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Sample records for reduces thrombus size

  1. [Presurgical treatment of axitinib reduced operation risk by downsizing the vena cava tumor thrombus in advanced renal cell carcinomas: two case reports].

    PubMed

    Hamada, Akihiro; Yamasaki, Toshinari; Negoro, Hiromitsu; Kobayashi, Takashi; Terada, Naoki; Sugino, Yoshio; Matsui, Yoshiyuki; Inoue, Takahiro; Kamba, Tomomi; Yoshimura, Koji; Ogawa, Osamu

    2014-12-01

    In cases of advanced renal cell carcinoma with inferior vena cava (IVC) thrombus, surgical resection of both tumor and thrombus contributes to the improvement of patient's prognosis, but the risk of perioperative complication is still high. We experienced two cases of advanced renal tumors with IVC tumor thrombus down-sized by presurgical treatment of axitinib. Axitinib treatment showed a marked tumor reduction effect without any severe adverse event. We could remove both tumor and thrombus without perioperative complications. In these two cases, downsizing of IVC thrombus enabled us to reduce the extent of the surgery.

  2. Performance of a thrombectomy device for aspiration of thrombus with various sizes based on a computational fluid dynamic modeling.

    PubMed

    Soleimani, Sajjad; Dubini, Gabriele; Pennati, Giancarlo

    2016-06-01

    It is important to thoroughly remove the thrombus within the course of aspiration thrombectomy; otherwise, it may lead to further embolization. The performance of the aspiration thrombectomy device with a generic geometry is studied through the computational approach. In order to model the thrombus aspiration, a real left coronary artery is chosen while thrombi with various sizes are located at the bifurcation area of the coronary artery and, depending on the size of the thrombus, it is stretched toward the side branches. The thrombus occupies the artery resembling the blood current obstruction in the coronary vessel similar to the situation that leads to heart attack. It is concluded that the aspiration ability of the thrombectomy device is not linked to the thrombus size; it is rather linked to the aspiration pressure and thrombus age (organized versus fresh thrombus). However, the aspiration time period correlates to the thrombus size. The minimum applicable aspiration pressure is also investigated in this study.

  3. Novel contact force sensor incorporated in irrigated radiofrequency ablation catheter predicts lesion size and incidence of steam pop and thrombus.

    PubMed

    Yokoyama, Katsuaki; Nakagawa, Hiroshi; Shah, Dipen C; Lambert, Hendrik; Leo, Giovanni; Aeby, Nicolas; Ikeda, Atsushi; Pitha, Jan V; Sharma, Tushar; Lazzara, Ralph; Jackman, Warren M

    2008-12-01

    An open-irrigated radiofrequency (RF) ablation catheter was developed to measure contact force (CF). Three optical fibers measure microdeformation of the catheter tip. The purpose of this study was to (1) validate the accuracy of CF sensor (CFS) (bench test); and (2) determine the relationship between CF and tissue temperatures, lesion size, steam pop, and thrombus during RF ablation using a canine thigh muscle preparation. CFS measurements (total 1409) from 2 catheters in 3 angles (perpendicular, parallel, and 45 degrees ) were compared with a certified balance (range, 0 to 50 g). CFS measurements correlated highly (R(2) > or =0.988; mean error, < or =1.0 g). In 10 anesthetized dogs, a skin cradle over the thigh muscle was superfused with heparinized blood at 37 degrees C. A 7F catheter with 3.5-mm saline-irrigated electrode and CFS (Endosense) was held perpendicular to the muscle at CF of 2, 10, 20, 30, and 40 g. RF was delivered (n=100) for 60 seconds at 30 or 50 W (irrigation 17 or 30 mL/min). Tissue temperature (3 and 7 mm depths), lesion size, thrombus, and steam pop increased significantly with increasing CF at each RF power. Lesion size was greater with applications of lower power (30 W) and greater CF (30 to 40 g) than at high power (50 W) with lower CF (2 to 10 g). This novel ablation catheter, which accurately measures CF, confirmed CF is a major determinant of RF lesion size. Steam pop and thrombus incidence also increases with CF. CFS in an open-irrigated ablation catheter that may optimize the selection of RF power and application time to maximize lesion formation and reduce the risk of steam pop and thrombus.

  4. Size of the thrombus in acute deep vein thrombosis and the significance of patients' age and sex.

    PubMed

    Kierkegaard, A

    1981-01-01

    To determine the significance of patients' age and sex on the size of the thrombus in acute deep vein thrombosis, 420 consecutive phlebograms with acute deep vein thrombosis were studied. A significant correlation between the size of the thrombus and increasing age of the patient as well as the sex of male was noted. It is concluded that older patients and men often are at a high risk of pulmonary embolism at the time of diagnosis.

  5. Platelet size and density affect shear-induced thrombus formation in tortuous arterioles

    NASA Astrophysics Data System (ADS)

    Chesnutt, Jennifer K. W.; Han, Hai-Chao

    2013-10-01

    Thrombosis accounts for 80% of deaths in patients with diabetes mellitus. Diabetic patients demonstrate tortuous microvessels and larger than normal platelets. Large platelets are associated with increased platelet activation and thrombosis, but the physical effects of large platelets in the microscale processes of thrombus formation are not clear. Therefore, the objective of this study was to determine the physical effects of mean platelet volume (MPV), mean platelet density (MPD) and vessel tortuosity on platelet activation and thrombus formation in tortuous arterioles. A computational model of the transport, shear-induced activation, collision, adhesion and aggregation of individual platelets was used to simulate platelet interactions and thrombus formation in tortuous arterioles. Our results showed that an increase in MPV resulted in a larger number of activated platelets, though MPD and level of tortuosity made little difference on platelet activation. Platelets with normal MPD yielded the lowest amount of mural thrombus. With platelets of normal MPD, the amount of mural thrombus decreased with increasing level of tortuosity but did not have a simple monotonic relationship with MPV. The physical mechanisms associated with MPV, MPD and arteriole tortuosity play important roles in platelet activation and thrombus formation.

  6. Platelet size and density affect shear-induced thrombus formation in tortuous arterioles

    PubMed Central

    Chesnutt, Jennifer K W; Han, Hai-Chao

    2013-01-01

    Thrombosis accounts for 80% of deaths in patients with diabetes mellitus. Diabetic patients demonstrate tortuous microvessels and larger than normal platelets. Large platelets are associated with increased platelet activation and thrombosis, but the physical effects of large platelets in the microscale processes of thrombus formation are not clear. Therefore, the objective of this study was to determine the physical effects of mean platelet volume (MPV), mean platelet density (MPD), and vessel tortuosity on platelet activation and thrombus formation in tortuous arterioles. A computational model of the transport, shear-induced activation, collision, adhesion, and aggregation of individual platelets was used to simulate platelet interactions and thrombus formation in tortuous arterioles. Our results showed that an increase in MPV resulted in a larger number of activated platelets, though MPD and level of tortuosity made little difference on platelet activation. Platelets with normal MPD yielded the lowest amount of mural thrombus. With platelets of normal MPD, the amount of mural thrombus decreased with increasing level of tortuosity but did not have a simple monotonic relationship with MPV. The physical mechanisms associated with MPV, MPD, and arteriole tortuosity play important roles in platelet activation and thrombus formation. PMID:23974300

  7. Factor XII inhibition reduces thrombus formation in a primate thrombosis model

    PubMed Central

    Matafonov, Anton; Leung, Philberta Y.; Gailani, Adam E.; Grach, Stephanie L.; Puy, Cristina; Cheng, Qiufang; Sun, Mao-fu; McCarty, Owen J. T.; Tucker, Erik I.; Kataoka, Hiroaki; Renné, Thomas; Morrissey, James H.; Gruber, Andras

    2014-01-01

    The plasma zymogens factor XII (fXII) and factor XI (fXI) contribute to thrombosis in a variety of mouse models. These proteins serve a limited role in hemostasis, suggesting that antithrombotic therapies targeting them may be associated with low bleeding risks. Although there is substantial epidemiologic evidence supporting a role for fXI in human thrombosis, the situation is not as clear for fXII. We generated monoclonal antibodies (9A2 and 15H8) against the human fXII heavy chain that interfere with fXII conversion to the protease factor XIIa (fXIIa). The anti-fXII antibodies were tested in models in which anti-fXI antibodies are known to have antithrombotic effects. Both anti-fXII antibodies reduced fibrin formation in human blood perfused through collagen-coated tubes. fXII-deficient mice are resistant to ferric chloride–induced arterial thrombosis, and this resistance can be reversed by infusion of human fXII. 9A2 partially blocks, and 15H8 completely blocks, the prothrombotic effect of fXII in this model. 15H8 prolonged the activated partial thromboplastin time of baboon and human plasmas. 15H8 reduced fibrin formation in collagen-coated vascular grafts inserted into arteriovenous shunts in baboons, and reduced fibrin and platelet accumulation downstream of the graft. These findings support a role for fXII in thrombus formation in primates. PMID:24408325

  8. Intracoronary thrombus.

    PubMed

    Achenbach, Stephan; Marwan, Mohamed

    2009-01-01

    We present the case of a 62 year old patient admitted with acute chest pain. Coronary CT angiography demonstrated presence of a high grade lesion with pronounced remodeling and the impression of an intracoronary thrombus in the proximal left circumflex coronary artery. Invasive angiography confirmed the presence of a thrombus; thrombus fragments were removed using an extraction device.

  9. Reference Works in Reduced Size

    ERIC Educational Resources Information Center

    Hennessey, David

    1977-01-01

    Lower cost and less shelf space requirements have made major reference works in miniaturized print editions attractive to small libraries. The major disadvantage is the necessity of a magnifying glass for reading entries. A bibliography of reduced-size editions is included. (JAB)

  10. Direct Thrombus Imaging in Stroke

    PubMed Central

    Kim, Jongseong; Park, Jung E.; Nahrendorf, Matthias; Kim, Dong-Eog

    2016-01-01

    There is an emergent need for imaging methods to better triage patients with acute stroke for tissue-plasminogen activator (tPA)-mediated thrombolysis or endovascular clot retrieval by directly visualizing the size and distribution of cerebral thromboemboli. Currently, magnetic resonance (MR) or computed tomography (CT) angiography visualizes the obstruction of blood flow within the vessel lumen rather than the thrombus itself. The present visualization method, which relies on observation of the dense artery sign (the appearance of cerebral thrombi on a non-enhanced CT), suffers from low sensitivity. When translated into the clinical setting, direct thrombus imaging is likely to enable individualized acute stroke therapy by allowing clinicians to detect the thrombus with high sensitivity, assess the size and nature of the thrombus more precisely, serially monitor the therapeutic effects of thrombolysis, and detect post-treatment recurrence. This review is intended to provide recent updates on stroke-related direct thrombus imaging using MR imaging, positron emission tomography, or CT. PMID:27733029

  11. The fluid mechanics of thrombus formation

    NASA Technical Reports Server (NTRS)

    1972-01-01

    Experimental data are presented for the growth of thrombi (blood clots) in a stagnation point flow of fresh blood. Thrombus shape, size and structure are shown to depend on local flow conditions. The evolution of a thrombus is described in terms of a physical model that includes platelet diffusion, a platelet aggregation mechanism, and diffusion and convection of the chemical species responsible for aggregation. Diffusion-controlled and convection-controlled regimes are defined by flow parameters and thrombus location, and the characteristic growth pattern in each regime is explained. Quantitative comparisons with an approximate theoretical model are presented, and a more general model is formulated.

  12. Clinical Sequelae of Thrombus in an Inferior Vena Cava Filter

    SciTech Connect

    Ahmad, Iftikhar; Yeddula, Kalpana; Wicky, Stephan; Kalva, Sanjeeva P.

    2010-04-15

    The purpose of this study was to assess the long-term clinical sequelae of inferior vena cava (IVC) filter thrombus and the effect of anticoagulation on filter thrombus. Of 1,718 patients who had IVC filters placed during 2001-2008, 598 (34.8%) had follow-up abdominal CT. Filter thrombus was seen in 111 of the 598 (18.6%). There were 44 men (39.6%). The mean age at filter placement was 64 years. The medical diseases included cancer in 64, trauma in 15, stroke in 12, and others in 20. The frequency of filter thrombus on CT and asymptomatic filter thrombus on CT was calculated. The frequency of pulmonary embolism (PE) in patients with filter thrombus was calculated. The frequency of thrombus progression or regression (on CT, available in 56) was calculated. The effect of anticoagulation on filter thrombus regression/progression was evaluated using the Fisher exact test by comparing the group of patients who received anticoagulants versus those who did not. A P-value of <0.05 was considered significant. The overall frequency of filter thrombus was 18.6%. Total occlusion of the IVC filter was seen in 12 of 598 (2%). The filter thrombus was asymptomatic in 110 (18.3%). Filter thrombus was detected after a median of 35 days (range, 0-2082) following filter placement. Thrombus extended above the filter in 4 (3.6%); IVC thrombus below the filter was seen in 35(31.5%). Thrombus in the filter occluded <25% of the filter volume in 58 (52.3%), 25-50% in 21 (18.9%), and 50-75% in 20 (18%). Total IVC occlusion was seen in 12 (10.8%). Eighty-three patients received anticoagulation. Sixteen patients developed symptoms of PE. PE was confirmed on CT in 3 of 15 (2.7%). On follow-up, filter thrombus regressed completely in 19 (33.9%) after a median of 6 months. Filter thrombus decreased in size in 13 (23.2%) and it progressed without IVC occlusion in 7 (12.6%). In one (1.7%), filter thrombus progressed to IVC occlusion. Filter thrombus remained stable in 16 (28.6%). There was no

  13. Reducing Class Size: Promises and Perils

    ERIC Educational Resources Information Center

    Bascia, Nina; Fredua-Kwarteng, Eric

    2008-01-01

    Reducing class size, especially in primary grades, can have tremendous academic and social benefits for children--benefits that endure well beyond those first years of school. But smaller class sizes are not a cure-all. Beyond the hoopla of enthusiasm for this seemingly simple change in educational practice lie serious consequences for students…

  14. Reducing Class Size: Promises and Perils

    ERIC Educational Resources Information Center

    Bascia, Nina; Fredua-Kwarteng, Eric

    2008-01-01

    Reducing class size, especially in primary grades, can have tremendous academic and social benefits for children--benefits that endure well beyond those first years of school. But smaller class sizes are not a cure-all. Beyond the hoopla of enthusiasm for this seemingly simple change in educational practice lie serious consequences for students…

  15. Effect of Red Blood Cells on Platelet Activation and Thrombus Formation in Tortuous Arterioles.

    PubMed

    Chesnutt, Jennifer K W; Han, Hai-Chao

    2013-01-01

    Thrombosis is a major contributor to cardiovascular disease, which can lead to myocardial infarction and stroke. Thrombosis may form in tortuous microvessels, which are often seen throughout the human body, but the microscale mechanisms and processes are not well understood. In straight vessels, the presence of red blood cells (RBCs) is known to push platelets toward walls, which may affect platelet aggregation and thrombus formation. However in tortuous vessels, the effects of RBC interactions with platelets in thrombosis are largely unknown. Accordingly, the objective of this work was to determine the physical effects of RBCs, platelet size, and vessel tortuosity on platelet activation and thrombus formation in tortuous arterioles. A discrete element computational model was used to simulate the transport, collision, adhesion, aggregation, and shear-induced platelet activation of hundreds of individual platelets and RBCs in thrombus formation in tortuous arterioles. Results showed that high shear stress near the inner sides of curved arteriole walls activated platelets to initiate thrombosis. RBCs initially promoted platelet activation, but then collisions of RBCs with mural thrombi reduced the amount of mural thrombus and the size of emboli. In the absence of RBCs, mural thrombus mass was smaller in a highly tortuous arteriole compared to a less tortuous arteriole. In the presence of RBCs however, mural thrombus mass was larger in the highly tortuous arteriole compared to the less tortuous arteriole. As well, smaller platelet size yielded less mural thrombus mass and smaller emboli, either with or without RBCs. This study shed light on microscopic interactions of RBCs and platelets in tortuous microvessels, which have implications in various pathologies associated with thrombosis and bleeding.

  16. Reduced clot debris size using standing waves formed via high intensity focused ultrasound

    NASA Astrophysics Data System (ADS)

    Guo, Shifang; Du, Xuan; Wang, Xin; Lu, Shukuan; Shi, Aiwei; Xu, Shanshan; Bouakaz, Ayache; Wan, Mingxi

    2017-09-01

    The feasibility of utilizing high intensity focused ultrasound (HIFU) to induce thrombolysis has been demonstrated previously. However, clinical concerns still remain related to the clot debris produced via fragmentation of the original clot potentially being too large and hence occluding downstream vessels, causing hazardous emboli. This study investigates the use of standing wave fields formed via HIFU to disintegrate the thrombus while achieving a reduced clot debris size in vitro. The results showed that the average diameter of the clot debris calculated by volume percentage was smaller in the standing wave mode than in the travelling wave mode at identical ultrasound thrombolysis settings. Furthermore, the inertial cavitation dose was shown to be lower in the standing wave mode, while the estimated cavitation bubble size distribution was similar in both modes. These results show that a reduction of the clot debris size with standing waves may be attributed to the particle trapping of the acoustic potential well which contributed to particle fragmentation.

  17. Phenylthiourea specifically reduces zebrafish eye size.

    PubMed

    Li, Zeran; Ptak, Devon; Zhang, Liyun; Walls, Elwood K; Zhong, Wenxuan; Leung, Yuk Fai

    2012-01-01

    Phenylthiourea (PTU) is commonly used for inhibiting melanization of zebrafish embryos. In this study, the standard treatment with 0.2 mM PTU was demonstrated to specifically reduce eye size in larval fish starting at three days post-fertilization. This effect is likely the result of a reduction in retinal and lens size of PTU-treated eyes and is not related to melanization inhibition. This is because the eye size of tyr, a genetic mutant of tyrosinase whose activity is inhibited in PTU treatment, was not reduced. As PTU contains a thiocarbamide group which is presented in many goitrogens, suppressing thyroid hormone production is a possible mechanism by which PTU treatment may reduce eye size. Despite the fact that thyroxine level was found to be reduced in PTU-treated larvae, thyroid hormone supplements did not rescue the eye size reduction. Instead, treating embryos with six goitrogens, including inhibitors of thyroid peroxidase (TPO) and sodium-iodide symporter (NIS), suggested an alternative possibility. Specifically, three TPO inhibitors, including those that do not possess thiocarbamide, specifically reduced eye size; whereas none of the NIS inhibitors could elicit this effect. These observations indicate that TPO inhibition rather than a general suppression of thyroid hormone synthesis is likely the underlying cause of PTU-induced eye size reduction. Furthermore, the tissue-specific effect of PTU treatment might be mediated by an eye-specific TPO expression. Compared with treatment with other tyrosinase inhibitors or bleaching to remove melanization, PTU treatment remains the most effective approach. Thus, one should use caution when interpreting results that are obtained from PTU-treated embryos.

  18. Thrombus Formation at High Shear Rates.

    PubMed

    Casa, Lauren D C; Ku, David N

    2017-06-21

    The final common pathway in myocardial infarction and ischemic stroke is occlusion of blood flow from a thrombus forming under high shear rates in arteries. A high-shear thrombus forms rapidly and is distinct from the slow formation of coagulation that occurs in stagnant blood. Thrombosis at high shear rates depends primarily on the long protein von Willebrand factor (vWF) and platelets, with hemodynamics playing an important role in each stage of thrombus formation, including vWF binding, platelet adhesion, platelet activation, and rapid thrombus growth. The prediction of high-shear thrombosis is a major area of biofluid mechanics in which point-of-care testing and computational modeling are promising future directions for clinically relevant research. Further research in this area will enable identification of patients at high risk for arterial thrombosis, improve prevention and treatment based on shear-dependent biological mechanisms, and improve blood-contacting device design to reduce thrombosis risk.

  19. Exogenous modification of platelet membranes with the omega-3 fatty acids EPA and DHA reduces platelet procoagulant activity and thrombus formation.

    PubMed

    Larson, Mark K; Tormoen, Garth W; Weaver, Lucinda J; Luepke, Kristen J; Patel, Ishan A; Hjelmen, Carl E; Ensz, Nicole M; McComas, Leah S; McCarty, Owen J T

    2013-02-01

    Several studies have implicated the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in inhibition of normal platelet function, suggesting a role for platelets in EPA- and DHA-mediated cardioprotection. However, it is unclear whether the cardioprotective mechanisms arise from alterations to platelet-platelet, platelet-matrix, or platelet-coagulation factor interactions. Our previous results led us to hypothesize that EPA and DHA alter the ability of platelets to catalyze the generation of thrombin. We tested this hypothesis by exogenously modifying platelet membranes with EPA and DHA, which resulted in compositional changes analogous to increased dietary EPA and DHA intake. Platelets treated with EPA and DHA showed reductions in the rate of thrombin generation and exposure of platelet phosphatidylserine. In addition, treatment of platelets with EPA and DHA decreased thrombus formation and altered the processing of thrombin precursor proteins. Furthermore, treatment of whole blood with EPA and DHA resulted in increased occlusion time and a sharply reduced accumulation of fibrin under flow conditions. These results demonstrate that EPA and DHA inhibit, but do not eliminate, the ability of platelets to catalyze thrombin generation in vitro. The ability of EPA and DHA to reduce the procoagulant function of platelets provides a possible mechanism behind the cardioprotective phenotype in individuals consuming high levels of EPA and DHA.

  20. Thyroid carcinoma with extensive tumor thrombus in the atrium.

    PubMed

    Yamagami, Yuko; Tori, Masayuki; Sakaki, Masayuki; Ohtake, Shigeaki; Nakahara, Masaaki; Nakao, Kazuyasu

    2008-11-01

    To our knowledge, only a few cases of thyroid carcinoma with an extensive tumor thrombus in the atrium have been reported in literature. We describe a unique case of papillary carcinoma of the thyroid with extensive tumor thrombus in the atrium. A 74-year-old man consulted our hospital because of thyroid carcinoma with an extensive tumor thrombus in the atrium. Computed tomography (CT) revealed a 2-cm tumor with extensive continuous tumor thrombus in the left jugular vein, innominate vein, superior vena cava, and atrium. The tumor was resected to reduce the risk of sudden death from tumor embolism into the pulmonary arteries. Histologically, the diagnosis was papillary carcinoma of the thyroid. Thyroid carcinoma, especially papillary carcinoma, rarely develops a macroscopic tumor thrombus. Patients with an extensive tumor thrombus generally have poor prognoses and high mortality. This patient has been followed for 7 months after successful operation without recurrence.

  1. Thrombus Aspiration in Patients With ST-Segment Elevation Myocardial Infarction Presenting Late After Symptom Onset.

    PubMed

    Desch, Steffen; Stiermaier, Thomas; de Waha, Suzanne; Lurz, Philipp; Gutberlet, Matthias; Sandri, Marcus; Mangner, Norman; Boudriot, Enno; Woinke, Michael; Erbs, Sandra; Schuler, Gerhard; Fuernau, Georg; Eitel, Ingo; Thiele, Holger

    2016-01-25

    The aim of this study was to examine whether manual thrombus aspiration reduces microvascular obstruction assessed by cardiac magnetic resonance imaging in patients with ST-segment elevation myocardial infarction (STEMI) presenting late after symptom onset. Thrombus aspiration is an established treatment option in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). However, there are only limited data on the efficacy of thrombus aspiration in patients with STEMI presenting ≥12 h after symptom onset. Patients with subacute STEMI presenting ≥12 and ≤48 h after symptom onset were randomized to primary PCI with or without manual thrombus aspiration in a 1:1 ratio. Patients underwent cardiac magnetic resonance imaging 1 to 4 days after randomization. The primary endpoint was the extent of microvascular obstruction. A total of 152 patients underwent randomization. The mean time between symptom onset and PCI was 28 ± 12 h. Baseline characteristics were comparable between groups. The majority of patients (60%) showed at least a moderate amount of viable myocardium in the affected region. Extent of microvascular obstruction was not significantly different between patients assigned to thrombus aspiration and the control group (2.5 ± 4.0% vs. 3.1 ± 4.4% of left ventricular mass, p = 0.47). There were also no significant differences in infarct size, myocardial salvage, left ventricular ejection fraction, and angiographic and clinical endpoints between groups. In this first randomized trial of thrombectomy in patients with STEMI presenting late after symptom onset, routine thrombus aspiration before PCI failed to show a benefit for markers of reperfusion success. (Effect of Thrombus Aspiration in Patients With Myocardial Infarction Presenting Late After Symptom Onset; NCT01379248). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. Left ventricular mural thrombus

    SciTech Connect

    Nixon, J.V.

    1983-08-01

    The identification of mural thrombus in patients with left ventricular aneurysm and mural thrombus probably warrants consideration of long-term anticoagulation. In patients with acute, large, anterior or anteroapical, transmural myocardial infarctions, serial noninvasive examinations are warranted to define a group of patients at high risk for the development of left ventricular aneurysm and/or mural thrombus. Anticoagulants should be considered in patients in whom mural thrombi develop as a complication of their infarction. Patients with congestive cardiomyopathy should be considered for long-term anticoagulation. These recommendations are all tempered by the realization that the use of anticoagulant therapy is not without its own risks. The decision to anticoagulate must be balanced against each individual patient's suitability for such therapy and the individual likelihood of the development of side effects.

  3. Computed Tomography-Based Thrombus Imaging for the Prediction of Recanalization after Reperfusion Therapy in Stroke

    PubMed Central

    Heo, Ji Hoe; Kim, Kyeonsub; Yoo, Joonsang; Kim, Young Dae; Nam, Hyo Suk; Kim, Eung Yeop

    2017-01-01

    The prediction of successful recanalization following thrombolytic or endovascular treatment may be helpful to determine the strategy of recanalization treatment in acute stroke. Thrombus can be detected using noncontrast computed tomography (CT) as a hyperdense artery sign or blooming artifact on a T2*-weighted gradient-recalled image. The detection of thrombus using CT depends on slice thickness. Thrombus burden can be determined in terms of the length, volume, and clot burden score. The thrombus size can be quantitatively measured on thin-section CT or CT angiography/magnetic resonance angiography. The determination of thrombus size may be predictive of successful recanalization/non-recanalization after intravenous thrombolysis and endovascular treatment. However, cut-offs of thrombus size for predicting recanalization/non-recanalization are different among studies, due to different methods of measurements. Thus, a standardized method to measure the thrombus is necessary for thrombus imaging to be useful and reliable in clinical practice. Software-based measurements may provide a reliable and accurate assessment. The measurement should be easy and rapid to be more widely used in practice, which could be achieved by improvement of the user interface. In addition to prediction of recanalization, sequential measurements of thrombus volume before and after the treatment may also be useful to determine the efficacy of new thrombolytic drugs. This manuscript reviews the diagnosis of thrombus, prediction of recanalization using thrombus imaging, and practical considerations for the measurement of thrombus burden and density on CT. PMID:28178411

  4. Reduced Boil-Off System Sizing

    NASA Technical Reports Server (NTRS)

    Guzik, Monica C.; Plachta, David W.; Feller, Jeffrey R.

    2015-01-01

    NASA is currently developing cryogenic propellant storage and transfer systems for future space exploration and scientific discovery missions by addressing the need to raise the technology readiness level of cryogenic fluid management technologies. Cryogenic propellants are baselined in many propulsion systems due to their inherently high specific impulse; however, their low boiling points can cause substantial boil-off losses over time. Recent efforts such as the Reduced Boil-off Testing and the Active Thermal Control Scaling Study provide important information on the benefit of an active cooling system applied to LH2 propellant storage. Findings show that zero-boil off technologies can reduce overall mass in LH2 storage systems when low Earth orbit loiter periods extend beyond two months. A significant part of this mass reduction is realized by integrating two stages of cooling: a 20 K stage to intercept heat at the tank surface, and a 90 K stage to reduce the heat entering the less efficient 20 K stage. A missing element in previous studies, which is addressed in this paper, is the development of a direct method for sizing the 90 K cooling stage. Such a method requires calculation of the heat entering both the 90 K and 20 K stages as compared to the overall system masses, and is reliant upon the temperature distribution, performance, and unique design characteristics of the system in question. By utilizing the known conductance of a system without active thermal control, the heat being intercepted by a 90 K stage can be calculated to find the resultant lift and mass of each active thermal control stage. Integral to this is the thermal conductance of the cooling straps and the broad area cooling shield, key parts of the 90 K stage. Additionally, a trade study is performed to show the ability of the 90 K cooling stage to reduce the lift on the 20 K cryocooler stage, which is considerably less developed and efficient than 90 K cryocoolers.

  5. Neutrophil stunning by metoprolol reduces infarct size

    PubMed Central

    García-Prieto, Jaime; Villena-Gutiérrez, Rocío; Gómez, Mónica; Bernardo, Esther; Pun-García, Andrés; García-Lunar, Inés; Crainiciuc, Georgiana; Fernández-Jiménez, Rodrigo; Sreeramkumar, Vinatha; Bourio-Martínez, Rafael; García-Ruiz, José M; del Valle, Alfonso Serrano; Sanz-Rosa, David; Pizarro, Gonzalo; Fernández-Ortiz, Antonio; Hidalgo, Andrés; Fuster, Valentín; Ibanez, Borja

    2017-01-01

    The β1-adrenergic-receptor (ADRB1) antagonist metoprolol reduces infarct size in acute myocardial infarction (AMI) patients. The prevailing view has been that metoprolol acts mainly on cardiomyocytes. Here, we demonstrate that metoprolol reduces reperfusion injury by targeting the haematopoietic compartment. Metoprolol inhibits neutrophil migration in an ADRB1-dependent manner. Metoprolol acts during early phases of neutrophil recruitment by impairing structural and functional rearrangements needed for productive engagement of circulating platelets, resulting in erratic intravascular dynamics and blunted inflammation. Depletion of neutrophils, ablation of Adrb1 in haematopoietic cells, or blockade of PSGL-1, the receptor involved in neutrophil–platelet interactions, fully abrogated metoprolol's infarct-limiting effects. The association between neutrophil count and microvascular obstruction is abolished in metoprolol-treated AMI patients. Metoprolol inhibits neutrophil–platelet interactions in AMI patients by targeting neutrophils. Identification of the relevant role of ADRB1 in haematopoietic cells during acute injury and the protective role upon its modulation offers potential for developing new therapeutic strategies. PMID:28416795

  6. The Paradox of Reducing Class Size and Improving Learning Outcomes

    ERIC Educational Resources Information Center

    Hattie, John

    2005-01-01

    This paper addresses four questions: What are the effects of reducing class size? How important are these effects? How can we explain these effects? and How can we improve the outcomes when class sizes are reduced? A major aim is to provide directions for resolving the paradox as to "Why reducing class size has not led to major improvements in…

  7. The Paradox of Reducing Class Size and Improving Learning Outcomes

    ERIC Educational Resources Information Center

    Hattie, John

    2005-01-01

    This paper addresses four questions: What are the effects of reducing class size? How important are these effects? How can we explain these effects? and How can we improve the outcomes when class sizes are reduced? A major aim is to provide directions for resolving the paradox as to "Why reducing class size has not led to major improvements in…

  8. Reducing Class Size: What Do We Know?

    ERIC Educational Resources Information Center

    Bascia, Nina

    2010-01-01

    This report provides an overview of findings from the research on primary class size reduction as a strategy to improve student learning. Its purpose is to provide a comprehensive and balanced picture of a very popular educational reform strategy that has often been seen as a "quick fix" for improving students' opportunities to learn in…

  9. Large right ventricular thrombus.

    PubMed

    Sousa, Carla; Almeida, Pedro; Gonçalves, Alexandra; Rodrigues, João; Rangel, Inês; Macedo, Filipe; Maciel, M Júlia

    2014-01-01

    Right ventricular thrombosis is a rare yet potentially fatal condition. It has been described in association with hypercoagulability states, autoimmune diseases and dilated cardiomyopathy. Echocardiography constitutes the election tool for diagnosis and characterization of these entities, allowing for the differentiation between the various types of thrombi. We present a case of a patient with alcoholic dilated cardiomyopathy admitted for congestive heart failure and lower respiratory infection. In the diagnostic approach, a routine echocardiography revealed a large mural right ventricular thrombus in association with severe biventricular dysfunction. The patient was proposed for anticoagulation strategy, which he refused.

  10. Incidence and management of inferior vena cava filter thrombus detected at time of filter retrieval.

    PubMed

    Teo, Terence K B; Angle, John F; Shipp, John I; Bluett, Michael K; Gilliland, Charles A; Turba, Ulku C; Matsumoto, Alan H

    2011-11-01

    To evaluate inferior vena cava (IVC) venograms (ie, cavograms) before filter retrieval to determine the incidence and volume of filter thrombus relative to filter dwell time and evaluate subsequent changes in thrombus volume with additional anticoagulation. IVC filter retrieval attempts between December 2002 and June 2010 were retrospectively reviewed to determine the incidence of filter thrombus and estimate thrombus volume on a preretrieval cavogram. Correlation between filter dwell times (assessed at 30-d intervals) and incidence and volume of thrombus was assessed. Follow-up images and management of filters with thrombus that were not initially removed were analyzed. A total of 463 retrieval attempts were performed in 440 patients, with a mean filter dwell time of 95 days ± 145 (SD; range, 0-1,762 d). Thirty (6.5%) had filter thrombus on initial cavograms, with a mean thrombus volume of 2.8 cm(3) ± 7.3 (range, 0.04-40.02 cm(3)). Incidence rate and estimated thrombus volume were highest in the 0-30-day dwell interval (8.0% and 6.3 cm(3), respectively) and decreased at subsequent time intervals. On linear regression analysis, incidence of filter thrombus was inversely related to dwell time (P < .05; correlation coefficient, -0.86). Seven patients with thrombus underwent additional anticoagulation for a mean of 48 days ± 25 (range, 14-90 d); thrombus resolved completely in five (71%) and partially in one (14%), and increased in one (14%). The incidence of filter thrombus at the time of filter retrieval appears to decrease with dwell time. If thrombus is detected, an additional period of anticoagulation is likely to reduce the thrombus burden and facilitate later retrieval. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  11. Hydroxyethyl starch increases patency and reduces thrombus formation following arteriotomy/intimectomy in small arteries: An experimental study in the rabbit

    SciTech Connect

    Wieslander, J.B.; Salemark, L.; Dougan, P. )

    1990-10-01

    Twenty-four arteries of rabbit ears, divided into two groups of 12 vessels each, were prepared and {sup 32}P-labelled platelets were infused. Arteriotomy/intimectomy was performed after 1 hr and in vivo platelet accumulation recorded for 2 hr. Group A comprised untreated control animals and group B was treated with 1 g hydroxyethyl starch (HES), MW 450,000 in 17 ml saline/kg b.w. (Plasma-steril). Vessel bleeding-times were normal, patency was improved, and intraluminal thrombotic material was reduced after HES treatment. Initial in vivo platelet accumulation was rapid and reached similar levels in both groups. However, the platelet accumulation curves decreased more frequently following HES than in the control group. HES does not prevent platelet accumulation at trauma sites, but reduces the sizes of the thrombi formed and may enhance disaggregation/fibrinolysis.

  12. Clinical management of renal cell carcinoma with venous tumor thrombus.

    PubMed

    Agochukwu, Nnenaya; Shuch, Brian

    2014-06-01

    Venous invasion is common in advanced renal cell carcinoma (RCC) due to the unique biology of this cancer. The presence of a tumor thrombus often makes clinical management challenging. In this review, we detail specific preoperative, perioperative, and surgical strategies involving the care of the complex kidney cancer patient with venous tumor involvement. We performed a comprehensive review of selected peer-reviewed publications regarding RCC tumor thrombus biology, medical and surgical management techniques, and immediate and long-term outcomes. The perioperative management may require special imaging techniques, preoperative testing, very recent imaging, and consultation with other surgical services. There are various approaches to these patients as the clinical presentation, stage of disease, primary tumor size, level of thrombus, degree of venous occlusion, presence of bland thrombus, and primary tumor laterality influence management. Select patients with metastatic disease can do well with cytoreductive nephrectomy and thrombectomy. Those with localized disease have a high risk of recurrence; however, some patients can exhibit durable survival with surgery alone. The evolving surgical and medical treatments are discussed. Even when these surgeries are performed in high volume centers, significant perioperative complications are common and greater complications are seen with higher thrombus extent. If surgery is attempted, it is important for urologic oncologists to follow strict attention to specific surgical principles. These general principles include complete vascular control, avoidance of thrombus embolization, close hemodynamic monitoring, and institutional resources for caval resection/replacement and venous bypass if necessary.

  13. Thrombus weight as a measure of hypercoagulability induced by drugs.

    PubMed

    MacIomhair, M; Lavelle, S M

    1979-10-31

    Thrombus weight was used as a measure of the thrombus enhancing effect of drugs in 135 rats. The weight of thrombus formed in one hour, on a 20 x 0.5 mm platinum wire, inserted in the vena cava was taken as a measure of thrombosis. The change in thrombus weight which followed the injection of ellagic acid to activate the coagulation system, adenosine diphosphate to activate the platelets, and epsilon-aminocaproic acid to inhibit the fibrinolytic system, was measured. Pilot studies showed that the drug doses used brought about the appropriate changes in the factors named. The mean thrombus weight in 45 control animals was 1.93 mg. Ellagic acid increased it about five-fold, and epsilon-aminocaproic acid almost two-fold, while adenosine diphosphate reduced it by almost a half. Concurrent controls were used in each case. Clotting tests (whole blood clotting time, kaolin-activated whole blood clotting time, thrombin time, and partial thromboplastin time), performed at the end of the hour, showed no significant correlation with thrombus weight.

  14. Thrombus aspiration catheter is a Dottering balloon.

    PubMed

    Sheshagiri Rao, D; Barik, Ramachandra; Prasad, Akula Siva

    2016-01-01

    Coronary angiogram in a young man with history of STEMI with delayed presentation revealed subtotal occlusion of left anterior descending artery (LAD) with large thrombotic filling defect distal to the critical lesion. PCI was preferred without delay because of ongoing chest pain. Several runs of thrombus aspiration failed to detect any visible thrombus. However, the immediate angiogram after thrombus aspiration showed complete distal embolization of the thrombus which could have been achieved by Dottering or balloon dilatation. In contrary to the general perception, does thrombus aspiration push more thrombus than it can aspirate?

  15. Reducing the Size of the Federal Civilian Work Force

    DTIC Science & Technology

    1993-12-01

    33 Hiring Freezes 39 Early Retirement 48 vi REDUCING THE SIZE OF THE FEDERAL CIVILIAN WORK FORCE December 1993 FIVE USE OF SEPARATION INCENTIVES AT...Cash Costs and Savings of Early Retirement 22 11. Near-Term Costs and Savings of Offering Employees Cash Incentives to Separate 24 viii REDUCING THE...Changes in U.S. Postal Service Employment, 1992-1993 55 22. Effect of Incentives on Regular and Early Retirement at the U.S. Postal Service and

  16. [Unusual thrombus embolization during primary coronary angioplasty: a case report].

    PubMed

    Di Marco, Massimo; Materazzo, Guido; Mascellanti, Marco; Paloscia, Leonardo

    2010-02-01

    Embolization of thrombotic material during primary angioplasty may occur even if the procedure is performed with appropriate medication as well as in hospital centers having a high volume of procedures. Over recent years the introduction of mechanical devices for thromboaspiration and/or distal protection have reduced the incidence of embolization thus improving myocardial reperfusion and survival. We report the case of a large thrombus migrated from the proximal left circumflex artery to the proximal left anterior descending artery during balloon inflation. In our opinion, the cause was retrograde expulsion of the thrombus by the deploying balloon.

  17. Thrombus aspiration during ST-segment elevation myocardial infarction.

    PubMed

    Fröbert, Ole; Lagerqvist, Bo; Olivecrona, Göran K; Omerovic, Elmir; Gudnason, Thorarinn; Maeng, Michael; Aasa, Mikael; Angerås, Oskar; Calais, Fredrik; Danielewicz, Mikael; Erlinge, David; Hellsten, Lars; Jensen, Ulf; Johansson, Agneta C; Kåregren, Amra; Nilsson, Johan; Robertson, Lotta; Sandhall, Lennart; Sjögren, Iwar; Ostlund, Ollie; Harnek, Jan; James, Stefan K

    2013-10-24

    The clinical effect of routine intracoronary thrombus aspiration before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is uncertain. We aimed to evaluate whether thrombus aspiration reduces mortality. We conducted a multicenter, prospective, randomized, controlled, open-label clinical trial, with enrollment of patients from the national comprehensive Swedish Coronary Angiography and Angioplasty Registry (SCAAR) and end points evaluated through national registries. A total of 7244 patients with STEMI undergoing PCI were randomly assigned to manual thrombus aspiration followed by PCI or to PCI only. The primary end point was all-cause mortality at 30 days. No patients were lost to follow-up. Death from any cause occurred in 2.8% of the patients in the thrombus-aspiration group (103 of 3621), as compared with 3.0% in the PCI-only group (110 of 3623) (hazard ratio, 0.94; 95% confidence interval [CI], 0.72 to 1.22; P=0.63). The rates of hospitalization for recurrent myocardial infarction at 30 days were 0.5% and 0.9% in the two groups, respectively (hazard ratio, 0.61; 95% CI, 0.34 to 1.07; P=0.09), and the rates of stent thrombosis were 0.2% and 0.5%, respectively (hazard ratio, 0.47; 95% CI, 0.20 to 1.02; P=0.06). There were no significant differences between the groups with respect to the rate of stroke or neurologic complications at the time of discharge (P=0.87). The results were consistent across all major prespecified subgroups, including subgroups defined according to thrombus burden and coronary flow before PCI. Routine thrombus aspiration before PCI as compared with PCI alone did not reduce 30-day mortality among patients with STEMI. (Funded by the Swedish Research Council and others; ClinicalTrials.gov number, NCT01093404.).

  18. Can serving-size labels reduce the portion-size effect? A pilot study.

    PubMed

    Spanos, Samantha; Kenda, Andree S; Vartanian, Lenny R

    2015-01-01

    Research has shown that the bigger the portion that people are served, the more food they eat; this phenomenon is referred to as the portion-size effect. Providing objective serving-size information on food products has been shown to reduce the influence of external food cues on people's eating behavior. The current study examined whether providing objective serving-size information would also reduce the portion-size effect. 100 female participants were served either a small or large portion of pizza in the context of a taste test. The large portion was either unlabeled, labeled as "Contains 2 servings," or labeled as "Contains 4 servings." Food intake was lower when the large portion was labeled "Contains 4 servings" compared to when it was labeled "Contains 2 servings." Moreover, participants' intake in the large portion/4 servings condition was statistically similar to the intake of participants in the small portion condition. Thus, the standard portion-size effect was observed when the large portion was unlabeled or was labeled as "Contains 2 servings," but not when the large portion was labeled as "Contains 4 servings". These findings suggest that providing serving-size information can reduce the portion-size effect, but that the specific content (and not just the presence) of serving-size information is important in determining food intake. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Clinical and histopathological effects of presurgical treatment with sunitinib for renal cell carcinoma with inferior vena cava tumor thrombus at a single institution.

    PubMed

    Ujike, Takeshi; Uemura, Motohide; Kawashima, Atsunari; Nagahara, Akira; Fujita, Kazutoshi; Miyagawa, Yasushi; Nonomura, Norio

    2016-11-01

    To evaluate the clinical and histopathological effects of presurgical treatment with sunitinib on inferior vena cava (IVC) tumor thrombus. Between 2010 and 2014, we treated seven patients with renal cell carcinoma and IVC tumor thrombus presurgically with sunitinib. We retrospectively evaluated primitive tumor size, the level of tumor thrombus according to Novick's classification, its distance above the renal vein, thrombus diameter at its widest segment, and histopathological change after sunitinib treatment. Three patients were diagnosed histologically. Percutaneous biopsy of the renal mass before sunitinib treatment was performed in two patients. One patient was diagnosed after sunitinib treatment following nephrectomy. The primitive tumors shrank upon sunitinib therapy in four cases; however, although the caval thrombus was downstaged (from level II to I) in one patient, the level of caval thrombus did not change in five patients and increased in one patient (from level III to IV). We evaluated the histopathological effects in two patients. In one patient, the IVC tumor thrombus was mostly replaced with necrotic tissue, but its thrombus level was not downstaged. In the other patient, the IVC tumor thrombus was downstaged, but tumor thrombus was not replaced with necrotic tissue and viable tumor cells remained. Presurgical treatment with sunitinib for renal cell carcinoma with IVC tumor thrombus appears to have limited effect on IVC tumor thrombus, in contrast to its effects on primitive tumor shrinkage. In the absence of evidence of presurgical benefits from prospective studies, this treatment may not be systematically advisable.

  20. Reducing myocardial infarct size: challenges and future opportunities

    PubMed Central

    Bulluck, Heerajnarain; Yellon, Derek M; Hausenloy, Derek J

    2016-01-01

    Despite prompt reperfusion by primary percutaneous coronary intervention (PPCI), the mortality and morbidity of patients presenting with an acute ST-segment elevation myocardial infarction (STEMI) remain significant with 9% death and 10% heart failure at 1 year. In these patients, one important neglected therapeutic target is ‘myocardial reperfusion injury’, a term given to the cardiomyocyte death and microvascular dysfunction which occurs on reperfusing ischaemic myocardium. A number of cardioprotective therapies (both mechanical and pharmacological), which are known to target myocardial reperfusion injury, have been shown to reduce myocardial infarct (MI) size in small proof-of-concept clinical studies—however, being able to demonstrate improved clinical outcomes has been elusive. In this article, we review the challenges facing clinical cardioprotection research, and highlight future therapies for reducing MI size and preventing heart failure in patients presenting with STEMI at risk of myocardial reperfusion injury. PMID:26674987

  1. Reducing myocardial infarct size: challenges and future opportunities.

    PubMed

    Bulluck, Heerajnarain; Yellon, Derek M; Hausenloy, Derek J

    2016-03-01

    Despite prompt reperfusion by primary percutaneous coronary intervention (PPCI), the mortality and morbidity of patients presenting with an acute ST-segment elevation myocardial infarction (STEMI) remain significant with 9% death and 10% heart failure at 1 year. In these patients, one important neglected therapeutic target is 'myocardial reperfusion injury', a term given to the cardiomyocyte death and microvascular dysfunction which occurs on reperfusing ischaemic myocardium. A number of cardioprotective therapies (both mechanical and pharmacological), which are known to target myocardial reperfusion injury, have been shown to reduce myocardial infarct (MI) size in small proof-of-concept clinical studies-however, being able to demonstrate improved clinical outcomes has been elusive. In this article, we review the challenges facing clinical cardioprotection research, and highlight future therapies for reducing MI size and preventing heart failure in patients presenting with STEMI at risk of myocardial reperfusion injury.

  2. Thrombus on pacemaker lead.

    PubMed

    Raut, Monish S; Maheshwari, Arun; Dubey, Sumir

    2015-12-01

    A 58-year-old male was admitted with history of shortness of breath and recurrent fever since two months. He had undergone permanent pacemaker implantation six years back for complete heart block. The patient was persistently having thrombocytopenia. Echocardiographic examination revealed mass (size 4.28 cm(2)) attached to pacemaker lead in right atrium. The patient was scheduled for open-heart surgery for removal of right atrial mass. During surgery, pacemaker leads and pulse generator were also removed along with mass considering the possible source of infection.

  3. Measurement of Thrombus Flux Using Transesophageal Echocardiography

    NASA Astrophysics Data System (ADS)

    Yamaguchi, Tadashi; Hirai, Kazuki; Aoki, Masami; Miyagi, Jin; Suzuki, Masahiko; Moriya, Hideshige; Hachiya, Hiroyuki

    2006-05-01

    Deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are serious problem of total knee replacement (TKR). These diseases may be caused by a thrombus formed during the TKR operation. Therefore, understanding the flow volume of thrombus is important for curing and preventing PTE. In this paper, we tried to understanding the situation of the flow of thrombus by using transesophageal echocardiography movies. We applied the signal processing technique the FSET to extract the anomalous information from ultrasonic echo image. As a result of processing, the time change of the flow volume of thrombus was confirmed.

  4. Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging.

    PubMed

    Delewi, Ronak; Nijveldt, Robin; Hirsch, Alexander; Marcu, Constantin B; Robbers, Lourens; Hassell, Marriela E C J; de Bruin, Rianne H A; Vleugels, Jim; van der Laan, Anja M; Bouma, Berto J; Tio, René A; Tijssen, Jan G P; van Rossum, Albert C; Zijlstra, Felix; Piek, Jan J

    2012-12-01

    Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI. 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events. On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B=0.02, SE=0.02, p<0.001). Routine TTE had a sensitivity of 21-24% and a specificity of 95-98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ=0.91 and κ=0.96) compared to TTE (κ=0.74 and κ=0.53). LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Red maca (Lepidium meyenii) reduced prostate size in rats

    PubMed Central

    Gonzales, Gustavo F; Miranda, Sara; Nieto, Jessica; Fernández, Gilma; Yucra, Sandra; Rubio, Julio; Yi, Pedro; Gasco, Manuel

    2005-01-01

    Background Epidemiological studies have found that consumption of cruciferous vegetables is associated with a reduced risk of prostate cancer. This effect seems to be due to aromatic glucosinolate content. Glucosinolates are known for have both antiproliferative and proapoptotic actions. Maca is a cruciferous cultivated in the highlands of Peru. The absolute content of glucosinolates in Maca hypocotyls is relatively higher than that reported in other cruciferous crops. Therefore, Maca may have proapoptotic and anti-proliferative effects in the prostate. Methods Male rats treated with or without aqueous extracts of three ecotypes of Maca (Yellow, Black and Red) were analyzed to determine the effect on ventral prostate weight, epithelial height and duct luminal area. Effects on serum testosterone (T) and estradiol (E2) levels were also assessed. Besides, the effect of Red Maca on prostate was analyzed in rats treated with testosterone enanthate (TE). Results Red Maca but neither Yellow nor Black Maca reduced significantly ventral prostate size in rats. Serum T or E2 levels were not affected by any of the ecotypes of Maca assessed. Red Maca also prevented the prostate weight increase induced by TE treatment. Red Maca administered for 42 days reduced ventral prostatic epithelial height. TE increased ventral prostatic epithelial height and duct luminal area. These increases by TE were reduced after treatment with Red Maca for 42 days. Histology pictures in rats treated with Red Maca plus TE were similar to controls. Phytochemical screening showed that aqueous extract of Red Maca has alkaloids, steroids, tannins, saponins, and cardiotonic glycosides. The IR spectra of the three ecotypes of Maca in 3800-650 cm (-1) region had 7 peaks representing 7 functional chemical groups. Highest peak values were observed for Red Maca, intermediate values for Yellow Maca and low values for Black Maca. These functional groups correspond among others to benzyl glucosinolate. Conclusions

  6. Organic Semiconducting Nanoparticles as Efficient Photoacoustic Agents for Lightening Early Thrombus and Monitoring Thrombolysis in Living Mice.

    PubMed

    Cui, Cao; Yang, Zhen; Hu, Xiang; Wu, Jinjun; Shou, Kangquan; Ma, Hengheng; Jian, Chao; Zhao, Yong; Qi, Baiwen; Hu, Xiaoming; Yu, Aixi; Fan, Quli

    2017-03-28

    Acute venous thrombosis is prevalent and potentially fatal. Accurate diagnosis of early thrombus is needed for patients in timely clinical intervention to prevent life-threatening conditions. Photoacoustic imaging (PAI) with excellent spatial resolution and high optical contrast shows more promise for this purpose. However, its application is dramatically limited by its signal-off effect on thrombus because of the ischemia in thrombus which lacks the endogenous photoacoustic (PA) signal of hemoglobin. To address this dilemma, we herein report the feasibility of using organic semiconducting nanoparticles (NPs) for contrast-enhanced PAI of thrombus in living mice. An organic semiconducting NP, self-assembled by amphiphilic perylene-3,4,9,10-tetracarboxylic diimide (PDI) molecules, is chemically modified with cyclic Arg-Gly-Asp (cRGD) peptides as a PA contrast agent (cRGD-PDI NPs) for selectively lightening early thrombus. cRGD-PDI NPs presents high PA intensity, good stability in light and serum, and sufficient blood-circulating half-life. In living mice, PA intensity of early thrombus significantly increases after tail vein injection of cRGD-PDI NPs, which is 4-fold greater than that of the control, blocking, and old thrombus groups. Pathological and immunohistochemical findings show that glycoprotein IIb/IIIa abundant in early thrombus is a good biomarker targeted by cRGD-PDI NPs for distinguishing early thrombus from old thrombus by PAI. Such a lightening PAI effect by cRGD-PDI NPs successfully provides accurate information including the profile, size and conformation, and spatial distribution of early thrombus, which may timely monitor the obstructive degree of thrombus in blood vessels and the thrombolysis effect.

  7. Cannabidiol Reduces Leukemic Cell Size – But Is It Important?

    PubMed Central

    Kalenderoglou, Nikoletta; Macpherson, Tara; Wright, Karen L.

    2017-01-01

    The anti-cancer effect of the plant-derived cannabinoid, cannabidiol, has been widely demonstrated both in vivo and in vitro. However, this body of preclinical work has not been translated into clinical use. Key issues around this failure can be related to narrow dose effects, the cell model used and incomplete efficacy. A model of acute lymphoblastic disease, the Jurkat T cell line, has been used extensively to study the cannabinoid system in the immune system and cannabinoid-induced apoptosis. Using these cells, this study sought to investigate the outcome of those remaining viable cells post-treatment with cannabidiol, both in terms of cell size and tracking any subsequent recovery. The phosphorylation status of the mammalian Target of Rapamycin (mTOR) signaling pathway and the downstream target ribosomal protein S6, were measured. The ability of cannabidiol to exert its effect on cell viability was also evaluated in physiological oxygen conditions. Cannabidiol reduced cell viability incompletely, and slowed the cell cycle with fewer cells in the G2/M phase of the cell cycle. Cannabidiol reduced phosphorylation of mTOR, PKB and S6 pathways related to survival and cell size. The remaining population of viable cells that were cultured in nutrient rich conditions post-treatment were able to proliferate, but did not recover to control cell numbers. However, the proportion of viable cells that were gated as small, increased in response to cannabidiol and normally sized cells decreased. This proportion of small cells persisted in the recovery period and did not return to basal levels. Finally, cells grown in 12% oxygen (physiological normoxia) were more resistant to cannabidiol. In conclusion, these results indicate that cannabidiol causes a reduction in cell size, which persists post-treatment. However, resistance to cannabidiol under physiological normoxia for these cells would imply that cannabidiol may not be useful in the clinic as an anti-leukemic agent. PMID

  8. Platelet Transport Rates and Binding Kinetics at High Shear over a Thrombus

    PubMed Central

    Bark, David L.; Ku, David N.

    2013-01-01

    Thrombus formation over a ruptured atherosclerotic plaque cap can occlude an artery with fatal consequences. We describe a computational model of platelet transport and binding to interpret rate-limiting steps seen in experimental thrombus formation over a collagen-coated stenosis. The model is used to compute shear rates in stenoses with growing boundaries. In the model, moving erythrocytes influence platelet transport based on shear-dependent enhanced diffusivity and a nonuniform platelet distribution. Adhesion is modeled as platelet-platelet binding kinetics. The results indicate that observed thrombus growth rates are limited by platelet transport to the wall for shear rates up to 6000 s−1. Above 7000 s−1, the thrombus growth rate is likely limited by binding kinetics (10−4 m/s). Thrombus growth computed from these rate-limiting steps match the thrombus location and occlusion times for experimental conditions if a lag time for platelet activation is included. Using fitted parameters, the model is then used to predict thrombus size and shape at a higher Reynolds number flow consistent with coronary artery disease. PMID:23870271

  9. Platelet transport rates and binding kinetics at high shear over a thrombus.

    PubMed

    Bark, David L; Ku, David N

    2013-07-16

    Thrombus formation over a ruptured atherosclerotic plaque cap can occlude an artery with fatal consequences. We describe a computational model of platelet transport and binding to interpret rate-limiting steps seen in experimental thrombus formation over a collagen-coated stenosis. The model is used to compute shear rates in stenoses with growing boundaries. In the model, moving erythrocytes influence platelet transport based on shear-dependent enhanced diffusivity and a nonuniform platelet distribution. Adhesion is modeled as platelet-platelet binding kinetics. The results indicate that observed thrombus growth rates are limited by platelet transport to the wall for shear rates up to 6000 s(-1). Above 7000 s(-1), the thrombus growth rate is likely limited by binding kinetics (10(-4) m/s). Thrombus growth computed from these rate-limiting steps match the thrombus location and occlusion times for experimental conditions if a lag time for platelet activation is included. Using fitted parameters, the model is then used to predict thrombus size and shape at a higher Reynolds number flow consistent with coronary artery disease. Copyright © 2013 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  10. Renewal of Mural Thrombus Releases Plasma Markers and Is Involved in Aortic Abdominal Aneurysm Evolution

    PubMed Central

    Touat, Ziad; Ollivier, Veronique; Dai, Jianping; Huisse, Marie-Genevieve; Bezeaud, Annie; Sebbag, Uriel; Palombi, Tony; Rossignol, Patrick; Meilhac, Olivier; Guillin, Marie-Claude; Michel, Jean-Baptiste

    2006-01-01

    Human abdominal aortic aneurysm (AAA) expansion has been linked to the presence of a mural thrombus. Here we explored the mechanism of the continual luminal renewal of this thrombus and its ability to release biological markers potentially detectable in plasma. We also explored the ability of platelet inhibition to pacify the thrombus and to limit aneurysm progression in an experimental model. Blood samples and mural thrombi were collected in 20 AAA patients. In parallel, segments of sodium dodecyl sulfate-decellularized guinea pig aorta were xenografted onto the abdominal aorta of 30 rats to induce aneurysms. Fifteen rats received abciximab treatment and fifteen received irrelevant immunoglobulins. Procoagulant activity and platelet activation markers (microparticles, sP-selectin, sGPV, sCD40L) were increased threefold to fivefold in eluates from the luminal thrombus layer compared to other layers. All these markers were increased twofold to fivefold in patients’ plasma compared to matched controls (P < 0.005). In the rat model, abciximab reduced both thrombus area and aneurysmal enlargement (P < 0.05). Platelet aggregation is probably responsible for the renewal of the thrombus in AAA. The luminal thrombus released markers of platelet activation that could easily be detected in plasma. Platelet inhibition limited aortic aneurysm expansion in a rat model, providing new therapeutic perspectives in the prevention of AAA enlargement. PMID:16507915

  11. Bile salt–dependent lipase interacts with platelet CXCR4 and modulates thrombus formation in mice and humans

    PubMed Central

    Panicot-Dubois, Laurence; Thomas, Grace M.; Furie, Barbara C.; Furie, Bruce; Lombardo, Dominique; Dubois, Christophe

    2007-01-01

    Bile salt–dependent lipase (BSDL) is an enzyme involved in the duodenal hydrolysis and absorption of cholesteryl esters. Although some BSDL is transported to blood, the role of circulating BSDL is unknown. Here, we demonstrate that BSDL is stored in platelets and released upon platelet activation. Because BSDL contains a region that is structurally homologous to the V3 loop of HIV-1, which binds to CXC chemokine receptor 4 (CXCR4), we hypothesized that BSDL might bind to CXCR4 present on platelets. In human platelets in vitro, both BSDL and a peptide corresponding to its V3-like loop induced calcium mobilization and enhanced thrombin-mediated platelet aggregation, spreading, and activated αIIbβ3 levels. These effects were abolished by CXCR4 inhibition. BSDL also increased the production of prostacyclin by human endothelial cells. In a mouse thrombosis model, BSDL accumulated at sites of vessel wall injury. When CXCR4 was antagonized, the accumulation of BSDL was inhibited and thrombus size was reduced. In BSDL–/– mice, calcium mobilization in platelets and thrombus formation were attenuated and tail bleeding times were increased in comparison with those of wild-type mice. We conclude that BSDL plays a role in optimal platelet activation and thrombus formation by interacting with CXCR4 on platelets. PMID:18037996

  12. Division of aperture to reduce the focus spot size

    NASA Astrophysics Data System (ADS)

    Li, Liangyu; Li, Changchun; Yang, Huajun; Li, Yinzhu; Dai, Yaping; Xie, Hu; Wang, Gongyu; Zhu, Jianqiang

    2000-10-01

    In the investigation of Inertial Confinement Fusion (ICF), the high power laser beam must be focused on the target (focus plane) given. In the ICF indirect drivers, the target fixed in a cavity is cylinderal, there are the Deuterium and the Tritium in the target, the experiment result relatives with the temperature radiated in the cavity, and the temperature relatives with the laser energy power incided. Thus, it is key that there must be enough of energy incided, and the energy runs out barely. So, to increase the laser energy incided, the focus spot should be very small. Base on the design of focus optical systems of the SHENGUANG serial facilities and the theory analyses, as the diffraction of the light, the laser beam passing through the optical systems gets a spot on the focus plane. In order to reduce the edge of the main spot or the focus spot size, we advance a method of dividing aperture of the focusing optical system, the diffraction theory of light shows that the diffraction main spot is reduced, it indicates that the method of dividing the aperture may be recommended.

  13. Computational Fluid Dynamics and Aortic Thrombus Formation Following Thoracic Endovascular Aortic Repair.

    PubMed

    Nauta, Foeke J H; Lau, Kevin D; Arthurs, Christopher J; Eagle, Kim A; Williams, David M; Trimarchi, Santi; Patel, Himanshu J; Figueroa, Carlos A

    2017-06-01

    We present the possible utility of computational fluid dynamics in the assessment of thrombus formation and virtual surgical planning illustrated in a patient with aortic thrombus in a kinked ascending aortic graft following thoracic endovascular aortic repair. A patient-specific three-dimensional model was built from computed tomography. Additionally, we modeled 3 virtual aortic interventions to assess their effect on thrombosis potential: (1) open surgical repair, (2) conformable endografting, and (3) single-branched endografting. Flow waveforms were extracted from echocardiography and used for the simulations. We used the computational index termed platelet activation potential (PLAP) representing accumulated shear rates of fluid particles within a fluid domain to assess thrombosis potential. The baseline model revealed high PLAP in the entire arch (119.8 ± 42.5), with significantly larger PLAP at the thrombus location (125.4 ± 41.2, p < 0.001). Surgical repair showed a 37% PLAP reduction at the thrombus location (78.6 ± 25.3, p < 0.001) and a 24% reduction in the arch (91.6 ± 28.9, p < 0.001). Single-branched endografting reduced PLAP in the thrombus region by 20% (99.7 ± 24.6, p < 0.001) and by 14% in the arch (103.8 ± 26.1, p < 0.001), whereas a more conformable endograft did not have a profound effect, resulting in a modest 4% PLAP increase (130.6 ± 43.7, p < 0.001) in the thrombus region relative to the baseline case. Regions of high PLAP were associated with aortic thrombus. Aortic repair resolved pathologic flow patterns, reducing PLAP. Branched endografting also relieved complex flow patterns reducing PLAP. Computational fluid dynamics may assist in the prediction of aortic thrombus formation in hemodynamically complex cases and help guide repair strategies. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  14. The ability of winter grazing to reduce wildfire size, intensity ...

    EPA Pesticide Factsheets

    A recent study by Davies et al. sought to test whether winter grazing could reduce wildfire size, fire behavior metrics, and fire-induced plant mortality in shrub-grasslands. The authors concluded that ungrazed rangelands may experience more fire-induced mortality of native perennial bunchgrasses. The authors also presented several statements regarding the benefits of winter grazing on post-fire plant community responses. However, this commentary will show that the study by Davies et al. has underlying methodological flaws, lacks data necessary to support their conclusions, and does not provide an accurate discussion on the effect of grazing on rangeland ecosystems. Importantly, Davies et al. presented no data on the post-fire mortality of the perennial bunchgrasses or on the changes in plant community composition following their experimental fires. Rather, Davies et al. inferred these conclusions based off their observed fire behavior metrics of maximum temperature and a term described as the “heat load”. However, neither metric is appropriate for elucidating the heat flux impacts on plants. This lack of post-fire data, several methodological flaws, and the use of inadequate metrics describing heat cast doubts on the authors’ ability to support their stated conclusions. This article is a commentary highlights the scientific shortcomings in a forthcoming paper by Davies et al. in the International Journal of Wildland Fire. The study has methodological flaw

  15. Tunable Reduced Size Planar Folded Slot Antenna Utilizing Varactor Diodes

    NASA Technical Reports Server (NTRS)

    Scardelletti, Maximilian C.; Ponchak, George E.; Jordan, Jennifer L.; Jastram, Nathan; Mahaffey, Joshua V.

    2010-01-01

    A tunable folded slot antenna that utilizes varactor diodes is presented. The antenna is fabricated on Rogers 6006 Duriod with a dielectric constant and thickness of 6.15 and 635 m, respectively. A copper cladding layer of 17 m defines the antenna on the top side (no ground on backside). The antenna is fed with a CPW 50 (Omega) feed line, has a center frequency of 3 GHz, and incorporates Micrometrics microwave hyper-abrupt 500MHV varactors to tune the resonant frequency. The varactors have a capacitance range of 2.52 pF at 0 V to 0.4 pF at 20 V; they are placed across the radiating slot of the antenna. The tunable 10 dB bandwidth of the 3 GHz antenna is 150 MHz. The varactors also reduce the size of the antenna by 30% by capacitively loading the resonating slot line. At the center frequency, 3 GHz, the antenna has a measured return loss of 44 dB and a gain of 1.6 dBi. Full-wave electromagnetic simulations using HFSS are presented that validate the measured data. Index Terms capacitive loading, Duriod, folded slot antenna, varactor.

  16. The ability of winter grazing to reduce wildfire size, intensity ...

    EPA Pesticide Factsheets

    A recent study by Davies et al. sought to test whether winter grazing could reduce wildfire size, fire behavior metrics, and fire-induced plant mortality in shrub-grasslands. The authors concluded that ungrazed rangelands may experience more fire-induced mortality of native perennial bunchgrasses. The authors also presented several statements regarding the benefits of winter grazing on post-fire plant community responses. However, this commentary will show that the study by Davies et al. has underlying methodological flaws, lacks data necessary to support their conclusions, and does not provide an accurate discussion on the effect of grazing on rangeland ecosystems. Importantly, Davies et al. presented no data on the post-fire mortality of the perennial bunchgrasses or on the changes in plant community composition following their experimental fires. Rather, Davies et al. inferred these conclusions based off their observed fire behavior metrics of maximum temperature and a term described as the “heat load”. However, neither metric is appropriate for elucidating the heat flux impacts on plants. This lack of post-fire data, several methodological flaws, and the use of inadequate metrics describing heat cast doubts on the authors’ ability to support their stated conclusions. This article is a commentary highlights the scientific shortcomings in a forthcoming paper by Davies et al. in the International Journal of Wildland Fire. The study has methodological flaw

  17. Stanniocalcin-1 Reduces Tumor Size in Human Hepatocellular Carcinoma

    PubMed Central

    Yeung, Bonnie H. Y.; Shek, Felix H.; Lee, Nikki P.; Wong, Chris K. C.

    2015-01-01

    Growing evidence has revealed high expression levels of stanniocalcin-1 (STC1) in different types of human cancers. Numerous experimental studies using cancer cell lines demonstrated the involvement of STC1 in inflammatory and apoptotic processes; however the role of STC1 in carcinogenesis remains elusive. Hepatocellular carcinoma (HCC) an exemplified model of inflammation-related cancer, represents a paradigm of studying the association between STC1 and tumor development. Therefore, we conducted a statistical analysis on the expression levels of STC1 using clinicopathological data from 216 HCC patients. We found that STC1 was upregulated in the tumor tissues and its expression levels was positively correlated with the levels of interleukin (IL)-6 and IL-8. Intriguingly tumors with greater expression levels of STC1 (tumor/normal ≥ 2) were significantly smaller than the lower level (tumor/normal<2) samples (p = 0.008). A pharmacological approach was implemented to reveal the functional correlation between STC1 and the ILs in the HCC cell-lines. IL-6 and IL-8 treatment of Hep3B cells induced STC1 expression. Lentiviral-based STC1 overexpression in Hep3B and MHCC-97L cells however showed inhibitory action on the pro-migratory effects of IL-6 and IL-8 and reduced size of tumor spheroids. The inhibitory effect of STC1 on tumor growth was confirmed in vivo using the stable STC1-overexpressing 97L cells on a mouse xenograft model. Genetic analysis of the xenografts derived from the STC1-overexpressing 97L cells, showed upregulation of the pro-apoptotic genes interleukin-12 and NOD-like receptor family, pyrin domain-containing 3. Collectively, the anti-inflammatory and pro-apoptotic functions of STC1 were suggested to relate its inhibitory effect on the growth of HCC cells. This study supports the notion that STC1 may be a potential therapeutic target for inflammatory tumors in HCC patients. PMID:26469082

  18. Multi-Constituent Simulation of Thrombus Deposition

    NASA Astrophysics Data System (ADS)

    Wu, Wei-Tao; Jamiolkowski, Megan A.; Wagner, William R.; Aubry, Nadine; Massoudi, Mehrdad; Antaki, James F.

    2017-02-01

    In this paper, we present a spatio-temporal mathematical model for simulating the formation and growth of a thrombus. Blood is treated as a multi-constituent mixture comprised of a linear fluid phase and a thrombus (solid) phase. The transport and reactions of 10 chemical and biological species are incorporated using a system of coupled convection-reaction-diffusion (CRD) equations to represent three processes in thrombus formation: initiation, propagation and stabilization. Computational fluid dynamic (CFD) simulations using the libraries of OpenFOAM were performed for two illustrative benchmark problems: in vivo thrombus growth in an injured blood vessel and in vitro thrombus deposition in micro-channels (1.5 mm × 1.6 mm × 0.1 mm) with small crevices (125 μm × 75 μm and 125 μm × 137 μm). For both problems, the simulated thrombus deposition agreed very well with experimental observations, both spatially and temporally. Based on the success with these two benchmark problems, which have very different flow conditions and biological environments, we believe that the current model will provide useful insight into the genesis of thrombosis in blood-wetted devices, and provide a tool for the design of less thrombogenic devices.

  19. Multi-Constituent Simulation of Thrombus Deposition

    PubMed Central

    Wu, Wei-Tao; Jamiolkowski, Megan A.; Wagner, William R.; Aubry, Nadine; Massoudi, Mehrdad; Antaki, James F.

    2017-01-01

    In this paper, we present a spatio-temporal mathematical model for simulating the formation and growth of a thrombus. Blood is treated as a multi-constituent mixture comprised of a linear fluid phase and a thrombus (solid) phase. The transport and reactions of 10 chemical and biological species are incorporated using a system of coupled convection-reaction-diffusion (CRD) equations to represent three processes in thrombus formation: initiation, propagation and stabilization. Computational fluid dynamic (CFD) simulations using the libraries of OpenFOAM were performed for two illustrative benchmark problems: in vivo thrombus growth in an injured blood vessel and in vitro thrombus deposition in micro-channels (1.5 mm × 1.6 mm × 0.1 mm) with small crevices (125 μm × 75 μm and 125 μm × 137 μm). For both problems, the simulated thrombus deposition agreed very well with experimental observations, both spatially and temporally. Based on the success with these two benchmark problems, which have very different flow conditions and biological environments, we believe that the current model will provide useful insight into the genesis of thrombosis in blood-wetted devices, and provide a tool for the design of less thrombogenic devices. PMID:28218279

  20. Multi-Constituent Simulation of Thrombus Deposition.

    PubMed

    Wu, Wei-Tao; Jamiolkowski, Megan A; Wagner, William R; Aubry, Nadine; Massoudi, Mehrdad; Antaki, James F

    2017-02-20

    In this paper, we present a spatio-temporal mathematical model for simulating the formation and growth of a thrombus. Blood is treated as a multi-constituent mixture comprised of a linear fluid phase and a thrombus (solid) phase. The transport and reactions of 10 chemical and biological species are incorporated using a system of coupled convection-reaction-diffusion (CRD) equations to represent three processes in thrombus formation: initiation, propagation and stabilization. Computational fluid dynamic (CFD) simulations using the libraries of OpenFOAM were performed for two illustrative benchmark problems: in vivo thrombus growth in an injured blood vessel and in vitro thrombus deposition in micro-channels (1.5 mm × 1.6 mm × 0.1 mm) with small crevices (125 μm × 75 μm and 125 μm × 137 μm). For both problems, the simulated thrombus deposition agreed very well with experimental observations, both spatially and temporally. Based on the success with these two benchmark problems, which have very different flow conditions and biological environments, we believe that the current model will provide useful insight into the genesis of thrombosis in blood-wetted devices, and provide a tool for the design of less thrombogenic devices.

  1. Plasma fibronectin promotes thrombus growth and stability in injured arterioles

    PubMed Central

    Ni, Heyu; Yuen, Peter S. T.; Papalia, Jessie M.; Trevithick, Jane E.; Sakai, Takao; Fässler, Reinhard; Hynes, Richard O.; Wagner, Denisa D.

    2003-01-01

    Mice lacking both of the best-known platelet ligands, von Willebrand factor and fibrinogen, can still form occlusive thrombi in injured arterioles. The platelets of these animals accumulate excessive amounts of fibronectin (FN). These observations led us to examine the contribution of plasma FN (pFN) to thrombus formation. Inactivation of the FN gene in FN conditional knockout mice reduced pFN levels to <2% and platelet FN to ≈20% of the levels in similarly treated control mice. The mice were then observed in a model of arterial injury to evaluate their capacity to form thrombi. The deficiency of pFN did not affect the initial platelet adhesion, but a delay of several minutes in thrombus formation was observed in the arterioles of pFN-deficient mice as compared with control mice. The thrombi that formed in the absence of pFN were stably anchored to the vessel wall but continuously shed platelets or small platelet clumps, thus slowing their growth significantly; the platelet/platelet cohesion was apparently diminished. Consequently the occlusion of pFN-deficient vessels was delayed, with the majority of vessels remaining patent at the end of the 40-min observation period. We conclude that, in addition to von Willebrand factor and fibrinogen, FN plays a significant role in thrombus initiation, growth, and stability at arterial shear rates and that deficiency in each of the three platelet ligands has its own specific impact on platelet plug formation. PMID:12606706

  2. Synthesis And Characterization Of Reduced Size Ferrite Reinforced Polymer Composites

    SciTech Connect

    Borah, Subasit; Bhattacharyya, Nidhi S.

    2008-04-24

    Small sized Co{sub 1-x}Ni{sub x}Fe{sub 2}O{sub 4} ferrite particles are synthesized by chemical route. The precursor materials are annealed at 400, 600 and 800 C. The crystallographic structure and phases of the samples are characterized by X-ray diffraction (XRD). The annealed ferrite samples crystallized into cubic spinel structure. Transmission Electron Microscopy (TEM) micrographs show that the average particle size of the samples are <20 nm. Particulate magneto-polymer composite materials are fabricated by reinforcing low density polyethylene (LDPE) matrix with the ferrite samples. The B-H loop study conducted at 10 kHz on the toroid shaped composite samples shows reduction in magnetic losses with decrease in size of the filler sample. Magnetic losses are detrimental for applications of ferrite at high powers. The reduction in magnetic loss shows a possible application of Co-Ni ferrites at high microwave power levels.

  3. Reducing Router Forwarding Table Size Using Aggregation and Caching

    ERIC Educational Resources Information Center

    Liu, Yaoqing

    2013-01-01

    The fast growth of global routing table size has been causing concerns that the Forwarding Information Base (FIB) will not be able to fit in existing routers' expensive line-card memory, and upgrades will lead to a higher cost for network operators and customers. FIB Aggregation, a technique that merges multiple FIB entries into one, is probably…

  4. Reducing Router Forwarding Table Size Using Aggregation and Caching

    ERIC Educational Resources Information Center

    Liu, Yaoqing

    2013-01-01

    The fast growth of global routing table size has been causing concerns that the Forwarding Information Base (FIB) will not be able to fit in existing routers' expensive line-card memory, and upgrades will lead to a higher cost for network operators and customers. FIB Aggregation, a technique that merges multiple FIB entries into one, is probably…

  5. Reducing Class Size in New York City: Promise vs. Practice

    ERIC Educational Resources Information Center

    Farrie, Danielle; Johnson, Monete; Lecker, Wendy; Luhm, Theresa

    2016-01-01

    In the landmark school funding litigation, "Campaign for Fiscal Equity v. State" ("CFE"), the highest Court in New York recognized that reasonable class sizes are an essential element of a constitutional "sound basic education." In response to the rulings in the case, in 2007, the Legislature adopted a law mandating…

  6. On being the right size: increased body size is associated with reduced telomere length under natural conditions.

    PubMed

    Ringsby, Thor Harald; Jensen, Henrik; Pärn, Henrik; Kvalnes, Thomas; Boner, Winnie; Gillespie, Robert; Holand, Håkon; Hagen, Ingerid Julie; Rønning, Bernt; Sæther, Bernt-Erik; Monaghan, Pat

    2015-12-07

    Evolution of body size is likely to involve trade-offs between body size, growth rate and longevity. Within species, larger body size is associated with faster growth and ageing, and reduced longevity, but the cellular processes driving these relationships are poorly understood. One mechanism that might play a key role in determining optimal body size is the relationship between body size and telomere dynamics. However, we know little about how telomere length is affected when selection for larger size is imposed in natural populations. We report here on the relationship between structural body size and telomere length in wild house sparrows at the beginning and end of a selection regime for larger parent size that was imposed for 4 years in an isolated population of house sparrows. A negative relationship between fledgling size and telomere length was present at the start of the selection; this was extended when fledgling size increased under the selection regime, demonstrating a persistent covariance between structural size and telomere length. Changes in telomere dynamics, either as a correlated trait or a consequence of larger size, could reduce potential longevity and the consequent trade-offs could thereby play an important role in the evolution of optimal body size. © 2015 The Author(s).

  7. Does Flattened Sky Dome Reduces Perceived Moon Size

    NASA Astrophysics Data System (ADS)

    Toskovic, O.

    2009-09-01

    The aim of this study was to examine the Flattened sky dome model as an explanation of the Moon illusion. Two experiments were done, in a dark room, in which distribution of depth cues is the same towards horizon as towards zenith. In the first experiment 14 participants had the task to equalize the perceived distances of three stimuli in three directions (horizontal, tilted 45 degrees and vertical). In the second experiment 16 participants had the task to estimate the perceived sizes of three stimuli in the same three directions. For distance estimates we found differences among three directions in a way, that as the head tilts upwards, the perceived space is being elongated, which is the opposite to flattened sky dome. For size estimates we found no difference among the three directions.

  8. Molecular MRI of intracranial thrombus in a rat ischemic stroke model

    PubMed Central

    Uppal, Ritika; Ay, Ilknur; Dai, Guangping; Kim, Young Ro; Sorensen, A. Gregory; Caravan, Peter

    2010-01-01

    Background and Purpose Intracranial thrombus is a principal feature in most ischemic stroke, and thrombus location and size may correlate with outcome and response to thrombolytic therapy. EP-2104R, a fibrin-specific molecular MR agent, was previously shown to enhance extracranial thrombi in animal models and recently, in clinical trials. The purpose of this work was to determine if a fibrin-specific molecular MR probe could noninvasively characterize intracranial thrombi. Methods Embolic stroke was induced in adult rats by occlusion of the right internal carotid artery with an aged thrombus. Diffusion weighted imaging, time of flight angiography, and high resolution three dimensional T1-weighted MRI were performed at 4.7T prior to and following contrast agents EP-2104R (10 µmol/kg, n=6) or Gd-DTPA (200 µmol/kg, control, n=5). Gd levels in thrombus, brain, and blood were determined by ex vivo elemental analysis. Results In all animals, MR angiography revealed a flow deficit and diffusion-weighted imaging showed a hyperintensity consistent with ischemia. EP-2104R-enhanced MRI resulted in visualization of all occlusive thrombi (6/6) as well as vessel wall enhancement in all 6 animals with high contrast to noise relative to blood (10.7 post EP-2104R vs. 0.54 pre, p<0.0001). Gd-DTPA injected animals showed no occlusive thrombus or vessel wall enhancement (0/5). The concentration of Gd in the thrombus post-EP2104 was 18 times that in the blood pool. Conclusions EP-2104R enhanced MRI successfully identifies intracranial thrombus in a rat embolic stroke model. PMID:20395615

  9. A review of macroscopic thrombus modeling methods.

    PubMed

    Cito, Salvatore; Mazzeo, Marco Domenico; Badimon, Lina

    2013-02-01

    Hemodynamics applied to mechanobiology offers powerful means to predict thrombosis, and to understand the kinetics of thrombus formation on areas of vascular damage in blood flowing through the human circulatory system. Specifically, the advances in computational processing and the progress in modeling complex biological processes with spatio-temporal multi-scale methods have the potential to shift the way in which cardiovascular diseases are diagnosed and treated. This article systematically surveys the state of the art of macroscopic computational fluid dynamics (CFD) Computational fluid dynamics techniques for modeling thrombus formation, highlighting their strengths and weaknesses. In particular, a comprehensive and systematic revision of the hemodynamics models and methods is given, and the strengths and weaknesses of those employed for studying thrombus formation are highlighted. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. High Speed Gear Sized and Configured to Reduce Windage Loss

    NASA Technical Reports Server (NTRS)

    Kunz, Robert F. (Inventor); Medvitz, Richard B. (Inventor); Hill, Matthew John (Inventor)

    2013-01-01

    A gear and drive system utilizing the gear include teeth. Each of the teeth has a first side and a second side opposite the first side that extends from a body of the gear. For each tooth of the gear, a first extended portion is attached to the first side of the tooth to divert flow of fluid adjacent to the body of the gear to reduce windage losses that occur when the gear rotates. The gear may be utilized in drive systems that may have high rotational speeds, such as speeds where the tip velocities are greater than or equal to about 68 m/s. Some embodiments of the gear may also utilize teeth that also have second extended portions attached to the second sides of the teeth to divert flow of fluid adjacent to the body of the gear to reduce windage losses that occur when the gear rotates.

  11. Pathophysiology of Coronary Thrombus Formation and Adverse Consequences of Thrombus During PCI

    PubMed Central

    Srikanth, Sundararajan; Ambrose, John A

    2012-01-01

    Atherosclerosis is a systemic vascular pathology that is preceded by endothelial dysfunction. Vascular inflammation “fuels” atherosclerosis and creates the milieu for episodes of intravascular thromboses. Thrombotic events in the coronary vasculature may lead to asymptomatic progression of atherosclerosis or could manifest as acute coronary syndromes or even sudden cardiac death. Thrombus encountered in the setting of acute coronary syndromes has been correlated with acute complications during percutaneous coronary interventions such as no-reflow, acute coronary occlusion and long term complications such as stent thrombus. This article reviews the pathophysiology of coronary thrombogenesis and explores the complications associated with thrombus during coronary interventions. PMID:22920487

  12. [Kidney cancer with venal thrombus-principles of menagement].

    PubMed

    Skiba, Ryszard; Syryło, Tomasz; Wieczorek, Andrzej; Zieliński, Henryk

    Frequency of renal cell carcinoma with tumor thrombus may reach up to 30% of cases. Epidemiologic data show that tumor thrombus by itself is not negative predictive factor. Meticulous preparation by analisis of high quality imaging, acurate preoperative patient and team preparation enables to make complete thrombus resection. In our analisis we propouse rules of holistic treatment for patients suffering from renal cell carcinoma with tumor thrombus. Applying of these rules results in satisfactory long term results.

  13. Testing new submersible pumps for proper sizing and reduced costs

    SciTech Connect

    O'Toole, W.P.; O'Brien, J.B.

    1986-01-01

    This paper describes an ongoing program to improve overall submersible pump performance by Thums Long Beach Company, acting as Contractor of the City of Long Beach, Operator of the Long Beach Unit. Thums Long Beach Company currently operates 700 submersible pump installations located on four man-made islands and one land fill pier location. The program began with spot testing of submersible pumps for Thums' use. It has evolved to 100 percent pump testing and the stipulation that only pumps with newly manufactured parts are acceptable. The primary goals of this program are to increase well production and lower lifting costs. Critical to these goals is increasing the average length of run by using accurate pump performance data to design equipment and by rejecting defective pumps before they are run. Increased production is realized from better designs. Lower lifting costs result from utilizing higher efficiency pumps and a reduced frequency of pulling submersible equipment.

  14. Testing new submersible pumps for proper sizing and reduced costs

    SciTech Connect

    O'Toole, W.P.; O'Brien, J.B.

    1989-02-01

    This paper describes an ongoing program to improve overall submersible pump performance by Thums Long Beach Co., acting as contractor for the City of Long Beach, operator of the Long Beach Unit. Thums Long Beach Co. currently operates 700 submersible pump installations located on four manmade islands and one landfill pier location. The program began with spot testing of submersible pumps for Thums' use. It has evolved to 100% pump testing and the stipulation that only pumps with newly manufactured parts are acceptable. The primary goals of this program are to increase well production and to lower lifting costs. Critical to these goals is increasing the average length of run by using accurate pump-performance data to design equipment and by rejecting defective pumps before they are run. Increased production is realized from better designs. Lower lifting costs result from using more efficient pumps and a reduced frequency of pulling submersible equipment.

  15. Encountering competitors reduces clutch size and increases offspring size in a parasitoid with female–female fighting

    PubMed Central

    Goubault, Marlène; Mack, Alexandra F.S; Hardy, Ian C.W

    2007-01-01

    Understanding the size of clutches produced by only one parent may require a game-theoretic approach: clutch size may affect offspring fitness in terms of future competitive ability. If larger clutches generate smaller offspring and larger adults are more successful in acquiring and retaining resources, clutch size optima should be reduced when the probability of future competitive encounters is higher. We test this using Goniozus nephantidis, a gregarious parasitoid wasp in which the assumption of size-dependent resource acquisition is met via female–female contests for hosts. As predicted, smaller clutches are produced by mothers experiencing competition, due to fewer eggs being matured and to a reduced proportion of matured eggs being laid. As assumed, smaller clutches generate fewer but larger offspring. We believe this is the first direct evidence for pre-ovipositional and game-theoretic clutch size adjustment in response to an intergenerational fitness effect when clutches are produced by a single individual. PMID:17698482

  16. 43 CFR 4300.53 - Can BLM reduce the size of the land in my permit?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR RANGE MANAGEMENT (4000) GRAZING ADMINISTRATION; ALASKA; REINDEER; GENERAL Changes in the Size of the Permit Area § 4300.53 Can BLM reduce the size of the...

  17. 43 CFR 4300.53 - Can BLM reduce the size of the land in my permit?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR RANGE MANAGEMENT (4000) GRAZING ADMINISTRATION; ALASKA; REINDEER; GENERAL Changes in the Size of the Permit Area § 4300.53 Can BLM reduce the size of the...

  18. [Study on interventional ultrasonic thrombus ablation technique].

    PubMed

    Lai, Yi-nan; Luo, Jian-wei; Liu, Xiang-dong

    2002-01-01

    Ultrasonic thrombus ablation is a newly-developed technology for percutaneous arterial recanalization. An ultrasound angioplasty device is described here in detail. The device has an adjustable power output range and distal tip longitudinal displacement range. Experimental data suggest that this ultrasound device is significantly effective in ablating fresh thrombi.

  19. Protein disulfide isomerase secretion following vascular injury initiates a regulatory pathway for thrombus formation

    PubMed Central

    Bowley, Sheryl R.; Fang, Chao; Merrill-Skoloff, Glenn; Furie, Barbara C.; Furie, Bruce

    2017-01-01

    Protein disulfide isomerase (PDI), secreted by platelets and endothelial cells on vascular injury, is required for thrombus formation. Using PDI variants that form mixed disulfide complexes with their substrates, we identify by kinetic trapping multiple substrate proteins, including vitronectin. Plasma vitronectin does not bind to αvβ3 or αIIbβ3 integrins on endothelial cells and platelets. The released PDI reduces disulfide bonds on plasma vitronectin, enabling vitronectin to bind to αVβ3 and αIIbβ3. In vivo studies of thrombus generation in mice demonstrate that vitronectin rapidly accumulates on the endothelium and the platelet thrombus following injury. This process requires PDI activity and promotes platelet accumulation and fibrin generation. We hypothesize that under physiologic conditions in the absence of secreted PDI, thrombus formation is suppressed and maintains a quiescent, patent vasculature. The release of PDI during vascular injury may serve as a regulatory switch that allows activation of proteins, among them vitronectin, critical for thrombus formation. PMID:28218242

  20. Factor XI-dependence of surface- and tissue factor-initiated thrombus propagation in primates.

    PubMed

    Gruber, Andras; Hanson, Stephen R

    2003-08-01

    Thrombin, generated through activation of factor XI (FXI) and/or tissue factor (TF)-factor VIIa, is essential for thrombosis and hemostasis. We investigated the role of FXI-dependent thrombus propagation under arterial flow conditions producing rapid thrombus growth that, after the initiation phase, could limit the availability of TF at the blood/thrombus interface. Thrombosis was initiated by knitted dacron or TF-presenting teflon grafts deployed into arteriovenous shunts in baboons treated with antihuman FXI antibody (aFXI). Although aFXI did not prevent thrombus initiation, it markedly reduced intraluminal thrombus growth on both surfaces. The antithrombotic effect of aFXI was comparable with that of heparin at doses that significantly prolonged the partial thromboplastin time (APTT), prothrombin time (PT), and bleeding time (BT). aFXI also prolonged the APTT, but the PT and BT were unaffected. Thus, antithrombotic targeting of FXI might inhibit thrombosis with relatively modest hemostatic impairment versus strategies targeting other coagulation factors.

  1. Computational analysis on the mechanical interaction between a thrombus and red blood cells: possible causes of membrane damage of red blood cells at microvessels.

    PubMed

    Kamada, Hiroki; Imai, Yohsuke; Nakamura, Masanori; Ishikawa, Takuji; Yamaguchi, Takami

    2012-12-01

    Previous studies investigating thrombus formation have not focused on the physical interaction between red blood cells (RBCs) and thrombus, although they have been speculated that some pathological conditions such as microangiopathic hemolytic anemia (MAHA) stem from interactions between RBCs and thrombi. In this study, we investigated the mechanical influence of RBCs on primary thrombi during hemostasis. We also explored the mechanics and aggravating factors of intravascular hemolysis. Computer simulations of primary thrombogenesis in the presence and the absence of RBCs demonstrated that RBCs are unlikely to affect the thrombus height and coverage, although their presence may change microvessel hemodynamics and platelet transportation to the injured wall. Our results suggest that intravascular hemolysis owing to RBC membrane damage would be promoted by three hemodynamic factors: (1) dispersibility of platelet thrombi, because more frequent spatial thrombus formation decreases the time available for an RBC to recover its shape and enforces more severe deformation; (2) platelet thrombus stiffness, because a stiffer thrombus increases the degree of RBC deformation upon collision; and (3) vessel size and hemocyte density, because a smaller vessel diameter and higher hemocyte density decrease the room for RBCs to escape as they come closer to a thrombus, thereby enhancing thrombus-RBC interactions. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  2. Thrombus and Plaque Erosion Characterized by Optical Coherence Tomography in Patients With Vasospastic Angina.

    PubMed

    Shin, Eun-Seok; Her, Ae-Young; Ann, Soe Hee; Balbir Singh, Gillian; Cho, Heeyoun; Jung, Eui Cheol; Shim, Eun Bo; Koo, Bon-Kwon; Akasaka, Takashi

    2017-06-01

    Vasospastic angina (VSA) can result in endothelial damage and thrombus formation. The aim of this study was to evaluate the incidence of thrombus and plaque characteristics at coronary spasm segments compared with nonspasm segments by using optical coherence tomography (OCT) in patients with suspected VSA. One hundred and eighty-three patients with suspected VSA were enrolled in this study. The ergonovine provocation test was performed in all patients for the diagnosis of VSA except in patients with spontaneous spasm. All target lesions were analyzed by OCT. Plaque erosion was defined as the presence of attached thrombus overlying an intact fibrous cap and visualized plaque on multiple adjacent OCT frames. One hundred and nine spasm segments (93 patients) were compared with 55 nonspasm segments (39 patients). Thrombus was more frequently seen at spasm segments than at nonspasm segments (28.4% vs 7.3%; P = .026) and thrombus size was larger at spasm segments than at nonspasm segments (0.26 ± 0.50 mm(2) vs 0.04 ± 0.01 mm(2); P = .023). Thin-cap fibroatheroma was more frequently seen at nonspasm segments than at spasm segments (16.4% vs 1.8%; P = .006). Plaque erosion was more prevalent at spasm segments than at nonspasm segments (25.7% vs 5.4%; P = .001). Thrombus and plaque erosion were more common at spasm segments than at nonspasm segments assessed by OCT in patients with suspected VSA. These findings suggest the potential benefit and treatment role of antiplatelet therapy in vasospastic angina. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  3. Application of cystoscope in surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus.

    PubMed

    Li, Nan; Wei, Xu-Biao; Cheng, Shu-Qun

    2016-06-14

    Development of portal vein tumor thrombus deteriorates the prognosis of hepatocellular carcinoma, while surgical treatment can offer a promising prognosis for selected patients. However, the possibility of residual lesions in portal vein after conventional thrombectomy is a main risk factor leading to postoperative recurrence. Therefore, ensuring the complete removal of tumor thrombus during operation is critical to improve prognosis. For the first time, we report here one case of hepatocellular carcinoma with portal vein tumor thrombus in which cystoscope was successfully applied as a substitute of intravascular endoscope to visualize the cavity of the portal vein. The patient was a 61-year-old man with a 7-cm tumor in the right lobe of the liver, with tumor thrombus invading the right branch and adjacent to the conjunction of the portal vein. After removal of the tumor, the Olympus CYF-VA2 cystoscope was used to check the portal vein from the opening stump of the right branch of the portal vein. In this case, residual thrombus tissue was found near the opening stump and the conjunction of the portal vein. The residual lesion was carefully retrieved from the stump after retraction of the cystoscope. The procedure was repeated until no residual lesion was found. The whole duration time of thrombectomy was 22.5 (15 + 7.5) min. The patient was free from recurrence at 8 months after the procedure. Our work indicated that the cystoscope is a suitable substitute, with a proper size and function to check the portal vein system and ensure the curability of thrombectomy. Although well-designed clinic trails are still needed, this procedure may further improve the postoperative prognosis of hepatocellular carcinoma with portal vein tumor thrombus.

  4. Novel risk predictor for thrombus deposition in abdominal aortic aneurysms

    NASA Astrophysics Data System (ADS)

    Nestola, M. G. C.; Gizzi, A.; Cherubini, C.; Filippi, S.; Succi, S.

    2015-10-01

    The identification of the basic mechanisms responsible for cardiovascular diseases stands as one of the most challenging problems in modern medical research including various mechanisms which encompass a broad spectrum of space and time scales. Major implications for clinical practice and pre-emptive medicine rely on the onset and development of intraluminal thrombus in which effective clinical therapies require synthetic risk predictors/indicators capable of informing real-time decision-making protocols. In the present contribution, two novel hemodynamics synthetic indicators, based on a three-band decomposition (TBD) of the shear stress signal, are introduced. Extensive fluid-structure computer simulations of patient-specific scenarios confirm the enhanced risk-prediction capabilities of the TBD indicators. In particular, they permit a quantitative and accurate localization of the most likely thrombus deposition in realistic aortic geometries, where previous indicators would predict healthy operation. The proposed methodology is also shown to provide additional information and discrimination criteria on other factors of major clinical relevance, such as the size of the aneurysm.

  5. Multifunctional nanoagent for thrombus-targeted fibrinolytic therapy

    PubMed Central

    McCarthy, Jason R.; Sazonova, Irina Y.; Erdem, S. Sibel; Hara, Tetsuya; Thompson, Brian D.; Patel, Purvish; Botnaru, Ion; Lin, Charles P.; Reed, Guy L.; Weissleder, Ralph; Jaffer, Farouc A.

    2011-01-01

    Aims Current thrombolytic therapies rely upon exogenous plasminogen activators (PA) to effectively lyse clots, thereby restoring blood flow and preventing tissue and organ death. Yet, these PAs may also impair normal hemostasis which may lead to life-threatening bleeding, including intracerebral hemorrhage. Thus, the aim of this current study is to develop new thrombus-targeted fibrinolytic agents that harness the multifunctional theranostic capabilities of nanomaterials, potentially allowing for the generation of efficacious thrombolytics while minimizing deleterious side effects. Materials and Methods A thrombus-targeted nano-fibrinolytic agent (CLIO-FXIII-PEG-tPA) was synthesized using a magnetofluorescent crosslinked dextran-coated iron oxide (CLIO) nanoparticle platform that was conjugated to recombinant tissue plasminogen activator (tPA). Thrombus-targeting was achieved by derivatizing the nanoparticle with an activated factor XIII (FXIIIa)-sensitive peptide based on the amino terminus of α2-antiplasmin. Human plasma clot binding ability of the targeted and control agents was assessed by fluorescence reflectance imaging. Next, the in vitro enzymatic activity of the agents was assessed by S2288-based amidolytic activity, and an ELISA D-dimer assay for fibrinolysis. In vivo targeting of the nanoagent was next examined by intravital fluorescence microscopy of murine arterial and venous thrombosis. The fibrinolytic activity of the targeted nanoagent compared to free tPA was then evaluated in vivo in murine pulmonary embolism. Results In vitro, the targeted thrombolytic nanoagent demonstrated binding to fresh frozen plasma (FFP) clots superior to control nanoagents (ANOVA p < 0.05). On a weight (mg) basis, the S2288 amidolytic efficiency of the targeted nanoagent was approximately 15% reduced compared to free tPA. When normalized by S2288-based activity, targeted, control, and free tPA samples demonstrated equivalent in vitro fibrinolytic activity against human

  6. Female Employment and Reduced Family Size: Some Additional Insight on the Direction of the Relationship.

    ERIC Educational Resources Information Center

    Houseknecht, Sharon K.

    Results of a study of the relationship between female employment and reduced family size are reported. Specifically, the study sought to determine whether career involvement precedes the final family size decision or whether the family size decision precedes career involvement. Thirty-two voluntarily childless women constituted the sample. The…

  7. 13 CFR 121.802 - What size standards are applicable to reduced patent fees programs?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What size standards are applicable to reduced patent fees programs? 121.802 Section 121.802 Business Credit and Assistance SMALL... Eligibility Requirements for Paying Reduced Patent Fees § 121.802 What size standards are applicable to...

  8. 13 CFR 121.802 - What size standards are applicable to reduced patent fees programs?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false What size standards are applicable to reduced patent fees programs? 121.802 Section 121.802 Business Credit and Assistance SMALL... Eligibility Requirements for Paying Reduced Patent Fees § 121.802 What size standards are applicable to...

  9. Sixty-Four-Section Cardiac Computed Tomography in Mechanical Prosthetic Heart Valve Dysfunction: Thrombus or Pannus.

    PubMed

    Gündüz, Sabahattin; Özkan, Mehmet; Kalçik, Macit; Gürsoy, Ozan Mustafa; Astarcioğlu, Mehmet Ali; Karakoyun, Süleyman; Aykan, Ahmet Çağri; Biteker, Murat; Gökdeniz, Tayyar; Kaya, Hasan; Yesin, Mahmut; Duran, Nilüfer Ekşi; Sevinç, Deniz; Güneysu, Tahsin

    2015-12-01

    Distinguishing pannus and thrombus in patients with prosthetic valve dysfunction is essential for the selection of proper treatment. We have investigated the utility of 64-slice multidetector computed tomography (MDCT) in distinguishing between pannus and thrombus, the latter amenable to thrombolysis. Sixty-two (23 men, mean age 44±14 years) patients with suspected mechanical prosthetic valve dysfunction assessed by transesophageal echocardiography were included in this prospective observational trial. Subsequently, MDCT was performed before any treatment was started. Periprosthetic masses were detected by MDCT in 46 patients, and their attenuation values were measured as Hounsfield Units (HU). Patients underwent thrombolysis unless contraindicated, and those with a contraindication or failed thrombolysis underwent surgery. A mass which was completely lysed or surgically detected as a clot was classified as thrombus, whereas a mass which was surgically detected as tissue overgrowth was classified as pannus. A definitive diagnosis could be achieved in 37 patients with 39 MDCT masses (22 thrombus and 17 pannus). The mean attenuation value of 22 thrombotic masses was significantly lower than that in 17 pannus (87±59 versus 322±122; P<0.001). Area under the receiver operating characteristic curve was 0.96 (95% confidence interval: 0.91-0.99; P<0.001), and a cutoff point of HU≥145 provided high sensitivity (87.5%) and specificity (95.5%) in discriminating pannus from thrombus. Complete lysis was more common for masses with HU<90 compared with those with HU 90 to 145 (100% versus 42.1%; P=0.007). Sixty-four slice MDCT is helpful in identifying masses amenable to thrombolysis in patients with prosthetic valve dysfunction. A high (HU≥145) attenuation suggests pannus overgrowth, whereas a lower value is associated with thrombus formation. A higher attenuation (HU>90) is associated with reduced lysis rates. © 2015 American Heart Association, Inc.

  10. Factors influencing acute thrombus formation on carotid artery vascular grafts

    SciTech Connect

    Torem, S.; Schneider, P.A.; Paxton, L.D.; Yasuda, H.; Hanson, S.R.

    1988-10-01

    Scintillation camera imaging of 111Indium-labeled platelets has been used to measure acute thrombus formation on modified expanded Teflon (ePTFE) vascular grafts placed in the carotid arteries of normal baboons. Platelet deposition plateaued over 2 hr postoperatively and occurred primarily at the graft-vessel anastomoses. A positive correlation was found between the circulating platelet count in individual animals and the extent of early platelet thrombus deposition. Unmodified ePTFE grafts accumulated 4.6 +/- 1.2 x 10(9) platelets per graft, or 2.3 +/- 0.71 x 10(9) platelets per anastomosis. Acutely, platelet accumulation was reduced versus control graft results by coating the graft lumenal surfaces with a smooth layer of silicone rubber polymer (0.60 +/- 0.19 x 10(9) platelets per anastomosis; P less than 0.02) but not by coating the grafts using a plasma polymer based on methane, which did not modify graft texture (8.2 +/- 1.7 x 10(9) platelets per graft; P greater than 0.10). The benefit of the silicone rubber coating persisted for at least 48 hr. However, longer term patency was not preserved because 10 of 12 grafts placed had failed within 1 to 2 months.

  11. Surgical treatment of renal cell carcinoma: Can morphological features of inferior vena cava tumor thrombus on computed tomography or magnetic resonance imaging be a prognostic factor?

    PubMed

    Choi, Don Kyoung; Jeon, Hwang Gyun; Jeong, Chang Wook; Kwak, Cheol; Song, Cheryn; Chung, Jinsoo; Hong, Sung Kyu; Hong, Sung-Hoo; Seo, Seong Il

    2017-02-01

    To evaluate the impact of morphological features of inferior vena cava thrombus on the overall survival and cancer-specific survival (cancer-specific survival of patients with renal cell carcinoma). We retrospectively analyzed the records of 156 renal cell carcinoma patients with inferior vena cava thrombus who underwent radical nephrectomy and thrombectomy from 1998 to 2013 at five tertiary centers. Inferior vena cava thrombi were classified as spherical (type I) and spiculated (type II) according to morphological features on computed tomography or magnetic resonance imaging. Multivariate cox regression models were used to quantify the impact of prognostic factors on overall survival and cancer-specific survival. Type I was found in 29 patients (18.6%), and type II in 127 patients (81.4%). Median follow up was 38.2 months (interquartile range 12-57). Demographic characteristics were not significantly different, except for the cranial thrombus height (P = 0.003). On multivariate analysis, Eastern Cooperative Oncology Group performance score, clinical tumor size, distant metastasis, histologic subtype, thrombus morphology and remnant venous thrombus significantly affected overall survival in pNany Many patients (all P < 0.05). Among the pNO /X MO patients, clinical tumor size, histologic subtype, thrombus morphology and remnant venous thrombus significantly affected overall survival (all P < 0.05). In terms of cancer-specific survival, Eastern Cooperative Oncology Group performance score, clinical tumor size, distant metastasis, histologic subtype and thrombus morphology significantly affected cancer-specific survival in pNany Many patients (all P < 0.05). In patients with pNO /X MO , body mass index, clinical tumor size, histological subtype, thrombus morphology and remnant venous thrombus significantly affected cancer-specific survival (all P < 0.05). Clinical tumor size, histological subtype, and thrombus morphology are independent predictors of overall survival

  12. Influence of Thrombus Age on the Mechanical Thrombectomy Efficacy of the Amplatz Thrombectomy Device In Vitro

    SciTech Connect

    Grimm, Jan Jahnke, Thomas; Muhle, Claus; Heller, Martin; Mueller-Huelsbeck, Stefan

    2003-06-15

    Purpose: To determine the efficacy of thrombectomy for the Amplatz Thrombectomy Device (ATD) according to the age of the thrombus. Methods: Thrombectomy was performed with the 7 Fr or 8 Fr ATD. Five-day-old or 8-day-old thrombi were made from porcine blood by clotting within silicone tubes to be used in a flow model. Emboli sizes, weight, remaining thrombus and activation time were evaluated. Results: The age of the thrombus had no influence on the activation time necessary for complete thrombolysis. A significant difference was found in the overall amount of embolization only with the 7 Fr device although a similar trend was shown with the 8 Fr device. The amount of embolized thrombotic material was higher for both devices if older thrombi (i.e., 8 days old) we reprocessed. The overall impression was that the 8 Fr device showed slightly better results (less remaining thrombus and embolization). Conclusion: A tendency toward higher amounts of embolization was observed if older thrombi were used in the model. Therefore the interventional radiologist should be aware of the potentially higher risk of peripheral embolization when performing mechanical thrombectomy(with the ATD) in older thrombotic occlusions, especially since the higher rate of embolization was mainly due to an increased proportion of larger embolic particles (1 mm), which are clinically more significant.

  13. Determination of linear viscoelastic behavior of abdominal aortic aneurysm thrombus.

    PubMed

    van Dam, Evelyne A; Dams, Susanne D; Peters, Gerrit W M; Rutten, Marcel C M; Schurink, Geert Willem H; Buth, Jaap; van de Vosse, Frans N

    2006-01-01

    The objective of this study is to determine whether the linear viscoelastic properties of an abdominal aortic aneurysm thrombus can be determined by rheometry. Although large strains occur in the in vivo situation, in this work only linear behavior is studied to show the applicability of the described methods. A thrombus exists of several layers that vary in composition, structure and mechanical properties. Two types of thrombus are described. In discrete transition thrombi the layers are not or at most weakly attached to each other and the structure of each layer is different. Continuous transition thrombi consist of strongly attached layers whose structure changes gradually throughout the thickness of the thrombus. Shear experiments are performed on samples from both types of thrombus on a rotational rheometer using a parallel plate geometry. In the discrete type the storage modulus G' cannot be assumed equal for the different layers. In the continuous thrombus, G', changes gradually throughout the layered structure. In both types the loss modulus, G'', does not vary throughout the thrombus. Furthermore, it was found that Time-Temperature Superposition is applicable to thrombus tissue. Since results were reproducible it can be concluded that the method we used to determine the viscoelastic properties is applicable to thrombus tissue.

  14. Challenges for reducing the size of laser activated remote phosphor light engines for DLP projection

    NASA Astrophysics Data System (ADS)

    Hartwig, Ulrich; Bruemmer, Mathias

    2014-12-01

    Laser activated remote phosphor (LARP) is an upcoming technology for high luminance SSL light engines. This presentation outlines some of the challenges met reducing the engine's size, so it can be retrofitted into DLP-projectors.

  15. Petite mutation in yeast. II. Isolation of mutants containing mitochondrial deoxyribonucleic acid of reduced size.

    PubMed

    Goldring, E S; Grossman, L I; Marmur, J

    1971-07-01

    A series of petite mutants of Saccharomyces cerevisiae, generated after treatment for various times with ethidium bromide, was isolated, and the mitochondrial deoxyribonucleic acid size for each member was estimated. It was found that, as the treatment time with ethidium bromide was increased, the mitochondrial deoxyribonucleic acid isolated from the petite series was increasingly reduced in size.

  16. Defective PDI release from platelets and endothelial cells impairs thrombus formation in Hermansky-Pudlak syndrome.

    PubMed

    Sharda, Anish; Kim, Sarah H; Jasuja, Reema; Gopal, Srila; Flaumenhaft, Robert; Furie, Barbara C; Furie, Bruce

    2015-03-05

    Protein disulfide isomerase (PDI), secreted from platelets and endothelial cells after injury, is required for thrombus formation. The effect of platelet and endothelial cell granule contents on PDI-mediated thrombus formation was studied by intravital microscopy using a mouse model of Hermansky-Pudlak syndrome in which platelet dense granules are absent. Platelet deposition and fibrin generation were nearly absent, and extracellular PDI was significantly reduced in HPS6(-/-) mice after vascular injury. HPS6(-/-) platelets displayed impaired PDI secretion and impaired exocytosis of α granules, lysosomes, and T granules due to decreased sensitivity to thrombin, but these defects could be corrected by addition of subthreshold amounts of adenosine 5'-diphosphate (ADP). Human Hermansky-Pudlak syndrome platelets demonstrated similar characteristics. Infusion of wild-type platelets rescued thrombus formation in HPS6(-/-) mice. Human umbilical vein endothelial cells in which the HPS6 gene was silenced displayed impaired PDI secretion and exocytosis of Weibel-Palade bodies. Defective thrombus formation in Hermansky-Pudlak syndrome, associated with impaired exocytosis of residual granules in endothelial cells and platelets, the latter due to deficiency of ADP, is characterized by a defect in T granule secretion, a deficiency in extracellular PDI secretion, and impaired fibrin generation and platelet aggregation. Hermansky-Pudlak syndrome is an example of a hereditary disease whereby impaired PDI secretion contributes to a bleeding phenotype.

  17. Calcified right ventricular thrombus and antiphospholipid syndrome.

    PubMed

    de Agustín, Jose Alberto; Nuñez-Gil, Iván Javier; Ruiz-Mateos, Borja; Manzano, Maria del Carmen; Vivas, David; de Isla, Leopoldo Pérez; Zamorano, Jose; Macaya, Carlos

    2009-05-01

    Antiphospholipid syndrome has been associated with venous and arterial thrombotic events but intracardiac thrombosis is rare. We describe a case about a 30-year-old woman, admitted with a 6-month history of arthralgia, fatigue, and intermittent fever. Subsequent investigation revealed the presence of a large and calcified mass in the right ventricular outflow tract attached to the subvalvular tricuspid apparatus. Cardiac surgery was performed and histological examination demonstrated it to be composed entirely of calcified thrombus. Screening laboratory evaluation for hypercoagulable states confirmed the diagnosis of antiphospholipid syndrome.

  18. Right ventricular outflow tract aneurysm with thrombus

    PubMed Central

    Peer, Syed Murfad; Bhat, P.S. Seetharama; Furtado, Arul Dominic; Chikkatur, Raghavendra

    2012-01-01

    Right ventricular outflow tract (RVOT) aneurysm is a known complication of tetralogy of Fallot repair when a ventriculotomy is done. It leads to RV dysfunction and may require re-operation. We describe a rare instance of a patient who developed an RVOT aneurysm after trans-ventricular repair of tetralogy of Fallot, which was complicated with the formation of a thrombus in the aneurysm sac. The patient underwent re-operation with thrombectomy, excision of the RVOT aneurysm and pulmonary valve replacement. To the best of our knowledge, the occurrence of this combination and its implications have not been reported. PMID:22232231

  19. Ultrasonic processor reduces drill-cuttings size and eliminates subsea mounds

    SciTech Connect

    Gaddy, D.E.

    1997-10-06

    Drill cuttings size reduction using ultrasonics eliminated a subsea clean-up and significantly reduced the environmental impact in a North Sea drilling project. Reduction in cuttings size allows for a wider areal dispersion when released into the ocean because they are held in suspension longer than larger sizes. Thus, ocean currents carry the smaller cuttings farther away from the well template, leaving a much wider footprint than larger cuttings sizes. This eliminates the pile-up of cuttings that otherwise would contaminate and harm the marine habitat.

  20. Character-Size Optimization for Reducing the Number of EB Shots of MCC Lithographic Systems

    NASA Astrophysics Data System (ADS)

    Sugihara, Makoto

    We propose a character size optimization technique to reduce the number of EB shots of multi-column-cell (MCC) lithographic systems in which transistor patterns are projected with multiple column cells in parallel. Each and every column cell is capable of projecting patterns with character projection (CP) and variable shaped beam (VSB) methods. Seeking the optimal character size of characters contributes to minimizing the number of EB shots and reducing the fabrication cost for ICs. Experimental results show that the character size optimization achieved 70.6% less EB shots in the best case with an available electron beam (EB) size. Our technique also achieved 40.6% less EB shots in the best case than a conventional character sizing technique.

  1. An analysis of pump thrombus events in patients in the HeartWare ADVANCE bridge to transplant and continued access protocol trial.

    PubMed

    Najjar, Samer S; Slaughter, Mark S; Pagani, Francis D; Starling, Randall C; McGee, Edwin C; Eckman, Peter; Tatooles, Antone J; Moazami, Nader; Kormos, Robert L; Hathaway, David R; Najarian, Kevin B; Bhat, Geetha; Aaronson, Keith D; Boyce, Steven W

    2014-01-01

    pump thrombosis include elevated blood pressure and sub-optimal anti-coagulation and anti-platelet therapies. This suggests that pump thrombus event rates could be reduced through careful adherence to patient management guidelines. © 2013 International Society for Heart and Lung Transplantation Published by International Society for the Heart and Lung Transplantation All rights reserved.

  2. Automated Entire Thrombus Density Measurements for Robust and Comprehensive Thrombus Characterization in Patients with Acute Ischemic Stroke

    PubMed Central

    Santos, Emilie M. M.; Niessen, Wiro J.; Yoo, Albert J.; Berkhemer, Olvert A.; Beenen, Ludo F.

    2016-01-01

    Background and Purpose In acute ischemic stroke (AIS) management, CT-based thrombus density has been associated with treatment success. However, currently used thrombus measurements are prone to inter-observer variability and oversimplify the heterogeneous thrombus composition. Our aim was first to introduce an automated method to assess the entire thrombus density and then to compare the measured entire thrombus density with respect to current standard manual measurements. Materials and Method In 135 AIS patients, the density distribution of the entire thrombus was determined. Density distributions were described using medians, interquartile ranges (IQR), kurtosis, and skewedness. Differences between the median of entire thrombus measurements and commonly applied manual measurements using 3 regions of interest were determined using linear regression. Results Density distributions varied considerably with medians ranging from 20.0 to 62.8 HU and IQRs ranging from 9.3 to 55.8 HU. The average median of the thrombus density distributions (43.5 ± 10.2 HU) was lower than the manual assessment (49.6 ± 8.0 HU) (p<0.05). The difference between manual measurements and median density of entire thrombus decreased with increasing density (r = 0.64; p<0.05), revealing relatively higher manual measurements for low density thrombi such that manual density measurement tend overestimates the real thrombus density. Conclusions Automatic measurements of the full thrombus expose a wide variety of thrombi density distribution, which is not grasped with currently used manual measurement. Furthermore, discrimination of low and high density thrombi is improved with the automated method. PMID:26765847

  3. Huge Free-Floating Thrombus in the Internal Carotid Artery.

    PubMed

    Tanriverdi, Uygur; Kizilkilic, Osman; Ince, Birsen

    2017-08-25

    Free-floating thrombus in the carotid artery is extremely rare. A 70-year-old male patient with pre-existing Crohn's disease admitted to our clinic with recurrent transient ischemic attacks. Angiography showed a huge thrombus in internal carotid artery. He responded to anticoagulation treatment and delayed endovascular intervention. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  4. Thrombus formation in a dilated torcula following aneurysmal subarachnoid haemorrhage.

    PubMed

    Haynes, H R; Visca, A; Renowden, S; Malcolm, G

    2013-08-01

    A case of thrombus formation occurring within a dilation of the dural venous sinuses following aneurysmal sub-arachnoid haemorrhage is presented. Acute neurological deterioration accompanied propagation of the thrombus. The patient was anticoagulated on day 5 post-SAH with no haemorrhagic complications and made a full recovery. The optimum time to commence anticoagulation is not clear and is discussed.

  5. [Thrombus visualisation during radiofrequency catheter ablation. A case report].

    PubMed

    Maciag, Aleksander; Szwed, Hanna; Pytkowski, Mariusz; Kraska, Alicja; Sterliński, Maciej

    2005-10-01

    We report two patients in whom thrombus formation during radiofrequency catheter ablation was detected by echocardiography. Resolution of thrombus after intravenous use of heparin was observed in both patients. Transesophageal and intracardiac echocardiography may be useful in management of this complication.

  6. Calcified right intraventricular thrombus in a patient with systemic lupus erythematous and antiphospholipid syndrome.

    PubMed

    Bittencourt, Márcio Sommer; Seltmann, Martin; Muschiol, Gerd; Achenbach, Stephan

    2010-01-01

    A 37-year-old patient with known systemic lupus erythematous, antiphospholipid syndrome and previous pulmonary embolism presented with non-ST elevation myocardial infarction while on adequate anticoagulation therapy. The patient was further evaluated with cardiac computed tomography. A small diagonal branch occlusion was the only coronary lesion present. A partially calcified right ventricular thrombus was incidentally found. Because of the small vessel size, cardiac catheterization was deemed unnecessary, and the patient was discharged with adjustment of immunosuppressive therapy and anticoagulation.

  7. Reduced body size and cub recruitment in polar bears associated with sea ice decline

    USGS Publications Warehouse

    Rode, K.D.; Amstrup, Steven C.; Regehr, E.V.

    2010-01-01

    Rates of reproduction and survival are dependent upon adequate body size and condition of individuals. Declines in size and condition have provided early indicators of population decline in polar bears (Ursus maritimus) near the southern extreme of their range. We tested whether patterns in body size, condition, and cub recruitment of polar bears in the southern Beaufort Sea of Alaska were related to the availability of preferred sea ice habitats and whether these measures and habitat availability exhibited trends over time, between 1982 and 2006. The mean skull size and body length of all polar bears over three years of age declined over time, corresponding with long-term declines in the spatial and temporal availability of sea ice habitat. Body size of young, growing bears declined over time and was smaller after years when sea ice availability was reduced. Reduced litter mass and numbers of yearlings per female following years with lower availability of optimal sea ice habitat, suggest reduced reproductive output and juvenile survival. These results, based on analysis of a longterm data set, suggest that declining sea ice is associated with nutritional limitations that reduced body size and reproduction in this population. ?? 2010 by the Ecological Society of America.

  8. Reduced body size and cub recruitment in polar bears associated with sea ice decline.

    PubMed

    Rode, Karyn D; Amstrup, Steven C; Regehr, Eric V

    2010-04-01

    Rates of reproduction and survival are dependent upon adequate body size and condition of individuals. Declines in size and condition have provided early indicators of population decline in polar bears (Ursus maritimus) near the southern extreme of their range. We tested whether patterns in body size, condition, and cub recruitment of polar bears in the southern Beaufort Sea of Alaska were related to the availability of preferred sea ice habitats and whether these measures and habitat availability exhibited trends over time, between 1982 and 2006. The mean skull size and body length of all polar bears over three years of age declined over time, corresponding with long-term declines in the spatial and temporal availability of sea ice habitat. Body size of young, growing bears declined over time and was smaller after years when sea ice availability was reduced. Reduced litter mass and numbers of yearlings per female following years with lower availability of optimal sea ice habitat, suggest reduced reproductive output and juvenile survival. These results, based on analysis of a long-term data set, suggest that declining sea ice is associated with nutritional limitations that reduced body size and reproduction in this population.

  9. Lymphoedema caused by idiopathic lymphatic thrombus.

    PubMed

    Hara, Hisako; Mihara, Makoto; Seki, Yukio; Koshima, Isao

    2013-12-01

    Primary lymphoedema includes some diseases whose genetic anomaly is detected and others whose pathology is unknown. In this article, we report a lymphatic thrombus found in a limb with lymphoedema during lymphatico-venous anastomosis (LVA). A 32-year-old man was aware of oedema in his left calcar pedis 3 years previously, which appeared without any trigger. Indocyanine green lymphography indicated lymphatic stasis in the left calf and thigh region, and we performed LVA for the patient. During the operation, we found yellow vessels, which were thought to be lymphatic vessels filled with a yellow solid substance, just beneath the superficial fascia at the left ankle. Pathological examination of the thrombi revealed hyaline material mixed with cell components. The cells were categorised as lymphatic endothelial cells, as they were positive for podoplanin. There was no evidence of malignancy. Causes of idiopathic lymphatic thrombus such as this may be one of the causes of so-called primary lymphoedema, and evaluation of such cases may be the first step towards elucidating the mechanisms involved in the development of primary lymphoedema.

  10. Differential Responses of Nitrate Reducer Community Size, Structure, and Activity to Tillage Systems▿ †

    PubMed Central

    Chèneby, D.; Brauman, A.; Rabary, B.; Philippot, L.

    2009-01-01

    The main objective of this study was to determine how the size, structure, and activity of the nitrate reducer community were affected by adoption of a conservative tillage system as an alternative to conventional tillage. The experimental field, established in Madagascar in 1991, consists of plots subjected to conventional tillage or direct-seeding mulch-based cropping systems (DM), both amended with three different fertilization regimes. Comparisons of size, structure, and activity of the nitrate reducer community in samples collected from the top layer in 2005 and 2006 revealed that all characteristics of this functional community were affected by the tillage system, with increased nitrate reduction activity and numbers of nitrate reducers under DM. Nitrate reduction activity was also stimulated by combined organic and mineral fertilization but not by organic fertilization alone. In contrast, both negative and positive effects of combined organic and mineral fertilization on the size of the nitrate reducer community were observed. The size of the nitrate reducer community was a significant predictor of the nitrate reduction rates except in one treatment, which highlighted the inherent complexities in understanding the relationships the between size, diversity, and structure of functional microbial communities along environmental gradients. PMID:19304827

  11. Presurgical treatment with sunitinib for renal cell carcinoma with a level III/IV vena cava tumour thrombus.

    PubMed

    Horn, Thomas; Thalgott, Mark K; Maurer, Tobias; Hauner, Katharina; Schulz, Stephan; Fingerle, Alexander; Retz, Margitta; Gschwend, Jürgen E; Kübler, Hubert R

    2012-05-01

    The feasibility and safety of a presurgical treatment approach with sunitinib for renal cell carcinoma (RCC) with level III/IV tumour thrombus in the inferior vena cava (IVC) were to be evaluated and its potential ability to reduce the surgical morbidity explored. In our institution, we treated five consecutive patients with suspected RCC and a level III/IV IVC tumour thrombus with preoperative sunitinib (50 mg, 4 weeks on, 2 weeks off). Side dose effects were assessed and the effect on the tumour size and the dependent surgical approach documented with a computed tomographic scan before and after the treatment. The data were analyzed retrospectively. The overall tolerability to presurgical sunitinib was good. All procedures were carried out without perioperative complications. In four patients, a reduction in tumour size was observed, which resulted in avoidance of a bicavital surgical approach with cardiopulmonary bypass in one patient. This patient was diagnosed with papillary renal cancer; the other four patients had clear cell carcinomas. Presurgical treatment with sunitinib is able to ease surgery for RCC tumour thrombi regardless of the histological subtype in selected patients. In our series, surgery was possible without additional morbidity. Two courses of a presurgical therapy with sunitinib seems to be an appropriate duration. In accordance with previously published data, presurgical sunitinib treatment may become more widely used in RCC with level III/IV IVC tumour thrombi but administered with restraint in cases of level I/II thrombi. The effects on the risk of recurrence and survival remain to be evaluated prospectively.

  12. Size-dependent mechanical properties of PVA nanofibers reduced via air plasma treatment

    NASA Astrophysics Data System (ADS)

    Fu, Qiang; Jin, Yu; Song, Xuefeng; Gao, Jingyun; Han, Xiaobing; Jiang, Xingyu; Zhao, Qing; Yu, Dapeng

    2010-03-01

    Organic nanowires/fibers have great potential in applications such as organic electronics and soft electronic techniques. Therefore investigation of their mechanical performance is of importance. The Young's modulus of poly(vinyl alcohol) (PVA) nanofibers was analyzed by scanning probe microscopy (SPM) methods. Air plasma treatment was used to reduce the nanofibers to different sizes. Size-dependent mechanical properties of PVA nanofibers were studied and revealed that the Young's modulus increased dramatically when the scales became very small (<80 nm).

  13. New mechanism to reduce the size of the monopivot magnetic suspension blood pump: direct drive mechanism.

    PubMed

    Yamane, T; Nishida, M; Kijima, T; Maekawa, J

    1997-07-01

    Size reduction of the monopivot magnetic suspension blood pump has been achieved by reducing the size of the magnetic suspension and employing a direct drive mechanism in place of a brushless DC motor and a magnetic coupling. The flow has also been improved using a closed hollow impeller to remove flow obstruction at the inlet and using radial straight vanes to reduce the impeller speed by 30%. Hemolysis testing was conducted for the new models. Results showed that model DD1 presented only a slightly higher level of hemolysis than a regular extracorporeal centrifugal pump.

  14. Thrombus aspiration therapy and coronary thrombus components in patients with acute ST-elevation myocardial infarction.

    PubMed

    Yunoki, Kei; Naruko, Takahiko; Sugioka, Kenichi; Inaba, Mayumi; Itoh, Akira; Haze, Kazuo; Yoshiyama, Minoru; Ueda, Makiko

    2013-01-01

    Inflammation and oxidative stress play key roles in atherosclerotic plaque instability, and plaque rupture/erosion and subsequent thrombus formation constitute the principal mechanisms of total vessel occlusion and acute ST-elevation myocardial infarction (STEMI). Plaque disruption triggers the formation of initial platelet aggregates that grow in association with an increase in fibrin formation, leading to persistent coronary flow obstruction and blood coagulation. The fibrin network may trap large numbers of erythrocytes and inflammatory cells to form an erythrocyte-rich thrombus. In fact, previous clinical studies have shown that not only platelet-rich white thrombi, but also erythrocyte-rich red thrombi can be visualized using angioscopy in patients with acute coronary syndrome. Recently, the development of thrombus aspiration and distal protection devices has significantly improved the clinical outcomes of percutaneous intervention in STEMI patients and has enabled the evaluation of antemortem coronary artery thrombi. This is important because previous autopsy studies were unable to differentiate coronary thrombi responsible for myocardial ischemia from postmortem clots. Using frozen samples of aspirated thrombi and specific monoclonal antibodies, we investigated the cellular components of thrombi (platelets, erythrocytes, fibrin and inflammatory cells, such as myeloperoxidase-positive cells) and pathologically evaluated the relationships between erythrocyte-rich thrombi and inflammation, oxidative stress and clinical outcomes in STEMI patients. Therefore, this review article focuses on the efficacy of thrombus aspiration therapy and the components of aspirated intracoronary thrombi in STEMI patients and presents the results of recent studies regarding the relationship between the composition of aspirated intracoronary thrombi and clinical outcomes.

  15. Delineation of an octopus-like thrombus attached to the eustachian valve.

    PubMed

    Kalcik, Macit; Toprak, Cüneyt; Ozan Gursoy, M; Yesin, Mahmut; Ocal, Lutfi; Eren, Hayati; Özkan, Mehmet

    2014-04-01

    Eustachian valve (EV) is a vestige of the valve of the inferior vena cava which directs the umbilical vein blood through open foramen ovale in fetal life. Following birth it gradually regresses, but it may persist in variable size, shape, and thickness as a functionless and benign structure. However, there are reports suggesting that persistent EV may not be completely innocent. It has been accused of being a predisposing cause of patent foramen ovale and paradoxical embolism and also interfering with transseptal interventional procedures. It may serve as a site of infective vegetations and be mistaken as a tumor or thrombus. In the present case, an octopus-like thrombus attached to the EV was delineated with the utility of two-dimensional and real time three-dimensional transesophageal echocardiography. EV was considered to play an essential role in preventing potential pulmonary embolism.

  16. Reducing sample size in experiments with animals: historical controls and related strategies.

    PubMed

    Kramer, Matthew; Font, Enrique

    2017-02-01

    Reducing the number of animal subjects used in biomedical experiments is desirable for ethical and practical reasons. Previous reviews of the benefits of reducing sample sizes have focused on improving experimental designs and methods of statistical analysis, but reducing the size of control groups has been considered rarely. We discuss how the number of current control animals can be reduced, without loss of statistical power, by incorporating information from historical controls, i.e. subjects used as controls in similar previous experiments. Using example data from published reports, we describe how to incorporate information from historical controls under a range of assumptions that might be made in biomedical experiments. Assuming more similarities between historical and current controls yields higher savings and allows the use of smaller current control groups. We conducted simulations, based on typical designs and sample sizes, to quantify how different assumptions about historical controls affect the power of statistical tests. We show that, under our simulation conditions, the number of current control subjects can be reduced by more than half by including historical controls in the analyses. In other experimental scenarios, control groups may be unnecessary. Paying attention to both the function and to the statistical requirements of control groups would result in reducing the total number of animals used in experiments, saving time, effort and money, and bringing research with animals within ethically acceptable bounds. © 2015 Cambridge Philosophical Society.

  17. Curative Analysis of Several Therapeutic Methods for Primary Hepatocellular Carcinoma with Portal Vein Tumor Thrombus.

    PubMed

    Tang, Zhen-Yu; Zhou, Bing-Hai; Wang, Wei; Du, Gang; Liu, Ze-Yang; Li, Jia; Zhang, Shi-Zhe; Fu, Zhi-Hao

    2015-05-01

    To evaluate the efficacy of different therapeutic methods for finding a promising treatment to this satanic disease and determined the prognostic factors affecting the survival time. A retrospective study was carried out on 589 patients who underwent different treatment for Primary hepatocellular carcinoma with portal vein tumor thrombus from January, 2005 to June, 2013. Patients were divided into 4 groups according to the initial treatment: Group A (N = 48), conservative treatment; Group B (N = 86), chemotherapy; Group C (N = 122), surgical resection; and Group D (N = 333), surgical resection with postoperative chemotherapy. There was no significant differences in clinical information (i.e., the number of tumor, the size of tumor, and the state of portal vein tumor thrombus) among the 4 groups (P > 0.05). Both surgical resection and chemotherapy can improve the survival rate of the patients, and comprehensive treatments are of greater effect over surgical resection or chemotherapy alone. Univariate and multiple analyses revealed that the levers of AFP(p=.001), the size of tumor (p < .001), the number of tumor(p < .001), the state of portal vein tumor thrombus(p < .001), and the number of chemotherapy(p = .000) affected the conditions of prognosis: Positive operation treatment is the most effective therapeutic strategy for this advanced disease. Surgical resection followed by postoperative chemotherapy would increase the survival rate.

  18. Reduced sample sizes for atrophy outcomes in Alzheimer's disease trials: baseline adjustment

    PubMed Central

    Schott, J.M.; Bartlett, J.W.; Barnes, J.; Leung, K.K.; Ourselin, S.; Fox, N.C.

    2010-01-01

    Cerebral atrophy rate is increasingly used as an outcome measure for Alzheimer's disease (AD) trials. We used the Alzheimer's disease Neuroimaging initiative (ADNI) dataset to assess if adjusting for baseline characteristics can reduce sample sizes. Controls (n = 199), patients with mild cognitive impairment (MCI) (n = 334) and AD (n = 144) had two MRI scans, 1-year apart; ~ 55% had baseline CSF tau, p-tau, and Aβ1-42. Whole brain (KN–BSI) and hippocampal (HMAPS-HBSI) atrophy rate, and ventricular expansion (VBSI) were calculated for each group; numbers required to power a placebo-controlled trial were estimated. Sample sizes per arm (80% power, 25% absolute rate reduction) for AD were (95% CI): brain atrophy = 81 (64,109), hippocampal atrophy = 88 (68,119), ventricular expansion = 118 (92,157); and for MCI: brain atrophy = 149 (122,188), hippocampal atrophy = 201 (160,262), ventricular expansion = 234 (191,295). To detect a 25% reduction relative to normal aging required increased sample sizes ~ 3-fold (AD), and ~ 5-fold (MCI). Disease severity and Aβ1-42 contributed significantly to atrophy rate variability. Adjusting for 11 predefined covariates reduced sample sizes by up to 30%. Treatment trials in AD should consider the effects of normal aging; adjusting for baseline characteristics can significantly reduce required sample sizes. PMID:20620665

  19. Implantation of cocoa butter reduces egg and hatchling size in Salmo trutta.

    PubMed

    Hoogenboom, M O; Armstrong, J D; Miles, M S; Burton, T; Groothuis, T G G; Metcalfe, N B

    2011-09-01

    This study demonstrated that, irrespective of hormone type or dose, administering cocoa butter implants during egg development affected the growth of female brown trout Salmo trutta and reduced the size of their offspring. Cortisol treatment also increased adult mortality. Caution is urged in the use of implants for studies of maternal hormonal influences on adult fishes and their offspring.

  20. Polychlorinated biphenyls may alter marine trophic pathways by reducing phytoplankton size and production.

    PubMed

    O'Connors, H B; Wurster, C F; Powers, C D; Biggs, D C; Rowland, R G

    1978-08-25

    Polychlorinated biphenyls at concentrations of 1 to 10 micrograms per liter reduced phytoplankton biomass and size in natural estuarine phytoplankton communities grown within dialysis bags in situ in an estuarine marsh. In polychlorinated biphenyls-contaminated waters, these changes could increase the number of trophic levels and divert the flow of biomass from harvestable fish to jellyfish and other gelatinous predators.

  1. Reduced Sampling Size with Nanopipette for Tapping-Mode Scanning Probe Electrospray Ionization Mass Spectrometry Imaging

    PubMed Central

    Kohigashi, Tsuyoshi; Otsuka, Yoichi; Shimazu, Ryo; Matsumoto, Takuya; Iwata, Futoshi; Kawasaki, Hideya; Arakawa, Ryuichi

    2016-01-01

    Mass spectrometry imaging (MSI) with ambient sampling and ionization can rapidly and easily capture the distribution of chemical components in a solid sample. Because the spatial resolution of MSI is limited by the size of the sampling area, reducing sampling size is an important goal for high resolution MSI. Here, we report the first use of a nanopipette for sampling and ionization by tapping-mode scanning probe electrospray ionization (t-SPESI). The spot size of the sampling area of a dye molecular film on a glass substrate was decreased to 6 μm on average by using a nanopipette. On the other hand, ionization efficiency increased with decreasing solvent flow rate. Our results indicate the compatibility between a reduced sampling area and the ionization efficiency using a nanopipette. MSI of micropatterns of ink on a glass and a polymer substrate were also demonstrated. PMID:28101441

  2. Reduced particle size wheat bran is butyrogenic and lowers Salmonella colonization, when added to poultry feed.

    PubMed

    Vermeulen, K; Verspreet, J; Courtin, C M; Haesebrouck, F; Ducatelle, R; Van Immerseel, F

    2017-01-01

    Feed additives, including prebiotics, are commonly used alternatives to antimicrobial growth promoters to improve gut health and performance in broilers. Wheat bran is a highly concentrated source of (in)soluble fiber which is partly degraded by the gut microbiota. The aim of the present study was to investigate the potential of wheat bran as such to reduce colonization of the cecum and shedding of Salmonella bacteria in vivo. Also, the effect of particle size was evaluated. Bran with an average reduced particle size of 280μm decreased levels of cecal Salmonella colonization and shedding shortly after infection when compared to control groups and groups receiving bran with larger particle sizes. In vitro fermentation experiments revealed that bran with smaller particle size was fermented more efficiently, with a significantly higher production of butyric and propionic acid, compared to the control fermentation and fermentation of a larger fraction. Fermentation products derived from bran with an average particle size of 280μm downregulated the expression of hilA, an important invasion-related gene of Salmonella. This downregulation was reflected in an actual lowered invasive potential when Salmonella bacteria were pretreated with the fermentation products derived from the smaller bran fraction. These data suggest that wheat bran with reduced particle size can be a suitable feed additive to help control Salmonella infections in broilers. The mechanism of action most probably relies on a more efficient fermentation of this bran fraction and the consequent increased production of short chain fatty acids (SCFA). Among these SCFA, butyric and propionic acid are known to reduce the invasion potential of Salmonella bacteria.

  3. Right atrial thrombus and its causes, complications, and therapy

    PubMed Central

    Afzal, Aasim; Chamogeorgakis, Themistokles; Feghali, Georges A.

    2017-01-01

    A 70-year-old man who presented with dyspnea and intermittent chest pain was found to have a large free-floating right atrial thrombus on two-dimensional echocardiogram. Atriotomy was performed, and an 18-cm-long thrombus was removed from the right atrium and inferior vena cava. Postoperatively, the patient developed cardiogenic shock treated by intravenous vasopressor agents and extracorporeal membrane oxygenation. The postoperative course was also complicated by bilateral pulmonary emboli requiring pulmonary artery thrombectomy. Right atrial thrombus is an underdiagnosed condition with a high mortality rate. The best management modality has not yet been established. PMID:28127133

  4. Smaller food item sizes of snack foods influence reduced portions and caloric intake in young adults.

    PubMed

    Marchiori, David; Waroquier, Laurent; Klein, Olivier

    2011-05-01

    Studies considering the impact of food-size variations on consumption have predominantly focused on portion size, whereas very little research has investigated variations in food-item size, especially at snacking occasions, and results have been contradictory. This study evaluated the effect of altering the size of food items (ie, small vs large candies) of equal-size food portions on short-term energy intake while snacking. The study used a between-subjects design (n=33) in a randomized experiment conducted in spring 2008. In a psychology laboratory (separate cubicles), participants (undergraduate psychology students, 29 of 33 female, mean age 20.3±2 years, mean body mass index 21.7±3.7) were offered unlimited consumption of candies while participating in an unrelated computerized experiment. For half of the subjects, items were cut in two to make the small food-item size. Food intake (weight in grams, kilocalories, and number of food items) was examined using analysis of variance. Results showed that decreasing the item size of candies led participants to decrease by half their gram weight intake, resulting in an energy intake decrease of 60 kcal compared to the other group. Appetite ratings and subject and food characteristics had no moderating effect. A cognitive bias could explain why people tend to consider that one unit of food (eg, 10 candies) is the appropriate amount to consume, regardless of the size of the food items in the unit. This study suggests a simple dietary strategy, decreasing food-item size without having to alter the portion size offered, may reduce energy intake at snacking occasions.

  5. Visualization and analysis of biomaterial-centered thrombus formation within a defined crevice under flow.

    PubMed

    Jamiolkowski, Megan A; Pedersen, Drake D; Wu, Wei-Tao; Antaki, James F; Wagner, William R

    2016-07-01

    The blood flow pathway within a device, together with the biomaterial surfaces and status of the patient's blood, are well-recognized factors in the development of thrombotic deposition and subsequent embolization. Blood flow patterns are of particular concern for devices such as blood pumps (i.e. ventricular assist devices, VADs) where shearing forces can be high, volumes are relatively large, and the flow fields can be complex. However, few studies have examined the effect of geometric irregularities on thrombus formation on clinically relevant opaque materials under flow. The objective of this study was to quantify human platelet deposition onto Ti6Al4V alloys, as well as positive and negative control surfaces, in the region of defined crevices (∼50-150 μm in width) that might be encountered in many VADs or other cardiovascular devices. To achieve this, reconstituted fresh human blood with hemoglobin-depleted red blood cells (to achieve optical clarity while maintaining relevant rheology), long working optics, and a custom designed parallel plate flow chamber were employed. The results showed that the least amount of platelet deposition occurred in the largest crevice size examined, which was counterintuitive. The greatest levels of deposition occurred in the 90 μm and 53 μm crevices at the lower wall shear rate. The results suggest that while crevices may be unavoidable in device manufacturing, the crevice size might be tailored, depending on the flow conditions, to reduce the risk of thromboembolic events. Further, these data might be used to improve the accuracy of predictive models of thrombotic deposition in cardiovascular devices to help optimize the blood flow path and reduce device thrombogenicity.

  6. Do antioxidant vitamins reduce infarct size following acute myocardial ischemia/reperfusion?

    PubMed

    Bellows, S D; Hale, S L; Simkhovich, B Z; Kay, G L; Kloner, R A

    1995-02-01

    There is controversy concerning the ability of antioxidant vitamins to reduce myocardial infarct size. We sought to determine whether a brief prophylactic treatment of vitamin C or vitamin C plus Trolox (a water-soluble form of vitamin E) could reduce myocardial infarct size in an experimental model. We used an anesthetized open-chest rabbit model in which a branch of the circumflex coronary artery was ligated for 30 minutes followed by 4 hours of reperfusion. Experiments were performed in a randomized and blinded fashion. An IV injection of normal saline pH balanced to 7.4 (control group n = 15), vitamin C (150 mg/kg, n = 14), or vitamin C plus Trolox (150 mg/kg plus 100 mg/kg, respectively, n = 15) was administered prior to coronary occlusion. Collateral blood flow during coronary occlusion was measured by radioactive microspheres, myocardial risk zone (AR) was assessed by blue dye injection, and myocardial infarct size (AN) was assessed by triphenyltetrazolium chloride staining. All rabbits received comparable ischemic insult: Collateral blood flow and AR were similar among all three groups. Infarct size, measured as a percent of AR, did not differ significantly among the controls (21%), vitamin C (29%), or the vitamin C plus Trolox (18%) groups. Therefore, in this ischemia/reperfusion model, antioxidant vitamins did not alter myocardial infarct size.

  7. Salmon calcitonin reduces food intake through changes in meal sizes in male rhesus monkeys.

    PubMed

    Bello, Nicholas T; Kemm, Matthew H; Moran, Timothy H

    2008-07-01

    Amylinergic mechanisms are believed to be involved in the control of appetite. This study examined the effects of the amylin agonist, salmon calcitonin, on food intake and meal patterns in adult male rhesus monkeys. Fifteen minutes before the onset of their 6-h daily feeding period, monkeys received intramuscular injections of various doses of salmon calcitonin (0.032, 0.056, 0.1, 0.32, and 1 microg/kg) or saline. Salmon calcitonin dose dependently reduced total daily and hourly food intake, with significant decreases at the 0.1, 0.32, and 1 microg/kg doses. Daily food intake was reduced by approximately 35%, 62%, and 96%, at these doses, respectively. An analysis of meal patterns revealed that size of the first meal was significantly reduced across the dose range of 0.056 to 1 microg/kg, while average meal size was reduced with the 0.32 and 1 microg/kg doses. Meal number was only affected at the 1 microg/kg dose. Repeated 5-day administration of the 0.1 microg/kg dose resulted in a reduction in daily food intake only on injection day 2, while significant reductions in food intake were observed on all five injection days with a 0.32 microg/kg dose. Daily food intake was also reduced for 1 day after the termination of the 5-day injections of the 0.32 microg/kg salmon calcitonin dose. These sustained reductions in intake were expressed through decreases in meal size. These data demonstrate that salmon calcitonin acutely and consistently decreases food intake mainly through reductions in meal sizes in nonhuman primates.

  8. Cathepsin G-Dependent Modulation of Platelet Thrombus Formation In Vivo by Blood Neutrophils

    PubMed Central

    Faraday, Nauder; Schunke, Kathryn; Saleem, Sofiyan; Fu, Juan; Wang, Bing; Zhang, Jian; Morrell, Craig; Dore, Sylvain

    2013-01-01

    Neutrophils are consistently associated with arterial thrombotic morbidity in human clinical studies but the causal basis for this association is unclear. We tested the hypothesis that neutrophils modulate platelet activation and thrombus formation in vivo in a cathepsin G-dependent manner. Neutrophils enhanced aggregation of human platelets in vitro in dose-dependent fashion and this effect was diminished by pharmacologic inhibition of cathepsin G activity and knockdown of cathepsin G expression. Tail bleeding time in the mouse was prolonged by a cathepsin G inhibitor and in cathepsin G knockout mice, and formation of neutrophil-platelet conjugates in blood that was shed from transected tails was reduced in the absence of cathepsin G. Bleeding time was highly correlated with blood neutrophil count in wildtype but not cathepsin G deficient mice. In the presence of elevated blood neutrophil counts, the anti-thrombotic effect of cathepsin G inhibition was greater than that of aspirin and additive to it when administered in combination. Both pharmacologic inhibition of cathepsin G and its congenital absence prolonged the time for platelet thrombus to form in ferric chloride-injured mouse mesenteric arterioles. In a vaso-occlusive model of ischemic stroke, inhibition of cathepsin G and its congenital absence improved cerebral blood flow, reduced histologic brain injury, and improved neurobehavioral outcome. These experiments demonstrate that neutrophil cathepsin G is a physiologic modulator of platelet thrombus formation in vivo and has potential as a target for novel anti-thrombotic therapies. PMID:23940756

  9. Management of Vertebral Stenosis Complicated by Presence of Acute Thrombus

    SciTech Connect

    Canyigit, Murat; Arat, Anil Cil, Barbaros E.; Sahin, Gurdal; Turkbey, Baris; Elibol, Bulent

    2007-04-15

    A 44-year-old male presented with multiple punctate acute infarcts of the vertebrobasilar circulation and a computed tomographic angiogram showing stenosis of the right vertebral origin. A digital subtraction angiogram demonstrated a new intraluminal filling defect at the origin of the stenotic vertebral artery where antegrade flow was maintained. This filling defect was accepted to be an acute thrombus of the vertebral origin, most likely due to rupture of a vulnerable plaque. The patient was treated with intravenous heparin. A control angiogram revealed dissolution of the acute thrombus under anticoagulation and the patient was treated with stenting with distal protection. Diffusion-weighted magnetic resonance imaging demonstrated no additional acute ischemic lesions. We were unable to find a similar report in the English literature documenting successful management of an acute vertebral ostial thrombus with anticoagulation. Anticoagulation might be considered prior to endovascular treatment of symptomatic vertebral stenoses complicated by the presence of acute thrombus.

  10. Large right atrial thrombus associated with central venous catheter requiring open heart surgery.

    PubMed

    Hussain, Nasir; Shattuck, Paul Eric; Senussi, Mourad Hussein; Velasquez Kho, Erwin; Mohammedabdul, Mubeenkhan; Sanghavi, Devang K; Mustafa, Usman; Balavenkataraman, Arvind; Obradovic, Dragic M

    2012-01-01

    Central venous catheters (CVC) are used commonly in clinical practice. Incidences of CVC-related right atrial thrombosis (CRAT) are variable, but, when right atrial thrombus is present, it carries a mortality risk of 18% in hemodialysis patients and greater than 40% risk in nonhemodialysis patients. Different pathogenic mechanisms have been postulated for the development of CRAT, which includes mechanical irritation of the myocardial wall, propagation of intraluminal clot, hypercoagulability, and hemodynamics of right atria. Presentation of CRAT may be asymptomatic or may be associated with one of the complications of CRAT like pulmonary embolism, systemic embolism, infected thrombi, or hemodynamic compromise. There are no established treatment guidelines for CRAT. We describe an interesting case of a 59-year-old asymptomatic male successfully treated with open heart surgery after failure of medical treatment for a large CRAT discovered during a preoperative evaluation for a kidney transplant. Our case underscores that early detection of CRAT may carry a favorable prognosis as opposed to waiting until catastrophic complications arise. It also underscores the importance of transesophageal echocardiography in the detection of thrombus and perhaps guides clinicians on which treatment modality to be used according to the size of the thrombus.

  11. Effect of ajoene, the major antiplatelet compound from garlic, on platelet thrombus formation.

    PubMed

    Apitz-Castro, R; Badimon, J J; Badimon, L

    1992-10-15

    Ajoene, (E,Z)-4,5,9-trithiadodeca-1,6,11-triene 9-oxide, is a potent antiplatelet compound isolated from alcoholic extracts of garlic (Allium sativum). Ajoene reversibly inhibits in vitro platelet aggregation as well as release reaction induced by all known agonists. We used a well characterized cylindrical perfusion chamber to study the effect of ajoene on platelet deposition onto physiological substrates such as pig aortic subendothelium and tunica media as a model of mildly and severely damaged vessel wall respectively. Experiments were performed under flow conditions of high and low shear rate that mimic laminar blood flow in small and medium size arteries (1690 sec-1 and 212 sec-1). Our results indicate that ajoene prevents thrombus formation both at low and high shear rate in citrated whole blood. The inhibitory effect of ajoene on platelet-thrombus formation seems to be dependent on its inhibition of fibrinogen binding, since significantly higher concentrations of ajoene are needed to affect von Willebrand factor binding to GPIIb/IIIa receptors. Further, ajoene does not impair Ristocetin-induced platelet agglutination, mediated by GPIb. Our results suggest that ajoene may be useful for the acute prevention of thrombus formation induced by vascular damage.

  12. Small portion sizes in worksite cafeterias: do they help consumers to reduce their food intake?

    PubMed Central

    Vermeer, W M; Steenhuis, I H M; Leeuwis, F H; Heymans, M W; Seidell, J C

    2011-01-01

    Background: Environmental interventions directed at portion size might help consumers to reduce their food intake. Objective: To assess whether offering a smaller hot meal, in addition to the existing size, stimulates people to replace their large meal with a smaller meal. Design: Longitudinal randomized controlled trial assessing the impact of introducing small portion sizes and pricing strategies on consumer choices. Setting/participants: In all, 25 worksite cafeterias and a panel consisting of 308 consumers (mean age=39.18 years, 50% women). Intervention: A small portion size of hot meals was offered in addition to the existing size. The meals were either proportionally priced (that is, the price per gram was comparable regardless of the size) or value size pricing was employed. Main outcome measures: Daily sales of small and the total number of meals, consumers' self-reported compensation behavior and frequency of purchasing small meals. Results: The ratio of small meals sales in relation to large meals sales was 10.2%. No effect of proportional pricing was found B=−0.11 (0.33), P=0.74, confidence interval (CI): −0.76 to 0.54). The consumer data indicated that 19.5% of the participants who had selected a small meal often-to-always purchased more products than usual in the worksite cafeteria. Small meal purchases were negatively related to being male (B=−0.85 (0.20), P=0.00, CI: −1.24 to −0.46, n=178). Conclusion: When offering a small meal in addition to the existing size, a percentage of consumers that is considered reasonable were inclined to replace the large meal with the small meal. Proportional prices did not have an additional effect. The possible occurrence of compensation behavior is an issue that merits further attention. PMID:21224829

  13. Population based analysis of survival in patients with renal cell carcinoma and venous tumor thrombus.

    PubMed

    Whitson, Jared M; Reese, Adam C; Meng, Maxwell V

    2013-02-01

    To identify prognostic factors for renal cell carcinoma (RCC) with venous tumor thrombus (VTT) and determine the significance of thrombus level on survival. Patients within the Surveillance, Epidemiology, and End Results (SEER) database with RCC and VTT were identified and included if managed surgically. The Kaplan-Meier method and Cox regression analyses were performed to identify factors associated with disease-specific survival. A total of 1,875 patients met the inclusion criteria. One-year survival for patients undergoing surgery was 60% for patients with metastases and 90% for those without. Factors associated with worse survival included larger tumor size (HR 1.2, 95% CI 1.0-1.4), medullary, collecting duct, or sarcomatoid histology (HR 2.2, 95% CI 1.5-3.3), Fuhrman grade 3 (HR 2.2, 95% CI 1.5-3.3) or grade 4 (HR 2.9, 95% CI 1.8-4.5) tumors, positive lymph nodes (HR 1.5, 95% CI 1.0-2.0), and metastases (HR 3.5, 95% CI 2.6-4.8). Thrombus level above the diaphragm (T3c) was not significantly associated with worse survival (HR 1.4, 95% CI 0.8-2.5). In this large, population-based study of patients with RCC and VTT, we identify several disease-specific factors strongly associated with cancer-specific mortality. After controlling for adverse prognostic factors, thrombus level was not associated with worse outcome. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Concentration Effect of Reducing Agents on Green Synthesis of Gold Nanoparticles: Size, Morphology, and Growth Mechanism

    NASA Astrophysics Data System (ADS)

    Kim, Hyun-seok; Seo, Yu Seon; Kim, Kyeounghak; Han, Jeong Woo; Park, Youmie; Cho, Seonho

    2016-04-01

    Under various concentration conditions of reducing agents during the green synthesis of gold nanoparticles (AuNPs), we obtain the various geometry (morphology and size) of AuNPs that play a crucial role in their catalytic properties. Through both theoretical and experimental approaches, we studied the relationship between the concentration of reducing agent (caffeic acid) and the geometry of AuNPs. As the concentration of caffeic acid increases, the sizes of AuNPs were decreased due to the adsorption and stabilizing effect of oxidized caffeic acids (OXCAs). Thus, it turns out that optimal concentration exists for the desired geometry of AuNPs. Furthermore, we investigated the growth mechanism for the green synthesis of AuNPs. As the caffeic acid is added and adsorbed on the surface of AuNPs, the aggregation mechanism and surface free energy are changed and consequently resulted in the AuNPs of various geometry.

  15. Clinical efforts to reduce myocardial infarct size--the next step.

    PubMed

    Braunwald, Eugene

    2011-01-01

    Prompt myocardial reperfusion reduces infarct size in patients experiencing coronary occlusion. However, its clinical value is limited because reperfusion also causes ischemic myocardial reperfusion injury (IMRI). Considerable research to reduce IMRI has been conducted. Three interventions appear to be promising: 1) myocardial conditioning, which consists of repetitive occlusions of coronary or other arteries prior to or at the time of myocardial reperfusion; 2) the administration of cyclosporine A; and 3) the administration of adenosine. A plan for the testing of these interventions in patients with acute myocardial infarction is described.

  16. Non-linear viscoelastic behavior of abdominal aortic aneurysm thrombus.

    PubMed

    van Dam, Evelyne A; Dams, Susanne D; Peters, Gerrit W M; Rutten, Marcel C M; Schurink, Geert Willem H; Buth, Jaap; van de Vosse, Frans N

    2008-04-01

    The objective of this work was to determine the linear and non-linear viscoelastic behavior of abdominal aortic aneurysm thrombus and to study the changes in mechanical properties throughout the thickness of the thrombus. Samples are gathered from thrombi of seven patients. Linear viscoelastic data from oscillatory shear experiments show that the change of properties throughout the thrombus is different for each thrombus. Furthermore the variations found within one thrombus are of the same order of magnitude as the variation between patients. To study the non-linear regime, stress relaxation experiments are performed. To describe the phenomena observed experimentally, a non-linear multimode model is presented. The parameters for this model are obtained by fitting this model successfully to the experiments. The model cannot only describe the average stress response for all thrombus samples but also the highest and lowest stress responses. To determine the influence on the wall stress of the behavior observed the model proposed needs to implemented in the finite element wall stress analysis.

  17. A DRAMATICALLY REDUCED SIZE IN THE GANTRY DESIGN FOR THE PROTON-CARBON THERAPY.

    SciTech Connect

    TRBOJEVIC, D.; GUPTA, R.; PARKER, B.; KEIL, E.; SESSLER, A.M.

    2006-06-23

    Gantries in the proton/carbon cancer therapy machines represent the major cost and are of the largest size. This report explains a new way to the gantry design. The size and cost of the gantries are reduced and their use is simplified by using the fixed magnetic field. The ''new'' gantry is made of a very large momentum acceptance non-scaling Fixed Field Alternating Gradient (FFAG) quarter and half arc beam lines. The gantry is made of combined function magnets with a very strong focusing and small dispersion function. Additional magnets with a fast response are required to allow adjustments of the beam position for different energies at the beginning of the gantry. Additional strong focusing magnets following the gantry have also to be adjustable to provide required spot size and radial scanning above the patients. The fixed field combined function magnets could be made of small permanent magnets for the proton machine, or of the high temperature superconductors or superconductors for the carbon machine, reducing dramatically the size.

  18. Renal cell carcinoma and tumour thrombus in the inferior vena cava: clinical outcome of 98 consecutive patients and the prognostic value of preoperative parameters.

    PubMed

    Niedworok, Christian; Dörrenhaus, Bettina; Vom Dorp, Frank; Piotrowski, Jarowit Adam; Tschirdewahn, Stephan; Szarvas, Tibor; Rübben, Herbert; Schenck, Marcus

    2015-10-01

    To evaluate the outcome of patients after nephrectomy and removal of tumour thrombus and to assess the prognostic value of preoperative parameters. Ninety-eight patients who were surgically treated between 2002 and 2011 were included. Patients' charts were reviewed, and patients with renal cell carcinoma (RCC) and concomitant tumour thrombus in the renal vein (RV) were compared with those with extended inferior vena cava (IVC) thrombus. Wilcoxon rank-sum test, Kaplan-Meier analysis and uni- and multivariate Cox regression analysis were used for statistical evaluation. Follow-up was 36 months (20-122 months), and 5-year disease-specific survival (DSS) and overall survival were 68.4 and 54.1 %, respectively. Patients with extended thrombus (levels 2-4) had higher intraoperative transfusion rates of concentrated red cells (CRC) and fresh-frozen plasma (FFP) compared with patients with thrombus confined to the RV (CRC: 5.8 vs. 1.5, p < 0.0001; FFP: 2.3 vs. 0.4, p = 0.0032). Surgery time (190 vs. 107 min, p < 0.0001), duration of hospitalisation (16 vs. 11 days, p = 0.0269), serum phosphate (3.64 vs. 3.29 mmol/l, p = 0.0369) and CRP levels (6.7 vs. 4.4 mg/dl, p = 0.0194) as well as aPTT were increased (33.7 vs. 29.6 s, p = 0.0059) in extended thrombus disease. In multivariate analysis, the presence of distant metastasis (p = 0.03) and lymphovascular invasion (p = 0.001), high platelet counts (p = 0.001) and high serum potassium levels (p = 0.032) proved to be independent prognostic factors. The surgical treatment of RCC with tumour thrombus in the RV or IVC has favourable results. Extended thrombus disease requires multidisciplinary approach. High serum potassium levels and platelet counts are associated with reduced DSS.

  19. Pulmonary embolism due to right atrial free-floating thrombus during echocardiographic examination: a case of a pulmonary saddle thrombus.

    PubMed

    Bando, Mika; Yamada, Hirotsugu; Kusunose, Kenya; Hayashi, Shuji; Takagawa, Yuriko; Saijo, Yoshihito; Nishio, Susumu; Ogasawara, Kozue; Sata, Masataka

    2015-12-01

    A 69-year-old female with polymyositis was referred to our hospital with a chief complaint of dyspnea. Transthoracic echocardiography showed right ventricular overloading. In addition to two-dimensional echocardiography, observation of the abnormal free-floating string-like mass by three-dimensional echocardiography provided superior visualization of the features of the mass which protruded into the right ventricle across the tricuspid valve during diastole. These findings enabled us to confirm the diagnosis of venous thrombus. The thrombus disappeared during the echocardiographic examination. Multidetector-row computed tomography showed a string-like thrombus across the bifurcation of the main pulmonary artery. Anticoagulation therapy was initiated with heparin and warfarin, and fondaparinux was started on the fourth day. Three-dimensional echocardiography was useful in characterizing the motion and extent of the thrombus.

  20. Do calorie-controlled portion sizes of snacks reduce energy intake?

    PubMed Central

    Stroebele, Nanette; Ogden, Lorraine G.; Hill, James O.

    2009-01-01

    In a cross-over study, participants (n=59) were randomly assigned to receive either 100 kcal packs or standard size packages of snacks for 1-week. After a minimum of a 1-week washout period, participants received the other form of the snack for 1 week. Snack consumption was recorded by participants in a diary. Participants consumed an average of 186.9 fewer grams of snacks per week when receiving 100 kcal snack packs compared to standard size packages of snacks. Post-hoc comparisons revealed the effect of package size depended on both randomization order and study week. Total grams of snacks consumed in week 1 differed significantly between the two randomized groups. In week 2, however, grams of snacks did not differ significantly between the two groups. This interaction was primarily due to a significantly lower consumption of snacks from standard size packages in the week following the portion-controlled packages. The results suggest that portion-controlled packaging reduce total intake from the provided snacks. Further, initial exposure to portion-controlled packages might have increased awareness of portion size such that less was consumed when larger packages were available. PMID:19501784

  1. Statins Improve the Resolution of Established Murine Venous Thrombosis: Reductions in Thrombus Burden and Vein Wall Scarring

    PubMed Central

    Kessinger, Chase W.; Kim, Jin Won; Henke, Peter K.; Thompson, Brian; McCarthy, Jason R.; Hara, Tetsuya; Sillesen, Martin; Margey, Ronan J. P.; Libby, Peter; Weissleder, Ralph; Lin, Charles P.; Jaffer, Farouc A.

    2015-01-01

    Despite anticoagulation therapy, up to one-half of patients with deep vein thrombosis (DVT) will develop the post-thrombotic syndrome (PTS). Improving the long-term outcome of DVT patients at risk for PTS will therefore require new approaches. Here we investigate the effects of statins—lipid-lowering agents with anti-thrombotic and anti-inflammatory properties—in decreasing thrombus burden and decreasing vein wall injury, mediators of PTS, in established murine stasis and non-stasis chemical-induced venous thrombosis (N = 282 mice). Treatment of mice with daily atorvastatin or rosuvastatin significantly reduced stasis venous thrombus burden by 25% without affecting lipid levels, blood coagulation parameters, or blood cell counts. Statin-driven reductions in VT burden (thrombus mass for stasis thrombi, intravital microscopy thrombus area for non-stasis thrombi) compared similarly to the therapeutic anticoagulant effects of low molecular weight heparin. Blood from statin-treated mice showed significant reductions in platelet aggregation and clot stability. Statins additionally reduced thrombus plasminogen activator inhibitor-1 (PAI-1), tissue factor, neutrophils, myeloperoxidase, neutrophil extracellular traps (NETs), and macrophages, and these effects were most notable in the earlier timepoints after DVT formation. In addition, statins reduced DVT-induced vein wall scarring by 50% durably up to day 21 in stasis VT, as shown by polarized light microscopy of picrosirius red-stained vein wall collagen. The overall results demonstrate that statins improve VT resolution via profibrinolytic, anticoagulant, antiplatelet, and anti-vein wall scarring effects. Statins may therefore offer a new pharmacotherapeutic approach to improve DVT resolution and to reduce the post-thrombotic syndrome, particularly in subjects who are ineligible for anticoagulation therapy. PMID:25680183

  2. Complement factor 5 blockade reduces porcine myocardial infarction size and improves immediate cardiac function.

    PubMed

    Pischke, Soeren E; Gustavsen, A; Orrem, H L; Egge, K H; Courivaud, F; Fontenelle, H; Despont, A; Bongoni, A K; Rieben, R; Tønnessen, T I; Nunn, M A; Scott, H; Skulstad, H; Barratt-Due, A; Mollnes, T E

    2017-05-01

    Inhibition of complement factor 5 (C5) reduced myocardial infarction in animal studies, while no benefit was found in clinical studies. Due to lack of cross-reactivity of clinically used C5 antibodies, different inhibitors were used in animal and clinical studies. Coversin (Ornithodoros moubata complement inhibitor, OmCI) blocks C5 cleavage and binds leukotriene B4 in humans and pigs. We hypothesized that inhibition of C5 before reperfusion will decrease infarct size and improve ventricular function in a porcine model of myocardial infarction. In pigs (Sus scrofa), the left anterior descending coronary artery was occluded (40 min) and reperfused (240 min). Coversin or placebo was infused 20 min after occlusion and throughout reperfusion in 16 blindly randomized pigs. Coversin significantly reduced myocardial infarction in the area at risk by 39% (p = 0.03, triphenyl tetrazolium chloride staining) and by 19% (p = 0.02) using magnetic resonance imaging. The methods correlated significantly (R = 0.92, p < 0.01). Tissue Doppler echocardiography showed increased systolic displacement (31%, p < 0.01) and increased systolic velocity (29%, p = 0.01) in coversin treated pigs. Interleukin-1β in myocardial microdialysis fluid was significantly reduced (31%, p < 0.05) and tissue E-selectin expression was significantly reduced (p = 0.01) in the non-infarcted area at risk by coversin treatment. Coversin ablated plasma C5 activation throughout the reperfusion period and decreased myocardial C5b-9 deposition, while neither plasma nor myocardial LTB4 were significantly reduced. Coversin substantially reduced the size of infarction, improved ventricular function, and attenuated interleukin-1β and E-selectin in this porcine model by inhibiting C5. We conclude that inhibition of C5 in myocardial infarction should be reconsidered.

  3. Outcomes after thrombus aspiration for ST elevation myocardial infarction: 1-year follow-up of the prospective randomised TOTAL trial.

    PubMed

    Jolly, Sanjit S; Cairns, John A; Yusuf, Salim; Rokoss, Michael J; Gao, Peggy; Meeks, Brandi; Kedev, Sasko; Stankovic, Goran; Moreno, Raul; Gershlick, Anthony; Chowdhary, Saqib; Lavi, Shahar; Niemela, Kari; Bernat, Ivo; Cantor, Warren J; Cheema, Asim N; Steg, Philippe Gabriel; Welsh, Robert C; Sheth, Tej; Bertrand, Olivier F; Avezum, Alvaro; Bhindi, Ravinay; Natarajan, Madhu K; Horak, David; Leung, Raymond C M; Kassam, Saleem; Rao, Sunil V; El-Omar, Magdi; Mehta, Shamir R; Velianou, James L; Pancholy, Samir; Džavík, Vladimír

    2016-01-09

    Two large trials have reported contradictory results at 1 year after thrombus aspiration in ST elevation myocardial infarction (STEMI). In a 1-year follow-up of the largest randomised trial of thrombus aspiration, we aimed to clarify the longer-term benefits, to help guide clinical practice. The trial of routine aspiration ThrOmbecTomy with PCI versus PCI ALone in Patients with STEMI (TOTAL) was a prospective, randomised, investigator-initiated trial of routine manual thrombectomy versus percutaneous coronary intervention (PCI) alone in 10,732 patients with STEMI. Eligible adult patients (aged ≥18 years) from 87 hospitals in 20 countries were enrolled and randomly assigned (1:1) within 12 h of symptom onset to receive routine manual thrombectomy with PCI or PCI alone. Permuted block randomisation (with variable block size) was done by a 24 h computerised central system, and was stratified by centre. Participants and investigators were not masked to treatment assignment. The trial did not show a difference at 180 days in the primary outcome of cardiovascular death, myocardial infarction, cardiogenic shock, or heart failure. However, the results showed improvements in the surrogate outcomes of ST segment resolution and distal embolisation, but whether or not this finding would translate into a longer term benefit remained unclear. In this longer-term follow-up of the TOTAL study, we report the results on the primary outcome (cardiovascular death, myocardial infarction, cardiogenic shock, or heart failure) and secondary outcomes at 1 year. Analyses of the primary outcome were by modified intention to treat and only included patients who underwent index PCI. This trial is registered with ClinicalTrials.gov, number NCT01149044. Between Aug 5, 2010, and July 25, 2014, 10,732 eligible patients were enrolled and randomly assigned to thrombectomy followed by PCI (n=5372) or to PCI alone (n=5360). After exclusions of patients who did not undergo PCI in each group (337 in

  4. A case of liver hemangioma with markedly reduced tumor size after metformin treatment: a case report.

    PubMed

    Ono, Minoru; Sawada, Koji; Okumura, Toshikatsu

    2017-02-01

    A 52-year-old man with a 9-year history of hepatic hemangioma was treated with the anti-diabetic drug metformin, resulting in complete remission of the tumor. In 2006, a hemangioma with diameter of 20 × 25 mm was detected incidentally in the liver. The results of imaging studies including ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) were all compatible with that of hepatic hemangioma. The patient consequently underwent imaging annually from 2006 to 2015. The tumor size increased slightly, to 30 × 35 mm in 2012; however, the general tumor characteristics in imaging were not changed. Beginning May 2012, metformin (750 mg/day) was administered because of an increase in blood sugar and hemoglobin A1c levels. After the start of metformin treatment, the tumor size on US gradually decreased. Finally, in October 2015, the tumor was no longer detected. Dynamic CT study also demonstrated markedly reduced tumor size, with a decrease of 2-3 mm in diameter. These results indicate that metformin treatment strongly suppressed cell proliferation in liver hemangioma. The anti-angiogenic effect of metformin was indicated as a possible cause of the reduction in tumor size.

  5. Deconvolution algorithms for photoacoustic tomography to reduce blurring caused by finite sized detectors

    NASA Astrophysics Data System (ADS)

    Burgholzer, Peter; Roitner, Heinz; Berer, Thomas; Grün, Hubert; O'Leary, D. P.; Nuster, R.; Paltauf, G.; Haltmeier, M.

    2013-03-01

    Most reconstruction algorithms for photoacoustic tomography, like back-projection or time-reversal, work ideally for point-like detectors. For real detectors, which integrate the pressure over their finite size, it was shown that images reconstructed by back-projection or time-reversal show some blurring. Iterative reconstruction algorithms using an imaging matrix can take the finite size of real detectors directly into account, but the numerical effort is significantly higher compared to the use of direct algorithms. For spherical or cylindrical detection surfaces the blurring caused by a finite detector size is proportional to the distance from the rotation center ("spin blur") and is equal to the detector size at the detection surface. In this work we use deconvolution algorithms to reduce this type of blurring on simulated and on experimental data. Experimental data were obtained on a plastisol cylinder with 6 thin holes filled with an absorbing liquid (OrangeG). The holes were located on a spiral emanating from the center of the cylinder. Data acquisition was done by utilization of a piezoelectric detector which was rotated around the plastisol cylinder.

  6. Incidence and Outcomes of Inferior Vena Cava Filter Thrombus during Catheter-directed Thrombolysis for Proximal Deep Venous Thrombosis.

    PubMed

    Jiang, Jianguang; Tu, Jianfei; Jia, Zhongzhi; Chen, Jiezhong; Cao, Haitao; Meng, Qingli; Fuller, Tyler A; Tian, Feng

    2017-01-01

    The aim of the study was to retrospectively evaluate the incidence and outcomes of inferior vena cava (IVC) filter thrombus during catheter-directed thrombolysis (CDT) for acute proximal deep venous thrombosis (DVT). From October 2006 to June 2015, patients diagnosed with acute proximal DVT and received CDT after a retrievable IVC filter was placed were included. The incidence, treatment, and outcomes of IVC filter thrombus during CDT were recorded and analyzed. A total of 189 patients (91 women, 98 men; mean age, 57.6 ± 9.8 years; range, 24-85 years) were included in this study. Among the 189 cases, the DVTs involved popliteal iliofemoral veins in 54 patients, iliofemoral veins in 113 patients, and iliac veins in 22 patients, of which 18 patients had thrombus extended into the IVC. Of the 189 patients, a total of 8 (4.2%, 8 of 189) patients were identified with IVC filter thrombus during CDT. The IVC filter thrombus was detected on a median of 2 days (range, 2-4 days) of CDT therapy, including small-size (n = 6) and large-size (n = 2) filter thrombus. Of the 8 patients, CDTs were performed with a mean 7.6 ± 1.1 days (range, 6-11 days) after the presence of symptoms for the treatment of proximal DVT, and all the IVC filter thrombi were lysed during CDT for the proximal DVT. All the IVC filters were removed successfully with a mean of 12.8 ± 0.93 days from placement. There were no procedure- or thrombolysis-related major complications, and no symptomatic pulmonary embolism breakthrough was seen in any of the patients after the filter placement. IVC filter thrombus during CDT for the acute proximal DVT is uncommon, and all of them did not need any additional treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Cerebral complexity preceded enlarged brain size and reduced olfactory bulbs in Old World monkeys

    PubMed Central

    Gonzales, Lauren A.; Benefit, Brenda R.; McCrossin, Monte L.; Spoor, Fred

    2015-01-01

    Analysis of the only complete early cercopithecoid (Old World monkey) endocast currently known, that of 15-million-year (Myr)-old Victoriapithecus, reveals an unexpectedly small endocranial volume (ECV) relative to body size and a large olfactory bulb volume relative to ECV, similar to extant lemurs and Oligocene anthropoids. However, the Victoriapithecus brain has principal and arcuate sulci of the frontal lobe not seen in the stem catarrhine Aegyptopithecus, as well as a distinctive cercopithecoid pattern of gyrification, indicating that cerebral complexity preceded encephalization in cercopithecoids. Since larger ECVs, expanded frontal lobes, and reduced olfactory bulbs are already present in the 17- to 18-Myr-old ape Proconsul these features evolved independently in hominoids (apes) and cercopithecoids and much earlier in the former. Moreover, the order of encephalization and brain reorganization was apparently different in hominoids and cercopithecoids, showing that brain size and cerebral organization evolve independently. PMID:26138795

  8. Cerebral complexity preceded enlarged brain size and reduced olfactory bulbs in Old World monkeys.

    PubMed

    Gonzales, Lauren A; Benefit, Brenda R; McCrossin, Monte L; Spoor, Fred

    2015-07-03

    Analysis of the only complete early cercopithecoid (Old World monkey) endocast currently known, that of 15-million-year (Myr)-old Victoriapithecus, reveals an unexpectedly small endocranial volume (ECV) relative to body size and a large olfactory bulb volume relative to ECV, similar to extant lemurs and Oligocene anthropoids. However, the Victoriapithecus brain has principal and arcuate sulci of the frontal lobe not seen in the stem catarrhine Aegyptopithecus, as well as a distinctive cercopithecoid pattern of gyrification, indicating that cerebral complexity preceded encephalization in cercopithecoids. Since larger ECVs, expanded frontal lobes, and reduced olfactory bulbs are already present in the 17- to 18-Myr-old ape Proconsul these features evolved independently in hominoids (apes) and cercopithecoids and much earlier in the former. Moreover, the order of encephalization and brain reorganization was apparently different in hominoids and cercopithecoids, showing that brain size and cerebral organization evolve independently.

  9. The Role of Social Norms in the Portion Size Effect: Reducing Normative Relevance Reduces the Effect of Portion Size on Consumption Decisions

    PubMed Central

    Versluis, Iris; Papies, Esther K.

    2016-01-01

    People typically eat more from large portions of food than from small portions. An explanation that has often been given for this so-called portion size effect is that the portion size acts as a social norm and as such communicates how much is appropriate to eat. In this paper, we tested this explanation by examining whether manipulating the relevance of the portion size as a social norm changes the portion size effect, as assessed by prospective consumption decisions. We conducted one pilot experiment and one full experiment in which participants respectively indicated how much they would eat or serve themselves from a given amount of different foods. In the pilot (N = 63), we manipulated normative relevance by allegedly basing the portion size on the behavior of either students of the own university (in-group) or of another university (out-group). In the main experiment (N = 321), we told participants that either a minority or majority of people similar to them approved of the portion size. Results show that in both experiments, participants expected to serve themselves and to eat more from larger than from smaller portions. As expected, however, the portion size effect was less pronounced when the reference portions were allegedly based on the behavior of an out-group (pilot) or approved only by a minority (main experiment). These findings suggest that the portion size indeed provides normative information, because participants were less influenced by it if it communicated the behaviors or values of a less relevant social group. In addition, in the main experiment, the relation between portion size and the expected amount served was partially mediated by the amount that was considered appropriate, suggesting that concerns about eating an appropriate amount indeed play a role in the portion size effect. However, since the portion size effect was weakened but not eliminated by the normative relevance manipulations and since mediation was only partial, other

  10. The Role of Social Norms in the Portion Size Effect: Reducing Normative Relevance Reduces the Effect of Portion Size on Consumption Decisions.

    PubMed

    Versluis, Iris; Papies, Esther K

    2016-01-01

    People typically eat more from large portions of food than from small portions. An explanation that has often been given for this so-called portion size effect is that the portion size acts as a social norm and as such communicates how much is appropriate to eat. In this paper, we tested this explanation by examining whether manipulating the relevance of the portion size as a social norm changes the portion size effect, as assessed by prospective consumption decisions. We conducted one pilot experiment and one full experiment in which participants respectively indicated how much they would eat or serve themselves from a given amount of different foods. In the pilot (N = 63), we manipulated normative relevance by allegedly basing the portion size on the behavior of either students of the own university (in-group) or of another university (out-group). In the main experiment (N = 321), we told participants that either a minority or majority of people similar to them approved of the portion size. Results show that in both experiments, participants expected to serve themselves and to eat more from larger than from smaller portions. As expected, however, the portion size effect was less pronounced when the reference portions were allegedly based on the behavior of an out-group (pilot) or approved only by a minority (main experiment). These findings suggest that the portion size indeed provides normative information, because participants were less influenced by it if it communicated the behaviors or values of a less relevant social group. In addition, in the main experiment, the relation between portion size and the expected amount served was partially mediated by the amount that was considered appropriate, suggesting that concerns about eating an appropriate amount indeed play a role in the portion size effect. However, since the portion size effect was weakened but not eliminated by the normative relevance manipulations and since mediation was only partial, other

  11. Usefulness of contrast computed tomography to detect left ventricular apical thrombus associated with takotsubo cardiomyopathy.

    PubMed

    Ouchi, Kotaro; Nakamura, Fumitaka; Ikutomi, Masayasu; Oshima, Tsukasa; Ishiwata, Jumpei; Shinohara, Hiroki; Kouzaki, Tsunashi; Amaki, Toshihiro

    2016-05-01

    Left ventricular (LV) apical thrombus can rarely occur during the early phase of takotsubo cardiomyopathy. We report such a case that was depicted clearly in contrast computed tomography (CT) but not in initial echocardiography. Because LV thrombus may lead to thromboembolic events, we should evaluate all patients with takotsubo cardiomyopathy for the presence of a LV thrombus. LV thrombus is generally recognized with echocardiography in the course of follow-up, but limited depiction of the LV apex with echocardiography can make evaluation of LV thrombus difficult. Contrast CT is useful to detect LV apical thrombus associated with takotsubo cardiomyopathy.

  12. Radiation damage in protein crystals is reduced with a micron-sized X-ray beam.

    PubMed

    Sanishvili, Ruslan; Yoder, Derek W; Pothineni, Sudhir Babu; Rosenbaum, Gerd; Xu, Shenglan; Vogt, Stefan; Stepanov, Sergey; Makarov, Oleg A; Corcoran, Stephen; Benn, Richard; Nagarajan, Venugopalan; Smith, Janet L; Fischetti, Robert F

    2011-04-12

    Radiation damage is a major limitation in crystallography of biological macromolecules, even for cryocooled samples, and is particularly acute in microdiffraction. For the X-ray energies most commonly used for protein crystallography at synchrotron sources, photoelectrons are the predominant source of radiation damage. If the beam size is small relative to the photoelectron path length, then the photoelectron may escape the beam footprint, resulting in less damage in the illuminated volume. Thus, it may be possible to exploit this phenomenon to reduce radiation-induced damage during data measurement for techniques such as diffraction, spectroscopy, and imaging that use X-rays to probe both crystalline and noncrystalline biological samples. In a systematic and direct experimental demonstration of reduced radiation damage in protein crystals with small beams, damage was measured as a function of micron-sized X-ray beams of decreasing dimensions. The damage rate normalized for dose was reduced by a factor of three from the largest (15.6 μm) to the smallest (0.84 μm) X-ray beam used. Radiation-induced damage to protein crystals was also mapped parallel and perpendicular to the polarization direction of an incident 1-μm X-ray beam. Damage was greatest at the beam center and decreased monotonically to zero at a distance of about 4 μm, establishing the range of photoelectrons. The observed damage is less anisotropic than photoelectron emission probability, consistent with photoelectron trajectory simulations. These experimental results provide the basis for data collection protocols to mitigate with micron-sized X-ray beams the effects of radiation damage.

  13. Radiation damage in protein crystals is reduced with a micron-sized X-ray beam

    PubMed Central

    Sanishvili, Ruslan; Yoder, Derek W.; Pothineni, Sudhir Babu; Rosenbaum, Gerd; Xu, Shenglan; Vogt, Stefan; Stepanov, Sergey; Makarov, Oleg A.; Corcoran, Stephen; Benn, Richard; Nagarajan, Venugopalan; Smith, Janet L.; Fischetti, Robert F.

    2011-01-01

    Radiation damage is a major limitation in crystallography of biological macromolecules, even for cryocooled samples, and is particularly acute in microdiffraction. For the X-ray energies most commonly used for protein crystallography at synchrotron sources, photoelectrons are the predominant source of radiation damage. If the beam size is small relative to the photoelectron path length, then the photoelectron may escape the beam footprint, resulting in less damage in the illuminated volume. Thus, it may be possible to exploit this phenomenon to reduce radiation-induced damage during data measurement for techniques such as diffraction, spectroscopy, and imaging that use X-rays to probe both crystalline and noncrystalline biological samples. In a systematic and direct experimental demonstration of reduced radiation damage in protein crystals with small beams, damage was measured as a function of micron-sized X-ray beams of decreasing dimensions. The damage rate normalized for dose was reduced by a factor of three from the largest (15.6 μm) to the smallest (0.84 μm) X-ray beam used. Radiation-induced damage to protein crystals was also mapped parallel and perpendicular to the polarization direction of an incident 1-μm X-ray beam. Damage was greatest at the beam center and decreased monotonically to zero at a distance of about 4 μm, establishing the range of photoelectrons. The observed damage is less anisotropic than photoelectron emission probability, consistent with photoelectron trajectory simulations. These experimental results provide the basis for data collection protocols to mitigate with micron-sized X-ray beams the effects of radiation damage. PMID:21444772

  14. Grain dissection as a grain size reducing mechanism during ice microdynamics

    NASA Astrophysics Data System (ADS)

    Steinbach, Florian; Kuiper, Ernst N.; Eichler, Jan; Bons, Paul D.; Drury, Martin R.; Griera, Albert; Pennock, Gill M.; Weikusat, Ilka

    2017-04-01

    Ice sheets are valuable paleo-climate archives, but can lose their integrity by ice flow. An understanding of the microdynamic mechanisms controlling the flow of ice is essential when assessing climatic and environmental developments related to ice sheets and glaciers. For instance, the development of a consistent mechanistic grain size law would support larger scale ice flow models. Recent research made significant progress in numerically modelling deformation and recrystallisation mechanisms in the polycrystalline ice and ice-air aggregate (Llorens et al., 2016a,b; Steinbach et al., 2016). The numerical setup assumed grain size reduction is achieved by the progressive transformation of subgrain boundaries into new high angle grain boundaries splitting an existing grain. This mechanism is usually termed polygonisation. Analogue experiments suggested, that strain induced grain boundary migration can cause bulges to migrate through the whole of a grain separating one region of the grain from another (Jessell, 1986; Urai, 1987). This mechanism of grain dissection could provide an alternative grain size reducing mechanism, but has not yet been observed during ice microdynamics. In this contribution, we present results using an updated numerical approach allowing for grain dissection. The approach is based on coupling the full field theory crystal visco-plasticity code (VPFFT) of Lebensohn (2001) to the multi-process modelling platform Elle (Bons et al., 2008). VPFFT predicts the mechanical fields resulting from short strain increments, dynamic recrystallisation process are implemented in Elle. The novel approach includes improvements to allow for grain dissection, which was topologically impossible during earlier simulations. The simulations are supported by microstructural observations from NEEM (North Greenland Eemian Ice Drilling) ice core. Mappings of c-axis orientations using the automatic fabric analyser and full crystallographic orientations using electron

  15. Grape seed proanthocyanidin supplementation reduces adipocyte size and increases adipocyte number in obese rats.

    PubMed

    Pascual-Serrano, A; Arola-Arnal, A; Suárez-García, S; Bravo, F I; Suárez, M; Arola, L; Bladé, C

    2017-08-01

    White adipose tissue (WAT) expands through hypertrophy (increased adipocyte size) and/or hyperplasia (increased adipocyte number). Hypertrophy has been associated with insulin resistance and dyslipidemia independently of body composition and fat distribution. In contrast, hyperplasia protects against metabolic alterations. Proanthocyanidins, which are the most abundant flavonoids in the human diet, improve metabolic disturbances associated with diet-induced obesity without reducing body weight or adiposity. The aim of this study was to determine whether grape seed proanthocyanidin extract (GSPE) can modulate WAT expandability. Because GSPE also contains gallic acid, we also studied the capacity of gallic acid to remodel WAT. Male Wistar rats were fed a standard chow diet (n=6) or a cafeteria diet (CAF) for 11 weeks. After 8 weeks, the CAF-fed animals were supplemented with 25 mg GSPE/kg body weight (n=6), 7 mg gallic acid/kg body weight (n=6) or the vehicle (n=6) for 3 weeks. Histological analyses were performed in the retroperitoneal (rWAT) and inguinal (iWAT) WAT to determine adipocyte size and number. Specific markers for adipogenesis and WAT functionality were analysed in rWAT using quantitative RT-PCR. GSPE or gallic acid supplementation did not reduce weight gain or reverse and adiposity. However, GSPE reduced adipocyte size significantly in rWAT and moderately in iWAT and tripled the adipocyte number in rWAT. Gallic acid slightly reduced adipocyte size in rWAT and iWAT and doubled the adipocyte number in both WATs. In accordance with this adipogenic activity, Pref-1 and PPARγ tended to be overexpressed in rWAT of rats supplemented with GSPE. Moreover, GSPE supplementation increased Plin1 and Fabp4 expression and restored adiponectin expression completely, indicating a better functionality of visceral WAT. GSPE supplementation has anti-hypertrophic and hyperplasic activities in rats with established obesity, mainly in visceral WAT inducing a healthier

  16. Public School Education: The Case for Reduced Class Size. Why the Present Class Size is Not Working and What Can We Do about It?

    ERIC Educational Resources Information Center

    Graham, Evol

    2009-01-01

    By reducing class size we will close the achievement gap in public school education, caused by prior neglect especially since the civil rights era of the sixties. Additional, highly qualified and specialized teachers will more effectively manage a smaller class size and serve more individual student needs in the crucial early grades, where a solid…

  17. Irradiation testing of full-sized, reduced-enrichment fuel elements

    SciTech Connect

    Snelgrove, J.L.; Copeland, G.L.

    1983-01-01

    The current status of the irradiation testing of full-sized, reduced-enrichment fuel elements and fuel rods under the US Reduced Enrichment Research and Test Reactor Program is reported. Being tested are UAl/sub x/-Al, U/sub 3/O/sub 8/-Al, U/sub 3/Si/sub 2/-Al, and U/sub 3/Si-Al dispersion fuels and UZrH/sub x/ (TRIGA) fuel at uranium densities in the fuel meat ranging from 1.7 to 6.0 Mg/m/sup 3/. Generally good performance has been experienced to date. Some preliminary results of postirradiation examinations are also included. A whole-core demonstration in the Oak Ridge Research Reactor is planned. Some details of this demonstration are provided.

  18. A microstructurally inspired damage model for early venous thrombus.

    PubMed

    Rausch, Manuel K; Humphrey, Jay D

    2015-03-01

    Accumulative damage may be an important contributor to many cases of thrombotic disease progression. Thus, a complete understanding of the pathological role of thrombus requires an understanding of its mechanics and in particular mechanical consequences of damage. In the current study, we introduce a novel microstructurally inspired constitutive model for thrombus that considers a non-uniform distribution of microstructural fibers at various crimp levels and employs one of the distribution parameters to incorporate stretch-driven damage on the microscopic level. To demonstrate its ability to represent the mechanical behavior of thrombus, including a recently reported Mullins type damage phenomenon, we fit our model to uniaxial tensile test data of early venous thrombus. Our model shows an agreement with these data comparable to previous models for damage in elastomers with the added advantages of a microstructural basis and fewer model parameters. We submit that our novel approach marks another important step toward modeling the evolving mechanics of intraluminal thrombus, specifically its damage, and hope it will aid in the study of physiological and pathological thrombotic events. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. A Microstructurally Inspired Damage Model for Early Venous Thrombus

    PubMed Central

    Rausch, Manuel K.; Humphrey, Jay D.

    2015-01-01

    Accumulative damage may be an important contributor to many cases of thrombotic disease progression. Thus, a complete understanding of the pathological role of thrombus requires an understanding of its mechanics and in particular mechanical consequences of damage. In the current study, we introduce a novel microstructurally inspired constitutive model for thrombus that considers a non-uniform distribution of microstructural fibers at various crimp levels and employs one of the distribution parameters to incorporate stretch-driven damage on the microscopic level. To demonstrate its ability to represent the mechanical behavior of thrombus, including a recently reported Mullins type damage phenomenon, we fit our model to uniaxial tensile test data of early venous thrombus. Our model shows an agreement with these data comparable to previous models for damage in elastomers with the added advantages of a microstructural basis and fewer model parameters. We submit that our novel approach marks another important step toward modeling the evolving mechanics of intraluminal thrombus, specifically its damage, and hope it will aid in the study of physiological and pathological thrombotic events. PMID:26523784

  20. Left ventricular mass: A tumor or a thrombus diagnostic dilemma

    PubMed Central

    Dinesh Kumar, U. S.; Shetty, Shyam Prasad; Sujay, K. R.; Wali, Murugesh

    2016-01-01

    Left ventricular (LV) mass is a rare condition, of which the most common is thrombus. Echocardiography is a very useful modality of investigation to evaluate the LV mass. We are reporting a case of LV mass presenting with neurological symptom. The diagnosis of this mass was dilemma as the echocardiographic features were favoring tumor as well as thrombi. Mass (a) measuring 3.8 cm × 1.9 cm attached to the left ventricle apex appeared to be pedunculated tumor and mass (b) measuring 2.4 cm × 1.8 cm attached to the chordae of anterior mitral leaflet resembled a thrombus or an embolized tumor entangled in the chordae. A differential diagnosis for the LV mass is thrombus, tumors such as fibroma, and vegetation. Preoperative detection of a thrombus leads to an alteration in surgical steps. A large and mobile thrombus with or without a hemodynamic alteration is an indication for surgical removal to prevent stroke, myocardial infarction, mesenteric ischemia, renal infarction, gangrene of the limbs, and mortality. PMID:27716707

  1. A Novel Mechanical Thrombectomy Device for Retrieval of Intravascular Thrombus

    SciTech Connect

    Monsky, Wayne L.; Finitsis, Stephanos; Cicco, Dino De; Brock, John M.; Kucharczyk, John; Latchaw, Richard E.

    2011-04-15

    Purpose: Thrombotic and embolic vascular occlusion represents a leading cause of morbidity and mortality. Currently available thrombectomy devices have limitations, including difficulty removing organized thrombus and clot fragmentation with distal embolization. A novel mechanical thrombectomy device (MTD), designed to remove both hard and soft thrombus without trauma to the blood vessel, was tested in preclinical porcine models evaluating efficacy, safety, and ease of use. Materials and Methods: A total of 26 vessels in 14 pigs underwent mechanical thrombectomy with MTD. Thrombectomy was performed in nine superficial femoral arteries, eight subclavian arteries, five primary branches of the subclavian artery, lateral thoracic artery or the thyrocervical trunk, and four external carotids. Subacute organized fibrin-laden thrombus was injected into the arteries producing vascular occlusion. The MTD was then used for thrombectomy to restore patency and blood flow. Results: Intact thrombus was retrieved from 24 of 26 of the vessels with a single pass of the MTD, resulting in complete restoration of patency in 21 vessels and partial patency in 4 vessels. In 8 cases that used an early design, the embolic material fragmented during withdrawal from the access sheath. In 4 procedures that used an early design, the MTD failed to deploy fully and the embolus was not completely captured. No intraprocedural complications or vascular damage occurred. Conclusions: The present pilot studies demonstrate basic safety and efficacy of a novel MTD with design attributes suitable for retrieval of intact acute and organized chronic thrombus. The device has potential intracranial and peripheral utility.

  2. Thrombus aspiration as a bailout procedure during percutaneous renal angioplasty.

    PubMed

    Di Valentino, Marcello; Alerci, Mario; Tutta, Paolo; Sartori, Fabio; Marone, Claudio; Vandoni, Riccardo; Mahler, Felix; Gallino, Augusto

    2004-08-01

    To present a case in which thrombus aspiration, urokinase, and abciximab were used to recanalize a sudden acute thrombotic occlusion of the right renal artery during percutaneous renal angioplasty. A 72-year-old man with severe arterial hypertension, impaired renal function, and peripheral artery disease was referred for interventional renal revascularization of a proximal stenosis of the right renal artery. Predilation was unsuccessful, and stent placement was followed by immediate occlusion of the distal renal artery, probably due to dislocation of a mural thrombus. Since intra-arterial administration of urokinase (300,000 IU) was ineffective, thrombus aspiration was performed using the 7-F guiding catheter. After successful removal of the thrombus, abciximab was given intravenously. Control angiograms showed recanalization of the stented segment and patency of the distal renal arteries, an outcome confirmed 8 months later by duplex ultrasound. As demonstrated in our case, thromboembolic complications can be rapidly and successfully treated on the table by combined measures, such as catheter thrombus extraction and pharmacological strategies.

  3. Embolic attack in patients with atrial fibrillation and atrial thrombus depends on the character of the thrombus.

    PubMed

    Abe, Yukihiko; Asakura, Tukasa; Sakamoto, Nobuo; Ishikawa, Shunichi; Muroi, Syuichi; Saitoh, Fujiko; Satoh, Masahiko; Suzuki, Shigebumi; Ono, Masahiro; Sakabe, Atsushi; Iwai, Masumi; Sando, Masahito; Gotou, Jun; Watanabe, Yasuyuki; Nagata, Kenji; Maehara, Kazuhira; Maruyama, Yukio

    2003-03-01

    It is very important to prevent embolisms from left atrial thrombi (LAT). The present study was a trial for the management of patients with AT using 122 patients with atrial fibrillation and LAT who were followed for 1 year after transesophageal echocardiography. LAT were classified by their shape and mobility into the mobile ball type (MB, n=28), fixed ball type (FB, n=32) and mountain type (MO, n=42). The patients were given warfarin (INR: 1.5-2.0, n=43), aspirin 81 mg (n=74) and/or ticlopidine 200 mg/day (n=31). The embolic rate (ER) in the MB group was significantly higher than in the other groups [ie, MB 39.3% vs FB 15.6% (p<0.05), vs MO 2.4% (p<0.05)]. The ER in the FB group was significantly higher than in the MO group (p<0.05). Therapy with a combination of ticlopidine and aspirin reduced the ER in the patients with ball thrombi. The ER of the ball thrombus type group, especially the MB group, was very high in spite of therapy with anti-coagulants and/or anti-platelet agents, and such patients should be treated by early surgical intervention. However, the combination of ticlopidine and aspirin may be useful for preventing embolism.

  4. Thrombus Degradation by Fibrinolytic Enzyme of Stenotrophomonas sp. Originated from Indonesian Soybean-Based Fermented Food on Wistar Rats

    PubMed Central

    Tjandrawinata, Raymond R.

    2016-01-01

    Objective. To evaluate thrombus degrading effect of a fibrinolytic enzyme from food origin Stenotrophomonas sp. of Indonesia. Methods. Prior to animal study, the enzyme safety was tested using cell culture. The effect on expression of tissue plasminogen activator was also analysed in the cell culture. For in vivo studies, 25 Wistar rats were used: normal control, negative control, treatment groups with crude and semipurified enzyme given orally at 25 mg/kg, and positive control group which received Lumbrokinase at 25 mg/kg. Blood clot in the tail was induced by kappa carrageenan injection at 1 mg/kg BW. Results. Experiment with cell culture confirmed the enzyme safety at the concentration used and increased expression of tPA. Decreasing of thrombus was observed in the positive group down to 70.35 ± 23.11% of the negative control animals (100%). The thrombus observed in the crude enzyme treatment was down to 56.99 ± 15.95% and 71.5 ± 15.7% for semipurified enzyme. Scanning electron microscopy showed clearly that bood clots were found in the animals injected with kappa carrageenan; however, in the treatment and positive groups, the clot was much reduced. Conclusions. Oral treatment of enzyme from Stenotrophomonas sp. of Indonesian fermented food was capable of degrading thrombus induced in Wistar rats. PMID:27635131

  5. Is there a critical endometrioma size associated with reduced ovarian responsiveness in assisted reproduction techniques?

    PubMed

    Coccia, Maria Elisabetta; Rizzello, Francesca; Barone, Stefano; Pinelli, Sara; Rapalini, Erika; Parri, Cristiana; Caracciolo, Domenico; Papageorgiou, Savvas; Cima, Gianpaolo; Gandini, Loredana

    2014-08-01

    This study investigated the relationships between ovarian endometrioma size, ovarian responsiveness and the number of retrieved oocytes following ovarian stimulation. A prospective study was conducted in a public clinical assisted reproduction centre. A total of 64 infertile women with monolateral endometriomas undergoing IVF or intracytoplasmic sperm injection were included in the study. The total number of follicles, number of follicles ≥ 16 mm and number of oocytes retrieved of ovaries containing endometrioma and normal ovaries were compared. Multivariate linear regression was used to assess whether number of follicles and collected oocytes varied by endometrioma size, age, basal FSH concentration. Significantly lower numbers of follicles ≥ 16 mm (P = 0.024) and oocytes retrieved (P = 0.001) in the ovaries containing endometrioma were observed. In patients with endometriomas ≥ 30 mm, endometrioma size was the most influential contributor to the total number of follicles and oocytes retrieved. Ovarian endometriomas result in reduced response to ovarian stimulation, compared with the response of the contralateral normal ovary in the same individual. In case of endometriomas <30 mm, basal FSH concentration remains the most important prognostic factor for oocyte retrieval. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  6. A brief mindfulness intervention reduces unhealthy eating when hungry, but not the portion size effect.

    PubMed

    Marchiori, David; Papies, Esther K

    2014-04-01

    The present research examined the effects of a mindfulness-based intervention to foster healthy eating. Specifically, we tested whether a brief mindfulness manipulation can prevent the portion size effect, and reduce overeating on unhealthy snacks when hungry. 110 undergraduate participants (MAge=20.9±2.3; MBMI=22.3±2.5) were served a small or a large portion of chocolate chip cookies after listening to an audio book or performing a mindfulness exercise (i.e., body scan). Current level of hunger was assessed unobtrusively on a visual analog scale before the eating situation. Calorie intake from chocolate chip cookies. When presented with a large compared to a small portion, participants consumed more cookies (+83kcal). This was not affected by the mindfulness intervention or by hunger. However, while control participants ate more unhealthy food when hungry than when not hungry (+67kcal), participants in the mindfulness condition did not (+1kcal). Findings confirm the prevalence and robustness of the portion size effect and suggest that it may be independent from awareness of internal cues. Prevention strategies may benefit more from targeting awareness of the external environment. However, mindfulness-based interventions may be effective to reduce effects of hunger on unhealthy food consumption. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. REDUCED CHLOROPLAST COVERAGE genes from Arabidopsis thaliana help to establish the size of the chloroplast compartment

    DOE PAGES

    Larkin, Robert M.; Stefano, Giovanni; Ruckle, Michael E.; ...

    2016-02-09

    Eukaryotic cells require mechanisms to establish the proportion of cellular volume devoted to particular organelles. These mechanisms are poorly understood. From a screen for plastid-to-nucleus signaling mutants in Arabidopsis thaliana, we cloned a mutant allele of a gene that encodes a protein of unknown function that is homologous to two other Arabidopsis genes of unknown function and Arabidopsis. In contrast to FRIENDLY, these three homologs of FRIENDLY are found only in photosynthetic organisms. Based on these data, we proposed that FRIENDLY expanded into a small gene family to help regulate the energy metabolism of cells that contain both mitochondria andmore » chloroplasts. Indeed, we found that knocking out these genes caused a number of chloroplast phenotypes, including a reduction in the proportion of cellular volume devoted to chloroplasts to 50% of wild type. Thus, we refer to these genes as REDUCED CHLOROPLAST COVERAGE (REC). The size of the chloroplast compartment was reduced most in rec1 mutants. The REC1 protein accumulated in the cytosol and the nucleus. REC1 was excluded from the nucleus when plants were treated with amitrole, which inhibits cell expansion and chloroplast function. Finally, we conclude that REC1 is an extraplastidic protein that helps to establish the size of the chloroplast compartment, and that signals derived from cell expansion or chloroplasts may regulate REC1.« less

  8. REDUCED CHLOROPLAST COVERAGE genes from Arabidopsis thaliana help to establish the size of the chloroplast compartment

    PubMed Central

    Larkin, Robert M.; Stefano, Giovanni; Ruckle, Michael E.; Stavoe, Andrea K.; Sinkler, Christopher A.; Brandizzi, Federica; Malmstrom, Carolyn M.; Osteryoung, Katherine W.

    2016-01-01

    Eukaryotic cells require mechanisms to establish the proportion of cellular volume devoted to particular organelles. These mechanisms are poorly understood. From a screen for plastid-to-nucleus signaling mutants in Arabidopsis thaliana, we cloned a mutant allele of a gene that encodes a protein of unknown function that is homologous to two other Arabidopsis genes of unknown function and to FRIENDLY, which was previously shown to promote the normal distribution of mitochondria in Arabidopsis. In contrast to FRIENDLY, these three homologs of FRIENDLY are found only in photosynthetic organisms. Based on these data, we proposed that FRIENDLY expanded into a small gene family to help regulate the energy metabolism of cells that contain both mitochondria and chloroplasts. Indeed, we found that knocking out these genes caused a number of chloroplast phenotypes, including a reduction in the proportion of cellular volume devoted to chloroplasts to 50% of wild type. Thus, we refer to these genes as REDUCED CHLOROPLAST COVERAGE (REC). The size of the chloroplast compartment was reduced most in rec1 mutants. The REC1 protein accumulated in the cytosol and the nucleus. REC1 was excluded from the nucleus when plants were treated with amitrole, which inhibits cell expansion and chloroplast function. We conclude that REC1 is an extraplastidic protein that helps to establish the size of the chloroplast compartment, and that signals derived from cell expansion or chloroplasts may regulate REC1. PMID:26862170

  9. REDUCED CHLOROPLAST COVERAGE genes from Arabidopsis thaliana help to establish the size of the chloroplast compartment.

    PubMed

    Larkin, Robert M; Stefano, Giovanni; Ruckle, Michael E; Stavoe, Andrea K; Sinkler, Christopher A; Brandizzi, Federica; Malmstrom, Carolyn M; Osteryoung, Katherine W

    2016-02-23

    Eukaryotic cells require mechanisms to establish the proportion of cellular volume devoted to particular organelles. These mechanisms are poorly understood. From a screen for plastid-to-nucleus signaling mutants in Arabidopsis thaliana, we cloned a mutant allele of a gene that encodes a protein of unknown function that is homologous to two other Arabidopsis genes of unknown function and to FRIENDLY, which was previously shown to promote the normal distribution of mitochondria in Arabidopsis. In contrast to FRIENDLY, these three homologs of FRIENDLY are found only in photosynthetic organisms. Based on these data, we proposed that FRIENDLY expanded into a small gene family to help regulate the energy metabolism of cells that contain both mitochondria and chloroplasts. Indeed, we found that knocking out these genes caused a number of chloroplast phenotypes, including a reduction in the proportion of cellular volume devoted to chloroplasts to 50% of wild type. Thus, we refer to these genes as REDUCED CHLOROPLAST COVERAGE (REC). The size of the chloroplast compartment was reduced most in rec1 mutants. The REC1 protein accumulated in the cytosol and the nucleus. REC1 was excluded from the nucleus when plants were treated with amitrole, which inhibits cell expansion and chloroplast function. We conclude that REC1 is an extraplastidic protein that helps to establish the size of the chloroplast compartment, and that signals derived from cell expansion or chloroplasts may regulate REC1.

  10. Adipocyte mitochondrial function is reduced in human obesity independent of fat cell size.

    PubMed

    Yin, Xiao; Lanza, Ian R; Swain, James M; Sarr, Michael G; Nair, K Sreekumaran; Jensen, Michael D

    2014-02-01

    It has been suggested that mitochondrial dysfunction in adipocytes contributes to obesity-related metabolic complications. However, obesity results in adipocyte hypertrophy, and large and small adipocytes from the same depot have different characteristics, raising the possibility that obesity-related mitochondrial defects are an inherent function of large adipocytes. Our goal was to examine whether obesity, independent of fat cell size and fat depot, is associated with mitochondria dysfunction. We compared adipocyte mitochondrial function using a cross-sectional comparison study design. The studies were performed at Mayo Clinic, an academic medical center. Omental and/or abdominal subcutaneous adipose samples were collected from 20 age-matched obese and nonobese nondiabetic men and women undergoing either elective abdominal surgery or research needle biopsy. Interventions were not conducted as part of these studies. We measured mitochondrial DNA abundance, oxygen consumption rates, and citrate synthase activity from populations of large and small adipocytes (separated with differential floatation). For both omental and subcutaneous adipocytes, at the cell and organelle level, oxygen consumption rates and citrate synthase activity were significantly reduced in cells from obese compared with nonobese volunteers, even when matched for cell size by comparing large adipocytes from nonobese and small adipocytes from obese. Adipocyte mitochondrial content was not significantly different between obese and nonobese volunteers. Mitochondrial function and content parameters were not different between small and large cells, omental, and subcutaneous adipocytes from the same person. Adipocyte mitochondrial oxidative capacity is reduced in obese compared with nonobese adults and this difference is not due to cell size differences. Adipocyte mitochondrial dysfunction in obesity is therefore related to overall adiposity rather than adipocyte hypertrophy.

  11. Fitness reduction for uncooperative fig wasps through reduced offspring size: a third component of host sanctions.

    PubMed

    Jandér, K C; Dafoe, A; Herre, E A

    2016-09-01

    Mutually beneficial interactions between two species-mutualisms-are ancient, diverse, and of fundamental ecological importance. Nonetheless, factors that prevent one partner from reaping the benefits of the interaction without paying the cost are still poorly understood. Fig trees and their unique pollinators, fig wasps, present a powerful model system for studying mutualism stability. Both partners depend completely on each other for reproduction, cooperation levels can be manipulated, and the resulting field-based fitness quantified. Previous work has shown that fig trees can impose two types of host sanctions that reduce the fitness of wasps that do not pollinate: (1) fig abortion, which kills all developing larvae, and (2) reduced number of wasp offspring in figs that are not aborted. Here we demonstrate a third component of host sanctions. Through manipulative field experiments, we show that for four of five studied species, offspring of pollen-free foundresses are only 50-90% the size of offspring of pollinating foundresses. We further show that in all four studied species, smaller wasps are less likely to reach and enter a flowering fig to become foundresses themselves. Therefore, the experimentally determined size reduction of offspring is estimated to cause an additional reduction of up to 80% in fitness for a pollen-free foundress. We determine that the size reduction of pollen-free offspring acts on the level of the entire fig fruit rather than on individual flowers. These results show that estimates of the fitness effect of host sanctions on uncooperative symbionts should consider not only offspring quantity but also offspring quality. We discuss implications beyond the fig tree-fig wasp mutualism.

  12. High Structural Stress and Presence of Intraluminal Thrombus Predict Abdominal Aortic Aneurysm 18F-FDG Uptake

    PubMed Central

    Huang, Yuan; Elkhawad, Maysoon; Tarkin, Jason M.; Joshi, Nikhil; Boyle, Jonathan R.; Buscombe, John R.; Fryer, Timothy D.; Zhang, Yongxue; Park, Ah Yeon; Wilkinson, Ian B.; Newby, David E.; Gillard, Jonathan H.

    2016-01-01

    Background— Abdominal aortic aneurysm (AAA) wall inflammation and mechanical structural stress may influence AAA expansion and lead to rupture. We hypothesized a positive correlation between structural stress and fluorine-18-labeled 2-deoxy-2-fluoro-d-glucose (18F-FDG) positron emission tomography–defined inflammation. We also explored the influence of computed tomography–derived aneurysm morphology and composition, including intraluminal thrombus, on both variables. Methods and Results— Twenty-one patients (19 males) with AAAs below surgical threshold (AAA size was 4.10±0.54 cm) underwent 18F-FDG positron emission tomography and contrast-enhanced computed tomography imaging. Structural stresses were calculated using finite element analysis. The relationship between maximum aneurysm 18F-FDG standardized uptake value within aortic wall and wall structural stress, patient clinical characteristics, aneurysm morphology, and compositions was explored using a hierarchical linear mixed-effects model. On univariate analysis, local aneurysm diameter, thrombus burden, extent of calcification, and structural stress were all associated with 18F-FDG uptake (P<0.05). AAA structural stress correlated with 18F-FDG maximum standardized uptake value (slope estimate, 0.552; P<0.0001). Multivariate linear mixed-effects analysis revealed an important interaction between structural stress and intraluminal thrombus in relation to maximum standardized uptake value (fixed effect coefficient, 1.68 [SE, 0.10]; P<0.0001). Compared with other factors, structural stress was the best predictor of inflammation (receiver-operating characteristic curve area under the curve =0.59), with higher accuracy seen in regions with high thrombus burden (area under the curve =0.80). Regions with both high thrombus burden and high structural stress had higher 18F-FDG maximum standardized uptake value compared with regions with high thrombus burdens but low stress (median [interquartile range], 1.93 [1

  13. Fibrin-targeted magnetic resonance imaging allows in vivo quantification of thrombus fibrin content and identifies thrombi amenable for thrombolysis.

    PubMed

    Andia, Marcelo E; Saha, Prakash; Jenkins, Julia; Modarai, Bijan; Wiethoff, Andrea J; Phinikaridou, Alkystis; Grover, Steven P; Patel, Ashish S; Schaeffter, Tobias; Smith, Alberto; Botnar, Rene M

    2014-06-01

    Deep venous thrombosis is a major health problem. Thrombolytic therapies are effective in recanalizing the veins and preventing post-thrombotic complications, but there is no consensus on selection criteria. The aim of this study was to investigate a fibrin-specific MRI contrast agent (EP-2104R) for the accurate quantification of thrombus' fibrin content in vivo and for the identification of thrombus suitable for thrombolysis. Venous thrombosis was induced in the inferior vena cava of 8- to 10-week-old male BALB/C mice and MRI performed 2, 4, 7, 10, 14, and 21 days later. Eighteen mice were scanned at each time point pre and 2 hours post injection of EP-2104R (8.0 μmol/kg) with 12 mice at each time point used to correlate fibrin contrast uptake with thrombus' histological stage and fibrin content. Six mice at each time point were immediately subjected to intravascular thrombolytic therapy (10 mg/kg of tissue-type plasminogen activator). Mice were imaged to assess response to lytic therapy 24 hours after thrombolytic treatment. Two mice at each time point were scanned post injection of 0.2 mmol/kg of Gd-DTPA (gadolinium with diethylenetriaminepentacetate, Magnevist, Schering AG, Berlin, Germany) for control purpose. Contrast uptake was correlated positively with the fibrin content of the thrombus measured by Western blotting (R(2)=0.889; P<0.001). Thrombus relaxation rate (R1) post contrast and the change in visualized thrombus size on late gadolinium enhancement inversion recovery MRI pre-EP-2104R and post-EP-2104R injection were the best predictors for successful thrombolysis (area under the curve, 0.989 [95% confidence interval, 0.97-1.00] and 0.994 [95% confidence interval, 0.98-1.00] respectively). MRI with a fibrin-specific contrast agent accurately estimates thrombus fibrin content in vivo and identifies thrombi that are amenable for thrombolysis. © 2014 American Heart Association, Inc.

  14. High Structural Stress and Presence of Intraluminal Thrombus Predict Abdominal Aortic Aneurysm 18F-FDG Uptake: Insights From Biomechanics.

    PubMed

    Huang, Yuan; Teng, Zhongzhao; Elkhawad, Maysoon; Tarkin, Jason M; Joshi, Nikhil; Boyle, Jonathan R; Buscombe, John R; Fryer, Timothy D; Zhang, Yongxue; Park, Ah Yeon; Wilkinson, Ian B; Newby, David E; Gillard, Jonathan H; Rudd, James H F

    2016-11-01

    Abdominal aortic aneurysm (AAA) wall inflammation and mechanical structural stress may influence AAA expansion and lead to rupture. We hypothesized a positive correlation between structural stress and fluorine-18-labeled 2-deoxy-2-fluoro-d-glucose ((18)F-FDG) positron emission tomography-defined inflammation. We also explored the influence of computed tomography-derived aneurysm morphology and composition, including intraluminal thrombus, on both variables. Twenty-one patients (19 males) with AAAs below surgical threshold (AAA size was 4.10±0.54 cm) underwent (18)F-FDG positron emission tomography and contrast-enhanced computed tomography imaging. Structural stresses were calculated using finite element analysis. The relationship between maximum aneurysm (18)F-FDG standardized uptake value within aortic wall and wall structural stress, patient clinical characteristics, aneurysm morphology, and compositions was explored using a hierarchical linear mixed-effects model. On univariate analysis, local aneurysm diameter, thrombus burden, extent of calcification, and structural stress were all associated with (18)F-FDG uptake (P<0.05). AAA structural stress correlated with (18)F-FDG maximum standardized uptake value (slope estimate, 0.552; P<0.0001). Multivariate linear mixed-effects analysis revealed an important interaction between structural stress and intraluminal thrombus in relation to maximum standardized uptake value (fixed effect coefficient, 1.68 [SE, 0.10]; P<0.0001). Compared with other factors, structural stress was the best predictor of inflammation (receiver-operating characteristic curve area under the curve =0.59), with higher accuracy seen in regions with high thrombus burden (area under the curve =0.80). Regions with both high thrombus burden and high structural stress had higher (18)F-FDG maximum standardized uptake value compared with regions with high thrombus burdens but low stress (median [interquartile range], 1.93 [1.60-2.14] versus 1.14 [0

  15. Ischemic Postconditioning After Routine Thrombus Aspiration During Primary Percutaneous Coronary Intervention: Rationale and Design of the POstconditioning Rotterdam Trial.

    PubMed

    Yetgin, Tuncay; van Kranenburg, Matthijs; Ten Cate, Tim; Duncker, Dirk J; de Boer, Menko-Jan; Diletti, Roberto; van Geuns, Robert-Jan M; Zijlstra, Felix; Manintveld, Olivier C

    2016-10-01

    Whether ischemic postconditioning (IPOC) immediately after routine thrombus aspiration (TA) reduces infarct size (IS) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) has not been established. The POstconditioning Rotterdam Trial (PORT) is a dual-center, prospective, open-label, randomized trial with blinded endpoint evaluation enrolling 72 subjects with first-time STEMI, and an occluded infarct-related artery (IRA) without collaterals undergoing PPCI. Subjects are randomized 1:1 to a strategy of IPOC immediately after TA followed by stenting of the IRA or to conventional percutaneous coronary intervention (PCI), including TA followed by stenting of the IRA (controls). Cardiac magnetic resonance imaging (MRI) is performed at 3-5 days after STEMI and at 3 months. The primary endpoint is IS at 3 months measured by delayed enhancement MRI. Other secondary endpoints include MRI-derived microvascular obstruction (MVO), left ventricular ejection fraction, myocardial salvage index, enzymatic IS, ST-segment resolution, myocardial blush grade, microcirculatory resistance, inflammation markers, and clinical events through 3-month follow-up. PORT is testing the hypothesis that adding IPOC (against lethal reperfusion injury) to TA (against distal embolization and MVO) is cardioprotective and reduces ultimate IS in STEMI patients undergoing PPCI (Dutch Trial Register identifier: NTR4040). © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  16. Traversing boundaries: thrombus in transit with paradoxical embolism

    PubMed Central

    Miriyala, Varun; Faraj, Kirmanj; Nagra, Bipinpreet

    2016-01-01

    A 72-year-old male is diagnosed with paradoxical embolus after he presented with concurrent deep vein thrombosis, stroke, and multiple arterial emboli in the presence of a patent foramen ovale (PFO). Paradoxical embolus requires the passage of a thrombus from the venous into the arterial circulation through a right-to-left shunt leading to systemic embolism. But, despite the high incidence of PFO (27.3% across all age groups by autopsy), paradoxical embolism (PDE) is uncommon, representing <2% of all arterial emboli. We present a case report where a thrombus has been directly observed passing through the PFO during an echocardiogram study; thus, clearly delineating the true cause of multiple thromboemboli and stoke in our patient. Subsequent Transesophageal Echocardiography (TEE) also interestingly showed the thrombus in transit in the aorta and pulmonary artery. PMID:27609716

  17. Successful Thrombectomy for an Idiopathic Floating Ascending Aortic Thrombus.

    PubMed

    Pang, Philip Y K; Nathan, Viswa B

    2016-09-01

    A mobile thrombus in an otherwise normal ascending aorta is rare, but it should be thoroughly searched for in patients with unexplained cerebral or peripheral embolism. We report the case of a 49-year-old man admitted for right lower quadrant abdominal pain secondary to embolic renal infarction. Echocardiography and computed tomography of the chest revealed a 2.5 cm × 1.5 cm hypermobile mass at the distal ascending aorta, which was otherwise normal. No hypercoagulable condition could be identified. The mass was successfully removed with the patient under deep hypothermic circulatory arrest and was confirmed to be a thrombus. The cause of this thrombus remains unknown.

  18. Synthetic thrombus model for in vitro studies of laser thrombolysis

    SciTech Connect

    Hermes, R.E.; Trajkovska, K.

    1998-07-01

    Laser thrombolysis is the controlled ablation of a thrombus (blood clot) blockage in a living arterial system. Theoretical modeling of the interaction of laser light with thrombi relies on the ability to perform in vitro experiments with well characterized surrogate materials. A synthetic thrombus formulation may offer more accurate results when compared to in vivo clinical experiments. The authors describe the development of new surrogate materials based on formulations incorporating chick egg, guar gum, modified food starch, and a laser light absorbing dye. The sound speed and physical consistency of the materials were very close to porcine (arterial) and human (venous) thrombi. Photographic and videotape recordings of pulsed dye laser ablation experiments under various experimental conditions were used to evaluate the new material as compared to in vitro tests with human (venous) thrombus. The characteristics of ablation and mass removal were similar to that of real thrombi, and therefore provide a more realistic model for in vitro laser thrombolysis when compared to gelatin.

  19. Descending thoracic aortic mural thrombus presentation and treatment strategies.

    PubMed

    Meyermann, Karol; Trani, Jose; Caputo, Francis J; Lombardi, Joseph V

    2017-09-01

    Thoracic aortic mural thrombus (TAMT) of the descending aorta is rare but can result in dramatic embolic events. Early treatment is therefore crucial; however, there is not a consensus on ideal initial treatment. A review of the literature using PubMed was conducted, and all relevant publications describing descending TAMT of the past 15 years were reviewed. Variables included for this analysis were presentation, initial treatment strategy employed, outcome measures of thrombus resolution or regression, recurrence of symptomatic emboli, and mortality. Seventy-four patients were included in this analysis. Women were significantly more likely to be described with descending TAMT. The majority (82.4%) of cases reported were diagnosed after an embolic event. Patients were equally likely to receive medical, open surgical, or endovascular therapy as the initial treatment modality. However, there is a trend within the past 5 years to report cases describing successful thoracic endovascular aortic repair for initial management. Of patients who initially underwent medical management, nine patients (34.6%) had persistent thrombus. Of the patients who initially underwent open surgical repair, six patients (31.6%) had persistent thrombus; of these patients, four underwent endovascular repair. Twenty-nine patients (39.2%) with descending TAMT initially underwent thoracic endovascular aortic repair. Twenty-seven (93.1%) had fully excluded thrombus at the time of the procedure, with no recurrence or evidence of repeated embolic phenomena at follow-up. Whereas mural thrombus of the thoracic aorta is uncommon, it must be considered in the differential diagnosis of embolic events. Although endovascular therapy may be a useful first-line option for TAMT with reports of positive outcomes in select literature, further study of this treatment option is required. Copyright © 2017. Published by Elsevier Inc.

  20. Floating arterial thrombus related stroke treated by intravenous thrombolysis.

    PubMed

    Vanacker, P; Cordier, M; Janbieh, J; Federau, C; Michel, P

    2014-01-01

    The effects of intravenous thrombolysis on floating thrombi in cervical and intracranial arteries of acute ischemic stroke patients are unknown. Similarly, the best prevention methods of early recurrences remain controversial. This study aimed to describe the clinical and radiological outcome of thrombolyzed strokes with floating thrombi. We retrospectively analyzed all thrombolyzed stroke patients in our institution between 2003 and 2010 with floating thrombi on acute CT-angiography before the intravenous thrombolysis. The floating thrombus was diagnosed if an elongated thrombus of at least 5 mm length, completely surrounded by contrast on supra-aortic neck or intracerebral arteries, was present on CT-angiography. Demographics, vascular risk factors, and comorbidities were recorded and stroke etiology was determined after a standardized workup. Repeat arterial imaging was performed by CTA at 24 h or before if clinical worsening was noted and then by Doppler and MRA during the first week and at four months. Of 409 thrombolyzed stroke patients undergoing acute CT Angiography, seven (1.7%) had a floating thrombus; of these seven, six had it in the anterior circulation. Demographics, risk factors and stroke severity of these patients were comparable to the other thrombolyzed patients. After intravenous thrombolysis, the floating thrombi resolved completely at 24 h in four of the patients, whereas one had an early recurrent stroke and one developed progressive worsening. One patient developed early occlusion of the carotid artery with floating thrombus and subsequently a TIA. The two patients with a stable floating thrombus had no clinical recurrences. In the literature, only one of four reported cases were found to have a thrombolysis-related early recurrence. Long-term outcome seemed similar in thrombolyzed patients with floating thrombus, despite a possible increase of very early recurrence. It remains to be established whether acute mechanical thrombectomy could be

  1. Thrombus segmentation by texture dynamics from microscopic image sequences

    NASA Astrophysics Data System (ADS)

    Brieu, Nicolas; Serbanovic-Canic, Jovana; Cvejic, Ana; Stemple, Derek; Ouwehand, Willem; Navab, Nassir; Groher, Martin

    2010-03-01

    The genetic factors of thrombosis are commonly explored by microscopically imaging the coagulation of blood cells induced by injuring a vessel of mice or of zebrafish mutants. The latter species is particularly interesting since skin transparency permits to non-invasively acquire microscopic images of the scene with a CCD camera and to estimate the parameters characterizing the thrombus development. These parameters are currently determined by manual outlining, which is both error prone and extremely time consuming. Even though a technique for automatic thrombus extraction would be highly valuable for gene analysts, little work can be found, which is mainly due to very low image contrast and spurious structures. In this work, we propose to semi-automatically segment the thrombus over time from microscopic image sequences of wild-type zebrafish larvae. To compensate the lack of valuable spatial information, our main idea consists of exploiting the temporal information by modeling the variations of the pixel intensities over successive temporal windows with a linear Markov-based dynamic texture formalization. We then derive an image from the estimated model parameters, which represents the probability of a pixel to belong to the thrombus. We employ this probability image to accurately estimate the thrombus position via an active contour segmentation incorporating also prior and spatial information of the underlying intensity images. The performance of our approach is tested on three microscopic image sequences. We show that the thrombus is accurately tracked over time in each sequence if the respective parameters controlling prior influence and contour stiffness are correctly chosen.

  2. Methotrexate carried in lipid core nanoparticles reduces myocardial infarction size and improves cardiac function in rats.

    PubMed

    Maranhão, Raul C; Guido, Maria C; de Lima, Aline D; Tavares, Elaine R; Marques, Alyne F; Tavares de Melo, Marcelo D; Nicolau, Jose C; Salemi, Vera Mc; Kalil-Filho, Roberto

    2017-01-01

    Acute myocardial infarction (MI) is accompanied by myocardial inflammation, fibrosis, and ventricular remodeling that, when excessive or not properly regulated, may lead to heart failure. Previously, lipid core nanoparticles (LDE) used as carriers of the anti-inflammatory drug methotrexate (MTX) produced an 80-fold increase in the cell uptake of MTX. LDE-MTX treatment reduced vessel inflammation and atheromatous lesions induced in rabbits by cholesterol feeding. The aim of the study was to investigate the effects of LDE-MTX on rats with MI, compared with commercial MTX treatment. Thirty-eight Wistar rats underwent left coronary artery ligation and were treated with LDE-MTX, or with MTX (1 mg/kg intraperitoneally, once/week, starting 24 hours after surgery) or with LDE without drug (MI-controls). A sham-surgery group (n=12) was also included. Echocardiography was performed 24 hours and 6 weeks after surgery. The animals were euthanized and their hearts were analyzed for morphometry, protein expression, and confocal microscopy. LDE-MTX treatment achieved a 40% improvement in left ventricular (LV) systolic function and reduced cardiac dilation and LV mass, as shown by echocardiography. LDE-MTX reduced the infarction size, myocyte hypertrophy and necrosis, number of inflammatory cells, and myocardial fibrosis, as shown by morphometric analysis. LDE-MTX increased antioxidant enzymes; decreased apoptosis, macrophages, reactive oxygen species production; and tissue hypoxia in non-infarcted myocardium. LDE-MTX increased adenosine bioavailability in the LV by increasing adenosine receptors and modulating adenosine catabolic enzymes. LDE-MTX increased the expression of myocardial vascular endothelium growth factor (VEGF) associated with adenosine release; this correlated not only with an increase in angiogenesis, but also with other parameters improved by LDE-MTX, suggesting that VEGF increase played an important role in the beneficial effects of LDE-MTX. Overall effects of

  3. Septic shock secondary to infection of a left ventricular thrombus.

    PubMed

    Ruiz-Bailén, Manuel; Ramos-Cuadra, Jose Angel; Aragón-Extremera, Victor Manuel; Rucabado-Aguilar, Luis

    2009-10-01

    We report the case of a 45-year-old woman who developed severe shock with multiorgan failure requiring admission to intensive care. Endomyocardial biopsy was performed and she was diagnosed with sepsis secondary to left ventricular thrombus abscess. Surgery was contraindicated and the patient received exclusively medical treatment; the clinical course was satisfactory and the patient is alive one year later. An apical thrombus may rarely be complicated by infection. Although management normally requires surgical excision, medical management may be effective in situations in which surgery is contraindicated.

  4. Gestational and lactational exposure of rats to xenoestrogens results in reduced testicular size and sperm production.

    PubMed Central

    Sharpe, R M; Fisher, J S; Millar, M M; Jobling, S; Sumpter, J P

    1995-01-01

    This study assessed whether exposure of male rats to two estrogenic, environmental chemicals, 4-octylphenol (OP) and butyl benzyl phthalate (BBP) during gestation or during the first 21 days of postnatal life, affected testicular size or spermatogenesis in adulthood (90-95 days of age). Chemicals were administered via the drinking water or concentrations of 10-1000 micrograms/l (OP) or 1000 micrograms/l (BBP), diethylstilbestrol (DES; 100 micrograms/l) and an octylphenol polyethoxylate (OPP; 1000 micrograms/l), which is a weak estrogen or nonestrogenic in vitro, were administered as presumptive positive and negative controls, respectively. Controls received the vehicle (ethanol) in tap water. In study 1, rats were treated from days 1-22 after births in studies 2 and 3, the mothers were treated for approximately 8-9 weeks, spanning a 2-week period before mating throughout gestation and 22 days after giving birth. With the exception of DES, treatment generally had no major adverse effect or body weight: in most instances, treated animals were heavier than controls at day 22 and at days 90-95. Exposure to OP, OPP, or BBP at a concentration of 1000 micrograms/1 resulted in a small (5-13%) but significant (p < 0.01 or p < 0.0001) reduction in mean testicular size in studies 2 and 3, an effect that was still evident when testicular weight was expressed relative to body, weight or kidney weight. The effect of OPP is attributed to its metabolism in vivo to OP. DES exposure caused similar reductions in testicular size but also caused reductions in body weight, kidney weight, and litter size. Ventral prostate weight was reduced significantly in DES-treated rats and to minor extent in OP-treated rats. Comparable but more minor effects of treatment with DES or OP on testicular size were observed in study 1. None of the treatments had any adverse effect on testicular morphology or on the cross-sectional area of the lumen or seminiferous epithelium at stages VII-VIII of the

  5. Reduced size liver transplantation from a donor supported by a Berlin Heart.

    PubMed

    Misra, M V; Smithers, C J; Krawczuk, L E; Jenkins, R L; Linden, B C; Weldon, C B; Kim, H B

    2009-11-01

    Patients on cardiac assist devices are often considered to be high-risk solid organ donors. We report the first case of a reduced size liver transplant performed using the left lateral segment of a pediatric donor whose cardiac function was supported by a Berlin Heart. The recipient was a 22-day-old boy with neonatal hemochromatosis who developed fulminant liver failure shortly after birth. The transplant was complicated by mild delayed graft function, which required delayed biliary reconstruction and abdominal wall closure, as well as a bile leak. However, the graft function improved quickly over the first week and the patient was discharged home with normal liver function 8 weeks after transplant. The presence of a cardiac assist device should not be considered an absolute contraindication for abdominal organ donation. Normal organ procurement procedures may require alteration due to the unusual technical obstacles that are encountered when the donor has a cardiac assist device.

  6. Type 2 Diabetes Risk Alleles Are Associated With Reduced Size at Birth

    PubMed Central

    Freathy, Rachel M.; Bennett, Amanda J.; Ring, Susan M.; Shields, Beverley; Groves, Christopher J.; Timpson, Nicholas J.; Weedon, Michael N.; Zeggini, Eleftheria; Lindgren, Cecilia M.; Lango, Hana; Perry, John R.B.; Pouta, Anneli; Ruokonen, Aimo; Hyppönen, Elina; Power, Chris; Elliott, Paul; Strachan, David P.; Järvelin, Marjo-Riitta; Smith, George Davey; McCarthy, Mark I.; Frayling, Timothy M.; Hattersley, Andrew T.

    2009-01-01

    OBJECTIVE Low birth weight is associated with an increased risk of type 2 diabetes. The mechanisms underlying this association are unknown and may represent intrauterine programming or two phenotypes of one genotype. The fetal insulin hypothesis proposes that common genetic variants that reduce insulin secretion or action may predispose to type 2 diabetes and also reduce birth weight, since insulin is a key fetal growth factor. We tested whether common genetic variants that predispose to type 2 diabetes also reduce birth weight. RESEARCH DESIGN AND METHODS We genotyped single-nucleotide polymorphisms (SNPs) at five recently identified type 2 diabetes loci (CDKAL1, CDKN2A/B, HHEX-IDE, IGF2BP2, and SLC30A8) in 7,986 mothers and 19,200 offspring from four studies of white Europeans. We tested the association between maternal or fetal genotype at each locus and birth weight of the offspring. RESULTS We found that type 2 diabetes risk alleles at the CDKAL1 and HHEX-IDE loci were associated with reduced birth weight when inherited by the fetus (21 g [95% CI 11–31], P = 2 × 10−5, and 14 g [4–23], P = 0.004, lower birth weight per risk allele, respectively). The 4% of offspring carrying four risk alleles at these two loci were 80 g (95% CI 39–120) lighter at birth than the 8% carrying none (Ptrend = 5 × 10−7). There were no associations between birth weight and fetal genotypes at the three other loci or maternal genotypes at any locus. CONCLUSIONS Our results are in keeping with the fetal insulin hypothesis and provide robust evidence that common disease-associated variants can alter size at birth directly through the fetal genotype. PMID:19228808

  7. Type 2 diabetes risk alleles are associated with reduced size at birth.

    PubMed

    Freathy, Rachel M; Bennett, Amanda J; Ring, Susan M; Shields, Beverley; Groves, Christopher J; Timpson, Nicholas J; Weedon, Michael N; Zeggini, Eleftheria; Lindgren, Cecilia M; Lango, Hana; Perry, John R B; Pouta, Anneli; Ruokonen, Aimo; Hyppönen, Elina; Power, Chris; Elliott, Paul; Strachan, David P; Järvelin, Marjo-Riitta; Smith, George Davey; McCarthy, Mark I; Frayling, Timothy M; Hattersley, Andrew T

    2009-06-01

    Low birth weight is associated with an increased risk of type 2 diabetes. The mechanisms underlying this association are unknown and may represent intrauterine programming or two phenotypes of one genotype. The fetal insulin hypothesis proposes that common genetic variants that reduce insulin secretion or action may predispose to type 2 diabetes and also reduce birth weight, since insulin is a key fetal growth factor. We tested whether common genetic variants that predispose to type 2 diabetes also reduce birth weight. We genotyped single-nucleotide polymorphisms (SNPs) at five recently identified type 2 diabetes loci (CDKAL1, CDKN2A/B, HHEX-IDE, IGF2BP2, and SLC30A8) in 7,986 mothers and 19,200 offspring from four studies of white Europeans. We tested the association between maternal or fetal genotype at each locus and birth weight of the offspring. We found that type 2 diabetes risk alleles at the CDKAL1 and HHEX-IDE loci were associated with reduced birth weight when inherited by the fetus (21 g [95% CI 11-31], P = 2 x 10(-5), and 14 g [4-23], P = 0.004, lower birth weight per risk allele, respectively). The 4% of offspring carrying four risk alleles at these two loci were 80 g (95% CI 39-120) lighter at birth than the 8% carrying none (P(trend) = 5 x 10(-7)). There were no associations between birth weight and fetal genotypes at the three other loci or maternal genotypes at any locus. Our results are in keeping with the fetal insulin hypothesis and provide robust evidence that common disease-associated variants can alter size at birth directly through the fetal genotype.

  8. Proton pump inhibitors reduce the size and acidity of the acid pocket in the stomach.

    PubMed

    Rohof, Wout O; Bennink, Roelof J; Boeckxstaens, Guy E

    2014-07-01

    The gastric acid pocket is believed to be the reservoir from which acid reflux events originate. Little is known about how changes in position, size, and acidity of the acid pocket contribute to the therapeutic effect of proton pump inhibitors (PPIs) in patients with gastroesophageal reflux disease (GERD). Thirty-six patients with GERD (18 not taking PPIs, 18 taking PPIs; 19 men; age, 55 ± 2.1 y) were analyzed by concurrent high-resolution manometry and pH-impedance monitoring after a standardized meal. The acid pocket was visualized using scintigraphy after intravenous administration of (99m)technetium-pertechnetate. The size of the acid pocket was measured and its position was determined, relative to the diaphragm, using radionuclide markers on a high-resolution manometry catheter. At the end of the study, the acid pocket was aspirated, and its pH level was measured. The number of reflux episodes was comparable between patients on and off PPIs, but the number of acid reflux episodes was reduced significantly in patients on PPIs. In patients on PPIs, the acid pocket was smaller and more frequently located below the diaphragm. The mean pH of the acid pocket was significantly lower in patients not taking PPIs (n = 6) than in those who were (n = 16) (0.9; range, 0.7-1.2 vs 4.0; range, 1.6-5.9; P < .001). The pH of acid pockets correlated significantly with the lowest pH values measured for refluxate (r = 0.72; P < .01). Based on analyses of acid pockets in patients with GERD, the acid pocket appears to be a reservoir from which reflux occurs when patients are receiving PPIs. PPIs might affect the size, acidity, or position of the acid pocket, which contributes to the efficacy in patients with GERD. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  9. Reduced size and starvation resistance in adult mosquitoes, Aedes notoscriptus, exposed to predation cues as larvae.

    PubMed

    van Uitregt, Vincent O; Hurst, Timothy P; Wilson, Robbie S

    2012-01-01

    1. Many prey organisms exhibit adaptive phenotypic plasticity in life-history traits that facilitate a better chance of survival in the presence of predators. The evolution of such plastic traits requires that the defensive phenotype incurs a cost in the absence of predation. 2. Model systems that are used to examine predator-induced defences are often organisms with complex life histories that only induce defences during the larval stage. While many studies have detected costs of inducible defences during the larval stage, detecting the costs of larval defences after metamorphosis is also important. 3. We examine the benefits and costs of inducible larval defences in the urban mosquito, Aedes notoscriptus, by rearing them in the presence and absence of predation cues. We compared survival of larvae inducing behavioural defences, when exposed to predation cues, in predation trials with predatory fish Hypseleotris galii to that of larvae reared in the absence predation cues. We also compared life-history traits of predator-exposed larvae to larvae reared in control conditions. 4. Larvae exposed to chemical predation cues limited activity and were able to avoid predation for longer in trials with H. galii. However, predator-exposed larvae suffered retarded larval growth and development, were smaller at metamorphosis and less resistant to starvation as adults. 5. While it is difficult to understand the 'fitness costs' that poorer starvation resistance might confer to adult mosquitoes, it is likely that smaller adult size of predator-exposed individuals would reduce fitness, particularly for females where body size limits the size of blood meal they could take to facilitate egg production. We suggest that the demonstrable costs of inducible defences in mosquito larvae make this a good system for testing theoretical models for the evolutionary maintenance of adaptive phenotypic plasticity.

  10. Xenoendocrine pollutants may reduce size of sexual organs in East Greenland polar bears (Ursus maritimus).

    PubMed

    Sonne, Christian; Leifsson, Pall S; Dietz, Rune; Born, Erik W; Letcher, Robert J; Hyldstrup, Lars; Riget, Frank F; Kirkegaard, Maja; Muir, Derek C G

    2006-09-15

    Reproductive organs from 55 male and 44 female East Greenland polar bears were examined to investigate the potential negative impact from organohalogen pollutants (OHCs). Multiple regressions normalizing for age showed a significant inverse relationship between OHCs and testis length and baculum length and weight, respectively, and was found in both subadults (dichlorodiphenyl trichloroethanes, dieldrin, chlordanes, hexacyclohexanes, polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs)) and adults (hexachlorobenzene [HCB]) (all p < 0.05). Baculum bone mineral densities decreased with increasing chlordanes, DDTs, and HCB in subadults and adults, respectively (all p < 0.05). In females, a significant inverse relationship was found between ovary length and sigma PCB (p = 0.03) and sigma CHL (p < 0.01), respectively, and between ovary weight and sigma PBDE (p < 0.01) and uterine horn length and HCB (p = 0.02). The study suggests thatthere is an impact from xenoendocrine pollutants on the size of East Greenland polar bear genitalia. This may pose a riskto this polar bear subpopulation in the future because of reduced sperm and egg quality/quantity and uterus and penis size/robustness.

  11. Measuring proteins with greater speed and resolution while reducing sample size.

    PubMed

    Hsieh, Vincent H; Wyatt, Philip J

    2017-08-30

    A multi-angle light scattering (MALS) system, combined with chromatographic separation, directly measures the absolute molar mass, size and concentration of the eluate species. The measurement of these crucial properties in solution is essential in basic macromolecular characterization and all research and production stages of bio-therapeutic products. We developed a new MALS methodology that has overcome the long-standing, stubborn barrier to microliter-scale peak volumes and achieved the highest resolution and signal-to-noise performance of any MALS measurement. The novel design simultaneously facilitates online dynamic light scattering (DLS) measurements. As National Institute of Standards and Technology (NIST) new protein standard reference material (SRM 8671) is becoming the benchmark molecule against which many biomolecular analytical techniques are assessed and evaluated, we present its measurement results as a demonstration of the unique capability of our system to swiftly resolve and measure sharp (20~25 µL full-width-half-maximum) chromatography peaks. Precise measurements of protein mass and size can be accomplished 10 times faster than before with improved resolution. In the meantime the sample amount required for such measurements is reduced commensurately. These abilities will have far-reaching impacts at every stage of the development and production of biologics and bio-therapeutic formulations.

  12. Gripe water as reducing and stabilizing agent for synthesis of size controlled gold nanoparticles.

    PubMed

    Kirubha, E; Palanisamy, P K

    2013-03-01

    Green synthesis techniques are emerging as more facile and eco-friendly approach for the synthesis of metal nanoparticles compared to chemical reduction methods. Herein we report a new approach to synthesize gold nanoparticles (AuNPs) using gripe water as a reducing as well as stabilizing agent. Good control over the size of the nanoparticles from 3.2 nm to 25 nm has been achieved with this method by simply varying the experimental conditions. The Surface Plasmon Resonance bands of tunable gold nanospheres with high monodispersity and polydispersity have been obtained by this technique and monitored using UV-Visible spectrum. The morphology and the size of these AuNPs are determined using High Resolution Transmission Electron Microscope (HR-TEM). X-Ray Diffraction (XRD) analysis confirms the crystalline nature and the phase of the AuNPs. The as-synthesized AuNPs exhibit good optical nonlinearity. The nonlinear optical studies have been carried out by Z-scan technique to demonstrate its optical limiting property. The threshold limit of the AuNPs is obtained at a input intensity of 30 mW. The nonlinear refractive index of the nanoparticles is in the order of 10(-9) cm2/W and the third-order nonlinearity is estimated to be 7 x 10(-5) esu.

  13. Calcified thrombus of the inferior vena cava in transposition of the great vessels.

    PubMed

    Velasquez, G; D'Souza, V J; Glass, T A; Sumner, T E; Formanek, A G

    1986-01-01

    Calcified thrombus of the inferior vena cava (IVC) in children is an entity usually not associated with significant complications. The possibility of pulmonary embolism from the soft thrombus, however, has been suggested but never reported. We give an account of a child with transposition of the great vessels who suffered embolization from a calcified thrombus in the IVC that entered the systemic circulation.

  14. Improved responsiveness and reduced sample size requirements of PROMIS physical function scales with item response theory.

    PubMed

    Fries, James F; Krishnan, Eswar; Rose, Matthias; Lingala, Bharathi; Bruce, Bonnie

    2011-01-01

    broader range of physical function. This can reduce sample size requirements and thus study costs.

  15. Somatostatin analogue, octreotide, reduces increased glomerular filtration rate and kidney size in insulin-dependent diabetes

    SciTech Connect

    Serri, O.; Beauregard, H.; Brazeau, P.; Abribat, T.; Lambert, J.; Harris, A.; Vachon, L. Sandoz Canada Inc., Dorval, Quebec )

    1991-02-20

    To determine whether treatment with a somatostatin analogue can reduce kidney hyperfiltration and hypertrophy in insulin-dependent diabetes mellitus, the authors studied 11 patients with insulin-dependent diabetes mellitus and glomerular hyperfiltration. The patients were assigned randomly to receive continuous subcutaneous infusion of either octreotide, 300 {mu}g/24 h (five patients) or placebo (six patients) for 12 weeks. At baseline, mean glomerular filtration rate and mean total kidney volume were not significantly different in the two groups. However, after 12 weeks of treatment, the mean glomerular filtration rate was significantly lower in the octreotide group than in the placebo group. Furthermore, the mean total kidney volume was significantly lower after treatment in the octreotide group than in the placebo group. Glycemic control did not change significantly in either group. They conclude that subcutaneous infusion of octreotide for 12 weeks reduces increased glomerular filtration rate and kidney size in patients with insulin-dependent diabetes mellitus despite the fact that glycemic control remains unchanged.

  16. A high-potassium diet reduces infarct size and improves vascular structure in hypertensive rats.

    PubMed

    Dorrance, Anne M; Pollock, David M; Romanko, Olga P; Stepp, David W

    2007-01-01

    High-potassium diets can improve vascular function, yet the effects of potassium supplementation on ischemic stroke have not been studied. We hypothesized that dietary potassium supplementation would reduce ischemic cerebral infarct size by reversing cerebral artery hypertrophy. Six-week-old male stroke-prone spontaneously hypertensive rats (SHRSP) were fed diets containing 0.79% potassium (LK) or 2.11% potassium (HK) for 6 wk; Wistar-Kyoto (WKY) rats were fed the LK diet. The HK diet did not reduce blood pressure, as measured by telemetry, in the SHRSP. Cerebral ischemia was induced by middle cerebral artery (MCA) occlusion. The resultant infarct was smaller in the HK-SHRSP than in the LK-SHRSP: 55.1 +/- 6.3 vs. 71.4 +/- 2.4% of the hemisphere infarcted (P < 0.05). Infarcts were smaller in WKY rats (33.5 +/- 4.8%) than in LK-SHRSP or HK-SHRSP. The vessel wall of MCAs from LK-SHRSP was hypertrophied compared with WKY rats; this was reversed in HK-SHRSP. RT-PCR analysis of the cerebral vessels showed that expression of platelet-derived growth factor receptors-alpha and -beta, epidermal growth factor receptor, and collagen I and III was increased in the vessels from LK-SHRSP compared with WKY rats and reduced in HK-SHRSP. These results suggest that potassium supplementation provides neuroprotection in a model of ischemic stroke independent of blood pressure and possibly through changes in vascular structure.

  17. Investigating intermolecular forces associated with thrombus initiation using optical tweezers

    NASA Astrophysics Data System (ADS)

    Arya, Maneesh; Lopez, Jose A.; Romo, Gabriel M.; Dong, Jing-Fei; McIntire, Larry V.; Moake, Joel L.; Anvari, Bahman

    2002-05-01

    Thrombus formation occurs when a platelet membrane receptor, glycoprotein (GP) Ib-IX-V complex, binds to its ligand, von Willebrand factor (vWf), in the subendothelium or plasma. To determine which GP Ib-IX-V amino acid sequences are critical for bond formation, we have used optical tweezers to measure forces involved in the binding of vWf to GP Ib-IX-V variants. Inasmuch as GP Ib(alpha) subunit is the primary component in human GP Ib-IX-V complex that binds to vWf, and that canine GP Ib(alpha) , on the other hand, does not bind to human vWf, we progressively replaced human GP Ib(alpha) amino acid sequences with canine GP Ib(alpha) sequences to determine the sequences essential for vWf/GP Ib(alpha) binding. After measuring the adhesive forces between optically trapped, vWf-coated beads and GP Ib(alpha) variants expressed on mammalian cells, we determined that leucine- rich repeat 2 of GP Ib(alpha) was necessary for vWf/GP Ib-IX- V bond formation. We also found that deletion of the N- terminal flanking sequence and leucine-rich repeat 1 reduced adhesion strength to vWf but did not abolish binding. While divalent cations are known to influence binding of vWf, addition of 1mM CaCl2 had no effect on measured vWf/GP Ib(alpha) bond strengths.

  18. Restaurant owners' perspectives on a voluntary program to recognize restaurants for offering reduced-size portions, Los Angeles County, 2012.

    PubMed

    Gase, Lauren; Dunning, Lauren; Kuo, Tony; Simon, Paul; Fielding, Jonathan E

    2014-03-20

    Reducing the portion size of food and beverages served at restaurants has emerged as a strategy for addressing the obesity epidemic; however, barriers and facilitators to achieving this goal are not well characterized. In fall 2012, the Los Angeles County Department of Public Health conducted semistructured interviews with restaurant owners to better understand contextual factors that may impede or facilitate participation in a voluntary program to recognize restaurants for offering reduced-size portions. Interviews were completed with 18 restaurant owners (representing nearly 350 restaurants). Analyses of qualitative data revealed 6 themes related to portion size: 1) perceived customer demand is central to menu planning; 2) multiple portion sizes are already being offered for at least some food items; 3) numerous logistical barriers exist for offering reduced-size portions; 4) restaurant owners have concerns about potential revenue losses from offering reduced-size portions; 5) healthful eating is the responsibility of the customer; and 6) a few owners want to be socially responsible industry leaders. A program to recognize restaurants for offering reduced-size portions may be a feasible approach in Los Angeles County. These findings may have applications for jurisdictions interested in engaging restaurants as partners in reducing the obesity epidemic.

  19. Restaurant Owners’ Perspectives on a Voluntary Program to Recognize Restaurants for Offering Reduced-Size Portions, Los Angeles County, 2012

    PubMed Central

    Dunning, Lauren; Kuo, Tony; Simon, Paul; Fielding, Jonathan E.

    2014-01-01

    Introduction Reducing the portion size of food and beverages served at restaurants has emerged as a strategy for addressing the obesity epidemic; however, barriers and facilitators to achieving this goal are not well characterized. Methods In fall 2012, the Los Angeles County Department of Public Health conducted semistructured interviews with restaurant owners to better understand contextual factors that may impede or facilitate participation in a voluntary program to recognize restaurants for offering reduced-size portions. Results Interviews were completed with 18 restaurant owners (representing nearly 350 restaurants). Analyses of qualitative data revealed 6 themes related to portion size: 1) perceived customer demand is central to menu planning; 2) multiple portion sizes are already being offered for at least some food items; 3) numerous logistical barriers exist for offering reduced-size portions; 4) restaurant owners have concerns about potential revenue losses from offering reduced-size portions; 5) healthful eating is the responsibility of the customer; and 6) a few owners want to be socially responsible industry leaders. Conclusion A program to recognize restaurants for offering reduced-size portions may be a feasible approach in Los Angeles County. These findings may have applications for jurisdictions interested in engaging restaurants as partners in reducing the obesity epidemic. PMID:24650622

  20. [Massive pulmonary embolism, thrombus in transit, and right ventricular dysfunction].

    PubMed

    Santos Martínez, Luis Efrén; Uriona Villarroel, Juan Eddy; Exaire Rodríguez, José Emilio; Mendoza, David; Martínez Guerra, María Luisa; Pulido, Tomás; Bautista, Edgar; Castañón, Alicia; Sandoval, Julio

    2007-01-01

    Massive pulmonary embolism is associated with an increased mortality. It is secondary to migration of a venous thrombus to the right atrium or ventricle (thrombus in transit) towards the pulmonary circulation. The hemodynamic performance depends on the baseline cardiopulmonary status of the patient and the extent of obstruction. Right ventricular dysfunction will appear as a direct consequence of a major obstruction and hemodynamic collapse. The treatment of choice is thrombolysis, either intravenous in a peripheral vein, or local administration associated with percutaneous thrombus fragmentation or surgical embolectomy. We present the clinic case of a woman with massive pulmonary embolism. The transthoracic echocardiogram showed the presence of three auricular thrombus, right ventricular dysfunction and pulmonary hypertension. A right side catheterization and angiography demonstrated the pulmonary artery obstruction and right ventricular dysfunction. The troponin-I was elevated as a result of right ventricular strain. Mechanical thrombectomy was made using a pigtail catheter and thrombolysis into the pulmonary artery using recombinant tisular plasminogen activator. There was an immediate hemodynamic improvement and the post-thrombolysis angiography performed after 24-h demonstrated an improvement of the pulmonary circulation as well as decreased pulmonary artery pressures.

  1. Thrombus formation induced by laser in a mouse model

    PubMed Central

    PÉREZ, PABLO; ALARCÓN, MARCELO; FUENTES, EDUARDO; PALOMO, IVÁN

    2014-01-01

    Animal models are used for the development of techniques and/or models that aid the study of thrombosis pathophysiology. The aim of the present study was to modify the technique of in vivo thrombosis induction to make it more accessible. BALB/c mice were intraperitoneally anesthetized with 0.4 ml 2,2,2-tribromoethanol (266.6 mg/kg) and xylazine (13.3 mg/kg), whilst maintaining stable blood pressure and temperature. Through abdominal surgery, the mesentery was identified and isolated for the visualization of the arteries. A simple epifluorescence magnifier was used to detect the presence of thrombi. The results obtained indicate that using rose bengal at concentrations of 25 and 50 mg/kg and a laser power of 5 mW, thrombus formation occurred. In addition, formation of the thrombus occurred ~30 min following induction and the thrombus had a total area of 4,878.3 μm2, which caused total occlusion of the mesenteric artery. For visualization, platelets were labeled with calcein acetyloxymethyl ester for 1 h, which resulted in improved observation of thrombus formation in real time. Therefore, this technique may be used to perform in vivo studies simply and at low cost, and is suitable for use in a variety of studies of thrombosis. PMID:24944598

  2. Thrombus formation induced by laser in a mouse model.

    PubMed

    Pérez, Pablo; Alarcón, Marcelo; Fuentes, Eduardo; Palomo, Iván

    2014-07-01

    Animal models are used for the development of techniques and/or models that aid the study of thrombosis pathophysiology. The aim of the present study was to modify the technique of in vivo thrombosis induction to make it more accessible. BALB/c mice were intraperitoneally anesthetized with 0.4 ml 2,2,2-tribromoethanol (266.6 mg/kg) and xylazine (13.3 mg/kg), whilst maintaining stable blood pressure and temperature. Through abdominal surgery, the mesentery was identified and isolated for the visualization of the arteries. A simple epifluorescence magnifier was used to detect the presence of thrombi. The results obtained indicate that using rose bengal at concentrations of 25 and 50 mg/kg and a laser power of 5 mW, thrombus formation occurred. In addition, formation of the thrombus occurred ~30 min following induction and the thrombus had a total area of 4,878.3 μm(2), which caused total occlusion of the mesenteric artery. For visualization, platelets were labeled with calcein acetyloxymethyl ester for 1 h, which resulted in improved observation of thrombus formation in real time. Therefore, this technique may be used to perform in vivo studies simply and at low cost, and is suitable for use in a variety of studies of thrombosis.

  3. Reduced neuronal size and dendritic length in the medial superior olivary nucleus of albino rabbits.

    PubMed

    Conlee, J W; Parks, T N; Creel, D J

    1986-01-15

    We have previously demonstrated that circumscribed structural and functional abnormalities exist in the brainstem auditory system of albino cats. Anomalies in the auditory brainstem evoked response of albino cats were correlated with anatomical defects in the medial superior olivary nucleus (MSO) of the same animals. To examine whether a similar syndrome is present in other albino mammals, we studied the MSO of albino and pigmented rabbits using both Nissl-stained and Golgi-impregnated material. Neurons in the MSO of the albinos were significantly smaller (24%) than those in the pigmented rabbits and there was no overlap in the size distributions between the two groups. Neurons in the abducens nucleus of the albinos were also 14% smaller than in the pigmented rabbits, but this difference was not statistically reliable. The broad overlap in the distributions of neuronal size in the abducens nucleus between groups indicated that not all cells in the albino brainstem are significantly smaller than normal. In the Golgi-impregnated material, the mean total dendritic length for the 'marginal' cell type in the MSO was 39% shorter in albinos than in the pigmented animals. The branching density of dendrites was also significantly reduced in the albinos. Mean total dendritic length for cerebellar granule cells was a statistically insignificant 6% longer in the albinos, demonstrating that dendritic structure is not uniformly affected in all regions of the albino brain. The demonstration of similar anatomical differences in albino rabbits and cats indicates that whatever process produces these effects is not species-specific and may be common to the albinos of other mammalian species. The evidence that the amount of cochlear melanin may be related to differences in auditory function further suggests that the differences in the MSO of the albinos may ultimately be related to absence of inner ear pigmentation and not to other gene effects.

  4. Using Ancillary Information to Reduce Sample Size in Discovery Sampling and the Effects of Measurement Error

    SciTech Connect

    Axelrod, M

    2005-08-18

    big sample size might bust the budget, or the number seems intuitively excessive. To reduce the sample size, you can increase the tolerable number of defectives, the ''10'' in the preceding example, or back off on the confidence level, say from 95% to 90%. Auditors also frequently bump up the sample size as a safety factor. They know that something can go wrong. For example, they might find out that the measurements or inspections were subject to errors. Unless the auditors know exactly how measurement error affects sample size, they might be forced to give up the safety factor. Clients often choose to ''live dangerously'' (without a compelling argument to the contrary) to save money. Thus, sometimes the auditor finds that ''you just can't get there from here'', because the goals of the audit and the resources available are inherently in conflict. For discovery audits, there is a way out of this apparent conundrum. It turns out that the classical method of confidence intervals uses an implicit and very conservative assumption. We will see that this assumption is too pessimistic and too conservative in the context of a discovery audit. If we abandon this assumption and use ancillary information about the inventory, then we can significantly reduce the sample size required to achieve the desired confidence level. We will see exactly how the classical method ignores this ancillary information and misses the opportunity for an efficient audit. In the following sections, we first review the standard approach using confidence intervals. Then we present a method that incorporates the ancillary information about the inventory to design a very efficient discovery audit. We also provide results on how measurement errors affect the audit, and how exactly how much the sample size must be modified to compensate for these errors. Finally, we state asymptotic formulas that provide useful approximations for large inventories. It is suggested that the reader review the glossary of

  5. Takotsubo Cardiomyopathy With a Rapidly Resolved Left Ventricular Thrombus

    PubMed Central

    Anabtawi, Abdel; Roldan, Paola C.; Roldan, Carlos A.

    2017-01-01

    This article presents the case of a 53-year-old man who presented with acute right superficial femoral and popliteal arterial thrombosis for which he underwent an emergent uncomplicated thrombectomy. He denied preceding cardiovascular or neurologic symptomatology and had no history of coronary or peripheral arterial disease, trauma, hypercoagulability, or malignancy. However, he reported having several days of intense emotional stress prior to presentation. His cardiac exam was normal, his electrocardiogram showed normal sinus rhythm and nonspecific ST-T wave abnormalities, and his troponin levels were normal. Transthoracic echocardiography (TTE) revealed a large (2.4 × 2 cm) apical left ventricle (LV) thrombus, LV apical akinesis, and LV ejection fraction of 40% to 45%. Coronary angiography revealed only luminal irregularities. A repeat TTE performed 3 days after initiating unfractionated heparin revealed complete resolution of the LV thrombus. The patient had an uneventful clinical course and was discharged home in stable condition on oral anticoagulants. The lower incidence of LV thrombus in takotsubo cardiomyopathy (TC) of 1.3% in comparison to 4% to 8% in acute myocardial infarction due to coronary artery disease in the current era of early reperfusion may be explained by the lower extent of ischemic myocardial necrosis associated with TC. This case suggests that the lower extent of myocardial necrosis in TC may also lead to faster resolution of LV thrombus. Therefore, earlier follow-up with TTE (within 2 weeks) and shorter duration of anticoagulation (<3 months) may be considered in patients with TC complicated by LV thrombus formation with or without systemic embolism.

  6. Dynamic clustering threshold reduces conformer ensemble size while maintaining a biologically relevant ensemble

    NASA Astrophysics Data System (ADS)

    Yongye, Austin B.; Bender, Andreas; Martínez-Mayorga, Karina

    2010-08-01

    Representing the 3D structures of ligands in virtual screenings via multi-conformer ensembles can be computationally intensive, especially for compounds with a large number of rotatable bonds. Thus, reducing the size of multi-conformer databases and the number of query conformers, while simultaneously reproducing the bioactive conformer with good accuracy, is of crucial interest. While clustering and RMSD filtering methods are employed in existing conformer generators, the novelty of this work is the inclusion of a clustering scheme (NMRCLUST) that does not require a user-defined cut-off value. This algorithm simultaneously optimizes the number and the average spread of the clusters. Here we describe and test four inter-dependent approaches for selecting computer-generated conformers, namely: OMEGA, NMRCLUST, RMS filtering and averaged- RMS filtering. The bioactive conformations of 65 selected ligands were extracted from the corresponding protein:ligand complexes from the Protein Data Bank, including eight ligands that adopted dissimilar bound conformations within different receptors. We show that NMRCLUST can be employed to further filter OMEGA-generated conformers while maintaining biological relevance of the ensemble. It was observed that NMRCLUST (containing on average 10 times fewer conformers per compound) performed nearly as well as OMEGA, and both outperformed RMS filtering and averaged- RMS filtering in terms of identifying the bioactive conformations with excellent and good matches (0.5 < RMSD < 1.0 Å). Furthermore, we propose thresholds for OMEGA root-mean square filtering depending on the number of rotors in a compound: 0.8, 1.0 and 1.4 for structures with low (1-4), medium (5-9) and high (10-15) numbers of rotatable bonds, respectively. The protocol employed is general and can be applied to reduce the number of conformers in multi-conformer compound collections and alleviate the complexity of downstream data processing in virtual screening experiments.

  7. Prediction of thrombus-related mechanical prosthetic valve dysfunction using transesophageal echocardiography

    NASA Technical Reports Server (NTRS)

    Lin, S. S.; Tiong, I. Y.; Asher, C. R.; Murphy, M. T.; Thomas, J. D.; Griffin, B. P.

    2000-01-01

    Identification of thrombus-related mechanical prosthetic valve dysfunction (MPVD) has important therapeutic implications. We sought to develop an algorithm, combining clinical and echocardiographic parameters, for prediction of thrombus-related MPVD in a series of 53 patients (24 men, age 52 +/- 16 years) who had intraoperative diagnosis of thrombus or pannus from 1992 to 1997. Clinical and echocardiographic parameters were analyzed to identify predictors of thrombus and pannus. Prevalence of thrombus and diagnostic yields relative to the number of predictors were determined. There were 22 patients with thrombus, 19 patients with pannus, and 12 patients with both. Forty-two of 53 masses were visualized using transesophageal echocardiography (TEE), including 29 of 34 thrombi or both thrombi and panni and 13 of 19 isolated panni. Predictors of thrombus or mixed presentation include mobile mass (p = 0.009), attachment to occluder (p = 0.02), elevated gradients (p = 0.04), and an international normalized ratio of < or = 2.5 (p = 0.03). All 34 patients with thrombus or mixed presentation had > or = 1 predictor. The prevalence of thrombus in the presence of < or = 1, 2, and > or = 3 predictors is 14%, 69%, and 91%, respectively. Thus, TEE is sensitive in the identification of abnormal mass in the setting of MPVD. An algorithm based on clinical and transesophageal echocardiographic predictors may be useful to estimate the likelihood of thrombus in the setting of MPVD. In the presence of > or = 3 predictors, the probability of thrombus is high.

  8. Prediction of thrombus-related mechanical prosthetic valve dysfunction using transesophageal echocardiography.

    PubMed

    Lin, S S; Tiong, I Y; Asher, C R; Murphy, M T; Thomas, J D; Griffin, B P

    2000-11-15

    Identification of thrombus-related mechanical prosthetic valve dysfunction (MPVD) has important therapeutic implications. We sought to develop an algorithm, combining clinical and echocardiographic parameters, for prediction of thrombus-related MPVD in a series of 53 patients (24 men, age 52 +/- 16 years) who had intraoperative diagnosis of thrombus or pannus from 1992 to 1997. Clinical and echocardiographic parameters were analyzed to identify predictors of thrombus and pannus. Prevalence of thrombus and diagnostic yields relative to the number of predictors were determined. There were 22 patients with thrombus, 19 patients with pannus, and 12 patients with both. Forty-two of 53 masses were visualized using transesophageal echocardiography (TEE), including 29 of 34 thrombi or both thrombi and panni and 13 of 19 isolated panni. Predictors of thrombus or mixed presentation include mobile mass (p = 0.009), attachment to occluder (p = 0.02), elevated gradients (p = 0.04), and an international normalized ratio of < or = 2.5 (p = 0.03). All 34 patients with thrombus or mixed presentation had > or = 1 predictor. The prevalence of thrombus in the presence of < or = 1, 2, and > or = 3 predictors is 14%, 69%, and 91%, respectively. Thus, TEE is sensitive in the identification of abnormal mass in the setting of MPVD. An algorithm based on clinical and transesophageal echocardiographic predictors may be useful to estimate the likelihood of thrombus in the setting of MPVD. In the presence of > or = 3 predictors, the probability of thrombus is high.

  9. Prediction of thrombus-related mechanical prosthetic valve dysfunction using transesophageal echocardiography

    NASA Technical Reports Server (NTRS)

    Lin, S. S.; Tiong, I. Y.; Asher, C. R.; Murphy, M. T.; Thomas, J. D.; Griffin, B. P.

    2000-01-01

    Identification of thrombus-related mechanical prosthetic valve dysfunction (MPVD) has important therapeutic implications. We sought to develop an algorithm, combining clinical and echocardiographic parameters, for prediction of thrombus-related MPVD in a series of 53 patients (24 men, age 52 +/- 16 years) who had intraoperative diagnosis of thrombus or pannus from 1992 to 1997. Clinical and echocardiographic parameters were analyzed to identify predictors of thrombus and pannus. Prevalence of thrombus and diagnostic yields relative to the number of predictors were determined. There were 22 patients with thrombus, 19 patients with pannus, and 12 patients with both. Forty-two of 53 masses were visualized using transesophageal echocardiography (TEE), including 29 of 34 thrombi or both thrombi and panni and 13 of 19 isolated panni. Predictors of thrombus or mixed presentation include mobile mass (p = 0.009), attachment to occluder (p = 0.02), elevated gradients (p = 0.04), and an international normalized ratio of < or = 2.5 (p = 0.03). All 34 patients with thrombus or mixed presentation had > or = 1 predictor. The prevalence of thrombus in the presence of < or = 1, 2, and > or = 3 predictors is 14%, 69%, and 91%, respectively. Thus, TEE is sensitive in the identification of abnormal mass in the setting of MPVD. An algorithm based on clinical and transesophageal echocardiographic predictors may be useful to estimate the likelihood of thrombus in the setting of MPVD. In the presence of > or = 3 predictors, the probability of thrombus is high.

  10. Mechanisms of Regulating Tissue Elongation in Drosophila Wing: Impact of Oriented Cell Divisions, Oriented Mechanical Forces, and Reduced Cell Size

    PubMed Central

    Li, Yingzi; Naveed, Hammad; Kachalo, Sema; Xu, Lisa X.; Liang, Jie

    2014-01-01

    Regulation of cell growth and cell division plays fundamental roles in tissue morphogenesis. However, the mechanisms of regulating tissue elongation through cell growth and cell division are still not well understood. The wing imaginal disc of Drosophila provides a model system that has been widely used to study tissue morphogenesis. Here we use a recently developed two-dimensional cellular model to study the mechanisms of regulating tissue elongation in Drosophila wing. We simulate the effects of directional cues on tissue elongation. We also computationally analyze the role of reduced cell size. Our simulation results indicate that oriented cell divisions, oriented mechanical forces, and reduced cell size can all mediate tissue elongation, but they function differently. We show that oriented cell divisions and oriented mechanical forces act as directional cues during tissue elongation. Between these two directional cues, oriented mechanical forces have a stronger influence than oriented cell divisions. In addition, we raise the novel hypothesis that reduced cell size may significantly promote tissue elongation. We find that reduced cell size alone cannot drive tissue elongation. However, when combined with directional cues, such as oriented cell divisions or oriented mechanical forces, reduced cell size can significantly enhance tissue elongation in Drosophila wing. Furthermore, our simulation results suggest that reduced cell size has a short-term effect on cell topology by decreasing the frequency of hexagonal cells, which is consistent with experimental observations. Our simulation results suggest that cell divisions without cell growth play essential roles in tissue elongation. PMID:24504016

  11. Thromboembolic complications after endovascular repair of abdominal aortic aneurysm with neck thrombus.

    PubMed

    Shintani, Tsunehiro; Mitsuoka, Hiroshi; Atsuta, Kouji; Saitou, Takaaki; Higashi, Shigeki

    2013-04-01

    To evaluate outcomes after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) with neck thrombus. We retrospectively reviewed patients who underwent EVAR for AAA at our institution from 2007 to 2011. Patients with ruptured AAA, chronic renal failure, or hostile neck characteristics other than thrombus were excluded. Patients were divided into 2 groups: group T (with neck thrombus) and group N (without neck thrombus). We compared complications and mid-term outcomes. There were no differences in success rates between the groups, but there were higher rates of thromboembolic complications such as distal embolization (20% vs 0%, P = .02) and renal dysfunction (36.8% vs 11.1%, P = .03) in group T than in group N. Suprarenal thrombus and suprarenal fixation in the presence of suprarenal thrombus were associated with postoperative renal dysfunction (P = .01). The EVAR for AAA with neck thrombus is associated with thromboembolic complications.

  12. From micro- to nanomagnetic dots: evolution of the eigenmode spectrum on reducing the lateral size

    NASA Astrophysics Data System (ADS)

    Carlotti, G.; Gubbiotti, G.; Madami, M.; Tacchi, S.; Hartmann, F.; Emmerling, M.; Kamp, M.; Worschech, L.

    2014-07-01

    Brillouin light scattering experiments and micromagnetic simulations have been exploited to investigate the spectrum of thermally excited magnetic eigenmodes in 10 nm-thick elliptical Permalloy dots, when the longer axis D is scaled down from about 1000 to 100 nm. It is shown that for D larger than about 200 nm the characteristics of the spin-wave eigenmodes are dominated by dipolar energy, while for D in the range of about 100 to 200 nm exchange energy effects cause qualitative and quantitative differences in the spin-wave spectrum. In this ‘mesoscopic’ regime, the usual classification scheme, involving one fundamental mode with large average magnetization and many other modes collected in families with specific symmetries, no longer holds. Rather, one finds the simultaneous presence of two modes with ‘fundamental’ character, i.e. with a significant and comparable value of the average dynamical magnetization: the former is at larger frequency and has its maximum amplitude at the dot's centre, while the latter occurs at lower frequency and is localized at the dot's edges. Interestingly, the maximum intensity swaps from the higher frequency mode to the lower frequency one, just when the dot size is reduced from about 200 to 100 nm. This is relevant in view of the exploitation of nanodots for the design of nanomagnetic devices with lateral dimensions in the above interval, such as memory cells, logic gates, reading heads and spin-torque oscillators.

  13. Impaired egocentric memory and reduced somatosensory cortex size in temporal lobe epilepsy with hippocampal sclerosis.

    PubMed

    Weniger, Godehard; Ruhleder, Mirjana; Lange, Claudia; Irle, Eva

    2012-02-01

    Recent research indicates that longstanding temporal lobe epilepsy (TLE) is associated with extratemporal, i.e. parietal cortex damage. We investigated egocentric and allocentric memory by use of first-person large-scale virtual reality environments in patients with TLE. We expected that TLE patients with parietal cortex damage were impaired in the egocentric memory task. Twenty-two TLE patients with hippocampal sclerosis (HS) and 22 TLE patients without HS were compared with 42 healthy matched controls on two virtual reality tasks affording to learn a virtual park (allocentric memory) and a virtual maze (egocentric memory). Participants further received a neuropsychological investigation and MRI volumetry at the time of the assessment. When compared with controls, TLE patients with HS had significantly reduced size of the ipsilateral and contralateral somatosensory cortex (postcentral gyrus). When compared with controls or TLE patients without HS, TLE patients with HS were severely impaired learning the virtual maze. Considering all participants, smaller volumes of the left-sided postcentral gyrus were related to worse performance on the virtual maze. It is concluded that the paradigm of egocentric navigation and learning in first-person large-scale virtual environments may be a suitable tool to indicate significant extratemporal damage in individuals with TLE. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Flocculated sediments can reduce the size of sediment basin at construction sites.

    PubMed

    Kang, Jihoon; King, Scott E; McLaughlin, Richard A

    2016-01-15

    Due to stringent water quality regulations on stormwater discharges, there is increasing interest in chemically-assisted settling of suspended sediments at construction sites. This study investigated settling characteristics of flocculated sediment by polyacrylamide (PAM) in a top-loading settling tube. Studied sediment materials were obtained from construction sites in North Carolina, USA: Coastal Plain loamy sand (CPLS), Piedmont sandy clay loam (PSCL), Piedmont silt loam (PSL), and Mountain clay loam (MCL). The four different sediment suspensions mixed with and without dissolved PAM were introduced to the top of the column individually. During a 1-h settling period, samples were taken at 1-m depth from surface at various times and analyzed for total suspended solids (TSS). Flocculated sediment by PAM greatly increased its settled TSS fraction up to 95-97% only in 1-min settling period compared to those of unflocculated sediment (16-72%). The settling improvement by PAM was profound in the finer-textured soils (PSL and MCL) by increasing their median particle settling velocity (>2 cm s(-1)) compared to unflocculated counterparts (<1.1 cm s(-1)). Estimated surface area requirement of sediment basin suggested that the basins receiving flocculated sediment could be reduced in size (surface area) by 2- to 4-times compared to those receiving unflocculated sediment. Our results suggests that current sediment basin design could be modified when chemically-assisted settling is implemented, taking up less space and cost in construction sites.

  15. Mobile thrombus on cardiac implantable electronic device leads of patients undergoing cardiac ablation: incidence, management, and outcomes.

    PubMed

    Sugrue, Alan; DeSimone, Christopher V; Lenz, Charles J; Packer, Douglas L; Asirvatham, Samuel J

    2016-08-01

    The rates of cardiovascular implantable electronic device (CIED) implantations and cardiac ablation procedures are increasing worldwide. To date, the management of CIED lead thrombi in the peri-ablation period remains undefined and key clinical management questions remained unanswered. We sought to describe the clinical course and management strategies of patients with a CIED lead thrombus detected in the peri-ablative setting. We performed a retrospective analysis of all patients who underwent a cardiac ablation procedure at Mayo Clinic Rochester from 2000 to 2014. Patients were included in our study cohort if they had documented CIED lead thrombus noted on peri-ablation imaging studies. Electronic medical records were reviewed to determine the overall management strategy, outcomes, and embolic complications in these patients. Our overall cohort included 1833 patients, with 27 (1.4 %) having both cardiac ablation procedures as well as CIED lead thrombus detected on imaging. Of these 27 patients, 21 were male (77 %), and the mean age was 59.2 years. The mean duration of follow-up was 16.5 months (range 3 days-48.3 months). Anticoagulation was an effective therapeutic strategy, with 11/14 (78.6 %) patients experiencing either resolution of the thrombus or reduction in size on re-imaging. For atrial fibrillation ablation, the most common management strategy was a deferment in ablation with initiation/intensification of anticoagulation medication. For ventricular tachycardia ablations, most procedures involved a modified approach with the use of a retrograde aortic approach to access the left ventricle. No patient had any documented embolic complications. The incidence of lead thrombi in patients undergoing an ablation was small in our study cohort (1.4 %). Anticoagulation and deferral of ablation represented successful management strategies for atrial fibrillation ablation. For patients undergoing ventricular tachycardia ablation, a modified approach using

  16. The Effect of Factor VIII Deficiencies and Replacement and Bypass Therapies on Thrombus Formation under Venous Flow Conditions in Microfluidic and Computational Models

    PubMed Central

    Onasoga-Jarvis, Abimbola A.; Leiderman, Karin; Fogelson, Aaron L.; Wang, Michael; Manco-Johnson, Marilyn J.; Di Paola, Jorge A.; Neeves, Keith B.

    2013-01-01

    Clinical evidence suggests that individuals with factor VIII (FVIII) deficiency (hemophilia A) are protected against venous thrombosis, but treatment with recombinant proteins can increase their risk for thrombosis. In this study we examined the dynamics of thrombus formation in individuals with hemophilia A and their response to replacement and bypass therapies under venous flow conditions. Fibrin and platelet accumulation were measured in microfluidic flow assays on a TF-rich surface at a shear rate of 100 s−1. Thrombin generation was calculated with a computational spatial-temporal model of thrombus formation. Mild FVIII deficiencies (5–30% normal levels) could support fibrin fiber formation, while severe (<1%) and moderate (1–5%) deficiencies could not. Based on these experimental observations, computational calculations estimate an average thrombin concentration of ∼10 nM is necessary to support fibrin formation under flow. There was no difference in fibrin formation between severe and moderate deficiencies, but platelet aggregate size was significantly larger for moderate deficiencies. Computational calculations estimate that the local thrombin concentration in moderate deficiencies is high enough to induce platelet activation (>1 nM), but too low to support fibrin formation (<10 nM). In the absence of platelets, fibrin formation was not supported even at normal FVIII levels, suggesting platelet adhesion is necessary for fibrin formation. Individuals treated by replacement therapy, recombinant FVIII, showed normalized fibrin formation. Individuals treated with bypass therapy, recombinant FVIIa, had a reduced lag time in fibrin formation, as well as elevated fibrin accumulation compared to healthy controls. Treatment of rFVIIa, but not rFVIII, resulted in significant changes in fibrin dynamics that could lead to a prothrombotic state. PMID:24236042

  17. The effect of factor VIII deficiencies and replacement and bypass therapies on thrombus formation under venous flow conditions in microfluidic and computational models.

    PubMed

    Onasoga-Jarvis, Abimbola A; Leiderman, Karin; Fogelson, Aaron L; Wang, Michael; Manco-Johnson, Marilyn J; Di Paola, Jorge A; Neeves, Keith B

    2013-01-01

    Clinical evidence suggests that individuals with factor VIII (FVIII) deficiency (hemophilia A) are protected against venous thrombosis, but treatment with recombinant proteins can increase their risk for thrombosis. In this study we examined the dynamics of thrombus formation in individuals with hemophilia A and their response to replacement and bypass therapies under venous flow conditions. Fibrin and platelet accumulation were measured in microfluidic flow assays on a TF-rich surface at a shear rate of 100 s⁻¹. Thrombin generation was calculated with a computational spatial-temporal model of thrombus formation. Mild FVIII deficiencies (5-30% normal levels) could support fibrin fiber formation, while severe (<1%) and moderate (1-5%) deficiencies could not. Based on these experimental observations, computational calculations estimate an average thrombin concentration of ∼10 nM is necessary to support fibrin formation under flow. There was no difference in fibrin formation between severe and moderate deficiencies, but platelet aggregate size was significantly larger for moderate deficiencies. Computational calculations estimate that the local thrombin concentration in moderate deficiencies is high enough to induce platelet activation (>1 nM), but too low to support fibrin formation (<10 nM). In the absence of platelets, fibrin formation was not supported even at normal FVIII levels, suggesting platelet adhesion is necessary for fibrin formation. Individuals treated by replacement therapy, recombinant FVIII, showed normalized fibrin formation. Individuals treated with bypass therapy, recombinant FVIIa, had a reduced lag time in fibrin formation, as well as elevated fibrin accumulation compared to healthy controls. Treatment of rFVIIa, but not rFVIII, resulted in significant changes in fibrin dynamics that could lead to a prothrombotic state.

  18. 30 CFR 203.76 - When might BSEE withdraw or reduce the approved size of my relief?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false When might BSEE withdraw or reduce the approved... ENFORCEMENT, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT RELIEF OR REDUCTION IN ROYALTY RATES OCS Oil, Gas, and Sulfur General § 203.76 When might BSEE withdraw or reduce the approved size of my...

  19. Invasive surgery reduces infarct size and preserves cardiac function in a porcine model of myocardial infarction

    PubMed Central

    van Hout, Gerardus PJ; Teuben, Michel PJ; Heeres, Marjolein; de Maat, Steven; de Jong, Renate; Maas, Coen; Kouwenberg, Lisanne HJA; Koenderman, Leo; van Solinge, Wouter W; de Jager, Saskia CA; Pasterkamp, Gerard; Hoefer, Imo E

    2015-01-01

    Reperfusion injury following myocardial infarction (MI) increases infarct size (IS) and deteriorates cardiac function. Cardioprotective strategies in large animal MI models often failed in clinical trials, suggesting translational failure. Experimentally, MI is induced artificially and the effect of the experimental procedures may influence outcome and thus clinical applicability. The aim of this study was to investigate if invasive surgery, as in the common open chest MI model affects IS and cardiac function. Twenty female landrace pigs were subjected to MI by transluminal balloon occlusion. In 10 of 20 pigs, balloon occlusion was preceded by invasive surgery (medial sternotomy). After 72 hrs, pigs were subjected to echocardiography and Evans blue/triphenyl tetrazoliumchloride double staining to determine IS and area at risk. Quantification of IS showed a significant IS reduction in the open chest group compared to the closed chest group (IS versus area at risk: 50.9 ± 5.4% versus 69.9 ± 3.4%, P = 0.007). End systolic LV volume and LV ejection fraction measured by echocardiography at follow-up differed significantly between both groups (51 ± 5 ml versus 65 ± 3 ml, P = 0.033; 47.5 ± 2.6% versus 38.8 ± 1.2%, P = 0.005). The inflammatory response in the damaged myocardium did not differ between groups. This study indicates that invasive surgery reduces IS and preserves cardiac function in a porcine MI model. Future studies need to elucidate the effect of infarct induction technique on the efficacy of pharmacological therapies in large animal cardioprotection studies. PMID:26282710

  20. Acadesine Inhibits Tissue Factor Induction and Thrombus Formation by Activating the Phosphoinositide 3-Kinase/Akt Signaling Pathway

    PubMed Central

    Zhang, Weiyu; Wang, Jianguo; Wang, Huan; Tang, Rong; Belcher, John D.; Viollet, Benoit; Geng, Jian-Guo; Zhang, Chunxiang; Wu, Chaodong; Slungaard, Arne; Zhu, Chuhong; Huo, Yuqing

    2013-01-01

    Objective Acadesine, an adenosine-regulating agent and activator of AMP-activated protein kinase, has been shown to possess antiinflammatory activity. This study investigated whether and how acadesine inhibits tissue factor (TF) expression and thrombus formation. Methods and Results Human umbilical vein endothelial cells and human peripheral blood monocytes were stimulated with lipopolysaccharide to induce TF expression. Pretreatment with acadesine dramatically suppressed the clotting activity and expression of TF (protein and mRNA). These inhibitory effects of acadesine were unchanged for endothelial cells treated with ZM241385 (a specific adenosine A2A receptor antagonist) or AMP-activated protein kinase inhibitor compound C, and in macrophages lacking adenosine A2A receptor or α1–AMP-activated protein kinase. In endothelial cells and macrophages, acadesine activated the phosphoinositide 3-kinase/Akt signaling pathway, reduced the activity of mitogen-activated protein kinases, and consequently suppressed TF expression by inhibiting the activator protein-1 and NF-κB pathways. In mice, acadesine suppressed lipopolysaccharide-mediated increases in blood coagulation, decreased TF expression in atherosclerotic lesions, and reduced deep vein thrombus formation. Conclusion Acadesine inhibits TF expression and thrombus formation by activating the phosphoinositide 3-kinase/Akt pathway. This novel finding implicates acadesine as a potentially useful treatment for many disorders associated with thrombotic pathology, such as angina pain, deep vein thrombosis, and sepsis. PMID:20185792

  1. Reducing Class Size: A Smart Way To Improve America's Urban Schools. Second Edition.

    ERIC Educational Resources Information Center

    Naik, Manish; Casserly, Michael; Uro, Gabriela

    The Council of the Great City Schools, a coalition of the largest urban public schools in the United States, surveyed its membership to determine how they were using federal class size reduction funds in the 2000-2001 school year. Thirty-six major urban school systems responded. Results indicate that the federal class size reduction program is…

  2. Ecological constraints on sensory systems: compound eye size in Daphnia is reduced by resource limitation.

    PubMed

    Brandon, Christopher S; Dudycha, Jeffry L

    2014-08-01

    Eye size is an indicator of visual capability, and macroevolutionary patterns reveal that taxa inhabiting dim environments have larger eyes than taxa from bright environments. This suggests that the light environment is a key driver of variation in eye size. Yet other factors not directly linked with visual tasks (i.e., non-sensory factors) may influence eye size. We sought to jointly investigate the roles of sensory (light) and non-sensory factors (food) in determining eye size and ask whether non-sensory factors could constrain visual capabilities. We tested environmental influences on eye size in four species of the freshwater crustacean Daphnia, crossing bright and dim light levels with high and low resource levels. We measured absolute eye size and eye size relative to body size in early and late adulthood. In general, Daphnia reared on low resources had smaller eyes, both absolutely and relatively. In contrast to the dominant macroevolutionary pattern, phenotypic plasticity in response to light was rarely significant. These patterns of phenotypic plasticity were true for overall diameter of the eye and the diameter of individual facets. We conclude that non-sensory environmental factors can influence sensory systems, and in particular, that resource availability may be an important constraint on visual capability.

  3. Reducing Class Size: A Smart Way To Improve America's Urban Schools. Second Edition.

    ERIC Educational Resources Information Center

    Naik, Manish; Casserly, Michael; Uro, Gabriela

    The Council of the Great City Schools, a coalition of the largest urban public schools in the United States, surveyed its membership to determine how they were using federal class size reduction funds in the 2000-2001 school year. Thirty-six major urban school systems responded. Results indicate that the federal class size reduction program is…

  4. Living in stable social groups is associated with reduced brain size in woodpeckers (Picidae).

    PubMed

    Fedorova, Natalia; Evans, Cara L; Byrne, Richard W

    2017-03-01

    Group size predicts brain size in primates and some other mammal groups, but no such relationship has been found in birds. Instead, stable pair-bonding and bi-parental care have been identified as correlates of larger brains in birds. We investigated the relationship between brain size and social system within the family Picidae, using phylogenetically controlled regression analysis. We found no specific effect of duration or strength of pair-bonds, but brain sizes were systematically smaller in species living in long-lasting social groups of larger sizes. Group-living may only present a cognitive challenge in groups in which members have individually competitive relationships; we therefore propose that groups functioning for cooperative benefit may allow disinvestment in expensive brain tissue.

  5. Evaluation of the thrombus of abdominal aortic aneurysms using contrast enhanced ultrasound - preliminary results

    NASA Astrophysics Data System (ADS)

    Łukasiewicz, Adam; Garkowski, Adam; Rutka, Katarzyna; Janica, Jacek; Łebkowska, Urszula

    2016-09-01

    It is hypothesized that the degree of vascularization of the thrombus may have a significant impact on the rupture of aortic aneurysms. The presence of neovascularization of the vessel wall and mural thrombus has been confirmed only in histopathological studies. However, no non-invasive imaging technique of qualitative assessment of thrombus and neovascularization has been implemented so far. Contrast-enhanced ultrasound (CEUS) has been proposed as a feasible and minimally invasive technique for in vivo visualization of neovascularization in the evaluation of tumors and atherosclerotic plaques. The aim of this study was the evaluation of mural thrombus and AAAs wall with CEUS. CEUS was performed in a group of seventeen patients with AAAs. The mural thrombus enhancement was recognized in 12 cases, yet no significant correlation between the degree of contrast enhancement and AAAs diameter, thrombus width, and thrombus echogenicity was found. We observed a rise in AAAs thrombus heterogeneity with the increase in the aneurysm diameter (r = 0.62, p = 0.017). In conclusion CEUS can visualize small channels within AAAs thrombus, which could be a result of an ongoing angiogenesis. There is a need for further research to find out whether the degree of vascularization of the thrombus may have a significant impact on the rupture of aneurysms.

  6. Impact of thrombus aspiration during ST-Elevation Myocardial Infarction: a six month composite endpoint and risk of stroke analyses of the TASTE trial.

    PubMed

    Olivecrona, Göran K; Lagerqvist, Bo; Fröbert, Ole; Gudnason, Thórarinn; Maeng, Michael; Råmunddal, Truls; Haupt, Jan; Kellerth, Thomas; Stewart, Jason; Sarno, Giovanna; Jensen, Jens; Östlund, Ollie; James, Stefan K

    2016-04-01

    Routine thrombus aspiration during primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) did not reduce the primary composite endpoint in the "A Randomised Trial of Routine Aspiration ThrOmbecTomy With PCI Versus PCI ALone in Patients With STEMI Undergoing Primary PCI" (TOTAL) trial. We aimed to analyse a similar endpoint in "The Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia" (TASTE) trial up to 180 days. In TASTE, 7244 patients with STEMI were randomised to thrombus aspiration followed by PCI or to PCI alone. We analysed the quadruple composite endpoint of cardiovascular death, cardiogenic shock, rehospitalisation for myocardial infarction, or new hospitalisation for heart failure. Furthermore, an extended net-benefit composite endpoint including stent thrombosis, target vessel revascularization or stroke within 180 days was analysed. The primary quadruple composite endpoint occurred in 8.7 % (316 of 3621) in the thrombus aspiration group compared to 9.3 % (338 of 3623) in the PCI alone group (hazard ratio (HR), 0.93; 95 % confidence interval (CI); 0.80 - 1.09, P = 0.36) and the extended net-benefit composite endpoint in 12.0 % (436) vs. 13.2 % (479) (HR, 0.90; 95 % CI; 0.79 - 1.03, P = 0.12). Stroke within 30 days occurred in 0.7 % (27) vs. 0.7 % (24) (HR, 0.89; 95 % CI; 0.51-1.54, P = 0.68). A large and an extended composite endpoint analysis from the TASTE trial did not demonstrate any clinical benefit of routine thrombus aspiration during PCI in patients with STEMI. There was no evidence of an increased risk of stroke with thrombus aspiration.

  7. Real-Time Observation of Thrombus Growth Process in an Impeller of a Hydrodynamically Levitated Centrifugal Blood Pump by Near-Infrared Hyperspectral Imaging.

    PubMed

    Sakota, Daisuke; Murashige, Tomotaka; Kosaka, Ryo; Fujiwara, Tatsuki; Nishida, Masahiro; Maruyama, Osamu

    2015-08-01

    Understanding the thrombus formation in cardiovascular devices such as rotary blood pumps is the most important issue in developing more hemocompatible devices. The objective of this study was to develop a hyperspectral imaging (HSI) method to visualize the thrombus growth process within a rotary blood pump and investigate the optical properties of the thrombus. An in vitro thrombogenic test was conducted using fresh porcine blood and a specially designed hydrodynamically levitated centrifugal blood pump with a transparent bottom. The pump rotating at 3000 rpm circulated the blood at 1.0 L/min. The bottom surface of the pump was illuminated with white light pulsed at the same frequency as the pump rotation, and the backward-scattered light was imaged using the HSI system. Using stroboscopic HSI and an image construction algorithm, dynamic spectral imaging at wavelengths ranging from 608 to 752 nm within the rotating pump was achieved. After completing the experiment, we collected the red thrombus formed in the pump impeller and quantified the thrombus hemoglobin concentration (Hbthrombus ). The spectrum changed around the center of the impeller, and the area of change expanded toward the impeller flow path. The shape corresponded approximately to the shape of the thrombus. The spectrum change indicated that the light scattering derived from red blood cells decreased. The Hbthrombus was 4.7 ± 1.3 g/dL versus a total hemoglobin of 13 ± 0.87 g/dL. The study revealed that Hbthrombus was reduced by the surrounding blood flow.

  8. Thrombus Volume Change Visualization after Endovascular Abdominal Aortic Aneurysm Repair

    NASA Astrophysics Data System (ADS)

    Maiora, Josu; García, Guillermo; Macía, Iván; Legarreta, Jon Haitz; Boto, Fernando; Paloc, Céline; Graña, Manuel; Abuín, Javier Sanchez

    A surgical technique currently used in the treatment of Abdominal Aortic Aneurysms (AAA) is the Endovascular Aneurysm Repair (EVAR). This minimally invasive procedure involves inserting a prosthesis in the aortic vessel that excludes the aneurysm from the bloodstream. The stent, once in place acts as a false lumen for the blood current to travel down, and not into the surrounding aneurysm sac. This procedure, therefore, immediately takes the pressure off the aneurysm, which thromboses itself after some time. Nevertheless, in a long term perspective, different complications such as prosthesis displacement or bloodstream leaks into or from the aneurysmatic bulge (endoleaks) could appear causing a pressure elevation and, as a result, increasing the danger of rupture. The purpose of this work is to explore the application of image registration techniques to the visual detection of changes in the thrombus in order to assess the evolution of the aneurysm. Prior to registration, both the lumen and the thrombus are segmented

  9. The role of von Willebrand factor in thrombus formation.

    PubMed

    Ruggeri, Zaverio M

    2007-01-01

    Von Willebrand factor (VWF) is a large multimeric glycoprotein produced in endothelial cells and megakaryocytes and present in subendothelial matrix, blood plasma and platelets. VWF mediates adhesion and aggregation of platelets at sites of vascular injury, processes that are critical for both haemostasis and thrombosis. Thrombus formation involves complex events that are influenced by different environmental conditions. Progress in understanding the structure and function of VWF and the mechanisms that underlie its interactions with platelets has led to important insight into the differentiation between normal haemostasis and pathological arterial thrombosis. The conventional view of signalling-induced platelet aggregation has recently been extended to include activation-independent aggregation. A novel mechanism has been demonstrated for initiating thrombus formation under high haemodynamic forces that involves alpha(IIb)beta(3)-independent platelet aggregation at the interface between immobilised and soluble VWF. This VWF-mediated process may be a key determinant of platelet accumulation in stenotic arteries leading to acute thrombotic occlusion.

  10. Left atrial appendage mass: is it always a thrombus?

    PubMed Central

    Guler, Adem; Kurkluoglu, Mustafa; Yesil, Fahri Gurkan; Tavlasoglu, Murat; Cingoz, Faruk

    2016-01-01

    Myxoma is the most common benign tumor of the heart, but it is very rare for it to originate from the left atrial appendage. Distinguishing between a mass, a thrombus, and a tumor in the body of the left atrium with preoperative transthoracic or transesophageal echocardiography is very difficult, even more so in patients with mitral valve disease and chronic atrial fibrillation. A 50-year-old male patient was admitted for surgery with the diagnosis of mitral stenosis and chronic atrial fibrillation. Transesophageal echocardiography demonstrated a mass attached to the wall of the left atrial appendage. Histopathological examination of the mass showed an image compatible with a myxoma. We hereby describe a case of a left atrial appendage myxoma mimicking a left atrial appendage thrombus. PMID:28096835

  11. Surgical Treatment for Thrombus Straddling a Patent Foramen Ovale

    PubMed Central

    de Oliveira, Marcos Aurélio Barboza; Sabbag, Amália Tieco da Rocha; Brandi, Antônio Carlos; dos Santos, Carlos Alberto; Botelho, Paulo Henrique Husseni; Patriarcha, Franz Andrei; Braile, Domingo M.

    2016-01-01

    We present a case of a 41-year-old female with deep vein thrombosis after abdominal surgery. The patient quickly developed severe pulmonary embolism and stroke representative of paradoxical embolism. Echocardiography showed a thrombus straddling a patent foramen ovale, which was confirmed intraoperatively. An accurate diagnosis and rapid treatment decisions are crucial for preventing patient deterioration in the form of new pulmonary embolisms or stroke. PMID:27982351

  12. A big floating thrombus in the common carotid artery.

    PubMed

    La Spada, Michele; Stilo, Francesco; Barillà, David; Spinelli, Francesco

    2011-11-01

    The management of the free-floating thrombus (FFT) is difficult, and it is unclear whether surgical or medical treatment is superior. The common carotid artery is rarely involved. An 80-year-old woman presented with right hand weakness and syncope. Ultrasound showed the presence of FFT in the left common carotid artery. A carotid endarterectomy with Dacron patch angioplasty was immediately performed without complications. In the presence of symptoms, the interventional management of FFT is advised.

  13. A jumping left atrial thrombus connected to a pulmonary vein thrombus using transthoracic echocardiography and 64-slice multi-detector computed tomography.

    PubMed

    Takeuchi, Hidekazu

    2015-03-01

    Few studies have reported the differences between transthoracic echocardiography (TTE) and 64-slice multidetector CT (64-MDCT) in identifying left atrium (LA) thrombi. I report the case of a 70 year old man with coronary artery disease and angina who was diagnosed with a thrombus in the left lower pulmonary vein extending to the LA using a non-invasive 64-MDCT scan and TTE. TTE was unable to clearly identify a thrombus in the pulmonary veins, whereas a 64-MDCT scan identified a thrombus in the pulmonary vein but was unable to detect a moving thrombus attached to the mitral valves. The 64-MDCT images of LA thrombi are smaller than those of TTE and the video created using TTE demonstrated a moving thrombus connected to the mitral valve, which was underdiagnosed by a 64-MDCT scan. This case illustrates the complementary role for both TTE and 64-MDCT in the noninvasive diagnosis of left atrial-pulmonary vein thrombi.

  14. Large Apical Thrombus in a Patient with Persistent Heart Failure and Hypereosinophilia: Löffler Endocarditis

    PubMed Central

    Cincin, A. Altug; Tanrikulu, M. Azra; Baskan, Ozdil; Agirbasli, Mehmet

    2008-01-01

    Idiopathic hypereosinophilic syndrome is an uncommon leukoproliferative systemic disorder characterized by the overproduction of eosinophils and poor prognosis. A major source of morbidity and mortality of this syndrome is the associated cardiac involvement represented by endocardial thickening and mural thrombi. We report a 64-year-old woman with persistent symptoms of heart failure despite standard medical therapy. Echocardiography revealed reduced left ventricular filling due to a large apical mass; an abnormal diastolic filling pattern was also noticed. Complete blood count revealed remarkable hypereosinophilia. Cardiac magnetic resonance imaging demonstrated an apical thrombus and intense linear enhancement of the endocardium, which were compatible with Löffler endocarditis. Medical therapy, including corticosteroids and anticoagulation, was initiated promptly. The symptoms improved as the peripheral hypereosinophilia resolved in 15 days. The patient was asymptomatic at the 1-year follow-up visit with complete regression of the apical thrombus and no evidence of restrictive cardiomyopathy. We report this case to draw attention to this particularly rare condition with poor prognosis since quick and accurate diagnosis and prompt initiation of therapy may improve symptoms and survival. PMID:18618193

  15. Selective endothelin a (ETA) receptor antagonist (BQ-123) reduces both myocardial infarct size and oxidant injury.

    PubMed

    Ozdemir, Ramazan; Parlakpinar, Hakan; Polat, Alaadin; Colak, Cemil; Ermis, Necip; Acet, Ahmet

    2006-02-15

    Endothelins (ET) can be considered stress-responsive regulators working in paracrine and autocrine fashion. It has been suggested that elevated levels of ET may be responsible for the low coronary re-flow phenomena. Ischemia-reperfusion (I/R) was shown to stimulate ET release in rat heart; however, the mechanism(s) of this effect has not been clarified. Therefore, this study was focused to investigate the effect of BQ-123, selective ETA receptor antagonist, on three aspects of myocardial ischemia-reperfusion (MI/R) injury: hemodynamic parameters, infarct size and oxidant-antioxidant status in the absence and presence of ET-1 in an vivo rat model. To produce MI/R, a branch of the descending left coronary artery was occluded for 30 min followed by 2h reperfusion. ECG changes, blood pressure (BP), and heart rate (HR) were measured before occlusion and continued both occlusion and reperfusion. Forty rats were randomly assigned to five groups equally: (1) sham-operated rats without coronary ligation, (2) I/R group, (3) I/R+BQ-123-treated group (10 microg/kg/min i.v.), (4) I/R+ET-treated group (25 ng/kg/min i.v.), (5) I/R+ET+BQ-123-treated group. The results are expressed as mean+/-S.E.M. In the ET-1 plus I/R group, the ratio between the infarcted area and area at risk 56+/-1% was significantly higher than I/R group (49+/-1%). In the BQ-123 group with or without exogenous ET-1 treatment in I/R group, this ratio was significantly lower at 40+/-2 and 37+/-1%, respectively. As compared to sham group, I/R increased lipid peroxidation whereas decreased nitric oxide (NO), glutathione (GSH), catalase (CAT) and superoxide dismutase (SOD) contents. This decreased antioxidant enzymatic defense could result in aggravated oxidative damage in I/R group rat hearts. ET-1 administration group showed severe oxidative damage. BQ-123 administrations to I/R group with or without ET-1 caused significantly decrease in lipid peroxidation and increased in SOD, CAT activities and NO generation

  16. Use of intradermal botulinum toxin to reduce sebum production and facial pore size.

    PubMed

    Shah, Anil R

    2008-09-01

    Review the safety profile and subjective efficacy of intradermal botulinum toxin type A in facial pore size and sebum production. Retrospective analysis of 20 patients. Twenty consecutive patients with a single application of intradermal botulinum toxin type A were examined: Patients (17/20) noted an improvement in sebum production and a decrease in pores size at 1 month after injection. No complications were observed, and 17/20 patients were satisfied with the procedure. Preliminary data suggests that intradermal botulinum toxin may play a role in decreasing sebum production. Further quantitive study may be necessary to determine effects of intradermal botulinum toxin on pore size.

  17. Predictions of Thrombus Formation Using Lattice Boltzmann Method

    NASA Astrophysics Data System (ADS)

    Tamagawa, Masaaki; Matsuo, Sumiaki

    This paper describes the prediction of index of thrombus formation in shear blood flow by computational fluid dynamics (CFD) with Lattice Boltzmann Method (LBM), applying to orifice-pipe blood flow and flow around a cylinder, which is simple model of turbulent shear stress in the high speed rotary blood pumps and complicated geometry of medical fluid machines. The results of the flow field in the orifice-pipe flow using LBM are compared with experimental data and those using finite difference method, and it is found that the reattachment length of the backward facing step flow is predicted as precise as that the experiment and the finite difference method. As for thrombus formation, from the computational data of flow around the cylinder in the channel, the thrombus formation (thickness) is estimated using (1) shear rate and adhesion force (effective distance) to the wall independently, and (2) shear rate function with adhesion force (effective distance), and it is found that the prediction method using shear rate function with adhesion force is more accurate than the method using the former one.

  18. Defective thrombus formation in mice lacking coagulation factor XII

    PubMed Central

    Renné, Thomas; Pozgajová, Miroslava; Grüner, Sabine; Schuh, Kai; Pauer, Hans-Ulrich; Burfeind, Peter; Gailani, David; Nieswandt, Bernhard

    2005-01-01

    Blood coagulation is thought to be initiated by plasma protease factor VIIa in complex with the membrane protein tissue factor. In contrast, coagulation factor XII (FXII)–mediated fibrin formation is not believed to play an important role for coagulation in vivo. We used FXII-deficient mice to study the contributions of FXII to thrombus formation in vivo. Intravital fluorescence microscopy and blood flow measurements in three distinct arterial beds revealed a severe defect in the formation and stabilization of platelet-rich occlusive thrombi. Although FXII-deficient mice do not experience spontaneous or excessive injury-related bleeding, they are protected against collagen- and epinephrine-induced thromboembolism. Infusion of human FXII into FXII-null mice restored injury-induced thrombus formation. These unexpected findings change the long-standing concept that the FXII-induced intrinsic coagulation pathway is not important for clotting in vivo. The results establish FXII as essential for thrombus formation, and identify FXII as a novel target for antithrombotic therapy. PMID:16009717

  19. Living in forest fragments reduces group cohesion in diademed sifakas (Propithecus diadema) in eastern Madagascar by reducing food patch size.

    PubMed

    Irwin, Mitchell T

    2007-04-01

    Forest fragmentation is thought to threaten primate populations, yet the mechanisms by which this occurs remain largely unknown. However, fragmentation is known to cause dietary shifts in several primate species, and links between food resource distribution and within-group spatial dynamics are well documented. Thus, fragmentation has the potential to indirectly affect spatial dynamics, and these changes may present additional stresses to fragmented populations. I present the results from a 12-month study of Propithecus diadema at Tsinjoarivo, eastern Madagascar, including two groups in fragments and two in continuous forest. Instantaneous data on activity and spatial position were collected during all-day focal animal follows. Fragment groups had much lower cohesion, being more likely to have no neighbor within 5 and 10 m. For continuous forest groups, cohesion was highest in the rainy season (when food patches are large) and lowest in winter (when the animals rely on small-crowned mistletoes), and the chance of having no neighbor within 5 m was positively correlated with mistletoe consumption. Thus their decreased cohesion in fragment groups is inferred to result from their increased reliance on mistletoes and other small resources, which causes them to spread out among multiple patches. This scenario is consistent with the reduced body mass of subordinate individuals (males and immatures) in fragments, and suggests the occurrence of steeper within-group fitness gradients. Further research is necessary to determine whether these patterns apply to other primates; however, since fragmentation tends to cause the loss of the largest trees, many primates in fragments may lose their largest food resources and undergo similar behavioral shifts.

  20. Aortic floating thrombus detected by computed tomography angiography incidentally: Five cases and a literature review.

    PubMed

    Yang, Shuyi; Yu, Jie; Zeng, Wenjuan; Yang, Liang; Teng, Lin; Cui, Yue; Shi, Heshui

    2017-04-01

    To analyze the findings of aortic floating thrombus (AFT) on computed tomography angiography (CTA) for a definitive, timely diagnosis and to select a reasonable management course to improve prognosis. We retrospectively analyzed imaging findings of 5 patients with AFT detected by CTA, including location, morphology, size, involved aortic segment, concomitant embolism, stent, and dynamic changes during the follow-up. Seven lesions were detected in the initial CTA studies of the 5 patients: 5 aortic intraluminal floating thrombi (3 patients) and 2 aortic in-stents floating thrombi (ASFTs; 2 patients). One aortic intraluminal floating thrombus was located in the right anterior wall of the ascending aorta and 2 in the aortic isthmus. Interval increasing in size of the splenic embolism and a new renal segmental artery embolism were noted in 1 patient after 7 days anticoagulation therapy. One ASFT was located in the original narrowing part of the aortic stent and another in the overlap of the stents. During the follow-up, some lesions disappeared, whereas the morphology and size varied in others. Four new ASFTs occurred. All the lesions were attached to the focal thickened inner walls of the stents with the free-floating portions along the direction of blood flow. AFT is a rare, life-threatening disease. Abnormal coagulation function, aortic disease, and history of aortic stent implantation are the potential predictors for AFT. CTA scanning can depict the lesions clearly and evaluate curative efficacy. The therapeutic strategy should be based on the etiology and the patient's physical condition, whereas the preferred treatment is conservative medication. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  1. Tree Size Inequality Reduces Forest Productivity: An Analysis Combining Inventory Data for Ten European Species and a Light Competition Model.

    PubMed

    Bourdier, Thomas; Cordonnier, Thomas; Kunstler, Georges; Piedallu, Christian; Lagarrigues, Guillaume; Courbaud, Benoit

    2016-01-01

    Plant structural diversity is usually considered as beneficial for ecosystem functioning. For instance, numerous studies have reported positive species diversity-productivity relationships in plant communities. However, other aspects of structural diversity such as individual size inequality have been far less investigated. In forests, tree size inequality impacts directly tree growth and asymmetric competition, but consequences on forest productivity are still indeterminate. In addition, the effect of tree size inequality on productivity is likely to vary with species shade-tolerance, a key ecological characteristic controlling asymmetric competition and light resource acquisition. Using plot data from the French National Geographic Agency, we studied the response of stand productivity to size inequality for ten forest species differing in shade tolerance. We fitted a basal area stand production model that included abiotic factors, stand density, stand development stage and a tree size inequality index. Then, using a forest dynamics model we explored whether mechanisms of light interception and light use efficiency could explain the tree size inequality effect observed for three of the ten species studied. Size inequality negatively affected basal area increment for seven out of the ten species investigated. However, this effect was not related to the shade tolerance of these species. According to the model simulations, the negative tree size inequality effect could result both from reduced total stand light interception and reduced light use efficiency. Our results demonstrate that negative relationships between size inequality and productivity may be the rule in tree populations. The lack of effect of shade tolerance indicates compensatory mechanisms between effect on light availability and response to light availability. Such a pattern deserves further investigations for mixed forests where complementarity effects between species are involved. When studying the

  2. Tree Size Inequality Reduces Forest Productivity: An Analysis Combining Inventory Data for Ten European Species and a Light Competition Model

    PubMed Central

    Bourdier, Thomas; Cordonnier, Thomas; Kunstler, Georges; Piedallu, Christian; Lagarrigues, Guillaume; Courbaud, Benoit

    2016-01-01

    Plant structural diversity is usually considered as beneficial for ecosystem functioning. For instance, numerous studies have reported positive species diversity-productivity relationships in plant communities. However, other aspects of structural diversity such as individual size inequality have been far less investigated. In forests, tree size inequality impacts directly tree growth and asymmetric competition, but consequences on forest productivity are still indeterminate. In addition, the effect of tree size inequality on productivity is likely to vary with species shade-tolerance, a key ecological characteristic controlling asymmetric competition and light resource acquisition. Using plot data from the French National Geographic Agency, we studied the response of stand productivity to size inequality for ten forest species differing in shade tolerance. We fitted a basal area stand production model that included abiotic factors, stand density, stand development stage and a tree size inequality index. Then, using a forest dynamics model we explored whether mechanisms of light interception and light use efficiency could explain the tree size inequality effect observed for three of the ten species studied. Size inequality negatively affected basal area increment for seven out of the ten species investigated. However, this effect was not related to the shade tolerance of these species. According to the model simulations, the negative tree size inequality effect could result both from reduced total stand light interception and reduced light use efficiency. Our results demonstrate that negative relationships between size inequality and productivity may be the rule in tree populations. The lack of effect of shade tolerance indicates compensatory mechanisms between effect on light availability and response to light availability. Such a pattern deserves further investigations for mixed forests where complementarity effects between species are involved. When studying the

  3. Massive Pulmonary Embolism: Treatment with Thrombus Fragmentation and Local Fibrinolysis with Recombinant Human-Tissue Plasminogen Activator

    SciTech Connect

    Stock, Klaus Wilhelm; Jacob, Augustinus Ludwig; Schnabel, Karl Jakob; Bongartz, Georg; Steinbrich, Wolfgang

    1997-09-15

    Purpose: To report the results of thrombus fragmentation in combination with local fibrinolysis using recombinant human-tissue plasminogen activator (rtPA) in patients with massive pulmonary embolism. Methods: Five patients with massive pulmonary embolism were treated with thrombus fragmentation followed by intrapulmonary injection of rtPA. Clot fragmentation was performed with a guidewire, angiographic catheter, and balloon catheter. Three patients had undergone recent surgery; one of them received a reduced dosage of rtPA. Results: All patients survived and showed clinical improvement with a resultant significant (p < 0.05) decrease in the pulmonary blood pressure (mean systolic pulmonary blood pressure before treatment, 49 mmHg; 4 hr after treatment, 28 mmHg). Angiographic follow-up in three patients revealed a decrease in thrombus material and an increase in pulmonary perfusion. Two patients developed retroperitoneal hematomas requiring transfusion. Conclusion: Clot fragmentation and local fibrinolysis with rtPA was an effective therapy for massive pulmonary embolism. Bleeding at the puncture site was a frequent complication.

  4. A novel embolic middle cerebral artery occlusion model induced by thrombus formed in common carotid artery in rat.

    PubMed

    Ma, Yin-Zhong; Li, Li; Song, Jun-Ke; Niu, Zi-Ran; Liu, Hai-Feng; Zhou, Xiang-Shan; Xie, Fu-Sheng; Du, Guan-Hua

    2015-12-15

    Stroke is a major cause of death and disability worldwide. However, treatment options to date are very limited. To meet the need for validating the novel therapeutic approaches and understanding the physiopathology of the ischemic brain injury, experimental stroke models were critical for preclinical research. However, commonly used embolic stroke models are reluctant to mimic the clinical situation and not suitable for thrombolytic timing studies. In this paper, we established a standard method for producing a rat embolic stroke model with autologous thrombus formed within the common carotid artery (CCA) by constant galvanic stimulation. Then the thrombus was shattered and channeled into the origin of the MCA and small (lacunar) artery. To identify the success of MCA occlusion, regional cerebral blood flow was monitored, neurological deficits and infarct volumes were measured at 2, 4 and 6h postischemia. This model developed a predictable infarct volume (38.37 ± 2.88%) and gradually reduced blood flow (20% of preischemic baselines) within the middle cerebral artery (MCA) territory. The thrombus occluded in the MCA was able to be lysed by a tissue-type plasminogen activator (t-PA) within 4h postischemia. The techniques presented in this paper would help investigators to overcome technical problems for stroke research.

  5. Prevention of occlusive arterial thrombus formation by a single loading dose of prasugrel suppresses neointimal hyperplasia in mice.

    PubMed

    Ohno, Kousaku; Tomizawa, Atsuyuki; Jakubowski, Joseph A; Mizuno, Makoto; Sugidachi, Atsuhiro

    2015-12-01

    The present study examined the effects of prasugrel in a mouse model of thrombosis-induced neointimal hyperplasia. Following carotid artery injury by application of ferric chloride solution, thrombus formation was assessed on Day 1 and neointimal thickening was assessed on Day 21. Single administrations of prasugrel at 0.3-3mg/kg (p.o.) resulted in a dose-related and sustained inhibition of ADP-induced platelet aggregation through 24h. Single and multiple (1 and 3 weeks) administration of prasugrel (3mg/kg loading and 1mg/kg/day maintenance doses) resulted in a marked inhibition of neointimal thickening in the injured artery. In the dose-response study, a single administration of prasugrel at 0.3-3mg/kg (p.o.) dose-relatedly inhibited thrombus formation and neointimal thickening on Days 1 and 21, respectively. The degree of neointimal hyperplasia in the injured artery correlated significantly with the thrombus indices, time to occlusion and patency rate. To explore possible mechanisms of inhibition of neointimal hyperplasia by prasugrel, mRNA expression levels of inflammatory and fibrosis markers were determined in injured arteries. Prasugrel treatment resulted in reduced MCP-1, ICAM-1 and TGF-β mRNA levels on Day 2 (24h after the injury) and Day 8 (1 week after the injury) in the target arteries. In conclusion, we found that a single oral loading dose of prasugrel markedly prevented neointimal hyperplasia by inhibiting platelet activation and thrombus formation and was associated with inhibition of the expression of inflammatory and fibrosis markers, including MCP-1, ICAM-1 and TGF-β, in the injured arteries. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Acarbose reduces myocardial infarct size by preventing postprandial hyperglycemia and hydroxyl radical production and opening mitochondrial KATP channels in rabbits.

    PubMed

    Minatoguchi, Shinya; Zhang, Zengi; Bao, Narentuoya; Kobayashi, Hiroyuki; Yasuda, Shinji; Iwasa, Masamitsu; Sumi, Syouhei; Kawamura, Itta; Yamada, Yoshihisa; Nishigaki, Kazuhiko; Takemura, Genzou; Fujiwara, Takako; Fujiwara, Hisayoshi

    2009-07-01

    Acarbose, an antidiabetic drug, is an alpha-glucosidase inhibitor that can inhibit glucose absorption in the intestine. A recent large-scale clinical trial, STOP-NIDDM, showed that acarbose reduces the risk of myocardial infarction. We examined whether acarbose reduces myocardial infarct size and investigated its mechanisms. Rabbits were fed with 1 of 2 diets in this study: normal chow, 30 mg acarbose per 100 g chow for 7 days. Rabbits were assigned randomly to 1 of 4 groups: control (n = 10), acarbose (n = 10), acarbose + 5HD (n = 10, intravenous 5 mg/kg of 5-hydroxydecanoate), and 5HD (n = 10, intravenous 5 mg/kg of 5HD). Rabbits then underwent 30 minutes of coronary occlusion followed by 48-hour reperfusion. Postprandial blood glucose levels were higher in the control group than in the acarbose group. The infarct size as a percentage of the left ventricular area at risk was reduced significantly in the acarbose (19.4% +/- 2.3%) compared with the control groups (42.8% +/- 5.4%). The infarct size-reducing effect of acarbose was abolished by 5HD (43.4% +/- 4.7%). Myocardial interstitial 2,5-dihydroxybenzoic acid levels, an indicator of hydroxyl radicals, increased during reperfusion after 30 minutes of ischemia, but this increase was inhibited in the acarbose group. This was reversed by 5HD. Acarbose reduces myocardial infarct size by opening mitochondrial KATP channels, which may be related to the prevention of postprandial hyperglycemia and hydroxyl radical production.

  7. Reducing bias in rainfall estimates from microwave links by considering variable drop size distribution

    NASA Astrophysics Data System (ADS)

    Fencl, Martin; Jörg, Rieckermann; Vojtěch, Bareš

    2015-04-01

    Commercial microwave links (MWL) are point-to-point radio systems which are used in backhaul networks of cellular operators. For several years, they have been suggested as rainfall sensors complementary to rain gauges and weather radars, because, first, they operate at frequencies where rain drops represent significant source of attenuation and, second, cellular networks almost completely cover urban and rural areas. Usually, path-average rain rates along a MWL are retrieved from the rain-induced attenuation of received MWL signals with a simple model based on a power law relationship. The model is often parameterized based on the characteristics of a particular MWL, such as frequency, polarization and the drop size distribution (DSD) along the MWL. As information on the DSD is usually not available in operational conditions, the model parameters are usually considered constant. Unfortunately, this introduces bias into rainfall estimates from MWL. In this investigation, we propose a generic method to eliminate this bias in MWL rainfall estimates. Specifically, we search for attenuation statistics which makes it possible to classify rain events into distinct groups for which same power-law parameters can be used. The theoretical attenuation used in the analysis is calculated from DSD data using T-Matrix method. We test the validity of our approach on observations from a dedicated field experiment in Dübendorf (CH) with a 1.85-km long commercial dual-polarized microwave link transmitting at a frequency of 38 GHz, an autonomous network of 5 optical distrometers and 3 rain gauges distributed along the path of the MWL. The data is recorded at a high temporal resolution of up to 30s. It is further tested on data from an experimental catchment in Prague (CZ), where 14 MWLs, operating at 26, 32 and 38 GHz frequencies, and reference rainfall from three RGs is recorded every minute. Our results suggest that, for our purpose, rain events can be nicely characterized based on

  8. Increasing age and tear size reduce rotator cuff repair healing rate at 1 year.

    PubMed

    Rashid, Mustafa S; Cooper, Cushla; Cook, Jonathan; Cooper, David; Dakin, Stephanie G; Snelling, Sarah; Carr, Andrew J

    2017-09-07

    Background and purpose - There is a need to understand the reasons why a high proportion of rotator cuff repairs fail to heal. Using data from a large randomized clinical trial, we evaluated age and tear size as risk factors for failure of rotator cuff repair. Patients and methods - Between 2007 and 2014, 65 surgeons from 47 hospitals in the National Health Service (NHS) recruited 447 patients with atraumatic rotator cuff tendon tears to the United Kingdom Rotator Cuff Trial (UKUFF) and 256 underwent rotator cuff repair. Cuff integrity was assessed by imaging in 217 patients, at 12 months post-operation. Logistic regression analysis was used to determine the influence of age and intra-operative tear size on healing. Hand dominance, sex, and previous steroid injections were controlled for. Results - The overall healing rate was 122/217 (56%) at 12 months. Healing rate decreased with increasing tear size (small tears 66%, medium tears 68%, large tears 47%, and massive tears 27% healed). The mean age of patients with a healed repair was 61 years compared with 64 years for those with a non-healed repair. Mean age increased with larger tear sizes (small tears 59 years, medium tears 62 years, large tears 64 years, and massive tears 66 years). Increasing age was an independent factor that negatively influenced healing, even after controlling for tear size. Only massive tears were an independent predictor of non-healing, after controlling for age. Interpretation - Although increasing age and larger tear size are both risks for failure of rotator cuff repair healing, age is the dominant risk factor.

  9. Reduced-size microchips for identification of horses: response to implantation and readability during a six-month period.

    PubMed

    Wulf, M; Aurich, C; von Lewinski, M; Möstl, E; Aurich, J E

    2013-11-09

    In this study, readability of reduced-size microchips in horses and the response to implantation were analysed. It was hypothesised that small microchips can be implanted stress-free but are less readable than larger microchips. Adult mares (n=40) were implanted with a reduced-size microchip (10.9×1.6 mm) at the left side of the neck (size of conventional microchips 11.4×2.2 mm). Microchips were identified with three different scanners (A, B, C) immediately, and at 6, 12 and 28 weeks after implantation. Twelve out of the 40 mares were submitted to microchip implantation and control treatments and cortisol, heart rate and heart rate variability (HRV) were determined. From the chip-bearing side of the neck, microchips were identified with all scanners in all horses at all times. From the contralateral side, correct readings were always 100 per cent with scanner C and with scanners A and B ranged between 60 and 100 per cent. Heart rate and HRV variable sd of beat-to-beat interval increased slightly (P<0.01) at microchip implantation and control treatment, but cortisol concentration did not increase. In conclusion, reduced-size microchips are highly reliable for identification of horses. Compared with conventional microchips, the reduction in size did not impair readability. Microchip implantation is no pronounced stressor for horses.

  10. Structure of von Willebrand factor and its function in platelet adhesion and thrombus formation.

    PubMed

    Ruggeri, Z M

    2001-06-01

    The adhesive protein von Willebrand factor mediates the initiation and progression of thrombus formation at sites of vascular injury. von Willebrand factor is synthesized in endothelial cells and megakaryocytes as a very large polymer composed of identical subunits. In the plasma, it appears as a series of multimers of regularly decreasing molecular mass, from several thousand to 500 kDa. The size of circulating von Willebrand factor multimers is controlled by proteolytic cleavage carried out by a specific protease. The biological functions of von Willebrand factor are exerted through specific domains that interact with extracellular matrix components and cell membrane receptors to promote the initial tethering and adhesion of platelets to subendothelial surfaces, as well as platelet aggregation. Moreover, von Willebrand factor binds the procoagulant co-enzyme, factor VIII, contributing to its stability and, indirectly, to its function in the generation of fibrin. This chapter presents a review of current knowledge on the structure, biosynthesis and functions of von Willebrand factor.

  11. Motor-Reducer Sizing through a MATLAB-Based Graphical Technique

    ERIC Educational Resources Information Center

    Giberti, H.; Cinquemani, S.

    2012-01-01

    The design of the drive system for an automatic machine and its correct sizing is a very important competence for an electrical or mechatronic engineer. This requires knowledge that crosses the fields of electrical engineering, electronics and mechanics, as well as the skill to choose commercial components based upon their technical documentation.…

  12. Size sorting of citrate reduced gold nanoparticles by sedimentation field-flow fractionation.

    PubMed

    Contado, Catia; Argazzi, Roberto

    2009-12-25

    Gold nanoparticles (GNPs) have been synthesized through the citrate reduction method; the citrate/gold(III) ratio was changed from 1:1 up to 10:1 and the size of the resulting nanoparticles was measured by sedimentation field-flow fractionation (SdFFF). Experimental data showed that the GNPs size decreases in the ratio range 1:1-3:1 and then increases from 5:1 to 10:1 passing through a plateau region in between, and is almost independent of the precursor solution concentrations. In the zone of minimum diameters the synthetic process does not produce monodispersed GNPs but often multiple distributions, very close in size, are observed as evidenced by the particle size distributions (PSDs) derived from the SdFFF fractograms. UV-vis spectrophotometry, being the most common technique employed in the optical characterization of nanoparticles suspensions, was used throughout this work. A confirmation of the nucleation-aggregation-fragmentation mechanism was inferred from the cross-correlation between UV-vis and SdFFF results.

  13. Winter grazing can reduce wildfire size, intensity, and behavior in a shrub-grassland

    USDA-ARS?s Scientific Manuscript database

    1. An increase in mega-fires and wildfires in general is a global issue that is expected to become worse with climate change. Fuel treatments are often recommended to decrease the risk, size, intensity, and severity of wildfires; however, the extensive nature of rangelands limits the use of many po...

  14. Motor-Reducer Sizing through a MATLAB-Based Graphical Technique

    ERIC Educational Resources Information Center

    Giberti, H.; Cinquemani, S.

    2012-01-01

    The design of the drive system for an automatic machine and its correct sizing is a very important competence for an electrical or mechatronic engineer. This requires knowledge that crosses the fields of electrical engineering, electronics and mechanics, as well as the skill to choose commercial components based upon their technical documentation.…

  15. Ex vivo Time Evolution of Thrombus Growth through Optical and Electrical Impedance data fusion

    NASA Astrophysics Data System (ADS)

    Affanni, A.; Specogna, R.; Trevisan, F.

    2013-09-01

    We designed a novel sensor specifically aimed at ex vivo measurements of white thrombus volume growth; a white thrombus is induced within an artificial micro-channel where hemostasis takes place starting from whole blood under flow conditions. The advantage of the proposed methodology is to identify the time evolution of the thrombus volume by means of an original data fusion methodology based on 2D optical and electrical impedance data simultaneously processed. On the contrary, the present state of the art optical imaging methodologies allow the thrombus volume estimation only at the end of the hemostatic process.

  16. 30 CFR 203.76 - When might BSEE withdraw or reduce the approved size of my relief?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Oil, Gas, and Sulfur General § 203.76 When might BSEE withdraw or reduce the approved size of my... our approval, we will withdraw the relief we granted. (c) Your actual development costs are less than 80 percent of the eligible development costs estimated in your application's most likely scenario...

  17. Brokering Dialogue between Secondary Students and Teachers to Co-Construct Appropriate Pedagogy in Reduced-Size Classes

    ERIC Educational Resources Information Center

    Harfitt, Gary James

    2014-01-01

    This study focuses on how two teachers working in reduced-size secondary classes of the same grade adapted their pedagogy as a result of a brokered dialogue between myself as researcher and 43 grade 10 students from the teachers' classes. Research was carried out over the course of one academic year. First, students' perspectives on studying in a…

  18. BIOREACTOR ECONOMICS, SIZE AND TIME OF OPERATION (BEST) COMPUTER SIMULATOR FOR DESIGNING SULFATE-REDUCING BACTERIA FIELD BIOREACTORS

    EPA Science Inventory

    BEST (bioreactor economics, size and time of operation) is an Excel™ spreadsheet-based model that is used in conjunction with the public domain geochemical modeling software, PHREEQCI. The BEST model is used in the design process of sulfate-reducing bacteria (SRB) field bioreacto...

  19. Testing Probation Outcomes in an Evidence-Based Practice Setting: Reduced Caseload Size and Intensive Supervision Effectiveness

    ERIC Educational Resources Information Center

    Jalbert, Sarah Kuck; Rhodes, William; Flygare, Christopher; Kane, Michael

    2010-01-01

    Probation and parole professionals argue that supervision outcomes would improve if caseloads were reduced below commonly achieved standards. Criminal justice researchers are skeptical because random assignment and strong observation studies have failed to show that criminal recidivism falls with reductions in caseload sizes. One explanation is…

  20. Testing Probation Outcomes in an Evidence-Based Practice Setting: Reduced Caseload Size and Intensive Supervision Effectiveness

    ERIC Educational Resources Information Center

    Jalbert, Sarah Kuck; Rhodes, William; Flygare, Christopher; Kane, Michael

    2010-01-01

    Probation and parole professionals argue that supervision outcomes would improve if caseloads were reduced below commonly achieved standards. Criminal justice researchers are skeptical because random assignment and strong observation studies have failed to show that criminal recidivism falls with reductions in caseload sizes. One explanation is…

  1. BIOREACTOR ECONOMICS, SIZE AND TIME OF OPERATION (BEST) COMPUTER SIMULATOR FOR DESIGNING SULFATE-REDUCING BACTERIA FIELD BIOREACTORS

    EPA Science Inventory

    BEST (bioreactor economics, size and time of operation) is an Excel™ spreadsheet-based model that is used in conjunction with the public domain geochemical modeling software, PHREEQCI. The BEST model is used in the design process of sulfate-reducing bacteria (SRB) field bioreacto...

  2. The Cumulative Effects of Indiana PRIME TIME: A State Sponsored Reduced Class Size Program, on Basic Skills Achievement.

    ERIC Educational Resources Information Center

    Malloy, Leanne; Gilman, David

    The purpose of this paper was to analyze the initial results of statewide implementation of the PRIME TIME program in Indiana. PRIME TIME is a state-wide program to reduce class size in the primary grades. Mean scores from 65,911 third graders who had completed the Indiana Competency Test in the spring of 1987 after completing 3 years of the…

  3. Size inequality in regenerating yellow birch stands is reduced by elevated CO[sub 2] atmospheres

    SciTech Connect

    Wayne, P.W.; Bazzaz, F.A. )

    1994-06-01

    Dense stands of yellow birch (Betula alleghaniensis) seedlings comprised of equal numbers of three maternal families were established in forest soil profiles in low (350 [mu]l l[sup [minus]1]) and high (700 [mu]l l[sup [minus]1]) CO[sub 2] atmospheres in a glasshouse. In both CO[sub 2] treatments, seedling size inequality (% CV) within stands increased through time with total with total stand biomass. However, while stands in high CO[sub 2] maintained greater final above and below ground biomass than stands at low CO[sub 2], inequalities in total seedling mass, shoot height, and leaf area were significantly lower in high CO[sub 2] throughout the growing season. This effect of elevated CO[sub 2] on stand development differs from the effects of other resources additions (e.g. light, nutrients) which generally increase inter-individual size inequality. Lower size inequalities in high CO[sub 2] may have occurred because sub-canopy plants in low light exhibited greater proportional responsiveness to elevated CO[sub 2] than did canopy plants in high light. Other studies with yellow birch suggest CO[sub 2]-induced photosynthetic and growth enhancements are proportionally greater at low vs. high light. Hypothesis which may explain greater CO[sub 2] enhancements at low light are presented. Strong correlations were found between individuals' final positions in stand size hierarchies and seedlings' initial sizes and abilities to preempt light and soil nutrients. The three maternal lines differed in their responsiveness to elevated CO[sub 2], and thus contributed differently to total stand biomass in the two CO[sub 2] treatments.

  4. Delayed Treatment With Hypothermia Protects Against the No‐Reflow Phenomenon Despite Failure to Reduce Infarct Size

    PubMed Central

    Hale, Sharon L.; Herring, Michael J.; Kloner, Robert A.

    2013-01-01

    Background Many studies have shown that when hypothermia is started after coronary artery reperfusion (CAR), it is ineffective at reducing necrosis. However, some suggest that hypothermia may preferentially reduce no‐reflow. Our aim was to test the effects of hypothermia on no‐reflow when initiated close to reperfusion and 30 minutes after reperfusion, times not associated with a protective effect on myocardial infarct size. Methods and Results Rabbits received 30 minutes coronary artery occlusion/3 hours CAR. In protocol 1, hearts were treated for 1 hour with topical hypothermia (myocardial temperature ≈32°C) initiated at 5 minutes before or 5 minutes after CAR, and the results were compared with a normothermic group. In protocol 2, hypothermia was delayed until 30 minutes after CAR and control hearts remained normothermic. In protocol 1, risk zones were similar and infarct size was not significantly reduced by hypothermia initiated close to CAR. However, the no‐reflow defect was significantly reduced by 43% (5 minutes before CAR) and 38% (5 minutes after CAR) in hypothermic compared with normothermic hearts (P=0.004, ANOVA, P=ns between the 2 treated groups). In protocol 2, risk zones and infarct sizes were similar, but delayed hypothermia significantly reduced no‐reflow in hypothermic hearts by 30% (55±6% of the necrotic region in hypothermia group versus 79±6% with normothermia, P=0.008). Conclusion These studies suggest that treatment with hypothermia reduces no‐reflow even when initiated too late to reduce infarct size and that the microvasculature is especially receptive to the protective properties of hypothermia and confirm that microvascular damage is in large part a form of true reperfusion injury. PMID:23525431

  5. Faltering lemming cycles reduce productivity and population size of a migratory Arctic goose species.

    PubMed

    Nolet, Bart A; Bauer, Silke; Feige, Nicole; Kokorev, Yakov I; Popov, Igor Yu; Ebbinge, Barwolt S

    2013-07-01

    The huge changes in population sizes of Arctic-nesting geese offer a great opportunity to study population limitation in migratory animals. In geese, population limitation seems to have shifted from wintering to summering grounds. There, in the Arctic, climate is rapidly changing, and this may impact reproductive performance, and perhaps population size of geese, both directly (e.g. by changes in snow melt) or indirectly (e.g. by changes in trophic interactions). Dark-bellied brent geese (Branta bernicla bernicla L.) increased 20-fold since the 1950s. Its reproduction fluctuates strongly in concert with the 3-year lemming cycle. An earlier analysis, covering the growth period until 1988, did not find evidence for density dependence, but thereafter the population levelled off and even decreased. The question is whether this is caused by changes in lemming cycles, population density or other factors like carry-over effects. Breeding success was derived from proportions of juveniles. We used an information-theoretical approach to investigate which environmental factors best explained the variation in breeding success over nearly 50 years (1960-2008). We subsequently combined GLM predictions of breeding success with published survival estimates to project the population trajectory since 1991 (year of maximum population size). In this way, we separated the effects of lemming abundance and population density on population development. Breeding success was mainly dependent on lemming abundance, the onset of spring at the breeding grounds, and the population size of brent goose. No evidence was found for carry-over effects (i.e. effects of conditions at main spring staging site). Negative density dependence was operating at a population size above c. 200 000 individuals, but the levelling off of the population could be explained by faltering lemming cycles alone. Lemmings have long been known to affect population productivity of Arctic-nesting migratory birds and, more

  6. Faltering lemming cycles reduce productivity and population size of a migratory Arctic goose species

    PubMed Central

    Nolet, Bart A; Bauer, Silke; Feige, Nicole; Kokorev, Yakov I; Popov, Igor Yu; Ebbinge, Barwolt S

    2013-01-01

    1. The huge changes in population sizes of Arctic-nesting geese offer a great opportunity to study population limitation in migratory animals. In geese, population limitation seems to have shifted from wintering to summering grounds. There, in the Arctic, climate is rapidly changing, and this may impact reproductive performance, and perhaps population size of geese, both directly (e.g. by changes in snow melt) or indirectly (e.g. by changes in trophic interactions). 2. Dark-bellied brent geese (Branta bernicla bernicla L.) increased 20-fold since the 1950s. Its reproduction fluctuates strongly in concert with the 3-year lemming cycle. An earlier analysis, covering the growth period until 1988, did not find evidence for density dependence, but thereafter the population levelled off and even decreased. The question is whether this is caused by changes in lemming cycles, population density or other factors like carry-over effects. 3. Breeding success was derived from proportions of juveniles. We used an information-theoretical approach to investigate which environmental factors best explained the variation in breeding success over nearly 50 years (1960–2008). We subsequently combined GLM predictions of breeding success with published survival estimates to project the population trajectory since 1991 (year of maximum population size). In this way, we separated the effects of lemming abundance and population density on population development. 4. Breeding success was mainly dependent on lemming abundance, the onset of spring at the breeding grounds, and the population size of brent goose. No evidence was found for carry-over effects (i.e. effects of conditions at main spring staging site). Negative density dependence was operating at a population size above c. 200 000 individuals, but the levelling off of the population could be explained by faltering lemming cycles alone. 5. Lemmings have long been known to affect population productivity of Arctic-nesting migratory

  7. Fibrin-Targeted Magnetic Resonance Imaging Allows In Vivo Quantification of Thrombus Fibrin Content and Identifies Thrombi Amenable for Thrombolysis

    PubMed Central

    Jenkins, Julia; Modarai, Bijan; Wiethoff, Andrea J.; Phinikaridou, Alkystis; Grover, Steven P.; Patel, Ashish S.; Schaeffter, Tobias; Smith, Alberto; Botnar, Rene M.

    2014-01-01

    Objective Deep venous thrombosis is a major health problem. Thrombolytic therapies are effective in recanalizing the veins and preventing post-thrombotic complications, but there is no consensus on selection criteria. The aim of this study was to investigate a fibrin-specific MRI contrast agent (EP-2104R) for the accurate quantification of thrombus’ fibrin content in vivo and for the identification of thrombus suitable for thrombolysis. Approach and Results Venous thrombosis was induced in the inferior vena cava of 8- to 10-week-old male BALB/C mice and MRI performed 2, 4, 7, 10, 14, and 21 days later. Eighteen mice were scanned at each time point pre and 2 hours post injection of EP-2104R (8.0 μmol/kg) with 12 mice at each time point used to correlate fibrin contrast uptake with thrombus’ histological stage and fibrin content. Six mice at each time point were immediately subjected to intravascular thrombolytic therapy (10 mg/kg of tissue-type plasminogen activator). Mice were imaged to assess response to lytic therapy 24 hours after thrombolytic treatment. Two mice at each time point were scanned post injection of 0.2 mmol/kg of Gd-DTPA (gadolinium with diethylenetriaminepentacetate, Magnevist, Schering AG, Berlin, Germany) for control purpose. Contrast uptake was correlated positively with the fibrin content of the thrombus measured by Western blotting (R2=0.889; P<0.001). Thrombus relaxation rate (R1) post contrast and the change in visualized thrombus size on late gadolinium enhancement inversion recovery MRI pre–EP-2104R and post–EP-2104R injection were the best predictors for successful thrombolysis (area under the curve, 0.989 [95% confidence interval, 0.97–1.00] and 0.994 [95% confidence interval, 0.98–1.00] respectively). Conclusions MRI with a fibrin-specific contrast agent accurately estimates thrombus fibrin content in vivo and identifies thrombi that are amenable for thrombolysis. PMID:24723557

  8. Reduced-size plutonium sample processing and packaging for the PAT-2 package

    SciTech Connect

    Kuhn, E.; Deron, S.; Aigner, H.; Andersen, J.A.

    1982-01-01

    A light-water container for the air transport of plutonium safeguards samples, the PAT-2 package, has been developed in the USA and is now licensed by the US NRC (Certificate of Compliance) and the US DOT (IAEA Certificate of Competent Authority). The very limited available space in this package for plutonium-bearing samples required the design of small-size canisters to meet the needs of international safeguards. The suitability of a new small canister and vial for powder and solution samples has been tested in an intralaboratory experiment. The results of the experiment, based on the concept of pre-weighed samples, show that the tested canister and quartz vial can be used successfully for containing small size PuO/sub 2/ powder samples of homogeneous source material, as well as for dried aliguands of plutonium nitrate solutions.

  9. Cryptic female choice: frogs reduce clutch size when amplexed by undesired males.

    PubMed

    Reyer, H U; Frei, G; Som, C

    1999-10-22

    In species with internal fertilization, females can 'cryptically' choose (e.g. through sperm selection) which individuals sire their offspring, even when their overt preferences for copulatory partners are overrun by male-male competition and sexual coercion. The experiment presented here reveals that control of paternity after copulation has begun is also possible in species with external fertilization. Females of the hybridogenetic Rana essonae-Rana esculenta (LL-LR) waterfrog complex adjust their clutch size in response to mate type: they release fewer eggs when amplexed by hybrid LR males who--jeopardize successful reproduction--than when amplexed by parental LL males. This reduction in the number of eggs laid can increase a female's residual reproductive value through a second mating in the same breeding season or a larger clutch size in the next year. We argue that cryptic female choice through clutch size adjustment (i) may have evolved more often than previously assumed, and (ii) can arise even where females mate only once during a reproductive period.

  10. Bland thrombus association with tumour thrombus in renal cell carcinoma: analysis of surgical significance and role of inferior vena caval interruption.

    PubMed

    Ayyathurai, Rajinikanth; Garcia-Roig, Michael; Gorin, Michael A; González, Javier; Manoharan, Murugesan; Kava, Bruce R; Soloway, Mark S; Ciancio, Gaetano

    2012-12-01

    What's known on the subject? and What does the study add? The surgical implications of renal cell carcinoma with coexisting bland and tumour thrombi of the inferior vena cava is not well described. In this study we review our experience managing these tumours. On multivariate analysis, we found that the presence of bland thrombus was associated with an increased need for surgical interruption of the inferior vena cava. • To study the role of interruption of the inferior vena cava (IVC) in patients with renal cell carcinoma (RCC) and associated bland and tumour thrombi. • We reviewed 129 consecutive patients with the preoperative diagnosis of RCC with tumour thrombus who underwent radical nephrectomy and tumour thrombectomy in one academic institution between May 1997 and February 2011. • Percentages of patients with levels I, II, III and IV tumour thrombus were 29%, 13%, 48% and 9%, respectively. • The perioperative mortality rate was 2.3%. There were 29 (22%) perioperative complications recorded. • In all, 19 patients underwent surgical interruption of the IVC by ligation or segmental resection, including one level II, 14 level III and four level IV thrombi. • A total of 15 patients (12%) had bland thrombus associated with the tumour thrombus; four of these underwent intraoperative IVC filter placement and eight underwent surgical IVC interruption. • Advanced level of tumour thrombus was the only significant factor predicting association of bland thrombus (odds ratio [OR]= 2.09, 95% confidence interval [CI]: 1.082-4.037, P= 0.028). • On multivariate analysis, level of thrombus (OR = 3.1, 95% CI: 1.30-7.74, P= 0.011) and association of bland thrombus (OR = 9.07, 95% CI: 2.42-34.01, P= 0.001) were significant factors for IVC interruption. • Surgical interruption of the IVC is a feasible option in selected patients with chronic IVC obstruction. Association of bland thrombus with tumour thrombus should alert the surgical team to the potential for a

  11. Reducing the availability of food to control feral pigeons: changes in population size and composition.

    PubMed

    Senar, Juan C; Montalvo, Tomás; Pascual, Jordi; Peracho, Victor

    2017-02-01

    As feeding by humans is one of the main food resources to pigeons (Columba livia), there is general agreement that public education that aims to reduce the food base may be the most feasible way to reduce pigeon abundance. However, except for the classic example of Basel, the method has rarely been tested or implemented. We provide results from a 1 year study in the city of Barcelona where we tested the effect of public education on pigeon population abundance and composition. The quantity of food provided by people to pigeons was significantly reduced during the study. Feral pigeon density was reduced by 40% in the two experimental districts, but no variation was detected in the control district. Detailed analyses in one of the districts showed that the reduction was mainly related to the reduction in food availability but not to culling. Pigeons captured at the end of the experiment were larger than at the start of the study, but body condition was reduced. Results show the effectiveness of public information to manage feral pigeon populations in a large city, and that control operations can exert important selection pressure on the population, leading to changes in population composition. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  12. Deletion of Irs2 causes reduced kidney size in mice: role for inhibition of GSK3β?

    PubMed Central

    2010-01-01

    Background Male Irs2-/- mice develop fatal type 2 diabetes at 13-14 weeks. Defects in neuronal proliferation, pituitary development and photoreceptor cell survival manifest in Irs2-/- mice. We identify retarded renal growth in male and female Irs2-/- mice, independent of diabetes. Results Kidney size and kidney:body weight ratio were reduced by approximately 20% in Irs2-/- mice at postnatal day 5 and was maintained in maturity. Reduced glomerular number but similar glomerular density was detected in Irs2-/- kidney compared to wild-type, suggesting intact global kidney structure. Analysis of insulin signalling revealed renal-specific upregulation of PKBβ/Akt2, hyperphosphorylation of GSK3β and concomitant accumulation of β-catenin in Irs2-/- kidney. Despite this, no significant upregulation of β-catenin targets was detected. Kidney-specific increases in Yes-associated protein (YAP), a key driver of organ size were also detected in the absence of Irs2. YAP phosphorylation on its inhibitory site Ser127 was also increased, with no change in the levels of YAP-regulated genes, suggesting that overall YAP activity was not increased in Irs2-/- kidney. Conclusions In summary, deletion of Irs2 causes reduced kidney size early in mouse development. Compensatory mechanisms such as increased β-catenin and YAP levels failed to overcome this developmental defect. These data point to Irs2 as an important novel mediator of kidney size. PMID:20604929

  13. Retrievable Inferior Vena Cava Filters in Trauma Patients: Prevalence and Management of Thrombus Within the Filter.

    PubMed

    Pan, Y; Zhao, J; Mei, J; Shao, M; Zhang, J; Wu, H

    2016-12-01

    The incidence of thrombus was investigated within retrievable filters placed in trauma patients with confirmed DVT at the time of retrieval and the optimal treatment for this clinical scenario was assessed. A technique called "filter retrieval with manual negative pressure aspiration thrombectomy" for management of filter thrombus was introduced and assessed. The retrievable filters referred for retrieval between January 2008 and December 2015 were retrospectively reviewed to determine the incidence of filter thrombus on a pre-retrieval cavogram. The clinical outcomes of different managements for thrombus within filters were recorded and analyzed. During the study 764 patients having Aegisy Filters implanted were referred for filter removal, from which 236 cases (134 male patients, mean age 50.2 years) of thrombus within the filter were observed on initial pre-retrieval IVC venogram 12-39 days after insertion (average 16.9 days). The incidence of infra-filter thrombus was 30.9%, and complete occlusion of the filter bearing IVC was seen in 2.4% (18) of cases. Retrieval was attempted in all 121 cases with small clots using a regular snare and sheath technique, and was successful in 120. A total of 116 cases with massive thrombus and IVC occlusion by thrombus were treated by CDT and/or the new retrieval technique. Overall, 213 cases (90.3%) of thrombus in the filter were removed successfully without PE. A small thrombus within the filter can be safely removed without additional management. CDT for reduction of the clot burden in filters was effective and safe. Filter retrieval with manual negative pressure aspiration thrombectomy seemed reasonable and valuable for management of massive thrombus within filters in some patients. Full assessment of the value and safety of this technique requires additional studies. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  14. Matrix Metalloproteinase 9 (MMP-9) Regulates Vein Wall Biomechanics in Murine Thrombus Resolution

    PubMed Central

    Nguyen, Khanh P.; McGilvray, Kirk C.; Puttlitz, Christian M.; Mukhopadhyay, Subhradip; Chabasse, Christine; Sarkar, Rajabrata

    2015-01-01

    Objective Deep venous thrombosis is a common vascular problem with long-term complications including post-thrombotic syndrome. Post-thrombotic syndrome consists of leg pain, swelling and ulceration that is related to incomplete or maladaptive resolution of the venous thrombus as well as loss of compliance of the vein wall. We examine the role of metalloproteinase-9 (MMP-9), a gene important in extracellular remodeling in other vascular diseases, in mediating thrombus resolution and biomechanical changes of the vein wall. Methods and Results The effects of targeted deletion of MMP-9 were studied in an in vivo murine model of thrombus resolution using the FVB strain of mice. MMP-9 expression and activity significantly increased on day 3 after DVT. The lack of MMP-9 impaired thrombus resolution by 27% and this phenotype was rescued by the transplantation of wildtype bone marrow cells. Using novel biomechanical techniques, we demonstrated that the lack of MMP-9 significantly decreased thrombus-induced loss of vein wall compliance. Biomechanical analysis of the contribution of individual structural components showed that MMP-9 affected the elasticity of the extracellular matrix and collagen-elastin fibers. Biochemical and histological analyses correlated with these biomechanical effects as thrombi of mice lacking MMP-9 had significantly fewer macrophages and collagen as compared to those of wildtype mice. Conclusions MMP-9 mediates thrombus-induced loss of vein wall compliance by increasing stiffness of the extracellular matrix and collagen-elastin fibers during thrombus resolution. MMP-9 also mediates macrophage and collagen content of the resolving thrombus and bone-marrow derived MMP-9 plays a role in resolution of thrombus mass. These disparate effects of MMP-9 on various aspects of thrombus illustrate the complexity of individual protease function on biomechanical and morphometric aspects of thrombus resolution. PMID:26406902

  15. Enlargement of the Excluded Left Atrial Appendage With Thrombus.

    PubMed

    Aoyagi, Shigeaki; Tobinaga, Satoru; Saisho, Hiroyuki

    2017-02-07

    We report progressive enlargement of the excluded left atrial appendage (LAA) with a thrombus in a patient who had undergone valve surgery and endocardial suture closure of the LAA previously. Echocardiography and CT detected no communication between the LAA and the left atrium. Magnetic resonance imaging showed the LAA was filled with fresh and old thrombi. Coronary arteriography demonstrated small left coronary artery-LAA fistulae. At surgery, successful exclusion of the LAA was confirmed after removal of the thrombi. Persistent inflow of blood through the coronary artery fistulae to the excluded LAA may be the primary mechanism of this pathology.

  16. Salt stress reduces root meristem size by nitric oxide-mediated modulation of auxin accumulation and signaling in Arabidopsis.

    PubMed

    Liu, Wen; Li, Rong-Jun; Han, Tong-Tong; Cai, Wei; Fu, Zheng-Wei; Lu, Ying-Tang

    2015-05-01

    The development of the plant root system is highly plastic, which allows the plant to adapt to various environmental stresses. Salt stress inhibits root elongation by reducing the size of the root meristem. However, the mechanism underlying this process remains unclear. In this study, we explored whether and how auxin and nitric oxide (NO) are involved in salt-mediated inhibition of root meristem growth in Arabidopsis (Arabidopsis thaliana) using physiological, pharmacological, and genetic approaches. We found that salt stress significantly reduced root meristem size by down-regulating the expression of PINFORMED (PIN) genes, thereby reducing auxin levels. In addition, salt stress promoted AUXIN RESISTANT3 (AXR3)/INDOLE-3-ACETIC ACID17 (IAA17) stabilization, which repressed auxin signaling during this process. Furthermore, salt stress stimulated NO accumulation, whereas blocking NO production with the inhibitor N(ω)-nitro-l-arginine-methylester compromised the salt-mediated reduction of root meristem size, PIN down-regulation, and stabilization of AXR3/IAA17, indicating that NO is involved in salt-mediated inhibition of root meristem growth. Taken together, these findings suggest that salt stress inhibits root meristem growth by repressing PIN expression (thereby reducing auxin levels) and stabilizing IAA17 (thereby repressing auxin signaling) via increasing NO levels. © 2015 American Society of Plant Biologists. All Rights Reserved.

  17. Herniated disks unchanged over time: Size reduced after oxygen–ozone therapy

    PubMed Central

    Bonetti, Matteo; Zambello, Alessio; Princiotta, Ciro

    2016-01-01

    The spontaneous regression of disk herniation secondary to dehydration is a much-debated topic in medicine. Some physicians wonder whether surgical removal of the extruded nucleus pulposus is really necessary when the spontaneous disappearance of a herniated lumbar disk is a well-known phenomenon. Unfortunately, without spontaneous regression, chronic pain leads to progressive disability for which surgery seems to be the only solution. In recent years, several studies have demonstrated the utility of oxygen–ozone therapy in the treatment of disk herniation, resulting in disk shrinkage. This retrospective study evaluates the outcomes of a series of patients with a history of herniated disks neuroradiologically unchanged in size for over two years, treated with oxygen–ozone therapy at our center over the last 15 years. We treated 96 patients, 84 (87.5%) presenting low back pain complicated or not by chronic sciatica. No drug therapy had yielded significant benefits. A number of specialists had been consulted in two or more years resulting in several neuroradiological scans prior to the decision to undertake oxygen–ozone therapy. Our study documents how ozone therapy for slipped disks “unchanged over time” solved the problem, with disk disruption or a significant reduction in the size of the prolapsed disk material extruded into the spinal canal. PMID:27066816

  18. Effect of sample size and reduced number of principle components on the Gillette Gait Index.

    PubMed

    Tulchin, Kirsten; Campbell, Scott; Browne, Richard; Orendurff, Michael

    2009-06-01

    The Gillette Gait Index uses principle components analysis of 16 variables to determine the deviation of an individual's gait compared to a normal control set. Previous literature has not reported on the effects of altering the size of the control set used to create the principle components, or described the effects of using less than the maximum number of principle components, 16, to calculate the Gillette Gait Index (GGI). Calculations of the GGI were determined for a group of 24 able-bodied normal subjects and 24 cerebral palsy subjects using 128 control subjects allotted into 15 subsets of varying sizes, from N=16-128. A minimum of 40 controls were needed for GGI estimates to achieve less than approximately 20% error, and 96 controls were needed for less than 10% error, if all 16 principle components were used. With smaller control sets, an alternative method to increase the accuracy would be to use only those principle components that represent 95% of the variance. Caution must still be used when describing differences in GGI among groups, or changes in an individual's GGI over time. In addition, absolute changes in GGI should always be reported, as differences as great as 150 were seen in cerebral palsy patients across control groups, even when greater than 40 controls are used to create the principle components.

  19. Herniated disks unchanged over time: Size reduced after oxygen-ozone therapy.

    PubMed

    Bonetti, Matteo; Zambello, Alessio; Leonardi, Marco; Princiotta, Ciro

    2016-08-01

    The spontaneous regression of disk herniation secondary to dehydration is a much-debated topic in medicine. Some physicians wonder whether surgical removal of the extruded nucleus pulposus is really necessary when the spontaneous disappearance of a herniated lumbar disk is a well-known phenomenon. Unfortunately, without spontaneous regression, chronic pain leads to progressive disability for which surgery seems to be the only solution. In recent years, several studies have demonstrated the utility of oxygen-ozone therapy in the treatment of disk herniation, resulting in disk shrinkage. This retrospective study evaluates the outcomes of a series of patients with a history of herniated disks neuroradiologically unchanged in size for over two years, treated with oxygen-ozone therapy at our center over the last 15 years. We treated 96 patients, 84 (87.5%) presenting low back pain complicated or not by chronic sciatica. No drug therapy had yielded significant benefits. A number of specialists had been consulted in two or more years resulting in several neuroradiological scans prior to the decision to undertake oxygen-ozone therapy. Our study documents how ozone therapy for slipped disks "unchanged over time" solved the problem, with disk disruption or a significant reduction in the size of the prolapsed disk material extruded into the spinal canal.

  20. Transient response in longitudinal grain size to reduced sediment supply in a large river

    NASA Astrophysics Data System (ADS)

    Singer, Michael

    2010-05-01

    Bed material grain size is an important degree of freedom in fluvial systems as they adjust to system-wide perturbations such as sediment supply changes. However, little is known about processes and patterns of such adjustment in longitudinal grain size sorting in large rivers. This research uses unprecedented datasets collected in a large fluvial system to investigate transient response to recent supply changes associated with anthropogenic activities. Separate fining trends for gravel and fines, a protracted gravel-sand (G-S) transition, and bed patchiness identified in Singer (2008) were interrogated using output from a hydraulic model with grain size distributions (GSDs) extracted from ~125 cross sections spanning ~400 river kilometers of the Sacramento River, California. The analysis suggests that interactions between hydraulics, bed material sorting, and sediment flux explain these previously identified anomalies. Highest values of sorting occur in the G-S transition and represent the overlap of separate fining trends for gravel and fines, where the long profile is jagged with evidence of progressive incision. Much of the sediment in this poorly sorted zone is organized into patches, where transport apparently occurs as bedload sheets. Patchiness occurs over short length scales leading to strong differences in entrainment and flux, regardless of hydraulic conditions. A modified Shields stress is proposed that is scaled by GSD sorting to improve characterization of entrainment/disentrainment. Sediment flux calculations based on an equation sensitive bed material conditions (Singer and Dunne, 2004) reveal a strong relationship between fine sediment flux and d90, suggesting that the efficiency of fine patch flux controls bed material bed surface roughness. Results are in part consistent with Paola and Seal (1995) suggesting that patches are a result of overlapping pdfs of shear stress and sorting and with Ferguson (2003) in that the final end of the protracted G

  1. Role of Gas6 receptors in platelet signaling during thrombus stabilization and implications for antithrombotic therapy

    PubMed Central

    Angelillo-Scherrer, Anne; Burnier, Laurent; Flores, Nathalie; Savi, Pierre; DeMol, Maria; Schaeffer, Paul; Herbert, Jean-Marc; Lemke, Greg; Goff, Stephen P.; Matsushima, Glenn K.; Earp, H. Shelton; Vesin, Christian; Hoylaerts, Marc F.; Plaisance, Stéphane; Collen, Désiré; Conway, Edward M.; Wehrle-Haller, Bernhard; Carmeliet, Peter

    2005-01-01

    Mechanisms regulating thrombus stabilization remain largely unknown. Here, we report that loss of any 1 of the Gas6 receptors (Gas6-Rs), i.e., Tyro3, Axl, or Mer, or delivery of a soluble extracellular domain of Axl that traps Gas6 protects mice against life-threatening thrombosis. Loss of a Gas6-R does not prevent initial platelet aggregation but impairs subsequent stabilization of platelet aggregates, at least in part by reducing “outside-in” signaling and platelet granule secretion. Gas6, through its receptors, activates PI3K and Akt and stimulates tyrosine phosphorylation of the β3 integrin, thereby amplifying outside-in signaling via αIIbβ3. Blocking the Gas6-R–αIIbβ3 integrin cross-talk might be a novel approach to the reduction of thrombosis. PMID:15650770

  2. One size does not fit all: evaluating an intervention to reduce antibiotic prescribing for acute bronchitis

    PubMed Central

    2013-01-01

    Background Overuse of antibiotics for upper respiratory tract infections (URIs) and acute bronchitis is a persistent and vexing problem. In the U.S., more than half of all patients with upper respiratory tract infections and acute bronchitis are treated with antibiotics annually, despite the fact that most cases are viral in etiology and are not responsive to antibiotics. Interventions aiming to reduce unnecessary antibiotic prescribing have had mixed results, and successes have been modest. The objective of this evaluation is to use mixed methods to understand why a multi-level intervention to reduce antibiotic prescribing for acute bronchitis among primary care providers resulted in measurable improvement in only one third of participating clinicians. Methods Clinician perspectives on print-based and electronic intervention strategies, and antibiotic prescribing more generally, were elicited through structured telephone surveys at high and low performing sites after the first year of intervention at the Geisinger Health System in Pennsylvania (n = 29). Results Compared with a survey on antibiotic use conducted 10 years earlier, clinicians demonstrated greater awareness of antibiotic resistance and how it is impacted by individual prescribing decisions—including their own. However, persistent perceived barriers to reducing prescribing included patient expectations, time pressure, and diagnostic uncertainty, and these factors were reported as differentially undermining specific intervention components’ effectiveness. An exam room poster depicting a diagnostic algorithm was the most popular strategy. Conclusions Future efforts to reduce antibiotic prescribing should address multi-level barriers identified by clinicians and tailor strategies to differences at individual clinician and group practice levels, focusing in particular on changing how patients and providers make decisions together about antibiotic use. PMID:24188573

  3. Face inversion and acquired prosopagnosia reduce the size of the perceptual field of view.

    PubMed

    Van Belle, Goedele; Lefèvre, Philippe; Rossion, Bruno

    2015-03-01

    Using a gaze-contingent morphing approach, we asked human observers to choose one of two faces that best matched the identity of a target face: one face corresponded to the reference face's fixated part only (e.g., one eye), the other corresponded to the unfixated area of the reference face. The face corresponding to the fixated part was selected significantly more frequently in the inverted than in the upright orientation. This observation provides evidence that face inversion reduces an observer's perceptual field of view, even when both upright and inverted faces are displayed at full view and there is no performance difference between these conditions. It rules out an account of the drop of performance for inverted faces--one of the most robust effects in experimental psychology--in terms of a mere difference in local processing efficiency. A brain-damaged patient with pure prosopagnosia, viewing only upright faces, systematically selected the face corresponding to the fixated part, as if her perceptual field was reduced relative to normal observers. Altogether, these observations indicate that the absence of visual knowledge reduces the perceptual field of view, supporting an indirect view of visual perception.

  4. Reducing Size, Weight, and Power (SWaP) of Perception Systems in Small Autonomous Aerial Systems

    NASA Technical Reports Server (NTRS)

    Jones, Kennie H.; Gross, Jason

    2014-01-01

    The objectives are to examine recent trends in the reduction of size, weight, and power (SWaP) requirements of sensor systems for environmental perception and to explore new technology that may overcome limitations in current systems. Improving perception systems to facilitate situation awareness is critical in the move to introduce increasing autonomy in aerial systems. Whether the autonomy is in the current state-of-the-art of increasing automation or is enabling cognitive decisions that facilitate adaptive behavior, collection of environmental information and fusion of that information into knowledge that can direct actuation is imperative to decisions resulting in appropriate behavior. Artificial sensory systems such as cameras, radar, LIDAR, and acoustic sensors have been in use on aircraft for many years but, due to the large size and weight of the airplane and electrical power made available through powerful engines, the SWaP requirements of these sensors was inconsequential. With the proliferation of Remote Piloted Vehicles (RPV), the trend is in significant reduction in SWaP of the vehicles. This requires at least an equivalent reduction in SWaP for the sensory systems. A survey of some currently available sensor systems and changing technology will reveal the trend toward reduction of SWaP of these systems and will predict future reductions. A new technology will be introduced that provides an example of a desirable new trend. A new device replaces multiple conventional sensory devices facilitating synchronization, localization, altimetry, collision avoidance, terrain mapping, and data communication in a single integrated, small form-factor, extremely lightweight, and low power device that it is practical for integration into small autonomous vehicles and can facilitate cooperative behavior. The technology is based on Ultra WideBand (UWB) radio using short pulses of energy rather than continuous sine waves. The characteristics of UWB yield several

  5. Laser system refinements to reduce variability in infarct size in the rat photothrombotic stroke model

    PubMed Central

    Alaverdashvili, Mariam; Paterson, Phyllis G.; Bradley, Michael P.

    2015-01-01

    Background The rat photothrombotic stroke model can induce brain infarcts with reasonable biological variability. Nevertheless, we observed unexplained high inter-individual variability despite using a rigorous protocol. Of the three major determinants of infarct volume, photosensitive dye concentration and illumination period were strictly controlled, whereas undetected fluctuation in laser power output was suspected to account for the variability. New method The frequently utilized Diode Pumped Solid State (DPSS) lasers emitting 532 nm (green) light can exhibit fluctuations in output power due to temperature and input power alterations. The polarization properties of the Nd:YAG and Nd:YVO4 crystals commonly used in these lasers are another potential source of fluctuation, since one means of controlling output power uses a polarizer with a variable transmission axis. Thus, the properties of DPSS lasers and the relationship between power output and infarct size were explored. Results DPSS laser beam intensity showed considerable variation. Either a polarizer or a variable neutral density filter allowed adjustment of a polarized laser beam to the desired intensity. When the beam was unpolarized, the experimenter was restricted to using a variable neutral density filter. Comparison with existing method(s) Our refined approach includes continuous monitoring of DPSS laser intensity via beam sampling using a pellicle beamsplitter and photodiode sensor. This guarantees the desired beam intensity at the targeted brain area during stroke induction, with the intensity controlled either through a polarizer or variable neutral density filter. Conclusions Continuous monitoring and control of laser beam intensity is critical for ensuring consistent infarct size. PMID:25840363

  6. Individual thorax geometry reduces position and size differences in reconstructed images of electrical impedance tomography.

    PubMed

    Zhao, Zhanqi; Frerichs, Inéz; Pulletz, Sven; Müller-Lisse, Ullrich; Möller, Knut

    2014-01-01

    Due to the ill-posed problem, the electrical impedance within the thorax cannot be exactly reconstructed. The aim of our study was to prove that reconstruction with individual thorax geometry improved the quality of EIT (electrical impedance tomography) images. Seven mechanically ventilated patients with acute respiratory distress syndrome were examined by EIT. The thorax contours were determined from routine computed tomography (CT) images based on automatic threshold filtering. EIT raw data was reconstructed offline with (1) back-projection with circular forward model; (2) GREIT reconstruction method with circular forward model and (3) GREIT with individual thorax geometry. The resulting EIT images were compared to rescaled CT images. The distance between the lung contour and the thorax contour was calculated for each method and the differences to that in CT were denoted as position differences. Shape differences was defined as the ratio of thorax (or lungs) size in EIT and that in rescaled CT. Method (3) has the smallest position differences (6.6 ± 2.8, 5.3 ± 3.3, 2.3 ± 1.4 in pixel, for each reconstruction method respectively; mean ± SD). The thorax and lungs sizes in the transformed CT images were 514 ± 73 and 177 ± 39. Shape differences of thorax were 1.81 ± 0.26, 1.81 ± 0.26, 1.10 ± 0.12 and that of lungs were 1.69 ± 0.45, 1.52 ± 0.45, 1.34 ± 0.35 for each method respectively. The reconstructed images using the GREIT method with individual thorax geometry were more realistic. Improvement of EIT image quality may foster the acceptance of EIT in routine clinical use.

  7. Novel, selective EPO receptor ligands lacking erythropoietic activity reduce infarct size in acute myocardial infarction in rats.

    PubMed

    Kiss, Krisztina; Csonka, Csaba; Pálóczi, János; Pipis, Judit; Görbe, Anikó; Kocsis, Gabriella F; Murlasits, Zsolt; Sárközy, Márta; Szűcs, Gergő; Holmes, Christopher P; Pan, Yijun; Bhandari, Ashok; Csont, Tamás; Shamloo, Mehrdad; Woodburn, Kathryn W; Ferdinandy, Péter; Bencsik, Péter

    2016-11-01

    Erythropoietin (EPO) has been shown to protect the heart against acute myocardial infarction in pre-clinical studies, however, EPO failed to reduce infarct size in clinical trials and showed significant safety problems. Here, we investigated cardioprotective effects of two selective non-erythropoietic EPO receptor ligand dimeric peptides (AF41676 and AF43136) lacking erythropoietic activity, EPO, and the prolonged half-life EPO analogue, darbepoetin in acute myocardial infarction (AMI) in rats. In a pilot study, EPO at 100U/mL significantly decreased cell death compared to vehicle (33.8±2.3% vs. 40.3±1.5%, p<0.05) in rat neonatal cardiomyocytes subjected to simulated ischemia/reperfusion. In further studies (studies 1-4), in vivo AMI was induced by 30min coronary occlusion and 120min reperfusion in male Wistar rats. Test compounds and positive controls for model validation (B-type natriuretic peptide, BNP or cyclosporine A, CsA) were administered iv. before the onset of reperfusion. Infarct size (IS) was measured by standard TTC staining. In study 1, 5000U/kg EPO reduced infarct size significantly compared to vehicle (45.3±4.8% vs. 59.8±4.5%, p<0.05). In study 2, darbepoetin showed a U-shaped dose-response curve with maximal infarct size-reducing effect at 5μg/kg compared to the vehicle (44.4±5.7% vs. 65.9±2.7%, p<0.01). In study 3, AF41676 showed a U-shaped dose-response curve, where 3mg/kg was the most effective dose compared to the vehicle (24.1±3.9% vs. 44.3±2.5%, p<0.001). The positive control BNP significantly decreased infarct size in studies 1-3 by approximately 35%. In study 4, AF43136 at 10mg/kg decreased infarct size, similarly to the positive control CsA compared to the appropriate vehicle (39.4±5.9% vs. 58.1±5.4% and 45.9±2.4% vs. 63.8±4.1%, p<0.05, respectively). This is the first demonstration that selective, non-erythropoietic EPO receptor ligand dimeric peptides AF41676 and AF43136 administered before reperfusion are able to reduce

  8. AngioVac extraction of intra-atrial hepatoma masquerading as PICC-associated thrombus

    PubMed Central

    Abboud, Samir; Raparia, Kirtee; Ubago, Julianne M.; Resnick, Scott

    2016-01-01

    Thrombus associated with peripherally inserted central catheterization is not uncommon. Treatment is typically conservative; however, more aggressive therapies can be considered in patients with tenuous medical condition. The authors present a patient with metastatic hepatocellular carcinoma masquerading as peripherally inserted central catheter-associated intra-atrial thrombus, subsequently removed via vacuum-assisted mechanical thrombectomy. PMID:26509915

  9. AngioVac extraction of intra-atrial hepatoma masquerading as PICC-associated thrombus.

    PubMed

    Abboud, Samir; Raparia, Kirtee; Ubago, Julianne M; Resnick, Scott

    2016-01-01

    Thrombus associated with peripherally inserted central catheterization is not uncommon. Treatment is typically conservative; however, more aggressive therapies can be considered in patients with tenuous medical condition. The authors present a patient with metastatic hepatocellular carcinoma masquerading as peripherally inserted central catheter-associated intra-atrial thrombus, subsequently removed via vacuum-assisted mechanical thrombectomy.

  10. Free-floating left atrial ball thrombus early after mitral valve replacement.

    PubMed

    Sanae, T; Kazama, S; Nie, M; Miyoshi, Y; Machii, M; Ohara, K; Yoshimura, H

    2000-12-01

    A 61-year-old woman was found to have a free-floating ball, thrombus in the left atrium on echocardiographic examination 2 weeks after mitral valve replacement and tricuspid, annuloplasty. The free-floating thrombus was successfully, removed by an open-heart procedure without clinical sequelae. The diagnostic value of routine echocardiography on follow-up of valve surgery is emphasized.

  11. Tumour thrombus consistency has no impact on survival in patients with renal cell carcinoma.

    PubMed

    Gołąbek, T; Przydacz, M; Okoń, K; Kopczyński, J; Bukowczan, J; Sobczyński, R; Curyło, Ł; Gołąbek, K; Curyło, Ł; Chłosta, P

    2016-06-01

    The prognosis of renal cell carcinoma (RCC) with venous tumour thrombus (VTT) is variable and not always possible to predict. The prognostic impact and independence of tumour thrombus-related factors including the recently introduced tumour thrombus consistency (TTC) on overall survival remain controversial. The aim of this study was to investigate the prognostic role of TTC in patients' survival. We determined the tumour thrombus consistency (solid vs. friable) in a cohort of 84 patients with RCC and VTT who underwent nephrectomy with thrombectomy, and performed a retrospective evaluation of the patients' data from the prospectively maintained database. A total of 45% of patients had solid thrombus (sTT) and 55% had friable thrombus (fTT). The venous tumour thrombus consistency was not predictive of overall survival. Further studies, preferably prospective and with a larger number of patients, are needed to validate the obtained results, as well as to evaluate the usefulness of tumour thrombus consistency in clinical practice for stratifying the risk of recurrence and planning further follow-up.

  12. Reducing Capsule Based on Electron Programming: Versatile Synthesizer for Size-Controlled Ultra-Small Metal Clusters.

    PubMed

    Kambe, Tetsuya; Imaoka, Takane; Yamamoto, Kimihisa

    2016-11-07

    Controlled reducing capsules with a specific number of reducing electrons were achieved by appropriately placed BH3 units in the dendritic polyphenylazomethines (DPAs). Using the 1:1 coordination fashion on their basic branches with radius affinity gradient, the 4th generation DPA (DPAG4) possessing four BH3 units in the central positions was prepared as a template synthesizer for size-controlled ultra-small metal clusters. This was well-demonstrated by reduction of Ag, Pt, and other metal ions resulting in monodispersed ultra-small clusters.

  13. Intermittent exposure to reduced oxygen levels affects prey size selection and consumption in swimming crab Thalamita danae Stimpson.

    PubMed

    Shin, P K S; Cheung, P H; Yang, F Y; Cheung, S G

    2005-01-01

    Portunid crabs Thalamita danae (carapace width: 46-56 mm) were exposed to low oxygen level (4.0 mg O2 l(-1)) and hypoxia (1.5 mg O2 l(-1)) for 6 h each day with three size classes (large: 15.0-19.9 mm, medium: 10.0-14.9 mm, small: 5.0-9.9 mm) of mussels Brachidontes variabilis offered as food. Consumption rate, prey size preference, and prey handling including breaking time, handling time, eating time and prey value, were studied during the time the crabs were exposed to reduced oxygen levels and results were compared with the crabs maintained at high oxygen level (8.0 mg O2 l(-1)) throughout the experiment. Consumption of mussels from all size classes was significantly higher at high oxygen level than at reduced oxygen levels. No mussel size preference was observed for crabs exposed to 4.0 or 8.0 mg O2 l(-1) but those crabs exposed to 1.5 mg O2 l(-1) preferred medium mussels. Both breaking time and handling time increased with mussel size but did not vary with oxygen level. Prey value of each mussel consumed (mg dry wt eaten crab(-1) s(-1)) was calculated by dividing the estimated dry weight of the mussel by the observed handling time. Mean prey value varied significantly with mussel size, with values obtained for large mussels being higher than small mussels at 4.0 and 8.0 mg O2 l(-1); the effect of oxygen level, however, was insignificant. In view of portunid crabs as major predators of mussels, results may help explain dominance of mussels in eutrophic harbours in Hong Kong.

  14. Imatinib mesylate (Glivec) inhibits Schwann cell viability and reduces the size of human plexiform neurofibroma in a xenograft model.

    PubMed

    Demestre, Maria; Herzberg, Jan; Holtkamp, Nikola; Hagel, Christian; Reuss, David; Friedrich, Reinhard E; Kluwe, Lan; Von Deimling, Andreas; Mautner, Victor-F; Kurtz, Andreas

    2010-05-01

    Plexiform neurofibromas (PNF), one of the major features of neurofibromatosis type 1 (NF1), are characterized by complex cellular composition and mostly slow but variable growth patterns. In this study, we examined the effect of imatinib mesylate, a receptor tyrosine kinase inhibitor, on PNF-derived Schwann cells and PNF tumour growth in vitro and in vivo. In vitro, PNF-derived primary Schwann cells express platelet-derived growth factors receptors (PDGFR) alpha and beta, both targets of imatinib, and cell viability was reduced by imatinib mesylate, with 50% inhibition concentration (IC(50)) of 10 microM. For in vivo studies, PNF tumour fragments xenografted onto the sciatic nerve of athymic nude mice were first characterized. The tumours persisted for at least 63 days and maintained typical characteristics of PNFs such as complex cellular composition, low proliferation rate and angiogenesis. A transient enlargement of the graft size was due to inflammation by host cells. Treatment with imatinib mesylate at a daily dose of 75 mg/kg for 4 weeks reduced the graft size by an average of 80% (n = 8), significantly different from the original sizes within the group and from sizes of the grafts in 11 untreated mice in the control group (P < 0.001). We demonstrated that grafting human PNF tumour fragments into nude mice provides an adequate in vivo model for drug testing. Our results provide in vivo and in vitro evidence for efficacy of imatinib mesylate for PNF.

  15. Reducing sample sizes in two-stage phase II cancer trials by using continuous tumour shrinkage end-points.

    PubMed

    Wason, James M S; Mander, Adrian P; Eisen, Tim G

    2011-05-01

    Reducing the number of patients required for a clinical trial is important for shortening development time. Phase II cancer trials assess the tumour-shrinking effect of a novel compound through a binary end-point formed from the percentage change in total lesion diameter. We compare single-arm two-stage designs which use the binary end-point to those which directly use the continuous end-point. Using the continuous end-point results in lower expected and maximum sample sizes. For larger trials the reduction is around 37%. This assumes that the dichotomisation point of the continuous end-point is chosen to give the best sample size, with the trial design using the binary end-point performing even worse otherwise. We consider a previous trial designed using a Simon two-stage design and show that if the continuous end-point had been used, the expected and maximum sample sizes of the trial would be reduced by around 50%. Using the continuous end-point in a two-stage cancer trial results in large sample size reductions. The methods discussed in this paper work best when the number of complete responses is low, as is true in several types of cancer. We discuss what could be done if this is not the case.

  16. Use of pharmacogenetics in bioequivalence studies to reduce sample size: an example with mirtazapine and CYP2D6.

    PubMed

    González-Vacarezza, N; Abad-Santos, F; Carcas-Sansuan, A; Dorado, P; Peñas-Lledó, E; Estévez-Carrizo, F; Llerena, A

    2013-10-01

    In bioequivalence studies, intra-individual variability (CV(w)) is critical in determining sample size. In particular, highly variable drugs may require enrollment of a greater number of subjects. We hypothesize that a strategy to reduce pharmacokinetic CV(w), and hence sample size and costs, would be to include subjects with decreased metabolic enzyme capacity for the drug under study. Therefore, two mirtazapine studies, two-way, two-period crossover design (n=68) were re-analysed to calculate the total CV(w) and the CV(w)s in three different CYP2D6 genotype groups (0, 1 and ≥ 2 active genes). The results showed that a 29.2 or 15.3% sample size reduction would have been possible if the recruitment had been of individuals carrying just 0 or 0 plus 1 CYP2D6 active genes, due to the lower CV(w). This suggests that there may be a role for pharmacogenetics in the design of bioequivalence studies to reduce sample size and costs, thus introducing a new paradigm for the biopharmaceutical evaluation of drug products.

  17. Arginase inhibition improves coronary microvascular function and reduces infarct size following ischemia-reperfusion in a rat model

    PubMed Central

    Grönros, Julia; Kiss, Attila; Palmér, Malin; Jung, Christian; Berkowitz, Dan; Pernow, John

    2013-01-01

    Aim Ischemia-reperfusion injury is associated with reduced bioavailability of nitric oxide and microvascular dysfunction. One emerging mechanism behind reduced nitric oxide bioavailability is upregulation of arginase which metabolizes the nitric oxide synthase substrate L-arginine. This study investigated the effects of arginase inhibition on coronary flow velocity and infarct size during reperfusion. Methods Anaesthetized rats, subjected to 30 min coronary artery ligation and reperfusion up to 8 days, were treated with vehicle or the arginase inhibitor Nω-hydroxy-nor-L-arginine (nor-NOHA; 100 mg/kg) intravenously 15 min before ischemia. Coronary flow velocity was determined repeatedly during reperfusion. Results Arginase activity in the ischemic-reperfused myocardium was increased already at 20 min of reperfusion and maintained at 8 days. Infarct size was reduced by arginase inhibition at 2 h (39 ± 3% of the area at risk vs. 51 ± 2% in the vehicle group, P<0.01) and at 8 days of reperfusion (13 ± 2% of the left ventricle vs. 22 ± 2%, P<0.05). Basal coronary flow velocity was higher during reperfusion in the group given nor-NOHA and it correlated inversely to infarct size (P<0.01, r=−0.60). Hyperemic coronary flow velocity was also increased in the nor-NOHA treated group compared to vehicle at 24 h and at day 8 (P<0.05). Conclusion It is concluded that arginase activity is increased already during early reperfusion. Arginase inhibition increases coronary flow velocity and reduces infarct size that is sustained 8 days after reperfusion. Inhibition of arginase may thus be a promising therapeutic target to prevent the development of microvascular dysfunction and myocardial injury following ischemia-reperfusion. PMID:23497275

  18. Awns reduce grain number to increase grain size and harvestable yield in irrigated and rainfed spring wheat

    PubMed Central

    Rebetzke, G. J.; Bonnett, D. G.; Reynolds, M. P.

    2016-01-01

    Genotypic variation in ear morphology is linked to differences in photosynthetic potential to influence grain yield in winter cereals. Awns contribute to photosynthesis, particularly under water-limited conditions when canopy assimilation is restricted. We assessed performance of up to 45 backcross-derived, awned–awnletted NILs representing four diverse genetic backgrounds in 25 irrigated or rainfed, and droughted environments in Australia and Mexico. Mean environment grain yields were wide-ranging (1.38–7.93 t ha−1) with vegetative and maturity biomass, plant height, anthesis date, spike number, and harvest index all similar (P >0.05) for awned and awnletted NILs. Overall, grain yields of awned–awnletted sister-NILs were equivalent, irrespective of yield potential and genetic background. Awnletted wheats produced significantly more grains per unit area (+4%) and per spike (+5%) reflecting more fertile spikelets and grains in tertiary florets. Increases in grain number were compensated for by significant reductions in grain size (–5%) and increased frequency (+0.8%) of small, shrivelled grains (‘screenings’) to reduce seed-lot quality of awnletted NILs. Post-anthesis canopies of awnletted NILs were marginally warmer over all environments (+0.27 °C) but were not different and were sometimes cooler than awned NILs at cooler air temperatures. Awns develop early and represented up to 40% of total spikelet biomass prior to ear emergence. We hypothesize that the allocation of assimilate to large and rapidly developing awns decreases spikelet number and floret fertility to reduce grain number, particularly in distal florets. Individual grain size is increased to reduce screenings and to increase test weight and milling quality, particularly in droughted environments. Despite the average reduction in grain size, awnless lines could be identified that combined higher grain yield with larger grain size, increased grain protein concentration, and reduced

  19. Low Sociability is Associated with Reduced Size of the Corpus Callosum in the BALB/cJ Inbred Mouse Strain

    PubMed Central

    Fairless, Andrew H.; Dow, Holly C.; Toledo, Monica M.; Malkus, Kristen A.; Edelmann, Michele; Li, Hongzhe; Talbot, Konrad; Arnold, Steven E.; Abel, Ted; Brodkin, Edward S.

    2008-01-01

    The behavioral manifestations of autism, including reduced sociability (reduced tendency to seek social interaction), may be related to underdevelopment of the corpus callosum (CC). The BALB/cJ inbred mouse strain is a useful model system for testing the relationship between reduced sociability and CC underdevelopment. BALB/cJ mice show low levels of sociability, on average, but substantial intrastrain variability in sociability, as well as striking variability in CC development. This study tested the hypothesis that sociability is positively correlated with CC size within the BALB/cJ inbred strain. 30-day-old BALB/cJ and C57BL/6J mice were tested for sociability towards gonadectomized A/J stimulus mice in a social choice task. The size of the corpus callosum was measured histologically at the mid-sagittal plane. BALB/cJ mice showed a significant positive correlation between the tendency to sniff the stimulus mouse and size of the CC relative to brain weight. C57BL/6J mice showed consistently high levels of sociability and normal corpus callosum development. These results suggest that abnormal white matter structure is associated with deficits in sociability in BALB/cJ mice. Additional studies are warranted to elucidate the relationship between brain connectivity and sociability in this model system. PMID:18662677

  20. Low sociability is associated with reduced size of the corpus callosum in the BALB/cJ inbred mouse strain.

    PubMed

    Fairless, Andrew H; Dow, Holly C; Toledo, Monica M; Malkus, Kristen A; Edelmann, Michele; Li, Hongzhe; Talbot, Konrad; Arnold, Steven E; Abel, Ted; Brodkin, Edward S

    2008-09-16

    The behavioral manifestations of autism, including reduced sociability (reduced tendency to seek social interaction), may be related to underdevelopment of the corpus callosum (CC). The BALB/cJ inbred mouse strain is a useful model system for testing the relationship between reduced sociability and CC underdevelopment. BALB/cJ mice show low levels of sociability, on average, but substantial intrastrain variability in sociability, as well as striking variability in CC development. This study tested the hypothesis that sociability is positively correlated with CC size within the BALB/cJ inbred strain. 30-day-old BALB/cJ and C57BL/6J mice were tested for sociability towards gonadectomized A/J stimulus mice in a social choice task. The size of the corpus callosum was measured histologically at the midsagittal plane. BALB/cJ mice showed a significant positive correlation between the tendency to sniff the stimulus mouse and size of the CC relative to brain weight. C57BL/6J mice showed consistently high levels of sociability and normal corpus callosum development. These results suggest that abnormal white matter structure is associated with deficits in sociability in BALB/cJ mice. Additional studies are warranted to elucidate the relationship between brain connectivity and sociability in this model system.

  1. Vessel wall BAMBI contributes to hemostasis and thrombus stability

    PubMed Central

    Monkman, James H.; Ahnström, Josefin; Lane, David A.; Crawley, James T. B.

    2014-01-01

    Bone morphogenetic protein and activin membrane-bound inhibitor (BAMBI) is a transmembrane protein related to the transforming growth factor-β superfamily, and is highly expressed in platelets and endothelial cells. We previously demonstrated its positive role in thrombus formation using a zebrafish thrombosis model. In the present study, we used Bambi-deficient mice and radiation chimeras to evaluate the function of this receptor in the regulation of both hemostasis and thrombosis. We show that Bambi−/− and Bambi+/− mice exhibit mildly prolonged bleeding times compared with Bambi+/+ littermates. In addition, using 2 in vivo thrombosis models in mesenterium or cremaster muscle arterioles, we demonstrate that Bambi-deficient mice form unstable thrombi compared with Bambi+/+ mice. No defects in thrombin generation in Bambi−/− mouse plasma could be detected ex vivo. Moreover, the absence of BAMBI had no effect on platelet counts, platelet activation, aggregation, or platelet procoagulant function. Similar to Bambi−/− mice, Bambi−/− transplanted with Bambi+/+ bone marrow formed unstable thrombi in the laser-induced thrombosis model that receded more rapidly than thrombi that formed in Bambi+/+ mice receiving Bambi−/− bone marrow transplants. Taken together, these results provide strong evidence for an important role of endothelium rather than platelet BAMBI as a positive regulator of both thrombus formation and stability. PMID:24627527

  2. Design and analysis of micro-stirrer for thrombus dissolution

    NASA Astrophysics Data System (ADS)

    Morita, Minoru; Jiang, Zhongwei; Chijimatsu, Naoki

    2007-12-01

    Thrombus or blood clot may cause cerebral infarction and myocardial infarction if the clot can not be dissolved within several hours after it was formed. The objective of this study is to design a new structure of stirrer for thrombus dissolution. In this paper, to stir the solution with a high viscosity like blood, large amplitude was confirmed to be necessary for the stirrer by the fundamental experiment. For this purpose, shape of the stirrer and type of the actuator were changed, and force and displacement of the stirrer were analyzed. Sine waves with the resonance frequencies of the stirrer (50 V; 571 Hz) were used as the input signals. The performance of the stirrer was simulated by Finite Element Analysis (FEA) to obtain large displacement. Results showed that the amplitude at the tip of stirrer was 100 times larger than the output displacement of the PZT actuator stimulated with the resonance frequency. Concluding this paper, a new type of the micro-stirrer was designed and analyzed by FEA and it was found that the proposed stirrer had a large amplitude with a good input voltage efficiency.

  3. Intracardiac thrombus in Behçet's disease.

    PubMed

    Ben Ghorbel, I; Belfeki, N; Houman, M H

    2016-12-16

    Behçet's disease (BD) is a multisystem inflammatory disorder. Intracardiac thrombus (ICT) formation is an uncommon but important complication of BD. Of the cases of Behçet's disease, we selected those with ICT. All patients fulfilled the diagnostic criteria of the International Study Group of Behçet's disease. The ICT in each case was confirmed by ultrasonography, computed tomography and MRI. Clinical features and laboratory parameters were determined. Among our 518 patients with BD, 8 were diagnosed as having intracardiac thrombus (ICT). All were male; the mean age at the time of the ICT diagnosis was 30.8 years. The main presenting symptoms were hemoptysis, chest pain, and dyspnea. It was associated with pulmonary artery aneurysm and vena cava thrombosis in 3 cases each, pulmonary embolism, and lower limbs deep venous thrombosis in 1 case each. The coexistence of other cardiac complications was as follows: pericarditis in 2 cases, myocarditis, endomyocardial fibrosis, and coronary arteritis with consequent myocardial infarction in one case each. In all cases, echocardiography was sufficient to reach the diagnosis. Chest computed tomography performed in all cases led to the diagnosis of associated pulmonary vasculo-Behçet lesions in 4 cases. All patients received colchicine, anticoagulation, and corticosteroids. Seven patients were on immunosuppressant agents (2 patients received azathioprine and 5 cyclophosphamide). Clinical remission with ICT resolution was observed in 5 cases. Combined immunosuppressive therapy with prednisone and cyclophosphamide might be needed to treat ICT due to BD.

  4. Multiscale Simulation for the Initial Stage of Thrombus Formation

    NASA Astrophysics Data System (ADS)

    Takagi, Shu; , Satoshi, II; Shiozaki, Seiji; Shimamoto, Norio; Sugiyama, Kazuyasu; Matsumoto, Yoichiro

    2012-11-01

    Thrombosis is regarded as one of the most important diseases, which cause the myocardial and cerebral infarctions. The thrombus formation is strongly related to the multiscale coupling phenomena from molecular scale protein-protein interaction to continuum scale in blood flow. Initially, platelets start aggregate at the injured vessel wall, where von Willebrand Factor (vWF) is attached. The Glycoprotein, GPIb- α, on platelet membrane starts showing ligand-receptor interaction with this vWF and platelets start aggregating around this spot. In the present study, multiscale coupling method is developed to simulate the initial stage of thrombus formation. In this method, the molecular scale interactions between vWF and GPIb- α is solve using the stochastic Monte Carlo simulations and the binding force at each computational cell is calculated. Then the force is directly coupled with the continuum scale simulation using finite different method. The results illustrate that fluctuation given by the motion of red blood cells plays an important role for the platelets to adhere to the injured vessel walls.

  5. Antiadhesive effect of fibrinogen: a safeguard for thrombus stability

    PubMed Central

    Lishko, Valeryi K.; Burke, Timothy; Ugarova, Tatiana

    2007-01-01

    The recruitment of phagocytic leukocytes to sites of vessel wall injury plays an important role in thrombus dissolution by proteases elaborated on their adhesion. However, leukocyte adhesion to the fibrin clot can be detrimental at the early stages of wound healing when hemostatic plug integrity is critical for preventing blood loss. Adhesion of circulating leukocytes to the insoluble fibrin(ogen) matrix is mediated by integrins and occurs in the presence of a high concentration of plasma fibrinogen. In this study, the possibility that soluble fibrinogen could protect fibrin from excessive adhesion of leukocytes was examined. Fibrinogen was a potent inhibitor of adhesion of U937 monocytoid cells and neutrophils to fibrin gel and immobilized fibrin(ogen). An investigation of the mechanism by which soluble fibrinogen exerts its influence on leukocyte adhesion indicated that it did not block integrins but rather associated with the fibrin(ogen) substrate. Consequently, leukocytes that engage fibrinogen molecules loosely bound to the surface of fibrin(ogen) matrix are not able to consolidate their grip on the substrate; subsequently, cells detach. This conclusion is based on the evidence obtained in adhesion studies using various cells and performed under static and flow conditions. These findings reveal a new role of fibrinogen in integrin-mediated leukocyte adhesion and suggest that this mechanism may protect the thrombus from premature dissolution. PMID:16849640

  6. A reduced estimate of the number of kilometre-sized near-Earth asteroids.

    PubMed

    Rabinowitz, D; Helin, E; Lawrence, K; Pravdo, S

    2000-01-13

    Near-Earth asteroids are small (diameters < 10 km), rocky bodies with orbits that approach that of the Earth (they come within 1.3 AU of the Sun). Most have a chance of approximately 0.5% of colliding with the Earth in the next million years. The total number of such bodies with diameters > 1 km has been estimated to be in the range 1,000-2,000, which translates to an approximately 1% chance of a catastrophic collision with the Earth in the next millennium. These numbers are, however, poorly constrained because of the limitations of previous searches using photographic plates. (One kilometre is below the size of a body whose impact on the Earth would produce global effects.) Here we report an analysis of our survey for near-Earth asteroids that uses improved detection technologies. We find that the total number of asteroids with diameters > 1 km is about half the earlier estimates. At the current rate of discovery of near-Earth asteroids, 90% will probably have been detected within the next 20 years.

  7. Efficacy of a 2% climbazole shampoo for reducing Malassezia population sizes on the skin of naturally infected dogs.

    PubMed

    Cavana, P; Petit, J-Y; Perrot, S; Guechi, R; Marignac, G; Reynaud, K; Guillot, J

    2015-12-01

    Shampoo therapy is often recommended for the control of Malassezia overgrowth in dogs. The aim of this study was to evaluate the in vivo activity of a 2% climbazole shampoo against Malassezia pachydermatis yeasts in naturally infected dogs. Eleven research colony Beagles were used. The dogs were distributed randomly into two groups: group A (n=6) and group B (n=5). Group A dogs were washed with a 2% climbazole shampoo, while group B dogs were treated with a physiological shampoo base. The shampoos were applied once weekly for two weeks. The population size of Malassezia yeasts on skin was determined by fungal culture through modified Dixon's medium contact plates pressed on left concave pinna, axillae, groins, perianal area before and after shampoo application. Samples collected were compared by Wilcoxon rank sum test. Samples collected after 2% climbazole shampoo application showed a significant and rapid reduction of Malassezia population sizes. One hour after the first climbazole shampoo application, Malassezia reduction was already statistically significant and 15 days after the second climbazole shampoo, Malassezia population sizes were still significantly decreased. No significant reduction of Malassezia population sizes was observed in group B dogs. The application of a 2% climbazole shampoo significantly reduced Malassezia population sizes on the skin of naturally infected dogs. Application of 2% climbazole shampoo may be useful for the control of Malassezia overgrowth and it may be also proposed as prevention when recurrences are frequent. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Effective size of a wild salmonid population is greatly reduced by hatchery supplementation

    PubMed Central

    Christie, M R; Marine, M L; French, R A; Waples, R S; Blouin, M S

    2012-01-01

    Many declining and commercially important populations are supplemented with captive-born individuals that are intentionally released into the wild. These supplementation programs often create large numbers of offspring from relatively few breeding adults, which can have substantial population-level effects. We examined the genetic effects of supplementation on a wild population of steelhead (Oncorhynchus mykiss) from the Hood River, Oregon, by matching 12 run-years of hatchery steelhead back to their broodstock parents. We show that the effective number of breeders producing the hatchery fish (broodstock parents; Nb) was quite small (harmonic mean Nb=25 fish per brood-year vs 373 for wild fish), and was exacerbated by a high variance in broodstock reproductive success among individuals within years. The low Nb caused hatchery fish to have decreased allelic richness, increased average relatedness, more loci in linkage disequilibrium and substantial levels of genetic drift in comparison with their wild-born counterparts. We also documented a substantial Ryman–Laikre effect whereby the additional hatchery fish doubled the total number of adult fish on the spawning grounds each year, but cut the effective population size of the total population (wild and hatchery fish combined) by nearly two-thirds. We further demonstrate that the Ryman–Laikre effect is most severe in this population when (1) >10% of fish allowed onto spawning grounds are from hatcheries and (2) the hatchery fish have high reproductive success in the wild. These results emphasize the trade-offs that arise when supplementation programs attempt to balance disparate goals (increasing production while maintaining genetic diversity and fitness). PMID:22805657

  9. Association of the Monocyte to HDL Cholesterol Ratio With Thrombus Burden in Patients With ST-Segment Elevation Myocardial Infarction.

    PubMed

    Arısoy, Arif; Altunkaş, Fatih; Karaman, Kayıhan; Karayakalı, Metin; Çelik, Ataç; Ceyhan, Köksal; Zorlu, Çağrı

    2016-01-01

    Intracoronary thrombus burden is associated with some adverse events and poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Identifying predictors of the intracoronary thrombus burden may contribute to the management of STEMI. In this study, we evaluated whether monocyte count to high-density lipoprotein cholesterol ratio (MHR) is a predictor of intracoronary thrombus burden in patients with STEMI. The study population consisted of 414 patients with STEMI who underwent primary percutaneous coronary intervention (PCI). Angiographic thrombus burden was classified based on thrombolysis in myocardial infarction (TIMI) thrombus grades. The patients were grouped into 2 categories of low thrombus burden and high thrombus burden. The MHR was significantly higher in the high thrombus burden group compared with the low thrombus group (16.0 [9.2-22.1] vs 25.4 [13.5-44.6]; P < .001). In multivariate logistic regression analysis, MHR was an independent predictor of high thrombus burden (odds ratio: 1.067, 95% CI: 1.031-1.105; P < .001). The area under the receiver-operating characteristic curve of the MHR was 0.688 (0.641-0.733; P < .001) to predict high thrombus burden. In conclusion, MHR was independent predictor of high thrombus burden in patients with STEMI who underwent primary PCI.

  10. Thrombus Permeability Is Associated With Improved Functional Outcome and Recanalization in Patients With Ischemic Stroke.

    PubMed

    Santos, Emilie M M; Marquering, Henk A; den Blanken, Mark D; Berkhemer, Olvert A; Boers, Anna M M; Yoo, Albert J; Beenen, Ludo F; Treurniet, Kilian M; Wismans, Carrie; van Noort, Kim; Lingsma, Hester F; Dippel, Diederik W J; van der Lugt, Aad; van Zwam, Wim H; Roos, Yvo B W E M; van Oostenbrugge, Robert J; Niessen, Wiro J; Majoie, Charles B

    2016-03-01

    Preclinical studies showed that thrombi can be permeable and may, therefore, allow for residual blood flow in occluded arteries of patients having acute ischemic stroke. This perviousness may increase tissue oxygenation, improve thrombus dissolution, and augment intra-arterial treatment success. We hypothesize that the combination of computed tomographic angiography and noncontrast computed tomography imaging allows measurement of contrast agent penetrating a permeable thrombus, and it is associated with improved outcome. Thrombus and contralateral artery attenuations in noncontrast computed tomography and computed tomographic angiography images were measured in 184 Multicenter Randomized Clinical trial of Endovascular treatment of acute ischemic stroke in the Netherlands (MR CLEAN) patients with thin-slice images. Two quantitative estimators of the thrombus permeability were introduced: computed tomographic angiography attenuation increase (Δ) and thrombus void fraction (ε). Patients were dichotomized as having a pervious or impervious thrombus and associated with outcome, recanalization, and final infarct volume. Patients with Δ≥10.9 HU (n=81 [44%]) and ε≥6.5% (n=77 [42%]) were classified as having a pervious thrombus. These patients were 3.2 (95% confidence interval, 1.7-6.4) times more likely to have a favorable outcome, and 2.5 (95% confidence interval, 1.3-4.8) times more likely to recanalyze, for Δ based classification, and similarly for ε. These odds ratios were independent from intravenous or intra-arterial treatment. Final infarct volume was negatively correlated with both perviousness estimates (correlation coefficient, -0.39 for Δ and -0.40 for ε). This study shows that simultaneous measurement of thrombus attenuation in noncontrast computed tomography and computed tomographic angiography allows for quantification of thrombus perviousness. Thrombus perviousness is strongly associated with improved functional outcome, smaller final infarct

  11. Total Mechanical Unloading Minimizes Metabolic Demand of Left Ventricle and Dramatically Reduces Infarct Size in Myocardial Infarction

    PubMed Central

    Kakino, Takamori; Arimura, Takahiro; Sakamoto, Takafumi; Nishikawa, Takuya; Sakamoto, Kazuo; Ikeda, Masataka; Kishi, Takuya; Ide, Tomomi; Sunagawa, Kenji

    2016-01-01

    Background Left ventricular assist device (LVAD) mechanically unloads the left ventricle (LV). Theoretical analysis indicates that partial LVAD support (p-LVAD), where LV remains ejecting, reduces LV preload while increases afterload resulting from the elevation of total cardiac output and mean aortic pressure, and consequently does not markedly decrease myocardial oxygen consumption (MVO2). In contrast, total LVAD support (t-LVAD), where LV no longer ejects, markedly decreases LV preload volume and afterload pressure, thereby strikingly reduces MVO2. Since an imbalance in oxygen supply and demand is the fundamental pathophysiology of myocardial infarction (MI), we hypothesized that t-LVAD minimizes MVO2 and reduces infarct size in MI. The purpose of this study was to evaluate the differential impact of the support level of LVAD on MVO2 and infarct size in a canine model of ischemia-reperfusion. Methods In 5 normal mongrel dogs, we examined the impact of LVAD on MVO2 at 3 support levels: Control (no LVAD support), p-LVAD and t-LVAD. In another 16 dogs, ischemia was induced by occluding major branches of the left anterior descending coronary artery (90 min) followed by reperfusion (300 min). We activated LVAD from the beginning of ischemia until 300 min of reperfusion, and compared the infarct size among 3 different levels of LVAD support. Results t-LVAD markedly reduced MVO2 (% reduction against Control: -56 ± 9%, p<0.01) whereas p-LVAD did less (-21 ± 14%, p<0.05). t-LVAD markedly reduced infarct size compared to p-LVAD (infarct area/area at risk: Control; 41.8 ± 6.4, p-LVAD; 29.1 ± 5.6 and t-LVAD; 5.0 ± 3.1%, p<0.01). Changes in creatine kinase-MB paralleled those in infarct size. Conclusions Total LVAD support that minimizes metabolic demand maximizes the benefit of LVAD in the treatment of acute myocardial infarction. PMID:27124411

  12. Anabolic steroids activate calcineurin-NFAT signaling and thereby increase myotube size and reduce denervation atrophy.

    PubMed

    Qin, Weiping; Pan, Jiangping; Wu, Yong; Bauman, William A; Cardozo, Christopher

    2015-01-05

    Anabolic androgens have been shown to reduce muscle loss due to immobilization, paralysis and many other medical conditions, but the molecular basis for these actions is poorly understood. We have recently demonstrated that nandrolone, a synthetic androgen, slows muscle atrophy after nerve transection associated with down-regulation of regulator of calcineurin 2 (RCAN2), a calcineurin inhibitor, suggesting a possible role of calcineurin-NFAT signaling. To test this possibility, rat gastrocnemius muscle was analyzed at 56 days after denervation. In denervated muscle, calcineurin activity declined and NFATc4 was excluded from the nucleus and these effects were reversed by nandrolone. Similarly, nandrolone increased calcineurin activity and nuclear NFATc4 levels in cultured L6 myotubes. Nandrolone also induced cell hypertrophy that was blocked by cyclosporin A or overexpression of RCAN2. Finally protection against denervation atrophy by nandrolone in rats was blocked by cyclosporin A. These results demonstrate for the first time that nandrolone activates calcineurin-NFAT signaling, and that such signaling is important in nandrolone-induced cell hypertrophy and protection against paralysis-induced muscle atrophy.

  13. Reduced size of the amygdala in individuals with 47,XXY and 47,XXX karyotypes.

    PubMed

    Patwardhan, Anil J; Brown, Wendy E; Bender, Bruce G; Linden, Mary G; Eliez, Stephan; Reiss, Allan L

    2002-01-08

    The excess of 47,XXX and 47,XXY karyotypes found in cytogenetic screening studies of individuals with schizophrenia has given support for an increased risk of psychiatric illness among men and women with sex chromosomal aneuploidy (SCA). Mesial temporal lobe structures, including the amygdala and hippocampus, are thought to be associated with abnormalities of mood and behavior in humans and in the neurobiology of schizophrenia. This study focuses on variations in volumes of mesial temporal lobe structures in men and women with SCA. Utilizing an unselected birth cohort of subjects with SCA and high-resolution magnetic resonance imaging (MRI), we investigated the neuroanatomical consequences of a supernumerary X chromosome on the morphology of the amygdala and hippocampus. Regional and total brain volumes were measured in 10 subjects with 47,XXY, 10 subjects with 47,XXX, and 20 euploid controls. Amygdala volumes were significantly reduced in men with 47,XXY, compared to control men, while the decrease in women with 47,XXX was not as pronounced. Hippocampus volumes were preserved in both groups, compared to same-gender controls. Longitudinal studies of SCA individuals have shown an increased incidence of mild psychopathology and behavioral dysfunction in men with 47,XXY and more overt psychiatric illness in women with 47,XXX, compared to control populations. The alteration in amygdala volumes in individuals with a supernumerary X chromosome may provide a neuroanatomic basis for these findings. Copyright 2001 Wiley-Liss, Inc.

  14. Role of coagulation in the recruitment of colon adenocarcinoma cells to thrombus under shear

    PubMed Central

    Itakura, Asako; Gruber, András; McCarty, Owen J. T.

    2013-01-01

    Colorectal cancer metastases can appear on the peritoneum and in lymph nodes, liver, and lungs, suggesting both hematogenous and lymphatic spreading of the primary tumor. While antithrombotic agents have been shown to reduce both long-term incidence and metastasis, the role of coagulation in facilitating metastasis is ill defined. We investigated the kinetics and molecular mechanisms of metastatic colon adenocarcinoma cell recruitment to thrombi under shear flow, ex vivo. Platelet aggregates were formed by perfusing citrated anticoagulated whole blood over immobilized fibrinogen or fibrillar collagen. Thrombi were formed by perfusing recalcified whole blood over fibrinogen or fibrillar collagen in the presence of coagulation. Cultured colon adenocarcinoma cells (SW620) were perfused either during or following platelet aggregate or thrombus formation. The degree of transient tumor cell interactions (recruitment, rolling, and release) and the number of firmly adhered tumor cells were quantified using fluorescence microscopy. Platelet aggregates and thrombi formed on either fibrinogen- or fibrillar-collagen supported SW620 cell interactions and adhesion under shear. Thrombi or fibrin supported a greater degree of SW620 cell interactions and adhesion compared with platelet aggregates or fibrinogen, respectively, demonstrating that coagulation promoted SW620 cell recruitment under shear. Interestingly, in the absence of anticoagulation, we observed SW620 preferentially binding to thrombus-bound polymorphonuclear leukocytes (PMNs). The addition of purified PMNs to thrombi resulted in a doubling of the number of interacting and bound SW620 cells. Since thrombi often accumulate and activate leukocytes, our findings suggest that leukocytes may play a role in localizing metastases to sites of thrombogenesis. PMID:23903698

  15. Reduced infarct size in neuroglobin-null mice after experimental stroke in vivo

    PubMed Central

    2012-01-01

    Background Neuroglobin is considered to be a novel important pharmacological target in combating stroke and neurodegenerative disorders, although the mechanism by which this protection is accomplished remains an enigma. We hypothesized that if neuroglobin is directly involved in neuroprotection, then permanent cerebral ischemia would lead to larger infarct volumes in neuroglobin-null mice than in wild-type mice. Methods Using neuroglobin-null mice, we estimated the infarct volume 24 hours after permanent middle cerebral artery occlusion using Cavalieri’s Principle, and compared the infarct volume in neuroglobin-null and wild-type mice. Neuroglobin antibody staining was used to examine neuroglobin expression in the infarct area of wild-type mice. Results Infarct volumes 24 hours after permanent middle cerebral artery occlusion were significantly smaller in neuroglobin-null mice than in wild-types (p < 0.01). Neuroglobin immunostaining of the penumbra area revealed no visible up-regulation of neuroglobin protein in ischemic wild-type mice when compared to uninjured wild-type mice. In uninjured wild-type mice, neuroglobin protein was seen throughout cortical layer II and sparsely in layer V. In contrast, no neuroglobin-immunoreactive neurons were observed in the aforementioned layers of the ischemia injured cortical area, or in the surrounding penumbra of ischemic wild-type mice. This suggests no selective sparing of neuroglobin expressing neurons in ischemia. Conclusions Neuroglobin-deficiency resulted in reduced tissue infarction, suggesting that, at least at endogenous expression levels, neuroglobin in itself is non-protective against ischemic injury. PMID:22901501

  16. Dipeptidyl peptidase-4 inhibitors and GLP-1 reduce myocardial infarct size in a glucose-dependent manner.

    PubMed

    Hausenloy, Derek J; Whittington, Hannah J; Wynne, Abigail M; Begum, Shah S; Theodorou, Louise; Riksen, Niels; Mocanu, Mihaela M; Yellon, Derek M

    2013-10-22

    The dipeptidyl peptidase-4 (DPP-4) inhibitors Sitagliptin and Vildagliptin lower blood glucose by augmenting endogenous levels of glucagon-like peptide-1 (GLP-1), an incretin which also confers cardioprotection. As such, we hypothesized that treatment with DPP-4 inhibitors are also cardioprotective. In ex vivo experiments: Male Sprague-Dawley rats were randomized to receive by oral gavage either Vildagliptin (20 mg/kg/day), Sitagliptin (100 mg/kg/day), or water for 2 weeks. Excised hearts were Langendorff-perfused with buffer containing either 5 mmol/L or 11 mmol/L glucose and subjected to 35 minutes ischaemia/120 minutes reperfusion. In in vivo experiments: Male young Wistar and Sprague-Dawley rats, middle aged Wistar and Goto-Kakizaki diabetic rats were randomized to receive by oral gavage either Sitagliptin (100 mg/kg/day), or water for 2 weeks. Rats were then subjected to 30 minutes ischaemia/120 minutes reperfusion and infarct size ascertained. Two weeks pre-treatment with either Vildagliptin or Sitagliptin reduced ex vivo myocardial infarction (MI) size in hearts perfused with buffer containing 11 mmol/L glucose but not 5 mmol/L glucose. This effect was abolished by Exendin 9-39 (GLP-1 receptor antagonist) and H-89 (PKA antagonist). Treatment of perfused hearts with native GLP-1 was also glucose-sensitive, reducing MI size, at glucose concentrations 7, 9, and 11 mmol/L but not at 5 mmol/L. Finally, Sitagliptin reduced in vivo MI size in middle aged Wistar (7-8 mmol/L glucose) and Goto-Kakizaki (9-10 mmol/L glucose) rats where blood glucose was elevated, but not in young Wistar (5 mmol/L glucose) or Sprague-Dawley (5 mmol/L glucose) rats, where blood glucose was normal. We find that chronic treatment with DPP-4 inhibitors reduced MI size, via the GLP-1 receptor-PKA pathway, in a glucose-dependent manner. Glucose-sensitive cardioprotection of endogenous GLP-1 in diabetic patients may in part explain why intensive control of serum glucose

  17. Effect of the hydrogen sulfide donor GYY4137 on platelet activation and microvascular thrombus formation in mice.

    PubMed

    Grambow, Eberhard; Mueller-Graf, Fabian; Delyagina, Evgenya; Frank, Marcus; Kuhla, Angela; Vollmar, Brigitte

    2014-01-01

    This study evaluates the effect of the H2S donor GYY4137 (GYY) on adhesion molecule expression, protein S-sulfhydration and morphology of platelets in vitro and on kinetics of microvascular thrombus formation in vivo. Using flowcytometry, untreated resting, TRAP-activated, or TRAP-activated and GYY-exposed human platelets were studied for expression of P-selectin, GPIb and GPIIb/IIIa as well as for fibrinogen binding. By means of electron microscopy, platelet morphology and intracellular granule numbers were assessed. Platelet shape change was studied using immunohistochemistry for P-selectin, NSF and F-actin by SR-SIM. Biotin switch assay served for the analysis of platelet protein S-sulfhydration by GYY. Using the FeCl3 and the light/dye model in dorsal skinfold chamber-equipped mice, the effect of GYY and its vehicle DMSO was studied on venular thrombus formation and tail-vein bleeding time. Soluble (s)P-selectin plasma concentrations were measured in GYY- or DMSO-treated animals. Exposure to GYY increased the S-sulfhydration of platelet proteins. GYY reduced dose-dependently the TRAP-induced adhesion molecule expression and attenuated the morphological signs of TRAP-associated platelet activation. In mice, GYY caused a significant prolongation of venular thrombus formation and tail-vein bleeding time. Application of an anti-P-selectin antibody in DMSO-exposed animals prolonged thrombosis formation comparably as GYY did. GYY reversed the TRAP-induced distribution of P-selectin at the plasma membrane of platelets. This indicates reduced exocytosis and shedding of P-selectin, which is supported by significantly lower sP-selectin concentrations in GYY- vs. DMSO-treated mice. H2S acts anti-thrombotic and seems to regulate thrombogenesis by interference with platelet activation and adhesion molecule-mediated aggregation.

  18. Hypothyroidism Reduces the Size of Ovarian Follicles and Promotes Hypertrophy of Periovarian Fat with Infiltration of Macrophages in Adult Rabbits

    PubMed Central

    Rodríguez-Castelán, J.; Méndez-Tepepa, M.; Carrillo-Portillo, Y.; Anaya-Hernández, A.; Zambrano, E.

    2017-01-01

    Ovarian failure is related to dyslipidemias and inflammation, as well as to hypertrophy and dysfunction of the visceral adipose tissue (VAT). Although hypothyroidism has been associated with obesity, dyslipidemias, and inflammation in humans and animals, its influence on the characteristics of ovarian follicles in adulthood is scarcely known. Control and hypothyroid rabbits were used to analyze the ovarian follicles, expression of aromatase in the ovary, serum concentration of lipids, leptin, and uric acid, size of adipocytes, and infiltration of macrophages in the periovarian VAT. Hypothyroidism did not affect the percentage of functional or atretic follicles. However, it reduced the size of primary, secondary, and tertiary follicles considered as large and the expression of aromatase in the ovary. This effect was associated with high serum concentrations of total cholesterol and low-density lipoprotein cholesterol (LDL-C). In addition, hypothyroidism induced hypertrophy of adipocytes and a major infiltration of CD68+ macrophages into the periovarian VAT. Our results suggest that the reduced size of ovarian follicles promoted by hypothyroidism could be associated with dyslipidemias, hypertrophy, and inflammation of the periovarian VAT. Present findings may be useful to understand the influence of hypothyroidism in the ovary function in adulthood. PMID:28133606

  19. Investigation of the InAs/GaAs Quantum Dots’ Size: Dependence on the Strain Reducing Layer’s Position

    PubMed Central

    Souaf, Manel; Baira, Mourad; Nasr, Olfa; Hadj Alouane, Mohamed Helmi; Maaref, Hassen; Sfaxi, Larbi; Ilahi, Bouraoui

    2015-01-01

    This work reports on theoretical and experimental investigation of the impact of InAs quantum dots (QDs) position with respect to InGaAs strain reducing layer (SRL). The investigated samples are grown by molecular beam epitaxy and characterized by photoluminescence spectroscopy (PL). The QDs optical transition energies have been calculated by solving the three dimensional Schrödinger equation using the finite element methods and taking into account the strain induced by the lattice mismatch. We have considered a lens shaped InAs QDs in a pure GaAs matrix and either with InGaAs strain reducing cap layer or underlying layer. The correlation between numerical calculation and PL measurements allowed us to track the mean buried QDs size evolution with respect to the surrounding matrix composition. The simulations reveal that the buried QDs’ realistic size is less than that experimentally driven from atomic force microscopy observation. Furthermore, the average size is found to be slightly increased for InGaAs capped QDs and dramatically decreased for QDs with InGaAs under layer. PMID:28793465

  20. Hypothyroidism Reduces the Size of Ovarian Follicles and Promotes Hypertrophy of Periovarian Fat with Infiltration of Macrophages in Adult Rabbits.

    PubMed

    Rodríguez-Castelán, J; Méndez-Tepepa, M; Carrillo-Portillo, Y; Anaya-Hernández, A; Rodríguez-Antolín, J; Zambrano, E; Castelán, F; Cuevas-Romero, E

    2017-01-01

    Ovarian failure is related to dyslipidemias and inflammation, as well as to hypertrophy and dysfunction of the visceral adipose tissue (VAT). Although hypothyroidism has been associated with obesity, dyslipidemias, and inflammation in humans and animals, its influence on the characteristics of ovarian follicles in adulthood is scarcely known. Control and hypothyroid rabbits were used to analyze the ovarian follicles, expression of aromatase in the ovary, serum concentration of lipids, leptin, and uric acid, size of adipocytes, and infiltration of macrophages in the periovarian VAT. Hypothyroidism did not affect the percentage of functional or atretic follicles. However, it reduced the size of primary, secondary, and tertiary follicles considered as large and the expression of aromatase in the ovary. This effect was associated with high serum concentrations of total cholesterol and low-density lipoprotein cholesterol (LDL-C). In addition, hypothyroidism induced hypertrophy of adipocytes and a major infiltration of CD68+ macrophages into the periovarian VAT. Our results suggest that the reduced size of ovarian follicles promoted by hypothyroidism could be associated with dyslipidemias, hypertrophy, and inflammation of the periovarian VAT. Present findings may be useful to understand the influence of hypothyroidism in the ovary function in adulthood.

  1. Factor XIII A-Subunit V34L Variant Affects Thrombus Cross-Linking in a Murine Model of Thrombosis.

    PubMed

    Duval, Cédric; Ali, Majid; Chaudhry, Waleed W; Ridger, Victoria C; Ariëns, Robert A S; Philippou, Helen

    2016-02-01

    Factor XIII (FXIII) cross-links fibrin upon activation by thrombin. Activation involves cleavage at residue 37 by thrombin, releasing an activation peptide. A common polymorphism (valine to leucine variant at residue 34, V34L), located in the activation peptide, has been associated with increased activation rates and paradoxically a protective effect in cardiovascular disease. There is, currently, no data available on the effects of V34L from in vivo models of thrombosis. We examined the effect of FXIII V34L on clot formation and cross-linking in vivo. We generated a panel of full-length recombinant human FXIII-A2 variants with amino acid substitutions in the activation peptide to investigate the effect of these variants on activation rate, and we used wild-type, V34L, and alanine to glycine variant at residue 33 variants to study the effects of varying FXIII activation rate on thrombus formation in a murine model of FeCl3 injury. FXIII activation assay showed that residues 29, 30, 33, and 34 play a critical role in thrombin interaction. Full-length recombinant human FXIII-A2 V34L has significant effects on clot formation, structure, and lysis in vitro, using turbidity assay. This variant influenced fibrin cross-linking but not size of the thrombus in vivo. Mutations in the activation peptide of full-length recombinant FXIII regulate activation rates by thrombin, and V34L influences in vivo thrombus formation by increased cross-linking of the clot. © 2016 American Heart Association, Inc.

  2. Reducing and Uniforming the Co3 O 4 Particle Size by Sulfonated Graphenal Polymers for Electrochemical Applications

    NASA Astrophysics Data System (ADS)

    Zhang, Xin; Liu, Xubo; Zeng, Sha; Fang, Jianhui; Men, Chuanling; Zhang, Xiaohua; Li, Qingwen

    2017-03-01

    A novel two-dimensional (2D) nanomaterial, namely sulfonated graphenal polymer (SGP), is used to tune the hydrothermal growth of Co3O4 nanoparticles. SGP provides abundant nucleation sites to grow Co3O4 nanoparticles and effectively reduces the particle size and dimension. As a result, with considering the improved size uniformity of Co3O4 and the tight wrapping of SGP around Co3O4 as well, the Co3O4/SGP hybrid electrode exhibits a high specific electrochemical capacitance of 234.28 F/g at a current density of 0.2 A/g, 237% higher than that of the pure Co3O4 electrode. By using the hybrid as the anode of an all-solid-state asymmetric supercapacitor, the capacitance can be well maintained up to 93% after 5000 cycles even at 2 A/g.

  3. Enhanced hydrogenation and reduced lattice distortion in size selected Pd-Ag and Pd-Cu alloy nanoparticles

    SciTech Connect

    Sengar, Saurabh K.; Mehta, B. R.; Kulriya, P. K.; Khan, S. A.

    2013-10-21

    Important correlation between valence band spectra and hydrogenation properties in Pd alloy nanoparticles is established by studying the properties of size selected and monocrystalline Pd, Ag, Cu, Pd-Ag, and Pd-Cu nanoparticles. The X-ray photoelectron spectroscopy and elastic recoil detection analysis show that size induced Pd4d centroid shift is related to enhanced hydrogenation with H/Pd ratio of 0.57 and 0.49 in Pd-Ag and Pd-Cu nanoparticles in comparison to reported bulk values of 0.2 and 0.1, respectively. Pd-alloy nanoparticles show lower hydrogen induced lattice distortion. The reduced distortion and higher hydrogen reactivity of Pd-alloy nanoparticles is important for numerous hydrogen related applications.

  4. Reduced microsatellite heterozygosity in island endemics supports the role of long-term effective population size in avian microsatellite diversity

    PubMed Central

    2011-01-01

    Because of the high mutation rate of microsatellites, polymorphism at microsatellite loci might be predicted to reflect the effective population size over a time span of about 10,000 years and thus to be associated with biogeographic factors impacting species on that time frame. This prediction was tested by comparing heterozygosity at microsatellite loci from 294 bird species, including 58 species endemic to oceanic islands. Controlling statistically for phylogenetic effects, mean heterozygosity was significantly reduced in oceanic island endemics compared to other species. There was also an effect of current endangerment, statistically independent of the effect of island endemicity. These results support the hypothesis that long-term effective population size can be an important causative factor behind differences among species with respect to microsatellite heterozygosity. PMID:21104002

  5. Use of High-Frequency In-Home Monitoring Data May Reduce Sample Sizes Needed in Clinical Trials

    PubMed Central

    Dodge, Hiroko H.; Zhu, Jian; Mattek, Nora C.; Austin, Daniel; Kornfeld, Judith; Kaye, Jeffrey A.

    2015-01-01

    individual-specific distributions of walking speed collected at baseline, 262 subjects are required. Similarly for computer use, 26 subjects are required. Conclusions Individual-specific thresholds of low functional performance based on high-frequency in-home monitoring data distinguish trajectories of MCI from NC and could substantially reduce sample sizes needed in dementia prevention RCTs. PMID:26379170

  6. Cytochrome P450 omega-hydroxylase inhibition reduces infarct size during reperfusion via the sarcolemmal KATP channel.

    PubMed

    Gross, Eric R; Nithipatikom, Kasem; Hsu, Anna K; Peart, Jason N; Falck, John R; Campbell, William B; Gross, Garrett J

    2004-12-01

    Inhibition of 20-hydroxyeicosatrienoic acid (20-HETE), by pretreatment with pharmacological inhibitors of cytochrome P450 (CYP) omega-hydroxylase, has been shown to reduce infarct size in canines when administered prior to ischemia. However, it is unknown whether these agents reduce infarct size when administered just prior to reperfusion and if the sarcolemmal and/or mitochondrial K(ATP) channels (sK(ATP) and mK(ATP)) contribute to cardioprotection. Therefore, we determined whether specific CYP inhibitors for epoxygenases and omega-hydroxylases are cardioprotective when given either prior to ischemia or prior to reperfusion and furthermore, if selective inhibition of the sK(ATP) by HMR-1098 or mK(ATP) by 5-hydroxydecanoic acid (5-HD) could abrogate this effect. Male Sprague-Dawley rats underwent 30 minutes of ischemia followed by 2 hours of reperfusion. Groups received either miconazole (MIC, non-selective CYP inhibitor, 3 mg/kg), 17-octadecynoic acid (17-ODYA, CYP omega-hydroxylase inhibitor, 0,3 or 3 mg/kg), N-methylsulfonyl-12, 12-dibromododec-11-enamide (DDMS, CYP omega-hydroxylase inhibitor, 0,4 or 4 mg/kg), N-methanesulfonyl-6-(2-propargyloxyphenyl)hexanamide (MS-PPOH, CYP epoxygenase inhibitor, 3 mg/kg), or vehicle either 10 minutes prior to ischemia or 5 minutes prior to reperfusion. Rats also received either HMR-1098 (6 mg/kg) or 5-HD (10 mg/kg) 10 minutes prior to reperfusion, with subsets of rats also receiving either MIC or 17-ODYA 5 minutes prior to reperfusion. DDMS and 17-ODYA dose dependently reduced infarct size. Rats treated with MIC, 17-ODYA and DDMS, but not MS-PPOH, produced comparable reductions in infarct size when administered prior to ischemia or reperfusion compared to vehicle. HMR-1098, but not 5-HD, also blocked the infarct size reduction afforded by MIC and 17-ODYA. These data suggest a novel cardioprotective pathway involving CYP omega-hydroxylase inhibition and subsequent activation of the sK(ATP) channel during reperfusion.

  7. Plasmodesmata formation and cell-to-cell transport are reduced in decreased size exclusion limit 1 during embryogenesis in Arabidopsis

    PubMed Central

    Xu, Min; Cho, Euna; Burch-Smith, Tessa M.; Zambryski, Patricia C.

    2012-01-01

    In plants, plasmodesmata (PD) serve as channels for micromolecular and macromolecular cell-to-cell transport. Based on structure, PD in immature tissues are classified into two types, simple and branched (X- and Y-shaped) or twinned. The maximum size of molecules capable of PD transport defines PD aperture, known as the PD size exclusion limit. Here we report an Arabidopsis mutation, decreased size exclusion limit1 (dse1), that exhibits reduced cell-to-cell transport of the small (524 Da) fluorescent tracer 8-hydroxypyrene-1,3,6-trisulfonic acid at the midtorpedo stage of embryogenesis. Correspondingly, the fraction of X- and Y-shaped and twinned PD was reduced in dse1 embryos compared with WT embryos at this stage, suggesting that the frequency of PD is related to transport capability. dse1 is caused by a point mutation in At4g29860 (previously termed TANMEI) at the last donor splice site of its transcript, resulting in alternative splicing in both the first intron and the last intron. AtDSE1 is a conserved eukaryotic 386-aa WD-repeat protein critical for Arabidopsis morphogenesis and reproduction. Similar to its homologs in mouse, null mutants are embryo-lethal. The weak loss-of-function mutant dse1 exhibits pleiotropic phenotypes, including retarded vegetative growth, delayed flowering time, dysfunctional male and female organs, and delayed senescence. Finally, silencing of DSE1 in Nicotiana benthamiana leaves leads to reduced movement of GFP fused to tobacco mosaic virus movement protein. Thus, DSE1 is important for regulating PD transport between plant cells. PMID:22411811

  8. Plasmodesmata formation and cell-to-cell transport are reduced in decreased size exclusion limit 1 during embryogenesis in Arabidopsis.

    PubMed

    Xu, Min; Cho, Euna; Burch-Smith, Tessa M; Zambryski, Patricia C

    2012-03-27

    In plants, plasmodesmata (PD) serve as channels for micromolecular and macromolecular cell-to-cell transport. Based on structure, PD in immature tissues are classified into two types, simple and branched (X- and Y-shaped) or twinned. The maximum size of molecules capable of PD transport defines PD aperture, known as the PD size exclusion limit. Here we report an Arabidopsis mutation, decreased size exclusion limit1 (dse1), that exhibits reduced cell-to-cell transport of the small (524 Da) fluorescent tracer 8-hydroxypyrene-1,3,6-trisulfonic acid at the midtorpedo stage of embryogenesis. Correspondingly, the fraction of X- and Y-shaped and twinned PD was reduced in dse1 embryos compared with WT embryos at this stage, suggesting that the frequency of PD is related to transport capability. dse1 is caused by a point mutation in At4g29860 (previously termed TANMEI) at the last donor splice site of its transcript, resulting in alternative splicing in both the first intron and the last intron. AtDSE1 is a conserved eukaryotic 386-aa WD-repeat protein critical for Arabidopsis morphogenesis and reproduction. Similar to its homologs in mouse, null mutants are embryo-lethal. The weak loss-of-function mutant dse1 exhibits pleiotropic phenotypes, including retarded vegetative growth, delayed flowering time, dysfunctional male and female organs, and delayed senescence. Finally, silencing of DSE1 in Nicotiana benthamiana leaves leads to reduced movement of GFP fused to tobacco mosaic virus movement protein. Thus, DSE1 is important for regulating PD transport between plant cells.

  9. Upfront thrombus aspiration in primary coronary intervention for patients with ST-segment elevation acute myocardial infarction: report of the VAMPIRE (VAcuuM asPIration thrombus REmoval) trial.

    PubMed

    Ikari, Yuji; Sakurada, Masami; Kozuma, Ken; Kawano, Shigeo; Katsuki, Takaaki; Kimura, Kazuo; Suzuki, Takahiko; Yamashita, Takehiro; Takizawa, Akinori; Misumi, Kazuo; Hashimoto, Hideki; Isshiki, Takaaki

    2008-08-01

    This study evaluated safety and efficacy of upfront thrombus aspiration during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Distal embolization during primary PCI results in reduced myocardial perfusion and poor clinical outcomes. The VAMPIRE (VAcuuM asPIration thrombus REmoval) study was a prospective, randomized, controlled multicenter trial conducted in 23 institutions. Patients (N = 355) presenting within 24 h of STEMI symptoms onset were randomized to primary PCI with (n = 180) or without (n = 175) upfront thrombus aspiration using Nipro's TransVascular Aspiration Catheter (Osaka, Japan). The TransVascular Aspiration Catheter reached the lesion in 100% of cases. It successfully crossed the target obstruction in 86% without any delay in procedure time or time to reperfusion; whereas macroscopic thrombi were removed in 75% of the cases. Procedure success was similar between groups (98.9% vs. 98.3%). There was a trend toward lower incidence of slow or no reflow (primary end point-defined as a Thrombolysis In Myocardial Infarction flow grade <3) in patients treated with aspiration versus conventional primary PCI (12.4% vs. 19.4%, p = 0.07). Rate of myocardial blush grade 3 was higher in the aspiration group (46.0% vs. 20.5%, p < 0.001). Aspiration was most effective in patients presenting after 6 h of symptoms onset (slow flow rate: 8.1% vs. 37.6%, p = 0.01). This study suggested the safety of primary PCI with upfront thrombectomy using a novel device in patients with STEMI. The study showed a trend toward improved myocardial perfusion and lower clinical events in patients treated with aspiration. Patients presenting late after STEMI appear to benefit the most from thrombectomy.

  10. Numerical modeling of the flow in intracranial aneurysms: prediction of regions prone to thrombus formation.

    PubMed

    Rayz, V L; Boussel, L; Lawton, M T; Acevedo-Bolton, G; Ge, L; Young, W L; Higashida, R T; Saloner, D

    2008-11-01

    The deposition of intralumenal thrombus in intracranial aneurysms adds a risk of thrombo-embolism over and above that posed by mass effect and rupture. In addition to biochemical factors, hemodynamic factors that are governed by lumenal geometry and blood flow rates likely play an important role in the thrombus formation and deposition process. In this study, patient-specific computational fluid dynamics (CFD) models of blood flow were constructed from MRA data for three patients who had fusiform basilar aneurysms that were thrombus free and then proceeded to develop intralumenal thrombus. In order to determine whether features of the flow fields could suggest which regions had an elevated potential for thrombus deposition, the flow was modeled in the baseline, thrombus-free geometries. Pulsatile flow simulations were carried out using patient-specific inlet flow conditions measured with MR velocimetry. Newtonian and non-Newtonian blood behavior was considered. A strong similarity was found between the intra-aneurysmal regions with CFD-predicted slow, recirculating flows and the regions of thrombus deposition observed in vivo in the follow-up MR studies. In two cases with larger aneurysms, the agreement between the low velocity zones and clotted-off regions improved when non-Newtonian blood behavior was taken into account. A similarity was also found between the calculated low shear stress regions and the regions that were later observed to clot.

  11. Neutrophil-lymphocyte ratio may predict left atrial thrombus in patients with nonvalvular atrial fibrillation.

    PubMed

    Yalcin, Murat; Aparci, Mustafa; Uz, Omer; Isilak, Zafer; Balta, Sevket; Dogan, Mehmet; Kardesoglu, Ejder; Uzun, Mehmet

    2015-03-01

    Neutrophil-lymphocyte ratio (NLR) has been associated with poor outcomes in patients with cardiovascular diseases. We aimed to compare NLRs among patients with nonvalvular atrial fibrillation (AF) with or without left atrial (LA) thrombus. A total of 309 (70.1 ± 9.8 years, 49% male) patients with nonvalvular AF have undergone transoesophageal echocardiography (TEE) to assess the presence of LA thrombus. Baseline NLR was measured by dividing neutrophil count to lymphocyte count. Left atrial thrombus was detected in 32 (10.3%) of 309 patients. Mean NLR (2.2 ± 1.0 vs 2.7 ± 1.1, P = .026) was significantly higher among patients with LA thrombus compared to patients without LA thrombus. On multivariate analysis, NLR (odds ratio 1.59, 95% confidence interval 0.87-4.18; P < .02) was an independent risk factor for the presence of LA thrombus in patients with nonvalvular AF. Neutrophil-lymphocyte ratio, an emerging marker of inflammation, was independently associated with the presence of LA thrombus in patients with nonvalvular AF. © The Author(s) 2013.

  12. Effect of GABA derivatives on the rate of thrombus formation, platelet aggregation, and plasma coagulation capacity in rats with experimental gestosis.

    PubMed

    Tyurenkov, I N; Perfilova, V N; Karamysheva, V I; Reznikova, L B; Mokrousov, I S; Mikhailova, L I; Berestovitskaya, V M; Vasil'eva, O S

    2014-12-01

    Experimental gestosis induced by replacement of drinking water with 1.8% NaCl promoted hypercoagulation, increased the rate and degree of platelet aggregation, and reduced clotting time in pregnant females. GABA derivatives, compounds RGPU-151, RGPU-152, and phenibut normalized parameters of hemostasis and platelet aggregation and the rate of thrombus formation in the animals. The efficiency of the test substances did not significantly differ from that of the reference drug sulodexide.

  13. Reduced neuronal size and mTOR pathway activity in the Mecp2 A140V Rett syndrome mouse model.

    PubMed

    Rangasamy, Sampathkumar; Olfers, Shannon; Gerald, Brittany; Hilbert, Alex; Svejda, Sean; Narayanan, Vinodh

    2016-01-01

    Rett syndrome (RTT) is a neurodevelopmental disorder caused by mutation in the X-linked MECP2 gene, encoding methyl-CpG-binding protein 2. We have created a mouse model ( Mecp2 A140V "knock-in" mutant) expressing the recurrent human MECP2 A140V mutation linked to an X-linked mental retardation/Rett syndrome phenotype. Morphological analyses focused on quantifying soma and nucleus size were performed on primary hippocampus and cerebellum granule neuron (CGN) cultures from mutant ( Mecp2(A140V/y)) and wild type ( Mecp2(+/y)) male mice. Cultured hippocampus and cerebellar granule neurons from mutant animals were significantly smaller than neurons from wild type animals. We also examined soma size in hippocampus neurons from individual female transgenic mice that express both a mutant  (maternal allele) and a wild type Mecp2 gene linked to an eGFP transgene (paternal allele). In cultures from such doubly heterozygous female mice, the size of neurons expressing the mutant (A140V) allele also showed a significant reduction compared to neurons expressing wild type MeCP2, supporting a cell-autonomous role for MeCP2 in neuronal development. IGF-1 (insulin growth factor-1) treatment of neuronal cells from Mecp2 mutant mice rescued the soma size phenotype. We also found that Mecp2  mutation leads to down-regulation of the mTOR signaling pathway, known to be involved in neuronal size regulation. Our results suggest that i) reduced neuronal size is an important in vitro cellular phenotype of Mecp2 mutation in mice, and ii) MeCP2 might play a critical role in the maintenance of neuronal structure by modulation of the mTOR pathway. The definition of a quantifiable cellular phenotype supports using neuronal size as a biomarker in the development of a high-throughput, in vitro assay to screen for compounds that rescue small neuronal phenotype ("phenotypic assay").

  14. Reduced neuronal size and mTOR pathway activity in the Mecp2 A140V Rett syndrome mouse model

    PubMed Central

    Rangasamy, Sampathkumar; Olfers, Shannon; Gerald, Brittany; Hilbert, Alex; Svejda, Sean; Narayanan, Vinodh

    2016-01-01

    Rett syndrome (RTT) is a neurodevelopmental disorder caused by mutation in the X-linked MECP2 gene, encoding methyl-CpG-binding protein 2. We have created a mouse model ( Mecp2 A140V “knock-in” mutant) expressing the recurrent human MECP2 A140V mutation linked to an X-linked mental retardation/Rett syndrome phenotype. Morphological analyses focused on quantifying soma and nucleus size were performed on primary hippocampus and cerebellum granule neuron (CGN) cultures from mutant ( Mecp2 A140V/y) and wild type ( Mecp2 +/y) male mice. Cultured hippocampus and cerebellar granule neurons from mutant animals were significantly smaller than neurons from wild type animals. We also examined soma size in hippocampus neurons from individual female transgenic mice that express both a mutant  (maternal allele) and a wild type Mecp2 gene linked to an eGFP transgene (paternal allele). In cultures from such doubly heterozygous female mice, the size of neurons expressing the mutant (A140V) allele also showed a significant reduction compared to neurons expressing wild type MeCP2, supporting a cell-autonomous role for MeCP2 in neuronal development. IGF-1 (insulin growth factor-1) treatment of neuronal cells from Mecp2 mutant mice rescued the soma size phenotype. We also found that Mecp2   mutation leads to down-regulation of the mTOR signaling pathway, known to be involved in neuronal size regulation. Our results suggest that i) reduced neuronal size is an important in vitro cellular phenotype of Mecp2 mutation in mice, and ii) MeCP2 might play a critical role in the maintenance of neuronal structure by modulation of the mTOR pathway. The definition of a quantifiable cellular phenotype supports using neuronal size as a biomarker in the development of a high-throughput, in vitro assay to screen for compounds that rescue small neuronal phenotype (“phenotypic assay”). PMID:27781091

  15. Mercury induces proliferation and reduces cell size in vascular smooth muscle cells through MAPK, oxidative stress and cyclooxygenase-2 pathways

    SciTech Connect

    Aguado, Andrea; Galán, María; Zhenyukh, Olha; Wiggers, Giulia A.; Roque, Fernanda R.; Redondo, Santiago; Peçanha, Franck; Martín, Angela; Fortuño, Ana; Cachofeiro, Victoria; Tejerina, Teresa; Salaices, Mercedes; and others

    2013-04-15

    MAPK activation, oxidative stress and COX-2 expression. ► Inhibition of MAPK reduces HgCl{sub 2}-induced oxidative stress and COX-2 expression. ► Inhibition of MAPK, oxidative stress and COX-2 restores the altered cell proliferation and size.

  16. Long-term survival after radical surgery for renal cell carcinoma with tumour thrombus extension into the right atrium.

    PubMed

    Dominik, Jan; Moravek, Petr; Zacek, Pavel; Vojacek, Jan; Brtko, Miroslav; Podhola, Miroslav; Pacovsky, Jaroslav; Harrer, Jan

    2013-03-01

    What's known on the subject? and What does the study add? Surgical treatment of renal cell carcinoma (RCC) with tumour thrombus extending into the right atrium remains, despite its complexity and specific technical aspects, the only radical therapeutic option. This single-centre study, unique in size for this rare condition, reports early and late results over a period of 18 years. All patients were operated on using a standardised protocol with use of cardiopulmonary bypass and deep hypothermic circulatory arrest. Overall and cancer-specific cumulative survival was better than in other reports. To evaluate the long-term results of radical surgical management of renal cell carcinoma (RCC) with tumour thrombus extension (TTE) level IV into the right atrium (RCC/TTE IV) in a large single-institution series. Radical complex urological and cardio-surgical procedure was performed over a period of 18 years (1993-2010) on 21 patients with RCC/TTE IV. A radical nephrectomy was performed followed by sternotomy, institution of cardiopulmonary bypass and extraction of the intracardiac tumour thrombus under direct visual control during deep hypothermic circulatory arrest (DHCA). Perioperative and postoperative variables, and long-term overall and cancer-specific survival using the Kaplan-Meier method were analysed. In all patients, precise removal of tumour thrombus was accomplished in a bloodless field during DHCA. The mean (sd) duration of circulatory arrest was 16 (6) min at a mean hypothermia of 20 (3) °C. In-hospital mortality was 9.5% (two patients). The median survival (including in-hospital mortality) was 25 months. In Kaplan-Meier analysis, 2- and 5-year overall cumulative survival rate was 57 (95% confidence interval, CI 36-78)% and 37 (95% CI 15-58)%, respectively. Cancer-specific cumulative survival was 68 (95% CI 49-89)% at 2 years and 51 (95% CI 28-74)% at 5 years. Late outcome after radical surgical treatment in patients with RCC and TTE reaching up to the

  17. Using a Reduced Spot Size for Intensity-Modulated Proton Therapy Potentially Improves Salivary Gland-Sparing in Oropharyngeal Cancer

    SciTech Connect

    Water, Tara A. van de; Lomax, Antony J.; Bijl, Hendrik P.; Schilstra, Cornelis; Hug, Eugen B.; Langendijk, Johannes A.

    2012-02-01

    Purpose: To investigate whether intensity-modulated proton therapy with a reduced spot size (rsIMPT) could further reduce the parotid and submandibular gland dose compared with previously calculated IMPT plans with a larger spot size. In addition, it was investigated whether the obtained dose reductions would theoretically translate into a reduction of normal tissue complication probabilities (NTCPs). Methods: Ten patients with N0 oropharyngeal cancer were included in a comparative treatment planning study. Both IMPT plans delivered simultaneously 70 Gy to the boost planning target volume (PTV) and 54 Gy to the elective nodal PTV. IMPT and rsIMPT used identical three-field beam arrangements. In the IMPT plans, the parotid and submandibular salivary glands were spared as much as possible. rsIMPT plans used identical dose-volume objectives for the parotid glands as those used by the IMPT plans, whereas the objectives for the submandibular glands were tightened further. NTCPs were calculated for salivary dysfunction and xerostomia. Results: Target coverage was similar for both IMPT techniques, whereas rsIMPT clearly improved target conformity. The mean doses in the parotid glands and submandibular glands were significantly lower for three-field rsIMPT (14.7 Gy and 46.9 Gy, respectively) than for three-field IMPT (16.8 Gy and 54.6 Gy, respectively). Hence, rsIMPT significantly reduced the NTCP of patient-rated xerostomia and parotid and contralateral submandibular salivary flow dysfunction (27%, 17%, and 43% respectively) compared with IMPT (39%, 20%, and 79%, respectively). In addition, mean dose values in the sublingual glands, the soft palate and oral cavity were also decreased. Obtained dose and NTCP reductions varied per patient. Conclusions: rsIMPT improved sparing of the salivary glands and reduced NTCP for xerostomia and parotid and submandibular salivary dysfunction, while maintaining similar target coverage results. It is expected that rsIMPT improves quality

  18. The role of Nox1 and Nox2 in GPVI-dependent platelet activation and thrombus formation☆

    PubMed Central

    Walsh, T.G.; Berndt, M.C.; Carrim, N.; Cowman, J.; Kenny, D.; Metharom, P.

    2014-01-01

    Background Activation of the platelet-specific collagen receptor, glycoprotein (GP) VI, induces intracellular reactive oxygen species (ROS) production; however the relevance of ROS to GPVI-mediated platelet responses remains unclear. Objective The objective of this study was to explore the role of the ROS-producing NADPH oxidase (Nox)1 and 2 complexes in GPVI-dependent platelet activation and collagen-induced thrombus formation. Methods and results ROS production was measured by quantitating changes in the oxidation-sensitive dye, H2DCF-DA, following platelet activation with the GPVI-specific agonist, collagen related peptide (CRP). Using a pharmacological inhibitor specific for Nox1, 2-acetylphenothiazine (ML171), and Nox2 deficient mice, we show that Nox1 is the key Nox homolog regulating GPVI-dependent ROS production. Nox1, but not Nox2, was essential for CRP-dependent thromboxane (Tx)A2 production, which was mediated in part through p38 MAPK signaling; while neither Nox1 nor Nox2 was significantly involved in regulating CRP-induced platelet aggregation/integrin αIIbβ3 activation, platelet spreading, or dense granule and α-granule release (ATP release and P-selectin surface expression, respectively). Ex-vivo perfusion analysis of mouse whole blood revealed that both Nox1 and Nox2 were involved in collagen-mediated thrombus formation at arterial shear. Conclusion Together these results demonstrate a novel role for Nox1 in regulating GPVI-induced ROS production, which is essential for optimal p38 activation and subsequent TxA2 production, providing an explanation for reduced thrombus formation following Nox1 inhibition. PMID:24494191

  19. No-Reflow Phoenomenon by Intracoronary Thrombus in Acute Myocardial Infarction.

    PubMed

    Lim, Sang Yup

    2016-01-01

    Recently, percutaneous coronary intervention has been the treatment of choice in most acute myocardial infarction cases. Although the results of percutaneous coronary interventions have ben good, the no-reflow phenomenon and distal embolization of intracoronary thrombus are still major problems even after successful interventions. In this article, we will briefly review the deleterious effects of no-reflow and distal embolization of intracoronary thrombus during percutaneous coronary interventions. The current trials focused on the prevention and treatment of the no-reflow phenomenon and intracoronary thrombus.

  20. Left Ventricular Thrombus Formation After Repair of Anomalous Left Coronary Artery From the Pulmonary Artery

    PubMed Central

    Freud, Lindsay R.; Koenig, Peter R.; Russell, Hyde M.; Patel, Angira

    2014-01-01

    Although thrombus formation following myocardial infarction in adults is well known, intracardiac thrombosis in children is uncommon. We report the case of a large left ventricular thrombus in an infant with ischemic cardiomyopathy secondary to anomalous origin of the left coronary artery from the pulmonary artery. Given its mobility and protrusion across the aortic valve, the patient underwent urgent thrombus removal through a transaortic approach. There were no embolic or neurologic complications. This case highlights that thrombectomy may be performed safely and successfully in critically ill pediatric patients. PMID:24668990

  1. A Left Ventricular Thrombus in a Patient With Primary Antiphospholipid Syndrome Removed Under Thoracoscopic Support.

    PubMed

    Suzuki, Kota; Totsugawa, Toshinori; Hiraoka, Arudo; Tamura, Kentaro; Chikazawa, Genta; Ishida, Atsuhisa; Sakaguchi, Taichi; Yoshitaka, Hidenori

    2016-08-01

    The antiphospholipid syndrome is an autoimmune disorder characterized by vascular thrombosis. Left ventricular thrombus with antiphospholipid syndrome is rare, and there are few reports regarding surgical resection of such cases. We report the case of a 45-year-old woman who had been diagnosed as having primary antiphospholipid syndrome and was admitted to our hospital for treatment of left ventricular thrombus detected by an echocardiography. The thrombus was completely removed using video-assisted thoracoscopy through a right minithoracotomy. Left ventricular thrombectomy through a right minithoracotomy in a patient with antiphospholipid syndrome has not been previously reported. This approach is less invasive and more effective in such coagulation system disorders.

  2. Stentriever thrombectomy with distal protection device for carotid free floating thrombus: a technical case report.

    PubMed

    Giragani, Suresh; Balani, Ankit; Agrawal, Vikas

    2017-01-18

    We report the clinical details, imaging findings and management of a 45-year-old man who presented with recurrent transient ischemic attacks due to carotid free floating thrombus. Free floating thrombus of the carotid artery is a very rare condition with a high risk of distal embolic shower. The optimal treatment options are debatable and include medical management, surgical thrombectomy and endovascular thrombectomy. We describe the use of a stentriever with filter protection in the management of carotid free floating thrombus as a novel treatment option. 2017 BMJ Publishing Group Ltd.

  3. Stentriever thrombectomy with distal protection device for carotid free floating thrombus: a technical case report.

    PubMed

    Giragani, Suresh; Balani, Ankit; Agrawal, Vikas

    2017-01-25

    We report the clinical details, imaging findings and management of a 45-year-old man who presented with recurrent transient ischemic attacks due to carotid free floating thrombus. Free floating thrombus of the carotid artery is a very rare condition with a high risk of distal embolic shower. The optimal treatment options are debatable and include medical management, surgical thrombectomy and endovascular thrombectomy. We describe the use of a stentriever with filter protection in the management of carotid free floating thrombus as a novel treatment option.

  4. Neonatal repair of left atrial diverticulum with gigantic thrombus without cardiopulmonary bypass.

    PubMed

    Higashida, Akihiko; Hoashi, Takaya; Sakaguchi, Heima; Ichikawa, Hajime

    2017-04-08

    A 5-day-old neonate with coarctation of the aorta, hypoplastic aortic arch, large apical muscular ventricular septal defect, and patent ductus arteriosus developed pulmonary over-circulation and systemic hypoperfusion underwent bilateral pulmonary artery banding through median sternotomy as a part of hybrid stage I palliation. At operation, left atrial diverticulum with gigantic thrombus formation at the base of the left atrial appendage was incidentally detected by intraoperative direct echocardiography, and therefore, was successfully resected with the whole thrombus inside it without use of cardiopulmonary bypass. Histopathological finding was compatible with diverticulum. The patient was free from atrial arrhythmia and recurrent thrombus formation.

  5. Impact of particle size distribution on rheological and textural properties of chocolate models with reduced fat content.

    PubMed

    Do, T-A L; Hargreaves, J M; Wolf, B; Hort, J; Mitchell, J R

    2007-11-01

    With an increasing consumption of lipids nowadays, decreasing the fat content in food products has become a trend. Chocolate is a fat-based suspension that contains about 30%wt fat. Reducing fat content causes an increase in the molten chocolate viscosity. This leads to 2 major issues: difficulties in the process and a loss of eating quality in the final product, reported to have poor in-mouth melting properties, remain hard, and difficult to swallow. Literature shows that optimizing the particle size distribution (PSD), that is, having one with an increased packing fraction, can decrease the viscosity of highly concentrated suspensions. This study focuses on the impact of the PSD and fat content on the rheological properties, melting behavior, and hardness of chocolate models (dispersions of sugar in fat). We show that optimizing the PSD while reducing the fat content to a critical amount (22%wt) can decrease the viscosity of the molten material and reduce the hardness of the crystallized chocolate models. Melting in the mouth, characterized by an in vitro collapse speed, is faster for the samples with an optimized PSD. The decrease in the viscosity by optimizing the PSD in systems with a constant fraction of medium phase is based on the decrease of interparticle contact, reducing the particle aggregates strength, and structure buildup during flow or meltdown. In its crystallized state, the particle network is less interconnected, providing less resistance to breakage and meltdown.

  6. Analysis of stunter1, a maize mutant with reduced gametophyte size and maternal effects on seed development.

    PubMed

    Phillips, Allison R; Evans, Matthew M S

    2011-04-01

    Many higher eukaryotes have evolved strategies for the maternal control of growth and development of their offspring. In higher plants this is achieved in part by postmeiotic gene activity controlling the development of the haploid female gametophyte. stunter1 (stt1) is a novel, recessive, maternal effect mutant in maize that displays viable, miniature kernels. Maternal inheritance of stt1 results in seeds with reduced but otherwise normal endosperms and embryos. The stt1 mutation displays reduced transmission through the male and female parents and causes significant changes in the sizes of both male and female gametophytes. stt1 pollen grains are smaller than wild type, have reduced germination efficiency, and reduced pollen tube growth. stt1 embryo sacs have smaller central cells and abnormal antipodal cells that are larger, more vacuolated, and fewer in number than wild type. Embryos and endosperms produced by fertilization of stt1 embryo sacs develop and grow more slowly than wild type. The data suggest that the morphology of mutant embryo sacs influences endosperm development, leading to the production of miniature kernels in stt1. Analysis of seeds carrying a mutant maternal allele of stt1 over a deletion of the paternal allele demonstrates that both parental alleles are active after fertilization in both the endosperm and embryo. This analysis also indicates that embryo development until the globular stage in maize can proceed without endosperm development and is likely supported directly by the diploid mother plant.

  7. The Educational Effects of a State Supported Reduced Class Size Program. A Comprehensive Evaluation of Indiana's Project PRIME TIME at the North Gibson School Corporation.

    ERIC Educational Resources Information Center

    Swan, Edward; And Others

    Research studies on class size date back to 1900. Common sense has suggested that small classes lead to greater academic achievement, but most research on the effects of class size on achievement have been inconclusive. Furthermore, the financial costs and political consequences of reducing class size have generally prohibited the adoption of…

  8. A facile completely 'green' size tunable synthesis of maltose-reduced silver nanoparticles without the use of any accelerator.

    PubMed

    Oluwafemi, Oluwatobi S; Lucwaba, Yolisa; Gura, Akhona; Masabeya, Moffat; Ncapayi, Vuyelwa; Olujimi, Olanrewaju O; Songca, Sandile P

    2013-02-01

    A simple, straightforward, cost effective and environmentally benign method for the synthesis of highly stable and small sized silver nanoparticles (Ag-NPs) with narrow size distribution without the use of an accelerator is reported. Silver nitrate, gelatin and maltose, a non-toxic disaccharide sugar were used as silver precursor, stabiliser and reducing agent. By varying the precursor concentration and reaction time, we monitored the temporal evolution of the optical and structural properties of the as-synthesised Ag-NPs. The as-synthesised Ag-NPs were characterised using UV-vis absorption spectroscopy, Fourier transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM), high resolution transmission electron microscopy (HRTEM) and X-ray diffraction (XRD). The absorption maxima of the surface plasmon resonance (SPR) were blue-shifted as the reaction time increased indicating decrease in particle size. The TEM images showed that, the particles are small, well dispersed and spherical in shape. The smallest particles with an average particle diameter of 3.76±1.00 nm and 4.09±1.83 nm were obtained at 24h for the 1.0M and 0.5M silver ion precursor solution concentration respectively. The smaller particles produced were attributed to the higher concentration of the reducing saccharides in the reaction system, which in turn increases the formation of stable silver ions in the reaction system. The HRTEM images confirmed the crystalline nature of the material while the FTIR confirmed the stabilisation of the Ag-NPs by the gelatin. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Cinacalcet Effectively Reduces Parathyroid Hormone Secretion and Gland Volume Regardless of Pretreatment Gland Size in Patients with Secondary Hyperparathyroidism

    PubMed Central

    Komaba, Hirotaka; Nakanishi, Shohei; Fujimori, Akira; Tanaka, Motoko; Shin, Jeongsoo; Shibuya, Koji; Nishioka, Masato; Hasegawa, Hirohito; Kurosawa, Takeshi

    2010-01-01

    Background and objectives: Cinacalcet is effective in reducing serum parathyroid hormone (PTH) in patients with secondary hyperparathyroidism. However, it has not been proven whether parathyroid gland size predicts response to therapy and whether cinacalcet is capable of inducing a reduction in parathyroid volume. Design, setting, participants, & measurements: This 52-week, multicenter, open-label study enrolled hemodialysis patients with moderate to severe secondary hyperparathyroidism (intact PTH >300 pg/ml). Doses of cinacalcet were adjusted between 25 and 100 mg to achieve intact PTH <180 pg/ml. Ultrasonography was performed to measure the parathyroid gland size at baseline, week 26, and week 52. Findings were also compared with those of historical controls. Results: Of the 81 subjects enrolled, 56 had parathyroid glands smaller than 500 mm3 (group S) and 25 had at least one enlarged gland larger than 500 mm3 (group L). Treatment with cinacalcet effectively decreased intact PTH by 55% from baseline in group S and by 58% in group L. A slightly greater proportion of patients in group S versus group L achieved an intact PTH <180 pg/ml (46 versus 32%) and a >30% reduction from baseline (88 versus 78%), but this was not statistically significant. Cinacalcet therapy also resulted in a significant reduction in parathyroid gland volume regardless of pretreatment size, which was in sharp contrast to historical controls (n = 87) where parathyroid gland volume progressively increased with traditional therapy alone. Conclusions: Cinacalcet effectively decreases serum PTH levels and concomitantly reduces parathyroid gland volume, even in patients with marked parathyroid hyperplasia. PMID:20798251

  10. The Educational Effects of a State Supported Reduced Class Size Program: A Comprehensive Evaluation of Indiana's Project PRIME TIME at the North Gibson School Corporation.

    ERIC Educational Resources Information Center

    Gilman, David Alan; And Others

    1988-01-01

    After describing the pros and cons of reduced class size, this article evaluates the effectiveness of a pilot project sponsored by the Indiana Department of Education to reduce the size of its primary grade classes. Methodology and results are presented and discussed. (JL)

  11. Facile Fabrication of Lubricant-Infused Wrinkling Surface for Preventing Thrombus Formation and Infection.

    PubMed

    Yuan, Shuaishuai; Luan, Shifang; Yan, Shunjie; Shi, Hengchong; Yin, Jinghua

    2015-09-02

    Despite the advanced modern biotechniques, thrombosis and bacterial infection of biomedical devices remain common complications that are associated with morbidity and mortality. Most antifouling surfaces are in solid form and cannot simultaneously fulfill the requirements for antithrombosis and antibacterial efficacy. In this work, we present a facile strategy to fabricate a slippery surface. This surface is created by combining photografting polymerization with osmotically driven wrinkling that can generate a coarse morphology, and followed by infusing with fluorocarbon liquid. The lubricant-infused wrinkling slippery surface can greatly prevent protein attachment, reduce platelet adhesion, and suppress thrombus formation in vitro. Furthermore, E. coli and S. aureus attachment on the slippery surfaces is reduced by ∼98.8% and ∼96.9% after 24 h incubation, relative to poly(styrene-b-isobutylene-b-styrene) (SIBS) references. This slippery surface is biocompatible and has no toxicity to L929 cells. This surface-coating strategy that effectively reduces thrombosis and the incidence of infection will greatly decrease healthcare costs.

  12. Novel Percutaneous Radiofrequency Ablation of Portal Vein Tumor Thrombus: Safety and Feasibility

    SciTech Connect

    Mizandari, Malkhaz; Ao, Guokun; Zhang Yaojun; Feng Xi; Shen Qiang; Chen Minshan; Lau, Wan Yee; Nicholls, Joanna; Jiao Long; Habib, Nagy

    2013-02-15

    We report our experience of the safety of partial recanalization of the portal vein using a novel endovascular radiofrequency (RF) catheter for portal vein tumor thrombosis. Six patients with liver cancer and tumor thrombus in the portal vein underwent percutaneous intravascular radiofrequency ablation (RFA) using an endovascular bipolar RF device. A 0.035-inch guidewire was introduced into a tributary of the portal vein and through which a 5G guide catheter was introduced into the main portal vein. After manipulation of the guide catheter over the thrombus under digital subtraction angiography, the endovascular RF device was inserted and activated around the thrombus. There were no observed technique specific complications, such as hemorrhage, vessel perforation, or infection. Post-RFA portography showed partial recanalization of portal vein. RFA of portal vein tumor thrombus in patients with hepatocellular carcinoma is technically feasible and warrants further investigation to assess efficacy compared with current recanalization techniques.

  13. Une angiocholite secondaire à un thrombus tumoral d'une tumeur neuroendocrine primitive du foie

    PubMed Central

    Baba, Hicham; Allaoui, Mohamed; Elfahssi, Mohammed; Bounaim, Ahmed; Ali, Abdelmounaim Ait; Oukabli, Mohamed; Sair, Khalid; Zentar, Aziz

    2015-01-01

    Nous rapportons le cas exceptionnel d'une patiente de 54 ans prise en charge pour une angiocholite due à un thrombus tumoral, d'une tumeur neuroendocrine primitive (TNE Ive) du foie, dans la voie biliaire principale. PMID:26966504

  14. Computational Study of Thrombus Formation and Clotting Factor Effects under Venous Flow Conditions

    PubMed Central

    Govindarajan, Vijay; Rakesh, Vineet; Reifman, Jaques; Mitrophanov, Alexander Y.

    2016-01-01

    A comprehensive understanding of thrombus formation as a physicochemical process that has evolved to protect the integrity of the human vasculature is critical to our ability to predict and control pathological states caused by a malfunctioning blood coagulation system. Despite numerous investigations, the spatial and temporal details of thrombus growth as a multicomponent process are not fully understood. Here, we used computational modeling to investigate the temporal changes in the spatial distributions of the key enzymatic (i.e., thrombin) and structural (i.e., platelets and fibrin) components within a growing thrombus. Moreover, we investigated the interplay between clot structure and its mechanical properties, such as hydraulic resistance to flow. Our model relied on the coupling of computational fluid dynamics and biochemical kinetics, and was validated using flow-chamber data from a previous experimental study. The model allowed us to identify the distinct patterns characterizing the spatial distributions of thrombin, platelets, and fibrin accumulating within a thrombus. Our modeling results suggested that under the simulated conditions, thrombin kinetics was determined predominantly by prothrombinase. Furthermore, our simulations showed that thrombus resistance imparted by fibrin was ∼30-fold higher than that imparted by platelets. Yet, thrombus-mediated bloodflow occlusion was driven primarily by the platelet deposition process, because the height of the platelet accumulation domain was approximately twice that of the fibrin accumulation domain. Fibrinogen supplementation in normal blood resulted in a nonlinear increase in thrombus resistance, and for a supplemented fibrinogen level of 48%, the thrombus resistance increased by ∼2.7-fold. Finally, our model predicted that restoring the normal levels of clotting factors II, IX, and X while simultaneously restoring fibrinogen (to 88% of its normal level) in diluted blood can restore fibrin generation to

  15. Huge ascending aortic aneurysm with an intraluminal thrombus in an embolic event-free patient.

    PubMed

    Parato, Vito Maurizio; Prifti, Edvin; Pezzuoli, Franco; Labanti, Benedetto; Baboci, Arben

    2015-03-01

    We present a case of an 87-year-old male patient with a huge ascending aortic aneurysm, filled by a huge thrombus most probably due to previous dissection. This finding was detected by two-dimensional transthoracic echocardiography and contrast-enhanced computed tomography (CT) angiography scan. The patient refused surgical treatment and was medically treated. Despite the huge and mobile intraluminal thrombus, the patient remained embolic event-free up to 6 years later, and this makes the case unique.

  16. Role of plant residues in determining temporal patterns of the activity, size, and structure of nitrate reducer communities in soil.

    PubMed

    Chèneby, D; Bru, D; Pascault, N; Maron, P A; Ranjard, L; Philippot, L

    2010-11-01

    The incorporation of plant residues into soil not only represents an opportunity to limit soil organic matter depletion resulting from cultivation but also provides a valuable source of nutrients such as nitrogen. However, the consequences of plant residue addition on soil microbial communities involved in biochemical cycles other than the carbon cycle are poorly understood. In this study, we investigated the responses of one N-cycling microbial community, the nitrate reducers, to wheat, rape, and alfalfa residues for 11 months after incorporation into soil in a field experiment. A 20- to 27-fold increase in potential nitrate reduction activity was observed for residue-amended plots compared to the nonamended plots during the first week. This stimulating effect of residues on the activity of the nitrate-reducing community rapidly decreased but remained significant over 11 months. During this period, our results suggest that the potential nitrate reduction activity was regulated by both carbon availability and temperature. The presence of residues also had a significant effect on the abundance of nitrate reducers estimated by quantitative PCR of the narG and napA genes, encoding the membrane-bound and periplasmic nitrate reductases, respectively. In contrast, the incorporation of the plant residues into soil had little impact on the structure of the narG and napA nitrate-reducing community determined by PCR-restriction fragment length polymorphism (RFLP) fingerprinting. Overall, our results revealed that the addition of plant residues can lead to important long-term changes in the activity and size of a microbial community involved in N cycling but with limited effects of the type of plant residue itself.

  17. Increased fat mass is associated with increased bone size but reduced volumetric density in pre pubertal children.

    PubMed

    Cole, Z A; Harvey, N C; Kim, M; Ntani, G; Robinson, S M; Inskip, H M; Godfrey, K M; Cooper, C; Dennison, E M

    2012-02-01

    Recent studies have shown that obesity is associated with an increased risk of fracture in both adults and children. It has been suggested that, despite greater bone size, obese individuals may have reduced true volumetric density; however this is difficult to assess using two dimensional techniques such as DXA. We evaluated the relationship between fat mass, and bone size and density, in a population cohort of children in whom DXA and pQCT measurements had been acquired. We recruited 530 children at 6 years old from the Southampton Women's Survey. The children underwent measurement of bone mass at the whole body, lumbar spine and hip, together with body composition, by DXA (Hologic Discovery, Hologic Inc., Bedford, MA, USA). In addition 132 of these children underwent pQCT measurements at the tibia (Stratec XCT2000, Stratec Biomedical Systems, Birkenfeld, Germany). Significant positive associations were observed between total fat mass and both bone area (BA) and bone mineral content (BMC) at the whole body minus head, lumbar spine and hip sites (all p<0.0001). When true volumetric density was assessed using pQCT data from the tibia, fat mass (adjusted for lean mass) was negatively associated with both trabecular and cortical density (β=-14.6 mg/mm(3) per sd, p=0.003; β=-7.7 mg/mm(3) per sd, p=0.02 respectively). These results suggest that fat mass is negatively associated with volumetric bone density at 6 years old, independent of lean mass, despite positive associations with bone size. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Continuous nicotinamide administration improves behavioral recovery and reduces lesion size following bilateral frontal controlled cortical impact injury

    PubMed Central

    Haar, Cole Vonder; Anderson, Gail D.; Hoane, Michael R.

    2011-01-01

    Previous research has demonstrated considerable preclinical efficacy of nicotinamide (NAM; vitamin B3) in animal models of TBI with systemic dosing at 50 and 500 mg/kg yielding improvements on sensory, motor, cognitive and histological measures. The current study aimed to utilize a more specific dosing paradigm in a clinically relevant delivery mechanism: continuously secreting subcutaneous pumps. A bilateral frontal controlled cortical impact (CCI) or sham surgery was performed and rats were treated with NAM (150 mg/kg/day) or saline (1 ml/kg) pumps 30 min after CCI, continuing until seven days post-CCI. Rats were given a loading dose of NAM (50 mg/kg) or saline (1 ml/kg) following pump implant. Rats received behavioral testing (bilateral tactile adhesive removal, locomotor placing task and Morris water maze) starting on day two post-CCI and were sacrificed at 31 days post-CCI and brains were stained to examine lesion size. NAM-treated rats had reductions in sensory, motor and cognitive behavioral deficits compared to vehicle-treated rats. Specifically, NAM-treated rats significantly improved on the bilateral tactile adhesive removal task, locomotor placing task and the reference memory paradigm of the Morris water maze. Lesion size was also significantly reduced in the NAM-treated group. The results from this study indicate that at the current dose, NAM produces beneficial effects on recovery from a bilateral frontal brain injury and that it may be a relevant compound to be explored in human studies. PMID:21704653

  19. Systematic adjustment of charge densities and size of polyglycerol amines reduces cytotoxic effects and enhances cellular uptake.

    PubMed

    Hellmund, Markus; Achazi, Katharina; Neumann, Falko; Thota, Bala N S; Ma, Nan; Haag, Rainer

    2015-11-01

    Excessive cationic charge density of polyplexes during cellular uptake is still a major hurdle in the field of non-viral gene delivery. The most efficient cationic vectors such as polyethylene imine (PEI) or polyamidoamine (PAMAM) can be highly toxic and may induce strong side effects due to their high cationic charge densities. Alternatives like polyethylene glycol (PEG) are used to 'shield' these charges and thus to reduce the cytotoxic effects known for PEI/PEG-core-shell architectures. In this study, we compared the ability of hyperbranched polyglycerol amines (hPG amines) with different amine densities and molecular weights as non-viral cationic vectors for DNA delivery. By adjusting the hydroxyl to amine group ratio on varying molecular weights, we were able to perform a systematic study on the cytotoxic effects caused by the effective charge density in correlation to size. We could demonstrate that carriers with moderate charge density have a higher potential for effective DNA delivery as compared to high/low charged ones independent of their size, but the final efficiency can be optimized by the molecular weight. We analyzed the physicochemical properties and cellular uptake capacity as well as the cytotoxicity and transfection efficiency of these new vector systems.

  20. Continuous nicotinamide administration improves behavioral recovery and reduces lesion size following bilateral frontal controlled cortical impact injury.

    PubMed

    Vonder Haar, Cole; Anderson, Gail D; Hoane, Michael R

    2011-10-31

    Previous research has demonstrated considerable preclinical efficacy of nicotinamide (NAM; vitamin B(3)) in animal models of TBI with systemic dosing at 50 and 500 mg/kg yielding improvements on sensory, motor, cognitive and histological measures. The current study aimed to utilize a more specific dosing paradigm in a clinically relevant delivery mechanism: continuously secreting subcutaneous pumps. A bilateral frontal controlled cortical impact (CCI) or sham surgery was performed and rats were treated with NAM (150 mg/kg day) or saline (1 ml/kg) pumps 30 min after CCI, continuing until seven days post-CCI. Rats were given a loading dose of NAM (50mg/kg) or saline (1 ml/kg) following pump implant. Rats received behavioral testing (bilateral tactile adhesive removal, locomotor placing task and Morris water maze) starting on day two post-CCI and were sacrificed at 31 days post-CCI and brains were stained to examine lesion size. NAM-treated rats had reductions in sensory, motor and cognitive behavioral deficits compared to vehicle-treated rats. Specifically, NAM-treated rats significantly improved on the bilateral tactile adhesive removal task, locomotor placing task and the reference memory paradigm of the Morris water maze. Lesion size was also significantly reduced in the NAM-treated group. The results from this study indicate that at the current dose, NAM produces beneficial effects on recovery from a bilateral frontal brain injury and that it may be a relevant compound to be explored in human studies.

  1. A targeted contrast agent for magnetic resonance imaging of thrombus: implications of spatial resolution.

    PubMed

    Johansson, L O; Bjørnerud, A; Ahlström, H K; Ladd, D L; Fujii, D K

    2001-04-01

    A preparation of ultra-small superparamagnetic iron oxide (USPIO) particles coupled to an RGD peptide (RGD-USPIO) was investigated as an MR contrast agent, targeted to activated platelets, in both ex vivo and in vivo thrombus models. Thrombus visualization ex vivo was compared using RGD-USPIO and a non-targeted UPSIO. The influence of thrombus visualization on thrombus exposure time to RGD-USPIO (ex vivo) and on the spatial resolution of the MR image (ex vivo and in vivo) was assessed. RGD-USPIO resulted in better thrombus visualization than non-targeted USPIO ex vivo, and maximum enhancement was achieved after approximately one hour exposure time of the thrombus to RGD-USPIO. The ability to visualize the clots was highly dependent on the spatial resolution of the image. In vivo, an in-plane resolution of less than 0.2 x 0.2 mm(2) was required for good clot visualization after contrast enhancement. It is concluded that the achievable resolution and sensitivity is a potential limitation to the usefulness of active vascular targeting in MRI.

  2. Methods to Determine the Lagrangian Shear Experienced by Platelets during Thrombus Growth

    PubMed Central

    Pinar, Isaac P.; Arthur, Jane F.; Andrews, Robert K.; Gardiner, Elizabeth E.; Ryan, Kris; Carberry, Josie

    2015-01-01

    Platelets can become activated in response to changes in flow-induced shear; however, the underlying molecular mechanisms are not clearly understood. Here we present new techniques for experimentally measuring the flow-induced shear rate experienced by platelets prior to adhering to a thrombus. We examined the dynamics of blood flow around experimentally grown thrombus geometries using a novel combination of experimental (ex vivo) and numerical (in silico) methodologies. Using a microcapillary system, platelet aggregate formation was analysed at elevated shear rates in the presence of coagulation inhibitors, where thrombus formation is predominantly platelet-dependent. These approaches permit the resolution and quantification of thrombus parameters at the scale of individual platelets (2 μm) in order to quantify real time thrombus development. Using our new techniques we can correlate the shear rate experienced by platelets with the extent of platelet adhesion and aggregation. The techniques presented offer the unique capacity to determine the flow properties for a temporally evolving thrombus field in real time. PMID:26660525

  3. Methods to Determine the Lagrangian Shear Experienced by Platelets during Thrombus Growth.

    PubMed

    Pinar, Isaac P; Arthur, Jane F; Andrews, Robert K; Gardiner, Elizabeth E; Ryan, Kris; Carberry, Josie

    2015-01-01

    Platelets can become activated in response to changes in flow-induced shear; however, the underlying molecular mechanisms are not clearly understood. Here we present new techniques for experimentally measuring the flow-induced shear rate experienced by platelets prior to adhering to a thrombus. We examined the dynamics of blood flow around experimentally grown thrombus geometries using a novel combination of experimental (ex vivo) and numerical (in silico) methodologies. Using a microcapillary system, platelet aggregate formation was analysed at elevated shear rates in the presence of coagulation inhibitors, where thrombus formation is predominantly platelet-dependent. These approaches permit the resolution and quantification of thrombus parameters at the scale of individual platelets (2 μm) in order to quantify real time thrombus development. Using our new techniques we can correlate the shear rate experienced by platelets with the extent of platelet adhesion and aggregation. The techniques presented offer the unique capacity to determine the flow properties for a temporally evolving thrombus field in real time.

  4. Schisandra chinensis and Morus alba Synergistically Inhibit In Vivo Thrombus Formation and Platelet Aggregation by Impairing the Glycoprotein VI Pathway

    PubMed Central

    Sung, Yoon-Young; Kim, Seung Hyung; Park, Sun Haeng

    2017-01-01

    Morus alba L. (MAL) extract has been used in traditional medicine for its cardioprotective and antiplatelet effects, while another herbal remedy, Schisandra chinensis (SCC), has been reported to have anti-inflammatory and antioxidant properties. We evaluated underlying cellular changes exerted by extracts of these plants on platelet function and effects of SCC + MAL on in vivo thrombus formation using AV shunt and tail thrombosis-length models in rats. In vitro platelet aggregation, granule secretion, and [Ca2+]i release assays were carried out. The activation of integrin αIIbβ3 and phosphorylation of downstream signaling molecules, including MAPK and Akt, were investigated using cytometry and immunoblotting, respectively. Scanning electron microscopy (SEM) was used to evaluate changes in platelet shape and HPLC analysis was carried out to identify the marker compounds in SCC + MAL mixture. In vivo thrombus weight and average length of tail thrombosis were significantly decreased by SCC + MAL. In vitro platelet aggregation, granule secretion, [Ca2+]i release, and integrin αIIbβ3 activation were notably inhibited. SCC + MAL markedly reduced the phosphorylation of MAPK pathway factors along with Akt. HPLC analysis identified four marker compounds: isoquercitrin, astragalin, schizandrol A, and gomisin A. The extracts exerted remarkable synergistic effects as natural antithrombotic and antiplatelet agent and a potent drug candidate for treating cardiovascular diseases. PMID:28194217

  5. Impact of poroelasticity of intraluminal thrombus on wall stress of abdominal aortic aneurysms

    PubMed Central

    2012-01-01

    Background The predictions of stress fields in Abdominal Aortic Aneurysm (AAA) depend on constitutive descriptions of the aneurysm wall and the Intra-luminal Thrombus (ILT). ILT is a porous diluted structure (biphasic solid–fluid material) and its impact on AAA biomechanics is controversially discussed in the literature. Specifically, pressure measurements showed that the ILT cannot protect the wall from the arterial pressure, while other (numerical and experimental) studies showed that at the same time it reduces the stress in the wall. Method To explore this phenomenon further a poroelastic description of the ILT was integrated in Finite Element (FE) Models of the AAA. The AAA model was loaded by a pressure step and a cyclic pressure wave and their transition into wall tension was investigated. To this end ILT’s permeability was varied within a microstructurally motivated range. Results The two-phase model verified that the ILT transmits the entire mean arterial pressure to the wall while, at the same time, it significantly reduces the stress in the wall. The predicted mean stress in the AAA wall was insensitive to the permeability of the ILT and coincided with the results of AAA models using a single-phase ILT description. Conclusion At steady state, the biphasic ILT behaves like a single-phase material in an AAA model. Consequently, computational efficient FE single-phase models, as they have been exclusively used in the past, accurately predict the wall stress in AAA models. PMID:22931215

  6. Modest hypoxia significantly reduces triglyceride content and lipid droplet size in 3T3-L1 adipocytes

    SciTech Connect

    Hashimoto, Takeshi; Yokokawa, Takumi; Endo, Yuriko; Iwanaka, Nobumasa; Higashida, Kazuhiko; Taguchi, Sadayoshi

    2013-10-11

    Highlights: •Long-term hypoxia decreased the size of LDs and lipid storage in 3T3-L1 adipocytes. •Long-term hypoxia increased basal lipolysis in 3T3-L1 adipocytes. •Hypoxia decreased lipid-associated proteins in 3T3-L1 adipocytes. •Hypoxia decreased basal glucose uptake and lipogenic proteins in 3T3-L1 adipocytes. •Hypoxia-mediated lipogenesis may be an attractive therapeutic target against obesity. -- Abstract: Background: A previous study has demonstrated that endurance training under hypoxia results in a greater reduction in body fat mass compared to exercise under normoxia. However, the cellular and molecular mechanisms that underlie this hypoxia-mediated reduction in fat mass remain uncertain. Here, we examine the effects of modest hypoxia on adipocyte function. Methods: Differentiated 3T3-L1 adipocytes were incubated at 5% O{sub 2} for 1 week (long-term hypoxia, HL) or one day (short-term hypoxia, HS) and compared with a normoxia control (NC). Results: HL, but not HS, resulted in a significant reduction in lipid droplet size and triglyceride content (by 50%) compared to NC (p < 0.01). As estimated by glycerol release, isoproterenol-induced lipolysis was significantly lowered by hypoxia, whereas the release of free fatty acids under the basal condition was prominently enhanced with HL compared to NC or HS (p < 0.01). Lipolysis-associated proteins, such as perilipin 1 and hormone-sensitive lipase, were unchanged, whereas adipose triglyceride lipase and its activator protein CGI-58 were decreased with HL in comparison to NC. Interestingly, such lipogenic proteins as fatty acid synthase, lipin-1, and peroxisome proliferator-activated receptor gamma were decreased. Furthermore, the uptake of glucose, the major precursor of 3-glycerol phosphate for triglyceride synthesis, was significantly reduced in HL compared to NC or HS (p < 0.01). Conclusion: We conclude that hypoxia has a direct impact on reducing the triglyceride content and lipid droplet size via

  7. Morphology, structural properties and reducibility of size-selected CeO2− x nanoparticle films

    PubMed Central

    D’Addato, Sergio; Gasperi, Gabriele; Benedetti, Francesco; Luches, Paola; Grillo, Vincenzo; Bertoni, Giovanni; Valeri, Sergio

    2015-01-01

    Summary Non-stoichiometric ceria nanoparticles (NPs) were obtained by a gas aggregation source with a magnetron and were mass-selected with a quadrupole mass filter. By varying magnetron power, Ar gas flow, and the length of the aggregation tube, NPs with an average diameter of 6, 9, and 14 nm were synthesized and deposited onto a substrate, thus obtaining NP films. The morphology of the films was studied with scanning electron microscopy, while high resolution transmission electron microscopy was used to gain a deeper insight into the atomic structure of individual NPs. By using X-ray photoelectron spectroscopy we analyzed the degree of reduction of the NPs of different diameters, before and after thermal treatments in vacuum (reduction cycle) and in O2 atmosphere (oxidation cycle) at different temperatures. From this analysis we inferred that the size is an important parameter only at intermediate temperatures. As a comparison, we evaluated the reducibility of an ultra-thin ceria film with the same surface to volume ratio as the 9 nm diameter NPs film, observing that NPs are more reducible than the ceria film. PMID:25671152

  8. The Relationship Between Pulsatile Flow Impingement and Intraluminal Thrombus Deposition in Abdominal Aortic Aneurysms.

    PubMed

    Lozowy, Richard J; Kuhn, David C S; Ducas, Annie A; Boyd, April J

    2017-03-01

    Direct numerical simulations were performed on four patient-specific abdominal aortic aneurysm (AAA) geometries and the resulting pulsatile blood flow dynamics were compared to aneurysm shape and correlated with intraluminal thrombus (ILT) deposition. For three of the cases, turbulent vortex structures impinged/sheared along the anterior wall and along the posterior wall a zone of recirculating blood formed. Within the impingement region the AAA wall was devoid of ILT and remote to this region there was an accumulation of ILT. The high wall shear stress (WSS) caused by the impact of vortexes is thought to prevent the attachment of ILT. WSS from impingement is comparable to peak-systolic WSS in a normal-sized aorta and therefore may not damage the wall. Expansion occurred to a greater extent in the direction of jet impingement and the wall-normal force from the continuous impact of vortexes may contribute to expansion. It was shown that the impingement region has low oscillatory shear index (OSI) and recirculation zones can have either low or high OSI. No correlation could be identified between OSI and ILT deposition since different flow dynamics can have similar OSI values.

  9. Flow in patients with left ventricular thrombus using optimized echo PIV-PTV

    NASA Astrophysics Data System (ADS)

    Sampath, Kaushik; Harfi, Thura T.; George, Richard T.; Katz, Joseph

    2016-11-01

    Applications of echocardiographic particle image velocimetry and particle tracking velocimetry (echo PIV-PTV) for characterizing cardiovascular flows have been expanding. It involves acquisition and processing of time-resolved contrast echocardiograms of in vivo flows seeded with micro bubbles. Here, a set of image enhancement and particle tracking methods are implemented on in-vivo data from five patients with history of past or current confirmed left ventricular thrombus (LVT). Our aim is to correlate the LV mixing with thrombogenicity. For cases with persistent LVT and low cardiac efficiency, results show low velocities around the clot as well as low penetration depth of the jet at the exit from the mitral valve and strength of the associated LV vortex. The speeds increase with increasing kinesis (wall motion) and distance from the clot. Patients with recovering cardiac function and diminishing clot size exhibit improved flow, LV vortex strength and penetration even when their efficiency is lower than normal. Trends of the apical washing are consistent with those predicted by the E-wave propagation index.

  10. Mesoscopic Modeling of Thrombus Formation and Growth: Platelet Deposition in Complex Geometries

    NASA Astrophysics Data System (ADS)

    Yazdani, Alireza; Karniadakis, George

    2014-11-01

    Haemodynamics and blood rheology are important contributing factors to thrombus formation at a vulnerable vessel wall, and adhesion of platelets to a vascular surface, particularly in regions of flow stagnation, recirculation and reattachment is significantly important in formation of thrombi. For example, haemodynamic micro-environment can have effects on thrombosis inside the atherosclerotic plaques and aneurysms. To study these effects, we have developed and validated a model for platelet aggregation in blood flow using Dissipative Particle Dynamics (DPD) method. In this model platelets are considered as single DPD particles interacting with each other via Morse potential once activated. We assign an activation delay time to each platelet such that they remain passive during that time. We investigate the effect of different geometries on platelet aggregation by considering arterial stenosis at different levels of occlusion, and aneurysms of different shapes and sizes. The results show a marked increase in platelet aggregation within the boundaries of deceleration zone by increasing the degree of stenosis. Further, we observe enhanced platelet margination and wall deposition in the presence of red blood cells.

  11. A natural antipredation experiment: predator control and reduced sea ice increases colony size in a long-lived duck

    PubMed Central

    Hanssen, Sveinn A; Moe, Børge; Bårdsen, Bård-Jørgen; Hanssen, Frank; Gabrielsen, Geir W

    2013-01-01

    Anthropogenic impact on the environment and wildlife are multifaceted and far-reaching. On a smaller scale, controlling for predators has been increasing the yield from local natural prey resources. Globally, human-induced global warming is expected to impose severe negative effects on ecosystems, an effect that is expected to be even more pronounced in the scarcely populated northern latitudes. The clearest indication of a changing Arctic climate is an increase in both air and ocean temperatures leading to reduced sea ice distribution. Population viability is for long-lived species dependent on adult survival and recruitment. Predation is the main mortality cause in many bird populations, and egg predation is considered the main cause of reproductive failure in many birds. To assess the effect of predation and climate, we compared population time series from a natural experiment where a trapper/down collector has been licensed to actively protect breeding common eiders Somateria mollissima (a large seaduck) by shooting/chasing egg predators, with time series from another eider colony located within a nature reserve with no manipulation of egg predators. We found that actively limiting predator activity led to an increase in the population growth rate and carrying capacity with a factor of 3–4 compared to that found in the control population. We also found that population numbers were higher in years with reduced concentration of spring sea ice. We conclude that there was a large positive impact of human limitation of egg predators, and that this lead to higher population growth rate and a large increase in size of the breeding colony. We also report a positive effect of warming climate in the high arctic as reduced sea-ice concentrations was associated with higher numbers of breeding birds. PMID:24223290

  12. A natural antipredation experiment: predator control and reduced sea ice increases colony size in a long-lived duck.

    PubMed

    Hanssen, Sveinn A; Moe, Børge; Bårdsen, Bård-Jørgen; Hanssen, Frank; Gabrielsen, Geir W

    2013-09-01

    Anthropogenic impact on the environment and wildlife are multifaceted and far-reaching. On a smaller scale, controlling for predators has been increasing the yield from local natural prey resources. Globally, human-induced global warming is expected to impose severe negative effects on ecosystems, an effect that is expected to be even more pronounced in the scarcely populated northern latitudes. The clearest indication of a changing Arctic climate is an increase in both air and ocean temperatures leading to reduced sea ice distribution. Population viability is for long-lived species dependent on adult survival and recruitment. Predation is the main mortality cause in many bird populations, and egg predation is considered the main cause of reproductive failure in many birds. To assess the effect of predation and climate, we compared population time series from a natural experiment where a trapper/down collector has been licensed to actively protect breeding common eiders Somateria mollissima (a large seaduck) by shooting/chasing egg predators, with time series from another eider colony located within a nature reserve with no manipulation of egg predators. We found that actively limiting predator activity led to an increase in the population growth rate and carrying capacity with a factor of 3-4 compared to that found in the control population. We also found that population numbers were higher in years with reduced concentration of spring sea ice. We conclude that there was a large positive impact of human limitation of egg predators, and that this lead to higher population growth rate and a large increase in size of the breeding colony. We also report a positive effect of warming climate in the high arctic as reduced sea-ice concentrations was associated with higher numbers of breeding birds.

  13. A General Shear-Dependent Model for Thrombus Formation

    PubMed Central

    Humphrey, Jay D.

    2017-01-01

    Modeling the transport, activation, and adhesion of platelets is crucial in predicting thrombus formation and growth following a thrombotic event in normal or pathological conditions. We propose a shear-dependent platelet adhesive model based on the Morse potential that is calibrated by existing in vivo and in vitro experimental data and can be used over a wide range of flow shear rates (100<γ˙<28,000s-1). We introduce an Eulerian-Lagrangian model where hemodynamics is solved on a fixed Eulerian grid, while platelets are tracked using a Lagrangian framework. A force coupling method is introduced for bidirectional coupling of platelet motion with blood flow. Further, we couple the calibrated platelet aggregation model with a tissue-factor/contact pathway coagulation cascade, representing the relevant biology of thrombin generation and the subsequent fibrin deposition. The range of shear rates covered by the proposed model encompass venous and arterial thrombosis, ranging from low-shear-rate conditions in abdominal aortic aneurysms and thoracic aortic dissections to thrombosis in stenotic arteries following plaque rupture, where local shear rates are extremely high. PMID:28095402

  14. A General Shear-Dependent Model for Thrombus Formation.

    PubMed

    Yazdani, Alireza; Li, He; Humphrey, Jay D; Karniadakis, George Em

    2017-01-01

    Modeling the transport, activation, and adhesion of platelets is crucial in predicting thrombus formation and growth following a thrombotic event in normal or pathological conditions. We propose a shear-dependent platelet adhesive model based on the Morse potential that is calibrated by existing in vivo and in vitro experimental data and can be used over a wide range of flow shear rates ([Formula: see text]). We introduce an Eulerian-Lagrangian model where hemodynamics is solved on a fixed Eulerian grid, while platelets are tracked using a Lagrangian framework. A force coupling method is introduced for bidirectional coupling of platelet motion with blood flow. Further, we couple the calibrated platelet aggregation model with a tissue-factor/contact pathway coagulation cascade, representing the relevant biology of thrombin generation and the subsequent fibrin deposition. The range of shear rates covered by the proposed model encompass venous and arterial thrombosis, ranging from low-shear-rate conditions in abdominal aortic aneurysms and thoracic aortic dissections to thrombosis in stenotic arteries following plaque rupture, where local shear rates are extremely high.

  15. Chlorogenic Acid Inhibits Human Platelet Activation and Thrombus Formation

    PubMed Central

    Fuentes, Eduardo; Caballero, Julio; Alarcón, Marcelo; Rojas, Armando; Palomo, Iván

    2014-01-01

    Background Chlorogenic acid is a potent phenolic antioxidant. However, its effect on platelet aggregation, a critical factor in arterial thrombosis, remains unclear. Consequently, chlorogenic acid-action mechanisms in preventing platelet activation and thrombus formation were examined. Methods and Results Chlorogenic acid in a dose-dependent manner (0.1 to 1 mmol/L) inhibited platelet secretion and aggregation induced by ADP, collagen, arachidonic acid and TRAP-6, and diminished platelet firm adhesion/aggregation and platelet-leukocyte interactions under flow conditions. At these concentrations chlorogenic acid significantly decreased platelet inflammatory mediators (sP-selectin, sCD40L, CCL5 and IL-1β) and increased intraplatelet cAMP levels/PKA activation. Interestingly, SQ22536 (an adenylate cyclase inhibitor) and ZM241385 (a potent A2A receptor antagonist) attenuated the antiplatelet effect of chlorogenic acid. Chlorogenic acid is compatible to the active site of the adenosine A2A receptor as revealed through molecular modeling. In addition, chlorogenic acid had a significantly lower effect on mouse bleeding time when compared to the same dose of aspirin. Conclusions Antiplatelet and antithrombotic effects of chlorogenic acid are associated with the A2A receptor/adenylate cyclase/cAMP/PKA signaling pathway. PMID:24598787

  16. Left atrial thrombus resolution in atrial fibrillation or flutter: Results of a prospective study with rivaroxaban (X-TRA) and a retrospective observational registry providing baseline data (CLOT-AF).

    PubMed

    Lip, Gregory Y H; Hammerstingl, Christoph; Marin, Francisco; Cappato, Riccardo; Meng, Isabelle Ling; Kirsch, Bodo; van Eickels, Martin; Cohen, Ariel

    2016-08-01

    Data on left atrial/left atrial appendage (LA/LAA) thrombus resolution after non-vitamin K antagonist (VKA) oral anticoagulant treatment are scarce. The primary objective of X-TRA was to explore the use of rivaroxaban for the resolution of LA/LAA thrombi in patients with nonvalvular atrial fibrillation (AF) or atrial flutter, with the CLOT-AF registry providing retrospective data after standard-of-care therapy in this setting. X-TRA was a prospective, single-arm, open-label, multicenter study that investigated rivaroxaban treatment for 6 weeks for LA/LAA thrombus resolution in patients with nonvalvular AF or atrial flutter and LA/LAA thrombus confirmed at baseline on a transesophageal echocardiogram (TEE). CLOT-AF retrospectively collected thrombus-related patient outcome data after standard-of-care anticoagulant treatment for 3 to 12 weeks in patients with nonvalvular AF or atrial flutter who had LA/LAA thrombi on TEE recorded in their medical file. In X-TRA, patients were predominantly (95.0%) from Eastern European countries. The adjudicated thrombus resolution rate was 41.5% (22/53 modified intention-to-treat [mITT] patients, 95% CI 28.1%-55.9%) based on central TEE assessments. Resolved or reduced thrombus was evident in 60.4% (32/53 mITT patients, 95% CI 46.0%-73.6%) of patients. In CLOT-AF, the reported thrombus resolution rate was 62.5% (60/96 mITT patients, 95% CI 52.0%-72.2%) and appeared better in Western European countries (34/50; 68.0%) than in Eastern European countries (26/46; 56.5%). X-TRA is the first prospective, multicenter study examining LA/LAA thrombus resolution with a non-VKA oral anticoagulant in VKA-naïve patients or in patients with suboptimal VKA therapy. Rivaroxaban could be a potential option for the treatment of LA/LAA thrombi. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Tocotrienols-induced inhibition of platelet thrombus formation and platelet aggregation in stenosed canine coronary arteries

    PubMed Central

    2011-01-01

    Background Dietary supplementation with tocotrienols has been shown to decrease the risk of coronary artery disease. Tocotrienols are plant-derived forms of vitamin E, which have potent anti-inflammatory, antioxidant, anticancer, hypocholesterolemic, and neuroprotective properties. Our objective in this study was to determine the extent to which tocotrienols inhibit platelet aggregation and reduce coronary thrombosis, a major risk factor for stroke in humans. The present study was carried out to determine the comparative effects of α-tocopherol, α-tocotrienol, or tocotrienol rich fraction (TRF; a mixture of α- + γ- + δ-tocotrienols) on in vivo platelet thrombosis and ex vivo platelet aggregation (PA) after intravenous injection in anesthetized dogs, by using a mechanically stenosed circumflex coronary artery model (Folts' cyclic flow model). Results Collagen-induced platelet aggregation (PA) in platelet rich plasma (PRP) was decreased markedly after treatment with α-tocotrienol (59%; P < 0.001) and TRF (92%; P < 0.001). α-Tocopherol treatment was less effective, producing only a 22% (P < 0.05) decrease in PA. Adenosine diphosphate-induced (ADP) PA was also decreased after treatment with α-tocotrienol (34%; P < 0.05) and TRF (42%; P < 0.025). These results also indicate that intravenously administered tocotrienols were significantly better than tocopherols in inhibiting cyclic flow reductions (CFRs), a measure of the acute platelet-mediated thrombus formation. Tocotrienols (TRF) given intravenously (10 mg/kg), abolished CFRs after a mean of 68 min (range 22 -130 min), and this abolition of CFRs was sustained throughout the monitoring period (50 - 160 min). Next, pharmacokinetic studies were carried out and tocol levels in canine plasma and platelets were measured. As expected, α-Tocopherol treatment increased levels of total tocopherols in post- vs pre-treatment specimens (57 vs 18 μg/mL in plasma, and 42 vs 10 μg/mL in platelets). However, treatment with

  18. Reduced fetal cerebral oxygen consumption is associated with smaller brain size in fetuses with congenital heart disease.

    PubMed

    Sun, Liqun; Macgowan, Christopher K; Sled, John G; Yoo, Shi-Joon; Manlhiot, Cedric; Porayette, Prashob; Grosse-Wortmann, Lars; Jaeggi, Edgar; McCrindle, Brian W; Kingdom, John; Hickey, Edward; Miller, Steven; Seed, Mike

    2015-04-14

    Fetal hypoxia has been implicated in the abnormal brain development seen in newborns with congenital heart disease (CHD). New magnetic resonance imaging technology now offers the potential to investigate the relationship between fetal hemodynamics and brain dysmaturation. We measured fetal brain size, oxygen saturation, and blood flow in the major vessels of the fetal circulation in 30 late-gestation fetuses with CHD and 30 normal controls using phase-contrast magnetic resonance imaging and T2 mapping. Fetal hemodynamic parameters were calculated from a combination of magnetic resonance imaging flow and oximetry data and fetal hemoglobin concentrations estimated from population averages. In fetuses with CHD, reductions in umbilical vein oxygen content (P<0.001) and failure of the normal streaming of oxygenated blood from the placenta to the ascending aorta were associated with a mean reduction in ascending aortic saturation of 10% (P<0.001), whereas cerebral blood flow and cerebral oxygen extraction were no different from those in controls. This accounted for the mean 15% reduction in cerebral oxygen delivery (P=0.08) and 32% reduction cerebral Vo2 in CHD fetuses (P<0.001), which were associated with a 13% reduction in fetal brain volume (P<0.001). Fetal brain size correlated with ascending aortic oxygen saturation and cerebral Vo2 (r=0.37, P=0.004). This study supports a direct link between reduced cerebral oxygenation and impaired brain growth in fetuses with CHD and raises the possibility that in utero brain development could be improved with maternal oxygen therapy. © 2015 American Heart Association, Inc.

  19. Chronic treatment with lithium and pretreatment with excess inositol reduce inositol pool size in astrocytes by different mechanisms.

    PubMed

    Wolfson, M; Hertz, E; Belmaker, R H; Hertz, L

    1998-03-16

    Chronic treatment with a lithium salt is the classical treatment for manic-depressive disorder. It is hypothesized that the therapeutic action of lithium is caused by its inhibition of inositol phosphatases which leads to a relative deficiency of inositol and, therefore, an impairment of inositol recycling and production of precursor for the second messengers inositol triphosphate (IP3) and diacylglycerol (DAG). However, peculiarly enough, treatment with high doses of inositol also has an antidepressant effect. In the present work, we have studied the acute and chronic effects of lithium and of excess inositol, in separation or together, on accumulation of 50 microM [3H]inositol (a physiologically relevant concentration) into primary cultures of mouse astrocytes. Two parameters were investigated: (1) rate of unidirectional uptake across the cell membrane (measured during short-term exposure to the radioisotope), and (2) magnitude of the intracellular pool of inositol, equilibrating with extracellular inositol (measured during long-term exposure to the radioisotope). Inositol uptake was highly concentrative and occurred with a Km of approximately 500 microM and a Vmax of 1.5 nmol/min/mg protein. The uptake rate was not affected by either acute or chronic treatment with LiCl (or both), but it was substantially reduced ('down-regulated') after pretreatment with a high concentration of inositol. The inositol pool size was decreased to a similar extent as the uptake rate by previous exposure to excess inositol. In spite of the fact that inositol uptake rate was unaffected by lithium, the magnitude of the inositol pool was significantly decreased by chronic treatment with a pharmacologically relevant concentration of LiCl (1 mM), but not by treatment with lower concentrations. This decrease is likely to reflect a reduction in either inositol synthesis or replenishment of inositol from IP3, due to the inhibition of inositol phosphatases by the lithium ion. In agreement

  20. Progression of Thrombus in Portal Vein, Superior Mesenteric Vein, and Splenic Vein Even on Anticoagulation in a Patient with Ascending Colonic Malignancy with Liver Metastasis: Portal Vein Thrombosis versus Portal Vein Tumor Thrombosis.

    PubMed

    Sule, Ashish; Borja, Annamarie; Chin, Tay Jam

    2016-12-01

    Portal vein thrombosis (PVT) in a setting of liver metastasis is not easy to treat as it may be portal vein tumor thrombus (PVTT). A 77-year-old male patient was diagnosed as ascending colon carcinoma, underwent right hemicolectomy in 1991 with a recurrence in July 2009. In August 2009, he underwent computed tomography (CT) scan of the abdomen which showed evidence of superior mesenteric vein thrombosis with no liver metastasis. He was started with anticoagulation and decision was to treat long term. He was admitted with mesenteric artery ischemic symptoms in February 2012 on anticoagulation. CT scan abdomen and pelvis in February 2012 showed tumor thrombus involving the superior mesenteric vein, portal vein, and splenic vein with hepatic metastasis. His tumor marker chorioembryonic antigen was 34 µg/L. He was continued on anticoagulation. A repeat CT scan abdomen after 2 years (in January 2014) showed, increase in size of hepatic metastasis, extensive thrombus involving the superior mesenteric vein, portal vein, and splenic vein with collaterals. Mesentery was congested due to extensive superior mesenteric vein thrombus. He finally succumbed in June 2014. It is very important to differentiate PVT from PVTT as the prognosis is different. PVTT progresses despite of long-term anticoagulation with poor prognosis.

  1. Shock-wave thrombus ablation, a new method for noninvasive mechanical thrombolysis.

    PubMed

    Rosenschein, U; Yakubov, S J; Guberinich, D; Bach, D S; Sonda, P L; Abrams, G D; Topol, E J

    1992-11-15

    Successful experimental and clinical experience with thrombus ablation has been attained with high-power acoustic energy delivered in a catheter. The goal of this study was to investigate the feasibility of noninvasive thrombus ablation by focused high-power acoustic energy. The source for high-power acoustic energy was a shock-wave generator in a water tank equipped with an acoustic lens with a fixed focal point at 22.5 cm. Thrombus was prepared in vitro, weighed (0.24 +/- 0.08 g), and inserted in excised human femoral artery segments. The arterial segments wer ligated, positioned at the focal point and then randomized into either test (n = 8) or control (n = 7). An x-ray system verified the 3-dimensional positioning of the arterial segment at the focal point. A 5 MHz ultrasound imaging system continuously visualized the arterial segment at the focal point before, during and after each experiment. The test segments were exposed to shock waves (1,000 shocks/24 kv). The arterial segment content was then flushed and the residual thrombus weighed. The arterial segment and thrombus were fixed and submitted to histologic examination. The test group achieved a significant ablation of thrombus mass (0.25 +/- 0.15 vs 0.07 +/- 0.003 g; p = 0.0001) after application of shock waves. Arterial segments showed no gross or microscopic damage. Ultrasound imaging revealed a localized (1.9 +/- 0.5 cm2), transient (744 +/- 733 ms), cavitation field at the focal point at the time of application of focused shock waves. Thus, focused high-power acoustic energy can effect noninvasive thrombus ablation without apparent damage to the arterial wall.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Development and Validation of Intracranial Thrombus Segmentation on CT Angiography in Patients with Acute Ischemic Stroke

    PubMed Central

    Santos, Emilie M. M.; Marquering, Henk A.; Berkhemer, Olvert A.; van Zwam, Wim H.; van der Lugt, Aad; Majoie, Charles B.; Niessen, Wiro J.

    2014-01-01

    Background and Purpose Thrombus characterization is increasingly considered important in predicting treatment success for patients with acute ischemic stroke. The lack of intensity contrast between thrombus and surrounding tissue in CT images makes manual delineation a difficult and time consuming task. Our aim was to develop an automated method for thrombus measurement on CT angiography and validate it against manual delineation. Materials and Methods Automated thrombus segmentation was achieved using image intensity and a vascular shape prior derived from the segmentation of the contralateral artery. In 53 patients with acute ischemic stroke due to proximal intracranial arterial occlusion, automated length and volume measurements were performed. Accuracy was assessed by comparison with inter-observer variation of manual delineations using intraclass correlation coefficients and Bland–Altman analyses. Results The automated method successfully segmented the thrombus for all 53 patients. The intraclass correlation of automated and manual length and volume measurements were 0.89 and 0.84. Bland-Altman analyses yielded a bias (limits of agreement) of −0.4 (−8.8, 7.7) mm and 8 (−126, 141) mm3 for length and volume, respectively. This was comparable to the best interobserver agreement, with an intraclass correlation coefficients of 0.90 and 0.85 and a bias (limits of agreement) of −0.1 (−11.2, 10.9) mm and −17 (−216, 185) mm3. Conclusions The method facilitates automated thrombus segmentation for accurate length and volume measurements, is relatively fast and requires minimal user input, while being insensitive to high hematocrit levels and vascular calcifications. Furthermore, it has the potential to assess thrombus characteristics of low-density thrombi. PMID:25032691

  3. Detection of Left Ventricular Thrombus by Cardiac Magnetic Resonance in Embolic Stroke of Undetermined Source.

    PubMed

    Takasugi, Junji; Yamagami, Hiroshi; Noguchi, Teruo; Morita, Yoshiaki; Tanaka, Tomotaka; Okuno, Yoshinori; Yasuda, Satoshi; Toyoda, Kazunori; Gon, Yasufumi; Todo, Kenichi; Sakaguchi, Manabu; Nagatsuka, Kazuyuki

    2017-09-01

    We aimed to use contrast-enhanced cardiac magnetic resonance (CE-CMR) imaging to elucidate the prevalence of left ventricular (LV) thrombus in patients suspected of embolic stroke of undetermined source (ESUS) with previous myocardial infarction or LV dysfunction (LV ejection fraction [LVEF] <50%). We prospectively investigated 797 consecutive patients who presented to our hospital with acute ischemic stroke between 2014 and 2015. Patients with myocardial infarction or LVEF<50% underwent CE-CMR imaging. ESUS was diagnosed according to proposal criteria based on transthoracic echocardiography findings. The prevalence of ESUS was 22% (178 of 797) on initial diagnosis. Among 60 patients with myocardial infarction or LVEF<50%, the stroke subtypes were as follows: small artery disease, 17% (10 of 60); large artery atherosclerosis, 5% (3 of 60); cardioembolic stroke, 49% (29 of 60); ESUS, 23% (14 of 60); and undetermined causes other than ESUS, 6% (4 of 60). Of 60 patients examined via CE-CMR, LV thrombus was confirmed in 12 patients, whereas only 1 had been detected on transthoracic echocardiography (P=0.04). Importantly, 29% (4 of 14) of patients with ESUS had LV thrombus. A prediction model based on CE-CMR findings showed higher performance in LV thrombus detection, permitting a net improvement of 0.46 (95% confidence interval, 0.08-0.82; P=0.016) in cardioembolic stroke reclassification. Compared with patients without LV thrombus, those with LV thrombus had lower LVEF (median: 26% versus 40%; P=0.003). Notably, 42% (5 of 12) of patients with LV thrombus had LVEF≥30%. When ESUS-suspected patients have myocardial infarction or LV dysfunction, CE-CMR may help improve detection of cardioembolic stroke and provide relevant information for anticoagulation therapy. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02251665. © 2017 American Heart Association, Inc.

  4. Prime Time in the First Grade at the North Gibson School Corporation: The First Four Years. A Longitudinal Evaluation of Indiana's State-Supported Reduced Class Size Program.

    ERIC Educational Resources Information Center

    Gilman, David A.

    The purpose of this study was to investigate the impact of reducing the size of first grade classes on students' achievement. Four groups of first grade students who had participated in Indiana's Project PRIME TIME (average class size of l8 or fewer) for 1 year were compared to one class of first grade students who had received first grade…

  5. An Examination of Teachers' Perceptions and Practice when Teaching Large and Reduced-Size Classes: Do Teachers Really Teach Them in the Same Way?

    ERIC Educational Resources Information Center

    Harfitt, Gary James

    2012-01-01

    Class size research suggests that teachers do not vary their teaching strategies when moving from large to smaller classes. This study draws on interviews and classroom observations of three experienced English language teachers working with large and reduced-size classes in Hong Kong secondary schools. Findings from the study point to subtle…

  6. Dutasteride reduces prostate size and prostate specific antigen in older hypogonadal men with benign prostatic hyperplasia undergoing testosterone replacement therapy.

    PubMed

    Page, Stephanie T; Hirano, Lianne; Gilchriest, Janet; Dighe, Manjiri; Amory, John K; Marck, Brett T; Matsumoto, Alvin M

    2011-07-01

    Benign prostatic hyperplasia and hypogonadism are common disorders in aging men. There is concern that androgen replacement in older men may increase prostate size and symptoms of benign prostatic hyperplasia. We examined whether combining dutasteride, which inhibits testosterone to dihydrotestosterone conversion, with testosterone treatment in older hypogonadal men with benign prostatic hyperplasia reduces androgenic stimulation of the prostate compared to testosterone alone. We conducted a double-blind, placebo controlled trial of 53 men 51 to 82 years old with symptomatic benign prostatic hyperplasia, prostate volume 30 cc or greater and serum total testosterone less than 280 ng/dl (less than 9.7 nmol/l). Subjects were randomized to daily transdermal 1% T gel plus oral placebo or dutasteride for 6 months. Testosterone dosing was adjusted to a serum testosterone of 500 to 1,000 ng/dl. The primary outcomes were prostate volume measured by magnetic resonance imaging, serum prostate specific antigen and androgen levels. A total of 46 subjects completed all procedures. Serum testosterone increased similarly into the mid-normal range in both groups. Serum dihydrotestosterone increased in the testosterone only but decreased in the testosterone plus dutasteride group. In the testosterone plus dutasteride group prostate volume and prostate specific antigen (mean ± SEM) decreased 12% ± 2.5% and 35% ± 5%, respectively, compared to the testosterone only group in which prostate volume and prostate specific antigen increased 7.5% ± 3.3% and 19% ± 7% (p = 0.03 and p = 0.008), respectively, after 6 months of treatment. Prostate symptom scores improved in both groups. Combined treatment with testosterone plus dutasteride reduces prostate volume and prostate specific antigen compared to testosterone only. Coadministration of a 5α-reductase inhibitor with testosterone appears to spare the prostate from androgenic stimulation during testosterone replacement in older

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

    PubMed Central

    Attard, Montalto S; Grech, V

    2016-01-01

    Introduction Kawasaki disease (KD) is an acute febrile, systemic vasculitic syndrome of unknown etiology, occurring primarily in children younger than 5 years of age. Administration of IVIG within the first 10 days after onset of fever in combination with high dose aspirin reduces the risk of coronary artery damage in KD. Though rare, giant aneurysms of the coronary arteries may develop in untreated cases and prove extremely challenging to manage. Case Presentation A 9-month-old Caucasian boy presented to our paediatric emergency department with a 4-week history of intermittent pyrexia and irritability. Typical mucocutaneous signs of Kawasaki Disease were absent upon presentation. A trans-thoracic echocardiogram identified a giant aneurysm of the left anterior descending artery with thrombus formation in-situ and the child was managed with intravenous immunoglobulin, steroids, high dose aspirin therapy and later warfarinisation. Discussion Cardiovascular sequelae of Kawasaki disease include giant coronary artery aneurysms with thrombosis. Enlargement of a coronary aneurysm after the acute phase of Kawasaki disease is uncommon and the outcome of interventional approaches poorly studied. PMID:28405208

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

    PubMed

    Micallef, Eynaud S; Attard, Montalto S; Grech, V

    2016-01-01

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

  9. Reduced size of sebaceous gland and altered sebum lipid composition in mice lacking fatty acid binding protein 5 gene.

    PubMed

    Sugawara, Tomoko; Nemoto, Kei; Adachi, Yasuhiro; Yamano, Nozomi; Tokuda, Nobuko; Muto, Masahiko; Okuyama, Ryuhei; Sakai, Shingo; Owada, Yuji

    2012-07-01

    Fatty acid binding proteins (FABPs) are capable of binding long-chain FA and are involved in intracellular FA transport and signal transduction. In sebaceous glands, FABP5 is highly expressed in differentiated sebocytes; though, its function remains unclear. In this study, we examined the role of FABP5 in sebocytes using FABP5-deficient mice. The size of sebaceous glands was significantly reduced, while the sebum volume was increased with altered lipid composition in FABP5-deficient mice. However, no significant differences were discerned in the expression of proliferation or differentiation markers including Blimp1, c-myc, Ki67 and peroxisome proliferator-activated receptors (PPAR)γ between wild-type and FABP5-deficient sebaceous glands. The expression of cellular retinoic acid binding protein-2 (CRABP2) that is a competitor of FABP5 for RA signalling was increased in FABP5-deficient mice. These results suggest that FABP5 is involved in the regulation of sebaceous gland activity through modulation of cellular lipid signalling and/or metabolism in the sebocytes. © 2012 John Wiley & Sons A/S.

  10. An Experimental Study of Lightning Overvoltages in Wind Turbine Generation Systems Using a Reduced-Size Model

    NASA Astrophysics Data System (ADS)

    Yamamoto, Kazuo; Noda, Taku; Yokoyama, Shigeru; Ametani, Akihiro

    Wind turbine generation systems are built at locations where few tall structures are found nearby so as to obtain good wind conditions, and thus, they are often struck by lightning. To promote wind power generation, lightning-protection methodologies for such wind turbine generation systems have to be established. This paper presents the result of an experimental study of lightning overvoltages in wind turbine generation systems using a reduced-size wind turbine model. Overvoltages observed at wavefronts of lightning surges are focused on in this study. In the experiments, lightning strokes to one of the blades and to the nacelle were considered, and voltages and currents at various positions of the wind turbine model were measured. The following points have been deduced from the results: (i) The voltage rise due to the tower footing resistance can cause a significant voltage difference between the tower foot and an incoming conductor led from a distant point. Also, a voltage difference between the bottom of down conductors installed inside the tower and an incoming conductor can be of significance. (ii) The lightning current flowing through the tower body induces voltages in main and control circuits which form loops, and the induced voltages can cause overvoltages and malfunctions. (iii) Traveling-wave phenomena in a wind turbine generation system for a lightning strike to the tip of a blade and to the nacelle have been made clear from the measured waveforms. This information can be used for developing an EMTP simulation model of wind turbine generation systems.

  11. Size characterization of silver nanoparticles after separation from silver ions in environmental water using magnetic reduced graphene oxide.

    PubMed

    Luo, Li; Yang, Yuan; Li, Haipu; Ding, Ru; Wang, Qiang; Yang, Zhaoguang

    2017-09-07

    This study involved the synthesis of magnetic reduced graphene oxide (M-rGO) using a co-precipitation method and examined its resultant adsorption properties for mixtures containing silver ions and silver nanoparticles (AgNPs). The results indicate that M-rGO preferentially adsorbs silver ions in mixtures containing AgNPs, enabling the size characterization of smaller AgNPs (<60nm) at ultra-trace concentration levels to be more attainable. The sorbents after adsorption could be easily recovered through an external magnet. The AgNPs retained in solution were characterized using single-particle ICPMS (SP-ICPMS). The adsorption behavior of silver ions on M-rGO was well fitted with the pseudo-second-order kinetic model and the Freundlich adsorption isotherm model, with the conclusion that the adsorption of silver ions occurred primarily through the chemical bond effect and the heterogeneous surface of the sorbent. Finally, the application of M-rGO with the approach developed herein to actual environmental water samples was successful. Copyright © 2017. Published by Elsevier B.V.

  12. Effectiveness of a Comprehensive Stress Management Program to Reduce Work-Related Stress in a Medium-Sized Enterprise

    PubMed Central

    2014-01-01

    Objectives To assess the effectiveness of a comprehensive workplace stress management program consisting of participatory action-oriented training (PAOT) and individual management. Methods A comprehensive workplace stress management program was conducted in a medium-sized enterprise. The baseline survey was conducted in September 2011, using the Korean Occupational Stress Scale (KOSS) and Worker’s Stress Response Inventory (WSRI). After implementing both organizational and individual level interventions, the follow up evaluation was conducted in November 2011. Results Most of the workers participated in the organizational level PAOT and made Team-based improvement plans. Based on the stress survey, 24 workers were interviewed by a researcher. After the organizational and individual level interventions, there was a reduction of several adverse psychosocial factors and stress responses. In the case of blue-collar workers, psychosocial factors such as the physical environment, job demands, organizational system, lack of rewards, and occupational climate were significantly improved; in the case of white-collar workers, the occupational climate was improved. Conclusions In light of these results, we concluded that the comprehensive stress management program was effective in reducing work-related stress in a short-term period. A persistent long-term follow up is necessary to determine whether the observed effects are maintained over time. Both team-based improvement activities and individual interviews have to be sustainable and complementary to each other under the long-term plan. PMID:24524591

  13. Ligands of the peroxisome proliferator-activated receptors (PPAR-gamma and PPAR-alpha) reduce myocardial infarct size.

    PubMed

    Wayman, Nicole S; Hattori, Yoshiyuki; McDonald, Michelle C; Mota-Filipe, Helder; Cuzzocrea, Salvatore; Pisano, Babrbara; Chatterjee, Prabal K; Thiemermann, Christoph

    2002-07-01

    This study was designed to investigate the effects of various chemically distinct activators of PPAR-gamma and PPAR-alpha in a rat model of acute myocardial infarction. Using Northern blot analysis and RT-PCR in samples of rat heart, we document the expression of the mRNA for PPAR-gamma (isoform 1 but not isoform 2) as well as PPAR-beta and PPAR-alpha in freshly isolated cardiac myocytes and cardiac fibroblasts and in the left and right ventricles of the heart. Using a rat model of regional myocardial ischemia and reperfusion (in vivo), we have discovered that various chemically distinct ligands of PPAR-gamma (including the TZDs rosiglitazone, ciglitazone, and pioglitazone, as well as the cyclopentanone prostaglandins 15D-PGJ2 and PGA1) cause a substantial reduction of myocardial infarct size in the rat. We demonstrate that two distinct ligands of PPAR-alpha (including clofibrate and WY 14643) also cause a substantial reduction of myocardial infarct size in the rat. The most pronounced reduction in infarct size was observed with the endogenous PPAR-gamma ligand, 15-deoxyDelta12,14-prostagalndin J2 (15D-PGJ2). The mechanisms of the cardioprotective effects of 15D-PGJ2 may include 1) activation of PPAR-alpha, 2) activation of PPAR-gamma, 3) expression of HO-1, and 4) inhibition of the activation of NF-kappaB in the ischemic-reperfused heart. Inhibition by 15D-PGJ2 of the activation of NF-kappaB in turn results in a reduction of the 1) expression of inducible nitric oxide synthase and the nitration of proteins by peroxynitrite, 2) formation of the chemokine MCP-1, and 3) expression of the adhesion molecule ICAM-1. We speculate that ligands of PPAR-gamma and PPAR-alpha may be useful in the therapy of conditions associated with ischemia-reperfusion of the heart and other organs. Our findings also imply that TZDs and fibrates may help protect the heart against ischemia-reperfusion injury. This beneficial effect of 15D-PGJ2 was associated with a reduction in the

  14. A Self-Organizing Map-Based Approach to Generating Reduced-Size, Statistically Similar Climate Datasets

    NASA Astrophysics Data System (ADS)

    Cabell, R.; Delle Monache, L.; Alessandrini, S.; Rodriguez, L.

    2015-12-01

    Climate-based studies require large amounts of data in order to produce accurate and reliable results. Many of these studies have used 30-plus year data sets in order to produce stable and high-quality results, and as a result, many such data sets are available, generally in the form of global reanalyses. While the analysis of these data lead to high-fidelity results, its processing can be very computationally expensive. This computational burden prevents the utilization of these data sets for certain applications, e.g., when rapid response is needed in crisis management and disaster planning scenarios resulting from release of toxic material in the atmosphere. We have developed a methodology to reduce large climate datasets to more manageable sizes while retaining statistically similar results when used to produce ensembles of possible outcomes. We do this by employing a Self-Organizing Map (SOM) algorithm to analyze general patterns of meteorological fields over a regional domain of interest to produce a small set of "typical days" with which to generate the model ensemble. The SOM algorithm takes as input a set of vectors and generates a 2D map of representative vectors deemed most similar to the input set and to each other. Input predictors are selected that are correlated with the model output, which in our case is an Atmospheric Transport and Dispersion (T&D) model that is highly dependent on surface winds and boundary layer depth. To choose a subset of "typical days," each input day is assigned to its closest SOM map node vector and then ranked by distance. Each node vector is treated as a distribution and days are sampled from them by percentile. Using a 30-node SOM, with sampling every 20th percentile, we have been able to reduce 30 years of the Climate Forecast System Reanalysis (CFSR) data for the month of October to 150 "typical days." To estimate the skill of this approach, the "Measure of Effectiveness" (MOE) metric is used to compare area and overlap

  15. Thrombus Formation After Percutaneous Catheterization and Manual Compression of the Femoral Artery in Heparinized Sheep

    SciTech Connect

    Kim, Young Hwan; Pavcnik, Dusan Kakizawa, Hideyaki; Uchida, Barry T.; Burke, Allen; Loriaux, Marc; Keller, Frederick S.; Rosch, Josef

    2010-04-15

    The purpose of this study was to evaluate the angiographic and histopathologic changes in the superficial femoral artery (SFA) in heparinized sheep shortly after catheterization with an 8-Fr sheath and manual compression hemostasis either with standard manual compression (SMC) or with the use of a procoagulant chitosan-based HemCon Bandage. The evaluation was done in 38 SFAs of 19 heparinized (100 mg/kg) sheep. After a 5-min catheterization with an 8-Fr sheath, a 5-min compression was applied. Follow-up angiograms to evaluate hemostasis were done immediately after release of compression and then at 2.5-min intervals until no extravasation was present. Compression was reapplied between angiograms. Final angiograms were performed approximately 30 min after hemostasis and after 3 min of passive flexion and extension of sheep hind limbs. Sheep were then euthanized and SFA specimens with surrounding tissues excised for histopathologic evaluation. Both types of compression caused similar changes in the catheterized SFAs. Follow-up angiograms showed mild arterial narrowing in 14 SFAs and intraluminal clots in 9 SFAs. Histology revealed periarterial hematoma in all 38 specimens. Intraluminal thrombi consisting predominantly of platelets and fibrin were present in 32 SFAs. Their size varied from superficial elevations (8 arteries) to medium-sized, 1- to 2-mm, polypoid protrusions (15 arteries) to large polypoid clots, 3-4 mm long (9 arteries). In six SFAs, the arterial access sites were not included in the obtained specimens. In conclusion, hemostasis with manual compression is achieved in the acute phase by formation of a predominantly platelet-fibrin thrombus occluding the arterial wall access site and often extending significantly into the arterial lumen. The healing process of arterial access sites should be explored several days after catheterization.

  16. [Two Cases of Colorectal Cancer with Tumor Thrombus in the Inferior Mesenteric Vein].

    PubMed

    Matsumura, Atsushi; Hatakeyama, Tomoya; Ogino, Shiro; Takemura, Manabu; Mugitani, Tatsuro; Akami, Toshikazu; Okano, Shinji; Ueda, Yuji

    2015-11-01

    In colorectal cancer, progression with an intravenous tumor thrombus is very rare. Here, we report 2 cases of colorectal cancer which showed a tumor thrombus in the inferior mesenteric vein (IMV). Case 1: A 69-year-old woman was admitted for the treatment of advanced rectal cancer, and underwent a low anterior resection. Six months of post-operative therapy was carried out with mFOLFOX6, but a metachronous lung metastasis was detected and a lung partial resection was performed. Case 2: A 67-year-old man was admitted for the treatment of advanced sigmoid colon cancer with simultaneous liver metastasis, and underwent a laparoscopic high anterior resection. Four courses of mFOLFOX6+bevacizumab chemotherapy were carried out after surgery, and subsequently he underwent a partial hepatectomy. In both cases IMV tumor thrombus was suspected from abdominal contrast-enhanced computed tomography (CT). Tumor thrombus filling the lumen of the IMV was confirmed on histopathological examination. Colorectal cancer with IMV tumor thrombus is a form of advanced cancer with advanced vascular invasion, and there is a high risk of simultaneous or metachronous hematogenous metastasis. Combined modality therapy should therefore be given to improve the prognosis.

  17. Review of Mechanical Testing and Modelling of Thrombus Material for Vascular Implant and Device Design.

    PubMed

    Johnson, S; Duffy, S; Gunning, G; Gilvarry, M; McGarry, J P; McHugh, P E

    2017-08-28

    A thrombus or blood clot is a solid mass, made up of a network of fibrin, platelets and other blood components. Blood clots can form through various pathways, for example as a result of exposed tissue factor from vascular injury, as a result of low flow/stasis, or in very high shear flow conditions. Embolization of cardiac or vascular originating blood clots, causing an occlusion of the neurovasculature, is the major cause of stroke and accounts for 85% of all stroke. With mechanical thrombectomy emerging as the new standard of care in the treatment of acute ischemic stroke (AIS), the need to generate a better understanding of the biomechanical properties and material behaviour of thrombus material has never been greater, as it could have many potential benefits for the analysis and performance of these treatment devices. Defining the material properties of a thrombus has obvious implications for the development of these treatment devices. However, to-date this definition has not been adequately established. While some experimentation has been performed, model development has been extremely limited. This paper reviews the previous literature on mechanical testing of thrombus material. It also explores the use of various constitutive and computational models to model thrombus formation and material behaviour.

  18. Simulation of thrombus formation in shear flows using Lattice Boltzmann Method.

    PubMed

    Tamagawa, Masaaki; Kaneda, Hiroaki; Hiramoto, Miki; Nagahama, Sho

    2009-08-01

    This article describes the prediction of index of thrombus formation in shear blood flow by computational fluid dynamics with the Lattice Boltzmann Method (LBM), applying to backward-facing step flow, which is a simple model of shear flow in the rotary blood pumps and complicated geometry of medical fluid devices. Assuming that the blood flow is a multiphase flow composed of blood plasma and activated fibrinogen, the effects of surface tension and adhesion force to the wall were added to the LBM computational model. It was found that the thrombus formation in the backward-facing step flow occurred just after the reattachment point and behind the step. These results corresponded to our observation results of thrombus formation. For the thrombus formation in every case of blood flow to be predicted, effects of threshold level of physical parameters such as shear rate and adhesion force (effective distance from the wall) were estimated. Moreover, it was also found that the predicted adhesion point on the wall agrees with the visualization of thrombus formation by predicting proper thresholds.

  19. [Recurrent right atrial thrombus in a patient with atrial fibrillation and heart failure].

    PubMed

    Elikowski, Waldemar; Wróblewski, Dariusz; Małek-Elikowska, Małgorzata; Mazurek, Andrzej; Foremska-Iciek, Joanna; Łazowski, Stanisław

    2015-11-01

    Atrial fibrillation and heart failure are factors predisposing to locally formed intracardiac thrombosis, which is usually localized in left-sided chambers. A case report. The authors present a case of a 50-year-old male with permanent atrial fibrillation and dilated cardiomyopathy in whom recurrent right atrial thrombus was observed. Initially, the lesion was detected in echocardiography while he was hospitalized due to extensive right-sided pneumonia. The thrombus was successfully treated with heparin, followed by warfarin. Even though the patient continued warfarin use properly, there was recurrence of the thrombus two years later during a new episode of heart failure exacerbation. Because the thrombus was resistant to intensified anticoagulation, cardiac surgery was needed. A large (30 x 25 mm) pedunculated thrombus, as well as two smaller ones (each of 10 x 10 mm) attached closely to the atrial wall and previously not detected either by echocardiography or by magnetic resonance imaging, were excited. A partially organized pattern of the thrombi in histological examination can explain lack of anticoagulation effectiveness.

  20. Mlck1a is expressed in zebrafish thrombocytes and an essential component for thrombus formation

    PubMed Central

    Tournoij, E.; Weber, G.J.; Akkerman, J.W.N.; de Groot, Ph.G.; Zon, L.I.; Moll, F.L.; Schulte-Merker, S.

    2010-01-01

    Background We have used the advantages of the zebrafish model system to demonstrate which of the vertebrate Myosin Light Chain Kinase (MLCK) genes is expressed in thrombocytes and important for thrombus formation. Methods and Results Here we report that Mlck1a is an essential component for thrombus formation. Phylogenetic data revealed four zebrafish orthologous for three human MLCK genes. To investigate expression of the zebrafish mlck genes in thrombocytes we, compared GFP-tagged platelets with other cells by microarray analysis, and showed that mlck1a expression was 4.5 fold enriched in platelets. Furthermore, mlck1a mRNA and mRNA for the platelet-specific cd41 co-localized in thrombi. Expression of other mlck subtypes was lower in GFP-tagged platelets (mlck1b; 0.77 fold enriched) and absent in thrombi (mlck1b, -2, -3). To investigate the role of Mlck1a in thrombus formation, we knocked down mlck1a using two morpholinos. This resulted in impaired morphology changes of platelets adhering on fibrinogen. In a thrombosis model, in which thrombocytes adhere to the vessel wall damaged by laser irradiation, thrombus formation was slowed down in mlck1a deficient embryos. Conclusion We conclude that Mlck1a is the subtype of MLCK that contributes to platelet shape change and thrombus formation. PMID:20002541

  1. Embolization: critical thrombus height, shear rates, and pulsatility. Patency of blood vessels.

    PubMed

    Basmadjian, D

    1989-11-01

    The present article builds on elementary fluid dynamics and previous analyses by the author to delineate approximate boundaries of mural thrombus height Hp, maximum shear rate gamma Max, and flow pulsatility beyond which thrombi are subject to either very high or very low probabilities of embolization. A thrombus height of approximately 0.1 mm emerges as a critical dividing line: Below it, the maximum embolizing shear stress tau s is independent of thrombus height and varies only linearly with shear rate. Above it, tau s quickly approaches a strong quadratic dependence on both thrombus height and shear rate: tau s approximately (Hp gamma)2, significantly increasing the likelihood of an embolizing event. By contrast, convective-diffusive removal of blood components during the initial stages of thrombus formation varies only weakly with gamma 1/3 in all but the smallest vessels. These maximum embolizing stresses are due principally to fluid drag. Acceleration (pulsatile) forces only begin to make their presence felt at gamma less than 500 s-1 and reach parity with fluid drag at gamma approximately 10 s-1, i.e., at a level where the presence of pulsatility is questionable. The results are used to provide maps of domains with high and low probabilities of an embolytic event and of vessel patency. The maps reveal that relatively modest changes in shear rate and/or vessel lumen can cause shifts from high to low likelihood of vessel patency, opening up possible ways of controlling blockage by manipulation of these variables.

  2. Common Carotid Artery Stump Syndrome Due to Mobile Thrombus Detected by Carotid Duplex Ultrasonography.

    PubMed

    Omoto, Shusaku; Hasegawa, Yuki; Sakai, Kenichiro; Matsuno, Hiromasa; Arai, Ayumi; Terasawa, Yuka; Mitsumura, Hidetaka; Iguchi, Yasuyuki

    2016-10-01

    Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., "CCA stump syndrome." Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation. According to carotid duplex ultrasonography (CDU), a low-echoic mobile thrombus was noted at the distal stump of the occluded CCA, which presumably caused distal embolism. The low-echoic mobile thrombus dramatically changed to a homogenously high-echoic thrombus, and there was no recurrence of stroke after antiplatelet and anticoagulant therapy. This is the first report to demonstrate a CDU-verified temporal change in the thrombus at the stump in CCA stump syndrome. CDU is a noninvasive and useful technique to characterize hemodynamics, thrombus morphology, and the response to therapy.

  3. Fibrin d-dimer concentration, deep vein thrombosis symptom duration, and venous thrombus volume.

    PubMed

    Kurklinsky, Andrew K; Kalsi, Henna; Wysokinski, Waldemar E; Mauck, Karen F; Bhagra, Anjali; Havyer, Rachel D; Thompson, Carrie A; Hayes, Sharonne N; McBane, Robert D

    2011-04-01

    To determine the relationship between fibrin D-dimer levels, symptom duration, and thrombus volume, consecutive patients with incident deep venous thrombosis (DVT) were evaluated. In a cross-sectional study design, patient symptom onset was determined by careful patient questioning. Venous thrombosis was confirmed by compression duplex ultrasonography. Thrombus volume was estimated based on patient's femur length using a forensic anthropology method. Fibrin D-dimer was measured by latex immunoassay. 72 consecutive patients with confirmed leg DVT agreed to participate. The median symptom duration at the time of diagnosis was 10 days. The median D-dimer concentration was 1050 ng/dL. The median thrombus volume was 12.92 cm(3). D-Dimer levels correlated with estimated thrombus volume (P < .0006 CI 0.12-0.41; R(2) (adjusted) = .15) but not symptom duration, patient's age, or gender. Despite varying symptom duration prior to diagnosis, fibrin D-dimer remains a sensitive measure of venous thrombosis and correlates with thrombus volume.

  4. How Well Does Fracture Set Characterization Reduce Uncertainty in Capture Zone Size for Wells Situated in Sedimentary Bedrock Aquifers?

    NASA Astrophysics Data System (ADS)

    West, A. C.; Novakowski, K. S.

    2005-12-01

    Regional groundwater flow models are rife with uncertainty. The three-dimensional flux vector fields must generally be inferred using inverse modelling from sparse measurements of hydraulic head, from measurements of hydraulic parameters at a scale that is miniscule in comparison to that of the domain, and from none to a very few measurements of recharge or discharge rate. Despite the inherent uncertainty in these models they are routinely used to delineate steady-state or time-of-travel capture zones for the purpose of wellhead protection. The latter are defined as the volume of the aquifer within which released particles will arrive at the well within the specified time and their delineation requires the additional step of dividing the magnitudes of the flux vectors by the assumed porosity to arrive at the ``average linear groundwater velocity'' vector field. Since the porosity is usually assumed constant over the domain one could be forgiven for thinking that the uncertainty introduced at this step is minor in comparison to the flow model calibration step. We consider this question when the porosity in question is fracture porosity in flat-lying sedimentary bedrock. We also consider whether or not the diffusive uptake of solute into the rock matrix which lies between the source and the production well reduces or enhances the uncertainty. To evaluate the uncertainty an aquifer cross section is conceptualized as an array of horizontal, randomly-spaced, parallel-plate fractures of random aperture, with adjacent horizontal fractures connected by vertical fractures again of random spacing and aperture. The source is assumed to be a continuous concentration (i.e. a dirichlet boundary condition) representing a leaking tank or a DNAPL pool, and the receptor is a fully pentrating well located in the down-gradient direction. In this context the time-of-travel capture zone is defined as the separation distance required such that the source does not contaminate the well

  5. Intrameal Hepatic Portal and Intraperitoneal Infusions of Glucagon-Like Peptide-1 Reduce Spontaneous Meal Size in the Rat via Different Mechanisms

    PubMed Central

    Rüttimann, Elisabeth B.; Arnold, Myrtha; Hillebrand, Jacquelien J.; Geary, Nori; Langhans, Wolfgang

    2009-01-01

    Peripheral administration of glucagon-like peptide (GLP)-1 reduces food intake in animals and humans, but the sites and mechanism of this effect and its physiological significance are not yet clear. To investigate these issues, we prepared rats with chronic catheters and infused GLP-1 (0.2 ml/min; 2.5 or 5.0 min) during the first spontaneous dark-phase meals. Infusions were remotely triggered 2–3 min after meal onset. Hepatic portal vein (HPV) infusion of 1.0 or 3.0 (but not 0.33) nmol/kg GLP-1 reduced the size of the ongoing meal compared with vehicle without affecting the subsequent intermeal interval, the size of subsequent meals, or cumulative food intake. In double-cannulated rats, HPV and vena cava infusions of 1.0 nmol/kg GLP-1 reduced meal size similarly. HPV GLP-1 infusions of 1.0 nmol/kg GLP-1 also reduced meal size similarly in rats with subdiaphragmatic vagal deafferentations and in sham-operated rats. Finally, HPV and ip infusions of 10 nmol/kg GLP-1 reduced meal size similarly in sham-operated rats, but only HPV GLP-1 reduced meal size in subdiaphragmatic vagal deafferentation rats. These data indicate that peripherally infused GLP-1 acutely and specifically reduces the size of ongoing meals in rats and that the satiating effect of ip, but not iv, GLP-1 requires vagal afferent signaling. The findings suggest that iv GLP-1 infusions do not inhibit eating via hepatic portal or hepatic GLP-1 receptors but may act directly on the brain. PMID:18948395

  6. Sampling hazelnuts for aflatoxin: effect of sample size and accept/reject limit on reducing the risk of misclassifying lots.

    PubMed

    Ozay, Guner; Seyhan, Ferda; Yilmaz, Aysun; Whitaker, Thomas B; Slate, Andrew B; Giesbrecht, Francis G

    2007-01-01

    About 100 countries have established regulatory limits for aflatoxin in food and feeds. Because these limits vary widely among regulating countries, the Codex Committee on Food Additives and Contaminants began work in 2004 to harmonize aflatoxin limits and sampling plans for aflatoxin in almonds, pistachios, hazelnuts, and Brazil nuts. Studies were developed to measure the uncertainty and distribution among replicated sample aflatoxin test results taken from aflatoxin-contaminated treenut lots. The uncertainty and distribution information is used to develop a model that can evaluate the performance (risk of misclassifying lots) of aflatoxin sampling plan designs for treenuts. Once the performance of aflatoxin sampling plans can be predicted, they can be designed to reduce the risks of misclassifying lots traded in either the domestic or export markets. A method was developed to evaluate the performance of sampling plans designed to detect aflatoxin in hazelnuts lots. Twenty hazelnut lots with varying levels of contamination were sampled according to an experimental protocol where 16 test samples were taken from each lot. The observed aflatoxin distribution among the 16 aflatoxin sample test results was compared to lognormal, compound gamma, and negative binomial distributions. The negative binomial distribution was selected to model aflatoxin distribution among sample test results because it gave acceptable fits to observed distributions among sample test results taken from a wide range of lot concentrations. Using the negative binomial distribution, computer models were developed to calculate operating characteristic curves for specific aflatoxin sampling plan designs. The effect of sample size and accept/reject limits on the chances of rejecting good lots (sellers' risk) and accepting bad lots (buyers' risk) was demonstrated for various sampling plan designs.

  7. Cardiac thrombus developing after an accidental high-voltage electric shock in a child.

    PubMed

    Akın, Alper; Bilici, Meki; Demir, Fikri; Gözü Pirinççioğlu, Ayfer; Yavuz, Celal

    2015-01-01

    Electric shock is a condition that may affect various organ systems and potentially cause death. Cardiac findings vary from asymptomatic mild injury to fatal myocardial involvement. Herein we present a five-year-old boy with a cardiac thrombus developing after an accidental electrical shock. Cardiac arrhythmias and evidence of ischemia have been reported after electric shock; we were, however, unable to identify an earlier case report of intracardiac thrombosis related to electric shock. Findings such as elevated cardiac enzymes and systolic dysfunction, which indicate myocardial damage following electric shock, were present in our patient. We think that the cardiac thrombus might have resulted from the myocardial damage and the slowed intracardiac blood flow related to systolic dysfunction. As the thrombus was thought to have been formed through known mechanisms, it was treated traditionally. However, further data regarding the etiology and management of such thrombi is needed.

  8. Surgery for retrohepatic caval thrombus in patients with advanced renal cell carcinoma: a case series.

    PubMed

    Polańska-Płachta, Małgorzata; Proczka, Robert; Dudek, Magdalena; Ostrowska, Małgorzata; Polański, Jerzy A

    2016-01-15

    Thrombotic involvement of the inferior vena cava (IVC) occurs in about 10% of all patients with renal cell carcinoma (RCC). It is treated with radical resection of tumor and thrombus. We present the results of a recent case series of 20 patients with retrohepatic IVC thrombus. Our cohort of 20 patients included 16 primary resections (radical nephrectomy and thrombectomy with and without vascular graft), three recurrences primarily operated on elsewhere (thrombectomy and vascular graft), and one recurrence due to a new liver metastasis. All surviving patients were discharged with a patent IVC. The overall mortality rate was 10%, and the overall complication rate was 35%. Both are in keeping with results presented worldwide. Our series provides a corroborating extension to the existing dataset on RCC-related IVC thrombus removal. It confirms that the radical surgical approach can be performed safely and successfully with respect to venous patency.

  9. Isolated Internal Carotid Artery Thrombus and Cerebral Infarction in a Patient with Necrotizing Pancreatitis: Case Report.

    PubMed

    Ludwig, Daniel R; Austin, Matthew J; Wallace, Adam N; Kamran, Mudassar; Kansagra, Akash P; Osbun, Joshua W; Cross, DeWitte T; Moran, Christopher J

    2017-09-08

    Isolated internal carotid artery (ICA) thrombus in the absence of underlying atherosclerotic disease is a rare entity. We report a case of a patient presenting with right arm weakness, slurred speech, and altered mental status in the setting of acute on chronic pancreatitis. The patient was found to have scattered left cerebral hemisphere cortical infarctions, and catheter angiography confirmed the presence of intraluminal left ICA thrombus, with no evidence of atherosclerotic disease in the cervical or intracranial vasculature. Further workup also demonstrated the presence of anemia of chronic disease. The patient was initiated on anticoagulation, and follow-up imaging demonstrated a complete resolution of the left ICA thrombus. In the reported case, coagulopathy in the setting of acute on chronic pancreatitis was presumably the primary etiology. Anemia of chronic disease, related to a proinflammatory state, may also play a contributory role. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. Platelets and coagulation in thrombus formation: aberrations in the Scott syndrome.

    PubMed

    van Geffen, Johanna P; Swieringa, Frauke; Heemskerk, Johan W M

    2016-05-01

    Platelets play key roles in thrombosis and hemostasis by forming aggregates and providing a procoagulant surface, at which thrombin is generated and fibrin fibers are formed. Here we present an overview of the different mechanisms how platelets orchestrate coagulation processes in thrombus formation in thrombosis and hemostasis. Parts of these are via Ca(2+)-dependent activation responses, leading to phosphatidylserine exposure; swelling to form balloons with increased binding of coagulation factors; and calpain-mediated integrin αIIbβ3 cleavage and inactivation. Other mechanisms are secretion of (anti) coagulation factors, and αIIbβ3-mediated thrombus retraction, and clot retraction. In a thrombus, coagulation factors are found at both platelets and fibrin fibers. Many of the procoagulant platelet activities are altered in the Scott syndrome.

  11. Allocating Sample Sizes to Reduce Budget for Fixed-Effect 2×2 Heterogeneous Analysis of Variance

    ERIC Educational Resources Information Center

    Luh, Wei-Ming; Guo, Jiin-Huarng

    2016-01-01

    This article discusses the sample size requirements for the interaction, row, and column effects, respectively, by forming a linear contrast for a 2×2 factorial design for fixed-effects heterogeneous analysis of variance. The proposed method uses the Welch t test and its corresponding degrees of freedom to calculate the final sample size in a…

  12. Allocating Sample Sizes to Reduce Budget for Fixed-Effect 2×2 Heterogeneous Analysis of Variance

    ERIC Educational Resources Information Center

    Luh, Wei-Ming; Guo, Jiin-Huarng

    2016-01-01

    This article discusses the sample size requirements for the interaction, row, and column effects, respectively, by forming a linear contrast for a 2×2 factorial design for fixed-effects heterogeneous analysis of variance. The proposed method uses the Welch t test and its corresponding degrees of freedom to calculate the final sample size in a…

  13. Ventricular Tachycardia Ablation in the Presence of Left Ventricular Thrombus: Safety and Efficacy.

    PubMed

    Rao, Hygriv B; Yu, Ricky; Chitnis, Nishad; DO, Duc; Boyle, Noel G; Shivkumar, Kalyanam; Bradfield, Jason S

    2016-04-01

    The safety of ventricular tachycardia (VT) ablation in patients with laminated left ventricular (LV) thrombus has not been examined. Patients with laminated LV thrombus on transthoracic echocardiogram who underwent scar-mediated VT ablation at two centers from 2010 to 2013 were retrospectively analyzed. All patients had failed medical therapy. Acute procedural outcomes, complications, and clinical outcomes at 1 year were assessed. Eight patients (four ischemic, four nonischemic cardiomyopathy) underwent VT ablation in the presence of laminated intracavitary thrombus. Six out of eight (75%) had electrical storm (ES). The mapping and ablation approach was LV endocardial-only in three patients, epicardial-only in two, combined epicardial-RV endocardial in two, and combined epicardial-LV endocardial in one. Major complication (ischemic stroke) occurred in one patient 9 days post-procedure. There was no procedural mortality. Complete acute procedural success (noninducibility of any VT after ablation) was achieved in five (63%), and partial success (ablation of only clinical VT) in an additional three (37%). At 1 year, freedom from VT and survival were achieved in six (75%) and seven (88%) patients, respectively. Initial data suggest that ablation of VT in the presence of intracavitary thrombus is feasible, is associated with a similar success rate to historical studies in patients without thrombus, and has an acceptable risk of complications given the high-risk nature of patients with ES. Further data are needed; however, the presence of a laminated thrombus should not necessarily preclude ablation in patients who have failed medical therapy for VT in whom ablation is otherwise indicated. © 2015 Wiley Periodicals, Inc.

  14. Prognostic importance of central thrombus in hemodynamically stable patients with pulmonary embolism.

    PubMed

    Senturk, Aysegul; Ozsu, Savas; Duru, Serap; Cakır, Ebru; Ulaslı, Sevinc Sarinc; Demirdogen, Ezgi; Kayhan, Servet; Guzel, Aygul; Yakar, Fatih; Berk, Serdar

    2017-03-01

    The association between mortality and localization of central thrombus in hemodynamically stable patients with pulmonary embolism (PE) is unclear. Sufficient data are not available to help clinicians to select between low molecular weight heparin (LMWH), unfractionated heparin (UFH) and thrombolytics for the management of central thrombus. The present study aims to investigate whether central thrombus in the pulmonary artery affects 30-day mortality rate, and to compare the outcomes of different treatment approaches in patients with central thrombus. This multi-central, prospective, observational study included 874 hemodynamically stable patients with PE confirmed by Multidetector Computed Tomography (MDCT) scan. The localization of the emboli was evaluated and categorized as central (saddle or at least one main pulmonary artery), lobar or distal. The primary study outcome was 30-day all-cause mortality. Localization of the emboli was central in 319 patients (36.5%), lobar in 264 (30.2%) and distal in 291 (33.2%) patients. Seventy-four patients (8.5%) died during the 30-day follow-up period. All-cause mortality rate was 11.9%, 6.8% and 6.2% in patients with central, lobar, and distal emboli, respectively (p < 0.001). Multivariate analysis did not show that hemodynamically stable central thrombus was an independent predictor of mortality. Additionally, mortality rate was not significantly different between UFH, LMWH and thrombolytic therapy groups. The present study showed that central thrombus was not an independent predictor of mortality in hemodynamically stable PE patients. LMWH and UFH were similarly effective in the treatment of this patient group.

  15. Multimodality Treatment for Hepatocellular Carcinoma With Portal Vein Tumor Thrombus

    PubMed Central

    Wang, Kang; Guo, Wei Xing; Chen, Min Shan; Mao, Yi Lei; Sun, Bei Cheng; Shi, Jie; Zhang, Yao Jun; Meng, Yan; Yang, Ye Fa; Cong, Wen Ming; Wu, Meng Chao; Lau, Wan Yee; Cheng, Shu Qun

    2016-01-01

    Abstract The optimal treatment for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) remains controversial. We aimed to investigate the best treatment for patients with HCC with PVTT. From January 2002 to January 2014, the data from all consecutive patients with HCC with PVTT who underwent surgical treatment (ST),TACE,TACE combined with sorafenib (TACE-Sor), or TACE combined with radiotherapy (TACE-RT) in the 4 largest tertiary hospitals in China were analyzed retrospectively. The patients were divided into 3 subtypes according to the extent of PVTT in the portal vein (type I-III). The primary endpoint was overall survival (OS). A total of 1580 patients with HCC with PVTT were included in the study. The median survival times (MST) for ST (n = 745) for type I, II, and III patients (95% CI) were 15.9 (13.3–18.5), 12.5 (10.7–14.3), and 6.0 (4.3–7.7) months, respectively. The corresponding figures for patients after TACE (n = 604) were 9.3 (5.6–12.9), 4.9 (4.1–5.7), and 4.0 (3.1–4.9), respectively; for patients after TACE-Sor (n = 113) 12.0 (6.6–17.4), 8.9 (6.7–11.1), and 7.0 (3.0–10.9), respectively; and for patients after TACE-RT (n = 118) 12.2 (0–24.7), 10.6 (6.8–14.5), and 8.9 (5.2–12.6), respectively. Comparison among the different treatments for the 3 subtypes of PVTT patients after propensity score (PS) matching showed the effectiveness of ST to be the best for type I and type II PVTT patients, and TACE-RT was most beneficial for type III patients. Treatment was an independent risk factor of OS. ST was the best treatment for type I and II PVTT patients with Child-Pugh A and selected B liver function. TACE-RT should be given to type III PVTT patients. PMID:26986115

  16. Preparation and characterization of gadolinium-loaded PLGA particles surface modified with RGDS for the detection of thrombus

    PubMed Central

    Zhang, Yu; Zhou, Jun; Guo, Dajing; Ao, Meng; Zheng, Yuanyi; Wang, Zhigang

    2013-01-01

    Thrombotic disease is a leading cause of death and disability worldwide. The development of magnetic resonance molecular imaging provides potential promise for early disease diagnosis. In this study, we explore the preparation and characterization of gadolinium (Gd)-loaded poly (lactic-co-glycolic acid) (PLGA) particles surface modified with the Arg-Gly-Asp-Ser (RGDS) peptide for the detection of thrombus. PLGA was employed as the carrier-delivery system, and a double emulsion solvent-evaporation method (water in oil in water) was used to prepare PLGA particles encapsulating the magnetic resonance contrast agent Gd diethylenetriaminepentaacetic acid (DTPA). To synthesize the Gd-PLGA/chitosan (CS)-RGDS particles, carbodiimide-mediated amide bond formation was used to graft the RGDS peptide to CS to form a CS-RGDS film that coated the surface of the PLGA particles. Blank PLGA, Gd-PLGA, and Gd-PLGA/CS particles were fabricated using the same water in oil in water method. Our results indicated that the RGDS peptide successfully coated the surface of the Gd-PLGA/CS-RGDS particles. The particles had a regular shape, smooth surface, relatively uniform size, and did not aggregate. The high electron density of the Gd-loaded particles and a translucent film around the particles coated with the CS and CS-RGDS films could be observed by transmission electron microscopy. In vitro experiments demonstrated that the Gd-PLGA/CS-RGDS particles could target thrombi and could be imaged using a clinical magnetic resonance scanner. Compared with the Gd-DTPA solution, the longitudinal relaxation time of the Gd-loaded particles was slightly longer, and as the Gd-load concentration increased, the longitudinal relaxation time values decreased. These results suggest the potential of the Gd-PLGA/CS-RGDS particles for the sensitive and specific detection of thrombus at the molecular level. PMID:24124363

  17. Feasibility of the optical imaging of thrombus formation in a rotary blood pump by near-infrared light.

    PubMed

    Sakota, Daisuke; Murashige, Tomotaka; Kosaka, Ryo; Nishida, Masahiro; Maruyama, Osamu

    2014-09-01

    Blood coagulation is one of the primary concerns when using mechanical circulatory support devices such as blood pumps. Noninvasive detection and imaging of thrombus formation is useful not only for the development of more hemocompatible devices but also for the management of blood coagulation to avoid risk of infarction. The objective of this study is to investigate the use of near-infrared light for imaging of thrombus formation in a rotary blood pump. The optical properties of a thrombus at wavelengths ranging from 600 to 750 nm were analyzed using a hyperspectral imaging (HSI) system. A specially designed hydrodynamically levitated centrifugal blood pump with a visible bottom area was used. In vitro antithrombogenic testing was conducted five times with the pump using bovine whole blood in which the activated blood clotting time was adjusted to 200 s prior to the experiment. Two halogen lights were used for the light sources. The forward scattering through the pump and backward scattering on the pump bottom area were imaged using the HSI system. HSI showed an increase in forward scattering at wavelengths ranging from 670 to 750 nm in the location of thrombus formation. The time at which the thrombus began to form in the impeller rotating at 2780 rpm could be detected. The spectral difference between the whole blood and the thrombus was utilized to image thrombus formation. The results indicate the feasibility of dynamically detecting and imaging thrombus formation in a rotary blood pump.

  18. Severe reversible dilated cardiomyopathy associated with a large left ventricular thrombus in a young child with middle aortic syndrome.

    PubMed

    Ponniah, U; Overholt, E

    2014-01-01

    We report a case of a seven-year girl who presented with severe dilated cardiomyopathy (DCM) associated with a large thrombus in the left ventricle (LV). She had a long segment stenosis of the lower thoracic descending aorta, possibly due to non-specific aortitis and underwent successful stent angioplasty. The LV thrombus resolved after heparin without sequelae.

  19. Jugular thrombophlebitis in horses: A review of fibrinolysis, thrombus formation, and clinical management

    PubMed Central

    Dias, Deborah Penteado Martins; de Lacerda Neto, José Corrêa

    2013-01-01

    Thrombophlebitis of the jugular vein is commonly observed in horses, particularly during intensive care, and leads to local and systemic inflammatory responses as well as head and neck circulatory impairment. Thrombolytic therapy is widely used in human practice with the aim of thrombus dissolution and recanalization of the injured vessels. There are similarities between human and horse coagulation and fibrinolytic processes. This review examines the fibrinolytic system, thrombus formation, and the clinical management of jugular thrombophlebitis, including thrombolytic therapy. There is evidence that early regional thrombolytic therapy for jugular thrombophlebitis in horses may be effective to achieve sustained recanalization. PMID:23814304

  20. Can eccentric arterial plaques alone cause flow stagnation points and favour thrombus incorporation?

    PubMed Central

    Beneli, Cristina T; Barbosa, Priscila F; Floriano, Elaine M; Abreu, Mônica A; Ramalho, Fernando S; Júnior, Jorge Elias; Rossi, Marcos A; Ramos, Simone G

    2009-01-01

    We have used an experimental model of aorta stenosis, with a Plexiglas plug, simulating a stable atheromatous plaque that promotes local turbulence and thrombosis. With animal survival of more than 24 h, we followed the partial fibrinolysis of the thrombus as well as its posterior organization and incorporation to the arterial wall as a neointima for up to 30 days. The mushroom plug form permitted the development of recirculation and stasis areas around it, favouring this evolution. Despite noted limitations, this study demonstrates that thrombus incorporation can contribute to plaque extension, as it can promote recirculation and stasis areas. PMID:19563612

  1. Flat fibrin thrombus deposition on tissue valve after aortic valve replacement.

    PubMed

    Ohnaka, Motoaki; Nishimura, Kazunobu; Kurokawa, Shunji

    2010-06-01

    Bioprosthetic valves have a lower thrombogenicity than mechanical valves, thus long-term systemic anticoagulation can be avoided. Herein, we present an extremely rare case of fibrin thrombus formation on tissue valve, which was observed during the second operation 2 years after the initial operation by chance. This report gives us a word of caution regarding the thrombus formation on the bioprosthetic valves that could be unaware of the presence for the long term. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Behçet's disease with a large intracardiac thrombus: a case report

    PubMed Central

    Baykan, M; Celik, S; Erdol, C; Baykan, E; Durmus, I; Bahadir, S; Erdol, H; Orem, C; Cakirbay, H

    2001-01-01

    Behçet's disease is recognised as a chronic multisystem disorder with vasculitis as its underlying pathological process. Cardiac involvement is rare and often associated with poor prognosis. A case of a 33 year old man with Behçet's disease, presenting with a large right ventricle and right atrial thrombus, is reported. Two dimensional (cross sectional), colour Doppler, and transoesophageal echocardiography, angiography, computed tomography, and magnetic resonance imaging were used to diagnose the disease. With cyclophosphamide and dexamethasone treatment, the cardiac lesions progressively resolved.


Keywords: Behçet's disease; intracardiac thrombus PMID:11250984

  3. Thrombus on Indwelling Central Venous Catheters: The Histopathology of 'Fibrin Sheaths'

    SciTech Connect

    Suojanen, James Norman; Brophy, David Paul; Nasser, Imad

    2000-03-15

    Purpose: Central venous catheters (CVC) may fail for many reasons, though 'fibrin sheaths' blocking catheter ports are usually implicated. We examined the sheaths removed from dialysis catheters to determine their histopathology.Methods: Ten catheter strippings were performed and the removed material was studied grossly and microscopically.Results: The histologic specimens showed thrombus both with and without a proteinaceous sheath.Conclusion: Dialysis catheters fail because of thrombus formation. This can occur in either the absence or presence of a protein coating on the catheter, the so-called 'fibrin sheath.'.

  4. Huge ascending aortic aneurysm with an intraluminal thrombus in an embolic event-free patient

    PubMed Central

    Parato, Vito Maurizio; Pezzuoli, Franco; Labanti, Benedetto; Baboci, Arben

    2015-01-01

    We present a case of an 87-year-old male patient with a huge ascending aortic aneurysm, filled by a huge thrombus most probably due to previous dissection. This finding was detected by two-dimensional transthoracic echocardiography and contrast-enhanced computed tomography (CT) angiography scan. The patient refused surgical treatment and was medically treated. Despite the huge and mobile intraluminal thrombus, the patient remained embolic event-free up to 6 years later, and this makes the case unique. PMID:25838924

  5. A spatio-temporal model for spontaneous thrombus formation in cerebral aneurysms.

    PubMed

    Malaspinas, O; Turjman, A; Ribeiro de Sousa, D; Garcia-Cardena, G; Raes, M; Nguyen, P-T T; Zhang, Y; Courbebaisse, G; Lelubre, C; Zouaoui Boudjeltia, K; Chopard, B

    2016-04-07

    We propose a new numerical model to describe thrombus formation in cerebral aneurysms. This model combines CFD simulations with a set of bio-mechanical processes identified as being the most important to describe the phenomena at a large space and time scales. The hypotheses of the model are based on in vitro experiments and clinical observations. We document that we can reproduce very well the shape and volume of patient specific thrombus segmented in giant aneurysms. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. A Multiscale Model of Venous Thrombus Formation with Surface-Mediated Control of Blood Coagulation Cascade

    PubMed Central

    Xu, Zhiliang; Lioi, Joshua; Mu, Jian; Kamocka, Malgorzata M.; Liu, Xiaomin; Chen, Danny Z.; Rosen, Elliot D.; Alber, Mark

    2010-01-01

    Abstract A combination of the extended multiscale model, new image processing algorithms, and biological experiments is used for studying the role of Factor VII (FVII) in venous thrombus formation. A detailed submodel of the tissue factor pathway of blood coagulation is introduced within the framework of the multiscale model to provide a detailed description of coagulation cascade. Surface reactions of the extrinsic coagulation pathway on membranes of platelets are studied under different flow conditions. It is shown that low levels of FVII in blood result in a significant delay in thrombin production, demonstrating that FVII plays an active role in promoting thrombus development at an early stage. PMID:20441735

  7. Robotic partial nephrectomy for renal cell carcinomas with venous tumor thrombus.

    PubMed

    Abaza, Ronney; Angell, Jordan

    2013-06-01

    To describe the first report of robotic partial nephrectomies (RPNs) for renal cell carcinoma (RCC) with venous tumor thrombus (VTT). Partial nephrectomy for RCC extending into the renal vein has been described in limited fashion, but such a complex procedure has not previously been reported in minimally-invasive fashion. We demonstrate the feasibility of robotic nephron-sparing surgery despite vein thrombi and the results of the initial four highly-selected patients to have undergone this novel procedure. Two patients underwent RPN for RCC with VTT involving intraparenchymal vein branches, and 2 others had VTT involving the main renal vein. Mean patient age was 65 years (range 50-74 years). Mean tumor size was 7.75 cm (range 4.3-12.8 cm) with mean RENAL (radius, exophytic/endophytic, nearness to collecting system, anterior/posterior, and location) nephrometry score of 9.75 (range 8-12). Mean warm ischemia time was 24.2 minutes (range 19-27 minutes) and mean estimated blood loss was 168.8 mL (range 100-300 mL). No patients required transfusion, and there were no intraoperative complications. No patients required conversion to open or standard laparoscopic surgery. All 4 patients were discharged home on the first postoperative day. A single postoperative complication occurred in 1 patient who was readmitted with an ileus that resolved spontaneously. All patients had negative surgical margins. Two patients developed metastatic disease on surveillance imaging. RPN in patients with VTT is safe and feasible in selected patients. Given the risk of metastatic disease in patients with pathologic stage T3a RCC, the role of nephron sparing requires further evaluation such that radical nephrectomy remains the standard of care. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Novel use of the AngioVac® system to remove thrombus during simultaneous extracorporeal membrane oxygenation life support.

    PubMed

    Griffith, Kevin E; Jenkins, Eric; Copenhaver, William; Williams, David M

    2016-03-01

    Extracorporeal membrane oxygenation (ECMO) was introduced to clinical medicine over 40 years ago. While initially used as a treatment for acute respiratory failure in infants, the use of ECMO has grown to include respiratory and circulatory failure in both children and adults, cardiogenic shock, pulmonary embolism, sepsis, trauma, malignancy, pulmonary hemorrhage and as a treatment for hypothermic drowning.(1) Recent technological improvements in ECMO circuitry make it possible to minimize anticoagulation of the ECMO patient, decreasing the incidence of bleeding. Thrombus deposition within the ECMO circuit can be a life-threating complication. ECMO circuit thrombus can be contained in the circuit, adherent to cannula and deposited within the patient. The ability to remove thrombus while the patient remains on ECMO support could be a life-saving measure for some patients. The present case report outlines use of the AngioVac(®) thrombus removal system in concert with ECMO to remove a large thrombus adherent to an ECMO cannula.

  9. Spontaneous echo contrast masking thrombus in giant left atrium of mitral stenosis-a dilemma in clinical diagnosis.

    PubMed

    Islam, Akm Monwarul; Salam, Md Abdus; Sayeed, Md Zahidus; Kibria, Md Golam

    2015-01-01

    Spontaneous echo contrast (SEC) and thrombus in enlarged left atrium (LA) are common in mitral valvular disease (MVD) and SEC is considered to be a prethrombotic condition. Reliable exclusion of LA thrombus is important before any definitive curative attempts like percutaneous transluminal mitral commissurotomy (PTMC), closed mitral commissurotomy (CMC) or innovative therapies like pulmonary vein isolation and percutaneous closure of the LA appendage. Echocardiography, particularly the transesophageal echocardiography (TEE) is considered to be the gold standard for the diagnosis and to exclude LA thrombus. However, LA thrombus may remain rarely undetected even by TEE potentially making the interventions a risky job. We present a case of mitral stenosis (MS) with giant LA where profuse, dense SEC masked the underlying thrombus in the LA cavity.

  10. Spontaneous echo contrast masking thrombus in giant left atrium of mitral stenosis-a dilemma in clinical diagnosis

    PubMed Central

    Islam, AKM Monwarul; Salam, Md. Abdus; Sayeed, Md. Zahidus; Kibria, Md. Golam

    2015-01-01

    Spontaneous echo contrast (SEC) and thrombus in enlarged left atrium (LA) are common in mitral valvular disease (MVD) and SEC is considered to be a prethrombotic condition. Reliable exclusion of LA thrombus is important before any definitive curative attempts like percutaneous transluminal mitral commissurotomy (PTMC), closed mitral commissurotomy (CMC) or innovative therapies like pulmonary vein isolation and percutaneous closure of the LA appendage. Echocardiography, particularly the transesophageal echocardiography (TEE) is considered to be the gold standard for the diagnosis and to exclude LA thrombus. However, LA thrombus may remain rarely undetected even by TEE potentially making the interventions a risky job. We present a case of mitral stenosis (MS) with giant LA where profuse, dense SEC masked the underlying thrombus in the LA cavity. PMID:26649032

  11. Applicability of colloid filtration theory in size-distributed, reduced porosity, granular media in the absence of energy barriers.

    PubMed

    Pazmino, Eddy F; Ma, Huilian; Johnson, William P

    2011-12-15

    The vast majority of colloid transport experiments use granular porous media with narrow size distribution to facilitate comparison with colloid filtration theory, which represents porous media with a single collector size. In this work we examine retention of colloids ranging in size from 0.21 to 9.1 μm in diameter, in columns packed with uniform and size-distributed borosilicate glass bead porous media with porosity ranging from 0.38 to 0.28. Conditions were favorable to attachment (absent a significant energy barrier). The goal was to determine the applicability of colloid filtration theory to colloid retention in these media. We also directly observed deposition at the pore scale in packed flow cells. The pore domain was characterized via high resolution computerized X-ray micro tomography (HRXMT). The flow field was examined using Lattice-Boltzmann flow simulation methods (LBM). The influence of preferential flow paths on colloid retention in the lowest porosity media was accounted for by correcting the fluid velocity. Straining in pore throats too small to pass was not a significant contributor to colloid retention despite colloid-to-collector size ratios up to 0.05. Mechanistic simulations via the Ma-Pedel-Fife-Johnson correlation equation (MPFJ) for colloid filtration predicted the experimentally observed trends in deposition with porosity when a number-based mean grain size was used.

  12. The insulin-like growth factor 1 receptor (IGF1R) contributes to reduced size in dogs.

    PubMed

    Hoopes, Barbara C; Rimbault, Maud; Liebers, David; Ostrander, Elaine A; Sutter, Nathan B

    2012-12-01

    Domestic dog breeds have undergone intense selection for a variety of morphologic features, including size. Among small-dog breeds, defined as those averaging less than ~15 in. at the withers, there remains still considerable variation in body size. Yet essentially all such dogs are fixed for the same allele at the insulin-like growth factor 1 gene, which we and others previously found to be a size locus of large effect. In this study we sought to identify additional genes that contribute to tiny size in dogs using an association scan with the single nucleotide polymorphism (SNP) dataset CanMap, in which 915 purebred dogs were genotyped at 60,968 SNP markers. Our strongest association for tiny size (defined as breed-average height not more than 10 in. at the withers) was on canine chromosome 3 (p = 1.9 × 10(-70)). Fine mapping revealed a nonsynonymous SNP at chr3:44,706,389 that changes a highly conserved arginine at amino acid 204 to histidine in the insulin-like growth factor 1 receptor (IGF1R). This mutation is predicted to prevent formation of several hydrogen bonds within the cysteine-rich domain of the receptor's ligand-binding extracellular subunit. Nine of 13 tiny dog breeds carry the mutation and many dogs are homozygous for it. This work underscores the central importance of the IGF1 pathway in controlling the tremendous size diversity of dogs.

  13. Modelled Cost-Effectiveness of a Package Size Cap and a Kilojoule Reduction Intervention to Reduce Energy Intake from Sugar-Sweetened Beverages in Australia

    PubMed Central

    Mantilla Herrera, Ana Maria; Neal, Bruce; Zheng, Miaobing; Lal, Anita; Sacks, Gary

    2017-01-01

    Interventions targeting portion size and energy density of food and beverage products have been identified as a promising approach for obesity prevention. This study modelled the potential cost-effectiveness of: a package size cap on single-serve sugar sweetened beverages (SSBs) >375 mL (package size cap), and product reformulation to reduce energy content of packaged SSBs (energy reduction). The cost-effectiveness of each intervention was modelled for the 2010 Australia population using a multi-state life table Markov model with a lifetime time horizon. Long-term health outcomes were modelled from calculated changes in body mass index to their impact on Health-Adjusted Life Years (HALYs). Intervention costs were estimated from a limited societal perspective. Cost and health outcomes were discounted at 3%. Total intervention costs estimated in AUD 2010 were AUD 210 million. Both interventions resulted in reduced mean body weight (package size cap: 0.12 kg; energy reduction: 0.23 kg); and HALYs gained (package size cap: 73,883; energy reduction: 144,621). Cost offsets were estimated at AUD 750.8 million (package size cap) and AUD 1.4 billion (energy reduction). Cost-effectiveness analyses showed that both interventions were “dominant”, and likely to result in long term cost savings and health benefits. A package size cap and kJ reduction of SSBs are likely to offer excellent “value for money” as obesity prevention measures in Australia. PMID:28878175

  14. Modelled Cost-Effectiveness of a Package Size Cap and a Kilojoule Reduction Intervention to Reduce Energy Intake from Sugar-Sweetened Beverages in Australia.

    PubMed

    Crino, Michelle; Herrera, Ana Maria Mantilla; Ananthapavan, Jaithri; Wu, Jason H Y; Neal, Bruce; Lee, Yong Yi; Zheng, Miaobing; Lal, Anita; Sacks, Gary

    2017-09-06

    Interventions targeting portion size and energy density of food and beverage products have been identified as a promising approach for obesity prevention. This study modelled the potential cost-effectiveness of: a package size cap on single-serve sugar sweetened beverages (SSBs) >375 mL ( package size cap ), and product reformulation to reduce energy content of packaged SSBs ( energy reduction ). The cost-effectiveness of each intervention was modelled for the 2010 Australia population using a multi-state life table Markov model with a lifetime time horizon. Long-term health outcomes were modelled from calculated changes in body mass index to their impact on Health-Adjusted Life Years (HALYs). Intervention costs were estimated from a limited societal perspective. Cost and health outcomes were discounted at 3%. Total intervention costs estimated in AUD 2010 were AUD 210 million. Both interventions resulted in reduced mean body weight ( package size cap : 0.12 kg; energy reduction : 0.23 kg); and HALYs gained ( package size cap : 73,883; energy reduction : 144,621). Cost offsets were estimated at AUD 750.8 million ( package size cap ) and AUD 1.4 billion ( energy reduction ). Cost-effectiveness analyses showed that both interventions were "dominant", and likely to result in long term cost savings and health benefits. A package size cap and kJ reduction of SSBs are likely to offer excellent "value for money" as obesity prevention measures in Australia.

  15. Renal Dysfunction on Admission Predicts No-Reflow Phenomenon in Patients Undergoing Manual Thrombus Aspiration during Primary Percutaneous Coronary Intervention

    PubMed Central

    Sensoy, Baris; Uzunget, Sezen Baglan; Acikgoz, SadikKadri; Sensoy, Nur; Sen, Fatih; Acar, Burak; Canpolat, Uğur; Ozeke, Ozcan; Cay, Serkan; Maden, Orhan

    2016-01-01

    Background No-reflow is a frequent complication during percutaneous coronary intervention (PCI) for acute ST segment elevation myocardial infarction (STEMI). Available data is limited regarding its impact on short-term outcomes in patients undergoing manual thrombus aspiration. Renal impairment is also associated with higher complication rates in STEMI. Herein, we aimed to evaluate the impact of baseline renal dysfunction on the no- reflow phenomenon and the association of no-reflow phenomenon with early clinical outcomes. Methods A total of 94 consecutive STEMI patients who underwent primary stent-based PCI and thrombus aspiration were enrolled. No-reflow was established by the use of angiographic and electrocardiographic reperfusion criteria, respectively. Additionally angiographic and clinical follow-up data were also recorded. Results In our study, the no-reflow phenomenon was observed in 10 patients (11%) angiographically and in 23 patients (24%) electrocardiographically. Whereas, the the estimated glomerular filtration rate (eGFR) [odds ratio (OR) 10.4], hypertension (OR 6.2), previous MI (OR 6.5), previous PCI history, (OR 4.2), predilatation (OR 7.2), final balloon pressure (OR 0.9) were found to be the significant predictors of angiographic no-reflow, only reperfusion time was the predictor of electrocardiographic no-reflow (OR 1.12) at univariate analysis. After adjustment, lower eGFR (OR 14.8) was found to be the independent predictor for angiographic no-reflow. In-hospital mortality was more common in patients with either no-reflow condition separately. Conclusions Longer ischemic time and lower initial eGFR values were associated with no-reflow phenomenon. Irrespective of poor reperfusion criteria, no-reflow phenomenon is associated with in-hospital outcome. Future efforts should be made to reduce the incidence of no-reflow especially in patients with lower initial eGFR values. PMID:27122949

  16. Effect of thrombus composition and viscosity on sonoreperfusion efficacy in a model of microvascular obstruction

    PubMed Central

    Black, John J.; Yu, Francois T. H.; Schnatz, Rick G.; Flordeliza, Xucai Chen; Villanueva, S.; Pacella, John J.

    2016-01-01

    Distal embolization of microthrombi during stenting for myocardial infarction (MI) causes microvascular obstruction (MVO). We have previously shown that sonoreperfusion (SRP), a microbubble (MB)-mediated ultrasonic (US) therapy, resolves MVO from venous microthrombi in vitro in saline. However, blood is more viscous than saline and arterial thrombi that embolize during stenting are mechanically distinct from venous clot. Therefore, we tested the hypothesis that MVO created with arterial microthrombi are more resistant to SRP therapy compared with venous microthrombi and higher viscosity further increases the US requirement for effective SRP in an in vitro model of MVO. Lipid MB suspended in plasma with adjusted viscosity (1.1 or 4.0 cP) were passed through tubing bearing a mesh with 40 μm pores to simulate a microvascular cross-section; upstream pressure reflected thrombus burden. To simulate MVO, the mesh was occluded with either arterial or venous microthrombi to increase upstream pressure to 40±5 mmHg. Therapeutic long-tone-burst US was delivered to the occluded area for 20 min. MB activity was recorded with a passive cavitation detector (PCD). MVO caused by arterial microthrombi at either blood or plasma viscosity resulted in less effective SRP therapy, compared to venous thrombi. Higher viscosity further reduced the effectiveness of SRP therapy. PCD showed a decrease in inertial cavitation when viscosity was increased while stable cavitation was affected in a more complex manner. Overall, these data suggest that arterial thrombi may require higher acoustic pressure US than venous thrombi to achieve similar SRP efficacy, increased viscosity decreases SRP efficacy, and both inertial and stable cavitation are implicated in observed SRP efficacy. PMID:27207018

  17. Closure of Left Atrial Appendage With Persistent Distal Thrombus Using an Amplatzer Amulet Occluder.

    PubMed

    Lange, Mathias; Bültel, Helmut; Weglage, Heinrich; Löffeld, Patrick; Wichter, Thomas

    2016-09-01

    A 73-year-old patient with permanent atrial fibrillation presented for left atrial appendage (LAA) occlusion. Transesophageal echocardiography demonstrated a thrombus in the distal LAA. This image series illustrates a "no touch" technique that was used to ensure successful implantation of an Amplatzer Amulet LAA occlusion device without the use of an embolization protection system.

  18. Factor XI regulates pathological thrombus formation on acutely ruptured atherosclerotic plaques.

    PubMed

    van Montfoort, Maurits L; Kuijpers, Marijke J E; Knaup, Véronique L; Bhanot, Sanjay; Monia, Brett P; Roelofs, Joris J T H; Heemskerk, Johan W M; Meijers, Joost C M

    2014-08-01

    Coagulation factor XI is proposed as therapeutic target for anticoagulation. However, it is still unclear whether the antithrombotic properties of factor XI inhibitors influence atherosclerotic disease and atherothrombosis. Our aim is to investigate whether factor XI antisense oligonucleotides could prevent thrombus formation on acutely ruptured atherosclerotic plaques. Atherosclerotic plaques in the carotid arteries of Apoe(-/-) mice were acutely ruptured using ultrasound. The subsequent thrombus formation was visualized and quantified by intravital microscopy and immunohistochemistry. Mice were pretreated with either factor XI antisense or nonsense oligonucleotides (50 mg/kg) to lower factor XI plasma levels. A tail bleeding assay was used to determine the safety. On plaque rupture, initial platelet adhesion and platelet plug formation were not impaired in animals treated with factor XI antisense oligonucleotides. However, the ensuing thrombus formation and fibrin deposition were significantly lower after 5 to 10 minutes (P<0.05) in factor XI antisense oligonucleotide-treated animals without inducing a bleeding tendency. Furthermore, thrombi from antisense-treated animals were less stable than thrombi from placebo-treated animals. Moreover, macrophage infiltration and collagen deposition were lower in the carotid arteries of factor XI antisense-treated animals. No neutrophils were present. Factor XI antisense oligonucleotides safely prevent thrombus formation on acutely ruptured atherosclerotic plaques in mice. Furthermore, perturbed carotid arteries from factor XI antisense-treated animals show a less severe inflammatory response. © 2014 American Heart Association, Inc.

  19. Pulmonary artery thrombus and subcapsular liver hematoma in a patient with HELLP syndrome: a therapeutic conundrum.

    PubMed

    Calderon, Eduardo G; Khawar, Sarwat; Cunningham, Jennifer A; Russell, Lori D; Alpert, Martin A

    2002-03-01

    HELLP syndrome (hemolysis, elevation of liver enzymes, and low platelet count) occurs during pregnancy. Intrahepatic hemorrhage and subcapsular liver hematoma with or without rupture are reported complications of this syndrome. The patient described in this report developed HELLP syndrome associated with a subcapsular liver hematoma and pulmonary artery thrombus, complications that created a therapeutic conundrum.

  20. Free Floating Right Heart Thrombus Associated with Acute Pulmonary Embolism: An Unsettled Therapeutic Difficulty

    PubMed Central

    Nkoke, Clovis; Faucher, Olivier; Camus, Lise; Flork, Laurence

    2015-01-01

    Free floating right heart thrombus is a rare phenomenon in the context of acute pulmonary embolism and it is associated with a poor outcome. The increased use of echocardiography has led to an increased detection of right heart thrombi. However, optimal management of free floating right heart thrombus remains controversial with no clear consensus. We present the case of a 74-year-old woman who presented to the emergency department with acute onset dyspnea on minimal exertion which had developed over a period of 1 day. A computed tomography of the chest demonstrated massive bilateral proximal pulmonary embolism. A bedside transthoracic echocardiography performed showed a moderately dilated, poorly functioning right ventricle with visible highly mobile serpiginous thrombus moving to and fro across the tricuspid valve. Thrombolytic therapy was immediately initiated with tenecteplase which resulted in excellent results. Although there is no clear consensus for the management of right heart thrombus associated with pulmonary embolism, thrombolysis is readily available and can be effective in carefully selected patients. PMID:26078887

  1. Mathematical modeling of thrombus formation in idealized models of aortic dissection: initial findings and potential applications.

    PubMed

    Menichini, Claudia; Xu, Xiao Yun

    2016-11-01

    Aortic dissection is a major aortic catastrophe with a high morbidity and mortality risk caused by the formation of a tear in the aortic wall. The development of a second blood filled region defined as the "false lumen" causes highly disturbed flow patterns and creates local hemodynamic conditions likely to promote the formation of thrombus in the false lumen. Previous research has shown that patient prognosis is influenced by the level of thrombosis in the false lumen, with false lumen patency and partial thrombosis being associated with late complications and complete thrombosis of the false lumen having beneficial effects on patient outcomes. In this paper, a new hemodynamics-based model is proposed to predict the formation of thrombus in Type B dissection. Shear rates, fluid residence time, and platelet distribution are employed to evaluate the likelihood for thrombosis and to simulate the growth of thrombus and its effects on blood flow over time. The model is applied to different idealized aortic dissections to investigate the effect of geometric features on thrombus formation. Our results are in qualitative agreement with in-vivo observations, and show the potential applicability of such a modeling approach to predict the progression of aortic dissection in anatomically realistic geometries.

  2. Cardiac MRI documented left ventricular thrombus complicating acute Takotsubo syndrome: an uncommon dilemma.

    PubMed

    Singh, Veerpal; Mayer, Tom; Salanitri, John; Salinger, Michael H

    2007-10-01

    Transient left ventricular apical hypokinesis results in a typical ampullary shape and has been described as Takotsubo cardiomyopathy (TCM). We report a case of TCM with the rare complication of left ventricular thrombus formation. Cardiac magnetic resonance imaging aided the diagnosis by characterizing the non-enhancing mass and evaluating the surrounding myocardium for scarring.

  3. A Thrombus Generation Model Applied to Aneurysms Treated with Shape Memory Polymer Foam and Metal Coils

    NASA Astrophysics Data System (ADS)

    Horn, John; Ortega, Jason; Hartman, Jonathan; Maitland, Duncan

    2015-11-01

    To prevent their rupture, intracranial aneurysms are often treated with endovascular metal coils which fill the aneurysm sac and isolate it from the arterial flow. Despite its widespread use, this method can result in suboptimal outcomes leading to aneurysm recurrence. Recently, shape memory polymer foam has been proposed as an alternative aneurysm filler. In this work, a computational model has been developed to predict thrombus formation in blood in response to such cardiovascular implantable devices. The model couples biofluid and biochemical phenomena present as the blood interacts with a device and stimulates thrombus formation. This model is applied to simulations of both metal coil and shape memory polymer foam treatments within an idealized 2D aneurysm geometry. Using the predicted thrombus responses, the performance of these treatments is evaluated and compared. The results suggest that foam-treated aneurysms may fill more quickly and more completely with thrombus than coil-filled aneurysms, potentially leading to improved long-term aneurysm healing. This work was performed in part under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  4. Recanalized chronic coronary thrombus: unraveling a hazy coronary lesion by intravascular ultrasound.

    PubMed

    Karamasis, Grigoris V; Chotai, Shayna; Khokhar, Azhar A; Kelly, Paul A

    2016-04-01

    Hazy lesions in coronary angiography can often be a puzzle for the interventional cardiologist. Recanalized chronic coronary thrombus, although rare, is one of the potential diagnoses. Intracoronary imaging with intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are tools that can guide to the correct diagnosis. We present the images of a case where IVUS was used to unravel such a lesion.

  5. Fluid Characteristics in Abdominal Aortic Aneurysms (AAAs) and Its Correlation to Thrombus Formation

    NASA Astrophysics Data System (ADS)

    Tang, Rubing; Bar-Yoseph, Pinhas Z.; Lasheras, Juan

    2008-11-01

    It has been observed that most large Abdominal Aortic Aneurysms (AAAs) develop an intraluminal thrombus as they progressively enlarge. Previous studies have suggested that the build up of the thrombus may be associated with the altered hemodynamic patterns that arise inside the AAA. We have performed a parametrical computational study of the flow patterns inside enlarging AAA to investigate the possible mechanism controlling the thrombus formation. Pulsatile blood flows were simulated in idealized models of fusiform aneurysms with different dilatation ratios and the effects of shear-activated platelet accumulation and platelet/wall interaction were evaluated based on the calculated flow fields. The platelet activation level (PAL) was determined by computing the integral over time of flow shear stresses exerted over the platelets as they are transported throughout the aneurysm. Our results have shown that the values of PAL in AAAs are in fact smaller than the maximum value obtained in a healthy abdominal aorta. However, we show that the transportation of blood cells towards the wall and the formation of stagnation points on the aneurysm's wall play more significant roles in thrombus formation than PAL.

  6. A Computational Model of Biochemomechanical Effects of Intraluminal Thrombus on the Enlargement of Abdominal Aortic Aneurysms

    PubMed Central

    Humphrey, Jay D.; Karšaj, Igor

    2015-01-01

    Abdominal aortic aneurysms (AAAs) typically develop an intraluminal thrombus (ILT), yet most computational models of AAAs have focused on either the mechanics of the wall or the hemodynamics within the lesion, both in the absence of ILT. In the few cases wherein ILT has been modeled directly, as, for example, in static models that focus on the state of stress in the aortic wall and the associated rupture risk, thrombus has been modeled as an inert, homogeneous, load-bearing material. Given the biochemomechanical complexity of an ILT, there is a pressing need to consider its diverse effects on the evolving aneurysmal wall. Herein, we present the first growth and remodeling model that addresses together the biomechanics, mechanobiology, and biochemistry of thrombus-laden AAAs. Whereas it has been shown that aneurysmal enlargement in the absence of ILT depends primarily on the stiffness and turnover of fibrillar collagen, we show that the presence of a thrombus within lesions having otherwise the same initial wall composition and properties can lead to either arrest or rupture depending on the biochemical effects (e.g., release of proteases) and biomechanical properties (e.g., stiffness of fibrin) of the ILT. These computational results suggest that ILT should be accounted for when predicting the potential enlargement or rupture risk of AAAs and highlight specific needs for further experimental and computational research. PMID:26070724

  7. Recanalized chronic coronary thrombus: unraveling a hazy coronary lesion by intravascular ultrasound

    PubMed Central

    Chotai, Shayna; Khokhar, Azhar A.; Kelly, Paul A.

    2016-01-01

    Hazy lesions in coronary angiography can often be a puzzle for the interventional cardiologist. Recanalized chronic coronary thrombus, although rare, is one of the potential diagnoses. Intracoronary imaging with intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are tools that can guide to the correct diagnosis. We present the images of a case where IVUS was used to unravel such a lesion. PMID:27054109

  8. Prevention of vascular graft occlusion and thrombus-associated thrombin generation by inhibition of factor XI

    PubMed Central

    Tucker, Erik I.; Marzec, Ulla M.; White, Tara C.; Hurst, Sawan; Rugonyi, Sandra; McCarty, Owen J. T.; Gailani, David; Hanson, Stephen R.

    2009-01-01

    The protease thrombin is required for normal hemostasis and pathologic thrombogenesis. Since the mechanism of coagulation factor XI (FXI)–dependent thrombus growth remains unclear, we investigated the contribution of FXI to thrombus formation in a primate thrombosis model. Pretreatment of baboons with a novel anti–human FXI monoclonal antibody (aXIMab; 2 mg/kg) inhibited plasma FXI by at least 99% for 10 days, and suppressed thrombin-antithrombin (TAT) complex and β-thromboglobulin (βTG) formation measured immediately downstream from thrombi forming within collagen-coated vascular grafts. FXI inhibition with aXIMab limited platelet and fibrin deposition in 4-mm diameter grafts without an apparent increase in D-dimer release from thrombi, and prevented the occlusion of 2-mm diameter grafts without affecting template bleeding times. In comparison, pretreatment with aspirin (32 mg/kg) prolonged bleeding times but failed to prevent graft occlusion, supporting the concept that FXI blockade may offer therapeutic advantages over other antithrombotic agents in terms of bleeding complications. In whole blood, aXIMab prevented fibrin formation in a collagen-coated flow chamber, independent of factor XII and factor VII. These data suggest that endogenous FXI contributes to arterial thrombus propagation through a striking amplification of thrombin generation at the thrombus luminal surface. PMID:18945968

  9. 30 CFR 203.76 - When might MMS withdraw or reduce the approved size of my relief?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... size of my relief? 203.76 Section 203.76 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION, AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT RELIEF OR REDUCTION IN... us the fabrication confirmation report or the post-production development report, or you...

  10. Higher temperatures during development reduce body size in the zebra finch in the lab and in the wild.

    PubMed

    Andrew, Samuel C; Hurley, Laura L; Mariette, Mylene M; Griffith, Simon C

    2017-10-04

    The most commonly documented morphological response across many taxa to climatic variation across their range follows Bergmann's rule, which predicts larger body size in colder climates. In observational data from wild zebra finches breeding across a range of temperatures in the spring and summer, we show that this relationship appears to be driven by the negative effect of high temperatures during development. This idea was then experimentally tested on zebra finches breeding in temperature controlled climates in the laboratory. These experiments confirmed that those individuals produced in a hot environment (30°C) were smaller than those produced in cool conditions (18°C). Our results suggest a proximate causal link between temperature and body size, and suggest that a hotter climate during breeding periods could drive significant changes in morphology within and between populations. This effect could account for much of the variation in body size that drives the well observed patterns first described by Bergmann, and that are still largely attributed to selection on adult body size during cold winters. The climate-dependent developmental plasticity that we have demonstrated is an important component in understanding how endotherms may be affected by climate change. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Randomized study to assess the effect of thrombus aspiration on flow area in patients with ST-elevation myocardial infarction: an optical frequency domain imaging study--TROFI trial.

    PubMed

    Onuma, Yoshinobu; Thuesen, Leif; van Geuns, Robert-Jan; van der Ent, Martin; Desch, Steffen; Fajadet, Jean; Christiansen, Evald; Smits, Peter; Holm, Niels Ramsing; Regar, Evelyn; van Mieghem, Nicolas; Borovicanin, Vladimir; Paunovic, Dragica; Senshu, Kazuhisa; van Es, Gerrit-Anne; Muramatsu, Takashi; Lee, Il-Soo; Schuler, Gerhard; Zijlstra, Felix; Garcia-Garcia, Hector M; Serruys, Patrick W

    2013-04-01

    Primary percutaneous coronary intervention (PPCI) with thrombectomy (TB) seems to reduce the thrombus burden, resulting in a larger flow area as measured with optical frequency domain imaging (OFDI). In a multi-centre study, 141 patients with ST elevation myocardial infarction <12 h from onset were randomized to either PPCI with TB using an Eliminate catheter (TB: n = 71) or without TB (non-TB: n = 70), having operators blinded for the OFDI results. The primary endpoint was minimum flow area (MinFA) post-procedure assessed by OFDI, defined as: [stent area + incomplete stent apposition (ISA) area] - (intraluminal defect + tissue prolapse area). Sample size was based on the expected difference of 0.72 mm(2) in MinFA. Baseline demographics, pre-procedural quantitative coronary angiography (QCA), and procedural characteristics were well matched between the two groups. On OFDI, the stent area (TB: 7.62 ± 2.23 mm(2), non-TB: 7.05 ± 2.12 mm(2), P = 0.14) and MinFA (TB: 7.08 ± 2.14 mm(2) vs. non-TB: 6.51 ± 1.99 mm(2), Δ0.57 mm(2), P = 0.12) were not different. In addition, the amount of protrusion, intraluminal defect, and ISA area were similar in the both groups. PPCI with TB was associated with a similar flow area as well as stent area to PPCI without TB.

  12. Comparison of diverse platelet activation markers as indicators for left atrial thrombus in atrial fibrillation.

    PubMed

    Tarnowski, Daniel; Poitz, David M; Plichta, Lina; Heidrich, Felix M; Wiedemann, Stephan; Ruf, Tobias; Mierke, Johannes; Löhn, Tobias; Jellinghaus, Stefanie; Strasser, Ruth H; Ibrahim, Karim; Pfluecke, Christian

    2017-03-13

    Atrial fibrillation (AF) is well known for being a major risk factor of thromboembolic stroke. We could recently demonstrate an association of monocyte-platelet aggregates (MPAs) with the degree of thrombogenicity in patients with AF. This study investigated platelet activation markers, as potential biomarkers for the presence of left atrial (LA) thrombus in patients with AF. One hundred and eight patients with symptomatic AF underwent transesophageal echocardiography (TEE) before scheduled cardioversion or pulmonary vein isolation. In order to determine the content of MPAs by flow-cytometric quantification analyses, blood was drawn on the day of TEE. The soluble CD40 Ligand (sCD40L) and soluble P-selectin (sP-selectin) were obtained by Cytometric Bead Arrays (CBA). D-dimer levels were detected by quantitative immunological determination of fibrin degradation products. Clinical, laboratory, and echocardiographic standard parameters were obtained from all patients, including the determination of the flow in the left atrial appendage (LAA). Patients with detected LA thrombus (n = 28) compared with patients without thrombus (n = 80) showed an increased number of common risk factors, such as age, diabetes, heart failure, and coronary artery disease (CAD). The presence of LA thrombus was associated with significantly increased levels of MPAs (147 ± 12 vs. 304 ± 29 per µl; p < 0.00), sCD40L (106.3 ± 31.0 vs. 33.5 ± 2.1 pg/ml, p = 0.027), and D-dimer (0.13 ± 0.02 vs. 0.69 ± 0.21 mg FEU/l, p = 0.015). In contrast, sP-selectin showed no association with LA thrombus. A multivariate regression analysis showed that MPAs, sCD40L as well as D-dimers were independent indicators for the existence of LA thrombus. MPAs above 170 cells/µl indicated LA thrombus with a high sensitivity of 93% and a specificity of 73% (OR 62, 95% CI. 6.9-557.2, p < 0.001) in patients with AF, whereas the D-dimer lost their quality as independent indicator by using the conventional cut-off of 0

  13. The ability of winter grazing to reduce wildfire size, intensity, and fire-induced plant mortality was not demonstrated: A comment on Davies et al. (2015)

    EPA Science Inventory

    A recent study by Davies et al. sought to test whether winter grazing could reduce wildfire size, fire behavior metrics, and fire-induced plant mortality in shrub-grasslands. The authors concluded that ungrazed rangelands may experience more fire-induced mortality of native peren...

  14. The ability of winter grazing to reduce wildfire size, intensity, and fire-induced plant mortality was not demonstrated: a comment on Davies et al. (2015)

    USDA-ARS?s Scientific Manuscript database

    A recent study by Davies et al. sought to test whether winter grazing could reduce wildfire size, fire behavior and intensity metrics, and fire-induced plant mortality in shrub-grasslands. The authors concluded that ungrazed rangelands may experience fire-induced mortality of native perennial bunchg...

  15. The ability of winter grazing to reduce wildfire size, intensity, and fire-induced plant mortality was not demonstrated: A comment on Davies et al. (2015)

    EPA Science Inventory

    A recent study by Davies et al. sought to test whether winter grazing could reduce wildfire size, fire behavior metrics, and fire-induced plant mortality in shrub-grasslands. The authors concluded that ungrazed rangelands may experience more fire-induced mortality of native peren...

  16. Endogenous tissue plasminogen activator enhances fibrinolysis and limits thrombus formation in a clinical model of thrombosis.

    PubMed

    Lucking, Andrew J; Gibson, Kyle R; Paterson, Elspeth E; Faratian, Dana; Ludlam, Christopher A; Boon, Nicholas A; Fox, Keith A A; Newby, David E

    2013-05-01

    Using a clinical model of deep arterial injury, we assessed the ability of exogenous and endogenous tissue plasminogen activator (t-PA) to limit acute in situ thrombus formation. Ex vivo thrombus formation was assessed in the Badimon chamber at low and high shear rates in 2 double-blind randomized cross-over studies of 20 healthy volunteers during extracorporeal administration of recombinant t-PA (0, 40, 200, and 1000 ng/mL) or during endogenous t-PA release stimulated by intra-arterial bradykinin infusion in the presence or absence of oral enalapril. Recombinant t-PA caused a dose-dependent reduction in thrombus area under low and high shear conditions (P<0.001 for all). Intra-arterial bradykinin increased plasma t-PA concentrations in the chamber effluent (P<0.01 for all versus saline) that was quadrupled in the presence of enalapril (P<0.0001 versus placebo). These increases were accompanied by an increase in plasma D-dimer concentration (P<0.005 for all versus saline) and, in the presence of enalapril, a reduction in thrombus area in the low shear (16±5; P=0.03) and a trend toward a reduction in the high shear chamber (13±7%; P=0.07). Using a well-characterized clinical model of coronary arterial injury, we demonstrate that endogenous t-PA released from the vascular endothelium enhances fibrinolysis and limits in situ thrombus propagation. These data support a crucial role for the endogenous fibrinolytic system in vivo and suggest that continued exploration and manipulation of its therapeutic potential are warranted.

  17. Echocardiographic detection of free-floating thrombus in left ventricle during coronary artery bypass grafting

    PubMed Central

    Vaggar, Jagadeesh N.; Gadhinglajkar, Shrinivas; Pillai, Vivek; Sreedhar, Rupa; Cahndran, Roshith; Roy, Suddhadeb

    2015-01-01

    We report an incident of detection of a free-floating thrombus in the left ventricle (LV) using intraoperative two-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography (TEE) during proximal coronary artery bypass graft anastomosis. A 58-year-old man presented to us with a 6-month history of chest pain without any history suggestive of myocardial infarction or transient ischemic attacks. His preoperative echocardiography revealed the systolic dysfunction of LV, mild hypokinesia of basal and mid-anterior wall, and the absence of an aneurysm. He was scheduled for on-pump coronary artery bypass surgery. On intraoperative TEE before establishing cardiopulmonary bypass (CPB), a small immobile mass was found attached to LV apical area. After completion of distal coronary artery grafting, when the aortic cross-clamp was removed, the heart was filled partially and beating spontaneously. TEE examination using 2D mode revealed a free-floating mass in the LV, which was suspected to be a thrombus. Additional navigation using biplane and 3D modes confirmed the presence of the thrombus and distinguished it from papillary muscles and artifact. The surgeon opened the left atrium after re-establishing electromechanical quiescence and removed a thrombus measuring 1.5 cm × 1 cm from the LV. The LV mass in the apical region was no longer seen after discontinuation of CPB. Accurate TEE-detection and timely removal of the thrombus averted disastrous embolic complications. Intraoperative 2D and recent biplane and 3D echocardiography modes are useful monitoring tools during the conduct of CPB. PMID:26440248

  18. Using measured equipment load profiles to 'right-size' HVACsystems and reduce energy use in laboratory buildings (Pt. 2)

    SciTech Connect

    Mathew, Paul; Greenberg, Steve; Frenze, David; Morehead, Michael; Sartor, Dale; Starr, William

    2005-06-29

    There is a general paucity of measured equipment load datafor laboratories and other complex buildings and designers often useestimates based on nameplate rated data or design assumptions from priorprojects. Consequently, peak equipment loads are frequentlyoverestimated, and load variation across laboratory spaces within abuilding is typically underestimated. This results in two design flaws.Firstly, the overestimation of peak equipment loads results in over-sizedHVAC systems, increasing initial construction costs as well as energy usedue to inefficiencies at low part-load operation. Secondly, HVAC systemsthat are designed without accurately accounting for equipment loadvariation across zones can significantly increase simultaneous heatingand cooling, particularly for systems that use zone reheat fortemperature control. Thus, when designing a laboratory HVAC system, theuse of measured equipment load data from a comparable laboratory willsupport right-sizing HVAC systems and optimizing their configuration tominimize simultaneous heating and cooling, saving initial constructioncosts as well as life-cycle energy costs.In this paper, we present datafrom recent studies to support the above thesis. We first presentmeasured equipment load data from two sources: time-series measurementsin several laboratory modules in a university research laboratorybuilding; and peak load data for several facilities recorded in anational energy benchmarking database. We then contrast this measureddata with estimated values that are typically used for sizing the HVACsystems in these facilities, highlighting the over-sizing problem. Next,we examine the load variation in the time series measurements and analyzethe impact of this variation on energy use, via parametric energysimulations. We then briefly discuss HVAC design solutions that minimizesimultaneous heating and cooling energy use.

  19. Optical Dynamic Analysis of Thrombus Inside a Centrifugal Blood Pump During Extracorporeal Mechanical Circulatory Support in a Porcine Model.

    PubMed

    Fujiwara, Tatsuki; Sakota, Daisuke; Ohuchi, Katsuhiro; Endo, Shu; Tahara, Tomoki; Murashige, Tomotaka; Kosaka, Ryo; Oi, Keiji; Mizuno, Tomohiro; Maruyama, Osamu; Arai, Hirokuni

    2017-03-20

    Complications due to pump thrombus remain the weak point of mechanical circulatory support (MCS), such as the use of a left ventricular assist device (LVAD) or extracorporeal membrane oxygenation, leading to poor outcomes. Hyperspectral imaging (HSI) is an effective imaging method using a hyperspectral (HS) camera, which comprises a spectrophotometer and a charge-coupled device camera to discriminate thrombus from whole blood. Animal experiments were conducted to analyze dynamic imaging of thrombus inside a prototype of a hydrodynamically levitated centrifugal blood pump using an HSI system. Six pigs were divided into a venous circulation group (n = 3) and an arterial circulation group (n = 3). Inflow and outflow cannulae were inserted into the jugular veins in the venous circulation group. The latter simulated an LVAD application. To create thrombogenic conditions, pump flow was maintained at 1 L/min without anticoagulation. An image of the bottom surface of the pump was captured by the HS camera every 4 nm over the wavelength range of 608-752 nm. Real-time dynamic images of the inside of the pump were displayed on the monitor. Appearance of an area displaying thrombus was detected within 24 h after the start of the circulation in every experiment. This imaging system also succeeded in determining the origins of pump thrombus: from inside the pump in two cases, and from outside in four cases. Two main possible sources of pump thrombus originating outside the pump were identified on autopsy: wedge thrombus around the inflow cannula; and string-like thrombus at the junction between the pump inlet and circuit tube. The results of this study from close observation of the changing appearance of pump thrombus may contribute to improvements in the safety of extracorporeal MCS.

  20. FG 7142 specifically reduces meal size and the rate and regularity of sustained feeding in female rats: evidence that benzodiazepine inverse agonists reduce food palatability.

    PubMed

    Cottone, Pietro; Sabino, Valentina; Steardo, Luca; Zorrilla, Eric P

    2007-05-01

    Benzodiazepine receptor inverse agonists reduce food intake in males, but their actions in females, in whom stress-related eating disorders are more common, as well as their behavioral mode of action remain unclear. The consummatory effects of benzodiazepine receptor ligands have alternately been hypothesized to reflect changes in the hedonic evaluation of food or secondary effects of anxiety-related or cognitive properties. To test the anorectic mode of action of benzodiazepine inverse agonists, the effects of FG 7142 on feeding microstructure were studied in nondeprived female Wistar rats (n=32). Microstructure analysis used a novel meal definition that recognizes prandial drinking. On pharmacologically synchronized diestrus I, rats were pretreated (-30 min dark onset) with the benzodiazepine partial inverse agonist FG 7142 (i.p. 0, 3.75, 7.5, 15 mg/kg) in a between-subjects design. FG 7142 delayed the onset of (16-541%), decreased the amount eaten (36-52%) and drunk (63-87%), and reduced the time spent drinking (59-87%) within the first nocturnal meal. Dose-dependent incremental anorexia continued 6 h into the dark cycle, whereas FG 7142 did not suppress the quantity, duration or rate of drinking past the first meal. Treated rats ate smaller meals (17-42%) of normal duration. This reflected that FG 7142 slowed feeding within meals (9-38%) by decreasing the regularity and maintenance of feeding from pellet-to-pellet. FG 7142 did not influence postprandial satiety; meal frequency and inter-meal intervals were unaffected. FG 7142 anorexia was blocked by the benzodiazepine receptor antagonist flumazenil in a 2:1 molar ratio (n=17 rats). The very early, nonspecific (+10 min), but not subsequent (2.5, 4.5 h) feeding-specific phase, of FG 7142 anorexia was mirrored by anxiogenic-like behavior in FG 7142-treated (7.5 mg/kg) female rats (n=48) in the elevated plus-maze. Thus, benzodiazepine receptor inverse agonists preferentially lessen the maintenance of feeding in

  1. Modulating the size of ZnO nanorods on SiO2 substrates by incorporating reduced graphene oxide into the seed layer solution

    NASA Astrophysics Data System (ADS)

    Yu, Tzu-Yi; Wei, Min Ruei; Weng, Chen Yuan; Su, Wei Ming; Lu, Chien Cheng; Chen, Yu Tzu; Chen, Hsiang

    2017-06-01

    In this research, reduced graphene oxide was incorporated into the ZnO seed layer to modulate the rod diameter of ZnO nanorods (NRs) during solgel/hydrothermal growth. To characterize the reduced graphene oxide incorporated ZnO NRs, multiple material analysis techniques including field-emission scanning electron microscopy, surface contact angle measurements, X-ray diffraction, and photoluminescence were used to explore distinct properties of these size modulatable NRs. Results indicate ZnO NRs with smaller diameters could be observed with more reduced graphene oxide added into the ZnO seed layer. Furthermore, better crystallinity, higher hydrophobicity and lower defect concentration could be obtained with more amount of reduced graphene oxide added into the ZnO seed layer. The modulatable reduced graphene oxide-incorporated ZnO NRs growth is promising for future ZnO NRs based nanodevice applications.

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

    PubMed Central

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

    2014-01-01

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

  3. N-acetylcysteine reduces the size and activity of von Willebrand factor in human plasma and mice

    PubMed Central

    Chen, Junmei; Reheman, Adili; Gushiken, Francisca C.; Nolasco, Leticia; Fu, Xiaoyun; Moake, Joel L.; Ni, Heyu; López, José A.

    2011-01-01

    Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease characterized by systemic microvascular thrombosis caused by adhesion of platelets to ultra-large vWF (ULVWF) multimers. These multimers accumulate because of a deficiency of the processing enzyme ADAMTS13. vWF protein forms long multimers from homodimers that first form through C-terminal disulfide bonds and then join through their N termini by further disulfide bonding. N-acetylcysteine (NAC) is an FDA-approved drug that has long been used to treat chronic obstructive lung disease and acetaminophen toxicity and is known to function in the former disorder by reducing mucin multimers. Here, we examined whether NAC could reduce vWF multimers, which polymerize in a manner similar to mucins. In vitro, NAC reduced soluble plasma-type vWF multimers in a concentration-dependent manner and rapidly degraded ULVWF multimer strings extruded from activated ECs. The effect was preceded by reduction of the intrachain disulfide bond encompassing the platelet-binding A1 domain. NAC also inhibited vWF-dependent platelet aggregation and collagen binding. Injection of NAC into ADAMTS13-deficient mice led to the rapid resolution of thrombi produced by ionophore treatment of the mesenteric venules and reduced plasma vWF multimers. These results suggest that NAC may be a rapid and effective treatment for patients with TTP. PMID:21266777

  4. Salt Stress Reduces Root Meristem Size by Nitric Oxide-Mediated Modulation of Auxin Accumulation and Signaling in Arabidopsis1[OPEN

    PubMed Central

    Liu, Wen; Li, Rong-Jun; Han, Tong-Tong; Cai, Wei; Fu, Zheng-Wei

    2015-01-01

    The development of the plant root system is highly plastic, which allows the plant to adapt to various environmental stresses. Salt stress inhibits root elongation by reducing the size of the root meristem. However, the mechanism underlying this process remains unclear. In this study, we explored whether and how auxin and nitric oxide (NO) are involved in salt-mediated inhibition of root meristem growth in Arabidopsis (Arabidopsis thaliana) using physiological, pharmacological, and genetic approaches. We found that salt stress significantly reduced root meristem size by down-regulating the expression of PINFORMED (PIN) genes, thereby reducing auxin levels. In addition, salt stress promoted AUXIN RESISTANT3 (AXR3)/INDOLE-3-ACETIC ACID17 (IAA17) stabilization, which repressed auxin signaling during this process. Furthermore, salt stress stimulated NO accumulation, whereas blocking NO production with the inhibitor Nω-nitro-l-arginine-methylester compromised the salt-mediated reduction of root meristem size, PIN down-regulation, and stabilization of AXR3/IAA17, indicating that NO is involved in salt-mediated inhibition of root meristem growth. Taken together, these findings suggest that salt stress inhibits root meristem growth by repressing PIN expression (thereby reducing auxin levels) and stabilizing IAA17 (thereby repressing auxin signaling) via increasing NO levels. PMID:25818700

  5. Estimated performance of an adaptive trailing-edge device aimed at reducing fuel consumption on a medium-size aircraft

    NASA Astrophysics Data System (ADS)

    Diodati, Gianluca; Concilio, Antonio; Ricci, Sergio; De Gaspari, Alessandro; Huvelin, Fabien; Dumont, Antoine; Godard, Jean-Luc

    2013-03-01

    This paper deals with the estimation of the performance of a medium-size aircraft (3-hour flight range) equipped with an adaptive trailing edge device (ATED) that runs span-wise from the wing root in the flap zone and extends chord-wise for a limited percentage of the MAC. Computations are calculated referring to the full wing and do not refer to the complete aircraft configuration. Aerodynamic computations, taking into account ideal shapes, have been performed by using both Euler and Navier- Stokes method in order to extract the wing polars for the reference and the optimal wing, implementing an ATED, deflected upwards and downwards. A comparison of the achieved results is discussed. Considering the shape domain, a suitable interpolation procedure has been set up to obtain the wing polar envelop of the adaptive wing, intended as the set of "best" values, picked by each different polar. At the end, the performances of the complete reference and adaptive wing are computed and compared for a symmetric, centered, leveled and steady cruise flight for a medium size aircraft. A significant fuel burn reduction estimate or, alternatively, an increased range capability is demonstrated, with margins of further improvements. The research leading to these results has gratefully received funding from the European Union Seventh Framework Programme (FP7/2007- 2013) under Grant Agreement n° 284562.

  6. Sublytic complement attack reduces infarct size in rabbit isolated hearts: evidence for C5a-mediated cardioprotection.

    PubMed

    Tanhehco, E J; Lee, H; Lucchesi, B R

    2000-09-01

    Sublytic complement attack can elicit protective cellular responses without precipitating cell death. Our investigation examined the effects of non-lethal complement activation in isolated hearts. New Zealand white rabbit hearts were subjected to 30 min of ischemia followed by 1 h of reperfusion. Prior to ischemia, hearts were perfused for 20 min with 0.5% normal human plasma (NHP). Hearts treated with NHP developed significantly (p<0.05) smaller infarcts compared with controls, expressed as percent of area at risk (AAR) (25.3+/-4.0% vs. 40.9+/-4.3%, respectively). Heat-inactivation, soluble complement receptor 1 (sCR1; 20 nM), and anti-C5a antibody reversed the protective effect of NHP (39.0+/-3.1%, 41.7+/-5.1% and 38.4+/-2.3% AAR, respectively). Hearts treated with 3 nM C5a exhibited infarct sizes similar to those exposed to NHP (27.6+/-5.0% AAR). sCR1 alone did not affect infarct size (37.9+/-4.5% AAR). The results suggest that non-lethal complement activation attenuates reperfusion injury through formation of C5a.

  7. Electrochemical, In Situ Raman Spectroscopic, and Conductivity Studies of Polypyrrole Incorporating Large Size Anions: Conducting Nature of Reduced Form

    DTIC Science & Technology

    1990-05-21

    oxidized (conducting) and reduced (nonconducting).I On the other hand, in our previous report a Pry thin-film incorporating copper phthalocyanine ...tetrasulfonates (PPy-MPcTs), copper phthalocyanine monosulfonate (PPy-CuPcS), copper porpyrin tetrasulfonate (PPy-CuPrTs), and a couple of anionic...Acetonitrile (MeCN) was purified by the method reported by Forcier and Olver.14 The copper phthalocyanine -3,4’,4’’,4’’’-tetrasulfonic acid tetrasodium

  8. Marine reserves reduce risk of climate-driven phase shift by reinstating size- and habitat-specific trophic interactions.

    PubMed

    Ling, S D; Johnson, C R

    2012-06-01

    Spatial closures in the marine environment are widely accepted as effective conservation and fisheries management tools. Given increasing human-derived stressors acting on marine ecosystems, the need for such effective action is urgently clear. Here we explore mechanisms underlying the utility of marine reserves to reinstate trophic dynamics and to increase resilience of kelp beds against climate-driven phase shift to sea urchin barrens on the rapidly warming Tasmanian east coast. Tethering and tagging experiments were used to examine size- and shelter-specific survival of the range-extending sea urchin Centrostephanus rodgersii (Diadematidae) translocated to reefs inside and outside no-take Tasmanian marine reserves. Results show that survival rates of C. rodgersii exposed on flat reef substratum by tethering were approximately seven times (small urchins 10.1 times; large urchins 6.1 times) lower on protected reef within marine reserve boundaries (high abundance of large predatory-capable lobsters) compared to fished reef (large predatory lobsters absent). When able to seek crevice shelter, tag-resighting models estimated that mortality rates of C. rodgersii were lower overall but remained 3.3 times (small urchins 2.1 times; large urchins 6.4 times) higher in the presence of large lobsters inside marine reserves, with higher survival of small urchins owing to greater access to crevices relative to large urchins. Indeed, shelter was 6.3 times and 3.1 times more important to survival of small and large urchins, respectively, on reserved relative to fished reef. Experimental results corroborate with surveys throughout the range extension region, showing greater occurrence of overgrazing on high-relief rocky habitats where shelter for C. rodgersii is readily available. This shows that ecosystem impacts mediated by range extension of such habitat-modifying organisms will be heterogeneous in space, and that marine systems with a more natural complement of large and thus

  9. Absorption and Bioavailability of Nano-Size Reduced Calcium Citrate Fortified Milk Powder in Ovariectomized and Ovariectomized-Osteoporosis Rats.

    PubMed

    Erfanian, Arezoo; Mirhosseini, Hamed; Rasti, Babak; Hair-Bejo, Mohd; Bin Mustafa, Shuhaimi; Abd Manap, Mohd Yazid

    2015-06-24

    The aim of this study was to evaluate the effects of fortification and nano-size reduction on calcium absorption and bioavailability of milk powder formula in sham, ovariectomized, and ovariectomized-osteoporosis rats as a menopause and menopause-osteoporosis model. Skim milk powder and skim milk powder fortified with calcium citrate and the suitable doses of inulin, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and vitamins D3, K1, and B6 were formulated based on the North American and Western European recommended dietary allowances. Optimization on cycle and pressure of high-pressure homogenizer was done to produce nano-fortified milk powder. In vivo study demonstrated that fortification and calcium citrate nano-fortified milk powder increased absorption and bioavailability of calcium, as well as bone stiffness and bone strength in sham, ovariectomized, and ovariectomized-osteoporosis rats. This study successfully developed an effective fortified milk powder for food application.

  10. Sizing community energy storage systems to reduce transformer overloading with emphasis on plug-in electric vehicle loads

    NASA Astrophysics Data System (ADS)

    Trowler, Derik Wesley

    The research objective of this study was to develop a sizing method for community energy storage systems with emphasis on preventing distribution transformer overloading due to plug-in electric vehicle charging. The method as developed showed the formulation of a diversified load profile based upon residential load data for several customers on the American Electric Power system. Once a load profile was obtained, plug-in electric vehicle charging scenarios which were based upon expected adoption and charging trends were superimposed on the load profile to show situations where transformers (in particular 25 kVA, 50 kVA, and 100 kVA) would be overloaded during peak hours. Once the total load profiles were derived, the energy and power requirements of community energy storage systems were calculated for a number of scenarios with different combinations of numbers of homes and plug-in electric vehicles. The results were recorded and illustrated into charts so that one could determine the minimum size per application. Other topics that were covered in this thesis were the state of the art and future trends in plug-in electric vehicle and battery chemistry adoption and development. The goal of the literature review was to confirm the already suspected notion that Li-ion batteries are best suited and soon to be most cost-effective solution for applications requiring small, efficient, reliable, and light-weight battery systems such as plug-in electric vehicles and community energy storage systems. This thesis also includes a chapter showing system modeling in MATLAB/SimulinkRTM. All in all, this thesis covers a wide variety of considerations involved in the designing and deploying of community energy storage systems intended to mitigate the effects of distribution transformer overloading.

  11. Ray Trace Modeling to Determine Optimal Forest Canopy Gap Size for Reduced Solar Irradiance During Snowmelt: Field Verification and Continental Scale Application

    NASA Astrophysics Data System (ADS)

    Musselman, K. N.; Pomeroy, J. W.; Link, T. E.

    2014-12-01

    Forest hydrology has long debated the influence of forest gap size on the shortwave radiation regime and subsequent snowmelt rates. To address this question, a new ray trace solar transmittance model is presented to evaluate the sensitivity of gap influence on shortwave irradiance patterns to latitude, gap size, and time of year in fragmented forest environments. The ray trace model takes into account solar position, gap and forest geometry, and position within or near the gap, and was tested against measurements of shortwave radiation from 20 pyranometers in and around a gap in a mixed conifer forest and compared to simpler canopy transmittance models that ignored shading or that scaled transmittance according to leaf area index. The ray trace model reduced the large errors obtained by simple canopy transmittance models; at the 20 pyranometer locations, average biases in excess of ~ ±90 W m-2 were reduced to better than 4 W m-2. These results suggest that an accurate description of the spatial variability of solar irradiance in and around a forest gap requires explicit calculation of how gaps modify the canopy transmittance. To examine model sensitivity to key parameters, gap size, latitude, and day of year were varied under clear-sky conditions. The calculated spatial distribution patterns of cumulative daily solar irradiance inform how forest gap sizes might be optimized to minimize (shortwave) snowmelt energy. As gap size was changed for a given latitude and date, the (spatial) coefficient of variation (CV) of cumulative daily irradiance exhibited a distinct maximum that is a function of gap geometry and solar angle; smaller (larger) gaps with more diffuse (direct beam) radiation exhibited reduced spatial variability of irradiance. The results indicate that optimum forest gap sizes to reduce solar radiation while maximizing gap area depend on date and latitude; using mean snowmelt onset dates for a range of latitudes (31°N - 71°N) spanning North American

  12. Single phase bi-directional AC-DC converter with reduced passive components size and common mode electro-magnetic interference

    DOEpatents

    Mi, Chris; Li, Siqi

    2017-01-31

    A bidirectional AC-DC converter is presented with reduced passive component size and common mode electro-magnetic interference. The converter includes an improved input stage formed by two coupled differential inductors, two coupled common and differential inductors, one differential capacitor and two common mode capacitors. With this input structure, the volume, weight and cost of the input stage can be reduced greatly. Additionally, the input current ripple and common mode electro-magnetic interference can be greatly attenuated, so lower switching frequency can be adopted to achieve higher efficiency.

  13. Plasma fibrin clot phenotype independently affects intracoronary thrombus ultrastructure in patients with acute myocardial infarction.

    PubMed

    Zalewski, Jaroslaw; Bogaert, Jan; Sadowski, Marcin; Woznicka, Olga; Doulaptsis, Konstantinos; Ntoumpanaki, Maria; Ząbczyk, Michal; Nessler, Jadwiga; Undas, Anetta

    2015-06-01

    Determinants of intracoronary thrombus (ICT) composition in patients with ST-elevation myocardial infarction (STEMI) are largely unknown. We sought to investigate whether plasma fibrin phenotype and platelet reactivity affect ICT ultrastructure. We assessed the content of fibrin, platelets and erythrocytes including polyhedrocytes by scanning electron microscopy on the surface and inside ICT aspirated from 80 STEMI patients within 12 hours since chest pain onset. Plasma fibrin clot permeability (Ks), which indicates the average pore size, lysis time (t50 %), platelet reactivity index (PRI) and ADP-induced platelet aggregation (ADP5, 20µM) were evaluated on admission. All patients received aspirin and 45 (56.3 %) 600 mg of clopidogrel, 80 (60-120) min prior to aspiration. Higher content of fibrin (61.6 vs 34.3 %, P< 0.0001) and platelets (8.2 vs 4.8 %, P=0.018) and lower erythrocyte content (15.8 vs 42.9 %, P< 0.0001) were found on ICT surface compared with its inner part. After adjustment for fibrinogen, in both ICT parts fibrin content was correlated with Ks (r≤-0.55, P< 0.0001) and t50 % (r≥ 0.29, P≤ 0.02) but not with PRI and ADP5,20µM. Polyhedrocytes were observed in 16 (20 %) patients and their large amount expressed as ≥ 50 % fields of view covered by polyhedrocytes was associated with the lower PRI values (40 vs 69 %, P=0.015), but not Ks or t50 %. By multivariate regression, Ks (β=-0.62, P< 0.0001), clopidogrel pretreatment (β=-0.36, P< 0.001), ischemia time (β=0.19, P=0.044) and family history (β=0.18, P=0.049) independently predicted fibrin content in the whole ICT (R²=0.65, P< 0.0001). Formation of denser plasma fibrin clots is independently associated with high fibrin content within the ICT in STEMI.

  14. Angiogenesis Is Induced and Wound Size Is Reduced by Electrical Stimulation in an Acute Wound Healing Model in Human Skin

    PubMed Central

    Ud-Din, Sara; Sebastian, Anil; Giddings, Pamela; Colthurst, James; Whiteside, Sigrid; Morris, Julie; Nuccitelli, Richard; Pullar, Christine; Baguneid, Mo; Bayat, Ardeshir

    2015-01-01

    Angiogenesis is critical for wound healing. Insufficient angiogenesis can result in impaired wound healing and chronic wound formation. Electrical stimulation (ES) has been shown to enhance angiogenesis. We previously showed that ES enhanced angiogenesis in acute wounds at one time point (day 14). The aim of this study was to further evaluate the role of ES in affecting angiogenesis during the acute phase of cutaneous wound healing over multiple time points. We compared the angiogenic response to wounding in 40 healthy volunteers (divided into two groups and randomised), treated with ES (post-ES) and compared them to secondary intention wound healing (control). Biopsy time points monitored were days 0, 3, 7, 10, 14. Objective non-invasive measures and H&E analysis were performed in addition to immunohistochemistry (IHC) and Western blotting (WB). Wound volume was significantly reduced on D7, 10 and 14 post-ES (p = 0.003, p = 0.002, p<0.001 respectively), surface area was reduced on days 10 (p = 0.001) and 14 (p<0.001) and wound diameter reduced on days 10 (p = 0.009) and 14 (p = 0.002). Blood flow increased significantly post-ES on D10 (p = 0.002) and 14 (p = 0.001). Angiogenic markers were up-regulated following ES application; protein analysis by IHC showed an increase (p<0.05) in VEGF-A expression by ES treatment on days 7, 10 and 14 (39%, 27% and 35% respectively) and PLGF expression on days 3 and 7 (40% on both days), compared to normal healing. Similarly, WB demonstrated an increase (p<0.05) in PLGF on days 7 and 14 (51% and 35% respectively). WB studies showed a significant increase of 30% (p>0.05) on day 14 in VEGF-A expression post-ES compared to controls. Furthermore, organisation of granulation tissue was improved on day 14 post-ES. This randomised controlled trial has shown that ES enhanced wound healing by reduced wound dimensions and increased VEGF-A and PLGF expression in acute cutaneous wounds, which further substantiates the role of ES in up

  15. Does Prostate Size Predict the Development of Incident Lower Urinary Tract Symptoms in Men with Mild to No Current Symptoms? Results from the REDUCE Trial.

    PubMed

    Simon, Ross M; Howard, Lauren E; Moreira, Daniel M; Roehrborn, Claus; Vidal, Adriana C; Castro-Santamaria, Ramiro; Freedland, Stephen J

    2016-05-01

    It has been shown that increased prostate size is a risk factor for lower urinary tract symptom (LUTS) progression in men who currently have LUTS presumed due to benign prostatic hyperplasia (BPH). To determine if prostate size is a risk factor for incident LUTS in men with mild to no symptoms. We conducted a post hoc analysis of the REDUCE study, which contained a substantial number of men (n=3090) with mild to no LUTS (International Prostate Symptom Score [IPSS] <8). Our primary outcome was determination of the effect of prostate size on incident LUTS presumed due to BPH defined as two consecutive IPSS values >14, or receiving any medical (α-blockers) or surgical treatment for BPH throughout the study course. To determine the risk of developing incident LUTS, we used univariable and multivariable Cox models, as well as Kaplan-Meier curves and the log-rank test. Among men treated with placebo during the REDUCE study, those with a prostate size of 40.1-80ml had a 67% higher risk (hazard risk 1.67, 95% confidence interval 1.23-2.26, p=0.001) of developing incident LUTS compared to men with a prostate size 40.0ml or smaller. There was no association between prostate size and risk of incident LUTS in men treated with 0.5mg of dutasteride. The post hoc nature of our study design is a potential limitation. Men with mild to no LUTS but increased prostate size are at higher risk of incident LUTS presumed due to BPH. This association was negated by dutasteride treatment. Benign prostatic hyperplasia (BPH) is a very common problem among older men, which often manifests as lower urinary tract symptoms (LUTS), and can lead to potentially serious side effects. In our study we determined that men with mild to no current LUTS but increased prostate size are much more likely to develop LUTS presumed due to BPH in the future. This association was not seen in men treated with dutasteride, a drug approved for treatment of BPH. Our study reveals that men with a prostate size of 40

  16. Chromium-Modified Li4Ti5O12 with a Synergistic Effect of Bulk Doping, Surface Coating, and Size Reducing.

    PubMed

    Zou, Hailin; Liang, Xin; Feng, Xuyong; Xiang, Hongfa

    2016-08-24

    Bulk doping, surface coating, and size reducing are three strategies for improving the electrochemical properties of Li4Ti5O12 (LTO). In this work, chromium (Cr)-modified LTO with a synergistic effect of bulk doping, surface coating, and size reducing is synthesized by a facile sol-gel method. X-ray diffraction (XRD) and Raman analysis prove that Cr dopes into the LTO bulk lattice, which effectively inhibits the generation of TiO2 impurities. Transmission electron microscopy (TEM) and X-ray photoelectron spectroscopy (XPS) verifies the surface coating of Li2CrO4 on the LTO surface, which decreases impedance of the LTO electrode. More importantly, the size of LTO particles can be significantly reduced from submicroscale to nanoscale as a result of the protection of the Li2CrO4 surface layer and the suppression from Cr atoms on the long-range order in the LTO lattice. As anode material, Li4-xCr3xTi5-2xO12 (x = 0.1) delivers a reversible capacity of 141 mAh g(-1) at 10 °C, and over 155 mAh g(-1) at 1 °C after 1000 cycles. Therefore, the Cr-modified Li4Ti5O12 prepared via a sol-gel method has potential for applications in high-power, long-life lithium-ion batteries.

  17. Reduced molecular size and altered disaccharide composition of cerebral chondroitin sulfate upon Alzheimer’s pathogenesis in mice

    PubMed Central

    Zhang, Zui; Ohtake-Niimi, Shiori; Kadomatsu, Kenji; Uchimura, Kenji

    2016-01-01

    ABSTRACT Alzheimer’s disease (AD) is