HR = 1.8, 95%CI = 1.073-1.756, P = 0.008) were independent risk factors of death of SICH patients with NC, and hematoma enlargement was independent risk factor of death of SICH patients with PC (HR = 3.0, 95%CI = 1.313-5.814, P = 0.000). SAE is the independent factor of inducing NC event and poor prognosis in SICH patients.

Two-dimensional molecular line transfer for a cometary coma

NASA Astrophysics Data System (ADS)

Szutowicz, S.

2017-09-01

In the proposed axisymmetric model of the cometary coma the gas density profile is described by an angular density function. Three methods for treating two-dimensional radiative transfer are compared: the Large Velocity Gradient (LVG) (the Sobolev method), Accelerated Lambda Iteration (ALI) and accelerated Monte Carlo (MC).

Modeling Coma Gas Jets in Comet Hale-Bopp

NASA Technical Reports Server (NTRS)

Lederer, S. M.; Campins, H.

2001-01-01

We present an analysis of OH, CN, and C2 jets observed in Comet Hale-Bopp. The relative contributions from and composition of the coma gas sources, and the parameters describing the active areas responsible for the gas jets will be discussed. Additional information is contained in the original extended abstract.

Modeling Cometary Coma with a Three Dimensional, Anisotropic Multiple Scattering Distributed Processing Code

NASA Technical Reports Server (NTRS)

Luchini, Chris B.

1997-01-01

Development of camera and instrument simulations for space exploration requires the development of scientifically accurate models of the objects to be studied. Several planned cometary missions have prompted the development of a three dimensional, multi-spectral, anisotropic multiple scattering model of cometary coma.

VizieR Online Data Catalog: Subaru-UDGs in the Coma cluster (Yagi+, 2016)

NASA Astrophysics Data System (ADS)

Yagi, M.; Koda, J.; Komiyama, Y.; Yamanoi, H.

2016-10-01

We retrieved a wide W-C-RC band (R-band) survey of the Coma cluster of Suprime-Cam from the Subaru public archive (SMOKA; Baba et al. 2002ASPC..281..298B) between 2011 Mar 02 and 2011 Apr 01. (1 data file).

[Cardiac failure in endocrine diseases].

PubMed

Hashizume, K

1993-05-01

Several endocrine diseases show the symptoms of cardiac failure. Among them, patients with acromegaly show a specific cardiomyopathy which results in a severe left-sided cardiac failure. Hypoparathyroidism also induces cardiac failure, which is resulted from hypocalcemia and low levels of serum parathyroid hormone. In the cases of hypothyroidism, the patients with myxedemal coma show a severe cardiac failure, which is characterized by disturbance of central nervous system, renal function, and cardiac function. In the patients with thyroid crisis (storm), the cardiac failure comes from the great reduction of cardiac output with dehydration. The reduction of circulation volume, observed in the patients with pheochromocytoma easily induces cardiac failure (shock) just after the removal of adrenal tumor. In patients with malignant carcinoid syndrome, right-sided ventricular failure which may be occurred through the actions of biogenic amines is observed.

These are two images of the inner coma of Comet Hyakutake

NASA Technical Reports Server (NTRS)

2002-01-01

These are two images of the inner coma of Comet Hyakutake made on April 3 and 4, 1996, using the NASA Hubble Space Telescope Wide Field Planetary Camera 2 (WFPC2). The first one, shown in red, was taken through a narrow-band red filter that shows only sunlight scattered by dust particles in the inner coma of the comet. The second one, shown in blue was taken with an ultraviolet 'Woods' filter image that shows the distribution of scattered ultraviolet radiation from hydrogen atoms in the inner coma. The coma is the head or dusty-gas atmosphere of a comet. The square field of view is 14,000 km on a side and the sun is toward the upper right corner of the image. Hydrogen atoms represent the most abundant gas in the whole coma of the comet. They are produced when solar ultraviolet light breaks up molecules of water, the major constitutent of the nucleus of the comet. These images were taken as part of an observing program to study water photochemistry in comets. Measurements of hydrogen (H) and hydroxyl (OH) in the coma (or atmosphere) of Comet Hyakutake were also made using the Goddard High Resolution Spectrograph (GHRS) and the Faint Object Spectrograph (FOS). A self-consistent analysis of all the data shows that the water production rate of the comet was between 7 and 8 tons per second on the April 3 and 4. A theoretical model was used in the analysis which accounts for the detailed physics and chemistry of the photochemical destruction of the water, the production of the H and OH, and their expansion in the coma (or atmosphere) of the comet. The model matched the velocity measurements of hydrogen atoms made using the high spectral resolution capabilities of the GHRS instrument. The importance of such a detailed model is that is permits the accurate calculation of the production rate of water from observations of H and OH. The inner yellow region near the center of the red dust image is dominated by the contribution from the dust which shows sunward directed spiral jets toward the upper right, and the thin straight particle trail pointing toward the lower left. The trail was a permanent feature of the comet around the time of its close approach to the earth in late March and early April. Also barely visible just beyond the lower left end of the trail are two of the many condensations which were seen to travel slowly down the tail are are believed to be clumps of material released from the nucleus. The inner white region of the blue image appears to show that the hydrogen atoms like the dust might be preferentially ejected toward the sunward or day side of the nucleus. However, this is not true. The asymmetric ultraviolet radiation pattern is produced by a roughly spherical distribution of hydrogen atoms because they are so efficient at scattering the incoming solar ultraviolet light. The atoms on the sunward side actually shadow the atoms on the tailward or night side of the coma. The same detailed model analysis of the coma which explains the expansion of the hydrogen atoms in the coma also explains the appearance of the image. The team was lead by Michael Combi, The University of Michigan, and included Michael Brown, California Institute of Technology, Paul Feldman, Johns Hopkins University, H. Uwe Keller of the Max Planck Institute, Lindau, Robert Meier of the Naval Research Laboratory, and William Smyth of Atmospheric and Environmental Research, Inc. Credit: M.R. Combi (The University of Michigan)

Extreme hyperphosphatemia and hypocalcemic coma associated with phosphate enema.

PubMed

Hsu, Heng Jung; Wu, Mai-Szu

2008-01-01

Fleet enema (sodium phosphate, C.B. Fleet Co., Inc., Lynchburg, Virginia) is widely used for bowel preparation or constipation relief in the hospital and over the counter. The potential risks, including hyperphosphatemia and hypocalcemic coma should be kept in mind of primary care physician. The patients with older age, bowel obstruction, small intestinal disorders, poor gut motility, and renal disease are contraindicated or should be administered with caution. We present a patient with old age and chronic renal failure who developed severe hyperphosphatemia and hypocalcemic tetany with coma after sodium phosphate enema. We recommend the use of alternative enema preparations, such as simple tap water or saline solution enemas, which can prevent fatal complications in high risk patients.

Study of the coma of comet 67P/Churyumov-Gerasimenko based on the ROSINA/RTOF instrument onboard Rosetta

NASA Astrophysics Data System (ADS)

Hoang, M.; Garnier, P.; Rème, H.; Altwegg, K.; Balsiger, H.; Calmonte, U.; Fiethe, B.; Galli, A.; Gasc, S.; Jäckel, A.; Mall, U.; Le Roy, L.; Rubin, M.; Tzou, C.-Y.; Waite, J. H.; Wurz, P.

2015-10-01

The Rosetta ESA mission investigates the environment of the comet 67P / Churyumov- Gerasimenko since August 2014. Among the experiments onboard the satellite, the ROSINA experiment (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) includes two mass spectrometers (DFMS and RTOF) to analyze the composition of neutrals and ions, and an instrument (COPS) to monitor the density and velocity of neutrals in the coma [1]. We will here analyze and discuss the data of the ROSINA/RTOF instrument during the comet escort phase. A detailed description of the main volatiles (H2O, CO2, CO) dynamics and of the heterogeneities of the coma will be provided.

The Meteoroid Fluence at Mars Due to Comet Siding Spring

NASA Technical Reports Server (NTRS)

Moorhead, Althea V.

2014-01-01

Long-period comet C/2013 A1 (Siding Spring) is headed for a close encounter with Mars on 2014 Oct 19. A collision between the comet and the planet has been ruled out, but the comets coma may envelop Mars and its man-made satellites. We present an analytic model of the dust component of cometary comae that describes the spatial distribution of cometary dust and meteoroids and their size distribution. If the coma reaches Mars, we estimate a total incident particle fluence on the planet and its satellites of 0.01 particles per square meter. We compare our model with numerical simulations, data from past comet missions, and recent Siding Spring observations.

[The myxoedema coma exists, we met it].

PubMed

Fritsch, N; Tran-Van, D; Dardare, E; Gentile, A; Deroudilhe, G; Fontaine, B

2007-09-01

The myxoedema coma corresponds to the ultimate evolution of a hypothyroidism and is characterized by a major deficit in thyroid hormones responsible for a collapse of the metabolism. The preventive and curative treatment is based on the administration of thyroid hormones, whose benefits are opposed to the cardiovascular risks related to an iatrogenic hyperthyroidism for patients often old with cardiopathy. We report the case of a 92-year-old patient with unbalanced hypothyroidism and chronic cardiac deficiency, who presented a myxoedema coma in the postoperative period of an urgent digestive surgery. This observation illustrates the difficulties in treating patients with unbalanced hypothyroidism following emergency surgery, in the absence of consensus on the type and the amounts of thyroid hormones substitution.

Coma of modified Gregorian and Cassegrainian mirror systems

NASA Technical Reports Server (NTRS)

Jones, R. T.

1976-01-01

The equivalence of the classical Newtonian, Cassegrainian, and Gregorian mirror systems with respect to the first two Seidel aberrations is rederived by means of a simple congruence. The effects of arbitrary small modifications of the two mirror systems are then studied and general formulas are derived for the effects of such modifications on the spherical aberration and coma. Spherical aberration is corrected to the third order if the amount of glass removed from one surface is replaced at the corresponding zone of the other surface. Modifications in which one surface is made spherical while the other is adjusted to eliminate spherical aberration result in large increases of coma for systems having the usual amplifying ratios.

Limb salvage after gas gangrene: a case report and review of the literature.

PubMed

Aggelidakis, John; Lasithiotakis, Konstantinos; Topalidou, Anastasia; Koutroumpas, John; Kouvidis, Georgios; Katonis, Paulos

2011-08-17

Gas gangrene is a necrotic infection of soft tissue associated with high mortality, often necessitating amputation in order to control the infection. Herein we present a case of gas gangrene of the arm in an intravenous drug user with a history of intramuscular injections with normal saline in the shoulder used to provoke pain for recovery after drug induced coma. The patient was early treated with surgery and antibiotics rendering possible the preservation of the limb and some of its function. Additionally, a review of the literature regarding case reports of limb salvage after gas gangrene is presented.

ERRATUM: 'MAPPING THE GAS TURBULENCE IN THE COMA CLUSTER: PREDICTIONS FOR ASTRO-H'

NASA Technical Reports Server (NTRS)

Zuhone, J. A.; Markevitch, M.; Zhuravleva, I.

2016-01-01

The published version of this paper contained an error in Figure 5. This figure is intended to show the effect on the structure function of subtracting the bias induced by the statistical and systematic errors on the line shift. The filled circles show the bias-subtracted structure function. The positions of these points in the left panel of the original figure were calculated incorrectly. The figure is reproduced below (with the original caption) with the correct values for the bias-subtracted structure function. No other computations or figures in the original manuscript are affected.

Clinical Applications of Wavefront Refraction

PubMed Central

Bruce, Adrian S.; Catania, Louis J.

2014-01-01

ABSTRACT Purpose To determine normative reference ranges for higher-order wavefront error (HO-WFE), compare these values with those in common ocular pathologies, and evaluate treatments. Methods A review of 17 major studies on HO-WFE was made, involving data for a total of 31,605 subjects. The upper limit of the 95% confidence interval (CI) for HO-WFE was calculated from the most comprehensive of these studies using normal healthy patients aged 20 to 80 years. There were no studies identified using the natural pupil size for subjects, and for this reason, the HO-WFE was tabulated for pupil diameters of 3 to 7 mm. Effects of keratoconus, pterygium, cataract, and dry eye on HO-WFE were reviewed and treatment efficacy was considered. Results The calculated upper limit of the 95% CI for HO-WFE in a healthy normal 35-year-old patient with a mesopic pupil diameter of 6 mm would be 0.471 μm (471 nm) root-mean-square or less. Although the normal HO-WFE increases with age for a given pupil size, it is not yet completely clear how the concurrent influence of age-related pupillary miosis affects these findings. Abnormal ocular conditions such as keratoconus can induce a large HO-WFE, often in excess of 3.0 μm, particularly attributed to coma. For pterygium or cortical cataract, a combination of coma and trefoil was more commonly induced. Nuclear cataract can induce a negative spherical HO-WFE, usually in excess of 1.0 μm. Conclusions The upper limit of the 95% CI for HO-WFE root-mean-square is about 0.5 μm with normal physiological pupil sizes. With ocular pathologies, HO-WFE can be in excess of 1.0 μm, although many devices and therapeutic and surgical treatments are reported to be highly effective at minimizing HO-WFE. More accurate normative reference ranges for HO-WFE will require future studies using the subjects’ natural pupil size. PMID:25216319

Effectiveness of hemodialysis in a case of severe valproate overdose.

PubMed

Nasa, Prashant; Sehrawat, Deepak; Kansal, Sudha; Chawla, Rajesh

2011-04-01

A case of severe sodium valproate overdose is presented in which medicinal management failed to reverse coma of the patient. High-flux hemodialysis was then used to eliminate sodium valproate. This case demonstrated the effectiveness of hemodialysis in not only decreasing valproate levels very rapidly but also as an effective anti-coma management.

Repetitive transcranial magnetic stimulation improves consciousness disturbance in stroke patients: A quantitative electroencephalography spectral power analysis.

PubMed

Xie, Ying; Zhang, Tong

2012-11-05

Repetitive transcranial magnetic stimulation is a noninvasive treatment technique that can directly alter cortical excitability and improve cerebral functional activity in unconscious patients. To investigate the effects and the electrophysiological changes of repetitive transcranial magnetic stimulation cortical treatment, 10 stroke patients with non-severe brainstem lesions and with disturbance of consciousness were treated with repetitive transcranial magnetic stimulation. A quantitative electroencephalography spectral power analysis was also performed. The absolute power in the alpha band was increased immediately after the first repetitive transcranial magnetic stimulation treatment, and the energy was reduced in the delta band. The alpha band relative power values slightly decreased at 1 day post-treatment, then increased and reached a stable level at 2 weeks post-treatment. Glasgow Coma Score and JFK Coma Recovery Scale-Revised score were improved. Relative power value in the alpha band was positively related to Glasgow Coma Score and JFK Coma Recovery Scale-Revised score. These data suggest that repetitive transcranial magnetic stimulation is a noninvasive, safe, and effective treatment technology for improving brain functional activity and promoting awakening in unconscious stroke patients.

Alpha coma in an adolescent with diabetic ketoacidosis.

PubMed

Ostojic, Slavica; Vukovic, Rade; Milenkovic, Tatjana; Mitrovic, Katarina; Djuric, Milena; Nikolic, Ljubica

2017-01-01

Ostojic S, Vukovic R, Milenkovic T, Mitrovic K, Djuric M, Nikolic L. Alpha coma in an adolescent with diabetic ketoacidosis. Turk J Pediatr 2017; 59: 318-321. This is the first report of alpha coma (AC) caused by brain edema in a patient with diabetic ketoacidosis (DKA). A previously healthy 15-year-old girl was admitted to the intensive care unit due to altered state of consciousness during the course of treatment for DKA. Patient was in a coma, intubated and had tachycardia with poor peripheral perfusion. Results of laboratory analyses indicated severe DKA and computed tomography scan indicated diffuse brain edema. The EEG pattern showed uniform alpha activity. Treatment with intravenous fluids, insulin and mannitol was started. Patient`s state of consciousness gradually improved and on the third day she was extubated. On the fifth day, her neurologic status and EEG findings were completely normal with no residual neurological deficits. In conclusion, although AC is associated with a high fatality rate, favorable outcome can be achieved with prompt recognition and treatment of cerebral edema in pediatric patients with DKA.

Hall effect in the coma of 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Huang, Z.; Tóth, G.; Gombosi, T. I.; Jia, X.; Combi, M. R.; Hansen, K. C.; Fougere, N.; Shou, Y.; Tenishev, V.; Altwegg, K.; Rubin, M.

2018-04-01

Magnetohydrodynamics simulations have been carried out in studying the solar wind and cometary plasma interactions for decades. Various plasma boundaries have been simulated and compared well with observations for comet 1P/Halley. The Rosetta mission, which studies comet 67P/Churyumov-Gerasimenko, challenges our understanding of the solar wind and comet interactions. The Rosetta Plasma Consortium observed regions of very weak magnetic field outside the predicted diamagnetic cavity. In this paper, we simulate the inner coma with the Hall magnetohydrodynamics equations and show that the Hall effect is important in the inner coma environment. The magnetic field topology becomes complex and magnetic reconnection occurs on the dayside when the Hall effect is taken into account. The magnetic reconnection on the dayside can generate weak magnetic field regions outside the global diamagnetic cavity, which may explain the Rosetta Plasma Consortium observations. We conclude that the substantial change in the inner coma environment is due to the fact that the ion inertial length (or gyro radius) is not much smaller than the size of the diamagnetic cavity.

A comparison of the near-infrared spectral features of early-type galaxies in the Coma Cluster, the Virgo cluster and the field

NASA Technical Reports Server (NTRS)

Houdashelt, Mark L.; Frogel, Jay A.

1993-01-01

Earlier researchers derived the relative distance between the Coma and Virgo clusters from color-magnitude relations of the early-type galaxies in each cluster. They found that the derived distance was color-dependent and concluded that the galaxies of similar luminosity in the two clusters differ in their red stellar populations. More recently, the color-dependence of the Coma-Virgo distance modulus has been called into question. However, because these two clusters differ so dramatically in their morphologies and kinematics, it is plausible that the star formation histories of the member galaxies also differed. If the conclusions of earlier researchers are indeed correct, then some signature of the resulting stellar population differences should appear in the near-infrared and/or infrared light of the respective galaxies. We have collected near-infrared spectra of 17 Virgo and 10 Coma early-type galaxies; this sample spans about four magnitudes in luminosity in each cluster. Seven field E/S0 galaxies have been observed for comparison. Pseudo-equivalent widths have been measured for all of the field galaxies, all but one of the Virgo members, and five of the Coma galaxies. The features examined are sensitive to the temperature, metallicity, and surface gravity of the reddest stars. A preliminary analysis of these spectral features has been performed, and, with a few notable exceptions, the measured pseudo-equivalent widths agree well with previously published values.

Status epilepticus severity score (STESS): A useful tool to predict outcome of status epilepticus.

PubMed

Goyal, Manoj Kumar; Chakravarthi, Sudheer; Modi, Manish; Bhalla, Ashish; Lal, Vivek

2015-12-01

The treatment protocols for status epilepticus (SE) range from small doses of intravenous benzodiazepines to induction of coma. The pros and cons of more aggressive treatment regimen remain debatable. The importance of an index need not be overemphasized which can predict outcome of SE and guide the intensity of treatment. We tried to evaluate utility of one such index Status epilepticus severity score (STESS). 44 consecutive patients of SE were enrolled in the study. STESS results were compared with various outcome measures: (a) mortality, (b) final neurological outcome at discharge as defined by functional independence measure (FIM) (good outcome: FIM score 5-7; bad outcome: FIM score 1-4), (c) control of SE within 1h of start of treatment and (d) need for coma induction. A higher STESS score correlated significantly with poor neurological outcome at discharge (p=0.0001), need for coma induction (p=0.0001) and lack of response to treatment within 1h (p=0.001). A STESS of <3 was found to have a negative predictive value of 96.9% for mortality, 96.7% for poor neurological outcome at discharge and 96.7% for need of coma induction, while a STESS of <2 had negative predictive value of 100% for mortality, coma induction and poor neurological outcome at discharge. STESS can reliably predict the outcome of status epilepticus. Further studies on STESS based treatment approach may help in designing better therapeutic regimens for SE. Copyright © 2015 Elsevier B.V. All rights reserved.

Fatal coma in a young adult due to late-onset urea cycle deficiency presenting with a prolonged seizure: a case report.

PubMed

Alameri, Majid; Shakra, Mustafa; Alsaadi, Taoufik

2015-11-23

Unexplained hyperammonemic coma in adults can be a medical dilemma in the absence of triggering factors and known comorbidities. Ornithine transcarbamylase deficiency presents most commonly with hyperammonemic coma. Although a rare disorder, ornithine transcarbamylase deficiency is the most common of the urea cycle disorders, which can occur both in children, and less commonly, in adults. The urea cycle disorder is usually acquired as an X-linked trait, and very rarely, similar to our reported case, may be acquired as a "new" mutation. Mutations that lead to later-onset presentations may lead to life-threatening disease and may be unrecognized, particularly when the first clinical symptoms occur in adulthood. We report the case of a previously healthy 17-year-old white man who developed a prolonged seizure and a rapid decline in mental status leading to coma over a 3-day period. Analysis of the OTC gene showed a 119G variant, which was identified in exon 2 of the OTC gene by sequencing. A diagnosis of ornithine transcarbamylase deficiency should be considered in adult patients who present with unexplained hyperammonemic coma and for all adult patients presenting with cryptogenic new-onset seizure and laboratory finding of elevated blood ammonia levels. This reported case highlights the importance of early recognition of this potentially reversible cause of life-threatening encephalopathy, as timely recognition and appropriate treatment can be lifesaving.

A Comparative Study of Glasgow Coma Scale and Full Outline of Unresponsiveness Scores for Predicting Long-Term Outcome After Brain Injury.

PubMed

McNett, Molly M; Amato, Shelly; Philippbar, Sue Ann

2016-01-01

The aim of this study was to compare predictive ability of hospital Glasgow Coma Scale (GCS) scores and scores obtained using a novel coma scoring tool (the Full Outline of Unresponsiveness [FOUR] scale) on long-term outcomes among patients with traumatic brain injury. Preliminary research of the FOUR scale suggests that it is comparable with GCS for predicting mortality and functional outcome at hospital discharge. No research has investigated relationships between coma scores and outcome 12 months postinjury. This is a prospective cohort study. Data were gathered on adult patients with traumatic brain injury admitted to urban level I trauma center. GCS and FOUR scores were assigned at 24 and 72 hours and at hospital discharge. Glasgow Outcome Scale scores were assigned at 6 and 12 months. The sample size was n = 107. Mean age was 53.5 (SD = ±21, range = 18-91) years. Spearman correlations were comparable and strongest among discharge GCS and FOUR scores and 12-month outcome (r = .73, p < .000; r = .72, p < .000). Multivariate regression models indicate that age and discharge GCS were the strongest predictors of outcome. Areas under the curve were similar for GCS and FOUR scores, with discharge scores occupying the largest areas. GCS and FOUR scores were comparable in bivariate associations with long-term outcome. Discharge coma scores performed best for both tools, with GCS discharge scores predictive in multivariate models.

The near-infrared Tully-Fisher relation - A preliminary study of the Coma and Abell 400 clusters

NASA Technical Reports Server (NTRS)

Guhathakurta, Puragra; Bernstein, Gary; Raychaudhury, Somak; Haynes, Martha; Giovanelli, Riccardo; Herter, Terry; Vogt, Nicole

1993-01-01

We have started a large project to study the NIR Tully-Fisher (TF) relation using H- and I-band surface photometry of spiral galaxies. A preliminary study of 20 spirals in the Coma and Abell 400 clusters is presented. The NIR images have been used to derive accurate inclinations and total magnitudes, and rotational linewidths are measured from high-quality 21-cm Arecibo data. The scatter in the Coma TF plot is found to be 0.19 mag in the H band and 0.20 mag in the I band for a set of 13 galaxies, if we assume that they are all at the same distance. The deviation of the Coma galaxies from the best-fit Tully-Fisher relation is correlated with their redshift, indicating that some of the galaxies are not bound to the cluster. Indeed, if we treat all the galaxies in the Coma sample as undergoing free Hubble expansion, the TF scatter drops to 0.12 and 0.13 mag for the H- and I-band datasets, respectively. The Abell 400 sample is best fit by a common distance model, yielding a scatter of 0.12 mag for seven galaxies in H using a fixed TF slope. We are in the process of studying cluster and field spirals out to about 10,000 km/s in order to calibrate the NIR TF relation and will apply it to more nearby galaxies to measure the peculiar velocity field in the local universe.

Higher-order aberrations of lenticular opacities.

PubMed

Sachdev, Nisha; Ormonde, Susan E; Sherwin, Trevor; McGhee, Charles N J

2004-08-01

To measure and quantify higher-order aberrations induced by different types of lenticular opacities. Department of Ophthalmology, University of Auckland, and Department of Ophthalmology, Auckland Public Hospital, Auckland, New Zealand. Patients with lenticular opacities were recruited from outpatient clinics of a major tertiary referral center for ophthalmology. Patients were included if they had clinically evident, mild to moderate lenticular opacity with no coexisting ocular pathology. Patients were examined using standard preoperative techniques with additional assessment by wavefront aberrometry (Zywave, Bausch & Lomb) and Scheimpflug photography (EAS-1000, Nidek). For comparison, 20 eyes of 10 subjects with no lenticular opacity (control group) were recruited and assessed in an identical manner. Thirty persons were recruited and 40 eyes assessed, 20 with lenticular opacities. Ten eyes had predominantly cortical opacification, and 10 had mainly nuclear opacification. In eyes with predominantly cortical opacification, the mean logMAR uncorrected visual acuity (UCVA) was 0.5 +/- 0.2 (SD) (6/18 Snellen equivalent) and the mean logMAR best spectacle-corrected visual acuity (BSCVA), 0.2 +/- 0.2 (6/9). Analysis of aberrometry data for a 6.0 mm pupil in this group revealed an increase in coma of cosine phase (Z(3), P =.06) and tetrafoil of cosine phase (Z(4), P =.07) compared to eyes in the control group. Eyes with predominantly nuclear opacification had a mean logMAR UCVA of 0.7 +/- 0.2 (6/30) and a logMAR BSCVA of 0.4 +/- 0.2 (6/15). Aberrometry data for this cohort for a 6.0 mm pupil showed a statistically greater amount of spherical aberration (Z(4)(0), P =.001) and tetrafoil of cosine phase (Z(4), P =.005; Z(4)(-4), P =.004). This pilot study suggests that different types of early lenticular opacities induce different wavefront aberration profiles. Predominantly cortical opacification produced an increase in coma and nuclear opacification induced an increase in spherical aberration compared to eyes without opacities. Both types of lenticular opacities also induced a higher amount of tetrafoil. This could explain the significant visual symptoms in patients with early cataract and relatively good high-contrast Snellen acuity.

Task Shifting: The Use of Laypersons for Acquisition of Vital Signs Data for Clinical Decision Making in the Emergency Room Following Traumatic Injury.

PubMed

Haac, Bryce E; Gallaher, Jared R; Mabedi, Charles; Geyer, Andrew J; Charles, Anthony G

2017-12-01

In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital signs in the initial evaluation of trauma patients. We conducted a quasi-experimental study of patients presenting with traumatic injury pre- and post-intervention. The study was conducted at Kamuzu Central Hospital, a tertiary care referral hospital, in Lilongwe, Malawi. All adult (age ≥ 18 years) trauma patients presenting to emergency department over a six-month period from January to June prior to intervention (2011), immediately post-intervention (2012), 1 year post-intervention (2013) and 2 years post-intervention (2014). Lay people were trained to take and record vital signs. The number of patients with recorded vital signs pre- and post-intervention and sustainability of the intervention as determined by time-series analysis. Availability of vital signs on initial evaluation of trauma patients increased significantly post-intervention. The percentage of patients with at least one vital sign recorded increased from 23.5 to 92.1%, and the percentage of patients with all vital signs recorded increased from 4.1 to 91.4%. Availability of Glasgow Coma Scale also increased from 40.3 to 88.6%. Increased documentation of vital signs continued at 1 year and 2 years post-intervention. However, the percentage of documented vital signs did decrease slightly after the US-trained medical student and surgeon who trained the trauma clerks were no longer available in country, except for Glasgow Coma Scale. Patients who died during emergency department evaluation were significantly less likely to have vital signs recorded. The training of lay people to collect vital signs and Glasgow Coma Scale is an effective and sustainable method of task shifting in a resource-limited setting.

Visual rehabilitation in low-moderate keratoconus: intracorneal ring segment implantation followed by same-day topography-guided photorefractive keratectomy and collagen cross linking

PubMed Central

Zeraid, Ferial M; Jawkhab, Asma A; Al-Tuwairqi, Waleed S; Osuagwu, Uchechukwu L

2014-01-01

AIM To present the results of same-day topography-guided photorefractive keratectomy (TG-PRK) and corneal collagen crosslinking (CXL) after previous intrastromal corneal ring segment (ISCR) implantation for keratoconus. METHODS An experimental clinical study on twenty-one eyes of 19 patients aged 27.1±6.6y (range 19-43y), with low to moderate keratoconus who were selected to undergo customized TG-PRK immediately followed by same-day CXL, 9mo after ISCR implantation in a university ophthalmology clinic. Refraction, uncorrected distance visual acuities (UDVA) and corrected distance visual acuities (CDVA), keratometry (K) values, central corneal thickness (CCT) and coma were assessed 3mo after TG-PRK and CXL. RESULTS After TG-PRK/CXL: the mean UDVA (logMAR) improved significantly from 0.66±0.41 to 0.20±0.25 (P<0.05); Kflat value decreased from: 48.44±3.66 D to 43.71±1.95 D; Ksteep value decreased from 45.61±2.40 D to 41.56±2.05 D; Kaverage also decreased from 47.00±2.66 D to 42.42±2.07 D (P<0.05 for all). The mean sphere and cylinder decreased significantly post-surgery from, -3.10±2.99 D to -0.11±0.93 D and from -3.68±1.53 to -1.11±0.75 D respectively, while the CDVA, CCT and coma showed no significant changes. Compared to post-ISCR, significant reductions (P<0.05 or all) in all K values, sphere and cylinder were observed after TG-PRK/CXL. CONCLUSION Same-day combined topography-guided PRK and corneal crosslinking following placement of ISCR is a safe and potentially effective option in treating low-moderate keratoconus. It significantly improves all visual acuity, reduced keratometry, sphere and astigmatism, but causes no change in central corneal thickness and coma. PMID:25349796

Intracranial Pressure Monitoring in Infants and Young Children With Traumatic Brain Injury.

PubMed

Dixon, Rebecca R; Nocera, Maryalice; Zolotor, Adam J; Keenan, Heather T

2016-11-01

To examine the use of intracranial pressure monitors and treatment for elevated intracranial pressure in children 24 months old or younger with traumatic brain injury in North Carolina between April 2009 and March 2012 and compare this with a similar cohort recruited 2000-2001. Prospective, observational cohort study. Twelve PICUs in North Carolina. All children 24 months old or younger with traumatic brain injury, admitted to an included PICU. None. The use of intracranial pressure monitors and treatments for elevated intracranial pressure were evaluated in 238 children with traumatic brain injury. Intracranial pressure monitoring (risk ratio, 3.7; 95% CI, 1.5-9.3) and intracranial pressure therapies were more common in children with Glasgow Coma Scale less than or equal to 8 compared with Glasgow Coma Scale greater than 8. However, only 17% of children with Glasgow Coma Scale less than or equal to 8 received a monitoring device. Treatments for elevated intracranial pressure were more common in children with monitors; yet, some children without monitors received therapies traditionally used to lower intracranial pressure. Unadjusted predictors of monitoring were Glasgow Coma Scale less than or equal to 8, receipt of cardiopulmonary resuscitation, nonwhite race. Logistic regression showed no strong predictors of intracranial pressure monitor use. Compared with the 2000 cohort, children in the 2010 cohort with Glasgow Coma Scale less than or equal to 8 were less likely to receive monitoring (risk ratio, 0.5; 95% CI, 0.3-1.0), although the estimate was not precise, or intracranial pressure management therapies. Children in the 2010 cohort with a Glasgow Coma Scale less than or equal to 8 were less likely to receive an intracranial pressure monitor or hyperosmolar therapy than children in the 2000 cohort; however, about 10% of children without monitors received therapies to decrease intracranial pressure. This suggests treatment heterogeneity in children 24 months old or younger with traumatic brain injury and a need for better evidence to support treatment recommendations for this group of children.

Myxedema coma in a patient with subclinical hypothyroidism.

PubMed

Mallipedhi, Akhila; Vali, Hamza; Okosieme, Onyebuchi

2011-01-01

Myxedema coma is the extreme manifestation of hypothyroidism, typically seen in patients with severe biochemical hypothyroidism. Its occurrence in association with subclinical hypothyroidism is extremely unusual. We describe a patient with subclinical hypothyroidism who developed clinical manifestations of myxedema coma. A 47-year-old woman presented to our endocrine clinic with complaints of fatigue and biochemical findings of subclinical hypothyroidism. She was started on treatment with thyroxine (T4) but remained unwell and was later admitted to hospital with hormone profile showing persisting subclinical hypothyroidism (elevated thyrotropin and normal free T4 [FT4] and free triiodothyronine [FT3]): FT4 10.7 pmol/L (reference range 10.3-24.5), FT3 2.7 pmol/L (reference range 2.67-7.03), and thyrotropin 6.09 mU/L (reference range 0.4-4.0). She subsequently developed hypothermia (temperature 33.2°C), circulatory collapse, and coma. Biochemical profile showed hyponatremia, elevated creatinine phosphokinase, metabolic acidosis, and renal failure. An echocardiogram revealed a moderate-sized pericardial effusion. We diagnosed myxedema coma and started treatment with intravenous T3. She responded dramatically with improvement in level of consciousness and normalization of metabolic parameters. We found no explanation other than hypothyroidism to account for the presentation. Adrenocorticotrophic hormone (ACTH) stimulation tests excluded adrenal insufficiency, and serum gonadotrophins were within the normal reference range. FT4 estimation by equilibrium dialysis excluded analytical interference, and molecular analysis for the thyroid hormone receptor β gene associated with thyroid hormone resistance was negative. To the best of our knowledge this is the first report of myxedema coma in a patient with subclinical hypothyroidism. The reason for normal thyroid hormone levels is unclear but may reflect deviation from a higher pre-morbid set-point. The case highlights the importance of careful clinical evaluation in patients with disparate clinical and laboratory findings.

A new 3D multi-fluid model: a study of kinetic effects and variations of physical conditions in the cometary coma

NASA Astrophysics Data System (ADS)

Shou, Yinsi; Combi, Michael R.; Toth, Gabor; Huang, Zhenguang; Jia, Xianzhe; Fougere, Nicolas; Tenishev, Valeriy; Gombosi, T. I.; Hansen, Kenneth C.; Bieler, Andre

2016-10-01

Physics-based numerical coma models are desirable whether to interpret the spacecraft observations of the inner coma or to compare with the ground-based observations of the outer coma. In this work, we develop a multi-neutral-fluid model based on BATS-R-US in the University of Michigan's SWMF (Space Weather Modeling Framework), which is capable of computing both the inner and the outer coma and simulating time-variable phenomena. It treats H2O, OH, H2, O, and H as separate fluids and each fluid has its own velocity and temperature, with collisions coupling all fluids together. The self-consistent collisional interactions decrease the velocity differences, re-distribute the excess energy deposited by chemical reactions among all species, and account for the varying heating efficiency under various physical conditions. Recognizing that the fluid approach has limitations in capturing all of the correct physics for certain applications, especially for very low density environment, we applied our multi-fluid coma model to comet 67P/Churyumov-Gerasimenko (CG) at various heliocentric distances and demonstrated that it is able to yield comparable results as the Direct Simulation Monte Carlo (DSMC) model, which is based on a kinetic approach that is valid under these conditions. Therefore, our model may be a powerful alternative to the particle-based model, especially for some computationally intensive simulations. In addition, by running the model with several combinations of production rates and heliocentric distances, we can characterize the cometary H2O expansion speeds and demonstrate the nonlinear effect of production rates or photochemical heating. Our results are also compared to previous modeling work (e.g., Bockelee-Morvan & Crovisier 1987) and remote observations (e.g., Tseng et al. 2007), which serve as further validation of our model. This work has been partially supported by grant NNX14AG84G from the NASA Planetary Atmospheres Program, and US Rosetta contracts JPL #1266313, JPL #1266314 and JPL #1286489.

Is the tail of 73P-B/Schwassman-Wachman 1 chasing its Remnant Nucleus?

NASA Technical Reports Server (NTRS)

Wooden, D. H.; Harker, D. E.; Woodward, C. E.; Ehrenfreund, P.; Geers, V. C.; Waters, L. B. F. M.; Cox, N.

2006-01-01

We report on imaging observations of comets 73P-B/Schwassmann-Wachmann 1 and 73P-C/Schwassmann-Wachmann 1 at the IRTF with SpeX (J, K) and MRSI (10 micron narrow band filter set) on 2006 Apr 17-19 UT and 2006 Jun 18-19, and at the VLT with VISIR (1 0 micron narrow band filters, 20 micron) on 2006 Apr 17 UT. Compared to when the comet was in the midst of breaking up in mid-April, in June the tail of 73P-B is much fainter and there is a compact coma detected well separated and ahead of its tail, and fainter than the tail. The width of the tail in J, K, and 10 micron images indicates that the pieces that were shed in April must still be outgassing and releasing small particles into the tail-shaped coma; small grains have relatively short lifetimes in the coma due to radiation pressure. The trailing tail is now well separated from the faint "leader of the pack" compact coma that we suppose is a remaining piece of the nucleus. It will be interesting to see post-perihelion if this "leading compact coma" object continues to gain distance on the debris and continues to weakly outgas and shed small grains. One wonders if it expended its volatiles (available to the surface) in breaking up; a short-lived release of volatiles occurred in the Deep Impact event with comet 9P/Tempel 1. 73P-C is extended with a more elongated coma structure closer to perihelion compared to 2006 Apr 18- 19 UT. The SEDs from 2006 Apr and Jun from SpeX-MIRSI (IRTF) are compared with VISIR (VLT) SEDs from 2006 Apr. Information on the heliocentric dependence of the activity and dust release yields insights into the origin of activity and the relationship between activity and grain size distribution/mineralogy.

The HST/ACS Coma Cluster Survey. II. Data Description and Source Catalogs

NASA Technical Reports Server (NTRS)

Hammer, Derek; Kleijn, Gijs Verdoes; Hoyos, Carlos; Den Brok, Mark; Balcells, Marc; Ferguson, Henry C.; Goudfrooij, Paul; Carter, David; Guzman, Rafael; Peletier, Reynier F.;

Polarization imaging of comets at geocentric distances smaller than 0.5 au: Comet 73P/Schwassmann-Wachmann 3

NASA Astrophysics Data System (ADS)

Hadamcik, E.; Levasseur-Regourd, A.-C.

2014-07-01

Remote observations of sunlight scattered by solid particles provide information on the particle properties for a large variety of comets. When comets approach the Sun, solid particles and gases are released from the surface or from the inner layers [1,2]. If the comet is close enough to the Earth, the inner coma may be studied. Different coma regions are observed corresponding to different dust properties, e.g., in jets or fresh ejected dust around the coma. Narrow-band continuum filters or broader-band filters in less contaminated spectral domains (red or near infrared) are currently used to avoid or reduce the contributions from gaseous emission. Comet 73P/Schwassmann-Wachmann 3 is a fascinating fragmenting comet. Different observations in 1995 revealed an increase of activity and at least four fragments of the nucleus. In its 2011 apparition, the fragments were well separated and appeared like small individual comets. In 2006, its apparition was very favorable and allowed high- spatial resolution imaging by different complementary techniques. We observed three fragments of comet 73P/Schwassmann-Wachmann 3 from April 27 to May 3, 2006, by imaging polarimetry with the 80-cm telescope at Observatoire de Haute-Provence. The distance to the Earth was smaller than 0.2 au. Fragment C resembles a classical active comet. Regions of high and lower polarization were observed in the inner coma, appearing to change almost periodically. The variation of polarization in the inner coma was important from one night to the next one, the whole coma polarization being about constant for nucleus distances greater than 2000 km and increasing with the phase angle. Fragment B continued its (sequential) fragmentation, with a region of secondary fragments progressively moving away from the main nucleus in the antisolar direction. The chemical composition has been reported as being similar in all the fragments [3], but differences were observed between them in polarization underlining differences in, e.g., structure or size distribution of the particles during their ejection and fragmentation. The variation of polarization in the coma and around the fragments will be presented. Finally, a comparison to other comets, including split comets observed at small geocentric distances, will be provided.

Jet morphology and coma analysis of comet 103P/Hartley 2

NASA Astrophysics Data System (ADS)

Vaughan, Charles M.

In 2010, comet 103P/Hartley 2 was observed pre- and post-perihelion using the George and Cynthia Mitchell Integral Field Spectrometer on the 2.7-m telescope at McDonald Observatory in Texas. Data for gaseous radicals C2, C3, CH, CN, and NH2 were collected over six nights from 15 July to 10 November. The spectral data were used to create coma maps for each of the observed species, and the maps were processed using radial and azimuthal mean division techniques to create enhanced images of the coma, revealing subtle morphological features. 340 enhanced coma images were created for each observation and species. Visual inspection reveals that the coma is heterogeneous between the five detected radicals, and statistical analyses verify this result. To compliment the ongoing investigation of Hartley 2 as studied by the EPOXI flyby mission, findings from other researchers (Belton et al., 2012; Syal et al., 2012; and Thomas et al., 2012) are used to characterize the nucleus spin state and identify dust jet locations on the nucleus. With rotational period measurements from EPOXI, dust jet vectors on the nucleus surface are rotated to relevant observation times in November to compare the computed jet directions with the radical densities in the coma. Dust jet sites on the smaller nucleus lobe show a stronger correlation with high radical concentrations than the dust sites on the larger nucleus lobe. Production rates for potential parentage of radical species are calculated using the radial outflow Haser model (Haser, 1957), which are compared to mixing ratios relative to water from separate campaigns to constrain parentage. NH3 is likely the sole producer of NH2, whereas CN may be produced from a combination of HCN, C2N2, and CH3CN. Traditional parentage of C2, C3, and CH do not yield acceptable fits or suitable mixing ratios with the Haser model, and it is possible that extended coma ices having relatively short scale lengths greatly contribute to production of these radicals. These results provide further evidence that the Hartley 2 nucleus is heterogeneous in composition, and the rotational analysis indicates that specific jet sites are correlated with certain radical species.

Efficacy of Intravenous Haloperidol on the duration of Delirium and Coma in Critically Ill Patients (Hope-ICU): a Randomised, Placebo-Controlled Trial

PubMed Central

Page, Valerie J; Ely, E Wesley; Gates, Simon; Zhao, Xiao Bei; Alce, Timothy; Shintani, Ayumi; Jackson, Jim; Perkins, Gavin D; McAuley, Daniel F

2016-01-01

Background Delirium is frequently diagnosed in critically ill patients and is associated with poor clinical outcomes. Haloperidol is the most commonly used drug for delirium despite little evidence of its effectiveness. The aim of this study was to establish whether early treatment with haloperidol would decrease the time that survivors of critical illness spent in delirium or in coma. Methods We did this double-blind, placebo-controlled randomised trial in a general adult intensive care unit (ICU). Critically ill patients (≥18 years) needing mechanical ventilation within 72 of admission were enrolled. Patients were randomised (by an independent nurse, in 1:1 ratio, with permuted block size of four and six, using a centralised, secure web-based randomisation service) to receive haloperidol 2·5mgs or 0·9% saline placebo intravenously every 8 h irrespective of coma or delirium status. Study drug was discontinued on ICU discharge, once delirium-free and coma-free for 2 consecutive days, or after a maximum of 14 days treatment, which ever came first. Delirium was assessed using the confusion assessment method - for the ICU (CAM-ICU). The primary outcome was delirium-free and coma-free days, defined as the number of days in the first 14 days after randomisation during which the patient was alive without delirium and not in coma from any cause. Patients who died within the 14-day study period were recorded as having 0 days free of delirium and coma. ICU clinical and research staff and patients were masked to treatment throughout the study. Analyses were by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Registry, number ISRCTN83567338. Findings 142 patients were randomised, 141 were included in the final analysis (71 haloperidol, 70 placebo). Patients in the haloperidol group spent about the same number of days alive, without delirium, and without coma as did patients in the placebo group (median 5 days [IQR 0-10] vs 6 days [0-11] days; p= 0·53). The most common adverse events were oversedation (11 patients in the haloperidol group vs. six in the placebo) and QTc prolongation (seven in haloperidol group and six in the placebo group). No patient had a serious adverse event related to study drug. Interpretation These results do not support the hypothesis that haloperidol modifies duration of delirium in critically ill patients. Although haloperidol can be used safely in this population of patients, pending the results of trials in progress, the use of intravenous haloperidol should be reserved for the short-term management of acute agitation. Funding National Institute for Health Research PMID:24461612

Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial.

PubMed

Page, Valerie J; Ely, E Wesley; Gates, Simon; Zhao, Xiao Bei; Alce, Timothy; Shintani, Ayumi; Jackson, Jim; Perkins, Gavin D; McAuley, Daniel F

2013-09-01

Delirium is frequently diagnosed in critically ill patients and is associated with poor clinical outcomes. Haloperidol is the most commonly used drug for delirium despite little evidence of its effectiveness. The aim of this study was to establish whether early treatment with haloperidol would decrease the time that survivors of critical illness spent in delirium or coma. We did this double-blind, placebo-controlled randomised trial in a general adult intensive care unit (ICU). Critically ill patients (≥18 years) needing mechanical ventilation within 72 h of admission were enrolled. Patients were randomised (by an independent nurse, in 1:1 ratio, with permuted block size of four and six, using a centralised, secure web-based randomisation service) to receive haloperidol 2.5 mg or 0.9% saline placebo intravenously every 8 h, irrespective of coma or delirium status. Study drug was discontinued on ICU discharge, once delirium-free and coma-free for 2 consecutive days, or after a maximum of 14 days of treatment, whichever came first. Delirium was assessed using the confusion assessment method for the ICU (CAM-ICU). The primary outcome was delirium-free and coma-free days, defined as the number of days in the first 14 days after randomisation during which the patient was alive without delirium and not in coma from any cause. Patients who died within the 14 day study period were recorded as having 0 days free of delirium and coma. ICU clinical and research staff and patients were masked to treatment throughout the study. Analyses were by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Registry, number ISRCTN83567338. 142 patients were randomised, 141 were included in the final analysis (71 haloperidol, 70 placebo). Patients in the haloperidol group spent about the same number of days alive, without delirium, and without coma as did patients in the placebo group (median 5 days [IQR 0-10] vs 6 days [0-11] days; p=0.53). The most common adverse events were oversedation (11 patients in the haloperidol group vs six in the placebo group) and QTc prolongation (seven patients in the haloperidol group vs six in the placebo group). No patient had a serious adverse event related to the study drug. These results do not support the hypothesis that haloperidol modifies duration of delirium in critically ill patients. Although haloperidol can be used safely in this population of patients, pending the results of trials in progress, the use of intravenous haloperidol should be reserved for short-term management of acute agitation. National Institute for Health Research. Copyright © 2013 Elsevier Ltd. All rights reserved.

Transmissive liquid-crystal device for correcting primary coma aberration and astigmatism in biospecimen in two-photon excitation laser scanning microscopy

NASA Astrophysics Data System (ADS)

Tanabe, Ayano; Hibi, Terumasa; Ipponjima, Sari; Matsumoto, Kenji; Yokoyama, Masafumi; Kurihara, Makoto; Hashimoto, Nobuyuki; Nemoto, Tomomi

2016-12-01

All aberrations produced inside a biospecimen can degrade the quality of a three-dimensional image in two-photon excitation laser scanning microscopy. Previously, we developed a transmissive liquid-crystal device to correct spherical aberrations that improved the image quality of a fixed-mouse-brain slice treated with an optical clearing reagent. In this study, we developed a transmissive device that corrects primary coma aberration and astigmatism. The motivation for this study is that asymmetric aberration can be induced by the shape of a biospecimen and/or by a complicated refractive-index distribution in a sample; this can considerably degrade optical performance even near the sample surface. The device's performance was evaluated by observing fluorescence beads. The device was inserted between the objective lens and microscope revolver and succeeded in improving the spatial resolution and fluorescence signal of a bead image that was originally degraded by asymmetric aberration. Finally, we implemented the device for observing a fixed whole mouse brain with a sloping surface shape and complicated internal refractive-index distribution. The correction with the device improved the spatial resolution and increased the fluorescence signal by ˜2.4×. The device can provide a simple approach to acquiring higher-quality images of biospecimens.

Activity of essential phospholipids (EPL) from soybean in liver diseases.

PubMed

Gundermann, Karl-Josef; Kuenker, Ann; Kuntz, Erwin; Droździk, Marek

2011-01-01

Essential phospholipids (EPL) contain a highly purified extract of polyenylphosphatidylcholine (PPC) molecules from soybean. The main active ingredient is 1,2-dilinoleoylphosphatidylcholine (DLPC), which differentiates it from other phospholipids, lecithins, or extracts from other sources. Although EPLis widely used in liver diseases of various origins, its mode of action and pharmacological and clinical evidence of its efficacy have not yet been concisely reviewed. This paper critically summarizes experimental and clinical results. With regard to in-vitro and animal tests, EPL influenced membrane-dependent cellular functions and showed anti-oxidant, anti-inflammatory, anti-fibrotic, apoptosis-modulating, regenerative, membrane-repairing and -protective, cell-signaling and receptor-influencing, as well as lipid-regulating effects in intoxication models with chemicals or drugs. Clinical studies, primarily from European and Asian countries, have shown improvement in subjective symptoms; clinical, biochemical and imaging findings; and histology in liver indications such as fatty liver of different origin, drug hepatotoxicity, and adjuvant in chronic viral hepatitis and hepatic coma. The available studies characterize EPL as evidence-based medicine, although further long-term controlled clinical trials are required to precisely determine its benefit for alleviating symptoms, improving well-being, inducing histological changes and slowing the progression of liver disease. EPL-related relevant side effects were not observed.

Interacting Turing-Hopf Instabilities Drive Symmetry-Breaking Transitions in a Mean-Field Model of the Cortex: A Mechanism for the Slow Oscillation

NASA Astrophysics Data System (ADS)

Steyn-Ross, Moira L.; Steyn-Ross, D. A.; Sleigh, J. W.

2013-04-01

Electrical recordings of brain activity during the transition from wake to anesthetic coma show temporal and spectral alterations that are correlated with gross changes in the underlying brain state. Entry into anesthetic unconsciousness is signposted by the emergence of large, slow oscillations of electrical activity (≲1Hz) similar to the slow waves observed in natural sleep. Here we present a two-dimensional mean-field model of the cortex in which slow spatiotemporal oscillations arise spontaneously through a Turing (spatial) symmetry-breaking bifurcation that is modulated by a Hopf (temporal) instability. In our model, populations of neurons are densely interlinked by chemical synapses, and by interneuronal gap junctions represented as an inhibitory diffusive coupling. To demonstrate cortical behavior over a wide range of distinct brain states, we explore model dynamics in the vicinity of a general-anesthetic-induced transition from “wake” to “coma.” In this region, the system is poised at a codimension-2 point where competing Turing and Hopf instabilities coexist. We model anesthesia as a moderate reduction in inhibitory diffusion, paired with an increase in inhibitory postsynaptic response, producing a coma state that is characterized by emergent low-frequency oscillations whose dynamics is chaotic in time and space. The effect of long-range axonal white-matter connectivity is probed with the inclusion of a single idealized point-to-point connection. We find that the additional excitation from the long-range connection can provoke seizurelike bursts of cortical activity when inhibitory diffusion is weak, but has little impact on an active cortex. Our proposed dynamic mechanism for the origin of anesthetic slow waves complements—and contrasts with—conventional explanations that require cyclic modulation of ion-channel conductances. We postulate that a similar bifurcation mechanism might underpin the slow waves of natural sleep and comment on the possible consequences of chaotic dynamics for memory processing and learning.

Thyroid Emergencies

PubMed Central

Leung, Angela M

2017-01-01

Myxedema coma and thyroid storm are thyroid emergencies associated with increased mortality. Prompt recognition of these states—which represent the severe, life-threatening conditions of extremely reduced or elevated circulating thyroid hormone concentrations, respectively—is necessary to initiate treatment. Management of myxedema coma and thyroid storm requires both medical and supportive therapies and should be treated in an intensive care unit setting. PMID:27598067

Heart failure presenting as myxedema coma: case report and review article.

PubMed

Chaudhari, Dhara; Gangadharan, Venkat; Forrest, Terry

2013-05-01

Hypothyroidism is a common medical problem easily treated when diagnosed but requiring regular follow-up and patient medication compliance. At times, this diagnosis can go untreated resulting in the development of severe consequences such as Myxedema Coma. Of all the clinical symptoms, cardiovascular manifestations tend to be especially severe and often life threatening.

Heart failure presenting as myxedema coma: case report and review article.

PubMed

Chaudhari, Dhara; Gangadharan, Venkat; Forrest, Terry

2014-02-01

Hypothyroidism is a common medical problem easily treated when diagnosed but requiring regular follow-up and patient medication compliance. At times, this diagnosis can go untreated resulting in the development of severe consequences such as Myxedema Coma. Of all the clinical symptoms, cardiovascular manifestations tend to be especially severe and often life threatening.

H2O(+) structures in the inner plasma tail of comet Austin

NASA Technical Reports Server (NTRS)

Jockers, Klaus; Bonev, T.; Geyer, E. H.

1992-01-01

We present images of comet Austin 1989c1 in the light of H2O(+) from which the contribution of the dust continuum and the gas coma was completely removed. We describe the behavior of the H2O(+) plasma in the inner coma where it is reliably observed for the first time.

Communication Opportunities via Special Messaging Technology for Two Post-Coma Persons with Multiple Disabilities

ERIC Educational Resources Information Center

Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Colonna, Fabio; Navarro, Jorge; Lanzilotti, Crocifissa; de Pace, Claudia; Megna, Marisa; Oliva, Doretta

2011-01-01

This study extended the assessment of a special messaging technology with two additional post-coma adults who had emerged from a minimally conscious state, but showed multiple disabilities including profound motor and communication impairments. For each participant, the study involved an ABAB design, in which the A represented baseline phases and…

Effectiveness of hemodialysis in a case of severe valproate overdose

PubMed Central

Nasa, Prashant; Sehrawat, Deepak; Kansal, Sudha; Chawla, Rajesh

2011-01-01

A case of severe sodium valproate overdose is presented in which medicinal management failed to reverse coma of the patient. High-flux hemodialysis was then used to eliminate sodium valproate. This case demonstrated the effectiveness of hemodialysis in not only decreasing valproate levels very rapidly but also as an effective anti-coma management. PMID:21814378

Hematin and propranolol in acute intermittent porphyria. Full recovery from quadriplegic coma and respiratory failure.

PubMed

Brezis, M; Ghanem, J; Weiler-Ravell, D; Epstein, O; Morris, D

1979-01-01

The authors present a case of acute intermittent porphyria (AIP) in an almost fatal relapse with quadriplegia, bulbar paralysis and coma. Intravenous hematin produced an immediate arousal from coma and allowed a gradual resumption of bulbar and autonomic functions. Persistent tachycardia and hypertension necessitated huge doses of intravenous propranolol. Both hematin and propranolol administrations were followed by a remarkable decrease in urinary amino-levulinic acid and porphobilinogen excretion. Nevertheless, after the acute stage, the patient was left with a severe generalized muscle wasting. After 7 months of intensive physical therapy, complete recovery of all neuromuscular functions was achieved. The modern aspects of the management of AIP are presented; the efficacy and the limits of hematin and propranolol therapy are discussed.

Active music therapy in the rehabilitation of severe brain injured patients during coma recovery.

PubMed

Formisano, R; Vinicola, V; Penta, F; Matteis, M; Brunelli, S; Weckel, J W

2001-01-01

Active improvised music therapy may offer an adjuvant from of treatment in the early rehabilitation of severe brain-injured patients. Active music therapy consists of musical improvisation between patient and therapist by singing or by playing different musical instruments, according to the vital functions, the neurological conditions and the motor abilities of the patients. We studied 34 severe brain-injured patients with a mean coma duration of 52 days +/- 37.21 and a mean interval from coma onset to the beginning of rehabilitation of 154 days on average. Our preliminary results show a significant improvement of the collaboration of the severe brain-injured patients and a reduction of undesired behaviours such as inertia (reduced psychomotor initiative) or psychomotor agitation.

Spectral constraints on models of gas in clusters of galaxies

NASA Technical Reports Server (NTRS)

Henriksen, M. J.; Mushotzky, R.

1985-01-01

The HEAO 1A2 spectra of clusters of galaxies are used to determine the temperature profile which characterizes the X-ray emitting gas. Strong evidence of nonisothermality is found for the Coma, A85, and A1795 clusters. Properties of the cluster potential which binds the gas are calculated for a range of model parameters. The typical binding mass, if the gas is adiabatic, is 2-4E14 solar masses and is quite centrally concentrated. In addition, the Fe abundance in Coma is .26 + or - .06 solar, less than the typical value (.5) found for rich clusters. The results for the gas in Coma may imply a physical description of the cluster which is quite different from what was previously believed.

Using Spectroscopic Profiles to Study the Morphology of Comets

NASA Astrophysics Data System (ADS)

Harris, Ien; Pierce, Donna M.; Cochran, Anita L.

2016-10-01

We have used the integral-field unit spectrograph (the George and Cynthia Mitchell Spectrograph) on the 2.7m Harlan J. Smith telescope at McDonald Observatory to obtain spectroscopic images of the comae of several comets. The images were obtained for various radical species (C2, C3. CH, CN, NH2). Radial and azimuthal average profiles of the radical species were created to enhance any observed cometary coma morphological features. We compare the observed coma features across the observed species and over the different observation periods in order to constrain possible rotational states of the observed comets. We will present results for several comets, including 2009P1 (Garradd). This work was funded by NASA's Planetary Atmospheres program (Award No. NNX14AH186).

Linear polarization of light scattered by cometary analogs: New samples

NASA Astrophysics Data System (ADS)

Hadamcik, E.; Renard, J.; Buch, A.; Carrasco, N.; Johnson, N.; Nuth, J.

2014-07-01

Mixtures of silicates (Mg and Fe) with carbonaceous compounds (carbon and/or organics) are currently proposed as cometary analogs. The particles are fluffy aggregates of submicron-sized constituent grains and compact grains (tens of micrometers), similar to those captured in the Earth's stratosphere (interplanetary dust particles or IDPs) and deduced from the Stardust results. They are lifted or in microgravity or levitated by an air-draught. The light source is unpolarized. The linear polarization of the scattered light floating in the beam is studied as a function of the phase angle. In previous experiments with the PROGRA2 instrument (Hadamcik et al., 2011), the general shape of the cometary polarimetric phase curves is reproduced with a shallow negative branch and a more developed positive branch (maximum polarization around 20--30 %) depending on the size distributions of the particles (compact and/or aggregates) and their constituent grains. To observe the increase of polarization with wavelength, the organic materials were necessary. When fluffy aggregates (silicates and carbon black mixtures) and compact silicate grains of tens of micrometers are present, the whole cometary coma polarization phase curve is well fitted by the phase curves obtained. The maximum polarization value decreases when the ratio of compact silicates to fluffy aggregates increases. The observed differences in polarization between different coma regions may be also simulated. When only fluffy aggregates are used, the maximum polarization corresponds to the polarization in jets of 'high polarization' active comets (Hadamcik and Levasseur-Regourd, 2003). A high polarization region may exist in some 'low polarization' comets, with large slowly moving particles; using the experimental results, we suggest the presence of dark relatively compact particles larger than 20 micrometers (Hadamcik et al., 2007; 2011). When not hidden by jets, a polarimetric halo is sometimes observed in the inner coma. The negative branch can be as deep as -6% and the positive branch is smaller as compared to the whole coma (Hadamcik et al., 2003). Zubko et al. (2012) have proposed an increased fraction of silicates. From the experiments, we suggest some carbonaceous compounds with refractive indices close to those of silicates (relatively transparent). This material, if heated by the Sun after ejection, should be darker as observed when these materials are heated to 200--300°C. We are working on new analogs with mixtures of silicates and organics (not only carbon), silicates coated by organics (Johnson et al., 2004), or organics heated or not and with different elemental compositions (N/C ratios).

2 years with comet 67P/Churyumov-Gerasimenko: H2O, CO2, CO as seen by ROSINA RTOF

NASA Astrophysics Data System (ADS)

Hoang, M.; Garnier, P.; Lasue, J.; Reme, H.; Altwegg, K.; Balsiger, H. R.; Bieler, A. M.; Calmonte, U.; Capria, M. T.; Combi, M. R.; De Keyser, J. M.; Fiethe, B.; Fougere, N.; Fuselier, S. A.; Galli, A.; Gasc, S.; Gombosi, T. I.; Hansen, K. C.; Jäckel, A.; Korth, A.; Mall, U.; Migliorini, A.; Rubin, M.; Sémon, T.; Tzou, C. Y.; Waite, J. H., Jr.; Wurz, P.

2017-12-01

The Rosetta space mission investigated comet 67P/Churyumov-Gerasimenko (67P) over two years from August 2014 to September 2016. Onboard the spacecraft, the ROSINA experiment included two mass spectrometers to derive the composition of neutrals and ions, and a COmet Pressure Sensor (COPS) to monitor the density and velocity of the neutrals in the coma. We will here analyse and discuss data from the Reflectron-type Time-Of-Flight instrument during the comet escort phase. The RTOF mass spectrometer possessed a wide mass range and a high temporal resolution (Balsiger et al., 2007). The analysis of 67P/C-G's coma major molecules over the mission showed strong variability of the comet coma's main volatiles concentrations (H2O, CO2, CO) and their relative abundances. The 2 years long Rosetta mission allowed us to observe the seasonal evolution in the atmosphere of 67P, in particular the change occurring during the equinoxes and at perihelion. In this work, we analyze the asymmetry in the outgassing rate before and after the perihelion (13/08/2015), the evolution of abundance ratios through the whole mission, and in particular the behavior of the very volatile CO molecules. Density maps projected on the surface of 67P demonstrate the evolution of the three main coma species after the outbound equinox. We will present first results of our comet nucleus thermal modelling used to simulate the internal structure and temperature evolution of 67P at characteristic surface areas. These results will be compared with the coma composition measurements obtained by ROSINA.

Adaptation to Low Temperature Exposure Increases Metabolic Rates Independently of Growth Rates

PubMed Central

Williams, Caroline M.; Szejner-Sigal, Andre; Morgan, Theodore J.; Edison, Arthur S.; Allison, David B.; Hahn, Daniel A.

2016-01-01

Metabolic cold adaptation is a pattern where ectotherms from cold, high-latitude, or -altitude habitats have higher metabolic rates than ectotherms from warmer habitats. When found, metabolic cold adaptation is often attributed to countergradient selection, wherein short, cool growing seasons select for a compensatory increase in growth rates and development times of ectotherms. Yet, ectotherms in high-latitude and -altitude environments face many challenges in addition to thermal and time constraints on lifecycles. In addition to short, cool growing seasons, high-latitude and - altitude environments are characterized by regular exposure to extreme low temperatures, which cause ectotherms to enter a transient state of immobility termed chill coma. The ability to resume activity quickly after chill coma increases with latitude and altitude in patterns consistent with local adaptation to cold conditions. We show that artificial selection for fast and slow chill coma recovery among lines of the fly Drosophila melanogaster also affects rates of respiratory metabolism. Cold-hardy fly lines, with fast recovery from chill coma, had higher respiratory metabolic rates than control lines, with cold-susceptible slow-recovering lines having the lowest metabolic rates. Fast chill coma recovery was also associated with higher respiratory metabolism in a set of lines derived from a natural population. Although their metabolic rates were higher than control lines, fast-recovering cold-hardy lines did not have faster growth rates or development times than control lines. This suggests that raised metabolic rates in high-latitude and -altitude species may be driven by adaptation to extreme low temperatures, illustrating the importance of moving “Beyond the Mean”. PMID:27103615

FORTY-SEVEN MILKY WAY-SIZED, EXTREMELY DIFFUSE GALAXIES IN THE COMA CLUSTER

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

Van Dokkum, Pieter G.; Merritt, Allison; Geha, Marla

2015-01-10

We report the discovery of 47 low surface brightness objects in deep images of a 3° × 3° field centered on the Coma cluster, obtained with the Dragonfly Telephoto Array. The objects have central surface brightness μ(g, 0) ranging from 24-26 mag arcsec{sup –2} and effective radii r {sub eff} = 3''-10'', as measured from archival Canada-France-Hawaii Telescope images. From their spatial distribution we infer that most or all of the objects are galaxies in the Coma cluster. This relatively large distance is surprising as it implies that the galaxies are very large: with r {sub eff} = 1.5-4.6 kpcmore » their sizes are similar to those of L {sub *} galaxies even though their median stellar mass is only ∼6 × 10{sup 7} M {sub ☉}. The galaxies are relatively red and round, with (g – i) = 0.8 and (b/a) = 0.74. One of the 47 galaxies is fortuitously covered by a deep Hubble Space Telescope Advanced Camera for Surveys (ACS) observation. The ACS imaging shows a large spheroidal object with a central surface brightness μ{sub 475} = 25.8 mag arcsec{sup –2}, a Sérsic index n = 0.6, and an effective radius of 7'', corresponding to 3.4 kpc at the distance of Coma. The galaxy is not resolved into stars, consistent with expectations for a Coma cluster object. We speculate that these ''ultra-diffuse galaxies'' may have lost their gas supply at early times, possibly resulting in very high dark matter fractions.« less

The Large-Grained Dust Coma of 174P/Echeclus

NASA Technical Reports Server (NTRS)

Bauer, James M.; Choi, Young-Jun; Weissman, Paul R.; Stansberry, John A.; Fernandez, Yanga R.; Roe, Henry G.; Buratti, Bonnie J.; Sung, Hyun-Il

2008-01-01

On 2005 December 30, Y.-J. Choi and P. R. Weissman discovered that the formerly dormant Centaur 2000 EC98 was in strong outburst. Previous observations by P. Rousselot et al. spanning a 3-year period indicated a lack of coma down to the 27 mag arcsec 2 level.We present Spitzer Space Telescope MIPS observations of this newly active Centaur--now known as 174P/Echeclus (2000 EC98)--or 60558 Echeclus--taken in 2006 late February. The images show strong signal at both the 24 and 70 micron bands and reveal an extended coma about 2' in diameter. Analyses yield estimates of the coma signal contribution that are in excess of 90% of the total signal in the 24 micron band. Dust production estimates ranging from 1.7-4 x 10(exp 2) kg/s are on the order of 30 times that seen in other Centaurs. Simultaneous visible-wavelength observations were also obtained with Palomar Observatory's 200-inch telescope, the 1.8-m Vatican Advanced Technology Telescope, the Bohyunsan Optical Astronomy Observatory (BOAO) 1.8-m telescope, and Table Mountain Observatory's 0.6-m telescope, revealing a coma morphology nearly identical to the mid-IR observations. The grain size distribution derived from the data yields a log particle mass power-law with slope parameter (alpha) = -0.87 +/- 0.07, and is consistent with steady cometary-activity, such as that observed during the Stardust spacecraft's encounter at 81P/Wild 2, and not with an impact driven event, such as that caused by the Deep Impact experiment.

Prospective Cohort Study Evaluating the Prognostic Value of Simple EEG Parameters in Postanoxic Coma.

PubMed

Azabou, Eric; Fischer, Catherine; Mauguiere, François; Vaugier, Isabelle; Annane, Djillali; Sharshar, Tarek; Lofaso, Fréderic

2016-01-01

We prospectively studied early bedside standard EEG characteristics in 61 acute postanoxic coma patients. Five simple EEG features, namely, isoelectric, discontinuous, nonreactive to intense auditory and nociceptive stimuli, dominant delta frequency, and occurrence of paroxysms were classified yes or no. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC) of each of these variables for predicting an unfavorable outcome, defined as death, persistent vegetative state, minimally conscious state, or severe neurological disability, as assessed 1 year after coma onset were computed as well as Synek's score. The outcome was unfavorable in 56 (91.8%) patients. Sensitivity, specificity, PPV, NPV, and AUC of nonreactive EEG for predicting an unfavorable outcome were 84%, 80%, 98%, 31%, and 0.82, respectively; and were all very close to the ones of Synek score>3, which were 82%, 80%, 98%, 29%, and 0.81, respectively. Specificities for predicting an unfavorable outcome were 100% for isoelectric, discontinuous, or dominant delta activity EEG. These 3 last features were constantly associated to unfavorable outcome. Absent EEG reactivity strongly predicted an unfavorable outcome in postanoxic coma, and performed as accurate as a Synek score>3. Analyzing characteristics of some simple EEG features may easily help nonneurophysiologist physicians to investigate prognostic issue of postanoxic coma patient. In this study (a) discontinuous, isoelectric, or delta-dominant EEG were constantly associated with unfavorable outcome and (b) nonreactive EEG performed prognostic as accurate as a Synek score>3. © EEG and Clinical Neuroscience Society (ECNS) 2015.

Evidence of Absence of Tidal Features in the Outskirts of Ultra Diffuse Galaxies in the Coma Cluster

NASA Astrophysics Data System (ADS)

Mowla, Lamiya; van Dokkum, Pieter; Merritt, Allison; Abraham, Roberto; Yagi, Masafumi; Koda, Jin

2017-12-01

We study the presence of tidal features associated with ultra diffuse galaxies (UDGs) in galaxy clusters. Specifically, we stack deep Subaru images of UDGs in the Coma cluster to determine whether they show position angle twists at large radii. Selecting galaxies with central surface brightness μ (g,0)> 24 magarcsec-2 and projected half-light radius {r}e> 1.5 {kpc}, we identify 287 UDGs in the Yagi et al. catalog of low surface brightness Coma objects. The UDGs have apparent spheroidal shapes with median Sérsic index < n> =0.8 and median axis ratio < b/a> =0.7. The images are processed by masking all background objects and rotating to align the major axis before stacking them in bins of properties such as axis ratio, angle of major axis with respect to the cluster center, and separation from cluster center. Our image stacks reach further than 7 kpc (≳4r e). Analysis of the isophotes of the stacks reveals that the ellipticity remains constant up to the last measured point, which means that the individual galaxies have a non-varying position angle and axis ratio and show no evidence for tidal disruption out to ˜ 4{r}e. We demonstrate this explicitly by comparing our stacks with stacks of model UDGs with and without tidal features in their outskirts. We infer that the average tidal radius of the Coma UDGs is >7 kpc and estimate that the average dark matter fraction within the tidal radius of the UDGs inhabiting the innermost 0.5 Mpc of Coma is >99%.

Disruption of posteromedial large-scale neural communication predicts recovery from coma

PubMed Central

de Pasquale, Francesco; Vuillaume, Corine; Riu, Beatrice; Loubinoux, Isabelle; Geeraerts, Thomas; Seguin, Thierry; Bounes, Vincent; Fourcade, Olivier; Demonet, Jean-Francois; Péran, Patrice

2015-01-01

Objective: We hypothesize that the major consciousness deficit observed in coma is due to the breakdown of long-range neuronal communication supported by precuneus and posterior cingulate cortex (PCC), and that prognosis depends on a specific connectivity pattern in these networks. Methods: We compared 27 prospectively recruited comatose patients who had severe brain injury (Glasgow Coma Scale score <8; 14 traumatic and 13 anoxic cases) with 14 age-matched healthy participants. Standardized clinical assessment and fMRI were performed on average 4 ± 2 days after withdrawal of sedation. Analysis of resting-state fMRI connectivity involved a hypothesis-driven, region of interest–based strategy. We assessed patient outcome after 3 months using the Coma Recovery Scale–Revised (CRS-R). Results: Patients who were comatose showed a significant disruption of functional connectivity of brain areas spontaneously synchronized with PCC, globally notwithstanding etiology. The functional connectivity strength between PCC and medial prefrontal cortex (mPFC) was significantly different between comatose patients who went on to recover and those who eventually scored an unfavorable outcome 3 months after brain injury (Kruskal-Wallis test, p < 0.001; linear regression between CRS-R and PCC-mPFC activity coupling at rest, Spearman ρ = 0.93, p < 0.003). Conclusion: In both etiology groups (traumatic and anoxic), changes in the connectivity of PCC-centered, spontaneously synchronized, large-scale networks account for the loss of external and internal self-centered awareness observed during coma. Sparing of functional connectivity between PCC and mPFC may predict patient outcome, and further studies are needed to substantiate this potential prognosis biomarker. PMID:26561296

Disruption of posteromedial large-scale neural communication predicts recovery from coma.

PubMed

Silva, Stein; de Pasquale, Francesco; Vuillaume, Corine; Riu, Beatrice; Loubinoux, Isabelle; Geeraerts, Thomas; Seguin, Thierry; Bounes, Vincent; Fourcade, Olivier; Demonet, Jean-Francois; Péran, Patrice

2015-12-08

We hypothesize that the major consciousness deficit observed in coma is due to the breakdown of long-range neuronal communication supported by precuneus and posterior cingulate cortex (PCC), and that prognosis depends on a specific connectivity pattern in these networks. We compared 27 prospectively recruited comatose patients who had severe brain injury (Glasgow Coma Scale score <8; 14 traumatic and 13 anoxic cases) with 14 age-matched healthy participants. Standardized clinical assessment and fMRI were performed on average 4 ± 2 days after withdrawal of sedation. Analysis of resting-state fMRI connectivity involved a hypothesis-driven, region of interest-based strategy. We assessed patient outcome after 3 months using the Coma Recovery Scale-Revised (CRS-R). Patients who were comatose showed a significant disruption of functional connectivity of brain areas spontaneously synchronized with PCC, globally notwithstanding etiology. The functional connectivity strength between PCC and medial prefrontal cortex (mPFC) was significantly different between comatose patients who went on to recover and those who eventually scored an unfavorable outcome 3 months after brain injury (Kruskal-Wallis test, p < 0.001; linear regression between CRS-R and PCC-mPFC activity coupling at rest, Spearman ρ = 0.93, p < 0.003). In both etiology groups (traumatic and anoxic), changes in the connectivity of PCC-centered, spontaneously synchronized, large-scale networks account for the loss of external and internal self-centered awareness observed during coma. Sparing of functional connectivity between PCC and mPFC may predict patient outcome, and further studies are needed to substantiate this potential prognosis biomarker. © 2015 American Academy of Neurology.

How does information influence hope in family members of traumatic coma patients in intensive care unit?

PubMed

Verhaeghe, Sofie T L; van Zuuren, Florence J; Defloor, Tom; Duijnstee, Mia S H; Grypdonck, Mieke H F

2007-08-01

To assess the interplay between hope and the information provided by health care professionals. Earlier research learned that hope is crucial for relatives of traumatic coma patients. Also it has been reported that the need for information is extremely important for relatives of critically ill patients. A qualitative approach according to the 'grounded theory' method with constant comparison was used. We held 24 in-depth interviews with 22 family members of 16 patients with traumatic coma. Data processing and data analysis took place in a cyclic process wherein the induction of themes was alternated by confrontation with new material. Family members of traumatic coma patients want information that is as accurate as possible, provided by doctors and nurses in an understandable manner and leaving room for hope. At first, family members can do no more than passively absorb the information they receive. After some time, they actively start working with information and learn what to build their hope on. In this way, concrete hope evolves and seems to be strongly determined by information. Information that is more positive than warranted is not appreciated at all. It leads to false hope and once its real nature becomes apparent, to increased distress and loss of trust in the professionals. The process of hope is crucial in coping with traumatic coma and information can facilitate this process. If professionals, especially nurses, keep the process in mind that family members go through in handling information, they can not only facilitate this process but also help them to establish realistic hope.

Post-Coma Persons with Extensive Multiple Disabilities Use Microswitch Technology to Access Selected Stimulus Events or Operate a Radio Device

ERIC Educational Resources Information Center

Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Alberti, Gloria; Oliva, Doretta; Megna, Gianfranco; Iliceto, Carla; Damiani, Sabino; Ricci, Irene; Spica, Antonella

2011-01-01

The present two studies extended research evidence on the use of microswitch technology by post-coma persons with multiple disabilities. Specifically, Study I examined whether three adults with a diagnosis of minimally conscious state and multiple disabilities could use microswitches as tools to access brief, selected stimulus events. Study II…

Myxedema Coma.

PubMed

Munir, Atif

2018-01-01

Myxedema may be the first presentation of patients with undiagnosed hypothyroidism. Definitive management is with thyroid hormone but supportive measures, identification and treatment of precipitating factors in an appropriately safe environment are vital. There is no consensus about preferred thyroid hormone regimen. Corticosteroid therapy is given until adrenal insufficiency has been excluded. We present here a case of seventy-four years old woman of myxodema coma.

A Technology-Assisted Learning Setup as Assessment Supplement for Three Persons with a Diagnosis of Post-Coma Vegetative State and Pervasive Motor Impairment

ERIC Educational Resources Information Center

Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Colonna, Fabio; Navarro, Jorge; Lanzilotti, Crocifissa; Bosco, Andrea; Megna, Gianfranco; De Tommaso, Marina

2009-01-01

Post-coma persons in an apparent condition of vegetative state and pervasive motor impairment pose serious problems in terms of assessment and intervention options. A technology-based learning assessment procedure might serve for them as a diagnostic supplement with possible implications for rehabilitation intervention. The learning assessment…

Protocol for Management of Penetrating Carotid Artery Injury.

DTIC Science & Technology

1977-02-08

after hypotension had been corrected. The deficits consisted of monoplegia, hemiplegia or quadriplegia , with or without an associated comatose state. All... quadriplegia , aphasia, or coma. The comatose state was often found in conjunction with lateralizing signs. Forty-nine patients had restoration of...athero- sclerotic disease. II. All patients who have a significant neurological deficit (monoplegia, hemiplegia, quadriplegia , or aphasia) short of coma

Post-Coma Persons Emerged from a Minimally Conscious State and Showing Multiple Disabilities Learn to Manage a Radio-Listening Activity

ERIC Educational Resources Information Center

Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Colonna, Fabio; Buonocunto, Francesca; Sacco, Valentina; Megna, Marisa; Oliva, Doretta

2012-01-01

This study assessed microswitch-based technology to enable three post-coma adults, who had emerged from a minimally conscious state but presented motor and communication disabilities, to operate a radio device. The material involved a modified radio device, a microprocessor-based electronic control unit, a personal microswitch, and an amplified…

Microswitch- and VOCA-Assisted Programs for Two Post-Coma Persons with Minimally Conscious State and Pervasive Motor Disabilities

ERIC Educational Resources Information Center

Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Colonna, Fabio; Navarro, Jorge; Oliva, Doretta; Signorino, Mario; Megna, Gianfranco

2009-01-01

Intervention programs, based on learning principles and assistive technology, were assessed in two studies with two post-coma men with minimally conscious state and pervasive motor disabilities. Study I assessed a program that included (a) an optic microswitch, activated via double blinking, which allowed a man direct access to brief music…

Post-Coma Persons with Motor and Communication/Consciousness Impairments Choose among Environmental Stimuli and Request Stimulus Repetitions via Assistive Technology

ERIC Educational Resources Information Center

Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Colonna, Fabio; Navarro, Jorge; Lanzilotti, Crocifissa; Oliva, Doretta; Megna, Gianfranco

2010-01-01

This study assessed whether a program based on microswitch and computer technology would enable three post-coma participants (adults) with motor and communication/consciousness impairments to choose among environmental stimuli and request their repetition whenever they so desired. Within each session, 16 stimuli (12 preferred and 4 non-preferred)…

Capturing the Coma

NASA Technical Reports Server (NTRS)

2005-01-01

This image shows comet Tempel 1, as seen by the Deep Impact spacecraft on June 21, 2005. It was taken using the clear filter of the spacecraft's medium resolution imager camera. The spacecraft was 11,564,081.7 kilometers (7,185,920 miles) away from the comet. Twelve images were combined together, and a logarithmic stretch was applied to enhance the coma of the comet.

Evidence for methane and ammonia in the coma of comet P/Halley

NASA Technical Reports Server (NTRS)

Allen, M.; Delitsky, M.; Huntress, W.; Yung, Y.; Ip, W.-H.

1987-01-01

Methane and ammonia abundances in the coma of Halley are derived from Giotto ion mass spectrometer data using an Eulerian model of chemical and physical processes inside the contact surface to simulate Giotto high-intensity spectrometer ion mass spectral data for mass-to-charge ratios (m/q) from 15 to 19. The ratio m/q = 19/18 as a function of distance from the nucleus is not reproduced by a model for a pure water coma. It is necessary to include the presence of NH3, and uniquely NH3, in coma gases in order to explain the data. A ratio of production rates Q(NH3)/Q(H2O) = 0.01 = 0.02 results in model values approximating the Giotto data. Methane is identified as the most probable source of the distinct peak at m/q = 15. The observations are fit best with Q(CH4)/Q(Q2O) = 0.02. The chemical composition of the comet nucleus implied by these production rate ratios is unlike that of the outer planets. On the other hand, there are also significant differences from observations of gas phase interstellar material.

Mismatch negativity to the patient's own name in chronic disorders of consciousness.

PubMed

Qin, Pengmin; Di, Haibo; Yan, Xiaodan; Yu, Senming; Yu, Dan; Laureys, Steven; Weng, Xuchu

2008-12-19

Previous studies implicated potential value of mismatch negativity (MMN) in predicting recovery of consciousness in patients with disorders of consciousness (DOC). We have adopted a novel MMN evoked by subject's own name (SON), a self-referential stimulus thought to be powerful in evoking residual brain activity, and examined the correlation between the MMN and recovery of consciousness in patients with chronic (>1 month) DOC. Twelve patients and 12 age-matched healthy controls were investigated. The patients were diagnosed as coma (n=4), vegetative state (VS, n=6), and minimally conscious state (MCS, n=2), mainly based on the JFK Coma Recovery Scale-Revised. The SON-evoked MMN (SON-MMN) was present in seven patients. Critically, the presence of SON-MMN was significantly correlated with recovery of consciousness. While four of the five patients (three VS and two coma) showing SON-MMN changed to MCS 3 months later, the rest of the patients (three VS and two coma) without SON-MMN failed to show any clinical improvement. Our study thus illustrates that the subject's own name is effective in evoking MMN in patients with DOC, and that SON-MMN has potential prognostic values in predicting recovery of consciousness.

A Comparison of the Near-Infrared Spectral Features of Early-Type Galaxies in the Virgo and Coma Clusters

NASA Astrophysics Data System (ADS)

Houdashelt, M. L.

1992-05-01

Initial results are presented from an examination of near-infrared spectra (6800 - 9200 Angstroms) of 34 early-type galaxies - 17 in the Virgo cluster, 10 in the Coma cluster and seven field members. It has previously been speculated that E/S0 galaxies of similar luminosity in the Virgo and Coma clusters have different red stellar populations. To explore this possibility, pseudo-equivalent widths of a number of near-IR spectral features have been measured. The important features studied include the TiO bands near 7100, 7890, 8197, 8500 and 8950 Angstroms, which are mainly produced by the late-type stars whose flux contributes only about 10-20\\ the near-IR. The strengths of the Ca triplet (8498, 8542, 8662 Angstroms) and Na I doublet (8183, 8195 Angstroms) are also measured, since these features are affected by the relative contribution of dwarf stars to the red light. Although the main focus of this work is the search for spectral differences among the Coma, Virgo and field E/S0 populations, each subgroup of galaxies (and the sample as a whole) are also examined for correlations among the feature strengths, galaxy color and luminosity.

Comet 209P/LINEAR's Very Close Approach to Earth: Probing the Inner-Coma Physical Environment and Volatile Composition

NASA Astrophysics Data System (ADS)

Bonev, Boncho P.; DiSanti, Michael; Mumma, Michael; Gibb, Erika; Villanueva, Geronimo; Paganini, Lucas; Combi, Michael; Magee-Sauer, Karen

2014-02-01

Using NIRSPEC at Keck 2 we propose spatially-resolved high- resolution spectroscopic observations of H_2O emission in the coma of the Jupiter-family comet 209P/LINEAR. The exceptionally small geocentric distance - 0.06 AU - will afford very high spatial resolution. Using long-slit spectroscopy we will measure the spatial variation of the temperature and column density of water, providing a very rare direct quantitative view of the physical state in the innermost region of a cometary atmosphere, within 50-100 km from the nucleus. To maximize the science return, we will also measure the abundances of CH_3OH and C_2H_6 simultaneously with H_2O. Only one instrument setting is required for our entire investigation, thereby optimizing observing efficiency. Our proposed study targets improved understanding of the near-nucleus coma physics, and of the primary volatile composition of Jupiter-family comets, a dynamical group which remains underrepresented in modern taxonomical studies. In addition, this project will provide a context for interpreting results from the Rosetta mission, and also a test of state-of-the-art physical models of the coma.

Severe oligozoospermia in a patient with myxedema coma.

PubMed

Komiya, Akira; Watanabe, Akihiko; Kawauchi, Yoko; Takano, Atsuko; Fuse, Hideki

2012-10-01

A case of severe oligozoospermia with myxedema coma is herein presented. The patient was referred to a male infertility clinic with a 5-year history of primary infertility. Decreased serum testosterone and elevated serum prolactin without abnormal MRI findings in the hypothalamus, and decreased semen volume and sperm motility were noted. A GnRH test revealed a decreased luteinizing hormone response, whereas the HCG test showed a normal testosterone increase. Because a urinalysis after ejaculation indicated retrograde ejaculation, imipramine administration was started. However, the semen quality deteriorated, so the patient was referred to an ART clinic. Twenty-one months from the initial visit, the patient developed a loss of consciousness and edema due to myxedema coma, a life-threatening state of hypothyroidism. The patient recovered after 1 month of thyroid hormone replacement therapy (HRT) with corticosteroids. Three months after the myxedema coma, a semen analysis showed a decreased semen volume (0.2 mL) and severe oligozoospermia (two spermatozoa/ejaculate). Elevated prolactin and decreased testosterone levels were still present. These parameters gradually improved after restoration of euthyroidism by HRT. In conclusion, physicians should confirm the thyroid function in the management of male infertility, especially in patients with elevated prolactin levels.

Application of Early Nutrition Support in Neurosurgical Coma Patients.

PubMed

Ren, Guoqin

2015-12-01

The present study was conducted to investigate the clinical efficacy of early parenteral and enteral nutrition (PN + EN) support in neurosurgical coma patients. Eighty cases of neurosurgical coma patients were randomly divided into intervention group and control group. The intervention group received early PN + EN support, and the control group received only total enteral nutritional (TEN) support. The levels of hemoglobin (HGB), serum albumin (ALB), prealbumin (PA), and retinol-binding protein (RBP) in two groups on days 1, 10, and 20 were observed. The incidences of pneumonia, stress ulcer, abnormal liver function, abdominal distension, and diarrhea between two groups were also compared. Results found that, on day 10, compared with the control group, the levels of HGB, PA, and RBP in the intervention group were significantly increased (P < 0.05). On day 20, ALB in the intervention group significantly increased (P < 0.05), and the incidences of pneumonia, abdominal distension, and diarrhea in the intervention group were significantly lower than those in the control group (P < 0.05). Compared with only TEN support, early PN + EN support can obviously improve the nutritional status of neurosurgical coma patients and reduce the occurrence of complications.

Negative Ion Chemistry in the Coma of Comet 1P/Halley

NASA Technical Reports Server (NTRS)

Cordiner, M. A.; Charnley, S. B.

2012-01-01

Negative ions (anions) were identified in the coma of comet 1P/Halley from in-situ measurements performed by the Giotto spacecraft in 1986. These anions were detected with masses in the range 7-110 amu, but with insufficient mass resolution to permit unambiguous identification. We present details of a new chemical-hydrodynamic model for the coma of comet Halley that includes - for the first time - atomic and molecular anions, in addition to a comprehensive hydrocarbon chemistry. Anion number densities arc calculated as a function of radius in the coma, and compared with the Giotto results. Important anion production mechanisms arc found to include radiative electron attachment, polar photodissociation, dissociative electron attachment, and proton transfer. The polyyne anions C4H(-) and C6H(-) arc found to be likely candidates to explain the Giotto anion mass spectrum in the range 49-73 amu. Thc CN(-) anion probably makes a significant contribution to the mass spectrum at 26 amu. Larger carbon-chain anions such as C8H(1) can explain the peak near 100 amu provided there is a source of large carbon-chain-bearing molecules from the cometary nucleus.

Interpopulational variation in the cold tolerance of a broadly distributed marine copepod

PubMed Central

Wallace, Gemma T.; Kim, Tiffany L.; Neufeld, Christopher J.

2014-01-01

Latitudinal trends in cold tolerance have been observed in many terrestrial ectotherms, but few studies have investigated interpopulational variation in the cold physiology of marine invertebrates. Here, the intertidal copepod Tigriopus californicus was used as a model system to study how local adaptation influences the cold tolerance of a broadly distributed marine crustacean. Among five populations spanning 18° in latitude, the following three metrics were used to compare cold tolerance: the temperature of chill-coma onset, the chill-coma recovery time and post-freezing recovery. In comparison to copepods from warmer southern latitudes, animals from northern populations exhibited lower chill-coma onset temperatures, shorter chill-coma recovery times and faster post-freezing recovery rates. Importantly, all three metrics showed a consistent latitudinal trend, suggesting that any single metric could be used equivalently in future studies investigating latitudinal variation in cold tolerance. Our results agree with previous studies showing that populations within a single species can display strong local adaptation to spatially varying climatic conditions. Thus, accounting for local adaptation in bioclimate models will be useful for understanding how broadly distributed species like T. californicus will respond to anthropogenic climate change. PMID:27293662

Interpopulational variation in the cold tolerance of a broadly distributed marine copepod.

PubMed

Wallace, Gemma T; Kim, Tiffany L; Neufeld, Christopher J

2014-01-01

Latitudinal trends in cold tolerance have been observed in many terrestrial ectotherms, but few studies have investigated interpopulational variation in the cold physiology of marine invertebrates. Here, the intertidal copepod Tigriopus californicus was used as a model system to study how local adaptation influences the cold tolerance of a broadly distributed marine crustacean. Among five populations spanning 18° in latitude, the following three metrics were used to compare cold tolerance: the temperature of chill-coma onset, the chill-coma recovery time and post-freezing recovery. In comparison to copepods from warmer southern latitudes, animals from northern populations exhibited lower chill-coma onset temperatures, shorter chill-coma recovery times and faster post-freezing recovery rates. Importantly, all three metrics showed a consistent latitudinal trend, suggesting that any single metric could be used equivalently in future studies investigating latitudinal variation in cold tolerance. Our results agree with previous studies showing that populations within a single species can display strong local adaptation to spatially varying climatic conditions. Thus, accounting for local adaptation in bioclimate models will be useful for understanding how broadly distributed species like T. californicus will respond to anthropogenic climate change.

The outskirts of the Coma cluster

NASA Astrophysics Data System (ADS)

Gavazzi, Giuseppe

Evolved Coma-like clusters of galaxies are constituted of relaxed cores composed of ''old'' early-type galaxies, embedded in large-scale structures, mostly constituted of unevolved (late-type) systems. According to the hierarchical theory of cluster formation the central regions are being fed with unevolved, low-mass systems infalling from the surroundings that are gradually transformed into elliptical/S0 galaxies by tidal galaxy-galaxy and galaxy-cluster interactions, taking place at some boundary distance. The Coma cluster, the most studied of all local clusters, provides us with the ideal test-bed for such an evolutionary study because of the completeness of the photometric and kinematic information already at hands. The field of view of the planned GALEX observations is not big enough to include the boundary interface where most transformations processes are expected to take place, including the truncation of the current star formation. We propose to complete the outskirt of Coma with an additional corona of 11 GALEX imaging fields of 1500 sec exposure each, matching the deepness (UV_{AB}=23.5 mag) of the fields observed in guarantee time. Given the priority of the target, we also propose one optional Central pointing that includes one bright star marginally exceeding the detector brightness limit.

Cometary coma chemical composition (C4) mission. [Abstract only

NASA Technical Reports Server (NTRS)

Carle, G. C.; Clark, B. C.; Niemann, H. B.; Alexander, M.; Knocke, P. C.; O'Hara, B. J.

1994-01-01

Cometary missions are of enormous fundamental importance for many different space science disciplines, including exobiology. Comets are presumed relics of the earliest, most primitive material in the solar nebula and are related to the planetesimals. They undoubtedly provided a general enrichment of volatiles to the inner solar system (contributing to atmospheres and oceans) and may have been key to the origin of life. A Discovery class, comet rendezvous mission, the Cometary Coma Chemical Composition (C4) Mission, was selected for further study by NASA earlier this year. The C4 Mission is a highly focused and usefully-limited subset of the Cometary Rendezvous Asteroid Flyby (CRAF) Mission, concentrating exclusively on measurements which will lead to an understanding of the chemical composition and make-up of the cometary nucleus. The scientific goals of the Cometary Coma Chemical Composition (C4) Mission are to rendezvous with a short-period comet and (1) to determine the elemental, chemical, and isotopic composition of the nucleus and (2) to characterize the chemical and isotopic nature of its atmosphere. Further, it is a goal to obtain preliminary data on the development of the coma (dust and gas composition) as a function of time and orbital position.

Comet Hyakutake C/1996 B2

NASA Technical Reports Server (NTRS)

1998-01-01

These are two images of the inner coma of Comet Hyakutake made on April 3 and 4, 1996, using the NASA Hubble Space Telescope Wide Field Planetary Camera 2 (WFPC2). The first one, shown in red, was taken through a narrow-band red filter that shows only sunlight scattered by dust particles in the inner coma of the comet. The second one, shown in blue was taken with an ultraviolet 'Woods' filter image that shows the distribution of scattered ultraviolet radiation from hydrogen atoms in the inner coma. The coma is the head or dusty-gas atmosphere of a comet. The square field of view is 14,000 km on a side and the sun is toward the upper right corner of the image. Hydrogen atoms represent the most abundant gas in the whole coma of the comet. They are produced when solar ultraviolet light breaks up molecules of water, the major constituent of the nucleus of the comet. These images were taken as part of an observing program to study water photochemistry in comets. Measurements of hydrogen (H) and hydroxyl (OH) in the coma (or atmosphere) of Comet Hyakutake were also made using the Goddard High Resolution Spectrograph (GHRS) and the Faint Object Spectrograph (FOS). A self-consistent analysis of all the data shows that the water production rate of the comet was between 7 and 8 tons per second on the April 3 and 4. A theoretical model was used in the analysis which accounts for the detailed physics and chemistry of the photochemical destruction of the water, the production of the H and OH, and their expansion in the coma (or atmosphere) of the comet. The model matched the velocity measurements of hydrogen atoms made using the high spectral resolution capabilities of the GHRS instrument. The importance of such a detailed model is that is permits the accurate calculation of the production rate of water from observations of H and OH.

The inner yellow region near the center of the red dust image is dominated by the contribution from the dust which shows sunward directed spiral jets toward the upper right, and the thin straight particle trail pointing toward the lower left. The trail was a permanent feature of the comet around the time of its close approach to the Earth in late March and early April. Also barely visible just beyond the lower left end of the trail are two of the many condensations which were seen to travel slowly down the tail are believed to be clumps of material released from the nucleus.

The inner white region of the blue image appears to show that the hydrogen atoms like the dust might be preferentially ejected toward the sunward or day side of the nucleus. However, this is not true. The asymmetric ultraviolet radiation pattern is produced by a roughly spherical distribution of hydrogen atoms because they are so efficient at scattering the incoming solar ultraviolet light. The atoms on the sunward side actually shadow the atoms on the tailward or night side of the coma. The same detailed model analysis of the coma which explains the expansion of the hydrogen atoms in the coma also explains the appearance of the image.

The team was lead by Michael Combi, The University of Michigan, and included Michael Brown, California Institute of Technology, Paul Feldman, Johns Hopkins University, H. Uwe Keller of the Max Planck Institute, Lindau, Robert Meier of the Naval Research Laboratory, and William Smyth of Atmospheric and Environmental Research, Inc.

The Wide Field/Planetary Camera 2 was developed by the Jet Propulsion Laboratory and managed by the Goddard Spaced Flight Center for NASA's Office of Space Science.

This image and other images and data received from the Hubble Space Telescope are posted on the World Wide Web on the Space Telescope Science Institute home page at URL http://oposite.stsci.edu/pubinfo/

Successful prospective management of neonatal citrullinemia.

PubMed

Go, Hayato; Imamura, Takashi; Hashimoto, Koichi; Ogasawara, Kei; Sakamoto, Osamu; Takubo, Noriyuki; Momoi, Nobuo; Hosoya, Mitsuaki

2012-01-01

Classical citrullinemia generally involves hyperammonemic coma in the first few days of life and leads to neurological sequelae in survivors. We report a case of an elder sister who fell into a hyperammonemic coma on the fifth day after birth. She was successfully treated with intravenous benzoate and hemodialysis, and was subsequently diagnosed with citrullinemia on the basis of biochemical analysis. Two years later, a younger sister was born without prenatal diagnosis. We monitored plasma ammonia and citrulline levels after birth, and again diagnosed her with CTLN1 on the basis of biochemical and DNA analyses. There have been few reports of the prospective treatment of citrullinemia; however, our experience indicates the need for the prospective management and the rapid reduction of ammonia levels to avoid neonatal hyperammonemic coma and subsequent sequelae.

Jet Morphology and Coma Analysis of 103P/Hartley 2

NASA Astrophysics Data System (ADS)

Vaughan, Charles; Pierce, D.; Dorman, G.; Cochran, A.

2012-10-01

We have observed comet 103P/Hartley 2 using the George and Cynthia Mitchell Spectrograph (formerly VIRUS-P) on the 2.7 m telescope at McDonald Observatory (Hill et al. 2008). Data for CN, C2, C3, and NH2 were collected over six nights from 2010 July 15 to November 10. The data were processed to form images of the coma for each of the observed species. We have performed azimuthal average division on each of the coma images to examine jet morphology and have investigated the nature of the production of the radical species using our modified vectorial model (Ihalawela et al. 2011). This work enhances the ongoing investigation of the chemistry and outgassing behavior of Hartley 2 as studied by the EPOXI flyby mission.

Myxedema coma.

PubMed

Kwaku, Maxwell P; Burman, Kenneth D

2007-01-01

Untreated or unrecognized hypothyroidism may progress to severe decompensated hypothyroidism or myxedema coma. Relatively few cases are reported in the literature since the first case was apparently reported from the St. Thomas Hospital in London in 1879. The paucity of cases may be due to either underreporting or improvement in the diagnosis and treatment of uncomplicated hypothyroidism. However, despite the ready availability of sensitive thyrotropin assays, the recognition and treatment of myxedema coma remains a challenge. Although thyroid hormone treatment is highly effective when combined with ventilatory and hemodynamic support in the intensive care unit setting, controversies abound on the optimal and most effective choice of thyroid hormone preparation: thyroxine and triiodothyronine and in what amount. Accumulated evidence now shows that proper use of either thyroxine alone or in combination with triiodothyronine may be effective therapy.

Neurotrauma pediatric scales

PubMed Central

Alexandru, Vlad Ciurea; Aurelia, Mihaela Sandu; Mihai, Popescu; Stefan, Mircea Iencean; Bogdan, Davidescu

2008-01-01

Cranial traumas have different particularities in infants, toddlers, preschool child, school child and teenagers. The assessment of these cases must be individualized according to age. It is completely different in children that in adults. Trauma scales, very useful in grading the severity and predicting outcome in traumatic brain injury, used in adults must be adapted in children. Children have age-related specificity and anatomic particularities, for each of this period of development. Neurotrauma scales, specific for infants and children, such as Pediatric Coma Scale, Children’s Coma Score, Trauma Infant Neurological Score, Glasgow Coma Scale, Liege Scale are reviewed, as well as neurotrauma outcome scales, like Glasgow Outcome Scale, modified Rankin score, KOSCHI score and Barthel Index. The authors present these scales in an exhaustive manner for thoroughgoing pediatric neurotrauma standards. PMID:20108520

EUV phase-shifting masks and aberration monitors

NASA Astrophysics Data System (ADS)

Deng, Yunfei; Neureuther, Andrew R.

2002-07-01

Rigorous electromagnetic simulation with TEMPEST is used to examine the use of phase-shifting masks in EUV lithography. The effects of oblique incident illumination and mask patterning by ion-mixing of multilayers are analyzed. Oblique incident illumination causes streamers at absorber edges and causes position shifting in aerial images. The diffraction waves between ion-mixed and pristine multilayers are observed. The phase-shifting caused by stepped substrates is simulated and images show that it succeeds in creation of phase-shifting effects. The diffraction process at the phase boundary is also analyzed. As an example of EUV phase-shifting masks, a coma pattern and probe based aberration monitor is simulated and aerial images are formed under different levels of coma aberration. The probe signal rises quickly as coma increases as designed.

Limb salvage after gas gangrene: a case report and review of the literature

PubMed Central

2011-01-01

Gas gangrene is a necrotic infection of soft tissue associated with high mortality, often necessitating amputation in order to control the infection. Herein we present a case of gas gangrene of the arm in an intravenous drug user with a history of intramuscular injections with normal saline in the shoulder used to provoke pain for recovery after drug induced coma. The patient was early treated with surgery and antibiotics rendering possible the preservation of the limb and some of its function. Additionally, a review of the literature regarding case reports of limb salvage after gas gangrene is presented. PMID:21846405

Severe hypothyroidism presenting as myxedema coma in the postoperative period in a patient taking sunitinib: case report and review of literature.

PubMed

Lele, Abhijit V; Clutter, Sarah; Price, Eleana; De Ruyter, Martin L

2013-02-01

The case of a 62-year-old Caucasian woman who underwent urgent hip hemiarthroplasty for repair of a pathological fracture is reported. The patient's medical history was significant for renal cell carcinoma, cerebellar metastases, and sunitinib-induced hypothyroidism. Her intraoperative course was complicated by profound hypothermia, bradycardia, augmentation of neuromuscular blockade, delayed emergence, failure of postoperative extubation, and need for mechanical ventilation. The intensive care course was significant for hypothermia requiring forced-air warming, treatment with intravenous thyroxine (T4), and hemodynamic supportive care. Copyright © 2013 Elsevier Inc. All rights reserved.

The Enigmatic (Almost) Dark Galaxy Coma P: The Atomic Interstellar Medium

NASA Astrophysics Data System (ADS)

Ball, Catherine; Cannon, John M.; Leisman, Lukas; Adams, Elizabeth A. K.; Haynes, Martha P.; Józsa, Gyula I. G.; McQuinn, Kristen B. W.; Salzer, John J.; Brunker, Samantha; Giovanelli, Riccardo; Hallenbeck, Gregory; Janesh, William; Janowiecki, Steven; Jones, Michael G.; Rhode, Katherine L.

2018-02-01

We present new high-resolution H I spectral line imaging of Coma P, the brightest H I source in the system HI 1232+20. This galaxy with extremely low surface brightness was first identified in the ALFALFA survey as an “(Almost) Dark” object: a clearly extragalactic H I source with no obvious optical counterpart in existing optical survey data (although faint ultraviolet emission was detected in archival GALEX imaging). Using a combination of data from the Westerbork Synthesis Radio Telescope and the Karl G. Jansky Very Large Array, we investigate the H I morphology and kinematics at a variety of physical scales. The H I morphology is irregular, reaching only moderate maxima in mass surface density (peak {σ }{{H}{{I}}}∼ 10 {M}ȯ pc‑2). Gas of lower surface brightness extends to large radial distances, with the H I diameter measured at 4.0 ± 0.2 kpc inside the 1 {M}ȯ pc‑2 level. We quantify the relationships between mass surface density of H I gas and star formation on timescales of ∼100–200 Myr as traced by GALEX far-ultraviolet emission. While Coma P has regions of dense H I gas reaching the {N}{{H}{{I}}}={10}21 cm‑2 level typically associated with ongoing star formation, it lacks massive star formation as traced by Hα emission. The H I kinematics are extremely complex: a simple model of a rotating disk cannot describe the H I gas in Coma P. Using spatially resolved position–velocity analysis we identify two nearly perpendicular axes of projected rotation that we interpret as either the collision of two H I disks or a significant infall event. Similarly, three-dimensional modeling of the H I dynamics provides a best fit with two H I components. Coma P is just consistent (within 3σ) with the known {M}{{H}{{I}}}{--}{D}{{H}{{I}}} scaling relation. It is either too large for its H I mass, has too low an H I mass for its H I size, or the two H I components artificially extend its H I size. Coma P lies within the empirical scatter at the faint end of the baryonic Tully–Fisher relation, although the complexity of the H I dynamics complicates the interpretation. Along with its large ratio of H I to stellar mass, the collective H I characteristics of Coma P make it unusual among known galaxies in the nearby universe.

Technology-Aided Leisure and Communication Opportunities for Two Post-Coma Persons Emerged from a Minimally Conscious State and Affected by Multiple Disabilities

ERIC Educational Resources Information Center

Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa; Oliva, Doretta

2013-01-01

This study assessed technology-aided programs for helping two post-coma persons, who had emerged from a minimally conscious state and were affected by multiple disabilities, to (a) engage with leisure stimuli and request caregiver's procedures, (b) send out and listen to text messages for communication with distant partners, and (c) combine…

Aerobraking strategies for the sample of comet coma earth return mission

NASA Astrophysics Data System (ADS)

Abe, Takashi; Kawaguchi, Jun'ichiro; Uesugi, Kuninori; Yen, Chen-Wan L.

The results of a study to the validate the applicability of the aerobraking concept to the SOCCER (sample of comet coma earth return) mission using a six-DOF computer simulation of the aerobraking process are presented. The SOCCER spacecraft and the aerobraking scenario and power supply problem are briefly described. Results are presented for the spin effect, payload exposure problem, and sun angle effect.

C/2013 A1 (Siding Spring vs. Mars)

NASA Technical Reports Server (NTRS)

Moorhead, Althea; Cooke, William

2013-01-01

Comet C/2013 A1 (Siding Spring): recently discovered long period comet. Will have close encounter with Mars on October 19, 2014. Collision is extremely unlikely. Passing through the coma and/or tail is likely. Increases risk to Martian spacecraft. Meteoroids (100 microns or larger): approx. or <20% chance of impact per square meter due to coma and tail. Gas may also a ect Martian atmosphere.

Elemental Abundances in the Intracluster Gas and the Hot Galactic Coronae in Cluster A194

NASA Technical Reports Server (NTRS)

Forman, William R.

1997-01-01

We have completed the analysis of observations of the Coma cluster and are continuing analysis of A1367 both of which are shown to be merging clusters. Also, we are analyzing observations of the Centaurus cluster which we see as a merger based in both its temperature and surface brightness distributions. Attachment: Another collision for the coma cluster.

Aerobraking strategies for the sample of comet coma earth return mission

NASA Technical Reports Server (NTRS)

Abe, Takashi; Kawaguchi, Jun'ichiro; Uesugi, Kuninori; Yen, Chen-Wan L.

1990-01-01

The results of a study to the validate the applicability of the aerobraking concept to the SOCCER (sample of comet coma earth return) mission using a six-DOF computer simulation of the aerobraking process are presented. The SOCCER spacecraft and the aerobraking scenario and power supply problem are briefly described. Results are presented for the spin effect, payload exposure problem, and sun angle effect.

Clinical, Radiologic, and Legal Significance of "Extensor Response" in Posttraumatic Coma.

PubMed

Firsching, Raimund; Woischneck, Dieter; Langejürgen, Alexander; Parreidt, Andreas; Bondar, Imre; Skalej, Martin; Röhl, Friedrich; Voellger, Benjamin

2015-11-01

The timely detection of neurologic deterioration can be critical for the survival of a neurosurgical patient following head injury. Because little reliable evidence is available on the prognostic value of the clinical sign "extensor response" in comatose posttraumatic patients, we investigated the correlation of this clinical sign with outcome and with early radiologic findings from magnetic resonance imaging (MRI). This retrospective analysis of prospectively obtained data included 157 patients who had remained in a coma for a minimum of 24 hours after traumatic brain injury. All patients received a 1.5-T MRI within 10 days (median: 2 days) of the injury. The correlations between clinical findings 12 and 24 hours after the injury-in particular, extensor response and pupillary function, MRI findings, and outcome after 1 year-were investigated. Statistical analysis included contingency tables, Fisher exact test, odds ratios (ORs) with confidence intervals (CIs), and weighted κ values. There were 48 patients with extensor response within the first 24 hours after the injury. Patients with extensor response (World Federation of Neurosurgical Societies coma grade III) statistically were significantly more likely to harbor MRI lesions in the brainstem when compared with patients in a coma who had no further deficiencies (coma grade I; p = 0.0004 by Fisher exact test, OR 10.8 with 95% CI, 2.7-42.5) and patients with unilateral loss of pupil function (coma grade II; p = 0.0187, OR 2.8 with 95% CI, 1.2-6.5). The correlation of brainstem lesions as found by MRI and outcome according to the Glasgow Outcome Scale after 1 year was also highly significant (p ≤ 0.016). The correlation of extensor response and loss of pupil function with an unfavorable outcome and with brainstem lesions revealed by MRI is highly significant. Their sudden onset may be associated with the sudden onset of brainstem dysfunction and should therefore be regarded as one of the most fundamental warning signs in the clinical monitoring of comatose patients. Georg Thieme Verlag KG Stuttgart · New York.

Economic evaluation of decompressive craniectomy versus barbiturate coma for refractory intracranial hypertension following traumatic brain injury.

PubMed

Alali, Aziz S; Naimark, David M J; Wilson, Jefferson R; Fowler, Robert A; Scales, Damon C; Golan, Eyal; Mainprize, Todd G; Ray, Joel G; Nathens, Avery B

2014-10-01

Decompressive craniectomy and barbiturate coma are often used as second-tier strategies when intracranial hypertension following severe traumatic brain injury is refractory to first-line treatments. Uncertainty surrounds the decision to choose either treatment option. We investigated which strategy is more economically attractive in this context. We performed a cost-utility analysis. A Markov Monte Carlo microsimulation model with a life-long time horizon was created to compare quality-adjusted survival and cost of the two treatment strategies, from the perspective of healthcare payer. Model parameters were estimated from the literature. Two-dimensional simulation was used to incorporate parameter uncertainty into the model. Value of information analysis was conducted to identify major drivers of decision uncertainty and focus future research. Trauma centers in the United States. Base case was a population of patients (mean age = 25 yr) who developed refractory intracranial hypertension following traumatic brain injury. We compared two treatment strategies: decompressive craniectomy and barbiturate coma. Decompressive craniectomy was associated with an average gain of 1.5 quality-adjusted life years relative to barbiturate coma, with an incremental cost-effectiveness ratio of $9,565/quality-adjusted life year gained. Decompressive craniectomy resulted in a greater quality-adjusted life expectancy 86% of the time and was more cost-effective than barbiturate coma in 78% of cases if our willingness-to-pay threshold is $50,000/quality-adjusted life year and 82% of cases at a threshold of $100,000/quality-adjusted life year. At older age, decompressive craniectomy continued to increase survival but at higher cost (incremental cost-effectiveness ratio = $197,906/quality-adjusted life year at mean age = 85 yr). Based on available evidence, decompressive craniectomy for the treatment of refractory intracranial hypertension following traumatic brain injury provides better value in terms of costs and health gains than barbiturate coma. However, decompressive craniectomy might be less economically attractive for older patients. Further research, particularly on natural history of severe traumatic brain injury patients, is needed to make more informed treatment decisions.

A Cluster Of Activities On Coma From The Hubble Space Telescope, StarDate, And McDonald Observatory

NASA Astrophysics Data System (ADS)

Hemenway, Mary Kay; Jogee, S.; Fricke, K.; Preston, S.

2011-01-01

With a goal of providing a vast audience of students, teachers, the general public, and Spanish-speakers with activities to learn about research on the Coma cluster of galaxies based on the HST ACS Treasury survey of Coma, McDonald Observatory used a many-faceted approach. Since this research offered an unprecedented legacy dataset, part of the challenge was to convey the importance of this project to a diverse audience. The methodology was to create different products for different (overlapping) audiences. Five radio programs were produced in English and Spanish for distribution on over 500 radio stations in the US and Mexico with a listening audience of over 2 million; in addition to the radio listeners, there were over 13,000 downloads of the English scripts and almost 6000 of the Spanish. Images were prepared for use in the StarDate Online Astronomy Picture of the Week, for ViewSpace (used in museums), and for the StarDate/Universo Teacher Guide. A high-school level activity on the Coma Cluster was prepared and distributed both on-line and in an upgraded printed version of the StarDate/Universo Teacher Guide. This guide has been distributed to over 1700 teachers nationally. A YouTube video about careers and research in astronomy using the Coma cluster as an example was produced. Just as the activities were varied, so were the evaluation methods. This material is based upon work supported by the National Aeronautics and Space Administration under Grant/Contract/Agreement No. HST-EO-10861.35-A issued through the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS5-26555.

Abandon the dead donor rule or change the definition of death?

PubMed

Veatch, Robert M

2004-09-01

Research by Siminoff and colleagues reveals that many lay people in Ohio classify legally living persons in irreversible coma or persistent vegetative state (PVS) as dead that additional respondents, although classifying such patients as living, would be willing to procure organs from them. This paper analyzes possible implications of these findings for public policy. A majority would procure organs from those in irreversible coma or in PVS. Two strategies for legitimizing such procurement are suggested. One strategy would be to make exceptions to the dead donor rule permitting procurement from those in PVS or at least those who are in irreversible coma while continuing to classify them as living. Another strategy would be to further amend the definition of death to classify one or both groups as deceased, thus permitting procurement without violation of the dead donor rule. Permitting exceptions to the dead donor rule would require substantial changes in law--such as authorizing procuring surgeons to end the lives of patients by means of organ procurement--and would weaken societal prohibitions on killing. The paper suggests that it would be easier and less controversial to further amend the definition of death to classify those in irreversible coma and PVS as dead. Incorporation of a conscience clause to permit those whose religious or philosophical convictions support whole-brain or cardiac-based death pronouncement would avoid violating their beliefs while causing no more than minimal social problems. The paper questions whether those who would support an exception to the dead donor rule in these cases and those who would support a further amendment to the definition of death could reach agreement to adopt a public policy permitting organ procurement of those in irreversible coma or PVS when proper consent is obtained.

Defining Surrogate Endpoints for Clinical Trials in Severe Falciparum Malaria

PubMed Central

Plewes, Katherine; Maude, Richard J.; Hanson, Josh; Herdman, M. Trent; Leopold, Stije J.; Ngernseng, Thatsanun; Charunwatthana, Prakaykaew; Phu, Nguyen Hoan; Ghose, Aniruddha; Hasan, M. Mahtab Uddin; Fanello, Caterina I.; Faiz, Md Abul; Hien, Tran Tinh; Day, Nicholas P. J.; White, Nicholas J.; Dondorp, Arjen M.

2017-01-01

Background Clinical trials in severe falciparum malaria require a large sample size to detect clinically meaningful differences in mortality. This means few interventions can be evaluated at any time. Using a validated surrogate endpoint for mortality would provide a useful alternative allowing a smaller sample size. Here we evaluate changes in coma score and plasma lactate as surrogate endpoints for mortality in severe falciparum malaria. Methods Three datasets of clinical studies in severe malaria were re-evaluated: studies from Chittagong, Bangladesh (adults), the African ‘AQUAMAT’ trial comparing artesunate and quinine (children), and the Vietnamese ‘AQ’ study (adults) comparing artemether with quinine. The absolute change, relative change, slope of the normalization over time, and time to normalization were derived from sequential measurements of plasma lactate and coma score, and validated for their use as surrogate endpoint, including the proportion of treatment effect on mortality explained (PTE) by these surrogate measures. Results Improvements in lactate concentration or coma scores over the first 24 hours of admission, were strongly prognostic for survival in all datasets. In hyperlactataemic patients in the AQ study (n = 173), lower mortality with artemether compared to quinine closely correlated with faster reduction in plasma lactate concentration, with a high PTE of the relative change in plasma lactate at 8 and 12 hours of 0.81 and 0.75, respectively. In paediatric patients enrolled in the ‘AQUAMAT’ study with cerebral malaria (n = 785), mortality was lower with artesunate compared to quinine, but this was not associated with faster coma recovery. Conclusions The relative changes in plasma lactate concentration assessed at 8 or 12 hours after admission are valid surrogate endpoints for severe malaria studies on antimalarial drugs or adjuvant treatments aiming at improving the microcirculation. Measures of coma recovery are not valid surrogate endpoints for mortality. PMID:28052109

Defining Surrogate Endpoints for Clinical Trials in Severe Falciparum Malaria.

PubMed

Jeeyapant, Atthanee; Kingston, Hugh W; Plewes, Katherine; Maude, Richard J; Hanson, Josh; Herdman, M Trent; Leopold, Stije J; Ngernseng, Thatsanun; Charunwatthana, Prakaykaew; Phu, Nguyen Hoan; Ghose, Aniruddha; Hasan, M Mahtab Uddin; Fanello, Caterina I; Faiz, Md Abul; Hien, Tran Tinh; Day, Nicholas P J; White, Nicholas J; Dondorp, Arjen M

2017-01-01

Clinical trials in severe falciparum malaria require a large sample size to detect clinically meaningful differences in mortality. This means few interventions can be evaluated at any time. Using a validated surrogate endpoint for mortality would provide a useful alternative allowing a smaller sample size. Here we evaluate changes in coma score and plasma lactate as surrogate endpoints for mortality in severe falciparum malaria. Three datasets of clinical studies in severe malaria were re-evaluated: studies from Chittagong, Bangladesh (adults), the African 'AQUAMAT' trial comparing artesunate and quinine (children), and the Vietnamese 'AQ' study (adults) comparing artemether with quinine. The absolute change, relative change, slope of the normalization over time, and time to normalization were derived from sequential measurements of plasma lactate and coma score, and validated for their use as surrogate endpoint, including the proportion of treatment effect on mortality explained (PTE) by these surrogate measures. Improvements in lactate concentration or coma scores over the first 24 hours of admission, were strongly prognostic for survival in all datasets. In hyperlactataemic patients in the AQ study (n = 173), lower mortality with artemether compared to quinine closely correlated with faster reduction in plasma lactate concentration, with a high PTE of the relative change in plasma lactate at 8 and 12 hours of 0.81 and 0.75, respectively. In paediatric patients enrolled in the 'AQUAMAT' study with cerebral malaria (n = 785), mortality was lower with artesunate compared to quinine, but this was not associated with faster coma recovery. The relative changes in plasma lactate concentration assessed at 8 or 12 hours after admission are valid surrogate endpoints for severe malaria studies on antimalarial drugs or adjuvant treatments aiming at improving the microcirculation. Measures of coma recovery are not valid surrogate endpoints for mortality.

High dose phenobarbitone coma in pediatric refractory status epilepticus; a retrospective case record analysis, a proposed protocol and review of literature.

PubMed

Gulati, Sheffali; Sondhi, Vishal; Chakrabarty, Biswaroop; Jauhari, Prashant; Lodha, Rakesh; Sankar, Jhuma

2018-04-01

Ongoing refractory status epilepticus is associated with significant morbidity and mortality. Therapeutic coma induction with midazolam, thiopentone, phenobarbitone or propofol is indicated when conventional antiepileptics fail to abort seizure. Of these, the most extensively studied is midazolam. Amongst the remaining three, phenobarbitone has the most favourable pharmacological profile, but has not been studied adequately, more so in the pediatric age group. The current retrospective case records analysis is an attempt to describe use of phenobarbitone coma in pediatric refractory status epilepticus. Case records of patients, admitted with status epilepticus to the pediatric inpatient services of a tertiary care teaching hospital of North India between January 2014 and December 2016 were reviewed. Those with refractory status epilepticus who failed to respond to midaolam infusion and phenobarbitone coma was used were included for analysis. Overall, 108 children presented in status, of which 34 developed refractory status epilepticus. Of these 34, 21 responded to midazolam infusion and in 13 high dose phenobarbitone coma following a standardised protocol was used. Amongst these 13 (8 males and 5 females, median age 6 years, IQR: 2.5-9.5), 12 responded and 1 succumbed. The median time to clinical seizure resolution and desired electroencephalographic changes post phenobarbitone initiation were 16 (IQR: 12-25) and 72 h (IQR: 48-120) respectively. High dose phenobarbitone appears to be an effective therapeutic modality in pediatric refractory status epilepticus. The current study provides a protocol for its use which can be validated in future studies with larger sample size. Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Intubation is not a marker for coma after in-hospital cardiac arrest: A retrospective study.

PubMed

Berg, Katherine M; Grossestreuer, Anne V; Uber, Amy; Patel, Parth V; Donnino, Michael W

2017-10-01

In-hospital cardiac arrest (IHCA) strikes over 200,000 people in the United States annually. Targeted temperature management (TTM) is considered beneficial in other settings, but there is no prospective data for IHCA. Recent work on TTM and IHCA found an association between TTM and worse outcome. However, the authors used intubation as a marker for coma to determine eligibility for TTM. The validity of this approach is unexplored. Retrospective, single center study of adult patients with IHCA occurring in an intensive care unit, intubated prior to or during the event, or immediately after ROSC. We evaluated the percentage of patients documented as comatose after arrest, defined as Glasgow Comas Score (GCS) <8 for the primary analysis. We also evaluated the difference in hospital survival in patients with GCS <8 versus ≥8. Two sensitivity analyses using different methods for defining coma using post-ROSC GCS were conducted. 29/102 (28%) intubated patients had a post-ROSC GCS≥8, and 22 (22%) were documented as following commands. Survival in patients with GCS≥8 vs.<8 was 62% (18/29) vs. 37% (27/73) in unadjusted analysis (p=0.02). The adjusted odds ratio for survival to hospital discharge was 3.81 (95%CI: 1.37-10.61, p=0.01). Results were similar in both sensitivity analyses. Intubation prior to or during IHCA was not a valid marker of coma after ROSC. Post-ROSC mental status was associated with hospital survival, and thus could be an important confounder when conducting observational studies on the association of TTM with outcomes in this patient population. Copyright © 2017 Elsevier B.V. All rights reserved.

The Nature and Origin of UCDs in the Coma Cluster

NASA Astrophysics Data System (ADS)

Chiboucas, Kristin; Tully, R. Brent; Madrid, Juan; Phillipps, Steven; Carter, David; Peng, Eric

2018-01-01

UCDs are super massive star clusters found largely in dense regions but have also been found around individual galaxies and in smaller groups. Their origin is still under debate but currently favored scenarios include formation as giant star clusters, either as the brightest globular clusters or through mergers of super star clusters, themselves formed during major galaxy mergers, or as remnant nuclei from tidal stripping of nucleated dwarf ellipticals. Establishing the nature of these enigmatic objects has important implications for our understanding of star formation, star cluster formation, the missing satellite problem, and galaxy evolution. We are attempting to disentangle these competing formation scenarios with a large survey of UCDs in the Coma cluster. Using ACS two-passband imaging from the HST/ACS Coma Cluster Treasury Survey, we are using colors and sizes to identify the UCD cluster members. With a large size limited sample of the UCD population within the core region of the Coma cluster, we are investigating the population size, properties, and spatial distribution, and comparing that with the Coma globular cluster and nuclear star cluster populations to discriminate between the threshing and globular cluster scenarios. In previous work, we had found a possible correlation of UCD colors with host galaxy and a possible excess of UCDs around a non-central giant galaxy with an unusually large globular cluster population, both suggestive of a globular cluster origin. With a larger sample size and additional imaging fields that encompass the regions around these giant galaxies, we have found that the color correlation with host persists and the giant galaxy with unusually large globular cluster population does appear to host a large UCD population as well. We present the current status of the survey.

Deep X-ray and UV Surveys of Galaxies with Chandra, XMM-Newton, and GALEX

NASA Technical Reports Server (NTRS)

Hornschemeier, Ann

2006-01-01

Only with the deepest Chandra surveys has X-ray emission from normal and star forming galaxies (as opposed to AGN, which dominate the X-ray sky) been accessible at cosmologically interesting distances. The X-ray emission from accreting binaries provide a critical glimpse into the binary phase of stellar evolution and studies of the hot gas reservoir constrain past star formation. UV studies provide important, sensitive diagnostics of the young star forming populations and provide the most mature means for studying galaxies at 2 < zeta < 4. This talk will review current progress on studying X-ray emission in concert with UV emission from normal/star-forming galaxies at higher redshift. We will also report on our new, deep surveys with GALEX and XMM-Newton in the nearby Coma cluster. These studies are relevant to DEEP06 as Coma is the nearest rich cluster of galaxies and provides an important benchmark for high-redshift studies in the X-ray and UV wavebands. The 30 ks GALEX (note: similar depth to the GALEX Deep Imaging Survey) and the 110 ks XMM observations provide extremely deep coverage of a Coma outskirts field, allowing the construction of the UV and X-ray luminosity function of galaxies and important constraints on star formation scaling relations such as the X-ray-Star Formation Rate correlation and the X-ray/Stellar Mass correlation. We will discuss what we learn from these deep observations of Coma, including the recently established suppression of the X-ray emission from galaxies in the Coma outskirts that is likely associated with lower levels of past star formation and/or the results of tidal gas stripping.

Poor outcome prediction by burst suppression ratio in adults with post-anoxic coma without hypothermia.

PubMed

Yang, Qinglin; Su, Yingying; Hussain, Mohammed; Chen, Weibi; Ye, Hong; Gao, Daiquan; Tian, Fei

2014-05-01

Burst suppression ratio (BSR) is a quantitative electroencephalography (qEEG) parameter. The purpose of our study was to compare the accuracy of BSR when compared to other EEG parameters in predicting poor outcomes in adults who sustained post-anoxic coma while not being subjected to therapeutic hypothermia. EEG was registered and recorded at least once within 7 days of post-anoxic coma onset. Electrodes were placed according to the international 10-20 system, using a 16-channel layout. Each EEG expert scored raw EEG using a grading scale adapted from Young and scored amplitude-integrated electroencephalography tracings, in addition to obtaining qEEG parameters defined as BSR with a defined threshold. Glasgow outcome scales of 1 and 2 at 3 months, determined by two blinded neurologists, were defined as poor outcome. Sixty patients with Glasgow coma scale score of 8 or less after anoxic accident were included. The sensitivity (97.1%), specificity (73.3%), positive predictive value (82.5%), and negative prediction value (95.0%) of BSR in predicting poor outcome were higher than other EEG variables. BSR1 and BSR2 were reliable in predicting death (area under the curve > 0.8, P < 0.05), with the respective cutoff points being 39.8% and 61.6%. BSR1 was reliable in predicting poor outcome (area under the curve  =  0.820, P < 0.05) with a cutoff point of 23.9%. BSR1 was also an independent predictor of increased risk of death (odds ratio  =  1.042, 95% confidence intervals: 1.012-1.073, P  =  0.006). BSR may be a better predictor in prognosticating poor outcomes in patients with post-anoxic coma who do not undergo therapeutic hypothermia when compared to other qEEG parameters.

The cometary activity of Centaur P/2004 A1 (LONEOS)

NASA Astrophysics Data System (ADS)

Epifani, E. Mazzotta; Dall'Ora, M.; Perna, D.; Palumbo, P.; Colangeli, L.

2011-08-01

P/2004 A1 (LONEOS) is one of the few active objects in the dynamical class of Centaurs. It has been recently injected into an inner orbit with a perihelion distance q = 5.5 au. The aim of this paper is to characterize the dust coma of this peculiar object, 2.5 yr after its first 'new' perihelion passage inside the Solar system. Broad-band visible images taken at the TNG telescope in 2007 February were analysed in order to characterize the dust coma of the Centaur: it was still quite active at rh = 6.5 au post-perihelion, with a coma and a well-developed wide tail-like structure, with a measured R-Afρ= 162 ± 10 cm in an aperture radius ρ= 104 km. The (V - R) colour and the reddening values depict a scenario of a slightly red dust coma. A dust mass-loss rate of ? = 133 kg s-1 is derived from a photometric model, consistent with a scenario of a quite constant emission rate along the Centaur orbit. An upper limit for the Centaur radius of 3.5 km is derived by some realistic hypotheses on CO molecular production rate and on the mean grain scatterer size in the coma. Dynamical lifetime estimates compared to modelled loss rate result in a radius lower limit of 0.5 km, indicating therefore that the Centaur size is likely of the same order of magnitude of the short-period comets. Based on observations made at the Italian Telescopio Nazionale Galileo (TNG), operated on the island of La Palma by the Fundación Galileo Galilei of the INAF (Istituto Nazionale di Astrofisica) at the Spanish Observatorio del Roque de los Muchachos of the Instituto de Astrofísica de Canarias.

THE INNER COMA OF COMET C/2012 S1 (ISON) AT 0.53 AU AND 0.35 AU FROM THE SUN

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

Bonev, Boncho P.; Villanueva, Geronimo L.; Paganini, Lucas

2014-11-20

Using long-slit spectroscopy at the NASA Infrared Telescope Facility, we extracted H{sub 2}O production rates and spatial profiles of gas rotational temperature and molecular column abundance in comet C/2012 S1 ISON, observed at heliocentric distances of 0.53 and 0.35 AU. These measurements uniquely probed the physical environment in the inner collisional coma of this comet during its first (and last) approach to the Sun since being emplaced in the Oort Cloud some 4.5 billion years ago. Our observations revealed a comet evolving on various timescales, both over hours and days. At 0.35 AU, ISON showed a considerable decrease in water production ratemore » in less than 2 hr, likely declining from a major outburst. Our measured temperature spatial distributions reflect the competition between the processes that cause heating and cooling in the coma, and also provide insight about the prevalent mechanism(s) of releasing gas-phase H{sub 2}O. The observed temperatures suggest that the comet was likely ejecting icy material continuously, which sublimated in the coma and heated the ambient gas, augmenting fast H-atoms produced by H{sub 2}O photolysis. ISON adds to the very limited sample of comets for which spatial-spectral studies of water temperatures have been conducted. These studies are now feasible and can be extended to comets having a variety of gas production rates. Continued synergy of such observations with both space missions like Rosetta and with physical models is strongly encouraged in order to gain a deeper understanding of the processes in the inner collisional zone of the cometary coma.« less

Hyperammonemic Coma—Barking Up the Wrong Tree

PubMed Central

Kruzel-Davila, Eti; Dori, Guy; Baron, Elzbieta; Bitterman, Haim

2007-01-01

Hepatic encephalopathy and myxedema coma share clinical features: coma, ascites, anemia, impaired liver functions, and a “metabolic” electroencephalogram (EEG). Hyperammonemia, a hallmark of hepatic encephalopathy, has also been described in hypothyroidism. Differentiation between the 2 conditions, recognition of their possible coexistence, and the consequent therapeutic implications are of utmost importance. We describe a case of an 82-year-old woman with a history of mild chronic liver disease who presented with hyperammonemic coma unresponsive to conventional therapy. Further investigation disclosed severe hypothyroidism. Thyroid hormone replacement resulted in gain of consciousness and normalization of hyperammonemia. In patients with an elevated ammonia level, altered mental status, and liver disease, who do not have a clear inciting event for liver disease decompensation, overwhelming evidence of hepatic decompensation, or who do not respond to appropriate therapy for hepatic encephalopathy, hypothyroidism should be considered and evaluated. PMID:17372808

A Chemical Model of the Coma of Comet C/2009 P1 (Garradd)

NASA Astrophysics Data System (ADS)

Boice, Daniel C.; Kawakita, H.; Kobayashi, H.; Naka, C.; Phelps, L.

2012-10-01

Modeling is essential to understand the important physical and chemical processes that occur in cometary comae. Photochemistry is a major source of ions and electrons that further initiate key gas-phase reactions, leading to the plethora of molecules and atoms observed in comets. The effects of photoelectrons that react via impacts are important to the overall ionization. We identify the relevant processes within a global modeling framework to understand simultaneous observations in the visible and near-IR of Comet C/2009 (Garradd) and to provide valuable insights into the intrinsic properties of its nucleus. Details of these processes are presented in the collision-dominated, inner coma of the comet to evaluate the relative chemical pathways and the relationship between parent and sibling molecules. Acknowledgements: We appreciate support from the NSF Planetary Astronomy Program.

Influence of prayer and prayer habits on outcome in patients with severe head injury.

PubMed

Vannemreddy, Prasad; Bryan, Kris; Nanda, Anil

2009-01-01

The objective of the study is to evaluate the effect of prayers on the recovery of the unconscious patients admitted after traumatic brain injury. A retrospective study of patients with severe head injury was conducted. The Glasgow Coma Scale and Glasgow Outcome Scale scores were examined along with age, gender, smoking, and alcohol intake. There were 13 patients who received prayer and 13 who did not receive prayer during the hospital stay with almost identical mean Glasgow Coma Scale score. The prayer group stayed in the hospital for more days (P = .03). On multivariate analysis, patients' age (P = .01), admission Glasgow Coma Scale score (P = .009), and prayer habits (P = .007) were significant factors. Patients with prayers habits recovered better following severe head injury. The role of intercessory prayer needs further studies in larger groups.

Hypoplastic anaemia complicating myxoedema coma.

PubMed

Song, S H; McCallum, C J; Campbell, I W

1998-10-01

The case of a 68 year old women presenting in myxoedema coma is described. She was found to be anaemic with a haemoglobin of 8.2 g/dl. Further investigations showed a pancytopenia and a hypoplastic anaemia confirmed by bone marrow. The patient recovered and became euthyroid following initial treatment with intravenous tri-iodothyronine (T3) and later oral thyroxine (T4) replacement with resolution of pancytopenia and return of bone marrow to normal.

Isotopic analysis of cometary organic matter

NASA Technical Reports Server (NTRS)

Kerridge, John F.

1991-01-01

Carbon isotope ratios have been measured for CN in the coma of Comet Halley and for several CHON particles emitted by Halley. Of these, only the CHON-particle data may be reasonably related to organic matter in the cometary nucleus, but the true range of (C-13)/(C-12) values in those particles is quite uncertain. The D/H ratio in H2O in the Halley coma resembles that in Titan/Uranus.

CoMA: A high resolution Time-Of-Flight Secondary Ion Mass Spectrometer (TOF-SIMS) for in situ analysis of cometary matter

NASA Technical Reports Server (NTRS)

Zscheeg, Harry; Kissel, J.; Natour, G.

1992-01-01

A lot of clues concerning the origin of the solar system can be found by sending an exploring spacecraft to a rendezvous with a comet. The space experiment CoMA, which will measure the elemental, isotopic, and molecular composition of cometary dust grains is described. It will be flown on NASA's Comet Rendezvous Asteroid Flyby (CRAF) mission.

Radio-continuum survey of the Coma/A1367 supercluster. IV - 1.4 GHz observations of CGCG galaxies

NASA Astrophysics Data System (ADS)

del Castillo, E.; Gavazzi, G.; Jaffe, W.

1988-05-01

1.4 GHz radio-continuum observations of 148 CGCG galaxies in the Coma supercluster region were obtained with the VLA in C array configuration. Comparison with previous measurements at 0.6 GHz leads to an average spectral index >α< = 0.8. The structures of 29 galaxies in this region determined with high-resolution VLA (A array) observations are presented.

Vibrational and rotational excitation of CO in comets. Part 1: Non-equilibrium calculations. Part 2: Results of the calculation for standard bright comet, comet Iras-Araki-Alcock and comet Halley

NASA Technical Reports Server (NTRS)

Chin, G.; Weaver, H. A.

1984-01-01

The vibrational and rotational excitation of the CO molecule in cometary comae were investigated using a model which includes IR vibrational pumping by the solar flux, vibrational and rotational radiative decay, and collisional coupling among rotational states. Steady state was not assumed in solving the rate equations. The evolution of a shell of CO gas was monitored as it expanded from the nucleus into the outer coma. Collisional effects were treated using a kinetic temperature profile derived from theoretical work on the coma energy balance. The kinetic temperature was assumed to be extremely cold in the inner coma; this has significant consequences for the CO excitation. If optical depth effects are ignored, only low J transitions will be significantly excited in comets observed at high spatial resolution. Ground-based observations of CO co-vibrational and rotational transitions will be extremely difficult due to lack of sensitivity and/or terrestrial absorption. However, CO should be detectable from a large comet with favorable observing geometry if the CO is a parent molecule present at the 10% level (or greater) relative to H2O. Observations using cooled, spaceborne instruments should be capable of detecting CO emission from even moderately bright comets.

Factors associated with mortality of patients with myxoedema coma: prospective study in 11 cases treated in a single institution.

PubMed

Rodríguez, I; Fluiters, E; Pérez-Méndez, L F; Luna, R; Páramo, C; García-Mayor, R V

2004-02-01

This study was carried out to investigate the clinical and biochemical factors which might be of importance in predicting the outcome of patients with myxoedema coma. Eleven patients (ten female) aged 68.1+/-19.5 years attended our institution over a period of 18 years. Glasgow and APACHE II scores and serum free thyroxine and TSH were measured in all the patients on entry. Patients were selected at random to be treated with two different regimens of l-thyroxine. Four patients died with the mortality rate being 36.4%. The patients in coma at entry had significantly higher mortality rates than those with minor degrees of consciousness (75% vs 14.3% respectively, P=0.04). The surviving patients had significantly higher Glasgow scores than those who died (11.85+/-2.3 vs 5.25+/-2.2 respectively, P<0.001). Comparison of the mean values of APACHE II scores between the surviving group and those who died was significantly different (18.0+/-2.08 vs 31.5+/-2.08 respectively, P<0.0001). The degree of consciousness, the Glasgow score and the severity of the illness measured by APACHE II score on entry were the main factors that determined the post-treatment outcome of patients with myxoedema coma.

Synergistic regulation of competence development in Bacillus subtilis by two Rap-Phr systems.

PubMed

Bongiorni, Cristina; Ishikawa, Shu; Stephenson, Sophie; Ogasawara, Naotake; Perego, Marta

2005-07-01

The 11 Rap proteins of Bacillus subtilis comprise a conserved family of tetratricopeptide (TPR)-containing regulatory proteins. Their activity is inhibited by specific Phr pentapeptides produced from the product of phr genes through an export-import maturation process. We found that one of the proteins, namely RapF, is involved in the regulation of competence to DNA transformation. The ComA response regulator and transcription factor for initiation of competence development is the target of RapF. Specific binding of RapF to the carboxy-terminal DNA-binding domain of ComA inhibits the response regulator's ability to bind its target DNA promoters. The PhrF C-terminal pentapeptide, QRGMI, inhibits RapF activity. The activity of RapF and PhrF in regulating competence development is analogous to the previously described activity of RapC and PhrC (L. J. Core and M. Perego, Mol. Microbiol. 49:1509-1522, 2003). In fact, the RapF and PhrF pair of proteins acts synergistically with RapC and PhrC in the overall regulation of the ComA transcription factor. Since the transcription of the RapC- and RapF-encoding genes is positively regulated by their own target ComA, an autoregulatory circuit must exist for the competence transcription factor in order to modulate its activity.

Vibrational and rotational excitation of CO in comets. Part 1: Non-equilibrium calculations. Part 2: Results of the calculation for standard bright comet, comet Iras-Araki-Alcock and comet Halley

NASA Astrophysics Data System (ADS)

Chin, G.; Weaver, H. A.

1984-05-01

The vibrational and rotational excitation of the CO molecule in cometary comae were investigated using a model which includes IR vibrational pumping by the solar flux, vibrational and rotational radiative decay, and collisional coupling among rotational states. Steady state was not assumed in solving the rate equations. The evolution of a shell of CO gas was monitored as it expanded from the nucleus into the outer coma. Collisional effects were treated using a kinetic temperature profile derived from theoretical work on the coma energy balance. The kinetic temperature was assumed to be extremely cold in the inner coma; this has significant consequences for the CO excitation. If optical depth effects are ignored, only low J transitions will be significantly excited in comets observed at high spatial resolution. Ground-based observations of CO co-vibrational and rotational transitions will be extremely difficult due to lack of sensitivity and/or terrestrial absorption. However, CO should be detectable from a large comet with favorable observing geometry if the CO is a parent molecule present at the 10% level (or greater) relative to H2O. Observations using cooled, spaceborne instruments should be capable of detecting CO emission from even moderately bright comets.

Chemical Recycling of Molecules in Cometary Comae

NASA Astrophysics Data System (ADS)

Boice, Daniel C.; Kawakita, Hideyo; Shinnaka, Yoshiharu; Kobayashi, Hitomi

2015-08-01

Modeling is essential to understand the important physical and chemical processes that occur in cometary comae, especially the relationship between native and sibling molecules, such as, HCN and CN. Photochemistry is a major source of ions and electrons that further initiate key gas-phase reactions, leading to the plethora of molecules and atoms observed in comets. The effects of photoelectrons that react via impacts are important to the overall ionization in the inner coma. We have found that many molecules undergo protonation reactions with primarily water, followed by electron recombination resulting in the original molecules in a vibrationally excited state. These excited molecules spontaneously emit photons back to the ground state. We identify this series of reactions as chemical “recycling.” We discuss the importance of this mechanism for HCN, NH3, and water in comets. We also identify other relevant processes in the collision-dominated, inner coma of a comet within a global modeling framework to better understand observations and in situ measurements of cometary species, especially relationships between native and sibling molecules for the Rosetta Mission to Comet 67P/Churyumov-Gerasimenko.Acknowledgements: We appreciate support from the NSF Planetary Astronomy Program under Grant No. 0908529. This program is partially supported by the MEXT Supported Program for the Strategic Research Foundation at Private Universities, 2014-2018.

Immediate, irreversible, posttraumatic coma: a review indicating that bilateral brainstem injury rather than widespread hemispheric damage is essential for its production.

PubMed

Rosenblum, William I

2015-03-01

Traumatic brain injury may result in immediate long-lasting coma. Much attention has been given to predicting this outcome from the initial examination because these predictions can guide future treatment and interactions with the patient's family. Reports of diffuse axonal injury in these cases have ascribed the coma to widespread damage in the deep white matter that disconnects the hemispheres from the ascending arousal system (AAS). However, brainstem lesions are also present in such cases, and the AAS may be interrupted at the brainstem level. This review examines autopsy and imaging literature that assesses the presence, extent, and predictive value of lesions in both sites. The evidence suggests that diffuse injury to the deep white matter is not the usual cause of immediate long-lasting posttraumatic coma. Instead, brainstem lesions in the rostral pons or midbrain are almost always the cause but only if the lesions are bilateral. Moreover, recovery is possible if critical brainstem inputs to the AAS are spared. The precise localization of the latter is subject to ongoing investigation with advanced imaging techniques using magnets of very high magnetic gradients. Limited availability of this equipment plus the need to verify the findings continue to require meticulous autopsy examination.

Disconnection of the Ascending Arousal System in Traumatic Coma

PubMed Central

Edlow, Brian L.; Haynes, Robin L.; Takahashi, Emi; Klein, Joshua P.; Cummings, Peter; Benner, Thomas; Greer, David M.; Greenberg, Steven M.; Wu, Ona; Kinney, Hannah C.; Folkerth, Rebecca D.

2013-01-01

Traumatic coma is associated with disruption of axonal pathways throughout the brain but the specific pathways involved in humans are incompletely understood. In this study, we used high angular resolution diffusion imaging (HARDI) to map the connectivity of axonal pathways that mediate the 2 critical components of consciousness – arousal and awareness – in the postmortem brain of a 62-year-old woman with acute traumatic coma and in 2 control brains. HARDI tractography guided tissue sampling in the neuropathological analysis. HARDI tractography demonstrated complete disruption of white matter pathways connecting brainstem arousal nuclei to the basal forebrain and thalamic intralaminar and reticular nuclei. In contrast, hemispheric arousal pathways connecting the thalamus and basal forebrain to the cerebral cortex were only partially disrupted, as were the cortical “awareness pathways.” Neuropathologic examination, which utilized β-amyloid precursor protein and fractin immunomarkers, revealed axonal injury in the white matter of the brainstem and cerebral hemispheres that corresponded to sites of HARDI tract disruption. Axonal injury was also present within the grey matter of the hypothalamus, thalamus, basal forebrain, and cerebral cortex. We propose that traumatic coma may be a subcortical disconnection syndrome related to the disconnection of specific brainstem arousal nuclei from the thalamus and basal forebrain. PMID:23656993

A French validation study of the Coma Recovery Scale-Revised (CRS-R).

PubMed

Schnakers, Caroline; Majerus, Steve; Giacino, Joseph; Vanhaudenhuyse, Audrey; Bruno, Marie-Aurelie; Boly, Melanie; Moonen, Gustave; Damas, Pierre; Lambermont, Bernard; Lamy, Maurice; Damas, Francois; Ventura, Manfredi; Laureys, Steven

2008-09-01

The aim of the present study was to explore the concurrent validity, inter-rater agreement and diagnostic sensitivity of a French adaptation of the Coma Recovery Scale-Revised (CRS-R) as compared to other coma scales such as the Glasgow Coma Scale (GCS), the Full Outline of UnResponsiveness scale (FOUR) and the Wessex Head Injury Matrix (WHIM). Multi-centric prospective study. To test concurrent validity and diagnostic sensitivity, the four behavioural scales were administered in a randomized order in 77 vegetative and minimally conscious patients. Twenty-four clinicians with different professional backgrounds, levels of expertise and CRS-R experience were recruited to assess inter-rater agreement. Good concurrent validity was obtained between the CRS-R and the three other standardized behavioural scales. Inter-rater reliability for the CRS-R total score and sub-scores was good, indicating that the scale yields reproducible findings across examiners and does not appear to be systematically biased by profession, level of expertise or CRS-R experience. Finally, the CRS-R demonstrated a significantly higher sensitivity to detect MCS patients, as compared to the GCS, the FOUR and the WHIM. The results show that the French version of the CRS-R is a valid and sensitive scale which can be used in severely brain damaged patients by all members of the medical staff.

ON THE ELECTRON-TO-NEUTRAL NUMBER DENSITY RATIO IN THE COMA OF COMET 67P/CHURYUMOV–GERASIMENKO: GUIDING EXPRESSION AND SOURCES FOR DEVIATIONS

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

Vigren, E.; Eriksson, A. I.; Edberg, N. J. T.

2015-10-10

We compute partial photoionization frequencies of H{sub 2}O, CO{sub 2}, and CO, the major molecules in the coma of comet 67P/Churyumov–Gerasimenko, the target comet of the ongoing ESA Rosetta mission. Values are computed from Thermosphere Ionosphere Mesosphere Energy and Dynamics/Solar EUV Experiment solar EUV spectra for 2014 August 1, 2015 March 1, and for perihelion (2015 August, as based on prediction). From the varying total photoionization frequency of H{sub 2}O, as computed from 2014 August 1 to 2015 May 20, we derive a simple analytical expression for the electron-to-neutral number density ratio as a function of cometocentric and heliocentric distance. Themore » underlying model assumes radial movement of the coma constituents and does not account for chemical loss or the presence of electric fields. We discuss various effects/processes that can cause deviations between values from the analytical expression and actual electron-to-neutral number density ratios. The analytical expression is thus not strictly meant as predicting the actual electron-to-neutral number density ratio, but is useful in comparisons with observations as an indicator of processes at play in the cometary coma.« less

Analysis of nodal aberration properties in off-axis freeform system design.

PubMed

Shi, Haodong; Jiang, Huilin; Zhang, Xin; Wang, Chao; Liu, Tao

2016-08-20

Freeform surfaces have the advantage of balancing off-axis aberration. In this paper, based on the framework of nodal aberration theory (NAT) applied to the coaxial system, the third-order astigmatism and coma wave aberration expressions of an off-axis system with Zernike polynomial surfaces are derived. The relationship between the off-axis and surface shape acting on the nodal distributions is revealed. The nodal aberration properties of the off-axis freeform system are analyzed and validated by using full-field displays (FFDs). It has been demonstrated that adding Zernike terms, up to nine, to the off-axis system modifies the nodal locations, but the field dependence of the third-order aberration does not change. On this basis, an off-axis two-mirror freeform system with 500 mm effective focal length (EFL) and 300 mm entrance pupil diameter (EPD) working in long-wave infrared is designed. The field constant aberrations induced by surface tilting are corrected by selecting specific Zernike terms. The design results show that the nodes of third-order astigmatism and coma move back into the field of view (FOV). The modulation transfer function (MTF) curves are above 0.4 at 20 line pairs per millimeter (lp/mm) which meets the infrared reconnaissance requirement. This work provides essential insight and guidance for aberration correction in off-axis freeform system design.

Acute fatal posthypoxic leukoencephalopathy following benzodiazepine overdose: a case report and review of the literature.

PubMed

Aljarallah, Salman; Al-Hussain, Fawaz

2015-04-30

Among the rare neurological complications of substances of abuse is the selective cerebral white matter injury (leukoencephalopathy). Of which, the syndrome of delayed post hypoxic encephalopathy (DPHL) that follows an acute drug overdose, in addition to "chasing the dragon" toxicity which results from chronic heroin vapor inhalation remain the most commonly described syndromes of toxic leukoencephalopathy. These syndromes are reported in association with opioid use. There are very few cases in the literature that described leukoencephalopathy following benzodiazepines, especially with an acute and progressive course. In this paper, we present a patient who developed an acute severe fatal leukoencephalopathy following hypoxic coma and systemic shock induced by benzodiazepine overdose. A 19-year-old male was found comatose at home and brought to hospital in a deep coma, shock, hypoxia, and acidosis. Brain magnetic resonant imaging (MRI) revealed a strikingly selective white matter injury early in the course of the disease. The patient remained in a comatose state with no signs of neurologic recovery until he died few weeks later following an increase in the brain edema and herniation. Toxic leukoencephalopathy can occur acutely following an overdose of benzodiazepine and respiratory failure. This is unlike the usual cases of toxic leukoencephalopathy where there is a period of lucidity between the overdose and the development of white matter disease. Unfortunately, this syndrome remains of an unclear pathophysiology and with no successful treatment.

A new hypothesis on the manifestation of cerebral malaria: the secret is in the liver.

PubMed

Martins, Yuri Chaves; Daniel-Ribeiro, Cláudio Tadeu

2013-11-01

Despite the abundance of information on cerebral malaria (CM), the pathogenesis of this disease is not completely understood. At present, two nonexclusive dominant hypotheses exist to explain how the neurological syndrome manifests: the sequestration (or mechanical) hypothesis and the inflammatory hypothesis. The sequestration hypothesis states that sequestration of Plasmodium falciparum-parasitized red blood cells (pRBCs) to brain capillary endothelia causes obstruction of capillary blood flow followed by brain tissue anoxia and coma. The inflammatory hypothesis postulates that P. falciparum infection releases toxic molecules in the circulation, inducing an imbalanced systemic inflammatory response that leads to coagulopathy, brain endothelial cell dysfunction, accumulation of leukocytes in the brain microcirculation, blood brain barrier (BBB) leakage, cerebral vasoconstriction, edema, and coma. However, both hypotheses, even when considered together, are not sufficient to fully explain the pathogenesis of CM. Here, we propose that the development of acute liver failure (ALF) together with BBB breakdown are the necessary and sufficient conditions for the genesis of CM. ALF is characterized by coagulopathy and hepatic encephalopathy (HE) in a patient without pre-existing liver disease. Signs of hepatic dysfunction have been shown to occur in 2.5-40% of CM patients. In addition, recent studies with murine models demonstrated that mice presenting experimental cerebral malaria (ECM) had hepatic damage and brain metabolic changes characteristic of HE. However, the occurrence of CM in patients with mild or without apparent hepatocellular liver damage and the presence of liver damage in non-CM murine models indicate that the development of ALF during malaria infection is not the single factor responsible for neuropathology. To solve this problem, we also propose that BBB breakdown contributes to the pathogenesis of CM and synergizes with hepatic failure to cause neurological signs and symptoms. BBB dysfunction would thus occur in CM by a mechanism similar to the one occurring in sepsis and is in agreement with the inflammatory hypothesis. Nevertheless, differently from in the inflammatory hypothesis, BBB leakage would facilitate the penetration of ammonia and other toxins into the brain parenchyma, but would not be sufficient to cause CM when occurring alone. We believe our hypothesis better explains the pathogenesis of CM, does not have problems to deal with the exception data not explained by the previous hypotheses, and reveals new targets for adjunctive therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Physical observations of comets: Their composition, origin and evolution

NASA Technical Reports Server (NTRS)

Cochran, Anita L.; Barker, Edwin S.; Cochran, William D.

1991-01-01

The composition, origins, and evolution of comets were studied. The composition was studied using spectroscopic observations of primarily brighter comets at moderate and high resolution for the distribution of certain gases in the coma. The origins was addressed through an imaging search for the Kuiper belt of comets. The evolution was addressed by searching for a link between comets and asteroids using an imaging approach to search for an OH coma.

MIRO Computational Model

NASA Technical Reports Server (NTRS)

Broderick, Daniel

2010-01-01

A computational model calculates the excitation of water rotational levels and emission-line spectra in a cometary coma with applications for the Micro-wave Instrument for Rosetta Orbiter (MIRO). MIRO is a millimeter-submillimeter spectrometer that will be used to study the nature of cometary nuclei, the physical processes of outgassing, and the formation of the head region of a comet (coma). The computational model is a means to interpret the data measured by MIRO. The model is based on the accelerated Monte Carlo method, which performs a random angular, spatial, and frequency sampling of the radiation field to calculate the local average intensity of the field. With the model, the water rotational level populations in the cometary coma and the line profiles for the emission from the water molecules as a function of cometary parameters (such as outgassing rate, gas temperature, and gas and electron density) and observation parameters (such as distance to the comet and beam width) are calculated.

Physical processes in comets

NASA Technical Reports Server (NTRS)

Whipple, F. L.; Huebner, W. F.

1976-01-01

The paper discusses physical processes in comets which involve solar and nuclear radial forces that affect the motions of gases and icy grains, gas-phase chemistry very close to the nuclei of large comets near the sun, sublimation of icy grains, dissociation of parent molecules into radicals and of radicals into atoms, and ionization by sunlight and collisions. The composition and dimensions of nuclei are examined along with variations in intrinsic brightness, the nature of volatiles, gas production rates in the coma, characteristics of icy grains in the coma, and the structure of streamers, ion tails, and dust tails. The structure of the coma is described in detail on the basis of spectroscopic observations of several comets. The origin of comets is briefly reviewed together with the relation of comets to earth, the interplanetary complex, and the interstellar medium. Desirable future observations are noted, especially by space missions to comets.

The atmosphere of a dirty-clathrate cometary nucleus - A two-phase, multifluid model

NASA Astrophysics Data System (ADS)

Marconi, M. L.; Mendis, D. A.

1983-10-01

The dynamical and thermal structure of a dirty-clathrate cometary nucleus' gas atmosphere is presently given a self-consistent, transonic multifluid solution in which, although the heavy neutron and ion species are treated as a single fluid in the collision-dominated region, the photoproduced H is treated separately. The thermal profile of the atmosphere thus obtained is entirely different from those predicted by the earlier, single-fluid models as well as the multifluid models which assumed equipartition of energy between electrons and ions. While the electron gas, like the neutrals and the ions, cools due to expansion, its main mode of energy loss in the inner coma is by way of inelastic collisions with the predominant H2O molecule. The high electron temperature in the outer coma also decreases the efficiency of electron removal by dissociative recombination, thereby increasing electron density throughout the coma.

Spectroscopic studies of the molecular parentage of radical species in cometary comae

NASA Astrophysics Data System (ADS)

Lewis, Benjamin; Pierce, Donna; Cochran, Anita

2015-11-01

We have observed several comets using an integral-field unit spectrograph (the George and Cynthia Mitchell Spectrograph) on the 2.7m Harlan J. Smith telescope at McDonald Observatory. Full-coma spectroscopic images were obtained for various radical species (C2, C3, CH, CN, NH2). By constructing azimuthal average profiles from the full-coma spectroscopic images we can test Haser model parameters with our observations. The Haser model was used to determine production rates and possible parent lifetimes that would be consistent with the model. By iterating through a large range of possible parents lifetimes, we can see what range of values in which the Haser model is consistent with observations. Also, this type of analysis gives us perspective on how sensitive the model's fit quality is to changes in parent lifetimes. Here, we present the work completed to date, and we compare our results to other comet taxonomic surveys.

Myxoedema coma in the setting of hyperglycaemic hyperosmolar state

PubMed Central

Spyridoulias, Alexander; Riaz, Muhammad Shakeel

2016-01-01

Decompensated hypothyroidism is a rare endocrine emergency but a differential that should be considered in patients presenting critically unwell with systemic illness. We report a case of myxoedema coma in a woman presenting with respiratory failure, hypotension, hypothermia and a reduced level of consciousness, all of which are poor prognostic features in decompensated hypothyroidism. The patient was admitted to critical care for mechanical ventilation and cardiovascular support and treated with a combination of insulin, liothyronine and levothyroxine, making a good recovery. We wanted to highlight this case of myxoedema coma occurring in the context of a hyperglycaemic hyperosmolar state (HHS), as the former condition is normally associated with hypoglycaemia, hyponatraemia and hypo-osmolality. Decompensated hypothyroidism should be considered in presentations of HHS as well as with other metabolic derangements, as delays in thyroid hormone replacement are associated with poorer outcomes. It has multisystem effects challenging its recognition and we discuss potential complications and their management. PMID:26759401

[Rare consciousness disturbances in toxicological practice: akinetic mutism, somnambulism, locked-in syndrome, and psychogenic coma].

PubMed

Ciszowski, Krzysztof; Mietka-Ciszowska, Aneta

2013-01-01

The toxicity of xenobiotics can result inrare disorders of consciousness, such as akinetic mutism and somnambulism as well as syndromes mimicking consciousness disturbances, such as locked-in syndrome and psychogenic coma. Akinetic mutism is a condition characterized by a lack of spontaneous movements and little or no vocalization. Somnambulism include performing of complex motor activity in an automatic manner during deep sleep, without any awareness of its execution. The locked-in syndrome is a state with quadriplegia coexisting with cranial nerves palsies and mutism, but with fully preserved consciousness. Psychogenic coma is a condition in which the patient has preserved level of consciousness and awareness, but does not communicate with theenvironment and does not exhibit the external manifestations of consciousness. This paper presents the etiology, clinical characteristics, as well as diagnostic and therapeutic issues for the above syndromes.

Hypoxic coma as a strategy to survive inundation in a salt-marsh inhabiting spider

PubMed Central

Pétillon, Julien; Montaigne, William; Renault, David

2009-01-01

Spiders constitute a major arthropod group in regularly inundated habitats. Some species survive a flooding period under water. We compared survival during both submersion and a recovery period after submersion, in three stenotopic lycosids: two salt-marsh species Arctosa fulvolineata and Pardosa purbeckensis, and a forest spider Pardosa lugubris. Both activity and survival rates were determined under controlled laboratory conditions by individually surveying 120 females kept submerged in sea water. We found significant differences between the three species, with the two salt-marsh spiders exhibiting higher survival abilities. To our knowledge, this study reports for the first time the existence of a hypoxic coma caused by submersion, which is most pronounced in A. fulvolineata, the salt-marsh spider known to overcome tidal inundation under water. Its ability to fall into that coma can therefore be considered a physiological adaptation to its regularly inundated habitat. PMID:19411268

Physical process in the coma of comet 67P derived from narrowband imaging of fragment species

NASA Astrophysics Data System (ADS)

Perez Lopez, F.; Küppers, M.; Marín-Yaseli de la Parra, J.; Besse, S.; Moissl, R.

2017-09-01

During the rendezvous of the Rosetta spacecraft with comet 67P/Churyumov-Gerasimenko, the OSIRIS scientific cameras monitored the near-nucleus gas environment in various narrow-band filters, observing various fragment species. It turned out that the excitation processes in the innermost coma are significantly different from the overall coma, as observed from the ground [1]. In particular, some of the observed emissions of fragments (daughter molecules) are created by direct dissociation of parent molecules, and in those cases the spatial distribution of the emission directly maps the distribution of parent molecules. We investigate the evolution of the brightness and distribution of the emissions over time to improve our understanding of the underlying emission mechanisms and to derive the spatial distribution of H2O and CO2. The outcome will provide constraints on the homogeneity of the cometary nucleus.

[Hysterical pseudo-coma: A case report].

PubMed

Chouaib, N; Chouaib, H; Belyamani, L; Otheman, Y; Bichra, M Z

2015-09-01

Hysterical pseudo-coma corresponds to a state of clinical sleep with contrasting waking electroencephalogram. It can last several hours or even several days in the absence of an underlying organic disease. In psychiatry, this disorder is currently part of the "dissociative disorder not otherwise specified". Through this case report, we describe the evolution of a hysterical pseudo-coma that lasted four days in a 28-year-old man. The normality of biological, radiological and electroencephalographic assessments, and responsiveness of the patient during the implementation of a nasogastric tube, led us to suspect a mental origin. An adapted psychiatric care allowed the patient to recover his autonomy after three days of hospitalization. This had prevented the escalation of explorations and invasive treatments. However, the search for organic comorbidity and its management remains a priority. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

A post-Rosetta understanding of polarimetric observations of comets

NASA Astrophysics Data System (ADS)

Levasseur-Regourd, A. Chantal; Ciarletti, Valérie; Hadamcik, Edith; Lasue, Jérémie; Mannel, Thurid

2017-04-01

Numerous polarimetric observations of solar light scattered by dust in cometary comae have been obtained by various teams, providing phase angle and wavelength dependences for many comets and revealing different classes of comets [e.g., 1]. Besides, numerical and experimental simulations have suggested interpretations for such observations. The Rosetta long duration rendezvous with comet 67P/Churyumov-Gerasimenko (thereafter 67P/C-G) now allows us to compare our understanding of the polarimetric properties of cometary dust with the ground-truth provided by the Rosetta mission, at least for two typical results. First, some comets present a highly-polarized positive branch, the most conspicuous case being that of new comet C/1995 O1 Hale-Bopp [2], while other comets suffering a partial fragmentation or a total disruption, such as C/1995 S4 LINEAR [3], present a significant increase in polarization. We will discuss these observations in the context of evidence for changes between the porosity (and possibly the dust/ice ratio) of the subsurface and of the interior of 67P/C-G, a periodic Jupiter Family Comet, as derived from analyses [4] of the CONSERT bi-static radar measurements on board Rosetta and Philae. Secondly, numerical simulations of the phase and wavelength dependence of polarimetric observations of some comets (extensively observed on a wide range of wavelengths and phase angles) have suggested the presence of fractal, likely-porous aggregates and of compact particles within their comae [e.g., 5]. We will review such results in the context of evidence for porous and compact aggregates of submicron-sized grains in the inner coma of 67P/C-G [6], as given by 3D images (with a resolution down to tens of nanometers) of the MIDAS atomic force microscope on board Rosetta. References: [1] Kiselev et al., 2015, In Polarization of stars and planetary systems, CUP 379-404. [2] Levasseur-Regourd & Hadamcik, 2003, JQSRT 79-80, 903-910. [3] Hadamcik & Levasseur-Regourd, 2003, Icarus 166, 188-194. [4] Ciarletti et al., 2015, Astron. Astrophys. 583, A40. [5] Lasue et al., 2009, Icarus 199, 129-144. [6] Mannel et al., 2016, MNRAS 462, S 304-S311.

Modeling of the Inner Coma of Comet 67P/Churyumov-Gerasimenko Constrained by VIRTIS and ROSINA Observations

NASA Astrophysics Data System (ADS)

Fougere, N.; Combi, M. R.; Tenishev, V.; Bieler, A. M.; Migliorini, A.; Bockelée-Morvan, D.; Toth, G.; Huang, Z.; Gombosi, T. I.; Hansen, K. C.; Capaccioni, F.; Filacchione, G.; Piccioni, G.; Debout, V.; Erard, S.; Leyrat, C.; Fink, U.; Rubin, M.; Altwegg, K.; Tzou, C. Y.; Le Roy, L.; Calmonte, U.; Berthelier, J. J.; Rème, H.; Hässig, M.; Fuselier, S. A.; Fiethe, B.; De Keyser, J.

2015-12-01

As it orbits around comet 67P/Churyumov-Gerasimenko (CG), the Rosetta spacecraft acquires more information about its main target. The numerous observations made at various geometries and at different times enable a good spatial and temporal coverage of the evolution of CG's cometary coma. However, the question regarding the link between the coma measurements and the nucleus activity remains relatively open notably due to gas expansion and strong kinetic effects in the comet's rarefied atmosphere. In this work, we use coma observations made by the ROSINA-DFMS instrument to constrain the activity at the surface of the nucleus. The distribution of the H2O and CO2 outgassing is described with the use of spherical harmonics. The coordinates in the orthogonal system represented by the spherical harmonics are computed using a least squared method, minimizing the sum of the square residuals between an analytical coma model and the DFMS data. Then, the previously deduced activity distributions are used in a Direct Simulation Monte Carlo (DSMC) model to compute a full description of the H2O and CO2 coma of comet CG from the nucleus' surface up to several hundreds of kilometers. The DSMC outputs are used to create synthetic images, which can be directly compared with VIRTIS measurements. The good agreement between the VIRTIS observations and the DSMC model, itself constrained with ROSINA data, provides a compelling juxtaposition of the measurements from these two instruments. Acknowledgements Work at UofM was supported by contracts JPL#1266313, JPL#1266314 and NASA grant NNX09AB59G. Work at UoB was funded by the State of Bern, the Swiss National Science Foundation and by the ESA PRODEX Program. Work at Southwest Research institute was supported by subcontract #1496541 from the JPL. Work at BIRA-IASB was supported by the Belgian Science Policy Office via PRODEX/ROSINA PEA 90020. The authors would like to thank ASI, CNES, DLR, NASA for supporting this research. VIRTIS was built by a consortium formed by Italy, France and Germany, under the scientific responsibility of the IAPS of INAF, which guides also the scientific operations. The consortium includes also the LESIA of the Observatoire de Paris, and the Institut für Planetenforschung of DLR. The authors wish to thank the RSGS and the RMOC for their continuous support.

Modeling of the VIRTIS-M Observations of the Coma of Comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Fougere, Nicolas; Combi, Michael R.; Tenishev, Valeriy; Bieler, Andre; Migliorini, Alessandra; Piccioni, Giuseppe; Capaccioni, Fabrizio; Filacchione, Gianrico; Toth, Gabor; Huang, Zhenguang; Gombosi, Tamas; Hansen, Kenneth; Bockelee-Morvan, Dominique; Debout, Vincent; Erard, Stephane; Leyrat, Cedric; Fink, Uwe; Rubin, Martin; Altwegg, Kathrin; Tzou, Chia-Yu; Le Roy, Lena; Calmonte, Ursina; Berthelier, Jean-Jacques; Reme, Henri; Hassig, Myrtha; Fuselier, Stephen; Fiethe, Bjorn; De Keyser, Johan

2015-11-01

The recent images of the inner coma of 67P/Churyumov-Gerasimenko (CG) made by the infrared channel of the VIRTIS-M instrument on board the Rosetta spacecraft show the gas distribution as it expands in the coma (Migliorini et al. 2015, DPS abstract).Since VIRTIS is a remote sensing instrument, a proper modeling of these observations requires the computation of the full coma of comet CG, which necessitates the use of a kinetic approach due to the rather low gas densities. Hence, we apply a Direct Simulation Monde Carlo (DSMC) method to solve the Boltzmann equation and describe CG’s coma from the nucleus surface up to a few hundreds of kilometers. The model uses the SHAP5 nucleus shape model from the OSIRIS team. The gas flux distribution takes into account solar illumination, including self-shadowing. The local activity at the surface of the nucleus is given by spherical harmonics expansion reproducing best the ROSINA-DFMS data. The densities from the DSMC model outputs are then integrated along the line-of-sight to create synthetic images that are directly comparable with the VIRTIS-M column density measurements.The good agreement between the observations and the model illustrates our continuously improving understanding of the physics of the coma of comet CG.AcknowledgementsWork at UofM was supported by contracts JPL#1266313, JPL#1266314 and NASA grant NNX09AB59G. Work at UoB was funded by the State of Bern, the Swiss National Science Foundation and by the European Space Agency PRODEX Program. Work at Southwest Research institute was supported by subcontract #1496541 from the JPL. Work at BIRA-IASB was supported by the Belgian Science Policy Office via PRODEX/ROSINA PEA 90020. The authors would like to thank ASI, CNES, DLR, NASA for supporting this research. VIRTIS was built by a consortium formed by Italy, France and Germany, under the scientific responsibility of the IAPS of INAF, which guides also the scientific operations. The consortium includes also the LESIA of the Observatoire de Paris, and the Institut für Planetenforschung of DLR. The authors wish to thank the RSGS and the RMOC for their continuous support.

Spatial and Temporal Variations of Atomic Species in the Coma of Comet 67P/Churyumov-Gerasimenko as Observed by Rosetta’s ALICE UV Spectrograph during Great Circle Scans

NASA Astrophysics Data System (ADS)

Knight, Matthew M.; Weaver, Harold A.; Vervack, Ronald J.; A'Hearn, Michael; Bertaux, Jean-Loup; Feaga, Lori M.; Feldman, Paul D.; Parker, Joel Wm.; Schindhelm, Eric; Steffl, Andrew J.; Stern, S. Alan; Bieler, Andre; Combi, Michael R.; Fougere, Nicolas; Keeney, Brian A.; Medina, Richard; Noonan, John; Pineau, Jon; Versteeg, Maarten H.

2017-10-01

The Alice far-ultraviolet (FUV) imaging spectrograph on the Rosetta orbiter obtained spatially resolved spectra of 67P/Churyumov-Gerasimenko (67P) from 700-2050 Å with a spectral resolution of 8-12 Å. Observations of 67P were obtained by Alice continually from arrival at the comet in August 2014 through the end of the mission in September 2016. “Great Circle” observations were performed every few weeks from January 2015 through May 2016 to survey the coma away from the nucleus. These sequences consisted of a series of slews along a celestial great circle passing through the nucleus, e.g., covering off-nadir angles from approximately 0-180°, with pauses for observations by Alice and other instruments. Alice’s line of sight during these scans included signal to the edge of the coma, thus sampling very different parts of the coma than most other instruments.We report here on observations acquired during these Great Circle scans that allow us to investigate the spatial distributions of various emissions, as well as seasonal variations in the coma composition. Bright lines consistently included H Ly-b, the OI triplet near 1304 Å, CI near 1657 Å, and the SI triplet near 1820 Å. Spatial distributions of the OI, CI, and SI brightnesses have been determined and are being fitted with Haser models. The process is more complicated than for traditional remote sensing FUV observations due to Rosetta’s location in the coma and because resonant scattering does not always dominate the excitation. Preliminary modeling yields H2O and CO2 production rates consistent with contemporaneous measurements obtained by other instruments on Rosetta and production rates that generally peak a few weeks after perihelion. A surprising phenomenon is a slight increase in OI brightness at large off-nadir angles for some Great Circles while the other measured emissions continue to decrease. We are investigating possible explanations.Rosetta is an ESA mission with contributions from its member states and NASA. The Alice team acknowledges continuing support from NASA’s Jet Propulsion Laboratory through contract 1336850 to the Southwest Research Institute.

Robust control of burst suppression for medical coma

NASA Astrophysics Data System (ADS)

Westover, M. Brandon; Kim, Seong-Eun; Ching, ShiNung; Purdon, Patrick L.; Brown, Emery N.

2015-08-01

Objective. Medical coma is an anesthetic-induced state of brain inactivation, manifest in the electroencephalogram by burst suppression. Feedback control can be used to regulate burst suppression, however, previous designs have not been robust. Robust control design is critical under real-world operating conditions, subject to substantial pharmacokinetic and pharmacodynamic parameter uncertainty and unpredictable external disturbances. We sought to develop a robust closed-loop anesthesia delivery (CLAD) system to control medical coma. Approach. We developed a robust CLAD system to control the burst suppression probability (BSP). We developed a novel BSP tracking algorithm based on realistic models of propofol pharmacokinetics and pharmacodynamics. We also developed a practical method for estimating patient-specific pharmacodynamics parameters. Finally, we synthesized a robust proportional integral controller. Using a factorial design spanning patient age, mass, height, and gender, we tested whether the system performed within clinically acceptable limits. Throughout all experiments we subjected the system to disturbances, simulating treatment of refractory status epilepticus in a real-world intensive care unit environment. Main results. In 5400 simulations, CLAD behavior remained within specifications. Transient behavior after a step in target BSP from 0.2 to 0.8 exhibited a rise time (the median (min, max)) of 1.4 [1.1, 1.9] min; settling time, 7.8 [4.2, 9.0] min; and percent overshoot of 9.6 [2.3, 10.8]%. Under steady state conditions the CLAD system exhibited a median error of 0.1 [-0.5, 0.9]%; inaccuracy of 1.8 [0.9, 3.4]%; oscillation index of 1.8 [0.9, 3.4]%; and maximum instantaneous propofol dose of 4.3 [2.1, 10.5] mg kg-1. The maximum hourly propofol dose was 4.3 [2.1, 10.3] mg kg-1 h-1. Performance fell within clinically acceptable limits for all measures. Significance. A CLAD system designed using robust control theory achieves clinically acceptable performance in the presence of realistic unmodeled disturbances and in spite of realistic model uncertainty, while maintaining infusion rates within acceptable safety limits.

Robust control of burst suppression for medical coma

PubMed Central

Westover, M Brandon; Kim, Seong-Eun; Ching, ShiNung; Purdon, Patrick L; Brown, Emery N

2015-01-01

Objective Medical coma is an anesthetic-induced state of brain inactivation, manifest in the electroencephalogram by burst suppression. Feedback control can be used to regulate burst suppression, however, previous designs have not been robust. Robust control design is critical under real-world operating conditions, subject to substantial pharmacokinetic and pharmacodynamic parameter uncertainty and unpredictable external disturbances. We sought to develop a robust closed-loop anesthesia delivery (CLAD) system to control medical coma. Approach We developed a robust CLAD system to control the burst suppression probability (BSP). We developed a novel BSP tracking algorithm based on realistic models of propofol pharmacokinetics and pharmacodynamics. We also developed a practical method for estimating patient-specific pharmacodynamics parameters. Finally, we synthesized a robust proportional integral controller. Using a factorial design spanning patient age, mass, height, and gender, we tested whether the system performed within clinically acceptable limits. Throughout all experiments we subjected the system to disturbances, simulating treatment of refractory status epilepticus in a real-world intensive care unit environment. Main results In 5400 simulations, CLAD behavior remained within specifications. Transient behavior after a step in target BSP from 0.2 to 0.8 exhibited a rise time (the median (min, max)) of 1.4 [1.1, 1.9] min; settling time, 7.8 [4.2, 9.0] min; and percent overshoot of 9.6 [2.3, 10.8]%. Under steady state conditions the CLAD system exhibited a median error of 0.1 [−0.5, 0.9]%; inaccuracy of 1.8 [0.9, 3.4]%; oscillation index of 1.8 [0.9, 3.4]%; and maximum instantaneous propofol dose of 4.3 [2.1, 10.5] mg kg−1. The maximum hourly propofol dose was 4.3 [2.1, 10.3] mg kg−1 h−1. Performance fell within clinically acceptable limits for all measures. Significance A CLAD system designed using robust control theory achieves clinically acceptable performance in the presence of realistic unmodeled disturbances and in spite of realistic model uncertainty, while maintaining infusion rates within acceptable safety limits. PMID:26020243

Hypothyroidism and myxedema coma.

PubMed

Finora, Kevin; Greco, Deborah

2007-01-01

Hypothyroidism is a common endocrinopathy in dogs but is rare in cats. Lymphocytic thyroiditis and idiopathic thyroid atrophy are common causes of this condition. Specific thyroid function tests, in conjunction with clinical signs and physical examination findings, are used to help confirm a diagnosis of hypothyroidism. This disease can be managed with synthetic hormone supplementation and has an excellent prognosis. Myxedema coma is a rare and potentially fatal manifestation of severe hypothyroidism that can be successfully treated using intravenous levothyroxine.

Complete paralytic botulism mimicking a deep coma in a child.

PubMed

Azapağası, Ebru; Kendirli, Tanıl; Öz-Tuncer, Gökçen; Albayrak, Pelin; Teber, Serap; Deda, Gülhis

2017-01-01

Botulism is a rare cause of neuroparalysis. Delay in diagnosis and treatment exerts adverse impact on mortality and morbidity. We report a child with complete flaccid paralysis followed by progression to coma-like consciousness. The patient required mechanical ventilation. As serological tests could not be performed, detailed history and physical examinations led to the suspicion of botulism, and repetitive nerve stimulation tests supported the diagnosis. Botulinum antitoxin was administered. The patient`s neuromuscular function improved rapidly.

Strategy for infrared photometry of comets with ISO

NASA Astrophysics Data System (ADS)

Solc, M.; Vanysek, V.; Gruen, E.

1994-07-01

The launch of the ISO (Infrared Satellite Observatory) by the European Space Agency is scheduled for autumn 1995. Photometry and spectrophotometry observing programs of comets in the wavelength range 2.5-200 microns for the onboard spectrophotometer ISOPHOT is now under final preparation. Technical details for preparing propasals are given. Phenomena in comets to be studied are surface properties of bare cometary nuclei at large heliocentric distances, onset of coma activity, and coma dust and gas emission (in inner solar system). Dust production, dust/gas mass ratio, dust distribution in coma, and their temporal variability are important for understanding the physical processes on nuclei, and spectrophotometry in the range of 2.5-12 microns could provide us with data of the chemical composition of cometary dust. Several active comets expected for the 18-month lifetime of ISO in 1995-1997 were selected for the ISO Central Program according to their orbital and physical parameters: P/Schwassman-Wachmann 1, P/Encke, P/d'Arrest, P/Honda-Mrkos-Pajdusakova, P/Churyumov-Gerasimenko, P/Kopff, P/IRAS, P/Wirtanen, P/Wild 2, P/Grigg-Skjellerup, P/Schwassman-Wachmann 3, P/Machholz, and (2060) Chiron. Four of them match well various constraints put on the observations by the technical arrangement of the satellite and instrument. A simple four-parameter model (size, albedo, rotation, optical thickness)was developed to estimate the temperatures and thermal fluxes of both solid nuclei and dust coma.

The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility.

PubMed

Giacino, Joseph T; Kalmar, Kathleen; Whyte, John

2004-12-01

To determine the measurement properties and diagnostic utility of the JFK Coma Recovery Scale-Revised (CRS-R). Analysis of interrater and test-retest reliability, internal consistency, concurrent validity, and diagnostic accuracy. Acute inpatient brain injury rehabilitation hospital. Convenience sample of 80 patients with severe acquired brain injury admitted to an inpatient Coma Intervention Program with a diagnosis of either vegetative state (VS) or minimally conscious state (MCS). Not applicable. The CRS-R, the JFK Coma Recovery Scale (CRS), and the Disability Rating Scale (DRS). Interrater and test-retest reliability were high for CRS-R total scores. Subscale analysis showed moderate to high interrater and test-retest agreement although systematic differences in scoring were noted on the visual and oromotor/verbal subscales. CRS-R total scores correlated significantly with total scores on the CRS and DRS indicating acceptable concurrent validity. The CRS-R was able to distinguish 10 patients in an MCS who were otherwise misclassified as in a VS by the DRS. The CRS-R can be administered reliably by trained examiners and repeated measurements yield stable estimates of patient status. CRS-R subscale scores demonstrated good agreement across raters and ratings but should be used cautiously because some scores were underrepresented in the current study. The CRS-R appears capable of differentiating patients in an MCS from those in a VS.

An extended source for CN jets in Comet P/Halley

NASA Technical Reports Server (NTRS)

Klavetter, James Jay; A'Hearn, Michael F.

1994-01-01

We examined radial intensity profiles of CN jets in comparison with the diffuse, isotropic component of the CN coma of Comet P/Halley. All images were bias-subtracted, flat-fielded, and continuum-subtracted. We calculated the diffuse profiles by finding the azimuthal mean of the coma least contaminated by jets yielding profiles similar to those of vectorial and Haser models of simple photodissociation. We found the jet profiles by calculating a mean around a Gaussian-fitted center in r-theta space. There is an unmistakable difference between the profiles of the CN jets and the profiles of the diffuse CN. Spatial derivatives of these profiles, corrected for geometrical expansion, show that the diffuse component is consistent with a simple photodissociation process, but the jet component is not. The peak production of the jet profile occurs 6000 km from the nucleus at a heliocentric distance of 1.4 AU. Modeling of both components of the coma indicate results that are consistent with the diffuse CN photochemically produced, but the CN jets need an additional extended source. We found that about one-half of the CN in the coma of Comet P/Halley originated from the jets, the rest from the diffuse component. These features, along with the width of the jet being approximately constant, are consistent with a CHON grain origin for the jets.

Medical problems related to recreational drug use at nocturnal dance parties.

PubMed

Van Sassenbroeck, Diederik K; Calle, Paul A; Rousseau, Filip M; Verstraete, Alain G; Belpaire, Frans M; Monsieurs, Koenraad G; Haentjens, Raoul; Allonsius, Jacques; Van Brantegem, Jean; Haenen, Wim; Buylaert, Walter A

2003-12-01

During 'I love techno' (edition 2001), an indoor rave party attended by 37 000 people, data about medical problems (especially drug-related problems) were collected. To place these data in a wider perspective, a similar registration was done during 'De Nacht', a traditional New Year's Eve dance party held at the same location and attended by 12 000 people. Furthermore, a prospective study on the time course of the level of consciousness (Glasgow Coma Score) and blood concentrations of illicit drugs, especially gamma-hydroxybutyrate was set up. The results revealed that during 'I love techno' the incidence of medical problems was high (66.5/10 000 attendees), but not higher than during 'De Nacht' (70.0/10 000 attendees). At 'I love techno', however, mainly illicit drugs were used, more frequently leading to severe drug-related medical problems. The observations in patients with a drug-related medical problem who had taken gamma-hydroxybutyrate showed that for a given level of consciousness the gamma-hydroxybutyrate concentrations may show important differences, that the transition from coma (Glasgow Coma Score < or =7) to full recovery (Glasgow Coma Score 15) takes only 30-60 min (and only a small decrease in gamma-hydroxybutyrate concentrations), and that the time it takes before a comatose patient reaches the above-mentioned 'transition area' may be a few hours.

[Euthanasia of patients in coma vigil. Results on German medical staff attitudes].

PubMed

Böttger-Kessler, G; Beine, K H

2007-07-01

An examination was made concerning doctors' and nursing staff's attitudes towards active euthanasia of patients suffering from coma vigil (2652 doctors and 5785 nursing staff were interviewed). This investigation made clear that most of the persons asked about this group of patients voted for a change in German laws following the Dutch example. There were noticeable differences observed between the professional groups. A majority (64.79%) were convinced that under certain circumstances it is justified to end intentionally the life of persons in a coma vigil. Of the nursing staff, 70.38% were in favour of this attitude, and 51.53% of the doctors share this opinion. Certain groups supported the question of active euthanasia more clearly than others. These were young participants in the investigation, first-time employees, nondenominational interviewees, those who are dissatisfied with their job situation, who are from the newly-formed German states, and who are divorced. The attitudes expressed by all these people originate in many different motives: thoughts about the patients, aspects concerning jobs, and personal aspects had an influence on results of the investigation. This single investigation which was restricted to patients suffering from coma vigil and to employees of the public health service, does not prove that the total population has generally changed its attitude toward active euthanasia. It is impossible to justify the necessity of new laws about euthanasia based on the above results.

Gas Distributions in Comet ISON’s Coma: Concurrent Integral-Field Spectroscopy and Narrow-band Imaging.

NASA Astrophysics Data System (ADS)

Schmidt, Carl; Johnson, Robert E.; Baumgardner, Jeffrey; Mendillo, Michael

2014-11-01

At a solar distance of 0.44 AU, Oort cloud comet C/2012 S1 (ISON) exhibited an outburst phase that was observed by small telescopes at the McDonald Observatory. In conjunction with narrow-band (14Å) imaging over a wide-field, an image-slicer spectrograph ( 20,000) simultaneously measured the spatial distribution of ISON’s coma over a 1.6 x 2.7 arcminute field made up of 246 individual spectra. More than fifty emission lines from C2, NH2, CO, H2O+ and Na were observed within a single Echelle order spanning 5868Å to 5930Å. Spatial reconstructions of these species reveal that ISON’s coma was quite elongated several thousand km along the axis perpendicular to its motion. The ion tail appeared distinctly broader than the neutral Na tail, providing strong evidence that Na in the coma did not originate by dissociative recombination of a sodium bearing molecular ion. Production rates increased from 1.6 ± 0.3 x 1023 to 5.8 ± 1 x 1023 Na atoms/s within 24 hours, outgassing much less than comparable comets relative to ISON’s water production. The anti-sunward Na tail was imaged >106 km from the nucleus. Its distribution indicates origins both near the nucleus and in the dust tail, with the ratio of these Na sources varying on hourly timescales due to outburst activity.

[Thyroid emergencies : Thyroid storm and myxedema coma].

PubMed

Spitzweg, C; Reincke, M; Gärtner, R

2017-10-01

Thyroid emergencies are rare life-threatening endocrine conditions resulting from either decompensated thyrotoxicosis (thyroid storm) or severe thyroid hormone deficiency (myxedema coma). Both conditions develop out of a long-standing undiagnosed or untreated hyper- or hypothyroidism, respectively, precipitated by an acute stress-associated event, such as infection, trauma, or surgery. Cardinal features of thyroid storm are myasthenia, cardiovascular symptoms, in particular tachycardia, as well as hyperthermia and central nervous system dysfunction. The diagnosis is made based on clinical criteria only as thyroid hormone measurements do not differentiate between thyroid storm and uncomplicated hyperthyroidism. In addition to critical care measures therapy focusses on inhibition of thyroid hormone synthesis and secretion (antithyroid drugs, perchlorate, Lugol's solution, cholestyramine, thyroidectomy) as well as inhibition of thyroid hormone effects in the periphery (β-blocker, glucocorticoids).Cardinal symptoms of myxedema coma are hypothermia, decreased mental status, and hypoventilation with risk of pneumonia and hyponatremia. The diagnosis is also purely based on clinical criteria as measurements of thyroid hormone levels do not differ between uncomplicated severe hypothyroidism and myxedema coma. In addition to substitution of thyroid hormones and glucocorticoids, therapy focusses on critical care measures to treat hypoventilation and hypercapnia, correction of hyponatremia and hypothermia.Survival of both thyroid emergencies can only be optimized by early diagnosis based on clinical criteria and prompt initiation of multimodal therapy including supportive measures and treatment of the precipitating event.

Synergistic Regulation of Competence Development in Bacillus subtilis by Two Rap-Phr Systems† ‡

PubMed Central

Bongiorni, Cristina; Ishikawa, Shu; Stephenson, Sophie; Ogasawara, Naotake; Perego, Marta

2005-01-01

The 11 Rap proteins of Bacillus subtilis comprise a conserved family of tetratricopeptide (TPR)-containing regulatory proteins. Their activity is inhibited by specific Phr pentapeptides produced from the product of phr genes through an export-import maturation process. We found that one of the proteins, namely RapF, is involved in the regulation of competence to DNA transformation. The ComA response regulator and transcription factor for initiation of competence development is the target of RapF. Specific binding of RapF to the carboxy-terminal DNA-binding domain of ComA inhibits the response regulator's ability to bind its target DNA promoters. The PhrF C-terminal pentapeptide, QRGMI, inhibits RapF activity. The activity of RapF and PhrF in regulating competence development is analogous to the previously described activity of RapC and PhrC (L. J. Core and M. Perego, Mol. Microbiol. 49:1509-1522, 2003). In fact, the RapF and PhrF pair of proteins acts synergistically with RapC and PhrC in the overall regulation of the ComA transcription factor. Since the transcription of the RapC- and RapF-encoding genes is positively regulated by their own target ComA, an autoregulatory circuit must exist for the competence transcription factor in order to modulate its activity. PMID:15968044

Dopamine agonist therapy in low-response children following traumatic brain injury.

PubMed

Patrick, Peter D; Blackman, James A; Mabry, Jennifer L; Buck, Marcia L; Gurka, Matthew J; Conaway, Mark R

2006-10-01

The objective of this study was to determine whether a dopamine agonist could improve mental status among children in a low-response state following traumatic brain injury. In an 8-week, prospective, double-blind, randomized trial, 10 children and adolescents ages 8 to 21 years (X = 16.7 years) with traumatic brain injury sustained at least 1 month previously and remaining in a low-response state (Rancho Los Amigos Scale level pound 3) received pramipexole or amantadine. Medication dosage was increased over 4 weeks, weaned over 2 weeks, and then discontinued. At baseline and weekly during the study, subjects were evaluated with the Coma Near Coma Scale, Western NeuroSensory Stimulation Profile, and Disability Rating Scale. Scores improved significantly from baseline to the medication phase on the Coma Near Coma Scale, Western NeuroSensory Stimulation Profile, and Disability Rating Scale (P < .005). The weekly rate of change was significantly better for all three measures on medication than off medication (P < .05). Rancho Los Amigos Scale levels improved significantly on medication as well (P < .05). There was no difference in efficacy between amantadine and pramipexole. No unexpected or significant side effects were observed with either drug. This clinical trial supports the benefit of two dopamine agonists in the restoration of functional arousal, awareness, and communication. These drugs can be helpful in accelerating eligibility for acute rehabilitation among children and adolescents who have sustained significant brain injuries.

Morphology and Dynamics of Jets of Comet 67P Churyumov-Gerasimenko: Early Phase Development

NASA Astrophysics Data System (ADS)

Lin, Zhong-Yi; Ip, Wing-Huen; Lai, Ian-Lin; Lee, Jui-Chi; Pajola, Maurizio; Lara, Luisa; Gutierrez, Pedro; Rodrigo, Rafael; Bodewits, Dennis; A'Hearn, Mike; Vincent, Jean-Baptiste; Agarwal, Jessica; Keller, Uwe; Mottola, Stefano; Bertini, Ivano; Lowry, Stephen; Rozek, Agata; Liao, Ying; Rosetta Osiris Coi Team

2015-04-01

The scientific camera, OSIRIS (Optical, Spectroscopic, and Infrared Remote Imaging System), onboard the Rosetta spacecraft comprises a Narrow Angle Camera (NAC) for nucleus surface and dust studies and a Wide Angle Camera (WAC) for the wide field of dust and gas coma investigations. The dynamical behavior of jets in the dust coma continuously monitored by using dust filters from the arrival at the comet (August 2014) throughout the mapping phase (Oct. 2014) is described here. The analysis will cover the study of the time variability of jets, the source regions of these jets, the excess brightness of jets relative to the averaged coma brightness, and the brightness distribution of dust jets along the projected distance. The jets detected between August and September originated mostly from the neck region (Hapi). Morphological changes appeared over a time scale of several days in September. The brightness slope of the dust jets is much steeper than the background coma. This might be related to the sublimation or fragmentation of the emitted dust grains. Inter-comparison with results from other experiments will be necessary to understand the difference between the dust emitted from Hapi and those from the head and the body of the nucleus surface. The physical properties of the Hapi jets will be compared to dust jets (and their source regions) to emerge as comet 67P moves around the perihelion.

Origins of ultra-diffuse galaxies in the Coma cluster - II. Constraints from their stellar populations

NASA Astrophysics Data System (ADS)

Ferré-Mateu, Anna; Alabi, Adebusola; Forbes, Duncan A.; Romanowsky, Aaron J.; Brodie, Jean; Pandya, Viraj; Martín-Navarro, Ignacio; Bellstedt, Sabine; Wasserman, Asher; Stone, Maria B.; Okabe, Nobuhiro

2018-06-01

In this second paper of the series we study, with new Keck/DEIMOS spectra, the stellar populations of seven spectroscopically confirmed ultra-diffuse galaxies (UDGs) in the Coma cluster. We find intermediate to old ages (˜ 7 Gyr), low metallicities ([Z/H]˜ - 0.7 dex) and mostly super-solar abundance patterns ([Mg/Fe] ˜ 0.13 dex). These properties are similar to those of low-luminosity (dwarf) galaxies inhabiting the same area in the cluster and are mostly consistent with being the continuity of the stellar mass scaling relations of more massive galaxies. These UDGs' star formation histories imply a relatively recent infall into the Coma cluster, consistent with the theoretical predictions for a dwarf-like origin. However, considering the scatter in the resulting properties and including other UDGs in Coma, together with the results from the velocity phase-space study of the Paper I in this series, a mixed-bag of origins is needed to explain the nature of all UDGs. Our results thus reinforce a scenario in which many UDGs are field dwarfs that become quenched through their later infall onto cluster environments, whereas some UDGs could be be genuine primordial galaxies that failed to develop due to an early quenching phase. The unknown proportion of dwarf-like to primordial-like UDGs leaves the enigma of the nature of UDGs still open.

Coma cluster of galaxies

NASA Technical Reports Server (NTRS)

1999-01-01

Atlas Image mosaic, covering 34' x 34' on the sky, of the Coma cluster, aka Abell 1656. This is a particularly rich cluster of individual galaxies (over 1000 members), most prominently the two giant ellipticals, NGC 4874 (right) and NGC 4889 (left). The remaining members are mostly smaller ellipticals, but spiral galaxies are also evident in the 2MASS image. The cluster is seen toward the constellation Coma Berenices, but is actually at a distance of about 100 Mpc (330 million light years, or a redshift of 0.023) from us. At this distance, the cluster is in what is known as the 'Hubble flow,' or the overall expansion of the Universe. As such, astronomers can measure the Hubble Constant, or the universal expansion rate, based on the distance to this cluster. Large, rich clusters, such as Coma, allow astronomers to measure the 'missing mass,' i.e., the matter in the cluster that we cannot see, since it gravitationally influences the motions of the member galaxies within the cluster. The near-infrared maps the overall luminous mass content of the member galaxies, since the light at these wavelengths is dominated by the more numerous older stellar populations. Galaxies, as seen by 2MASS, look fairly smooth and homogeneous, as can be seen from the Hubble 'tuning fork' diagram of near-infrared galaxy morphology. Image mosaic by S. Van Dyk (IPAC).

The incidence of increased ICP in ICU patients with non-traumatic coma as diagnosed by ONSD and CT: a prospective cohort study.

PubMed

Salahuddin, Nawal; Mohamed, Alaa; Alharbi, Nadia; Ansari, Hamad; Zaza, Khaled J; Marashly, Qussay; Hussain, Iqbal; Solaiman, Othman; Wetterberg, Torbjorn V; Maghrabi, Khalid

2016-10-25

Unexplained coma after critical illness can be multifactorial. We evaluated the diagnostic ability of bedside Optic Nerve Sheath Diameter [ONSD] as a screening test for non-traumatic radiographic cerebral edema. In a prospective study, mixed medical-surgical intensive care units [ICU] patients with non-traumatic coma [GCS < 9] underwent bedside ultrasonographic ONSD measurements. Non-traumatic radiographic cerebral edema [NTRCE] was defined as > 5 mm midline shift, cisternal, sulcal effacement, or hydrocephalus on CT. NTRCE was identified in 31 of 102 patients [30.4 %]. The area under the ROC curve for detecting radiographic edema by ONSD was 0.785 [95 % CI 0.695-0.874, p <0.001]. ONSD diameter of 0.57 cm was found to be the best cutoff threshold with a sensitivity 84 % and specificity 71 %, AUC 0.785 [95 % CI 0.695-0.874, p <0.001]. Using ONSD as a bedside test increased the post-test odds ratio [OR] for NTRCE by 2.89 times [positive likelihood ratio], whereas post-test OR for NTRCE decreased markedly given a negative ONSD test [ONSD measurement less than 0.57 cm]; negative likelihood ratio 0.22. The use of ONSD as a bedside test in patients with non-traumatic coma has diagnostic value in identifying patients with non-traumatic radiographic cerebral edema.

Prognostic and diagnostic value of EEG signal coupling measures in coma.

PubMed

Zubler, Frederic; Koenig, Christa; Steimer, Andreas; Jakob, Stephan M; Schindler, Kaspar A; Gast, Heidemarie

2016-08-01

Our aim was to assess the diagnostic and predictive value of several quantitative EEG (qEEG) analysis methods in comatose patients. In 79 patients, coupling between EEG signals on the left-right (inter-hemispheric) axis and on the anterior-posterior (intra-hemispheric) axis was measured with four synchronization measures: relative delta power asymmetry, cross-correlation, symbolic mutual information and transfer entropy directionality. Results were compared with etiology of coma and clinical outcome. Using cross-validation, the predictive value of measure combinations was assessed with a Bayes classifier with mixture of Gaussians. Five of eight measures showed a statistically significant difference between patients grouped according to outcome; one measure revealed differences in patients grouped according to the etiology. Interestingly, a high level of synchrony between the left and right hemisphere was associated with mortality on intensive care unit, whereas higher synchrony between anterior and posterior brain regions was associated with survival. The combination with the best predictive value reached an area-under the curve of 0.875 (for patients with post anoxic encephalopathy: 0.946). EEG synchronization measures can contribute to clinical assessment, and provide new approaches for understanding the pathophysiology of coma. Prognostication in coma remains a challenging task. qEEG could improve current multi-modal approaches. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

The Blue Coma: The Role of Methylene Blue in Unexplained Coma After Cardiac Surgery.

PubMed

Martino, Enrico Antonio; Winterton, Dario; Nardelli, Pasquale; Pasin, Laura; Calabrò, Maria Grazia; Bove, Tiziana; Fanelli, Giovanna; Zangrillo, Alberto; Landoni, Giovanni

2016-04-01

Methylene blue commonly is used as a dye or an antidote, but also can be used off label as a vasopressor. Serotonin toxicity is a potentially lethal and often misdiagnosed condition that can result from drug interaction. Mild serotonin toxicity previously was reported in settings in which methylene blue was used as a dye. The authors report 3 cases of life-threatening serotonin toxicity in patients undergoing chronic selective serotonin reuptake inhibitor (SSRI) therapy who also underwent cardiac surgery and received methylene blue to treat vasoplegic syndrome. An observational study. A cardiothoracic intensive care unit (ICU) in a teaching hospital. Three patients who received methylene blue after cardiac surgery, later discovered to be undergoing chronic SSRI therapy. None. All 3 patients received high doses of fentanyl during general anesthesia. They all developed vasoplegic syndrome and consequently were given methylene blue in the ICU. All 3 patients developed serotonin toxicity, including coma, after this administration and diagnostic tests were negative for acute intracranial pathology. Coma lasted between 1 and 5 days. Two patients were discharged from the ICU shortly after awakening, whereas the third patient experienced a complicated postoperative course for concomitant refractory low-cardiac-output syndrome. Patients undergoing chronic SSRI therapy should not be administered methylene blue to treat vasoplegic syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

A study of the reliability of the Nociception Coma Scale.

PubMed

Riganello, F; Cortese, M D; Arcuri, F; Candelieri, A; Guglielmino, F; Dolce, G; Sannita, W G; Schnakers, C

2015-04-01

In this study, we investigated the reliability of the Nociception Coma Scale which has recently been developed to assess nociception in non-communicative, severely brain-injured patients. Prospective cross-sequential study. Semi-intensive care unit and long-term brain injury care. Forty-four patients diagnosed as being in a vegetative state (n=26) or in a minimally conscious state (n=18). Patients were assessed by two experts (rater A and rater B) on two consecutive weeks to measure inter-rater agreement and test-retest reliability. Total scores and subscores of the Nociception Coma Scale. We performed a total of 176 assessments. The inter-rater agreement was moderate for the total scores (k = 0.57) and fair to substantial for the subscores (0.33 ≤ k ≤ 0.62) on week 2. The test-retest reliability was substantial for the total scores (k = 0.66) and moderate to almost perfect for the subscores (0.53 ≤ k ≤ 0.96) for rater A. The inter-rater agreement was weaker on week 1, whereas the test-retest reliability was lower for the least experienced rater (rater B). This study provides further evidence of the psychometric qualities of the Nociception Coma Scale. Future studies should assess the impact of practical experience and background on administration and scoring of the scale. © The Author(s) 2014.

Photobiomodulation on alcohol induced dysfunction

NASA Astrophysics Data System (ADS)

Yang, Zheng-Ping; Liu, Timon C.; Zhang, Yan; Wang, Yan-Fang

2007-05-01

Alcohol, which is ubiquitous today, is a major health concern. Its use was already relatively high among the youngest respondents, peaked among young adults, and declined in older age groups. Alcohol is causally related to more than 60 different medical conditions. Overall, 4% of the global burden of disease is attributable to alcohol, which accounts for about as much death and disability globally as tobacco and hypertension. Alcohol also promotes the generation of reactive oxygen species (ROS) and/or interferes with the body's normal defense mechanisms against these compounds through numerous processes, particularly in the liver. Photobiomodulation (PBM) is a cell-specific effect of low intensity monochromatic light or low intensity laser irradiation (LIL) on biological systems. The cellular effects of both alcohol and LIL are ligand-independent so that PBM might rehabilitate alcohol induced dysfunction. The PBM on alcohol induced human neutrophil dysfunction and rat chronic atrophic gastritis, the laser acupuncture on alcohol addiction, and intravascular PBM on alcoholic coma of patients and rats have been observed. The endonasal PBM (EPBM) mediated by Yangming channel, autonomic nervous systems and blood cells is suggested to treat alcohol induced dysfunction in terms of EPBM phenomena, the mechanism of alcohol induced dysfunction and our biological information model of PBM. In our opinion, the therapeutic effects of PBM might also be achieved on alcoholic myopathy.

Modelling observations of the inner gas and dust coma of comet 67P/Churyumov-Gerasimenko using ROSINA/COPS and OSIRIS data: First results

NASA Astrophysics Data System (ADS)

Marschall, R.; Su, C. C.; Liao, Y.; Thomas, N.; Altwegg, K.; Sierks, H.; Ip, W.-H.; Keller, H. U.; Knollenberg, J.; Kührt, E.; Lai, I. L.; Rubin, M.; Skorov, Y.; Wu, J. S.; Jorda, L.; Preusker, F.; Scholten, F.; Gracia-Berná, A.; Gicquel, A.; Naletto, G.; Shi, X.; Vincent, J.-B.

2016-05-01

Context. This paper describes the initial modelling of gas and dust data acquired in August and September 2014 from the European Space Agency's Rosetta spacecraft when it was in close proximity to the nucleus of comet 67P/Churyumov-Gerasimenko. Aims: This work is an attempt to provide a self-consistent model of the innermost gas and dust coma of the comet, as constrained by the Rosetta Orbiter Spectrometer for Ion and Neutral Analysis (ROSINA) data set for the gas and by the Optical, Spectroscopic, and Infrared Remote Imaging System (OSIRIS) data set for the dust. Methods: The model uses a previously developed shape model for the nucleus, and from this the water sublimation rate and gas temperatures at the surface are computed with a simple thermal model. The gas expansion is modelled with a 3D parallel implementation of a Direct Simulation Monte Carlo algorithm. A dust drag algorithm is then used to produce dust densities in the coma, which are then converted to brightnesses using Mie theory and a line-of-sight integration. Results: We show that a purely insolation-driven model for surface outgassing does not produce a reasonable fit to ROSINA/COPS data. A stronger source in the "neck" region of the nucleus (region Hapi) is needed to match the observed modulation of the gas density in detail. This agrees with OSIRIS data, which shows that the dust emission from the "neck" was dominant in the August-September 2014 time frame. The current model matches this observation reasonably if a power index of 2-3 for the dust size distribution is used. A better match to the OSIRIS data is seen by using a single large particle size for the coma. Conclusions: We have shown possible solutions to the gas and dust distributions in the inner coma, which are consistent with ROSINA and OSIRIS data.

Study of the coma of comet 67P/Churyumov-Gerasimenko based on the ROSINA/RTOF instrument onboard Rosetta

NASA Astrophysics Data System (ADS)

Hoang, M.; Garnier, P.; Lasue, J.; Reme, H.; Altwegg, K.; Balsiger, H. R.; Bieler, A. M.; Calmonte, U.; Fiethe, B.; Galli, A.; Gasc, S.; Gombosi, T. I.; Jäckel, A.; Mall, U.; Le Roy, L.; Rubin, M.; Tzou, C. Y.; Waite, J. H., Jr.; Wurz, P.

2015-12-01

The ROSETTA spacecraft of ESA is in the environment of comet 67P/Churyumov-Gerasimenko since August 2014. Among the experiments onboard the spacecraft, the ROSINA experiment (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) includes two mass spectrometers (DFMS and RTOF) to analyze the composition of neutrals and ions, and a pressure sensor (COPS) to monitor the density and velocity of neutrals in the coma [1]. We will here analyze and discuss the data of the ROSINA/RTOF instrument during the comet escort phase. The Reflectron-type Time-Of-Flight (RTOF) mass spectrometer possesses a wide mass range and a high temporal resolution [1,2]. It was designed to measure cometary neutral gas as well as cometary ions. A detailed description of the main volatiles (H2O, CO2, CO) dynamics and of the heterogeneities of the coma will then be provided. The influence of various parameters on the coma measurements is investigated on a statistical basis, with the parameters being distance to the comet, heliocentric distance, longitude and latitude of nadir point. Our analysis of the northern hemisphere summer season shows the presence of water vapor mostly in the illuminated northern hemisphere near the neck region with cyclic diurnal variations whereas CO2 was confined to the cold southern hemisphere with a more spatially homogeneous composition, in agreement with previous observations of 67P [2] or Hartley 2 [3]. A comparison will also be provided with the COPS total density and DFMS abundance measurements. [1] Balsiger et al., "ROSINA - Rosetta Orbiter Spectrometer for Ion and Neutral Analysis", Space Sci. Rev., 2007. [2] Scherer et al., "A novel principle for an ion mirror design in time-of-flight mass spectrometry," Int. Jou. Mass Spectr., 2006. [3] Hässig et al., "Time variability and heterogeneity in the coma of 67P/Churyumov-Gerasimenko", Science, 2015. [4] A'Hearn et al., "EPOXI at comet Hartley 2", Science, 2011.

The LCO/Gemini-South campaign for Deep Impact target Comet 9P/Tempel 1: Temporally resolved wide-field narrowband imaging results

NASA Astrophysics Data System (ADS)

Lederer, S. M.; Osip, D. J.; Thomas-Osip, J. E.; DeBuizer, J. M.; Mondragon, L. A.; Schweiger, D. L.; Viehweg, J.; SB Collaboration

2005-08-01

An extensive observing campaign to monitor Comet 9P/Tempel 1 will be conducted from 20 June to 19 July, 2005 at Las Campanas Observatory, Chile. These observations will precede and follow the impact of the Deep Impact projectile, which is likely to create a crater on the nucleus that will act as a fresh active area on the surface of the comet. Discreet nucleus active areas, believed to be the source of coma gas and dust jets, will likely result in changing morphology in the coma. We present the initial results of the wide-field narrowband visible imaging of the comet. Data will be taken with the 2.5m DuPont telescope from 27 June - 9 July, following the comet from 4 rotations prior to impact, to 4 rotations after impact using the narrowband Hale-Bopp filters, including CN, C2, and two continuum filters. These data will allow an accurate determination of the rotation state of the embedded nucleus immediately preceding the impact event as well as a measure of any changes to the rotation state due to the impact. In addition, modeling of these data will provide the total dust and gas production rates from the unaltered nucleus compared to the enhanced dust and gas emission from the newly created active region and freely sublimating pieces of mantle material ejected into the coma by the impactor. We will monitor temporal changes (on hours and days time-scales) in the morphology of both the gas and refractory components. We will use coma morphology studies to estimate the dust and gas outflow velocities and infer the presence of discreet nucleus source regions (pre- and post-impact). Of particular interest is the study of the gas-to-dust ratio and the ratio of the minor carbon species emitted from the newly created active region relative to the pre-impact coma environment.

Coma in fatal adult human malaria is not caused by cerebral oedema

PubMed Central

2011-01-01

Background The role of brain oedema in the pathophysiology of cerebral malaria is controversial. Coma associated with severe Plasmodium falciparum malaria is multifactorial, but associated with histological evidence of parasitized erythrocyte sequestration and resultant microvascular congestion in cerebral vessels. To determine whether these changes cause breakdown of the blood-brain barrier and resultant perivascular or parenchymal cerebral oedema, histology, immunohistochemistry and image analysis were used to define the prevalence of histological patterns of oedema and the expression of specific molecular pathways involved in water balance in the brain in adults with fatal falciparum malaria. Methods The brains of 20 adult Vietnamese patients who died of severe malaria were examined for evidence of disrupted vascular integrity. Immunohistochemistry and image analysis was performed on brainstem sections for activation of the vascular endothelial growth factor (VEGF) receptor 2 and expression of the aquaporin 4 (AQP4) water channel protein. Fibrinogen immunostaining was assessed as evidence of blood-brain barrier leakage and perivascular oedema formation. Correlations were performed with clinical, biochemical and neuropathological parameters of severe malaria infection. Results The presence of oedema, plasma protein leakage and evidence of VEGF signalling were heterogeneous in fatal falciparum malaria and did not correlate with pre-mortem coma. Differences in vascular integrity were observed between brain regions with the greatest prevalence of disruption in the brainstem, compared to the cortex or midbrain. There was a statistically non-significant trend towards higher AQP4 staining in the brainstem of cases that presented with coma (P = .02). Conclusions Histological evidence of cerebral oedema or immunohistochemical evidence of localised loss of vascular integrity did not correlate with the occurrence of pre-mortem coma in adults with fatal falciparum malaria. Enhanced expression of AQP4 water channels in the brainstem may, therefore, reflect a mix of both neuropathological or attempted neuroprotective responses to oedema formation. PMID:21923924

Near-death experiences in non-life-threatening events and coma of different etiologies

PubMed Central

Charland-Verville, Vanessa; Jourdan, Jean-Pierre; Thonnard, Marie; Ledoux, Didier; Donneau, Anne-Francoise; Quertemont, Etienne; Laureys, Steven

2014-01-01

Background: Near death experiences (NDEs) are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have attempted to associate the experiences' intensity and content to etiology. Methods: This retrospective investigation assessed the intensity and the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., “NDE-like” experience) or after a pathological coma (i.e., “real NDE”) and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE scale. Results: From our 190 reports who met the criteria for NDE (i.e., Greyson NDE scale total score >7/32), intensity (i.e., Greyson NDE scale total score) and content (i.e., Greyson NDE scale features) did not differ between “NDE-like” (n = 50) and “real NDE” (n = 140) groups, nor within the “real NDE” group depending on the cause of coma (anoxic/traumatic/other). The most frequently reported feature was peacefulness (89–93%). Only 2 patients (1%) recounted a negative experience. The overall NDE core features' frequencies were higher in our retrospective anoxic cohort when compared to historical published prospective data. Conclusions: It appears that “real NDEs” after coma of different etiologies are similar to “NDE-like” experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have experienced a different content compared to the prospective experiencers. PMID:24904345

GLOBULAR CLUSTERS AND SPUR CLUSTERS IN NGC 4921, THE BRIGHTEST SPIRAL GALAXY IN THE COMA CLUSTER

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

Lee, Myung Gyoon; Jang, In Sung, E-mail: mglee@astro.snu.ac.kr, E-mail: isjang@astro.snu.ac.kr

2016-03-01

We resolve a significant fraction of globular clusters (GCs) in NGC 4921, the brightest spiral galaxy in the Coma cluster. We also find a number of extended bright star clusters (star complexes) in the spur region of the arms. The latter are much brighter and bluer than those in the normal star-forming region, being as massive as 3 × 10{sup 5} M{sub ⊙}. The color distribution of the GCs in this galaxy is found to be bimodal. The turnover magnitudes of the luminosity functions of the blue (metal-poor) GCs (0.70 < (V − I) ≤ 1.05) in the halo are estimated V(max) = 27.11 ± 0.09 mag and I(max) = 26.21 ± 0.11 mag.more » We obtain similar values for NGC 4923, a companion S0 galaxy, and two Coma cD galaxies (NGC 4874 and NGC 4889). The mean value for the turnover magnitudes of these four galaxies is I(max) = 26.25 ± 0.03 mag. Adopting M{sub I} (max) = −8.56 ± 0.09 mag for the metal-poor GCs, we determine the mean distance to the four Coma galaxies to be 91 ± 4 Mpc. Combining this with the Coma radial velocity, we derive a value of the Hubble constant, H{sub 0} = 77.9 ± 3.6 km s{sup −1} Mpc{sup −1}. We estimate the GC specific frequency of NGC 4921 to be S{sub N} = 1.29 ± 0.25, close to the values for early-type galaxies. This indicates that NGC 4921 is in the transition phase to S0s.« less

Contemporary Rates of Severe Hypoglycaemia in Youth with Type 1 Diabetes: Variability by Insulin Regimen

PubMed Central

Katz, M. L.; Volkening, L. K.; Anderson, B. J.; Laffel, L. M.

2013-01-01

Aims To determine incidence rates of severe hypoglycaemia and compare incidence rates by insulin regimen in a diverse sample of youth with type 1 diabetes from two sites. Methods In this observational study, 255 youth (51% female) aged 9–15 years receiving varied insulin regimens provided data prospectively for a median of 1.2 years. Reported episodes of severe hypoglycaemia, defined as episodes requiring help from another person for oral treatment or episodes resulting in seizure/coma, and current insulin regimens were collected systematically. Incidence rates were calculated and compared according to insulin regimen in bivariate and multivariate analyses. Results At first encounter, participants had a median age of 12.2 years (range 9.0–15.0), median diabetes duration of 4.4 years (range 1.0–13.0) and mean A1C of 67±12 mmol/mol (8.3±1.1%). The incidence rate was 37.6/100-patient-years for all severe hypoglycaemia and 9.6/100-patient-years for seizure/coma. The incidence rate for severe hypoglycaemia was 31.8/100-patient-years on continuous subcutaneous insulin infusion (CSII), 34.4/100-patient-years on basal-bolus injections (B-B) and 46.1/100-patient-years on NPH (NPH vs. CSII: p=.04). The incidence rate for seizure/coma was 4.5/100-patient-years on CSII, 11.1/100-patient-years on B-B, and 14.4/100-patient-years on NPH (NPH vs. CSII: p=.004). In the multivariate analysis, the rate of seizure/coma was significantly higher for those on NPH vs. CSII (rate ratio 2.9, p=.03). Conclusions Rates of severe hypoglycaemia in youth with type 1 diabetes remain high. CSII was associated with lower rates of all severe hypoglycaemia and seizure/coma in comparison to NPH. PMID:22417321

Coma in fatal adult human malaria is not caused by cerebral oedema.

PubMed

Medana, Isabelle M; Day, Nicholas P J; Sachanonta, Navakanit; Mai, Nguyen T H; Dondorp, Arjen M; Pongponratn, Emsri; Hien, Tran T; White, Nicholas J; Turner, Gareth D H

2011-09-17

The role of brain oedema in the pathophysiology of cerebral malaria is controversial. Coma associated with severe Plasmodium falciparum malaria is multifactorial, but associated with histological evidence of parasitized erythrocyte sequestration and resultant microvascular congestion in cerebral vessels. To determine whether these changes cause breakdown of the blood-brain barrier and resultant perivascular or parenchymal cerebral oedema, histology, immunohistochemistry and image analysis were used to define the prevalence of histological patterns of oedema and the expression of specific molecular pathways involved in water balance in the brain in adults with fatal falciparum malaria. The brains of 20 adult Vietnamese patients who died of severe malaria were examined for evidence of disrupted vascular integrity. Immunohistochemistry and image analysis was performed on brainstem sections for activation of the vascular endothelial growth factor (VEGF) receptor 2 and expression of the aquaporin 4 (AQP4) water channel protein. Fibrinogen immunostaining was assessed as evidence of blood-brain barrier leakage and perivascular oedema formation. Correlations were performed with clinical, biochemical and neuropathological parameters of severe malaria infection. The presence of oedema, plasma protein leakage and evidence of VEGF signalling were heterogeneous in fatal falciparum malaria and did not correlate with pre-mortem coma. Differences in vascular integrity were observed between brain regions with the greatest prevalence of disruption in the brainstem, compared to the cortex or midbrain. There was a statistically non-significant trend towards higher AQP4 staining in the brainstem of cases that presented with coma (P = .02). Histological evidence of cerebral oedema or immunohistochemical evidence of localised loss of vascular integrity did not correlate with the occurrence of pre-mortem coma in adults with fatal falciparum malaria. Enhanced expression of AQP4 water channels in the brainstem may, therefore, reflect a mix of both neuropathological or attempted neuroprotective responses to oedema formation.

Near-death experiences in non-life-threatening events and coma of different etiologies.

PubMed

Charland-Verville, Vanessa; Jourdan, Jean-Pierre; Thonnard, Marie; Ledoux, Didier; Donneau, Anne-Francoise; Quertemont, Etienne; Laureys, Steven

2014-01-01

Near death experiences (NDEs) are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have attempted to associate the experiences' intensity and content to etiology. This retrospective investigation assessed the intensity and the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., "NDE-like" experience) or after a pathological coma (i.e., "real NDE") and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE scale. From our 190 reports who met the criteria for NDE (i.e., Greyson NDE scale total score >7/32), intensity (i.e., Greyson NDE scale total score) and content (i.e., Greyson NDE scale features) did not differ between "NDE-like" (n = 50) and "real NDE" (n = 140) groups, nor within the "real NDE" group depending on the cause of coma (anoxic/traumatic/other). The most frequently reported feature was peacefulness (89-93%). Only 2 patients (1%) recounted a negative experience. The overall NDE core features' frequencies were higher in our retrospective anoxic cohort when compared to historical published prospective data. It appears that "real NDEs" after coma of different etiologies are similar to "NDE-like" experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have experienced a different content compared to the prospective experiencers.

Successful use of alternate waste nitrogen agents and hemodialysis in a patient with hyperammonemic coma after heart-lung transplantation.

PubMed

Berry, G T; Bridges, N D; Nathanson, K L; Kaplan, P; Clancy, R R; Lichtenstein, G R; Spray, T L

1999-04-01

Lethal hyperammonemic coma has been reported in 2 adults after lung transplantation. It was associated with a massive elevation of brain glutamine levels, while plasma glutamine levels were normal or only slightly elevated. In liver tissue, glutamine synthetase activity was markedly reduced, and the histologic findings resembled those of Reye syndrome. The adequacy of therapy commonly used for inherited disorders of the urea cycle has not been adequately evaluated in patients with this form of secondary hyperammonemia. To determine whether hemodialysis, in conjunction with intravenous sodium phenylacetate, sodium benzoate, and arginine hydrochloride therapy, would be efficacious in a patient with hyperammonemic coma after solid-organ transplantation. Case report. A children's hospital. A 41-year-old woman with congenital heart disease developed a hyperammonemic coma with brain edema 19 days after undergoing a combined heart and lung transplantation. Ammonium was measured in plasma. Amino acids were quantitated in plasma and cerebrospinal fluid by column chromatography. The effectiveness of therapy was assessed by measuring plasma ammonium levels and intracranial pressure and performing sequential neurological examinations. The patient had the anomalous combination of increased cerebrospinal fluid and decreased plasma glutamine levels. To our knowledge, she is the first patient with this complication after solid-organ transplantation to survive after combined therapy with sodium phenylacetate, sodium benzoate, arginine hydrochloride, and hemodialysis. Complications of the acute coma included focal motor seizures, which were controlled with carbamazepine, and difficulty with short-term memory. The aggressive use of hemodialysis in conjunction with intravenous sodium phenylacetate, sodium benzoate, and arginine hydrochloride therapy may allow survival in patients after solid-organ transplantation. An acute acquired derangement in extra-central nervous system glutamine metabolism may play a role in the production of hyperammonemia in this illness that resembles Reye syndrome, and, as in other hyperammonemic disorders, the duration and degree of elevation of brain glutamine levels may be the important determining factors in responsiveness to therapy.

The Radio Luminosity Function and Galaxy Evolution in the Coma Cluster

NASA Technical Reports Server (NTRS)

Miller, Neal A.; Hornschemeier, Ann E.; Mabasher, Bahram; Brudgesm Terrry J.; Hudson, Michael J.; Marzke, Ronald O.; Smith, Russell J.

2008-01-01

We investigate the radio luminosity function and radio source population for two fields within the Coma cluster of galaxies, with the fields centered on the cluster core and southwest infall region and each covering about half a square degree. Using VLA data with a typical rms sensitivity of 28 (mu)Jy per 4.4" beam, we identify 249 radio sources with optical counterparts brighter than r = 22 (equivalent to M(sub r) = -13 for cluster member galaxies). Comprehensive optical spectroscopy identifies 38 of these as members of the Coma cluster, evenly split between sources powered by an active nucleus and sources powered by active star formation. The radio-detected star-forming galaxies are restricted to radio luminosities between about 10(exp 21) and 10(exp 22) W/Hz, an interesting result given that star formation dominates field radio luminosity functions below about 10(exp 23) W/Hz. The majority of the radio-detected star-forming galaxies have characteristics of starbursts, including high specific star formation rates and optical spectra with strong emission lines. In conjunction with prior studies on post-starburst galaxies within the Coma cluster, this is consistent with a picture in which late-type galaxies entering Coma undergo a starburst prior to a rapid cessation of star formation. Optically bright elliptical galaxies (Mr less than or equals -20.5) make the largest contribution to the radio luminosity function at both the high (> approx. 3x10(exp 22) W/Hz) and low (< approx. 10(exp 21) W/Hz) ends. Through a stacking analysis of these optically-bright ellipticals we find that they continue to harbor radio sources down to luminosities as faint as 3x10(exp 19) W/Hz. However, contrary to published results for the Virgo cluster we find no evidence for the existence of a population of optically faint (M(sub r) approx. equals -14) dwarf ellipticals hosting strong radio AGN.

The fragmentation of dust in the innermost comae of comets: Possible evidence from ground-based images

NASA Technical Reports Server (NTRS)

Combi, Michael R.

1994-01-01

Dust particles when released from the nucleus of a comet are entrained in the expanding gas flow created by the vaporization of ices (mainly water ice). Traditional approaches to dusty-gas dynamics in the inner comae of comets consider there to be an initial distribution of dust particle sizes which do not fragment or evaporate. The standard Finson-Probstein model (and subsequent variations) yields a one-to-one-to-one correspondence between the size of a dust particle, its terminal velocity owing to gas drag, and its radiation pressure acceleration which creates the notable cometary dust tail. The comparison of a newly developed dust coma model shows that the typical elongated shapes of isophotes in the dust comae of comets on the scale of greater than 10(exp 4) km from the nucleus requires that the one-to-one-to-one relationship between particle size, terminal velocity and radiation pressure acceleration cannot in general be correct. There must be a broad range of particles including those having a small velocity but large radiation pressure acceleration in order to explain the elongated shape. A straightforward way to create such a distribution is if particle fragmentation, or some combination of fragmentation with vaporization, routinely occurs within and/or just outside of the dusty-gas dynamic acceleration region (i.e., up to several hundred km). In this way initially large particles, which are accelerated to fairly slow velocities by gas-drag, fragment to form small particles which still move slowly but are subject to a relatively large radiation pressure acceleration. Fragmentation has already been suggested as one possible interpretation for the flattened gradient in the spatial profiles of dust extracted from Giotto images of Comet Halley. Grain vaporization has been suggested as a possible spatially extended source of coma gases. The general elongated isophote shapes seen in ground-based images for many years represents another possible signature of fragmentation.

Coma of unknown origin in the emergency department: implementation of an in-house management routine.

PubMed

Braun, Mischa; Schmidt, Wolf Ulrich; Möckel, Martin; Römer, Michael; Ploner, Christoph J; Lindner, Tobias

2016-04-27

Coma of unknown origin is an emergency caused by a variety of possibly life-threatening pathologies. Although lethality is high, there are currently no generally accepted management guidelines. We implemented a new interdisciplinary standard operating procedure (SOP) for patients presenting with non-traumatic coma of unknown origin. It includes a new in-house triage process, a new alert call, a new composition of the clinical response team and a new management algorithm (altogether termed "coma alarm"). It is triggered by two simple criteria to be checked with out-of-hospital emergency response teams before the patient arrives. A neurologist in collaboration with an internal specialist leads the in-hospital team. Collaboration with anaesthesiology, trauma surgery and neurosurgery is organised along structured pathways that include standardised laboratory tests and imaging. Patients were prospectively enrolled. We calculated response times as well as sensitivity and false positive rates, thus proportions of over- and undertriaged patients, as quality measures for the implementation in the SOP. During 24 months after implementation, we identified 325 eligible patients. Sensitivity was 60 % initially (months 1-4), then fluctuated between 84 and 94 % (months 5-24). Overtriage never exceeded 15 % and undertriage could be kept low at a maximum of 11 % after a learning period. We achieved a median door-to-CT time of 20 minutes. 85 % of patients needed subsequent ICU treatment, 40 % of which required specialised neuro-ICUs. Our results indicate that our new simple in-house triage criteria may be sufficient to identify eligible patients before arrival. We aimed at ensuring the fastest possible proceedings given high portions of underlying time-sensitive neurological and medical pathologies while using all available resources as purposefully as possible. Our SOP may provide an appropriate tool for efficient management of patients with non-traumatic coma. Our results justify the assignment of the initial diagnostic workup to neurologists and internal specialists in collaboration with anaesthesiologists.

The etiology and outcome of non-traumatic coma in critical care: a systematic review.

PubMed

Horsting, Marlene Wb B; Franken, Mira D; Meulenbelt, Jan; van Klei, Wilton A; de Lange, Dylan W

2015-04-29

Non-traumatic coma (NTC) is a serious condition requiring swift medical or surgical decision making upon arrival at the emergency department. Knowledge of the most frequent etiologies of NTC and associated mortality might improve the management of these patients. Here, we present the results of a systematic literature search on the etiologies and prognosis of NTC. Two reviewers independently performed a systematic literature search in the Pubmed, Embase and Cochrane databases with subsequent reference and citation checking. Inclusion criteria were retrospective or prospective observational studies on NTC, which reported on etiologies and prognostic information of patients admitted to the emergency department or intensive care unit. Eventually, 14 studies with enough data on NTC, were selected for this systematic literature review. The most common causes of NTC were stroke (6-54%), post-anoxic coma (3-42%), poisoning (<1-39%) and metabolic causes (1-29%). NTC was also often caused by infections, especially in African studies affecting 10-51% of patients. The NTC mortality rate ranged from 25 to 87% and the mortality rate continued to increase long after the event had occurred. Also, 5-25% of patients remained moderately-severely disabled or in permanent vegetative state. The mortality was highest for stroke (60-95%) and post-anoxic coma (54-89%) and lowest for poisoning (0-39%) and epilepsy (0-10%). NTC represents a challenge to the emergency and the critical care physicians with an important mortality and moderate-severe disability rate. Even though, included studies were very heterogeneous, the most common causes of NTC are stroke, post anoxic, poisoning and various metabolic etiologies. The best outcome is achieved for patients with poisoning and epilepsy, while the worst outcome was seen in patients with stroke and post-anoxic coma. Adequate knowledge of the most common causes of NTC and prioritizing the causes by mortality ensures a swift and adequate work-up in diagnosis of NTC and may improve outcome.

Post-anoxic quantitative MRI changes may predict emergence from coma and functional outcomes at discharge.

PubMed

Reynolds, Alexandra S; Guo, Xiaotao; Matthews, Elizabeth; Brodie, Daniel; Rabbani, Leroy E; Roh, David J; Park, Soojin; Claassen, Jan; Elkind, Mitchell S V; Zhao, Binsheng; Agarwal, Sachin

2017-08-01

Traditional predictors of neurological prognosis after cardiac arrest are unreliable after targeted temperature management. Absence of pupillary reflexes remains a reliable predictor of poor outcome. Diffusion-weighted imaging has emerged as a potential predictor of recovery, and here we compare imaging characteristics to pupillary exam. We identified 69 patients who had MRIs within seven days of arrest and used a semi-automated algorithm to perform quantitative volumetric analysis of apparent diffusion coefficient (ADC) sequences at various thresholds. Area under receiver operating characteristic curves (ROC-AUC) were estimated to compare predictive values of quantitative MRI with pupillary exam at days 3, 5 and 7 post-arrest, for persistence of coma and functional outcomes at discharge. Cerebral Performance Category scores of 3-4 were considered poor outcome. Excluding patients where life support was withdrawn, ≥2.8% diffusion restriction of the entire brain at an ADC of ≤650×10 -6 m 2 /s was 100% specific and 68% sensitive for failure to wake up from coma before discharge. The ROC-AUC of ADC changes at ≤450×10 -6 mm 2 /s and ≤650×10 -6 mm 2 /s were significantly superior in predicting failure to wake up from coma compared to bilateral absence of pupillary reflexes. Among survivors, >0.01% of diffusion restriction of the entire brain at an ADC ≤450×10 -6 m 2 /s was 100% specific and 46% sensitive for poor functional outcome at discharge. The ROC curve predicting poor functional outcome at ADC ≤450×10 -6 mm 2 /s had an AUC of 0.737 (0.574-0.899, p=0.04). Post-anoxic diffusion changes using quantitative brain MRI may aid in predicting persistent coma and poor functional outcomes at hospital discharge. Copyright © 2017 Elsevier B.V. All rights reserved.

The kinetics and dynamics of the coma of Halley's comet

NASA Technical Reports Server (NTRS)

Combi, Michael R.

1994-01-01

This grant to the University of Michigan supported the efforts of Michael R. Combi to serve as a co-investigator in collaboration with a larger effort by the principal investigator, William Smyth of Atmospheric and Environmental Research, Inc. The overall objective of this project was to analyze in a self-consistent manner unique optical O((sup 1)D) and NH2 ultra-high resolution line profile data of excellent quality and other supporting lower-resolution spectral data for the coma of comet P/Halley by using highly developed and physically-based cometary coma models in order to determine and explain in terms of physical processes the actual dynamics and photochemical kinetics that occur in the coma. The justification for this work is that it provides a valuable and underlying physical base from which to interpret significantly different types of coma observations in a self-consistent manner and hence bring into agreement (or avoid) apparent inconsistencies that arise from non-physically based interpretations. The level of effort for the Michigan component amounted to less than three person-months over a planned period of three years. The period had been extended at no extra cost to four years because the Michigan grant and the AER contract did not have coincident time periods. An effort of somewhat larger scope was undertaken by the PI. The importance of the O((sup 1)D) profiles is that they provide a direct trace of the water distribution in comets. The line profile shape is produced by the convolution of the outflow velocity and thermal dispersion of the parent water molecules with the photokinetic ejection of the oxygen atoms upon photodissociation of the parent water molecules. Our understanding of the NH2 and its precursor ammonia are important for comet-to-comet composition variations as they relate to the cosmo-chemistry of the early solar nebula. Modeling of the distribution of NH2 is necessary in order to infer the ammonia production rates from NH2 observations.

Combinatorial Effects of Aromatic 1,3-Disubstituted Ureas and Fluoride on In vitro Inhibition of Streptococcus mutans Biofilm Formation.

PubMed

Kaur, Gurmeet; Balamurugan, P; Uma Maheswari, C; Anitha, A; Princy, S Adline

2016-01-01

Dental caries occur as a result of disequilibrium between acid producing pathogenic bacteria and alkali generating commensal bacteria within a dental biofilm (dental plaque). Streptococcus mutans has been reported as a primary cariogenic pathogen associated with dental caries. Emergence of multidrug resistant as well as fluoride resistant strains of S. mutans due to over use of various antibiotics are a rising problem and prompted the researchers worldwide to search for alternative therapies. In this perspective, the present study was aimed to screen selective inhibitors against ComA, a bacteriocin associated ABC transporter, involved in the quorum sensing of S. mutans. In light of our present in silico findings, 1,3-disubstituted urea derivatives which had better affinity to ComA were chemically synthesized in the present study for in vitro evaluation of S. mutans biofilm inhibition. The results revealed that 1,3-disubstituted urea derivatives showed good biofilm inhibition. In addition, synthesized compounds exhibited potent synergy with a very low concentration of fluoride (31.25-62.5 ppm) in inhibiting the biofilm formation of S. mutans without affecting the bacterial growth. Further, the results were supported by confocal laser scanning microscopy. On the whole, from our experimental results we conclude that the combinatorial application of fluoride and disubstituted ureas has a potential synergistic effect which has a promising approach in combating multidrug resistant and fluoride resistant S. mutans in dental caries management.

Cold resistance depends on acclimation and behavioral caste in a temperate ant

NASA Astrophysics Data System (ADS)

Modlmeier, Andreas P.; Pamminger, Tobias; Foitzik, Susanne; Scharf, Inon

2012-10-01

Adjusting to low temperatures is important for animals living in cold environments. We studied the chill-coma recovery time in temperate ant workers ( Temnothorax nylanderi) from colonies collected in autumn and spring in Germany. We experimentally acclimated these ant colonies to cold temperatures followed by warm temperatures. As expected, cold-acclimated workers recovered faster from freezing temperatures, but subsequent heat acclimation did not change the short recovery times observed after cold acclimation. Hence, either heat acclimation improves cold tolerance, possibly as a general response to stress, or at least it does not negate enhanced cold tolerance following cold acclimation. Colonies collected in spring showed similar cold tolerance levels to cold-acclimated colonies in the laboratory. Next, we compared the chill-coma recovery time of different worker castes and found that exterior workers recovered faster than interior workers. This difference may be related to their more frequent exposure to cold, higher activity level, or distinct physiology. Interior workers were also heavier and showed a higher gaster-to-head ratio and thorax ratio compared to exterior workers. An obvious difference between exterior and interior workers is activity level, but we found no link between activity and cold tolerance. This suggests that physiology rather than behavioral differences could cause the increased cold tolerance of exterior workers. Our study reveals the importance of acclimation for cold tolerance under natural and standardized conditions and demonstrates differences in cold tolerance and body dimensions in monomorphic behavioral castes of an ant.