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Sample records for hypertrophic contaminated shallow

  1. Phytoplankton biodiversity changes in a shallow tropical reservoir during the hypertrophication process.

    PubMed

    Crossetti, L O; Bicudo, D C; Bicudo, C E M; Bini, L M

    2008-11-01

    Study aimed at evaluating phytoplankton biodiversity changes in a shallow tropical reservoir during its hypertrophication process. Samplings were carried out monthly during 8 consecutive years (1997-2004) in 5 depths. Conspicuous limnological changes in the reservoir derived from the presence and/or removal of the water hyacinth, characterized 3 different phases. Over the time series, reservoir changed from a typical polymictic eutrophic system to hypertrophic one, leading to a reduction of approximately 70 species (average 37%). Chlorophyceae accounted for the highest species richness (46%) among all algal classes and strictly followed total species richness variation. Internal feedback mechanisms intensification over phase III clearly promoted the sharp decrease in biodiversity. Highest decreases, mainly during springs, occurred simultaneously to the highest Cyanobacteria blooms. Increased turbidity due to heavy phytoplankton blooms suppressed all other algal groups, so that at the end of the present study even Cyanobacteria species richness decreased. Total dissolved phosphorous was included in most of the best selected models used to analyze the temporal patterns in species richness loss. Present data show that biodiversity loss following trophic change was not a single dimension of a single factor but, rather, a template of factors (e.g. light, stability) co-varying in consequence of the larger levels of biomass supported in the reservoir.

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

    SciTech Connect

    Ademoroti, C.M.A. )

    1987-01-01

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

  3. The relationships between certain physical and chemical variables and the seasonal dynamics of phytoplankton assemblages of two inlets of a shallow hypertrophic lake with different nutrient inputs.

    PubMed

    Celik, Kemal; Ongun, Tugba

    2007-01-01

    The relationships between water discharge, temperature, total dissolved solids (TDS) conductivity, turbidity, nitrate, ammonium, phosphate and the seasonal dynamics of phytoplankton assemblages of two inlets of a shallow hypertrophic lake (Lake Manyas, Turkey) were studied between January 2003 and December 2004. The results showed that different levels of water discharge, turbidity, conductivity, TDS and nutrients could lead to the development of significantly different phytoplankton assemblages in inlets of shallow hypertrophic lakes. The multiple regression analysis identified water discharge, turbidity and water temperature as the driving factors behind the dynamics of phytoplankton biovolume in the studied inlets. The first two axes of Canonical Correspondence Analysis (CCA) explained 78% of the total variance in dominant phytoplankton species at Siğirci Inlet and 88% at Kocaçay Inlet, respectively. The purpose of this study was to determine the relationships between water discharge, temperature, conductivity, turbidity, pH, TDS, nitrate, ammonium, phosphate and the seasonal dynamics of phytoplankton assemblages of two inlets of the shallow hypertrophic Lake Manyas, Turkey by means of multivariate statistical analysis.

  4. Circumventing shallow air contamination in Mid Ocean Ridge Basalts

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  5. Modeling contamination of shallow unconfined aquifers through infiltration beds

    USGS Publications Warehouse

    Ostendorf, D.W.

    1986-01-01

    We model the transport of a simply reactive contaminant through an infiltration bed and underlying shallow, one-dimensional, unconfined aquifer with a plane, steeply sloping bottom in the assumed absence of dispersion and downgradient dilution. The effluent discharge and ambient groundwater flow under the infiltration beds are presumed to form a vertically mixed plume marked by an appreciable radial velocity component in the near field flow region. The near field analysis routes effluent contamination as a single linear reservoir whose output forms a source plane for the one-dimensional, far field flow region downgradient of the facility; the location and width of the source plane reflect the relative strengths of ambient flow and effluent discharge. We model far field contaminant transport, using an existing method of characteristics solution with frame speeds modified by recharge, bottom slope, and linear adsorption, and concentrations reflecting first-order reaction kinetics. The near and far field models simulate transport of synthetic detergents, chloride, total nitrogen, and boron in a contaminant plume at the Otis Air Force Base sewage treatment plant in Barnstable County, Massachusetts, with reasonable accuracy.

  6. Modeling Contamination of Shallow Unconfined Aquifers Through Infiltration Beds

    NASA Astrophysics Data System (ADS)

    Ostendorf, D. W.

    1986-03-01

    We model the transport of a simply reactive contaminant through an infiltration bed and underlying shallow, one-dimensional, unconfined aquifer with a plane, steeply sloping bottom in the assumed absence of dispersion and downgradient dilution. The effluent discharge and ambient groundwater flow under the infiltration beds are presumed to form a vertically mixed plume marked by an appreciable radial velocity component in the near field flow region. The near field analysis routes effluent contamination as a single linear reservoir whose output forms a source plane for the one-dimensional, far field flow region downgradient of the facility; the location and width of the source plane reflect the relative strengths of ambient flow and effluent discharge. We model far field contaminant transport, using an existing method of characteristics solution with frame speeds modified by recharge, bottom slope, and linear adsorption, and concentrations reflecting first-order reaction kinetics. The near and far field models simulate transport of synthetic detergents, chloride, total nitrogen, and boron in a contaminant plume at the Otis Air Force Base sewage treatment plant in Barnstable County, Massachusetts, with reasonable accuracy.

  7. Arsenic contamination of Ronphibun residents associated with uses of arsenic-contaminated shallow-well water other than drinking.

    PubMed

    Oshikawa, Shoko; Geater, Alan; Chongsuvivatwong, Virasakdi; Chakraborti, Dipankar

    2007-10-01

    High levels of urinary arsenic have been reported among residents of an area of southern Thailand where many households have shallow wells heavily contaminated with arsenic. However, the finding that very few of the residents in this area have used contaminated shallow-well water for drinking or cooking in the last 10 years prompted this investigation. The aim was to identify the uses of shallow-well water by adult residents that were related to a positive association between shallow-well water and urinary arsenic levels. Information on shallow-well water use for all personal and domestic purposes was obtained and arsenic levels of household shallow-well water and urine (after refraining from seafood for 2 days) were measured. Urinary and shallow-well water arsenic levels were strongly positively associated among residents who regularly used shallow-well water for bathing (including washing face, hair, hands and feet) but not among residents regularly using arsenic-safe water for bathing or regularly using shallow-well water for other purposes, such as brushing teeth, domestic cleaning or washing food and utensils. The findings suggest that appreciable transdermal absorption of arsenic is possible and that successful abatement of human contamination with arsenic may require the provision of arsenic-safe water, not only for consumption but also for personal hygiene purposes.

  8. Using H2O2 treatments for the degradation of cyanobacteria and microcystins in a shallow hypertrophic reservoir.

    PubMed

    Papadimitriou, Theodoti; Kormas, Konstantinos; Dionysiou, Dionysios D; Laspidou, Chrysi

    2016-11-01

    Toxins produced by cyanobacteria in freshwater ecosystems constitute a serious health risk worldwide for humans that may use the affected water bodies for recreation, drinking water, and/or irrigation. Cyanotoxins have also been deemed responsible for loss of animal life in many places around the world. This paper explores the effect of H2O2 treatments on cyanobacteria and microcystins in natural samples from a hypertrophic reservoir in microcosm experiments. According to the results, cyanobacteria were more easily affected by H2O2 than by other phytoplanktonic groups. This was shown by the increase in the fractions of chlorophyll-a (a proxy for phytoplankton) and chlorophyll-b (a proxy for green algae) over total phytoplankton pigments and the decrease in the fraction of phycocyanin (a proxy for cyanobacteria) over total phytoplankton pigments. Thus, while an overall increase in phytoplankton occurred, a preferential decrease in cyanobacteria was observed with H2O2 treatments over a few hours. Moreover, significant degradation of total microcystins was observed under H2O2 treatments, while more microcystins were degraded when UV radiation was used in combination with H2O2. The combination of H2O2 and ultraviolet (UV) treatment in natural samples resulted in total microcystin concentrations that were below the World Health Organization limit for safe consumption of drinking water of 1 μg/L. Although further investigation into the effects of H2O2 addition on ecosystem function must be performed, our results show that the application of H2O2 could be a promising method for the degradation of microcystins in reservoirs and the reduction of public health risks related to the occurrence of harmful algal blooms.

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

    SciTech Connect

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

    2012-02-01

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

  10. Predicting geogenic arsenic contamination in shallow groundwater of south Louisiana, United States.

    PubMed

    Yang, Ningfang; Winkel, Lenny H E; Johannesson, Karen H

    2014-05-20

    Groundwater contaminated with arsenic (As) threatens the health of more than 140 million people worldwide. Previous studies indicate that geology and sedimentary depositional environments are important factors controlling groundwater As contamination. The Mississippi River delta has broadly similar geology and sedimentary depositional environments to the large deltas in South and Southeast Asia, which are severely affected by geogenic As contamination and therefore may also be vulnerable to groundwater As contamination. In this study, logistic regression is used to develop a probability model based on surface hydrology, soil properties, geology, and sedimentary depositional environments. The model is calibrated using 3286 aggregated and binary-coded groundwater As concentration measurements from Bangladesh and verified using 78 As measurements from south Louisiana. The model's predictions are in good agreement with the known spatial distribution of groundwater As contamination of Bangladesh, and the predictions also indicate high risk of As contamination in shallow groundwater from Holocene sediments of south Louisiana. Furthermore, the model correctly predicted 79% of the existing shallow groundwater As measurements in the study region, indicating good performance of the model in predicting groundwater As contamination in shallow aquifers of south Louisiana.

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

    PubMed Central

    2011-01-01

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

  12. Fecal contamination of shallow tubewells in Bangladesh inversely related to arsenic.

    PubMed

    van Geen, Alexander; Ahmed, Kazi Matin; Akita, Yasuyuki; Alam, Md Jahangir; Culligan, Patricia J; Emch, Michael; Escamilla, Veronica; Feighery, John; Ferguson, Andrew S; Knappett, Peter; Layton, Alice C; Mailloux, Brian J; McKay, Larry D; Mey, Jacob L; Serre, Marc L; Streatfield, P Kim; Wu, Jianyong; Yunus, Mohammad

    2011-02-15

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

  13. Contaminant attenuation by shallow aquifer systems under steady flow

    NASA Astrophysics Data System (ADS)

    Soltani, S. S.; Cvetkovic, V.

    2017-10-01

    We present a framework for analyzing advection-dominated solute transport and transformation in aquifer systems of boreal catchments that are typically shallow and rest on crystalline bedrock. A methodology is presented for estimating tracer discharge based on particle trajectories from recharge to discharge locations and computing their first passage times assuming that the flow pattern is approximately steady-state. Transformation processes can be included by solving one-dimensional reactive transport with randomized water travel time as the independent variable; the distribution of the travel times incorporates morphological dispersion (due to catchment geometry/topography) as well as macro-dispersion (due to heterogeneity of underlying hydraulic properties). The implementation of the framework is illustrated for the well characterized coastal catchment of Forsmark (Sweden). We find that macro-dispersion has a notable effect on attenuation even though the morphological dispersion is significantly larger. Preferential flow on the catchment scale is found to be considerable with only 5% of the Eulerian velocities contributing to transport over the simulation period of 375 years. Natural attenuation is illustrated as a simple (linear decay) transformation process. Simulated natural attenuation can be estimated analytically reasonably well by using basic hydrological and structural information, the latter being the pathway length distribution and average aquifer depth to the bedrock.

  14. Selection of an appropriate management strategy for contaminated sediment: A case study at a shallow contaminated harbour in Quebec, Canada.

    PubMed

    Pourabadehei, Mehdi; Mulligan, Catherine N

    2016-12-01

    Harbours, as strategic places in tourism and transportation, are exposed to many sources of contamination. Assessing the quality of harbours sediment by guidelines and regulations does not reflect the actual level of contamination and the risk posed to aquatic ecosystems. Selection of an appropriate management technique for contaminated sediments in those strategic locations is crucial for the aquatic environment. The purpose of this study is to show that insufficient information, provided by sediment quality guidelines (SQGs) to identify the actual contaminants, could lead to a destructive or potentially ineffective decision for risk reduction in contaminated harbours. A comprehensive evaluation on physicochemical characteristics of sediment and water samples of a shallow harbour in St. Lawrence River was performed. Results of trace metal fractionation and risk assessment indicated that Cd and Pb were the contaminants that could pose a threat to aquatic ecosystem, although the SQG outcomes implied that Cu and Zn may cause an adverse effect on the benthic organisms. The results of multivariate statistical analysis demonstrated that the locations in the vicinity of the maintenance area contained the most contaminated sediment samples and require appropriate management. Antifouling paint particles and probably the runoff entering the harbour were the main sources of pollution. Among the diverse range of management strategies, the resuspension technique is suggested as a viable alternative in this specific case for shallow locations with contaminated sediments. A suitable management strategy could reduce the cost of remediation process by identifying the actual contaminated spots and also reduce the risk of remobilization of trace metals. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    USGS Publications Warehouse

    Kalkhoff, S.J.

    1986-01-01

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

  16. In situ disinfection of sewage contaminated shallow groundwater: a feasibility study.

    PubMed

    Bailey, Morgan M; Cooper, William J; Grant, Stanley B

    2011-11-01

    Sewage-contaminated shallow groundwater is a potential cause of beach closures and water quality impairment in marine coastal communities. In this study we set out to evaluate the feasibility of several strategies for disinfecting sewage-contaminated shallow groundwater before it reaches the coastline. The disinfection rates of Escherichia coli (EC) and enterococci bacteria (ENT) were measured in mixtures of raw sewage and brackish shallow groundwater collected from a coastal community in southern California. Different disinfection strategies were explored, ranging from benign (aeration alone, and aeration with addition of brine) to aggressive (chemical disinfectants peracetic acid (PAA) or peroxymonosulfate (Oxone)). Aeration alone and aeration with brine did not significantly reduce the concentration of EC and ENT after 6 h of exposure, while 4-5 mg L(-1) of PAA or Oxone achieved >3 log reduction after 15 min of exposure. Oxone disinfection was more rapid at higher salinities, most likely due to the formation of secondary oxidants (e.g., bromine and chlorine) that make this disinfectant inappropriate for marine applications. Using a Lagrangian modeling framework, we identify several factors that could influence the performance of in-situ disinfection with PAA, including the potential for bacterial regrowth, and the non-linear dependence of disinfection rate upon the residence time of water in the shallow groundwater. The data and analysis presented in this paper provide a framework for evaluating the feasibility of in-situ disinfection of shallow groundwater, and elucidate several topics that warrant further investigation.

  17. Susceptibility of ground water to surface and shallow sources of contamination, Orange County, North Carolina

    USGS Publications Warehouse

    Terziotti, Silvia; Eimers, J.L.

    1999-01-01

    In 1998, the relative susceptibility of ground water in Orange County, North Carolina,to contamination from surface and shallow sources was evaluated. A geographic information system was used to build three county-wide layers--soil permeability, land use/land cover, and land-surface slope. The harmonic mean permeability of soil layers was used to estimate a location's capacity to transmit water through the soil. Values for each of these three factors were categorized and ranked from 1 to 10 according to relative potential for contamination. Each factor was weighted to reflect its relative potential contribution to ground-water contamination, then the factors were combined to create a relative susceptibility index. The relative susceptibility index was categorized to reflect lowest, low, moderate, high, and highest potential for ground-water contamination. The relative susceptibility index for about 12 percent of the area in Orange County was categorized as high or highest. The high and highest range areas have highly permeable soils, land cover or land-use activities that have a high contamination potential, and low to moderate slopes. Most of the county is within the moderate category of relative susceptibility to ground-water contamination. About 21 percent of the county is ranked as low or lowest relative susceptibility to ground-water contamination.

  18. Toxicological assessment of aquatic ecosystems: application to watercraft contaminants in shallow water environments

    USGS Publications Warehouse

    Winger, P.V.; Kemmish, Michael J.

    2002-01-01

    Recreational boating and personal watercraft use have the potential to adversely impact shallow water systems through contaminant release and physical disturbance of bottom sediments. These nearshore areas are often already degraded by surface runoff, municipal and industrial effluents, and other anthropogenic activities. For proper management, information is needed on the level of contamination and environmental quality of these systems. A number of field and laboratory procedures can be used to provide this much needed information. Contaminants, such as metals, pesticides, polychlorinated biphenyls and polycyclic aromatic hydrocarbons, entering aquatic environments generally attach to particulate matter that eventually settles and becomes incorporated into the bottom sediments. Because bottom sediments serve as a sink and as a source for contaminants, environmental assessments generally focus on this matrix. While contaminant residues in sediments and sediment pore waters can reflect environmental quality, characteristics of sediment (redox potential, sediment/pore-water chemistry, acid volatile sulfides, percent organic matter, and sediment particle size) influence their bioavailability and make interpretation of environmental significance difficult. Comparisons of contaminant concentrations in pore water (interstitial water) and sediment with water quality criteria and sediment quality guidelines, respectively, can provide insight into potential biological effects. Laboratory bioaccumulation studies and residue concentrations in resident or caged biota also yield information on potential biological impacts. The usefulness of these measurements may increase as data are developed relating in-situ concentrations, tissue residue levels, and biological responses. Exposure of test organisms in situ or to field-collected sediment and pore water are additional procedures that can be used to assess the biological effects of contaminants. A battery of tests using multi

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    McKenna, J; Sherlock, D; Evans, B

    2001-12-01

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

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

    USGS Publications Warehouse

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

    2000-01-01

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

  2. Influence of Climate Extremes and Land Use on Fecal Contamination of Shallow Tubewells in Bangladesh.

    PubMed

    Wu, Jianyong; Yunus, Mohammad; Islam, Md Sirajul; Emch, Michael

    2016-03-01

    Climate extremes in conjunction with some land use practices are expected to have large impacts on water quality. However, the impacts of land use and climate change on fecal contamination of groundwater has not been well characterized. This work quantifies the influences of extreme weather events and land use practices on Escherichia coli presence and concentration in groundwater from 125 shallow wells, a dominant drinking water resource in rural Bangladesh, monitored over a 17 month period. The results showed that E. coli presence was significantly associated with the number of heavy rain days, developed land and areas with more surface water. These variables also had significant impacts on E. coli concentration, with risk ratios of 1.38 (95% CI = 1.16, 1.65), 1.07 (95% CI: 1.05, 1.09), and 1.02 (95% CI = 1.01, 1.03), respectively. Significant synergistic effects on E. coli presence and concentration were observed when land use and weather variables were combined. The findings suggest that climate extremes and land use practices, particularly urbanization, might promote fecal contamination of shallow well water, thus increasing the risk of diarrheal diseases.

  3. Shallow Groundwater Conveyance of Geologically Derived Contaminants to Urban Creeks in Southern California.

    PubMed

    Bardsley, Audra I; Hammond, Douglas E; von Bitner, Theodore; Buenning, Nikolaus H; Townsend-Small, Amy

    2015-08-18

    In California alone, there are currently over 200 instances on the EPA's list of impaired water bodies with unknown sources of excessive salinity or trace contaminants. This investigation focuses on Orange County, CA, a region that has undergone extensive hydrological modification, relies heavily on imported water for municipal supply, and has come under regulatory scrutiny for elevated TDS, sulfate, Cd, Ni, and Se. A survey of shallow groundwater weeps and springs, discharging directly to urban creeks, reveals high concentrations of TDS, sulfate, Cd, Ni, Zn, Cu, and Se that are often far in excess of water quality standards. Isotopic (δ(34)S and δ(18)O) and geochemical evidence indicate that the source of sulfate and TDS is weathering of sulfide minerals in the Capistrano Formation marine mudstone and dissolution of secondary minerals formed during past periods of sulfide oxidation, rather than anthropogenic inputs. The relative availability of carbonate minerals along the flow path appears to control pH, which then influences trace metal mobility to surface waters. Stable isotopes of H2O indicate that despite widespread use of imported water, meteoric recharge dominates shallow groundwater inputs with municipal sources contributing only 13-29% of discharge. These findings highlight the importance of understanding the hydrogeological setting to properly apportion contaminant sources and conveyances.

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

    USGS Publications Warehouse

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

    1999-01-01

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

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

    SciTech Connect

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

    2012-09-01

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

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

    USGS Publications Warehouse

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

    2006-01-01

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

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

    USGS Publications Warehouse

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

    1995-01-01

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

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

    USGS Publications Warehouse

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

    2001-01-01

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

  9. Nitrate contamination of shallow aquifer groundwater in the central districts of Punjab, India.

    PubMed

    Bhardwaj, Anil; Garg, Sunil; Sondhi, S K; Taneja, D S

    2012-01-01

    The increasing trend in nitrogenous fertilizer use and extensive irrigation in the agricultural production system in Punjab, India are the reasons of contamination of groundwater, which is the main source of drinking water. A study was conducted to determine the extent of nitrate-nitrogen (NO3-N) contamination of groundwater in the shallow aquifers of Ludhiana district. Pre and post-monsoon groundwater samples from hand pumps of 36 villages, located at or near the nodes of 6-12 km grid, were collected during the years 1998 and 1999 and were analyzed for NO3-N concentration. During the period of study, the NO3-N concentration in 34.7%, 37.5%, 15.3%, 11.1% and 1.4% of the groundwater samples was between 0-5 mg/L, 6-10 mg/L, 11-15 mg/L, 16-20 mg/L and 21-25 mg/L, respectively. Around 72% of the groundwater samples were safe and did not exceed the critical limit of NO3-N concentration (10 mg/L) prescribed for drinking water. Although, statistically no change in the mean NO3-N concentration level has been observed during the study period and is within the safe limit in most of the samples (72%), yet there is every possibility of further contamination of groundwater due to continuous high N-fertilizer use and over irrigation which necessitates judicious and efficient N-fertilizer and irrigation water use in Punjab (India).

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

    PubMed

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

    2007-01-01

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

  11. Susceptibility of ground water to surface and shallow sources of contamination in Mississippi

    USGS Publications Warehouse

    O'Hara, Charles G.

    1996-01-01

    Ground water, because of its extensive use in agriculture, industry, and public-water supply, is one of Mississippi's most important natural resources.  Ground water is the source for about 80 percent of the total freshwater used by the State's population (Solley and others, 1993).  About 2,600 Mgal/d of freshwater is withdrawn from aquifers in Mississippi (D.E. Burt, Jr., U.S. Geological Survey, oral commun., 1995).  Wells capable of yielding 200 gal/min of water with quality suitable for most uses can be developed nearly anywhere in the State (Bednar, 1988).  The U.S. Geological Survey (USGS), in cooperation with the Mississippi Department of Environmental Quality, Office of Pollution Control, and the Mississippi Department of Agriculture and Commerce, Bureau of Plant Industry, conducted an investigation to evaluate the susceptibility of ground water to contamination from surgace and shallow sources in Mississippi.  A geographic information system (GIS) was used to develop and analyze statewide spatial data layers that contain geologic, hydrologic, physiographic, and cultural information.

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

    SciTech Connect

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

    1994-03-01

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

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

    NASA Astrophysics Data System (ADS)

    Lockhart, K.; King, A.

    2011-12-01

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

  14. Hypertrophic Cardiomyopathy Association

    MedlinePlus

    ... purchased, 10% will be donated to Hypertrophic Cardiomyopathy Association. iGive.com - Online Shopping Joing iGive.com to ... 5% of the purchase price to Hypertrophic Cardiomyopathy Association. Bookmark the link http://smile.amazon.com/ch/ ...

  15. Inorganic contaminants from diffuse pollution in shallow groundwater of the Campanian Plain (Southern Italy). Implications for geochemical survey.

    PubMed

    Cuoco, E; Darrah, T H; Buono, G; Verrengia, G; De Francesco, S; Eymold, W K; Tedesco, D

    2015-02-01

    The Campanian Plain (CP) shallow aquifer (Southern Italy) represents a natural laboratory to validate geochemical methods for differentiating diffuse anthropogenic pollution from natural water-rock interaction processes. The CP is an appropriate study area because of numerous potential anthropogenic pollution vectors including agriculture, animal husbandry, septic/drainage sewage systems, and industry. In order to evaluate the potential for geochemical methods to differentiate various contamination vectors, 538 groundwater wells from the shallow aquifer in Campanian Plain (CP) were sampled. The dataset includes both major and trace elements. Natural water-rock interactions, which primarily depend on local lithology, control the majority of geochemical parameters, including most of the major and trace elements. Using prospective statistical methods in combination with the traditional geochemical techniques, we determined the chemical variables that are enriched by anthropogenic contamination (i.e. NO3, SO4 and U) by using NO3 as the diagnostic variable for detecting polluted groundwater. Synthetic agricultural fertilizers are responsible for the majority of SO4 and U pollution throughout the CP area. Both SO4 and U are present in the groundmass of synthetic fertilizers; the uranium concentration is specifically applicable as a tracer for non-point source agricultural fertilizer contamination. The recognition of non-geological (anthropogenic) inputs of these elements has to be considered in the geochemical investigations of contaminated aquifers.

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

    PubMed

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

    1996-06-01

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  19. Statistical characterization of arsenic contamination in shallow tube wells of western Bangladesh

    NASA Astrophysics Data System (ADS)

    Hossain, Faisal; Bagtzoglou, Amvrossios C.; Nahar, Nurun; Delawer Hossain, M.

    2006-04-01

    A regional assessment of the arsenic (As) contamination scenario in shallow tube wells (depth < 150 m) of western Bangladesh is presented. Comparisons are made in light of bulk geological differences (Pleistocene versus Holocene deposits/northwest versus southwest) and As measurement protocols (field kit (FK) versus atomic absorption spectroscopy (AAS)). Our As database comprised the following: (1) the nationwide As survey completed in 1999 by the British Geological Survey in collaboration with the Department of Public Health Engineering (DPHE); and (2) a regional As survey conducted in southwest Bangladesh by the Japan International Cooperation Agency in collaboration with DPHE in 2002. First, we characterize the error structure of the semi-quantitative FK As measurements using collocated AAS As measurements as reference from a set of 307 wells located in southwest Bangladesh. The depth distribution of As is identified using a very dense cluster of 2963 wells over a 560 km2 domain. The probability of the FK method for successful detection of a well sample as unsafe (safe) was found to be 96.9% (34.1%) and 95.2% (80.3%) for the World Health Organization (WHO) and Bangladesh safe limits, respectively. Similarly, the probability of false alarms and false hopes for WHO (Bangladesh) safe limits were found to be 3.1% (4.8%) and 87.5% (19.7%), respectively. The depth at which the highest fraction of wells exceeding a given safe limit occurred could still be inferred correctly by FK measurements. A simple bias adjustment procedure on FK As data did not result in a more accurate characterization of depth distribution of As. This indicated that simple error statistics are inadequate for advancing the utility of FKs; rather, an understanding of the complex and multidimensional error structure is required. Regional anisotropy in the spatial dependence of As for the northwest was found to be stronger than the southwest. The correlation length for As concentration in the east

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

    USGS Publications Warehouse

    Juracek, K.E.

    2008-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

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

    EPA Science Inventory

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

  3. CO2 Leakage-Induced Shallow Aquifer Contaminations and Associated Health Risk Assessment.

    NASA Astrophysics Data System (ADS)

    Kim, C. Y.; Han, W. S.; Park, E.; Choung, S.; Piao, J.; Han, G.; Tianfu, X.

    2016-12-01

    Leakage of stored CO2 from designated deep formation could degrade portable groundwater quality in overlaying shallow aquifers. Dissolution of leaked CO2 causes to reduction of pH and alters dominant geochemical reactions, which ultimately enhances mobility of toxic heavy metals in shallow aquifer. In this study, among various toxic heavy metals, mobilization of As and U were focused because these metals are considered to be cancer potency factor when human being continuously exposes for long period. For this reason, it is critical to evaluate relationship between the amount of leaked CO2 into shallow aquifer and a degree of mobility in As and U. In the end, cancer risk to human body were quantified with probabilistic approach after accounting for shallow groundwater velocity, pumping rate from residential well, geologic heterogeneity. For this study, two-dimensional reactive transport models were developed. Geologic heterogeneity was accounted with three interbedded rock types, which consisted of sandstone, As and U bearing shale, and carbonate rocks, respectively. Within these three-rock types, variability includes changes in permeability, porosity, a type of minerals, and its volume fraction, accounting for both physical and chemical heterogeneities Finally, human health risk is calculated through multiplying cancer potency factor by average daily dose, which is obtained after acquiring for both As and U concentrations profile at residential well through reactive transport modeling. As per variability, a series of human health risks were calculated. Quantification of risk in conjunction with sensitivity analysis aids to evaluate a list of geologic parameters enhancing human health risk.

  4. Sediment chemical contamination of a shallow water area close to the industrial zone of Porto Marghera (Venice Lagoon, Italy).

    PubMed

    Zonta, Roberto; Botter, Margherita; Cassin, Daniele; Pini, Roberto; Scattolin, Mario; Zaggia, Luca

    2007-01-01

    The industrial zone of Porto Marghera is one the most important "contaminated sites of national interest" (SIN) in Italy, being identified as an area of high environmental risk. The site includes a wide shallow water area of the Venice Lagoon extending toward the city of Venice, which was investigated in order to acquire information on the pollutant level and distribution. Grain-size, heavy metal, nutrient, and organic micropollutant concentrations were determined in the surface sediment layers (0-5 and 5-10 cm depths) of 51 sites. A generally low contamination was found, except for Hg concentration, which increases the toxicological risk in most of the sites of the area, according to the results of a comparison with Sediment Quality Guidelines. A heavy pollution fingerprint (Cd, Cu, Hg, Pb, and Zn up to 15.2, 257, 11.9, 248, and 3010 mg/kg d.w., respectively) was instead found near the Tresse Island, which is ascribed to the spill of pollutants from the contaminated sediment disposed therein. Grain-size and heavy metal profiles down to a depth of 40 cm in eight selected sites, finally show a probable decrease of the pollution affecting the area in recent years.

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    PubMed

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

    2015-03-01

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

  8. Geochemical and isotopic characteristics associated with high electrical conductivities in a shallow hydrocarbon-contaminated aquifer

    NASA Astrophysics Data System (ADS)

    Legall, F.; Atekwana, E.; Atekwana, E.; Krishnamurthy, R.; Sauck, W.

    2003-04-01

    Data collected from a network of in-situ vertical resistivity probes (VRPs) deployed within a hydrocarbon contaminated aquifer showed high soil conductivities associated with zones where residual and dissolved phase hydrocarbons (RDH) occur and zones where these phases coexist with free phase hydrocarbons (RDFH). Bulk soil conductivities were highest (12 to 30 mS/m) in the RDFH zone compared to the RDH zone (10 to 25 mS/m). Groundwater from closely spaced multi-level piezometers (MLPs) installed in the aquifer was analyzed to investigate the role of mineral weathering as the source of ions responsible for the high soil conductivity. Evidence for mineral weathering in the aquifer was assessed using major inorganic ions, dissolved inorganic carbon (DIC), stable carbon isotope ratio of DIC (δ13CDIC), and bulk soil conductivity. The link between bulk soil conductivity and δ13CDIC in contaminant plumes has never been reported in the literature. The results show higher Na, Ca, and Mg in the contaminated zone compared to background. The higher TDS in the contaminated zones is consistent with the weathering of carbonates and Na and Ca feldspars, the dominant minerals in the aquifer. Higher TDS at the contaminated locations was also coincident with higher DIC. The δ13CDIC values of 16.9 to 9.5 ppm suggest that DIC evolution within this zone is controlled by carbonate dissolution through enhanced CO_2 production related to microbial hydrocarbon degradation. Within the range of δ13CDIC values reported for groundwater at the RDH locations, the more positive δ13CDIC values were observed in zones where reduction of NO_3, Mn(IV), Fe(III), and SO_4 was occurring and was coincident with higher bulk soil conductivity. Within the portion of the aquifer with RDFH, δ13CDIC ranged from +6.5 to 4.4 ppm, suggesting that methanogenesis is the dominant redox process at this location. High DIC within the methanogenic zone is also coincident with higher bulk soil conductivity. Thus the

  9. Geochemical and isotopic characteristics associated with high soil conductivities in a shallow hydrocarbon-contaminated aquifer

    NASA Astrophysics Data System (ADS)

    Legall, Franklyn David

    Data collected from a network of in-situ vertical resistivity probes (VRPs) deployed at a hydrocarbon-contaminated site in SW Michigan showed high conductivities associated with the zone of contamination. Within the contaminated portion of the aquifer, different phases of hydrocarbon impact are recognized, namely, zones with residual and dissolved phase hydrocarbons (RDH) and zones where these phases coexist with free product (RDFH). Bulk soil conductivities were highest (12 to 30 mS/m) in the RDFH zone compared to the RDH zone (10 to 25 mS/m). Geochemical and isotopic data from closely spaced vertical samples within the high conductive zones were used to provide geochemical evidence for biodegradation and to investigate redox processes occurring within the conductive zones. Depth distribution of TEAs and educts showed evidence of reduction of nitrate, iron, manganese, and sulfate across steep vertical gradients. Within the portion of the plume characterized by RDH, SO4 reduction has supplanted denitrification via dissimilatory nitrate reduction, and the reduction of Fe (III) and Mn(IV) as the major observed redox process. This zone was also characterized by the highest DIC. The delta 13CDIC values of -16.9 to -9.5‰ suggest that DIC evolution within this zone is controlled by carbonate dissolution through enhanced CO2 production related to microbial hydrocarbon degradation. Within the portion of the aquifer with RDFH, DIC was lower compared to the RDH location with an associated delta13CDIC in the range of +6.5 to -4.4‰. Both the DIC and delta 13CDIC suggest that methanogenesis is the dominant redox process. With respect to mineral weathering as a possible source of ions contributing to high conductivities, the results show higher concentrations of Na, Ca, and Mg in the contaminated portion of the aquifer compared to uncontaminated parts. This is consistent with the weathering of carbonate and Na and Ca feldspars, the dominant minerals in the aquifer. Higher

  10. Baseline evaluation of sediment contamination in the shallow coastal areas of Saudi Arabian Red Sea.

    PubMed

    Ruiz-Compean, Pedro; Ellis, Joanne; Cúrdia, João; Payumo, Richard; Langner, Ute; Jones, Burton; Carvalho, Susana

    2017-09-12

    Despite the growing recognition of the importance of water and sediment quality there is still limited information on contamination levels in many regions globally including the Red Sea. This study provides a comprehensive assessment of three classes of contaminants (Polycyclic Aromatic Hydrocarbons - PAH; metals; plastics) in coastal sediments along the Saudi Arabian Red Sea mainly collected using grabs. Background concentrations are provided for metals in the region. Concentrations of metals and PAH were generally low in comparison to international guidelines. A clear relationship between the concentration of metals and anthropogenic sources was not always apparent and dust and vegetation may be relevant players in the region. Microplastic items (mainly polyethylene) were abundant (reaching up to 1gm(-2) and 160piecesm(-2)) and in general associated with areas of high human activity. This study provides critical information for future monitoring and the development of national policies within the Red Sea region. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Microbial community structure in a shallow hydrocarbon-contaminated aquifer associated with high electrical conductivity

    NASA Astrophysics Data System (ADS)

    Duris, J. W.; Rossbach, S.; Atekwana, E. A.; Werkema, D., Jr.

    2003-04-01

    Little is known about the complex interactions between microbial communities and electrical properties in contaminated aquifers. In order to investigate possible connections between these parameters a study was undertaken to investigate the hypothesis that the degradation of hydrocarbons by resident microbial communities causes a local increase in organic acid concentrations, which in turn cause an increase in native mineral weathering and a concurrent increase in the bulk electrical conductivity of soil. Microbial community structure was analyzed using a 96-well most probable number (MPN) method and rDNA intergenic spacer region analysis (RISA). Microbial community structure was found to change in the presence of hydrocarbon contaminants and these changes were consistently observed in regions of high electrical conductivity. We infer from this relationship that geophysical methods for monitoring the subsurface are a promising new technology for monitoring changes in microbial community structure and simultaneous changes in geochemistry that are associated with hydrocarbon degradation.

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

    SciTech Connect

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

    1980-09-01

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

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

    PubMed

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

    2007-02-01

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

  14. Occurrence and distribution of microbiological contamination and enteric viruses in shallow ground water in Baltimore and Harford counties, Maryland

    USGS Publications Warehouse

    Banks, William S.L.; Battigelli, David A.

    2002-01-01

    The U.S. Geological Survey, in cooperation with the Maryland Department of the Environment and the Wisconsin State Laboratory of Hygiene, conducted a study to characterize the occurrence and distribution of viral contamination in small (withdrawing less than 10,000 gallons per day) public water-supply wells screened in the shallow aquifer in the Piedmont Physiographic Province in Baltimore and Harford Counties, Maryland. Two hundred sixty-three small public water-supply wells were in operation in these counties during the spring of 2000. Ninety-one of these sites were selected for sampling using a methodology that distributed the samples evenly over the population and the spatial extent of the study area. Each site, and its potential susceptibility to microbiological contamination, was evaluated with regard to hole depth, casing interval, and open interval. Each site was evaluated using characteristics such as on-site geology and on-site land use.Samples were collected by pumping between 200 and 400 gallons of untreated well water through an electropositive cartridge filter. Water concentrates were subjected to cell-culture assay for the detection of culturable viruses and reverse-transcription polymerase chain reaction/gene probe assays to detect viral ribonucleic acid; grab samples were analyzed for somatic and male-specific coliphages, Bacteroides fragilis, Clostridium perfringens, enterococci, Escherichia coli, total coliforms, total oxidized nitrogen, nitrite, organic nitrogen, total phosphate, ortho-phosphate, calcium, magnesium, sodium, potas-sium, chloride, sulfate, iron, acid-neutralizing capacity, pH, specific conductance, temperature, and dissolved oxygen.One sample tested positive for the presence of the ribonucleic acid of rotavirus through poly-merase chain-reaction analysis. Twenty-nine per-cent of the samples (26 of 90) had bacterial con-tamination. About 7 percent of the samples (6 of 90) were contaminated with either male-specific coliphage

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

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

    PubMed

    Colín Lizalde, Luis de Jesús

    2003-01-01

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

  17. Diversity, abundance, and consistency of microbial oxygenase expression and biodegradation in a shallow contaminated aquifer

    SciTech Connect

    Yagi, J.M.; Madsen, E.L.

    2009-10-15

    The diversity of Rieske dioxygenase genes and short-term temporal variability in the abundance of two selected dioxygenase gene sequences were examined in a naphthalene-rich, coal tar waste-contaminated subsurface study site. Using a previously published PCR-based approach (S. M. Ni Chadhain, R. S. Norman, K. V. Pesce, J. J. Kukor, and G. J. Zylstra, Appl. Environ. Microbiol. 72: 4078-4087, 2006) a broad suite of genes was detected, ranging from dioxygenase sequences associated with Rhodococcus and Sphingomonas to 32 previously uncharacterized Rieske gene sequence clone groups. The nag genes appeared frequently (20% of the total) in two groundwater monitoring wells characterized by low (similar to 10{sup 2} ppb; similar to 1 {mu} M) ambient concentrations of naphthalene. A quantitative competitive PCR assay was used to show that abundances of nag genes (and archetypal nah genes) fluctuated substantially over a 9-month period. To contrast short-term variation with long-term community stability, in situ community gene expression (dioxygenase mRNA) and biodegradation potential (community metabolism of naphthalene in microcosms) were compared to measurements from 6 years earlier. cDNA sequences amplified from total RNA extracts revealed that nah- and nag-type genes were expressed in situ, corresponding well with structural gene abundances. Despite evidence for short-term (9-month) shifts in dioxygenase gene copy number, agreement in field gene expression (dioxygenase mRNA) and biodegradation potential was observed in comparisons to equivalent assays performed 6 years earlier. Thus, stability in community biodegradation characteristics at the hemidecadal time frame has been documented for these subsurface microbial communities.

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  19. Spore-forming, Desulfosporosinus-like sulphate-reducing bacteria from a shallow aquifer contaminated with gasoline.

    PubMed

    Robertson, W J; Franzmann, P D; Mee, B J

    2000-02-01

    Previous studies on the geochemistry of a shallow unconfined aquifer contaminated with hydrocarbons suggested that the degradation of some hydrocarbons was linked to bacterial sulphate reduction. There was attenuation of naphthalene, 1,3,5-trimethylbenzene (TMB), toluene, p-xylene and ethylbenzene in the groundwater with concomitant loss of sulphate. Here, the recovery of eight strains of sulphate-reducing bacteria (SRB) from the contaminated site is reported. All were straight or curved rod-shaped cells which formed endospores. Amplification and sequencing of the 16S rDNA indicated that the strains were all sulphate reducers of the Gram-positive line of descent, and were most closely related to Desulfosporosinus (previously Desulfotomaculum) orientis DSM 8344 (97-98.9% sequence similarity). The strains clustered in three phylogenetic groups based on 16S rRNA sequences. Whole cell fatty acid compositions were similar to those of D. orientis DSM 8344, and were consistent with previous studies of fatty acids in soil and groundwater from the site. Microcosms containing groundwater from this aquifer indicated a role for sulphate reduction in the degradation of [ring-UL-14C]toluene, but not for the degradation of [UL-14C]benzene which could also be degraded by the microcosms. Adding one of the strains that was isolated from the groundwater (strain T2) to sulphate-enriched microcosms increased the rate of toluene degradation four- to 10-fold but had no effect on the rate of benzene degradation. The addition of molybdate, an inhibitor of sulphate reduction, to the groundwater samples decreased the rate of toluene mineralization. There was no evidence to support the mineralization of [UL-14C]benzene, [ring-UL-14C]toluene or unlabelled m-xylene, p-xylene, ethylbenzene, TMB or naphthalene by any of the strains in pure culture. Growth of all the strains was completely inhibited by 100 micromol l-1 TMB.

  20. Perfluorinated contaminants in sediments and aquatic organisms collected from shallow water and tidal flat areas of the Ariake Sea, Japan: environmental fate of perfluorooctane sulfonate in aquatic ecosystems.

    PubMed

    Nakata, Haruhiko; Kannan, Kurunthachalam; Nasu, Tetsuya; Cho, Hyeon-Seo; Sinclair, Ewan; Takemurai, Akira

    2006-08-15

    Perfluorinated compounds (PFCs), such as perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), perfluorohexane sulfonate (PFHS), and perfluorooctane sulfonamide (PFOSA) are widely distributed in aquatic ecosystems. Despite studies reporting the occurrence of PFCs in aquatic organisms, the fate of PFCs in tidal flat and marine coastal ecosystems is not known. In this study, we determined concentrations of PFOS, PFOA, PFNA, PFHS, and PFOSA in sediments; benthic organisms, including lugworm, mussel, crab, clam, oyster, and mudskipper fish from tidal flat; and shallow water species, such as filefish, bream, flounder, shark, finless porpoise, gull, and mallard collected from the Ariake Sea, Japan. PFOS and PFOA were detected in most of the samples analyzed, followed by PFNA, PFOSA, and PFHS. In shallow water species, PFOS was the dominant contaminant, and elevated concentrations were found in higher trophic level species, such as marine mammals and omnivorous birds. These results suggest biomagnification of PFOS through the coastal food chain. In contrast, PFOA was the most abundant compound in tidal flat organisms and sediments. PFOA concentrations in sediments, lugworms, and omnivorous mudskippers in tidal flat were approximately 1 order of magnitude greater than the levels of PFOS. This indicates differences in exposure pattern and bioavailability of PFOS and PFOA between shallow water and tidal flat organisms. The accumulation profiles of PFCs were compared with those of organochlorines (polychlorinated biphenyls, PCB), organotin (tributyltin,TBT), and polycyclic aromatic hydrocarbons (PAHs) in tidal flat and shallow water samples collected from the Ariake Sea. Concentrations of PFCs in sediments and in tidal flat organisms were significantly lower than that found for PCBs, TBT, and PAHs. Nevertheless, PFOS concentrations in shallow water species were comparable to and/or significantly greater than those of other classes of

  1. Assessment of multi-trophic changes in a shallow boreal lake simultaneously exposed to climate change and aerial deposition of contaminants from the Athabasca Oil Sands Region, Canada.

    PubMed

    Summers, Jamie C; Kurek, Joshua; Rühland, Kathleen M; Neville, Erin E; Smol, John P

    2017-08-15

    The Athabasca Oil Sands Region (AOSR) has been intensely developed for industrial bitumen extraction and upgrading since the 1980s. A paucity of environmental monitoring prior to development raises questions about baseline conditions in freshwater systems in the region and ecological responses to industrial activities. Further, climatic changes prompt questions about the relative roles of climate and industry in shaping aquatic ecosystems through time. We use aquatic bioindicators from multiple trophic levels, concentrations of petrogenic contaminants (dibenzothiophenes), and spectrally-inferred chlorophyll-a preserved in well-dated sediments of a closed-basin, shallow lake ~50km away from the main area of industry, in conjunction with climate observations, to assess how the biotic assemblages of a typical AOSR lake have changed during the past ~75years. We examine the contributions of the area's stressors in structuring aquatic communities. Increases in sedimentary measures of petrogenic contaminants provide clear evidence of aerial contaminant deposition from local industry since its establishment, while climate records demonstrate consistent warming and a recent period of reduced precipitation. Quantitative comparisons of biological assemblages from before and after the establishment of regional industry find significant (p<0.05) differences; however, the magnitude and overall timing of the changes are not consistent with a threshold-type shift in response to the onset of regional industry. Rather, biotic assemblages from multiple trophic levels suggest transitions to an increasingly complex benthic environment and relatively warmer waters, which, like the increasing trends in inferred primary production, are consistent with a changing climate. These findings highlight the important role of climate conditions in regulating primary production and structuring aquatic communities in these shallow systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Hypertrophic obstructive cardiomyopathy.

    PubMed

    Veselka, Josef; Anavekar, Nandan S; Charron, Philippe

    2017-03-25

    Hypertrophic obstructive cardiomyopathy is an inherited myocardial disease defined by cardiac hypertrophy (wall thickness ≥15 mm) that is not explained by abnormal loading conditions, and left ventricular obstruction greater than or equal to 30 mm Hg. Typical symptoms include dyspnoea, chest pain, palpitations, and syncope. The diagnosis is usually suspected on clinical examination and confirmed by imaging. Some patients are at increased risk of sudden cardiac death, heart failure, and atrial fibrillation. Patients with an increased risk of sudden cardiac death undergo cardioverter-defibrillator implantation; in patients with severe symptoms related to ventricular obstruction, septal reduction therapy (myectomy or alcohol septal ablation) is recommended. Life-long anticoagulation is indicated after the first episode of atrial fibrillation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Occurrence and distribution of enteric viruses in shallow ground water and factors affecting well vulnerability to microbiological contamination in Worcester and Wicomico counties, Maryland

    USGS Publications Warehouse

    Banks, William S.L.; Klohe, Cheryl A.; Battigelli, David A.

    2001-01-01

    The U.S. Geological Survey, in cooperation with the Maryland Department of the Environment and the Wisconsin State Laboratory of Hygiene, conducted a study to characterize the occurrence and distribution of viral contamination in small (withdrawing less than 10,000 gallons per day) public water-supply wells screened in the water-table aquifer in the Coastal Plain in Worcester and Wicomico Counties, Maryland.Two hundred seventy-eight well sites were evaluated with regard to simulated ground-water flow paths, land use, natural soils groups, and well characteristics, such as well depth and well age. Flow and transport simulations of the water-table aquifer indicated that wells screened less than about 50 feet below land surface (shallow wells) were most vulnerable to surface contamination, which in some cases could originate from as far as 2,000 feet upgradient of the well. Animal-feeding and agricultural-storage operations were considered among the most likely sources for viral contamination; therefore, sites close to these activities were considered most vulnerable. Soil groups were evaluated with regard to depth to water and moisture-holding capacity. Wells with shallow depths to water or in very sandy soils were considered more vulnerable to contamination than deep wells (greater than 50 feet) and those completed in finer-grained soils. Older wells and wells where coliform bacteria had been detected in the past were classified as highly vulnerable. On the basis of this evaluation, 27 sites considered to be susceptible were sampled.Samples were collected by pumping up to 400 gallons of untreated well water through an electropositive filter. Water concentrates were subjected to cell-culture assay for the detection of culturable viruses and reverse-transcription polymerase chain reaction/gene probe assays to detect nonculturable viruses; grab samples were analyzed for somatic and male-specific coliphages, Bacteroides fragilis, Clostridium perfringens, enterococci

  4. GIS-based colour composites and overlays to delineate heavy metal contamination zones in the shallow alluvial aquifers, Ankaleshwar industrial estate, south Gujarat, India

    NASA Astrophysics Data System (ADS)

    Kumar, Suyash; Shirke, K. D.; Pawar, N. J.

    2008-03-01

    In an attempt to delineate heavy metal contamination precincts and to evaluate the extent and degree of toxic levels, besides their possible sources, 38 water samples from Ankaleshwar Industrial Estate, south Gujarat, India were analyzed. By clutching geochemical analyses and GIS-based colour composites areas depicting anomalously high concentration of heavy metals (Mo, Zn, Pb, Ni, Co, Cd, etc.) in the groundwater were revealed. The multicomponent overlays in grey-scale facilitated in identifying situates of heavy metal ‘hot spots’, and lateral protuberances of the contamination plume around defile stretch of the main stream Amla Khadi flowing through the area. The multiple pollution plumes emerging from other parts of the area further coincide with effluent laden streams and small channels indicating industrial establishments as major sources of groundwater contamination. Influent nature of the streams, accelerated infiltration process, high mass influx and shallow groundwater table are the factors conducive for easy access of heavy metals to the phreatic aquifers affecting over 20 km2 area. On the basis of P/ U ratios (concentration of metals in polluted water to unpolluted water), geogenic and anthropogenic sources have been identified. Very high levels of technogenic elements present in the ground water raise concerns about possible migration into food crops, as the area is an important horticultural locale and is highly cultivated.

  5. Update on hypertrophic scar treatment

    PubMed Central

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

    2014-01-01

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

  6. Update on hypertrophic scar treatment.

    PubMed

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

    2014-08-01

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

  7. Bacterial contamination of tile drainage water and shallow groundwater under different application methods of liquid swine manure.

    PubMed

    Samarajeewa, A D; Glasauer, S M; Lauzon, J D; O'Halloran, I P; Parkin, Gary W; Dunfield, K E

    2012-05-01

    A 2 year field experiment evaluated liquid manure application methods on the movement of manure-borne pathogens (Salmonella sp.) and indicator bacteria (Escherichia coli and Clostridium perfringens) to subsurface water. A combination of application methods including surface application, pre-application tillage, and post-application incorporation were applied in a randomized complete block design on an instrumented field site in spring 2007 and 2008. Tile and shallow groundwater were sampled immediately after manure application and after rainfall events. Bacterial enumeration from water samples showed that the surface-applied manure resulted in the highest concentration of E. coli in tile drainage water. Pre-tillage significantly (p < 0.05) reduced the movement of manure-based E. coli and C. perfringens to tile water and to shallow groundwater within 3 days after manure application (DAM) in 2008 and within 10 DAM in 2007. Pre-tillage also decreased the occurrence of Salmonella sp. in tile water samples. Indicator bacteria and pathogens reached nondetectable levels within 50 DAM. The results suggest that tillage before application of liquid swine manure can minimize the movement of bacteria to tile and groundwater, but is effective only for the drainage events immediately after manure application or initial rainfall-associated drainage flows. Furthermore, the study highlights the strong association between bacterial concentrations in subsurface waters and rainfall timing and volume after manure application.

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

    USGS Publications Warehouse

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

    1994-01-01

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

  9. Spatial variability of shallow groundwater level, electrical conductivity and nitrate concentration, and risk assessment of nitrate contamination in North China Plain.

    PubMed

    Hu, Kelin; Huang, Yuangfang; Li, Hong; Li, Baoguo; Chen, Deli; White, Robert Edlin

    2005-08-01

    In recent years, nitrate (NO3) contamination of groundwater has become a growing concern for people in rural areas in North China Plain (NCP) where groundwater is used as drinking water. The objective of this study was to evaluate groundwater resource level, to determine groundwater quality and to assess the risk of NO3 pollution in groundwater in Quzhou County in the NCP. Ordinary Kriging (OK) method was used to analyze the spatial variability of shallow groundwater level, groundwater electrical conductivity (EC) and NO3-N concentrations, and Indictor Kriging (IK) method was used to analyze the data with NO3-N concentrations equal or greater than the groundwater NO3 pollution threshold (20 mg L(-1)). The results indicated that groundwater level averaged 9.81 m, a level 6 m lower than in 1990. The spatial correlation distances for groundwater level, EC and NO3-N concentration were 21.93, 2.19 and 3.55 km, respectively. The contour map showed that shallow groundwater level areas extended from north to south across the County. Groundwater EC was above 3 dS m(-1) in the most part of the northern county. Groundwater NO3 pollution (NO3-N> or =20 mg L(-1)) mainly occurred in the County Seat areas due to wastewater irrigation and excessive fertilizer leaching from agricultural fields. At Henantuang town, besides suburban of the County Seat, groundwater was also contaminated by NO3 shown by the map generated using the IK method, which was not reflected in the map generated using the OK method. The map generated using the OK method could not reflect correctly the groundwater NO3 pollution status. The IK method is useful to assess the risk of NO3 pollution by giving the conditional probability of NO3 concentration exceeding the threshold value. It is suggested that risk assessment of NO3 pollution is useful for better managing groundwater resource, preventing soil salinization and minimizing NO3 pollution in groundwater.

  10. Misconceptions and Facts About Hypertrophic Cardiomyopathy.

    PubMed

    Argulian, Edgar; Sherrid, Mark V; Messerli, Franz H

    2016-02-01

    Hypertrophic cardiomyopathy is the most common genetic heart disease. Once considered relentless, untreatable, and deadly, it has become a highly treatable disease with contemporary management. Hypertrophic cardiomyopathy is one of cardiology's "great masqueraders." Mistakes and delays in diagnosis abound. Hypertrophic cardiomyopathy commonly "masquerades" as asthma, anxiety, mitral prolapse, and coronary artery disease. However, once properly diagnosed, patients with hypertrophic cardiomyopathy can be effectively managed to improve both symptoms and survival. This review highlights some of the misconceptions about hypertrophic cardiomyopathy. Providers at all levels should have awareness of hypertrophic cardiomyopathy to promptly diagnose and properly manage these individuals. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    NASA Astrophysics Data System (ADS)

    Mansoor, Nasser M.

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

  12. Delineation of recharge patterns and contaminant transport using 3H-3He in a shallow aquifer contaminated by chlorinated solvents in South Korea

    NASA Astrophysics Data System (ADS)

    Kaown, Dugin; Koh, Dong-Chan; Solomon, D. Kip; Yoon, Yoon-Yeol; Yang, Jaeha; Lee, Kang-Kun

    2014-08-01

    Stable isotopes of water and 3H-3He were used to delineate recharge patterns and contaminant transport for a granitic regolith aquifer in an industrial complex in Wonju, South Korea, that has historically been contaminated with chlorinated solvents including trichloroethene (TCE) and carbon tetrachloride (CT). Groundwater recharge mainly occurred in upgradient forested areas while little recharge occurred in the downgradient industrial areas covered with extensive sections of impermeable pavement and paddy fields. δ18O and δD data indicated that groundwater was mainly derived from summer precipitation. The apparent groundwater ages using 3H-3He ranged from 1 to 4 yrs in the upgradient area and from 9 to 10 yrs in the downgradient area. Comparison of groundwater flow velocities based on Darcy's law and those calculated with simple mass balance models and groundwater age supported the presence of preferential pathways for TCE movement in the study area. Measureable TCE was observed in groundwater irrespective of groundwater age. Considering the 3-yr duration of the TCE spill, 14 yrs before sampling, this indicates that TCE plumes were continuously fed from sources in the unsaturated zone after the spill ended and moved downgradient without significant degradation in the aquifer.

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

    SciTech Connect

    Conrad, Mark E.; DePaolo, Donald J.

    2003-09-04

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

  14. Burns, hypertrophic scar and galactorrhea.

    PubMed

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

    2013-07-01

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

  15. Burns, hypertrophic scar and galactorrhea

    PubMed Central

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

    2013-01-01

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

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

    SciTech Connect

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

    1982-01-01

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

  17. Kinetics and reactive transport of N2O in a nitrate-contaminated shallow aquifer: How to transfer static Batch Experiments to highly-transient Field Conditions?

    NASA Astrophysics Data System (ADS)

    Geistlinger, Helmut; Weymann, Daniel; Well, Reinhard

    2010-05-01

    ., Ruiyan Jia, D. Eisermann, and C.-F. Stange (2008): Spatial and temporal variability of dissolved nitrous oxide in near-surface groundwater and bubble-mediated mass transfer to the unsaturated zone, J. Plant Nutrition and Soil Science, in press. Geistlinger, H., G. Wriedt, D. Weymann, and R. Well (2009) Kinetics and reactive transport of N2O in a nitrate contaminated shallow aquifer: Development of a process-based reaction module for gas transport, Vadose Zone Journal, in review.

  18. Living with hypertrophic cardiomyopathy.

    PubMed

    Subasic, Kim

    2013-12-01

    The purpose of this study is to provide an insider's account of what it is like to live with hypertrophic cardiomyopathy (HCM), a genetic cardiovascular illness that carries the risk for sudden cardiac death. This study aims to reveal how HCM impacts the family and guides the decision whether or not to pursue genetic testing, how the physical limitations associated with HCM alter being-in-the-world, and how HCM alters social relationships. Fifteen adults with HCM were recruited for a longitudinal, phenomenological, qualitative study through purposive sampling and word of mouth. A total of 45 interviews were conducted by the researcher at a time and place designated by the participant between August 2011 and January 2012. The first interview with each participant was conducted in person. While efforts were made to conduct all interviews in person, a total of three interviews were conducted by telephone as requested by three participants due to scheduling conflicts. Through methods of interpretive phenomenology, three audio-recorded, semistructured interviews occurred over the course of 3 months. Detailed narratives were solicited and transcribed verbatim. Methodological and analytical documentation was supported with the identification of key phrases, similar experiences, themes, and documentation of the rationale for decisions throughout the research process. Participation in genetic testing carries a multitude of personal, familial, financial, and emotional implications. The results of a genetic test elicited an emotional response regardless of whether the results were negative, positive, or inconclusive. Living with a potentially life-threatening illness altered identity, disrupted social relationships, and generated chronic fear and uncertainty. A new normal was re-ordered or transformed by the demands and limitations posed by HCM, and by the person's concerns, priorities, and the meaning of the illness. Results from this study underscore the need for healthcare

  19. Heavy metal contamination and human health risk assessment in drinking water from shallow groundwater wells in an agricultural area in Ubon Ratchathani province, Thailand.

    PubMed

    Wongsasuluk, Pokkate; Chotpantarat, Srilert; Siriwong, Wattasit; Robson, Mark

    2014-02-01

    Most local people in the agricultural areas of Hua-ruea sub-district, Ubon Ratchathani province (Thailand), generally consume shallow groundwater from farm wells. This study aimed to assess the health risk related to heavy metal contamination in that groundwater. Samples were randomly collected from 12 wells twice in each of the rainy and the dry seasons and were analyzed by inductive coupled plasma spectrometry-mass spectrometry (ICP-MS). The concentration of detected metals in each well and the overall mean were below the acceptable groundwater standard limits for As, Cd, Cr, Cu, Hg, Ni and Zn, but Pb levels were higher in four wells with an overall average Pb concentration of 16.66 ± 18.52 μg/l. Exposure questionnaires, completed by face-to-face interviews with 100 local people who drink groundwater from farm wells, were used to evaluate the hazard quotients (HQs) and hazard indices (HIs). The HQs for non-carcinogenic risk for As, Cu, Zn and Pb, with a range of 0.004-2.901, 0.053-54.818, 0.003-6.399 and 0.007-26.80, respectively, and the HI values (range from 0.10 to 88.21) exceeded acceptable limits in 58 % of the wells. The HI results were higher than one for groundwater wells located in intensively cultivated chili fields. The highest cancer risk found was 2.6 × 10(-6) for As in well no. 11. This study suggested that people living in warmer climates are more susceptible to and at greater risk of groundwater contamination because of their increased daily drinking water intake. This may lead to an increased number of cases of non-carcinogenic and carcinogenic health defects among local people exposed to heavy metals by drinking the groundwater.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  1. Hypertrophic cardiomyopathy in Friedreich's ataxia.

    PubMed

    Fayssoil, A; Nardi, O; Orlikowski, D; Annane, D

    2008-07-21

    Friedreich's ataxia is an autosomal recessive disorder characterized by spinocerebellar degeneration. It is caused by a mutation that consists of an unstable expansion of GAA repeats in the first intron of the gene encoding frataxin on chromosome 9 (9q13). We reported a case of hypertrophic cardiomyopathy associated with Friedreich's ataxia in a twenty year old patient.

  2. [The origin of hypertrophic cardiomyopathy].

    PubMed

    Moiseev, V S

    1985-01-01

    The author describes the clinical cases of hypertrophic cardiomyopathy (CMP). The development of obstructive CMP in a patient with hyperparathyroidism indicates a possible pathogenetic role of endocrine factors and calcium metabolism abnormalities. The familial character of the disease and its combination with hereditary diseases (familial microspherocytosis) point to the significance of genetic factors. In addition, marked hypertrophy of the myocardium (without dilatation) including hypertrophy with obstruction of the outflow tract of the left ventricle was observed in nonspecific protracted myocarditis, alcoholic injury to the heart, in athletes, in coronary heart disease (after survival of myocardial infarction). It is suggested that hypertrophic CMP (similarly to restrictive and congestive CMP) is most likely a syndrome of varying origin.

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

    USGS Publications Warehouse

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

    1996-01-01

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

  4. 3D Traveltime Tomography and 1D Wavefield Inversion of Dense 3D Seismic Refraction Data From a Shallow Groundwater Contamination Site

    NASA Astrophysics Data System (ADS)

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

    2016-12-01

    In 2012 Rice University carried out a shallow seismic survey in Rifle, Colorado where the groundwater was contaminated by vanadium and uranium ore-processing operations ending in 1958. The purpose of the seismic survey is to provide constraints to improve hydrogeologic modeling. The 3-D P-wave survey over 96 m x 60 m included 2158 shots recorded by 384 channels yielding 828,672 traces. An accelerated weight drop provided data with good signal-to-noise ratio (SNR) and a dominant frequency of 60 Hz. The overall good SNR allows for precise picking and an average uncertainty of 0.65 ms was assigned based on an analysis of all reciprocal time differences. Unreliable source triggering necessitated solving for shot time corrections during travelitme tomography, creating a mixed-parameter inverse problem. Several steps in addition to conventional 3-D traveltime tomography were applied to exploit the dense data and precise picking to overcome the data's low frequency content: (1) stacking the arrival-time-corrected traces in offset bins for 1-D reflectivity modeling to constrain discontinuities; (2) reduced smoothing regularization based on the local angular distribution of raypaths; and (3) a frequency-dependent form of traveltime tomography to account for the data's frequency content. Model assessment techniques include: (1) removal of the best and poorest fit data to assess the effect of outliers, (2) a jackknife procedure to estimate the uncertainty of each velocity node, and (3) checkerboard tests to estimate lateral model resolution using random shot and picking errors consistent with the real data. The results show that most of the velocity model has a relative error of less than 2% and lateral resolution of better than 5, 10 and 20 m to depths of 5, 10 and 20 m, respectively. Results include an isovelocity surface that represents the top of the Wasatch formation.

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

    NASA Astrophysics Data System (ADS)

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

    2014-02-01

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

  6. Identification of groundwater contamination sources of nitrate and sulfate in shallow alluvial aquifers using a dual-isotope approach in an agricultural area

    NASA Astrophysics Data System (ADS)

    Kaown, D.; Koh, D.; Mayer, B.; Hyun, Y.; Bae, G.; Lee, K.

    2007-12-01

    The elevated level of nitrate in groundwater is a serious problem in Korean agricultural areas. Yupori, a small agricultural area in Chuncheon (Korea), shows a rising level of NO3-N and displays multiple NO3-N sources from non-point and point sources in shallow aquifer groundwater. Numerous vegetable fields are located in the western part of the study area and fruit orchards dominate the landscape with only few vegetable fields in the eastern part of the study area. The source identification of groundwater contamination from overburden agricultural area was undertaken by analyzing hydrochemical data and stable isotopic compositions of dissolved nitrate and sulfate (¥ä15N-NO3-, ¥ä18O-NO3-, ¥ä34S-SO42-, and ¥ä18O-SO42-). The measurements of ¥ä15N- NO3- are in the range of 7.1 to 14.4¢¶ and the values of ¥ä18O-NO3- are in the range of -1.8 to 6.5¢¶. High ¥ä15N-NO3- values shown at low concentrations of nitrate in the eastern Yupori are characteristics of manure- derived nitrate and organic soil. The values of ¥ä34S-SO4-2 ranged from 2.9 to 9.9¢¶ and ¥ä18O-SO42- ranged from 2.5 to 4.7¢¶. At high concentrations of SO42- in the western Yupori, the value of ¥ä34S-SO42- are low around 3-4¢¶. The value of ¥ä34S-SO42- increased with decreasing SO42- concentration in the eastern Yupori. Groundwater quality and stable isotopic compositions of dissolved nitrate and sulfate seem to be significantly affected by agricultural land use pattern of the study site.

  7. Automating Shallow Seismic Imaging

    SciTech Connect

    Steeples, Don W.

    2004-12-09

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

  8. Idiopathic hypertrophic pachymeningitis presenting with occipital neuralgia.

    PubMed

    Auboire, Laurent; Boutemy, Jonathan; Constans, Jean Marc; Le Gallou, Thomas; Busson, Philippe; Bienvenu, Boris

    2015-03-01

    Although occipital neuralgia is usually caused by degenerative arthropathy, nearly 20 other aetiologies may lead to this condition. We present the first case report of hypertrophic pachymeningitis revealed by isolated occipital neuralgia. Idiopathic hypertrophic pachymeningitis is a plausible cause of occipital neuralgia and may present without cranial-nerve palsy. There is no consensus on the treatment for idiopathic hypertrophic pachymeningitis, but the usual approach is to start corticotherapy and then to add immunosuppressants. When occipital neuralgia is not clinically isolated or when a first-line treatment fails, another disease diagnosis should be considered. However, the cost effectiveness of extended investigations needs to be considered.

  9. Hypertrophic lupus vulgaris: an unusual presentation.

    PubMed

    Jain, Vijay K; Aggarwal, Kamal; Jain, Sarika; Singh, Sunita

    2009-07-01

    Lupus vulgaris is the most common form of cutaneous tuberculosis occurring in previously sensitized individuals with a high degree of tuberculin sensitivity. Various forms including plaque, ulcerative, hypertrophic, vegetative, papular, and nodular forms have been described. A 30-year-old male patient presented with a very large hypertrophic lupus vulgaris lesion over left side of chest since 22 years. Histopathological examination showed granulomatous infiltration without caseation necrosis. The Mantoux reaction was strongly positive. Hypertrophic lupus vulgaris of such a giant size and that too at an unusual site is extremely rare and hence is being reported.

  10. HYPERTROPHIC LUPUS VULGARIS: AN UNUSUAL PRESENTATION

    PubMed Central

    Jain, Vijay K; Aggarwal, Kamal; Jain, Sarika; Singh, Sunita

    2009-01-01

    Lupus vulgaris is the most common form of cutaneous tuberculosis occurring in previously sensitized individuals with a high degree of tuberculin sensitivity. Various forms including plaque, ulcerative, hypertrophic, vegetative, papular, and nodular forms have been described. A 30-year-old male patient presented with a very large hypertrophic lupus vulgaris lesion over left side of chest since 22 years. Histopathological examination showed granulomatous infiltration without caseation necrosis. The Mantoux reaction was strongly positive. Hypertrophic lupus vulgaris of such a giant size and that too at an unusual site is extremely rare and hence is being reported. PMID:20161866

  11. Laser application for hypertrophic rhinitis

    NASA Astrophysics Data System (ADS)

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

    1995-05-01

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

  12. Hypertrophic cardiomyopathy: the early years.

    PubMed

    Braunwald, Eugene

    2009-12-01

    Hypertrophic obstructive cardiomyopathy (HOCM) has four major features: (1) severe left ventricular hypertrophy, often most prominent in the basal interventricular septum; (2) frequent familial occurrence with autosomal dominant transmission; (3) occurrence of sudden cardiac death that is usually considered to be due to ventricular fibrillation; and (4) presence of hemodynamic evidence of labile intraventricular obstruction. The key papers describing the recognition of each of these features, as well as of various combinations of them, are reviewed in this paper. Particular attention is focused on the very frequent finding of marked lability of intraventricular obstruction. The recognition of this fourth and last major feature in 1959 makes 2009 the golden anniversary year marking completion of the description of the major features of HOCM.

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

    EPA Science Inventory

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

  14. Hypertrophic cardiomyopathy: Clinical recognition and management

    SciTech Connect

    Ten Cate, F.J.

    1985-01-01

    This book contains 14 chapters. Some of the titles are: Hemodynamics and angiography; Familial and genetic aspects; Recognition and management in children; Morphologic and microscopic aspects of hypertrophic cardiomyopathy; Clinical recognition; and Management with beta-adrenergic blocking drugs.

  15. Genetics of hypertrophic and dilated cardiomyopathy.

    PubMed

    Friedrich, Felix W; Carrier, Lucie

    2012-10-01

    Cardiomyopathies are categorized as extrinsic, being caused by external factors, such as hypertension, ischemia, inflammation, valvular dysfunction, or as intrinsic, which correspond to myocardial diseases without identifiable external causes. These so called primary cardiomyopathies can be categorized in four main forms: hypertrophic, dilated, restrictive, and arrhythmogenic right ventricular cardiomyopathy. Cardiomyopathies are diagnosed by clinical expression, echocardiography, electrocardiography, non-invasive imaging, and sometimes by cardiac catheterization to rule out external causes as ischemia. The two main forms of primary cardiomyopathies are the hypertrophic and dilated cardiomyopathies. Most of hypertrophic cardiomyopathy and 20-50% of dilated cardiomyopathy are familial showing a wide genetic and phenotypic heterogeneity. This review presents the current knowledge on the causative genes, molecular mechanisms and the genotype � phenotype relations of hypertrophic and dilated cardiomyopathies.

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

    USDA-ARS?s Scientific Manuscript database

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

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

    USGS Publications Warehouse

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

    2008-01-01

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

  18. Rapid shallow breathing

    MedlinePlus

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

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

    PubMed Central

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

    2015-01-01

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

  20. Infective endocarditis in hypertrophic cardiomyopathy

    PubMed Central

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

    2016-01-01

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

  1. Aortic biomechanics in hypertrophic cardiomyopathy

    PubMed Central

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

    2015-01-01

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

  2. [Gastric adenomyoma clinically simulating hypertrophic pyloric stenosis].

    PubMed

    Sánchez García, S; Rubio Solís, D; Anes González, G; González Sánchez, S

    2016-01-01

    Gastric adenomyomas are extremely uncommon benign tumors in children. On histologic examination, these tumors have an epithelial component similar to pancreatic ducts. We present a case of a pyloric adenomyoma that clinically simulated hypertrophic pyloric stenosis in a newborn girl. Imaging tests, fundamentally magnetic resonance imaging, were very important in the characterization and diagnosis of this entity.

  3. Hypertrophic Cardiomyopathy in Athletes: Catching a Killer.

    ERIC Educational Resources Information Center

    Maron, Barry J.

    1993-01-01

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

  4. Hypertrophic Cardiomyopathy in Athletes: Catching a Killer.

    ERIC Educational Resources Information Center

    Maron, Barry J.

    1993-01-01

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

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

    USGS Publications Warehouse

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

    2009-01-01

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

  6. Arsenic and fluoride co-contamination in shallow aquifers from agricultural suburbs and an industrial area of Punjab, Pakistan: Spatial trends, sources and human health implications.

    PubMed

    Farooqi, Abida; Sultana, Jawairia; Masood, Noshin

    2017-08-01

    Release of arsenic (As) and fluoride (F(-)) species into groundwater is a serious health concern around the world. The present study was the first systematic baseline study conducted in Rahim Yar Khan district, Punjab, focusing on As and F(-) contamination in groundwater. A total of 51 representative groundwater samples comprising of 44 samples from agricultural suburbs and 7 from an industrial base were analysed. Statistical parameters, principal component analysis-multiple linear regression (PCA-MLR) and health risk assessment model were used to investigate the hydro geochemistry, spatial patterns, interrelation, source contribution and associated health risks of high As and F(-) in groundwater of the study area. Results showed high risk of F(-) exposure to people of the study area, with all samples exceeding the WHO standard of 1.5 mg/L, and for As, 32.5% of the studied groundwater samples exceeded the WHO standard (10 µg/L). The maximum As (107.23 µg/L) and F(-) (26.4 mg/L) levels were observed in samples close to the agricultural and smelting areas, implicating the frequent use of fertilizers and influence of industrial effluents in the study area. The PCA-MLR receptor model quantitatively illustrates that the majority of As and F(-) comes from natural sources, while, among anthropogenic sources, industrial and agricultural activities contributed the most. Health risk assessment revealed a high risk of As and F(-) contamination to the exposed population; therefore, detailed control strategies and policies are required in order to mitigate the health risks.

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

    NASA Astrophysics Data System (ADS)

    Miller, Daniel N.; Smith, Richard L.

    2009-01-01

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

  8. Geobacter daltonii sp. nov., an Fe(III)- and uranium(VI)-reducing bacterium isolated from a shallow subsurface exposed to mixed heavy metal and hydrocarbon contamination.

    PubMed

    Prakash, Om; Gihring, Thomas M; Dalton, Dava D; Chin, Kuk-Jeong; Green, Stefan J; Akob, Denise M; Wanger, Greg; Kostka, Joel E

    2010-03-01

    An Fe(III)- and uranium(VI)-reducing bacterium, designated strain FRC-32(T), was isolated from a contaminated subsurface of the USA Department of Energy Oak Ridge Field Research Center (ORFRC) in Oak Ridge, Tennessee, where the sediments are exposed to mixed waste contamination of radionuclides and hydrocarbons. Analyses of both 16S rRNA gene and the Geobacteraceae-specific citrate synthase (gltA) mRNA gene sequences retrieved from ORFRC sediments indicated that this strain was abundant and active in ORFRC subsurface sediments undergoing uranium(VI) bioremediation. The organism belonged to the subsurface clade of the genus Geobacter and shared 92-98 % 16S rRNA gene and 75-81 % rpoB gene sequence similarities with other recognized species of the genus. In comparison to its closest relative, Geobacter uraniireducens Rf4(T), according to 16S rRNA gene sequence similarity, strain FRC-32(T) showed a DNA-DNA relatedness value of 21 %. Cells of strain FRC-32(T) were Gram-negative, non-spore-forming, curved rods, 1.0-1.5 microm long and 0.3-0.5 microm in diameter; the cells formed pink colonies in a semisolid cultivation medium, a characteristic feature of the genus Geobacter. The isolate was an obligate anaerobe, had temperature and pH optima for growth at 30 degrees C and pH 6.7-7.3, respectively, and could tolerate up to 0.7 % NaCl although growth was better in the absence of NaCl. Similar to other members of the Geobacter group, strain FRC-32(T) conserved energy for growth from the respiration of Fe(III)-oxyhydroxide coupled with the oxidation of acetate. Strain FRC-32(T) was metabolically versatile and, unlike its closest relative, G. uraniireducens, was capable of utilizing formate, butyrate and butanol as electron donors and soluble ferric iron (as ferric citrate) and elemental sulfur as electron acceptors. Growth on aromatic compounds including benzoate and toluene was predicted from preliminary genomic analyses and was confirmed through successive transfer with

  9. Hypertrophic osteoarthropathy: a palindrome with a pathogenic connotation.

    PubMed

    Martinez-Lavin, Manuel; Vargas, Angélica; Rivera-Viñas, Miguel

    2008-01-01

    The review seeks to update advances on the pathogenesis of hypertrophic osteoarthropathy, describe a previously unrecognized palindrome that occurs in hypertrophic osteoarthropathy and that may have pathogenic implications, and review the role of bisphosphonates in the treatment of this condition. Some patients with primary hypertrophic osteoarthropathy display an interesting palindrome. Many years after the onset of the osteoarthropathy, they develop diseases that in other circumstances are known to generate secondary hypertrophic osteoarthropathy. This palindrome has been reported in cases of patent ductus arteriosus, Crohn's disease and myelofibrosis. Additionally, primary hypertrophic osteoarthropathy and POEMS syndrome share important clinical features. The many diseases associated with hypertrophic osteoarthropathy have in common abnormal production of vascular endothelial growth factor. This cytokine has been proposed to play a major role in the pathogenesis of Crohn's disease, myelofibrosis and POEMS syndrome. A controlled study showed that vascular endothelial growth factor is abnormally expressed in cases of hypertrophic osteoarthropathy. The biologic effects of vascular endothelial growth factor may explain hypertrophic osteoarthropathy histological features. Several isolated reports suggest that pamidronate is effective in relieving painful osteoarthropathy. Hypertrophic osteoarthropathy is a palindromic syndrome. Anomalous vascular endothelial growth factor expression may explain this phenomenon. Bisphosphonates may have a role in the symptomatic treatment of hypertrophic osteoarthropathy.

  10. Scar contractures, hypertrophic scars, and keloids.

    PubMed

    Brissett, A E; Sherris, D A

    2001-11-01

    A scar contracture is the result of a contractile wound-healing process occurring in a scar that has already been reepithelialized and adequately healed. Keloids and hypertrophic scars (HTSs) are fibrous tissue outgrowths that result from a derailment in the normal wound-healing process. The exact incidence of keloids and HTSs remains unknown. Beyond the common belief that trauma is the initiating event of keloid and hypertrophic scar formation, the remainder of the process remains uncertain. A combination of biochemical factors, skin tension, endocrinologic factors, and genetic factors are the likely culprits. Treatment begins by educating the patient about the etiology of the scarring process. All treatment protocols are individualized, but the standard approach to keloids and HTSs begins with corticosteroid injection followed by surgical excision, pressure dressings, and long-term follow-up.

  11. Calcification of in vitro developed hypertrophic cartilage

    SciTech Connect

    Tacchetti, C.; Quarto, R.; Campanile, G.; Cancedda, R.

    1989-04-01

    We have recently reported that dedifferentiated cells derived from stage 28-30 chick embryo tibiae, when transferred in suspension culture in the presence of ascorbic acid, develop in a tissue closely resembling hypertrophic cartilage. Ultrastructural examination of this in vitro formed cartilage showed numerous matrix vesicles associated with the extracellular matrix. In the present article we report that the in vitro developed hypertrophic cartilage undergoes calcification. We indicate a correlation between the levels of alkaline phosphatase activity and calcium deposition at different times of development. Following the transfer of cells into suspension culture and an initial lag phase, the level of alkaline phosphatase activity rapidly increased. In most experiments the maximum of activity was reached after 5 days of culture. When alkaline phosphatase activity and /sup 45/Ca deposition were measured in the same experiment, we observed that the increase in alkaline phosphatase preceded the deposition of nonwashable calcium deposits in the cartilage.

  12. Magnetic resonance imaging of hypertrophic olivary degeneration.

    PubMed

    Blanco Ulla, M; López Carballeira, A; Pumar Cebreiro, J M

    2015-01-01

    To review the pathophysiologic mechanisms involved in hypertrophic olivary degeneration, with attention to epidemiologic and clinical aspects and especially to imaging findings. We reviewed 5 patients diagnosed with hypertrophic olivary degeneration at our center from 2010 through 2013, analyzing relevant clinical, epidemiologic, and radiologic findings. In all cases, a hyperintensity was seen in the inferior olivary nuclei in FLAIR and T2-weighted sequences. No signal alterations were seen on T1-weighted sequences, and no enhancement was seen after intravenous injection of contrast material. In the cases studied by diffusion-weighted imaging, no significant alterations were seen in these sequences. Olivary hypertrophy was seen in all patients except in one, in whom presumably not enough time had elapsed for hypertrophy to occur. The alterations were bilateral in two of the five cases. Only one case exhibited the typical clinical manifestations. Given that patients may not present clinical manifestations that can be attributed to hypertrophic olivary degeneration, it is important to recognize the characteristic radiologic signs of this entity. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

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

    PubMed

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

    2015-10-15

    We report a case of idiopathic cerebral hypertrophic pachymeningitis accompanying neuromyelitis optica spectrum disorder. No other identifiable cause of pachymeningitis was detected. Corticosteroid therapy was effective for both diseases. Hypertrophic pachymeningitis is closely related to autoimmune inflammatory disease of the central nervous system. This case supports the hypothesis that hypertrophic pachymeningitis can be a rare comorbidity of neuromyelitis optica spectrum disorder. Copyright © 2015. Published by Elsevier B.V.

  14. An unusual ST-segment elevation: apical hypertrophic cardiomyopathy shows the ace up its sleeve.

    PubMed

    de Santis, Francesco; Pergolini, Amedeo; Zampi, Giordano; Pero, Gaetano; Pino, Paolo Giuseppe; Minardi, Giovanni

    2013-01-01

    Apical hypertrophic cardiomyopathy is part of the broad clinical and morphologic spectrum of hypertrophic cardiomyopathy. We report a patient with electrocardiographic abnormalities in whom acute coronary syndrome was excluded and apical hypertrophic cardiomyopathy was demonstrated by careful differential diagnosis.

  15. Inflammation and cutaneous nervous system involvement in hypertrophic scarring

    PubMed Central

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

    2015-01-01

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

  16. Hypertrophic Cardiomyopathy Registry: The rationale and design of an international, observational study of hypertrophic cardiomyopathy.

    PubMed

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

    2015-08-01

    Hypertrophic cardiomyopathy (HCM) is the most common monogenic heart disease with a frequency as high as 1 in 200. In many cases, HCM is caused by mutations in genes encoding the different components of the sarcomere apparatus. Hypertrophic cardiomyopathy is characterized by unexplained left ventricular hypertrophy, myofibrillar disarray, and myocardial fibrosis. The phenotypic expression is quite variable. Although most patients with HCM are asymptomatic, serious consequences are experienced in a subset of affected individuals who present initially with sudden cardiac death or progress to refractory heart failure. The Hypertrophic Cardiomyopathy Registry study is a National Heart, Lung, and Blood Institute-sponsored 2,750-patient, 44-site, international registry and natural history study designed to address limitations in extant evidence to improve prognostication in HCM (NCT01915615). In addition to the collection of standard demographic, clinical, and echocardiographic variables, patients will undergo state-of-the-art cardiac magnetic resonance for assessment of left ventricular mass and volumes as well as replacement scarring and interstitial fibrosis. In addition, genetic and biomarker analyses will be performed. The Hypertrophic Cardiomyopathy Registry has the potential to change the paradigm of risk stratification in HCM, using novel markers to identify those at higher risk. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Myocardial Fibrosis as an Early Manifestation of Hypertrophic Cardiomyopathy

    PubMed Central

    Ho, Carolyn Y.; López, Begoña; Coelho-Filho, Otavio R.; Lakdawala, Neal K.; Cirino, Allison L.; Jarolim, Petr; Kwong, Raymond; González, Arantxa; Colan, Steven D.; Seidman, J.G.; Díez, Javier; Seidman, Christine E.

    2011-01-01

    BACKGROUND Myocardial fibrosis is a hallmark of hypertrophic cardiomyopathy and a proposed substrate for arrhythmias and heart failure. In animal models, profibrotic genetic pathways are activated early, before hypertrophic remodeling. Data showing early profibrotic responses to sarcomere-gene mutations in patients with hypertrophic cardiomyopathy are lacking. METHODS We used echocardiography, cardiac magnetic resonance imaging (MRI), and serum biomarkers of collagen metabolism, hemodynamic stress, and myocardial injury to evaluate subjects with hypertrophic cardiomyopathy and a confirmed genotype. RESULTS The study involved 38 subjects with pathogenic sarcomere mutations and overt hypertrophic cardiomyopathy, 39 subjects with mutations but no left ventricular hypertrophy, and 30 controls who did not have mutations. Levels of serum C-terminal propeptide of type I procollagen (PICP) were significantly higher in mutation carriers without left ventricular hypertrophy and in subjects with overt hypertrophic cardiomyopathy than in controls (31% and 69% higher, respectively; P<0.001). The ratio of PICP to C-terminal telopeptide of type I collagen was increased only in subjects with overt hypertrophic cardiomyopathy, suggesting that collagen synthesis exceeds degradation. Cardiac MRI studies showed late gadolinium enhancement, indicating myocardial fibrosis, in 71% of subjects with overt hypertrophic cardiomyopathy but in none of the mutation carriers without left ventricular hypertrophy. CONCLUSIONS Elevated levels of serum PICP indicated increased myocardial collagen synthesis in sarcomere-mutation carriers without overt disease. This profibrotic state preceded the development of left ventricular hypertrophy or fibrosis visible on MRI. (Funded by the National Institutes of Health and others.) PMID:20818890

  18. Psychosocial impact of specialized cardiac genetic clinics for hypertrophic cardiomyopathy.

    PubMed

    Ingles, Jodie; Lind, Joanne M; Phongsavan, Philayrath; Semsarian, Christopher

    2008-02-01

    The diagnosis of hypertrophic cardiomyopathy, an autosomal dominant chronic heart disease, can have significant implications, including increased risk of sudden death, exercise limitations, and risk of transmission to offspring. This study sought to describe the psychosocial factors associated with attending a specialty cardiac genetic clinic, and to determine whether these may be predictors of comorbid anxiety and depression in this population. Questionnaires were sent to 184 individuals attending the Royal Prince Alfred Hospital Hypertrophic Cardiomyopathy Clinic. Questionnaires were anonymous and comprised demographics, the Hospital Anxiety and Depression Scale, Patient Experience Scales, and Patient Satisfaction Scales. Completed questionnaires were returned by 109 participants (59.2% response rate), of which 76.9% had a diagnosis of hypertrophic cardiomyopathy, while 23.1% were at-risk relatives attending for clinical screening. Patient satisfaction scores were generally high to very high across all groups, though only 24% of HCM patients showed good adjustment to hypertrophic cardiomyopathy and 10% had low worry about hypertrophic cardiomyopathy scores. Within the disease group, logistic regression analysis adjusting for age, gender, and education revealed adjustment to hypertrophic cardiomyopathy and worry about hypertrophic cardiomyopathy scores to be significantly associated with anxiety, while adjustment scores and location of patient follow-up (i.e., Hypertrophic Cardiomyopathy clinic or another cardiologist) to be significantly associated with depression scores. HCM patients who attend specialized cardiac genetic clinics are better adjusted and worry less, than those who do not attend. An integrated approach, including a genetic counselor, is important in the management of HCM families.

  19. Periostin induces fibroblast proliferation and myofibroblast persistence in hypertrophic scarring.

    PubMed

    Crawford, Justin; Nygard, Karen; Gan, Bing Siang; O'Gorman, David Brian

    2015-02-01

    Hypertrophic scarring is characterized by the excessive development and persistence of myofibroblasts. These cells contract the surrounding extracellular matrix resulting in the increased tissue density characteristic of scar tissue. Periostin is a matricellular protein that is abnormally abundant in fibrotic dermis, however, its roles in hypertrophic scarring are largely unknown. In this report, we assessed the ability of matrix-associated periostin to promote the proliferation and myofibroblast differentiation of dermal fibroblasts isolated from the dermis of hypertrophic scars or healthy skin. Supplementation of a thin type-I collagen cell culture substrate with recombinant periostin induced a significant increase in the proliferation of hypertrophic scar fibroblasts but not normal dermal fibroblasts. Periostin induced significant increases in supermature focal adhesion formation, α smooth muscle actin levels and collagen contraction in fibroblasts cultured from hypertrophic scars under conditions of increased matrix tension in three-dimensional type-I collagen lattices. Inhibition of Rho-associated protein kinase activity significantly attenuated the effects of matrix-associated periostin on hypertrophic scar fibroblasts and myofibroblasts. Depletion of endogenous periostin expression in hypertrophic scar myofibroblasts resulted in a sustained decrease in α smooth muscle actin levels under conditions of reducing matrix tension, while matrix-associated periostin levels caused the cells to retain high levels of a smooth muscle actin under these conditions. These findings indicate that periostin promotes Rho-associated protein kinase-dependent proliferation and myofibroblast persistence of hypertrophic scar fibroblasts and implicate periostin as a potential therapeutic target to enhance the resolution of scars.

  20. [Idiopathic hypertrophic pachymeningitis: a case report].

    PubMed

    Vargas-Bellina, V; Saavedra-Pastor, H; Alvarado-Rosales, M; Porras-Carrión, M; Cjuno-Pinto, R; Gonzales-Quispe, I; Alban-Zapata, G

    Hypertrophic pachymeningitis is a clinical condition that is caused by a diffuse or localised thickening of the dura mater. It predominantly affects males and manifests as chronic headache, with or without association to neurological manifestations, such as paralysis of the cranial nerves, cerebellar ataxia and neuro-ophthalmic complications. A 61-year-old male, with no relevant past history, who, one month before admission, had begun to suffer from right frontotemporal headache that irradiated to the ipsilateral orbital region and was more pronounced at night. A week later he was affected by a decrease in visual acuity in the right eye and two weeks later he noted the presence of right palpebral ptosis, while the headaches increased. The examination showed: right palpebral ptosis with global ophthalmoparesis with predominance of adduction and abduction, and diminished photomotor reflex in the right eye. The visual acuity of the right eye was reduced and the palpebral fissure was 0 in the right eye. The fundus oculi was normal. Infectious and non-infectious causations of meningitis were precluded. Magnetic resonance imaging revealed a diffuse thickening of the supratentorial and infratentorial meninges, as well as diffuse uptake of the paramagnetic substance; thickening of the mucus in both paranasal maxillary sinuses was also observed. A meningeal biopsy study confirmed the existence of hypertrophic pachymeningitis. Treatment was established with prednisone and the clinical symptoms improved. Idiopathic hypertrophic pachymeningitis is an underdiagnosed condition that must be taken into consideration in cases of patients with a history of subacute or chronic meningitis in which infectious and non-infectious causations have been precluded, and high-dose steroid treatment must be established.

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

  2. Hypertrophic cardiomyopathy simulating an infiltrative myocardial disease.

    PubMed Central

    Frustaci, A; Loperfido, F; Pennestrì, F

    1985-01-01

    Congestive heart failure developed in a patient with low electrocardiographic QRS voltages, diffuse thickening of the septum and free cardiac wall, and a reduction in left ventricular internal diameter, which suggested an infiltrative heart muscle disease. Histological examination at necropsy showed hypertrophic cardiomyopathy with symmetrical left ventricular hypertrophy. Myocardial disarray of type 1A disorganisation was extensive and equally distributed in the ventricular septum and the left anterior and left posterior ventricular free walls. Severe fibrosis (40%) was also present and may have been a possible cause of the electrocardiographic abnormalities as well as of the lack of ventricular dilatation. Images PMID:4041302

  3. Factors associated with infantile hypertrophic pyloric stenosis.

    PubMed

    Jedd, M B; Melton, L J; Griffin, M R; Kaufman, B; Hoffman, A D; Broughton, D; O'Brien, P C

    1988-03-01

    We examined perinatal factors in relation to the rise in incidence of infantile hypertrophic pyloric stenosis among children in Olmsted County, Minnesota, during the period from 1950 through 1984. Primogeniture was associated with male infants but not female infants; some factor related to primogeniture, such as breast-feeding, may be etiologically important. Our data did not support a role for maternal disease, use of doxylamine succinate-pyridoxide hydrochloride (Bendectin), or an infectious process. Further study should be directed toward environmental factors associated with primogeniture.

  4. Blepharoptosis and hypertrophic osteoarthropathy: A case report

    PubMed Central

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

    2016-01-01

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

  5. Diagnosis and management of hypertrophic cardiomyopathy

    PubMed Central

    Vischer, Annina S; Perez-Tome, Maria Carrillo; Castelletti, Silvia

    2015-01-01

    The clinical spectrum of hypertrophic cardiomyopathy (HCM) is complex and includes a variety of phenotypes, which leads to different types of manifestations. Although most of the patients are asymptomatic, a significant proportion of them will develop symptoms or risk of arrhythmias and sudden cardiac death (SCD). Therefore, the objectives of HCM diagnosis and management are to relieve the patients' symptoms (chest pain, heart failure, syncope, palpitations, etc.), prevent disease progression and major cardiovascular complications and SCD. The heterogeneity of HCM patterns, their symptoms and assessment is a challenge for the cardiologist. PMID:26693331

  6. Screening for hypertrophic cardiomyopathy in cats.

    PubMed

    Häggström, Jens; Luis Fuentes, Virginia; Wess, Gerhard

    2015-12-01

    Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats, and it can lead to increased morbidity and mortality. Cats are often screened for HCM because of the presence of a heart murmur, but screening for breeding purposes has also become common. These cats are usually purebred cats of breeding age, and generally do not present with severe disease or with any clinical signs. This type of screening is particularly challenging because mild disease may be difficult to differentiate from a normal phenotype, and the margin for error is small, with potentially major consequences for the breeder. This article reviews HCM screening methods, with particular emphasis on echocardiography.

  7. Hypertrophic cardiomyopathy in owl monkeys (Aotus spp.).

    PubMed

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

    2013-06-01

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

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

    PubMed Central

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

    2013-01-01

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

  9. What is the prevalence of hypertrophic scarring following burns?

    PubMed

    Bombaro, Kristine M; Engrav, Loren H; Carrougher, Gretchen J; Wiechman, Shelly A; Faucher, Lee; Costa, Beth A; Heimbach, David M; Rivara, Frederick P; Honari, Shari

    2003-06-01

    Hypertrophic scarring after burns remains a major problem and is considered to be "common". Pressure garments are commonly used as treatment even though there is little sound data that they reduce the prevalence or magnitude of the scarring. In 1999 we began a study of the efficacy of pressure garments on forearm burns. After studying 30 patients, mainly white adults, we found no hypertrophic scar in either those treated with pressure or without. This prompted us to review the literature on the prevalence of hypertrophic scarring after burns and found only four articles with a relatively small number of patients and only three geographical locations. It became clear that the prevalence of hypertrophic scarring is really unknown. We then did a retrospective study of 110 burn survivors and counted all hypertrophic scars of all sizes and locations in all races and found the prevalence hypertrophic scarring to be 67% which conflicts with the published reports and our prospective study and suggests that further research is necessary. We concluded that a worldwide, prospective survey is necessary to establish the prevalence of hypertrophic scarring after burns. In this article we are calling for and offering to organize this survey.

  10. Clinical predictors of genetic testing outcomes in hypertrophic cardiomyopathy.

    PubMed

    Ingles, Jodie; Sarina, Tanya; Yeates, Laura; Hunt, Lauren; Macciocca, Ivan; McCormack, Louise; Winship, Ingrid; McGaughran, Julie; Atherton, John; Semsarian, Christopher

    2013-12-01

    Genetic testing for hypertrophic cardiomyopathy has been commercially available for almost a decade; however, low mutation detection rate and cost have hindered uptake. This study sought to identify clinical variables that can predict probands with hypertrophic cardiomyopathy in whom a pathogenic mutation will be identified. Probands attending specialized cardiac genetic clinics across Australia over a 10-year period (2002-2011), who met clinical diagnostic criteria for hypertrophic cardiomyopathy and who underwent genetic testing for hypertrophic cardiomyopathy were included. Clinical, family history, and genotype information were collected. A total of 265 unrelated individuals with hypertrophic cardiomyopathy were included, with 138 (52%) having at least one mutation identified. The mutation detection rate was significantly higher in the probands with hypertrophic cardiomyopathy with an established family history of disease (72 vs. 29%, P < 0.0001), and a positive family history of sudden cardiac death further increased the detection rate (89 vs. 59%, P < 0.0001). Multivariate analysis identified female gender, increased left-ventricular wall thickness, family history of hypertrophic cardiomyopathy, and family history of sudden cardiac death as being associated with greatest chance of identifying a gene mutation. Multiple mutation carriers (n = 16, 6%) were more likely to have suffered an out-of-hospital cardiac arrest or sudden cardiac death (31 vs. 7%, P = 0.012). Family history is a key clinical predictor of a positive genetic diagnosis and has direct clinical relevance, particularly in the pretest genetic counseling setting.

  11. Posterolateral hypertrophic cardiomyopathy: a rare, but clinically significant variant of hypertrophic cardiomyopathy.

    PubMed

    Seki, Atsuko; Perens, Gregory; Fishbein, Michael C

    2014-01-01

    Posterolateral hypertrophic cardiomyopathy (HCM) is a rare variant of HCM. Segmental HCM is seen in 12% of cases of HCM. Among the patterns of segmental HCM, posterolateral HCM is the least common type. Our case of an 18-year old male documents this unusual type of cardiomyopathy. In this form of HCM, left ventricular thickness and the extent of hypertrophy might be underestimated by 2-dimensional echocardiography. This case illustrates the echocardiographic and pathologic features of posterolateral HCM.

  12. Cardiopulmonary Exercise Test in Hypertrophic Cardiomyopathy.

    PubMed

    Magri, Damiano; Santolamazza, Caterina

    2017-04-04

    Understanding the functional limitation in hypertrophic cardiomyopathy, the most common inherited heart disease, is challenging. Beside the occurrence of disease-related complications, several factors are potential determinants of exercise limitation, including left ventricular hypertrophy, myocardial fiber disarray, left ventricular outflow tract obstruction, microvascular ischemia, and interstitial fibrosis. Furthermore, drugs commonly used in the daily management of these patients may interfere with exercise capacity, especially those with a negative chronotropic effect. Cardiopulmonary exercise testing can safely and objectively evaluate the functional capacity of these patients and help the physician in understanding the mechanisms that underlie this limitation. Features that reduce exercise capacity may predict progression to heart failure in these patients and even the risk of sudden cardiac death.

  13. Mucin gene expression in hypertrophic adenoids.

    PubMed

    Ali, Mahmoud S; Wilson, J A; Bennett, M; Pearson, Jeffrey P

    2007-10-01

    Membrane-bound mucin MUC4 represents the predominant mucin expressed in the adenoid epithelium followed by MUC5AC (gel-forming mucin). This may suggest that membrane-bound mucins could be involved in pathogen binding and immunological stimulation. The aim of this study was to investigate mucin expression in hypertrophic adenoids. Adenoidal samples were obtained from 12 children. The expression of eight mucin genes, MUC1-4, MUC5AC, 5B, 6 and 7 was studied by in situ hybridization utilizing digoxigenin-labelled oligonucleotide probes. The dominant mucin genes were MUC4, 3 and 5AC, while MUC1, 2, 5B and 7 were sparsely expressed and MUC6 was not expressed. Expression patterns were very different from those in the upper airways. Most samples expressed two membrane-bound mucins (MUC4 and 3) and one secretory mucin (MUC5AC).

  14. Idiopathic hypertrophic spinal pachymeningitis: a case report.

    PubMed Central

    Park, S. H.; Whang, C. J.; Sohn, M.; Oh, Y. C.; Lee, C. H.; Whang, Y. J.

    2001-01-01

    Idiopathic hypertrophic pachymeningitis (IHP) is a rare, chronic nonspecific and granulomatous inflammatory disorder of the dura with unknown etiology. The diagnosis can be established by open biopsy and exclusion of all other specific granulomatous and infectious diseases. We report a typical case of spinal IHP occurring in a long segment of cervical and thoracic dura from C6 to T8. The patient was 56-yr-old female, who had been suffered from pain on her upper back and both arms for 3 months and recent onset motor weakness of both legs. During the 9 months of follow-up period, she experienced the improvement of her neurologic symptoms with combined therapy of partial excision and corticosteroid medication. Since early surgical intervention and subsequent pulse steroid therapy are mandatory for this disease to avoid irreversible damage of nervous system, the identification of this unique disease entity is essential on frozen diagnosis. A few cases have been reported in Korean literature. PMID:11641545

  15. Hypertrophic gastropathy with transient sessile polyps.

    PubMed

    Pesce, F; Barabino, A; Dufour, C; Caffarena, P E; Callea, F; Gatti, R

    1992-04-01

    We report an 8-year-old boy with hypertrophic gastropathy (HG) associated with duodenal Giardia lamblia infestation. The follow-up was complicated by the development of gastric polyps at the site of previous biopsies that spontaneously disappeared within 15 months. Despite the histological similarity, the different course between Ménétrier's disease (MD) in adults (chronic, with frequent development of sessile or pedunculate polyps) and HG (uncomplicated and usually spontaneously resolving) suggests a different pathogenesis. Viral (cytomegalovirus) and bacterial (Helicobacter pylori) infections have been described in association with HG and they could play an important pathogenetic role. The term HG better defines the childhood disease in which a conservative management is recommended.

  16. [Hypertrophic miocardiopathy. An historical and anatomopathological review].

    PubMed

    Márquez, Manlio F; Ruíz-Siller, Teresita de Jesús; Méndez-Ramos, Rosario; Karabut, Erick; Aranda-Fraustro, Alberto; Jiménez-Becerra, Silvia

    Hypertrophic cardiomyopathy (HCM) is characterized by the presence of an abnormal hypertrophy of the left ventricle (LV), without dilation, and in the absence of any condition or another cardiac or systemic disease capable of inducing such hypertrophy. This primary or idiopathic hypertrophy can occur with or without dynamic obstruction (induced by exercise) of the LV outflow tract, so in its natural history two fundamental aspects are highlighted: the production of symptoms by blocking the LV outflow tract and the occurrence of sudden cardiac death secondary to ventricular arrhythmias. This revision includes the work of different Iberoamerican investigators, who contributed in an important way to lay the groundwork of what we know nowadays as HCM. It also includes the main anatomopathological characteristics, from its initial description to the new perspective we have concerning the myofiber disarray as the main histopathologic feature.

  17. Current Therapeutic Approach to Hypertrophic Scars

    PubMed Central

    Mokos, Zrinka Bukvić; Jović, Anamaria; Grgurević, Lovorka; Dumić-Čule, Ivo; Kostović, Krešimir; Čeović, Romana; Marinović, Branka

    2017-01-01

    Abnormal scarring and its accompanying esthetic, functional, and psychological sequelae still pose significant challe nges. To date, there is no satisfactory prevention or treatment option for hypertrophic scars (HSs), which is mostly due to not completely comprehending the mechanisms underlying their formation. That is why the apprehension of regular and controlled physiological processes of scar formation is of utmost importance when facing hypertrophic scarring, its pathophysiology, prevention, and therapeutic approach. When treating HSs and choosing the best treatment and prevention modality, physicians can choose from a plethora of therapeutic options and many commercially available products, among which currently there is no efficient option that can successfully overcome impaired skin healing. This article reviews current therapeutic approach and emerging therapeutic strategies for the management of HSs, which should be individualized, based on an evaluation of the scar itself, patients’ expectations, and practical, evidence-based guidelines. Clinicians are encouraged to combine various prevention and treatment modalities where combination therapy that includes steroid injections, 5-fluorouracil, and pulsed-dye laser seems to be the most effective. On the other hand, the current therapeutic options are usually empirical and their results are unreliable and unpredictable. Therefore, there is an unmet need for an effective, targeted therapy and prevention, which would be based on an action or a modulation of a particular factor with clarified mechanism of action that has a beneficial effect on wound healing. As the extracellular matrix has a crucial role in cellular and extracellular events that lead to pathological scarring, targeting its components mostly by regulating bone morphogenetic proteins may throw up new therapeutic approach for reduction or prevention of HSs with functionally and cosmetically acceptable outcome. PMID:28676850

  18. Hypertrophic cardiomyopathy in a neonate associated with nemaline myopathy.

    PubMed

    Mir, Arshid; Lemler, Matthew; Ramaciotti, Claudio; Blalock, Shannon; Ikemba, Catherine

    2012-01-01

    Nemaline myopathy is a congenital nonprogressive skeletal muscle disorder with a characteristic rod body formation in the skeletal muscle fibers. Cardiac involvement in nemaline myopathy is rare, although both dilated and hypertrophic cardiomyopathy have been reported. We describe an infant diagnosed with hypertrophic cardiomyopathy and hypotonia on the first day of life. Muscle biopsy confirmed nemaline myopathy at 3 weeks of age. The diagnosis of nemaline myopathy precluded consideration of heart transplantation, thus shifting the focus to comfort care. This is the earliest presentation of hypertrophic cardiomyopathy reported in the literature in the setting of nemaline myopathy. The approach to determining an etiology for hypertrophic cardiomyopathy in an infant is reviewed. © 2011 Wiley Periodicals, Inc.

  19. [Hypertrophic obstructive cardiomyopathy in a patient with Turner syndrome].

    PubMed

    Conte, M R; Bonfiglio, G; Orzan, F; Mangiardi, L; Camaschella, C; Alfarano, A; Brusca, A

    1995-12-01

    A case of hypertrophic obstructive cardiomyopathy in a patient with Turner syndrome is reported. The most frequently associated cardiac anomalies are coarctation of the aorta and bicuspid aortic valve. Hypertrophic cardiomyopathy has never been reported in this syndrome but is frequent in Noonan syndrome. In these two conditions the phenotype may be indistinguishable but the cariotype is different: normal in Noonan and 45X in Turner syndrome. Our patient had the typical somatic features, and the cariotype was 45X in all examined cells. A familial form of hypertrophic cardiomyopathy was excluded by the normal clinical examination of other members of the family. The presence of hypertrophic cardiomyopathy also in Turner syndrome and the recent localization on the long arm of the chromosome 12 of the gene for Noonan syndrome might postulate a common pathogenesis of the two syndromes.

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

    MedlinePlus

    Septal Myectomy Surgery to Treat Obstructive Hypertrophic Cardiomyopathy (HCM) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. All rights reserved.

  1. Hypertrophic cardiomyopathy and hyperthyroidism: a report of three cases

    PubMed Central

    Symons, C.; Richardson, P. J.; Feizi, O.

    1974-01-01

    Symons, C., Richardson, P. J., and Feizi, O. (1974).Thorax, 29, 713-719. Hypertrophic cardiomyopathy and hyperthyroidism. The combination of hypertrophic cardiomyopathy and hyperthyroidism gives rise to a complex clinical picture as some of the symptoms and signs may be common to both conditions. The presentation and investigation of three patients are reported. In one patient there was evidence of progression from the hypertrophic obstructive phase to that associated with loss of outflow tract obstruction. The echocardiogram was especially useful in assessing the presence or absence of hypertrophic disease in the thyrotoxic subject. It is suggested that the long continued high-output circulatory state in clinically undetected hyperthyroidism may prove to be a stimulus for unrestrained cardiac muscle hypertrophy. Images PMID:4281112

  2. Epidermolysis Bullosa with Hypertrophic Pyloric Stenosis in a Newborn.

    PubMed

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

    2015-01-01

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

  3. Epidermolysis Bullosa with Hypertrophic Pyloric Stenosis in a Newborn

    PubMed Central

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

    2015-01-01

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

  4. Hypertrophic osteoarthropathy associated with Fallot's tetralogy—a case report

    PubMed Central

    George, B. Olu.; Mabayoje, J. Olu.

    1975-01-01

    A case of Fallot's tetralogy associated with hypertrophic osteoarthropathy in a young Nigerian female is described. The clinical spectrum of hypertrophic osteoarthropathy is reviewed. The rarity of this syndrome is stressed. Some other aspects of the clinical manifestation of cyanotic congenital heart disease which may mimic the skeletal syndrome are mentioned. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6 PMID:1197165

  5. Primary intrapulmonary neurogenic sarcoma with hypertrophic pulmonary osteoarthropathy and asbestosis

    PubMed Central

    Caves, P. K.; Jacques, J.

    1971-01-01

    A case of primary intrapulmonary neurogenic sarcoma with hypertrophic pulmonary osteoarthropathy and asbestosis is described. The essential histological features of this rare tumour are detailed, and the five authentic cases previously reported are reviewed. The pathogenesis of hypertrophic pulmonary osteoarthropathy and its occurrence in this case are discussed. After surgical removal of the tumour recurrence appeared in the chest within six months. It responded poorly to radiotherapy, and death from metastases occurred 16 months after operation. Images PMID:5576539

  6. Management of scar contractures, hypertrophic scars, and keloids.

    PubMed

    Sherris, D A; Larrabee, W F; Murakami, C S

    1995-10-01

    Aberrant fibrous tissue formation after surgery or trauma still presents a challenge to surgeons. Current research hopes to identify the characteristics of the population of fibroblasts that lead to hypertrophic or keloid scar formation. Surgical procedures and laser therapy followed by intralesional steroid treatments still are the foundation of treatment; but new modalities are being applied. The pathogenesis and management of hypertrophic scars, keloids, and scar contractures are discussed in this article.

  7. Keloids and Hypertrophic Scars: Pathophysiology, Classification, and Treatment.

    PubMed

    Berman, Brian; Maderal, Andrea; Raphael, Brian

    2017-01-01

    Keloid and hypertrophic scars represent an aberrant response to the wound healing process. These scars are characterized by dysregulated growth with excessive collagen formation, and can be cosmetically and functionally disruptive to patients. Objectives are to describe the pathophysiology of keloid and hypertrophic scar, and to compare differences with the normal wound healing process. The classification of keloids and hypertrophic scars are then discussed. Finally, various treatment options including prevention, conventional therapies, surgical therapies, and adjuvant therapies are described in detail. Literature review was performed identifying relevant publications pertaining to the pathophysiology, classification, and treatment of keloid and hypertrophic scars. Though the pathophysiology of keloid and hypertrophic scars is not completely known, various cytokines have been implicated, including interleukin (IL)-6, IL-8, and IL-10, as well as various growth factors including transforming growth factor-beta and platelet-derived growth factor. Numerous treatments have been studied for keloid and hypertrophic scars,which include conventional therapies such as occlusive dressings, compression therapy, and steroids; surgical therapies such as excision and cryosurgery; and adjuvant and emerging therapies including radiation therapy, interferon, 5-fluorouracil, imiquimod, tacrolimus, sirolimus, bleomycin, doxorubicin, transforming growth factor-beta, epidermal growth factor, verapamil, retinoic acid, tamoxifen, botulinum toxin A, onion extract, silicone-based camouflage, hydrogel scaffold, and skin tension offloading device. Keloid and hypertrophic scars remain a challenging condition, with potential cosmetic and functional consequences to patients. Several therapies exist which function through different mechanisms. Better understanding into the pathogenesis will allow for development of newer and more targeted therapies in the future.

  8. Hypertrophic pyloric stenosis in the third world.

    PubMed

    Saula, P W; Hadley, G P

    2011-10-01

    The relative rarity of hypertrophic pyloric stenosis (HPS) in the developing world makes its diagnosis a challenge to many physicians. This study audits the management of HPS at a tertiary hospital in South Africa, with a view to defining its regional pattern. This is a retrospective review of records of all patients (n = 63) managed for HPS over an eight-year period (2002-2010). The mean age at presentation was 6.2 weeks and the male/female ratio was 6:1. The majority of patients presented with non-bilious vomiting. Abdominal ultrasound had a sensitivity of 65% and 81.3% when the criteria of pyloric muscle thickness >4 mm and pyloric channel length >16 mm were used, respectively. The overall complication rate was 14.3% and the mortality rate was 0%. Despite the rarity of HPS in the Third World, the outcome of its management is favourable. However, the sensitivity of abdominal ultrasound for diagnosing HPS is low.

  9. Paraneoplastic hypertrophic osteopathy in 30 dogs

    PubMed Central

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

    2016-01-01

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

  10. Hypertrophic olivary degeneration secondary to pontine haemorrhage.

    PubMed

    Wein, Sara; Yan, Bernard; Gaillard, Frank

    2015-07-01

    We report a 58-year-old man who developed hyptertrophic olivary degeneration (HOD) after haemorrhage of a cavernous malformation in the pons. Lesions of the triangle of Guillain and Mollaret (the dentatorubro-olivary pathway) may lead to HOD, a secondary transsynaptic degeneration of the inferior olivary nucleus. HOD is considered unique because the degenerating olive initially becomes hypertrophic rather than atrophic. The primary lesion causing pathway interruption is often haemorrhage, either due to hypertension, trauma, surgery or, as in our patient, a vascular malformation such as a cavernoma. Ischaemia and demyelination can also occasionally be the inciting events. The classic clinical presentation of HOD is palatal myoclonus, although not all patients with HOD develop this symptom. The imaging features of HOD evolve through characteristic phases. The clue to the diagnosis of HOD is recognition of the distinct imaging stages and identification of a remote primary lesion in the triangle of Guillain and Mollaret. Familiarity with the classic imaging findings of this rare phenomenon is necessary in order to avoid misdiagnosis and prevent unnecessary intervention.

  11. Cardiac norepinephrine kinetics in hypertrophic cardiomyopathy

    SciTech Connect

    Brush, J.E. Jr.; Eisenhofer, G.; Garty, M.; Stull, R.; Maron, B.J.; Cannon, R.O. III; Panza, J.A.; Epstein, S.E.; Goldstein, D.S.

    1989-04-01

    We examined the uptake and release of norepinephrine in the cardiac circulation and other regional vascular beds in 11 patients with hypertrophic cardiomyopathy (HCM) and in 10 control subjects during simultaneous infusion of tracer-labeled norepinephrine and isoproterenol. Cardiac neuronal uptake of norepinephrine was assessed by comparing regional removal of tracer-labeled norepinephrine with that of tracer-labeled isoproterenol (which is not a substrate for neuronal uptake) and by the relation between production of dihydroxyphenylglycol (DHPG), an exclusively intraneuronal metabolite of norepinephrine, and regional spillover of norepinephrine. Cardiac extraction of norepinephrine averaged 59 +/- 17% in the patients with HCM, significantly less than in the control subjects (79 +/- 13%, p less than 0.05), whereas cardiac extraction of isoproterenol was similar in the two groups (13 +/- 23% versus 13 +/- 14%), indicating that neuronal uptake of norepinephrine was decreased in the patients with HCM. The cardiac arteriovenous difference in norepinephrine was significantly larger in the patients with HCM than in the control subjects (73 +/- 77 versus 13 +/- 50 pg/ml, p less than 0.05), as was the product of the arteriovenous difference in norepinephrine and coronary blood flow (7.3 +/- 7.3 versus 0.8 +/- 3.0 ng/min, p less than 0.05).

  12. Paraneoplastic hypertrophic osteopathy in 30 dogs.

    PubMed

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

    2015-09-01

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

  13. Hypertrophic osteopathy associated with mycotic pneumonia in two juvenile elk (Cervus elaphus).

    PubMed

    Ferguson, Nicole M; Lévy, Michel; Ramos-Vara, José A; Baird, Debra K; Wu, Ching Ching

    2008-11-01

    Two yearling bull elk (cervus claphus) from the same farm developed anorexia, weight loss, and lameness. On physical examination, both elk were thin and showed diffuse swelling of all lower limbs. Radiographs of the lower limbs showed periosteal thickening of the distal extremities, consistent with hypertrophic osteopathy. Thoracic radiographs indicated the presence of pulmonary nodules. Cytologic evaluations of tracheal washes on both elk were consistent with inflammation. Acid-fast stains on both samples were negative. Because of the poor prognosis, both elk were euthanized. At necropsy, the carpal, metacarpal, tarsal, and metatarsal bones, as well as the radius, ulna, and tibia had thickening of cortical bone. There were multiple encapsulated nodules throughout the lungs, lymph nodes, and kidney, and smaller nodules in the myocardium. On microscopic examination, these nodules contained myriads of hyphae, and immunohistochemistry for Aspergillus sp. was strongly positive. Aspergillus fumigatus was isolated from affected tissue in 1 elk. Necropsy findings in both elk were consistent with disseminated fungal granulomas and periosteal hyperostosis. This case presents the first description of hypertrophic osteopathy in elk. The source of infection was undetermined, but inhalation of spores from contaminated feed or bedding was suspected.

  14. Medicinal Plants for the Treatment of Hypertrophic Scars

    PubMed Central

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

    2015-01-01

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

  15. Potential applications for transesophageal echocardiography in hypertrophic cardiomyopathies.

    PubMed

    Widimsky, P; Ten Cate, F J; Vletter, W; van Herwerden, L

    1992-01-01

    The purpose of the present study was to evaluate the potential advantages of transesophageal echocardiography (TEE) in comparison with transthoracic echocardiography (TTE) in selected patients with hypertrophic cardiomyopathy. Ten patients with previously established or suspected diagnosis of hypertrophic cardiomyopathy were examined by TEE to solve specific clinical questions. TEE was well tolerated by all patients; no arrhythmias were seen during the procedure. The comparison of TTE and TEE showed the following: Advantages of TTE--better assessment of the left ventricle, myocardial thickness measurements available in all regions and sufficient for the diagnosis of hypertrophic cardiomyopathy in nine out of 10 patients; advantages of TEE--precise assessment of mitral valve morphology and regurgitant jets, detailed evaluation of systolic anterior motion, and subaortic membrane (not seen by TTE) recognized in one patient. Clinically, in three patients TEE influenced the management (mitral leaflet perforation, subaortic membrane, and residual mitral regurgitation after valvuloplasty). Thus TEE enables more precise diagnosis in some patients with hypertrophic cardiomyopathy and has the potential to influence their surgical management. However, for medical treatment of hypertrophic cardiomyopathy, TTE is sufficient.

  16. Impaired cardiac hypertrophic response in Calcineurin Aβ-deficient mice

    PubMed Central

    Bueno, Orlando F.; Wilkins, Benjamin J.; Tymitz, Kevin M.; Glascock, Betty J.; Kimball, Thomas F.; Lorenz, John N.; Molkentin, Jeffery D.

    2002-01-01

    Calcineurin is a calcium–calmodulin-regulated, serine–threonine phosphatase that functions as a key inducer of stress responsive gene expression in multiple cell types through a direct activation of nuclear factor of activated T cells and myocyte enhancer factor 2 transcription factors. In cardiomyocytes, calcineurin signaling has been implicated in the regulation of the hypertrophic response caused by pressure overload or neuroendocrine stimulation. Three separate genes encode the catalytic subunit of calcineurin in mammalian cells, CnAα, CnAβ, and CnAγ. To evaluate the necessary function of calcineurin as a hypertrophic regulatory factor, the CnAβ gene was disrupted in the mouse. CnAβ-deficient mice were viable, fertile, and overtly normal well into adulthood, but displayed a 80% decrease in calcineurin enzymatic activity in the heart that was associated with a 12% reduction in basal heart size. CnAβ-deficient mice were dramatically impaired in their ability to mount a productive hypertrophic response induced by pressure overload, angiotensin II infusion, or isoproterenol infusion. Analysis of marker genes associated with the hypertrophic response revealed a partial defect in the molecular program of hypertrophy. Collectively, these data solidify the hypothesis that calcineurin functions as a central regulator of the cardiac hypertrophic growth response in vivo. PMID:11904392

  17. Penile agenesis and congenital hypertrophic pyloric stenosis: an association or a random coexistence?

    PubMed

    Yagmurlu, Aydin; Vargun, Rahsan; Gollu, Gulnur; Gokcora, I Haluk

    2004-01-01

    A neonate with penile agenesis and congenital hypertrophic pyloric stenosis is presented. The patterns of associated anomalies with penile agenesis, and those of congenital hypertrophic pyloric stenosis are discussed.

  18. Genetic risk factors for hypertrophic scar development.

    PubMed

    Thompson, Callie M; Hocking, Anne M; Honari, Shari; Muffley, Lara A; Ga, Maricar; Gibran, Nicole S

    2013-01-01

    Hypertrophic scars (HTSs) occur in 30 to 72% patients after thermal injury. Risk factors include skin color, female sex, young age, burn site, and burn severity. Recent correlations between genetic variations and clinical conditions suggest that single-nucleotide polymorphisms (SNPs) may be associated with HTS formation. The authors hypothesized that an SNP in the p27 gene (rs36228499) previously associated with decreased restenosis after coronary stenting would be associated with lower Vancouver Scar Scale (VSS) measurements and decreased itching. Patient and injury characteristics were collected from adults with thermal burns. VSS scores were calculated at 4 to 9 months after injury. Genotyping was performed using real-time polymerase chain reaction. Logistic regression was used to determine risk factors for HTS as measured by a VSS score >7. Three hundred subjects had a median age of 39 years (range, 18-91); 69% were male and median burn size was 7% TBSA (range, 0.25-80). Consistent with literature, the p27 variant SNP had an allele frequency of 40%, but was not associated with reduced HTS formation or lower itch scores in any genetic model. HTS formation was associated with American Indian/Alaskan Native race (odds ratio [OR], 12.2; P = .02), facial burns (OR, 9.4; P = .04), and burn size ≥20% TBSA (OR, 1.99; P = .03). Although the p27 SNP may protect against vascular fibroproliferation, the effect cannot be generalized to cutaneous scars. This study suggests that American Indian/Alaskan Native race, facial burns, and higher %TBSA are independent risk factors for HTS. The American Indian/Alaskan Native association suggests that there are potentially yet-to-be-identified genetic variants.

  19. Platelet activation in cats with hypertrophic cardiomyopathy.

    PubMed

    Tablin, F; Schumacher, T; Pombo, M; Marion, C T; Huang, K; Norris, J W; Jandrey, K E; Kittleson, M D

    2014-01-01

    Cats with hypertrophic cardiomyopathy (HCM) are at risk for development of systemic thromboembolic disease. However, the relationship between platelet activation state and cardiovascular parameters associated with HCM is not well described. To characterize platelet activation by flow cytometric evaluation of platelet P-selectin and semiquantitative Western blot analysis of soluble platelet-endothelial cell adhesion molecule-1 (sPECAM-1). Eight normal healthy cats (controls) owned by staff and students of the School of Veterinary Medicine and 36 cats from the UC Davis Feline HCM Research Laboratory were studied. Platelet-rich plasma (PRP) was used for all flow cytometry studies. Platelet surface CD41 and P-selectin expression were evaluated before and after ADP stimulation. sPECAM-1 expression was evaluated by Western blot analysis of platelet-poor plasma that had been stabilized with aprotinin. Standard echocardiographic studies were performed. Resting platelets from cats with severe HCM had increased P-selectin expression compared to controls, and expressed higher surface density of P-selectin reflected by their increased mean fluorescence intensities (MFI). Stimulation with ADP also resulted in significantly increased P-selectin MFI of platelets from cats with severe HCM. Increased P-selectin expression and MFI correlated with the presence of a heart murmur and end-systolic cavity obliteration (ESCO). sPECAM-1 expression from cats with moderate and severe HCM was significantly increased above those of control cats. P-selectin and sPECAM expression may be useful biomarkers indicating increased platelet activation in cats with HCM. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  20. Williams-Beuren syndrome with brain malformation and hypertrophic cardiomyopathy.

    PubMed

    Okamoto, Noriko; Yamagata, Takanori; Yada, Yukari; Ichihashi, Ko; Matsumoto, Naomichi; Momoi, Mariko Y; Mizuguchi, Takeshi

    2014-06-01

    Williams-Beuren syndrome (WBS) is a multisystemic genetic disorder caused by a contiguous gene deletion at 7q11.23. We report a severely affected WBS patient with cerebral and cerebellar dysplasia as well as hypertrophic cardiomyopathy. Microarray comparative genomic hybridization (aCGH) detected a deletion on 7q11.23 expanding from RP11-614D7 to RP11-137E8, which is a typical deletion in WBS. To the best of our knowledge, this is the first case report of a WBS patient with severe congenital central nervous system anomaly and progressive hypertrophic cardiomyopathy. The relationship between the genes deleted in WBS and a CNS anomaly plus hypertrophic cardiomyopathy requires further analysis. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  1. Hypertrophic scarring: the greatest unmet challenge following burn injury

    PubMed Central

    Finnerty, Celeste C; Jeschke, Marc G; Branski, Ludwik K; Barret, Juan P.; Dziewulski, Peter; Herndon, David N

    2017-01-01

    Summary Improvements in acute burn care have enabled patients to survive massive burns which would have once been fatal. Now up to 70% of patients develop hypertrophic scars following burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. The current approach is to optimise the healing potential of the burn wound using targeted wound care and surgery in order to minimise the development of hypertrophic scarring. This approach often fails, and modulation of established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established. The need for novel treatments is paramount, and future efforts to improve outcomes and quality of life should include optimisation of wound healing to attenuate or prevent hypertrophic scarring, well-designed trials to confirm treatment efficacy, and further elucidation of molecular mechanisms to allow development of new preventative and therapeutic strategies. PMID:27707499

  2. Shallow Water Acoustics Studies

    DTIC Science & Technology

    2015-09-30

    this year towards publishing one of the last SW06 papers, on acoustic scattering from crossing nonlinear internal wave trains. This is submitted for...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Shallow Water Acoustics Studies James F. Lynch MS #12...N00014-14-1-0040 http://acoustics.whoi.edu/sw06/ LONG TERM GOALS The long term goals of our shallow water acoustics work are to: 1) understand the

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

    SciTech Connect

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

    1982-05-01

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

  4. Process of Hypertrophic Scar Formation: Expression of Eukaryotic Initiation Factor 6

    PubMed Central

    Yang, Qing-Qing; Yang, Si-Si; Tan, Jiang-Lin; Luo, Gao-Xing; He, Wei-Feng; Wu, Jun

    2015-01-01

    Background: Hypertrophic scar is one of the most common complications and often causes the disfigurement or deformity in burn or trauma patients. Therapeutic methods on hypertrophic scar treatment have limitations due to the poor understanding of mechanisms of hypertrophic scar formation. To throw light on the molecular mechanism of hypertrophic scar formation will definitely improve the outcome of the treatment. This study aimed to illustrate the negative role of eukaryotic initiation factor 6 (eIF6) in the process of human hypertrophic scar formation, and provide a possible indicator of hypertrophic scar treatment and a potential target molecule for hypertrophic scar. Methods: In the present study, we investigated the protein expression of eIF6 in the human hypertrophic scar of different periods by immunohistochemistry and Western blot analysis. Results: In the hypertrophic scar tissue, eIF6 expression was significantly decreased and absent in the basal layer of epidermis in the early period, and increased slowly and began to appear in the basal layer of epidermis by the scar formation time. Conclusions: This study confirmed that eIF6 expression was significantly related to the development of hypertrophic scar, and the eIF6 may be a target molecule for hypertrophic scar control or could be an indicator of the outcomes for other treatment modalities. PMID:26481747

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

    ERIC Educational Resources Information Center

    Maron, Barry J.

    2002-01-01

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

  6. Adult hypertrophic pyloric stenosis — a description in 1834?

    PubMed Central

    Stout, G.

    1983-01-01

    John Peacock MD was in practice in Darlington when he published his Practical Hints on the Treatment of Several Diseases in 1834. It is suggested that his cases described therein of `scirrhous pylorus' are adult hypertrophic pyloric stenosis. If authenticated, his work would predate the earliest description of this condition by the French pathologist, Professor Jean Cruveilhier in 1835. PMID:6350566

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

    ERIC Educational Resources Information Center

    Maron, Barry J.

    2002-01-01

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

  8. Difficulty of diagnosing infected hypertrophic pseudarthrosis by radionuclide imaging

    SciTech Connect

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

    1983-02-01

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

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

    SciTech Connect

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

    1982-01-01

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

  10. Hypertrophic scar in a dog: histological and clinical features.

    PubMed

    Avallone, Giancarlo; Bonaldi, Martina; Caniatti, Mario; Lombardo, Rocco

    2011-08-01

    An adult male bullmastiff dog was treated for paraparesis and ataxia due to discospondylitis and disc herniation. At this time, the dog had a nonhealing ulcer between the pads of the left hindfoot. At re-evaluation, the dog had developed a large exophitic mass in the previously ulcerated area. Cytological examination revealed occasional spindle cells with mild atypia, and a soft tissue tumour was suspected. The mass was excised and submitted for histology. The lesion was characterized by superficial ulceration, an intermediate layer of granulation tissue and a deep portion containing vertically orientated capillaries and perpendicularly arranged fibroblasts and collagen. The histological features led to a diagnosis of hypertrophic scar. Eight weeks after surgery, the lesion recurred and was treated with an intralesional injection of methylprednisolone acetate. The lesion regressed in 10 days, but recurred after 3 months following severe self-trauma. Hypertrophic scars and keloids are two types of exuberant scarring reported in human beings, the pathogenesis of which is still unclear but seems to involve several cytokines, growth factors and inflammatory cells. The histological features identified in this case paralleled those reported in hypertrophic scars in humans. In this case, intralesional corticosteroid therapy was useful in the management of the lesion, but the severe self-trauma could have influenced the recurrence. Even if uncommon, hypertrophic scar should be included among the differential diagnoses of spindle cell tumours in dogs. © 2011 The Authors. Veterinary Dermatology. © 2011 ESVD and ACVD.

  11. A case of hypertrophic osteoarthropathy in a Belgian blue cow

    PubMed Central

    Guyot, Hugues; Sandersen, Charlotte; Rollin, Frédéric

    2011-01-01

    A 12-year-old cow was presented with chronic respiratory disease and lameness. Chronic pleuritis, pneumonia, and bronchial carcinoma were found as well as periosteal proliferation on limb bones. Ancillary tests and necropsy confirmed a combined pathology of pulmonary inflammation and neoplasm, and hypertrophic pulmonary osteopathy. PMID:22654134

  12. Sarcomeric hypertrophic cardiomyopathy: genetic profile in a Portuguese population.

    PubMed

    Brito, Dulce; Miltenberger-Miltenyi, Gabriel; Vale Pereira, Sónia; Silva, Doroteia; Diogo, António Nunes; Madeira, Hugo

    2012-09-01

    Sarcomeric hypertrophic cardiomyopathy has heterogeneous phenotypic expressions, of which sudden cardiac death is the most feared. A genetic diagnosis is essential to identify subjects at risk in each family. The spectrum of disease-causing mutations in the Portuguese population is unknown. Seventy-seven unrelated probands with hypertrophic cardiomyopathy were systematically screened for mutations by PCR and sequencing of five sarcomeric genes: MYBPC3, MYH7, TNNT2, TNNI3 and MYL2. Familial cosegregation analysis was performed in most patients. Thirty-four different mutations were identified in 41 (53%) index patients, 71% with familial hypertrophic cardiomyopathy. The most frequently involved gene was MYBPC3 (66%) with 22 different mutations (8 novel) in 27 patients, followed by MYH7 (22%), TNNT2 (12%) and TNNI3 (2.6%). In three patients (7%), two mutations were found in MYBPC3 and/or MYH7. Additionally, 276 relatives were screened, leading to the identification of a mean of three other affected relatives for each pedigree with the familial form of the disease. Disease-associated mutations were identified mostly in familial hypertrophic cardiomyopathy, corroborating the idea that rarely studied genes may be implicated in sporadic forms. Private mutations are the rule, MYBPC3 being the most commonly involved gene. Mutations in MYBPC3 and MYH7 accounted for most cases of sarcomere-related disease. Multiple mutations in these genes may occur, which highlights the importance of screening both. The detection of novel mutations strongly suggests that all coding regions should be systematically screened. Genotyping in hypertrophic cardiomyopathy enables a more precise diagnosis of the disease, with implications for risk stratification and genetic counseling. Copyright © 2011 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

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

    PubMed

    Hudak, Paul F

    2013-07-01

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

  14. Optimizing fluid resuscitation in hypertrophic pyloric stenosis.

    PubMed

    Dalton, Brian G A; Gonzalez, Katherine W; Boda, Sushanth R; Thomas, Priscilla G; Sherman, Ashley K; St Peter, Shawn D

    2016-08-01

    Hypertrophic pyloric stenosis (HPS) is the most common diagnosis requiring surgery in infants. Electrolytes are used as a marker of resuscitation for these patients prior to general anesthesia induction. Often multiple fluid boluses and electrolyte panels are needed, delaying operative intervention. We have attempted to predict the amount of IV fluid boluses needed for electrolyte correction based on initial values. A single center retrospective review of all patients diagnosed with HPS from 2008 through 2014 was performed. Abnormal electrolytes were defined as chloride <100mmol/L, bicarbonate ≥30mmol/L or potassium >5.2 or <3.1mmol/L. Patients with abnormal electrolytes were resuscitated with 20ml/kg saline boluses and continuous fluids at 1.5 times maintenance rate. During the study period 542 patients were identified with HPS. Of the 505 who were analyzed 202 patients had electrolyte abnormalities requiring IV fluid resuscitation above maintenance, and 303 patients had normal electrolytes at time of diagnosis. Weight on presentation was significantly lower in the patients with abnormal electrolytes (3.8 vs 4.1kg, p<0.01). Length of stay was significantly longer in the patients with electrolyte abnormalities, 2.6 vs 1.9days (p<0.01). Fluid given was higher over the entire hospital stay for patients with abnormal electrolytes (106 vs 91ml/kg/d, p<0.01). The number of electrolyte panels drawn was significantly higher in patients with initial electrolyte abnormalities, 2.8 vs 1.3 (p<0.01). Chloride was the most sensitive and specific indicator of the need for multiple saline boluses. Using an ROC curve, parameters of initial Cl(-)80mmol/L and the need for 3 or more boluses AUC was 0.71. Modifying the parameters to initial Cl(-) ≤97mmol/L and 2 boluses AUC was 0.65. A patient with an initial Cl(-)85 will need three 20ml/kg boluses 73% (95% CI 52-88%) of the time. A patient with an initial Cl(-) ≤97 will need two 20ml/kg boluses at a rate of 73% (95% CI 64

  15. Evaluating the vulnerability of bored and driven wells in a shallow unconfined aquifer.

    PubMed

    Schmalzried, Hans; Keil, Charles

    2008-11-01

    Shallow unconfined aquifers are the only source of water for private wells in some rural areas. The Oak Openings region of Ohio is one such location. Wells are usually bored or driven in shallow aquifers and are more susceptible to contamination caused by human activities on the surface. To provide better protection for consumers developing shallow wells, local health departments have doubled the required minimum 50 feet distance for isolation from sources of contamination. The potential for contamination still exists, however. Over a two year period, 42 wells were tested in the region for a large suite of pesticides and inorganic chemicals. Results showed little evidence of persistent contamination. Data provided evidence, however, indicating that these wells are vulnerable. Sodium and chloride concentrations were higher in wells at households with water softeners, illustrating the potential for contaminant transport even with increased isolation distances. To ensure public health, regular monitoring of shallow wells is recommended.

  16. Shallow Water Propagation

    DTIC Science & Technology

    2014-09-30

    1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Shallow Water Propagation William L. Siegmann...mechanisms of propagation . OBJECTIVES (A) Treat propagation from narrowband and broadband sources over elastic and poro-elastic sediments, and...and other sediments on propagation , and specify for one class of muds the physical variations that affect geoacoustical properties. APPROACH

  17. Invasive alien species water hyacinth Eichhornia crassipes as abode for macroinvertebrates in hypertrophic Ramsar Site, Lake Xochimilco, Mexico.

    PubMed

    Rocha-Ramirez, A; Robles-Valderrama, E; Ramirez-Flores, E

    2014-11-01

    This paper presents information on the density, diversity and functional feeding groups of macroinvertebrate assemblages associated with water hyacinth in Antiguo Canal Cuemanco, part of Lake Xochimilco in Mexico City. Rare (low frequency and density) and dominant (high frequency and density) taxa prevailed in the assemblages, with the most predominant being Hyalella azteca, Chironomus plumosus and Ischnura denticollis. Nonmetric Multidimensional Scaling confirmed two climatic seasons: warm-rainy and cold-dry; the former with the highest diversity and density of taxa. Canonical Correspondence Analysis showed that conductivity, nitrates and turbidity explained the density variations of taxa. Antiguo Canal Cuemanco waters are spatially homogeneous with the characteristics of hypertrophic shallow lakes, inhabited by scrapers and gathering-collectors. The species found were tolerant to organic pollution.

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

    PubMed Central

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

    2015-01-01

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

  19. Analysis of 8 sarcomeric candidate genes for feline hypertrophic cardiomyopathy mutations in cats with hypertrophic cardiomyopathy.

    PubMed

    Meurs, K M; Norgard, M M; Kuan, M; Haggstrom, J; Kittleson, M

    2009-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats. Causative mutations have been identified in the Maine Coon (MC) and Ragdoll breed in the cardiac myosin binding protein C gene (MYBPC3). HCM is thought to be inherited in other breeds. That a causative mutation for HCM in the British Shorthair (BSH), Norwegian Forest (NWF), Siberian, Sphynx, or MC cats would be identified in the exonic and splice site regions of 1 of 8 genes associated with human familial HCM. Three affected BSH, NWF, Siberians, Sphynx, 2 MC (without the known MC mutation), and 2 Domestic Shorthair cats (controls) were studied. Prospective, observational study. Exonic and splice site regions of the genes encoding the proteins cardiac troponin I, troponin T, MYBPC3, cardiac essential myosin light chain, cardiac regulatory myosin light chain, alpha tropomyosin, actin, and beta-myosin heavy chain were sequenced. Sequences were compared for nucleotide changes between affected cats, the published DNA sequences, and control cats. Changes were considered to be causative for HCM if they involved a conserved amino acid and changed the amino acid to a different polarity, acid-base status, or structure. A causative mutation for HCM was not identified, although several single nucleotide polymorphisms were detected. Mutations within these cardiac genes do not appear to be the only cause of HCM in these breeds. Evaluation of additional cardiac genes is warranted to identify additional molecular causes of this feline cardiac disease.

  20. Innovative Therapies in the Treatment of Keloids and Hypertrophic Scars

    PubMed Central

    Viera, Martha H.; Amini, Sadegh; Valins, Whitney

    2010-01-01

    Keloids and hypertrophic scars are benign fibrous overgrowths of scar tissue, which results from an abnormal response to trauma. Several therapeutic modalities have been described for the treatment and prevention of these conditions, but the optimal management approach has not yet been defined. This article reviews the most recent, innovative, therapeutic strategies for the management of hypertrophic scars and keloids, including mitomycin-C, tamoxifen citrate, methotrexate, imidazolaquinolines, retinoids, calcineurin inhibitors, phenylakylamine calcium channel blockers, botulinum toxin, vascular endothelial growth factor inhibitors, hepatocyte growth factor, basic fibroblast growth factor, interleukin-10, manosa-6-phosphate, transforming growth factor beta, antihistamines, and prostaglandin E2. No consensus in treatment regimens has been reached due to the limited evidence-based information found in the literature. Most therapeutic options have potential effectiveness as both monotherapy and as combination therapy. However, recent reports offer novel modalities that may approach scarring from different angles. PMID:20725565

  1. Atrial Myxoma in a Patient with Hypertrophic Cardiomyopathy

    PubMed Central

    Abdou, Mahmoud; Hayek, Salim; Williams, Byron R.

    2013-01-01

    Atrial myxoma is the most common primary cardiac tumor. Patients with atrial myxoma typically present with obstructive, embolic, or systemic symptoms; asymptomatic presentation is very rare. To our knowledge, isolated association of atrial myxoma with hypertrophic cardiomyopathy has been reported only once in the English-language medical literature. We report the case of an asymptomatic 71-year-old woman with known hypertrophic cardiomyopathy in whom a left atrial mass was incidentally identified on cardiac magnetic resonance images. After surgical excision of the mass and partial excision of the left atrial septum, histopathologic analysis confirmed the diagnosis of atrial myxoma. The patient was placed on preventive implantable cardioverter-defibrillator therapy and remained asymptomatic. The management of asymptomatic cardiac myxoma is a topic of debate, because no reports definitively favor either conservative or surgical measures. PMID:24082380

  2. Pulmonary capillary hemangiomatosis and hypertrophic cardiomyopathy in a Persian cat.

    PubMed

    Jenkins, Tiffany L; Jennings, Ryan N

    2017-07-01

    Pulmonary capillary hemangiomatosis (PCH) and pulmonary veno-occlusive disease (PVOD) are rare causes of primary pulmonary hypertension in humans, and, in 2016, were reported in dogs. A 1-y-old, neutered male Persian cat was presented for autopsy after sudden death several hours after grooming. Grossly, the lungs were mottled red-to-pink, contained rubbery-to-firm nodular foci, and there was moderate-to-marked left-sided cardiomegaly and left atrial dilation, consistent with hypertrophic cardiomyopathy. Microscopically, there was multifocal to regionally extensive capillary proliferation within pulmonary alveolar septa and around respiratory bronchioles, with nodular aggregates of densely arranged capillaries that replaced pulmonary alveolar spaces. Rare occlusive venous remodeling was identified in Verhoeff-van Gieson-stained sections. The gross and microscopic changes were consistent with PCH with rare features of PVOD. Hypertrophic cardiomyopathy was interpreted as potentially contributing to the cause of death, but unrelated to the pulmonary vascular proliferation.

  3. A Tension-Based Model Distinguishes Hypertrophic versus Dilated Cardiomyopathy.

    PubMed

    Davis, Jennifer; Davis, L Craig; Correll, Robert N; Makarewich, Catherine A; Schwanekamp, Jennifer A; Moussavi-Harami, Farid; Wang, Dan; York, Allen J; Wu, Haodi; Houser, Steven R; Seidman, Christine E; Seidman, Jonathan G; Regnier, Michael; Metzger, Joseph M; Wu, Joseph C; Molkentin, Jeffery D

    2016-05-19

    The heart either hypertrophies or dilates in response to familial mutations in genes encoding sarcomeric proteins, which are responsible for contraction and pumping. These mutations typically alter calcium-dependent tension generation within the sarcomeres, but how this translates into the spectrum of hypertrophic versus dilated cardiomyopathy is unknown. By generating a series of cardiac-specific mouse models that permit the systematic tuning of sarcomeric tension generation and calcium fluxing, we identify a significant relationship between the magnitude of tension developed over time and heart growth. When formulated into a computational model, the integral of myofilament tension development predicts hypertrophic and dilated cardiomyopathies in mice associated with essentially any sarcomeric gene mutations, but also accurately predicts human cardiac phenotypes from data generated in induced-pluripotent-stem-cell-derived myocytes from familial cardiomyopathy patients. This tension-based model also has the potential to inform pharmacologic treatment options in cardiomyopathy patients.

  4. [Risk stratification of sudden death in hypertrophic cardiomyopathy in 2016].

    PubMed

    Dubourg, Olivier; Charron, Philippe; Sirol, Marc; Siam-Tsieu, Valérie; Mansencal, Nicolas

    2016-10-01

    Patients with hypertrophic cardiomyopathy (HCM) are at an increased risk of death from many causes and sudden cardiac death is one of them. The study of the sudden cardiac death of patients with HCM has allowed the identification of risk factors and among them major risk factor are: family history of sudden cardiac death, the occurrence of syncope/dizziness, the existence of non-sustained ventricular tachycardia an abnormal blood pressure response during stress test, presence of severe left ventricular hypertrophy≥30mm. Risk stratification for sudden cardiac death is essential, for symptomatic or asymptomatic HCM patients. Two approaches are possible: the classical approach or risk stratification methods with major risk factors and the new approach using the risk-calculator recommended by the ESC. Both methods are not in opposition but complementary. The risk stratification in hypertrophic cardiomyopathy should be still improved to be sure that only the most high-risk patients receive an implantable cardiac defibrillator.

  5. Shallow Water Acoustics Studies

    DTIC Science & Technology

    2014-09-30

    the nature of low frequency (10-1500 Hz) acoustic propagation , scattering and noise in shallow water when strong oceanic variability is present in...field data The work on internal wave scattering of sound continues, and we have looked at mode coupling, ducting by curved waves, and high...understanding of the propagation of sound through complicated coastal oceanography, 2) an eventual capability to model these effects for use in sonar

  6. Water contamination, land prices, and the statute of repose

    Treesearch

    John F. Chamblee; Carolyn A. Dehring; Craig A. Depken; Joseph R. Nicholson

    2015-01-01

    We examine how water contamination risk from an inactive hazardous waste site is capitalized into surrounding vacant land prices. After public knowledge of the first instance of off-site contamination, we find that shallow groundwater contamination potential is negatively capitalized into land prices, as is proximity to a known contaminated well. Public knowledge of...

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

    PubMed

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

    2012-11-01

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

  8. Atrial fibrillation in hypertrophic cardiomyopathy: mechanisms, embolic risk and prognosis.

    PubMed

    Nair, Ajith G; Fischer, Avi G

    2006-12-01

    Hypertrophic cardiomyopathy (HCM) is associated with an increased incidence of supraventricular and ventricular arrhythmias. Atrial fibrillation (AF) is the most common arrhythmia in HCM with a prevalence of 20% and an annual incidence of two percent per year. Increased left atrial size and volume along with impaired left atrial function confer an increased likelihood of AF. The onset of AF is often accompanied by a decrease in functional status in conjunction with an increased risk of stroke and overall mortality.

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

    PubMed Central

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

    2012-01-01

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

  10. Primary amyloid heart disease presenting as hypertrophic obstructive cardiomyopathy

    SciTech Connect

    Weston, L.T.; Raybuck, B.D.; Robinowitz, M.; Brinker, J.A.; Oetgen, W.J.

    1986-01-01

    This report describes the unusual presentation of a patient with primary cardiac amyloidosis. Initial clinical symptoms and hemodynamic studies, including Technetium-99m-pyrophosphate scintigraphy, suggested hypertrophic obstructive cardiomyopathy, but endomyocardial biopsy revealed diffuse amyloid infiltration. Only two other cases of left ventricular outflow tract obstruction due to cardiac amyloidosis have been reported. The false-negative technetium-99m-pyrophosphate scintigram in this patient argues for the use of endomyocardial biopsy to aid in the diagnosis of left ventricular hypertrophy.

  11. Shallow subsurface applications of high-resolution seismic reflection

    NASA Astrophysics Data System (ADS)

    Steeples, Don

    2002-11-01

    Shallow seismic reflection surveys have been applied to a wide variety of problems. For example, in many geologic settings, variations and discontinuities on the surface of bedrock can influence the transport and eventual fate of contaminants introduced at or near the ground surface. Using seismic methods to determine the nature and location of anomalous bedrock can be an essential component of hydrologic characterization. Shallow seismic surveys can also be used to detect earthquake faults and to image underground voids. During the early 1980s, the advent of digital engineering seismographs designed for shallow, high-resolution surveying spurred significant improvements in engineering and environmental reflection seismology. Commonly, shallow seismic reflection methods are used in conjunction with other geophysical and geological methods, supported by a well-planned drilling-verification effort. To the extent that seismic reflection, refraction, and surface-wave methods can constrain shallow stratigraphy, geologic structure, engineering properties, and relative permeability, these methods are useful in civil-engineering applications and in characterizing environmental sites. Case histories from Kansas, California, and Texas illustrate how seismic reflection can be used to map bedrock beneath alluvium at hazardous waste sites, detect abandoned coal mines, follow the top of the saturated zone during an alluvial aquifer pumping test, and map shallow faults that serve as contaminant flowpaths.

  12. [Doppler evaluation of diastolic function in hypertrophic cardiomyopathy].

    PubMed

    Borzi, M; Capria, A; Calò, L; Luzi, M; Cannata, D

    1995-01-01

    Diastolic function may play a significant role in patients affected by hypertrophic cardiomyopathy, because abnormalities in diastolic function, even in presence of a normal systolic function, may determine the clinical features of the disease. Doppler ecocardiography, using a non-invasive and not highly expensive method, easily allows to analize the indexes of diastolic function, as soon as some morpho-functional parameters, represented by extent and localization of the myocardial hypertrophy and presence or absence of obstruction in the left ventricular outflow, which have always been considered relevant in the prognosis together with the typical arrhythmic abnormalities of the disease. The aim of this study was to investigate the behaviour of Doppler ecocardiographic parameters of diastolic function in 38 patients with hypertrophic cardiomyopathy and to analize whether they might be correlated with the morpho-functional patterns and clinical features of the disease, represented by the NYHA functional class and occurrence of ventricular tachycardia during 48 hour ambulatory electrocardiographic monitoring. Diastolic function abnormalities, although occurring in most patients, do not seem to be related with clinical conditions and/or with the typical morpho-functional patterns of the disease; however, an increase in the left atrial size together with a specific increase in the rate of deceleration of flow velocity in early diastole that were detected in patients with ventricular tachycardia, by suggesting a relation between diastolic dysfunction and arrhythmogenic substrate, remarks the importance of the analysis of diastolic function for a better prognostic evaluation of the hypertrophic cardiomyopathy.

  13. Modeling Hypertrophic IP3 Transients in the Cardiac Myocyte

    PubMed Central

    Cooling, Michael; Hunter, Peter; Crampin, Edmund J.

    2007-01-01

    Cardiac hypertrophy is a known risk factor for heart disease, and at the cellular level is caused by a complex interaction of signal transduction pathways. The IP3-calcineurin pathway plays an important role in stimulating the transcription factor NFAT which binds to DNA cooperatively with other hypertrophic transcription factors. Using available kinetic data, we construct a mathematical model of the IP3 signal production system after stimulation by a hypertrophic α-adrenergic agonist (endothelin-1) in the mouse atrial cardiac myocyte. We use a global sensitivity analysis to identify key controlling parameters with respect to the resultant IP3 transient, including the phosphorylation of cell-membrane receptors, the ligand strength and binding kinetics to precoupled (with GαGDP) receptor, and the kinetics associated with precoupling the receptors. We show that the kinetics associated with the receptor system contribute to the behavior of the system to a great extent, with precoupled receptors driving the response to extracellular ligand. Finally, by reparameterizing for a second hypertrophic α-adrenergic agonist, angiotensin-II, we show that differences in key receptor kinetic and membrane density parameters are sufficient to explain different observed IP3 transients in essentially the same pathway. PMID:17693463

  14. Two Cases of Apical Ballooning Syndrome Masking Apical Hypertrophic Cardiomyopathy

    PubMed Central

    Roy, Ranjini Raina; Hakim, Fayaz A.; Hurst, R. Todd; Simper, David; Appleton, Christopher P.

    2014-01-01

    Apical akinesis and dilation in the absence of obstructive coronary artery disease is a typical feature of stress-induced (takotsubo) cardiomyopathy, whereas apical hypertrophy is seen in apical-variant hypertrophic cardiomyopathy. We report the cases of 2 patients who presented with takotsubo cardiomyopathy and were subsequently found to have apical-variant hypertrophic cardiomyopathy, after the apical ballooning from the takotsubo cardiomyopathy had resolved. The first patient, a 43-year-old woman with a history of alcohol abuse, presented with shortness of breath, electrocardiographic and echocardiographic features consistent with takotsubo cardiomyopathy, and no significant coronary artery disease. An echocardiogram 2 weeks later revealed a normal left ventricular ejection fraction and newly apparent apical hypertrophy. The 2nd patient, a 70-year-old woman with pancreatitis, presented with chest pain, apical akinesis, and a left ventricular ejection fraction of 0.39, consistent with takotsubo cardiomyopathy. One month later, her left ventricular ejection fraction was normal; however, hypertrophy of the left ventricular apex was newly noted. To our knowledge, these are the first reported cases in which apical-variant hypertrophic cardiomyopathy was masked by apical ballooning from stress-induced cardiomyopathy. PMID:24808780

  15. Age-dependent heterogeneity of familiar hypertrophic cardiomyopathy phenotype: a role of cardiovascular magnetic resonance.

    PubMed

    Glaveckaitė, Sigita; Rudys, Alfredas; Mikštienė, Violeta; Valevičienė, Nomeda; Palionis, Darius; Laucevičius, Aleksandras

    2013-01-01

    In this case report, we present familiar hypertrophic cardiomyopathy with age-dependent heterogeneity of the disease phenotype among the members of one family who carry the same mutation of the myosin-binding protein C gene. Phenotypic heterogeneity is common in patients with familial forms of hypertrophic cardiomyopathy, both in clinical expression and outcome. Compared with other noninvasive cardiac imaging modalities, cardiovascular magnetic resonance provides an opportunity to more accurately characterize the varying phenotypic presentations of hypertrophic cardiomyopathy.

  16. Quantification of Shallow Groundwater Nutrient Dynamics in Septic Areas

    Treesearch

    Ying Ouyang; Jia-En Zhang

    2012-01-01

    Of all groundwater pollution sources, septic systems are the second largest source of groundwater nitrate contamination in USA. This study investigated shallow groundwater (SGW) nutrient dynamics in septic areas at the northern part of the Lower St. Johns River Basin, Florida, USA. Thirty-five SGW-monitoring wells, located at nine different urban areas served by septic...

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  19. [A computational fluid dynamics study of inner flow through nasal cavity with unilateral hypertrophic inferior turbinate].

    PubMed

    Guo, Yufeng; Zhang, Yuning; Chen, Guang; Liu, Shuhong; Lu, Xiaofeng; Zhu, Min; Cai, Changping; Chen, Xueming

    2009-09-01

    To investigate the anatomical influence of the hypertrophic inferior turbinate on computational fluid dynamics (CFD) model of unilateral hypertrophic inferior turbinate nasal cavity, and to analyze the bilateral detailed nasal airflow simulations under both inspiratory and expiratory phases in CFD model. One male volunteer troubled with unilateral hypertrophic inferior turbinate accepted CT scan. CFD model was built by CT scans through Simplant 10.0 and ANSYS ICEM. Fluent 6.3.26 simulated the airflow of both nasal cavity in breathing rates 200 ml/s. 1) In infraturbinal region, the cross-section area (CSA) of the nasal cavity with hypertrophic inferior turbinate was smaller than that in healthy side and the average area difference between two sides was 1.62 cm2. 2) In both inspiration and expiration phases, the hypertrophic infraturbinal produced a markable reduction in intranasal pressures drop along the full length of the infraturbinal region. The volumetric flow rate in the hypertrophic infraturbinal side was 50 ml/s, which equalled to one third of that in healthy side; Mean air speed in the anterior valve region was estimated to be 0.57 m/s at hypertrophic infraturbinal side and 1.83 m/s at healthy side during inspiration; More vortices happened in the hypertrophic infraturbinal side. The unilateral hypertrophic infraturbinal change the normal anatomy and influence the aerodynamic of nasal cavity, which is harmful to the functions of human nasal in ventilation, temperature accommodation and olfactory sensation.

  20. Review of a long-term air sparging pilot test in a shallow aquifer

    SciTech Connect

    Weymann, D.F.; Hoffman, G.D.; Kuhn, E.M.

    1995-12-31

    A 5-month-long air sparging pilot study was conducted on a shallow surficial aquifer contaminated with gasoline. The pilot study was conducted on a shallow surficial aquifer contaminated with gasoline. The pilot study documented the physical and biological response of the aquifer and evaluated sampling techniques. Results indicated that sparging increased biological activity, but the zone of influence was limited. A transition from methanogenic to aerobic conditions was indicated. Monitoring results were significantly affected by sampling techniques.

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

    SciTech Connect

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

    1988-10-01

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

  2. Electrocardiographic changes announcing the rapid development of apical hypertrophic cardiomyopathy in an adult male.

    PubMed

    Freites, Alfonso; Canovas, Ester; Rubio, J

    2015-07-01

    We presented the case of an adult male without structural heart disease, who in the period of 3 years developed apical hypertrophic cardiomyopathy. ECG changes preceded the development of ventricular hypertrophy. We discussed the appearance of ventricular enlargement during adulthood, in some cases of hypertrophic cardiomyopathy (HC), and how the ECG abnormalities may precede the onset of ventricular hypertrophy. © 2014 Wiley Periodicals, Inc.

  3. Role of beta adrenoceptors in the hypertrophic response to thyroxine

    SciTech Connect

    Eliades, D.; Weiss, H.R. )

    1989-07-01

    The ability of beta-adrenoceptor blockade to reduce the hypertrophic response to thyroxine (T4, 0.5 mg/kg per day, s.c.) was tested in New Zealand white rabbits. Two beta-adrenergic blocking agents, one a full antagonist (propranolol, 9.6 mg/kg per day) and the other a partial agonist (pindolol, 0.96 mg/kg per day) were administered in combination with T4 in an effort to reduce myocardial hypertrophy. A 3 and 16 day group were generated to test the time course of the hypertrophic and receptor responses. Coronary blood flow was measured using radioactive microspheres, and beta-adrenoceptor number and affinity were measured using 125I(-) pindolol as the radioligand. T4 increased coronary blood flow to 1.95 times control values in the 3 day group and 2.2 times control levels in the 16 day group; beta-adrenoceptor number was increased similarly in 3 and 16 day groups to 1.9 times control Bmax levels. Heart weight (HW) to body weight (BW) ratios were significantly increased in only the 16 day group to 1.22 and 1.61 times control, respectively. Treatment with propranolol + T4 blunted the coronary blood flow increase, but receptor upregulation occurred to the same extent as with either substance alone. The HW/BW was increased to 1.49 times control. Pindolol + T4 did not decrease coronary blood flow but blocked beta-adrenoceptor upregulation. The HW was reduced to control levels and the HW/BW ratio was 1.40 times control and significantly decreased from T4 alone. Thus, pindolol was effective in reducing the hypertrophic response to T4, whereas propranolol was only moderately effective in doing so.

  4. Structural differences in epiphyseal and physeal hypertrophic chondrocytes

    PubMed Central

    Shapiro, Frederic; Flynn, Evelyn

    2015-01-01

    We have observed that epiphyseal and physeal hypertrophic chondrocytes in BALB/c mice show considerable differences of light microscopic and ultrastructural appearance, even when the cells are at the same stage of differentiation. In addition, cell structure maintenance improved with tissue preparation controlled for osmolarity and for membrane stabilization using 0.5% ruthenium hexammine trichloride (RHT) for both light microscopy (LM) and electron microscopy (EM) or 0.5% lanthanum nitrate for LM. Physeal hypertrophic chondrocytes showed a gradual increase in size closer to the metaphysis and a change in shape as cells elongated along the long axis. The nucleus remained central, with uniformly dispersed chromatin, and the rough endoplasmic reticulum (RER) was randomly dispersed throughout cytoplasm with little to no presence against the cell membrane. Even the lowermost cells showed thin elongated or dilated cisternae of RER and intact cell membranes. Epiphyseal chondrocytes remained circular to oval with no elongation. Nucleus and RER were positioned as a complete transcellular central nucleocytoplasmic column or as an incomplete bud with RER of the column/bud always continuous with RER peripherally against the intact cell membrane. RER was densely packed with parallel cisternae with adjacent cytoplasm empty of organelles but often filled with circular deposits of moderately electron-dense material consistent with fat. Optimal technique for LM involved fixation using glutaraldehyde (GA) 1.3%, paraformaldehyde (PFA) 1% and RHT 0.5% (mOsm 606) embedded in JB-4 plastic and stained with 0.5% toluidine blue. Optimal technique for EM used fixation with GA 1.3%, PFA 1%, RHT 0.5% and cacodylate buffer 0.03 M (mOsm 511) and post-fixation including 1% osmium tetroxide. These observations lead to the possibility that the same basic cell, the hypertrophic chondrocyte, has differing functional mechanisms at different regions of the developing bone. PMID:25987982

  5. Compression therapy affects collagen type balance in hypertrophic scar.

    PubMed

    Tejiram, Shawn; Zhang, Jenny; Travis, Taryn E; Carney, Bonnie C; Alkhalil, Abdulnaser; Moffatt, Lauren T; Johnson, Laura S; Shupp, Jeffrey W

    2016-04-01

    The effects of pressure on hypertrophic scar are poorly understood. Decreased extracellular matrix deposition is hypothesized to contribute to changes observed after pressure therapy. To examine this further, collagen composition was analyzed in a model of pressure therapy in hypertrophic scar. Hypertrophic scars created on red Duroc swine (n = 8) received pressure treatment (pressure device mounting and delivery at 30 mm Hg), sham treatment (device mounting and no delivery), or no treatment for 2 wk. Scars were assessed weekly and biopsied for histology, hydroxyproline quantification, and gene expression analysis. Transcription levels of collagen precursors COL1A2 and COL3A1 were quantified using reverse transcription-polymerase chain reaction. Masson trichrome was used for general collagen quantification, whereas immunofluorescence was used for collagen types I and III specific quantification. Total collagen quantification using hydroxyproline assay showed a 51.9% decrease after pressure initiation. Masson trichrome staining showed less collagen after 1 (P < 0.03) and 2 wk (P < 0.002) of pressure application compared with sham and untreated scars. Collagen 1A2 and 3A1 transcript decreased by 41.9- and 42.3-fold, respectively, compared with uninjured skin after pressure treatment, whereas a 2.3- and 1.3-fold increase was seen in untreated scars. This decrease was seen in immunofluorescence staining for collagen types I (P < 0.001) and III (P < 0.04) compared with pretreated levels. Pressure-treated scars also had lower levels of collagen I and III after pressure treatment (P < 0.05) compared with sham and untreated scars. These results demonstrate the modulation of collagen after pressure therapy and further characterize its role in scar formation and therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Percutaneous transluminal septal myocardial ablation in hypertrophic cardiomyopathy

    PubMed Central

    van der Lee, C.; Foley, D.P.; Vletter, W.B.; ten Cate, F.J.; Kofflard, M.J.M.

    2001-01-01

    Background Percutaneous transluminal septal myocardial ablation (PTSMA) is a new interventional technique to treat patients with hypertrophic cardiomyopathy. Methods Small doses of ethanol 96% were injected into a targeted septal artery causing a chemical myocardial infarction. Three patients were evaluated, including a follow-up of three months. Results There were no complications during the procedure LVOT gradient was reduced from 120±140 mmHg. At follow-up, all three patients showed improvement in validity. Conclusion The method requires an echocardiographic contrast determination of the myocardium at risk for ethanol treatment, in addition to haemodynamic monitoring. ImagesFigure 1Figure 2Figure 3A PMID:25696698

  7. Atrial fibrillation and hypertrophic cardiomyopathy: who to anticoagulate?

    PubMed

    Frontera, Antonio; Wilson, D G; Sekhon, H; Duncan, E R; Thomas, G

    2015-10-01

    Hypertrophic cardiomyopathy (HCM) is one of the most common genetic cardiac conditions. Atrial fibrillation (AF) has been demonstrated to be the most frequent arrhythmia encountered in HCM patients. Research focusing on AF and embolic stroke in HCM patients has been sparse and the sample size of most studies is small. The prognostic significance of AF in HCM patients is still not well known. The aim of this article is to provide further understanding of the anti-coagulation requirement of HCM patients with AF.

  8. Echocardiographic sign of right-sided hypertrophic obstructive cardiomyopathy.

    PubMed Central

    Cardiel, E A; Alonso, M; Delcan, J L; Menarguez, L

    1978-01-01

    The echocardiographic and haemodynamic findings with a patient with hypertrophic obstructive cardiomyopathy (HOCM) and dynamic subpulmonary stenosis, without left ventricular gradient, are described. The echocardiogram shows not only asymmetric septal hypertrophy, systolic anterior movement of the anterior mitral leaflet, and midsystolic collapse of the aortic valve, but also increase in the right ventricular wall echoes and systolic collapse of the pulmonary valve. We believe that in the absence of pulmonary hypertension these signs, particularly the systolic closing movement of the pulmonary valve cusp, may suggest right ventricular obstruction in HOCM. Images PMID:568930

  9. Ultrasonic "double track" sign in hypertrophic pyloric stenosis.

    PubMed

    Cohen, H L; Schechter, S; Mestel, A L; Eaton, D H; Haller, J O

    1987-03-01

    Ultrasound has been used in the diagnosis of hypertrophic pyloric stenosis since the first reports of its use with contact B mode scanners. Real-time imaging has allowed measurements of pyloric diameter, length, and muscle wall thickness. Wall thickness measurements taken with the pylorus in longitudinal (elongated) view improve diagnostic accuracy. Fluid aided real-time examination of 10 cases showed the ultrasound equivalent of the "double track" sign. This finding is the result of pyloric fluid compressed into smaller tracks as it is impinged upon circumferentially by the thickened circular muscle. This sign, previously seen in barium studies, although nonspecific, may prove to be a sensitive diagnostic criterion.

  10. Radiotherapy for extreme hypertrophic pulmonary osteoarthropathy associated with malignancy.

    PubMed

    Yeo, W; Leung, S F; Chan, A T; Chiu, K W

    1996-01-01

    A patient with florid hypertrophic pulmonary osteoarthropathy (HPOA) associated with metastatic nasopharyngeal carcinoma is presented. Despite the presence of metastatic disease in the thorax and in bone, the patient's main symptom was severe pain from the HPOA, which was temporarily relieved by chemotherapy. Her disease subsequently progressed during chemotherapy and the pain became resistant to conventional treatment, including high dose morphine, non-steriodal anti-inflammatory agents and steriods. It was only with local radiation to the involved joints that the pain could be controlled. Our patient demonstrates that local radiotherapy is an option for the palliation of extreme HPOA.

  11. Recent progress in end-stage hypertrophic cardiomyopathy.

    PubMed

    Xiao, Yan; Yang, Kun-Qi; Jiang, Yong; Zhou, Xian-Liang

    2015-05-01

    Within the diverse spectrum of hypertrophic cardiomyopathy (HCM), a unique subgroup characterized by left ventricular enlargement and systolic dysfunction has emerged (defined as end-stage HCM [ES-HCM]). This underestimated entity provides challenging treatment strategies for extremely high risk of refractory heart failure and sudden cardiac death. Over the last 2 decades, the clinical features of ES-HCM have expanded and the underlying mechanisms gradually elucidated. Moreover, there is increasing evidence for early recognition of ES-HCM. New insights into early prevention and management will improve the clinical outcomes of this entity.

  12. Simultaneous pressure recording in mid-ventricular obstructive hypertrophic cardiomyopathy.

    PubMed

    Hanaoka, Yousuke; Misumi, Ikuo; Rokutanda, Taku; Akahoshi, Ryuichiro; Matsumoto, Mitsuhiro; Sakamoto, Tomohiro; Kaikita, Koichi; Yamamuro, Megumi; Sugiyama, Seigo; Ogawa, Hisao

    2012-01-01

    A 70-year-old man was diagnosed with mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) with apical aneurysm and paradoxic jet flow. At cardiac catheterization, pressure study showed that there was a markedly high pressure-gradient of 90 mmHg between the apex and the base in systole. Apical pressure was 350 mmHg after premature ventricular contraction. The apical aneurysm was already dilated and spherical in late systole; the absence of active relaxation was considered to be the cause of the paradoxic jet flow. In this report, we suggest the pathogenesis of left ventricular apical aneurysm and paradoxic jet flow in MVOHCM.

  13. Surgical Myectomy after Failed Ablation for Hypertrophic Obstructive Cardiomyopathy

    PubMed Central

    Bougioukas, Ioannis; Hoppe, Uta; Danner, Bernhard; Schoendube, Friedrich A.

    2016-01-01

    Background Hypertrophic cardiomyopathy is a genetic disease of the myocardial sarcolemma characterized by left ventricular hypertrophy. When obstruction to the left ventricular outflow tract is present and symptoms are refractory to medication, surgical myectomy or alcohol septal ablation is indicated. Case Description We report a case of a patient presented for myectomy due to recurrence only 1 year after alcohol ablation. Interesting findings were a firm subaortic membrane and a direct insertion of the papillary muscle into the mitral valve. Conclusion After myectomy and extensive papillary muscle mobilization, a significant relief of obstruction was achieved. PMID:28018818

  14. Effective Response of Methotrexate for Recurrent Idiopathic Hypertrophic Spinal Pachymeningitis

    PubMed Central

    Park, Tae Joon; Seo, Won Deok; Kim, Sang Young; Cho, Jae Hoon; Kim, Dae Hyun

    2016-01-01

    Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic progressive and diffuse inflammatory fibrosis of the spinal dura mater. Though treatment of IHSP is surgical decompression with steroid therapy, treatment for recurrent IHSP is controversial. Our patient was diagnosed with IHSP based on magnetic resonance imaging (MRI) and underwent laminectomy for decompression following steroid pulse therapy. Despite maintenance of steroid therapy, the patient experienced 3 recurrences. As an alternative immunosuppressant medication, methotrexate was introduced with low-dose steroid. Fortunately, the symptom was resolved, and a decrease of dura thickening was revealed on MRI. We present the case and suggest that methotrexate might be an effective treatment modality for recurrent IHSP. PMID:28127378

  15. Genetic counseling and testing for hypertrophic cardiomyopathy: the pediatric perspective.

    PubMed

    Demo, Erin M; Skrzynia, Cécile; Baxter, Samantha

    2009-12-01

    Hypertrophic cardiomyopathy (HCM) is a common cardiac disease that is now being identified in the pediatric population. The etiology of this disease is largely genetic, and as a result, genetics professionals are becoming more involved in the management of these patients. We present multiple case scenarios that highlight the complex nature of this disease and how genetic counselors and cardiologists can interact to identify the genetic etiology of HCM and provide comprehensive care for these patients. Additionally, we describe knowledge gaps in this field and how research endeavors can assist in more effectively managing this patient cohort.

  16. Hypertrophic cardiomyopathy in a mixed breed cat family.

    PubMed

    Nakagawa, Kiyoshi; Takemura, Naoyuki; Machida, Noboru; Kawamura, Masamichi; Amasaki, Hajime; Hirose, Hisashi

    2002-07-01

    A spayed female mixed cat (case 1) and its female offspring, the result of a pairing between case 1 and its male sibling, were diagnosed with hypertrophic cardiomyopathy (HCM). A pedigree survey revealed that the prevalence of HCM was at least 12.5% in the family, which was considered to be significantly higher than that in a hospital-based population (approximately 1.6%). Thus, this finding seems to support the suspected occurrence of familial HCM in this group of related cats.

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

    PubMed

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

    2015-01-01

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

  18. The structure of winter phytoplankton in Lake Nero, Russia, a hypertrophic lake dominated by Planktothrix-like Cyanobacteria

    PubMed Central

    2013-01-01

    Background The permanent dominance of Planktothrix-like сyanobacteria has been often reported for shallow eutrophic\\hypertrophic lakes in central Europe in summer\\autumn. However studies on phytoplankton growth under ice cover in nutrient-rich lakes are very scarce. Lake Nero provides a good example of the contrasting seasonal extremes in environmental conditions. Moreover, the ecosystem underwent a catastrophic transition from eutrophic to hypertrophic 2003–05, with dominance of filamentous cyanobacteria in summer\\autumn. Towards the end of the period of ice cover, there is an almost complete lack of light and oxygen but abundance in nutrients, especially ammonium nitrogen, soluble reactive phosphorus and total phosphorus in lake Nero. The aim of the present study was to describe species composition and abundance of the phytoplankton, in relation to the abiotic properties of the habitat to the end of winters 1999–2010. We were interested if Planktothrix-like сyanobacteria kept their dominant role under the ice conditions or only survived, and how did the under-ice phytoplankton community differ from year to year. Results Samples collected contained 172 algal taxa of sub-generic rank. Abundance of phytoplankton varied widely from very low to the bloom level. Cyanobacteria (Limnothrix, Pseudanabaena, Planktothrix) were present in all winter samples but did not always dominate. Favourable conditions included low winter temperature, thicker ice, almost complete lack of oxygen and high ammonium concentration. Flagellates belonging to Euglenophyta and Cryptophyta dominated in warmer winters, when phosphorus concentrations increased. Conclusion A full picture of algal succession in the lake may be obtained only if systematic winter observations are taken into account. Nearly anoxic conditions, severe light deficiency and high concentration of biogenic elements present a highly selective environment for phytoplankton. Hypertrophic water bodies of moderate zone

  19. Planktonic ciliates in a hypertrophic pond: functional role and importance.

    PubMed

    Sanchez Rodriguez, Ma del Rosario; Lugo Vazquez, Alfonso; Oliva Martinez, Ma Guadalupe; Verver y Vargas, Jaqueline Garcia; Rodriguez Rocha, Armando; Peralta Soriano, Laura

    2011-07-01

    Taxonomical composition and abundance of the planktonic ciliate assemblage in a Lake Tezozomoc, a hypertrophic pond located into an urban park in Mexico City, was investigated along the rainy season (May to October). The aims of the study were to know the main trophic roles and ecological significance of ciliates in a highly productive environment. A low number of taxa (27) and a wide abundance fluctuation (104-387 cil ml(-1)) were found. The most abundant species (up to 162 cil ml(-1)) was Halteria grandinella, an oligotrich ciliate that graze on bacteria and picoplankton, but also several big body sized species that feed on pico and nanoplankton were abundant. Sudden temporal changes in species dominance occurred. Ciliate biomass was very high and fluctuated widely (1.6-88 10(6) microm(3) ml(-1)) being dominated by the >50 microm size fraction that mainly included the pico and nanoplankton feeders. Ciliates are a very important component in the plankton of hypertrophic lakes and their main control factor seems to be the grazing by big-body size Daphnia species.

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

    PubMed Central

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

    2015-01-01

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

  1. Cranial and lumbosacral hypertrophic pachymeningitis associated with systemic lupus erythematosus

    PubMed Central

    Han, Fei; Zhong, Ding-Rong; Hao, Hong-Lin; Kong, Wei-Ze; Zhu, Yi-Cheng; Guan, Hong-Zhi; Cui, Li-Ying

    2016-01-01

    Abstract Background: Hypertrophic pachymeningitis (HP) is a chronic disease characterized by inflammatory hypertrophy and fibrosis of dura mater. It can be divided into cranial and spinal forms depending on the location of the lesion. HP involving 2 separate sites simultaneously is quite uncommon. Case summary: This study presents a case of a 49-year-old woman with pathologically confirmed cranial and lumbosacral hypertrophic pachymeningitis associated with systemic lupus erythematosus (SLE), which is a rare etiology of HP. She experienced persistent numbness and pain of the left lower limb, followed by headache and seizures. In laboratory tests, levels of erythrocyte sedimentation rate and C-reactive protein were elevated, and antinuclear antibodies and anti–double-strand deoxyribonucleic acid (DNA) antibodies were detected. Magnetic resonance imaging revealed dural thickening with homogenous gadolinium enhancement both at lumbosacral level and over cerebral convexities. Histology suggested chronic inflammation in spinal dura mater with extensive fibrosis, dense lymphoplasmacytic infiltrate, and focal vasculitis. Treatment with corticosteroids and cyclophosphamide was started with significant clinical and radiological improvement. Conclusion: HP is etiologically heterogeneous. Despite its rarity, SLE should be considered in the differential diagnosis of HP. Early recognition and therapy may provide an optimal outcome. PMID:27684799

  2. Neuromuscular fatigue during dynamic maximal strength and hypertrophic resistance loadings.

    PubMed

    Walker, Simon; Davis, Lisa; Avela, Janne; Häkkinen, Keijo

    2012-06-01

    The purpose of this study was to compare the acute neuromuscular fatigue during dynamic maximal strength and hypertrophic loadings, known to cause different adaptations underlying strength gain during training. Thirteen healthy, untrained males performed two leg press loadings, one week apart, consisting of 15 sets of 1 repetition maximum (MAX) and 5 sets of 10 repetition maximums (HYP). Concentric load and muscle activity, electromyography (EMG) amplitude and median frequency, was assessed throughout each set. Additionally, maximal bilateral isometric force and muscle activity was assessed pre-, mid-, and up to 30 min post-loading. Concentric load during MAX was decreased after set 10 (P<0.05), while the load was maintained throughout HYP. Both loadings caused large reductions in maximal isometric force (MAX=-30±6.4% vs. HYP=-48±9.7%, P<0.001). The decreased concentric and isometric strength during MAX loading was accompanied by reduced EMG amplitude (P<0.05). Conversely, hypertrophic loading caused decreased median frequency only during isometric contractions (P<0.01). During concentric contractions, EMG amplitude increased and median frequency decreased in HYP (P<0.01). Our results indicate reduced neural drive during MAX loading and more complex changes in muscle activity during HYP loading. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2015-04-01

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

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

    PubMed Central

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

    2007-01-01

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

  5. Anesthetic Practices for Laser Rehabilitation of Pediatric Hypertrophic Burn Scars.

    PubMed

    Wong, Brendan M; Keilman, Jeffrey; Zuccaro, Jennifer; Kelly, Charis; Maynes, Jason T; Fish, Joel S

    The use of ablative fractional carbon dioxide laser therapy and pulsed dye laser therapy has led to significant improvements in the rehabilitation of hypertrophic burn scars. However, laser procedures are associated with appreciable pain among pediatric patients. Clinical consensus suggests using general anesthesia for pediatric laser procedures; however, guidelines for perioperative care are lacking. The objective of this quality improvement study is to determine whether a difference exists in postoperative pain outcomes in pediatric patients who receive intraoperative opioid regimens compared with patients who receive opioid-sparing regimens for laser therapy of hypertrophic burn scars. A retrospective review of patients who received laser therapy at a pediatric burn center from April 2014 to May 2015 was performed. Overall, 88 of the 92 procedures reviewed were included. A statistically significant difference was not found between the likelihood of postoperative pain when intraoperative opioid regimens (n = 63) were given compared with opioid-sparing regimens (n = 25) X (1, n = 88) = 2.870, P = .0902. There was also no difference between short-acting (n = 48), long-acting (n = 9), or combination (n = 6) intraoperative opioids compared with opioid-sparing regimens (n = 25) in the likelihood of postoperative pain. Despite the small sample size, the low number of postoperative pain cases is encouraging. Ultimately, these data provide a foundation for developing anesthetic guidelines for pediatric laser procedures. Specifically, clinicians should consider the potential to deliver adequate perioperative care via an opioid-sparing regimen ± adjuvant.

  6. Reversible transition from a hypertrophic to a dilated cardiomyopathy

    PubMed Central

    Spillmann, Frank; Kühl, Uwe; Van Linthout, Sophie; Dominguez, Fernando; Escher, Felicitas; Schultheiss, Heinz‐Peter; Pieske, Burkert

    2015-01-01

    Abstract We report the case of a 17‐year‐old female patient with known hypertrophic cardiomyopathy and a Wolff‐Parkinson‐White syndrome. She came to our department for further evaluation of a new diagnosed dilated cardiomyopathy characterized by an enlargement of the left ventricle and a fall in ejection fraction. Clinically, she complained about atypical chest pain, arrhythmic episodes with presyncopal events, and dyspnea (NYHA III) during the last 6 months. Non‐invasive and invasive examinations including magnetic resonance imaging, electrophysiological examinations, and angiography did not lead to a conclusive diagnosis. Therefore, endomyocardial biopsies (EMBs) were taken to investigate whether a specific myocardial disease caused the impairment of the left ventricular function. EMB analysis resulted in the diagnosis of a virus‐negative, active myocarditis. Based on this diagnosis, an immunosuppressive treatment with prednisolone and azathioprine was started, which led to an improvement of cardiac function and symptoms within 3 months after initiating therapy. In conclusion, we show that external stress triggered by myocarditis can induce a reversible transition from a hypertrophic cardiomyopathy to a dilated cardiomyopathy phenotype. This case strongly underlines the need for a thorough and invasive examination of heart failure of unknown causes, including EMB investigations as recommend by the actual ESC position statement. PMID:27774273

  7. Accelerated shallow water modeling

    NASA Astrophysics Data System (ADS)

    Gandham, Rajesh; Medina, David; Warburton, Timothy

    2015-04-01

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

  8. Ablation of hypertrophic septum using radiofrequency energy: an alternative for gradient reduction in patient with hypertrophic obstructive cardiomyopathy?

    PubMed

    Riedlbauchová, Lucie; Janoušek, Jan; Veselka, Josef

    2013-06-01

    Alcohol septal ablation and surgical myectomy represent accepted therapeutic options for treatment of symptomatic patients with hypertrophic obstructive cardiomyopathy. Long-term experience with radiofrequency ablation of arrhythmogenic substrates raised a question if this technique might be effective for left ventricular outflow tract (LVOT) gradient reduction. We report on a 63-year-old patient with recurrence of symptoms 1 year after alcohol septal ablation (ASA) leading originally to a significant reduction of both symptoms and gradient. Due to a new increase of gradient in the LVOT up to 200 mm Hg with corresponding worsening of symptoms and due to refusal of surgical myectomy by the patient, endocardial radiofrequency ablation of the septal hypertrophy (ERASH) was indicated. Radiofrequency ablation was performed in the LVOT using irrigated-tip ablation catheter; the target site was identified using intracardiac echocardiography and electroanatomical CARTO mapping. ERASH caused an immediate gradient reduction due to hypokinesis of the ablated septum. At 2-month follow-up exam, significant clinical improvement was observed, together with persistent gradient reduction assessed with Doppler echocardiography. Echocardiography and magnetic resonance revealed persistent septal hypokinesis and slight thinning of the ablated region. Septal ablation using radiofrequency energy may be a promising alternative or adjunct to the treatment of hypertrophic obstructive cardiomyopathy. Intracardiac echocardiography and electroanatomical CARTO mapping enable exact lesion placement and preservation of atrioventricular conduction.

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

    USGS Publications Warehouse

    Gilkeson, R.H.; Cartwright, K.

    1983-01-01

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

  10. Review of Silicone Gel Sheeting and Silicone Gel for the Prevention of Hypertrophic Scars and Keloids.

    PubMed

    Hsu, Kuei-Chang; Luan, Chih-Wei; Tsai, Yi-Wen

    2017-05-01

    Keloids and hypertrophic scars are fibroproliferative disorders of dermal tissue after skin injury. Many clinical control studies have reported evidence that silicone gel is effective in preventing and alleviating hypertrophic scarring. Whether silicone gel sheeting prevents hypertrophic scars or keloids requires clear evidence of its clinical effectiveness. This review investigated the effectiveness of silicone gel and silicone gel sheeting for the prevention of hypertrophic or keloid scarring in patients with newly healed wounds. The authors searched the MEDLINE, EMBASE, CINAHL, and CENTRAL databases (January 1, 1990 to September 24, 2014) for any randomized or quasi-randomized controlled trials or controlled clinical trials comparing silicone gel sheeting or silicone gel with a control group for prevention of hypertrophic scars or keloids. All collected trials were assessed for methodological quality, control group and treatment group, and number of participants developing hypertrophic scars and keloids. The authors calculated risk ratios (RR) from each trial for the development of abnormal scarring and combined these using random-effects model meta-analysis. Between-study heterogeneity was calculated by using the I2 statistic. Ten trials in 9 studies were pooled (random effect; I² = 88%). There was a significant difference between the silicone gel sheeting group and the placebo group (RR 0.70; 95% confidence interval, 0.49-0.99; P = .04) in preventing the risk of hypertrophic scars. There was statistical significance in the effectiveness of silicone gel and silicone gel sheeting on the prevention of keloids or hypertrophic scars, especially in skin lesion wounds. However, most of the trials evaluating silicone gel sheeting or silicone gel as a prevention of hypertrophic scars and keloids had poor quality with high or uncertain risk of biases either in study design or in conduct.

  11. Hearing Profile in Patients with Dilated and Hypertrophic Cardiomyopathies

    PubMed Central

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

    2016-01-01

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

  12. On the Shallow Water Equations

    NASA Astrophysics Data System (ADS)

    Abdelrahman, Mahmoud A. E.

    2017-08-01

    We studied the shallow water equations of nonlinear conservation laws. First we studied the parametrisation of nonlinear elementary waves and hence we present the solution to the Riemann problem. We also prove the uniqueness of the Riemann solution. The Riemann invariants are formulated. Moreover we give an interesting application of the Riemann invariants. We present the shallow water system in a diagonal form, which admits the existence of a global smooth solution for these equations. The other application is to introduce new conservation laws for the shallow water equations.

  13. Hypertrophic Pachymeningitis as a Potential Cause of Headache Associated with Temporal Arteritis.

    PubMed

    Tokushige, Shin-Ichi; Matsuura, Hiroyoshi; Hideyama, Takuto; Tamura, Koichi; Maekawa, Risa; Shiio, Yasushi

    2016-01-01

    We herein describe a rare case of temporal arteritis associated with hypertrophic pachymeningitis. An 81-year-old man presented with a right temporal headache that had persisted for one month. A right superficial temporal artery biopsy revealed intimal hypertrophy with increased elastic fibers, consistent with temporal arteritis. Brain MRI using gadolinium enhancement showed thickened dura mater on the right frontal and temporal lobes, which led to the diagnosis of hypertrophic pachymeningitis. Intravenous methylprednisolone and oral prednisolone improved the patient's symptoms. According to our findings, hypertrophic pachymeningitis may be a potential cause of an ipsilateral temporal headache associated with temporal arteritis.

  14. Down Syndrome with Complete Atrioventricular Septal Defect, Hypertrophic Cardiomyopathy, and Pulmonary Vein Stenosis.

    PubMed

    Mahadevaiah, Guruprasad; Gupta, Manoj; Ashwath, Ravi

    2015-10-01

    The prevalence of congenital heart disease in infants with Down syndrome is 40%, compared with 0.3% in children who have normal chromosomes. Atrioventricular and ventricular septal defects are often associated with chromosomal aberrations, such as in trisomy 21, whereas hypertrophic cardiomyopathy is chiefly thought to be secondary to specific gene mutations. We found only one reported case of congenital hypertrophic cardiomyopathy and atrioventricular septal defect in an infant with Down syndrome. Here, we report atrioventricular septal defect, hypertrophic cardiomyopathy, and pulmonary vein stenosis in a neonate with Down syndrome-an apparently unique combination. In addition, we discuss the relevant medical literature.

  15. Cardiac sarcoid: a chameleon masquerading as hypertrophic cardiomyopathy and dilated cardiomyopathy in the same patient.

    PubMed

    Agarwal, Anushree; Sulemanjee, Nasir Z; Cheema, Omar; Downey, Francis X; Tajik, A Jamil

    2014-05-01

    Sarcoidosis is a multisystem, granulomatous disease of unknown etiology often seen in young adults, with cardiac involvement in more than one-quarter of sarcoid patients. The clinical presentation of cardiac sarcoid depends upon the location and extent of myocardium involved. Although cardiac sarcoid may produce asymmetrical septal hypertrophy, it is most commonly considered in the differential diagnosis of dilated cardiomyopathy. The hypertrophic stage of cardiac sarcoid is rarely seen. We describe a case of cardiac sarcoid in a young patient wherein a distinctive appearance of the cardiac sarcoid spectrum from "hypertrophic" stage to thinned/scarred stage, masquerading as hypertrophic cardiomyopathy followed by dilated cardiomyopathy, is demonstrated.

  16. An Unusual Type of Localized Hypertrophic Cardiomyopathy With Wolf Parkinson White Syndrome Presenting With Pulmonary Edema

    PubMed Central

    Vatan, Mehmet Bulent; Gunduz, Huseyin; Gurel, Safiye; Kocayigit, Ibrahim; Vural, Ahmet; Demirtas, Saadet; Cakar, Mehmet Akif; Gunduz, Yasemin

    2012-01-01

    Hypertrophic cardiomyopathy (HCM) is an autosomal dominant heart disease that is the most common genetic cardiac disorder. The disease is characterized by excessive thickening of the left ventricular myocardium. The anterior portion of the interventricular ventricular septum is often involved. Asymmetric hypertrophy of apical site, left ventricular free wall, and right ventricle are less common in hypertrophic cardiomyopathy that occur in 1% cases. We report a case of a patient with an unusual type of hypertrophic cardiomyopathy and Wolf Parkinson White (WPW) presenting with pulmonary edema.

  17. Pesticides in shallow groundwater in the Delmarva Peninsula

    USGS Publications Warehouse

    Koterba, M.T.; Banks, W.S.L.; Shedlock, R.J.

    1993-01-01

    A regional study of the areal and depth distribution of pesticides in shallow groundwater in the Delmarva Peninsula of Delaware, Maryland, and Virginia was done to (i) relate the pesticides detected to landscape and shallow subsurface features, and (ii) evaluate aquifer vulnerability and the potential contamination of drinking-water supplies. Water samples collected at 100 wells from 1988 to 1990 were analyzed for concentrations of 36 pesticides, four metabolites, and other constituents. The most commonly detected residues were atrazine, cyanazine, simazine, alachlor, metolachlor, and dicamba. Concentrations were low; few exceeded 3 ??g L-1. Most detections correlate with the intensive use of these herbicides in three widely distributed and commonly rotated crops-corn (Zea mays L.), soybean [Glycine max (L.) Merr.], and small grain-particularly if grown in well- drained soils. Most detections occurred in samples collected from shallow wells screened within 10 m of the overlying water table. The shallow depth distribution of most residues is consistent with their suspected history of use (ca. 20 yr), and patterns in shallow groundwater flow in the surficial aquifer in the study area. The areal and depth distributions of detectable residues in groundwater did not correlate with a vulnerability index, nor any of the component scores developed to estimate that index using the DRASTIC method. The shallow depth of most detections also indicates why few samples from water-supply wells in this study had measurable concentrations of pesticides; most supply wells are deeper than 10 m below the water table. The low number of contaminated samples from supply wells implies that deep groundwater currently (1992) used for drinking generally does not contain detectable pesticide residues.

  18. Geotechnical characteristics of shallow ocean dredge spoil disposal mounds

    SciTech Connect

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

    1984-05-01

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

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

    PubMed Central

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

    2015-01-01

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

  20. [Cause and prevention of surgical site infection and hypertrophic scars].

    PubMed

    Ogawa, Rei

    2012-03-01

    Surgical site infection (SSI) occurs at the site of surgery within 1 month of an operation or within 1 year of an operation if a foreign body is implanted as part of the surgery. Most SSIs (about 70%) are superficial infections involving the skin and subcutaneous tissues only. The remaining infections are more serious and can involve tissues under the skin, organs, or implanted material. Hypertrophic scars( HSs) occur frequently on particular sites, including the anterior chest wall. The anterior chest wall is frequently subjected to skin stretching caused by the natural daily movements of the body. Most cases of SSIs and HSs can be prevented by (1) suture technique modification to prevent high stretching tension and ischemia, and (2) appropriate wound care after surgery. It would be useful to avoid subjecting wounded skin to sustained mechanical force, thereby permitting the wound to rest and heal normally.

  1. Aesthetic correction of hypertrophic frontal sinus with beveled osteotomy.

    PubMed

    Kang, Seok Joo; Jeon, Seong Pin; Kim, Jin Woo; Sun, Hook

    2013-01-01

    The authors performed aesthetic correction of hypertrophic frontal sinus in 3 patients with protruded supraorbital region by using beveled osteotomy. Under general anesthesia, a bicoronal incision was performed followed by dissection through the subgaleal plane to the supraorbital ridge. Subsequently, the anterior wall of the frontal sinus was sectioned with a reciprocating saw and an osteotome by using the beveled osteotomy technique. Beveled osteotomy is a technique applied during sectioning of the anterior wall of the frontal sinus whereby the upper portion of the sinus remains intact and the lower portion of the sinus is changed. The technique used by the authors differed from the conventional method in that the existing shape of the outer wall of the frontal sinus was preserved when osteotomy was performed. This technique therefore preserves a more natural contour of the forehead and is advantageous in that it does not require additional interventions.

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

    PubMed Central

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

    2014-01-01

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

  3. [A case of localized hypertrophic neuropathy in the sciatic nerve].

    PubMed

    Izumi, T; Kusaka, H; Imai, T

    1995-01-01

    A 26-year-old male patient gradually developed muscular atrophy of the right lower leg over a two-year period. Neurological examination revealed absent Achilles tendon reflex and muscular atrophy of the right lower leg and right hamstring muscles. Conduction velocity of the F waves was delayed in the right posterior tibial nerve. A computerized tomography scan and magnetic resonance imaging revealed a mass lesion along the proximal segment of the right sciatic nerve. Exploration revealed a fusiformly swollen sciatic nerve. Histological examination showed that a swollen segment of the sciatic nerve was filled with onion-bulb formations of perineurial cells, consistent with the diagnosis of localized hypertrophic neuropathy. This condition should be added to several etiologies of monomelic amyotrophy. Electrophysiological studies and neuroimaging techniques were useful in obtaining differential diagnosis.

  4. Hypertrophic cardiomyopathy and ultra-endurance running - two incompatible entities?

    PubMed Central

    2011-01-01

    Regular and prolonged exercise is associated with increased left ventricular wall thickness that can overlap with hypertrophic cardiomyopathy (HCM). Differentiating physiological from pathological hypertrophy has important implications, since HCM is the commonest cause of exercise-related sudden cardiac death in young individuals. Most deaths have been reported in intermittent 'start-stop' sports such as football (soccer) and basketball. The theory is that individuals with HCM are unable to augment stroke volume sufficiently to meet the demands of endurance sports and are accordingly 'selected-out' of participation in such events. We report the case of an ultra-endurance athlete with 25 years of > 50 km competitive running experience, with genetically confirmed HCM; thereby demonstrating that these can be two compatible entities. PMID:22122802

  5. Fabry Disease Presenting with Hypertrophic Cardiomyopathy and Tricuspid Regurgitation

    PubMed Central

    Cho, Sang-Cheol; Yoo, Han-Wook; Lee, Jae Won; Jang, Jeong Yoon; Heo, Ran

    2016-01-01

    A 71-year-old female who was diagnosed with nonobstructive hypertrophic cardiomyopathy since 1999 presented with dyspnea and severe edema on both legs. For the management of her symptom, cardiac surgery including tricuspid annuloplasty, Maze operation and right atrial reduction plasty was performed. During follow-up after cardiac surgery, a plasma α-galactosidase activity was checked for the screening of Fabry disease and the result was around lower normal limit. DNA analysis was implemented for confirmation and it revealed a heterozygote α-galactosidase mutation at exon 6 [c.901C>T (p.Arg301Ter)]. This case suggests that Fabry disease might be easily undetected, and clinical suspicion is critical. PMID:28090261

  6. Hypertrophic Osteoarthropathy in Patient with Crohn's Disease: A Case Report

    PubMed Central

    Rhee, Sung-Min; Park, Ki Jeong

    2014-01-01

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

  7. ICD Therapy for Primary Prevention in Hypertrophic Cardiomyopathy

    PubMed Central

    Trivedi, Amar

    2016-01-01

    Hypertrophic cardiomyopathy (HCM) is a common and heterogeneous disorder that increases an individual’s risk of sudden cardiac death (SCD). This review article discusses the relevant factors that are involved in the challenge of preventing SCD in patients with HCM. The epidemiology of SCD in patients is reviewed as well as the structural and genetic basis behind ventricular arrhythmias in HCM. The primary prevention of SCD with implantable cardioverter-defibrillator (ICD) therapy is the cornerstone of modern treatment for individuals at high risk of SCD. The focus here is on the current and emerging predictors of SCD as well as risk stratification recommendations from both North American and European guidelines. Issues related to ICD implantation, such as programming, complications and inappropriate therapies, are discussed. The emerging role of the fully subcutaneous ICD and the data regarding its implantation are reviewed. PMID:28116084

  8. Surgery Management of Rare Hypertrophic Frenum in an Infant

    PubMed Central

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

    2014-01-01

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

  9. Surgery management of rare hypertrophic frenum in an infant.

    PubMed

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

    2014-01-01

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

  10. Features of a syndrome with congenital cataract and hypertrophic cardiomyopathy.

    PubMed

    Cruysberg, J R; Sengers, R C; Pinckers, A; Kubat, K; van Haelst, U J

    1986-12-15

    We studied 12 patients from six unrelated families with a syndrome that has an autosomal recessive pattern of inheritance and can be diagnosed from clinical, histologic, and biochemical characteristics. The four major symptoms are congenital cataract, hypertrophic cardiomyopathy, mitochondrial myopathy of voluntary muscles, and exercise-related lactic acidosis. The patients had bilateral and total cataract in the first weeks of life, underwent cataract surgery, and developed nystagmus and strabismus. Corrected visual acuity was lower than 20/40 in aphakic eyes. Patients were mentally normal, and at school age they visited a school for blind and visually impaired children. The majority of the patients developed axial myopia with myopic fundus changes; aphakic refraction usually was lower than 10.0 diopters after the first decade. The cardiac myopathy was progressive and the cause of premature death. Three of the 12 patients died in the neonatal period and six patients died in early adulthood.

  11. Hypertrophic cardiomyopathy: a heart in need of an energy bar?

    PubMed Central

    Vakrou, Styliani; Abraham, M. Roselle

    2014-01-01

    Hypertrophic cardiomyopathy (HCM) has been recently recognized as the most common inherited cardiovascular disorder, affecting 1 in 500 adults worldwide. HCM is characterized by myocyte hypertrophy resulting in thickening of the ventricular wall, myocyte disarray, interstitial and/or replacement fibrosis, decreased ventricular cavity volume and diastolic dysfunction. HCM is also the most common cause of sudden death in the young. A large proportion of patients diagnosed with HCM have mutations in sarcomeric proteins. However, it is unclear how these mutations lead to the cardiac phenotype, which is variable even in patients carrying the same causal mutation. Abnormalities in calcium cycling, oxidative stress, mitochondrial dysfunction and energetic deficiency have been described constituting the basis of therapies in experimental models of HCM and HCM patients. This review focuses on evidence supporting the role of cellular metabolism and mitochondria in HCM. PMID:25191275

  12. A new era in clinical genetic testing for hypertrophic cardiomyopathy.

    PubMed

    Wheeler, Matthew; Pavlovic, Aleksandra; DeGoma, Emil; Salisbury, Heidi; Brown, Colleen; Ashley, Euan A

    2009-12-01

    Building on seminal studies of the last 20 years, genetic testing for hypertrophic cardiomyopathy (HCM) has become a clinical reality in the form of targeted exonic sequencing of known disease-causing genes. This has been driven primarily by the decreasing cost of sequencing, but the high profile of genome-wide association studies, the launch of direct-to-consumer genetic testing, and new legislative protection have also played important roles. In the clinical management of hypertrophic cardiomyopathy, genetic testing is primarily used for family screening. An increasing role is recognized, however, in diagnostic settings: in the differential diagnosis of HCM; in the differentiation of HCM from hypertensive or athlete's heart; and more rarely in preimplantation genetic diagnosis. Aside from diagnostic clarification and family screening, use of the genetic test for guiding therapy remains controversial, with data currently too limited to derive a reliable mutation risk prediction from within the phenotypic noise of different modifying genomes. Meanwhile, the power of genetic testing derives from the confidence with which a mutation can be called present or absent in a given individual. This confidence contrasts with our more limited ability to judge the significance of mutations for which co-segregation has not been demonstrated. These variants of "unknown" significance represent the greatest challenge to the wider adoption of genetic testing in HCM. Looking forward, next-generation sequencing technologies promise to revolutionize the current approach as whole genome sequencing will soon be available for the cost of today's targeted panel. In summary, our future will be characterized not by lack of genetic information but by our ability to effectively parse it.

  13. The genetic basis of hypertrophic cardiomyopathy in cats and humans.

    PubMed

    Kittleson, Mark D; Meurs, Kathryn M; Harris, Samantha P

    2015-12-01

    Mutations in genes that encode for muscle sarcomeric proteins have been identified in humans and two breeds of domestic cats with hypertrophic cardiomyopathy (HCM). This article reviews the history, genetics, and pathogenesis of HCM in the two species in order to give veterinarians a perspective on the genetics of HCM. Hypertrophic cardiomyopathy in people is a genetic disease that has been called a disease of the sarcomere because the preponderance of mutations identified that cause HCM are in genes that encode for sarcomeric proteins (Maron and Maron, 2013). Sarcomeres are the basic contractile units of muscle and thus sarcomeric proteins are responsible for the strength, speed, and extent of muscle contraction. In people with HCM, the two most common genes affected by HCM mutations are the myosin heavy chain gene (MYH7), the gene that encodes for the motor protein β-myosin heavy chain (the sarcomeric protein that splits ATP to generate force), and the cardiac myosin binding protein-C gene (MYBPC3), a gene that encodes for the closely related structural and regulatory protein, cardiac myosin binding protein-C (cMyBP-C). To date, the two mutations linked to HCM in domestic cats (one each in Maine Coon and Ragdoll breeds) also occur in MYBPC3 (Meurs et al., 2005, 2007). This is a review of the genetics of HCM in both humans and domestic cats that focuses on the aspects of human genetics that are germane to veterinarians and on all aspects of feline HCM genetics. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Determination of multidirectional myocardial deformations in cats with hypertrophic cardiomyopathy by using two-dimensional speckle-tracking echocardiography.

    PubMed

    Suzuki, Ryohei; Mochizuki, Yohei; Yoshimatsu, Hiroki; Teshima, Takahiro; Matsumoto, Hirotaka; Koyama, Hidekazu

    2017-02-01

    Objectives Hypertrophic cardiomyopathy, a primary disorder of the myocardium, is the most common cardiac disease in cats. However, determination of myocardial deformation with two-dimensional speckle-tracking echocardiography in cats with various stages of hypertrophic cardiomyopathy has not yet been reported. This study was designed to measure quantitatively multidirectional myocardial deformations of cats with hypertrophic cardiomyopathy. Methods Thirty-two client-owned cats with hypertrophic cardiomyopathy and 14 healthy cats serving as controls were enrolled and underwent assessment of myocardial deformation (peak systolic strain and strain rate) in the longitudinal, radial and circumferential directions. Results Longitudinal and radial deformations were reduced in cats with hypertrophic cardiomyopathy, despite normal systolic function determined by conventional echocardiography. Cats with severely symptomatic hypertrophic cardiomyopathy also had lower peak systolic circumferential strain, in addition to longitudinal and radial strain. Conclusions and relevance Longitudinal and radial deformation may be helpful in the diagnosis of hypertrophic cardiomyopathy. Additionally, the lower circumferential deformation in cats with severe hypertrophic cardiomyopathy may contribute to clinical findings of decompensation, and seems to be related to severe cardiac clinical signs. Indices of multidirectional myocardial deformations by two-dimensional speckle-tracking echocardiography may be useful markers and help to distinguish between cats with hypertrophic cardiomyopathy and healthy cats. Additionally, they may provide more detailed assessment of contractile function in cats with hypertrophic cardiomyopathy.

  15. A case of subarachnoid hemorrhage with pituitary apoplexy caused by idiopathic hypertrophic pachymeningitis.

    PubMed

    Yamada, Shoko M; Aoki, Makoto; Nakane, Makoto; Nakayama, Hitoshi

    2011-06-01

    Steroid therapy is considered to improve clinical symptoms in hypertrophic pachymeningitis. We present a 70-year-old man with idiopathic hypertrophic pachymeningitis, whose clinical signs progressively worsened despite steroid therapy. He died of subarachnoid hemorrhage (SAH) with pituitary apoplexy 2 months after the admission regardless of improvement of laboratory data and magnetic resonance imaging appearance by one-and-half-month steroid therapy. Autopsy revealed thickened dura mater supporting the diagnosis of hypertrophic pachymeningitis. Brain parenchyma is generally not affected by the disease; however, histological investigation suggested that inflammation of the dura caused damage to superior hypophyseal artery resulting in SAH and apoplexy in the anterior lobe of the pituitary gland. The higher dose and the longer duration of steroid therapy should have achieved in our case although most laboratory data recovered within the normal range. The aggressiveness of hypertrophic pachymeningitis must be evaluated by clinical signs rather than by laboratory data or imaging examinations.

  16. Use of bilidase for the treatment of experimental hypertrophic postburn cicatrices.

    PubMed

    Loladze, M; Alibegashvili, M; Turmanidze, Ts; Iashvili, B; Kutivadze, D; Chanishvili, T

    2005-01-01

    The efficiency of bilidase (hyaluronidase preparation) was studied in guinea pigs with experimental postburn cicatrices. Bilidase promoted normalization of the structure and histochemical picture of new cicatricial tissue. The drug can be used for the treatment of hypertrophic postburn cicatrices.

  17. Production of cytokines by mononuclear cells of hypertrophic adenoids in children with otitis media with effusion.

    PubMed

    Zelazowska-Rutkowska, Beata; Ilendo, Elzbieta; Skotnicka, Bozena; Wysocka, Jolanta; Kasprzycka, Edwina

    2012-01-01

    Hypertrophic adenoids with otitis media with effusion is a common infectious disease and present a serious otological problem in children. Cytokines, potent inflammatory mediators, play important role in the initiation of immunological response in otitis media. Adenoids excised due to hypertrophy with or without chronic otitis media with effusion were used to isolate mononuclear cells. Secretion of cytokines by non-stimulated and PHA-stimulated cells was determined by specific ELISAs. We found a significant increase in the production of IL-5 and TNF-α secreted by adenoidal cells of children with otitis media with effusion compared to group with hypertrophic adenoids. No differences were found in the secretion of IL-8, IL-6, and IL-10 between these two groups of patients. Our results suggest a difference between the immunological responses in the course of hypertrophic adenoids with otitis media as compared to hypertrophic adenoids.

  18. Granulomatosis With Polyangiitis-Associated Hypertrophic Pachymeningitis Mimicking Spontaneous Intracranial Hypotension: A Case Report.

    PubMed

    Jung, Young Hee; Lee, Mi Ji; Lee, Chungbin; Cha, Jihoon; Chung, Chin-Sang

    2017-03-01

    Dural enhancement is a characteristic finding in both spontaneous intracranial hypotension and hypertrophic pachymeningitis. Positional headache is the most important feature that distinguishes the two diseases. We report a patient with granulomatosis with polyangiitis (formerly Wegener's granulomatosis) who initially manifested like spontaneous intracranial hypotension. We report here the case of a 63-year old man who presented with severe positional headache. The patient had typical symptoms, symmetric dural enhancement, and a recent history of nontraumatic subdural hygroma which led to the diagnosis of spontaneous intracranial hypotension, but was finally diagnosed as granulomatosis with polyangiitis-associated secondary hypertrophic pachymeningitis. Cyclophosphamide therapy was effective for the maintenance of remission. Hypertrophic pachymeningitis associated with granulomatosis with polyangiitis can present with positional headache and subdural hygroma, mimicking spontaneous intracranial hypotension. Granulomatosis with polyangiitis should be suspected when patients with spontaneous intracranial hypotension or hypertrophic pachymeningitis show atypical features. © 2016 American Headache Society.

  19. [Leopard syndrome with hypertrophic obstructive cardiomyopathy and cerebral arteriovenous malformation. Report of a case].

    PubMed

    Cabañas, A; Baduí, E; Estañol, B; Aguilar, F; González, N; López, J

    1985-01-01

    We report a case of a 27-year-old woman with Leopard syndrome in which we observed the association of hypertrophic obstructive cardiomyopathy with arteriovenous cerebral shunt. This association has not been reported previously in the literature.

  20. Subarachnoid block and enlargement of the spinal canal in hypertrophic neuritis.

    PubMed

    De León, G A; Hodges, F J

    1976-06-01

    A case of Dejerine-Sottas hypertrophic neuritis is reported. The patient, a 45-year-old male, suffered from chronic hypertrophic polyneuropathy, abnormal pupils, fasciculations, tremor, back pain, impotence, sphincter disorders, cramps, and lightning pains in the lower extremities. Besides extensive subarachnoid block, there was X-ray evidence of enlargement of the bony spinal canal with scalloping of the lumbar vertebrae. Surgical exploration showed these abnormalities to be due to extreme hypertrophy of the cauda equina. Histologic findings in peripheral nerve and lumbar root biopsies were typical of hypertrophic neuropathy of the onion bulb type. Vertebral changes secondary to hypertrophied nerve roots appear not to have been described before in hypertrophic neuritis; however, knowledge of their possible occurrence may be of practical importance in the management of similar future cases. A simple way of visualizing enlarged peripheral nerves is briefly described.

  1. Hypertrophic cardiomyopathy in the Sphynx cat: a retrospective evaluation of clinical presentation and heritable etiology.

    PubMed

    Silverman, Sarah J; Stern, Joshua A; Meurs, Kathryn M

    2012-04-01

    Hypertrophic cardiomyopathy is an inherited disease in some feline breeds including the Maine Coon and Ragdoll. In these breeds, distinct causative genetic mutations have been identified. The two breeds appear to have slightly different clinical presentations, including age of diagnosis. The observation that these two breeds may have different clinical presentations, as well as different genetic mutations, suggests that hypertrophic cardiomyopathy is a diverse disease in the cat. Hypertrophic cardiomyopathy is poorly described in the Sphynx. The objective of this study was to phenotypically characterize Sphynx hypertrophic cardiomyopathy and to evaluate for a familial etiology. Records of 18 affected cats (11 female, seven male) were evaluated. Age of affected cats ranged from 0.5 to 7 years (median, 2 years). Four affected cats were from a single family and included an affected cat in each of four generations (three females, one male). Further studies are warranted to evaluate for a causative mutation and better classify the phenotypic expression.

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

    PubMed

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

    2015-12-01

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

  3. Pressure therapy in treatment of hypertrophic scar, burn contracture and keloid: the Kenyan experience.

    PubMed

    Haq, M A; Haq, A

    1990-11-01

    A preliminary report of the results of pressure therapy for hypertrophic scar, burn contracture and keloid is presented. Thirty four patients over a four year period were treated with four types of pressure therapy. Results showed over 50% improvement in 21 (61.8%) cases. This method obviated the need for repetitive surgery and no recurrence was noted. Pressure therapy is advocated as an adjunct measure for all cases of hypertrophic scarring, burn contracture and keloid.

  4. Shallow End Response from ATEM

    NASA Astrophysics Data System (ADS)

    Vetrov, A.

    2014-12-01

    Different geological, hydrological, environmental and engineering targets are located shallow underground. The information collected with ATEM systems might be very useful for their study; although there are many deeper targets that the ATEM systems are traditionally used for. The idea to raise magnetic moment output and get deeper penetration response was one of the goals of ATEM systems development during the last decade. The shallow geology response was a trade for such systems, which sometimes were almost blind in the first hundred meter under surface. The possibility to achieve shallow end response from ATEM systems has become significant subject in last years. Several airborne TDEM systems got second higher frequency and lower magnetic moment signal to pick up shallow response together with deep one. Having a potential advantage such implementation raises complication and cost of the system. There's no need to receive 500 meter deep response when exploring shallow geology. P-THEM system having a compact size transmitter and relatively light weight is working on one base frequency at a time, but this frequency can be preset before a flight considering survey goals. A study of shallow geology response of the P-THEM system working on different base frequency has been conducted in 2014 in Ontario. The Alliston test area located in Southern Ontario has been flown with the P-THEM system working on base frequencies 30Hz and 90Hz. Results of the observations will be discussed in the presentation. The shallow end data can be used for mineral exploration applications and also for hydrological and environmental studies.

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

    USGS Publications Warehouse

    Carmichael, J.K.

    1989-01-01

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

  6. Contaminated Sediment

    EPA Pesticide Factsheets

    Contaminated sediments are a significant problem in the Great Lakes basin. Persistent high concentrations of contaminants in the bottom sediments of rivers and harbors pose risks to aquatic organisms, wildlife, and humans.

  7. Water and contaminant movement: migration barriers

    SciTech Connect

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

    1984-11-01

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

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

    PubMed

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

    2015-11-01

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

  9. [Rehabilitation of phonosurgically treated patients with edematous-hypertrophic changes of larynx].

    PubMed

    Kosztyła-Hojna, Bożena; Moskal, Diana; Falkowski, Dawid; Łobaczuk-Sitnik, Anna; Kraszewska, Anna; Skorupa, Małgorzata

    2016-08-01

    Advanced change of organic dysphonia are an indication for phonosurgery. Edematous-hypertrophic changes are cause of serious disturbances of voice. High-speed digital imaging (HSDI) technique is the unique method, allowing for assessment the effects of therapy and rehabilitation. The aim of the study is evaluation the usefulness of vibratory method in voice rehabilitation of patients with edematous-hypertrophic changes treated phonosurgically. The group I contained 40 patients with edematous-hypertrophical changes phonosurgically treated. Type of clinical dysphonia was diagnosed with HSDI technique. Glottal closure was evaluated according to Committee on Phoniatrics of the European Laryngological Society (ELS) classification, postoperative material was pathomorphologically verified by Transmission Electron Microscopy (TEM). Patients with hyperfunction of larynx were rehabilitated for 21 days using massage device and after that visualization of larynx by HSDI technique was made again. Control group contains people with physiological voice. Severe dysphonia with oedematous-hypertrophic changes was found by HSDI technique in group I. Postoperative material was evaluated histopathological by TEM and confirmed the existing clinical morphological changes of larynx. Hyperfunction of phonation organ were diagnosed in 30 patients (75%). After 21 days of rehabilitation using massage device, hyperfunction was reduced as confirmed by HSDI. Normalization of amplitude, regularity, synchrony of vibration and physiological glottal closure were found at 67% cases. HSDI technique in digital sequence is useful in the diagnosis of edematous-hypertrophic changes of the larynx and monitoring the effects of the rehabilitation. Pathomorphological evaluation of postoperative material made by TEM confirmed the rightness of clinical diagnosis of the edematous-hypertrophic changes by HSDI. The consequence of phonosurgical procedures in edematous-hypertrophic changes of larynx is hyperfunction

  10. Gene regulatory mechanisms governing energy metabolism during cardiac hypertrophic growth.

    PubMed

    Lehman, John J; Kelly, Daniel P

    2002-04-01

    Studies in a variety of mammalian species, including humans, have demonstrated a reduction in fatty acid oxidation (FAO) and increased glucose utilization in pathologic cardiac hypertrophy, consistent with reinduction of the fetal energy metabolic program. This review describes results of recent molecular studies aimed at delineating the gene regulatory events which facilitate myocardial energy substrate switches during hypertrophic growth of the heart. Studies aimed at the characterization of transcriptional control mechanisms governing FAO enzyme gene expression in the cardiac myocyte have defined a central role for the fatty acid-activated nuclear receptor peroxisome proliferator-activated receptor alpha (PPAR(alpha)). Cardiac FAO enzyme gene expression was shown to be coordinately downregulated in murine models of ventricular pressure overload, consistent with the energy substrate switch away from fatty acid utilization in the hypertrophied heart. Nuclear protein levels of PPAR(alpha) decline in the ventricle in response to pressure overload, while several Sp and nuclear receptor transcription factors are induced to fetal levels, consistent with their binding to DNA as transcriptional repressors of rate-limiting FAO enzyme genes with hypertrophy. Knowledge of key components of this transcriptional regulatory pathway will allow for the development of genetic engineering strategies in mice that will modulate fatty acid oxidative flux and assist in defining whether energy metabolic derangements play a primary role in the development of pathologic cardiac hypertrophy and eventual progression to heart failure.

  11. The Signaling Pathways Involved in Chondrocyte Differentiation and Hypertrophic Differentiation

    PubMed Central

    Li, Jianmei

    2016-01-01

    Chondrocytes communicate with each other mainly via diffusible signals rather than direct cell-to-cell contact. The chondrogenic differentiation of mesenchymal stem cells (MSCs) is well regulated by the interactions of varieties of growth factors, cytokines, and signaling molecules. A number of critical signaling molecules have been identified to regulate the differentiation of chondrocyte from mesenchymal progenitor cells to their terminal maturation of hypertrophic chondrocytes, including bone morphogenetic proteins (BMPs), SRY-related high-mobility group-box gene 9 (Sox9), parathyroid hormone-related peptide (PTHrP), Indian hedgehog (Ihh), fibroblast growth factor receptor 3 (FGFR3), and β-catenin. Except for these molecules, other factors such as adenosine, O2 tension, and reactive oxygen species (ROS) also have a vital role in cartilage formation and chondrocyte maturation. Here, we outlined the complex transcriptional network and the function of key factors in this network that determine and regulate the genetic program of chondrogenesis and chondrocyte differentiation. PMID:28074096

  12. Hypertrophic cardiomyopathy--state of the art in 2007.

    PubMed

    Monteiro, Silvia; Costa, Susana; Monteiro, Pedro; Gonçalves, Lino; Providência, Luís A

    2008-05-01

    Hypertrophic cardiomyopathy (HCM) is a primary disease of the sarcomere, with considerable genetic heterogeneity and variability in phenotypic expression, whose main complication is sudden cardiac death (SCD). Genetic aspects of HCM, its molecular pathophysiology and genotype-phenotype relationships are the subject of this review, which is aimed at better understanding of practical management in this patient population. As HCM is a genetic disease whose initial manifestation can be sudden death, it is essential to establish the diagnosis at an early stage, to proceed with risk stratification and implementation of SCD prevention strategies, and to promote genetic counseling of patients and screening of their families. Detection of pathological mutations through progressive sequencing of the genes most commonly involved is the most efficient way to diagnose HCM, even in the absence of clinical evidence of the disease. Identification of individuals at high risk of SCD is a major challenge in the management of this population, since SCD can be prevented by use of an implantable cardioverter-defibrillator. The selection of patients for prophylactic implantation of these devices, particularly those who have only one major risk factor, is currently the subject of controversy.

  13. Hemolytic anemia in a patient with hypertrophic obstructive cardiomyopathy.

    PubMed

    Kubo, Toru; Kitaoka, Hiroaki; Terauchi, Yasunobu; Tamura, Shinjiro; Okawa, Makoto; Yamasaki, Naohito; Yabe, Toshikazu; Doi, Yoshinori L

    2010-01-01

    A 66-year-old woman was referred for further evaluation and treatment of normocytic and normochromic anemia with hemoglobin level of 8.6 g/dL. A peripheral blood smear showed fragmented erythrocytes. The patient was then referred to the department of cardiology because of systolic murmur, ECG abnormality, and red cell fragmentation. Transthoracic echocardiography revealed hypertrophic cardiomyopathy with particularly increased interventricular septal thickness of 24 mm and a hyperkinetic wall motion, resulting in marked obstruction to left ventricular outflow tract (pressure gradient of 200 mmHg). Mitral regurgitation due to systolic anterior motion of the mitral valve leaflets was also seen. The cause of anemia was thought to be mechanical intravascular hemolysis due to left ventricular outflow tract obstruction and mitral regurgitation. She was treated with atenolol and the class Ia antiarrhythmic drug cibenzoline to relieve the outflow tract obstruction, and the pressure gradient was reduced to 70 mmHg. After 3 months of treatment, her hemoglobin level had increased to 11.4 g/dL without additional treatment for anemia.

  14. The Ups and Downs of Genetic Diagnosis of Hypertrophic Cardiomyopathy.

    PubMed

    Gómez, Juan; Reguero, Julián R; Coto, Eliecer

    2016-01-01

    Massive DNA sequencing, also known as next-generation sequencing, has revolutionized genetic diagnosis. This technology has reduced the effort and cost needed to analyze several genes simultaneously and has made genetic evaluation available to a larger number of patients. In hypertrophic cardiomyopathy, genetic analysis has increased from the 3 main genes implicated in the disease (MYH7, MYBPC3, TNNT2) to sequencing of more than 20 related genes. Despite the advantages of acquiring this additional information, many patients show variants of uncertain significance (mainly amino acid changes), which may also be present in at least 1 healthy control undergoing genome sequencing. This will be a dead-end situation unless the variant can be demonstrated to be associated with the disease in the patient's family. In the absence of clear evidence that these variants are truly pathogenic, they cannot be used for reliable genetic counselling in family members. Massive sequencing also enables identification of new candidate genes, but again, the problem of variants of uncertain significance limits the success of these assessments.

  15. Exercise heart rates in patients with hypertrophic cardiomyopathy.

    PubMed

    Luo, Hong-Chang; Dimaano, Veronica L; Kembro, Jackelyn M; Hilser, Alex; Hurtado-de-Mendoza, David; Pozios, Iraklis; Tomas, Miguel S; Yalcin, Hulya; Dolores-Cerna, Ketty; Mormontoy, Wilfredo; Aon, Miguel A; Cameron, Duke; Bluemke, David A; Stewart, Kerry J; Russell, Stuart D; Cordova, Jorge G; Abraham, Theodore P; Abraham, M Roselle

    2015-04-15

    The exercise heart rate (HR) profile and its relation to cardiac function and arrhythmias were investigated in patients with hypertrophic cardiomyopathy (HC). Chronotropic response (CR) and heart rate recovery (HRR) were computed during and after treadmill exercise testing in 273 patients with HC and 95 age-matched healthy controls. Patients with HC had higher prevalence of chronotropic incompetence and lower HRR1-5min compared with controls. Exercise capacity, diastolic function (assessed by E/e') and left atrial volume index were associated with HRR1min and CR in HC. Septal myectomy was associated with reduction in chronotropic incompetence but did not affect HRR1min. In conclusion, impaired CR and HRR1min are associated with advanced disease and do not appear to be independent clinical markers indicating high-risk status in HC. Improving CR by titrating doses of negative chronotropic agents, myectomy, and atrial pacing may be useful to increase exercise capacity in patients with HC. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. [Perioperative management for patients with hypertrophic cardiomyopathy undergoing noncardiac surgery].

    PubMed

    Okuyama, A; Goda, Y; Kawahigashi, H; Takita, K; Okuyama, M; Kubota, M

    1992-01-01

    We had two patients with hypertrophic cardiomyopathy for noncardiac surgeries. Case 1: A 74-year-old man for right nephrectomy received epidural lidocaine and nitrous oxide combined with 0.2-0.6% isoflurane. During the operation, heart rate and blood pressure were relatively unstable, but he woke up promptly after the operation. Early on the morning of the 2nd post-operative day, he was found dead on his bed. Case 2: A 52-year-old man for gastrectomy was anesthetized with nitrous oxide and halothane with continuous propranolol infusion. Through the operative period, heart rate and blood pressure were stable and postoperative course was uneventful. In these two patients, preoperative Holter ECG showed ventricular tachycardia, which may increase the risk of a sudden death. These cases demonstrate that general anesthesia with nitrous oxide combined with halothane, can be administered with a low risk in patients with HCM for noncardiac surgery and that postoperative intensive care unit monitoring is necessary for these patients for several days to prevent a sudden death.

  17. Hypertrophic Olivary Degeneration: A Neurosurgical Point of View.

    PubMed

    Carvalho, Carlos Henrique; Kimmig, Hubert; Lopez, William Omar Contreras; Lange, Manfred; Oeckler, Reinhard

    2016-01-01

    Hypertrophic olivary degeneration (HOD) is a rare form of transsynaptic degeneration characterized by hypertrophy of the inferior olivary nucleus situated in the olivary body, part of the medulla oblongata, representing a major source of input to the cerebellum. HOD typically results from focal lesions interrupting connections from the inferior olive within the dentato-rubro-olivary pathway, a region also known as the triangle of Guillain-Mollaret (TGM) (red nucleus, inferior olivary nucleus, and contralateral dentate nucleus). Clinically, HOD presents classically as palatal tremor and can include dentatorubral tremor and/or ocular myoclonus. The pathologic changes associated with HOD feature radiologic changes with the inferior olivary nucleus appearing larger and increasing its T2-weighted signal intensity on magnetic resonance images. HOD is commonly managed with pharmacotherapy but may require surgical intervention in extreme cases. HOD has been found to develop as a consequence of any injury that disrupts the TGM pathways (e.g., pontine cavernoma).These findings highlight the critical importance of a thorough knowledge of TGM anatomy to avoid secondary HOD. We present a patient who developed HOD secondary to resection of a tectal plate cavernous malformation and review the literature with an emphasis on the current knowledge of this disorder.

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

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

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

  19. Office laser delivery systems for the treatment of hypertrophic turbinates

    NASA Astrophysics Data System (ADS)

    Krespi, Y. P.; Slatkine, Michael

    1995-05-01

    We present two different methods to treat hypertrophic turbinates in an office environment: (a) with the aid of 1 mm thin hollow waveguides transmitting a CO2 laser beam to produce char-free ablation of turbinate mucosa, and (b) with the aid of a 800 micron thin optical fiber transmitting low power Nd:YAG laser radiation to interstitially coagulate and shrink submucosal tissue. Char-free ablation of mucusal tissue: An office CO2 laser regularly used for LAUP in the treatment of snoring problems is operated in the Superpulse mode (peak power 350 W) at 8 W average power. The optical beam is coupled to angled and straight hollow waveguides. Ablation of inferior turbinates is performed within a few minutes under topical or local anesthesia. No post operative packing is required and the patient can return to normal activities. Healing is fast due to the highly controlled superficial thermal damage. Interstitial coagulation of inferior turbinates: Submucosal coagulation of tissue is attained with a flat 800 (mu) fiber longitudinally pushed and pulled while operating an Nd:YAG laser at 8 W power level. A 4 - 6 mm thin coagulated and shrunken volume of cylindrical shape is being produced with no damage to bones or mucosa. The procedure is fast and performed under local anesthesia. An analysis of both surgical techniques and clinical results with over 100 patients will be presented.

  20. Intravenous atropine treatment in infantile hypertrophic pyloric stenosis

    PubMed Central

    Kawahara, H; Imura, K; Nishikawa, M; Yagi, M; Kubota, A

    2002-01-01

    Aims: To assess the efficacy of a new regimen of intravenous atropine treatment for infantile hypertrophic pyloric stenosis (IHPS) with special reference to regression of pyloric hypertrophy. Methods: Atropine was given intravenously at a dose of 0.01 mg/kg six times a day before feeding in 19 patients with IHPS diagnosed from radiographic and ultrasonographic findings. When vomiting ceased and the infants were able to ingest 150 ml/kg/day formula after stepwise increases in feeding volume, they were given 0.02 mg/kg atropine six times a day orally and the dose was decreased stepwise. Results: Of the 19 infants, 17 (89%) ceased projectile vomiting after treatment with intravenous (median seven days) and subsequent oral (median 44 days) atropine administration. The remaining two infants required surgery. No significant complications were encountered. Ultrasonography showed a significant (p < 0.05) decrease in pyloric muscle thickness, but no significant shortening of the pyloric canal after completion of the atropine treatment. The patients exhibited failure to thrive at presentation, but were thriving at 6 months of age (p < 0.01). Conclusions: This atropine therapy resulted in satisfactory clinical recovery. Pyloric muscle thickness was significantly reduced. PMID:12089130

  1. Vps34 regulates myofibril proteostasis to prevent hypertrophic cardiomyopathy

    PubMed Central

    Kimura, Hirotaka; Eguchi, Satoshi; Sasaki, Junko; Kuba, Keiji; Nakanishi, Hiroki; Yamazaki, Masakazu; Goto, Akiteru; Watanabe, Hiroyuki; Itoh, Hiroshi; Imai, Yumiko; Suzuki, Akira

    2017-01-01

    Hypertrophic cardiomyopathy (HCM) is a common heart disease with a prevalence of 1 in 500 in the general population. Several mutations in genes encoding cardiac proteins have been found in HCM patients, but these changes do not predict occurrence or prognosis and the molecular mechanisms underlying HCM remain largely elusive. Here we show that cardiac expression of vacuolar protein sorting 34 (Vps34) is reduced in a subset of HCM patients. In a mouse model, muscle-specific loss of Vps34 led to HCM-like manifestations and sudden death. Vps34-deficient hearts exhibited abnormal histopathologies, including myofibrillar disarray and aggregates containing αB-crystallin (CryAB). These features result from a block in the ESCRT-mediated proteolysis that normally degrades K63-polyubiquitinated CryAB. CryAB deposition was also found in myocardial specimens from a subset of HCM patients whose hearts showed decreased Vps34. Our results identify disruption of the previously unknown Vps34-CryAB axis as a potentially novel etiology of HCM. PMID:28097232

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

    PubMed

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

    2015-08-01

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

  3. Geoacoustic Inversion in Shallow Water

    DTIC Science & Technology

    2013-09-30

    sound speed profiles in the bottom sediment materials ( Tolstoy et al., 1998; Chapman et al., 2003). However, there has not been a benchmark comparison...EL115, (2008). Tolstoy , A., N.R. Chapman and G. Brooke, Workshop ’97: Benchmarking for Geoacoustic Inversion in Shallow Water, J. Comp. Acoustics, 6, 1

  4. Parameterization of precipitating shallow convection

    NASA Astrophysics Data System (ADS)

    Seifert, Axel

    2015-04-01

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

  5. Shallow Geothermal Admissibility Maps: a Methodology to Achieve a Sustainable Development of Shallow Geothermal Energy with Regards to Groundwater Resources

    NASA Astrophysics Data System (ADS)

    Bréthaut, D.; Parriaux, A.; Tacher, L.

    2009-04-01

    Implantation and use of shallow geothermal systems may have environmental impacts. Traditionally, risks are divided into 2 categories: direct and indirect. Direct risks are linked with the leakage of the circulating fluid (usually water with anti-freeze) of ground source heat pumps into the underground which may be a source of contamination. Indirect risks are linked with the borehole itself and the operation of the systems which can modify the groundwater flow, change groundwater temperature and chemistry, create bypasses from the surfaces to the aquifers or between two aquifers. Groundwater source heat pumps (GWSHP) may provoke indirect risks, while ground source heat pumps (GSHP) may provoke both direct and indirect risks. To minimize those environmental risks, the implantation of shallow geothermal systems must be regulated. In 2007, more than 7000 GSHP have been installed in Switzerland, which represents 1.5 Mio drilled meters. In the canton of Vaud, each shallow geothermal project has to be approved by the Department of the Environment. Approximately 1500 demands have been treated during 2007, about 15 times more than in 1990. Mapping shallow geothermal systems implantation restrictions due to environmental constrains permits: 1) to optimize the management and planning of the systems, 2) to minimize their impact on groundwater resources and 3) to facilitate administrative procedures for treating implantation demands. Such maps are called admissibility maps. Here, a methodology to elaborate them is presented and tested. Interactions between shallow geothermal energy and groundwater resources have been investigated. Admissibility criteria are proposed and structured into a flow chart which provides a decision making tool for shallow geothermal systems implantation. This approach has been applied to three areas of West Switzerland ranging from 2 to 6 km2. For each area, a geological investigation has been realized and complementary territorial information (e

  6. Fixed subaortic stenosis associated with hypertrophic cardiomyopathy: report of a rare familial occurrence.

    PubMed

    Conte, M R; Bongioanni, S; Dall'Orto, G; Nicastro, C; Bonfiglio, G; Morello, M; Mangiardi, L; Brusca, A

    1998-01-01

    Fixed subaortic stenosis is considered to be an acquired condition. It is often associated with congenital heart disease, creating a turbulence in the left ventricle outflow tract. Familial forms of fixed subaortic stenosis are very unusual. We report a remarkable familial cluster in which fixed subaortic stenosis is associated with hypertrophic cardiomyopathy. Fourteen relatives of a patient affected with hypertrophic cardiomyopathy and fixed subaortic stenosis underwent cardiological examination, electrocardiogram and echo-doppler study. Two of the proband's sisters showed an association between asymmetrical hypertrophic cardiomyopathy and fixed subaortic stenosis. The brother presented a subaortic ridge and concentric left ventricular hypertrophy. The other members of the family (another brother and the third-generation relatives) were unaffected. While the association between fixed subaortic stenosis and hypertrophic cardiomyopathy has commonly been reported, there is little in the literature to suggest the family-related nature of this association. The familial occurrence of this association reveals genetic transmission, with a recessive autosomal pattern of inheritance. This finding goes against the usual autosomal dominant pattern of inheritance in hypertrophic cardiomyopathy. Familial studies of FSS are needed in order to gain a better understanding of the genetic background of these patients.

  7. Environmental contaminants

    USGS Publications Warehouse

    Custer, T.W.; Kushlna, J.A.; Hafner, H.

    2000-01-01

    Throughout the world, individuals and populations of herons are affected by environmental contaminants, leading to direct mortality, decreased reproductive success, or degradation of feeding habitat. Contaminants suspected or known to affect herons include organochlorine compounds, organophosphorus insecticides, trace elements, and petroleum (Parnell et al. 1988).General reviews on the effects of pesticides on birds (Risebrough 1986, 1991) and colonial water birds (Nisbet 1980) are presented elsewhere. The objective of this chapter is to review toxic effects of contaminants on herons. Unless otherwise noted, contaminant concentrations are presented as parts per million (ppm) on a wet weight (ww) basis.

  8. OBSERVATIONS FROM CONTAMINANT PLUMES ON LONG ISLAND

    EPA Science Inventory

    The aquifers of Long Island serve as a sole source drinking water supply for the entire
    local population of about three million people. Where the shallow Upper Glacial Aquifer has been contaminated with petroleum hydrocarbons and methyl tert-butyl ether (MTBE), intensive site ...

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

    SciTech Connect

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

    1990-04-01

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

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

    PubMed

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

    2016-04-01

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

  11. [Septal alcohol ablation in patients with hypertrophic cardiomyopathy].

    PubMed

    López-Aburto, Gustavo; Palacios-Rodríguez, Juan Manuel; Cantú-Ramírez, Samuel; Galván-García, Eduardo; Tolosa-Dzul, Gonzalo; Morán-Benavente, Armando; Ontiveros-Martínez, Raúl

    2013-01-01

    to know the clinical and hemodynamic course in septal obstructive hypertrophic cardiomyopathy (SOHC) after alcohol ablation. this was an observational, longitudinal study, including 21 patients with SOHC with functional class of the New York Heart Association (CF-NYHA) refractory to treatment and/or = 30 mm Hg gradient at rest or = 60 mm Hg provoked, or have systolic anterior motion or mitral incompetence (MI) > grade II by echocardiography. average age was 50 ± 16 years, males 38.1 %, females 61.9 %; symptoms: angina 42.9 %, dyspnea 85.7 %, syncope 23.8 %. Pre-ablation CF-NYHA was III and IV in 61.9 %; after a year follow-up all of them were class I-II. Pre-ablation, after and one year later, interventricle septum measures were 22.7 ± 4.9 and 20.7 ± 3.1 mm; left ventricular ejection fraction was 65.5 ± 7 %, 62.2 % ± 6.5 % and 68.7 ± 6.2 %; the output gradient of the left ventricle were 106.9 ± 29.9, 44.6 ± 24.3 and 22.0 ± 5.7 mm Hg. Pre-ablation MI grade-III and IV were 33.3 % and 47.6 %; after a year it was grade-0, 52.4 %, grade-I 28.6 %, grade-II, 19 %. There were no hospital mortality. the alcohol septal ablation in SOHC patients had a high success treatment with a low complication rate.

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

    PubMed Central

    Ankad, Balachandra S.; Beergouder, Savitha L.

    2016-01-01

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

  13. Hypertrophic Cardiomyopathy: Genetics, Pathogenesis, Clinical Manifestations, Diagnosis, and Therapy.

    PubMed

    Marian, Ali J; Braunwald, Eugene

    2017-09-15

    Hypertrophic cardiomyopathy (HCM) is a genetic disorder that is characterized by left ventricular hypertrophy unexplained by secondary causes and a nondilated left ventricle with preserved or increased ejection fraction. It is commonly asymmetrical with the most severe hypertrophy involving the basal interventricular septum. Left ventricular outflow tract obstruction is present at rest in about one third of the patients and can be provoked in another third. The histological features of HCM include myocyte hypertrophy and disarray, as well as interstitial fibrosis. The hypertrophy is also frequently associated with left ventricular diastolic dysfunction. In the majority of patients, HCM has a relatively benign course. However, HCM is also an important cause of sudden cardiac death, particularly in adolescents and young adults. Nonsustained ventricular tachycardia, syncope, a family history of sudden cardiac death, and severe cardiac hypertrophy are major risk factors for sudden cardiac death. This complication can usually be averted by implantation of a cardioverter-defibrillator in appropriate high-risk patients. Atrial fibrillation is also a common complication and is not well tolerated. Mutations in over a dozen genes encoding sarcomere-associated proteins cause HCM. MYH7 and MYBPC3, encoding β-myosin heavy chain and myosin-binding protein C, respectively, are the 2 most common genes involved, together accounting for ≈50% of the HCM families. In ≈40% of HCM patients, the causal genes remain to be identified. Mutations in genes responsible for storage diseases also cause a phenotype resembling HCM (genocopy or phenocopy). The routine applications of genetic testing and preclinical identification of family members represents an important advance. The genetic discoveries have enhanced understanding of the molecular pathogenesis of HCM and have stimulated efforts designed to identify new therapeutic agents. © 2017 American Heart Association, Inc.

  14. Angiotensin converting enzyme gene polymorphism in familial hypertrophic cardiomyopathy patients

    SciTech Connect

    Yu, B; Peric, S.; Ross, D.

    1994-09-01

    An insertion/deletion (I/D) polymorphism of the angiotensin I converting enzyme (ACE) gene is a useful predictor of human plasma ACE levels. ACE levels tend to be lowest in subjects with ACE genotype DD and intermediate in subjects with ACE genotype ID. Angiotensin II (Ang II) as a product of ACE is a cardiac growth factor and produces a marked hypertrophy of the chick myocyte in cell culture. Rat experiments also suggest that a small dose of ACE inhibitor that does not affect the afterload results in prevention or regression of cardiac hypertrophy. In order to study the relationship of ACE and the severity of hypertrophy, the ACE genotype has been determined in 28 patients with a clinical diagnosis of familial hypertrophic cardiomyopathy (FHC) and 51 normal subjects. The respective frequencies of I and D alleles were: 0.52 and 0.48 (in FHC patients) and 0.44 and 0.56 (in the normal controls). There was no significant difference in the allele frequencies between FHC and normal subjects ({chi}{sup 2}=0.023, p>0.05). The II, ID, and DD genotypes were present in 7, 15, and 6 FHC patients, respectively. The averages of maximal thickness of the interventricular septum measured by echocardiography or at autopsy were 18 {plus_minus}3, 19{plus_minus}4, and 19{plus_minus}3 mm in II, ID and DD genotypes, respectively. The ACE gene polymorphism did not correlate with the severity of left ventricular hypertrophy in FHC patients (r{sub s}=0.231, p>0.05). These results do not necessarily exclude the possible effect of Ang II on the hypertrophy since the latter may be produced through the action of chymase in the human ventricles. However, ACE gene polymorphism is not a useful predictor of the severity of myocardial hypertrophy in FHC patients.

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

    PubMed

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

    2008-01-01

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

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

    PubMed Central

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

    1996-01-01

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

  17. Clinical Characteristics and Prognosis of End-stage Hypertrophic Cardiomyopathy

    PubMed Central

    Xiao, Yan; Yang, Kun-Qi; Yang, Yan-Kun; Liu, Ya-Xin; Tian, Tao; Song, Lei; Jiang, Xiong-Jing; Zhou, Xian-Liang

    2015-01-01

    Background: End-stage hypertrophic cardiomyopathy (HCM) is complicated by substantial adverse events. However, few studies have focused on electrocardiographic features and their prognostic values in HCM. This study aimed to evaluate the clinical manifestations and prognostic value of electrocardiography in patients with end-stage HCM. Methods: End-stage HCM patients were enrolled from a total of 1844 consecutive HCM patients from April 2002 to November 2013 at Fuwai Hospital. Clinical data, including medical history, electrocardiography, and echocardiography, were analyzed. Cox hazards regression analysis was used to assess the risk factors for cardiovascular mortality. Results: End-stage HCM was identified in 99 (5.4%) patients, averaged at 52 ± 16 years old at entry. Atrial fibrillation was observed in 53 patients and mural thrombus in 19 patients. During 3.9 ± 3.0 years of follow-up, embolic stroke, refractory heart failure, and death or transplantation were observed in 20, 39, and 51 patients, respectively. The incidence of annual mortality was 13.2%. Multivariate Cox hazards regression analysis identified New York Heart Association Class (NYHA) III/IV at entry (hazard ratio [HR]: 1.99; 95% confidence interval [CI]: 1.05–3.80; P = 0.036), left bundle branch block (LBBB) (HR: 2.80; 95% CI: 1.47–5.31; P = 0.002), and an abnormal Q wave (HR: 2.21; 95% CI: 1.16–4.23; P = 0.016) as independent predictors of cardiovascular death, in accordance with all-cause death and heart failure-related death. Conclusions: LBBB and an abnormal Q wave are risk factors of cardiovascular mortality in end-stage HCM and provide new evidence for early intervention. Susceptibility of end-stage HCM patients to mural thrombus and embolic events warrants further attention. PMID:26021505

  18. Genetics of hypertrophic cardiomyopathy after 20 years: clinical perspectives.

    PubMed

    Maron, Barry J; Maron, Martin S; Semsarian, Christopher

    2012-08-21

    Hypertrophic cardiomyopathy (HCM) is the most common familial heart disease with vast genetic heterogeneity, demonstrated over the past 20 years. Mutations in 11 or more genes encoding proteins of the cardiac sarcomere (>1,400 variants) are responsible for (or associated with) HCM. Explosive progress achieved in understanding the rapidly evolving science underlying HCM genomics has resulted in fee-for-service testing, making genetic information widely available. The power of HCM mutational analysis, albeit a more limited role than initially envisioned, lies most prominently in screening family members at risk for developing disease and excluding unaffected relatives, which is information not achievable otherwise. Genetic testing also allows expansion of the broad HCM disease spectrum and diagnosis of HCM phenocopies with different natural history and treatment options, but is not a reliable strategy for predicting prognosis. Interfacing a heterogeneous disease such as HCM with the vast genetic variability of the human genome, and high frequency of novel mutations, has created unforeseen difficulties in translating complex science (and language) into the clinical arena. Indeed, proband diagnostic testing is often expressed on a probabilistic scale, which is frequently incompatible with clinical decision making. Major challenges rest with making reliable distinctions between pathogenic mutations and benign variants, and those judged to be of uncertain significance. Genotyping in HCM can be a powerful tool for family screening and diagnosis. However, wider adoption and future success of genetic testing in the practicing cardiovascular community depends on a standardized approach to mutation interpretation, and bridging the communication gap between basic scientists and clinicians.

  19. A myomesin mutation associated with hypertrophic cardiomyopathy deteriorates dimerisation properties.

    PubMed

    Siegert, Romy; Perrot, Andreas; Keller, Sandro; Behlke, Joachim; Michalewska-Włudarczyk, Aleksandra; Wycisk, Anna; Tendera, Michal; Morano, Ingo; Ozcelik, Cemil

    2011-02-18

    Myomesin plays an important structural and functional role in the M-band of striated muscles. The C-terminal domain 13 of myomesin dimerises and forms antiparallel strands which cross-link neighboring Myosin filaments and titin in the M-line of the sarcomeres. These interactions stabilise the contractile apparatus during striated muscle contraction. Since myomesin is an important component of the M-band we screened the myomesin gene for genetic variants in patients with hypertrophic cardiomyopathy (HCM). We identified the missense mutation V1490I in domain 12 of myomesin in a family with inherited HCM. Analytical ultracentrifugation experiments, circular dichroism spectra, and surface plasmon resonance spectroscopy of myomesin fragments were carried out to investigate the effects of the mutation V1490I on structure and function of myomesin domains 11-13 and 12-13. Both the wild type and mutated myomesin domains My11-13 revealed similar secondary structures and formed stable dimers. Mutated myomesin domains My11-13 and My12-13 dimers revealed a reduced thermal stability and a significantly decreased dimerisation affinity, showing disturbed functional properties of V1490I mutated myomesin. However, monomeric myomesin domains My11-12, i.e. without dimerisation domain 13 showed no difference in thermal stability between wild type and V1490I mutated myomesin. In conclusion, the V1490I mutation associated with HCM lead to myomesin proteins with abnormal functional properties which affect dimerisation properties of myomesin domain 13. These effects may contribute to the pathogenesis of HCM. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    PubMed Central

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

    2015-01-01

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

  1. Nonfamilial Hypertrophic Cardiomyopathy: Prevalence, Natural History, and Clinical Implications.

    PubMed

    Ingles, Jodie; Burns, Charlotte; Bagnall, Richard D; Lam, Lien; Yeates, Laura; Sarina, Tanya; Puranik, Rajesh; Briffa, Tom; Atherton, John J; Driscoll, Tim; Semsarian, Christopher

    2017-04-01

    Yield of causative variants in hypertrophic cardiomyopathy (HCM) is increased in some probands, suggesting different clinical subgroups of disease occur. We hypothesized that a negative family history and no sarcomere mutations represent a nonfamilial subgroup of HCM. We sought to determine the prevalence, natural history, and potential clinical implications of this nonfamilial subgroup of HCM. Four hundred and thirteen unrelated probands with HCM seen in a specialized HCM center between 2002 and 2015 and genetic testing performed were included in this retrospective cohort study. There were 251 (61%) probands with no reported family history of HCM, including 166 (40% of total) probands with no sarcomere mutation, that is, nonfamilial HCM. Quantified family pedigree data revealed no difference in mean number of first-degree relatives screened between nonfamilial and sarcomere-positive groups. Adjusted predictors of nonfamilial status were older age (odds ratio, 1.04; 95% confidence interval, 1.02-1.06; P=0.0001), male sex (odds ratio, 1.96; 95% confidence interval, 1.11-3.45; P=0.02), hypertension (odds ratio, 2.80; 95% confidence interval, 1.57-5.00; P=0.0005), and nonasymmetric septal morphology (odds ratio, 3.41; 95% confidence interval, 1.64-7.08; P=0.001). They had a less severe clinical course with greater event-free survival from major cardiac events (P=0.04) compared with sarcomere-positive HCM probands. Genotype prediction scores showed good performance in identifying genotype-positive patients (area under the curve, 0.71-0.75) and, in combination with pedigree characteristics, were further improved. Approximately 40% of HCM probands have a nonfamilial subtype, with later onset and less severe clinical course. We propose a revised clinical pathway for management, highlighting the role of genetic testing, a detailed pedigree, and refined clinical surveillance recommendations for family members. © 2017 American Heart Association, Inc.

  2. Social determinants of health in the setting of hypertrophic cardiomyopathy.

    PubMed

    Ingles, Jodie; Johnson, Renee; Sarina, Tanya; Yeates, Laura; Burns, Charlotte; Gray, Belinda; Ball, Kylie; Semsarian, Christopher

    2015-04-01

    Social determinants of health play an important role in explaining poor health outcomes across many chronic disease states. The impact of the social gradient in the setting of an inherited heart disease, hypertrophic cardiomyopathy (HCM), has not been investigated. This study sought to profile the socioeconomic status of patients attending a specialized multidisciplinary clinic and to determine the impact on clinical factors, psychosocial wellbeing and adherence to medical advice. Patients with HCM and at-risk relatives attending a specialized multidisciplinary clinic in Sydney Australia between 2011 and 2013 were included. Clinical, socioeconomic, geographic remoteness and adherence data were available. A broader clinic and registry-based group completed a survey including psychological wellbeing, health-related quality of life, Morisky Medication Adherence Scale and individual-level socioeconomic information. Over a 3-year period, 486 patients were seen in the specialized clinic. There was an over-representation of patients from socioeconomically advantaged and the least geographically remote areas. Socioeconomic disadvantage was associated with comorbidities, poor psychological wellbeing and health-related quality of life, lower understanding of HCM and more complex clinical management issues such as NYHA class, atrial fibrillation and left ventricular outflow tract obstruction. Approximately 10% of patients were non-adherent to medical advice, and poor medication adherence was seen in 30% of HCM patients with associated factors being younger age, minority ethnicity, anxiety and poor mental quality of life. Of all the patients attending a specialized cardiac genetic clinic, there is an overrepresentation of patients from very advantaged and major metropolitan areas and suggests that those most in need of a multidisciplinary approach to care are not accessing it. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Characteristics of hypertrophic pachymeningitis in patients with granulomatosis with polyangiitis.

    PubMed

    Choi, Hyun Ah; Lee, Mi Ji; Chung, Chin-Sang

    2017-02-20

    Hypertrophic pachymeningitis (HP) is an important neurologic complication of granulomatosis with polyangiitis (GPA, formerly Wegener's granulomatosis). The aim of this study is to investigate the clinical features, radiological findings, and diagnostic pitfalls of GPA-related HP. A retrospective chart review was performed to screen patients diagnosed with GPA at Samsung Medical Center between 1997 and 2016. Neurologic manifestation, laboratory findings, neuroimaging data, and clinical course were evaluated in all patients. Characteristics of patients with HP were compared to those of patients without HP. Sixty-five patients with GPA were identified. Twenty-five of these patients had central nervous system involvement. HP (N = 9, 36%) was the second most common radiologic finding. Other neurologic findings included stroke (N = 7, 28%) and granulomatous disease (N = 10, 40%). Patients with HP had lower incidences of systemic manifestations (N = 2, 22.2% vs. N = 38, 67.9%, p = 0.013 in the lung and N = 1, 11.1% vs. N = 28, 50.0%, p = 0.030 in the kidney) than those without HP. Six patients with GPA-related HP were MPO-ANCA positive (66.7%) and two had PR3-ANCA (22.2%). Most of the patients with HP presented with headache (N = 8, 88.9%) at a rate that is similar to those of primary headache disorders (migraine, tension-type, and stabbing) and other secondary headache disorders (postural type and meningitis). Patients with HP rarely had neurologic deficits (N = 3, 37.5%). Different clinical or radiologic features may be observed in GPA-related HP. Early recognition and accurate diagnosis of GPA-related HP are needed in addition to neuroimaging findings.

  4. Influence of soil structure on contaminant leaching from injected slurry

    USDA-ARS?s Scientific Manuscript database

    Animal manure application to agricultural land provides beneficial organic matter and nutrients but can spread harmful contaminants to the environment. Contamination of fresh produce, surface water and shallow groundwater with the manure-borne pollutants can be a critical concern. Leaching and persi...

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

    NASA Astrophysics Data System (ADS)

    Liu, Honghui; Gisquet, Héloïse; Guillemin, F.; Blondel, Walter C. P. M.

    2011-07-01

    Objective: The objective of this study was two folds: firstly, we would like to investigate the efficiency of bimodal spectroscopic technique in characterization of hypertrophic scarring tissue deliberately created on a preclinical model (rabbit's ear); on the other hand, we evaluate the inhibition effect of an anti-inflammatory medication (tacrolimus) on hypertrophic formation in scar by using our bimodal spectroscopic system. Study design: This study was conducted on 20 New Zealand Rabbits receiving hypertrophic scarring treatment on their ears. Fluorescence and Diffuse Reflectance spectra were collected from each scar, amongst which some had received tacrolimus treatment. Features were extracted from corrected spectral data and analyzed to classify the scarring tissues into hypertrophic or non-hypertrophic. Diagnostic algorithms were developed with the use of k-NN classifier and validated by comparing to histological classification result with Leave-one- out cross validation. Results and discussion: The accuracy of our bimodal spectroscopy method for detecting hypertrophic scarring scar tissue was good (sensibility: 90.84%, specificity: 94.44%). The features used for classification were mainly extracted from the spectra exited at 360, 410 and 420 nm. This indicates that the difference between the spectra acquired from hypertrophic and non-hypertrophic tissue may be due to the different intensity distribution of several fluorophores (collagen,elastin and NADH) excited in this range, or to the change in proportion of tissue layers (epidermis and dermis) explored by the CEFS in use.

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

    PubMed

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

    2012-12-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

  9. Successful management of hypertrophic cardiomyopathy in a Matschie's tree kangaroo (Dendrolagus matschiei).

    PubMed

    Fredholm, Daniel V; Jones, Ashley E; Hall, Natalie H; Russell, Kathleen; Heard, Darryl J

    2015-03-01

    A 3-yr-old, intact male Matschie's tree kangaroo (Dendrolagus matschiei) was examined for a 1-wk history of intermittent lethargy and tachypnea. An echocardiogram revealed concentric hypertrophy of the left ventricular free wall and interventricular septum. These findings were compared to measurements from healthy Matschie's tree kangaroos, supporting a diagnosis of hypertrophic cardiomyopathy. At the time of publication, the patient has been managed for over 11.5 yr, using a combination of enalapril, furosemide, diltiazem, and diet modifications. Hypertrophic cardiomyopathy should be considered as a differential diagnosis in tree kangaroos exhibiting signs of cardiovascular or respiratory distress. This case represents the first report of antemortem diagnosis and successful management of hypertrophic cardiomyopathy in a Matschie's tree kangaroo.

  10. Shallow waters require platform innovation

    SciTech Connect

    Not Available

    1984-11-01

    Conventional platform designs generally apply to production facilities for relatively shallow-water oil and gas fields and consequently do not attract much attention in the offshore industry. But although new designs relate largely to deeper waters, specific requirements of a particular field in shallow water may well force designers to search for unconventional designs to meet a need for lower costs and rapid development. A central production facility is planned offshore at the drilling location AWG-1, approximately 3 km offshore and in a water depth of about six meters. The choice is governed by the optimum interfield pipeline configuration available at the AWG-1 location, taking into account the other locations required for adequate subsea well coverage. The platform is described.

  11. Shallow Water Fluctuations and Communications

    DTIC Science & Technology

    2007-09-30

    propagation, while spatial focusing achieves a high SNR at the intended receiver with a low probability of interception (LPI) elsewhere. The spatial... SNR versus the number of receiver elements M: (1) time reversal alone (TR) and (2) time reversal combined with channel equalization (TR+EQ). Earlier...shallow region of the Mediterranean Sea [6] for two specific reasons. First, the data exhibit a high input SNR across the array (e.g., 12-19 dB

  12. Shallow cells in directional solidification

    NASA Technical Reports Server (NTRS)

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

    1989-01-01

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

  13. Effect of BTXA on Inhibiting Hypertrophic Scar Formation in a Rabbit Ear Model.

    PubMed

    Liu, Dong-Qing; Li, Xiao-Jing; Weng, Xiao-Juan

    2017-06-01

    Hypertrophic scar (HS) is a refractory skin disease caused by major physical damage or other inflammation. Some reports found that botulinum toxin type A (BTXA) could be an alternative treatment of the HS. Therefore, the authors studied the effects of BTXA on the treatment of HS and the dose response of BTXA. Hypertrophic scars were harvested from the ears of 18 young adult New Zealand big-eared rabbits and treated with BTXA or triamcinolone acetonide (TAC) in vivo experiment. The hypertrophic index (HI) was measured by histological examination. Collagen fibrils were checked by sirius red straining, and the cell nucleuses of fibroblasts were checked by Ki67. The HI of hypertrophic scars with BTXA treatment was lower than that with phosphate-buffered saline treatment (P < 0.05). Compared with the TAC treatment group, the efficacy of treatment with the middle dose of BTXA (1.0, 1.5 IU) had no significant difference, as shown by sirius red staining and immunohistochemistry Ki67. These results demonstrated that BTXA effectively improved the appearance of hypertrophic scars and inhibited the formation of collagen fibrils and fibroblasts in vivo. Treatment with the middle dose of BTXA achieved similar efficacy as TAC treatment, indicating that BTXA might be useful for inhibiting hypertrophic scars and worth investigating further. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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

    PubMed

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

    2013-06-01

    Burn injury-mediated destruction of the skin barrier normally induces microbial invasion, in turn leading to the development of systemic infection and occasional septic shock by the release of endotoxins. The objective of this work was to study the influence of lipopolysaccharide (LPS) on the biological characteristics of normal skin fibroblasts and to elucidate the influence of LPS in the initial stage of skin wound healing. Twenty patients with hypertrophic scar in proliferative stage were selected randomly and primary cultures were established from fibroblasts derived from their hypertrophic scar tissue and normal skin. Normal skin fibroblasts of passage 3 were stimulated with different concentrations of LPS. LPS stimulated the proliferation and collagen synthesis of fibroblasts within a certain extent of concentrations (0.005-0.5 μg/mL) (P < 0.05), whereas at a concentration of 1 μg/mL inhibited the proliferation and collagen synthesis of fibroblasts (P < 0.05). Collagen synthesis by normal skin fibroblasts after LPS stimulation mimicked those derived from hypertrophic scar tissue. LPS of 0.1 μg/mL had significant effect on normal skin fibroblasts-continuous passage of these fibroblasts resulted in ultrastructural pattern similar to fibroblasts derived from hypertrophic scar tissue, and the findings was substantiated by hematoxylin and eosin staining and immunohistochemistry detection of proliferation cell nuclear antigen, type I procollagen and α-smooth muscle actin. Our results suggest that LPS might convert normal skin fibroblasts to hypertrophic scar tissue fibroblasts and participate in the formation of hypertrophic scar; hence, appropriate concentration of LPS may have no effect or be beneficial to skin wound healing, whereas excessive concentration of LPS may delay the time of wound healing. Copyright © 2013 International Union of Biochemistry and Molecular Biology, Inc.

  15. Vortex Formation in Shallow Flows

    NASA Astrophysics Data System (ADS)

    Rockwell, Donald

    2006-11-01

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

  16. Emerging Contaminants.

    EPA Science Inventory

    Recent temporal trends of contaminants from Narragansett Bay show the appearance of CECs resulting from the use of personal care products, pharmaceuticals and industrial products over time. In contrast, legacy contaminants such as PCBs and toxic heavy metals generally show susta...

  17. In vitro mechanical compression induces apoptosis and regulates cytokines release in hypertrophic scars.

    PubMed

    Renò, Filippo; Sabbatini, Maurizio; Lombardi, Francesca; Stella, Maurizio; Pezzuto, Carla; Magliacani, Gilberto; Cannas, Mario

    2003-01-01

    Hypertrophic scars resulting from severe burns are usually treated by continuous elastic compression. Although pressure therapy reaches success rates of 60-85% its mechanisms of action are still poorly understood. In this study, apoptosis induction and release of interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) were evaluated in normal (n = 3) and hypertrophic (=7) scars from burns after in vitro mechanical compression. In the absence of compression (basal condition) apoptotic cells, scored using terminal deoxyribonucleotidyl transferase assay, were present after 24 hours in the derma of both normal scar (23 +/- 0.4% of total cell) and hypertrophic scar (11.3 +/- 1.4%). Mechanical compression (constant pressure of 35 mmHg for 24 hours) increased apoptotic cell percentage both in normal scar (29.5 +/- 0.4%) and hypertrophic scar (29 +/- 1.7%). IL-1beta released in the medium was undetectable in normal scar under basal conditions while in hypertrophic scar the IL-1beta concentration was 3.48 +/- 0.2 ng/g. Compression in hypertrophic scar-induced secretion of IL-1beta twofold higher compared to basal condition. (7.72 +/- 0.2 ng/g). TNF-alpha basal concentration measured in normal scar medium was 8.52 +/- 4.01 ng/g and compression did not altered TNF-alpha release (12.86 +/- 7.84 ng/g). TNF-alpha basal release was significantly higher in hypertrophic scar (14.74 +/- 1.42 ng/g) compared to normal scar samples and TNF-alpha secretion was diminished (3.52 +/- 0.97 ng/g) after compression. In conclusion, in our in vitro model, mechanical compression resembling the clinical use of elastocompression was able to strongly increase apoptosis in the hypertrophic scar derma as observed during granulation tissue regression in normal wound healing. Moreover, the observed modulation of IL-1beta and TNF-alpha release by mechanical loading could play a key role in hypertrophy regression induced by elastocompression.

  18. Infantile Hypertrophic Pyloric Stenosis in Postoperative Esophageal Atresia with Tracheoesophageal Fistula.

    PubMed

    R A A, Hassan; Y U, Choo; R, Noraida; I, Rosida

    2015-01-01

    Development of infantile hypertrophic pyloric stenosis during postoperative period in EA with TEF is rare. Postoperative vomiting or feeding intolerance in EA is more common which is due to esophageal stricture, gastroesophageal reflux and esophageal dysmotility. A typical case of IHPS also presents with non-bilious projectile vomiting at around 3-4 weeks of life. The diagnosis of infantile hypertrophic pyloric stenosis in this subset is usually delayed because of its rarity. We report a case of IHPS in postoperative EA and emphasize on high index of suspicion to avoid any delay in diagnosis with its metabolic consequences.

  19. Physiological hypertrophic subaortic stenosis and subendocardial infarction in a patient with a pheochromocytoma.

    PubMed

    Levister, E C; Taylor, J B

    1981-04-01

    This report describes the occurrence of a pheochromocytoma in a middle-aged, black female with a 12-year history of hypertension, and a strong family history of hypertension. In this case, the pheochromocytoma was associated with a subendocardial myocardial infarction and congestive heart failure which occurred in the presence of large, dilated coronary arteries without intraluminal obstructions. The patient also had the murmur and echocardiographic and ventriculographic signs typical of idiopathic hypertrophic subaortic stenosis, which resolved following removal of the tumor and return of the blood pressure to normal. The authors believe this to represent a form of transient physiological hypertrophic subaortic stenosis secondary to a hypercatecholamine state.

  20. The spectrum of soft tissue and skeletal abnormalities of hypertrophic osteoarthropathy.

    PubMed

    Pineda, C; Fonseca, C; Martinez-Lavin, M

    1990-05-01

    We review our radiographic experience with hypertrophic osteoarthropathy. Soft tissue abnormalities such as finger clubbing, "elephant feet" and cutis verticis gyrata are well appreciated by plain radiography. Hypertrophic osteoarthropathy is characterized by a bone remodeling process at the tip of the digits. In older patients it is manifested as tuftal hypertrophy whereas in younger individuals acroosteolysis takes place. Radiographic signs of inflammatory arthropathy are conspicuously absent. Periosteal proliferation is an orderly evolving process in 3 dimensions: in the number of affected bones, in the area of involvement of a given bone and in the shape of periostitis.

  1. Cytomegalovirus-induced transient protein-losing hypertrophic gastropathy in an immunocompetent adult.

    PubMed

    Suter, W R; Neuweiler, J; Borovicka, J; Binek, J; Fantin, A C; Meyenberger, C

    2000-01-01

    Transient protein-losing hypertrophic gastropathy with similarity to Ménétrier's disease is described. Acute infection with cytomegalovirus (CMV) could be shown to play a causative role. Immunodeficiency was ruled out. The 34-year-old patient had complete resolution of the disease without antiviral treatment. To our knowledge the present report is the first case of CMV-associated protein-losing hypertrophic gastropathy in an immunocompetent adult. To date, a similar disorder has only been described in children. CMV infection should be considered in patients with acute and symptomatic protein loss of gastrointestinal origin. Copyright 2000 S. Karger AG, Basel

  2. Acute monocular visual loss in carcinomatous hypertrophic pachymeningitis mimicking giant cell arteritis.

    PubMed

    Chan, Jane W

    2006-05-01

    This report describes a 69-year-old woman who presented with acute monocular visual loss, ipsilateral headache, and elevated sedimentation rate (ESR) and C-reactive protein (CRP). Both temporal artery biopsies were negative. Neuroimaging, dural biopsy, and breast biopsy all confirmed the diagnosis of carcinomatous hypertrophic pachymeningitis associated with metastatic breast carcinoma. After treatment with corticosteroids, her vision improved. Her clinical presentation initially mimicked the symptoms and signs of giant cell arteritis. Acute monocular visual loss without other cranial nerve palsies may be an uncommon presentation of hypertrophic pachymeningitis from metastatic breast carcinoma.

  3. Acute monocular visual loss in carcinomatous hypertrophic pachymeningitis mimicking giant cell arteritis.

    PubMed

    Chan, Jane W

    2006-02-01

    This report describes a 69-year-old woman who presented with acute monocular visual loss, ipsilateral headache, and elevated sedimentation rate and C-reactive protein. Both temporal artery biopsies were negative. Neuroimaging, dural biopsy, and breast biopsy all confirmed the diagnosis of carcinomatous hypertrophic pachymeningitis associated with metastatic breast carcinoma. After treatment with corticosteroids, her vision improved. Her clinical presentation initially mimicked the symptoms and signs of giant cell arteritis. Acute monocular visual loss without other cranial nerve palsies may be an uncommon presentation of hypertrophic pachymeningitis from metastatic breast carcinoma.

  4. [The thickness/radius ratio (t/r) in patients with dilated and hypertrophic cardiomyopathy].

    PubMed

    Guadalajara, J F; Valenzuela, F; Martínez Sánchez, C; Huerta, D

    1990-01-01

    We studied 17 patients with cardiomyopathy (10 hypertrophic and 7 dilated). With two-dimensional echocardiography, we obtained a short axis view at the level of papillary muscle. We calculated the ratio between thickness (h), of ventricular wall and cavity's radius (r) in diastole and systole (h/r ratio). Hypertrophic cardiomyopathy has a high h/r ratio in diastole (inappropriate hypertrophy), hypercontractility and low and systolic wall stress. Dilated cardiomyopathy has a low diastolic h/r ratio (inadequate hypertrophy) with low contractility and elevated end-systolic, wall stress. We discuss the mechanisms and consequences of different patterns of hypertrophy on the ventricular performance.

  5. Refining the shallow slip deficit

    NASA Astrophysics Data System (ADS)

    Xu, Xiaohua; Tong, Xiaopeng; Sandwell, David T.; Milliner, Christopher W. D.; Dolan, James F.; Hollingsworth, James; Leprince, Sebastien; Ayoub, Francois

    2016-03-01

    Geodetic slip inversions for three major (Mw > 7) strike-slip earthquakes (1992 Landers, 1999 Hector Mine and 2010 El Mayor-Cucapah) show a 15-60 per cent reduction in slip near the surface (depth < 2 km) relative to the slip at deeper depths (4-6 km). This significant difference between surface coseismic slip and slip at depth has been termed the shallow slip deficit (SSD). The large magnitude of this deficit has been an enigma since it cannot be explained by shallow creep during the interseismic period or by triggered slip from nearby earthquakes. One potential explanation for the SSD is that the previous geodetic inversions lack data coverage close to surface rupture such that the shallow portions of the slip models are poorly resolved and generally underestimated. In this study, we improve the static coseismic slip inversion for these three earthquakes, especially at shallow depths, by: (1) including data capturing the near-fault deformation from optical imagery and SAR azimuth offsets; (2) refining the interferometric synthetic aperture radar processing with non-boxcar phase filtering, model-dependent range corrections, more complete phase unwrapping by SNAPHU (Statistical Non-linear Approach for Phase Unwrapping) assuming a maximum discontinuity and an on-fault correlation mask; (3) using more detailed, geologically constrained fault geometries and (4) incorporating additional campaign global positioning system (GPS) data. The refined slip models result in much smaller SSDs of 3-19 per cent. We suspect that the remaining minor SSD for these earthquakes likely reflects a combination of our elastic model's inability to fully account for near-surface deformation, which will render our estimates of shallow slip minima, and potentially small amounts of interseismic fault creep or triggered slip, which could `make up' a small percentages of the coseismic SSD during the interseismic period. Our results indicate that it is imperative that slip inversions include

  6. Controlling cyanobacterial blooms in hypertrophic Lake Taihu, China: will nitrogen reductions cause replacement of non-N2 fixing by N2 fixing taxa?

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  8. Characterisation of the water quality from open and rope-pump shallow wells in rural Cambodia.

    PubMed

    Bennett, H B; Shantz, A; Shin, G; Sampson, M L; Meschke, J S

    2010-01-01

    An 8 month investigation into the quality of water from open and rope-pump shallow wells in rural Cambodia was conducted. Wells were analysed for indicators of the health (arsenic, fluoride, manganese, nitrate, total coliforms, E. coli, male-specific coliphage) and aesthetic (iron, chloride, conductivity, total dissolved solids, hardnesss, turbidity, pH) quality of the water, and referenced to the Cambodian Drinking Water Standard when available. The shallow aquifer was chemically less of a health risk than the deep aquifer; however, microbial contamination was considerable for both shallow well types with mean E. coli loads of 10(3) CFU/100 mL and male-specific coliphage contamination of 10(2) PFU/eluate. Temporal variation in microbial contamination was significant (p<0.05), with overall loads decreasing during the dry season. The aesthetic quality of the water was poor for all samples, but worsened during the dry season. No significant difference was observed in the quality of water from open and rope-pump wells, despite their classification as unimproved and improved respectively by the WHO/UNICEF Joint Monitoring Programme. Contaminants present in both well types may readily be removed by simple water treatment, suggesting that household treatment may be more beneficial to rural Cambodian households than shallow aquifer source improvements.

  9. Postoperative ad lib feeding for hypertrophic pyloric stenosis.

    PubMed

    Carpenter, R O; Schaffer, R L; Maeso, C E; Sasan, F; Nuchtern, J G; Jaksic, T; Harberg, F J; Wesson, D E; Brandt, M L

    1999-06-01

    The aim of this study was to compare three methods of postoperative feeding after pyloromyotomy for hypertrophic pyloric stenosis (HPS). The authors reviewed retrospectively the charts of 308 patients who underwent pyloromyotomy for HPS from 1984 to 1997. Nineteen patients had prolonged hospitalization for other reasons and were excluded from the study, leaving 289 patients for analysis. All procedures were performed by a single group of pediatric surgeons. The individual preferences of these surgeons resulted in three different feeding schedules: R, strictly regimented (>12 hours nothing by mouth, then incremental feeding over > or =24 hours), I, intermediate (>8 hours nothing by mouth, then incremental feeding over <24 hours), or A, ad lib (< or =4 hours nothing by mouth, with or without a single small feeding, then ad lib feedings). Of the 289 patients, 248 (80.5%) were boys. The average age of the patients was 5.64 weeks (range, 1 to 21 weeks). A total of 265 of 289 (92%) were full term. Thirty-nine of 289 (13.5%) had a family history positive for pyloric stenosis. A total of 104 of 289 (36%) were first-born infants, 89 of 289 (31%) were second born. The diagnosis of pyloric stenosis was made by a combination of physical examination findings and diagnostic image for most patients. An "olive" was palpated in 60.6% of the patients. Sixty percent (60.4%) of patients had an upper gastrointestinal series performed, and 42.5% were examined by ultrasonography. Overall, 53% of the patients had postoperative emesis. Only 3.5% had emesis that persisted greater than 48 hours after surgery. Patients fed ad lib after pyloromyotomy had slightly more emesis (2.2 A v. 1.2 R, and 0.7 I episodes, P = .002), but tolerated full feedings sooner than patients fed with a regimented or intermediate schedule. No patient required additional therapy or readmission after tolerating two consecutive full feedings, suggesting that this might be a suitable discharge criterion for most

  10. IgG4-Related Disease and Hypertrophic Pachymeningitis

    PubMed Central

    Wallace, Zachary S.; Carruthers, Mollie N.; Khosroshahi, Arezou; Carruthers, Robert; Shinagare, Shweta; Stemmer-Rachamimov, Anat; Deshpande, Vikram

    2013-01-01

    Abstract Hypertrophic pachymeningitis (HP) is an inflammatory condition in which the dura mater of the cranium or spine becomes thickened, leading to symptoms that result from mass effect, nerve compression, or vascular compromise. The differential diagnosis of HP includes immune-mediated conditions such as rheumatoid arthritis and vasculitis, malignancies, and infections. Many times, no diagnosis is reached; in such cases, the disease has been described as idiopathic HP. IgG4-related disease (IgG4-RD) is a recently described inflammatory condition known to cause tumefactive lesions at myriad anatomical locations. Both IgG4-RD and idiopathic HP share similar demographics, histopathology, and natural history. We hypothesized that IgG4-RD is a common cause of idiopathic HP. To investigate this hypothesis, we identified all pathology specimens diagnosed as noninfectious HP during 25 years at our institution. Fourteen cases had stained slides and paraffin blocks to permit review of the original hematoxylin and eosin stained slides as well as immunostaining of cell blocks. Recently published consensus guidelines describing characteristic histopathology and the necessary quantity of IgG4+ plasma cell infiltrate were used to diagnose IgG4-RD. Four cases (66.6%) that had been regarded previously as representing idiopathic HP were diagnosed as IgG4-RD; of all the reviewed cases, IgG4-RD represented 29% of cases. Of the remaining cases, 3 cases were associated with granulomatosis with polyangiitis (GPA), 2 with lymphoma, and 1 each with rheumatoid arthritis, giant cell arteritis, and sarcoidosis. Two of the cases could not be diagnosed more precisely and were classified as undifferentiated HP. Clinical history, serologic tests, cerebrospinal fluid studies, and radiology alone could not identify the cause of HP. Rather, biopsy with histopathology and immunostaining was necessary to reach an accurate diagnosis. Significant IgG4+ plasma cell infiltrates were observed in

  11. Relationship between Regional Fat Distribution and Hypertrophic Cardiomyopathy Phenotype

    PubMed Central

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

    2016-01-01

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

  12. DDDR pacing for symptomatic patients with hypertrophic obstructive cardiomyopathy

    PubMed Central

    Achterberg, H.J.; Scheffer, M.G.; van Mechelen, R.; Kofflard, M.J.M.; ten Cate, F.J.

    2002-01-01

    Background Hypertrophic obstructive cardiomyopathy (HOCM) is a primary cardiac disorder with a heterogeneous expression. When medical therapy fails in patients with symptomatic HOCM, three additional therapeutic strategies exist: ventricular septal myectomy, alcohol-induced percutaneous transluminal septal myocardial ablation (PTSMA) of the first septal branch of the anterior descending artery and pacemaker implantation. In this paper we present the results of seven patients in whom a dual-chamber pacemaker was implanted to reduce the gradient in the left ventricular outflow tract (LVOT) and to relieve their symptoms. Methods In patients with drug refractory symptomatic HOCM, not eligible for surgery, pacemaker therapy was recommended. Symptomatic HOCM was defined as symptoms of angina and dyspnoea, functional class NYHA 3-4 and a resting LVOT gradient during Doppler echocardiography of more than 2.75 m/s (30 mmHg). In these patients, a dual-chamber pacemaker was implanted with a right ventricular lead positioned in the right ventricular apex and an atrial lead positioned in the right atrial appendage. In all patients the AV setting was programmed between 50 and 100 ms, using Doppler echocardiography to determine the optimal filling and to ensure ventricular capture. Results A statistically significant reduction of the LVOT gradient was observed in all patients. The pre-implantation gradient in the LVOT measured by Doppler echocardiography varied from 3-5.8 m/s with a mean of 4.7±1.1 m/s. The post-implantation gradient varied from 1.4-2.6 m/s with a mean of 1.9±0.4 m/s (p<0.001). Symptomatic improvement was present in all patients. NYHA functional class went from 3-4 (mean 3.1±0.5) pre-implantation to 1-2 mean (1.3±0.4) after implantation (p<0.001). During a mean follow-up of 2.3±1.1 years, the improvement in functional class was maintained. Conclusion Our preliminary results demonstrate that dual-chamber pacing is an effective and safe treatment for

  13. Quantitative measurement of hypertrophic scar: intrarater reliability, sensitivity, and specificity.

    PubMed

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

    2008-01-01

    The comparison of scar evaluation over time requires measurement tools with acceptable intrarater reliability and the ability to discriminate skin characteristics of interest. The objective of this study was to evaluate the intrarater reliability and sensitivity and specificity of the Cutometer, the Mexameter, and the DermaScan C relative to the modified Vancouver Scar Scale (mVSS) in patient-matched normal skin, normal scar (donor sites), and hypertrophic scar (HSc). A single investigator evaluated four tissue types (severe HSc, less severe HSc, donor site, and normal skin) in 30 burn survivors with all four measurement tools. The intraclass correlation coefficient (ICC) for the Cutometer was acceptable (> or =0.75) for the maximum deformation measure for the donor site and normal skin (>0.78) but was below the acceptable range for the HSc sites and all other parameters. The ICC for the Mexameter erythema (>0.75) and melanin index (>0.89) and the DermaScan C total thickness measurement (>0.82) were acceptable for all sites. The ICC for the total of the height, pliability, and vascularity subscales of the mVSS was acceptable (0.81) for normal scar but below the acceptable range for the scar sites. The DermaScan C was clearly able to discriminate HSc from normal scar and normal skin based on the total thickness measure. The Cutometer was less discriminating but was still able to discriminate HSc from normal scar and normal skin. The Mexameter erythema index was not a good discriminator of HSc and normal scar. Receiver operating characteristic curves were generated to establish the best cutoff point for the DermaScan C total thickness and the Cutometer maximum deformation, which were 2.034 and 0.387 mm, respectively. This study showed that although the Cutometer, the DermaScan C, and the Mexameter have measurement properties that make them attractive substitutes for the mVSS, caution must be used when interpreting results since the Cutometer has a ceiling effect when

  14. Clinical Utility of Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy

    PubMed Central

    2012-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  16. Noise From Shallow Underwater Explosions

    NASA Astrophysics Data System (ADS)

    Soloway, Alexander G.

    Naval activities such as ordnance disposal, demolition and requisite training, can involve detonation of small explosive charges in shallow water that have the potential to harm nearby marine life. Measurements of the underwater sound generated by sub-surface explosions were collected as part of a naval training exercise. In this thesis the noise levels from these explosions will be investigated using peak pressure, sound exposure level and energy spectral density. Measurements of very-low frequency Scholte interface waves will also be presented and used to investigate elastic parameters in the sediment.

  17. Contamination Control

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Upjohn Company sought a solution to their problem of potential particulate contamination of sterile injectable drugs. Contamination was caused by dust particles attracted by static electrical charge, which clung to plastic curtains in clean rooms. Upjohn found guidance in NASA Tech Briefs which provided detailed information for reducing static electricity. Guidelines for setting up static free work stations, materials and equipment needed to maintain antistatic protection.

  18. Anesthetic Management Guided by Transthoracic Echocardiography During Cesarean Delivery Complicated by Hypertrophic Cardiomyopathy.

    PubMed

    DesRoches, Jaclyn M; McKeen, Dolores Madeline; Warren, Andrew; Allen, Victoria M; George, Ronald B; Kells, Catherine; Shukla, Romesh

    2016-03-15

    We describe the management of a parturient woman with hypertrophic cardiomyopathy who developed a symptomatic accelerated idioventricular rhythm who required an urgent cesarean delivery at 32 weeks. Transthoracic echocardiography helped guide anesthetic management, including epidural dosing, fluid management, and phenylephrine infusion rates. This case demonstrates the application of transthoracic echocardiography to guide anesthetic management in a parturient woman at risk for cardiovascular compromise.

  19. [Apical hypertrophic myocardiopathy. Report of the first case identified on the American continent].

    PubMed

    Zanoniani, C; Guadalajara, J F; Gil, M; Medrano, G A; Vargas, J; Salazar, E

    1981-01-01

    What appears to be the first case of hypertrophic apical myocardiography described in the western hemisphere is presented in this report. The diagnosis was confirmed by angiocardiography and echocardiography. The electrocardiogram showed the characteristic giant T waves. It is of interest that the coronary radioangiography suggested alterations in the microcirculation which could explain the striking electrocardiographic pattern of subepicardial ischemia seen in these patients.

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

    PubMed

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

    2016-03-01

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

  1. Galangin inhibits hypertrophic scar formation via ALK5/Smad2/3 signaling pathway.

    PubMed

    Zhang, Yifan; Shan, Shengzhou; Wang, Jing; Cheng, Xinyu; Yi, Bo; Zhou, Jia; Li, Qingfeng

    2016-02-01

    Hypertrophic scar (HS) is characterized by excessive fibrosis associated with aberrant function of fibroblasts. Currently, no satisfactory drug has been developed to treat the disease. Here we found that a flavonoid natural product, galangin, could significantly attenuate hypertrophic scar formation in a mechanical load-induced mouse model. Both in vivo and in vitro studies demonstrated that galangin remarkably inhibited collagen production, proliferation, and activation of fibroblasts. Besides, galangin suppressed the contractile ability of hypertrophic scar fibroblasts. Further Western blot analysis revealed that galangin dose-dependently down-regulated Smad2 and Smad3 phosphorylation. Such bioactivity of galangin resulted from its selective targeting to the activin receptor-like kinase 5 (ALK5) was demonstrated by ALK5 knockdown and over-expression experiments. Taken together, this compound could simultaneously inhibit both the accumulation of collagen and abnormal activation/proliferation of fibroblasts, which were the two pivotal factors for hypertrophic scar formation, thus suggesting that galangin serves as a potential agent for treatment of HS or other fibroproliferative disorders.

  2. Hair-thread tourniquet syndrome of the hypertrophic clitoris in a 6-year-old girl.

    PubMed

    Parlak, Mesut; Karakaya, Ali Erdal

    2015-05-01

    Hair-thread tourniquet syndrome is defined as the ischemic strangulation of hair resulting in edema and severe pain and may cause amputation of organs. Strangulation of the external genitalia (clitoris, labia minora) has rarely been described in girls. Here, we present a case of hypertrophic clitoris injury secondary to hair strangulation in a 6-year-old girl.

  3. [Right ventricular involvement in hypertrophic cardiomyopathy. A case report and brief review of the literature].

    PubMed

    Comella, Alessandro; Magnacca, Massimo; Gistri, Roberto; Lombardi, Massimo; Neglia, Danilo; Poddighe, Rosa; Pesola, Antonio

    2004-02-01

    A clinical case of non-obstructive hypertrophic cardiomyopathy with involvement of the right ventricle is reported. The patient was a 42-year-old male with symptoms suggesting an effort angina of recent onset. The diagnosis was established by echocardiography, which showed asymmetric hypertrophy of the interventricular septum (20 mm), hypertrophy of the right ventricular free wall, and severe hypertrophy of the septal papillary muscle of the tricuspid valve. The patient underwent a complete diagnostic evaluation, including exercise stress test, Holter monitoring, magnetic resonance, myocardial tomoscintigraphy and complete hemodynamic assessment. Medical treatment with atenolol 50 mg day was started; at 1-year follow-up the patient's clinical conditions are good, with decrease of anginal episodes. The literature review elicits the paucity of information about this condition, despite a frequent involvement of both ventricles in hypertrophic obstructive cardiomyopathy. The case reported shows two atypical aspects: a) the involvement of the right ventricle in non-obstructive hypertrophic cardiomyopathy is anecdotal; b) this pattern of hypertrophy (right ventricular free wall/septal papillary muscle) has never been previously reported. Right ventricular involvement in patients with hypertrophic cardiomyopathy must be carefully investigated, because it may be more frequent than conventionally deemed.

  4. Clinical features and outcomes of childhood hypertrophic cardiomyopathy: results from a national population-based study.

    PubMed

    Nugent, Alan W; Daubeney, Piers E F; Chondros, Patty; Carlin, John B; Colan, Steven D; Cheung, Michael; Davis, Andrew M; Chow, C W; Weintraub, Robert G

    2005-08-30

    Population-based studies have provided insight into the natural history of adult hypertrophic cardiomyopathy, but comparable information for affected children is lacking. All Australian children who presented with primary cardiomyopathy at 0 to 10 years of age between January 1, 1987, and December 31, 1996, were enrolled in a longitudinal cohort study. A single cardiologist reviewed serial cardiac investigations on each subject. A total of 80 subjects with hypertrophic cardiomyopathy were identified. An underlying syndromal, genetic, or metabolic condition was identified in 46 subjects (57.5%). There were no cases of sudden death at presentation. Left ventricular outflow tract obstruction was present in 32 subjects (40%); right ventricular outflow obstruction was present in 10 (12.5%). Freedom from death or transplantation was 83% (95% CI, 73 to 90) 5 years after presentation and 76% (95% CI, 62 to 86) 10 years after presentation. By proportional-hazards regression analysis, risk factors for death or transplantation included concentric left ventricular hypertrophy, age at presentation <1 year, lower initial fractional shortening Z score, and increasing left ventricular posterior wall thickness relative to body surface area. At the latest follow-up, 54 of 65 surviving subjects had no symptoms, and 46 were receiving no regular medication. Syndromal, genetic, and metabolic causes predominate in children with hypertrophic cardiomyopathy. Ventricular outflow tract obstruction is common. The clinical status of long-term survivors is good. This population-based study identifies children with hypertrophic cardiomyopathy who are at risk of adverse events.

  5. Missense mutation of the {beta}-cardiac myosin heavy-chain gene in hypertrophic cardiomyopathy

    SciTech Connect

    Arai, Shoichi; Matsuoka, Rumiko; Hirayama, Kenji; Sakurai, Hisanao

    1995-09-11

    Hypertrophic cardiomyopathy occurs as an autosomal dominant familial disorder or as a sporadic disease without familial involvement. We describe a missense mutation of the {beta}-cardiac myosin heavy chain (MHC) gene, a G to T transversion (741 Gly{r_arrow}Trp) identified by direct sequencing of exon 20 in four individuals affected with familial hypertrophic cardiomyopathy. Three individuals with sporadic hypertrophic cardiomyopathy, whose parents are clinically and genetically unaffected, had sequence variations of exon 34 of the {alpha}-cardiac MHC gene (a C to T transversion, 1658 Asp{r_arrow}Asp, resulting in FokI site polymorphism), of intron 33 of the {alpha}-cardiac MHC gene (a G to A and an A to T transversion), and also of intron 14 of the {beta}-cardiac MHC gene (a C to T transversion in a patient with Noonan syndrome). Including our case, 30 missense mutations of the {beta}-cardiac MHC gene in 49 families have been reported thus far worldwide. Almost all are located in the region of the gene coding for the globular head of the molecule, and only one mutation was found in both Caucasian and Japanese families. Missense mutations of the {Beta}-cardiac MHC gene in hypertrophic cardiomyopathy may therefore differ according to race. 29 refs., 6 figs., 3 tabs.

  6. Three patients presenting with severe macrosomia and congenital hypertrophic cardiomyopathy: a case series.

    PubMed

    Vincent, Marie; Benbrik, Nadir; Romefort, Bénédicte; Colombel, Agnès; Bézieau, Stéphane; Isidor, Bertrand

    2017-03-24

    Macrosomia and hypertrophic cardiomyopathy are two features often associated in neonates of diabetic mothers. We report the cases of three patients with severe macrosomia and critical hypertrophic cardiomyopathy without severely unbalanced maternal diabetes. Only three patients with those two features and no uncontrolled maternal diabetes have been previously reported. The first patient was a 39-week-old girl, the second patient was a 39-week-old girl, and the third patient was a 41-week-old boy. The two French girls and the French boy had severe macrosomia and hypertrophic cardiomyopathy, leading to the death of the boy. The outcome of the two girls was favorable, with a standardization of growth curves and ventricular hypertrophy. Their mothers presented with high body mass index but no severe documented maternal diabetes; glycemic imbalance was only suspected on postnatal analyses. There was no hydramnios during pregnancy and no other environmental factor, especially toxic exposure. Their parents are from Mayotte, Guadeloupe, and Guinea-Conakry. The usual genetics causes, Beckwith-Wiedemann syndrome, and chromosomal copy number variation, were also excluded. This report suggests the implication of other factors in addition to glycemic disorders, including genetic factors, in the occurrence of macrosomia and severe hypertrophic cardiomyopathy in neonates. These three original observations indicate that gynecologists and neonatologists should pay attention to neonates from mothers with a high body mass index and when maternal diabetes is not documented.

  7. Osteogenic Treatment Initiating a Tissue-Engineered Cartilage Template Hypertrophic Transition.

    PubMed

    Fu, J Y; Lim, S Y; He, P F; Fan, C J; Wang, D A

    2016-10-01

    Hypertrophic chondrocytes play a critical role in endochondral bone formation as well as the progress of osteoarthritis (OA). An in vitro cartilage hypertrophy model can be used as a platform to study complex molecular mechanisms involved in these processes and screen new drugs for OA. To develop an in vitro cartilage hypertrophy model, we treated a tissue-engineered cartilage template, living hyaline cartilaginous graft (LhCG), with osteogenic medium for hypertrophic induction. In addition, endothelial progenitor cells (EPCs) were seeded onto LhCG constructs to mimic vascular invasion. The results showed that osteogenic treatment significantly inhibited the synthesis of endostatin in LhCG constructs and enhanced expression of hypertrophic marker-collagen type X (Col X) and osteogenic markers, as well as calcium deposition in vitro. Upon subcutaneous implantation, osteogenic medium-treated LhCG constructs all stained positive for Col X and showed significant calcium deposition and blood vessel invasion. Col X staining and calcium deposition were most obvious in osteogenic medium-treated only group, while there was no difference between EPC-seeded and non-seeded group. These results demonstrated that osteogenic treatment was of the primary factor to induce hypertrophic transition of LhCG constructs and this model may contribute to the establishment of an in vitro cartilage hypertrophy model.

  8. Scar management practice and science: a comprehensive approach to controlling scar tissue and avoiding hypertrophic scarring.

    PubMed

    Widgerow, Alan David; Chait, Laurence A

    2011-12-01

    A meta-analysis of the literature forms the basis of a treatment regimen focused on the principles of support, controlled inflammation, hydration, and hastened collagen remodeling. The presented clinical trial avoided hypertrophic scarring in more than 80% of cases, validating the theory of targeting many areas of scar control in 1 approach.

  9. Marked left ventricular hypertrophy mimicking hypertrophic cardiomyopathy associated with steroid therapy for congenital adrenal hyperplasia.

    PubMed

    Scirè, Giuseppe; D'Anella, Giorgio; Cristofori, Laura; Mazzuca, Valentina; Cianfarani, Stefano

    2007-06-01

    We describe a child treated with high-dose steroid therapy for congenital adrenal hyperplasia who showed marked left ventricular hypertrophy mimicking hypertrophic cardiomyopathy associated with steroid therapy for congenital adrenal hyperplasia. Cardiomyopathy reversed completely when an appropriate steroid therapeutic regimen was established.

  10. The effect of burn rehabilitation massage therapy on hypertrophic scar after burn: a randomized controlled trial.

    PubMed

    Cho, Yoon Soo; Jeon, Jong Hyun; Hong, Aram; Yang, Hyeong Tae; Yim, Haejun; Cho, Yong Suk; Kim, Do-Hern; Hur, Jun; Kim, Jong Hyun; Chun, Wook; Lee, Boung Chul; Seo, Cheong Hoon

    2014-12-01

    To evaluate the effect of burn rehabilitation massage therapy on hypertrophic scar after burn. One hundred and forty-six burn patients with hypertrophic scar(s) were randomly divided into an experimental group and a control group. All patients received standard rehabilitation therapy for hypertrophic scars and 76 patients (massage group) additionally received burn scar rehabilitation massage therapy. Both before and after the treatment, we determined the scores of visual analog scale (VAS) and itching scale and assessed the scar characteristics of thickness, melanin, erythema, transepidermal water loss (TEWL), sebum, and elasticity by using ultrasonography, Mexameter(®), Tewameter(®), Sebumeter(®), and Cutometer(®), respectively. The scores of both VAS and itching scale decreased significantly in both groups, indicating a significant intragroup difference. With regard to the scar characteristics, the massage group showed a significant decrease after treatment in scar thickness, melanin, erythema, TEWL and a significant intergroup difference. In terms of scar elasticity, a significant intergroup difference was noted in immediate distension and gross skin elasticity, while the massage group significant improvement in skin distensibility, immediate distension, immediate retraction, and delayed distension. Our results suggest that burn rehabilitation massage therapy is effective in improving pain, pruritus, and scar characteristics in hypertrophic scars after burn. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  11. Primary hypertrophic osteoarthropathy with myelofibrosis and anemia: a case report and review of literature

    PubMed Central

    Li, Sheyu; Li, Qianrui; Wang, Qin; Chen, Decai; Li, Jianwei

    2015-01-01

    Primary hypertrophic osteoarthropathy (PHO) is a rare and usually benign disorder of bone and connective tissue growth. Here we present a 28-year-old male patient presenting to our hospital with PHO and symptomatic anemia. Bone marrow biopsy suggested myelofibrosis, a serious complication of PHO, which is often neglected upon admission, but may lead to life-threatening anemia. PMID:25785156

  12. Transforming growth factor alpha controls the transition from hypertrophic cartilage to bone during endochondral bone growth.

    PubMed

    Usmani, Shirine E; Pest, Michael A; Kim, Gunwoo; Ohora, Sara N; Qin, Ling; Beier, Frank

    2012-07-01

    We have recently identified transforming growth factor alpha (TGFα) as a novel growth factor involved in the joint disease osteoarthritis. The role of TGFα in normal cartilage and bone physiology however, has not been well defined. The objective of this study was to determine the role of TGFα in bone development through investigation of the Tgfa knockout mouse. The gross skeletons as well as the cartilage growth plates of Tgfa knockout mice and their control littermates were examined during several developmental stages ranging from newborn to ten weeks old. Knockout mice experienced skeletal growth retardation and expansion of the hypertrophic zone of the growth plate. These phenotypes were transient and spontaneously resolved by ten weeks of age. Tgfa knockout growth plates also had fewer osteoclasts along the cartilage/bone interface. Furthermore, knockout mice expressed less RUNX2, RANKL, and MMP13 mRNA in their cartilage growth plates than controls did. Tgfa knockout mice experience a delay in bone development, specifically the conversion of hypertrophic cartilage to true bone. The persistence of the hypertrophic zone of the growth plate appears to be mediated by a decrease in MMP13 and RANKL expression in hypertrophic chondrocytes and a resulting reduction in osteoclast recruitment. Overall, TGFα appears to be an important growth factor regulating the conversion of cartilage to bone during the process of endochondral ossification. Copyright © 2012 Elsevier Inc. All rights reserved.

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

    PubMed Central

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

    2014-01-01

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

  14. MicroRNA 181b regulates decorin production by dermal fibroblasts and may be a potential therapy for hypertrophic scar.

    PubMed

    Kwan, Peter; Ding, Jie; Tredget, Edward E

    2015-01-01

    Hypertrophic scarring is a frequent fibroproliferative complication following deep dermal burns leading to impaired function and lifelong disfigurement. Decorin reduces fibrosis and induces regeneration in many tissues, and is significantly downregulated in hypertrophic scar and normal deep dermal fibroblasts. It was hypothesized that microRNAs in these fibroblasts downregulate decorin and blocking them would increase decorin and may prevent hypertrophic scarring. Lower decorin levels were found in hypertrophic scar as compared to normal skin, and in deep as compared to superficial dermis. A decorin 3' un-translated region reporter assay demonstrated microRNA decreased decorin in deep dermal fibroblasts, and microRNA screening predicted miR- 24, 181b, 421, 526b, or 543 as candidates. After finding increased levels of mir-181b in deep dermal fibroblasts, it was demonstrated that TGF-β1 stimulation decreased miR-24 but increased miR-181b and that hypertrophic scar and deep dermis contained increased levels of miR-181b. By blocking miR-181b with an antagomiR, it was possible to increase decorin protein expression in dermal fibroblasts. This suggests miR-181b is involved in the differential expression of decorin in skin and wound healing. Furthermore, blocking miR-181b reversed TGF-β1 induced decorin downregulation and myofibroblast differentiation in hypertrophic scar fibroblasts, suggesting a potential therapy for hypertrophic scar.

  15. Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis

    PubMed Central

    Ogawa, Rei

    2017-01-01

    Keloids and hypertrophic scars are caused by cutaneous injury and irritation, including trauma, insect bite, burn, surgery, vaccination, skin piercing, acne, folliculitis, chicken pox, and herpes zoster infection. Notably, superficial injuries that do not reach the reticular dermis never cause keloidal and hypertrophic scarring. This suggests that these pathological scars are due to injury to this skin layer and the subsequent aberrant wound healing therein. The latter is characterized by continuous and histologically localized inflammation. As a result, the reticular layer of keloids and hypertrophic scars contains inflammatory cells, increased numbers of fibroblasts, newly formed blood vessels, and collagen deposits. Moreover, proinflammatory factors, such as interleukin (IL)-1α, IL-1β, IL-6, and tumor necrosis factor-α are upregulated in keloid tissues, which suggests that, in patients with keloids, proinflammatory genes in the skin are sensitive to trauma. This may promote chronic inflammation, which in turn may cause the invasive growth of keloids. In addition, the upregulation of proinflammatory factors in pathological scars suggests that, rather than being skin tumors, keloids and hypertrophic scars are inflammatory disorders of skin, specifically inflammatory disorders of the reticular dermis. Various external and internal post-wounding stimuli may promote reticular inflammation. The nature of these stimuli most likely shapes the characteristics, quantity, and course of keloids and hypertrophic scars. Specifically, it is likely that the intensity, frequency, and duration of these stimuli determine how quickly the scars appear, the direction and speed of growth, and the intensity of symptoms. These proinflammatory stimuli include a variety of local, systemic, and genetic factors. These observations together suggest that the clinical differences between keloids and hypertrophic scars merely reflect differences in the intensity, frequency, and duration of

  16. Organic contaminant amplification during snowmelt.

    PubMed

    Meyer, Torsten; Wania, Frank

    2008-04-01

    The release of organic contaminants from melting snow poses risks to aquatic and terrestrial organisms and to humans who rely on drinking water and food production from regions that are seasonally snow-covered. Measured and model-predicted spring peak concentrations in waters receiving snowmelt motivate a thorough investigation of organic contaminant behaviour during melting. On the basis of the current understanding of snow metamorphosis, snowmelt hydrology and chemical partitioning in snow, this critical review aims to provide a qualitative picture of the processes involved in the release of organic contaminants from a melting snowpack. The elution sequence of organic substances during snowmelt is strongly dependent on their environmental partitioning properties and the physical properties of the snowpack. Water-soluble organic contaminants can be discharged in greatly elevated concentrations at an early stage of melting, while the bulk of the hydrophobic chemicals attached to particles is often released at the end of the melt period. Melting of a highly metamorphosed and deep snowpack promotes such shock load releases, whereas a shallow snow cover over a relatively warm ground experiencing irregular melting over the winter season is unlikely to generate notable peak releases of organic substances. Meltwater runoff over frozen ground directly transfers contaminant shock loads into receiving water bodies, while permeable soils buffer and dilute the contaminants. A more quantitative understanding of the behaviour of organic contaminants in varying snowmelt scenarios will depend on controlled laboratory studies combined with field investigations. Reliable numerical process descriptions will need to be developed to integrate water quality and contaminant fate models.

  17. Designing shallow donors in diamond

    NASA Astrophysics Data System (ADS)

    Moussa, Jonathan

    2015-03-01

    The production of n-type semiconducting diamond has been a long-standing experimental challenge. The first-principles simulation of shallow dopants in semiconductors has been a long-standing theoretical challenge. A desirable theoretical goal is to identify impurities that will act as shallow donors in diamond and assess their experimental viability. I will discuss this identification process for the LiN4 donor complex. It builds a scientific argument from several models and computational results in the absence of computational tools that are both trustworthy and computationally tractable for this task. I will compare the theoretical assessment of viability with recent experimental efforts to co-dope diamond with lithium and nitrogen. Finally, I discuss the computational tools needed to facilitate future work on this problem and some preliminary simulations of donors near diamond surfaces. Sandia National Laboratories is a multi-program lab managed and operated by Sandia Corp., a wholly owned subsidiary of Lockheed Martin Corp., for the U.S. Department of Energy's National Nuclear Security Administration under Contract DE-AC04-94AL85000.

  18. Response of phytoplankton to protective-restoration treatments enhancing water quality in a shallow urban lake.

    PubMed

    Zębek, Elżbieta; Napiórkowska-Krzebietke, Agnieszka

    2016-11-01

    Lake Jeziorak Mały is a shallow urban lake where storm water pretreatment separators and a fountain-based water aeration system were installed as protective-restoration measures to enhance water quality. We investigated the effect of these procedures on phytoplankton dynamics and physicochemical properties in the littoral and pelagial zones in 1996-2003, 2005, and 2013. A decrease in cyanobacteria proportion, abundance, and biomass has been noticed, and other phytoplankton groups increased after these procedures. Significantly elevated species diversity was recorded in the littoral zone with the exchange of cyanobacteria and diatom dominant species typically induced by alteration from hypertrophic to eutrophic status. For example, the polytrophic Limnothrix redekei was replaced by eutrophic Planktolyngbya brevicellularis. This stemmed from greater oxygenation, water visibility and diminished pH, conductivity, and orthophosphates. Our results showed that introducing these restoration measures influence on the long-term succession of phytoplankton and induced the change from a polytrophic to eutrophic state, and that such measures are vitally important in future considerations of shallow urban lake management.

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

    PubMed

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

    2015-01-01

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

  20. Potential Molecular Mechanisms Involved in 5-Aminolevulinic Acid-Based Photodynamic Therapy against Human Hypertrophic Scars.

    PubMed

    Chang, Mengling; Ma, Xiaorong; Ouyang, Tianxiang; Lin, Jun; Liu, Jun; Xiao, Yan; Chen, Huiping; Yu, Jie; Huang, Yingying; Xu, Miao

    2015-10-01

    Hypertrophic scars are manifestations of an abnormal process of tissue repair. Although photodynamic therapy is a promising treatment, details of the mechanisms underlying its inhibitory effects remain to be elucidated. Fibroblasts were isolated from human hypertrophic scar specimens and subjected to photodynamic therapy; 5-aminolevulinic acid was used as a photosensitizer. The accumulation of 5-aminolevulinic acid-derived protoporphyrin IX was detected under fluorescence microscopy. The potential cytotoxicity of 5-aminolevulinic acid alone and with photodynamic therapy was measured by 3-(4,5-dimethylthiazol-2-yl)2,5-diphenyltetrazolium bromide. Hoechst 33258 staining and flow cytometry were conducted to search for clues to apoptosis. Protein and/or mRNA expression levels of apoptosis-related pathways and other hypertrophic scar pathogenesis-associated signaling were investigated by Western blot analysis and/or real-time polymerase chain reaction. Protoporphyrin IX accumulation peak was achieved at 1.0 mM 5-aminolevulinic acid. 5-Aminolevulinic acid ranging from 0 to 1.0 mM was demonstrated to be noncytotoxic but reduced cell viabilities in a dose-dependent manner with acid-based photodynamic therapy were demonstrated. Reduction of cell viability was attributed mainly to cell apoptosis and probably to mechanisms such as up-regulation of p53/p21, Bax/Bcl-2 ratio, and cleaved caspase-3. Concurrently, deregulation of transforming growth factor-β1-mediated signaling, serving as another putative mechanism underlying hypertrophic scar formation, was found to be reversely modulated in response to acid-based photodynamic therapy. The p53-related apoptosis pathway and transforming growth factor-β1-mediated signaling may be important factors used to predict and evaluate the treatment outcomes of 5-aminolevulinic acid-based photodynamic therapy used in hypertrophic scar patients. Therapeutic, V.

  1. Identification of sirtuin 1 as a promising therapeutic target for hypertrophic scars

    PubMed Central

    Bai, Xiao‐Zhi; Liu, Jia‐Qi; Yang, Long‐Long; Fan, Lei; He, Ting; Su, Lin‐Lin; Shi, Ji‐Hong; Tang, Chao‐Wu

    2016-01-01

    Background and Purpose Sirtuin1 (SIRT1), the founding member of mammalian class III histone deacetylases, is reported to be a drug target involved in fibrotic diseases. However, whether it is an effective drug target in hypertrophic scar treatment is still not known. Experimental Approach In the present study, we observed that SIRT1 localized to both the epidermis and the dermis of skin tissues by immunohistochemistry. After knock‐down of SIRT1 by shRNA or up‐regulating SIRT1 by resveratrol, the expression of α‐SMA, Col1 and Col3 in fibroblasts were detected by western blots. A mouse excision wound healing model was used to observe the changes in collagen fibre associated with the different expression levels of SIRT1. Key Results SIRT1 expression was inhibited in hypertrophic scar tissue. The down‐regulation of SIRT1 resulted in an increased expression of α‐SMA, Col1 and Col3 in hypertrophic scar‐derived fibroblasts. In contrast, the up‐regulation of SIRT1 not only inhibited the expression of α‐SMA, Col1 and Col3 in hypertrophic scar‐derived fibroblasts but also blocked the activation of TGFβ1‐induced normal skin‐derived fibroblasts. In the mouse model of wound healing, the deletion of SIRT1 resulted in denser collagen fibres and a more disordered structure, whereas resveratrol treatment led to a more organized and thinner collagen fibre, which was similar to that observed during normal wound healing. Conclusions and Implications The results revealed that SIRT1 negatively regulates TGFβ1‐induced fibroblast activation and inhibits excessive scar formation and is, therefore, a promising drug target for hypertrophic scar formation. PMID:26891034

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

    PubMed Central

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

    2015-01-01

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

  3. [Sigmoid septum: A variant of the ventricular hypertrophy or of the hypertrophic cardiomyopathy?].

    PubMed

    Gentille-Lorente, Delicia; Salvadó-Usach, Teresa

    2016-01-01

    Sigmoid septum and hypertrophic cardiomyopathy presenting with left ventricular hypertrophy and, although they appear to be different entities, often involve problems in the differential diagnosis. This study was carried out to assess the prevalence and characteristics of the echocardiographic sigmoid septum and its differential findings regarding hypertrophic cardiomyopathy. Descriptive, observational and prospective study. A total of 1,770 patients were studied by echocardiography. Sigmoid septum (focal and isolated hypertrophy of the basal interventricular septum≥13mm in men and ≥12mm in women, exceeding ≥50% of the median septum thickness) was classified as «Type 1» (≤14mm) and «Type 2» (≥15mm). There were 59 cases of sigmoid septum (prevalence of 3.3%): 26 (1.5%) patients with type 1 (50% male) and 33 (1.9%) patients with type 2 (72.7% male); there were 25 (1.4%) cases of hypertrophic cardiomyopathy (76% male). The group with type 2 sigmoid septum differed from hypertrophic cardiomyopathy in: was older (73±10.5years; P<.0001), with more hypertension (84.8%; P<.0001), lower glomerular filtering (73.3±21.4ml/min; P=.007), lower repolarization abnormalities (18.2%; P=.004) and Cornell index (in men, 22.2±11mm; P=.041), more diastolic dysfunction (75%; P=.0089) and in ventricular morphology and fibrosis location in magnetic resonance. Regarding the hypertrophic cardiomyopathy, patients with type 2 sigmoid septum are older and generally hypertensive; otherwise, often they have no clear differences in their clinical, electrocardiographic or echocardiographic characteristics. Therefore, cardiac resonance is helpful in the differential diagnosis. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  4. Anti-inflammatory cytokine TSG-6 inhibits hypertrophic scar formation in a rabbit ear model.

    PubMed

    Wang, Hui; Chen, Zhao; Li, Xiao-Jing; Ma, Li; Tang, Yue-Ling

    2015-03-15

    Hypertrophic scars are characterized by excessive fibrosis and extracellular matrix (ECM) deposition and can be functionally and cosmetically problematic; however, there are few satisfactory treatments for controlling hypertrophic scars. The inflammatory cells and cytokines involved in excessive inflammation during wound healing facilitate fibroblast proliferation and collagen deposition, leading to pathologic scar formation. TSG-6 exhibits anti-inflammatory activity. This study examined the effect of recombinant TSG-6 on inflammation in hypertrophic scars using a rabbit ear model. Six 7-mm, full-thickness, circular wounds were made on the ears of 12 rabbits. TSG-6 and PBS were intradermally injected into the right and left ear wounds, respectively. The methods of TEM and TUNEL were used to detect fibroblast apoptosis. The expressions of inflammatory factors: IL-1β, IL-6 and TNF-α, were detected by immunohistochemistry and real time polymerase chain reaction. Collagen I and III expression detected by immunohistochemistry and Masson׳s trichrome staining and SEI (scar elevation index) was used to evaluate the extent of scarring. TSG-6 injection mitigated the formation of a hypertrophic scar in the rabbit ear. TSG-6-treated wounds exhibited decreased inflammation compared with the control group, as evidenced by the lower levels of IL-1β, IL-6, TNF-α and MPO. The SEI and the synthesis of collagens I and III were significantly decreased in the TSG-6-treated scars compared with control scars. The apoptosis rate was higher in the TSG-6-treated scars. TSG-6 exhibited anti-inflammatory effects during the wound healing process and cicatrization and significantly diminished hypertrophic scar formation in a rabbit ear model.

  5. Comparative effect and safety of verapamil in keloid and hypertrophic scar treatment: a meta-analysis

    PubMed Central

    Li, Zhouna; Jin, Zhehu

    2016-01-01

    Background Keloids and hypertrophic scars are the most common types of pathological scarring. Traditionally, keloids have been considered as a result of aberrant wound healing, involving excessive fibroblast participation that is characterized by hyalinized collagen bundles. However, the usefulness of this characterization has been questioned. In recent years, studies have reported the appropriate use of verapamil for keloids and hypertrophic scars. Methods Searches were conducted on the databases Medline, Embase, Cochrane, PubMed, and China National Knowledge Infrastructure from 2006 to July 2016. State12.0 was used for literature review, data extraction, and meta-analysis. Treatment groups were divided into verapamil and nonverapamil group. Nonverapamil group includes steroids and intense pulsed light (IPL) therapy. Total effective rates include cure rate and effective rate. Cure: skin lesions were completely flattened, became soft and symptoms disappeared. Efficacy: skin lesions subsided, patient significantly reduced symptoms. Inefficient definition of skin was progression free or became worse. Random-effects model was used for the meta-analysis. Results Six studies that included 331 patients with keloids and hypertrophic scars were analyzed. Analysis of the total effective rate of skin healing was performed. The total effective rates in the two groups were 54.07% (verapamil) and 53.18% (nonverapamil), respectively. The meta-analysis showed that there was no difference between the two groups. We also compared the adverse reactions between the verapamil treatment group and the steroids treatment group in two studies, and the result indicated that the verapamil group showed less adverse reactions. Conclusion There were no differences between the application of verapamil and nonverapamil group in keloids and hypertrophic scars treatment. Verapamil could act as an effective alternative modality in the prevention and treatment of keloid and hypertrophic scars. A

  6. Down to 2 nm Ultra Shallow Junctions : Fabrication by IBS Plasma Immersion Ion Implantation Prototype PULSION registered

    SciTech Connect

    Torregrosa, Frank; Etienne, Hasnaa; Mathieu, Gilles; Roux, Laurent

    2006-11-13

    Classical beam line implantation is limited in low energies and cannot achieve P+/N junctions requirements for <45nm node. Compared to conventional beam line ion implantation, limited to a minimum of about 200 eV, the efficiency of Plasma Immersion Ion Implantation (PIII) is no more to prove for the realization of Ultra Shallow Junctions (USJ) in semiconductor applications: this technique allows to get ultimate shallow profiles (as implanted) thanks to no lower limitation of energy and offers high dose rate. In the field of the European consortium NANOCMOS, Ultra Shallow Junctions implanted on a semi-industrial PIII prototype (PULSION registered ) designed by the French company IBS, have been studied. Ultra shallow junctions implanted with BF3 at acceleration voltages down to 20V were realized. Contamination level, homogeneity and depth profile are studied. The SIMS profiles obtained show the capability to make ultra shallow profiles (as implanted) down to 2nm.

  7. Nitrogen related shallow thermal donors in silicon

    NASA Astrophysics Data System (ADS)

    Fujita, N.; Jones, R.; Öberg, S.; Briddon, P. R.

    2007-07-01

    In this letter, the authors investigate the electrical properties of nitrogen related shallow thermal donor (STD) candidates and their concentrations under different doping conditions by means of density functional theory. Experimentally, the existence of STDs containing one nitrogen atom and both even and odd numbers of oxygen atoms has been proposed. However, so far first principles studies have not presented a candidate for the latter. Here, they show that the NO defect possesses a shallow donor level. Adding one or two more oxygen atoms results in the donor level to become shallower. The fraction of shallow nitrogen related donors to N dimers increases in material with low concentration of nitrogen.

  8. Environmental contaminants

    USGS Publications Warehouse

    Hoffman, D.J.; Rattner, B.A.; Scheunert, I.; Korte, F.; Shore, Richard F.; Rattner, Barnett A.

    2001-01-01

    The purpose of this chapter is to provide an overview of the ecotoxicology of major classes of environmental contaminants, with respect to sources, environmental chemistry, most likely routes of exposure, potential bioaccumulation and biomagification, mechanisms of toxicity, and effects on potentially vulnerable species of mammalian wildlife. Major contaminants reviewed were selected on the basis of their use patterns, availability and potential toxicity to wild mammals. These included pesticides used in agroecosystems (organochlorines, organophosphorus and carbamate compounds, anticoagulants, herbicides and fungicides), various organic pollutants (chlorobenzenes, chlorophenols, polychlorinated biphenyls, dibenzodioxins and dibenzofurans, and polycyclic aromatic hydrocarbons), heavy metals (lead, mercury, and cadmium), agricultural drainwater mixtures, leachates and radionuclides. Many of the above aspects of ecotoxicology and contaminants will be expanded upon in subsequent chapters of this book as they relate to distinct mammalian species and potential risk.

  9. Shallow land burial technology: Humid

    NASA Astrophysics Data System (ADS)

    Davis, E. C.; Yeh, G. T.

    Trench lining and grouting, are being demonstrated and evaluated experimental trenches containing compacted low-level waste. Two finite-element hydrologic models were developed to model water movement and solute transport at a waste disposal site. Though the economic analysis of the two trench treatments favored Hypalon lining, results of field experiments examining waste hydrologic isolation favored the cement-bentonite grout treatment. Data from water pump-out and water pump-in tests suggest that the original goal of constructing watertight liners in three experimental trenches was not achieved. Trench-cover subsidence measured over two of the three lined trenches did not occur over any of the three grouted or three control (untreated) trenches. Results indicate that the cement-bentonite treatment provides a degree of waste isolation not afforded by the lined and control trenches and should be considered for use at shallow land burial (SLB) sites with water-related problems.

  10. Shallow cumulus rooted in photosynthesis

    NASA Astrophysics Data System (ADS)

    Vilá-Guerau de Arellano, Jordi; Ouwersloot, Huug G.; Baldocchi, Dennis; Jacobs, Cor M. J.

    2014-03-01

    We study the interactions between plant evapotranspiration, controlled by photosynthesis (C3 and C4 grasses), and moist thermals responsible for the formation of shallow cumulus clouds (SCu). Our findings are based on a series of systematic numerical experiments at fine spatial and temporal scales using large eddy simulations explicitly coupled to a plant-physiology model. The shading provided by SCu leads to strong spatial variability in photosynthesis and the surface energy balance. This in turn results in SCu characterized by less extreme and less skewed values of liquid water path. The larger water use efficiency of C4 grass leads to two opposite effects that influence boundary layer clouds: more vigorous and deeper thermals due to the larger buoyancy surface flux (positive effect) characterized by less moisture content (negative). We find that under these midlatitude and well-watered soil conditions, SCu are characterized by a larger cloud cover and liquid water path over C4 grass fields.

  11. (Contaminated soil)

    SciTech Connect

    Siegrist, R.L.

    1991-01-08

    The traveler attended the Third International Conference on Contaminated Soil, held in Karlsruhe, Germany. The Conference was a status conference for worldwide research and practice in contaminated soil assessment and environmental restoration, with more than 1500 attendees representing over 26 countries. The traveler made an oral presentation and presented a poster. At the Federal Institute for Water, Soil and Air Hygiene, the traveler met with Dr. Z. Filip, Director and Professor, and Dr. R. Smed-Hildmann, Research Scientist. Detailed discussions were held regarding the results and conclusions of a collaborative experiment concerning humic substance formation in waste-amended soils.

  12. Contamination study

    NASA Technical Reports Server (NTRS)

    Johnson, R. Barry; Herren, Kenneth A.

    1990-01-01

    The time dependence of the angular reflectance from molecularly contaminated optical surfaces in the Vacuum Ultraviolet (VUV) is measured. The light scattering measurements are accomplished in situ on optical surfaces in real time during deposition of molecular contaminants. The measurements are taken using non-coherent VUV sources with the predominant wavelengths being the Krypton resonance lines at 1236 and 1600 A. Detection of the scattered light is accomplished using a set of three solar blind VUV photomultipliers. An in-plane VUV BRDF (Bidirectional Reflectance Distribution Functions) experiment is described and details of the ongoing program to characterize optical materials exposed to the space environment is reported.

  13. The combined use of cryosurgery and intralesional injections of suspensions of fluorinated adrenocorticosteroids for reducing keloids and hypertrophic scars.

    PubMed

    Ceilley, R I; Babin, R W

    1979-01-01

    Freezing with liquid nitrogen in the conventional manner of cryosurgery followed immediately by injection of a suspension of a fluorinated adrenocorticosteroid is an effective way of treating keloids and hypertrophic scars. Details of the method are given.

  14. Groundwater contamination

    SciTech Connect

    Haimes, Y. . Dept. of Systems Engineering)

    1986-01-01

    The subject of these conference proceedings is the groundwater contamination. It is by nature multifarious - dealing with detection and monitoring, prevention, abatement and containment, and correction and restoration of contaminated groundwater - it intrinsically encompasses myriad disciplines, and it involves all levels of government. Also, the subject of groundwater contamination is complex because decisions concerning groundwater pollution control that are scientifically sound, technologically within the state of the art, economically feasible, politically tractable, legally sustainable, socially acceptable, morally accountable, and organizationally implementable must be grounded on appropriate information and intelligence bases in their respective areas - science, technology, economics, politics, the law, society, ethics, and management. Indeed, the human health effects (e.g., cancer, damage to the central nervous system, liver and kidney damage) and non-health effects (economic hardship to industry, agriculture, households, and municipalities; environmental impacts; social impacts) necessitate that we, as a society, address in a somber way the following variations of the same question: How safe is safe enough How clean is safe enough The enormous cost - in billions of dollars over the next decade - that various studies project for the prevention, detection and monitoring, abatement and containment, and correction and restoration of groundwater contamination make an answer to these questions even more urgent. There are sixteen papers in these proceedings.

  15. Water quality in shallow alluvial aquifers, Upper Colorado River Basin, Colorado, 1997

    USGS Publications Warehouse

    Apodaca, L.E.; Bails, J.B.; Smith, C.M.

    2002-01-01

    Shallow ground water in areas of increasing urban development within the Upper Colorado River Basin was sampled for inorganic and organic constituents to characterize water-quality conditions and to identify potential anthropogenic effects resulting from development. In 1997, 25 shallow monitoring wells were installed and sampled in five areas of urban development in Eagle, Grand, Gunnison, and Summit Counties, Colorado. The results of this study indicate that the shallow ground water in the study area is suitable for most uses. Nonparametric statistical methods showed that constituents and parameters measured in the shallow wells were often significantly different between the five developing urban areas. Radon concentrations exceeded the proposed USEPA maximum contaminant level at all sites. The presence of nutrients, pesticides, and volatile organic compounds indicate anthropogenic activities are affecting the shallow ground-water quality in the study area. Nitrate as N concentrations greater than 2.0 mg/L were observed in ground water recharged between the 1980s and 1990s. Low concentrations of methylene blue active substances were detected at a few sites. Total coliform bacteria were detected at ten sites; however, E. coli was not detected. Continued monitoring is needed to assess the effects of increasing urban development on the shallow ground-water quality in the study area.

  16. Estimation of Direct and Indirect Discharge of Shallow Groundwater Nutrients into Rivers

    NASA Astrophysics Data System (ADS)

    Ouyang, Y.

    2008-05-01

    Pollution of the Lower St. Johns River, Florida due to leaching, discharging, and loading of excess nutrients is a problem of increasing environmental and ecological concern. While surface runoff and atmospheric deposition of excess nutrients into the LSJR have received great attention, the mechanisms by which nutrients enter the LSJR through shallow groundwater discharge have not been well documented. Currently, mixed results are reported regarding the contamination of streams with shallow groundwater nutrients. Some studies show that about 70-80 percent of groundwater nutrients are removed through the wetland before entering the streams, while others observe that groundwater discharge associated with nutrient seepage into estuaries and rivers can be significant across a wide range of temporal and spatial scales. More interestingly, one study demonstrates that discharge of shallow groundwater nutrients into the streams goes both indirectly through wetlands and directly beneath wetlands. In this study, a dynamic model for shallow groundwater nutrient discharge into rivers is developed using STELLA. The structure of the model consisted of time-dependent simultaneous discharge of water and nutrients from shallow aquifers into rivers indirectly through wetland attenuations and directly beneath wetlands. Field data are used to test the model prior to its application in a septic area of the LSJR basin. Our study suggests that the model, developed with STELLA, is a useful tool for estimating shallow groundwater nutrient discharge into rivers.

  17. 40 CFR 230.43 - Vegetated shallows.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Special Aquatic Sites § 230.43 Vegetated shallows. (a) Vegetated shallows are permanently inundated areas that under normal circumstances support communities of rooted aquatic vegetation, such as turtle grass...) releasing chemicals that adversely affect plants and animals; (4) increasing turbidity levels, thereby...

  18. 40 CFR 230.43 - Vegetated shallows.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Special Aquatic Sites § 230.43 Vegetated shallows. (a) Vegetated shallows are permanently inundated areas that under normal circumstances support communities of rooted aquatic vegetation, such as turtle grass...) releasing chemicals that adversely affect plants and animals; (4) increasing turbidity levels, thereby...

  19. 40 CFR 230.43 - Vegetated shallows.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Special Aquatic Sites § 230.43 Vegetated shallows. (a) Vegetated shallows are permanently inundated areas that under normal circumstances support communities of rooted aquatic vegetation, such as turtle grass...) releasing chemicals that adversely affect plants and animals; (4) increasing turbidity levels, thereby...

  20. 40 CFR 230.43 - Vegetated shallows.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Special Aquatic Sites § 230.43 Vegetated shallows. (a) Vegetated shallows are permanently inundated areas that under normal circumstances support communities of rooted aquatic vegetation, such as turtle grass...) releasing chemicals that adversely affect plants and animals; (4) increasing turbidity levels, thereby...

  1. Ground water contamination

    SciTech Connect

    Not Available

    1991-01-01

    This book covers: Ground water contamination and basic concepts of water law; Federal law governing water contamination and remediation; Ground water flow and contaminant migration; Ground water cleanup under CERCLA; Technical methods of remediation and prevention of contamination; Liability for ground water contamination; State constraints on contamination of ground water; Water quantity versus water quality; Prevention of use of contaminated ground water as an alternative to remediation; Economic considerations in liability for ground water contamination; and Contamination, extraction, and injection issues.

  2. Electromagnetics for Detecting Shallow Tunnels

    NASA Astrophysics Data System (ADS)

    Won, I.

    2006-05-01

    Detecting tunnels by geophysical means, even very shallow ones, has been difficult, to say the least. Despite heavy R&D funding from the military since the early 70s, geophysicists have not produced tools that are simple and practical enough to meet the military needs. The initial interest and R&D funding on the subject perhaps started with the Vietcong tunnels in the 60s. Tunnels in the Korean DMZ, first found in the mid 70s, sharply escalated the R&D spending. During the 90s, covert tunnels along the US-Mexico border have kept the topic alive but at a minimal funding level. Most recent interest appears to be in the terrorism-related shallow tunnels, more or less anywhere in the regions of conflict. Despite the longstanding effort in the geophysical community under heavy public funding, there is a dearth of success stories where geophysicists can actually claim to have found hitherto unknown tunnels. For instance, geophysics has not discovered a single tunnel in Vietnam or in Korea! All tunnels across the Korean DMZ were found from human intelligence. The same is true to all illicit tunnels found along the southwestern border. The tunnels under discussion are clandestine, which implies that the people who built them do not wish others to succeed in finding them. The place around the tunnel, therefore, may not be the friendliest venue for surveyors to linger around. The situation requires tools that are fast, little noticeable, and hardly intrusive. Many geophysical sensors that require ground contacts, such as geophones and electrodes that are connected by a myriad of cables, may not be ideal in this situation. On the other hand, a sensor that can be carried by vehicle without stopping, and is nothing obviously noticeable to bystanders, could be much more acceptable. Working at unfriendly environment also requires forgoing our usual practices where we collect data leisurely and make pretty maps later. To be useful, geophysical tools must be able to process

  3. Geohydrology of the shallow aquifers in the Denver metropolitan area, Colorado

    USGS Publications Warehouse

    Robson, Stanley G.

    1996-01-01

    The Denver metropolitan area is underlain by shallow layers of water-bearing sediments (aquifers) consisting of unconsolidated gravel, sand, silt, and clay. The depth to water in these aquifers is less than 20 feet in much of the area, and the aquifers provide a ready source of water to numerous shallow, small-capacity wells. The shallow depth to water also makes the aquifers susceptible to contamination from the land surface. Water percolating downward from residential, commercial, and industrial property, spills of hazardous materials, and leaks from underground storage tanks and pipelines can cause contaminants to enter the shallow aquifers. Wet basements, unstable foundation materials, and waterlogged soils also are common in areas of very shallow ground water.Knowledge of the extent, thickness, and water-table altitude of the shallow aquifers is incomplete. This, coupled with the complexity of development in this large metropolitan area, makes effective use, management, and protection of these aquifers extremely difficult. Mapping of the geologic and hydrologic characteristics of these aquifers would provide the general public and technical users with information needed to better use, manage, and protect this water resource. A study to map the geohydrology of shallow aquifers in the Denver metropolitan area was begun in 1994. The work was undertaken by the U.S. Geological Survey in cooperation with the U.S. Army-Rocky Mountain Arsenal, U.S. Department of Energy-Rocky Flats Field Office, Colorado Department of Public Health and Environment, Colorado Department of Natural Resources-State Engineers Office, Denver Water Department, Littleton-Englewood Wastewater Treatment Plant, East Cherry Creek Valley Water and Sanitation District, Metro Wastewater Reclamation District, Willows Water District, and the cities of Aurora, Lakewood, and Thornton.This report presents the results of a systematic mapping of the extent, thickness, and water-table altitude of the shallow

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

    SciTech Connect

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

    1989-05-01

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

  5. Pachydermoperiostosis (primary hypertrophic osteoarthropathy): report of a case with evidence of endothelial and connective tissue involvement.

    PubMed Central

    Matucci-Cerinic, M; Cinti, S; Morroni, M; Lotti, T; Nuzzaci, G; Lucente, E; di Lollo, S; Ceruso, M; Cagnoni, M

    1989-01-01

    A case of pachydermoperiostosis characterised by the presence of finger clubbing, periostosis, sweating of hands and feet is described. Modifications of capillaroscopic pattern and of arteriovenous anastomoses are reported. The periungual border and finger tip tissue showed diffuse endothelial hyperplasia, hyalinosis, and sclerosis with packing of collagen fibres. Electron microscopy showed hypertrophic and activated endothelia (numerous and hypertrophic Golgi complexes, several Weibel-Palade bodies, vesicles of micropinocytosis, and glycogen particles), the basal membrane thickened and reduplicated, perivasal infiltrate in superficial derma, reticulation and segmentary reduplication of basal membrane in arteriovenous shunt. In the perineural connective tissue numerous Luse bodies (long spacing collagen) were evident. The data indicate that in the early phase of pachydermoperiostosis morphological endothelial and collagen fibre abnormalities are present, though there is a normal peripheral blood flow. Images PMID:2930280

  6. Microvascular permeability changes might explain cardiac tamponade after alcohol septal ablation for hypertrophic cardiomyopathy.

    PubMed

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

    2014-04-01

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

  7. Left Atrial trajectory impairment in Hypertrophic Cardiomyopathy disclosed by Geometric Morphometrics and Parallel Transport

    PubMed Central

    Piras, Paolo; Torromeo, Concetta; Re, Federica; Evangelista, Antonietta; Gabriele, Stefano; Esposito, Giuseppe; Nardinocchi, Paola; Teresi, Luciano; Madeo, Andrea; Chialastri, Claudia; Schiariti, Michele; Varano, Valerio; Uguccioni, Massimo; Puddu, Paolo E.

    2016-01-01

    The analysis of full Left Atrium (LA) deformation and whole LA deformational trajectory in time has been poorly investigated and, to the best of our knowledge, seldom discussed in patients with Hypertrophic Cardiomyopathy. Therefore, we considered 22 patients with Hypertrophic Cardiomyopathy (HCM) and 46 healthy subjects, investigated them by three–dimensional Speckle Tracking Echocardiography, and studied the derived landmark clouds via Geometric Morphometrics with Parallel Transport. Trajectory shape and trajectory size were different in Controls versus HCM and their classification powers had high AUC (Area Under the Receiving Operator Characteristic Curve) and accuracy. The two trajectories were much different at the transition between LA conduit and booster pump functions. Full shape and deformation analyses with trajectory analysis enabled a straightforward perception of pathophysiological consequences of HCM condition on LA functioning. It might be worthwhile to apply these techniques to look for novel pathophysiological approaches that may better define atrio–ventricular interaction. PMID:27713503

  8. Left Atrial trajectory impairment in Hypertrophic Cardiomyopathy disclosed by Geometric Morphometrics and Parallel Transport.

    PubMed

    Piras, Paolo; Torromeo, Concetta; Re, Federica; Evangelista, Antonietta; Gabriele, Stefano; Esposito, Giuseppe; Nardinocchi, Paola; Teresi, Luciano; Madeo, Andrea; Chialastri, Claudia; Schiariti, Michele; Varano, Valerio; Uguccioni, Massimo; Puddu, Paolo E

    2016-10-07

    The analysis of full Left Atrium (LA) deformation and whole LA deformational trajectory in time has been poorly investigated and, to the best of our knowledge, seldom discussed in patients with Hypertrophic Cardiomyopathy. Therefore, we considered 22 patients with Hypertrophic Cardiomyopathy (HCM) and 46 healthy subjects, investigated them by three-dimensional Speckle Tracking Echocardiography, and studied the derived landmark clouds via Geometric Morphometrics with Parallel Transport. Trajectory shape and trajectory size were different in Controls versus HCM and their classification powers had high AUC (Area Under the Receiving Operator Characteristic Curve) and accuracy. The two trajectories were much different at the transition between LA conduit and booster pump functions. Full shape and deformation analyses with trajectory analysis enabled a straightforward perception of pathophysiological consequences of HCM condition on LA functioning. It might be worthwhile to apply these techniques to look for novel pathophysiological approaches that may better define atrio-ventricular interaction.

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

    PubMed

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

    2016-04-19

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

  10. The myosin mesa and a possible unifying hypothesis for the molecular basis of human hypertrophic cardiomyopathy

    PubMed Central

    Spudich, James A.

    2015-01-01

    No matter how many times one explores the structure of the myosin molecule, there is always something new to discover. Here, I describe the myosin mesa, a structural feature of the motor domain that has the characteristics of a binding domain for another protein, possibly myosin-binding protein C (MyBP-C). Interestingly, many well-known hypertrophic cardiomyopathy (HCM) mutations lie along this surface and may affect the putative interactions proposed here. A potential unifying hypothesis for the molecular basis of human hypertrophic cardiomyopathy is discussed here. It involves increased power output of the cardiac muscle as a result of HCM mutations causing the release of inhibition by myosin binding protein C. PMID:25619247

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

    PubMed Central

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

    2016-01-01

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

  12. Physiological Hypertrophic Subaortic Stenosis and Subendocardial Infarction in a Patient with a Pheochromocytoma

    PubMed Central

    Levister, Ernest C.; Taylor, Jack B.

    1981-01-01

    This report describes the occurrence of a pheochromocytoma in a middle-aged, black female with a 12-year history of hypertension, and a strong family history of hypertension. In this case, the pheochromocytoma was associated with a subendocardial myocardial infarction and congestive heart failure which occurred in the presence of large, dilated coronary arteries without intraluminal obstructions. The patient also had the murmur and echocardiographic and ventriculographic signs typical of idiopathic hypertrophic subaortic stenosis, which resolved following removal of the tumor and return of the blood pressure to normal. The authors believe this to represent a form of transient physiological hypertrophic subaortic stenosis secondary to a hypercatecholamine state. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:7194379

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

    PubMed Central

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

    2011-01-01

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

  14. Left Atrial trajectory impairment in Hypertrophic Cardiomyopathy disclosed by Geometric Morphometrics and Parallel Transport

    NASA Astrophysics Data System (ADS)

    Piras, Paolo; Torromeo, Concetta; Re, Federica; Evangelista, Antonietta; Gabriele, Stefano; Esposito, Giuseppe; Nardinocchi, Paola; Teresi, Luciano; Madeo, Andrea; Chialastri, Claudia; Schiariti, Michele; Varano, Valerio; Uguccioni, Massimo; Puddu, Paolo E.

    2016-10-01

    The analysis of full Left Atrium (LA) deformation and whole LA deformational trajectory in time has been poorly investigated and, to the best of our knowledge, seldom discussed in patients with Hypertrophic Cardiomyopathy. Therefore, we considered 22 patients with Hypertrophic Cardiomyopathy (HCM) and 46 healthy subjects, investigated them by three-dimensional Speckle Tracking Echocardiography, and studied the derived landmark clouds via Geometric Morphometrics with Parallel Transport. Trajectory shape and trajectory size were different in Controls versus HCM and their classification powers had high AUC (Area Under the Receiving Operator Characteristic Curve) and accuracy. The two trajectories were much different at the transition between LA conduit and booster pump functions. Full shape and deformation analyses with trajectory analysis enabled a straightforward perception of pathophysiological consequences of HCM condition on LA functioning. It might be worthwhile to apply these techniques to look for novel pathophysiological approaches that may better define atrio-ventricular interaction.

  15. An autopsy report of acute myocardial infarction with hypertrophic obstructive cardiomyopathy-like heart.

    PubMed

    Ushikoshi, Hiroaki; Okada, Hideshi; Morishita, Kentaro; Imai, Hajime; Tomita, Hiroyuki; Nawa, Takahide; Suzuki, Kodai; Ikeshoji, Haruka; Kato, Hisaaki; Yoshida, Takahiro; Yoshida, Shozo; Shirai, Kunihiro; Toyoda, Izumi; Hara, Akira; Ogura, Shinji

    2015-01-01

    An 84-year-old woman, who was followed up as hypertrophic obstructive cardiomyopathy (HOCM) in a local hospital, was transferred to our center because of anterior chest pain and diagnosed with acute myocardial infarction (MI). Coronary angiography showed total occlusion of the mid-left anterior descending, and flow was restored after endovascular thrombectomy. An autopsy was performed after she died on hospital day 6. At autopsy, there was no significant stenosis in this vessel and the absence of plaque rupture was confirmed. Likewise, it was unclear asymmetric hypertrophy at autopsy, it could not deny that a sigmoid deformity of the basal septum occurs in elderly patients and can mimic the asymmetric septal hypertrophy of hypertrophic cardiomyopathy. MI was thought to be caused by coronary spasm or squeezing in HOCM-like heart. Therefore, it may be necessary antithrombosis therapy in HOCM-like patients with no history of paroxysmal atrial fibrillation.

  16. [Functional regulation of genome with peptide bioregulators by hypertrophic cardiomyopathy (by patients and relatives)].

    PubMed

    Dzhokhadze, T A; Buadze, T Zh; Gaĭozishvili, M N; Rogava, M A; Lazhava, T A

    2013-12-01

    In this paper, a comparative study of the functional genome indicators using lymphocyte cultures of patients with hypertrophic cardiomyopathy (HCM) and their first relatives. Studies conducted both in intact cultures and cultures exposed to the influence of peptide - bioregulators Epithalon, Vilon and Livagen. Last (Livagen) tested at separate and joint application with cobalt chloride salt. As indicated according to the results of the analysis, the cells of the individuals with HCM and their first relatives were characterized by higher frequency of spontaneous quantitative - structural disorders in comparison with the cells of healthy individuals. The findings suggest a different effect of bioregulators. The most effective protective action in relation normalization of functional parameters of the genome shows Epithalon for lowering the level of chromosomal instability in patients with hypertrophic cardiomyopathy and relatives of patients with HCM. On the basis of identified protective action Epithalon concludes prospects of its application in the development of preventive measures for individuals at increased risk of morbidity HCM.

  17. The myosin mesa and a possible unifying hypothesis for the molecular basis of human hypertrophic cardiomyopathy.

    PubMed

    Spudich, James A

    2015-02-01

    No matter how many times one explores the structure of the myosin molecule, there is always something new to discover. Here, I describe the myosin mesa, a structural feature of the motor domain that has the characteristics of a binding domain for another protein, possibly myosin-binding protein C (MyBP-C). Interestingly, many well-known hypertrophic cardiomyopathy (HCM) mutations lie along this surface and may affect the putative interactions proposed here. A potential unifying hypothesis for the molecular basis of human hypertrophic cardiomyopathy is discussed here. It involves increased power output of the cardiac muscle as a result of HCM mutations causing the release of inhibition by myosin binding protein C.

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

    PubMed Central

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

    2014-01-01

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

  19. [Chronic subdural hematoma with a markedly fibrous hypertrophic membrane. Case report].

    PubMed

    Sato, M; Kuwana, N; Kojima, Y; Tanaka, N; Kitamura, H

    1990-01-01

    A 40-year-old female, who had taken low-dose oral contraceptives for 2 months before onset, developed transient dysarthria, left hemiparesis, and left hemihypesthesia. One month later, a computed tomography (CT) scan revealed a uniformly enhanced, convex-shaped, hypertrophic membrane with a lobulated lumen in the subdural space of the right parietal region. A right parietal craniotomy was performed. The membrane, consisting of elastic-hard, hypertrophic granulation tissue and yellowish, sticky fluid in the lumen, was readily freed and totally extirpated. Subsequently, the patient recovered without persistent symptoms. Light microscopic examination detected the sinusoidal channel layer and the fibrous layer in an alternating configuration, along with intramembranous hemorrhagic foci. Such hypertrophy must have been caused by repeated intramembranous hemorrhages and reactive granulation. Such findings of hematoma membrane have never previously been reported. Thus, this is an interesting case, clearly distinguished from typical chronic subdural hematoma.

  20. Radial nerve palsy owing to localized hypertrophic neuropathy (intraneural perineurioma) in early childhood.

    PubMed

    Isaac, Sherif; Athanasou, Nicholas A; Pike, Michael; Burge, Peter D

    2004-01-01

    Localized hypertrophic neuropathy, also termed intraneural perineurioma, is a rare disorder of unknown etiology that produces a slowly progressive painless focal lesion of a peripheral nerve. It is characterized histologically by concentric whorls ("onion bulbs") of epithelial membrane antigen-reactive, S-100 protein-negative perineurial cells surrounding nerve fibers. We report a radial nerve palsy in a child aged 2 years in whom the diagnosis of localized hypertrophic neuropathy was made by biopsy. Resection of the affected nerve segment and sural nerve grafting produced no useful recovery after 3 years, probably because of the long duration of denervation. When this mononeuropathy presents in early childhood, uncertainty over the time of onset can lead to difficulty in distinguishing this potentially treatable lesion from congenital and other causes of nerve palsy.

  1. The diagnosis of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.

    PubMed

    Piva e Mattos, Beatriz; Torres, Marco Antonio Rodrigues; Rebelatto, Taiane Francieli; Loreto, Melina Silva de; Scolari, Fernando Luís

    2012-07-01

    Hypertrophic cardiomyopathy is a prevalent genetic disease characterized by left ventricular hypertrophy, presenting dynamic obstruction of outflow tract with subaortic gradient happening at rest in 30% of the cases. It is attributed to the intricate interaction between the anterior mitral leaflet, the interventricular septum and altered flow vectors generated in left ventricle along with changes in outflow tract geometry. Mitral regurgitation in varying degrees is found with or without association with structural deformities of the valve apparatus. The exercise echocardiogram evidences latent obstruction easily induced by exercise in 60 to 75% of non-obstructive forms. The determination of the gradient under this condition must be considered in routine investigation of patients with mild or no obstruction at rest. The evaluation of hypertrophic cardiomyopathy incorporates methods based on the ultrasound image, which, along with MRI, allow recognizing ventricular obstruction generating mechanisms, thus facilitating the diagnosis and management of obstructive and latent obstructive forms.

  2. [Application of photodynamic therapy combined with compound betamethasone in treatment of hypertrophic scar].

    PubMed

    Fang, Fang; Hong, Zhang; Yan, Zhao; Meiling, Lin

    2015-09-01

    To investigate the effect of photodynamic therapy combined with compound betamethasone in the treatment of hypertrophic scar. 37 cases of keloid were divided into two groups, 19 cases in the treatment group, 18 cases in the control group. The patients in treatment group were treated with photodynamic therapy combined with compound betamethasone injection therapy. The patients in the control group were treated by compound betamethasone injection. The effect and recurrence rate were compared before and after treatment. The effective rate was 89.5% in the treatment group, 55. 6% in the control group, showing significant difference between the two groups (P = 0.029) The relapse rate in treatment group was significantly lower than that in the control group (P = 0.047) CONCLUSIONS: Photodynamic therapy combined with compound betamethasone has good effect and safety for the treatment of hypertrophic scar. The combined treatment can reduce the treatment period and side effects

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

    PubMed

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

    2016-02-05

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

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

    PubMed

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

    2015-02-15

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

  5. All That Glitters is not Gold: Apical Hypertrophic Cardiomyopathy Mimicking Acute Coronary Syndrome

    PubMed Central

    Lakshmanadoss, Umashankar; Kulkarni, Abhishek; Balakrishnan, Shobana; Shree, Nidhi; Harjai, Kishore; Jagasia, Dinesh

    2012-01-01

    Hypertrophic cardiomyopathy is characterized by the idiopathic hypertrophy of the left ventricle (and occasionally right ventricle). HCM is an autosomal dominant disease, with variable penetration. In Asian population, apical hypertrophic cardiomyopathy is relatively common (25%). However, this is relatively rare in Caucasian population (0.2%). Patients with HCM, often presents with typical exertional chest pain and shortness of breath. Apical HCM patients tend to have milder symptoms. However, the clinical presentation and electrocardiographic features of Apical HCM often mimic acute coronary syndrome and high index of suspicion is warranted in differentiating this condition. Patients with apical HCM have relatively better prognosis when compare to the other varieties. Here, we are presenting a patient who presented with typical exertional chest pain whose electrocardiographic changes are concerning for acute ischemic changes.

  6. Effects of Prolonged Hypertrophic Resistance Training on Acute Endocrine Responses in Young and Older Men.

    PubMed

    Walker, Simon; Santolamazza, Fabrizio; Kraemer, William; Häkkinen, Keijo

    2014-05-02

    The present study investigated changes in acute serum hormone responses to a resistance exercise bout following a prolonged period of hypertrophic resistance training in young (YM) and older men (OM). Subjects performed a 5 × 10RM leg press exercise protocol before and after 20 weeks of hypertrophic resistance training. In YM, the acute responses in growth hormone were greater compared to before training (P < 0.05), and cortisol concentration did not increase after training. Endocrine responses in OM were similar before and after training. Greater acute growth hormone responses after training were associated with larger gains in lean mass in the entire subject group (r = 0.596, P = 0.019). These findings suggest that, in general, YM demonstrate greater adaptability within the endocrine system compared to OM. However, adaptability in growth hormone response was associated with larger training-induced gains independent of age.

  7. Effects of prolonged hypertrophic resistance training on acute endocrine responses in young and older men.

    PubMed

    Walker, Simon; Santolamazza, Fabrizio; Kraemer, William; Häkkinen, Keijo

    2015-04-01

    The present study investigated changes in acute serum hormone responses to a resistance exercise bout following a prolonged period of hypertrophic resistance training in young (YM) and older men (OM). Subjects performed a 5 × 10RM leg press exercise protocol before and after 20 weeks of hypertrophic resistance training. In YM, the acute responses in growth hormone were greater compared with before training (p < .05), and cortisol concentration did not increase after training. Endocrine responses in OM were similar before and after training. Greater acute growth hormone responses after training were associated with larger gains in lean mass in the entire subject group (r = .596, p = .019). These findings suggest that, in general, YM demonstrate greater adaptability within the endocrine system compared with OM. However, adaptability in growth hormone response was associated with larger training-induced gains independent of age.

  8. Up-to-date approach to manage keloids and hypertrophic scars: a useful guide.

    PubMed

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

    2014-11-01

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

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

    NASA Astrophysics Data System (ADS)

    Abraham, Theodore P.

    2011-11-01

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

  10. Hypertrophic non-union of a pathological forearm fracture secondary to multiple myeloma: a case report

    PubMed Central

    2010-01-01

    Skeletal lesions in multiple myeloma are predominantly lytic and when non-union of pathological fractures occur it is typically atrophic. We report a lady of 61 years of age with myeloma who presented with a pathological fracture through an ulnar myeloma deposit. The fracture was immobilised initially then irradiated. Nine months later she re-presented with marked forearm pain particularly on rotation. Radiographs demonstrated a hypertrophic non-union of a pathological fracture with a typical elephant's hoof appearance. The fracture was immobilised using an ulnar nail. Whilst non-unions in metastatic malignancy are typically atrophic, just occasionally hypertrophic non-unions can occur. Management principles remain the same with stabilisation of the entire bone and early mobilisation being appropriate. PMID:20409318

  11. Shallow Carbon Sequestration Demonstration Project

    SciTech Connect

    Pendergrass, Gary; Fraley, David; Alter, William; Bodenhamer, Steven

    2013-09-30

    The potential for carbon sequestration at relatively shallow depths was investigated at four power plant sites in Missouri. Exploratory boreholes were cored through the Davis Shale confining layer into the St. Francois aquifer (Lamotte Sandstone and Bonneterre Formation). Precambrian basement contact ranged from 654.4 meters at the John Twitty Energy Center in Southwest Missouri to over 1100 meters near the Sioux Power Plant in St. Charles County. Investigations at the John Twitty Energy Center included 3D seismic reflection surveys, downhole geophysical logging and pressure testing, and laboratory analysis of rock core and water samples. Plans to perform injectivity tests at the John Twitty Energy Center, using food grade CO{sub 2}, had to be abandoned when the isolated aquifer was found to have very low dissolved solids content. Investigations at the Sioux Plant and Thomas Hill Energy Center in Randolph County found suitably saline conditions in the St. Francois. A fourth borehole in Platte County was discontinued before reaching the aquifer. Laboratory analyses of rock core and water samples indicate that the St. Charles and Randolph County sites could have storage potentials worthy of further study. The report suggests additional Missouri areas for further investigation as well.

  12. Deep and shallow inelastic scattering

    SciTech Connect

    Ray, Heather

    2015-05-15

    In this session we focused on the higher energy deep and shallow inelastic particle interactions, DIS and SIS. DIS interactions occur when the energy of the incident particle beam is so large that the beam is able to penetrate the nucleons inside of the target nuclei. These interactions occur at the smallest level possible, that of the quark-gluon, or parton, level. SIS interactions occur in an intermediate energy range, just below the energy required for DIS interactions. The DIS cross section formula contains structure functions that describe our understanding of the underlying parton structure of nature. The full description of DIS interactions requires three structure functions: two may be measured in charged lepton or neutrino scattering, but one can only be extracted from neutrino DIS data. There are reasons to expect that the impact of nuclear effects could be different for neutrinos engaging in the DIS interaction, vs those felt by leptons. In fact, fits by the nCTEQ collaboration have found that the neutrino-Fe structure functions appear to differ from those extracted from lepton scattering data [1]. To better understand the global picture of DIS and SIS, we chose a three-pronged attack that examined recent experimental results, data fits, and latest theory predictions. Experimental results from neutrino and lepton scattering, as well as collider experiments, were presented.

  13. Management of Peri-Implant Hypertrophic Scarring for an Ear Prosthesis.

    PubMed

    Alfenas, Elizabeth Rodrigues; Moreno, Amália; Tanner, Paul Benjamin; Netto, Henrique Duque; Fonseca, Maria Fernanda Lopes; Rios, Fernando Gonçalves

    2017-09-19

    The clinical report describes a case of a 14-year-old patient with a traumatic amputation of the left auricle and severe hypertrophic scarring. The management of peri-implant soft tissue was challenging, but successful in the rehabilitation of a patient with auricular prosthesis retained by implants. The prosthesis restored the patient's facial aesthetics and contributed not only to function, but also to psychosocial well-being.

  14. Treatment of hypertrophic scars using a long-pulsed dye laser with cryogen-spray cooling.

    PubMed

    Kono, Taro; Erçöçen, Ali Rza; Nakazawa, Hiroaki; Nozaki, Motohiro

    2005-05-01

    Hypertrophic scars are common and cause functional and psychologic morbidity. The conventional pulsed dye laser (585 nm) has been shown previously to be effective in the treatment of a variety of traumatic and surgical scars, with improvement in scar texture, color, and pliability, with minimal side effects. This prospective study was performed to determine the effectiveness of the long-pulsed dye laser (595 nm) with cryogen-spray cooling device in the treatment of hypertrophic scars. Fifteen Asian patients with 22 hypertrophic scars were treated by the long-pulsed dye laser (595 nm) with cryogen-spray cooling device. In 5 patients, the scar area was divided into halves, one half of which was treated with the laser, whereas the other half was not treated and was used as a negative control. All patients received 2 treatments at 4-week intervals, and evaluations were done by photographic and clinical assessment and histologic evaluation before the treatment and 1 month after the last laser treatment. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. Symptoms such as pain, pruritus, and burning of the scar improved significantly. VGH scores improved in all treated sites, and there was a significant difference between the baseline and posttreatment scores, corresponding to an improvement of 51.4 +/- 14.7% (P < 0.01). Compared with the baseline, the mean percentage of scar flattening and erythema elimination was 40.7 +/- 20.7 and 65.3 +/- 25.5%, respectively (P < 0.01). The long-pulsed dye laser (595-nm) equipped with cryogen spray cooling device is an effective treatment of hypertrophic scars and can improve scar pliability and texture and decrease scar erythema and associated symptoms.

  15. Evidence of invasive and noninvasive treatment modalities for hypertrophic scars: A systematic review.

    PubMed

    Kafka, Mona; Collins, Vanessa; Kamolz, Lars-Peter; Rappl, Thomas; Branski, Ludwik K; Wurzer, Paul

    2017-01-01

    Currently, there are various therapeutic approaches to reduce hypertrophic scarring; however, there is no standard evidence-based treatment protocol. Hence, a systematic review was performed to obtain a summary of the latest clinical trials to evaluate evidence for the treatment of hypertrophic scars. The review protocol was registered and approved by PROSPERO (CRD42015027040). PubMed and Web of Science were searched using predefined MeSH-Terms to identify studies published within the last 10 years regarding treatment for hypertrophic scars. Exclusion criteria included a level of evidence (LoE) lower than I, nonhuman in vivo studies, in vitro studies, studies on keloids, literature reviews, and non-English articles. The literature search identified 1,029 unique articles, whereas 6 articles were prospective, randomized, blinded, controlled clinical trials with a LoE I, and were thus included in the systematic analysis. Three clinical trials evaluated silicone products and pressure garments, and the other three studies investigated the efficacy of intralesional injections of triamcinolone (TAC), 5-Fluorouracil (5-FU) combined with TAC as well as the additional irradiation with a 585 nm pulsed-dye laser (PDL). Intralesional injections revealed significant improvements of the scar quality in terms of height, thickness, erythema, and pigmentation. Pressure garments showed favorable results but there was no evidence that silicone products were able to improve the scar quality. The systematic review demonstrated that there are just a few clinical trials with a LoE of I. Consequently, evidence is still lacking especially for noninvasive treatment regimens for hypertrophic scars. Intralesional injections of 5-FU mixed with a low dose of TAC can be seen as most appropriate treatment modality. Prospective clinical trials to determine the efficiency of silicone products are warranted.

  16. A single case study of treating hypertrophic lichen planus with Ayurvedic medicine.

    PubMed

    Ratha, Kshirod Kumar; Barik, Laxmidhar; Panda, Ashok Kumar; Hazra, Jayram

    2016-01-01

    Ayurvedic medicines are often considered effective for chronic and lifestyle disorders. Hypertrophic lichen planus (HLP) is a rare inflammatory skin condition and develops into squamous cell carcinoma in few cases. It has resemblance with Charma Kushtha mentioned in Ayurvedic classics. Conventional therapy used in this condition is unsatisfactory and is not free from side effects. A case of long-standing systemic steroid-dependent HLP is presented here which was intervened successfully with Ayurvedic modalities.

  17. A single case study of treating hypertrophic lichen planus with Ayurvedic medicine

    PubMed Central

    Ratha, Kshirod Kumar; Barik, Laxmidhar; Panda, Ashok Kumar; Hazra, Jayram

    2016-01-01

    Ayurvedic medicines are often considered effective for chronic and lifestyle disorders. Hypertrophic lichen planus (HLP) is a rare inflammatory skin condition and develops into squamous cell carcinoma in few cases. It has resemblance with Charma Kushtha mentioned in Ayurvedic classics. Conventional therapy used in this condition is unsatisfactory and is not free from side effects. A case of long-standing systemic steroid-dependent HLP is presented here which was intervened successfully with Ayurvedic modalities. PMID:28827956

  18. Sequential Atrioventricular Pacing in Patients With Hypertrophic Cardiomyopathy: An 18-year Experience.

    PubMed

    Jurado Román, Alfonso; Montero Cabezas, José M; Rubio Alonso, Belén; García Tejada, Julio; Hernández Hernández, Felipe; Albarrán González-Trevilla, Agustín; Velázquez Martín, María T; Coma Samartín, Raúl; Rodríguez García, Jesús; Tascón Pérez, Juan C

    2016-04-01

    Controversy persists regarding the role of sequential atrioventricular pacing in patients with obstructive hypertrophic cardiomyopathy and disabling symptoms. The aim of this study was to evaluate the effect of pacing on symptoms, dynamic gradient, and left ventricular function in patients with hypertrophic cardiomyopathy. From 1991 to 2009, dual-chamber pacemakers were implanted in 82 patients with obstructive hypertrophic cardiomyopathy and disabling symptoms despite optimal medical therapy. Sequential pacing was performed with a short atrioventricular delay. Clinical and echocardiographic parameters were measured before and immediately after implantation and after a long follow-up (median, 8.5 years [range, 1-18 years]). The New York Heart Association functional class was immediately reduced after pacemaker implantation in 95% of patients (P < .0001), and this improvement was maintained until the final follow-up in 89% (P = .016). The gradient was significantly reduced after implantation (94.5 ± 36.5 vs 46.4 ± 26.7mmHg; P < .0001) and at final follow-up (94.5 ± 36.5 vs 35.9 ± 24.0mmHg; P < .0001). Mitral regurgitation permanently improved in 52% of the patients (P < .0001). There were no differences in ventricular thickness or diameters, ejection fraction, or diastolic function. Sequential pacing in selected patients with obstructive hypertrophic cardiomyopathy improves functional class and reduces dynamic gradient and mitral regurgitation immediately after pacemaker implantation and at final follow-up. Prolonged ventricular pacing has no negative effects on systolic or diastolic function in these patients. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Exposure to Varying Strain Magnitudes Influences the Conversion of Normal Skin Fibroblasts Into Hypertrophic Scar Cells.

    PubMed

    Kuang, Ruixia; Wang, Zhiguo; Xu, Quanchen; Cai, Xia; Liu, Tao

    2016-04-01

    Mechanical strain is a key contributor in the pathogenesis of hypertrophic scarring, whose optimal stretch magnitudes to initiate the differentiation of normal skin fibroblasts into aberrant fibroblasts phenotype remains largely unresolved. Influence of varying cyclic strain magnitudes on cultured human normal skin fibroblasts and its transformation into hypertrophic scar fibroblast-like phenotype is investigated in this study. Cultured fibroblasts isolated from hypertrophic scar and normal skin tissue were subjected to cyclic mechanical stretching under individual 10%, 15%, and 20% strain magnitudes at a frequency of 0.1 Hz for 24 hours. Stretched normal skin fibroblasts demonstrated significantly increased rates of cell proliferation, and also apparently oriented away nearly perpendicular to the applied stretching direction. Interestingly, the applied 10% strains magnitude resulted in a markedly enhanced cell proliferative ability compared with that of 20% strain magnitude. Parameters involving the mechanotransduction signaling, such as integrin β1 and P130Cas, were significantly improved at both mRNA and protein levels in the stretched normal skin fibroblasts, which was demonstrated in a negative magnitude-dependent manner. In addition, 10% strains magnitude triggered the highest expression levels of growth factor TGF-β1 and collagen matrix in stretched normal skin fibroblasts. Collectively, these results indicate that the 10% stretching magnitude, of the 3 strain magnitudes studied, is most effective for triggering the optimal mechanotransduction effects and biological responses inside cultured skin fibroblasts. The demonstrable conversion of normal skin fibroblasts into hypertrophic scar fibroblasts was also observed when 10% stretching magnitude was applied to cultured fibroblasts in vitro.

  20. Development of a Hypertrophic Ovarian Artery After Uterine Artery Embolization with Polyvinyl Alcohol Particles

    SciTech Connect

    Kim, Hyun S. Paxton, Ben E.

    2007-09-15

    Uterine artery embolization (UAE) for the treatment of symptomatic leiomyomata has shown excellent short-term clinical efficacy and minimal complications, yet recurrences after successful treatments at mid- and long-term follow-up have been reported. Exact etiologies for such recurrences have not been fully understood. We present a case of symptom recurrence with the development of a hypertrophic ovarian artery after successful UAE with polyvinyl alcohol particles, successfully treated with ovarian and repeat UAEs.

  1. Lack of reliable clinical predictors to identify obstructive sleep apnea in patients with hypertrophic cardiomyopathy

    PubMed Central

    Nerbass, Flávia B.; Pedrosa, Rodrigo P.; Genta, Pedro R.; Antunes, Murillo O.; Arteaga-Fernández, Edmundo; Drager, Luciano F.; Lorenzi-Filho, Geraldo

    2013-01-01

    OBJECTIVE: Obstructive sleep apnea is common among patients with hypertrophic cardiomyopathy and may contribute to poor cardiovascular outcomes. However, obstructive sleep apnea is largely unrecognized in this population. We sought to identify the clinical predictors of obstructive sleep apnea among patients with hypertrophic cardiomyopathy. METHODS: Consecutive patients with hypertrophic cardiomyopathy were recruited from a tertiary University Hospital and were evaluated using validated sleep questionnaires (Berlin and Epworth) and overnight portable monitoring. Ninety patients (males, 51%; age, 46±15 years; body mass index, 26.6±4.9 kg/m2) were included, and obstructive sleep apnea (respiratory disturbance index ≥15 events/h) was present in 37 patients (41%). RESULTS: Compared with the patients without obstructive sleep apnea, patients with obstructive sleep apnea were older and had higher body mass index, larger waist circumference, larger neck circumference, and higher prevalence of atrial fibrillation. Excessive daytime sleepiness (Epworth scale) was low and similar in the patients with and without obstructive sleep apnea, respectively. The only predictors of obstructive sleep apnea (using a logistic regression analysis) were age ≥45 years (odds ratio [OR], 4.46; 95% confidence interval [CI 95%], 1.47–13.54; p = 0.008) and the presence of atrial fibrillation [OR, 5.37; CI 95%, 1.43–20.12; p = 0.013]. CONCLUSION: Consistent clinical predictors of obstructive sleep apnea are lacking for patients with hypertrophic cardiomyopathy, which suggests that objective sleep evaluations should be considered in this population, particularly among elderly patients with atrial fibrillation. PMID:23917665

  2. Stress cardiomyopathy in a patient with hypertrophic cardiomyopathy and myocardial bridging

    PubMed Central

    Benavides, Miguel; Vinardell, Juan M; Arenas, Ivan; Santana, Orlando

    2017-01-01

    Stress cardiomyopathy is an acquired cardiomyopathy of unknown aetiology. It usually occurs in women over the age of 70 who have experienced physical or emotional stress. It is most commonly characterised by a transient, left ventricular systolic dysfunction in the apical portion and hyperkinesia in the basal segments, without obstructive coronary artery disease. Its association with obstructive hypertrophic cardiomyopathy and myocardial bridging is rare. Herein, we present such a case. PMID:28228389

  3. Hypertrophic Effects of Concentric vs. Eccentric Muscle Actions: A Systematic Review and Meta-analysis.

    PubMed

    Schoenfeld, Brad J; Ogborn, Dan I; Vigotsky, Andrew D; Franchi, Martino V; Krieger, James W

    2017-09-01

    Schoenfeld, BJ, Ogborn, DI, Vigotsky, AD, Franchi, MV, and Krieger, JW. Hypertrophic effects of concentric vs. eccentric muscle actions: A systematic review and meta-analysis. J Strength Cond Res 31(9): 2599-2608, 2017-Controversy exists as to whether different dynamic muscle actions produce divergent hypertrophic responses. The purpose of this paper was to conduct a systematic review and meta-analysis of randomized controlled trials comparing the hypertrophic effects of concentric vs. eccentric training in healthy adults after regimented resistance training (RT). Studies were deemed eligible for inclusion if they met the following criteria: (a) were an experimental trial published in an English-language refereed journal; (b) directly compared concentric and eccentric actions without the use of external implements (i.e., blood pressure cuffs) and all other RT variables equivalent; (c) measured morphologic changes using biopsy, imaging (magnetic resonance imaging, computerized tomography, or ultrasound), bioelectrical impedance, and/or densitometry; (d) had a minimum duration of 6 weeks; and (e) used human participants without musculoskeletal injury or any health condition that could directly, or through the medications associated with the management of said condition, be expected to impact the hypertrophic response to resistance exercise. A systematic literature search determined that 15 studies met inclusion criteria. Results showed that eccentric muscle actions resulted in a greater effect size (ES) compared with concentric actions, but results did not reach statistical significance (ES difference = 0.25 ± 0.13; 95% confidence interval: -0.03 to 0.52; p = 0.076). The mean percent change in muscle growth across studies favored eccentric compared with concentric actions (10.0% vs. 6.8, respectively). The findings indicate the importance of including eccentric and concentric actions in a hypertrophy-oriented RT program, as both have shown to be effective in

  4. Hypertrophic osteodystrophy preceding canine juvenile cellulitis in an Australian shepherd puppy

    PubMed Central

    Wentzell, Meaghan L.

    2011-01-01

    A 10-week-old intact female Australian shepherd dog was presented sternally recumbent, mildly pyrexic, and painful on long bone palpation of both forelimbs. Based on radiographs she was diagnosed with hypertrophic osteodystrophy. Analgesia was provided with intravenous, oral, and topical medications. Approximately 2 wk later she was presented for facial swelling, regional dermatitis, and lymphadenopathy. Canine juvenile cellulitis was diagnosed and successfully treated. PMID:21731101

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  7. Burden of Recurrent and Ancestral Mutations in Families With Hypertrophic Cardiomyopathy.

    PubMed

    Ross, Samantha Barratt; Bagnall, Richard D; Ingles, Jodie; Van Tintelen, J Peter; Semsarian, Christopher

    2017-06-01

    Hypertrophic cardiomyopathy is a genetically heterogeneous myocardial disease with >1000 causal variants identified. Nonunique variants account for disease in many families. We sought to characterize nonunique variants in Australian families and determine whether they arise from common ancestral mutations or recurrent mutation events. Genetic test results of 467 index patients from apparently unrelated families with hypertrophic cardiomyopathy were evaluated. Causal variants were found in 185 of 467 (40%) families. Nonunique variants accounted for 122 of 185 (66%) families. The most common single genetic cause of hypertrophic cardiomyopathy is the recurrent MYBPC3 (myosin-binding protein-C) variant c.1504C>T, p.Arg502Trp, which was found in 13 of 185 (7%) families with a causal variant identified. Thirteen variants in MYBPC3 and MYH7 (myosin heavy chain 7) were each identified >3 times and accounted for 78 of 185 (42%) hypertrophic cardiomyopathy families with a causal variant. Haplotype analysis of these 13 variants was performed on 126 individuals from 70 Australian families, and 11 variants arose through recurrent mutation events. Two variants, MYBPC3 c.1928-2A>G and MYH7 c.2681A>G, p.Glu894Gly, were found on 1 haplotype in 6 families each, supportive of a single mutation event inherited from a common ancestor. The majority of families with a causal variant identified have a nonunique variant. Discovery of the genetic origins of human disease forms a fundamental basis for improved understanding of disease pathogenesis and phenotype development. © 2017 American Heart Association, Inc.

  8. Multiple Gene Variants in Hypertrophic Cardiomyopathy in the Era of Next-Generation Sequencing.

    PubMed

    Burns, Charlotte; Bagnall, Richard D; Lam, Lien; Semsarian, Christopher; Ingles, Jodie

    2017-08-01

    Multiple likely pathogenic/pathogenic (LP/P; ≥2) variants in patients with hypertrophic cardiomyopathy were described 10 years ago with a prevalence of 5%. We sought to re-examine the significance of multiple rare variants in patients with hypertrophic cardiomyopathy in the setting of comprehensive and targeted panels. Of 758 hypertrophic cardiomyopathy probands, we included 382 with ≥45 cardiomyopathy genes screened. There were 224 (59%) with ≥1 rare variant (allele frequency ≤0.02%). Variants were analyzed using varying sized gene panels to represent comprehensive or targeted testing. Based on a 45-gene panel, 127 (33%) had a LP/P variant, 139 (36%) had variants of uncertain significance, and 66 (17%) had multiple rare variants. A targeted 8-gene panel yielded 125 (32%) LP/P variants, 52 (14%) variants of uncertain significance, and 14 (4%) had multiple rare variants. No proband had 2 LP/P variants. Including affected family members (total n=412), cluster-adjusted analyses identified a phenotype effect, with younger age (odds ratio, 0.95; 95% confidence interval, 0.92-0.98; P=0.004) and family history of sudden cardiac death (odds ratio, 3.5; 95% confidence interval, 1.3-9.9; P=0.02) significantly more likely in multiple versus single variant patients when considering an 8-gene panel but not larger panels. Those with multiple variants had worse event-free survival from all-cause death, cardiac transplantation, and cardiac arrest (log-rank P=0.008). No proband had multiple LP/P variants in contrast to previous reports. However, multiple rare variants regardless of classification were seen in 4% and contributed to earlier disease onset and cardiac events. Our findings support a cumulative variant hypothesis in hypertrophic cardiomyopathy. © 2017 American Heart Association, Inc.

  9. Vagal enhancement linking abnormal blood pressure response and subendocardial ischemia in hypertrophic cardiomyopathy.

    PubMed

    Kawasaki, Tatsuya; Sugihara, Hiroki

    2014-01-01

    An abnormal blood pressure response to exercise has been reported to be associated with left ventricular subendocardial ischemia in patients with hypertrophic cardiomyopathy (HCM), but the underlying mechanism remains unclear. We report a case of HCM with an abnormal blood pressure response and subendocardial ischemia, in which the analysis of heart rate variability revealed exercise-induced vagal enhancement. The present case highlights the possible mechanism linking abnormal blood pressure response and left ventricular subendocardial ischemia in patients with HCM.

  10. Fate and transport potential for dissolved polycyclic aromatic hydrocarbons from a shallow to a deep aquifer at the Madisonville Creosote works

    USGS Publications Warehouse

    Lee, R.W.; Tzhone, S.; ,

    2002-01-01

    The Remedy selected for a deep aquifer at the Madisonville Creosote Works, which have a potential threat of contamination from a nearby contaminated shallow aquifer is presented. The remedy includes monitoring, in consideration of the low permeability of the clay unit separating the two aquifers and the limited transport potential of the dissolved polycyclic aromatic hydrocarbons. A computer model was used for predication of the potential fate and transport of contaminants to the deep drinking water supply aquifer. The model results show conservative breakthrough of naphthalene from the source creosote in the shallow water bearing zone at about 150 years.

  11. Co-localization of LTBP-2 with FGF-2 in fibrotic human keloid and hypertrophic scar.

    PubMed

    Sideek, Mohamed A; Teia, Abdulrahman; Kopecki, Zlatko; Cowin, Allison J; Gibson, Mark A

    2016-02-01

    We have recently shown that Latent transforming growth factor-beta-1 binding protein-2 (LTBP-2) has a single high-affinity binding site for fibroblast growth factor-2 (FGF-2) and that LTBP-2 blocks FGF-2 induced cell proliferation. Both proteins showed strong co-localisation within keloid skin from a single patient. In the current study, using confocal microscopy, we have investigated the distribution of the two proteins in normal and fibrotic skin samples including normal scar tissue, hypertrophic scars and keloids from multiple patients. Consistently, little staining for either protein was detected in normal adult skin and normal scar samples but extensive co-localisation of the two proteins was observed in multiple examples of hypertrophic scars and keloids. LTBP-2 and FGF-2 were co-localised to fine fibrous elements within the extracellular matrix identified as elastic fibres by immunostaining with anti-fibrillin-1 and anti-elastin antibodies. Furthermore, qPCR analysis of RNA samples from multiple patients confirmed dramatically increased expression of LTBP-2 and FGF-2, similar TGF-beta 1, in hypertrophic scar compared to normal skin and scar tissue. Overall the results suggest that elevated LTBP-2 may bind and sequester FGF-2 on elastic fibres in fibrotic tissues and modulate FGF-2's influence on the repair and healing processes.

  12. Aberrant α-Adrenergic Hypertrophic Response in Cardiomyocytes from Human Induced Pluripotent Cells

    PubMed Central

    Földes, Gabor; Matsa, Elena; Kriston-Vizi, János; Leja, Thomas; Amisten, Stefan; Kolker, Ljudmila; Kodagoda, Thusharika; Dolatshad, Nazanin F.; Mioulane, Maxime; Vauchez, Karine; Arányi, Tamás; Ketteler, Robin; Schneider, Michael D.; Denning, Chris; Harding, Sian E.

    2014-01-01

    Summary Cardiomyocytes from human embryonic stem cells (hESC-CMs) and induced pluripotent stem cells (hiPSC-CMs) represent new models for drug discovery. Although hypertrophy is a high-priority target, we found that hiPSC-CMs were systematically unresponsive to hypertrophic signals such as the α-adrenoceptor (αAR) agonist phenylephrine (PE) compared to hESC-CMs. We investigated signaling at multiple levels to understand the underlying mechanism of this differential responsiveness. The expression of the normal α1AR gene, ADRA1A, was reversibly silenced during differentiation, accompanied by ADRA1B upregulation in either cell type. ADRA1B signaling was intact in hESC-CMs, but not in hiPSC-CMs. We observed an increased tonic activity of inhibitory kinase pathways in hiPSC-CMs, and inhibition of antihypertrophic kinases revealed hypertrophic increases. There is tonic suppression of cell growth in hiPSC-CMs, but not hESC-CMs, limiting their use in investigation of hypertrophic signaling. These data raise questions regarding the hiPSC-CM as a valid model for certain aspects of cardiac disease. PMID:25418732

  13. Activation of PKCα and PI3K Kinases in Hypertrophic and Nodular Port Wine Stain Lesions.

    PubMed

    Yin, Rong; Gao, Lin; Tan, Wenbin; Guo, Wei; Zhao, Tao; Nelson, Jhon Stuart; Wang, Gang

    2017-10-01

    Port wine stain (PWS) is a congenital, progressive vascular malformation. Many patients with PWS develop hypertrophy and discrete nodularity during their adult life, but the mechanism(s) remain incompletely understood. In this study, we attempted to investigate activation status of PKCα, PI3K, PDPK1 and PLC-γ and protein levels of PP2A and DAG to explore their potential roles in the formation of hypertrophic and nodular PWS lesions. We found phosphorylated levels of PKCα, PI3K, PDPK1, and PLC-γ and protein levels of PP2A and DAG showed moderate increases in the endothelial cells of hypertrophic PWS as compared to the adjacent normal skin. These increases extended throughout the entire stroma of blood vessels in PWS nodules. Many proliferating cells, such as fibroblasts, also showed strong activation of PKCα, PI3K, PDPK1 and PLC-γ and upregulations of PP2A and DAG in nodular PWS lesions. Our data showed that there is aberrant activation of PKCα, PI3K, PDPK1 and PLC-γ and upregulation of PP2A and DAG mainly in endothelial cells in hypertrophic PWS areas, but presenting in the entire vasculatures and surrounding fibroblasts in PWS nodules. Our data suggest that both PKCα and PI3K signaling pathways contribute to the development of hypertrophy and nodularity in adult PWS.

  14. [Detection and quantification of myocardial fibrosis in hypertrophic cardiomyopathy by contrast-enhanced cardiovascular magnetic resonance].

    PubMed

    Pujadas, Sandra; Carreras, Francesc; Arrastio, Xabier; Leta, Rubén; Vila, Montserrat; Subirana, María Teresa; Bayés-Genís, Antoni; Pons-Lladó, Guillem

    2007-01-01

    Severity of hypertrophic cardiomyopathy has been associated with the amount of myocardial fibrosis in autopsy studies. Cardio-vascular magnetic resonance allows, by means of the delayed contrast-enhancement technique, an in vivo detection of focal myocardial fibrosis. Our aim was to study myocardial fibrosis in patients with hypertrophic cardiomyopathy by means of contrast-enhance cardio-vascular magnetic resonance. 43 patients (30 males; mean age 47 [18] years) were studied by cardio-vascular magnetic resonance. In all patients left ventricular function and mass was analyzed. Total mass of myocardial fibrosis, as identified by delayed contrast-enhancement, was also calculated. In 63% of patients some degree of myocardial delayed contrast-enhancement was observed, total mass of myocardial fibrosis ranging between 1 and 59 g (mean: 17 g). There was a positive correlation between the amount of myocardial fibrosis and the degree of hypertrophy. Maximal wall thickness was higher in patients with myocardial fibrosis (23 [7] vs 18 [4] mm, respectively, P=.04). Familial cases were also more prevalent among this group (48% vs 13%, respectively), as well as conventional clinical risk factors. Myocardial fibrosis as detected by contrast-enhanced cardio-vascular magnetic resonance is highly prevalent in hypertrophic cardiomyopathy patients, particularly in familial cases with severe hypertrophy and associated risk factors.

  15. Acute effects of sildenafil and dobutamine in the hypertrophic and failing right heart in vivo

    PubMed Central

    2013-01-01

    Abstract The purpose of this study was to investigate whether acute intravenous administration of the phosphodiesterase type 5 (PDE-5) inhibitor sildenafil in a single clinically relevant dose improves the in vivo function of the hypertrophic and failing right ventricle (RV). Wistar rats () were subjected to pulmonary trunk banding (PTB) causing RV hypertrophy and failure. Four weeks after surgery, they were randomized to receive an intravenous bolus dose of sildenafil (1 mg/kg; ), vehicle (), or dobutamine (10 μg/kg; ). Invasive RV pressures were recorded continuously, and transthoracic echocardiography was performed 1, 5, 15, 25, 35, 50, 70, and 90 minutes after injecting the bolus. Cardiac function was compared to baseline measurements to evaluate the in vivo effects of each specific treatment. The PTB procedure caused significant hypertrophy, cardiac fibrosis, and reduction in RV function evaluated by echocardiography (TAPSE) and invasive pressure measurements. Sildenafil did not improve the function of the hypertrophic failing right heart in vivo, measured by TAPSE, RV systolic pressure (RVsP), and dp/dtmax. Dobutamine improved RV function 1 minute after injection measured by TAPSE ( vs. cm; ), RVsP ( vs. mmHg; ), and dp/dtmax ( vs. mmHg/s; ). Acute administration of the PDE-5 inhibitor sildenafil in a single clinically relevant dose did not modulate the in vivo function of the hypertrophic failing right heart of the rat measured by echocardiography and invasive hemodynamics. In the same model, dobutamine acutely improved RV function. PMID:24618544

  16. Idiopathic non-hypertrophic pyloric stenosis in an infant successfully treated via endoscopic approach

    PubMed Central

    Karnsakul, Wikrom; Cannon, Mary L; Gillespie, Stacey; Vaughan, Richard

    2010-01-01

    Non-peptic, non-hypertrophic pyloric stenosis has rarely been reported in pediatric literature. Endoscopic pyloric balloon dilation has been shown to be a safe procedure in treating gastric outlet obstruction in older children and adults. Partial gastric outlet obstruction (GOO) was diagnosed in an infant by history and confirmed by an upper gastrointestinal series (UGI). Abdominal ultrasonography and computed tomography scan excluded idiopathic hypertrophic pyloric stenosis, abdominal tumors, gastrointestinal and hepato-biliary-pancreatic anomalies. Endoscopic findings showed a pinhole-sized pylorus and did not indicate peptic ulcer disease, Helicobacter pylori infection, antral web, or evidence of allergic and inflammatory bowel diseases. Three sessions of a step-wise endoscopic pyloric balloon dilation were conducted under general anesthesia and a fluoroscopy at two week intervals using catheter balloons (Boston Scientific Microvasive®, MA, USA) of increasing diameters. Repeat UGI after the first session revealed normal gastrointestinal transit and no intestinal obstruction. The patient tolerated solid food without any gastrointestinal symptoms since the first session. The endoscope was able to be passed through the pylorus after the last session. Although the etiology of GOO in this infant is unclear (proposed mechanisms are herein discussed), endoscopic pyloric balloon dilation was a safe procedure for treating this young infant with non-peptic, non-hypertrophic pyloric stenosis and should be considered as an initial approach before pyloroplasty in such presentations. PMID:21191516

  17. Topical Silicone Sheet Application in the Treatment of Hypertrophic Scars and Keloids.

    PubMed

    Westra, Iris; Pham, Hth; Niessen, Frank B

    2016-10-01

    Objective: Since the early 1980s, topical silicone sheets have been used in the treatment of hypertrophic scars and keloids.This study aimed to determine the optimal duration and application of these sheets. Design: multi-centered therapeutic study. Setting and participants: A total of 224 patients were included in this study; 205 patients with hypertrophic scars and 19 patients with keloids. Patients received treatment with a topical silicone sheet. Treated scars varied in age, ranging from two weeks to 62 years and treatment time ranged from one month to 16 months. Assessment of the scars was performed by the use of standardized study forms and digital photography. Measurements: Skin therapists objectively assessed the scars on its color, thickness, and elasticity. Patients themselves subjectively assessed their perception of their scar and their experience with the usage of the topical silicone sheet. Results: After applying the topical silicone sheet, all scars, regardless of type of scar and maturity, improved significantly in color, thickness, and elasticity. Conclusion: In this study, treatment with the topical silicone sheet showed significant improvement on both hypertrophic scars and keloids. Best results were reached when the silicone sheet was applied at least four hours per day.

  18. Benazepril and subclinical feline hypertrophic cardiomyopathy: A prospective, blinded, controlled study

    PubMed Central

    Di Fruscia, Rocky

    2006-01-01

    Abstract Twenty-one cats with hypertrophic cardiomyopathy were enrolled in this study to determine if the administration of benazepril (0.5 mg/kg body weight [BW], PO, q24h) to cats with subclinical hypertrophic cardiomyopathy improves cardiac diastolic function and reverses left ventricular hypertrophy when compared with diltiazem controlled delivery (CD) (10 mg/kg BW, PO, q24h). Cats were evaluated at day 0 and after 3 and 6 months of therapy. In the benazepril group (n = 11), the diastolic transmitral flow of the E and A waves ratio (E/A ratio) increased significantly between 0 and 6 months (P = 0.009) and the thickness of the left ventricular free wall in systole (LVFWs) decreased significantly between 0 and 3 months (P = 0.04). In the diltiazem CD group (n = 5), none of the parameters varied significantly throughout the study. There was no difference between the benazepril and the diltiazem CD group throughout the study. Therefore, the variations observed for the E/A ratio and the LVFWs may have been incidental. Further studies will be needed to establish the role of benazepril in subclinical hypertrophic cardiomyopathy in cat. PMID:16734369

  19. HOXA9 regulates angiogenesis in human hypertrophic scars: induction of VEGF secretion by epidermal stem cells

    PubMed Central

    Cao, Peng-Fei; Xu, Ying-Bin; Tang, Jin-Ming; Yang, Rong-Hua; Liu, Xu-Sheng

    2014-01-01

    Hypertrophic scars are fibroproliferative disorders of excessive wound healing after skin injury. Vascular endothelial growth factor (VEGF)-induced angiogenesis plays a major role in fibrogenesis and hypertrophic scar formation. Over recent years, there has been a major interest in homeobox gene regulation of VEGF-VEGFR mediated angiogenesis in dermal tissue. In the current study, we investigated the role of homeobox genes in the epidermis, for their role in angiogenesis, with a focus on epidermal-mesenchymal interactions. As epidermal stem cells (ESCs) have a central role in epidermal homeostasis, we tested the hypothesis that these cells play a key role in the pathogenesis of hypertrophic scars through the HOXA9-VEGF/VEGFR signaling pathways. We found significant differences in the expression of homeobox A9 in hyperplastic scar tissue during different phases of development. These differences coincided with similar regulations in VEGF expression and with the distribution of ESCs. HOXA9 is expressed in cultured human ESCs in vitro. Antisense suppression of HOXA9 expression was found to suppress VEGF levels in ESCs. Together these findings indicate that homeobox A9 regulates the expression of VEGF in ESCs. PMID:25031718

  20. Assessment of chest pain in hypertrophic cardiomyopathy using exercise thallium-201 myocardial scintigraphy.

    PubMed Central

    Pitcher, D; Wainwright, R; Maisey, M; Curry, P; Sowton, E

    1980-01-01

    Exercise thallium-201 myocardial scintigraphy was performed in 23 patients with hypertrophic cardiomyopathy. Eighteen patients presented with chest pain which was a persistent symptom in 11. Selective coronary arteriography was performed in 16 patients and showed normal coronary arteries in 15 and insignificant luminal irregularities in one patient. Eighteen patients had abnormal scintigrams. Three had an abnormal distribution of tracer entirely attributable to asymmetric septal hypertrophy, whereas 15 had discrete tracer uptake defects which could not be explained solely by myocardial hypertrophy. In this latter group of patients three scintigraphic patterns were identified: (1) in 10 patients defects were seen in scintigrams immediately after exercise but not in delayed images obtained four to six hours later. Eight of these patients had chest pain. (2) Four patients had uptake defects seen in both initial and delayed images. One patient had chest pain. (3) In three patients, one of whom had chest pain, tracer defects were seen only in delayed images and were not apparent in the initial scintigrams. Chest pain occurred in eight out of 10 patients with scintigraphic evidence of myocardial ischaemia but was present in only three out of 13 patients with non-ischaemic scintigrams. The value of exercise thallium-201 myocardial imaging as a diagnostic technique in hypertrophic cardiomyopathy appears limited. Scintigraphic evidence of regional myocardial ischaemia in the absence of significant coronary artery disease, however, contributes to an understanding of the mechanism of angina production in patients with hypertrophic cardiomyopathy. Images PMID:7193039

  1. Short term reduction of left ventricular mass in primary hypertrophic cardiomyopathy by octreotide injections.

    PubMed Central

    Günal, A. I.; Işik, A.; Celiker, H.; Eren, O.; Celebi, H.; Günal, S. Y.; Lüleci, C.

    1996-01-01

    Growth factors have been shown to be associated with primary hypertrophic cardiomyopathy. Octreotide, a long acting somatostatin analogue, can prevent the stimulating effect of growth factors and decrease the left ventricular mass in patients with acromegaly. In the light of these results, three patients with primary hypertrophic cardiomyopathy were treated with subcutaneous octreotide (50 micrograms three times a day during the first week and 100 micrograms twice a day for the following three weeks). Initially, two patients were in New York Heart Association class II in and one was in class III. At the end of a four week treatment session all were in class I. There were significant decreases in left ventricular posterior wall thickness, interventricular septum thickness, and left ventricular mass in all three patients. Both left ventricular end diastolic and end systolic diameters had increased in all of the patients at the end of the fourth week. Two of three patients showed improved diastolic filling: their hyperdynamic systolic performance returned to normal. No side effects were observed during octreotide treatment. The considerable improvement obtained with the short term octreotide treatment in patients with primary hypertrophic cardiomyopathy seems promising. PMID:8944587

  2. Altered hypertrophic chondrocyte kinetics in GDF-5 deficient murine tibial growth plates.

    PubMed

    Mikic, B; Clark, R T; Battaglia, T C; Gaschen, V; Hunziker, E B

    2004-05-01

    The growth/differentiation factors (GDFs) are a subgroup of the bone morphogenetic proteins best known for their role in joint formation and chondrogenesis. Mice deficient in one of these signaling proteins, GDF-5, exhibit numerous skeletal abnormalities, including shortened limb bones. The primary aim of this study was determine whether GDF-5 deficiency would alter the growth rate in growth plates from the long bones in mice and, if so, how this is achieved. Stereologic and cell kinetic parameters in proximal tibial growth plates from 5-week-old female GDF-5 -/- mice and control littermates were examined. GDF-5 deficiency resulted in a statistically significant reduction in growth rate (-14%, p=0.03). The effect of genotype on growth rate was associated with an altered hypertrophic phase duration, with hypertrophic cells from GDF-5 deficient mice exhibiting a significantly longer phase duration compared to control littermates (+25%, p=0.006). These data suggest that one way in which GDF-5 might modulate the rate of endochondral bone growth could be by affecting the duration of the hypertrophic phase in growth plate chondrocytes.

  3. Porous decellularized tissue engineered hypertrophic cartilage as a scaffold for large bone defect healing.

    PubMed

    Cunniffe, Gráinne M; Vinardell, Tatiana; Murphy, J Mary; Thompson, Emmet M; Matsiko, Amos; O'Brien, Fergal J; Kelly, Daniel J

    2015-09-01

    Clinical translation of tissue engineered therapeutics is hampered by the significant logistical and regulatory challenges associated with such products, prompting increased interest in the use of decellularized extracellular matrix (ECM) to enhance endogenous regeneration. Most bones develop and heal by endochondral ossification, the replacement of a hypertrophic cartilaginous intermediary with bone. The hypothesis of this study is that a porous scaffold derived from decellularized tissue engineered hypertrophic cartilage will retain the necessary signals to instruct host cells to accelerate endogenous bone regeneration. Cartilage tissue (CT) and hypertrophic cartilage tissue (HT) were engineered using human bone marrow derived mesenchymal stem cells, decellularized and the remaining ECM was freeze-dried to generate porous scaffolds. When implanted subcutaneously in nude mice, only the decellularized HT-derived scaffolds were found to induce vascularization and de novo mineral accumulation. Furthermore, when implanted into critically-sized femoral defects, full bridging was observed in half of the defects treated with HT scaffolds, while no evidence of such bridging was found in empty controls. Host cells which had migrated throughout the scaffold were capable of producing new bone tissue, in contrast to fibrous tissue formation within empty controls. These results demonstrate the capacity of decellularized engineered tissues as 'off-the-shelf' implants to promote tissue regeneration.

  4. [Relationship between the level of maternal glycated hemoglobin and fetal hypertrophic cardiomyopathy].

    PubMed

    Sánchez-Martínez, Karla Lucía; Oseguera-Torres, Luis Fernando; Ávalos-Nuño, Joel

    2016-01-01

    Diabetes mellitus is a metabolic disorder commonly associated with pregnancy. It is shown that as the management of diabetes during pregnancy is optimized, decreases the frequency and severity of fetal and neonatal complications. The aim of this paper is to identify the relation between the level of maternal glycated hemoglobin and fetal hypertrophic cardiomyopathy. An analitytic cross-sectional study was conducted. It included patients with single pregnancy of 28-37 weeks diagnosed with gestational or preconception diabetes mellitus. A fetal echocardiogram were performed, likewise measuring of glycated hemoglobin. 104 diabetic pregnant patients were included in the study, 83 patients in the group with normal glycated hemoglobin and 21 in the group with altered glycated hemoglobin. Of the 104 patients, 12 had fetal hypertrophic cardiomyopathy; 5 of the group with normal glycated hemoglobin and 7 with altered glycated hemoglobin. There is a clear association previously reported between the level maternal metabolic control and the presence of fetal and neonatal complications. A positive correlation between the values of high maternal glycated hemoglobin and increased thickness of the fetal ventricular septum was observed. Fetal echocardiographic assessment is recommended for all pregnant women with gestational and pre-pregnancy diabetes mellitus in order to early detection of fetal hypertrophic cardiomyopathy.

  5. Community composition of nirS-type denitrifier in a shallow eutrophic lake.

    PubMed

    Yang, Jiang-Ke; Cheng, Zhan-Bing; Li, Jia; Miao, Li-Hong

    2013-11-01

    Denitrification is a major biological process to reduce nitrate to molecular nitrogen (N2). In shallow eutrophic lakes, this process can remove the largest portion of fixed nitrogen and plays an important role in self-purification of this ecosystem. To understand the structure of denitrifying communities in a shallow eutrophic lake, denitrifier communities in four sub-lakes of East Lake in Wuhan, China, were explored by restriction fragment length polymorphisms (RFLP) analysis and sequencing of nirS gene clone libraries. nirS is a functional marker gene for denitrification encoding cytochrome cd 1-containing nitrite reductase, which catalyzes the reduction of nitrite to nitric oxide. Both RFLP fingerprints clustering analysis and phylogeny analysis based on the amino acid sequences of NirS revealed that NirS-type communities in East Lake sediment could be roughly divided into three clusters. Cluster I accounted for 74-82 % of clones from the moderately eutrophic sub-lakes Tuan, Tang Ling, and Guo Zheng. Cluster II accounted for 76 % of the communities in hypertrophic sub-lake Miao Lake and cluster III as a minor group (7 % of the total), mainly presented in Miao Lake. Phylogenetic analysis revealed that cluster I was related to the reference clones from a broad range of ecological environments, and clusters II and III were more phylogenetically related to the reference clones from entrophic environments. Canonical correspondence analysis indicated that total nitrogen, total phosphate, total organic carbon, and NH4-N and NO2-N were important environmental factors affecting the dispersion of NirS-type denitrifier in the sediments. Cluster I showed a weak relationship with the nutrient content, while cluster II and III were positively related with the nutrient content. Principal coordinates analysis indicated that NirS-type communities from Tuan Lake, Tang Ling Lake, and Guo Zheng Lake sediments were divergent from those found in river, estuary sediment, and forest

  6. Laboratory assessment of bioleaching of shallow eutrophic sediment by immobilized photosynthetic bacteria.

    PubMed

    Sun, Shiyong; Fan, Shenglan; Shen, Kexuan; Lin, Shen; Nie, Xiaoqin; Liu, Mingxue; Dong, Faqin; Li, Jian

    2016-12-07

    Eutrophic sediment is a serious problem in ecosystem restoration, especially in shallow lake ecosystems. We present a novel bioleaching approach to treat shallow eutrophic sediment with the objective of preventing the release of nitrate, phosphate, and organic compounds from the sediment to the water column, using porous mineral-immobilized photosynthetic bacteria (PSB). Bioactivity of bacteria was maintained during the immobilization process. Immobilized PSB beads were directly deposited on the sediment surface. The deposited PSB utilized pollutants diffused from the sediment as a nutritive matrix for growth. We evaluated the effects of light condition, temperature, initial pH, amount of PSB beads, and frequency of addition of PSB beads for contaminant removal efficiency during bioleaching operations. The presented study indicated that immobilized PSB beads using porous minerals as substrates have considerable application potential in bioremediation of shallow eutrophic lakes.

  7. The Argentinean network for the assessment and monitoring of Pampean shallow-lakes (PAMPA2)

    NASA Astrophysics Data System (ADS)

    Zagarese, H. E.

    2012-12-01

    The Pampa region of Argentina is an extensive wetland containing nearly 200,000 shallow-lakes. The region is under increasing agricultural pressure resulting from climate change (increased temperature and precipitation) and the substitution of cattle breeding and traditional cultures by transgenic soy. Among the many services that they provide, shallow-lakes are highly responsive to changes in climate and land use. Therefore, long-term studies of shallow-lakes provide useful clues to understand and track changes occurring in their complex watersheds. PAMPA2 is a recently funded, long-term network project, with wide geographic coverage, aimed at studying Pampean shallow-lakes. Thirteen network sites (i.e., shallow lakes) occurring along the precipitation gradient (from < 300 mm y-1 to > 1000 mm y-1) form the core of the project. The network integrates various research teams from eight universities and research centers, with a strong multidisciplinary component. The approaches combine traditional sampling; high-rate monitoring using automated sensors; and remote sensing. The network develops and manufactures most the instruments, including automated buoys and unmanned aircrafts. In this presentation, we will provide details on the structure and state of development of the PAMPA2 network, and present a long-term case study of a large Pampean shallow-lake, exemplifying the strong dependence of lake processes on weather variables. Laguna Chascomús is a large, hypertrophic shallow-lake. Chascomús is one of the PAMPA2 study sites that have been more extensively studied. In this shallow-lake, high nutrient availability permits the development of a dense microbial plankton community, which in turn translates into exceptionally high water turbidity. Phytoplankton primary production is strongly limited by light availability. As a consequence, turbidity is strongly and positively correlated to the incoming solar radiation, resulting in a remarkable seasonal pattern of water

  8. Unconventional shallow biogenic gas systems

    USGS Publications Warehouse

    Shurr, G.W.; Ridgley, J.L.

    2002-01-01

    Unconventional shallow biogenic gas falls into two distinct systems that have different attributes. Early-generation systems have blanketlike geometries, and gas generation begins soon after deposition of reservoir and source rocks. Late-generation systems have ringlike geometries, and long time intervals separate deposition of reservoir and source rocks from gas generation. For both types of systems, the gas is dominantly methane and is associated with source rocks that are not thermally mature. Early-generation biogenic gas systems are typified by production from low-permeability Cretaceous rocks in the northern Great Plains of Alberta, Saskatchewan, and Montana. The main area of production is on the southeastern margin of the Alberta basin and the northwestern margin of the Williston basin. The huge volume of Cretaceous rocks has a generalized regional pattern of thick, non-marine, coarse clastics to the west and thinner, finer grained marine lithologies to the east. Reservoir rocks in the lower part tend to be finer grained and have lower porosity and permeability than those in the upper part. Similarly, source beds in the units have higher values of total organic carbon. Patterns of erosion, deposition, deformation, and production in both the upper and lower units are related to the geometry of lineament-bounded basement blocks. Geochemical studies show that gas and coproduced water are in equilibrium and that the fluids are relatively old, namely, as much as 66 Ma. Other examples of early-generation systems include Cretaceous clastic reservoirs on the southwestern margin of Williston basin and chalks on the eastern margin of the Denver basin. Late-generation biogenic gas systems have as an archetype the Devonian Antrim Shale on the northern margin of the Michigan basin. Reservoir rocks are fractured, organic-rich black shales that also serve as source rocks. Although fractures are important for production, the relationships to specific geologic structures are

  9. Shallow cumulus rooted in photosynthesis

    NASA Astrophysics Data System (ADS)

    Vila-Guerau Arellano, J.; Ouwersloot, H.; Horn, G.; Sikma, M.; Jacobs, C. M.; Baldocchi, D.

    2014-12-01

    We investigate the interaction between plant evapotranspiration, controlled by photosynthesis (for a low vegetation cover by C3 and C4 grasses), and the moist thermals that are responsible for the formation and development of shallow cumulus clouds (SCu). We perform systematic numerical experiments at fine spatial scales using large-eddy simulations explicitly coupled to a plant-physiology model. To break down the complexity of the vegetation-atmospheric system at the diurnal scales, we design the following experiments with increasing complexity: (a) clouds that are transparent to radiation, (b) clouds that shade the surface from the incoming shortwave radiation and (c) plant stomata whose apertures react with an adjustment in time to cloud perturbations. The shading by SCu leads to a strong spatial variability in photosynthesis and the surface energy balance. As a result, experiment (b) simulates SCu that are characterized by less extreme and less skewed values of the liquid water path and cloud-base height. These findings are corroborated by the calculation of characteristics lengths scales of the thermals and clouds using autocorrelation and spectral analysis methods. We find that experiments (a) and (b) are characterized by similar cloud cover evolution, but different cloud population characteristics. Experiment (b), including cloud shading, is characterized by smaller clouds, but closer to each other. By performing a sensitivity analysis on the exchange of water vapor and carbon dioxide at the canopy level, we show that the larger water-use efficiency of C4 grass leads to two opposing effects that directly influence boundary-layer clouds: the thermals below the clouds are more vigorous and deeper driven by a larger buoyancy surface flux (positive effect), but are characterized by less moisture content (negative effect). We conclude that under the investigated mid-latitude atmospheric and well-watered soil conditions, SCu over C4 grass fields is characterized

  10. Shallow Land Burial Technology - Humid

    SciTech Connect

    Davis, E.C.; Spalding, B.P.; Lee, S.Y.

    1983-01-01

    The Shallow Land Burial Technology - Humid Project is being conducted for the Department of Energy Low-Level Waste Management Program with the objective of identifying and demonstrating improved technology for disposing of low-level solid waste in humid environments. Two improved disposal techniques are currently being evaluated using nine demonstration trenches at the Engineered Test Facility (ETF). The first is use of a cement-bentonite grout applied as a waste backfill material prior to trench closure and covering. The second is complete hydrologic isolation of waste by emplacement in a trench that is lined on all four sides, top and bottom using synthetic impermeable lining material. An economic analysis of the trench grouting and lining demonstration favored the trench lining operation ($1055/demonstration trench) over trench grouting ($1585/demonstration trench), with the cost differential becoming even greater (as much as a factor of 6 in favor of lining for typical ORNL trenches) as trench dimensions increase and trench volumes exceed those of the demonstration trenches. In addition to the evaluation of trench grouting and lining, major effort has centered on characterization of the ETF site. Though only a part of the overall study, characterization is an extremely important component of the site selection process; it is during these activities that potential problems, which may obviate the site from further consideration, are found. Characterization of the ETF has included studies of regional and site-specific geology, the physical and chemical properties of the soils in which the demonstration trenches are located, and hydrology of the small watershed of which the ETF is a part. 12 references, 6 figures, 2 tables.

  11. Shallow land burial technology: humid

    SciTech Connect

    Davis, E.C.; Yeh, G.T.

    1984-01-01

    Applying engineered modifications to present shallow land burial (SLB) practices is one method of ensuring safe operation and improving overall disposal-site performance. Two such engineered modifications, trench lining and grouting, are being demonstrated and evaluated at the Oak Ridge National Laboratory (ORNL) Engineered Test Facility (ETF), using nine 28-m/sup 3/ experimental trenches containing compacted low-level waste (LLW). Concurrent to this field demonstration experiment, two finite-element hydrologic models have been developed to model water movement and solute transport at a waste disposal site. This paper covers progress made in these two areas during FY 1984. Though the economic analysis of the two trench treatments favored Hypalon lining (lining costs were 33% lower at this demonstration scale), results of field experiments examining waste hydrologic isolation favored the cement-bentonite grout treatment. Data from water pump-out and water pump-in tests, combined with observed intratrench water-level fluctuations, suggest that the original goal of constructing watertight liners in three experimental trenches was not achieved. In addition, trench-cover subsidence of approx. 2% of the total trench depth has been measured over two of the three lined trenches but has not occurred over any of the three grouted or three control (untreated) trenches. The evaluation of the two trench treatments is continuing. However, results indicate that the cement-bentonite treatment, implemented at a cost of $160/m/sup 3/ of grout, provides a degree of waste isolation not afforded by the lined and control trenches and should be considered for use at SLB sites with water-related problems. 11 references, 6 figures, 2 tables.

  12. Assessment of groundwater quality in shallow wells within the southern districts of Malawi

    NASA Astrophysics Data System (ADS)

    Pritchard, M.; Mkandawire, T.; O'Neill, J. G.

    Lack of safe drinking water is a major problem in developing countries. Within Africa most people rely mainly on local groundwater sources for their water needs. These can be deep boreholes or shallow wells, the latter are normally found in poorer communities as they are the least expensive to construct. Over time water from these sources can be contaminated leading to fatal consequences. Previous monitoring of the quality of water from boreholes and shallow wells have been irregular, with the focus being mainly on boreholes. Information on seasonal water quality changes in shallow wells used by rural communities in Malawi has generally been lacking. A study was conducted from 2006 to 2007 to determine the quality of water from shallow wells in three districts in southern Malawi namely, Balaka, Chikwawa and Zomba districts. Water samples from 21 covered and five open shallow wells were analysed for chemical, microbiological and physical parameters using a portable water testing kit. Sampling was carried out at four different times of the year i.e. in August and October 2006 (dry season) and February and April 2007 (wet season). Microbiological data indicated that around 80% of the samples, obtained from the covered wells, failed to meet safe drinking water limits, set by World Health Organisation guidelines and Malawi Bureau of Standards, of zero total and faecal colony forming units (cfu)/100 ml. Values in excess of 1000 cfu/100 ml were noted in 10% of the samples, indicating gross contamination and the probability of pathogens being present. Contamination levels were higher during the wet season than the dry season in all three districts. Arsenic, ammonia, nitrate, nitrite and sulphate were all within the acceptable limits. Elevated levels of hardness, turbidity were noted in certain wells.

  13. Nutrient dynamics in shallow lakes of Northern Greece.

    PubMed

    Petaloti, Christina; Voutsa, Dimitra; Samara, Constantini; Sofoniou, Mihalis; Stratis, Ioannis; Kouimtzis, Themistocles

    2004-01-01

    GOAL, SCOPE, BACKGROUND: Shallow lakes display a number of features that set them apart from the more frequently studied deeper systems. The majority of lakes in Northern Greece are small to moderate in size with a relatively low depth and are considered as sites of high value of the wetland habitat. However, the water quality of these lakes has only been evaluated segmentally and occasionally. The objectives of this study were to thoroughly investigate nitrogen and phosphorus speciation in lakes of a high ecological significance located in N. Greece, in order to evaluate their eutrophication status and possible nutrient limitation factors, and to investigate the main factors/sources that affect the water quality of these systems. An extensive survey was carried out during the period from 1998-1999. Water samples were collected on a monthly basis from lakes Koronia, Volvi, Doirani, Mikri Prespa and Megali Prespa located in N. Greece. Water quality parameters (temperature, dissolved oxygen, pH and conductivity), organic indices (COD, BOD5), and N- and P-species (NO3(-), NO2(-), NH4(+), and PO4(3-), Kieldahl nitrogen and acid-hydrolysable phosphorus) were determined according to standard methods for surface water. Statistical treatment of the data was employed. The physicochemical parameters determined in the lakes studied revealed a high temporal variation. The trophic state of the lakes ranged from meso- to hypertrophic. The nutrient limiting factor varied among lakes suggesting either P-limitation conditions or mixed conditions changing from P- to N-limitation throughout the year. Urban/industrial activities and agricultural runoff are the major factors affecting all lakes, although with a varying contribution. This lake-specific research offers valuable information about water quality and nutrient dynamics in lakes of significant ecological value located in N. Greece that can be useful for an effective pollution control/management of these systems. Due to the

  14. Applications of isotopes to tracing sources of solutes and water in shallow systems

    USGS Publications Warehouse

    Kendall, Carol; Krabbenhoft, David P.

    1995-01-01

    New awareness of the potential danger to water supplies posed by the use of agricultural chemicals has focused attention on the nature of groundwater recharge and the mobility of various solutes, especially nitrate and pesticides, in shallow systems. A better understanding of hydrologic flowpaths and solute sources is required to determine the potential impact of sources of contamination on water supplies, to develop management practices for preserving water quality, and to develop remediation plans for sites that are already contaminated. In many cases, environmental isotopes can be employed as 'surgical tools' for answering very specific questions about water and solute sources. Isotopic data can often provide more accurate information about the system than hydrologic measurements or complicated hydrologic models. This note focuses on practical and cost-effective examples of how naturally-occurring isotopes can be used to track water and solutes as they move through shallow systems.

  15. [Mode of splitting of the second heart sound in patients with hypertrophic cardiomyopathy].

    PubMed

    Fukuda, N; Oki, T; Sakai, H; Asai, M; Ohshima, C; Kusaka, Y; Tominaga, T; Murao, A; Niki, T; Mori, H

    1983-06-01

    Mode of the splitting of the second heart sound ( IIs ) and left ventricular systolic time intervals (STIs) in patients (pts) with hypertrophic cardiomyopathy were compared with those in hypertension (HT) with the global hypertrophy of the left ventricular wall. Forty-seven pts with hypertrophic cardiomyopathy [non-obstructive type (HCM, 30 pts), obstructive type (HOCM, 17 pts)] and 21 pts with HT were studied. The pts with HCM were classified as septal hypertrophic type (19 pts) and apical hypertrophic type (11 pts) on the basis of the echocardiographic findings. The pts with HOCM were classified as resting type (13 pts) and latent type (provoked by amyl nitrite: 4 pts) on the basis of the obstructive sign at rest. Mode of the splitting of the IIs : a) The pts with HCM showed a wide splitting of the IIs . The mean split interval during held expiration (IIA-IIP) was 41.0 +/- 9.9 msec. Twenty pts (67%) showed abnormal respiratory splitting. The mean IIA-IIP interval in septal hypertrophic type (45.3 +/- 9.0 msec) was significantly wider than that in apical hypertrophic type (33.6 +/- 6.7 msec) (p less than 0.05). There was a positive correlation between IIA-IIP interval and the thickness of the upper portion of the interventricular septum (r = 0.63). b) Nine out of 13 pts with resting type of HOCM showed a paradoxical (reversed) splitting with a mean IIA-IIP interval of -23.8 +/- 24.4 msec. On the other hand, pts with latent type showed a wide splitting similar to HCM with a mean IIA-IIP interval of 35.0 +/- 7.1 msec. c) The pts with HT showed a single IIs or physiological splitting. The mean IIA-IIP interval was 14.5 +/- 9.3 msec, which was significantly decreased than that of normals or the pts with HCM (p less than 0.01). Left ventricular systolic time intervals: a) The pts with an either type of HCM showed a short corrected left ventricular electromechanical systole [(Q-IIA)c] due to the shortening of the corrected left ventricular ejection time (LVETc). b) The

  16. Contaminant hydrogeology

    SciTech Connect

    Fetter, C.W.

    1993-01-01

    Hydrogeology is a rapidly evolving field in which new approaches and tools are being applied to solve problems. This new book fills an important niche. Fetter focuses primarily on chemical processes in the subsurface, avoiding duplication of materials that are covered in other, more classical texts. This book is an excellent follow-up to his earlier text, Applied Hydrogeology, and reviews only briefly the foundational concepts covered in the earlier textbook. Contaminant Hydrogeology is written at the graduate student level and assumes prerequisite courses in physics, chemistry, and hydrogeology. For the most part, each of the nine chapters covers a major area of concern common to applied contaminant studies. A thorough, theoretical treatment of solute transport through the vadose zone is presented, and a sample problem and a case study add unusually high value to this discussion of a topic that generally is not well understood in the practice. Topics covered include the Buckingham Flux Law, the Richards Equation, vapor-phase transport, equilibrium and nonequilibrium models of mass transport, and preferential flow paths. Nonaqueous-phase liquid migrations under both saturated and unsaturated conditions is covered for horizontal as well as vertical migration. Both light and dense nonaqueous phase liquids are presented, and Darcy's Law for two-phase flow is introduced. The strength of Contaminant Hydrogeology lies in the author's ability to translate concepts through practical experience. This book links the theoretical to the practical through example problems and case histories. It should be considered for use in graduate classes and would be a valuable reference in the library of any practicing hydrogeologist.

  17. Contamination Analyzer

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Measurement of the total organic carbon content in water is important in assessing contamination levels in high purity water for power generation, pharmaceutical production and electronics manufacture. Even trace levels of organic compounds can cause defects in manufactured products. The Sievers Model 800 Total Organic Carbon (TOC) Analyzer, based on technology developed for the Space Station, uses a strong chemical oxidizing agent and ultraviolet light to convert organic compounds in water to carbon dioxide. After ionizing the carbon dioxide, the amount of ions is determined by measuring the conductivity of the deionized water. The new technique is highly sensitive, does not require compressed gas, and maintenance is minimal.

  18. Comparison of borehole geophysics, CPT, resistivity, GPR, and high-resolution seismic data across a shallow structure in unconsolidated sediments

    SciTech Connect

    Temples, T.J.; Wyatt, D.E.; Cumbest, R.; Waddell, M.G.

    1995-12-31

    The geological characterization of the shallow subsurface in the unconsolidated sediments of the Atlantic Coastal Plain, and other unconsolidated sediment regimes, may involve faulting and channeling not readily detectable by conventional drilling and mapping. A knowledge of these features is required in environment and geotechnical studies in areas that may have critical impact to groundwater flow and contaminant transport. In many cases, shallow structural influences are missed during site characterization. A case study is presented using ground penetrating radar (GPR) and high resolution seismic data, compared with a geologic interpretation from borehole logs and core data, with Wenner and dipole-dipole resistivity data and with cone penetrometer (CPT) data in an area where shallow structure is probable and contamination exists.

  19. On the Calculation of Shallow Shells

    NASA Technical Reports Server (NTRS)

    Ambartsumyan, S. A.

    1956-01-01

    This paper considers a sufficiently thin shallow shell of nonzero Gaussian curvature. It also presents a system of symmetrically constructed differential equations, constructed by the mixed method through the stress function and the displpacement function.

  20. Shallow moonquakes - How they compare with earthquakes

    NASA Technical Reports Server (NTRS)

    Nakamura, Y.

    1980-01-01

    Of three types of moonquakes strong enough to be detectable at large distances - deep moonquakes, meteoroid impacts and shallow moonquakes - only shallow moonquakes are similar in nature to earthquakes. A comparison of various characteristics of moonquakes with those of earthquakes indeed shows a remarkable similarity between shallow moonquakes and intraplate earthquakes: (1) their occurrences are not controlled by tides; (2) they appear to occur in locations where there is evidence of structural weaknesses; (3) the relative abundances of small and large quakes (b-values) are similar, suggesting similar mechanisms; and (4) even the levels of activity may be close. The shallow moonquakes may be quite comparable in nature to intraplate earthquakes, and they may be of similar origin.

  1. Collaborative Investigations of Shallow Water Optics Problems

    DTIC Science & Technology

    2004-12-01

    contrast attenuation is also greatest. These results suggest several fruitful avenues Although the range of water types commonly inhabited for future...Collaborative Investigations of Shallow Water Optics Problems FINAL REPORT On Work Performed by Curtis D. Mobley Sequoia Scientific, Inc. 2700...To) 21-12-2004 Final Report Dec 2002 - Dec 2004 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Collaborative Investigations of Shallow Water Optics

  2. Hybrid designed for shallow Arctic operations

    SciTech Connect

    Not Available

    1984-11-01

    A hybrid concrete and steel gravity structure has been developed for drilling and production operations in shallow Arctic waters. Steel is used for interior framing and deck members of the conical structure to reduce weight and draft. An important feature of the design is a minimum draft under 30 ft, permitting near-shore transit of Pt. Barrow and installation in shallow waters. The unique features of the structure are described.

  3. Computerized methodology for evaluating the long-range radiological impact of shallow-land burial

    SciTech Connect

    Fields, D.E.; Little, C.A.; Emerson, C.J.

    1981-01-01

    A computerized methodology has been implemented to calculate the risk to local and intermediate-range (up to 80 km distant) populations resulting from water- and air-borne transport of radionuclides present in low-level wastes buried in shallow trenches such as those used at Oak Ridge. Our computer code, PRESTO (Prediction of Radiation Effects from Shallow Trench Operations), was developed under United States Environmental Protection Agency funding to evaluate possible health effects resulting from shallow burial operations. Sources of contamination include radionuclide releases from the trenches and from areas contaminated with operational spillage. The model is intended to predict radionuclide transport and the ensuing exposure and health impact to at-risk populations for a 1000-year period following cessation of burial ground operations. Several classes of submodels are used in PRESTO to represent scheduled event, unit system response, and risk evaluation processes. Examples of scheduled events are trench cap failure, stabilization of insoluble surface contaminant, the onset of farming or reclamation practices, and human intrusion. Unit system response submodels simulate processes such as infiltration of rainwater into the trench and erosion of soil overburden from the trench cover. System response submodels generate parameters used repeatedly in the 1000-year simulation loop.

  4. Contaminant treatment method

    DOEpatents

    Shapiro, Andrew Philip; Thornton, Roy Fred; Salvo, Joseph James

    2003-01-01

    The present invention provides a method for treating contaminated media. The method comprises introducing remediating ions consisting essentially of ferrous ions, and being peroxide-free, in the contaminated media; applying a potential difference across the contaminated media to cause the remediating ions to migrate into contact with contaminants in the contaminated media; chemically degrading contaminants in the contaminated media by contact with the remediating ions; monitoring the contaminated media for degradation products of the contaminants; and controlling the step of applying the potential difference across the contaminated media in response to the step of monitoring.

  5. Shallow seismicity at open-vent volcanoes

    NASA Astrophysics Data System (ADS)

    Girona, T.; Caudron, C.; Huber, C.

    2016-12-01

    Understanding the origin of the shallow seismicity detected at active volcanoes is fundamental to interpret geophysical and geochemical signals in terms of sub-surface magmatic processes. One of the most intriguing seismic signals is shallow tremor, which is long-lasting (from minutes to months), is usually sourced at shallow levels ( 100's of meters), has dominant frequencies in the range 0.1-20 Hz, and is common to many open-vent and hydrothermal systems. Here, we present a viable mechanism to explain the origin of shallow tremor and its correlation with magma degassing. In particular, we show from basic principles (mass and momentum balance) that shallow tremor can emerge spontaneously as a result of three coupled processes: (1) the formation of gas pockets beneath rheological or geometrical barriers; (2) the intermittent supply of volatiles from depth, e.g., through a bubbly magma column; and (3) the permeable transfer of these gases through a porous lava dome, conduit, or volcanic edifice. Our model, which can be solved analytically at first order, reproduces and provides an explanation for the main features of shallow tremor, including frequency gliding, changes of seismic amplitude when volcanoes enter a period of unrest, and the different types of amplitude spectra observed (i.e., monochromatic, harmonic, and broadband). A crucial conclusion of our study is that different processes (e.g., magma ascent and sealing of gas pathways) cause distinguishable variations in the tremor properties, which could be used by monitoring agencies to improve volcanic forecasting.

  6. Nonlinear spectral imaging of human hypertrophic scar based on two-photon excited fluorescence and second-harmonic generation.

    PubMed

    Chen, G; Chen, J; Zhuo, S; Xiong, S; Zeng, H; Jiang, X; Chen, R; Xie, S

    2009-07-01

    A noninvasive method using microscopy and spectroscopy for analysing the morphology of collagen and elastin and their biochemical variations in skin tissue will enable better understanding of the pathophysiology of hypertrophic scars and facilitate improved clinical management and treatment of this disease. To obtain simultaneously microscopic images and spectra of collagen and elastin fibres in ex vivo skin tissues (normal skin and hypertrophic scar) using a nonlinear spectral imaging method, and to compare the morphological structure and spectral characteristics of collagen and elastin fibres in hypertrophic scar tissues with those of normal skin, to determine whether this approach has potential for in vivo assessment of the pathophysiology of human hypertrophic scars and for monitoring treatment responses as well as for tracking the process of development of hypertrophic scars in clinic. Ex vivo human skin specimens obtained from six patients aged from 10 to 50 years old who were undergoing skin plastic surgery were examined. Five patients had hypertrophic scar lesions and one patient had no scar lesion before we obtained his skin specimen. A total of 30 tissue section samples of 30 mum thickness were analysed by the use of a nonlinear spectral imaging system consisting of a femtosecond excitation light source, a high-throughput scanning inverted microscope, and a spectral imaging detection system. The high-contrast and high-resolution second harmonic generation (SHG) images of collagen and two-photon excited fluorescence (TPEF) images of elastin fibres in hypertrophic scar tissues and normal skin were acquired using the extracting channel tool of the system. The emission spectra were analysed using the image-guided spectral analysis method. The depth-dependent decay constant of the SHG signal and the image texture characteristics of hypertrophic scar tissue and normal skin were used to quantitatively assess the amount, distribution and orientation of their

  7. Repair of bone defects in vivo using tissue engineered hypertrophic cartilage grafts produced from nasal chondrocytes.

    PubMed

    Bardsley, Katie; Kwarciak, Agnieska; Freeman, Christine; Brook, Ian; Hatton, Paul; Crawford, Aileen

    2017-01-01

    The regeneration of large bone defects remains clinically challenging. The aim of our study was to use a rat model to use nasal chondrocytes to engineer a hypertrophic cartilage tissue which could be remodelled into bone in vivo by endochondral ossification. Primary adult rat nasal chondrocytes were isolated from the nasal septum, the cell numbers expanded in monolayer culture and the cells cultured in vitro on polyglycolic acid scaffolds in chondrogenic medium for culture periods of 5-10 weeks. Hypertrophic differentiation was assessed by determining the temporal expression of key marker genes and proteins involved in hypertrophic cartilage formation. The temporal changes in the genes measured reflected the temporal changes observed in the growth plate. Collagen II gene expression increased 6 fold by day 7 and was then significantly downregulated from day 14 onwards. Conversely, collagen X gene expression was detectable by day 14 and increased 100-fold by day 35. The temporal increase in collagen X expression was mirrored by increases in alkaline phosphatase gene expression which also was detectable by day 14 with a 30-fold increase in gene expression by day 35. Histological and immunohistochemical analysis of the engineered constructs showed increased chondrocyte cell volume (31-45 μm), deposition of collagen X in the extracellular matrix and expression of alkaline phosphatase activity. However, no cartilage mineralisation was observed in in vitro culture of up to 10 weeks. On subcutaneous implantation of the hypertrophic engineered constructs, the grafts became vascularised, cartilage mineralisation occurred and loss of the proteoglycan in the matrix was observed. Implantation of the hypertrophic engineered constructs into a rat cranial defect resulted in angiogenesis, mineralisation and remodelling of the cartilage tissue into bone. Micro-CT analysis indicated that defects which received the engineered hypertrophic constructs showed 38.48% in bone volume

  8. Review of factors affecting the distribution and abundance of waterfowl in shallow-water habitats of Chesapeake Bay

    USGS Publications Warehouse

    Perry, M.C.; Deller, A.S.

    1996-01-01

    Long-term trends of waterfowl populations in Chesapeake Bay demonstrate the importance of shallow-water habitats for waterfowl species. Although recent increases in field feeding by geese and swans lessened the importance of shallow-water areas for these species, most duck species depend almost exclusively on shallow-water habitats. Many factors influenced the distribution and abundance of waterfowl in shallow-water habitats. Habitat degradation resulted in the decline in numbers of most duck species and a change in distribution of some species. Increased numbers of mallards (Anas platyrhynchos) in recent decades probably resulted from release programs conducted by the Maryland Department of Natural Resources and private individuals. Studies of food habits since 1885 showed a decline in submerged-aquatic vegetation in the diet of some species, such as the canvasback (Aythya valisineria ), and an increase in the proportions of invertebrates in the diet. Diversity of food organisms for many waterfowl species has declined. Surveys of vegetation and invertebrates in the Chesapeake Bay generally reflect a degradation of shallow-water habitat. Human population increases in the Chesapeake Bay watershed directly and indirectly affected waterfowl distribution and abundance. The increase of exotic plant and invertebrate species in the bay, in most cases, benefited waterfowl populations. Increased contaminants have reduced the quality and quantity of habitat, although serious attempts to reverse this trend are underway. The use of shallow-water habitats by humans for fishing, hunting, boating, and other recreational and commercial uses reduced the use of shallow-water habitats by waterfowl. Humans can lessen the adverse influences on the valuable shallow-water habitats by restricting human population growth near these habitats and improving the water quality of the bay tributaries. Other affirmative actions that will improve these areas for waterfowl include greater

  9. Flagging optically shallow pixels for improved analysis of ocean color data

    NASA Astrophysics Data System (ADS)

    McKinna, L. I. W.; Werdell, J.; Knowles, D., Jr.

    2016-02-01

    Ocean color remote-sensing is routinely used to derive marine geophysical parameters from sensor-observed water-leaving radiances. However, in clear geometrically shallow regions, traditional ocean color algorithms can be confounded by light reflected from the seafloor. Such regions are typically referred to as "optically shallow". When performing spatiotemporal analyses of ocean color datasets, optically shallow features such as coral reefs can lead to unexpected regional biases. Benthic contamination of the water-leaving radiance is dependent on bathymetry, water clarity and seafloor albedo. Thus, a prototype ocean color processing flag called OPTSHAL has been developed that takes all three variables into account. In the method described here, the optical depth of the water column at 547 nm, ζ(547), is predicted from known bathymetry and estimated inherent optical properties. If ζ(547) is less then the pre-defined threshold, a pixel is flagged as optically shallow. Radiative transfer modeling was used to identify the appropriate threshold value of ζ(547) for a generic benthic sand albedo. OPTSHAL has been evaluated within the NASA Ocean Biology Processing Group's L2GEN code. Using MODIS Aqua imagery, OPTSHAL was tested in two regions: (i) the Pedro Bank south-west of Jamaica, and (ii) the Great Barrier Reef, Australia. It is anticipated that OPTSHAL will benefit end-users when quality controlling derived ocean color products. Further, OPTSHAL may prove useful as a mechanism for switching between optically deep and shallow algorithms during ocean color processing.

  10. Effect of HMME-PDT with different parameters in rabbit ear model: a possible way for hypertrophic scarring

    NASA Astrophysics Data System (ADS)

    Cai, Hong; Gu, Ying; Zeng, Jing; Li, Shao-ran; Sun, Qiang; Wang, Ying; Shi, Dong-wen; Zhang, Lu-yong

    2007-11-01

    Background and Objective: Hypertrophic scar is a pathological scar that grows aberrantly by excessive deposition of collagens in the dermis. It is known that photodynamic therapy (PDT) contributes to a variety of diseases, however, the use of inhibiting scar formation has not been fully explored. The purpose of this study is to investigate the effect of HMME-PDT (Photodynamic therapy induced by Hematoporphyrin Monomethyl Ether) with different parameters on hypertrophic scar in rabbit ear. Materials and Methods: After the placement of 7-mm diameter dermal wounds on each ear, the acute model of dermal hypertrophic scar in the New Zealand white rabbits was established. Scar wounds were randomly separated into 2 groups: the experimental group received HMME-PDT with different parameters, and the control group received no special treatment. Specimens were harvested from scar wounds on postoperative day 28. Scar and hypertrophic index (HI) were observed by haematoxylin-eosin staining. Results: Compared with the control group, scar formation was inhibited by HMME-PDT in the experimental group with parameters as follows: photosensitizer dose 10mg/kg, power density 20mw/cm2, fluence 5J/cm2, meanwhile, HI was decreased significantly. Conclusion: HMME-PDT may play a role in inhibiting hypertrophic scarring in rabbit ear. The biological effect is determined by the dose of photosensitizer, interval between the injection of photosensitizer and irradiation, power density and energy fluence.

  11. Ablative fractional laser treatment for hypertrophic scars: comparison between Er:YAG and CO2 fractional lasers.

    PubMed

    Choi, Jae Eun; Oh, Ga Na; Kim, Jong Yeob; Seo, Soo Hong; Ahn, Hyo Hyun; Kye, Young Chul

    2014-08-01

    Nonablative fractional photothermolysis has been reported to show early promise in the treatment of hypertrophic scars, but there are few reports on ablative fractional photothermolysis for the treatment of hypertrophic scars. To evaluate and compare the efficacy and safety of Er:YAG fractional laser (EYFL) and CO2 fractional laser (CO2FL) for treatment of hypertrophic scars. Thirteen patients with hypertrophic scars were treated with 2,940 nm EYFL, and ten were treated with 10,600 nm CO2FL. An independent physician evaluator assessed the treatment outcomes using Vancouver scar scale (VSS) and 5-point grading scale (grade 0, no improvement; grade 1, 1-25%; grade 2, 26-50%; grade 3, 51-75%; grade 4, 76-100% improvement). Patients are queried about their subjective satisfaction with the treatment outcomes. After the final treatment, average percentage changes of VSS were 28.2% for EYFL and 49.8% for CO2FL. Improvement was evident in terms of pliability, while insignificant in terms of vascularity and pigmentation. Based on physician's global assessment, mean grade of 1.8 for EYFL and 2.7 for CO2FL was achieved. Patient's subjective satisfaction scores paralleled the physician's objective evaluation. CO2FL is a potentially effective and safe modality for the treatment of hypertrophic scars, particularly in terms of pliability.

  12. Mitochondrial ND5 12338T>C variant is associated with maternally inherited hypertrophic cardiomyopathy in a Chinese pedigree.

    PubMed

    Liu, Zhong; Song, Yanrui; Gu, Shulian; He, Xiangyu; Zhu, Xiaoyu; Shen, Yaoyao; Wu, Bifeng; Wang, Wei; Li, Shishi; Jiang, Pingping; Lu, Jianhua; Huang, Wendong; Yan, Qingfeng

    2012-09-15

    Hypertrophic cardiomyopathy is a primary disorder characterized by asymmetric thickening of the septum and left ventricular wall, which affects 1 in 500 individuals in the general population. Mutations in mitochondrial DNA have been found to be one of the most important causes of hypertrophic cardiomyopathy. Here we report the clinical, genetic and molecular characterization of a Han Chinese family with a likely maternally transmitted hypertrophic cardiomyopathy. Four (2 men/2 women) of 5 matrilineal relatives in this 3-generation family exhibited the variable severity and age at onset of 44 to 79 years old. Sequence analysis of the entire mitochondrial DNA in this pedigree identified the known homoplasmic ND5 12338T>C variant. This mitochondrial DNA haplogroup belongs to the Eastern Asian F2a. The 12338T>C variant, highly evolutionarily conserved, resulted in the replacement of the translation initiating methionine with a threonine, shortening the ND5 polypeptide by 2 amino acids. The occurrence of ND5 12338T>C variant exclusively in maternal members of this Chinese family suggested that the 12338T>C variant is associated with maternally inherited hypertrophic cardiomyopathy. Our findings will provide theoretical basis for genetic counseling of maternally inherited hypertrophic cardiomyopathy.

  13. Nonobstructive Hypertrophic Cardiomyopathy Out of the Shadows: Known from the Beginning but Largely Ignored … Until Now.

    PubMed

    Maron, Barry J; Rowin, Ethan J; Maron, Martin S; Braunwald, Eugene

    2017-02-01

    Hypertrophic cardiomyopathy was first recognized as a disease of obstruction to left ventricular outflow, hence, its early names and acronyms such as idiopathic hypertrophic subaortic obstruction. The nonobstructive subset of patients, incapable of developing mechanical impedance to left ventricular outflow at rest or with physiologic exercise, was initially recognized by the Braunwald group at the National Institutes of Health >50 years ago in the preimaging era, and is now recognized as comprising about one-third of hypertrophic cardiomyopathy patients. Nevertheless, until recently, and for 25 years, this substantial patient subset has been largely ignored and incompletely understood in terms of its clinical significance and consequences. However, the newfound interest in nonobstructive hypertrophic cardiomyopathy with recent cohort data permits more robust clarity of this subset, as well as the overall disease spectrum. As a group, patients with nonobstructive disease experience a largely stable clinical course at relatively low risk for progressive heart failure symptoms to New York Heart Association class III/IV in (90%). On the other hand, there is a small but important subgroup of 10% at risk for developing drug-refractory advanced heart failure sufficient to justify consideration for heart transplant as the only definitive treatment option. This recognition closes a significant gap in understanding the natural history of hypertrophic cardiomyopathy, also underscoring that the disease is not uniformly grim but instead consistent with extended longevity, thereby providing many patients with a measure of reassurance.

  14. Concentrations and potential health hazards of organochlorine pesticides in (shallow) groundwater of Taihu Lake region, China.

    PubMed

    Wu, Chunfa; Luo, Yongming; Gui, Tong; Huang, Yujuan

    2014-02-01

    A total of 27 shallow groundwater samples were collected from the Taihu Lake region (TLR), to determine the concentrations of 14 organochlorine pesticide (OCP) species, identify their possible sources, and estimate health risk of drinking the shallow groundwater. All OCP species occurred in the shallow groundwater of TLR with high detection frequency except p, p'-dichlorodiphenyldichlorothane (p, p'-DDD) and p, p'-dichlorodiphenyltrichloroethane (p, p'-DDT). DDTs and hexachlorocyclohexanes (HCHs) were the dominant OCP contaminants in the shallow groundwater of TLR, and they account for 44.2% total OCPs. The low α-HCH/γ-HCH ratio, high β-HCH/(α+γ)-HCH ratio and β-HCH being the dominant HCH isomers for the majority of samples suggest that the HCHs were mainly from the historical use of lindane after a period of degradation. p, p'-DDE being the dominant DDT metabolite for all the samples indicated that the DDTs were mainly from the historical residues. Compositional analysis also suggested that there were fresh input sources of heptachlors, aldrins and endrins in addition to the historical residues. Correlation analysis indicated the hexachlorobenzene (HCB) impurity in the shallow groundwater of TLR was likely from the historical application of lindane and technical HCH (a mixture of HCH isomers that is produced by photochlorination of benzene). Carcinogenic risk values for α-HCH, heptachlor, heptachlor epoxide, aldrins and dieldrin in the shallow groundwater in majority area of TLR were found to be >10(-6), posing a potentially serious cancer risk to those dependant on shallow groundwater for drinking water. © 2013.

  15. Environmental contaminants

    PubMed Central

    2011-01-01

    Contaminants such as cadmium, bisphenol A and lead pollute our environment and affect male reproductive function. There is evidence that toxicant exposure adversely affects fertility. Cadmium and bisphenol A exert their effects in the testis by perturbing blood-testis barrier function, which in turn affects germ cell adhesion in the seminiferous epithelium because of a disruption of the functional axis between these sites. In essence, cadmium mediates its adverse effects at the blood-testis barrier by disrupting cell adhesion protein complexes, illustrating that toxicants can dismantle cell junctions in the testis. Herein, we will discuss how environmental toxicants may affect reproductive function. We will also examine how these adverse effects on fertility may be mediated in part by adipose tissue and bone. Lastly, we will briefly discuss how toxicant-induced damage may be effectively managed so that fertility can be maintained. It is hoped that this information will offer a new paradigm for future studies. PMID:22332111

  16. Chemical composition and trophic state of shallow saline steppe lakes in central Asia (North Kazakhstan).

    PubMed

    Boros, Emil; Jurecska, Laura; Tatár, Enikő; Vörös, Lajos; Kolpakova, Marina

    2017-10-09

    The purpose of this study was to identify the prevailing chemical composition and trophic state of the shallow saline steppe lakes of North Kazakhstan along a wide size range (< 1-454 km(2)) and salinity gradient (2-322 g L(-1)) on a large spatial scale (1000 km), taking into account the potential effects of human disturbances. Water depth, Secchi disk transparency, temperature, pH, electric conductivity, major ions, total dissolved solids, total organic carbon, total nitrogen and phosphorus, nitrate, soluble reactive phosphorus, and chlorophyll a were measured. The equivalent percentage of major ions, Spearman rank correlation, multivariate analyses, equilibrium state of lakes, and spatial GIS autocorrelation were calculated. The impact of human disturbances (settlements, farms, and mines) on total organic carbon, nitrogen, phosphorus, and chlorophyll a were tested by Kruskal-Wallis ANOVA. The most common combinations of dominant ions were Na-Cl>SO4 and Na-Cl (n = 16; 64%); the Ca, Mg, HCO3, and SO4 ions precipitate with increasing salinity (2-322 g L(-1)); and ion composition shifts from Na>Mg-Cl>SO4 to Na-Cl. The most of the chemical variables positively, but chlorophyll a negatively, correlated with total dissolved solids, and the total phosphorus had no significant correlation with any variables. The trophic state of these lakes in most cases exceeded the hypertrophic level. The increase in salinity causes change in chemical composition and effects on the phytoplankton development independently from the size of water surface, and the human disturbances had negligible effect on the trophic state of shallow saline lakes in this region of Kazakhstan.

  17. Suppressed inflammatory gene expression during human hypertrophic scar compared to normotrophic scar formation.

    PubMed

    van den Broek, Lenie J; van der Veer, Willem M; de Jong, Etty H; Gibbs, Susan; Niessen, Frank B

    2015-08-01

    Hypertrophic scar formation is a result of adverse cutaneous wound healing. The pathogenesis of hypertrophic scar formation is still poorly understood. A problem next to the lack of suitable animal models is that often normal skin is compared to hypertrophic scar (HTscar) and not to normotrophic scar (NTscar) tissue. Another drawback is that often only one time period after wounding is studied, while scar formation is a dynamic process over a period of several months. In this study, we compared the expression of genes involved in inflammation, angiogenesis and extracellular matrix (ECM) formation and also macrophage infiltration in biopsies obtained before and up to 52 weeks after standard surgery in five patients who developed HTscar and six patients who developed NTscar. It was found that HTscar formation coincided with a prolonged decreased expression of inflammatory genes (TNFα, IL-1α, IL-1RN, CCL2, CCL3, CXCL2, CXCR2, C3 and IL-10) and an extended increased expression of ECM-related genes (PLAU, Col3A1, TGFβ3). This coincided with a delayed but prolonged infiltration of macrophages (type 2) in HTscar tissue compared to NTscar tissue. These findings were supported by immunohistochemical localization of proteins coding for select genes named above. Our study emphasizes that human cutaneous wound healing is a dynamic process that is needed to be studied over a period of time rather than a single point of time. Taken together, our results suggest innate immune stimulatory therapies may be a better option for improving scar quality than the currently used anti-inflammatory scar therapies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Logistics of building a laser practice for the treatment of hypertrophic burn scars.

    PubMed

    Hultman, Charles Scott; Edkins, Renee E; Cairns, Bruce A; Meyer, Anthony A

    2013-05-01

    Although lasers can improve burn scars, such treatment has not been adopted universally, due to operational challenges starting a practice and the perception that such a program is not financially viable. We report the logistics of building a laser practice for the treatment of hypertrophic burn scars. We analyzed the clinical, operational, and financial components of our laser practice, focusing on treatment of hypertrophic burn scars, using pulsed dye laser, fractional CO2 laser, and intense pulsed light. Cases were performed in an operating room, with anesthesia, after preauthorization. We examined professional charges and collections, case time, variable and indirect expenses, and breakeven volumes. Our practice grew as follows: 2008, 1 case; 2009, 44 cases; 2010, 169 cases; and 2011, 415 cases. Overall collection rate was 32.1%. Expenses incurred by the provider, per 8-hour session, included laser rental/lease ($2375), personnel salaries ($1900), and physician overhead ($808), for a total cost of $5083. Mean charge was $1642 per case; mean collection was $527 per case. Median case time (procedure plus turnover) was 40 minutes. In this model, breakeven volume is 9.7 cases per day; breakeven time is 49.7 minutes. Provider profit margin for 10 cases per day, or 83% capacity utilization, is $187 per day (income - expenses = $5270 - $5083). Despite high costs associated with starting and operating a laser practice for the treatment of hypertrophic burn scars, a sustainable enterprise can be achieved when the provider has accrued enough volume to batch cases over an entire day. Critical to achieving breakeven is preauthorization, controlling overhead, and efficient throughput.

  19. Thermal Injury Model in the Rabbit Ear with Quantifiable Burn Progression and Hypertrophic Scar.

    PubMed

    Friedrich, Emily E; Niknam-Bienia, Solmaz; Xie, Ping; Jia, Sheng-Xian; Hong, Seok Jong; Mustoe, Thomas A; Galiano, Robert D

    2017-04-01

    Hypertrophic scar is a major clinical outcome of deep-partial thickness to full thickness thermal burn injury. Appropriate animal models are a limitation to burn research due to the lack of, or access to, animal models which address the endpoint of hypertrophic scar. Lower species, such as rodents, heal mainly by contracture, which limits the duration of study. Higher species, such as pigs, heal more similarly to humans, but are associated with high cost, long duration for scar development, challenges in quantifying scar hypertrophy, and poor manageability. Here we present a quantifiable deep-partial thickness burn model in the rabbit ear. Burns were created using a dry-heated brass rod for 10 s and 20 s at 90°C. At the time of eschar excision on day 3, excisional wounds were made on the contralateral ear for comparison. Burn wound progression, in which the wound size expands over time is a major distinction between excisional and thermal injuries, was quantified at 1 h and 3 d after the injuries using calibrated photographs and histology and the size of the wounds was found to be unchanged from the initial wound size at 1 h, but 10% in the 20 s burn wounds at 3 d. A quantifiable hypertrophic scar, measured by histology as the scar elevation index, was present in both 20 s burn wounds and excisional wounds at day 35. ImageJ measurements revealed that the 20 s burn wound scars were 22% larger than the excisional wound scars and the 20 s burn scar area measurements from histology were 26% greater than in the excisional wound scar. The ability to measure both burn progression and scar hypertrophy over a 35-day time frame suits this model to screening early intervention burn wound therapeutics or scar treatments in a burn-specific scar model. This article is protected by copyright. All rights reserved.

  20. 11β-HSD1 reduces metabolic efficacy and adiponectin synthesis in hypertrophic adipocytes.

    PubMed

    Koh, Eun Hee; Kim, Ah-Ram; Kim, Hyunshik; Kim, Jin Hee; Park, Hye-Sun; Ko, Myoung Seok; Kim, Mi-Ok; Kim, Hyuk-Joong; Kim, Bum Joong; Yoo, Hyun Ju; Kim, Su Jung; Oh, Jin Sun; Woo, Chang-Yun; Jang, Jung Eun; Leem, Jaechan; Cho, Myung Hwan; Lee, Ki-Up

    2015-06-01

    Mitochondrial dysfunction in hypertrophic adipocytes can reduce adiponectin synthesis. We investigated whether 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) expression is increased in hypertrophic adipocytes and whether this is responsible for mitochondrial dysfunction and reduced adiponectin synthesis. Differentiated 3T3L1 adipocytes were cultured for up to 21 days. The effect of AZD6925, a selective 11β-HSD1 inhibitor, on metabolism was examined. db/db mice were administered 600 mg/kg AZD6925 daily for 4 weeks via gastric lavage. Mitochondrial DNA (mtDNA) content, mRNA expression levels of 11 β -H sd1 and mitochondrial biogenesis factors, adiponectin synthesis, fatty acid oxidation (FAO), oxygen consumption rate and glycolysis were measured. Adipocyte hypertrophy in 3T3L1 cells exposed to a long duration of culture was associated with increased 11 β -Hsd1 mRNA expression and reduced mtDNA content, mitochondrial biogenesis factor expression and adiponectin synthesis. These cells displayed reduced mitochondrial respiration and increased glycolysis. Treatment of these cells with AZD6925 increased adiponectin synthesis and mitochondrial respiration. Inhibition of FAO by etomoxir blocked the AZD6925-induced increase in adiponectin synthesis, indicating that 11β-HSD1-mediated reductions in FAO are responsible for the reduction in adiponectin synthesis. The expression level of 11 β -Hsd1 was higher in adipose tissues of db/db mice. Administration of AZD6925 to db/db mice increased the plasma adiponectin level and adipose tissue FAO. In conclusion, increased 11β-HSD1 expression contributes to reduced mitochondrial respiration and adiponectin synthesis in hypertrophic adipocytes. © 2015 Society for Endocrinology.

  1. Identification of Fabry Disease in a Tertiary Referral Cohort of Patients with Hypertrophic Cardiomyopathy.

    PubMed

    Maron, Martin S; Xin, Winnie; Sims, Katherine B; Butler, Rita; Haas, Tammy S; Rowin, Ethan J; Desnick, Robert J; Maron, Barry J

    2017-09-21

    Fabry Disease is a X-linked lysosomal storage disorder caused by the deficient activity of α-galactosidase A due to mutations in the GLA gene, which may be associated with increased left ventricular wall thickness, and mimic the morphologic features of hypertrophic cardiomyopathy. Management strategies for these two diseases diverge, with Fabry disease-specific treatment utilizing recombinant α-galactosidase A enzyme replacement therapy. We studied a prospectively assembled consecutive cohort of 585 patients (71% male) from two hypertrophic cardiomyopathy tertiary referral centers by screening for low α-galactosidase A activity in dried blood spots. Male patients with low α -Gal A activity levels and all females were tested for mutations in the GLA gene. In 585 patients previously diagnosed with hypertrophic cardiomyopathy, we identified two unrelated patients (0.34%), both with the GLA mutation encoding P.N215S the most common mutation causing later-onset Fabry disease phenotype. These patients were both asymptomatic, a male age 53 years and a female aged 69 yearsand demonstrated a mild cardiac phenotype with symmetric distribution of left ventricular hypertrophy..Following family screening, a total of 27 new Fabry disease patients ages 2-81 years were identified in the two families, including 12individuals who are now receiving enzyme replacement therapy. These observations support consideration for routine prospective screening for Fabry disease in all patients without a definitive etiology for left ventriclar hypertrophy. This strategy would likely result, through cascade family testing, in the earlier identification of new Fabry disease-affected males and female heterozygotes who may benefit from monitoring and/or enzyme replacement therapy. Copyright © 2017. Published by Elsevier Inc.

  2. Quantitative analysis of sup 123 I-meta-iodobenzylguanidine (MIBG) uptake in hypertrophic cardiomyopathy

    SciTech Connect

    Nakajima, K.; Bunko, H.; Taki, J.; Shimizu, M.; Muramori, A.; Hisada, K. )

    1990-06-01

    Myocardial scintigraphy with 123I-meta-iodobenzylguanidine (MIBG) and thallium-201 (201Tl) was performed in 29 patients with hypertrophic cardiomyopathy (HCM) using whole-body scintigraphy and single-photon emission computed tomography (SPECT). Nonhypertensive patients were classified into three groups according to the septal thickness determined by ultrasonography; group 1 (wall thickness less than 16 mm, n = 5), group 2 (from 16 to 20 mm, n = 12) and group 3 (greater than 20 mm, n = 4). The regional myocardial uptakes of both 201Tl and 123I-MIBG (percent of injected dose/cm3 myocardium) were higher in the more hypertrophic septa. However, when regional MIBG uptake at 3 hours was divided by the 201Tl uptake to calculate the MIBG uptake per unit of blood flow, the hypertrophic septa showed lower mean values--0.39 +/- 0.23 and 0.50 +/- 0.10 in groups 3 and 2, respectively (p less than 0.1 compared with 0.69 +/- 0.20 in group 1). The regional MIBG clearance rate in the septum was significantly higher in group 3 compared with group 1 (13.4 +/- 8.0%/hr versus 1.5 +/- 6.2%/hr, p less than 0.05). The uptake and 123I-MIBG clearance rate in the lateral wall showed a similar tendency. Myocardial uptake determined by whole-body scintigraphy was slightly increased in group 2 (3.5 +/- 0.6%, p less than 0.05) compared with group 1 (2.7 +/- 0.8%); however, it was lower in group 3 (2.7 +/- 0.4%). Myocardial 123I-MIBG distribution demonstrated various patterns in comparison with 201Tl distribution, suggesting that flow-independent changes in sympathetic innervation or activity may exist in patients with HCM.

  3. Clinical Profile and Prognosis of Left Ventricular Apical Aneurysm in Hypertrophic Cardiomyopathy.

    PubMed

    Xiao, Yan; Wang, Lin-Ping; Yang, Yan-Kun; Tian, Tao; Yang, Kun-Qi; Sun, Xin; Jiang, Yong; Liu, Ya-Xin; Zhou, Xian-Liang; Li, Jian-Jun

    2016-01-01

    Hypertrophic cardiomyopathy with left ventricular apical aneurysm is a unique entity with diverse manifestations and varied prognoses among races. This study evaluated the prevalence, clinical characteristics and outcomes of apical aneurysm in Chinese patients with hypertrophic cardiomyopathy. Consecutive patients with apical aneurysm were recruited from 1,844 patients with HCM treated at our hospital from 2002-2013. Basic clinical data and follow-up data were collected and analyzed. Apical aneurysm was identified in 24 patients (1.3%) (mean age: 52 ± 14 years). We identified an hourglass-shaped (71%) or distally hypertrophic (29%) left ventricle and found mural thrombi and nonsustained and sustained ventricular tachycardia in 11 (46%), 4 (17%) and 9 (38%) patients, respectively. During follow-up (5.0 ± 3.4 years [range: 1-14 years]), following were the clinical adverse events experienced by 14 patients (58%) (annual rate: 11.7%): sudden cardiac death (n = 4), appropriate discharge of an implantable cardioverter-defibrillator (n = 4), progressive heart failure (n = 4) or heart failure-related death (n = 1) and stroke (n = 4). The 4 patients who underwent aneurysmectomy had no adverse events. Patients with SCD had a lower ejection fraction (P = 0.004) and a larger left ventricular end-diastolic diameter (P < 0.001) than nonoperated survivors. Apical aneurysm is not rare in patients with HCM and it confers an extremely poor prognosis. Early aggressive therapies should be considered for this entity and prophylactic aneurysmectomy may be an option. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  4. The Dynamic Nature of Hypertrophic and Fibrotic Remodeling of the Fish Ventricle

    PubMed Central

    Keen, Adam N.; Fenna, Andrew J.; McConnell, James C.; Sherratt, Michael J.; Gardner, Peter; Shiels, Holly A.

    2016-01-01

    Chronic pressure or volume overload can cause the vertebrate heart to remodel. The hearts of fish remodel in response to seasonal temperature change. Here we focus on the passive properties of the fish heart. Building upon our previous work on thermal-remodeling of the rainbow trout ventricle, we hypothesized that chronic cooling would initiate fibrotic cardiac remodeling, with increased myocardial stiffness, similar to that seen with pathological hypertrophy in mammals. We hypothesized that, in contrast to pathological hypertrophy in mammals, the remodeling response in fish would be plastic and the opposite response would occur following chronic warming. Rainbow trout held at 10°C (control group) were chronically (>8 weeks) exposed to cooling (5°C) or warming (18°C). Chronic cold induced hypertrophy in the highly trabeculated inner layer of the fish heart, with a 41% increase in myocyte bundle cross-sectional area, and an up-regulation of hypertrophic marker genes. Cold acclimation also increased collagen deposition by 1.7-fold and caused an up-regulation of collagen promoting genes. In contrast, chronic warming reduced myocyte bundle cross-sectional area, expression of hypertrophic markers and collagen deposition. Functionally, the cold-induced fibrosis and hypertrophy were associated with increased passive stiffness of the whole ventricle and with increased micromechanical stiffness of tissue sections. The opposite occurred with chronic warming. These findings suggest chronic cooling in the trout heart invokes a hypertrophic phenotype with increased cardiac stiffness and fibrosis that are associated with pathological hypertrophy in the mammalian heart. The loss of collagen and increased compliance following warming is particularly interesting as it suggests fibrosis may oscillate seasonally in the fish heart, revealing a more dynamic nature than the fibrosis associated with dysfunction in mammals. PMID:26834645

  5. Generation of Immortalized Equine Chondrocytes With Inducible Sox9 Expression Allows Control of Hypertrophic Differentiation.

    PubMed

    Gurusinghe, Saliya; Hilbert, Bryan; Trope, Gareth; Wang, Lexin; Bandara, Nadeeka; Strappe, Padraig

    2016-10-27

    Immortalization of chondrocytes enables long term in vitro culture; however, the chondrogenic capacity of transformed cells varies, thus highlighting the need to develop a proliferative and tuneable chondrocyte cell line where hypertrophic differentiation can be controlled. In this study the SV40 large T antigen and human telomerase reverse transcriptase were employed to immortalize pooled equine chondrocytes through lentiviral vector mediated transduction either singly or on combination. Transformed chondrocytes proliferated stably over multiple passages, but resulted in significantly lower expression of chondrocyte specific collagen II mRNA (P < 0.0001) and up regulation of the hypertrophic marker collagen X (P < 0.0001) in three dimensional cultures. A Col2a1 promoter driven GFP reporter was constructed for real time monitoring of chondrogenic differentiation and a significant increase in promoter activation was observed in cultures treated with the growth factor TGFβ-3 (P < 0.05). To recapitulate the native articular chondrocyte phenotype we further transduced large T antigen immortalized chondrocytes with lentiviral vectors allowing either constitutive or doxycycline inducible expression of Sox9. In 3D cultures, the Sox9 over-expressing chondrocytes secreted significantly higher levels of extracellular matrix polysaccharide glycosaminoglycan (P < 0.05), while up-regulating collagen II and Aggrecan mRNA (P < 0.05) in both expression systems with a similar patterns observed with imunohistochemical staining. High levels of collagen X mRNA and protein were maintained with constitutive sox9 reflecting hypetrophic differentiation but significantly lower expression could be achieved with inducible Sox9. In conclusion, immortalization of equine chondrocytes results in stable proliferation but a reduction of chondrogenic potential whilst modulation of sox9 expression enabled control of hypertrophic characteristics. J. Cell. Biochem. 9999: 1

  6. Fate of the hypertrophic chondrocyte: microenvironmental perspectives on apoptosis and survival in the epiphyseal growth plate.

    PubMed

    Shapiro, Irving M; Adams, Christopher S; Freeman, Theresa; Srinivas, Vickram

    2005-12-01

    The goal of this review is to examine the fate of the hypertrophic chondrocyte in the epiphyseal growth plate and consider the impact of the cartilage microenvironment on cell survival and apoptosis. Early investigations pointed to a direct role of the hypertrophic chondrocyte in osteogenesis. The terminally differentiated cells were considered to undergo a dramatic change in shape, size, and phenotype, and assume the characteristics of an osteoblast. While some studies have supported the notion of transdifferentiation, much of the evidence in favor of reprogramming epiphyseal chondrocytes is circumstantial and based on microscopic evaluation of cells that are present at the chondro-osseous junction. Although these investigations provided a novel perspective on endochondral bone formation, they were flawed by the failure to consider the importance of stem cells in osseous tissue formation. Subsequent studies indicated that many, if not all, of the cells of the cartilage plate die through the induction of apoptosis. With respect to agents that mediate apoptosis, at the chondro-osseous junction, solubilization of mineral and hydrolysis of organic matrix constituents by septoclasts generates high local concentrations of ions, peptides, and glycans, and secreted matrix metalloproteins. Individually, and in combination, a number of these agents serve as potent chondrocyte apoptogens. We present a new concept: hypertrophic cells die through the induction of autophagy. In the cartilage microenvironment, combinations of local factors cause chondrocytes to express an initial survival phenotype and oxidize their own structural macromolecules to generate ATP. While delaying death, autophagy leads to a state in which cells are further sensitized to changes in the local microenvironment. One such change is similar to ischemia reperfusion injury, a condition that leads to tissue damage and cell death. In the growth cartilage, an immediate effect of this type of injury is

  7. Acromegalic patients show the presence of hypertrophic remodeling of subcutaneous small resistance arteries.

    PubMed

    Rizzoni, Damiano; Porteri, Enzo; Giustina, Andrea; De Ciuceis, Carolina; Sleiman, Intissar; Boari, Gianluca E M; Castellano, Maurizio; Muiesan, Maria Lorenza; Bonadonna, Stefania; Burattin, Anna; Cerudelli, Bruno; Agabiti-Rosei, Enrico

    2004-03-01

    Structural alterations of small resistance arteries in patients with essential hypertension (EH) are mostly characterized by inward eutrophic remodeling. However, we have observed the presence of hypertrophic remodeling in patients with renovascular hypertension, as well as in patients with noninsulin-dependent diabetes mellitus, suggesting a relevant effect of humoral growth factors on vascular structure. Growth hormone may stimulate in vitro proliferation of vascular smooth muscle cells. However, no data are presently available about small artery structure in acromegalic patients. Therefore, we have investigated the structure of subcutaneous small arteries in 12 normotensive (NT) subjects, in 12 EH subjects, and in 9 acromegalic patients (APs). All subjects underwent biopsy of the subcutaneous fat; then, small resistance arteries were dissected and mounted on a micromyograph. The normalized internal diameter, media thickness, media-to-lumen ratio, the media cross-sectional area together with remodeling, and growth indices were calculated. Demographic variables were similar in the three groups, except for blood pressure. The media-to-lumen ratio was significantly greater in EH and AP, compared with NT. No difference was observed between EH and AP. The media cross-sectional area was significantly greater in AP compared with EH and with NT. The calculation of remodeling and growth index suggests the presence of eutrophic remodeling in EH (growth index 0%) and of hypertrophic remodeling in AP (growth index 40%). In conclusion, our data suggest the presence of hypertrophic remodeling of subcutaneous small resistance arteries of AP, probably as a consequence of growth-stimulator properties of IGF-1.

  8. Myocardial metabolic, hemodynamic, and electrocardiographic significance of reversible thallium-201 abnormalities in hypertrophic cardiomyopathy

    SciTech Connect

    Cannon, R.O. 3d.; Dilsizian, V.; O'Gara, P.T.; Udelson, J.E.; Schenke, W.H.; Quyyumi, A.; Fananapazir, L.; Bonow, R.O. )

    1991-05-01

    Exercise-induced abnormalities during thallium-201 scintigraphy that normalize at rest frequently occur in patients with hypertrophic cardiomyopathy. However, it is not known whether these abnormalities are indicative of myocardial ischemia. Fifty patients with hypertrophic cardiomyopathy underwent exercise {sup 201}Tl scintigraphy and, during the same week, measurement of myocardial lactate metabolism and hemodynamics during pacing stress. Thirty-seven patients (74%) had one or more {sup 201}Tl abnormalities that completely normalized after 3 hours of rest; 26 had regional myocardial {sup 201}Tl defects, and 26 had apparent left ventricular cavity dilatation with exercise, with 15 having coexistence of these abnormal findings. Of the 37 patients with reversible {sup 201}Tl abnormalities, 27 (73%) had metabolic evidence of myocardial ischemia during rapid atrial pacing compared with four of 13 patients (31%) with normal {sup 201}Tl scans (p less than 0.01). Eleven patients had apparent cavity dilatation as their only {sup 201}Tl abnormality; their mean postpacing left ventricular end-diastolic pressure was significantly higher than that of the 13 patients with normal {sup 201}Tl studies (33 +/- 5 versus 21 +/- 10 mm Hg, p less than 0.001). There was no correlation between the angiographic presence of systolic septal or epicardial coronary arterial compression and the presence or distribution of {sup 201}Tl abnormalities. Patients with ischemic ST segment responses to exercise had an 80% prevalence rate of reversible {sup 201}Tl abnormalities and a 70% prevalence rate of pacing-induced ischemia. However, 69% of patients with nonischemic ST segment responses had reversible {sup 201}Tl abnormalities, and 55% had pacing-induced ischemia. Reversible {sup 201}Tl abnormalities during exercise stress are markers of myocardial ischemia in hypertrophic cardiomyopathy and most likely identify relatively underperfused myocardium.

  9. Myocardial edema in Takotsubo syndrome mimicking apical hypertrophic cardiomyopathy: An insight into diagnosis by cardiovascular magnetic resonance.

    PubMed

    Izgi, Cemil; Ray, Sanjoy; Nyktari, Evangelia; Alpendurada, Francisco; Lyon, Alexander R; Rathore, Sudhir; Baksi, Arun John

    2015-01-01

    Myocardial edema is one of the characteristic features in the pathogenesis of Takotsubo syndrome. We report a middle aged man who presented with typical clinical and echocardiographic features of apical variant of Takotsubo syndrome. However, a cardiovascular magnetic resonance study performed 10 days after presentation did not show any apical 'ballooning' but revealed features of an apical hypertrophic cardiomyopathy on cine images. Tissue characterization with T2 weighted images proved severe edema as the cause of significantly increased apical wall thickness. A follow-up cardiovascular magnetic resonance study was performed 5 months later which showed that edema, wall thickening and the appearance of apical hypertrophic cardiomyopathy all resolved, confirming Takotsubo syndrome as the cause of the initial appearance. As the affected myocardium most commonly involves the apical segments, an edema induced increase in apical wall thickness may lead to appearances of an apical hypertrophic cardiomyopathy rather than apical ballooning in the acute to subacute phase of Takotsubo syndrome.

  10. Environmental assessment model for shallow land disposal of low-level radioactive wastes: interim report. [PRESTO (Prediction of Radiation Effects from Shallow Trench Operations)

    SciTech Connect

    Little, C.A.; Fields, D.E.; Emerson, C.J.; Hiromoto, G.

    1981-09-01

    PRESTO (Prediction of Radiation Effects from Shallow Trench Operations) is a computer code developed under US Environmental Protection Agency (EPA) funding to evaluate possible health effects from shallow land burial trenches. The model is intended to be generic and to assess radionuclide transport, ensuing exposure, and health impact to a static local population for a 1000-y period following the end of burial operations. Human exposure scenarios considered by the model include normal releases (including leaching and operational spillage), human intrusion, and site farming or reclamation. Pathways and processes of transit from the trench to an individual or population include: groundwater transport, overland flow, erosion, surface water dilution, resuspension, atmospheric transport, deposition, inhalation, and ingestion of contaminated beef, milk, crops, and water. Both population doses and individual doses are calculated as well as doses to the intruder and farmer.

  11. Hypertrophic Cardiomyopathy due to Mitochondrial Disease: Prenatal Diagnosis, Management, and Outcome

    PubMed Central

    García-Díaz, Lutgardo; Coserria, Félix; Antiñolo, Guillermo

    2013-01-01

    A case of prenatally diagnosed fetal hypertrophic cardiomyopathy is reported. The mother was referred to our department at 37 weeks' gestation because of suspected congenital heart disease. Prenatal echocardiography showed biventricular hypertrophy and pericardial effusion, without additional abnormalities. Postnatal echocardiography confirmed prenatal diagnosis. Neonatal EKG showed biventricular hypertrophy and Wolff-Parkinson-White syndrome. Skeletal muscle biopsy was consistent with mitochondrial oxidative phosphorylation defect involving a combined defect of respiratory complexes I and IV. Echocardiographic followup during the first year of life showed progressive regression of hypertrophy and evolution to left ventricular myocardial noncompaction. PMID:23346437

  12. Visualization of myocardial perfusion after percutaneous myocardial septal ablation for hypertrophic cardiomyopathy using superharmonic imaging.

    PubMed

    Ten Cate, Folkert J; Bouakaz, Ayache; Krenning, Boudewijn; Vletter, Wim; de Jong, Nico

    2003-04-01

    Harmonic imaging is used for detection of ultrasound contrast agents in myocardial perfusion studies. However, harmonic imaging has limitations because of the presence of tissue harmonics, which results in less specificity and sensitivity, thus, lower contrast-to-tissue ratio. We describe a clinical example using superharmonic imaging. This technique detects the third, fourth, and fifth harmonics. These harmonics are not created in tissue, resulting, hence, in a high contrast-to-tissue ratio. After myocardial alcohol ablation for hypertrophic cardiomyopathy areas of nontreated and treated myocardium, normal and low flow could be visualized with superharmonic imaging.

  13. Evolutionary change mimicking apical hypertrophic cardiomyopathy in a patient with takotsubo cardiomyopathy.

    PubMed

    Hwang, Hui-Jeong; Lee, Hyae-Min; Yang, In-Ho; Kim, Dong-Hee; Byun, Jong-Kyu; Sohn, Il Suk

    2014-11-01

    In this report, we introduce a case of thickening of the involved left ventricular apical segment on echocardiography and deep T-wave inversions in precordial leads on electrocardiography transiently seen in the course of recovery from biventricular takotsubo cardiomyopathy, mimicking apical hypertrophic cardiomyopathy. This result suggests that the echocardiographic finding of transient myocardial edema can be identified by cardiac magnetic resonance imaging in takotsubo cardiomyopathy. Additionally, it persisted a few weeks after full functional recovery. We believe that this case will contribute in part toward clarifying the pathophysiology of takotsubo cardiomyopathy.

  14. Hypertrophic Pachymeningitis as an Early Manifestation of Relapsing Polychondritis: Case Report and Review of the Literature

    PubMed Central

    Ushiyama, Satoru; Kinoshita, Tomomi; Shimojima, Yasuhiro; Ohashi, Nobuhiko; Kishida, Dai; Miyazaki, Daigo; Nakamura, Katsuya; Sekijima, Yoshiki; Ikeda, Shu-ichi

    2016-01-01

    Neurological involvement in relapsing polychondritis (RP) is relatively rare. We describe the case of an 80-year-old man who presented with hypertrophic pachymeningitis (HP) together with arthritis as the first manifestation of RP. Auricular chondritis, which subsequently determined the diagnosis of RP, occurred a few weeks after the detection of HP. The neurological symptoms, as well as arthritis, were promptly improved by treatment with corticosteroids. It is generally difficult to diagnose RP in the absence of typical cartilaginous involvement; however, the present case suggests that HP may occur as an early clinical manifestation of RP. PMID:27920712

  15. Phaeochromocytoma and hypertrophic cardiomyopathy: apparent suppression of symptoms and noradrenaline secretion by calcium-channel blockade.

    PubMed

    Serfas, D; Shoback, D M; Lorell, B H

    1983-09-24

    A 44-year-old woman with hypertrophic cardiomyopathy and a noradrenaline-secreting phaeochromocytoma is described. She experienced as great improvement in cardiovascular symptoms during double-blind treatment with the calcium-channel blocker nifedipine compared with the placebo period. Symptom relief on nifedipine therapy was associated with a pronounced decline in elevated urinary noradrenaline levels. This observation suggests that calcium-channel blockers interfere with the release of noradrenaline from phaeochromocytoma tissue and thus may be beneficial in patients with phaeochromocytoma.

  16. Successful surgical optic nerve decompression in a patient with hypertrophic pachymeningitis due to granulomatous polyangiitis

    PubMed Central

    de Hoog, Joeri; Volovici, Victor; Dammers, Ruben

    2015-01-01

    A 57-year-old woman presented with subacute vision loss of first the left, and later the right eye. She was diagnosed with granulomatous polyangiitis with hypertrophic pachymeningitis and optic nerve compression. Her visual acuity could not be permanently restored with immune suppressants alone, so a surgical decompression of the right optic nerve, via a modified cranio-orbitozygomatic pretemporal approach, was performed. Her right eye regained 20/20 vision and has remained stable during 8 months of follow-up. PMID:25612758

  17. [Effects of citrus reticulata blanco extract on fibroblasts from human hypertrophic scar in vitro].

    PubMed

    Qi, Shao-hai; Xu, Ying-bin; Bian, Hui-ning; Liu, Po; Xie, Ju-lin; He, Jie-hua; Shu, Bin; Li, Tian-zeng

    2006-08-01

    To investigate the effects of citrus reticulata blanco extract on the proliferation and collagen metabolism of fibroblasts from human hypertrophic scar. Human hypertrophic scar fibroblasts from two burn patients obtained from plastic surgery were cultured in vitro and divided into experimental group (n = 12, with basic culture medium and 2.5, 5.0, 10.0,25.0 mg/L citrus reticulata blanco extract, respectively, 3 bottles for each concentration of citrus reticulata blanco extract ), control group 1 (n = 3, with basic culture medium) , and control group 2 ( n = 3, with basic culture medium and 5% ethyl alcohol). The cell proliferation in each group was observed with MTT method, then the inhibition rate was calculated. Apoptosis and its index ( AI) in each group were determined after TUNEL staining . The changes in the content of ICTP and PINP in each group were observed by radioimmunity. The inhibition rate in the experimental group with the citrus reticulata blanco extract in concentration of 2. 5, 5.0, 10.0, 25. 0 microg/ ml were (7. 100+/-0.038)% , (8. 100+/- 0. 048)% , (10. 900+/-0. 055)%, (15.900+/-0. 097) %, respectively, which were significantly higher than those in other two groups ( P <0.05 ). The Al (69. 7% , 71.7%, 86.4% , 95.2% ), ICTP [(17.2+/-0.6), (18.3+/-0.6), (19.8+/-0.5), (23.2+/-0.6) microg/L] and PINP [ (101.7+/-1.4) , (107. 8+/-1. 1) , (111.6+/-1.2) , (124. 6+/-1.3) microg/L] in experimental group with the citrus reticulata blanco extract in concentration of 2.5, 5.0, 10.0 , 25.0 mg/L were also obviously higher than other two control groups( P <0.05) ,but these indices in control 1 group were similar to those in control 2 group( P >0. 05). The citrus reticulata blanco extract might be beneficial for the management of hypertrophic scar through inhibition of the proliferation of fibroblasts in hypertrophic scar, by promoting apoptosis and collagen degradation.

  18. Two different cardiomyopathies in a single patient : hypertrophic cardiomyopathy and left ventricular noncompaction.

    PubMed

    Sunbul, M; Ozben, B; Mutlu, B

    2013-05-01

    Hypertrophic cardiomyopathy is a complex and relatively common genetic disorder characterized by left ventricular (LV) hypertrophy, usually associated with a nondilated and hyperdynamic chamber with heterogeneous phenotypic expression and clinical course. On the other hand, LV noncompaction is an uncommon cardiomyopathy characterized by the persistence of fetal myocardium with a pattern of prominent trabecular meshwork and deep intertrabecular recesses, systolic dysfunction, and LV dilatation. We report a 29-year-old man with these two different inherent conditions. Our case raises the possibility of a genetic mutation common to these two clinical entities or different gene mutations existing in the same individual.

  19. Trileaflet Mitral Valve with Three Papillary Muscles Associated with Hypertrophic Cardiomyopathy: A Novel Case.

    PubMed

    Rosanio, Salvatore; Simonsen, Cameron J; Starwalt, John; Keylani, Abdul M; Vitarelli, Antonio

    2015-09-01

    Congenital mitral valve (MV) malformations are uncommon, except for MV prolapse. Despite their infrequency, most of them are well-known and defined entities, such as congenital MV stenosis with two papillary muscles, parachute MV, supravalvular mitral ring, hypoplastic MV, isolated cleft in the anterior and/or posterior leaflets, and double-orifice MV. A trileaflet MV with three separate papillary muscles with concordant atrioventricular and ventricle-arterial connections is exceptionally rare. To the best of the authors' knowledge, it has been reported only once in association with subaortic valvular stenosis. We hereby describe a novel case associated with hypertrophic cardiomyopathy. © 2015, Wiley Periodicals, Inc.

  20. Hypertrophic Cardiomyopathy After a Single Dose of Dexamethasone in a Preterm Infant.

    PubMed

    Kale, Yusuf; Aydemir, Ozge; Ceylan, Ozben; Bas, Ahmet Yagmur; Demirel, Nihal

    2015-08-01

    Dexamethasone is widely used in preterm infants with severe pulmonary disease. Hypertrophic cardiomyopathy (HCM) is a transient side effect observed after multiple doses of dexamethasone. We report a preterm infant with myocardial hypertrophy after a single dose of dexamethasone (0.5 mg/kg) used to treat laryngeal edema secondary to prolonged intubation. A benign course was observed without left ventricular outflow tract obstruction and with recovery within 4 weeks. Myocardial effects of dexamethasone may be independent of dose and duration of treatment. The risk/benefit ratio must be carefully considered before using even a single dose of dexamethasone in preterm infants.