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Sample records for myxoma reconstructive considerations

  1. Recurrent Maxillary Odontogenic Myxoma Following Partial Maxillary Resection and Consecutive Osseous Reconstruction Including Tooth Transplantation.

    PubMed

    Friedrich, Reinhard E; Scheuer, Hanna A; Höltje, Wolf

    2016-06-01

    Odontogenic myxoma (OM) is a rare tumour arising in the jaws. The tumour is purported to be odontogenic in origin due to the frequent localisation of the tumour inside the jaws in close relation to teeth. The aim of this report was to detail the course of a patient who developed OM of the maxilla, underwent adequate ablative surgery and reconstruction, including tooth transplantation to the original tumour site, and subsequently developed a local recurrence in close proximity to the teeth transplanted to the reconstructed maxilla 6 years after the first diagnosis. Once again, a partial maxillary resection was performed, with no reconstruction. The patient has been free from tumour recurrence for over 20 years. We discuss the current hypothesis on OM pathogenesis and the possible impact of actively dividing cells on tumour re-growth. PMID:27272841

  2. [Myxoma Originating from the Tricuspid Annulus Requiring Annular Reconstruction and Valve Replacement;Report of a Case].

    PubMed

    Hattori, Masashi; Matsumura, Yu; Yamaki, Fumitaka

    2016-07-01

    A 66-year-old woman who had had coughing and worsening dyspnea for 3 weeks was admitted to our hospital. Echocardiography showed a solid round mass (72×49 mm in diameter) attached to the tricuspid septal annulus with a short stalk. A right atrial myxoma was suspected and operation was performed under cardiopulmonary bypass after heart failure symptoms subsided. The tumor was extirpated along with the tricuspid valve annulus. We performed reconstruction of the tricuspid annulus, tricuspid valve replacement with a bioprosthetic valve and pacemaker implantation. The histopathologic diagnosis was myxoma. The postoperative course was uneventful, and no recurrence has been noted for 1 year after surgery. PMID:27365071

  3. Intramuscular myxoma

    SciTech Connect

    McCook, T.A.; Martinez, S.; Korobkin, M.; Ram, P.C.; Breiman, R.S.; Gehweiler, J.A.; Bowen, J.H.; Harrelson, J.M.; Harrelson, J.M.

    1981-10-01

    Two patients with intramuscular myxoma (IMM) were evaluated preoperatively using radiography and computed tomography (CT). In both patients CT demonstrated a homogeneous mass with an attenuation value (density) slightly greater than water but less than surrounding muscle. Dystrophic amorphous calcification, previously unreported in this condition, was present in one case. The differential diagnosis of low density intramuscular masses is discussed.

  4. Prosthetic considerations in reconstructive implantology.

    PubMed

    Finger, I M; Guerra, L R

    1986-01-01

    Diagnosis and treatment planning are essential prior to the placement of any dental implant. An overview of prosthodontic considerations in the restoration of such implants is presented in this article. Concepts for both the edentulous and partially edentulous mouth are discussed.

  5. Prosthodontic Considerations in Post-cancer Reconstructions.

    PubMed

    Boonsiriphant, Piriya; Hirsch, Joel A; Greenberg, Alex M; Genden, Eric M

    2015-05-01

    The restoration of function after oncologic surgery of the oral cavity constitutes one of the major challenges facing head and neck oncology. Within the general objective of securing esthetic as well as functional reconstructions, dental rehabilitation is crucial for achieving a good outcome. Adequate dental rehabilitation allows the patient to chew food and considerably improves speech and swallowing. These reconstructions will be driven biologically or prosthetically following surgical design and outcome. PMID:25951959

  6. Atrial mass: a myxoma?

    PubMed

    Chatzis, Andrew C; Kostopanagiotou, Kostas; Kousi, Theofili; Mitropoulos, Fotios

    2016-08-01

    A middle-aged woman with a history of resected colorectal cancer and receiving chemotherapy presented with a right atrial mass and the provisional diagnosis of myxoma supported by echocardiography, computed tomography, and magnetic resonance imaging. Successful surgical removal revealed organized thrombus instead. Atrial thrombus may be mistaken for myxoma and long-term intracardiac indwelling catheters can be thrombogenic. PMID:27525099

  7. Important considerations in chest wall reconstruction.

    PubMed

    Momeni, Arash; Kovach, Stephen J

    2016-06-01

    Chest wall reconstruction represents one of the most challenging tasks in plastic surgery. Over the past several decades, a more profound understanding of surgical anatomy and physiology along with tremendous advances in surgical technique have resulted in substantial improvements in postoperative outcomes. Conceptually, the reconstructive goals include dead space obliteration, restoration of skeletal stability with protection of intrathoracic structures, and stable soft tissue coverage. Ideally, these goals are achieved with minimal aesthetic deformity. J. Surg. Oncol. 2016;113:913-922. © 2016 Wiley Periodicals, Inc. PMID:26969557

  8. [Cutaneous myxoma (focal dermal mucinosis)].

    PubMed

    Senff, H; Kuhlwein, A; Jänner, M; Schäfer, R

    1988-09-01

    Two cases of cutaneous myxoma are presented. In case 1 the cutaneous myxoma was localized on the left thumb and clinically resembled a pyogenic granuloma. In case 2 it was found at the left nipple. The benign cutaneous tumor may herald a cardiac myxoma and other conditions. Thus, a cutaneous myxoma should be accepted as an indication for thorough investigation of the whole body at regular intervals. As there are neither clinically nor histologically adequate criteria for differentiation, cutaneous myxoma and focal dermal mucinosis can be considered as variants of a single entity.

  9. CT findings of atrial myxoma

    SciTech Connect

    Tsuchiya, F.; Kohno, A.; Saitoh, R.; Shigeta, A.

    1984-04-01

    The computed tomographic (CT) appearance of six atrial myxomas was analyzed. Five of the myxomas were located in the left atrium and one was in the right atrium. The margin of the myxoma was at least slightly lobulated in five cases and the content was inhomogeneous in all. Calcification was demonstrated in three cases. The site of attachment of the myxoma was demonstrated by CT to be the arial septum in all cases. The CT finding correlated well with the operative findings. It is concluded that it is possible with CT to diagnose atrial myxoma by the location and nature of the intracardiac mass and to differentiate it from thrombus.

  10. Right Ventricular Myxoma.

    PubMed

    Vadivelmurugan, S; Senthamarai; Sakthimohan; Janarthanan; Balanayagam; Anand, Vijay; Venkateswaran, K J; Ramkumar; Selvaraj

    2015-10-01

    We report a case of 30 year female who presented with complaints of intermittent chest pain and breathlessness for 8 months, Diagnosed to have right ventricular mass protruding into main pulmonary artery during each systole. The mass was completely excised. Histopathological examination showed myxoma. PMID:27608701

  11. ACL Reconstruction With Autografts Weighing Performance Considerations and Postoperative Care.

    PubMed

    Grant, John A; Mohtadi, Nicholas G

    2003-04-01

    Anterior cruciate ligament (ACL) reconstruction is the treatment of choice for patients who experience episodes of instability and a decreased quality of life after ACL rupture. The bone-patellar tendon-bone and hamstring autografts are the current standards for ACL reconstruction. Primary care physicians, especially sports medicine clinicians, are the first-line providers of nonoperative care for patients who have ACL injuries. Care providers need to know the biologic and biomechanic properties of these grafts, clinical indications for each graft, and rehabilitation considerations to appropriately counsel their patients. PMID:20086463

  12. Atrial myxomas and coronary angiography.

    PubMed

    Rafiq, Isma; Parthasarthy, H; Clark, C Grahame

    2010-07-01

    Coronary angiography is not an only important component of preoperative evaluation of the patient with underlying coronary artery disease but also diagnostic tool for delineating cardiac myxomas. This also serve as an important surgical anatomical marker. We present two cases which presented with repeated episode of chest pain, were found to have atrial blushing on coronary angiography subsequent confirmation of diagnosis of atrial myxoma on echocardiography. PMID:20578102

  13. Left atrial myxoma masquerading as viral flu

    PubMed Central

    Chhabra, Lovely; Kiernan, Francis

    2016-01-01

    Atrial myxoma is a rare cardiac tumor that may be diagnosed incidentally on cardiac imaging or may present with life-threatening cardiac symptoms. We present a case of giant left atrial myxoma that presented as a flulike illness.

  14. [Secondary pulmonary embolism to right atrial myxoma].

    PubMed

    Vico Besó, L; Zúñiga Cedó, E

    2013-10-01

    A case of pulmonary thromboembolism secondary to atrial myxoma right. The myxoma is a primary cardiac tumor, namely, has his origin in the cardiac tissue. Primary cardiac tumors are rare, including myxomas, the most common type. Have a predilection for females and the most useful tool for diagnosis is echocardiography. About 75% of myxomas occur in the left atrium of the heart and rest are in the right atrium. Right atrial myxomas in some sometimes associated with tricuspid stenosis and atrial fibrillation. The most common clinical manifestations include symptoms of this neoplasm constitutional, and embolic phenomena resulting from the obstruction to the flow intracavitary. The treatment of this condition is surgical.

  15. Optimizing Reconstruction with Periorbital Transplantation: Clinical Indications and Anatomic Considerations

    PubMed Central

    Sosin, Michael; Mundinger, Gerhard S.; Dorafshar, Amir H.; Iliff, Nicholas T.; Christensen, Joani M.; Christy, Michael R.; Bojovic, Branko

    2016-01-01

    Background: Complex periorbital subunit reconstruction is challenging because the goals of effective reconstruction vary from one individual to another. The purpose of this article is to explore the indications and anatomic feasibility of periorbital transplantation by reviewing our institutional repository of facial injury. Methods: Institutional review board approval was obtained at the R Adams Cowley Shock Trauma Center for a retrospective chart review conducted on patients with periorbital defects. Patient history, facial defects, visual acuity, and periorbital function were critically reviewed to identify indications for periorbital or total face (incorporating the periorbital subunit) vascularized composite allotransplantation. Cadaveric allograft harvest was then designed and performed for specific patient defects to determine anatomic feasibility. Disease conditions not captured by our patient population warranting consideration were reviewed. Results: A total of 7 facial or periorbital transplant candidates representing 6 different etiologies were selected as suitable indications for periorbital transplantation. Etiologies included trauma, burn, animal attack, and tumor, whereas proposed transplants included isolated periorbital and total face transplants. Allograft recovery was successfully completed in 4 periorbital subunits and 1 full face. Dual vascular supply was achieved in 5 of 6 periorbital subunits (superficial temporal and facial vessels). Conclusions: Transplantation of isolated periorbital structures or full face transplantation including periorbital structures is technically feasible. The goal of periorbital transplantation is to re-establish protective mechanisms of the eye, to prevent deterioration of visual acuity, and to optimize aesthetic outcomes. Criteria necessary for candidate selection and allograft design are identified by periorbital defect, periorbital function, ophthalmologic evaluation, and defect etiology. PMID:27014557

  16. Computed tomography of intramuscular myxoma

    SciTech Connect

    Ekelund, L.; Herrlin, K.; Rydholm, A.

    1982-11-01

    Computed tomography (CT) was performed in seven patients with intramuscular myxoma. All lesions were well demarcated, of homogeneous appearance and attenuation values ranging from 10 to 60 (HU). The tumor size, as estimated at CT, correlated well with the size of the surgical specimen, which is in contrast to the findings in some high grade malignant sarcomas.

  17. Right Atrial Myxoma.

    PubMed

    Sikri, T; Sharma, R K; Singh, P; Tibdewal, P; Sharma, A

    2015-09-01

    A 54 yr old man, non-smoker, non-alcoholic, and non-diabetic, non-hypertensive, non-obese, with moderate daily activity and no significant past medical history, presented with chief complaints of dyspnoea NYHA Class III, which was associated with diaphoresis and restlessness. On examination, a long systolic murmur of grade III-IV, increasing on inspiration, was audible in the tricuspid area. The murmur did not have any postural relation. An abnormal thud-like sound was audible in left parasternal region. There was no evidence of any pleuro-pericardial rub. Transthoracic echocardiography showed a large (7×4 cm), mobile mass arising in the right atrium superiorly, prolapsing through tricuspid valve, into the right ventricle, resulting in moderate tricuspid regurgitation. 2D echo (Figure 1) and cardiac MRI (Figure 2) of the heart showed a isointense to mildly hypointense mass from the right atrium prolapsing through the tricuspid valves into the right ventricle on T2 weighted images. There was abscence of any enhancement of the mass after administration of IV gadolinium. The patient underwent excision of the myxoma. Histopathological examination showed a tumour with extensive myxomatous matrix with dispersed cellular components. The tumour cells were arranged in single or multiple layers surrounding vascular channels, which were lined by endothelium. The tumour cells had spindle-shaped nuclei with occasionaly vacuolated eosinophilic cytoplasm. There was no increase in mitosis. In addition there was background of lympho-plasmacytic infiltrate (Figure 3). The patient remained asymptomatic for the period of one and a half years of follow up post-operatively. PMID:27608869

  18. Bilateral Atrial Myxoma: A Case Report.

    PubMed

    Susupaus, Attapoom; Foofuengmonkolkit, Kumpoo

    2016-02-01

    Among the rare cardiac tumors, myxoma, which is mostly located in the left atrium, is the most common type. Bilateral atrial myxoma is extremely rare, and requires urgent surgery. The authors report the case of a 34-year-old male, who presented with one month of right hemiparesis and aphasia and subsequently diagnosed with bilateral atrial myxoma based on transthoracic echocardiography. An urgent operation for intra-cardiac tumor removal was performed with the biatrial approach. Once a diagnosis of myxoma has been made, an urgent operation for tumor removal is necessary due to the risk of serious complications, including sudden death from normal blood flow obstruction. PMID:27266240

  19. Skin-sparing mastectomy. Oncologic and reconstructive considerations.

    PubMed Central

    Carlson, G W; Bostwick, J; Styblo, T M; Moore, B; Bried, J T; Murray, D R; Wood, W C

    1997-01-01

    OBJECTIVE: The authors compared skin-sparing mastectomy and traditional mastectomy both followed by immediate reconstruction in the treatment of breast cancer. SUMMARY BACKGROUND DATA: Skin-sparing mastectomy is used increasingly in the treatment of breast cancer to improve the aesthetic results of immediate reconstruction. The oncologic and reconstructive outcomes of this procedure have never been analyzed closely. METHODS: Institutional experience with 435 consecutive patients who underwent total mastectomy and immediate reconstruction from January 1989 through December 1994 was examined. Mastectomies were stratified into skin-sparing (SSM) and non-skin-sparing (non-SSM) types. RESULTS: Three hundred twenty-seven SSMs and 188 non-SSMs were performed. The mean follow-up was 41.3 months (SSM, 37.5 months, non-SSM, 48.2 months). Local recurrences from invasive cancer occurred after 4.8% of SSMs versus 9.5% of non-SSMs. Sixty-five percent of patients who underwent SSMs had nothing performed on the opposite breast versus 45% in the group of patients who underwent non-SSM (p = 0.0002). Native skin flap necrosis occurred in 10.7% of patients who underwent SSMs versus 11.2% of patients who underwent non-SSMs. CONCLUSIONS: Skin-sparing mastectomy facilitates immediate breast reconstruction by reducing remedial surgery on the opposite breast. Native skin flap necrosis is not increased over that seen with non-SSM. Skin-sparing mastectomies can be used in the treatment of invasive cancer without compromising local control. Images Figure 1. Figure 3. Figure 4. Figure 5. PMID:9193184

  20. Molecular Basis of Cardiac Myxomas

    PubMed Central

    Singhal, Pooja; Luk, Adriana; Rao, Vivek; Butany, Jagdish

    2014-01-01

    Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis. PMID:24447924

  1. The Strange Case of the Infarcted Myxoma.

    PubMed

    Pergolini, Amedeo; Zampi, Giordano; Tinti, Maria Denitza; Pontillo, Daniele; Di Paolo, Barbara; Buffa, Vitaliano; Pulignano, Giovanni; Pino, Paolo Giuseppe; Minardi, Giovanni; Musumeci, Francesco

    2016-03-01

    In the setting of an acute coronary syndrome, the differential diagnosis between a thrombus and a myxoma may be cumbersome. We describe the case of a patient presenting with an acute coronary syndrome associated with an aneurysmatic apical left ventricular myxoma.

  2. Left atrial myxoma masquerading as viral flu

    PubMed Central

    Chhabra, Lovely; Kiernan, Francis

    2016-01-01

    Atrial myxoma is a rare cardiac tumor that may be diagnosed incidentally on cardiac imaging or may present with life-threatening cardiac symptoms. We present a case of giant left atrial myxoma that presented as a flulike illness. PMID:27695187

  3. Familial recurrent atrial myxoma: Carney's complex.

    PubMed

    Shetty Roy, A Nagesh; Radin, Michael; Sarabi, Dennis; Shaoulian, Emanuel

    2011-02-01

    We report on a family of 4 members, all of whom have had multifocal, recurrent atrial myxomas associated with skin pigmentation, melanotic schwannomas, mucocutaneous myxomas, and tumors of the ovary and pituitary, adrenal, and thyroid glands. Immunochemistry of the myxoma cells is positive for calretinin, confirming their neuroendocrine origin. Genetic studies confirmed mutations in the gene coding protein kinase A, regulatory subunit 1-α (PRKAR1α). This is Carney's complex, characterized by multiple, mucocutaneous myxomas; pigmented lesions over the lips, conjunctiva, and genitalia; adenomas of the breast and thyroid; schwannomas; and endocrinal abnormalities including Cushing syndrome and acromegaly. Members of the family require vigorous screening, including urinary free cortisol, plasma transforming growth factor-β(1) and thyrotropin-releasing hormone, testicular ultrasound, routine echocardiographic screening, searches for cardiac and mucocutaneous myxomas in multiple locations, and genetic studies for the PRKAR1α gene sequence. PMID:21298650

  4. Carney complex with right ventricular myxoma following second excision of left atrial myxoma.

    PubMed

    Tamura, Yamato; Seki, Toshio

    2014-01-01

    We report a case of Carney complex with massive right ventricular myxoma after two-time excision of a left atrial myxoma. The patient was a 45-year-old woman with pyrexia. She temporarily lost consciousness during examination, and echocardiography and computed tomography (CT) showed a massive tumor in the right ventricle. Loss of consciousness was determined to be caused by intracardiac obstruction of blood flow due to the tumor, and corrective surgery was performed. Pathological findings indicated myxoma with no malignancy. Myxomas are benign, but there is frequent recurrence of tumors associated with Carney complex. Because her myxomas were accompanied by unusual skin pigmentation, she was diagnosed with Carney complex. Carney complex has a high rate of myxoma recurrence, and often runs in families. In all cases, it is necessary to observe the patient's course closely.

  5. Normal Vulvovaginal, Perineal, and Pelvic Anatomy with Reconstructive Considerations

    PubMed Central

    Yavagal, Sujata; de Farias, Thais F.; Medina, Carlos A.; Takacs, Peter

    2011-01-01

    A thorough insight into the female genital anatomy is crucial for understanding and performing pelvic reconstructive procedures. The intimate relationship between the genitalia and the muscles, ligaments, and fascia that provide support is complex, but critical to restore during surgery for correction of prolapse or aesthetic reasons. The external female genitalia include the mons pubis, labia majora and minora, clitoris, vestibule with glands, perineal body, and the muscles and fascia surrounding these structures. Through the perineal membrane and the perineal body, these superficial vulvar structures are structurally related to the deep pelvic muscle levator ani with its fascia. The levator ani forms the pelvic floor with the coccygeus muscle and provides vital support to all the pelvic organs and stability to the perineum. The internal female genital organs include the vagina, cervix, uterus, tubes, and ovaries with their visceral fascia. The visceral fascia also called the endopelvic fascia, surrounds the pelvic organs and connects them to the pelvic walls. It is continuous with the paraurethral and paravaginal fascia, which is attached to the perineal membrane. Thus, the internal and external genitalia are closely related to the muscles and fascia, and work as one functioning unit. PMID:22547969

  6. Carney complex with biatrial cardiac myxoma.

    PubMed

    Havrankova, Eniko; Stenova, Emoke; Olejarova, Ingrid; Sollarova, Katarina; Kinova, Sona

    2014-01-01

    Cardiac myxomas make up approximately 50% of all benign cardiac tumors and represented 86% of all surgically treated cardiac tumors. Most of them originated from the left atrium, in some cases from both of atria. We report a case of male patient with biatrial myxomas and other extra-cardiac involvement: hypophyseal adenoma, enlargement of thyroid gland, tubular adenoma polyp of colon and bilateral large cell calcifying Sertoli cell tumor (LCCSCT) of testis. These findings led to the diagnosis of Carney's complex, which is a syndrome with multiple neoplasias, cardiac myxomas, lentigines, and endocrine abnormalities. A genetic test confirm this diagnosis. PMID:24088910

  7. Current diagnosis and management of cardiac myxomas.

    PubMed

    Jain, Sonia; Maleszewski, Joseph J; Stephenson, Christopher R; Klarich, Kyle W

    2015-04-01

    Cardiac myxoma is the most common cardiac neoplasm. In the majority of cases, it is isolated (non-syndromic) and located in the left atrium. In up to 10% cases, it is seen in syndromic association with the Carney complex where it is encountered in younger patients, with atypical and multiple locations, such as the right atrium or ventricles, and carries a high risk of recurrence. Imaging is pivotal in the diagnosis, management guidance and surveillance. Surgical excision is the established definitive treatment. Further research should address management strategies in incidentally discovered small myxomas in asymptomatic patients and the role of genetic testing and screening in syndromic myxomas. PMID:25797902

  8. Left Atrial Myxoma Mimicking Mitral Stenosis

    PubMed Central

    Ojji, Dike B; Mamven, Manmak H; Omonua, Odiase; Habib, Zaiyad; Osaze, Hamamatu; Sliwa, Karen

    2012-01-01

    Cardiac myxoma is a benign (non-malignant) neoplasm that represents the most common primary tumour of the heart. We present the case of a 36 year old woman with background hypertension who presented with features of left ventricular failure and seizures, and was found during transthoracic echocardiography to have left atrial myxoma protruding through the mitral valve orifice. She subsequently had excision of the atrial myxoma. The usefulness of early transthoracic echocardiography in any patient presenting with features of heart failure even when the aetiology seems obvious cannot be over-emphasised. PMID:22844201

  9. Myxoma of the kidney associated with hemorrhage.

    PubMed

    Shah, Abhishek; Sun, Wenbin; Cao, Dianbo

    2013-06-01

    Myxomas are relatively rare tumors and most of them occur in the heart, skin, and soft tissues and bones. Renal myxomas are extremely rare neoplasms and very few cases have been reported in the literature. A review of medical literatures reveals no previous description of renal myxoma complicated with extensive areas of hemorrhage. So, we report such a case in a 43-year-old female. She had a left renal mass incidentally discovered during ultrasonography at a regular health checkup, and further computed tomography scan showed 4.9 × 3.1 cm mass with circular septal enhancement and ill-defined margin with the left psoas major muscle. Radical nephrectomy was performed because of suspected malignant renal tumor. Postoperative histopathology of resected specimen revealed the typical appearance of a myxoma associated with extensive hemorrhage. PMID:24426654

  10. Cylindrical deformity of the nail plate secondary to subungual myxoma.

    PubMed

    Gourdin, F W; Lang, P G

    1996-11-01

    Digital myxomas are rare neoplasms. We describe a subungual myxoma arising in a previously unreported location, the nail matrix. This produced an interesting cylindrical deformity of the nail. Complete surgical excision is usually curative. PMID:8912602

  11. Left atrial myxoma presenting as paroxysmal supraventricular tachycardia.

    PubMed

    Seol, Sang-Hoon; Kim, Doo-Il; Jang, Jae-Sik; Yang, Tae-Hyun; Kim, Dae-Kyeong; Kim, Dong-Soo

    2014-02-01

    Cardiac myxomas are benign intracavitary neoplasms. Their incidence in cardiac surgery is approximately 0.3%. Symptoms of cardiac myxomas are typically variable, from obstruction of mitral valve to coronary embolism resulting in acute myocardial infarction. In this case, left atrial myxoma is presented as paroxysmal supraventricular tachycardia.

  12. Technical considerations for ligation of ruptured hepatic artery aneurysm: is arterial reconstruction necessary?

    PubMed

    Lam, S; Chan, Albert C Y; Poon, Ronnie T P

    2015-06-01

    Ruptured hepatic artery aneurysm is a rare life-threatening condition. Open surgery with ligation of the aneurysm is the treatment of choice if the patient presents with haemodynamic instability. Controversies exist on whether hepatic artery reconstruction is needed after exclusion of the aneurysm. Involvement of the gastroduodenal artery origin was proposed as an indication for reconstruction, but this might be difficult to ascertain upon laparotomy. Recent studies showed that arterial ligation distal to the gastroduodenal artery origin does not necessarily result in ischaemic liver injury, implying that reconstruction in such cases may not be required, especially in a haemodynamically unstable patient. A patient with common hepatic artery aneurysm involving the gastroduodenal artery origin presented with rupture and underwent aneurysm ligation. Adequacy of intrahepatic arterial flow was determined by intra-operative Doppler ultrasonography and arterial reconstruction was not performed. The technical considerations during the operative management of ruptured hepatic artery aneurysms are discussed. PMID:26045071

  13. Odontogenic myxoma: Report of three cases and retrospective review of literature in Indian population

    PubMed Central

    Chaudhary, Zainab; Sharma, Pankaj; Gupta, Shalini; Mohanty, Sujata; Naithani, Manish; Jain, Anshul

    2015-01-01

    Purpose: To review the clinical pattern and treatment modalities meted out to patients of odontogenic myxoma (OM) in Indian population in last 30 years and also to report 3 cases of OM. Method: A retrospective review of radiograph and histopathology of three cases of odontogenic myxoma treated between 2005 and 2011 was done. Immunohistochemical analysis was performed to examine the pattern of vimentin and NSE. Also a computerized literature search using Medline and Google scholar was conducted for published articles on OM in Indian population in last 30 years. Result: A total of 32 OM cases reviewed from 25 articles retrieved. Out of them 24 myxomas were present in maxilla, only 8 were in mandible and a single case was present in supraglottic region (larynx). Surgical procedure carried out was excision and curettage in 16 patients and resection with safe margin followed by reconstruction 13 patients. All the three reported cases were successfully treated by tumor enucleation and peripheral ostectomy with no recurrence after 3 to 7 years. Conclusion: Odontogenic myxoma is a rare odontogenic tumor with inconclusive clinical and radiographic features, hence histopathological examination is mandatory to confirm its diagnosis. Although the immunohistochemical analysis may help in diagnosis but plays no role in guiding treatment planning or predicting the rate of recurrence. Currently we lack data on number of reported OM cases in Indian population as author feels more patients must have been treated then reported. PMID:26681859

  14. [Familial cases of cutaneous myxomas and spotty pigmentation (Carney's complex)].

    PubMed

    Koyano, T; Satoh, T; Ohtaki, N

    1990-09-01

    In 1985, Carney et al reported a complex of myxomas, spotty pigmentation, and endocrine overactivity and subsequently demonstrated dominant inheritance of the condition. The criteria for diagnosis of the complex is the presence of two or more of the following conditions: (1) cardiac myxoma, (2) cutaneous myxoma, (3) mammary myxoma, (4) spotty mucocutaneous pigmentation, (5) primary pigmented nodular adrenocortical disease (Cushing's syndrome), (6) testicular tumors (sexual precocity), (7) pituitary adenoma secreting growth hormone (acromegaly or gigantism). We encountered a family with an affected mother and daughter. Case 1 was a 43-year-old woman with multiple cutaneous myxomas, mammary myxomas and spotty mucocutaneous pigmentation. Case 2, the 19-year-old daughter of case 1 had multiple cutaneous myxomas and spotty cutaneous pigmentation. These two cases both met the criteria for the diagnosis of the complex. Our report is believed to be the first report on the complex in Japan. PMID:2266598

  15. Synchronous Fibrolamellar Hepatocellular Carcinoma and Auricular Myxoma

    PubMed Central

    González-Cantú, Yessica M.; Rodriguez-Padilla, Cristina; Tena-Suck, Martha Lilia; García de la Fuente, Alberto; Mejía-Bañuelos, Rosa María; Díaz Mendoza, Raymundo; Quintanilla-Garza, Samuel; Batisda-Acuña, Yolaester

    2015-01-01

    Synchronic occurrence of benign and malignant tumors is extremely rare. Fibrolamellar hepatocellular carcinoma represents 1% to 2% of all hepatocarcinomas, while myxomas represent about half of all the cases of primary tumors of the heart. We present the case of a 53-year-old woman with a left atrial myxoma that was surgically removed. Several weeks later, the patient returned to the hospital with abdominal pain. CT scan showed a mass in the left lobe of the liver that was resected and diagnosed as fibrolamellar hepatocellular carcinoma. As of this writing, the patient is healthy. PMID:26509093

  16. Synchronous Fibrolamellar Hepatocellular Carcinoma and Auricular Myxoma.

    PubMed

    González-Cantú, Yessica M; Rodriguez-Padilla, Cristina; Tena-Suck, Martha Lilia; García de la Fuente, Alberto; Mejía-Bañuelos, Rosa María; Díaz Mendoza, Raymundo; Quintanilla-Garza, Samuel; Batisda-Acuña, Yolaester

    2015-01-01

    Synchronic occurrence of benign and malignant tumors is extremely rare. Fibrolamellar hepatocellular carcinoma represents 1% to 2% of all hepatocarcinomas, while myxomas represent about half of all the cases of primary tumors of the heart. We present the case of a 53-year-old woman with a left atrial myxoma that was surgically removed. Several weeks later, the patient returned to the hospital with abdominal pain. CT scan showed a mass in the left lobe of the liver that was resected and diagnosed as fibrolamellar hepatocellular carcinoma. As of this writing, the patient is healthy.

  17. Delay in diagnosis of right atrial myxoma

    SciTech Connect

    Northcote, R.J.; Sethia, B.; Ballantyne, D.

    1985-02-01

    Clinical, echocardiographic, and nuclear angiographic findings in a 51-year-old woman who presented with a history of dyspnea are discussed. Initial echocardiography revealed no abnormality. However, a subsequent radionuclide angiogram revealed a filling defect on the right side of the heart. This represented a right atrial myxoma. Radionuclide angiography can provide a useful noninvasive tool in the diagnosis of intracardiac tumors when echocardiography has not been helpful.

  18. Intramuscular myxoma of the deltoid muscle: report of a case

    PubMed Central

    Costamagna, Daniela; Erra, Stefania; Durando, Riccardo

    2009-01-01

    Intramuscular myxoma is a rare, benign lesion of mesenchymal origin, affecting the skeletal muscles. We report the case of a 75-year-old woman presenting with a mass of the right deltoid region. On the MRI examination it was interpreted as a lipomatous lesion. She underwent marginal excision. The pathological examination revealed the diagnosis of intramuscular myxoma. PMID:21686685

  19. The complex of myxomas, spotty pigmentation, and endocrine overactivity.

    PubMed

    Carney, J A; Gordon, H; Carpenter, P C; Shenoy, B V; Go, V L

    1985-07-01

    Of 40 patients (16 males and 24 females), 29 had cardiac myxoma(s), 14 had skin pigmentation (lentigo and several types of nevi) which also commonly affected the lips, 6 had skin myxoma(s), and 12 had both pigmentation and myxoma(s); 18 had primary pigmented nodular adrenocortical disease (Cushing syndrome was present in 11); 10 had myxoid mammary fibroadenomas; 9 had testicular tumor(s) (large-cell calcifying Sertoli cell tumor, Leydig cell tumor, or adrenocortical rest tumor, or a combination); and 4 had pituitary adenoma with gigantism or acromegaly. The maximum number of conditions present together was five, occurring in two patients; each of the remaining patients had at least two of the conditions. The overlap, in this sizeable number of patients, of various combinations of the same rare or very rare conditions unlikely to occur together by chance with any degree of frequency is striking evidence for a unique syndrome. The patients were young (mean age at diagnosis of the first component, 18 years). Pathologic involvement tended to be multicentric (heart and skin) and bilateral in paired organs (adrenal, breast, and testis). Thirteen patients (32%) are alive and well. Twelve patients are alive but with complications of cardiac myxoma (in 8), testicular tumors (in 2), residual Cushing syndrome (in 1), or bilateral pulmonary nodules (in 1). Twelve patients are dead: 9 of cardiac myxoma, 1 of intracranial (nonpituitary) tumor, and 2 postoperatively. The status of three is unknown. PMID:4010501

  20. Cartilage grafting in facial reconstruction with special consideration of irradiated grafts

    SciTech Connect

    Donald, P.J.

    1986-07-01

    The search for the perfect facial implant for reconstruction of the face continues. Cartilage, once thought to be an undesirable graft material because of its propensity for absorption, has regained popularity in the past decade. Various preparation techniques have been employed to ensure graft sterility and diminished absorption. An improved understanding of cartilage structure and physiology has shed considerable light on the host-graft relationship. Gamma irradiation is a time-honored method of preservation. An experiment was undertaken to investigate the physiology of irradiated cartilage grafts following prolonged implantation on the facial skeleton of sheep and dog. Merthiolate preserved grafts were used as controls. Direct observation, histochemical techniques, autoradiography, and transmission electron micrography were used to determine chondrocyte viability and matrix composition. It was surprising to note that following implantation of 16 to 72 months, complete resorption was seen in 87.7% of the irradiated grafts and in 43.8% of the Merthiolate stored controls. Many of the grafts acquired chondrocytes from the host and produced new proteoglycan matrix as well as undergoing some degree of ossification. A comparison to the clinical situation in humans is made. 98 references.

  1. [Asymptomatic myxoma of the tricuspid valve septal leaflet].

    PubMed

    Jedliński, Ireneusz; Jamrozek-Jedlińska, Maria; Bugajski, Paweł; Kalawski, Ryszard; Poprawski, Kajetan; Słomczyński, Marek

    2012-01-01

    We presented a case of asymptomatic myxoma of the tricuspid valve septal leaflet. The tumour was diagnosed accidentally during rutine transthoracic echocardiography and confirmed by transesophageal echocardiography. It was resected and the septal leaflet repaired during surgery.

  2. [Right ventricular myxoma. A rare case of pulmonary stenosis].

    PubMed

    Riera, J M; Vila, I C; Serrano, J M; Aleixandre, L M; Baliarda, X R; de Auta, G M; Ruiz, F E; Domenech, J P; Garriga, J R

    1996-02-01

    We discuss a case of a fourteen year old girl in whom, clinical signs of right ventricular outflow obstruction were discovered following a syncopal attack. A right ventricular tumor was observed by echocardiography. Histology confirmed the diagnosis of myxoma.

  3. Surgical and prosthetic management of maxillary odontogenic myxoma

    PubMed Central

    Rashid, Haroon; Bashir, Atif

    2015-01-01

    Odontogenic myxomas are uncommon tumors of comprising of 3% of all the tumors of odontogenic origin. They usually occur during the second and third decades of life and are more commonly seen in females. The current case report sheds light upon the surgical treatment of a myxoma of odontogenic origin in posterior maxilla of a young female patient. Prosthodontic rehabilitation stages are also briefly described following complete healing of the lesion after surgery. PMID:26038664

  4. Two-time recurrence of a right atrial myxoma

    PubMed Central

    Madhavan, Suresh; Akhil, P. C.; Jayaprakash, K.; George, Raju

    2015-01-01

    We report a case of a second recurrence of a right atrial myxoma in a 38-year-old woman who had surgical excision in March 2008 and excision of a recurrence in August 2012. She presented with a similar clinical picture in December 2014 and again underwent surgical excision. The case is unusual both for its location in the right atrium and its multiple recurrences in a sporadic form without any sign of the myxoma complex. PMID:26424957

  5. Cerebral embolism complicating left atrial myxoma: a case report.

    PubMed

    Ihsen, Zairi; Hela, Mssaad; Khadija, Mzoughi; Zouhayer, Jnifene

    2016-01-01

    Cardiac myxoma are the most common benign primary cardiac tumors that can lead to many complications as described in literature. Here we report the case of a boy aged 11 that was referred for etiological diagnosis of ischemic stroke. Transthoracic echocardiography reveals a myxoma in the left atrium. Patient was referred to surgery. The diagnosis was confirmed and the mass was completely resected. PMID:27642478

  6. Preoperative Emboli in a Pregnant Woman with Myxoma.

    PubMed

    Sabzi, Freidoun; Faraji, Reza

    2016-07-01

    The left atrium is the most common location of myxomas, which are benign tumors. Only a few cases of myxomas in pregnancies have been reported. Our thorough medical literature search showed only 17 reported cases in the course of pregnancy. Myxomas during pregnancy and in the preterm period constitute a serious phenomenon that can mimic an early sign of a life-threatening pathology like severe mitral stenosis. We describe a 33-year-old woman, who presented with acute dyspnea to a gynecology center and was referred to our hospital for further evaluation of pulmonary embolism. Transthoracic echocardiography showed a huge left atrial myxoma, and computed tomography scan illustrated paradoxical pulmonary embolism in the left upper lung lobe via a large patent foramen ovale. The tumor required urgent cardiac surgery. In this article, we review causes of dyspnea in pregnancy and the cardiovascular effects of myxomas in pregnancy. We also describe the pathophysiological effects of cardiopulmonary bypass on the mother, fetus, and the feto-placental system during open-heart surgery. We performed a successful surgical resection of a myxoma in a pregnant woman. Given the rarity of such cases, individual multidisciplinary assessment and management strategies are essential. PMID:27365558

  7. Preoperative Emboli in a Pregnant Woman with Myxoma

    PubMed Central

    Sabzi, Freidoun; Faraji, Reza

    2016-01-01

    The left atrium is the most common location of myxomas, which are benign tumors. Only a few cases of myxomas in pregnancies have been reported. Our thorough medical literature search showed only 17 reported cases in the course of pregnancy. Myxomas during pregnancy and in the preterm period constitute a serious phenomenon that can mimic an early sign of a life-threatening pathology like severe mitral stenosis. We describe a 33-year-old woman, who presented with acute dyspnea to a gynecology center and was referred to our hospital for further evaluation of pulmonary embolism. Transthoracic echocardiography showed a huge left atrial myxoma, and computed tomography scan illustrated paradoxical pulmonary embolism in the left upper lung lobe via a large patent foramen ovale. The tumor required urgent cardiac surgery. In this article, we review causes of dyspnea in pregnancy and the cardiovascular effects of myxomas in pregnancy. We also describe the pathophysiological effects of cardiopulmonary bypass on the mother, fetus, and the feto-placental system during open-heart surgery. We performed a successful surgical resection of a myxoma in a pregnant woman. Given the rarity of such cases, individual multidisciplinary assessment and management strategies are essential. PMID:27365558

  8. Systemic Embolism and Septic Shock Complicated Left Atrial Myxoma: Case Report

    PubMed Central

    Trimeche, B.; Bouraoui, H.; Garbaa, R.; Mahdhaoui, A.; Ben Rhomdane, M.; Ernez-Hajri, S.; Jeridi, G.

    2009-01-01

    Myxoma is the most common primary tumor of the heart. The rarity of infected cardiac myxomas leads to numerous diagnostic and therapeutic difficulties. We present a case of infected left atrial myxoma caused by methicillin-sensible Staphylococcus aureus in a 48-year-old woman complicated by systemic embolism and septic shock. PMID:20204064

  9. Mechanical thrombectomy in cardiac myxoma stroke: a case report and review of the literature.

    PubMed

    Chung, Yoon Sang; Lee, Woong Jae; Hong, Joonhwa; Byun, Jun Soo; Kim, Jae Kyun; Chae, Soo Ahn

    2016-06-01

    Cardiac myxoma is the most common primary tumor of the heart. It is a rare cause of acute ischemic stroke and commonly not detected until after the stroke. There is no current guideline for the treatment of cardiac myxoma stroke and only a few cases of mechanical thrombectomy have been reported. We present a case of cardiac myxoma stroke in a 4-year-old boy treated with a stent-retrieval device and review the literature describing the safety and efficacy of mechanical thrombectomy in cardiac myxoma stroke. We also describe imaging features of the myxoma clot on susceptibility weighted images. PMID:27040551

  10. NIMROD modeling of quiescent H-mode: Reconstruction considerations and saturation mechanism

    DOE PAGESBeta

    King, J. R.; Burrell, K. H.; Garofalo, A. M.; Groebner, R. J.; Kruger, S. E.; Pankin, A. Y.; Snyder, P. B.

    2016-09-30

    The extended-MHD NIMROD code (Sovinec and King 2010 J. Comput. Phys. 229 5803) models broadband-MHD activity from a reconstruction of a quiescent H-mode shot on the DIII-D tokamak (Luxon 2002 Nucl. Fusion 42 614). Computations with the reconstructed toroidal and poloidal ion flows exhibit low-nΦ perturbations (nΦ ≃1–5) that grow and saturate into a turbulent-like MHD state. The workflow used to project the reconstructed state onto the NIMROD basis functions re-solves the Grad–Shafranov equation and extrapolates profiles to include scrape-off-layer currents. In conclusion, evaluation of the transport from the turbulent-like MHD state leads to a relaxation of the density andmore » temperature profiles.« less

  11. [Myxoma of the left atrium presenting as repeated cerebrovascular disorders].

    PubMed

    Serrano, A; Machado, J; Gonçalves, L P; Proença, R

    1994-10-01

    Infarction of the central nervous system secondary to embolism from a left atrial myxoma is a recognized phenomenon. However, a myxoma as the source of an embolus may be overlooked, if, during the evaluation of a patient with a stroke of unknown etiology, an index of suspicion is not present. We report a case of a 57-year old woman presenting three episodes of cerebral infarction always in the same brain territory, suggesting a carotid pathology. The physical examination of the patient only showed a loud S1 with no other sounds and neurologic alterations, namely, right hemiparesia and aphasia. Diagnosis was made by two-dimensional echocardiography and better delineation was obtained by magnetic resonance imaging (MRI). The patient subsequently received a successful ressection of the myxoma. Eighteen months later the patient was well. PMID:7856464

  12. Maxillary odontogenic myxoma: a diagnostic pitfall on aspiration cytology.

    PubMed

    Kumar, Neeta; Jain, Shyama; Gupta, Sunita

    2002-08-01

    A painless, slow-growing cheek swelling in a young male clinically considered a salivary gland mass was aspirated. Cytology smears were hypocellular. The striking feature was abundant myxoid material with a few monomorphic oval cells, interpreted as myxoid variant of pleomorphic adenoma. Subsequent CT scan was suggestive of a malignant tumor but biopsy confirmed it as myxoma. Myxoma of the jaw is a rare benign tumor that has a tendency for bone destruction, invasion into surrounding structures, and a relatively high recurrence rate. Maxillary myxoma is less frequent but behaves more aggressively than in the mandible, as it spreads through the maxillary sinus. Cytologically, it should be differentiated from other tumors showing predominant myxoid change. Awareness of potential diagnostic pitfalls and careful evaluation of clinical and radiological data is necessary to narrow the differential diagnosis.

  13. Left Atrial Myxoma in a Late Case of Lung Carcinoma.

    PubMed

    Rahman, M M; Ranjan, R; Khan, O S; Aftabuddin, M; Hoque, M R

    2016-04-01

    Concomitant occurrence of lung carcinoma and an atrial myxoma is rare. We are reporting such a case, a 55 year old male, farmer, smoker for 30 years was under evaluation for his recent episode of stroke with hemiparesis during which an echocardiography showed presence of a left atrial myxoma and chest x-ray showed a lesion in the midzone of right lung. Fine needle aspiration cytology (FNAC) from enlarged right supraclavicular lymphnode revealed metastatic adenocarcinoma. Patient was referred to a tertiary cancer care hospital thereafter. PMID:27277375

  14. Odontogenic Myxoma in Children: A Case Report and Literature Review

    PubMed Central

    Dalbo Contrera Toro, Mariana; Siqueira Barreto, Icléia; Amstalden, Eliane Maria Ingrid; Takahiro Chone, Carlos; Nizam Pfeilsticker, Leopoldo

    2016-01-01

    Benign odontogenic lesions are rare entities but are very important due to their locally aggressive nature. Odontogenic myxoma is even rarer in children than in adults. There is no evidence in the literature in regard to the best treatment approach, in terms of conservative or aggressive surgery, for this type of tumor. This paper reports a case of odontogenic myxoma in a child treated with a compromised approach through bone osteotomies and a review of the literature about this disease, especially in pediatric patients. PMID:27064694

  15. Odontogenic Myxoma in Children: A Case Report and Literature Review.

    PubMed

    Dalbo Contrera Toro, Mariana; Siqueira Barreto, Icléia; Amstalden, Eliane Maria Ingrid; Takahiro Chone, Carlos; Nizam Pfeilsticker, Leopoldo

    2016-01-01

    Benign odontogenic lesions are rare entities but are very important due to their locally aggressive nature. Odontogenic myxoma is even rarer in children than in adults. There is no evidence in the literature in regard to the best treatment approach, in terms of conservative or aggressive surgery, for this type of tumor. This paper reports a case of odontogenic myxoma in a child treated with a compromised approach through bone osteotomies and a review of the literature about this disease, especially in pediatric patients. PMID:27064694

  16. Multiple Metastatic Intracranial Lesions Associated with Left Atrial Myxoma

    PubMed Central

    Kierdaszuk, Biruta; Gogol, Paweł; Kolasa, Anna; Maj, Edyta; Zakrzewska-Pniewska, Beata; Gołębiowski, Marek; Kamińska, Anna M.

    2014-01-01

    Summary Background One of the most common cardiac tumors is myxoma. Despite its predominantly benign course, diverse cardiological, systemic as well as neurological complications have been reported. Case Report We are the first from Poland to present the case of a patient with multiple central nervous system metastases associated with the left atrial myxoma. Various diagnostic, neuroradiological and histopathological procedures were described. The patient underwent cardiac surgery. Conclusions Follow-up studies excluded the recurrence of the heart tumor and confirmed partial resolution of brain metastases. Nevertheless, subsequent neurological assessment was advised according to the literature data and possible late relapses mainly due to cerebral emboli. PMID:25152797

  17. D Virtual Reconstruction of AN Urban Historical Space: a Consideration on the Method

    NASA Astrophysics Data System (ADS)

    Galizia, M.; Santagati, C.

    2011-09-01

    Urban historical spaces are often characterized by a variety of shapes, geometries, volumes, materials. Their virtual reconstruction requires a critical approach in terms of acquired data's density, timing optimization, final product's quality and slimness. The research team has focused its attention on the study on Francesco Neglia square (previously named Saint Thomas square) in Enna. This square is an urban space fronted by architectures which present historical and stylistic differences. For example you can find the Saint Thomas'church belfry (in aragounese-catalan stile dated XIV century) and the porch, the Anime Sante baroque's church (XVII century), Saint Mary of the Grace's nunnery (XVIII century) and as well as some civil buildings of minor importance built in the mid twentieth century. The research has compared two different modeling tools approaches: the first one is based on the construction of triangulated surfaces which are segmented and simplified; the second one is based on the detection of surfaces geometrical features, the extraction of the more significant profiles by using a software dedicated to the elaboration of cloud points and the subsequent mathematical reconstruction by using a 3d modelling software. The following step was aimed to process the virtual reconstruction of urban scene by assembling the single optimized models. This work highlighted the importance of the image of the operator and of its cultural contribution, essential to recognize geometries which generates surfaces in order to create high quality semantic models.

  18. Reconstructing the Teacher as a Post Secular Pedagogue: A Consideration of the New Teachers' Standards

    ERIC Educational Resources Information Center

    Bryan, Hazel

    2012-01-01

    The new Teachers' Standards draw upon the Prevent Strategy in foregrounding the upholding of "fundamental British values" as a central tenet in teacher work. This article explores the relationship between values, religion and Standards in teacher work. A consideration of the new Standards gives rise to the notion of teacher as cultural custodian,…

  19. Sporadic Multicentric Right Atrial and Right Ventricular Myxoma Presenting as Acute Pulmonary Thromboembolism.

    PubMed

    Singh, Satyajit; Tripathy, Mahendra Prasad; Mohanty, Bipin Bihari; Biswas, Sutapa

    2016-01-01

    Multicentric cardiac myxoma is a rare syndrome; usually it is familial. We report a rare case of sporadic right atrium (RA) and right ventricle (RV) myxoma in a 26-year-old female presenting to our hospital for the evaluation of sudden onset of dyspnea and left precordial pain attributed to the embolization of degenerating tumor fragments to the pulmonary artery (PA). The exact incidence of sporadic multicentric RA and RV myxoma presenting as acute pulmonary embolism is unknown as multicentric RA and RV myxoma are very rare. Myxomas presenting as pulmonary embolism is <10%. Majority of cardiac myxomas present as exertional dyspnea, chest pain, positional syncope, fever, weight loss and other constitutional symptoms. Any young patient presenting with acute onset dyspnea with multiple cardiac masses may have tumor embolization to the PA diagnosis with transthoracic echocardiography and high-resolution computed tomography of thorax, fast-tracks patient transfer for urgent cardiac surgery to prevent further embolization. PMID:27293525

  20. Fourth Recurrence of Cardiac Myxoma in a Patient with the Carney Complex.

    PubMed

    Kwon, O Young; Kim, Gun Jik; Jang, Woo Sung; Lee, Young Ok; Cho, Jun Yong; Lee, Jong Tae

    2016-04-01

    Although cardiac myxoma is the most commonly encountered benign cardiac tumor in cardiac surgery practice, recurrent cardiac myxoma is very rare, is most commonly related to the Carney complex, and usually requires multiple cardiac operations with specific requirements in terms of perioperative management. In this report, we describe a patient who experienced the fourth recurrence of cardiac myxoma and review the diagnostic criteria of the Carney complex. This is the first report of such a case in Korea. PMID:27066435

  1. Fourth Recurrence of Cardiac Myxoma in a Patient with the Carney Complex

    PubMed Central

    Kwon, O Young; Kim, Gun Jik; Jang, Woo Sung; Lee, Young Ok; Cho, Jun Yong; Lee, Jong Tae

    2016-01-01

    Although cardiac myxoma is the most commonly encountered benign cardiac tumor in cardiac surgery practice, recurrent cardiac myxoma is very rare, is most commonly related to the Carney complex, and usually requires multiple cardiac operations with specific requirements in terms of perioperative management. In this report, we describe a patient who experienced the fourth recurrence of cardiac myxoma and review the diagnostic criteria of the Carney complex. This is the first report of such a case in Korea. PMID:27066435

  2. Systemic embolisation as presentation and recurrence of cardiac myxoma two years after surgery.

    PubMed

    Liesting, C; Ramjankhan, F Z; van Herwerden, L A; Kofflard, M J M

    2010-10-01

    Primary cardiac tumours are rare when compared with metastatic involvement. The majority of primary cardiac tumours are benign and in adults the majority of these masses are myxomas. The treatment is surgical removal because of the risk of embolisation and/or cardiovascular complications. We describe a female presenting with systemic embolisation and recurrence of cardiac myxoma after surgery. Recurrence of myxoma is rare after surgery in case of solitary tumours but more frequent in patients with familial myxomas in association with the Carney complex. Genetic analysis revealed a mutation in the PRKAR1A gene that has never been described before. (Neth Heart J 2010;18:499502.). PMID:20978595

  3. Not all pain in the left iliac fossa is diverticular disease: A case study of a psoas myxoma and review.

    PubMed

    Dormand, E L; Prabhu-Desai, A; Rice, A J; Rosin, R D

    2006-08-01

    Intramuscular myxomas are rare, benign, mesenchymal tumours that may present to a wide variety of specialties. We present a case study of an intramuscular myxoma in the psoas muscle, followed by a review of the literature regarding the diagnosis and treatment of intramuscular myxomas PMID:16892842

  4. Condyloma acuminatum associated with odontogenic myxoma: a case report.

    PubMed

    Rajasekhar, G; Mushtaq, Mohammed; Vura, Nanda Gopal; Shekar, Ravi; Kumar, Sravan

    2009-12-01

    Condylomata acuminatum is a sexually transmitted infectious disease caused by human papiloma virus on the skin. The transmission is mainly by close contact with infected person and autoinoculation. In oral cavity the condition manifests as soft pink nodules which proliferate and coalesce rapidly to form diffuse papillomatous clusters of varying size. Odontogenic myxoma is a rare tumor of jaws which occurs in the tooth-bearing areas of the mandible and maxilla. It is an uncommon, benign, but locally aggressive neoplasm. This case report highlights a 17-year-old girl with two lesions in oral cavity with soft tissue growth on the palate which has been diagnosed as Condyloma Acuminatum, treated by surgical excision and a large swelling on the right side of the mandible in the same patient diagnosed as odontogenic myxoma where marginal resection was performed.

  5. Simultaneous resection of left atrial myxoma and esophageal carcinoma via right thoraco-abdominal approach

    PubMed Central

    Ni, Buqing; Lu, Xiaohu; Gong, Qixing

    2016-01-01

    Concomitant occurrence of atrial myxoma and esophageal carcinoma is an extremely rare entity. Here we present two cases of synchronously suffered left atrial myxoma and esophageal carcinoma. Both patients underwent simultaneous resection of two tumors via the right thoraco-abdominal approach and recovered well. PMID:27499990

  6. Simultaneous resection of left atrial myxoma and esophageal carcinoma via right thoraco-abdominal approach.

    PubMed

    Ni, Buqing; Lu, Xiaohu; Gong, Qixing; Shao, Yongfeng

    2016-07-01

    Concomitant occurrence of atrial myxoma and esophageal carcinoma is an extremely rare entity. Here we present two cases of synchronously suffered left atrial myxoma and esophageal carcinoma. Both patients underwent simultaneous resection of two tumors via the right thoraco-abdominal approach and recovered well. PMID:27499990

  7. GIANT-CELL RICH ATRIAL MYXOMA: REPORT OF TWO CASES AND REVIEW OF LITERATURE.

    PubMed

    Tariq, Hina; Mamoon, Nadira

    2016-01-01

    The cases of two middle age males are presented who were incidentally diagnosed to have atrial myxoma. Both of them underwent successful surgical interventions. Histologically, both myxomas showed abundant multinucleated giant cells, in addition to typical myxoid stroma with stellate and cord-like structures. PMID:27323595

  8. A Late Case of Ischemic Cerebral Event after Resection of a Left Atrial Myxoma.

    PubMed

    Lafleur, Reginald; Watkowska, Justyna; Zhou, Guoping; Alcide, Phenix; Saint-Jacques, Henock

    2016-01-01

    Atrial myxoma is one of the most common primary cardiac tumors reported in the literature. In very rare instances, stroke has been the sequelae after a myxomatous tumor resection. We report this unique case of late ischemic cerebral event in a 46-year-old female some days after resection of a left atrial myxoma. PMID:27403129

  9. Simultaneous resection of left atrial myxoma and esophageal carcinoma via right thoraco-abdominal approach.

    PubMed

    Ni, Buqing; Lu, Xiaohu; Gong, Qixing; Shao, Yongfeng

    2016-07-01

    Concomitant occurrence of atrial myxoma and esophageal carcinoma is an extremely rare entity. Here we present two cases of synchronously suffered left atrial myxoma and esophageal carcinoma. Both patients underwent simultaneous resection of two tumors via the right thoraco-abdominal approach and recovered well.

  10. A Late Case of Ischemic Cerebral Event after Resection of a Left Atrial Myxoma

    PubMed Central

    Lafleur, Reginald; Watkowska, Justyna; Zhou, Guoping; Alcide, Phenix; Saint-Jacques, Henock

    2016-01-01

    Abstract Atrial myxoma is one of the most common primary cardiac tumors reported in the literature. In very rare instances, stroke has been the sequelae after a myxomatous tumor resection. We report this unique case of late ischemic cerebral event in a 46-year-old female some days after resection of a left atrial myxoma. PMID:27403129

  11. Asymptomatic Left Ventricular Myxoma in a 12-Year-Old Male.

    PubMed

    Chlebowski, Meghan; O'Brien, James; Hertzenberg, Casey; Wagner, Jonathan

    2016-06-01

    Cardiac myxoma is the most common cardiac tumor in patients of all ages; the majority are encountered as single left atrial tumors. Left ventricular myxomas are exceedingly rare, having been recorded in a small number of case reports involving children worldwide. We report a case of a left ventricular myxoma with left ventricular outflow tract obstruction in a previously healthy, asymptomatic adolescent black male. Transthoracic echocardiograms revealed a single, large (2.5 × 5-cm), lobulated, mobile mass within the left ventricular cavity that oscillated into the outflow tract, thereby causing moderate obstruction during systole. Advanced images delineated the location and tissue composition of the mass, characterizing it as a myxoma. Complete surgical excision of the mass was accomplished via aortotomy. Gross examination and histology confirmed the diagnosis of myxoma. PMID:27303249

  12. Asymptomatic Left Ventricular Myxoma in a 12-Year-Old Male

    PubMed Central

    O'Brien, James; Hertzenberg, Casey; Wagner, Jonathan

    2016-01-01

    Cardiac myxoma is the most common cardiac tumor in patients of all ages; the majority are encountered as single left atrial tumors. Left ventricular myxomas are exceedingly rare, having been recorded in a small number of case reports involving children worldwide. We report a case of a left ventricular myxoma with left ventricular outflow tract obstruction in a previously healthy, asymptomatic adolescent black male. Transthoracic echocardiograms revealed a single, large (2.5 × 5-cm), lobulated, mobile mass within the left ventricular cavity that oscillated into the outflow tract, thereby causing moderate obstruction during systole. Advanced images delineated the location and tissue composition of the mass, characterizing it as a myxoma. Complete surgical excision of the mass was accomplished via aortotomy. Gross examination and histology confirmed the diagnosis of myxoma. PMID:27303249

  13. [The method of three-dimensional modeling for the reconstruction of the circumstances of the event taking into consideration blood stains].

    PubMed

    Pigolkin, Iu I; Leonov, S V; Leonova, E N; Nagornov, M N

    2014-01-01

    The objective of the present study was to estimate the possibility of using computer-assisted three-dimensional modeling for the solution of selected problems of forensic medical expertise. This approach is illustrated by an example of the reconstruction of the scene of action and circumstances of the injury taking into consideration blood stains. PMID:25764873

  14. The Echocardiographic Spectrum of Atrial Myxoma: A Ten-Year Experience

    PubMed Central

    Pechacek, Leonard W.; Gonzalez-Camid, Felipe; Hall, Robert J.; Garcia, Efrain; De Castro, Carlos M.; Leachman, Robert D.; Montiel-Amoroso, Gilberto

    1986-01-01

    We analyzed the echocardiograms of 28 patients with a left atrial myxoma and two with a right atrial myxoma. Our purpose was to evaluate the value of echocardiography for the diagnosis of these cardiac masses. Only 59% of the m-mode echocardiograms in patients with a left atrial myxoma showed the characteristic findings of multiple diastolic echoes within the mitral orifice as well as abnormal systolic echoes within the left atrium. M-mode echocardiograms were atypical for left atrial myxoma in the remaining patients, and a definitive diagnosis could not be established on the basis of this procedure in six of the patients (22%). Two-dimensional echocardiography showed the presence of a left atrial mass in all 16 patients who had the procedure, and aided in understanding the atypical m-mode recordings. There was a close relationship (r = .82) between two-dimensional echocardiographic measurements of the myxomas' size and pathologic measurements. Both right atrial myxomas could be identified on the m-mode echocardiogram. Our experience indicates that two-dimensional echocardiography is superior to the m-mode technique for the diagnosis and characterization of left atrial myxomas. Images PMID:15227359

  15. [Treatment of Right Atrial Myxoma Complicated with Pulmonary Embolism;Report of a Case].

    PubMed

    Jinnouchi, Kouki; Rikitake, Kazuhisa; Furutachi, Akira; Yoshida, Nozomi

    2016-07-01

    Myxomas are account for approximately half of primary cardiac tumors, 75% of which originate in the left atrium. We report a case of a right atrial myxoma complicated with bilateral pulmonary embolism. A 54-year-old woman was admitted to the hospital with a complaint of dyspnea. Echocardiography and computed tomography angiography showed a right atrial tumor and bilateral pulmonary embolism. We performed an emergency surgery to remove both the right atrial tumor and the pulmonary emboli. Histopathologically, the tumor was revealed to be myxoma. The postoperative course was uneventful. She is now doing well without any symptoms. PMID:27365068

  16. Pleomorphic rhabdomyosarcoma of the left atrium mimicking myxoma.

    PubMed

    Aggarwal, Tanvi; Goyal, Surbhi; Zaheer, Sufian

    2016-01-01

    Primary rhabdomyosarcoma (RMS) of the heart is a rare malignant tumor which has poor prognosis and survival despite surgery and adjuvant chemotherapy. The preoperative diagnosis is often difficult in view of nonspecific clinicoradiological findings. This report describes a case of a 60-year-old woman who was clinically diagnosed as left atrial myxoma. A diagnosis of pleomorphic RMS was made on histopathology after excision. Our case discusses the clinicopathological features and treatment options of cardiac RMS emphasizing the fact that histopathology and immunohistochemistry are essential to confirm the diagnosis of such an aggressive malignant tumor. PMID:27510683

  17. Considerations and Protocols in Virtual Surgical Planning of Reconstructive Surgery for More Accurate and Esthetic Neomandible with Deep Circumflex Iliac Artery Free Flap

    PubMed Central

    Kim, Nam-Kyoo; Kim, Hyun Young; Kim, Hyung Jun; Cha, In-Ho; Nam, Woong

    2014-01-01

    Purpose: The reconstruction of mandibular defects poses many difficulties due to the unique, complex shape of the mandible and the temporomandibular joints. With development of microvascular anastomosis, free tissue transplantation techniques, such as deep circumflex iliac artery (DCIA) flap and fibular free flap (FFF), were developed. The DCIA offers good quality and quantity of bone tissue for mandibular segmental defect and implant for dental rehabilitation. Virtual surgical planning (VSP) and stereolithography-guided osteotomy are currently successfully applied in three-dimensional mandibular reconstruction, but most use FFF. There are only a few articles on reconstruction with the DCIA that assess the postoperative results. Methods: Three patients admitted during a five month period (April of 2013 to August of 2013) underwent resection of mandible and DCIA musculo-osseous reconstruction using a VSP and stereolithographic modeling and assessment of outcomes included technical accuracy, esthetic contour, and functional outcomes. Results: This technique yielded iliac bone segment with excellent apposition and duplication of the preoperative plan. Flap survival was 100 percent and all patients maintained preoperative occlusion and contour. Conclusion: Based on our experience, we offer considerations and logically consistent protocols by classification of mandibular defects, and demonstrate the benefits in VSP and stereolithographic modeling of mandibular reconstructive surgery with DCIA flap. PMID:27489828

  18. [Odontogenic myxoma of nasosinusal localization in a pediatric patient].

    PubMed

    Arjona Amo, M; Belmonte Caro, R; Valdivieso del Pueblo, C; Batista Cruzado, A; Torres Lagares, D; Gutiérrez Pérez, J L

    2011-04-01

    In the present study we report and discuss a case of odontogenic myxoma in a 13-month-old patient. Only two other reports have been published in the literature describing the occurrence of this type of tumor at an earlier age. Odontogenic myxoma is a benign mesenchymal neoplasm of the maxilla more common between the third and fourth decades of life. The case here reported is exceptional as it presents in an infant and, although some cases have been reported in the literature, this type of tumor is rare in early childhood. The most common locations include the ascending ramus and the angle of the jaw, although these tumors may also affect the upper maxilla, in which case they may involve the maxillary sinus. According to the review of the literature, these tumors show a recurrence rate of about 25%. Consequently, after the intraoperative clinical examination of the lesion and the assessment of the initial suspected diagnosis by means of intraoperative biopsy under general anesthesia, we carried out the resection of the tumor with wide margins at some points of the tumor location.

  19. Primary Multiple Cardiac Myxomas in a Patient without the Carney Complex.

    PubMed

    Kataoka, Shohei; Otsuka, Masato; Goto, Masayuki; Kahata, Mitsuru; Kumagai, Asako; Inoue, Koji; Koganei, Hiroshi; Enta, Kenji; Ishii, Yasuhiro

    2016-03-01

    Cardiac tumors are rare, and multiple myxomas are even rarer. The latter phenomenon is mostly associated with the Carney complex, a dominantly inherited disease characterized by multiple primary cardiac myxomas, endocrinopathy, and spotty pigmentation of the skin. We report the rare case of a patient who did not have the Carney complex but had multiple primary cardiac tumors. A 78-year-old woman with a past history of breast cancer was referred to our hospital for further examination of multiple cardiac tumors. Echocardiography showed 4 tumors in the left atrium and left ventricle. We could not diagnose them preoperatively and decided to resect them surgically because they were mobile and could have caused embolism and obstruction. The postoperative pathological findings of all 4 tumors were myxomas, although the patient did not meet the diagnostic criteria of the Carney complex. Therefore, a rare case of multiple primary cardiac myxomas was diagnosed. PMID:27081449

  20. Primary Multiple Cardiac Myxomas in a Patient without the Carney Complex

    PubMed Central

    Otsuka, Masato; Goto, Masayuki; Kahata, Mitsuru; Kumagai, Asako; Inoue, Koji; Koganei, Hiroshi; Enta, Kenji; Ishii, Yasuhiro

    2016-01-01

    Cardiac tumors are rare, and multiple myxomas are even rarer. The latter phenomenon is mostly associated with the Carney complex, a dominantly inherited disease characterized by multiple primary cardiac myxomas, endocrinopathy, and spotty pigmentation of the skin. We report the rare case of a patient who did not have the Carney complex but had multiple primary cardiac tumors. A 78-year-old woman with a past history of breast cancer was referred to our hospital for further examination of multiple cardiac tumors. Echocardiography showed 4 tumors in the left atrium and left ventricle. We could not diagnose them preoperatively and decided to resect them surgically because they were mobile and could have caused embolism and obstruction. The postoperative pathological findings of all 4 tumors were myxomas, although the patient did not meet the diagnostic criteria of the Carney complex. Therefore, a rare case of multiple primary cardiac myxomas was diagnosed. PMID:27081449

  1. Benign Nerve Sheath Myxoma in an Infant Misdiagnosed as Infantile Digital Fibromatosis.

    PubMed

    Güngör, Şule; Şişman, Servet; Kocaturk, Emek; Oguz Topal, Ilteris; Yıldırım, Selda

    2016-07-01

    Herein we present the case of a 16-month boy, clinically diagnosed with infantile digital fibromatosis, but 9 months after continued growth, the mass was excised and the histopathologic diagnosis was that of a benign nerve sheath myxoma. We present this case to emphasize that nerve sheath myxomas (also known as myxoid neurothekeoma) should be included in the differential diagnosis of dermal nodules in infants. PMID:27196676

  2. Left atrial myxomas in childhood: Presentation with emboli—diagnosis by ultrasonics

    PubMed Central

    Pridie, Ronald B.

    1972-01-01

    Three children with left atrial myxomas are described. All suffered major arterial occlusion with consequent permanent morbidity before the diagnosis was made and the tumour removed. Each child had had previous small embolic phenomena. In two, the diagnosis was made by ultrasound. In any child who has had an arterial embolus without obvious cause, a left atrial myxoma should be considered and looked for by an ultrasonic mitral echogram. Images PMID:4647636

  3. Protection against myxomatosis and rabbit viral hemorrhagic disease with recombinant myxoma viruses expressing rabbit hemorrhagic disease virus capsid protein.

    PubMed Central

    Bertagnoli, S; Gelfi, J; Le Gall, G; Boilletot, E; Vautherot, J F; Rasschaert, D; Laurent, S; Petit, F; Boucraut-Baralon, C; Milon, A

    1996-01-01

    Two myxoma virus-rabbit hemorrhagic disease virus (RHDV) recombinant viruses were constructed with the SG33 strain of myxoma virus to protect rabbits against myxomatosis and rabbit viral hemorrhagic disease. These recombinant viruses expressed the RHDV capsid protein (VP60). The recombinant protein, which is 60 kDa in size, was antigenic, as revealed by its reaction in immunoprecipitation with antibodies raised against RHDV. Both recombinant viruses induced high levels of RHDV- and myxoma virus-specific antibodies in rabbits after immunization. Inoculations by the intradermal route protected animals against virulent RHDV and myxoma virus challenges. PMID:8764013

  4. Two-strand posterior cruciate ligament reconstruction with a quadriceps tendon-patellar bone autograft: technical considerations and clinical results.

    PubMed

    Noyes, Frank R; Barber-Westin, Sue D

    2006-01-01

    In patients with complete posterior cruciate ligament (PCL) ruptures in which 10 mm or more of increased posterior tibial translation is detected, associated knee disorders must be treated at the same time as the PCL injury. Varus malalignment and any abnormal medial or lateral ligament deficiency must be corrected before or with PCL reconstruction to avoid the risk of failure of the PCL graft. Gait retraining is recommended for patients with abnormal knee hyperextension patterns before ligament reconstruction is performed. Advances in PCL reconstruction include the use of a two-strand graft that may be placed using either a tibial inlay or an all-arthroscopic tibial tunnel technique. Biomechanical studies have shown a reduction in graft tension and improved load sharing in these constructs compared with single-strand reconstructions. The tibial inlay method can be used in athletic patients, and it also is required in PCL revisions in which a prior tibial tunnel must be avoided to achieve graft fixation. The tibial tunnel technique is used to treat dislocated knees for which reconstruction of multiple knee ligaments is required or when prior arterial injury or posterior skin or muscle damage limits the indications for a posterior open approach. Postoperative rehabilitation should protect the PCL graft from high forces and repetitive cyclic knee motions during the first 4 weeks postoperatively.

  5. [About a case of a recurrent glandular cardiac myxoma in a child].

    PubMed

    Meurgey, Alexandra; Henaine, Roland; Bouvagnet, Patrice; Chalabreysse, Lara

    2016-06-01

    Primary cardiac tumors are extremely rare and mainly benign. The majority of these are myxomas (40%). Myxoma are generally sporadic tumors which occur most commonly in adult females between 30 and 40 years, and are seldom found in the paediatric population (5%). Seven percent are associated with igenetic diseases. We report the case of an eight-year-old boy presenting a recurrent glandular cardiac myxoma. In 2011, he presented a deterioration of the general state. An echocardiography highlighted a left atrial mass on the interatrial septum, with a pedicular insertion. On the microscope, it consisted of a proliferation of stellate cells isolated or clustered in rudimentary vessels in a myxoid stroma presenting haemorrhage changes. These cells expressed CD34 and calretinine. Glandular elements without atypia were clustered within the myxomatous proliferation. They expressed cytokeratin (CK) 7. Surgical resection was macroscopically complete. In 2014, the boy had a sudden neurological deficit during a football match. An echocardiography revealed a recurrence at the same location. The lesion was excised and addressed in several fragments. Classical myxoma was associated with glands without atypia. This last component expressed CKAE1/AE3 and CK7. Ki67 index of proliferation was low. The surgical reintervention was macroscopically complete. The final diagnosis was glandular cardiac myxoma. A genetic survey was conducted, showing the presence of Carney complex. This is the first description in the litterature of a recurrent glandular cardiac myxoma occuring in a child. PMID:27234518

  6. Ancient cardiac myxomas - another point of view in the light of tetraspanins.

    PubMed

    Lewitowicz, P; Bernaczyk, P; Horecka-Lewitowicz, A; Leszczyńska, U; Reszeć, J; Hirnle, T; Wincewicz, A

    2016-03-01

    Myxomas are the most common non-invasive but life-threatening cardiac neoplasms due to obstruction of heart chambers and risk of embolism in a manner resembling thromboembolism as well. They can occasionally disseminate via their detached fragments into the bloodstream to seed and grow as secondary still benign tumors. In this study we evaluated morphological and clinical aspects of 14 ancient, degenerated left or right-sided cardiac atrial myxomas with expression of CD9 and CD63, which are found to contribute to platelet activation, aggregation and, as a result, intratumoral thrombosis or fragmentation. The appearance of tumors varied from sessile to polypoid revealing that a higher rate of endocardial thrombosis was associated with sessile compared to polypoid myxomas and left-sided tumors compared to right-sided ones in our study. In the general aspect of ancient calcifications, amorphous calcification with intra-tumor thrombosis was noted more frequently in sessile tumors, while well-formed osseous metaplasia was usually a feature of polypoid tumors. In our material osseous metaplasia did not coexist with massive thrombosis and was found in polypoid, pedunculated myxomas. Most importantly, CD9 overexpression was recorded in every studied myxoma and CD63 gave a weak reaction in myxoma cells. PMID:27179277

  7. PRKAR1A in the development of cardiac myxoma: a study of 110 cases including isolated and syndromic tumors.

    PubMed

    Maleszewski, Joseph J; Larsen, Brandon T; Kip, Nefize Sertac; Castonguay, Mathieu C; Edwards, William D; Carney, J Aidan; Kipp, Benjamin R

    2014-08-01

    Cardiac myxoma usually occurs as a solitary mass, but occasionally develops as part of a familial syndrome, the Carney complex (CNC). Two thirds of CNC-associated cardiac myxomas exhibit mutations in PRKAR1A. PRKAR1A mutations occur in both familial and sporadic forms of CNC but have not been described in isolated (nonsyndromic) cardiac myxomas. A total of 127 consecutive cardiac myxomas surgically resected at Mayo Clinic (1993 to 2011) from 110 individuals were studied. Clinical, radiologic, and pathologic findings were reviewed. Of these, 103 patients had isolated cardiac myxomas, and 7 patients had the tumor as a component of CNC. Age and sex distributions were different for CNC (mean 26 y, range 14 to 44 y, 71% female) and non-CNC (mean 62 y, range 18 to 92 y, 63% female) patients. PRKAR1A immunohistochemical analysis (IHC) was performed, and myxoma cell reactivity was graded semiquantitatively. Bidirectional Sanger sequencing was performed in 3 CNC patients and 29 non-CNC patients, to test for the presence of mutations in all coding regions and intron/exon boundaries of the PRKAR1A gene. IHC staining showed that all 7 CNC cases lacked PRKAR1A antigenicity and that 33 (32%) isolated cardiac myxomas were similarly nonreactive. Of tumors subjected to sequencing analysis, 2 (67%) CNC myxomas and 9 (31%) non-CNC myxomas had pathogenic PRKAR1A mutations. No germline mutations were found in 4 non-CNC cases tested. PRKAR1A appears to play a role in the development of both syndromic and nonsyndromic cardiac myxomas. Routine IHC evaluation of cardiac myxomas for PRKAR1A expression may be useful in excluding a diagnosis of CNC. PMID:24618615

  8. Left atrial myxoma associated with obstructive coronary artery disease.

    PubMed

    Gismondi, Ronaldo Altenburg Odebrecht Curi; Kaufman, Renato; Correa, Gabriel Angelo de Cata Preta; Nascimento, César; Weitzel, Luiz Henrique; Reis, José Oscar Brito; da Rocha, Antônio Sérgio Cordeiro; da Cunha, Ademir Batista

    2007-01-01

    We describe a case of a 67 year-old patient with obstructive coronary artery disease that, in the preoperative survey for inguinal herniorraphy surgery, discovered, by a two-dimensional echocardiogram, a tumor in left atrium, mobile, non-obstructive. The patient underwent a cineangiocoronariography showing severe stenosis in the left anterior descending artery, moderate stenosis in the left circumflex artery, near the origin of the first marginal branch, and a non-obstructive plaque in the right coronary artery. There was also moderate left ventricular dysfunction. After that, the patient has gone coronary artery bypass surgery and resection of the left atrial tumor. The histological exam revealed that the tumor was, in fact, a myxoma. PMID:17364102

  9. Myxoma Virus Encodes an α2,3-Sialyltransferase That Enhances Virulence

    PubMed Central

    Jackson, Ronald J.; Hall, Diana F.; Kerr, Peter J.

    1999-01-01

    A 4.7-kb region of DNA sequence contained at the right end of the myxoma virus EcoRI-G2 fragment located 24 kb from the right end of the 163-kb genome has been determined. This region of the myxoma virus genome encodes homologs of the vaccinia virus genes A51R, A52R, A55R, A56R, and B1R; the myxoma virus gene equivalents have been given the prefix M. The MA55 gene encodes a protein belonging to the kelch family of actin-binding proteins, while the MA56 gene encodes a member of the immunoglobulin superfamily related to a variety of cellular receptors and adhesion molecules. A novel myxoma virus early gene, MST3N, is a member of the eukaryotic sialyltransferase gene family located between genes MA51 and MA52. Detergent lysates prepared from myxoma virus-infected cell cultures contained a virally encoded sialyltransferase activity that catalyzed the transfer of sialic acid (Sia) from CMP-Sia to an asialofetuin glycoprotein acceptor. Analysis of the in vitro-sialylated glycoprotein acceptor by digestion with N-glycosidase F and by lectin binding suggested that the MST3N gene encodes an enzyme with Galβ1,3(4)GlcNAc α2,3-sialyltransferase specificity for the N-linked oligosaccharide of glycoprotein. Lectin binding assays demonstrated that α2,3-sialyltransferase activity is expressed by several known leporipoxviruses that naturally infect Sylvilagus rabbits. The sialyltransferase is nonessential for myxoma virus replication in cell culture; however, disruption of the MST3N gene caused attenuation in vivo. The possible implications of the myxoma virus-expressed sialyltransferase in terms of the host’s defenses against infection are discussed. PMID:9971821

  10. In vitro pulsatile flow visualization on extracardiac conduits for the right ventricular outflow tract reconstruction: qualitative considerations.

    PubMed

    Yuan, S M; Chang, Q; Guo, Y R; Guo, J Q

    1998-05-01

    Valved homograft conduits play an important role in the right ventricular outflow tract (RVOT) reconstruction for the surgical treatment of complex congenital heart disease. An excellent immediate rather than long-term outcome could be obtained. The hemodynamics for late failure, however, remained unclear. In vitro pulsatile flow visualization was not conducted before. A simplified right heart duplicator system was set up and driven under physiologic conditions. Polystyrene of 0.18 mm in diameter was applied as the tracing particle. Flow characteristics of models of normal pulmonary circulation as well as pulmonary artery atresia with the RVOT reconstructed utilizing valved and non-valved extracardiac conduits were observed. Flow patterns in the normal pulmonary circulatory model were mainly of axial flow associated with small scope of flow disturbances. A single vortex in the right ventricle was noted in diastole. In the pulmonary artery atresia model, a couple of vortexes were found in the right ventricle, a secondary flow in the main pulmonary artery, and a stronger secondary flow than in the normal pulmonary circulatory model in the two branches in both systole and diastole. A secondary flow was found in the proximal, an axial flow was observed in the distal portion of the extracardiac conduit with normal bioprosthetic valves and a secondary flow was observed in the entire conduit with stenotic bioprosthetic valves. The secondary flow intensity became stronger with the development of the stenosis. Severe insufficiency occurred in the bileaflet ceramic tilting-disc prosthesis during the entire cardiac circle, i.e., the prosthesis was in a maximum open position. Severe reverse flow could be found in the extracardiac conduit in the deceleration phase. Concavity of the crank shaft was found by examination to be filled with tracing particles and the prosthesis became stuck. Model of RVOT reconstruction with non-valved conduit yielded reverse flow inside the

  11. Isolated Myxoma in the External Auditory Canal of a 10-Year-Old Girl.

    PubMed

    Lee, Dong Hee; Jeong, Su Hee; Kim, Hojong; Shin, Eunhye

    2015-12-01

    Myxoma is a benign connective tissue tumor that is most commonly found in the heart. Because myxoma of the external ear is extremely rare, its diagnosis may be easily delayed or it may be misdiagnosed as another disease. Moreover, because it can be a part of Carney complex (autosomal dominant syndrome), its correct diagnosis is very important. We experienced a 10-year-old girl who had a mass on the posterior surface of the tragus at the entrance of the left ear canal. Fine-needle aspiration revealed mucoid content of the cystic mass, but its cytology did not confirm the diagnosis. The whole mass was surgically removed, and the diagnosis was confirmed as myxoma with a stellate spindle cell proliferation in the hypocellular matrix. Thorough examination failed to determine any presentation of Carney complex, and her final diagnosis was isolated myxoma of the external auditory canal. This is the first reported study regarding myxoma of the external auditory canal in the Korean literature. PMID:26915162

  12. EBV+ diffuse large B-cell lymphoma arising within atrial myxoma in Chinese immunocompetent patient

    PubMed Central

    Liu, Xiaoyan; Liu, Pu; Li, Jun

    2015-01-01

    The incidence rate of Primary cardiac lymphoma is very low. Primary cardiac lymphoma within myxoma is extremely rare disease. So far, these cases have been reported only eight in the world, which has not reported in Chinese so far. Hence, we reported the unique Chinese case of 52-year-old immunocompetent male with primary Epstein-Barr virus positive diffuse large B-cell lymphoma arising within atrial myxoma, and had no evidence of systemic lymphoma. The patient presented right sided body numbness, arm weakness no incentive and mouth twitch. A transthoracic echocardiogram revealed a large intraatrial mass, attached to the left atrial wall. The mass was removed by open thoracic surgery and subsequently diagnosed as malignant diffuse large B-cell lymphoma with myxoma by histopathology. This was the fourth case of discovered Epstein-Barr virus positive diffuse large B-cell lymphoma in a cardiac myxoma reported so far. The patient has been well by followed up for 5 months without chemotherapy. Now we discuss the importance of histodiagnosis and the proper treatment. Epstein-Barr virus positive diffuse large B-cell lymphoma arising within atrial myxoma is an extraordinary lymphoma for better prognosis, avoiding excessive treatment. PMID:25973119

  13. Effective mechanical thrombectomy in a patient with hyperacute ischemic stroke associated with cardiac myxoma.

    PubMed

    Baek, Seol-Hee; Park, Soonchan; Lee, Nam Joon; Kang, Youngjin; Cho, Kyung-Hee

    2014-10-01

    Ischemic stroke is the most common neurologic manifestation of cardiac myxoma. However, there has been no current guideline on the treatment of hyperacute ischemic stroke due to cardiac myxoma. We describe a patient with hyperacute stroke caused by cardiac myxoma who had a good outcome with rapid recanalization through mechanical thrombectomy. A 46-year-old man was admitted with acute symptoms of right side hemiplegia and global aphasia. Brain computed tomography (CT) angiography showed a T occlusion of the left internal carotid artery. Intravenous recombinant tissue plasminogen activator was administered. However, his clinical symptoms did not improve. Thus, we performed endovascular treatment and had a successful outcome. A pathologic examination of the retrieved clot revealed a tumor emboli from a cardiac myxoma. Transthoracic echocardiogram revealed a left atrial myxoma in which a large mass was attached to the posterior wall of the aorta. The patient's neurologic deficits recovered with the exception of left eye blindness. Reperfusion therapy with mechanical thrombectomy might be safe and effective for the rapid revascularization of large vessel occlusions in hyperacute ischemic stroke, from which the tumor thrombi can be retrieved. PMID:25174564

  14. Genome Sequence of SG33 Strain and Recombination between Wild-Type and Vaccine Myxoma Viruses

    PubMed Central

    Gretillat, Magalie; Py, Robert; Gelfi, Jacqueline; Guérin, Jean-Luc; Bertagnoli, Stéphane

    2011-01-01

    Myxomatosis in Europe is the result of the release of a South America strain of myxoma virus in 1952. Several attenuated strains with origins in South America or California have since been used as vaccines in the rabbit industry. We sequenced the genome of the SG33 myxoma virus vaccine strain and compared it with those of other myxoma virus strains. We show that SG33 genome carries a large deletion in its right end. Furthermore, our data strongly suggest that the virus isolate from which SG33 is derived results from an in vivo recombination between a wild-type South America (Lausanne) strain and a California MSD-derived strain. These findings raise questions about the use of insufficiently attenuated virus in vaccination. PMID:21470452

  15. Single-Stage Minimally Invasive Surgery for Synchronous Primary Pulmonary Adenocarcinoma and Left Atrial Myxoma.

    PubMed

    van der Merwe, Johan; Beelen, Roel; Martens, Sebastiaan; Van Praet, Frank

    2015-12-01

    We report the first successful short-term outcome of single-stage combined video-assisted thoracoscopic surgery lobectomy and port access surgery in a patient with operable primary right lower lobe adenocarcinoma and a synchronous cardiac myxoma. The video-assisted thoracic surgery right lower lobectomy with systematic lymph node dissection was performed first, followed by myxoma excision by port access surgery through the same working port incision. The histopathologic analysis confirmed a pT2a N0 M0 R0 (TNM 7th edition) primary poorly differentiated pulmonary adenocarcinoma and a completely excised cardiac myxoma. Postoperative recovery was uneventful, and follow-up at 6 weeks confirmed an excellent surgical and oncologic outcome.

  16. Myxoma of the ear lobe in a 23-month-old girl with Carney complex.

    PubMed

    Briassoulis, George; Quezado, Martha; Lee, Chyi-Chia Richard; Xekouki, Paraskevi; Keil, Meg; Stratakis, Constantine A

    2012-01-01

    Myxomas of the ear are extremely uncommon, especially in young children. A 23-month-old girl born to a family with known Carney complex, a condition that predisposes to multiple myxomas, presented with a large, cauliflower-like mass located on the back of her right ear. Histopathologically, the lesion was composed of scattered spindle-shaped or stellate cells with abundant associated mucin and a very sparse inflammatory infiltrate containing lymphocytes and neutrophils. The patient was a carrier of a protein kinase A regulatory subunit 1A (PRKAR1A) mutation; PRKAR1A mutations cause Carney complex in most patients with this rare disorder. This is the earliest presentation of an ear lobe myxoma reported in the literature. PMID:21880053

  17. Rare appearance of an odontogenic myxoma in cone-beam computed tomography: a case report.

    PubMed

    Dabbaghi, Arash; Nikkerdar, Nafiseh; Bayati, Soheyla; Golshah, Amin

    2016-01-01

    Odontogenic myxoma (OM) is an infiltrative benign bone tumor that occurs almost exclusively in the facial skeleton. The radiographic characteristics of odontogenic myxoma may produce several patterns, making diagnosis difficult. Cone-beam computed tomography (CBCT) may prove extremely useful in clarifying the intraosseous extent of the tumor and its effects on surrounding structures. Here, we report a case of odontogenic myxoma of the mandible in a 27-year-old female. The patient exhibited a slight swelling in the left mandible. Surgical resection was performed. No recurrence was noted. In the CBCT sections, we observed perforation of the cortical plate and radiopaque line that extended from the periosteum, resembling "sunray" appearance-a rare feature of OM-which could not be assessed by panoramic radiography. PMID:27092217

  18. Rare appearance of an odontogenic myxoma in cone-beam computed tomography: a case report

    PubMed Central

    Dabbaghi, Arash; Nikkerdar, Nafiseh; Bayati, Soheyla; Golshah, Amin

    2016-01-01

    Odontogenic myxoma (OM) is an infiltrative benign bone tumor that occurs almost exclusively in the facial skeleton. The radiographic characteristics of odontogenic myxoma may produce several patterns, making diagnosis difficult. Cone-beam computed tomography (CBCT) may prove extremely useful in clarifying the intraosseous extent of the tumor and its effects on surrounding structures. Here, we report a case of odontogenic myxoma of the mandible in a 27-year-old female. The patient exhibited a slight swelling in the left mandible. Surgical resection was performed. No recurrence was noted. In the CBCT sections, we observed perforation of the cortical plate and radiopaque line that extended from the periosteum, resembling "sunray" appearance—a rare feature of OM—which could not be assessed by panoramic radiography. PMID:27092217

  19. Rare appearance of an odontogenic myxoma in cone-beam computed tomography: a case report.

    PubMed

    Dabbaghi, Arash; Nikkerdar, Nafiseh; Bayati, Soheyla; Golshah, Amin

    2016-01-01

    Odontogenic myxoma (OM) is an infiltrative benign bone tumor that occurs almost exclusively in the facial skeleton. The radiographic characteristics of odontogenic myxoma may produce several patterns, making diagnosis difficult. Cone-beam computed tomography (CBCT) may prove extremely useful in clarifying the intraosseous extent of the tumor and its effects on surrounding structures. Here, we report a case of odontogenic myxoma of the mandible in a 27-year-old female. The patient exhibited a slight swelling in the left mandible. Surgical resection was performed. No recurrence was noted. In the CBCT sections, we observed perforation of the cortical plate and radiopaque line that extended from the periosteum, resembling "sunray" appearance-a rare feature of OM-which could not be assessed by panoramic radiography.

  20. Coincidence of congenital infiltrative facial lipoma and lingual myxoma in a newborn Holstein calf.

    PubMed

    Hobbenaghi, R; Dalir-Naghadeh, B; Nazarizadeh, A

    2015-01-01

    A one-day-old male Holstein calf was presented with a palpable subcutaneous mass, extending from the parotid to the orbital region, involving the entire right side of the face and a large flabby mass without any evidence of inflammation or edema on the tongue. Macroscopically, the cut surface of the lingual mass appeared slightly lobulated, pink, with a mucoid appearance and gelatinous consistency. Histopathological examination confirmed the infiltrative subcutaneous lipoma and lingual myxoma evidenced by low cellularity and abundant basophilic, mucinous stroma. In this report, clinical and detailed histhopathological findings of congenital infiltrative myxoma and its coincidence with infiltrative facial lipoma is reported in a newborn calf.

  1. The prevention of circulatory collapse in left atrial myxoma or left atrail thrombus patients.

    PubMed

    Sun, Jie; Ding, Zhengnian

    2016-05-01

    Some patients with myxoma or thrombus may develop to severe hypotension or sudden death. In this article, we hypothesize a clinical scenario that when the myxoma or thrombus blocks in the mitral valve and causes significant hypotension during anesthesia or surgery. Increasing cardiac preload will be an effective preventive method to increasing the mitral valve annulus and decreasing the severity of stenosis, as a result it will prevent circulatory collapse. Our hypothesis will decrease the possibility of lethal mitral valve stenosis induced by left atrial mass blocking the mitral valve area. In addition, we should also maintain a relative slow heart rate and a relative high systemic vascular resistance. PMID:27063074

  2. Odontogenic myxoma of maxilla: A rare presentation in an elderly female

    PubMed Central

    Vijayabanu, B.; Sreeja, C.; Bharath, N.; Aesha, I.; Kannan, V. Sadesh; Devi, M.

    2015-01-01

    Odontogenic myxomas are rare benign neoplasm of mesenchymal origin, comprising 3–6% of all odontogenic tumors. They are slow growing, non-metastasizing, often asymptomatic with local aggressiveness due to its infiltrative nature and hence high recurrence rate, with a high incidence of occurrence in the mandible. Most frequently occurs in second to third decade of life, seldom occurs beyond these age groups. Hereby, we present a case of odontogenic myxoma occurring in the maxilla in a 65-year-old female managed by partial maxillectomy. PMID:26538962

  3. Odontogenic myxoma of maxilla: A rare presentation in an elderly female.

    PubMed

    Vijayabanu, B; Sreeja, C; Bharath, N; Aesha, I; Kannan, V Sadesh; Devi, M

    2015-08-01

    Odontogenic myxomas are rare benign neoplasm of mesenchymal origin, comprising 3-6% of all odontogenic tumors. They are slow growing, non-metastasizing, often asymptomatic with local aggressiveness due to its infiltrative nature and hence high recurrence rate, with a high incidence of occurrence in the mandible. Most frequently occurs in second to third decade of life, seldom occurs beyond these age groups. Hereby, we present a case of odontogenic myxoma occurring in the maxilla in a 65-year-old female managed by partial maxillectomy. PMID:26538962

  4. Coincidence of congenital infiltrative facial lipoma and lingual myxoma in a newborn Holstein calf.

    PubMed

    Hobbenaghi, R; Dalir-Naghadeh, B; Nazarizadeh, A

    2015-01-01

    A one-day-old male Holstein calf was presented with a palpable subcutaneous mass, extending from the parotid to the orbital region, involving the entire right side of the face and a large flabby mass without any evidence of inflammation or edema on the tongue. Macroscopically, the cut surface of the lingual mass appeared slightly lobulated, pink, with a mucoid appearance and gelatinous consistency. Histopathological examination confirmed the infiltrative subcutaneous lipoma and lingual myxoma evidenced by low cellularity and abundant basophilic, mucinous stroma. In this report, clinical and detailed histhopathological findings of congenital infiltrative myxoma and its coincidence with infiltrative facial lipoma is reported in a newborn calf. PMID:27175195

  5. Report of a Rare Case of an Odontogenic Myxoma of the Maxilla and Review of Literature

    PubMed Central

    Manjunath, SM; Gupta, AA; Swetha, P; Moon, NJ; Singh, S; Singh, A

    2014-01-01

    Odontogenic myxoma (OM) is a mesenchymal tissue benign neoplasia, being relatively rare which is almost exclusively seen in tooth-bearing areas. OM commonly occurs in the 2nd and 3rd decade and the mandible is involved more commonly than the maxilla. The lesion often grows without symptoms and presents as a painless swelling. Radiographically, the myxoma appears as a unilocular or multilocular radiolucency. This article presents a rare case of OM occurring in the maxilla of a 28-year-old female patient with a brief review of the literature. PMID:25031907

  6. Deletion analysis of two tandemly arranged virulence genes in myxoma virus, M11L and myxoma growth factor.

    PubMed Central

    Opgenorth, A; Graham, K; Nation, N; Strayer, D; McFadden, G

    1992-01-01

    Myxoma virus (MYX) is a leporipoxvirus of rabbits that induces a lethal syndrome characterized by disseminated tumorlike lesions, generalized immunosuppression, and secondary gram-negative bacterial infection. A MYX deletion mutant (vMYX-GF- delta M11L) was constructed to remove the entire myxoma growth factor (MGF) coding sequence and that for the C-terminal five amino acids of the partially overlapping upstream gene, M11L. Unexpectedly, this deletion completely abrogates the capacity of MYX to cause the characteristic disease symptoms of myxomatosis. Upon inoculation of rabbits with vMYX-GF- delta M11L, recipient animals developed only a benign, localized nodule reminiscent of a Shope fibroma virus-induced tumor in which a single primary lesion appeared at the site of injection and then completely regressed within 14 days, leaving the animals resistant to challenge with wild-type MYX. No evidence of the purulent conjunctivitis and rhinitis that always accompany wild-type MYX infection was observed. To ascertain whether the attenuation observed in vMYX-GF- delta M11L was due to a combined effect of the MGF deletion and alteration of the upstream M11L gene, two additional MYX recombinants were constructed: an MGF- virus (vMYX-GF-) containing an intact M11L gene and an M11L- virus (vMYX-M11L-) containing an intact MGF gene. Infection with vMYX-GF- resulted in moderated symptoms of myxomatosis, but all clinical stages of the disease were still detectable. In contrast, disruption of M11L alone dramatically reduced the virus virulence, resulting in a nonlethal syndrome whose clinical course was nevertheless distinct from that of vMYX-GF- delta M11L. Upon inoculation with vMYX-M11L-, rabbits developed primary and secondary tumors which were larger and more circumscribed than those of wild-type MYX recipients. Whereas wild-type MYX infection always includes severe, purulent conjunctivitis and rhinitis, vMYX-M11L- recipients remained healthy and displayed only minimal

  7. Prevention of EBV lymphoma development by oncolytic myxoma virus in a murine xenograft model of post-transplant lymphoproliferative disease

    SciTech Connect

    Kim, Manbok; Rahman, Masmudur M.; Cogle, Christopher R.

    2015-07-10

    Epstein–Barr virus (EBV) has been associated with a variety of epithelial and hematologic malignancies, including B-, T- and NK cell-lymphomas, Hodgkin's disease (HD), post-transplant lymphoproliferative diseases (LPDs), nasopharyngeal and gastric carcinomas, smooth muscle tumors, and HIV-associated lymphomas. Currently, treatment options for EBV-associated malignancies are limited. We have previously shown that myxoma virus specifically targets various human solid tumors and leukemia cells in a variety of animal models, while sparing normal human or murine tissues. Since transplant recipients of bone marrow or solid organs often develop EBV-associated post-transplant LPDs and lymphoma, myxoma virus may be of utility to prevent EBV-associated malignancies in immunocompromised transplant patients where treatment options are frequently limited. In this report, we demonstrate the safety and efficacy of myxoma virus purging as a prophylactic strategy for preventing post-transplant EBV-transformed human lymphomas, using a highly immunosuppressed mouse xenotransplantation model. This provides support for developing myxoma virus as a potential oncolytic therapy for preventing EBV-associated LPDs following transplantation of bone marrow or solid organ allografts. - Highlights: • Myxoma virus effectively infects and purges EBV lymphoma cells in vivo. • Oncolytic myxoma virus effectively eradicates oncogenic EBV tumorigenesis. • Ex vivo pre-treatment of myxoma virus can be effective as a preventive treatment modality for post-transplant lymphoproliferative diseases.

  8. The myxoma virus thymidine kinase gene: sequence and transcriptional mapping.

    PubMed

    Jackson, R J; Bults, H G

    1992-02-01

    The myxoma virus thymidine kinase (TK) gene is encoded on a 1.6 kb SacI-SalI restriction fragment located between 57.7 and 59.3 kb on the 163 kb genomic map. The nucleotide sequence of this fragment as well as 228 bp from the adjacent SalI-AA2 fragment was determined and found to encode four major open reading frames (ORFs). Three of these ORFs are similar in nucleotide sequence to ORFs L5R and J1R, and the TK gene of vaccinia virus (VV). The fourth ORF, MF8a, shows similarity to the ORFs found in the same position relative to the TK genes of Shope fibroma virus, Kenya sheep-1 virus and swine-pox virus. A search of the complete VV nucleotide sequence for regions of similarity to MF8a identified the host specificity gene C7L. Northern blot analysis of early viral RNA identified transcripts of approximately 700 nucleotides for both the TK gene and ORF MF8a. The 5' ends of the TK gene and ORF MF8a early mRNAs were mapped by primer extension to initiation sites 13 nucleotides downstream of sequences with similarity to the VV early promoter consensus. The sizes of the TK and MF8a mRNAs are consistent with transcription termination and polyadenylation occurring downstream of the sequence TTTTTNT, which is identical to the consensus sequence for the VV transcription termination signal.

  9. A case of large atrial myxoma presenting as an acute stroke.

    PubMed

    Iyer, Praneet; Aung, Myo Myo; Awan, Muhammad Umer; Kososky, Charles; Barn, Kulpreet

    2016-01-01

    Left atrial myxomas are rare primary cardiac tumors. Their incidence is estimated to be about 0.1% of total cases. Neurological complications resulting from cardiac myxomas are seen in 20-35% of patients. Transesophageal echocardiogram (TEE) is preferred over transthoracic echocardiogram for evaluation of left atrial myxoma. Three-dimensional (3D) echocardiography ensures better visualization of intracardiac structures. It has been used prior to surgery for diagnostic support in the surgical treatment of cardiac masses. We present a case of a 46-year-old Hispanic male who developed acute ischemic stroke of left frontal lobe and was also found to have multiple 'silent' cerebral infarcts in the MRI of the brain. On further workup, he was found to have a left atrial myxoma on 3D TEE. This was resected with the assistance of intra-operative 3D TEE imaging. We present this case to increase awareness and to stress at early evaluation of secondary causes of ischemic cerebrovascular accident, outside the realm of hypercoagulability. This case also exhibits the need for basic cardiac workup in young individuals who present with symptoms of intermittent palpitations or chest pain to minimize significant morbidity or mortality.

  10. A case of large atrial myxoma presenting as an acute stroke

    PubMed Central

    Iyer, Praneet; Aung, Myo Myo; Awan, Muhammad Umer; Kososky, Charles; Barn, Kulpreet

    2016-01-01

    Left atrial myxomas are rare primary cardiac tumors. Their incidence is estimated to be about 0.1% of total cases. Neurological complications resulting from cardiac myxomas are seen in 20–35% of patients. Transesophageal echocardiogram (TEE) is preferred over transthoracic echocardiogram for evaluation of left atrial myxoma. Three-dimensional (3D) echocardiography ensures better visualization of intracardiac structures. It has been used prior to surgery for diagnostic support in the surgical treatment of cardiac masses. We present a case of a 46-year-old Hispanic male who developed acute ischemic stroke of left frontal lobe and was also found to have multiple ‘silent’ cerebral infarcts in the MRI of the brain. On further workup, he was found to have a left atrial myxoma on 3D TEE. This was resected with the assistance of intra-operative 3D TEE imaging. We present this case to increase awareness and to stress at early evaluation of secondary causes of ischemic cerebrovascular accident, outside the realm of hypercoagulability. This case also exhibits the need for basic cardiac workup in young individuals who present with symptoms of intermittent palpitations or chest pain to minimize significant morbidity or mortality. PMID:26908377

  11. [Myxoma of the left ventricle: a cause of syncope in an adolescent].

    PubMed

    Delgado, L J; Montiel, J; Guindo, J; Margarit, L; Casas, I; Ramírez, I; Sánchez, J M; Bayes de Luna, A; Caralps, J M

    1998-08-01

    Clinical diagnosis of cardiac tumours is often difficult. We present the case of a 17 year-old boy in whom a left ventricular tumour was discovered during on diagnostic work-up for a syncope. The tumour was removed and histology confirmed the diagnosis of myxoma.

  12. Carney complex: the complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas.

    PubMed

    Carney, J A

    1995-06-01

    The complex of myxomas, spotty pigmentation, endocrine overactivity, and schwannomas (the Carney complex) is a multisystem tumorous disorder that is transmitted as a mendelian autosomal dominant trait. Approximately 150 affected patients are known worldwide. The myxomas, which tend to be multiple in the involved organ, affect the heart, skin and breast. Typical sites for the skin myxomas are the eyelids, external ear canal, and nipples. The lesions commonly recur after excision. The spotty skin pigmentation includes lentigines and blue nevi, but ephelides and junctional and compound nevi also occur. The lentigines are widespread and typically involve the centrofacial area, including the vermilion border of the lips, and the conjunctiva, especially the lacrimal caruncle and the conjunctival semilunar fold. One or more intraoral pigmented spots are seen occasionally. The blue nevi occur on the face, trunk, and limbs, but not the hands and feet. Endocrine overactivity includes Cushing's syndrome (caused by primary pigmented nodular adrenocortical disease), acromegaly (caused by growth hormone-producing pituitary adenoma), and sexual precocity (caused by large-cell calcifying Sertoli cell tumor). The schwannomas are a special histological type, featuring psammoma bodies and melanin. Most commonly, they affect the upper gastrointestinal tract and sympathetic nerve chains, but a few have occurred in the skin. The most serious component of the Carney complex is cardiac myxoma. Patients suspected of having the syndrome (and their primary relatives) should be examined for this neoplasm.

  13. Myxoma virus and the Leporipoxviruses: an evolutionary paradigm.

    PubMed

    Kerr, Peter J; Liu, June; Cattadori, Isabella; Ghedin, Elodie; Read, Andrew F; Holmes, Edward C

    2015-03-01

    Myxoma virus (MYXV) is the type species of the Leporipoxviruses, a genus of Chordopoxvirinae, double stranded DNA viruses, whose members infect leporids and squirrels, inducing cutaneous fibromas from which virus is mechanically transmitted by biting arthropods. However, in the European rabbit (Oryctolagus cuniculus), MYXV causes the lethal disease myxomatosis. The release of MYXV as a biological control for the wild European rabbit population in Australia, initiated one of the great experiments in evolution. The subsequent coevolution of MYXV and rabbits is a classic example of natural selection acting on virulence as a pathogen adapts to a novel host species. Slightly attenuated mutants of the progenitor virus were more readily transmitted by the mosquito vector because the infected rabbit survived longer, while highly attenuated viruses could be controlled by the rabbit immune response. As a consequence, moderately attenuated viruses came to dominate. This evolution of the virus was accompanied by selection for genetic resistance in the wild rabbit population, which may have created an ongoing co-evolutionary dynamic between resistance and virulence for efficient transmission. This natural experiment was repeated on a continental scale with the release of a separate strain of MYXV in France and its subsequent spread throughout Europe. The selection of attenuated strains of virus and resistant rabbits mirrored the experience in Australia in a very different environment, albeit with somewhat different rates. Genome sequencing of the progenitor virus and the early radiation, as well as those from the 1990s in Australia and Europe, has shown that although MYXV evolved at high rates there was no conserved route to attenuation or back to virulence. In contrast, it seems that these relatively large viral genomes have the flexibility for multiple pathways that converge on a similar phenotype. PMID:25757062

  14. Myxoma Virus and the Leporipoxviruses: An Evolutionary Paradigm

    PubMed Central

    Kerr, Peter J.; Liu, June; Cattadori, Isabella; Ghedin, Elodie; Read, Andrew F.; Holmes, Edward C.

    2015-01-01

    Myxoma virus (MYXV) is the type species of the Leporipoxviruses, a genus of Chordopoxvirinae, double stranded DNA viruses, whose members infect leporids and squirrels, inducing cutaneous fibromas from which virus is mechanically transmitted by biting arthropods. However, in the European rabbit (Oryctolagus cuniculus), MYXV causes the lethal disease myxomatosis. The release of MYXV as a biological control for the wild European rabbit population in Australia, initiated one of the great experiments in evolution. The subsequent coevolution of MYXV and rabbits is a classic example of natural selection acting on virulence as a pathogen adapts to a novel host species. Slightly attenuated mutants of the progenitor virus were more readily transmitted by the mosquito vector because the infected rabbit survived longer, while highly attenuated viruses could be controlled by the rabbit immune response. As a consequence, moderately attenuated viruses came to dominate. This evolution of the virus was accompanied by selection for genetic resistance in the wild rabbit population, which may have created an ongoing co-evolutionary dynamic between resistance and virulence for efficient transmission. This natural experiment was repeated on a continental scale with the release of a separate strain of MYXV in France and its subsequent spread throughout Europe. The selection of attenuated strains of virus and resistant rabbits mirrored the experience in Australia in a very different environment, albeit with somewhat different rates. Genome sequencing of the progenitor virus and the early radiation, as well as those from the 1990s in Australia and Europe, has shown that although MYXV evolved at high rates there was no conserved route to attenuation or back to virulence. In contrast, it seems that these relatively large viral genomes have the flexibility for multiple pathways that converge on a similar phenotype. PMID:25757062

  15. Characterisation of immunosuppression in rabbits after infection with myxoma virus.

    PubMed

    Jeklova, Edita; Leva, Lenka; Matiasovic, Jan; Kovarcik, Kamil; Kudlackova, Hana; Nevorankova, Zora; Psikal, Ivan; Faldyna, Martin

    2008-05-25

    Myxoma virus (MXV) causes the systemic disease myxomatosis in the European rabbit. Despite many in vitro studies on the function of MXV immunomodulatory proteins and detailed molecular knowledge of virus, little is known about the dynamics of interaction of the virus with the integrated host-immune system during infection. In this study changes in haematological profile, changes in lymphocyte subset distribution and non-specific proliferation activity of lymphocytes from different lymphoid compartments on the 2nd, 4th, 6th, 9th and 11th day after experimental infection of rabbits with MXV strain Lausanne was characterised. The relationship between alterations of immune parameters and dynamic of virus dissemination through the body was investigated. Haematological changes included moderate leucopenia with significant lymphopenia, neutrophilia, monocytosis and eosinopenia. A decrease of T cells including CD4+ and CD8+ and increase of CD79alpha+ were observed in draining popliteal lymph node 4 days after virus inoculation. From day 6, comparable changes were seen in collateral popliteal lymph node, spleen and peripheral blood. From day 9, the mentioned lymphocyte subsets tended to reach their original state in all of these lymphocyte compartments except draining popliteal lymph node. In thymus, MXV infection affected mainly CD4+CD8+ double positive thymocytes. On the other hand, proliferation activity of lymphocytes determined by the proliferation assay with plant-derived mitogens was significantly reduced from day 4 or 6 and remained reduced until the end of experiment in all observed lymphoid organs. Presence of MXV in respective lymphoid compartments preceded changes in lymphocyte subset distribution or lymphocyte activity.

  16. [A case of cerebral embolism due to cardiac myxoma presenting with multiple cerebral microaneurysms detected on first MRI scans].

    PubMed

    Sato, Takahiro; Saji, Naoki; Kobayashi, Kazuto; Shibazaki, Kensaku; Kimura, Kazumi

    2016-01-01

    A 64-year-old man developed right arm weakness and dysarthria, and was admitted to our hospital. Diffusion-weighted magnetic resonance imaging of the brain showed a high intensity area in the frontal lobe. T2*-weighted images showed multiple spotty low intensity lesions in bilateral cerebral hemispheres, mimicking cerebral microbleeds. Cerebral angiography showed multiple aneurysms in the anterior, middle, posterior cerebral arteries and cerebellar arteries. Transthoracic echocardiography revealed a floating structure in the left atrial chamber, indicating cardiac myxoma. We diagnosed cardioembolic ischemic stroke due to left atrial myxoma. Cardiac surgery for excision of a left atrial myxoma was performed on the 3rd hospital day. Multiple aneurysms should be taken into account for differential diagnosis in patients with cardiac myxoma and with atypical spotty low intensity on T2*-weighted images. PMID:26797485

  17. An Unusual ST Elevation in a Case of Left Atrial Myxoma.

    PubMed

    Vyas, Nikunj; Ghatanatti, Ravi; Nerlikar, Amrutraj; Gan, Mohan; Dixit, Mahadev

    2016-02-01

    Myxomas are the most common and potentially dangerous benign tumours of the heart. They may have either smooth or papillary surfaces and may have thrombus adherent. As both the papillary excrescences and the surface thrombi are friable in nature hence may undergo embolization. We report a case of left atrial myxoma, which underwent excision of the tumour for mitral valve obstructive features. In the immediate postoperative period patient developed ST elevation in lead II, III and aVF. Coronary angiogram revealed normal coronary pattern. Patient was treated with aspirin, heparin and IABP for 48 hours and recovered well. We conclude that there is a tendency for spontaneous recanalization of the obstructed coronary vessels by tumour emboli, hence patient can be managed conservatively. PMID:27042520

  18. [Perioperative Multiple Pulmonary Embolism in a Patient with Giant Right Atrial Myxoma: Report of a Case].

    PubMed

    Nakashima, Koki; Hanayama, Naoji; Kitamura, Tadashi; Sakaki, Kenjiro; Nie, Masaki; Miyaji, Kagami

    2016-02-01

    It is reported that 20% of cardiac myxomas are located in the right atrium. An 81-year-old man presented with dyspnea, general fatigue and leg edema lasting for a year. Echocardiography revealed an 80 mm tumor occupying the right atrium and the right ventricle. At surgery, the tumor attached to the atrial septum was removed with the surrounding septal wall. As the tricuspid annulus was dilated, tricuspid annuloplasty with an artificial ring was also carried out. After coming off cardiopulmonary bypass, the patient developed pulmonary hypertension with the pulmonary arterial pressure being 80% of the systemic pressure, which subsided gradually day by day. Histopathological diagnosis was cardiac myxoma. Postoperative lung perfusion scintigraphy revealed postoperative multiple defects. It was considered that multiple tumor embolisms in the distal pulmonary artery caused postoperative pulmonary hypertension. Careful follow-up for remote recurrence would be essential. PMID:27075159

  19. Intra-Arterial Treatment in a Child with Embolic Stroke Due to Atrial Myxoma

    PubMed Central

    van den Wijngaard, Ido; Wermer, Marieke; van Walderveen, Marianne; Wiendels, Natalie; Peeters-Scholte, Cacha; Lycklama à Nijeholt, Geert

    2014-01-01

    Summary Arterial ischaemic stroke is an important cause of morbidity in children. Timely diagnosis is necessary for acute stroke treatment but can be challenging in clinical practice. Due to a paucity of data there are no specific recommendations regarding the use of mechanical thrombectomy devices in current paediatric stroke guidelines. A 14-year-old boy presented with a severe acute left hemisphere stroke due to a proximal middle cerebral artery occlusion caused by emboli from an atrial myxoma. No clinical improvement was seen after administration of intravenous thrombolysis. Subsequent mechanical thrombectomy with a second-generation stent-based thrombectomy device resulted in successful recanalization and clinical improvement. To our knowledge, this is the first report of mechanical thrombectomy in a child with acute embolic stroke caused by atrial myxoma. PMID:24976098

  20. Surgical Outcomes of Cardiac Myxoma: Right Minithoracotomy Approach versus Median Sternotomy Approach

    PubMed Central

    Lee, Han Pil; Cho, Won Chul; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won

    2016-01-01

    Background The standard approach in treating cardiac myxoma is the median full sternotomy. With the evolution of surgical techniques, the right minithoracotomy approach has emerged as an alternative method. Since few studies have been published assessing the right minithoracotomy approach, we performed a retrospective study to compare the clinical outcomes of the right minithoracotomy approach with those of the sternotomy approach. Methods From January 2005 to December 2014, 203 patients underwent resection of a cardiac myxoma. Patients with preexisting cardiac problems were excluded from this study. 146 patients were enrolled in this study; 83 patients were treated using a median sternotomy and 63 patients were treated using a right minithoracotomy. Results No early mortalities were recorded in either group. Although the cardiopulmonary bypass time and aorta cross-clamp time were significantly shorter in the sternotomy group (p<0.001 and p=0.005), postoperative blood transfusions and arrhythmia events were significantly less common in the thoracotomy group (p=0.004 and p=0.025, respectively). No significant differences were found in the duration of the hospital stay, postoperative intubation time, the duration of the intensive care unit stay, and recurrence. Conclusion The minimally invasive right minithoracotomy approach is a good alternative method for treating cardiac myxoma because it was found to be associated with a lower incidence of postoperative complications and a shorter postoperative recovery period. PMID:27733995

  1. Atrial Myxoma Presenting as Myocardial Infarction Diagnosed by Echocardiography, Managed Endoscopically with Robot-Assisted Surgery.

    PubMed

    Chaudhuri, Aadel A; Simmons, Charles; Ellison, Douglas; Hemp, James; Chung, Kiyon

    2016-01-01

    Atrial myxomatous embolization into the coronary arteries is a rare event. Management of large myxomas is usually via surgical resection involving a median sternotomy. Echocardiography is not a routine part of non-ST-elevation myocardial infarction (NSTEMI) management. Here, we present the case of a 70-year-old Caucasian man with a history of hypertension and hyperlipidemia who presented to the emergency department with an NSTEMI. Transthoracic echocardiogram and transesophageal echocardiogram revealed a large and highly mobile atrial mass, traversing through the mitral valve orifice during diastole. Coronary angiography revealed a focal 60% lesion in the right coronary artery and no other significant obstructive coronary artery disease, suggesting that the cause of his presentation was tumor embolization into the coronary circulation. The patient underwent robot-assisted endoscopic resection of his atrial mass and was discharged in stable condition on postoperative day 2. Pathology revealed atrial myxoma. To our knowledge, this is the first reported case of an atrial myxoma presenting with an NSTEMI and managed with a robot-assisted endoscopic approach. This case also highlights the importance of routine early echocardiography in patients presenting with NSTEMI. PMID:27014518

  2. The orosomucoid 1 protein (α1 acid glycoprotein) is overexpressed in odontogenic myxoma

    PubMed Central

    2012-01-01

    Background Odontogenic myxoma (OM) is a benign, but locally invasive, neoplasm occurring in the jaws. However, the molecules implicated in its development are unknown. OM as well as Dental Follicle (DF), an odontogenic tissue surrounding the enamel organ, is derived from ectomesenchymal/mesencyhmal elements. To identify some protein that could participate in the development of this neoplasm, total proteins from OM were separated by two-dimensional electrophoresis and the profiles were compared with those obtained from DF, used as a control. Results We identified eight proteins with differential expression; two of them were downregulated and six upregulated in OM. A spot consistently overexpressed in odontogenic myxoma, with a molecular weight of 44-kDa and a pI of 3.5 was identified as the orosomucoid 1 protein. Western blot experiments confirmed the overexpression of this protein in odontogenic myxoma and immunohistochemical assays showed that this protein was mainly located in the cytoplasm of stellate and spindle-shaped cells of this neoplasm. Conclusion Orosomucoid 1, which belongs to a group of acute-phase proteins, may play a role in the modulation of the immune system and possibly it influences the development of OM. PMID:22888844

  3. Anesthetic experiences of myxoma removal surgery in two patients with Carney complex -A report of two cases-.

    PubMed

    Kang, Young Mi; Kim, Yoon Hee

    2011-12-01

    Carney complex is an autosomal dominant disorder that occurs due to a mutation in PRKAR1A, which encodes protein kinase A. The clinical features are multiple endocrine gland neoplasms, skin tumors, pigmented skin lesions, myxomas, and schwannomas. In Carney complex, the cardiac myxoma is a common co-morbidity. It occurs in multiples, during young age, regardless of gender and cardiac chamber and is known to recur frequently. Therefore there are high risks of adhesion and massive bleeding due to repeated surgeries. Such surgical risks account for over 50% of disease-specific mortality of Carney complex patients. Here, we present anesthetic experiences of myxoma removal surgery in two patients with Carney complex. PMID:22220234

  4. Obstruction of the tricuspid valve orifice by a huge right atrial myxoma associated with the Carney complex: a case report.

    PubMed

    Affronti, Alessandro; Di Bella, Isidoro; Prontera, Paolo; Da Col, Uberto; Ramoni, Enrico; Donti, Emilio; Paris, Marco; Ragni, Temistocle

    2010-11-01

    Carney complex (CNC) is an inherited autosomal dominant disorder associated with multiple neoplasms. Myxomas associated with CNC differ from their sporadic forms because the former usually develop at a younger age and they may be multicentric and have a tendency to recur. Furthermore, their localization may be atypical. We report the case of a 57-year-old man, with a huge right atrial myxoma obstructing the tricuspid valve orifice. A diagnosis of CNC was established by genetic analysis. The importance of early diagnosis and an adequate follow-up is emphasized. PMID:20880078

  5. Unusual presentation of localized gingival enlargement associated with a slow-growing odontogenic myxoma

    PubMed Central

    Miranda Rius, Jaume; Nadal, Alfons; Lahor, Eduard; Mtui, Beatus; Brunet, Lluís

    2013-01-01

    Unusual presentation of localized gingival enlargement associated with a subjacent tumoural pathology is reported. The patient was a 55-year-old black male, whose chief complaint was a progressive gingival overgrowth for more than ten years, in the buccal area of the anterior left mandible. According to the clinical features and the radiological diagnosis of odontogenic keratocyst, a conservative surgery with enucleation and curettage was performed. Tissue submitted for histopathological analysis rendered the diagnosis of odontogenic myxoma. After 12-month of follow-up, no evidence of recurrence was found. Clinicians should be cautious when facing any gingival enlargement to avoid diagnostic pitfalls and to indicate the appropriate treatment. PMID:23722914

  6. A Case of Sudden Death in Decameron IV.6: Aortic Dissection or Atrial Myxoma?

    PubMed

    Toscano, Fabrizio; Spani, Giovanni; Papio, Michael; Rühli, Frank J; Galassi, Francesco M

    2016-07-01

    Giovanni Boccaccio's Decameron contains a novella that details the sudden death of a young man called Gabriotto, including a portrayal of the discomfort that the protagonist experienced and a rudimentary autopsy performed by local physicians. The intriguing description of symptoms and pathologies has made it possible to read a 7-century-old case through the modern clinical lens. Thanks to the medical and philological analysis of the text-despite the vast difference between modern and medieval medicine-2 hypothetical diagnoses have emerged: either an aortic dissection or an atrial myxoma.

  7. Odontogenic Myxoma of the Maxilla: A Report of Unusual Pediatric Case

    PubMed Central

    Mohan Das, Usha; Manjunath, V; Manoj Bavle, Radhika; Sudhakar, M; Kumar, Nanda; Srinath, Srinath

    2011-01-01

    Odontogenic myxoma (OM) is a rare and locally benign neoplasm of high aggressive behavior found exclusively in the jaws. OM commonly occurs in the second and third decade, its quite rare to find in maxilla that to invading the maxillary sinus completely. The lesion often grows without symptoms and presents as a painless swelling. The radiographic features are variable, and the diagnosis is therefore not easy. This article presents a case of OM of maxilla in a 13-year-old boy, which was previously diagnosed as fibrosseous lesion with the help of CT.

  8. A Case of Sudden Death in Decameron IV.6: Aortic Dissection or Atrial Myxoma?

    PubMed

    Toscano, Fabrizio; Spani, Giovanni; Papio, Michael; Rühli, Frank J; Galassi, Francesco M

    2016-07-01

    Giovanni Boccaccio's Decameron contains a novella that details the sudden death of a young man called Gabriotto, including a portrayal of the discomfort that the protagonist experienced and a rudimentary autopsy performed by local physicians. The intriguing description of symptoms and pathologies has made it possible to read a 7-century-old case through the modern clinical lens. Thanks to the medical and philological analysis of the text-despite the vast difference between modern and medieval medicine-2 hypothetical diagnoses have emerged: either an aortic dissection or an atrial myxoma. PMID:27390329

  9. A case of multi-system signs and symptoms unified under the diagnosis of atrial myxoma.

    PubMed

    West, Brian T; Kaluza, Amy

    2011-05-01

    Patients often present to the Emergency Department (ED) with a constellation of seemingly unassociated complaints. It is a clinical challenge not only to address all signs and symptoms that concern the patient but to reconcile these incongruous findings into one all-encompassing diagnosis. We present the case of a 48-year-old man who manifested neurologic, cardiac, and constitutional signs and symptoms in the ED. Through historic clues, physical examination findings, and electrocardiogram, we obtained an urgent cardiac ultrasound that demonstrated a large left atrial myxoma. This one disease entity was able to explain all of the patient's diverse findings.

  10. Novel Association of Odontogenic Myxoma with Constitutional Chromosomal 1q21 Microduplication: Case Report and Review of the Literature.

    PubMed

    Best-Rocha, Alejandro; Patel, Kalyani; Hicks, John; Edmonds, Joseph L; Paldino, Michael J; Wu, Hao

    2016-01-01

    Odontogenic myxoma (OM) is a rare, benign, and locally aggressive tumor. It tends to occur in the posterior maxilla and mandible and is often associated with root resorption and perforation of cortex. Histopathologically, there is a proliferation of spindle, bipolar, and stellate cells, with bland nuclei within a myxoid to infrequently fibromyxoid extracellular matrix. Long, thin residual bony trabeculae are often seen floating within the spindle cell proliferation because of the infiltrating nature of this tumor, and these trabeculae impart a "soap bubble" or "tennis-racket" radiologic appearance. No syndromic association of OM has been reported. Although similar histopathologic features are shared with cardiac myxoma and soft tissue myxoma, mutations in the GNAS gene have not been identified in OM to date, and only 2 of 17 OMs showed mutations in the PRKAR1A gene. In this report, we describe a case of OM in a patient with constitutional 1q21 microduplication, a locus that harbors genes encoding certain proteins in the cAMP-dependent protein kinase A (PKA) signaling pathway, including G-protein-coupled receptors and 1 phosphodiesterase interacting protein. Review of the literature describes the key clinical features and molecular pathogenesis of 1q21 microduplication, as well as highlighting the role of PKA signaling pathway in the pathogenesis of myxomas in general. PMID:26230961

  11. A Case of Microangiopathic Hemolytic Anemia after Myxoma Excision and Mitral Valve Repair Presenting as Hemolytic Uremic Syndrome

    PubMed Central

    Park, Young Joo; Kim, Sang Pil; Shin, Ho-Jin

    2016-01-01

    Microangiopathic hemolytic anemia occurs in a diverse group of disorders, including thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and prosthetic cardiac valves. Hemolytic anemia also occurs as a rare complication after mitral valve repair. In this report, we describe a case of microangiopathic hemolytic anemia following myxoma excision and mitral valve repair, which was presented as hemolytic uremic syndrome. PMID:27081450

  12. Cerebral infarction due to cardiac myxoma developed with the loss of consciousness immediately after defecation-a case report.

    PubMed

    Ikeda, Toshimasa; Oomura, Masahiro; Sato, Chikako; Anan, Chise; Yamada, Kentaro; Kamimoto, Kaoru

    2016-05-31

    A 74-year-old man lost consciousness immediately after defecation. The loss of consciousness lasted for several minutes, and he experienced difficulty in walking when he regained consciousness. He was transferred to our hospital via an ambulance. Upon neurological examination, nystagmus and ataxia in the left arm and leg were noted. An MRI of the brain revealed multiple acute infarcts mainly in the bilateral cerebellum. Intravenous thrombolytic therapy with alteplase was initiated 3 h and 20 min after the onset of symptoms, and an improvement in neurological symptoms was observed. Echocardiography displayed a mobile mass in the left atrium, suggesting myxoma. After 14 days from the onset of symptoms, the tumor was surgically resected, and a pathological diagnosis of myxoma was established. Because of the unique event surrounding the onset in this case, we considered that there was a potential detachment of myxoma and/or thrombi fragments triggered by an increase in intrathoracic pressure induced by the action of defecation. This present case suggests that clinicians should consider cardiac myxoma in patients with cerebral infarction if the stroke is preceded by a Valsalva maneuver-like action and accompanied by the loss of consciousness. PMID:27151226

  13. A Case of Microangiopathic Hemolytic Anemia after Myxoma Excision and Mitral Valve Repair Presenting as Hemolytic Uremic Syndrome.

    PubMed

    Park, Young Joo; Kim, Sang Pil; Shin, Ho-Jin; Choi, Jung Hyun

    2016-03-01

    Microangiopathic hemolytic anemia occurs in a diverse group of disorders, including thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and prosthetic cardiac valves. Hemolytic anemia also occurs as a rare complication after mitral valve repair. In this report, we describe a case of microangiopathic hemolytic anemia following myxoma excision and mitral valve repair, which was presented as hemolytic uremic syndrome. PMID:27081450

  14. Intramuscular myxoma of the paraspinal muscles: A case report and systematic review of the literature

    PubMed Central

    RACHIDI, SALEH; SOOD, AMIT J.; RUMBOLDT, TIHANA; DAY, TERRY A.

    2016-01-01

    Intramuscular myxoma (IM) is a rare mesenchymal tumor of the head and neck region. The current study reports a case of a 45-year-old man who presented with a painless neck mass. Imaging showed involvement of the levator scapulae and scalene muscles. Core needle biopsy was consistent with intramuscular myxoma. Surgical excision was performed and follow-up for 30 months showed no recurrence. The present study includes a systematic review of head and neck IMs, with a summary of the clinical and demographic parameters of all reported cases in the head and neck region. Surgery was curative in 28 of the 29 published cases, as well as in the current case (96.7%), with the lone recurrent tumor cured following re-resection. Females constituted 57% of the cases and the mean age was 49.7±20.4 years. Although uncommon, IM should be considered in the differential diagnosis of deep neck masses, and surgical excision is the treatment of choice with a low risk of recurrence. PMID:26870235

  15. Abundant lubricin expression suggests a link between synoviocytes, synovial tumors, and myxomas.

    PubMed

    Solka, Kathryn A; Schmid, Thomas M; Miller, Ira J

    2016-10-01

    Progenitor cell differentiation into fibroblast-like synoviocytes (FLSs) and their ensuing phenotypic changes are incompletely explored. Synovial lining is composed of intimal macrophages and FLSs. FLSs have epithelioid morphology and directionally secrete components of synovial fluid, including lubricin. We stained human tissues and tumors using two anti-lubricin antibodies. Lubricin was found in FLSs in synovium and in tenosynovial giant cell tumors (TSGCTs) and not in the associated monocyte/macrophage cells, which were identified by double immunostaining for CD163. In TSGCTs, giant cells, known to form by fusion of mononuclear cells, were negative for both lubricin and CD163. Occasional mononuclear cells with the same phenotype were also seen, suggesting that the precursors of the giant cells are derived from the minor CD163-negative monocyte subset. Lubricin was also detected in intramuscular myxomas, in early myxoid changes of ganglion cysts, and in one of five low-grade myxofibrosarcomas, but not in other fibroconnective tissues, epithelial tissues, or other tumors tested. This suggests that lubricin expression may typify adaptive and neoplastic changes along a pathway toward FLSs. Further support for this concept comes from ganglion cysts and juxta-articular myxoma tumors, which show a spectrum of myxoid, cystic and synovial differentiation, and in which moderate lubricin staining of myxoid stroma was seen.

  16. Synovial myxoma in the vertebral column of a dog: MRI description and surgical removal.

    PubMed

    Neary, Casey P; Bush, William W; Tiches, Deena M; Durham, Amy C; Gavin, Patrick R

    2014-01-01

    A 12 yr old castrated male mixed-breed dog presented with a 2 wk history of progressive tetraparesis. Neurologic deficits included a short-strided choppy gait in the thoracic limbs and a long-strided proprioceptive ataxia in the pelvic limbs. Withdrawal reflexes were decreased bilaterally in the thoracic limbs. Signs were consistent with a myelopathy of the caudal cervical/cranial thoracic spinal cord (i.e., the sixth cervical [C] vertebra to the second thoracic [T] vertebra). A mass associated with the C6-C7 articular facet on the left side was identified on MRI of the cervical spinal cord. The lesion was hyperintense to spinal cord parenchyma on T2-weighted images, hypointense on T1-weighted images, and there was strong homogenous contrast enhancement. Significant spinal cord compression was associated with the lesion. The mass was removed through a C6-C7 dorsal laminectomy and facetectomy. Histopathology of the mass was consistent with a synovial myxoma of the articular facet. A postoperative MRI showed complete surgical resection. Albeit rare, synovial myxomas should be included in the list of differential diagnoses for neoplasms affecting the vertebral columns in dogs.

  17. The complex of myxomas, spotty skin pigmentation and endocrine overactivity (Carney complex): imaging findings with clinical and pathological correlation.

    PubMed

    Courcoutsakis, Nikos A; Tatsi, Christina; Patronas, Nicholas J; Lee, Chiy-Chia Richard; Prassopoulos, Panos K; Stratakis, Constantine A

    2013-02-01

    The complex of myxomas, spotty skin pigmentation and endocrine overactivity, or Carney complex (CNC), is a familial multiple endocrine neoplasia and lentiginosis syndrome. CNC is inherited in an autosomal dominant manner and is genetically heterogeneous. Its features overlap those of McCune-Albright syndrome and other multiple endocrine neoplasia (MEN) syndromes. Spotty skin pigmentation is the major clinical manifestation of the syndrome, followed by multicentric heart myxomas, which occur at a young age and are the lethal component of the disease. Myxomas may also occur on the skin (eyelid, external ear canal and nipple) and the breast. Breast myxomas, when present, are multiple and bilateral among female CNC patients, an entity which is also described as "breast-myxomatosis" and is a characteristic feature of the syndrome. Affected CNC patients often have tumours of two or more endocrine glands, including primary pigmented nodular adrenocortical disease (PPNAD), an adrenocorticotropin hormone (ACTH)-independent cause of Cushing's syndrome, growth hormone (GH)-secreting and prolactin (PRL)-secreting pituitary adenomas, thyroid adenomas or carcinomas, testicular neoplasms (large-cell calcifying Sertoli cell tumours [LCCSCT]) and ovarian lesions (cysts and cancinomas). Additional infrequent but characteristic manifestations of CNC are psammomatous melanotic schwannomas (PMS), breast ductal adenomas (DAs) with tubular features, and osteochondromyxomas or "Carney bone tumour". Teaching Points • Almost 60 % of the known CNC kindreds have a germline inactivating mutations in the PRKAR1A gene. • Spotty skin pigmentation is the major clinical manifestation of CNC, followed by heart myxomas. • Indicative imaging signs of PPNAD are contour abnormality and hypodense spots within the gland. • Two breast tumours may present in CNC: myxoid fibroadenomas (breast myxomatosis) and ductal adenomas. • Additional findings of CNC are psammomatous melanotic schwannomas

  18. Cellular/intramuscular myxoma and grade I myxofibrosarcoma are characterized by distinct genetic alterations and specific composition of their extracellular matrix

    PubMed Central

    Willems, Stefan M; Mohseny, Alex B; Balog, Crina; Sewrajsing, Raj; Briaire-de Bruijn, Inge H; Knijnenburg, Jeroen; Cleton-Jansen, Anne-Marie; Sciot, Raf; Fletcher, Christopher D M; Deelder, André M; Szuhai, Karoly; Hensbergen, Paul J; Hogendoorn, Pancras C W

    2009-01-01

    Cellular myxoma and grade I myxofibrosarcoma are mesenchymal tumours that are characterized by their abundant myxoid extracellular matrix (ECM). Despite their histological overlap, they differ clinically. Diagnosis is therefore difficult though important. We investigated their (cyto) genetics and ECM. GNAS1-activating mutations have been described in intramuscular myxoma, and lead to downstream activation of cFos. KRAS and TP53 mutations are commonly involved in sarcomagenesis whereby KRAS subsequently activates c-Fos. A well-documented series of intramuscular myxoma (three typical cases and seven cases of the more challenging cellular variant) and grade I myxofibrosarcoma (n= 10) cases were karyotyped, analyzed for GNAS1, KRAS and TP53 mutations and downstream activation of c-Fos mRNA and protein expression. ECM was studied by liquid chromatography mass spectrometry and expression of proteins identified was validated by immunohistochemistry and qPCR. Grade I myxofibrosarcoma showed variable, non-specific cyto-genetic aberrations in 83,5% of cases (n= 6) whereas karyotypes of intramuscular myxoma were all normal (n= 7). GNAS1-activating mutations were exclusively found in 50% of intramuscular myxoma. Both tumour types showed over-expression of c-Fos mRNA and protein. No mutations in KRAS codon 12/13 or in TP53 were detected. Liquid chromatography mass spectrometry revealed structural proteins (collagen types I, VI, XII, XIV and decorin) in grade I myxofibrosarcoma lacking in intramuscular myxoma. This was confirmed by immunohistochemistry and qPCR. Intramuscular/cellular myxoma and grade I myxofibrosarcoma show different molecular genetic aberrations and different composition of their ECM that probably contribute to their diverse clinical behaviour. GNAS1 mutation analysis can be helpful to distinguish intramuscular myxoma from grade I myxofibrosarcoma in selected cases. PMID:19320777

  19. Breast Reconstruction after Mastectomy

    PubMed Central

    Schmauss, Daniel; Machens, Hans-Günther; Harder, Yves

    2016-01-01

    Breast cancer is the leading cause of cancer death in women worldwide. Its surgical approach has become less and less mutilating in the last decades. However, the overall number of breast reconstructions has significantly increased lately. Nowadays, breast reconstruction should be individualized at its best, first of all taking into consideration not only the oncological aspects of the tumor, neo-/adjuvant treatment, and genetic predisposition, but also its timing (immediate versus delayed breast reconstruction), as well as the patient’s condition and wish. This article gives an overview over the various possibilities of breast reconstruction, including implant- and expander-based reconstruction, flap-based reconstruction (vascularized autologous tissue), the combination of implant and flap, reconstruction using non-vascularized autologous fat, as well as refinement surgery after breast reconstruction. PMID:26835456

  20. Multi-event capture–recapture modeling of host–pathogen dynamics among European rabbit populations exposed to myxoma and Rabbit Hemorrhagic Disease Viruses: common and heterogeneous patterns

    PubMed Central

    2014-01-01

    Host–pathogen epidemiological processes are often unclear due both to their complexity and over-simplistic approaches used to quantify them. We applied a multi-event capture–recapture procedure on two years of data from three rabbit populations to test hypotheses about the effects on survival of, and the dynamics of host immunity to, both myxoma virus and Rabbit Hemorrhagic Disease Virus (MV and RHDV). Although the populations shared the same climatic and management conditions, MV and RHDV dynamics varied greatly among them; MV and RHDV seroprevalences were positively related to density in one population, but RHDV seroprevalence was negatively related to density in another. In addition, (i) juvenile survival was most often negatively related to seropositivity, (ii) RHDV seropositives never had considerably higher survival, and (iii) seroconversion to seropositivity was more likely than the reverse. We suggest seropositivity affects survival depending on trade-offs among antibody protection, immunosuppression and virus lethality. Negative effects of seropositivity might be greater on juveniles due to their immature immune system. Also, while RHDV directly affects survival through the hemorrhagic syndrome, MV lack of direct lethal effects means that interactions influencing survival are likely to be more complex. Multi-event modeling allowed us to quantify patterns of host–pathogen dynamics otherwise difficult to discern. Such an approach offers a promising tool to shed light on causative mechanisms. PMID:24708296

  1. Horizontal Transmissible Protection against Myxomatosis and Rabbit Hemorrhagic Disease by Using a Recombinant Myxoma Virus

    PubMed Central

    Bárcena, Juan; Morales, Mónica; Vázquez, Belén; Boga, José A.; Parra, Francisco; Lucientes, Javier; Pagès-Manté, Albert; Sánchez-Vizcaíno, José M.; Blasco, Rafael; Torres, Juan M.

    2000-01-01

    We have developed a new strategy for immunization of wild rabbit populations against myxomatosis and rabbit hemorrhagic disease (RHD) that uses recombinant viruses based on a naturally attenuated field strain of myxoma virus (MV). The recombinant viruses expressed the RHDV major capsid protein (VP60) including a linear epitope tag from the transmissible gastroenteritis virus (TGEV) nucleoprotein. Following inoculation, the recombinant viruses induced specific antibody responses against MV, RHDV, and the TGEV tag. Immunization of wild rabbits by the subcutaneous and oral routes conferred protection against virulent RHDV and MV challenges. The recombinant viruses showed a limited horizontal transmission capacity, either by direct contact or in a flea-mediated process, promoting immunization of contact uninoculated animals. PMID:10627521

  2. Right coronary artery fistula misdiagnosed as right atrial cardiac myxoma: A case report

    PubMed Central

    WEN, BING; YANG, JUNYA; JIAO, ZHOUYANG; FU, GUOWEI; ZHAO, WENZENG

    2016-01-01

    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. PMID:27284376

  3. Myxoma and vaccinia viruses exploit different mechanisms to enter and infect human cancer cells

    SciTech Connect

    Villa, Nancy Y.; Bartee, Eric; Mohamed, Mohamed R.; Rahman, Masmudur M.; Barrett, John W.; McFadden, Grant

    2010-06-05

    Myxoma (MYXV) and vaccinia (VACV) viruses have recently emerged as potential oncolytic agents that can infect and kill different human cancer cells. Although both are structurally similar, it is unknown whether the pathway(s) used by these poxviruses to enter and cause oncolysis in cancer cells are mechanistically similar. Here, we compared the entry of MYXV and VACV-WR into various human cancer cells and observed significant differences: 1 - low-pH treatment accelerates fusion-mediated entry of VACV but not MYXV, 2 - the tyrosine kinase inhibitor genistein inhibits entry of VACV, but not MYXV, 3 - knockdown of PAK1 revealed that it is required for a late stage event downstream of MYXV entry into cancer cells, whereas PAK1 is required for VACV entry into the same target cells. These results suggest that VACV and MYXV exploit different mechanisms to enter into human cancer cells, thus providing some rationale for their divergent cancer cell tropisms.

  4. The Differentiation of Giant Right Atrial Myxoma from Metastatic Cancer with the Use of Multiple Imaging Modalities.

    PubMed

    Nakabayashi, Keisuke; Murata, Satoru; Kato, Hiroko; Oka, Toshiaki

    2016-01-01

    Whether a cardiac tumor is primary or metastatic strongly influences the therapeutic strategy. We herein present a case of a cardiac tumor that occupied most of the right atrium which required immediate treatment in a patient with breast cancer. Multiple imaging modalities, especially computed tomography and cardiac magnetic resonance imaging, provided a precise preoperative diagnosis. We performed cardiac surgery prior to breast cancer surgery because the cardiac tumor was thought to be a myxoma rather than a metastatic cancer. PMID:27086806

  5. Osteogenic sarcoma and soft tissue myxoma in a patient with fibrous dysplasia and hemoglobins JBaltimore and S.

    PubMed

    Witkin, G B; Guilford, W B; Siegal, G P

    1986-03-01

    A 41-year-old man with recognized polyostotic fibrous dysplasia since late childhood developed fibroblastic osteogenic sarcoma in the left tibia. Four months after the initial diagnosis, an intramuscular myxoma was discovered in the left thigh. Twenty years previously he had been found to be heterozygous for hemoglobins JBaltimore and S. Malignant transformation in fibrous dysplasia is unusual and may be associated in some individuals with prior irradiation. Soft tissue myxomas associated with fibrous dysplasia are even rarer. To the best of the authors' knowledge the occurrence of both of these lesions in a patient with fibrous dysplasia has been reported only once before. Patients with both fibrous dysplasia and myxomas may be at greater risk for malignant transformation than are individuals with only one of these lesions. There is no well-recognized association between hemoglobinopathies and either fibrous dysplasia or bone tumors. It is therefore probable that the rare constellation of findings is in this patient a stochastic event. PMID:3456858

  6. Atrial myxoma

    MedlinePlus

    Lenihan DJ, Yusuf SW. Tumors affecting the cardiovascular system. In: Bonow RO, Mann DL, Zipes DP, Libby P, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, ...

  7. Oncolytic viral purging of leukemic hematopoietic stem and progenitor cells with Myxoma virus.

    PubMed

    Rahman, Masmudur M; Madlambayan, Gerard J; Cogle, Christopher R; McFadden, Grant

    2010-01-01

    High-dose chemotherapy and radiation followed by autologous blood and marrow transplantation (ABMT) has been used for the treatment of certain cancers that are refractory to standard therapeutic regimes. However, a major challenge with ABMT for patients with hematologic malignancies is disease relapse, mainly due to either contamination with cancerous hematopoietic stem and progenitor cells (HSPCs) within the autograft or the persistence of residual therapy-resistant disease niches within the patient. Oncolytic viruses represent a promising therapeutic approach to prevent cancer relapse by eliminating tumor-initiating cells that contaminate the autograft. Here we summarize an ex vivo "purging" strategy with oncolytic Myxoma virus (MYXV) to remove cancer-initiating cells from patient autografts prior to transplantation. MYXV, a novel oncolytic poxvirus with potent anti-cancer properties in a variety of in vivo tumor models, can specifically eliminate cancerous stem and progenitor cells from samples obtained from acute myelogenous leukemia (AML) patients, while sparing normal CD34+ hematopoietic stem and progenitor cells capable of rescuing hematopoiesis following high dose conditioning. We propose that a broader subset of patients with intractable hematologic malignancies who have failed standard therapy could become eligible for ABMT when the treatment schema is coupled with ex vivo oncolytic therapy. PMID:20211576

  8. Cardiac myxoma in Iceland: a case series with an estimation of population incidence.

    PubMed

    Sigurjonsson, Hannes; Andersen, Karl; Gardarsdottir, Marianna; Petursdottir, Vigdis; Klemenzson, Gudmundur; Gunnarsson, Gunnar; Danielsen, Ragnar; Gudbjartsson, Tomas

    2011-09-01

    Cardiac myxoma (CM) is the most common primary benign tumor of the heart, but the true age-standardized incidence rate (ASR) has remained unknown. We therefore used nationwide registries in Iceland to study CM and establish its incidence rate. This was a retrospective study involving all patients diagnosed with CM in Iceland between 1986 and 2010. Cases were identified through three different registries, and hospital charts and histology results reviewed. An ASR was estimated based on a world standard population (w). Nine cases of CM (six women) were identified with a mean age of 62.8 years (range: 37-85), giving an ASR of 0.11 (95% CI: 0.05-0.22) per 100,000. The mean tumor size was 4.4 cm (range: 1.5-8.0) with all the tumors located in the left atrium. Dyspnea (n = 6) and ischemic stroke (n = 2) were the most common symptoms. All patients underwent complete resection of the tumor and there were no postoperative deaths or CM-related deaths at follow-up (mean 85 months). The ASR of CM in Iceland was 0.11 per 100,000. To our knowledge, this is the first study to determine the incidence of CM in an entire population. In Iceland, the presenting symptoms and mode of detection of CM are similar to those in other series.

  9. Myxoma virus suppresses proliferation of activated T lymphocytes yet permits oncolytic virus transfer to cancer cells

    PubMed Central

    Villa, Nancy Y.; Wasserfall, Clive H.; Meacham, Amy M.; Wise, Elizabeth; Chan, Winnie; Wingard, John R.; McFadden, Grant

    2015-01-01

    Allogeneic hematopoietic cell transplant (allo-HCT) can be curative for certain hematologic malignancies, but the risk of graft-versus-host disease (GVHD) is a major limitation for wider application. Ideally, strategies to improve allo-HCT would involve suppression of T lymphocytes that drive GVHD while sparing those that mediate graft-versus-malignancy (GVM). Recently, using a xenograft model, we serendipitously discovered that myxoma virus (MYXV) prevented GVHD while permitting GVM. In this study, we show that MYXV binds to resting, primary human T lymphocytes but will only proceed into active virus infection after the T cells receive activation signals. MYXV-infected T lymphocytes exhibited impaired proliferation after activation with reduced expression of interferon-γ, interleukin-2 (IL-2), and soluble IL-2Rα, but did not affect expression of IL-4 and IL-10. MYXV suppressed T-cell proliferation in 2 patterns (full vs partial) depending on the donor. In terms of GVM, we show that MYXV-infected activated human T lymphocytes effectively deliver live oncolytic virus to human multiple myeloma cells, thus augmenting GVM by transfer of active oncolytic virus to residual cancer cells. Given this dual capacity of reducing GVHD plus increasing the antineoplastic effectiveness of GVM, ex vivo virotherapy with MYXV may be a promising clinical adjunct to allo-HCT regimens. PMID:25904246

  10. The current status and future directions of myxoma virus, a master in immune evasion

    PubMed Central

    2011-01-01

    Myxoma virus (MYXV) gained importance throughout the twentieth century because of the use of the highly virulent Standard Laboratory Strain (SLS) by the Australian government in the attempt to control the feral Australian population of Oryctolagus cuniculus (European rabbit) and the subsequent illegal release of MYXV in Europe. In the European rabbit, MYXV causes a disease with an exceedingly high mortality rate, named myxomatosis, which is passively transmitted by biting arthropod vectors. MYXV still has a great impact on European rabbit populations around the world. In contrast, only a single cutaneous lesion, restricted to the point of inoculation, is seen in its natural long-term host, the South-American Sylvilagus brasiliensis and the North-American S. Bachmani. Apart from being detrimental for European rabbits, however, MYXV has also become of interest in human medicine in the last two decades for two reasons. Firstly, due to the strong immune suppressing effects of certain MYXV proteins, several secreted virus-encoded immunomodulators (e.g. Serp-1) are being developed to treat systemic inflammatory syndromes such as cardiovascular disease in humans. Secondly, due to the inherent ability of MYXV to infect a broad spectrum of human cancer cells, the live virus is also being developed as an oncolytic virotherapeutic to treat human cancer. In this review, an update will be given on the current status of MYXV in rabbits as well as its potential in human medicine in the twenty-first century. Table of contents Abstract 1. The virus 2. History 3. Pathogenesis and disease symptoms 4. Immunomodulatory proteins of MYXV 4.1. MYXV proteins with anti-apoptotic functions 4.1.1. Inhibition of pro-apoptotic molecules 4.1.2. Inhibition by protein-protein interactions by ankyrin repeat viral proteins 4.1.3. Inhibition of apoptosis by enhancing the degradation of cellular proteins 4.1.4. Inhibition of apoptosis by blocking host Protein Kinase R (PKR) 4.2. MYXV proteins

  11. Synthesis and structure-activity study of myxoma virus growth factor

    SciTech Connect

    Lin, Yao-Zhong; Ke, Xiao-Hong; Tam, J.P. )

    1991-04-02

    Myxoma virus growth factor (MGF) is an 85-residue peptide derived from the gene product of a DNA tumor virus that infects rabbits. The carboxyl domain of MGF possesses about 40% sequence homology with the epidermal growth factor (EGF). This EGF-like domain covering residues 30-83 was synthesized and found to possess putative activities of EGF. It was, however, about 200-fold less active than EGF in the competitive binding of human EGF receptor in A431 cells and the stimulation of ({sup 3}H)thymidine uptake in NRK 49F cells. MGF(30-83) is a basic and a hydrophobic peptide rich in {beta}-sheet structure. These features in MGF tend to promote aggregation, leading to precipitation even in strongly denaturing solutions. Thus, the refolding of MGF was achieved with difficulty and resulted in low yield. To increase the synthetic yield of MGF(30-83), a cluster of acidic amino acids was added to the NH{sub 2}-terminus of MGF(30-83). This approach was found to be effective in minimizing the refolding difficulties and allowed accessibility to the synthesis of analogues in this class of compounds. The relationships of structure and function of MGF were studied by using analogues with point substitution by the corresponding D-amino acid or by Ala at position 44 or 52 and analogues with deletion of basic residues from the amino terminus. Modifications of both the receptor contact and the structural residues greatly reduced the potency of MGF(30-83), and the overall result correlated well with the known structure-activity of the EGF family.

  12. Myxoma virus therapy for human embryonal rhabdomyosarcoma in a nude mouse model.

    PubMed

    Kinn, Veronica G; Hilgenberg, Valerie A; MacNeill, Amy L

    2016-01-01

    Rhabdomyosarcoma (RMS) is a devastating tumor of young people that is difficult to cure. To determine if oncolytic virus therapy can improve outcomes in individuals with RMS, myxoma virus expressing a red fluorescent protein (MYXV-red) was evaluated for antitumoral effects using a murine model of RMS. Fluorescent protein was expressed in four RMS cell lines inoculated with MYXV-red, indicating that these cells were semipermissive to MYXV infection. MYXV-red replication and cytopathic effects were further evaluated using human embryonal RMS (CCL-136) cells. Logarithmic growth of MYXV-red and significant cell death were observed 72 hours after inoculation with MYXV. The oncolytic effects of MYXV-red were then studied in nude mice that were injected subcutaneously with CCL-136 cells to establish RMS xenografts. Once tumors measured 5 mm in diameter, mice were treated with multiple intratumoral injections of MXYV-red or saline. The average final tumor volume and rate of tumor growth were significantly decreased, and median survival time was significantly increased in MYXV-red-treated mice (P-values =0.0416, 0.0037, and 0.0004, respectively). Histologic sections of MYXV-red-treated tumors showed increased inflammation compared to saline-treated tumors (P-value =0.0002). In conclusion, MXYV-red treatment of RMS tumors was successful in individual mice as it resulted in decreased tumor burden in eight of eleven mice with nearly complete tumor remission in five of eleven mice. These data hold promise that MYXV-red treatment may be beneficial for people suffering from RMS. To our knowledge, this is the first report of successful treatment of RMS tumors using an oncolytic poxvirus. PMID:27579297

  13. Myxoma virus therapy for human embryonal rhabdomyosarcoma in a nude mouse model

    PubMed Central

    Kinn, Veronica G; Hilgenberg, Valerie A; MacNeill, Amy L

    2016-01-01

    Rhabdomyosarcoma (RMS) is a devastating tumor of young people that is difficult to cure. To determine if oncolytic virus therapy can improve outcomes in individuals with RMS, myxoma virus expressing a red fluorescent protein (MYXV-red) was evaluated for antitumoral effects using a murine model of RMS. Fluorescent protein was expressed in four RMS cell lines inoculated with MYXV-red, indicating that these cells were semipermissive to MYXV infection. MYXV-red replication and cytopathic effects were further evaluated using human embryonal RMS (CCL-136) cells. Logarithmic growth of MYXV-red and significant cell death were observed 72 hours after inoculation with MYXV. The oncolytic effects of MYXV-red were then studied in nude mice that were injected subcutaneously with CCL-136 cells to establish RMS xenografts. Once tumors measured 5 mm in diameter, mice were treated with multiple intratumoral injections of MXYV-red or saline. The average final tumor volume and rate of tumor growth were significantly decreased, and median survival time was significantly increased in MYXV-red-treated mice (P-values =0.0416, 0.0037, and 0.0004, respectively). Histologic sections of MYXV-red-treated tumors showed increased inflammation compared to saline-treated tumors (P-value =0.0002). In conclusion, MXYV-red treatment of RMS tumors was successful in individual mice as it resulted in decreased tumor burden in eight of eleven mice with nearly complete tumor remission in five of eleven mice. These data hold promise that MYXV-red treatment may be beneficial for people suffering from RMS. To our knowledge, this is the first report of successful treatment of RMS tumors using an oncolytic poxvirus. PMID:27579297

  14. Myxoma Virus Expressing a Fusion Protein of Interleukin-15 (IL15) and IL15 Receptor Alpha Has Enhanced Antitumor Activity

    PubMed Central

    Tosic, Vesna; Thomas, Diana L.; Kranz, David M.; Liu, Jia; McFadden, Grant; Shisler, Joanna L.; MacNeill, Amy L.; Roy, Edward J.

    2014-01-01

    Myxoma virus, a rabbit poxvirus, can efficiently infect various types of mouse and human cancer cells. It is a strict rabbit-specific pathogen, and is thought to be safe as a therapeutic agent in all non-rabbit hosts tested including mice and humans. Interleukin-15 (IL15) is an immuno-modulatory cytokine with significant potential for stimulating anti-tumor T lymphocytes and NK cells. Co-expression of IL15 with the α subunit of IL15 receptor (IL15Rα) greatly enhances IL15 stability and bioavailability. Therefore, we engineered a new recombinant myxoma virus (vMyx-IL15Rα-tdTr), which expresses an IL15Rα-IL15 fusion protein plus tdTomato red fluorescent reporter protein. Permissive rabbit kidney epithelial (RK-13) cells infected with vMyx-IL15Rα-tdTr expressed and secreted the IL15Rα-IL15 fusion protein. Functional activity was confirmed by demonstrating that the secreted fusion protein stimulated proliferation of cytokine-dependent CTLL-2 cells. Multi-step growth curves showed that murine melanoma (B16-F10 and B16.SIY) cell lines were permissive to vMyx-IL15Rα-tdTr infection. In vivo experiments in RAG1-/- mice showed that subcutaneous B16-F10 tumors treated with vMyx-IL15Rα-tdTr exhibited attenuated tumor growth and a significant survival benefit for the treated group compared to the PBS control and the control viruses (vMyx-IL15-tdTr and vMyx-tdTr). Immunohistological analysis of the subcutaneous tumors showed dramatically increased infiltration of NK cells in vMyx-IL15Rα-tdTr treated tumors compared to the controls. In vivo experiments with immunocompetent C57BL/6 mice revealed a strong infiltrate of both NK cells and CD8+ T cells in response to vMyx-IL15Rα-tdTr, and prolonged survival. We conclude that delivery of IL15Rα-IL15 in a myxoma virus vector stimulates both innate and adaptive components of the immune system. PMID:25329832

  15. A very rare association between giant right atrial myxoma and patent foramen ovale. Extracellular matrix and morphological aspects: a case report.

    PubMed

    Molnar, Adrian; Encică, Svetlana; Săcui, Diana Maria; Mureşan, Ioan; Trifan, Aurelian Cătălin

    2016-01-01

    We report a case of sporadic giant cardiac myxoma with a rare localization in the right atrium, operated in our Service, in a 73-year-old female patient who also presented a patent foramen ovale and a history of ischemic stroke in the year prior to current admission. Intra-operatively, the tumor had a very friable, gelatinous aspect, with a high potential for embolization due to its reduced consistency. The present paper refers to clinical, histochemical and immunohistochemical particularities, as well as to macroscopic and microscopic characteristics of the cardiac myxoma, emphasizing the extracellular matrix aspects, and without leaving out the cellular components of this rare tumor, with possible inference in the management of this disease. The authors present their own observations related to the data from the literature. Also, there are some particularities of the case which justify the current presentation. PMID:27516037

  16. Mitral chordae myxoma-chordae replacement with a premeasured gore-tex loop using a minimally invasive video-assisted approach.

    PubMed

    Hata, Masatoshi; Gummert, Jan F; Börgermann, Jochen; Hakim-Meibodi, Kavous

    2013-12-11

    Cardiac myxomas are one of the most common types of primary cardiac tumors and are associated with embolization, angina, and sudden death. Most cardiac myxomas arise from the fossa ovalis, while those that arise from the mitral valve are exceedingly rare and those that arise from the chordae are even rarer. We report the case of a 28-year-old Caucasian woman who suffered from a brain infarction. A duplex ultrasound showed no cerebrovascular stenosis or occlusion, but an echocardiogram revealed a left ventricle pedunculated mobile mass (5 mm in diameter) that was attached to the mitral valve chordae tendineae. We elected cardiac surgery to resect the cardiac tumor and to avoid further embolic events. The traditional surgical strategy-mitral valve replacement through full sternotomy-has many disadvantages, particularly for young women. Therefore we desided to use the Premeasured Gore-Tex chordal loop method followed by annuloplasty using a minimally invasive video-assisted approach. Exploration of the mitral valve showed a globular tumor involving the anterior mitral leaflet chordae tendineae, which was removed along with the involved chordae tendineae. Histopathological examination of the tissue revealed a benign polypoid myxoma. The patient had an uneventful recovery and has remained symptom-free.Echocardiography one week after surgery showed satisfactory valve function. We believe our surgical treatment was the most appropriate option for this case and it resulted in an excellent medical outcome and improved the quality of life, including only a small lateral scar without the need for teratogenic anticoagulants.

  17. Bioethical considerations.

    PubMed

    Leyser-Whalen, Ophra; Lawson, Erma; Macdonald, Arlene; Temple, Jeff R; Phelps, John Y

    2014-11-01

    The clinical literature notes that pregnancy has become an expected benefit of solid organ transplant. Establishing "best practices" in the management of this particular transplant population requires careful consideration of the ethical dimensions, broadly speaking, of posttransplant pregnancies and these women's lived experiences. In this article, we present the current clinical and social science posttransplant pregnancy research. We specifically address the psychosocial and ethical issues surrounding preconception counseling and posttransplant health quality of life and mothering and suggest areas for future research. PMID:25151472

  18. Advances in breast reconstruction after mastectomy.

    PubMed

    Edlich, Richard F; Winters, Kathryne L; Faulkner, Brent C; Bill, Timothy J; Lin, Kant Y

    2005-01-01

    Over the past 40 years, surgical reconstruction of the breast following mastectomy has become an important aspect of the cancer patient's rehabilitation process. While the surgical emphasis remains on a cure for the cancer, experience with breast reconstruction has not demonstrated any increased rate of cancer recurrence, even when reconstruction is performed immediately following tumor resection. Advances in surgical technique and biotechnology have made post-mastectomy reconstruction possible. The development of silicone gel and saline-filled implants as well as tissue expanders has revolutionized breast reconstruction. The elucidation of musculocutaneous flaps now provides the surgeon with the ability to transfer adequate quantities of vascularized tissue to reconstruct the surgical defects. The advent of microsurgical techniques has provided an additional reconstructive option, with free tissue transfer allowing the plastic surgeon to move musculocutaneous flaps from remote or distant sites to reconstruct the defect. The option of having the reconstruction immediately following the mastectomy procedure is now available to the patient. When reviewing the anatomy of the breast region, the surgeon must consider the mammary gland, its vascular supply, and its lymphatic system. The surgical techniques involved in reconstruction after mastectomy include the use of breast implants and tissue expansion, as well as reconstruction with autogenous tissues. Reconstruction with autogenous tissues includes the use of latissimus dorsi musculocutaneous flap, transverse rectus abdominus musculocutaneous flap, free flap transfer, as well as nipple-areola reconstruction. Breast reconstruction after mastectomy should be undertaken by a plastic and reconstructive surgeon with considerable training and experience with these diversified procedures.

  19. Prosthodontic considerations.

    PubMed

    Taylor, T D; Belser, U; Mericske-Stern, R

    2000-01-01

    The prosthodontic section of the 1997 ITI Consensus Conference in Vitznau, Switzerland, examined a broad spectrum of issues related to the prosthodontic phase of dental implant therapy. Topics included diagnosis and treatment planning, considerations for the use of ITI prosthodontic components, management of the partially edentulous patient, management of the edentulous patient, implant occlusion, and the use of narrow- and wide-body implants. The management of partially and totally edentulous patients will be discussed in separate papers. This paper is written so that each major consensus point discussed by the prosthodontic section is the first sentence of a paragraph. The remainder of each paragraph serves as background information or justification for the consensus statement. It should be noted that agreement on all points was reached by voting within the prosthodontic section. Many of the consensus statements were reached unanimously, while some were reached through compromise and split vote. Not all of the points presented here were presented to the plenum session on the final day of the conference. PMID:11168260

  20. Case studies of two related Chinese patients with Carney complex presenting with extensive cardiac myxomas and PRKAR1A gene mutation of c.491_492delTG.

    PubMed

    Guo, Hongwei; Xu, Jianping; Xiong, Hui; Hu, Shengshou

    2015-01-01

    Carney complex is an autosomal dominant disease that is clinically characterized by cardiac myxomas, spotty skin pigmentation, and endocrine overactivity. Carney complex is most commonly caused by mutations in the PRKAR1A gene on chromosome 17q22-24. Currently, there are at least 117 pathogenic mutations in PRKAR1A that have been identified. Herein, we report on two cases of Carney complex in related Chinese patients with a c.491_492delTG mutation that presented with multiple and extensive cardiac myxomas and skin pigmentation. PMID:25890363

  1. Surgical Treatment of Primary Intracardiac Myxoma: 20-Year Experience in “Shahid Modarres Hospital”—A Tertiary University Hospital—Tehran, Iran

    PubMed Central

    Ansari Aval, Zahra; Ghaderi, Hamid; Tatari, Hassan; Foroughi, Mahnoosh; Mirjafari, Seyedeh Adeleh; Forozeshfard, Mohammad; Fani, Kamal; Khaheshi, Isa

    2015-01-01

    Although cardiac tumors are not common they may vary in terms of race and surgical approach in different countries. Method. Patients data of 20 years was collected and evaluated in the “Shahid Modarres Hospital”—a tertiary university hospital—Tehran, Iran. Results. 42 patients with cardiac myxoma (all cases in 20 years) were included in study, 17 males and 25 females, age difference: 13 to 76 years (mean 50.6). Most of patients were in functional classes I, II. 35 patients complained of dyspnea and 3 patients had embolic events. 97.6% of tumors were primary (41 patients) and one tumor was recurrent (2.4%), 85.7% of tumors (36 cases) were located in LA, and 88.1% of tumors (37 cases) were pediculated. 40 patients (95%) had one tumor. In 22 patients (52.3%) after tumor resection septal defects were repaired primarily while in 18 patients (42.8%) the defects were repaired with pericardial patch and In one patient, tumor resected without any septal defect. Mean tumor size was about 5.22 cm (range of 2.2 to 8.2 cm). Postoperatively, 33 patients discharged from hospital without any complication. Discussion. The research reveals that patients' age and gender were similar to that of other studies in other countries while tumor's incidence seems to be higher. 3 patients were diagnosed after remote embolic event and one patient was diagnosed after MI reflecting relatively high tumor complications and late diagnosis. Conclusion. In our study mean time from diagnosis to operation was too long. The patients had more preoperative embolic events and complication. However, size of myxoma and location of that was as same as its rate in the other literature. As recommendation we suggested that in all patients with vague chest pain or remote embolic events cardiac myxomas should be ruled out. PMID:25688375

  2. Project Reconstruct.

    ERIC Educational Resources Information Center

    Helisek, Harriet; Pratt, Donald

    1994-01-01

    Presents a project in which students monitor their use of trash, input and analyze information via a database and computerized graphs, and "reconstruct" extinct or endangered animals from recyclable materials. The activity was done with second-grade students over a period of three to four weeks. (PR)

  3. Vaginal reconstruction

    SciTech Connect

    Lesavoy, M.A.

    1985-05-01

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients.

  4. Blob-enhanced reconstruction technique

    NASA Astrophysics Data System (ADS)

    Castrillo, Giusy; Cafiero, Gioacchino; Discetti, Stefano; Astarita, Tommaso

    2016-09-01

    A method to enhance the quality of the tomographic reconstruction and, consequently, the 3D velocity measurement accuracy, is presented. The technique is based on integrating information on the objects to be reconstructed within the algebraic reconstruction process. A first guess intensity distribution is produced with a standard algebraic method, then the distribution is rebuilt as a sum of Gaussian blobs, based on location, intensity and size of agglomerates of light intensity surrounding local maxima. The blobs substitution regularizes the particle shape allowing a reduction of the particles discretization errors and of their elongation in the depth direction. The performances of the blob-enhanced reconstruction technique (BERT) are assessed with a 3D synthetic experiment. The results have been compared with those obtained by applying the standard camera simultaneous multiplicative reconstruction technique (CSMART) to the same volume. Several blob-enhanced reconstruction processes, both substituting the blobs at the end of the CSMART algorithm and during the iterations (i.e. using the blob-enhanced reconstruction as predictor for the following iterations), have been tested. The results confirm the enhancement in the velocity measurements accuracy, demonstrating a reduction of the bias error due to the ghost particles. The improvement is more remarkable at the largest tested seeding densities. Additionally, using the blobs distributions as a predictor enables further improvement of the convergence of the reconstruction algorithm, with the improvement being more considerable when substituting the blobs more than once during the process. The BERT process is also applied to multi resolution (MR) CSMART reconstructions, permitting simultaneously to achieve remarkable improvements in the flow field measurements and to benefit from the reduction in computational time due to the MR approach. Finally, BERT is also tested on experimental data, obtaining an increase of the

  5. Comparative Analysis of the Complete Genome Sequence of the California MSW Strain of Myxoma Virus Reveals Potential Host Adaptations

    PubMed Central

    Kerr, Peter J.; Rogers, Matthew B.; Fitch, Adam; DePasse, Jay V.; Cattadori, Isabella M.; Hudson, Peter J.; Tscharke, David C.; Holmes, Edward C.

    2013-01-01

    Myxomatosis is a rapidly lethal disease of European rabbits that is caused by myxoma virus (MYXV). The introduction of a South American strain of MYXV into the European rabbit population of Australia is the classic case of host-pathogen coevolution following cross-species transmission. The most virulent strains of MYXV for European rabbits are the Californian viruses, found in the Pacific states of the United States and the Baja Peninsula, Mexico. The natural host of Californian MYXV is the brush rabbit, Sylvilagus bachmani. We determined the complete sequence of the MSW strain of Californian MYXV and performed a comparative analysis with other MYXV genomes. The MSW genome is larger than that of the South American Lausanne (type) strain of MYXV due to an expansion of the terminal inverted repeats (TIRs) of the genome, with duplication of the M156R, M154L, M153R, M152R, and M151R genes and part of the M150R gene from the right-hand (RH) end of the genome at the left-hand (LH) TIR. Despite the extreme virulence of MSW, no novel genes were identified; five genes were disrupted by multiple indels or mutations to the ATG start codon, including two genes, M008.1L/R and M152R, with major virulence functions in European rabbits, and a sixth gene, M000.5L/R, was absent. The loss of these gene functions suggests that S. bachmani is a relatively recent host for MYXV and that duplication of virulence genes in the TIRs, gene loss, or sequence variation in other genes can compensate for the loss of M008.1L/R and M152R in infections of European rabbits. PMID:23986601

  6. Myxoma Virus Immunomodulatory Protein M156R is a Structural Mimic of Eukaryotic Translation Initiation Factor eIF2 alpha

    SciTech Connect

    Ramelot, Theresa A.; Cort, John R.; Yee, Adelinda; Liu, Furong; Goshe, Michael B.; Edwards, Aled M.; Smith, Richard D.; Arrowsmith, Cheryl H.; Dever, Thomas E.; Kennedy, Michael A.

    2002-10-04

    M156R, the product of the myxoma virus M156R open reading frame, is a protein of unknown function. However, several homologs of M156R from other viruses are immunomodulatory proteins that bind to interferon-induced protein kinase PKR and inhibit phosphorylation of the eukaryotic translation initiation factor eIF2a. In this study, we have determined the nuclear magnetic resonance (NMR) structure of M156R, the first structure of a myxoma virus protein. The fold consists of a five-stranded antiparallel b-barrel with two of the strands connected by a long loop and a short a-helix. The similarity between M156R and the predicted S1 motif structure of eIF2a suggests that the viral homologs are pseudosubstrate inhibitors of PKR that mimic eIF2a in order to compete for binding to PKR. A homology modeled structure of the well studied vaccinia virus K3L was generated based on alignment with M156R. Residues important for binding to PKR are conserved residues on the surface of the b-barrel and in the mobile loop, identifying the putative PKR recognition motif.

  7. Technical basis for dose reconstruction

    SciTech Connect

    Anspaugh, L.R.

    1996-01-31

    The purpose of this paper is to consider two general topics: technical considerations of why dose-reconstruction studies should or should not be performed and methods of dose reconstruction. The first topic is of general and growing interest as the number of dose-reconstruction studies increases, and one asks the question whether it is necessary to perform a dose reconstruction for virtually every site at which, for example, the Department of Energy (DOE) has operated a nuclear-related facility. And there is the broader question of how one might logically draw the line at performing or not performing dose-reconstruction (radiological and chemical) studies for virtually every industrial complex in the entire country. The second question is also of general interest. There is no single correct way to perform a dose-reconstruction study, and it is important not to follow blindly a single method to the point that cheaper, faster, more accurate, and more transparent methods might not be developed and applied.

  8. Lead - nutritional considerations

    MedlinePlus

    Lead poisoning - nutritional considerations; Toxic metal - nutritional considerations ... utensils . Old paint poses the greatest danger for lead poisoning , especially in young children. Tap water from lead ...

  9. Electronic noise modeling in statistical iterative reconstruction.

    PubMed

    Xu, Jingyan; Tsui, Benjamin M W

    2009-06-01

    We consider electronic noise modeling in tomographic image reconstruction when the measured signal is the sum of a Gaussian distributed electronic noise component and another random variable whose log-likelihood function satisfies a certain linearity condition. Examples of such likelihood functions include the Poisson distribution and an exponential dispersion (ED) model that can approximate the signal statistics in integration mode X-ray detectors. We formulate the image reconstruction problem as a maximum-likelihood estimation problem. Using an expectation-maximization approach, we demonstrate that a reconstruction algorithm can be obtained following a simple substitution rule from the one previously derived without electronic noise considerations. To illustrate the applicability of the substitution rule, we present examples of a fully iterative reconstruction algorithm and a sinogram smoothing algorithm both in transmission CT reconstruction when the measured signal contains additive electronic noise. Our simulation studies show the potential usefulness of accurate electronic noise modeling in low-dose CT applications.

  10. Tooth autotransplantation in a free iliac crest graft for prosthetic reconstruction.

    PubMed

    Landes, Constantin A; Glasl, Bettina; Ludwig, Björn; Rieger, Jörg; Sader, Robert

    2008-09-01

    This report documents successful tooth autotransplantation to a free iliac crest graft in an exemplar case. A 14-year-old male patient was operated thrice with increasing amounts of resection for recurrent odontogenic myxoma. When mandibular continuity resection finally was performed, a free iliac crest block autotransplant was used for reconstruction. Upon metal removal 5 months later, 3 wisdom teeth with two-thirds complete root development were transplanted to the free graft and retained by fixed orthodontic appliances including skeletal anchorage with orthodontic microscrews. Tooth graft taking was awaited for 8 weeks with retention. Following undisturbed healing without occlusal forces, 6 months of orthodontic treatment intentionally extruded the autotransplanted teeth to antagonist contact. The third and most dorsal tooth became mobile after 3 months and was lost. The surviving 2 teeth were fitted by a prosthetic bridge as extrusion into the occlusal plane was not completely successful. This exemplar case shows benefit of tooth autotransplants in selected cases of jaw reconstruction with distal bone autotransplants as alternative to dental titanium implants and suprastructures. Orthodontic microscrews can moreover support tooth movement and positioning as anchorage device in altered anatomy.

  11. Neuromagnetic source reconstruction

    SciTech Connect

    Lewis, P.S.; Mosher, J.C.; Leahy, R.M.

    1994-12-31

    In neuromagnetic source reconstruction, a functional map of neural activity is constructed from noninvasive magnetoencephalographic (MEG) measurements. The overall reconstruction problem is under-determined, so some form of source modeling must be applied. We review the two main classes of reconstruction techniques-parametric current dipole models and nonparametric distributed source reconstructions. Current dipole reconstructions use a physically plausible source model, but are limited to cases in which the neural currents are expected to be highly sparse and localized. Distributed source reconstructions can be applied to a wider variety of cases, but must incorporate an implicit source, model in order to arrive at a single reconstruction. We examine distributed source reconstruction in a Bayesian framework to highlight the implicit nonphysical Gaussian assumptions of minimum norm based reconstruction algorithms. We conclude with a brief discussion of alternative non-Gaussian approachs.

  12. Nipple and areola reconstruction.

    PubMed

    Hutcheson, H A; Bostwick, J

    1989-01-01

    Nipple-areola reconstruction is an integral part of breast reconstruction. Optimum results are usually obtained when nipple-areola reconstruction is staged after the breast mound has attained its final shape and is well vascularized. The use of intradermal tattoo allows the use of a variety of nonpigmented donor sites. Women report that reconstruction of the nipple-areola enhances their overall satisfaction with breast reconstruction. The knowledgeable and skilled nurse is a valuable member of the professional team during this final phase of breast reconstruction. PMID:2479039

  13. Early infections by myxoma virus of young rabbits (Oryctolagus cuniculus) protected by maternal antibodies activate their immune system and enhance herd immunity in wild populations

    PubMed Central

    2014-01-01

    The role of maternal antibodies is to protect newborns against acute early infection by pathogens. This can be achieved either by preventing any infection or by allowing attenuated infections associated with activation of the immune system, the two strategies being based on different cost/benefit ratios. We carried out an epidemiological survey of myxomatosis, which is a highly lethal infectious disease, in two distant wild populations of rabbits to describe the epidemiological pattern of the disease. Detection of specific IgM and IgG enabled us to describe the pattern of immunity. We show that maternal immunity attenuates early infection of juveniles and enables activation of their immune system. This mechanism associated with steady circulation of the myxoma virus in both populations, which induces frequent reinfections of immune rabbits, leads to the maintenance of high immunity levels within populations. Thus, myxomatosis has a low impact, with most infections being asymptomatic. This work shows that infection of young rabbits protected by maternal antibodies induces attenuated disease and activates their immune system. This may play a major role in reducing the impact of a highly lethal disease when ecological conditions enable permanent circulation of the pathogen. PMID:24589193

  14. Early infections by myxoma virus of young rabbits (Oryctolagus cuniculus) protected by maternal antibodies activate their immune system and enhance herd immunity in wild populations.

    PubMed

    Marchandeau, Stéphane; Pontier, Dominique; Guitton, Jean-Sébastien; Letty, Jérôme; Fouchet, David; Aubineau, Jacky; Berger, Francis; Léonard, Yves; Roobrouck, Alain; Gelfi, Jacqueline; Peralta, Brigitte; Bertagnoli, Stéphane

    2014-03-04

    The role of maternal antibodies is to protect newborns against acute early infection by pathogens. This can be achieved either by preventing any infection or by allowing attenuated infections associated with activation of the immune system, the two strategies being based on different cost/benefit ratios. We carried out an epidemiological survey of myxomatosis, which is a highly lethal infectious disease, in two distant wild populations of rabbits to describe the epidemiological pattern of the disease. Detection of specific IgM and IgG enabled us to describe the pattern of immunity. We show that maternal immunity attenuates early infection of juveniles and enables activation of their immune system. This mechanism associated with steady circulation of the myxoma virus in both populations, which induces frequent reinfections of immune rabbits, leads to the maintenance of high immunity levels within populations. Thus, myxomatosis has a low impact, with most infections being asymptomatic. This work shows that infection of young rabbits protected by maternal antibodies induces attenuated disease and activates their immune system. This may play a major role in reducing the impact of a highly lethal disease when ecological conditions enable permanent circulation of the pathogen.

  15. PPARγ suppresses the proliferation of cardiac myxoma cells through downregulation of MEF2D in a miR-122-dependent manner.

    PubMed

    Qiu, Youzhu; Yang, Jie; Bian, Shizhu; Chen, Guozhu; Yu, Jie

    2016-06-01

    Peroxisome proliferator-activated receptor gamma (PPARγ), a multiple functional transcription factor, has been reported to have anti-tumor effects through inhibition of cells proliferation. However, its effects on cardiac myxoma (CM) cells and the underlying signaling mechanism is unclear. In the present study, we demonstrated that the level of PPARγ is inversely correlated with that of myocyte enhancer factor 2D (MEF2D), a biomarker of CM. We found that activation of PPARγ inhibit MEF2D expression via upregulation of miR-122, which can target the 3'-UTR of MEF2D and inhibit MEF2D expression, by directly binding to the PPRE in the miR-122 promoter region. Functional experiments further showed that miR-122-dependent downregulation of MEF2D by PPARγ suppress the proliferation of CM cells. These results suggest that PPARγ may exert its antiproliferative effects by negatively regulating the MEF2D in CM cells, which through upregulation of miR-122, and PPARγ/miR-122/MEF2D signaling pathway may be a novel target for treatment of CM. PMID:27109478

  16. Reoperative midface reconstruction.

    PubMed

    Acero, Julio; García, Eloy

    2011-02-01

    Reoperative reconstruction of the midface is a challenging issue because of the complexity of this region and the severity of the aesthetic and functional sequela related to the absence or failure of a primary reconstruction. The different situations that can lead to the indication of a reoperative reconstructive procedure after previous oncologic ablative procedures in the midface are reviewed. Surgical techniques, anatomic problems, and limitations affecting the reoperative reconstruction in this region of the head and neck are discussed.

  17. DOE handbook: Design considerations

    SciTech Connect

    1999-04-01

    The Design Considerations Handbook includes information and suggestions for the design of systems typical to nuclear facilities, information specific to various types of special facilities, and information useful to various design disciplines. The handbook is presented in two parts. Part 1, which addresses design considerations, includes two sections. The first addresses the design of systems typically used in nuclear facilities to control radiation or radioactive materials. Specifically, this part addresses the design of confinement systems and radiation protection and effluent monitoring systems. The second section of Part 1 addresses the design of special facilities (i.e., specific types of nonreactor nuclear facilities). The specific design considerations provided in this section were developed from review of DOE 6430.1A and are supplemented with specific suggestions and considerations from designers with experience designing and operating such facilities. Part 2 of the Design Considerations Handbook describes good practices and design principles that should be considered in specific design disciplines, such as mechanical systems and electrical systems. These good practices are based on specific experiences in the design of nuclear facilities by design engineers with related experience. This part of the Design Considerations Handbook contains five sections, each of which applies to a particular engineering discipline.

  18. [Breast reconstruction after mastectomy].

    PubMed

    Ho Quoc, C; Delay, E

    2013-02-01

    The mutilating surgery for breast cancer causes deep somatic and psychological sequelae. Breast reconstruction can mitigate these effects and permit the patient to help rebuild their lives. The purpose of this paper is to focus on breast reconstruction techniques and on factors involved in breast reconstruction. The methods of breast reconstruction are presented: objectives, indications, different techniques, operative risks, and long-term monitoring. Many different techniques can now allow breast reconstruction in most patients. Clinical cases are also presented in order to understand the results we expect from a breast reconstruction. Breast reconstruction provides many benefits for patients in terms of rehabilitation, wellness, and quality of life. In our mind, breast reconstruction should be considered more as an opportunity and a positive choice (the patient can decide to do it), than as an obligation (that the patient would suffer). The consultation with the surgeon who will perform the reconstruction is an important step to give all necessary informations. It is really important that the patient could speak again with him before undergoing reconstruction, if she has any doubt. The quality of information given by medical doctors is essential to the success of psychological intervention. This article was written in a simple, and understandable way to help gynecologists giving the best information to their patients. It is maybe also possible to let them a copy of this article, which would enable them to have a written support and would facilitate future consultation with the surgeon who will perform the reconstruction.

  19. Non-small cell lung cancer with concomitant intramuscular myxoma of the right psoas mimicking intramuscular metastasis: A case report and literature review

    PubMed Central

    ZHANG, PENG; MENG, XUE; XIA, LIANKE; XIE, PENG; SUN, XINDONG; GAO, YONGSHENG; WANG, SHIJIANG; ZHAO, XIANGUANG; YU, JINMING

    2015-01-01

    Intramuscular myxoma (IMM) as a rare soft-tissue tumor arising from the muscles is completely benign. When IMM accompanies malignance, it may be misdiagnosed as muscle metastasis, and for this extremely rare concurrence, the subsequent treatment would vary accordingly. The current study presents, to the best of our knowledge, the first case of non-small cell lung cancer (NSCLC) concomitant with IMM mimicking skeletal muscle metastasis. A 64-year-old female was hospitalized with a history of chest discomfort and right lumbar pain that had persisted for four months. The computed tomography scan showed a lesion in the left upper lobe of the lung and the right psoas, respectively. Serum biomarkers for NSCLC were abnormal. A presumptive clinical diagnosis was compatible with left NSCLC and right psoas muscle metastasis (cT2aN3M1b, stage IV). Stage IV lung cancer would receive palliative treatment. However, the final diagnosis of synchronous left lung squamous cell carcinoma (cT2aN3M0, stage IIIB) and IMM in the right psoas was confirmed by biopsy. The patient therefore underwent definitive chemoradiotherapy for lung carcinoma, and conservative treatment, including analgesics, for IMM. The diagnosis process for a malignant neoplasm concomitant with IMM is not straightforward due to a lack of clinical experience, and it significantly affects the tumor staging and subsequent treatment strategy. The present case suggests that IMM should be included in the differential diagnosis when an abnormal intramuscular lesion concomitant with malignancy is identified. The value of histopathological diagnosis prior to definitive treatment also requires highlighting. PMID:26722289

  20. Myxoma virus M156 is a specific inhibitor of rabbit PKR but contains a loss-of-function mutation in Australian virus isolates

    PubMed Central

    Peng, Chen; Haller, Sherry L.; Rahman, Masmudur M.; McFadden, Grant; Rothenburg, Stefan

    2016-01-01

    Myxoma virus (MYXV) is a rabbit-specific poxvirus, which is highly virulent in European rabbits. The attenuation of MYXV and the increased resistance of rabbits following the release of MYXV in Australia is one of the best-documented examples of host–pathogen coevolution. To elucidate the molecular mechanisms that contribute to the restriction of MYXV infection to rabbits and MYXV attenuation in the field, we have studied the interaction of the MYXV protein M156 with the host antiviral protein kinase R (PKR). In yeast and cell-culture transfection assays, M156 only inhibited rabbit PKR but not PKR from other tested mammalian species. Infection assays with human HeLa PKR knock-down cells, which were stably transfected with human or rabbit PKR, revealed that only human but not rabbit PKR was able to restrict MYXV infection, whereas both PKRs were able to restrict replication of a vaccinia virus (VACV) strain that lacks the PKR inhibitors E3 and K3. Inactivation of M156R led to MYXV virus attenuation in rabbit cells, which was rescued by the ectopic expression of VACV E3 and K3. We further show that a mutation in the M156 encoding gene that was identified in more than 50% of MYXV field isolates from Australia resulted in an M156 variant that lost its ability to inhibit rabbit PKR and led to virus attenuation. The species-specific inhibition of rabbit PKR by M156 and the M156 loss-of-function in Australian MYXV field isolates might thus contribute to the species specificity of MYXV and to the attenuation in the field, respectively. PMID:26903626

  1. Astrocyte elevated gene-1 regulates CCL3/CCR5-induced epithelial-to-mesenchymal transition via Erk1/2 and Akt signaling in cardiac myxoma.

    PubMed

    Shi, Ping; Fang, Changcun; Pang, Xinyan

    2015-09-01

    In recent years, astrocyte elevated gene-1 (AEG-1) has been reported as a key mediator that is involved in the epithelial-to-mesenchymal transition (EMT) process. However, the mechanisms underlying CCL3/CCR5-AEG-1 pathway-mediated EMT in cardiac myxoma (CM) has not been well featured till now. We used immnohistochemistry and immunoblotting to assess the expression of CCR5 and AEG-1 in 30 cases of CM tissues and cells. Subsequently, cultured CM cells were treated with si-AEG-1 or si-CCR5 and then subjected to in vitro assays. We observed that CCR5 and AEG-1 proteins were highly expressed in CM tissues (73.3 and 76.7%, respectively) and closely correlated with tumor size (>5 cm). Importantly, we validated the expression of AEG-1, p-Erk1/2, p-Akt, vimentin, N-cadherin and MMP2 increased in the CM cell with CCL3 treatment in a time- and concentration-dependent manner. When CM cells were treated with si-CCR5, the expression of AEG-1, p-Erk1/2, p-Akt, vimentin, N-cadherin and MMP2 was downregulated. In addition, when CM cells were treated with si-AEG-1, the expression of p-Erk1/2, p-Akt, vimentin, N-cadherin and MMP2 was also downregulated. Using the cell cycle and proliferation assay, the knockdown of AEG-1 inhibited the entry of G1 into S phase and the proliferation capacity of CM cells. In conclusion, AEG-1 mediates CCL3/CCR5-induced EMT development via both Erk1/2 and Akt signaling pathway in CM patients, which indicates CCL3/CCR5-AEG-1-EMT pathway could be suggested as a useful target to affect the progression of CM.

  2. Myxoma virus M156 is a specific inhibitor of rabbit PKR but contains a loss-of-function mutation in Australian virus isolates.

    PubMed

    Peng, Chen; Haller, Sherry L; Rahman, Masmudur M; McFadden, Grant; Rothenburg, Stefan

    2016-04-01

    Myxoma virus (MYXV) is a rabbit-specific poxvirus, which is highly virulent in European rabbits. The attenuation of MYXV and the increased resistance of rabbits following the release of MYXV in Australia is one of the best-documented examples of host-pathogen coevolution. To elucidate the molecular mechanisms that contribute to the restriction of MYXV infection to rabbits and MYXV attenuation in the field, we have studied the interaction of the MYXV protein M156 with the host antiviral protein kinase R (PKR). In yeast and cell-culture transfection assays, M156 only inhibited rabbit PKR but not PKR from other tested mammalian species. Infection assays with human HeLa PKR knock-down cells, which were stably transfected with human or rabbit PKR, revealed that only human but not rabbit PKR was able to restrict MYXV infection, whereas both PKRs were able to restrict replication of a vaccinia virus (VACV) strain that lacks the PKR inhibitors E3 and K3. Inactivation of M156R led to MYXV virus attenuation in rabbit cells, which was rescued by the ectopic expression of VACV E3 and K3. We further show that a mutation in the M156 encoding gene that was identified in more than 50% of MYXV field isolates from Australia resulted in an M156 variant that lost its ability to inhibit rabbit PKR and led to virus attenuation. The species-specific inhibition of rabbit PKR by M156 and the M156 loss-of-function in Australian MYXV field isolates might thus contribute to the species specificity of MYXV and to the attenuation in the field, respectively. PMID:26903626

  3. Head and neck reconstruction

    PubMed Central

    Yadav, Prabha

    2013-01-01

    Whatever is excisable, is reconstructable! “You excise, we will reconstruct” are the confident words of reconstructive surgeons today. Reconstruction with multiple flaps has become routine. Radial artery (FRAF), Antero lateral thigh (ALT) and Fibula osteo cutaneous flap (FFOCF) are three most popular free flaps which can reconstruct any defect with excellent asthetics and performance. Radial Artery provides thin, pliable innervated skin; ALT large amount of skin & bulk; and FFOCF strong 22 to 25 centimetres of bone and reliable skin paddle. Free flap survival has gone to 98% in most of the renouned institutes and is an established escalator in management of defects. PMID:24501464

  4. Flexor pulley reconstruction.

    PubMed

    Dy, Christopher J; Daluiski, Aaron

    2013-05-01

    Flexor pulley reconstruction is a challenging surgery. Injuries often occur after traumatic lacerations or forceful extension applied to an acutely flexed finger. Surgical treatment is reserved for patients with multiple closed pulley ruptures, persistent pain, or dysfunction after attempted nonoperative management of a single pulley rupture, or during concurrent or staged flexor tendon repair or reconstruction. If the pulley cannot be repaired primarily, pulley reconstruction can be performed using graft woven into remnant pulley rim or looping graft around the phalanx. Regardless of the reconstructive technique, the surgeon should emulate the length, tension, and glide of the native pulley. PMID:23660059

  5. Facility Design Considerations.

    ERIC Educational Resources Information Center

    Chase, William W.

    1967-01-01

    Increasing need for vocational education under the impetus of federal aid is generating a demand for vocational teaching facilities. Factors to be considered in planning these facilities inclued--(1) site development, (2) program needs, (3) administrative considerations, (4) environmental controls. (5) mechanical systems, and (6) area and space…

  6. Fast iterative image reconstruction of 3D PET data

    SciTech Connect

    Kinahan, P.E.; Townsend, D.W.; Michel, C.

    1996-12-31

    For count-limited PET imaging protocols, two different approaches to reducing statistical noise are volume, or 3D, imaging to increase sensitivity, and statistical reconstruction methods to reduce noise propagation. These two approaches have largely been developed independently, likely due to the perception of the large computational demands of iterative 3D reconstruction methods. We present results of combining the sensitivity of 3D PET imaging with the noise reduction and reconstruction speed of 2D iterative image reconstruction methods. This combination is made possible by using the recently-developed Fourier rebinning technique (FORE), which accurately and noiselessly rebins 3D PET data into a 2D data set. The resulting 2D sinograms are then reconstructed independently by the ordered-subset EM (OSEM) iterative reconstruction method, although any other 2D reconstruction algorithm could be used. We demonstrate significant improvements in image quality for whole-body 3D PET scans by using the FORE+OSEM approach compared with the standard 3D Reprojection (3DRP) algorithm. In addition, the FORE+OSEM approach involves only 2D reconstruction and it therefore requires considerably less reconstruction time than the 3DRP algorithm, or any fully 3D statistical reconstruction algorithm.

  7. Infections in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Stucken, Charlton; Garras, David N.; Shaner, Julie L.; Cohen, Steven B.

    2013-01-01

    Context: Anterior cruciate ligament (ACL) reconstruction is a safe, common, and effective method of restoring stability to the knee after injury, but evolving techniques of reconstruction carry inherent risk. Infection after ACL reconstruction, while rare, carries a high morbidity, potentially resulting in a poor clinical outcome. Evidence Acquisition: Data were obtained from previously published peer-reviewed literature through a search of the entire PubMed database (up to December 2012) as well as from textbook chapters. Results: Treatment with culture-specific antibiotics and debridement with graft retention is recommended as initial treatment, but with persistent infection, consideration should be given to graft removal. Graft type likely has no effect on infection rates. Conclusion: The early diagnosis of infection and appropriate treatment are necessary to avoid the complications of articular cartilage damage and arthrofibrosis. PMID:24427432

  8. Facial artery flaps in facial oncoplastic reconstruction.

    PubMed

    Fabrizio, Tommaso

    2013-10-01

    The face is one of the common sites for cutaneous cancer localization. It is well known that the face is the localization of more than 50% of skin cancers. Nowadays, the principles of modern "oncoplasty" recommend the complete excision of the cancer and the reconstruction with respect to cosmetic features of the face in terms of good color, good softness, and good texture of the flaps, utilized in cancer repair. The oncological and cosmetic results of facial reconstruction are strictly linked and the modern plastic and reconstructive surgeon must respect both oncological and cosmetic aspects. For that reason the best solution in facial cancer repair is the utilization of locoregional flaps based on the tributary vessels of the facial artery. In consideration of the dimension of recipient area to repair, the retroangular flap (RAF) or the submental flap could be used. This article is voted to illustrate a very large and long-term casuistry dedicated to these flaps.

  9. Human factors workplace considerations

    NASA Technical Reports Server (NTRS)

    Haines, Richard F.

    1988-01-01

    Computer workstations assume many different forms and play different functions today. In order for them to assume the effective interface role which they should play they must be properly designed to take into account the ubiguitous human factor. In addition, the entire workplace in which they are used should be properly configured so as to enhance the operational features of the individual workstation where possible. A number of general human factors workplace considerations are presented. This ongoing series of notes covers such topics as achieving comfort and good screen visibility, hardware issues (e.g., mouse maintenance), screen symbology features (e.g., labels, cursors, prompts), and various miscellaneous subjects. These notes are presented here in order to: (1) illustrate how one's workstation can be used to support telescience activities of many other people working within an organization, and (2) provide a single complete set of considerations for future reference.

  10. Education for Reconstruction.

    ERIC Educational Resources Information Center

    Phillips, David; And Others

    This report describes the main questions that various international agencies must address in order to reconstruct education in countries that have experienced crisis. "Crisis" is defined as war, natural disaster, and extreme political and economic upheaval. Many of the problems of educational reconstruction with which the Allies contended in…

  11. High-luminosity considerations

    SciTech Connect

    Platner, E.D.

    1982-01-01

    There appears to be some controversy over how high a luminosity one can use before a variety of detector limitations impose a practical limit. Factors leading to flux limitations for a variety of detector types are discussed, and practical considerations to extending those limits are reviewed. Also, a method of reducing the effects of pileup inherent in calorimeter use at L = 10/sup 33//cm/sup 2//sec is given.

  12. Fusion facility siting considerations

    NASA Astrophysics Data System (ADS)

    Bussell, G. T.

    1985-02-01

    Inherent in the fusion program's transition from hydrogen devices to commercial power machines is a general increase in the size and scope of succeeding projects. This growth will lead to increased emphasis on safety, environmental impact, and the external effects of fusion in general, and of each new device in particular. An important consideration in this regard is site selection. Major siting issues that may affect the economics, safety, and environmental impact of fusion are examined.

  13. Posterolateral knee reconstruction.

    PubMed

    Djian, P

    2015-02-01

    Injury to the cruciate ligaments of the knee commonly occurs in association with posterolateral instability, which can cause severe functional disability including varus, posterior translation, and external rotational instability. Failure to diagnose and treat an injury of the posterolateral corner in a patient who has a tear of the cruciate ligament can also result in the failure of the reconstructed cruciate ligament. There seems to be a consensus of opinion that injury to the posterolateral corner, whether isolated or combined, is best treated by reconstructing the posterolateral corner along with the coexisting cruciate ligament injury, if combined. Commonly proposed methods of reconstructing the posterolateral corner have focused on the reconstruction of the popliteus, the popliteofibular ligament, and the lateral collateral ligament. The aim of this conference is to describe the posterolateral corner reconstruction technique and to provide an algorithm of treatment. PMID:25596981

  14. Keyhole Flap Nipple Reconstruction.

    PubMed

    Chen, Joseph I; Cash, Camille G; Iman, Al-Haj; Spiegel, Aldona J; Cronin, Ernest D

    2016-05-01

    Nipple-areola reconstruction is often one of the final but most challenging aspects of breast reconstruction. However, it is an integral and important component of breast reconstruction because it transforms the mound into a breast. We performed 133 nipple-areola reconstructions during a period of 4 years. Of these reconstructions, 76 of 133 nipple-areola complexes were reconstructed using the keyhole flap technique. The tissue used for the keyhole dermoadipose flap technique include transverse rectus abdominus myocutaneous flaps (60/76), latissimus dorsi flaps (15/76), or mastectomy skin flaps after tissue expanders (1/76). The average patient follow-up was 17 months. The design of the flap is based on a keyhole configuration. The base of the flap determines the width of the future nipple, whereas the length of the flap determines the projection. We try to match the projection of the contralateral nipple if present. The keyhole flap is simple to construct yet reliable. It provides good symmetry and projection and avoids the creation of new scars. The areola is then tattooed approximately 3 months after the nipple reconstruction. PMID:27579228

  15. Endoscopic considerations in children.

    PubMed

    Lobritto, S J

    2001-01-01

    Endoscopy often is required in the management of patients with chronic liver disease. Endoscopy in this pediatric population is a safe and effective diagnostic and therapeutic modality for the appropriate clinical situation. The clear advantage afforded by reduced-sized equipment, new anesthetic agents, better operator training, and specialized pediatric endoscopy units have resulted in better outcomes and reduced risk to the patient. Advances in technical innovations will expand the currently offered diagnostic and therapeutic options for management of pediatric with portal hypertension. This article reviews specific considerations for endoscopy in this demanding patient population. PMID:11175977

  16. Acromioclavicular Joint Reconstruction.

    PubMed

    Scillia, Anthony J; Cain, E Lyle

    2015-12-01

    Our technique for acromioclavicular joint reconstruction provides a variation on coracoclavicular ligament reconstruction to also include acromioclavicular ligament reconstruction. An oblique acromial tunnel is drilled, and the medial limb of the gracilis graft, after being crossed and passed beneath the coracoid and through the clavicle, is passed through this acromial tunnel and sutured to the trapezoid graft limb after appropriate tensioning. Tenodesis screws are not placed in the bone tunnels to avoid graft fraying, and initial forces on the graft are offloaded with braided absorbable sutures passed around the clavicle. PMID:27284528

  17. Reconstruction of biofilm images: combining local and global structural parameters

    SciTech Connect

    Resat, Haluk; Renslow, Ryan S.; Beyenal, Haluk

    2014-11-07

    Digitized images can be used for quantitative comparison of biofilms grown under different conditions. Using biofilm image reconstruction, it was previously found that biofilms with a completely different look can have nearly identical structural parameters and that the most commonly utilized global structural parameters were not sufficient to uniquely define these biofilms. Here, additional local and global parameters are introduced to show that these parameters considerably increase the reliability of the image reconstruction process. Assessment using human evaluators indicated that the correct identification rate of the reconstructed images increased from 50% to 72% with the introduction of the new parameters into the reconstruction procedure. An expanded set of parameters especially improved the identification of biofilm structures with internal orientational features and of structures in which colony sizes and spatial locations varied. Hence, the newly introduced structural parameter sets helped to better classify the biofilms by incorporating finer local structural details into the reconstruction process.

  18. Considerations for the Management of Medial Orbital Wall Blowout Fracture

    PubMed Central

    Park, Youngsoo; Chung, Kyu Jin

    2016-01-01

    Recently, diagnoses of and operations for medial orbital blowout fracture have increased because of the development of imaging technology. In this article, the authors review the literature, and overview the accumulated knowledge about the orbital anatomy, fracture mechanisms, surgical approaches, reconstruction materials, and surgical methods. In terms of surgical approaches, transcaruncular, transcutaneous, and transnasal endoscopic approaches are discussed. Reconstruction methods including onlay covering, inlay implantation, and repositioning methods are also discussed. Consideration and understanding of these should lead to more optimal outcomes. PMID:27218019

  19. Advances in Tracheal Reconstruction

    PubMed Central

    Salna, Michael; Waddell, Thomas K.; Hofer, Stefan O.

    2014-01-01

    Summary: A recent revival of global interest for reconstruction of long-segment tracheal defects, which represents one of the most interesting and complex problems in head and neck and thoracic reconstructive surgery, has been witnessed. The trachea functions as a conduit for air, and its subunits including the epithelial layer, hyaline cartilage, and segmental blood supply make it particularly challenging to reconstruct. A myriad of attempts at replacing the trachea have been described. These along with the anatomy, indications, and approaches including microsurgical tracheal reconstruction will be reviewed. Novel techniques such as tissue-engineering approaches will also be discussed. Multiple attempts at replacing the trachea with synthetic scaffolds have been met with failure. The main lesson learned from such failures is that the trachea must not be treated as a “simple tube.” Understanding the anatomy, developmental biology, physiology, and diseases affecting the trachea are required for solving this problem. PMID:25426361

  20. Overview of Image Reconstruction

    SciTech Connect

    Marr, R. B.

    1980-04-01

    Image reconstruction (or computerized tomography, etc.) is any process whereby a function, f, on Rn is estimated from empirical data pertaining to its integrals, ∫f(x) dx, for some collection of hyperplanes of dimension k < n. The paper begins with background information on how image reconstruction problems have arisen in practice, and describes some of the application areas of past or current interest; these include radioastronomy, optics, radiology and nuclear medicine, electron microscopy, acoustical imaging, geophysical tomography, nondestructive testing, and NMR zeugmatography. Then the various reconstruction algorithms are discussed in five classes: summation, or simple back-projection; convolution, or filtered back-projection; Fourier and other functional transforms; orthogonal function series expansion; and iterative methods. Certain more technical mathematical aspects of image reconstruction are considered from the standpoint of uniqueness, consistency, and stability of solution. The paper concludes by presenting certain open problems. 73 references. (RWR)

  1. Breast Reconstruction After Mastectomy

    MedlinePlus

    ... Women who have autologous tissue reconstruction may need physical therapy to help them make up for weakness experienced ... 127(1):15–22. [PubMed Abstract] Monteiro M. Physical therapy implications following the TRAM procedure. Physical Therapy. 1997; ...

  2. Reconstruction of Mandibular Defects

    PubMed Central

    Chim, Harvey; Salgado, Christopher J.; Mardini, Samir; Chen, Hung-Chi

    2010-01-01

    Defects requiring reconstruction in the mandible are commonly encountered and may result from resection of benign or malignant lesions, trauma, or osteoradionecrosis. Mandibular defects can be classified according to location and extent, as well as involvement of mucosa, skin, and tongue. Vascularized bone flaps, in general, provide the best functional and aesthetic outcome, with the fibula flap remaining the gold standard for mandible reconstruction. In this review, we discuss classification and approach to reconstruction of mandibular defects. We also elaborate upon four commonly used free osteocutaneous flaps, inclusive of fibula, iliac crest, scapula, and radial forearm. Finally, we discuss indications and use of osseointegrated implants as well as recent advances in mandibular reconstruction. PMID:22550439

  3. Breast Reconstruction and Prosthesis

    MedlinePlus

    ... feel of the breast after a mastectomy. A plastic surgeon can do it at the same time ... want breast reconstruction. • Have you talked with your plastic surgeon about your options? You may not be ...

  4. Facial transplantation: the next frontier in head and neck reconstruction.

    PubMed

    Park, Eunice E; Genden, Eric M

    2009-05-01

    Facial reconstruction poses a unique surgical challenge-restoring the aesthetic form and function of the face. Established techniques for reconstruction include skin grafts, local cutaneous tissue flaps, and free flap autografts. The anatomic complexity of the face renders it challenging, however, to obtain a successful cosmetic and functional result. The success of recent hand, knee joint, and larynx allotransplantation and advances in immunosuppressive regimens have pushed the technical frontiers of composite tissue transfer to include partial facial transplantation. This article reviews current techniques for reconstruction of facial defects, with a focus on the microsurgical, immunologic, and ethical considerations of facial allotransplantation. PMID:19393949

  5. Paediatric pharmacokinetics: key considerations

    PubMed Central

    Batchelor, Hannah Katharine; Marriott, John Francis

    2015-01-01

    A number of anatomical and physiological factors determine the pharmacokinetic profile of a drug. Differences in physiology in paediatric populations compared with adults can influence the concentration of drug within the plasma or tissue. Healthcare professionals need to be aware of anatomical and physiological changes that affect pharmacokinetic profiles of drugs to understand consequences of dose adjustments in infants and children. Pharmacokinetic clinical trials in children are complicated owing to the limitations on blood sample volumes and perception of pain in children resulting from blood sampling. There are alternative sampling techniques that can minimize the invasive nature of such trials. Population based models can also limit the sampling required from each individual by increasing the overall sample size to generate robust pharmacokinetic data. This review details key considerations in the design and development of paediatric pharmacokinetic clinical trials. PMID:25855821

  6. Coracoclavicular Ligament Reconstruction

    PubMed Central

    Li, Qi; Hsueh, Pei-ling; Chen, Yun-feng

    2014-01-01

    Abstract Operative intervention is recommended for complete acromioclavicular (AC) joint dislocation to restore AC stability, but the best operative technique is still controversial. Twelve fresh-frozen male cadaveric shoulders (average age, 62.8 ± 7.8 years) were equally divided into endobutton versus the modified Weaver-Dunn groups. Each potted scapula and clavicle was fixed in a custom made jig to allow translation and load to failure testing using a Zwick BZ2.5/TS1S material testing machine (Zwick/Roell Co, Germany). A systematic review of 21 studies evaluating reconstructive methods for coracoclavicular or AC joints using a cadaveric model was also performed. From our biomechanical study, after ligament reconstruction, the triple endobutton technique demonstrated superior, anterior, and posterior displacements similar to that of the intact state (P > 0.05). In the modified Weaver-Dunn reconstruction group, however, there was significantly greater anterior (P < 0.001) and posterior (P = 0.003) translation after ligament reconstruction. In addition, there was no significant difference after reconstruction between failure load of the triple endobutton group and that of the intact state (686.88 vs 684.9 N, P > 0.05), whereas the failure load after the modified Weaver-Dunn reconstruction was decreased compared with the intact state (171.64 vs 640.86 N, P < 0.001). From our systematic review of 21 studies, which involved comparison of the modified Weaver-Dunn technique with other methods, the majority showed that the modified Weaver-Dunn procedure had significantly (P < .05) greater laxity than other methods including the endobutton technique. The triple endobutton reconstruction proved superior to the modified Weaver-Dunn technique in restoration of AC joint stability and strength. Triple endobutton reconstruction of the coracoclavicular ligament is superior to the modified Weaver-Dunn reconstruction in controlling both superior and

  7. Augmented Likelihood Image Reconstruction.

    PubMed

    Stille, Maik; Kleine, Matthias; Hägele, Julian; Barkhausen, Jörg; Buzug, Thorsten M

    2016-01-01

    The presence of high-density objects remains an open problem in medical CT imaging. Data of projections passing through objects of high density, such as metal implants, are dominated by noise and are highly affected by beam hardening and scatter. Reconstructed images become less diagnostically conclusive because of pronounced artifacts that manifest as dark and bright streaks. A new reconstruction algorithm is proposed with the aim to reduce these artifacts by incorporating information about shape and known attenuation coefficients of a metal implant. Image reconstruction is considered as a variational optimization problem. The afore-mentioned prior knowledge is introduced in terms of equality constraints. An augmented Lagrangian approach is adapted in order to minimize the associated log-likelihood function for transmission CT. During iterations, temporally appearing artifacts are reduced with a bilateral filter and new projection values are calculated, which are used later on for the reconstruction. A detailed evaluation in cooperation with radiologists is performed on software and hardware phantoms, as well as on clinically relevant patient data of subjects with various metal implants. Results show that the proposed reconstruction algorithm is able to outperform contemporary metal artifact reduction methods such as normalized metal artifact reduction.

  8. Reconstruction in Warfare Injuries.

    PubMed

    Langer, V

    2010-10-01

    Traumatic injuries, especially in the combat setting, stress the surgical team that may be sited in a remote forward area, battling against paucity of time, resources and infrastructure. The lone surgeon may be faced with the arduous challenge of saving life. There is seldom thought given to reconstruction in this high-pressure situation. If the patient survives, morbidity for want of reconstruction can be severe and quality of life can suffer significantly. Reconstruction after 3 to 5 days is fraught with complications and usually does compromise outcome in the post-operative phase. The reconstructive surgeon should be involved early in the management as he can provide coverage for large soft tissue defects after aggressive debridement with panache. If the patient is haemodynamically stable, he should be transferred urgently, preferrably by air, to a higher centre with multi-specialty care, especially being equipped with an orthopaedic and trauma reconstructive surgeon. It has been proved beyond doubt that the healing improves significantly and there is marked decrease in morbidity if coverage of wounds is provided early, before colonized wounds get infected. PMID:27365741

  9. Regulatory Considerations for Biosimilars

    PubMed Central

    Nellore, Ranjani

    2010-01-01

    Currently there is considerable interest in the legislative debate around generic biological drugs or “biosimilars” in the EU and US due to the large, lucrative market that it offers to the industry. While some countries have issued a few regulatory guidelines as well as product specific requirements, there is no general consensus as to a single, simple mechanism similar to the bioequivalence determination that leads to approval of generic small molecules all over the world. The inherent complex nature of the molecules, along with complicated manufacturing and analytical techniques to characterize them make it difficult to rely on a single human pharmacokinetic study for assurance of safety and efficacy. In general, the concept of comparability has been used for evaluation of the currently approved “similar” biological where a step by step assessment on the quality, preclinical and clinical aspects is made. In India, the focus is primarily on the availability and affordability of life-saving drugs. In this context every product needs to be evaluated on its own merit irrespective of the innovator brand. The formation of the National Biotechnology Regulatory Authority may provide a step in the right direction for regulation of these complex molecules. However, in order to have an efficient machinery for initial approval and ongoing oversight with a country-specific focus, cooperation with international authorities for granting approvals and continuous risk-benefit review is essential. Several steps are still needed for India to be perceived as a country that leads the world in providing quality biological products. PMID:21829775

  10. Manufacturability considerations for DSA

    NASA Astrophysics Data System (ADS)

    Farrell, Richard A.; Hosler, Erik R.; Schmid, Gerard M.; Xu, Ji; Preil, Moshe E.; Rastogi, Vinayak; Mohanty, Nihar; Kumar, Kaushik; Cicoria, Michael J.; Hetzer, David R.; DeVilliers, Anton

    2014-03-01

    Implementation of Directed Self-Assembly (DSA) as a viable lithographic technology for high volume manufacturing will require significant efforts to co-optimize the DSA process options and constraints with existing work flows. These work flows include established etch stacks, integration schemes, and design layout principles. The two foremost patterning schemes for DSA, chemoepitaxy and graphoepitaxy, each have their own advantages and disadvantages. Chemoepitaxy is well suited for regular repeating patterns, but has challenges when non-periodic design elements are required. As the line-space polystyrene-block-polymethylmethacrylate chemoepitaxy DSA processes mature, considerable progress has been made on reducing the density of topological (dislocation and disclination) defects but little is known about the existence of 3D buried defects and their subsequent pattern transfer to underlayers. In this paper, we highlight the emergence of a specific type of buried bridging defect within our two 28 nm pitch DSA flows and summarize our efforts to characterize and eliminate the buried defects using process, materials, and plasma-etch optimization. We also discuss how the optimization and removal of the buried defects impacts both the process window and pitch multiplication, facilitates measurement of the pattern roughness rectification, and demonstrate hard-mask open within a back-end-of-line integration flow. Finally, since graphoepitaxy has intrinsic benefits in terms of design flexibility when compared to chemoepitaxy, we highlight our initial investigations on implementing high-chi block copolymer patterning using multiple graphoepitaxy flows to realize sub-20 nm pitch line-space patterns and discuss the benefits of using high-chi block copolymers for roughness reduction.

  11. Interferometric phase reconstruction using simplified coherence network

    NASA Astrophysics Data System (ADS)

    Zhang, Kui; Song, Ruiqing; Wang, Hui; Wu, Di; Wang, Hua

    2016-09-01

    Interferometric time-series analysis techniques, which extend the traditional differential radar interferometry, have demonstrated a strong capability for monitoring ground surface displacement. Such techniques are able to obtain the temporal evolution of ground deformation within millimeter accuracy by using a stack of synthetic aperture radar (SAR) images. In order to minimize decorrelation between stacked SAR images, the phase reconstruction technique has been developed recently. The main idea of this technique is to reform phase observations along a SAR stack by taking advantage of a maximum likelihood estimator which is defined on the coherence matrix estimated from each target. However, the phase value of a coherence matrix element might be considerably biased when its corresponding coherence is low. In this case, it will turn to an outlying sample affecting the corresponding phase reconstruction process. In order to avoid this problem, a new approach is developed in this paper. This approach considers a coherence matrix element to be an arc in a network. A so-called simplified coherence network (SCN) is constructed to decrease the negative impact of outlying samples. Moreover, a pointed iterative strategy is designed to resolve the transformed phase reconstruction problem defined on a SCN. For validation purposes, the proposed method is applied to 29 real SAR images. The results demonstrate that the proposed method has an excellent computational efficiency and could obtain more reliable phase reconstruction solutions compared to the traditional method using phase triangulation algorithm.

  12. Lateral Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Lateral abdominal wall (LAW) defects can manifest as a flank hernias, myofascial laxity/bulges, or full-thickness defects. These defects are quite different from those in the anterior abdominal wall defects and the complexity and limited surgical options make repairing the LAW a challenge for the reconstructive surgeon. LAW reconstruction requires an understanding of the anatomy, physiologic forces, and the impact of deinnervation injury to design and perform successful reconstructions of hernia, bulge, and full-thickness defects. Reconstructive strategies must be tailored to address the inguinal ligament, retroperitoneum, chest wall, and diaphragm. Operative technique must focus on stabilization of the LAW to nonyielding points of fixation at the anatomic borders of the LAW far beyond the musculofascial borders of the defect itself. Thus, hernias, bulges, and full-thickness defects are approached in a similar fashion. Mesh reinforcement is uniformly required in lateral abdominal wall reconstruction. Inlay mesh placement with overlying myofascial coverage is preferred as a first-line option as is the case in anterior abdominal wall reconstruction. However, interposition bridging repairs are often performed as the surrounding myofascial tissue precludes a dual layered closure. The decision to place bioprosthetic or prosthetic mesh depends on surgeon preference, patient comorbidities, and clinical factors of the repair. Regardless of mesh type, the overlying soft tissue must provide stable cutaneous coverage and obliteration of dead space. In cases where the fasciocutaneous flaps surrounding the defect are inadequate for closure, regional pedicled flaps or free flaps are recruited to achieve stable soft tissue coverage. PMID:23372458

  13. Adaptive iterative reconstruction

    NASA Astrophysics Data System (ADS)

    Bruder, H.; Raupach, R.; Sunnegardh, J.; Sedlmair, M.; Stierstorfer, K.; Flohr, T.

    2011-03-01

    It is well known that, in CT reconstruction, Maximum A Posteriori (MAP) reconstruction based on a Poisson noise model can be well approximated by Penalized Weighted Least Square (PWLS) minimization based on a data dependent Gaussian noise model. We study minimization of the PWLS objective function using the Gradient Descent (GD) method, and show that if an exact inverse of the forward projector exists, the PWLS GD update equation can be translated into an update equation which entirely operates in the image domain. In case of non-linear regularization and arbitrary noise model this means that a non-linear image filter must exist which solves the optimization problem. In the general case of non-linear regularization and arbitrary noise model, the analytical computation is not trivial and might lead to image filters which are computationally very expensive. We introduce a new iteration scheme in image space, based on a regularization filter with an anisotropic noise model. Basically, this approximates the statistical data weighting and regularization in PWLS reconstruction. If needed, e.g. for compensation of the non-exactness of backprojector, the image-based regularization loop can be preceded by a raw data based loop without regularization and statistical data weighting. We call this combined iterative reconstruction scheme Adaptive Iterative Reconstruction (AIR). It will be shown that in terms of low-contrast visibility, sharpness-to-noise and contrast-to-noise ratio, PWLS and AIR reconstruction are similar to a high degree of accuracy. In clinical images the noise texture of AIR is also superior to the more artificial texture of PWLS.

  14. Anatomic Posterolateral Corner Reconstruction.

    PubMed

    Serra Cruz, Raphael; Mitchell, Justin J; Dean, Chase S; Chahla, Jorge; Moatshe, Gilbert; LaPrade, Robert F

    2016-06-01

    Posterolateral corner injuries represent a complex injury pattern, with damage to important coronal and rotatory stabilizers of the knee. These lesions commonly occur in association with other ligament injuries, making decisions regarding treatment challenging. Grade III posterolateral corner injuries result in significant instability and have poor outcomes when treated nonoperatively. As a result, reconstruction is advocated. A thorough knowledge of the anatomy is essential for surgical treatment of this pathology. The following technical note provides a diagnostic approach, postoperative management, and details of a technique for anatomic reconstruction of the 3 main static stabilizers of the posterolateral corner of the knee. PMID:27656379

  15. The Roles of SPW in Reconstruction of Humane Society.

    ERIC Educational Resources Information Center

    Williamson, E. G.

    We have indeed achieved considerable "good" for many youth; but of course as with every other social reconstruction effort, more remains to be achieved. While it is a small minority, efforts must be made to reduce even the small percentage of serious deviates who may well emerge as adults in serious need of complex therapy. Each member of the new…

  16. Tracheal Resection With Carinal Reconstruction for Squamous Cell Carcinoma.

    PubMed

    Lancaster, Timothy S; Krantz, Seth B; Patterson, G Alexander

    2016-07-01

    Surgical resection is the treatment of choice for primary malignancies of the trachea. We present here the rare case of a lifelong nonsmoker with primary squamous cell carcinoma of the trachea, requiring tracheal resection and anterior carinal reconstruction. Patient preparation, surgical technique, and considerations to avoid airway anastomotic complications are discussed.

  17. Editorial Commentary: Anterior Cruciate Ligament Reconstruction: Auto or Allo?

    PubMed

    Verma, Nikhil N

    2016-01-01

    Considerable controversy exists regarding appropriate graft choice for patients undergoing anterior cruciate ligament reconstruction. Allografts pretreated with high-dose irradiation should be avoided. Otherwise, multiple factors should be considered to individualize patient decision making, including patient age and activity level, graft type, and fixation type. PMID:26743418

  18. Editorial Commentary: Anterior Cruciate Ligament Reconstruction: Auto or Allo?

    PubMed

    Verma, Nikhil N

    2016-01-01

    Considerable controversy exists regarding appropriate graft choice for patients undergoing anterior cruciate ligament reconstruction. Allografts pretreated with high-dose irradiation should be avoided. Otherwise, multiple factors should be considered to individualize patient decision making, including patient age and activity level, graft type, and fixation type.

  19. Reconstruction of the trachea

    PubMed Central

    Grillo, Hermes C.

    1973-01-01

    Grillo, H. C. (1973).Thorax, 28, 667-679. Reconstruction of the trachea. Experience in 100 consecutive cases. Anatomic mobilization of the trachea permits resection of one-half or more with primary anastomosis. An anterior approach by a cervical or cervicomediastinal route utilizes cervical flexion to devolve the larynx and tracheal mobilization with preservation of the lateral blood supply. The transthoracic route is employed for lower tracheal lesions. Over 100 tracheal resections have been done using these methods of direct reconstruction. Eighty-four patients suffered from benign strictures, 79 resulting from intubation injuries. Eleven primary tracheal tumours and five secondary tumours are included. The majority of lesions following intubation occurred at the level of the cuff. It was possible to repair 78 of the 84 stenotic lesions through a cervical or cervicomediastinal approach. Seventy-three of the 84 patients with inflammatory lesions obtained an excellent or good functional and anatomic result. Nine of 11 patients with primary neoplasms who underwent reconstruction are alive and without known disease. There were five early postoperative deaths in these 100 consecutive patients who underwent tracheal reconstruction. Images PMID:4362789

  20. Breast reconstruction - natural tissue

    MedlinePlus

    ... muscle flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; ... If you are having breast reconstruction at the same time as mastectomy, the surgeon may do either of the following: Skin-sparing mastectomy. This means ...

  1. Reconstructing Community History

    ERIC Educational Resources Information Center

    Shields, Amy

    2004-01-01

    History is alive and well in Lebanon, Missouri. Students in this small town in the southwest region of the state went above and beyond the community's expectations on this special project. This article describes this historical journey which began when students in a summer mural class reconstructed a mural that was originally created by a…

  2. Two-Stage Revision Anterior Cruciate Ligament Reconstruction.

    PubMed

    Erickson, Brandon J; Cvetanovich, Gregory; Waliullah, Khalid; Khair, Michael; Smith, Patrick; Bach, Bernard; Sherman, Seth

    2016-05-01

    The number of primary anterior cruciate ligament (ACL) tears is rapidly increasing. In patients who wish to return to their preoperative level of function, specifically as it pertains to participation in sports, the gold standard of treatment following an ACL tear remains an anterior cruciate ligament (ACL) reconstruction. Despite a majority of good/excellent results following primary ACL reconstruction, there is a growing subset of patients with persistent or recurrent functional instability who require revision ACL reconstruction. Preoperative planning for revision ACL reconstruction requires a careful understanding of the root cause of ACL failure, including possible technical causes of primary ACL failure and the presence of combined knee pathology that was not addressed at the index ACL reconstruction. The decision to perform 2-stage revision ACL reconstruction is multifactorial and is reached by technical considerations that may make a 1-stage revision less optimal, including tunnel widening, arthrofibrosis, active infection, and others. Concomitant knee pathology such as meniscal deficiency, malalignment (including an increase in posterior tibial slope), chondral lesions, and other ligamentous laxity may also require a staged approach to treatment. This evidence-based review covers the indications for 2-stage revision ACL reconstruction, surgical techniques, evidence for and technique of bone grafting prior ACL tunnels, and outcomes of 2-stage revision stratified by initial cause of ACL reconstruction failure. With proper preoperative planning and an understanding of the cause of failure following the primary ACL reconstruction, revision ACL reconstruction can offer excellent outcomes in the motivated patient. [Orthopedics. 2016; 39(3):e456-e464.]. PMID:27045480

  3. Comparative Study of Computational Methods for Reconstructing Genetic Networks of Cancer-Related Pathways

    PubMed Central

    Sedaghat, Nafiseh; Saegusa, Takumi; Randolph, Timothy; Shojaie, Ali

    2014-01-01

    Network reconstruction is an important yet challenging task in systems biology. While many methods have been recently proposed for reconstructing biological networks from diverse data types, properties of estimated networks and differences between reconstruction methods are not well understood. In this paper, we conduct a comprehensive empirical evaluation of seven existing network reconstruction methods, by comparing the estimated networks with different sparsity levels for both normal and tumor samples. The results suggest substantial heterogeneity in networks reconstructed using different reconstruction methods. Our findings also provide evidence for significant differences between networks of normal and tumor samples, even after accounting for the considerable variability in structures of networks estimated using different reconstruction methods. These differences can offer new insight into changes in mechanisms of genetic interaction associated with cancer initiation and progression. PMID:25288880

  4. Preparing for Breast Reconstruction Surgery

    MedlinePlus

    ... after breast reconstruction surgery Preparing for breast reconstruction surgery Your surgeon can help you know what to ... The plan for follow-up Costs Understanding your surgery costs Health insurance policies often cover most or ...

  5. Channeled spectropolarimetry using iterative reconstruction

    NASA Astrophysics Data System (ADS)

    Lee, Dennis J.; LaCasse, Charles F.; Craven, Julia M.

    2016-05-01

    Channeled spectropolarimeters (CSP) measure the polarization state of light as a function of wavelength. Conventional Fourier reconstruction suffers from noise, assumes the channels are band-limited, and requires uniformly spaced samples. To address these problems, we propose an iterative reconstruction algorithm. We develop a mathematical model of CSP measurements and minimize a cost function based on this model. We simulate a measured spectrum using example Stokes parameters, from which we compare conventional Fourier reconstruction and iterative reconstruction. Importantly, our iterative approach can reconstruct signals that contain more bandwidth, an advancement over Fourier reconstruction. Our results also show that iterative reconstruction mitigates noise effects, processes non-uniformly spaced samples without interpolation, and more faithfully recovers the ground truth Stokes parameters. This work offers a significant improvement to Fourier reconstruction for channeled spectropolarimetry.

  6. CEnPiT: Helical cardiac CT reconstruction

    SciTech Connect

    Bontus, Claas; Koken, Peter; Koehler, Thomas; Grass, Michael

    2006-08-15

    Computer tomography (CT) scanners with an increasing number of detector rows offer the potential of shorter scanning times. Nevertheless, the reconstruction problem becomes more challenging, since cone beam artifacts are likely to enter. Here, we consider helical cardiac CT. We analyze how a relationship can be established between exact reconstruction algorithms and the demand to perform a cardiac gating. Utilizing the redundancies requires the consideration of all kinds of Radon planes. For the reconstruction algorithm proposed here, we separate the data into two parts. The first part contains contributions of Radon planes, which are measured with a large number of redundancies. The second part contains the remaining contributions. As it turns out, the second part contributes rather to the low-frequency contents of trans-axial slices. Therefore, we propose to perform a gated back-projection only for the first part, while the second part is back-projected in an ungated way. Data from the complete source trajectory are employed in the reconstruction process in contrary to conventional helical cardiac reconstruction methods. Moreover, all different types of Radon planes are taken into account in the reconstruction, though an ECG-dependent cardiac gating is applied. The reconstruction results, which we present for clinical and simulated data, demonstrate the high potential of CEnPiT for helical cardiac CT with large cone angle systems.

  7. [Multiple embolisms by atrial myxoma].

    PubMed

    Contreras, Alejandro E; Cragnolini, Ana C; Brenna, Eduardo J; Parisi, Gustavo R; Chamale, Roberto A; Assante, Maria L; Paladini, Guillermo; Martinez Colombres, Alejandro

    2013-01-01

    El mixoma es el tumor cardiaco más frecuente, se presenta comúnmente entre la tercera y sexta decada de la vida y es más prevalente en mujeres. Una forma de presentación es la embolia sistémica. Una mujer de 56 años de edad presentó síntomas de isquemia cerebral, infarto agudo de miocardio silente e isquemia en miembro inferior derecho. Se diagnosticó mixoma de aurícula izquierda y fue intervenida quirúrgicamente de urgencia.

  8. Advanced LBB methodology and considerations

    SciTech Connect

    Olson, R.; Rahman, S.; Scott, P.

    1997-04-01

    LBB applications have existed in many industries and more recently have been applied in the nuclear industry under limited circumstances. Research over the past 10 years has evolved the technology so that more advanced consideration of LBB can now be given. Some of the advanced considerations for nuclear plants subjected to seismic loading evaluations are summarized in this paper.

  9. Ethical Considerations in Technology Transfer.

    ERIC Educational Resources Information Center

    Froehlich, Thomas J.

    1991-01-01

    Examines ethical considerations involved in the transfer of appropriate information technology to less developed countries. Approaches to technology are considered; two philosophical frameworks for studying ethical considerations are discussed, i.e., the Kantian approach and the utilitarian perspective by John Stuart Mill; and integration of the…

  10. Stochastic reconstruction of sandstones

    PubMed

    Manwart; Torquato; Hilfer

    2000-07-01

    A simulated annealing algorithm is employed to generate a stochastic model for a Berea sandstone and a Fontainebleau sandstone, with each a prescribed two-point probability function, lineal-path function, and "pore size" distribution function, respectively. We find that the temperature decrease of the annealing has to be rather quick to yield isotropic and percolating configurations. A comparison of simple morphological quantities indicates good agreement between the reconstructions and the original sandstones. Also, the mean survival time of a random walker in the pore space is reproduced with good accuracy. However, a more detailed investigation by means of local porosity theory shows that there may be significant differences of the geometrical connectivity between the reconstructed and the experimental samples.

  11. LOFAR sparse image reconstruction

    NASA Astrophysics Data System (ADS)

    Garsden, H.; Girard, J. N.; Starck, J. L.; Corbel, S.; Tasse, C.; Woiselle, A.; McKean, J. P.; van Amesfoort, A. S.; Anderson, J.; Avruch, I. M.; Beck, R.; Bentum, M. J.; Best, P.; Breitling, F.; Broderick, J.; Brüggen, M.; Butcher, H. R.; Ciardi, B.; de Gasperin, F.; de Geus, E.; de Vos, M.; Duscha, S.; Eislöffel, J.; Engels, D.; Falcke, H.; Fallows, R. A.; Fender, R.; Ferrari, C.; Frieswijk, W.; Garrett, M. A.; Grießmeier, J.; Gunst, A. W.; Hassall, T. E.; Heald, G.; Hoeft, M.; Hörandel, J.; van der Horst, A.; Juette, E.; Karastergiou, A.; Kondratiev, V. I.; Kramer, M.; Kuniyoshi, M.; Kuper, G.; Mann, G.; Markoff, S.; McFadden, R.; McKay-Bukowski, D.; Mulcahy, D. D.; Munk, H.; Norden, M. J.; Orru, E.; Paas, H.; Pandey-Pommier, M.; Pandey, V. N.; Pietka, G.; Pizzo, R.; Polatidis, A. G.; Renting, A.; Röttgering, H.; Rowlinson, A.; Schwarz, D.; Sluman, J.; Smirnov, O.; Stappers, B. W.; Steinmetz, M.; Stewart, A.; Swinbank, J.; Tagger, M.; Tang, Y.; Tasse, C.; Thoudam, S.; Toribio, C.; Vermeulen, R.; Vocks, C.; van Weeren, R. J.; Wijnholds, S. J.; Wise, M. W.; Wucknitz, O.; Yatawatta, S.; Zarka, P.; Zensus, A.

    2015-03-01

    Context. The LOw Frequency ARray (LOFAR) radio telescope is a giant digital phased array interferometer with multiple antennas distributed in Europe. It provides discrete sets of Fourier components of the sky brightness. Recovering the original brightness distribution with aperture synthesis forms an inverse problem that can be solved by various deconvolution and minimization methods. Aims: Recent papers have established a clear link between the discrete nature of radio interferometry measurement and the "compressed sensing" (CS) theory, which supports sparse reconstruction methods to form an image from the measured visibilities. Empowered by proximal theory, CS offers a sound framework for efficient global minimization and sparse data representation using fast algorithms. Combined with instrumental direction-dependent effects (DDE) in the scope of a real instrument, we developed and validated a new method based on this framework. Methods: We implemented a sparse reconstruction method in the standard LOFAR imaging tool and compared the photometric and resolution performance of this new imager with that of CLEAN-based methods (CLEAN and MS-CLEAN) with simulated and real LOFAR data. Results: We show that i) sparse reconstruction performs as well as CLEAN in recovering the flux of point sources; ii) performs much better on extended objects (the root mean square error is reduced by a factor of up to 10); and iii) provides a solution with an effective angular resolution 2-3 times better than the CLEAN images. Conclusions: Sparse recovery gives a correct photometry on high dynamic and wide-field images and improved realistic structures of extended sources (of simulated and real LOFAR datasets). This sparse reconstruction method is compatible with modern interferometric imagers that handle DDE corrections (A- and W-projections) required for current and future instruments such as LOFAR and SKA.

  12. Kinky tomographic reconstruction

    SciTech Connect

    Hanson, K.M.; Cunningham, G.S.; Bilisoly, R.L.

    1996-05-01

    We address the issue of how to make decisions about the degree of smoothness demanded of a flexible contour used to model the boundary of a 2D object. We demonstrate the use of a Bayesian approach to set the strength of the smoothness prior for a tomographic reconstruction problem. The Akaike Information Criterion is used to determine whether to allow a kink in the contour.

  13. Tissue expanders in reconstruction of maxillofacial defects.

    PubMed

    John, Jacob; Edward, Joseph; George, Joju

    2015-03-01

    Tissue expansion in its natural ways had fascinated man from prehistoric times itself. But tissue expansion for medical purposes was first tried and reported only in the early half of twentieth century. Presently the principle of tissue expansion is being used in reconstruction of many hard and soft tissue defects of larger dimension, which were previously regarded as great challenge for maxillofacial and plastic surgeons. Making use of the viscoelastic nature of the skin, considerable amount of tissue expansion based tissue engineering is possible in the maxillofacial region. Here we present a case of a facial scar of large dimension with a central oro cutaneous fistula developed as a result of facial artery blow out in a 24 year old female for which esthetic correction was done using the excess tissue obtained from tissue expansion. In this case where other methods of reconstruction such as local flaps, free flaps and normal tissue grafts were assessed to be non viable, tissue expansion was found to be an apt solution for esthetic reconstruction. PMID:25848145

  14. Alcohol dependence--classificatory considerations.

    PubMed

    Lesch, O M; Ades, J; Badawy, A; Pelc, I; Sasz, H

    1993-01-01

    The term alcoholism or alcohol dependence has acquired a broad range of meanings. The Plinius Maior Society herewith presents new classificatory considerations and suggests additional recording of special dimensions according to the individual hypothesis and design of a study.

  15. Regulatory Considerations in Toxicological Neuropathology

    EPA Science Inventory

    Pathological assessment of the nervous system is included in several US Environmental Protection Agency [US EPA or Agency] and Organization for Economic Cooperation and Development [OECD] testing guidelines for health effects of chemicals. A variety of considerations are importan...

  16. [Considerations on aging in Cuba].

    PubMed

    López Fernández, R

    1996-12-01

    This article presents some considerations about how the elderly Cuban population is behaving and the challenges for the near future. It also offers information on the main characteristics of the old woman in Cuba.

  17. New designs in the reconstruction of coke-sorting systems

    SciTech Connect

    A.S. Larin; V.V. Demenko; V.L. Voitanik

    2009-07-15

    In recent Giprokoks designs for the reconstruction of coke-sorting systems, high-productivity vibrational-inertial screens have been employed. This permits single-stage screening and reduction in capital and especially operating expenditures, without loss of coke quality. In two-stage screening, >80 mm coke (for foundry needs) is additionally separated, with significant improvement in quality of the metallurgical coke (25-80 mm). New designs for the reconstruction of coke-sorting systems employ mechanical treatment of the coke outside the furnace, which offers new scope for stabilization of coke quality and permits considerable improvement in mechanical strength and granulometric composition of the coke by mechanical crushing.

  18. Posterior Wall Blowout in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Mitchell, Justin J.; Dean, Chase S.; Chahla, Jorge; Menge, Travis J.; Cram, Tyler R.; LaPrade, Robert F.

    2016-01-01

    Violation of the posterior femoral cortex, commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament (ACL) reconstruction and lead to loss of graft fixation or early graft failure. If cortical blowout occurs despite careful planning and adherence to proper surgical technique, a thorough knowledge of the anatomy and alternative fixation techniques is imperative to ensure optimal patient outcomes. This article highlights anatomic considerations for femoral tunnel placement in ACL reconstruction and techniques for avoidance and salvage of a posterior wall blowout. PMID:27335885

  19. Evolutionary tree reconstruction

    NASA Technical Reports Server (NTRS)

    Cheeseman, Peter; Kanefsky, Bob

    1990-01-01

    It is described how Minimum Description Length (MDL) can be applied to the problem of DNA and protein evolutionary tree reconstruction. If there is a set of mutations that transform a common ancestor into a set of the known sequences, and this description is shorter than the information to encode the known sequences directly, then strong evidence for an evolutionary relationship has been found. A heuristic algorithm is described that searches for the simplest tree (smallest MDL) that finds close to optimal trees on the test data. Various ways of extending the MDL theory to more complex evolutionary relationships are discussed.

  20. Reconstructing the Antikythera Mechanism

    NASA Astrophysics Data System (ADS)

    Freeth, Tony

    The Antikythera Mechanism is a geared astronomical calculating machine from ancient Greece. The extraordinary nature of this device has become even more apparent in recent years as a result of research under the aegis of the Antikythera Mechanism Research Project (AMRP) - an international collaboration of scientists, historians, museum staff, engineers, and imaging specialists. Though many questions still remain, we may now be close to reconstructing the complete machine. As a technological artifact, it is unique in the ancient world. Its brilliant design conception means that it is a landmark in the history of science and technology.

  1. Photometric Lunar Surface Reconstruction

    NASA Technical Reports Server (NTRS)

    Nefian, Ara V.; Alexandrov, Oleg; Morattlo, Zachary; Kim, Taemin; Beyer, Ross A.

    2013-01-01

    Accurate photometric reconstruction of the Lunar surface is important in the context of upcoming NASA robotic missions to the Moon and in giving a more accurate understanding of the Lunar soil composition. This paper describes a novel approach for joint estimation of Lunar albedo, camera exposure time, and photometric parameters that utilizes an accurate Lunar-Lambertian reflectance model and previously derived Lunar topography of the area visualized during the Apollo missions. The method introduced here is used in creating the largest Lunar albedo map (16% of the Lunar surface) at the resolution of 10 meters/pixel.

  2. Adolescent ACL injury: treatment considerations.

    PubMed

    Pavlovich, Raymond; Goldberg, Steven H; Bach, Bernard R

    2004-04-01

    Anterior cruciate ligament (ACL) injury in a skeletally immature patient presents unique treatment challenges. In many cases, conservative treatment with bracing and physical therapy fails, resulting in recurrent instability, pain, swelling, and meniscal and chondral injury. The goal of surgical reconstruction is to recreate ACL stability without causing growth plate arrest, leg-length discrepancy, or angular deformity. Patient characteristics such as skeletal age, Tanner stage, onset of menses, family member height, growth spurt, recent change in foot size, and growth charts can help the surgeon approximate the degree of skeletal maturity and aid in selecting the timing and safest type of reconstruction. Numerous surgical techniques, ranging from an extra-articular reconstruction to intra-articular graft passage without physeal violation to standard transtibial and transfemoral tunnel placement with physeal violation, have been popularized. The majority of existing studies are retrospective case series, describing a particular author's specific technique experience. This article reviews the basic science and clinical literature, presents a treatment algorithm, and provides several case studies.

  3. Nipple-areola complex reconstruction techniques: A literature review.

    PubMed

    Sisti, A; Grimaldi, L; Tassinari, J; Cuomo, R; Fortezza, L; Bocchiotti, M A; Roviello, F; D'Aniello, C; Nisi, G

    2016-04-01

    Many techniques for nipple-areola complex (NAC) reconstruction are described. Clarity is required on the currently available options. Since a complete list of all the techniques described until now is not available, a possibly comprehensive literature overview was carried out from 75 papers (years 1946-2015). The local flap was the most frequently described technique for the nipple reconstruction with no significant difference in complications' rate among the various types of techniques. Complications in nipple reconstruction were 46.9% after graft, 7.9% after local flap, and 5.3% in case of flaps with autologous graft/alloplastic/allograft augmentation, while complications in areola reconstruction were 10.1% after graft, and 1.6% after areola tattoo. Flaps appear to be more reliable than grafts in nipple reconstruction, while tattoo is thought to be safer than graft in areola reconstruction. The loss of projection, although considerable (45%-75%), had not significant impact on patients' satisfaction. Due to contraction, overcorrection of 25-50% of the desired result is advisory when adopting local flaps, in order to prevent loss of projection. The use of flaps with autologous graft/alloplastic/allograft augmentation (cartilage, fat, calcium hydroxylapatite, acellular dermal matrix, polymethylmethacrylate, biologic collagen) showed a minor loss of nipple projection but may expose to a relative increased number of postoperative flap necrosis. PMID:26868167

  4. Biomaterials for craniofacial reconstruction

    PubMed Central

    Neumann, Andreas; Kevenhoerster, Kevin

    2011-01-01

    Biomaterials for reconstruction of bony defects of the skull comprise of osteosynthetic materials applied after osteotomies or traumatic fractures and materials to fill bony defects which result from malformation, trauma or tumor resections. Other applications concern functional augmentations for dental implants or aesthetic augmentations in the facial region. For ostheosynthesis, mini- and microplates made from titanium alloys provide major advantages concerning biocompatibility, stability and individual fitting to the implant bed. The necessity of removing asymptomatic plates and screws after fracture healing is still a controversial issue. Risks and costs of secondary surgery for removal face a low rate of complications (due to corrosion products) when the material remains in situ. Resorbable osteosynthesis systems have similar mechanical stability and are especially useful in the growing skull. The huge variety of biomaterials for the reconstruction of bony defects makes it difficult to decide which material is adequate for which indication and for which site. The optimal biomaterial that meets every requirement (e.g. biocompatibility, stability, intraoperative fitting, product safety, low costs etc.) does not exist. The different material types are (autogenic) bone and many alloplastics such as metals (mainly titanium), ceramics, plastics and composites. Future developments aim to improve physical and biological properties, especially regarding surface interactions. To date, tissue engineered bone is far from routine clinical application. PMID:22073101

  5. Parallel ptychographic reconstruction

    PubMed Central

    Nashed, Youssef S. G.; Vine, David J.; Peterka, Tom; Deng, Junjing; Ross, Rob; Jacobsen, Chris

    2014-01-01

    Ptychography is an imaging method whereby a coherent beam is scanned across an object, and an image is obtained by iterative phasing of the set of diffraction patterns. It is able to be used to image extended objects at a resolution limited by scattering strength of the object and detector geometry, rather than at an optics-imposed limit. As technical advances allow larger fields to be imaged, computational challenges arise for reconstructing the correspondingly larger data volumes, yet at the same time there is also a need to deliver reconstructed images immediately so that one can evaluate the next steps to take in an experiment. Here we present a parallel method for real-time ptychographic phase retrieval. It uses a hybrid parallel strategy to divide the computation between multiple graphics processing units (GPUs) and then employs novel techniques to merge sub-datasets into a single complex phase and amplitude image. Results are shown on a simulated specimen and a real dataset from an X-ray experiment conducted at a synchrotron light source. PMID:25607174

  6. Synchronized dynamic dose reconstruction

    SciTech Connect

    Litzenberg, Dale W.; Hadley, Scott W.; Tyagi, Neelam; Balter, James M.; Ten Haken, Randall K.; Chetty, Indrin J.

    2007-01-15

    Variations in target volume position between and during treatment fractions can lead to measurable differences in the dose distribution delivered to each patient. Current methods to estimate the ongoing cumulative delivered dose distribution make idealized assumptions about individual patient motion based on average motions observed in a population of patients. In the delivery of intensity modulated radiation therapy (IMRT) with a multi-leaf collimator (MLC), errors are introduced in both the implementation and delivery processes. In addition, target motion and MLC motion can lead to dosimetric errors from interplay effects. All of these effects may be of clinical importance. Here we present a method to compute delivered dose distributions for each treatment beam and fraction, which explicitly incorporates synchronized real-time patient motion data and real-time fluence and machine configuration data. This synchronized dynamic dose reconstruction method properly accounts for the two primary classes of errors that arise from delivering IMRT with an MLC: (a) Interplay errors between target volume motion and MLC motion, and (b) Implementation errors, such as dropped segments, dose over/under shoot, faulty leaf motors, tongue-and-groove effect, rounded leaf ends, and communications delays. These reconstructed dose fractions can then be combined to produce high-quality determinations of the dose distribution actually received to date, from which individualized adaptive treatment strategies can be determined.

  7. Stereoscopic liver surface reconstruction

    PubMed Central

    Karwan, Adam; Rudnicki, Jerzy; Wróblewski, Tadeusz

    2012-01-01

    The paper presents a practical approach to measuring liver motion, both respiratory and laparoscopic, with a tool guided in the operating room. The presented method is based on standard operating room equipment, i.e. rigid laparoscopic cameras and a single incision laparoscopic surgery trocar. The triangulation algorithm is used and stereo correspondence points are marked manually by two independent experts. To calibrate the cameras two perpendicular chessboards, a pinhole camera model and a Tsai algorithm are used. The data set consists of twelve real liver surgery video sequences: ten open surgery and two laparoscopic, gathered from different patients. The setup equipment and methodology are presented. The proposed evaluation method based on both calibration points of the chessboard reconstruction and measurements made by the Polaris Vicra tracking system are used as a reference system. In the analysis stage we focused on two specific goals, measuring respiration and laparoscopic tool guided liver motions. We have presented separate examples for left and right liver lobes. It is possible to reconstruct liver motion using the SILS trocar. Our approach was made without additional position or movement sensors. Diffusion of cameras and laser for distance measurement seems to be less practical for in vivo laparoscopic data, but we do not exclude exploring such sensors in further research. PMID:23256023

  8. Reconstruction in Fourier space

    NASA Astrophysics Data System (ADS)

    Burden, A.; Percival, W. J.; Howlett, C.

    2015-10-01

    We present a fast iterative fast Fourier transform (FFT) based reconstruction algorithm that allows for non-parallel redshift-space distortions (RSDs). We test our algorithm on both N-body dark matter simulations and mock distributions of galaxies designed to replicate galaxy survey conditions. We compare solenoidal and irrotational components of the redshift distortion and show that an approximation of this distortion leads to a better estimate of the real-space potential (and therefore faster convergence) than ignoring the RSD when estimating the displacement field. Our iterative reconstruction scheme converges in two iterations for the mock samples corresponding to Baryon Oscillation Spectroscopic Survey CMASS Data Release 11 when we start with an approximation of the RSD. The scheme takes six iterations when the initial estimate, measured from the redshift-space overdensity, has no RSD correction. Slower convergence would be expected for surveys covering a larger angle on the sky. We show that this FFT based method provides a better estimate of the real-space displacement field than a configuration space method that uses finite difference routines to compute the potential for the same grid resolution. Finally, we show that a lognormal transform of the overdensity, used as a proxy for the linear overdensity, is beneficial in estimating the full displacement field from a dense sample of tracers. However, the lognormal transform of the overdensity does not perform well when estimating the displacements from sparser simulations with a more realistic galaxy density.

  9. Exercises in PET Image Reconstruction

    NASA Astrophysics Data System (ADS)

    Nix, Oliver

    These exercises are complementary to the theoretical lectures about positron emission tomography (PET) image reconstruction. They aim at providing some hands on experience in PET image reconstruction and focus on demonstrating the different data preprocessing steps and reconstruction algorithms needed to obtain high quality PET images. Normalisation, geometric-, attenuation- and scatter correction are introduced. To explain the necessity of those some basics about PET scanner hardware, data acquisition and organisation are reviewed. During the course the students use a software application based on the STIR (software for tomographic image reconstruction) library 1,2 which allows them to dynamically select or deselect corrections and reconstruction methods as well as to modify their most important parameters. Following the guided tutorial, the students get an impression on the effect the individual data precorrections have on image quality and what happens if they are forgotten. Several data sets in sinogram format are provided, such as line source data, Jaszczak phantom data sets with high and low statistics and NEMA whole body phantom data. The two most frequently used reconstruction algorithms in PET image reconstruction, filtered back projection (FBP) and the iterative OSEM (ordered subset expectation maximation) approach are used to reconstruct images. The exercise should help the students gaining an understanding what the reasons for inferior image quality and artefacts are and how to improve quality by a clever choice of reconstruction parameters.

  10. Respiratory motion correction in emission tomography image reconstruction.

    PubMed

    Reyes, Mauricio; Malandain, Grégoire; Koulibaly, Pierre Malick; González Ballester, Miguel A; Darcourt, Jacques

    2005-01-01

    In Emission Tomography imaging, respiratory motion causes artifacts in lungs and cardiac reconstructed images, which lead to misinterpretations and imprecise diagnosis. Solutions like respiratory gating, correlated dynamic PET techniques, list-mode data based techniques and others have been tested with improvements over the spatial activity distribution in lungs lesions, but with the disadvantages of requiring additional instrumentation or discarding part of the projection data used for reconstruction. The objective of this study is to incorporate respiratory motion correction directly into the image reconstruction process, without any additional acquisition protocol consideration. To this end, we propose an extension to the Maximum Likelihood Expectation Maximization (MLEM) algorithm that includes a respiratory motion model, which takes into account the displacements and volume deformations produced by the respiratory motion during the data acquisition process. We present results from synthetic simulations incorporating real respiratory motion as well as from phantom and patient data.

  11. A reconstruction of solar irradiance using a flux transport model

    NASA Astrophysics Data System (ADS)

    Dasi Espuig, Maria; Jiang, Jie; Krivova, Natalie; Solanki, Sami

    2013-04-01

    Reconstructions of solar irradiance into the past are of considerable interest for studies of solar influence on climate. Models based on the assumption that irradiance changes are caused by the evolution of the photospheric magnetic field have been the most successful in reproducing the measured irradiance variations. Our SATIRE-S model is one of these. It uses solar full-disc magnetograms as an input, and these are available for less than four decades. Thus, to reconstruct the irradiance back to times when no observed magnetograms are available, we combine the SATIRE-S model with synthetic magnetograms, produced using a surface flux transport model. The model is fed with daily, observed or modelled statistically, records of sunspot positions, areas, and tilt angles. To describe the secular change in the irradiance, we used the concept of overlapping ephemeral region cycles. With this technique TSI can be reconstructed back to 1610.

  12. Pediatric facial transplantation: Ethical considerations

    PubMed Central

    Flynn, Jennifer; Shaul, Randi Zlotnik; Hanson, Mark D; Borschel, Gregory H; Zuker, Ronald

    2014-01-01

    Facial transplantation is becoming increasingly accepted as a method of reconstructing otherwise unreconstructable adult faces. As this modality is made more available, we must turn our attention to pediatric patients who may benefit from facial transplantation. In the current article, the authors present and briefly examine the most pressing ethical challenges posed by the possibility of performing facial transplantation on pediatric patients. Furthermore, they issue a call for a policy statement on pediatric facial transplantation. The present article may serve as a first step in that direction, highlighting ethical issues that would need to be considered in the creation of such a statement. PMID:25114614

  13. Metrological digital audio reconstruction

    DOEpatents

    Fadeyev; Vitaliy , Haber; Carl

    2004-02-19

    Audio information stored in the undulations of grooves in a medium such as a phonograph record may be reconstructed, with little or no contact, by measuring the groove shape using precision metrology methods coupled with digital image processing and numerical analysis. The effects of damage, wear, and contamination may be compensated, in many cases, through image processing and analysis methods. The speed and data handling capacity of available computing hardware make this approach practical. Two examples used a general purpose optical metrology system to study a 50 year old 78 r.p.m. phonograph record and a commercial confocal scanning probe to study a 1920's celluloid Edison cylinder. Comparisons are presented with stylus playback of the samples and with a digitally re-mastered version of an original magnetic recording. There is also a more extensive implementation of this approach, with dedicated hardware and software.

  14. Reconstructing the Alcatraz escape

    NASA Astrophysics Data System (ADS)

    Baart, F.; Hoes, O.; Hut, R.; Donchyts, G.; van Leeuwen, E.

    2014-12-01

    In the night of June 12, 1962 three inmates used a raft made of raincoatsto escaped the ultimate maximum security prison island Alcatraz in SanFrancisco, United States. History is unclear about what happened tothe escapees. At what time did they step into the water, did theysurvive, if so, where did they reach land? The fate of the escapees has been the subject of much debate: did theymake landfall on Angel Island, or did the current sweep them out ofthe bay and into the cold pacific ocean? In this presentation, we try to shed light on this historic case using avisualization of a high-resolution hydrodynamic simulation of the San Francisco Bay, combined with historical tidal records. By reconstructing the hydrodynamic conditions and using a particle based simulation of the escapees we show possible scenarios. The interactive model is visualized using both a 3D photorealistic and web based visualization. The "Escape from Alcatraz" scenario demonstrates the capabilities of the 3Di platform. This platform is normally used for overland flooding (1D/2D). The model engine uses a quad tree structure, resulting in an order of magnitude speedup. The subgrid approach takes detailed bathymetry information into account. The inter-model variability is tested by comparing the results with the DFlow Flexible Mesh (DFlowFM) San Francisco Bay model. Interactivity is implemented by converting the models from static programs to interactive libraries, adhering to the Basic ModelInterface (BMI). Interactive models are more suitable for answeringexploratory research questions such as this reconstruction effort. Although these hydrodynamic simulations only provide circumstantialevidence for solving the mystery of what happened during the foggy darknight of June 12, 1962, it can be used as a guidance and provides aninteresting testcase to apply interactive modelling.

  15. Reconstruction of an ablated breast.

    PubMed

    Scarfì, A; Ordemann, K; Hüter, J

    1986-01-01

    It is the aim of the reconstruction of an ablated breast to repair the woman's integrity. The technique of this operation, according to Bomert, is the sliding of a flap of skin in the case of a horizontal breast scar. For the reconstruction, a silicone prosthesis is implanted which in most cases is prepectoral.

  16. Reconstruction of Skull Base Defects.

    PubMed

    Klatt-Cromwell, Cristine N; Thorp, Brian D; Del Signore, Anthony G; Ebert, Charles S; Ewend, Matthew G; Zanation, Adam M

    2016-02-01

    "Endoscopic endonasal skull base surgery has dramatically changed and expanded over recent years due to significant advancements in instrumentation, techniques, and anatomic understanding. With these advances, the need for more robust skull base reconstructive techniques was vital. In this article, reconstructive options ranging from acellular grafts to vascular flaps are described, including the strengths, weaknesses, and common uses."

  17. Theoretical Considerations for Project Costs.

    ERIC Educational Resources Information Center

    Johnson, Charles E.; Johnson, Cecil G.

    This bulletin is a reprint of Part 3 of the College of Education, University of Georgia's proposal to the U.S. Department of Health, Education and Welfare, Office of Education (USOE) to undertake a feasibility study of the Georgia educational model (Johnson, 1969). It is a discussion of the theoretical considerations underlying procedures which…

  18. LABORATORY DESIGN CONSIDERATIONS FOR SAFETY.

    ERIC Educational Resources Information Center

    National Safety Council, Chicago, IL. Campus Safety Association.

    THIS SET OF CONSIDERATIONS HAS BEEN PREPARED TO PROVIDE PERSONS WORKING ON THE DESIGN OF NEW OR REMODELED LABORATORY FACILITIES WITH A SUITABLE REFERENCE GUIDE TO DESIGN SAFETY. THERE IS NO DISTINCTION BETWEEN TYPES OF LABORATORY AND THE EMPHASIS IS ON GIVING GUIDES AND ALTERNATIVES RATHER THAN DETAILED SPECIFICATIONS. AREAS COVERED INCLUDE--(1)…

  19. Ethical considerations in revision rhinoplasty.

    PubMed

    Wayne, Ivan

    2012-08-01

    The problems that arise when reviewing another surgeon's work, the financial aspects of revision surgery, and the controversies that present in marketing and advertising will be explored. The technological advances of computer imaging and the Internet have introduced new problems that require our additional consideration.

  20. Basic Considerations in Interviewing Children.

    ERIC Educational Resources Information Center

    Jennings, Rick L.

    This manual summarizes and highlights basic considerations in interviewing children. The relationship between interviewing for data collection and interviewing within the counseling or psychotherapeutic context is discussed. The Interviewer's Functional Checklist is presented to provide a method for self-evaluating interviewer behavior, and for…

  1. Asbestos Abatement--Practical Considerations.

    ERIC Educational Resources Information Center

    Sedrel, Roy A.

    Illinois Senate Bill 1644, the recently passed "Asbestos Abatement Act," requires all schools in the state, public and private alike, to remove friable asbestos by whichever comes first: July 1, 1989, or 3 years following the establishment of a system for state funding for corrective action. This document addresses practical considerations in…

  2. Predicting success in ACL reconstruction.

    PubMed

    Shalvoy, Robert M

    2014-11-03

    Anterior Cruciate Ligament (ACL) injury and ACL reconstruction is common in the United States. However, when compared to the standards of other orthopedics procedures today, ACL reconstruction is NOT predictably successful in restoring patients to their pre-injury state. Only 60-70% of reconstructed patients resume their previous level of activity and many patients experience some degree of osteoarthritis. The reasons for such limitations of success are many. A recent renewal of interest in the many variables affecting ACL reconstruction and the understanding of the varying needs of patients with ACL injury holds promise for improving success even today as well as ultimately providing a normal knee for patients after ACL reconstruction.

  3. Nasal Reconstruction: Extending the Limits

    PubMed Central

    Corsten, Marcus; Haack, Sebastian; Gubisch, Wolfgang M.; Fischer, Helmut

    2016-01-01

    Summary: Reconstructing the 3-dimensional structure of the nose requires the maintenance of its aesthetic form and function. Restoration of the correct dimension, projection, skin quality, symmetrical contour, and function remains problematic. Consequently, modern approaches of nasal reconstruction aim at rebuilding the units rather than just covering the defect. However, revising or redoing a failed or insufficient reconstruction remains very challenging and requires experience and creativity. Here, we present a very particular case with a male patient, who underwent 37 operations elsewhere and presented with a failed nasal reconstruction. We describe and illustrate the complex steps of the nasal rereconstruction, including the reconstruction of the forehead donor site, surgical delay procedures for lining, and the coverage with a third paramedian forehead flap. PMID:27536483

  4. Nasal Reconstruction: Extending the Limits.

    PubMed

    Rezaeian, Farid; Corsten, Marcus; Haack, Sebastian; Gubisch, Wolfgang M; Fischer, Helmut

    2016-07-01

    Reconstructing the 3-dimensional structure of the nose requires the maintenance of its aesthetic form and function. Restoration of the correct dimension, projection, skin quality, symmetrical contour, and function remains problematic. Consequently, modern approaches of nasal reconstruction aim at rebuilding the units rather than just covering the defect. However, revising or redoing a failed or insufficient reconstruction remains very challenging and requires experience and creativity. Here, we present a very particular case with a male patient, who underwent 37 operations elsewhere and presented with a failed nasal reconstruction. We describe and illustrate the complex steps of the nasal rereconstruction, including the reconstruction of the forehead donor site, surgical delay procedures for lining, and the coverage with a third paramedian forehead flap. PMID:27536483

  5. Convex accelerated maximum entropy reconstruction

    NASA Astrophysics Data System (ADS)

    Worley, Bradley

    2016-04-01

    Maximum entropy (MaxEnt) spectral reconstruction methods provide a powerful framework for spectral estimation of nonuniformly sampled datasets. Many methods exist within this framework, usually defined based on the magnitude of a Lagrange multiplier in the MaxEnt objective function. An algorithm is presented here that utilizes accelerated first-order convex optimization techniques to rapidly and reliably reconstruct nonuniformly sampled NMR datasets using the principle of maximum entropy. This algorithm - called CAMERA for Convex Accelerated Maximum Entropy Reconstruction Algorithm - is a new approach to spectral reconstruction that exhibits fast, tunable convergence in both constant-aim and constant-lambda modes. A high-performance, open source NMR data processing tool is described that implements CAMERA, and brief comparisons to existing reconstruction methods are made on several example spectra.

  6. Reconstructive challenges in war wounds

    PubMed Central

    Bhandari, Prem Singh; Maurya, Sanjay; Mukherjee, Mrinal Kanti

    2012-01-01

    War wounds are devastating with extensive soft tissue and osseous destruction and heavy contamination. War casualties generally reach the reconstructive surgery centre after a delayed period due to additional injuries to the vital organs. This delay in their transfer to a tertiary care centre is responsible for progressive deterioration in wound conditions. In the prevailing circumstances, a majority of war wounds undergo delayed reconstruction, after a series of debridements. In the recent military conflicts, hydrosurgery jet debridement and negative pressure wound therapy have been successfully used in the preparation of war wounds. In war injuries, due to a heavy casualty load, a faster and reliable method of reconstruction is aimed at. Pedicle flaps in extremities provide rapid and reliable cover in extremity wounds. Large complex defects can be reconstructed using microvascular free flaps in a single stage. This article highlights the peculiarities and the challenges encountered in the reconstruction of these ghastly wounds. PMID:23162233

  7. Evidence-Based ACL Reconstruction

    PubMed Central

    Rodriguez-Merchan, E. Carlos

    2015-01-01

    There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACL) reconstruction. The purpose of this article is to answer the following questions: 1) Bone-patellar tendon-bone reconstruction (BPTB-R) or hamstrimg reconstruction (H-R); 2) Double bundle or single bundle; 3) Allograft or authograft; 4) Early or late reconstruction; 5) Rate of return to sports after ACL reconstruction; 6) Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE) search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analyses focused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II) of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years. PMID:25692162

  8. Revision Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Wilde, Jeffrey; Bedi, Asheesh; Altchek, David W.

    2014-01-01

    Context: Reconstruction of the anterior cruciate ligament (ACL) is one of the most common surgical procedures, with more than 200,000 ACL tears occurring annually. Although primary ACL reconstruction is a successful operation, success rates still range from 75% to 97%. Consequently, several thousand revision ACL reconstructions are performed annually and are unfortunately associated with inferior clinical outcomes when compared with primary reconstructions. Evidence Acquisition: Data were obtained from peer-reviewed literature through a search of the PubMed database (1988-2013) as well as from textbook chapters and surgical technique papers. Study Design: Clinical review. Level of Evidence: Level 4. Results: The clinical outcomes after revision ACL reconstruction are largely based on level IV case series. Much of the existing literature is heterogenous with regard to patient populations, primary and revision surgical techniques, concomitant ligamentous injuries, and additional procedures performed at the time of the revision, which limits generalizability. Nevertheless, there is a general consensus that the outcomes for revision ACL reconstruction are inferior to primary reconstruction. Conclusion: Excellent results can be achieved with regard to graft stability, return to play, and functional knee instability but are generally inferior to primary ACL reconstruction. A staged approach with autograft reconstruction is recommended in any circumstance in which a single-stage approach results in suboptimal graft selection, tunnel position, graft fixation, or biological milieu for tendon-bone healing. Strength-of-Recommendation Taxonomy (SORT): Good results may still be achieved with regard to graft stability, return to play, and functional knee instability, but results are generally inferior to primary ACL reconstruction: Level B. PMID:25364483

  9. Evidence-Based ACL Reconstruction.

    PubMed

    Rodriguez-Merchan, E Carlos

    2015-01-01

    There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACL) reconstruction. The purpose of this article is to answer the following questions: 1) Bone-patellar tendon-bone reconstruction (BPTB-R) or hamstrimg reconstruction (H-R); 2) Double bundle or single bundle; 3) Allograft or authograft; 4) Early or late reconstruction; 5) Rate of return to sports after ACL reconstruction; 6) Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE) search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analyses focused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II) of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years. PMID:25692162

  10. Porcelain three-dimensional shape reconstruction and its color reconstruction

    NASA Astrophysics Data System (ADS)

    Yu, Xiaoyang; Wu, Haibin; Yang, Xue; Yu, Shuang; Wang, Beiyi; Chen, Deyun

    2013-01-01

    In this paper, structured light three-dimensional measurement technology was used to reconstruct the porcelain shape, and further more the porcelain color was reconstructed. So the accurate reconstruction of the shape and color of porcelain was realized. Our shape measurement installation drawing is given. Because the porcelain surface is color complex and highly reflective, the binary Gray code encoding is used to reduce the influence of the porcelain surface. The color camera was employed to obtain the color of the porcelain surface. Then, the comprehensive reconstruction of the shape and color was realized in Java3D runtime environment. In the reconstruction process, the space point by point coloration method is proposed and achieved. Our coloration method ensures the pixel corresponding accuracy in both of shape and color aspects. The porcelain surface shape and color reconstruction experimental results completed by proposed method and our installation, show that: the depth range is 860 ˜ 980mm, the relative error of the shape measurement is less than 0.1%, the reconstructed color of the porcelain surface is real, refined and subtle, and has the same visual effect as the measured surface.

  11. Adapted fan-beam volume reconstruction for stationary digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Wu, Gongting; Inscoe, Christine; Calliste, Jabari; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2015-03-01

    Digital breast tomosynthesis (DBT) provides 3D images which remove tissue overlapping and enables better cancer detection. Stationary DBT (s-DBT) uses a fixed X-ray source array to eliminate image blur associated with the x-ray tube motion and provides better image quality as well as faster scanning speed. For limited angle tomography, it is known that iterative reconstructions generally produces better images with fewer artifacts. However classical iterative tomosynthesis reconstruction methods are considerably slower than the filtered back-projection (FBP) reconstruction. The linear x-ray source array used in s-DBT enables a computationally more efficient volume reconstruction using adapted fan beam slice sampling, which transforms the 3-D cone beam reconstruction to a series of 2-D fan beam slice reconstructions. In this paper, we report the first results of the adapted fan-beam volume reconstruction (AFVR) for the s-DBT system currently undergoing clinical trial at UNC, using a simultaneous algebraic reconstruction technique (SART). An analytic breast phantom is used to quantitatively analyze the performance of the AFVR. Image quality of a CIRS biopsy phantom reconstructed using the AFVR method are compared to that using FBP algorithm with a commercial package. Our results show a significant reduction in memory usage and an order of magnitude speed increase in reconstructing speed using AFVR compared to that of classical 3-D cone beam reconstruction. We also observed that images reconstructed by AFVR with SART had a better sharpness and contrast compared to that using FBP. Preliminary results on patient images demonstrates the improved detectability of the s-DBT system over the mammography. By utilizing parallel computing with graphics processing unit (GPU), it is expected that the AFVR method will enable iterative reconstruction technique to be practical for clinical applications.

  12. Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Arcuri, Francisco; Barclay, Fernando; Nacul, Ivan

    2015-01-01

    Introduction: The most recent advances in ACL reconstruction try to reproduce the anatomic femoral and tibial footprints as close as possible. Creating independent tunnels would allow an optimal of the entry point and the femoral tunnel obliquity, and together with an adequate reamer diameter they wouldreproduce with greater certainty the anatomy. Objective: To compare the radiographic parameters of the femoral and tibial tunnel positions in two groups of patients, one operated with a transtibial and other with transportal anatomic techniques. Materials and Methods: From December 2012 to December 2013, 59 patients with a primary ACL reconstruction divided in two groups, a trans tibial technique (TT), 19 patients, and an transportal one (TP) with 40 patients were prospectively evaluated with AP and lateral X-rays. The femoral tunnel angle, the insertion site with respect of the Blumensaat line, the trans osseous distance, the tibial tunnel position as a percentage of the tibial plateau in the AP and lateral views. And finally the tibial tunnel angle in the AP and Lateral views. Results: The femoral tunnel angle was in the TP group of 45,92º and in the TT one 24,53º, p 0,002. The insertion site percentage of the Blumensaat line was of 20,96 in TP and 20,74 in the TT, p 0,681.Trans osseous distance was in the TP of 3,43 cm and in the TT of 4,79 cm, p <0,000. The tibial tunnel position as a percentage in the AP tibial plateau was of 44,35 in TP and of 40,80 TT with a p of 0,076. The tibial tunnel position as a percentage of the lateral tibial plateau was of 28,70 in TP and 34,53 in TT with a p 0,367. Tibial tunnel angle in the AP was of 73,48º in TP and 62,81 in TT with a p of 0,002, and in the lateral plateau of 114,69º in TP and 112,79º in TT with a p of 0,427. Conclusion: It is possible to create tibial and femoral tunnel in optimal positions but not equal between both groups. Creating independent tunnels allow a more anterior and vertical tibial tunnel

  13. Synthetic biomaterials for pelvic floor reconstruction.

    PubMed

    Karlovsky, Matthew E; Kushner, Leslie; Badlani, Gopal H

    2005-09-01

    Pelvic organ prolapse and stress urinary incontinence increase with age. The increasing proportion of the aging female population is likely to result in a demand for care of pelvic floor prolapse and incontinence. Experimental evidence of altered connective tissue metabolism may predispose to pelvic floor dysfunction, supporting the use of biomaterials, such as synthetic mesh, to correct pelvic fascial defects. Re-establishing pelvic support and continence calls for a biomaterial to be inert, flexible, and durable and to simultaneously minimize infection and erosion risk. Mesh as a biomaterial has evolved considerably throughout the past half century to the current line that combines ease of use, achieves good outcomes, and minimizes risk. This article explores the biochemical basis for pelvic floor attenuation and reviews various pelvic reconstructive mesh materials, their successes, failures, complications, and management.

  14. Three-dimensional image reconstruction for electrical impedance tomography.

    PubMed

    Kleinermann, F; Avis, N J; Judah, S K; Barber, D C

    1996-11-01

    Very little work has been conducted on three-dimensional aspects of electrical impedance tomography (EIT), partly due to the increased computational complexity over the two-dimensional aspects of EIT. Nevertheless, extending EIT to three-dimensional data acquisition and image reconstruction may afford significant advantages such as an increase in the size of the independent data set and improved spatial resolution. However, considerable challenges are associated with the software aspects of three-dimensional EIT systems due to the requirement for accurate three-dimensional forward problem modelling and the derivation of three-dimensional image reconstruction algorithms. This paper outlines the work performed to date to derive a three-dimensional image reconstruction algorithm for EIT based on the inversion of the sensitivity matrix approach for a finite right circular cylinder. A comparison in terms of the singular-value spectra and the singular vectors between the sensitivity matrices for a three-dimensional cylinder and a two-dimensional disc has been performed. This comparison shows that the three-dimensional image reconstruction algorithm recruits more central information at lower condition numbers than the two-dimensional image reconstruction algorithm.

  15. An efficient simultaneous reconstruction technique for tomographic particle image velocimetry

    NASA Astrophysics Data System (ADS)

    Atkinson, Callum; Soria, Julio

    2009-10-01

    To date, Tomo-PIV has involved the use of the multiplicative algebraic reconstruction technique (MART), where the intensity of each 3D voxel is iteratively corrected to satisfy one recorded projection, or pixel intensity, at a time. This results in reconstruction times of multiple hours for each velocity field and requires considerable computer memory in order to store the associated weighting coefficients and intensity values for each point in the volume. In this paper, a rapid and less memory intensive reconstruction algorithm is presented based on a multiplicative line-of-sight (MLOS) estimation that determines possible particle locations in the volume, followed by simultaneous iterative correction. Reconstructions of simulated images are presented for two simultaneous algorithms (SART and SMART) as well as the now standard MART algorithm, which indicate that the same accuracy as MART can be achieved 5.5 times faster or 77 times faster with 15 times less memory if the processing and storage of the weighting matrix is considered. Application of MLOS-SMART and MART to a turbulent boundary layer at Re θ = 2200 using a 4 camera Tomo-PIV system with a volume of 1,000 × 1,000 × 160 voxels is discussed. Results indicate improvements in reconstruction speed of 15 times that of MART with precalculated weighting matrix, or 65 times if calculation of the weighting matrix is considered. Furthermore the memory needed to store a large weighting matrix and volume intensity is reduced by almost 40 times in this case.

  16. Inverse polynomial reconstruction method in DCT domain

    NASA Astrophysics Data System (ADS)

    Dadkhahi, Hamid; Gotchev, Atanas; Egiazarian, Karen

    2012-12-01

    The discrete cosine transform (DCT) offers superior energy compaction properties for a large class of functions and has been employed as a standard tool in many signal and image processing applications. However, it suffers from spurious behavior in the vicinity of edge discontinuities in piecewise smooth signals. To leverage the sparse representation provided by the DCT, in this article, we derive a framework for the inverse polynomial reconstruction in the DCT expansion. It yields the expansion of a piecewise smooth signal in terms of polynomial coefficients, obtained from the DCT representation of the same signal. Taking advantage of this framework, we show that it is feasible to recover piecewise smooth signals from a relatively small number of DCT coefficients with high accuracy. Furthermore, automatic methods based on minimum description length principle and cross-validation are devised to select the polynomial orders, as a requirement of the inverse polynomial reconstruction method in practical applications. The developed framework can considerably enhance the performance of the DCT in sparse representation of piecewise smooth signals. Numerical results show that denoising and image approximation algorithms based on the proposed framework indicate significant improvements over wavelet counterparts for this class of signals.

  17. Considerations when collecting coal dust

    SciTech Connect

    Olechiw, W.J.

    1995-12-31

    There are several applications in the handling of coal in which capturing coal dust is important. They are in pulverizing operations at belt conveyor transfer points and pneumatic conveying receivers. In each case the processing and handling of coal generates considerable dust which is suspended in the air. Health and safety, environmental considerations and good housekeeping practices dictate that the suspended coal dust be captured, contained and transferred for re-use or disposal. It is no longer acceptable practice to expose operating personnel to breathing dust (OSSA regulations). In addition particulate emissions are being more closely regulated both in total mass and particle size (PM-10 legislation). In general dusty environments reduce the efficiency of operating equipment by fouling bearings and rollers, increasing friction, clogging air filters and increasing wear and tear on equipment and energy costs. Of paramount concern is the fact that spontaneous combustion can occur where coal dust accumulates on horizontal surfaces.

  18. Operative considerations for rectovaginal fistulas

    PubMed Central

    Kniery, Kevin R; Johnson, Eric K; Steele, Scott R

    2015-01-01

    To describe the etiology, anatomy and pathophysiology of rectovaginal fistulas (RVFs); and to describe a systematic surgical approach to help achieve optimal outcomes. A current review of the literature was performed to identify the most up-to-date techniques and outcomes for repair of RVFs. RVFs present a difficult problem that is frustrating for patients and surgeons alike. Multiple trips to the operating room are generally needed to resolve the fistula, and the recurrence rate approaches 40% when considering all of the surgical options. At present, surgical options range from collagen plugs and endorectal advancement flaps to sphincter repairs or resection with colo-anal reconstruction. There are general principles that will allow the best chance for resolution of the fistula with the least morbidity to the patient. These principles include: resolving the sepsis, identifying the anatomy, starting with least invasive surgical options, and interposing healthy tissue for complex or recurrent fistulas. PMID:26328032

  19. Update on rehabilitation following ACL reconstruction

    PubMed Central

    Nyland, John; Brand, Emily; Fisher, Brent

    2010-01-01

    As anterior cruciate ligament (ACL) reconstruction has evolved to less invasive, more anatomical approaches, rehabilitation of the injured athlete has likewise become more progressive and innovative, with a sound understanding of graft and fixation strength and biologic healing-remodeling constraints. This review discusses these innovations including specific considerations before surgery, when planning rehabilitation timetables, and the importance of reestablishing nonimpaired active and passive knee range of motion and biarticular musculotendinous extensibility in positions of function. Concepts of self-efficacy or confidence and reestablishing the “athlete role” are also addressed. Since ACL injury and reinjury are largely related to the influence of structure-form-function on dynamic knee joint stability, the interrelationships between sensorimotor, neuromuscular, and conventional resistance training are also discussed. Although pivot shift “giving way” relates to function loss following ACL injury, anterior translational laxity often does not. Although there is growing evidence that progressive eccentric training may benefit the patient following ACL reconstruction, there is less evidence supporting the use of functional ACL knee braces. Of considerable importance is selecting and achieving a criteria-based progression to sports-specific training, reestablishing osseous homeostasis and improved bone density, blending open and closed kinetic chain exercises at the appropriate time period, and appreciating the influence of the trunk, upper extremities, and sports equipment use on knee loads. We believe that knee dysfunction and functional recovery should be considered from a local, regional, and global perspective. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. PMID:24198553

  20. Orthotopic neobladder reconstruction

    PubMed Central

    Chang, Dwayne T. S.; Lawrentschuk, Nathan

    2015-01-01

    Orthotopic neobladder reconstruction is becoming an increasingly common urinary diversion following cystectomy for bladder cancer. This is in recognition of the potential benefits of neobladder surgery over creation of an ileal conduit related to quality of life (QoL), such as avoiding the need to form a stoma with its cosmetic, psychological and other potential complications. The PubMed database was searched using relevant search terms for articles published electronically between January 1994 and April 2014. Full-text articles in English or with English translation were assessed for relevance to the topic before being included in the review. Patients with neobladders have comparable or better post-operative sexual function than those with ileal conduits. They also have comparable QoL to those with ileal conduits. Orthotopic neobladder is a good alternative to ileal conduit in suitable patients who do not want a stoma and are motivated to comply with neobladder training. However, the selection of a neobladder as the urinary diversion of choice requires that patients have good renal and liver functions and are likely to be compliant with neobladder training. With benefits also come potential risks of neobladder formation. These include electrolyte abnormalities and nocturnal incontinence. This short review highlights current aspects of neobladder formation and its potential advantages. PMID:25657535

  1. Total airway reconstruction.

    PubMed

    Connor, Matthew P; Barrera, Jose E; Eller, Robert; McCusker, Scott; O'Connor, Peter

    2013-02-01

    We present a case of obstructive sleep apnea (OSA) that required multilevel surgical correction of the airway and literature review and discuss the role supraglottic laryngeal collapse can have in OSA. A 34-year-old man presented to a tertiary otolaryngology clinic for treatment of OSA. He previously had nasal and palate surgeries and a Repose tongue suspension. His residual apnea hypopnea index (AHI) was 67. He had a dysphonia associated with a true vocal cord paralysis following resection of a benign neck mass in childhood. He also complained of inspiratory stridor with exercise and intolerance to continuous positive airway pressure. Physical examination revealed craniofacial hypoplasia, full base of tongue, and residual nasal airway obstruction. On laryngoscopy, the paretic aryepiglottic fold arytenoid complex prolapsed into the laryngeal inlet with each breath. This was more pronounced with greater respiratory effort. Surgical correction required a series of operations including awake tracheostomy, supraglottoplasty, midline glossectomy, genial tubercle advancement, maxillomandibular advancement, and reconstructive rhinoplasty. His final AHI was 1.9. Our patient's supraglottic laryngeal collapse constituted an area of obstruction not typically evaluated in OSA surgery. In conjunction with treating nasal, palatal, and hypopharyngeal subsites, our patient's supraglottoplasty represented a key component of his success. This case illustrates the need to evaluate the entire upper airway in a complicated case of OSA. PMID:22965285

  2. Facial Reconstruction and Rehabilitation.

    PubMed

    Guntinas-Lichius, Orlando; Genther, Dane J; Byrne, Patrick J

    2016-01-01

    Extracranial infiltration of the facial nerve by salivary gland tumors is the most frequent cause of facial palsy secondary to malignancy. Nevertheless, facial palsy related to salivary gland cancer is uncommon. Therefore, reconstructive facial reanimation surgery is not a routine undertaking for most head and neck surgeons. The primary aims of facial reanimation are to restore tone, symmetry, and movement to the paralyzed face. Such restoration should improve the patient's objective motor function and subjective quality of life. The surgical procedures for facial reanimation rely heavily on long-established techniques, but many advances and improvements have been made in recent years. In the past, published experiences on strategies for optimizing functional outcomes in facial paralysis patients were primarily based on small case series and described a wide variety of surgical techniques. However, in the recent years, larger series have been published from high-volume centers with significant and specialized experience in surgical and nonsurgical reanimation of the paralyzed face that have informed modern treatment. This chapter reviews the most important diagnostic methods used for the evaluation of facial paralysis to optimize the planning of each individual's treatment and discusses surgical and nonsurgical techniques for facial rehabilitation based on the contemporary literature.

  3. Crystallographic image reconstruction problem

    NASA Astrophysics Data System (ADS)

    ten Eyck, Lynn F.

    1993-11-01

    The crystallographic X-ray diffraction experiment gives the amplitudes of the Fourier series expansion of the electron density distribution within the crystal. The 'phase problem' in crystallography is the determination of the phase angles of the Fourier coefficients required to calculate the Fourier synthesis and reveal the molecular structure. The magnitude of this task varies enormously as the size of the structures ranges from a few atoms to thousands of atoms, and the number of Fourier coefficients ranges from hundreds to hundreds of thousands. The issue is further complicated for large structures by limited resolution. This problem is solved for 'small' molecules (up to 200 atoms and a few thousand Fourier coefficients) by methods based on probabilistic models which depend on atomic resolution. These methods generally fail for larger structures such as proteins. The phase problem for protein molecules is generally solved either by laborious experimental methods or by exploiting known similarities to solved structures. Various direct methods have been attempted for very large structures over the past 15 years, with gradually improving results -- but so far no complete success. This paper reviews the features of the crystallographic image reconstruction problem which render it recalcitrant, and describes recent encouraging progress in the application of maximum entropy methods to this problem.

  4. Bayesian reconstruction of projection reconstruction NMR (PR-NMR).

    PubMed

    Yoon, Ji Won

    2014-11-01

    Projection reconstruction nuclear magnetic resonance (PR-NMR) is a technique for generating multidimensional NMR spectra. A small number of projections from lower-dimensional NMR spectra are used to reconstruct the multidimensional NMR spectra. In our previous work, it was shown that multidimensional NMR spectra are efficiently reconstructed using peak-by-peak based reversible jump Markov chain Monte Carlo (RJMCMC) algorithm. We propose an extended and generalized RJMCMC algorithm replacing a simple linear model with a linear mixed model to reconstruct close NMR spectra into true spectra. This statistical method generates samples in a Bayesian scheme. Our proposed algorithm is tested on a set of six projections derived from the three-dimensional 700 MHz HNCO spectrum of a protein HasA. PMID:25218584

  5. Self-Neglect: Ethical Considerations.

    PubMed

    Day, Mary Rose; Leahy-Warren, Patricia; McCarthy, Geraldine

    2016-01-01

    Self-neglect is a significant international public health issue. Estimates suggest that there may be over one million cases per year in the United States. Aging populations will put more people at risk of self-neglect. This chapter presents background literature, self-neglect definitions and policy context, risk factors, and a brief overview of research on perspectives of self-neglect from both clients and community health and social care professionals. A case study is presented from the perspective of an individual and is used to explore ethical issues therein. A person-centered assessment within a multidisciplinary team approach is required for building a therapeutic relationship with clients. Capacity is a central issue in the management of responses to self-neglect. Ethical considerations of importance for community health and social care professionals include beneficence and nonmaleficence, autonomy and capacity, and respect for people's rights and dignity. A model of ethical justification is presented to explain dilemmas, challenges, and actions. Competence of professionals, multidisciplinary team working, informed consent, privacy, confidentiality, and best interest are also critical considerations. Effective decision making by an interdisciplinary team of professionals needs to be person-centered and give due consideration to the best interest of self-neglecting clients. The purpose of this chapter is to provide an in-depth discussion and examination of ethical issues and challenges relating to self-neglecting clients. PMID:26673378

  6. Self-Neglect: Ethical Considerations.

    PubMed

    Day, Mary Rose; Leahy-Warren, Patricia; McCarthy, Geraldine

    2016-01-01

    Self-neglect is a significant international public health issue. Estimates suggest that there may be over one million cases per year in the United States. Aging populations will put more people at risk of self-neglect. This chapter presents background literature, self-neglect definitions and policy context, risk factors, and a brief overview of research on perspectives of self-neglect from both clients and community health and social care professionals. A case study is presented from the perspective of an individual and is used to explore ethical issues therein. A person-centered assessment within a multidisciplinary team approach is required for building a therapeutic relationship with clients. Capacity is a central issue in the management of responses to self-neglect. Ethical considerations of importance for community health and social care professionals include beneficence and nonmaleficence, autonomy and capacity, and respect for people's rights and dignity. A model of ethical justification is presented to explain dilemmas, challenges, and actions. Competence of professionals, multidisciplinary team working, informed consent, privacy, confidentiality, and best interest are also critical considerations. Effective decision making by an interdisciplinary team of professionals needs to be person-centered and give due consideration to the best interest of self-neglecting clients. The purpose of this chapter is to provide an in-depth discussion and examination of ethical issues and challenges relating to self-neglecting clients.

  7. Tomographic reconstruction of binary fields

    NASA Astrophysics Data System (ADS)

    Roux, Stéphane; Leclerc, Hugo; Hild, François

    2012-09-01

    A novel algorithm is proposed for reconstructing binary images from their projection along a set of different orientations. Based on a nonlinear transformation of the projection data, classical back-projection procedures can be used iteratively to converge to the sought image. A multiscale implementation allows for a faster convergence. The algorithm is tested on images up to 1 Mb definition, and an error free reconstruction is achieved with a very limited number of projection data, saving a factor of about 100 on the number of projections required for classical reconstruction algorithms.

  8. Application of Hydrogel in Reconstruction Surgery: Hydrogel/Fat Graft Complex Filler for Volume Reconstruction in Critical Sized Muscle Defects.

    PubMed

    Lui, Y F; Ip, W Y

    2016-01-01

    Autogenic fat graft usually suffers from degeneration and volume shrinkage in volume reconstruction applications. How to maintain graft viability and graft volume is an essential consideration in reconstruction therapies. In this presented investigation, a new fat graft transplantation method was developed aiming to improve long term graft viability and volume reconstruction effect by incorporation of hydrogel. The harvested fat graft is dissociated into small fragments and incorporated into a collagen based hydrogel to form a hydrogel/fat graft complex for volume reconstruction purpose. In vitro results indicate that the collagen based hydrogel can significantly improve the survivability of cells inside isolated graft. In a 6-month investigation on artificial created defect model, this hydrogel/fat graft complex filler has demonstrated the ability of promoting fat pad formation inside the targeted defect area. The newly generated fat pad can cover the whole defect and restore its original dimension in 6-month time point. Compared to simple fat transplantation, this hydrogel/fat graft complex system provides much improvement on long term volume restoration effect against degeneration and volume shrinkage. One notable effect is that there is continuous proliferation of adipose tissue throughout the 6-month period. In summary, the hydrogel/fat graft system presented in this investigation demonstrated a better and more significant effect on volume reconstruction in large sized volume defect than simple fat transplantation. PMID:27446947

  9. Application of Hydrogel in Reconstruction Surgery: Hydrogel/Fat Graft Complex Filler for Volume Reconstruction in Critical Sized Muscle Defects

    PubMed Central

    Ip, W. Y.

    2016-01-01

    Autogenic fat graft usually suffers from degeneration and volume shrinkage in volume reconstruction applications. How to maintain graft viability and graft volume is an essential consideration in reconstruction therapies. In this presented investigation, a new fat graft transplantation method was developed aiming to improve long term graft viability and volume reconstruction effect by incorporation of hydrogel. The harvested fat graft is dissociated into small fragments and incorporated into a collagen based hydrogel to form a hydrogel/fat graft complex for volume reconstruction purpose. In vitro results indicate that the collagen based hydrogel can significantly improve the survivability of cells inside isolated graft. In a 6-month investigation on artificial created defect model, this hydrogel/fat graft complex filler has demonstrated the ability of promoting fat pad formation inside the targeted defect area. The newly generated fat pad can cover the whole defect and restore its original dimension in 6-month time point. Compared to simple fat transplantation, this hydrogel/fat graft complex system provides much improvement on long term volume restoration effect against degeneration and volume shrinkage. One notable effect is that there is continuous proliferation of adipose tissue throughout the 6-month period. In summary, the hydrogel/fat graft system presented in this investigation demonstrated a better and more significant effect on volume reconstruction in large sized volume defect than simple fat transplantation. PMID:27446947

  10. Spatial-temporal total variation regularization (STTVR) for 4D-CT reconstruction

    NASA Astrophysics Data System (ADS)

    Wu, Haibo; Maier, Andreas; Fahrig, Rebecca; Hornegger, Joachim

    2012-03-01

    Four dimensional computed tomography (4D-CT) is very important for treatment planning in thorax or abdomen area, e.g. for guiding radiation therapy planning. The respiratory motion makes the reconstruction problem illposed. Recently, compressed sensing theory was introduced. It uses sparsity as a prior to solve the problem and improves image quality considerably. However, the images at each phase are reconstructed individually. The correlations between neighboring phases are not considered in the reconstruction process. In this paper, we propose the spatial-temporal total variation regularization (STTVR) method which not only employs the sparsity in the spatial domain but also in the temporal domain. The algorithm is validated with XCAT thorax phantom. The Euclidean norm of the reconstructed image and ground truth is calculated for evaluation. The results indicate that our method improves the reconstruction quality by more than 50% compared to standard ART.

  11. Hologram-reconstruction signal enhancement

    NASA Technical Reports Server (NTRS)

    Mezrich, R. S.

    1977-01-01

    Principle of heterodyne detection is used to combine object beam and reconstructed virtual image beam. All light valves in page composer are opened, and virtual-image beam is allowed to interfere with light from valves.

  12. [Reconstructing oneself after an amputation].

    PubMed

    Anne, M

    2015-03-01

    Anne, in her forties, was the victim of a serious road traffic accident resulting in the amputation of her foot. Demonstrating strength and modesty, she shares with us the main stages of her journey towards her reconstruction. PMID:26145134

  13. Vermilion Reconstruction with Genital Mucosa

    PubMed Central

    Weyandt, Gerhard H.; Woeckel, Achim; Kübler, Alexander C.

    2016-01-01

    Summary: Functional and aesthetical reconstruction, especially of the upper lip after ablative tumor surgery, can be very challenging. The skin of the lip might be sufficiently reconstructed by transpositional flaps from the nasolabial or facial area. Large defects of the lip mucosa, including the vestibule, are even more challenging due to the fact that flaps from the inner lining of the oral cavity often lead to functional impairments. We present a case of multiple vermilion and skin resections of the upper lip. At the last step, we had to resect even the whole vermilion mucosa, including parts of the oral mucosa of the vestibule, leaving a bare orbicularis oris muscle. To reconstruct the mucosal layer, we used a mucosal graft from the labia minora and placed it on the compromised lip and the former transpositional flaps for the reconstructed skin of the upper lip with very good functional and aesthetic results. PMID:27579226

  14. Vermilion Reconstruction with Genital Mucosa.

    PubMed

    Müller-Richter, Urs D A; Weyandt, Gerhard H; Woeckel, Achim; Kübler, Alexander C

    2016-05-01

    Functional and aesthetical reconstruction, especially of the upper lip after ablative tumor surgery, can be very challenging. The skin of the lip might be sufficiently reconstructed by transpositional flaps from the nasolabial or facial area. Large defects of the lip mucosa, including the vestibule, are even more challenging due to the fact that flaps from the inner lining of the oral cavity often lead to functional impairments. We present a case of multiple vermilion and skin resections of the upper lip. At the last step, we had to resect even the whole vermilion mucosa, including parts of the oral mucosa of the vestibule, leaving a bare orbicularis oris muscle. To reconstruct the mucosal layer, we used a mucosal graft from the labia minora and placed it on the compromised lip and the former transpositional flaps for the reconstructed skin of the upper lip with very good functional and aesthetic results. PMID:27579226

  15. Surface Reconstruction of an Ordered Fluid: An Analogy with Crystal Surfaces

    SciTech Connect

    Rehse, N.; Knoll, A.; Konrad, M.; Magerle, R.; Krausch, G.

    2001-07-16

    The surface structure of a lamellar polystyrene-block-polybutadiene-block-polymethylmethacrylate (SBM) triblock copolymer forms a complex reconstruction, which breaks the two-dimensional continuous translational symmetry of an ideal (homogeneous) SBM surface. Despite the very different types of matter and order, our findings reveal a remarkable analogy with the well-known phenomenon of surface reconstruction of single crystals, in particular, with the (2 x 1) ''buckling row'' reconstruction of the Si(100) surface. Similarities and differences between both classes of materials are discussed on the basis of symmetry considerations.

  16. Commercial considerations in tissue engineering

    PubMed Central

    Mansbridge, Jonathan

    2006-01-01

    Tissue engineering is a field with immense promise. Using the example of an early tissue-engineered skin implant, Dermagraft, factors involved in the successful commercial development of devices of this type are explored. Tissue engineering has to strike a balance between tissue culture, which is a resource-intensive activity, and business considerations that are concerned with minimizing cost and maximizing customer convenience. Bioreactor design takes place in a highly regulated environment, so factors to be incorporated into the concept include not only tissue culture considerations but also matters related to asepsis, scaleup, automation and ease of use by the final customer. Dermagraft is an allogeneic tissue. Stasis preservation, in this case cryopreservation, is essential in allogeneic tissue engineering, allowing sterility testing, inventory control and, in the case of Dermagraft, a cellular stress that may be important for hormesis following implantation. Although the use of allogeneic cells provides advantages in manufacturing under suitable conditions, it raises the spectre of immunological rejection. Such rejection has not been experienced with Dermagraft. Possible reasons for this and the vision of further application of allogeneic tissues are important considerations in future tissue-engineered cellular devices. This review illustrates approaches that indicate some of the criteria that may provide a basis for further developments. Marketing is a further requirement for success, which entails understanding of the mechanism of action of the procedure, and is illustrated for Dermagraft. The success of a tissue-engineered product is dependent on many interacting operations, some discussed here, each of which must be performed simultaneously and well. PMID:17005024

  17. Commercial considerations in tissue engineering.

    PubMed

    Mansbridge, Jonathan

    2006-10-01

    Tissue engineering is a field with immense promise. Using the example of an early tissue-engineered skin implant, Dermagraft, factors involved in the successful commercial development of devices of this type are explored. Tissue engineering has to strike a balance between tissue culture, which is a resource-intensive activity, and business considerations that are concerned with minimizing cost and maximizing customer convenience. Bioreactor design takes place in a highly regulated environment, so factors to be incorporated into the concept include not only tissue culture considerations but also matters related to asepsis, scaleup, automation and ease of use by the final customer. Dermagraft is an allogeneic tissue. Stasis preservation, in this case cryopreservation, is essential in allogeneic tissue engineering, allowing sterility testing, inventory control and, in the case of Dermagraft, a cellular stress that may be important for hormesis following implantation. Although the use of allogeneic cells provides advantages in manufacturing under suitable conditions, it raises the spectre of immunological rejection. Such rejection has not been experienced with Dermagraft. Possible reasons for this and the vision of further application of allogeneic tissues are important considerations in future tissue-engineered cellular devices. This review illustrates approaches that indicate some of the criteria that may provide a basis for further developments. Marketing is a further requirement for success, which entails understanding of the mechanism of action of the procedure, and is illustrated for Dermagraft. The success of a tissue-engineered product is dependent on many interacting operations, some discussed here, each of which must be performed simultaneously and well.

  18. Fully 4D list-mode reconstruction applied to respiratory-gated PET scans

    NASA Astrophysics Data System (ADS)

    Grotus, N; Reader, A J; Stute, S; Rosenwald, J C; Giraud, P; Buvat, I

    2009-03-01

    18F-fluoro-deoxy-glucose (18F-FDG) positron emission tomography (PET) is one of the most sensitive and specific imaging modalities for the diagnosis of non-small cell lung cancer. A drawback of PET is that it requires several minutes of acquisition per bed position, which results in images being affected by respiratory blur. Respiratory gating techniques have been developed to deal with respiratory motion in the PET images. However, these techniques considerably increase the level of noise in the reconstructed images unless the acquisition time is increased. The aim of this paper is to evaluate a four-dimensional (4D) image reconstruction algorithm that combines the acquired events in all the gates whilst preserving the motion deblurring. This algorithm was compared to classic ordered subset expectation maximization (OSEM) reconstruction of gated and non-gated images, and to temporal filtering of gated images reconstructed with OSEM. Two datasets were used for comparing the different reconstruction approaches: one involving the NEMA IEC/2001 body phantom in motion, the other obtained using Monte-Carlo simulations of the NCAT breathing phantom. Results show that 4D reconstruction reaches a similar performance in terms of the signal-to-noise ratio (SNR) as non-gated reconstruction whilst preserving the motion deblurring. In particular, 4D reconstruction improves the SNR compared to respiratory-gated images reconstructed with the OSEM algorithm. Temporal filtering of the OSEM-reconstructed images helps improve the SNR, but does not achieve the same performance as 4D reconstruction. 4D reconstruction of respiratory-gated images thus appears as a promising tool to reach the same performance in terms of the SNR as non-gated acquisitions while reducing the motion blur, without increasing the acquisition time.

  19. SPECT reconstruction on the GPU

    NASA Astrophysics Data System (ADS)

    Vetter, Christoph; Westermann, Rüdiger

    2008-03-01

    With the increasing reliance of doctors on imaging procedures, not only visualization needs to be optimized, but the reconstruction of the volumes from the scanner output is another bottleneck. Accelerating the computationally intensive reconstruction process improves the medical work flow, matches the reconstruction speed to the acquisition speed, and allows fast batch processing and interactive or near-interactive parameter tuning. Recently, much effort has been focused on using the computational power of graphics processing units (GPUs) for general purpose computations. This paper presents a GPU-accelerated implementation of single photon emission computed tomography (SPECT) reconstruction based on an ordered-subset expectation maximization algorithm. The algorithm uses models for the point-spread-function (PSF) to improve spatial resolution in the reconstruction images. Instead of computing the PSF directly, it is modeled as efficient blurring of slabs on the GPU in order to accelerate the process. The algorithm for the calculation of accumulated attenuation factors that allows correcting the generated volume according to the attenuation properties of the volume is optimized for processing on the GPU. Since these factors can be reused between different iterations, a cache is used that is adapted to different sizes of the video memory so that only those factors have to be recomputed that do not fit onto graphics memory. These improvements make the reconstruction of typical SPECT volume near interactive.

  20. Costal Grafting in Mandibular Reconstruction

    PubMed Central

    Bourlet, Jerôme; Château, Joseph; Jacquemart, Mathieu; Dufour, Clémence; Mojallal, Ali; Gleizal, Arnaud

    2015-01-01

    Background: Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery, and free fibular flap is the gold standard for this indication. However, there are alternatives; nonvascular bone grafting is one of them, and we present the costal grafting for mandibular reconstruction, a classic technique that is reliable, efficient, and produced less morbidity than the technique of using composite free flaps. Method: A 9-year retrospective review of 54 patients treated surgically for mandibular reconstruction was performed. The criterion mainly analyzed was graft survival. The surgical technique was described in detail. Results: A total of 54 patients with mandibular bone defect were identified. Five symphysis, 46 corpus, and 20 ramus defects were considered. These patients underwent reconstruction by costal grafting, and the engrafting was successful in 92.6% of cases. Dental rehabilitation with dental implants was realized in 70% of cases. Conclusions: The approach described in this article allowed the authors to obtain good results with costal grafting for mandibular reconstruction and dental rehabilitation. Costal grafting is a good alternative for fibula free flap in specific indications. Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery. Since the 1980s, the gold standard for these defects is the use of free fibular flap.1 In some cases, this technique is contradicted; the surgeon then has several possibilities for the use of free osteomyocutaneous flaps (iliac crest, scapula, and serrato-costal flaps).2–8 PMID:26893990

  1. Lip Reconstruction after Tumor Ablation

    PubMed Central

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hossein; Ebrahimi, Azin; Kazemi, Mohammad; Shams, Amin; Hashemzadeh, Haleh

    2016-01-01

    Approximately 25% of all oral cavity carcinomas involve the lips, and the primary management of these lesions is complete surgical resection. Loss of tissue in the lips after resection is treated with a variety of techniques, depending on the extension and location of the defect. Here we review highly accepted techniques of lip reconstruction and some of new trials with significant clinical results. Reconstruction choice is primarily depend to size of the defect, localization of defect, elasticity of tissues. But patient’s age, comorbidities, and motivation are also important. According to the defect location and size, different reconstruction methods can be used. For defects involved less than 30% of lips, primary closures are sufficient. In defects with 35–70% lip involvement, the Karapandzic, Abbe, Estlander, McGregor or Gillies’ fan flaps or their modifications can be used. When lip remaining tissues are insufficient, cheek tissue can be used in Webster and Bernard advancement flaps and their various modifications. Deltopectoral or radial forearm free flaps can be options for large defects of the lip extending to the Jaws. To achieve best functional and esthetic results, surgeons should be able to choose most appropriate reconstruction method. Considering defects’ size and location, patients’ expects and surgeon’s ability and knowledge, a variety of flaps are presented in order to reconstruct defects resulted from tumor ablation. It’s necessary for surgeons to trace the recent innovations in lip reconstruction to offer best choices to patients. PMID:27308236

  2. Physiology Considerations in Geriatric Patients.

    PubMed

    Alvis, Bret D; Hughes, Christopher G

    2015-09-01

    Physiology changes at the structural, functional, and molecular levels as people age, and every major organ system experiences physiologic change with time. The changes to the nervous system result mostly in cognitive impairments, the cardiovascular system develops higher blood pressures with lower cardiac output, the respiratory system undergoes a reduction of arterial oxyhemoglobin levels, the gastrointestinal system experiences delayed gastric emptying and reduction of hepatic metabolism, and the renal system experiences a diminished glomerular filtration rate. Combined, these changes create a complex physiologic condition. This unique physiology must be taken into consideration for geriatric patients undergoing general anesthesia. PMID:26315630

  3. Anesthetic consideration for neurointerventional procedures.

    PubMed

    Joung, Kyung Woon; Yang, Ku Hyun; Shin, Won Jung; Song, Myung Hee; Ham, Kyungdon; Jung, Seung Chul; Lee, Deok Hee; Suh, Dae Chul

    2014-09-01

    Interventional neuroradiology (INR) has been a rapidly expanding and advancing clinical area during the past few decades. As the complexity and diversity of INR procedures increases, the demand for anesthesia also increases. Anesthesia for interventional neuroradiology is a challenge for the anesthesiologist due to the unfamiliar working environment which the anesthesiologist must consider, as well as the unique neuro-interventional components. This review provides an overview of the anesthetic options and specific consideration of the anesthesia requirements for each procedure. We also introduce the anesthetic management for interventional neuroradiology performed in our medical institution.

  4. Health Considerations in Female Runners.

    PubMed

    Kim, Brian Y; Nattiv, Aurelia

    2016-02-01

    Female participation in running is at a historical high. Special consideration should be given to this population, in whom suboptimal nutritional intake, menstrual irregularity, and bone stress injury are common. Immature athletes should garner particular attention. Advances in the understanding of the Triad and Triad-related conditions have largely informed the approach to the health of this population. Clinicians should be well versed in the identification of Triad-related risk factors. A multidisciplinary team may be necessary for the optimal treatment of at-risk runners. Nonpharmacologic strategies to increase energy availability in athletes should be used as first-line treatment. PMID:26616182

  5. Preliminary considerations concerning actinide solubilities

    SciTech Connect

    Newton, T.W.; Bayhurst, B.P.; Daniels, W.R.; Erdal, B.R.; Ogard, A.E.

    1980-01-01

    Work at the Los Alamos Scientific Laboratory on the fundamental solution chemistry of the actinides has thus far been confined to preliminary considerations of the problems involved in developing an understanding of the precipitation and dissolution behavior of actinide compounds under environmental conditions. Attempts have been made to calculate solubility as a function of Eh and pH using the appropriate thermodynamic data; results have been presented in terms of contour maps showing lines of constant solubility as a function of Eh and pH. Possible methods of control of the redox potential of rock-groundwater systems by the use of Eh buffers (redox couples) is presented.

  6. Practical considerations in aeroelastic design

    NASA Technical Reports Server (NTRS)

    Rommel, B. A.; Dodd, A. J.

    1984-01-01

    The structural design process for large transport aircraft is described. Critical loads must be determined from a large number of load cases within the flight maneuver envelope. The structural design is also constrained by considerations of producibility, reliability, maintainability, durability, and damage tolerance, as well as impact dynamics and multiple constraints due to flutter and aeroelasticity. Aircraft aeroelastic design considerations in three distinct areas of product development (preliminary design, advanced design, and detailed design) are presented and contrasted. The present state of the art is challenged to solve the practical difficulties associated with design, analysis, and redesign within cost and schedule constraints. The current practice consists of largely independent engineering disciplines operating with unorganized data interfaces. The need is then demonstrated for a well-planned computerized aeroelastic structural design optimization system operating with a common interdisciplinary data base. This system must incorporate automated interfaces between modular programs. In each phase of the design process, a common finite-element model for static and dynamic optimization is required to reduce errors due to modeling discrepancies. As the design proceeds from the simple models in preliminary design to the more complex models in advanced and detailed design, a means of retrieving design data from the previous models must be established.

  7. Considerations for climate intervention research

    NASA Astrophysics Data System (ADS)

    Duren, R. M.

    2015-12-01

    Action to mitigate greenhouse gas emissions is essential for addressing rapid environmental change in the Earth's polar regions. However, the potential for threshold crossing events in polar climate elements with untenable consequences for society and ecosystems may motivate consideration of additional "climate interventions". A recent National Research Council study identified risks and research needs associated with global scale intervention options such as atmospheric carbon removal and albedo modification. In addition to the issues raised by the NRC panel, any serious study of climate interventions would likely transcend the traditional scope of earth system science. Current observational systems are not designed to detect, attribute or monitor climate intervention attempts and would warrant significant augmentation. Potential field experiments to improve scientific understanding of albedo modification options would likely span a huge range of physical scales, material and energy (some in-family with established atmospheric research but others that would be wholly unprecedented). Targeted interventions focused on polar climate elements have received even less study than global-scale intervention and their consideration could present unique challenges. Finally, research priorities have not yet been informed by any strategy or scenarios about where and when climate interventions might fit in society's portfolio of climate responses.

  8. Psychosocial considerations for mass decontamination.

    PubMed

    Lemyre, Louise; Johnson, Colleen; Corneil, Wayne

    2010-11-01

    Mass exposure to explosions, infectious agents, foodborne illnesses, chemicals or radiological materials may require mass decontamination that have critical psychosocial implications for the public and for both traditional and non-traditional responders in terms of impact and of response. Five main issues are common to mass decontamination events: (i) perception, (ii) somatisation, (iii) media role and communication, (iv) information sharing, (v) behavioural guidance and (vi) organisational issues. Empirical evidence is drawn from a number of cases, including Chernobyl; Goiania, Brazil; the sarin gas attack in Tokyo; the anthrax attacks in the USA; Three Mile Island; and by features of the 2003 severe acute respiratory syndrome pandemic. In this paper, a common platform for mass casualty management is explored and suggestions for mass interventions are proposed across the complete event timeline, from pre-event threat and warning stages through to the impact and reconstruction phases. Implication for responders, healthcare and emergency infrastructure, public behaviour, screening processes, risk communication and media management are described. PMID:20924122

  9. Psychosocial considerations for mass decontamination.

    PubMed

    Lemyre, Louise; Johnson, Colleen; Corneil, Wayne

    2010-11-01

    Mass exposure to explosions, infectious agents, foodborne illnesses, chemicals or radiological materials may require mass decontamination that have critical psychosocial implications for the public and for both traditional and non-traditional responders in terms of impact and of response. Five main issues are common to mass decontamination events: (i) perception, (ii) somatisation, (iii) media role and communication, (iv) information sharing, (v) behavioural guidance and (vi) organisational issues. Empirical evidence is drawn from a number of cases, including Chernobyl; Goiania, Brazil; the sarin gas attack in Tokyo; the anthrax attacks in the USA; Three Mile Island; and by features of the 2003 severe acute respiratory syndrome pandemic. In this paper, a common platform for mass casualty management is explored and suggestions for mass interventions are proposed across the complete event timeline, from pre-event threat and warning stages through to the impact and reconstruction phases. Implication for responders, healthcare and emergency infrastructure, public behaviour, screening processes, risk communication and media management are described.

  10. Alloplastic adjuncts in breast reconstruction

    PubMed Central

    Cabalag, Miguel S.; Rostek, Marie; Miller, George S.; Chae, Michael P.; Quinn, Tam; Rozen, Warren M.

    2016-01-01

    Background There has been an increasing role of acellular dermal matrices (ADMs) and synthetic meshes in both single- and two-stage implant/expander breast reconstruction. Numerous alloplastic adjuncts exist, and these vary in material type, processing, storage, surgical preparation, level of sterility, available sizes and cost. However, there is little published data on most, posing a significant challenge to the reconstructive surgeon trying to compare and select the most suitable product. The aims of this systematic review were to identify, summarize and evaluate the outcomes of studies describing the use of alloplastic adjuncts for post-mastectomy breast reconstruction. The secondary aims were to determine their cost-effectiveness and analyze outcomes in patients who also underwent radiotherapy. Methods Using the PRSIMA 2009 statement, a systematic review was conducted to find articles reporting on the outcomes on the use of alloplastic adjuncts in post-mastectomy breast reconstruction. Multiple databases were searched independently by three authors (Cabalag MS, Miller GS and Chae MP), including: Ovid MEDLINE (1950 to present), Embase (1980 to 2015), PubMed and Cochrane Database of Systematic Reviews. Results Current published literature on available alloplastic adjuncts are predominantly centered on ADMs, both allogeneic and xenogeneic, with few outcome studies available for synthetic meshes. Outcomes on the 89 articles, which met the inclusion criteria, were summarized and analyzed. The reported outcomes on alloplastic adjunct-assisted breast reconstruction were varied, with most data available on the use of ADMs, particularly AlloDerm® (LifeCell, Branchburg, New Jersey, USA). The use of ADMs in single-stage direct-to-implant breast reconstruction resulted in lower complication rates (infection, seroma, implant loss and late revision), and was more cost effective when compared to non-ADM, two-stage reconstruction. The majority of studies demonstrated

  11. Ulnar Collateral Ligament Reconstruction

    PubMed Central

    Erickson, Brandon J.; Bach, Bernard R.; Cohen, Mark S.; Bush-Joseph, Charles A.; Cole, Brian J.; Verma, Nikhil N.; Nicholson, Gregory P.; Romeo, Anthony A.

    2016-01-01

    Background: Ulnar collateral ligament reconstruction (UCLR) is a common surgery performed in professional, collegiate, and high school athletes. Purpose: To report patient demographics, surgical techniques, and outcomes of all UCLRs performed at a single institution from 2004 to 2014. Study Design: Case series; Level of evidence, 4. Methods: All patients who underwent UCLR from January 1, 2004, through December 31, 2014, at a single institution were identified. Charts were reviewed to determine patient age, sex, date of surgery, sport played, athletic level, surgical technique, graft type, and complications. Data were collected prospectively, and patients were contacted via phone calls to obtain the return-to-sport rate, Conway-Jobe score, Andrews-Timmerman score, and Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow score. Continuous variable data were reported as weighted means, and categorical variable data were reported as frequencies with percentages. Results: A total of 187 patients (188 elbows) underwent UCLR during the study period (92% male; mean age, 19.6 ± 4.7 years; 78.2% right elbows). There were 165 baseball players (87.8% of all patients), 155 of whom were pitchers (82.5% of all patients). Ninety-seven (51.6%) were college athletes, 68 (36.2%) high school athletes, and 7 (3.7%) professional athletes at the time of surgery. The docking technique was used in 110 (58.5%) patients while the double-docking technique was used in 78 (41.5%). An ipsilateral palmaris longus graft was used in 110 (58.5%) patients while a hamstring autograft was used in 48 (25.5%) patients. The ulnar nerve was subcutaneously transposed in 79 (42%) patients. Clinical follow-up data were available on 85 patients. Mean follow-up was 60 ± 30.8 months. Overall, 94.1% of patients were able to return to sport and had a Conway-Jobe score of good/excellent while 4.3% had a score of fair. The mean KJOC score was 90.4 ± 6.7 and mean Andrews-Timmerman score was 92.5 ± 7

  12. [Indications and techniques of reconstruction after mastectomy].

    PubMed

    Koch, Nathalie; Delaloye, Jean-François; Raffoul, Wassim

    2012-10-24

    Reconstructive surgery takes an important place in breast cancer treatment. Immediate breast reconstruction is performed during the same operation as mastectomy. It is contraindicated following radiotherapy. Reconstruction performed after mastectomy is called differed breast reconstruction. It is completed 6 months after chemotherapy and 1 year after radiotherapy. Prosthetic breast reconstruction is indicated when tissues are of good qualities and breast are small. Autologous reconstruction is performed in case of radiotherapy or large breast. After breast reconstruction, imperfections can be corrected with autologous fat injection.

  13. Modified functional obturator for the consideration of facial growth in the mucoepidermoid carcinoma pediatric patient.

    PubMed

    Kim, Soung Min; Park, Min Woo; Cho, Young Ah; Myoung, Hoon; Lee, Jong Ho; Lee, Suk Keun

    2015-10-01

    Mucoepidermoid carcinoma (MEC) is a common salivary gland tumor in a adults but is very rare in pediatric patients. The standard treatment of MEC is en bloc resection with wide safety margins and subsequent reconstruction of the jaw, but few surgeons or pediatric specialists have experience with this procedure. An 11-year-old boy received a hemi-maxillectomy with subsequent application of the modified functional obturator (MFO) by the functional matrix concept of Moss. And the patient's face showed normal growth pattern. The purpose of this report is to demonstrate the novel concept of pediatric maxillary reconstruction using MFO for the consideration of facial growth.

  14. Considerations for an exercise prescription

    NASA Technical Reports Server (NTRS)

    Convertino, Victor A.

    1989-01-01

    A number of past and most recent research findings that describe some of the physiological responses to exercise in man and their relationship with exposure to various gravitational environments are discussed. Most of the data pertain to adaptations of the cardiovascular and body fluid systems. It should be kept in mind that the data from studies on microgravity simulation in man include exposures of relatively short duration (5 hours to 14 days). However, it is argued that the results may provide important guidelines for the consideration of many variables which are pertinent to the development of exercise prescription for long-duration space flight. The following considerations for exercise prescriptions during long-duration space flight are noted: (1) Relatively high aerobic fitness and strength, especially of the upper body musculature, should be a criterion for selection of astronauts who will be involved in EVA, since endurance and strength appear to be predominant characteristics for work performance. (2) Some degree of upper body strength will probably be required for effective performance of EVA. However, the endurance and strength required by the upper body for EVA can probably be obtained through preflight exercise prescription which involves swimming. (3) Although some degree of arm exercise may be required to maintain preflight endurance and strength, researchers propose that regular EVA will probably be sufficient to maintain the endurance and strength required to effectively perform work tasks during space flight. (4) A minimum of one maximal aerobic exercise every 7 to 10 days during space flight may be all that is necessary for maintenance of normal cardiovascular responsiveness and replacement of body fluids for reentry following prolonged space flight. (5) The possible reduction in the amount of exercise required for maintenance of cardiovascular system and body fluids in combination with the use of electromyostimulation (EMS) or methods other

  15. Translational considerations for cancer nanomedicine

    PubMed Central

    Stern, Stephan T.; Hall, Jennifer B.; Yu, Lee L.; Wood, Laura J.; Paciotti, Giulio F.; Tamarkin, Lawrence; Long, Stephen E.; McNeil, Scott E.

    2010-01-01

    There are many important considerations during preclinical development of cancer nanomedicines, including: 1) unique aspects of animal study design; 2) the difficulties in evaluating biological potency, especially for complex formulations; 3) the importance of analytical methods that can determine platform stability in vivo, and differentiate bound and free active pharmaceutical ingredient (API) in biological matrices; and 4) the appropriateness of current dose scaling techniques for estimation of clinical first-in-man dose from preclinical data. Biologics share many commonalities with nanotechnology products with regard to complexity and biological attributes, and can, in some cases, provide context for dealing with these preclinical issues. In other instances, such as the case of in vivo stability analysis, new approaches are required. This paper will discuss the significance of these preclinical issues, and present examples of current methods and best practices for addressing them. Where possible, these recommendations are justified using the existing regulatory guidance literature. PMID:20385183

  16. Safety considerations in clinical engineering.

    PubMed

    Scott, R N; Paasche, P E

    1986-01-01

    Clinical engineering is a professional specialty which emerged in the 1960s primarily in response to concern about the hazard of electrocution in hospitals. It has already developed to encompass a much broader range of topics affecting the safe and effective use of technology in health care. However, safety remains as one major focus of clinical engineering. In this paper, issues arising in relation to electrical safety and treated in considerable detail. The next major safety area of concern involves medical gases. This area is newer and, consequently, the issues are less well resolved and therefore it is treated in less detail. Other safety issues, which are numerous, await review at some time in the future.

  17. Design considerations for slurry bioreactors

    SciTech Connect

    Zappi, M.E.; Banerji, S.K.; Bajpai, R.K.

    1994-12-31

    Slurry treatment is an innovative approach for bioremediation of contaminated soils under controlled conditions of pH, temperature, and nutrients. This treatment of excavated soils permits better control of environmental conditions than in landfarming, composting, and biocell units, and therefore may achieve accelerated rates of decontamination. Bioslurry reactors have been used to remediate a variety of contaminants, such as soils and sludges from refinery wastes, wood-preserving wastes, wastes containing polychlorinated biphenyls and halogenated solvents. Key considerations in design of such reactors involve meeting the oxygen requirements for biodegradation, preventing the settling of soil particles, efficient mixing of additives, and control of foaming. The aspects of reactor design, specifically agitation system have been discussed in this paper.

  18. Cultural variation: considerations and implications.

    PubMed

    Cohen, D

    2001-07-01

    Cultural systems vary widely across the world. Partly this is due to different cultures' occupying different ecological and environmental niches. But partly it is due to similar circumstances giving rise to multiple stable equilibriums, each with a distinct cultural form. Using insights and examples from various fields, this article illustrates the way that multiple equilibriums can emerge and the forces that push a culture toward one equilibrium point or another. Considerations of game theory principles, mutual interdependence, historical circumstance, dependence on initial conditions, and crucial choice points are highlighted in discussing the ways humans create and re-create their culture. Cultural traits develop within physical, social, intracultural, and intercultural niches, and implications of this for how culture might be studied and the benefits of combining an "equilibrium" perspective and a "meaning" perspective are discussed. PMID:11439707

  19. Titanium template for scaphoid reconstruction.

    PubMed

    Haefeli, M; Schaefer, D J; Schumacher, R; Müller-Gerbl, M; Honigmann, P

    2015-06-01

    Reconstruction of a non-united scaphoid with a humpback deformity involves resection of the non-union followed by bone grafting and fixation of the fragments. Intraoperative control of the reconstruction is difficult owing to the complex three-dimensional shape of the scaphoid and the other carpal bones overlying the scaphoid on lateral radiographs. We developed a titanium template that fits exactly to the surfaces of the proximal and distal scaphoid poles to define their position relative to each other after resection of the non-union. The templates were designed on three-dimensional computed tomography reconstructions and manufactured using selective laser melting technology. Ten conserved human wrists were used to simulate the reconstruction. The achieved precision measured as the deviation of the surface of the reconstructed scaphoid from its virtual counterpart was good in five cases (maximal difference 1.5 mm), moderate in one case (maximal difference 3 mm) and inadequate in four cases (difference more than 3 mm). The main problems were attributed to the template design and can be avoided by improved pre-operative planning, as shown in a clinical case. PMID:25167978

  20. Investigation of optimization-based reconstruction with an image-total-variation constraint in PET

    NASA Astrophysics Data System (ADS)

    Zhang, Zheng; Ye, Jinghan; Chen, Buxin; Perkins, Amy E.; Rose, Sean; Sidky, Emil Y.; Kao, Chien-Min; Xia, Dan; Tung, Chi-Hua; Pan, Xiaochuan

    2016-08-01

    Interest remains in reconstruction-algorithm research and development for possible improvement of image quality in current PET imaging and for enabling innovative PET systems to enhance existing, and facilitate new, preclinical and clinical applications. Optimization-based image reconstruction has been demonstrated in recent years of potential utility for CT imaging applications. In this work, we investigate tailoring the optimization-based techniques to image reconstruction for PET systems with standard and non-standard scan configurations. Specifically, given an image-total-variation (TV) constraint, we investigated how the selection of different data divergences and associated parameters impacts the optimization-based reconstruction of PET images. The reconstruction robustness was explored also with respect to different data conditions and activity up-takes of practical relevance. A study was conducted particularly for image reconstruction from data collected by use of a PET configuration with sparsely populated detectors. Overall, the study demonstrates the robustness of the TV-constrained, optimization-based reconstruction for considerably different data conditions in PET imaging, as well as its potential to enable PET configurations with reduced numbers of detectors. Insights gained in the study may be exploited for developing algorithms for PET-image reconstruction and for enabling PET-configuration design of practical usefulness in preclinical and clinical applications.

  1. Investigation of iterative image reconstruction in low-dose breast CT

    NASA Astrophysics Data System (ADS)

    Bian, Junguo; Yang, Kai; Boone, John M.; Han, Xiao; Sidky, Emil Y.; Pan, Xiaochuan

    2014-06-01

    There is interest in developing computed tomography (CT) dedicated to breast-cancer imaging. Because breast tissues are radiation-sensitive, the total radiation exposure in a breast-CT scan is kept low, often comparable to a typical two-view mammography exam, thus resulting in a challenging low-dose-data-reconstruction problem. In recent years, evidence has been found that suggests that iterative reconstruction may yield images of improved quality from low-dose data. In this work, based upon the constrained image total-variation minimization program and its numerical solver, i.e., the adaptive steepest descent-projection onto the convex set (ASD-POCS), we investigate and evaluate iterative image reconstructions from low-dose breast-CT data of patients, with a focus on identifying and determining key reconstruction parameters, devising surrogate utility metrics for characterizing reconstruction quality, and tailoring the program and ASD-POCS to the specific reconstruction task under consideration. The ASD-POCS reconstructions appear to outperform the corresponding clinical FDK reconstructions, in terms of subjective visualization and surrogate utility metrics.

  2. Plastic Surgery Challenges in War Wounded I: Flap-Based Extremity Reconstruction

    PubMed Central

    Sabino, Jennifer M.; Slater, Julia; Valerio, Ian L.

    2016-01-01

    Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases. Advanced reconstructive techniques coupled with regenerative medicine applications have played a critical role in the restoration, recovery, and rehabilitation of functional limb salvage. Translational Relevance: The past 14 years of war trauma have increased our understanding of tissue transfer for extremity reconstruction in the treatment of combat casualties. Injury patterns, flap choice, and reconstruction timing are critical variables to consider for optimal outcomes. Clinical Relevance: Subacute reconstruction with specifically chosen flap tissue and donor site location based on individual injuries result in successful tissue transfer, even in critically injured patients. These considerations can be combined with regenerative therapies to optimize massive wound coverage and limb salvage form and function in previously active patients. Summary: Traditional soft tissue reconstruction is integral in the treatment of war extremity trauma. Pedicle and free flaps are a critically important part of the reconstructive ladder for salvaging extreme extremity injuries that are seen as a result of the current practice of war. PMID:27679751

  3. Plastic Surgery Challenges in War Wounded I: Flap-Based Extremity Reconstruction

    PubMed Central

    Sabino, Jennifer M.; Slater, Julia; Valerio, Ian L.

    2016-01-01

    Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases. Advanced reconstructive techniques coupled with regenerative medicine applications have played a critical role in the restoration, recovery, and rehabilitation of functional limb salvage. Translational Relevance: The past 14 years of war trauma have increased our understanding of tissue transfer for extremity reconstruction in the treatment of combat casualties. Injury patterns, flap choice, and reconstruction timing are critical variables to consider for optimal outcomes. Clinical Relevance: Subacute reconstruction with specifically chosen flap tissue and donor site location based on individual injuries result in successful tissue transfer, even in critically injured patients. These considerations can be combined with regenerative therapies to optimize massive wound coverage and limb salvage form and function in previously active patients. Summary: Traditional soft tissue reconstruction is integral in the treatment of war extremity trauma. Pedicle and free flaps are a critically important part of the reconstructive ladder for salvaging extreme extremity injuries that are seen as a result of the current practice of war.

  4. Conservative mastectomies and Immediate-DElayed AutoLogous (IDEAL) breast reconstruction: the DIEP flap

    PubMed Central

    Nestle-Krämling, Carolin; Fertsch, Sonia; Hagouan, Mazen; Munder, Beatrix; Richrath, Philip; Stambera, Peter; Abu-Ghazaleh, Alina; Andree, Christoph

    2016-01-01

    Background With the development of conservative mastectomies, there are an increasing number of women seeking immediate implant based and autologous breast reconstruction. Despite the oncologic safety of the procedures, the focus will be on the timing of reconstruction. Methods Our plastic surgery unit is focused primarily on autologous breast reconstruction and is part of an interdisciplinary breast center. We offer immediate breast reconstruction (IBR) with autologous tissue for patients with positive BRCA 1 and 2, ductal carcinoma in situ (DCIS), invasive cancer without margin problems to the skin, as well as to correct poor oncologic and aesthetic breast conserving therapy (BCT) outcomes. In the majority of cases we prefer an Immediate-DElayed AutoLogous (IDEAL) breast reconstruction concept with a two-stage procedure. Results Over the last 10 years we performed more than 1,600 breast reconstructions with free flaps, performing the deep inferior epigastric perforator (DIEP) flap as our first choice for autologous tissue. We recommend IDEAL breast reconstruction, however approximately 15% of our cases are immediate one stage conservative mastectomies and breast reconstruction with the DIEP flap. Conclusions For immediate reconstruction, the aesthetic outcome should not take precedence over oncologic considerations. Immediate one-stage, breast reconstruction with autologous tissue can be offered to the suitable patients which is most likely a healthy women with a small-to-medium sized non ptotic breast receiving a conservative mastectomy. In all other cases, we recommend an IDEAL breast reconstruction approach in order to achieve a final result that is both satisfyingly pleasing and oncologically safe. PMID:26855905

  5. Bayesian optimal reconstruction of the primordial power spectrum

    NASA Astrophysics Data System (ADS)

    Bridges, M.; Feroz, F.; Hobson, M. P.; Lasenby, A. N.

    2009-12-01

    The form of the primordial power spectrum has the potential to differentiate strongly between competing models of perturbation generation in the early universe and so is of considerable importance. The recent release of five years of Wilkinson Microwave Anisotropy Probe observations have confirmed the general picture of the primordial power spectrum as deviating slightly from scale invariance with a spectral tilt parameter of ns ~ 0.96. None the less, many attempts have been made to isolate further features such as breaks and cut-offs using a variety of methods, some employing more than ~10 varying parameters. In this paper, we apply the robust technique of the Bayesian model selection to reconstruct the optimal degree of structure in the spectrum. We model the spectrum simply and generically as piecewise linear in lnk between `nodes' in k space whose amplitudes are allowed to vary. The number of nodes and their k-space positions are chosen by the Bayesian evidence so that we can identify both the complexity and location of any detected features. Our optimal reconstruction contains, perhaps, surprisingly few features, the data preferring just three nodes. This reconstruction allows for a degree of scale dependence of the tilt with the `turn-over' scale occurring around k ~ 0.016 Mpc-1. More structure is penalized by the evidence as overfitting the data, so there is currently little point in attempting reconstructions that are more complex.

  6. The reconstruction of inflationary potentials

    NASA Astrophysics Data System (ADS)

    Lin, Jianmang; Gao, Qing; Gong, Yungui

    2016-07-01

    The observational data on the anisotropy of the cosmic microwave background constraints the scalar spectral tilt ns and the tensor to scalar ratio r which depend on the first and second derivatives of the inflaton potential. The information can be used to reconstruct the inflaton potential in the polynomial form up to some orders. However, for some classes of potentials, ns and r behave as ns(N) and r(N) universally in terms of the number of e-folds N. The universal behaviour of ns(N) can be used to reconstruct a class of inflaton potentials. By parametrizing one of the parameters ns(N), ɛ(N) and φ(N), and fitting the parameters in the models to the observational data, we obtain the constraints on the parameters and reconstruct the classes of the inflationary models which include the chaotic inflation, T-model, hilltop inflation, s-dual inflation, natural inflation and R2 inflation.

  7. Reconstructing Ancient Forms of Life

    NASA Technical Reports Server (NTRS)

    Benner, Steven A.

    1998-01-01

    Progress in the past three months has occurred in two areas, reconstruction of ancestral proteins and improved understanding of chemical features that are likely to be universal in generic matter regardless of its genesis. Ancestral ribonucleases have been reconstructed, and an example has been developed that shows how physiological function can be assigned to in vitro behaviors observed in biological systems. Sequence data have been collected to permit the reconstruction of src homology 2 domains that underwent radiative divergence at the time of the radiative divergence of chordates. New studies have been completed that show how genetic matter (or its remnants) might be detected on Mars (or other non-terrean locations.) Last, the first in vitro selection experiments have been completed using a nucleoside library carrying positively charged functionality, illustrating the importance of non-standard nucleotides to those attempting to obtain evidence for an "RNA world" as an early episode of life on earth.

  8. Upper Blepharoplasty for Areola Reconstruction.

    PubMed

    Friedrich, O L; Heil, J; Golatta, M; Domschke, C; Sohn, C; Blumenstein, M

    2013-07-01

    Blepharoplasty is one of the most common rejuvenating facial plastic surgery procedures. The procedure has been described many times and has very few complications. The tissue removed from the upper eyelid during blepharoplasty can be used as a skin graft for areola reconstruction due to the tissue's similarity to the areola's natural skin. The present study investigated the use of upper blepharoplasty for areola reconstruction. Criteria were patient satisfaction, objective measurements and the assessment of cosmesis by a panel of physicians. All eight patients included in the study were very satisfied with the cosmetic result. Objective measurements and assessment by a panel of physicians using photographs of the reconstructed nipple-areola complex showed very good aesthetic results.

  9. Upper Blepharoplasty for Areola Reconstruction

    PubMed Central

    Friedrich, O. L.; Heil, J.; Golatta, M.; Domschke, C.; Sohn, C.; Blumenstein, M.

    2013-01-01

    Blepharoplasty is one of the most common rejuvenating facial plastic surgery procedures. The procedure has been described many times and has very few complications. The tissue removed from the upper eyelid during blepharoplasty can be used as a skin graft for areola reconstruction due to the tissueʼs similarity to the areolaʼs natural skin. The present study investigated the use of upper blepharoplasty for areola reconstruction. Criteria were patient satisfaction, objective measurements and the assessment of cosmesis by a panel of physicians. All eight patients included in the study were very satisfied with the cosmetic result. Objective measurements and assessment by a panel of physicians using photographs of the reconstructed nipple-areola complex showed very good aesthetic results. PMID:24771929

  10. Space Tourism: Orbital Debris Considerations

    NASA Astrophysics Data System (ADS)

    Mahmoudian, N.; Shajiee, S.; Moghani, T.; Bahrami, M.

    2002-01-01

    Space activities after a phase of research and development, political competition and national prestige have entered an era of real commercialization. Remote sensing, earth observation, and communication are among the areas in which this growing industry is facing competition and declining government money. A project like International Space Station, which draws from public money, has not only opened a window of real multinational cooperation, but also changed space travel from a mere fantasy into a real world activity. Besides research activities for sending man to moon and Mars and other outer planets, space travel has attracted a considerable attention in recent years in the form of space tourism. Four countries from space fairing nations are actively involved in the development of space tourism. Even, nations which are either in early stages of space technology development or just beginning their space activities, have high ambitions in this area. This is worth noting considering their limited resources. At present, trips to space are available, but limited and expensive. To move beyond this point to generally available trips to orbit and week long stays in LEO, in orbital hotels, some of the required basic transportations, living requirements, and technological developments required for long stay in orbit are already underway. For tourism to develop to a real everyday business, not only the price has to come down to meaningful levels, but also safety considerations should be fully developed to attract travelers' trust. A serious hazard to space activities in general and space tourism in particular is space debris in earth orbit. Orbiting debris are man-made objects left over by space operations, hazardous to space missions. Since the higher density of debris population occurs in low earth orbit, which is also the same orbit of interest to space tourism, a careful attention should be paid to the effect of debris on tourism activities. In this study, after a

  11. Shape Reconstruction from Generalized Projections

    NASA Astrophysics Data System (ADS)

    Viikinkoski, Matti

    2016-01-01

    In this thesis we develop methods for recovering the three-dimensional shape of an object from generalized projections. We particularly focus on the problems encountered when data are presented as discrete image fields. We demonstrate the usefulness of the Fourier transform in transferring the image data and shape model projections to a domain more suitable for gradient based optimization. To substantiate the general applicability of our methods to observational astronomy, we reconstruct shape models for several asteroids observed with adaptive optics, thermal infrared interferometry, or range-Doppler radar. The reconstructions are carried out with the ADAM software package that we have designed for general use.

  12. Heminasal agenesis: a reconstructive challenge.

    PubMed

    Fisher, Mark; Zelken, Jonathan; Redett, Richard J

    2014-05-01

    Heminasal agenesis is a rare congenital malformation often associated with deformities of the eyes and lacrimal system, midface, and proboscis lateralis. Reconstruction is especially challenging because of missing lining, cartilage, and skin. We present a case of heminasal agenesis in a 5-year-old girl with concomitant hypertelorism, coloboma of the eyelids, and maxillary hypoplasia. The patient underwent facial bipartition for hypertelorism correction and cantilever bone graft. A forehead flap was designed using an anaplastic model from the patient's twin sister. Cartilage harvested from the conchal bowl and rib provided alar and dorsal support. Reconstructive goals, timing, and options are discussed. PMID:24777004

  13. Shape reconstruction from gradient data

    SciTech Connect

    Ettl, Svenja; Kaminski, Juergen; Knauer, Markus C.; Haeusler, Gerd

    2008-04-20

    We present a generalized method for reconstructing the shape of an object from measured gradient data. A certain class of optical sensors does not measure the shape of an object but rather its local slope. These sensors display several advantages, including high information efficiency, sensitivity, and robustness. For many applications, however, it is necessary to acquire the shape, which must be calculated from the slopes by numerical integration. Existing integration techniques show drawbacks that render them unusable in many cases. Our method is based on an approximation employing radial basis functions. It can be applied to irregularly sampled, noisy, and incomplete data, and it reconstructs surfaces both locally and globally with high accuracy.

  14. [Reconstructions after periorbital burn injuries].

    PubMed

    Klett, A; Rebane, R

    2013-01-01

    Nowadays burn patients who also have periocular symptoms are usually treated by reconstructive surgeons and the role of the ophthalmic surgeon has decreased.Although periocular complications occur in a minority of burned patients, they pose a greater challenge in surgical and non-surgical treatment. Chemical, electrical and thermal burns can lead to disfiguring scar formations and delayed treatment can lead to devastating ocular complications. Achieving a successful reconstruction requires a comprehensive approach, entailing many advanced techniques with an emphasis on preserving function and balancing intricate aesthetic requirements. The theory is illustrated in this article with clinical examples. PMID:23345146

  15. Tuberous Sclerosis Complex: Perioperative Considerations

    PubMed Central

    Rabito, Matthew J.; Kaye, Alan David

    2014-01-01

    Background Tuberous sclerosis complex (TSC), also known as Bourneville disease, is an inherited, progressive neurocutaneous disorder characterized by the potential for hamartoma formation throughout the body. TSC is an autosomal dominant genetic disorder, but more than two-thirds of cases are sporadic. Methods Clinical manifestations and treatment options are discussed. Both surgical and anesthetic perioperative considerations are described in this review. Results Routine monitoring is appropriate for minor surgical procedures for patients with TSC who have mild disease manifestations. More extensive monitoring is indicated for major procedures that have the potential for significant blood loss and for patients with more severe pathology. Postoperatively, TSC patients should be admitted for monitoring and treatment after more extensive procedures or if significant organ dysfunction occurs. Postoperative complications, which may be related to either the surgery or the TSC pathology itself, may have origins in many different organs and may include seizures, severe hypertension, and bradyarrhythmias. Conclusion TSC is a rare disease with a highly variable clinical presentation and provides a multitude of challenges for the patient, the family, and the healthcare team. PMID:24940133

  16. Canonical considerations in corporate restructuring.

    PubMed

    Holland, S

    1985-03-01

    Religious institutes sponsoring Catholic health facilities face competitive economic pressures that impel them to seek corporate restructuring and joint ventures to fulfill their mission to the poor. They especially must look to the Church's Code of Canon Law to protect ecclesiastical goods and maintain their Catholic identity when entering such ventures. The U.S. bishops directives also assist in guaranteeing patient expectations that the health facility will observe the Church's ethical principles. Institutes first must ensure that subsidiaries will operate according to Catholic mission and philosophy. The canons delineate proper protection of assets and identify ends toward which the religious must apply temporal goods, such as supporting clergy and performing charitable works. Alienation, or conveyance of goods, is a critical consideration in such financial transactions; canons specify the institute's administrative limits and require superiors' written permission along with their councils' consent. All involved must be "thoroughly informed concerning the economic situation," show "just cause" for the transaction, and obtain expert estimates of property values. Religious administrators retain certain faith and executive obligations, such as amending the charter, appointing the board, and merging or dissolving the corporation. With the canons they help to ensure that collaborative efforts preserve the institute's corporate mission and allow religious to carry out their responsibility for ecclesiastical goods. Though alternatives to corporate ventures may be limited, options regarding how to structure and with whom to affiliate do exist. Sponsoring bodies dedicated to providing high-quality care must explore these options

  17. [Postoperative digestive fistulas. Etiopathogenic considerations].

    PubMed

    Munteanu, Iulia; Stefan, S; Sirbu-Boeti, Mirela; Popescu, R; Burcoveanu, Ioana; Topală, Roxana; Burcoveanu, C

    2009-01-01

    The digestive fistula is one of the most serious complications that might appear following different types of resectional digestive surgery. This condition still carries a considerable morbidity and mortality rate and therefore all surgical and ICU staff pay a great deal of attention and intensify their care to avoid the fatalities. The postoperative digestive fistulas, through their physiopathological and clinical complexity induce the disturbance of the biological equilibrium with vital consequences. The trend of the last decades is the increasing of digestive fistulas incidence with a variable mortality rate after different authors. A therapeutic algorithm is needed. The mortality rate due to digestive fistulas, two decades ago was, around 60%; at the present there is a decrease of the mortality rate, which is around 10%. The explanation is the introduction of the new methods of treatment such as lactic acid lavage aspiration for alkaline fistulas or total parenteral nutrition, continuous enteral nutrition and antiexocrine chemotherapy. A fistula is a communication between two epithelial or endothelial surfaces, lined by granulation tissue. It can be a life-threatening condition. PMID:21495307

  18. Reconstructing geographical boundary conditions for palaeoclimate modelling during the Cenozoic

    NASA Astrophysics Data System (ADS)

    Baatsen, Michiel; van Hinsbergen, Douwe J. J.; von der Heydt, Anna S.; Dijkstra, Henk A.; Sluijs, Appy; Abels, Hemmo A.; Bijl, Peter K.

    2016-08-01

    Studies on the palaeoclimate and palaeoceanography using numerical model simulations may be considerably dependent on the implemented geographical reconstruction. Because building the palaeogeographic datasets for these models is often a time-consuming and elaborate exercise, palaeoclimate models frequently use reconstructions in which the latest state-of-the-art plate tectonic reconstructions, palaeotopography and -bathymetry, or vegetation have not yet been incorporated. In this paper, we therefore provide a new method to efficiently generate a global geographical reconstruction for the middle-late Eocene. The generalised procedure is also reusable to create reconstructions for other time slices within the Cenozoic, suitable for palaeoclimate modelling. We use a plate-tectonic model to make global masks containing the distribution of land, continental shelves, shallow basins and deep ocean. The use of depth-age relationships for oceanic crust together with adjusted present-day topography gives a first estimate of the global geography at a chosen time frame. This estimate subsequently needs manual editing of areas where existing geological data indicate that the altimetry has changed significantly over time. Certain generic changes (e.g. lowering mountain ranges) can be made relatively easily by defining a set of masks while other features may require a more specific treatment. Since the discussion regarding many of these regions is still ongoing, it is crucial to make it easy for changes to be incorporated without having to redo the entire procedure. In this manner, a complete reconstruction can be made that suffices as a boundary condition for numerical models with a limited effort. This facilitates the interaction between experts in geology and palaeoclimate modelling, keeping reconstructions up to date and improving the consistency between different studies. Moreover, it facilitates model inter-comparison studies and sensitivity tests regarding certain

  19. 46 CFR 390.3 - Policy considerations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... of an existing vessel, unless such reconstruction will exceed $1,000,000 in cost, will be capitalized... may waive the monetary limit in paragraph (b)(2)(i) of this section where the applicant proposes...

  20. 46 CFR 390.3 - Policy considerations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... of an existing vessel, unless such reconstruction will exceed $1,000,000 in cost, will be capitalized... may waive the monetary limit in paragraph (b)(2)(i) of this section where the applicant proposes...

  1. The reconstructive microsurgery ladder in orthopaedics.

    PubMed

    Tintle, Scott M; Levin, L Scott

    2013-03-01

    Since the advent of the operating microscope by Julius Jacobson in 1960, reconstructive microsurgery has become an integral part of extremity reconstruction and orthopaedics. During World War I, with the influx of severe extremity trauma Harold Gillies introduced the concept of the reconstructive ladder for wound closure. The concept of the reconstructive ladder goes from simple to complex means of attaining wound closure. Over the last half century microsurgery has continued to evolve and progress. We now have a microsurgical reconstructive ladder. The microsurgical reconstruction ladder is based upon the early work on revascularization and replantation extending through the procedures that are described in this article.

  2. The reconstructive microsurgery ladder in orthopaedics.

    PubMed

    Tintle, Scott M; Levin, L Scott

    2013-03-01

    Since the advent of the operating microscope by Julius Jacobson in 1960, reconstructive microsurgery has become an integral part of extremity reconstruction and orthopaedics. During World War I, with the influx of severe extremity trauma Harold Gillies introduced the concept of the reconstructive ladder for wound closure. The concept of the reconstructive ladder goes from simple to complex means of attaining wound closure. Over the last half century microsurgery has continued to evolve and progress. We now have a microsurgical reconstructive ladder. The microsurgical reconstruction ladder is based upon the early work on revascularization and replantation extending through the procedures that are described in this article. PMID:23352571

  3. 14 CFR 1203.303 - Dissemination considerations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Dissemination considerations. 1203.303 Section 1203.303 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.303 Dissemination considerations. The...

  4. 14 CFR 1203.303 - Dissemination considerations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Dissemination considerations. 1203.303 Section 1203.303 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.303 Dissemination considerations. The...

  5. 14 CFR 1203.303 - Dissemination considerations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Dissemination considerations. 1203.303 Section 1203.303 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.303 Dissemination considerations. The...

  6. 32 CFR 643.53 - Consideration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Consideration. 643.53 Section 643.53 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE Leases § 643.53 Consideration. (a) Unless otherwise authorized by this regulation or directed by the SA, the consideration for a lease of real...

  7. 14 CFR 1203.303 - Dissemination considerations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Dissemination considerations. 1203.303 Section 1203.303 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.303 Dissemination considerations. The...

  8. Breast cancer in young women: special considerations in multidisciplinary care

    PubMed Central

    Reyna, Chantal; Lee, Marie Catherine

    2014-01-01

    Breast cancer is one of the most prevalent cancers in females, and 5%–7% of breast cancer cases occur in women under 40 years of age. Breast cancer in the young has gained increased attention with an attempt to improve diagnosis and prognosis. Young patients tend to have different epidemiology, presenting with later stages and more aggressive phenotypes. Diagnostic imaging is also more difficult in this age group. Multidisciplinary care generally encompasses surgeons, medical oncologists, radiation oncologists, radiologists, and social workers. Other special considerations include reconstruction options, fertility, genetics, and psychosocial issues. These concerns enlarge the already diverse multidisciplinary team to incorporate new expertise, such as reproductive specialists and genetic counselors. This review encompasses an overview of the current multimodal treatment regimens and the unique challenges in treating this special population. Integration of diagnosis, treatment, and quality of life issues should be addressed and understood by each member in the interdisciplinary team in order to optimize outcomes. PMID:25300196

  9. PRISM3/GISS Topographic Reconstruction

    USGS Publications Warehouse

    Sohl, Linda E.; Chandler, Mark A.; Schmunk, Robert B.; Mankoff, Ken; Jonas, Jeffrey A.; Foley, Kevin M.; Dowsett, Harry J.

    2009-01-01

    The PRISM3/GISS topographic reconstruction is one of the global data sets incorporated into a new reconstruction for the mid-Piacenzian warm interval of the Pliocene, at about 3.3 to 3.0 Ma. The PRISM3/GISS topography-gridded data set is a digitization of a graphical reconstruction, provided at 2 deg x 2 deg resolution and based on updated paleoaltimetry data and a refined land/ocean mask. Mid-Piacenzian topography as shown in this data set is generally quite similar to modern topography, with three notable differences: (1) the coastline as shown is 25 meters higher than modern sea level, reflecting the hypothesized reduction in ice sheet volume; (2) Hudson Bay is filled in to low elevation, in the absence of evidence for submergence at that time; and (3) the West Antarctic ice sheet is absent, permitting open seaways to exist in Ellsworth and Marie Byrd Lands. Two alternate ice sheet configurations with corresponding vegetation schemes are available; one is a minor modification of the PRISM2 ice reconstruction, and one is derived from the British Antarctic Survey Ice Sheet Model (BAS ISM).

  10. Reconstructing Death in Postmodern Society.

    ERIC Educational Resources Information Center

    Kastenbaum, Robert

    1993-01-01

    Examines interaction between emerging thanatological movement and its sociohistorical context. Notes that thanatology will take on new shape as individuals and society attempt to cope with postmodernistic forces and deconstructive mentality. Considers prospect for authentic solidarity against distress in reconstructed death system. (Author/NB)

  11. Poethical: Breaking Ground for Reconstruction

    ERIC Educational Resources Information Center

    Krojer, Jo; Holge-Hazelton, Bibi

    2008-01-01

    Departing from a methodological experiment performed by the authors, this article reflects on and discusses issues of ethics and politics in poetic strategies of "representation". In relation to the experiment the article questions how to conceive the notion of connectedness between empirical time and the reconstruction of it in poststructuralist…

  12. Microsurgical reconstruction of the hand.

    PubMed

    Gould, J S

    1987-12-01

    Microsurgical reconstruction of the hand includes methods of surface coverage, replacement of end organ sensibility, component restoration of tendons and joints, and composite transfers of toes and toe parts for digits and thumbs. In the past decade, these procedures have become available in most university medical centers.

  13. Ulysses S. Grant and Reconstruction.

    ERIC Educational Resources Information Center

    Wilson, David L.

    1989-01-01

    Discusses the role played by Ulysses S. Grant during the four years of Reconstruction before he became President of the United States. Describes the dynamics of the relationship between Grant and Andrew Johnson. Points out that Grant's attitude of service to the laws created by Congress submerged his desire to create a new South. (KO)

  14. Reconstruction: From the Students' Perspective.

    ERIC Educational Resources Information Center

    Schaeffer, Lys A.

    1989-01-01

    Presents two lesson plans for learning strategies employing the skills of empathy and reciprocity. The lessons cover the Black Codes developed during Reconstruction and the impeachment of Andrew Johnson. Lists objectives, instructional procedures, and makes suggestions for essay questions to be used in summative evaluation procedures. (KO)

  15. Ethical considerations in sex selection.

    PubMed

    Eftekhaari, Tasnim Eghbal; Nejatizadeh, Abdol Azim; Rajaei, Minoo; Soleimanian, Saeede; Fallahi, Soghra; Ghaffarzadegan, Rahman; Mahmoudi, Forough

    2015-01-01

    Advances in modern medicine are resulted from unrestricted and unlimited research disregarding many essentials of a research including ethical issues. Following ethical issues, many of unwanted pregnancies and abortions can be avoided. Several factors such as medical issues including X linked disease, has encouraged couples to select traditional or modern techniques in selecting the gender of their children. Some of these methods are corrected Swim-up method or washing of spermatozoa, Percoll gradient sperm separation method, grass wool column filter method method, albumin separation method, microsort method using FISH (Fluorescence in situ hybridization), free electrophoresis method, Ph adjustment method, pre implantation genetic diagnosis (PGD)/fluorescence in situ hybridization. This technology is confronted with many ethical issues. Ethical considerations PGD in the SEX SELECTION differ in different religions and their perspectives on this issue. In this this review, electronic databases, books and Internet sites were completely searched and full articles including required keywords and techniques were obtained and reviewed. The rites and religions, were different and had legal perspectives and opinions about PGD. In some non-Islamic countries there are strict rules to control the use of technology. Some of these methods are costly and even risky. They also involve ethical issues such as legitimacy of the conceived fetus; recommending final touches in sex selection is still considered a taboo and a big issue in some cultures or mono-sexual families. Islamic views and beliefs are more flexible and the use of these technologies are allowed to preserve the health and lives permit. Islam strongly favors humanity and supports different issues if they are not in conflict with the primary concept of legitimate reproduction and are beneficial to human beings. PMID:26097846

  16. Percutaneous penetration--methodological considerations.

    PubMed

    Holmgaard, Rikke; Benfeldt, Eva; Nielsen, Jesper B

    2014-07-01

    Studies on percutaneous penetration are needed to assess the hazards after unintended occupational skin exposures to industrial products as well as the efficacy after intended consumer exposure to topically applied medicinal or cosmetic products. During recent decades, a number of methods have been developed to replace methods involving experimental animals. The results obtained from these methods are decided not only by the chemical or product tested, but to a significant degree also by the experimental set-up and decisions made by the investigator during the planning phase. The present MiniReview discusses some of the existing and well-known experimental in vitro and in vivo methods for studies of percutaneous penetration together with some more recent and promising methods. After this, some considerations and recommendations about advantages and limitations of the different methods and their relevance for the prediction of percutaneous penetration are given. Which method to prefer will depend on the product to be tested and the question asked. Regulatory guidelines exist for studies on percutaneous penetration, but researchers as well as regulatory bodies need to pay specific attention to the vehicles and solvents used in donor and sampling fluids so that it reflects in-use conditions as closely as possible. Based on available experimental data, mathematical models have been developed to aid predictions of skin penetration. The authors question the general use of the present mathematical models in hazard assessment, as they seem to ignore outliers among chemicals as well as the heterogeneity of skin barrier properties and skin conditions within the exposed populations. PMID:24373389

  17. Materials considerations in accelerator targets

    SciTech Connect

    Peacock, H.B. Jr.; Iyer, N.C.; Louthan, M.R. Jr.

    1994-08-01

    Future nuclear materials production and/or the burn-up of long lived radioisotopes may be accomplished through the capture of spallation produced neutrons in accelerators. Aluminum clad-lead and/or lead alloys has been proposed as a spallation target. Aluminum was the cladding choice because of the low neutron absorption cross section, fast radioactivity decay, high thermal conductivity, and excellent fabricability. Metallic lead and lead oxide powders were considered for the target core with the fabrication options being casting or powder metallurgy (PM). Scoping tests to evaluate gravity casting, squeeze casting, and casting and swaging processes showed that, based on fabricability and heat transfer considerations, squeeze casting was the preferred option for manufacture of targets with initial core cladding contact. Thousands of aluminum clad aluminum-lithium alloy core targets and control rods for tritium production have been fabricated by coextrusion processes and successfully irradiated in the SRS reactors. Tritium retention in, and release from the coextruded product was modeled from experimental and operational data. Newly produced tritium atoms were trapped by lithium atoms to form a lithium tritide. The effective tritium pressure required for trap or tritide stability was the equilibrium decomposition pressure of tritium over a lithium tritide-aluminum mixture. The temperature dependence of tritium release was determined by the permeability of the cladding to tritium and the local equilibrium at the trap sites. The model can be used to calculate tritium release from aluminum clad, aluminum-lithium alloy targets during postulated accelerator operational and accident conditions. This paper describes the manufacturing technologies evaluated and presents the model for tritium retention in aluminum clad, aluminum-lithium alloy tritium production targets.

  18. Ethical considerations in orthopaedic surgery.

    PubMed

    Capozzi, J D; Rhodes, R; Springfield, D S

    2000-01-01

    Because our actions as physicians have far-reaching consequences, and because society allows us to do things to others that no one else is free to do, physicians' professional activities fall under the domain of ethical evaluation. We are charged with the obligation to use specialized scientific knowledge, to work in concert with others, and to act for the good of our patients. In fact, acting for the good of our patients is the central tenet of ethical medical behavior. What constitutes the good of the patient, however, is not always clear. In general, we act to limit disease, restore function, alleviate suffering, and prolong life. We understand fully, however, that these goals may conflict with one another. Judgment about what is right for a particular patient leads us to another crucial consideration of ethical behavior, namely, respect for patient autonomy. We recognize that individuals have the right to control their own destiny. Patients have a right, therefore, to make choices about their medical care. As physicians, we must respect those rights. As such, certain ethical behavior is expected of us. We must be honest with our patients. We must provide them with accurate information on which to base their decisions. We must convey to them information about their diagnosis, prognosis, and treatment, even when it is unpleasant to do so. We must be open about our expertise and level of training for a particular procedure. We must respect their privacy and their right to withhold information even from family and friends. In short, we must respect their choices, even if we may disagree with those choices. To truly respect patient autonomy is to understand that, ultimately, the final decision lies with the patient. PMID:10829220

  19. Considerations on causality in pharmacovigilance.

    PubMed

    Edwards, I Ralph

    2012-01-01

    Causality has been a topic of debate by philosophers, scientists, lawyers and for centuries. It is essential to define as precisely as possible all steps in the logical chain of events, since each may strengthen or confound an argument. Almost always there are issues of missing and conflicting data that need to be addressed specifically. In pharmacovigilance, as in many other situations, there is not just one possible causation for an effect but several. Each must be evaluated in the given context for probability. There is also likely to be a causal chain of events to the adverse effect under consideration, and each must be considered. In an individual patient diagnosis the components of patient history, clinical findings and various laboratory test findings are combined to point to the probability of the patho-physiological diagnosis, which in turn is related to possible causes with a strength determined by the constellation of findings. The established Bradford-Hill criteria are valuable in considering all the possible causal factors. Pharmacoepidemiology allows for population incidences of causes for particular effects and therefore provides an a priori probability listing for competing possible causes, or at least of one possible cause against the background of all others in a control group. Since adverse effects of medicines are generally rare, it is not possible to exclude drug causation in an individual by reliance on epidemiological evidence alone, only to argue that the incidence is below a level determined by statistical power, of the study or studies combined. Other areas of society are concerned with the process of causal inference, and this is especially true in legal cases in which judgements are made on possible personal injury by drugs.

  20. Ethical considerations in sex selection

    PubMed Central

    Eftekhaari, Tasnim Eghbal; Nejatizadeh, Abdol Azim; Rajaei, Minoo; Soleimanian, Saeede; Fallahi, Soghra; Ghaffarzadegan, Rahman; Mahmoudi, Forough

    2015-01-01

    Advances in modern medicine are resulted from unrestricted and unlimited research disregarding many essentials of a research including ethical issues. Following ethical issues, many of unwanted pregnancies and abortions can be avoided. Several factors such as medical issues including X linked disease, has encouraged couples to select traditional or modern techniques in selecting the gender of their children. Some of these methods are corrected Swim-up method or washing of spermatozoa, Percoll gradient sperm separation method, grass wool column filter method method, albumin separation method, microsort method using FISH (Fluorescence in situ hybridization), free electrophoresis method, Ph adjustment method, pre implantation genetic diagnosis (PGD)/fluorescence in situ hybridization. This technology is confronted with many ethical issues. Ethical considerations PGD in the SEX SELECTION differ in different religions and their perspectives on this issue. In this this review, electronic databases, books and Internet sites were completely searched and full articles including required keywords and techniques were obtained and reviewed. The rites and religions, were different and had legal perspectives and opinions about PGD. In some non-Islamic countries there are strict rules to control the use of technology. Some of these methods are costly and even risky. They also involve ethical issues such as legitimacy of the conceived fetus; recommending final touches in sex selection is still considered a taboo and a big issue in some cultures or mono-sexual families. Islamic views and beliefs are more flexible and the use of these technologies are allowed to preserve the health and lives permit. Islam strongly favors humanity and supports different issues if they are not in conflict with the primary concept of legitimate reproduction and are beneficial to human beings. PMID:26097846

  1. Ancestral reconstruction of tick lineages.

    PubMed

    Mans, Ben J; de Castro, Minique H; Pienaar, Ronel; de Klerk, Daniel; Gaven, Philasande; Genu, Siyamcela; Latif, Abdalla A

    2016-06-01

    Ancestral reconstruction in its fullest sense aims to describe the complete evolutionary history of a lineage. This depends on accurate phylogenies and an understanding of the key characters of each parental lineage. An attempt is made to delineate our current knowledge with regard to the ancestral reconstruction of the tick (Ixodida) lineage. Tick characters may be assigned to Core of Life, Lineages of Life or Edges of Life phenomena depending on how far back these characters may be assigned in the evolutionary Tree of Life. These include housekeeping genes, sub-cellular systems, heme processing (Core of Life), development, moulting, appendages, nervous and organ systems, homeostasis, respiration (Lineages of Life), specific adaptations to a blood-feeding lifestyle, including the complexities of salivary gland secretions and tick-host interactions (Edges of Life). The phylogenetic relationships of lineages, their origins and importance in ancestral reconstruction are discussed. Uncertainties with respect to systematic relationships, ancestral reconstruction and the challenges faced in comparative transcriptomics (next-generation sequencing approaches) are highlighted. While almost 150 years of information regarding tick biology have been assembled, progress in recent years indicates that we are in the infancy of understanding tick evolution. Even so, broad reconstructions can be made with relation to biological features associated with various lineages. Conservation of characters shared with sister and parent lineages are evident, but appreciable differences are present in the tick lineage indicating modification with descent, as expected for Darwinian evolutionary theory. Many of these differences can be related to the hematophagous lifestyle of ticks. PMID:26868413

  2. Genital reconstruction in exstrophy patients

    PubMed Central

    Nerli, R. B.; Shirol, S. S.; Guntaka, Ajay; Patil, Shivagouda; Hiremath, Murigendra B.

    2012-01-01

    Introduction: Surgery for bladder exstrophy has been evolving over the last four to five decades. Because survival has become almost universal, the focus has changed in the exstrophy-epispadias complex to improving quality of life. The most prevalent problem in the long-term function of exstrophy patients is the sexual activity of the adolescent and adult males. The penis in exstrophy patients appears short because of marked congenital deficiency of anterior corporal tissue. Many patients approach for genital reconstruction to improve cosmesis as well as to correct chordee. We report our series of male patients seeking genital reconstruction following exstrophy repair in the past. Materials and Methods: Fourteen adolescent/adult male patients attended urology services during the period January 2000-December 2009 seeking genital reconstruction following exstrophy repair in the past. Results: Three patients underwent epispadias repair, four patients had chordee correction with cosmetic excision of skin tags and seven patients underwent chordee correction with penile lengthening. All patients reported satisfaction in the answered questionnaire. Patients undergoing penile lengthening by partial corporal dissection achieved a mean increase in length of 1.614 ± 0.279 cm dorsally and 1.543 ± 0.230 cm ventrally. The satisfactory rate assessed by the Short Form-36 (SF-36) showed that irrespective of the different genital reconstructive procedures done, the patients were satisfied with cosmetic and functional outcome. Conclusions: Surgical procedures have transformed the management in these patients with bladder exstrophy. Bladders can be safely placed within the pelvis, with most patients achieving urinary continence and cosmetically acceptable external genitalia. Genital reconstruction in the form of correction of chordee, excision of ugly skin tags and lengthening of penis can be performed to give the patients a satisfactory cosmetic and functional system. PMID:23204655

  3. Stability indicators in network reconstruction.

    PubMed

    Filosi, Michele; Visintainer, Roberto; Riccadonna, Samantha; Jurman, Giuseppe; Furlanello, Cesare

    2014-01-01

    The number of available algorithms to infer a biological network from a dataset of high-throughput measurements is overwhelming and keeps growing. However, evaluating their performance is unfeasible unless a 'gold standard' is available to measure how close the reconstructed network is to the ground truth. One measure of this is the stability of these predictions to data resampling approaches. We introduce NetSI, a family of Network Stability Indicators, to assess quantitatively the stability of a reconstructed network in terms of inference variability due to data subsampling. In order to evaluate network stability, the main NetSI methods use a global/local network metric in combination with a resampling (bootstrap or cross-validation) procedure. In addition, we provide two normalized variability scores over data resampling to measure edge weight stability and node degree stability, and then introduce a stability ranking for edges and nodes. A complete implementation of the NetSI indicators, including the Hamming-Ipsen-Mikhailov (HIM) network distance adopted in this paper is available with the R package nettools. We demonstrate the use of the NetSI family by measuring network stability on four datasets against alternative network reconstruction methods. First, the effect of sample size on stability of inferred networks is studied in a gold standard framework on yeast-like data from the Gene Net Weaver simulator. We also consider the impact of varying modularity on a set of structurally different networks (50 nodes, from 2 to 10 modules), and then of complex feature covariance structure, showing the different behaviours of standard reconstruction methods based on Pearson correlation, Maximum Information Coefficient (MIC) and False Discovery Rate (FDR) strategy. Finally, we demonstrate a strong combined effect of different reconstruction methods and phenotype subgroups on a hepatocellular carcinoma miRNA microarray dataset (240 subjects), and we validate the

  4. Venous outflow reconstruction in living donor liver transplantation: Dealing with venous anomalies

    PubMed Central

    Jeng, Long-Bin; Thorat, Ashok; Yang, Horng-Ren; Li, Ping-Chun

    2015-01-01

    The reconstruction of the vascular outflow tract of partial liver grafts has received considerable attention in the past, especially in the setting of right liver grafts with undrained segments. Hepatic venous outflow reconstruction is an important factor for successful living donor liver transplantation outcome. However, in presence of undrained anterior sector and presence of multiple short hepatic veins that drain substantial portions of liver, outflow reconstruction without backtable venoplasty may lead to severe graft congestion and subsequent graft dysfunction. Various backtable venoplasty techniques in presence of multiple hepatic veins that can be used in either right- or left-lobe liver transplantation are devised to ensure a single, wide outflow channel. In this overview, various techniques to overcome the hepatic venous variations of liver allograft and outflow reconstruction are discussed. PMID:26722643

  5. Experimental reconstruction of monsoon drought variability for Australasia using tree rings and corals

    NASA Astrophysics Data System (ADS)

    D'Arrigo, Rosanne; Baker, Patrick; Palmer, Jonathan; Anchukaitis, Kevin; Cook, Garry

    2008-06-01

    An experimental reconstruction uses three well-dated, annually-resolved proxies from Australasia (0-40°S, 95-155°E) to provide large-scale information on Sep-Jan Australasian monsoon variability based on the Palmer Drought Severity Index (PDSI) for 1787-2002. The proxies are: (1) a ring width chronology of Callitris intratropica for northern Australia (1847-2006) (2) a tree-ring and coral-based reconstruction of the Oct-Nov PDSI (1787-2003) for Java, Indonesia; and (3) a rainfall reconstruction for northeastern Australia (1631-2002) based on Great Barrier Reef coral luminescence. All three proxies show considerable explanatory value for reconstructing monsoon rainfall variability over much of Australia and environs, which will improve as additional records become available. The success of this ``proof of concept'' experiment largely reflects the highly significant, spatially-coherent correlations between austral spring and summer PDSI, Australasian climate and ENSO.

  6. Prosthodontic treatment and medical considerations for a patient with Turner syndrome: a clinical report.

    PubMed

    Nguyen, Caroline T; Hofstede, Theresa M

    2012-10-01

    This clinical report describes a multidisciplinary approach in the rehabilitation of a 23-year-old Caucasian woman affected with Turner's syndrome and subsequently diagnosed with T4 Giant cell reparative granuloma of the right maxillary sinus. The surgical treatment included a maxillectomy and infratemporal fossa dissection followed by a free fibula palatal reconstruction, fibula bone graft of the orbital floor, dental implant placement, and prosthodontic rehabilitation. Prosthodontic planning and treatment considerations in an adult patient with Turner Syndrome are discussed. PMID:22672559

  7. What to Expect After Breast Reconstruction Surgery

    MedlinePlus

    ... Topic References What to expect after breast reconstruction surgery It’s important to have an idea of what ... regular mammograms. Possible risks during and after reconstruction surgery There are certain risks from any type of ...

  8. Muon Reconstruction and Identification in CMS

    SciTech Connect

    Everett, A.

    2010-02-10

    We present the design strategies and status of the CMS muon reconstruction and identification identification software. Muon reconstruction and identification is accomplished through a variety of complementary algorithms. The CMS muon reconstruction software is based on a Kalman filter technique and reconstructs muons in the standalone muon system, using information from all three types of muon detectors, and links the resulting muon tracks with tracks reconstructed in the silicon tracker. In addition, a muon identification algorithm has been developed which tries to identify muons with high efficiency while maintaining a low probability of misidentification. The muon identification algorithm is complementary by design to the muon reconstruction algorithm that starts track reconstruction in the muon detectors. The identification algorithm accepts reconstructed tracks from the inner tracker and attempts to quantify the muon compatibility for each track using associated calorimeter and muon detector hit information. The performance status is based on detailed detector simulations as well as initial studies using cosmic muon data.

  9. Maximum entropy image reconstruction from projections

    NASA Astrophysics Data System (ADS)

    Bara, N.; Murata, K.

    1981-07-01

    The maximum entropy method is applied to image reconstruction from projections, of which angular view is restricted. The relaxation parameters are introduced to the maximum entropy reconstruction and after iteration the median filtering is implemented. These procedures improve the quality of the reconstructed image from noisy projections

  10. Reconstructing Deweyan Pragmatism: A Review Essay

    ERIC Educational Resources Information Center

    Neubert, Stefan

    2009-01-01

    In this essay Stefan Neubert argues that John Dewey was a philosopher of reconstruction and that the best use we can make of him today is to reconstruct his work in and for our own contexts. Neubert distinguishes three necessary and equally important components of the overall project of reconstructing Deweyan pragmatism: first, to make strong and…

  11. Palliative care. Some organisational considerations.

    PubMed

    Welshman, A

    2005-01-01

    consideration. Another important issue faced daily by palliative care physicians is the broad number of chronic conditions which could make use of opioids. Severe cancer pain is the most obvious example of an appropriate use of opioids, but hardly the only one. The North American Chronic Pain Association of Canada (NACPAC) advocates the use of opioids for a wide range of conditions causing severe chronic pain, including lower back pain, inflammatory bowel disease, migraines, AIDS, multiple sclerosis and arthritis. Concerns regarding under treatment of chronic pain have captured the attention of patient advocacy groups, policy makers and scientific organisations. Misconceptions of opioid laws, negative social stigma and lack of valid prescribing alternatives to overcome this, together with paucity of formal provider education confound the issue. Much education needs to be done before opioids will be seen as a safe and reasonable treatment for chronic pain here in Italy.

  12. Reconstruction of crimes by infrared photography.

    PubMed

    Sterzik, V; Bohnert, M

    2016-09-01

    Whenever blunt or sharp forces are used in a crime, analysis of bloodstain pattern distribution may provide important information for the reconstruction of happenings. Thereby, attention should be paid to both the crime scene and the clothes of everyone involved in the crime. On dark textiles, though, it is difficult or even impossible for the human eye to detect bloodstains because of the low contrast to the background. However, in the near infrared wavelength range, contrast is considerably higher. Many textiles reflect light beyond a wavelength of 830 nm and thus appear light-colored, whereas blood absorbs the light and appears dark. In our studies, a D7000 NIKON reflex camera modified for infrared photography produced high-resolution photographs visualizing even very small spatter stains on dark textiles. The equipment can be used at any crime scene or lab and provides immediately available and interpretable images. Thus, important findings can be obtained at an early stage of police investigations, as two examples (homicide and attempted homicide) illustrate. PMID:26932868

  13. Reconstruction of crimes by infrared photography.

    PubMed

    Sterzik, V; Bohnert, M

    2016-09-01

    Whenever blunt or sharp forces are used in a crime, analysis of bloodstain pattern distribution may provide important information for the reconstruction of happenings. Thereby, attention should be paid to both the crime scene and the clothes of everyone involved in the crime. On dark textiles, though, it is difficult or even impossible for the human eye to detect bloodstains because of the low contrast to the background. However, in the near infrared wavelength range, contrast is considerably higher. Many textiles reflect light beyond a wavelength of 830 nm and thus appear light-colored, whereas blood absorbs the light and appears dark. In our studies, a D7000 NIKON reflex camera modified for infrared photography produced high-resolution photographs visualizing even very small spatter stains on dark textiles. The equipment can be used at any crime scene or lab and provides immediately available and interpretable images. Thus, important findings can be obtained at an early stage of police investigations, as two examples (homicide and attempted homicide) illustrate.

  14. Fingerprint reconstruction: from minutiae to phase.

    PubMed

    Feng, Jianjiang; Jain, Anil K

    2011-02-01

    Fingerprint matching systems generally use four types of representation schemes: grayscale image, phase image, skeleton image, and minutiae, among which minutiae-based representation is the most widely adopted one. The compactness of minutiae representation has created an impression that the minutiae template does not contain sufficient information to allow the reconstruction of the original grayscale fingerprint image. This belief has now been shown to be false; several algorithms have been proposed that can reconstruct fingerprint images from minutiae templates. These techniques try to either reconstruct the skeleton image, which is then converted into the grayscale image, or reconstruct the grayscale image directly from the minutiae template. However, they have a common drawback: Many spurious minutiae not included in the original minutiae template are generated in the reconstructed image. Moreover, some of these reconstruction techniques can only generate a partial fingerprint. In this paper, a novel fingerprint reconstruction algorithm is proposed to reconstruct the phase image, which is then converted into the grayscale image. The proposed reconstruction algorithm not only gives the whole fingerprint, but the reconstructed fingerprint contains very few spurious minutiae. Specifically, a fingerprint image is represented as a phase image which consists of the continuous phase and the spiral phase (which corresponds to minutiae). An algorithm is proposed to reconstruct the continuous phase from minutiae. The proposed reconstruction algorithm has been evaluated with respect to the success rates of type-I attack (match the reconstructed fingerprint against the original fingerprint) and type-II attack (match the reconstructed fingerprint against different impressions of the original fingerprint) using a commercial fingerprint recognition system. Given the reconstructed image from our algorithm, we show that both types of attacks can be successfully launched against

  15. Markov random field surface reconstruction.

    PubMed

    Paulsen, Rasmus R; Baerentzen, Jakob Andreas; Larsen, Rasmus

    2010-01-01

    A method for implicit surface reconstruction is proposed. The novelty in this paper is the adaptation of Markov Random Field regularization of a distance field. The Markov Random Field formulation allows us to integrate both knowledge about the type of surface we wish to reconstruct (the prior) and knowledge about data (the observation model) in an orthogonal fashion. Local models that account for both scene-specific knowledge and physical properties of the scanning device are described. Furthermore, how the optimal distance field can be computed is demonstrated using conjugate gradients, sparse Cholesky factorization, and a multiscale iterative optimization scheme. The method is demonstrated on a set of scanned human heads and, both in terms of accuracy and the ability to close holes, the proposed method is shown to have similar or superior performance when compared to current state-of-the-art algorithms.

  16. X-Ray Tomographic Reconstruction

    SciTech Connect

    Bonnie Schmittberger

    2010-08-25

    Tomographic scans have revolutionized imaging techniques used in medical and biological research by resolving individual sample slices instead of several superimposed images that are obtained from regular x-ray scans. X-Ray fluorescence computed tomography, a more specific tomography technique, bombards the sample with synchrotron x-rays and detects the fluorescent photons emitted from the sample. However, since x-rays are attenuated as they pass through the sample, tomographic scans often produce images with erroneous low densities in areas where the x-rays have already passed through most of the sample. To correct for this and correctly reconstruct the data in order to obtain the most accurate images, a program employing iterative methods based on the inverse Radon transform was written. Applying this reconstruction method to a tomographic image recovered some of the lost densities, providing a more accurate image from which element concentrations and internal structure can be determined.

  17. Direct reconstruction of dark energy.

    PubMed

    Clarkson, Chris; Zunckel, Caroline

    2010-05-28

    An important issue in cosmology is reconstructing the effective dark energy equation of state directly from observations. With so few physically motivated models, future dark energy studies cannot only be based on constraining a dark energy parameter space. We present a new nonparametric method which can accurately reconstruct a wide variety of dark energy behavior with no prior assumptions about it. It is simple, quick and relatively accurate, and involves no expensive explorations of parameter space. The technique uses principal component analysis and a combination of information criteria to identify real features in the data, and tailors the fitting functions to pick up trends and smooth over noise. We find that we can constrain a large variety of w(z) models to within 10%-20% at redshifts z≲1 using just SNAP-quality data. PMID:20867085

  18. Direct reconstruction of dark energy.

    PubMed

    Clarkson, Chris; Zunckel, Caroline

    2010-05-28

    An important issue in cosmology is reconstructing the effective dark energy equation of state directly from observations. With so few physically motivated models, future dark energy studies cannot only be based on constraining a dark energy parameter space. We present a new nonparametric method which can accurately reconstruct a wide variety of dark energy behavior with no prior assumptions about it. It is simple, quick and relatively accurate, and involves no expensive explorations of parameter space. The technique uses principal component analysis and a combination of information criteria to identify real features in the data, and tailors the fitting functions to pick up trends and smooth over noise. We find that we can constrain a large variety of w(z) models to within 10%-20% at redshifts z≲1 using just SNAP-quality data.

  19. Growing self-reconstruction maps.

    PubMed

    do Rêgo, Renata Lúcia Mendonça Ernesto; Araújo, Aluizio Fausto Ribeiro; de Lima Neto, Fernando Buarque

    2010-02-01

    In this paper, we propose a new method for surface reconstruction based on growing self-organizing maps (SOMs), called growing self-reconstruction maps (GSRMs). GSRM is an extension of growing neural gas (GNG) that includes the concept of triangular faces in the learning algorithm and additional conditions in order to include and remove connections, so that it can produce a triangular two-manifold mesh representation of a target object given an unstructured point cloud of its surface. The main modifications concern competitive Hebbian learning (CHL), the vertex insertion operation, and the edge removal mechanism. The method proposed is able to learn the geometry and topology of the surface represented in the point cloud and to generate meshes with different resolutions. Experimental results show that the proposed method can produce models that approximate the shape of an object, including its concave regions, boundaries, and holes, if any. PMID:20007030

  20. Ear Reconstruction in Young Children.

    PubMed

    Reinisch, John

    2015-12-01

    The use of a porous high-density polyethylene ear implant, rather than a costal cartilage framework, allows ear reconstruction in young children before they enter school. The fact that the growth of the normal ear matures early allows for good symmetry. If the implant is covered completely with a large, well-vascularized superficial parietal fascia flap and appropriately color-matched skin, an ear with excellent projection and definition can be obtained with minimal complications and long-term viability. Ear reconstruction in young children is preferred by the author because the necessary fascial flap coverage is thinner, easier to harvest than in older patients, and can be done in a single outpatient procedure with minimal discomfort or psychological trauma. PMID:26667634

  1. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.

    1990-09-01

    This monthly report summarizes the technical progress and project status for the Hanford Environmental Dose Reconstruction (HEDR) Project being conducted at the Pacific Northwest Laboratory (PNL) under the direction of a Technical Steering Panel (TSP). The TSP is composed of experts in numerous technical fields related to this project and represents the interests of the public. The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): source terms, environmental transport, environmental monitoring data, demographics, agriculture, food habits, environmental pathways and dose estimates. 3 figs.

  2. Reconstruction of the Genesis Entry

    NASA Technical Reports Server (NTRS)

    Desai, Prasun N.; Qualls, Garry D.; Schoenenberger, Mark

    2005-01-01

    This paper provides an overview of the findings from a reconstruction analysis of the Genesis capsule entry. First, a comparison of the atmospheric properties (density and winds) encountered during the entry to the pre-entry profile is presented. The analysis that was performed on the video footage (obtained from the tracking stations at UTTR) during the descent is then described from which the Mach number at the onset of the capsule tumble was estimated following the failure of the drogue parachute deployment. Next, an assessment of the Genesis capsule aerodynamics that was extracted from the video footage is discussed, followed by a description of the capsule hypersonic attitude that must have occurred during the entry based on examination of the recovered capsule heatshield. Lastly, the entry trajectory reconstruction that was performed is presented.

  3. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1991-01-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): Source terms; environmental transport environmental monitoring data; demographics, agriculture, food habits; environmental pathways and dose estimates.

  4. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1992-02-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): source terms; environmental transport; environmental monitoring data; demography, food consumption, and agriculture; environmental pathways and dose estimates.

  5. Craniofacial reconstruction following oncologic resection.

    PubMed

    Hanasono, Matthew M; Hofstede, Theresa M

    2013-01-01

    The ability to reliably reconstruct complex and sizable wounds has decreased the morbidity of skull base surgery substantially, preventing major complications and allowing treatment of tumors previously considered inoperable. Addressing facial nerve function with static and dynamic procedures as well as fabrication of craniofacial prostheses to replace delicate facial landmarks has further increased surgeons' ability to restore the appearance and function of the face. PMID:23174362

  6. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Cannon, S.D.; Finch, S.M.

    1992-10-01

    The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The independent Technical Steering Panel (TSP) provides technical direction. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed from release to impact on humans (dose estimates):Source Terms, Environmental Transport, Environmental Monitoring Data, Demography, Food Consumption, and Agriculture, and Environmental Pathways and Dose Estimates.

  7. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1992-01-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): Source Terms, Environmental Transport, Environmental Monitoring Data, Demography, Food Consumption, and Agriculture, and Environmental Pathways and Dose Estimates.

  8. Reconstructing propagation networks with temporal similarity

    PubMed Central

    Liao, Hao; Zeng, An

    2015-01-01

    Node similarity significantly contributes to the growth of real networks. In this paper, based on the observed epidemic spreading results we apply the node similarity metrics to reconstruct the underlying networks hosting the propagation. We find that the reconstruction accuracy of the similarity metrics is strongly influenced by the infection rate of the spreading process. Moreover, there is a range of infection rate in which the reconstruction accuracy of some similarity metrics drops nearly to zero. To improve the similarity-based reconstruction method, we propose a temporal similarity metric which takes into account the time information of the spreading. The reconstruction results are remarkably improved with the new method. PMID:26086198

  9. Reconstructing propagation networks with temporal similarity.

    PubMed

    Liao, Hao; Zeng, An

    2015-01-01

    Node similarity significantly contributes to the growth of real networks. In this paper, based on the observed epidemic spreading results we apply the node similarity metrics to reconstruct the underlying networks hosting the propagation. We find that the reconstruction accuracy of the similarity metrics is strongly influenced by the infection rate of the spreading process. Moreover, there is a range of infection rate in which the reconstruction accuracy of some similarity metrics drops nearly to zero. To improve the similarity-based reconstruction method, we propose a temporal similarity metric which takes into account the time information of the spreading. The reconstruction results are remarkably improved with the new method. PMID:26086198

  10. Photogrammetric Reconstruction with Bayesian Information

    NASA Astrophysics Data System (ADS)

    Masiero, A.; Fissore, F.; Guarnieri, A.; Pirotti, F.; Vettore, A.

    2016-06-01

    Nowadays photogrammetry and laser scanning methods are the most wide spread surveying techniques. Laser scanning methods usually allow to obtain more accurate results with respect to photogrammetry, but their use have some issues, e.g. related to the high cost of the instrumentation and the typical need of high qualified personnel to acquire experimental data on the field. Differently, photogrammetric reconstruction can be achieved by means of low cost devices and by persons without specific training. Furthermore, the recent diffusion of smart devices (e.g. smartphones) embedded with imaging and positioning sensors (i.e. standard camera, GNSS receiver, inertial measurement unit) is opening the possibility of integrating more information in the photogrammetric reconstruction procedure, in order to increase its computational efficiency, its robustness and accuracy. In accordance with the above observations, this paper examines and validates new possibilities for the integration of information provided by the inertial measurement unit (IMU) into the photogrammetric reconstruction procedure, and, to be more specific, into the procedure for solving the feature matching and the bundle adjustment problems.

  11. PRP Augmentation for ACL Reconstruction.

    PubMed

    Andriolo, Luca; Di Matteo, Berardo; Kon, Elizaveta; Filardo, Giuseppe; Venieri, Giulia; Marcacci, Maurilio

    2015-01-01

    Current research is investigating new methods to enhance tissue healing to speed up recovery time and decrease the risk of failure in Anterior Cruciate Ligament (ACL) reconstructive surgery. Biological augmentation is one of the most exploited strategies, in particular the application of Platelet Rich Plasma (PRP). Aim of the present paper is to systematically review all the preclinical and clinical papers dealing with the application of PRP as a biological enhancer during ACL reconstructive surgery. Thirty-two studies were included in the present review. The analysis of the preclinical evidence revealed that PRP was able to improve the healing potential of the tendinous graft both in terms of histological and biomechanical performance. Looking at the available clinical evidence, results were not univocal. PRP administration proved to be a safe procedure and there were some evidences that it could favor the donor site healing in case of ACL reconstruction with patellar tendon graft and positively contribute to graft maturation over time, whereas the majority of the papers did not show beneficial effects in terms of bony tunnels/graft area integration. Furthermore, PRP augmentation did not provide superior functional results at short term evaluation. PMID:26064903

  12. Environment reconstruction for robot navigation

    SciTech Connect

    Bohn, S.; Thornton, E.

    1994-04-01

    The United State Department of Energy (DOE) is facing a large task in characterizing and remediating waste tanks and their contents. Because of the hazardous materials inside the waste tanks, all of the work must be done remotely. The purpose of this paper is to show how to reconstruct an enclosed environment from various scans of a Laser Range Finder (LRF). The reconstructed environment can then be used by a robot for path planning, and by an operator to monitor the progress of the waste remediation process. Environment reconstruction consists of two tasks: image processing and laser sculpting. The image processing task focuses first on reducing the quantity of low-confidence data and on smoothing random fluctuations in the data. Then the processed range data must be converted into an XYZ Cartesian coordinate space, a process for which we examined two methods. The first method is a geometrical transform of the LRF data. The second uses an artificial neural network to transform the data to XYZ coordinates. Once an XYZ data set is computed, laser sculpting can be performed. Laser sculpting employs a hierarchical tree structure formally called an octree. The octree structure allows efficient storage of volumetric data and the ability to fuse multiple data sets. Our research has allowed us to examine the difficulties of fusing multiple LRF scans into an octree and to develop algorithms for converting an octree structure into a representation of polygon surfaces.

  13. Reconstruction of FXR Beam Conditions

    SciTech Connect

    Nexen, W E; Scarpetti, R D; Zentler, J

    2001-05-31

    Beam-envelope radius, envelope angle, and beam emittance can be derived from measurements of beam radius for at least three different transport conditions. We have used this technique to reconstruct exit parameters from the FXR injector and accelerator. We use a diamagnetic loop (DML) to measure the magnetic moment of the high current beam. With no assumptions about radial profile, we can derive the beam mean squire radius from the moment under certain easily met conditions. Since it is this parameter which is required for the reconstruction, it is evident that the DML is the ideal diagnostic for this technique. The simplest application of this technique requires at least three shots for a reconstruction but in reality requires averaging over many more shots because of shot to shot variation. Since DML measurements do not interfere with the beam, single shot time resolved measurements of the beam parameters appear feasible if one uses an array of at least three DMLs separated by known transport conditions.

  14. CMB temperature lensing power reconstruction

    SciTech Connect

    Hanson, Duncan; Efstathiou, George; Challinor, Anthony; Bielewicz, Pawel

    2011-02-15

    We study the reconstruction of the lensing potential power spectrum from CMB temperature data, with an eye to the Planck experiment. We work with the optimal quadratic estimator of Okamoto and Hu, which we characterize thoroughly in an application to the reconstruction of the lensing power spectrum. We find that at multipoles L<250, our current understanding of this estimator is biased at the 15% level by beyond-gradient terms in the Taylor expansion of lensing effects. We present the full lensed trispectrum to fourth order in the lensing potential to explain this effect. We show that the low-L bias, as well as a previously known bias at high L, is relevant to the determination of cosmology and must be corrected for in order to avoid significant parameter errors. We also investigate the covariance of the reconstructed power, finding broad correlations of {approx_equal}0.1%. Finally, we discuss several small improvements which may be made to the optimal estimator to mitigate these problems.

  15. Equilibrium reconstruction based on core magnetic measurement and its applications on equilibrium transition in Joint-TEXT tokamak

    SciTech Connect

    Chen, J.; Zhuang, G. Jian, X.; Li, Q.; Liu, Y.; Gao, L.; Wang, Z. J.

    2014-10-15

    Evaluation and reconstruction of plasma equilibrium, especially to resolve the safety factor profile, is imperative for advanced tokamak operation and physics study. Based on core magnetic measurement by the high resolution laser polarimeter-interferometer system (POLARIS), the equilibrium of Joint-TEXT (J-TEXT) plasma is reconstructed and profiles of safety factor, current density, and electron density are, therefore, obtained with high accuracy and temporal resolution. The equilibrium reconstruction procedure determines the equilibrium flux surfaces essentially from the data of POLARIS. Refraction of laser probe beam, a major error source of the reconstruction, has been considered and corrected, which leads to improvement of accuracy more than 10%. The error of reconstruction has been systematically assessed with consideration of realistic diagnostic performance and scrape-off layer region of plasma, and its accuracy has been verified. Fast equilibrium transitions both within a single sawtooth cycle and during the penetration of resonant magnetic perturbation have been investigated.

  16. Equilibrium reconstruction based on core magnetic measurement and its applications on equilibrium transition in Joint-TEXT tokamak.

    PubMed

    Chen, J; Zhuang, G; Jian, X; Li, Q; Liu, Y; Gao, L; Wang, Z J

    2014-10-01

    Evaluation and reconstruction of plasma equilibrium, especially to resolve the safety factor profile, is imperative for advanced tokamak operation and physics study. Based on core magnetic measurement by the high resolution laser polarimeter-interferometer system (POLARIS), the equilibrium of Joint-TEXT (J-TEXT) plasma is reconstructed and profiles of safety factor, current density, and electron density are, therefore, obtained with high accuracy and temporal resolution. The equilibrium reconstruction procedure determines the equilibrium flux surfaces essentially from the data of POLARIS. Refraction of laser probe beam, a major error source of the reconstruction, has been considered and corrected, which leads to improvement of accuracy more than 10%. The error of reconstruction has been systematically assessed with consideration of realistic diagnostic performance and scrape-off layer region of plasma, and its accuracy has been verified. Fast equilibrium transitions both within a single sawtooth cycle and during the penetration of resonant magnetic perturbation have been investigated. PMID:25362387

  17. Surface Reconstruction and Optimization of Cerebral Cortex for Application Use.

    PubMed

    Shin, Dong Sun; Park, Sang Kyu

    2016-03-01

    For the purposes of virtual surgery, medical education, medical communication, and realistic surface models of anatomic structures are required. In the most involved method, surface models can be made using segmentation and three-dimensional reconstruction procedures. Such models, however, are computationally expensive, and can be difficult to use. Therefore, optimization is often performed manually, but this is a time-consuming job that requires considerable artistic talent. In this article, the authors describe a method that uses Maya and ZBrush to construct optimized surface models of anatomic structures. The authors take 235 anatomic images generated from a cadaver, and perform segmentation and surface reconstruction using Photoshop and Mimics. Reconstructed surface models of the cerebral cortex are then optimized and divided by a morphing technique in Maya and ZBrush for use in medical applications. The optimized surface models do not require significant storage space, and are easily manufactured and modified. The resulting surface models can be displayed off-line and on-line in real time, as well as on smart phones. Using commercial software with the specialized functions described in this study, it is expected that the efficiencies produced by the proposed method will enable researchers to conveniently create surface models from serially sectioned images such as computed tomographs and magnetic resonance images. The surface models created in this research will also have widespread applications in both medical education and communication. PMID:26854785

  18. Reconstruction of N-acetyltransferase 2 haplotypes using PHASE.

    PubMed

    Golka, Klaus; Blaszkewicz, Meinolf; Samimi, Mirabutaleb; Bolt, Hermann M; Selinski, Silvia

    2008-04-01

    The genotyping of N-acetyltransferase 2 (NAT2) by PCR/RFLP methods yields in a considerable percentage ambiguous results. To resolve this methodical problem a statistical approach was applied. PHASE v2.1.1, a statistical program for haplotype reconstruction was used to estimate haplotype pairs from NAT2 genotyping data, obtained by the analysis of seven single nucleotide polymorphisms relevant for Caucasians. In 1,011 out of 2,921 (35%) subjects the haplotype pairs were clearcut by the PCR/RFLP data only. For the majority of the data the applied method resulted in a multiplicity (2-4) of possible haplotype pairs. Haplotype reconstruction using PHASE v2.1.1 cleared this ambiguity in all cases but one, where an alternative haplotype pair was considered with a probability of 0.029. The estimation of the NAT2 haplotype is important because the assignment of the NAT2 alleles *12A, *12B, *12C or *13 to the rapid or slow NAT2 genotype has been discussed controversially. A clear assignment is indispensable in surveys of human bladder cancer caused by aromatic amine exposures. In conclusion, PHASE v2.1.1 software allowed an unambiguous haplotype reconstruction in 2,920 of 2,921 cases (>99.9%).

  19. Reconstruction of the mandible and the maxilla: the evolution of surgical technique.

    PubMed

    Genden, Eric M

    2010-01-01

    The upper and lower jaws play an essential role in mastication, articulation, and cosmetic form. The mandible provides support for tongue position and elevation of the larynx during swallowing, while the maxilla provides support for the nasal structures as well as an opposing structure to the mandible during mastication. The evolution of mandibular and maxillary reconstruction dates back to the early 19th century. Before the introduction of free tissue transfer, a variety of local flaps, regional flaps, and prosthetics were introduced, yet each was met with eventual failure. Since the introduction of free tissue transfer, mandibular and maxillary reconstruction has become as much of an art as it has a science. Whether the mandibular or the palatomaxillary defects are a result of trauma, congenital deformity, or tumor extirpation, the resultant effect often disrupts both form and function. With these considerations taken together, jaw reconstruction is a unique undertaking in which the artistic reconstruction of the facial skeleton is met with the science of reestablishing the mechanics of mastication. The site, size, and associated soft-tissue defects represent the 3 most important factors in determining the impact of a given defect on function and aesthetics. There is also an inherent difference between defects that are sustained in a controlled fashion, such as during cancer ablation, and those that result from trauma. The consideration of these complexities in jaw reconstruction is reflected in the wide variety of approaches and techniques that have evolved over the past century. PMID:20231587

  20. 7 CFR 3430.909 - Other considerations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Other considerations. 3430.909 Section 3430.909 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND... ADMINISTRATIVE PROVISIONS New Era Rural Technology Competitive Grants Program § 3430.909 Other considerations....

  1. 46 CFR 390.3 - Policy considerations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Policy considerations. 390.3 Section 390.3 Shipping... CONSTRUCTION FUND § 390.3 Policy considerations. (a) In general. It is the policy of the United States, as set... may waive the monetary limit in paragraph (b)(2)(i) of this section where the applicant proposes...

  2. 12 CFR 308.157 - Relevant considerations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Relevant considerations. 308.157 Section 308.157 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE RULES OF PRACTICE AND PROCEDURE Procedures and Standards Applicable to an Application Pursuant to Section 19 of the FDIA § 308.157 Relevant considerations....

  3. 46 CFR 390.3 - Policy considerations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Policy considerations. 390.3 Section 390.3 Shipping... CONSTRUCTION FUND § 390.3 Policy considerations. (a) In general. It is the policy of the United States, as set... the policies of the Act. (2) Specific unacceptable programs. The Maritime Administrator will not...

  4. Employment Considerations of AIDS in Dental Institutions.

    ERIC Educational Resources Information Center

    Crumpler, Diane C.; Carey, Moses

    1987-01-01

    Policies governing the employment of health care workers with AIDS, and the AIDS employment issue facing dental practitioners, administrators, and educators are discussed. Legal considerations of AIDS in the workplace are addressed as to HIV testing, employee rights to gain and/or retain employment, economic considerations, and confidentiality…

  5. 7 CFR 1710.117 - Environmental considerations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 11 2012-01-01 2012-01-01 false Environmental considerations. 1710.117 Section 1710... GUARANTEES Loan Purposes and Basic Policies § 1710.117 Environmental considerations. Borrowers are required to comply with 7 CFR part 1794, which sets forth applicable requirements of the...

  6. 7 CFR 1710.117 - Environmental considerations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 11 2014-01-01 2014-01-01 false Environmental considerations. 1710.117 Section 1710... GUARANTEES Loan Purposes and Basic Policies § 1710.117 Environmental considerations. Borrowers are required to comply with 7 CFR part 1794, which sets forth applicable requirements of the...

  7. 29 CFR 1614.305 - Consideration procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Consideration procedures. 1614.305 Section 1614.305 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.305 Consideration procedures. (a) Once a petition is filed... extent that the Commission finds that, as a matter of law: (i) The decision of the MSPB constitutes...

  8. 28 CFR 51.34 - Expedited consideration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Expedited consideration. 51.34 Section 51.34 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED Processing of Submissions § 51.34 Expedited consideration. (a) When a submitting authority...

  9. 32 CFR 643.104 - Consideration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Consideration. 643.104 Section 643.104 National... Permits § 643.104 Consideration. (a) Permits are usually granted on a rent-free basis. (b) The Army is... receipts unless otherwise authorized by law. Reimbursement for utilities and services furnished to...

  10. 49 CFR 209.119 - Assessment considerations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Assessment considerations. 209.119 Section 209.119 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Penalties § 209.119 Assessment considerations. The assessment of a civil penalty under § 209.117 is...

  11. 49 CFR 209.329 - Assessment considerations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Assessment considerations. 209.329 Section 209.329 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Assessment considerations. (a) Proof of a respondent's willful violation of one of the requirements of...

  12. 49 CFR 190.225 - Assessment considerations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Assessment considerations. 190.225 Section 190.225 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PROCEDURES Enforcement Civil Penalties § 190.225 Assessment considerations. In determining the amount of...

  13. Psycho-Social Considerations of Environmental Design.

    ERIC Educational Resources Information Center

    Izumi, K.

    Identifying psychological and sociological design considerations is a difficult matter. So much is hidden behind our normal, but biased, level of perception. The importance of psycho-social considerations can be drawn from an examination of the quantity and types of buildings produced today for human occupancy--office buildings, libraries,…

  14. 46 CFR 169.112 - Special consideration.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Special consideration. 169.112 Section 169.112 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS General Provisions § 169.112 Special consideration. In applying the provisions of this part, the Officer in...

  15. 46 CFR 169.112 - Special consideration.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Special consideration. 169.112 Section 169.112 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS General Provisions § 169.112 Special consideration. In applying the provisions of this part, the Officer in...

  16. 46 CFR 169.112 - Special consideration.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Special consideration. 169.112 Section 169.112 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS General Provisions § 169.112 Special consideration. In applying the provisions of this part, the Officer in...

  17. 46 CFR 169.112 - Special consideration.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Special consideration. 169.112 Section 169.112 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS General Provisions § 169.112 Special consideration. In applying the provisions of this part, the Officer in...

  18. 46 CFR 169.112 - Special consideration.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Special consideration. 169.112 Section 169.112 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS General Provisions § 169.112 Special consideration. In applying the provisions of this part, the Officer in...

  19. 5 CFR 330.206 - Job consideration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Job consideration. 330.206 Section 330.206 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Reemployment Priority List (RPL) § 330.206 Job consideration. (a)(1)...

  20. 5 CFR 330.206 - Job consideration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Job consideration. 330.206 Section 330.206 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Reemployment Priority List (RPL) § 330.206 Job consideration. (a)(1)...

  1. 32 CFR 637.12 - Legal considerations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Legal considerations. 637.12 Section 637.12 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.12 Legal considerations....

  2. 32 CFR 637.12 - Legal considerations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Legal considerations. 637.12 Section 637.12 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.12 Legal considerations....

  3. 32 CFR 637.12 - Legal considerations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Legal considerations. 637.12 Section 637.12 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.12 Legal considerations....

  4. 32 CFR 637.12 - Legal considerations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Legal considerations. 637.12 Section 637.12 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.12 Legal considerations....

  5. 32 CFR 637.12 - Legal considerations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Legal considerations. 637.12 Section 637.12 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.12 Legal considerations....

  6. 33 CFR 239.5 - Engineering considerations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Engineering considerations. 239.5 Section 239.5 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF... § 239.5 Engineering considerations. Reports on proposals to provide covered channels shall include...

  7. 33 CFR 239.5 - Engineering considerations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Engineering considerations. 239.5 Section 239.5 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF... § 239.5 Engineering considerations. Reports on proposals to provide covered channels shall include...

  8. 12 CFR 108.11 - Relevant considerations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 1 2014-01-01 2014-01-01 false Relevant considerations. 108.11 Section 108.11 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 108.11 Relevant considerations. (a) In determining...

  9. 12 CFR 508.11 - Relevant considerations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 6 2014-01-01 2012-01-01 true Relevant considerations. 508.11 Section 508.11 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 508.11 Relevant considerations. (a) In determining...

  10. 12 CFR 108.11 - Relevant considerations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 1 2012-01-01 2012-01-01 false Relevant considerations. 108.11 Section 108.11 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 108.11 Relevant considerations. (a) In determining...

  11. 12 CFR 508.11 - Relevant considerations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Relevant considerations. 508.11 Section 508.11 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 508.11 Relevant considerations. (a) In determining...

  12. 7 CFR 1735.92 - Accounting considerations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 11 2012-01-01 2012-01-01 false Accounting considerations. 1735.92 Section 1735.92... All Acquisitions and Mergers § 1735.92 Accounting considerations. (a) Proper accounting shall be... in the absence of such a commission, as required by RUS based on Generally Accepted...

  13. 7 CFR 1735.92 - Accounting considerations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 11 2014-01-01 2014-01-01 false Accounting considerations. 1735.92 Section 1735.92... All Acquisitions and Mergers § 1735.92 Accounting considerations. (a) Proper accounting shall be... in the absence of such a commission, as required by RUS based on Generally Accepted...

  14. 7 CFR 1735.92 - Accounting considerations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 11 2013-01-01 2013-01-01 false Accounting considerations. 1735.92 Section 1735.92... All Acquisitions and Mergers § 1735.92 Accounting considerations. (a) Proper accounting shall be... in the absence of such a commission, as required by RUS based on Generally Accepted...

  15. 16 CFR 1061.3 - Statutory considerations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Statutory considerations. 1061.3 Section... PREEMPTION § 1061.3 Statutory considerations. (a) The Commission's statutory preemption provisions provide... made unenforceable, if both are designed to protect against the same risk of injury or illness,...

  16. 7 CFR 1735.92 - Accounting considerations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 11 2011-01-01 2011-01-01 false Accounting considerations. 1735.92 Section 1735.92... All Acquisitions and Mergers § 1735.92 Accounting considerations. (a) Proper accounting shall be... in the absence of such a commission, as required by RUS based on Generally Accepted...

  17. 7 CFR 1735.92 - Accounting considerations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Accounting considerations. 1735.92 Section 1735.92... All Acquisitions and Mergers § 1735.92 Accounting considerations. (a) Proper accounting shall be... in the absence of such a commission, as required by RUS based on Generally Accepted...

  18. 14 CFR 25.795 - Security considerations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... incorporation by reference of this document under 5 U.S.C. 552(a) and 1 CFR part 51. (2) You may review copies... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Security considerations. 25.795 Section 25... § 25.795 Security considerations. (a) Protection of flightcrew compartment. If a flightdeck door...

  19. 7 CFR 1703.310 - Environmental considerations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 11 2011-01-01 2011-01-01 false Environmental considerations. 1703.310 Section 1703... § 1703.310 Environmental considerations. Prospective recipients of funds received from the deferment of loan payments are encouraged to consider the potential environmental impact of their proposed...

  20. 32 CFR 644.316 - Environmental considerations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Environmental considerations. 644.316 Section... PROPERTY REAL ESTATE HANDBOOK Disposal § 644.316 Environmental considerations. The National Environmental Policy Act of 1969 (NEPA), as amended, (42 U.S.C. 4321 et seq.) directs that a five point...

  1. 32 CFR 644.316 - Environmental considerations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Environmental considerations. 644.316 Section 644... PROPERTY REAL ESTATE HANDBOOK Disposal § 644.316 Environmental considerations. The National Environmental Policy Act of 1969 (NEPA), as amended, (42 U.S.C. 4321 et seq.) directs that a five point...

  2. 33 CFR 239.5 - Engineering considerations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Engineering considerations. 239.5 Section 239.5 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF... § 239.5 Engineering considerations. Reports on proposals to provide covered channels shall include...

  3. 33 CFR 239.5 - Engineering considerations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Engineering considerations. 239.5 Section 239.5 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF... § 239.5 Engineering considerations. Reports on proposals to provide covered channels shall include...

  4. 33 CFR 239.5 - Engineering considerations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Engineering considerations. 239.5 Section 239.5 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF... § 239.5 Engineering considerations. Reports on proposals to provide covered channels shall include...

  5. Graft impingement in anterior cruciate ligament reconstruction.

    PubMed

    Iriuchishima, Takanori; Shirakura, Kenji; Fu, Freddie H

    2013-03-01

    Anterior cruciate ligament (ACL) graft impingement is one of the most troubling complications in ACL reconstruction. In the previous strategy of isometric "non-anatomical" ACL reconstruction, posterior tibial tunnel placement and notchplasty were recommended to avoid graft impingement. Recently, the strategy of ACL reconstruction is shifting towards "anatomical" reconstruction. In anatomical ACL reconstruction, the potential risk of graft impingement is higher than in non-anatomical reconstruction because the tibial tunnel is placed at a more anterior portion on the tibia. However, there have been few studies reporting on graft impingement in anatomical ACL reconstruction. This study will provide a review of graft impingement status in both non-anatomical and the more recent anatomical ACL reconstruction techniques. In conclusion, with the accurate creation of bone tunnels within ACL native footprint, the graft impingement might not happen in anatomical ACL reconstruction. For the clinical relevance, to prevent graft impingement, surgeons should pay attention of creating correct anatomical tunnels when they perform ACL reconstruction. Level of evidence IV.

  6. Reconstruction of Anacostia wetlands: success?

    USGS Publications Warehouse

    Hammerschlag, R.S.; Perry, M.C.

    2002-01-01

    Historically, the tidal Anacostia River in Washington, D.C. had been an extensive system of freshwater tidal marshes replete with a full array of wetland vegetation dominated by wild rice. The local Nacochtank Indians had found the abundant fish and wildlife sufficient to sustain their daily lives. White man's intrusion upon the landscape gradually brought about deterioration of the natural (and associated cultural) system. Total demise followed mid-20th century dredge and fill channelization, which was conducted from the confluence of the Anacostia with the Potomac near the heart of Washington, D.C. to the terminus of the tidal regime at Bladensburg, Maryland. The National Park Service (NPS) became the manager for much of the land along the Anacostia, particularly the eastern bank. As part of its planning effort, the NPS envisioned returning portions of the Anacostia under its control to a natural system as a vignette. The concept was based on bringing back as comprehensive a collection of vegetation and wildlife as possible through the reestablishment of tidal marshes at Kenilworth and Kingman. The resultant wetlands were to be made accessible to the public both logistically and through a well designed interpretative program. In fact, this vision has been realized due to an impressive cooperative effort among a number of Federal and local agencies and organizations. In 1993, 32 acres of freshwater tidal marsh were reconstructed at Kenilworth. Based upon the 5-year monitoring program that has been in place since reconstruction, several generalizations may be made concerning the degree of success of the marsh reconstruction. Water quality in the marsh system and nearby tidal waters has not been noticeably improved. The poor quality may be clue to the overwhelmingly high loads (e.g., sediment, nutrients, etc.) brought in on the twice daily tidal cycle from the Anacostia and to the relatively small volume of water which actually interacts with the emergent marsh

  7. Suspensory Anterior Tibial Fixation in the Anatomic Transtibial Posterior Cruciate Ligament Reconstruction

    PubMed Central

    Elazab, Ashraf; Lee, Yong Seuk; Kang, Seo Goo

    2016-01-01

    The transtibial technique is the most relevant among many surgical techniques for posterior cruciate ligament reconstruction, and many types of fixation devices are used for tibial fixation according to the technique and the length of the graft. However, bone density in the fixation areas should be taken into consideration when choosing the fixation device to achieve rigid and stable fixation. However, density is not a substantial issue for anteromedial cortical fixation using a cortical suspension device. We describe tibial fixation with a TightRope RT (Arthrex, Naples, FL), which is a cortical suspension device, in anatomic transtibial posterior cruciate ligament reconstruction. PMID:27073781

  8. State space reconstruction in the presence of noise

    NASA Astrophysics Data System (ADS)

    Casdagli, Martin; Eubank, Stephen; Farmer, J. Doyne; Gibson, John

    1991-08-01

    Takens' theorem demonstrates that in the absence of noise a multidimensional state space can be reconstructed from a scalar time series. This theorem gives little guidance, however, about practical considerations for reconstructing a good state space. We extend Takens' treatment, applying statistical methods to incorporate the effects of observational noise and estimation error. We define the distortion matrix, which is proportional to the conditional covariance of a state, given a series of noisy measurements, and the noise amplification, which is proportional to root-square time series prediction errors with an ideal model. We derive explicit formulae for these quantities, and we prove that in the low noise limit minimizing the distortion is equivalent to minimizing the noise amplification. We identify several different scaling regimes for distortion and noise amplification, and derive asymptotic scaling laws. When the dimension and Lyapunov exponents are sufficiently large these scaling laws show that, no matter how the state space is reconstructed, there is an explosion in the noise amplification - from a practical point of view determinism is lost, and the time series is effectively a random process. In the low noise, large data limit we show that the technique of local singular value decomposition is an optimal coordinate transformation, in the sense that it achieves the minimum distortion in a state space of the lowest possible dimension. However, in numerical experiments we find that estimation error complicates this issue. For local approximation methods, we analyze the effect of reconstruction on estimation error, derive a scaling law, and suggest an algorithm for reducing estimation errors.

  9. PRISM3 Global Paleoclimate Reconstruction: A Global Warming Data Set

    NASA Astrophysics Data System (ADS)

    Dowsett, H. J.; Chandler, M. A.; Cronin, T. M.; Dwyer, G. S.; Haywood, A. M.; Hill, D. J.; Robinson, M. M.; Salzmann, U.; Williams, M.

    2007-12-01

    The Pliocene Research, Interpretation and Synoptic Mapping (PRISM) Project provides a conceptual model and synoptic view of the earth during the last interval considerably warmer than modern (3.3 to 3.0 Ma) through reconstruction of sea-surface temperature (SST) and other paleoenvironmental parameters. The first PRISM reconstruction, with its foundation in a global network of paleontological analyses, was completed in the early 1990s. Since then, several significant revisions have been released culminating in the PRISM2 data set. The primary goal of PRISM remains a better understanding of the Earth's climate system during the mid-Pliocene, and to that end, includes the development of digital data sets for use with climate models. The new PRISM3 reconstruction, slated to be released early in 2008, has revised SST fields based upon integration of previous and new faunal and floral analyses with new geochemical proxies and biomarkers, a revised vegetation/land cover data set utilizing the BIOME 4 vegetation classification scheme, 3-dimensional land ice distribution based upon ice-sheet model experiments, new sea level estimates based upon stable isotopes and bottom water temperatures, and revised sea-ice distribution. A deep ocean temperature reconstruction, PRISM3D, adds a 3- dimensional component, which can be used for initiating coupled ocean-atmosphere GCM simulations. PRISM3 is a collaborative effort between the U.S. Geological Survey (USGS), National Science Foundation (NSF), National Aeronautics and Space Administration (NASA), British Antarctic Survey (BAS), and several national and international academic institutions (Columbia University, Duke University, George Mason University, University of Leeds and University of Leicester).

  10. A fast and accurate algorithm for diploid individual haplotype reconstruction.

    PubMed

    Wu, Jingli; Liang, Binbin

    2013-08-01

    Haplotypes can provide significant information in many research fields, including molecular biology and medical therapy. However, haplotyping is much more difficult than genotyping by using only biological techniques. With the development of sequencing technologies, it becomes possible to obtain haplotypes by combining sequence fragments. The haplotype reconstruction problem of diploid individual has received considerable attention in recent years. It assembles the two haplotypes for a chromosome given the collection of fragments coming from the two haplotypes. Fragment errors significantly increase the difficulty of the problem, and which has been shown to be NP-hard. In this paper, a fast and accurate algorithm, named FAHR, is proposed for haplotyping a single diploid individual. Algorithm FAHR reconstructs the SNP sites of a pair of haplotypes one after another. The SNP fragments that cover some SNP site are partitioned into two groups according to the alleles of the corresponding SNP site, and the SNP values of the pair of haplotypes are ascertained by using the fragments in the group that contains more SNP fragments. The experimental comparisons were conducted among the FAHR, the Fast Hare and the DGS algorithms by using the haplotypes on chromosome 1 of 60 individuals in CEPH samples, which were released by the International HapMap Project. Experimental results under different parameter settings indicate that the reconstruction rate of the FAHR algorithm is higher than those of the Fast Hare and the DGS algorithms, and the running time of the FAHR algorithm is shorter than those of the Fast Hare and the DGS algorithms. Moreover, the FAHR algorithm has high efficiency even for the reconstruction of long haplotypes and is very practical for realistic applications.

  11. Review of jet reconstruction algorithms

    NASA Astrophysics Data System (ADS)

    Atkin, Ryan

    2015-10-01

    Accurate jet reconstruction is necessary for understanding the link between the unobserved partons and the jets of observed collimated colourless particles the partons hadronise into. Understanding this link sheds light on the properties of these partons. A review of various common jet algorithms is presented, namely the Kt, Anti-Kt, Cambridge/Aachen, Iterative cones and the SIScone, highlighting their strengths and weaknesses. If one is interested in studying jets, the Anti-Kt algorithm is the best choice, however if ones interest is in the jet substructures then the Cambridge/Aachen algorithm would be the best option.

  12. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1992-06-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is being managed and conducted by the Battelle Pacific Northwest Laboratories under contract with the Centers for Disease Control. The independent Technical Steering Panel (TSP) provides technical direction. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): source terms; environmental transport; environmental monitoring data; demography, food consumption, and agriculture; environmental pathways and dose estimates.

  13. Reconstruction of fundamental SUSY parameters

    SciTech Connect

    P. M. Zerwas et al.

    2003-09-25

    We summarize methods and expected accuracies in determining the basic low-energy SUSY parameters from experiments at future e{sup +}e{sup -} linear colliders in the TeV energy range, combined with results from LHC. In a second step we demonstrate how, based on this set of parameters, the fundamental supersymmetric theory can be reconstructed at high scales near the grand unification or Planck scale. These analyses have been carried out for minimal supergravity [confronted with GMSB for comparison], and for a string effective theory.

  14. The Arthroscopic Superior Capsular Reconstruction.

    PubMed

    Adams, Christopher R; Denard, Patrick J; Brady, Paul C; Hartzler, Robert U; Burkhart, Stephen S

    2016-01-01

    In a subset of patients with rotator cuff tears, the glenohumeral joint has minimal degenerative changes and the rotator cuff tendon is either irreparable or very poor quality and unlikely to heal. Reverse shoulder arthroplasty (RSA) is often considered for these patients despite the lack of glenohumeral arthritis. However, due to the permanent destruction of the glenohumeral articular surfaces, complication rates, and concerns about implant longevity with RSA, we believe the superior capsular reconstruction (SCR) is a viable alternative. In this article, we describe our technique for the SCR. PMID:27552457

  15. Reconstruction of coded aperture images

    NASA Technical Reports Server (NTRS)

    Bielefeld, Michael J.; Yin, Lo I.

    1987-01-01

    Balanced correlation method and the Maximum Entropy Method (MEM) were implemented to reconstruct a laboratory X-ray source as imaged by a Uniformly Redundant Array (URA) system. Although the MEM method has advantages over the balanced correlation method, it is computationally time consuming because of the iterative nature of its solution. Massively Parallel Processing, with its parallel array structure is ideally suited for such computations. These preliminary results indicate that it is possible to use the MEM method in future coded-aperture experiments with the help of the MPP.

  16. [Reconstruction of facial burn sequelae].

    PubMed

    Foyatier, J L; Comparin, J P; Boulos, J P; Bichet, J C; Jacquin, F

    2001-06-01

    The deep burns of the face can lead to horrible scars functionally and aesthetically. Treatment of these scars need several surgical interventions frequently and during many years. In our region we deal with this type of wounds as team work, multidisciplinary approach carrying out many process starting by emergency treatment of acute burns till the social rehabilitation. The expansion technique was great help in improving the shape of scars, by using the expanding skin as full thickness grafts. Reconstruction of the anatomical units and application of aesthetic techniques (like rhinoplasty, lifting, tattooing and autologous fat injections) participate equally in improving the quality of results. Many examples of treatments of burns scars are shown.

  17. Chord-based image reconstruction in cone-beam CT with a curved detector

    SciTech Connect

    Zuo Nianming; Xia Dan; Zou Yu; Jiang Tianzi; Pan Xiaochuan

    2006-10-15

    Modern computed tomography (CT) scanners use cone-beam configurations for increasing volume coverage, improving x-ray-tube utilization, and yielding isotropic spatial resolution. Recently, there have been significant developments in theory and algorithms for exact image reconstruction from cone-beam projections. In particular, algorithms have been proposed for image reconstruction on chords; and advantages over the existing algorithms offered by the chord-based algorithms include the high flexibility of exact image reconstruction for general scanning trajectories and the capability of exact reconstruction of images within a region of interest from truncated data. These chord-based algorithms have been developed only for flat-panel detectors. Many cone-beam CT scanners employ curved detectors for important practical considerations. Therefore, in this work, we have derived chord-based algorithms for a curved detector so that they can be applied to reconstructing images directly from data acquired by use of a CT scanner with a curved detector. We have also conducted preliminary numerical studies to demonstrate and evaluate the reconstruction properties of the derived chord-based algorithms for curved detectors.

  18. Quality Analysis of 3d Surface Reconstruction Using Multi-Platform Photogrammetric Systems

    NASA Astrophysics Data System (ADS)

    Lari, Z.; El-Sheimy, N.

    2016-06-01

    In recent years, the necessity of accurate 3D surface reconstruction has been more pronounced for a wide range of mapping, modelling, and monitoring applications. The 3D data for satisfying the needs of these applications can be collected using different digital imaging systems. Among them, photogrammetric systems have recently received considerable attention due to significant improvements in digital imaging sensors, emergence of new mapping platforms, and development of innovative data processing techniques. To date, a variety of techniques haven been proposed for 3D surface reconstruction using imagery collected by multi-platform photogrammetric systems. However, these approaches suffer from the lack of a well-established quality control procedure which evaluates the quality of reconstructed 3D surfaces independent of the utilized reconstruction technique. Hence, this paper aims to introduce a new quality assessment platform for the evaluation of the 3D surface reconstruction using photogrammetric data. This quality control procedure is performed while considering the quality of input data, processing procedures, and photo-realistic 3D surface modelling. The feasibility of the proposed quality control procedure is finally verified by quality assessment of the 3D surface reconstruction using images from different photogrammetric systems.

  19. An experimental streamflow reconstruction for the River Murray, Australia, 1783-1988

    NASA Astrophysics Data System (ADS)

    Gallant, Ailie J. E.; Gergis, JoëLle

    2011-12-01

    We present an experimental reconstruction of River Murray streamflow to assess present-day variations in the context of the past two centuries. Nine annually resolved paleoclimate proxy records from the Australasian region are used to develop a reconstruction of streamflow from 1783 to 1988. An ensemble of reconstructions is presented, providing probabilistic estimates of River Murray flows for each year back in time. The best-estimate reconstruction captures approximately 23% (50%) of annual (decadal) naturalized streamflow variability. High and low streamflow phases and their association with decadal climate variability in the Pacific are discussed. Reconstructed River Murray streamflow shows considerable variation since 1783. We estimate that there is a 2.3% chance that the 1998-2008 record low decadal streamflow deficit has been exceeded since European settlement. Stochastic simulations of the decadal variations in River Murray streamflow are computed using the paleostreamflow reconstruction to estimate model parameters. From these simulations, we estimate that the 1998-2008 streamflow deficit has an approximate 1 in 1500 year return period. As climate models are assessed relative to short instrumental records, future projections of decadal-scale variations in Murray-Darling Basin (MDB) streamflow may be inadequately represented. Given the immense socioeconomic importance of Australia's "food bowl," future paleoclimate and modeling efforts should be directed at understanding variability at this scale. This would greatly enhance our capacity to estimate regional sensitivity of the MDB's hydroclimate to further anthropogenic influences.

  20. An improved technique for the reconstruction of former glacier mass-balance and dynamics

    NASA Astrophysics Data System (ADS)

    Carr, Simon; Coleman, Christopher

    2007-11-01

    The recognition of past glacier extent and dynamics is a fundamental aspect of investigations of the climatic sensitivity of glaciers, especially when examining short-lived climate events such as the Younger Dryas or Little Ice Age. Existing approaches to the reconstruction of glacier form and dynamics depend on speculative reasoning of key glacier dynamic parameters, including the role of basal slip and subglacial deformation in glacier mass-transfer. This study reviews approaches to glacier reconstruction, derivation of former glacier equilibrium line altitudes (ELA's) and estimation of mass-balance and dynamics, concluding that most reconstructions of glacier mass-balance are compromised by a lack of glaciological considerations. An alternative approach to glacier reconstruction is presented, demonstrated and discussed, by which an empirical relationship between ablation gradient and mass loss at the ELA is used to derive mass-balance, mass-flux through the ELA and average balance velocity at the ELA. This 'glaciological' approach is applied to four reconstructed glaciers to test previous interpretations that each reflects Younger Dryas glaciation in the UK. The study concludes that this approach provides a more robust technique for reconstructing former glacier dynamics, and may be applied to test geomorphological interpretations of former mountain glaciation.

  1. Method for position emission mammography image reconstruction

    DOEpatents

    Smith, Mark Frederick

    2004-10-12

    An image reconstruction method comprising accepting coincidence datat from either a data file or in real time from a pair of detector heads, culling event data that is outside a desired energy range, optionally saving the desired data for each detector position or for each pair of detector pixels on the two detector heads, and then reconstructing the image either by backprojection image reconstruction or by iterative image reconstruction. In the backprojection image reconstruction mode, rays are traced between centers of lines of response (LOR's), counts are then either allocated by nearest pixel interpolation or allocated by an overlap method and then corrected for geometric effects and attenuation and the data file updated. If the iterative image reconstruction option is selected, one implementation is to compute a grid Siddon retracing, and to perform maximum likelihood expectation maiximization (MLEM) computed by either: a) tracing parallel rays between subpixels on opposite detector heads; or b) tracing rays between randomized endpoint locations on opposite detector heads.

  2. Inverse Problem of Vortex Reconstruction

    NASA Astrophysics Data System (ADS)

    Protas, Bartosz; Danaila, Ionut

    2014-11-01

    This study addresses the following question: given incomplete measurements of the velocity field induced by a vortex, can one determine the structure of the vortex? Assuming that the flow is incompressible, inviscid and stationary in the frame of reference moving with the vortex, the ``structure'' of the vortex is uniquely characterized by the functional relation between the streamfunction and vorticity. To focus attention, 3D axisymmetric vortex rings are considered. We show how this inverse problem can be framed as an optimization problem which can then be efficiently solved using variational techniques. More precisely, we use measurements of the tangential velocity on some contour to reconstruct the function defining the streamfunction-vorticity relation in a continuous setting. Two test cases are presented, involving Hill's and Norbury vortices, in which very good reconstructions are obtained. A key result of this study is the application of our approach to obtain an optimal inviscid vortex model in an actual viscous flow problem based on DNS data which leads to a number of nonintuitive findings.

  3. Stereo reconstruction from multiperspective panoramas.

    PubMed

    Li, Yin; Shum, Heung-Yeung; Tang, Chi-Keung; Szeliski, Richard

    2004-01-01

    A new approach to computing a panoramic (360 degrees) depth map is presented in this paper. Our approach uses a large collection of images taken by a camera whose motion has been constrained to planar concentric circles. We resample regular perspective images to produce a set of multiperspective panoramas and then compute depth maps directly from these resampled panoramas. Our panoramas sample uniformly in three dimensions: rotation angle, inverse radial distance, and vertical elevation. The use of multiperspective panoramas eliminates the limited overlap present in the original input images and, thus, problems as in conventional multibaseline stereo can be avoided. Our approach differs from stereo matching of single-perspective panoramic images taken from different locations, where the epipolar constraints are sine curves. For our multiperspective panoramas, the epipolar geometry, to the first order approximation, consists of horizontal lines. Therefore, any traditional stereo algorithm can be applied to multiperspective panoramas with little modification. In this paper, we describe two reconstruction algorithms. The first is a cylinder sweep algorithm that uses a small number of resampled multiperspective panoramas to obtain dense 3D reconstruction. The second algorithm, in contrast, uses a large number of multiperspective panoramas and takes advantage of the approximate horizontal epipolar geometry inherent in multiperspective panoramas. It comprises a novel and efficient 1D multibaseline matching technique, followed by tensor voting to extract the depth surface. Experiments show that our algorithms are capable of producing comparable high quality depth maps which can be used for applications such as view interpolation. PMID:15382685

  4. Genetic reconstructions of invasion history.

    PubMed

    Cristescu, Melania E

    2015-05-01

    A diverse array of molecular markers and constantly evolving analytical approaches have been employed to reconstruct the invasion histories of the most notorious invasions. Detailed information on the source(s) of introduction, invasion route, type of vectors, number of independent introductions and pathways of secondary spread has been corroborated for a large number of biological invasions. In this review, I present the promises and limitations of current techniques while discussing future directions. Broad phylogeographic surveys of native and introduced populations have traced back invasion routes with surprising precision. These approaches often further clarify species boundaries and reveal complex patterns of genetic relationships with noninvasive relatives. Moreover, fine-scale analyses of population genetics or genomics allow deep inferences on the colonization dynamics across invaded ranges and can reveal the extent of gene flow among populations across various geographical scales, major demographic events such as genetic bottlenecks as well as other important evolutionary events such as hybridization with native taxa, inbreeding and selective sweeps. Genetic data have been often corroborated successfully with historical, geographical and ecological data to enable a comprehensive reconstruction of the invasion process. The advent of next-generation sequencing, along with the availability of extensive databases of repository sequences generated by barcoding projects opens the opportunity to broadly monitor biodiversity, to identify early invasions and to quantify failed invasions that would otherwise remain inconspicuous to the human eye. PMID:25703061

  5. Locomotive wheel 3D reconstruction

    NASA Astrophysics Data System (ADS)

    Guan, Xin; Luo, Zhisheng; Gao, Xiaorong; Wu, Jianle

    2010-08-01

    In the article, a system, which is used to reconstruct locomotive wheels, is described, helping workers detect the condition of a wheel through a direct view. The system consists of a line laser, a 2D camera, and a computer. We use 2D camera to capture the line-laser light reflected by the object, a wheel, and then compute the final coordinates of the structured light. Finally, using Matlab programming language, we transform the coordinate of points to a smooth surface and illustrate the 3D view of the wheel. The article also proposes the system structure, processing steps and methods, and sets up an experimental platform to verify the design proposal. We verify the feasibility of the whole process, and analyze the results comparing to standard date. The test results show that this system can work well, and has a high accuracy on the reconstruction. And because there is still no such application working in railway industries, so that it has practical value in railway inspection system.

  6. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S. M.; McMakin, A. H.

    1991-09-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation dose that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into five technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (i.e., dose estimates). The Source Terms Task develops estimates of radioactive emissions from Hanford facilities since 1944. The Environmental Transport Task reconstructs the movements of radioactive particles from the areas of release to populations. The Environmental Monitoring Data Task assemblies, evaluates and reports historical environmental monitoring data. The Demographics, Agriculture and Food Habits Task develops the data needed to identify the populations that could have been affected by the releases. The Environmental Pathways and Dose Estimates Task used the information derived from the other Tasks to estimate the radiation doses individuals could have received from Hanford radiation. This document lists the progress on this project as of September 1991. 3 figs., 2 tabs.

  7. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.

    1990-01-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that populations could have received from nuclear operations at Hanford since 1944. The project is being managed and conducted by the Pacific Northwest Laboratory (PNL) under the direction of an independent Technical Steering Panel (TSP). The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates). The Source Terms Task develops estimates of radioactive emissions from Hanford facilities since 1944. The Environmental Transport Task reconstructs the movement of radioactive materials from the areas of release to populations. The Environmental Monitoring Data Task assembles, evaluates, and reports historical environmental monitoring data. The Demographics, Agriculture, Food Habits Task develops the data needed to identify the populations that could have been affected by the releases. In addition to population and demographic data, the food and water resources and consumption patterns for populations are estimated because they provide a primary pathway for the intake of radionuclides. The Environmental Pathways and Dose Estimates Task use the information produced by the other tasks to estimate the radiation doses populations could have received from Hanford radiation. Project progress is documented in this monthly report, which is available to the public. 3 figs., 3 tabs.

  8. Bayes Estimators for Phylogenetic Reconstruction

    PubMed Central

    Huggins, P. M.; Li, W.; Haws, D.; Friedrich, T.; Liu, J.; Yoshida, R.

    2011-01-01

    Tree reconstruction methods are often judged by their accuracy, measured by how close they get to the true tree. Yet, most reconstruction methods like maximum likelihood (ML) do not explicitly maximize this accuracy. To address this problem, we propose a Bayesian solution. Given tree samples, we propose finding the tree estimate that is closest on average to the samples. This “median” tree is known as the Bayes estimator (BE). The BE literally maximizes posterior expected accuracy, measured in terms of closeness (distance) to the true tree. We discuss a unified framework of BE trees, focusing especially on tree distances that are expressible as squared euclidean distances. Notable examples include Robinson–Foulds (RF) distance, quartet distance, and squared path difference. Using both simulated and real data, we show that BEs can be estimated in practice by hill-climbing. In our simulation, we find that BEs tend to be closer to the true tree, compared with ML and neighbor joining. In particular, the BE under squared path difference tends to perform well in terms of both path difference and RF distances. PMID:21471560

  9. Prosthetic breast reconstruction: indications and update

    PubMed Central

    Quinn, Tam T.; Miller, George S.; Rostek, Marie; Cabalag, Miguel S.; Rozen, Warren M.

    2016-01-01

    Background Despite 82% of patients reporting psychosocial improvement following breast reconstruction, only 33% patients choose to undergo surgery. Implant reconstruction outnumbers autologous reconstruction in many centres. Methods A systematic review of the literature was undertaken. Inclusion required: (I) Meta-analyses or review articles; (II) adult patients aged 18 years or over undergoing alloplastic breast reconstruction; (III) studies including outcome measures; (IV) case series with more than 10 patients; (V) English language; and (VI) publication after 1st January, 2000. Results After full text review, analysis and data extraction was conducted for a total of 63 articles. Definitive reconstruction with an implant can be immediate or delayed. Older patients have similar or even lower complication rates to younger patients. Complications include capsular contracture, hematoma and infection. Obesity, smoking, large breasts, diabetes and higher grade tumors are associated with increased risk of wound problems and reconstructive failure. Silicone implant patients have higher capsular contracture rates but have higher physical and psychosocial function. There were no associations made between silicone implants and cancer or systemic disease. There were no differences in outcomes or complications between round and shaped implants. Textured implants have a lower risk of capsular contracture than smooth implants. Smooth implants are more likely to be displaced as well as having higher rates of infection. Immediate breast reconstruction (IBR) gives the best aesthetic outcome if radiotherapy is not required but has a higher rate of capsular contracture and implant failure. Delayed-immediate reconstruction patients can achieve similar aesthetic results to IBR whilst preserving the breast skin if radiotherapy is required. Delayed breast reconstruction (DBR) patients have fewer complications than IBR patients. Conclusions Implant reconstruction is a safe and popular

  10. Irradiation autogenous mandibular grafts in primary reconstructions

    SciTech Connect

    Hamaker, R.C.

    1981-07-01

    The procedure, irradiated mandibular autografts, for primary reconstruction, is presented with an immediate success rate of 88%. Eight cases have undergone primary mandibular reconstruction with the tumorous mandible irradiated to 10,000 rads in a single dose. The longest follow-up is 2 3/4 years. The autograft has proven to be an ideal implant. Major resections of the mandible in conjunction with large myocutaneous flaps have been reconstructed utilizing this implant.

  11. Reasons why women who have mastectomy decide to have or not to have breast reconstruction.

    PubMed

    Reaby, L L

    1998-06-01

    reason cited most often by this group was to feel whole again. None of the women in the reconstruction group experienced any difficulty when deciding their method of breast restoration. What factors are taken into consideration by women when they decide either to have or not to have reconstruction need to be understood by physicians. This knowledge will assist them in conveying appropriate information regarding alternatives and will help them deal with the women's concerns and/or misconceptions. PMID:9623821

  12. Advances in Bioprinting Technologies for Craniofacial Reconstruction.

    PubMed

    Visscher, Dafydd O; Farré-Guasch, Elisabet; Helder, Marco N; Gibbs, Susan; Forouzanfar, Tymour; van Zuijlen, Paul P; Wolff, Jan

    2016-09-01

    Recent developments in craniofacial reconstruction have shown important advances in both the materials and methods used. While autogenous tissue is still considered to be the gold standard for these reconstructions, the harvesting procedure remains tedious and in many cases causes significant donor site morbidity. These limitations have subsequently led to the development of less invasive techniques such as 3D bioprinting that could offer possibilities to manufacture patient-tailored bioactive tissue constructs for craniofacial reconstruction. Here, we discuss the current technological and (pre)clinical advances of 3D bioprinting for use in craniofacial reconstruction and highlight the challenges that need to be addressed in the coming years.

  13. Advances in Bioprinting Technologies for Craniofacial Reconstruction.

    PubMed

    Visscher, Dafydd O; Farré-Guasch, Elisabet; Helder, Marco N; Gibbs, Susan; Forouzanfar, Tymour; van Zuijlen, Paul P; Wolff, Jan

    2016-09-01

    Recent developments in craniofacial reconstruction have shown important advances in both the materials and methods used. While autogenous tissue is still considered to be the gold standard for these reconstructions, the harvesting procedure remains tedious and in many cases causes significant donor site morbidity. These limitations have subsequently led to the development of less invasive techniques such as 3D bioprinting that could offer possibilities to manufacture patient-tailored bioactive tissue constructs for craniofacial reconstruction. Here, we discuss the current technological and (pre)clinical advances of 3D bioprinting for use in craniofacial reconstruction and highlight the challenges that need to be addressed in the coming years. PMID:27113634

  14. Normal lid margin after eyelid reconstruction.

    PubMed

    Cies, W A; Baylis, H I

    1977-04-01

    To prevent corneal damage, the central lid margin must have a normal skin-conjunctiva interface following the lid reconstruction. A two-step procedure may be employed: In the lower lid an initial Hughes reconstruction should be tried. If this is unacceptable, a subsequent block excision of the segment is performed. The important step in both phases is a thorough lateral cantholysis. In the upper lid, the central defect is immediately reconstructed by sliding the lateral lid remnant to the medial remnant. The resulting lateral defect is reconstructed with a Hughes procedure. In both cases, a physiologic lid margin is insured, because normal lid is sutured to normal lid.

  15. Uncertainty estimation in reconstructed deformable models

    SciTech Connect

    Hanson, K.M.; Cunningham, G.S.; McKee, R.

    1996-12-31

    One of the hallmarks of the Bayesian approach to modeling is the posterior probability, which summarizes all uncertainties regarding the analysis. Using a Markov Chain Monte Carlo (MCMC) technique, it is possible to generate a sequence of objects that represent random samples drawn from the posterior distribution. We demonstrate this technique for reconstructions of two-dimensional objects from noisy projections taken from two directions. The reconstructed object is modeled in terms of a deformable geometrically-defined boundary with a constant interior density yielding a nonlinear reconstruction problem. We show how an MCMC sequence can be used to estimate uncertainties in the location of the edge of the reconstructed object.

  16. Reconstruction of Congenital Defects of the Vagina

    PubMed Central

    Eldor, Liron; Friedman, Jeffrey D.

    2011-01-01

    Congenital absence of the vagina is a relatively rare condition most commonly associated with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Historically, several reconstructive techniques have been described to provide for functional vaginal reconstruction on these patients, both operative and nonoperative. Although there are many advantages and disadvantages of the various procedures, one experience with the use of split thickness skin grafts to reconstruct the vagina has produced acceptable functional results with limited donor site morbidity. Careful planning and timing of this form of reconstruction can produce predictable results in patients who are nearing sexual maturity. PMID:22547971

  17. CSM RCS Design Considerations and Failure Modes

    NASA Technical Reports Server (NTRS)

    Interbartolo, Michael

    2009-01-01

    Objectives include: a) Define major Command and Service Module (CSM) design considerations; b) List Command Module (CM) RCS failures and lessons learned; and c) List Service Module (SM) RCS failures and lessons learned.

  18. 33 CFR 51.8 - Relevant considerations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... GUARD DISCHARGE REVIEW BOARD § 51.8 Relevant considerations. In determining the equity and propriety of... applicant's capability to serve, the DRB considers such factors as the applicant's age and...

  19. Aggressive dogs: assessment and treatment considerations.

    PubMed

    Crowell-Davis, Sharon L

    2008-05-01

    The question of what to do with an aggressive dog involves clinical, legal, and ethical considerations. This first column on the subject addresses the clinical aspects from the standpoint of the general veterinarian. PMID:18581290

  20. Quality control considerations in performing washability analyses

    SciTech Connect

    Graham, R.D.

    1984-10-01

    The author describes, in considerable detail, the procedures for carrying out washability analyses as laid down in ASTM Standard Test Method D4371. These include sampling, sample preparation, hydrometer standardisation, washability testing, and analysis of specific gravity fractions.

  1. Surgery Considerations for Adults and Children

    MedlinePlus

    Surgery Considerations for Adults and Children 804 W. Diamond Ave., Ste. 210 Gaithersburg, MD 20878 (800) 981- ... orbdnrc@nof.org Osteogenesis Imperfecta Foundation 804 W. Diamond Avenue Suite 210 Gaithersburg, MD 20878 Tel (800) ...

  2. 23 CFR 650.709 - Special considerations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS BRIDGES, STRUCTURES, AND HYDRAULICS Discretionary Bridge Candidate Rating Factor § 650.709 Special considerations. (a) The selection process for new discretionary bridge projects will be based upon the rating...

  3. 23 CFR 650.709 - Special considerations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS BRIDGES, STRUCTURES, AND HYDRAULICS Discretionary Bridge Candidate Rating Factor § 650.709 Special considerations. (a) The selection process for new discretionary bridge projects will be based upon the rating...

  4. 23 CFR 650.709 - Special considerations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS BRIDGES, STRUCTURES, AND HYDRAULICS Discretionary Bridge Candidate Rating Factor § 650.709 Special considerations. (a) The selection process for new discretionary bridge projects will be based upon the rating...

  5. Creating Library Interiors: Planning and Design Considerations.

    ERIC Educational Resources Information Center

    Jones, Plummer Alston, Jr.; Barton, Phillip K.

    1997-01-01

    Examines design considerations for public library interiors: access; acoustical treatment; assignable and nonassignable space; building interiors: ceilings, clocks, color, control, drinking fountains; exhibit space: slotwall display, floor coverings, floor loading, furniture, lighting, mechanical systems, public address, copying machines,…

  6. 15 CFR 2301.5 - Special consideration.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... natives; Asian or Pacific Islanders, Hispanics, and Blacks, not of Hispanic Origin. The special consideration element is provided as one of several evaluation criteria contained in the regulations at 15...

  7. 15 CFR 2301.5 - Special consideration.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... natives; Asian or Pacific Islanders, Hispanics, and Blacks, not of Hispanic Origin. The special consideration element is provided as one of several evaluation criteria contained in the regulations at 15...

  8. 15 CFR 2301.5 - Special consideration.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... natives; Asian or Pacific Islanders, Hispanics, and Blacks, not of Hispanic Origin. The special consideration element is provided as one of several evaluation criteria contained in the regulations at 15...

  9. 15 CFR 2301.5 - Special consideration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... natives; Asian or Pacific Islanders, Hispanics, and Blacks, not of Hispanic Origin. The special consideration element is provided as one of several evaluation criteria contained in the regulations at 15...

  10. 15 CFR 2301.5 - Special consideration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... natives; Asian or Pacific Islanders, Hispanics, and Blacks, not of Hispanic Origin. The special consideration element is provided as one of several evaluation criteria contained in the regulations at 15...

  11. A theory of state space reconstruction in the presence of noise

    SciTech Connect

    Casdagli, M.; Eubank, S.; Farmer, J.D.; Gibson, J. Santa Fe Inst., NM )

    1990-01-01

    Takens' theorem demonstrates that in the absence of noise a multidimensional state space can be reconstructed from a single time series. This theorem does not treat the effect of noise, however, and so gives no guidance about practical considerations for reconstructing a good state space. We study the problem of reconstructing a state space with observational noise, examining the likelihood for a particular state given a series of noisy observations. We define a quantity called distortion, which is proportional to the covariance of the likelihood function in a reconstructed state space. This is related to the noise amplification, which corresponds to the root-mean-square errors for time series prediction with an ideal model. We prove that in the low noise limit minimizing the distortion is equivalent to minimizing the noise amplification. We derive several asymptotic scaling laws for distortion and noise amplification. They depend on properties of the state space reconstruction, such as the sampling time and the reconstruction dimension, and properties of the dynamical system, such as the dimension and Lyapunov exponents. When the dimension and Lyapunov exponents are sufficiently large these scaling laws show that, no matter how the state space is reconstructed, there is an explosion in the noise amplification -- from a practical point of view all determinism is lost, even for short times, so that the time series is effectively a random process. In the low noise, large data limit we show that the technique of local principal value decomposition (PVD) is an optimal method of state space reconstruction, in the sense that it achieves the minimum distortion in a state space of the lowest possible dimension. 20 refs., 12 figs.

  12. Immediate, but Not Delayed, Microsurgical Skull Reconstruction Exacerbates Brain Damage in Experimental Traumatic Brain Injury Model

    PubMed Central

    Lau, Tsz; Kaneko, Yuji; van Loveren, Harry; Borlongan, Cesario V.

    2012-01-01

    Moderate to severe traumatic brain injury (TBI) often results in malformations to the skull. Aesthetic surgical maneuvers may offer normalized skull structure, but inconsistent surgical closure of the skull area accompanies TBI. We examined whether wound closure by replacement of skull flap and bone wax would allow aesthetic reconstruction of the TBI-induced skull damage without causing any detrimental effects to the cortical tissue. Adult male Sprague-Dawley rats were subjected to TBI using the controlled cortical impact (CCI) injury model. Immediately after the TBI surgery, animals were randomly assigned to skull flap replacement with or without bone wax or no bone reconstruction, then were euthanized at five days post-TBI for pathological analyses. The skull reconstruction provided normalized gross bone architecture, but 2,3,5-triphenyltetrazolium chloride and hematoxylin and eosin staining results revealed larger cortical damage in these animals compared to those that underwent no surgical maneuver at all. Brain swelling accompanied TBI, especially the severe model, that could have relieved the intracranial pressure in those animals with no skull reconstruction. In contrast, the immediate skull reconstruction produced an upregulation of the edema marker aquaporin-4 staining, which likely prevented the therapeutic benefits of brain swelling and resulted in larger cortical infarcts. Interestingly, TBI animals introduced to a delay in skull reconstruction (i.e., 2 days post-TBI) showed significantly reduced edema and infarcts compared to those exposed to immediate skull reconstruction. That immediate, but not delayed, skull reconstruction may exacerbate TBI-induced cortical tissue damage warrants a careful consideration of aesthetic repair of the skull in TBI. PMID:22438975

  13. Lethal mass mimicking myxoma in the heart.

    PubMed

    Soo, Wern Miin; Pang, Yin Huei; Poh, Kian-Keong

    2014-10-01

    A 70-year-old man presented in advanced heart failure with jaundice. Transthoracic echocardiography revealed a 21 × 24-mm mass in the left atrium attached to the posterior mitral valve leaflet. Surgical excision was attempted, but the tumor had infiltrated the entire left atrial wall and was deemed too extensive to be resectable. Histology confirmed a high-grade pleomorphic sarcoma with malignant fibrous histiocytoma-like features. Liver biopsy revealed a high-grade liver sarcoma.

  14. Effect of concurrent mental nerve reconstruction at the same time as mandibular reconstruction using a fibula osteoseptocutaneous flap.

    PubMed

    Shimizu, Fumiaki; Ooatari, Miwako; Uehara, Miyuki; Takahashi, Yoshihiro; Kawano, Kenji

    2015-09-01

    The damage of inferior alveolar nerve causes some functional problem including numbness of lower lip and drooling. During segmental mandibulectomy, inferior alveolar nerve commonly resected, therefore, it is ideal to reconstruct the nerve to get better functional result. Sensory recovery was assessed after mandibular reconstruction using free fibula osteoseptocutaneous flap in thirteen cases. In six cases, the mental nerve reconstruction was performed simultaneously, and in seven cases, the mental nerve reconstruction was not performed. In the case that the mental nerve was reconstructed simultaneously, unilateral mental nerve reconstruction was performed in five cases, and bilateral mental nerve reconstruction was performed in one cases. More than one year after the reconstruction, sensory recovery was assessed and compared between the group that the mental nerve was reconstructed and the group that was not reconstructed. Our results showed almost a normal sensory recovery of the lips on the reconstructed side more than one year after the reconstruction in reconstructed group. In contrast, sensory recovery was poor in non-reconstructed group and non-reconstructed side. These results showed that mental nerve reconstruction at the same time as mandibular reconstruction affects the postoperative mandibular function. The sural nerve can be harvested from the same donor site of the free fibula osteoseptocutaneous flap and such mental nerve reconstruction with nerve grafting can be completed within an hour. Most cases of mandibular reconstruction using a free fibula osteoseptocutaneous flap transfer can therefore be candidates for mental nerve reconstruction at the time of mandibular reconstruction. PMID:26051850

  15. Contralateral Prophylactic Mastectomy: Challenging Considerations for the Surgeon.

    PubMed

    Angelos, Peter; Bedrosian, Isabelle; Euhus, David M; Herrmann, Virginia M; Katz, Steven J; Pusic, Andrea

    2015-10-01

    The use of both bilateral prophylactic mastectomy and contralateral prophylactic mastectomy (CPM) has increased significantly during the last decade. Various risk models have been developed to identify patients at increased risk for breast cancer. The indications for bilateral prophylactic mastectomy for patients without a diagnosis of breast cancer include high risk from mutation in BRCA or other breast cancer predisposition gene, very strong family history with no identifiable mutation, and high risk based on breast histology. Additionally, the use of CPM has more than doubled in the last decade, and this increase is noted among all stages of breast cancer, even in patients with ductal carcinoma in situ (stage 0). The risk of contralateral breast cancer often is overestimated by both patients and physicians. Nevertheless, specific risk factors are associated with an increased risk of contralateral breast cancer, including BRCA or other genetic mutation, young age at diagnosis, lobular histology, family history, and prior chest wall irradiation. Although CPM reduces the incidence of contralateral breast cancer, the effect on disease-free survival and, more importantly, overall survival is questionable and underscored by the fact that the reason most patients choose CPM is to achieve "peace of mind." Newer and effective reconstructive options have made the procedure more attractive. This panel addresses the indications and rationale for bilateral prophylactic mastectomy and CPM, the decision-making process by patients, and ethical considerations. Changes in the physician-patient relationship during the past few decades have altered the approach, and ethical considerations are paramount in addressing these issues. PMID:26259752

  16. Model-based respiratory motion compensation for emission tomography image reconstruction.

    PubMed

    Reyes, M; Malandain, G; Koulibaly, P M; González-Ballester, M A; Darcourt, J

    2007-06-21

    In emission tomography imaging, respiratory motion causes artifacts in lungs and cardiac reconstructed images, which lead to misinterpretations, imprecise diagnosis, impairing of fusion with other modalities, etc. Solutions like respiratory gating, correlated dynamic PET techniques, list-mode data based techniques and others have been tested, which lead to improvements over the spatial activity distribution in lungs lesions, but which have the disadvantages of requiring additional instrumentation or the need of discarding part of the projection data used for reconstruction. The objective of this study is to incorporate respiratory motion compensation directly into the image reconstruction process, without any additional acquisition protocol consideration. To this end, we propose an extension to the maximum likelihood expectation maximization (MLEM) algorithm that includes a respiratory motion model, which takes into account the displacements and volume deformations produced by the respiratory motion during the data acquisition process. We present results from synthetic simulations incorporating real respiratory motion as well as from phantom and patient data.

  17. Avoiding Breast Animation Deformity with Pectoralis-Sparing Subcutaneous Direct-to-Implant Breast Reconstruction.

    PubMed

    Kobraei, Edward M; Cauley, Ryan; Gadd, Michele; Austen, William G; Liao, Eric C

    2016-05-01

    There is renewed interest in sparing the pectoralis major muscle in implant breast reconstruction, placing the implant in the subcutaneous position. This advance is made reliable by improvements in mastectomy skin flap quality, evolution of technique, and increased awareness of breast animation deformity. This retrospective review presents 13 patients (23 breasts) reconstructed immediately with placing the definitive implant in the subcutaneous space without disruption of the underlying chest muscles. None of the 13 patients had breast animation deformity postoperatively. One patient experienced an early hematoma, and 3 patients had small seromas that resolved uneventfully. One morbidly obese patient undergoing chemotherapy using a nearby chest port experienced infection requiring implant removal. This study describes an early experience, demonstrates feasibility, and discusses patient selection considerations that are important because we continue to evolve breast reconstruction approaches.

  18. Avoiding Breast Animation Deformity with Pectoralis-Sparing Subcutaneous Direct-to-Implant Breast Reconstruction

    PubMed Central

    Kobraei, Edward M.; Cauley, Ryan; Gadd, Michele; Austen, William G.

    2016-01-01

    Summary: There is renewed interest in sparing the pectoralis major muscle in implant breast reconstruction, placing the implant in the subcutaneous position. This advance is made reliable by improvements in mastectomy skin flap quality, evolution of technique, and increased awareness of breast animation deformity. This retrospective review presents 13 patients (23 breasts) reconstructed immediately with placing the definitive implant in the subcutaneous space without disruption of the underlying chest muscles. None of the 13 patients had breast animation deformity postoperatively. One patient experienced an early hematoma, and 3 patients had small seromas that resolved uneventfully. One morbidly obese patient undergoing chemotherapy using a nearby chest port experienced infection requiring implant removal. This study describes an early experience, demonstrates feasibility, and discusses patient selection considerations that are important because we continue to evolve breast reconstruction approaches. PMID:27579232

  19. Anterolateral Ligament of the Knee: Back to the Future in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Bonasia, Davide Edoardo; D’Amelio, Andrea; Pellegrino, Pietro; Rosso, Federica; Rossi, Roberto

    2015-01-01

    Although the importance of the anterolateral stabilizing structures of the knee in the setting of anterior cruciate ligament (ACL) injuries has been recognized since many years, most of orthopedic surgeons do not take into consideration the anterolateral structures when performing an ACL reconstruction. Anatomic single or double bundle ACL reconstruction will improve knee stability, but a small subset of patients may experience some residual anteroposterior and rotational instability. For this reason, some researchers have turned again towards the anterolateral aspect of the knee and specifically the anterolateral ligament. The goal of this review is to summarize the existing knowledge regarding the anterolateral ligament of the knee, including anatomy, histology, biomechanics and imaging. In addition, the most common anterolateral reconstruction/tenodesis techniques are described together with their respective clinical outcomes. PMID:26330991

  20. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1991-01-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is being managed and conducted by the Pacific Northwest Laboratory (PNL) under the direction of an independent Technical Steering Panel (TSP). The TSP consists of experts in environmental pathways, epidemiology, surface-water transport, ground-water transport, statistics, demography, agriculture, meteorology, nuclear engineering, radiation dosimetry, and cultural anthropology. Included are appointed technical members representing the states of Oregon and Washington, a representative of Native American tribes, and an individual representing the public. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on human (dose estimates): Source Terms; Environmental Transport; Environmental Monitoring Data; Demographics, Agriculture, Food Habits and; Environmental Pathways and Dose Estimates.