Inaccuracy of diagnosis in a cohort of patients on the waiting list for dacryocystorhinostomy when the diagnosis was made by only syringing the lacrimal system.

PubMed

Beigi, B; Uddin, J M; McMullan, T F W; Linardos, E

2007-01-01

Accurate identification of the factors contributing to epiphora is essential in directing appropriate management and treatment strategies. The authors applied a methodical strategy of assessment for epiphora to patients who were already on the waiting list for dacryocystorhinostomy (DCR). The findings were compared to the original findings. Forty-four eyes of 35 patients listed for DCR were re-examined. All canaliculi were examined using four tests: dye disappearance, Jones 1 (dye retrieval), probing using Bowman probes, and syringing of the nasolacrimal duct (NLD) under local anesthesia. Some patients were examined using an endocanalicular mini-endoscope. Patients with NLD obstruction underwent DCR and those with canalicular and NLD stenosis underwent intubation of the lacrimal system-canaliculus, lacrimal sac, and nasolacrimal duct-using silicone stents. The authors refer to this as canaliculodacryocystoplasty (CDCP). The patients were assessed for symptoms of epiphora at 12 months. Forty-four eyes had been listed for DCR. They had been originally diagnosed, by means of lacrimal syringing, as NLD obstruction (24 eyes) or stenosis (12 eyes), and functional blocks (8 eyes). Four out of the original 44 planned DCR surgeries were performed after re-evaluation. After re-examination, 28 lacrimal systems were found to have canalicular stenosis, 4 NLD stenosis, 4 NLD obstruction, 4 punctal phimosis, 3 ocular surface disease, and 1 patient was asymptomatic. Twenty-eight lacrimal systems underwent CDCP, 4 underwent DCR, 4 had punctoplasty, and 4 had probing alone. Three had treatment for ocular surface disease and one patient required no treatment. After a follow-up of 12 months, 41 (93%) systems had improvement or were free of their Syringing of the lacrimal apparatus may result in a high false positive diagnosis of NLD obstruction. Canalicular pathology is not uncommon in this cohort of patients and may be underdiagnosed.

Incidence and Risk Factors for Right Ventricular Outflow Tract Obstruction after the Arterial Switch Operation.

PubMed

Cleuziou, Julie; Vitanova, Keti; Pabst von Ohain, Jelena; Ono, Masamichi; Tanase, Daniel; Burri, Melchior; Lange, Rüdiger

2018-05-01

 The aim of this study was to evaluate the incidence and risk factors for the development of right ventricular outflow tract obstruction (RVOTO) after the arterial switch operation (ASO).  Between 1983 and 2014, a total of 688 patients underwent ASO. RVOTO was defined as any obstruction of the right ventricular outflow tract (RVOT) requiring reintervention.  RVOTO developed in 79 patients (11%) at a median time of 3.8 years (range, 1 day-23.6 years) after ASO. Freedom from RVOT reintervention was 96 ± 1, 89 ± 1, and 83 ± 2% at 1, 10, and 25 years, respectively. Independent risk factors for the development of RVOTO in a Cox's regression model were side-by-side great arteries ( p  < 0.001), aortic arch anomalies ( p  < 0.001), use of a pericardial patch for augmentation of the coronary buttons ( p  < 0.001), and a peak gradient more than 20 mm Hg over the RVOT at discharge ( p  < 0.001).  The incidence of RVOTO after ASO is not negligible. Complex morphology, such as side-by-side great arteries and aortic arch anomalies influences the development of RVOTO. Georg Thieme Verlag KG Stuttgart · New York.

Maximal venous outflow velocity: an index for iliac vein obstruction.

PubMed

Jones, T Matthew; Cassada, David C; Heidel, R Eric; Grandas, Oscar G; Stevens, Scott L; Freeman, Michael B; Edmondson, James D; Goldman, Mitchell H

2012-11-01

Leg swelling is a common cause for vascular surgical evaluation, and iliocaval obstruction due to May-Thurner syndrome (MTS) can be difficult to diagnose. Physical examination and planar radiographic imaging give anatomic information but may miss the fundamental pathophysiology of MTS. Similarly, duplex ultrasonographic examination of the legs gives little information about central impedance of venous return above the inguinal ligament. We have modified the technique of duplex ultrasonography to evaluate the flow characteristics of the leg after tourniquet-induced venous engorgement, with the objective of revealing iliocaval obstruction characteristic of MTS. Twelve patients with signs and symptoms of MTS were compared with healthy control subjects for duplex-derived maximal venous outflow velocity (MVOV) after tourniquet-induced venous engorgement of the leg. The data for healthy control subjects were obtained from a previous study of asymptomatic volunteers using the same MVOV maneuvers. The tourniquet-induced venous engorgement mimics that caused during vigorous exercise. A right-to-left ratio of MVOV was generated for patient comparisons. Patients with clinical evidence of MTS had a mean right-to-left MVOV ratio of 2.0, asymptomatic control subjects had a mean ratio of 1.3, and MTS patients who had undergone endovascular treatment had a poststent mean ratio of 1.2 (P = 0.011). Interestingly, computed tomography and magnetic resonance imaging results, when available, were interpreted as positive in only 53% of the patients with MTS according to both our MVOV criteria and confirmatory venography. After intervention, the right-to-left MVOV ratio in the MTS patients was found to be reduced similar to asymptomatic control subjects, indicating a relief of central venous obstruction by stenting the compressive MTS anatomy. Duplex-derived MVOV measurements are helpful for detection of iliocaval venous obstruction, such as MTS. Right-to-left MVOV ratios and

Endoscopic endonasal dacryocystorhinostomy combined with canaliculus repair for the management of dacryocystitis with canalicular obstruction.

PubMed

Tu, Yunhai; Qian, Zhenbin; Zhang, Jiao; Wu, Wencan; Xiao, Tianlin

2015-01-01

Purpose. The aim of this study is to propose a simple and efficient combination surgery for the management of dacryocystitis with canalicular obstruction. Methods. A retrospective noncomparative case series of dacryocystitis with canalicular obstruction has been studied. Twelve patients with dacryocystitis and canalicular obstruction underwent a conventional endoscopic endonasal dacryocystorhinostomy (EE-DCR) combined with a modified canalicular repair. Postoperative observations included slit lamp, fluorescein dye disappearance test, lacrimal syringing, lacrimal endoscopy, and nasal endoscopy. Results. After 6-18 months of postoperative follow-up, the symptoms of epiphora and mucopurulent discharge disappeared completely in 10 patients, and occasional or intermittent epiphora remained in 2 patients. All of the twelve patients showed an opened intranasal ostium and normal fluorescein dye disappearance test. Patent bicanalicular irrigation was achieved in 9 patients. One patient had a partial and the other two had a complete reobstruction by lacrimal irrigation to their repaired lower canaliculus; however, all of them had a patent lacrimal irrigation to upper canaliculus. The functional success rate for the combination surgery is 83% (10/12), and anatomical success rate is 75% (9/12). Conclusion. EE-DCR combined with modified canalicular repair is a simple and efficient method for the management of dacryocystitis with canalicular obstruction.

Apical Aortic Conduit Infection 27 Years After Repaired Left Ventricular Outflow Tract Obstruction.

PubMed

Carpenter, Dustin J; Fiore, Andrew C; Huddleston, Charles B

2014-07-01

Left ventricle to aortic conduits were used for the treatment of complex left ventricular outflow tract obstruction in the pediatric population in the mid-1970s. Although this technique has been largely replaced by the Ross-Konno procedure, many patients still have functioning apicoaortic conduits in place today. Few clinical reports or case series exist in pediatric cohorts documenting the natural history or potential long-term complications of this prosthesis. In this report, we describe our experience managing a patient with Shone's syndrome and an apical aortic porcine-valved conduit remnant that became infected 17 years postconduit valve excision for valvular insufficiency. © The Author(s) 2014.

Mitral valve replacement complicated by iatrogenic left ventricular outflow obstruction and paravalvular leak: case report and review of literature.

PubMed

Lee, Justin Z; Tey, Kai R; Mizyed, Ahmad; Hennemeyer, Charles T; Janardhanan, Rajesh; Lotun, Kapildeo

2015-10-09

Left ventricular outflow tract (LVOT) obstruction and paravalvular leak (PVL) are relatively uncommon, but are serious complications of prosthetic valve replacement. We present a case that displays the unique therapeutic challenges of treating a patient who developed both LVOT obstruction and mitral PVL after undergoing surgical aortic and mitral valve replacement (MVR). We also describe the use of alcohol septal ablation and albumin-glutaraldehyde (BioGlue) for septal ablation to percutaneously treat the patient's LVOT obstruction, followed by use of an Amplatzer vascular plug for percutaneous closure of an antero-medial mitral PVL associated with severe regurgitation. Percutaneous interventional management of these entities may be considered as an initial therapeutic option, especially in high-risk patients with significant morbidity and mortality of repeat surgical operations.

A Spanner in the works: the use of a new temporary urethral stent to relieve bladder outflow obstruction after prostate brachytherapy.

PubMed

Henderson, Alastair; Laing, Robert W; Langley, Stephen E M

2002-01-01

Assessment of the Spanner, a new temporary urethral stent to relieve bladder outflow obstruction and urinary symptoms after brachytherapy. Five patients with unusually severe urinary morbidity after (125)I brachytherapy were recruited. The mean time after implant was 40 days (range 25-90). Spanner intraprostatic stents were introduced using topical anesthetic without complication. All patients were able to void spontaneously with no post-void residual volume of urine. The flow rates increased in all cases (p=0.03) and the International Prostate Symptom Scores were significantly improved after stent insertion in all patients (p=0.03). All patients experienced some degree of pain or dysuria during stent use. Bladder outflow obstruction was effectively treated with the Spanner intraprostatic stent, however pain limited the use of the device in the early post-brachytherapy patient group. Pharmacotherapy, stent design modification, or smaller stent diameter may increase the utility of stents after brachytherapy.

Functional and Anatomic Esophagogastic Junction Outflow Obstruction: Manometry, Timed Barium Esophagram Findings, and Treatment Outcomes.

PubMed

Clayton, Steven B; Patel, Rupal; Richter, Joel E

2016-06-01

Little is known about the clinical features, radiology and manometry findings, and treatment outcomes of patients with functional and mechanical esophagogastic junction outflow obstruction (EGJOO). Between November 2011 and February 2015, a total of 1443 high-resolution manometries were reviewed and 49 patients (3.4%) met the manometric criteria for EGJOO. Then, we performed a retrospective chart review, collecting data from manometric studies, timed barium esophagram findings (TBEs), endoscopic reports, and clinical records. Twenty-seven patients had functional EGJOO and 22 patients had an anatomic esophageal obstruction. Common causes of anatomic EGJOO included strictures (36% of patients) and hiatal hernias (31% of patients). There were no differences between groups in manometric or radiographic metrics. Each group had increased basal lower esophageal sphincter and intrabolus pressures, compared with individuals without EGJOO, and most patients had abnormal findings on TBE analysis. Two patients with functional EGJOO progressed to type 3 achalasia. We conclude that patients diagnosed with EGJOO based on manometry findings can have anatomic obstruction or functional EGJOO; high-resolution manometry and TBE do not distinguish between disease causes. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Morphological Features of the Porcine Lacrimal Gland and Its Compatibility for Human Lacrimal Gland Xenografting

PubMed Central

Gaffling, Simone; Asano, Nagayoshi; Hampel, Ulrike; Garreis, Fabian; Hornegger, Joachim; Paulsen, Friedrich

2013-01-01

In this study, we present first data concerning the anatomical structure, blood supply and location of the lacrimal gland of the pig. Our data indicate that the porcine lacrimal gland may serve as a potential xenograft candidate in humans or as an animal model for engineering of a bioartificial lacrimal gland tissue construct for clinical application. For this purpose, we used different macroscopic preparation techniques and digital reconstruction of the histological gland morphology to gain new insights and important information concerning the feasibility of a lacrimal gland transplantation from pig to humans in general. Our results show that the lacrimal gland of the pig reveals a lot of morphological similarities to the analogous human lacrimal gland and thus might be regarded as a xenograft in the future. This is true for a similar anatomical location within the orbit as well as for the feeding artery supply to the organ. Functional differences concerning the composition of the tear fluid, due to a different secretory unit distribution within the gland tissue will, however, be a challenge in future investigations. PMID:24069265

Morphological features of the porcine lacrimal gland and its compatibility for human lacrimal gland xenografting.

PubMed

Henker, Robert; Scholz, Michael; Gaffling, Simone; Asano, Nagayoshi; Hampel, Ulrike; Garreis, Fabian; Hornegger, Joachim; Paulsen, Friedrich

2013-01-01

In this study, we present first data concerning the anatomical structure, blood supply and location of the lacrimal gland of the pig. Our data indicate that the porcine lacrimal gland may serve as a potential xenograft candidate in humans or as an animal model for engineering of a bioartificial lacrimal gland tissue construct for clinical application. For this purpose, we used different macroscopic preparation techniques and digital reconstruction of the histological gland morphology to gain new insights and important information concerning the feasibility of a lacrimal gland transplantation from pig to humans in general. Our results show that the lacrimal gland of the pig reveals a lot of morphological similarities to the analogous human lacrimal gland and thus might be regarded as a xenograft in the future. This is true for a similar anatomical location within the orbit as well as for the feeding artery supply to the organ. Functional differences concerning the composition of the tear fluid, due to a different secretory unit distribution within the gland tissue will, however, be a challenge in future investigations.

Cytokeratin expression in mouse lacrimal gland germ epithelium.

PubMed

Hirayama, Masatoshi; Liu, Ying; Kawakita, Tetsuya; Shimmura, Shigeto; Tsubota, Kazuo

2016-05-01

The lacrimal gland secretes tear fluids that protect the ocular surface epithelium, and its dysfunction leads to dry eye disease (DED). The functional restoration of the lacrimal gland by engraftment of a bioengineered lacrimal gland using lacrimal gland germ epithelial cells has been proposed to cure DED in mice. Here, we investigate the expression profile of cytokeratins in the lacrimal gland germ epithelium to clarify their unique characteristics. We performed quantitative polymerase chain reaction (Q-PCR) and immunohistochemistry (IHC) analysis to clarify the expression profile of cytokeratin in the lacrimal gland germ epithelium. The mRNA expression of keratin (KRT) 5, KRT8, KRT14, KRT15, and KRT18 in the lacrimal gland germ epithelium was increased compared with that in mouse embryonic stem cells and the lacrimal gland germ mesenchyme, as analyzed by Q-PCR. The expression level of KRT15 increased in the transition from stem cells to lacrimal gland germ epithelium, then decreased as the lacrimal gland matured. IHC revealed that the expression set of these cytokeratins in the lacrimal gland germ epithelium was different from that in the adult lacrimal gland. The expression of KRT15 was observed in the lacrimal gland germ epithelium, and it segmentalized into some of the basal cells in the intercanulated duct in mature gland. We determined the expression profile of cytokeratins in the lacrimal gland epithelium, and identified KRT15 as a candidate unique cellular marker for the lacrimal gland germ epithelium. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Papilloma of the lacrimal sac].

PubMed

Burduk, Paweł K; Seredyka-Burduk, Małgorzata; Kaźmierczak, Wojciech; Dalke, Krzysztof; Marszałek, Andrzej

2013-01-01

The benign lesions of the lacrimal sac are very rare. The most typical epithelial tumor is squamous papilloma. This tumors often present with symptoms of dacryostenosis and dacriocystitis. Human papillomavirus (HPV) infection is known to be causative agent in the development of epithelial tumor. Lacrimal sac tumors could transform to malignant neoplasms, especially if they are developed of coexisting HPV infection. We present a patient with a squamous papilloma of the lacrimal sac and discussed the method of treatment. The patient was suffered from epiphora and recurrent dacriocystitis. An endoscopic surgery with dacriocystorhinostomy and local resection of the tumor could be an effective method of choice. The usage of a shaver for wide removal of the lacrimal sac wall is recommended to prevent local recurrence. The histopathology examination showed squamous papilloma. The patient is free of the disease over 8 months of follow up. Primary lacrimal sac papilloma require long term follow up for recurrence or malignant transformation. HPV infection could be associated with the development of lacrimal sac papillomas. Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

Bioengineered Lacrimal Gland Organ Regeneration in Vivo

PubMed Central

Hirayama, Masatoshi; Tsubota, Kazuo; Tsuji, Takashi

2015-01-01

The lacrimal gland plays an important role in maintaining a homeostatic environment for healthy ocular surfaces via tear secretion. Dry eye disease, which is caused by lacrimal gland dysfunction, is one of the most prevalent eye disorders and causes ocular discomfort, significant visual disturbances, and a reduced quality of life. Current therapies for dry eye disease, including artificial tear eye drops, are transient and palliative. The lacrimal gland, which consists of acini, ducts, and myoepithelial cells, develops from its organ germ via reciprocal epithelial-mesenchymal interactions during embryogenesis. Lacrimal tissue stem cells have been identified for use in regenerative therapeutic approaches aimed at restoring lacrimal gland functions. Fully functional organ replacement, such as for tooth and hair follicles, has also been developed via a novel three-dimensional stem cell manipulation, designated the Organ Germ Method, as a next-generation regenerative medicine. Recently, we successfully developed fully functional bioengineered lacrimal gland replacements after transplanting a bioengineered organ germ using this method. This study represented a significant advance in potential lacrimal gland organ replacement as a novel regenerative therapy for dry eye disease. In this review, we will summarize recent progress in lacrimal regeneration research and the development of bioengineered lacrimal gland organ replacement therapy. PMID:26264034

EFFECT OF INFLAMMATION ON LACRIMAL GLAND FUNCTION

PubMed Central

Zoukhri, Driss

2005-01-01

The lacrimal gland is the main contributor to the aqueous layer of the tear film. It secretes proteins, electrolytes and water, which helps to nourish and protect the ocular surface. Lacrimal gland secretion is primarily under neural control, which is achieved through a neural reflex arc. Stimuli to the ocular surface activate afferent sensory nerves in the cornea and conjunctiva. This in turn activates efferent parasympathetic and sympathetic nerves in the lacrimal gland to stimulate secretion. Sex steroid hormones are also important regulators of lacrimal gland functions. A decrease or lack of lacrimal gland secretion is the leading cause of aqueous tear deficient dry eye syndrome (DES). It has been suggested that DES is an inflammatory disorder that affects the ocular surface and the lacrimal gland. In several pathological instances, the lacrimal gland can become a target of the immune system and show signs of inflammation. This can result from autoimmune diseases (Sjögren's syndrome), organ transplantation (graft versus host disease), or simply as a result of aging. The hallmarks of lacrimal gland inflammation are the presence of focal lymphocytic infiltrates and increased production of proinflammatory cytokines. The mechanisms leading to lacrimal gland dysfunction are still poorly understood. Apoptosis, production of autoantibodies, hormonal imbalance, alterations in signaling molecules, neural dysfunction, and increased levels of proinflammatory cytokines have been proposed as possible mediators of lacrimal gland insufficiency in disease states. PMID:16309672

Patterns of intraocular pressure elevation after aqueous humor outflow obstruction in rats.

PubMed

Jia, L; Cepurna, W O; Johnson, E C; Morrison, J C

2000-05-01

To determine the diural intraocular pressure (IOP) response of Brown Norway rat eyes after sclerosis of the aqueous humor outflow pathways and its relationship to optic nerve damage. Hypertonic saline was injected into a single episcleral vein in 17 animals and awake IOP measured in both the light and dark phases of the circadian cycle for 34 days. Mean IOP for light and dark phases during the experimental period were compared with the respective pressures of the uninjected fellow eyes. Optic nerve cross sections from each nerve were graded for injury by five independent masked observers. For fellow eyes, mean light- and dark-phase IOP was 21 +/- 1 and 31 +/- 1 mm Hg, respectively. For four experimental eyes, mean IOPs for both phases were not altered. Six eyes demonstrated significant mean IOP elevations only during the dark phase. Of these, five showed persistent, large circadian oscillations, and four had partial optic nerve lesions. The remaining seven eyes experienced significant IOP elevations during both phases, and all had extensive optic nerve damage. Episcleral vein injection of hypertonic saline is more likely to increase IOP during the dark phase than the light. This is consistent with aqueous outflow obstruction superimposed on a circadian rhythm of aqueous humor production. Because these periodic IOP elevations produced optic nerve lesions, both light- and dark-phase IOP determinations are necessary for accurate correlation of IOP history to optic nerve damage in animals housed in a light- dark environment.

Isotretinoin in lacrimal gland fluid and tears.

PubMed

Rismondo, V; Ubels, J L

1987-03-01

Isotretinoin (13-cis-retinoic acid) is used in the treatment of severe cystic acne. Adverse ocular reactions, including blepharoconjunctivitis and dry eye symptoms, are frequent side effects of this drug. Our previous observation that retinol is present in tears and lacrimal gland fluid suggests that isotretinoin may also be secreted by the lacrimal gland. Rabbits were treated with isotretinoin, and lacrimal gland fluid was collected from the cannulated lacrimal gland duct. Tears were collected from patients who were being treated with isotretinoin. Lacrimal gland fluid and tears were analyzed by reverse-phase high-pressure liquid chromatography and a peak eluted from each sample, which was identified as isotretinoin. We conclude that the lacrimal gland is able to secrete isotretinoin in addition to retinol and that, in animals and patients treated systemically with isotretinoin, the ocular surface is exposed to the drug via the tear film.

Morphogenesis of the human excretory lacrimal system

PubMed Central

de la Cuadra-Blanco, C; Peces-Peña, M D; Jáñez-Escalada, L; Mérida-Velasco, J R

2006-01-01

The aim of this study was to determine the principal developmental stages in the formation of the excretory lacrimal system in humans and to establish its morphogenetic period. The study was performed using light microscopy on serial sections of 51 human specimens: 33 embryos and 18 fetuses ranging from 8 to 137 mm crown–rump length (CR; 5–16 weeks of development). Three stages were identified in the morphogenesis of the excretory lacrimal system: (1) the formative stage of the lacrimal lamina (Carnegie stages 16–18); (2) the formative stage of the lacrimal cord (Carnegie stages 19–23); and (3) the maturative stage of the excretory lacrimal system, from the 9th week of development onward. A three-dimensional reconstruction of the excretory lacrimal system was performed from serial sections of an embryo at the end of the embryonic period (27 mm CR). PMID:16879594

Provocation of left ventricular outflow tract obstruction using nitrate inhalation in hypertrophic cardiomyopathy: Relation to electromechanical delay.

PubMed

Badran, Hala Mahfouz; Ibrahim, Waleed Abdou; Faheem, Naglaa; Yassin, Rehab; Alashkar, Tamer; Yacoub, Magdi

2015-01-01

Left ventricular outflow tract obstruction (LVOT) is an independent predictor of adverse outcome in hypertrophic cardiomyopathy (HCM). It is of major importance that the provocation modalities used are validated against each other. To define the magnitude of LVOT gradients provocation during both isosorbide dinitrate (ISDN) inhalation and treadmill exercise in non-obstructive HCM and analyze the correlation to the electromechanical delay using speckle tracking. We studied 39 HCM pts (64% males, mean age 38 ± 13 years) regional LV longitudinal strain and electromechanical delay (TTP) was analyzed at rest using speckle tracking. LVOT gradient was measured at rest and after ISDN then patients underwent a treadmill exercise echocardiography (EE) and LVOT gradient was measured at peak exercise. The maximum effect of ISDN on LVOT gradient was obtained at 5 minutes, it increased to a significant level in 12 (31%) patients, and in 14 (36%) patients using EE, with 85.6% sensitivity & 100% specificity. Patients with latent obstruction had larger left atrial volume and lower E/A ratio compared to the non-obstructive group (p < 0.01). LVOTG using ISDN was significantly correlated with that using EE (p < 0.0001), resting LVOTG (p < 0.0001), SAM (p < 0.0001), EF% (p < 0.02) and regional electromechanical delay but not related to global LV longitudinal strain. Using multivariate regression, resting LVOTG (p = 0.006) & TTP mid septum (p = 0.01) were found to be independent predictors of latent LVOT obstruction using ISDN. There is a comparable diagnostic value of nitrate inhalation to exercise testing in provocation of LVOT obstruction in HCM. Latent obstruction is predominantly dependent on regional electromechanical delay.

Provocation of left ventricular outflow tract obstruction using nitrate inhalation in hypertrophic cardiomyopathy: Relation to electromechanical delay

PubMed Central

Badran, Hala Mahfouz; Ibrahim, Waleed Abdou; Faheem, Naglaa; Yassin, Rehab; Alashkar, Tamer; Yacoub, Magdi

2015-01-01

Background: Left ventricular outflow tract obstruction (LVOT) is an independent predictor of adverse outcome in hypertrophic cardiomyopathy (HCM). It is of major importance that the provocation modalities used are validated against each other. Aim: To define the magnitude of LVOT gradients provocation during both isosorbide dinitrate (ISDN) inhalation and treadmill exercise in non-obstructive HCM and analyze the correlation to the electromechanical delay using speckle tracking. Methods: We studied 39 HCM pts (64% males, mean age 38 ± 13 years) regional LV longitudinal strain and electromechanical delay (TTP) was analyzed at rest using speckle tracking. LVOT gradient was measured at rest and after ISDN then patients underwent a treadmill exercise echocardiography (EE) and LVOT gradient was measured at peak exercise. Results: The maximum effect of ISDN on LVOT gradient was obtained at 5 minutes, it increased to a significant level in 12 (31%) patients, and in 14 (36%) patients using EE, with 85.6% sensitivity & 100% specificity. Patients with latent obstruction had larger left atrial volume and lower E/A ratio compared to the non-obstructive group (p < 0.01). LVOTG using ISDN was significantly correlated with that using EE (p < 0.0001), resting LVOTG (p < 0.0001), SAM (p < 0.0001), EF% (p < 0.02) and regional electromechanical delay but not related to global LV longitudinal strain. Using multivariate regression, resting LVOTG (p = 0.006) & TTP mid septum (p = 0.01) were found to be independent predictors of latent LVOT obstruction using ISDN. Conclusion: There is a comparable diagnostic value of nitrate inhalation to exercise testing in provocation of LVOT obstruction in HCM. Latent obstruction is predominantly dependent on regional electromechanical delay. PMID:26779503

[Eye-associated lymphoid tissue (EALT) is continuously spread throughout the ocular surface from the lacrimal gland to the lacrimal drainage system].

PubMed

Knop, E; Knop, N

2003-11-01

Components of the mucosal immune system (MALT) have been identified in the conjunctiva (as CALT) and the lacrimal drainage system (as LDALT). Their structural and functional relation with the established immune protection by the lacrimal gland is unclear. Macroscopically normal and complete tissues of the conjunctiva, lacrimal drainage system and lacrimal gland from human body donors were investigated by analysis of translucent whole mounts, and using histology, immunohistology as well as scanning and transmission electron microscopy. A typical diffuse lymphoid tissue, composed of effector cells of the immune system (T-lymphocytes and IgA producing plasma cells) under an epithelium that contains the IgA transporter SC, is not isolated in the conjunctiva and lacrimal drainage system. It is anatomically continuous from the lacrimal gland along its excretory ducts into the conjunctiva and from there via the lacrimal canaliculi into the lacrimal drainage system. Lymphoid follicles occur in a majority (about 60%) and with bilateral symmetry. The topography of CALT corresponds to the position of the cornea in the closed eye. These results show that the MALT of the lacrimal gland, conjunctiva and lacrimal drainage system constitute an anatomical and functional unit for immune protection of the ocular surface. Therefore it should be integrated as an "eye-associated lymphoid tissue" (EALT) into the MALT system of the body. EALT can detect ocular surface antigens by the lymphoid follicles and can supply other organs and the ocular surface including the lacrimal gland with specific effector cells via the regulated recirculation of lymphoid cells.

Surgical treatment of left ventricular outflow tract obstruction with apicoaortic valved conduit.

PubMed

Cooley, D A; Norman, J C; Reul, G J; Kidd, J N; Nihill, M R

1976-12-01

From Aug. 13, 1975, through May, 1976, nine patients underwent creation of a left ventricular "vent" for relief of severe left ventricular outflow tract obstruction. A Dacron fabric graft containing a heterograft valve was used to establish a conduit from the left ventricle to the abdominal aorta. There were five male and four female patients in this group; their ages ranged from 4 to 72 years. All had valvular, subvalvular, or supravalvular aortic stenosis, and all but two had undergone previous surgical procedures for relief of the stenosis. All patients survived the operation and none are receiving anticoagulant therapy. All are asymptomatic at present and follow-up is approaching one year. Postoperative cardiac catheterization studies revealed gradients across the aortic valve to be reduced by approximately 90% and mean ventricular systolic pressures by 45%. Although this concept is not new, it has not been used widely and we believe its effectiveness warrants further application.

Acquired fistula of the lacrimal sac and laisser-faire approach. Description of the natural history of acquired fistulas between the lacrimal sac and the skin occurring before planned endonasal dacryocystorhinostomy (DCR) and without any treatment of the fistula.

PubMed

Pison, A; Fau, J-L; Racy, E; Fayet, B

2016-10-01

The formation of a fistula between the lacrimal sac and the skin is a classic outcome of resistant lacrimal sac abscesses. There is currently no consensus about treatment in such cases. The goal of this study was to describe the natural history of acquired fistulas between the lacrimal sac and the skin, occurring before planned endonasal dacryocystorhinostomy (DCR) and without any treatment of the fistula. This prospective study was only descriptive and included patients between 1999 and 2012. The patients included were adults with a nasolacrimal duct (NLD) obstruction that was planned to be treated with endonasal DCR. A resistant lacrimal sac abscess appeared a few days before the planned surgery, and fistulized spontaneously despite medical treatment. The surgery was not delayed. The DCR was endoscopic. Nothing was done for the fistula. Its healing was spontaneous. The exclusion criteria were the following: congenital fistulas, post-traumatic and/or iatrogenic fistulas, fistulas which had regressed by the day of the surgery, postoperative follow-up less than 5 months, post-traumatic and/or iatrogenic fistulas, any history of previous DCR or any other lacrimal surgery, children. Twenty adults (25 cases) were included in the analysis. Mean age was 79 years old (from 41 to 90). The mean follow-up was 41 months (from 5 to 108 months). The fistula spontaneously disappeared in all cases, less than one month after it had appeared and in a permanent fashion. No unsightly scar developed. Spontaneously acquired fistulas between the lacrimal sac and the skin may occur in the natural course of abscessed acute dacryocystitis. Our study showed spontaneous healing of the fistula post-endoscopic DCR. Fistula excision in fistulous acute dacryocystitis does not seem essential to its healing. The laisser-faire approach appears adequate for aesthetic outcomes as well as for functional outcomes of DCR. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Erythrocyte creatine as a marker of intravascular hemolysis due to left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.

PubMed

Kubo, Toru; Okumiya, Toshika; Baba, Yuichi; Hirota, Takayoshi; Tanioka, Katsutoshi; Yamasaki, Naohito; Sugiura, Tetsuro; Doi, Yoshinori L; Kitaoka, Hiroaki

2016-03-01

Erythrocyte creatine, a marker of erythrocyte age that increases with shortening of erythrocyte survival, has been reported to be a quantitative and reliable marker for intravascular hemolysis. We hypothesized that hemolysis could also occur due to intraventricular obstruction in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to examine the presence of subclinical hemolysis and the relation between intravascular hemolysis and intraventricular pressure gradient (IVPG). We measured erythrocyte creatine in 92 HCM patients. Twelve patients had left ventricular outflow tract obstruction (LVOTO), 4 had midventricular obstruction (MVO), and the remaining 76 were non-obstructive. Erythrocyte creatine levels ranged from 0.92 to 4.36μmol/g hemoglobin. Higher levels of erythrocyte creatine were associated with higher IVPG (r=0.437, p<0.001). If erythrocyte creatine levels are high (≥1.8μmol/g hemoglobin), subclinical hemolysis is considered to be present. Half of LVOTO patients and no MVO patients showed high erythrocyte creatine levels. Although non-obstructive patients did not show significant intraventricular obstruction at rest, some showed high erythrocyte creatine levels. When LVOT-PG was measured during the strain phase of the Valsalva maneuver in 20 non-obstructive patients, 7 of those 20 patients showed LVOTO. In the 20 patients, there was no relation between erythrocyte creatine levels and LVOT-PG before the Valsalva maneuver (r=0.125, p=0.600), whereas there was a significant correlation between erythrocyte creatine and LVOT-PG provoked by the Valsalva maneuver (r=0.695, p=0.001). There is biochemical evidence of subclinical hemolysis in patients with HCM, and this hemolysis seems to be associated with LVOTO provoked by daily physical activities. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Endocanalicular diode laser dacryocystorhinostomy for nasolacrimal duct obstruction: short-term results of a new minimally invasive surgical technique.

PubMed

Özçimen, Muammer; Uysal, Ismail Onder; Eryılmaz, Mehmet Akif; Kal, Ali

2010-11-01

To evaluate the results, complications, effectiveness, and operative results of the endocanalicular laser dacryocystorhinostomy (ECL DCR) in the distal obstructions of the lacrimal drainage system. Sixty eyes of 57 patients who had a diagnosis of distal obstruction of the lacrimal drainage system were evaluated retrospectively in this study. All patients underwent ECL DCR by diode laser between October 2008 and July 2009. Forty-nine patients (86%) were females, 8 patients (14%) were males, and age distribution was between 3 and 84 years old (median, 40 y). The canaliculi were intubated by a silicone tube. The patency of the nasolacrimal system was controlled by lacrimal lavage, loss of epiphora, and endoscopic evaluation of the endonasal rhinostomy site with routine follow-up scheduled at first day and 1-week, 1-month, and 3-month postoperative intervals. After the 60 ECL DCRs, 10 patients underwent revision ECL DCR because of the persistent epiphora. The patency of the nasolacrimal duct or the decrease of the symptoms was assigned as success. There were no symptoms at all in 83.3% of the patients. The ECL DCR in the treatment of the distal obstructions of the lacrimal drainage system was easily tolerated by the patients, cosmetically preferred because there was no incision and scar formation with high success rates, and a minimally invasive alternative technique.

Mitral stenosis and hypertrophic obstructive cardiomyopathy: An unusual combination.

PubMed

Hong, Joonhwa; Schaff, Hartzell V; Ommen, Steve R; Abel, Martin D; Dearani, Joseph A; Nishimura, Rick A

2016-04-01

Systolic anterior motion of mitral valve (MV) leaflets is a main pathophysiologic feature of left ventricular outflow tract (LVOT) obstruction in hypertrophic obstructive cardiomyopathy. Thus, restricted leaflet motion that occurs with MV stenosis might be expected to minimize outflow tract obstruction related to systolic anterior motion. From January 1993 through February 2015, we performed MV replacement and septal myectomy in 12 patients with mitral stenosis and hypertrophic obstructive cardiomyopathy at Mayo Clinic Hospital in Rochester, Minn. Preoperative data, echocardiographic images, operative records, and postoperative outcomes were reviewed. Mean (standard deviation) age was 70 (7.6) years. Preoperative mean (standard deviation) maximal LVOT pressure gradient was 75.0 (35.0) mm Hg; MV gradient was 13.7 (2.8) mm Hg. From echocardiographic images, 4 mechanisms of outflow tract obstruction were identified: systolic anterior motion without severe limitation in MV leaflet excursion, severe limitation in MV leaflet mobility with systolic anterior motion at the tip of the MV anterior leaflet, septal encroachment toward the LVOT, and MV displacement toward the LVOT by calcification. Mitral valve replacement and extended septal myectomy relieved outflow gradients in all patients, with no death or serious morbidity. Patients with mitral stenosis and hypertrophic obstructive cardiomyopathy have multiple LVOT obstruction mechanisms, and MV replacement may not be adequate treatment. We favor septal myectomy and MV replacement in this complex subset of hypertrophic obstructive cardiomyopathy. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Pleomorphic adenoma of a deep orbital ectopic lacrimal gland.

PubMed

Misra, Somen; Bhandari, Akshay; Misra, Neeta; Gogri, Pratik; Mahajan, Shruti

2016-10-01

Ectopic lacrimal gland, being one of the choristomas, is comprised of lacrimal gland tissue outside the lacrimal gland fossa in the fronto-lateral part of the orbital roof. Ectopic lacrimal gland is a rare condition where the gland may be found in the orbit, eyelids, ocular adnexa or within the globe. Neoplastic transformation of such tissue may occur. A sixty-two-year old male patient presented with right eye proptosis and slight nasal displacement of the globe. Computerized tomography scan revealed a well-defined hypodense lesion of size 19 x 18 x 20 mm supero-lateral to lateral rectus muscle, with mild proptosis and thinning of the right lateral orbital wall. Excisional biopsy was performed through a lateral orbitotomy approach. A well circumscribed globular mass was removed from the right orbit, well behind the fossa for the lacrimal gland in the retrobulbar space. Histopathology was suggestive of pleomorphic adenoma of lacrimal gland. Pleomorphic adenoma is an epithelial tumor of the lacrimal gland which is extremely rare from an ectopic lacrimal gland and only few cases have been reported in literature till date.

Characterization of cultivated murine lacrimal gland epithelial cells

PubMed Central

Kobayashi, Shinya; Kawashima, Motoko; Okada, Naoko; Mishima, Kenji; Saito, Ichiro; Ito, Masataka; Shimmura, Shigeto; Tsubota, Kazuo

2012-01-01

Purpose To date, mouse lacrimal gland epithelial cells have been cultured successfully but only in cases involving newborn mouse lacrimal glands. In this work, we attempted to cultivate and characterize adult mouse lacrimal gland epithelial cells. Methods Lacrimal glands were removed from newborn mice (C57B/6) and isolated lacrimal gland epithelial cells were seeded onto tissue culture treated or low adherent culture dishes in Cnt-07 culture medium with or without cholera toxin. Cultivated cells were characterized by immunostaining with pan-cytokeratin, α-smooth muscle actin, and lactoferrin antibodies. Lacrimal gland cells from 7-week-old green fluorescent protein (GFP) and non-GFP (C57B/6) mice were mixed and seeded onto uncoated dishes to assess sphere-forming efficiency. Cells were also seeded onto 3T3 cell feeder layers to assess colony forming efficiency. Results Lacrimal gland epithelial cells were selectively cultured with cholera toxin, and cell type was verified by pan-cytokeratin and α-smooth muscle actin immunostaining. Sphere formation from single cells of adult mice was observed using specific medium and low adherent culture dishes. These cells could also undergo colony formation on 3T3 feeder cells. Conclusions Adult mouse lacrimal gland epithelial cells were successfully cultivated in cholera toxin-containing medium, and were observed to form spheres from single cells. PMID:22665974

Lacrimal Gland Radiosensitivity in Uveal Melanoma Patients

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

Muller, Karin; Nowak, Peter J.C.M.; Naus, Nicole

2009-06-01

Purpose: To find a dose-volume effect for inhomogeneous irradiated lacrimal glands. Methods and Materials: Between 1999 and 2006, 72 patients (42 men and 30 women) were treated with fractionated stereotactic radiotherapy in a prospective, nonrandomized clinical trial (median follow-up, 32 months). A total dose of 50 Gy was given on 5 consecutive days. The mean of all Schirmer test results obtained {>=}6 months after treatment was correlated with the radiation dose delivered to the lacrimal gland. Also, the appearance of dry eye syndrome (DES) was related to the lacrimal gland dose distribution. Results: Of the 72 patients, 17 developed amore » late Schirmer value <10 mm; 9 patients developed DES. A statistically significant relationship was found between the received median dose in the lacrimal gland vs. reduced tear production (p = 0.000) and vs. the appearance of DES (p = 0.003), respectively. A median dose of 7 Gy/fraction to the lacrimal gland caused a 50% risk of low Schirmer results. A median dose of 10 Gy resulted in a 50% probability of DES. Conclusion: We found a clear dose-volume relationship for irradiated lacrimal glands with regard to reduced tear production and the appearance of DES.« less

Measurement of Lacrimal Sac Fossa Using Orbital Computed Tomography.

PubMed

Kang, Dongwan; Park, Jinhwan; Na, Jaehoon; Lee, Hwa; Baek, Sehyun

2017-01-01

To evaluate the clinical usefulness of measuring the lacrimal sac fossa length using orbital computed tomography in normal Koreans. The authors retrospectively evaluated 140 patients (70 males and 70 females) who underwent orbital computed tomography at Guro Hospital and who had no history of orbital disease or orbital trauma. Computed tomography scans of the right orbit, including the proportion of the lacrimal bone and maxillary bone that comprise the lacrimal sac fossa, were evaluated at 3 different axial planes (lower, middle, and upper levels). Additionally, the mid-point thickness and maximum thickness of the maxillary bone were measured. Finally, the authors also evaluated the relationship between nasal bone height and maxillary bone thickness in the lacrimal sac fossa. Maxillary bone thickness in the lacrimal sac fossa was thicker in males than in females at mid-point thickness and maximum thickness (P < 0.05). However, there was no significant difference in the size of the lacrimal sac fossa and the proportion of the maxillary bone between males and females.In comparisons between maxillary cross-sections, bone thickness was greater toward the upper level of the lacrimal sac fossa (P = 0.008), and the proportion of the maxillary bone was also greater (P = 0.006).Aging had a significant positive correlation with maxillary bone thickness at all 3 axial planes (P < 0.05), but there was no relationship between age and maxillary bone proportion. Nasal bone height and maxillary bone thickness were also not significantly related. In comprising the lacrimal sac fossa, the maxillary bone accounted for a bigger proportion than the lacrimal bone. Male maxillary bone thickness was greater than female thickness. The authors also observed that maxillary bone thickness increased toward the upper areas of the lacrimal sac fossa and with increasing subject age. Understanding the form and variation of a normal lacrimal sac fossa is helpful for preparing for a

Effect of general anesthetics on IOP in rats with experimental aqueous outflow obstruction.

PubMed

Jia, L; Cepurna, W O; Johnson, E C; Morrison, J C

2000-10-01

To determine the effect of several common general anesthetics on intraocular pressure (IOP) after experimental aqueous outflow obstruction in the rat. A single episcleral vein injection of hypertonic saline was used to sclerose aqueous humor outflow pathways and produce elevated IOP in Brown Norway rats. Animals were housed in either standard lighting or a constant low-level light environment. Awake IOPs were determined using a TonoPen (Mentor, Norwell, MA) immediately before induction of anesthesia by either isoflurane, ketamine, or a mixture of injectable anesthetics (xylazine, ketamine, and acepromazine). For each anesthetic, IOPs were measured immediately after adequate sedation (time 0) and at 5-minute intervals, up to 20 minutes. RESULTS; Awake IOPs ranged from 18 to 52 mm Hg. All anesthetics resulted in a statistically significant (P: < 0.01) reduction in measured IOP at every duration of anesthesia when compared with the corresponding awake IOP. With increasing duration of anesthesia, measured IOP decreased approximately linearly for both the anesthetic mixture and isoflurane. However, with ketamine, IOP declined to 48% +/- 11% (standard lighting) and 60% +/- 7% (constant light) of awake levels at 5 minutes of anesthesia, where it remained stable. In fellow eyes, the SD of the mean IOP in animals under anesthesia was always greater than the corresponding SD of the awake mean. Anesthesia's effects in normal eyes and eyes with elevated IOP were indistinguishable. All anesthetics resulted in rapid and substantial decreases in IOP in all eyes and increased the interanimal variability in IOPs. Measurement of IOP in awake animals provides the most accurate documentation of pressure histories for rat glaucoma model studies.

The Aging Lacrimal Gland: Changes in Structure and Function

PubMed Central

Rocha, Eduardo M.; Alves, Monica; Rios, J. David; Dartt, Darlene A.

2014-01-01

The afferent nerves of the cornea and conjunctiva, efferent nerves of the lacrimal gland, and the lacrimal gland are a functional unit that works cooperatively to produce the aqueous component of tears. A decrease in the lacrimal gland secretory function can lead to dry eye disease. Because aging is a risk factor for dry eye disease, study of the changes in the function of the lacrimal gland functional unit with age is important for developing treatments to prevent dry eye disease. No one mechanism is known to induce the changes that occur with aging, although multiple different mechanisms have been associated with aging. These fall into two theoretical categories: programmed theories of aging (immunological, genetic, apoptotic, and neuroendocrine) and error theories of aging (protein alteration, somatic mutation, etc). Lacrimal glands undergo structural and functional alteration with increasing age. In mouse models of aging, it has been shown that neural stimulation of protein secretion is an early target of aging, accompanied by an increase in mast cells and lipofuscin accumulation. Hyperglycemia and increased lymphocytic infiltration can contribute to this loss of function at older ages. These findings suggest that an increase in oxidative stress may play a role in the loss of lacrimal gland function with age. For the afferent and efferent neural components of the lacrimal gland functional unit, immune or inflammatory mediated decrease in nerve function could contribute to loss of lacrimal gland secretion with age. More research in this area is critically needed. PMID:18827949

The aging lacrimal gland: changes in structure and function.

PubMed

Rocha, Eduardo M; Alves, Monica; Rios, J David; Dartt, Darlene A

2008-10-01

The afferent nerves of the cornea and conjunctiva, efferent nerves of the lacrimal gland, and the lacrimal gland are a functional unit that works cooperatively to produce the aqueous component of tears. A decrease in the lacrimal gland secretory function can lead to dry eye disease. Because aging is a risk factor for dry eye disease, study of the changes in the function of the lacrimal gland functional unit with age is important for developing treatments to prevent dry eye disease. No one mechanism is known to induce the changes that occur with aging, although multiple different mechanisms have been associated with aging. These fall into two theoretical categories: programmed theories of aging (immunological, genetic, apoptotic, and neuroendocrine) and error theories of aging (protein alteration, somatic mutation, etc). Lacrimal glands undergo structural and functional alteration with increasing age. In mouse models of aging, it has been shown that neural stimulation of protein secretion is an early target of aging, accompanied by an increase in mast cells and lipofuscin accumulation. Hyperglycemia and increased lymphocytic infiltration can contribute to this loss of function at older ages. These findings suggest that an increase in oxidative stress may play a role in the loss of lacrimal gland function with age. For the afferent and efferent neural components of the lacrimal gland functional unit, immune or inflammatory mediated decrease in nerve function could contribute to loss of lacrimal gland secretion with age. More research in this area is critically needed.

Lacrimal neuralgia: so far, a missing cranial neuralgia.

PubMed

Pareja, Juan A; Cuadrado, María-Luz

2013-10-01

The lacrimal nerve supplies the lacrimal gland, the lateral upper eyelid, and a small cutaneous area adjacent to the external CANTHUS . First division trigeminal neuralgia, supraorbital/supratrochlear neuralgia, and infraorbital neuralgia have been acknowledged as neuralgic causes of pain in the forehead and periorbit. However, the lacrimal nerve has never been identified as a source of facial pain. Here we report two cases of lacrimal neuralgia. A 66-year-old woman had continuous pain in the lateral aspect of her left superior eyelid and an adjacent area of the temple since age 64. A 33-year-old woman suffered from continuous pain in a small area next to the lateral CANTHUS of her left eye since age 25. In both patients the superoexternal edge of the orbit was tender. In addition, sensory dysfunction could be demonstrated within the painful area. Anaesthetic blockades of the lacrimal nerve with lidocaine 2% resulted in complete but short-lasting relief. Pregabalin provided a complete response in the first patient. The second patient was refractory to various oral and topical drugs and different radiofrequency procedures, but she eventually obtained partial relief with pregabalin. Lacrimal neuralgia should be considered among the neuralgic causes of orbital and periorbital pain.

Ultrasound parameters of normal lacrimal sac and chronic dacryocystitis.

PubMed

Machado, Marco Antonio de Campos; Silva, João Amaro Ferrari; Garcia, Eduardo Alonso; Allemann, Norma

2017-06-01

To compared the ultrasound findings of the lacrimal sac between subjects with normal lacrimal systems those with chronic dacryocystitis. A retrospective study of 10 subjects with a normal lacrimal system (Group 1) and 10 with chronic dacryocystitis (Group 2) diagnosed according to B-mode ultrasound with a 10-MHz transducer and the direct-contact technique (AVISO, Quantel Medical) for lacrimal sac assessment. We analyzed the dimensions, features, and content of the sacs. Characteristics of the population: female: 6, Group 1; 8, Group 2; mean age 48.4 years (SD=19.9; range, 22-80 years), Group 1; 50.5 years (SD=15.5; range, 25-75 years), Group 2. The dimensions of the lacrimal sac were as follows: anteroposterior 1.86 and 10.99 mm in Groups 1 and 2, respectively, p<0.0001; vertical 9.79 and 14.13 mm in Groups 1 and 2, respectively, p=0.049. Qualitative evaluation of the lacrimal sac contents showed hypoechogenic content in Group 1 (10, 100%) and hyperechogenic punctiform content in Group 2 (10, 100%) with partial filling in seven cases (70%). Ultrasonography can differentiate normal lacrimal sacs from sacs compromised by chronic dacryocystitis, thus being useful as an adjunct to clinical examination and surgical planning.

Human lacrimal gland regeneration: Perspectives and review of literature

PubMed Central

Tiwari, Shubha; Ali, Mohammad Javed; Vemuganti, Geeta K.

2013-01-01

The human lacrimal gland is an essential component of the lacrimal functional unit (LFU). Any perturbation of this unit can lead to the debilitating morbid condition called the dry eye syndrome (DES). The current line of therapy available for dry eye remains supportive and palliative with the patient being dependent on life long and frequent administration of lubricating eye drops. Even advanced therapies like punctual plugs, cyclosporine B administration, and salivary gland auto-transplantation have led to a limited success. Under these scenarios, the option of cell based therapy needs to be explored to provide better and long term relief to these patients. This review gives an overview of the efforts in lacrimal gland regeneration and examines the past and ongoing research in cell based therapies in animals as well as human lacrimal gland cultures. The authors discuss their first of its kind functionally viable human lacrimal gland in vitro culture system from fresh exenteration specimens. A brief overview of research in near future and the potential implications of lacrimal gland regenerative therapies have been discussed. PMID:24526853

Human lacrimal gland regeneration: Perspectives and review of literature.

PubMed

Tiwari, Shubha; Ali, Mohammad Javed; Vemuganti, Geeta K

2014-01-01

The human lacrimal gland is an essential component of the lacrimal functional unit (LFU). Any perturbation of this unit can lead to the debilitating morbid condition called the dry eye syndrome (DES). The current line of therapy available for dry eye remains supportive and palliative with the patient being dependent on life long and frequent administration of lubricating eye drops. Even advanced therapies like punctual plugs, cyclosporine B administration, and salivary gland auto-transplantation have led to a limited success. Under these scenarios, the option of cell based therapy needs to be explored to provide better and long term relief to these patients. This review gives an overview of the efforts in lacrimal gland regeneration and examines the past and ongoing research in cell based therapies in animals as well as human lacrimal gland cultures. The authors discuss their first of its kind functionally viable human lacrimal gland in vitro culture system from fresh exenteration specimens. A brief overview of research in near future and the potential implications of lacrimal gland regenerative therapies have been discussed.

Functional lacrimal gland regeneration by transplantation of a bioengineered organ germ

PubMed Central

Hirayama, Masatoshi; Ogawa, Miho; Oshima, Masamitsu; Sekine, Yurie; Ishida, Kentaro; Yamashita, Kentaro; Ikeda, Kazutaka; Shimmura, Shigeto; Kawakita, Tetsuya; Tsubota, Kazuo; Tsuji, Takashi

2013-01-01

The lacrimal gland has a multifaceted role in maintaining a homeostatic microenvironment for a healthy ocular surface via tear secretion. Dry-eye disease, which is caused by lacrimal gland dysfunction, is one of the most prevalent eye diseases that cause corneal epithelial damage and results in significant loss of vision and a reduction in the quality of life. Here we demonstrate orthotopic transplantation of bioengineered lacrimal gland germs into adult mice with an extra-orbital lacrimal gland defect, a mouse model that mimics the corneal epithelial damage caused by lacrimal gland dysfunction. The bioengineered lacrimal gland germs and harderian gland germs both develop in vivo and achieve sufficient physiological functionality, including tear production in response to nervous stimulation and ocular surface protection. This study demonstrates the potential for bioengineered organ replacement to functionally restore the lacrimal gland. PMID:24084941

Dynamic left ventricular outflow tract obstruction secondary to hypovolemia in a German Shepard dog with splenic hemangiosarcoma.

PubMed

Aoki, Takuma; Sunahara, Hiroshi; Sugimoto, Keisuke; Ito, Tetsuro; Kanai, Eiichi; Neo, Sakurako; Fujii, Yoko; Wakao, Yoshito

2015-09-01

Dynamic left ventricular outflow tract obstruction (DLVOTO) is a common condition in cats and humans. In this case report, a dog is described with DLVOTO secondary to severe intra-abdominal hemorrhage caused by a hemangiosarcoma. The dog was a 9-year-old, 35.7-kg, spayed female German Shepard dog that presented with a history of tachypnea and collapse. A Levine II/VI systolic murmur was present at the heart base. Abdominal ultrasonography revealed a splenic mass and a large amount of ascites. Echocardiography showed a reduced left ventricular diameter and an increased aortic velocity caused by systolic anterior motion (SAM) of the mitral valve apparatus. The heart murmur and the SAM were resolved after treatment including a splenectomy and a blood transfusion.

EDUCATIONAL SERIES IN CONGENITAL HEART DISEASE: Congenital left-sided heart obstruction

PubMed Central

Carr, Michelle; Curtis, Stephanie; Marek, Jan

2018-01-01

Congenital obstruction of the left ventricular outflow tract remains a significant problem and multilevel obstruction can often coexist. Obstruction can take several morphological forms and may involve the subvalvar, valvar or supravalvar portion of the aortic valve complex. Congenital valvar stenosis presenting in the neonatal period represents a spectrum of disorders ranging from the hypoplastic left heart syndrome to almost normal hearts. Treatment options vary dependent on the severity of the left ventricular outflow tract obstruction (LVOTO) and the variable degree of left ventricular hypoplasia as well as the associated lesions such as arch hypoplasia and coarctation. PMID:29681546

Human lacrimal gland mucins.

PubMed

Paulsen, Friedrich; Langer, Gesa; Hoffmann, Werner; Berry, Monica

2004-05-01

The objective of this study was to determine whether the lacrimal gland synthesizes mucins and whether they are changed with age or in cases of dry eye. Expression of mucins in human lacrimal glands was monitored by reverse transcription-polymerase chain reaction analysis. Furthermore, the presence and distribution of MUC1, -2, -4, -5AC, -5B, -6 and -7 in epithelia of the human lacrimal gland and its excretory duct system were assessed with antisera to mucin peptide cores. Thirty normal tissues from cadavers of different ages were tested, plus four with dry eye treated with artificial tears. Expression studies detected mRNAs for mucins MUC1, -4, -5AC, -5B, -6 and -7; whereas the MUC2 message was absent. The message for MUC4 was present in all four cases of dry eye, but only in six out of the 30 normal glands from individuals who did not receive artificial tears. MUC6 mRNA was detected only in about half of the investigated samples. Immunohistochemistry revealed membrane-bound MUC1 at the apical surface of acinar cells, absence of MUC2, MUC5AC associated with goblet cells of excretory ducts, MUC5B and -7 in the cytoplasm of acinar cells, and MUC7 also in epithelial cells of excretory ducts. MUC4 mucin was detected only in those individuals in which message was identified. In dry eyes, MUC5AC and -5B were localized in the same acinar cells; whereas MUC2 and MUC6 were not detectable. Dot-blot analysis clearly revealed increased amounts of MUC4, -5AC, and -5B in the glands of elderly women who received treatment for dry eyes. These results confirm that the human lacrimal gland synthesizes a spectrum of mucins; part of them might be correlated with age. Copyright 2004 Springer-Verlag

Comparison of Valsalva Maneuver, Amyl Nitrite, and Exercise Echocardiography to Demonstrate Latent Left Ventricular Outflow Obstruction in Hypertrophic Cardiomyopathy.

PubMed

Ayoub, Chadi; Geske, Jeffrey B; Larsen, Carolyn M; Scott, Christopher G; Klarich, Kyle W; Pellikka, Patricia A

2017-12-15

Guidelines recommend exercise stress echocardiogram (ESE) for patients with hypertrophic cardiomyopathy (HC) if a 50 mm Hg gradient is not present at rest or provoked with Valsalva or amyl nitrite, to direct medical and surgical management. However, no study has directly compared all 3 methods. We sought to evaluate efficacy and degree of provocation of left ventricular outflow gradients by ESE, and compare with Valsalva and amyl nitrite. In patients with HC between 2002 and 2015, resting echocardiograms and ESEs within 1 year were retrospectively reviewed. Gradients elicited by each provocation method were compared. Rest and ESE were available in 97 patients (mean age 54 ± 18 years, 57% male); 78 underwent Valsalva maneuver and 41 amyl nitrite provocation. Median gradients (interquartile range) were 10 mm Hg (7,19) at rest, 16 mm Hg (9,34) with Valsalva, 23 mm Hg (13,49) with amyl nitrite, and 26 mm Hg (13,58) with ESE. ESE and amyl nitrite were able to provoke obstruction (≥30 mm Hg) and severe obstruction (≥50 mm Hg) more frequently than Valsalva. In patients with resting gradient <30 mm Hg (n = 83), provocation maneuvers demonstrated dynamic obstruction in 51%; in those with Valsalva gradient <30 mm Hg (n = 57), ESE or amyl nitrite provoked a gradient in 44%; and in those with amyl nitrite gradient <30 mm Hg (n = 20), ESE provoked a gradient in 29%. No demographic or baseline echocardiographic parameter predicted provocable obstruction. In conclusion, ESE is clinically useful; however, different provocation maneuvers may be effective in different patients with HC, and all maneuvers may be required to provoke dynamic obstruction in symptomatic patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Dacryocystography using cone beam CT in patients with lacrimal drainage system obstruction.

PubMed

Tschopp, Markus; Bornstein, Michael M; Sendi, Pedram; Jacobs, Reinhilde; Goldblum, David

2014-01-01

To assess the usefulness of cone beam CT (CBCT) for dacryocystography (DCG) using either direct syringing or passive application of contrast medium. Ten consecutive patients with epiphora who had CBCT-DCG in a sitting position were retrospectively analyzed. CBCT-DCGs were performed using 2 techniques: direct syringing with contrast medium or using the passive technique, where patients received 3 drops of contrast medium into the conjunctival sac before CBCT-DCG. Clinical and radiologic diagnoses were compared for both groups. The 10 patients (men = 3) had a mean age of 63.2 years. Both techniques proved to be simple procedures with good delineation of the bone, soft tissue, and the contrast medium in the lacrimal system. No side effects were noted. CBCT-DCG is a useful alternative to determine the localization of stenosis in patients with chronic epiphora.

Low frequency of V617F mutation in JAK2 gene in Indian patients with hepatic venous outflow obstruction and extrahepatic portal venous obstruction.

PubMed

Rai, Praveer; Kumar, Pankaj; Mishra, Swapnil; Aggarwal, Rakesh

2016-09-01

Hepatic venous outflow tract obstruction (HVOTO) and extrahepatic portal venous obstruction (EHPVO) are important causes of portal hypertension and related complications in India. Both these conditions result from splanchnic venous thrombosis. In recent years, a V617F somatic mutation in Janus kinase 2 (JAK2) gene which is highly specific for myeloproliferative disorders has been detected in 40 % to 50 % and 30 % to 35 % of Western patients with HVOTO and EHPVO, respectively. However, data on this mutation in these conditions from Asian countries are limited. We looked for JAK2 V617F mutation in Indian patients with HVOTO (n = 40, median age 31 [range 17-51] years, 21 female) and EHPVO (n = 50, median age 23 [15-70] years, 25 female) by using two separate methods. Both the methods involved polymerase chain reaction using allele-specific primers. Positive results on one or both of these techniques were confirmed using DNA sequencing. None of the 40 patients with HVOTO and only 1 of 50 patients with EHPVO was found to have JAK2 V617F mutation. In the one patient who was found to have this mutation, both the PCR methods and DNA sequencing showed positive results. Hypercoagulability associated with JAK2 V617F mutation and associated chronic myeloproliferative disorders was not a major cause of HVOTO and EHPVO in this population.

Breast carcinoma metastasis to the lacrimal gland: Two case reports

PubMed Central

NICKELSEN, MARIE N.; VON HOLSTEIN, SARAH; HANSEN, ALASTAIR B.; PRAUSE, JAN U.; HEEGAARD, STEFFEN

2015-01-01

A 77-year-old female, with proptosis, reduced eye motility and diplopia which had developed over two to three months and a 69-year-old female with proptosis, oedema of the eyelid, reduced motility and ptosis, which had developed over three weeks, are presented in the present study. Computed tomography scans revealed irregular lacrimal gland tumours in the two patients. The two patients had history of breast cancer. The first breast cancer metastasis in the lacrimal gland demonstrated a cribriform growth pattern containing ductal elements. The epithelial tumour cells stained positive for cytokeratin (1–8, 10, 14–16, 18 and 19), oestrogen receptor, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and gross cystic disease fluid protein 15 (GCDFP-15). The second metastatic tumour was positive for EMA and estrogen receptor, but variably positive for CEA and GCDFP-15. The metastasis in the lacrimal gland was a pleomorphic tumour. The tumour cells were positive for EMA and variably positive for oestrogen and CEA. Metastases to the lacrimal gland are extremely rare, and metastases to the lacrimal gland should be considered in the diagnoses of lacrimal gland tumours. The present study aimed to describe two such cases and draw attention to breast carcinomas as a differential diagnosis and the most frequent cause of lacrimal gland metastasis. PMID:26622620

Polycystin-2 Expression and Function in Adult Mouse Lacrimal Acinar Cells

PubMed Central

Hilgenberg, Jill D.; Rybalchenko, Volodymyr; Medina-Ortiz, Wanda E.; Gregg, Elaine V.; Koulen, Peter

2011-01-01

Purpose. Lacrimal glands regulate the production and secretion of tear fluid. Dysfunction of lacrimal gland acinar cells can ultimately result in ocular surface disorders, such as dry eye disease. Ca2+ homeostasis is tightly regulated in the cellular environment, and secretion from the acinar cells of the lacrimal gland is regulated by both cholinergic and adrenergic stimuli, which both result in changes in the cytosolic Ca2+ concentration. We have previously described the detailed intracellular distribution of inositol-1,4,5-trisphosphate receptors (IP3Rs), and ryanodine receptors (RyRs) in lacrimal acinar cells, however, little is known regarding the expression and distribution of the third major class of intracellular Ca2+ release channels, transient receptor potential polycystin family (TRPP) channels. Methods. Studies were performed in adult lacrimal gland tissue of Swiss-Webster mice. Expression, localization, and intracellular distribution of TRPP Ca2+ channels were investigated using immunocytochemistry, immunohistochemistry, and electron microscopy. The biophysical properties of single polycystin-2 channels were investigated using a planar lipid bilayer electrophysiology system. Results. All channel-forming isoforms of TRPP channels (polycystin-2, polycystin-L, and polycystin-2L2) were expressed in adult mouse lacrimal gland. Subcellular analysis of immunogold labeling revealed strongest polycystin-2 expression on the membranes of the endoplasmic reticulum, Golgi, and nucleus. Biophysical properties of lacrimal gland polycystin-2 channels were similar to those described for other tissues. Conclusions. The expression of TRPP channels in lacrimal acinar cells suggests a functional role of the proteins in the regulation of lacrimal fluid secretion under physiological and disease conditions, and provides the basis for future studies focusing on physiology and pharmacology. PMID:21508103

[Evidence of lacrimal plugs via high resolution ultrasound].

PubMed

Tost, Frank H W; Darman, Jacques

2003-07-01

The practical value of high-frequency ultrasound (transducer frequency of 20 MHz) for studying lacrimal plugs positioned into canaliculi was proved. Twelve patients with twenty intracanalicular plugs and two punctum plugs were examined via high-frequency B-scan ultrasonography using 20 MHz transducer (model I3 Sacramento, USA). Detection and localisation of the intracanalicular plugs was made by a 20 MHz sector scanner. The ultrasound examinations were performed 1 - 24 month after the placement of lacrimal plugs. After patient's head positioning, the high-frequency ultrasound investigation was done via immersion fluid (2 % methylcellulose). All patients with dry eye treated by lacrimal plug implant showed echographic structure in the lacrimal canaliculus. In transversal echograms it was possible to image both canaliculi together when the lids were half-closed. Contrary to the normal state, it was not necessary to inject viscous fluid into the canaliculus. High-resolution ultrasound was able to differentiate the normal canaliculus from the findings after plug placement. The echograms can vary from one plug type to another. Highly reflective structures were found after the placement of silicone intracanalicular plugs, e. g. HERRICK-Plug. In contrast, the ultrasonic image taken through acrylic polymer intracanalicular plugs showed homogeneous small reflective inner structure, e. g. SMART-Plug. However, smooth and flat acoustic interface between acrylic polymer plug and the lacrimal canaliculus produced strong echoes. 20 MHz ultrasound seems to be well suited for the detection and localisation of intracanalicular plugs. By use of 20 MHz ultrasound scans it is possible to get high-quality images of the intracanalicular plug and around lacrimal canaliculus. Compared with UBM, the depth of penetration is much higher with negligible resolution. On the whole, we believe that 20 MHz ultrasound can become a useful tool for evaluating the placement of intracanalicular plugs

Probing of congenital nasolacrimal duct obstruction with dacryoendoscope

PubMed Central

Kato, Kumiko; Matsunaga, Koichi; Takashima, Yuko; Kondo, Mineo

2014-01-01

Background A congenital nasolacrimal duct obstruction (CNLDO) is a relatively common disease in infants. We evaluated the results of probing three patients with CNLDO, under direct view, with a dacryoendoscope. Methods Three cases of CNLDO were examined and treated by probing with a dacryoendoscope, under intravenous anesthesia. The diameter of the dacryoendoscope probe was 0.7 mm, and we were able to observe the inner walls of the lacrimal duct and able to guide the probe through the duct. Results In all cases, the site of obstruction was detected, and the probe was used to remove the obstruction. At 2 weeks after the removal of the obstruction, there was no epiphora or mucopurulent discharge in any of the cases. No complications were detected intra- and postoperatively. Conclusion Although only three cases were studied, we believe that probing with a dacryoendoscope is a safe and effective method of treating a CNLDO. More cases need to be studied. PMID:24876765

Sjögren-Like Lacrimal Keratoconjunctivitis in Germ-Free Mice

PubMed Central

Wang, Changjun; Zaheer, Mahira; Bian, Fang; Quach, Darin; Swennes, Alton G.; Britton, Robert A.; Pflugfelder, Stephen C.

2018-01-01

Commensal bacteria play an important role in the formation of the immune system but their role in the maintenance of immune homeostasis at the ocular surface and lacrimal gland remains poorly understood. This study investigated the eye and lacrimal gland phenotype in germ-free and conventional C57BL/6J mice. Our results showed that germ-free mice had significantly greater corneal barrier disruption, greater goblet cell loss, and greater total inflammatory cell and CD4+ T cell infiltration within the lacrimal gland compared to the conventionally housed group. A greater frequency of CD4+IFN-γ+ cells was observed in germ-free lacrimal glands. Females exhibited a more severe phenotype compared to males. Adoptive transfer of CD4+ T cells isolated from female germ-free mice into RAG1KO mice transferred Sjögren-like lacrimal keratoconjunctivitis. Fecal microbiota transplant from conventional mice reverted dry eye phenotype in germ-free mice and decreased CD4+IFN-γ+ cells to levels similar to conventional C57BL/6J mice. These findings indicate that germ-free mice have a spontaneous lacrimal keratoconjunctivitis similar to that observed in Sjögren syndrome patients and demonstrate that commensal bacteria function in maintaining immune homeostasis on the ocular surface. Thus, manipulation of intestinal commensal bacteria has the potential to become a novel therapeutic approach to treat Sjögren Syndrome. PMID:29438346

Neurostimulation of the Lacrimal Nerve for Enhanced Tear Production

PubMed Central

Kossler, Andrea L.; Wang, Jianhua; Feuer, William; Tse, David T.

2014-01-01

Purpose To design a proof-of-concept study to assess the effect of lacrimal nerve stimulation (LNS) with an implantable pulse generator (IPG) to increase aqueous tear production. Methods Experimental animal study design of six Dutch Belted rabbits. Ultra high-resolution optical coherence tomography (UHR-OCT) quantified tear production by measuring the baseline tear volume of each rabbit’s right and left eye. A neurostimulator was implanted adjacent to the right lacrimal nerve. After two minutes of LNS (100 μs, 1.6 mAmp, 20 Hz, 5–8 volts), the tear volumes were measured with UHR-OCT. The change in tear volume was quantified and compared to the non-stimulated left eye. Three rabbits underwent chronic LNS (100 μS, 1.6 mAmp, 10 Hz, 2 volts) and their lacrimal glands were harvested for histopathologic analysis. Results UHR-OCT imaging of the right eyes tear volume showed a 441% average increase in tear production after LNS as a percent of baseline. After stimulation, right eyes had statistically significant greater increase in tear volumes than left eyes (p=0.028, Wilcoxon test). Post-stimulation right eye tear volumes were significantly greater compared to baseline (p=0.028, Wilcoxon test). Histopathologic examination of the lacrimal glands showed no discernible tissue damage from chronic neurostimulation. Additionally, there were no gross adverse effects on the general well-beings of the animals due to chronic stimulation. Conclusions Lacrimal nerve stimulation with an implantable pulse generator appears to increase aqueous tear production. Chronic LNS showed no histopathologic lacrimal gland damage. This study suggests LNS is a promising new treatment strategy to increase aqueous tear production. PMID:25126767

Alx4 relays sequential FGF signaling to induce lacrimal gland morphogenesis

PubMed Central

Garg, Ankur; Gotoh, Noriko; Feng, Gen-Sheng; Zhong, Jian; Wang, Fen; Kariminejad, Ariana; Brooks, Steven

2017-01-01

The sequential use of signaling pathways is essential for the guidance of pluripotent progenitors into diverse cell fates. Here, we show that Shp2 exclusively mediates FGF but not PDGF signaling in the neural crest to control lacrimal gland development. In addition to preventing p53-independent apoptosis and promoting the migration of Sox10-expressing neural crests, Shp2 is also required for expression of the homeodomain transcription factor Alx4, which directly controls Fgf10 expression in the periocular mesenchyme that is necessary for lacrimal gland induction. We show that Alx4 binds an Fgf10 intronic element conserved in terrestrial but not aquatic animals, underlying the evolutionary emergence of the lacrimal gland system in response to an airy environment. Inactivation of ALX4/Alx4 causes lacrimal gland aplasia in both human and mouse. These results reveal a key role of Alx4 in mediating FGF-Shp2-FGF signaling in the neural crest for lacrimal gland development. PMID:29028795

Alx4 relays sequential FGF signaling to induce lacrimal gland morphogenesis.

PubMed

Garg, Ankur; Bansal, Mukesh; Gotoh, Noriko; Feng, Gen-Sheng; Zhong, Jian; Wang, Fen; Kariminejad, Ariana; Brooks, Steven; Zhang, Xin

2017-10-01

The sequential use of signaling pathways is essential for the guidance of pluripotent progenitors into diverse cell fates. Here, we show that Shp2 exclusively mediates FGF but not PDGF signaling in the neural crest to control lacrimal gland development. In addition to preventing p53-independent apoptosis and promoting the migration of Sox10-expressing neural crests, Shp2 is also required for expression of the homeodomain transcription factor Alx4, which directly controls Fgf10 expression in the periocular mesenchyme that is necessary for lacrimal gland induction. We show that Alx4 binds an Fgf10 intronic element conserved in terrestrial but not aquatic animals, underlying the evolutionary emergence of the lacrimal gland system in response to an airy environment. Inactivation of ALX4/Alx4 causes lacrimal gland aplasia in both human and mouse. These results reveal a key role of Alx4 in mediating FGF-Shp2-FGF signaling in the neural crest for lacrimal gland development.

Lacrimal fossa lesions: a review of 146 cases in Egypt

PubMed Central

Eldesouky, Mohammed A; Elbakary, Molham A; Sabik, Saly; Shareef, Mohamed M

2014-01-01

Purpose The incidence and clinical and imaging criteria of different pathological forms of lacrimal fossa lesions in the Delta region of Egypt were studied. Methods A retrospective study of patients with lacrimal fossa lesions for the past 10 years was conducted. A total of 146 cases were identified. Their medical records were reviewed for clinical and imaging data (computed tomography scan, magnetic resonance imaging scan, or both). A definitive diagnosis based on pathological examination of biopsies was also reviewed. Results Among the patients reviewed, 43.15% had inflammatory lacrimal gland lesions, 26.71% had lymphoproliferative lesions, and 21.92% had epithelial lesions; 8.22% had rare lesions (5.48% were dacryops and 2.74% had hemangioma). The study included 71.92% benign lesions and 28.08% malignant lesions, which were distributed between 19.18% malignant lymphoma and 8.9% malignant epithelial tumors. According to the pathological origin of the lesions, they may be classified into 78.08% nonepithelial lesions and 21.92% epithelial lesions (16.44% epithelial tumors, and 5.48% dermoid cysts). Conclusion Lacrimal fossa lesions show a wide pathological range. Inflammatory lesions are most frequent, followed by lymphoproliferative and epithelial lesions. Analysis of clinical and radiological criteria is helpful in the differential diagnosis of lacrimal gland lesions. PMID:25210428

Isolated lacrimal gland involvement in Rosai-Dorfman-Destombes disease

PubMed Central

Bhalla, Sunita; Srivastava, Amit

2008-01-01

Rosai-Dorfman-Destombes (sinus histiocytosis with massive lymphadenopathy) disease is an uncommon disease characterized by benign proliferation of histiocytes, with painless lymph node enlargement and frequent extranodal disease. Orbital involvement occurs in 9-11% of cases. However, isolated Rosai- Dorfman-Destombes disease of the lacrimal gland without any systemic involvement is very rare with only three case reports. We describe here one such young male patient with unilateral lacrimal gland swelling. Excision biopsy revealed almost complete replacement of the lacrimal gland by lymphocytes, plasma cells and large pale histiocytes. The latter exhibited emperipolesis and stained positive for S-100 and CD68 on immunohistochemistry. Patient is well and has no other manifestation or recurrence of the disease during a follow-up of 24 months. PMID:18974525

The role of the lacrimal functional unit in the pathophysiology of dry eye.

PubMed

Stern, Michael E; Gao, Jianping; Siemasko, Karyn F; Beuerman, Roger W; Pflugfelder, Stephen C

2004-03-01

The majority of dry eye symptoms are due to a chronic inflammation of the lacrimal functional unit resulting in a loss of tear film integrity and normal function. This leads to a reduction in the ability of the ocular surface to respond to environmental challenges. The underlying cause of tear film dysfunction is the alteration of tear aqueous, mucin, and lipid components. This may result from a systemic autoimmune disease or a local autoimmune event. A lack of systemic androgen support to the lacrimal gland has been shown to be a facilitative factor in the initiation of this type of pathophysiology. Tear secretion is controlled by the lacrimal functional unit consisting of the ocular surface (cornea, conjunctiva, accessory lacrimal glands, and meibomian glands), the main lacrimal gland and the interconnecting innervation. If any portion of this functional unit is compromised, lacrimal gland support to the ocular surface is impeded. Factors such as neurogenic inflammation and T cell involvement in the disease pathogenesis as well as newly developed animal models of ocular surface inflammation are discussed.

Hypertrophic obstructive cardiomyopathy: the Mayo Clinic experience.

PubMed

Kotkar, Kunal D; Said, Sameh M; Dearani, Joseph A; Schaff, Hartzell V

2017-07-01

Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease characterized by left ventricular hypertrophy in the absence of other etiologies. Clinical presentation may vary from asymptomatic to sudden cardiac death. Medical treatment is the first-line therapy for symptomatic patients. Extended left ventricular septal myectomy is the procedure of choice if medical treatment is unsuccessful or intolerable. More than 3,000 patients have had septal myectomy for HCM at the Mayo Clinic (MN, USA) from 1993 to 2016. Risk of hospital death after isolated septal myectomy for obstructive HCM is <1% and is similar to the risk of operation for elective mitral valve repair. Complications, such as complete heart block requiring permanent pacemaker, are uncommon (2%), although partial or complete left bundle branch block is a frequent finding on the postoperative ECG. Relief of left ventricular outflow tract (LVOT) obstruction with septal myectomy dramatically improves symptoms and exercise capacity in symptomatic patients with obstructive HCM. More than 90% of severely symptomatic patients have improvement by at least two functional classes, and reduction of outflow gradients by myectomy decreases or eliminates symptoms of dyspnea, angina and/or syncope. Basal obstruction with systolic anterior motion (SAM) is treated by transaortic myectomy. The transapical approach was applied in 115 patients with obstructive midventricular and apical variants of HCM between 1993 and 2012. All patients with midventricular obstruction had gradient relief and none developed an apical aneurysm or ventricular septal defect. Recurrent obstruction after satisfactory myectomy was rare. Septal myectomy effectively and definitively relieves LVOT obstruction and cardiac symptoms in patients with obstructive HCM. In experienced centers, early mortality for isolated septal myectomy is less than 1%, and overall results are excellent and continue to improve in the current era.

Pyloric obstruction secondary to epicardial pacemaker implantation: a case report.

PubMed

Bedoya Nader, G; Kellihan, H B; Bjorling, D E; McAnulty, J

2017-02-01

A 10-year old Lhasa Apso dog was presented for an acute history of exercise intolerance and hind limb weakness. High grade second degree atrioventricular block with an atrial rate of 200 beats per minute, ventricular rate of 40 beats per minute and an intermittent ventricular escape rhythm, was diagnosed on electrocardiograph. A transdiaphragmatic, unipolar, epicardial pacemaker was implanted without immediate surgical complications. Severe vomiting was noted 12 h post-operatively. Abdominal ultrasound and a barium study supported a diagnosis of pyloric outflow obstruction and exploratory abdominal surgery was performed. The pyloric outflow tract appeared normal and no other causes of an outflow obstruction were identified. The epicardial generator was repositioned from the right to the left abdominal wall. Pyloric cell pacing was presumed to be the cause for the pyloric obstruction and severe vomiting, and this was thought to be due to close proximity of the pacemaker generator to the pylorus situated in the right abdominal wall. Repositioning of the pulse generator to the left abdominal wall resulted in resolution of vomiting. Copyright © 2016 Elsevier B.V. All rights reserved.

Neural Regulation of Lacrimal Gland Secretory Processes: Relevance in Dry Eye Diseases

PubMed Central

Dartt, Darlene A.

2013-01-01

The lacrimal gland is the major contributor to the aqueous layer of the tear film which consists of water, electrolytes and proteins. The amount and composition of this layer is critical for the health, maintenance, and protection of the cells of the cornea and conjunctiva (the ocular surface). Small changes in the concentration of tear electrolytes have been correlated with dry eye syndrome. While the mechanisms of secretion of water, electrolytes and proteins from the lacrimal gland differ, all three are under tight neural control. This allows for a rapid response to meet the needs of the cells of the ocular surface in response to environmental conditions. The neural response consists of the activation of the afferent sensory nerves in the cornea and conjunctiva to stimulate efferent parasympathetic and sympathetic nerves that innervate the lacrimal gland. Neurotransmitters are released from the stimulated parasympathetic and sympathetic nerves that cause secretion of water, electrolytes, and proteins from the lacrimal gland and onto the ocular surface. This review focuses on the neural regulation of lacrimal gland secretion under normal and dry eye conditions. PMID:19376264

Isolation and Propagation of Mesenchymal Stem Cells from the Lacrimal Gland

PubMed Central

You, Samantha; Kublin, Claire L.; Avidan, Orna; Miyasaki, David

2011-01-01

Purpose. Previously, it was reported that the murine lacrimal gland is capable of repair after experimentally induced injury and that the number of stem/progenitor cells was increased during the repair phase (2–3 days after injury). The aim of the present study was to determine whether these cells can be isolated from the lacrimal gland and propagated in vitro. Methods. Lacrimal gland injury was induced by injection of interleukin (IL)-1, and injection of saline vehicle served as control. Two and half days after injection, the lacrimal glands were removed and used to prepare explants or acinar cells for tissue culture. Cells derived from the explants and the acinar cells were grown in DMEM supplemented with 10% fetal bovine serum. Cells were stained for the stem cells markers, nestin, vimentin, ABCG2, and Sca-1. Cell proliferation was measured using an antibody against Ki67 or a cell-counting kit. The adipogenic capability of these cells was also tested in vitro. Results. Results show that nestin-positive cells can be isolated from IL-1–injected, but not saline-injected, lacrimal glands. A population of nestin-positive cells was also positive for vimentin, an intermediate filament protein expressed by mesenchymal cells. In addition, cultured cells expressed two other markers of stem cells, ABCG2 and Sca-1. These cells proliferated in vitro and can be induced to form adipocytes, attesting to their mesenchymal stem cell property. Conclusions. Murine lacrimal glands contain mesenchymal stem cells that seem to play a pivotal role in tissue repair. PMID:21178145

Improving left ventricular outflow tract obstruction repair in common atrioventricular canal defects.

PubMed

Myers, Patrick O; del Nido, Pedro J; Marx, Gerald R; Emani, Sitaram; Mayer, John E; Pigula, Frank A; Baird, Christopher W

2012-08-01

Left ventricular outflow tract obstruction (LVOTO) is the second most frequent reason for reoperation after atrioventricular canal (AVC) defect repair. Limited data are available on the mechanisms of LVOTO, their treatment, and outcomes. Between 1998 and 2010, 56 consecutive children with AVC underwent 68 LVOTO procedures. The AVC was partial in 4, transitional in 9, and complete in 43. The LVOTO procedure was required in 21 patients at the primary AVC repair, and the initial LVOTO procedure in 35 patients was a late reoperation after AVC repair. During a mean follow-up of 50±41 months, 5 patients (24%) with LVOTO repair at AVC repair required a reoperation for LVOTO, and 7 patients (20%) whose initial LVOTO repair was a reoperation required a second reoperation for LVOTO repair. Overall freedom from LVOTO reoperation was 98.5% at 1 year, 92.5% at 3 years, 81% at 5 years, 72.2% at 7 years, and 52.5% at 10 and 12 years. The freedom from reoperation was neither significantly different between partial, transitional, and complete AVC (p=0.78) nor between timing of the LVOT procedure (p=0.49). Modified single-patch AVC repair was associated with a higher LVOTO reoperation rate (p=0.04). Neither the mechanisms leading to LVOTO nor the surgical techniques used were independent predictors of reoperation. LVOTO in AVC is a complex and multifactorial disease. Aggressive surgical repair has improved late outcomes; however, risk factors for reoperation and the ideal approach for repair remain to be defined. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Endoscopic Dacrocystorhinostomy in Lacrimal Canalicular Trauma

PubMed Central

Khan, Humayun A; Bayat, Aredeshir; De Carpentier, JP

2007-01-01

A case is presented where the common insertion of the upper and lower canaliculus of the lacrimal sac was repaired using endoscopic dacrocystorhinostomy (DCR) techniques, with silicone stenting and securing of stents intranasally. PMID:17316509

The Relation Between Light-Induced Lacrimation and the Melanopsin-Driven Postillumination Pupil Response.

PubMed

Lei, Shaobo; Goltz, Herbert C; Chen, Xingqiao; Zivcevska, Marija; Wong, Agnes M F

2017-03-01

To investigate the chromatic characteristics and intensity-response function of light-induced reflex lacrimation and its correlation with the melanopsin-driven postillumination pupil response (PIPR). Eleven visually normal participants completed the experiment. Lacrimation was measured in one eye by placing a calibrated filter paper strip in the conjunctival sac over a 1 minute-interval (Schirmer's test) during which participants received either no light stimulation (baseline trial) or one flash of blue or red light stimuli presented binocularly with a Ganzfeld stimulator, while the pupil response was recorded simultaneously from the fellow eye by using an eye tracker. Light stimulation trials were presented in alternating fashion at seven incremental intensity steps (0.1, 1, 3.16, 10, 31.6, 100, and 400 cd/m2). Postillumination pupil response was defined as the mean pupil constriction from 10 to 30 seconds post illumination. The amount of lacrimation in response to 10 to 400 cd/m2 blue light was significantly greater than baseline and increased monotonically with increasing light intensity. Red light did not induce significant reflex lacrimation until the brightest stimulation at 400 cd/m2. There was a positive linear correlation between PIPR and lacrimation in response to blue light (r = 0.74, P < 0.001) but not to red light (r = 0.13, P = 0.25). The chromatic characteristics and intensity-response of light-induced lacrimation are highly consistent with the features of melanopsin phototransduction. This finding is the first in vivo evidence in humans, supporting the hypothesis that light-induced reflex lacrimation is mediated primarily by melanopsin photoactivity, and provides new insight into the putative mechanisms of photophobia.

The pathology of dry eye: the interaction between the ocular surface and lacrimal glands.

PubMed

Stern, M E; Beuerman, R W; Fox, R I; Gao, J; Mircheff, A K; Pflugfelder, S C

1998-11-01

Most dry-eye symptoms result from an abnormal, nonlubricative ocular surface that increases shear forces under the eyelids and diminishes the ability of the ocular surface to respond to environmental challenges. This ocular-surface dysfunction may result from immunocompromise due to systemic autoimmune disease or may occur locally from a decrease in systemic androgen support to the lacrimal gland as seen in aging, most frequently in the menopausal female. Components of the ocular surface (cornea, conjunctiva, accessory lacrimal glands, and meibomian glands), the main lacrimal gland, and interconnecting innervation act as a functional unit. When one portion is compromised, normal lacrimal support of the ocular surface is impaired. Resulting immune-based inflammation can lead to lacrimal gland and neural dysfunction. This progression yields the OS symptoms associated with dry eye. Restoration of lacrimal function involves resolution of lymphocytic activation and inflammation. This has been demonstrated in the MRL/lpr mouse using systemic androgens or cyclosporine and in the dry-eye dog using topical cyclosporine. The efficacy of cyclosporine may be due to its immunomodulatory and antiinflammatory (phosphatase inhibitory capability) functions on the ocular surface, resulting in a normalization of nerve traffic. Although the etiologies of dry eye are varied, common to all ocular-surface disease is an underlying cytokine/receptor-mediated inflammatory process. By treating this process, it may be possible to normalize the ocular surface/lacrimal neural reflex and facilitate ocular surface healing.

Lacrimal gland uptake of (67)Ga-gallium citrate correlates with biopsy results in patients with suspected sarcoidosis.

PubMed

Tannen, Bradford L; Kolomeyer, Anton M; Turbin, Roger E; Frohman, Larry; Langer, Paul D; Oh, Cheongeun; Ghesani, Nasrin V; Zuckier, Lionel S; Chu, David S

2014-02-01

To investigate whether lacrimal gland uptake on (67)Ga-gallium citrate scintigraphy correlates with histopathologic evidence of sarcoidosis. A retrospective, pilot study of 31 patients with suspected sarcoidosis who underwent gallium scintigraphy and lacrimal gland biopsy. Lacrimal gland gallium uptake was assessed by subjective visual scoring (SVS) and lacrimal uptake ratio (LUR). Eleven (36%) patients had lacrimal gland biopsies containing noncaseating granulomas. A statistically significant correlation was found between lacrimal gland gallium uptake and biopsy positivity using SVS (p = 0.03) or LUR (p = 0.01). Using SVS, biopsy positivity rate increased from 0 to 50% in patients with mild to intense uptake. Using LUR, biopsy positivity rate increased linearly as the ratio increased from 13% (LUR < 4) to 100% (LUR > 8). Lacrimal biopsy positivity rate significantly correlated with gallium uptake on scintigraphy. Both SVS and LUR methods appear to correlate with histologic results and may potentially aid in patient selection for biopsy.

Glycosaminoglycan-dependent restriction of FGF diffusion is necessary for lacrimal gland development

PubMed Central

Qu, Xiuxia; Pan, Yi; Carbe, Christian; Powers, Andrea; Grobe, Kay; Zhang, Xin

2012-01-01

Glycosaminoglycans (GAGs) play a central role in embryonic development by regulating the movement and signaling of morphogens. We have previously demonstrated that GAGs are the co-receptors for Fgf10 signaling in the lacrimal gland epithelium, but their function in the Fgf10-producing periocular mesenchyme is still poorly understood. In this study, we have generated a mesenchymal ablation of UDP-glucose dehydrogenase (Ugdh), an essential biosynthetic enzyme for GAGs. Although Fgf10 RNA is expressed normally in the periocular mesenchyme, Ugdh mutation leads to excessive dispersion of Fgf10 protein, which fails to elicit an FGF signaling response or budding morphogenesis in the presumptive lacrimal gland epithelium. This is supported by genetic rescue experiments in which the Ugdh lacrimal gland defect is ameliorated by constitutive Ras activation in the epithelium but not in the mesenchyme. We further show that lacrimal gland development requires the mesenchymal expression of the heparan sulfate N-sulfation genes Ndst1 and Ndst2 but not the 6-O and 2-O-sulfation genes Hs6st1, Hs6st2 and Hs2st. Taken together, these results demonstrate that mesenchymal GAG controls lacrimal gland induction by restricting the diffusion of Fgf10. PMID:22745308

[Traumatic Lacrimal Duct Stenosis: Demographics and Success Rate of Surgical Procedures for Secondary Treatment].

PubMed

Alnawaiseh, M; Böhm, M R R; Rosentreter, A; Wieneke, A C; Wirths, G; Merté, R L; Eter, N; Zumhagen, L

2016-06-01

Traumatic lacrimal duct stenosis can be the result of sharp trauma of the eyelid, indirect trauma or surgery in the nasoorbital region, as well as burns, chemotherapy and radiation of the facial region. The aim of the study is to present the demographics, patient satisfaction, and course of different surgical procedures for secondary treatment of traumatic lacrimal duct stenosis. We retrospectively reviewed the medical records of 50 patients who required surgery for traumatic lacrimal duct stenosis from 2009 to 2011 at the University Eye Hospital in Muenster. The evaluation included the following criteria: age, sex, duration of symptoms, complication rate and the rate of recurrence. We systematically evaluated the medical data and asked the patients about the recent symptoms via telephone questionnaire. 60 eyes of 50 patients were included (18 women; 32 men; age: 51.8 ± 17.1 years); 34 eyes (56.7 %) had already had operations of the lacrimal system. The success rate was 58.1 %. The mean postoperative follow-up was 52.3 ± 10.7 months. In 11 cases (18.3 %), a dakryocystorhinostomy (DCR) was necessary. Traumatic lacrimal stenosis is more common in men, and has a poorer prognosis than lacrimal duct stenosis from other causes. Georg Thieme Verlag KG Stuttgart · New York.

Gene Expression in Human Accessory Lacrimal Glands of Wolfring

PubMed Central

Ubels, John L.; Gipson, Ilene K.; Spurr-Michaud, Sandra J.; Tisdale, Ann S.; Van Dyken, Rachel E.; Hatton, Mark P.

2012-01-01

Purpose. The accessory lacrimal glands are assumed to contribute to the production of tear fluid, but little is known about their function. The goal of this study was to conduct an analysis of gene expression by glands of Wolfring that would provide a more complete picture of the function of these glands. Methods. Glands of Wolfring were isolated from frozen sections of human eyelids by laser microdissection. RNA was extracted from the cells and hybridized to gene expression arrays. The expression of several of the major genes was confirmed by immunohistochemistry. Results. Of the 24 most highly expressed genes, 9 were of direct relevance to lacrimal function. These included lysozyme, lactoferrin, tear lipocalin, and lacritin. The glands of Wolfring are enriched in genes related to protein synthesis, targeting, and secretion, and a large number of genes for proteins with antimicrobial activity were detected. Ion channels and transporters, carbonic anhydrase, and aquaporins were abundantly expressed. Genes for control of lacrimal function, including cholinergic, adrenergic, vasoactive intestinal polypeptide, purinergic, androgen, and prolactin receptors were also expressed in gland of Wolfring. Conclusions. The data suggest that the function of glands of Wolfring is similar to that of main lacrimal glands and are consistent with secretion electrolytes, fluid, and protein under nervous and hormonal control. Since these glands secrete directly onto the ocular surface, their location may allow rapid response to exogenous stimuli and makes them readily accessible to topical drugs. PMID:22956620

Extrinsic cerebral venous sinus obstruction resulting in intracranial hypertension

PubMed Central

Goldsmith, P; Burn, D; Coulthard, A; Jenkins, A

1999-01-01

We report the case of a 70-year-old man reporting with headache and visual disturbances who was being treated for prostate cancer. Investigations showed him to have intracranial hypertension caused by venous sinus obstruction. Patients with metastatic disease and raised intracranial pressure in the absence of focal signs should be considered as possible cases of venous outflow obstruction.


Keywords: intracranial hypertension; venous sinus thrombosis; malignancy PMID:10616691

The Epidemiological, Clinical, and Histopathological Characteristics of Lacrimal Gland Biopsies in a Tertiary Care Center in Israel.

PubMed

Priel, Ayelet; Vishnevskia-Dai, Vicktoria; Hochma, Liran; Gildener-Leapman, Juliana; Ben Simon, Guy J; Rosner, Mordechai; Antman, Gal; Zloto, Ofira

2018-02-01

The distribution of pathology and clinical characteristics of lacrimal gland diseases are different in different areas of the world. To evaluate the incidence rate, patient characteristics, and indications for surgical intervention of lacrimal gland lesions in a tertiary care center in Israel. All biopsied or surgically removed lacrimal gland lesions at the Goldschleger Eye Institute from 2009 to 2015 were identified. The following data were collected: age, gender, indications for surgical intervention, diagnosis, treatment, and prognosis. We evaluated 28 lacrimal gland biopsies from 26 patients (11 men, 15 women). Mean age at biopsy was 47.5 years old. The most common presenting symptoms were: eyelid swollenness (57.14%), ptosis (32.14%), and proptosis (10.71%). All patients underwent computed tomography and magnetic resonance imaging. In 28 cases, infiltrations of the lacrimal gland were found. In nine cases infiltration of muscles or orbital extension were found. The most common pathologies were non-specified inflammation (44.82%), lymphoma (20.68%), and immunoglobulin G4-related disease (10.34%). The treatment was diverse according to the patient diagnosis. Prognosis of lacrimal gland disease was good; however, in five patients the systemic disease progressed. Lesions of the lacrimal gland comprise a wide variety of pathological findings that require different treatment strategies. Lacrimal gland biopsies enable physicians to precisely recognize the pathology; therefore, it is important to consider this surgical method in any patient with lesions in the lacrimal gland.

Gross, Histologic, and Computed Tomographic Anatomy of the Lacrimal System of Snakes

PubMed Central

Souza, Nicole M.; Maggs, David J.; Park, Shin Ae; Puchalski, Sarah; Reilly, Christopher M.; Paul-Murphy, Joanne; Murphy, Christopher J.

2014-01-01

Objective To describe the lacrimal system of snakes using contrast micro-computed tomography (micro-CT) with 3-dimensional reconstruction, fluorescein passage (“Jones”) testing, histology, and gross dissection. Animals studied One Royal Python and 19 snake cadavers representing 10 species. Procedures Direct observation following injection of fluorescein into the subspectacular space, micro-CT following injection of 3 contrast agents into the subspectacular space, gross dissection following injection of latex into the subspectacular space, and histopathology. Results Injection of fluorescein confirmed patency but not course of the lacrimal duct. Barium enabled clear visualization of the lacrimal duct whereas two iodinated contrast agents proved inadequate. Collectively, micro-CT, anatomic dissections, and histology suggest tears are produced by a single, large, serous, retrobulbar gland, released into the subspectacular space via several ductules, and drained through a single punctum originating in the ventronasal subspectacular space and the lacrimal duct taking one of 3 routes of variable tortuosity before opening into the oral cavity in close association with the opening of the duct of the vomeronasal organ. Conclusions The ophidian lacrimal duct has a generally tortuous course and the details of its anatomy is species variable. The tortuous course of the duct likely predisposes snakes to duct occlusion and must be considered when planning medical and surgical interventions in snakes with pseudobuphthalmos and subspectacular abscessation. PMID:24862081

Primary Mucoepidermoid Carcinoma of the Lacrimal Sac -  a Case Report and Literature Review.

PubMed

Janakiram, T N; Sagar, S; Sharma, S B; Subramaniam, V

Lacrimal sac tumors are very rare and are often missed because patients present with features consistent with chronic dacryocystitis. Squamous cell carcinoma is the common-est lacrimal sac malignancy. Although primary mucoepidermoid carcinomas of the lacrimal sac are rare, they are locally aggressive. Furthermore, their proximity to vital structures and the skull base makes them potentially life-threatening. Multidisciplinary management is required, and wide excision followed by chemoradiation is the recommended treatment. Here, we report a 65-year-old male who presented with watering eyes and a mass in the region of the medial canthus. A dia-gnosis of primary mucoepidermoid carcinoma of the lacrimal sac was made, and the case was managed successfully with radical surgery and reconstruction. The tumor was resected using the extended Lynch-Howarth incision and the resulting defect was reconstructed using a forehead flap. Histopathological examination of the excised specimen revealed mucoepidermoid carcinoma. Immunohistochemical analysis revealed that the speci-men was positive for epithelial growth factor receptor and Ki-67 protein. The patient was referred for post-operative chemoradiation. The literature is reviewed and pathological features, including immunohistochemistry are discussed. Primary mucoepidermoid carcinoma of the lacrimal sac is a rare, locally aggressive tumor that is often mistaken for dacryocystitis. The treatment of choice is radical surgery followed by chemoradiation. lacrimal sac -  mucoepidermoid carcinoma -  epithelial growth factor receptor -  Ki-67 protein.

Salivation induced better lacrimal gland function in dry eyes.

PubMed

Pramanik, T; Ghising, R

2009-12-01

The dry eye syndrome is a common eye symptom causing blurry vision. To meet the demand of the modem world students and professionals are compelled to expose themselves to the computer screen for long stretch of time, which is one of the causes of dry eye. It is not always feasible to instil eyes with artificial tears time to time to protect them from dryness. Rather to adopt any simple physiological process associated with optimum lacrimation is a better option to keep eyes moist during computer works. Volunteers (n = 22) having mild dry eyes participated in this study. Tear production was assessed by Schirmer test by keeping Schirmer strip on ocular surface for 5 minutes and recording the length of the moistened area. Then the subject was allowed to keep a piece of lopsy candy (a sour fruit pulp mixed with sugar that is sweet and sour in taste) in mouth for 5 minutes that caused salivation. During salivation, again tear production was assessed. [It was standardized in such a way that, the length of the moistened strip will be 25 - 30 mm for normal eyes, 15 - 10 mm for dry eye, 06 - 10 mm for mild dry eye, 02 - 05 mm for moderate dryness and 00 - 01 mm for severe dry eye.] Tear production was found to be increased significantly (supported by increased length of moistened area of Schirmer strip) during salivation especially in dry eye in all volunteers. The lacrimal gland is the major contributor to the aqueous layer of the tear film which consists of water, electrolytes and proteins; secretion of which are under tight neural control. Anticholinergic agents play an important role in ocular dryness because of hypo-secretion. The sensory root of facial nucleus contains efferent preganglionic parasympathetic fibers for submandibular and sublingual salivary gland and lacrimal gland. The sensory root conveys gustatory fibers from the presulcul area (anterior two-third) of the tongue via the chorda tympani and via the palatine and greater petrosal nerve, taste fibers from

Adenoid cystic carcinoma of the lacrimal gland.

PubMed

Sanders, Jason C; Mendenhall, William M; Werning, John W

2016-01-01

This is a retrospective analysis of the 50-year University of Florida experience treating adenoid cystic carcinoma of the lacrimal gland with radiation therapy. Between 1965 and 2015, 8 patients with adenoid cystic carcinoma of the lacrimal gland received radiation therapy with curative intent. Four patients received postoperative radiation therapy and 4 received definitive radiation therapy alone. The median follow-up was 3.3 years (range, 0.3 to 11.2 years). All 4 patients who received postoperative radiation therapy received 74.4 Gy. The 4 patients who received radiation therapy alone received a median dose of 72.3 Gy (range, 70.0 to 74.4 Gy). The overall survival rates at 5 and 10 years were 25% and 13%, respectively. The cause-specific survival rates at 5 and 10 years were 29% and 14%, respectively. The local control and freedom from metastases rates at 5 and 10 years were both 43%. Local recurrences occurred in 50% of patients, and distant metastatic disease occurred in 38% of patients. No patients experienced acute complications of treatment that warranted a treatment break. Two patients experienced bone exposure as late complications of treatment. The results of this study illustrate the propensity for adenoid cystic carcinoma of the lacrimal gland to recur both locally and with distant metastases despite aggressive local treatment measures. This study also demonstrates the relatively poor outcomes for individuals with this type of tumor. Copyright © 2016 Elsevier Inc. All rights reserved.

A Single Injection of Interleukin-1 Induces Reversible Aqueous-tear Deficiency, Lacrimal Gland Inflammation, and Acinar and Ductal Cell Proliferation

PubMed Central

Zoukhri, Driss; Macari, Elizabeth; Kublin, Claire L.

2011-01-01

Emerging studies from our laboratory demonstrate that interleukin-1 (IL-1) family members play a major role in impairing lacrimal gland functions. Here we have extended our investigations to observe the effects of IL-1 on aqueous tear production, lacrimal gland secretion, lacrimal gland histology, and acinar and ductal cell proliferation. We demonstrate that a single injection of IL-1 into the lacrimal glands inhibited neurally- as well as agonist-induced protein secretion resulting in decreased tear output. Meanwhile, IL-1 injection induced a severe, but reversible (7–13 days), inflammatory response that led to destruction of lacrimal gland acinar epithelial cells. Finally, we demonstrate that as the inflammatory response subsided and lacrimal gland secretion and tear production returned to normal levels, there was increased proliferation of acinar and ductal epithelial cells. Our work uncovers novel effects of IL-1 on lacrimal gland functions and the potential regenerative capacity of the mouse lacrimal gland. PMID:17362931

Right ventricular outflow tract obstruction in complicated monochorionic twin pregnancy.

PubMed

Eschbach, S J; Boons, L S T M; Van Zwet, E; Middeldorp, J M; Klumper, F J C M; Lopriore, E; Teunissen, A K K; Rijlaarsdam, M E; Oepkes, D; Ten Harkel, A D J; Haak, M C

2017-06-01

Severe right ventricular outflow tract obstruction (RVOTO) is a potential complication in recipient twins of twin-to-twin transfusion syndrome (TTTS) that requires postnatal follow-up or treatment. We aimed to evaluate pregnancy characteristics of neonates with RVOTO from complicated monochorionic twin pregnancies, determine the incidence of RVOTO in TTTS cases and construct a prediction model for its development. This was an observational cohort study of all complicated monochorionic twin pregnancies with a postnatal diagnosis of RVOTO examined at our center. Cases were referred for evaluation of the need for fetal therapy or intervention because of TTTS, selective intrauterine growth restriction (sIUGR) or multiple congenital malformations in one of the twins. Ultrasound data were retrieved from our monochorionic twin database. Among liveborn TTTS recipients treated prenatally with laser therapy, those with RVOTO were compared with those without RVOTO (controls). We describe four additional cases with RVOTO that were not TTTS recipients. A total of 485 twin pregnancies received laser therapy for TTTS during the study period. RVOTO was diagnosed in 3% (11/368) of liveborn TTTS recipients, of whom two showed mild Ebstein's anomaly. Before laser therapy, pericardial effusion was seen in 45% (5/11) of RVOTO cases (P < 0.01) and abnormal A-wave in the ductus venosus (DV) in 73% (8/11) (P = 0.03), significantly higher proportions than in controls. Mean gestational age at laser therapy was 17 + 3 weeks in RVOTO cases compared with 20 + 3 weeks in controls (P = 0.03). A prediction model for RVOTO was constructed incorporating these three significant variables. One TTTS donor had RVOTO after the development of transient hydrops following laser therapy. Three larger twins in pregnancies complicated by sIUGR developed RVOTO, the onset of which was detectable early in the second trimester. RVOTO occurs in TTTS recipient twins but can also develop in

Patterns of innervation of the lacrimal gland with clinical application.

PubMed

Scott, Gabriel; Balsiger, Heather; Kluckman, Matthew; Fan, Jerry; Gest, Thomas

2014-11-01

Parasympathetic stimulation of the lacrimal gland is responsible for tear production, and this innervation originates from fibers conveyed in the facial nerve. After synapse in the pterygopalatine ganglion, postsynaptic parasympathetic fibers travel within the zygomatic and zygomaticotemporal nerves (ZTN) into the orbit. As described in most anatomy texts, ZTN communicates with the lacrimal nerve (LN) posterior to the gland and then secretomotor fibers enter the gland. This study was performed to gain a better understanding of the innervation of the lacrimal gland. Seventeen cadaver heads were bisected for a total of 34 sides, which then underwent dissection of the superolateral orbital region to observe the course for the LN and ZTN. Three variations of the course of the LN and ZTN were found. In 20 (60.6%) dissections it was documented that the ZTN entered directly into the lacrimal gland with no communication with the LN. In 12 (36.4%) of the bisected heads, ZTN had both a direct connection into the gland and a communicating branch with the LN. In only one (3.0%) bisected head, ZTN communicated with the LN before entering the gland as it is commonly described in anatomy texts. Our study reveals that the ZTN usually takes a different course than is classically described in most anatomy textbooks. A greater understanding of the typical course these nerves take may help surgeons identify them more easily and avoid damaging them. © 2014 Wiley Periodicals, Inc.

Sarcoidosis of the lacrimal gland as a first manifestation.

PubMed

Peralta-Gómez, M Y; Ávila-Ocampo, K A; Huerta-Velázquez, S; Rivera-Salgado, M I

2018-04-01

The first manifestation of sarcoidosis is usually at the pulmonary level. The case is described of a 40-year-old female patient, who presented with an increased volume of the lacrimal gland and mechanical ptosis of upper left eyelid as the first expression of this disease. The diagnosis of systemic sarcoidosis with primary presentation of the lacrimal gland was made after performing several immunological studies with negative results, imaging studies, and taking of glandular and lymph node biopsies. A favourable response was achieved with oral methotrexate treatment. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Contribution of mitral valve leaflet length and septal wall thickness to outflow tract obstruction in patients with hypertrophic cardiomyopathy.

PubMed

Morant, Kareem; Mikami, Yoko; Nevis, Immaculate; McCarty, David; Stirrat, John; Scholl, David; Rajchl, Martin; Giannoccaro, Peter; Kolman, Louis; Heydari, Bobby; Lydell, Carmen; Howarth, Andrew; Grant, Andrew; White, James A

2017-08-01

We sought to examine whether elongation of the mitral valve leaflets in patients with hypertrophic cardiomyopathy (HCM) is synergistic to septal wall thickness (SWT) in the development of left ventricular outflow tract obstruction (LVOTO). HCM is a common genetic cardiac disease characterized by asymmetric septal hypertrophy and predisposition towards LVOTO. It has been reported that elongation of the mitral valve leaflets may be a primary phenotypic feature and contribute to LVOTO. However, the relative contribution of this finding versus SWT has not been studied. 152 patients (76 with HCM and 76 non-diseased age, race and BSA-matched controls) and 18 young, healthy volunteers were studied. SWT and the anterior mitral valve leaflet length (AMVLL) were measured using cine MRI. The combined contribution of these variables (SWT × AMVLL) was described as the Septal Anterior Leaflet Product (SALP). Peak LVOT pressure gradient was determined by Doppler interrogation and defined as "obstructive" if ≥ 30 mmHg. Patients with HCM were confirmed to have increased AMVLL compared with controls and volunteers (p < 0.01). Among HCM patients, both SWT and SALP were significantly higher in patients with LVOTO (N = 17) versus without. SALP showed modest improvement in predictive accuracy for LVOTO (AUC = 0.81) among the HCM population versus SWT alone (AUC = 0.77). However, in isolated patients this variable identified patients with LVOTO despite modest SWT. Elongation of the AMVLL is a primary phenotypic feature of HCM. While incremental contributions to LVOTO appear modest at a population level, specific patients may have dominant contribution to LVOTO. The combined marker of SALP allows for maintained identification of such patients despite modest increases in SWT.

[High resolution functional magnetic resonance tomography with Gd-DTPA eyedrops in diagnosis of lacrimal apparatus diseases].

PubMed

Hoffmann, K T; Anders, N; Hosten, N; Holschbach, A; Walkow, T; Sörensen, R; Hartmann, C; Felix, R

1998-08-01

Both dacryocystography and dacryoscintigraphy are well established in the evaluation of stenoses of the lacrimal drainage system. They provide limited information about the ductal anatomy itself and about periductal structures. MR imaging was evaluated for its capability to directly visualize the lacrimal drainage system in detail and simultaneously provide functional characterization of dacryostenosis. Twenty-seven lacrimal drainage systems of 23 patients suffering from epiphora were examined in an MR unit before and after conjunctival and intravenous application of Gd-DTPA using a surface coil. Dacryostenosis was found in 23 of 27 lacrimal systems. Stenoses were localized to the canalicular (n = 3), saccular (n = 8), and ductal (n = 12) level, and were classified as stenosis or occlusion. MR imaging with conjunctival contrast application allows within one examination both detailed morphological and functional assessment of the lacrimal drainage system with depiction of surrounding structures. Limitations arise mainly from demands on technical and patient-related preconditions.

Role of Orai1 and store-operated calcium entry in mouse lacrimal gland signalling and function.

PubMed

Xing, Juan; Petranka, John G; Davis, Felicity M; Desai, Pooja N; Putney, James W; Bird, Gary S

2014-03-01

Lacrimal glands function to produce an aqueous layer, or tear film, that helps to nourish and protect the ocular surface. Lacrimal glands secrete proteins, electrolytes and water, and loss of gland function can result in tear film disorders such as dry eye syndrome, a widely encountered and debilitating disease in ageing populations. To combat these disorders, understanding the underlying molecular signalling processes that control lacrimal gland function will give insight into corrective therapeutic approaches. Previously, in single lacrimal cells isolated from lacrimal glands, we demonstrated that muscarinic receptor activation stimulates a phospholipase C-coupled signalling cascade involving the inositol trisphosphate-dependent mobilization of intracellular calcium and the subsequent activation of store-operated calcium entry (SOCE). Since intracellular calcium stores are finite and readily exhausted, the SOCE pathway is a critical process for sustaining and maintaining receptor-activated signalling. Recent studies have identified the Orai family proteins as critical components of the SOCE channel activity in a wide variety of cell types. In this study we characterize the role of Orai1 in the function of lacrimal glands using a mouse model in which the gene for the calcium entry channel protein, Orai1, has been deleted. Our data demonstrate that lacrimal acinar cells lacking Orai1 do not exhibit SOCE following activation of the muscarinic receptor. In comparison with wild-type and heterozygous littermates, Orai1 knockout mice showed a significant reduction in the stimulated tear production following injection of pilocarpine, a muscarinic receptor agonist. In addition, calcium-dependent, but not calcium-independent exocytotic secretion of peroxidase was eliminated in glands from knockout mice. These studies indicate a critical role for Orai1-mediated SOCE in lacrimal gland signalling and function.

Unilateral orbital lacrimal gland abscess in a horse.

PubMed

Greenberg, Shari M; Plummer, Caryn E; Brooks, Dennis E; Porter, Michael; Farina, Lisa L; Winter, Matthew D

2011-01-01

A 20-year-old Thoroughbred gelding presented for evaluation of a periorbital dorsal swelling of the left eye that had been intermittently present for 3 months. Upon ocular examination, a firm, non-painful swelling was identified under the upper eyelid in the region of the orbital lacrimal gland, and was noted to extend anteriorly from underneath the dorsal orbital rim. Ultrasonographic examination revealed a mixed echogenic mass along the dorsal orbital rim that followed the contour of the globe. CT scan showed a moderately contrast enhancing mass that was contiguous with the eyelid. Differential diagnoses included neoplasia, inflammatory lesions such as a granuloma, foreign body or abscess. Surgical exploration and excision of the mass revealed a lobular structure with a purulent center. Histopathology identified the mass as the orbital lacrimal gland with concurrent severe dacryoadenitis. Culture of the purulent center of the mass revealed beta-hemolytic Staphylococcus aureus. The patient was maintained on supportive care and antibiotic treatment based on sensitivity postoperatively. No recurrence was reported 40 months later. This paper aims to identify bacterial dacryoadenitis as a cause for unilateral periorbital swelling in the horse. Differential diagnoses for this presentation, as well as successful surgical management are discussed. To the author's knowledge, this is the first case of bacterial dacryoadenitis and subsequent abscessation of the orbital lacrimal gland in the horse. © 2011 American College of Veterinary Ophthalmologists.

Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography.

PubMed

Steindler, Piero; Mantovani, Enrico; Incorvaia, Carlo; Parmeggiani, Francesco

2009-06-01

To evaluate B-scan echography for the assessment of lacrimal sac (LS) in pediatric epiphora secondary to congenital nasolacrimal duct obstruction (CNLDO), and to verify its predictive role in functional efficacy of nasolacrimal duct probing. Thirty-nine eyes of 23 consecutive children, treated with a single probing for persistent CNLDO-related epiphora, were retrospectively studied. These cases were investigated both collectively and considering two sub-groups: group A (ten patients [20 eyes] 13 months. Fluorescein dye disappearance test at 10 minutes (FDDT-10) and ultrasound examination of LS were performed before and after probing. An echographic LS scoring system (grade 0 = no LS enlargement; grade 1 = slight longitudinal LS enlargement; grade 2 = longitudinal and slight transverse LS enlargement; grade 3 = marked longitudinal and transverse LS enlargement) was introduced as a predictor of probing efficacy, estimating FDDT-10 modification between pre- and post-operative checks. Echographic LS evaluation was easily practicable without sedation. In the total cluster and in both age sub-groups, post-probing FDDT-10 decreased with respect to pre-probing value (p < 0.001). Post-probing LS score improved with respect to pre-probing check within the total cluster and group A (p < 0.05). Strong correlation between pre-probing LS alteration and functional probing failure was present in each studied cluster (all p values <0.0001). Within group B, a greater gain of post-probing FDDT-10 was more frequent in patients with a better pre-probing LS score, as well as in younger children (both p values <0.0001). In children with CNLDO-related epiphora, B-scan echography of the LS can represent a reliable and useful examination for a better understanding of the functional prognosis after probing treatment.

Detection of BrdU-label Retaining Cells in the Lacrimal Gland: Implications for Tissue Repair

PubMed Central

You, Samantha; Tariq, Ayesha; Kublin, Claire L.; Zoukhri, Driss

2011-01-01

The purpose of the present study was to determine if the lacrimal gland contains 5-bromo-2’-deoxyuridine (BrdU)-label retaining cells and if they are involved in tissue repair. Animals were pulsed daily with BrdU injections for 7 consecutive days. After a chase period of 2, 4, or 12 weeks, the animals were sacrificed and the lacrimal glands were removed and processed for BrdU immunostaining. In another series of experiments, the lacrimal glands of 12-week chased animals were either left untreated or were injected with interleukin 1 (IL-1) to induce injury. Two and half day post-injection, the lacrimal glands were removed and processed for BrdU immunostaining. After 2 and 4 week of chase period, a substantial number of lacrimal gland cells were BrdU+ (11.98 ± 1.84 and 7.95 ± 1.83 BrdU+ cells/mm2, respectively). After 12 weeks of chase, there was a 97% decline in the number of BrdU+ cells (0.38 ± 0.06 BrdU+ cells/mm2), suggesting that these BrdU-label retaining cells may represent slow-cycling adult stem/progenitor cells. In support of this hypothesis, the number of BrdU labeled cells increased over 7-fold during repair of the lacrimal gland (control: 0.41 ± 0.09 BrdU+ cells/mm2, injured: 2.91 ± 0.62 BrdU+ cells/mm2). Furthermore, during repair, among BrdU+ cells 58.2 ± 3.6 % were acinar cells, 26.4 ± 4.1% were myoepithelial cells, 0.4 ± 0.4% were ductal cells, and 15.0 ± 3.0% were stromal cells. We conclude that the murine lacrimal gland contains BrdU-label retaining cells that are mobilized following injury to generate acinar, myoepithelial and ductal cells. PMID:22101331

An in vitro evaluation of various biomaterials for the development of a tissue-engineered lacrimal gland

NASA Astrophysics Data System (ADS)

Selvam, Shivaram

The most common cause of ocular morbidity in developed countries is dry eye, many cases of which are due to lacrimal insufficiency. It has been established that lacrimal insufficiency results from processes caused by both immune-related and non-immune related events such as Sjogren's syndrome, Stevens-Johnson syndrome, chemical and thermal injuries and ocular cicatricial pemphigoid. Patients with these conditions would benefit from repair of their damaged lacrimal tissue by the creation of a replacement for the lacrimal gland. The new field of tissue engineering built on the interface between principles and methods of the life sciences with those of engineering to develop biocompatible materials has created the possibility for repairing or replacing damaged tissues. This thesis explores the use of tissue engineering principles for the development of a tissue-engineered lacrimal gland. This thesis also contributes to the development of a novel model for addressing lacrimal gland physiology and epithelial fluid transport. The first part of the research work focused on the evaluation of morphological and physiological properties of purified lacrimal gland acinar cells (pLGACs) cultured on various biopolymers: silicone, collagen I, poly-D,L-lactide-co-glycolide (PLGA; 85:15 and 50:50), and poly-L-lactic acid (PLLA) in the presence and absence of an extracellular matrix, MatrigelRTM. Results indicated that PLLA demonstrated the best support expression of acinar cell-like morphology. The second part demonstrated the ex vivo reconstitution of an electrophysiologically functional lacrimal gland tissue on porous polyester membrane scaffolds. Results showed that pLGACs were capable of establishing continuous epithelial monolayers that generate active ionic fluxes consistent with current models for Na +-dependent Cl-- secretion. The third part outlined the fabrication of porous PLLA membranes, the optimal biomaterial for culturing lacrimal epithelial cells. Microporous PLLA

Development of Causative Treatment Strategies for Lacrimal Gland Insufficiency by Tissue Engineering and Cell Therapy. Part 2: Reconstruction of Lacrimal Gland Tissue: What Has Been Achieved So Far and What Are the Remaining Challenges?

PubMed

Massie, Isobel; Dietrich, Jana; Roth, Mathias; Geerling, Gerd; Mertsch, Sonja; Schrader, Stefan

2016-10-01

The lacrimal gland is located in the upper temporal compartment of the orbita, and along with the ocular surface, eye lids, and sensory and motor nerves forms the lacrimal functional unit (LFU). The LFU is responsible for producing, distributing, and maintaining the tear film in order to maintain a smooth, moist, and regular ocular surface epithelium such that appropriate refractive properties are achieved and the eyeball is protected against dust, debris, and pathogens. If the main lacrimal gland is impaired (due to either disease or injury), this balance is disrupted, and severe quantitative dry eye syndrome (DES) can develop. DES treatments remain palliative, with the most commonly used therapies being based on tear substitution, tear retention, and control of inflammation on the ocular surface. Causative treatments such as salivary gland transplantation have shown to reduce symptoms in very severe cases, however can cause problems on the ocular surface due to different properties of saliva and tears. Therefore, causative approaches for treating DES by regeneration or reconstruction of lacrimal gland tissue depending on disease severity seem highly appealing. This article reviews current approaches for in vitro reconstruction of lacrimal gland tissue. Finally, the limitations that must be overcome before a new, tissue-engineered therapy may be delivered to clinic will be discussed.

Role of Epithelial–Mesenchymal Transition in Repair of the Lacrimal Gland after Experimentally Induced Injury

PubMed Central

You, Samantha; Avidan, Orna; Tariq, Ayesha; Ahluwalia, Ivy; Stark, Paul C.; Kublin, Claire L.

2012-01-01

Purpose. Ongoing studies demonstrate that the murine lacrimal gland is capable of repair after experimentally induced injury. It was recently reported that repair of the lacrimal gland involved the mobilization of mesenchymal stem cells (MSCs). These cells expressed the type VI intermediate filament protein nestin whose expression was upregulated during the repair phase. The aim of the present study was to investigate the roles of vimentin, a type III intermediate filament protein and a marker of epithelial–mesenchymal transition (EMT) in repair of the lacrimal gland. Methods. Injury was induced by direct injection of interleukin (IL)-1 into the exorbital lacrimal gland. MSCs were prepared from injured glands using tissue explants. Expression of vimentin and the transcription factor Snai1, a master regulator of EMT, was determined by RT-PCR, Western blotting analysis, and immunofluorescence. Results. These data show that vimentin expression, at both the mRNA and the protein levels, was upregulated during the repair phase (2–3 days postinjury) and returned to the control level when repair ended. Temporal expression of Snai1 mirrored that of vimentin and was localized in cell nuclei. Cultured MSCs isolated from injured lacrimal glands expressed Snai1 and vimentin alongside nestin and alpha smooth muscle actin (another biomarker of EMT). There was a strong positive correlation between Snai1 expression and vimentin expression. Conclusions. It was found that EMT is induced during repair of the lacrimal gland to generate MSCs to initiate repair, and that mesenchymal–epithelial transition is then activated to form acinar and ductal epithelial cells. PMID:22025566

Diagnosis and Treatment Strategy of Achalasia Subtypes and Esophagogastric Junction Outflow Obstruction Based on High-Resolution Manometry.

PubMed

Ihara, Eikichi; Muta, Kazumasa; Fukaura, Keita; Nakamura, Kazuhiko

2017-01-01

Based on Chicago Classification version 3.0, the disorders of esophagogastric junction outflow obstruction (EGJOO) include achalasia (types I, II and III) and EGJOO. Although no curative treatments are currently available for the treatment of the disorders of EGJOO, medical treatments, endoscopic pneumatic dilation (PD), laparoscopic Heller myotomy (LHM), and per-oral endoscopic myotomy (POEM) are usually the sought-after modes of treatment. Since the etiology and pathogenesis might vary depending on the types of EGJOO disorders, treatment strategies should be considered based on those subtypes. Based on the accumulated evidences, the treatment strategies of our institution are as follows: effects of medical treatments on achalasia are limited. Either PD or LHM/POEM can be considered a first-line in achalasia type I, according to the patient's wish. PD and POEM can be considered first-line in achalasia types II and III, respectively. Conversely, In EGJOO, medical treatments including drugs like acotiamide and/or diltiazem can be tested as a first-line, and PD and POEM will be considered second and third-line treatments, respectively. Key Messages: The classification of subtypes based on high-resolution manometry will help us consider which treatment option can be selected as a first-line treatment depending upon the subtypes of disorders of EGJOO. Acotiamide has the potential to cure patients with EGJOO. © 2016 S. Karger AG, Basel.

Lacrimal drainage-associated lymphoid tissue (LDALT): a part of the human mucosal immune system.

PubMed

Knop, E; Knop, N

2001-03-01

Mucosa-associated lymphoid tissue (MALT) specifically protects mucosal surfaces. In a previous study of the human conjunctiva, evidence was also found for the presence of MALT in the lacrimal sac. The present study, therefore, aims to investigate its morphology and topographical distribution in the human lacrimal drainage system. Lacrimal drainage systems (n = 51) obtained from human cadavers were investigated by clearing flat wholemounts or by serial sections of tissue embedded in paraffin, OCT compound, or epoxy resin. These were further analyzed by histology, immunohistochemistry, and electron microscopy. All specimens showed the presence of lymphocytes and plasma cells as a diffuse lymphoid tissue in the lamina propria, together with intraepithelial lymphocytes and occasional high endothelial venules (HEV). It formed a narrow layer along the canaliculi that became thicker in the cavernous parts. The majority of lymphocytes were T cells, whereas B cells were interspersed individually or formed follicular centers. T cells were positive for CD8 and the human mucosa lymphocyte antigen (HML-1). Most plasma cells were positive for IgA and the overlying epithelium expressed its transporter molecule secretory component (SC). Basal mucous glands were present in the lacrimal canaliculi and in the other parts accompanied by alveolar and acinar glands, all producing IgA-rich secretions. Primary and secondary lymphoid follicles possessing HEV were present in about half of the specimens. The term lacrimal drainage-associated lymphoid tissue (LDALT) is proposed here to describe the lymphoid tissue that is regularly present and belongs to the common mucosal immune system and to the secretory immune system. It is suggested that it may form a functional unit together with the lacrimal gland and conjunctiva, connected by tear flow, lymphocyte recirculation, and probably the neural reflex arc, and play a major role in preserving ocular surface integrity.

S-1-Induced Lacrimal Drainage Obstruction and Its Association with Ingredients/Metabolites of S-1 in Tears and Plasma: A Prospective Multi-institutional Study.

PubMed

Kim, Namju; Kim, Jin Won; Baek, Je-Hyun; Kim, Jin-Soo; Choung, Ho-Kyung; Kim, Tae-Yong; Lee, Kyung-Hun; Bang, Yung-Jue; Khwarg, Sang In; Ahn, Sang-Hoon; Park, Do Joong; Kim, Hyung-Ho; Chung, Jae-Yong; Ahn, Soyeon; Lee, Keun-Wook

2018-01-01

This prospective study was conducted to determine the incidence of lacrimal drainage obstruction (LDO) during S-1 chemotherapy and evaluate the association between the development of LDO and the concentrations of ingredients/metabolites of S-1 in tears and plasma. A total of 145 patients with gastric cancer who received adjuvant S-1 therapy were enrolled. Ophthalmologic examinations were performed regularly during S-1 chemotherapy. Concentrations of tegafur, 5-chloro-2,4-dihydroxypyridine (CDHP), and 5-fluorouracil at steady-state trough level were measured in both tears and plasma. Fifty-three patients (37%) developed LDO. The median time to the onset of LDO was 10.9 weeks, and LDO developed most frequently in the nasolacrimal duct. Univariable analyses revealed that an older age (≥ 70 years), creatinine clearance rate (Ccr) < 80 mL/min, 5-fluorouracil concentration in plasma ≥ 22.3 ng/mL (median), CDHP concentration in plasma ≥ 42.0 ng/mL (median), and tegafur concentration in tears ≥ 479.2 ng/mL (median) were related to increased development of LDO. Multivariable analysis indicated that a high plasma 5-fluorouracil concentration was predictive of increased development of LDO (hazard ratio, 2.02; p=0.040), along with older age and decreased Ccr. Patients with LDO also developed S-1-related non-hematologic toxicity more frequently than those without LDO (p=0.016). LDO is a frequent adverse event during S-1 chemotherapy. An older age, decreased Ccr, and high plasma 5-fluorouracil concentration were found to be independent risk factors for LDO. The high incidence of LDO warrants regular ophthalmologic examination and early intervention in patients receiving S-1 therapy.

Dynamic Ocular Surface and Lacrimal Gland Changes Induced in Experimental Murine Dry Eye

PubMed Central

Xiao, Bing; Wang, Yu; Reinach, Peter S.; Ren, Yueping; Li, Jinyang; Hua, Shanshan; Lu, Huihui; Chen, Wei

2015-01-01

Dry eye disease can be a consequence of lacrimal gland insufficiency in Sjögren’s Syndrome or increased tear film evaporation despite normal lacrimal gland function. To determine if there is a correlation between severity effects in these models and underlying pathophysiological responses, we compared the time dependent changes in each of these parameters that occur during a 6 week period. Dry eye was induced in 6-week-old female C57BL/6 mice by exposing them to an Intelligently Controlled Environmental System (ICES). Sixty mice were housed in ICES for 1, 2, 4 and 6 weeks respectively. Twelve were raised in normal environment and received subcutaneous injections of scopolamine hydrobromide (SCOP) 3 times daily for 5 days. Another sixty mice were housed in a normal environment and received no treatment. Corneal fluorescein staining along with corneal MMP-9 and caspase-3 level measurements were performed in parallel with the TUNEL assay. Interleukin-17(IL-17), IL-23, IL-6, IL-1, TNF-α, IFN-γ and TGF-β2 levels were estimated by real-time PCR measurements of conjunctival and lacrimal gland samples (LGs). Immunohistochemistry of excised LGs along with flow cytometry in cervical lymph nodes evaluated immune cell infiltration. Light and transmission electron microscopy studies evaluated LGs cytoarchitectural changes. ICES induced corneal epithelial destruction and apoptosis peaked at 2 weeks and kept stable in the following 4 weeks. In the ICES group, lacrimal gland proinflammatory cytokine level increases were much lower than those in the SCOP group. In accord with the lower proinflammatory cytokine levels, in the ICES group, lacrimal gland cytosolic vesicular density and size exceeded that in the SCOP group. ICES and SCOP induced murine dry eye effects became progressively more severe over a two week period. Subsequently, the disease process stabilized for the next four weeks. ICES induced local effects in the ocular surface, but failed to elicit lacrimal gland

Dynamic ocular surface and lacrimal gland changes induced in experimental murine dry eye.

PubMed

Xiao, Bing; Wang, Yu; Reinach, Peter S; Ren, Yueping; Li, Jinyang; Hua, Shanshan; Lu, Huihui; Chen, Wei

2015-01-01

Dry eye disease can be a consequence of lacrimal gland insufficiency in Sjögren's Syndrome or increased tear film evaporation despite normal lacrimal gland function. To determine if there is a correlation between severity effects in these models and underlying pathophysiological responses, we compared the time dependent changes in each of these parameters that occur during a 6 week period. Dry eye was induced in 6-week-old female C57BL/6 mice by exposing them to an Intelligently Controlled Environmental System (ICES). Sixty mice were housed in ICES for 1, 2, 4 and 6 weeks respectively. Twelve were raised in normal environment and received subcutaneous injections of scopolamine hydrobromide (SCOP) 3 times daily for 5 days. Another sixty mice were housed in a normal environment and received no treatment. Corneal fluorescein staining along with corneal MMP-9 and caspase-3 level measurements were performed in parallel with the TUNEL assay. Interleukin-17(IL-17), IL-23, IL-6, IL-1, TNF-α, IFN-γ and TGF-β2 levels were estimated by real-time PCR measurements of conjunctival and lacrimal gland samples (LGs). Immunohistochemistry of excised LGs along with flow cytometry in cervical lymph nodes evaluated immune cell infiltration. Light and transmission electron microscopy studies evaluated LGs cytoarchitectural changes. ICES induced corneal epithelial destruction and apoptosis peaked at 2 weeks and kept stable in the following 4 weeks. In the ICES group, lacrimal gland proinflammatory cytokine level increases were much lower than those in the SCOP group. In accord with the lower proinflammatory cytokine levels, in the ICES group, lacrimal gland cytosolic vesicular density and size exceeded that in the SCOP group. ICES and SCOP induced murine dry eye effects became progressively more severe over a two week period. Subsequently, the disease process stabilized for the next four weeks. ICES induced local effects in the ocular surface, but failed to elicit lacrimal gland

P63 Positive Mucoepidermoid Tumor of the Lacrimal Sac with Associated Papilloma.

PubMed

Iordanous, Yiannis; Belrose, Jillian C; Cadieux, Dani C; Chakrabarti, Subrata; Farmer, James P; Allen, Larry H

2015-01-01

We report a case of a 44-year-old man who presented with a left medial canthal mass and epiphora. Imaging was suggestive of a mass continuous with the nasolacrimal sac. Subsequent surgical exploration revealed a mass adherent to bone with invasion of the lacrimal system. Histological examination revealed a squamous/transitional cell papilloma overlying a low-grade mucoepidermoid carcinoma (MEC). Complete surgical resection was completed and pathology confirmed the diagnosis. This is the first case in which a MEC has been reported concurrently with an overlying papilloma, providing support for the hypothesis that MECs arise from papillomas in the lacrimal sac. Additionally, the tissue stained positive for p63, which is congruent with MEC immunoreactivity in the salivary gland. The description of these unique histopathological findings may assist in definitive diagnosis and improve our understanding of the pathophysiology underlying lacrimal sac MEC tumors.

Granulomatosis with polyangiitis confined to lacrimal gland, a case report.

PubMed

Zuazo, F; González, M; Abdala, A; Olvera-Morales, O; Monroy, M H; Rodríguez-Reyes, A; Tovilla-Canales, J L; Nava-Castañeda, Á

2017-11-01

A 43 year-old woman consulted due to 2 months of swelling on the superolateral side of the left orbit, with pain and erythema. An excisional biopsy was performed that revealed vasculitis with polyangiitis of the lacrimal gland. A systemic study showed that no other system was compromised. Orbital involvement occurs in up to 60% of patients with granulomatosis with polyangiitis. The involvement of the lacrimal gland is rare and often unilateral. Serological tests are generally negative, both in initial stages, as in localized forms of the disease. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Long-Term Outcomes of Eye-Sparing Surgery for Adenoid Cystic Carcinoma of Lacrimal Gland.

PubMed

Han, Jisang; Kim, Yoon-Duck; Woo, Kyung In; Sobti, Deepak

This study's primary purpose is to assess the long-term outcomes of patients who have undergone eye-sparing surgery and adjuvant radiotherapy for adenoid cystic carcinoma of the lacrimal gland. In this retrospective analysis, clinical records were reviewed of all patients diagnosed with adenoid cystic carcinoma of the lacrimal gland, at a single institution, between March 1998 and November 2012. Ten patients were identified as having undergone eye-sparing surgery and adjuvant radiotherapy for adenoid cystic carcinoma of the lacrimal gland. Preoperative radiographic findings, treatment modalities, histological results, and patient outcomes were analyzed. There were 6 male and 4 female patients. The patients' tumors were staged according to the 8th American Joint Committee on Cancer staging system, and were as follows: 1 patient was classified as T1aN0M0; 6 patients were classified as T2aN0M0; 1 patient was classified as T2cN0M0; 2 patients were classified as T3aN0M0. All patients had a histologically confirmed diagnosis of lacrimal gland adenoid cystic carcinoma, which was confined to the orbit, and was without extension into adjacent bone marrow or other organs. All patients underwent eye-sparing tumor excision followed by postoperative radiotherapy, with a median dose of 6000 cGy (range: 5000-6600 cGy). At the last follow up, 8 patients were alive without evidence of disease. One patient was deceased at 58 months post-surgery, due to esophageal carcinoma; this was unrelated to the lacrimal gland tumor. The final patient experienced tumor recurrence in the medial orbit 53 months post-surgery, and exenteration was performed. This patient was alive, without disease recurrence, at 90 months following exenteration. The median follow-up time was 89.5 months (range: 37-217 months). Systemic metastasis did not occur in any patient. Eye-sparing surgery and adjuvant radiotherapy have demonstrated favorable local control and long-term survival outcomes in patients with orbit

New experimental method to study acid/base transporters and their regulation in lacrimal gland ductal epithelia.

PubMed

Tóth-Molnár, Edit; Venglovecz, Viktória; Ozsvári, Béla; Rakonczay, Zoltán; Varró, András; Papp, Julius G; Tóth, András; Lonovics, János; Takács, Tamás; Ignáth, Imre; Iványi, Béla; Hegyi, Péter

2007-08-01

The main function of the lacrimal gland is to produce the most aqueous component of the tear film covering the surfaces of the cornea and the conjunctiva. Studies have been conducted that characterize the mixed fluid and protein secretion of isolated acini, but no methods have been developed to characterize lacrimal gland ductal cell (LGDC) secretion. Secretory mechanisms of ductal epithelia may play physiological roles in the maintenance of the standard environments for the cornea and the conjunctiva. In this study, the authors developed a rapid method to isolate large quantities of intact lacrimal ducts. The preparation of isolated intact lacrimal gland ducts for the first time enabled the performance of real-time functional experiments on cleaned ducts. Electron microscopy and fluorescence measurements were used to evaluate the viability of lacrimal ducts. Fluorescence measurements showed that LGDCs express functionally active Na(+)/H(+) exchanger (NHE) and Cl(-)/HCO(3)(-) exchanger (AE). Parasympathomimetic stimulation by carbachol stimulated NHE and AE through the elevation of intracellular calcium concentration. This mechanism can play a role in the regulation of ion and water secretion by LGDCs. The authors have described a lacrimal gland duct isolation technique in which the intact ducts remain viable and the role of duct cells in tear film secretion can be characterized. These data combined with the novel isolation facilitated understanding of the regulation mechanisms of ductal cell secretion at cellular and molecular levels under normal and pathologic conditions.

Use of the Crawford tube for symptomatic epiphora without nasolacrimal obstruction.

PubMed

Tong, Nyu-Xia; Zhao, Ying-Ying; Jin, Xiu-Ming

2016-01-01

To evaluate the effectiveness of the Crawford tube in treating symptomatic epiphora without nasolacrimal obstruction. A protocol was adopted for the management of symptomatic epiphora without nasolacrimal obstruction. Patients who suffered symptomatic epiphora without nasolacrimal obstruction in both eyes were included in the study. One eye was treated with Crawford tube intubation and the other eye was treated with medication therapy. Degree of watering, patient satisfaction, and symptomatic improvement were carefully evaluated by one of the authors at the end of the follow-up period, after Crawford tube removal, to ascertain functional results. Thirty-seven adult patients (37 eyes) underwent Crawford tube intubation for functional epiphora. The mean follow-up time after removal of the tube was 14.8±4.8mo. The procedure was an overall success in 28 eyes (75.7%), with symptoms improving significantly. Two eyes (5.4%) were relieved of indoor epiphora, two (5.4%) had minimal epiphora outdoors, but only with wind or cold, and five (13.5%) continued to experience tearing both indoors and outdoors. Thirty of the patients (81%) expressed satisfaction with the procedure. Crawford tube insertion is an effective, safe, simple, and relatively noninvasive treatment strategy for functional lacrimal system obstruction.

Interaction of corneal nociceptive stimulation and lacrimal secretion.

PubMed

Situ, Ping; Simpson, Trefford L

2010-11-01

To investigate the interaction between corneal stimuli at different positions and tear secretion and to establish relationships between nociceptive stimuli detection thresholds and stimulated tearing. Using a computerized Belmonte-esthesiometer, mechanical and chemical stimuli, from 0% to 200% of the threshold in 50% steps, were delivered (in random order) to the central and peripheral (approximately 2-mm inside the limbus) cornea during four separate sessions to 15 subjects. Immediately after each stimulus, tear meniscus height (TMH) was measured using optical coherence tomography to quantify the amount of lacrimal secretion, and subjects reported whether they felt tears starting to accumulate in their eyes. Thresholds (50% detection) for detection of tearing were estimated. TMH increased with increasing stimulus intensity (P < 0.05), and the overall increase was higher with central stimulation than with peripheral stimulation (P < 0.05). The changes in TMH with threshold-scaled stimulus intensity depended on test location (P < 0.05) and stimulus modality (P < 0.05). The maximum intensity of mechanical stimulation of the central cornea induced the greatest TMH (all P < 0.05). For chemical stimulation, the stimulus intensity required to induce detectable tearing was higher than that required to detect a stimulus and higher in the periphery than at the center (all P < 0.05). Noxious mechanical and chemical stimuli evoked measurable tear secretion, with central corneal mechanical stimulation evoking the strongest lacrimation reflex. Central mechanical corneal stimulation is the most effective stimulus-position pairing and appears to be the major sensory driving force for reflex tear secretion by the lacrimal functional unit.

Mitochondria-targeted antioxidant SkQ1 reduces age-related alterations in the ultrastructure of the lacrimal gland

PubMed Central

Bakeeva, Lora E.; Eldarov, Chupalav M.; Vangely, Irina M.; Kolosova, Nataliya G.; Vays, Valeriya B.

2016-01-01

Dry eye syndrome is an eye disorder affecting many people at an old age. Because dry eye syndrome is accelerated by aging, a useful approach to the prevention of this syndrome may be an intervention into the aging process. Previously, we showed that the mitochondria-targeted antioxidant SkQ1 delays manifestations of aging and inhibits the development of age-related diseases including dry eye syndrome. Nevertheless, the link between SkQ1's effects and its suppression of age-related changes in the lacrimal gland remains unclear. Here we demonstrated that dietary supplementation with SkQ1 (250 nmol/[kg body weight] daily) starting at age 1.5 months significantly alleviated the pathological changes in lacrimal glands of Wistar rats by age 24 months. By this age, lacrimal glands underwent dramatic deterioration of the ultrastructure that was indicative of irreversible disturbances in these glands' functioning. In contrast, in SkQ1-treated rats, the ultrastructure of the lacrimal gland was similar to that in much younger rats. Morphometric analysis of electron-microscopic specimens of lacrimal glands revealed the presence of numerous secretory granules in acinar cells and a significant increase in the number of operating intercalary ducts. Our results confirm that dietary supplementation with SkQ1 is a promising approach to healthy ageing and to prevention of aberrations in the lacrimal gland that underlie dry eye syndrome. PMID:27852065

Expression profiles of aquaporins in rat conjunctiva, cornea, lacrimal gland and Meibomian gland.

PubMed

Yu, Dongfang; Thelin, William R; Randell, Scott H; Boucher, Richard C

2012-10-01

The aim of the study was to elucidate aquaporin (AQP) family member mRNA expression and protein expression/localization in the rat lacrimal functional unit. The mRNA expression of all rat AQPs (AQP0-9, 11-12) in palpebral, fornical, and bulbar conjunctiva, cornea, lacrimal gland, and Meibomian gland was measured by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) and real time RT-PCR. Antibodies against AQP1, 3, 4, 5, 9, and 11 were used in Western blotting and immunohistochemistry to determine protein expression and distribution. Our study demonstrated characteristic AQP expression profiles in rat ocular tissues. AQP1, 3, 4, 5, 8, 9, 11, and 12 mRNA were detected in conjunctiva. AQP0, 1, 2, 3, 4, 5, 6, 11, and 12 mRNA were expressed in cornea. AQP0, 1, 2, 3, 4, 5, 7, 8, and 11 mRNA were detected in lacrimal gland. AQP1, 3, 4, 5, 7, 8, 9, 11, and 12 mRNA were identified in Meibomian gland. By Western blot, AQP1, 3, 5, and 11 were detected in conjunctiva; AQP1, 3, 5, and 11 were identified in cornea; AQP1, 3, 4, 5, and 11 were detected in lacrimal gland; and AQP1, 3, 4, 5, 9, and 11 were present in Meibomian gland. Immunohistochemistry localized AQPs to distinct sites in the various tissues. This study rigorously analyzed AQPs expression and localization in rat conjunctiva, cornea, lacrimal gland, and Meibomian gland tissues. Our findings provide a comprehensive platform for further investigation into the physiological or pathophysiological relevance of AQPs in ocular surface. Copyright © 2012 Elsevier Ltd. All rights reserved.

Blocking of the Hepatic Vein Outflow by Neointima Covering a Wallstent Across a Membranous Stenosis of the Inferior Vena Cava

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

Dutta, Usha; Garg, Pramod K.; Agarwal, Rajeev

1999-11-15

A 31-year-old man presented with idiopathic membranous obstruction of the suprahepatic inferior vena cava (IVC) and was treated by balloon dilation and placement of a Wallstent. The patient improved markedly. However, he developed obstruction of the hepatic vein outflow secondary to neointima formation over the stent that covered the hepatic vein ostia. The patient died of liver failure and septicemia. We believe that this is the first report of such a serious complication.

Anatomical factors determining surgical decision-making in patients with transposition of the great arteries with left ventricular outflow tract obstruction.

PubMed

Honjo, Osami; Kotani, Yasuhiro; Bharucha, Tara; Mertens, Luc; Caldarone, Christopher A; Redington, Andrew N; Van Arsdell, Glen

2013-12-01

Transposition of the great arteries (TGA) and left ventricular outflow tract obstruction (LVOTO) with or without ventricular septal defect have multiple surgical treatment options. We sought to identify pre- and intraoperative factors that determine the timing of repair, procedure type and subsequent LVOT outcome. Twenty-eight (8.2% of all TGA) patients with TGA with LVOTO (double outlet ventricle, n = 5, TGA/intact septum, n = 1) between 2000 and 2012 were reviewed. Anatomical factors were identified by prerepair echocardiography. LVOTO complexity was characterized by the degree of obstruction (0 = none, 0.33 = mild, 0.66 moderate and 1 = severe) at various levels: pulmonary valve (PV) dysplasia/hypoplasia, posterior deviation of the infundibular septum, fibromuscular ridge, tissue tag and abnormal chordal attachment. Summation of the obstruction score, at each level, yielded the LVOT complexity score. The descriptive analysis of intraoperative decision-making at late repair was performed. early arterial switch operation (ASO) + LVOT resection (n = 9, 32%), late ASO + LVOT resection (n = 3, 10%), Nikaidoh (n = 8, 29%), Rastelli (n = 6, 21%), single-ventricle palliation (n = 2, 7%). The primary LVOT obstruction mechanism was posterior deviation of the infundibular septum (n = 16, 57%) and PV dysplasia (n = 6, 21%). The early ASO group had a lower PV complexity score (0.42 ± 0.22 vs 0.96 ± 0.55, P = 0.007), tissue tag score (0.03 ± 0.15 vs 0.26 ± 0.34, P = 0.018) and LVOT complexity score (2.11 ± 0.86 vs 3.2 ± 0.96, P = 0.006). The LVOT complexity score in the Nikaidoh group was higher than in the late ASO group (P = 0.019). Of 16 candidates for the Nikaidoh procedure, 6 patients underwent a Rastelli operation due to coronary artery patterns (single coronary, n = 3, 1RL-2Cx, n = 2 or an abnormal left anterior descending coronary artery course, n = 1). Two patients underwent single-ventricle palliation due to the interference of essential chordae. All patients

An alternative method of closed silicone intubation of the lacrimal system.

PubMed

Henderson, P N; McNab, A A

1996-05-01

An alternative method of closed lacrimal intubation is described, the basis of which is to place the end of a piece of silicone tubing over the end of a small-diameter metal introducer, stretch the silicone tubing back along the introducer, and then pass the introducer together with the tubing through the lacrimal system into the nasal cavity. The tubing is visualized in the inferior meatus, from where it is retrieved, and then the introducer is withdrawn. The other end of the tubing is passed in a similar fashion. The technique is easily mastered, inexpensive, and less traumatic than other described techniques.

Urodynamic findings in women with pelvic organ prolapse and obstructive voiding symptoms.

PubMed

Dain, Lena; Auslander, Ron; Rosen, Talma; Segev, Yakir; Goldschmidt, Eyal; Abramov, Yoram

2010-11-01

To determine whether obstructive voiding symptoms in women with advanced pelvic organ prolapse (POP) were associated with objective bladder outflow tract obstruction. We reviewed preoperative data from patients with advanced POP who underwent surgical correction at the Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel, between December 1, 2005, and November 30, 2007. Obstructive voiding symptoms were recorded from Pelvic Floor Distress Inventory-20 questionnaires. Of the 81 women aged 44-80 years who were included in the study, 40 (49.4%) reported incomplete bladder emptying preoperatively. There was no significant difference between these women and asymptomatic women in terms of demographic and clinical parameters such as age, parity, and stage of prolapse. Furthermore, there was no significant difference with regard to postvoid residual bladder volume (52.8 ± 65.8 vs 41.6 ± 41.2 mL), maximal (23.8 ± 11 vs 21.9 ± 9.6 mL/second) and average (10.3 ± 6.2 vs 9.3 ± 4 mL/second) urinary flow velocities, prevalence of increased postvoid residual volume (10.0% vs 4.8%), or obstructive urinary flow (17.5% vs 7.3%). Almost half of all women with advanced POP experienced incomplete bladder emptying; however, this symptom did not correlate with objective urodynamic bladder outflow tract obstruction. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Impaired bolus clearance in combined high-resolution esophageal manometry and impedance measurement helps to differentiate between esophagogastric junction outflow obstruction and achalasia.

PubMed

Zizer, Eugen; Seufferlein, Thomas; Hänle, Mark Martin

2017-02-01

Introduction and aims  High-resolution esophageal manometry (HRM) has improved the diagnostic work-up of esophageal motility disorders. Simultaneous evaluation of bolus clearance delivers useful information about the function of tubular esophagus. We assessed bolus clearance in a combined HRM-impedance examination for esophagogastric junction outflow obstruction (EGJOO) in comparison to achalasia patients. The collected data were assessed in a retrospective analysis. Patients and methods  After gastroscopy excluded a mechanical esophageal or gastric obstruction, 142 consecutive patients underwent combined HRM-impedance examination. The assessment and interpretation of the manometry results were done according to the Chicago Classification of esophageal motility disorders v3.0. After classifying the motility disorder, the evaluation of bolus clearance was done according to published studies. Results  All patients with achalasia (n = 24) showed a significantly impaired bolus clearance (< 80 %). Patients with unaffected peristalsis (n = 56) or patients with EGJOO (n = 14) each showed impaired clearance in 7 %, respectively. The evidence of axial hernia was not associated with impaired clearance. Conclusion  Our results demonstrate a significant difference in impedance measurements between EGJOO and achalasia cases. This might be helpful as an additional tool to differentiate between achalasia and EGJOO patients. Furthermore, the role of the combined impedance-HRM investigation for early diagnosis of achalasia in "pre-achalasia" condition or in evaluation of potential progress of EGJOO to achalasia should be evaluated in a prospective study. © Georg Thieme Verlag KG Stuttgart · New York.

Shining a light on galactic outflows: photoionized outflows

NASA Astrophysics Data System (ADS)

Chisholm, John; Tremonti, Christy A.; Leitherer, Claus; Chen, Yanmei; Wofford, Aida

2016-04-01

We study the ionization structure of galactic outflows in 37 nearby, star-forming galaxies with the Cosmic Origins Spectrograph on the Hubble Space Telescope. We use the O I, Si II, Si III, and Si IV ultraviolet absorption lines to characterize the different ionization states of outflowing gas. We measure the equivalent widths, line widths, and outflow velocities of the four transitions, and find shallow scaling relations between them and galactic stellar mass and star formation rate. Regardless of the ionization potential, lines of similar strength have similar velocities and line widths, indicating that the four transitions can be modelled as a comoving phase. The Si equivalent width ratios (e.g. Si IV/Si II) have low dispersion, and little variation with stellar mass; while ratios with O I and Si vary by a factor of 2 for a given stellar mass. Photoionization models reproduce these equivalent width ratios, while shock models under predict the relative amount of high ionization gas. The photoionization models constrain the ionization parameter (U) between -2.25 < log (U) < -1.5, and require that the outflow metallicities are greater than 0.5 Z⊙. We derive ionization fractions for the transitions, and show that the range of ionization parameters and stellar metallicities leads to a factor of 1.15-10 variation in the ionization fractions. Historically, mass outflow rates are calculated by converting a column density measurement from a single metal ion into a total hydrogen column density using an ionization fraction, thus mass outflow rates are sensitive to the assumed ionization structure of the outflow.

Influence of ribosomal protein L39-L in the drug resistance mechanisms of lacrimal gland adenoid cystic carcinoma cells.

PubMed

Ye, Qing; Ding, Shao-Feng; Wang, Zhi-An; Feng, Jie; Tan, Wen-Bin

2014-01-01

Cancer constitutes a key pressure on public health regardless of the economy state in different countries. As a kind of highly malignant epithelial tumor, lacrimal gland adenoid cystic carcinoma can occur in any part of the body, such as salivary gland, submandibular gland, trachea, lung, breast, skin and lacrimal gland. Chemotherapy is one of the key treatment techniques, but drug resistance, especially MDR, seriously blunts its effects. As an element of the 60S large ribosomal subunit, the ribosomal protein L39-L gene appears to be documented specifically in the human testis and many human cancer samples of different origins. Total RNA of cultured drug-resistant and susceptible lacrimal gland adenoid cystic carcinoma cells was seperated, and real time quantitative RT-PCR were used to reveal transcription differences between amycin resistant and susceptible strains of lacrimal gland adenoid cystic carcinoma cells. Viability assays were used to present the amycin resistance difference in a RPL39-L transfected lacrimal gland adenoid cystic carcinoma cell line as compared to control vector and null-transfected lacrimal gland adenoid cystic carcinoma cell lines. The ribosomal protein L39-L transcription level was 6.5-fold higher in the drug-resistant human lacrimal gland adenoid cystic carcinoma cell line than in the susceptible cell line by quantitative RT-PCR analysis. The ribosomal protein L39-L transfected cells revealed enhanced drug resistance compared to plasmid vector-transfected or null-transfected cells as determined by methyl tritiated thymidine (3H-TdR) incorporation. The ribosomal protein L39-L gene could possibly have influence on the drug resistance mechanism of lacrimal gland adenoid cystic carcinoma cells.

Urethral Stenting for Obstructive Uropathy Utilizing Digital Radiography for Guidance: Feasibility and Clinical Outcome in 26 Dogs.

PubMed

Radhakrishnan, A

2017-03-01

Urethral stent placement is an interventional treatment option to alleviate urethral outflow obstruction. It has been described utilizing fluoroscopy, but fluoroscopy is not as readily available in private practice as digital radiography. To describe the use of digital radiography for urethral stent placement in dogs with obstructive uropathy. Twenty-six client-owned dogs presented for dysuria associated with benign and malignant causes of obstructive uropathy that underwent urethral stent placement. Retrospective study. Causes of obstructive uropathy included transitional cell carcinoma, prostatic carcinoma, hemangiosarcoma, obstructive proliferative urethritis, compressive vaginal leiomyosarcoma, and detrusor-sphincter dyssynergia. Survival time range was 1-48 months (median, 5 months). All dogs were discharged from the hospital with urine outflow restored. Intraprocedural complications included guide wire penetration of the urethral wall in 1 dog and improper stent placement in a second dog. Both complications were successfully managed at the time of the procedure with no follow-up problems noted in either patient. Urethral stent placement can be successfully performed utilizing digital radiography. The complications experienced can be avoided by more cautious progression with each step through the procedure and serial radiography. The application of digital radiography may allow treatment of urethral obstruction to become more readily available. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Videoreflective dacryomeniscometry in normal adults and in patients with functional or primary acquired nasolacrimal duct obstruction.

PubMed

Francis, Ian C; Chan, Derek G; Papalkar, Daya; Papas, Eric B; Stapleton, Fiona

2005-03-01

Videoreflective dacryomeniscometry (VRD) for evaluation of marginal tear film has not been performed in patients with watery eye or in a controlled study. We used VRD to evaluate the height of the central marginal lower lid tear film in normal adults and compared it with two watery-eye groups and a postoperative dacryocystorhinostomy (DCR) group. Case-controlled interventional case series. We evaluated with VRD 20 subjects with normal lacrimal drainage function, 21 patients with primary acquired nasolacrimal duct obstruction (PANDO), 28 patients with functional nasolacrimal duct obstruction (FNLDO), and a postoperative group of 14 patients derived from the previous two pathologic groups. Comparison between the four groups was performed to determine statistically significant differences between tear film height. PANDO and FNLDO groups were shown to have significantly greater median tear meniscus heights ([TMH] PANDO: 620 microm, interquartile range [IQR] 453 microm; FNLDO: 731 microm, IQR 529 microm) than normal subjects (296 microm, IQR 214 microm; P < .001) and postoperative PANDO patients (265 microm, IQR 159 microm). There was no significant difference in TMH between PANDO and FNLDO groups preoperatively (P = .275). There was a reduction in median TMH postoperatively of 355 microm (P = .008) in PANDO and 360 microm (P = .068) in FNLDO. PANDO and FNLDO patients have similar preoperative TMH. In both these groups, TMH is significantly greater than in normal control subjects. Lacrimal drainage surgery substantially reduces TMH as measured using VRD in PANDO.

Corneal Sensitivity Following Lacrimal Gland Excision in the Rat

PubMed Central

Meng, Ian D.; Barton, Stephen T.; Mecum, Neal E.; Kurose, Masayuki

2015-01-01

Purpose. Dry eye disease (DED) produces ocular pain and irritation, yet a detailed characterization of ocular sensitivity in a preclinical model of DED is lacking. The aim of the present study was to assess nociceptive behaviors in an aqueous tear deficiency model of DED in the rat. Methods. Spontaneous blinking, corneal mechanical thresholds, and eye wipe behaviors elicited by hypertonic saline (5.0 M) were examined over a period of 8 weeks following the unilateral excision of either the exorbital lacrimal gland or of the exorbital and infraorbital lacrimal glands, and in sham surgery controls. The effect of topical proparacaine on spontaneous blinking and of systemic morphine (0.5–3.0 mg/kg, subcutaneous [SC]) on spontaneous blinking and eye wipe responses were also examined. Results. Lacrimal gland excision resulted in mechanical hypersensitivity and an increase in spontaneous blinking in the ipsilateral eye over an 8-week period that was more pronounced after infra- and exorbital gland excision. The time spent eye wiping was also enhanced in response to hypertonic saline (5.0 M) at both 1- and 8-week time-points, but only in infra- and exorbital gland excised animals. Morphine attenuated spontaneous blinking, and the response to hypertonic saline in dry eye animals and topical proparacaine application reduced spontaneous blinking down to control levels. Conclusions. These results indicate that aqueous tear deficiency produces hypersensitivity in the rat cornea. In addition, the increase in spontaneous blinks and their reduction by morphine and topical anesthesia indicate the presence of persistent irritation elicited by the activation of corneal nociceptors. PMID:26024120

Ultrafast Outflows: Galaxy-scale Active Galactic Nucleus Feedback

NASA Astrophysics Data System (ADS)

Wagner, A. Y.; Umemura, M.; Bicknell, G. V.

2013-01-01

We show, using global three-dimensional grid-based hydrodynamical simulations, that ultrafast outflows (UFOs) from active galactic nuclei (AGNs) result in considerable feedback of energy and momentum into the interstellar medium (ISM) of the host galaxy. The AGN wind interacts strongly with the inhomogeneous, two-phase ISM consisting of dense clouds embedded in a tenuous, hot, hydrostatic medium. The outflow floods through the intercloud channels, sweeps up the hot ISM, and ablates and disperses the dense clouds. The momentum of the UFO is primarily transferred to the dense clouds via the ram pressure in the channel flow, and the wind-blown bubble evolves in the energy-driven regime. Any dependence on UFO opening angle disappears after the first interaction with obstructing clouds. On kpc scales, therefore, feedback by UFOs operates similarly to feedback by relativistic AGN jets. Negative feedback is significantly stronger if clouds are distributed spherically rather than in a disk. In the latter case, the turbulent backflow of the wind drives mass inflow toward the central black hole. Considering the common occurrence of UFOs in AGNs, they are likely to be important in the cosmological feedback cycles of galaxy formation.

ULTRAFAST OUTFLOWS: GALAXY-SCALE ACTIVE GALACTIC NUCLEUS FEEDBACK

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

Wagner, A. Y.; Umemura, M.; Bicknell, G. V., E-mail: ayw@ccs.tsukuba.ac.jp

We show, using global three-dimensional grid-based hydrodynamical simulations, that ultrafast outflows (UFOs) from active galactic nuclei (AGNs) result in considerable feedback of energy and momentum into the interstellar medium (ISM) of the host galaxy. The AGN wind interacts strongly with the inhomogeneous, two-phase ISM consisting of dense clouds embedded in a tenuous, hot, hydrostatic medium. The outflow floods through the intercloud channels, sweeps up the hot ISM, and ablates and disperses the dense clouds. The momentum of the UFO is primarily transferred to the dense clouds via the ram pressure in the channel flow, and the wind-blown bubble evolves inmore » the energy-driven regime. Any dependence on UFO opening angle disappears after the first interaction with obstructing clouds. On kpc scales, therefore, feedback by UFOs operates similarly to feedback by relativistic AGN jets. Negative feedback is significantly stronger if clouds are distributed spherically rather than in a disk. In the latter case, the turbulent backflow of the wind drives mass inflow toward the central black hole. Considering the common occurrence of UFOs in AGNs, they are likely to be important in the cosmological feedback cycles of galaxy formation.« less

[The expression of MMP-2 and MMP-9 in adenoid cystic carcinoma of lacrimal gland].

PubMed

Zhang, Lei; Zhang, Hong; Song, Guo-xiang; Lin, Ting-ting; Xu, Guang-chang; Zhu, Li-min

2013-01-01

To investigate the expression of matrix metal proteinase (MMP)-2 and MMP-9 in adenoid cystic carcinoma of lacrimal gland as well as their relation with biological behaviour of adenoid cystic carcinoma. Experimental study. The research objects were 60 cases of adenoid cystic carcinoma of lacrimal gland which were collected from No.2 Hospital of Tianjin Medical University from January 1991 to Jule 2011. There were 25 males and 35 females aged from 29 to 42 years. Based on histological revision, there were 36 cases of cribriform-tubular subtype and 24 cases of solid subtype. Forty-five cases were primary lesions and 15 cases were recurrent lesions. Ten samples of normal lacrimal gland around polymorphic adenoma were selected as the control group. The expression of CD105, MMP-2 and MMP-9 were evaluated by immunohistochemistry. The microvessel density (MVD) was defined by expression of CD105. One way ANOVA, χ(2)-test and spearman correlation test were used to analyzed the data. The number of MVD [(17.71 ± 5.63)/100 folds field of vision] and the positive rates of MMP-2 (45.0%, 27/60) and MMP-9 (55.0%, 33/60) in the samples of adenoid cystic carcinoma of lacrimal gland were higher than those in the normal lacrimal gland [the number of MVD was (0.70 ± 0.95)/100 folds field of vision, the expressions of MMP-2 and MMP-9 were negative] (t' = 2.039, P < 0.05; χ(2) = 5.550, P < 0.05; χ(2) = 8.315, P < 0.01), the solid subtypes had more MVD [(26.12 ± 5.32)/100 folds field of vision] and higher positive rates of MMP-2 (62.5%, 15/24) and MMP-9 (79.2%, 19/24) than the cribriform-tubular subtypes (t' = 2.060, P < 0.05; χ(2) = 4.950, P < 0.05; χ(2) = 9.439, P < 0.05); the recurrent lesions had more MVD and higher positive rate of MMP-2 and MMP-9 than the primary lesions (t' = 2.129, P < 0.05; χ(2) = 9.899, P < 0.05; χ(2) = 8.103, P < 0.05). The number of MVD in ACC of lacrimal gland patients was correlated with the positive rate of MMP-2 and MMP-9 respectively (rs = 0

A rare case of late solitary vertebral metastasis from an adenoid cystic carcinoma of the lacrimal gland.

PubMed

Ahmed, Awaiz; Rajankulam Ganesan, Satish Kannan; Haleem, Shahnawaz; Nicoll, James

2017-06-13

Adenoid cystic carcinoma of the lacrimal gland is one among the common malignancies affecting the lacrimal gland. However, overall, it is a rare condition. It has a rather poor prognosis with local recurrence and distant haematological metastasis which are invariably multiple. We present a rare case of a 51-year-old woman who presented with localised lower thoracic pain with collapse of the T10 vertebral body, which turned out be a solitary late metastasis from her previously treated lacrimal gland tumour. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Lacrimal gland-derived IL-22 regulates IL-17-mediated ocular mucosal inflammation

PubMed Central

Ji, Yong Woo; Mittal, Sharad K.; Hwang, Ho Sik; Chang, Eun-Ju; Lee, Joon H.; Seo, Yuri; Yeo, Areum; Noh, Hyemi; Lee, Hye Sun; Chauhan, Sunil K.; Lee, Hyung Keun

2016-01-01

Inflammatory damage of mucosal surface of the eye is a hallmark of dry eye disease (DED), and in severe cases can lead to significant discomfort, visual impairment, and blindness. DED is a multifactorial autoimmune disorder with a largely unknown pathogenesis. Using a cross-sectional patient study and a well-characterized murine model of DED, herein we investigated the immunoregulatory function of interleukin-22 (IL-22) in the pathogenesis of DED. We found that IL-22 levels were elevated in lacrimal fluids of DED patients and inversely correlated with severity of disease. Acinar cells of the lacrimal glands, not inflammatory immune cells, are the primary source of IL-22, which suppresses inflammation in ocular surface epithelial cells upon desiccating stress. Moreover, loss of function analyses using IL-22 knock-out mice demonstrated that IL-22 is essential for suppression of ocular surface infiltration of Th17 cells and inhibition of DED induction. Our novel findings elucidate immunoregulatory function of lacrimal gland-derived IL-22 in inhibiting IL-17-mediated ocular surface epitheliopathy in DED thus making IL-22 a new relevant therapeutic target. PMID:28051088

Differential Canalograms Detect Outflow Changes from Trabecular Micro-Bypass Stents and Ab Interno Trabeculectomy.

PubMed

Parikh, Hardik A; Loewen, Ralitsa T; Roy, Pritha; Schuman, Joel S; Lathrop, Kira L; Loewen, Nils A

2016-11-04

Recently introduced microincisional glaucoma surgeries that enhance conventional outflow offer a favorable risk profile over traditional surgeries, but can be unpredictable. Two paramount challenges are the lack of an adequate training model for angle surgeries and the absence of an intraoperative quantification of surgical success. To address both, we developed an ex vivo training system and a differential, quantitative canalography method that uses slope-adjusted fluorescence intensities of two different chromophores to avoid quenching. We assessed outflow enhancement by trabecular micro-bypass (TMB) implantation or by ab interno trabeculectomy (AIT). In this porcine model, TMB resulted in an insignificant (p > 0.05) outflow increase of 13 ± 5%, 14 ± 8%, 9 ± 3%, and 24 ± 9% in the inferonasal, superonasal, superotemporal, and inferotemporal quadrant, respectively. AIT caused a 100 ± 50% (p = 0.002), 75 ± 28% (p = 0.002), 19 ± 8%, and 40 ± 21% increase in those quadrants. The direct gonioscopy and tactile feedback provided a surgical experience that was very similar to that in human patients. Despite the more narrow and discontinuous circumferential drainage elements in the pig with potential for underperformance or partial stent obstruction, unequivocal patterns of focal outflow enhancement by TMB were seen in this training model. AIT achieved extensive access to outflow pathways beyond the surgical site itself.

Differential Canalograms Detect Outflow Changes from Trabecular Micro-Bypass Stents and Ab Interno Trabeculectomy

PubMed Central

Parikh, Hardik A.; Loewen, Ralitsa T.; Roy, Pritha; Schuman, Joel S.; Lathrop, Kira L.; Loewen, Nils A.

2016-01-01

Recently introduced microincisional glaucoma surgeries that enhance conventional outflow offer a favorable risk profile over traditional surgeries, but can be unpredictable. Two paramount challenges are the lack of an adequate training model for angle surgeries and the absence of an intraoperative quantification of surgical success. To address both, we developed an ex vivo training system and a differential, quantitative canalography method that uses slope-adjusted fluorescence intensities of two different chromophores to avoid quenching. We assessed outflow enhancement by trabecular micro-bypass (TMB) implantation or by ab interno trabeculectomy (AIT). In this porcine model, TMB resulted in an insignificant (p > 0.05) outflow increase of 13 ± 5%, 14 ± 8%, 9 ± 3%, and 24 ± 9% in the inferonasal, superonasal, superotemporal, and inferotemporal quadrant, respectively. AIT caused a 100 ± 50% (p = 0.002), 75 ± 28% (p = 0.002), 19 ± 8%, and 40 ± 21% increase in those quadrants. The direct gonioscopy and tactile feedback provided a surgical experience that was very similar to that in human patients. Despite the more narrow and discontinuous circumferential drainage elements in the pig with potential for underperformance or partial stent obstruction, unequivocal patterns of focal outflow enhancement by TMB were seen in this training model. AIT achieved extensive access to outflow pathways beyond the surgical site itself. PMID:27811973

Computed tomographic imaging characteristics of the normal canine lacrimal glands

PubMed Central

2014-01-01

Background The canine lacrimal gland (LG) and accessory lacrimal gland of the third eyelid (TEG) are responsible for production of the aqueous portion of the precorneal tear film. Immune-mediated, toxic, neoplastic, or infectious processes can affect the glands directly or can involve adjacent tissues, with secondary gland involvement. Disease affecting these glands can cause keratoconjunctivitis sicca, corneal ulcers, and loss of vision. Due to their location in the orbit, these small structures are difficult to evaluate and measure, making cross-sectional imaging an important diagnostic tool. The detailed cross-sectional imaging appearance of the LG and TEG in dogs using computed tomography (CT) has not been reported to date. Results Forty-two dogs were imaged, and the length, width, and height were measured and the volume calculated for the LGs & TEGs. The glands were best visualized in contrast-enhanced CT images. The mean volume of the LG was 0.14 cm3 and the TEG was 0.1 cm3. The mean height, width, and length of the LG were, 9.36 mm, 4.29 mm, and 9.35 mm, respectively; the corresponding values for the TEG was 2.02 mm, 9.34 mm, and 7.90 mm. LG and TEG volume were positively correlated with body weight (p < 0.05). Conclusions Contrast-enhanced CT is a valuable tool for noninvasive assessment of canine lacrimal glands. PMID:24886364

Long-term clinical outcome after alcohol septal ablation for obstructive hypertrophic cardiomyopathy: results from the Euro-ASA registry.

PubMed

Veselka, Josef; Jensen, Morten Kvistholm; Liebregts, Max; Januska, Jaroslav; Krejci, Jan; Bartel, Thomas; Dabrowski, Maciej; Hansen, Peter Riis; Almaas, Vibeke Marie; Seggewiss, Hubert; Horstkotte, Dieter; Tomasov, Pavol; Adlova, Radka; Bundgaard, Henning; Steggerda, Robbert; Ten Berg, Jurriën; Faber, Lothar

2016-05-14

The first cases of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) were published two decades ago. Although the outcomes of single-centre and national ASA registries have been published, the long-term survival and clinical outcome of the procedure are still debated. We report long-term outcomes from the as yet largest multinational ASA registry (the Euro-ASA registry). A total of 1275 (58 ± 14 years, median follow-up 5.7 years) highly symptomatic patients treated with ASA were included. The 30-day post-ASA mortality was 1%. Overall, 171 (13%) patients died during follow-up, corresponding to a post-ASA all-cause mortality rate of 2.42 deaths per 100 patient-years. Survival rates at 1, 5, and 10 years after ASA were 98% (95% CI 96-98%), 89% (95% CI 87-91%), and 77% (95% CI 73-80%), respectively. In multivariable analysis, independent predictors of all-cause mortality were age at ASA (P < 0.01), septum thickness before ASA (P < 0.01), NYHA class before ASA (P = 0.047), and the left ventricular (LV) outflow tract gradient at the last clinical check-up (P = 0.048). Alcohol septal ablation reduced the LV outflow tract gradient from 67 ± 36 to 16 ± 21 mmHg (P < 0.01) and NYHA class from 2.9 ± 0.5 to 1.6 ± 0.7 (P < 0.01). At the last check-up, 89% of patients reported dyspnoea of NYHA class ≤2, which was independently associated with LV outflow tract gradient (P < 0.01). The Euro-ASA registry demonstrated low peri-procedural and long-term mortality after ASA. This intervention provided durable relief of symptoms and a reduction of LV outflow tract obstruction in selected and highly symptomatic patients with obstructive HCM. As the post-procedural obstruction seems to be associated with both worse functional status and prognosis, optimal therapy should be focused on the elimination of LV outflow tract gradient. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please

Predictors of Silicone Tube Intubation Success in Patients with Lacrimal Drainage System Stenosis.

PubMed

Baek, Ji Sun; Lee, Saem; Lee, Jung Hye; Choi, Hye Sun; Jang, Jae Woo; Kim, Sung Joo

2016-06-01

To evaluate prognostic factors affecting silicone tube intubation outcomes in Asian patients with lacrimal drainage system stenosis. A retrospective review was conducted on the medical records of 822 patients (1,118 eyes) who had undergone silicone tube intubation to treat lacrimal drainage system stenosis between January 2011 and December 2012. Patients were divided into two groups: a success group and a failure group. Success was defined as the disappearance of epiphora symptoms, normalization of tear meniscus height, and the easy passage of fluid without resistance on the postoperative syringing test. Patient and ocular parameters were compared between the success and failure groups. A total of 994 eyes of 727 patients were included in analyses. Patients had a mean follow-up period of 34.11 ± 18.70 weeks. Silicone tube intubation was successful in 67.2% of participants. Significant differences between the success and failure groups were found for age (p < 0.001), history of ipsilateral facial palsy (p = 0.028), follow-up period (p < 0.001), and degree of passage on the preoperative syringing test (p = 0.001). Only age (p < 0.001) and degree of passage on the preoperative syringing test (p = 0.002) remained significantly associated with silicone tube intubation success in multivariate analysis. Age was negatively associated with silicone tube intubation success in patients with lacrimal drainage system stenosis. The success rate was higher in patients who showed easy passage of fluid without resistance on the preoperative syringing test. These factors should be considered by surgeons planning silicone tube intubation in patients with lacrimal drainage system stenosis.

External dacryocystorhinostomy for the treatment of epiphora in patients with patent but non-functioning lacrimal systems.

PubMed

Peter, Neena M; Pearson, Andrew R

2010-02-01

To assess the outcome of external dacryocystorhinostomies (DCRs) in patients with patent but non-functional lacrimal drainage systems and to identify any preoperative clinical or dacryocystography (DCG) and lacrimal scintigraphy (LS) factors associated with successful surgery. A retrospective study of 46 DCRs with silicone intubation performed for patients with epiphora associated with a clinically patent lacrimal drainage system. All patients underwent preoperative DCG and LS which were evaluated for presence, site and severity of delayed clearance. DCGs were also evaluated for reflux and anatomical abnormalities. Postoperative success was determined by subjective resolution of epiphora. Patients with persistent symptoms were offered Lester Jones Tube (LJT) insertion after establishment of a patent anastomosis to syringing and normal ostium on nasal endoscopy. Statistical analysis was performed using the chi2 and Fisher exact tests to determine whether there was any association between surgical outcome and preoperative resistance to lacrimal syringing, DCG and LS findings. 29 cases (63%) reported subjective surgical success after 11 months' average follow-up. There was a statistically significant association between increased resistance to syringing preoperatively and successful DCR (p=0.012). Of the 17 eyes that failed, all had patent anastomoses, and seven went on to have LJT insertion with complete resolution of symptoms. The majority of patients with patent but non-functional lacrimal drainage systems will be helped by DCR surgery, with greater success rates in those with significant reflux on preoperative syringing. For patients with residual epiphora, functional success can reach 100% with subsequent LJT insertion.

Normative dimensions and symmetry of the lacrimal drainage system on dacryocystography: statistical analysis of morphometric characteristics.

PubMed

Horsburgh, A; Massoud, T F

2013-05-01

Asymmetric lacrimal flow occurs in females more than males. We hypothesised that the normal lacrimal drainage system (LDS) may show subtle left-right asymmetry in morphometry when imaged on dacryocystography (DCG). We retrospectively reviewed 60 normal bilateral LDSs.Images were analysed for 7 parameters: (1) combined length of either the superior or inferior canaliculus plus common canaliculus, (2) angle of insertion of common canaliculus into lacrimal sac (LS), (3, 4) length and width of the LS, (5) length of the naso lacrimal duct (NLD), and (6, 7) width of proximal and distal NLD. We tested the effect of independent variables (age, gender, and side) on each dependent variable (length, width, or angle) using regression analysis. We used a Studentt-test for independent samples to statistically compare bilateral LDSs. Patient median age was 62 years, and male:female ratio was 27:73. Mean dimensions and angles for all LDSs were: (1) 14.5 mm, (2) 57°,(3) 11.6 mm, (4) 2.1 mm, (5) 20.7 mm, (6) 1.4 mm, and (7) 1.8 mm. No independent variable affected variation in length, width, or angle. No significant difference emerged between dimensions of right and left LDSs in both sexes. A degree of affective lateralisation in the brain is known to result in lacrimal flow asymmetry after mood manipulation. We show that this is not reflected in LDS anatomy. Moreover, our detailed morphometric data can aid in therapeutic planning of LDS luminal procedures, especially when DCG images of one LDS are used as a road map for contralateral interventions.

The value of hemodynamic measurements by air plethysmography in diagnosing venous obstruction of the lower limb.

PubMed

Kurstjens, Ralph L M; de Wolf, Mark A F; Alsadah, Sarah A; Arnoldussen, Carsten W K P; Strijkers, Rob H W; Toonder, Irwin M; Wittens, Cees H A

2016-07-01

Air plethysmography (APG) is a functional, noninvasive test that can assess volumetric changes in the lower limb and might therefore be used as a diagnostic tool in chronic deep venous disease. However, use of APG in chronic deep venous obstructive disease remains debatable. This study assessed the clinical value of APG in identifying chronic deep venous obstruction. All patients referred to our tertiary, outpatient clinic between January 2011 and August 2013 with chronic venous complaints and suspected outflow obstruction underwent an outflow fraction (OF), ejection fraction (EF), and residual volume fraction (RVF) test using APG. Duplex ultrasound and magnetic resonance venography were used to establish whether and where obstruction was present. Diagnostic values of these tests were assessed for obstructions at different levels of the deep venous system. A total of 312 limbs in 248 patients were tested. Mean age was 45.5 ± 14.0 years, and 62.5% were female. In post-thrombotic disease, specificity and positive predictive value for OF were as high as 98.4% and 95.0%, respectively; however, sensitivity was 34.8% and negative predictive value was 29.6%, with no clinically relevant positive or negative likelihood ratios. No clinically relevant differences were observed in stratifying for level of obstruction. EF and RVF were as inconclusive. Neither could these parameters be used in diagnosing nonthrombotic iliac vein compression. We found a poor correlation between OF, EF, or RVF, determined by APG, and the presence of chronic deep venous obstruction. Therefore, use of its relative parameters is unwarranted in daily clinical practice. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Clinicomanometric factors associated with clinically relevant esophagogastric junction outflow obstruction from the Sandhill high-resolution manometry system.

PubMed

Song, B G; Min, Y W; Lee, H; Min, B-H; Lee, J H; Rhee, P-L; Kim, J J

2018-03-01

Integrated relaxation pressure (IRP) is a key metric for diagnosing esophagogastric junction outflow obstruction (EGJOO). However, its normal value might be different according to the manufacturer of high-resolution manometry (HRM). This study aimed to investigate optimal value of IRP for diagnosing EGJOO in Sandhill HRM and to find clinicomanometric variables to segregate clinically relevant EGJOO. We analyzed 262 consecutive subjects who underwent HRM between June 2011 and December 2016 showing elevated median IRP (> 15 mm Hg) but did not satisfy criteria for achalasia. Clinically relevant subjects were defined as follows: (i) subsequent HRM met achalasia criteria during follow-up (early achalasia); (ii) Eckardt score was decreased at least two points without exceeding a score of 3 after pneumatic dilatation (variant achalasia); and (iii) significant passage disturbance on esophagogram without structural abnormality (possible achalasia). Seven subjects were clinically relevant, including two subjects with early achalasia, four subjects with variant achalasia, and one subject with possible achalasia. All clinically relevant subjects had IRP 20 mm Hg or above. Among subjects (n = 122) with IRP 20 mm Hg or more, clinically relevant group (n = 7) had significantly higher rate of dysphagia (100% vs 24.3%, P < .001) and compartmentalized pressurization (85.7% vs 21.7%, P = .001) compared to clinically non-relevant group (n = 115). Our results suggest that IRP of 20 mm Hg or higher could segregate clinically relevant subjects showing EGJOO in Sandhill HRM. Additionally, if subjects have both dysphagia and compartmentalized pressurization, careful follow-up is essential. © 2017 John Wiley & Sons Ltd.

Primary lymphocytic lymphoma of lacrimal gland.

PubMed

Romero-Caballero, M D; Lozano-García, I; Gómez-Molina, C; Gil-Liñán, A I; Arcas, I

2017-02-01

We report a case of primary small-cell lymphocytic lacrimal gland lymphoma in a male diagnosed with primary antiphospholipid syndrome. These rare lymphomas are usually presented in the clinic as disseminations secondary to chronic lymphocytic leukaemia, and the primary site is rare in the orbit. Non-Hodgkin lymphomas are a heterogeneous group of tumours. Although treatment in the IE stage is usually radiotherapy, due to its association with antiphospholipid syndrome, systemic treatment with rituximab was administered. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Hemodynamic changes in systolic and diastolic function during isoproterenol challenge predicts symptomatic response to myectomy in hypertrophic cardiomyopathy with labile obstruction.

PubMed

Prasad, Megha; Geske, Jeffrey B; Sorajja, Paul; Ommen, Steve R; Schaff, Hartzell V; Gersh, Bernard J; Nishimura, Rick A

2016-11-15

We aimed to assess the utility of changes in systolic and diastolic function by isoproterenol challenge in predicting symptom resolution post-myectomy in selected patients with hypertrophic cardiomyopathy (HCM) and labile obstruction. In a subset of symptomatic HCM patients without resting/provocable obstruction on noninvasive assessment, isoproterenol challenge during hemodynamic catheterization may elicit labile left ventricular outflow tract (LVOT) obstruction, and demonstrate the effect of obstruction on diastolic function. These changes may determine whether patients achieve complete symptom resolution post-myectomy. Between February 2003 and April 2009, 18 symptomatic HCM patients without LVOT obstruction on noninvasive testing underwent isoproterenol provocation and septal myectomy due to presence of provocable gradient and were followed for 4 (IQR 3-7) years. Thirteen (72.2%) had complete symptom resolution, while 5 (27.8%) had improved, but persistent symptoms. Those with provoked gradient >100 mm Hg or increase in left atrial pressure (LAP) with isoproterenol had symptom resolution. Symptomatic HCM patients without LVOT gradient on noninvasive testing may demonstrate labile obstruction with isoproterenol. With isoproterenol, patients with high LVOT gradient or increase in LAP concomitant with an increase in gradient achieved complete symptom resolution post-myectomy. Thus, improved diastolic filling as well as outflow gradient production in patients with HCM may predict symptom response to myectomy. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Mechanisms Involved in Injury and Repair of the Murine Lacrimal Gland: Role of Programmed Cell Death and Mesenchymal Stem Cells

PubMed Central

Zoukhri, Driss

2011-01-01

The non-keratinized epithelia of the ocular surface are constantly challenged by environmental insults, such as smoke, dust, and airborne pathogens. Tears are the sole physical protective barrier for the ocular surface. Production of tears in inadequate quantity or of inadequate quality results in constant irritation of the ocular surface, leading to dry eye disease, also referred to as keratoconjunctivitis sicca (KCS). Inflammation of the lacrimal gland, such as occurs in Sjögren’s syndrome, sarcoidosis, chronic graft versus-host disease, and other pathological conditions, results in inadequate secretion of the aqueous layer of the tear film, and is a leading cause of dry eye disease. The hallmarks of lacrimal gland inflammation are the presence of immune cell infiltrates, loss of acinar epithelial cells (the secreting cells), and increased production of proinflammatory cytokines. To date, the mechanisms leading to acinar cell loss and the associated decline in lacrimal gland secretion are still poorly understood. It is also not understood why the remaining lacrimal gland cells are unable to proliferate in order to regenerate a functioning lacrimal gland. This article reviews recent advances in exocrine tissue injury and repair, with emphasis on the roles of programmed cell death and stem/progenitor cells. PMID:20427009

Cardiobacterium hominis-induced acute dacryocystitis and lacrimal abscess

PubMed Central

Manderwad, Guru Prasad; Kodiganti, Manjulatha; Ali, Mohammad Javed

2014-01-01

Cardiobacterium hominis is a member of the HACEK (Haemophilus sp., Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens, and Kingella kingae) group commonly associated with endocarditits and is normally present in the respiratory tract. We describe the first case of acute dacryocystitis with lacrimal abscess caused by C. hominis along with a brief review of the literature. The patient responded to oral and topical ciprofloxacin after incision and drainage and awaits dacryocystorhinostomy. PMID:24008805

Impact of left ventricular outflow tract area on systolic outflow velocity in hypertrophic cardiomyopathy: a real-time three-dimensional echocardiographic study

NASA Technical Reports Server (NTRS)

Qin, Jian Xin; Shiota, Takahiro; Lever, Harry M.; Rubin, David N.; Bauer, Fabrice; Kim, Yong Jin; Sitges, Marta; Greenberg, Neil L.; Drinko, Jeanne K.; Martin, Maureen;

Production and localization of Muc4/sialomucin complex and its receptor tyrosine kinase ErbB2 in the rat lacrimal gland.

PubMed

Arango, M E; Li, P; Komatsu, M; Montes, C; Carraway, C A; Carraway, K L

2001-11-01

To show the presence and forms of sialomucin complex (rat Muc4) and receptor tyrosine kinase ErbBs in the rat lacrimal gland and analyze for complexes of ErbB2 and its ligand Muc4. Northern blot analyses were used to identify sialomucin complex/Muc4 (SMC/Muc4) mRNA in rat lacrimal gland. Immunoblot analyses were performed to detect SMC/Muc4 and ErbBs. Sequential immunoprecipitation and immunoblot analyses were used to differentiate membrane and soluble forms of the SMC/Muc4 transmembrane subunit ASGP-2. Methacarn-fixed, paraffin-embedded sections of lacrimal glands from female adult rats were immunocytochemically stained using antisera to SMC/Muc4 and ErbBs to determine their relative locations in the gland. Colocalization of SMC/Muc4 and ErbB2 was confirmed by confocal immunofluorescence. Sequential immunoprecipitation and immunoblot were performed to analyze complexes of the SMC/Muc4 and ErbB2 in the lacrimal tissue. Northern blot analyses of rat lacrimal glands, with a probe for SMC/Muc4, demonstrated the presence of a approximately 9-kb transcript, consistent with observations in other tissues. Similarly, immunoblot analyses with antibodies against both the transmembrane (ASGP-2) and mucin (ASGP-1) subunits showed the presence of the two SMC/Muc4 subunits in lysates from rat lacrimal gland. Significantly, two different forms of ASGP-2 were observed, a high-molecular-weight ( approximately 200-kDa) form and the more common 120- to 140-kDa form. Sequential immunoprecipitation and immunoblot analyses to differentiate membrane and soluble forms of SMC/Muc4 indicated that the high-molecular-weight form of ASGP-2 was predominantly associated with membranes, whereas the 120- to 140-kDa form was both membrane-associated and soluble. The lacrimal gland consists of acini connected by intercalated and interlobular ducts. Both acini and some intercalated ducts were stained by anti-ASGP-2 monoclonal antisera. Two patterns of acinar staining were observed: membrane staining

Massive Outflows Associated with ATLASGAL Clumps

NASA Astrophysics Data System (ADS)

Yang, A. Y.; Thompson, M. A.; Urquhart, J. S.; Tian, W. W.

2018-03-01

We have undertaken the largest survey for outflows within the Galactic plane using simultaneously observed {}13{CO} and {{{C}}}18{{O}} data. Out of a total of 919 ATLASGAL clumps, 325 have data suitable to identify outflows, and 225 (69% ± 3%) show high-velocity outflows. The clumps with detected outflows show significantly higher clump masses ({M}clump}), bolometric luminosities ({L}bol}), luminosity-to-mass ratios ({L}bol}/{M}clump}), and peak H2 column densities ({N}{{{H}}2}) compared to those without outflows. Outflow activity has been detected within the youngest quiescent clump (i.e., 70 μ {{m}} weak) in this sample, and we find that the outflow detection rate increases with {M}clump}, {L}bol}, {L}bol}/{M}clump}, and {N}{{{H}}2}, approaching 90% in some cases (UC H II regions = 93% ± 3%; masers = 86% ± 4%; HC H II regions = 100%). This high detection rate suggests that outflows are ubiquitous phenomena of massive star formation (MSF). The mean outflow mass entrainment rate implies a mean accretion rate of ∼ {10}-4 {M}ȯ {yr}}-1, in full agreement with the accretion rate predicted by theoretical models of MSF. Outflow properties are tightly correlated with {M}clump}, {L}bol}, and {L}bol}/{M}clump} and show the strongest relation with the bolometric clump luminosity. This suggests that outflows might be driven by the most massive and luminous source within the clump. The correlations are similar for both low-mass and high-mass outflows over 7 orders of magnitude, indicating that they may share a similar outflow mechanism. Outflow energy is comparable to the turbulent energy within the clump; however, we find no evidence that outflows increase the level of clump turbulence as the clumps evolve. This implies that the origin of turbulence within clumps is fixed before the onset of star formation.

[Comparative ultrastructural study of parotid gland, lacrimal gland and pituitary gland between miniature pig and mouse].

PubMed

Yan, Xing; Hai, Bo; Sun, Yi-lin; Zhang, Chun-mei; Wang, Song-ling

2009-02-01

To study the ultrastructure of parotid glands, lacrimal glands and pituitary glands between miniature pig and mouse. Five adult miniature pigs and 5 mice were studied. Ultrastructure of their parotid glands, lacrimal glands, and pituitary glands was observed. The secretary granules in acinar cell of miniature pig parotid glands showed higher density and more aequalis than those of mice. The cell apparatus in acinar cell of mouse parotid glands were more plentiful than those of miniature pigs. The secretary granules on blood vessel wall were richer in parotid gland of miniature pigs compared with mouse parotid gland. Lacrimal gland had the similar ultrastructure to parotid gland in these two animals. Many blood vessel antrum were found in pituitary glands of these two animals. Compared with mouse parotid glands, there are more secretary granules in acinar cells and vascular endothelial cells in miniature pig parotid glands, which might enter blood stream and have function of endocrine secretion.

A Case of Recurrent Schneiderian Papilloma of the Lacrimal Sac Invading the Nasal Cavity

PubMed Central

Jang, Ji Hye; Choe, Mi Sun

2009-01-01

A 44-year-old man presented with a history of chronic epiphora, discharge from the right eye, and a palpable mass in the medial canthal area. Irrigation of the lacrimal system revealed bloody discharge. Orbital magnetic resonance imaging (MRI) showed a well-defined heterogeneous enhanced mass filling the lacrimal sac and upper nasolacrimal duct (NLD). A wide excision and surgical biopsy were performed. Histopathology showed the tumor to be an exophytic Schneiderian papilloma with moderate to severe dysplasia. Three months later, the mass was found to be invading the nasal cavity through the NLD. Endoscopic histopathological evaluation confirmed that it was identical to the originally identified papilloma. PMID:19568358

Studying the outflow-core interaction with ALMA Cycle 1 observations of the HH 46/47 molecular outflow

NASA Astrophysics Data System (ADS)

Zhang, Yichen; Arce, Hector G.; Mardones, Diego; Dunham, Michael; Garay, Guido; Noriega-Crespo, Alberto; Corder, Stuartt; Offner, Stella; Cabrit, Sylvie

2016-01-01

We present ALMA Cycle 1 observations of the HH 46/47 molecular outflow which is driven by a low-mass Class 0/I protostar. Previous ALMA Cycle 0 12CO observation showed outflow cavities produced by the entrainment of ambient gas by the protostellar jet and wide-angle wind. Here we present analysis of observation of 12CO, 13CO, C18O and other species using combined 12m array and ACA observations. The improved angular resolution and sensitivity allow us to detect details of the outflow structure. Specially, we see that the outflow cavity wall is composed of two or more layers of outflowing gas, which separately connect to different shocked regions along the outflow axis inside the cavity, suggesting the outflow cavity wall is composed of multiple shells entrained by a series of jet bow-shock events. The new 13CO and C18O data also allow us to trace relatively denser and slower outflow material than that traced by the 12CO. These species are only detected within about 1 to 2 km/s from the cloud velocity, tracing the outflow to lower velocities than what is possible using only the 12CO emission. Interestingly, the cavity wall of the red lobe appears at very low outflow velocities (as low as ~0.2 km/s). In addition, 13CO and C18O allow us to correct for the CO optical depth, allowing us to obtain more accurate estimates of the outflow mass, momentum and kinetic energy. Applying the optical depth correction significantly increases the previous mass estimate by a factor of 14. The outflow kinetic energy distribution shows that even though the red lobe is mainly entrained by jet bow-shocks, most of the outflow energy is being deposited into the cloud at the base of the outflow cavity rather than around the heads of the bow shocks. The estimated total mass, momentum, and energy of the outflow indicate that the outflow has the ability to disperse the parent core. We found possible evidence for a slowly moving rotating outflow in CS. Our 13CO and C18O observations also trace a

Iodine-131 Therapy and Nasolacrimal Duct Obstructions: What We Know and What We Need to Know.

PubMed

Ali, Mohammad Javed

2016-01-01

The aims of the current review are to summarize the etiopathogenesis, symptomatology, management, complications, and outcomes of iodine-131-induced nasolacrimal duct obstructions, to propose a screening protocol and elucidate the potential avenues of future research. The authors performed an electronic database (PubMed, MEDLINE, EMBASE, and Cochrane Library) search of all articles published in English on nasolacrimal duct obstructions following radioiodine therapy. These articles were reviewed along with their relevant cross references. Data reviewed included demographics, presentations, investigations, management, complications, and outcomes. In addition, based on relevant unanswered questions and current lacunae in literature, potential avenues for further research have been elucidated. The frequency of nasolacrimal duct obstruction is reported to range from 2.2% to 18% following I-131 therapy. They are mostly bilateral and noted in patients who receive more than 150 mCi radioiodine. Exact etiopathogenesis is unknown but radiotoxicity to lacrimal sac and nasolacrimal duct is believed to be mediated through a sodium-iodine symporter protein. Although uncommon, it is important to increase awareness among treating physicians and patients receiving radioiodine therapy about the potential side effect of nasolacrimal duct obstruction. Imaging modalities are useful adjuncts in the diagnosis. Dacryocystorhinostomy is the most common modality of management with good outcomes. Nasolacrimal duct obstruction following radioiodine treatment is a distinct clinical entity. Increased awareness would facilitate timely diagnosis, management, and an enhanced quality of life for the patients.

Reliability of fluorescein dye disappearance test in assessment of adults with nasolacrimal duct obstruction.

PubMed

Kashkouli, Mohsen Bahmani; Mirzajani, Hoora; Jamshidian-Tehrani, Mansooreh; Pakdel, Farzad; Nojomi, Marzieh; Aghaei, Gholam-Hossein

2013-01-01

To evaluate the role of fluorescein dye disappearance test (FDDT) in assessment of adults with primary acquired nasolacrimal duct obstruction (PANDO) and its correlation with age and severity of epiphora. In a prospective, cross-sectional comparative study, FDDT at 2 (2-FDDT), 5 (5-FDDT), and 10 (10-FDDT) minutes were performed in 58 eyes of 58 patients with PANDO (case) and 58 eyes of 58 subjects without epiphora (control) between 2008 and 2010. Exclusion criteria were any disease, trauma, or medications that might have an effect on tear drainage system. Patients with functional or incomplete obstruction and upper lacrimal drainage system obstruction were excluded in the case group. FDDT and severity of epiphora were graded. Case and control groups were matched. 2-FDDT showed a sensitivity of 82.8%, specificity of 91.4%, positive predictive value of 90.6%, and negative predictive value of 84.1%. Sensitivity and negative predictive value decreased to 71.1% and 78.6% in 5-FDDT. 5-FDDT specificity and positive predictive value, however, increased to 94.8% and 93.5%, respectively. There was no statistically significant correlation between severity of epiphora and age with FDDT. FDDT is a simple, reliable, and highly specific test in assessment of adults with PANDO.

Microbiology and Biofilm Trends of Silicone Lacrimal Implants: Comparing Infected Versus Routinely Removed Stents.

PubMed

Samimi, David B; Ediriwickrema, Lilangi S; Bielory, Brett P; Miller, Darlene; Lee, Wendy; Johnson, Thomas E

To investigate the pathogens and biofilms responsible for clinically significant infection of silicone stents implanted within the lacrimal system. Retrospective review of culture results and patient demographics for all silicone lacrimal stents removed early for clinically significant infection and sent to the Bascom Palmer Microbiology Laboratory through the end of year 2010. As a control, routinely removed, clinically noninfected stents from the same institution were prospectively sent for culture over a 6-month period. Four clinically infected and 6 clinically noninfected stents showing mucus within the lumen at removal were sent for scanning electron microscopy. Images were randomized and graded by a microbiologist for the presence of organisms, matrix deposits, organisms within matrix, and overall impression of significant biofilm formation. Nineteen stents were included in the study; 100% of clinically infected (n = 10) and noninfected (n = 9) stents were culture positive. Culture positivity for nontuberculous mycobacterium was found in 90% of infected stents and none of the noninfected stents (p < 0.001). Of infected stents, 50% grew Gram-positive organisms compared with 89% of noninfected stents (p = 0.07). Fifty percent of infected versus 67% of noninfected stents were culture positive for Gram-negative organisms (p = 0.46). Electron microscopy of stents revealed organisms consistent with culture results (size, shape) in planktonic and biofilm form. Masked observer image grading revealed a statistically significant higher amount of organism and biofilm on infected versus noninfected specimen. Nontuberculous mycobacteria comprise the primary pathogens responsible for clinically significant infection of silicone stents in the lacrimal system in South Florida. Robust biofilm production by this organism likely plays a role in pathogenesis. Further research into biofilm-related lacrimal implant infection may aid in the development of useful prevention and

Transitional neoplasms of the naso-lacrimal system: A review of the histopathology and histogenesis☆

PubMed Central

Heathcote, J. Godfrey

2012-01-01

Transitional papilloma (inverted papilloma, Schneiderian papilloma) is a relatively common, benign epithelial neoplasm of the sinonasal tract that also occurs in the lacrimal drainage system. The name transitional papilloma is recommended because it reflects the key histological features required for pathological diagnosis, as well as the histogenesis of the tumour. The histogenesis of the tumour is reviewed, together with its natural history, which is characterized by bone remodelling and destruction, a tendency to recur and to undergo malignant transformation. Biomarkers associated with these features have been identified in the sinonasal tumours and may also be of relevance to the lacrimal sac tumours, although the necessary studies have not yet been undertaken. PMID:23960982

Central Connections of the Lacrimal Functional Unit.

PubMed

Willshire, Catherine; Buckley, Roger J; Bron, Anthony J

2017-08-01

To study the contribution of each eye to the reflex tear response, after unilateral and bilateral topical anesthesia. A closed-eye, modified Schirmer test was performed bilaterally in 8 normal subjects, in a controlled environment chamber set to 23°C, 45% relative humidity, and 0.08 m/s airflow. Eye drops were instilled into each eye 10 minutes before the Schirmer test. Experiments were as follows: 1) bilateral saline (control), 2) unilateral anesthesia (ipsilateral anesthetic; contralateral saline), and 3) bilateral anesthesia. There was no difference in between-eye wetting lengths in the saline control eyes (P = 0.394) or the bilaterally anesthetized eyes (P = 0.171). The wetting length was reduced in both eyes after bilateral anesthesia compared with saline controls (P = 0.001; P ≤ 0.0005). After unilateral anesthesia, the wetting length was reduced in the anesthetized eye compared with its saline control by 51.4% (P ≤ 0.0005) and compared with its fellow, unanesthetized eye (P = 0.005). The fellow eye value was also reduced compared with its saline control (P = 0.06). The wetting length was reduced by topical anesthesia, when instilled bilaterally and ipsilaterally. The latter response implies an ipsilateral, reflex sensory drive to lacrimal secretion. In the unanesthetized fellow eye, the reduction compared with its saline control was not quite significant. This implies a relative lack of central, sensory, reflex cross-innervation, although the possibility cannot entirely be ruled out. These results are relevant to the possibility of reflex lacrimal compensation from a normal fellow eye, in cases of unilateral corneal anesthesia.

MUC19 expression in human ocular surface and lacrimal gland and its alteration in Sjögren syndrome patients.

PubMed

Yu, D F; Chen, Y; Han, J M; Zhang, H; Chen, X P; Zou, W J; Liang, L Y; Xu, C C; Liu, Z G

2008-02-01

This study investigated the expression of MUC19, a newly discovered gel-forming mucin gene, in normal human lacrimal functional unit components and its alteration in Sjögren syndrome patients. Real-time PCR and immunohistochemistry were performed to determine the expression of MUC19 and MUC5AC in human cornea, conjunctiva, and lacrimal gland tissues. Conjunctival impression cytology specimens were collected from normal control subjects and Sjögren syndrome patients for Real-time PCR, PAS staining, and immunohistochemistry assays. In addition, conjunctiva biopsy specimens from both groups were examined for the expression differences of MUC19 and MUC5AC at both mRNA and protein level. The MUC19 mRNA was found to be present in cornea, conjunctiva and lacrimal gland tissues. The immunohistochemical staining of mucins showed that MUC19 was expressed in epithelial cells from corneal, conjunctival, and lacrimal gland tissues. In contrast, MUC5AC mRNA was only present in conjunctiva and lacrimal gland tissues, but not in cornea. Immunostaining demonstrates the co-staining of MUC19 and MUC5AC in conjunctival goblet cells. Consistent with the significant decrease of mucous secretion, both MUC19 and MUC5AC were decreased in conjunctiva of Sjögren syndrome patients compared to normal subjects. Considering the contribution of gel-forming mucins to the homeostasis of the ocular surface, the decreased expression of MUC19 and MUC5AC in Sjögren syndrome patients suggested that these mucins may be involved in the disruption of the ocular surface homeostasis in this disease.

Altered Morphology and Function of the Lacrimal Functional Unit in Protein Kinase Cα Knockout Mice

PubMed Central

Chen, Zhuo; Li, Zhijie; Basti, Surendra; Farley, William J.

2010-01-01

Purpose. Protein kinase C (PKC) α plays a major role in the parasympathetic neural stimulation of lacrimal gland (LG) secretion. It also has been reported to have antiapoptotic properties and to promote cell survival. Therefore, the hypothesis for the present study was that PKCα knockout (−/−) mice have impaired ocular surface–lacrimal gland signaling, rendering them susceptible to desiccating stress and impaired corneal epithelial wound healing. In this study, the lacrimal function unit (LFU) and the stressed wound-healing response were examined in PKCα−/− mice. Methods. In PKCα+/+ control mice and PKCα−/− mice, tear production, osmolarity, and clearance rate were evaluated before and after experimental desiccating stress. Histology and immunofluorescent staining of PKC and epidermal growth factor were performed in tissues of the LFU. Cornified envelope (CE) precursor protein expression and cell proliferation were evaluated. The time course of healing and degree of neutrophil infiltration was evaluated after corneal epithelial wounding. Results. Compared with the PKCα+/+ mice, the PKCα−/− mice were noted to have significantly increased lacrimal gland weight, with enlarged, carbohydrate-rich, PAS-positive acinar cells; increased corneal epithelia permeability, with reduced CE expression; and larger conjunctival epithelial goblet cells. The PKCα−/− mice showed more rapid corneal epithelial healing, with less neutrophil infiltration and fewer proliferating cells than did the PKCα+/+ mice. Conclusions. The PKCα−/− mice showed lower tear production, which appeared to be caused by impaired secretion by the LG and conjunctival goblet cells. Despite their altered tear dynamics, the PKCα−/− mice demonstrated more rapid corneal epithelial wound healing, perhaps due to decreased neutrophil infiltration. PMID:20505191

GCDFP-15, AR, and Her-2 as biomarkers for primary ductal adenocarcinoma of the lacrimal gland: a Chinese case and literature review

PubMed Central

Zhu, Miao-Miao; Cui, Hong-Guang; Teng, Xiao-Dong

2015-01-01

Purpose Primary ductal adenocarcinoma (PDA) of the lacrimal gland is a rare malignant epithelial tumor, and its clinicopathological characteristics are still unclear. This study aimed to report a novel case of PDA of the lacrimal gland in the People’s Republic of China, as well as to determine its histopathological and immunohistochemical characteristics to support early diagnosis and direct further therapy. Patient and methods Clinical data (including ocular examination, computed tomography, magnetic resonance imaging, positron emission tomography, mammography, and serum tumor marker examination) and treatment of a 49-year-old woman with a left lacrimal gland mass, which was diagnosed as PDA of the lacrimal gland, were reported. Histopathological and immunohistochemical studies were performed. Eleven papers regarding this uncommon neoplasm were reviewed. Results Histopathologically, most of the tumor cells featured abundant granular eosinophilic cytoplasm, while few of them had a frothy appearance. The mass showed breast ductal carcinoma-like structural features, which most commonly demonstrated central necrosis, while less of these features showed cord-like infiltration. Immunohistochemically, the tumor cells were positive for GCDFP-15, CK 18 (++), AR (90%), Her-2 (+++), P53 (100%), and Ki-67 (with a proliferation index approximately 60%), while they were negative for ER, PR, P63, calponin, and CD 117. Conclusion This was the first Chinese case of PDA of the lacrimal gland that had been reported. We suggested that GCDFP-15, AR, and Her-2 should be tested as biomarkers for ductal adenocarcinoma of lacrimal gland to confirm diagnosis, guide therapy, and further predict prognosis. PMID:25999735

A rare case of atypical pleomorphic adenoma arising from periocular ectopic lacrimal gland.

PubMed

Wajda, Brynn N; Mancini, Ronald; Evers, Bret; Nick Hogan, R

2018-06-23

To describe features of atypical pleomorphic adenoma, a rare clinical entity, particularly when found in ectopic periocular lacrimal gland tissue. Case report of biopsy-confirmed periocular atypical pleomorphic adenoma. A 35-year-old female presented with a unique orbital lesion found to be ectopic lacrimal gland demonstrating atypical pleomorphic adenoma on formal histopathologic review. Pleomorphic adenoma is pathologically characterized as an epithelial lesion intermixed with mesenchymal elements. It is further classified as atypical with the presence of features such as hypercellularity, regions of necrosis or hyalinization, cellular dysplasia, capsular violation, and malignant characteristics without frank local extension or distant metastases. Due to its rarity, the natural history and prognosis of atypical pleomorphic adenoma is unclear. Physicians need to recognize this entity, and complete surgical excision with strict follow-up regimens are likely warranted.

Effect of rebamipide ophthalmic suspension on the success of lacrimal stent intubation.

PubMed

Mimura, Masashi; Ueki, Mari; Oku, Hidehiro; Sato, Bunpei; Ikeda, Tsunehiko

2016-02-01

To evaluate the effect of the postoperative administration of rebamipide ophthalmic suspension on the success rate of lacrimal stent intubation (LSI) for the treatment of primary acquired nasolacrimal duct obstruction (PANDO). This comparative interventional cohort study investigated 110 consecutive patients with PANDO who were treated with LSI and followed up for 12 months postoperatively at one institution. LSI was performed by one surgeon, and all patients received identical postoperative care. Among the total 110 patients, 71 underwent LSI with postoperative administration of rebamipide ophthalmic suspension, and 39 underwent LSI without administration of the suspension. Data related to patient age, gender, laterality, and postoperative administration of rebamipide ophthalmic suspension were collected and used as independent variables, and logistic regression analyses were performed to compare the anatomical success rate at 12 months postoperatively between patients with and without postoperative administration of the suspension. The anatomical success rate of LSI in patients with and without postoperative administration of rebamipide ophthalmic suspension was 90.1 and 69.2 %, respectively. A comparison of these success rates showed statistical significance, in that the rate of treatment success was higher in PANDO patients who underwent LSI with postoperative administration of the suspension [odds ratio (OR), 3.37; P < 0.05]. The findings of this study show that postoperative administration of rebamipide ophthalmic suspension increases the rate of anatomical success in patients who undergo LSI for the treatment of PANDO.

Numerical Study on Outflows in Seyfert Galaxies I: Narrow Line Region Outflows in NGC 4151

NASA Astrophysics Data System (ADS)

Mou, Guobin; Wang, Tinggui; Yang, Chenwei

2017-07-01

The origin of narrow line region (NLR) outflows remains unknown. In this paper, we explore the scenario in which these outflows are circumnuclear clouds driven by energetic accretion disk winds. We choose the well-studied nearby Seyfert galaxy NGC 4151 as an example. By performing 3D hydrodynamical simulations, we are able to reproduce the radial distributions of velocity, mass outflow rate, and kinetic luminosity of NLR outflows in the inner 100 pc deduced from spatial resolved spectroscopic observations. The demanded kinetic luminosity of disk winds is about two orders of magnitude higher than that inferred from the NLR outflows, but is close to the ultrafast outflows (UFO) detected in the X-ray spectrum and a few times lower than the bolometric luminosity of the Seyfert. Our simulations imply that the scenario is viable for NGC 4151. The existence of the underlying disk winds can be confirmed by their impacts on higher density ISM, e.g., shock excitation signs, and the pressure in NLR.

Altered morphology and function of the lacrimal functional unit in protein kinase C{alpha} knockout mice.

PubMed

Chen, Zhuo; Li, Zhijie; Basti, Surendra; Farley, William J; Pflugfelder, Stephen C

2010-11-01

Protein kinase C (PKC) α plays a major role in the parasympathetic neural stimulation of lacrimal gland (LG) secretion. It also has been reported to have antiapoptotic properties and to promote cell survival. Therefore, the hypothesis for the present study was that PKCα knockout ((-/-)) mice have impaired ocular surface-lacrimal gland signaling, rendering them susceptible to desiccating stress and impaired corneal epithelial wound healing. In this study, the lacrimal function unit (LFU) and the stressed wound-healing response were examined in PKCα(-/-) mice. In PKCα(+/+) control mice and PKCα(-/-) mice, tear production, osmolarity, and clearance rate were evaluated before and after experimental desiccating stress. Histology and immunofluorescent staining of PKC and epidermal growth factor were performed in tissues of the LFU. Cornified envelope (CE) precursor protein expression and cell proliferation were evaluated. The time course of healing and degree of neutrophil infiltration was evaluated after corneal epithelial wounding. Compared with the PKCα(+/+) mice, the PKCα(-/-) mice were noted to have significantly increased lacrimal gland weight, with enlarged, carbohydrate-rich, PAS-positive acinar cells; increased corneal epithelia permeability, with reduced CE expression; and larger conjunctival epithelial goblet cells. The PKCα(-/-) mice showed more rapid corneal epithelial healing, with less neutrophil infiltration and fewer proliferating cells than did the PKCα(+/+) mice. The PKCα(-/-) mice showed lower tear production, which appeared to be caused by impaired secretion by the LG and conjunctival goblet cells. Despite their altered tear dynamics, the PKCα(-/-) mice demonstrated more rapid corneal epithelial wound healing, perhaps due to decreased neutrophil infiltration.

Colocalization of Outflow Segmentation and Pores Along the Inner Wall of Schlemm’s Canal

PubMed Central

Braakman, Sietse T.; Read, A. Thomas; Chan, Darren W.-H.; Ethier, C. Ross; Overby, Darryl R.

2014-01-01

B-pores (p < 0.0015 and p < 10−4) but not I-pores (p > 0.38). These data suggest that aqueous humor passes through micron-sized pores in the inner wall endothelium of SC. Paracellular B-pores appear to have a dominant contribution towards transendothelial filtration across the inner wall relative to transcellular I-pores. Impaired pore formation, as previously described in glaucomatous SC cells, may thereby contribute to greater outflow heterogeneity, outflow obstruction, and IOP elevation in glaucoma. PMID:25450060

Endoscopic laser recanalisation of presaccal canalicular obstruction

PubMed Central

Kuchar, A.; Novak, P.; Pieh, S.; Fink, M.; Steinkogler, F. J.

1999-01-01

AIM—To document the results of erbium (Er)-YAG laser treatment in presaccal canalicular obstruction in combination with the use of a flexible endoscope.
METHODS—For the first time an Er-YAG laser (Schwind, Sklerostom) was attached to a flexible endoscope (Schwind, Endognost) and used to recanalise a stenosis of the upper, lower, or common canaliculus. In 17 patients (mean age 41.5 (SD 11.9) years), 19 treatments (two bilateral) were performed. In all cases the scar was observed using the endoscope and was excised by laser ablation. A silicone intubation was performed in all cases. In addition to the endoscopy an irrigation was performed to prove the intactness of the lacrimal pathway system after laser treatment.
RESULTS—Membranous obstructions with a maximum length of 2.0 mm (14 procedures) in the canaliculus were opened easily using the laser, and the silicone intubation was subsequently performed without difficulty. Scars thicker than 2.0 mm could not be opened safely without canaliculus penetration (five procedures). Irrigation was positive in all cases up to the end of a 6 month period, providing the tubes remained in place. The maximum follow up is now 17 months (minimum 8 months) and in 16 cases (84.2%) the canaliculi are still intact.
CONCLUSION—Endoscopic laser treatment combined with silicone intubation enables us to recanalise presaccal stenoses of canaliculi under local anaesthesia up to a scar thickness of 2.0 mm. Best results can be achieved in cases where much tissue can be saved. Under such conditions this procedure can substitute for more invasive surgical techniques, especially a conjunctivo-dacryocystorhinostomy (CDCR).

 Keywords: laser recanalisation; presaccal canalicular obstruction; endoscopy PMID:10434867

Hepatic venous outflow obstruction after living donor liver transplantation managed with ectopic placement of a foley catheter: A case report

PubMed Central

Wahab, Mohamed Abdel; Shehta, Ahmed; Hamed, Hosam; Elshobary, Mohamed; Salah, Tarek; Sultan, Ahmed Mohamed; Fathy, Omar; Elghawalby, Ahmed; Yassen, Amr; Shiha, Usama

2015-01-01

Introduction The early hepatic venous outflow obstruction (HVOO) is a rare but serious complication after liver transplantation, which may result in graft loss. We report a case of early HVOO after living donor liver transplantation, which was managed by ectopic placement of foley catheter. Presentation A 51 years old male patient with end stage liver disease received a right hemi-liver graft. On the first postoperative day the patient developed impairment of the liver functions. Doppler ultrasound (US) showed absence of blood flow in the right hepatic vein without thrombosis. The decision was to re-explore the patient, which showed torsion of the graft upward and to the right side causing HVOO. This was managed by ectopic placement of a foley catheter between the graft and the diaphragm and the chest wall. Gradual deflation of the catheter was gradually done guided by Doppler US and the patient was discharged without complications. Discussion Mechanical HVOO results from kinking or twisting of the venous anastomosis due to anatomical mismatch between the graft and the recipient abdomen. It should be managed surgically by repositioning of the graft or redo of venous anastomosis. Several ideas had been suggested for repositioning and fixation of the graft by the use of Sengstaken–Blakemore tubes, tissue expanders, and surgical glove expander. Conclusion We report the use of foley catheter to temporary fix the graft and correct the HVOO. It is a simple and safe way, and could be easily monitored and removed under Doppler US without any complications. PMID:25805611

High left ventricular outflow tract gradient: Aortic stenosis, obstructive hypertrophic cardiomyopathy or both?

PubMed

Almeida, Inês; Caetano, Francisca; Trigo, Joana; Mota, Paula; Marques, António Leitão

2015-05-01

The authors report the case of a patient diagnosed with both hypertrophic cardiomyopathy and aortic stenosis. Due to clinical deterioration, additional investigation was performed, and a high left ventricular outflow tract gradient was identified. Correct identification of the condition causing the symptoms was challenging, and involved several imaging techniques, the contribution of transesophageal echocardiography being crucial. The final diagnosis of severe aortic stenosis led to successful valve replacement surgery. The presence of these two conditions in the same patient has been documented, although it is uncommon. This association poses particular diagnostic and therapeutic challenges, which are discussed in this paper. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Primary lacrimal canaliculitis - A clinical entity often misdiagnosed.

PubMed

Singh, Manpreet; Gautam, Natasha; Agarwal, Aniruddha; Kaur, Manpreet

2018-03-01

Primary lacrimal canaliculitis (PLC) is a unique disorder which often gets misdiagnosed by the general as well as speciality-trained ophthalmologists. Elderly patients with history of chronic or recurrent epiphora with discharge, often get mislead towards chronic dacryocystitis. The aim of our report is to discuss the misleading diseases in our PLC patients and to revisit this hidden disease. The patients of PLC who were previously misdiagnosed were studied. The clinical history, presenting clinical features, misdiagnosis, and final management of the patients is described. There were 5 misdiagnosed female patients. A history of chronic redness, watering, discharge, and medial canthal region edema lead to the misdiagnosis of chronic dacryocystitis in 3 (60%) and medial marginal chalazion in 2 (40%) cases. Slit-lamp examination revealed localized hyperemia (n = 5), classical pouting of lacrimal punctum (n = 3), and expressible purulent discharge (n = 3). Two patients without punctum pouting had an explicit yellowish hue/discoloration of the canalicular region. Our patients had a mean 4 visits before an accurate diagnosis. Three-snip punctoplasty with canalicular curettage was performed in three while two were managed conservatively. At last follow-up, all patients were symptom-free with punctum and canalicular scarring in three, who underwent surgery. PLC is a frequently misdiagnosed clinical entity which delays the initiation of appropriate treatment. A succinct magnified examination of punctum and canalicular region can provide sufficient clues pivotal for accurate diagnosis.

Directly Driven Ion Outflow

NASA Technical Reports Server (NTRS)

Elliott, H. A.; Comfort, R. H.; Craven, P. D.; Moore, T. E.; Russell, C. T.; Rose, M. Franklin (Technical Monitor)

2001-01-01

We examine ionospheric outflows in the high altitude magnetospheric polar cap during the POLAR satellite's apogee on April 19, 1996 using the Thermal Ion Dynamics Experiment (TIDE) instrument. The elevated levels of O(+) observed in this pass may be due to the geophysical conditions during and prior to the apogee pass. In addition to the high abundance of O(+) relative to H(+), several other aspects of this data are noteworthy. We observe relationships between the density, velocity, and temperature which appear to be associated with perpendicular heating and the mirror force, rather than adiabatic expansion. The H(+) outflow is at a fairly constant flux which is consistent with being source limited by charge exchange at lower altitudes. Local centrifugal acceleration in the polar cap is found to be insufficient to account for the main variations we observe in the outflow velocity. The solar wind speed is high during this pass approximately 700 kilometers per second, and there are Alfve'n waves present in the solar wind such that the solar wind speed and IMF Bx are correlated. In this pass both the H(+) and O(+) outflow velocities correlate with both the solar wind speed and IMF fluctuations. Polar cap magnetometer and Hydra electron data show the same long period wave structure as found in the solar wind and polar cap ion outflow. In addition, the polar cap Poynting flux along the magnetic field direction correlates well with the H(+) temperature (R=0.84). We conclude that the solar wind can drive polar cap ion outflow particularly during polar squalls by setting up a parallel drop that is tens of eV which then causes the ion outflow velocity of O(+) and H(+), the electrons, and magnetic perturbations to vary in a similar fashion.

Unconventional Aqueous Humor Outflow: A Review

PubMed Central

Johnson, Mark; McLaren, Jay W.; Overby, Darryl R.

2016-01-01

Aqueous humor flows out of the eye primarily through the conventional outflow pathway that includes the trabecular meshwork and Schlemm's canal. However, a fraction of aqueous humor passes through an alternative or ‘unconventional’ route that includes the ciliary muscle, supraciliary and suprachoroidal spaces. From there, unconventional outflow may drain through two pathways: a uveoscleral pathway where aqueous drains across the sclera to be resorbed by orbital vessels, and a uveovortex pathway where aqueous humor enters the choroid to drain through the vortex veins. We review the anatomy, physiology and pharmacology of these pathways. We also discuss methods to determine unconventional outflow rate, including direct techniques that use radioactive or fluorescent tracers recovered from tissues in the unconventional pathway and indirect methods that estimate unconventional outflow based on total outflow over a range of pressures. Indirect methods are subject to a number of assumptions and generally give poor agreement with tracer measurements. We review the variety of animal models that have been used to study conventional and unconventional outflow. The mouse appears to be a promising model because it captures several aspects of conventional and unconventional outflow dynamics common to humans, although questions remain regarding the magnitude of unconventional outflow in mice. Finally, we review future directions. There is a clear need to develop improved methods for measuring unconventional outflow in both animals and humans. PMID:26850315

Colocalization of outflow segmentation and pores along the inner wall of Schlemm's canal.

PubMed

Braakman, Sietse T; Read, A Thomas; Chan, Darren W-H; Ethier, C Ross; Overby, Darryl R

2015-01-01

and B-pores (p < 0.0015 and p < 10(-4)) but not I-pores (p > 0.38). These data suggest that aqueous humor passes through micron-sized pores in the inner wall endothelium of SC. Paracellular B-pores appear to have a dominant contribution towards transendothelial filtration across the inner wall relative to transcellular I-pores. Impaired pore formation, as previously described in glaucomatous SC cells, may thereby contribute to greater outflow heterogeneity, outflow obstruction, and IOP elevation in glaucoma. Copyright © 2014 Elsevier Ltd. All rights reserved.

Numerical Study on Outflows in Seyfert Galaxies I: Narrow Line Region Outflows in NGC 4151

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

Mou, Guobin; Wang, Tinggui; Yang, Chenwei, E-mail: gbmou@ustc.edu.cn

The origin of narrow line region (NLR) outflows remains unknown. In this paper, we explore the scenario in which these outflows are circumnuclear clouds driven by energetic accretion disk winds. We choose the well-studied nearby Seyfert galaxy NGC 4151 as an example. By performing 3D hydrodynamical simulations, we are able to reproduce the radial distributions of velocity, mass outflow rate, and kinetic luminosity of NLR outflows in the inner 100 pc deduced from spatial resolved spectroscopic observations. The demanded kinetic luminosity of disk winds is about two orders of magnitude higher than that inferred from the NLR outflows, but ismore » close to the ultrafast outflows (UFO) detected in the X-ray spectrum and a few times lower than the bolometric luminosity of the Seyfert. Our simulations imply that the scenario is viable for NGC 4151. The existence of the underlying disk winds can be confirmed by their impacts on higher density ISM, e.g., shock excitation signs, and the pressure in NLR.« less

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction.

PubMed

Mor, Joel M; Guo, Yongwei; Koch, Konrad R; Heindl, Ludwig M

2017-10-13

Today's gold standard in the treatment of infrasaccal primary acquired nasolacrimal duct obstruction (PANDO) is external dacryocystorhinostomy (DCR), a relatively invasive procedure that can be performed after failure of recanalizing treatments. However, with progress in the field of diode laser technology, new approaches have emerged. Laser-assisted transcanalicular DCR with subsequent bicanalicular silicon intubation is a new option showing great promise as a viable minimally invasive procedure. Under permanent endoscopic visual control from the nasal cavity, a diode laser fiber is inserted into the lacrimal sac and laser energy is applied to create a bony ostium between the lacrimal sac and the nasal cavity. Since no skin incision needs to be made, advantages of this method comprise the sparing of the skin as well as the medial palpebral structures and the physiological palpebral-canalicular pump mechanism. The duration of surgery as well as reconvalescence is generally shorter than with external DCR. Complications include silicon tube prolapse, mild swelling and, rarely, canalicular infection and thermal injury. One-year functional success rates, defined as complete resolution of symptoms and ostium patency, are high, yet still range behind those of external DCR. However, secondary external DCR after failure of laser-assisted DCR can be performed without difficulty. Thus, laser-assisted transcanalicular DCR is a valid option that should be considered as a second-step procedure after failure of recanalization procedures and before external DCR.

Multicenter study of the efficacy and safety of disopyramide in obstructive hypertrophic cardiomyopathy.

PubMed

Sherrid, Mark V; Barac, Ivan; McKenna, William J; Elliott, Perry M; Dickie, Shaughan; Chojnowska, Lidia; Casey, Susan; Maron, Barry J

2005-04-19

In this study we assessed the long-term efficacy and safety of disopyramide for patients with obstructive hypertrophic cardiomyopathy (HCM). It has been reported that disopyramide may reduce left ventricular outflow gradient and improve symptoms in patients with HCM. However, long-term efficacy and safety of disopyramide has not been shown in a large cohort. Clinical and echocardiographic data were evaluated in 118 obstructive HCM patients treated with disopyramide at 4 HCM treatment centers. Mortality in the disopyramide-treated patients was compared with 373 obstructive HCM patients not treated with disopyramide. Patients were followed with disopyramide for 3.1 +/- 2.6 years; dose 432 +/- 181 mg/day (97% also received beta-blockers). Seventy-eight patients (66%) were maintained with disopyramide without the necessity for major non-pharmacologic intervention with surgical myectomy, alcohol ablation, or pacing; outflow gradient at rest decreased from 75 +/- 33 to 40 +/- 32 mm Hg (p < 0.0001) and mean New York Heart Association functional class from 2.3 +/- 0.7 to 1.7 +/- 0.6 (p < 0.0001). Forty other patients (34%) could not be satisfactorily managed with disopyramide and required major invasive interventions because of inadequate symptom and gradient control or vagolytic side effects. All-cause annual cardiac death rate between disopyramide and non-disopyramide-treated patients did not differ significantly, 1.4% versus 2.6%/year (p = 0.07). There was also no difference in sudden death rate, 1.0%/year versus 1.8%/year (p = 0.08). Two-thirds of obstructed HCM patients treated with disopyramide could be managed medically with amelioration of symptoms and about 50% reduction in subaortic gradient over >/=3 years. Disopyramide therapy does not appear to be proarrhythmic in HCM and should be considered before proceeding to surgical myectomy or alternate strategies.

Ionospheric Outflow in the Magnetosphere: Circulation and Consequences

NASA Astrophysics Data System (ADS)

Welling, D. T.; Liemohn, M. W.

2017-12-01

Including ionospheric outflow in global magnetohydrodynamic models of near-Earth outer space has become an important step towards understanding the role of this plasma source in the magnetosphere. Such simulations have revealed the importance of outflow in populating the plasma sheet and inner magnetosphere as a function of outflow source characteristics. More importantly, these experiments have shown how outflow can control global dynamics, including tail dynamics and dayside reconnection rate. The broad impact of light and heavy ion outflow can create non-linear feedback loops between outflow and the magnetosphere. This paper reviews some of the most important revelations from global magnetospheric modeling that includes ionospheric outflow of light and heavy ions. It also introduces new advances in outflow modeling and coupling outflow to the magnetosphere.

The novel β3-adrenoceptor agonist mirabegron reduces carbachol-induced contractile activity in detrusor tissue from patients with bladder outflow obstruction with or without detrusor overactivity.

PubMed

Svalø, Julie; Nordling, Jørgen; Bouchelouche, Kirsten; Andersson, Karl-Erik; Korstanje, Cees; Bouchelouche, Pierre

2013-01-15

β(3)-Adrenoceptors are major players in detrusor relaxation and have been suggested as a new putative target for the treatment of overactive bladder syndrome. We determined the effects of mirabegron (YM178), a novel β(3)-adrenoceptor agonist, on carbachol-induced tone in isolated human detrusor preparations from patients with bladder outflow obstruction (BOO) with and without detrusor overactivity (DO), and from patients with normal bladder function. We compared the effects to those of isoprenaline, a non-selective β-adrenoceptor agonist. Detrusor specimens were obtained from patients with benign prostatic hyperplasia undergoing cystoscopy and from patients undergoing radical prostatectomy/cystectomy (in total 33 donors). Detrusor contractility was evaluated by organ bath studies and strips were incubated with carbachol (1μM) to induce and enhance tension. Both mirabegron and isoprenaline reduced carbachol-induced tone in tissues from all groups. Isoprenaline decreased tension with higher potency than mirabegron in normal, BOO and BOO+DO detrusor strips with pIC(50) values of 7.49 ± 0.16 vs. 6.23 ± 0.26 (P=0.0002), 6.89 ± 0.34 vs. 6.04 ± 0.31 (P=0.01), and 6.57 ± 0.20 vs. 5.41 ± 0.08 (P<0.0001, n=4), respectively. The maximal relaxant effect of isoprenaline and mirabegron in the normal, BOO and BOO+DO detrusor was 37.7 ± 14.4% and 36.1 ± 23.3%, 14.4 ± 12.2% vs. 33.4 ± 21.0% and 18.3 ± 10.0% vs. 28.3 ± 12.2% (n=4, P>0.05), respectively. Mirabegron and isoprenaline reduced carbachol-induced tone in both normal bladders and obstructed bladder with and without DO. Isoprenaline had higher potency than mirabegron, but the efficacy of mirabegron effect was the same as that of isoprenaline. Copyright © 2012 Elsevier B.V. All rights reserved.

Bright crater outflows: Possible emplacement mechanisms

NASA Technical Reports Server (NTRS)

Chadwick, D. John; Schaber, Gerald G.; Strom, Robert G.; Duval, Darla M.

1992-01-01

Lobate features with a strong backscatter are associated with 43 percent of the impact craters cataloged in Magellan's cycle 1. Their apparent thinness and great lengths are consistent with a low-viscosity material. The longest outflow yet identified is about 600 km in length and flows from the 90-km-diameter crater Addams. There is strong evidence that the outflows are largely composed of impact melt, although the mechanisms of their emplacement are not clearly understood. High temperatures and pressures of target rocks on Venus allow for more melt to be produced than on other terrestrial planets because lower shock pressures are required for melting. The percentage of impact craters with outflows increases with increasing crater diameter. The mean diameter of craters without outflows is 14.4 km, compared with 27.8 km for craters with outflows. No craters smaller than 3 km, 43 percent of craters in the 10- to 30-km-diameter range, and 90 percent in the 80- to 100-km-diameter range have associated bright outflows. More melt is produced in the more energetic impact events that produce larger craters. However, three of the four largest craters have no outflows. We present four possible mechanisms for the emplacement of bright outflows. We believe this 'shotgun' approach is justified because all four mechanisms may indeed have operated to some degree.

Star formation inside a galactic outflow.

PubMed

Maiolino, R; Russell, H R; Fabian, A C; Carniani, S; Gallagher, R; Cazzoli, S; Arribas, S; Belfiore, F; Bellocchi, E; Colina, L; Cresci, G; Ishibashi, W; Marconi, A; Mannucci, F; Oliva, E; Sturm, E

2017-04-13

Recent observations have revealed massive galactic molecular outflows that may have the physical conditions (high gas densities) required to form stars. Indeed, several recent models predict that such massive outflows may ignite star formation within the outflow itself. This star-formation mode, in which stars form with high radial velocities, could contribute to the morphological evolution of galaxies, to the evolution in size and velocity dispersion of the spheroidal component of galaxies, and would contribute to the population of high-velocity stars, which could even escape the galaxy. Such star formation could provide in situ chemical enrichment of the circumgalactic and intergalactic medium (through supernova explosions of young stars on large orbits), and some models also predict it to contribute substantially to the star-formation rate observed in distant galaxies. Although there exists observational evidence for star formation triggered by outflows or jets into their host galaxy, as a consequence of gas compression, evidence for star formation occurring within galactic outflows is still missing. Here we report spectroscopic observations that unambiguously reveal star formation occurring in a galactic outflow at a redshift of 0.0448. The inferred star-formation rate in the outflow is larger than 15 solar masses per year. Star formation may also be occurring in other galactic outflows, but may have been missed by previous observations owing to the lack of adequate diagnostics.

Comparison of left ventricular diastolic function in obstructive hypertrophic cardiomyopathy in patients undergoing percutaneous septal alcohol ablation versus surgical myotomy/myectomy

NASA Technical Reports Server (NTRS)

Sitges, Marta; Shiota, Takahiro; Lever, Harry M.; Qin, Jian Xin; Bauer, Fabrice; Drinko, Jeannie K.; Agler, Deborah A.; Martin, Maureen G.; Greenberg, Neil L.; Smedira, Nicholas G.;

Common T cell receptor clonotype in lacrimal glands and labial salivary glands from patients with Sjögren's syndrome.

PubMed Central

Matsumoto, I; Tsubota, K; Satake, Y; Kita, Y; Matsumura, R; Murata, H; Namekawa, T; Nishioka, K; Iwamoto, I; Saitoh, Y; Sumida, T

1996-01-01

Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration into lacrimal and salivary glands leading to symptomatic dry eyes and mouth. Immunohistological studies have clarified that the majority of infiltrating lymphocytes around the lacrimal glands and labial salivary glands are CD4 positive alphabeta T cells. To analyze the pathogenesis of T cells infiltrating into lacrimal and labial salivary glands, we examined T cell clonotype of these cells in both glands from four SS patients using PCR-single-strand conformation polymorphism (SSCP) and a sequencing method. SSCP analysis showed that some infiltrating T cells in both glands expand clonally, suggesting that the cells proliferate by antigen-driven stimulation. Intriguingly, six to sixteen identical T cell receptor (TCR) Vbeta genes were commonly found in lacrimal glands and labial salivary glands from individual patients. This indicates that some T cells infiltrating into both glands recognize the shared epitopes on autoantigens. Moreover, highly conserved amino acid sequence motifs were found in the TCR CDR3 region bearing the same TCR Vbeta family gene from four SS patients, supporting the notion that the shared epitopes on antigens are limited. In conclusion, these findings suggest that some autoreactive T cells infiltrating into the lips and eyes recognized restricted epitopes of a common autoantigen in patients with SS. PMID:8621782

Lymphotoxin-beta receptor blockade reduces CXCL13 in lacrimal glands and improves corneal integrity in the NOD model of Sjögren's syndrome

PubMed Central

2011-01-01

Introduction In Sjögren's syndrome, keratoconjunctivitis sicca (dry eye) is associated with infiltration of lacrimal glands by leukocytes and consequent losses of tear-fluid production and the integrity of the ocular surface. We investigated the effect of blockade of the lymphotoxin-beta receptor (LTBR) pathway on lacrimal-gland pathology in the NOD mouse model of Sjögren's syndrome. Methods Male NOD mice were treated for up to ten weeks with an antagonist, LTBR-Ig, or control mouse antibody MOPC-21. Extra-orbital lacrimal glands were analyzed by immunohistochemistry for high endothelial venules (HEV), by Affymetrix gene-array analysis and real-time PCR for differential gene expression, and by ELISA for CXCL13 protein. Leukocytes from lacrimal glands were analyzed by flow-cytometry. Tear-fluid secretion-rates were measured and the integrity of the ocular surface was scored using slit-lamp microscopy and fluorescein isothiocyanate (FITC) staining. The chemokine CXCL13 was measured by ELISA in sera from Sjögren's syndrome patients (n = 27) and healthy controls (n = 30). Statistical analysis was by the two-tailed, unpaired T-test, or the Mann-Whitney-test for ocular integrity scores. Results LTBR blockade for eight weeks reduced B-cell accumulation (approximately 5-fold), eliminated HEV in lacrimal glands, and reduced the entry rate of lymphocytes into lacrimal glands. Affymetrix-chip analysis revealed numerous changes in mRNA expression due to LTBR blockade, including reduction of homeostatic chemokine expression. The reduction of CXCL13, CCL21, CCL19 mRNA and the HEV-associated gene GLYCAM-1 was confirmed by PCR analysis. CXCL13 protein increased with disease progression in lacrimal-gland homogenates, but after LTBR blockade for 8 weeks, CXCL13 was reduced approximately 6-fold to 8.4 pg/mg (+/- 2.7) from 51 pg/mg (+/-5.3) in lacrimal glands of 16 week old control mice. Mice given LTBR blockade exhibited an approximately two-fold greater tear-fluid secretion than

Does septal thickness influence outcome of myectomy for hypertrophic obstructive cardiomyopathy?

PubMed

Nguyen, Anita; Schaff, Hartzell V; Nishimura, Rick A; Dearani, Joseph A; Geske, Jeffrey B; Lahr, Brian D; Ommen, Steve R

2018-03-01

Patients with hypertrophic obstructive cardiomyopathy and basal septal thickness <18 mm are often considered unsuitable candidates for myectomy. Mitral valve (MV) replacement is frequently performed instead. We aimed to determine whether septal thickness affects outcomes and adequacy of myectomy. Clinical and echocardiographic data were reviewed for 1486 consecutive adult patients with hypertrophic obstructive cardiomyopathy who underwent transaortic septal myectomy from January 2005 through December 2014. Comparisons between patients, grouped by septal thickness (<18 mm, n = 369; 18-21 mm, n = 612 and >21 mm, n = 505), were performed with the Kruskal-Wallis and the Pearson χ2 tests and semiparametric analysis of covariance. Median group ages were 57, 57 and 54 years (P = 0.007); men comprised 50.4%, 56.7% and 62.0%, respectively (P = 0.003). Intrinsic MV disease was present in 5.9%, 5.2% and 4.6%, respectively (P = 0.80). All patients underwent transaortic septal myectomy. Additional mitral procedures were performed in 7.6%, 7.8% and 8.1%, respectively (P = 0.90). Reasons for MV surgery included intrinsic MV disease (66.7%), residual mitral regurgitation (30.8%) and residual gradient (2.6%). All groups had postoperative gradient relief (median reduction: 51, 54 and 50 mmHg; P = 0.11). Ventricular septal defect occurred in 4 patients (0.3%), and risk did not differ by group (P = 0.24). Adequate relief of left ventricular outflow tract obstruction can be achieved via transaortic septal myectomy without concomitant MV procedures when septal thickness is < 18 mm, and the risk of ventricular septal defect is minimal. Concomitant MV repair/replacement should be reserved for patients with intrinsic MV disease or inadequate relief of mitral regurgitation/left ventricular outflow tract obstruction following adequate extended septal myectomy. © The Author 2017. Published by Oxford University Press on behalf of the

PROTOSTELLAR OUTFLOWS AND RADIATIVE FEEDBACK FROM MASSIVE STARS. II. FEEDBACK, STAR-FORMATION EFFICIENCY, AND OUTFLOW BROADENING

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

Kuiper, Rolf; Turner, Neal J.; Yorke, Harold W., E-mail: rolf.kuiper@uni-tuebingen.de, E-mail: Neal.J.Turner@jpl.nasa.gov, E-mail: Harold.W.Yorke@jpl.nasa.gov

2016-11-20

We perform two-dimensional axially symmetric radiation hydrodynamic simulations to assess the impact of outflows and radiative force feedback from massive protostars by varying when the protostellar outflow starts, and to determine the ratio of ejection to accretion rates and the strength of the wide-angle disk wind component. The star-formation efficiency, i.e., the ratio of final stellar mass to initial core mass, is dominated by radiative forces and the ratio of outflow to accretion rates. Increasing this ratio has three effects. First, the protostar grows slower with a lower luminosity at any given time, lowering radiative feedback. Second, bipolar cavities clearedmore » by the outflow become larger, further diminishing radiative feedback on disk and core scales. Third, the higher momentum outflow sweeps up more material from the collapsing envelope, decreasing the protostar's potential mass reservoir via entrainment. The star-formation efficiency varies with the ratio of ejection to accretion rates from 50% in the case of very weak outflows to as low as 20% for very strong outflows. At latitudes between the low-density bipolar cavity and the high-density accretion disk, wide-angle disk winds remove some of the gas, which otherwise would be part of the accretion flow onto the disk; varying the strength of these wide-angle disk winds, however, alters the final star-formation efficiency by only ±6%. For all cases, the opening angle of the bipolar outflow cavity remains below 20° during early protostellar accretion phases, increasing rapidly up to 65° at the onset of radiation pressure feedback.« less

Simulating Supernovae Driven Outflows in Dwarf Galaxies

NASA Astrophysics Data System (ADS)

Rodriguez, Jaimee-Ian

2018-01-01

Galactic outflows, or winds, prove to be a necessary input for galactic simulations to produce results comparable to observation, for it solves issues caused by what previous literature dubbed the “angular momentum catastrophe.” While it is known that the nature of outflows depends on the nature of the Interstellar Medium (ISM), the mechanisms behind outflows are still not completely understood. We investigate the driving force behind galactic outflows and the factors that influence their behavior, hypothesizing that supernovae within the galaxy drive these winds. We study isolated, high-resolution, smooth particle hydrodynamic simulations, focusing specifically on dwarf galaxies due to their shallow potential wells, which allow for more significant outflows. We find that outflows follow star formation (and associated supernovae) suggesting the causal relationship between the two. Furthermore, simulations with higher diffusivity differ little in star formation rate, but show significantly lower outflow rates, suggesting that environmental factors that have little effect on regulating star formation can greatly influence outflows, and so efficient outflows can be driven by a constant rate of supernovae, depending on ISM behavior. We are currently analyzing disk morphology and ambient density in order to comprehend the effect of supernovae on the immediate interstellar gas. By attaining greater understanding of the origin of galactic outflows, we will be able to not only improve the accuracy of simulations, we will also be able to gain greater insight into galactic formation and evolution, as outflows and resultant inflows may be vital to the regulation of galaxies throughout their lifetimes.

PLUTO trial protocol: percutaneous shunting for lower urinary tract obstruction randomised controlled trial.

PubMed

Kilby, Mark; Khan, Khalid; Morris, Katie; Daniels, Jane; Gray, Richard; Magill, Laura; Martin, Bill; Thompson, Peter; Alfirevic, Zarko; Kenny, Simon; Bower, Sarah; Sturgiss, Stephen; Anumba, Dilly; Mason, Gerald; Tydeman, Graham; Soothill, Peter; Brackley, Karen; Loughna, Pamela; Cameron, Alan; Kumar, Sailesh; Bullen, Phil

2007-07-01

The primary objective is to determine whether intrauterine vesicoamniotic shunting for fetal bladder outflow obstruction, compared with conservative, noninterventional care, improves prenatal and perinatal mortality and renal function. The secondary objectives are to determine if shunting for fetal bladder outflow obstruction improves perinatal morbidity, to determine if improvement in outcomes is related to prognostic assessment at diagnosis and, if possible, derive a prognostic risk index and to determine the safety and long-term efficacy of shunting. A multicentre randomised controlled trial (RCT). Fetal medicine units. Pregnant women with singleton, male fetus with isolated lower urinary tract obstruction (LUTO). Following ultrasound diagnosis of LUTO in a male fetus and exclusion of other structural and chromosomal anomalies, participation in the trial will be discussed with the mother and written information given. Consent for participation in the trial will be taken and the mother randomised via the internet to either insertion of a vesicoamniotic shunt or expectant management. During pregnancy, both groups will be followed with regular ultrasound scans looking at viability, renal measurements and amniotic fluid volume. Following delivery, babies will be followed up by paediatric nephrologists/urologists at 4-6 weeks, 12 months and 3 and 5 years to assess renal function via serum creatinine, renal ultrasound and need for dialysis/transplant. The main outcome measures will be perinatal mortality rates and renal function at 4-6 weeks and 12 months measured via serum creatinine, renal ultrasound and need for dialysis/transplant. Wellbeing of Women. ESTIMATED COMPLETION DATE: September 2010. TRIAL ALGORITHM: [flowchart: see text].

Functional and Molecular Evidence for Kv7 Channel Subtypes in Human Detrusor from Patients with and without Bladder Outflow Obstruction

PubMed Central

Svalø, Julie; Sheykhzade, Majid; Nordling, Jørgen; Matras, Christina; Bouchelouche, Pierre

2015-01-01

The aim of the study was to investigate whether Kv7 channels and their ancillary β-subunits, KCNE, are functionally expressed in the human urinary bladder. Kv7 channels were examined at the molecular level and by functional studies using RT-qPCR and myography, respectively. We found mRNA expression of KCNQ1, KCNQ3-KCNQ5 and KCNE1-5 in the human urinary bladder from patients with normal bladder function (n = 7) and in patients with bladder outflow obstruction (n = 3). Interestingly, a 3.4-fold up-regulation of KCNQ1 was observed in the latter. The Kv7 channel subtype selective modulators, ML277 (activator of Kv7.1 channels, 10 μM) and ML213 (activator of Kv7.2, Kv7.4, Kv7.4/7.5 and Kv7.5 channels, 10 μM), reduced the tone of 1 μM carbachol pre-constricted bladder strips. XE991 (blocker of Kv7.1–7.5 channels, 10 μM) had opposing effects as it increased contractions achieved with 20 mM KPSS. Furthermore, we investigated if there is interplay between Kv7 channels and β-adrenoceptors. Using cumulative additions of isoprenaline (β-adrenoceptor agonist) and forskolin (adenylyl cyclase activator) in combination with the Kv7 channel activator and blocker, retigabine and XE991, we did not find interplay between Kv7 channels and β-adrenoceptors in the human urinary bladder. The performed gene expression analysis combined with the organ bath studies imply that compounds that activate Kv7 channels could be useful for treatment of overactive bladder syndrome. PMID:25692982

Functional and molecular evidence for Kv7 channel subtypes in human detrusor from patients with and without bladder outflow obstruction.

PubMed

Svalø, Julie; Sheykhzade, Majid; Nordling, Jørgen; Matras, Christina; Bouchelouche, Pierre

2015-01-01

The aim of the study was to investigate whether Kv7 channels and their ancillary β-subunits, KCNE, are functionally expressed in the human urinary bladder. Kv7 channels were examined at the molecular level and by functional studies using RT-qPCR and myography, respectively. We found mRNA expression of KCNQ1, KCNQ3-KCNQ5 and KCNE1-5 in the human urinary bladder from patients with normal bladder function (n = 7) and in patients with bladder outflow obstruction (n = 3). Interestingly, a 3.4-fold up-regulation of KCNQ1 was observed in the latter. The Kv7 channel subtype selective modulators, ML277 (activator of Kv7.1 channels, 10 μM) and ML213 (activator of Kv7.2, Kv7.4, Kv7.4/7.5 and Kv7.5 channels, 10 μM), reduced the tone of 1 μM carbachol pre-constricted bladder strips. XE991 (blocker of Kv7.1-7.5 channels, 10 μM) had opposing effects as it increased contractions achieved with 20 mM KPSS. Furthermore, we investigated if there is interplay between Kv7 channels and β-adrenoceptors. Using cumulative additions of isoprenaline (β-adrenoceptor agonist) and forskolin (adenylyl cyclase activator) in combination with the Kv7 channel activator and blocker, retigabine and XE991, we did not find interplay between Kv7 channels and β-adrenoceptors in the human urinary bladder. The performed gene expression analysis combined with the organ bath studies imply that compounds that activate Kv7 channels could be useful for treatment of overactive bladder syndrome.

Massive outflow properties suggest AGN fade slowly

NASA Astrophysics Data System (ADS)

Zubovas, Kastytis

2018-01-01

Massive large-scale active galactic nucleus (AGN) outflows are an important element of galaxy evolution, being a way through which the AGN can affect most of the host galaxy. However, outflows evolve on time-scales much longer than typical AGN episode durations, therefore most AGN outflows are not observed simultaneously with the AGN episode that inflated them. It is therefore remarkable that rather tight correlations between outflow properties and AGN luminosity exist. In this paper, I show that such correlations can be preserved during the fading phase of the AGN episode, provided that the AGN luminosity evolves as a power law with exponent αd ∼ 1 at late times. I also show that subsequent AGN episodes that illuminate an ongoing outflow are unlikely to produce outflow momentum or energy rates rising above the observed correlations. However, there may be many difficult-to-detect outflows with momentum and energy rates lower than expected from the current AGN luminosity. Detailed observations of AGN outflow properties might help constrain the activity histories of typical and/or individual AGN.

Rapamycin Eye Drops Suppress Lacrimal Gland Inflammation In a Murine Model of Sjögren's Syndrome

PubMed Central

Shah, Mihir; Edman, Maria C.; Reddy Janga, Srikanth; Yarber, Frances; Meng, Zhen; Klinngam, Wannita; Bushman, Jonathan; Ma, Tao; Liu, Siyu; Louie, Stan; Mehta, Arjun; Ding, Chuanqing; MacKay, J. Andrew; Hamm-Alvarez, Sarah F.

2017-01-01

Purpose To evaluate the efficacy of topical rapamycin in treating autoimmune dacryoadenitis in a mouse model of Sjögren's syndrome. Methods We developed rapamycin in a poly(ethylene glycol)-distearoyl phosphatidylethanolamine (PEG-DSPE) micelle formulation to maintain solubility. Rapamycin or PEG-DSPE eye drops (vehicle) were administered in a well-established Sjögren's syndrome disease model, the male nonobese diabetic (NOD) mice, twice daily for 12 weeks starting at 8 weeks of age. Mouse tear fluid was collected and tear Cathepsin S, a putative tear biomarker for Sjögren's syndrome, was measured. Lacrimal glands were retrieved for histological evaluation, and quantitative real-time PCR of genes associated with Sjögren's syndrome pathogenesis. Tear secretion was measured using phenol red threads, and corneal fluorescein staining was used to assess corneal integrity. Results Lymphocytic infiltration of lacrimal glands from rapamycin-treated mice was significantly (P = 0.0001) reduced by 3.8-fold relative to vehicle-treated mice after 12 weeks of treatment. Rapamycin, but not vehicle, treatment increased tear secretion and decreased corneal fluorescein staining after 12 weeks. In rapamycin-treated mice, Cathepsin S activity was significantly reduced by 3.75-fold in tears (P < 0.0001) and 1.68-fold in lacrimal gland lysates (P = 0.003) relative to vehicle-treated mice. Rapamycin significantly altered the expression of several genes linked to Sjögren's syndrome pathogenesis, including major histocompatibility complex II, TNF-α, IFN-γ, and IL-12a, as well as Akt3, an effector of autophagy. Conclusions Our findings suggest that topical rapamycin reduces autoimmune-mediated lacrimal gland inflammation while improving ocular surface integrity and tear secretion, and thus has potential for treating Sjögren's syndrome–associated dry eye. PMID:28122086

Regulating temporospatial dynamics of morphogen for structure formation of the lacrimal gland by chitosan biomaterials.

PubMed

Hsiao, Ya-Chuan; Yang, Tsung-Lin

2017-01-01

The lacrimal gland is an important organ responsible for regulating tear synthesis and secretion. The major work of lacrimal gland (LG) is to lubricate the ocular surface and maintain the health of eyes. Functional deterioration of the lacrimal gland happens because of aging, diseases, or therapeutic complications, but without effective treatments till now. The LG originates from the epithelium of ocular surface and develops by branching morphogenesis. To regenerate functional LGs, it is required to explore the way of recapitulating and facilitating the organ to establish the intricate and ramified structure. In this study, we proposed an approach using chitosan biomaterials to create a biomimetic environment beneficial to the branching structure formation of developing LG. The morphogenetic effect of chitosan was specific and optimized to promote LG branching. With chitosan, increase in temporal expression and local concentration of endogenous HGF-related molecules creates an environment around the emerging tip of LG epithelia. By efficiently enhancing downstream signaling of HGF pathways, the cellular activities and behaviors were activated to contribute to LG branching morphogenesis. The morphogenetic effect of chitosan was abolished by either ligand or receptor deprivation, or inhibition of downstream signaling transduction. Our results elucidated the underlying mechanism accounting for chitosan morphogenetic effects on LG, and also proposed promising approaches with chitosan to assist tissue structure formation of the LG. Copyright © 2016 Elsevier Ltd. All rights reserved.

Role of chemotherapy and molecularly targeted agents in the treatment of adenoid cystic carcinoma of the lacrimal gland.

PubMed

Le Tourneau, Christophe; Razak, Albiruni R A; Levy, Christine; Calugaru, Valentin; Galatoire, Olivier; Dendale, Rémi; Desjardins, Laurence; Gan, Hui K

2011-11-01

Adenoid cystic carcinoma (ACC) is the most common malignant epithelial cancer of the lacrimal gland. Despite a slow rate of growth, ACCs are ultimately associated with poor clinical outcome. Given the rarity of this disease, most recommendations regarding therapy are guided by expert opinion and retrospective data rather than level 1 evidence. Surgery and postoperative radiation therapy are commonly used as initial local treatment. In patients at high risk of recurrence, concomitant platinum-based chemotherapy may be added to postoperative radiotherapy in an attempt to enhance radio-sensitivity. While encouraging responses have been reported with intra-arterial neoadjuvant chemotherapy, this strategy is associated with substantial toxicity and should be considered investigational. For patients with metastatic disease not amenable to surgery or radiotherapy, chemotherapy may have a role based on its modest efficacy in non-lacrimal ACC. Similarly, molecular targeted agents may have a role, although the agents tested to date in non-lacrimal ACC have been disappointing. A better understanding of the biology of ACC will be crucial to the future success of developing targeted agents for this disease.

On the Fraction of Quasars with Outflows

NASA Astrophysics Data System (ADS)

Ganguly, Rajib; Brotherton, Michael S.

2008-01-01

Outflows from active galactic nuclei (AGNs) seem to be common and are thought to be important from a variety of perspectives: as an agent of chemical enhancement of the interstellar and intergalactic media, as an agent of angular momentum removal from the accreting central engine, and as an agent limiting star formation in starbursting systems by blowing out gas and dust from the host galaxy. To understand these processes, we must determine what fraction of AGNs feature outflows and understand what forms they take. We examine recent surveys of quasar absorption lines, reviewing the best means to determine if systems are intrinsic and result from outflowing material, and the limitations of approaches taken to date. The surveys reveal that, while the fraction of specific forms of outflows depends on AGN properties, the overall fraction displaying outflows is fairly constant, approximately 60%, over many orders of magnitude in luminosity. We emphasize some issues concerning classification of outflows driven by data type rather than necessarily the physical nature of outflows and illustrate how understanding outflows probably requires a more comprehensive approach than has usually been taken in the past.

Quantifying the AGN-driven outflows in ULIRGs (QUADROS) II: evidence for compact outflow regions from HST [OIII] imaging observations

NASA Astrophysics Data System (ADS)

Tadhunter, C.; Zaurín, J. Rodríguez; Rose, M.; Spence, R. A. W.; Batcheldor, D.; Berg, M. A.; Ramos Almeida, C.; Spoon, H. W. W.; Sparks, W.; Chiaberge, M.

2018-05-01

The true importance of the warm, AGN-driven outflows for the evolution of galaxies remains uncertain. Measurements of the radial extents of the outflows are key for quantifying their masses and kinetic powers, and also establishing whether the AGN outflows are galaxy-wide. Therefore, as part of a larger project to investigate the significance of warm, AGN-driven outflows in the most rapidly evolving galaxies in the local universe, here we present deep Hubble Space Telescope (HST) narrow-band [OIII]λ5007 observations of a complete sample of 8 nearby ULIRGs with optical AGN nuclei. Combined with the complementary information provided by our ground-based spectroscopy, the HST images show that the warm gas outflows are relatively compact for most of the objects in the sample: in three objects the outflow regions are barely resolved at the resolution of HST (0.065 < R[OIII] < 0.12 kpc); in a further four cases the outflows are spatially resolved but with flux weighted mean radii in the range 0.65 < R[OIII] < 1.2 kpc; and in only one object (Mrk273) is there clear evidence for a more extended outflow, with a maximum extent of R[OIII] ˜ 5 kpc. Overall, our observations show little evidence for the galaxy-wide outflows predicted by some models of AGN feedback.

Effect of sensory denervation on the structure and physiologic responsiveness of rabbit lacrimal gland.

PubMed

Meneray, M A; Bennett, D J; Nguyen, D H; Beuerman, R W

1998-01-01

This work was conducted to determine the effects of unilateral trigeminal ganglion ablation on lacrimal gland structure and secretory activity. Adult male New Zealand rabbits underwent unilateral thermocoagulation of the ophthalmic division of the trigeminal ganglion. Sensory denervation was affirmed by anatomic inspection of the lesion and transmission electron microscopy (TEM) of the lacrimal gland innervation. Eight to 10 days after the procedure, the intraorbital lacrimal glands were removed from both sides. To compare the physiologic competence of the intact and denervated glands, freshly isolated gland fragments from the paired intact and denervated glands were stimulated with carbachol (100 microM), isoproterenol (10 microM), phorbol-12,13-dibutyrate (PDBu, 10 microM), forskolin (40 microM), or vehicle. Total secreted protein was measured at 30 or 60 min after the establishment of baseline values. Intact and denervated glands also were examined by light and TEM, and the morphologic appearance of the acinar structures as well as the appearance of nerves innervating the gland after denervation were assessed. Similar experiments were conducted with animals that underwent unilateral superior cervical ganglionectomy. Tissues from sensory denervated glands released significantly more protein than did tissues from innervated glands in response to in vitro stimulation by carbachol or isoproterenol but not in response to PDBu or forskolin. Microscopy showed that the acinar cells that had undergone sensory denervation showed a massive accumulation of secretory granules. The secretory granules filled the entire cytoplasmic space and displaced the ellipsoidal nuclei to the extreme periphery. Examination of segments of nerves revealed numerous unmyelinated axons, a few small-diameter myelinated axons, and a large amount of nerve degeneration after sensory denervation. In contrast to the effects of sensory denervation, sympathetic denervation did not alter either the

Muscular subaortic stenosis: the initial left ventricular inflow tract pressure as evidence of outflow tract obstruction.

PubMed

Wigle, E D; Auger, P; Marquis, Y

1966-10-15

Two types of intraventricular pressure differences within the left ventricle of man are described. The first is encountered in cases of muscular (or fibrous) subaortic stenosis, in which the outflow tract pressure distal to the stenosis (and proximal to the aortic valve) is low, whereas all pressures recorded in the left ventricle proximal to the stenosis, including that just inside the mitral valve (the initial inflow tract pressure) are high.The second type of intraventricular pressure difference may be recorded in patients without muscular subaortic stenosis when a heart catheter is advanced to the left ventricular wall in such a manner that it becomes imbedded or entrapped by cardiac muscle in systole. Such an entrapped catheter records a high intraventricular pressure that is believed to reflect intramyocardial tissue pressure, which normally exceeds intracavitary pressure. In such cases the initial inflow tract pressure is not high and is precisely equal to the outflow tract systolic pressure, i.e. both are recording intracavity pressure. This type of intramyocardial to intracavitary pressure difference may also be encountered in the left ventricle of dogs.The recent suggestion that intraventricular pressure differences in the left ventricle of cases of muscular subaortic stenosis are due to catheter entrapment by cardiac muscle is refuted by using the initial inflow tract pressure as the means of differentiation between the two types of intraventricular pressure differences outlined.

Broad Absorption Line Quasars with Polar Outflows

NASA Astrophysics Data System (ADS)

Wang, Junxian

2005-10-01

It is widely accepted that the broad absorption line (BAL) outflow exists in most (if not all) quasars with a small covering factor. Various evidences show that equatorial outflows are responsible for the BALs in most BAL QSOs. By searching for radio variable quasars in SDSS, we built the first sample of 6 BAL QSOs with polar BAL outflows. It is very likely that polar outflows are associated with relativistic jets, and their origins should be different from the equatorial outflows in the majority of BAL QSOs. We propose an XMM snapshot survey to a) check whether strong X-ray absorption, one of the most prominent characteristics of most BAL QSOs, also exist in the polar outflows b) check whether face-on BAL QSOs are otherwise X-ray normal c) provide a baseline for future extensive X-ray studies.

Large-Scale Outflows in Seyfert Galaxies

NASA Astrophysics Data System (ADS)

Colbert, E. J. M.; Baum, S. A.

1995-12-01

\\catcode`\\@=11 \\ialign{m @th#1hfil ##hfil \\crcr#2\\crcr\\sim\\crcr}}} \\catcode`\\@=12 Highly collimated outflows extend out to Mpc scales in many radio-loud active galaxies. In Seyfert galaxies, which are radio-quiet, the outflows extend out to kpc scales and do not appear to be as highly collimated. In order to study the nature of large-scale (>~1 kpc) outflows in Seyferts, we have conducted optical, radio and X-ray surveys of a distance-limited sample of 22 edge-on Seyfert galaxies. Results of the optical emission-line imaging and spectroscopic survey imply that large-scale outflows are present in >~{{1} /{4}} of all Seyferts. The radio (VLA) and X-ray (ROSAT) surveys show that large-scale radio and X-ray emission is present at about the same frequency. Kinetic luminosities of the outflows in Seyferts are comparable to those in starburst-driven superwinds. Large-scale radio sources in Seyferts appear diffuse, but do not resemble radio halos found in some edge-on starburst galaxies (e.g. M82). We discuss the feasibility of the outflows being powered by the active nucleus (e.g. a jet) or a circumnuclear starburst.

Characterizing Quasar Outflows II: The Incidence of the Highest Velocity Outflows

NASA Astrophysics Data System (ADS)

Stark, Michele A.; Ganguly, R.; Christenson, D. H.; Richmond, J. M.; Derseweh, J. A.; Robbins, J. M.; Townsend, S. L.

2012-05-01

Galaxy evolution models have shown that quasars are a crucial ingredient in the evolution of massive galaxies. Outflows play a key role in the story of quasars and their host galaxies, by helping regulate the accretion process, the star-formation rate and mass of the host galaxy (i.e., feedback). The prescription for modeling outflows as a contributor to feedback requires knowledge of the outflow velocity, geometry, and column density. In particular, we need to understand how these depend on physical parameters and how much is determined stochastically (and with what distribution). For this purpose, we are examining a sample of 11000 z=1.7-2.0 quasars from the Sloan Digital Sky Survey. This redshift range permits the following from the SDSS spectra: (1) separation of objects that do and do not exhibit outflows; (2) classification/measurement of outflow properties (ionization, velocity, velocity width); and (3) measurements of UV emission line and continuum parameters. In an accompanying poster, we subjectively divide these quasars into four categories (broad absorption-line quasars, associated absorption-line quasars, reddened quasars, and unabsorbed/unreddened quasars). This subjective scheme is limited with regard to classifying narrow absorption-line systems (NALs). With single epoch, low dispersion SDSS spectra, we cannot distinguish between cosmologically intervening NALs, and intrinsic NALs that appear at large velocity offsets. In this poster, we tackle this uncertainty statistically by considering the incidence of both CIV and MgII NALs as a function of velocity, and how this distribution changes with quasar properties. We expect that absorption by intervening structures should not vary with quasar property. Other accompanying posters add photometry from rest-frame X-ray through the infrared (WISE) to complete the SED, which we utilize in these efforts. This material is based upon work supported by the National Aeronautics and Space Administration under

Molecular Outflows: Explosive versus Protostellar

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

Zapata, Luis A.; Rodríguez, Luis F.; Palau, Aina

2017-02-10

With the recent recognition of a second, distinctive class of molecular outflows, namely the explosive ones not directly connected to the accretion–ejection process in star formation, a juxtaposition of the morphological and kinematic properties of both classes is warranted. By applying the same method used in Zapata et al., and using {sup 12}CO( J = 2-1) archival data from the Submillimeter Array, we contrast two well-known explosive objects, Orion KL and DR21, to HH 211 and DG Tau B, two flows representative of classical low-mass protostellar outflows. At the moment, there are only two well-established cases of explosive outflows, butmore » with the full availability of ALMA we expect that more examples will be found in the near future. The main results are the largely different spatial distributions of the explosive flows, consisting of numerous narrow straight filament-like ejections with different orientations and in almost an isotropic configuration, the redshifted with respect to the blueshifted components of the flows (maximally separated in protostellar, largely overlapping in explosive outflows), the very-well-defined Hubble flow-like increase of velocity with distance from the origin in the explosive filaments versus the mostly non-organized CO velocity field in protostellar objects, and huge inequalities in mass, momentum, and energy of the two classes, at least for the case of low-mass flows. Finally, all the molecular filaments in the explosive outflows point back to approximately a central position (i.e., the place where its “exciting source” was located), contrary to the bulk of the molecular material within the protostellar outflows.« less

The energetics of AGN radiation pressure-driven outflows

NASA Astrophysics Data System (ADS)

Ishibashi, W.; Fabian, A. C.; Maiolino, R.

2018-05-01

The increasing observational evidence of galactic outflows is considered as a sign of active galactic nucleus (AGN) feedback in action. However, the physical mechanism responsible for driving the observed outflows remains unclear, and whether it is due to momentum, energy, or radiation is still a matter of debate. The observed outflow energetics, in particular the large measured values of the momentum ratio (\\dot{p}/(L/c) ˜ 10) and energy ratio (\\dot{E}_k/L ˜ 0.05), seems to favour the energy-driving mechanism; and most observational works have focused their comparison with wind energy-driven models. Here, we show that AGN radiation pressure on dust can adequately reproduce the observed outflow energetics (mass outflow rate, momentum flux, and kinetic power), as well as the scalings with luminosity, provided that the effects of radiation trapping are properly taken into account. In particular, we predict a sublinear scaling for the mass outflow rate (\\dot{M} ∝ L^{1/2}) and a superlinear scaling for the kinetic power (\\dot{E}_k ∝ L^{3/2}), in agreement with the observational scaling relations reported in the most recent compilation of AGN outflow data. We conclude that AGN radiative feedback can account for the global outflow energetics, at least equally well as the wind energy-driving mechanism, and therefore both physical models should be considered in the interpretation of future AGN outflow observations.

Shocks and Molecules in Protostellar Outflows

NASA Astrophysics Data System (ADS)

Arce, Héctor

2014-06-01

As protostars form through the gravitational infall of material from their parent molecular cloud, they power energetic bipolar outflows that interact with the surrounding medium. Protostellar outflows are important to the chemical evolution of star forming regions, as the shocks produced by the interaction of the high-velocity protostellar wind and the ambient cloud can heat the surrounding medium and trigger chemical and physical processes that would otherwise not take place in a quiescent molecular cloud. Protostellar outflows, are therefore a great laboratory to study shock physics and shock-induced chemistry. I will present results from millimeter-wave observations of a small sample of outflow shocks. The spectra show clear evidence of the existence of complex organic molecules (e.g., methyl formate, ethanol, acetaldehyde) and high abundance of certain simple molecules (e.g., HCO^+, HCN, H_2O) in outflows. Results indicate that, most likely, the complex species formed on the surface of grains and were then ejected from the grain mantles by the shock. Spectral surveys of shocked regions using ALMA could therefore be used to probe the composition of dust in molecular clouds. Our results demonstrate that outflows modify the chemical composition of the surrounding gaseous environment and that this needs to be considered when using certain species to study active star forming regions.

Distended Bladder Presenting with Altered Mental Status and Venous Obstruction

PubMed Central

Washco, Vaughan; Engel, Lee; Smith, David L.; McCarron, Ross

2015-01-01

Background New onset or acute worsening of bilateral lower extremity swelling is commonly caused by venous congestion from decompensated heart failure, pulmonary disease, liver dysfunction, or kidney insufficiency. A thromboembolic event, lymphatic obstruction, or even external compression of venous flow can also be the culprit. Case Report We report the case of an 83-year-old male with a history of myelodysplastic syndrome that progressed to acute myeloid leukemia, bipolar disorder, and benign prostatic hypertrophy. He presented with altered mental status and new onset lower extremity edema caused by acute bladder outflow obstruction. Computed tomography of the abdomen and pelvis showed the patient's distended bladder compressing bilateral external iliac veins. Conclusion Insertion of a Foley catheter resulted in several liters of urine output and marked improvement in his lower extremity edema and mental status a few hours later. Our extensive workup failed to reveal a cause of the patient's acute change in mental status, and we attributed it to a concept known as cystocerebral syndrome. PMID:25829883

Rethinking the process of detrainment: jets in obstructed natural flows

NASA Astrophysics Data System (ADS)

Mossa, Michele; de Serio, Francesca

2016-12-01

A thorough understanding of the mixing and diffusion of turbulent jets released in porous obstructions is still lacking in literature. This issue is undoubtedly of interest because it is not strictly limited to vegetated flows, but also includes outflows which come from different sources and which spread among oyster or wind farms, as well as aerial pesticide treatments sprayed onto orchards. The aim of the present research is to analyze this process from a theoretical point of view. Specifically, by examining the entrainment coefficient, it is deduced that the presence of a canopy prevents a momentum jet from having an entrainment process, but rather promotes its detrainment. In nature, detrainment is usually associated with buoyancy-driven flows, such as plumes or density currents flowing in a stratified environment. The present study proves that detrainment occurs also when a momentum-driven jet is issued in a not-stratified obstructed current, such as a vegetated flow.

Ionised outflows in z ~ 2.4 quasar host galaxies

NASA Astrophysics Data System (ADS)

Carniani, S.; Marconi, A.; Maiolino, R.; Balmaverde, B.; Brusa, M.; Cano-Díaz, M.; Cicone, C.; Comastri, A.; Cresci, G.; Fiore, F.; Feruglio, C.; La Franca, F.; Mainieri, V.; Mannucci, F.; Nagao, T.; Netzer, H.; Piconcelli, E.; Risaliti, G.; Schneider, R.; Shemmer, O.

2015-08-01

Aims: Outflows driven by active galactic nuclei (AGN) are invoked by galaxy evolutionary models to quench star formation and to explain the origin of the relations observed locally between super-massive black holes and their host galaxies. We here aim to detect extended ionised outflows in luminous quasars, where we expect the highest activity both in star formation and in black-hole accretion. Currently, there are only a few studies based on spatially resolved observations of outflows at high redshift, z > 2. Methods: We analysed a sample of six luminous (L > 1047 erg/s) quasars at z ~ 2.4, observed in H-band using the near-IR integral field spectrometer SINFONI at the VLT. We performed a kinematic analysis of the [Oiii] emission line at λ = 5007 Å. Results: We detect fast, spatially extended outflows in five out of six targets. [Oiii]λ5007 has a complex gas kinematic, with blue-shifted velocities of a few hundreds of km s-1 and line widths up to 1500 km s-1. Using the spectroastrometric method, we infer a size of the ionised outflows of up to ~2 kpc. The properties of the ionised outflows, mass outflow rate, momentum rate, and kinetic power, are correlated with the AGN luminosity. The increase in outflow rate with increasing AGN luminosity is consistent with the idea that a luminous AGN pushes away the surrounding gas through fast outflows that are driven by radiation pressure, which depends on the emitted luminosity. Conclusions: We derive mass outflow rates of about 6-700 M⊙ yr-1 for our sample, which are lower than those observed in molecular outflows. The physical properties of ionised outflows show dependences on AGN luminosity that are similar to those of molecular outflows, but indicate that the mass of ionised gas is lower than that of molecular outflows. Alternatively, this discrepancy between ionised and molecular outflows could be explained with different acceleration mechanisms. Based on Observations collected at the European Organisation for

Gene Expression Profiling and Heterogeneity of Nonspecific Orbital Inflammation Affecting the Lacrimal Gland.

PubMed

Rosenbaum, James T; Choi, Dongseok; Harrington, Christina A; Wilson, David J; Grossniklaus, Hans E; Sibley, Cailin H; Salek, Sherveen S; Ng, John D; Dailey, Roger A; Steele, Eric A; Hayek, Brent; Craven, Caroline M; Edward, Deepak P; Maktabi, Azza M Y; Al Hussain, Hailah; White, Valerie A; Dolman, Peter J; Czyz, Craig N; Foster, Jill A; Harris, Gerald J; Bee, Youn-Shen; Tse, David T; Alabiad, Chrisfouad R; Dubovy, Sander R; Kazim, Michael; Selva, Dinesh; Yeatts, R Patrick; Korn, Bobby S; Kikkawa, Don O; Silkiss, Rona Z; Sivak-Callcott, Jennifer A; Stauffer, Patrick; Planck, Stephen R

2017-11-01

Although a variety of well-characterized diseases, such as sarcoidosis and granulomatosis with polyangiitis, affect the lacrimal gland, many patients with dacryoadenitis are diagnosed as having nonspecific orbital inflammation (NSOI) on the basis of histology and systemic disease evaluation. The ability to further classify the disease in these patients should facilitate selection of effective therapies. To test the a priori hypothesis that gene expression profiles would complement clinical and histopathologic evaluations in identifying well-characterized diseases and in subdividing NSOI into clinically relevant groups. In this cohort study, gene expression levels in biopsy specimens of inflamed and control lacrimal glands were measured with microarrays. Stained sections of the same biopsy specimens were used for evaluation of histopathology. Tissue samples of patients were obtained from oculoplastic surgeons at 7 international centers representing 4 countries (United States, Saudi Arabia, Canada, and Taiwan). Gene expression analysis was done at Oregon Health & Science University. Participants were 48 patients, including 3 with granulomatosis with polyangiitis, 28 with NSOI, 7 with sarcoidosis, 4 with thyroid eye disease, and 6 healthy controls. The study dates were March 2012 to April 2017. The primary outcome was subdivision of biopsy specimens based on gene expression of a published list of approximately 40 differentially expressed transcripts in blood, lacrimal gland, and orbital adipose tissue from patients with sarcoidosis. Stained sections were evaluated for inflammation (none, mild, moderate, or marked), granulomas, nodules, or fibrosis by 2 independent ocular pathologists masked to the clinical diagnosis. Among 48 patients (mean [SD] age, 41.6 [19.0] years; 32 [67%] female), the mclust algorithm segregated the biopsy specimens into 4 subsets, with the differences illustrated by a heat map and multidimensional scaling plots. Most of the sarcoidosis biopsy

MOLECULAR OUTFLOWS FROM THE PROTOCLUSTER SERPENS SOUTH

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

Nakamura, Fumitaka; Higuchi, Aya; Sugitani, Kohji

2011-08-20

We present the results of CO (J = 3-2) and HCO{sup +} (J = 4-3) mapping observations toward a nearby embedded cluster, Serpens South, using the ASTE 10 m telescope. Our CO (J = 3-2) map reveals that many outflows are crowded in the dense cluster-forming clump that can be recognized as an HCO{sup +} clump with a size of {approx}0.2 pc and mass of {approx}80 M{sub sun}. The clump contains several subfragments with sizes of {approx}0.05 pc. By comparing the CO (J = 3-2) map with the 1.1 mm dust continuum image taken by AzTEC on ASTE, we findmore » that the spatial extents of the outflow lobes are sometimes anti-correlated with the distribution of the dense gas, and some of the outflow lobes apparently collide with the dense gas. The total outflow mass, momentum, and energy are estimated to be 0.6 M{sub sun}, 8 M{sub sun} km s{sup -1}, and 64 M{sub sun} km{sup 2} s{sup -2}, respectively. The energy injection rate due to the outflows is comparable to the turbulence dissipation rate in the clump, implying that the protostellar outflows can maintain the supersonic turbulence in this region. The total outflow energy seems only about 10% of the clump gravitational energy. We conclude that the current outflow activity is not enough to destroy the whole cluster-forming clump, and therefore star formation is likely to continue for several or many local dynamical times.« less

The COS revolution of AGN outflow science

NASA Astrophysics Data System (ADS)

Arav, Nahum

2016-10-01

HST/COS has opened a new discovery space for quasar outflow science. Specifically, it provides high quality FUV spectra covering the diagnostic-rich 500A-1050A rest-frame of medium redshift objects. We have published three refereed papers based on the analysis of such data that were supported by our concluded COS archive program, in which we reported: a) a new population of very high ionization outflows, b) robust cases of two-ionization-phase outflows, which are the missing link between UV AGN outflows and x-ray warm absorbers, and most importantly c) spectral diagnostics that allowed us to determine the distance of the outflows from the central source. The latter is a cardinal issue in the field as many researchers believe that most outflows are situated close to the accretion disk ( 0.01 pc) while the few reliable measurements show distances of 10-10,000 pc. Therefore, every empirical distance measurement is of importance. Our archive based publication also demonstrates that quasar outflows have sufficient energy to match theoretical predictions for AGN feedback influencing galaxy evolution.We propose to continue this successful archive program. Thus far we've analyzed about 300 COS G130M and G160M orbits of AGN observations. There are roughly 900 additional orbits that satisfy our criteria and will be available within a year. Based on our published survey, we expect that these 900 orbits will yield about 20-30 additional very-high ionization outflows and 4-6 cases of distance and kinetic luminosity determinations, all in cosmologically important luminous-quasars.

Particle Acceleration in Relativistic Outflows

NASA Technical Reports Server (NTRS)

Bykov, Andrei; Gehrels, Neil; Krawczynski, Henric; Lemoine, Martin; Pelletier, Guy; Pohl, Martin

2012-01-01

In this review we confront the current theoretical understanding of particle acceleration at relativistic outflows with recent observational results on various source classes thought to involve such outflows, e.g. gamma-ray bursts, active galactic nuclei, and pulsar wind nebulae. We highlight the possible contributions of these sources to ultra-high-energy cosmic rays.

A New Look at Speeding Outflows

NASA Astrophysics Data System (ADS)

Kohler, Susanna

2018-02-01

The compact centers of active galaxies known as active galactic nuclei, or AGN are known for the dynamic behavior they exhibit as the supermassive black holes at their centers accrete matter. New observations of outflows from a nearby AGN provide a more detailed look at what happens in these extreme environments.Outflows from GiantsThe powerful radio jets of Cygnus A, which extend far beyond the galaxy. [NRAO/AUI]AGN consist of a supermassive black hole of millions to tens of billions of solar masses surrounded by an accretion disk of in-falling matter. But not all the material falling toward the black hole accretes! Some of it is flung from the AGN via various types of outflows.The most well-known of these outflows are powerful radio jets collimated and incredibly fast-moving streams of particles that blast their way out of the host galaxy and into space. Only around 10% of AGN are observed to host such jets, however and theres another outflow thats more ubiquitous.Fast-Moving AbsorbersPerhaps 30% of AGN both those with and without observed radio jets host wider-angle, highly ionized gaseous outflows known as ultra-fast outflows (UFOs). Ultraviolet and X-ray radiation emitted from the AGN is absorbed by the UFO, revealing the outflows presence: absorption lines appear in the ultraviolet and X-ray spectra of the AGN, blue-shifted due to the high speeds of the absorbing gas in the outflow.Quasar PG 1211+143, indicated by the crosshairs at the center of the image, in the color context of its surroundings. [SDSS/S. Karge]But what is the nature of UFOs? Are they disk winds? Or are they somehow related to the radio jets? And what impact do they have on the AGNs host galaxy?X-ray and Ultraviolet CooperationNew observations are now providing fresh information about one particular UFO. A team of scientists led by Ashkbiz Danehkar (Harvard-Smithsonian Center for Astrophysics) recently used the Chandra and Hubble space telescopes to make the first simultaneous observations

AGN outflows and feedback twenty years on

NASA Astrophysics Data System (ADS)

Harrison, C. M.; Costa, T.; Tadhunter, C. N.; Flütsch, A.; Kakkad, D.; Perna, M.; Vietri, G.

2018-03-01

It is twenty years since the seminal works by Magorrian and co-authors and by Silk and Rees, which, along with other related work, ignited an explosion of publications connecting active galactic nucleus (AGN)-driven outflows to galaxy evolution. With a surge in observations of AGN outflows, studies are attempting to test AGN feedback models directly using the outflow properties. With a focus on outflows traced by optical and CO emission lines, we discuss significant challenges that greatly complicate this task, from both an observational and theoretical perspective. We highlight the observational uncertainties involved and the assumptions required when deriving kinetic coupling efficiencies (that is, outflow kinetic power as a fraction of AGN luminosity) from typical observations. Based on recent models we demonstrate that extreme caution should be taken when comparing observationally derived kinetic coupling efficiencies to coupling efficiencies from fiducial feedback models.

Retroperitoneal haematoma causing gastric outflow obstruction following endovascular repair of a ruptured abdominal aortic aneurysm

PubMed Central

Hunter, Benjamin; Tod, Laura; Ghosh, Jonathan

2012-01-01

A 74-year-old man presented with back pain and collapse. A ruptured infrarenal abdominal aortic aneurysm was successfully managed by endovascular aneurysm repair. Postoperatively, he developed gastric outlet obstruction owing to duodenal compression from the unevacuated retroperitoneal haematoma. In the absence of abdominal compartment syndrome, conservative management with gastric decompression and parenteral nutrition led to a full recovery. PMID:23162028

Prostate Artery Embolization for Complete Urinary Outflow Obstruction Due to Benign Prostatic Hypertrophy

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

Yu, Simon Chun Ho, E-mail: simonyu@cuhk.edu.hk; Cho, Carmen Chi Min; Hung, Esther Hiu Yee

BackgroundWe aimed to evaluate the effectiveness of PAE in weaning of catheter and relieving obstructive urinary symptoms in patients with acute urinary retention (AUR) due to benign prostatic hypertrophy (BPH) and failed trial without catheter (TWOC).Materials and MethodsIn this prospective study approved by the institutional review board, a signed informed consent was obtained. Eighteen consecutive patients with AUR due to BPH and failed TWOC were recruited. Nineteen consecutive patients with BPH but without AUR were recruited as a control. Patients with CTA evidence of arterial occlusion or significant stenosis along the prostate artery access path were excluded. PAE was performedmore » using microspheres (100–300 μm diameter). Outcome assessment included successful weaning of catheter in 2 weeks, procedure-related complications, change of symptomatology and urodynamic findings at 1 month as compared to baseline, percent non-perfused prostate volume, and prostate volume reduction on MRI at 2 weeks.ResultsTwo patients in the study group and four in the control group were excluded due to arterial pathology. Embolization of bilateral prostate arteries was achieved in all patients in both the groups (100%). There was no complication. The catheter was successfully weaned in 87.5% (14/16) of patients within 14 days in the treatment group. There was no significant difference in patient demographics, prostate characteristics, and all outcome assessment parameters between both the groups.ConclusionsPAE was probably safe and effective in weaning of catheter and relieving obstructive urinary symptoms in patients due to BPH, with treatment outcomes comparable to those without AUR.« less

A distance-limited sample of massive molecular outflows

NASA Astrophysics Data System (ADS)

Maud, L. T.; Moore, T. J. T.; Lumsden, S. L.; Mottram, J. C.; Urquhart, J. S.; Hoare, M. G.

2015-10-01

We have observed 99 mid-infrared-bright, massive young stellar objects and compact H II regions drawn from the Red MSX source survey in the J = 3-2 transition of 12CO and 13CO, using the James Clerk Maxwell Telescope. 89 targets are within 6 kpc of the Sun, covering a representative range of luminosities and core masses. These constitute a relatively unbiased sample of bipolar molecular outflows associated with massive star formation. Of these, 59, 17 and 13 sources (66, 19 and 15 per cent) are found to have outflows, show some evidence of outflow, and have no evidence of outflow, respectively. The time-dependent parameters of the high-velocity molecular flows are calculated using a spatially variable dynamic time-scale. The canonical correlations between the outflow parameters and source luminosity are recovered and shown to scale with those of low-mass sources. For coeval star formation, we find the scaling is consistent with all the protostars in an embedded cluster providing the outflow force, with massive stars up to ˜30 M⊙ generating outflows. Taken at face value, the results support the model of a scaled-up version of the accretion-related outflow-generation mechanism associated with discs and jets in low-mass objects with time-averaged accretion rates of ˜10-3 M⊙ yr-1 on to the cores. However, we also suggest an alternative model, in which the molecular outflow dynamics are dominated by the entrained mass and are unrelated to the details of the acceleration mechanism. We find no evidence that outflows contribute significantly to the turbulent kinetic energy of the surrounding dense cores.

Shining a light on star formation driven outflows: the physical conditions within galactic outflows

NASA Astrophysics Data System (ADS)

Chisholm, John P.; Tremonti, Christina A.; Leitherer, Claus; Wofford, Aida; Chen, Yanmei

2016-01-01

Stellar feedback drives energy and momentum into the surrounding gas, which drives gas and metals out of galaxies through a galactic outflow. Unfortunately, galactic outflows are difficult to observe and characterize because they are extremely diffuse, and contain gas at many different temperatures. Here we present results from a sample of 37 nearby (z < 0.27) star forming galaxies observed in the ultraviolet with the Cosmic Origins Spectrograph on the Hubble Space Telescope. The sample covers over three decades in stellar mass and star formation rate, probing different morphologies such as dwarf irregulars and high-mass merging systems. Using four different UV absorption lines (O I, Si II, Si III and Si IV) that trace a wide range of temperatures (ionization potentials between 13.6 eV and 45 eV), we find shallow correlations between the outflow velocity or the equivalent width of absorption lines with stellar mass or star formation rate. Absorption lines probing different temperature phases have similar centroid velocities and line widths, indicating that they are comoving. Using the equivalent width ratios of the four different transitions, we find the ratios to be consistent with photo-ionized outflows, with moderately strong ionization parameters. By constraining the ionization mechanism we model the ionization fractions for each transition, but find the ionization fractions depend crucially on input model parameters. The shallow velocity scalings imply that low-mass galaxies launch outflows capable of escaping their galactic potential, while higher mass galaxies retain all of their gas, unless they undergo a merger.

AGN outflows as neutrino sources: an observational test

NASA Astrophysics Data System (ADS)

Padovani, P.; Turcati, A.; Resconi, E.

2018-04-01

We test the recently proposed idea that outflows associated with Active Galactic Nuclei (AGN) could be neutrino emitters in two complementary ways. First, we cross-correlate a list of 94 "bona fide" AGN outflows with the most complete and updated repository of IceCube neutrinos currently publicly available, assembled by us for this purpose. It turns out that AGN with outflows matched to an IceCube neutrino have outflow and kinetic energy rates, and bolometric powers larger than those of AGN with outflows not matched to neutrinos. Second, we carry out a statistical analysis on a catalogue of [O III] λ5007 line profiles using a sample of 23,264 AGN at z < 0.4, a sub-sample of which includes mostly possible outflows sources. We find no significant evidence of an association between the AGN and the IceCube events, although we get the smallest p-values (˜6 and 18 per cent respectively, pre-trial) for relatively high velocities and luminosities. Our results are consistent with a scenario where AGN outflows are neutrino emitters but at present do not provide a significant signal. This can be tested with better statistics and source stacking. A predominant role of AGN outflows in explaining the IceCube data appears in any case to be ruled out.

AGN outflows as neutrino sources: an observational test

NASA Astrophysics Data System (ADS)

Padovani, P.; Turcati, A.; Resconi, E.

2018-07-01

We test the recently proposed idea that outflows associated with Active Galactic Nuclei (AGN) could be neutrino emitters in two complementary ways. First, we cross-correlate a list of 94 'bona fide' AGN outflows with the most complete and updated repository of IceCube neutrinos currently publicly available, assembled by us for this purpose. It turns out that AGN with outflows matched to an IceCube neutrino have outflow and kinetic energy rates, and bolometric powers larger than those of AGN with outflows not matched to neutrinos. Secondly, we carry out a statistical analysis on a catalogue of [O III] λ5007 line profiles using a sample of 23 264 AGN at z < 0.4, a subsample of which includes mostly possible outflow sources. We find no significant evidence of an association between the AGN and the IceCube events, although we get the smallest p-values (˜6 and 18 per cent, respectively, pre-trial) for relatively high velocities and luminosities. Our results are consistent with a scenario where AGN outflows are neutrino emitters but at present do not provide a significant signal. This can be tested with better statistics and source stacking. A predominant role of AGN outflows in explaining the IceCube data appears in any case to be ruled out.

Key Issues in the Production of Ionospheric Outflows

NASA Astrophysics Data System (ADS)

Lotko, W.

2017-12-01

Global models demonstrate that outflows of ionospheric ions can have profound effects on the dynamics of the solar wind-magnetosphere-ionosphere-thermosphere system, particularly during geomagnetic storms. Yet the processes that determine where and when outflows occur are poorly understood, in large part because a full complement of critical multivariable measurements of outflows and their causal drivers has yet to be assembled. Development of accurate regional and global predictive models of outflows has been hampered by this lack of empirical knowledge, but models are also challenged by the additional requirement of having to reduce the complex microphysics of ion energization into lumped relations that specify outflow characteristics through causal regulators. Opportunities to improve understanding of this problem are vast. This overview will focus on a limited set of priority questions that address how ions overcome gravity to leave the ionosphere; the timing, rate, spatial distribution and energetics of their exodus; how their flight impacts the ionosphere-thermosphere environment that spawns outflows; and the influence of magnetospheric feedback on outflow production.

THE PREVALENCE OF GAS OUTFLOWS IN TYPE 2 AGNs. II. 3D BICONICAL OUTFLOW MODELS

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

Bae, Hyun-Jin; Woo, Jong-Hak, E-mail: hjbae@galaxy.yonsei.ac.kr, E-mail: woo@astro.snu.ac.kr

We present 3D models of biconical outflows combined with a thin dust plane for investigating the physical properties of the ionized gas outflows and their effect on the observed gas kinematics in type 2 active galactic nuclei (AGNs). Using a set of input parameters, we construct a number of models in 3D and calculate the spatially integrated velocity and velocity dispersion for each model. We find that three primary parameters, i.e., intrinsic velocity, bicone inclination, and the amount of dust extinction, mainly determine the simulated velocity and velocity dispersion. Velocity dispersion increases as the intrinsic velocity or the bicone inclinationmore » increases, while velocity (i.e., velocity shifts with respect to systemic velocity) increases as the amount of dust extinction increases. Simulated emission-line profiles well reproduce the observed [O iii] line profiles, e.g., narrow core and broad wing components. By comparing model grids and Monte Carlo simulations with the observed [O iii] velocity–velocity dispersion distribution of ∼39,000 type 2 AGNs, we constrain the intrinsic velocity of gas outflows ranging from ∼500 to ∼1000 km s{sup −1} for the majority of AGNs, and up to ∼1500–2000 km s{sup −1} for extreme cases. The Monte Carlo simulations show that the number ratio of AGNs with negative [O iii] velocity to AGNs with positive [O iii] velocity correlates with the outflow opening angle, suggesting that outflows with higher intrinsic velocity tend to have wider opening angles. These results demonstrate the potential of our 3D models for studying the physical properties of gas outflows, applicable to various observations, including spatially integrated and resolved gas kinematics.« less

Contrast‐enhanced computed tomography with myocardial three‐dimensional printing can guide treatment in symptomatic hypertrophic obstructive cardiomyopathy

PubMed Central

Hamatani, Yasuhiro; Amaki, Makoto; Kanzaki, Hideaki; Yamashita, Kizuku; Nakashima, Yasuteru; Shibata, Atsushi; Okada, Atsushi; Takahama, Hiroyuki; Hasegawa, Takuya; Shimahara, Yusuke; Sugano, Yasuo; Fujita, Tomoyuki; Shiraishi, Isao; Yasuda, Satoshi; Kobayashi, Junjiro

2017-01-01

Abstract Both surgical myectomy and percutaneous transluminal septal myocardial ablation are effective treatments for drug‐refractory symptomatic hypertrophic obstructive cardiomyopathy (HOCM). However, in some cases, it is not easy to elucidate the abnormal structure of left ventricular outflow obstruction to adopt these treatments. Here, we presented a young female patient with drug‐refractory symptomatic HOCM. In this case, contrast‐enhanced computed tomography enabled us to assess the suitability of percutaneous transluminal septal myocardial ablation. By creating three‐dimensional printed models using computed tomography data, we could also visualize intracardiac structure and simulate the surgical procedure. A multimodality assessment strategy is useful for evaluating patients complicated with drug‐refractory symptomatic HOCM. PMID:29154429

Powerful Molecular Outflows in Nearby Active Galaxies

NASA Astrophysics Data System (ADS)

Veilleux, Sylvain; Meléndez, Marcio

2014-07-01

We report the results from a systematic search for molecular (OH 119 μm) outflows with Herschel-PACS† in a sample of 43 nearby (z < 0.3) galaxy mergers, mostly ultraluminous infrared galaxies (ULIRGs) and QSOs. We find that the character of the OH feature (strength of the absorption relative to the emission) correlates with that of the 9.7-μm silicate feature, a measure of obscuration in ULIRGs. Unambiguous evidence for molecular outflows, based on the detection of OH absorption profiles with median velocities more blueshifted than -50 km s-1, is seen in 26 (70%) of the 37 OH-detected targets, suggesting a wide-angle (~ 145°) outflow geometry. Conversely, unambiguous evidence for molecular inflows, based on the detection of OH absorption profiles with median velocities more redshifted than +50 km s-1, is seen in only 4 objects, suggesting a planar or filamentary geometry for the inflowing gas. Terminal outflow velocities of ~ -1000 km s-1 are measured in several objects, but median outflow velocities are typically ~ -200 km s-1. While the outflow velocities show no statistically significant dependence on the star formation rate, they are distinctly more blueshifted among systems with large AGN fractions and luminosities [log (L AGN/L ⊙) >= 11.8 +/- 0.3]. The quasars in these systems play a dominant role in driving the molecular outflows. In contrast, the most AGN dominated systems, where OH is seen purely in emission, show relatively modest OH line widths, despite their large AGN luminosities, perhaps indicating that molecular outflows subside once the quasar has cleared a path through the obscuring material.

Bipolar outflows and Jets From Young Stars

NASA Astrophysics Data System (ADS)

Bally, J.

2000-05-01

Stars produce powerful jets and winds during their birth. These primary outflows power shock waves (Herbig-Haro objects) and entrain surrounding gas to produce molecular outflows. Many outflows reach parsec-scale dimensions whose dynamical ages can become comparable to the accretion age of the source star. Thus, these giant outflows provide fossil records of the mass loss histories of their parent stars. Jet symmetries provide tantalizing clues about the violent history of stellar accretion and dynamical interactions with nearby companions. These flows inject sufficient energy and momentum into the surrounding medium to alter the physical and chemical state of the gas, generate turbulence, disrupt the parent cloud, and self-regulate the rate of star formation. Recent observations have revealed a new class of externally irradiated jets which are rendered visible by the light of nearby massive stars. Some of these jets appear to be millions of years old, indicating that outflow activity can persist for much longer than previously thought. Stellar jets provide ideal laboratories for the investigation of accretion powered outflows and associated shocks since their time-dependent behavior can be observed with a rich variety of spectral line diagnostics.

Routine Papillary Muscle Realignment and Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy.

PubMed

Song, Howard K; Turner, Jason; Macfie, Rebekah; Kumar, Suwen; Mannello, Meghan J; Smith, Danielle; Bhamidipati, Castigliano; Raman, Jaishankar; Tibayan, Frederick; Heitner, Stephen B

2018-05-10

Septal myectomy has been the mainstay of the surgical treatment of obstructive hypertrophic cardiomyopathy (HCM), however recently there is growing appreciation for associated mitral valve abnormalities that contribute to left ventricular outflow tract (LVOT) obstruction. In this study, we describe our experience with combined papillary muscle realignment (PMR) and septal myectomy for the treatment of obstructive HCM. We identified 44 patients undergoing surgery for obstructive HCM whose anatomy was amenable to combined PMR and septal myectomy at our institution over a 20-month period. All patients underwent resting and stress echocardiography pre- and postoperatively. Demographic, clinical, and imaging data were prospectively collected in a cardiac surgery database. Patient age ranged broadly, with mean age of 54 years (range 18-76). Preoperatively, 70% of patients were NYHA Class III or IV, the mean stress LVOT gradient was 144 mmHg, and severe mitral regurgitation (MR) with stress was seen in 81% . Additional procedures included division of myocardial bands (50%) and chordae (43%) and resection of accessory papillary muscles (25%). Following the procedure, mean resting and stress gradients were reduced to normal (12 and 27 mmHg, respectively, p < 0.0001). No patient had severe MR and only 3 (6.8%) had moderate MR (p < 0.0001).Mean length of stay was 6 days and there were no mortalities. Septal myectomy combined with PMR is a safe, highly effective, and reproducible procedure that reliably relieves LVOT obstruction and corrects MR without the need for mitral valve repair or replacement. Copyright © 2018. Published by Elsevier Inc.

Identification of P2X3 and P2X7 Purinergic Receptors Activated by ATP in Rat Lacrimal Gland

PubMed Central

Vrouvlianis, Joanna; Scott, Rachel; Dartt, Darlene A.

2011-01-01

Purpose. To identify the type of purinergic receptors activated by adenosine triphosphate (ATP) in rat lacrimal gland and to determine their role in protein secretion. Methods. Purinergic receptors were identified by RT-PCR, Western blot analysis, and immunofluorescence techniques. Acini from rat lacrimal gland were isolated by collagenase digestion. Acini were incubated with the fluorescence indicator fura-2 tetra-acetoxylmethyl ester, and intracellular [Ca2+] ([Ca2+]i) was determined. Protein secretion was measured by fluorescence assay. Results. The authors previously showed that P2X7 receptors were functional in the lacrimal gland. In this study, they show that P2X1–4, and P2X6receptors were identified in the lacrimal gland by RT-PCR, Western blot, and immunofluorescence analyses. P2X5 receptors were not detected. ATP increased [Ca2+]i and protein secretion in a concentration-dependent manner. Removal of extracellular Ca2+ significantly reduced the ATP-stimulated increase in [Ca2+]i. Repeated applications of ATP caused desensitization of the [Ca2+]i response. Incubation with the P2X1 receptor inhibitor NF023 did not alter ATP-stimulated [Ca2+]i. Incubation with zinc, which potentiates P2X2 and P2X4 receptor responses, or lowering the pH to 6.8, which potentiates P2X2 receptor responses, did not alter the ATP-stimulated [Ca2+]i. P2X3 receptor inhibitors A-317491 and TNP-ATP significantly decreased ATP-stimulated [Ca2+]i and protein secretion, whereas the P2X3 receptor agonist α,β methylene ATP significantly increased them. The P2X7 receptor inhibitor A438079 had no effect on ATP-stimulated [Ca2+]i at 10−6 M but did have an effect at 10−4 M. Conclusions. Purinergic receptors P2X1–4 and P2X6 are present in the lacrimal gland. ATP uses P2X3 and P2X7 receptors to stimulate an increase in [Ca2+]i and protein secretion. PMID:21421865

Endoscopic-modified medial maxillectomy and its limitation for a solitary fibrous tumor of the lacrimal sac and nasolacrimal duct.

PubMed

Moriyama, Munehito; Kodama, Satoru; Hirano, Takashi; Suzuki, Masashi

2017-06-01

Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises from the pleura. Recently, SFTs have been reported in the head and neck region located in subsites such as the orbit. SFTs of the lacrimal sac are extremely rare, with only six cases reported in the English literature. We describe a SFT arising from the right lacrimal sac and extending along the nasolacrimal duct into the nasal cavity. Although, the tumor could not be removed by endoscopic-modified medial maxillectomy (EMMM) alone, combined approach with EMMM and a small external incision achieved the complete removal of the tumor. The patient has remained disease-free 24 months after surgery. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Far-Ultraviolet Observations of Outflows from Infrared-Luminous Galaxies

NASA Astrophysics Data System (ADS)

Leitherer, Claus; Chandar, Rupali; Tremonti, Christy A.; Wofford, Aida

2013-03-01

We have obtained ultraviolet spectra between 1150 and 1450 Å of four ultraviolet-bright, infrared-luminous starburst galaxies. Our selected sight-lines towards the starburst nuclei probe the conditions in the starburst-driven outflows. We detect outflowing gas with velocities of up to ˜900 km s-1. It is likely that the outflows are a major source of metal enrichment of the galaxies' halos. The mass outflow rates of several tens of M⊙ yr-1 are similar to the star-formation rates. The outflows may quench star formation and ultimately regulate the starburst.

Studies of Quasar Outflows

NASA Technical Reports Server (NTRS)

Arav, Nahum

2002-01-01

The main aim of this research program is to determine the ionization equilibrium and abundances in quasar outflows. Especially in the broad absorption line QSO PG 0946+301. We find that the outflow's metalicity is consistent with being solar, while the abundance ratio of phosphorus to other metals is at least ten times solar. These findings are based on diagnostics that are not sensitive to saturation and partial covering effects in the BALs (Broad Adsorption Lines), which considerably weakened previous claims for enhanced metalicity. Ample evidence for these effects is seen in the spectrum.

Effect of radioactive iodine therapy on lacrimal gland functions in patients with hyperthyroidism.

PubMed

Aydogan, Fusun; Ayhan Tuzcu, Esra; Aydogan, Akin; Akkucuk, Seckin; Coskun, Mesut; Ustun, Ihsan; Gökçe, Cumali

2014-04-01

Radioactive iodine (RAI) therapy is preferred in the treatment of hyperthyroidism because of its effectiveness, noninvasiveness, and low costs. I has been detected in extrathyroidal tissues, such as in gastric mucosa, salivary glands, and lacrimal glands. To the best of our knowledge, there is no publication concerning the effects of RAI therapy for hyperthyroidism on tear production. In the present study, we evaluated whether or not the lacrimal glands are affected after RAI therapy when compared with pretreatment period. The Schirmer and tear break-up time (TBUT) tests were used to assess 32 eyes of 16 patients with conditions that were diagnosed as hyperthyroidism before and at 3 and 6 months after RAI treatment. In addition, pretreatment values of patients were compared with that of controls. It was evaluated whether or not a correlation exists between the results and the dose or iodine uptake values. There was no significant difference between pretreatment values of Schirmer and TBUT tests obtained in the patient group and those of the control group (P > 0.05). In the patient group, there was a significant difference between the posttreatment and pretreatment values (P < 0.05). There was a positive correlation between uptake values obtained at 24 hours and the values obtained by TBUT and Schirmer tests on both eyes at 3 and 6 months. At 6 months, the uptake value at 24 hours was 28.83 ± 60 for both eyes in patients with TBUT test values less than 10, whereas it was 39.25 ± 7.88 for the right eye and 39.00 ± 6.85 for the left eyes in patients with TBUT test values greater than 10. The difference was statistically significant (P < 0.05). In our study, we concluded that the decrease in mucin and aqueous production occurs due to affected lacrimal glands by RAI therapy; however, this effect is not dose dependent.

Does the X-ray outflow quasar PDS 456 have a UV outflow at 0.3c?

NASA Astrophysics Data System (ADS)

Hamann, Fred; Chartas, George; Reeves, James; Nardini, Emanuele

2018-05-01

The quasar PDS 456 (at redshift ˜0.184) has a prototype ultra-fast outflow (UFO) measured in X-rays. This outflow is highly ionized with relativistic speeds, large total column densities log NH(cm-2) > 23, and large kinetic energies that could be important for feedback to the host galaxy. A UV spectrum of PDS 456 obtained with the Hubble Space Telescope in 2000 contains one well-measured broad absorption line (BAL) at ˜1346 Å (observed) that might be Ly α at v ≈ 0.06c or N V λ1240 at v ≈ 0.08c. However, we use photoionization models and comparisons to other outflow quasars to show that these BAL identifications are problematic because other lines that should accompany them are not detected. We argue that the UV BAL is probably C IV at v ≈ 0.30c. This would be the fastest UV outflow ever reported, but its speed is similar to the X-ray outflow and its appearance overall is similar to relativistic UV BALs observed in other quasars. The C IV BAL identification is also supported indirectly by the tentative detection of another broad C IV line at v ≈ 0.19c. The high speeds suggest that the UV outflow originates with the X-ray UFO crudely 20-30 rg from the central black hole. We speculate that the C IV BAL might form in dense clumps embedded in the X-ray UFO, requiring density enhancements of only ≳0.4 dex compared to clumpy structures already inferred for the soft X-ray absorber in PDS 456. The C IV BAL might therefore be the first detection of low-ionization clumps proposed previously to boost the opacities in UFOs for radiative driving.

Development of lacrimal gland spheroids for lacrimal gland tissue regeneration.

PubMed

Massie, Isobel; Spaniol, Kristina; Barbian, Andreas; Geerling, Gerd; Metzger, Marco; Schrader, Stefan

2018-04-01

Severe dry eye syndrome resulting from lacrimal gland (LG) dysfunction can cause blindness, yet treatments remain palliative. In vitro reconstruction of LG tissue could provide a curative treatment. We aimed to combine epithelial cells with endothelial cells and mesenchymal stem cells (MSCs) to form a 3D functional unit. Epithelial cells and MSCs were isolated from porcine LG; endothelial cells were isolated from human foreskin. MSCs were characterised (flow cytometry and differentiation potential assays). All 3 cell types were combined on Matrigel and spheroid formation observed. Spheroids were characterised [immunohistochemistry (IHC) and transmission electron microscopy] and function assessed (β-hexosaminidase assay). Spheroids were transferred to decellularised jejunum (SIS-Muc) in dynamic cultures for 1 week before further characterisation. MSCs did not express CD31 but expressed CD44 and CD105 and differentiated towards osteogenic and adipogenic lineages. Spheroids formed on Matrigel within 18 hr, contracting to ~10% of the well area (p < .005). IHC revealed presence of all 3 cells within spheroids. Transmission electron microscopy revealed cell-cell contacts and polarisation at the apical surface. In static cultures, function was increased in spheroids cf. monolayer controls (p < .05) but over 72 hr, spheroid function (p < .05), viability (p < .05), and proliferation decreased, whilst apoptosis increased. On SIS-Muc under dynamic culture, however, spheroids continued to proliferate to repopulate SIS-Muc. IHC revealed LG epithelial cells coexpressing pan-cytokeratin and lysozyme, as well as endothelial cells and MSCs and cells remained capable of responding to carbachol (p < .05). These spheroids could form the basis of a regenerative medicine treatment approach for dry eye syndrome. In vivo studies are required to evaluate this further. Copyright © 2017 John Wiley & Sons, Ltd.

TH17 cells mediate inflammation in a novel model of spontaneous experimental autoimmune lacrimal keratoconjunctivitis with neural damage.

PubMed

Seo, Kyoung Yul; Kitamura, Kazuya; Han, Soo Jung; Kelsall, Brian

2017-09-27

Dry eye disease (DED) affects one third of the population worldwide. In prior studies, experimental autoimmune lacrimal keratoconjunctivitis (EALK) induced by desiccating stress in mice has been used as a model of DED. This model is complicated by a requirement for exogenous epithelial cell injury and administration of anticholinergic agents with broad immunologic effects. We sought to develop a novel mouse model of EALK and to demonstrate the responsible pathogenic mechanisms. CD4 + CD45RB high naive T cells with and without CD4 + CD45RB low regulatory T cells were adoptively transferred to C57BL/10 recombination-activating gene 2 (Rag2) -/- mice. The eyes, draining lymph nodes, lacrimal glands, and surrounding tissues of mice with and without spontaneous keratoconjunctivitis were evaluated for histopathologic changes, cellular infiltration, and cytokine production in tissues and isolated cells. Furthermore, the integrity of the corneal nerves was evaluated using whole-tissue immunofluorescence imaging. Gene-deficient naive T cells or RAG2-deficient hosts were evaluated to assess the roles of IFN-γ, IL-17A, and IL-23 in disease pathogenesis. Finally, cytokine levels were determined in the tears of patients with DED. EALK developed spontaneously in C57BL/10 Rag2 -/- mice after adoptive transfer of CD4 + CD45RB high naive T cells and was characterized by infiltration of CD4 + T cells, macrophages, and neutrophils. In addition to lacrimal keratoconjunctivitis, mice had damage to the corneal nerve, which connects components of the lacrimal functional unit. Pathogenic T-cell differentiation was dependent on IL-23p40 and controlled by cotransferred CD4 + CD45RB low regulatory T cells. T H 17 rather than T H 1 CD4 + cells were primarily responsible for EALK, even though levels of both IL-17 and IFN-γ were increased in inflammatory tissues, likely because of their ability to drive expression of CXC chemokines within the cornea and the subsequent influx of myeloid cells

What Fraction of Active Galaxies Actually Show Outflows?

NASA Astrophysics Data System (ADS)

Ganguly, Rajib; Brotherton, M. S.

2007-12-01

Outflows from active galactic nuclei (AGNs) seem to be common and are thought to be important from a variety of perspectives: as an agent of chemical enhancement of the interstellar and intergalactic media, as an agent of angular momentum removal from the accreting central engine, and as an agent limiting star formation in starbursting systems by blowing out gas and dust from the host galaxy. To understand these processes, we must determine what fraction of AGNs feature outflows and understand what forms they take. We examine recent surveys of outflows detected in ultraviolet absorption over the entire range of velocities and velocity widths (i.e., broad absorption lines, associated absorption lines, and high-velocity narrow absorption lines). While the fraction of specific forms of outflows depends on AGN properties, the overall fraction displaying outflows is fairly constant, approximately 60%, over many orders of magnitude in luminosity. We discuss implications of this result and ways to refine our understanding of outflows. We acknowledge support from the US National Science Foundation through grant AST 05-07781.

Northwestern Tharsis Latent Outflow Activity Mars

NASA Technical Reports Server (NTRS)

Dohm, J. M.; Anderson, R. C.; Baker, V. R.; Ferris, J. C.; Hare, T. M.; Strom, R. G.; Rudd, L.; Rice, J. W., Jr.; Scott, D. H.

2000-01-01

Previously defined outflow channels, which are indicated by relict landforms similar to those observed on Earth, signify ancient catastrophic flood events on Mars. These conspicuous geomorphic features are some of the most remarkable yet profound discoveries made by geologists to date. These outflow channels, which debouched tremendous volumes of water into topographic lows such as Chryse, Utopia, Elysium, and Hellas Planitiae, may represent the beginning of warmer and wetter climatic periods unlike the present-day cold and dry Mars. In addition to the previously identified outflow channels, observations permitted by the newly acquired Mars Orbiter Laser Altimeter (MOLA) data have revealed a system of gigantic valleys, referred to as the northwestern slope valleys (NSV), that are located to the northwest of a huge shield volcano, Arsia Mons, western hemisphere of Mars. These features generally correspond spatially to gravity lows similar to the easternmost, circum-Chryse outflow channel systems. Geologic investigations of the Tharsis region suggest that the large valley system pre-dates the construction of Arsia Mons and its extensive associated lava flows of mainly Late Hesperian and Amazonian age and coincides stratigraphically with the early development of the circum-Chryse outflow channel systems that debouch into Chryse Planitia. This newly identified system, the NSV, potentially signifies the largest flood event(s) ever recorded for the solar system. Additional information is contained in original extended abstract.

Topical Application of Apricot Kernel Extract Improves Dry Eye Symptoms in a Unilateral Exorbital Lacrimal Gland Excision Mouse

PubMed Central

Kim, Chan-Sik; Jo, Kyuhyung; Lee, Ik-Soo; Kim, Junghyun

2016-01-01

The purpose of this study was to investigate the therapeutic effects of topical application of apricot kernel extract (AKE) in a unilateral exorbital lacrimal gland excision mouse model of experimental dry eye. Dry eye was induced by surgical removal of the lacrimal gland. Eye drops containing 0.5 or 1 mg/mL AKE were administered twice a day from day 3 to day 7 after surgery. Tear fluid volume and corneal irregularity scores were determined. In addition, we examined the immunohistochemical expression level of Muc4. The topical administration of AKE dose-dependently improved all clinical dry eye symptoms by promoting the secretion of tear fluid and mucin. Thus, the results of this study indicate that AKE may be an efficacious topical agent for treating dry eye disease. PMID:27886047

Topical Application of Apricot Kernel Extract Improves Dry Eye Symptoms in a Unilateral Exorbital Lacrimal Gland Excision Mouse.

PubMed

Kim, Chan-Sik; Jo, Kyuhyung; Lee, Ik-Soo; Kim, Junghyun

2016-11-23

The purpose of this study was to investigate the therapeutic effects of topical application of apricot kernel extract (AKE) in a unilateral exorbital lacrimal gland excision mouse model of experimental dry eye. Dry eye was induced by surgical removal of the lacrimal gland. Eye drops containing 0.5 or 1 mg/mL AKE were administered twice a day from day 3 to day 7 after surgery. Tear fluid volume and corneal irregularity scores were determined. In addition, we examined the immunohistochemical expression level of Muc4. The topical administration of AKE dose-dependently improved all clinical dry eye symptoms by promoting the secretion of tear fluid and mucin. Thus, the results of this study indicate that AKE may be an efficacious topical agent for treating dry eye disease.

Broad Redshifted Line as a Signature of Outflow

NASA Astrophysics Data System (ADS)

Titarchuk, Lev; Kazanas, Demos; Becker, Peter A.

2003-11-01

We formulate and solve the diffusion problem of line photon propagation in a bulk outflow from a compact object (black hole or neutron star) using a generic assumption regarding the distribution of line photons within the outflow. Thomson scattering of the line photons within the expanding flow leads to a decrease of their energy which is of first order in v/c, where v is the outflow velocity and c is the speed of light. We demonstrate that the emergent line profile is closely related to the time distribution of photons diffusing through the flow (the light curve) and consists of a broad redshifted feature. We analyzed the line profiles for the general case of outflow density distribution. We emphasize that the redshifted lines are intrinsic properties of the powerful outflow that are supposed to be in many compact objects.

Results of surgical septal myectomy for obstructive hypertrophic cardiomyopathy: the Tufts experience

PubMed Central

Boll, Griffin; Rowin, Ethan J.; Dolan, Noreen; Carroll, Catherine; Udelson, James E.; Wang, Wendy; Carpino, Philip; Maron, Barry J.; Maron, Martin S.; Chen, Frederick Y.

2017-01-01

Background For over 50 years, surgical septal myectomy has been the preferred treatment for drug-refractory heart failure symptoms in patients with obstructive hypertrophic cardiomyopathy (HCM). Over this time in the United States, the majority of myectomy operations have been performed in a small number of select referral centers. Methods We have taken the opportunity to report results from the relatively new Tufts HCM Center and surgical program, incorporated 13 years ago, during which 507 myectomies (52±14 years of age; 56% male) were performed by one cardiothoracic surgeon, Dr. Hassan Rastegar. Results Resting left ventricular (LV) outflow gradients were reduced from 56±42 mmHg preoperatively to 1.2±6.8 mmHg on most recent echocardiogram 2.0±2.5 years after surgery, and 94% of patients showed clinical improvement to NYHA functional class I or II. The first 200 myectomies were performed without mortality or major complications. Among all patients, 30-day mortality rate was 0.8%. Over follow-up of 3.2±2.8 years, 11 patients died (four due to HCM causes) with long-term survival after myectomy of 94% at 5 years (95% CI: 89–96%) and 91% at 10 years (95% CI: 84–95%), which did not differ from the age- and gender-matched general U.S. population (log-rank P=0.9). Conclusions This experience demonstrates that, with the appropriate support, new HCM surgical programs can provide patients successful relief of outflow obstruction, extended longevity and restored of quality of life. PMID:28944176

A resolved outflow of matter from a brown dwarf.

PubMed

Whelan, Emma T; Ray, Thomas P; Bacciotti, Francesca; Natta, Antonella; Testi, Leonardo; Randich, Sofia

2005-06-02

The birth of stars involves not only accretion but also, counter-intuitively, the expulsion of matter in the form of highly supersonic outflows. Although this phenomenon has been seen in young stars, a fundamental question is whether it also occurs among newborn brown dwarfs: these are the so-called 'failed stars', with masses between stars and planets, that never manage to reach temperatures high enough for normal hydrogen fusion to occur. Recently, evidence for accretion in young brown dwarfs has mounted, and their spectra show lines that are suggestive of outflows. Here we report spectro-astrometric data that spatially resolve an outflow from a brown dwarf. The outflow's characteristics appear similar to, but on a smaller scale than, outflows from normal young stars. This result suggests that the outflow mechanism is universal, and perhaps relevant even to the formation of planets.

Cytochrome P450 3A expression and activity in the rabbit lacrimal gland: glucocorticoid modulation and the impact on androgen metabolism.

PubMed

Attar, Mayssa; Ling, Kah-Hiing John; Tang-Liu, Diane D-S; Neamati, Nouri; Lee, Vincent H L

2005-12-01

Cytochrome P450 3A (CYP3A) is an enzyme of paramount importance to drug metabolism. The expression and activity of CYP3A, an enzyme responsible for active androgen clearance, was investigated in the rabbit lacrimal gland. Analysis of CYP3A expression and activity was performed on lacrimal gland tissues obtained from naïve untreated and treated New Zealand White rabbits. For 5 days, treated rabbits received daily administration of vehicle or 0.1% or 1.0% dexamethasone, in the lower cul-de-sac of each eye. Changes in mRNA expression were monitored by real-time RT-PCR. Protein expression was confirmed by Western blot. Functional activity was measured by monitoring the metabolism of CYP3A probe substrates-namely, 7-benzyloxyquinoline (BQ) and [3H]testosterone. Cytochrome P450 heme protein was detected at a concentration of 44.6 picomoles/mg protein, along with its redox partner NADPH reductase and specifically CYP3A6 in the naïve rabbit lacrimal gland. Genes encoding CYP3A6, in addition to the pregnane-X-receptor (PXR) and P-glycoprotein (P-gp) were expressed in the untreated tissue. BQ dealkylation was measured in the naïve rabbit lacrimal gland at a rate of 14 +/- 7 picomoles/mg protein per minute. Changes in CYP3A6, P-gp, and androgen receptor mRNA expression levels were detected after dexamethasone treatment. In addition, dexamethasone treatment resulted in significant increases in BQ dealkylation and CYP3A6-mediated [3H]testosterone metabolism. Concomitant increases in CYP3A6-mediated hydroxylated testosterone metabolites were observed in the treated rabbits. Furthermore, ketoconazole, all-trans retinoic acid, and cyclosporine inhibited CYP3A6 mediated [3H]testosterone 6beta hydroxylation in a concentration-dependent manner, with IC50 ranging from 3.73 to 435 microM. The results demonstrate, for the first time, the expression and activity of CYP3A6 in the rabbit lacrimal gland. In addition, this pathway was shown to be subject to modulation by a commonly

Compact binary merger and kilonova: outflows from remnant disc

NASA Astrophysics Data System (ADS)

Yi, Tuan; Gu, Wei-Min; Liu, Tong; Kumar, Rajiv; Mu, Hui-Jun; Song, Cui-Ying

2018-05-01

Outflows launched from a remnant disc of compact binary merger may have essential contribution to the kilonova emission. Numerical calculations are conducted in this work to study the structure of accretion flows and outflows. By the incorporation of limited-energy advection in the hyper-accretion discs, outflows occur naturally from accretion flows due to imbalance between the viscous heating and the sum of the advective and radiative cooling. Following this spirit, we revisit the properties of the merger outflow ejecta. Our results show that around 10-3 ˜ 10-1 M⊙ of the disc mass can be launched as powerful outflows. The amount of unbound mass varies with the disc mass and the viscosity. The outflow-contributed peak luminosity is around 1040 ˜ 1041 erg s-1. Such a scenario can account for the observed kilonovae associated with short gamma-ray bursts, including the recent event AT2017gfo (GW170817).

Global-scale Ionospheric Outflow: Major Processes and Unresolved Problems

NASA Astrophysics Data System (ADS)

Liemohn, M. W.; Welling, D. T.; Ilie, R.; Khazanov, G. V.; Jahn, J. M.; Zou, S.; Ganushkina, N. Y.; Valek, P. W.; Elliott, H. A.; Gilchrist, B. E.; Hoegy, W. R.; Glocer, A.

2016-12-01

Outflow from the ionosphere is a major source of plasma to the magnetosphere. Its presence, especially that of ions heavier than He+, mass loads the magnetosphere and changes reconnection rates, current system configurations, plasma wave excitation and wave-particle interactions. It even impacts the propagation of information. We present a brief overview of the major processes and scientific history of this field. There are still major gaps, however, in our understanding of the global-scale nature of ionospheric outflow. We discuss these unresolved problems highlighting the leading questions still outstanding on this topic. First and foremost, since the measurements of ionospheric outflow have largely come from individual satellites and sounding rockets, the processes are best known on the local level, while the spatial distribution of outflow has never been simultaneously measured on more global scales. The spatial coherence and correlation of outflow across time and space have not been quantified. Furthermore, the composition of the outflow is often only measured at a coarse level of H+, He+, and O+, neglecting other species such as N+ or moleculars. However, resolving O+ from N+, as is customary in planetary research, aids in revealing the physics and altitude dependence of the energization processes in the ionosphere. Similarly, fine-resolution velocity space measurements of ionospheric outflow have been limited, yet such observations can also reveal energization processes driving the outflow. A final unresolved issue to mention is magnetically conjugate outflow and the full extent of hemispherically asymmetric outflow fluxes or fluence. Each of these open questions have substantial ramifications for magnetospheric physics; their resolution could yield sweeping changes in our understanding of nonlinear feedback and cross-scale physical interactions, magnetosphere-ionosphere coupling, and geospace system-level science.

Cumulative neutrino background from quasar-driven outflows

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

Wang, Xiawei; Loeb, Abraham, E-mail: xiawei.wang@cfa.harvard.edu, E-mail: aloeb@cfa.harvard.edu

2016-12-01

Quasar-driven outflows naturally account for the missing component of the extragalactic γ-ray background through neutral pion production in interactions between protons accelerated by the forward outflow shock and interstellar protons. We study the simultaneous neutrino emission by the same protons. We adopt outflow parameters that best fit the extragalactic γ-ray background data and derive a cumulative neutrino background of ∼ 10{sup −7} GeV cm{sup −2} s{sup −1} sr{sup −1} at neutrino energies E {sub ν} ∼> 10 TeV, which naturally explains the most recent IceCube data without tuning any free parameters. The link between the γ-ray and neutrino emission frommore » quasar outflows can be used to constrain the high-energy physics of strong shocks at cosmological distances.« less

Adenoid cystic carcinomas of the salivary gland, lacrimal gland, and breast are morphologically and genetically similar but have distinct microRNA expression profiles.

PubMed

Andreasen, Simon; Tan, Qihua; Agander, Tina Klitmøller; Steiner, Petr; Bjørndal, Kristine; Høgdall, Estrid; Larsen, Stine Rosenkilde; Erentaite, Daiva; Olsen, Caroline Holkmann; Ulhøi, Benedicte Parm; von Holstein, Sarah Linéa; Wessel, Irene; Heegaard, Steffen; Homøe, Preben

2018-02-21

Adenoid cystic carcinoma is among the most frequent malignancies in the salivary and lacrimal glands and has a grave prognosis characterized by frequent local recurrences, distant metastases, and tumor-related mortality. Conversely, adenoid cystic carcinoma of the breast is a rare type of triple-negative (estrogen and progesterone receptor, HER2) and basal-like carcinoma, which in contrast to other triple-negative and basal-like breast carcinomas has a very favorable prognosis. Irrespective of site, adenoid cystic carcinoma is characterized by gene fusions involving MYB, MYBL1, and NFIB, and the reason for the different clinical outcomes is unknown. In order to identify the molecular mechanisms underlying the discrepancy in clinical outcome, we characterized the phenotypic profiles, pattern of gene rearrangements, and global microRNA expression profiles of 64 salivary gland, 9 lacrimal gland, and 11 breast adenoid cystic carcinomas. All breast and lacrimal gland adenoid cystic carcinomas had triple-negative and basal-like phenotypes, while salivary gland tumors were indeterminate in 13% of cases. Aberrations in MYB and/or NFIB were found in the majority of cases in all three locations, whereas MYBL1 involvement was restricted to tumors in the salivary gland. Global microRNA expression profiling separated salivary and lacrimal gland adenoid cystic carcinoma from their respective normal glands but could not distinguish normal breast adenoid cystic carcinoma from normal breast tissue. Hierarchical clustering separated adenoid cystic carcinomas of salivary gland origin from those of the breast and placed lacrimal gland carcinomas in between these. Functional annotation of the microRNAs differentially expressed between salivary gland and breast adenoid cystic carcinoma showed these as regulating genes involved in metabolism, signal transduction, and genes involved in other cancers. In conclusion, microRNA dysregulation is the first class of molecules separating adenoid

Microbiology of primary acquired nasolacrimal duct obstruction: simple epiphora, acute dacryocystitis, and chronic dacryocystitis

PubMed Central

Pornpanich, Kanograt; Luemsamran, Panitee; Leelaporn, Amornrut; Santisuk, Jiraporn; Tesavibul, Nattaporn; Lertsuwanroj, Buntitar; Vangveeravong, Sumalee

2016-01-01

Purpose The aim of this study was to determine the microbiology of primary acquired nasolacrimal duct obstruction (PANDO) and its antimicrobial susceptibilities. Methods Ninety-three patients (100 eyes) diagnosed with PANDO, categorized as acute, chronic dacryocystitis, or simple epiphora, were prospectively enrolled. Lacrimal sac contents were cultured for aerobic and anaerobic bacteria and fungi. Cultured organisms were identified, and antimicrobial susceptibility testing was performed for aerobic bacteria. Results Seventy-nine of the 100 samples were culture positive. One hundred twenty-seven organisms were isolated, and 29 different species were identified. Most microorganisms were Gram-positive bacteria (45 samples or 57.0% of all positive culture samples), whereas Gram-negative bacteria, anaerobic bacteria, and fungi were found in 39 (49.4%), 24 (30.4%), and four samples (5.1%), respectively. The most frequently isolated group was coagulase-negative staphylococci (27.8%), followed by nonspore-forming Gram-positive rods (anaerobe) (17.7%) and Pseudomonas aeruginosa (15.2%). Of the 100 samples, five, 45, and 50 samples were obtained from patients with acute dacryocystitis, chronic dacryocystitis, and simple epiphora, respectively. Subgroup analysis showed that Gram-negative organisms were isolated more frequently from the chronic dacryocystitis subgroup than from the simple epiphora subgroup (P=0.012). Antimicrobial susceptibility testing demonstrated that ciprofloxacin was the most effective drug against all Gram-positive and Gram-negative organisms. Conclusion Patients with PANDO, with or without clinical signs of lacrimal infection, were culture positive. Gram-negative organisms were frequently isolated, which were different from previous studies. Ciprofloxacin was the most effective agent against all Gram-positive and Gram-negative organisms. PMID:26955261

Theory of Bipolar Outflows from Accreting Hot Stars

NASA Astrophysics Data System (ADS)

Konigl, A.

1996-05-01

There is a growing number of observational indicators for the presence of bipolar outflows in massive, young stellar objects that are still accreting mass as part of their formation process. In particular, there is evidence that the outflows from these objects can attain higher velocities and kinetic luminosities than their lower-mass counterparts. Furthermore, the higher-mass objects appear to smoothly continue the correlation found in T Tauri stars between outflow and accretion signatures, and in several cases there are direct clues to the existence of a disk from optical and infrared spectroscopy. These results suggest that the disk--outflow connection found in low-mass pre--main-sequence stars extends to more massive objects, and that a similar physical mechanism may drive the outflows in both cases. In this presentation, I first critically examine the observational basis for this hypothesis, considering, among other things, the possibility that several low-luminosity outflows might occasionally masquerade as a single flow from a luminous object, and the effects that the radiation field of a hot star could have on the spectroscopic diagnostics of an accretion-driven outflow. I then go on to consider how the commonly invoked centrifugally driven wind models of bipolar outflows in low-mass stars would be affected by the various physical processes (such as photoionization, photoevaporation, radiation pressure, and stellar wind ram pressure) that operate in higher-mass stars. I conclude by mentioning some of the tantalizing questions that one could hope to address as this young field of research continues to develop (for example: is there a high-mass analog of the FU Orionis outburst phenomenon? Could one use observations of progressively more massive, and hence less convective, stars to elucidate the role of stellar magnetic fields in the accretion and outflow processes? Would it be possible to observationally identify massive stars that have reached the main

Relativistic Outflows from ADAFs

NASA Astrophysics Data System (ADS)

Becker, Peter; Subramanian, Prasad; Kazanas, Demosthenes

2001-04-01

Advection-dominated accretion flows (ADAFs) have a positive Bernoulli parameter, and are therefore gravitationally bound. The Newtonian ADAF model has been generalized recently to obtain the ADIOS model that includes outflows of energy and angular momentum, thereby allowing accretion to proceed self-consistently. However, the utilization of a Newtonian gravitational potential limits the ability of this model to describe the inner region of the disk, where any relativistic outflows are likely to originate. In this paper we modify the ADIOS scenario to incorporate a seudo - Newtonian potential, which approximates the effects of general relativity. The analysis yields a unique, self - similar solution for the structure of the coupled disk/wind system. Interesting features of the new solution include the relativistic character of the outflow in the vicinity of the radius of marginal stability, which represents the inner edge of the quasi-Keplerian disk in our model. Our self - similar model may therefore help to explain the origin of relativistic jets in active galaxies. At large distances the radial dependence of the accretion rate approachs the unique form dot M ∝ r^1/2, with an associated density variation given by ρ ∝ r-1. This density variation agrees with that implied by the dependence of the X-ray hard time lags on the Fourier frequency for a number of accreting galactic black hole candidates. While intriguing, the results of our self-similar model need to be confirmed in the future by incorporating a detailed physical description of the energization mechanism that drives the outflow, which is likely to be powered by the shear of the underlying accretion disk.

Density diagnostics of ionized outflows in active galacitc nuclei

NASA Astrophysics Data System (ADS)

Mao, J.; Kaastra, J.; Mehdipour, M.; Raassen, T.; Gu, L.

2017-10-01

Ionized outflows in Active Galactic Nuclei are thought to influence their nuclear and local galactic environment. However, the distance of outflows with respect to the central engine is poorly constrained, which limits our understanding of the kinetic power by the outflows. Therefore, the impact of AGN outflows on their host galaxies is uncertain. Given the density of the outflows, their distance can be immediately obtained by the definition of the ionization parameter. Here we carry out a theoretical study of density diagnostics of AGN outflows using absorption lines from metastable levels in Be-like to F-like ions. With the new self-consistent photoionization model (PION) in the SPEX code, we are able to calculate ground and metastable level populations. This enable us to determine under what physical conditions these levels are significantly populated. We then identify characteristic transitions from these metastable levels in the X-ray band. Firm detections of absorption lines from such metastable levels are challenging for current grating instruments. The next generation of spectrometers like X-IFU onboard Athena will certainly identify the presence/absence of these density- sensitive absorption lines, thus tightly constraining the location and the kinetic power of AGN outflows.

Quantifying the AGN-driven outflows in ULIRGs (QUADROS) III: Measurements of the radii and kinetic powers of 8 near-nuclear outflows

NASA Astrophysics Data System (ADS)

Spence, R. A. W.; Tadhunter, C. N.; Rose, M.; Rodríguez Zaurín, J.

2018-05-01

As part of the QUADROS project to quantify the impact of AGN-driven outflows in rapidly evolving galaxies in the local universe, we present observations of 8 nearby ULIRGs (0.04 < z < 0.2) taken with the ISIS spectrograph on the William Herschel Telescope (WHT), and also summarize the results of the project as a whole. Consistent with Rose et al. (2018), we find that the outflow regions are compact (0.08 < R_{[O III]} < 1.5 kpc), and the electron densities measured using the [S II], [O II] trans-auroral emission-line ratios are relatively high (2.5 < log ne (cm-3) < 4.5, median log ne (cm-3) ˜ 3.1). Many of the outflow regions are also significantly reddened (median E(B - V) ˜ 0.5). Assuming that the de-projected outflow velocities are represented by the 5^{th} percentile velocities (v05) of the broad, blueshifted components of [O III] λ5007, we calculate relatively modest mass outflow rates (0.1 < \\dot{M} < 20 M⊙ yr-1, median \\dot{M} ˜ 2 M⊙ yr-1), and find kinetic powers as a fraction of the AGN bolometric luminosity (\\dot{F} = \\dot{E}/L_bol) in the range 0.02 < \\dot{F} < 3 per cent, median \\dot{F} ˜ 0.3 per cent). The latter estimates are in line with the predictions of multi-stage outflow models, or single-stage models in which only a modest fraction of the initial kinetic power of the inner disk winds is transferred to the larger-scale outflows. Considering the QUADROS sample as a whole, we find no clear evidence for correlations between the properties of the outflows and the bolometric luminosities of the AGN, albeit based on a sample that covers a relatively small range in Lbol. Overall, our results suggest that there is a significant intrinsic scatter in outflow properties of ULIRGs for a given AGN luminosity.

Toward a Prescription for Feedback from Quasar Outflows

NASA Astrophysics Data System (ADS)

Ganguly, Rajib; Bourjaily, M.; Munsell, J.; Brotherton, M. S.; Bhattacharjee, A.; Runnoe, J.; Charlton, J. C.; Eracleous, M.

2011-01-01

Models have shown that quasars are a crucial ingredient in the evolution of massive galaxies. Outflows play a key role in the story of quasars and their host galaxies, by helping regulate the accretion process, the star-formation rate and mass of the host galaxy (i.e., feedback). The prescription for modeling outflows as a contributor to feedback requires knowledge of the outflow velocity, distance, geometry, and column density. In particular, we need to understand how these depend on physical parameters and how much is determined stochastically (and with what distribution). For this purpose, we are examining a sample of 14000 z=1.7-2.0 quasars from the Sloan Digital Sky Survey. This redshift range permits the following from the SDSS spectra: (1) separation of objects that do and do not exhibit outflows; (2) classification/measurement of outflow properties (ionization, velocity, velocity width); and (3) estimates of the quasar black hole mass. To this, we are adding photometry from GALEX, 2MASS, and ROSAT in an effort to characterize more fully the quasar SEDs. ROSAT photometry provides estimates of the level of soft X-ray absorption, which helps regulate the velocity of outflows. GALEX photometry samples the extreme ultraviolet range where several high ionization species, that may be present in the outflows, absorb light. 2MASS photometry samples the rest-frame optical, where the effects of absorption and dust reddening are minimal, yield better estimates of the bolometric luminosity (hence, Eddington ratio). In this poster, we will present preliminary measurements of the amount of absorption in the soft X-ray and extreme ultraviolet bands as a function of both outflow properties and quasar physical properties. This material is based upon work supported by the National Aeronautics and Space Administration under Grant No. 09-ADP09-0016 issued through the Astrophysics Data Analysis Program.

Fast Outflow of Molecular Gas in the Seyfert Galaxy IC 5063

NASA Astrophysics Data System (ADS)

Morganti, Raffaella; Oosterloo, T.; Oonk, R.; Tadhunter, C.

2017-11-01

AGN-driven gas outflows may play an important role in the evolution of galaxies, as they impact on the growth on the central supermassive black hole as well on the star formation of the host galaxy. Much of the detailed physics of these gas outflows, and their actual impact on the host galaxy, is still not well understood. We present a detailed analysis, using ALMA observations, of the radio-jet driven outflow of molecular gas in the nearby radio-loud Seyfert galaxy IC 5063 which allows to derive important physical parameters of the gas and the outflow which, in turn, provide crucial input to numerical models. In recent years, a surprising result in the field of AGN-driven outflows has been that the cold phases of the gas (atomic and molecular) in some galaxies are the massive components of these outflows, despite the huge amounts of energy involved in driving these outflows. However, why most of the outflowing gas should be molecular/atomic, and in general, what are the physical conditions of the gas in the outflows and what really drives them, are still open questions. We present the results obtained from ALMA observations of multiple CO transitions and other molecules of what appears to be a textbook case of a jet-driven multi- phase outflow in the central regions of the Seyfert galaxy IC 5063. The data on multiple transitions allow us to derive the physical conditions in the different regions of the outflowing molecular gas. The signature of the impact of the radio jet is clearly seen in the spatial distribution of the excitation temperature and pressure of the outflowing gas, with the highest excitation and pressure found for the gas with the highest outflow velocities. We obtain a detailed three- dimensional picture of the outflow, and its kinematics, and find that outflowing molecular gas is present across the entire region co-spatial with the radio plasma, providing unambiguous evidence that the radio jets/cocoon are responsible for the outflow. The

Maja Valley and the Chryse outflow complex sites

NASA Technical Reports Server (NTRS)

Rice, Jim W.

1994-01-01

This candidate landing site is located at 19 deg N, 53.5 deg W near the mouth of a major outflow channel. Maja Valles, and two 'valley network' channel systems, Maumee and Vedra Valles. The following objectives are to be analyzed in this region: (1) origin and paleohydrology of outflow and valley network channels; (2) fan delta complex composition (the deposit located in this area is one of the few identified at the mouth s of any channels on the planet); and (3) analysis of any paleolake sediments (carbonates, evaporites). The primary objectives of the Chryse Outflow Complex region (Ares, Tiu, Mawrth, Simud, and Shalbatana Valles) would be outflow channel dynamics (paleohydrology) of five different channel systems.

A Study of PG Quasar-Driven Outflows with COS

NASA Astrophysics Data System (ADS)

Hamann, Frederick

2013-10-01

Quasar outflows are an important part of the quasar phenomenon, but many questions remain about their energetics, physical properties and the role they might play in providing feedback to host galaxy evolution. We searched our own COS far-UV observations from the QUEST survey and other large COS programs to find a sample of 6 bright PG quasars with broad {FWHM > 400 km/s} high velocity {v > 1000 km/s} absorption lines that clearly form in quasar-driven winds. These quasars can fill an important gap in our understanding between local Seyferts with low-speed winds and high-redshift quasars with extreme BAL outflows. They are also well-studied at other wavelengths, with some evidence for the quasars driving galaxy-scale blowouts and shutting down star formation. But almost nothing is known about the quasar outflows themselves. We propose a detailed study of these 6 outflow quasars using new COS FUV observations to 1} expand the existing wavelength coverage across critical lines that are diagnostic of the outflow physical conditions, kinetic energies, and metallicities, and 2} check for line variability as an indicator of the outflow structure and locations. This quasar sample includes unusual cases with many low-abundance {PV 1118,1128 and SIV 1063} and excited-state lines {SIV 1073*, CIII* 1175, CII* 1335} that will provide unprecedented constraints on the outflow properties, plus the first known OVI-only mini-BAL outflow {no lower ions detected} for which we will cover NeVIII 770,780 to probe the highest ionization gas. The high FUV sensitivity of COS is uniquely able to measure this wide range of outflow lines in low-redshift quasars with no Lya forest contamination.

Acute dacryocystitis associated with epstein-barr virus infection.

PubMed

Ghauri, Abdul-Jabbar; Keane, Pearse A; Scotcher, Stephen M; Clarke, Jayne L; Madge, Simon N

2011-10-01

Acute dacryocystitis is a rare complication of infectious mononucleosis with only three previous reports in the English literature. We present two further children with acute dacryocystitis and clinical and laboratory features of Epstein-Barr Virus related infectious mononucleosis. Both were treated with systemic antibiotics and one child additionally required surgical drainage of a lacrimal sac abscess. Both children made a complete recovery without any lacrimal symptoms. Acute dacryocystitis is uncommon in children without a history of congenital nasolacrimal duct obstruction, and an underlying systemic condition such as infectious mononucleosis should be suspected. In such patients, dacryocystitis can be expected to resolve without symptoms of nasolacrimal duct obstruction and dacryocystorhinostomy is seldom required.

The Mass Outflow Rate of the Milky Way

NASA Astrophysics Data System (ADS)

Fox, Andrew

2017-08-01

The balance between gaseous inflow and outflow regulates star formation in spiral galaxies. This paradigm can be tested in the Milky Way, but whereas the star formation rate and inflow rate have both been measured, the outflow rate has not. We propose an archival COS program to determine the Galactic outflow rate in cool gas ( 10^4 K) by surveying UV absorption line high-velocity clouds (HVCs). This project will make use of the newly updated Hubble Spectroscopic Legacy Archive, which contains a uniformly reduced sample of 233 COS G130M spectra of background AGN. The outflow rate will be determined by (1) searching for redshifted HVCs; (2) modeling the clouds with photoionization simulations to determine their masses and physical properties; (3) combining the cloud masses with their velocities and distances. We will measure how the outflow is distributed spatially across the sky, calculate its mass loading factor, and compare the line profiles to synthetic spectra extracted from new hydrodynamic simulations. The distribution of HVC velocities will inform us what fraction of the outflowing clouds will escape the halo and what fraction will circulate back to the disk, to better understand how and where gas enters and exits the Milky Way.

Quantification of Focal Outflow Enhancement Using Differential Canalograms

PubMed Central

Loewen, Ralitsa T.; Brown, Eric N.; Scott, Gordon; Parikh, Hardik; Schuman, Joel S.; Loewen, Nils A.

2016-01-01

Purpose To quantify regional changes of conventional outflow caused by ab interno trabeculectomy (AIT). Methods Gonioscopic, plasma-mediated AIT was established in enucleated pig eyes. We developed a program to automatically quantify outflow changes (R, package eye-canalogram, github.com) using a fluorescent tracer reperfusion technique. Trabecular meshwork (TM) ablation was demonstrated with fluorescent spheres in six eyes before formal outflow quantification with two-dye reperfusion canalograms in six additional eyes. Eyes were perfused with a central, intracameral needle at 15 mm Hg. Canalograms and histology were correlated for each eye. Results The pig eye provided a model with high similarity to AIT in human patients. Histology indicated ablation of TM and unroofing of most Schlemm's canal segments. Spheres highlighted additional circumferential and radial outflow beyond the immediate area of ablation. Differential canalograms showed that AIT caused an increase of outflow of 17 ± 5-fold inferonasally, 14 ± 3-fold superonasally, and also an increase in the opposite quadrants with a 2 ± 1-fold increase superotemporally, and 3 ± 3 inferotemporally. Perilimbal specific flow image analysis showed an accelerated nasal filling with an additional perilimbal flow direction into adjacent quadrants. Conclusions A quantitative, differential canalography technique was developed that allows us to quantify supraphysiological outflow enhancement by AIT. PMID:27227352

Exploring the engines of molecular outflows

NASA Astrophysics Data System (ADS)

Testi, Leonardo

1995-03-01

Water vapour masers and CO outflows are well known to be associated with the youngest phases of evolution of massive stellar objects. Nevertheless, up to now there is a lack of high resolution multiwavelength study of the regions containing these objects. Using the VLA, the CSO and the TIRGO equipped with the new Near-Infrared (NIR) camera ARNICA, we have begun a systematic study of water maser/CO outflow regions. These new high resolution and high sensitivity data have proved to be very useful in probing the star formation activity and the connection between infrared and radio sources. Here we report the results obtained in a preliminary sub- sample of objects. The NIR data showed that both the maser spots and the large- scale outflows tend to be associated to the most embedded and probably younger sources of the infrared clusters. Infrared emission lines observed with narrow band filters show the presence of jet-like structures in most of the sources observed. Water masers, jet-like and Herbig-Haro-like infrared structures, and CO outflows enable to probe ejection phenomena at all spacial scales ranging from 0.01 to 1 parsec.

Outflow from a Nocturnal Thunderstorm.

DTIC Science & Technology

1980-11-01

P AD-A093 796 ILLINOIS STATE WATER SURVEY URBANAF/ .2 OUTFLOW FROM A NOCTURNAL THUNDERSTORM. (U) NOV a0 R W SCOTT NSF-ATHN78-0a865 UNCLASSIFIED SWS...CR-242 ARO-15529.5-6S N I muuuuuuuuuuuu iDA0937 9 6 State Water Survey Division k istitute of METEOROLOGY SECTION 0 uJD AT THE UNIVERSITY OF ILLINOIS...SWS Contract Report 242 / F OUTFLOW FROM A NOCTURNAL THUNDERSTORM Robert W. Scott Meteorology Section Illinois State Water Survey -- DTIC ELECTE CD

No Sign of Strong Molecular Gas Outflow in an Infrared-bright Dust-obscured Galaxy with Strong Ionized-gas Outflow

NASA Astrophysics Data System (ADS)

Toba, Yoshiki; Komugi, Shinya; Nagao, Tohru; Yamashita, Takuji; Wang, Wei-Hao; Imanishi, Masatoshi; Sun, Ai-Lei

2017-12-01

We report the discovery of an infrared (IR)-bright dust-obscured galaxy (DOG) that shows a strong ionized-gas outflow but no significant molecular gas outflow. Based on detailed analysis of their optical spectra, we found some peculiar IR-bright DOGs that show strong ionized-gas outflow ([O III] λ5007) from the central active galactic nucleus (AGN). For one of these DOGs (WISE J102905.90+050132.4) at z spec = 0.493, we performed follow-up observations using ALMA to investigate their CO molecular gas properties. As a result, we successfully detected 12CO(J = 2–1) and 12CO(J = 4–3) lines and the continuum of this DOG. The intensity-weighted velocity map of both lines shows a gradient, and the line profile of those CO lines is well-fitted by a single narrow Gaussian, meaning that this DOG has no sign of strong molecular gas outflow. The IR luminosity of this object is log (L IR/L ⊙) = 12.40, which is classified as an ultraluminous IR galaxy (ULIRG). We found that (i) the stellar mass and star formation rate relation and (ii) the CO luminosity and far-IR luminosity relation are consistent with those of typical ULIRGs at similar redshifts. These results indicate that the molecular gas properties of this DOG are normal despite the fact that its optical spectrum shows a powerful AGN outflow. We conclude that a powerful ionized-gas outflow caused by the AGN does not necessarily affect the cold interstellar medium in the host galaxy, at least for this DOG.

Urolume stent placement for the treatment of postbrachytherapy bladder outlet obstruction.

PubMed

Konety, B R; Phelan, M W; O'Donnell, W F; Antiles, L; Chancellor, M B

2000-05-01

Transurethral resection (TURP) or incision of the prostate is generally not effective for treating bladder outlet obstruction after transperineal brachytherapy for prostate cancer. Furthermore, TURP could compromise full-dose effective radiation delivery to the prostate. We analyzed the efficacy of the UroLume stent in treating the urinary outflow obstruction in such patients. Five patients who had undergone brachytherapy (3 with (192)Ir high-dose radiation and 2 with (125)I) subsequently developed one or more episodes of urinary retention 2 weeks to 4 years after treatment. The patients failed or could not tolerate alpha-blockers or clean intermittent catheterization. Three patients subsequently underwent urethral dilation/optical internal urethrotomy for strictures, and 1 patient underwent suprapubic tube placement. Following the failure of these interventions, each of these patients had a UroLume stent placement. A single UroLume stent (2 cm in 3 patients and 2.5 cm in 2 patients) was placed under local/spinal anesthesia. All patients were able to void spontaneously immediately after stent placement. Of the patients with previous urethral strictures, 1 remained continent and 1 had persistent incontinence. Neither of the patients with early postbrachytherapy retention developed incontinence after stent placement. The main complaints following stent placement were referred pain to the head of the penis and dysuria. Stent-related symptoms necessitated stent removal in 2 of 5 patients, 4 to 6 weeks after placement. The UroLume stent can be used as an alternative form of therapy for managing postbrachytherapy bladder outlet obstruction. The treatment is easily reversible by removing the stent when obstruction resolves.

Characterizing Quasar Outflows I: Sample, Spectral Measurements

NASA Astrophysics Data System (ADS)

Ganguly, Rajib; Christenson, D. H.; Richmond, J. M.; Derseweh, J. A.; Robbins, J. M.; Townsend, S. L.; Stark, M. A.

2012-05-01

Galaxy evolution models have shown that quasars are a crucial ingredient in the evolution of massive galaxies. Outflows play a key role in the story of quasars and their host galaxies, by helping regulate the accretion process, the star-formation rate and mass of the host galaxy (i.e., feedback). The prescription for modeling outflows as a contributor to feedback requires knowledge of the outflow velocity, geometry, and column density. In particular, we need to understand how these depend on physical parameters and how much is determined stochastically (and with what distribution). For this purpose, we are examining a sample of 11000 z=1.7-2.0 quasars from the Sloan Digital Sky Survey. This redshift range permits the following from the SDSS spectra: (1) separation of objects that do and do not exhibit outflows; (2) classification/measurement of outflow properties (ionization, velocity, velocity width); and (3) measurements of UV emission line and continuum parameters. In this poster, we subjectively divide these quasars into four categories: broad absorption-line quasars (2700 objects), associated absorption-line quasars (1700 objects), reddened quasars (160 objects), and unabsorbed/unreddened quasars (6300 objects). We present measurements of the absorption (velocities, velocity widths, equivalent widths), composite spectral profiles of outflows as a function of velocity, as well as measurements of the continuum and CIV, MgII, and FeII emission-line properties. In accompanying posters, we add photometry from the rest-frame X-ray (ROSAT and Chandra), EUV (GALEX), optical (2MASS), and infrared (WISE) bands to complete the SED. The continuum and emission-line measurements from the SDSS spectra and accompanying photometry provides estimates on the black hole masses, bolometric luminsosities, and SED. We consider empirically how these affect the outflow properties. This material is based upon work supported by the National Aeronautics and Space Administration under

Lacritin and Other New Proteins of the Lacrimal Functional Unit

PubMed Central

McKown, Robert L.; Wang, Ningning; Raab, Ronald W.; Karnati, Roy; Zhang, Yinghui; Williams, Patricia B.; Laurie, Gordon W.

2009-01-01

The lacrimal functional unit (LFU) is defined by the 2007 International Dry Eye WorkShop as ‘an integrated system comprising the lacrimal glands, ocular surface (cornea, conjunctiva and meibomian glands) and lids, and the sensory and motor nerves that connect them’. The LFU maintains a healthy ocular surface primarily through a properly functioning tear film that provides protection, lubrication, and an environment for corneal epithelial cell renewal. LFU cells express thousands of proteins. Over two hundred new LFU proteins have been discovered in the last decade. Lacritin is a new LFU-specific growth factor in human tears that flows through ducts to target corneal epithelial cells on the ocular surface. When applied topically in rabbits, lacritin appears to increase the volume of basal tear secretion. Lacritin is one of only a handful of tear proteins preliminarily reported to be downregulated in blepharitis and in two dry eye syndromes. Computational analysis predicts an ordered C-terminal domain that binds the corneal epithelial cell surface proteoglycan syndecan-1 (SDC1) and is required for lacritin’s low nanomolar mitogenic activity. The lacritin binding site on the N-terminus of SDC1 is exposed by heparanase. Heparanase is constitutively expressed by the corneal epithelium and appears to be a normal constituent of tears. Binding triggers rapid signaling to downstream NFAT and mTOR. A wealth of other new proteins, originally designated as hypothetical when first identified by genomic sequencing, are expressed by the human LFU including: ALS2CL, ARHGEF19, KIAA1109, PLXNA1, POLG, WIPI1 and ZMIZ2. Their demonstrated or implied roles in human genetic disease or basic cellular functions are fuel for new investigation. Addressing topical areas in ocular surface physiology with new LFU proteins may reveal interesting new biological mechanisms and help get to the heart of ocular surface dysfunction. PMID:18840430

Lacritin and other new proteins of the lacrimal functional unit.

PubMed

McKown, Robert L; Wang, Ningning; Raab, Ronald W; Karnati, Roy; Zhang, Yinghui; Williams, Patricia B; Laurie, Gordon W

2009-05-01

The lacrimal functional unit (LFU) is defined by the 2007 International Dry Eye WorkShop as 'an integrated system comprising the lacrimal glands, ocular surface (cornea, conjunctiva and meibomian glands) and lids, and the sensory and motor nerves that connect them'. The LFU maintains a healthy ocular surface primarily through a properly functioning tear film that provides protection, lubrication, and an environment for corneal epithelial cell renewal. LFU cells express thousands of proteins. Over 200 new LFU proteins have been discovered in the last decade. Lacritin is a new LFU-specific growth factor in human tears that flows through ducts to target corneal epithelial cells on the ocular surface. When applied topically in rabbits, lacritin appears to increase the volume of basal tear secretion. Lacritin is one of only a handful of tear proteins preliminarily reported to be downregulated in blepharitis and in two dry eye syndromes. Computational analysis predicts an ordered C-terminal domain that binds the corneal epithelial cell surface proteoglycan syndecan-1 (SDC1) and is required for lacritin's low nanomolar mitogenic activity. The lacritin-binding site on the N-terminus of SDC1 is exposed by heparanase. Heparanase is constitutively expressed by the corneal epithelium and appears to be a normal constituent of tears. Binding triggers rapid signaling to downstream NFAT and mTOR. A wealth of other new proteins, originally designated as hypothetical when first identified by genomic sequencing, are expressed by the human LFU including: ALS2CL, ARHGEF19, KIAA1109, PLXNA1, POLG, WIPI1 and ZMIZ2. Their demonstrated or implied roles in human genetic disease or basic cellular functions are fuel for new investigation. Addressing topical areas in ocular surface physiology with new LFU proteins may reveal interesting new biological mechanisms and help get to the heart of ocular surface dysfunction.

Chryse Outflow Channel

NASA Image and Video Library

1998-06-08

A color image of the south Chryse basin Valles Marineris outflow channels on Mars; north toward top. The scene shows on the southwest corner the chaotic terrain of the east part of Valles Marineris and two of its related canyons: Eos and Capri Chasmata (south to north). Ganges Chasma lies directly north. The chaos in the southern part of the image gives rise to several outflow channels, Shalbatana, Simud, Tiu, and Ares Valles (left to right), that drained north into the Chryse basin. The mouth of Ares Valles is the site of the Mars Pathfinder lander. This image is a composite of NASA's Viking medium-resolution images in black and white and low-resolution images in color. The image extends from latitude 20 degrees S. to 20 degrees N. and from longitude 15 degrees to 53 degrees; Mercator projection. http://photojournal.jpl.nasa.gov/catalog/PIA00418

DISCOVERY OF RELATIVISTIC OUTFLOW IN THE SEYFERT GALAXY Ark 564

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

Gupta, A.; Mathur, S.; Krongold, Y.

2013-07-20

We present Chandra High Energy Transmission Grating Spectra of the narrow-line Seyfert-1 galaxy Ark 564. The spectrum shows numerous absorption lines which are well modeled with low-velocity outflow components usually observed in Seyfert galaxies. There are, however, some residual absorption lines which are not accounted for by low-velocity outflows. Here, we present identifications of the strongest lines as K{alpha} transitions of O VII (two lines) and O VI at outflow velocities of {approx}0.1c. These lines are detected at 6.9{sigma}, 6.2{sigma}, and 4.7{sigma}, respectively, and cannot be due to chance statistical fluctuations. Photoionization models with ultra-high velocity components improve the spectralmore » fit significantly, providing further support for the presence of relativistic outflow in this source. Without knowing the location of the absorber, its mass and energy outflow rates cannot be well constrained; we find E-dot (outflow)/L{sub bol} lower limit of {>=}0.006% assuming a bi-conical wind geometry. This is the first time that absorption lines with ultra-high velocities are unambiguously detected in the soft X-ray band. The presence of outflows with relativistic velocities in active galactic nuclei (AGNs) with Seyfert-type luminosities is hard to understand and provides valuable constraints to models of AGN outflows. Radiation pressure is unlikely to be the driving mechanism for such outflows and magnetohydrodynamic may be involved.« less

Efficacy of laser stimulation of the lacrimal gland and collagen punctual occlusion in the treatment of dry-eye syndrome

NASA Astrophysics Data System (ADS)

Switka-Wieclawska, Iwona; Kecik, Tadeusz; Ciszewska, Joanna

1997-10-01

In this study we would like to monitor the tear secretion during a 7 day period of temporary intracanalicular occlusion and laser stimulation of lacrimal gland in a small group of female suffering of dry eye syndrome.

Character and dynamics of the Red Sea and Persian Gulf outflows

NASA Astrophysics Data System (ADS)

Bower, Amy S.; Hunt, Heather D.; Price, James F.

2000-03-01

Historical hydrographic data and a numerical plume model are used to investigate the initial transformation, dynamics, and spreading pathways of Red Sea and Persian Gulf outflow waters where they enter the Indian Ocean. The annual mean transport of these outflows is relatively small (<0.4 Sv), but they have a major impact on the hydrographic properties of the Indian Ocean at the thermocline level because of their high salinity. They are different from other outflows in that they flow over very shallow sills (depth < 200 m) into a highly stratified upper ocean environment and they are located at relatively low latitudes (12°N and 26°N). Furthermore, the Red Sea outflow exhibits strong seasonal variability in transport. The four main results of this study are as follows. First, on the basis of observed temperature-salinity (T-S) characteristics of the outflow source and product waters we estimate that the Red Sea and Persian Gulf outflows are diluted by factors of ˜2.5 and 4, respectively, as they descend from sill depth to their depth of neutral buoyancy. The high-dilution factor for the Persian Gulf outflow results from the combined effects of large initial density difference between the outflow source water and oceanic water and low outflow transport. Second, the combination of low latitude and low outflow transport (and associated low outflow thickness) results in Ekman numbers for both outflows that are O(1). This indicates that they should be thought of as frictional density currents modified by rotation rather than geostrophic density currents modified by friction. Third, different mixing histories along the two channels that direct Red Sea outflow water into the open ocean result in product waters with significantly different densities, which probably contributes to the multilayered structure of the Red Sea product waters. In both outflows, seasonal variations in source water and oceanic properties have some effect on the T-S of the product waters, but

The Role of Cosmic-Ray Pressure in Accelerating Galactic Outflows

NASA Astrophysics Data System (ADS)

Simpson, Christine M.; Pakmor, Rüdiger; Marinacci, Federico; Pfrommer, Christoph; Springel, Volker; Glover, Simon C. O.; Clark, Paul C.; Smith, Rowan J.

2016-08-01

We study the formation of galactic outflows from supernova (SN) explosions with the moving-mesh code AREPO in a stratified column of gas with a surface density similar to the Milky Way disk at the solar circle. We compare different simulation models for SN placement and energy feedback, including cosmic rays (CRs), and find that models that place SNe in dense gas and account for CR diffusion are able to drive outflows with similar mass loading as obtained from a random placement of SNe with no CRs. Despite this similarity, CR-driven outflows differ in several other key properties including their overall clumpiness and velocity. Moreover, the forces driving these outflows originate in different sources of pressure, with the CR diffusion model relying on non-thermal pressure gradients to create an outflow driven by internal pressure and the random-placement model depending on kinetic pressure gradients to propel a ballistic outflow. CRs therefore appear to be non-negligible physics in the formation of outflows from the interstellar medium.

THE ROLE OF COSMIC-RAY PRESSURE IN ACCELERATING GALACTIC OUTFLOWS

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

Simpson, Christine M.; Pakmor, Rüdiger; Pfrommer, Christoph

We study the formation of galactic outflows from supernova (SN) explosions with the moving-mesh code AREPO in a stratified column of gas with a surface density similar to the Milky Way disk at the solar circle. We compare different simulation models for SN placement and energy feedback, including cosmic rays (CRs), and find that models that place SNe in dense gas and account for CR diffusion are able to drive outflows with similar mass loading as obtained from a random placement of SNe with no CRs. Despite this similarity, CR-driven outflows differ in several other key properties including their overallmore » clumpiness and velocity. Moreover, the forces driving these outflows originate in different sources of pressure, with the CR diffusion model relying on non-thermal pressure gradients to create an outflow driven by internal pressure and the random-placement model depending on kinetic pressure gradients to propel a ballistic outflow. CRs therefore appear to be non-negligible physics in the formation of outflows from the interstellar medium.« less

Formation and spatial distribution of hypervelocity stars in AGN outflows

NASA Astrophysics Data System (ADS)

Wang, Xiawei; Loeb, Abraham

2018-05-01

We study star formation within outflows driven by active galactic nuclei (AGN) as a new source of hypervelocity stars (HVSs). Recent observations revealed active star formation inside a galactic outflow at a rate of ∼ 15M⊙yr-1 . We verify that the shells swept up by an AGN outflow are capable of cooling and fragmentation into cold clumps embedded in a hot tenuous gas via thermal instabilities. We show that cold clumps of ∼ 103 M⊙ are formed within ∼ 105 yrs. As a result, stars are produced along outflow's path, endowed with the outflow speed at their formation site. These HVSs travel through the galactic halo and eventually escape into the intergalactic medium. The expected instantaneous rate of star formation inside the outflow is ∼ 4 - 5 orders of magnitude greater than the average rate associated with previously proposed mechanisms for producing HVSs, such as the Hills mechanism and three-body interaction between a star and a black hole binary. We predict the spatial distribution of HVSs formed in AGN outflows for future observational probe.

Broad Red-Shifted Lines as a Signature of Outflow

NASA Astrophysics Data System (ADS)

Kazanas, Demosthenes; Titarchuk, Lev; Becker, Peter A.

2004-07-01

We formulate and solve the diffusion problem of line photon propagation in a bulk outflow from a compact object (black hole or neutron star) using a generic assumption regarding the distribution of line photons within the outflow. Thomson scattering of the line photons within the expanding flow leads to a decrease of their energy which is of first order in v/c, where v is the outflow velocity and c the speed of light. We demonstrate that the emergent line profile is closely related to the time distribution of photons diffusing through the flow (the light curve) and consists of a broad redshifted feature. We analyzed the line profiles for the general case of outflow density distribution. We emphasize that the redshifted lines are intrinsic properties of the powerful outflow that are supposed to be in many compact objects.

Broad Red-Shifted Lines as a Signature of Outflows

NASA Astrophysics Data System (ADS)

Titarchuck, Lev; Kazanas, Demos; Becker, Peter A.

2006-02-01

We formulate and solve the diffusion problem of line photon propagation in a bulk outflow from a compact object (black hole or neutron star) using a generic assumption regarding the distribution of line photons within the outflow. Thomson scattering of the line photons within the expanding flow leads to a decrease of their energy which is of first order in υ/c, where υ the outflow velocity and c is the speed of light. We demonstrate that the emergent line profile is closely related to the time distribution of photons diffusing through the flow (the light curve) and consists of a broad redshifted feature. We analyzed the line profiles for the general case of outflow density distribution. We emphasize that the redshifted lines are intrinsic properties of the powerful outflow that are supposed to be in many compact objects.

Cryopreservation and hypothermic storage of lacrimal gland: towards enabling delivery of regenerative medicine therapies for treatment of dry eye syndrome.

PubMed

Massie, I; Spaniol, K; Geerling, G; Schrader, S

2017-12-01

Severe dry eye syndrome (DES) can cause painful loss of vision and may result from lacrimal gland dysfunction. Current treatments are palliative, so a causative therapy is desirable. The ability to (cryo)preserve lacrimal gland tissue or epithelial cells would simplify this. Here, lacrimal gland tissue was cryopreserved in 10% dimethylsulphoxide in liquid nitrogen, or stored at 4 °C in culture medium for up to 7 days, and compared with fresh tissue using immunohistochemistry. Cultures were initiated from fresh and stored tissue, and cells characterised in P1 for proliferation (WST-1), colony-forming efficiency (CFE) and secretory capacity (immunocytochemistry and β-hexosaminidase activity assay). Tissue stored for > 3 days at 4 °C displayed grossly altered tissue architecture when compared with fresh tissue, decreased acinus density and increased caspase-3 activity. Cryopreserved tissue showed less obvious signs of damage without caspase-3 activation. Storage at 4 °C and cryopreservation delayed epithelial outgrowth compared with that from fresh tissue initially (p  <  0.05) but, by day 9, all explants showed comparable outgrowth (~90%), except tissue stored at 4 °C for 3 or 7 days (p  <  0.05 compared with fresh tissue). Epithelial cell yields per explant were similar from fresh and stored tissue, apart from tissue stored at 4 °C for 7 days (p  <  0.01). In P1, epithelial cells from fresh and stored tissue were largely equivalent in terms of: proliferation; CFE (~21%); Rab3D, HexA and lysozyme expression; mucin production; and β-hexosaminidase activity. These data demonstrate that cryo(preservation) of lacrimal gland tissue and cells is possible, which may enable use of autologous cells in regenerative medicine approaches to treating DES. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Wind influence on a coastal buoyant outflow

NASA Astrophysics Data System (ADS)

Whitney, Michael M.; Garvine, Richard W.

2005-03-01

This paper investigates the interplay between river discharge and winds in forcing coastal buoyant outflows. During light winds a plume influenced by the Earth's rotation will flow down shelf (in the direction of Kelvin wave propagation) as a slender buoyancy-driven coastal current. Downwelling favorable winds augment this down-shelf flow, narrow the plume, and mix the water column. Upwelling favorable winds drive currents that counter the buoyancy-driven flow, spread plume waters offshore, and rapidly mix buoyant waters. Two criteria are developed to assess the wind influence on a buoyant outflow. The wind strength index (Ws) determines whether a plume's along-shelf flow is in a wind-driven or buoyancy-driven state. Ws is the ratio of the wind-driven and buoyancy-driven along-shelf velocities. Wind influence on across-shelf plume structure is rated with a timescale (ttilt) for the isopycnal tilting caused by wind-driven Ekman circulation. These criteria are used to characterize wind influence on the Delaware Coastal Current and can be applied to other coastal buoyant outflows. The Delaware buoyant outflow is simulated for springtime high-river discharge conditions. Simulation results and Ws values reveal that the coastal current is buoyancy-driven most of the time (∣Ws∣ < 1 on average). Wind events, however, overwhelm the buoyancy-driven flow (∣Ws∣ > 1) several times during the high-discharge period. Strong upwelling events reverse the buoyant outflow; they constitute an important mechanism for transporting fresh water up shelf. Across-shelf plume structure is more sensitive to wind influence than the along-shelf flow. Values of ttilt indicate that moderate or strong winds persisting throughout a day can modify plume width significantly. Plume widening during upwelling events is accompanied by mixing that can erase the buoyant outflow.

Estimation of cold plasma outflow during geomagnetic storms

NASA Astrophysics Data System (ADS)

Haaland, S.; Eriksson, A.; André, M.; Maes, L.; Baddeley, L.; Barakat, A.; Chappell, R.; Eccles, V.; Johnsen, C.; Lybekk, B.; Li, K.; Pedersen, A.; Schunk, R.; Welling, D.

2015-12-01

Low-energy ions of ionospheric origin constitute a significant contributor to the magnetospheric plasma population. Measuring cold ions is difficult though. Observations have to be done at sufficiently high altitudes and typically in regions of space where spacecraft attain a positive charge due to solar illumination. Cold ions are therefore shielded from the satellite particle detectors. Furthermore, spacecraft can only cover key regions of ion outflow during segments of their orbit, so additional complications arise if continuous longtime observations, such as during a geomagnetic storm, are needed. In this paper we suggest a new approach, based on a combination of synoptic observations and a novel technique to estimate the flux and total outflow during the various phases of geomagnetic storms. Our results indicate large variations in both outflow rates and transport throughout the storm. Prior to the storm main phase, outflow rates are moderate, and the cold ions are mainly emanating from moderately sized polar cap regions. Throughout the main phase of the storm, outflow rates increase and the polar cap source regions expand. Furthermore, faster transport, resulting from enhanced convection, leads to a much larger supply of cold ions to the near-Earth region during geomagnetic storms.

Estimation of cold plasma outflow during geomagnetic storms

NASA Astrophysics Data System (ADS)

Haaland, S.; Eriksson, A. I.; Andre, M.; Maes, L.; Baddeley, L. J.; Barakat, A. R.; Chappell, C. R.; Eccles, V.; Johnsen, C.; Lybekk, B.; Li, K.; Pedersen, A.; Schunk, R. W.; Welling, D. T.

2015-12-01

Low energy ions of ionospheric origin provide a significant contributon to the magnetospheric plasmapopulation. Measuring cold ions is difficult though. Observations have to be done at sufficiently high altitudes and typically in regions of space where spacecraft attain a positive charge due to solar illumination. Cold ions are therefore shielded from the satellite particle detectors. Furthermore, spacecraft can only cover key regions of ion outflow during segments of their orbit, so additional complications arise arise if continuous longtime observations such as the during a geomagnetic storms are needed. In this paper we suggest a new approach, based on a combination of synoptic observations and a novel technique to estimate the flux and total outflow during the various phases of geomagnetic storms. Our results indicate large variations in both outflow rates and transport throughout the storm. Prior to the storm main phase, outflow rates are moderate, and the cold ions are mainly emanating from moderately sized polar cap regions. Throughout the main phase of the storm, outflow rates increase and the polar cap source regions expand. Furthermore, faster transport, resulting from enhanced convection, leads to a much larger supply of cold ions to the near Earth region during gemagnetic storms.

Outcomes of Subaortic Obstruction Resection in Children.

PubMed

Donald, Julia S; Naimo, Phillip S; d'Udekem, Yves; Richardson, Malcolm; Bullock, Andrew; Weintraub, Robert G; Brizard, Christian P; Konstantinov, Igor E

2017-02-01

Studies of long-term outcomes of discrete subaortic stenosis are rare. Therefore, we reviewed the long-term outcomes of fibromuscular resection in children with subaortic stenosis over 26 years from a single institution. We conducted a retrospective review of all children (n=72) who underwent resection of subaortic obstruction for discrete subaortic stenosis between 1989 and 2015. Median age at surgery was 5.0 years (2.7-7.6 years). There were no operative deaths but three late deaths (4.2%, 3/72). Overall Kaplan-Meier survival at 10 years was 93.0 ± 3.9% (95% CI: 79.6, 97.7). Peak instantaneous left ventricular outflow tract Doppler gradient decreased from 74.2±36.7mmHg (16.0-242.0mmHg) preoperatively to 12.8±7.4mmHg (2.6-36.0mmHg) postoperatively (p<0.001). Mean left ventricular outflow tract Doppler gradient decreased from 42.4±17.2mmHg (12.0-98.0) preoperatively to 7.5±2.7mmHg (1.4-19.3mmHg) postoperatively (p<0.001). However, over the mean follow-up period of 7.8±6.1 years (0.1-25.2 years), 29.0% (20/69) of patients had recurrence and 18.8% (13/69) required reoperation at median time of 4.8 years (3.1-9.1 years) after the initial repair. Freedom from reoperation at 10 years was 71.1±7.1% (95% CI: 54.6, 82.3). Risk factors for reoperation were age less than five years at initial repair (p=0.036) and extension of the membrane to the aortic valve (p=0.001). Aortic insufficiency was present in 54.2% (39/72) of patients preoperatively. Progression of aortic insufficiency occurred in 38.9% (28/72). Involvement of the aortic valve at initial repair was associated with need for subsequent aortic valve repair or replacement (p=0.01). Resection of subaortic obstruction is associated with low mortality and morbidity. Recurrence and reoperation rates are high and progression of aortic insufficiency following subaortic resection is common. Therefore, these patients warrant close follow-up into adult life. Crown Copyright © 2016. Published by Elsevier B.V. All

Active galactic nucleus outflows in galaxy discs

NASA Astrophysics Data System (ADS)

Hartwig, Tilman; Volonteri, Marta; Dashyan, Gohar

2018-05-01

Galactic outflows, driven by active galactic nuclei (AGNs), play a crucial role in galaxy formation and in the self-regulated growth of supermassive black holes (BHs). AGN feedback couples to and affects gas, rather than stars, and in many, if not most, gas-rich galaxies cold gas is rotationally supported and settles in a disc. We present a 2D analytical model for AGN-driven outflows in a gaseous disc and demonstrate the main improvements, compared to existing 1D solutions. We find significant differences for the outflow dynamics and wind efficiency. The outflow is energy-driven due to inefficient cooling up to a certain AGN luminosity (˜1043 erg s-1 in our fiducial model), above which the outflow remains momentum-driven in the disc up to galactic scales. We reproduce results of 3D simulations that gas is preferentially ejected perpendicular to the disc and find that the fraction of ejected interstellar medium is lower than in 1D models. The recovery time of gas in the disc, defined as the free-fall time from the radius to which the AGN pushes the ISM at most, is remarkably short, of the order 1 Myr. This indicates that AGN-driven winds cannot suppress BH growth for long. Without the inclusion of supernova feedback, we find a scaling of the BH mass with the halo velocity dispersion of MBH ∝ σ4.8.

Outcomes of malignant tumors of the lacrimal apparatus: the University of Texas MD Anderson Cancer Center experience.

PubMed

Skinner, Heath D; Garden, Adam S; Rosenthal, David I; Ang, K Kian; Morrison, William H; Esmaeli, Bita; Pinnix, Chelsea C; Frank, Steven J

2011-06-15

Malignant epithelial neoplasms of the lacrimal apparatus are rare and are typically treated with surgery and occasionally adjuvant radiation therapy (RT). The purpose of this study was to assess treatment outcomes by type of surgery (orbital exenteration vs eye-sparing surgery) and clarify the role of adjuvant RT for this rare disease. Forty-six patients with malignant epithelial neoplasms of the lacrimal apparatus were treated at a single institution from 1945 through 2008. Twenty-seven patients (59%) were treated with orbital exenteration and 19 (41%) with eye-sparing surgery; 64% of the orbital exenteration group and 83% of the eye-sparing surgery group also received adjuvant RT (median dose, 60 grays). Median follow-up time for all patients was 38 months (range, 3-460 months). For the orbital exenteration and eye-sparing surgery groups, the 5-year overall survival (OS) rates were 59% and 62%, and the 5-year disease-free survival (DFS) rates were 49% and 39%, respectively (P = .56, P = .35). Tumor status (T1-2 vs T3-4) was associated with OS (P = .02), and tumor size (<3.5 vs >3.5 cm) with DFS (P = .015). Median time to locoregional recurrence was 85 months for orbital exenteration, and 123 months for eye-sparing surgery. All patients who did not receive RT experienced local recurrence, and RT extended time to locoregional recurrence (median 460 vs 30 months, P = .009). Seven grade ≥3 complications were experienced after adjuvant RT. For appropriately selected patients, an eye-sparing surgery for lacrimal apparatus tumors can achieve similar survival outcomes to those in patients treated with an orbital exenteration. Adjuvant RT should be considered for all patients presenting with these rare tumors. Copyright © 2011 American Cancer Society.

(abstract) A Test of the Theoretical Models of Bipolar Outflows: The Bipolar Outflow in Mon R2

NASA Technical Reports Server (NTRS)

Xie, Taoling; Goldsmith, Paul; Patel, Nimesh

1993-01-01

We report some results of a study of the massive bipolar outflow in the central region of the relatively nearby giant molecular cloud Monoceros R2. We make a quantative comparison of our results with the Shu et al. outflow model which incorporates a radially directed wind sweeping up the ambient material into a shell. We find that this simple model naturally explains the shape of this thin shell. Although Shu's model in its simplest form predicts with reasonable parameters too much mass at very small polar angles, as previously pointed out by Masson and Chernin, it provides a reasonable good fit to the mass distribution at larger polar angles. It is possible that this discrepancy is due to inhomogeneities of the ambient molecular gas which is not considered by the model. We also discuss the constraints imposed by these results on recent jet-driven outflow models.

Quantifying Feedback from Narrow Line Region Outflows in Nearby Active Galaxies. I. Spatially Resolved Mass Outflow Rates for the Seyfert 2 Galaxy Markarian 573

NASA Astrophysics Data System (ADS)

Revalski, M.; Crenshaw, D. M.; Kraemer, S. B.; Fischer, T. C.; Schmitt, H. R.; Machuca, C.

2018-03-01

We present the first spatially resolved mass outflow rate measurements ({\\dot{M}}out}) of the optical emission line gas in the narrow line region (NLR) of a Seyfert 2 galaxy, Markarian 573. Using long slit spectra and [O III] imaging from the Hubble Space Telescope and Apache Point Observatory in conjunction with emission line diagnostics and Cloudy photoionization models, we find a peak outflow rate of {\\dot{M}}out}≈ 3.4 +/- 0.5 {M}ȯ {yr}}-1 at a distance of 210 pc from the central supermassive black hole (SMBH). The outflow extends to distances of 600 pc from the nucleus with a total mass and kinetic energy of M ≈ 2.2 × 106 M ⊙ and E ≈ 5.1 × 1054 erg, revealing the outflows to be more energetic than those in the lower luminosity Seyfert 1 galaxy NGC 4151. The peak outflow rate is an order of magnitude larger than the mass accretion and nuclear outflow rates, indicating local in situ acceleration of the circumnuclear NLR gas. We compare these results to global techniques that quantify an average outflow rate across the NLR, and find the latter are subject to larger uncertainties. These results indicate that spatially resolved observations are critical for probing AGN feedback on scales where circumnuclear star formation occurs.

Scaling Relations Between Warm Galactic Outflows and Their Host Galaxies

NASA Astrophysics Data System (ADS)

Chisholm, John; Tremonti, Christy A.; Leitherer, Claus; Chen, Yanmei; Wofford, Aida; Lundgren, Britt

2015-10-01

We report on a sample of 48 nearby, star-forming galaxies observed with the Cosmic Origin Spectrograph on the Hubble Space Telescope. We measure the kinematics of warm gas in galactic outflows using a combination of four Si ii absorption lines. We use multi-wavelength ancillary data to estimate stellar masses (M*), star formation rates (SFR), circular velocities (vcirc), and morphologies. The galaxies cover four orders of magnitude in M* and SFR, and sample a wide range of morphologies from starbursting mergers to normal star-forming galaxies. We derive 3.0-3.5σ relations between outflow velocity and SFR, M*, and vcirc. The outflow velocities scale as SFR0.08-0.22, {M}*0.12-0.20 and {v}{circ}0.44-0.87, with the range depending on whether we use a maximum or a central velocity to quantify the outflow velocity. After accounting for their increased SFR, mergers drive 32% faster outflows than non-merging galaxies, with all of the highest velocity outflows arising from mergers. Low-mass galaxies (log(M*/ M⊙) < 10.5) lose some low-ionization gas through galactic outflows, while more massive galaxies retain all of their low-ionization gas, unless they undergo a merger.

Quasars Outflows As A Function of SED - An Empirical Approach

NASA Astrophysics Data System (ADS)

Richmond, Joseph M.; Ganguly, Rajib

2015-08-01

Feedback from quasars (jets, outflows, and luminosity) is now recognized as a vital phase in describing galaxy evolution, growth, and star formation efficiency. Regarding outflows, roughly 60% are observed to have outflowing gas appearing at large velocities and with a variety of velocity dispersions. The most extreme observed form of these outflows appears in the ultraviolet spectrum of 15-20% of objects. Understanding the physics of these outflows is important for both astrophysical and cosmological reasons. Establishing empirical relationships to test the theoretical models of how these outflows are driven (and hence, how they impact their surroundings) is currently plagued by having too few objects, where other parameters like the black hole mass or accretion rate, may add to the scatter. We aim to fix this by using a systematic study of a large sample of objects. As a follow up to a previous study, we have identified a sample of nearly 11000 z=1.7-2 quasars using archived data from the Sloan Digital Sky Survey (Data Release 7), of which roughly 4400 appear to show outflows according to the visual inspection. The specific redshift range is chosen to feature both the Mg II 2800 emission line as well as wavelengths extending to nearly 20,000 km/s blueward of the C IV 1549 emission line. Our goals for this study are: (1) To temper our visual inspection schemes with a more automated, computer-driven scheme; (2) To measure the properties of the outflows (velocity, velocity dispersion, equivalent width, ionization); (3) To supplement the SDSS spectra with photometric measurements from GALEX, 2MASS, and WISE to further characterize the spectral energy distributions (SEDs) and dust content; (4) To form spectral composites to investigate possible SED changes with outflow properties; and (5) To use published estimates of the quasar physical properties (black hole mass, accretion rate, etc.) to fully establish in an empirical way the complex dependencies between the

Orbital adenocarcinoma of lacrimal gland origin in a dog.

PubMed

Wang, F I; Ting, C T; Liu, Y S

2001-03-01

A 13-year-old intact female mixed-breed dog was presented for a progressive enlargement of the right eye, which had been treated previously for conjunctivitis. A round, firm mass, approximately 4 cm in diameter, was protruding from the superotemporal aspect of the right orbit, displacing the eyeball anteriorly and ventromedially. The mass was encapsulated, distinct from the eyeball, and not associated with the eyelids. On cut surface, there was a pale multilobulated periphery, with a dark red, soft, and depressed core. Histologically, tumor cells formed cords and tubules, which were stained with mouse anti-human cytokeratin antibody AE1/AE3. Residual glands were serous, and the majority of tumor cells were negative for mucin. The supraorbital location, encapsulation, and residual serous glands suggest that this mass was a low-grade adenocarcinoma of the lacrimal gland.

Asymmetric MHD outflows/jets from accreting T Tauri stars

NASA Astrophysics Data System (ADS)

Dyda, S.; Lovelace, R. V. E.; Ustyugova, G. V.; Lii, P. S.; Romanova, M. M.; Koldoba, A. V.

2015-06-01

Observations of jets from young stellar objects reveal the asymmetric outflows from some sources. A large set of 2.5D magnetohydrodynamic simulations was carried out for axisymmetric viscous/diffusive disc accretion to rotating magnetized stars for the purpose of assessing the conditions where the outflows are asymmetric relative to the equatorial plane. We consider initial magnetic fields that are symmetric about the equatorial plane and consist of a radially distributed field threading the disc (disc field) and a stellar dipole field. (1) For pure disc-fields the symmetry or asymmetry of the outflows is affected by the mid-plane plasma β of the disc. For discs with small plasma β, outflows are symmetric to within 10 per cent over time-scales of hundreds of inner disc orbits. For higher β discs, the coupling of the upper and lower coronal plasmas is broken, and quasi-periodic field motion leads to asymmetric episodic outflows. (2) Accreting stars with a stellar dipole field and no disc-field exhibit episodic, two component outflows - a magnetospheric wind and an inner disc wind. Both are characterized by similar velocity profiles but the magnetospheric wind has densities ≳ 10 times that of the disc wind. (3) Adding a disc field parallel to the stellar dipole field enhances the magnetospheric winds but suppresses the disc wind. (4) Adding a disc field which is antiparallel to the stellar dipole field in the disc suppresses the magnetospheric and disc winds. Our simulations reproduce some key features of observations of asymmetric outflows of T Tauri stars.

The Simbol-X Perspective on the Physics of Quasar Outflows

NASA Astrophysics Data System (ADS)

Giustini, M.; Cappi, M.; Vignali, C.; Palumbo, G. G. C.; Fiore, F.; Malaguti, G.

2009-05-01

There is increasing evidence that quasar outflows may play a key role in providing the feedback between AGN/QSOs and their surrounding (and feeding) media, in regulating the central supermassive black hole growth and the galaxy formation and, on larger scales, in shaping the growth of cosmic structures (see e.g. [1]). X-ray observations of quasar outflows are crucial to probe their innermost parts and assess the global energetics entrained in the outflow by studying its most extreme (in terms of velocity, ionization state, mass outflow rate) phases. Simbol-X-with its high effective area in the Fe K energy band and above-will allow the detection and the characterization of powerful outflows in bright, nearby AGN and notably also in moderately faint AGN, thus shedding light on feedback processes in these objects.

A Doppler dimming determination of coronal outflow velocity

NASA Technical Reports Server (NTRS)

Strachan, Leonard; Kohl, John L.; Weiser, Heinz; Withbroe, George L.; Munro, Richard H.

1993-01-01

Outflow velocities in a polar coronal hole are derived from observations made during a 1982 sounding rocket flight. The velocity results are derived from a Doppler dimming analysis of resonantly scattered H I Ly-alpha. This analysis indicates radial outflow velocities of 217 km/s at 2 solar radii from sun-center with an uncertainty range of 153 to 251 km/s at a confidence level of 67 percent. These results are best characterized as strong evidence for supersonic outflow within 2 solar radii of sun-center in a polar coronal hole. Several means for obtaining improved accuracy in future observations are discussed.

ALMA Studies of the Disk-Jet-Outflow Connection

NASA Astrophysics Data System (ADS)

Dougados, Catherine; Louvet, F.; Mardones, D.; Cabrit, S.

2017-06-01

I will describe in this contribution recent results obtained with ALMA on the origin of the disk/jet/outflow connexion in T Tauri stars. I will first present ALMA observations of the disk associated with the jet source Th 28, which question previous jet rotation measurements in this source and the implications drawn from them. I will then discuss Cycle 2 ALMA observations of the disk and small scale CO outflow associated with the prototypical edge-on HH 30 source. The unprecedented angular resolution of this dataset brings new constraints on the origin of the CO outflows in young stars.

Alignment between Protostellar Outflows and Filamentary Structure

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

Stephens, Ian W.; Dunham, Michael M.; Myers, Philip C.

2017-09-01

We present new Submillimeter Array (SMA) observations of CO(2–1) outflows toward young, embedded protostars in the Perseus molecular cloud as part of the Mass Assembly of Stellar Systems and their Evolution with the SMA (MASSES) survey. For 57 Perseus protostars, we characterize the orientation of the outflow angles and compare them with the orientation of the local filaments as derived from Herschel observations. We find that the relative angles between outflows and filaments are inconsistent with purely parallel or purely perpendicular distributions. Instead, the observed distribution of outflow-filament angles are more consistent with either randomly aligned angles or a mixmore » of projected parallel and perpendicular angles. A mix of parallel and perpendicular angles requires perpendicular alignment to be more common by a factor of ∼3. Our results show that the observed distributions probably hold regardless of the protostar’s multiplicity, age, or the host core’s opacity. These observations indicate that the angular momentum axis of a protostar may be independent of the large-scale structure. We discuss the significance of independent protostellar rotation axes in the general picture of filament-based star formation.« less

Alignment between Protostellar Outflows and Filamentary Structure

NASA Astrophysics Data System (ADS)

Stephens, Ian W.; Dunham, Michael M.; Myers, Philip C.; Pokhrel, Riwaj; Sadavoy, Sarah I.; Vorobyov, Eduard I.; Tobin, John J.; Pineda, Jaime E.; Offner, Stella S. R.; Lee, Katherine I.; Kristensen, Lars E.; Jørgensen, Jes K.; Goodman, Alyssa A.; Bourke, Tyler L.; Arce, Héctor G.; Plunkett, Adele L.

2017-09-01

We present new Submillimeter Array (SMA) observations of CO(2-1) outflows toward young, embedded protostars in the Perseus molecular cloud as part of the Mass Assembly of Stellar Systems and their Evolution with the SMA (MASSES) survey. For 57 Perseus protostars, we characterize the orientation of the outflow angles and compare them with the orientation of the local filaments as derived from Herschel observations. We find that the relative angles between outflows and filaments are inconsistent with purely parallel or purely perpendicular distributions. Instead, the observed distribution of outflow-filament angles are more consistent with either randomly aligned angles or a mix of projected parallel and perpendicular angles. A mix of parallel and perpendicular angles requires perpendicular alignment to be more common by a factor of ˜3. Our results show that the observed distributions probably hold regardless of the protostar’s multiplicity, age, or the host core’s opacity. These observations indicate that the angular momentum axis of a protostar may be independent of the large-scale structure. We discuss the significance of independent protostellar rotation axes in the general picture of filament-based star formation.

Simulation of California's Major Reservoirs Outflow Using Data Mining Technique

NASA Astrophysics Data System (ADS)

Yang, T.; Gao, X.; Sorooshian, S.

2014-12-01

The reservoir's outflow is controlled by reservoir operators, which is different from the upstream inflow. The outflow is more important than the reservoir's inflow for the downstream water users. In order to simulate the complicated reservoir operation and extract the outflow decision making patterns for California's 12 major reservoirs, we build a data-driven, computer-based ("artificial intelligent") reservoir decision making tool, using decision regression and classification tree approach. This is a well-developed statistical and graphical modeling methodology in the field of data mining. A shuffled cross validation approach is also employed to extract the outflow decision making patterns and rules based on the selected decision variables (inflow amount, precipitation, timing, water type year etc.). To show the accuracy of the model, a verification study is carried out comparing the model-generated outflow decisions ("artificial intelligent" decisions) with that made by reservoir operators (human decisions). The simulation results show that the machine-generated outflow decisions are very similar to the real reservoir operators' decisions. This conclusion is based on statistical evaluations using the Nash-Sutcliffe test. The proposed model is able to detect the most influential variables and their weights when the reservoir operators make an outflow decision. While the proposed approach was firstly applied and tested on California's 12 major reservoirs, the method is universally adaptable to other reservoir systems.

Modeling Jet and Outflow Feedback during Star Cluster Formation

NASA Astrophysics Data System (ADS)

Federrath, Christoph; Schrön, Martin; Banerjee, Robi; Klessen, Ralf S.

2014-08-01

Powerful jets and outflows are launched from the protostellar disks around newborn stars. These outflows carry enough mass and momentum to transform the structure of their parent molecular cloud and to potentially control star formation itself. Despite their importance, we have not been able to fully quantify the impact of jets and outflows during the formation of a star cluster. The main problem lies in limited computing power. We would have to resolve the magnetic jet-launching mechanism close to the protostar and at the same time follow the evolution of a parsec-size cloud for a million years. Current computer power and codes fall orders of magnitude short of achieving this. In order to overcome this problem, we implement a subgrid-scale (SGS) model for launching jets and outflows, which demonstrably converges and reproduces the mass, linear and angular momentum transfer, and the speed of real jets, with ~1000 times lower resolution than would be required without the SGS model. We apply the new SGS model to turbulent, magnetized star cluster formation and show that jets and outflows (1) eject about one-fourth of their parent molecular clump in high-speed jets, quickly reaching distances of more than a parsec, (2) reduce the star formation rate by about a factor of two, and (3) lead to the formation of ~1.5 times as many stars compared to the no-outflow case. Most importantly, we find that jets and outflows reduce the average star mass by a factor of ~ three and may thus be essential for understanding the characteristic mass of the stellar initial mass function.

Inhibition of agonist-induced smooth muscle contraction by picotamide in the male human lower urinary tract outflow region.

PubMed

Hennenberg, Martin; Tamalunas, Alexander; Wang, Yiming; Keller, Patrick; Schott, Melanie; Strittmatter, Frank; Herlemann, Annika; Yu, Qingfeng; Rutz, Beata; Ciotkowska, Anna; Stief, Christian G; Gratzke, Christian

2017-05-15

Male lower urinary tract symptoms (LUTS) due to bladder outlet obstruction are characterized by abnormal smooth muscle contractions in the lower urinary tract. Alpha 1 -adrenoceptor antagonists may induce smooth muscle relaxation in the outflow region and represent the current gold standard of medical treatment. However, results may be unsatisfactory or inadequate. Apart from α 1 -adrenoceptor agonists, smooth muscle contraction in the outflow region may be induced by thromboxane A 2 (TXA 2 ), endothelins, or muscarinic receptor agonists. Here, we studied effects of the thromboxane A 2 receptor (TP receptor) antagonist picotamide on contraction in the human male bladder trigone and prostate. Carbachol, the α 1 -adrenoceptor agonist phenylephrine, the thromboxane A 2 analog U46619, and electric field stimulation (EFS) induced concentration- or frequency-dependent contractions of trigone tissues in an organ bath. Picotamide (300µM) inhibited carbachol-, phenylephrine-, U46619-, and EFS-induced contractions. Endothelins 1-3 induced concentration-dependent contractions of prostate tissues, which were inhibited by picotamide. Analyses using real time polymerase chain reaction and antibodies suggested expression of thromboxane A 2 receptors and synthase in trigone smooth muscle cells. Thromboxane B 2 (the stable metabolite of thromboxane A 2 ) was detectable by enzyme immune assay in trigone samples, with most values ranging between 50 and 150pg/mg trigone protein. Picotamide inhibits contractions induced by different stimuli in the human lower urinary tract, including cholinergic, adrenergic, thromboxane A 2 - and endothelin-induced, and neurogenic contractions in different locations of the outflow region. This distinguishes picotamide from current medical treatments for LUTS, and suggests that picotamide may induce urodynamic effects in vivo. Copyright © 2017. Published by Elsevier B.V.

The Anatomy of the Young Protostellar Outflow HH 211

NASA Astrophysics Data System (ADS)

Tappe, A.; Forbrich, J.; Martín, S.; Yuan, Y.; Lada, C. J.

2012-05-01

We present Spitzer Space Telescope 5-36 μm mapping observations toward the southeastern lobe of the young protostellar outflow HH 211. The southeastern terminal shock of the outflow shows a rich mid-infrared spectrum including molecular emission lines from OH, H2O, HCO+, CO2, H2, and HD. The spectrum also shows a rising infrared continuum toward 5 μm, which we interpret as unresolved emission lines from highly excited rotational levels of the CO v = 1-0 fundamental band. This interpretation is supported by a strong excess flux observed in the Spitzer/IRAC 4-5 μm channel 2 image compared to the other IRAC channels. The extremely high critical densities of the CO v = 1-0 ro-vibrational lines and a comparison to H2 and CO excitation models suggest jet densities larger than 106 cm-3 in the terminal shock. We also observed the southeastern terminal outflow shock with the Submillimeter Array and detected pure rotational emission from CO 2-1, HCO+ 3-2, and HCN 3-2. The rotationally excited CO traces the collimated outflow backbone as well as the terminal shock. HCN traces individual dense knots along the outflow and in the terminal shock, whereas HCO+ solely appears in the terminal shock. The unique combination of our mid-infrared and submillimeter observations with previously published near-infrared observations allow us to study the interaction of one of the youngest known protostellar outflows with its surrounding molecular cloud. Our results help us to understand the nature of some of the so-called green fuzzies (Extended Green Objects), and elucidate the physical conditions that cause high OH excitation and affect the chemical OH/H2O balance in protostellar outflows and young stellar objects. In an appendix to this paper, we summarize our Spitzer follow-up survey of protostellar outflow shocks to find further examples of highly excited OH occurring together with H2O and H2.

Two separate outflows in the dual supermassive black hole system NGC 6240

NASA Astrophysics Data System (ADS)

Müller-Sánchez, F.; Nevin, R.; Comerford, J. M.; Davies, R. I.; Privon, G. C.; Treister, E.

2018-04-01

Theoretical models and numerical simulations have established a framework of galaxy evolution in which galaxies merge and create dual supermassive black holes (with separations of one to ten kiloparsecs), which eventually sink into the centre of the merger remnant, emit gravitational waves and coalesce. The merger also triggers star formation and supermassive black hole growth, and gas outflows regulate the stellar content1-3. Although this theoretical picture is supported by recent observations of starburst-driven and supermassive black hole-driven outflows4-6, it remains unclear how these outflows interact with the interstellar medium. Furthermore, the relative contributions of star formation and black hole activity to galactic feedback remain unknown7-9. Here we report observations of dual outflows in the central region of the prototypical merger NGC 6240. We find a black-hole-driven outflow of [O iii] to the northeast and a starburst-driven outflow of Hα to the northwest. The orientations and positions of the outflows allow us to isolate them spatially and study their properties independently. We estimate mass outflow rates of 10 and 75 solar masses per year for the Hα bubble and the [O iii] cone, respectively. Their combined mass outflow is comparable to the star formation rate10, suggesting that negative feedback on star formation is occurring.

Two separate outflows in the dual supermassive black hole system NGC 6240.

PubMed

Müller-Sánchez, F; Nevin, R; Comerford, J M; Davies, R I; Privon, G C; Treister, E

2018-04-01

Theoretical models and numerical simulations have established a framework of galaxy evolution in which galaxies merge and create dual supermassive black holes (with separations of one to ten kiloparsecs), which eventually sink into the centre of the merger remnant, emit gravitational waves and coalesce. The merger also triggers star formation and supermassive black hole growth, and gas outflows regulate the stellar content 1-3 . Although this theoretical picture is supported by recent observations of starburst-driven and supermassive black hole-driven outflows 4-6 , it remains unclear how these outflows interact with the interstellar medium. Furthermore, the relative contributions of star formation and black hole activity to galactic feedback remain unknown 7-9 . Here we report observations of dual outflows in the central region of the prototypical merger NGC 6240. We find a black-hole-driven outflow of [O III] to the northeast and a starburst-driven outflow of Hα to the northwest. The orientations and positions of the outflows allow us to isolate them spatially and study their properties independently. We estimate mass outflow rates of 10 and 75 solar masses per year for the Hα bubble and the [O III] cone, respectively. Their combined mass outflow is comparable to the star formation rate 10 , suggesting that negative feedback on star formation is occurring.

Time-dependent and outflow boundary conditions for Dissipative Particle Dynamics

PubMed Central

Lei, Huan; Fedosov, Dmitry A.; Karniadakis, George Em

2011-01-01

We propose a simple method to impose both no-slip boundary conditions at fluid-wall interfaces and at outflow boundaries in fully developed regions for Dissipative Particle Dynamics (DPD) fluid systems. The procedure to enforce the no-slip condition is based on a velocity-dependent shear force, which is a generalized force to represent the presence of the solid-wall particles and to maintain locally thermodynamic consistency. We show that this method can be implemented in both steady and time-dependent fluid systems and compare the DPD results with the continuum limit (Navier-Stokes) results. We also develop a force-adaptive method to impose the outflow boundary conditions for fully developed flow with unspecified outflow velocity profile or pressure value. We study flows over the backward-facing step and in idealized arterial bifurcations using a combination of the two new boundary methods with different flow rates. Finally, we explore the applicability of the outflow method in time-dependent flow systems. The outflow boundary method works well for systems with Womersley number of O(1), i.e., when the pressure and flowrate at the outflow are approximately in-phase. PMID:21499548

Outflows in X-ray binaries

NASA Astrophysics Data System (ADS)

Diaz Trigo, M.

2017-10-01

Accretion onto neutron stars and black holes powers the most luminous phenomena in the Universe. Associated to it is the existence of outflows, in the form of uncollimated winds or highly collimated relativistic jets. The origin of outflows and their feedback to the environment is one of the most debated topics in astrophysics today. In this talk I will review the current understanding of accretion disc winds in X-ray binaries, their launching mechanism and their relation to specific accretion states. I will also discuss the potential interplay between the appearance/disappearance of such winds and relativistic jets and the insight gained with ongoing multi-wavelength observational programmes focused on the variability of such phenomena.

Cosmic ray driven outflows in an ultraluminous galaxy

NASA Astrophysics Data System (ADS)

Fujita, Akimi; Mac Low, Mordecai-Mark

2018-06-01

In models of galaxy formation, feedback driven both by supernova (SN) and active galactic nucleus is not efficient enough to quench star formation in massive galaxies. Models of smaller galaxies have suggested that cosmic rays (CRs) play a major role in expelling material from the star-forming regions by diffusing SN energy to the lower density outskirts. We therefore run gas dynamical simulations of galactic outflows from a galaxy contained in a halo with 5 × 1012 M⊙ that resembles a local ultraluminous galaxy, including both SN thermal energy and a treatment of CRs using the same diffusion approximation as Salem & Bryan. We find that CR pressure drives a low-density bubble beyond the edge of the shell swept up by thermal pressure, but the main bubble driven by SN thermal pressure overtakes it later, which creates a large-scale biconical outflow. CRs diffusing into the disc are unable to entrain its gas in the outflows, yielding a mass-loading rate of only ˜ 0.1 per cent with varied CR diffusion coefficients. We find no significant difference in mass-loading rates in SN-driven outflows with or without CR pressure. Our simulations strongly suggest that it is hard to drive a heavily mass-loaded outflow with CRs from a massive halo potential, although more distributed star formation could lead to a different result.

THE ORION FINGERS: NEAR-IR SPECTRAL IMAGING OF AN EXPLOSIVE OUTFLOW

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

Youngblood, Allison; Bally, John; Ginsburg, Adam, E-mail: allison.youngblood@colorado.edu

2016-06-01

We present near-IR (1.1–2.4 μ m) position–position–velocity cubes of the 500 year old Orion BN/KL explosive outflow with spatial resolution 1″ and spectral resolution 86 km s{sup −1}. We construct integrated intensity maps free of continuum sources of 15 H{sub 2} and [Fe ii] lines while preserving kinematic information of individual outflow features. Included in the detected H{sub 2} lines are the 1-0 S(1) and 1-0 Q(3) transitions, allowing extinction measurements across the outflow. Additionally, we present dereddened flux ratios for over two dozen outflow features to allow for the characterization of the true excitation conditions of the BN/KL outflow. All of themore » ratios show the dominance of the shock excitation of the H{sub 2} emission, although some features exhibit signs of fluorescent excitation from stellar radiation or J-type shocks. We also detect tracers of the PDR/ionization front north of the Trapezium stars in [O i] and [Fe ii] and analyze other observed outflows not associated with the BN/KL outflow.« less

Comparison of telomere length and association with progenitor cell markers in lacrimal gland between Sjögren syndrome and non-Sjögren syndrome dry eye patients

PubMed Central

Kawashima, Motoko; Maida, Yoshiko; Kamoi, Mizuka; Ogawa, Yoko; Shimmura, Shigeto; Masutomi, Kenkichi; Tsubota, Kazuo

2011-01-01

Purpose Indicators of aging such as disruption of telomeric function due to shortening may be more frequent in dysfunctional lacrimal gland. The aims of this study were to 1) determine the viability of quantitative fluorescence in situ hybridization of telomeres (telo-FISH) for the assessment of telomere length in lacrimal gland in Sjögren and non- Sjögren syndrome patients; and 2) investigate the relationship between progenitor cell markers and telomere length in both groups. Methods Quantitative fluorescence in situ hybridization with a peptide nucleic acid probe complementary to the telomere repeat sequence was performed on frozen sections from human lacrimal gland tissues. The mean fluorescence intensity of telomere spots was automatically quantified by image analysis as relative telomere length in lacrimal gland epithelial cells. Immunostaining for p63, nucleostemin, ATP-binding cassette, sub-family G, member 2 (ABCG2), and nestin was also performed. Results Telomere intensity in the Sjögren syndrome group (6,785.0±455) was significantly lower than that in the non-Sjögren syndrome group (7,494.7±477; p=0.02). Among the samples from the non-Sjögren syndrome group, immunostaining revealed that p63 was expressed in 1–3 acinar cells in each acinar unit and continuously in the basal layer of duct cells. In contrast, in the Sjögren syndrome group, p63 and nucleostemin showed a lower level of expression. ABCG2 was expressed in acinar cells in both sjogren and non-Sjogren syndrome. Conclusions The results of this study indicate that 1) telo-FISH is a viable method of assessing telomere length in lacrimal gland, and 2) telomere length in Sjögren syndrome is shorter and associated with lower levels of expression of p63 and nucleostemin than in non-Sjögren syndrome. PMID:21655359

Lumbar elastance and resistance to CSF outflow correlated to patency of the cranial subarachnoid space and clinical outcome of endoscopic third ventriculostomy in obstructive hydrocephalus.

PubMed

Bech-Azeddine, R; Nielsen, O A; Løgager, V B; Juhler, M

2007-08-01

The purpose of the present study was to elucidate the value of the lumbar and intraventricular infusion tests in the selection of patients with obstructive hydrocephalus (OH) for endoscopic third ventriculostomy (ETV), and whether the presence of a diminished cranial subarachnoid space was a source of error in the interpretation of the results. In 32 consecutive adult patients (15 M, 17 F, mean age: 46 years) with possible treatment-requiring OH, the resistance to cerebrospinal fluid (CSF) outflow (Rout) and elastance was measured with a lumbar infusion test. Eleven of the patients underwent an additional intraventricular infusion test. An ETV was subsequently performed in 20 patients, of whom 11 presented with idiopathic aqueductal stenosis and 9 with other various causes of OH. The presence of a diminished cranial SAS correlated significantly with increased lumbar elastance, but not with lumbar Rout. However, distinctly increased Rout values (>24 mmHg/mL/min, n=4) were only measured in the presence of a diminished cranial SAS. No significant correlation was demonstrated between the clinical outcome of ETV and lumbar elastance or lumbar Rout, although seven out of the eight improving patients with aqueductal stenosis presented normal lumbar Rout values. In patients undergoing both a lumbar and an intraventricular infusion test and improving after ETV (n=6), lumbar elastance was significantly increased compared to the intraventricular elastance. A diminished cranial SAS correlates with increased lumbar elastance and may explain the highly increased lumbar Rout values, possibly by impeding the bulk flow from the infusion. The majority of patients improving after ETV and presenting a normal sized cranial SAS presented normal lumbar Rout values. Supplementing the lumbar infusion test with an intraventricular test may help in predicting the outcome of ETV.

Did ice streams carve martian outflow channels?

USGS Publications Warehouse

Lucchitta, B.K.; Anderson, D.M.; Shoji, H.

1981-01-01

Outflow channels on Mars1 are long sinuous linear depressions that occur mostly in the equatorial area (??30?? lat.). They differ from small valley networks2 by being larger and arising full born from chaotic terrains. Outflow channels resemble terrestrial stream beds, and their origin has generally been attributed to water3-5 in catastrophic floods6,7 or mudflows8. The catastrophic-flood hypothesis is derived primarily from the morphological similarities of martian outflow channels and features created by the catastrophic Spokane flood that formed the Washington scablands. These similarities have been documented extensively3,6,7, but differences of scale remain a major problemmartian channel features are on the average much larger than their proposed terrestrial analogues. We examine here the problem of channel origin from the perspective of erosional characteristics and the resultant landf orms created by former and present-day ice streams and glaciers on Earth. From morphologic comparisons, an ice-stream origin seems equally well suited to explain the occurrences and form of the outflow channels on Mars, and in contrast with the hydraulic hypothesis, ice streams and ice sheets produce terrestrial features of the same scale as those observed on Mars. ?? 1981 Nature Publishing Group.

A precessing jet in the NGC2264G outflow

NASA Astrophysics Data System (ADS)

McCoey, Carolyn; Teixeira, P. S.; Fich, M.; Lada, C. J.

2007-05-01

We present new infrared imaging of the NGC 2264 G protostellar outflow region, obtained with the Spitzer Space Telescope. A jet in the red (eastern) outflow lobe is clearly detected in all four IRAC bands and, for the first time, is shown to continuously extend over the entire length of the red outflow lobe, as traced by CO observations. The jet also extends to a deeply embedded Class 0 source, VLA2, confirming previous suggestions that it is the driving source of the outflow. The images show that the easternmost part of the jet exhibits what appears to be multiple changes of direction. We consider two possible explanations for the jet morphology: (i) deflection of the jet off the walls of the outflow lobes as proposed by Fich & Lada (1997) and (ii) precession. The jet structure shown in the IRAC images can be largely, although not entirely, explained by a slowly precessing jet (period 8000 yr) that lies mostly on the plane of the sky. In either case it appears that the observed and inferred changes in the jet direction are sufficient to broaden the NGC 2264 G outflow to an extent comparable to that observed in the CO emission. P. S. T. acknowledges support from the scholarship SFRH/BD/13984/2003 awarded by the Fundaçao para a Ciencia e Tecnologia (Portugal). Both M. F. and C. M. are supported by a Natural Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant.

The Resolved Outflow from 3C 48

NASA Astrophysics Data System (ADS)

Shih, Hsin-Yi; Stockton, Alan

2014-10-01

We investigate the properties of the high-velocity outflow driven by the young radio jet of 3C 48, a compact-steep-spectrum source. We use the Space Telescope Imaging Spectrograph on board the Hubble Space Telecope to obtain (1) low-resolution UV and optical spectra and (2) multi-slit medium-resolution spectra of the ionized outflow. With supporting data from ground-based spectrographs, we are able to accurately measure the ratios of diagnostic emission lines such as [O III] λ5007, [O III] λ3727, [N II] λ6548, Hα, Hβ, [Ne V] λ3425, and [Ne III] λ3869. We fit the observed emission-line ratios using a range of ionization models, powered by active galactic nucleus (AGN) radiation and shocks, produced by the MAPPINGS code. We have determined that AGN radiation is likely the dominant ionization source. The outflow's density is estimated to be in the range n = 103-104 cm-3, the mass is ~6 × 106 M ⊙, and the metallicity is likely equal to or higher than solar. Compared with the typical outflows associated with more evolved radio jets, this young outflow is denser, less massive, and more metal rich. Multi-slit observations allow us to construct a two-dimensional velocity map of the outflow that shows a wide range of velocities with distinct velocity components, suggesting a wide-angle clumpy outflow. Based in part on observations made with the NASA/ESA Hubble Space Telescope, obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555. These observations are associated with program GO-11574. Some of the data presented herein were obtained at the W. M. Keck Observatory, which is operated as a scientific partnership among the California Institute of Technology, the University of California and the National Aeronautics and Space Administration. The Observatory was made possible by the generous financial support of the W. M. Keck Foundation. Some of the

Multi-level obstruction in obstructive sleep apnoea: prevalence, severity and predictive factors.

PubMed

Phua, C Q; Yeo, W X; Su, C; Mok, P K H

2017-11-01

To characterise multi-level obstruction in terms of prevalence, obstructive sleep apnoea severity and predictive factors, and to collect epidemiological data on upper airway morphology in obstructive sleep apnoea patients. Retrospective review of 250 obstructive sleep apnoea patients. On clinical examination, 171 patients (68.4 per cent) had multi-level obstruction, 49 (19.6 per cent) had single-level obstruction and 30 (12 per cent) showed no obstruction. Within each category of obstructive sleep apnoea severity, multi-level obstruction was more prevalent. Multi-level obstruction was associated with severe obstructive sleep apnoea (more than 30 events per hour) (p = 0.001). Obstructive sleep apnoea severity increased with the number of obstruction sites (correlation coefficient = 0.303, p < 0.001). Multi-level obstruction was more likely in younger (p = 0.042), male (p = 0.045) patients, with high body mass index (more than 30 kg/m2) (p < 0.001). Palatal (p = 0.004), tongue (p = 0.026) and lateral pharyngeal wall obstructions (p = 0.006) were associated with severe obstructive sleep apnoea. Multi-level obstruction is more prevalent in obstructive sleep apnoea and is associated with increased severity. Obstruction at certain anatomical levels contributes more towards obstructive sleep apnoea severity.

Quenching star formation with quasar outflows launched by trapped IR radiation

NASA Astrophysics Data System (ADS)

Costa, Tiago; Rosdahl, Joakim; Sijacki, Debora; Haehnelt, Martin G.

2018-06-01

We present cosmological radiation-hydrodynamic simulations, performed with the code RAMSES-RT, of radiatively-driven outflows in a massive quasar host halo at z = 6. Our simulations include both single- and multi-scattered radiation pressure on dust from a quasar and are compared against simulations performed with thermal feedback. For radiation pressure-driving, we show that there is a critical quasar luminosity above which a galactic outflow is launched, set by the equilibrium of gravitational and radiation forces. While this critical luminosity is unrealistically high in the single-scattering limit for plausible black hole masses, it is in line with a ≈ 3 × 10^9 M_⊙ black hole accreting at its Eddington limit, if infrared (IR) multi-scattering radiation pressure is included. The outflows are fast (v ≳ 1000 km s^{-1}) and strongly mass-loaded with peak mass outflow rates ≈ 10^3 - 10^4 M_⊙ yr^{-1}, but short-lived (< 10 Myr). Outflowing material is multi-phase, though predominantly composed of cool gas, forming via a thermal instability in the shocked swept-up component. Radiation pressure- and thermally-driven outflows both affect their host galaxies significantly, but in different, complementary ways. Thermally-driven outflows couple more efficiently to diffuse halo gas, generating more powerful, hotter and more volume-filling outflows. IR radiation, through its ability to penetrate dense gas via diffusion, is more efficient at ejecting gas from the bulge. The combination of gas ejection through outflows with internal pressurisation by trapped IR radiation leads to a complete shut down of star formation in the bulge. We hence argue that radiation pressure-driven feedback may be an important ingredient in regulating star formation in compact starbursts, especially during the quasar's `obscured' phase.

[Structuro-functional units of the salivary and lacrimal glands].

PubMed

Kostilenko, Iu P; Mysliuk, I V; Deviatkin, E A

1986-09-01

By means of the multilayer graphic and plastic reconstruction methods using series of semithin sections, spatial tridimensional organization of the epithelial complexes and blood microcirculatory bed in the rat palatal salivary glands and the lacrimal gland of the human newborn have been studied. Since their ducts serve not only for discharging their secrete into the external medium, but also for accumulation (as collectors), the sublobular unit--adenomere should be referred to as a part of elementary level of organization of the epithelial complexes. The adenomere has in its composition a collecting centrally situating duct. However, while studying structure of the blood microcirculatory bed, it is found out that there is not any strict territorial correspondence between its functional units and structural units of the glandular epithelium. Nevertheless, giving a great importance to a tight syntopic connection of the collecting ducts of the adenomeres with the postcapillary venules (that belong to filtrating microvessels), these are sublobular units--adenomeres that are distinguished as structural-functional units in the glands.

Effects of stellar outflows on interstellar sulfur oxide chemistry

NASA Technical Reports Server (NTRS)

Welch, W. J.; Vogel, S.; Terebey, S.; Dreher, J.; Jackson, J.; Carlstrom, J.

1986-01-01

Interferometer Maps with 2" to 6" resolution of a number of regions with active star formation (Orion A, W49, W51, SGRB2) show that the distribution of the molecule SO is very compact around stellar outflow sources. Both SO and SO2 were studied near three outflows, OrionA/IRc2 and two sources in W49. The two molecules have similar distributions and abundances. More than 95% of the emission comes from regions whose extents are only .05 to .2 pc., being larger around the more energetic sources. Their spectra are broad, 30 km/sec or more, suggesting that the oxide production is associated with the flows. The outflows are identified by water masers and by extended bipolar flows in SiO. Maps in other molecules, such as HCO+ and CS, which have similar collisional excitation requirements, have much greater spatial extent. Thus it appears that the SO and SO2 abundances are truly compact and are closely associated with the outflows.

An In Vitro Perfusion System to Enhance Outflow Studies in Mouse Eyes

PubMed Central

Kizhatil, Krishnakumar; Chlebowski, Arthur; Tolman, Nicholas G.; Freeburg, Nelson F.; Ryan, Margaret M.; Shaw, Nicholas N.; Kokini, Alexander D. M.; Marchant, Jeffrey K.; John, Simon W. M.

2016-01-01

Purpose The molecular mechanisms controlling aqueous humor (AQH) outflow and IOP need much further definition. The mouse is a powerful system for characterizing the mechanistic basis of AQH outflow. To enhance outflow studies in mice, we developed a perfusion system that is based on human anterior chamber perfusion culture systems. Our mouse system permits previously impractical experiments. Methods We engineered a computer-controlled, pump-based perfusion system with a platform for mounting whole dissected mouse eyes (minus lens and iris, ∼45% of drainage tissue is perfused). We tested the system's ability to monitor outflow and tested the effects of the outflow-elevating drug, Y27632, a rho-associated protein kinase (ROCK) inhibitor. Finally, we tested the system's ability to detect genetically determined decreases in outflow by determining if deficiency of the candidate genes Nos3 and Cav1 alter outflow. Results Using our system, the outflow facility (C) of C57BL/6J mouse eyes was found to range between 7.7 and 10.4 nl/minutes/mm Hg (corrected for whole eye). Our system readily detected a 74.4% Y27632-induced increase in C. The NOS3 inhibitor L-NG-nitroarginine methyl ester (L-NAME) and a Nos3 null mutation reduced C by 28.3% and 35.8%, respectively. Similarly, in Cav1 null eyes C was reduced by 47.8%. Conclusions We engineered a unique perfusion system that can accurately measure changes in C. We then used the system to show that NOS3 and CAV1 are key components of mechanism(s) controlling outflow. PMID:27701632

AGN feedback in action? - outflows and star formation in type 2 AGNs

NASA Astrophysics Data System (ADS)

Woo, Jong-Hak

2017-01-01

We present the statistical constraints on the ionized gas outflows and their connection to star formation, using a large sample of ~110,000 AGNs and star-forming galaxies at z < 0.3. First, we find a dramatic difference of the outflow signatures between AGNs and star-forming galaxies based on the [OIII] emission line kinematics. While the [OIII] velocity and velocity dispersion of star forming galaxies can be entirely accounted by the gravitational potential of host galaxies, AGNs clearly show non-gravitational kinematics, which is comparable to or stronger than the virial motion caused by the gravitational potential. Second, the distribution in the [OIII] velocity - velocity dispersion diagram dramatically expands toward large values with increasing AGN luminosity, implying that the outflows are AGN-driven. Third, the fraction of AGNs with a signature of outflow kinematics, steeply increases with AGN luminosity and Eddington ratio. In particular, the majority of luminous AGNs presents strong non-gravitational kinematics in the [OIII] profile. Interestingly, we find that the specific star formation of non-outflow AGNs is much lower than that of strong outflow AGNs, while the star formation rate of strong outflow AGNs is comparable to that of star forming galaxies. We interpret this trend as a delayed AGN feedback as it takes dynamical time for the outflows to suppress star formation in galactic scales.

A young bipolar outflow from IRAS15398-3359

NASA Astrophysics Data System (ADS)

Bjerkeli, Per; Jørgensen, Jes K.

2015-08-01

The Class 0 protostar IRAS 15398-3359 is located in the Lupus I cloud at a distance of 155 pc. The source is known to harbour a molecular outflow, but the region has not attracted much interest until recently. IRAS 15398 is known to show interesting chemical signatures and being one of the very nearby, young outflow sources makes it an excellent target for detailed studies of the gas kinematics of different species.We present observations of several molecular species, carried out with the Submillimeter Array and ALMA, towards the IRAS 15398 outflow. The analysis of CO emission show obvious signs of episodic mass ejections, with a dynamical time scale between the knots in the jet, of the order 100 years. This is consistent with recent ALMA results where luminosity outbursts are estimated to occur on similar time-scales. The physical properties of the outflow, such as mass, momentum, momentum rate, mechanical luminosity, kinetic energy and mass-loss rate are estimated at relatively low values. We argue that this source is of a very young age, possibly younger than ~1000 years. This is consistent with recent studies of the kinematics of the inner envelope/disk. The observed line profiles were compared to full 3D radiative transfer models of the source, constructed with the Line Modelling Engine (LIME). The observed line shapes can only be understood when considering several distinctly different physical components, viz. the outflow cavity, the infalling envelope and the surrounding cloud material. This allows us to put quantitative constraints on the kinematics of the material close to the central source.

A young bipolar outflow from IRAS 15398-3359

NASA Astrophysics Data System (ADS)

Bjerkeli, P.; Jørgensen, J. K.; Brinch, C.

2016-03-01

Context. Changing physical conditions in the vicinity of protostars allow for a rich and interesting chemistry to occur. Heating and cooling of the gas allows molecules to be released from and frozen out on dust grains. These changes in physics, traced by chemistry as well as the kinematical information, allows us to distinguish between different scenarios describing the infall of matter and the launching of molecular outflows and jets. Aims: We aim to determine the spatial distribution of different species that are of different chemical origin. This is to examine the physical processes in play in the observed region. From the kinematical information of the emission lines we aim to determine the nature of the infalling and outflowing gas in the system. We also aim to determine the physical properties of the outflow. Methods: Maps from the Submillimeter Array (SMA) reveal the spatial distribution of the gaseous emission towards IRAS 15398-3359. The line radiative transfer code LIME is used to construct a full 3D model of the system taking all relevant components and scales into account. Results: CO, HCO+, and N2H+ are detected and shown to trace the motions of the outflow. For CO, the circumstellar envelope and the surrounding cloud also have a profound impact on the observed line profiles. N2H+ is detected in the outflow, but is suppressed towards the central region, perhaps because of the competing reaction between CO and H3+ in the densest regions as well as the destruction of N2H+ by CO. N2D+ is detected in a ridge south-west of the protostellar condensation and is not associated with the outflow. The morphology and kinematics of the CO emission suggests that the source is younger than ~1000 years. The mass, momentum, momentum rate, mechanical luminosity, kinetic energy, and mass-loss rate are also all estimated to be low. A full 3D radiative transfer model of the system can explain all the kinematical and morphological features in the system.

Formation of Hydrocarbons in the Outflows from Red Giants

NASA Technical Reports Server (NTRS)

Roberge, Wayne; Kress, Monika; Tielens, Alexander G.

1995-01-01

The formation of hydrocarbons in the oxygen-rich outflows from red giants was studied. The existence of organic molecules in such outflows has been known for several years; however, their surprisingly high abundances has been a mystery since all of the carbon had been thought to be irretrievably locked up in CO, the most strongly bound molecule. CO is the first molecule to form from the atoms present in the star's extended atmosphere, and as strong stellar winds drive a cooling outflow, dust grains condense out. In oxygen-rich outflows, the dust is thought to be composed mainly of silicates and other metal oxides. Perhaps the noble metals can condense out in metallic form, in particular the relatively abundant transition metals iron and nickel. We proposed that perhaps the carbon reservoir held as CO can be accessed through a catalytic process involving the chemisorption of CO and H2 onto grains rich in metallic iron. CO and H2 are the two most abundant molecules in circumstellar outflows, and they both are known to dissociate on transition metal surfaces at elevated temperatures, freeing carbon to form organic molecules such as methane. We believe methane is a precursor molecule to the organics observed in oxygen-rich red giants. We have developed a nonequilibrium numerical model of a surface chemical (catalytic) process. Based on this model, we believe that methane can be formed under the conditions present in circumstellar outflows. Although the methane formation rates are exceptionally low under these conditions, over dynamical timescales, a significant amount of CO can be converted to methane and driven further out in the envelope, explaining the presence of organics there.

Protostellar Outflows Mapped with ALMA and Techniques to Include Short Spacings

NASA Astrophysics Data System (ADS)

Plunkett, Adele

2018-01-01

Protostellar outflows are early signs of star formation, yet in cluster environments - common sites of star formation - their role and interaction with surrounding gas are complicated. Protostellar outflows are interesting and complex because they connect protostars (scales 10s au) to the surrounding gas environment (few pc), and their morphology constrains launching and/or accretion modes. A complete outflow study must use observing methods that recover several orders of magnitude of spatial scales, ideally with sub-arcsecond resolution and mapping over a few parsecs. ALMA provides high-resolution observations of outflows, and in some cases outflows have been mapped in clusters. Combining with observations using the Total Power array is possible, but challenging, and a large single dish telescope providing more overlap in uv space is advantageous. In this presentation I show protostellar outflows observed with ALMA using 12m, 7m, and To tal Power arrays. With a new CASA tool TP2VIS we create total power ``visibility'' data and perform joint imaging and deconvolution of interferometry and single dish data. TP2VIS will ultimately provide synergy between ALMA and AtLAST data.

Cusp field-aligned currents and ion outflows

NASA Astrophysics Data System (ADS)

Strangeway, R. J.; Russell, C. T.; Carlson, C. W.; McFadden, J. P.; Ergun, R. E.; Temerin, M.; Klumpar, D. M.; Peterson, W. K.; Moore, T. E.

2000-09-01

On September 24 and 25, 1998, the Polar spacecraft observed intense outflows of terrestrial ions in association with the passage of an interplanetary shock and coronal mass ejection. The orbit of the Fast Auroral Snapshot (FAST) Explorer was in the noon-midnight meridian during this ion outflow event, and FAST passed through the day side cusp region at ˜4000 km altitude every 2.2 hours. FAST was therefore able to monitor the ion outflows subsequently observed by Polar. We show that while the outflows were more intense after the shock passage, the overall particle and field signatures within the cusp region were qualitatively similar both before and after the shock passage. FAST observations show that the cusp particle precipitation marks the lower latitude leg of a pair of field-aligned currents and further, that both field-aligned current sheets appear to be on open field lines. Moreover, the polarity of the cusp currents is controlled by the polarity of the interplanetary magnetic field (IMF) y-component, such that the magnetic field perturbation associated with the pair of cusp currents is in the same direction as the IMF By. This is a consequence of the reconnection of cusp-region field lines at the magnetopause, with the flux transport resulting in electromagnetic energy being transmitted along field lines to the ionosphere as Poynting flux. We show that this Poynting flux can be as high as 120 mW m-2 (120 ergs cm-2 s-1) at FAST altitudes (˜500 mW m-2 at ionospheric altitudes), presumably because of the strong IMF By (˜40 nT), and is the dominant energy input to the cusp-region ionosphere. Furthermore, we find that the peak ion outflow flux is correlated with the peak downward Poynting flux, although only a few passes through the cusp centered around the time of the shock passage were used to determine this correlation. The energy carried by Poynting flux is dissipated as heat within the ionosphere, through Joule dissipation. The heating will tend to

Superposed epoch analysis of O+ auroral outflow during sawtooth events and substorms

NASA Astrophysics Data System (ADS)

Nowrouzi, N.; Kistler, L. M.; Lund, E. J.; Cai, X.

2017-12-01

Sawtooth events are repeated injection of energetic particles at geosynchronous orbit. Studies have shown that 94% of sawtooth events occurred during magnetic storm times. The main factor that causes a sawtooth event is still an open question. Simulations have suggested that heavy ions like O+ may play a role in triggering the injections. One of the sources of the O+ in the Earth's magnetosphere is the nightside aurora. O+ ions coming from the nightside auroral region have direct access to the near-earth magnetotail. A model (Brambles et al. 2013) for interplanetary coronal mass ejection driven sawtooth events found that nightside O+ outflow caused the subsequent teeth of the sawtooth event through a feedback mechanism. This work is a superposed epoch analysis to test whether the observed auroral outflow supports this model. Using FAST spacecraft data from 1997-2007, we examine the auroral O+ outflow as a function of time relative to an injection onset. Then we determine whether the profile of outflow flux of O+ during sawtooth events is different from the outflow observed during isolated substorms. The auroral region boundaries are estimated using the method of (Andersson et al. 2004). Subsequently the O+ outflow flux inside these boundaries are calculated and binned as a function of superposed epoch time for substorms and sawtooth "teeth". In this way, we will determine if sawtooth events do in fact have greater O+ outflow, and if that outflow is predominantly from the nightside, as suggested by the model results.

Acro-Dermato-Ungual-Lacrimal-Tooth Syndrome: An Uncommon Member of the Ectodermal Dysplasias.

PubMed

Whittington, Adam; Stein, Sarah; Kenner-Bell, Brandi

2016-09-01

Acro-dermato-ungual-lacrimal-tooth (ADULT) syndrome is a rare form of autosomal dominant ectodermal dysplasia due to mutations in the TP63 gene, a locus that has also been implicated in other syndromic forms of ectodermal dysplasia. It shares many phenotypic characteristics with other TP63 gene mutation syndromes, often making an accurate diagnosis difficult. Long-term management and follow-up of the various sequelae of ectodermal dysplasia require an accurate diagnosis. We report a familial case of ADULT syndrome in a daughter, mother, and son and provide a brief review of the clinical characteristics of this syndrome. © 2016 Wiley Periodicals, Inc.

Dissecting the Butterfly: Dual Outflows in the Dual AGN NGC 6240

NASA Astrophysics Data System (ADS)

Mueller Sanchez, Francisco; Comerford, Julie; Nevin, Rebecca; Davies, Richard; Treister, Ezequiel; Privon, George

2018-01-01

Current theories of galaxy evolution invoke some kind of feedback (from the stars or the supermassive black hole) to explain the properties of galaxies. However, numerical simulations and observations have not been able to evaluate the real impact of feedback in galaxies. This is largely because most studies have focused on studying stellar feedback or AGN feedback alone, instead of considering the combined effect of both. In fact, this is an unexplored territory for observations due to the difficulty of separating the contribution from the two sources.In this contribution I present the discovery of a dual outflow of different species of gas in the prototypical merging galaxy NGC 6240 using HST imaging, long-slit and integral-eld spectroscopy: an AGN-driven outflow of highly-ionized gas to the northeast and a starburst-driven outflow of ionized hydrogen to the northwest. The AGN outflow extends up to 4 kpc along a position angle of 56 degrees, has a conical shape with an opening angle of 52 degrees and a maximum line-of-sight velocity of 350 km/s. The WFC3 images also reveal a bubble of Halpha emission in the northwest, which has no counterpart in [O III], consistent with a scenario in which the starburst is ionizing and driving outflowing winds which inflate the bubble at an expansion velocity of 380 km/s. Assuming a spherical geometry for the starburst-driven bubble and a conical geometry for the AGN-driven outflow, we estimate mass outflow rates of 26 Msun/yr and 62 Msun/yr, respectively. We conclude that the AGN contribution to the evolution of the merger remnant and the formation of outflowing winds is signicant in the central 5 kpc of NGC 6240.

An X-Ray/SDSS Sample: Observational Characterization of The Outflowing Gas

NASA Astrophysics Data System (ADS)

Perna, Michele; Brusa, M.; Lanzuisi, G.; Mignoli, M.

2016-10-01

Powerful ionised AGN-driven outflows, commonly detected both locally and at high redshift, are invoked to contribute to the co-evolution of SMBH and galaxies through feedback phenomena. Our recent works (Brusa+2015; 2016; Perna+2015a,b) have shown that the XMM-COSMOS targets with evidence of outflows collected so far ( 10 sources) appear to be associated with low X-ray kbol corrections (Lbol /LX ˜ 18), in spite of their spread in obscuration, in the locations on the SFR-Mstar diagram, in their radio emission. A higher statistical significance is required to validate a connection between outflow phenomena and a X-ray loudness. Moreover, in order to validate their binding nature to the galaxy fate, it is crucial to correctly determine the outflow energetics. This requires time consuming integral field spectroscopic (IFS) observations, which are, at present, mostly limited to high luminosity objectsThe study of SDSS data offers a complementary strategy to IFS efforts. I will present physical and demographic characterization of the AGN-galaxy system during the feedback phase obtained studying a sample of 500 X-ray/SDSS AGNs, at z<0.8. Outflow velocity inferred from [OIII]5007 emission line profile has been related to optical (e.g., [OIII] and bolometric luminosities, Eddington ratio, stellar velocity dispersion) and X-ray properties (intrinsic X-ray luminosity, obscuration and X-ray kbol correction), to determine what drives ionised winds. Several diagnostic line ratios have been used to infer the physical properties of the ionised outflowing gas. The knowledge of these properties can reduce the actual uncertainties in the outflow energetics by a factor of ten, pointing to improve our understanding of the AGN outflow phenomenon and its impact on galaxy evolution.

Comparison of endoscopic and external dacryocystorhinostomy for treatment of primary acquired nasolacrimal duct obstruction

PubMed Central

Su, Pei-Yuan

2018-01-01

PURPOSE: The purpose of this study is to compare the success rates of endoscopic endonasal dacryocystorhinostomy (EN-DCR) and external DCR (EX-DCR) for the treatment of primary acquired nasolacrimal duct obstruction (PANLDO). DESIGN: This was a retrospective, comparative, nonrandomized clinical study. METHODS: Reviewed medical records of PANLDO underwent DCR at Far-Eastern Memorial Hospital from May 2011 to June 2017. Data regarding the lacrimal passage system, comorbidities, surgical outcomes, and postoperative complications were analyzed. Anatomical success was defined as patency confirmed by intranasal endoscopic inspection of the ostium and successful lacrimal irrigation; functional success was defined as complete resolution of epiphora and positive fluorescein dye disappearance test, which were assessed at postoperative 6th months. RESULTS: One hundred and seventy patients (37 males, 133 females, mean age 57 years) underwent 178 DCR surgeries for PANLDO. The overall anatomical success rate was 94.4% (93.5% in EN-DCR vs. 95.8% in EX-DCR, P = 0.511) and functional success rate was 90.4% (90.7% in EN-DCR and 90.1% in EX-DCR, P = 0.909). Surgical outcomes were comparable between two groups. Complication rate was low in both groups, including 11 cases of early canalicular stent dislodge (7 in EN-DCR, 4 in EX-DCR), one case of postoperative nasal bleeding in EN-DCR, and two skin wound dehiscence and three cutaneous keloid formation in EX-DCR. None of these cases were concluded into surgical failure at the final visit. The time to symptoms relief was statistical significantly shorter in EN-DCR group (1.7 vs. 3.7 weeks in EX-DCR, P < 0.001). CONCLUSIONS: Success rate of DCR for PANLDO in our study was high, and complication rate was low for both endoscopic and external approaches. There was no statistically significant difference between them. EN-DCR provided higher satisfaction due to quicker recovery and lack of external incision. Endoscopic DCR should be considered

Ionized and Neutral Outflows in the QUEST QSOs

NASA Astrophysics Data System (ADS)

Veilleux, Sylvain

2011-10-01

The role of galactic winds in gas-rich mergers is of crucial importance to understand galaxy and SMBH evolution. In recent months, our group has had three major scientific breakthroughs in this area: {1} The discovery with Herschel of massive molecular {OH-absorbing} outflows in several ULIRGs, including the nearest quasar, Mrk 231. {2} The independent discovery from mm-wave interferometric observations in the same object of a spatially resolved molecular {CO-emitting} wind with estimated mass outflow rate 3x larger than the star formation rate and spatially coincident with blueshifted neutral {Na ID-absorbing} gas in optical long-slit spectra. {3} The unambiguous determination from recent Gemini/IFU observations that the Na ID outflow in this object is wide-angle, thus driven by a QSO wind rather than a jet. This powerful outflow may be the long-sought "smoking gun" of quasar mechanical feedback purported to transform gas-rich mergers. However, our Herschel survey excludes all FIR-faint {UV-bright} "classic" QSOs by necessity. So here we propose a complementary FUV absorption-line survey of all FIR-bright -and- FIR-faint QSOs from the same parent sample. New {19 targets} and archival {11} spectra will be used to study, for the first time, the gaseous environments of QSOs as a function of host properties and age across the merger sequence ULIRG -> QSO. These data will allow us to distinguish between ionized & neutral quasar-driven outflows, starburst-driven winds, and tidal debris around the mergers. They will also be uniquely suited for a shallow but broad study of the warm & warm-hot intergalactic media, complementary to on-going surveys that are deeper but narrower.

Observations of Water Vapor Outflow from NML Cygnus

NASA Astrophysics Data System (ADS)

Zubko, Viktor; Li, Di; Lim, Tanya; Feuchtgruber, Helmut; Harwit, Martin

2004-07-01

We report new observations of the far-infrared and submillimeter water vapor emission of NML Cygnus based on data gathered with the Infrared Space Observatory and the Submillimeter Wave Astronomy Satellite. We compare the emission from NML Cyg to that previously published for VY CMa and W Hya in an attempt to establish the validity of recently proposed models for the outflow from evolved stars. The data obtained support the contention by Ivezić & Elitzur that the atmospheres of evolved stars obey a set of scaling laws in which the optical depth of the outflow is the single most significant scaling parameter, affecting both the radiative transfer and the dynamics of the outflow. Specifically, we provide observations comparing the water vapor emission from NML Cyg, VY CMa, and W Hya and find, to the extent permitted by the quality of our data, that the results are in reasonable agreement with a model developed by Zubko & Elitzur. Using this model we derive a mass loss based on the dust opacities, spectral line fluxes, and outflow velocities of water vapor observed in the atmospheres of these oxygen-rich giants. For VY CMa and NML Cyg, we also obtain an estimate of the stellar mass.

Quasar feedback revealed by giant molecular outflows

NASA Astrophysics Data System (ADS)

Feruglio, C.; Maiolino, R.; Piconcelli, E.; Menci, N.; Aussel, H.; Lamastra, A.; Fiore, F.

2010-07-01

In the standard scenario for galaxy evolution young star-forming galaxies transform into red bulge-dominated spheroids, where star formation has been quenched. To explain this transformation, a strong negative feedback generated by accretion onto a central super-massive black hole is often invoked. The depletion of gas resulting from quasar-driven outflows should eventually stop star-formation across the host galaxy and lead the black hole to “suicide” by starvation. Direct observational evidence for a major quasar feedback onto the host galaxy is still missing, because outflows previously observed in quasars are generally associated with the ionized component of the gas, which only accounts for a minor fraction of the total gas content, and typically occurrs in the central regions. We used the IRAM PdB Interferometer to observe the CO(1-0) transition in Mrk 231, the closest quasar known. Thanks to the wide band we detected broad wings of the CO line, with velocities of up to 750 km s-1 and spatially resolved on the kpc scale. These broad CO wings trace a giant molecular outflow of about 700 M_⊙/year, far larger than the ongoing star-formation rate (~200 M_⊙/year) observed in the host galaxy. This wind will totally expel the cold gas reservoir in Mrk 231 in about 107 yrs, therefore halting the star-formation activity on the same timescale. The inferred kinetic energy in the molecular outflow is ~1.2 × 1044 erg/s, corresponding to a few percent of the AGN bolometric luminosity, which is very close to the fraction expected by models ascribing quasar feedback to highly supersonic shocks generated by radiatively accelerated nuclear winds. Instead, the contribution by the SNe associated with the starburst fall short by several orders of magnitude to account for the kinetic energy observed in the outflow. The direct observational evidence for quasar feedback reported here provides solid support to the scenarios ascribing the observed properties of local massive

[Lacrimal gland-associated mucins. Age related production and their role in the pathophysiology of dry eye].

PubMed

Schäfer, G; Hoffmann, W; Berry, M; Paulsen, F

2005-02-01

The secretory cells of the human lacrimal gland show a PAS-positive reaction in cytochemical staining procedures, suggesting the production of mucous substances. Recently, these substances were differentiated according to modern molecular classifications. Expression studies detected mRNA for MUC1, MUC4, MUC5AC, MUC5B, MUC6, and MUC7, whereas MUC2 transcripts were absent in all samples investigated. Immunohistochemistry revealed membrane-bound MUC1 at the apical surface of acinar cells, MUC5AC associated with goblet cells of excretory ducts, MUC5B and MUC7 in the cytoplasm of acinar cells, and MUC7 also in epithelial cells of excretory ducts. MUC2 (RT-PCR negative) and MUC6 (RT-PCR positive) were not detectable by immunohistochemistry. MUC4 mRNA was present in all samples from patients treated for dry eye but only in 6 of 30 glands from individuals who did not receive treatment with artificial tears. Dot-blot analyses clearly revealed increased amounts of MUC4, MUC5AC and MUC5B in the glands of elderly women who received treatment for dry eye as compared to the remaining samples. These results confirm that the human lacrimal gland synthesizes a spectrum of mucins, some of which might be involved in the pathophysiology of dry eye syndrome.

Outflow and Accretion Physics in Active Galactic Nuclei

NASA Astrophysics Data System (ADS)

McGraw, Sean Michael

2016-09-01

This dissertation focuses on placing observational constraints on outflows and accretion disks in active galactic nuclei (AGN) for the purpose of better understanding the physics of super-massive black holes (SMBHs) and their evolution with the host galaxy over cosmic time. Quasar outflows and their importance in SMBH-host galaxy co-evolution can be further understood by analyzing broad absorption lines (BALs) in rest-frame UV spectra that trace a range of wind conditions. We quantify the properties of the flows by conducting BAL variability studies using multiple-epoch spectra acquired primarily from MDM Observatory and from the Sloan Digital Sky Survey. Iron low-ionization BALs (FeLoBALs) are a rare type of outflow that may represent a transient phase in galaxy evolution, and we analyze the variations in 12 FeLoBAL quasars with redshifts between 0.7 ≤ z ≤ 1.9 and rest frame timescales between ˜10 d to 7.6 yr. We investigate BAL variability in 71 quasar outflows that exhibit P V absorption, a tracer of high column density gas (i.e. NH ≥ 1022 cm -2), in order to quantify the energies and momenta of the flows. We also characterize the variability patterns of 26 quasars with mini-BALs, an interesting class of absorbers that may represent a distinct phase in the evolution of outflows. Low-luminosity AGN (LLAGN) are important objects to study since their prominence in the local Universe suggest a possible evolution from the quasar era, and their low radiative outputs likely indicate a distinct mode of accretion onto the SMBH. We probe the accretion conditions in the LLAGN NGC 4203 by estimating the SMBH mass, which is obtained by modeling the 2-dimensional velocity field of the nebular gas using spectra from the Hubble Space Telescope. We detect significant BAL and mini-BAL variability in a subset of quasars from each of our samples, with measured rest-frame variability time-scales from days to years and over multiple years on average. Variable wavelength

Segmental Versican Expression in the Trabecular Meshwork and Involvement in Outflow Facility

PubMed Central

Keller, Kate E.; Bradley, John M.; Vranka, Janice A.

2011-01-01

Purpose. Versican is a large proteoglycan with numerous chondroitin sulfate (CS) glycosaminoglycan (GAG) side chains attached. To assess versican's potential contributions to aqueous humor outflow resistance, its segmental distribution in the trabecular meshwork (TM) and the effect on outflow facility of silencing the versican gene were evaluated. Methods. Fluorescent quantum dots (Qdots) were perfused to label outflow pathways of anterior segments. Immunofluorescence with confocal microscopy and quantitative RT-PCR were used to determine versican protein and mRNA distribution relative to Qdot-labeled regions. Lentiviral delivery of shRNA-silencing cassettes to TM cells in perfused anterior segment cultures was used to evaluate the involvement of versican and CS GAG chains in outflow facility. Results. Qdot uptake by TM cells showed considerable segmental variability in both human and porcine outflow pathways. Regional levels of Qdot labeling were inversely related to versican protein and mRNA levels; versican levels were relatively high in sparsely Qdot-labeled regions and low in densely labeled regions. Versican silencing decreased outflow facility in human and increased facility in porcine anterior segments. However, RNAi silencing of ChGn, an enzyme unique to CS GAG biosynthesis, increased outflow facility in both species. The fibrillar pattern of versican immunostaining in the TM juxtacanalicular region was disrupted after versican silencing in perfusion culture. Conclusions. Versican appears to be a central component of the outflow resistance, where it may organize GAGs and other ECM components to facilitate and control open flow channels in the TM. However, the exact molecular organization of this resistance appears to differ between human and porcine eyes. PMID:21596823

Low-energy ion outflow modulated by the solar wind energy input

NASA Astrophysics Data System (ADS)

Li, Kun; Wei, Yong; Andre, Mats; Eriksson, Anders; Haaland, Stein; Kronberg, Elena; Nilsson, Hans; Maes, Lukas

2017-04-01

Due to the spacecraft charging issue, it has been difficult to measure low-energy ions of ionospheric origin in the magnetosphere. A recent study taking advantage of the spacecraft electric potential has found that the previously 'hidden' low-energy ions is dominant in the magnetosphere. This comprehensive dataset of low-energy ions allows us to study the relationship between the ionospheric outflow and energy input from the solar wind (ɛ). In this study, we discuss the ratios of the solar wind energy input to the energy of the ionospheric outflow. We show that the ɛ controls the ionospheric outflow when the ɛ is high, while the ionospheric outflow does not systematically change with the ɛ when the ɛ is low.

Outflows in low-mass galaxies at z >1

NASA Astrophysics Data System (ADS)

Maseda, Michael V.; MUSE GTO Consortium

2017-03-01

Star formation histories of local dwarf galaxies, derived through resolved stellar populations, appear complex and varied. The general picture derived from hydrodynamical simulations is one of cold gas accretion and bursty star formation, followed by feedback from supernovae and winds that heat and eject the central gas reservoirs. This ejection halts star formation until the material cools and re-accretes, resulting in an episodic SFH, particularly at stellar masses below ~ 109 M⊙. Such feedback has often been cited as the driving force behind the observed slowly-rising rotation curves in local dwarfs, due to an under-density of dark matter compared to theoretical models, which is one of the primary challenges to LCDM cosmology. However, these events have not yet been directly observed at high-redshift. Recently, using HST imaging and grism spectroscopy, we have uncovered an abundant population of low-mass galaxies (M* < 109 M⊙) at z = 1 - 2 that are undergoing strong bursts of star formation, in agreement with the theoretical predictions. These Extreme Emission Line Galaxies, with high specific SFRs and shallow gravitational potential wells, are ideal places to test the theoretical prediction of strong feedback-driven outflows. Here we use deep MUSE spectroscopy to search these galaxies for signatures of outflowing material, namely kinematic offsets between absorption lines (in the restframe optical and UV), which trace cool gas, and the nebular emission lines, which define the systemic redshift of the galaxy. Although the EELGs are intrinsically very faint, stacked spectra reveal blueshifted velocity centroids for Fe II absorption, which is indicative of outflowing cold gas. This represents the first constraint on outflows in M* < 109 M⊙ galaxies at z = 1 - 2. These outflows should regulate the star formation histories of low-mass galaxies at early cosmic times and thus play a crucial role in galaxy growth and evolution.

Plasma Outflows: Known Knowns, Known Unknowns, and The Unknown

NASA Technical Reports Server (NTRS)

Moore, T. E.

2012-01-01

A brief summary is given of i) what we know from observing ionospheric outflows and ii) how outflow parameterizations are being used in global simulations to evaluate their effects on magnetospheric dynamics. Then, a list of unanswered questions and issues to be resolved is given, followed by a description of the known future mission plans expressed in the Heliophysics Roadmap, such as Origin of Near-Earth Plasmas (ONEP), and Ion-Neutral Coupling in the Atmosphere (INCA). Finally, a set of requirements for definitive plasma outflow observations are identified, along with possible methods for fulfilling them in future missions. Since results of the current Heliophysics Decadal Survey are expected soon, it is hoped that future plans can be summarized and discussed without speculation at the GEM 2012 meeting.

The JCMT Gould Belt Survey: Understanding the influence of outflows on Gould Belt clouds

NASA Astrophysics Data System (ADS)

Drabek-Maunder, E.; Hatchell, J.; Buckle, J. V.; Di Francesco, J.; Richer, J.

2016-03-01

Using James Clerk Maxwell Telescope (JCMT) Gould Belt Survey data from CO J = 3 → 2 isotopologues, we present a meta-analysis of the outflows and energetics of star-forming regions in several Gould Belt clouds. The majority of the regions are strongly gravitationally bound. There is evidence that molecular outflows transport large quantities of momentum and energy. Outflow energies are at least 20 per cent of the total turbulent kinetic energies in all of the regions studied and greater than the turbulent energy in half of the regions. However, we find no evidence that outflows increase levels of turbulence, and there is no correlation between the outflow and turbulent energies. Even though outflows in some regions contribute significantly to maintaining turbulence levels against dissipation, this relies on outflows efficiently coupling to bulk motions. Other mechanisms (e.g. supernovae) must be the main drivers of turbulence in most if not all of these regions.

Isotopic tracing of the outflow during artificial rain-on-snow event

NASA Astrophysics Data System (ADS)

Juras, Roman; Pavlásek, Jirka; Vitvar, Tomáš; Šanda, Martin; Holub, Jirka; Jankovec, Jakub; Linda, Miloslav

2016-10-01

The frequency of rain-on-snow (ROS) occurrence is increasing and this natural phenomenon is beginning to play an important role in temperate climate regions. Present knowledge of outflow generation mechanisms and rainwater dynamics during ROS is still insufficient. The study introduces a combined method of artificial ROS, isotopic tracing and energy balance to partition the event rainwater and the pre-event non-rainwater in the outflow. A rainfall simulator and water enriched with deuterium were used for identifying event rainwater and pre-event non-rainwater during an ROS event. The ROS experiment was conducted in the Krkonoše Mountains in the Czech Republic. An experimental snow block consisting of ripe and isothermal snow was sprayed with deuterium enriched water. The outflow from the snowpack was continuously monitored to gain quantitative and qualitative information about outflow water. The isotopic deuterium content was further analysed from the samples by means of laser spectroscopy in order to separate the hydrograph components. The deuterium content was also analysed from the snow samples gathered before and after the experiment to identify the retention of event rainwater in the snowpack. Isotopic hydrograph separation revealed that although high rain intensity was applied, the event rainwater represented one half (52.7%) of the total outflow volume. The ripe snowpack retained about one third of the rainwater input (33.6%). Significant changes in the outflowing water quality can therefore be expected during ROS events. This experiment also shows that rainwater during ROS firstly pushes-out the non-rainwater and then contributes to the outflow. These results show that the presented technique allows us to gain sufficient information about rainwater dynamics during ROS.

Estimating outflow facility through pressure dependent pathways of the human eye

PubMed Central

Gardiner, Bruce S.

2017-01-01

We develop and test a new theory for pressure dependent outflow from the eye. The theory comprises three main parameters: (i) a constant hydraulic conductivity, (ii) an exponential decay constant and (iii) a no-flow intraocular pressure, from which the total pressure dependent outflow, average outflow facilities and local outflow facilities for the whole eye may be evaluated. We use a new notation to specify precisely the meaning of model parameters and so model outputs. Drawing on a range of published data, we apply the theory to animal eyes, enucleated eyes and in vivo human eyes, and demonstrate how to evaluate model parameters. It is shown that the theory can fit high quality experimental data remarkably well. The new theory predicts that outflow facilities and total pressure dependent outflow for the whole eye are more than twice as large as estimates based on the Goldman equation and fluorometric analysis of anterior aqueous outflow. It appears likely that this discrepancy can be largely explained by pseudofacility and aqueous flow through the retinal pigmented epithelium, while any residual discrepancy may be due to pathological processes in aged eyes. The model predicts that if the hydraulic conductivity is too small, or the exponential decay constant is too large, then intraocular eye pressure may become unstable when subjected to normal circadian changes in aqueous production. The model also predicts relationships between variables that may be helpful when planning future experiments, and the model generates many novel testable hypotheses. With additional research, the analysis described here may find application in the differential diagnosis, prognosis and monitoring of glaucoma. PMID:29261696

Simulated O VI Doppler dimming measurements of coronal outflow velocities

NASA Technical Reports Server (NTRS)

Strachan, Leonard; Gardner, L. D.; Kohl, John L.

1992-01-01

The possibility of determining O(5+) outflow velocities by using a Doppler dimming analysis of the resonantly scattered intensities of O VI lambda 1031.9 and lambda 1037.6 is addressed. The technique is sensitive to outflow velocities, W, in the range W greater than 30 and less than 250 km/s and can be used for probing regions of the inner solar corona, where significant coronal heating and solar wind acceleration may be occurring. These velocity measurements, when combined with measurements of other plasma parameters (temperatures and densities of ions and electrons) can be used to estimate the energy and mass flux of O(5+). In particular, it may be possible to locate where the flow changes from subsonic to supersonic and to identify source regions for the high and low speed solar wind. The velocity diagnostic technique is discussed with emphasis placed on the requirements needed for accurate outflow velocity determinations. Model determinations of outflow velocities based on simulated Doppler observations are presented.

HELICAL MAGNETIC FIELDS IN THE NGC 1333 IRAS 4A PROTOSTELLAR OUTFLOWS

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

Ching, Tao-Chung; Lai, Shih-Ping; Zhang, Qizhou

We present Submillimeter Array polarization observations of the CO J = 3–2 line toward NGC 1333 IRAS 4A. The CO Stokes I maps at an angular resolution of ∼1″ reveal two bipolar outflows from the binary sources of NGC 1333 IRAS 4A. The kinematic features of the CO emission can be modeled by wind-driven outflows at ∼20° inclined from the plane of the sky. Close to the protostars the CO polarization, at an angular resolution of ∼2.″3, has a position angle approximately parallel to the magnetic field direction inferred from the dust polarizations. The CO polarization direction appears to vary smoothly frommore » an hourglass field around the core to an arc-like morphology wrapping around the outflow, suggesting a helical structure of magnetic fields that inherits the poloidal fields at the launching point and consists of toroidal fields at a farther distance of outflow. The helical magnetic field is consistent with the theoretical expectations for launching and collimating outflows from a magnetized rotating disk. Considering that the CO polarized emission is mainly contributed from the low-velocity and low-resolution data, the helical magnetic field is likely a product of the wind–envelope interaction in the wind-driven outflows. The CO data reveal a PA of ∼30° deflection in the outflows. The variation in the CO polarization angle seems to correlate with the deflections. We speculate that the helical magnetic field contributes to ∼10° deflection of the outflows by means of Lorentz force.« less

An X-ray/SDSS sample. II. AGN-driven outflowing gas plasma properties

NASA Astrophysics Data System (ADS)

Perna, M.; Lanzuisi, G.; Brusa, M.; Cresci, G.; Mignoli, M.

2017-10-01

Aims: Galaxy-scale outflows are currently observed in many active galactic nuclei (AGNs); however, characterisation of them in terms of their (multi-) phase nature, amount of flowing material, and effects on their host galaxy is still unresolved. In particular, ionised gas mass outflow rate and related energetics are still affected by many sources of uncertainty. In this respect, outflowing gas plasma conditions, being largely unknown, play a crucial role. Methods: We have analysed stacked spectra and sub-samples of sources with high signal-to-noise temperature- and density-sensitive emission lines to derive the plasma properties of the outflowing ionised gas component. We did this by taking advantage of the spectroscopic analysis results we obtained while studying the X-ray/SDSS sample of 563 AGNs at z < 0.8 presented in our companion paper. For these sources, we also studied in detail various diagnostic diagrams to infer information about outflowing gas ionisation mechanisms. Results: We derive, for the first time, median values for electron temperature and density of outflowing gas from medium-size samples ( 30 targets) and stacked spectra of AGNs. Evidence of shock excitation are found for outflowing gas. Conclusions: We measure electron temperatures of the order of 1.7 × 104 K and densities of 1200 cm-3 for faint and moderately luminous AGNs (intrinsic X-ray luminosity 40.5 < log (LX) < 44 in the 2-10 keV band). We note that the electron density that is usually assumed (Ne = 100 cm-3) in ejected material might result in relevant overestimates of flow mass rates and energetics and, as a consequence, of the effects of AGN-driven outflows on the host galaxy.

The Production of Cold Gas Within Galaxy Outflows

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

Scannapieco, Evan

2017-03-01

I present a suite of three-dimensional simulations of the evolution of initially hot material ejected by starburst-driven galaxy outflows. The simulations are conducted in a comoving frame that moves with the material, tracking atomic/ionic cooling, Compton cooling, and dust cooling and destruction. Compton cooling is the most efficient of these processes, while the main role of atomic/ionic cooling is to enhance density inhomogeneities. Dust, on the other hand, has little effect on the outflow evolution, and is rapidly destroyed in all the simulations except for the case with the smallest mass flux. I use the results to construct a simplemore » steady-state model of the observed UV/optical emission from each outflow. The velocity profiles in this case are dominated by geometric effects, and the overall luminosities are extremely strong functions of the properties of the host system, as observed in ultra-luminous infrared galaxies (ULIRGs). Furthermore the luminosities and maximum velocities in several models are consistent with emission-line observations of ULIRGs, although the velocities are significantly greater than observed in absorption-line studies. It may be that absorption line observations of galaxy outflows probe entrained cold material at small radii, while emission-line observations probe cold material condensing from the initially hot medium at larger distances.« less

Geochemistry and source waters of rock glacier outflow, Colorado Front Range

USGS Publications Warehouse

Williams, M.W.; Knauf, M.; Caine, N.; Liu, F.; Verplanck, P.L.

2006-01-01

We characterize the seasonal variation in the geochemical and isotopic content of the outflow of the Green Lake 5 rock glacier (RG5), located in the Green Lakes Valley of the Colorado Front Range, USA. Between June and August, the geochemical content of rock glacier outflow does not appear to differ substantially from that of other surface waters in the Green Lakes Valley. Thus, for this alpine ecosystem at this time of year there does not appear to be large differences in water quality among rock glacier outflow, glacier and blockslope discharge, and discharge from small alpine catchments. However, in September concentrations of Mg2+ in the outflow of the rock glacier increased to more than 900 ??eq L-1 compared to values of less than 40 ??eq L-1 at all the other sites, concentrations of Ca2+ were greater than 4,000 ??eq L-1 compared to maximum values of less than 200 ??eq L-1 at all other sites, and concentrations of SO42- reached 7,000 ??eq L-1, compared to maximum concentrations below 120 ??eq L-1 at the other sites. Inverse geochemical modelling suggests that dissolution of pyrite, epidote, chlorite and minor calcite as well as the precipitation of silica and goethite best explain these elevated concentrations of solutes in the outflow of the rock glacier. Three component hydrograph separation using end-member mixing analysis shows that melted snow comprised an average of 30% of RG5 outflow, soil water 32%, and base flow 38%. Snow was the dominant source water in June, soil water was the dominant water source in July, and base flow was the dominant source in September. Enrichment of ?? 18O from - 10??? in the outflow of the rock glacier compared to -20??? in snow and enrichment of deuterium excess from +17.5??? in rock glacier outflow compared to +11??? in snow, suggests that melt of internal ice that had undergone multiple melt/freeze episodes was the dominant source of base flow. Copyright ?? 2005 John Wiley & Sons, Ltd.

The Dual Role of Starbursts and Active Galactic Nuclei in Driving Extreme Molecular Outflows

NASA Astrophysics Data System (ADS)

Gowardhan, Avani; Spoon, Henrik; Riechers, Dominik A.; González-Alfonso, Eduardo; Farrah, Duncan; Fischer, Jacqueline; Darling, Jeremy; Fergulio, Chiara; Afonso, Jose; Bizzocchi, Luca

2018-05-01

We report molecular gas observations of IRAS 20100‑4156 and IRAS 03158+4227, two local ultraluminous infrared galaxies (ULIRGs) hosting some of the fastest and most massive molecular outflows known. Using Atacama Large Millimeter Array and Plateau de Bure Interferometer observations, we spatially resolve the CO (1‑0) emission from the outflowing molecular gas in both and find maximum outflow velocities of v max ∼ 1600 and ∼1700 km s‑1 for IRAS 20100‑4156 and IRAS 03158+4227, respectively. We find total gas mass outflow rates of {\\dot{M}}OF}∼ 670 and ∼350 M ⊙ yr‑1, respectively, corresponding to molecular gas depletion timescales {τ }OF}dep}∼ 11 and ∼16 Myr. This is nearly 3 times shorter than the depletion timescales implied by star formation, {τ }SFR}dep}∼ 33 and ∼46 Myr, respectively. To determine the outflow driving mechanism, we compare the starburst luminosity (L *) and active galactic nucleus (AGN) luminosity (L AGN) to the outflowing energy and momentum fluxes, using mid-infrared spectral decomposition to discern L AGN. Comparison to other molecular outflows in ULIRGs reveals that outflow properties correlate similarly with L * and L IR as with L AGN, indicating that AGN luminosity alone may not be a good tracer of feedback strength and that a combination of AGN and starburst activity may be driving the most powerful molecular outflows. We also detect the OH 1.667 GHz maser line from both sources and demonstrate its utility in detecting molecular outflows.

Urgency of micturition and detrusor contractility in men with prostatic obstruction and overactive bladders.

PubMed

Cucchi, A; Quaglini, S; Giannantoni, A; Guarnaschelli, C; Rovereto, B

2005-01-01

In men with prostatic obstruction and detrusor overactivity (DO), to ascertain whether urgency of micturition affects bladder contractility. We urodynamically assessed five groups of 20 men each who had bladder outflow obstruction (BOO) from benign prostatic enlargement-Groups 1 (with no DO and no urgency), 2 (with DO and no urgency), 3A (with DO and moderate urgency), 3B (with DO and severe urgency), and 4 (with DO, severe urgency and chronic ischemic cerebral lesions). Urgency was graded as moderate or severe by the ability to avert an urgent void at cystometry for > or =2 or <2 min, respectively. BOO was assessed by the "Abrams-Griffiths number" (AG) and bladder contractility by the parameters PIP and WF(max). AG did not differ significantly in Groups 2, 3A, and 3B, proved higher in such groups than in Group 1, and was nearly the same in Groups 1 and 4. PIP and WF(max) were significantly higher in Groups 2, 3A, and 3B than in Groups 1 and 4, had the highest levels in Group 3B, and did not differ significantly in Groups 1-4 and 2-3A. In DO patients with prostatic obstruction there seems to be a DO-related facilitation of bladder contractility. In the same patients, severe urgency of micturition might over-amplify (i.e., enhance a DO-related facilitation of) bladder contractility, provided there are no neurogenic (chronic ischemic cerebral) lesions.

Salvage with a Secondary Infrahepatic Cavocavostomy of the Occluded Modified Piggyback Anastomosis during Split Liver Transplantation: A Case Report.

PubMed

Kinaci, Erdem; Kayaalp, Cuneyt; Yilmaz, Sezai; Otan, Emrah

2014-01-01

Hepatic venous outflow obstruction following liver transplantation is rare but disastrous. Here we described a 14-year-old boy who underwent a split right lobe liver transplantation with modified (side-to-side) piggyback technique which resulted in hepatic venous outflow obstruction. When the liver graft was lifted up, the outflow drainage returned to normal but when it was placed back into the abdomen, the outflow obstruction recurred. Because reanastomosis would have resulted in hepatic reischemia, alternatively, a second infrahepatic cavocavostomy was planned without requiring hepatic reischemia. During this procedure, the first assistant hung the liver up to provide sufficient outflow and the portal inflow of the graft continued as well. We only clamped the recipient's infrahepatic vena cava and the caudal cuff of the graft cava. After the second end-to-side cavocaval anastomosis, the graft was placed in its orthotopic position and there was no outflow problem anymore. The patient tolerated the procedure well and there were no problems after three months of follow-up. A second cavocavostomy can provide an extra bypass for some hepatic venous outflow problems after piggyback anastomosis by avoiding hepatic reischemia.

Salvage with a Secondary Infrahepatic Cavocavostomy of the Occluded Modified Piggyback Anastomosis during Split Liver Transplantation: A Case Report

PubMed Central

Kinaci, Erdem; Kayaalp, Cuneyt; Yilmaz, Sezai; Otan, Emrah

2014-01-01

Hepatic venous outflow obstruction following liver transplantation is rare but disastrous. Here we described a 14-year-old boy who underwent a split right lobe liver transplantation with modified (side-to-side) piggyback technique which resulted in hepatic venous outflow obstruction. When the liver graft was lifted up, the outflow drainage returned to normal but when it was placed back into the abdomen, the outflow obstruction recurred. Because reanastomosis would have resulted in hepatic reischemia, alternatively, a second infrahepatic cavocavostomy was planned without requiring hepatic reischemia. During this procedure, the first assistant hung the liver up to provide sufficient outflow and the portal inflow of the graft continued as well. We only clamped the recipient's infrahepatic vena cava and the caudal cuff of the graft cava. After the second end-to-side cavocaval anastomosis, the graft was placed in its orthotopic position and there was no outflow problem anymore. The patient tolerated the procedure well and there were no problems after three months of follow-up. A second cavocavostomy can provide an extra bypass for some hepatic venous outflow problems after piggyback anastomosis by avoiding hepatic reischemia. PMID:24959369

Unveiling the molecular bipolar outflow of the peculiar red supergiant VY Canis Majoris

NASA Astrophysics Data System (ADS)

Shinnaga, Hiroko; Claussen, Mark J.; Lim, Jeremy; Dinh-van-Trung; Tsuboi, Masato

2003-04-01

We carried out polarimetric spectral-line imaging of the molecular outflow of the peculiar red supergiant VY Canis Majoris in SiO J=1-0 line in the ground vibrational state, which contains highly linearly-polarized velocity components, using the Very Large Array. We succeeded in unveiling the highly linearly polarized bipolar outflow for the first time at subarcsecond spatial resolution. The results clearly show that the direction of linear polarization of the brightest maser components is parallel to the outflow axis. The results strongly suggest that the linear polarization of the SiO maser is closely related to the outflow phenomena of the star. Furthermore, the results indicate that the linear polarization observed in the optical and infrared also occur due to the outflow phenomena.

Controlling Factors of the Fate of Ionospheric Outflow at Earth and Mars

NASA Astrophysics Data System (ADS)

Liemohn, M. W.; Welling, D. T.; Ilie, R.; Ganushkina, N. Y.; Johnson, B. C.; Xu, S.; Dong, C.

2015-12-01

Both Earth and Mars experience ionospheric outflow, but the radically different magnetic field configurations at the two planets yield significantly different patterns of outflow and processes governing outflow. This study examines a set of numerical simulations for Earth and Mars to explore the factors controlling ionospheric outflow and the fate of the escaping ions (immediate precipitation, magnetospheric recirculation, or loss to deep space). Specifically, simulation results from the Space Weather Modeling Framework (SWMF), which is capable of handling both planetary space environments, are analyzed to assess the physical processes governing the fate of ionospheric ions. Velocity streamlines from the SWMF results are traced from the high-latitude inner boundary of the BATS-R-US MHD simulation domain and followed through geospace. Some of these streamlines return to the inner boundary of the simulation domain, others extend to the outer boundary of the domain, while most others eventually cross (or at least approach) the magnetospheric equatorial plane. At Earth, this plane is well defined, while at Mars there are multiple mini-magnetospheres in which ionospheric ions can become trapped. These streamlines are categorized according to their eventual destination. Multi-fluid MHD simulations are examined in this study, assessing the influence of species mass on trajectories through near-planet space. Steady-state numerical experiments with different levels of solar driving are examined to quantify the influence of each driver on outflow characteristics and the fate of outflowing ions. Real event intervals are considered to assess flows in a time-varying magnetospheric system. For Earth, as solar wind dynamic pressure increases, the dominant outflow region moves to lower latitudes and significantly more of the outflowing ions escape to deep space. As the interplanetary magnetic field increases in southward magnitude, the region of dominant outflow shifts to lower

How stellar feedback simultaneously regulates star formation and drives outflows

NASA Astrophysics Data System (ADS)

Hayward, Christopher C.; Hopkins, Philip F.

2017-02-01

We present an analytic model for how momentum deposition from stellar feedback simultaneously regulates star formation and drives outflows in a turbulent interstellar medium (ISM). Because the ISM is turbulent, a given patch of ISM exhibits sub-patches with a range of surface densities. The high-density patches are 'pushed' by feedback, thereby driving turbulence and self-regulating local star formation. Sufficiently low-density patches, however, are accelerated to above the escape velocity before the region can self-adjust and are thus vented as outflows. When the gas fraction is ≳ 0.3, the ratio of the turbulent velocity dispersion to the circular velocity is sufficiently high that at any given time, of the order of half of the ISM has surface density less than the critical value and thus can be blown out on a dynamical time. The resulting outflows have a mass-loading factor (η ≡ dot{M}_{out}/M_{star }) that is inversely proportional to the gas fraction times the circular velocity. At low gas fractions, the star formation rate needed for local self-regulation, and corresponding turbulent Mach number, declines rapidly; the ISM is 'smoother', and it is actually more difficult to drive winds with large mass-loading factors. Crucially, our model predicts that stellar-feedback-driven outflows should be suppressed at z ≲ 1 in M⋆ ≳ 1010 M⊙ galaxies. This mechanism allows massive galaxies to exhibit violent outflows at high redshifts and then 'shut down' those outflows at late times, thereby enabling the formation of a smooth, extended thin stellar disc. We provide simple fitting functions for η that should be useful for sub-resolution and semi-analytic models.

Outflow and Infall in Star-forming Region L1221

NASA Astrophysics Data System (ADS)

Lee, Chin-Fei; Ho, Paul T. P.

2005-10-01

We have mapped the 3.3 mm continuum, CO, HCO+, N2H+, and CS emission around a nearby Class I source, IRAS 22266+6845, in the L1221 cometary dark cloud. L1221 is a complicated star-forming region. It hosts three infrared sources: a close binary consisting of an east source and a west source around the IRAS source position and a southeast source ~45" to the southeast (T. Bourke 2004, private communication). The east source is identified as the IRAS source. Continuum emission is seen around the east and southeast sources, probably tracing the dust around them. No continuum emission is seen toward the west source, probably indicating that there is not much dust there. An east-west molecular outflow is seen in CO, HCO+, and CS originated from around the binary. It is bipolar with an east lobe and a west lobe, both appearing as a wide-opening outflow shell originated from around the binary. It is likely powered by the east source, which shows a southeast extension along the outflow axis in the K' image. A ringlike envelope is seen in N2H+ around the binary surrounding the outflow waist. It is tilted with the major axis perpendicular to the outflow axis. The kinematics is well reproduced by a thin-disk model with both infall and rotation, and a column density peak in a ring. The ringlike envelope is not rotationally supported, as the rotation velocity is smaller than the infall velocity.

Far-ultraviolet Observations of Outflows from Infrared-luminous Galaxies

NASA Astrophysics Data System (ADS)

Leitherer, Claus; Chandar, Rupali; Tremonti, Christy A.; Wofford, Aida; Schaerer, Daniel

2013-08-01

We obtained medium-resolution ultraviolet (UV) spectra between 1150 and 1450 Å of the four UV-bright, infrared-luminous starburst galaxies IRAS F08339+6517, NGC 3256, NGC 6090, and NGC 7552 using the Cosmic Origins Spectrograph on board the Hubble Space Telescope. The selected sightlines toward the starburst nuclei probe the properties of the recently formed massive stars and the physical conditions in the starburst-driven galactic superwinds. Despite being metal-rich and dusty, all four galaxies are strong Lyα emitters with equivalent widths ranging between 2 and 13 Å. The UV spectra show strong P Cygni-type high-ionization features indicative of stellar winds and blueshifted low-ionization lines formed in the interstellar and circumgalactic medium. We detect outflowing gas with bulk velocities of ~400 km s-1 and maximum velocities of almost 900 km s-1. These are among the highest values found in the local universe and comparable to outflow velocities found in luminous Lyman-break galaxies at intermediate and high redshift. The outflow velocities are unlikely to be high enough to cause escape of material from the galactic gravitational potential. However, the winds are significant for the evolution of the galaxies by transporting heavy elements from the starburst nuclei and enriching the galaxy halos. The derived mass outflow rates of ~100 M ⊙ yr-1 are comparable to or even higher than the star formation rates. The outflows can quench star formation and ultimately regulate the starburst as has been suggested for high-redshift galaxies.

Solar forcing, and ionospheric ion outflow from Venus, Earth and Mars - A comparison

NASA Astrophysics Data System (ADS)

Lundin, R. N.

2012-12-01

Solar forcing by e.g. EUV radiation and the solar wind leads to outflow and escape of ionospheric ions from Earth, Venus and Mars. In-situ measurements in the Earth's space environment have demonstrated that the ion escape rate correlates with the magnitude of solar forcing, i.e. high solar EUV and solar wind forcing leads to enhanced escape rates. The Terrestrial outflow is dominated by H+ and O+ suggesting that the ultimate origin of outflowing ions is water. Recent measurements from the two arid planets Mars and Venus, their atmospheres dominated by CO2, display characteristics similar to that of the Earth - an outflow dominated by hydrogen (H+) and oxygen (O+, O2+) ions. Despite major differences in atmospheric composition, the composition of the ion outflow from Earth and Venus is very similar, i.e. H+ and O+ dominates and the outflow has a stoichiometric H/O ratio of close to 2. The latter implies escape of water. The ion outflow from Mars is dominated by O+, O2+, and H+. Here the stoichiometric ratio between hydrogen and oxygen ion is ≈1, implying that if the ion outflow originates from water, about half of the hydrogen mass disappears by other means. The primary origin of the ion outflow from Earth, Venus and Mars is a complex issue. Nevertheless, a predominant hydrogen and oxygen loss implies that water can easily escape planets orbiting close to the Sun, while Carbon-based molecules (e.g. CO2) resides more easily. Observations shows that the outflow of e.g. CO+ and CO2+ from Mars and Venus is minute compared to the outflow of hydrogen and oxygen ions. Magnetic shielding is an issue affecting the net ion outflow and escape from a planet, because acceleration processes are also the characteristics of magnetized plasmas. Recent findings suggests that, despite magnetic field pile-up at Mars and Venus, the stand-off distance is insufficient to prohibit a direct interaction between the solar wind and the magnetized ionospheric plasma in the induced

UNRAVELLING THE COMPLEX STRUCTURE OF AGN-DRIVEN OUTFLOWS. II. PHOTOIONIZATION AND ENERGETICS

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

Karouzos, Marios; Woo, Jong-Hak; Bae, Hyun-Jin, E-mail: woo@astro.snu.ac.kr

2016-12-20

Outflows have been shown to be prevalent in galaxies hosting luminous active galactic nuclei (AGNs); they present a physically plausible way to couple the AGN energy output with the interstellar medium of their hosts. Despite their prevalence, accurate characterization of these outflows has been challenging. In the second of a series of papers, we use Gemini Multi-Object Spectrograph integral field unit (IFU) data of six local ( z  < 0.1) and moderate-luminosity Type 2 AGNs to study the ionization properties and energetics of AGN-driven outflows. We find strong evidence connecting the extreme kinematics of the ionized gas to the AGN photoionization.more » The kinematic component related to the AGN-driven outflow is clearly separated from other kinematic components, such as virial motions or rotation, on the velocity and velocity dispersion diagram. Our spatially resolved kinematic analysis reveals that 30 to 90% of the total mass and kinetic energy of the outflow is contained within the central kpc of the galaxy. The spatially integrated mass and kinetic energy of the gas entrained in the outflow correlate well with the AGN bolometric luminosity and results in energy conversion efficiencies between 0.01% and 1%. Intriguingly, we detect ubiquitous signs of ongoing circumnuclear star formation. Their small size, the centrally contained mass and energy, and the universally detected circumnuclear star formation cast doubts on the potency of these AGN-driven outflows as agents of galaxy-scale negative feedback.« less

Characterizing Quasar Outflows III: SEDs, and Bolometric Luminosity Estimates

NASA Astrophysics Data System (ADS)

Richmond, Joseph; Robbins, J. M.; Ganguly, R.; Stark, M. A.; Christenson, D. H.; Derseweh, J. A.; Townsend, S. L.

2012-05-01

Galaxy evolution models have shown that quasars are a crucial ingredient in the evolution of massive galaxies. Outflows play a key role in the story of quasars and their host galaxies, by helping regulate the accretion process, the star-formation rate and mass of the host galaxy (i.e., feedback). The prescription for modeling outflows as a contributor to feedback requires knowledge of the outflow velocity, geometry, and column density. In particular, we need to understand how these depend on physical parameters and how much is determined stochastically (and with what distribution). For this purpose, we are examining a sample of 11000 z=1.7-2.0 quasars from the Sloan Digital Sky Survey. This redshift range permits the following from the SDSS spectra: (1) separation of objects that do and do not exhibit outflows; (2) classification/measurement of outflow properties (ionization, velocity, velocity width); and (3) measurements of UV emission line and continuum parameters. In this poster, we add photometry from both the Two Micron All-Sky Survey (2MASS) and from the Wide-Field Infrared Survey Explorer (WISE). 2MASS photometry covers the rest-frame optical regime of these qusars, while the WISE W1, W2, and W3 bands cover the rest-frame wavelength ranges 0.9-1.27 micron, 1.35-1.75 micron, and 2.52-5.51 micron, respectively. The preliminary release of WISE data cover 3800 of our quasars. In an accompnying poster, we have subjectively divided these quasars into four categories: broad absorption-line quasars (2700 objects), associated absorption-line quasars (1700 objects), reddened quasars (160 objects), and unabsorbed/unreddened quasars (6300 objects). Here, we present average SEDs for these subsamples, estimates of bolometric luminosity, and explore changes in SED based on both outflow properties and quasar physical properties. This material is based upon work supported by the National Aeronautics and Space Administration under Grant No. 09-ADP09-0016 issued through the

Investigations of protostellar outflow launching and gas entrainment: Hydrodynamic simulations and molecular emission

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

Offner, Stella S. R.; Arce, Héctor G., E-mail: stella.offner@yale.edu

2014-03-20

We investigate protostellar outflow evolution, gas entrainment, and star formation efficiency using radiation-hydrodynamic simulations of isolated, turbulent low-mass cores. We adopt an X-wind launching model, in which the outflow rate is coupled to the instantaneous protostellar accretion rate and evolution. We vary the outflow collimation angle from θ = 0.01-0.1 and find that even well-collimated outflows effectively sweep up and entrain significant core mass. The Stage 0 lifetime ranges from 0.14-0.19 Myr, which is similar to the observed Class 0 lifetime. The star formation efficiency of the cores spans 0.41-0.51. In all cases, the outflows drive strong turbulence in themore » surrounding material. Although the initial core turbulence is purely solenoidal by construction, the simulations converge to approximate equipartition between solenoidal and compressive motions due to a combination of outflow driving and collapse. When compared to simulation of a cluster of protostars, which is not gravitationally centrally condensed, we find that the outflows drive motions that are mainly solenoidal. The final turbulent velocity dispersion is about twice the initial value of the cores, indicating that an individual outflow is easily able to replenish turbulent motions on sub-parsec scales. We post-process the simulations to produce synthetic molecular line emission maps of {sup 12}CO, {sup 13}CO, and C{sup 18}O and evaluate how well these tracers reproduce the underlying mass and velocity structure.« less

Outflow channel sources, reactivation, and chaos formation, Xanthe Terra, Mars

USGS Publications Warehouse

Rodriguez, J.A.P.; Sasaki, S.; Kuzmin, R.O.; Dohm, J.M.; Tanaka, K.L.; Miyamoto, H.; Kurita, K.; Komatsu, G.; Fairen, A.G.; Ferris, J.C.

2005-01-01

The undulating, warped, and densely fractured surfaces of highland regions east of Valles Marineris (located north of the eastern Aureum Chaos, east of the Hydraotes Chaos, and south of the Hydaspis Chaos) resulted from extensional surface warping related to ground subsidence, caused when pressurized water confined in subterranean caverns was released to the surface. Water emanations formed crater lakes and resulted in channeling episodes involved in the excavation of Ares, Tiu, and Simud Valles of the eastern part of the circum-Chryse outflow channel system. Progressive surface subsidence and associated reduction of the subsurface cavernous volume, and/or episodes of magmatic-driven activity, led to increases of the hydrostatic pressure, resulting in reactivation of both catastrophic and non-catastrophic outflow activity. Ancient cratered highland and basin materials that underwent large-scale subsidence grade into densely fractured terrains. Collapse of rock materials in these regions resulted in the formation of chaotic terrains, which occur in and near the headwaters of the eastern circum-Chryse outflow channels. The deepest chaotic terrain in the Hydaspis Chaos region resulted from the collapse of pre-existing outflow channel floors. The release of volatiles and related collapse may have included water emanations not necessarily linked to catastrophic outflow. Basal warming related to dike intrusions, thermokarst activity involving wet sediments and/or dissected ice-enriched country rock, permafrost exposed to the atmosphere by extensional tectonism and channel incision, and/or the injection of water into porous floor material, may have enhanced outflow channel floor instability and subsequent collapse. In addition to the possible genetic linkage to outflow channel development dating back to at least the Late Noachian, clear disruption of impact craters with pristine ejecta blankets and rims, as well as preservation of fine tectonic fabrics, suggest that

Multi-phase outflows as probes of AGN accretion history

NASA Astrophysics Data System (ADS)

Nardini, Emanuele; Zubovas, Kastytis

2018-05-01

Powerful outflows with a broad range of properties (such as velocity, ionization, radial scale and mass loss rate) represent a key feature of active galactic nuclei (AGN), even more so since they have been simultaneously revealed also in individual objects. Here we revisit in a simple analytical framework the recent remarkable cases of two ultraluminous infrared quasars, IRAS F11119+3257 and Mrk 231, which allow us to investigate the physical connection between multi-phase AGN outflows across the ladder of distance from the central supermassive black hole (SMBH). We argue that any major deviations from the standard outflow propagation models might encode unique information on the past SMBH accretion history, and briefly discuss how this could help address some controversial aspects of the current picture of AGN feedback.

Prosthetic aortic valve endocarditis complicated with annular abscess, sub-aortic obstruction and valve dehiscence.

PubMed

Hassoulas, Joannis; Patrianakos, Alexandros P; Parthenakis, Fragiskos I; Vardas, Panos E

2009-01-01

We present a 76-year-old woman with infective endocarditis of a prosthetic aortic valve. The course of her illness started with an ischaemic stroke and she was admitted with prolonged fever and an episode of loss of consciousness. Echocardiography revealed acute aortic regurgitation and dehiscence of the prosthetic valve with excessive "rocking motion", aortic abscesses and left ventricular outflow obstruction caused by a semilunar shelf of tissue probably due to endocarditis vegetations. She underwent an urgent surgical procedure that confirmed the echocardiographic findings. Our case report reinforces the value of early diagnosis in the presence of a high clinical suspicion of prosthetic valve endocarditis. An extended workup, including transoesophageal echocardiography, in such a patient with a mechanical valve is mandatory.

Percutaneous transluminal alcohol septal myocardial ablation after aortic valve replacement

NASA Technical Reports Server (NTRS)

Sitges, M.; Kapadia, S.; Rubin, D. N.; Thomas, J. D.; Tuzcu, M. E.; Lever, H. M.

2001-01-01

When left ventricular outflow tract obstruction develops after aortic valve replacement, few treatment choices have been available until now. We present a patient with prior aortic valve replacement who developed left ventricle outflow tract obstruction that was successfully treated with a percutaneous transcoronary myocardial septal alcohol ablation. This technique is a useful tool for the treatment of obstructive hypertrophic cardiomyopathy, especially in those patients with prior heart surgery. Copyright 2001 Wiley-Liss, Inc.

Electron-positron outflow from black holes.

PubMed

van Putten, M H

2000-04-24

Cosmological gamma-ray bursts (GRBs) appear as the brightest transient phenomena in the Universe. The nature of their central engine is a missing link in the theory of fireballs to stellar mass progenitors, and may be associated with low mass black holes. In contact with an external magnetic field B, black hole spin produces a gravitational potential on the wave function of charged particles. We show that a rapidly rotating black hole of mass M produces outflow from initially electrostatic equilibrium with normalized isotropic emission approximately 10(48)(B/B(c))(2)(M/7M)(2)sin (2) theta erg/s, where B(c) = 4.4x10(13) G. The half-opening angle satisfies theta >or = square root[B(c)/3B]. The outflow proposed as input to GRB fireball models.

Transport Pathways for Asian Pollution Outflow Over the Pacific: Interannual and Seasonal Variations

NASA Technical Reports Server (NTRS)

Liu, Hong-Yu; Jacob, Daniel J.; Bey, Isabelle; Yantosca, Robert M.; Duncan, Bryan N.; Sachse, Glen W.

2003-01-01

The meteorological pathways contributing to Asian pollution outflow over the Pacific are examined with a global three-dimensional model analysis of CO observations from the Transport and Chemical Evolution over the Pacific (TRACE-P) aircraft mission (February-April 2001). The model is used also to place the TRACE-P observations in an interannual (1994-2001) and seasonal context. The major process driving Asian pollution outflow in spring is frontal lifting ahead of southeastward-moving cold fronts (the leading edge of cold surges) and transport in the boundary layer behind the cold fronts. Orographic lifting over central and eastern China combines with the cold fronts to promote the transport of Chinese pollution to the free troposphere. Outflow of seasonal biomass burning in Southeast Asia during spring takes place mostly by deep convection but also by northeastward transport and frontal lifting, mixing with the anthropogenic outflow. Boundary layer outflow over the western Pacific is largely devoid of biomass burning influence. European and African (biomass burning) plumes in Asian outflow during TRACE-P were weak (less than 60 ppbv and 20 ppbv CO, respectively) and were not detectable in the observations because of superposition of the much larger Asian pollution signal. Spring 2001 (La Nina) was characterized by unusually frequent cold surge events in the Asian Pacific rim and strong convection in Southeast Asia, leading to unusually strong boundary layer outflow of anthropogenic emissions and convective outflow of biomass burning emissions in the upper troposphere. The Asian outflow flux of CO to the Pacific is found to vary seasonally by a factor of 3-4 (maximum in March and minimum in summer). The March maximum results from frequent cold surge events and seasonal biomass burning emissions.

Transport pathways for Asian pollution outflow over the Pacific: Interannual and seasonal variations

NASA Astrophysics Data System (ADS)

Liu, Hongyu; Jacob, Daniel J.; Bey, Isabelle; Yantosca, Robert M.; Duncan, Bryan N.; Sachse, Glen W.

2003-10-01

The meteorological pathways contributing to Asian pollution outflow over the Pacific are examined with a global three-dimensional model analysis of CO observations from the Transport and Chemical Evolution over the Pacific (TRACE-P) aircraft mission (February-April 2001). The model is used also to place the TRACE-P observations in an interannual (1994-2001) and seasonal context. The major process driving Asian pollution outflow in spring is frontal lifting ahead of southeastward-moving cold fronts (the leading edge of cold surges) and transport in the boundary layer behind the cold fronts. Orographic lifting over central and eastern China combines with the cold fronts to promote the transport of Chinese pollution to the free troposphere. Outflow of seasonal biomass burning in Southeast Asia during spring takes place mostly by deep convection but also by northeastward transport and frontal lifting, mixing with the anthropogenic outflow. Boundary layer outflow over the western Pacific is largely devoid of biomass burning influence. European and African (biomass burning) plumes in Asian outflow during TRACE-P were weak (<60 ppbv and 20 ppbv CO, respectively) and were not detectable in the observations because of superposition of the much larger Asian pollution signal. Spring 2001 (La Niña) was characterized by unusually frequent cold surge events in the Asian Pacific rim and strong convection in Southeast Asia, leading to unusually strong boundary layer outflow of anthropogenic emissions and convective outflow of biomass burning emissions in the upper troposphere. The Asian outflow flux of CO to the Pacific is found to vary seasonally by a factor of 3-4 (maximum in March and minimum in summer). The March maximum results from frequent cold surge events and seasonal biomass burning emissions.

X-Ray Evidence for the Accretion Disc-Outflow Connection in 3C 111

NASA Technical Reports Server (NTRS)

Tombesi, Frank; Sambruna, R. M.; Reeves, J. N.; Reynolds, C. S.; Braito, V.

2011-01-01

We present the spectral analysis of three Suzaku X-ray Imaging Spectrometer observations of 3C III requested to monitor the predicted variability of its ultrafast outflow on approximately 7 d time-scales. We detect an ionized iron emission line in the first observation and a blueshifted absorption line in the second, when the flux is approximately 30 per cent higher. The location of the material is constrained at less than 0.006 pc from the variability. Detailed modelling supports an identification with ionized reflection off the accretion disc at approximately 20-100rg from the black hole and a highly ionized and massive ultrafast outflow with velocity approximately 0.1c, respectively. The outflow is most probably accelerated by radiation pressure, but additional magnetic thrust cannot be excluded. The measured high outflow rate and mechanical energy support the claims that disc outflows may have a significant feedback role. This work provides the first direct evidence for an accretion disc-outflow connection in a radio-loud active galactic nucleus, possibly linked also to the jet activity.

Endovascular treatment of post-thrombotic and non-thrombotic iliofemoral venous outflow obstructions with self-expanding nitinol stents.

PubMed

Stuck, Anna K; Reich, Thomas; Engelberger, Rolf P; Sebastian, Tim; Kucher, Nils

2018-06-01

The aim of the study was to investigate venous patency and clinical outcomes for endovascular treatment of iliofemoral venous obstruction in patients with post-thrombotic syndrome (PTS) and non-thrombotic iliac vein lesion (NIVL) with dedicated self-expanding nitinol stents. Data were collected from the prospective Swiss Venous Stent Registry, enrolling consecutive patients with a standardized follow-up procedure since January 2008. Patency was evaluated by duplex sonography and clinical outcome by various scores including the Villalta score at baseline, three, six, and 12 months, and then annually after endovascular therapy. Overall, 93 patients (64 PTS, 29 NIVL) were analysed. Mean follow-up time was 20 ± 16 (range 3-70) months. A total of 11 (12 %) patients had a stent occlusion, all of which occurred in the PTS group, and 13 (14 %) patients had a symptomatic stent stenosis. Primary patency was 79 % (95 % CI 68-87 %) at 12 months and 72 % (95 % CI 59-82 %) at 24 months. In PTS patients, primary patency at 12 months was 75 % (95 % CI 61-84 %) vs. 89 % (95 % CI 63-97 %) in NIVL patients (p = 0.10). Secondary patency at 24 months was 94 % (95 % CI 84-98 %) in PTS and 100 % in NIVL, p = 0.19). Overall, 62 (67 %) patients were free from PTS at the latest follow-up with a Villalta score < 5 points. Predictive factors for the loss of primary patency were stents placed below the inguinal ligament (OR 2.59, 95 % CI, 0.99-6.84, p = 0.05). In symptomatic patients with chronic iliofemoral vein obstruction, endovascular therapy with self-expanding nitinol stents was associated with favourable patency rates and clinical improvement in the majority of patients.

Netarsudil Increases Outflow Facility in Human Eyes Through Multiple Mechanisms

PubMed Central

Ren, Ruiyi; Li, Guorong; Le, Thuy Duong; Kopczynski, Casey; Stamer, W. Daniel; Gong, Haiyan

2016-01-01

Purpose Netarsudil is a Rho kinase/norepinephrine transporter inhibitor currently in phase 3 clinical development for glaucoma treatment. We investigated the effects of its active metabolite, netarsudil-M1, on outflow facility (C), outflow hydrodynamics, and morphology of the conventional outflow pathway in enucleated human eyes. Methods Paired human eyes (n = 5) were perfused with either 0.3 μM netarsudil-M1 or vehicle solution at constant pressure (15 mm Hg). After 3 hours, fluorescent microspheres were added to perfusion media to trace the outflow patterns before perfusion-fixation. The percentage effective filtration length (PEFL) was calculated from the measured lengths of tracer distribution in the trabecular meshwork (TM), episcleral veins (ESVs), and along the inner wall (IW) of Schlemm's canal after global and confocal imaging. Morphologic changes along the trabecular outflow pathway were investigated by confocal, light, and electron microscopy. Results Perfusion with netarsudil-M1 significantly increased C when compared to baseline (51%, P < 0.01) and to paired controls (102%, P < 0.01), as well as significantly increased PEFL in both IW (P < 0.05) and ESVs (P < 0.01). In treated eyes, PEFL was significantly higher in ESVs than in the IW (P < 0.01) and was associated with increased cross-sectional area of ESVs (P < 0.01). Percentage effective filtration length in ESVs positively correlated with the percentage change in C (R2 = 0.58, P = 0.01). A significant increase in juxtacanalicular connective tissue (JCT) thickness (P < 0.05) was found in treated eyes compared to controls. Conclusions Netarsudil acutely increased C by expansion of the JCT and dilating the ESVs, which led to redistribution of aqueous outflow through a larger area of the IW and ESVs. PMID:27842161

Dense Molecular Gas Tracers in the Outflow of the Starburst Galaxy NGC 253

NASA Astrophysics Data System (ADS)

Walter, Fabian; Bolatto, Alberto D.; Leroy, Adam K.; Veilleux, Sylvain; Warren, Steven R.; Hodge, Jacqueline; Levy, Rebecca C.; Meier, David S.; Ostriker, Eve C.; Ott, Jürgen; Rosolowsky, Erik; Scoville, Nick; Weiss, Axel; Zschaechner, Laura; Zwaan, Martin

2017-02-01

We present a detailed study of a molecular outflow feature in the nearby starburst galaxy NGC 253 using ALMA. We find that this feature is clearly associated with the edge of NGC 253's prominent ionized outflow, has a projected length of ˜300 pc, with a width of ˜50 pc, and a velocity dispersion of ˜40 km s-1, which is consistent with an ejection from the disk about 1 Myr ago. The kinematics of the molecular gas in this feature can be interpreted (albeit not uniquely) as accelerating at a rate of 1 km s-1 pc-1. In this scenario, the gas is approaching an escape velocity at the last measured point. Strikingly, bright tracers of dense molecular gas (HCN, CN, HCO+, CS) are also detected in the molecular outflow: we measure an HCN(1-0)/CO(1-0) line ratio of ˜ 1/10 in the outflow, similar to that in the central starburst region of NGC 253 and other starburst galaxies. By contrast, the HCN/CO line ratio in the NGC 253 disk is significantly lower (˜ 1/30), similar to other nearby galaxy disks. This strongly suggests that the streamer gas originates from the starburst, and that its physical state does not change significantly over timescales of ˜1 Myr during its entrainment in the outflow. Simple calculations indicate that radiation pressure is not the main mechanism for driving the outflow. The presence of such dense material in molecular outflows needs to be accounted for in simulations of galactic outflows.

The Soft X-ray View of Ultra Fast Outflows

NASA Astrophysics Data System (ADS)

Reeves, J.; Braito, V.; Nardini, E.; Matzeu, G.; Lobban, A.; Costa, M.; Pounds, K.; Tombesi, F.; Behar, E.

2017-10-01

The recent large XMM-Newton programmes on the nearby quasars PDS 456 and PG 1211+143 have revealed prototype ultra fast outflows in the iron K band through highly blue shifted absorption lines. The wind velocities are in excess of 0.1c and are likely to make a significant contribution to the host galaxy feedback. Here we present evidence for the signature of the fast wind in the soft X-ray band from these luminous quasars, focusing on the spectroscopy with the RGS. In PDS 456, the RGS spectra reveal the presence of soft X-ray broad absorption line profiles, which suggests that PDS 456 is an X-ray equivalent to the BAL quasars, with outflow velocities reaching 0.2c. In PG 1211, the soft X-ray RGS spectra show a complex of several highly blue shifted absorption lines over a wide range of ionisation and reveal outflowing components with velocities between 0.06-0.17c. For both quasars, the soft X-ray absorption is highly variable, even on timescales of days and is most prominent when the quasar flux is low. Overall the results imply the presence of a soft X-ray component of the ultra fast outflows, which we attribute to a clumpy or inhomogeneous phase of the disk wind.

Regulation of Breathing and Autonomic Outflows by Chemoreceptors

PubMed Central

Guyenet, Patrice G.

2016-01-01

Lung ventilation fluctuates widely with behavior but arterial PCO2 remains stable. Under normal conditions, the chemoreflexes contribute to PaCO2 stability by producing small corrective cardiorespiratory adjustments mediated by lower brainstem circuits. Carotid body (CB) information reaches the respiratory pattern generator (RPG) via nucleus solitarius (NTS) glutamatergic neurons which also target rostral ventrolateral medulla (RVLM) presympathetic neurons thereby raising sympathetic nerve activity (SNA). Chemoreceptors also regulate presympathetic neurons and cardiovagal preganglionic neurons indirectly via inputs from the RPG. Secondary effects of chemoreceptors on the autonomic outflows result from changes in lung stretch afferent and baroreceptor activity. Central respiratory chemosensitivity is caused by direct effects of acid on neurons and indirect effects of CO2 via astrocytes. Central respiratory chemoreceptors are not definitively identified but the retrotrapezoid nucleus (RTN) is a particularly strong candidate. The absence of RTN likely causes severe central apneas in congenital central hypoventilation syndrome. Like other stressors, intense chemosensory stimuli produce arousal and activate circuits that are wake- or attention-promoting. Such pathways (e.g., locus coeruleus, raphe, and orexin system) modulate the chemoreflexes in a state-dependent manner and their activation by strong chemosensory stimuli intensifies these reflexes. In essential hypertension, obstructive sleep apnea and congestive heart failure, chronically elevated CB afferent activity contributes to raising SNA but breathing is unchanged or becomes periodic (severe CHF). Extreme CNS hypoxia produces a stereotyped cardiorespiratory response (gasping, increased SNA). The effects of these various pathologies on brainstem cardiorespiratory networks are discussed, special consideration being given to the interactions between central and peripheral chemoreflexes. PMID:25428853

Interactions between gravity waves and cold air outflows in a stably stratified uniform flow

NASA Technical Reports Server (NTRS)

Lin, Yuh-Lang; Wang, Ting-An; Weglarz, Ronald P.

1993-01-01

Interactions between gravity waves and cold air outflows in a stably stratified uniform flow forced by various combinations of prescribed heat sinks and sources are studied using a hydrostatic two-dimensional nonlinear numerical model. The formation time for the development of a stagnation point or reversed flow at the surface is not always directly proportional to the Froude number when wave reflections exist from upper levels. A density current is able to form by the wave-otuflow interaction, even though the Froude number is greater than a critical value. This is the result of the wave-outflow interaction shifting the flow response to a different location in the characteristic parameter space. A density current is able to form or be destroyed due to the wave-outflow interaction between a traveling gravity wave and cold air outflow. This is proved by performing experiments with a steady-state heat sink and an additional transient heat source. In a quiescent fluid, a region of cold air, convergence, and upward motion is formed after the collision between two outflows produced by two prescribed heat sinks. After the collision, the individual cold air outflows lose their own identity and merge into a single, stationary, cold air outflow region. Gravity waves tend to suppress this new stationary cold air outflow after the collision. The region of upward motion associated with the collision is confined to a very shallow layer. In a moving airstream, a density current produced by a heat sink may be suppressed or enhanced nonlinearly by an adjacent heat sink due to the wave-outflow interaction.

The small observed scale of AGN-driven outflows, and inside-out disc quenching

NASA Astrophysics Data System (ADS)

Zubovas, Kastytis; King, Andrew

2016-11-01

Observations of massive outflows with detectable central active galactic nuclei (AGN) typically find them within radii ≲10 kpc. We show that this apparent size restriction is a natural result of AGN driving if this process injects total energy only of the order of the gas binding energy to the outflow, and the AGN varies over time (`flickers') as suggested in recent work. After the end of all AGN activity, the outflow continues to expand to larger radii, powered by the thermal expansion of the remnant-shocked AGN wind. We suggest that on average, outflows should be detected further from the nucleus in more massive galaxies. In massive gas-rich galaxies, these could be several tens of kpc in radius. We also consider the effect that pressure of such outflows has on a galaxy disc. In moderately gas-rich discs, with gas-to-baryon fraction <0.2, the outflow may induce star formation significant enough to be distinguished from quiescent by an apparently different normalization of the Kennicutt-Schmidt law. The star formation enhancement is probably stronger in the outskirts of galaxy discs, so coasting outflows might be detected by their effects upon the disc even after the driving AGN has shut off. We compare our results to the recent inference of inside-out quenching of star formation in galaxy discs.

Morphological and Hydrodynamic Correlations with Increasing Outflow Facility by Rho-Kinase Inhibitor Y-27632

PubMed Central

Yang, Chen-Yuan Charlie

2014-01-01

Abstract Rho-kinase inhibitors affect actomyosin cytoskeletal networks and have been shown to significantly increase outflow facility and lower intraocular pressure in various animal models and human eyes. This article summarizes common morphological changes in the trabecular meshwork induced by Rho-kinase inhibitors and specifically compares the morphological and hydrodynamic correlations with increased outflow facility by Rho-kinase inhibitor, Y-27632, in bovine, monkey, and human eyes under similar experimental conditions. Interspecies comparison has shown that morphological changes in the juxtacanalicular connective tissue (JCT) of these 3 species were different. However, these different morphological changes in the JCT, no matter if it's separation between the JCT and inner wall in bovine eyes, or separation between the JCT cells or between the JCT cells and their matrix in monkey eyes, or even no separation between the inner wall and the JCT but a more subtle expansion of the JCT in human eyes, appear to correlate with the increased percent change of outflow facility. More importantly, these different morphological changes all resulted in an increase in effective filtration area, which was positively correlated with increased outflow facility in all 3 species. These results suggest a link among changes in outflow facility, tissue architecture, and aqueous outflow pattern. Y-27632 increases outflow facility by redistributing aqueous outflow through a looser and larger area in the JCT. PMID:24460021

Ultra-fast outflows (aka UFOs) from AGNs and QSOs

NASA Astrophysics Data System (ADS)

Cappi, M.; Tombesi, F.; Giustini, M.

During the last decade, strong observational evidence has been accumulated for the existence of massive, high velocity winds/outflows (aka Ultra Fast Outflows, UFOs) in nearby AGNs and in more distant quasars. Here we briefly review some of the most recent developments in this field and discuss the relevance of UFOs for both understanding the physics of accretion disk winds in AGNs, and for quantifying the global amount of AGN feedback on the surrounding medium.

Optimizing gene transfer to conventional outflow cells in living mouse eyes

PubMed Central

Li, G; Gonzalez, P; Camras, LJ; Navarro, I; Qiu, J; Challa, P; Stamer, WD

2013-01-01

The mouse eye has physiological and genetic advantages to study conventional outflow function. However, its small size and shallow anterior chamber presents technical challenges to efficient intracameral delivery of genetic material to conventional outflow cells. The goal of this study was to optimize methods to overcome this technical hurdle, without damaging ocular structures or compromising outflow function. Gene targeting was monitored by immunofluorescence microscopy after transduction of adenovirus encoding green fluorescent protein driven by a CMV promoter. Guided by a micromanipulator and stereomicroscope, virus was delivered intracamerally to anesthetized mice by bolus injection using 33 gauge needle attached to Hamilton syringe or infusion with glass micropipette connected to syringe pump. The total number of particles introduced remained constant, while volume of injected virus solution (3–10 µl) was varied for each method and time of infusion (3–40 min) tested. Outflow facility and intraocular pressure were monitored invasively using established techniques. Unlike bolus injections or slow infusions, introduction of virus intracamerally during rapid infusions (3 min) at any volume tested preferentially targeted trabecular meshwork and Schlemm's canal cells, with minimal transduction of neighboring cells. While infusions resulted in transient intraocular pressure spikes (commensurate with volume infused, Δ40–70 mmHg), eyes typically recovered within 60 minutes. Transduced eyes displayed normal outflow facility and tissue morphology 3–6 days after infusions. Taken together, fast infusion of virus solution in small volumes intracamerally is a novel and effective method to selectively deliver agents to conventional outflow cells in living mice. PMID:23337742

Generation of shockwave and vortex structures at the outflow of a boiling water jet

NASA Astrophysics Data System (ADS)

Alekseev, M. V.; Lezhnin, S. I.; Pribaturin, N. A.; Sorokin, A. L.

2014-12-01

Results of numerical simulation for shock waves and generation of vortex structures during unsteady outflow of boiling liquid jet are presented. The features of evolution of shock waves and vortex structures formation during unsteady outflow of boiling water are compared with corresponding structures during unsteady gas outflow.

Fast Molecular Outflows in Luminous Galaxy Mergers: Evidence for Quasar Feedback from Herschel

NASA Astrophysics Data System (ADS)

Veilleux, S.; Meléndez, M.; Sturm, E.; Gracia-Carpio, J.; Fischer, J.; González-Alfonso, E.; Contursi, A.; Lutz, D.; Poglitsch, A.; Davies, R.; Genzel, R.; Tacconi, L.; de Jong, J. A.; Sternberg, A.; Netzer, H.; Hailey-Dunsheath, S.; Verma, A.; Rupke, D. S. N.; Maiolino, R.; Teng, S. H.; Polisensky, E.

2013-10-01

We report the results from a systematic search for molecular (OH 119 μm) outflows with Herschel/PACS in a sample of 43 nearby (z < 0.3) galaxy mergers, mostly ultraluminous infrared galaxies (ULIRGs) and QSOs. We find that the character of the OH feature (strength of the absorption relative to the emission) correlates with that of the 9.7 μm silicate feature, a measure of obscuration in ULIRGs. Unambiguous evidence for molecular outflows, based on the detection of OH absorption profiles with median velocities more blueshifted than -50 km s-1, is seen in 26 (70%) of the 37 OH-detected targets, suggesting a wide-angle (~145°) outflow geometry. Conversely, unambiguous evidence for molecular inflows, based on the detection of OH absorption profiles with median velocities more redshifted than +50 km s-1, is seen in only four objects, suggesting a planar or filamentary geometry for the inflowing gas. Terminal outflow velocities of ~-1000 km s-1 are measured in several objects, but median outflow velocities are typically ~-200 km s-1. While the outflow velocities show no statistically significant dependence on the star formation rate, they are distinctly more blueshifted among systems with large active galactic nucleus (AGN) fractions and luminosities [log (L AGN/L ⊙) >= 11.8 ± 0.3]. The quasars in these systems play a dominant role in driving the molecular outflows. However, the most AGN dominated systems, where OH is seen purely in emission, show relatively modest OH line widths, despite their large AGN luminosities, perhaps indicating that molecular outflows subside once the quasar has cleared a path through the obscuring material.

Fast Molecular Outflows in Luminous Galaxy Mergers: Evidence for Quasar Feedback from Herschel

NASA Technical Reports Server (NTRS)

Veilleux, S.; Melendez, M.; Sturm, E.; Garcia-Carpio, J.; Fischer, J.; Gonzalez-Alfonso, E.; Contursi, A.; Lutz, D.; Poglitsch, A.; Davies, R.;

Grain formation around carbon stars. 1: Stationary outflow models

NASA Technical Reports Server (NTRS)

Egan, Michael P.; Leung, Chun Ming

1995-01-01

Asymptotic giant branch (AGB) stars are known to be sites of dust formation and undergo significant mass loss. The outflow is believed to be driven by radiation pressure on grains and momentum coupling between the grains and gas. While the physics of shell dynamics and grain formation are closely coupled, most previous models of circumstellar shells have treated the problem separately. Studies of shell dynamics typically assume the existence of grains needed to drive the outflow, while most grain formation models assume a constant veolcity wind in which grains form. Furthermore, models of grain formation have relied primarily on classical nucleation theory instead of using a more realistic approach based on chemical kinetics. To model grain formation in carbon-rich AGB stars, we have coupled the kinetic equations governing small cluster growth to moment equations which determine the growth of large particles. Phenomenological models assuming stationary outflow are presented to demonstrate the differences between the classical nucleation approach and the kinetic equation method. It is found that classical nucleation theory predicts nucleation at a lower supersaturation ratio than is predicted by the kinetic equations, resulting in significant differences in grain properties. Coagulation of clusters larger than monomers is unimportant for grain formation in high mass-loss models but becomes more important to grain growth in low mass-loss situations. The properties of the dust grains are altered considerably if differential drift velocities are ignored in modeling grain formation. The effect of stellar temperature, stellar luminosity, and different outflow velocities are investigated. The models indicate that changing the stellar temperature while keeping the stellar luminosity constant has little effect on the physical parameters of the dust shell formed. Increasing the stellar luminosity while keeping the stellar temperature constant results in large differences in

Another piece of the puzzle: The fast H I outflow in Mrk 231

NASA Astrophysics Data System (ADS)

Morganti, Raffaella; Veilleux, Sylvain; Oosterloo, Tom; Teng, Stacy H.; Rupke, David

2016-09-01

We present the detection, performed with the Westerbork Synthesis Radio Telescope (WSRT) and the Karl Jansky Very Large Array (VLA), of a fast H I 21 cm outflow in the ultra-luminous infrared galaxy Mrk 231. The outflow is observed as shallow H I absorption blueshifted ~1300 km s-1 with respect to the systemic velocity and located against the inner kpc of the radio source. The outflowing gas has an estimated column density between 5 and 15 × 1018Tspin cm-2. We derive the Tspin to lie in the range 400-2000 K and the corresponding H I densities are nHI ~ 10-100 cm-3. Our results complement previous findings and confirm the multiphase nature of the outflow in Mrk 231. Although effects of the interaction between the radio plasma and the surrounding medium cannot be ruled out, the energetics and the lack of a clear kpc-scale jet suggest that the most likely origin of the H I outflow is a wide-angle nuclear wind, as earlier proposed to explain the neutral outflow traced by Na I and molecular gas in this source. Our results suggest that an H I component is present in fast outflows regardless of the acceleration mechanism (wind vs. jet driven) and that it must be connected with common properties of the pre-interaction gas involved. Considering the observed similarity of their column densities, the H I outflow likely represents the inner part of the broad wind identified on larger scales in atomic Na I. The mass outflow rate of the H I outflow (between 8 and 18 M⊙ yr-1) does not appear to be as large as that observed in molecular gas, partly owing to the smaller sizes of the outflowing region sampled by the H I absorption. These characteristics are commonly seen in other cases of outflows driven by the active galactic nucleus (AGN) suggesting that the H I may represent a short intermediate phase in the rapid cooling of the gas. The results further confirm H I as a good tracer for AGN-driven outflows not only in powerful radio sources. We also obtained deeper continuum

Obstructed labour.

PubMed

Neilson, J P; Lavender, T; Quenby, S; Wray, S

2003-01-01

Obstructed labour is an important cause of maternal deaths in communities in which undernutrition in childhood is common resulting in small pelves in women, and in which there is no easy access to functioning health facilities with the capability of carrying out operative deliveries. Obstructed labour also causes significant maternal morbidity in the short term (notably infection) and long term (notably obstetric fistulas). Fetal death from asphyxia is also common. There are differences in the behaviour of the uterus during obstructed labour, depending on whether the woman has delivered previously. The pattern in primigravid women (typically diminishing contractility with risk of infection and fistula) may result from tissue acidosis, whereas in parous women, contractility may be maintained with the risk of uterine rupture. Ultimately, tackling the problem of obstructed labour will require universal adequate nutritional intake from childhood and the ability to access adequately equipped and staffed clinical facilities when problems arise in labour. These seem still rather distant aspirations. In the meantime, strategies should be implemented to encourage early recognition of prolonged labour and appropriate clinical responses. The sequelae of obstructed labour can be an enormous source of human misery and the prevention of obstetric fistulas, and skilled treatment if they do occur, are important priorities in regions where obstructed labour is still common.

Effects of Energetic Ion Outflow on Magnetospheric Dynamics

NASA Astrophysics Data System (ADS)

Kistler, L. M.; Mouikis, C.; Lund, E. J.; Menz, A.; Nowrouzi, N.

2016-12-01

There are two dominant regions of energetic ion outflow: the nightside auroral region and the dayside cusp. Processes in these regions can accelerate ions up to keV energies. Outflow from the nightside has direct access to the plasma sheet, while outflow from the cusp is convected over the polar cap and into the lobes. The cusp population can enter the plasma sheet from the lobe, with higher energy ions entering further down the tail than lower energy ions. During storm times, the O+ enhanced plasma sheet population is convected into the inner magnetosphere. The plasma that does not get trapped in the inner magnetosphere convects to the magnetopause where reconnection is taking place. An enhanced O+ population can change the plasma mass density, which may have the effect of decreasing the reconnection rate. In addition O+ has a larger gyroradius than H+ at the same velocity or energy. Because of this, there are larger regions where the O+ is demagnetized, which can lead to larger acceleration because the O+ can move farther in the direction of the electric field. In this talk we will review results from Cluster, Van Allen Probes, and MMS, on how outflow from the two locations affects magnetospheric dynamics. We will discuss whether enhanced O+ from either population has an effect on the reconnection rate in the tail or at the magnetopause. We will discuss how the two populations impact the inner magnetosphere during storm times. And finally, we will discuss whether either population plays a role in triggering substorms, particularly during sawtooth events.

Measuring the Outflow Properties of FeLoBAL Quasars

NASA Astrophysics Data System (ADS)

Dabbieri, Collin; Choi, Hyunseop; MacInnis, Francis; Leighly, Karen; Terndrup, Donald

2018-01-01

Roughly 20 percent of the quasar population shows broad absorption lines, which are indicators of an energetic wind. Within the broad absorption line class of quasars exist FeLoBAL quasars, which show strong absorption lines from the Fe II and Fe III transitions as well as other low-ionization lines. FeLoBALs are of particular interest because they are thought to possibly be a short-lived stage in a quasar's life where it expels its shroud of gas and dust. This means the winds we see from FeLoBALs are one manifestation of galactic feedback. This idea is supported by Farrah et al. (2012) who found an anti correlation between outflow strength and contribution from star formation to the total IR luminosity of the host galaxy when examining a sample of FeLoBAL quasars. We analyze the sample of 26 FeLoBALs from Farrah et al. (2012) in order to measure the properties of their outflows, including ionization, density, column density and covering fraction. The absorption and continuum profiles of these objects are modeled using SimBAL, a program which creates synthetic spectra using a grid of Cloudy models. A Monte-Carlo method is employed to determine posterior probabilities for the physical parameters of the outflow. From these probabilities we extract the distance of the outflow, the mass outflow rate and the kinetic luminosity. We demonstrate SimBAL is capable of modeling a wide range of spectral morphologies. From the 26 objects studied we observe interesting correlations between ionization parameter, distance and density. Analysis of our sample also suggests a dearth of objects with velocity widths greater than or equal to 300 km/s at distances greater than or equal to 100 parsecs.

Can Radio Emission From Luminous Obscured AGN Blow Kpc-scale Ionized Outflows?

NASA Astrophysics Data System (ADS)

Goulding, Andy

2017-09-01

We propose joint VLA radio and Chandra X-ray to observe 4 AGN selected from the SDSS-BOSS and the Hyper Suprime-Cam surveys that present spectacular extended outflowing [O III] regions, reaching up to 50kpc in diameter. Our proposed observations allow us to study the mechanical and kinematical output of the AGN through radio and X-ray observations, measure the fraction of the AGN bolometric luminosity that is transferred to the outflow, and to determine the morphology and spectral index (by producing high-res continuum maps) of the radio emission that may be co-spatial with the extended ionized AGN outflow. In turn, our study will determine what role the AGN plays in producing extended outflows, and hence, provide an in-depth understanding of the physical drivers of AGN feedback.

Evaluation of Accessory Lacrimal Gland in Muller's Muscle Conjunctival Resection Specimens for Precursor Cell Markers and Biological Markers of Dry Eye Disease.

PubMed

Ali, Marwan; Shah, Dhara; Pasha, Zeeshan; Jassim, Sarmad H; Jassim Jaboori, Assraa; Setabutr, Pete; Aakalu, Vinay K

2017-04-01

The accessory lacrimal glands (ALGs) are an understudied component of the tear functional unit, even though they are important in the development of dry eye syndrome (DES). To advance our understanding of aging changes, regenerative potential, and histologic correlates to human characteristics, we investigated human ALG tissue from surgical samples to determine the presence or absence of progenitor cell markers and lacrimal epithelial markers and to correlate marker expression to relevant patient characteristics. ALG tissues obtained from Muller's muscle conjunctival resection (MMCR) specimens were created using tissue microarrays (TMAs). Immunofluorescence staining of MMCR sections was performed using primary antibodies specific to cell protein markers. Cell marker localization in TMAs was then assessed by two blinded observers using a standardized scoring system. Patient characteristics including age, race, and status of ocular surface health were then compared against expression of stem cell markers. Human ALG expressed a number of epithelial markers, and in particular, histatin-1 was well correlated with the expression of epithelial markers and was present in most acini. In addition, we noted the presence of precursor cell markers nestin, ABCG2, and CD90 in ALG tissue. There was a decrease in precursor cell marker expression with increasing age. Finally, we noted that a negative association was present between histatin-1 expression and DES. Thus, we report for the first time that human ALG tissues contain precursor marker-positive cells and that this marker expression may decrease with increasing age. Moreover, histatin-1 expression may be decreased in DES. Future studies will be performed to use these cell markers to isolate and culture lacrimal epithelial cells from heterogeneous tissues, determine the relevance of histatin-1 expression to DES, and isolate candidate precursor cells from ALG tissue.

Evidence that 50% of BALQSO Outflows Are Situated at Least 100 pc from the Central Source

NASA Astrophysics Data System (ADS)

Arav, Nahum; Liu, Guilin; Xu, Xinfeng; Stidham, James; Benn, Chris; Chamberlain, Carter

2018-04-01

The most robust way for determining the distance of quasar absorption outflows is the use of troughs from ionic excited states. The column density ratio between the excited and resonance states yields the outflow number density. Combined with a knowledge of the outflow’s ionization parameter, a distance from the central source (R) can be determined. Here we report results from two surveys targeting outflows that show troughs from S IV. One survey includes 1091 SDSS and BOSS quasar spectra, and the other includes higher-quality spectra of 13 quasars observed with the Very Large Telescope. Our S IV samples include 38 broad absorption line (BAL) outflows and four mini-BAL outflows. The S IV is formed in the same physical region of the outflow as the canonical outflow-identifying species C IV. Our results show that S IV absorption is only detected in 25% of C IV BAL outflows. The smaller detection fraction is due to the higher total column density (N H) needed to detect S IV absorption. Since R empirically anticorrelates with N H, the results of these surveys can be extrapolated to C IV quasar outflows with lower N H as well. We find that at least 50% of quasar outflows are at distances larger than 100 pc from the central source, and at least 12% are at distances larger than 1000 pc. These results have profound implications for the study of the origin and acceleration mechanism of quasar outflows and their effects on the host galaxy.

X-ray Evidence for Ultra-Fast Outflows in Local AGNs

NASA Astrophysics Data System (ADS)

Tombesi, F.; Cappi, M.; Sambruna, R. M.; Reeves, J. N.; Reynolds, C. S.; Braito, V.; Dadina, M.

2012-08-01

X-ray evidence for ultra-fast outflows (UFOs) has been recently reported in a number of local AGNs through the detection of blue-shifted Fe XXV/XXVI absorption lines. We present the results of a comprehensive spectral analysis of a large sample of 42 local Seyferts and 5 Broad-Line Radio Galaxies (BLRGs) observed with XMM-Newton and Suzaku. We detect UFOs in ga 40% of the sources. Their outflow velocities are in the range ˜ 0.03-0.3c, with a mean value of ˜ 0.14c. The ionization is high, in the range logℰ ˜3-6rm erg s-1 cm, and also the associated column densities are large, in the interval ˜ 1022-1024rm cm-2. Overall, these results point to the presence of highly ionized and massive outflowing material in the innermost regions of AGNs. Their variability and location on sub-pc scales favor a direct association with accretion disk winds/outflows. This also suggests that UFOs may potentially play a significant role in the AGN cosmological feedback besides jets, and their study can provide important clues on the connection between accretion disks, winds, and jets.

The two-way relationship between ionospheric outflow and the ring current

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

Welling, Daniel T.; Jordanova, Vania Koleva; Glocer, Alex

It is now well established that the ionosphere, because it acts as a significant source of plasma, plays a critical role in ring current dynamics. However, because the ring current deposits energy into the ionosphere, the inverse may also be true: the ring current can play a critical role in the dynamics of ionospheric outflow. This study uses a set of coupled, first-principles-based numerical models to test the dependence of ionospheric outflow on ring current-driven region 2 field-aligned currents (FACs). A moderate magnetospheric storm event is modeled with the Space Weather Modeling Framework using a global MHD code (Block Adaptivemore » Tree Solar wind Roe-type Upwind Scheme, BATS-R-US), a polar wind model (Polar Wind Outflow Model), and a bounce-averaged kinetic ring current model (ring current atmosphere interaction model with self-consistent magnetic field, RAM-SCB). Initially, each code is two-way coupled to all others except for RAM-SCB, which receives inputs from the other models but is not allowed to feed back pressure into the MHD model. The simulation is repeated with pressure coupling activated, which drives strong pressure gradients and region 2 FACs in BATS-R-US. It is found that the region 2 FACs increase heavy ion outflow by up to 6 times over the non-coupled results. The additional outflow further energizes the ring current, establishing an ionosphere-magnetosphere mass feedback loop. This study further demonstrates that ionospheric outflow is not merely a plasma source for the magnetosphere but an integral part in the nonlinear ionosphere-magnetosphere-ring current system.« less

The two-way relationship between ionospheric outflow and the ring current

DOE PAGES

Welling, Daniel T.; Jordanova, Vania Koleva; Glocer, Alex; ...

2015-06-01

It is now well established that the ionosphere, because it acts as a significant source of plasma, plays a critical role in ring current dynamics. However, because the ring current deposits energy into the ionosphere, the inverse may also be true: the ring current can play a critical role in the dynamics of ionospheric outflow. This study uses a set of coupled, first-principles-based numerical models to test the dependence of ionospheric outflow on ring current-driven region 2 field-aligned currents (FACs). A moderate magnetospheric storm event is modeled with the Space Weather Modeling Framework using a global MHD code (Block Adaptivemore » Tree Solar wind Roe-type Upwind Scheme, BATS-R-US), a polar wind model (Polar Wind Outflow Model), and a bounce-averaged kinetic ring current model (ring current atmosphere interaction model with self-consistent magnetic field, RAM-SCB). Initially, each code is two-way coupled to all others except for RAM-SCB, which receives inputs from the other models but is not allowed to feed back pressure into the MHD model. The simulation is repeated with pressure coupling activated, which drives strong pressure gradients and region 2 FACs in BATS-R-US. It is found that the region 2 FACs increase heavy ion outflow by up to 6 times over the non-coupled results. The additional outflow further energizes the ring current, establishing an ionosphere-magnetosphere mass feedback loop. This study further demonstrates that ionospheric outflow is not merely a plasma source for the magnetosphere but an integral part in the nonlinear ionosphere-magnetosphere-ring current system.« less

Did the martian outflow channels mostly form during the Amazonian Period?

NASA Astrophysics Data System (ADS)

Rodriguez, J. Alexis P.; Platz, Thomas; Gulick, Virginia; Baker, Victor R.; Fairén, Alberto G.; Kargel, Jeffrey; Yan, Jianguo; Miyamoto, Hideaki; Glines, Natalie

2015-09-01

Simud, Tiu, and Ares Valles comprise some of the largest outflow channels on Mars. Their excavation has been attributed variously to (or a combination of) erosion by catastrophic floods, glaciers, and debris flows. Numerous investigations indicate that they formed largely during the Late Hesperian (3.61-3.37 Ga). However, these studies mostly equate the ages of the outflow channel floors to those of the flows that generated mesoscale (several hundred meters to a few kilometers) bedforms within them. To improve the statistical accuracy in the age determinations of these flow events, we have used recently acquired high-resolution image and topographic data to map and date portions of Simud, Tiu and Ares Valles, which are extensively marked by these bedforms. Our results, which remove the statistical effects of older and younger outflow channel floor surfaces on the generation of modeled ages, reveal evidence for major outflow channel discharges occurring during the Early (3.37-1.23 Ga) and Middle (1.23-0.328 Ga) Amazonian, with activity significantly peaking during the Middle Amazonian stages. We also find that during the documented stages of Middle Amazonian discharges, the floor of Tiu Valles underwent widespread collapse, resulting in chaotic terrain formation. In addition, we present evidence showing that following the outflow channel discharges, collapse within northern Simud Valles generated another chaotic terrain. This younger chaos region likely represents the latest stage of large-scale outflow channel resurfacing within the study area. Our findings imply that in southern circum-Chryse the martian hydrosphere experienced large-scale drainage during the Amazonian, which likely led to periodic inundation and sedimentation within the northern plains.

Analysis of obstruction site in obstructive sleep apnea syndrome patients by drug induced sleep endoscopy.

PubMed

Koo, Soo Kweon; Choi, Jang Won; Myung, Nam Suk; Lee, Hyoung Ju; Kim, Yang Jae; Kim, Young Joong

2013-01-01

We analyzed site, pattern and degree of obstruction in Korean male obstructive sleep apnea syndrome (OSAS) patients by drug-induced sleep endoscopy (DISE). We also investigated possible links between BMI, AHI and DISE findings. Sixty-nine male patients underwent DISE. DISE findings were reported using our classification system in which modified 'VOTE classification' - obstruction type, site of obstruction, degree of obstruction and anatomical site contributing obstruction - was reported. Associations were analyzed among the results of the polysomnography, patients' characteristics and DISE finding. Multilevel airway obstruction was found in 84.06% of patients and 15.94% had a unilevel obstruction. Among those with unilevel obstruction, 90.90% had retropalatal level obstruction and 9.10% had retrolingual level obstruction. Palate with lateral pharyngeal wall obstruction (49.28%) is the most common obstruction type of the retropalatal level and tongue with lateral pharyngeal wall (37.68%) is the most common obstruction type of the retrolingual level. Examining the relation between obstruction site according to body mass index (BMI) and severity of OSAS (apnea hypopnea index, AHI), the lateral pharyngeal wall had an increasing tendency associated with higher BMI and higher AHI. But the lateral pharyngeal wall of both levels was statistically significant associated with higher AHI. The majority of the Korean male OSAS patients have multilevel obstruction and according to BMI and AHI, the DISE findings indicate that the lateral pharyngeal wall is the most important anatomical site contributing to obstruction regardless of the level at which the obstruction lies. © 2013 Elsevier Inc. All rights reserved.

Epithelial Markers aSMA, Krt14, and Krt19 Unveil Elements of Murine Lacrimal Gland Morphogenesis and Maturation.

PubMed

Kuony, Alison; Michon, Frederic

2017-01-01

As an element of the lacrimal apparatus, the lacrimal gland (LG) produces the aqueous part of the tear film, which protects the eye surface. Therefore, a defective LG can lead to serious eyesight impairment. Up to now, little is known about LG morphogenesis and subsequent maturation. In this study, we delineated elements of the cellular and molecular events involved in LG formation by using three epithelial markers, namely aSMA, Krt14, and Krt19. While aSMA marked a restricted epithelial population of the terminal end buds (TEBs) in the forming LG, Krt14 was found in the whole embryonic LG epithelial basal cell layer. Interestingly, Krt19 specifically labeled the presumptive ductal domain and subsequently, the luminal cell layer. By combining these markers, the Fucci reporter mouse strain and genetic fate mapping of the Krt14 + population, we demonstrated that LG epithelium expansion is fuelled by a patterned cell proliferation, and to a lesser extent by epithelial reorganization and possible mesenchymal-to-epithelial transition. We pointed out that this epithelial reorganization, which is associated with apoptosis, regulated the lumen formation. Finally, we showed that the inhibition of Notch signaling prevented the ductal identity from setting, and led to a LG covered by ectopic TEBs. Taken together our results bring a deeper understanding on LG morphogenesis, epithelial domain identity, and organ expansion.

Epithelial Markers aSMA, Krt14, and Krt19 Unveil Elements of Murine Lacrimal Gland Morphogenesis and Maturation

PubMed Central

Kuony, Alison; Michon, Frederic

2017-01-01

As an element of the lacrimal apparatus, the lacrimal gland (LG) produces the aqueous part of the tear film, which protects the eye surface. Therefore, a defective LG can lead to serious eyesight impairment. Up to now, little is known about LG morphogenesis and subsequent maturation. In this study, we delineated elements of the cellular and molecular events involved in LG formation by using three epithelial markers, namely aSMA, Krt14, and Krt19. While aSMA marked a restricted epithelial population of the terminal end buds (TEBs) in the forming LG, Krt14 was found in the whole embryonic LG epithelial basal cell layer. Interestingly, Krt19 specifically labeled the presumptive ductal domain and subsequently, the luminal cell layer. By combining these markers, the Fucci reporter mouse strain and genetic fate mapping of the Krt14+ population, we demonstrated that LG epithelium expansion is fuelled by a patterned cell proliferation, and to a lesser extent by epithelial reorganization and possible mesenchymal-to-epithelial transition. We pointed out that this epithelial reorganization, which is associated with apoptosis, regulated the lumen formation. Finally, we showed that the inhibition of Notch signaling prevented the ductal identity from setting, and led to a LG covered by ectopic TEBs. Taken together our results bring a deeper understanding on LG morphogenesis, epithelial domain identity, and organ expansion. PMID:29033846

Incision of the Jezero Crater Outflow Channel by Fluvial Sediment Transport

NASA Astrophysics Data System (ADS)

Holo, S.; Kite, E. S.

2017-12-01

Jezero crater, the top candidate landing site for the Mars 2020 rover, once possessed a lake that over-spilled and eroded a large outflow channel into the Eastern rim. The Western deltaic sediments that would be the primary science target of the rover record a history of lake level, which is modulated by the inflow and outflow channels. While formative discharges for the Western delta exist ( 500 m3/s), little work has been done to see if these flows are the same responsible for outflow channel incision. Other models of the Jezero outflow channel incision assume that a single rapid flood (incision timescales of weeks), with unknown initial hydraulic head and no discharge into the lake (e.g. from the inflow channels or the subsurface), incised an open channel with discharge modulated by flow over a weir. We present an alternate model where, due to an instability at the threshold of sediment motion, the incision of the outflow channel occurs in concert with lake filling. In particular, we assume a simplified lake-channel-valley system geometry and that the channel is hydraulically connected to the filling/draining crater lake. Bed load sediment transport and water discharge through the channel are quantified using the Meyer-Peter and Mueller relation and Manning's law respectively. Mass is conserved for both water and sediment as the lake level rises/falls and the channel incises. This model does not resolve backwater effects or concavity in the alluvial system, but it does capture the non-linear feedbacks between lake draining, erosion rate, channel flow rate, and slope relaxation. We identify controls on incision of the outflow channel and estimate the time scale of outflow channel formation through a simple dynamical model. We find that the observed 300m of channel erosion can be reproduced in decades to centuries of progressive bed load as the delta forming flows fill the lake. This corresponds to time scales on the order of or smaller than the time scale

Vector flow mapping in obstructive hypertrophic cardiomyopathy to assess the relationship of early systolic left ventricular flow and the mitral valve.

PubMed

Ro, Richard; Halpern, Dan; Sahn, David J; Homel, Peter; Arabadjian, Milla; Lopresto, Charles; Sherrid, Mark V

2014-11-11

The hydrodynamic cause of systolic anterior motion of the mitral valve (SAM) is unresolved. This study hypothesized that echocardiographic vector flow mapping, a new echocardiographic technique, would provide insights into the cause of early SAM in obstructive hypertrophic cardiomyopathy (HCM). We analyzed the spatial relationship of left ventricular (LV) flow and the mitral valve leaflets (MVL) on 3-chamber vector flow mapping frames, and performed mitral valve measurements on 2-dimensional frames in patients with obstructive and nonobstructive HCM and in normal patients. We compared 82 patients (22 obstructive HCM, 23 nonobstructive HCM, and 37 normal) by measuring 164 LV pre- and post-SAM velocity vector flow maps, 82 maximum isovolumic vortices, and 328 2-dimensional frames. We observed color flow and velocity vector flow posterior to the MVL impacting them in the early systolic frames of 95% of obstructive HCM, 22% of nonobstructive HCM, and 11% of normal patients (p < 0.001). In both pre- and post-SAM frames, we measured a high angle of attack >60° of local vector flow onto the posterior surface of the leaflets whether the flow was ejection (59%) or the early systolic isovolumic vortex (41%). Ricochet of vector flow, rebounding off the leaflet into the cul-de-sac, was noted in 82% of the obstructed HCM, 9% of nonobstructive HCM, and none (0%) of the control patients (p < 0.001). Flow velocities in the LV outflow tract on the pre-SAM frame 1 and 2 mm from the tip of the anterior leaflet were low: 39 and 43 cm/s, respectively. Early systolic flow impacts the posterior surfaces of protruding MVL initiating SAM in obstructive HCM. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Triamcinolone Acetonide Decreases Outflow Facility in C57BL/6 Mouse Eyes

PubMed Central

Kumar, Sandeep; Shah, Shaily; Deutsch, Emily Rose; Tang, Hai Michael; Danias, John

2013-01-01

Purpose. To determine the effect of triamcinolone acetonide (TA) on outflow facility in mice. Methods. Animals received 20 μL of TA (40 mg/mL) suspension subconjunctivally either bilaterally or unilaterally and were euthanized after either 1 week or 3 weeks. Before mice were killed, IOP was measured with a rebound tonometer. Outflow facility was determined using simultaneous pressure and flow measurements. Another set of animals received bilateral injection of anecortave acetate (AA) with or without bilateral TA injection and their outflow facility was also determined. Myocilin expression was investigated in a subset of eyes using quantitative PCR (qPCR). Results. Outflow facility of eyes in animals receiving bilateral TA injection (TABL) and TA-treated eyes of animals receiving unilateral injection (TAUL) was significantly decreased compared to naïve control eyes (Cnaive) after 1 week and 3 weeks of TA treatment (ANOVA P < 0.01, P < 0.001, respectively). Eyes treated with AA (with or without TA) had higher outflow facility than animals treated with TA (P < 0.05). IOP data did not show any significant difference between groups. qPCR analysis revealed significant decrease in myocilin expression in eyes receiving AA compared to naïve control and TA-treated eyes (ANOVA P < 0.001). Conclusions. Steroid treatment significantly decreases outflow facility in C57BL/6 mice despite having small effect on IOP. This animal model can be useful for studying the pathogenesis of steroid-induced glaucoma. PMID:23322580

The HST-pNFL program: Mapping the Fluorescent Emission of Galactic Outflows

NASA Astrophysics Data System (ADS)

Heckman, Timothy

2017-08-01

Galactic outflows associated with star formation are believed to play a crucial role in the evolution of galaxies and the IGM. Most of our knowledge about outflows has come from down-the-barrel UV absorption spectroscopy of star-forming galaxies. However, absorption-line data alone provide only indirect information about the radial structure of the gas flows, which introduces large systematic uncertainties in some of the most important quantities, such as the outflow rate, the mass loading factor, and the momentum, metal, and energy fluxes. Recent spectroscopic observations of star-forming galaxies with large (projected physical) apertures have revealed non-resonant (fluorescent) emission in the UV, e.g., FeII* and SiII*, that can be naturally produced by spatially extended emission from the same outflowing material traced in absorption. Encouraged by the most recent observations of FeII* emission by the SDSS-IV/eBOSS survey (Zhu et al. 2015), we propose a pilot program to use narrow-band filter UVIS F280N images to map the extended FeII* 2626 and 2613 fluorescent emission in a carefully-chosen sample of 4 starburst galaxies at z=0.065, and COS G130M to obtain down-the- barrel spectra for SiII absorption and SiII* emission. This HST pilot program can provide unique information about the spatial structure of galactic outflows and can potentially lead to a revolution in our understanding of outflow physics and its impact on galaxies and the IGM.

Properties of the molecular gas in the fast outflow in the Seyfert galaxy IC 5063

NASA Astrophysics Data System (ADS)

Oosterloo, Tom; Raymond Oonk, J. B.; Morganti, Raffaella; Combes, Françoise; Dasyra, Kalliopi; Salomé, Philippe; Vlahakis, Nektarios; Tadhunter, Clive

2017-12-01

We present a detailed study of the properties of the molecular gas in the fast outflow driven by the active galactic nucleus (AGN) in the nearby radio-loud Seyfert galaxy IC 5063. By using ALMA observations of a number of tracers of the molecular gas (12CO(1-0), 12CO(2-1), 12CO(3-2), 13CO(2-1) and HCO+(4-3)), we map the differences in excitation, density and temperature of the gas as function of position and kinematics. The results show that in the immediate vicinity of the radio jet, a fast outflow, with velocities up to 800 km s-1, is occurring of which the gas has high excitation with excitation temperatures in the range 30-55 K, demonstrating the direct impact of the jet on the ISM. The relative brightness of the 12CO lines, as well as that of 13CO(2-1) vs. 12CO(2-1), show that the outflow is optically thin. We estimate the mass of the molecular outflow to be at least 1.2 × 106 M⊙ and likely to be a factor between two and three larger than this value. This is similar to that of the outflow of atomic gas, but much larger than that of the ionised outflow, showing that the outflow in IC 5063 is dominated by cold gas. The total mass outflow rate we estimated to be 12 M⊙ yr-1. The mass of the outflow is much smaller than the total gas mass of the ISM of IC 5063. Therefore, although the influence of the AGN and its radio jet is very significant in the inner regions of IC 5063, globally speaking the impact will be very modest. We used RADEX non-LTE modelling to explore the physical conditions of the molecular gas in the outflow. Models with the outflowing gas being quite clumpy give the most consistent results and our preferred solutions have kinetic temperatures in the range 20-100 K and densities between 105 and 106 cm-3. The resulting pressures are 106-107.5 K cm-3, about two orders of magnitude higher than in the outer quiescent disk. The highest densities and temperatures are found in the regions with the fastest outflow. The results strongly suggest that

Extreme Gaseous Outflows in Radio-Loud Narrow-Line Seyfert 1 Galaxies

NASA Astrophysics Data System (ADS)

Komossa, S.; Xu, D. W.; Wagner, A. Y.

2018-04-01

We present four radio-loud NLS1 galaxies with extreme emission-line shifts, indicating radial outflow velocities of the ionized gas of up to 2450 km/s, above the escape velocity of the host galaxies. The forbidden lines show strong broadening, up to 2270 km/s. An ionization stratification (higher line shift at higher ionization potential) implies that we see a large-scale outflow rather than single, localized jet-cloud interactions. Similarly, the paucity of zero-velocity [OIII]λ5007 emitting gas implies the absence of a second narrow-line region (NLR) component at rest, and therefore a large part of the high-ionization NLR is affected by the outflow. Given the radio loudness of these NLS1 galaxies, the observations are consistent with a pole on view onto their central engines, so that the effects of polar outflows are maximized. In addition, a very efficient driving mechanism is required, to reach the high observed velocities. We explore implications from recent hydrodynamic simulations of the interaction between fast winds or jets with the large-scale NLR. Overall, the best agreement with observations (and especially the high outflow speeds of the [NeV] emitting gas) can be reached if the NLS1 galaxies are relatively young sources with lifetimes not much exceeding 1 Myr. These systems represent sites of strong feedback at NLR scales at work, well below redshift one.

OUTFLOWS FROM EVOLVED STARS: THE RAPIDLY CHANGING FINGERS OF CRL 618

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

Balick, Bruce; Huarte-Espinosa, Martin; Frank, Adam

2013-07-20

Our ultimate goal is to probe the nature of the collimator of the outflows in the pre-planetary nebula CRL 618. CRL 618 is uniquely suited for this purpose owing to its multiple, bright, and carefully studied finger-shaped outflows east and west of its nucleus. We compare new Hubble Space Telescope images to images in the same filters observed as much as 11 yr ago to uncover large proper motions and surface brightness changes in its multiple finger-shaped outflows. The expansion age of the ensemble of fingers is close to 100 yr. We find strong brightness variations at the fingertips duringmore » the past decade. Deep IR images reveal a multiple ring-like structure of the surrounding medium into which the outflows propagate and interact. Tightly constrained three-dimensional hydrodynamic models link the properties of the fingers to their possible formation histories. We incorporate previously published complementary information to discern whether each of the fingers of CRL 618 are the results of steady, collimated outflows or a brief ejection event that launched a set of bullets about a century ago. Finally, we argue on various physical grounds that fingers of CRL 618 are likely to be the result of a spray of clumps ejected at the nucleus of CRL 618 since any mechanism that form a sustained set of unaligned jets is unprecedented.« less

Brain Circuitry Supporting Multi-Organ Autonomic Outflow in Response to Nausea.

PubMed

Sclocco, Roberta; Kim, Jieun; Garcia, Ronald G; Sheehan, James D; Beissner, Florian; Bianchi, Anna M; Cerutti, Sergio; Kuo, Braden; Barbieri, Riccardo; Napadow, Vitaly

2016-02-01

While autonomic outflow is an important co-factor of nausea physiology, central control of this outflow is poorly understood. We evaluated sympathetic (skin conductance level) and cardiovagal (high-frequency heart rate variability) modulation, collected synchronously with functional MRI (fMRI) data during nauseogenic visual stimulation aimed to induce vection in susceptible individuals. Autonomic data guided analysis of neuroimaging data, using a stimulus-based (analysis windows set by visual stimulation protocol) and percept-based (windows set by subjects' ratings) approach. Increased sympathetic and decreased parasympathetic modulation was associated with robust and anti-correlated brain activity in response to nausea. Specifically, greater autonomic response was associated with reduced fMRI signal in brain regions such as the insula, suggesting an inhibitory relationship with premotor brainstem nuclei. Interestingly, some sympathetic/parasympathetic specificity was noted. Activity in default mode network and visual motion areas was anti-correlated with parasympathetic outflow at peak nausea. In contrast, lateral prefrontal cortical activity was anti-correlated with sympathetic outflow during recovery, soon after cessation of nauseogenic stimulation. These results suggest divergent central autonomic control for sympathetic and parasympathetic response to nausea. Autonomic outflow and the central autonomic network underlying ANS response to nausea may be an important determinant of overall nausea intensity and, ultimately, a potential therapeutic target. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Positron annihilation in the nuclear outflows of the Milky Way

NASA Astrophysics Data System (ADS)

Panther, Fiona H.; Crocker, Roland M.; Birnboim, Yuval; Seitenzahl, Ivo R.; Ruiter, Ashley J.

2018-02-01

Observations of soft gamma rays emanating from the Milky Way from SPI/INTEGRAL reveal the annihilation of ˜2 × 1043 positrons every second in the Galactic bulge. The origin of these positrons, which annihilate to produce a prominent emission line centred at 511 keV, has remained mysterious since their discovery almost 50 yr ago. A plausible origin for the positrons is in association with the intense star formation ongoing in the Galactic centre. Moreover, there is strong evidence for a nuclear outflow in the Milky Way. We find that advective transport and subsequent annihilation of positrons in such an outflow cannot simultaneously replicate the observed morphology of positron annihilation in the Galactic bulge and satisfy the requirement that 90 per cent of positrons annihilate once the outflow has cooled to 104 K.

Exploring the engines of molecular outflows. Radio continuum and H_2_O maser observations.

NASA Astrophysics Data System (ADS)

Tofani, G.; Felli, M.; Taylor, G. B.; Hunter, T. R.

1995-09-01

We present A-configuration VLA observations of the 22GHz H_2_O maser line and 8.4GHz continuum emission of 22 selected CO bipolar outflows associated with water masers. These observations allow us to study the region within 10^4^AU of the engine powering the outflow. The positions of the maser spots are compared with those of ultra-compact (UC) continuum sources found in our observations, with IRAS data and with data from the literature on the molecular outflows. Weak unresolved continuum sources are found in several cases associated with the maser. Most probably they represent the ionized envelope surrounding the young stellar object (YSO) which powers the maser and the outflow. These weak radio continuum sources are not necessarily associated with the IRAS sources, which are more representative of the global emission from the star forming region. A comparison of the velocity pattern of the CO outflow with those of the maser spots detected with the VLA is also made. Asymmetries in the H_2_O velocities are found on opposite sides of the YSO, suggesting that the outflow acceleration begins from the YSO itself. In a few cases we find evidence for two outflows in different evolutionary stages. The H_2_O masers in these sources are always found at the centre of the younger outflow. The degree of variability of each maser is derived from single dish observations obtained with the Medicina radiotelescope before and after the VLA observations. Velocity drifts of some features are interpreted as acceleration of the maser.

Institutional Experience in the Management of Hilar Liver Obstruction- A Series of 13 Cases.

PubMed

Pathanki, Adithya Malolan; Naragund, Adithya V; Mahadevappa, Basant

2016-12-01

Neoplastic hilar obstruction to the liver outflow presents a unique challenge to the surgeon, wherein, the balance between a curative and possibly larger resection has to be achieved against a more conservative local resection. These are often technically demanding and have thus, far produced equivocal outcomes on both ends. The present case series is on 13 patients who presented with hilar obstruction. They all underwent resections with possible curative intent. The focus of our review is on the technical nuances and the strategies we used, intra- and peri-operatively to make resections possible in these patients, who at first look were deemed inoperable. Among the 13, 10 had hilar cholangiocarcinoma (CCA) while the others had a more benign diagnosis e.g., Hydatid disease. We did not encounter any peri-operative mortality in our series. Two of our patients had to be re-explored for intra-abdominal complications. Among the 13, we encountered two deaths. The rest of the patients are still on follow-up as of April 2016. Hilar CCA continue to be rare and challenging tumours for the Hepato Pancreato Biliary (HPB) surgeon to manage. Outlooks are currently changing as we try to resect bigger and more complicated hilar liver tumours with better results.

The Dependence of Galactic Outflows on the Properties and Orientation of zCOSMOS Galaxies at z ~ 1

NASA Astrophysics Data System (ADS)

Bordoloi, R.; Lilly, S. J.; Hardmeier, E.; Contini, T.; Kneib, J.-P.; Le Fevre, O.; Mainieri, V.; Renzini, A.; Scodeggio, M.; Zamorani, G.; Bardelli, S.; Bolzonella, M.; Bongiorno, A.; Caputi, K.; Carollo, C. M.; Cucciati, O.; de la Torre, S.; de Ravel, L.; Garilli, B.; Iovino, A.; Kampczyk, P.; Kovač, K.; Knobel, C.; Lamareille, F.; Le Borgne, J.-F.; Le Brun, V.; Maier, C.; Mignoli, M.; Oesch, P.; Pello, R.; Peng, Y.; Perez Montero, E.; Presotto, V.; Silverman, J.; Tanaka, M.; Tasca, L.; Tresse, L.; Vergani, D.; Zucca, E.; Cappi, A.; Cimatti, A.; Coppa, G.; Franzetti, P.; Koekemoer, A.; Moresco, M.; Nair, P.; Pozzetti, L.

2014-10-01

We present an analysis of cool outflowing gas around galaxies, traced by Mg II absorption lines in the coadded spectra of a sample of 486 zCOSMOS galaxies at 1 <= z <= 1.5. These galaxies span a range of stellar masses (9.45 <= log10[M */M ⊙] <= 10.7) and star formation rates (0.14 <= log10[SFR/M ⊙ yr-1] <= 2.35). We identify the cool outflowing component in the Mg II absorption and find that the equivalent width of the outflowing component increases with stellar mass. The outflow equivalent width also increases steadily with the increasing star formation rate of the galaxies. At similar stellar masses, the blue galaxies exhibit a significantly higher outflow equivalent width as compared to red galaxies. The outflow equivalent width shows strong correlation with the star formation surface density (ΣSFR) of the sample. For the disk galaxies, the outflow equivalent width is higher for the face-on systems as compared to the edge-on ones, indicating that for the disk galaxies, the outflowing gas is primarily bipolar in geometry. Galaxies typically exhibit outflow velocities ranging from -150 km s-1 ~-200 km s-1 and, on average, the face-on galaxies exhibit higher outflow velocity as compared to the edge-on ones. Galaxies with irregular morphologies exhibit outflow equivalent width as well as outflow velocities comparable to face on disk galaxies. These galaxies exhibit mass outflow rates >5-7 M ⊙ yr-1 and a mass loading factor ({ η = \\dot{M}out /SFR}) comparable to the star formation rates of the galaxies. Based on observations undertaken at the European Southern Observatory (ESO) Very Large Telescope (VLT) under Large Program 175.A-0839.

Magnetic Topology and Ion Outflow in Mars' Magnetotail

NASA Astrophysics Data System (ADS)

Mitchell, D. L.; Xu, S.; McFadden, J. P.; Hara, T.; Luhmann, J. G.; Mazelle, C. X.; Andersson, L.; DiBraccio, G. A.; Connerney, J. E. P.

2017-12-01

Planetary ion outflow down the Martian magnetotail could be an important atmospheric loss mechanism. This process depends on magnetic connectivity to the day-side ionosphere and on acceleration of ions to escape velocity. The Mars Atmosphere and Volatile Evolution (MAVEN) mission has obtained comprehensive ion, electron, and magnetic field data in Mars' magnetotail. The spacecraft is in a 75°-inclination, elliptical orbit that samples altitudes from 150 to 6200 km. As the orbit precesses, it sweeps through the tail at a variety of altitudes in this range. Data from the Solar Wind Electron Analyzer (SWEA) and Magnetometer (MAG) are used to determine the magnetic field topology in the tail at high cadence (every 2-4 seconds), and in particular whether field lines are open, closed, or draped, and if open whether they have access to the day-side or night-side ionosphere. Simultaneous observations by the Supra-Thermal and Thermal Ion Composition (STATIC) instrument and the Langmuir Probe and Waves (LPW) experiment are used to measure the density, composition, and velocity of planetary plasma on these field lines. We find that magnetic topology in the tail is complex and variable, and is influenced by the IMF polarity and the orientation of Mars' crustal magnetic fields with respect to the Sun. We find that planetary ion outflow occurs on both open and draped field lines. On open field lines, outflow tends to occur parallel to the field line, with colder, denser, and slower outflow on field lines connected to the day-side ionosphere (Fig. 1). On these same field lines (after correction for the spacecraft potential) a shift in the position of the He-II photoelectron feature indicates a 1-Volt parallel electric potential directed away from the planet. Except for H+ and occasionally O+, this potential is insufficient by itself to accelerate planetary ions to escape velocity. Outflow is warmer, less dense, and faster moving on draped field lines. In this case, the ion bulk

Intralacrimal migration of Masterka® stents.

PubMed

Fayet, B; Racy, E; Katowitz, W R; Katowitz, J A; Ruban, J-M; Brémond-Gignac, D

2018-03-01

Tearing and conjunctivitis in children are commonly due to lacrimal drainage system obstruction. Congenital nasolacrimal obstruction is a common pathology treated by probing with or without silicone stent insertion, depending upon the age of the child. The silicone stent is self-retaining and placed for at least one month. Masterka ® is a recent version of Monoka ® , which may lead to the same surgical complications, such as intralacrimal migration. The medical records of two patients surgically treated with the Masterka ® probe for nasolacrimal duct obstruction, who developed intralacrimal migration of the stent, were retrospectively reviewed and analyzed. A 41-month-old child and an 18-month-old child presented with disappearance of the silicone tube after 7 days and 2 years respectively. In the first case, the tube migrated completely within the lacrimal system and became externalized through the nose at 2 years, while in the second case, the Masterka ® was retrieved through a canalicular approach. In both cases, infants had no further tearing. The frequency self-retaining stent disappearance is estimated at 15%. Among these cases, intralacrimal migration is only reported in 0.5% of cases. To prevent intralacrimal migration, the surgical technique must follow a certain number of rules. Management, based on residual epiphora, is discussed. Prevention of intralacrimal migration of self-retaining stents involves a rigorous analysis of the relationship between the meatus and the fixation head at the time of placement. After lacrimal intubation, scheduled monitoring is necessary to screen for stent disappearance. Management is based on clinical findings, anterior rhinoscopy and even exploratory canaliculotomy. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Ultrafast outflows disappear in high-radiation fields

NASA Astrophysics Data System (ADS)

Pinto, C.; Alston, W.; Parker, M. L.; Fabian, A. C.; Gallo, L. C.; Buisson, D. J. K.; Walton, D. J.; Kara, E.; Jiang, J.; Lohfink, A.; Reynolds, C. S.

2018-05-01

Ultrafast outflows (UFOs) are the most extreme winds launched by active galactic nuclei (AGN) due to their mildly relativistic speeds (˜0.1-0.3c) and are thought to significantly contribute to galactic evolution via AGN feedback. Their nature and launching mechanism are however not well understood. Recently, we have discovered the presence of a variable UFO in the narrow-line Seyfert 1 IRAS 13224-3809. The UFO varies in response to the brightness of the source. In this work we perform flux-resolved X-ray spectroscopy to study the variability of the UFO and found that the ionization parameter is correlated with the luminosity. In the brightest states the gas is almost completely ionized by the powerful radiation field and the UFO is hardly detected. This agrees with our recent results obtained with principal component analysis. We might have found the tip of the iceberg: the high ionization of the outflowing gas may explain why it is commonly difficult to detect UFOs in AGN and possibly suggest that we may underestimate their actual feedback. We have also found a tentative correlation between the outflow velocity and the luminosity, which is expected from theoretical predictions of radiation-pressure-driven winds. This trend is rather marginal due to the Fe XXV-XXVI degeneracy. Further work is needed to break such degeneracy through time-resolved spectroscopy.

The WISSH quasars project. I. Powerful ionised outflows in hyper-luminous quasars

NASA Astrophysics Data System (ADS)

Bischetti, M.; Piconcelli, E.; Vietri, G.; Bongiorno, A.; Fiore, F.; Sani, E.; Marconi, A.; Duras, F.; Zappacosta, L.; Brusa, M.; Comastri, A.; Cresci, G.; Feruglio, C.; Giallongo, E.; La Franca, F.; Mainieri, V.; Mannucci, F.; Martocchia, S.; Ricci, F.; Schneider, R.; Testa, V.; Vignali, C.

2017-02-01

Models and observations suggest that both the power and effects of AGN feedback should be maximised in hyper-luminous (LBol > 1047 erg s-1) quasars, I.e. objects at the brightest end of the AGN luminosity function. In this paper, we present the first results of a multiwavelength observing programme, focusing on a sample of WISE/SDSS selected hyper-luminous (WISSH) broad-line quasars at z ≈ 1.5-5. The WISSH quasars project has been designed to reveal the most energetic AGN-driven outflows, estimate their occurrence at the peak of quasar activity, and extend the study of correlations between outflows and nuclear properties up to poorly investigated, extreme AGN luminosities, I.e. LBol 1047 - 1048 erg s-1. We present near-infrared, long-slit LBT/LUCI1 spectroscopy of five WISSH quasars at z ≈ 2.3 - 3.5, showing prominent [OIII] emission lines with broad (FWHM 1200-2200 km s-1) and skewed profiles. The luminosities of these broad [OIII] wings are the highest measured so far, with L[OIII]broad ≳ 5 × 1044 erg s-1, and reveal the presence of powerful ionised outflows with associated mass outflow rates Ṁ ≳ 1700M⊙ yr-1 and kinetic powers Ėkin ≳ 1045 erg s-1. Although these estimates are affected by large uncertainties because of the use of [OIII] as a tracer of ionised outflows and the very basic outflow model adopted here, these results suggest that in our hyper-luminous targets the AGN is highly efficient at pushing large amounts of ionised gas outwards. Furthermore, the mechanical outflow luminosities measured for WISSH quasars correspond to higher percentages ( 1-3%) of LBol than those derived for AGN with lower LBol. Our targets host very massive (MBH ≳ 2 × 109M⊙) black holes that are still accreting at a high rate (I.e. a factor of 0.4-3 of the Eddington limit). These findings clearly demonstrate that WISSH quasars offer the opportunity to probe the extreme end of both luminosity and supermassive black holes (SMBH) mass functions and revealing

Champagne flutes and brandy snifters: modelling protostellar outflow-cloud chemical interfaces

NASA Astrophysics Data System (ADS)

Rollins, R. P.; Rawlings, J. M. C.; Williams, D. A.; Redman, M. P.

2014-10-01

A rich variety of molecular species has now been observed towards hot cores in star-forming regions and in the interstellar medium. An increasing body of evidence from millimetre interferometers suggests that many of these form at the interfaces between protostellar outflows and their natal molecular clouds. However, current models have remained unable to explain the origin of the observational bias towards wide-angled `brandy snifter' shaped outflows over narrower `champagne flute' shapes in carbon monoxide imaging. Furthermore, these wide-angled systems exhibit unusually high abundances of the molecular ion HCO+. We present results from a chemodynamic model of such regions where a rich chemistry arises naturally as a result of turbulent mixing between cold, dense molecular gas and the hot, ionized outflow material. The injecta drives a rich and rapid ion-neutral chemistry in qualitative and quantitative agreement with the observations. The observational bias towards wide-angled outflows is explained naturally by the geometry-dependent ion injection rate causing rapid dissociation of CO in the younger systems.

The influence of the environment on the propagation of protostellar outflows

NASA Astrophysics Data System (ADS)

Moraghan, Anthony; Smith, Michael D.; Rosen, Alexander

2008-06-01

The properties of bipolar outflows depend on the structure in the environment as well as the nature of the jet. To help distinguish between the two, we investigate here the properties pertaining to the ambient medium. We execute axisymmetric hydrodynamic simulations, injecting continuous atomic jets into molecular media with density gradients (protostellar cores) and density discontinuities (thick swept-up sheets). We determine the distribution of outflowing mass with radial velocity (the mass spectrum) to quantify our approach and to compare to observationally determined values. We uncover a sequence from clump entrainment in the flanks to bow shock sweeping as the density profile steepens. We also find that the dense, highly supersonic outflows remain collimated but can become turbulent after passing through a shell. The mass spectra vary substantially in time, especially at radial speeds exceeding 15 kms-1. The mass spectra also vary according to the conditions: both envelope-type density distributions and the passage through dense sheets generate considerably steeper mass spectra than a uniform medium. The simulations suggest that observed outflows penetrate highly non-uniform media.

Multiple outflows in the bipolar planetary nebula M1-16: A molecular line study

NASA Astrophysics Data System (ADS)

Sahai, Raghvendra; Wootten, Alwyn; Schwarz, Hugo E.; Wild, W.

1994-06-01

Extensive observations of the molecular gas in the young, compact planetary nebula M1-16 have been made, using the Swedish-ESO-Submillimeter Telescope. A map of the CO J = 2-1 emission shows that the molecular envelope contains both a slow and a fast outflow with expansion velocities of 19 km/s and greater than 34 km/s, respectively. The slow outflow is mildly elliptical, while the fast molecular outflow is bipolar. This fast outflow is roughly aligned with the very fast outflows recently found in the optical, while the long axis of the slow elliptical outflow is roughly orthogonal to the optical outflow axis. The kinematic timescales for the CO fast outflow and the optical very fast outflow agree closely, supporting the view that the former represents material in the slow outflow accelerated by the very fast outflow. The kinematic signature of a disk expanding with about 15.5 km/s can also be seen in the CO J = 2-1 data. The mass-loss rate (a) for the slow outflow is greater than or equal to 2.8 x 10-5 solar mass/yr and possibly as large as 9 x 10-5 solar mass/yr, (b) for the fast outflow is greater than or equal to 5 x 10-6 solar mass/yr, and (c) for the very fast optically visible outflow is approximately equal 5 x 10-7 solar mass/yr. The disk mass is approximately equal 6 x 10-3 solar mass. Grain photoelectric heating results in temperatures of 20-70 K in molecular gas of the slow outflow. The (13)C/(12)C abundance ratio in M1-16 is found to be 0.33, quite possibly the highest found for any evolved object. Upper limits for the (18)O/(16)O and (17)O/(16)O ratios were found to be consistent with the values found in AGB stars. A search for other molecular species in M1-16 resulted in the detection of the high-excitation species HCN, CN, (13)CN, HCO(+), and H(13)CO(+) and possibly N2H(+). Both the HCO(+)/HCN and CN/HCN line-intensity ratios are enhanced, the former by a very large factor, over the values found in the envelopes of AGB stars, probably as a result of

A Comparison of Techniques for Determining Mass Outflow Rates in the Type 2 Quasar Markarian 34

NASA Astrophysics Data System (ADS)

Revalski, Mitchell; Crenshaw, D. Michael; Fischer, Travis C.; Kraemer, Steven B.; Schmitt, Henrique R.; Dashtamirova, Dzhuliya; Pope, Crystal L.

2018-06-01

We present spatially resolved measurements of the mass outflow rates and energetics for the Narrow Line Region (NLR) outflows in the type 2 quasar Markarian 34. Using data from the Hubble Space Telescope and Apache point observatory, together with Cloudy photoionization models, we calculate the radial mass distribution of ionized gas and map its kinematics. We compare the results of this technique to global outflow rates that characterize NLR outflows with a single outflow rate and energetic measurement. We find that NLR mass estimates based on emission line luminosities produce more consistent results than techniques employing filling factors.

X-ray evidence for ultra-fast outflows in AGNs

NASA Astrophysics Data System (ADS)

Tombesi, Francesco; Sambruna, Rita; Braito, Valentina; Reeves, James; Reynolds, Christopher; Cappi, Massimo

2012-07-01

X-ray evidence for massive, highly ionized, ultra-fast outflows (UFOs) has been recently reported in a number of AGNs through the detection of blue-shifted Fe XXV/XXVI absorption lines. We present the results of a comprehensive spectral analysis of a large sample of 42 local Seyferts and 5 radio galaxies observed with XMM-Newton and Suzaku. We assessed the global detection significance of the absorption lines and performed a detailed photo-ionization modeling. We find that UFOs are common phenomena, being present in >40% of the sources. Their outflow velocity distribution is in the range ˜0.03--0.3c, with mean value of ˜0.14c. The ionization parameter is very high, in the range logξ˜3--6 erg~s^{-1}~cm, and the associated column densities are also large, in the range ˜10^{22}--10^{24} cm^{-2}. Their location is constrained at ˜0.0003--0.03pc (˜10^2--10^4 r_s) from the central black hole, consistent with what is expected for accretion disk winds/outflows. The mass outflow rates are in the interval ˜0.01--1M_{⊙}~yr^{-1} and the associated mechanical power is high, in the range ˜10^{43}--10^{45} erg/s. Therefore, UFOs are capable to provide a significant contribution to the AGN cosmological feedback and their study can provide important clues on the connection between accretion disks, winds and jets.

Transparency Parameters from Relativistically Expanding Outflows

NASA Astrophysics Data System (ADS)

Bégué, D.; Iyyani, S.

2014-09-01

In many gamma-ray bursts a distinct blackbody spectral component is present, which is attributed to the emission from the photosphere of a relativistically expanding plasma. The properties of this component (temperature and flux) can be linked to the properties of the outflow and have been presented in the case where there is no sub-photospheric dissipation and the photosphere is in coasting phase. First, we present the derivation of the properties of the outflow for finite winds, including when the photosphere is in the accelerating phase. Second, we study the effect of localized sub-photospheric dissipation on the estimation of the parameters. Finally, we apply our results to GRB 090902B. We find that during the first epoch of this burst the photosphere is most likely to be in the accelerating phase, leading to smaller values of the Lorentz factor than the ones previously estimated. For the second epoch, we find that the photosphere is likely to be in the coasting phase.

Aqueous outflow - a continuum from trabecular meshwork to episcleral veins

PubMed Central

Carreon, Teresia; van der Merwe, Elizabeth; Fellman, Ronald L.; Johnstone, Murray; Bhattacharya, Sanjoy K.

2016-01-01

In glaucoma, lowered intraocular pressure (IOP) confers neuroprotection. Elevated IOP characterizes glaucoma and arises from impaired aqueous humor (AH) outflow. Increased resistance in the trabecular meshwork (TM), a filter-like structure essential to regulate AH outflow, may result in the impaired outflow. Flow through the 360° circumference of TM structures may be non-uniform, divided into high and low flow regions, termed as segmental. After flowing through the TM, AH enters Schlemm’s canal (SC), which expresses both blood and lymphatic markers; AH then passes into collector channel entrances (CCE) along the SC external well. From the CCE, AH enters a deep scleral plexus (DSP) of vessels that typically run parallel to SC. From the DSP, intrascleral collector vessels run radially to the scleral surface to connect with AH containing vessels called aqueous veins to discharge AH to blood-containing episcleral veins. However, the molecular mechanisms that maintain homeostatic properties of endothelial cells along the pathways are not well understood. How these molecular events change during aging and in glaucoma pathology remain unresolved. In this review, we propose mechanistic possibilities to explain the continuum of AH outflow control, which originates at the TM and extends through collector channels to the episcleral veins. PMID:28028002

Financial Crisis, Capital Outflows, and Policy Responses: Examples from East Asia

ERIC Educational Resources Information Center

Rajan, Ramkishen S.

2007-01-01

Financial crises seem to have become the norm rather than the exception since 1992. The author examines the impact of a crisis of confidence and resultant capital outflows from a small and open economy and the possible policy options in response to such outflows, using simple tools and definitions that will be familiar to any money and banking or…

Evaluation of Accessory Lacrimal Gland in Muller’s Muscle Conjunctival Resection Specimens for Precursor Cell Markers and Biological Markers of Dry Eye Disease

PubMed Central

Ali, Marwan; Shah, Dhara; Pasha, Zeeshan; Jassim, Sarmad H.; Jaboori, Assraa Jassim; Setabutr, Pete; Aakalu, Vinay K.

2017-01-01

Purpose The accessory lacrimal glands (ALG) are an understudied component of the tear functional unit, even though they are important in the development of dry eye syndrome (DES). To advance our understanding of aging changes, regenerative potential and histologic correlates to human characteristics, we investigated human ALG tissue from surgical samples to determine the presence or absence of progenitor cell markers and lacrimal epithelial markers and to correlate marker expression to relevant patient characteristics. Materials and Methods ALG tissues obtained from Muller’s Muscle Conjunctival Resection (MMCR) specimens were created using tissue microarrays (TMAs). Immunofluorescence staining of MMCR sections was performed using primary antibodies specific to cell protein markers. Cell marker localization in TMAs was then assessed by two blinded observers using a standardized scoring system. Patient characteristics including age, race, and status of ocular surface health were then compared against expression of stem cell markers. Results Human ALG expressed a number of epithelial markers, and in particular, histatin-1 was well correlated with the expression of epithelial markers and was present in most acini. In addition, we noted the presence of precursor cell markers nestin, ABCG2 and CD90 in ALG tissue. There was a decrease in precursor cell marker expression with increasing age. Finally, we noted that a negative association was present between histatin-1 expression and DES. Conclusions Thus, we report for the first time that human ALG tissues contain precursor marker positive cells and that this marker expression may decrease with increasing age. Moreover, histatin-1 expression may be decreased in DES. Future studies will be performed to use these cell markers to isolate and culture lacrimal epithelial cells from heterogeneous tissues, determine the relevance of histatin-1 expression to DES and isolate candidate precursor cells from ALG tissue. PMID:27612554

Embedded Outflows from Herbig-Haro 46/47

NASA Technical Reports Server (NTRS)

2003-01-01

[figure removed for brevity, see original site] Click on image for larger view of insert

This image from NASA's Spitzer Space Telescope transforms a dark cloud into a silky translucent veil, revealing the molecular outflow from an otherwise hidden newborn star. Using near-infrared light, Spitzer pierces through the dark cloud to detect the embedded outflow in an object called HH 46/47. Herbig-Haro (HH) objects are bright, nebulous regions of gas and dust that are usually buried within dark clouds. They are formed when supersonic gas ejected from a forming protostar, or embryonic stars, interacts with the surrounding interstellar medium. These young stars are often detected only in the infrared.

The Spitzer image was obtained with the infrared array camera and is a three-color mosaic. Emission at 3.6 microns is shown as blue, emission from 4.5 and 5.8 microns has been combined as green, and 8.0 micron emission is depicted as red.

HH 46/47 is a striking example of a low mass protostar ejecting a jet and creating a bipolar, or two-sided, outflow. The central protostar lies inside a dark cloud (known as a 'Bok globule') which is illuminated by the nearby Gum Nebula. Located at a distance of 1,140 light-years and found in the constellation Vela, the protostar is hidden from view in the visible-light image (inset). With Spitzer, the star and its dazzling jets of molecular gas appear with clarity.

The 8-micron channel of the infrared array camera is sensitive to emission from polycyclic aromatic hydrocarbons. These organic molecules, comprised of carbon and hydrogen, are excited by the surrounding radiation field and become luminescent, accounting for the reddish cloud. Note that the boundary layer of the 8-micron emission corresponds to the lower right edge of the dark cloud in the visible-light picture.

Outflows are fascinating objects, since they characterize one of the most energetic phases of the formation of low-mass stars (like our Sun). The

Morphology and function of lacrimal gland acinar cells in primary culture.

PubMed

Hann, L E; Tatro, J B; Sullivan, D A

1989-01-01

The objectives of the current investigation were fourfold: (1) to establish an effective procedure for the isolation of acinar cells from the rat lacrimal gland; (2) to evaluate the functional capacity of freshly isolated cells; (3) to determine defined culture conditions which permit maintenance of viable, differentiated cells, as well as secretory component (SC) production, during long-term culture; and (4) to characterize the morphological features of cultured cells. Acinar cells were isolated by serial incubation of gland fragments in chelating and enzymatic solutions, followed by centrifugation through a Ficoll gradient. The yield of viable cells/gland appeared to be age-dependent: cell recovery was inversely proportional to the age of the animals. Immunofluorescence analysis of freshly isolated cells showed the presence of SC, the IgA antibody receptor, within isolated cells. In addition, experiments with a labeled analog (Nle4-D-Phe7-alpha MSH) of alpha-melanocyte-stimulating hormone (alpha-MSH) demonstrated specific binding sites on freshly isolated cells; alpha-MSH is a known modulator of acinar protein secretion. Maximum binding of the alpha-MSH analog occurred within 30 min, was dependent upon cell density and was reduced by coincubation with unlabeled alpha-MSH. To determine the culture requirements of acinar cells, cells were cultured on a variety of substrates (plastic or modified plastic [Primaria], coated with or without extracellular matrix [Matrigel]) in the presence or absence of various supplements and/or fetal calf serum (FCS) for 0.7 to 3.5 weeks. Cell attachment, function and long-term viability required an extracellular matrix. Moreover, in long term cultures (25 days), acinar cell attachment was enhanced by the inclusion of supplements to media containing 10% FCS. Replacement of serum with fibroblast growth factor, high-density lipoprotein and an increased concentration of epidermal growth factor resulted in a distinct "cobblestone

OUTFLOW AND METALLICITY IN THE BROAD-LINE REGION OF LOW-REDSHIFT ACTIVE GALACTIC NUCLEI

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

Shin, Jaejin; Woo, Jong-Hak; Nagao, Tohru

2017-01-20

Outflows in active galactic nuclei (AGNs) are crucial to understand in investigating the co-evolution of supermassive black holes (SMBHs) and their host galaxies since outflows may play an important role as an AGN feedback mechanism. Based on archival UV spectra obtained with the Hubble Space Telescope and IUE , we investigate outflows in the broad-line region (BLR) in low-redshift AGNs ( z < 0.4) through detailed analysis of the velocity profile of the C iv emission line. We find a dependence of the outflow strength on the Eddington ratio and the BLR metallicity in our low-redshift AGN sample, which ismore » consistent with earlier results obtained for high-redshift quasars. These results suggest that BLR outflows, gas accretion onto SMBHs, and past star formation activity in host galaxies are physically related in low-redshift AGNs as in powerful high-redshift quasars.« less

Tropical Convective Outflow and Near Surface Equivalent Potential Temperatures

NASA Technical Reports Server (NTRS)

Folkins, Ian; Oltmans, Samuel J.; Thompson, Anne M.; Einaudi, Franco (Technical Monitor)

2000-01-01

We use clear sky heating rates to show that convective outflow in the tropics decreases rapidly with height between the 350 K and 360 K potential temperature surfaces (or between roughly 13 and 15 km). There is also a rapid fall-off in the pseudoequivalent potential temperature probability distribution of near surface air parcels between 350 K and 360 K. This suggests that the vertical variation of convective outflow in the upper tropical troposphere is to a large degree determined by the distribution of sub cloud layer entropy.

Extreme gaseous outflows in radio-loud narrow-line Seyfert 1 galaxies

NASA Astrophysics Data System (ADS)

Komossa, S.; Xu, D. W.; Wagner, A. Y.

2018-07-01

We present four radio-loud narrow-line Seyfert 1 (NLS1) galaxies with extreme emission-line shifts, indicating radial outflow velocities of the ionized gas of up to 2450 km s-1, above the escape velocity of the host galaxies. The forbidden lines show strong broadening, up to 2270 km s-1. An ionization stratification (higher line shift at higher ionization potential) implies that we see a large-scale outflow rather than single, localized jet-cloud interactions. Similarly, the paucity of zero-velocity [O III] λ5007 emitting gas implies the absence of a second narrow-line region (NLR) component at rest, and therefore a large part of the high-ionization NLR is affected by the outflow. Given the radio loudness of these NLS1 galaxies, the observations are consistent with a pole on view onto their central engines, so that the effects of polar outflows are maximized. In addition, a very efficient driving mechanism is required to reach the high observed velocities. We explore implications from recent hydrodynamic simulations of the interaction between fast winds or jets with the large-scale NLR. Overall, the best agreement with observations (and especially the high outflow speeds of the [Ne V] emitting gas) can be reached if the NLS1 galaxies are relatively young sources with lifetimes not much exceeding 1 Myr. These systems represent sites of strong feedback at NLR scales at work, well below redshift one.

Delayed or No Feedback? Gas Outflows in Type 2 AGNs. III

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

Woo, Jong-Hak; Son, Donghoon; Bae, Hyun-Jin, E-mail: woo@astro.snu.ac.kr, E-mail: hjbae@galaxy.yonsei.ac.kr

2017-04-20

We present gas kinematics based on the [O iii] λ 5007 line and their connection to galaxy gravitational potential, active galactic nucleus (AGN) energetics, and star formation, using a large sample of ∼110,000 AGNs and star-forming (SF) galaxies at z < 0.3. Gas and stellar velocity dispersions are comparable to each other in SF galaxies, indicating that the ionized gas kinematics can be accounted by the gravitational potential of host galaxies. In contrast, AGNs clearly show non-gravitational kinematics, which is comparable to or stronger than the virial motion caused by the gravitational potential. The [O iii] velocity–velocity dispersion (VVD) diagrammore » dramatically expands toward high values as a function of AGN luminosity, implying that the outflows are AGN-driven, while SF galaxies do not show such a trend. We find that the fraction of AGNs with a signature of outflow kinematics, steeply increases with AGN luminosity and Eddington ratio. In particular, the majority of luminous AGNs presents strong non-gravitational kinematics in the [O iii] profile. AGNs with strong outflow signatures show on average similar specific star formation rates (sSFRs) to those of star-forming galaxies. In contrast, AGNs with weak or no outflows have an order of magnitude lower sSFRs, suggesting that AGNs with current strong outflows do now show any negative AGN feedback and that it may take dynamical time to impact on star formation over galactic scales.« less

Evidence for ultrafast outflows in radio-quiet AGNs - III. Location and energetics

NASA Astrophysics Data System (ADS)

Tombesi, F.; Cappi, M.; Reeves, J. N.; Braito, V.

2012-05-01

Using the results of a previous X-ray photoionization modelling of blueshifted Fe K absorption lines on a sample of 42 local radio-quiet AGNs observed with XMM-Newton, in this Letter we estimate the location and energetics of the associated ultrafast outflows (UFOs). Due to significant uncertainties, we are essentially able to place only lower/upper limits. On average, their location is in the interval ˜0.0003-0.03 pc (˜ 102-104rs) from the central black hole, consistent with what is expected for accretion disc winds/outflows. The mass outflow rates are constrained between ˜0.01 and 1 M⊙ yr-1, corresponding to >rsim5-10 per cent of the accretion rates. The average lower/upper limits on the mechanical power are log? 42.6-44.6 erg s-1. However, the minimum possible value of the ratio between the mechanical power and bolometric luminosity is constrained to be comparable or higher than the minimum required by simulations of feedback induced by winds/outflows. Therefore, this work demonstrates that UFOs are indeed capable to provide a significant contribution to the AGN cosmological feedback, in agreement with theoretical expectations and the recent observation of interactions between AGN outflows and the interstellar medium in several Seyfert galaxies.

Can Gas Outflows Explain The Strong Lyα Emission Of Lyman Alpha Emitters?

NASA Astrophysics Data System (ADS)

Hashimoto, Takuya; Ouchi, M.; Shimasaku, K.; Nakajima, K.; Ono, Y.; Rauch, M.

2012-05-01

Lyman alpha emitters (LAEs) are galaxies commonly seen at high redshift, probably playing an important role in galaxy evolution as building blocks of massive galaxies. The most interesting feature of LAEs is strong Lyα emission, because Lyα photons produced in a galaxy are expected to be easily absorbed by dust in the ISM before escaping the galaxy due to their resonant nature. Previous studies have suggested that outflow may help their escape thanks to reduced cross sections of outflowing (ie, redshifted) neutral hydrogen atoms. Although the presence of outflows can be examined from the offset of the Lyα emission from the systemic velocity defined by Hα emission, there are only four LAEs with reliable detection of Hα emission. We present the results of Magellan/MMIRS and Keck/NIRSPEC spectroscopic observations of five LAEs at z˜2.2 from our wide-field narrow-band survey with Subaru/Suprime-Cam. We successfully detect Hα emission for five objects. After eliminating an AGN contaminated object, we measure the velocityoffset between Lyα and Hα (Δ v_Lyα) for the remaining four, to find that three have a positive offset, suggesting an outflow. Since three among the four from the the literature also have an outflow, we conclude that ˜75% of LAEs have an outflow, with velocities of 75-280 km/s. We then use these eight LAEs to examine how the Lyα strength defined by Lyα escape fraction (f_esc) and/or Lyα equivalent width (EW(Lyα)) depend on other physical quantities including those derived from SED fitting. Contrary to our expectation, we find that both f_esc and EW(Lyα) decrease with Δ v_Lyα. Thus, although LAEs do have outflow, high outflow velocities are not the primary cause of strong Lyα emission. We also find that the Lyα strength does not depend on E(B-V). However, we find that objects with a clumpier gas distribution may have higher f_esc.

Not All Lacrimal Epithelial Cells are Created Equal—Heterogeneity of the Rabbit Lacrimal Gland and Differential Secretion

PubMed Central

Ding, Chuanqing; Huang, Jianyan; MacVeigh-Aloni, Michelle; Lu, Michael

2013-01-01

Aims To test the hypotheses that some epithelial cells in the rabbit lacrimal gland (LG) are mucin-secreting cells that are also particularly rich in aquaporin 5 (AQP5) and sodium potassium ATPase β1 subunit (NKAβ1), LG-secreted mucins contribute to the total mucin pool in tear film, and that the rabbit LG is a heterogenic gland where proteins secreted in response to different agonists are varied. Materials and methods LGs were obtained from adult female rabbits and processed for paraffin sections for hematoxylin and eosin (HE) staining, periodic acid-Schiff (PAS), mucicarmine, and Alcian blue (pH 0.4, 1.0, and 2.5) for the detection of mucins. Serial sections were used for immunohistochemistry (IHC) and PAS. LG lysates and fluids were assayed by dot blot for detection of mucins, and by SDS-PAGE to detect differences in protein profiles of LG fluids stimulated by different agonists. Results HE staining demonstrated that the LG is a heterogeneous gland where most epithelial cells are serous, while all duct cells are mucous cells. Some acini and individual acinar cells within serous acini are also mucous or seromucous cells and these cells are particularly rich in AQP5 and NKAβ1. Dot blot assay showed the presence of mucins in the LG fluids. The protein profiles of LG fluids from pilocarpine, phenylephrine, and isoproterenol varied significantly, particularly in the mid range. Conclusions Our data indicated that the rabbit LG is a heterogeneous gland that is composed of both serous and mucin-secreting cells, and mucins produced by the LG contribute to the mucin pool in the tear film. The heterogeneity of the rabbit LG supports the notion of differential secretion, i.e. the volume and composition of the LG fluids vary depending on various circumstances in the ocular surface and the body’s needs. PMID:21999223

Microarray analysis of the rat lacrimal gland following the loss of parasympathetic control of secretion

PubMed Central

Nguyen, Doan H.; Toshida, Hiroshi; Schurr, Jill; Beuerman, Roger W.

2010-01-01

Previous studies showed that loss of muscarinic parasympathetic input to the lacrimal gland (LG) leads to a dramatic reduction in tear secretion and profound changes to LG structure. In this study, we used DNA microarrays to examine the regulation of the gene expression of the genes for secretory function and organization of the LG. Long-Evans rats anesthetized with a mixture of ketamine/xylazine (80:10 mg/kg) underwent unilateral sectioning of the greater superficial petrosal nerve, the input to the pterygopalatine ganglion. After 7 days, tear secretion was measured, the animals were killed, and structural changes in the LG were examined by light microscopy. Total RNA from control and experimental LGs (n = 5) was used for DNA microarray analysis employing the U34A GeneChip. Three statistical algorithms (detection, change call, and signal log ratio) were used to determine differential gene expression using the Microarray Suite (5.0) and Data Mining Tools (3.0). Tear secretion was significantly reduced and corneal ulcers developed in all experimental eyes. Light microscopy showed breakdown of the acinar structure of the LG. DNA microarray analysis showed downregulation of genes associated with the endoplasmic reticulum and Golgi, including genes involved in protein folding and processing. Conversely, transcripts for cytoskeleton and extracellular matrix components, inflammation, and apoptosis were upregulated. The number of significantly upregulated genes (116) was substantially greater than the number of downregulated genes (49). Removal of the main secretory input to the rat LG resulted in clinical symptoms associated with severe dry eye. Components of the secretory pathway were negatively affected, and the increase in cell proliferation and inflammation may lead to loss of organization in the parasympathectomized lacrimal gland. PMID:15084711

Valles Marineris and Chryse Outflow Channels

NASA Image and Video Library

1998-06-08

A color image of Valles Marineris, the great canyon and the south Chryse basin-Valles Marineris outflow channels of Mars; north toward top. The scene shows the entire Valles Marineris canyon system, over 3,000 km long and averaging 8 km deep, extending from Noctis Labyrinthus, the arcuate system of graben to the west, to the chaotic terrain to the east and related outflow canyons that drain toward the Chryse basin. Eos and Capri Chasmata (south to north) are two canyons connected to Valles Marineris. Ganges Chasma lies directly north. The chaos in the southeast part of the image gives rise to several outflow channels, Shalbatana, Simud, Tiu, and Ares Valles (left to right), that drained north into the Chryse basin. The mouth of Ares Valles is the site of the Mars Pathfinder lander. This image is a composite of Viking medium-resolution images in black and white and low-resolution images in color; Mercator projection. The image roughly extends from latitude 20 degrees S. to 20 degrees N. and from longitude 15 degrees to 102.5 degrees. The connected chasma or valleys of Valles Marineris may have formed from a combination of erosional collapse and structural activity. Layers of material in the eastern canyons might consist of carbonates deposited in ancient lakes, eolian deposits, or volcanic materials. Huge ancient river channels began from Valles Marineris and from adjacent canyons and ran north. Many of the channels flowed north into Chryse Basin. The south Chryse outflow channels are cut an average of 1 km into the cratered highland terrain. This terrain is about 9 km above datum near Valles Marineris and steadily decreases in elevation to 1 km below datum in the Chryse basin. Shalbatana is relatively narrow (10 km wide) but can reach 3 km in depth. The channel begins at a 2- to 3-km-deep circular depression within a large impact crater, whose floor is partly covered by chaotic material, and ends in Simud Valles. Tiu and Simud Valles consist of a complex of

The Gaseous Environments of Quasars: Outflows, Feedback & Cold Mode Accretion

NASA Astrophysics Data System (ADS)

Chen, Chen; Hamann, Fred

2018-06-01

The early stages of massive galaxy evolution can involve galaxy-scale outflows driven by a starburst or a central quasar and cold-mode accretion (infall) that adds to the mass buildup in the galaxies. I will describe three related studies that use quasar absorption lines to measure outflows, infall, and the general gaseous environments of quasars across a range of spatial scales. The three studies are: 1) High-resolution spectroscopy with Keck-HIRES and VLT-UVES to study associated absorption lines (AALs) that have redshifts greater than the emission redshifts indicating infall and/or rich multi-component AAL complexes that might be interstellar clouds in the host galaxies that have been shredded and dispersed by a fast unseen quasar-driven wind. The data provide strong constraints on the gas kinematics, spatial structure, column densities, metallicities, and energetics. 2) A complete inventory of high-velocity CIV 1548,1550 mini-BAL outflows in quasars using high-resolution high signal-to-noise spectra in the public VLT-UVES and Keck-HIRES archives. This sensitive mini-BAL survey fills an important niche between previous work on narrow absorption lines (NALs) and the much-studied broad absorption lines (BALs) to build a more complete picture of quasar outflows. I will report of the mini-BAL statistics, the diversity of lines detected, and some tests for correlations with the quasar properties. We find, for example, that mini-BALs at v > 4000 km/s in at least 10% of 511 quasars studied, including 1% at v > 0.1 c. Finally, 3) Use the much larger database of NALs measured in 262,449 BOSS quasars by York et al. (in prep.) to study their potential relationships to the quasars and, specifically, their origins in quasar outflows. This involves primarily comparisons of the incidence and properties of NALs at different velocity shifts to other measured properties of the quasars such as BAL outflows, emission line characteristics, radio-loudness, and red colors. We find

Assessment of the ductus arteriosus in fetuses with tetralogy of Fallot and the implication for postnatal management.

PubMed

Tuo, Giulia; Volpe, Paolo; Buffi, Davide; De Robertis, Valentina; Marasini, Maurizio

2014-01-01

To describe the antenatal and neonatal echocardiographic morphology and flow pattern of the ductus arteriosus in patients with tetralogy of Fallot. We included patients with a prenatal diagnosis of tetralogy of Fallot between January 2006 and December 2012. Among the 52 fetuses with tetralogy of Fallot the severity of right ventricular outflow obstruction was considered mild in 32, moderate in 14, and severe in 6. In the mild right ventricular outflow obstruction group (n = 32) all had normal ductal morphology and flow pattern, eight (25%) elected for termination of pregnancy and two died in the neonatal period from extracardiac causes. In the moderate right ventricular outflow obstruction group (n = 14) the fetuses had a small ductus arteriosus with antegrade but abnormal flow velocity, one (7%) elected for termination of pregnancy. Immediately after birth the ductus arteriosus was very small or already closed at echocardiographic examination. Two out of 13 patients (15%) developed severe hypoxic spells and underwent modified Blalock-Taussig shunt during the neonatal period. Six fetuses were considered to have severe right ventricular outflow obstruction with flow reversal in the ductus arteriosus, three (50%) of whom elected for termination of pregnancy. The other three newborns underwent modified Blalock-Taussig shunt. In fetuses with tetralogy of Fallot, ductal diameter can be reduced even up to prenatal closure. Prenatal ductal morphology assessment may be useful for improving management of patients with moderate right ventricular outflow obstruction and small ductus arteriosus who may become cyanotic at birth. © 2013 Wiley Periodicals, Inc.

Secondary chaotic terrain formation in the higher outflow channels of southern circum-Chryse, Mars

USGS Publications Warehouse

Rodriguez, J.A.P.; Kargel, J.S.; Tanaka, K.L.; Crown, D.A.; Berman, D.C.; Fairen, A.G.; Baker, V.R.; Furfaro, R.; Candelaria, P.; Sasaki, S.

2011-01-01

Higher outflow channel dissection in the martian region of southern circum-Chryse appears to have extended from the Late Hesperian to the Middle Amazonian Epoch. These outflow channels were excavated within the upper 1. km of the cryolithosphere, where no liquid water is expected to have existed during these geologic epochs. In accordance with previous work, our examination of outflow channel floor morphologies suggests the upper crust excavated by the studied outflow channels consisted of a thin (a few tens of meters) layer of dry geologic materials overlying an indurated zone that extends to the bases of the investigated outflow channels (1. km in depth). We find that the floors of these outflow channels contain widespread secondary chaotic terrains (i.e., chaotic terrains produced by the destruction of channel-floor materials). These chaotic terrains occur within the full range of outflow channel dissection and tend to form clusters. Our examination of the geology of these chaotic terrains suggests that their formation did not result in the generation of floods. Nevertheless, despite their much smaller dimensions, these chaotic terrains are comprised of the same basic morphologic elements (e.g., mesas, knobs, and smooth deposits within scarp-bound depressions) as those located in the initiation zones of the outflow channels, which suggests that their formation must have involved the release of ground volatiles. We propose that these chaotic terrains developed not catastrophically but gradually and during multiple episodes of nested surface collapse. In order to explain the formation of secondary chaotic terrains within zones of outflow channel dissection, we propose that the regional Martian cryolithosphere contained widespread lenses of volatiles in liquid form. In this model, channel floor collapse and secondary chaotic terrain formation would have taken place as a consequence of instabilities arising during their exhumation by outflow channel dissection

Staging and follow-up of lacrimal gland carcinomas by 18F-FDG PET/CT imaging.

PubMed

Tafti, Bashir Akhavan; Shaba, Wisam; Li, Yuxin; Yevdayev, Ella; Berenji, Gholam Reza

2012-10-01

A 74-year-old man with right eye proptosis, diplopia, and orbital discomfort for 3 to 4 months underwent biopsy, the specimen of which showed transitional cell carcinoma of the lacrimal gland. 18F-FDG PET/CT was also performed for staging purposes. Six months after orbital exenteration, a follow-up CT scan demonstrated soft tissue thickening along the nasal bridge but could not differentiate between postsurgical changes and cancer recurrence. A concurrent PET/CT scan did not show any evidence of abnormal metabolic activity, further emphasizing the higher accuracy of PET/CT in staging and restaging of head and neck cancers. An annual follow-up scan was still negative for active disease.

Suzaku Discovery of Ultra-fast Outflows in Radio-loud AGN

NASA Astrophysics Data System (ADS)

Sambruna, Rita M.; Tombesi, F.; Reeves, J.; Braito, V.; Gofford, J.; Cappi, M.

2010-03-01

We present the results of an analysis of the 3.5--10.5 keV spectra of five bright Broad-Line Radio Galaxies (BLRGs) using proprietary and archival Suzaku observations. In three sources -- 3C 111, 3C 120, and 3C 390.3 -- we find evidence, for the first time in a radio-loud AGN, for absorption features at observed energies 7 keV and 8--9 keV, with high significance according to both the F-test and extensive Monte Carlo simulations (99% or larger). In the remaining two BLRGs, 3C 382 and 3C 445, there is no evidence for such absorption features in the XIS spectra. If interpreted as due to Fe XXV and/or Fe XXVI K-shell resonance lines, the absorption features in 3C 111, 3C 120, and 3C 390.3 imply an origin from an ionized gas outflowing with velocities in the range v 0.04-0.15c, reminiscent of Ultra-Fast Outflows (UFOs) previously observed in radio-quiet Seyfert galaxies. A fit with specific photoionization models gives ionization parameters log ξ 4--5.6 erg s-1 cm and column densities of NH 1022-23 cm-2, similar to the values observed in Seyferts. Based on light travel time arguments, we estimate that the UFOs in the three BLRGs are located within 20--500 gravitational radii from the central black hole, and thus most likely are connected to disk winds/outflows. Our estimates show that the UFOs mass outflow rate is comparable to the accretion rate and their kinetic energy a significant fraction of the AGN bolometric luminosity, making these outflows significant for the global energetic of these systems, in particular for mechanisms of jet formation.

Long-Term Results of Stent Placement in Patients with Outflow Block After Living-Donor-Liver Transplantation

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

Fujimori, Masashi, E-mail: fujimorim@clin.medic.mie-u.ac.jp; Yamakado, Koichiro, E-mail: yamakado47@gmail.com; Takaki, Haruyuki, E-mail: takaki-h@clin.medic.mie-u.ac.jp

PurposeTo evaluate long-term results of stent placement retrospectively in patients with outflow block after living-donor-liver transplantation (LDLT).Materials and MethodsFor this institutional review board approved retrospective study conducted during 2002–2012, stents were placed in outflow veins in 15 patients (11.3 %, 15/133) (12 men; 3 female) in whom outflow block developed after LDLT. Their mean age was 52.3 years ± 15.3 (SD) (range, 4–69 years). Venous stenosis with a pressure gradient ≥5 mmHg (outflow block) was observed in the inferior vena cava in seven patients, hepatic vein in seven patients, and both in one patient. Technical success, change in a pressure gradient and clinical manifestations, and complicationsmore » were evaluated. Overall survival of 15 patients undergoing outflow block stenting was compared with that of 116 patients without outflow block after LDLT.ResultsStents were placed across the outflow block veins without complications, lowering the pressure gradient ≤ 3 mmHg in all patients (100 %, 15/15). Clinical manifestations improved in 11 patients (73.3 %, 11/15), and all were discharged from the hospital. However, they did not improve in the other 4 patients (26.7 %, 4/15) who died in the hospital 1.0–3.7 months after stenting (mean, 2.0 ± 1.2 months). No significant difference in 5-year survival rates was found between patients with and without outflow block after LDLT (61.1 vs. 72.2 %, p = .405).ConclusionStenting is a feasible, safe, and useful therapeutic option to resolve outflow block following LDLT, providing equal survival to that of patients without outflow block.« less

Reconstructing Global-scale Ionospheric Outflow With a Satellite Constellation

NASA Astrophysics Data System (ADS)

Liemohn, M. W.; Welling, D. T.; Jahn, J. M.; Valek, P. W.; Elliott, H. A.; Ilie, R.; Khazanov, G. V.; Glocer, A.; Ganushkina, N. Y.; Zou, S.

2017-12-01

The question of how many satellites it would take to accurately map the spatial distribution of ionospheric outflow is addressed in this study. Given an outflow spatial map, this image is then reconstructed from a limited number virtual satellite pass extractions from the original values. An assessment is conducted of the goodness of fit as a function of number of satellites in the reconstruction, placement of the satellite trajectories relative to the polar cap and auroral oval, season and universal time (i.e., dipole tilt relative to the Sun), geomagnetic activity level, and interpolation technique. It is found that the accuracy of the reconstructions increases sharply from one to a few satellites, but then improves only marginally with additional spacecraft beyond 4. Increased dwell time of the satellite trajectories in the auroral zone improves the reconstruction, therefore a high-but-not-exactly-polar orbit is most effective for this task. Local time coverage is also an important factor, shifting the auroral zone to different locations relative to the virtual satellite orbit paths. The expansion and contraction of the polar cap and auroral zone with geomagnetic activity influences the coverage of the key outflow regions, with different optimal orbit configurations for each level of activity. Finally, it is found that reconstructing each magnetic latitude band individually produces a better fit to the original image than 2-D image reconstruction method (e.g., triangulation). A high-latitude, high-altitude constellation mission concept is presented that achieves acceptably accurate outflow reconstructions.

Required, tissue-specific roles for Fgf8 in outflow tract formation and remodeling.

PubMed

Park, Eon Joo; Ogden, Lisa A; Talbot, Amy; Evans, Sylvia; Cai, Chen-Leng; Black, Brian L; Frank, Deborah U; Moon, Anne M

2006-06-01

Fibroblast growth factor 8 (Fgf8) is a secreted signaling protein expressed in numerous temporospatial domains that are potentially relevant to cardiovascular development. However, the pathogenesis of complex cardiac and outflow tract defects observed in Fgf8-deficient mice, and the specific source(s) of Fgf8 required for outflow tract formation and subsequent remodeling are unknown. A detailed examination of the timing and location of Fgf8 production revealed previously unappreciated expression in a subset of primary heart field cells; Fgf8 is also expressed throughout the anterior heart field (AHF) mesoderm and in pharyngeal endoderm at the crescent and early somite stages. We used conditional mutagenesis to examine the requirements for Fgf8 function in these different expression domains during heart and outflow tract morphogenesis. Formation of the primary heart tube and the addition of right ventricular and outflow tract myocardium depend on autocrine Fgf8 signaling in cardiac crescent mesoderm. Loss of Fgf8 in this domain resulted in decreased expression of the Fgf8 target gene Erm, and aberrant production of Isl1 and its target Mef2c in the anterior heart field, thus linking Fgf8 signaling with transcription factor networks that regulate survival and proliferation of the anterior heart field. We further found that mesodermal- and endodermal-derived Fgf8 perform specific functions during outflow tract remodeling: mesodermal Fgf8 is required for correct alignment of the outflow tract and ventricles, whereas activity of Fgf8 emanating from pharyngeal endoderm regulates outflow tract septation. These findings provide a novel insight into how the formation and remodeling of primary and anterior heart field-derived structures rely on Fgf8 signals from discrete temporospatial domains.

Molecular emission in chemically active protostellar outflows

NASA Astrophysics Data System (ADS)

Lefloch, B.

2011-12-01

Protostellar outflows play an important role in the dynamical and chemical evolution of cloud through shocks. The Herschel Space Observatory (HSO) brings new insight both on the molecular content and the physical conditions in protostellar shocks through high spectral and angular resolution studies of the emission of major gas cooling agents and hydrides. The Herschel/CHESS key-program is carrying out an in depth study of the prototypical shock region L1157-B1. Analysis of the line profiles detected allows to constrain the formation/destruction route of various molecular species, in relation with the predictions of MHD shock models. The Herschel/WISH key-program investigates the properties and origin of water emission in a broad sample of protostellar outflows and envelopes. Implications of the first results for future studies on mass-loss phenomena are discussed.

Velocity Space Evolution of Dayside Reconnection Outflow

NASA Astrophysics Data System (ADS)

Broll, J. M.; Fuselier, S. A.; Trattner, K. J.

2015-12-01

Magnetic reconnection is a universal phenomenon occurring when energy stored in a complicated magnetic field topology is released into the surrounding plasma as the field simplifies its configuration. At Earth's dayside magnetopause, reconnection is responsible for mass and energy input from the solar wind into the magnetosphere. We describe the evolution of the velocity-space evolution of plasma outflow from a dayside magnetic reconnection region. We analyze Cluster magnetopause crossings between 1 and 10 Earth radii from the reconnection X-line predicted by the maximum magnetic shear model. The effects of nonadiabatic processes, such as deformation of the profile due to finite-gyroradius-induced pitch-angle scattering and wave-particle interactions, are described. We compare observations and simulation results to describe the outflow evolution and infer the field-aligned distance between an observation and the reconnection site producing it.

A Massive X-ray Outflow From The Quasar PDS 456

NASA Technical Reports Server (NTRS)

Reeves, J. N.; O'Brien, P. T.; Ward, M. J.

2003-01-01

We report on XMM-Newton spectroscopic observations of the luminous, radio-quiet quasar PDS 456. The hard X-ray spectrum of PDS 456 shows a deep absorption trough (constituting 50% of the continuum) at energies above 7 keV in the quasar rest frame, which can be attributed to a series of blue-shifted K-shell absorption edges due to highly ionized iron. The higher resolution soft X-ray grating RGS spectrum exhibits a broad absorption line feature near 1 keV, which can be modeled by a blend of L-shell transitions from highly ionized iron (Fe XVII - XXIV). An extreme outflow velocity of approx. 50000 km/s is required to model the K and L shell iron absorption present in the XMM-Newton data. Overall, a large column density (N(sub H) = 5 x 10(exp 23)/sq cm) of highly ionized gas (log xi = 2.5) is required in PDS 456. A large mass outflow rate of approx. 10 solar mass/year (assuming a conservative outflow covering factor of 0.1 steradian) is derived, which is of the same order as the overall mass accretion rate in PDS 456. This represents a substantial fraction (approx. 10%) of the quasar energy budget, whilst the large column and outflow velocity place PDS 456 towards the extreme end of the broad absorption line quasar population.

X-ray evidence for ultra-fast outflows in Seyfert galaxies

NASA Astrophysics Data System (ADS)

Tombesi, Francesco; Braito, Valentina; Reeves, James; Cappi, Massimo; Dadina, Mauro

2012-07-01

X-ray evidence for massive, highly ionized, ultra-fast outflows (UFOs) has been recently reported in a number of AGNs through the detection of blue-shifted Fe XXV/XXVI absorption lines. We present the results of a comprehensive spectral analysis of a large sample of 42 local Seyferts observed with XMM-Newton. Similar results are also obtained from a Suzaku analysis of 5 radio galaxies. We find that UFOs are common phenomena, being present in >40% of the sources. Their outflow velocity distribution is in the range ˜0.03--0.3c, with mean value of ˜0.14c. The ionization parameter is very high, in the range logξ˜3--6 erg~s^{-1}~cm, and the associated column densities are also large, in the range ˜10^{22}--10^{24} cm^{-2}. Their location is constrained at ˜0.0003--0.03pc (˜10^2--10^4 r_s) from the central black hole, consistent with what is expected for accretion disk winds/outflows. The mass outflow rates are in the interval ˜0.01--1M_{⊙}~yr^{-1}. The associated mechanical power is also high, in the range ˜10^{43}--10^{45} erg/s, which indicates that UFOs are capable to provide a significant contribution to the AGN cosmological feedback.

Quasar outflows and AGN feedback in the extreme UV: HST/COS observations of HE 0238-1904

NASA Astrophysics Data System (ADS)

Arav, Nahum; Borguet, Benoit; Chamberlain, Carter; Edmonds, Doug; Danforth, Charles

2013-12-01

Spectroscopic observations of quasar outflows at rest-frame 500-1000 Å have immense diagnostic power. We present analyses of such data, where absorption troughs from O IV and O IV* allow us to obtain the distance of the outflows from the AGN and troughs from Ne VIII and Mg X reveal the warm absorber phase of the outflow. Their inferred column densities, combined with those of O VI, N IV and H I, yield two important results. (1) The outflow shows two ionization phases, where the high-ionization phase carries the bulk of the material. This is similar to the situation seen in X-ray warm absorber studies. Furthermore, the low-ionization phase is inferred to have a volume filling factor of 10-5-10-6. (2) We determine a distance of 3000 pc from the outflow to the central source using the O IV*/O IV column density ratio and the knowledge of the ionization parameter. Since this is a typical high-ionization outflow, we can determine robust values for the outflow's mass flux and kinetic luminosity of 40 M⊙ yr-1 and 1045 erg s-1, respectively, where the latter is roughly equal to 1 per cent of the bolometric luminosity. Such a large kinetic luminosity and mass flow rate measured in a typical high-ionization wind suggest that quasar outflows are a major contributor to AGN feedback mechanisms.

Soft X-ray Emission from Large-Scale Galactic Outflows in Seyfert Galaxies

NASA Astrophysics Data System (ADS)

Colbert, E. J. M.; Baum, S.; O'Dea, C.; Veilleux, S.

1998-01-01

Kiloparsec-scale soft X-ray nebulae extend along the galaxy minor axes in several Seyfert galaxies, including NGC 2992, NGC 4388 and NGC 5506. In these three galaxies, the extended X-ray emission observed in ROSAT HRI images has 0.2-2.4 keV X-ray luminosities of 0.4-3.5 x 10(40) erg s(-1) . The X-ray nebulae are roughly co-spatial with the large-scale radio emission, suggesting that both are produced by large-scale galactic outflows. Assuming pressure balance between the radio and X-ray plasmas, the X-ray filling factor is >~ 10(4) times as large as the radio plasma filling factor, suggesting that large-scale outflows in Seyfert galaxies are predominantly winds of thermal X-ray emitting gas. We favor an interpretation in which large-scale outflows originate as AGN-driven jets that entrain and heat gas on kpc scales as they make their way out of the galaxy. AGN- and starburst-driven winds are also possible explanations if the winds are oriented along the rotation axis of the galaxy disk. Since large-scale outflows are present in at least 50 percent of Seyfert galaxies, the soft X-ray emission from the outflowing gas may, in many cases, explain the ``soft excess" X-ray feature observed below 2 keV in X-ray spectra of many Seyfert 2 galaxies.

Intermediate-term efficacy of Tm:YAG laser prostate vaporesection for bladder outlet obstruction: initial experience from a UK teaching hospital.

PubMed

Pal, Raj P; Khan, Masood A

2012-01-01

To assess the safety and clinical efficacy of Tm:YAG laser vaporesection of the prostate (ThuVaRP) at intermediate-term follow-up. We identified the first 60 consecutive patients who underwent ThuVaRP at our institute. Operative outcomes assessed were resection time, resection weight, drop in haemoglobin, transfusion rate, catheter time and complication rate. The International Prostate Symptom Score (IPSS) was documented at a mean follow-up period of 19 months postoperatively. 45/60 patients underwent treatment due to lower urinary tract symptoms secondary to benign prostatic obstruction, 11/60 patients had a long-term catheter in situ for refractory urinary retention secondary to benign prostatic obstruction, and 4/60 patients had bladder outflow obstruction secondary to adenocarcinoma of the prostate. 1/60 patients developed urosepsis, 1/60 patients developed a urinary tract infection and 1/60 patients required 3-way catheterization and irrigation due to haematuria. No patients required a blood transfusion. The mean IPSS at a mean follow-up interval of 19 months (range 15-28 months) was 5.1 (range 1-23). Postoperative maximum flow rate improved from 7.9 to 17.1 ml/s, and post-micturition residual volume decreased from 254 to 86 ml. ThuVaRP is safe and appears to have durable efficacy at intermediate follow-up. Copyright © 2011 S. Karger AG, Basel.

Multiple outflows in the bipolar planetary nebula M1-16: A molecular line study

NASA Technical Reports Server (NTRS)

Sahai, Raghvendra; Wootten, Alwyn; Schwarz, Hugo E.; Wild, W.

1994-01-01

Extensive observations of the molecular gas in the young, compact planetary nebula M1-16 have been made, using the Swedish-ESO-Submillimeter Telescope. A map of the CO J = 2-1 emission shows that the molecular envelope contains both a slow and a fast outflow with expansion velocities of 19 km/s and greater than 34 km/s, respectively. The slow outflow is mildly elliptical, while the fast molecular outflow is bipolar. This fast outflow is roughly aligned with the very fast outflows recently found in the optical, while the long axis of the slow elliptical outflow is roughly orthogonal to the optical outflow axis. The kinematic timescales for the CO fast outflow and the optical very fast outflow agree closely, supporting the view that the former represents material in the slow outflow accelerated by the very fast outflow. The kinematic signature of a disk expanding with about 15.5 km/s can also be seen in the CO J = 2-1 data. The mass-loss rate (a) for the slow outflow is greater than or equal to 2.8 x 10(exp -5) solar mass/yr and possibly as large as 9 x 10(exp -5) solar mass/yr, (b) for the fast outflow is greater than or equal to 5 x 10(exp -6) solar mass/yr, and (c) for the very fast optically visible outflow is approximately equal 5 x 10(exp -7) solar mass/yr. The disk mass is approximately equal 6 x 10(exp -3) solar mass. Grain photoelectric heating results in temperatures of 20-70 K in molecular gas of the slow outflow. The (13)C/(12)C abundance ratio in M1-16 is found to be 0.33, quite possibly the highest found for any evolved object. Upper limits for the (18)O/(16)O and (17)O/(16)O ratios were found to be consistent with the values found in AGB stars. A search for other molecular species in M1-16 resulted in the detection of the high-excitation species HCN, CN, (13)CN, HCO(+), and H(13)CO(+) and possibly N2H(+). Both the HCO(+)/HCN and CN/HCN line-intensity ratios are enhanced, the former by a very large factor, over the values found in the envelopes of AGB

Interannual variation, decadal trend, and future change in ozone outflow from East Asia

NASA Astrophysics Data System (ADS)

Zhu, Jia; Liao, Hong; Mao, Yuhao; Yang, Yang; Jiang, Hui

2017-03-01

We examine the past and future changes in the O3 outflow from East Asia using a global 3-D chemical transport model, GEOS-Chem. The simulations of Asian O3 outflow for 1986-2006 are driven by the assimilated GEOS-4 meteorological fields, and those for 2000-2050 are driven by the meteorological fields archived by the NASA Goddard Institute for Space Studies (GISS) general circulation model (GCM) 3 under the IPCC SRES A1B scenario. The evaluation of the model results against measurements shows that the GEOS-Chem model captures the seasonal cycles and interannual variations of tropospheric O3 concentrations fairly well with high correlation coefficients of 0.82-0.93 at four ground-based sites and 0.55-0.88 at two ozonesonde sites where observations are available. The increasing trends in surface-layer O3 concentrations in East Asia over the past 2 decades are captured by the model, although the modeled O3 trends have low biases. Sensitivity studies are conducted to examine the respective impacts of meteorological parameters and emissions on the variations in the outflow flux of O3. When both meteorological parameters and anthropogenic emissions varied from 1986-2006, the simulated Asian O3 outflow fluxes exhibited a statistically insignificant decadal trend; however, they showed large interannual variations (IAVs) with seasonal values of 4-9 % for the absolute percent departure from the mean (APDM) and an annual APDM value of 3.3 %. The sensitivity simulations indicated that the large IAVs in O3 outflow fluxes were mainly caused by variations in the meteorological conditions. The variations in meteorological parameters drove the IAVs in O3 outflow fluxes by altering the O3 concentrations over East Asia and by altering the zonal winds; the latter was identified to be the key factor, since the O3 outflow was highly correlated with zonal winds from 1986-2006. The simulations of the 2000-2050 changes show that the annual outflow flux of O3 will increase by 2.0, 7.9, and

Fluid outflows from Venus impact craters - Analysis from Magellan data

NASA Technical Reports Server (NTRS)

Asimow, Paul D.; Wood, John A.

1992-01-01

Many impact craters on Venus have unusual outflow features originating in or under the continuous ejecta blankets and continuing downhill into the surrounding terrain. These features clearly resulted from flow of low-viscosity fluids, but the identity of those fluids is not clear. In particular, it should not be assumed a priori that the fluid is an impact melt. A number of candidate processes by which impact events might generate the observed features are considered, and predictions are made concerning the rheological character of flows produce by each mechanism. A sample of outflows was analyzed using Magellan images and a model of unconstrained Bingham plastic flow on inclined planes, leading to estimates of viscosity and yield strength for the flow materials. It is argued that at least two different mechanisms have produced outflows on Venus: an erosive, channel-forming process and a depositional process. The erosive fluid is probably an impact melt, but the depositional fluid may consist of fluidized solid debris, vaporized material, and/or melt.

OBSERVATIONS OF MOLECULAR OUTFLOW IN CAR 291.6-01.9

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

Saul, M.; Saul, L., E-mail: msaul@phys.unsw.edu.au, E-mail: luke.saul@space.unibe.ch

We report the first observations of a dense molecular gas nebula and bipolar outflow in Car 291.6-01.9, showing characteristics of an embedded young stellar object (YSO). Using the Mopra radio telescope near Coonabarabaran, Australia, we image the kinematic structure of several emission features to examine physical properties within a molecular clump of mass {approx}3.2 {+-} 0.6 Multiplication-Sign 10{sup 3} M{sub Sun} in which a stellar cluster may be forming. Motivated by acquiring a more thorough understanding of star formation we ask what may have initiated collapse in the clump; observed outflow alignment is suggestive of {approx}1.0 pc distant massive starmore » HD 308280 radiative-driven compression as a formation trigger for the dense core. An outflow derived age of <10{sup 6} years, together with significant C{sup 18}O and SO core depletion, support the case for the core as the host of an extremely YSO cluster.« less

Acute GI obstruction.

PubMed

Hucl, Tomas

2013-10-01

Acute gastrointestinal obstruction occurs when the normal flow of intestinal contents is interrupted. The blockage can occur at any level throughout the gastrointestinal tract. The clinical symptoms depend on the level and extent of obstruction. Various benign and malignant processes can produce acute gastrointestinal obstruction, which often represents a medical emergency because of the potential for bowel ischemia leading to perforation and peritonitis. Early recognition and appropriate treatment are thus essential. The typical clinical symptoms associated with obstruction include nausea, vomiting, dysphagia, abdominal pain and failure to pass bowel movements. Abdominal distention, tympany due to an air-filled stomach and high-pitched bowel sounds suggest the diagnosis. The diagnostic process involves imaging including radiography, ultrasonography, contrast fluoroscopy and computer tomography in less certain cases. In patients with uncomplicated obstruction, management is conservative, including fluid resuscitation, electrolyte replacement, intestinal decompression and bowel rest. In many cases, endoscopy may aid in both the diagnostic process and in therapy. Endoscopy can be used for bowel decompression, dilation of strictures or placement of self-expandable metal stents to restore the luminal flow either as a final treatment or to allow for a delay until elective surgical therapy. When gastrointestinal obstruction results in ischemia, perforation or peritonitis, emergency surgery is required. Copyright © 2013. Published by Elsevier Ltd.

Suicide right ventricle after lung transplantation for pulmonary vascular disease.

PubMed

Gangahanumaiah, Shivanand; Scarr, Bronwyn C; Buckland, Mark R; Pilcher, David V; Paraskeva, Miranda A; McGiffin, David C

2018-06-19

A 27-year-old female with Eisenmenger's syndrome underwent closure of a patent ductus arteriosus, closure of a perimembranous ventricular septal defect and mid muscular defect and bilateral lung transplantation. Her immediate postoperative course was complicated by severe right ventricular outflow tract (RVOT) obstruction resulting in hemodynamic collapse, a condition described as suicide right ventricle. The patient was placed on central Veno-Arterial Extra-Corporeal Membrane Oxygenation as a bridge to the relief of RVOT obstruction which included a right ventricular outflow muscle resection and a right ventricle outflow tract patch. The patient made an uneventful recovery. © 2018 Wiley Periodicals, Inc.

Triggering a Wet Climate on Mars: The Role of Outflow Channels in Martian Water Cycles

NASA Astrophysics Data System (ADS)

Santiago, D.; Asphaug, E. I.; Colaprete, A.

2011-12-01

The triggering of a robust water cycle on Mars has been hypothesized to be caused by gigantic flooding events evidenced by outflow channels. Here we use the Ames Mars General Circulation Model (MGCM) to study how these presumably abrupt eruptions of water (Carr,1996) affected the climate of Mars. We model where the water ultimately went as part of a transient hydrologic cycle. Chryse Planitia, east of Tharsis, has evidence for multiple water outflow channels. One of the largest channels is Ares Valles, which was carved by floods with estimated water volumes of order 10^5 km^2 (Andrews-Hanna, 2007 & Carr, 1996). Outflow discharge rate estimates range from 10^6 to 10^7 m^3/seconds or greater (Andrews-Hanna & Phillips, 2007, Harrison & Grimm, 2008). Studies suggest that outflow channels formed with smaller, successive floods instead of a single large flood (Wilson, et al.,2004). Warner et al. (2009) suggest up to six outflow events for the formation of Ares Valles, while estimates for another large outflow, Kasei Valles, might have been flooded by over two thousand floods with a total water volume of 5.5 x 10^5 km^3 (Harrison & Grimm, 2008). By adding water to the surface of Mars at the given outflow rate, as an expanding one-layer lake, we are able to study quantitatively how these outflow events influenced Mars climate, particularly the hydrologic cycle. In particular: Could sudden introductions of large amounts of water on the Martian surface lead to a new equilibrated water cycle? Can we tie certain fluvial surface features to transient or sustained water cycles? What are the roles of water vapor and water ice clouds to sudden changes in the water cycle on Mars? How are radiative feedbacks involved with this? What is the ultimate fate of the outflow water? This work uses the NASA Ames MGCM version 2.1 and other schemes that are part of the NASA Ames MGCM suite of tools. Various versions of the MGCM developed at Ames have been used extensively to examine dust and

Evidence that Most BALQSO Outflows are situated at Least 100 Parsecs from the Central Source

NASA Astrophysics Data System (ADS)

Arav, Nahum; Xu, Xinfeng

2018-01-01

The most robust way for determining the distance of quasar absorption outflows is the use of troughs from ionic excited states. The column densities ratio between the excited and resonance states is a sensitive diagnostic of the outflows’ number density. Combined with a knowledge of the outflow's ionization parameter a distance can be determined. Here we report the results of two surveys targeting outflows that show troughs from S IV. One survey includes 1091 SDSS and BOSS quasar spectra, and the other includes higher quality spectra of 13 quasar observed with the Very Large Telescope.We find that at least 50% of quasar outflows are at distances larger than 100 parsecs from the central source, and at least 12% are at distances larger than 1000 parsecs. These results have profound implications to the study of the origin and acceleration mechanism of quasar outflows, and their effects on the host galaxy.

Morphometric Analysis of Aqueous Humor Outflow Structures with Spectral-Domain Optical Coherence Tomography

PubMed Central

Francis, Andrew W.; Kagemann, Larry; Wollstein, Gadi; Ishikawa, Hiroshi; Folz, Steven; Overby, Darryl R.; Sigal, Ian A.; Wang, Bo; Schuman, Joel S.

2012-01-01

Purpose. To describe morphometric details of the human aqueous humor (AH) outflow microvasculature visualized with 360-degree virtual castings during active AH outflow in cadaver eyes and to compare these structures with corrosion casting studies. Methods. The conventional AH outflow pathways of donor eyes (n = 7) and eyes in vivo (n = 3) were imaged with spectral-domain optical coherence tomography (SD-OCT) and wide-bandwidth superluminescent diode array during active AH outflow. Digital image contrast was adjusted to isolate AH microvasculature, and images were viewed in a 3D viewer. Additional eyes (n = 3) were perfused with mock AH containing fluorescent tracer microspheres to compare microvasculature patterns. Results. Observations revealed components of the conventional outflow pathway from Schlemm's canal (SC) to the superficial intrascleral venous plexus (ISVP). The superficial ISVP in both our study and corrosion casts were composed of interconnected venules (10–50 μm) forming a hexagonal meshwork. Larger radial arcades (50–100 μm) drained the region nearest SC and converged with larger tortuous vessels (>100 μm). A 360-degree virtual casting closely approximated corrosion casting studies. Tracer studies corroborated our findings. Tracer decorated several larger vessels (50–100 μm) extending posteriorly from the limbus in both raw and contrast-enhanced fluorescence images. Smaller tracer-labeled vessels (30–40 μm) were seen branching between larger vessels and exhibited a similar hexagonal network pattern. Conclusions. SD-OCT is capable of detailed morphometric analysis of the conventional outflow pathway in vivo or ex vivo with details comparable to corrosion casting techniques. PMID:22499987

Results of the application of intraoperative mitomycin C in dacryocystorhinostomy.

PubMed

Roozitalab, M H; Amirahmadi, M; Namazi, M R

2004-01-01

Dacryocystorhinostomy (DCR) is widely accepted as the procedure of choice for surgical correction of lacrimal drainage system obstruction distal to common canaliculus in adulthood. The success rate of DCR has been reported to be from 63% to 99%. DCR failure has been attributed to membranous occlusion of the rhinostomy site caused by soft tissue scarring. More recently, use of mitomycin C (MMC) has been described in lacrimal drainage surgery. The beneficial effect of MMC as a surgical adjunct is thought to be related to its potent inhibition of fibroblast proliferation. To improve the success rate of DCR, the authors used MMC as an adjunct to surgery in 130 patients with nasolacrimal duct obstruction undergoing lacrimal surgery. They were assigned randomly into a MMC DCR group and a regular DCR group (control group). The mean age of the MMC group was 40+/-15 years and that of the control group was 42+/-16 years. The standard surgical techniques of an external DCR were used in all patients of both groups. Patients were followed for 6 months. The authors evaluated the patients with subjective symptoms (improvement in tearing) and objective findings such as the height of tear meniscus, fluorescein dye test, and patency at the time of irrigation. There was no significant difference in the age between the two groups (p=1.00). Six patients in the mitomycin group were symptomatic after 6 months' follow-up; probe and irrigation showed non-patency of lacrimal system. The success rate in the MMC group was therefore 90.5% (59/65), and in the conventional group it was 92.4% (60/65). No significant difference between the two groups was present (p=0.75). The authors conclude that the use of intraoperative MMC in DCR surgery does not change the success rate of this procedure.

Spin properties of supermassive black holes with powerful outflows

NASA Astrophysics Data System (ADS)

Daly, Ruth. A.

2016-05-01

Relationships between beam power and accretion disc luminosity are studied for a sample of 55 high excitation radio galaxies (HERG), 13 low excitation radio galaxies (LERG), and 29 radio loud quasars (RLQ) with powerful outflows. The ratio of beam power to disc luminosity tends to be high for LERG, low for RLQ, and spans the full range of values for HERG. Writing general expressions for the disc luminosity and beam power and applying the empirically determined relationships allows a function that parametrizes the spins of the holes to be estimated. Interestingly, one of the solutions that is consistent with the data has a functional form that is remarkably similar to that expected in the generalized Blandford-Znajek model with a magnetic field that is similar in form to that expected in magnetically arrested disk (MAD) and advection-dominated accretion flow (ADAF) models. Values of the spin function, obtained independent of specific outflow models, suggest that spin and active galactic nucleus type are not related for these types of sources. The spin function can be used to solve for black hole spin in the context of particular outflow models, and one example is provided.

Postural Tachycardia Syndrome and Vasovagal Syncope: A Hidden Case of Obstructive Cardiomyopathy without Severe Septal Hypertrophy

PubMed Central

Ho, Natalie; Shields, Robert W.; Cremer, Paul; Rodriguez, L. Leonardo

2018-01-01

A 36-year-old female with symptoms of orthostatic intolerance and syncope was diagnosed with vasovagal syncope on a tilt table test and with postural tachycardia syndrome (POTS) after a repeat tilt table test. However, an echocardiogram at our institution revealed obstructive cardiomyopathy without severe septal hypertrophy, with a striking increase in left ventricular outflow tract gradient from 7 mmHg at rest to 75 mmHg during Valsalva, with a septal thickness of only 1.3 cm. Cardiac MRI showed an apically displaced multiheaded posteromedial papillary muscle with suggestion of aberrant chordal attachments to the anterior mitral leaflet contributing to systolic anterior motion of the mitral valve. She underwent surgery with reorientation of the posterior medial papillary muscle head, resection of the tethering secondary chordae to the A1 segment of the mitral valve, chordal shortening and tacking of the chordae to the A1 and A2 segments of the mitral valve, and gentle septal myectomy. After surgery, she had significant improvement in her prior symptoms. To our knowledge, this is the first reported case of obstructive cardiomyopathy without severe septal hypertrophy with abnormalities in papillary muscle and chordal attachment, in a patient diagnosed with vasovagal syncope and POTS. PMID:29850268

Postural Tachycardia Syndrome and Vasovagal Syncope: A Hidden Case of Obstructive Cardiomyopathy without Severe Septal Hypertrophy.