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Sample records for multiple giant coronary

  1. Technical Considerations of Giant Right Coronary Artery Aneurysm Exclusion

    PubMed Central

    Barr, James; Kourliouros, Antonios

    2016-01-01

    Giant coronary artery aneurysms are rare clinical entities. We report the case of a 49-year-old man who presented with dyspnoea and exertional chest pain. Investigations confirmed an aneurysmal right coronary artery measuring 4 cm with a fistulous communication to the right atrium. Following right atriotomy, the fistula was oversewn and the aneurysmal right coronary artery ligated at its origin and at several points along its course. A saphenous vein graft was anastomosed to the posterior descending artery. Persistent ventricular fibrillation occurred upon chest closure, attributed to ischaemia following ligation of the aneurysmal coronary artery. Emergent resternotomy and internal defibrillation were successfully performed. The sternum was stented open to reduce right ventricular strain and closed the following day. The patient made an unremarkable recovery. We here address the technical challenges associated with surgical repair of right coronary aneurysms and the physiology and management of potential complications. PMID:28018699

  2. Primary percutaneous coronary intervention for acute myocardial infarction in a pediatric patient with giant coronary aneurysm due to Kawasaki disease.

    PubMed

    Mongiovì, Maurizio; Alaimo, Annalisa; Vernuccio, Federica; Pieri, Daniele

    2014-01-01

    We report a case of acute myocardial infarction in an 8-year-old boy with a history of Kawasaki disease and giant coronary aneurysms in the right and left coronary arteries. We performed coronary angiography and percutaneous coronary intervention 4 hours after the onset of symptoms. This case suggests that primary percutaneous coronary intervention might be safe and effective in the long-term treatment of acute myocardial infarction due to coronary sequelae of Kawasaki.

  3. Congenital Giant Right Coronary Artery to Pulmonary Artery Fistula and Congenital Left Main Coronary Artery Atresia: A Case Report.

    PubMed

    Ding, Ya-Hui; Zou, Hai

    2016-02-01

    Both of congenital giant RCA, RCA to PA fistula, and CLMCA-A are one of exceedingly rare vascular abnormalities. We present the case of a 34-year-old man with multiple congenital coronary anomalies above, and a successful surgical intervention was proceeded for our patient.This is a case of a 34-year-old man presented with apical systolic murmur and exertional chest pain. Furthermore, a dilated left heart and abnormal pulmonary blood flow was observed in this patient. Coronary CTA and selective CAG showed a 15-mm diameter RCA with a fistula to pulmonary trunk and CLMCA-A. During cardiac surgery, the coronary abnormalities were confirmed and the outlet of the fistula was closed. After surgery, less chest pain, respiratory infection, and left heart failure were observed in this patient.This case illustrates that the surgery of closing the fistula between the giant RCA and pulmonary trunk could improve the symptoms and signs for this patient. It could be predicted that simplified operation could be a promising therapy for patient with giant RCA to PA fistula and CLMCA-A. Moreover, CABG should be taken full account of when myocardial ischemia was found in the blood-supply area of LAD.

  4. Two Cases of Super-Giant Coronary Aneurysms after Kawasaki Disease

    PubMed Central

    Lee, Joowon; Kwon, Bo Sang; Bae, Eun Jung; Noh, Chung Il

    2014-01-01

    Acute giant coronary aneurysm after Kawasaki disease (KD) is a catastrophic complication that can be fatal and very difficult to manage. However, no fixed consensus has been reached for the management of super-giant coronary aneurysms in the acute setting. Here, we report the successful management of young children with super-giant coronary aneurysms after KD. Based on our experience, hemodynamic stabilization to prevent further coronary dilation or rupture and strict anticoagulation to avoid thrombus formation are mandatory in the management of this condition. PMID:24497892

  5. Interposition vein graft for giant coronary aneurysm repair

    NASA Technical Reports Server (NTRS)

    Firstenberg, M. S.; Azoury, F.; Lytle, B. W.; Thomas, J. D.

    2000-01-01

    Coronary aneurysms in adults are rare. Surgical treatment is often concomitant to treating obstructing coronary lesions. However, the ideal treatment strategy is poorly defined. We present a case of successful treatment of a large coronary artery aneurysm with a reverse saphenous interposition vein graft. This modality offers important benefits over other current surgical and percutaneous techniques and should be considered as an option for patients requiring treatment for coronary aneurysms.

  6. Giant Coronary Artery Aneurysm Causing Acute Anterior Myocardial Infarction

    PubMed Central

    Yanık, Ahmet; Akçay, Murat; Menekşe, Serdar; Yazgan, Uğur Gökmen

    2016-01-01

    A 70-year-old man with hypertension was admitted to our coronary ICU with acute anterior MI. Emergent primary PCI was planned and coronary angiography was performed. LAD artery was totally occluded in the proximal segment just after a huge 32 × 26 mm sized aneurysm. Emergent CABG operation was performed in 75 minutes because of multivessel disease including the RCA and left circumflex artery. Aneurysm was ligated and coronary bypass was performed using LIMA and saphenous grafts. The postoperative course of the patient was uneventful. He was discharged with medical therapy including ASA, clopidogrel, and atorvastatin. He was asymptomatic at his polyclinic visit in the first month. PMID:27891151

  7. Strict management of a pregnant patient with giant coronary artery aneurysm due to Kawasaki disease.

    PubMed

    Taniguchi, Kosuke; Ono, Hiroshi; Sato, Anna; Kinomoto, Satoko; Tagawa, Naomi; Umehara, Nagayoshi; Kato, Hitoshi; Sago, Haruhiko

    2015-10-01

    Coronary artery aneurysms (CAA) may occur in Kawasaki disease (KD). Patients with giant CAA (diameter >8 mm), in particular, have higher risk of myocardial infarction. Previous reports have demonstrated the necessity of anticoagulation therapy in such cases. The management of patients with KD complicated by giant CAA later in life, however, remains controversial. Here, we describe the strict management in the case of a 28-year-old pregnant Japanese woman with KD with giant CAA (diameter, 11 mm). Instead of warfarin, the patient was given low-dose aspirin and i.v. unfractionated heparin during pregnancy to prevent thrombosis in the giant CAA. At 38 weeks of gestation, she had spontaneous delivery of a healthy baby. No thrombotic or bleeding complications were observed. The strict anticoagulation therapy resulted in successful pregnancy and delivery without any adverse events.

  8. A case of atypical Kawasaki disease with giant coronary artery aneurysm containing thrombus

    PubMed Central

    Attard, Montalto S; Grech, V

    2016-01-01

    Introduction Kawasaki disease (KD) is an acute febrile, systemic vasculitic syndrome of unknown etiology, occurring primarily in children younger than 5 years of age. Administration of IVIG within the first 10 days after onset of fever in combination with high dose aspirin reduces the risk of coronary artery damage in KD. Though rare, giant aneurysms of the coronary arteries may develop in untreated cases and prove extremely challenging to manage. Case Presentation A 9-month-old Caucasian boy presented to our paediatric emergency department with a 4-week history of intermittent pyrexia and irritability. Typical mucocutaneous signs of Kawasaki Disease were absent upon presentation. A trans-thoracic echocardiogram identified a giant aneurysm of the left anterior descending artery with thrombus formation in-situ and the child was managed with intravenous immunoglobulin, steroids, high dose aspirin therapy and later warfarinisation. Discussion Cardiovascular sequelae of Kawasaki disease include giant coronary artery aneurysms with thrombosis. Enlargement of a coronary aneurysm after the acute phase of Kawasaki disease is uncommon and the outcome of interventional approaches poorly studied.

  9. Recurrent Giant Cell Tumor of Skull Combined with Multiple Aneurysms

    PubMed Central

    Kim, Dae Hwan

    2016-01-01

    Giant cell tumors are benign but locally invasive and frequently recur. Giant cell tumors of the skull are extremely rare. A patient underwent a surgery to remove a tumor, but the tumor recurred. Additionally, the patient developed multiple aneurysms. The patient underwent total tumor resection and trapping for the aneurysms, followed by radiotherapy. We report this rare case and suggest some possibilities for treating tumor growth combined with aneurysm development. PMID:27195256

  10. Multiple coronary arterial loops as a cause of myocardial ischemia

    NASA Technical Reports Server (NTRS)

    Bashour, Tali T.; Mansour, Nagi N.; Lee, Damon

    1993-01-01

    A case of long-standing angina with ischemia documented by exercise testing and thallium scintigraphy in a patient who had multiple proximal loops in all three major coronary arteries in the absence of luminal stenosis, is reported.

  11. Kawasaki Disease With Giant Coronary Aneurysms Requiring a Ventricular Assist Device to Separate From Extracorporeal Membrane Oxygenation: Coronary Issues Can Be a Pediatric Problem Too!

    PubMed

    Adler, Adam C; Kodavatiganti, Ramesh

    2016-08-15

    Kawasaki disease, although common in children, may rarely affect the coronary arteries, leading to aneurysm formation and potential for coronary thrombus formation. Extremely rarely, coronary aneurysms from Kawasaki disease can thrombose, resulting in ischemic myocardium. We present a case of a 31-month-old patient requiring a left ventricular assist device after thrombosis of giant coronary aneurysms led to ischemic cardiomyopathy. At the termination of the surgical procedure, we encountered 2 periods of ventricular assist device dropout requiring intervention. With the increase in the number of pediatric patients with assist devices, we review the basic care for a patient requiring emergent surgery.

  12. A case of giant saphenous vein graft aneurysm followed serially after coronary artery bypass surgery

    PubMed Central

    Akutsu, Naotaka; Hiro, Takafumi; Oya, Toshiyuki; Fukamachi, Daisuke; Haruta, Hironori; Iida, Korehito; Kougo, Takaaki; Mineki, Takashi; Nishida, Toshihiko; Murata, Nobuhiro; Oshima, Toru; Hata, Hiroaki; Shiono, Motomi; Hirayama, Atsushi

    2016-01-01

    Abstract Saphenous vein graft aneurysm (SVGA) is one of the chronic complications after coronary aorta bypass grafting (CABG) and may be caused by atherosclerosis-like phenomena of the vein graft, weakness around the vein valve, rupturing of the suture of the graft anastomosis, or perioperative graft injury. We describe a case of a large, growing saphenous vein graft aneurysm that was followed serially by chest radiography and computed tomography. Eighteen years after CABG, an SVGA (23 × 24 mm) was incidentally detected. The patient was asymptomatic and was followed conservatively. Four years later, coronary computed tomographic angiography showed that the giant aneurysm had grown to 52.1 by 63.8 mm and revealed a second, smaller aneurysm. Finally, the SVG was ultimately resected without bypass via off-pump surgery. Therefore, this case suggested that aggressive treatment that includes surgical intervention should be considered before the aneurysm becomes larger, even if it is asymptomatic.

  13. Giant Hernia of Morgagni with Acute Coronary Syndrome: A Rare Case Report and Review of Literature.

    PubMed

    Ahmad, Munir; Al-Arifi, Ahmed; Najm, Hani K

    2015-09-01

    Hernia of Morgagni is a congenital defect of the sternal part of the diaphragm and frequently presents on the right side of the midline. The hernial sac is usually small and can be dealt with through either an abdominal approach or through a lateral thoracotomy incision. Median sternotomy as an approach to repair these defects has very rarely been described in the literature when concomitant cardiac surgical procedures were required. We report the case of a 42 year-old male with Morgagni hernia that was approached through median sternotomy because of concomitant requirement for open heart surgery. The patient presented with acute coronary syndrome necessitating urgent coronary artery bypass surgery and was found to have a giant hernia of Morgagni due to bilateral defects. This entity is very rarely described and may pose difficulty in repair due to excessive adhesions to the surrounding thoracic or mediastinal tissues. Median sternotomy seems to be the ideal approach to deal with these giant lesions. Clinical presentation of Morgagni hernia and different options for surgical repair of the defect are discussed with reference to relevant literature.

  14. Telescoping Technique to Engage Left Main Coronary Artery in a Case of Giant Aortic Aneurysm in a Geriatric Patient

    PubMed Central

    Shah, Priyank; Vasudev, Rahul; Bikkina, Mahesh; Virk, Hartaj

    2016-01-01

    We present a case of a geriatric male with giant ascending aortic aneurysm (AAA) who underwent successful coronary angiography using telescoping technique for evaluation his coronary arteries before surgery for AAA. Since the ascending aorta and root were extremely dilated, we knew it would not have been possible to engage the coronaries using regular catheters and standard technique. Hence, telescopic technique was used. Amplatz left 3 (AL3) 7F (French) guide catheter (90 cm) was initially used, and nonselective injection of contrast was done to see the coronary ostium. After that, a 5F multipurpose catheter (110 cm) was telescoped through 7F AL3 guide catheter to engage the ostium of the left main coronary artery. Using this technique, images of coronaries were obtained, and it showed minimal luminal irregularities in major epicardial coronary arteries. The patient underwent successful surgery with aortic valve replacement and excision of aneurysm with graft placement. Although this technique has been described previously in enlarged aortas, this is the first to our knowledge use of telescoping technique in giant aortic aneurysm in a geriatric patient. PMID:27833782

  15. Multiple Coronary Artery Microfistulas in a Girl with Kleefstra Syndrome

    PubMed Central

    Vargiami, Euthymia; Ververi, Athina; Al-Mutawa, Hamda; Gioula, Georgia; Gerou, Spyridon; Rouvalis, Fotios; Kambouris, Marios; Zafeiriou, Dimitrios I.

    2016-01-01

    Kleefstra syndrome is characterized by hypotonia, developmental delay, dysmorphic features, congenital heart defects, and so forth. It is caused by 9q34.3 microdeletions or EHMT1 mutations. Herein a 20-month-old girl with Kleefstra syndrome, due to a de novo subterminal deletion, is described. She exhibits a rare and complex cardiopathy, encompassing multiple coronary artery microfistulas, VSD/ASD, and PFO. PMID:27239352

  16. Multiple Outflows in the Giant Eruption of a Massive Star

    NASA Astrophysics Data System (ADS)

    Humphreys, Roberta M.; Martin, John C.; Gordon, Michael S.; Jones, Terry J.

    2016-08-01

    The supernova impostor PSN J09132750+7627410 in NGC 2748 reached a maximum luminosity of ≈-14 mag. It was quickly realized that it was not a true supernova, but another example of a nonterminal giant eruption. PSN J09132750+7627410 is distinguished by multiple P Cygni absorption minima in the Balmer emission lines that correspond to outflow velocities of -400, -1100, and -1600 km s-1. Multiple outflows have been observed in only a few other objects. In this paper we describe the evolution of the spectrum and the P Cygni profiles for 3 months past maximum, the post-maximum formation of a cool, dense wind, and the identification of a possible progenitor. One of the possible progenitors is an infrared source. Its pre-eruption spectral energy distribution suggests a bolometric luminosity of -8.3 mag and a dust temperature of 780 K. If it is the progenitor, it is above the AGB limit, unlike the intermediate-luminosity red transients. The three P Cygni profiles could be due to ejecta from the current eruption, the wind of the progenitor, or previous mass-loss events. We suggest that they were all formed as part of the same high-mass-loss event and are due to material ejected at different velocities or energies. We also suggest that multiple outflows during giant eruptions may be more common than reported. Based on observations obtained with the Large Binocular Telescope (LBT), an international collaboration among institutions in the United States, Italy, and Germany. LBT Corporation partners are the University of Arizona on behalf of the Arizona university system; Istituto Nazionale di Astrofisica, Italy; LBT Beteiligungsgesellschaft, Germany, representing the Max-Planck Society, the Astrophysical Institute Potsdam, and Heidelberg University; The Ohio State University and The Research Corporation, on behalf of the University of Notre Dame, University of Minnesota, and University of Virginia.

  17. Gallstone ileus with a giant stone and associated multiple stones.

    PubMed

    Ozbalci, G S; Tanrikulu, Y; Kismet, K; Dinc, S; Akkus, M A

    2012-01-01

    Gallstone ileus is an uncommon cause of small bowel obstruction. Gallstone ileus accounts for only about 1-3 % of cases of mechanical obstructions of the small bowel. It usually occurs in the elderly with a female predominance and may result in high mortality rates. The diagnosis is difficult and early diagnosis reduces the mortality. Terminal ileum is the most common site of gallstone impaction. We report a case of gallstone ileus in an 81-year-old female patient who was admitted to our clinic for abdominal pain, vomiting and constipation. The ultrasonography of abdomen revealed a decrease in bowel motion, and dilated bowel segments. Intraoperatively, a giant gallstone and associated multiple stones were found in the ileum 80 cm from the ileocecal valve and extracted from a longitudinal enterotomy (Fig. 4, Ref. 24).

  18. Coronary CT angiography (cCTA): automated registration of coronary arterial trees from multiple phases.

    PubMed

    Hadjiiski, Lubomir; Zhou, Chuan; Chan, Heang-Ping; Chughtai, Aamer; Agarwal, Prachi; Kuriakose, Jean; Kazerooni, Ella; Wei, Jun; Patel, Smita

    2014-08-21

    Coronary computed tomography angiography (cCTA) is a commonly used imaging modality for the evaluation of coronary artery disease. cCTA is generally reconstructed in multiple cardiac phases because different coronary arteries may be better visualized in some phases than in others due to the periodic cardiac motion. We are developing an automated registration method for coronary arterial trees from multiple-phase cCTA that has potential application in building a 'best-quality' tree to facilitate image analysis and detection of stenotic plaques. Given the segmented left or right coronary arterial (LCA or RCA) trees from the multiple phases as input, the adjacent phase pairs, where displacements are relatively small, are registered by a specifically designed method based on a cubic B-spline with fast localized optimization (CBSO). For the phase pairs with large displacements, a global registration using an affine transform with quadratic terms and nonlinear simplex optimization (AQSO) is followed by a local registration using CBSO to refine the AQSO registered volumes. 26 LCA and 26 RCA trees with six cCTA phases from 26 patients were used for registration evaluation. The average distances for the tree pairs between the adjacent phases with small displacements before and after CBSO registration were 0.96  ±  0.79 and 0.76  ±  0.61 mm respectively for LCA, and 0.93  ±  0.97 and 0.64  ±  0.43 mm, respectively for RCA. The average distance differences before and after registration were statistically significant (p < 0.001) for both LCA and RCA trees. The average distances for the distant phases with large displacements before registration, after AQSO registration, and finally after the CBSO registration were 2.85  ±  1.46, 1.62  ±  0.76, and 0.97  ±  0.43 mm, respectively for LCA, and 4.03  ±  2.36, 2.18  ±  1.11, and 0.97  ±  0.44 mm, respectively for RCA. The average distance differences

  19. Coronary CT angiography (cCTA): automated registration of coronary arterial trees from multiple phases

    NASA Astrophysics Data System (ADS)

    Hadjiiski, Lubomir; Zhou, Chuan; Chan, Heang-Ping; Chughtai, Aamer; Agarwal, Prachi; Kuriakose, Jean; Kazerooni, Ella; Wei, Jun; Patel, Smita

    2014-08-01

    Coronary computed tomography angiography (cCTA) is a commonly used imaging modality for the evaluation of coronary artery disease. cCTA is generally reconstructed in multiple cardiac phases because different coronary arteries may be better visualized in some phases than in others due to the periodic cardiac motion. We are developing an automated registration method for coronary arterial trees from multiple-phase cCTA that has potential application in building a ‘best-quality’ tree to facilitate image analysis and detection of stenotic plaques. Given the segmented left or right coronary arterial (LCA or RCA) trees from the multiple phases as input, the adjacent phase pairs, where displacements are relatively small, are registered by a specifically designed method based on a cubic B-spline with fast localized optimization (CBSO). For the phase pairs with large displacements, a global registration using an affine transform with quadratic terms and nonlinear simplex optimization (AQSO) is followed by a local registration using CBSO to refine the AQSO registered volumes. 26 LCA and 26 RCA trees with six cCTA phases from 26 patients were used for registration evaluation. The average distances for the tree pairs between the adjacent phases with small displacements before and after CBSO registration were 0.96  ±  0.79 and 0.76  ±  0.61 mm respectively for LCA, and 0.93  ±  0.97 and 0.64  ±  0.43 mm, respectively for RCA. The average distance differences before and after registration were statistically significant (p < 0.001) for both LCA and RCA trees. The average distances for the distant phases with large displacements before registration, after AQSO registration, and finally after the CBSO registration were 2.85  ±  1.46, 1.62  ±  0.76, and 0.97  ±  0.43 mm, respectively for LCA, and 4.03  ±  2.36, 2.18  ±  1.11, and 0.97  ±  0.44 mm, respectively for RCA. The average distance differences between every two

  20. Automated registration of coronary arterial trees from multiple phases in coronary CT angiography (cCTA)

    NASA Astrophysics Data System (ADS)

    Hadjiiski, Lubomir; Zhou, Chuan; Chan, Heang-Ping; Chughtai, Aamer; Agarwal, Prachi; Kuriakose, Jean; Patel, Smita; Wei, Jun; Kazerooni, Ella

    2013-03-01

    We are developing an automated registration method for coronary arterial trees from multiple-phase cCTA to build a best-quality tree to facilitate detection of stenotic plaques. Cubic B-spline with fast localized optimization (CBSO) is designed to register the initially segmented left and right coronary arterial trees (LCA or RCA) separately in adjacent phase pairs where displacements are small. First, the corresponding trees in phase 1 and 2 are registered. The phase 3 tree is then registered to the combined tree. Similarly the trees in phases 4, 5, and 6 are registered. An affine transform with quadratic terms and nonlinear simplex optimization (AQSO) is designed to register the trees between phases with large displacements, namely, registering the combined tree from phases 1, 2, and 3 to that from phases 4, 5, and 6. Finally, CBSO is again applied to the AQSO registered volumes for final refinement. The costs determined by the distances between the vessel centerlines, bifurcation points and voxels of the trees are minimized to guide both CBSO and AQSO registration. The registration performance was evaluated on 22 LCA and 22 RCA trees on 22 CTA scans with 6 phases from 22 patients. The average distance between the centerlines of the registered trees was used as a registration quality index. The average distances for LCA and RCA registration for 6 phases and 22 patients were 1.49 and 1.43 pixels, respectively. This study demonstrates the feasibility of using automated method for registration of coronary arterial trees from multiple cCTA phases.

  1. Multiple giant duodenal ulcers associated with duodenal gastrinoma.

    PubMed

    Fujihara, Shintaro; Mori, Hirohito; Nishiyama, Noriko; Kobayashi, Mitsuyoshi; Kobara, Hideki; Masaki, Tsutomu

    2012-02-01

    A 59-year-old Japanese man with a history of chronic hepatitis C and cirrhosis was admitted to hospital because of severe abdominal pain and diarrhea. His discomfort had begun 2 months earlier and was localized to the upper abdomen. Upper gastrointestinal endoscopy showed multiple ulcerative lesions from the duodenal bulb to the descending part of the duodenum, one of which was a giant ulcer that filled half of the intestinal lumen. Despite continuous intravenous lansoprazole therapy, his abdominal symptoms did not improve. Upper gastrointestinal endoscopy was again performed to detect the tumor, but it was difficult to observe the tumor with a conventional endoscope. We then inverted a transnasal endoscope into the duodenum, and this enabled us to detect a 15-mm submucosal tumor in the upper wall of the duodenal bulb. Examination of specimens from endoscopic ultrasonography fine-needle aspiration biopsy of the tumor revealed gastrinoma in the duodenal bulb. We decided to perform an operative resection. The patient's symptoms resolved after surgery, and he remained asymptomatic at follow-up 18 months later. Therefore, when it is difficult to detect the tumor directly by conventional endoscopy, we recommend that attempts be made to detect the tumor by inverting a transnasal endoscope into the duodenal bulb.

  2. Giant viruses: The difficult breaking of multiple epistemological barriers.

    PubMed

    Claverie, Jean-Michel; Abergel, Chantal

    2016-10-01

    The discovery of the first "giant virus", Mimivirus, in 2003 could solely have been that of an exceptional freak, a blind alley of evolution as occasionally encountered in biology, albeit without conceptual significance. On the contrary, once broken this epistemological barrier, additional unrelated families of giant viruses such as the Pandoraviruses, the Pithoviruses and most recently Mollivirus, were quickly unraveled, suggesting that an entire chapter of microbiology had been ignored since Pasteur and Ivanovski. In this article, we examine to what extent the giant viruses challenge previous definitions of viruses, the diversity of forms they could take, and how they might have evolved from extinct ancestral cellular lineages. Inspired by the epistemology of Gaston Bachelard, we will also suggest the reasons for which giant viruses laid hidden in plain sight for more than a century. Finally, we propose a new definition for "viruses" that paradoxically emphasize the fact that they do not encode a single universally shared macromolecule or biochemical function.

  3. Giant aneurysm of the left anterior descending coronary artery in a pediatric patient with Behcet's disease.

    PubMed

    Cook, Amanda L; Rouster-Stevens, Kelly; Williams, Derek A; Hines, Michael H

    2010-07-01

    Behcet's disease is a rare autoimmune vasculitis characterized by oral aphthosis, genital ulcers, and ocular and cutaneous lesions. Vascular involvement usually affects the veins more commonly than the arteries, and coronary arterial involvement is extremely rare. We report an adolescent with Behcet's disease who developed a large pseudoaneurysm of the left anterior descending coronary artery requiring a coronary arterial bypass graft.

  4. Multiple coronary artery-left ventricular fistulas associated with hereditary hemorrhagic telangiectasia.

    PubMed

    Jacob, M A; Goyal, S B; Pacifico, L; Spodick, D H

    2001-10-01

    Coronary artery-left ventricular (LV) fistulas are extremely rare and can cause myocardial ischemia from coronary steal. We describe an elderly woman who presented with unstable angina from multiple and extensive coronary artery-LV fistulas. She also had clinical features suggestive of hereditary hemorrhagic telangiectasia (HHT). Association of coronary artery-LV fistulas with HHT has not been reported and can pose a management dilemma in view of the risks of extensive cardiopulmonary surgery and potential complications of myocardial ischemia, stroke, and brain abscess.

  5. Giant right coronary artery aneurysm secondary to Kawasaki disease in child: a case report.

    PubMed

    Zhang, Shanshan; Liu, Geli; Yu, Tielian; Zhou, Guiming; Zheng, Rongxiu

    2015-01-01

    Coronary artery aneurysm or ectasia was reported in approximately 15% to 25% of the affected children, particularly in the proximal end of the main blood vessel and the left anterior descending part. Rare patients have been reported with aneurysm in the distal end of the right coronary artery. In this case report, we present a rare case with aneurysm in the distal end of the right coronary artery. Multi-slice computed tomography was performed for the coronary angiography. Aspirin (10 mg/kg body weight per day) and gamma globulin (2 kg/kg body weight) was administrated via intravenous injection. The patient is currently in a healthy status with a 12-month follow up.

  6. Giant viruses, giant chimeras: The multiple evolutionary histories of Mimivirus genes

    PubMed Central

    2008-01-01

    Background Although capable to evolve, viruses are generally considered non-living entities because they are acellular and devoid of metabolism. However, the recent publication of the genome sequence of the Mimivirus, a giant virus that parasitises amoebas, strengthened the idea that viruses should be included in the tree of life. In fact, the first phylogenetic analyses of a few Mimivirus genes that are also present in cellular lineages suggested that it could define an independent branch in the tree of life in addition to the three domains, Bacteria, Archaea and Eucarya. Results We tested this hypothesis by carrying out detailed phylogenetic analyses for all the conserved Mimivirus genes that have homologues in cellular organisms. We found no evidence supporting Mimivirus as a new branch in the tree of life. On the contrary, our phylogenetic trees strongly suggest that Mimivirus acquired most of these genes by horizontal gene transfer (HGT) either from its amoebal hosts or from bacteria that parasitise the same hosts. The detection of HGT events involving different eukaryotic donors suggests that the spectrum of hosts of Mimivirus may be larger than currently known. Conclusion The large number of genes acquired by Mimivirus from eukaryotic and bacterial sources suggests that HGT has been an important process in the evolution of its genome and the adaptation to parasitism. PMID:18205905

  7. Coronary Artery Disease - Multiple Languages: MedlinePlus

    MedlinePlus

    ... sharing features on this page, please enable JavaScript. Arabic (العربية) Bosnian (Bosanski) Chinese - Simplified (简体中文) Chinese - Traditional ( ... español) Tagalog (Tagalog) Ukrainian (Українська) Vietnamese (Tiếng Việt) Arabic (العربية) Coronary Artery Disease (CAD) (Arabic) (CAD) تصلب ...

  8. Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is ... bypass multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of ...

  9. Unstable angina pectoris secondary to multiple calcified coronary artery masses. Successful treatment with coronary artery bypass surgery.

    PubMed

    Przybojewski, J Z; Barnard, P M; Van der Walt, J J; Botha, J A

    1986-05-24

    A 31-year-old doctor's wife suffered from severe unstable angina pectoris (AP) due to two large, heavily calcified masses involving the right coronary artery and the left anterior descending branch of the left coronary artery. The causes of the masses could not be determined with certainty, but in view of the history (which included the ingestion of large quantities of raw boerewors (traditional spiced sausage) and histopathological findings, we believe that they were coronary artery aneurysms which developed secondary to coronary arteritis many years previously. The possibility of echinococcal (hydatid) infection is also discussed. Cardiac surgery entailed total excision of both masses, together with sections of their accompanying coronary arteries which had become fibrotic as a result of the arteritis, and reestablishment of coronary blood flow by the insertion of two saphenous vein coronary artery bypass grafts. Her AP was dramatically relieved and she continues to be asymptomatic without taking anti-anginal drugs.

  10. Multiple populations along the asymptotic giant branch of the globular cluster M4

    NASA Astrophysics Data System (ADS)

    Lardo, C.; Salaris, M.; Savino, A.; Donati, P.; Stetson, P. B.; Cassisi, S.

    2017-04-01

    Nearly all Galactic globular clusters host stars that display characteristic abundance anticorrelations, like the O-rich/Na-poor pattern typical of field halo stars, together with O-poor/Na-rich additional components. A recent spectroscopic investigation questioned the presence of O-poor/Na-rich stars amongst a sample of asymptotic giant branch (AGB) stars in the cluster M4, at variance with the spectroscopic detection of a O-poor/Na-rich component along both the cluster red giant branch (RGB) and horizontal branch. This is contrary to what is expected from the cluster horizontal branch morphology and horizontal branch stellar evolution models. Here, we have investigated this issue by employing the CUBI = (U - B) - (B - I) index, that previous studies have demonstrated to be very effective in separating multiple populations along both the RGB and AGB sequences. We confirm previous results that the RGB is intrinsically broad in the V-CUBI diagram, with the presence of two components that nicely correspond to the two populations identified by high-resolution spectroscopy. We find that AGB stars are distributed over a wide range of CUBI values, in close analogy with what is observed for the RGB, demonstrating that the AGB of M4 also hosts multiple stellar populations.

  11. HUBBLE SPACE TELESCOPE REVEALS MULTIPLE SUB-GIANT BRANCH IN EIGHT GLOBULAR CLUSTERS

    SciTech Connect

    Piotto, G.; Nascimbeni, V.; Milone, A. P.; Aparicio, A.; Anderson, J.; Bellini, A.; Bedin, L. R.; Cassisi, S.; Marino, A. F. E-mail: luigi.bedin@oapd.inaf.it E-mail: aparicio@iac.es E-mail: bellini@stsci.edu E-mail: amarino@MPA-Garching.MPG.DE

    2012-11-20

    In the last few years many globular clusters (GCs) have revealed complex color-magnitude diagrams, with the presence of multiple main sequences (MSs), broad or multiple sub-giant branches (SGBs) and MS turnoffs, and broad or split red giant branches (RGBs). After a careful correction for differential reddening, high-accuracy photometry with the Hubble Space Telescope (HST) presented in this paper reveals a broadened or even split SGB in five additional Milky Way GCs: NGC 362, NGC 5286, NGC 6656, NGC 6715, and NGC 7089. In addition, we confirm (with new and archival HST data) the presence of a split SGB in 47 Tuc, NGC 1851, and NGC 6388. The fraction of faint SGB stars with respect to the entire SGB population varies from one cluster to another and ranges from {approx}0.03 for NGC 362 to {approx}0.50 for NGC 6715. The average magnitude difference between the bright SGB and the faint SGB is almost the same at different wavelengths. This peculiarity is consistent with the presence of two groups of stars with either an age difference of about 1-2 Gyr or a significant difference in their overall C+N+O content.

  12. Nonlinear SU(2,1) Model of Multiple Giant Dipole Resonance Coulomb Excitation

    NASA Astrophysics Data System (ADS)

    Hussein, Mahir; de Toledo Piza, Antonio; Vorov, Oleg

    2000-10-01

    We construct a three-dimensional analytically soluble model of the nonlinear effects in Coulomb excitation of multiphonon Giant Dipole Resonances (GDR) based on the SU(2,1) algebra^1. Analytical expressions for the multi-phonon transition probabilities are derived. For reasonably small magnitude of nonlinearity x~= 0.15-0.3, the enhancement factor for the Double Giant Resonance excitation probabilities and the cross sections reaches values 1.3-2 compatible^1,2 with experimental data from relativistic ion collision experiments^3. The full 3-dimensional model predicts enhancement of the multiple GDR cross sections at low and high bombarding energies (with the minimum at ~= 1.3 GeV for the Pb+Pb colliding system). Enhancement factors for Double GDR measured in thirteen different processes with various projectiles and targets at different bombarding energies are well reproduced with the same value of the nonlinearity parameter with the exception of the anomalous case of ^136Xe which requires a larger value. The work has been supported by the FAPESP and by the CNPq. References ^1 M. S. Hussein, A. F. R. de Toledo Piza and O. K.Vorov, Ann. Phys. (N.Y.), 2000, to appear. ^2 M. S. Hussein, A. F. R. de Toledo Piza and O. K.Vorov, Phys. Rev. C59,R1242 (1999). ^3 T. Aumann, P.F. Bortignon, and H. Emling, Annu. Rev. Nucl. Part. Sci. 48, 351 (1998).

  13. Exercise training enhances multiple mechanisms of relaxation in coronary arteries from ischemic hearts

    PubMed Central

    Deer, Rachel R.

    2013-01-01

    Exercise training of coronary artery disease patients is of considerable interest, since it has been shown to improve vascular function and, thereby, enhance blood flow into compromised myocardial regions. However, the mechanisms underlying exercise-induced improvements in vascular function have not been fully elucidated. We tested the hypothesis that exercise training increases the contribution of multiple mediators to endothelium-dependent relaxation of coronary arteries in the underlying setting of chronic coronary artery occlusion. To induce gradual occlusion, an ameroid constrictor was placed around the proximal left circumflex coronary artery in Yucatan miniature swine. At 8 wk postoperatively, pigs were randomly assigned to sedentary or exercise (treadmill, 5 days/wk) regimens for 14 wk. Exercise training significantly enhanced the contribution of nitric oxide, prostanoids, and large-conductance Ca2+-dependent K+ (BKCa) channels to endothelium-dependent, bradykinin-mediated relaxation in nonoccluded and collateral-dependent arteries. Combined nitric oxide synthase, prostanoid, and BKCa channel inhibition ablated the enhanced relaxation associated with exercise training. Exercise training significantly increased nitric oxide levels in response to bradykinin in endothelial cells isolated from nonoccluded and collateral-dependent arteries. Bradykinin treatment significantly increased PGI2 levels in all artery treatment groups and tended to be further enhanced after nitric oxide synthase inhibition in exercise-trained pigs. No differences were found in whole cell BKCa channel currents, BKCa channel protein levels, or arterial cyclic nucleotide levels. Although redundant, upregulation of parallel vasodilator pathways appears to contribute to enhanced endothelium-dependent relaxation, potentially providing a more refined control of blood flow after exercise training. PMID:23997097

  14. Automated identification of best-quality coronary artery segments from multiple-phase coronary CT angiography (cCTA) for vessel analysis

    NASA Astrophysics Data System (ADS)

    Zhou, Chuan; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Chughtai, Aamer; Wei, Jun; Kazerooni, Ella A.

    2016-03-01

    We are developing an automated method to identify the best quality segment among the corresponding segments in multiple-phase cCTA. The coronary artery trees are automatically extracted from different cCTA phases using our multi-scale vessel segmentation and tracking method. An automated registration method is then used to align the multiple-phase artery trees. The corresponding coronary artery segments are identified in the registered vessel trees and are straightened by curved planar reformation (CPR). Four features are extracted from each segment in each phase as quality indicators in the original CT volume and the straightened CPR volume. Each quality indicator is used as a voting classifier to vote the corresponding segments. A newly designed weighted voting ensemble (WVE) classifier is finally used to determine the best-quality coronary segment. An observer preference study is conducted with three readers to visually rate the quality of the vessels in 1 to 6 rankings. Six and 10 cCTA cases are used as training and test set in this preliminary study. For the 10 test cases, the agreement between automatically identified best-quality (AI-BQ) segments and radiologist's top 2 rankings is 79.7%, and between AI-BQ and the other two readers are 74.8% and 83.7%, respectively. The results demonstrated that the performance of our automated method was comparable to those of experienced readers for identification of the best-quality coronary segments.

  15. RED GIANTS IN ECLIPSING BINARY AND MULTIPLE-STAR SYSTEMS: MODELING AND ASTEROSEISMIC ANALYSIS OF 70 CANDIDATES FROM KEPLER DATA

    SciTech Connect

    Gaulme, P.; McKeever, J.; Rawls, M. L.; Jackiewicz, J.; Mosser, B.; Guzik, J. A.

    2013-04-10

    Red giant stars are proving to be an incredible source of information for testing models of stellar evolution, as asteroseismology has opened up a window into their interiors. Such insights are a direct result of the unprecedented data from space missions CoRoT and Kepler as well as recent theoretical advances. Eclipsing binaries are also fundamental astrophysical objects, and when coupled with asteroseismology, binaries provide two independent methods to obtain masses and radii and exciting opportunities to develop highly constrained stellar models. The possibility of discovering pulsating red giants in eclipsing binary systems is therefore an important goal that could potentially offer very robust characterization of these systems. Until recently, only one case has been discovered with Kepler. We cross-correlate the detected red giant and eclipsing-binary catalogs from Kepler data to find possible candidate systems. Light-curve modeling and mean properties measured from asteroseismology are combined to yield specific measurements of periods, masses, radii, temperatures, eclipse timing variations, core rotation rates, and red giant evolutionary state. After using three different techniques to eliminate false positives, out of the 70 systems common to the red giant and eclipsing-binary catalogs we find 13 strong candidates (12 previously unknown) to be eclipsing binaries, one to be a non-eclipsing binary with tidally induced oscillations, and 10 more to be hierarchical triple systems, all of which include a pulsating red giant. The systems span a range of orbital eccentricities, periods, and spectral types F, G, K, and M for the companion of the red giant. One case even suggests an eclipsing binary composed of two red giant stars and another of a red giant with a {delta}-Scuti star. The discovery of multiple pulsating red giants in eclipsing binaries provides an exciting test bed for precise astrophysical modeling, and follow-up spectroscopic observations of many

  16. Simultaneous thrombosis of multiple coronary arteries in a patient with rheumatoid arthritis

    PubMed Central

    Kalayci, Arzu; Arslan, Erol; Bakar, Salih Murat; Guneri, Mahmut; Dizman, Rafet; Kivanc, Eylem; Karabay, Can Yucel

    2016-01-01

    We present a case of simultaneous coronary thrombosis of the left main, the left anterior descending artery and the right coronary artery in a patient, recently diagnosed with rheumatoid arthritis. PMID:27489603

  17. Numerical and experimental investigations of the flow-pressure relation in multiple sequential stenoses coronary artery.

    PubMed

    Li, S; Chin, Cheng; Thondapu, Vikas; Poon, Eric K W; Monty, Jason P; Li, Yingguang; Ooi, Andrew S H; Tu, Shengxian; Barlis, Peter

    2017-02-20

    Virtual fractional flow reserve (vFFR) has been evaluated as an adjunct to invasive fractional flow reserve (FFR) in the light of its operational and economic benefits. The accuracy of vFFR and the complexity of hyperemic flow simulation are still not clearly understood. This study investigates the flow-pressure relation in an idealised multiple sequential stenoses coronary artery model via numerical and experimental approaches. Pressure drop is linearly correlated with flow rate irrespective of the number of stenosis. Computational fluid dynamics results are in good agreement with the experimental data, demonstrating reasonable accuracy of vFFR. It was also found that the difference between data obtained with steady and pulsatile flows is negligible, indicating the steady flow may be used instead of pulsatile flow conditions in vFFR computation. This study adds to the current understanding of vFFR and may improve its clinical applicability as an adjunct to invasively determined FFR.

  18. [Coronary angioplasty of multiple vessels and lesions in unstable functional class-IV angina].

    PubMed

    Frutos Rangel, E; García García, R; Fernández Valadez, E; Zúñiga Sedano, J; Verduzco Bazavilvazo, S; Siordia Zamorano, R; García y Otero, J M

    1991-01-01

    A select group of 26, class IV unstable angina patients that had multiple lesions or multivessel disease were treated with percutaneous transluminal coronary angioplasty (PTCA). Complete revascularization was the endpoint in all patients. Seventy lesions were dilated (mean = 2.6 lesions per patient). In the tandem multi-lesion group (13 patients) 2.23 lesions per patient were approached (Range 2-3) and in the multivessel disease group (13 patients) a mean of 3.15 lesions per patient were attempted (Range 2-6). An overall success rate of 96% per patient (25/26 patients) and 95.7% primary success per lesion were achieved with no mortality. We report the results of a select group of unstable angina patients with multi-lesion or multivessel disease who underwent PTCA. A careful performance was associated with high primary success in the high risk group achieving clinical and angiographic improvement.

  19. Systematic review of randomised controlled trials of multiple risk factor interventions for preventing coronary heart disease.

    PubMed Central

    Ebrahim, S.; Smith, G. D.

    1997-01-01

    OBJECTIVE: To assess the effectiveness of multiple risk factor intervention in reducing cardiovascular risk factors, total mortality, and mortality from coronary heart disease among adults. DESIGN: Systematic review and meta-analysis of randomised controlled trials in workforces and in primary care in which subjects were randomly allocated to more than one of six interventions (stopping smoking, exercise, dietary advice, weight control, antihypertensive drugs, and cholesterol lowering drugs) and followed up for at least six months. SUBJECTS: Adults aged 17-73 years, 903000 person years of observation were included in nine trials with clinical event outcomes and 303000 person years in five trials with risk factor outcomes alone. MAIN OUTCOME MEASURES: Changes in systolic and diastolic blood pressure, smoking rates, blood cholesterol concentrations, total mortality, and mortality from coronary heart disease. RESULTS: Net decreases in systolic and diastolic blood pressure, smoking prevalence, and blood cholesterol were 4.2 mm Hg (SE 0.19 mm Hg), 2.7 mm Hg (0.09 mm Hg), 4.2% (0.3%), and 0.14 mmol/l (0.01 mmol/l) respectively. In the nine trials with clinical event end points the pooled odds ratios for total and coronary heart disease mortality were 0.97 (95% confidence interval 0.92 to 1.02) and 0.96 (0.88 to 1.04) respectively. Statistical heterogeneity between the studies with respect to changes in mortality and risk factors was due to trials focusing on hypertensive participants and those using considerable amounts of drug treatment, with only these trials showing significant reductions in mortality. CONCLUSIONS: The pooled effects of multiple risk factor intervention on mortality were insignificant and a small, but potentially important, benefit of treatment (about a 10% reduction in mortality) may have been missed. Changes in risk factors were modest, were related to the amount of pharmacological treatment used, and in some cases may have been overestimated

  20. Acute coronary syndrome: a rare case of multiple endocrine neoplasia syndromes with pheochromocytoma and medullary thyroid carcinoma

    PubMed Central

    Maloberti, Alessadro; Meani, Paolo; Pirola, Roberto; Varrenti, Marisa; Boniardi, Marco; De Biase, Anna Maria; Vallerio, Paola; Bonacina, Edgardo; Mancia, Giuseppe; Loli, Paola; Giannattasio, Cristina

    2015-01-01

    Pheochromocytoma is a tumor arising from neuroectodermal chromaffin tissues in the adrenal gland or extra-adrenal paraganglia (paragangliomas). The prevalence of the tumor is 0.1%-0.6% in the hypertensive population, of which 10%-20% are malignant. Pheochromocytoma produces, stores, and secretes catecholamines, as well as leads to hypertensive crisis, arrhythmia, angina, and acute myocardial infarction without coronary artery diseases. We report a case of acute coronary syndrome (ACS) with a final diagnosis of multiple endocrine neoplasia with pheochromocytoma and medullary thyroid carcinoma (MTC). PMID:26487970

  1. Acute coronary syndrome: a rare case of multiple endocrine neoplasia syndromes with pheochromocytoma and medullary thyroid carcinoma.

    PubMed

    Maloberti, Alessadro; Meani, Paolo; Pirola, Roberto; Varrenti, Marisa; Boniardi, Marco; De Biase, Anna Maria; Vallerio, Paola; Bonacina, Edgardo; Mancia, Giuseppe; Loli, Paola; Giannattasio, Cristina

    2015-09-01

    Pheochromocytoma is a tumor arising from neuroectodermal chromaffin tissues in the adrenal gland or extra-adrenal paraganglia (paragangliomas). The prevalence of the tumor is 0.1%-0.6% in the hypertensive population, of which 10%-20% are malignant. Pheochromocytoma produces, stores, and secretes catecholamines, as well as leads to hypertensive crisis, arrhythmia, angina, and acute myocardial infarction without coronary artery diseases. We report a case of acute coronary syndrome (ACS) with a final diagnosis of multiple endocrine neoplasia with pheochromocytoma and medullary thyroid carcinoma (MTC).

  2. Analysis on the evolution process of BFW-like model with discontinuous percolation of multiple giant components

    NASA Astrophysics Data System (ADS)

    Zhang, Renquan; Wei, Wei; Guo, Binghui; Zhang, Yang; Zheng, Zhiming

    2013-03-01

    Recently, the modified BFW model on random graphs [W. Chen, R.M. D’Souza, Phys. Rev. Lett. 106 (2011) 115701], which shows a discontinuous percolation transition with multiple giant components, has attracted much attention from physicists and statisticians. In this paper, by establishing the evolution equations on the modified BFW model, the evolution process and steady-states on both random graphs and finite-dimensional lattices are analyzed. On a random graph, by varying the edge accepted rate α, the system stabilizes in a steady-state with different numbers of giant components. Moreover, a close correspondence is built between the values of α and the number of giant components in steady-states, the efficiency of which is verified by the numerical simulations. Then, the sizes of giant components for different evolution strategies can be obtained by solving some constraints derived from the evolution equations. Meanwhile, a similar analysis is expanded to finite-dimensional lattices, and we find the BFW (α) model on a finite-dimensional lattice has different steady-states from those on a random graph, but they have the same evolution mechanism. The analysis of the evolution process and steady-state is of great help to explain the properties of discontinuous percolation and the role of nonlocality.

  3. Increased myocardial ischemia during nitrate therapy: caused by multiple coronary artery-left ventricle fistulae?

    PubMed

    Heper, Gulumser; Kose, Sedat

    2005-01-01

    We present the case of a 54-year-old man who had crescendo angina during nitrate therapy. Selective coronary angiograms showed no atherosclerotic lesions, but did show plexuses of intramural vessels that connected the distal thirds of the left and right coronary systems with the left ventricle. The cause of our patient's increased myocardial ischemia during nitrate therapy may have been the coronary "steal" phenomenon.

  4. A simplified approach for evaluating multiple test outcomes and multiple disease states in relation to the exercise thallium-201 stress test in suspected coronary artery disease

    SciTech Connect

    Pollock, S.G.; Watson, D.D.; Gibson, R.S.; Beller, G.A.; Kaul, S. )

    1989-09-01

    This study describes a simplified approach for the interpretation of electrocardiographic and thallium-201 imaging data derived from the same patient during exercise. The 383 patients in this study had also undergone selective coronary arteriography within 3 months of the exercise test. This matrix approach allows for multiple test outcomes (both tests positive, both negative, 1 test positive and 1 negative) and multiple disease states (no coronary artery disease vs 1-vessel vs multivessel coronary artery disease). Because this approach analyzes the results of 2 test outcomes simultaneously rather than serially, it also negates the lack of test independence, if such an effect is present. It is also demonstrated that ST-segment depression on the electrocardiogram and defects on initial thallium-201 images provide conditionally independent information regarding the presence of coronary artery disease in patients without prior myocardial infarction. In contrast, ST-segment depression on the electrocardiogram and redistribution on the delayed thallium-201 images may not provide totally independent information regarding the presence of exercise-induced ischemia in patients with or without myocardial infarction.

  5. Vascular and cardiac contractile reserve in the dog heart with chronic multiple coronary occlusions.

    PubMed

    Schwarz, F; Flameng, W; Mack, B; Türschmann, W; Schaper, W

    1976-11-01

    Nineteen mongrel dogs survived chronic occlusion of the left circumflex and of the right coronary artery without infarction due to the timely development of a collateral circulation. Only 38 per cent of the conductance of the arteries before occlusion was restored by collateral vessels. In these animals and in 15 control dogs with normal coronary arteries myocardial contractility, contractility reserve, and myocardial blood flow were studied. The same was done in dogs with chronic coronary artery occlusion after aortocoronary bypass. Myocardial blood flow was determined woth the tracer microsphere technique. Contractility reserve was tested and defined as isovolumetric left ventricular pressure and dp/dt max with norepinephrine infusion and cross-clamping of the aorta. Contractile reserve was not significantly different between normal dogs and dogs with chronic coronary artery occlusion before and after aortocoronary bypass. Myocardial blood flow during control conditions was homogenously distributed in all three groups studied. The ratio of blood flow to the endocardium and the epicardium was not significantly different from inity. Coronary reserve was determined at peak reactive hyperemia following a 20 second period of coronary artery occlusion, with ongoing norepinephrine infusion. Under these conditions subendocardial fow in normal dogs rose by a factor of 7.9 while subepicardial flow increased 7.4 times. In dogs with chronic occlusion of two coronary arteries the increase of myocardial flow was nonnomogenous; subendocardial flow to areas supplied by a normal coronary artery rose by a factor of 7.0 while subepicardial flow increased 5.7 times control. Subendocardial collateral flow rose by a factor of 2.4 and subepicardial collateral flow increased 3.5 times control. In normal dogs norepinephrine alone did not result in maximal coronary flow but only 57 per cent thereof. Dogs with chronic coronary occlusion, however, required the entire coronary reserve in

  6. Suspected Giant cell aortitis : from multiple aortic structural damage to fatal listeria sepsi. A case report.

    PubMed

    Silvestri, Valeria; Isernia, Giacomo

    2017-03-16

    Giant cell arteritis ( GCA) is an inflammatory vasculopathy affecting large and middle-sized vessels , specifically cranial arteries derived from carotid artery. Isolated extracranial vessel involvement can occur. Interest in extravascular manifestations is recently increasing because of diffusion of sensitive and specific imaging tools such as 18FDG PET TC . Patients have an increased relative risk of severe infection. Listeria monocytogenes infection risk is increased, and vascular system involvement and graft infection have been, even though rarely, reported. We report the case of a 72 year old woman with a history of suspected giant cell aortitis , previous surgical treatment of ascendant and descendant thoracic aortic aneurysm, presenting 7 year after TEVAR with thoracic pain , fever, inflammatory indexes increase, leukocytosis, listeria sepsis and rapidly increasing type I proximal endoleak on CT. 18 FDG PET positivity was associated. Endograft listeria infection on aortitis reactivation was suspected but death for multi-organ failure and absence of autopsy data couldn't confirm diagnosis . Listeria vascular graft infection has been reported previously. Giant cell arteritis is a predisposing condition. We report the first case of endograft infection by listeria monocytogenes in a patient with positive history of suspected giant cell aortic aneurysm.

  7. Automatic selection of best quality vessels from multiple-phase coronary CT angiography (cCTA)

    NASA Astrophysics Data System (ADS)

    Liu, Jordan; Hadjiiski, Lubomir; Chan, Heang-Ping; Zhou, Chuan; Wei, Jun; Chughtai, Aamer; Kuriakose, Jean; Agarwal, Prachi; Kazerooni, Ella

    2015-03-01

    We are developing an automated method to select the best-quality vessels from coronary arterial trees in multiplephase cCTA and build a best-quality tree to facilitate the detection of stenotic plaques. Using our previously developed vessel registration method, the vessels from different phases were automatically registered. Branching points on the centerline are projected onto the registered trees. The centerlines are split into branches based on the projected branching points. Each tree branch is then straightened. The registered trees and centerline branches are used to determine the correspondence of branches between phases so that each branch can be compared to its corresponding branches in the other phases. A vessel quality measure (VQM) is calculated as the average radial gradients at the vessel wall over the entire vessel branch. The quality of the corresponding branches from all phases is automatically compared using the VQM. An observer preference study was conducted with two radiologists to visually compare the quality of the vessels. For each branch, the pair that was automatically determined to be the best and worst quality by the VQM was used for the radiologists' visual assessment. Each radiologist, blinded to the VQM, evaluated pairs of corresponding branches and provided their preference. The performance of the automatic selection using VQM was evaluated as the percentage of the total number of vessel pairs for which the automatic selection agreed with the radiologist's selection of the higher quality branch in the pair. The agreement between the first radiologist and the automated selection was 80% and that between the second radiologist and the automated selection was 82%. In comparison, the agreement between the two radiologists was 90%. This preliminary study demonstrates the feasibility of using an automated method to select the best-quality vessels from multiple cCTA phases.

  8. Effect of multiple clinical factors on recurrent angina after percutaneous coronary intervention

    PubMed Central

    Zhang, Jing; Liu, Chengyu; Pan, Chenliang; Bai, Ming; Zhang, Jin; Peng, Yu; Zheng, Dingchang; Zhang, Zheng

    2016-01-01

    Abstract Recurrent angina (RA) has an important influence on health status of patients after percutaneous coronary intervention (PCI). This study aimed to retrospectively investigate the effect of multiple clinical factors on both short-term and long-term development of RA. A total of 398 ST-segment elevation myocardial infarction (STEMI) patients were studied for up to 12 months. The primary clinical outcome, RA, was assessed at 1-month and 12-month. In multivariate analyses, the effect of clinical factors, including baseline demographics, medical history, infarction-related arteries, procedural characteristics of PCI, and the use of medicines, was investigated in patients with and without RA. The Logistic regression analysis showed that the patients with treatment through radial approach PCI (odds ratio [OR]: 0.42, 95% confidence interval [CI]: 0.18–0.96, P < 0.05) were less likely to have RA during 1-month assessment. During 12 months after PCI, male patients (OR: 0.53, 95% CI: 0.29–0.96, P < 0.05), and/or those treated with radial approach PCI (OR: 0.45, 95% CI: 0.21–0.97, P < 0.05) were less likely to have RA, whereas the patients with infarction related artery (IRA) in left anterior descending (LAD) (OR: 2.41, 95% CI: 1.20–4.84, P < 0.01) were more likely to have RA at follow-up. The Cox regression analysis further revealed that the patients with infarction of the LAD artery (hazard ratio [HR]: 2.08, 95% CI: 1.10–3.92, P < 0.05), but not with treatment through radial artery during PCI (HR: 0.42, 95% CI: 0.18–0.96, P < 0.05) had higher potential of development of RA during 12 months after PCI. We studied the effects of multiple clinical factors on the development of RA after PCI. Our findings suggest that patients with infarction of the LAD artery, and/or treatment not through radial artery during PCI were associated with higher risk of RA and may require close follow-up. PMID:27741110

  9. Multiple risk factor interventions for primary prevention of coronary heart disease

    PubMed Central

    Ebrahim, Shah; Beswick, Andrew; Burke, Margaret; Smith, George Davey

    2014-01-01

    Background Primary prevention programmes in many countries attempt to reduce mortality and morbidity due to coronary heart disease (CHD) through risk factor modification. It is widely believed that multiple risk factor intervention using counselling and educational methods is efficacious and cost-effective and should be expanded. Recent trials examining risk factor changes have cast considerable doubt on the effectiveness of these multiple risk factor interventions. Objectives To assess the effects of multiple risk factor intervention for reducing cardiovascular risk factors, total mortality, and mortality from CHD among adults without clinical evidence of established cardiovascular disease. Search strategy MEDLINE was searched for the original review to 1995. This was updated by searching the Cochrane Central Register of Controlled Trials on The Cochrane Library Issue 3 2001, MEDLINE(2000 to September 2001) and EMBASE (1998 to September 2001). Selection criteria Intervention studies using counselling or education to modify more than one cardiovascular risk factor in adults from general populations, occupational groups, or high risk groups. Trials of less than 6 months duration were excluded. Data collection and analysis Data were extracted by two reviewers independently. Investigators were contacted to obtain missing information. Main results A total of 39 trials were found of which ten reported clinical event data. In the ten trials with clinical event end-points, the pooled odds ratios for total and CHD mortality were 0.96 (95% confidence intervals (CI) 0.92 to 1.01) and 0.96 (95% CI 0.89 to 1.04) respectively. Net changes in systolic and diastolic blood pressure, and blood cholesterol were (weighted mean differences) −3.6 mmHg (95% CI −3.9 to −3.3 mmHg), −2.8 mmHg (95% CI −2.9 to −2.6 mmHg) and −0.07 mMol/l (95% CI −0.8 to −0.06 mMol/l) respectively. Odds of reduction in smoking prevalence was 20% (95% CI 8% to 31%). Statistical heterogeneity

  10. Multiple giant angiokeratoma of Fordyce on the shaft of the penis masquerading as keratoacanthoma*

    PubMed Central

    Ghosh, Sudip Kumar; Ghosh, Shouvik; Agarwal, Megha

    2015-01-01

    The term 'angiokeratoma' includes a wide range of dermatological conditions of hyperkeratotic vascular disorders with a similar histologic combination of hyperkeratosis and superficial dermal vascular ectasia. Angiokeratomas can be classified into localized and systemic forms. Angiokeratoma of Fordyce (AKF) is a localized form of angiokeratoma, clinically characterized by 1- to 6-mm, black, blue, or dark red, dome-shaped papules located on the scrotum, shaft of penis, labia majora, clitoris, inner thigh, and lower abdomen. We describe herein a case of giant angiokeratoma of Fordyce on shaft of the penis in an elderly man, clinically masquerading as keratoacanthoma. PMID:26312700

  11. Multiple coronary thrombosis and stent implantation to the subtotally occluded right renal artery in a patient with essential thrombocytosis: a case report with review.

    PubMed

    Ozben, Beste; Ekmekci, Ahmet; Bugra, Zehra; Umman, Sabahattin; Meric, Mehmet

    2006-08-01

    Essential thrombocytosis is a myeloproliferative disorder of unknown etiology manifested clinically by the overproduction of platelets in the absence of a definable cause. Platelet dysfunction in essential thrombocytosis results in both hemorrhage and thrombosis. It is one of the rare causes of ischemic cardiovascular events. Fewer than 20 cases of essential thrombocytosis with involvement of coronary arteries leading to acute coronary syndromes or myocardial infarction have been reported. We report a case of multiple coronary thrombosis involving the left anterior descending artery and circumflex artery and stent implantation to the subtotally stenotic right renal artery in a women with unstable angina pectoris, essential thrombocytosis and previous history of renal artery trombosis.

  12. The significance of coronary topography for operative technique and tactics in multiple myocardial revascularization with jump-grafts.

    PubMed

    Eschenbruch, E M; Pabst, F; Tollenaere, P; Roskamm, H; Schmuziger, M

    1981-08-01

    Aortocoronary bypass procedures for proximal lesions are accepted with widely documented excellent results, but are still controversial in their application for diffuse disease. However, failures of the single graft technique to small coronary branches with marginal flows are markedly reduced by the jump technique. In our experience with 447 angiographic controls from April 1978 to December 1980, the jump-graft patency rate was 87.8% versus 84.9% for single grafts, and as high as 96.3% in the subgroup of multiple jumps (sequential grafts). The sequence of the anastomoses as far as the individual flow is concerned significantly influences the results of the jump-graft technique.

  13. Multiple Infectious Agents and the Origins of Atherosclerotic Coronary Artery Disease.

    PubMed

    Lawson, James S

    2016-01-01

    Although deaths due to atherosclerotic coronary artery disease (ACAD) have fallen dramatically during the past 50 years, ACAD remains as the leading cause of death in all continents, except Africa, where deaths due to infections are still dominant. Although food and nutrition have a proven role in atherosclerosis, the underlying causes of ACAD remain unknown. This is despite a century of intensive research dominated by investigations into the saturated fat hypothesis. In this review, it is hypothesized that the rise and fall in ACAD during the past 100 years is primarily due to the parallel rise and fall in the prevalence of coronary atheroma, the underlying disease. It is further hypothesized that infectious pathogens initiate atherosclerosis mainly during infancy and childhood. It is speculated that widespread use of antibiotics and vaccines against bacterial and viral infections may be the reason for the dramatic fall in coronary atheroma and ACAD during the past 50 years. The relevant evidence and a working hypothesis are included in this review.

  14. Multiple Infectious Agents and the Origins of Atherosclerotic Coronary Artery Disease

    PubMed Central

    Lawson, James S.

    2016-01-01

    Although deaths due to atherosclerotic coronary artery disease (ACAD) have fallen dramatically during the past 50 years, ACAD remains as the leading cause of death in all continents, except Africa, where deaths due to infections are still dominant. Although food and nutrition have a proven role in atherosclerosis, the underlying causes of ACAD remain unknown. This is despite a century of intensive research dominated by investigations into the saturated fat hypothesis. In this review, it is hypothesized that the rise and fall in ACAD during the past 100 years is primarily due to the parallel rise and fall in the prevalence of coronary atheroma, the underlying disease. It is further hypothesized that infectious pathogens initiate atherosclerosis mainly during infancy and childhood. It is speculated that widespread use of antibiotics and vaccines against bacterial and viral infections may be the reason for the dramatic fall in coronary atheroma and ACAD during the past 50 years. The relevant evidence and a working hypothesis are included in this review. PMID:27672638

  15. Logistic regression analysis of multiple noninvasive tests for the prediction of the presence and extent of coronary artery disease in men

    SciTech Connect

    Hung, J.; Chaitman, B.R.; Lam, J.; Lesperance, J.; Dupras, G.; Fines, P.; Cherkaoui, O.; Robert, P.; Bourassa, M.G.

    1985-08-01

    The incremental diagnostic yield of clinical data, exercise ECG, stress thallium scintigraphy, and cardiac fluoroscopy to predict coronary and multivessel disease was assessed in 171 symptomatic men by means of multiple logistic regression analyses. When clinical variables alone were analyzed, chest pain type and age were predictive of coronary disease, whereas chest pain type, age, a family history of premature coronary disease before age 55 years, and abnormal ST-T wave changes on the rest ECG were predictive of multivessel disease. The percentage of patients correctly classified by cardiac fluoroscopy (presence or absence of coronary artery calcification), exercise ECG, and thallium scintigraphy was 9%, 25%, and 50%, respectively, greater than for clinical variables, when the presence or absence of coronary disease was the outcome, and 13%, 25%, and 29%, respectively, when multivessel disease was studied; 5% of patients were misclassified. When the 37 clinical and noninvasive test variables were analyzed jointly, the most significant variable predictive of coronary disease was an abnormal thallium scan and for multivessel disease, the amount of exercise performed. The data from this study provide a quantitative model and confirm previous reports that optimal diagnostic efficacy is obtained when noninvasive tests are ordered sequentially. In symptomatic men, cardiac fluoroscopy is a relatively ineffective test when compared to exercise ECG and thallium scintigraphy.

  16. Analog electrical model of the coronary circulation in case of multiple revascularizations.

    PubMed

    Maasrani, Mahmoud; Verhoye, Jean-Philippe; Corbineau, Herve; Drochon, Agnes

    2008-07-01

    In this work, we propose an analog electrical model of the coronary circulation for patients with obstructive disease undergoing revascularization. In this clinical situation, the collateral circulation to the occluded artery is difficult to ascertain via preoperative measurements and well-developed collaterals might induce long-term restenosis of the revascularized artery due to flow competition mechanisms. The proposed model allows an original biomechanical analysis of per-operative hemodynamic data in order to assess quantitative evaluation of pressures and flows inside the native stenosed arteries, the collateral network and the bypass grafts. Average cardiac cycle values are analysed. In the case of 3-vessel disease and chronic occlusion of the right coronary artery, the quantitative results confirm the protective effects of the collateral flows in the pathological situation, but also show that the revascularization of the occluded right artery is fully justified since the collateral flows remain low, even when the left territory is revascularized. The model thus provides a computational tool to evaluate therapeutic strategies for each patient.

  17. Coronary Heart Disease Risk between Active and Inactive Women with Multiple Sclerosis.

    ERIC Educational Resources Information Center

    Slawta, Jennifer N.; McCubbin, Jeffrey A.; Wilcox, Anthony R.; Fox, Susan D.; Nalle, Darek J.; Anderson, Gail

    2002-01-01

    Investigated whether abdominal fat accumulation and levels of triglyceride, high-density lipoprotein cholesterol, and glucose differed between 123 active and inactive women with multiple sclerosis (MS). Results indicated that low-to-moderate leisure time physical activity significantly related to less abdominal fat accumulation, lower triglyceride…

  18. Coronary Arteries

    MedlinePlus

    ... and animations for grades K-6. The Coronary Arteries Coronary Circulation The heart muscle, like every other ... into two main coronary blood vessels (also called arteries). These coronary arteries branch off into smaller arteries, ...

  19. [Gigantic coronary aneurysm arisen from coronary fistula between the left circumflex artery and the left ventricle].

    PubMed

    Uchida, T; Andou, H; Yasutsune, T; Iwai, T; Fukumura, F; Tanaka, J

    2008-12-01

    A 71-year-old male was referred to our hospital due to abnormality detected by a chest roentgenogram. He had no symptoms except for slight chest oppression. He was found to have a giant coronary aneurysm. It was originated from a coronary artery (left circum flex branch) left ventricular fistula. The orifice of this fistula to the left ventricle was also dilated and formed diverticulum. Ligation of the feeding coronary branch, closure of the aneurysmal fistula in the left ventricular wall and aneurysmectomy were performed under cardiopulmonary bypass. Postoperative course was uneventful. A giant aneurysm originated from a coronary-left ventricular fistula was considered to be very rare.

  20. Progress in coronary angioplasty.

    PubMed

    Silverton, P

    1986-10-01

    Angioplasty offers an alternative to bypass grafting for an increasing number of patients with coronary artery disease. Improvements in catheter design and manufacture have been responsible for an enlargement of the indications which now include patients with multiple vessel coronary artery disease and those with acute evolving myocardial infarction. The application of laser technology may assist in the reopening of chronically occluded arteries.

  1. Relationship of the estrogen surge and multiple mates to cub paternity in the giant panda (Ailuropoda melanoleuca): implications for optimal timing of copulation or artificial insemination.

    PubMed

    Huang, Yan; Zhang, Hemin; Li, Desheng; Zhang, Guiquan; Wei, Rongping; Huang, Zhi; Zhou, Yingmin; Zhou, Qiang; Liu, Yang; Wildt, David E; Hull, Vanessa

    2012-11-01

    The effectiveness of ex situ breeding programs for endangered species can be limited by challenges in mimicking mating competitions that naturally occur among multiple mates in the wild. The objective of this study was to evaluate the impact of timed natural matings and/or artificial inseminations in the context of the urinary estrogen surge on cub production in the giant panda (Ailuropoda melanoleuca). We used a large cohort of giant pandas, including 12 females and 17 males. DNA paternity exclusion was used to pinpoint accurately the interval during the estrogen surge that coincided with the ideal sperm deposition time to produce offspring. Of the 31 cubs (in 19 pregnancies), 22 (71.0%; 15 pregnancies) were produced from matings occurring on the day of or the day after the maximal urinary estrogen peak. Sixteen of the 19 pregnancies (84.2%) produced at least one offspring sired by the first male mating with the dam. There was a preponderance of twins (12 of 19; 63.2%), and dual paternities were discovered in 3 of 12 twin sets (25%). These findings indicate a strong relationship between the excreted estrogen surge and sperm deposition to achieve pregnancy in the giant panda. To ensure the production of the most genetically diverse young, it is imperative that the most appropriate male mate first and on the day of or the day after the highest detected estrogen value. There is no advantage to increasing the number of copulations or mating partners within 1 day of the estrogen peak on the incidence of twinning, although this practice may increase the prevalence of dual paternity in cases of multiple births.

  2. Visualization and quantitation of coronary arteries using multiple-view energy subtraction digital radiography. Interim report 30 September 1983-29 September 1984

    SciTech Connect

    Macovski, A.

    1984-08-27

    The authors have studied a general approach to the imaging of coronary arteries using minimally invasive intravenous administration of contrast material. Using conventional DSA techniques this visualization would fail due to motion, low SNR, and intervening iodinated structures. The authors have implemented the digital fluoroscopy system with a rotating gantry and tested it on phantoms. Evaluation of stenosis in coronary arteries is difficult with low SNR images. The authors have studied and implemented a vessel outlining system using a global estimation procedure. The most recent approach has significantly improved computational efficiency. The processing of multiple-energy data to eliminate the moving soft tissue results in a noise penalty. The authors have studied and implemented an approach to restore the original SNR by deriving the high frequency components from a non-selective image. The authors have also implemented a scatter-cancellation system for minimizing this source of error.

  3. Successful endovascular reconstruction of a recurrent giant middle cerebral artery aneurysm with multiple telescoping flow diverters in a pediatric patient.

    PubMed

    Ikeda, Daniel S; Marlin, Evan S; Shaw, Andrew; Powers, Ciarán J

    2015-01-01

    Intracranial aneurysms of the pediatric population are rare, but giant fusiform aneurysms (GFAs) of the middle cerebral artery (MCA) are common within this cohort of patients. These aneurysms are difficult to treat and often require advanced microsurgical skills, as they are usually not amenable to direct clipping. Here, we report the successful treatment of a recurrent GFA of the MCA with three telescoping Pipeline Embolization Devices 6 months after attempted clip reconstruction in a pediatric patient.

  4. Small bowel intussusception caused by multiple intestinal metastases from a giant cell carcinoma of the lung: a case report.

    PubMed

    Mandeville, Y; de Gheldere, C; Vanclooster, P

    2015-01-01

    Small bowel obstruction (SBO) due to intussusception in adults is a rare condition. Diagnosis at the time of admission is usually challenging. More often than not, a bowel intussusception in adults is secondary to an organic condition, frequently malignancies. Therefore, a surgical approach is indicated most of the times. We report the case of a forty-nine years old lady presenting with a SBO secondary to small bowel metastases with two ileo-ileal intussusceptions, one of which was missed at initial surgical exploration. A giant cell carcinoma of the lung (GCCL) with small bowel metastases was diagnosed subsequently. The case is presented as well as a brief review of literature.

  5. Small Bowel Intussusception Caused by Multiple Intestinal Metastases from a Giant Cell Carcinoma of the Lung: a Case Report.

    PubMed

    Mandeville, Y; de Gheldere, C; Vanclooster, P

    2015-01-01

    Small bowel obstruction (SBO) due to intussusception in adults is a rare condition. Diagnosis at the time of admission is usually challenging. More often than not, a bowel intussusception in adults is secondary to an organic condition, frequently malignancies. Therefore, a surgical approach is indicated most of the times. We report the case of a forty-nine years old lady presenting with a SBO secondary to small bowel metastases with two ileo-ileal intussusceptions, one of which was missed at initial surgical exploration. A giant cell carcinoma of the lung (GCCL) with small bowel metastases was diagnosed subsequently. The case is presented as well as a brief review of literature.

  6. Adenosine Attenuates Human Coronary Artery Smooth Muscle Cell Proliferation by Inhibiting Multiple Signaling Pathways That Converge on Cyclin D.

    PubMed

    Dubey, Raghvendra K; Fingerle, Jürgen; Gillespie, Delbert G; Mi, Zaichuan; Rosselli, Marinella; Imthurn, Bruno; Jackson, Edwin K

    2015-12-01

    The goal of this study was to determine whether and how adenosine affects the proliferation of human coronary artery smooth muscle cells (HCASMCs). In HCASMCs, 2-chloroadenosine (stable adenosine analogue), but not N(6)-cyclopentyladenosine, CGS21680, or N(6)-(3-iodobenzyl)-adenosine-5'-N-methyluronamide, inhibited HCASMC proliferation (A2B receptor profile). 2-Chloroadenosine increased cAMP, reduced phosphorylation (activation) of ERK and Akt (protein kinases known to increase cyclin D expression and activity, respectively), and reduced levels of cyclin D1 (cyclin that promotes cell-cycle progression in G1). Moreover, 2-chloroadenosine inhibited expression of S-phase kinase-associated protein-2 (Skp2; promotes proteolysis of p27(Kip1)) and upregulated levels of p27(Kip1) (cell-cycle regulator that impairs cyclin D function). 2-Chloroadenosine also inhibited signaling downstream of cyclin D, including hyperphosphorylation of retinoblastoma protein and expression of cyclin A (S phase cyclin). Knockdown of A2B receptors prevented the effects of 2-chloroadenosine on ERK1/2, Akt, Skp2, p27(Kip1), cyclin D1, cyclin A, and proliferation. Likewise, inhibition of adenylyl cyclase and protein kinase A abrogated 2-chloroadenosine's inhibitory effects on Skp2 and stimulatory effects on p27(Kip1) and rescued HCASMCs from 2-chloroadenosine-mediated inhibition. Knockdown of p27(Kip1) also reversed the inhibitory effects of 2-chloroadenosine on HCASMC proliferation. In vivo, peri-arterial (rat carotid artery) 2-chloroadenosine (20 μmol/L for 7 days) downregulated vascular expression of Skp2, upregulated vascular expression of p27(Kip1), and reduced neointima hyperplasia by 71% (P<0.05; neointimal thickness: control, 37 424±18 371 pixels; treated, 10 352±2824 pixels). In conclusion, the adenosine/A2B receptor/cAMP/protein kinase A axis inhibits HCASMC proliferation by blocking multiple signaling pathways (ERK1/2, Akt, and Skp2) that converge at cyclin D, a key G1 cyclin

  7. Self-condensation of a thiazole-peptide bearing a 21-membered loop into a library of giant macrocycles with multiple orthogonal loops.

    PubMed

    Singh, Yogendra; Hoang, Huy N; Flanagan, Bernadine; Fairlie, David P

    2006-03-16

    [reaction: see text] Tetrapeptide analogue H-[Glu-Ser-Lys(Thz)]-OH, containing a turn-inducing thiazole constraint, was used as a template to produce a 21-membered structurally characterized loop by linking Glu and Lys side chains with a Val-Ile dipeptide. This template was oligomerized in one pot to a library (cyclo-[1](n)(), n = 2-10) of giant symmetrical macrocycles (up to 120-membered rings), fused to 2-10 appended loops that were carried intact through multiple oligomerization (chain extension) and cyclization (chain terminating) reactions of the template. A three-dimensional solution structure for cyclo-[1](3) shows all three appended loops projecting from the same face of the macrocycle. This is a promising approach to separating peptide motifs over large distances.

  8. The Gaia-ESO Spectroscopic Survey: CNO abundances in giants of the multiple-population globular cluster NGC 1851

    NASA Astrophysics Data System (ADS)

    Tautvaisiene, Grazina; Drazdauskas, Arnas; Lardo, Carmela; Martell, Sarah; Pancino, Elena; Stonkute, Edita

    2015-08-01

    It has been suspected already more than thirty year ago that NGC 1851 is not chemically homogeneous. By now, it is clear that NGC 1851 has two distinct subgiant branches, however explanations of their origin so far lack consensus. Some authors explain them by two generations of stars, the first being primordial, while the second one being born from the ejecta of a fraction of the stars of the earlier one. There are suggestions that NGC 1851 might be the result of a merger of two globular clusters, or originated as the nucleus of a dwarf galaxy that was captured by the Milky Way. In this presentation, we provide a crucial missing information on CNO abundances determined in a homogeneous way for a large sample of NGC 1851 giants. High-resolution spectra were obtained with the VLT UVES spectrograph in a framework of the Gaia-ESO Survey. From the investigated stars we clearly see that the two NGC 1851 populations have by about 0.2 dex difference in metallicity, the sums of C+O+N differ by about 0.1 dex, the mean C/N ratio values differ by about 0.5 dex, chemical elements that are insensitive to internal stellar mixing show normal Galactic abundances of the corresponding metallicities. This leads us to the conclusion that NGC 1851 is a binary cluster. We provide interpretations of these and other results of the study.

  9. Left Anterior Descending Coronary Artery and Multiple Peripheral Mycotic Aneurysms Due to Mycobacterium Bovis Following Intravesical Bacillus Calmette-Guerin Therapy: A Case Report

    PubMed Central

    Duvnjak, Petar; Laguna, Mario

    2016-01-01

    The use of live attenuated intravesicular Bacillus Calmette-Guerin (BCG) therapy is a generally accepted safe and effective method for the treatment of superficial transitional cell carcinoma (TCC) of the bladder. Although rare, < 5% of patient’s treated with intravesicular BCG therapy may develop potentially serious complications, including localized infections to the genitourinary tract, mycotic aneurysms and osteomyelitis. We present here a case of a 63-year-old male who developed left coronary and multiple peripheral M. Bovis mycotic aneurysms as a late complication of intravesicular BCG therapy for superficial bladder cancer. The patient initially presented with acute onset pain and swelling in the left knee > 2 years following initial therapy, and initial workup revealed a ruptured saccular aneurysm of the left popliteal artery as well as incidental bilateral common femoral artery aneurysms. Following endovascular treatment and additional workup, the patient was discovered to have additional aneurysms in the right popliteal artery and left anterior descending artery (LAD). Surgical pathology and bacterial cultures obtained from the excised femoral aneurysms and surgical groin wounds were positive for Mycobacterium Bovis, and the patient was initiated on a nine-month antimycobacterial course of isoniazid, rifampin and ethambutol. Including the present case, there has been a total of 32 reported cases of mycotic aneurysms as a complication from intravesicular BCG therapy, which we will review here. The majority of reported cases involve the abdominal aorta; however, this represents the first known reported case of a coronary aneurysm. PMID:27761190

  10. Surviving All Odds: A Unique Case of Multiple Congenital Unruptured Sinus of Valsalva Aneurysms Involving Both Left and Right Coronary Sinuses with Biventricular Dysfunction and Heart Block

    PubMed Central

    Vijay B, Aniketh; Mathew, Navin

    2016-01-01

    Aneurysms of the sinus of Valsalva are very uncommon, with an incidence ranging from 0.1 to 3.5% of all congenital heart defects. Very few cases have been reported in the literature that presented with involvement of two or more sinuses. We report a case of 27-year-old male with a history of exertional breathlessness of one-month duration. After complete evaluation using transesophageal echocardiography (TEE) and multiple detector computed tomography (MDCT) scanning, the patient was diagnosed to have large congenital unruptured sinus of Valsalva aneurysms involving both left and right coronary sinuses with extension into the interventricular septum. The patient also displayed second-degree heart block (Mobitz type 2) and biventricular dysfunction. The patient was managed successfully. We present the case with an aim to highlight the management challenges including intraoperative and postoperative complications that are associated with unruptured sinus of Valsalva aneurysms of ≥2 sinuses. PMID:27882249

  11. Noninvasive Imaging in Coronary Artery Disease

    PubMed Central

    Heo, Ran; Nakazato, Ryo; Kalra, Dan; Min, James K.

    2014-01-01

    Noninvasive cardiac imaging is widely used to evaluate the presence of coronary artery disease. Recently, with improvements in imaging technology, noninvasive imaging has also been used for evaluation of the presence, severity, and prognosis of coronary artery disease. Coronary CT angiography and MRI of coronary arteries provide an anatomical assessment of coronary stenosis, whereas the hemodynamic significance of a coronary artery stenosis can be assessed by stress myocardial perfusion imaging, such as SPECT/PET and stress MRI. For appropriate use of multiple imaging modalities, the strengths and limitations of each modality are discussed in this review. PMID:25234083

  12. Coronary artery fistulas

    PubMed Central

    Said, S.A.M.; Thiadens, A.A.H.J.; Fieren, M.J.C.H.; Meijboom, E.J.; van der Werf, T.; Bennink, G.B.W.E.

    2002-01-01

    The aetiology of congenital coronary artery fistulas remains a challenging issue. Coronary arteries with an anatomically normal origin may, for obscure reasons, terminate abnormally and communicate with different single or multiple cardiac chambers or great vessels. When this occurs, the angiographic morphological appearance may vary greatly from discrete channels to plexiform network of vessels. Coronary arteriovenous fistulas (CAVFs) have neither specific signs nor pathognomonic symptoms; the spectrum of clinical features varies considerably. The clinical presentation of symptomatic cases can include angina pectoris, myocardial infarction, fatigue, dyspnoea, CHF, SBE, ventricular and supraventricular tachyarrhythmias or even sudden cardiac death. CAVFs may, however, be a coincidental finding during diagnostic coronary angiography (CAG). CAG is considered the gold standard for diagnosing and delineating the morphological anatomy and pathway of CAVFs. There are various tailored therapeutic modalities for the wide spectrum of clinical manifestations of CAVFs, including conservative pharmacological strategy, percutaneous transluminal embolisation and surgical ligation. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:25696067

  13. Characterization of TCF21 Downstream Target Regions Identifies a Transcriptional Network Linking Multiple Independent Coronary Artery Disease Loci.

    PubMed

    Sazonova, Olga; Zhao, Yuqi; Nürnberg, Sylvia; Miller, Clint; Pjanic, Milos; Castano, Victor G; Kim, Juyong B; Salfati, Elias L; Kundaje, Anshul B; Bejerano, Gill; Assimes, Themistocles; Yang, Xia; Quertermous, Thomas

    2015-05-01

    To functionally link coronary artery disease (CAD) causal genes identified by genome wide association studies (GWAS), and to investigate the cellular and molecular mechanisms of atherosclerosis, we have used chromatin immunoprecipitation sequencing (ChIP-Seq) with the CAD associated transcription factor TCF21 in human coronary artery smooth muscle cells (HCASMC). Analysis of identified TCF21 target genes for enrichment of molecular and cellular annotation terms identified processes relevant to CAD pathophysiology, including "growth factor binding," "matrix interaction," and "smooth muscle contraction." We characterized the canonical binding sequence for TCF21 as CAGCTG, identified AP-1 binding sites in TCF21 peaks, and by conducting ChIP-Seq for JUN and JUND in HCASMC confirmed that there is significant overlap between TCF21 and AP-1 binding loci in this cell type. Expression quantitative trait variation mapped to target genes of TCF21 was significantly enriched among variants with low P-values in the GWAS analyses, suggesting a possible functional interaction between TCF21 binding and causal variants in other CAD disease loci. Separate enrichment analyses found over-representation of TCF21 target genes among CAD associated genes, and linkage disequilibrium between TCF21 peak variation and that found in GWAS loci, consistent with the hypothesis that TCF21 may affect disease risk through interaction with other disease associated loci. Interestingly, enrichment for TCF21 target genes was also found among other genome wide association phenotypes, including height and inflammatory bowel disease, suggesting a functional profile important for basic cellular processes in non-vascular tissues. Thus, data and analyses presented here suggest that study of GWAS transcription factors may be a highly useful approach to identifying disease gene interactions and thus pathways that may be relevant to complex disease etiology.

  14. Giant osteochondroma of axis in a child with multiple hereditary exostoses: case report and review of literature.

    PubMed

    Tahasildar, Naveen; Sudesh, Pebam; Goni, Vijay; Tripathy, Sujit Kumar

    2012-05-01

    Though osteochondromas are the most common benign bone tumour, their spinal involvement is less frequent. We report a case of osteochondroma in a 5-year-old female child with multiple hereditary exostoses that originated from posterior elements of C2 vertebra, not involving spinal canal and caused restriction of neck movement. It was excised from its base without disturbing the continuity of lamina. Two years later she had normal neck movements without any recurrence. The rarity of this tumour at this location, with such a large size at an early age, makes this article unique.

  15. Regulation of Coronary Blood Flow.

    PubMed

    Goodwill, Adam G; Dick, Gregory M; Kiel, Alexander M; Tune, Johnathan D

    2017-03-16

    The heart is uniquely responsible for providing its own blood supply through the coronary circulation. Regulation of coronary blood flow is quite complex and, after over 100 years of dedicated research, is understood to be dictated through multiple mechanisms that include extravascular compressive forces (tissue pressure), coronary perfusion pressure, myogenic, local metabolic, endothelial as well as neural and hormonal influences. While each of these determinants can have profound influence over myocardial perfusion, largely through effects on end-effector ion channels, these mechanisms collectively modulate coronary vascular resistance and act to ensure that the myocardial requirements for oxygen and substrates are adequately provided by the coronary circulation. The purpose of this series of Comprehensive Physiology is to highlight current knowledge regarding the physiologic regulation of coronary blood flow, with emphasis on functional anatomy and the interplay between the physical and biological determinants of myocardial oxygen delivery. © 2017 American Physiological Society. Compr Physiol 7:321-382, 2017.

  16. Coronary Calcium Scan

    MedlinePlus

    ... Scan Coronary Calcium Scan Related Topics Angina Atherosclerosis Coronary Heart Disease Electrocardiogram Heart Attack Send a link to NHLBI ... calcium, or calcifications, are a sign of atherosclerosis, coronary heart disease, or coronary microvascular disease. A coronary calcium scan ...

  17. Development of a concept for a personalized approach in the perioperative antiplatelet therapy administration/discontinuation management based on multiple electrode aggregometry in patients undergoing coronary artery surgery.

    PubMed

    Petricevic, Mate; Milicic, Davor; White, Alexandra; Boban, Marko; Mihaljevic, Martina Zrno; Piljic, Dragan; Rotim, Ante; Buca, Ante; Mihalj, Mario; Biocina, Bojan

    2015-10-01

    In patients undergoing coronary artery surgery, improvements in clinical outcomes currently rely on continued refinements of the surgical technique and modulation of adjuvant pharmacotherapy. Despite medical and technological advances, negligible rate of bleeding and ischemic events still persist necessitating further improvements in patient management. Platelet function testing (PFT) might play an important role in meticulous balancing between the risk of bleeding and thrombotic events. A suitable balance can be achieved by implementing a personalized, PFT based approach in antiplatelet therapy (APT) administration/discontinuation management. Despite emerging evidence on the widespread variability in platelet inhibitory response to APT, numerous PFT devices and heterogeneity in reporting study results hamper pooling of the evidence which in turn results with a lack of consensus in "on treatment" platelet reactivity associated with ischemic and bleeding events in perioperative phase. The literature on multiple electrode aggregometry (Multiplate(®); Roche Diagnostics, Mannheim, Germany) in coronary artery disease patients was reviewed systematically. Based on the evidence evaluating the relationship between "drug specific" PFT and bleeding or adverse ischemic events, we sought to define therapeutic window for the most commonly administered antiplatelet drugs such as aspirin (ASPI test) and adenosine-diphosphate receptor blockers (ADP test). Preoperatively, APT administration was primarily focused to avoid bleeding complications. ASPI test value of 20 AUC and ADP test value of <73 AUC were set as cut-off values that delineate bleeding tendency. Postoperatively, "therapeutic window" was set to avoid both bleeding and adverse ischemic events. Therapeutic ranges were as follows: 20 AUC < ASPItest ≤ 30 AUC and 19AUC < ADP ≤ 46AUC, respectively. This is the first attempt to define PFT based "therapeutic window" according to, perioperative APT administration

  18. Tracking Advanced Planetary Systems (TAPAS) with HARPS-N . I. A multiple planetary system around the red giant star TYC 1422-614-1

    NASA Astrophysics Data System (ADS)

    Niedzielski, A.; Villaver, E.; Wolszczan, A.; Adamów, M.; Kowalik, K.; Maciejewski, G.; Nowak, G.; García-Hernández, D. A.; Deka, B.; Adamczyk, M.

    2015-01-01

    Context. Stars that have evolved off the main sequence are crucial for expanding the frontiers of knowledge on exoplanets toward higher stellar masses and for constraining star-planet interaction mechanisms. These stars have an intrinsic activity, however, which complicates the interpretation of precise radial velocity (RV) measurements, and therefore they are often avoided in planet searches. Over the past ten years, we have monitored about 1000 evolved stars for RV variations in search for low-mass companions under the Penn State - Toruń Centre for Astronomy Planet Search program with the Hobby-Eberly Telescope. Selected prospective candidates that required higher RV precision measurements have been followed with HARPS-N at the 3.6 m Telescopio Nazionale Galileo. Aims: We aim to detect planetary systems around evolved stars, to be able to build sound statistics on the frequency and intrinsic nature of these systems, and to deliver in-depth studies of selected planetary systems with evidence of star-planet interaction processes. Methods: We obtained 69 epochs of precise RV measurements for TYC 1422-614-1 collected over 3651 days with the Hobby-Eberly Telescope, and 17 epochs of ultra-precise HARPS-N data collected over 408 days. We complemented these RV data with photometric time-series from the All Sky Automatic Survey archive. Results: We report the discovery of a multiple planetary system around the evolved K2 giant star TYC 1422-614-1. The system orbiting the 1.15 M⊙ star is composed of a planet with mass msini = 2.5 MJ in a 0.69 AU orbit, and a planet or brown dwarf with msini = 10 MJ in an orbit of 1.37 AU. The multiple planetary system orbiting TYC 1422-614-1 is the first finding of the TAPAS project, a HARPS-N monitoring of evolved planetary systems identified with the Hobby-Eberly Telescope. Based on observations obtained with the Hobby-Eberly Telescope, which is a joint project of the University of Texas at Austin, the Pennsylvania State University

  19. A rare case of asymptomatic bilateral submandibular gland sialolithiasis: a giant, fistulized calculus on the right and multiple calculi on the left.

    PubMed

    Emir, Hatice; Kaptan, Zeynep Kizilkaya; Uzunkulaoglu, Hakki; Dogan, Sedat

    2010-10-01

    Sialolithiasis is the most common disease of the submandibular gland; sialoliths account for at least 80% of all salivary duct calculi. We present a rare case of asymptomatic bilateral submandibular gland sialoliths. On the right, the patient had a giant (35 × 35 mm) sialolith that had fistulized into the oral cavity. In the left submandibular gland, he had 30 differently sized sialoliths.

  20. How did bacterial ancestors reproduce? Lessons from L-form cells and giant lipid vesicles: multiplication similarities between lipid vesicles and L-form bacteria.

    PubMed

    Briers, Yves; Walde, Peter; Schuppler, Markus; Loessner, Martin J

    2012-12-01

    In possible scenarios on the origin of life, protocells represent the precursors of the first living cells. To study such hypothetical protocells, giant vesicles are being widely used as a simple model. Lipid vesicles can undergo complex morphological changes enabling self-reproduction such as growth, fission, and extra- and intravesicular budding. These properties of vesicular systems may in some way reflect the mechanism of reproduction used by protocells. Moreover, remarkable similarities exist between the morphological changes observed in giant vesicles and bacterial L-form cells, which represent bacteria that have lost their rigid cell wall, but retain the ability to reproduce. L-forms feature a dismantled cellular structure and are unable to carry out classical binary fission. We propose that the striking similarities in morphological transitions of L-forms and giant lipid vesicles may provide insights into primitive reproductive mechanisms and contribute to a better understanding of the origin and evolution of mechanisms of cell reproduction. Editor's suggested further reading in BioEssays Synthesizing artificial cells from giant unilamellar vesicles: State-of-the art in the development of microfluidic technology Abstract.

  1. Coronary collaterals.

    PubMed

    Gorlin, R

    1976-01-01

    Coronary collaterals are probably enlargements of pre-existing channels which respond to local vasodilators and which function whenever pressure differences exist across them. Thus, in human coronary atherosclerosis collaterals are only seen when there is a severe intervening arterial obstruction (in excess of 75%). Coronary collaterals follow epicardial and intramycardial pathways, and the intermediary connections may be at vessels of highly varying caliber. The flow potential of most collateral pathways in man is possibly adequate for segmental myocardial function at lower than normal demands but clearly is inadequate for most, if not all, stressful interventions. In the last analysis, coronary collaterals in man are more an indication of severe regional ischemia (present or potential) than a sign of biological "compensation'' for a perfusion deficit.

  2. Multivessel spontaneous coronary artery dissection of left and right coronary systems

    PubMed Central

    Asrar ul Haq, Muhammad; Mutha, Vivek; van Gaal, William J

    2013-01-01

    Spontaneous coronary artery dissection (SCAD) involving multiple coronary arteries simultaneously is extremely rare. It should be considered in younger patients, especially who do not have traditional cardiac risk factors. We present a case of young male patient presenting with acute coronary syndrome associated with ST segments elevation on ECG following physical stress whose coronary angiography revealed SCAD of the left anterior descending as well as the right coronary artery and discuss the therapeutic options with a brief review of the limited evidence. PMID:24158301

  3. Asymptomatic fistula from a giant aneurysmatic left anterior descending artery to the right ventricular outflow tract.

    PubMed

    Mustelier, Juan Valiente; Rego, Julio Oscar Cabrera; Aquiles, Eddy W Olivares; Llerena, Luis Roberto

    2010-12-01

    Coronary artery fistulas are unusual congenital or acquired coronary artery abnormalities in which blood is shunted into a cardiac chamber, great vessel or other structure, bypassing the myocardial capillary network (Jung et al. in Cardiovasc Ultrasound 5:10, 2007). We present a young adult patient with an asymptomatic fistula from a giant aneurysmatic left anterior descending artery to the right ventricular outflow tract, first diagnosed by echocardiography examination and further confirmed by 128-slice computed tomography coronary angiography.

  4. Total temporary occlusion of blood flow for several hours to treat a giant deep arteriovenous malformation: A series of multiple operations to save a young life

    PubMed Central

    Kozyrev, Danil A.; Jahromi, Behnam Rezai; Hernesniemi, Juha

    2016-01-01

    Background: The treatment of giant deep arteriovenous malformations (AVMs) remains challenging. Case Description: We report a case of giant deep AVM diagnosed in a 9-year-old girl, for whom the AVM rupture occurred 9 years later. At the age of 9, the girl developed mild left hemiparesis. Magnetic resonance imaging revealed a giant deep AVM. The patient underwent one course of stereotactic radiotherapy followed by serial imaging. At the age of 18, we admitted her to our department with left hemiparesis and a loss of consciousness. Computed tomography showed intracerebral hemorrhage related to AVM. The treatment process proved challenging, with recurrent intracerebral hemorrhages. During the second operation, we used total temporary occlusion for almost 4 hours. Eventually, after 4 rounds of embolizations, 4 microsurgical operations, and a month-and-a-half after admission, AVM was successfully occluded. Five years after this treatment, the patient regained the ability to walk without assistance, although a moderate disability with visual changes remained (Modified Rankin Scale score 3). Conclusion: This case illustrates that the cumulative risk of rupture of a high-grade AVM in young patients is evident, while treatment may prove successful with satisfactory results. PMID:27625889

  5. Case Report: Incidental Finding of a Giant Cardiac Mass

    PubMed Central

    2014-01-01

    Coronary artery fistula (CAF) is a rare anomalous connection between a coronary artery and another coronary artery, major vessel, or cardiac chamber. Prevalence of CAF is reportedly 1% to 2% in patients who undergo coronary angiography.1 One of the most common complications of CAF is formation of a coronary artery aneurysm (CAA). A study conducted by Said and colleagues in 1995 found that CAA formation was present in 26% of patients who had proven CAF by way of angiography.2 Although a precise definition of the term “giant” CAA is still lacking, it generally refers to a dilatation that exceeds the reference vessel diameter by four times.3 We report an interesting case of a 38-year-old patient who was incidentally found to have a presumed large right ventricular aneurysm, which after an open-heart surgery was identified as a CAF with formation of an unruptured giant CAA. PMID:25114764

  6. Woven right coronary artery: a case report and review of the literature.

    PubMed

    Iyisoy, Atila; Celik, Turgay; Yuksel, U Cagdas; Isik, Ersoy

    2010-07-01

    Woven coronary artery is an extremely rare and is still not a clearly defined coronary anomaly in which epicardial coronary artery is divided into multiple thin channels at any segment of the coronary artery, and subsequently, these multiple channels merge again in a normal conduit. A few cases have been reported till now. In this case report, we present a 58-year-old male with a woven right coronary artery.

  7. Atmospheres of Extrasolar Giant Planets

    NASA Astrophysics Data System (ADS)

    Marley, M. S.; Fortney, J.; Seager, S.; Barman, T.

    The key to understanding an extrasolar giant planet's spectrum - and hence its detectability and evolution - lies with its atmosphere. Now that direct observations of thermal emission from extrasolar giant planets (EGPs) are in hand, atmosphere models can be used to constrain atmospheric composition, thermal structure, and ultimately the formation and evolution of detected planets. We review the important physical processes that influence the atmospheric structure and evolution of EGPs and consider what has already been learned from the first generation of observations and modeling. We pay particular attention to the roles of cloud structure, metallicity, and atmospheric chemistry in affecting detectable properties through Spitzer Space Telescope observations of the transiting giant planets. Our review stresses the uncertainties that ultimately limit our ability to interpret EGP observations. Finally we will conclude with a look to the future as characterization of multiple individual planets in a single stellar system leads to the study of comparative planetary architectures.

  8. Structure of giant muscle proteins

    PubMed Central

    Meyer, Logan C.; Wright, Nathan T.

    2013-01-01

    Giant muscle proteins (e.g., titin, nebulin, and obscurin) play a seminal role in muscle elasticity, stretch response, and sarcomeric organization. Each giant protein consists of multiple tandem structural domains, usually arranged in a modular fashion spanning 500 kDa to 4 MDa. Although many of the domains are similar in structure, subtle differences create a unique function of each domain. Recent high and low resolution structural and dynamic studies now suggest more nuanced overall protein structures than previously realized. These findings show that atomic structure, interactions between tandem domains, and intrasarcomeric environment all influence the shape, motion, and therefore function of giant proteins. In this article we will review the current understanding of titin, obscurin, and nebulin structure, from the atomic level through the molecular level. PMID:24376425

  9. Coronary Artery Fistula Draining into the Left Ventricle

    PubMed Central

    Sohn, Jihyun; Jang, Jeong Yoon; Sun, Byung Joo; Kim, Dae-Hee; Kang, Duk-Hyun; Song, Jae-Kwan

    2014-01-01

    We present a case of 48-year-old male who presented with coronary artery fistula draining into left ventricle. Transthoracic echocardiography showed abnormal blood flow draining into left ventricle, with enlarged coronary arteries and multiple vascular structures around ventricular myocardium. Coronary computed tomography revealed dilatation of entire left coronary artery which was wrapping around left ventricle, and draining into the posterior side of left ventricle. He did not undergo any invasive treatment, because he was not symptomatic. PMID:24753806

  10. Giant cell tumor occurring in familial Paget's disease of bone: report of clinical characteristics and linkage analysis of a large pedigree.

    PubMed

    Gianfrancesco, Fernando; Rendina, Domenico; Merlotti, Daniela; Esposito, Teresa; Amyere, Mustapha; Formicola, Daniela; Muscariello, Riccardo; De Filippo, Gianpaolo; Strazzullo, Pasquale; Nuti, Ranuccio; Vikkula, Mikka; Gennari, Luigi

    2013-02-01

    Neoplastic degeneration represents a rare but serious complication of Paget's disease of bone (PDB). Although osteosarcomas have been described in up to 1% of PDB cases, giant cell tumors are less frequent and mainly occur in patients with polyostotic disease. We recently characterized a large pedigree with 14 affected members of whom four developed giant cell tumors at pagetic sites. The high number of affected subjects across multiple generations allowed us to better characterize the clinical phenotype and look for possible susceptibility loci. Of interest, all the affected members had polyostotic PDB, but subjects developing giant cell tumors showed an increased disease severity with a reduced clinical response to bisphosphonate treatment and an increased prevalence of bone pain, deformities, and fractures. Together with an increased occurrence of common pagetic complications, affected patients of this pedigree also evidenced a fivefold higher prevalence of coronary artery disease with respect to either the unaffected family members or a comparative cohort of 150 unrelated PDB cases from the same geographical area. This association was further enhanced in the four cases with PDB and giant cell tumors, all of them developing coronary artery disease before 60 years of age. Despite the early onset and the severe phenotype, PDB patients from this pedigree were negative for the presence of SQSTM1 or TNFRSF11A mutations, previously associated with enhanced disease severity. Genome-wide linkage analysis identified six possible candidate regions on chromosomes 1, 5, 6, 8, 10, and 20. Because the chromosome 8 and 10 loci were next to the TNFRSF11B and OPTN genes, we extended the genetic screening to these two genes, but we failed to identify any causative mutation at both the genomic and transcription level, suggesting that a different genetic defect is associated with PDB and potentially giant cell tumor of bone in this pedigree.

  11. Giant Magnons Meet Giant Gravitons

    SciTech Connect

    Hofman, Diego M.

    2008-07-28

    We study the worldsheet reflection matrix of a string attached to a D-brane in AdS{sub 5}xS{sup 5}. The D-brane corresponds to a maximal giant graviton that wraps an S{sup 3} inside S{sup 5}. In the gauge theory, the open string is described by a spin chain with boundaries. We focus on open strings with a large SO(6) charge and define an asymptotic boundary reflection matrix. Using the symmetries of the problem, we review the computation of the boundary reflection matrix, up to a phase. We also discuss weak and strong coupling computations where we obtain the overall phase factor and test our exact results.

  12. Coronary arteriography and angioplasty

    SciTech Connect

    King, S.B.; Douglas, J.S.

    1985-01-01

    This book explores biomedical radiography of the heart. Topics considered include six bench marks in the history of cardiac catheterization; normal coronary anatomy; anomalies of the coronary arteries; pathoanotomy of the coronary arteries and complications; indications, limitations, and risks of coronary arteriography and left ventriculography; catheterization techniques in coronary arteriography and left ventriculography: the Sones technique; catheterization techniques in coronary arteriography and left ventriculography: the Judkins technique; modification of Judkins catheters; catheterization techniques in coronary arteriography and left ventriculography multipurpose technique; new views in coronary arteriography; quantitative evaluation of left ventricular function; complications of coronary arteriography: management during and following the procedure; interpretation of coronary arteriograms and left ventriculograms; prevalence and distribution of disease in patients catheterized for suspected coronary disease at Emory University Hospital; the Cardiac Catheterization Laboratory; selection for surgery or percutaneous transluminal coronary angioplasty; intracoronary thrombolysis; and percutaneous transluminal coronary angioplasty.

  13. Spontaneous Coronary Artery Dissection

    MedlinePlus

    Spontaneous coronary artery dissection (SCAD) Overview By Mayo Clinic Staff Spontaneous coronary artery dissection — sometimes referred to as SCAD — is an ... the blood vessels in the heart. Spontaneous coronary artery dissection (SCAD) can slow or block blood flow ...

  14. Coronary artery fistula

    MedlinePlus

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the ...

  15. Giant papillary conjunctivitis.

    PubMed Central

    Donshik, P C

    1994-01-01

    Giant papillary conjunctivitis is a syndrome found frequently as a complication of contact lenses. Many variables can affect the onset and severity of the presenting signs and symptoms. Rigid gas permeable contact lenses appear to result in less severe signs and symptoms, with a longer time before the development of giant papillary conjunctivitis. Nonionic, low-water-content soft contact lenses tend to produce less severe signs and symptoms than ionic, low-water-content soft contact lenses. Enzymatic treatment appears to lessen the severity of signs and symptoms. The association of an allergy appears to play a role in the onset of the severity of the signs and symptoms but does not appear to affect the final ability of the individual to wear contact lenses. Using multiple treatment options, such as changing the polymer to a glyceryl methyl methacrylate or a rigid lens, or utilizing a soft lens on a frequent-replacement basis, can result in a success rate of over 90%. In individuals who still have a return of symptoms, the use of topical mast cell stabilizers or a nonsteroidal anti-inflammatory drug as an adjunctive therapy offers the added possibility of keeping these patients in contact lenses. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 11 A FIGURE 11 B FIGURE 11 C FIGURE 11 D PMID:7886881

  16. Transforming giants.

    PubMed

    Kanter, Rosabeth Moss

    2008-01-01

    Large corporations have long been seen as lumbering, inflexible, bureaucratic--and clueless about global developments. But recently some multinationals seem to be transforming themselves: They're engaging employees, moving quickly, and introducing innovations that show true connection with the world. Harvard Business School's Kanter ventured with a research team inside a dozen global giants--including IBM, Procter & Gamble, Omron, CEMEX, Cisco, and Banco Real--to discover what has been driving the change. After conducting more than 350 interviews on five continents, she and her colleagues came away with a strong sense that we are witnessing the dawn of a new model of corporate power: The coordination of actions and decisions on the front lines now appears to stem from widely shared values and a sturdy platform of common processes and technology, not from top-down decrees. In particular, the values that engage the passions of far-flung workforces stress openness, inclusion, and making the world a better place. Through this shift in what might be called their guidance systems, the companies have become as creative and nimble as much smaller ones, even while taking on social and environmental challenges of a scale that only large enterprises could attempt. IBM, for instance, has created a nonprofit partnership, World Community Grid, through which any organization or individual can donate unused computing power to research projects and see what is being done with the donation in real time. IBM has gained an inspiring showcase for its new technology, helped business partners connect with the company in a positive way, and offered individuals all over the globe the chance to contribute to something big.

  17. Giant Cell Arteritis

    MedlinePlus

    Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. ... arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia ...

  18. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2013-10-01

    The 2009 impact and recent superbolides on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution {enabling the 2009 impact debris field detection} and rapid frame rates {enabling the 2010/2012 impact flash detections and lightcurve measurements}.We propose a ToO program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere {10^20 J}.HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing {not achievable from the ground} is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  19. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2014-10-01

    The 2009 impact and recent superbolides on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution (enabling the 2009 impact debris field detection) and rapid frame rates (enabling the 2010/2012 impact flash detections and lightcurve measurements).We propose a ToO program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere (10^20 J).HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing (not achievable from the ground) is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  20. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2012-10-01

    The 2009 impact on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution {enabling the 2009 impact debris field detection} and rapid frame rates {enabling the 2010 impact flash detections and lightcurve measurements}.We propose a Target of Opportunity program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere.HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing {not achievable from the ground} is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  1. Diffuse coronary artery ectasia in a patient with left main coronary artery trifurcation

    PubMed Central

    Desperak, Piotr; Bujak, Kamil; Głowacki, Jan; Gąsior, Mariusz

    2016-01-01

    The term coronary ectasia is reserved to describe a diffuse dilatation of coronary artery segments that have a diameter that exceeds the size of normal adjacent coronary segments by 1.5 times. The occurrence of coronary artery ectasia (CAE) ranges from 3% to 8% in the group of patients undergoing coronary computed tomography angiography. The CAE is associated with traditional risk factors and often co-exists with coronary atherosclerosis, which suggests that ectasia may represent an advanced form of atherosclerosis. Nevertheless, there is a lack of consensus on the clinical implications and management of patients in whom the occurrence of CAE is observed, especially in patients without concomitant obstructive atherosclerosis. Here, we present a rare case of a 62-year-old patient with multiple CAEs and left main trifurcation. PMID:27785148

  2. Enhanced current-perpendicular-to-plane giant magnetoresistance effect in half-metallic NiMnSb based nanojunctions with multiple Ag spacers

    NASA Astrophysics Data System (ADS)

    Wen, Zhenchao; Kubota, Takahide; Yamamoto, Tatsuya; Takanashi, Koki

    2016-06-01

    Current-perpendicular-to-plane giant magnetoresistance (CPP-GMR) heterostructure devices using half-metallic NiMnSb Heusler alloy electrodes with single, dual, and triple Ag spacers were fabricated. The NiMnSb alloy films and Ag spacers show (001) epitaxial growth in all CPP-GMR multilayer structures. The dual-spacer CPP-GMR nanojunction exhibited an enhanced CPP-GMR ratio of 11% (a change in the resistance-area product, ΔRA, of 3.9 mΩ μm2) at room temperature, which is approximately twice (thrice) of 6% (1.3 mΩ μm2) in the single-spacer device. The enhancement of the CPP-GMR effects in the dual-spacer devices could be attributed to improved interfacial spin asymmetry. Moreover, it was observed that the CPP-GMR ratios increased monotonically as the temperatures decreased. At 4.2 K, a CPP-GMR ratio of 41% (ΔRA = 10.5 mΩ μm2) was achieved in the dual-spacer CPP-GMR device. This work indicates that multispacer structures provide an efficient enhancement of CPP-GMR effects in half-metallic material-based CPP-GMR systems.

  3. Coronary magnetic resonance imaging.

    PubMed

    Manning, Warren J; Nezafat, Reza; Appelbaum, Evan; Danias, Peter G; Hauser, Thomas H; Yeon, Susan B

    2007-02-01

    This article highlights the technical challenges and general imaging strategies for coronary MRI. This is followed by a review of the clinical results for the assessment of anomalous CAD, coronary artery aneurysms, native vessel integrity, and coronary artery bypass graft disease using the more commonly applied MRI methods. It concludes with a brief discussion of the advantages/disadvantages and clinical results comparing coronary MRI with multidetector CT (MDCT) coronary angiography.

  4. Transient cortical blindness after coronary artery angiography.

    PubMed

    Terlecki, Michał; Wojciechowska, Wiktoria; Rajzer, Marek; Jurczyszyn, Artur; Bazan-Socha, Stanisława; Bryniarski, Leszek; Czarnecka, Danuta

    2013-01-01

    Coronary angiography is the current gold standard for the diagnosis of ischemic heart disease and therefore the prevalence of percutaneous coronary procedures such as angiography and angioplasty is high. The occurrence of cerebral complications after coronary angiography and coronary angioplasty is low and it mainly includes transient ischemic attack and stroke. The prevalence of transient cortical blindness after X-ray contrast media is low and it is usually seen after cerebral angiography. Until now only a few cases of transient cortical blindness have been described after coronary artery angiography. Regarding the spread of coronary angiography worldwide and in Poland this complication is uniquely rare. A 32-year-old man with multiple extrasystolic ventricular arrhythmia suggesting Brugada syndrome diagnosis according to morphology of the left bundle branch block and with decreased left ventricular ejection fraction was admitted to the First Department of Cardiology and Hypertension, Medical College of the Jagiellonian University in Krakow. Coronary angiography was performed in order to exclude ischemic etiology of the observed abnormalities. No arteriosclerotic lesions were found in coronary arteries. Transient cortical blindness was observed directly after angiography which may have been caused by the neurotoxic effect of the used X-ray contrast medium. In ophthalmologic and neurologic examination as well as in the cerebral computed tomography scan no pathologies were found. Visual impairment disappeared totally within several hours.

  5. The Electric Giant Resonances

    NASA Astrophysics Data System (ADS)

    van der Woude, A.

    The following sections are included: * Introduction * Experimental Methods to Study Giant Resonances * Introduction * The Tools * Introduction * Tools for Isoscalar Scattering * INELASTIC α-SCATTERING * INELASTIC PROTON SCATTERING * Tools for Isovector Excitations * γ-ABSORPTION AND PARTICLE CAPTURE REACTIONS * CHARGE EXCHANGE REACTIONS - THE (π+, π0) REACTION * Tools For Isoscalar And Isovector Excitations * INELASTIC ELECTRON SCATTERING * GIANT RESONANCE EXCITATION BY FAST HEAVY IONS * From Multipole Cross Section To Multipole Strength * The Electric Isoscalar Resonances * The Isoscalar Giant Monopole Resonance * Systematics on the GMR * Compressibility and the Giant Monopole Resonance * Introduction * The Compressibility of nuclear matter from the GMR energies * Discussion * The Isoscalar Giant Quadrupole Resonance * General Trends In Medium-Heavy and Heavy Nuclei * The GQR In Light Nuclei * The Isoscalar 3- Strength, LEOR and HEOR * Isoscalar 4+ Strength * Miscellaneous; Isoscalar 1- and L > 4-Strength * The Electric Isovector Giant Resonances * The Isovector Giant Dipole Resonance: GDR * The Isovector Giant Monopole Resonances: IVGMR * The Isovector Quadrupole Resonance: IVGQR * The Effect of Ground State Deformation on the Shape of Giant Resonance: Microscopic Picture * Giant Resonances Built on Excited States * Introduction * Capture Reactions on Light Nuclei * Statistical decay of GDR γ Emission in Heavy Compound Systems * Introduction * Theoretical Predictions * Some Experimental Results * Summary and Outlook * Acknowledgements * General References * References

  6. Two cases of giant pyogenic granuloma of scalp

    PubMed Central

    Chandra, B. Satish; Rao, P. Narasimha

    2013-01-01

    Pyogenic granuloma is a benign vascular tumor of unknown etiology, though multiple factors play a role in its onset, e.g., trauma, chronic irritation, drugs etc., It is commonly seen in children and adolescents. Giant pyogenic granuloma is its atypical variant. We are presenting two cases of giant pyogenic granuloma, one, in a 28-year-old adult, presenting as a giant fluffy swelling of scalp and the other in a 11-year-old child, presenting as a giant ulcerated globular swelling of the scalp. PMID:24350008

  7. Spontaneous multi-focal coronary artery spasm: a case report

    PubMed Central

    Ostovan, Mohammad Ali; Khanian, Mahdi Sajedi; Hamidi, Sahand; Fattahi, Mostafa; Dehghani, Pooyan

    2016-01-01

    Spontaneous coronary artery vasospasm is one of the important causes of acute chest pain syndromes. The diagnosis of diffuse multifocal spasm can be quite challenging and it could be easily mistaken for diffuse coronary artery disease. The use of intracoronary nitroglycerin can relieve spasm and reveal the real extent of coronary artery disease. Herein we present a case presenting with acute myocardial infarction due to severe coronary artery spasm that had even received fibrinolytic therapy. Multiple narrowing was shown during coronary angiography and the patient was scheduled for percutaneous coronary intervention (PCI). But after intracoronary (IC) injection of nitroglycerin, all of lesions disappeared completely and the diagnosis of coronary spasm was confirmed. PMID:27777700

  8. Expanding pseudoaneurysm compressing the coronary arteries and causing cardiogenic shock.

    PubMed

    Maliske, Seth M; Alshawabkeh, Laith; Schouweiler, Katie; Sigurdsson, Gardar

    2015-01-01

    A 37-year-old man who recently underwent aortic valve replacement after endocarditis presented with cardiogenic shock. A large expansile pseudoaneurysm was subsequently discovered using multiple imaging modalities. Although transesophageal echocardiography is important in diagnosing valve endocarditis, coronary CT angiography of prosthetic valves is feasible and image quality is good. In this case, coronary CT angiography allowed for better understanding of transesophageal echocardiography images and earlier diagnosis of coronary involvement as cause for left ventricular dysfunction.

  9. Multivessel Coronary Thrombosis in a Patient with Idiopathic Thrombocytopenic Purpura

    PubMed Central

    Yagmur, Julide; Cansel, Mehmet; Acikgoz, Nusret; Yagmur, Murat; Eyupkoca, Ferhat; Ermis, Necip; Akturk, Erdal

    2012-01-01

    A 49-year-old woman who had idiopathic thrombocytopenic purpura was admitted to our hospital with severe chest pain. Electrocardiography revealed inferolateral myocardial infarction. The patient underwent immediate coronary angiography, which revealed thrombi in the left coronary system. Percutaneous intervention was not indicated, because the thrombi had occluded the distal segments of multiple coronary arteries. Administration of tirofiban satisfactorily dissolved the thrombi. PMID:23304046

  10. Giant Herbig-Haro Flows

    NASA Astrophysics Data System (ADS)

    Reipurth, Bo; Bally, John; Devine, David

    1997-12-01

    We present the discovery of a number of Herbig-Haro flows which extend over parsec-scale distances. The largest of these is the well known HH 111 jet complex, which is shown, through CCD images and a proper motion study, to have an angular extent of almost one degree on the sky, corresponding to 7.7 pc, making it the largest known HH flow. In our imaging survey we also found that T Tauri is at the center of a huge bipolar HH flow, HH 355, with a total extent of 38 arcmin, corresponding to 1.55 pc, and aligned with the axis of the tiny HH 255 flow surrounding the infrared companion T Tau S. We additionally have found a number of other giant HH flow candidates, including HH 315 at PV Cep, HH 41/295 at Haro 5a/6a, HH 300 in Bl8w, HH 354 in Li 165, HH 376 in Li 152, and HH 114/115 and HH 243/244/245/179 in the X Orionis molecular ring. It thus appears that it is common for HH flows to attain parsec-scale dimensions. The ubiquity of parsec-scale HH flows profoundly alters our view of the impact of young stars on their environment. Giant flows have dynamical ages comparable to the duration of the accretion phase of the sources, and provide a fossil record of their mass loss and accretion history. Multiple internal working surfaces and their S-shaped point symmetry provide evidence for variability of ejection velocity and orientation of the source jets. Giant HH flows are either longer or comparable in length to associated CO outflows, providing evidence for unified models in which HH flows power CO flows. Many giant flows have burst out of their source cloud cores and are dissociating molecules and injecting momentum and kinetic energy into the interclump medium of the host clouds. They contribute to the UV radiation field, and may produce C I and C ii in cloud interiors. Giant flows may contribute to the chemical rejuvenation of clouds, the generation of turbulent motions, and the self-regulation of star formation. The terminal working surfaces of giant flows may be

  11. The Shared Crosstalk of Multiple Pathways Involved in the Inflammation between Rheumatoid Arthritis and Coronary Artery Disease Based on a Digital Gene Expression Profile

    PubMed Central

    Zhang, Zhiguo; Jiang, Miao; He, Dan; Bian, Yanqin; Zhang, Ge; Bian, Zhaoxiang; Lu, Aiping

    2014-01-01

    Rheumatoid arthritis (RA) and coronary artery disease (CAD) are both complex inflammatory diseases, and an increased prevalence of CAD and a high rate of mortality have been observed in RA patients. But the molecular mechanism of inflammation that is shared between the two disorders is unclear. High-throughput techniques, such as transcriptome analysis, are becoming important tools for genetic biomarker discovery in highly complex biological samples, which is critical for the diagnosis, prognosis, and treatment of disease. In the present study, we reported one type of transcriptome analysis method: digital gene expression profiling of peripheral blood mononuclear cells of 10 RA patients, 10 CAD patients and 10 healthy people. In all, 213 and 152 differently expressed genes (DEGs) were identified in RA patients compared with normal controls (RA vs. normal) and CAD patients compared with normal controls (CAD vs. normal), respectively, with 73 shared DEGs between them. Using this technique in combination with Ingenuity Pathways Analysis software, the effects on inflammation of four shared canonical pathways, three shared activated predicted upstream regulators and three shared molecular interaction networks were identified and explored. These shared molecular mechanisms may provide the genetic basis and potential targets for optimizing the application of current drugs to more effectively treat these diseases simultaneously and for preventing one when the other is diagnosed. PMID:25514790

  12. Coronary artery disease

    MedlinePlus Videos and Cool Tools

    ... heart muscle itself. Damage to or blockage of a coronary artery can result in injury to the heart. Normally, blood flows through a coronary artery unimpeded. However, a process called atherosclerosis ...

  13. Coronary heart disease

    MedlinePlus

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... buildup of plaque in the arteries to your heart. This may also be called hardening of the ...

  14. Counseling the Coronary Patient

    ERIC Educational Resources Information Center

    Semmler, Caryl; Semmler, Maynard

    1974-01-01

    The article discusses counseling sessions designed to a) help the coronary patient adjust to cardiovascular disease, b) diminish patient anxieties and fears, and c) educate the patient and family members on controlling risk factors to deter another coronary attack. (JS)

  15. Giant venous aneurysm jeopardising internal mammary arterial graft patency.

    PubMed

    Van Caenegem, Olivier; le Polain de Waroux, Jean-Benoit; de Kerchove, Laurent; Coche, Emmanuel

    2012-09-01

    The authors report a 79-year old man with a history of coronary bypass surgery, presenting with acute heart failure and elevated troponin. Coronarography revealed a giant saphenous vein graft aneurysm, which was compressing the left internal mammary artery bypass graft. This was confirmed by a multislice enhanced-ECG gated cardiac CT, showing the venous aneurysm responsible for external compression of the arterial graft and its functional occlusion. Myocardial ischaemia, the mechanism leading to cardiac failure, was confirmed by hypoperfusion of the sub-endocardial area shown by the CT. The aneurysm was surgically removed without complications. The patient recovered and his cardiac function improved. This is the first recorded case of compression of the left internal mammary artery by an giant saphenous vein graft aneurysm having triggered severe myocardial ischaemia and heart failure. The authors review the incidence and complications of giant venous bypass graft aneurysms reported in the literature.

  16. Giant venous aneurysm jeopardising internal mammary arterial graft patency

    PubMed Central

    Van Caenegem, Olivier; le Polain de Waroux, Jean-Benoit; de Kerchove, Laurent; Coche, Emmanuel

    2012-01-01

    The authors report a 79-year old man with a history of coronary bypass surgery, presenting with acute heart failure and elevated troponin. Coronarography revealed a giant saphenous vein graft aneurysm, which was compressing the left internal mammary artery bypass graft. This was confirmed by a multislice enhanced-ECG gated cardiac CT, showing the venous aneurysm responsible for external compression of the arterial graft and its functional occlusion. Myocardial ischaemia, the mechanism leading to cardiac failure, was confirmed by hypoperfusion of the sub-endocardial area shown by the CT. The aneurysm was surgically removed without complications. The patient recovered and his cardiac function improved. This is the first recorded case of compression of the left internal mammary artery by an giant saphenous vein graft aneurysm having triggered severe myocardial ischaemia and heart failure. The authors review the incidence and complications of giant venous bypass graft aneurysms reported in the literature. PMID:22723090

  17. Management of Coronary Artery Calcium and Coronary CTA Findings.

    PubMed

    Thomas, Dustin M; Divakaran, Sanjay; Villines, Todd C; Nasir, Khurram; Shah, Nishant R; Slim, Ahmad M; Blankstein, Ron; Cheezum, Michael K

    Coronary artery calcium (CAC) testing and coronary computed tomography angiography (CTA) have significant data supporting their ability to identify coronary artery disease (CAD) and classify patient risk for atherosclerotic cardiovascular disease (ASCVD). Evidence regarding CAC use for screening has established an excellent prognosis in patients with no detectable CAC, and the ability to risk re-classify the majority of asymptomatic patients considered intermediate risk by traditional risk scores. While data regarding the ideal management of CAC findings are limited, evidence supports statin consideration in patients with CAC > 0 and individualized aspirin therapy accounting for CAD risk factors, CAC severity, and factors which increase a patient's risk of bleeding. In patients with stable or acute symptoms undergoing coronary CTA, a normal CTA predicts excellent prognosis, allowing reassurance and disposition without further testing. When CTA identifies nonobstructive CAD (<50 % stenosis), observational data support consideration of statin use/intensification in patients with extensive plaque (at least four coronary segments involved) and patients with high-risk plaque features. In patients with both nonobstructive and obstructive CAD, multiple studies have now demonstrated an ability of CTA to guide management and improve CAD risk factor control. Still, significant under-treatment of cardiovascular risk factors and high-risk image findings remain, among concerns that CTA may increase invasive angiography and revascularization. To fully realize the impact of atherosclerosis imaging for ASCVD prevention, patient engagement in lifestyle changes and the modification of ASCVD risk factors remain the foundation of care. This review provides an overview of available data and recommendations in the management of CAC and CTA findings.

  18. High regression rate of coronary aneurysms developed in patients with immune globulin-resistant Kawasaki disease treated with steroid pulse therapy.

    PubMed

    Adachi, Shinya; Sakaguchi, Heima; Kuwahara, Takashi; Uchida, Yasushi; Fukao, Toshiyuki; Kondo, Naomi

    2010-04-01

    Kawasaki disease is an acute vasculitis syndrome of unknown etiology that mainly affects small and medium-size arteries, particularly the coronary artery. Coronary artery lesions may develop into aneurismal formation and thrombotic occlusion, and progress to ischemic heart disease. The aim of the present study was to investigate the effect of steroid pulse therapy following intravenous immune globulin (IVIG) treatment on the regression rate of aneurysms in Kawasaki disease. Among 93 sequential patients referred to us, because of coronary artery lesions in the acute phase, we found 23 aneurysms in 12 patients during the period from January 1997 to January 2008. We divided them into two groups: a non-steroid group, 7 patients (13 aneurysms) treated with single or multiple IVIG but no steroid pulse therapy; and a steroid group, 5 patients (10 aneurysms) treated with multiple IVIG followed by steroid pulse therapy. We compared the regression rate of the aneurysms between the two groups, retrospectively. The regression rates of the aneurysms in the steroid group were significantly higher than those in the non-steroid group when we analyzed 1) all aneurysms (p = 0.007), 2) giant aneurysms (aneurismal diameter was 4 or more x normal, or > 8 mm) (p = 0.018), and 3) aneurysms in IVIG-resistant patients who were resistant to initial IVIG therapy (p = 0.035). All aneurysms, including the giant aneurysms in the steroid group, regressed, and the regression rate of the aneurysms in the non-steroid group was about 46%(6/13). Steroid pulse therapy may be beneficial for IVIG-resistant patients. Our data suggest that steroid pulse therapy may lead to regression of aneurysms.

  19. Unstable giant gravitons

    SciTech Connect

    Mello Koch, Robert de; Ives, Norman; Smolic, Jelena; Smolic, Milena

    2006-03-15

    We find giant graviton solutions in Frolov's three parameter generalization of the Lunin-Maldacena background. The background we study has {gamma}-tilde{sub 1}=0 and {gamma}-tilde{sub 2}={gamma}-tilde{sub 3}={gamma}-tilde. This class of backgrounds provides a nonsupersymmetric example of the gauge theory/gravity correspondence that can be tested quantitatively, as recently shown by Frolov, Roiban, and Tseytlin. The giant graviton solutions we find have a greater energy than the point gravitons, making them unstable states. Despite this, we find striking quantitative agreement between the gauge theory and gravity descriptions of open strings attached to the giant.

  20. The Next Giant Step

    NASA Video Gallery

    Artist Robert McCall painted "The Next Giant Step" in 1979 to commemorate the heroism and courage of spaceflight pioneers. Located in the lobby of Johnson's building 2, the mural depicts America's ...

  1. The Giant Cell.

    ERIC Educational Resources Information Center

    Stockdale, Dennis

    1998-01-01

    Provides directions for the construction of giant plastic cells, including details for building and installing the organelles. Also contains instructions for preparing the ribosomes, nucleolus, nucleus, and mitochondria. (DDR)

  2. What Causes Coronary Microvascular Disease?

    MedlinePlus

    ... Living With Clinical Trials Links Related Topics Angina Atherosclerosis Coronary Heart Disease Coronary Heart Disease Risk Factors ... Microvascular Disease? The same risk factors that cause atherosclerosis may cause coronary microvascular disease. Atherosclerosis is a ...

  3. Coronary revascularisation in women

    PubMed Central

    Mikhail, G W

    2006-01-01

    Coronary heart disease is the leading cause of death in men and women worldwide. It is still considered a disease of men and there has been little recognition of its importance in women. Gender differences exist in acute and chronic ischaemia in terms of clinical manifestations, investigations and treatment. There are clear gender differences in coronary revascularisation with a higher mortality seen in women. At the time a woman presents with coronary artery disease she is older and has more co‐morbid factors. Furthermore, women have smaller coronary arteries making them more difficult to revascularise. In recent years there has been a general trend towards improved outcomes in women undergoing both surgical and percutaneous coronary intervention. The increasing use of drug eluting stents and adjunctive medical treatment as well as the use of off‐pump bypass surgery needs further evaluation in terms of gender differences. This article reviews the current literature on coronary revascularisation in women. PMID:16614263

  4. Assessment of coronary thrombolysis

    SciTech Connect

    Geltman, E.M.; Abendschein, D.R.; Devries, S.R.

    1987-02-01

    The efficacy of coronary thrombolysis may be assessed by several invasive and noninvasive means, including coronary angiography, contrast and radionuclide angiography, thallium 201 or /sup 99m/Tc-pyrophosphate scintigraphy, positron emission tomography, cardiac ultrasonography, electrocardiography, and analysis of plasma creatine kinase activity. Each technique has its own strengths and limitations, but when used in concert these methods may provide insight into the physiology of coronary reperfusion and the efficacy of reperfusion in individual patients and populations. 104 references.

  5. Giant and thrombosed left ventricular aneurysm.

    PubMed

    de Agustin, Jose Alberto; de Diego, Jose Juan Gomez; Marcos-Alberca, Pedro; Rodrigo, Jose Luis; Almeria, Carlos; Mahia, Patricia; Luaces, Maria; Garcia-Fernandez, Miguel Angel; Macaya, Carlos; de Isla, Leopoldo Perez

    2015-07-26

    Left ventricular aneurysms are a frequent complication of acute extensive myocardial infarction and are most commonly located at the ventricular apex. A timely diagnosis is vital due to the serious complications that can occur, including heart failure, thromboembolism, or tachyarrhythmias. We report the case of a 78-year-old male with history of previous anterior myocardial infarction and currently under evaluation by chronic heart failure. Transthoracic echocardiogram revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. Coronary angiography demonstrated that the left anterior descending artery was chronically occluded, and revealed a big and spherical mass with calcified borders in the left hemithorax. Left ventriculogram confirmed that this spherical mass was a giant calcified left ventricular aneurysm, causing very severe left ventricular systolic dysfunction. The patient underwent cardioverter-defibrillator implantation for primary prevention.

  6. Evaluation of Coronary Artery Status by Coronary Angiography after First Survival of Acute Myocardial Infarction

    PubMed Central

    Jain, Siddhant; Sarkar, Piyabi; Modi, Nitin; Tilkar, Mahendra

    2015-01-01

    Introduction Acute Myocardial Infarction (AMI) is a life threatening medical emergency which needs urgent medical attention. It is one of the major cause of mortality and morbidity throughout the world. Aim The aim of the present study was to assess the coronary artery status by Coronary Angiography (CAG) after first survival of the Acute Myocardial Infarction (AMI) and to correlate the CAG findings with Coronary Artery Disease (CAD) Risk Factor (RF) and effect of early thrombolysis. Materials and Methods CAG was done on 870 patients consecutively from June 2013 to May 2015. Age, Gender, Body Mass Index (BMI), CAD risk factors (RF) such as Type 2 diabetes mellitus (T2 DM), hypertension, dyslipidaemia, smoking status and history of thrombolyctic status were recorded. The correlation between the CAD risk factors (RF) and the CAG findings were statistically analyzed. Results Coronary heart disease risk factors analysis revealed ≥ three RF in 23.88%, two RF in 29.88% and one RFin 45.86% of patients. CAG showed Single Vessel Disease (SVD) in 236 (27.1%) patients, double vessel disease (DVD) in 220(25.2%) patients, Triple Vessel Disease (TVD) in 252 (28.9%) patients. Multiple coronary artery involvement were found in the high risk group patients, which was found statistically significant (p-value<0.0001). A total of 348/870 (40%) patients were thrombolysed amongst them 80 (22.9%) revealed minimal and/or normal coronary artery which was found statistically significant (p-value<0.0001). Conclusion Higher the coronary risk factors, more the chance of the multiple coronary arteries involvement. All AMI patients should be thrombolysed as early as possible to get the benefit of recanalization of the culprit vessel. PMID:26816930

  7. Giant congenital melanocytic nevus*

    PubMed Central

    Viana, Ana Carolina Leite; Gontijo, Bernardo; Bittencourt, Flávia Vasques

    2013-01-01

    Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is estimated in <1:20,000 newborns. Despite its rarity, this lesion is important because it may associate with severe complications such as malignant melanoma, affect the central nervous system (neurocutaneous melanosis), and have major psychosocial impact on the patient and his family due to its unsightly appearance. Giant congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion. PMID:24474093

  8. Giant congenital melanocytic nevus.

    PubMed

    Viana, Ana Carolina Leite; Gontijo, Bernardo; Bittencourt, Flávia Vasques

    2013-01-01

    Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is estimated in <1:20,000 newborns. Despite its rarity, this lesion is important because it may associate with severe complications such as malignant melanoma, affect the central nervous system (neurocutaneous melanosis), and have major psychosocial impact on the patient and his family due to its unsightly appearance. Giant congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion.

  9. Isolated giant molluscum contagiosum mimicking epidermoid cyst

    PubMed Central

    Uzuncakmak, Tugba K.; Kuru, Burce C.; Zemheri, Ebru I.; Zindanci, Ilkin; Turkoglu, Zafer; Kavala, Mukaddes

    2016-01-01

    Molluscum contagiosum is a benign cutaneous viral infection which is caused by double- stranded DNA poxvirus. It affects mainly children and young adults and usually presents with single or multiple umblicated papules or nodules on face, arms, legs and anogenital regions. It may present in atypical size and clinical appearance in patients with altered or impaired immunity and rarely in immuncompetent patients. Herein we present an immuncompetent young adult patient with isolated giant molluscum contagiosum, which was mimicking epidermoid cyst clinically. PMID:27648389

  10. An Innocent Giant

    PubMed Central

    Solanki, Lakhan Singh; Dhingra, Mandeep; Raghubanshi, Gunjan; Thami, Gurvinder Pal

    2014-01-01

    A cutaneous horn (cornu cutaneum) is a protrusion from the skin composed of a cornified material. It may be associated with a benign, premalignant, or malignant lesion at the base, masking numerous dermatoses. In a 24-year-old female, a giant cutaneous horn arising from a seborrheic keratosis located on the leg is presented. This case has been reported to emphasize that a giant cutaneous horn may also occur in young patients, even in photoprotected areas, and are not always associated with malignancy. PMID:25484426

  11. Pathophysiology of coronary collaterals.

    PubMed

    Stoller, Michael; Seiler, Christian

    2014-02-01

    While the existence of structural adaptation of coronary anastomoses is undisputed, the potential of coronary collaterals to be capable of functional adaptation has been questioned. For many years, collateral vessels were thought to be rigid tubes allowing only limited blood flow governed by the pressure gradient across them. This concept was consistent with the notion that although collaterals could provide adequate blood flow to maintain resting levels, they would be unable to increase blood flow sufficiently in situations of increased myocardial oxygen demand. However, more recent studies have demonstrated the capability of the collateral circulation to deliver sufficient blood flow even during exertion or pharmacologic stress. Moreover, it has been shown that increases in collateral flow could be attributed directly to collateral vasomotion. This review summarizes the pathophysiology of the coronary collateral circulation, ie the functional adapation of coronary collaterals to acute alterations in the coronary circulation.

  12. Pathophysiology of Coronary Collaterals#

    PubMed Central

    Stoller, Michael; Seiler, Christian

    2014-01-01

    While the existence of structural adaptation of coronary anastomoses is undisputed, the potential of coronary collaterals to be capable of functional adaptation has been questioned. For many years, collateral vessels were thought to be rigid tubes allowing only limited blood flow governed by the pressure gradient across them. This concept was consistent with the notion that although collaterals could provide adequate blood flow to maintain resting levels, they would be unable to increase blood flow sufficiently in situations of increased myocardial oxygen demand. However, more recent studies have demonstrated the capability of the collateral circulation to deliver sufficient blood flow even during exertion or pharmacologic stress. Moreover, it has been shown that increases in collateral flow could be attributed directly to collateral vasomotion. This review summarizes the pathophysiology of the coronary collateral circulation, ie the functional adapation of coronary collaterals to acute alterations in the coronary circulation. PMID:23701025

  13. Coronary plaque imaging by coronary computed tomography angiography

    PubMed Central

    Sato, Akira

    2014-01-01

    Coronary computed tomography angiography (CTA) has become the useful noninvasive imaging modality alternative to the invasive coronary angiography for detecting coronary artery stenoses in patients with suspected coronary artery disease (CAD). With the development of technical aspects of coronary CTA, clinical practice and research are increasingly shifting toward defining the clinical implication of plaque morphology and patients outcomes by coronary CTA. In this review we discuss the coronary plaque morphology estimated by CTA beyond coronary angiography including the comparison to the currently available other imaging modalities used to examine morphological characteristics of the atherosclerotic plaque. Furthermore, this review underlies the value of a combined assessment of coronary anatomy and myocardial perfusion in patients with CAD, and adds to an increasing body of evidence suggesting an added diagnostic value when combining both modalities. We hope that an integrated, multi-modality imaging approach will become the gold standard for noninvasive evaluation of coronary plaque morphology and outcome data in clinical practice. PMID:24876919

  14. An apparent case of undiagnosed donor Kawasaki disease manifesting as coronary artery aneurysm in a pediatric heart transplant recipient.

    PubMed

    Friedland-Little, Joshua; Aiyagari, Ranjit; Gajarski, Robert J; Schumacher, Kurt R

    2013-02-01

    We present a case of coronary ectasia and LAD coronary artery aneurysm with angiographic characteristics of Kawasaki disease in a three-yr-old girl two-yr status post-orthotopic heart transplant. Coronary anomalies were noted during initial screening coronary angiography two yr after transplant. Subsequent review of the donor echocardiogram revealed that the LMCA had been mildly dilated prior to transplant. In the absence of any symptoms consistent with Kawasaki disease in the transplant recipient, this appears to be a case of Kawasaki disease in the organ donor manifesting with coronary anomalies in the transplant recipient. The patient has done well clinically, and repeat coronary angiography has revealed partial regression of coronary anomalies. Given multiple reports in the literature of persistent abnormalities of coronary artery morphology and function after Kawasaki disease, close monitoring is warranted, with consideration of potential coronary protective medical therapies.

  15. Coronary stenting during burn shock: diagnostic and treatment considerations.

    PubMed

    Gregg, Shea C; Fidler, Philip E; Atweh, Nabil A

    2006-01-01

    Myocardial injury is known to occur in victims of both thermal and electrical burns. A variety of mechanisms have been ascribed to the pathogenesis of cardiac damage during burn shock. However, limited evidence exists that coronary artery thrombosis plays a frequent role. Distinguishing between acute coronary syndrome (impending myocardial infarction from coronary artery occlusion) vs global cardiac injury is essential; the care diverges drastically. The following case describes a patient who was angiographically proven to have acute coronary thrombosis amidst burn shock ftera 50% TBSA electrical flash burn. Managing the patient's burn shock, myocardial injury, and multiple surgical procedures while considering antiplatelet medications for a newly placed coronary artery stent presented a number of challenges not previously reported.

  16. Recurrent post-partum coronary artery dissection

    PubMed Central

    2010-01-01

    Coronary artery dissection is a rare but well-described cause for myocardial infarction during the post-partum period. Dissection of multiple coronary arteries is even less frequent. Here we present a case of recurrent post-partum coronary artery dissections. This unusual presentation poses unique problems for management. A 35 year-old female, gravida 3 para 2, presented with myocardial infarction 9 weeks and 3 days post-partum. Cardiac catheterization demonstrated left anterior descending (LAD) dissection but an otherwise normal coronary anatomy. The lesion was treated with four everolimus eluting stents. Initially the patient made an unremarkable recovery until ventricular fibrillation arrest occurred on the following day. Unsynchronized cardioversion restored a normal sinus rhythm and repeat catheterization revealed new right coronary artery (RCA) dissection. A wire was passed distally, but it was unclear whether this was through the true or false lumen and no stents could be placed. However, improvement of distal RCA perfusion was noted on angiogram. Despite failure of interventional therapy the patient was therefore treated conservatively. Early operation after myocardial infarction has a significantly elevated risk of mortality and the initial dissection had occurred within 24 hours. This strategy proved successful as follow-up transthoracic echocardiography after four months demonstrated a preserved left ventricular ejection fraction of 55-60% without regional wall motion abnormalities. The patient remained asymptomatic from a cardiac point of view. PMID:20932332

  17. Recurrent post-partum coronary artery dissection.

    PubMed

    Rajab, Taufiek K; Khalpey, Zain; Kraemer, Bernhard; Resnic, Frederic S; Gallegos, Robert P

    2010-10-09

    Coronary artery dissection is a rare but well-described cause for myocardial infarction during the post-partum period. Dissection of multiple coronary arteries is even less frequent. Here we present a case of recurrent post-partum coronary artery dissections. This unusual presentation poses unique problems for management. A 35 year-old female, gravida 3 para 2, presented with myocardial infarction 9 weeks and 3 days post-partum. Cardiac catheterization demonstrated left anterior descending (LAD) dissection but an otherwise normal coronary anatomy. The lesion was treated with four everolimus eluting stents. Initially the patient made an unremarkable recovery until ventricular fibrillation arrest occurred on the following day. Unsynchronized cardioversion restored a normal sinus rhythm and repeat catheterization revealed new right coronary artery (RCA) dissection. A wire was passed distally, but it was unclear whether this was through the true or false lumen and no stents could be placed. However, improvement of distal RCA perfusion was noted on angiogram. Despite failure of interventional therapy the patient was therefore treated conservatively. Early operation after myocardial infarction has a significantly elevated risk of mortality and the initial dissection had occurred within 24 hours. This strategy proved successful as follow-up transthoracic echocardiography after four months demonstrated a preserved left ventricular ejection fraction of 55-60% without regional wall motion abnormalities. The patient remained asymptomatic from a cardiac point of view.

  18. [Pregnancy and coronary artery dissection].

    PubMed

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-01-01

    Acute myocardial infarction during pregnancy is associated with high maternal and fetal mortality. Coronary atherosclerosis is the most common cause due to an increase in the age of the patients and the association with cardiovascular risk factors such as smoking, hypertension, diabetes mellitus, preeclampsia, and the existence of family history of coronary disease. However, thrombosis, coronary dissection or coronary vasospasms are other causes that may justify it. We report the case of a 33 weeks pregnant first-time mother, without cardiovascular risk factors, who presented an acute coronary event in the context of atherosclerotic disease and coronary dissection after percutaneous coronary intervention.

  19. Giant scrotal elephantiasis.

    PubMed

    Kuepper, Daniel

    2005-02-01

    How much can a man carry? Penoscrotal elephantiasis is a debilitating syndrome. This is a case report of a patient with giant genital elephantiasis secondary to long-standing lymphogranuloma venereum infection in Ethiopia. Complete surgical resection of the pathologic tissue and penile reconstruction was undertaken with good cosmetic and functional results.

  20. Electroluminescence of Giant Stretchability.

    PubMed

    Yang, Can Hui; Chen, Baohong; Zhou, Jinxiong; Chen, Yong Mei; Suo, Zhigang

    2016-06-01

    A new type of electroluminescent device achieves giant stretchability by integrating electronic and ionic components. The device uses phosphor powders as electroluminescent materials, and hydrogels as stretchable and transparent ionic conductors. Subject to cyclic voltage, the phosphor powders luminesce, but the ionic conductors do not electrolyze. The device produces constant luminance when stretched up to an area strain of 1500%.

  1. Giant lateral left ventricular wall aneurysm sparing the submitral apparatus

    PubMed Central

    2013-01-01

    Left ventricular aneurysms are a frequent and serious complication following acute transmural myocardial infarction and are most commonly located at the ventricular apex. The majority of these patients presents with severe mitral insufficiency, congestive heart failure, systemic embolism and sudden cardiac death. Giant aneurysms occurring in a submitral position between anterior and posterior papillary muscles on the lateral ventricular wall constitute a minor entity and those leaving the mitral apparatus intact are extremely rare. Herein, we report the case of a 57 y/o Caucasian male patient with a past medical history of coronary artery disease and myocardial infarction with a giant left ventricular aneurysm measuring 15x10x8 cm in diameter. Despite the size of the aneurysm and its close topographical relation to the posterior mitral annulus the mitral apparatus was intact with a competent valve and normal left atrial size. He underwent successful surgical ventricular restoration. PMID:24172071

  2. Takayasu Arteritis of the Coronary Arteries Presenting as Sudden Death in a White Teenager.

    PubMed

    Hlavaty, Leigh; Diaz, Francisco; Sung, LokMan

    2015-09-01

    Takayasu arteritis is a rare disease that expresses chronic, large vessel inflammation. The etiology remains unclear and its presentation depends on the affected arteries. With coronary artery involvement, manifestations range from chest pain and shortness of breath to sudden death. We report a case of a 15-year-old white girl who presented with syncope immediately before passing. On autopsy, all 3 major coronary arteries grossly contained multiple proximal lesions that were consistent with Takayasu arteritis, microscopically. Takayasu arteritis solely affecting multiple coronary arteries is exceedingly rare. This report discusses the significance of coronary involvement in Takayasu arteritis at autopsy and sudden death.

  3. LITHIUM ABUNDANCES IN RED GIANTS OF M4: EVIDENCE FOR ASYMPTOTIC GIANT BRANCH STAR POLLUTION IN GLOBULAR CLUSTERS?

    SciTech Connect

    D'Orazi, Valentina; Marino, Anna F. E-mail: anna.marino@unipd.i

    2010-06-20

    The determination of Li and proton-capture element abundances in globular cluster (GC) giants allows us to constrain several key questions on the multiple population scenarios in GCs, from formation and early evolution to pollution and dilution mechanisms. In this Letter, we present our results on Li abundances for a large sample of giants in the intermediate-metallicity GC NGC 6121 (M4), for which Na and O have been already determined by Marino et al. The stars analyzed are both below and above the red giant branch bump luminosity. We found that the first and second generation stars share the same Li content, suggesting that a Li production must have occurred. This provides strong observational evidence supporting the scenario in which asymptotic giant branch stars are GC polluters.

  4. Alternative Surgical Approach to Repairing a Giant Sinus of Valsalva Aneurysm

    PubMed Central

    Cucchietti, Cristina; Pisano, Calogera; Hyde, Jonathan

    2016-01-01

    We report our method of surgically repairing an unruptured giant aneurysm of the right coronary sinus of Valsalva, a lesion that caused moderate aortic regurgitation but no symptoms in a 61-year-old woman. We excised the aneurysm, reconstructed the right sinus of Valsalva with use of a patch, performed mechanical aortic valve replacement directly through the excised aneurysm's cavity, and constructed a single bypass graft to the right coronary artery. The patient was discharged from the hospital after 5 days. Twelve months postoperatively, her clinical and echocardiographic results were normal, and she was doing well. To our knowledge, our surgical approach to this repair has not been described previously. PMID:27047284

  5. Pictorial review of coronary anomalies in Tetralogy of Fallot.

    PubMed

    Kapur, Sangita; Aeron, Gunjan; Vojta, Christopher N

    2015-01-01

    Tetralogy of Fallot (TOF) classically consists of four characteristic features-right ventricular outflow obstruction, right ventricular hypertrophy, ventricular septal defect and an overriding aorta. In addition there are multiple other associated cardiac anomalies, including coronary artery anomalies. In this review, the role of CT angiography and the spectrum of coronary anomalies will be discussed along with importance of such anomalies in the context of surgery.

  6. Novel treatment of coronary artery fistulae concealing severe coronary artery lesion: using thrombus aspiration catheter as a delivery guide

    PubMed Central

    Korkmaz, Levent; Acar, Zeydin; Dursun, İhsan; Akyüz, Ali Rıza; Korkmaz, Ayca Ata

    2014-01-01

    In this case report, we present the occlusion of multiple coronary artery fistulae originating from proximal left anterior descending (LAD) and right sinus valsavla and empting to the pulmonary artery at the same place. We occluded LAD fistulae by using thrombus aspiration catheter as a delivery guide. To the best of our knowlege, this is the first case of occlusion of coronary fistulae with the help of thrombus aspiration catheter. Our experience may suggest that thrombus aspiration catheters can be used in treating coronary artery fistulae with difficult anotomy. PMID:24748888

  7. Coronary Artery Disease

    MedlinePlus

    Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death ... both men and women. CAD happens when the arteries that supply blood to heart muscle become hardened ...

  8. Acute Coronary Syndrome

    MedlinePlus

    ... angina? This content was last reviewed July 2015. Heart Attack • Home • About Heart Attacks Acute Coronary Syndrome (ACS) ... Recovery FAQs • Heart Attack Tools & Resources • Support Network Heart Attack Tools & Resources What Is a Heart Attack? How ...

  9. Percutaneous Coronary Intervention

    MedlinePlus

    ... to open coronary arteries that are narrowed or blocked by the buildup of atherosclerotic plaque. PCI may ... that will highlight the blockage. To open a blocked artery, your doctor will insert another catheter over ...

  10. Coronary artery spasm

    MedlinePlus

    ... blocker or a long-acting nitrate long-term. Beta-blockers are another type of medicine that is used with other coronary artery problems. However, beta-blockers may make this problem worse. They should be ...

  11. Coronary Artery Fistula

    DTIC Science & Technology

    2007-04-01

    Figure 1A; oblique, Figure 1B), the left circumflex artery was identified by its black central lumen and noted to arise normally from the left main...but the mid left circumflex coronary artery was less well seen because of volume averaging with the left atrium and pulmonary venous confluence which...Figures 1C-D. Select oblique conventional x-ray views (C, early phase; D, late phase) from a coronary catheterization study following injection of

  12. Association of Serum Osteocalcin with Insulin Resistance and Coronary Atherosclerosis

    PubMed Central

    2016-01-01

    Background To determine the associations between serum osteocalcin level and insulin resistance, coronary atherosclerosis by using dual-source coronary computed tomography angiography. Methods A total of 98 subjects (24 men and 74 women) were selected for this retrospective cross-sectional study who voluntarily visited a health examination center for routine health check-up including the blood test for serum osteocalcin level and coronary computed tomography angiography. Multiple regression analysis was used to determine which variables were independently related to osteocalcin levels and coronary atherosclerosis. Results Stepwise multiple regression analysis adjusted for age, sex, menopausal status, body mass index, serum alkaline phosphatase, serum calcium and phosphate showed that osteocalcin negatively correlated with serum glucose (β=-0.145, P=0.001) and homeostasis model assessment of insulin resistance (HOMA-IR) index (β=-1.794, P=0.027) independently. The age, serum glucose, smoking status but not osteocalcin level were independent risk factors for coronary atherosclerosis by use of multiple logistic regression analysis after controlling for other variables. Conclusions Serum osteocalcin level was inversely associated with fasting glucose level and insulin resistance measured by HOMA-IR, suggesting that osteocalcin is important for glucose metabolism. However, in this study, no significant difference was observed in the serum osteocalcin level according to the presence of coronary atherosclerotic plaques. PMID:27965939

  13. Venous waterfalls in coronary circulation.

    PubMed

    Gosselin, R E; Kaplow, S M

    1991-03-21

    Several studies of flow through collapsible tubing deformed by external pressures have led to a concept known as the "vascular waterfall". One hallmark of this state is a positive zero-flow pressure intercept (Pe) in flow-pressure curves. This intercept is commonly observed in the coronary circulation, but in blood-perfused beating hearts a vascular waterfall is not the only putative cause. To restrict the possibilities, we have measured flow-pressure curves in excised non-beating rabbit hearts in which the coronary arteries were perfused in a non-pulsatile way with a newtonian fluid (Ringers solution) containing potent vasodilator drugs. Under these circumstances, vascular waterfalls are believed to be the only tenable explanation for Pe. In physical terms the waterfall is a region where the vessel is in a state of partial collapse with a stabilized intraluminal fluid pressure (Pw). It is argued that the most probable site of this collapse was the intramural veins just before they reached the epicardial surface. In accord with the waterfall hypothesis, Pe increased as the heart became more edematous, but flow-pressure curves also became flatter, implying multiple waterfalls with differing Pws, leading to complete collapse of some of the venous channels. The principal compressive force is believed to have been the interstitial fluid pressure as registered through a needle (Pn) implanted in the left ventricular wall, but a small additional force (Ps) was probably due to swelling of interstitial gels. A method is presented for estimating Ps and Pw. Unlike rubber tubing, blood vessels are both collapsible and porous. Apparently because of increased capillary filtration, Pn was found to increase linearly with the perfusion pressure. Thus, Pw was not the same at all points on the flow-pressure curve. This finding has interesting implications with respect to the concept of coronary resistance.

  14. Ice Giant Exploration

    NASA Astrophysics Data System (ADS)

    Rymer, A. M.; Arridge, C. S.; Masters, A.; Turtle, E. P.; Simon, A. A.; Hofstadter, M. D.; Turrini, D.; Politi, R.

    2015-12-01

    The Ice Giants in our solar system, Uranus and Neptune, are fundamentally different from their Gas Giant siblings Jupiter and Saturn, from the different proportions of rock and ice to the configuration of their planetary magnetic fields. Kepler space telescope discoveries of exo-planets indicate that planets of this type are among the most ubiquitous universally and therefore a future mission to explore the nature of the Ice Giants in our own solar system will provide insights into the nature of extra-solar system objects in general. Uranus has the smallest self- luminosity of all the planets, potentially related to catastrophic events early in the planet's history, which also may explain Uranus' large obliquity. Uranus' atmosphere is subject to extreme seasonal forcing making it unique in the Solar System. Neptune is also unique in a number of ways, notably its large moon Triton which is likely a captured Kuiper Belt Object and one of only two moons in the solar system with a robustly collisional atmosphere. Similar to Uranus, the angle between the solar wind and the magnetic dipole axis is subject to large-amplitude variations on both diurnal and seasonal timescales, but peculiarly it has one of the quietest magnetospheres of the solar system, at least according to Voyager 2, the only spacecraft to encounter Neptune to date. A comprehensive mission, as advocated in the Decadal Survey, would provide enormous science return but is also challenging and expensive. In this presentation we will discuss mission scenarios and suggest how collaboration between disciplines and internationally can help us to pursue a mission that includes Ice Giant exploration.

  15. Giant cell arteritis

    PubMed Central

    Calvo-Romero, J

    2003-01-01

    Giant cell arteritis (GCA), temporal arteritis or Horton's arteritis, is a systemic vasculitis which involves large and medium sized vessels, especially the extracranial branches of the carotid arteries, in persons usually older than 50 years. Permanent visual loss, ischaemic strokes, and thoracic and abdominal aortic aneurysms are feared complications of GCA. The treatment consists of high dose steroids. Mortality, with a correct treatment, in patients with GCA seems to be similar that of controls. PMID:13679546

  16. Giant Cell Arteritis.

    PubMed

    Hoffman, Gary S

    2016-11-01

    This issue provides a clinical overview of giant cell arteritis, focusing on diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  17. Early severe coronary artery disease and aortic coarctation in a child with familial hypercholesterolaemia.

    PubMed

    Labib, Dina; Soliman, Haytham; Said, Kareem; Sorour, Khaled

    2016-11-30

    An 11-year-old boy presented with easy fatigability, multiple xanthomas, and absent pedal pulsations. Laboratory workup showed severe hypercholesterolaemia and non-invasive imaging revealed 'normally functioning' bicuspid aortic valve and tight aortic coarctation. Coronary angiography showed severe right coronary artery (RCA) stenosis. Medical treatment resulted in significant improvement of dyslipidaemia. We successfully performed balloon dilation and stenting of his coarctation, as well as percutaneous coronary intervention for RCA lesion.

  18. Aortitis due to giant cell arteritis and psoriatic arthritis: An uncommon association.

    PubMed

    García-Cezón de la Cruz, M Del Pilar; Almodóvar, Raquel; García Pérez, Javier; Dhimes, Patricia Fanny; Zarco, Pedro

    2016-04-27

    We report the case of a 65-year-old woman with psoriatic arthritis who developed aortitis secondary to giant cell arteritis. She presented with a 2-mounth history of dry cough, fever and fatigue. There was no evidence of tumor or infectious processes. Abdominal computed tomographic and computed tomography coronary angiographic findings were suggestive of aortitis. Histological study of a temporal artery biopsy confirmed temporal arteritis. We also review the available literature on this uncommon condition.

  19. [Giant negative T waves in idiopathic apical diverticulum of the left ventricle in adults].

    PubMed

    Barboteu, M; Desnos, M; Hagège, A; Dufour, M; Chauvaud, S; Junes, G; Baleynaud, S; Bruneval, P; Guérot, C

    1995-10-01

    Left ventricular diverticula, congenital or acquired, with normal coronary arteries are rare. Apical diverticula are exceptionally rare in the adult. The authors present the clinical, paraclinical, anatomopathological pre- and postoperative data in a case of apical diverticulum of the left ventricle presenting with giant negative T waves. The differential diagnosis of these electrocardiographic changes is discussed, in particular apical cardiomyopathy, especially as the two conditions may be associated.

  20. Measurement and modeling of coronary blood flow.

    PubMed

    Sinclair, Matthew D; Lee, Jack; Cookson, Andrew N; Rivolo, Simone; Hyde, Eoin R; Smith, Nicolas P

    2015-01-01

    Ischemic heart disease that comprises both coronary artery disease and microvascular disease is the single greatest cause of death globally. In this context, enhancing our understanding of the interaction of coronary structure and function is not only fundamental for advancing basic physiology but also crucial for identifying new targets for treating these diseases. A central challenge for understanding coronary blood flow is that coronary structure and function exhibit different behaviors across a range of spatial and temporal scales. While experimental studies have sought to understand this feature by isolating specific mechanisms, in tandem, computational modeling is increasingly also providing a unique framework to integrate mechanistic behaviors across different scales. In addition, clinical methods for assessing coronary disease severity are continuously being informed and updated by findings in basic physiology. Coupling these technologies, computational modeling of the coronary circulation is emerging as a bridge between the experimental and clinical domains, providing a framework to integrate imaging and measurements from multiple sources with mathematical descriptions of governing physical laws. State-of-the-art computational modeling is being used to combine mechanistic models with data to provide new insight into coronary physiology, optimization of medical technologies, and new applications to guide clinical practice.

  1. Chromospheric Activity in Red Giants of M67

    NASA Astrophysics Data System (ADS)

    Dupree, A. K.; Whitney, B. A.; Pasquini, L.

    1994-12-01

    Red giants in the old open cluster M67 present a well-studied, homogeneous group of 1.27Msun stars with which to determine the evolution of chromospheric activity and mass loss. Echelle spectra of the Ca II H and K line region (lambda 3950) have been obtained with the 4-m telescope at KPNO, the MMT of the F. L. Whipple Observatory (K only), and the 3.6-m ESO telescope at La Silla, Chile. Spectra of 16 red giant stars down to V ~ 11 were obtained; five of the sample are identified as clump giants. The flux of the emission reversal in the Ca II K core has been calibrated using normalization based on the narrow-band absolute spectrophotometry of Gunn &\\ Stryker (1983, ApJS, 52, 121). A new spectral synthesis of the Calcium line region for radiative models of the M67 giants based on Kurucz atmospheres provides the correction necessary to extract the chromospheric component of the flux. The Ca K emission reversals display asymmetries indicative of outward motions for giants more luminous than M_V ~ +0.5. The chromospheric emission flux in Ca II K decreases with increasing stellar luminosity. Clump giants, which are thought to be in a core-helium burning stage, show Ca II emission comparable to the stars on the red giant branch. Evidence for chromospheric variability is found from multiple observations of several objects. Implications of these results upon the evolution of chromospheres and presence of mass loss in giants will be discussed.

  2. Percutaneous transluminal coronary angioplasty (PTCA)

    MedlinePlus Videos and Cool Tools

    Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. The procedure begins with ...

  3. Functional Testing Underlying Coronary Revascularisation

    ClinicalTrials.gov

    2016-10-04

    Multivessel Coronary Artery Disease; Vessel Disease; Stable Angina; Unstable Angina or Stabilized Non-ST Elevated Myocardial Infarction; Patients With ST-elevated Myocardial Infarction; Revascularization of Culprit Coronary Artery

  4. Coronary artery balloon angioplasty - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100160.htm Coronary artery balloon angioplasty - series—Normal anatomy To use the ... slide 9 out of 9 Overview The coronary arteries supply blood to the heart muscle. The right ...

  5. Integrative physiology of coronary microcirculation.

    PubMed

    Kajiya, F; Goto, M

    1999-06-01

    Coronary microvessels play a crucial role for mechanoenergetic interaction between blood flow and myocardial function, which is not uniform transmurally. Thus, highly organized vascular regulations are required for matching local blood flow with myocardial energy requirement. Recently, new technologies to investigate in vivo coronary microcirculation with new knowledge of the signaling molecules for vascular regulation have revolutionized our abilities to understand the integrative regulation of coronary microcirculation. In this review, the mechanical aspects of the interaction between coronary blood flow and myocardium, coronary arte-rial tree and its roles in myocardial blood flow regulation, hierarchical and dynamic control of coronary flow, capillary network and function, function of venous drainage system, and molecular and cellular aspects of integrative coronary blood flow regulation are discussed, focusing on their integrational roles in maintaining coronary microvascular function and cell signaling.

  6. [Partial internal hemipelvectomy for a secondary giant pelvic chondrosarcoma. A case report].

    PubMed

    Rico Martínez, Genaro; Linares González, Luis Miguel; Delgado Cedillo, Ernesto A; Miranda Roa, Josué Antonio; Mendoza Cardona, Alejandro; Estrada Villaseñor, Eréndira

    2007-01-01

    The purpose of this paper is to present the orthopedic-oncologic and functional outcomes of internal partial hemipelvectomy for a secondary giant pelvic chondrosarcoma in a patient with multiple hereditary osteochondromatosis.

  7. [Coronary angioplasty today].

    PubMed

    Metzger, J P

    1991-10-01

    The rise of coronary angioplasty has been rapid in the last ten years. It is a method of myocardial revascularisation without thoracotomy or cardiopulmonary bypass and is curative in the absence of restenosis. Recent advances concern the development of the material and the pharmacological support which reduce the risk of coronary thrombosis during the procedure. The primary success rate now approaches 90%, that of emergency bypass surgery less than 5%. The use of autoperfusion catheters and the use of intra-aortic balloon pumping improve the safety of the procedure but surgical stand-by remains a necessity in cases of dilatation of proximal main coronary stenosis. Stable and unstable angina are the main indications of a technique particularly appropriate for elderly patients and the treatment of residual post-thrombolytic stenoses, post-radic stenosis or stenosis of a single functional coronary artery. Restenosis is observed in 30 to 40% of cases during the first six months after the dilatation. Its occurrence is not influenced by any of the drugs tested but it could be reduced by the insertion of an endocoronary stent. Abrasive endocoronary techniques and laser angioplasty are alternative methods of treating coronary stenoses inaccessible to conventional balloon angioplasty but they do not reduce the risk of restenosis.

  8. Plasmacytic Aortitis with Occlusion of the Right Coronary Artery

    PubMed Central

    Zambetti, Benjamin R.; Garrett, Edward

    2016-01-01

    Patient: Male, 55 Final Diagnosis: Plasmacytic aortitis Symptoms: Dizziness • nausea Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Inflammation of the aortic wall, known as aortitis, is a rare clinical entity which is frequently asymptomatic, or identified when the patient presents with an aortic aneurysm or dissection. It is most often caused by infection or autoimmune vasculitides such as giant cell or Takayasu’s arteritis. Case Report: The case presented is that of a 55-year-old man with symptomatic occlusion of the right coronary artery caused by a plasmacytic aortitis suggestive of IgG4 disease, which was successfully treated with coronary artery bypass grafting and an ascending aortic graft. Conclusions: A review of the current literature emphasizes how poorly the etiology and natural history of plasmacytic aortitis is understood. PMID:27471062

  9. Giant saphenous vein graft pseudoaneurysm to right posterior descending artery presenting with superior vena cava syndrome.

    PubMed

    Vargas-Estrada, Andres; Edwards, Dianna; Bashir, Mohammad; Rossen, James; Zahr, Firas

    2015-06-26

    Saphenous vein grafts (SVG) pseudoaneurysms, especially giant ones, are rare and occur as a late complication of coronary artery bypass grafting. This condition affects both genders and typically occurs within the sixth decade of life. The clinical presentation ranges from an asymptomatic incidental finding on imaging studies to new onset angina, dyspnea, myocardial infarction or symptoms related to compression of neighboring structures. An 82-year-old woman presented with acute onset back pain, dyspnea and was noted to have significantly engorged neck veins. In the emergency department, a chest computed tomographic angiogram with intravenous contrast revealed a ruptured giant bilobed SVG pseudoaneurysm to the right posterior descending artery (RPDA). This imaging modality also demonstrated compression of the superior vena cava (SVC) by the SVG pseudoaneurysm. Coronary angiogram with bypass study was performed to establish the patency of this graft. Endovascular coiling and embolization of the SVG to RPDA was initially considered but disfavored after the coronary angiogram revealed preserved flow from the graft to this arterial branch. After reviewing the angiogram films, a surgical strategy was favored over a percutaneous intervention with a Nitinol self-expanding stent since the latter would have not addressed the superior vena cava compression caused by the giant pseudoaneurysm. Intraoperative transesophageal echocardiogram demonstrated SVC compression by the giant pseudoaneurysm cranial lobe. Our patient underwent surgical ligation and excision of the giant pseudoaneurysm and the RPDA was regrafted successfully. In summary, saphenous vein grafts pseudoaneurysms can be life-threatening and its therapy should be guided based on the presence of mechanical complications, the patency of the affected vein graft and the involved myocardial territory viability.

  10. Giant saphenous vein graft pseudoaneurysm to right posterior descending artery presenting with superior vena cava syndrome

    PubMed Central

    Vargas-Estrada, Andres; Edwards, Dianna; Bashir, Mohammad; Rossen, James; Zahr, Firas

    2015-01-01

    Saphenous vein grafts (SVG) pseudoaneurysms, especially giant ones, are rare and occur as a late complication of coronary artery bypass grafting. This condition affects both genders and typically occurs within the sixth decade of life. The clinical presentation ranges from an asymptomatic incidental finding on imaging studies to new onset angina, dyspnea, myocardial infarction or symptoms related to compression of neighboring structures. An 82-year-old woman presented with acute onset back pain, dyspnea and was noted to have significantly engorged neck veins. In the emergency department, a chest computed tomographic angiogram with intravenous contrast revealed a ruptured giant bilobed SVG pseudoaneurysm to the right posterior descending artery (RPDA). This imaging modality also demonstrated compression of the superior vena cava (SVC) by the SVG pseudoaneurysm. Coronary angiogram with bypass study was performed to establish the patency of this graft. Endovascular coiling and embolization of the SVG to RPDA was initially considered but disfavored after the coronary angiogram revealed preserved flow from the graft to this arterial branch. After reviewing the angiogram films, a surgical strategy was favored over a percutaneous intervention with a Nitinol self-expanding stent since the latter would have not addressed the superior vena cava compression caused by the giant pseudoaneurysm. Intraoperative transesophageal echocardiogram demonstrated SVC compression by the giant pseudoaneurysm cranial lobe. Our patient underwent surgical ligation and excision of the giant pseudoaneurysm and the RPDA was regrafted successfully. In summary, saphenous vein grafts pseudoaneurysms can be life-threatening and its therapy should be guided based on the presence of mechanical complications, the patency of the affected vein graft and the involved myocardial territory viability. PMID:26131340

  11. Computer quantitation of coronary angiograms

    NASA Technical Reports Server (NTRS)

    Ledbetter, D. C.; Selzer, R. H.; Gordon, R. M.; Blankenhorn, D. H.; Sanmarco, M. E.

    1978-01-01

    A computer technique is being developed at the Jet Propulsion Laboratory to automate the measurement of coronary stenosis. A Vanguard 35mm film transport is optically coupled to a Spatial Data System vidicon/digitizer which in turn is controlled by a DEC PDP 11/55 computer. Programs have been developed to track the edges of the arterial shadow, to locate normal and atherosclerotic vessel sections and to measure percent stenosis. Multiple frame analysis techniques are being investigated that involve on the one hand, averaging stenosis measurements from adjacent frames, and on the other hand, averaging adjacent frame images directly and then measuring stenosis from the averaged image. For the latter case, geometric transformations are used to force registration of vessel images whose spatial orientation changes.

  12. Imaging Extrasolar Giant Planets

    NASA Astrophysics Data System (ADS)

    Bowler, Brendan P.

    2016-10-01

    High-contrast adaptive optics (AO) imaging is a powerful technique to probe the architectures of planetary systems from the outside-in and survey the atmospheres of self-luminous giant planets. Direct imaging has rapidly matured over the past decade and especially the last few years with the advent of high-order AO systems, dedicated planet-finding instruments with specialized coronagraphs, and innovative observing and post-processing strategies to suppress speckle noise. This review summarizes recent progress in high-contrast imaging with particular emphasis on observational results, discoveries near and below the deuterium-burning limit, and a practical overview of large-scale surveys and dedicated instruments. I conclude with a statistical meta-analysis of deep imaging surveys in the literature. Based on observations of 384 unique and single young (≈5-300 Myr) stars spanning stellar masses between 0.1 and 3.0 M ⊙, the overall occurrence rate of 5-13 M Jup companions at orbital distances of 30-300 au is {0.6}-0.5+0.7 % assuming hot-start evolutionary models. The most massive giant planets regularly accessible to direct imaging are about as rare as hot Jupiters are around Sun-like stars. Dividing this sample into individual stellar mass bins does not reveal any statistically significant trend in planet frequency with host mass: giant planets are found around {2.8}-2.3+3.7 % of BA stars, <4.1% of FGK stars, and <3.9% of M dwarfs. Looking forward, extreme AO systems and the next generation of ground- and space-based telescopes with smaller inner working angles and deeper detection limits will increase the pace of discovery to ultimately map the demographics, composition, evolution, and origin of planets spanning a broad range of masses and ages.

  13. A Giant Urethral Calculus.

    PubMed

    Sigdel, G; Agarwal, A; Keshaw, B W

    2014-01-01

    Urethral calculi are rare forms of urolithiasis. Majority of the calculi are migratory from urinary bladder or upper urinary tract. Primary urethral calculi usually occur in presence of urethral stricture or diverticulum. In this article we report a case of a giant posterior urethral calculus measuring 7x3x2 cm in a 47 years old male. Patient presented with acute retention of urine which was preceded by burning micturition and dribbling of urine for one week. The calculus was pushed in to the bladder through the cystoscope and was removed by suprapubic cystolithotomy.

  14. Giant left ventricular pseudoaneurysm.

    PubMed

    Prakash, Sumi; Garg, Nadish; Xie, Gong-Yuan; Dellsperger, Kevin C

    2010-01-01

    Left ventricular (LV) pseudoaneurysm (PS) is an uncommon, often fatal complication associated with myocardial infarction, cardiothoracic surgery, trauma, and, rarely, infective endocarditis. A 28-year-old man with prior history of bioprosthetic mitral valve replacement presented with congestive heart failure and bacteremia with Abiotrophia granulitica. Transesophageal echocardiogram showed bioprosthesis dysfunction, large vegetations, mitral regurgitation, and probable PS. Cardiac and chest CT confirmed a PS communicating with the left ventricle Patient had pulseless electrical activity and died. Autopsy showed a giant PS with layered thrombus and pseudo-endothelialized cavity. Our case highlights the importance of multimodality imaging as an important tool in management of PS.

  15. Acute coronary syndromes as auto-inflammatory disorders.

    PubMed

    Suzuki, Makoto

    2012-01-01

    From the onset to the healing stage of acute coronary syndromes, an endless inflammation has been presented with complex, multiple cross-talk mechanisms at the molecular, cellular, and organ levels. Even though the early reperfusion treatment either by thrombolysis or percutaneous coronary intervention provides the excellent clinical benefits in patients with acute coronary syndromes, ischemia/ reperfusion injury may somewhat offset those great advantages. Inflammation, although potentially protective, has been deeply associated with those detrimental conditions. The hexagonal vascular inflammatory network which is composed of activated various leukocytes, vascular endothelial cells, vascular smooth muscle cells, platelets, excess reactive oxygen species, and cholesterol may contribute these vicious circles. To address these complex syndromes with more benefits regarding the prevention and treatment, this review comprehensively updates the pathogenesis of acute coronary syndromes from the view points of vascular inflammation.

  16. Spontaneous coronary artery dissection.

    PubMed

    Giacoppo, Daniele; Capodanno, Davide; Dangas, George; Tamburino, Corrado

    2014-07-15

    Spontaneous coronary artery dissection (SCAD) is a relatively rare and unexplored type of coronary disease. Although atherosclerosis, hormonal changes during pregnancy and connective tissue disorders might represent a sufficiently convincing explanation for some patients with SCAD, the many remaining cases display only a weak relationship with these causes. While on one side the clinical heterogeneity of SCAD masks a full understanding of their underlying pathophysiologic process, on the other side paucity of data and misleading presentations hamper the quick diagnosis and optimal management of this condition. A definite diagnosis of SCAD can be significantly facilitated by endovascular imaging techniques. In fact, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) overcome the limitations of coronary angiography providing detailed endovascular morphologic information. In contrast, optimal treatment strategies for SCAD still represent a burning controversial question. Herein, we review the published data examining possible causes and investigating the best therapy for SCAD in different clinical scenarios.

  17. Giant Malignant Pheochromocytoma with Palpable Rib Metastases

    PubMed Central

    Gokce, Gokhan; Kilicli, Fatih; Elagoz, Sahande; Ayan, Semih; Gultekin, Emin Yener

    2014-01-01

    Pheochromocytoma is a rare and usually benign neuroendocrine neoplasm. Only 10% of all these tumors are malignant and there are no definitive histological or cytological criteria of malignancy. Single malignancy criteria are the presence of advanced locoregional disease or metastases. We report a case, with a giant retroperitoneal tumor having multiple metastases including palpable rib metastases, who was diagnosed as a malignant pheochromocytoma. The patient was treated with surgery. The literature was reviewed to evaluate tumor features and current diagnostic and therapeutic approaches for patients with metastatic or potentially malignant pheochromocytoma. PMID:25152826

  18. Giant extragenital Bowen's disease.

    PubMed

    Bakardzhiev, Ilko; Chokoeva, Anastasiya Atanasova; Tchernev, Georgi

    2015-12-01

    Giant extragenital forms of Morbus Bowen are extremely rare. The already described cases in the word literature are most commonly with periungual localization, as well as located on the foot and neck area. The clinical manifestation is presented most commonly by non-specific erythematous to erythematous-squamous plaques or papules, which is confusing to the clinician. From the pathogenic point of view, it is important to be confirmed or rejected the presence of human papilloma viruses (HPVs) in each case of affected patient, as this information is mandatory in respect to the adequate selection of the subsequent regimen. If HPVs are detected, systemic antiviral therapy could be initiated to reduce the size of the lesions before subsequent surgical eradication. A postoperative prevention through vaccination could be also considered additionally. In cases of HPV-negative giant extragenital forms of Morbus Bowen (as in the described patient), the focus should be on local immunomodulation by substances such as imiquimod, which reduce the size of the lesions, thereby creating optimal opportunities for their future surgical eradication. Other possible options described in the literature include topical application of 5-fluorouracil, photodynamic therapy, cryotherapy, and laser therapy (carbon dioxide laser). The choice of the most appropriate regimen should have been an individual decision of the clinician, considering also the location and the extent of the lesion.

  19. Gas Giants Form Quickly

    NASA Technical Reports Server (NTRS)

    2007-01-01

    This is an artist's concept of a hypothetical 10-million-year-old star system. The bright blur at the center is a star much like our sun. The other orb in the image is a gas-giant planet like Jupiter. Wisps of white throughout the image represent traces of gas.

    Astronomers using NASA's Spitzer Space Telescope have found evidence showing that gas-giant planets either form within the first 10 million years of a sun-like star's life, or not at all. The lifespan for sun-like stars is about 10 billion years.

    The scientists came to this conclusion after searching for traces of gas around 15 different sun-like stars, most with ages ranging from 3 million to 30 million years. With the help of Spitzer's Infrared Spectrometer instrument, they were able to search for relatively warm gas in the inner regions of these star systems, an area comparable to the zone between Earth and Jupiter in our own solar system. They also used ground-based radio telescopes to search for cooler gas in the outer regions of these systems, an area comparable to the zone around Saturn and beyond.

  20. Giant Intradiverticular Bladder Tumor

    PubMed Central

    Noh, Mohamad Syafeeq Faeez Md; Aziz, Ahmad Fuad Abdul; Ghani, Khairul Asri Mohd; Siang, Christopher Lee Kheng; Yunus, Rosna; Yusof, Mubarak Mohd

    2017-01-01

    Patient: Male, 74 Final Diagnosis: Giant intradiverticular bladder tumor with metastasis Symptoms: Hematuria Medication:— Clinical Procedure: — Specialty: Urology Objective: Rare disease Background: Intradiverticular bladder tumors are rare. This renders diagnosis of an intradiverticular bladder tumor difficult. Imaging plays a vital role in achieving the diagnosis, and subsequently staging of the disease. Case Report: A 74-year-old male presented to our center with a few months history of constitutional symptoms. Upon further history, he reported hematuria two months prior to presentation, which stopped temporarily, only to recur a few days prior to coming to the hospital. The patient admitted to having lower urinary tract symptoms. However, there was no dysuria, no sandy urine, and no fever. Palpation of his abdomen revealed a vague mass at the suprapubic region, which was non tender. In view of his history and the clinical examination findings, an ultrasound of the abdomen and computed tomography (CT) was arranged. These investigations revealed a giant tumor that seemed to be arising from a bladder diverticulum, with a mass effect and hydronephrosis. He later underwent operative intervention. Conclusions: Intradiverticular bladder tumors may present a challenge to the treating physician in an atypical presentation; thus requiring a high index of suspicion and knowledge of tumor pathophysiology. As illustrated in our case, CT with its wide availability and multiplanar imaging capabilities offers a useful means for diagnosis, disease staging, operative planning, and follow-up. PMID:28246375

  1. Magma Reservoirs Feeding Giant Radiating Dike Swarms: Insights from Venus

    NASA Technical Reports Server (NTRS)

    Grosfils, E. B.; Ernst, R. E.

    2003-01-01

    Evidence of lateral dike propagation from shallow magma reservoirs is quite common on the terrestrial planets, and examination of the giant radiating dike swarm population on Venus continues to provide new insight into the way these complex magmatic systems form and evolve. For example, it is becoming clear that many swarms are an amalgamation of multiple discrete phases of dike intrusion. This is not surprising in and of itself, as on Earth there is clear evidence that formation of both magma reservoirs and individual giant radiating dikes often involves periodic magma injection. Similarly, giant radiating swarms on Earth can contain temporally discrete subswarms defined on the basis of geometry, crosscutting relationships, and geochemical or paleomagnetic signatures. The Venus data are important, however, because erosion, sedimentation, plate tectonic disruption, etc. on Earth have destroyed most giant radiating dike swarm's source regions, and thus we remain uncertain about the geometry and temporal evolution of the magma sources from which the dikes are fed. Are the reservoirs which feed the dikes large or small, and what are the implications for how the dikes themselves form? Does each subswarm originate from a single, periodically reactivated reservoir, or do subswarms emerge from multiple discrete geographic foci? If the latter, are these discrete foci located at the margins of a single large magma body, or do multiple smaller reservoirs define the character of the magmatic center as a whole? Similarly, does the locus of magmatic activity change with time, or are all the foci active simultaneously? Careful study of giant radiating dike swarms on Venus is yielding the data necessary to address these questions and constrain future modeling efforts. Here, using giant radiating dike swarms from the Nemesis Tessera (V14) and Carson (V43) quadrangles as examples, we illustrate some of the dike swarm focal region diversity observed on Venus and briefly explore some

  2. Reinflating Giant Planets

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2017-01-01

    Two new, large gas-giant exoplanets have been discovered orbiting close to their host stars. A recent study examining these planets and others like them may help us to better understand what happens to close-in hot Jupiters as their host stars reach the end of their main-sequence lives.OversizedGiantsUnbinned transit light curves for HAT-P-65b. [Adapted from Hartman et al. 2016]The discovery of HAT-P-65b and HAT-P-66b, two new transiting hot Jupiters, is intriguing. These planets have periods of just under 3 days and masses of roughly 0.5 and 0.8 times that of Jupiter, but their sizes are whats really interesting: they have inflated radii of 1.89 and 1.59 times that of Jupiter.These two planets, discovered using the Hungarian-made Automated Telescope Network (HATNet) in Arizona and Hawaii, mark the latest in an ever-growing sample of gas-giant exoplanets with radii larger than expected based on theoretical planetary structure models.What causes this discrepancy? Did the planets just fail to contract to the expected size when they were initially formed, or were they reinflated later in their lifetimes? If the latter, how? These are questions that scientists are only now starting to be able to address using statistics of the sample of close-in, transiting planets.Unbinned transit light curves for HAT-P-66b. [Hartman et al. 2016]Exploring Other PlanetsLed by Joel Hartman (Princeton University), the team that discovered HAT-P-65b and HAT-P-66b has examined these planets observed parameters and those of dozens of other known close-in, transiting exoplanets discovered with a variety of transiting exoplanet missions: HAT, WASP, Kepler, TrES, and KELT. Hartman and collaborators used this sample to draw conclusions about what causes some of these planets to have such large radii.The team found that there is a statistically significant correlation between the radii of close-in giant planets and the fractional ages of their host stars (i.e., the stars age divided by its full

  3. Allometry indicates giant eyes of giant squid are not exceptional

    PubMed Central

    2013-01-01

    Background The eyes of giant and colossal squid are among the largest eyes in the history of life. It was recently proposed that sperm whale predation is the main driver of eye size evolution in giant squid, on the basis of an optical model that suggested optimal performance in detecting large luminous visual targets such as whales in the deep sea. However, it is poorly understood how the eye size of giant and colossal squid compares to that of other aquatic organisms when scaling effects are considered. Results We performed a large-scale comparative study that included 87 squid species and 237 species of acanthomorph fish. While squid have larger eyes than most acanthomorphs, a comparison of relative eye size among squid suggests that giant and colossal squid do not have unusually large eyes. After revising constants used in a previous model we found that large eyes perform equally well in detecting point targets and large luminous targets in the deep sea. Conclusions The eyes of giant and colossal squid do not appear exceptionally large when allometric effects are considered. It is probable that the giant eyes of giant squid result from a phylogenetically conserved developmental pattern manifested in very large animals. Whatever the cause of large eyes, they appear to have several advantages for vision in the reduced light of the deep mesopelagic zone. PMID:23418818

  4. Transradial artery coronary angioplasty.

    PubMed

    Kiemeneij, F; Laarman, G J; de Melker, E

    1995-01-01

    This study explored the feasibility and safety of percutaneous coronary balloon angioplasty (PTCA) with miniaturized PTCA equipment via the radial artery. Coronary angioplasty (PTCA) via the femoral or brachial arteries may be associated with rare vascular complications such as bleeding and damage to the artery and adjacent structures. It was postulated that PTCA via the radial artery with miniaturized angioplasty equipment is feasible and that no major puncture site-related complications occur because hemostasis is obtained easily and because no major structures are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. In 100 patients with collateral blood supply to the right hand, PTCA was attempted with 6F guiding catheters and rapid-exchange balloon catheters for exertional angina (87 patients) or nonexertional angina (13 patients). Angioplasty was attempted in 122 lesions (type A n = 67 [55%], Type B n = 37 [30%], and type C n = 18 [15%]). Pre- and post-PTCA computerized quantitative coronary analysis was performed. Radial artery function and structure were assessed clinically and with Doppler and two-dimensional ultrasound on the day of discharge. Coronary catheterization via the radial artery was successful in 94 patients (94%). The 6 remaining patients had successful PTCA via the femoral artery (n = 5) or the brachial artery (n = 1). Procedural success (120 of 122 lesions) was achieved in 92 patients (98%) via the radial artery and in 98 patients of the total study population.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. [Acute coronary syndrome -- 2012].

    PubMed

    Becker, Dávid; Merkely, Béla

    2012-12-23

    The acute coronary syndrome is the most severe form of coronary artery disease. It is an immediate threat of life and the mortality rate can be high without proper therapy and patient management. Based on the first ECG, two different forms can be distinguished: acute coronary syndrome with and without ST elevation. Besides adequate medication, management of these patients is an essential part of treatment. In case of ST elevation, coronarography and percutaneous coronary intervention is needed in general, within 24 hours from the onset of symptoms. When ST elevation is not detected on the ECG, individual ischemic risk factors and predictable mortality of the patient may define the necessity and the date of the invasive examination. The Hungarian hemodynamic laboratory network covers almost the whole country and, therefore, practically each patient may receive a state-of-the-art therapy. Although indicators of cardiovascular diseases are still prominent, the mortality rate of myocardial Infarction is decreasing in Hungary due to the well-organized invasive care.

  6. Coronary artery disease (image)

    MedlinePlus

    ... through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the ... blood to the heart can slow or stop, causing chest pain (stable ...

  7. Coronary covered stents.

    PubMed

    Kilic, Ismail Dogu; Fabris, Enrico; Serdoz, Roberta; Caiazzo, Gianluca; Foin, Nicolas; Abou-Sherif, Sara; Di Mario, Carlo

    2016-11-20

    Covered stents offer an effective bail-out strategy in vessel perforations, are an alternative to surgery for the exclusion of coronary aneurysms, and have a potential role in the treatment of friable embolisation-prone plaques. The aim of this manuscript is to offer an overview of currently available platforms and to report results obtained in prior studies.

  8. Percutaneous Coronary Intervention of Hidden Coronary Artery-Unusual Type of Isolated Single Coronary Artery

    PubMed Central

    Patil, Shivanand; Ramalingam, Rangaraj; Manjunath, Cholenahally Nanjappa; Subramanyam, Kasamsetty

    2016-01-01

    Single coronary artery is a rare congenital coronary artery anomaly, the incidence of which is 0.024-0.066% as described in literature. Report of cases having single coronary artery along with acute myocardial infarction are scanty and reports of percutaneous intervention in such a situation are even fewer, technically challenging and potentially cataclysmic. As single coronary artery supplies the entire myocardium, occlusion of this can result in significant ischemic insult, resulting in severe biventricular dysfunction. Percutaneous Coronary Intervention (PCI) of single coronary artery is technically challenging and carries high risk which may be equated to left main intervention. We report a rare interesting case of L1 variety of single coronary artery which presented as acute inferoposterior myocardial infarction with successful rescue PCI to Left Circumflex Artery (LCx). PMID:27656488

  9. [Giant esophageal fibrovascular polyp].

    PubMed

    Palacios, Fernando; Contardo, Carlos; Guevara, Jorge; Vera, Augusto; Aguilar, Luis; Huamán, Manuel; Palomino, Américo; Yabar, Alejandro

    2003-01-01

    Fibrovascular polyps are extremely rare benign neoplasias of the esophagus, which usually originate in the lower cricoid area. They do not produce any discomfort in the patient for a long time, however it may make itself evident by the patient's regurgitation of the polyp, producing asphyxia or, more frequently, dysphagia. The case of a 58 year old male patient is presented herein, with a 9 month record of dysphagia, weight loss and intermittent melena. The barium x-ray showed a distended esophagus, with a tumor running from the upper esophageal sphincter to the cardia. The endoscopy confirmed the presence of a pediculated tumor, implanted in the cervical esophagus. Surgeons suspected the potential malignancy of the tumor and performed a transhiatal esophagectomy. The final pathologic diagnosis was giant fibrovascular esophageal polyp.

  10. [Multidetector row CT in assessment of coronary artery calcification on hemodialisis].

    PubMed

    Caro, P; Delgado, R; Dapena, F; Núñez, A

    2007-01-01

    Vascular calcification is a strong predictor of cardiovascular and all-cause mortality. Coronary artery calcification is more frequent, more extensive and progresses more rapidly in CKD than in general population. They are also considered a marker of coronary heart disease, with high prevalence and functional significance. It suggests that detection and surveillance may be worthwhile in general clinical practice. New non-invasive image techniques, like Multi-detector row CT, a type of spiral scanner, assess density and volume of calcification at multiple sites and allow quantitative scoring of vascular calcification using calcium scores analogous to those from electron-beam CT. We have assessed and quantified coronary artery calcification with 16 multidetector row CT in 44 patients on hemodialysis and their relationship with several cardiovascular risk factors. Coronary artery calcification prevalence was of 84 % with mean calcium score of 1580 +/- 2010 ( r 0-9844) with calcium score > 400 in 66% of patients. It was usually multiple, affecting more than two vessels in more than 50%. In all but one patient, left anterior descending artery was involved with higher calcium score level at right coronary artery. Advanced age, male, diabetes, smoking, more morbidity, cerebrovascular disease previous, and calcium-binders phosphate and analogous vitamin D treatment would seem to be associated with coronary artery calcification. Coronary artery calcification is very frequent and extensive, usually multiple and associated to modifiable risk factors in hemodialysis patients. Multi-detector-row CT seems an effective, suitable, readily applicable method to assess and quantify coronary artery calcification.

  11. Giant resonances: Progress, new directions, new challenges

    SciTech Connect

    Bertrand, J.R.; Beene, J.R.

    1989-01-01

    A review of some recent developments in the field of giant multipole resonances is presented. Particular emphasis is placed on directions that the authors feel will be followed in this field during the next several years. In particular, the use of high-energy heavy ions to excite the giant resonances is shown to provide exciting new capabilities for giant resonance studies. Among subjects covered are: Coulomb excitation of giant resonances, photon decay of giant resonances, the recent controversy over the identity of the giant monopole resonance, the most recent value for incompressibility of nuclear matter from analysis of giant monopole data, the isospin character of the 63 A/sup /minus/1/3/ GQR, agreement between (e,e/prime/) and (hadron, hadron/prime/) excitation of the giant quadrupole resonance, prospects for multiphonon giant resonance observation, and isolation of the isovector giant quadrupole resonance. 55 refs., 23 figs., 4 tabs.

  12. Giant Hedge-Hogs: Spikes on Giant Gravitons

    SciTech Connect

    Sadri, D

    2004-01-28

    We consider giant gravitons on the maximally supersymmetric plane-wave background of type IIB string theory. Fixing the light-cone gauge, we work out the low energy effective light-cone Hamiltonian of the three-sphere giant graviton. At first order, this is a U(1) gauge theory on R x S{sup 3}. We place sources in this effective gauge theory. Although non-vanishing net electric charge configurations are disallowed by Gauss' law, electric dipoles can be formed. From the string theory point of view these dipoles can be understood as open strings piercing the three-sphere, generalizing the usual BIons to the giant gravitons, BIGGons. Our results can be used to give a two dimensional (worldsheet) description of giant gravitons, similar to Polchinski's description for the usual D-branes, in agreement with the discussions of hep-th/0204196.

  13. A giant Ordovician anomalocaridid.

    PubMed

    Van Roy, Peter; Briggs, Derek E G

    2011-05-26

    Anomalocaridids, giant lightly sclerotized invertebrate predators, occur in a number of exceptionally preserved early and middle Cambrian (542-501 million years ago) biotas and have come to symbolize the unfamiliar morphologies displayed by stem organisms in faunas of the Burgess Shale type. They are characterized by a pair of anterior, segmented appendages, a circlet of plates around the mouth, and an elongate segmented trunk lacking true tergites with a pair of flexible lateral lobes per segment. Disarticulated body parts, such as the anterior appendages and oral circlet, had been assigned to a range of taxonomic groups--but the discovery of complete specimens from the middle Cambrian Burgess Shale showed that these disparate elements all belong to a single kind of animal. Phylogenetic analyses support a position of anomalocaridids in the arthropod stem, as a sister group to the euarthropods. The anomalocaridids were the largest animals in Cambrian communities. The youngest unequivocal examples occur in the middle Cambrian Marjum Formation of Utah but an arthropod retaining some anomalocaridid characteristics is present in the Devonian of Germany. Here we report the post-Cambrian occurrence of anomalocaridids, from the Early Ordovician (488-472 million years ago) Fezouata Biota in southeastern Morocco, including specimens larger than any in Cambrian biotas. These giant animals were an important element of some marine communities for about 30 million years longer than previously realized. The Moroccan specimens confirm the presence of a dorsal array of flexible blades attached to a transverse rachis on the trunk segments; these blades probably functioned as gills.

  14. Cardiogenic Shock From Global Myocardial Ischemia Induced by Simultaneous Multivessel Coronary Spasm

    PubMed Central

    Ahn, Jihye; Kim, Bo-sung; Park, Hyekyong; Park, Kyungil

    2012-01-01

    Coronary artery spasm is an uncommon, but well recognized, etiology for acute myocardial infarction. However, cardiogenic shock with myocardial infarction resulting from simultaneous multiple coronary artery spasm has been rarely reported, and not in Korea. Recently, we experienced such a case in a 50-year-old Korean man without previous diagnosis of variant angina. The patient, hospitalized for blood sugar control, developed severe chest pain accompanying ST-segment elevation in multiple leads. The patient immediately received cardiac catheterization because of cardiogenic shock. Coronary angiogram revealed the severe and simultaneous spasm of three major epicardial arteries, which was promptly relieved by an intracoronary administration of isosorbide dinitrate. This case highlights the need to rule out the potential mechanism of coronary spasm even in the most severe episodes of acute coronary syndrome. PMID:22787475

  15. Multifocal Central Giant Cell Granuloma - A Case Report

    PubMed Central

    Sandhya, Tamgadge; Avinash, Tamgadge; Snehal, Dhauskar; Neha, Tiwari; Uma, Mudaliar

    2016-01-01

    Central giant cell granuloma is a benign, aggressive neoplasm composed of multinucleated giant cells that almost exclusively occurs in the jaws though extra- gnathic incidence is rare. Multifocal CGCGs of the jaws are very rare and suggestive of systemic diseases such as hyperparathyroidism, an inherited syndrome such as Noonan- like multiple giant cell lesion syndrome or other disorders.Very few cases of multifocal CGCGs in the jaws without any concomitant systemic disease have been reported. This paper describes an unusual case reported to the Oral Surgery Department of Dr. D.Y.Patil Dental College & Hospital, Nerul, Navi-Mumbai in 2014 in a 45-year-old male with multifocal central giant cell granuloma involving maxilla and mandible. The serum alkaline phosphatase, calcium and phosphorus levels were within the normal limits. After complete clinical examination hyperparathyroidism and clinical characteristic of any syndromes such as Noonan-like syndrome and neurofibromatosis were ruled out. Thus this paper reports a non-syndromic multifocal central giant cell granuloma. PMID:27799978

  16. Giant lupus vulgaris: A rare presentation.

    PubMed

    Sacchidanand, S; Sharavana, S; Mallikarjun, M; Nataraja, H V

    2012-01-01

    Cutaneous tuberculosis continues to be an important public health problem even with the availability of highly effective anti-tuberculous drugs. It constitutes 0.1% of all cases of extrapulmonary tuberculosis. Lupus vulgaris is the most common form of cutaneous tuberculosis that occurs in previously sensitized individuals with a moderate degree of immunity against tubercle bacilli. The different types of lupus vulgaris include plaque, ulcerative, vegetative, papular and nodular, and tumor forms. A 40-year-old man presented with large multiple plaques over right upper limb, right side of chest and back, and right lower limb for the past 30 years. Histopathology showed numerous noncaseating granulomas with Langhan's type of giant cells. The Mantoux test showed strong positivity and there was excellent response to anti-tuberculous treatment. This case is being reported because of its extreme chronicity of 30 years duration, unusually large size and multiplicity of lesions.

  17. Pharma giants swap research programs.

    PubMed

    2014-07-01

    Pharmaceutical giants Novartis and GlaxoSmithKline (GSK) agreed in late April to swap some assets, with Novartis handing off its vaccine business to GSK and getting most of the British company's cancer portfolio in return.

  18. Theories of Giant Planet Formation

    NASA Technical Reports Server (NTRS)

    Lissauer, Jack J.; Young, Richard E. (Technical Monitor)

    1998-01-01

    An overview of current theories of planetary formation, with emphasis on giant planets, is presented. The most detailed models are based upon observations of our own Solar System and of young stars and their environments. While these models predict that rocky planets should form around most single stars, the frequency of formation of gas giant planets is more difficult to predict theoretically. Terrestrial planets are believed to grow via pairwise accretion until the spacing of planetary orbits becomes large enough that the configuration is stable for the age of the system. Giant planets begin their growth as do terrestrial planets, but they become massive enough that they are able to accumulate substantial amounts of gas before the protoplanetary disk dissipates. Most models for extrasolar giant planets suggest that they formed as did Jupiter and Saturn (in nearly circular orbits, far enough from the star that ice could), and subsequently migrated to their current positions, although some models suggest in situ formation.

  19. Lichens On Galapagos Giant Tortoises.

    PubMed

    Hendrickson, J R; Weber, W A

    1964-06-19

    The association of Physcia picta with the giant Galdpagos tortoise is believed to be the first reported occurrence of lichens on land animals. The habitat is restricted to specific sites on the carapace of male tortoises.

  20. Landscape of the lost giants

    NASA Astrophysics Data System (ADS)

    2013-09-01

    The Pleistocene megafauna extinction erased a group of remarkable animals. Whether humans had a prominent role in the extinction remains controversial, but it is emerging that the disappearance of the giants has markedly affected the environment.

  1. Atmospheres of Extrasolar Giant Planets

    NASA Technical Reports Server (NTRS)

    Marley, Mark

    2006-01-01

    The next decade will almost certainly see the direct imaging of extrasolar giant planets around nearby stars. Unlike purely radial velocity detections, direct imaging will open the door to characterizing the atmosphere and interiors of extrasola planets and ultimately provide clues on their formation and evolution through time. This process has already begun for the transiting planets, placing new constraints on their atmospheric structure, composition, and evolution. Indeed the key to understanding giant planet detectability, interpreting spectra, and constraining effective temperature and hence evolution-is the atmosphere. I will review the universe of extrasolar giant planet models, focusing on what we have already learned from modeling and what we will likely be able to learn from the first generation of direct detection data. In addition to these theoretical considerations, I will review the observations and interpretation of the - transiting hot Jupiters. These objects provide a test of our ability to model exotic atmospheres and challenge our current understanding of giant planet evolution.

  2. Outcomes of patients with spontaneous coronary artery dissection

    PubMed Central

    McGrath-Cadell, Lucy; McKenzie, Pamela; Emmanuel, Sam; Muller, David W M; Graham, Robert M; Holloway, Cameron J

    2016-01-01

    Background Spontaneous coronary artery dissection (SCAD) is an uncommon but serious condition presenting as an acute coronary syndrome (ACS) or cardiac arrest. The pathophysiology and outcomes are poorly understood. We investigated the characteristics and outcomes of patients presenting with SCAD. Methods In a retrospective study of a large cohort of patients with SCAD, data were collected regarding clinical presentation, patient characteristics, vascular screening, coronary artery involvement and clinical outcomes. Results 40 patients with SCAD (95% women, mean age 45±10 years) were included. At least 1 traditional cardiovascular risk factor was present in 40% of patients. Migraine was reported in 43% of patients. Events preceding SCAD included parturition (8%), physical stress (13%), emotional stress (10%) and vasoconstrictor substance-use (8%). 65% of patients had a non-ST elevation ACS (NSTEACS) at presentation, 30% had an ST elevation myocardial infarction (STEMI) and 13% had a cardiac arrest. The left anterior descending artery was most frequently involved (68% of patients), and 13% had involvement of multiple coronary territories. Fibromuscular dysplasia (FMD) was identified in 7 (37%) of 19 patients screened. 68% of patients were managed medically, 30% had percutaneous coronary intervention and 5% had coronary artery bypass grafting. Over a median 16-month follow-up period, 8% of patients had at least 1 recurrent SCAD event. There were no deaths. Conclusions Patients with SCAD in this study often had multiple coronary territories involved (13%) and extracardiac vascular abnormalities, suggesting a systemic vascular process, which may explain the high incidence of migraine. All patients with SCAD should be screened for FMD and followed closely due to the possibility of recurrence. PMID:27621835

  3. Types of Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. Types of Coronary Artery Bypass Grafting There are several types of coronary ... for you based on your needs. Traditional Coronary Artery Bypass Grafting Traditional CABG is used when at ...

  4. Giants in the Local Region

    NASA Astrophysics Data System (ADS)

    Luck, R. Earle; Heiter, Ulrike

    2007-06-01

    We present parameter and abundance data for a sample of 298 nearby giants. The spectroscopic data for this work have a resolution of R~60,000, S/N>150, and spectral coverage from 475 to 685 nm. Overall trends in the Z>10 abundances are dominated by Galactic chemical evolution, while the light-element abundances are influenced by stellar evolution, as well as Galactic evolution. We find several super-Li stars in our sample and confirm that Li abundances in the first giant branch are related to mixing depths. Once astration of lithium on the main sequence along with the overall range of main-sequence lithium abundances are taken into account, the lithium abundances of the giants are not dramatically at odds with the predictions of standard stellar evolution. We find the giants to be carbon-diluted in accord with standard stellar evolution and that the carbon and oxygen abundances determined for the local giants are consistent with those found in local field dwarfs. We find that there is evidence for systematic carbon variations in the red giant clump in the sense that the blue side of the clump is carbon-poor (more diluted) than the red side.

  5. Impact of coronary bifurcation morphology on wave propagation

    PubMed Central

    Rivolo, Simone; Hadjilucas, Lucas; Sinclair, Matthew; van Horssen, Pepijn; van den Wijngaard, Jeroen; Wesolowski, Roman; Chiribiri, Amedeo; Smith, Nicolas P.

    2016-01-01

    The branching pattern of the coronary vasculature is a key determinant of its function and plays a crucial role in shaping the pressure and velocity wave forms measured for clinical diagnosis. However, although multiple scaling laws have been proposed to characterize the branching pattern, the implications they have on wave propagation remain unassessed to date. To bridge this gap, we have developed a new theoretical framework by combining the mathematical formulation of scaling laws with the wave propagation theory in the pulsatile flow regime. This framework was then validated in multiple species using high-resolution cryomicrotome images of porcine, canine, and human coronary networks. Results demonstrate that the forward well-matchedness (no reflection for pressure/flow waves traveling from the coronary stem toward the microcirculation) is a salient feature in the coronary vasculature, and this result remains robust under many scenarios of the underlying pulse wave speed distribution assumed in the network. This result also implies a significant damping of the backward traveling waves, especially for smaller vessels (radius, <0.3 mm). Furthermore, the theoretical prediction of increasing area ratios (ratio between the area of the mother and daughter vessels) in more symmetric bifurcations found in the distal circulation was confirmed by experimental measurements. No differences were observed by clustering the vessel segments in terms of transmurality (from epicardium to endocardium) or perfusion territories (left anterior descending, left circumflex, and right coronary artery). PMID:27402665

  6. Anaplastic giant cell thyroid carcinoma.

    PubMed

    Wallin, G; Lundell, G; Tennvall, J

    2004-01-01

    Anaplastic (giant cell) thyroid carcinoma (ATC), is one of the most aggressive malignancies in humans with a median survival time after diagnosis of 3-6 months. Death from ATC was earlier seen because of local growth and suffocation. ATC is uncommon, accounting for less than 5 % of all thyroid carcinomas. The diagnosis can be established by means of multiple fine needle aspiration biopsies, which are neither harmful nor troublesome for the patient. The cytological diagnosis of this high-grade malignant tumour is usually not difficult for a well trained cytologist. The intention to treat patients with ATC is cure, although only few of them survive. The majority of the patients are older than 60 years and treatment must be influenced by their high age. We have by using a combined modality regimen succeeded in achieving local control in most patients. Every effort should be made to control the primary tumour and thereby improve the quality of remaining life and it is important for patients, relatives and the personnel to know that cure is not impossible. Different treatment combinations have been used since 30 years including radiotherapy, cytostatic drugs and surgery, when feasible. In our latest combined regimen, 22 patients were treated with hyper fractionated radiotherapy 1.6Gy x 2 to a total target dose of 46 Gy given preoperatively, 20 mg doxorubicin was administered intravenously once weekly and surgery was carried out 2-3 weeks after the radiotherapy. 17 of these 22 patients were operated upon and none of these 17 patients got a local recurrence. In the future we are awaiting the development of new therapeutic approaches to this aggressive type of carcinoma. Inhibitors of angiogenesis might be useful. Combretastatin has displayed cytotoxicity against ATC cell lines and has had a positive effect on ATC in a patient. Sodium iodide symporter (NIS) genetherapy is also being currently considered for dedifferentiated thyroid carcinomas with the ultimate aim of

  7. Balloon catheter coronary angioplasty

    SciTech Connect

    Angelini, P.

    1987-01-01

    The author has produced a reference and teaching book on balloon angioplasty. Because it borders in surgery and is performed on an awake patient without circulatory assistance, it is a complex and demanding procedure that requires thorough knowledge before it is attempted. The text is divided into seven sections. The first section describes coronary anatomy and pathophysiology, defines the objectives and mechanisms of the procedure and lists four possible physiologic results. The next section describes equipment in the catheterization laboratory, catheters, guidewires and required personnel. The following section is on the procedure itself and includes a discussion of examination, testing, technique and follow-up. The fourth section details possible complications that can occur during the procedure, such as coronary spasms, occlusion, thrombosis, perforations and ruptures, and also discusses cardiac surgery after failed angioplasty. The fifth section details complex or unusual cases that can occur. The sixth and seventh sections discuss radiation, alternative procedures and the future of angioplasty.

  8. The Giant Magnetocaloric Effect

    NASA Astrophysics Data System (ADS)

    Pecharsky, Vitalij K.

    1998-03-01

    Since the discovery of the magnetocaloric effect in pure iron by E.Warburg in 1881, it has been measured experimentally on many magnetic metals and compounds. The majority of the materials studied order magnetically undergoing a second order phase transformation. The magnetocaloric effect, typically peaking near the Curie or the Néel temperature, generally ranges from 0.5 to 2 K (in terms of adiabatic temperature change) or at 1 to 4 J/kg K (in terms of isothermal magnetic entropy change) per 1 T magnetic field change. The giant magnetocaloric effect recently discovered in Gd_5(Si_xGe_1-x)4 alloys, where x <= 0.5, is associated with a first order magnetic phase transition and it reaches values of 3 to 4 K and 6 to 10 J/kg K per 1 T field change, respectively. The refrigerant capacity, which is the measure of how much heat can be transferred from a cold to a hot reservoir in one ideal thermodynamic cycle, is larger than that of the best second order phase transition materials by 25 to 100%. When the Gd_5(Si_xGe_1-x)4 alloys are compared with other known materials, which show first order magnetic phase transition, such as Dy, Ho, Er, HoCo_2, NdMn_2Si_2, Fe_0.49Rh_0.51, and (Hf_0.83Ta_0.17)Fe_2+x, only Fe_0.49Rh_0.51 has comparable magnetocaloric properties. However, the first order magnetic phase transition in Fe_0.49Rh_0.51 is irreversible, and the magnetocaloric effect disappears after one magnetizing/demagnetizing cycle. A study of the crystal structure, thermodynamics, and magnetism of the Gd_5(Si_xGe_1-x)4 alloys, where 0 <= x <= 1 allowed us to obtain a qualitative understanding of the basic relations between the composition, the crystal structure, and the change in thermodynamics and magnetocaloric properties, which occur in the Gd_5(Si_xGe_1-x)4 system, and which brings about the giant magnetocaloric effect when x <= 0.5.

  9. Coronary Atherosclerosis and Interventional Cardiology.

    PubMed

    Peña-Duque, Marco Antonio; Romero-Ibarra, José Luis; Gaxiola-Macías, Manuel Ben Adoniram; Arias-Sánchez, Eduardo A

    2015-07-01

    The atherosclerotic process in coronary arteries begins with endothelial dysfunction and may provoke thrombotic total occlusion and myocardial infarction. In this state-of-the-art review, we discuss recent evidence of atheroslerosis, vulnerable plaque, and hemodynamic changes in the coronary tree, as well as the current techniques we implement in the catheterization lab to evaluate coronary stenosis. It is clear that atherosclerosis is a chronic inflammatory condition with several consequences in the coronary tree, however, we are able now to characterize the plaque and to select the appropriate treatment for many patients.

  10. Left Main Coronary Artery Aneurysm

    PubMed Central

    Doustkami, Hossein; Maleki, Nasrollah; Tavosi, Zahra

    2016-01-01

    Aneurysms of the left main coronary artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of coronary artery aneurysms is atherosclerosis. Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting coronary stenosis, patients with left main coronary artery aneurysms can be effectively managed either surgically or pharmacologically. We herein report a case of left main coronary artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. Coronary angiography revealed a saccular aneurysm of the left main coronary artery with significant stenosis in the left anterior descending, left circumflex, and right coronary artery. The patient immediately underwent coronary artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic. PMID:27403190

  11. Coronary revascularization after arterial switch operation.

    PubMed

    Prifti, Edvin; Bonacchi, Massimo; Luisi, Stefano Vincenzo; Vanini, Vittorio

    2002-01-01

    We report two cases presenting bilateral coronary artery obstruction after arterial switch operation. The first patient underwent bilateral internal thoracic artery grafting to the left and right coronary arteries. The other patient, presenting a single coronary ostium, underwent surgical coronary ostial angioplasty in concomitance to proximal arterioplasty of both coronary arteries employing a single "pantaloon" shape autologous pericardial patch. Both patients survived and, at 1 year and 9 months after the coronary revascularization procedures, the coronary angiography demonstrated a good patency of the internal thoracic grafts and excellent ostial plasty results, respectively. A complete literature review of patients undergoing different coronary revascularization procedures after arterial switch operation is reported.

  12. A unique advantage for giant eyes in giant squid.

    PubMed

    Nilsson, Dan-Eric; Warrant, Eric J; Johnsen, Sönke; Hanlon, Roger; Shashar, Nadav

    2012-04-24

    Giant and colossal deep-sea squid (Architeuthis and Mesonychoteuthis) have the largest eyes in the animal kingdom [1, 2], but there is no explanation for why they would need eyes that are nearly three times the diameter of those of any other extant animal. Here we develop a theory for visual detection in pelagic habitats, which predicts that such giant eyes are unlikely to evolve for detecting mates or prey at long distance but are instead uniquely suited for detecting very large predators, such as sperm whales. We also provide photographic documentation of an eyeball of about 27 cm with a 9 cm pupil in a giant squid, and we predict that, below 600 m depth, it would allow detection of sperm whales at distances exceeding 120 m. With this long range of vision, giant squid get an early warning of approaching sperm whales. Because the sonar range of sperm whales exceeds 120 m [3-5], we hypothesize that a well-prepared and powerful evasive response to hunting sperm whales may have driven the evolution of huge dimensions in both eyes and bodies of giant and colossal squid. Our theory also provides insights into the vision of Mesozoic ichthyosaurs with unusually large eyes.

  13. Formation of the giant planets

    NASA Technical Reports Server (NTRS)

    Lissauer, Jack J.

    2006-01-01

    The observed properties of giant planets, models of their evolution and observations of protoplanetary disks provide constraints on the formation of gas giant planets. The four largest planets in our Solar System contain considerable quantities of hydrogen and helium, which could not have condensed into solid planetesimals within the protoplanetary disk. All three (transiting) extrasolar giant planets with well determined masses and radii also must contain substantial amounts of these light gases. Jupiter and Saturn are mostly hydrogen and helium, but have larger abundances of heavier elements than does the Sun. Neptune and Uranus are primarily composed of heavier elements. HD 149026 b, which is slightly more massive than is Saturn, appears to have comparable quantities of light gases and heavy elements. HD 209458 b and TrES-1 are primarily hydrogen and helium, but may contain supersolar abundances of heavy elements. Spacecraft flybys and observations of satellite orbits provide estimates of the gravitational moments of the giant planets in our Solar System, which in turn provide information on the internal distribution of matter within Jupiter, Saturn, Uranus and Neptune. Atmospheric thermal structure and heat flow measurements constrain the interior temperatures of planets. Internal processes may cause giant planets to become more compositionally differentiated or alternatively more homogeneous; high-pressure laboratory .experiments provide data useful for modeling these processes. The preponderance of evidence supports the core nucleated gas accretion model. According to this model, giant planets begin their growth by the accumulation of small solid bodies, as do terrestrial planets. However, unlike terrestrial planets, the growing giant planet cores become massive enough that they are able to accumulate substantial amounts of gas before the protoplanetary disk dissipates. The primary questions regarding the core nucleated growth model is under what conditions

  14. Clump Giants in the Hyades

    NASA Technical Reports Server (NTRS)

    Mushotzky, Richard F. (Technical Monitor); Brickhouse, Nancy

    2003-01-01

    The project is entitled 'Clump Giants in the Hyades.' This observation of one of the late-type Hyades giants (Gamma Tau) has implications for understanding the formation of late-type stellar coronae as a function of the evolutionary state of the star. The Hyades giants are interesting because they are all clump giants in the Helium burning phase, similar to the cool primary of Capella. The Hyades giants show significantly more magnetic activity than expected from their state of evolution (and slowed-down rotation). Thus these systems provide an important clue to dynamo action. The data were obtained by the satellite on 13 March 2001 for a total RGS exposure of 58220 seconds. These data were delivered to the PI on 7 August 2001. The data could not be reprocessed until SAS Version 5.3.3 which became available 7 June 2002. Although the guidelines for assessing background rates suggested that half the data were contaminated, it does not appear that the spectral region of the RGS was adversely affected by unusually high background. The spectra show strong lines of Fe XVII and XVIII, O VII and VIII, Ne IX and X, along with numerous weaker lines. The emission measure distribution is highly reminiscent of Capella; if anything, the emission measure distribution is steeper at 6 million K than for Capella. Gamma Tau is the second brightest of the Hyades clump giants. Pallavicini et al. have shown that the luminosity of the brightest Hyades giant (Theta Tau) is remarkably similar to its luminosity as measured by Einstein. Short-term variability is also modest. We are addressing the variability issue now for Gamma Tau. Initial results were reported at the 2003 Seattle AAS meeting. A paper is in preparation for submission to the Astrophysical Journal.

  15. Technique of Coronary Transfer for TGA with Single Coronary Artery

    PubMed Central

    Kim, Tae Ho; Jung, Jae Jun; Kim, Yong Han; Yang, Ji-Hyuk; Jun, Tae-Gook

    2014-01-01

    An eight-day-old neonate was diagnosed with dextro-transposition of the great arteries, atrial septal defect, patent ductus arteriosus, and a single sinus origin of the coronary arteries. The single coronary artery originated from the left sinus (sinus 2), had a proximal left circumflex arterial branch, and passed anteriorly to the right side of the aorta, further branching into the right coronary and left anterior descending arteries. We successfully performed an arterial switch operation and coronary transfer by tube graft reconstruction with autologous aortic tissue to treat the dextro-transposition of the great arteries and atrial septal defect with a single-sinus origin of the coronary arteries. PMID:25551074

  16. High-speed coronary rotational angioplasty with the rotablator

    NASA Astrophysics Data System (ADS)

    Zacca, Nadim M.; Kleiman, Neal S.; Asimacopoulos, P. J.

    1992-08-01

    Percutaneous mechanical rotational ablation with the rotablator can be used effectively as a stand alone treatment for coronary arterial lesions, including those with angiographic morphology considered unfavorable for balloon angioplasty (eccentric, at bends, bifurcating, calcified, ulcerated, completely occluded_, as well as for balloon angioplasty procedure failures. The use of single rather than multiple burrs without balloon assistance, the use of fewer passes and of the nitroglycerine infusion through the rotablator catheter have considerably shortened the time necessary to complete a rotational atherectomy. Further, the apparently infrequent occurrence of post procedure abrupt closure makes this technique attractive in the clinical management of patients with complex coronary artery lesions.

  17. An adult case of Kawasaki disease with multiplex coronary aneurysms and myocardial infarction: the role of transesophageal echocardiography.

    PubMed

    Habon, T; Toth, K; Keltai, M; Lengyel, M; Palik, I

    1998-07-01

    Kawasaki disease (mucocutaneous lymph node syndrome) is an acute inflammatory disease that primarily affects infants and young children. In spite of proper therapy, coronary aneurysms develop in 10 to 25% of cases. Adult diagnosis of coronary aneurysm, presumably caused by Kawasaki disease, is rare. A 37-year-old male patient with previous inferior wall myocardial infarction (MI) was admitted with an acute anterior wall MI. Coronary angiography, performed 2 weeks after successful thrombolytic therapy, showed right coronary artery occlusion and multiplex (left main, left anterior descending, left circumflex, right coronary artery) giant coronary aneurysms. Transthoracic echocardiography was unable to detect the aneurysms. Transesophageal echocardiography (TEE) visualized a large left main coronary aneurysm with an occlusive thrombus and measured low flow velocity (0.2 m/s) in the proximal left anterior descending artery. At 4 weeks control, TEE showed marked regression of the thrombus, and it was not detectable after 6 months of oral anticoagulation with acenocumarol (International Normalized Ratio: 3-3.5) and standard postinfarction therapy. After 2 years of follow-up, the patient has no symptoms, and myocardial ischemia could not be provoked by stress tests [treadmill, dipyridamole single-photon emission computed tomography (SPECT)]. We conclude that, for diagnosis and follow-up of adult Kawasaki disease, transesophageal echocardiography is indicated. The importance and efficacy of long-term anticoagulant treatment should be emphasized in this disease.

  18. Open questions about giant viruses.

    PubMed

    Claverie, Jean-Michel; Abergel, Chantal

    2013-01-01

    The recent discovery of giant viruses exhibiting double-stranded DNA genomes larger than a million base pairs, encoding more than a thousand proteins and packed in near micron-sized icosahedral particles, opened a new and unexpected chapter in virology. As of today, these giant viruses and their closest relatives of lesser dimensions infect unicellular eukaryotes found in aquatic environments, but belonging to a wide diversity of early branching phyla. This broad phylogenetic distribution of hosts is consistent with the hypothesis that giant viruses originated prior to the radiation of the eukaryotic domain and/or might have been involved in the partition of nuclear versus cytoplasmic functions in ancestral cells. The distinctive features of the known giant viruses, in particular the recurrent presence of components of the translation apparatus in their proteome, raise a number of fundamental questions about their origin, their mode of evolution, and the relationship they may entertain with other dsDNA viruses, the genome size of which exhibits the widest distribution among all biological entities, from less than 5 kb to more than 1.25 Mb (a ratio of 1:250). At a more conceptual level, the convergence between the discovery of increasingly reduced parasitic cellular organisms and that of giant viruses exhibiting a widening array of cellular-like functions may ultimately abolish the historical discontinuity between the viral and the cellular world.

  19. Giant Magellan Telescope: overview

    NASA Astrophysics Data System (ADS)

    Johns, Matt; McCarthy, Patrick; Raybould, Keith; Bouchez, Antonin; Farahani, Arash; Filgueira, Jose; Jacoby, George; Shectman, Steve; Sheehan, Michael

    2012-09-01

    The Giant Magellan Telescope (GMT) is a 25-meter optical/infrared extremely large telescope that is being built by an international consortium of universities and research institutions. It will be located at the Las Campanas Observatory, Chile. The GMT primary mirror consists of seven 8.4-m borosilicate honeycomb mirror segments made at the Steward Observatory Mirror Lab (SOML). Six identical off-axis segments and one on-axis segment are arranged on a single nearly-paraboloidal parent surface having an overall focal ratio of f/0.7. The fabrication, testing and verification procedures required to produce the closely-matched off-axis mirror segments were developed during the production of the first mirror. Production of the second and third off-axis segments is underway. GMT incorporates a seven-segment Gregorian adaptive secondary to implement three modes of adaptive-optics operation: natural-guide star AO, laser-tomography AO, and ground-layer AO. A wide-field corrector/ADC is available for use in seeing-limited mode over a 20-arcmin diameter field of view. Up to seven instruments can be mounted simultaneously on the telescope in a large Gregorian Instrument Rotator. Conceptual design studies were completed for six AO and seeing-limited instruments, plus a multi-object fiber feed, and a roadmap for phased deployment of the GMT instrument suite is being developed. The partner institutions have made firm commitments for approximately 45% of the funds required to build the telescope. Project Office efforts are currently focused on advancing the telescope and enclosure design in preparation for subsystem- and system-level preliminary design reviews which are scheduled to be completed in the first half of 2013.

  20. What Is Coronary Microvascular Disease?

    MedlinePlus

    ... narrows the heart's large arteries and reduces the flow of oxygen-rich blood to your heart muscle. The buildup of plaque also makes it more likely that blood clots will form in your arteries. Blood clots can mostly or completely block blood flow through a coronary artery. In coronary MVD, however, ...

  1. Coronary Arteriovenous Fistulae: A Review

    PubMed Central

    Challoumas, Dimitris; Pericleous, Agamemnon; Dimitrakaki, Inetzi A.; Danelatos, Christos; Dimitrakakis, Georgios

    2014-01-01

    Coronary arteriovenous fistulae are a coronary anomaly, presenting in 0.002% of the general population. Their etiology can be congenital or acquired. We present a review of recent literature related to their epidemiology, etiology, pathophysiology, clinical presentation, diagnostic approach, and therapeutic management. PMID:24940026

  2. The Coronary Patient in Industry

    NASA Technical Reports Server (NTRS)

    Schuster, B.

    1971-01-01

    The coronary patient, as he pertains to industry particularly NASA, is discussed. Concepts of precoronary care, acute attacks which may develop while on the job, and the return of the cardiac patient to work are covered. Major emphasis was on the prevention of sudden death due to coronary disease.

  3. Polymyalgia Rheumatica and Giant Cell Arteritis

    MedlinePlus

    ... Clinical Trial Journal Articles Polymyalgia Rheumatica and Giant Cell Arteritis May 2016 Questions and Answers about Polymyalgia Rheumatica and Giant Cell Arteritis This publication contains general information about polymyalgia ...

  4. Giant lobelias exemplify convergent evolution

    PubMed Central

    2010-01-01

    Giant lobeliads on tropical mountains in East Africa and Hawaii have highly unusual, giant-rosette growth forms that appear to be convergent on each other and on those of several independently evolved groups of Asteraceae and other families. A recent phylogenetic analysis by Antonelli, based on sequencing the widest selection of lobeliads to date, raises doubts about this paradigmatic example of convergent evolution. Here I address the kinds of evidence needed to test for convergent evolution and argue that the analysis by Antonelli fails on four points. Antonelli's analysis makes several important contributions to our understanding of lobeliad evolution and geographic spread, but his claim regarding convergence appears to be invalid. Giant lobeliads in Hawaii and Africa represent paradigmatic examples of convergent evolution. PMID:20074322

  5. CMB lensing and giant rings

    SciTech Connect

    Rathaus, Ben; Itzhaki, Nissan E-mail: ben.rathaus@gmail.com

    2012-05-01

    We study the CMB lensing signature of a pre-inationary particle (PIP), assuming it is responsible for the giant rings anomaly that was found recently in the WMAP data. Simulating Planck-like data we find that generically the CMB lensing signal to noise ratio associated with such a PIP is quite small and it would be difficult to cross correlate the temperature giant rings with the CMB lensing signal. However, if the pre-inationary particle is also responsible for the bulk flow measured from the local large scale structure, which happens to point roughly at the same direction as the giant rings, then the CMB lensing signal to noise ratio is fairly significant.

  6. Magnetocardiography with sensors based on giant magnetoresistance

    NASA Astrophysics Data System (ADS)

    Pannetier-Lecoeur, M.; Parkkonen, L.; Sergeeva-Chollet, N.; Polovy, H.; Fermon, C.; Fowley, C.

    2011-04-01

    Biomagnetic signals, mostly due to the electrical activity in the body, are very weak and they can only be detected by the most sensitive magnetometers, such as Superconducting Quantum Interference Devices (SQUIDs). We report here biomagnetic recordings with hybrid sensors based on Giant MagnetoResistance (GMR). We recorded magnetic signatures of the electric activity of the human heart (magnetocardiography) in healthy volunteers. The P-wave and QRS complex, known from the corresponding electric recordings, are clearly visible in the recordings after an averaging time of about 1 min. Multiple recordings at different locations over the chest yielded a dipolar magnetic field map and allowed localizing the underlying current sources. The sensitivity of the GMR-based sensors is now approaching that of SQUIDs and paves way for spin electronics devices for functional imaging of the body.

  7. Constraining Planetary Migration Mechanisms in Systems of Giant Planets

    NASA Astrophysics Data System (ADS)

    Dawson, Rebekah I.; Murray-Clay, Ruth A.; Johnson, John Asher

    2014-01-01

    largely recovered for giants orbiting metal-rich Kepler host stars. These two studies suggest that both disk migration and planet-planet interactions may be widespread, with the latter occurring primarily in metal-rich planetary systems where multiple giant planets can form. Funded by NSF-GRFP DGE-1144152.

  8. Giant right atrial thrombi treated with thrombolysis.

    PubMed

    Ruiz-Bailén, Manuel; López-Caler, Carmen; Castillo-Rivera, Ana; Rucabado-Aguilar, Luis; Ramos Cuadra, José Angel; Lara Toral, Juan; Lozano Cabezas, Cristobal; Fernández Guerrero, Juan Carlos

    2008-04-01

    The present report describes giant atrial thrombi that were treated with thrombolysis in a community hospital. Two patients with giant atrial thrombi whose treatment involved complications are presented. Both patients developed cardiogenic shock and were treated unsuccessfully with thrombolysis. Because thrombolysis of giant thrombi may be ineffective, patients in this situation may require surgery.

  9. Giant right atrial thrombi treated with thrombolysis

    PubMed Central

    Ruiz-Bailén, Manuel; López-Caler, Carmen; Castillo-Rivera, Ana; Rucabado-Aguilar, Luis; Cuadra, José Ángel Ramos; Toral, Juan Lara; Cabezas, Cristobal Lozano; Guerrero, Juan Carlos Fernández

    2008-01-01

    The present report describes giant atrial thrombi that were treated with thrombolysis in a community hospital. Two patients with giant atrial thrombi whose treatment involved complications are presented. Both patients developed cardiogenic shock and were treated unsuccessfully with thrombolysis. Because thrombolysis of giant thrombi may be ineffective, patients in this situation may require surgery. PMID:18401474

  10. Cabergoline treatment in invasive giant prolactinoma.

    PubMed

    Alsubaie, Sadeem; Almalki, Mussa H

    2014-01-01

    Patients with invasive giant prolactinoma suffer from a constellation of symptoms including headache, blurred vision, lethargy, and sexual dysfunction. Cabergoline, a potent dopamine agonist, is a known medication prescribed for the treatment of invasive giant prolactinoma. Here, we report a case of invasive giant prolactinoma in a 52-year-old Saudi male with dramatic response to cabergoline treatment clinically, biochemically, and radiologically.

  11. Charting the Giants

    NASA Astrophysics Data System (ADS)

    2004-06-01

    zero expansion asymptotically after an infinite time and has a flat geometry). All three observational tests by means of supernovae (green), the cosmic microwave background (blue) and galaxy clusters converge at a Universe around Ωm ~ 0.3 and ΩΛ ~ 0.7. The dark red region for the galaxy cluster determination corresponds to 95% certainty (2-sigma statistical deviation) when assuming good knowledge of all other cosmological parameters, and the light red region assumes a minimum knowledge. For the supernovae and WMAP results, the inner and outer regions corespond to 68% (1-sigma) and 95% certainty, respectively. References: Schuecker et al. 2003, A&A, 398, 867 (REFLEX); Tonry et al. 2003, ApJ, 594, 1 (supernovae); Riess et al. 2004, ApJ, 607, 665 (supernovae) Galaxy clusters are far from being evenly distributed in the Universe. Instead, they tend to conglomerate into even larger structures, "super-clusters". Thus, from stars which gather in galaxies, galaxies which congregate in clusters and clusters tying together in super-clusters, the Universe shows structuring on all scales, from the smallest to the largest ones. This is a relict of the very early (formation) epoch of the Universe, the so-called "inflationary" period. At that time, only a minuscule fraction of one second after the Big Bang, the tiny density fluctuations were amplified and over the eons, they gave birth to the much larger structures. Because of the link between the first fluctuations and the giant structures now observed, the unique REFLEX catalogue - the largest of its kind - allows astronomers to put considerable constraints on the content of the Universe, and in particular on the amount of dark matter that is believed to pervade it. Rather interestingly, these constraints are totally independent from all other methods so far used to assert the existence of dark matter, such as the study of very distant supernovae (see e.g. ESO PR 21/98) or the analysis of the Cosmic Microwave background (e

  12. [Difficult respiratory management in a patient with bilateral giant bullae].

    PubMed

    Fujita, Ayaka; Hashiba, Eiji; Takahira, Yoko; Kitayama, Masatou; Tubo, Toshihito; Hirota, Kazuyoshi

    2009-10-01

    We report a case of bilateral giant bullae in a patient with multiple traumas. He had his arm amputated at the shoulder because of a machine accident and admitted to our hospital. Chest X-ray showed right-sided pneumothorax with bilateral giant bullae. Trimming of the stump was performed immediately after the placement of a right chest tube. He gradually developed hypoxia and hypercapnia with acidemia during the operation because of atelectasis due to sputum. Postoperatively, enlargement of right giant bulla led to frequent respiratory failure and he received a bilateral bullectomy through a median sternotomy 3 weeks after the accident. It was difficult to ventilate him due to air leak from the bilateral bulla and SpO2 dropped to below 70% with 100% oxygen. We continued the operation with standby extracorporeal membrane oxygenator (ECMO). Although the operation was finished without ECMO finally, ECMO had better been kept ready during anethesia with giant bullae when life threatening complication may occur at any point.

  13. Giant primary angiosarcoma of the small intestine showing severe sepsis.

    PubMed

    Takahashi, Mizuna; Ohara, Masanori; Kimura, Noriko; Domen, Hiromitsu; Yamabuki, Takumi; Komuro, Kazuteru; Tsuchikawa, Takahiro; Hirano, Satoshi; Iwashiro, Nozomu

    2014-11-21

    Primary malignant tumors of the small intestine are rare, comprising less than 2% of all gastrointestinal tumors. An 85-year-old woman was admitted with fever of 40 °C and marked abdominal distension. Her medical history was unremarkable, but blood examination showed elevated inflammatory markers. Abdominal computed tomography showed a giant tumor with central necrosis, extending from the epigastrium to the pelvic cavity. Giant gastrointestinal stromal tumor of the small intestine communicating with the gastrointestinal tract or with superimposed infection was suspected. Because no improvement occurred in response to antibiotics, surgery was performed. Laparotomy revealed giant hemorrhagic tumor adherent to the small intestine and occupying the peritoneal cavity. The giant tumor was a solid tumor weighing 3490 g, measuring 24 cm × 17.5 cm × 18 cm and showing marked necrosis. Histologically, the tumor comprised spindle-shaped cells with anaplastic large nuclei. Immunohistochemical studies showed tumor cells positive for vimentin, CD31, and factor VIII-related antigen, but negative for c-kit and CD34. Angiosarcoma was diagnosed. Although no postoperative complications occurred, the patient experienced enlargement of multiple metastatic tumors in the abdominal cavity and died 42 d postoperatively. The prognosis of small intestinal angiosarcoma is very poor, even after volume-reducing palliative surgery.

  14. Complimentary use of epicardial echo imaging and Doppler in quantification of coronary artery stenoses

    NASA Astrophysics Data System (ADS)

    Richards, Kent L.; Cannon, Scott R.

    1990-08-01

    As more advanced therapeutic procedures are performed on coronary arteries during open chest surgery more advanced diagnostic procedures will be required to define the location and severity of coronary artery disease. This manuscript describes our preliminary experiences in identifying human coronary artery stenoses using epicardial two-dimensional color flow Doppler. Once the lesions were identified we used standard echo Doppler and imaging techniques to define their severity. The accuracy of stenotic cross sectional area calculated using the continuity equation and pressure gradient calculated using the Bernoulli equation were defined using a pulsatile flow model of the coronary circulation. Suggestions about further hardware development required to allow easy clinical application of this technique are described. 1 - CLINICAL NEED FOR INTRA-OPERATIVE EVAUJATION OFCORONARY ARTERIES The severity of coronary artery disease in adults who require coronary bypass surgery has changed significantly in the last ten years. More effective medications used to control angina pectoris and the wide use of percutaneous y artery angioplasty have delayed the timing of surgery until atherosclerotic involvement is more extensive. In addition patients who have had initial coronary bypass operations are now reaching ages at which atherosclerotic involvement of their bypass grafts and native vessels has progressed and reoperation is required. To meet the challenge of coronary arteries with multiple lesions or diffuse disease intraoperative angioplasty devices are being developed. Whether bypass surgery for advanced lesions or reoperation of

  15. Giant Serpentine Aneurysms: Multidisciplinary Management

    PubMed Central

    Anshun, W.; Feng, L.; Daming, W.

    2000-01-01

    Summary Sixty-five cases of intracranial giant serpentine aneurysms (GSΛs), including 61 cases reported in the literature and four additional cases presented in this study were reviewed. The clinical presentation, possible causes, natural history, and especially management of GSAs are discussed with emphasis on the need for aggressive intervention and multidisciplinary management. PMID:20667180

  16. On the Shoulders of Giants...

    DTIC Science & Technology

    2013-01-01

    REFERENCES 1. Newton I. Turnbull HW, ed. Correspondence of Isaac Newton . Vol I: 1661Y1675. Cambridge, United Kingdom: Cambridge University Press; 1959:416...calendar), Sir Isaac Newtonopined to Robert Hooke, ‘‘If I have seen further [than you and Descartes], it is by standing on the shoulders of giants.’’1 That

  17. The giant panda gut microbiome.

    PubMed

    Wei, Fuwen; Wang, Xiao; Wu, Qi

    2015-08-01

    Giant pandas (Ailuropoda melanoleuca) are bamboo specialists that evolved from carnivores. Their gut microbiota probably aids in the digestion of cellulose and this is considered an example of gut microbiota adaptation to a bamboo diet. However, this issue remains unresolved and further functional and compositional studies are needed.

  18. Multiple factors in the reptile extinctions of the Cretaceous period.

    PubMed

    Cloudsley-Thompson, J

    2001-08-01

    The selective extinction of the dinosaurs and other giant reptiles has long been a topic of speculation and controversy. Everyone is familiar with the theory of the giant bollide colliding with Earth. But, would it not be more likely that that multiple factors acted over a relatively long period of time to produce this mass extinction?

  19. Nursery of Giants

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Hidden behind a shroud of dust in the constellation Cygnus is a stellar nursery called DR21, which is giving birth to some of the most massive stars in our galaxy. Visible light images reveal no trace of this interstellar cauldron because of heavy dust obscuration. In fact, visible light is attenuated in DR21 by a factor of more than 10,000,000,000,000,000,000,000,000,000,000,000,000,000 (ten thousand trillion heptillion).

    New images from NASA's Spitzer Space Telescope allow us to peek behind the cosmic veil and pinpoint one of the most massive natal stars yet seen in our Milky Way galaxy. The never-before-seen star is 100,000 times as bright as the Sun. Also revealed for the first time is a powerful outflow of hot gas emanating from this star and bursting through a giant molecular cloud.

    This image is a large-scale mosaic assembled from individual photographs obtained with the InfraRed Array Camera (IRAC) aboard Spitzer. The image covers an area about two times that of a full moon. The mosaic is a composite of images obtained at mid-infrared wavelengths of 3.6 microns (blue), 4.5 microns (green), 5.8 microns (orange) and 8 microns (red). The brightest infrared cloud near the top center corresponds to DR21, which presumably contains a cluster of newly forming stars at a distance of 10,000 light-years.

    Protruding out from DR21 toward the bottom left of the image is a gaseous outflow (green), containing both carbon monoxide and molecular hydrogen. Data from the Spitzer spectrograph, which breaks light into its constituent individual wavelengths, indicate the presence of hot steam formed as the outflow heats the surrounding molecular gas. Outflows are physical signatures of processes that create supersonic beams, or jets, of gas. They are usually accompanied by discs of material around the new star, which likely contain the materials from which future planetary systems are formed. Additional newborn stars, depicted in green, can be seen surrounding the

  20. Human immunodeficiency virus (HIV) is highly associated with giant idiopathic esophageal ulcers in acquired immunodeficiency syndrome (AIDS) patients

    PubMed Central

    Lv, Bei; Cheng, Xin; Gao, Jackson; Zhao, Hong; Chen, Liping; Wang, Liwei; Huang, Shaoping; Fan, Zhenyu; Zhang, Renfang; Shen, Yinzhong; Li, Lei; Liu, Baochi; Qi, Tangkai; Wang, Jing; Cheng, Jilin

    2016-01-01

    Objective: This study aimed to determine whether the human immunodeficiency virus (HIV) exists in giant idiopathic esophageal ulcers in the patients with acquired immune deficiency syndrome (AIDS). Methods: 16 AIDS patients with a primary complaint of epigastric discomfort were examined by gastroscopy. Multiple and giant esophageal ulcers were biopsied and analyzed with pathology staining and reverse transcription-polymerase chain reaction (RT-PCR) to determine the potential pathogenic microorganisms, including HIV, cytomegalovirus (CMV) and herpes simplex viruses (HSV). Results: HIV was detected in ulcer samples from 12 out of these 16 patients. Ulcers in 2 patients were infected with CMV and ulcers in another 2 patients were found HSV positive. No obvious cancerous pathological changes were found in these multiple giant esophageal ulcer specimens. Conclusion: HIV may be one of the major causative agents of multiple benign giant esophageal ulcers in AIDS patients. PMID:27830031

  1. Percutaneous Coronary Intervention Enhances Accelerative Wave Intensity in Coronary Arteries

    PubMed Central

    Narayan, Om; Leung, Michael C. H.; Wong, Dennis T. L.; Meredith, Ian T.; Cameron, James D.

    2015-01-01

    Background The systolic forward travelling compression wave (sFCW) and diastolic backward travelling decompression waves (dBEW) predominantly accelerate coronary blood flow. The effect of a coronary stenosis on the intensity of these waves in the distal vessel is unknown. We investigated the relationship between established physiological indices of hyperemic coronary flow and the intensity of the two major accelerative coronary waves identified by Coronary Wave Intensity analysis (CWIA). Methodology / Principal Findings Simultaneous intracoronary pressure and velocity measurement was performed during adenosine induced hyperemia in 17 patients with pressure / Doppler flow wires positioned distal to the target lesion. CWI profiles were generated from this data. Fractional Flow Reserve (FFR) and Coronary Flow Velocity Reserve (CFVR) were calculated concurrently. The intensity of the dBEW was significantly correlated with FFR (R = -0.70, P = 0.003) and CFVR (R = -0.73, P = 0.001). The intensity of the sFCW was also significantly correlated with baseline FFR (R = 0.71, p = 0.002) and CFVR (R = 0.59, P = 0.01). Stenting of the target lesion resulted in a median 178% (interquartile range 55–280%) (P<0.0001) increase in sFCW intensity and a median 117% (interquartile range 27–509%) (P = 0.001) increase in dBEW intensity. The increase in accelerative wave intensity following PCI was proportionate to the baseline FFR and CFVR, such that stenting of lesions associated with the greatest flow limitation (lowest FFR and CFVR) resulted in the largest increases in wave intensity. Conclusions Increasing ischemia severity is associated with proportionate reductions in cumulative intensity of both major accelerative coronary waves. Impaired diastolic microvascular decompression may represent a novel, important pathophysiologic mechanism driving the reduction in coronary blood flow in the setting of an epicardial stenosis. PMID:26658896

  2. Coronary Artery Disease Risk Factors, Coronary Artery Calcification and Coronary Bypass Surgery

    PubMed Central

    Ulusoy, Fatih Rifat; Ipek, Emrah; Korkmaz, Ali Fuat; Gurler, Mehmet Yavuz; Gulbaran, Murat

    2015-01-01

    Introduction Atherosclerosis is an intimal disease which affects large and medium size arteries including aorta and carotid, coronary, cerebral and radial arteries. Calcium accumulated in the coronary arterial plaques have substantial contribution to the plaque volume. The aim of our study is to investigate the relationship between coronary artery disease (CAD) risk factors and coronary arterial calcification, and to delineate the importance of CACS in coronary artery bypass surgery. Materials and Methods The current study is retrospective and 410 patients admitted to our clinic with atypical chest pain and without known CAD were included. These individuals were evaluated by 16 slice electron beam computed tomography with suspicion of CAD and their calcium scores were calculated. Detailed demographic and medical history were obtained from all of the patients. Results In our study, we employed five different analyses using different coronary arterial calcification score (CACS) thresold levels reported in previous studies. All of the analyses, performed according to the previously defined thresold levels, showed that risk factors had strong positive relationship with CACS as mentioned in previous studies. Conclusion Coronary arterial calcification is part of the athero-sclerotic process and although it can be detected in atherosclerotic vessel, it is absent in a normal vessel. It can be concluded that the clinical scores, even they are helpful, have some limitations in a significant part of the population for cardiovascular risk determination. It is important for an anastomosis region to be noncalcified in coronary bypass surgery. In a coronary artery, it will be helpness for showing of calcific field and anostomosis spot. PMID:26155507

  3. Coronary collateral circulation: its relevance.

    PubMed

    Karrowni, Wassef; El Accaoui, Ramzi N; Chatterjee, Kanu

    2013-11-15

    The interest in coronary collateral circulation (CCC) as "natural bypasses" is growing, especially in patients in whom the extent of coronary atherosclerosis is too severe to allow for conventional revascularization. The anatomic foundation of CCC has been recognized for long time. Recently, reliable methods have become available for the assessment of the adequacy of collateral flow. However, the debate regarding the importance of CCC in the different clinical settings continues. In this article, we present the recent progress in the understanding of anatomy and physiology of the CCC and focus on the studies addressing their functional significance in acute, subacute, and chronic coronary artery disease. In addition, we provide a focused update on the essential role of collateral circulation in the management of coronary chronic total occlusions.

  4. Transcatheter Arterial Embolization Alone for Giant Hepatic Hemangioma

    PubMed Central

    Zhang, Yue-Lin; Zhou, Guan-Hui; Ai, Jing; Zhou, Tan-Yang; Zhu, Tong-Yin; Zhang, Ai-Bin; Wang, Wei-Lin; Zheng, Shu-Sen

    2015-01-01

    Giant hepatic hemangioma is a benign liver condition that may be treated using surgery. We studied the digital subtraction angiographic (DSA) characteristics of giant hepatic hemangioma, and the effectiveness of transcatheter arterial embolization (TAE) alone for its treatment. This was a retrospective study of 27 patients diagnosed with giant hepatic hemangioma and treated with TAE alone (using lipiodol mixed with pingyangmycin) at the Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University, between January 2010 and March 2013. The feeding arteries were identified using DSA. All patients were followed up for between three weeks and 12 months. Changes in tumor diameter and symptoms were observed. The 27 patients included had giant hepatic hemangiomas ranging from 5.3 to 24.5 cm (mean, 11.24±5.08 cm) in the right (n = 13), left (n = 1) or both (n = 13) lobes. Preoperative hepatic angiography showed multiple abnormal vascular lakes in the early phase, known as the “early leaving but late returning, hanging nut on a twig” sign. On the day after TAE, hepatic transaminase levels were increased (ALT: 22.69±17.95 to 94.88±210.32 U/L; ALT: 24.00±12.37 to 99.70±211.54 U/L; both P<0.05), but not total bilirubin. Six patients complained of abdominal pain, and 12 experienced transient fever. In the months after TAE, tumor size decreased (baseline: 11.24±5.08; 3 months: 8.95±4.33; 6 months: 7.60±3.90 cm; P<0.05), and the patients’ condition improved. These results indicated that TAE was effective and safe for treating giant hepatic hemangioma. TAE may be a useful alternative to surgery for the treatment of hepatic hemangioma. PMID:26287964

  5. Anomalous right coronary artery arising next to the left coronary ostium: unambiguous detection of the anatomy by computed tomography and evaluation of functional significance by cardiovascular magnetic resonance.

    PubMed

    Korosoglou, Grigorios; Heye, Tobias; Giannitsis, Evangelos; Hosch, Waldemar; Kauczor, Hans U; Katus, Hugo A

    2010-11-19

    Herein we report on the diagnostic potential of multi-detector row computed tomography (MDCT) combined with cardiovascular magnetic resonance (CMR) for the diagnostic workup in an adult patient with a rare coronary anomaly. MDCT unambiguously detected the anomalous right coronary artery (RCA), which originated next to the left coronary ostium and coursed inter-arterially between the ascending aorta and the pulmonary trunk. The intramural proximal intussusception of the ectopic RCA could be clearly appreciated on MDCT images, while multiple mixed plaques were detected in the left anterior descending (LAD), resulting in moderate stenosis of this vessel. CMR during adenosine infusion ruled-out inducible ischemia, yielding normal perfusion patterns both in the RCA and in the LAD coronary territory. Since ischemia was not demonstrated by stress CMR, revascularization was not performed.

  6. EFFECTS OF DYNAMICAL EVOLUTION OF GIANT PLANETS ON SURVIVAL OF TERRESTRIAL PLANETS

    SciTech Connect

    Matsumura, Soko; Ida, Shigeru; Nagasawa, Makiko

    2013-04-20

    The orbital distributions of currently observed extrasolar giant planets allow marginally stable orbits for hypothetical, terrestrial planets. In this paper, we propose that many of these systems may not have additional planets on these ''stable'' orbits, since past dynamical instability among giant planets could have removed them. We numerically investigate the effects of early evolution of multiple giant planets on the orbital stability of the inner, sub-Neptune-like planets which are modeled as test particles, and determine their dynamically unstable region. Previous studies have shown that the majority of such test particles are ejected out of the system as a result of close encounters with giant planets. Here, we show that secular perturbations from giant planets can remove test particles at least down to 10 times smaller than their minimum pericenter distance. Our results indicate that, unless the dynamical instability among giant planets is either absent or quiet like planet-planet collisions, most test particles down to {approx}0.1 AU within the orbits of giant planets at a few AU may be gone. In fact, out of {approx}30% of survived test particles, about three quarters belong to the planet-planet collision cases. We find a good agreement between our numerical results and the secular theory, and present a semi-analytical formula which estimates the dynamically unstable region of the test particles just from the evolution of giant planets. Finally, our numerical results agree well with the observations, and also predict the existence of hot rocky planets in eccentric giant planet systems.

  7. Physiologic assessment of coronary artery fistula

    SciTech Connect

    Gupta, N.C.; Beauvais, J. )

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

  8. Animal models of coronary heart disease.

    PubMed

    Liao, Jiawei; Huang, Wei; Liu, George

    2015-08-20

    Cardiovascular disease, predominantly coronary heart disease and stroke, leads to high morbidity and mortality not only in developed worlds but also in underdeveloped regions. The dominant pathologic foundation for cardiovascular disease is atherosclerosis and as to coronary heart disease, coronary atherosclerosis and resulting lumen stenosis, even total occlusions. In translational research, several animals, such as mice, rabbits and pigs, have been used as disease models of human atherosclerosis and related cardiovascular disorders. However, coronary lesions are either naturally rare or hard to be fast induced in these models, hence, coronary heart disease induction mostly relies on surgical or pharmaceutical interventions with no or limited primary coronary lesions, thus unrepresentative of human coronary heart disease progression and pathology. In this review, we will describe the progress of animal models of coronary heart disease following either spontaneous or diet-accelerated coronary lesions.

  9. Hiatal hernia causing extrapericardial tamponade after coronary bypass surgery.

    PubMed

    Papoulidis, Pavlos; Beatty, Jasmine Winter; Dandekar, Uday

    2014-10-01

    Cardiac tamponade is defined as compression of the heart due to accumulation of fluid in the pericardial sac, leading to raised pericardial pressures with haemodynamic compromise. We describe the case of a 76-year old female patient who underwent a routine off-pump coronary artery bypass graft operation and within 48 h developed classic signs of cardiac tamponade. The perioperative echocardiogram and operative findings at re-exploration revealed no clots or fluid collection. A giant hiatus hernia was found to be responsible for the tamponade through extrinsic compression. After insertion of a nasogastric tube and decompression of the stomach, there was a rapid improvement of the clinical picture. The remaining postoperative course was uneventful and the patient was discharged 5 days later, with referral to the general surgeon for further management. We conclude that, in cases of tamponade post-cardiac surgery, extrapericardial pathologies should be considered.

  10. Dutch survey of congenital coronary artery fistulas in adults

    PubMed Central

    Said, S.A.M.; van der Werf, T.

    2006-01-01

    Aims This Dutch survey focused on the clinical presentation, noninvasive and invasive diagnostic methods, and treatment modalities of adult patients with congenital coronary artery fistulas (CAFs). Methods Between 1996 and 2003, the initiative was taken to start a registry on congenital CAFs in adults. In total 71 patients from a diagnostic coronary angiographic population of 30,829 at 28 hospitals were collected from previously developed case report forms. Patient demographic data, clinical presentation, noninvasive and invasive techniques and treatment options were retrospectively collected and analysed. Results Out of 71 patients with angiographically proven CAFs, 51 (72%) had 63 congenital solitary fistulas and 20 (28%) had 31 congenital coronary-ventricular multiple microfistulas. Patients with pseudofistulas were excluded from the registry. Coronary angiograms were independently re-analysed for morphology and specific fistula details. The majority (72%) of the fistulas were unilateral, 24% were bilateral and only 4% were multilateral. The morphological characteristics of these 94 fistulas were as follows: the origin was multiple in 47% and single in 53%; the termination was multiple in 52% and single in 48%; and the pathway of the fistulous vessels was tortuous/multiple in 66%, tortuous/single in 28%, straight/multiple in 3% and straight/single in 3%. Percutaneous transluminal embolisation (PTE) was performed in two (3%) patients; surgical ligation was undertaken in 13 (18%) patients. The overwhelming majority of the patients (56; 79%) were treated with conservative medical management. The total mortality was 6% (4/71) at a mean follow-up period of approximately five years. Cardiac mortality accounted for 4% (3/71); in all three patients, death could possibly be attributed to the presence of the fistula. Conclusion Registry of congenital coronary artery fistulas in adults in the Netherlands is feasible. In spite of restrictions imposed by the Dutch Privacy

  11. Revisiting the "Sleeping Giant" Metaphor: Is It Still Sleeping in the Commonwealth of Virginia, and Is It Still Really a Giant?

    ERIC Educational Resources Information Center

    Hicks, David; van Hover, Stephanie

    2014-01-01

    In order to revisit Martorella's metaphor of technology as a sleeping giant this paper analyzes data collected over multiple years in order to provide a portrait of how preservice teachers make sense of and choose (if at all) to integrate digital technologies within their internship classrooms. Findings indicate that in the Commonwealth of…

  12. Atherosclerosis and Liver Function Tests in Coronary Angiography Patients

    PubMed Central

    Doganer, YC; Rohrer, JE; Aydogan, U; Agerter, DC; Cayci, T; Barcin, C

    2015-01-01

    ABSTRACT Objective: Elevated aminotransferase levels indicating liver function, even in the normal range, have attracted great concern as potential novel markers of cardiovascular risk assessment. We hypothesized the possibility that liver function test variations in the normal range might be meaningfully associated to coronary artery disease (CAD). Method: Eighty-eight patients were randomly selected from those who underwent coronary angiography from June 2010 to June 2011 after applying to the outpatient cardiology clinic in Gulhane Military Medical Academy. According to the results of angiographies, patients were classified into three groups as normal, non-critical (< 50% involvement in coronaries), and critical (≥ 50% involvement in coronaries). In addition to angiographic intervention, measurements of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations, albumin and the other serum parameters were performed in all patients. Results: The patient groups of CAD were balanced (28 critical cases, 30 non-critical cases and 30 normal cases). Mean age was 51.93 ± 9.3 (range 32–65) years and 19.3 per cent (n = 17) were females. Multiple linear regression analysis of all three liver function tests explained a significant portion of the variance, but adjusted r-squares were small (AST = 0.174, ALT = 0.242, albumin = 0.124). Albumin was significantly higher for patients with critical CAD than for patients with no CAD (beta = 3.205, p = 0.002). Non-critical CAD was not significantly different from no CAD for any of the dependent variables. Mean AST was significantly higher for patients taking aspirin (beta = 0.218, p = 0.049), as was mean ALT (beta = 0.264, p = 0.015). Conclusion: Alanine aminotransferase and AST may not be associated with angiographically determined coronary atherosclerosis. Albumin may be more sensitive to demonstrate the burden of atherosclerosis. These results indicate that the association between the liver

  13. Transposition of Great Arteries with Intramural Coronary Artery: Experience with a Modified Surgical Technique

    PubMed Central

    Mishra, Amit; Jain, Anil; Hinduja, Manish; Wadhawa, Vivek; Patel, Ramesh; Vaidhya, Nikunj; Rodricks, Dayesh; Patel, Hardik

    2016-01-01

    Objective: Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands. We are presenting our experience with a modified technique for intramural coronary arteries in arterial switch operation. Methods: This prospective study involves 450 patients undergoing arterial switch operation at our institute from April 2006 to December 2013 (7.6 years). Eighteen patients underwent arterial switch operation with intramural coronary artery. The coronary patterns and technique used are detailed in the text. Results: The overall mortality found in the subgroup of 18 patients having intramural coronary artery was 16% (n=3). Our first patient had an accidental injury to the left coronary artery and died in the operating room. A seven-day old newborn died from intractable ventricular arrhythmia fifteen hours after surgery. Another patient who had multiple ventricular septal defects with type B arch interruption died from residual apical ventricular septal defect and sepsis on the eleventh postoperative day. The remainder of the patients are doing well, showing a median follow-up duration of 1235.34±815.26 days (range 369 - 2730). Conclusion: Transposition of the great arteries with intramural coronary artery is demanding in a subset of patients undergoing arterial switch operation. We believe our technique of coronary button dissection in the presence of intramural coronary arteries using coronary shunt is simple and can be a good addition to the surgeons' armamentarium. PMID:27074270

  14. Variant angina and coronary artery spasm: the clinical spectrum, pathophysiology, and management.

    PubMed

    Kusama, Yoshiki; Kodani, Eitaro; Nakagomi, Akihiro; Otsuka, Toshiaki; Atarashi, Hirotsugu; Kishida, Hiroshi; Mizuno, Kyoichi

    2011-01-01

    variant angina is favorable, if early complications can be overcome. However, because coronary artery spasm cannot be suppressed in some patients, even with multiple medications, medications to suppress intractable coronary artery spasm must be developed.

  15. Proteorhodopsin genes in giant viruses.

    PubMed

    Yutin, Natalya; Koonin, Eugene V

    2012-10-04

    Viruses with large genomes encode numerous proteins that do not directly participate in virus biogenesis but rather modify key functional systems of infected cells. We report that a distinct group of giant viruses infecting unicellular eukaryotes that includes Organic Lake Phycodnaviruses and Phaeocystis globosa virus encode predicted proteorhodopsins that have not been previously detected in viruses. Search of metagenomic sequence data shows that putative viral proteorhodopsins are extremely abundant in marine environments. Phylogenetic analysis suggests that giant viruses acquired proteorhodopsins via horizontal gene transfer from proteorhodopsin-encoding protists although the actual donor(s) could not be presently identified. The pattern of conservation of the predicted functionally important amino acid residues suggests that viral proteorhodopsin homologs function as sensory rhodopsins. We hypothesize that viral rhodopsins modulate light-dependent signaling, in particular phototaxis, in infected protists.

  16. Giant viruses come of age.

    PubMed

    Fischer, Matthias G

    2016-06-01

    Viruses with genomes up to a few megabases in length are a common occurrence in nature, even though they have escaped our notice until recently. These giant viruses infect mainly single-celled eukaryotes and isolation efforts concentrating on amoebal hosts alone have spawned hundreds of viral isolates, featuring viruses with previously unseen virion morphologies and the largest known viral genomes and particles. One of the challenges that lie ahead is to analyze and categorize the available data and to establish an approved classification system that reflects the evolutionary relationships and biological properties of these viruses. Extensive sampling of Acanthamoeba-infecting mimiviruses and initial characterization of their virophage parasites have provided a first blueprint of the genetic diversity and composition of a giant virus clade that will facilitate the taxonomic grouping of these fascinating microorganisms.

  17. Giant thermoelectric effect in graphene

    NASA Astrophysics Data System (ADS)

    Dragoman, D.; Dragoman, M.

    2007-11-01

    The paper predicts a giant thermoelectric coefficient in a nanostructure consisting of metallic electrodes periodically patterned over graphene, which is deposited on a silicon dioxide substrate. The Seebeck coefficient in this device attains 30mV/K, this value being among the largest reported ever. The calculations are based on a transfer matrix approach that takes a particular form for graphene-based devices. The results are important for future nanogenerators with applications in the area of sensors, energy harvesting, and scavenging.

  18. Giant viruses infecting algae.

    PubMed

    Van Etten, J L; Meints, R H

    1999-01-01

    Paramecium bursaria chlorella virus (PBCV-1) is the prototype of a family of large, icosahedral, plaque-forming, double-stranded-DNA-containing viruses that replicate in certain unicellular, eukaryotic chlorella-like green algae. DNA sequence analysis of its 330, 742-bp genome leads to the prediction that this phycodnavirus has 376 protein-encoding genes and 10 transfer RNA genes. The predicted gene products of approximately 40% of these genes resemble proteins of known function. The chlorella viruses have other features that distinguish them from most viruses, in addition to their large genome size. These features include the following: (a) The viruses encode multiple DNA methyltransferases and DNA site-specific endonucleases; (b) PBCV-1 encodes at least part, if not the entire machinery to glycosylate its proteins; (c) PBCV-1 has at least two types of introns--a self-splicing intron in a transcription factor-like gene and a splicesomal processed type of intron in its DNA polymerase gene. Unlike the chlorella viruses, large double-stranded-DNA-containing viruses that infect marine, filamentous brown algae have a circular genome and a lysogenic phase in their life cycle.

  19. Who is at risk of a coronary?

    PubMed Central

    Khosla, T; Newcombe, R G; Campbell, H

    1977-01-01

    The Joint Working Party of the Royal College of Physicians and the British Cardiac Society have recently given advice to medical practitioners about preventing coronary heart disease. We have formulated an easy method by which the medical practitioner may apply a rule to identify individuals who are at moderate to high risk of developing the disease. The simple arithmetic requires finding the product of four numbers and can be done with a pocket calculator costing less than pound 10. The four numbers correspond to known values of the four risk variables--age, systolic blood pressure, serum cholesterol levels, and smoking--for a given individual. Tables of relative risk components for men aged 40 to 59 years for coronary heart disease defined by hard criteria (fatal or definite myocardial infarction) have been drawn up. The overall effect of the four risk variables is multiplicative so that some men aged 40 are at far greater risk than some of 55 year olds. PMID:837093

  20. Percutaneous Coronary Intervention on Right Coronary Artery With All Coronary Arteries From Three Separate Ostiums in the Right Sinus of Valsalva

    PubMed Central

    Sayin, Muhammet Rasit; Aydin, Mustafa; Dogan, Sait Mesut; Karabag, Turgut

    2011-01-01

    Some of coronary artery anomalies, such as origin of all coronary arteries from three separate ostiums in the right sinus of valsalva, represent a small amount of coronary anomalies. We describe a 63-year-old female patient which coronary angiogram revealed an origin of all coronary arteries from three separate ostiums in the right sinus of valsalva, with significant atherosclerotic plaque at the midportion of the right coronary artery. The stenosis was treated through percutaneous coronary intervention.

  1. Observed Properties of Giant Cells

    NASA Technical Reports Server (NTRS)

    Hathaway, David H.; Upton, Lisa; Colegrove, Owen

    2014-01-01

    The existence of Giant Cells has been suggested by both theory and observation for over 45 years. We have tracked the motions of supergranules in SDO/HMI Doppler velocity data and find larger (Giant Cell) flows that persist for months. The flows in these cells are clockwise around centers of divergence in the north and counter-clockwise in the south. Equatorward flows are correlated with prograde flows - giving the transport of angular momentum toward the equator that is needed to maintain the Sun's rapid equatorial rotation. The cells are most pronounced at mid- and high-latitudes where they exhibit the rotation rates representative of those latitudes. These are clearly large, long-lived, cellular features, with the dynamical characteristics expected from the effects of the Sun's rotation, but the shapes of the cells are not well represented in numerical models. While the Giant Cell flow velocities are small (<10 m/s), their long lifetimes should nonetheless substantially impact the transport of magnetic flux in the Sun's near surface layers.

  2. KEPLER RAPIDLY ROTATING GIANT STARS

    SciTech Connect

    Costa, A. D.; Martins, B. L. Canto; Bravo, J. P.; Paz-Chinchón, F.; Chagas, M. L. das; Leão, I. C.; Oliveira, G. Pereira de; Silva, R. Rodrigues da; Roque, S.; Oliveira, L. L. A. de; Silva, D. Freire da; De Medeiros, J. R.

    2015-07-10

    Rapidly rotating giant stars are relatively rare and may represent important stages of stellar evolution, resulting from stellar coalescence of close binary systems or accretion of substellar companions by their hosting stars. In the present Letter, we report 17 giant stars observed in the scope of the Kepler space mission exhibiting rapid rotation behavior. For the first time, the abnormal rotational behavior for this puzzling family of stars is revealed by direct measurements of rotation, namely from photometric rotation period, exhibiting a very short rotation period with values ranging from 13 to 55 days. This finding points to remarkable surface rotation rates, up to 18 times the rotation of the Sun. These giants are combined with six others recently listed in the literature for mid-infrared (IR) diagnostics based on Wide-field Infrared Survey Explorer information, from which a trend for an IR excess is revealed for at least one-half of the stars, but at a level far lower than the dust excess emission shown by planet-bearing main-sequence stars.

  3. Hairpin Furans and Giant Biaryls.

    PubMed

    Geng, Xin; Mague, Joel T; Donahue, James P; Pascal, Robert A

    2016-05-06

    The thermal reaction of two cyclopentadienones with 5,5'-binaphthoquinone or 6,6'-dimethoxy-5,5'-binaphthoquinone in refluxing nitrobenzene (210 °C) gives, in a single synthetic step that includes two Diels-Alder additions, two decarbonylations, and two dehydrogenations, giant biaryl bisquinones (compounds 13, 14, 15, 18, and 21). However, when two cyclopentadienones react with 6,6'-dimethoxy-5,5'-binaphthoquinone in nitrobenzene at higher temperatures (250-260 °C), the resulting products are molecular ribbons composed of two twisted aromatic systems fused to a heteropentahelicene (19, 20, and 22). These molecules are representatives of a new class of chiral polycyclic aromatic compounds, the "hairpin furans". Interestingly, reheating a dimethoxy-substituted giant biaryl (e.g., 21) in nitrobenzene at 260 °C does not yield the corresponding hairpin furan (22), and mechanistic studies indicate that some intermediate or byproduct of the synthesis of the giant biaryls is a reagent or catalyst necessary for the conversion of the dimethoxybiaryl to the furan.

  4. Electrodynamics in Giant Planet Atmospheres

    NASA Astrophysics Data System (ADS)

    Koskinen, T.; Yelle, R. V.; Lavvas, P.; Cho, J.

    2014-12-01

    The atmospheres of close-in extrasolar giant planets such as HD209458b are strongly ionized by the UV flux of their host stars. We show that photoionization on such planets creates a dayside ionosphere that extends from the thermosphere to the 100 mbar level. The resulting peak electron density near the 1 mbar level is higher than that encountered in any planetary ionosphere of the solar system, and the model conductivity is in fact comparable to the atmospheres of Sun-like stars. As a result, the momentum and energy balance in the upper atmosphere of HD209458b and similar planets can be strongly affected by ion drag and resistive heating arising from wind-driven electrodynamics. Despite much weaker ionization, electrodynamics is nevertheless also important on the giant planets of the solar system. We use a generic framework to constrain the conductivity regimes on close-in extrasolar planets, and compare the results with conductivites based on the same approach for Jupiter and Saturn. By using a generalized Ohm's law and assumed magnetic fields, we then demonstrate the basic effects of wind-driven ion drag in giant planet atmospheres. Our results show that ion drag is often significant in the upper atmosphere where it can also substantially alter the energy budget through resistive heating.

  5. Giant-cell granuloma of the axis.

    PubMed

    González-Martínez, Emilio; Santamarta, David; Lomas-García, Jesús; Ibáñez-Plágaro, F Javier; Fernández-Fernández, J Javier; Ariño, Teresa Ribas; García-Cosamalón, José

    2012-02-01

    Giant-cell granuloma is a benign and nonneoplastic lesion with an expansive and locally destructive behavior. It typically involves the mandible and the maxilla. Only 1 case arising from the odontoid process of the axis has been reported previously. The authors report on a 64-year-old man with a giant-cell granuloma of the axis. They review this uncommon entity, emphasizing the complexity of differentiating between this lesion and other giant-cell tumors.

  6. Cabergoline Treatment in Invasive Giant Prolactinoma

    PubMed Central

    Alsubaie, Sadeem; Almalki, Mussa H

    2014-01-01

    Patients with invasive giant prolactinoma suffer from a constellation of symptoms including headache, blurred vision, lethargy, and sexual dysfunction. Cabergoline, a potent dopamine agonist, is a known medication prescribed for the treatment of invasive giant prolactinoma. Here, we report a case of invasive giant prolactinoma in a 52-year-old Saudi male with dramatic response to cabergoline treatment clinically, biochemically, and radiologically. PMID:25002819

  7. Guiding the Giant

    NASA Astrophysics Data System (ADS)

    1998-08-01

    New ESO Survey Provides Targets for the VLT Giant astronomical telescopes like the ESO Very Large Telescope (VLT) must be used efficiently. Observing time is expensive and there are long waiting lines of excellent research programmes. Thus the work at the telescope must be very well prepared and optimized as much as possible - mistakes should be avoided and no time lost! Astronomers working with the new 8-m class optical/infrared telescopes must base their observations on detailed lists of suitable target objects if they want to perform cutting-edge science. This is particularly true for research programmes that depend on observations of large samples of comparatively rare, distant objects. This type of work requires that extensive catalogues of such objects must be prepared in advance. One such major catalogue - that will serve as a very useful basis for future VLT observations - has just become available from the new ESO Imaging Survey (EIS). The Need for Sky Surveys Astronomers have since long recognized the need to carry out preparatory observations with other telescopes in order to "guide" large telescopes. To this end, surveys of smaller or larger parts of the sky have been performed by wide-field telescopes, paving the way for subsequent work at the limits of the largest available ground-based telescopes. For instance, a complete photographic survey of the sourthern sky (declination < -17.5°) was carried out in the 1970's with the ESO 1-metre Schmidt Telescope in support of the work at the 3.6-m telescope at the ESO La Silla observatory. However, while until recently most observational programmes could rely on samples of objects found on photographic plates, this is no longer possible. New image surveys must match the fainter limiting magnitudes reached by the new and larger telescopes. Modern digital, multi-colour, deep imaging surveys have thus become an indispensable complement to the 8-m telescopes. The new generation of imaging surveys will, without

  8. Stress scintigraphy using single-photon emission computed tomography in the evaluation of coronary artery disease

    SciTech Connect

    Nohara, R.; Kambara, H.; Suzuki, Y.; Tamaki, S.; Kadota, K.; Kawai, C.; Tamaki, N.; Torizuka, K.

    1984-05-01

    Twenty-seven patients with angina pectoris, 24 with postmyocardial infarction angina and 7 with normal coronary arteries were examined by exercise thallium-201 emission computed tomography (SPECT) and planar scintigraphy. Exercise SPECT was compared with the reperfusion imaging obtained approximately 2 to 3 hours after exercise. The sensitivity and specificity of demonstrating involved coronary arteries by identifying the locations of myocardial perfusion defects were 96 and 87% for right coronary artery, 88 and 89% for left anterior descending artery (LAD) and 78 and 100% for left circumflex artery (LC). These figures are higher than those for planar scintigraphy (85 and 87% for right coronary artery, 73 and 89% for LAD and 39 and 100% for LC arteries). In patients with 3-vessel disease, sensitivity of SPECT (100, 88 and 75% for right coronary artery, LAD and LC, respectively) was higher than planar imaging (88, 63 and 31%, respectively), with a significant difference for LC (p less than 0.05). In 1, 2 and 0-vessel disease the sensitivity and specificity of the 2 techniques were comparable. Multivessel disease was more easily identified as multiple coronary involvement than planar imaging with a significant difference in 3-vessel disease (p less than 0.05). In conclusion, stress SPECT provides useful information for the identification of LC lesions in coronary heart disease, including 3-vessel involvement.

  9. Screening for Coronary Heart Disease with Electrocardiography

    MedlinePlus

    ... Force Recommendations Screening for Coronary Heart Disease with Electrocardiography The U.S. Preventive Services Task Force (Task Force) ... recommendations on Screening for Coronary Heart Disease with Electrocardiography . These recommendations are for adult men and women ...

  10. Who Needs Coronary Artery Bypass Grafting?

    MedlinePlus

    ... from the NHLBI on Twitter. Who Needs Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is used to treat people ... or after a heart attack to treat blocked arteries. Your doctor may recommend CABG if other treatments, ...

  11. Radiation-induced accelerated coronary arteriosclerosis

    SciTech Connect

    Mittal, B.; Deutsch, M.; Thompson, M.; Dameshek, H.L.

    1986-07-01

    There is a paucity of information on radiation-induced coronary heart disease. A young patient with myocardial infarction following mediastinal irradiation is described. The role of radiotherapy and chemotherapy on the subsequent development of coronary heart disease is discussed.

  12. Red giants: then and now

    NASA Astrophysics Data System (ADS)

    Faulkner, John

    Fred Hoyle's work on the structure and evolution of red giants, particularly his pathbreaking contribution with Martin Schwarzschild (Hoyle and Schwarzschild 1955), is both lauded and critically assessed. In his later lectures and work with students in the early 1960s, Hoyle presented more physical ways of understanding some of the approximations used, and results obtained, in that seminal paper. Although later ideas by other investigators will be touched upon, Hoyle's viewpoint - that low-mass red giants are essentially white dwarfs with a serious mass-storage problem - is still extremely fruitful. Over the years, I have further developed his method of attack. Relatively recently, I have been able to deepen and broaden the approach, finally extending the theory to provide a unifying treatment of the structure of low-mass stars from the main sequence though both the red-giant and horizontal-branch phases of evolution. Many aspects of these stars that had remained puzzling, even mysterious, for decades have now fallen into place, and some questions have been answered that were not even posed before. With low-mass red giants as the simplest example, this recent work emphasizes that stars, in general, may have at least two distinct but very important centres: (I) a geometrical centre, and (II) a separate nuclear centre, residing in a shell outside a zero-luminosity dense core for example. This two-centre perspective leads to an explicit, analytical, asymptotic theory of low-mass red-giant structure. It enables one to appreciate that the problem of understanding why such stars become red giants is one of anticipating a remarkable yet natural structural bifurcation that occurs in them. This bifurcation occurs because of a combination of known and understandable facts just summarized namely that, following central hydrogen exhaustion, a thin nuclear-burning shell does develop outside a more-or-less dense core. In the resulting theory, both ρsh/ρolinec and

  13. Spontaneous thrombosis in giant intracranial aneurysms.

    PubMed Central

    Whittle, I R; Dorsch, N W; Besser, M

    1982-01-01

    Twelve patients in a series of 22 with giant intracranial aneurysms demonstrated neuroradiological features of partial or total spontaneous intra-aneurysmal thrombosis. The presence of this intra-aneurysmal clot significantly altered the computed tomographic appearance of the giant aneurysm. Massive intra-aneurysmal thrombosis did not protect against subarachnoid haemorrhage and the likelihood of rupture of a clot containing giant aneurysm was not significantly different from that of a non-thrombosed giant aneurysm. Although parent artery occlusion from a thrombosed giant aneurysm, and massive aneurysmal thrombosis leading to the formation of giant serpentine aneurysm were documented, these are rare epiphenomena. The risk of embolisation from a partially thrombosed giant aneurysm, which was documented in one case, would appear to be greater than that from a non-thrombosed giant aneurysm. The findings in this series, and a review of literature, suggest that the presence of intra-aneurysmal clot in giant intracranial aneurysms has little prognostic significance and does not alter the management or outcome after treatment. Images PMID:7175528

  14. ORIGIN OF LITHIUM ENRICHMENT IN K GIANTS

    SciTech Connect

    Kumar, Yerra Bharat; Reddy, Bacham E.; Lambert, David L.

    2011-03-20

    In this Letter, we report on a low-resolution spectroscopic survey for Li-rich K giants among 2000 low-mass (M {<=} 3 M{sub sun}) giants spanning the luminosity range from below to above the luminosity of the clump. Fifteen new Li-rich giants including four super Li-rich K giants (log {epsilon}(Li) {>=}3.2) were discovered. A significant finding is that there is a concentration of Li-rich K giants at the luminosity of the clump or red horizontal branch. This new finding is partly a consequence of the fact that our low-resolution survey is the first large survey to include giants well below and above the red giant branch (RGB) bump and clump locations in the H-R diagram. Origin of the lithium enrichment may be plausibly attributed to the conversion of {sup 3}He via {sup 7}Be to {sup 7}Li by the Cameron-Fowler mechanism but the location for the onset of the conversion is uncertain. Two possible opportunities to effect this conversion are discussed: the bump in the first ascent of the RGB and the He-core flash at the tip of the RGB. The finite luminosity spread of the Li-rich giants serves to reject the idea that Li enhancement is, in general, a consequence of a giant swallowing a large planet.

  15. Coronary x-ray angiographic reconstruction and image orientation

    SciTech Connect

    Sprague, Kevin; Drangova, Maria; Lehmann, Glen

    2006-03-15

    We have developed an interactive geometric method for 3D reconstruction of the coronary arteries using multiple single-plane angiographic views with arbitrary orientations. Epipolar planes and epipolar lines are employed to trace corresponding vessel segments on these views. These points are utilized to reconstruct 3D vessel centerlines. The accuracy of the reconstruction is assessed using: (1) near-intersection distances of the rays that connect x-ray sources with projected points, (2) distances between traced and projected centerlines. These same two measures enter into a fitness function for a genetic search algorithm (GA) employed to orient the angiographic image planes automatically in 3D avoiding local minima in the search for optimized parameters. Furthermore, the GA utilizes traced vessel shapes (as opposed to isolated anchor points) to assist the optimization process. Differences between two-view and multiview reconstructions are evaluated. Vessel radii are measured and used to render the coronary tree in 3D as a surface. Reconstruction fidelity is demonstrated via (1) virtual phantom, (2) real phantom, and (3) patient data sets, the latter two of which utilize the GA. These simulated and measured angiograms illustrate that the vessel centerlines are reconstructed in 3D with accuracy below 1 mm. The reconstruction method is thus accurate compared to typical vessel dimensions of 1-3 mm. The methods presented should enable a combined interpretation of the severity of coronary artery stenoses and the hemodynamic impact on myocardial perfusion in patients with coronary artery disease.

  16. Noninvasive coronary artery angiography using electron beam computed tomography

    NASA Astrophysics Data System (ADS)

    Rumberger, John A.; Rensing, Benno J.; Reed, Judd E.; Ritman, Erik L.; Sheedy, Patrick F., II

    1996-04-01

    Electron beam computed tomography (EBCT), also known as ultrafast-CT or cine-CT, uses a unique scanning architecture which allows for multiple high spatial resolution electrocardiographic triggered images of the beating heart. A recent study has demonstrated the feasibility of qualitative comparisons between EBCT derived 3D coronary angiograms and invasive angiography. Stenoses of the proximal portions of the left anterior descending and right coronary arteries were readily identified, but description of atherosclerotic narrowing in the left circumflex artery (and distal epicardial disease) was not possible with any degree of confidence. Although these preliminary studies support the notion that this approach has potential, the images overall were suboptimal for clinical application as an adjunct to invasive angiography. Furthermore, these studies did not examine different methods of EBCT scan acquisition, tomographic slice thicknesses, extent of scan overlap, or other segmentation, thresholding, and interpolation algorithms. Our laboratory has initiated investigation of these aspects and limitations of EBCT coronary angiography. Specific areas of research include defining effects of cardiac orientation; defining the effects of tomographic slice thickness and intensity (gradient) versus positional (shaped based) interpolation; and defining applicability of imaging each of the major epicardial coronary arteries for quantitative definition of vessel size, cross-sectional area, taper, and discrete vessel narrowing.

  17. Immunohistochemical characterization of subependymal giant cell astrocytomas.

    PubMed

    Lopes, M B; Altermatt, H J; Scheithauer, B W; Shepherd, C W; VandenBerg, S R

    1996-01-01

    Subependymal giant cell astrocytoma (SEGA) is the most common neoplastic process involving the brain in patients with tuberous sclerosis complex (TSC). Morphologically, these tumors exhibit a wide range of cytoarchitecture with spindle and epithelioid cells resembling astrocytes, and also large, occasionally giant cells, some of which have a distinctly ganglion-like appearance. Unresolved questions regarding SEGAs center on: (a) their cytogenesis, i.e., whether they are derived from single or multiple precursors; and (b) their differentiating capacity along glial or neuronal lines. We sought to determine whether SEGAs represent truly mixed tumors or whether they consist of a single population of cells with a capacity for divergent differentiation. Twenty SEGAs were assessed for immunophenotypic features of either neuronal or glial differentiation or both. Only tumors from patients with a clinically confirmed diagnosis of TSC were included. Immunoreactivity for glial fibrillary acidic protein (GFAP) and/or S-100 protein was considered indicative of a glial phenotype, whereas the presence of neuronal differentiation was assessed by staining for cytoskeletal proteins [neurofilament epitopes, class III Beta-tubulin, microtubule-associated protein 2 (MAP2), synaptophysin], neurosecretory substances [serotonin, cholecystokinin, Beta-endorphin, substance P, somatostatin, metenkephalin, neuropeptide Y, vasoactive intestinal polypeptide (VIP), and for the 28-kDa neuron-associated calcium binding protein calbindin. Of the tumors examined, 18 exhibited both glial and neuronal epitopes, the staining pattern being variable. In 19 tumors, the constituent spindle, polygonal and giant or ganglion-like cells showed variable immunoreactivity for GFAP and S-100 proteins both within the cell body and processes. Neuron-associated cytoskeletal proteins were present in 18 cases. Class III Beta-tubulin immunoreactivity was demonstrated in 17 tumors, both within the bodies of all three

  18. Computer storage and retrieval of coronary trees

    NASA Technical Reports Server (NTRS)

    Starmer, C. F.; Smith, W. M.

    1975-01-01

    Coronary cineangiography is a routine procedure for evaluation of the coronary circulation. From the biplane cineangiograms a visual representation of coronary perfusion was obtained. A collection of simple ideas and procedures to aid in the collection is described. The uses to which the tree data will be put include the evaluation of myocardial function and the formation of a library sufficiently large to enable some taxonomic classification of coronary artery patterns to be made.

  19. Coronary Ostial Stenosis after Aortic Valve Replacement

    PubMed Central

    Ziakas, Antonios G.; Economou, Fotios I.; Charokopos, Nicholas A.; Pitsis, Antonios A.; Parharidou, Despina G.; Papadopoulos, Thomas I.; Parharidis, Georgios E.

    2010-01-01

    Coronary ostial stenosis is a rare but potentially serious sequela after aortic valve replacement. It occurs in the left main or right coronary artery after 1% to 5% of aortic valve replacement procedures. The clinical symptoms are usually severe and may appear from 1 to 6 months postoperatively. Although the typical treatment is coronary artery bypass grafting, patients have been successfully treated by means of percutaneous coronary intervention. Herein, we present the cases of 2 patients in whom coronary ostial stenosis developed after aortic valve replacement. In the 1st case, a 72-year-old man underwent aortic valve replacement and bypass grafting of the saphenous vein to the left anterior descending coronary artery. Six months later, he experienced a non-ST-segment-elevation myocardial infarction. Coronary angiography revealed a critical stenosis of the right coronary artery ostium. In the 2nd case, a 78-year-old woman underwent aortic valve replacement and grafting of the saphenous vein to an occluded right coronary artery. Four months later, she experienced unstable angina. Coronary angiography showed a critical left main coronary artery ostial stenosis and occlusion of the right coronary artery venous graft. In each patient, we performed percutaneous coronary intervention and deployed a drug-eluting stent. Both patients were asymptomatic on 6-to 12-month follow-up. We attribute the coronary ostial stenosis to the selective ostial administration of cardioplegic solution during surgery. We conclude that retrograde administration of cardioplegic solution through the coronary sinus may reduce the incidence of postoperative coronary ostial stenosis, and that stenting may be an efficient treatment option. PMID:20844624

  20. [Single coronary artery and right aortic arch].

    PubMed

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-01-01

    Coronary anomalies are mostly asymptomatic and diagnosed incidentally during coronary angiography or echocardiography. However, they must be taken into account in the differential diagnosis of angina, dyspnea, syncope, acute myocardial infarction or sudden death in young patients. The case is presented of two rare anomalies, single coronary artery originating from right sinus of Valsalva and right aortic arch, in a 65 year-old patient with atherosclerotic coronary artery disease treated percutaneously.

  1. Cell proliferation in human coronary arteries.

    PubMed Central

    Gordon, D; Reidy, M A; Benditt, E P; Schwartz, S M

    1990-01-01

    Despite the lack of direct evidence for cell multiplication, proliferation of smooth muscle cells in human atherosclerotic lesions has been assumed to play a central role in ontogeny of the plaque. We used antibodies to cell cycle-related proteins on tissue sections of human arteries and coronary atherosclerotic plaques. Specific cell types were identified by immunochemical reagents for smooth muscle, monocyte-macrophages, and other blood cells. Low rates of smooth muscle cell proliferation were observed. Macrophages were also observed with rates of proliferation comparable to that of the smooth muscle. Additional replicating cells could not be defined as belonging to specific cell types with the reagents used in this study. These findings imply that smooth muscle replication in advanced plaques is indolent and raise the possibility of a role for proliferating leukocytes. Images PMID:1972277

  2. Epidemiology of coronary heart disease and acute coronary syndrome

    PubMed Central

    Perez-Quilis, Carme; Leischik, Roman; Lucia, Alejandro

    2016-01-01

    The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). Although CHD mortality has gradually declined over the last decades in western countries, this condition still causes about one-third of all deaths in people older than 35 years. This evidence, along with the fact that mortality from CHD is expected to continue increasing in developing countries, illustrates the need for implementing effective primary prevention approaches worldwide and identifying risk groups and areas for possible improvement. PMID:27500157

  3. PULSATION FREQUENCIES AND MODES OF GIANT EXOPLANETS

    SciTech Connect

    Le Bihan, Bastien; Burrows, Adam E-mail: burrows@astro.princeton.edu

    2013-02-10

    We calculate the eigenfrequencies and eigenfunctions of the acoustic oscillations of giant exoplanets and explore the dependence of the characteristic frequency {nu}{sub 0} and the eigenfrequencies on several parameters: the planet mass, the planet radius, the core mass, and the heavy element mass fraction in the envelope. We provide the eigenvalues for degree l up to 8 and radial order n up to 12. For the selected values of l and n, we find that the pulsation eigenfrequencies depend strongly on the planet mass and radius, especially at high frequency. We quantify this dependence through the calculation of the characteristic frequency {nu}{sub 0} which gives us an estimate of the scale of the eigenvalue spectrum at high frequency. For the mass range 0.5 M{sub J} {<=} M{sub P} {<=} 15 M{sub J} , and fixing the planet radius to the Jovian value, we find that {nu}{sub 0} {approx} 164.0 Multiplication-Sign (M{sub P} /M{sub J} ){sup 0.48}{mu}Hz, where M{sub P} is the planet mass and M{sub J} is Jupiter's mass. For the radius range from 0.9 to 2.0 R{sub J} , and fixing the planet's mass to the Jovian value, we find that {nu}{sub 0} {approx} 164.0 Multiplication-Sign (R{sub P} /R{sub J} ){sup -2.09}{mu}Hz, where R{sub P} is the planet radius and R{sub J} is Jupiter's radius. We explore the influence of the presence of a dense core on the pulsation frequencies and on the characteristic frequency of giant exoplanets. We find that the presence of heavy elements in the envelope affects the eigenvalue distribution in ways similar to the presence of a dense core. Additionally, we apply our formalism to Jupiter and Saturn and find results consistent with both the observational data of Gaulme et al. and previous theoretical work.

  4. Rescue coronary stenting in acute myocardial infarction

    NASA Astrophysics Data System (ADS)

    Barbieri, Enrico; Meneghetti, Paolo; Molinari, Gionata; Zardini, Piero

    1996-01-01

    Failed rescue coronary angioplasty is a high risk situation because of high mortality. Coronary stent has given us the chance of improving and maintaining the patency of the artery. We report our preliminary experience of rescue stenting after unsuccessful coronary angioplasty.

  5. The ASSURE ROT Registry: Bioresorbable Vascular Scaffold Following Rotablation for Complex Coronary Lesions

    ClinicalTrials.gov

    2015-02-05

    Cardiovascular Diseases; Coronary Artery Disease; Myocardial Ischemia; Coronary Disease; Coronary Restenosis; Heart Diseases; Coronary Stenosis; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

  6. Non-invasive Detection of Aortic and Coronary Atherosclerosis in Homozygous Familial Hypercholesterolemia by 64 Slice Multi-detector Row Computed Tomography Angiography

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Homozygous familial hypercholesterolemia (HoFH) is a rare disorder characterized by the early onset of atherosclerosis, often at the ostia of coronary arteries. In this study we document for the first time that aortic and coronary atherosclerosis can be detected using 64 slice multiple detector-row ...

  7. Non-invasive detection of aortic and coronary atherosclerosis in homozygous familial hypercholesterolemia by 64 slice multi-detector row computed tomography angiography

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Homozygous familial hypercholesterolemia (HoFH) is a rare disorder characterized by the early onset of atherosclerosis, often at the ostia of coronary arteries. In this study we document for the first time that aortic and coronary atherosclerosis can be detected using 64 slice multiple detector row ...

  8. FLUORINE ABUNDANCES OF GALACTIC LOW-METALLICITY GIANTS

    SciTech Connect

    Li, H. N.; Zhao, G.; Ludwig, H.-G.; Caffau, E.; Christlieb, N. E-mail: gzhao@nao.cas.cn E-mail: ecaffau@lsw.uni-heidelberg.de

    2013-03-01

    With abundances and 2{sigma} upper limits of fluorine (F) in seven metal-poor field giants, nucleosynthesis of stellar F at low metallicity is discussed. The measurements are derived from the HF(1-0) R9 line at 23358 A using near-infrared K-band high-resolution spectra obtained with CRIRES at the Very Large Telescope. The sample reaches lower metallicities than previous studies on F of field giants, ranging from [Fe/H] = -1.56 down to -2.13. Effects of three-dimensional model atmospheres on the derived F and O abundances are quantitatively estimated and shown to be insignificant for the program stars. The observed F yield in the form of [F/O] is compared with two sets of Galactic chemical evolution models, which quantitatively demonstrate the contribution of Type II supernova (SN II) {nu}-process and asymptotic giant branch/Wolf-Rayet stars. It is found that at this low-metallicity region, models cannot well predict the observed distribution of [F/O], while the observations are better fit by models considering an SN II {nu}-process with a neutrino energy of E {sub {nu}} = 3 Multiplication-Sign 10{sup 53} erg. Our sample contains HD 110281, a retrograde orbiting low-{alpha} halo star, showing a similar F evolution as globular clusters. This supports the theory that such halo stars are possibly accreted from dwarf galaxy progenitors of globular clusters in the halo.

  9. Warm Disks from Giant Impacts

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2015-10-01

    In the process of searching for exoplanetary systems, weve discovered tens of debris disks close around distant stars that are especially bright in infrared wavelengths. New research suggests that we might be looking at the late stages of terrestrial planet formation in these systems.Forming Terrestrial PlanetsAccording to the widely-accepted formation model for our solar-system, protoplanets the size of Mars formed within a protoplanetary disk around our Sun. Eventually, the depletion of the gas in the disk led the orbits of these protoplanets to become chaotically unstable. Finally, in the giant impact stage, many of the protoplanets collided with each other ultimately leading to the formation of the terrestrial planets and their moons as we know them today.If giant impact stages occur in exoplanetary systems, too leading to the formation of terrestrial exoplanets how would we detect this process? According to a study led by Hidenori Genda of the Tokyo Institute of Technology, we might be already be witnessing this stage in observations of warm debris disks around other stars. To test this, Genda and collaborators model giant impact stages and determine what we would expect to see from a system undergoing this violent evolution.Modeling CollisionsSnapshots of a giant impact in one of the authors simulations. The collision causes roughly 0.05 Earth masses of protoplanetary material to be ejected from the system. Click for a closer look! [Genda et al. 2015]The collaborators run a series of simulations evolving protoplanetary bodies in a solar system. The simulations begin 10 Myr into the lifetime of the solar system, i.e., after the gas from the protoplanetary disk has had time to be cleared and the protoplanetary orbits begin to destabilize. The simulations end when the protoplanets are done smashing into each other and have again settled into stable orbits, typically after ~100 Myr.The authors find that, over an average giant impact stage, the total amount of

  10. Abnormalities of capillary microarchitecture in a rat model of coronary ischemic congestive heart failure.

    PubMed

    Chen, Jiqiu; Yaniz-Galende, Elisa; Kagan, Heather J; Liang, Lifan; Hekmaty, Saboor; Giannarelli, Chiara; Hajjar, Roger

    2015-04-15

    The aim of the present study is to explore the role of capillary disorder in coronary ischemic congestive heart failure (CHF). CHF was induced in rats by aortic banding plus ischemia-reperfusion followed by aortic debanding. Coronary arteries were perfused with plastic polymer containing fluorescent dye. Multiple fluorescent images of casted heart sections and scanning electric microscope of coronary vessels were obtained to characterize changes in the heart. Cardiac function was assessed by echocardiography and in vivo hemodynamics. Stenosis was found in all levels of the coronary arteries in CHF. Coronary vasculature volume and capillary density in remote myocardium were significantly increased in CHF compared with control. This occurred largely in microvessels with a diameter of ≤3 μm. Capillaries in CHF had a tortuous structure, while normal capillaries were linear. Capillaries in CHF had inconsistent diameters, with assortments of narrowed and bulged segments. Their surfaces appeared rough, potentially indicating endothelial dysfunction in CHF. Segments of main capillaries between bifurcations were significantly shorter in length in CHF than in control. Transiently increasing preload by injecting 50 μl of 30% NaCl demonstrated that the CHF heart had lower functional reserve; this may be associated with congestion in coronary microcirculation. Ischemic coronary vascular disorder is not limited to the main coronary arteries, as it occurs in arterioles and capillaries. Capillary disorder in CHF included stenosis, deformed structure, proliferation, and roughened surfaces. This disorder in the coronary artery architecture may contribute to the reduction in myocyte contractility in the setting of heart failure.

  11. Abnormalities of capillary microarchitecture in a rat model of coronary ischemic congestive heart failure

    PubMed Central

    Chen, Jiqiu; Yaniz-Galende, Elisa; Kagan, Heather J.; Liang, Lifan; Hekmaty, Saboor; Giannarelli, Chiara

    2015-01-01

    The aim of the present study is to explore the role of capillary disorder in coronary ischemic congestive heart failure (CHF). CHF was induced in rats by aortic banding plus ischemia-reperfusion followed by aortic debanding. Coronary arteries were perfused with plastic polymer containing fluorescent dye. Multiple fluorescent images of casted heart sections and scanning electric microscope of coronary vessels were obtained to characterize changes in the heart. Cardiac function was assessed by echocardiography and in vivo hemodynamics. Stenosis was found in all levels of the coronary arteries in CHF. Coronary vasculature volume and capillary density in remote myocardium were significantly increased in CHF compared with control. This occurred largely in microvessels with a diameter of ≤3 μm. Capillaries in CHF had a tortuous structure, while normal capillaries were linear. Capillaries in CHF had inconsistent diameters, with assortments of narrowed and bulged segments. Their surfaces appeared rough, potentially indicating endothelial dysfunction in CHF. Segments of main capillaries between bifurcations were significantly shorter in length in CHF than in control. Transiently increasing preload by injecting 50 μl of 30% NaCl demonstrated that the CHF heart had lower functional reserve; this may be associated with congestion in coronary microcirculation. Ischemic coronary vascular disorder is not limited to the main coronary arteries, as it occurs in arterioles and capillaries. Capillary disorder in CHF included stenosis, deformed structure, proliferation, and roughened surfaces. This disorder in the coronary artery architecture may contribute to the reduction in myocyte contractility in the setting of heart failure. PMID:25659485

  12. Ultrastructural and Functional Properties of a Giant Synapse Driving the Piriform Cortex to Mediodorsal Thalamus Projection.

    PubMed

    Pelzer, Patric; Horstmann, Heinz; Kuner, Thomas

    2017-01-01

    Neocortico-thalamo-cortical loops represent a common, yet poorly understood, circuit employing giant synapses also referred to as "class I", giant, or driver synapses. Here, we characterize a giant synapse formed by projection neurons of the paleocortical piriform cortex (PIR) onto neurons of the mediodorsal thalamus (MD). Three-dimensional (3D) ultrastructure of labeled PIR-MD terminals, obtained by using serial-section scanning electron microscopy (EM) combined with photooxidation-based detection of labeled terminals, revealed a large terminal engulfing multiple postsynaptic dendritic excrescences. The terminal contained multiple synaptic contacts, a high density of synaptic vesicles and several central mitochondria. Using targeted stimulations of single identified PIR-MD terminals in combination with patch-clamp recordings from the connected MD neuron, we found large postsynaptic currents with fast kinetics and strong short-term depression, yet fast recovery upon repetitive stimulation. We conclude that the phylogenetically old paleocortex already developed giant synaptic connections exhibiting similar functional properties as connections formed by giant neocortico-thalamic projections.

  13. Ultrastructural and Functional Properties of a Giant Synapse Driving the Piriform Cortex to Mediodorsal Thalamus Projection

    PubMed Central

    Pelzer, Patric; Horstmann, Heinz; Kuner, Thomas

    2017-01-01

    Neocortico-thalamo-cortical loops represent a common, yet poorly understood, circuit employing giant synapses also referred to as “class I”, giant, or driver synapses. Here, we characterize a giant synapse formed by projection neurons of the paleocortical piriform cortex (PIR) onto neurons of the mediodorsal thalamus (MD). Three-dimensional (3D) ultrastructure of labeled PIR-MD terminals, obtained by using serial-section scanning electron microscopy (EM) combined with photooxidation-based detection of labeled terminals, revealed a large terminal engulfing multiple postsynaptic dendritic excrescences. The terminal contained multiple synaptic contacts, a high density of synaptic vesicles and several central mitochondria. Using targeted stimulations of single identified PIR-MD terminals in combination with patch-clamp recordings from the connected MD neuron, we found large postsynaptic currents with fast kinetics and strong short-term depression, yet fast recovery upon repetitive stimulation. We conclude that the phylogenetically old paleocortex already developed giant synaptic connections exhibiting similar functional properties as connections formed by giant neocortico-thalamic projections. PMID:28197093

  14. New Percutaneous Transluminal Coronary Angioscope

    NASA Astrophysics Data System (ADS)

    Arai, Tsunenori; Kikuchi, Makoto; Mizuno, Kyoichi; Arakawa, Ko; Shibuya, Toshio; Horiuchi, Kenji; Okamoto, Yasuyuki; Miyamoto, Akira; Isojima, Kazushige; Kurita, Akira

    1988-06-01

    A new thin coronary angioscope which has a inflatable balloon at its distal tip is described in this paper. This angioscope is formed into very thin flexible catheter, less than 4F(1.33mm) in sheath outer diameter at the catheter tip. The angioscope contains two penetrated lumina which utilize for either flushing blood or manipulating of a guiding wire. A selective intracoronary visualization in left anterior descending coronary artery (LAD) and circumuflex(CX) of dogs up to 15kg in their weight were carried out during up to 20s until occurring of ST segment change of the electro-cardiogram(ECG).

  15. Provocative Testing for Coronary Reactivity and Spasm

    PubMed Central

    Zaya, Melody; Mehta, Puja K.; Merz, C. Noel Bairey

    2014-01-01

    Coronary spasm is an important and often overlooked etiology of chest pain. While coronary spasm, or Prinzmetal’s angina, has been thought of as benign, contemporary studies have shown serious associated adverse outcomes including acute coronary syndrome, arrhythmia, and death. Definitive diagnosis of coronary spasm can at times be difficult given the transience of symptoms. Numerous agents have been historically described for provocative testing. We provide a review of literature for the role of provocation testing in the diagnosis of coronary spasm. PMID:24201078

  16. Giant melanocytic nevi with neurocutaneous melanosis masquerading as neurofibromas

    PubMed Central

    Gowda, Vykuntaraju K.; Basude, Anita; Srinivas, Sahana M.; Bhat, Maya

    2016-01-01

    Neurocutaneous melanosis is congenital melanocytic nevus with neurological manifestations. We report a 4-year-old female child presenting with hyperpigmented and nodular skin lesion associated with developmental delay and convulsions. The child had multiple brownish-black nevi on the face and chest and giant melanocytic nevi on thoraco-abdomen, back, and gluteal region. Computed tomography scan of the brain showed calcification in the pons, right cerebellar hemisphere, and left medial temporal lobe. Skin biopsy done from nodular hyperpigmented site was suggestive of melanocytic nevi. Electroencephalogram showed multifocal epileptiform discharges. PMID:27857802

  17. Sodium in weak G-band giants

    NASA Technical Reports Server (NTRS)

    Drake, Jeremy J.; Lambert, David L.

    1994-01-01

    Sodium abundances have been determined for eight weak G-band giants whose atmospheres are greatly enriched with products of the CN-cycling H-burning reactions. Systematic errors are minimized by comparing the weak G-band giants to a sample of similar but normal giants. If, further, Ca is selected as a reference element, model atmosphere-related errors should largely be removed. For the weak-G-band stars (Na/Ca) = 0.16 +/- 0.01, which is just possibly greater than the result (Na/Ca) = 0.10 /- 0.03 from the normal giants. This result demonstrates that the atmospheres of the weak G-band giants are not seriously contaminated with products of ON cycling.

  18. Acquired and congenital coronary artery abnormalities.

    PubMed

    Young, Ming-Lon; McLeary, Michael; Chan, Kak-Chen

    2017-01-01

    Sudden unexpected cardiac deaths in approximately 20% of young athletes are due to acquired or congenital coronary artery abnormalities. Kawasaki disease is the leading cause for acquired coronary artery abnormalities, which can cause late coronary artery sequelae including aneurysms, stenosis, and thrombosis, leading to myocardial ischaemia and ventricular fibrillation. Patients with anomalous left coronary artery from the pulmonary artery can develop adequate collateral circulation from the right coronary artery in the newborn period, which remains asymptomatic only to manifest in adulthood with myocardial ischaemia, ventricular arrhythmias, and sudden death. Anomalous origin of coronary artery from the opposite sinus occurs in 0.7% of the young general population aged between 11 and 15 years. If the anomalous coronary artery courses between the pulmonary artery and the aorta, sudden cardiac death may occur during or shortly after vigorous exercise, especially in patients where the anomalous left coronary artery originates from the right sinus of Valsalva. Symptomatic patients with evidence of ischaemia should have surgical correction. No treatment is needed for asymptomatic patients with an anomalous right coronary artery from the left sinus of Valsalva. At present, there is no consensus regarding how to manage asymptomatic patients with anomalous left coronary artery from the right sinus of Valsalva and interarterial course. Myocardial bridging is commonly observed in cardiac catheterisation and it rarely causes exercise-induced coronary syndrome or cardiac death. In symptomatic patients, refractory or β-blocker treatment and surgical un-bridging may be considered.

  19. Periodontal and coronary heart disease in patients undergoing coronary angiography.

    PubMed

    Berent, Robert; Auer, Johann; Schmid, Peter; Krennmair, Gerald; Crouse, Stephen F; Green, John S; Sinzinger, Helmut; von Duvillard, Serge P

    2011-01-01

    Periodontal inflammation has been implicated in atherosclerosis and coronary heart disease (CHD). Coronary angiography (CA) is used in the assessment of CHD; only a few studies have evaluated periodontal disease (PD) and angiographic measures of coronary atherosclerosis. The aim of this study was to investigate the association between CHD and PD. In this prospective epidemiologic study, 466 patients underwent CA and were assessed for PD. All patients underwent physical, laboratory, cardiac, and dental examination including dental x-rays. Periodontal disease and coronary angiograms were evaluated blindly by a dentist and 2 cardiologists, respectively. A coronary stenosis greater than 50% was ruled as CHD. Periodontal disease was defined and measured with the Community Periodontal Index of Treatment Needs (CPITN); and if at least 2 sextants (segments dividing mandible and maxilla into 6) were recorded as having CPITN of at least 3 (signifying that sextant had periodontal pocket depth ≥ 3.5 mm), the patient was coded as having PD. Three-hundred forty-nine patients (74.9%) had CHD assessed by CA The CHD patients had PD in 55.6% vs 41.9% in the non-CHD patients (P < .01). The CPITN scores were significantly higher in patients with vs without CHD, 2.43 vs 2.16, respectively (P = .023). After adjusting for age, sex, and risk factors for atherosclerosis with additional inclusion of C-reactive protein and erythrocyte sedimentation rate, PD remained significantly related to CHD (odds ratio = 1.9; 95% confidence interval, 1.2-3.1). Other predictors for CHD were male sex, age, high-density lipoprotein cholesterol, and diabetes. Our results demonstrate an increased odds ratio for angiographically determined CHD in patients with PD and that CHD and PD may cluster in particular groups of a population. Our data indicate that PD represents a potentially modifiable risk factor that is both preventable and treatable with predictable treatments that pose negligible risk.

  20. Giant Planets in Open Clusters

    NASA Astrophysics Data System (ADS)

    Quinn, S. N.; White, R. J.; Latham, D. W.

    2015-10-01

    Two decades after the discovery of 51 Peg b, more than 200 hot Jupiters have now been confirmed, but the details of their inward migration remain uncertain. While it is widely accepted that short period giant planets could not have formed in situ, several different mechanisms (e.g., Type II migration, planet-planet scattering, Kozai-Lidov cycles) may contribute to shrinking planetary orbits, and the relative importance of each is not well-constrained. Migration through the gas disk is expected to preserve circular, coplanar orbits and must occur quickly (within ˜ 10 Myr), whereas multi-body processes should initially excite eccentricities and inclinations and may take hundreds of millions of years. Subsequent evolution of the system (e.g., orbital circularization and inclination damping via tidal interaction with the host star) may obscure these differences, so observing hot Jupiters soon after migration occurs can constrain the importance of each mechanism. Fortunately, the well-characterized stars in young and adolescent open clusters (with known ages and compositions) provide natural laboratories for such studies, and recent surveys have begun to take advantage of this opportunity. We present a review of the discoveries in this emerging realm of exoplanet science, discuss the constraints they provide for giant planet formation and migration, and reflect on the future direction of the field.

  1. Total revascularization for an epsilon right coronary artery and severe left main disease combined with profound cardiogenic shock

    PubMed Central

    Fang, Hsiu-Yu; Lee, Wei-Chieh; Wu, Chiung-Jen

    2016-01-01

    Abstract Rationale: Severe left main disease combined with right coronary artery occlusion was rarely encountered in our daily practice. Percutaneous coronary intervention in these patients was most challenging due to high probability of hemodynamic changes. Patient Concerns: Here, we report a 67-year-old man with Non–ST-Segment Elevation Myocardial Infarction (NSTEMI) and profound cardiogenic shock and we attempted coronary intervention with total revisualization for severe left main (LM) disease and angulated epsilon right coronary artery total occlusion. He was treated successfully under intra-aortic balloon pump (IABP) and extracorporeal membrane oxygenation (ECMO) support. Diagnoses: NSTEMI and profound cardiogenic shock. Interventions: Coronary intervention with total revisualization was performed for severe LM disease and angulated epsilon right coronary artery total occlusion under IABP and ECMO support. Outcomes: IABP and ECMO were removed until cardiac contractile function improved to left ventricular ejection fraction over 40 percentage 1 week later. The patient was discharged after 2 months and had survival for 5 years. Lessons: Coronary intervention could be performed safely in this cardiogenic shock patient with severe LM and triple vessel disease who was supported by IABP and ECMO. Stent deployment for extremely angulated coronary artery was required multiple combination techniques to facilitate the final success. PMID:27977615

  2. Emergency coronary stenting with the Palmaz-Schatz stent for failed transluminal coronary angioplasty: results of a learning phase.

    PubMed

    Kiemeneij, F; Laarman, G J; van der Wieken, R; Suwarganda, J

    1993-07-01

    This study describes initial results of Palmaz-Schatz stent implantation in our department to restore and maintain vessel patency in 52 patients with obstructive dissection, defined as an intraluminal filling defect with coronary flow impairment after percutaneous transluminal coronary angioplasty (PTCA). The majority of patients (62%) underwent PTCA for unstable angina (n = 28), defined as angina at rest with documented ST segment changes resistant to nitrates, or acute myocardial infarction (n = 4). In six patients (11%) the stent could not be delivered. Seven of the remaining 46 patients (15%) had coronary artery bypass surgery performed because of increased risk for subacute stent occlusion, residual thrombosis, residual obstruction near the stent, coronary artery diameter less than 3.0 mm, or multiple and overlapping stents. One patient (3%) died in hospital from intracranial bleeding. Nine patients (23%) had subacute stent occlusion, retrospectively unpredictable in four patients. Nine of 29 patients (29%) with an uncomplicated clinical course after stenting had angiographic restenosis at a mean follow-up of 6.0 +/- 1.4 months (range 12 days to 8.3 months). Two patients (7%) died 3 months after successful stenting: one patient because of stent thrombosis after stopping warfarin before an abdominal operation and one patient after acute vascular surgery for late traumatic groin bleeding. Of the 39 medically treated patients with a stent, three (8%) had major bleeding complications. It is concluded that stent implantation is feasible in most patients with obstructive dissection after PTCA. After successful stent delivery, coronary flow is temporarily restored.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Invasive coronary imaging: any role in primary and secondary prevention?

    PubMed

    Di Mario, Carlo; Moreno, Pedro R

    2016-06-21

    This review discusses the possibilities offered by new modalities of non-invasive and invasive coronary imaging in an effort to optimize risk stratification for coronary artery disease, and identify subgroups at high risk that may benefit from an aggressive, personalized approach, with access to a growing number of novel drugs and interventions. Special emphasis is placed on the progress of novel invasive imaging techniques such as near infrared spectroscopy and optical coherence tomography that can reliably identify thin-capped fibroatheromas. Multiple trials are exploring the feasibility of these techniques to guide modulation of risk factor control and treatment of non-flow limiting lesions at high risk of destabilization and progression in patients undergoing clinically mandated angioplasty of angiographically critical lesions. Asymptomatic patients at high risk of cardiovascular ischaemic events may also benefit, with the intermediate step of a wider application of calcium score and angiography with multi-slice computed tomography, by a selective use of invasive imaging.

  4. Giant mini-clusters as possible origin of halo phenomena observed in super-families

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Among 91 mini-clusters from 30 high energy Chiron-type families in Chacaltaya emulsion chambers, there were observed several extremely large multiplicity clusters in the highest energy range, far beyond the average of ordinary type clusters. Some details of microscopic observation of those giant mini-clusters in nuclear emulsion plates and some phenomenological regularity found in common among them are described. Such giant mini-clusters are possible candidates for the origin of narrow symmetric single halo phenomena in X-ray films which are frequently observed in super-families of visible energy greater than 1,000 TeV.

  5. Sex, season, and time of day interact to affect body temperatures of the Giant Gartersnake

    USGS Publications Warehouse

    Wylie, G.D.; Casazza, M.L.; Halstead, B.J.; Gregory, C.J.

    2009-01-01

    1.We examined multiple hypotheses regarding differences in body temperatures of the Giant Gartersnake using temperature-sensitive radio telemetry and an information-theoretic analytical approach.2.Giant Gartersnakes selected body temperatures near 30 ??C, and males and females had similar body temperatures most of the year, except during the midsummer gestation period.3.Seasonal differences in the body temperatures of males and females may relate to both the costs associated with thermoregulatory behavior, such as predation, and the benefits associated with maintaining optimal body temperatures, such as successful incubation.

  6. Recent advances in coronary angioscopy.

    PubMed

    Uchida, Yasumi

    2011-01-01

    Angioscopy enables macroscopic pathological diagnosis of cardiovascular diseases from the inside. This imaging modality has been intensively directed to characterizing vulnerable coronary plaques. Scoring of plaque color was developed, and based on prospective studies; dark yellow or glistening yellow plaques were proposed as vulnerable ones. Colorimetry apparatus was developed to assess the yellow color of the plaques quantitatively. The effects of lipid-lowering therapies on coronary plaques were confirmed by angioscopy. However, since observation is limited to surface color and morphology, pitfalls of this imaging technology became evident. Dye-staining angioscopy and near-infrared fluorescence angioscopy were developed for molecular imaging, and the latter method was successfully applied to patients. Color fluorescence angioscopy was also established for molecular and chemical basis characterization of vulnerable coronary plaques in both in vitro and in vivo. Drug-eluting stents (DES) reduce coronary restenosis significantly, however, late stent thrombosis (LST) occurs, which requires long-term antiplatelet therapy. Angioscopic grading of neointimal coverage of coronary stent struts was established, and it was revealed that neointimal formation is incomplete and prevalence of LST is higher in DES when compared to bare-metal stent. Many new stents were devised and they are now under experimental or clinical investigations to overcome the shortcomings of the stents that have been employed clinically. Endothelial cells are highly anti-thrombotic. Neoendothelial cell damage is considered to be caused by friction between the cells and stent struts due to the thin neointima between them that might act as a cushion. Therefore, development of a DES that causes an appropriate thickness (around 100 μm) of the neointima is a potential option with which to prevent neoendothelial cell damage and consequent LST while preventing restenosis.

  7. Separating gas-giant and ice-giant planets by halting pebble accretion

    NASA Astrophysics Data System (ADS)

    Lambrechts, M.; Johansen, A.; Morbidelli, A.

    2014-12-01

    In the solar system giant planets come in two flavours: gas giants (Jupiter and Saturn) with massive gas envelopes, and ice giants (Uranus and Neptune) with much thinner envelopes around their cores. It is poorly understood how these two classes of planets formed. High solid accretion rates, necessary to form the cores of giant planets within the life-time of protoplanetary discs, heat the envelope and prevent rapid gas contraction onto the core, unless accretion is halted. We find that, in fact, accretion of pebbles (~cm sized particles) is self-limiting: when a core becomes massive enough it carves a gap in the pebble disc. This halt in pebble accretion subsequently triggers the rapid collapse of the super-critical gas envelope. Unlike gas giants, ice giants do not reach this threshold mass and can only bind low-mass envelopes that are highly enriched by water vapour from sublimated icy pebbles. This offers an explanation for the compositional difference between gas giants and ice giants in the solar system. Furthermore, unlike planetesimal-driven accretion scenarios, our model allows core formation and envelope attraction within disc life-times, provided that solids in protoplanetary discs are predominantly made up of pebbles. Our results imply that the outer regions of planetary systems, where the mass required to halt pebble accretion is large, are dominated by ice giants and that gas-giant exoplanets in wide orbits are enriched by more than 50 Earth masses of solids.

  8. Successful management of grade III coronary perforation after percutaneous angioplasty in a high-risk patient: a case report.

    PubMed

    Coloma Araniya, Ricardo; Beas, Renato; Maticorena-Quevedo, Jesús; Anduaga-Beramendi, Alexander; Pastrana Castillo, Marco Antonio

    2016-03-03

    Coronary perforation is a rare complication in patients undergoing percutaneous coronary angioplasty. The mortality of this complication varies depending on factors related to the patient and the procedure performed, reaching 44% in patients with Ellis type III perforation. We report the case of an 81 year old male with multiple cardiovascular risk factors, who underwent percutaneous angioplasty for unstable angina management. The patient developed grade III coronary perforation in the anterior descending artery, which was successfully managed with balloon inflation to 6 atmospheres for 10 minutes twice in the affected area, with an interval of 5 minutes between each dilatation. The patient improved and was discharged.

  9. A different kind of Christmas tree: anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA).

    PubMed

    Afolabi-Brown, Olayinka; Witzke, Christian; Moldovan, Raul; Pressman, Gregg

    2014-02-01

    Anomalous right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly that has an incidence of 0.002%. We report a case of a previously healthy female who presented to our hospital with pneumonia and was incidentally discovered to have ARCAPA. This was initially diagnosed on echocardiography by the unusual echocardiographic finding of multiple color flow Doppler signals around the right ventricular free wall and apex which were subsequently confirmed by angiography to be due to extensive collateral circulation between the left and right coronary arteries. This represents an unusual echocardiographic manifestation of this very rare condition.

  10. TOWARD A DETERMINISTIC MODEL OF PLANETARY FORMATION. VII. ECCENTRICITY DISTRIBUTION OF GAS GIANTS

    SciTech Connect

    Ida, S.; Lin, D. N. C.

    2013-09-20

    The ubiquity of planets and diversity of planetary systems reveal that planet formation encompasses many complex and competing processes. In this series of papers, we develop and upgrade a population synthesis model as a tool to identify the dominant physical effects and to calibrate the range of physical conditions. Recent planet searches have led to the discovery of many multiple-planet systems. Any theoretical models of their origins must take into account dynamical interactions between emerging protoplanets. Here, we introduce a prescription to approximate the close encounters between multiple planets. We apply this method to simulate the growth, migration, and dynamical interaction of planetary systems. Our models show that in relatively massive disks, several gas giants and rocky/icy planets emerge, migrate, and undergo dynamical instability. Secular perturbation between planets leads to orbital crossings, eccentricity excitation, and planetary ejection. In disks with modest masses, two or less gas giants form with multiple super-Earths. Orbital stability in these systems is generally maintained and they retain the kinematic structure after gas in their natal disks is depleted. These results reproduce the observed planetary mass-eccentricity and semimajor axis-eccentricity correlations. They also suggest that emerging gas giants can scatter residual cores to the outer disk regions. Subsequent in situ gas accretion onto these cores can lead to the formation of distant (∼> 30 AU) gas giants with nearly circular orbits.

  11. HIDE AND SEEK BETWEEN ANDROMEDA'S HALO, DISK, AND GIANT STREAM

    SciTech Connect

    Clementini, Gisella; Contreras Ramos, Rodrigo; Federici, Luciana; Macario, Giulia; Tosi, Monica; Bellazzini, Michele; Fusi Pecci, Flavio; Diolaiti, Emiliano; Cacciari, Carla; Beccari, Giacomo; Testa, Vincenzo; Giallongo, Emanuele; Di Paola, Andrea; Gallozzi, Stefano; Cignoni, Michele; Marano, Bruno; Marconi, Marcella; Ripepi, Vincenzo; Ragazzoni, Roberto; Smareglia, Riccardo

    2011-12-10

    Photometry in B, V (down to V {approx} 26 mag) is presented for two 23' Multiplication-Sign 23' fields of the Andromeda galaxy (M31) that were observed with the blue channel camera of the Large Binocular Telescope during the Science Demonstration Time. Each field covers an area of about 5.1 Multiplication-Sign 5.1 kpc{sup 2} at the distance of M31 ({mu}{sub M31} {approx} 24.4 mag), sampling, respectively, a northeast region close to the M31 giant stream (field S2) and an eastern portion of the halo in the direction of the galaxy minor axis (field H1). The stream field spans a region that includes Andromeda's disk and giant stream, and this is reflected in the complexity of the color-magnitude diagram of the field. One corner of the halo field also includes a portion of the giant stream. Even though these demonstration time data were obtained under non-optimal observing conditions, the B photometry, which was acquired in time-series mode, allowed us to identify 274 variable stars (among which 96 are bona fide and 31 are candidate RR Lyrae stars, 71 are Cepheids, and 16 are binary systems) by applying the image subtraction technique to the selected portions of the observed fields. Differential flux light curves were obtained for the vast majority of these variables. Our sample mainly includes pulsating stars that populate the instability strip from the Classical Cepheids down to the RR Lyrae stars, thus tracing the different stellar generations in these regions of M31 down to the horizontal branch of the oldest (t {approx} 10 Gyr) component.

  12. A Genome-wide Trans-ethnic Interaction Study Links the PIGR-FCAMR Locus to Coronary Atherosclerosis Via Interactions Between Genetic Variants and Residential Exposure to Traffic

    EPA Science Inventory

    Air pollution is a worldwide contributor to cardiovascular disease mortality and morbidity. Traffic air pollution is a ubiquitous source of air pollution in developed nations, and is associated with multiple cardiovascular outcomes such as: coronary atherosclerosis, peripheral ar...

  13. Revascularization therapy for coronary artery disease. Coronary artery bypass grafting versus percutaneous transluminal coronary angioplasty.

    PubMed Central

    Wilson, J M; Ferguson, J J

    1995-01-01

    Coronary artery bypass surgery relieves the symptoms of myocardial ischemia and prolongs survival of patients with more severe coronary artery disease. Randomized trials of surgical therapy have consistently shown that the benefits of surgical revascularization are proportional to the amount of myocardium affected by, or at risk for, ischemic injury. This risk is inferred from angiographically delineated coronary anatomy, estimates of left ventricular function, and physiologic testing. The population that may see a survival benefit from surgical revascularization has probably been expanded beyond that reported in the VA, CASS, and ECSS trials, due to improved perioperative care, longer graft survival, and the use of internal mammary artery grafts. Percutaneous transluminal coronary angioplasty revascularizes myocardium by dilating a stenotic segment of coronary artery. While successful in relieving the symptoms of myocardial ischemia, PTCA is hindered by the occurrence of abrupt vessel closure and the frequent development of restenosis. Furthermore, firm proof of a survival benefit, outside of emergency therapy for acute myocardial infarction, is not yet available. However, because the risk of procedure-related death or serious complication is lower than that seen with bypass surgery, PTCA provides a useful alternative revascularization method for patients with less extensive disease, in whom the risk of surgery may equal or exceed any beneficial effect. New technology and growing experience are widening the scope of percutaneous revascularization by extending the hope of symptomatic relief and survival benefit even to patients with extensive, severe coronary artery disease. Comparisons between surgical therapy and PTCA in select populations with single- and multivessel coronary artery disease have shown that PTCA is not as effective as surgery for long-term symptomatic control, and that it often requires repeat PTCA or cross-over to bypass surgery; however, long

  14. Randomized comparison of transradial coronary angiography via right or left radial artery approaches.

    PubMed

    Kanei, Yumiko; Nakra, Navin C; Liou, Michael; Vales, Lori L; Gowda, Ramesh; Rosero, Hugo; Kwan, Tak; Fox, John T

    2011-01-15

    Previous studies have shown that the right radial approach encounters more tortuosity than the left radial approach during transradial coronary angiography. The objective of this study was to compare the procedural difficulty of the right and left radial approaches in the modern era with dedicated transradial catheters. One hundred ninety-three patients scheduled for transradial coronary angiography with normal Allen test results and without histories of coronary artery bypass grafting were randomized to the right or left radial approach. The choice of catheter was left to the discretion of the operator, with the preferred catheter being a dedicated transradial Optitorque catheter. The primary end point was procedural difficulty, defined as (1) hydrophilic or coronary wire use for tortuosity, (2) stiff wire use for the coronary engagement, (3) multiple catheters used, or (4) nonselective injection. The clinical characteristics were similar between the 2 groups. Procedural success was achieved in 98 of 101 (98%) in the right radial group and 91 of 92 (99%) in the left radial group. Procedural difficulty, fluoroscopy time, and contrast use were similar between the 2 groups. The use of a single catheter was more common in the right radial group (73% vs 18%, p <0.001). In conclusion, procedural success and difficulty were similar in the comparison groups. The right and left radial approaches are feasible and effective to perform coronary angiography and intervention.

  15. Standardized Evaluation Methodology and Reference Database for Evaluating Coronary Artery Centerline Extraction Algorithms

    PubMed Central

    Schaap, Michiel; Metz, Coert T.; van Walsum, Theo; van der Giessen, Alina G.; Weustink, Annick C.; Mollet, Nico R.; Bauer, Christian; Bogunović, Hrvoje; Castro, Carlos; Deng, Xiang; Dikici, Engin; O’Donnell, Thomas; Frenay, Michel; Friman, Ola; Hoyos, Marcela Hernández; Kitslaar, Pieter H.; Krissian, Karl; Kühnel, Caroline; Luengo-Oroz, Miguel A.; Orkisz, Maciej; Smedby, Örjan; Styner, Martin; Szymczak, Andrzej; Tek, Hüseyin; Wang, Chunliang; Warfield, Simon K.; Zambal, Sebastian; Zhang, Yong; Krestin, Gabriel P.; Niessen, Wiro J.

    2013-01-01

    Efficiently obtaining a reliable coronary artery centerline from computed tomography angiography data is relevant in clinical practice. Whereas numerous methods have been presented for this purpose, up to now no standardized evaluation methodology has been published to reliably evaluate and compare the performance of the existing or newly developed coronary artery centerline extraction algorithms. This paper describes a standardized evaluation methodology and reference database for the quantitative evaluation of coronary artery centerline extraction algorithms. The contribution of this work is fourfold: 1) a method is described to create a consensus centerline with multiple observers, 2) well-defined measures are presented for the evaluation of coronary artery centerline extraction algorithms, 3) a database containing thirty-two cardiac CTA datasets with corresponding reference standard is described and made available, and 4) thirteen coronary artery centerline extraction algorithms, implemented by different research groups, are quantitatively evaluated and compared. The presented evaluation framework is made available to the medical imaging community for benchmarking existing or newly developed coronary centerline extraction algorithms. PMID:19632885

  16. Recurrent chest pain after treatment of spontaneous coronary artery dissection: An enigma.

    PubMed

    Bhatt, Dheeraj D; Kachru, Ranjan; Gupta, Sanjay; Kaul, Upendra

    2015-12-01

    Spontaneous coronary artery dissection (SCAD) is a rare entity. It has been described in various settings like pregnancy, collagen vascular diseases, cocaine abuse, heavy exercise, variant angina, eosinophilic arteritis, or fibro muscular dysplasia. It is also easy to miss a dissection during angiography, as the typical radiolucent lumen seen in coronary angiography may be absent in many cases. In this report, we describe the case of a 35-year-old female who presented with acute ST elevation myocardial infarction due to spontaneous coronary dissection. She had been having episodic chest pain for one year and had been seen by two different cardiologists but was thought to have non-cardiac symptoms. Even during the index hospitalization, she underwent coronary angiography three times before coronary dissection could be identified as the cause of her symptoms. She underwent coronary artery bypass graft surgery uneventfully. However, even after myocardial revascularization, she has had multiple episodes of chest pain requiring hospitalization. However, we have not been able to find a specific cause for it and the cause of her recurrent chest pain remains an enigma. This case highlights the problems, which arise while managing a case of SCAD. More research is needed to find the exact etiology and long-term prognosis of this condition.

  17. Giant tunneling magnetoresistance in silicene

    SciTech Connect

    Wang, Yu; Lou, Yiyi

    2013-11-14

    We have theoretically studied ballistic electron transport in silicene under the manipulation of a pair of ferromagnetic gate. Transport properties like transmission and conductance have been calculated by the standard transfer matrix method for parallel and antiparallel magnetization configurations. It is demonstrated here that, due to the stray field-induced wave-vector filtering effect, remarkable difference in configuration-dependent transport gives rise to a giant tunneling magnetoresistance. In combination with the peculiar buckled structure of silicene and its electric tunable energy gap, the receiving magnetoresistance can be efficiently modulated by the externally-tunable stray field, electrostatic potential, and staggered sublattice potential, providing some flexible strategies to construct silicene-based nanoelectronic device.

  18. Toward Controlled Hierarchical Heterogeneities in Giant Molecules with Precisely Arranged Nano Building Blocks

    PubMed Central

    2016-01-01

    Herein we introduce a unique synthetic methodology to prepare a library of giant molecules with multiple, precisely arranged nano building blocks, and illustrate the influence of minute structural differences on their self-assembly behaviors. The T8 polyhedral oligomeric silsesquioxane (POSS) nanoparticles are orthogonally functionalized and sequentially attached onto the end of a hydrophobic polymer chain in either linear or branched configuration. The heterogeneity of primary chemical structure in terms of composition, surface functionality, sequence, and topology can be precisely controlled and is reflected in the self-assembled supramolecular structures of these giant molecules in the condensed state. This strategy offers promising opportunities to manipulate the hierarchical heterogeneities of giant molecules via precise and modular assemblies of various nano building blocks. PMID:27163025

  19. Giant Cell Lesions in Noonan Syndrome: Case Report and Review of The Literature

    PubMed Central

    Bufalino, Andreia; Carrera, Manoela; Carlos, Roman

    2010-01-01

    Noonan-like/multiple giant cell lesion syndrome (NS/MGCLS) is a rare condition with phenotypic overlap with Noonan syndrome (NS). Once thought to be a specific and separate entity, it is now suggested to be a variant of the NS spectrum. We report a patient with classical cardinal features of NS, including short stature, mild ptosis, hypertelorism, down-slating palpebral fissures, low-set and posteriorly angulated ears, short neck, pectus excavatum, widely spaced nipples and cryptochidism, which were associated with bilateral central giant cell lesions in the mandible and germ-line mutation (C218T, Thr73Ile) in the exon 3 of the PTPN11 gene. The similar clinical and genetic aspects support the observation that NS/MGCLS is a variant of NS and giant cell lesions are an integrant part of this disorder. PMID:20383758

  20. Giant juvenile fibroadenoma: a case and review of novel modalities in treatment.

    PubMed

    Sosin, Michael; Feldman, Elizabeth

    2012-01-01

    A giant juvenile fibroadenoma is defined as a fibroadenoma greater than 5 centimeters in size occurring in the pediatric population. It frequently affects adolescents. Rapid growth of the mass may result in breast asymmetry and deformity. Varying techniques in surgical extirpation have been described in order to optimize aesthetics and minimize distortion. The advent of new methods to remove benign breast disease is in its infancy stages. Many practitioners are unaware of the novel options that are emerging in the treatment of fibroadenoma. We describe an excision of a 12 centimeter giant juvenile fibroadenoma and adjacent juvenile fibroadenoma using a strategically atypical incision that resulted in excellent cosmesis and contour of the breast without subsequent reconstruction. Multiple modalities of removing a fibroadenoma are described with a review of the associated risks, benefits, and long term implications as well as a discussion on the indication for reconstructive surgery in patients with giant juvenile fibroadenoma.

  1. [Endovascular treatment of giant intracranial aneurysms].

    PubMed

    Bracard, S; Derelle, A L; Tonnelet, R; Barbier, C; Proust, F; Anxionnat, R

    2016-02-01

    Giant aneurysms are defined as having a maximal diameter higher than 25mm. The dynamic aspect of giant aneurysms, in particular, is its growth, which was responsible for parenchyma sequellae either due to haemorrhagic complications or a compression of cranial nerves. The treatment of these giant aneurysms was challenging because of its size, the mass effect and the neck diameter. These morphologic conditions required complex endovascular procedures such as remodelling, stenting, using flow diverters. Subsequently, the complex procedures increased the risk of morbidity because of ischemic complications. Despite these procedures, the risk of recurrence was high.

  2. SYNOVIAL GIANT CELL TUMOR OF THE KNEE.

    PubMed

    Abdalla, Rene Jorge; Cohen, Moisés; Nóbrega, Jezimar; Forgas, Andrea

    2009-01-01

    Synovial giant cell tumor is a benign neoplasm, rarely reported in the form of malignant metastasis. Synovial giant cell tumor most frequently occurs on the hand, and, most uncommon, on the ankle and knee. In the present study, the authors describe a rare case of synovial giant cell tumor on the knee as well as the treatment approach. Arthroscopy has been shown, in this case, to be the optimal method for treating this kind of lesion, once it allowed a less aggressive approach, while providing good visualization of all compartments of knee joint and full tumor resection.

  3. Idiopathic Giant Cell Myocarditis: A Case Report

    PubMed Central

    Kumari M.K., Kalpana; Mysorekar, Vijaya V.; S., Praveen

    2012-01-01

    Giant-cell myocarditis is a disease of relatively young, predominantly healthy adults. The patients usually die of heart failure and ventricular arrhythmia unless a cardiac transplantation is performed. We are reporting here an autopsy case of idiopathic giant cell myocarditis with no symptoms in a 27-year old -worker who died suddenly. The purpose of this report was to emphasize that idiopathic giant cell myocarditis was a rare disease and that it could exist in the absence of any symptomatic heart disease. PMID:23205365

  4. A giant pancreatic pseudocyst treated by cystogastrostomy

    PubMed Central

    Wang, Grace C; Misra, Subhasis

    2015-01-01

    We report a case of a giant pancreatic pseudocyst in a 65-year-old man presenting with abdominal pain, loss of appetite and abdominal distension. CT scans demonstrated a giant pancreatic pseudocyst measuring 25.7 cm×15.3 cm×10.9 cm anteroposteriorly, with significant compression of surrounding organs. An open cystogastrostomy was performed through a midline incision, and 3 L of fluid was drained from the giant pseudocyst. Recovery has been uneventful. PMID:25804943

  5. Rotation and macroturbulence in bright giants

    SciTech Connect

    Gray, D.F.; Toner, C.G.

    1986-11-01

    Spectral line profiles of 35 F, G, and K bright giants were analyzed to obtain rotation rates, v sin i, and macroturbulence dispersion. This sample indicates that rotation rates of cool class II giants is less than 11 km/s, in contrast with some recent periodicity measurements. Macroturbulence dispersion generally increases with effective temperature, but the range of values at a given effective temperature is much larger than seen for lower luminosity classes; this is interpreted in terms of red-giant and blue-loop evolution. No evidence is found for angular momentum dissipation on the first crossing of the H-R diagram. 57 references.

  6. SYNOVIAL GIANT CELL TUMOR OF THE KNEE

    PubMed Central

    Abdalla, Rene Jorge; Cohen, Moisés; Nóbrega, Jezimar; Forgas, Andrea

    2015-01-01

    Synovial giant cell tumor is a benign neoplasm, rarely reported in the form of malignant metastasis. Synovial giant cell tumor most frequently occurs on the hand, and, most uncommon, on the ankle and knee. In the present study, the authors describe a rare case of synovial giant cell tumor on the knee as well as the treatment approach. Arthroscopy has been shown, in this case, to be the optimal method for treating this kind of lesion, once it allowed a less aggressive approach, while providing good visualization of all compartments of knee joint and full tumor resection. PMID:27004193

  7. Direct Imaging of Giant Exoplanets

    NASA Astrophysics Data System (ADS)

    Tamura, Motohide

    Since the first detection of exoplanets around a Sun-like star 51 Peg in 1995, their detection and characterization are mainly led by indirect methods such as radial velocity and transit methods. However, recent progresses of observational techniques have finally enabled the direct imaging observations of giant planets of solar-system-scale orbit (with their semi-major axes less than about 50 AU) around A-type stars (e.g., Marois et al. 2008, 2010) and G-type stars (e.g., Kuzuhara et al. 2013). Direct imaging is useful to obtain the physical and atmospheric parameters of exoplanets. In fact not only colors but also a medium-resolution spectroscopy of such planets has been successfully obtained for their atmospheric characterization (Barman et al. 2013). Their masses are typically a few to ~10 Jupiter masses and they orbit at a Saturn- to-Pluto distance. Therefore, like hot-Jupiters and super-Earths they are unlike any solar-system planets, and called wide-orbit giant planets. A recent large search for planets and disk on the Subaru 8.2-m telescope (SEEDS project) has detected a 3-5 Jupiter-masses planet around a Sun-like star GJ 504 (Kuzuhara et al. 2013). It is the coolest planetary companion so far directly imaged and its near-infrared color is “bluer” than that of other directly imaged planets. In this contribution, I will review the recent progresses on direct imaging of exoplanets, highlight the results of the SEEDS project, and discuss the future developments.

  8. [Diffuse left ventricular hypokinesis mimicking dilated cardiomyopathy with multi-vessel coronary vasospasm].

    PubMed

    Shimizu, M; Kawata, M; Okada, T; Mizutani, T

    2000-06-01

    We investigated 7 patients with multi-vessel coronary vasospasm (> or = 75%) and diffuse left ventricular hypokinesis by coronary angiography and echocardiography. Four patients were male and 3 were female and mean +/- SD age was 63.0 +/- 11.2 years. Chief complaints were dyspnea in 3 patients, and chest pain, appetite loss, palpitation and general fatigue in one each. New York Heart Association functional classification was I in one patient, II in 5 and III in one. Mean heart rate was 73.9 +/- 11.6 beats/min. Initial echocardiography showed left ventricular end-diastolic diameter (LVDd) 54.4 +/- 5.5 mm, left ventricular end-systolic diameter (LVDs) 43.7 +/- 4.8 mm and percentage fractional shortening (%FS) 19.7 +/- 2.6%. The left ventricle was not remarkably enlarged despite poor contraction. Coronary vasospasm was induced after acetylcholine injection into the right coronary artery in 6 patients, left anterior descending artery in 7 and circumflex artery in 5. Four patients developed three-vessel coronary vasospasm. Three patients underwent endomyocardial biopsy which showed non-specific mild fibrosis. They were treated with nitrates and/or Ca-antagonists to prevent coronary vasospasm. Follow-up echocardiography was performed in 6 patients after 8.5 +/- 6.6 months. Echocardiography revealed marked improvement in left ventricular contraction (LVDd 49.7 +/- 4.6 mm, LVDs 35.8 +/- 4.4 mm, p < 0.05; %FS 27.9 +/- 4.5%, p < 0.05). These data suggested that left ventricular dilation was not prominent despite the poor contractility in patients with multi-vessel coronary vasospasm and diffuse left ventricular hypokinesis. The left ventricular dysfunction might be hibernating myocardium produced by multiple episodes of coronary vasospasm. Anti-vasospastic agents were effective in these patients.

  9. Collateral circulation from the conus coronary artery to the anterior descending coronary artery: assessment using multislice coronary computed tomography.

    PubMed

    de Agustín, José A; Marcos-Alberca, Pedro; Hernández-Antolín, Rosana; Vilacosta, Isidre; Pérez de Isla, Leopoldo; Rodríguez, Enrique; Macaya, Carlos; Zamorano, José

    2010-03-01

    The prognosis of patients with coronary artery disease largely depends on the presence of a collateral circulation. The location and extent of the collateral circulation is highly variable and these parameters determine whether or not ischemic symptoms occur and whether left ventricular contractility is abnormal. The collateral circulation is generally established through small-caliber distal vessels, although many different forms have been described. We report on three patients with severe left coronary artery disease and collateral circulation through a large conus coronary artery that joined a proximal or medial segment of the left anterior descending coronary artery. In all three cases, left ventricular function was preserved.

  10. GIANT PLANETS ORBITING METAL-RICH STARS SHOW SIGNATURES OF PLANET-PLANET INTERACTIONS

    SciTech Connect

    Dawson, Rebekah I.; Murray-Clay, Ruth A.

    2013-04-20

    Gas giants orbiting interior to the ice line are thought to have been displaced from their formation locations by processes that remain debated. Here we uncover several new metallicity trends, which together may indicate that two competing mechanisms deliver close-in giant planets: gentle disk migration, operating in environments with a range of metallicities, and violent planet-planet gravitational interactions, primarily triggered in metal-rich systems in which multiple giant planets can form. First, we show with 99.1% confidence that giant planets with semimajor axes between 0.1 and 1 AU orbiting metal-poor stars ([Fe/H] < 0) are confined to lower eccentricities than those orbiting metal-rich stars. Second, we show with 93.3% confidence that eccentric proto-hot Jupiters undergoing tidal circularization primarily orbit metal-rich stars. Finally, we show that only metal-rich stars host a pile-up of hot Jupiters, helping account for the lack of such a pile-up in the overall Kepler sample. Migration caused by stellar perturbers (e.g., stellar Kozai) is unlikely to account for the trends. These trends further motivate follow-up theoretical work addressing which hot Jupiter migration theories can also produce the observed population of eccentric giant planets between 0.1 and 1 AU.

  11. Severe asymptomatic coronary obstruction in chronic hemodialysed patient – a case report

    PubMed Central

    Voiculeț, C; Zara, O; Văcăroiu, I; Bogeanu, C; Tiron, T; Turcu, F; Aron, G; Ciocâlteu, A

    2016-01-01

    Introduction. Arterial stiffness and vascular calcifications are independent predictors of cardiovascular morbidity and mortality in the chronic kidney disease (CKD) stage 5D population. According to the guidelines, patients on renal replacement therapy represent a very high cardiovascular risk class. Case report. We report the case of a 67-year-old hypertensive male patient, known with CKD stage 5D on hemodialysis (three times per week), secondary bone mineral disease, admitted for progressive right leg pain. The physical examination detected right dorsalis pedis artery pulse absence. Blood biochemistry emphasized hypercalcemia, hyperphosphatemia, increased alkaline phosphatase, metabolic acidosis, hypoalbuminemia, iPTH values above upper limits. The X-ray of right shin highlighted a vascular calcification with a “train track” aspect on the tibial-peroneal artery trunk and the thoracic X-ray (performed with low ray regime) showed calcium deposits in coronary arteries walls. Legs arteriography and coronary angiography were performed revealing multiple lesions on investigated vessels with an 80% narrowing of right coronary artery. The particularity of the case lies in the absence of angina in a chronic hemodialysis patient in whom multiple significant angiographically stenosis of the coronary arteries were found and successful endovascular therapy was performed. Conclusion. The broadening of the indication for coronary angiography should be considered in certain asymptomatic CKD stage 5D patients based on a risk score involving calcium, phosphate, PTH and acid-base imbalances, while considering their major influence on the structure and tone of vascular walls thus on cardiovascular morbidity and mortality rates. Abbreviations. ABI = ankle-brachial index,CAD = coronary artery disease,CKD = chronic kidney disease,CT = computed tomography, EBCT = electron-beam computed tomography,ESRD = end-stage renal disease,GFR = glomerular filtration rate,iPTH = intact

  12. Severe asymptomatic coronary obstruction in chronic hemodialysed patient - a case report.

    PubMed

    C, Voiculeț; O, Zara; I, Văcăroiu; C, Bogeanu; T, Tiron; F, Turcu; G, Aron; A, Ciocâlteu

    2016-01-01

    Introduction. Arterial stiffness and vascular calcifications are independent predictors of cardiovascular morbidity and mortality in the chronic kidney disease (CKD) stage 5D population. According to the guidelines, patients on renal replacement therapy represent a very high cardiovascular risk class. Case report. We report the case of a 67-year-old hypertensive male patient, known with CKD stage 5D on hemodialysis (three times per week), secondary bone mineral disease, admitted for progressive right leg pain. The physical examination detected right dorsalis pedis artery pulse absence. Blood biochemistry emphasized hypercalcemia, hyperphosphatemia, increased alkaline phosphatase, metabolic acidosis, hypoalbuminemia, iPTH values above upper limits. The X-ray of right shin highlighted a vascular calcification with a "train track" aspect on the tibial-peroneal artery trunk and the thoracic X-ray (performed with low ray regime) showed calcium deposits in coronary arteries walls. Legs arteriography and coronary angiography were performed revealing multiple lesions on investigated vessels with an 80% narrowing of right coronary artery. The particularity of the case lies in the absence of angina in a chronic hemodialysis patient in whom multiple significant angiographically stenosis of the coronary arteries were found and successful endovascular therapy was performed. Conclusion. The broadening of the indication for coronary angiography should be considered in certain asymptomatic CKD stage 5D patients based on a risk score involving calcium, phosphate, PTH and acid-base imbalances, while considering their major influence on the structure and tone of vascular walls thus on cardiovascular morbidity and mortality rates. Abbreviations. ABI = ankle-brachial index,CAD = coronary artery disease,CKD = chronic kidney disease,CT = computed tomography, EBCT = electron-beam computed tomography,ESRD = end-stage renal disease,GFR = glomerular filtration rate,iPTH = intact parathormon

  13. What to Expect during Coronary Artery Bypass Grafting

    MedlinePlus

    ... NHLBI on Twitter. What To Expect During Coronary Artery Bypass Grafting Coronary artery bypass grafting (CABG) requires ... surgery to newer, less-invasive methods. Traditional Coronary Artery Bypass Grafting This type of surgery usually lasts ...

  14. Diagnosis and therapy of coronary artery disease: Second edition

    SciTech Connect

    Cohn, P.F.

    1985-01-01

    This book contains 18 selections. Some of the titles are: Nuclear cardiology; Diagnosis of acute myocardial infarction; Therapy of angina pectoris; Psychosocial aspects of coronary artery disease; Nonatherosclerotic coronary artery disease; and The epidemiology of coronary artery disease.

  15. Coronary Artery Bypass Surgery: MedlinePlus Health Topic

    MedlinePlus

    ... arteries from becoming clogged again. NIH: National Heart, Lung, and Blood Institute Start Here Coronary Artery Bypass (Texas Heart ... in Spanish Coronary Artery Bypass Grafting (National Heart, Lung, and Blood Institute) What Is Coronary Bypass Surgery? (American Heart ...

  16. Spontaneous Coronary Artery Dissection with Cardiac Tamponade.

    PubMed

    Goh, Anne C H; Lundstrom, Robert J

    2015-10-01

    Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome. Clinical presentation ranges from chest pain alone to ST-segment-elevation myocardial infarction, ventricular fibrillation, and sudden death. The treatment of patients with spontaneous coronary artery dissection is challenging because the disease pathophysiology is unclear, optimal treatment is unknown, and short- and long-term prognostic data are minimal. We report the case of a 70-year-old woman who presented with an acute ST-segment-elevation myocardial infarction secondary to a spontaneous dissection of the left anterior descending coronary artery. She was treated conservatively. Cardiac tamponade developed 16 hours after presentation. Repeat coronary angiography revealed extension of the dissection. Medical therapy was continued after the hemopericardium was aspirated. The patient remained asymptomatic 3 years after hospital discharge. To our knowledge, this is the first reported case of spontaneous coronary artery dissection in association with cardiac tamponade that was treated conservatively and had a successful outcome.

  17. Noninvasive diagnosis of vulnerable coronary plaque

    PubMed Central

    Pozo, Eduardo; Agudo-Quilez, Pilar; Rojas-González, Antonio; Alvarado, Teresa; Olivera, María José; Jiménez-Borreguero, Luis Jesús; Alfonso, Fernando

    2016-01-01

    Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease. For this reason, screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine. Necropsy studies have described histopathological changes associated with the development of acute coronary events. In this regard, thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature. Hence, many imaging techniques, such as coronary computed tomography, cardiac magnetic resonance or positron emission tomography, have tried to detect noninvasively these histomorphological characteristics with different approaches. In this article, we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings. PMID:27721935

  18. Spontaneous Coronary Artery Dissection during Cabergoline Therapy

    PubMed Central

    Mehta, Nishaki Kiran; Malkani, Samir; Ockene, Ira

    2012-01-01

    Although spontaneous coronary artery dissection is a rare cause of acute coronary syndrome, it should be considered during the evaluation of patients who have chest pain. Coronary vasospasm can lead to spontaneous dissection. The dopamine agonist cabergoline is known to cause digital vasospasm. Herein, we report a case of spontaneous right coronary artery dissection in a 43-year-old woman who was taking cabergoline as therapy for prolactinoma. To our knowledge, this is the first report of an apparent relationship between cabergoline therapy and spontaneous coronary artery dissection. The possible association of cabergoline with coronary artery spasm and dissection should be considered in patients who present with chest pain while taking this medication. PMID:22412238

  19. Coronary Artery Manifestations of Fibromuscular Dysplasia

    PubMed Central

    Michelis, Katherine C.; Olin, Jeffrey W.; Kadian-Dodov, Daniella; d’Escamard, Valentina; Kovacic, Jason C.

    2015-01-01

    Fibromuscular dysplasia (FMD) involving the coronary arteries is an uncommon but important condition that can present as acute coronary syndrome, left ventricular dysfunction, or potentially sudden cardiac death. Although the classic angiographic “string of beads” that may be observed in renal artery FMD does not occur in coronary arteries, potential manifestations include spontaneous coronary artery dissection, distal tapering or long, smooth narrowing that may represent dissection, intramural hematoma, spasm, or tortuosity. Importantly, FMD must be identified in at least one other noncoronary arterial territory to attribute any coronary findings to FMD. Although there is limited evidence to guide treatment, many lesions heal spontaneously; thus, a conservative approach is generally preferred. The etiology is poorly understood, but there are ongoing efforts to better characterize FMD and define its genetic and molecular basis. This report reviews the clinical course of FMD involving the coronary arteries and provides guidance for diagnosis and treatment strategies. PMID:25190240

  20. Coronary artery manifestations of fibromuscular dysplasia.

    PubMed

    Michelis, Katherine C; Olin, Jeffrey W; Kadian-Dodov, Daniella; d'Escamard, Valentina; Kovacic, Jason C

    2014-09-09

    Fibromuscular dysplasia (FMD) involving the coronary arteries is an uncommon but important condition that can present as acute coronary syndrome, left ventricular dysfunction, or potentially sudden cardiac death. Although the classic angiographic "string of beads" that may be observed in renal artery FMD does not occur in coronary arteries, potential manifestations include spontaneous coronary artery dissection, distal tapering or long, smooth narrowing that may represent dissection, intramural hematoma, spasm, or tortuosity. Importantly, FMD must be identified in at least one other noncoronary arterial territory to attribute any coronary findings to FMD. Although there is limited evidence to guide treatment, many lesions heal spontaneously; thus, a conservative approach is generally preferred. The etiology is poorly understood, but there are ongoing efforts to better characterize FMD and define its genetic and molecular basis. This report reviews the clinical course of FMD involving the coronary arteries and provides guidance for diagnosis and treatment strategies.

  1. Cangrelor in percutaneous coronary intervention.

    PubMed

    Oestreich, Julie H; Steinhubl, Steven R

    2009-03-01

    Cangrelor is a novel, intravenous P2Y12 receptor antagonist in development for use in percutaneous coronary intervention. Currently in Phase III testing, the reversible platelet inhibitor provides several inherent advantages over other P2Y12 receptor antagonists in this setting for the prevention of adverse cardiac events. Unlike the class of thienopyridines (ticlopidine, clopidogrel and potentially soon to be available, prasugrel), cangrelor has nearly immediate onset after a bolus dose and a short half-life, and achieves maximal inhibition of ADP-mediated platelet function. Cangrelor's distinct mechanism of action allows for intravenous administration and avoids both hepatic and renal metabolism. These unique characteristics make cangrelor a promising agent for use in cardiovascular patients undergoing percutaneous coronary intervention.

  2. MRI in coronary artery disease.

    PubMed

    Barkhausen, Jörg; Hunold, Peter; Waltering, Kai-Uwe

    2004-12-01

    Diagnosis of coronary artery disease (CAD) is a major challenge for medical imaging, because CAD is the leading cause of death in developed nations. Several non-invasive tests are used in clinical routine for the detection of CAD. However, due to limited sensitivity and specificity, the reliable diagnosis as well as the exclusion of CAD can only be established by catheter angiography. In patients with known CAD, therapeutic decisions require accurate information on myocardial function, ischemia and viability. Recently, magnetic resonance (MR) imaging has emerged as a non-invasive cardiac imaging technique that provides information on cardiac morphology, cardiac function, myocardial viability, and coronary morphology. This review discusses technical aspects and the clinical impact of different MR techniques.

  3. Behavior patterns and coronary heart disease

    NASA Technical Reports Server (NTRS)

    Townsend, J. C.; Cronin, J. P.

    1975-01-01

    The relationships between two behavioral patterns, cardiac risk factors, and coronary heart disease are investigated. Risk factors used in the analysis were family history of coronary disease, smoking, cholesterol, obesity, systotic blood pressure, diastolic blood pressure, blood sugar, uric acid, erythrocyte sedimentation rate, and white blood unit. It was found that conventional, non-behavioral pattern risk factors alone were not significantly related to coronary heart disease.

  4. Radiation dose measurements in coronary CT angiography

    PubMed Central

    Sabarudin, Akmal; Sun, Zhonghua

    2013-01-01

    Coronary computed tomography (CT) angiography is associated with high radiation dose and this has raised serious concerns in the literature. Awareness of various parameters for dose estimates and measurements of coronary CT angiography plays an important role in increasing our understanding of the radiation exposure to patients, thus, contributing to the implementation of dose-saving strategies. This article provides an overview of the radiation dose quantity and its measurement during coronary CT angiography procedures. PMID:24392190

  5. Transthoracic coronary Doppler vibrometry in the evaluation of normal volunteers and patients with coronary artery stenosis.

    PubMed

    Comess, Keith A; Choi, Joon Hwan; Xie, Zhiyong; Achenbach, Stephan; Daniel, Werner; Beach, Kirk W; Kim, Yongmin

    2011-05-01

    Coronary artery vibrometry is a new transthoracic Doppler ultrasound method for the detection of coronary artery stenosis. It detects audio-frequency vibrations generated by coronary artery luminal diameter reduction. We studied 31 patients with known or suspected stenosis using coronary artery vibrometry and quantitative coronary angiography and 83 normal volunteers. A tissue vibration difference index (TVDI) was calculated from the left anterior descending, circumflex, left main and right coronary arteries. Accuracy for coronary artery stenosis detection using TVDI was assessed. Sensitivity for detecting coronary stenosis equal or greater than 25% diameter reduction was 89% in the left anterior descending coronary artery (16/18, 95% confidence interval [CI] = 64%-98%), 87% in the right coronary artery (13/15, 95% CI = 58%-98%), 83% in the circumflex coronary artery (5/6, 95% CI = 36%-99%) and 100% in the left main artery (3/3, 95% CI = 31%-100%). The median TVDI increased with severity of stenosis, suggesting that this measure might be used to track progression/regression of coronary artery stenosis.

  6. Lithium Abundance in M3 Red Giant

    NASA Astrophysics Data System (ADS)

    Givens, Rashad; Pilachowski, Catherine A.

    2015-01-01

    We present the abundance of lithium in the red giant star vZ 1050 (SK 291) in the globular cluster M3. A previous survey of giants in the cluster showed that like IV-101, vZ 1050 displays a prominent Li I 6707 Å feature. vZ 1050 lies on the blue side of the red giant branch about 1.3 magnitudes above the level of the horizontal branch, and may be an asymptotic giant branch star. A high resolution spectrum of M3 vZ1050 was obtained with the ARC 3.5m telescope and the ARC Echelle Spectrograph (ARCES). Atmospheric parameters were determined using Fe I and Fe II lines from the spectrum using the MOOG spectral analysis program, and the lithium abundance was determined using spectrum synthesis.

  7. Giant cell arteritis presenting as scalp necrosis.

    PubMed

    Maidana, Daniel E; Muñoz, Silvia; Acebes, Xènia; Llatjós, Roger; Jucglà, Anna; Alvarez, Alba

    2011-07-07

    The differential of scalp ulceration in older patients should include several causes, such as herpes zoster, irritant contact dermatitis, ulcerated skin tumors, postirradiation ulcers, microbial infections, pyoderma gangrenosum, and giant cell arteritis. Scalp necrosis associated with giant cell arteritis was first described in the 1940s. The presence of this dermatological sign within giant cell arteritis represents a severity marker of this disease, with a higher mean age at diagnosis, an elevated risk of vision loss and tongue gangrene, as well as overall higher mortality rates, in comparison to patients not presenting this manifestation. Even though scalp necrosis due to giant cell arteritis is exceptional, a high level of suspicion must be held for this clinical finding, in order to initiate prompt and proper treatment and avoid blindness.

  8. Mass loss in red giants and supergiants

    NASA Technical Reports Server (NTRS)

    Sanner, F.

    1975-01-01

    The circumstellar envelopes surrounding late-type giants and supergiants were studied using high resolution, photoelectric scans of strong optical resonance lines. A method for extracting the circumstellar from the stellar components of the lines allowed a quantitative determination of the physical conditions in the envelopes and the rates of mass loss at various positions in the red giant region of the HR diagram. The observed strengthening of the circumstellar spectrum with increasing luminosity and later spectral type is probably caused by an increase in the mass of the envelopes. The mass loss rate for individual stars is proportional to the visual luminosity; high rates for the supergiants suggest that mass loss is important in their evolution. The bulk of the mass return to the interstellar medium in the red giant region comes from the normal giants, at a rate comparable to that of planetary nebulae.

  9. "GIANT" Steps to Create Online Orientations

    ERIC Educational Resources Information Center

    Bacon, Pamela

    2005-01-01

    Online orientation is provided due to the flexibility of online learning. The online orientation consists of the GIANT steps which stands for Get support, Identify your curriculum, Assemble your program, Navigate students through the pilot project and Test students.

  10. Tests of the Giant Impact Hypothesis

    NASA Technical Reports Server (NTRS)

    Jones, J. H.

    1998-01-01

    The giant impact hypothesis has gained popularity as a means of explaining a volatile-depleted Moon that still has a chemical affinity to the Earth. As Taylor's Axiom decrees, the best models of lunar origin are testable, but this is difficult with the giant impact model. The energy associated with the impact would be sufficient to totally melt and partially vaporize the Earth. And this means that there should he no geological vestige of Barber times. Accordingly, it is important to devise tests that may be used to evaluate the giant impact hypothesis. Three such tests are discussed here. None of these is supportive of the giant impact model, but neither do they disprove it.

  11. Giant salivary calculi of the submandibular gland

    PubMed Central

    Fowell, C; MacBean, A

    2012-01-01

    Sialolithasis is the most common salivary gland disease. A case of an unusually large sialolith arising in the submandibular gland is presented, along with a review of the management of giant salivary gland calculi. PMID:24960792

  12. Spontaneous Coronary Dissection Masquerading as Benign Fascicular Ventricular Tachycardia.

    PubMed

    Ho, Sara Wei-Fen; Lin, Weiqin; Chan, Koo Hui; Seow, Swee-Chong

    2016-01-01

    Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome. Diagnosis of coronary artery dissection is made on coronary angiogram and prompt revascularisation is the key in management. We present a case of coronary artery dissection with an atypical presentation of cardiac arrhythmia mimicking benign fascicular ventricular tachycardia. A high index of suspicion and early coronary angiogram allowed us to diagnose and treat this potentially life-threatening disease.

  13. [Update on coronary syndrome X].

    PubMed

    Iglesias, I; Velasco, S; Alegría, E; Bolao, I G; Díaz, M C; Huelmos, A; Alzamora, P

    1990-01-01

    Syndrome X is not a well-defined clinical entity. Patients included are those with typical effort angina with angiographically normal coronary arteries and with no evidence of other causes of chest pain. The pathophysiologic mechanisms involved in this syndrome could be a reduced vasodilatory capacity. The prognosis is usually good, but a subgroup of patients with left bundle brunch block in the ECG may develop a dilated cardiomyopathy. To present it lacks a full effective treatment.

  14. Coronary air embolism treated with aspiration catheter

    PubMed Central

    Patterson, M S; Kiemeneij, F

    2005-01-01

    Coronary air embolism remains a recognised complication of coronary catheterisation despite a strong emphasis on prevention. Current treatment consists of supportive measures with 100% oxygen and analgesia. Recent case reports describe the use of mechanical treatments aimed at dispersing or removing the air embolus with variable success. A case of coronary air embolism causing an acute coronary syndrome is described that was definitively treated with an aspiration system. The effectiveness of the aspiration system in the distal section of an obtuse marginal artery indicates that such dedicated aspiration systems may prove useful in the standard treatment of air embolism. PMID:15831621

  15. Coronary air embolism treated with aspiration catheter.

    PubMed

    Patterson, M S; Kiemeneij, F

    2005-05-01

    Coronary air embolism remains a recognised complication of coronary catheterisation despite a strong emphasis on prevention. Current treatment consists of supportive measures with 100% oxygen and analgesia. Recent case reports describe the use of mechanical treatments aimed at dispersing or removing the air embolus with variable success. A case of coronary air embolism causing an acute coronary syndrome is described that was definitively treated with an aspiration system. The effectiveness of the aspiration system in the distal section of an obtuse marginal artery indicates that such dedicated aspiration systems may prove useful in the standard treatment of air embolism.

  16. Cardiac CT: atherosclerosis to acute coronary syndrome

    PubMed Central

    Munnur, Ravi Kiran; Cameron, James D.; Ko, Brian S.; Meredith, Ian T.

    2014-01-01

    Coronary computed tomographic angiography (CCTA) is a robust non-invasive method to assess coronary artery disease (CAD). Qualitative and quantitative assessment of atherosclerotic coronary stenosis with CCTA has been favourably compared with invasive coronary angiography (ICA) and intravascular ultrasound (IVUS). Importantly, it allows the study of preclinical stages of atherosclerotic disease, may help improve risk stratification and monitor the progressive course of the disease. The diagnostic accuracy of CCTA in the assessment of coronary artery bypass grafts (CABG) is excellent and the constantly improving technology is making the evaluation of stents feasible. Novel techniques are being developed to assess the functional significance of coronary stenosis. The excellent negative predictive value of CCTA in ruling out disease enables early and safe discharge of patients with suspected acute coronary syndromes (ACS) in the Emergency Department (ED). In addition, CCTA is useful in predicting clinical outcomes based on the extent of coronary atherosclerosis and also based on individual plaque characteristics such as low attenuation plaque (LAP), positive remodelling and spotty calcification. In this article, we review the role of CCTA in the detection of coronary atherosclerosis in native vessels, stented vessels, calcified arteries and grafts; the assessment of plaque progression, evaluation of chest pain in the ED, assessment of functional significance of stenosis and the prognostic significance of CCTA. PMID:25610801

  17. Arterial Embolization of Giant Hepatic Hemangiomas

    SciTech Connect

    Giavroglou, Constantinos; Economou, Hippolete; Ioannidis, Ioannis

    2003-02-15

    Hepatic cavernous hemangiomas are usually small and asymptomatic. They are usually discovered incidentally and only a few require treatment. However, giant hemangiomas may cause symptoms,which are indications for treatment. We describe four cases of symptomatic giant hepatic hemangiomas successfully treated with transcatheter arterial embolization, performed with polyvinyl alcohol particles. There were no complications. Follow-up with clinical and imaging examinations showed disappearance of symptoms and decrease in size of lesions.

  18. Body composition in multiple sclerosis

    PubMed Central

    Dionyssiotis, Y

    2013-01-01

    Multiple sclerosis affects central nervous system leading to disability. Among other complications the deterioration of body composition is usually neglected and increases the risk for diseases such as coronary heart disease, non-insulin dependent diabetes mellitus, lipid abnormalities and bone loss leading to fractures in this population. Body mass index values, the effect of spasticity, the increased number of drugs used and the relationship between skeletal muscle and bone which interacts with impaired motor function leading to body composition alterations in multiple sclerosis are reviewed. PMID:23935336

  19. Congenital coronary artery anomalies: a bridge from embryology to anatomy and pathophysiology--a position statement of the development, anatomy, and pathology ESC Working Group.

    PubMed

    Pérez-Pomares, José María; de la Pompa, José Luis; Franco, Diego; Henderson, Deborah; Ho, Siew Yen; Houyel, Lucile; Kelly, Robert G; Sedmera, David; Sheppard, Mary; Sperling, Silke; Thiene, Gaetano; van den Hoff, Maurice; Basso, Cristina

    2016-02-01

    Congenital coronary artery anomalies are of major significance in clinical cardiology and cardiac surgery due to their association with myocardial ischaemia and sudden death. Such anomalies are detectable by imaging modalities and, according to various definitions, their prevalence ranges from 0.21 to 5.79%. This consensus document from the Development, Anatomy and Pathology Working Group of the European Society of Cardiology aims to provide: (i) a definition of normality that refers to essential anatomical and embryological features of coronary vessels, based on the integrated analysis of studies of normal and abnormal coronary embryogenesis and pathophysiology; (ii) an animal model-based systematic survey of the molecular and cellular mechanisms that regulate coronary blood vessel development; (iii) an organization of the wide spectrum of coronary artery anomalies, according to a comprehensive anatomical and embryological classification scheme; (iv) current knowledge of the pathophysiological mechanisms underlying symptoms and signs of coronary artery anomalies, with diagnostic and therapeutic implications. This document identifies the mosaic-like embryonic development of the coronary vascular system, as coronary cell types differentiate from multiple cell sources through an intricate network of molecular signals and haemodynamic cues, as the necessary framework for understanding the complex spectrum of coronary artery anomalies observed in human patients.

  20. Intravascular ultrasound for angiographically indeterminant left main coronary artery disease.

    PubMed

    Parashara, D K; Jacobs, L E; Ledley, G S; Yazdanfar, S; Oline, J; Kotler, M N

    1994-01-01

    The precise diagnosis of the presence of significant left main coronary artery disease has profound prognostic and therapeutic implications. Coronary cineangiography has shown to be imprecise and inaccurate to determine the percent stenosis of the left main coronary artery. We report a case with significant left main coronary artery disease in whom coronary cineangiography was in discordance with the clinical data and intravascular ultrasonography. Based on the intravascular ultrasound findings, the patient underwent coronary artery bypass graft surgery. Therefore, the intravascular ultrasonography may be the procedure of choice for assessing indeterminant left main coronary artery lesions by coronary angiography.

  1. Bayesian Inference of Giant Exoplanet Physics

    NASA Astrophysics Data System (ADS)

    Thorngren, Daniel; Fortney, Jonathan J.

    2017-01-01

    The physical processes within a giant planet directly set its observed radius for a given mass, age, and insolation. The important aspects are the planet’s bulk composition and its interior thermal evolution. By studying many giant planets as an ensemble, we can gain insight into this physics. We demonstrate two novel examples here. We examine 50 cooler transiting giant planets, whose insolation is sufficiently low (T_eff < 1000 K) that they are not affected by the hot Jupiter radius inflation effect. For these planets, the thermal evolution is relatively well understood, and we show that the bulk planet metallicity increases with the total planet mass, which directly impacts plans for future atmospheric studies. We also examine the relation with stellar metallicity and discuss how these relations place new constraints on the core accretion model of planet formation. Our newest work seeks to quantify the flow of energy into hot Jupiters needed to explain their enlarged radii, in addition to their bulk composition. Because the former is related to stellar insolation and the latter is related to mass, we are able to create a hierarchical Bayesian model to disentangle the two effects in our sample of ~300 transiting giant planets. Our results show conclusively that the inflation power is not a simple fraction of stellar insolation: instead, the power increases with incident flux at a much higher rate. We use these results to test published models of giant planet inflation and to provide accurate empirical mass-radius relations for giant planets.

  2. Formation of Giant Planets and Brown Dwarves

    NASA Technical Reports Server (NTRS)

    Lissauer, Jack J.

    2003-01-01

    According to the prevailing core instability model, giant planets begin their growth by the accumulation of small solid bodies, as do terrestrial planets. However, unlike terrestrial planets, the growing giant planet cores become massive enough that they are able to accumulate substantial amounts of gas before the protoplanetary disk dissipates. Models predict that rocky planets should form in orbit about most stars. It is uncertain whether or not gas giant planet formation is common, because most protoplanetary disks may dissipate before solid planetary cores can grow large enough to gravitationally trap substantial quantities of gas. Ongoing theoretical modeling of accretion of giant planet atmospheres, as well as observations of protoplanetary disks, will help decide this issue. Observations of extrasolar planets around main sequence stars can only provide a lower limit on giant planet formation frequency . This is because after giant planets form, gravitational interactions with material within the protoplanetary disk may cause them to migrat inwards and be lost to the central star. The core instability model can only produce planets greater than a few jovian masses within protoplanetary disks that are more viscous than most such disks are believed to be. Thus, few brown dwarves (objects massive enough to undergo substantial deuterium fusion, estimated to occur above approximately 13 jovian masses) are likely to be formed in this manner. Most brown dwarves, as well as an unknown number of free-floating objects of planetary mass, are probably formed as are stars, by the collapse of extended gas/dust clouds into more compact objects.

  3. Management of giant liver hemangiomas: an update.

    PubMed

    Hoekstra, Lisette T; Bieze, Matthanja; Erdogan, Deha; Roelofs, Joris J T H; Beuers, Ulrich H W; van Gulik, Thomas M

    2013-03-01

    Liver hemangiomas are the most common benign liver tumors and are usually incidental findings. Liver hemangiomas are readily demonstrated by abdominal ultrasonography, computed tomography or magnetic resonance imaging. Giant liver hemangiomas are defined by a diameter larger than 5 cm. In patients with a giant liver hemangioma, observation is justified in the absence of symptoms. Surgical resection is indicated in patients with abdominal (mechanical) complaints or complications, or when diagnosis remains inconclusive. Enucleation is the preferred surgical method, according to existing literature and our own experience. Spontaneous or traumatic rupture of a giant hepatic hemangioma is rare, however, the mortality rate is high (36-39%). An uncommon complication of a giant hemangioma is disseminated intravascular coagulation (Kasabach-Merritt syndrome); intervention is then required. Herein, the authors provide a literature update of the current evidence concerning the management of giant hepatic hemangiomas. In addition, the authors assessed treatment strategies and outcomes in a series of patients with giant liver hemangiomas managed in our department.

  4. Coronary Artery Bypass Surgery - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Artery Bypass Surgery Операция шунтирования коронарной ... displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  5. Rare Giant Cell Tumor of Olecranon Bone!!!!

    PubMed Central

    Goyal, Pawan; Gautam, Vishal; Saini, Narender; Sharma, Yogesh

    2016-01-01

    Introduction: Giant cell tumor (GCT) is a bone tumor involving epiphyseal area of bone abutting the subchondral bone. Commonly found in long bones such as proximal tibia and distal femur. We report a case of GCT of olecranon bone in a 23-year-old male. Case Report: A 23-year-old patient presented to our outpatient department with pain and mild swelling at the elbow from last 2 to 3 months. On examination, it was seen that there was a moderate swelling at the tip of the olecranon. The magnetic resonance imaging reported a lytic lesion in the olecranon but sparing the coronoid process of the ulna, the biopsy report confirmed that histologically it was a GCT of the bone. Total excision of the tumor was done after lifting the aponeurosis of the triceps muscle. The area remaining after excision of the tumor was phenol cauterized and cleaned with hydrogen peroxide solution. Triceps was reinserted on the remaining ulna. At follow-up the radiographs showed adequate excision of the tumor. The patient gained a full range of movement at the elbow and was functionally restored. There were no signs of any systemic spread of the tumor. Conclusion: GCT though a very common bone tumor could be missed if present in atypical locations. Radiographically soap bubble appearance might not be present in every case, and there could be multiple diagnoses for lytic lesion in bone. Proper investigations and histopathological examination are necessary for accurate diagnosis and further treatment planning. Early treatment helps in complete excision of tumor along with return of adequate function of the patient. PMID:28164048

  6. A New Survey for Giant Arcs

    SciTech Connect

    Hennawi, Joseph F.; Gladders, Michael D.; Oguri, Masamune; Dalal, Neal; Koester, Benjamin; Natarajan, Priyamvada; Strauss, Michael A.; Inada, Naohisa; Kayo, Issha; Lin, Huan; Lampeitl, Hubert; Annis, James; Bahcall, Neta A.; Schneider, Donald P.

    2006-11-15

    We report on the first results of an imaging survey to detect strong gravitational lensing targeting the richest clusters selected from the photometric data of the Sloan Digital Sky Survey (SDSS) with follow-up deep imaging observations from the Wisconsin Indiana Yale NOAO (WIYN) 3.5m telescope and the University of Hawaii 88-inch telescope (UH88). The clusters are selected from an area of 8000 deg{sup 2} using the Red Cluster Sequence technique and span the redshift range 0.1 {approx}< z {approx}< 0.6, corresponding to a comoving cosmological volume of {approx} 2Gpc{sup 3}. Our imaging survey thus targets a volume more than an order of magnitude larger than any previous search. A total of 240 clusters were imaged of which 141 had sub-arcsecond image quality. Our survey has uncovered 16 new lensing clusters with definite giant arcs, an additional 12 systems for which the lensing interpretation is very likely, and 9 possible lenses which contain shorter arclets or candidate arcs which are less certain and will require further observations to confirm their lensing origin. The number of new cluster lenses detected in this survey is likely > 30. Among these new systems are several of the most dramatic examples of strong gravitational lensing ever discovered with multiple bright arcs at large angular separation. These will likely become 'poster-child' gravitational lenses similar to Abell 1689 and CL0024+1654. The new lenses discovered in this survey will enable future systematic studies of the statistics of strong lensing and its implications for cosmology and our structure formation paradigm.

  7. Biomass yield comparisons of giant miscanthus, giant reed, and miscane grown under irrigated and rainfed conditions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The U.S. Department of Energy has initiated efforts to decrease the nation’s dependence on imported oil by developing domestic renewable sources of cellulosic-derived bioenergy. In this study, giant miscanthus (Miscanthus x giganteus), sugarcane (complex hybrid of Saccharum spp.), and giant reed (Ar...

  8. Rapidly progressive coronary artery disease as the first manifestation of antiphospholipid syndrome.

    PubMed

    Abdullah, Abdullah Sayied; Yagoub, Hatim; Kiernan, Thomas J; Daly, Caroline

    2014-04-08

    Antiphospholipid syndrome (APS) is an autoimmune multisystem disorder characterised by high incidence of arterial and venous thrombosis. Cardiovascular manifestations also include valvular heart disease, ventricular thrombi and higher risk for coronary artery disease (CAD). In this case report, we describe a 61-year-old woman who had no significant risk factors for CAD, and presented with aggressive disease in native and graft vessels that required multiple coronary interventions. The extent of her aggressive CAD could not be explained by her risk factors profile. Therefore autoantibodies screening was carried out and showed a strongly positive anticardiolipin and β2 glycoprotein-I antibody, and hence a diagnosis of antiphospholipid syndrome was made.

  9. Successful angioplasty of three cases of coronary artery dissections using hydrophilic wires

    PubMed Central

    Menon, Rajeev; Kapadia, Anuj

    2014-01-01

    Three cases of successful angioplasty of high-grade coronary dissections using hydrophilic wires were reported. Our first case had edge dissection after a stent deployed in the left anterior descending artery, after which we found it impossible to track the second stent over the regular wires, and which was successful when we tried with a stiffer hydrophilic wire. The second had spontaneous coronary artery dissections (SCAD), and the third case was a complicated plaque with multiple stenotic and ectatic segments along with dissection and successful angioplasty carried out using the same wires and without additional hardware. These wires also provided adequate support in tracking the required balloons and stents PMID:25489325

  10. [Pediatric case of congenital coronary artery fistula; surgical result and late changes in coronary artery aneurysm].

    PubMed

    Sugawara, Masaaki; Oguma, Fumiaki; Hirahara, Hiroyuki

    2014-07-01

    Congenital coronary artery fistula is an uncommon heart anomaly involving the coronary arteries. We report here a case of a 4-year-old boy who had a coronary fistula from the right coronary artery to the right ventricle, with a coronary aneurysm. He was asymptomatic, but the calculated ratio of pulmonary blood flow to systemic blood flow was shown to be high [pulmonary flow (Qp)/systemic flow(Qs)=1.78]. The coronary angiography showed that the right coronary artery was dilated beginning at the ostium and had an aneurysm at the acute marginal portion. A large spherical aneurysm approximately 20 mm in diameter was found to have been connected with coronary fistula opening into the right ventricle. Surgical repair by closure of the fistula under direct vision, partial resection and suture closure of the aneurysm was performed. Plication of the proximal portion of the right coronary artery was not performed, and the diffusely dilated artery was left untouched. After this operation, he recovered well under anticoagulant treatment with warfarin and aspirin. Postoperative angiography was performed 17 months after the surgery to evaluate morphological changes in the coronary artery. The angiography confirmed the closure of the fistula and the regression of coronary artery dilatation.

  11. Migration of accreting giant planets

    NASA Astrophysics Data System (ADS)

    Crida, A.; Bitsch, B.; Raibaldi, A.

    2016-12-01

    We present the results of 2D hydro simulations of giant planets in proto-planetary discs, which accrete gas at a more or less high rate. First, starting from a solid core of 20 Earth masses, we show that as soon as the runaway accretion of gas turns on, the planet is saved from type I migration : the gap opening mass is reached before the planet is lost into its host star. Furthermore, gas accretion helps opening the gap in low mass discs. Consequently, if the accretion rate is limited to the disc supply, then the planet is already inside a gap and in type II migration. We further show that the type II migration of a Jupiter mass planet actually depends on its accretion rate. Only when the accretion is high do we retrieve the classical picture where no gas crosses the gap and the planet follows the disc spreading. These results impact our understanding of planet migration and planet population synthesis models. The e-poster presenting these results in French can be found here: L'e-poster présentant ces résultats en français est disponible à cette adresse: http://sf2a.eu/semaine-sf2a/2016/posterpdfs/156_179_49.pdf.

  12. The Giant Planet Satellite Exospheres

    NASA Astrophysics Data System (ADS)

    McGrath, M. A.

    2014-12-01

    Exospheres are relatively common in the outer solar system among the moons of the gas giant planets. They span the range from very tenuous, surface-bounded exospheres (e.g., Rhea, Dione) to quite robust exospheres with exobase above the surface (e.g., Io, Triton), and include many intermediate cases (e.g., Europa, Ganymede, Enceladus). The exospheres of these moons exhibit an interesting variety of sources, from surface sputtering, to frost sublimation, to active plumes, and also well illustrate another common characteristic of the outer planet satellite exospheres, namely, that the primary species often exists both as a gas in atmosphere, and a condensate (frost or ice) on the surface. As described by Yelle et al. (1995) for Triton, "The interchange of matter between gas and solid phases on these bodies has profound effects on the physical state of the surface and the structure of the atmosphere." A brief overview of the exospheres of the outer planet satellites will be presented, including an inter-comparison of these satellites exospheres with each other, and with the exospheres of the Moon and Mercury.

  13. A giant thunderstorm on Saturn.

    PubMed

    Fischer, G; Kurth, W S; Gurnett, D A; Zarka, P; Dyudina, U A; Ingersoll, A P; Ewald, S P; Porco, C C; Wesley, A; Go, C; Delcroix, M

    2011-07-06

    Lightning discharges in Saturn's atmosphere emit radio waves with intensities about 10,000 times stronger than those of their terrestrial counterparts. These radio waves are the characteristic features of lightning from thunderstorms on Saturn, which last for days to months. Convective storms about 2,000 kilometres in size have been observed in recent years at planetocentric latitude 35° south (corresponding to a planetographic latitude of 41° south). Here we report observations of a giant thunderstorm at planetocentric latitude 35° north that reached a latitudinal extension of 10,000 kilometres-comparable in size to a 'Great White Spot'-about three weeks after it started in early December 2010. The visible plume consists of high-altitude clouds that overshoot the outermost ammonia cloud layer owing to strong vertical convection, as is typical for thunderstorms. The flash rates of this storm are about an order of magnitude higher than previous ones, and peak rates larger than ten per second were recorded. This main storm developed an elongated eastward tail with additional but weaker storm cells that wrapped around the whole planet by February 2011. Unlike storms on Earth, the total power of this storm is comparable to Saturn's total emitted power. The appearance of such storms in the northern hemisphere could be related to the change of seasons, given that Saturn experienced vernal equinox in August 2009.

  14. Atmospheres of the Giant Planets

    NASA Technical Reports Server (NTRS)

    Ingersoll, Andrew P.

    2002-01-01

    The giant planets, Jupiter, Saturn, Uranus, and Neptune, are fluid objects. They have no solid surfaces because the light elements constituting them do not condense at solar-system temperatures. Instead, their deep atmospheres grade downward until the distinction between gas and liquid becomes meaningless. The preceding chapter delved into the hot, dark interiors of the Jovian planets. This one focuses on their atmospheres, especially the observable layers from the base of the clouds to the edge of space. These veneers arc only a few hundred kilometers thick, less than one percent of each planet's radius, but they exhibit an incredible variety of dynamic phenomena. The mixtures of elements in these outer layers resemble a cooled-down piece of the Sun. Clouds precipitate out of this gaseous soup in a variety of colors. The cloud patterns are organized by winds, which are powered by heat derived from sunlight (as on Earth) and by internal heat left over from planetary formation. Thus the atmospheres of the Jovian planets are distinctly different both compositionally and dynamically from those of the terrestrial planets. Such differences make them fascinating objects for study, providing clues about the origin and evolution of the planets and the formation of the solar system.

  15. Treatment of Giant Intracranial Aneurysms

    PubMed Central

    Lv, X.; Jiang, C.; Li, Y.; Yang, X.; Zhang, J.; Wu, Z.

    2009-01-01

    Summary We report on report the clinical outcome obtained in treatment of giant intracranial aneurysms (GAs). Between 2005 and 2007, 51 patients with 51 GAs presented at our hospital. Twentynine were treated with primary parent vessel occlusion without distal bypass and ten underwent treatment preserving the parent artery. Twelve patients could not be treated endovascularly. Selective embolization (including two remodeling techniques and two stent-coil embolizations) resulted in only one cure. Two patients died as a result of subarachnoid hemorrhage periprocedurely. Twenty-nine patients treated primarily with parent vessel occlusion and three patients treated with covered stent were considered cured after their treatments. Only one patient treated with parent vessel occlusion experienced ischemia during follow-up, which resulted in a mild neurological deficit. Of the twelve patients who could not be treated endovascularly, one succumbed to surgery, four died while being treated conservatively, and three were lost to follow-up. Parent artery occlusion, covered stent and coil occlusion provide effective protection against bleeding. In treatment of paraclinoid GAs of the internal carotid artery, the use of a stent, and stent-assisted coil embolization may be a pitfall. PMID:20465907

  16. Giant electrocaloric effect around Tc.

    PubMed

    Rose, Maimon C; Cohen, R E

    2012-11-02

    We use molecular dynamics with a first-principles-based shell model potential to study the electrocaloric effect (ECE) in lithium niobate, LiNbO(3), and find a giant electrocaloric effect along a line passing through the ferroelectric transition. With an applied electric field, a line of maximum ECE passes through the zero field ferroelectric transition, continuing along a Widom line at high temperatures with increasing fields, and along the instability that leads to homogeneous ferroelectric switching below T(c) with an applied field antiparallel to the spontaneous polarization. This line is defined as the minimum in the inverse capacitance under an applied electric field. We investigate the effects of pressure, temperature and an applied electric field on the ECE. The behavior we observe in LiNbO(3) should generally apply to ferroelectrics; we therefore suggest that the operating temperature for refrigeration and energy scavenging applications should be above the ferroelectric transition region to obtain a large electrocaloric response. The relationship between T(c), the Widom line, and homogeneous switching should be universal among ferroelectrics, relaxors, multiferroics, and the same behavior should be found under applied magnetic fields in ferromagnets.

  17. Red Giant Plunging Through Space

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Poster Version

    This image from NASA's Spitzer Space Telescope (left panel) shows the 'bow shock' of a dying star named R Hydrae, or R Hya, in the constellation Hydra.

    Bow shocks are formed where the stellar wind from a star are pushed into a bow shape (illustration, right panel) as the star plunges through the gas and dust between stars. Our own Sun has a bow shock, but prior to this image one had never been observed around this particular class of red giant star.

    R Hya moves through space at approximately 50 kilometers per second. As it does so, it discharges dust and gas into space. Because the star is relatively cool, that ejecta quickly assumes a solid state and collides with the interstellar medium. The resulting dusty nebula is invisible to the naked eye but can be detected using an infrared telescope. This bow shock is 16,295 astronomical units from the star to the apex and 6,188 astronomical units thick (an astronomical unit is the distance between the sun and Earth). The mass of the bow shock is about 400 times the mass of the Earth.

    The false-color Spitzer image shows infrared emissions at 70 microns. Brighter colors represent greater intensities of infrared light at that wavelength. The location of the star itself is drawn onto the picture in the black 'unobserved' region in the center.

  18. The Giant Planet Satellite Exospheres

    NASA Technical Reports Server (NTRS)

    McGrath, Melissa A.

    2014-01-01

    Exospheres are relatively common in the outer solar system among the moons of the gas giant planets. They span the range from very tenuous, surface-bounded exospheres (e.g., Rhea, Dione) to quite robust exospheres with exobase above the surface (e.g., lo, Triton), and include many intermediate cases (e.g., Europa, Ganymede, Enceladus). The exospheres of these moons exhibit an interesting variety of sources, from surface sputtering, to frost sublimation, to active plumes, and also well illustrate another common characteristic of the outer planet satellite exospheres, namely, that the primary species often exists both as a gas in atmosphere, and a condensate (frost or ice) on the surface. As described by Yelle et al. (1995) for Triton, "The interchange of matter between gas and solid phases on these bodies has profound effects on the physical state of the surface and the structure of the atmosphere." A brief overview of the exospheres of the outer planet satellites will be presented, including an inter-comparison of these satellites exospheres with each other, and with the exospheres of the Moon and Mercury.

  19. Giant resonances of endohedral atoms

    NASA Astrophysics Data System (ADS)

    Amusia, M. Ya.; Baltenkov, A. S.; Chernysheva, L. V.

    2008-04-01

    It is demonstrated for the first time that the effect of a fullerene shell on the photoionization of a “caged” atom in an endohedral can result in the formation of giant endohedral resonances or GER. This is illustrated by the concrete case of the Xe@C60 photoionization cross section that, at 17 eV, exhibits a powerful resonance with total oscillator strengths of about 25. The prominent modification of the 5 p 6 electron photoionization cross section of Xe@C60 takes place due to the strong fullerene shell polarization under the action of the incoming electromagnetic wave and the oscillation of this cross section due to the reflection of the photoelectron from Xe by the C60. These two factors transform the smoothly decreasing 5 p 6 cross section of Xe into a rather complex curve with a powerful maximum for Xe@C60, with the oscillator strength of it being equal to 25. We also present the results for the dipole angular anisotropy parameter that is strongly affected by the reflection of the photoelectron waves, but not modified by C60 polarization.

  20. Giant resonances of endohedral atoms

    NASA Astrophysics Data System (ADS)

    Amusia, M. Ya.; Baltenkov, Arkadiy; Chernysheva, Larissa

    2008-05-01

    We demonstrate for that the effect of fullerene shell upon photoionization of the ``caged'' atom in an endohedral can result in formation of Giant Endohedral Resonances or GER. This is illustrated by the concrete case of Xe@C60 photoionization cross-section that exhibits at 17 eV a powerful resonance with total oscillator strengths of about 25. The prominent modification of the 5p^6 electron photoionization cross-section of Xe@C60 takes place due to strong fullerene shell polarization under the action of the incoming electromagnetic wave and oscillation of this cross-section due to the reflection of the photoelectron from Xe by the C60. These two factors transform the smoothly decreasing 5p^6 cross-section of Xe into a rather complex curve with a powerful maximum for Xe@C60, with the oscillator strength of it being equal to 25! We present also the results for the dipole angular anisotropy parameter that is strongly affected by the reflection of the photoelectron waves but not modified by C60 polarization.

  1. The "Giant Virus Finder" discovers an abundance of giant viruses in the Antarctic dry valleys.

    PubMed

    Kerepesi, Csaba; Grolmusz, Vince

    2017-02-28

    Mimivirus was identified in 2003 from a biofilm of an industrial water-cooling tower in England. Later, numerous new giant viruses were found in oceans and freshwater habitats, some of them having 2,500 genes. We have demonstrated their likely presence in four soil samples taken from the Kutch Desert (Gujarat, India). Here we describe a bioinformatics work-flow, called the "Giant Virus Finder" that is capable of discovering the likely presence of the genomes of giant viruses in metagenomic shotgun-sequenced datasets. The new workflow is applied to numerous hot and cold desert soil samples as well as some tundra- and forest soils. We show that most of these samples contain giant viruses, especially in the Antarctic dry valleys. The results imply that giant viruses could be frequent not only in aqueous habitats, but in a wide spectrum of soils on our planet.

  2. Giant elves: Lightning-generated electromagnetic pulses in giant planets.

    NASA Astrophysics Data System (ADS)

    Luque Estepa, Alejandro; Dubrovin, Daria; José Gordillo-Vázquez, Francisco; Ebert, Ute; Parra-Rojas, Francisco Carlos; Yair, Yoav; Price, Colin

    2015-04-01

    We currently have direct optical observations of atmospheric electricity in the two giant gaseous planets of our Solar System [1-5] as well as radio signatures that are possibly generated by lightning from the two icy planets Uranus and Neptune [6,7]. On Earth, the electrical activity of the troposphere is associated with secondary electrical phenomena called Transient Luminous Events (TLEs) that occur in the mesosphere and lower ionosphere. This led some researchers to ask if similar processes may also exist in other planets, focusing first on the quasi-static coupling mechanism [8], which on Earth is responsible for halos and sprites and then including also the induction field, which is negligible in our planet but dominant in Saturn [9]. However, one can show that, according to the best available estimation for lightning parameters, in giant planets such as Saturn and Jupiter the effect of the electromagnetic pulse (EMP) dominates the effect that a lightning discharge has on the lower ionosphere above it. Using a Finite-Differences, Time-Domain (FDTD) solver for the EMP we found [10] that electrically active storms may create a localized but long-lasting layer of enhanced ionization of up to 103 cm-3 free electrons below the ionosphere, thus extending the ionosphere downward. We also estimate that the electromagnetic pulse transports 107 J to 1010 J toward the ionosphere. There emissions of light of up to 108 J would create a transient luminous event analogous to a terrestrial elve. Although these emissions are about 10 times fainter than the emissions coming from the lightning itself, it may be possible to target them for detection by filtering the appropiate wavelengths. [1] Cook, A. F., II, T. C. Duxbury, and G. E. Hunt (1979), First results on Jovian lightning, Nature, 280, 794, doi:10.1038/280794a0. [2] Little, B., C. D. Anger, A. P. Ingersoll, A. R. Vasavada, D. A. Senske, H. H. Breneman, W. J. Borucki, and The Galileo SSI Team (1999), Galileo images of

  3. YOUNG SOLAR SYSTEM's FIFTH GIANT PLANET?

    SciTech Connect

    Nesvorny, David

    2011-12-15

    Studies of solar system formation suggest that the solar system's giant planets formed and migrated in the protoplanetary disk to reach the resonant orbits with all planets inside {approx}15 AU from the Sun. After the gas disk's dispersal, Uranus and Neptune were likely scattered by the gas giants, and approached their current orbits while dispersing the transplanetary disk of planetesimals, whose remains survived to this time in the region known as the Kuiper Belt. Here we performed N-body integrations of the scattering phase between giant planets in an attempt to determine which initial states are plausible. We found that the dynamical simulations starting with a resonant system of four giant planets have a low success rate in matching the present orbits of giant planets and various other constraints (e.g., survival of the terrestrial planets). The dynamical evolution is typically too violent, if Jupiter and Saturn start in the 3:2 resonance, and leads to final systems with fewer than four planets. Several initial states stand out in that they show a relatively large likelihood of success in matching the constraints. Some of the statistically best results were obtained when assuming that the solar system initially had five giant planets and one ice giant, with the mass comparable to that of Uranus and Neptune, and which was ejected to interstellar space by Jupiter. This possibility appears to be conceivable in view of the recent discovery of a large number of free-floating planets in interstellar space, which indicates that planet ejection should be common.

  4. Coronary CT angiography: Beyond morphological stenosis analysis.

    PubMed

    Sun, Zhonghua

    2013-12-26

    Rapid technological developments in computed tomography (CT) imaging technique have made coronary CT angiography an attractive imaging tool in the detection of coronary artery disease. Despite visualization of excellent anatomical details of the coronary lumen changes, coronary CT angiography does not provide hemodynamic changes caused by presence of plaques. Computational fluid dynamics (CFD) is a widely used method in the mechanical engineering field to solve complex problems through analysing fluid flow, heat transfer and associated phenomena by using computer simulations. In recent years, CFD is increasingly used in biomedical research due to high performance hardware and software. CFD techniques have been used to study cardiovascular hemodynamics through simulation tools to assist in predicting the behaviour of circulatory blood flow inside the human body. Blood flow plays a key role in the localization and progression of coronary artery disease. CFD simulation based on 3D luminal reconstructions can be used to analyse the local flow fields and flow profiling due to changes of vascular geometry, thus, identifying risk factors for development of coronary artery disease. The purpose of this article is to provide an overview of the coronary CT-derived CFD applications in coronary artery disease.

  5. Experiments On Flow In A Coronary Artery

    NASA Technical Reports Server (NTRS)

    Back, Lloyd H.; Kwack, Eug-Yon; Liem, Timothy K.; Crawford, Donald W.

    1993-01-01

    Report describes experiments on simulated flow of blood in atherosclerotic human coronary artery. Experiments performed on polyurethane cast made from S-shaped coronary artery of cadaver. Sucrose solution with viscosity of blood pumped through cast at physiologically realistic rates, and flow made pulsatile by mechanism alternately compressing and releasing elastic tube just upstream of cast.

  6. [Triggering of acute coronary syndromes. Pathophysiologic relationships].

    PubMed

    González Pliego, José Angel

    2006-01-01

    In this review, the relationship of external triggers with the development of acute coronary syndromes is described. Based on current evidence, the pathophysiological mechanisms that probably result in the rupture of vulnerable coronary plaques are revised and preventive measures to stop the functional and lethal consequences of its occurrence are proposed.

  7. Registration of 3D+t coronary CTA and monoplane 2D+t X-ray angiography.

    PubMed

    Metz, Coert T; Schaap, Michiel; Klein, Stefan; Baka, Nora; Neefjes, Lisan A; Schultz, Carl J; Niessen, Wiro J; van Walsum, Theo

    2013-05-01

    A method for registering preoperative 3D+t coronary CTA with intraoperative monoplane 2D+t X-ray angiography images is proposed to improve image guidance during minimally invasive coronary interventions. The method uses a patient-specific dynamic coronary model, which is derived from the CTA scan by centerline extraction and motion estimation. The dynamic coronary model is registered with the 2D+t X-ray sequence, considering multiple X-ray time points concurrently, while taking breathing induced motion into account. Evaluation was performed on 26 datasets of 17 patients by comparing projected model centerlines with manually annotated centerlines in the X-ray images. The proposed 3D+t/2D+t registration method performed better than a 3D/2D registration method with respect to the accuracy and especially the robustness of the registration. Registration with a median error of 1.47 mm was achieved.

  8. [Invasive diagnostic imaging of coronary atherosclerosis].

    PubMed

    Gamou, Tadatsugu; Kawashiri, Masaaki; Tada, Hayato; Hayashi, Kenshi; Yamagishi, Masakazu

    2011-01-01

    Invasive diagnostic imaging technique of coronary atherosclerosis has rapidly developed. For example, intravascular ultrasound(IVUS) is recognized as an essential device for percutaneous coronary intervention to evaluate the vessel wall, vascular lumen and coronary plaque morphologies because of its accuracy for quantitative analysis capability. Recently new imaging modalities such as radio-frequency signal analysis, elastography and contrast harmonic echography have been developed for the evaluation of histological characteristics. Also, optical coherence tomography(OCT), which provides approximately ten-times higher-resolutional cross-section images of the coronary arterial wall in comparison with IVUS, became available in clinical setting. In this article, we review the latest progress of the invasive diagnostic imaging of coronary atherosclerosis.

  9. Single Coronary Artery with Aortic Regurgitation

    SciTech Connect

    Katsetos, Manny C. Toce, Dale T.

    2003-11-15

    An isolated single coronary artery can be associated with normal life expectancy; however, patients are at an increased risk of sudden death. A case is reported of a 54-year-old man with several months of chest pressure with activity. On exercise Sestamibi stress testing, the patient developed a hypotensive response with no symptoms and minimal electrocardiographic changes. Nuclear scanning demonstrated reversible septal and lateral perfusion defects consistent with severe ischemia. Coronary angiography revealed a single coronary artery with the right coronary artery arising from the left main. There were high-grade stenotic lesions in the left anterior descending and circumflex arteries with only moderate atherosclerotic disease in the right coronary artery. An aortogram showed 2-3+ aortic regurgitation, with an ejection fraction of 45% on ventriculography. The patient underwent four-vessel revascularization and aortic valve replacement and did well postoperatively.

  10. Spontaneous Coronary Artery Dissection: The Phantom Menace

    PubMed Central

    Spinthakis, Nikolaos; Abdulkareem, Nada; Farag, Mohamed; Gorog, Diana A.

    2016-01-01

    We present a case of a 66-year-old lady with chest pain, without dynamic 12-lead electrocardiographic (ECG) changes and normal serial troponin. Coronary angiography revealed a linear filing defect in the first obtuse marginal branch of the circumflex artery indicating coronary artery dissection, with superadded thrombus. She was managed medically with dual antiplatelet therapy and has responded well. Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiac chest pain, which can be missed without coronary angiography. Unlike most other lesions in patients with unstable symptoms, where coronary intervention with stenting is recommended, patients with SCAD generally fare better with conservative measures than with intervention, unless there is hemodynamic instability. PMID:28197295

  11. Plasma Catestatin: A Useful Biomarker for Coronary Collateral Development with Chronic Myocardial Ischemia

    PubMed Central

    Xu, Weixian; Yu, Haiyi; Li, Weihong; Gao, Wei; Guo, Lijun; Wang, Guisong

    2016-01-01

    Backgrounds Catestatin is an endogenous multifunctional neuroendocrinepeptide. Recently, catestatin was discovered as a novel angiogenic cytokine. The study was to investigate the associations between endogenous catestatin and coronary collateral development among the patients with chronic myocardial ischemia. Methods Thirty-eight patients with coronary artery chronic total occlusions (CTO) (CTO group) and 38 patients with normal coronary arteries (normal group) were enrolled in the series. Among the patients with CTO, coronary collateral development was graded according to the Rentrop score method. Rentrop score 0–1 collateral development was regarded as poor collateral group and 2–3 collateral development was regarded as good collateral group. Plasma catestatin level and vascular endothelial growth factor (VEGF) were measured by ELISA kits. Results The plasma catestatin levels in CTO group were significantly higher than that in normal group (1.97±1.01 vs 1.36±0.97ng/ml, p = 0.009). In the CTO group, the patients with good collateral development had significantly higher catestatin and VEGF levels than those with poor collateral development (2.36±0.73 vs 1.61±1.12 ng/ml, p = 0.018; 425.23±140.10 vs 238.48±101.00pg/mL, p<0.001). There is a positive correlation between plasma catestatin levels and Rentrop scores (r = 0.40, p = 0.013) among the patients with CTO. However, there is no correlations between plasma catestatin levels and VEGF (r = -0.06, p = 0.744). In the multiple linear regression models, plasma catestatin level was one of the independent factors of coronary collateral development after adjustment for confounders. Conclusions Plasma catestatin was associated with coronary collateral developments. It may be a useful biomarker for coronary collateral development and potential target for therapeutic angiogenesis in patients with CTO. PMID:27304618

  12. Hemorheological parameters in coronary artery disease detected by multi-slice CT

    NASA Astrophysics Data System (ADS)

    Toth, Andras; Szukits, Sandor; Varady, Edit; Sandor, Barbara; Rabai, Miklos; Papp, Judit; Juricskay, Istvan; Kesmarky, Gabor; Toth, Kalman; Sumegi, Balazs; Battyani, Istvan

    2014-05-01

    Epidemiological studies have confirmed that hemorheological parameters are primary risk factors in CAD; and their alterations in CAD have been described. We aimed to investigate both macro- and microrheological properties of blood in patients with CAD. The data of 121 patients (mean age: 58.8 ± 9.6 years) undergoing coronary CT were analyzed. Blood samples were obtained right before CT examinations. Hematocrit (Hct), plasma (PV) and apparent whole blood viscosity (WBV), red blood cell (RBC) aggregation and RBC deformability were measured. Patients were classified into four groups according to their coronary vessel state: Negative group (n = 32, mean age: 56.8 ± 11.1 years) without any coronary stenosis or atherosclerotic lesion and zero calcium-score, Non-significant group (n = 27, mean age: 59.2 ± 7.5 years) below 40% area stenosis, Singlevessel group (n = 32, mean age: 58.8 ± 8.5 years) over 40% area stenosis or history of PCI or CABG on one coronary vessel, Multi-vessel group (n = 30, mean age: 62.1 ± 8.4 years) with over 40% area stenosis or history of PCI or CABG on multiple coronary vessels. Hct was significantly (p < 0.05) higher in all CAD ( Non-significant, Single-vessel, Multi-vessel) groups compared to the Negative group. WBV was significantly (p<0.05) higher in the Multi-vessel group compared to the Negative group. No significant (p > 0.05) differences were observed in PV. RBC aggregation was significantly (p < 0.05) increased in the Multi-vessel group compared to the Negative group. RBC deformability showed a decreasing tendency with the increasing number of atherosclerotic vessels. Our results indicate that hemorheological variables are deteriorated in patients with CAD established by coronary CT, which is more pronounced in severe coronary disease.

  13. A possible giant planet orbiting the cataclysmic variable LX Ser

    NASA Astrophysics Data System (ADS)

    Li, Kai; Hu, Shaoming; Zhou, Jilin; Wu, Donghong; Guo, Difu; Jiang, Yunguo; Gao, Dongyang; Chen, Xu; Wang, Xianyu

    2017-02-01

    LX Ser is a deeply eclipsing cataclysmic variable with an orbital period of 0.1584325 d. 62 new eclipse times were determined by our observations and the AAVSO International Data base. Combining all available eclipse times, we analyzed the O - C behavior of LX Ser. We found that the O - C diagram of LX Ser shows a sinusoidal oscillation with a period of 22.8 yr and an amplitude of 0.00035 d. Two mechanisms (i.e., the Applegate mechanism and the light-travel time effect) are applied to explain the cyclic modulation. We found that it is difficult to apply the Applegate mechanism to explain the cyclic oscillation in the orbital period. Therefore, the cyclic period change is most likely to be caused by the light-travel time effect due to the presence of a third body. The mass of the tertiary component was determined to be M3 ∼ 7.5 MJup. We supposed that the tertiary companion is plausibly a giant planet. The stability of the giant planet was checked, and we found that the multiple system is stable.

  14. Hunting the Huntsmen: Compact Pulsar Binaries with Giant Companions

    NASA Astrophysics Data System (ADS)

    Swihart, Samuel; Strader, Jay; Chomiuk, Laura; Sand, David J.; Cheung, Chi C.; Johnson, Tyrel J.

    2017-01-01

    Our group has been pursuing follow-up observations of unassociated Fermi-LAT γ-ray sources in an effort to identify new Milky Way compact binaries. Some of our recent observations include the preliminary discovery of a long-period (~8.1d), γ-ray bright binary with a heavy (~1.9 M) neutron star (NS) primary and giant secondary (~0.5 M) that shows some unusual variability characteristics in multiple wavelengths. Evolutionary models of compact binaries indicate that this system is likely in the late phases of typical millisecond pulsar (MSP) binary formation in the Galactic field, phases which up until now have been unobserved. This system also appears remarkably similar to the recently discovered NS binary 1FGL J1417.7-4407 (Strader et al. 2015), which showed optical, X-ray, and γ-ray signatures consistent with transitional MSPs in their disk state. Despite this evidence, 1FGL J1417.7-4407 was simultaneously found to host a radio MSP, implying accreting material is not reaching the pulsar surface and further bringing into question how and when these systems switch on or off as radio MSPs. The confirmation of a second long-period γ-ray bright binary system with a massive NS primary and giant secondary would show that the rich phenomenology that can be observed when an accretion disk is present remains unclear, and facilitates a discussion on whether such systems constitute a distinct class of compact binaries.

  15. Sunspots and Giant-Cell Convection

    NASA Technical Reports Server (NTRS)

    Moore, Ron L.; Hathaway, David H.; Reichmann, Ed J.

    2000-01-01

    From analysis of Doppler velocity images from SOHO/MDI, Hathaway et al (2000, Solar Phys., in press) have found clear evidence for giant convection cells that fill the solar surface, have diameters 3 - 10 times that typical of supergranules, and have lifetimes approx. greater than 10 days. Analogous to the superposition of the granular convection on the supergranular convection, the approx. 30,000 km diameter supergranules are superposed on these still larger giant cells. Because the giant cells make up the large-scale end of a continuous power spectrum that peaks at the size scale of supergranules, it appears that the giant cells are made by the same mode of convection as the supergranules. This suggests that the giant cells are similar to supergranules, just longer-lived, larger in diameter, and deeper. Here we point out that the range of lengths of large bipolar sunspot groups is similar to the size range of giant cells. This, along with the long lives (weeks) of large sunspots, suggests that large sunspots sit in long-lived, deep downflows at the corners of giant cells, and that the distance from leader to follower sunspots in large bipolar groups is the distance from one giant-cell corner to the next. By this line of reasoning, an unusually large and strong downdraft might pull in both legs of a rising spot-group magnetic flux loop, resulting in the formation of a delta sunspot. This leads us to suggest that a large, strong giant-cell corner downdraft should be present at the birthplaces of large delta sunspots for some time (days to weeks) before the birth. Thus, early detection of such downdrafts by local helioscismology might provide an early warning for the formation of those active regions (large delta sunspot groups) that produce the Sun's most violent flares and coronal mass ejections. This work is supported by NASA's Office of Space Science through the Solar Physics Branch of its Sun-Earth Connection Program.

  16. An MHD model for magnetar giant flares

    SciTech Connect

    Meng, Y.; Lin, J.; Zhang, Q. S.; Zhang, L.; Reeves, K. K.; Yuan, F. E-mail: jlin@ynao.ac.cn

    2014-04-10

    Giant flares on soft gamma-ray repeaters that are thought to take place on magnetars release enormous energy in a short time interval. Their power can be explained by catastrophic instabilities occurring in the magnetic field configuration and the subsequent magnetic reconnection. By analogy with the coronal mass ejection events on the Sun, we develop a theoretical model via an analytic approach for magnetar giant flares. In this model, the rotation and/or displacement of the crust causes the field to twist and deform, leading to flux rope formation in the magnetosphere and energy accumulation in the related configuration. When the energy and helicity stored in the configuration reach a threshold, the system loses its equilibrium, the flux rope is ejected outward in a catastrophic way, and magnetic reconnection helps the catastrophe develop to a plausible eruption. By taking SGR 1806–20 as an example, we calculate the free magnetic energy released in such an eruptive process and find that it is more than 10{sup 47} erg, which is enough to power a giant flare. The released free magnetic energy is converted into radiative energy, kinetic energy, and gravitational energy of the flux rope. We calculated the light curves of the eruptive processes for the giant flares of SGR 1806–20, SGR 0526–66, and SGR 1900+14, and compared them with the observational data. The calculated light curves are in good agreement with the observed light curves of giant flares.

  17. Giant cell tumor in adipose package Hoffa

    PubMed Central

    Etcheto, H. Rivarola; Escobar, G.; Blanchod, C. Collazo; Palanconi, M.; Zordan, J.; Salinas, E. Alvarez; Autorino₁, Carlos

    2017-01-01

    Tumors of adipose Hoffa package are very uncommon, with isolated cases reported in the literature. His presentation in pediatric patients knee is exceptional. The most frequently described tumors are benign including vellonodular synovitis. The extra-articular localized variant there of is known as giant cell tumor of the tendon sheath. It is characterized by locally aggressive nature, and has been described in reports of isolated cases. Objective: A case of giant cell tumor of the tendon sheath in adipose presentation package Hoffa in pediatric patients is presented in this paper. Methods: male patient eleven years with right knee pain after sports practice was evaluated. Physical examination, showed limited extension -30º, joint effusion, stable negative Lachman maneuver without peripheral knee laxity. MRI hyperintense on tumor is observed in T2 and hypointense on T1 homogeneous and defined edges content displayed prior to LCA related to adipose Hoffa package. Results: The tumor specimen was obtained and histopathology is defined as densely cellular tissue accumulation of xantomisados fibrocollagenous with histiocytes and multinucleated giant cells, compatible with giant cell tumor of tendon sheath. Conclusion: The presentation of giant cell tumors of the tendon sheath in Hoffa fat pad is exceptional. However, his suspicion allows adequate preoperative surgical planning, as a whole resection is the only procedure that has been shown to decrease the rate of recurrence of this disease.

  18. Anelastic models of the zonal winds in gas giants

    NASA Astrophysics Data System (ADS)

    Gastine, T.; Wicht, J.

    2012-12-01

    The banded structures observed at the surfaces of Jupiter and Saturn are associated with eastward and westward zonal flows. In both gas giants, we observe a large amplitude prograde equatorial jet, which is flanked by multiple alternating zonal winds of weaker amplitudes. The depth of these jets is however poorly known and highly debated. Theoretical scenarios encompass "shallow models", that assume that these zonal flows are restricted to the outer weather layer; as well as "deep models" that suppose that the jets penetrate deeper down in the molecular envelope. The latter idea has been supported by 3-D numerical simulations using the so-called "Boussinesq approximation", that assumes the reference state to be constant with radius (e.g. Heimpel et al., 2005). While this approximation is well-adapted to weakly-stratified fluids (e.g. iron cores of Earth-like planets), it becomes more questionable in the gas giants interiors, where the density contrast is huge (ρ bot/ρ top ˜ 104). The "anelastic approximation", already employed in recent models of the gas giants (e.g. Jones & Kuzanyan 2009; Gastine & Wicht 2012), thus provides a more realistic framework to simulate the interior dynamics of such planets. We present here the results of a systematic parameter study where we explore the dependence of convection and zonal flows on density stratification. While the density contrast affects the convective flow amplitude and the typical lengthscale of convection, global quantities and zonal jets properties are found to be fairly independent of the density contrast. Notwithstanding these common properties, compressibility effects also yield interesting differences to Boussinesq approaches. For instance, in the strongly stratified models, the main force balance can significantly vary with depth. While the flow in the deep interior is dominated by rotation, buoyancy can indeed become larger than Coriolis force close to the surface. This "transitional regime" has a visible

  19. Electrodynamics on extrasolar giant planets

    SciTech Connect

    Koskinen, T. T.; Yelle, R. V.; Lavvas, P.; Cho, J. Y-K.

    2014-11-20

    Strong ionization on close-in extrasolar giant planets (EGPs) suggests that their atmospheres may be affected by ion drag and resistive heating arising from wind-driven electrodynamics. Recent models of ion drag on these planets, however, are based on thermal ionization only and do not include the upper atmosphere above the 1 mbar level. These models are also based on simplified equations of resistive magnetohydrodynamics that are not always valid in extrasolar planet atmospheres. We show that photoionization dominates over thermal ionization over much of the dayside atmosphere above the 100 mbar level, creating an upper ionosphere dominated by ionization of H and He and a lower ionosphere dominated by ionization of metals such as Na, K, and Mg. The resulting dayside electron densities on close-in exoplanets are higher than those encountered in any planetary ionosphere of the solar system, and the conductivities are comparable to the chromosphere of the Sun. Based on these results and assumed magnetic fields, we constrain the conductivity regimes on close-in EGPs and use a generalized Ohm's law to study the basic effects of electrodynamics in their atmospheres. We find that ion drag is important above the 10 mbar level where it can also significantly alter the energy balance through resistive heating. Due to frequent collisions of the electrons and ions with the neutral atmosphere, however, ion drag is largely negligible in the lower atmosphere below the 10 mbar level for a reasonable range of planetary magnetic moments. We find that the atmospheric conductivity decreases by several orders of magnitude in the night side of tidally locked planets, leading to a potentially interesting large-scale dichotomy in electrodynamics between the day and night sides. A combined approach that relies on UV observations of the upper atmosphere, phase curve and Doppler measurements of global dynamics, and visual transit observations to probe the alkali metals can potentially be

  20. An evaluation of coronary atherosclerosis using coronary CT in subjects with asymptomatic carotid lesions

    PubMed Central

    Bonomo, Vito; Piraino, Davide; Bracale, Umberto Marcello; Evola, Salvatore; Di Piazza, Mariaconcetta; Vicari, Claudia; Lupo, Ambra; Inga, Giuseppe; Andolina, Giuseppe; Assennato, Pasquale; Novo, Salvatore

    2014-01-01

    The evaluation of coronary lesions in patients with asymptomatic carotid plaque represents a very promising line of research to assess cardiovascular risk and the possible implementation of a more aggressive prevention therapy. Methods: In this study we enrolled 102 patients with intermediate to high cardiovascular risk but no history of coronary artery disease. The first group, consisting of 51 patients, underwent a Coronary CT scan (CCT-group) as well as carotid ultrasonography. The second group, also consisting of 51 patients, underwent coronary angiography (CA) and carotid ultrasonography. Results: The absence of a statistically significant difference between the involvement of both coronary and carotid sites, assessed by CCT and CA, confirms the role of coronary CT as a useful method in the preclinical evaluation of cardiovascular risk. In the CCT group, the correlation between atherosclerosis of carotid artery and coronary disease, as well as between the mean carotid intimal medial thickness and the number of involved coronary vessels, and between the maximum values of carotid plaque and the presence of coronary artery stenosis > 50%, were statistically significant. The Agatson calcium score was also statistically associated with carotid plaque size. Conclusion: The imaging biomarkers have a key role in the evaluation of subclinical atherosclerotic disease. Moreover, carotid ultrasound examination and a CT-scan of coronary arteries, in a particular sub-group of patients with intermediate to high cardiovascular risk, can play a crucial role to assess the preventive therapeutic strategies. PMID:25147763

  1. A GIANT SAMPLE OF GIANT PULSES FROM THE CRAB PULSAR

    SciTech Connect

    Mickaliger, M. B.; McLaughlin, M. A.; Lorimer, D. R.; Palliyaguru, N.; Langston, G. I.; Bilous, A. V.; Kondratiev, V. I.; Lyutikov, M.; Ransom, S. M.

    2012-11-20

    We observed the Crab pulsar with the 43 m telescope in Green Bank, WV over a timespan of 15 months. In total we obtained 100 hr of data at 1.2 GHz and seven hours at 330 MHz, resulting in a sample of about 95,000 giant pulses (GPs). This is the largest sample, to date, of GPs from the Crab pulsar taken with the same telescope and backend and analyzed as one data set. We calculated power-law fits to amplitude distributions for main pulse (MP) and interpulse (IP) GPs, resulting in indices in the range of 2.1-3.1 for MP GPs at 1.2 GHz and in the range of 2.5-3.0 and 2.4-3.1 for MP and IP GPs at 330 MHz. We also correlated the GPs at 1.2 GHz with GPs from the Robert C. Byrd Green Bank Telescope (GBT), which were obtained simultaneously at a higher frequency (8.9 GHz) over a span of 26 hr. In total, 7933 GPs from the 43 m telescope at 1.2 GHz and 39,900 GPs from the GBT were recorded during these contemporaneous observations. At 1.2 GHz, 236 (3%) MP GPs and 23 (5%) IP GPs were detected at 8.9 GHz, both with zero chance probability. Another 15 (4%) low-frequency IP GPs were detected within one spin period of high-frequency IP GPs, with a chance probability of 9%. This indicates that the emission processes at high and low radio frequencies are related, despite significant pulse profile shape differences. The 43 m GPs were also correlated with Fermi {gamma}-ray photons to see if increased pair production in the magnetosphere is the mechanism responsible for GP emission. A total of 92,022 GPs and 393 {gamma}-ray photons were used in this correlation analysis. No significant correlations were found between GPs and {gamma}-ray photons. This indicates that increased pair production in the magnetosphere is likely not the dominant cause of GPs. Possible methods of GP production may be increased coherence of synchrotron emission or changes in beaming direction.

  2. Automatic detection of plaques with severe stenosis in coronary vessels of CT angiography

    NASA Astrophysics Data System (ADS)

    Dinesh, M. S.; Devarakota, Pandu; Kumar, Jitendra

    2010-03-01

    Coronary artery disease is the end result of the accumulation of atheromatous plaques within the walls of coronary arteries and is the leading cause of death worldwide. Computed tomography angiography (CTA) has been proved to be very useful for accurate noninvasive diagnosis and quantification of plaques. However, the existing methods to measure the stenosis in the plaques are not accurate enough in mid and distal segments where the vessels become narrower. To alleviate this, we propose a method that consists of three stages namely, automatic extraction of coronary vessels; vessels straightening; lumen extraction and stenosis evaluation. In the first stage, the coronary vessels are segmented using a parametric approach based on circular vessel model at each point on the centerline. It is assumed that centerline information is available in advance. Vessel straightening in the second stage performs multi-planar reformat (MPR) to straighten the curved vessels. MPR view of a vessel helps to visualize and measure the plaques better. On the straightened vessel, lumen and vessel wall are segregated using a nearest neighbor classification. To detect the plaques with severe stenosis in the vessel lumen, we propose a "Diameter Luminal Stenosis" method for analyzing the smaller segments of the vessel. Proposed measurement technique identifies the segments that have plaques and reports the top three severely stenosed segments. Proposed algorithm is applied on 24 coronary vessels belonging to multiple cases acquired from Sensation 64 - slice CT and initial results are promising.

  3. The Implication of Coronary Artery Calcium Testing for Cardiovascular Disease Prevention and Diabetes

    PubMed Central

    Gupta, Ankur; Rana, Jamal S.; Nasir, Khurram

    2017-01-01

    Over the last two decades coronary artery calcium (CAC) scanning has emerged as a quick, safe, and inexpensive method to detect the presence of coronary atherosclerosis. Data from multiple studies has shown that compared to individuals who do not have any coronary calcifications, those with severe calcifications (i.e., CAC score >300) have a 10-fold increase in their risk of coronary heart disease events and cardiovascular disease. Conversely, those that have a CAC of 0 have a very low event rate (~0.1%/year), with data that now extends to 15 years in some studies. Thus, the most notable implication of identifying CAC in individuals who do not have known cardiovascular disease is that it allows targeting of more aggressive therapies to those who have the highest risk of having future events. Such identification of risk is especially important for individuals who are not on any therapies for coronary heart disease, or when intensification of treatment is being considered but has an uncertain role. This review will highlight some of the recent data on CAC testing, while focusing on the implications of those findings on patient management. The evolving role of CAC in patients with diabetes will also be highlighted. PMID:28345316

  4. Giant Angiokeratoma of Fordyce over the Vulva in a Middle-Aged Woman: Case Report and Review of Literature

    PubMed Central

    Kudur, Mohan H; Hulmani, Manjunath

    2013-01-01

    Angiokeratoma of Fordyce occurring over vulva is rare. Angiokeratoma of Fordyce commonly occurs in males over scrotum or penile shaft and presents as multiple verrucous reddish papules. They are usually asymptomatic and noticed accidentally. In the present article, we present and review the literature of giant angiokeratoma of Fordyce in middle-aged women due to its rarity. PMID:23723496

  5. a Survey of Giant Resonance Excitations with 200 Mev Protons

    NASA Astrophysics Data System (ADS)

    Tinsley, James Royce

    The giant resonance region in ('60)Ni, ('90)Zr, ('120)Sn, and ('208)Pb has been studied using inelastic scattering of 200 MeV protons. Angular distributions were obtained for the giant quadrupole resonance, giant octupole resonance, and for the combined giant dipole and giant monopole resonance between 4 and 20 degrees. The 2(H/2PI)(omega) component of the giant hexadecapole resonance has been directly observed for the first time in ('208)Pb. In the other nuclei, upper limits on the amount of hexadecapole strength contained within the giant quadrupole resonance have been obtained. Peaks are observed in ('60)Ni and ('90)Zr that are consistent with recently reported M1 states. Discrepancies between sum rules extracted from this data and from previous work are discussed. Possible explanations include DWBA breakdown or difficulties in estimating the magnitude of the continuum. Systematics obtained for the giant resonances are compared to earlier work.

  6. What Are Polymyalgia Rheumatica and Giant Cell Arteritis?

    MedlinePlus

    ... permanently damaged. There is also a risk of blindness or stroke. Early symptoms of giant cell arteritis ... giant cell arteritis are more likely to develop blindness. The likelihood of getting these conditions peaks between ...

  7. Anomalous Single Coronary Artery Presenting with Acute Myocardial Infarction

    PubMed Central

    Ramachandran, Padmakumar; Krishnan, Anand Muthu; Chowdary, Ravella Keerthika; Malpe, Umesh Pai

    2016-01-01

    The anomalous origin of the entire coronary system from the right coronary sinus is a very rare anomaly. Here a patient with this rare anomaly, who developed acute coronary syndrome, requiring revascularization, is presented and treated successfully. His coronary angiographic findings are also discussed. We would like to highlight the rarity of the origin of all 3 coronary arteries from a single coronary trunk. The case also highlights the importance of using Amplantzer AR1 guiding catheter for such anatomical variations arising in the right coronary cusp. PMID:28208910

  8. Woven coronary artery: a case report and review of literature.

    PubMed

    Kursaklioglu, Hurkan; Iyisoy, Atila; Celik, Turgay

    2006-10-26

    Woven coronary artery is an extremely rare and clearly undefined coronary malformation. Up to now, very few cases have been reported. In this anomaly, epicardial coronary artery are branched into thin channels at any segment of the coronary artery and then these longitudinal twisted thin channels merge again as the main coronary lumen. This anomaly is regarded as a benign condition since there is completely normal blood flow after the distal segment of the abnormal coronary artery. In this case report, we present a 48-year-old male patient with a woven coronary artery anomaly in the circumflex artery and who had been followed up for 5 years.

  9. Lithium and chromospherically active single giants

    NASA Technical Reports Server (NTRS)

    Fekel, Francis C.

    1988-01-01

    Nine chromospherically active single K giants were identified from surveys of chromospherically active stars. The stars have v sin i's ranging from 6 to 46 km/sec. Such large velocities are not explained by scenarios of main sequence to giant star evolution. Fluxes of the ultraviolet emission lines of these stars are substantially less than those of FK Comae. Many of these giants have a moderate or strong lithium line strongly suggesting that these stars recently evolved from rapidly rotating A or early F stars as is suggested by their space motions. Thus, they are not spun down FK Com stars. The characteristics of these stars are such that they may be confused with pre-main sequence stars. The primary difference may be that the post main sequence stars have strong H alpha absorption lines while the pre-main sequence stars appear to have a weak H alpha absorption line or possibly H alpha in emission above the continuum.

  10. Heavy elements and mixing in red giants

    NASA Astrophysics Data System (ADS)

    Smith, Verne V.

    A brief overview of the s-process in red giants is presented, followed by discussions of three specific topics involving heavy-element s-process nucleosynthesis and mixing in red giants: (1) a comparison of neutron densities derived from observations and from the most recent stellar models, (2) how observations of technetium in S stars have led to a natural division of these stars into two separate groups, one of which is the result of single-star stellar evolution while the other is the result of mass transfer in a binary system, (3) a brief discussion of the recent speculative suggestion that gamma-ray induced photofission of heavy elements (Th and U) might be a source of the Tc observed in certain types of red giants.

  11. Trace Molecules in Giant Planet Atmospheres

    NASA Astrophysics Data System (ADS)

    Huestis, D. L.; Smith, G. P.

    2010-12-01

    Chemical kinetics matters in the upper atmospheres of giant planets in our solar system and in extrasolar systems. The composition of a volume of gas depends not only on where it is, but also on how it got there. The giant planets in our own solar system still have much to teach us about what we will be observing on extrasolar giant planets and how to interpret what we observe. Some molecules, such as CO, C2H2, C2H6, PH3, and NH3, which we call tracer molecules, provide remotely observable signatures of vertical transport. PH3 and NH3 especially have complicated thermochemistry and chemical kinetics that, until recently, have been poorly understood. Based on analysis of recent literature, we have identified new chemical mechanisms for interconverting NH3 and N2 and for interconverting PH3 and NH4-H2PO4.

  12. Compositional constraints on giant planet formation

    NASA Astrophysics Data System (ADS)

    Owen, Tobias; Encrenaz, Therese

    2006-10-01

    Using Ockham's razor as a guide, we have tried to find the simplest model for the formation of giant planets that can explain current observations of atmospheric composition. While this "top-down" approach is far from sufficient to define such models, it establishes a set of boundary conditions whose satisfaction is necessary. Using Jupiter as the prototype, we find that a simple model for giant planet formation that begins with a solar nebula of uniform composition and relies on accretion of low temperature icy planetesimals plus collapse of surrounding solar nebula gas supplies that satisfaction. We compare the resulting predictions of elemental abundances and isotope ratios in the atmospheres of the other giants with those from contrasting models and suggest some key measurements to make further progress.

  13. ɛ Ophiuchi: Revisiting a Red Giant

    NASA Astrophysics Data System (ADS)

    Kallinger, T.; Matthews, J. M.; Guenther, D. B.; Gruberbauer, M.; Kuschnig, R.; Weiss, W. W.; MOST Team

    2012-09-01

    In only a decade, seismology of red-giant stars has grown from infancy to adulthood in the study of stellar structure and evolution. The stimulants for this accelerated growth have been space observations, first provided by the WIRE star-tracker and MOST, and continuing with CoRoT and Kepler, having detected oscillations in thousands of cool giants. However, almost all of the stars in this impressive sample are faint, with little known about their basic properties. Even reliable spectral classifications are lacking for many of them. MOST is the only space-based photometer capable of continuous observations of bright red giants for which we have independent constraints (e.g., spectroscopy) essential to extract the internal structure from the stars' p-modes.

  14. On the shape of giant soap bubbles.

    PubMed

    Cohen, Caroline; Darbois Texier, Baptiste; Reyssat, Etienne; Snoeijer, Jacco H; Quéré, David; Clanet, Christophe

    2017-03-07

    We study the effect of gravity on giant soap bubbles and show that it becomes dominant above the critical size [Formula: see text], where [Formula: see text] is the mean thickness of the soap film and [Formula: see text] is the capillary length ([Formula: see text] stands for vapor-liquid surface tension, and [Formula: see text] stands for the liquid density). We first show experimentally that large soap bubbles do not retain a spherical shape but flatten when increasing their size. A theoretical model is then developed to account for this effect, predicting the shape based on mechanical equilibrium. In stark contrast to liquid drops, we show that there is no mechanical limit of the height of giant bubble shapes. In practice, the physicochemical constraints imposed by surfactant molecules limit the access to this large asymptotic domain. However, by an exact analogy, it is shown how the giant bubble shapes can be realized by large inflatable structures.

  15. Asymptomatic post-rheumatic giant left atrium

    PubMed Central

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-01-01

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m2 for the definition of a “giant left atrium”. PMID:27354895

  16. Solitary giant neurofibroma of the scalp with calvarial defect in a child.

    PubMed

    Ismail, N J; Shehu, B B; Lasseini, A; Hassan, I; Shilong, D J; Obande, J O; Sahabi, S M

    2010-01-01

    Neurofibroma of the scalp are mostly multiple as part of neurofibromatosis or other phakomatosis. De novo solitary types are less common and rarely erode the skull, unlike the intracranial counterpart. Skull erosion has been reported in adults with longstanding plexiform neurofibromas. We report a giant neurofibroma on the scalp of a five-year-old boy, managed in our center. Although this condition is a rare entity, it should be anticipated and the treatment strategy should include repair of the skull defect.

  17. Saphenous vein patch for correction of anomalous origin of the right coronary artery from the left main coronary artery

    PubMed Central

    AlQuadan, Obadah F.; AlSmady, Moaath M.; Saleh, Suhayl S.; Aqel, Raed A.; Al-Antary, Eman T.

    2017-01-01

    Anomalous origin of the coronary arteries is a rare congenital heart defect that may lead to disturbed life style, myocardial infarction and sudden death. This report describes a young lady with the right coronary artery arising from the left main coronary artery, which was confirmed by coronary angiography and corrected surgically using saphenous vein patch. PMID:28096325

  18. LITHIUM-RICH GIANTS IN GLOBULAR CLUSTERS

    SciTech Connect

    Kirby, Evan N.; Cohen, Judith G.; Guhathakurta, Puragra; Hong, Jerry; Guo, Michelle; Guo, Rachel; Cunha, Katia

    2016-03-10

    Although red giants deplete lithium on their surfaces, some giants are Li-rich. Intermediate-mass asymptotic giant branch (AGB) stars can generate Li through the Cameron–Fowler conveyor, but the existence of Li-rich, low-mass red giant branch (RGB) stars is puzzling. Globular clusters are the best sites to examine this phenomenon because it is straightforward to determine membership in the cluster and to identify the evolutionary state of each star. In 72 hours of Keck/DEIMOS exposures in 25 clusters, we found four Li-rich RGB and two Li-rich AGB stars. There were 1696 RGB and 125 AGB stars with measurements or upper limits consistent with normal abundances of Li. Hence, the frequency of Li-richness in globular clusters is (0.2 ± 0.1)% for the RGB, (1.6 ± 1.1)% for the AGB, and (0.3 ± 0.1)% for all giants. Because the Li-rich RGB stars are on the lower RGB, Li self-generation mechanisms proposed to occur at the luminosity function bump or He core flash cannot explain these four lower RGB stars. We propose the following origin for Li enrichment: (1) All luminous giants experience a brief phase of Li enrichment at the He core flash. (2) All post-RGB stars with binary companions on the lower RGB will engage in mass transfer. This scenario predicts that 0.1% of lower RGB stars will appear Li-rich due to mass transfer from a recently Li-enhanced companion. This frequency is at the lower end of our confidence interval.

  19. Lithium-rich Giants in Globular Clusters

    NASA Astrophysics Data System (ADS)

    Kirby, Evan N.; Guhathakurta, Puragra; Zhang, Andrew J.; Hong, Jerry; Guo, Michelle; Guo, Rachel; Cohen, Judith G.; Cunha, Katia

    2016-03-01

    Although red giants deplete lithium on their surfaces, some giants are Li-rich. Intermediate-mass asymptotic giant branch (AGB) stars can generate Li through the Cameron-Fowler conveyor, but the existence of Li-rich, low-mass red giant branch (RGB) stars is puzzling. Globular clusters are the best sites to examine this phenomenon because it is straightforward to determine membership in the cluster and to identify the evolutionary state of each star. In 72 hours of Keck/DEIMOS exposures in 25 clusters, we found four Li-rich RGB and two Li-rich AGB stars. There were 1696 RGB and 125 AGB stars with measurements or upper limits consistent with normal abundances of Li. Hence, the frequency of Li-richness in globular clusters is (0.2 ± 0.1)% for the RGB, (1.6 ± 1.1)% for the AGB, and (0.3 ± 0.1)% for all giants. Because the Li-rich RGB stars are on the lower RGB, Li self-generation mechanisms proposed to occur at the luminosity function bump or He core flash cannot explain these four lower RGB stars. We propose the following origin for Li enrichment: (1) All luminous giants experience a brief phase of Li enrichment at the He core flash. (2) All post-RGB stars with binary companions on the lower RGB will engage in mass transfer. This scenario predicts that 0.1% of lower RGB stars will appear Li-rich due to mass transfer from a recently Li-enhanced companion. This frequency is at the lower end of our confidence interval. 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.

  20. Spontaneous healing of spontaneous coronary artery dissection.

    PubMed

    Almafragi, Amar; Convens, Carl; Heuvel, Paul Van Den

    2010-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and sudden cardiac death. It should be suspected in every healthy young woman without cardiac risk factors, especially during the peripartum or postpartum periods. It is important to check for a history of drug abuse, collagen vascular disease or blunt trauma of the chest. Coronary angiography is essential for diagnosis and early management. We wonder whether thrombolysis might aggravate coronary dissection. All types of treatment (medical therapy, percutaneous intervention or surgery) improve the prognosis without affecting survival times if used appropriately according to the clinical stability and the angiographic features of the involved coronary arteries. Prompt recognition and targeted treatment improve outcomes. We report a case of SCAD in a young female free of traditional cardiovascular risk factors, who presented six hours after thrombolysis for ST elevation myocardial infarction. Coronary angiography showed a dissection of the left anterior descending and immediate branch. She had successful coronary artery bypass grafting, with complete healing of left anterior descending dissection.

  1. Percutaneous transradial artery approach for coronary stent implantation.

    PubMed

    Kiemeneij, F; Laarman, G J

    1993-10-01

    A new approach for implantation of Palmaz Schatz coronary stents is reported. We describe the technique and rationale of coronary stenting with miniaturized angioplasty equipment via the radial artery. This technique is illustrated in three patients. One patient underwent Palmaz Schatz stent implantation for a saphenous vene coronary bypass graft stenosis, the second patient for a restenosis in the anterior descending coronary artery after atherectomy, and the third patient for a second restenosis after balloon angioplasty in the circumflex coronary artery.

  2. [Giant cell arteritis--case report].

    PubMed

    Napora, Katarzyna J; Obuchowska, Iwona; Mariak, Zofia

    2008-01-01

    Giant cell arteritis is a systemic disease of unknown origin. Vasculitis involves large and medium-sized vessels. Frequent clinical manifestations include characteristic headache in the temporal area, jaw or tongue claudication, apathy, fatigue, weight loss. The incidence of ocular involvement is reported in up to 70% patients. The most common and serious ophthalmic presentation is arteritic anterior ischemic optic neuropathy, which can lead to irreversible visual loss. Only early and aggressive steroid therapy may prevent this dangerous complication. The authors presented a case of a 68-years-old woman with giant cell arteritis. The main visual manifestation of this disease was anterior ischemic optic neuropathy.

  3. A giant Pseudomonas phage from Poland.

    PubMed

    Drulis-Kawa, Zuzanna; Olszak, Tomasz; Danis, Katarzyna; Majkowska-Skrobek, Grazyna; Ackermann, Hans-W

    2014-03-01

    A novel giant phage of the family Myoviridae is described. Pseudomonas phage PA5oct was isolated from a sewage sample from an irrigated field near Wroclaw, Poland. The virion morphology indicates that PA5oct differs from known giant phages. The phage has a head of about 131 nm in diameter and a tail of 136 × 19 nm. Phage PA5oct contains a genome of approximately 375 kbp and differs in size from any tailed phages known. PA5oct was further characterized by determination of its latent period and burst size and its sensitivity to heating, chloroform, and pH.

  4. Isoscalar giant resonances in {sup 48}Ca

    SciTech Connect

    Lui, Y.-W.; Youngblood, D. H.; Shlomo, S.; Chen, X.; Tokimoto, Y.; Krishichayan,; Anders, M.; Button, J.

    2011-04-15

    The giant resonance region from 9.5 MeV < E{sub x} < 40 MeV in {sup 48}Ca has been studied with inelastic scattering of 240-MeV {alpha} particles at small angles, including 0 deg. 95{sub -15}{sup +11}% of E0 energy-weighted sum rule (EWSR), 83{sub -16}{sup +10}% of E2 EWSR, and 137 {+-} 20% of E1 EWSR were located below E{sub x}=40 MeV. A comparison of the experimental data with calculated results for the isoscalar giant monopole resonance, obtained within the mean-field-based random-phase approximation, is also given.

  5. Giant-cell lesions of the facial bones

    SciTech Connect

    Som, P.M.; Lawson, W.; Cohen, B.A.

    1983-04-01

    Giant-cell lesions of the paranasal sinuses, including the giant-cell reparative granuloma, the brown tumor of hyperparathyroidism, the true giant-cell tumor, cherubism, and the aneurysmal bone cyst, are uncommon entities. Plain radiographic and computed-tomographic studies of these lesions are described and the differential diagnosis is discussed.

  6. Syphilitic Coronary Artery Ostial Stenosis Resulting in Acute Myocardial Infarction Treated by Percutaneous Coronary Intervention

    PubMed Central

    Nakazone, Marcelo A.; Machado, Maurício N.; Barbosa, Raphael B.; Santos, Márcio A.; Maia, Lilia N.

    2010-01-01

    Cardiovascular abnormalities are well-known manifestations of tertiary syphilis infections which although not frequent, are still causes of morbidity and mortality. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 46-year-old male admitted due to acute anterior ST elevation myocardial infarction submitted to primary percutaneous coronary intervention successfully. Coronary angiography showed a suboccluded ostial lesion of left main coronary artery. VDRL was titrated to 1/512. The patient was discharged with treatment including benzathine penicillin. Previous case reports of acute myocardial infarction in association with syphilitic coronary artery ostial stenosis have been reported, but the fact that the patient was treated by percutaneous coronary intervention is unique in this case. PMID:21052501

  7. Coronary artery bypass is superior to drug-eluting stents in multivessel coronary artery disease.

    PubMed

    Guyton, Robert A

    2006-06-01

    Percutaneous intervention for the treatment of multivessel coronary artery disease continues to displace coronary artery bypass graft surgery. But controlled trials of percutaneous intervention versus coronary bypass, in meta-analysis, have shown a significant survival advantage for coronary bypass. Studies of bare metal stents have not presented any data to prompt reversal of this conclusion for all but the small portion of patients most suited for stenting. Drug-eluting stents have no survival advantage compared with bare metal stents. Data from real-world registries have shown that the current therapy of multivessel disease patients has resulted in a relative excess mortality of as much as 46% in patients with initial stenting compared with patients with initial coronary bypass. Ethical considerations demand that patients with multivessel disease be informed of the documented mortality benefit of coronary bypass graft surgery.

  8. Benefits of exercise training on coronary blood flow in coronary artery disease patients

    PubMed Central

    Bruning, Rebecca S.; Sturek, Michael

    2014-01-01

    Every 34 seconds an American experiences a myocardial infarction or cardiac death. Approximately 80% of these coronary artery disease (CAD)-related deaths are attributable to modifiable behaviors, such as a lack of physical exercise training (ET). Regular ET decreases CAD morbidity and mortality through systemic and cardiac-specific adaptations. ET increases myocardial oxygen demand acting as a stimulus to increase coronary blood flow and thus myocardial oxygen supply, which reduces myocardial infarction and angina. ET augments coronary blood flow through direct actions on the vasculature that improve endothelial and coronary smooth muscle function, enhancing coronary vasodilation. Additionally, ET promotes collateralization, thereby, increasing blood flow to ischemic myocardium and also treats macrovascular CAD by attenuating the progression of coronary atherosclerosis and restenosis, potentially through stabilization of atherosclerotic lesions. In summary, ET can be used as a relatively safe and inexpensive way to prevent and treat CAD. PMID:25446554

  9. MAPPING DIRECTLY IMAGED GIANT EXOPLANETS

    SciTech Connect

    Kostov, Veselin; Apai, Daniel

    2013-01-01

    With the increasing number of directly imaged giant exoplanets, the current atmosphere models are often not capable of fully explaining the spectra and luminosity of the sources. A particularly challenging component of the atmosphere models is the formation and properties of condensate cloud layers, which fundamentally impact the energetics, opacity, and evolution of the planets. Here we present a suite of techniques that can be used to estimate the level of rotational modulations these planets may show. We propose that the time-resolved observations of such periodic photometric and spectroscopic variations of extrasolar planets due to their rotation can be used as a powerful tool to probe the heterogeneity of their optical surfaces. In this paper, we develop simulations to explore the capabilities of current and next-generation ground- and space-based instruments for this technique. We address and discuss the following questions: (1) what planet properties can be deduced from the light curve and/or spectra, and in particular can we determine rotation periods, spot coverage, spot colors, and spot spectra?; (2) what is the optimal configuration of instrument/wavelength/temporal sampling required for these measurements?; and (3) can principal component analysis be used to invert the light curve and deduce the surface map of the planet? Our simulations describe the expected spectral differences between homogeneous (clear or cloudy) and patchy atmospheres, outline the significance of the dominant absorption features of H{sub 2}O, CH{sub 4}, and CO, and provide a method to distinguish these two types of atmospheres. Assuming surfaces with and without clouds for most currently imaged planets the current models predict the largest variations in the J band. Simulated photometry from current and future instruments is used to estimate the level of detectable photometric variations. We conclude that future instruments will be able to recover not only the rotation periods

  10. Perturbation of Compact Planetary Systems by Distant Giant Planets

    NASA Astrophysics Data System (ADS)

    Hansen, Bradley M. S.

    2017-01-01

    We examine the effect of secular perturbations by giant planets on systems of multiple, lower mass planets orbiting Sun-like stars and compare our results to the statistics of the observed Kepler data. We cannot reproduce the observed excess of single transitting planets by pumping only inclination without driving most systems to dynamical instability. Thus we expect the underlying planetary population for single transitting planets to contain an intrinsically low multiplicity component. We can reproduce the Kepler statistics and occurrence rates for R < 2R⊕ planets with a perturber population consistent with that inferred from radial velocity surveys, but require too many giant planets if we wish to explain all planets with R < 4R⊕. These numbers can be brought into agreement if we posit the existence of an equivalent size population of planets below the RV detection limit (of characteristic mass ˜0.1MJ). This population would need to be dynamically hot to produce sufficiently strong perturbations and would leave the imprint of high obliquities and eccentricities amongst the surviving planets. The histories of our perturbed populations also produce a significant number of planets that are lost by collision with the star and some that are driven to short orbital periods by the combined action of secular evolution and tidal dissipation. Some of our simulations also produce planetary systems with planets that survive in the habitable zone but have no planets interior to them - much as in the case of our Solar System. Such configurations may occur around a few percent of FGK stars.

  11. Stent-based percutaneous coronary interventions in small coronary arteries.

    PubMed

    Roguin, Ariel; Grenadier, Ehud

    2006-01-01

    A third to half of all percutaneous coronary interventions involve small diameter vessels of less than 3 mm. Small vessel size is a predictor of restenosis after balloon angioplasty, as well as after stent placement. Stents deployed in small arteries, have a higher metal-to-artery ratio; this may increase the risk of sub-acute thrombosis or restenosis. Various studies have shown that stent design, stent coating, and stent strut thickness may determine event-free survival. Dedicated stents for small vessels with less amount of metal, appropriate expansion to the vessel size with correct radial force and cells morphology, and less prothrombotic properties, may further improve the results of stenting in this setting (thinner struts, fewer cells, or loops per circumference). This review provides an update on the current status, review the major trials and define the clinical utility of small vessel stenting, particularly in the era of drug-eluting stents.

  12. Rudimentary coronary artery in Syrian hamsters (Mesocricetus auratus).

    PubMed

    Durán, A C; Arqué, J M; Fernández, B; Fernández, M C; Fernández-Gallego, T; Rodríguez, C; Sans-Coma, V

    2009-08-01

    Congenital underdevelopment of one or more main branches of the coronary arteries has been reported in man, but not in non-human mammals. In man, this defective coronary artery arrangement may cause myocardial ischaemia and even sudden death. The main goal of this study was to describe the coronary artery distribution patterns associated with the presence of a markedly underdeveloped (rudimentary) coronary artery in Syrian hamsters. Moreover, an attempt was made to explain the morphogenesis of these patterns, according to current knowledge on coronary artery development. Eleven affected hamsters belonging to a laboratory inbred family were examined by means of internal casts of the heart, great arterial trunks and coronary arteries. The aortic valve was tricuspid (normal) in seven hamsters and bicuspid in the other four. A rudimentary coronary artery arose from the right side of the aortic valve in four specimens, from the left side of the aortic valve in a further three, and from the dorsal aortic sinus in the remaining four. In all cases, a second, well-developed coronary artery provided for all the coronary blood flow. Except for the existence of a rudimentary coronary artery, the present anomalous coronary artery distribution patterns are similar to coronary artery patterns reported in Syrian hamsters, dogs and humans in association with a solitary coronary ostium in aorta. We suggest that an unusual prolonged time interval in the development of the embryonic coronary stems might be a key factor in the formation of coronary arteries displaying significantly dissimilar developmental degrees.

  13. Allergic acute coronary syndrome (Kounis syndrome)

    PubMed Central

    Chhabra, Lovely; Masrur, Shihab; Parker, Matthew W.

    2015-01-01

    Anaphylaxis rarely manifests as a vasospastic acute coronary syndrome with or without the presence of underlying coronary artery disease. The variability in the underlying pathogenesis produces a wide clinical spectrum of this syndrome. We present three cases of anaphylactic acute coronary syndrome that display different clinical variants of this phenomenon. The main pathophysiological mechanism of the allergic anginal syndromes is the inflammatory mediators released during a hypersensitivity reaction triggered by food, insect bites, or drugs. It is important to appropriately recognize and treat Kounis syndrome in patients with exposure to a documented allergen. PMID:26130889

  14. Polarization of Directly Imaged Young Giant Planets as a Probe of Mass, Rotation, and Clouds

    NASA Technical Reports Server (NTRS)

    Marley, Mark Scott; Sengupta, Sujan

    2012-01-01

    Young, hot gas giant planets at large separations from their primaries have been directly imaged around several nearby stars. More such planets will likely be detected by ongoing and new imaging surveys with instruments such as the Gemini Planet Imager (GPI). Efforts continue to model the spectra of these planets in order to constrain their masses, effective temperatures, composition, and cloud structure. One potential tool for analyzing these objects, which has received relatively less attention, is polarization. Linear polarization of gas giant exoplanets can arise from the combined influences of light scattering by atmospheric dust and a rotationally distorted shape. The oblateness of gas giant planet increases of course with rotation rate and for fixed rotation also rises with decreasing gravity. Thus young, lower mass gas giant planets with youthful inflated radii could easily have oblateness greater than that of Saturn s 10%. We find that polarizations of over 1% may easily be produced in the near-infrared in such cases. This magnitude of polarization may be measurable by GPI and other instruments. Thus if detected, polarization of a young Jupiter places constraints on the combination of its gravity, rotation rate, and degree of cloudiness. We will present results of our multiple scattering analysis coupled with a self-consistent dusty atmospheric models to demonstrate the range of polarizations that might be expected from resolved exoplanets and the range of parameter space that such observations may inform.

  15. Giant panda׳s tooth enamel: Structure, mechanical behavior and toughening mechanisms under indentation.

    PubMed

    Weng, Z Y; Liu, Z Q; Ritchie, R O; Jiao, D; Li, D S; Wu, H L; Deng, L H; Zhang, Z F

    2016-12-01

    The giant panda׳s teeth possess remarkable load-bearing capacity and damage resistance for masticating bamboos. In this study, the hierarchical structure and mechanical behavior of the giant panda׳s tooth enamel were investigated under indentation. The effects of loading orientation and location on mechanical properties of the enamel were clarified and the evolution of damage in the enamel under increasing load evaluated. The nature of the damage, both at and beneath the indentation surfaces, and the underlying toughening mechanisms were explored. Indentation cracks invariably were seen to propagate along the internal interfaces, specifically the sheaths between enamel rods, and multiple extrinsic toughening mechanisms, e.g., crack deflection/twisting and uncracked-ligament bridging, were active to shield the tips of cracks from the applied stress. The giant panda׳s tooth enamel is analogous to human enamel in its mechanical properties, yet it has superior hardness and Young׳s modulus but inferior toughness as compared to the bamboo that pandas primarily feed on, highlighting the critical roles of the integration of underlying tissues in the entire tooth and the highly hydrated state of bamboo foods. Our objective is that this study can aid the understanding of the structure-mechanical property relations in the tooth enamel of mammals and further provide some insight on the food habits of the giant pandas.

  16. Pathological and microbiological findings from mortality of the Chinese giant salamander (Andrias davidianus).

    PubMed

    Meng, Yan; Ma, Jie; Jiang, Nan; Zeng, Ling-Bing; Xiao, Han-Bing

    2014-06-01

    The Chinese giant salamander, Andrias davidianus, is a nationally protected and cultured species in China. Recently, a severe epizootic occurred in cultured Chinese giant salamanders in Hubei, Hunan, Sichuan, Shaanxi, and Zhejiang provinces of China, causing substantial economic losses. The typical clinical signs of diseased larval animals were jaw and abdominal swelling and subcutaneous hemorrhaging. Diseased adult animals exhibited skin hemorrhages, ulceration of the hind limbs, and multiple hemorrhagic spots in the visceral organs. Histopathological observation indicated tissue necrosis and cytoplasmic inclusions in the spleen, liver and kidney, suggestive of viral disease. A viral agent was isolated from affected tissues in cell culture. The virus was determined to be pathogenic after experimental infection. Electron microscopy revealed iridovirus-like virions with a size of 140-180 nm in diameter inside the kidney of naturally infected animals and in cell culture. The major capsid protein (MCP) of the virus exhibited 98-99 % sequence identity to ranaviruses. Additionally, phylogenetic analysis indicated that the virus belonged to the genus Ranavirus. Comparative analysis of the MCP gene sequence with those of other viruses previously isolated from Chinese giant salamanders revealed that these isolates were highly similar, although a few variations were observed. The virus was preliminarily named Chinese giant salamander iridovirus (GSIV).

  17. Analysis of the cytochrome c oxidase subunit II (COX2) gene in giant panda, Ailuropoda melanoleuca.

    PubMed

    Ling, S S; Zhu, Y; Lan, D; Li, D S; Pang, H Z; Wang, Y; Li, D Y; Wei, R P; Zhang, H M; Wang, C D; Hu, Y D

    2017-01-23

    The giant panda, Ailuropoda melanoleuca (Ursidae), has a unique bamboo-based diet; however, this low-energy intake has been sufficient to maintain the metabolic processes of this species since the fourth ice age. As mitochondria are the main sites for energy metabolism in animals, the protein-coding genes involved in mitochondrial respiratory chains, particularly cytochrome c oxidase subunit II (COX2), which is the rate-limiting enzyme in electron transfer, could play an important role in giant panda metabolism. Therefore, the present study aimed to isolate, sequence, and analyze the COX2 DNA from individuals kept at the Giant Panda Protection and Research Center, China, and compare these sequences with those of the other Ursidae family members. Multiple sequence alignment showed that the COX2 gene had three point mutations that defined three haplotypes, with 60% of the sequences corresponding to haplotype I. The neutrality tests revealed that the COX2 gene was conserved throughout evolution, and the maximum likelihood phylogenetic analysis, using homologous sequences from other Ursidae species, showed clustering of the COX2 sequences of giant pandas, suggesting that this gene evolved differently in them.

  18. Transradial approach for coronary angiography and interventions in patients with coronary bypass grafts: tips and tricks.

    PubMed

    Burzotta, Francesco; Trani, Carlo; Hamon, Martial; Amoroso, Giovanni; Kiemeneij, Ferdinand

    2008-08-01

    Among patients undergoing coronary procedures, patients with coronary artery bypass grafts represent an important, high risk subgroup. Routine transradial approach may be successfully adopted in these patients to reduce access-site complications. However, transradial cannulation of the grafts may result technically demanding. In this article we discuss the specific technical issues and we present a series of tips and tricks which may facilitate angiography and interventions on both internal mammary and aorto-coronary grafts.

  19. Unusual Malignant Coronary Artery Anomaly: Results of Coronary Angiography, MR Imaging, and Multislice CT

    SciTech Connect

    Apitzsch, Jonas; Kuehl, Harald P.; Muehlenbruch, Georg; Mahnken, Andreas H.

    2010-04-15

    We report the case of a man with an uncommon anomaly of the origin and course of the left coronary artery. Clinical, coronary angiography, magnetic resonance imaging, and multislice computed tomography findings of this intermittently symptomatic 49 year-old patient with the rare anomaly of his left coronary artery stemming from the right sinus of Valsalva and taking an interarterial and intraseptal course are presented. The diagnostic value of the different imaging modalities is discussed.

  20. Direct communication between the left circumflex and the right coronary arteries: a very rare coronary anomaly circulation

    PubMed Central

    Oliveira, Marcos Danillo Peixoto; Cavalcanti, Rafael R. César; Kajita, Alexandre H.; Miranda, Thais; Kajita, Luiz J.; Horta, Pedro E.; Ribeiro, Expedito E.

    2016-01-01

    Coronary artery anomalies (CAA) are congenital changes in their origin, course, and/or structure. Intercoronary communication (ICC) is a very rare subset with uni- or bidirectional blood flow between two or more coronary arteries. We present the case of a 58-year-old man with an acute coronary syndrome whose coronary angiography incidentally showed a surprising and very rare communication between the right coronary and left circumflex arteries. PMID:26885496

  1. The coronary circulation in exercise training

    PubMed Central

    Bowles, Douglas K.; Duncker, Dirk J.

    2012-01-01

    Exercise training (EX) induces increases in coronary transport capacity through adaptations in the coronary microcirculation including increased arteriolar diameters and/or densities and changes in the vasomotor reactivity of coronary resistance arteries. In large animals, EX increases capillary exchange capacity through angiogenesis of new capillaries at a rate matched to EX-induced cardiac hypertrophy so that capillary density remains normal. However, after EX coronary capillary exchange area is greater (i.e., capillary permeability surface area product is greater) at any given blood flow because of altered coronary vascular resistance and matching of exchange surface area and blood flow distribution. The improved coronary capillary blood flow distribution appears to be the result of structural changes in the coronary tree and alterations in vasoreactivity of coronary resistance arteries. EX also alters vasomotor reactivity of conduit coronary arteries in that after EX, α-adrenergic receptor responsiveness is blunted. Of interest, α- and β-adrenergic tone appears to be maintained in the coronary microcirculation in the presence of lower circulating catecholamine levels because of increased receptor responsiveness to adrenergic stimulation. EX also alters other vasomotor control processes of coronary resistance vessels. For example, coronary arterioles exhibit increased myogenic tone after EX, likely because of a calcium-dependent PKC signaling-mediated alteration in voltage-gated calcium channel activity in response to stretch. Conversely, EX augments endothelium-dependent vasodilation throughout the coronary arteriolar network and in the conduit arteries in coronary artery disease (CAD). The enhanced endothelium-dependent dilation appears to result from increased nitric oxide bioavailability because of changes in nitric oxide synthase expression/activity and decreased oxidant stress. EX also decreases extravascular compressive forces in the myocardium at rest

  2. Indications, algorithms, and outcomes for coronary artery bypass surgery in patients with acute coronary syndromes

    PubMed Central

    Yerokun, Babatunde A.; Williams, Judson B.; Gaca, Jeffrey; Smith, Peter K.; Roe, Matthew T.

    2016-01-01

    For patients with a non-ST-segment elevation acute coronary syndrome (NSTE-ACS), guideline recommendations and treatment pathways focus on revascularization for definitive treatment if the patient is an appropriate candidate. Despite the widespread use of revascularization for NSTE-ACS, most patients undergo a percutaneous coronary intervention, whereas a minority of patients undergo coronary artery bypass grafting. Focusing specifically on the USA, the contemporary utilization, preoperative and perioperative considerations, and outcomes of NSTE-ACS patients undergoing coronary artery bypass grafting have not been comprehensively reviewed. PMID:26945187

  3. Functional assessment of a left coronary-pulmonary artery fistula by coronary flow reserve

    PubMed Central

    Sasi, Viktor; Forster, Tamás; Ungi, Imre

    2014-01-01

    We report a 71-year-old man who presented with atypical chest pain. Coronary angiography did not reveal left main or proximal left anterior descending coronary artery stenosis, but a fistulous communication with a stronger tube-like fistula was present originating from the proximal left anterior descending coronary artery and emptying into the main pulmonary artery. Fractional flow reserve and coronary flow reserve measurements were performed to gain more data on the potential functional aspects of this fistula. With the present case, the importance of functional evaluation of these fistulas is demonstrated. PMID:25061466

  4. Number of coronary ostia in Syrian hamsters (Mesocricetus auratus) with normal and anomalous coronary arteries.

    PubMed

    Durán, A C; Fernández, M C; Fernández, B; Fernández-Gallego, T; Arqué, J M; Sans-Coma, V

    2007-12-01

    Little attention is being paid to the presence of accessory coronary artery ostia in man and non-human mammals due to their limited clinical relevance. However, information about their frequency and the cardiac territories irrigated by the vessels arising from them is of interest to obtain an accurate survey of the establishment of the coronary artery system in each species. The aim here was to compare the incidence and significance of the accessory coronary ostia in Syrian hamsters with normal coronary arteries and several coronary anomalies characterized by the absence of a left coronary artery originating from the left aortic sinus. The hearts from 2829 hamsters were examined using a corrosion-cast technique, micro-dissection, histochemical techniques, and scanning electron microscopy. Overall, 148 specimens displayed accessory ostia. A limited number of them belonged to the conal artery which supplies the wall of the right ventricular outflow tract. The other accessory ostia led to the septal artery, a vessel which irrigates the most part of the interventricular septum. The incidence of accessory ostia in normal and anomalous coronary artery patterns was quite similar. This suggests that the morphogenetic deviations producing the coronary artery anomalies reported in this study do not alter the connections of the septal and conal arteries to the aorta. The present observations lead to the notion that in the Syrian hamster, the septal artery should be regarded as a third coronary artery.

  5. Early Post-Operative Coronary Thrombosis Following Repair of a Proximal Coronary Artery Fistula

    PubMed Central

    Lau, Bryan; Taub, Cynthia C

    2016-01-01

    Patients with aneurysmal coronary artery fistulas are often a treatment challenge. We hereby, report a case of aneurysmal left main coronary artery to coronary sinus fistula repair, complicated by an early post-operative thrombosis of the left main coronary artery, necessitating an orthotropic heart transplant. Routine use of peri-procedural and long-term anti-coagulation is usually not a standard recommendation in these cases; however, early institution of the same may prevent flow stasis, thrombus formation and unfavourable outcomes pre- or post-operatively. PMID:28208917

  6. [Results of emergency coronary artery bypass surgery after failed coronary angioplasty].

    PubMed

    Imazeki, T; Yokoyama, M; Murai, N; Kurimoto, Y; Sakurada, M; Simizu, Y

    1995-06-01

    In the past 7 years, 9 emergent or urgent coronary artery bypass operations after failed percutaneous transluminal angioplasty (PTCA) were performed among 947 (PTCA). Since the introduction of coronary perfusion catheter system for the support of coronary perfusion during PTCA we could reduce the number of emergent cases and these patients could be operated on semi-emergently and securely without endangering co-medical staffs in a hurry. It is also unnecessary to be on standby all the time when the PTCA is being undertaken. Two acute myocardial infarction cases died in the early phase of this study (operative mortality 22%) and none after the introduction of coronary perfusion system during PTCA.

  7. Coronary DSA: enhancing coronary tree visibility through discriminative learning and robust motion estimation

    NASA Astrophysics Data System (ADS)

    Zhu, Ying; Prummer, Simone; Chen, Terrence; Ostermeier, Martin; Comaniciu, Dorin

    2009-02-01

    Digital subtraction angiography (DSA) is a well-known technique for improving the visibility and perceptibility of blood vessels in the human body. Coronary DSA extends conventional DSA to dynamic 2D fluoroscopic sequences of coronary arteries which are subject to respiratory and cardiac motion. Effective motion compensation is the main challenge for coronary DSA. Without a proper treatment, both breathing and heart motion can cause unpleasant artifacts in coronary subtraction images, jeopardizing the clinical value of coronary DSA. In this paper, we present an effective method to separate the dynamic layer of background structures from a fluoroscopic sequence of the heart, leaving a clean layer of moving coronary arteries. Our method combines the techniques of learning-based vessel detection and robust motion estimation to achieve reliable motion compensation for coronary sequences. Encouraging results have been achieved on clinically acquired coronary sequences, where the proposed method considerably improves the visibility and perceptibility of coronary arteries undergoing breathing and cardiac movement. Perceptibility improvement is significant especially for very thin vessels. The potential clinical benefit is expected in the context of obese patients and deep angulation, as well as in the reduction of contrast dose in normal size patients.

  8. Experience with Biodegradable Polymer Coated Sirolimus-Eluting Coronary Stent System in “Real-Life” Percutaneous Coronary Intervention: 24-Month Data from the Manipal-S Registry

    PubMed Central

    Shetty, Ranjan; Vivek, G.; Thakkar, Ashok; Mishra, Supriya Sunder; Joseph, Vivek; Devraj, Mithun Gopal; Tumkur, Anil; Pai, Umesh

    2013-01-01

    Introduction: Despite the undeniable clinical efficacy of drug-eluting stents with durable polymers, concerns regarding their long-term safety have been raised, especially in more complex subsets. The Manipal-S Registry was designed to evaluate the safety and effectiveness of the biodegradable polymer coated Supralimus® Sirolimus-Eluting Coronary Stent for the treatment of coronary artery disease, across a wide range of patients who are treated in real-life clinical practice. Methods: All the consecutive 116 patients who underwent single-vessel or multiple vessel percutaneous coronary interventions with the use of Supralimus® sirolimus-eluting stents between September 2009 and December 2010, were included in this study. Patients were clinically followed-up at 1, 9, 12 and 24 months post-procedure. All clinical, procedural, and follow-up information were collected and analysed. Results: In total 116 patients, 126 lesions were implanted with 144 stents which had an average stent length of 25.8±8.0 mm. The incidences of any major adverse cardiac and cerebral events at 1, 9, 12 and 24 months were 0, 5 (4.3%), 8 (6.9%), and 10 (8.6%) respectively. Conclusion: These 24-month results clearly provide evidence for safety and effectiveness of the Supralimus® Sirolimus-eluting coronary stent system with the biodegradable polymer in real-life patients, even in those with acute myocardial infarctions. PMID:24179909

  9. THE REDSHIFT DISTRIBUTION OF GIANT ARCS IN THE SLOAN GIANT ARCS SURVEY

    SciTech Connect

    Bayliss, Matthew B.; Gladders, Michael D.; Koester, Benjamin P.; Oguri, Masamune; Hennawi, Joseph F.; Sharon, Keren; Dahle, Haakon

    2011-01-20

    We measure the redshift distribution of a sample of 28 giant arcs discovered as a part of the Sloan Giant Arcs Survey. Gemini/GMOS-North spectroscopy provides precise redshifts for 24 arcs, and 'redshift desert' constrains for the remaining 4 arcs. This is a direct measurement of the redshift distribution of a uniformly selected sample of bright giant arcs, which is an observable that can be used to inform efforts to predict giant arc statistics. Our primary giant arc sample has a median redshift z = 1.821 and nearly two-thirds of the arcs, 64%, are sources at z {approx}> 1.4, indicating that the population of background sources that are strongly lensed into bright giant arcs resides primarily at high redshift. We also analyze the distribution of redshifts for 19 secondary strongly lensed background sources that are not visually apparent in Sloan Digital Sky Survey imaging, but were identified in deeper follow-up imaging of the lensing cluster fields. Our redshift sample for the secondary sources is not spectroscopically complete, but combining it with our primary giant arc sample suggests that a large fraction of all background galaxies that are strongly lensed by foreground clusters reside at z {approx}> 1.4. Kolmogorov-Smirnov tests indicate that our well-selected, spectroscopically complete primary giant arc redshift sample can be reproduced with a model distribution that is constructed from a combination of results from studies of strong-lensing clusters in numerical simulations and observational constraints on the galaxy luminosity function.

  10. Sucrose-mediated giant cell formation in the genus Neisseria.

    PubMed

    Johnson, K G; McDonald, I J

    1976-03-01

    Growth of Neisseria perflava, Neisseria cinerea, and Neisseria sicca strain Kirkland in media supplemented with sucrose (0.5 to 5.0% w/v) resulted in the formation of giant cells. Response to sucrose was specific in that a variety of other carbohydrates did not mediate giant cell formation. Giant cells appeared only under growth conditions and did not lyse upon transfer to medium lacking sucrose or upon resuspension in hypotonic media. Reversion of giant to normal cells occurred when giant cells were used as inocula and allowed to multiply in media lacking sucrose.

  11. Giant-cell granuloma of the sinuses

    SciTech Connect

    Rhea, J.T.; Weber, A.L.

    1983-04-01

    Three cases are presented which illustrate giant-cell granulomas in the maxillary, ethmoid, and sphenoid sinuses. The radiographic features are nonspecific, and the lesion can mimic carcinoma. Ossification can be demonstrated, especially with computed tomography, and may indicate a benign lesion.

  12. Vocal repertoire of the social giant otter.

    PubMed

    Leuchtenberger, Caroline; Sousa-Lima, Renata; Duplaix, Nicole; Magnusson, William E; Mourão, Guilherme

    2014-11-01

    According to the "social intelligence hypothesis," species with complex social interactions have more sophisticated communication systems. Giant otters (Pteronura brasiliensis) live in groups with complex social interactions. It is likely that the vocal communication of giant otters is more sophisticated than previous studies suggest. The objectives of the current study were to describe the airborne vocal repertoire of giant otters in the Pantanal area of Brazil, to analyze call types within different behavioral contexts, and to correlate vocal complexity with level of sociability of mustelids to verify whether or not the result supports the social intelligence hypothesis. The behavior of nine giant otters groups was observed. Vocalizations recorded were acoustically and statistically analyzed to describe the species' repertoire. The repertoire was comprised by 15 sound types emitted in different behavioral contexts. The main behavioral contexts of each sound type were significantly associated with the acoustic variable ordination of different sound types. A strong correlation between vocal complexity and sociability was found for different species, suggesting that the communication systems observed in the family mustelidae support the social intelligence hypothesis.

  13. Giant Viruses of Amoebas: An Update.

    PubMed

    Aherfi, Sarah; Colson, Philippe; La Scola, Bernard; Raoult, Didier

    2016-01-01

    During the 12 past years, five new or putative virus families encompassing several members, namely Mimiviridae, Marseilleviridae, pandoraviruses, faustoviruses, and virophages were described. In addition, Pithovirus sibericum and Mollivirus sibericum represent type strains of putative new giant virus families. All these viruses were isolated using amoebal coculture methods. These giant viruses were linked by phylogenomic analyses to other large DNA viruses. They were then proposed to be classified in a new viral order, the Megavirales, on the basis of their common origin, as shown by a set of ancestral genes encoding key viral functions, a common virion architecture, and shared major biological features including replication inside cytoplasmic factories. Megavirales is increasingly demonstrated to stand in the tree of life aside Bacteria, Archaea, and Eukarya, and the megavirus ancestor is suspected to be as ancient as cellular ancestors. In addition, giant amoebal viruses are visible under a light microscope and display many phenotypic and genomic features not found in other viruses, while they share other characteristics with parasitic microbes. Moreover, these organisms appear to be common inhabitants of our biosphere, and mimiviruses and marseilleviruses were isolated from human samples and associated to diseases. In the present review, we describe the main features and recent findings on these giant amoebal viruses and virophages.

  14. Giant infantile gliosarcoma: magnetic resonance imaging findings.

    PubMed

    Sanal, Hatice Tuba; Bulakbasi, Nail; Kocaoglu, Murat; Onguru, Onder; Chen, Lina

    2008-08-01

    Gliosarcoma is an uncommon variant of glioblastoma multiforme, which is composed of gliomatous and sarcomatous elements. The tumor is rarely encountered in childhood. This case report presents the magnetic resonance imaging characteristics of a giant gliosarcoma in a 3-year-old girl. Size and location of the tumor are described.

  15. Giant leucaena (koa haole) energy tree farm

    SciTech Connect

    Brewbaker, J.L.

    1980-09-01

    Giant leucaena is a tall arboreal form of the common koa haole of the tropics that is known for its wide adaptability, hardiness, and rapid growth. Wood yields of the giant leucaena equal or exceed those of other tropical trees and can be the equivalent annually of 30 barrels of oil per acre. In addition, the tree is a legume that produces a marketable co-product, a nutritious, high-nitrogen leaf meal. A thorough assessment is provided of the known yield capability of giant leucaena, its soil and fertilizer needs, its impact on the environment, its water and irrigation needs, its handling from nursery through establishment, its wood properties and combustion characteristics, and methods of harvesting suitable for the comparatively small trees to be grown. Analyses are also given of capital equipment and operating expenses, labor needs, effects of tax incentives, and economic considerations of application to various scenarios and market conditions in Hawaii. This study suggests that giant leucaena could be grown profitably in Molokai as a source of fuel wood and co-product animal feed.

  16. Giant light enhancement in atomic clusters

    SciTech Connect

    Gadomsky, O. N. Gadomskaya, I. V.; Altunin, K. K.

    2009-07-15

    We show that the polarizing effect of the atoms in an atomic cluster can lead to full compensation of the radiative damping of excited atomic states, a change in the sign of the dispersion of the atomic polarizability, and giant light enhancement by the atomic cluster.

  17. Asteroseismic Diagram for Subgiants and Red Giants

    NASA Astrophysics Data System (ADS)

    Gai, Ning; Tang, Yanke; Yu, Peng; Dou, Xianghua

    2017-02-01

    Asteroseismology is a powerful tool for constraining stellar parameters. NASA’s Kepler mission is providing individual eigenfrequencies for a huge number of stars, including thousands of red giants. Besides the frequencies of acoustic modes, an important breakthrough of the Kepler mission is the detection of nonradial gravity-dominated mixed-mode oscillations in red giants. Unlike pure acoustic modes, mixed modes probe deeply into the interior of stars, allowing the stellar core properties and evolution of stars to be derived. In this work, using the gravity-mode period spacing and the large frequency separation, we construct the ΔΠ1–Δν asteroseismic diagram from models of subgiants and red giants with various masses and metallicities. The relationship ΔΠ1–Δν is able to constrain the ages and masses of the subgiants. Meanwhile, for red giants with masses above 1.5 M ⊙, the ΔΠ1–Δν asteroseismic diagram can also work well to constrain the stellar age and mass. Additionally, we calculate the relative “isochrones” τ, which indicate similar evolution states especially for similar mass stars, on the ΔΠ1–Δν diagram.

  18. Giant Cavernous Haemangioma of the Anterior Mediastinum

    PubMed Central

    Kaya, Seyda Ors; Samancılar, Ozgur; Usluer, Ozan; Acar, Tuba; Yener, Ali Galip

    2015-01-01

    Cavernous hemangiomas of the anterior mediastinum is rare. We present a case of a 56-year-old male patient with a giant cavernous hemangioma of the anterior mediastinum, 18 cm in diameters, approached by left posterolateral thoracotomy. To the best of our knowledge, such a unique case has not been previously presented in the literature. PMID:26644773

  19. Giant Viruses of Amoebas: An Update

    PubMed Central

    Aherfi, Sarah; Colson, Philippe; La Scola, Bernard; Raoult, Didier

    2016-01-01

    During the 12 past years, five new or putative virus families encompassing several members, namely Mimiviridae, Marseilleviridae, pandoraviruses, faustoviruses, and virophages were described. In addition, Pithovirus sibericum and Mollivirus sibericum represent type strains of putative new giant virus families. All these viruses were isolated using amoebal coculture methods. These giant viruses were linked by phylogenomic analyses to other large DNA viruses. They were then proposed to be classified in a new viral order, the Megavirales, on the basis of their common origin, as shown by a set of ancestral genes encoding key viral functions, a common virion architecture, and shared major biological features including replication inside cytoplasmic factories. Megavirales is increasingly demonstrated to stand in the tree of life aside Bacteria, Archaea, and Eukarya, and the megavirus ancestor is suspected to be as ancient as cellular ancestors. In addition, giant amoebal viruses are visible under a light microscope and display many phenotypic and genomic features not found in other viruses, while they share other characteristics with parasitic microbes. Moreover, these organisms appear to be common inhabitants of our biosphere, and mimiviruses and marseilleviruses were isolated from human samples and associated to diseases. In the present review, we describe the main features and recent findings on these giant amoebal viruses and virophages. PMID:27047465

  20. Insights on a Giant Aneurysm Treated Endovascularly.

    PubMed

    Graziano, Francesca; Iacopino, Domenico Gerardo; Ulm, Arthur John

    2016-07-01

    Background Endovascular treatment with stent-assisted Guglielmi detachable coils is an accepted method for treating intracranial giant aneurysms that otherwise would require more invasive or destructive treatment or could not be treated at all. Nevertheless, there is a paucity of information concerning inner postcoiling aneurysmal changes in human subjects over the long term. We report a postmortem analysis of a patient with a giant aneurysm at the vertebrobasilar junction (VBJ) who was treated endovascularly and studied pathologically 24 months after treatment. Materials and Method The head was removed at autopsy and prefixed in a 10% neutral buffered formalin solution. The brain was gently removed from the skull base after cutting the intracranial nerves and vascular structures. The giant VBJ aneurysm and its relationship with the brainstem, cranial nerves, and vessels were captured photographically and analyzed. Afterward, under operating microscope guidance, the vertebrobasilar system with the aneurysm was gently and carefully detached from the brainstem and carefully analyzed. Results No complete fibrous obliteration of the aneurysm lumen could be detected in our case, and no endothelialization had taken place 24 months after treatment. Conclusions Our findings agree with those of previous similar reports. Coiling, in particular in large or giant aneurysms, may be burdened by the risk of coil compaction and recanalization, but it has the advantage of not affecting the flow in the perforating arteries.

  1. Tuberculosis Detection by Giant African Pouched Rats

    ERIC Educational Resources Information Center

    Poling, Alan; Weetjens, Bart; Cox, Christophe; Beyene, Negussie; Durgin, Amy; Mahoney, Amanda

    2011-01-01

    In recent years, operant discrimination training procedures have been used to teach giant African pouched rats to detect tuberculosis (TB) in human sputum samples. This article summarizes how the rats are trained and used operationally, as well as their performance in studies published to date. Available data suggest that pouched rats, which can…

  2. Reading on the Shoulders of Giants

    ERIC Educational Resources Information Center

    Ben-Chaim, Michael; Riendeau, Michael

    2012-01-01

    Reflecting on his successful scientific career, Isaac Newton highlighted his intellectual debt to his predecessors. "If I have seen further," he wrote, "it was "only" by standing on the shoulders of giants." The authors have chosen the title of their article as a token of recognition of their debt to the teachings of…

  3. Standing on the shoulders of giants.

    PubMed

    Romanovsky, Andrej A

    2014-01-01

    In this editorial, the author explains that the journal Temperature stands on the shoulders of giants-prominent scientists of the past and current members of the Temperature community. Temperature also uses the best tools, such as Google Scholar profiles. The editorial includes a new puzzle: why does warm water freeze faster than cold water?

  4. Recovery From Giant Eruptions in Massive Stars

    NASA Astrophysics Data System (ADS)

    Kashi, A.; Davidson, K.; Humphreys, R. M.

    2015-12-01

    We perform radiation hydrodynamic simulations to study how very massive stars recover from giant eruptions. The post eruption star experience strong mass loss due to strong winds, driven by radial pulsations in the star*s interior, that operate by the κ-mechanism. The mass loss history obtained in our simulations resembles η Car*s history.

  5. [Habitat selection attributes of giant panda].

    PubMed

    Kang, Dong-Wei; Zhao, Zhi-Jiang; Guo, Wen-Xia; Tan, Liu-Yi; Kang, Wen; Li, Jun-Qing

    2011-02-01

    Based on the 1997-2009 inventory data of Wanglang Nature Reserve, the habitat selection attributes of giant panda were studied from the aspects of topography, forest community structure, and main feeding bamboo by the methods of frequency distribution and Bailey. The giant panda had obvious habitat preferences. Topographically, the preferred microhabitat was on the even or convex slopes at the ridge, top, or middle part of mountain body at an elevation 2500-3000 m, with southwest aspect, 6 degrees-30 degrees, and the distance to the nearest water source > 300 m. As for the forest community structure, the giant panda preferred the microhabitat with the bamboo succeeded from secondary forest or mixed conifer and broad-leaved forest, and with the average tree height being 20-29 m and the shrub coverage being 0-24%. The preferred main feeding bamboo by the giant panda was the growing well Fargesia denudate with an average height of 2-5 m and the coverage of > 50%.

  6. Depression in Coronary Artery Disease

    PubMed Central

    Safaie, Nasser; Jodati, Ahmad Reza; Raoofi, Mohammad; Khalili, Majid

    2012-01-01

    Introduction Depression is one of the Common psychological disorders. From the cognitive point of view, the unhealthy attitudes increase the severity of the depression. The aim of this study was to investigate depression and unhealthy attitudes in coronary patients hospitalized at Tabriz Shahid Madani Heart Center. Methods One hundred twenty eight hospitalized patients having myocardial Infarctions were studied regarding unhealthy attitudes, severity of depression and demographic data. Results The study showed a significant relation between unhealthy attitudes, BDI (Beck Depression Inventory) and severe depression. Moreover, a significant relation existed between gender and depression (P=0.0001). In addition, the level of education increased the intensity of unhealthy attitudes (P=0.0001). Several researches in both outside and inside Iran support the idea. Conclusion Based on present study and more other investigations, it can be suggested to provide the necessary elements and parameters such as antidepressant medication, psychologists, complementary treatment for coping with negative mood and its unwanted consequences. PMID:24250990

  7. Capecitabine-Induced Coronary Vasospasm

    PubMed Central

    Henry, Danish; Rudzik, Francine; Butts, Allison; Mathew, Aju

    2016-01-01

    Capecitabine, an oral prodrug of 5-fluorouracil (5-FU), is approved for early-stage and advanced colorectal cancer and metastatic breast cancer. Cardiotoxicity of 5-FU is well described in the literature. However, cardiac adverse effects of capecitabine are poorly described. We report a case of coronary vasospasm induced by capecitabine. A 41-year-old female with metastatic breast cancer presented with chest pain 3 days after starting capecitabine. The chest pain was relieved by rest and exacerbated by exertion. Her physical examination was unremarkable except for a rapid heart rate of 100 bpm. Electrocardiogram test showed no acute ischemic changes. Troponin tests were negative. CT angiography of the chest was negative for acute pulmonary embolism. An echocardiogram showed a left ventricular ejection fraction of 60% without any wall motion abnormalities. The chest pain resolved with aspirin and analgesic use. She was discharged following an inconclusive cardiac workup. Further use of capecitabine was discontinued. PMID:27920693

  8. Assimilation of planets by red giant stars

    NASA Astrophysics Data System (ADS)

    Carlberg, Joleen Karen

    The typical red giant star rotates slowly. This characteristic is expected from the conservation of angular momentum as these stars expand during their evolution. Nevertheless, a small percentage of red giant stars are rapidly rotating. One possible source of these stars' excess angular momenta is the orbital angular momentum of a planetary companion. The transfer of orbital angular momentum to the stellar envelope decays the planet's orbit, ultimately leading to the rapid in-spiral of the planet into the star. Using the known sample of exoplanets around main sequence host stars, I simulated both the future evolution of these stars and the expected interactions with their planets and found that Jupiter-mass planets residing at inner solar system distances---relatively common in exoplanetary systems---can contribute enough angular momentum to cause rapid rotation in their host stars during the red giant phase. Gas giant planets are also massive enough to alter the chemical composition of their host stars' envelopes when they are accreted. The central experiment of this thesis is to search for abundance anomalies in the rapid rotators that could be indicative of planet accretion. Hypothetical anomalies include the replenishment of light elements that are diluted by giant stars during first dredge-up (such as the stellar surface abundance of lithium), changes in isotopic abundance ratios that were altered by nucleosynthesis (such as increasing the stellar surface 12C/13C), and the preferential enhancement of refractory elements (indicative of the accretion of chemically fractionated material such as a planet). To increase the total number of known rapid rotators, I measured rotational velocities in a large database of spectra collected for the Grid Giant Star Survey developed for NASA's Space Interferometry Mission's astrometric grid. The 28 new rapid rotators discovered in this sample were combined with rapid rotators from the literature and a control sample of slow

  9. Coronary Computed Tomography and Magnetic Resonance Imaging

    PubMed Central

    Kantor, Birgit; Nagel, Eike; Schoenhagen, Paul; Barkhausen, Jörg; Gerber, Thomas C.

    2009-01-01

    Cardiac computed tomography and magnetic resonance are relatively new imaging modalities that can exceed the ability of established imaging modalities to detect present pathology or predict patient outcomes. Coronary calcium scoring may be useful in asymptomatic patients at intermediate risk. Computed tomographic coronary angiography is a first-line indication to evaluate congenitally abnormal coronary arteries and, along with stress magnetic resonance myocardial perfusion imaging, is useful in symptomatic patients with nondiagnostic conventional stress tests. Cardiac magnetic resonance is indicated for visualizing cardiac structure and function, and delayed enhancement magnetic resonance is a first-line indication for assessing myocardial viability. Imaging plaque and molecular mechanisms related to plaque rupture holds great promise for the presymptomatic detection of patients at risk for coronary events but is not yet suitable for routine clinical use. PMID:19269527

  10. Coronary computed tomography and magnetic resonance imaging.

    PubMed

    Kantor, Birgit; Nagel, Eike; Schoenhagen, Paul; Barkhausen, Jörg; Gerber, Thomas C

    2009-04-01

    Cardiac computed tomography and magnetic resonance are relatively new imaging modalities that can exceed the ability of established imaging modalities to detect present pathology or predict patient outcomes. Coronary calcium scoring may be useful in asymptomatic patients at intermediate risk. Computed tomographic coronary angiography is a first-line indication to evaluate congenitally abnormal coronary arteries and, along with stress magnetic resonance myocardial perfusion imaging, is useful in symptomatic patients with nondiagnostic conventional stress tests. Cardiac magnetic resonance is indicated for visualizing cardiac structure and function, and delayed enhancement magnetic resonance is a first-line indication for assessing myocardial viability. Imaging plaque and molecular mechanisms related to plaque rupture holds great promise for the presymptomatic detection of patients at risk for coronary events but is not yet suitable for routine clinical use.

  11. Coronary Artery Disease: Angioplasty or Bypass Surgery?

    MedlinePlus

    Coronary artery disease: Angioplasty or bypass surgery? I'm getting a cardiac catheterization. If blockages are found, ... angioplasty or bypass surgery? Answers from Rekha Mankad, M.D. During cardiac catheterization, your doctor will examine ...

  12. Radiation-induced coronary artery disease

    SciTech Connect

    Dunsmore, L.D.; LoPonte, M.A.; Dunsmore, R.A.

    1986-07-01

    This report describes three patients who developed myocardial infarction at an untimely age, 4 to 12 years after radiation therapy for Hodgkin's disease. These cases lend credence to the cause and effect relation of such therapy to coronary artery disease.

  13. Angioscopic observation of coronary lesions in Kawasaki disease

    NASA Astrophysics Data System (ADS)

    Ishikawa, Hiromi

    1993-05-01

    Kawasaki disease is an acute systematic angiitis, specifically affecting the coronary arteries in young children. Coronary aneurysms develop in 10 to 15% of patients with Kawasaki disease. The coronary aneurysm frequently changes into coronary stenosis and obstruction. Hitherto, we could observe and access the severity of these coronary lesions with the use of two dimensional echocardiography and selective coronary angiography. Angiography is the most sensitive means available for diagnosing significant coronary lesions and their severity. However, it is insensitive for detecting intraluminal minute and pathologic changes such as intimal thickening, regeneration of endothelium and thrombus. Recent advance in fiberscopie technology, enabled us to observe the inside of coronary artery percutaneously. We tried to use this angioscopic technique for the observation of coronary lesions in eight patients with Kawasaki disease at chronic stage.

  14. Coronary perforation and covered stents: an update and review.

    PubMed

    Al-Mukhaini, Mohammed; Panduranga, Prashanth; Sulaiman, Kadhim; Riyami, Abdulla Amour; Deeb, Mohammed; Riyami, Mohamed Barkat

    2011-04-01

    Coronary perforation is a rare complication of percutaneous coronary intervention. We present two different types of coronary intervention, but both ending with coronary perforation. However, these perforations were tackled successfully by covered stents. This article reviews the incidence, causes, presentation, and management of coronary perforation in the present era of aggressive interventional cardiology. Coronary perforations are classified as type I (extraluminal crater), II (myocardial or pericardial blushing), and III (contrast streaming or cavity spilling). Types I and II coronary perforations are caused by stiff or hydrophilic guidewires. Type I has a benign prognosis, whereas type II coronary perforations have the potential to progress to tamponade. Type III coronary perforations are caused by balloons, stents, or other intracoronary devices and commonly lead to cardiac tamponade necessitating pericardial drainage. However, type III perforations can be managed with covered stents without need for surgical intervention.

  15. Quantification of left coronary bifurcation angles and plaques by coronary computed tomography angiography for prediction of significant coronary stenosis: A preliminary study with dual-source CT

    PubMed Central

    Cui, Yue; Zeng, Wenjuan; Yu, Jie; Lu, Jing; Hu, Yuannan; Diao, Nan; Liang, Bo; Han, Ping; Shi, Heshui

    2017-01-01

    Purpose To evaluate the diagnostic performance of left coronary bifurcation angles and plaque characteristics for prediction of coronary stenosis by dual-source CT. Methods 106 patients suspected of coronary artery disease undergoing both coronary computed tomography angiography (CCTA) and invasive coronary angiography (CAG) within three months were included. Left coronary bifurcation angles including the angles between the left anterior descending artery and left circumflex artery (LAD-LCx), left main coronary artery and left anterior descending artery (LM-LAD), left main coronary artery and left circumflex artery (LM-LCx) were measured on CT images. CCTA plaque parameters were calculated by plaque analysis software. Coronary stenosis ≥ 50% by CAG was defined as significant. Results 106 patients with 318 left coronary bifurcation angles and 126 vessels were analyzed. The bifurcation angle of LAD-LCx was significantly larger in left coronary stenosis ≥ 50% than stenosis < 50%, and significantly wider in the non-calcified plaque group than calcified. Multivariable analyses showed the bifurcation angle of LAD-LCx was an independent predictor for significant left coronary stenosis (OR = 1.423, P = 0.002). In ROC curve analysis, LAD-LCx predicted significant left coronary stenosis with a sensitivity of 66.7%, specificity of 78.4%, positive predictive value of 85.2% and negative predictive value of 55.8%. The lipid plaque volume improved the diagnostic performance of CCTA diameter stenosis (AUC: 0.854 vs. 0.900, P = 0.045) in significant coronary stenosis. Conclusions The bifurcation angle of LAD-LCx could predict significant left coronary stenosis. Wider LAD-LCx is related to non-calcified lesions. Lipid plaque volume could improve the diagnostic performance of CCTA for coronary stenosis prediction. PMID:28346530

  16. Suture-induced right coronary artery stenosis.

    PubMed

    Seltmann, Martin; Achenbach, Stephan; Muschiol, Gerd; Feyrer, Richard

    2010-01-01

    An 82-year-old patient developed right heart failure in the days after surgical aortic valve replacement. Coronary CT angiography showed a high-grade stenosis of the mid-right coronary artery. Adjacent suture material seen on noncontrast CT suggested that the lesion was related to surgical closure of the right atrial cannulation site. Invasive angiography confirmed the stenosis, and percutaneous intervention was successfully performed.

  17. Arginine methylation dysfunction increased risk of acute coronary syndrome in coronary artery disease population

    PubMed Central

    Zhang, Shengyu; Zhang, Shuyang; Wang, Hongyun; Wu, Wei; Ye, Yicong

    2017-01-01

    Abstract The plasma levels of asymmetric dimethylarginine (ADMA) had been proved to be an independent cardiovascular risk factor. Few studies involved the entire arginine methylation dysfunction. This study was designed to investigate whether arginine methylation dysfunction is associated with acute coronary syndrome risk in coronary artery disease population. In total 298 patients undergoing coronary angiography because of chest pain with the diagnosis of stable angina pectoris or acute coronary syndrome from February 2013 to June 2014 were included. Plasma levels of free arginine, citrulline, ornithine, and the methylated form of arginine, ADMA, and symmetric dimethylarginine (SDMA) were measured with high-performance liquid chromatography coupled with tandem mass spectrometry. We examined the relationship between arginine metabolism-related amino acids or arginine methylation index (AMI, defined as ratio of [arginine + citrulline + ornithine]/[ADMA + SDMA]) and acute coronary events. We found that plasma ADMA levels were similar in the stable angina pectoris group and the acute coronary syndrome group (P = 0.88); the AMI differed significantly between 2 groups (P < 0.001). Multivariate logistic regression demonstrated that AMI was an independent risk factor of acute coronary events in patients with coronary artery disease (OR = 0.975, 95% confidence interval 0.956–0.993; P = 0.008). Our study suggested that ADMA levels were very similar in the stable angina and acute coronary syndrome patients; AMI might be an independent risk factor of acute coronary events in coronary artery disease population. PMID:28207514

  18. Effects of residual coronary artery disease on results of coronary artery bypass grafting.

    PubMed

    Iskandrian, A S; Hakki, A H; Nestico, P F; DePace, N L; Goel, I P; Kane, S

    1984-10-01

    To assess the effects of residual coronary artery disease (non-revascularized coronary vessels) after coronary artery bypass grafting on symptoms and exercise left ventricular function, we categorized 77 patients into 3 groups according to the extent of residual coronary artery disease: group I (n = 17) had no residual coronary artery disease (residual score = 0); group II (n = 30) had light residual coronary artery disease (score of 1 to 9, mean 4.7); and group III (n = 30) had moderate residual coronary artery disease (score greater than or equal to 10, mean 23). Sixty patients were asymptomatic after coronary artery bypass grafting (14 in group I, 24 in group II, and 22 in group III), but the remaining patients had occasional angina pectoris. The resting left ventricular ejection fraction was significantly higher in group I than in the remaining 2 groups (56 +/- 18% in group I, 47 +/- 19% in group II, and 43 +/- 16% in group III, P less than 0.05). The exercise left ventricular ejection fraction was also significantly higher in group I (61 +/- 16% in group I, 51 +/- 18% in group II and 45 +/- 18% in group III, P less than 0.01). The ejection fraction response to exercise was abnormal in 5 patients in group I, 15 patients in group II, and 19 patients in group III. Thus, coronary artery bypass grafting results in symptomatic improvement, even in patients with residual coronary artery disease. The presence of residual coronary artery disease, however, may be a determinant of exercise left ventricular function in these patients.

  19. Coronary artery calcium and exercise electrocardiogram as predictors of coronary events in asymptomatic adults.

    PubMed

    Grossman, Chagai; Ehrlich, Shay; Shemesh, Joseph; Koren-Morag, Nira; Grossman, Ehud

    2015-03-15

    Early identification of patients at risk for coronary heart disease is crucial to formulate effective preventive strategies. The elevated risk of coronary artery calcium (CAC) for coronary heart disease is well established. Our aim was to estimate the relative risk of abnormal exercise electrocardiography (Ex ECG) in the presence of CAC. During the year 2001, 566 asymptomatic subjects performed a treadmill exercise test and consented to perform an unenhanced computed tomography to assess CAC. Patients were followed until December 2012. The relative risk for coronary events (acute myocardial infarction, hospitalization for unstable angina or coronary catheterization that resulted in angioplasty or coronary artery bypass surgery), of abnormal Ex ECG and presence of CAC were analyzed. An abnormal Ex ECG was found in 71 subjects (12.5%), and CAC was found in 286 subjects (50.5%). During a mean follow-up of 6.5 ± 3.3 years, 35 subjects experienced a first coronary event. In those without CAC, the rate of coronary events was low (4 of 280; 1.4%) regardless of the Ex ECG results. Subjects with both CAC and abnormal Ex ECG had the highest rate of coronary events (13 of 39; 33%). The adjusted hazard ratio for coronary events, in subjects with CAC, was 5.16 (95% confidence interval 2.52 to 10.60) in those with abnormal Ex ECG compared with those with normal Ex ECG. In conclusion, in subjects with CAC, further risk stratification can be achieved by an Ex ECG, whereas in those without CAC, an Ex ECG has less additional value in predicting coronary events.

  20. Simultaneous multivessel coronary artery spasm demonstrated by quantitative analysis of thallium-201 single photon emission computed tomography

    SciTech Connect

    Kugiyama, K.; Yasue, H.; Okumura, K.; Minoda, K.; Takaoka, K.; Matsuyama, K.; Kojima, A.; Koga, Y.; Takahashi, M.

    1987-11-01

    Thallium-201 myocardial scintigraphy with quantitative analysis of emission computed tomography was performed during episodes of angina in 19 patients with variant angina and nearly normal coronary arteriographic findings. Eleven patients (group I) were shown by arteriography to have spasm in 2 or more large coronary arteries. Eight patients (group II) had spasm in only 1 coronary artery. In 7 patients in group I, significant diffuse perfusion defects simultaneously appeared in multiple coronary artery regions on the scintigram (group IA). The extent and severity of the perfusion defect as measured by thallium-201 tomography were significantly greater in group IA than in group II (p less than 0.001 and p less than 0.01, respectively). The duration of transient ST-segment elevation during the attack in group IA was significantly longer than in group II (p less than 0.001). The incidence of ventricular arrhythmias, including ventricular tachycardia, or complete atrioventricular block during the anginal attack was significantly higher (p less than 0.05) in group IA than in group II. In all study patients, neither attack nor scintigraphic perfusion defect appeared on the repeat test after oral administration of nifedipine. In conclusion, multivessel coronary artery spasm simultaneously appears and causes the attack in many patients with variant angina and nearly normal coronary arteriographic findings, and myocardial ischemia due to simultaneous multivessel coronary spasm is likely to be more extensive and severe, persist longer and have a higher frequency of potentially dangerous arrhythmias than that due to spasm of only 1 coronary artery.

  1. Right coronary artery fistula misdiagnosed as right atrial cardiac myxoma: A case report.

    PubMed

    Wen, Bing; Yang, Junya; Jiao, Zhouyang; Fu, Guowei; Zhao, Wenzeng

    2016-06-01

    The current study describes a case of right coronary artery fistula (CAF) misdiagnosed as right atrial myxoma (RAM). A 33-year-old man presented with a 13-year history of intermittent chest pain, and aggravation for 3 days. Echocardiography revealed an occupying lesion in the right atrium producing a partial dynamic tricuspid obstruction. The initial diagnosis was RAM, which causes partial right ventricular inflow tract obstruction. During cardiopulmonary bypass surgery, a giant mass was detected in the anterior wall of the right ventricle and an abnormal vascular fistula was observed at the bottom of the mass. Successful excision of the mass and closure of the fistula completely relieved the patient's presenting symptoms. The disease was subsequently diagnosed as right CAF draining to the myocardial void. The surgical management and misdiagnosis of the case are discussed herein.

  2. Myocardial perfusion echocardiography and coronary microvascular dysfunction

    PubMed Central

    Barletta, Giuseppe; Del Bene, Maria Riccarda

    2015-01-01

    Our understanding of coronary syndromes has evolved in the last two decades out of the obstructive atherosclerosis of epicardial coronary arteries paradigm to include anatomo-functional abnormalities of coronary microcirculation. No current diagnostic technique allows direct visualization of coronary microcirculation, but functional assessments of this circulation are possible. This represents a challenge in cardiology. Myocardial contrast echocardiography (MCE) was a breakthrough in echocardiography several years ago that claimed the capability to detect myocardial perfusion abnormalities and quantify coronary blood flow. Research demonstrated that the integration of quantitative MCE and fractional flow reserve improved the definition of ischemic burden and the relative contribution of collaterals in non-critical coronary stenosis. MCE identified no-reflow and low-flow within and around myocardial infarction, respectively, and predicted the potential functional recovery of stunned myocardium using appropriate interventions. MCE exhibited diagnostic performances that were comparable to positron emission tomography in microvascular reserve and microvascular dysfunction in angina patients. Overall, MCE improved echocardiographic evaluations of ischemic heart disease in daily clinical practice, but the approval of regulatory authorities is lacking. PMID:26730291

  3. Coronary artery disease and diabetes mellitus

    PubMed Central

    Aronson, Doron; Edelman, Elazer R.

    2015-01-01

    SUMMARY Coronary artery disease (CAD) is a major determinant of the long-term prognosis among patients with diabetes mellitus (DM). DM is associated with a 2 to 4-fold increased mortality risk from heart disease. Furthermore, in patients with DM there is an increased mortality after MI, and worse overall prognosis with CAD. Near-normal glycemic control for a median of 3.5 to 5 years does not reduce cardiovascular events. Thus, the general goal of HbA1c <7% appears reasonable for the majority of patients. Iatrogenic hypoglycemia is the limiting factor in the glycemic management of diabetes, and is an independent cause of excess morbidity and mortality. Statins are effective in reducing major coronary events, stroke, and the need for coronary revascularization. Selection of the optimal myocardial revascularization strategy for patients with DM and multivessel coronary artery disease is crucial and requires a multidisciplinary team approach (‘heart team’). Large scale clinical trials have shown that for many patients with 1- or 2-vessel coronary artery disease, there is little prognostic benefit from any intervention over optimal medical therapy (OMT). PCI with drug-eluting or bare metal stents is appropriate for patients who remain symptomatic with OMT. Randomized trials comparing multivessel PCI to coronary artery bypass grafting (CABG) have consistently demonstrated the superiority of CABG in reducing mortality, myocardial infarctions and need for repeat revascularizations. PMID:25091969

  4. Surgical management of congenital coronary artery fistulas.

    PubMed Central

    Lowe, J E; Oldham, H N; Sabiston, D C

    1981-01-01

    Congenital fistulas are the most common of the coronary arterial malformations and with the widespread use of selective coronary arteriography are being recognized with increasing frequency. Twenty-eight patients with congenital coronary fistulas have been evaluated at the Duke University Medical Center between 1960 and 1981. An additional 258 patients have previously been reported in the literature, making a total of 286 available for review. The right coronary artery is most commonly involved, and the fistulous communication is most often to the right ventricle, right atrium or pulmonary artery. Slightly more than half of the patients with coronary fistulas are symptomatic at the time the diagnosis is made. Surgical correction is strongly recommended to prevent the development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and pulmonary hypertension, as well as coronary aneurysm formation, with subsequent rupture or embolization. There were no operative or late deaths in the patients who underwent operations. Moreover, there have been no recurrent fistulas during a mean follow-up period of ten years. The risks of operative correction appear to be considerably less than the potential for development of serious and potentially fatal complications, even in asymptomatic patients. Images Fig. 2a. Fig. 2b. Fig. 3. PMID:7283502

  5. Women, Loneliness, and Incident Coronary Heart Disease

    PubMed Central

    Thurston, Rebecca C.; Kubzansky, Laura D.

    2010-01-01

    Objective To examine associations between loneliness and risk of incident coronary heart disease (CHD) over a 19-year follow-up period in a community sample of men and women. Loneliness, the perceived discrepancy between actual and desired social relationships, has been linked to several adverse health outcomes. However, no previous research has prospectively examined the association between loneliness and incident CHD in a community sample of men and women. Methods Hypotheses were examined using data from the First National Health and Nutrition Survey and its follow-up studies (n = 3003). Loneliness, assessed by one item from the Center for Epidemiologic Studies of Depression scale, and covariates were derived from baseline interviews. Incident CHD was derived from hospital records/death certificates over 19 years of follow-up. Hypotheses were evaluated, using Cox proportional hazards models. Results Among women, high loneliness was associated with increased risk of incident CHD (high: hazard ratio = 1.76, 95% Confidence Interval = 1.17â2.63; medium: hazard ratio = 0.98, 95% Confidence Interval = 0.64â1.49; reference: low), controlling for age, race, education, income, marital status, hypertension, diabetes, cholesterol, physical activity, smoking, alcohol use, systolic and diastolic blood pressures, and body mass index. Findings persisted additionally controlling for depressive symptoms. No significant associations were observed among men. Conclusions Loneliness was prospectively associated with increased risk of incident CHD, controlling for multiple confounding factors. Loneliness among women may merit clinical attention, not only due to its impact on quality of life but also its potential implications for cardiovascular health. PMID:19661189

  6. Complete Revascularization of Simultaneous Multiple Culprit Lesions in a Septuagenarian with ST-Elevation Myocardial Infarction

    PubMed Central

    Ifedili, Ikechukwu A.; Bob-Manuel, Tamunoinemi; Bolorunduro, Oluwaseyi; Askari, Raza; Ibebuogu, Uzoma N.

    2016-01-01

    Patient: Female, 74 Final Diagnosis: Multiple culprit lesions in ST-elevation myocardial infarction Symptoms: Chest pain • shortness of breath Medication: — Clinical Procedure: Cardiac catheterization Specialty: Cardiology Objective: Unusual clinical course Background: ST-elevation myocardial infarction (STEMI) is usually caused by rupture of unstable plaque with thrombus formation and abrupt cessation of blood flow through a single coronary artery that is deemed the culprit. The simultaneous thrombotic occlusions of multiple coronary arteries in the setting of STEMI is a rare occurrence with implications for patient management and outcome not fully addressed in the current STEMI guidelines, although more recent studies suggest a benefit of complete revascularization compared to culprit vessel-only treatment in the setting of STEMI. Case Report: A 74-year-old female presented with STEMI. Coronary angiography revealed simultaneous multiple coronary thrombotic occlusions involving the right coronary, left circumflex, and ramus intermedius arteries successfully treated with primary percutaneous revascularization at the same setting with good outcome and short hospital length of stay. Conclusions: Although the most appropriate timing to treat simultaneous multiple culprit lesions has yet to be definitively defined, multi-vessel percutaneous coronary intervention in the setting of a STEMI with multiple culprit lesions is feasible with good outcome as shown by our index case. PMID:28035135

  7. Coronary Spastic Angina Induced after Oral Desmopressin (DDAVP) Administration

    PubMed Central

    Adachi, Yusuke; Sakakura, Kenichi; Akashi, Naoyuki; Wada, Hiroshi; Momomura, Shin-ichi; Fujita, Hideo

    2016-01-01

    A 60-year-old man was prescribed oral desmopressin (1-deamino-8-D-arginine vasopressin acetate trihydrate; DDAVP) for nocturnal polyuria. One week after starting to take desmopressin, he frequently felt chest pain while resting. Coronary angiography revealed no organic stenosis; however, an acetylcholine provocation test showed severe coronary spasm with ST elevation. He was diagnosed with coronary spastic angina, and we stopped the oral desmopressin and added diltiazem. While DDAVP should dilate the coronary vessels in healthy subjects, it may provoke coronary vasospasm in patients with endothelial dysfunction. We should be careful to avoid triggering coronary spasm when administering DDAVP to patients that may have potential endothelial dysfunction. PMID:27980260

  8. Precise radial velocities of giant stars. IX. HD 59686 Ab: a massive circumstellar planet orbiting a giant star in a 13.6 au eccentric binary system

    NASA Astrophysics Data System (ADS)

    Ortiz, Mauricio; Reffert, Sabine; Trifonov, Trifon; Quirrenbach, Andreas; Mitchell, David S.; Nowak, Grzegorz; Buenzli, Esther; Zimmerman, Neil; Bonnefoy, Mickaël; Skemer, Andy; Defrère, Denis; Lee, Man Hoi; Fischer, Debra A.; Hinz, Philip M.

    2016-10-01

    Context. For over 12 yr, we have carried out a precise radial velocity (RV) survey of a sample of 373 G- and K-giant stars using the Hamilton Échelle Spectrograph at the Lick Observatory. There are, among others, a number of multiple planetary systems in our sample as well as several planetary candidates in stellar binaries. Aims: We aim at detecting and characterizing substellar and stellar companions to the giant star HD 59686 A (HR 2877, HIP 36616). Methods: We obtained high-precision RV measurements of the star HD 59686 A. By fitting a Keplerian model to the periodic changes in the RVs, we can assess the nature of companions in the system. To distinguish between RV variations that are due to non-radial pulsation or stellar spots, we used infrared RVs taken with the CRIRES spectrograph at the Very Large Telescope. Additionally, to characterize the system in more detail, we obtained high-resolution images with LMIRCam at the Large Binocular Telescope. Results: We report the probable discovery of a giant planet with a mass of mp sin i = 6.92-0.24+0.18 MJup orbiting at ap = 1.0860-0.0007+0.0006 au from the giant star HD 59686 A. In addition to the planetary signal, we discovered an eccentric (eB = 0.729-0.003+0.004) binary companion with a mass of mB sin i = 0.5296-0.0008+0.0011 M⊙ orbiting at a close separation from the giant primary with a semi-major axis of aB = 13.56-0.14+0.18 au. Conclusions: The existence of the planet HD 59686 Ab in a tight eccentric binary system severely challenges standard giant planet formation theories and requires substantial improvements to such theories in tight binaries. Otherwise, alternative planet formation scenarios such as second-generation planets or dynamical interactions in an early phase of the system's lifetime need to be seriously considered to better understand the origin of this enigmatic planet. Based on observations collected at the Lick Observatory, University of California.Based on observations collected at the

  9. Recanalized chronic coronary thrombus: unraveling a hazy coronary lesion by intravascular ultrasound

    PubMed Central

    Chotai, Shayna; Khokhar, Azhar A.; Kelly, Paul A.

    2016-01-01

    Hazy lesions in coronary angiography can often be a puzzle for the interventional cardiologist. Recanalized chronic coronary thrombus, although rare, is one of the potential diagnoses. Intracoronary imaging with intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are tools that can guide to the correct diagnosis. We present the images of a case where IVUS was used to unravel such a lesion. PMID:27054109

  10. Woven Coronary Artery Disease Successfully Managed with Percutaneous Coronary Intervention: A New Case Report.

    PubMed

    Alsancak, Yakup; Sezenoz, Burak; Turkoglu, Sedat; Abacı, Adnan

    2015-01-01

    Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.

  11. Coronary ectasia in a man on breast cancer therapy presenting with acute coronary syndrome

    PubMed Central

    Johnson, Dana C.; Rifai, Luay; Patel, Parag V.

    2016-01-01

    Limited data exist on the association between breast cancer treatments and coronary artery disease anatomy, particularly in males. We describe an unusual case of diffuse coronary ectasia in a man with breast cancer presenting with acute coronary syndrome (ACS). A 66-year-old man with breast cancer on paclitaxel, tamoxifen, and carboplatin chemotherapy regimen, presents with new onset chest pain. Electrocardiogram reveals anterolateral ST-segment depressions and elevated troponin I level. Emergent angiography revealed grossly ectatic coronary arteries with a total thrombotic occlusion of the mid right coronary artery. Serial intracoronary aspiration thrombectomy revealed fragments of red thrombus. Intracoronary tenectaplase was ultimately administered to restore perfusion. The patient clinically improved and warfarin was added to his cardiac regimen. Laboratory work up for connective tissue disease was negative. Although paclitaxel has been implicated in coronary artery neointima and media proliferation in the setting of drug-eluting stents, we believe our case is the first to describe massive coronary ectasia with significant thrombus burden requiring complex coronary intervention and thrombolysis in the setting of breast cancer therapy in a man. PMID:27843802

  12. High Platelet Reactivity in Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: Randomised Controlled Trial Comparing Prasugrel and Clopidogrel

    PubMed Central

    Geisler, Tobias; Booth, Jean; Tavlaki, Elli; Karathanos, Athanasios; Müller, Karin; Droppa, Michal; Gawaz, Meinrad; Yanez-Lopez, Monica; Davidson, Simon J.; Stables, Rod H.; Banya, Winston; Zaman, Azfar; Flather, Marcus; Dalby, Miles

    2015-01-01

    Background Prasugrel is more effective than clopidogrel in reducing platelet aggregation in acute coronary syndromes. Data available on prasugrel reloading in clopidogrel treated patients with high residual platelet reactivity (HRPR) i.e. poor responders, is limited. Objectives To determine the effects of prasugrel loading on platelet function in patients on clopidogrel and high platelet reactivity undergoing percutaneous coronary intervention for acute coronary syndrome (ACS). Patients Patients with ACS on clopidogrel who were scheduled for PCI found to have a platelet reactivity ≥40 AUC with the Multiplate Analyzer, i.e. “poor responders” were randomised to prasugrel (60 mg loading and 10 mg maintenance dose) or clopidogrel (600 mg reloading and 150 mg maintenance dose). The primary outcome measure was proportion of patients with platelet reactivity <40 AUC 4 hours after loading with study medication, and also at one hour (secondary outcome). 44 patients were enrolled and the study was terminated early as clopidogrel use decreased sharply due to introduction of newer P2Y12 inhibitors. Results At 4 hours after study medication 100% of patients treated with prasugrel compared to 91% of those treated with clopidogrel had platelet reactivity <40 AUC (p = 0.49), while at 1 hour the proportions were 95% and 64% respectively (p = 0.02). Mean platelet reactivity at 4 and 1 hours after study medication in prasugrel and clopidogrel groups respectively were 12 versus 22 (p = 0.005) and 19 versus 34 (p = 0.01) respectively. Conclusions Routine platelet function testing identifies patients with high residual platelet reactivity (“poor responders”) on clopidogrel. A strategy of prasugrel rather than clopidogrel reloading results in earlier and more sustained suppression of platelet reactivity. Future trials need to identify if this translates into clinical benefit. Trial Registration ClinicalTrials.gov NCT01339026 PMID:26317618

  13. Spontaneous coronary artery dissection causing acute coronary syndrome in a young patient without risk factors

    PubMed Central

    Chevli, Parag; Kelash, Fnu; Gadhvi, Pragnesh; Grandhi, Sreeram; Syed, Amer

    2014-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction that is more common in younger patients (under age 50) and in women. Although the etiology is not known, some predisposing conditions to SCAD are well known and include Marfan syndrome, pregnancy and peripartum state, drug abuse, and some anatomical abnormalities of the coronary arteries such as aneurysms and severe kinking. We describe a case of SCAD in a young woman who presented with sudden onset of chest pain and was admitted for the treatment of acute coronary syndrome. The coronary angiography showed dissection of the left anterior descending artery. The patient underwent successful percutaneous transluminal coronary angioplasty and stent placement. PMID:25317268

  14. Simultaneous formation of solar system giant planets

    NASA Astrophysics Data System (ADS)

    Guilera, O. M.; Fortier, A.; Brunini, A.; Benvenuto, O. G.

    2011-08-01

    Context. In the last few years, the so-called "Nice model" has become increasingly significant for studying the formation and evolution of the solar system. According to this model, the initial orbital configuration of the giant planets was much more compact than the one we observe today. Aims: We study the formation of the giant planets in connection with several parameters that describe the protoplanetary disk. We aim to establish which conditions enable their simultaneous formation in line with the initial configuration proposed by the Nice model. We focus on the conditions that lead to the simultaneous formation of two massive cores, corresponding to Jupiter and Saturn, which are able to reach the cross-over mass (where the mass of the envelope of the giant planet equals the mass of the core, and gaseous runway starts), while two other cores that correspond to Uranus and Neptune have to be able to grow to their current masses. Methods: We compute the in situ planetary formation, employing the numerical code introduced in our previous work for different density profiles of the protoplanetary disk. Planetesimal migration is taken into account and planetesimals are considered to follow a size distribution between r_pmin (free parameter) and r_pmax= 100 km. The core's growth is computed according to the oligarchic growth regime. Results: The simultaneous formation of the giant planets was successfully completed for several initial conditions of the disk. We find that for protoplanetary disks characterized by a power law (Σ ∝ r - p), flat surface density profiles (p ≤ 1.5) favor the simultaneous formation. However, for steep slopes (p 2, as previously proposed by other authors) the simultaneous formation of the solar system giant planets is unlikely. Conclusions: The simultaneous formation of the giant planets - in the context of the Nice model - is favored by flat surface density profiles. The formation time-scale agrees with the estimates of disk lifetimes if

  15. Antipsychotic Medications and Risk of Acute Coronary Syndrome in Schizophrenia: A Nested Case-Control Study

    PubMed Central

    Liu, Hsing-Cheng; Yang, Shu-Yu; Liao, Ya-Tang; Chen, Chiao-Chicy; Kuo, Chian-Jue

    2016-01-01

    Background This study assessed the risk of developing acute coronary syndrome requiring hospitalization in association with the use of certain antipsychotic medications in schizophrenia patients. Methods A nationwide cohort of 31,177 inpatients with schizophrenia between the ages of 18 and 65 years whose records were enrolled in the National Health Insurance Research Database in Taiwan from 2000 to 2008 and were studied after encrypting the identifications. Cases (n = 147) were patients with subsequent acute coronary syndrome requiring hospitalization after their first psychiatric admission. Based on a nested case-control design, each case was matched with 20 controls for age, sex and the year of first psychiatric admission using risk-set sampling. The effects of antipsychotic agents on the development of acute coronary syndrome were assessed using multiple conditional logistic regression and sensitivity analyses to confirm any association. Results We found that current use of aripiprazole (adjusted risk ratio [RR] = 3.68, 95% CI: 1.27–10.64, p<0.05) and chlorpromazine (adjusted RR = 2.96, 95% CI: 1.40–6.24, p<0.001) were associated with a dose-dependent increase in the risk of developing acute coronary syndrome. Although haloperidol was associated with an increased risk (adjusted RR = 2.03, 95% CI: 1.20–3.44, p<0.01), there was no clear dose-dependent relationship. These three antipsychotic agents were also associated with an increased risk in the first 30 days of use, and the risk decreased as the duration of therapy increased. Sensitivity analyses using propensity score-adjusted modeling showed that the results were similar to those of multiple regression analysis. Conclusions Patients with schizophrenia who received aripiprazole, chlorpromazine, or haloperidol could have a potentially elevated risk of developing acute coronary syndrome, particularly at the start of therapy. PMID:27657540

  16. NSLS transvenous coronary angiography beamline upgrade and advanced technology initiatives

    SciTech Connect

    Gmuer, N.F.; Chapman, D.; Thomlinson, W.; Thompson, A.C.; Lavender, W.M.; Scalia, K.; Malloy, N.; Mangano, J.; Jacob, J.

    1994-11-01

    Since October 1990, the coronary anatomies of a total of 16 patients (male and female) have been imaged at the National Synchrotron Light Source (NSLS) as part of the Dual Energy Digital Subtraction Transvenous Coronary Angiography research program. This program takes place in the Synchrotron Medical Research Facility (SMERF) on the X17B2 wiggler beamline. Encouraged by the success of the initial patient images, the NSLS has recently embarked on an ambitious upgrade effort. This effort covers all aspects of the X17B2 beamline and includes improved radiation shielding, a Laue monochromator assembly, a computer-controlled 5 motion patient scanning chair assembly, a fast low-noise image acquisition system, and a modularized patient safety system. These improvements will allow major advances in imaging patients based on ECG signal gating and multiple view imaging. Two advanced technology initiatives are underway with industrial collaborators. One will develop real-time image acquisition and display of the subtracted digital images. The second will develop a compact x-ray source for medical imaging. The source will be a linear electron accelerator creating characteristic radiation line emissions.

  17. NSLS transvenous coronary angiography beamline upgrade and advanced technology initiatives

    SciTech Connect

    Gmuer, N.F.; Chapman, D.; Thomlinson, W. ); Thompson, A.C. ); Lavender, W.M. ); Scalia, K.; Malloy, N. ); Mangano, J.; Jacob, J. )

    1995-02-01

    Since October 1990, the coronary anatomies of a total of 16 patients (male and female) have been imaged at the National Synchrotron Light Source (NSLS) as part of the Dual Energy Digital Subtraction Transvenous Coronary Angiography research program. This program takes place in the Synchrotron Medical Research Facility (SMERF) on the X17B2 wiggler beamline. Encouraged by the success of the initial patient images, the NSLS has recently embarked on an ambitious upgrade effort. This effort covers all aspects of the X17B2 beamline and includes improved radiation shielding, a Laue monochromator assembly, a computer-controlled five motion patient scanning chair assembly, a fast low-noise image acquisition system, and a modularized patient safety system. These improvements will allow major advances in imaging patients based on ECG signal gating and multiple view imaging. Two advanced technology initiatives are underway with industrial collaborators. One will develop real-time image acquisition and display of the subtracted digital images. The second will develop a compact x-ray source of medical imaging. The source will be a linear electron accelerator creating characteristic radiation line emissions.

  18. Bilateral pulmonary artery aneurysms, coronary artery aneurysm, and ventricular pseudoaneurysm in Behçet disease.

    PubMed

    Lai, Ying-Rong; Hong, Jun-Mou; Liu, Zhen-Guo; Deng, Zhen-Sheng; Yeung, Sai-Ching J; Cheng, Chao

    2014-04-01

    Massive hemoptysis in Behçet disease (BD) is rare but often fatal. This report presents a 28-year-old man with recurrent massive hemoptysis. He was diagnosed with bilateral multiple pulmonary artery aneurysms (PAAs), coronary artery aneurysm, and ventricular pseudoaneurysm from BD. The patient underwent emergency right lower lobectomy with no obvious complications. No hemoptysis recurred during an 18-month follow-up. This report also reviews the occurrence of PAAs in BD, with an emphasis on the treatment approaches.

  19. Role of coronary physiology in the contemporary management of coronary artery disease.

    PubMed

    Ruparelia, Neil; Kharbanda, Rajesh K

    2015-02-16

    Coronary artery disease (CAD) remains the leading cause of death worldwide with approximately 1 in 30 patients with stable CAD experiencing death or acute myocardial infarction each year. The presence and extent of resultant myocardial ischaemia has been shown to confer an increased risk of adverse outcomes. Whilst, optimal medical therapy (OMT) forms the cornerstone of the management of patients with stable CAD, a significant number of patients present with ischaemia refractory to OMT. Historically coronary angiography alone has been used to determine coronary lesion severity in both stable and acute settings. It is increasingly clear that this approach fails to accurately identify the haemodynamic significance of lesions; especially those that are visually "intermediate" in severity. Revascularisation based upon angiographic appearances alone may not reduce coronary events above OMT. Technological advances have enabled the measurement of physiological indices including the fractional flow reserve, the index of microcirculatory resistance and the coronary flow reserve. The integration of these parameters into the routine management of patients presenting to the cardiac catheterization laboratory with CAD represents a critical adjunctive tool in the optimal management of these patients by identifying patients that would most benefit from revascularisation and importantly also highlighting patients that would not gain benefit and therefore reducing the likelihood of adverse outcomes associated with coronary revascularisation. Furthermore, these techniques are applicable to a broad range of patients including those with left main stem disease, proximal coronary disease, diabetes mellitus, previous percutaneous coronary intervention and with previous coronary artery bypass grafting. This review will discuss current concepts relevant to coronary physiology assessment, its role in the management of both stable and acute patients and future applications.

  20. Giant oil fields of the Gulf Coast area

    SciTech Connect

    Haeberle, F.R.

    1993-09-01

    The 134 giant fields in the Gulf Coastal area contain 29% of the total giant-field reserves. Cumulative production is 32% of the giant-field cumulative total and 20% of the United States cumulative production. Eighty-nine of the giant fields are offshore with 22% of the reserves, 11 fields are in east Texas with 24% of the reserves, and 1 field is in Florida with 1% of the reserves. In 106 of the giant fields the primary producing interval is Cenozoic with 65% of the reserves, and in 28 giant fields the producing interval is Mesozoic with 35% of the reserves. The primary producing interval is Mesozoic with 35% of the reserves. The primary producing interval in 124 giant fields consists of clastics with 91% of the reserves, in 7 fields the primary lithology is carbonates with 6% of the reserves, and in 3 giant fields the lithology is mixed clastics and carbonates. A total of 127 fields are in structural traps with all of the reserves, 4 fields are stratigraphic traps (3%) with 18% of the reserves, and 3 fields are combination traps with 1% of the reserves. Over 50 of the giant oil fields in structural traps are salt domes. The most prevalent types of giant fields in the Gulf Coastal area are onshore structural traps with Cenozoic clastics as the primary producing intervals.