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  1. Toxic shock syndrome

    MedlinePlus

    ... of toxic shock syndrome involved women who used tampons during their periods (menstruation). However, today less than half of cases are linked to tampon use. Toxic shock syndrome can also occur with ...

  2. Update: Toxic Shock Syndrome.

    ERIC Educational Resources Information Center

    Price, James H.

    1981-01-01

    School health professionals can help reduce the incidence of Toxic Shock Syndrome by suggesting that women not use tampons continuously during menses and that tampons should not be left in place for long periods of time. Tampons should be changed every few hours and used intermittently with pads. (JN)

  3. Toxic shock syndrome and tampons.

    PubMed

    Schuchat, A; Broome, C V

    1991-01-01

    There has been a substantial reduction in the incidence of toxic shock syndrome in the 10 years since the association between tampons and toxic shock syndrome was first recognized. The decreased incidence is real, and not the result of decreased reporting to the passive surveillance system. The decreased incidence of menstrual toxic shock syndrome can primarily be explained by changes in the absorbency and composition of tampons available to the consumer. The reduction in the occurrence of menstrual toxic shock syndrome can be attributed to the withdrawal of Rely brand, which consisted of a unique composition, and subsequently to the lowering of absorbency of all brands of tampons. The conclusions of the early studies of toxic shock syndrome pointed the way to prompt public health interventions and resulted in the prevention of substantial morbidity.

  4. Toxic Shock Syndrome (For Parents)

    MedlinePlus

    ... Problems Talking to Your Child About Menstruation Cellulitis MRSA Staph Infections What Are Germs? Why Is Hand ... in? Feeling Fresh All About Menstruation Staph Infections MRSA Toxic Shock Syndrome Contact Us Print Resources Send ...

  5. Myelodysplastic Syndrome Occurring in a Patient with Gorlin Syndrome.

    PubMed

    Mull, Jamie L; Madden, Lisa M; Bayliss, Susan J

    2016-07-01

    We report a case of myelodysplastic syndrome (MDS) occurring in an African American boy with Gorlin syndrome with a novel PTCH1 mutation. Before developing MDS, the patient had been treated with chemotherapy and radiation for a medulloblastoma. He received a bone marrow transplant for the MDS and eventually died of treatment complications. Secondary hematologic malignancies are a known complication of certain chemotherapeutics, although whether a patient with Gorlin syndrome has a greater propensity for the development of such malignancies is unclear. PMID:27241746

  6. [Hemorrhagic fever and the dengue shock syndrome].

    PubMed

    Ramos, C; García, H; Villaseca, J M

    1993-01-01

    Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) are the severe and/or fatal clinical manifestations of dengue fever. Epidemics of DHF/DSS occur mainly in the southeast Asian countries where children are seriously affected and high case-fatality ratio is annually reported. Recently significant epidemics of DHF/DSS have been reported in Cuba, Venezuela and Brazil, which means that reinforcements of the epidemiological surveillance in the countries of the American region that show high virus transmission, are urgently needed. The main purpose of the present article is to review relevant information regarding the clinical manifestations, pathology, diagnostic procedures, treatment of cases, pathophysiologic mechanisms and some data related with specific DHF/DSS epidemics.

  7. Toxic Shock Syndrome: An Unusual Organism.

    PubMed

    Young, Katie; Luni, Faraz Khan; Yoon, Youngsook

    2016-07-01

    Streptococcal toxic shock syndrome is a rapidly fatal disease causing hypotension with multi organ dysfunction (MODS) early in the course of infection, which by definition is caused by Group A streptococcus (GAS). We describe a case of Toxic Shock like Syndrome (TSLS) in which the causative organism was not a GAS. A 71-year-old woman with hepatitis C and primary biliary cirrhosis had sudden onset of slurred speech and left arm and facial numbness. She had bilateral erythematous macular rash present on the flanks and legs. She was started on empiric antibiotics but her condition rapidly deteriorated 6 hours after admission. During this time, the development of multiple large reddish-pink areas of ecchymosis with bullae on her lower extremities, flanks, and groin were noted. She also developed multiorgan dysfunction (MODS) with renal dysfunction, coagulopathy and liver involvement. Patient expired before surgery could be performed and the time from presentation to the time of death was 16 hours. The blood and bullae fluid cultures grew Streptococcus dysgalactiae equisimilis. Streptococcus dysgalactiae equisimilis is a rare cause of TSLS which typically affects elderly or immunocompromised patients and only a few cases have been described in the literature. Our patient met criteria for TSLS which caused rapid shock and MODS. We review the literature of the cases describing the clinical characteristics of TSLS cause by non-GAS. Group G Streptococci is a rare but lethal cause of streptococcal toxic shock syndrome. PMID:27432040

  8. Toxic Shock Syndrome: A Family Physician's Perspective

    PubMed Central

    Myhre, D. L.

    1982-01-01

    Although similar cases have been reported as far back as 1927, the term toxic shock syndrome was coined in 1978 to describe an acute fever involving Staph. aureus. The reported mortality rate in Canada is 3.8%, but may be much higher. Association with tampon use was made in 1980, but is still unclear. Treatment remains supportive and is aimed at reducing risk of recurrence, until the role of the exotoxin can be explained. This article reviews reported cases to date, listing diagnostic criteria, signs and symptoms. A high index of suspicion for this new syndrome is recommended. PMID:21286566

  9. Cardiogenic shock in acute coronary syndrome.

    PubMed

    Ruiz-Bailén, Manuel; Rucabado-Aguilar, Luis; Expósito-Ruiz, Manuela; Morante-Valle, Antonia; Castillo-Rivera, Ana; Pintor-Mármol, Antonio; Rosell-Ortiz, Fernando; Mellado-Vergel, Francisco José; Machado-Casas, Juan; Tejero-Pedregosa, Armando; Lara-Torrano, Juan

    2009-03-01

    This is a review of current knowledge on cardiogenic shock (CS), with particular attention to recommended management. The bibliography for the study was compiled through a search of different databases between 1966-2008. The references cited in the selected articles were also reviewed. The selection criteria included all reports published on CS, from case reports and case series to controlled studies. Languages used were Spanish, French, Italian, Portuguese, German, and English. Cardiogenic shock is the most frequent cause of in-hospital death as a complication of acute coronary syndrome. The incidence is about 7% and, despite therapeutic advances, it continues to have an ominous prognosis, with mortality rates of over 50%. Coronary reperfusion is fundamental in the management of cardiogenic shock, particularly with the use of percutaneous coronary intervention. However, if this is not available, systemic thrombolysis may be performed together with balloon counterpulsation or the use of pressor drugs. Despite the historical importance of the Swan-Ganz catheter, this would appear to have limited use, with echocardiography nonetheless having a fundamental role in the management of CS. Although patients with cardiogenic shock often present a left ventricular ejection fraction of around 30%, survivors often have a good functional classification one year after the event. Neurohormonal and inflammatory mechanisms play a fundamental role in the pathophysiology of CS. These mechanisms are currently the target of studies looking into developing new therapeutic strategies. PMID:19247258

  10. Childhood dengue shock syndrome in Trinidad.

    PubMed

    Teelucksingh, S; Lutchman, G; Udit, A; Pooransingh, S

    1999-09-01

    Dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) is a major cause of hospitalisation and mortality among children in South East Asia. We now report, for the first time, the occurrence of DHF/DSS in Trinidadian children. The presence of vomiting, abdominal pain and hepatomegaly in the setting of a dengue epidemic should alert clinicians to the possibility of DHF/DSS. Timely diagnosis and aggressive supportive treatment are essential for a successful outcome. Source reduction, vector control and community participation are also necessary to avert the South East Asian scenario from emerging in the Caribbean.

  11. Cold Shock Syndrome in Anacystis nidulans.

    PubMed

    Rao, V S; Brand, J J; Myers, J

    1977-05-01

    The phenomenon of cold shock in Anacystis nidulans has been explored further in terms of loss of viability and immediate and subsequent metabolic effects. Cold shock was observed also in two closely related strains in which unsaturated fatty acid contents are also known to be low and temperature-dependent. Loss of viability was maximum for cells grown at temperatures above 40 C (<10(-4) survivors after 5 min at 0 C) but became negligibly small for cells grown below 34 C. Development of the cold-sensitive condition after transfer 25 --> 39 C was slow and comparable to rate of growth; development of the insensitive condition after transfer 39 --> 25 C was rapid, implying rapid in situ alteration. An immediate metabolic effect, observed as a decrease in rate of photosynthetic O(2) evolution measured at growth temperature, was less severe than loss of viability. Continued light incubation under growth conditions led to slow decay in rate of O(2) evolution accompanied by loss of membrane chlorophyll. The multiple effects which comprise the cold shock syndrome appear to be membrane-related phenomena and thereby provide an experimental probe of normal membrane function.

  12. Toxic shock syndrome Staphylococcus aureus: effect of tampons on toxic shock syndrome toxin 1 production.

    PubMed

    Schlievert, P M; Blomster, D A; Kelly, J A

    1984-11-01

    Tampons were tested for effect on growth and production of toxic shock syndrome toxin 1 by Staphylococcus aureus. Under good growth conditions, regular absorbency tampons had little effect on bacterial growth and inhibited toxin production two- to fourfold. In contrast, higher absorbency tampons had three different effects: 1) some tampons had no effect on bacterial growth but inhibited toxin production; 2) many tampons inhibited both growth and toxin production; 3) one tampon inhibited growth but increased exotoxin per cell. These effects were independent of degree of saturation of the tampons and were observed at incubation times of six, 12, and 18 hours. In no instance was the production of toxic shock syndrome toxin 1 per milliliter increased in the presence of tampons when compared with control.

  13. [Toxic shock syndrome in 3 children].

    PubMed

    van der Meulen, M; van Elzakker, E P M; van Veen, L; van der Lely, N

    2004-08-14

    A 16-year-old and a 10-year-old girl were admitted with general signs of illness, and respectively a green vaginal discharge and a panaritium. They recovered following antibiotic treatment and surgical relief of the panaritium. A 2-year-old boy became ill the morning after eating tainted cold meat; he died in the course of the following night. In all 3 patients Staphylococcus aureus was incubated with the toxic-shock-toxin-1-gene and/or the enterotoxin-A-gene. These 3 cases occurred within one year in a general hospital. TSS probably occurs more frequently than is generally assumed. Given that it is a life-threatening disease, rapid diagnosis is of major importance.

  14. Involvement of coagulase-negative staphylococci in toxic shock syndrome.

    PubMed

    Crass, B A; Bergdoll, M S

    1986-01-01

    Coagulase-negative staphylococci that produce toxic shock syndrome toxin 1 (TSST-1) or a staphylococcal enterotoxin or both were isolated from various sources. Coagulase-negative strains that produce TSST-1 alone or with enterotoxin A were the only staphylococci isolated from seven patients with toxic shock syndrome. Two other toxic shock syndrome patients had coagulase-positive staphylococci also, but only the coagulase-negative strains produced TSST-1. Coagulase-positive and coagulase-negative strains that produced TSST-1 were isolated from two other toxic shock syndrome patients. In addition, coagulase-negative staphylococci that produced toxins were isolated from patients with other staphylococcal infections and from food implicated in a case of food poisoning.

  15. Infectious Shock and Toxic Shock Syndrome Diagnoses in Hospitals, Colorado, USA

    PubMed Central

    Smit, Michael A.; Nyquist, Ann-Christine

    2013-01-01

    In Colorado, USA, diagnoses coded as toxic shock syndrome (TSS) constituted 27.3% of infectious shock cases during 1993–2006. The incidence of staphylococcal TSS did not change significantly overall or in female patients 10–49 years of age but increased for streptococcal TSS. TSS may be underrecognized among all ages and both sexes. PMID:24188357

  16. Panayiotopoulos syndrome in a child masquerading as septic shock

    PubMed Central

    Zaki, Syed Ahmed; Verma, Devendra Kumar; Tayde, Pavan

    2016-01-01

    Panayiotopoulos syndrome (PS) is a benign childhood epilepsy with predominant autonomic symptoms. The syndrome can have varied presentations resulting in diagnostic dilemma. We herein describe a 3-year-old boy with PS, who had manifestations similar to septic shock. His investigations were normal and had a complete recovery. Through this case, we wish to highlight the unusual presentation of PS as septic shock. Physicians should be aware of the different ways in which this syndrome can present to ensure its early diagnosis and treatment. PMID:27390462

  17. Mild forms of toxic shock syndrome toxin-1-mediated exanthematous disease related to Staphylococcus aureus infection.

    PubMed

    Moriguchi, Naohiko; Kano, Tomowa; Yoshimatsu, Yutaka; Yanagida, Hidehiko

    2016-08-01

    The present report describes three patients with toxic shock syndrome toxin (TSST)-1-associated exanthematous disease. In all patients, fever and systemic erythema without hemodynamic disturbance occurred following cellulitis of the lower limbs. At the site of infection, TSST-1 producing Methicillin-susceptible Staphylococcus aureus was detected. They defervesced and erythema resolved in response to administration of an antimicrobial drug, thereby avoiding severe illness. These patients did not meet the criteria for a clinical diagnosis of toxic shock syndrome. Measurement of T-cell receptor Vβ2-positive T cells in the peripheral blood early after onset of symptoms was useful for diagnosis.

  18. Dengue haemorrhagic fever/dengue shock syndrome. An unwelcome arrival in Trinidad.

    PubMed

    Teelucksingh, S; Mangray, A S; Barrow, S; Jankey, N; Prabhakar, P; Lewis, M

    1997-06-01

    This is the first report of dengue haemorrhagic fever and dengue shock syndrome in Trinidad. Dengue infection was confirmed serologically or by viral isolation in five patients, aged 15 to 53 years, who presented with fever, thrombocytopenia and haemoconcentration. Three patients developed dengue shock syndrome, which was fatal; although there was no haemorrhagic tendency among these patients, bleeding occurred shortly before death in one of them. Two patients who had dengue haemorrhagic fever survived. The co-circulation of dengue virus serotypes 1, 2, and 4 in the Caribbean facilitates the development of dengue shock syndrome (DSS) or dengue haemorrhagic fever (DHF). Clinicians should therefore be aware of their clinical features, laboratory diagnosis and clinical management. Appropriate public health interventions and improved surveillance should be implemented to reduce the risk of DHF/DSS associated mortality in Trinidad and Tobago.

  19. Lesson of the month 2: toxic shock syndrome.

    PubMed

    Shalaby, Tamer; Anandappa, Samantha; Pocock, Nicholas John; Keough, Alexander; Turner, Angus

    2014-06-01

    Toxic shock syndrome (TSS) represents a fascinating example of immune activation caused by infection resulting in a dramatic and challenging clinical syndrome. TSS is commonly associated with tampon use and still causes significant morbidity and mortality in young healthy women. A misconception is that TSS presents with a skin rash and only occurs in women and children; however, it can occur in males and can present without skin changes. TSS presents initially as a febrile illness and within a few hours can progress to severe hypotension and multiple organ failure (MOF). Staphylococcus aureus and group A beta haemolytic streptococcus (GABHS) can secrete toxins from a small or hidden focus of infection and hence blood culture and sensitivity (C+S) tests can be negative, thereby making diagnosing this condition challenging. Clindamycin is superior to penicillin in the treatment of this condition and significantly decreases the mortality rate in TSS. However, there is also an important role for intravenous immunoglobulins (IVIG). Early intensive care unit (ICU) as well as surgical team involvement (in selected cases) is required to avoid mortality which may approach 70%. PMID:24889583

  20. Knowledge and Self-Perceived Risk for Toxic Shock Syndrome.

    ERIC Educational Resources Information Center

    Colbry, Sheila Lynds; Boutsen, Frank R.

    1993-01-01

    Survey investigated female college students' knowledge about toxic shock syndrome (TSS), noting relationships between knowledge, self-perceived risk of developing TSS, and menstrual product use. Data analysis indicated knowledge about TSS was inadequate, particularly among young females. Neither risk perception nor product use were mediated by…

  1. Death in pediatric Cushing syndrome is uncommon but still occurs

    PubMed Central

    Gkourogianni, Alexandra; Lodish, Maya B.; Zilbermint, Mihail; Lyssikatos, Charalampos; Belyavskaya, Elena; Keil, Margaret F.; Stratakis, Constantine A.

    2014-01-01

    Cushing syndrome (CS) in children is rare. Delayed diagnosis and treatment of CS may be associated with increased morbidity and, unfortunately, mortality. We performed a retrospective review of all patients with CS under the age of 18 referred to the NIH from 1998 to 2013 in order to describe deceased patients among cases of pediatric CS referred to the National Institutes of Health (NIH). The deaths of 4 children (3 females and 1 male), aged 7.5–15.5 years (mean age 11.2 years) with length of disease 2–4 years were recorded among 160 (2.5%) children seen at, or referred to the NIH over the last 15 years. All died at different institutions, prior to coming to the NIH (two of them) or after leaving NIH (two of them). Presenting symptoms included increasing weight and decreasing height gain, facial plethora, dorsocervical fat pad (webbed neck), striae, headache, vision disturbances and depression and other mood or behavior changes; there were no differences between how these patients presented and the others in our cohort. The causes of CS in the deceased patients were also not different, in fact, they spanned the entire spectrum of CS: pituitary disease (on of them), ectopic corticotropin production (one of them), and primary adrenal hyperplasia (1). In one patient, the cause of CS could not be verified. Three died of sepsis and one due to residual disease and complications of the primary tumor. Conclusions Despite advances in early diagnosis and treatment of pediatric CS, a 2.5% mortality rate was identified in a large cohort of patients with this condition referred to an experienced, tertiary care referral center (although these deaths occurred elsewhere). Pediatricians need to recognize the possibility of death, primarily due to sepsis, in a patient with pediatric CS and act accordingly. PMID:25241829

  2. Recurrent menstrual toxic shock syndrome despite discontinuation of tampon use: is menstrual toxic shock syndrome really caused by tampons?

    PubMed

    Dixit, Shreya; Fischer, Gayle; Wittekind, Carola

    2013-11-01

    Menstrual toxic shock syndrome (MTSS) is a rare and potentially life-threatening illness. We present a case of recurrent MTSS initially associated with tampon use that continued to recur when tampons were discontinued, which was successfully treated with rifampicin and clindamycin.

  3. Recurrent SDSE bacteraemia resulting in streptococcal toxic shock syndrome in a patient with Noonan syndrome.

    PubMed

    Suzuki, Kei; Nakamura, Akiko; Ishikura, Ken; Imai, Hiroshi

    2016-01-01

    A 19-year-old man with chronic lymphoedema due to Noonan syndrome presented at our hospital with septic shock and pain in his lower leg. Blood cultures were positive for Streptococcus dysgalactiae subsp equisimilis (SDSE), resulting in a diagnosis of cellulitis with toxic involvement. He was treated with ampicillin for 3 weeks. Although he did well for 6 weeks, septic shock recurred. Blood culture again revealed SDSE, with the strain being identical to the first episode, suggesting that this infection had relapsed. He was treated with ampicillin for 6 weeks and prophylactically with trimethoprim-sulfamethoxazole for 12 months. Although SDSE bacteraemia occurs commonly in elderly patients, findings in this patient showed that it can also develop in younger persons with predisposing factors. This case also indicates that SDSE has the potential to recur, despite generally sufficient antibiotic administration, and that patients who experience recurrent episodes may require prolonged treatment with antibiotics, including prophylaxis. PMID:27485878

  4. Progressive multifocal leukoencephalopathy occurring with the acquired immune deficiency syndrome.

    PubMed

    England, J D; Hsu, C Y; Garen, P D; Goust, J M; Biggs, P J

    1984-08-01

    A 33-year-old homosexual man with symptoms and signs of a focal brain process was subsequently found to have an acquired immune deficiency syndrome (AIDS) with biopsy-proven progressive multifocal leukoencephalopathy. This report reemphasizes the association of progressive multifocal leukoencephalopathy with AIDS and probably is best viewed as another example of an opportunistic CNS infection complicating deficient cell-mediated immunity. PMID:6540476

  5. An epidemic of dengue haemorrhagic fever/dengue shock syndrome in tropical India.

    PubMed

    Pushpa, V; Venkatadesikalu, M; Mohan, S; Cherian, T; John, T J; Ponnuraj, E M

    1998-12-01

    An epidemic of dengue haemorrhagic fever/dengue shock syndrome occurred in Chennai, South India in 1989 during and following the rainy season. Sixty-nine infants and children admitted to the Institute of Child Health and Hospital for Children with a brief febrile illness associated with skin and mucous membrane bleeds and/or shock were studied. Forty-nine had antibodies to dengue viruses. The specific serotype of the virus responsible could not be identified owing to cross-reacting antibodies. Primary infection occurred in 11 cases, secondary infection in 17 cases, antibodily titres were indicative of 'probable' dengue infection in 16 and were uninterpretable in five. In 11 cases, serology could not be done. The pattern of disease in these 60 cases was similar, with a high mortality. Haemoconcentration was not a feature in the majority and the Hess test was negative in all those tested. Nine cases with a similar but milder illness tested negative for dengue.

  6. An epidemic of dengue haemorrhagic fever and dengue shock syndrome in Delhi: a clinical study.

    PubMed

    Srivastava, V K; Suri, S; Bhasin, A; Srivastava, L; Bharadwaj, M

    1990-01-01

    Twenty-four cases of dengue haemorrhagic fever/dengue shock syndrome were studied in Delhi in the months of September and October, 1988. The majority of these cases were boys aged 6-10 years. Classical symptoms of dengue (fever, headache, aesthesia, myalgia) occurred in all the patients. Digestive symptoms (nausea, vomiting, anorexia, abdominal pain and hepatomegaly) were also common. Haemorrhagic manifestations were present in 41.7% of the cases. Of these, 90% had gastrointestinal haemorrhages. Shock occurred in 17 cases (70.8%). Thrombocytopenia and prolongation of coagulation profile were found in 62.5% of cases. Three patients (12.5%) who presented with encephalopathy died. The other 21 patients recovered after an average period of 2-8 days.

  7. [Necrotising fasciitis caused by streptococcal toxic shock syndrome].

    PubMed

    Wedler, V; Meuli-Simmen, C; Künzi, W; Giovanoli, P; Meyer, V E

    2002-03-01

    Between 1994 and 1997, sixteen patients suffering from necrotising soft tissue infection were treated at the burn centre of the Division of Reconstructive Surgery, University of Zurich. The case of a 47 year old man is presented: He suffered from a necrotising fasciitis caused by Streptococcal induced Toxic Shock Syndrome (STSS). This example emphasizes the necessity of early diagnosis, priority of surgical intervention, and the antibiotic strategy. Necrotising fasciitis is a serious disease, caused by a variety of bacteria, which shows a high mortality rate, and its frequency was increasing over the last years.

  8. Rely and Toxic Shock Syndrome: A Technological Health Crisis

    PubMed Central

    Vostral, Sharra L.

    2011-01-01

    This essay examines factors leading to the identification of Toxic Shock Syndrome with the bacteria Staphylococcus aureus in 1978 and the specific role of Rely tampons in generating a technologically rooted health crisis. The concept biologically incompatible technology is offered to explain the relationship between constituent bacteria, women’s menstrual cycles, and a reactive technology that converged to create the ideal environment for the S. aureus bacteria to live and flourish in some women. The complicated and reactive relationship of the Rely tampon to emergent disease, corporate interests, public health, and injury law reveals the dangers of naturalizing technologies. PMID:22180682

  9. Rely and Toxic Shock Syndrome: a technological health crisis.

    PubMed

    Vostral, Sharra L

    2011-12-01

    This essay examines factors leading to the identification of Toxic Shock Syndrome with the bacteria Staphylococcus aureus in 1978 and the specific role of Rely tampons in generating a technologically rooted health crisis. The concept biologically incompatible technology is offered to explain the relationship between constituent bacteria, women's menstrual cycles, and a reactive technology that converged to create the ideal environment for the S. aureus bacteria to live and flourish in some women. The complicated and reactive relationship of the Rely tampon to emergent disease, corporate interests, public health, and injury law reveals the dangers of naturalizing technologies.

  10. [Septic shock Fusobacterium necrophorum from origin gynecological at complicated an acute respiratory distress syndrome: a variant of Lemierre's syndrome].

    PubMed

    Huynh-Moynot, Sophie; Commandeur, Diane; Danguy des Déserts, Marc; Drouillard, Isabelle; Leguen, Patrick; Ould-Ahmed, Mehdi

    2011-01-01

    We report a case of a female patient of 47 years old who presents in a state of septic shock with acute insufficient respiratory complicated with syndrome of acute respiratory distress, together with a list of abdominal pain and polyarthralgia too. In her case of medical history, it is retained that she has had a intra-uterine device since 6 years without medical follow up. The initial thoraco-abdomino-pelvic scan shows a left ovarian vein thrombosis, as well as the opaqueness alveolus diffused interstitiel bilaterally and an aspect of ileitis. The IUD is taken off because of sudden occuring of purulent leucorrhoea. This results in a clinical and paraclinical improvement, whereas aminopenicillin was administered to the patient since 1 week. The microbiological blood test allows to put in evidence Fusobacterium necrophorum found in a blood culture and is sensitive to the amoxicilline-acide clavulanique and metronidazole. Isolation of this bacteria, classically found in Lemierre's syndrome, allowed to explain the multilfocalization of the symtoms and the list of pain. The whole concerns about a variant of Lemierre's syndrom: a state of septic shock secondary then caused by the anaerobic Gram negative bacilli, which is a commensal bacteria of the female genital tractus, complicated of septic emboli typical.

  11. Toxic-shock syndrome, United States, 1970-1982.

    PubMed

    1982-04-30

    A total of 1660 cases of toxic shock syndrome (TSS) have been reported to the Centers for Disease Control as of April 9, 1982, 88 of which have resulted in death. Of the 1588 cases involving women, at least 92% had onset during a menstrual period. The age range for female patients was 1-64 years, with a mean of 22.9 and a median of 21 years. Of the 1355 cases in which the patient's race was known, 1315 occurred in white non-Hispanics. Although TSS cases have been reported by all 50 states and the District of Columbia, 35% have come from 3 states: Minnesota, California, and Wisconsin. 492 cases with onset in 1981 have been reported compared with 867 cases with 1980 onset. Nonmenstrual cases accounted for 15% of the reported cases with onset in 1981 compared with 6% of cases with onset before 1981. Nonmenstrual TSS has been seen following childbirth by vaginal delivery and cesarean section and in association with induced abortion, infected surgical wounds, hydradenitis, lymphadenitis, deep abscesses, and infected cutaneous and subcutaneous lesions. This increase in the proportion of cases unassociated with menstruation is largely due to the decrease in the number of menstrual TSS cases reported. Factors that may have contributed to the decline in reported TSS cases since the summer and early fall of 1980 include changes in the number of tampon users, in the way in which women use tampons, in the availability and frequency of use of different brands of tampons, or in the rate of vaginal carriage of strains of Staphylococcus aureus capable of causing TSS. Increased recognition of the disease, waning media publicity, variable activity of state and local health department surveillance programs, changes in referral patterns, and changes in the treatment of TSS also may have affected the reporting of TSS. All suspected cases of TSS should be reported promptly to the state health department, and women should be advised to remove their tampons and seek medical attention if

  12. Dengue haemorrhagic fever/dengue shock syndrome: lessons from the Cuban epidemic, 1981.

    PubMed Central

    Kouri, G. P.; Guzmán, M. G.; Bravo, J. R.; Triana, C.

    1989-01-01

    Dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) is one of the principal causes of hospitalization and death among children in several south-east Asian countries. Also, in the Region of the Americas, there has been an increase in the frequency of dengue fever epidemics and in the number of cases of DHF/DSS. In 1981 an epidemic of dengue haemorrhagic fever occurred in Cuba and this suggests that there is a high risk that such epidemics could recur in the region. The article summarizes the main clinical, virological, and epidemiological data obtained during the outbreak, some of which are reported for the first time. PMID:2805215

  13. Dengue haemorrhagic fever/dengue shock syndrome: lessons from the Cuban epidemic, 1981.

    PubMed

    Kouri, G P; Guzmán, M G; Bravo, J R; Triana, C

    1989-01-01

    Dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) is one of the principal causes of hospitalization and death among children in several south-east Asian countries. Also, in the Region of the Americas, there has been an increase in the frequency of dengue fever epidemics and in the number of cases of DHF/DSS. In 1981 an epidemic of dengue haemorrhagic fever occurred in Cuba and this suggests that there is a high risk that such epidemics could recur in the region. The article summarizes the main clinical, virological, and epidemiological data obtained during the outbreak, some of which are reported for the first time.

  14. Toxic shock and Down syndromes in a dental patient: a case report and review of the literature.

    PubMed

    Navazesh, M; Mulligan, R; Sobel, S

    1994-01-01

    A literature review of Toxic Shock Syndrome is presented, including epidemiology, etiology, signs, symptoms and management, and its relationship to infection susceptibility in the Down Syndrome patient. A case of a Down Syndrome patient with Toxic Shock Syndrome is described, and the role of odontogenic infection is discussed.

  15. Toxic shock syndrome: clinical and laboratory findings in 30 patients.

    PubMed Central

    Chow, A. W.; Wong, C. K.; MacFarlane, A. M.; Bartlett, K. H.

    1984-01-01

    Thirty patients with toxic shock syndrome (TSS) that developed between May 1980 and March 1983 in Vancouver were studied prospectively. In the 15 cases related to menstruation the illness followed a uniform and predictable clinical course. In the 15 other cases (3 in males) the disease was not related to menstruation, and the sources of the Staphylococcus aureus infections were diverse; 67% were hospital-acquired. Profound but transient lymphocytopenia associated with marked leukocytosis was the most striking laboratory finding and one not previously emphasized in the literature. S. aureus was isolated from sites of soft-tissue infection, the vagina or the endocervix in all except one case. Two patients had bacteremia. Phage types 29 and 29 + predominated among the isolates tested. All the genital S. aureus isolates tested produced the TSS marker protein, while the bacteria from wounds, throat, nose and blood were sometimes positive. Two patients (7%) died from refractory shock and multiple organ failure. All patients with a febrile, exanthematous, multisystem illness, particularly if it is associated with menstruation or a staphylococcal infection, should be evaluated promptly and treated empirically for TSS. Images FIG. 1 FIG. 2 PMID:6692240

  16. Dengue haemorrhagic fever and the dengue shock syndrome in India.

    PubMed

    Lall, R; Dhanda, V

    1996-01-01

    The clinical spectrum of dengue fever ranges from asymptomatic infection through severe haemorrhage and sudden fatal shock. Increased capillary permeability is the diagnostic feature of dengue haemorrhagic fever (DHF). The pathophysiology of DHF/dengue shock syndrome (DSS) is related to sequential infection with different serotypes of the virus, variations in virus virulence, interaction of the virus with environmental or host factors and a combination of various risk factors. Infection due to low virulence strains is assumed to be the reason for the infrequent incidence of serious dengue disease in India. Since all four serotypes of the dengue virus have been implicated in various outbreaks in this country and several outbreaks of DHF/DSS have been recorded since the first report in 1963, further epidemics of the disease are likely. The situation is aggravated by the recent emergence of DHF/DSS in Sri Lanka. In view of the potential of this disease to spread, effective preventive and control measures should be a priority.

  17. Culture Shock: What Problems in Acculturation Can Occur in a New Society?

    ERIC Educational Resources Information Center

    Katcher, Roberta

    Personal experiences illustrating the psychological phenomenon of "culture shock" are integrated with a discussion of the pedagogic significance of the process of acculturation. Problems encountered in acculturation processes appear to be particularly significant for teachers of English-as-a-second-language, and practical suggestions for improving…

  18. A confirmed case of toxic shock syndrome associated with the use of a menstrual cup

    PubMed Central

    Mitchell, Michael A; Bisch, Steve; Arntfield, Shannon; Hosseini-Moghaddam, Seyed M

    2015-01-01

    Menstrual cups have been reported to be an acceptable substitute for tampons. These flexible cups have also been reported to provide a sustainable solution to menstrual management, with modest cost savings and no significant health risk. The present article documents the first case of toxic shock syndrome associated with the use of a menstrual cup in a woman 37 years of age, using a menstrual cup for the first time. Toxic shock syndrome and the literature on menstrual cups is reviewed and a possible mechanism for the development of toxic shock syndrome in the patient is described. PMID:26361491

  19. Kawasaki shock syndrome complicating a recurrence of Kawasaki disease.

    PubMed

    Tissandier, Côme; Lang, Matthieu; Lusson, Jean René; Bœuf, Benoit; Merlin, Etienne; Dauphin, Claire

    2014-12-01

    We describe a case of recurrent Kawasaki disease (KD) in a non-Asian 6-year-old boy who had been diagnosed with typical KD without cardiac involvement at age 3 years. He was admitted to the PICU 3 years later for heart failure, hypotension, and deterioration of his general condition. Ultrasonography revealed left ventricular dysfunction with a 44% ejection fraction and grade I mitral valve failure without coronary artery involvement. Subsequent observation of hyperemic conjunctiva, bilateral cervical adenopathies with erythematous skin (normal neck ultrasound and computed axial tomography findings), peeling of the fingertips at day 8 of the illness, and occurrence of an inflammatory syndrome led to a diagnosis of incomplete recurrent KD with a clinical picture of Kawasaki shock syndrome (KSS). Clinical improvement was rapidly obtained after intravenous immunoglobulin and intravenous corticosteroid therapy (30 mg/kg per day for 3 subsequent days). Left ventricular function gradually improved, with ultrasound returning to normal after 3 months. Diagnosis was difficult to establish because of the recurrence of the disease and the incomplete clinical picture, with clinical features of KSS. Physicians need to be aware of these pitfalls in the management of patients with clinical signs of KD. PMID:25384485

  20. A rabbit model of toxic shock syndrome that uses a constant, subcutaneous infusion of toxic shock syndrome toxin 1.

    PubMed

    Parsonnet, J; Gillis, Z A; Richter, A G; Pier, G B

    1987-05-01

    We have developed a rabbit model of toxic shock syndrome that uses a subcutaneous infusion pump to administer toxic shock syndrome toxin 1 (TSST-1). A dose of 150 micrograms, infused at a constant rate over a period of 7 days, resulted in a characteristic illness highlighted by fever, conjunctival hyperemia, cachexia, and lethargy. The illness was uniformly fatal, with a mean interval until death of 3.2 +/- 0.4 days. Serial determinations of serum chemistries confirmed the multisystem nature of this illness. Rabbits developed profound hypocalcemia, with levels falling from 15.5 +/- 0.2 to 7.6 +/- 0.4 mg/dl under the influence of TSST-1. Blood urea nitrogen and creatinine rose dramatically, in the setting of oliguria or anuria. Serum glutamicpyruvic transaminase was the most reliable indicator of hepatic dysfunction, with the mean rising from 48 U/liter before administration of TSST-1 to 546 U/liter among rabbits surviving 2 days of the infusion. Creatine phosphokinase also rose dramatically in 10 of 16 rabbits. Rabbits demonstrated relative neutrophilia and lymphopenia as well as an increase in the partial thromboplastin time. Histopathologic examination demonstrated disease of multiple organs, particularly the liver, spleen, and lymph nodes, all of which demonstrated inflammation, thrombosis, hemorrhage, and erythrophagocytosis. The concurrent administration of prednisolone with TSST-1 prevented death in four of four rabbits and greatly lessened the morbidity. Rabbits were not protected from morbidity or mortality by the concurrent administration of polymyxin B. We believe that a constant, subcutaneous infusion of TSST-1 in rabbits provides a reproducible model for studying the pathogenesis of TSS.

  1. Dengue shock syndrome in an American traveler with primary dengue 3 infection.

    PubMed

    Morens, D M; Sather, G E; Gubler, D J; Rammohan, M; Woodall, J P

    1987-03-01

    A previously reported case of childhood dengue shock syndrome in an American traveler to India was investigated serologically. The original studies neither indicated the infecting serotype nor proved primary or secondary infection. However, BHK suspension PRNT of 6-year convalescent serum now indicates that the child had primary dengue type 3 infection. Dengue, dengue hemorrhagic fever, and dengue shock syndrome are potential hazards for American travelers and American residents of dengue-receptive areas.

  2. Possible toxic shock syndrome in an 18-year-old girl. A case report.

    PubMed

    Labuschagne, G P; Du Toit, P W; Venter, P F

    1982-07-01

    An 18-year-old girl with fulminating disease and severe shock consistent with toxic shock syndrome, which resulted in multiple organ failure and death, is described. This very serious condition, which has a mortality rate of 10-15%, is discussed.

  3. Streptococcus suis toxic-shock syndrome and meningitis.

    PubMed

    Leelarasamee, A; Nilakul, C; Tien-Grim, S; Srifuengfung, S; Susaengrat, W

    1997-01-01

    Three cases with S. suis bacteremia and meningitis were reported. The first case was a 23-year-old butcher who was a regular drinker of alcohol for two years and developed streptococcal toxic-shock syndrome. The organism was transmitted to him through a minor cut in his right arm. The second cases was a 49-year-old female laborer who had been consuming locally produced alcohol for 20 years and developed fever and meningitis. Unfortunately, she succumbed in seven days despite intensive supportive and cefotaxime treatments. The third case was a 45-year-old regular alcoholic drinker and car painter who was seen at a private hospital due to contusion at his left lateral chest wall. However, fever and confusion due to meningitis was detected upon admission. Irreversible deafness developed within 48 hours of ceftriaxone therapy for meningitis. He finally recovered with deafness. S. suis was isolated from blood and cerebrospinal fluid cultures in all three cases though initially reported to be viridans group of streptococci.

  4. Management of dengue shock syndrome. A prospective study.

    PubMed

    Tjandra, H

    1991-01-01

    Since dengue hemorrhagic fever (DHF) was first reported 20 years ago, the only serious variant of the disease, dengue shock syndrome (DSS), still continues to cause a relatively high mortality. An effective yet simple management of DSS which can be carried out in every hospital is certainly necessary if the dead toll is to be reduced. Prospective study of a simple procedure in managing DSS patients in Bhayangkara Police Hospital Kediri is reported. Depends on the severity of the disease, for DHF grade III: 30 ml/kg bw Lactated-Ringer solution was given at free rate. This is followed by 20 ml/kg bw of synthetic plasma expander (Expafusin) in a rate of thrice the body weight and continued with lactated-ringer and 5% dextrose in 1/2 Saline alternately with a rate of twice the body weight per minute for the remaining first 24 hours. For DHF grade IV, the same fluids were given, except for the amount and the infusion rate. Drugs administered and medical care were all the same for both groups. A close observation, a critical assessment, and an accurate as well as a rapid action are very important factors. Totally there were 115 patients of which 8 died. The mortality rate was 7%. A better management and/or treatment has to be developed to further reduce the mortality.

  5. Sulphoraphane, a naturally occurring isothiocyanate induces apoptosis in breast cancer cells by targeting heat shock proteins

    SciTech Connect

    Sarkar, Ruma; Mukherjee, Sutapa; Biswas, Jaydip; Roy, Madhumita

    2012-10-12

    Highlights: Black-Right-Pointing-Pointer HSPs (27, 70 and 90) and HSF1 are overexpressed in MCF-7 and MDA-MB-231 cells. Black-Right-Pointing-Pointer Sulphoraphane, a natural isothiocyanate inhibited HSPs and HSF1 expressions. Black-Right-Pointing-Pointer Inhibition of HSPs and HSF1 lead to regulation of apoptotic proteins. Black-Right-Pointing-Pointer Alteration of apoptotic proteins activate of caspases particularly caspase 3 and 9 leading to induction of apoptosis. Black-Right-Pointing-Pointer Alteration of apoptotic proteins induce caspases leading to induction of apoptosis. -- Abstract: Heat shock proteins (HSPs) are involved in protein folding, aggregation, transport and/or stabilization by acting as a molecular chaperone, leading to inhibition of apoptosis by both caspase dependent and/or independent pathways. HSPs are overexpressed in a wide range of human cancers and are implicated in tumor cell proliferation, differentiation, invasion and metastasis. HSPs particularly 27, 70, 90 and the transcription factor heat shock factor1 (HSF1) play key roles in the etiology of breast cancer and can be considered as potential therapeutic target. The present study was designed to investigate the role of sulphoraphane, a natural isothiocyanate on HSPs (27, 70, 90) and HSF1 in two different breast cancer cell lines MCF-7 and MDA-MB-231 cells expressing wild type and mutated p53 respectively, vis-a-vis in normal breast epithelial cell line MCF-12F. It was furthermore investigated whether modulation of HSPs and HSF1 could induce apoptosis in these cells by altering the expressions of p53, p21 and some apoptotic proteins like Bcl-2, Bax, Bid, Bad, Apaf-1 and AIF. Sulphoraphane was found to down-regulate the expressions of HSP70, 90 and HSF1, though the effect on HSP27 was not pronounced. Consequences of HSP inhibition was upregulation of p21 irrespective of p53 status. Bax, Bad, Apaf-1, AIF were upregulated followed by down-regulation of Bcl-2 and this effect was prominent

  6. Plantar Purpura as the Initial Presentation of Viridians Streptococcal Shock Syndrome Secondary to Streptococcus gordonii Bacteremia

    PubMed Central

    Liao, Chen-Yi; Su, Kuan-Jen; Lin, Cheng-Hui; Huang, Shu-Fang; Chin, Hsien-Kuo; Chang, Chin-Wen; Kuo, Wu-Hsien; Ben, Ren-Jy; Yeh, Yen-Cheng

    2016-01-01

    Viridians streptococcal shock syndrome is a subtype of toxic shock syndrome. Frequently, the diagnosis is missed initially because the clinical features are nonspecific. However, it is a rapidly progressive disease, manifested by hypotension, rash, palmar desquamation, and acute respiratory distress syndrome within a short period. The disease course is generally fulminant and rarely presents initially as a purpura over the plantar region. We present a case of a 54-year-old female hospital worker diagnosed with viridians streptococcal shock syndrome caused by Streptococcus gordonii. Despite aggressive antibiotic treatment, fluid hydration, and use of inotropes and extracorporeal membrane oxygenation, the patient succumbed to the disease. Early diagnosis of the potentially fatal disease followed by a prompt antibiotic regimen and appropriate use of steroids are cornerstones in the management of this disease to reduce the risk of high morbidity and mortality. PMID:27366188

  7. Comment on "Electrostatic compressive and rarefactive shocks and solitons in relativistic plasmas occurring in polar regions of pulsar"

    NASA Astrophysics Data System (ADS)

    Hafez, M. G.; Talukder, M. R.; Hossain Ali, M.

    2016-05-01

    The aim of this comment is to show the solution of the KdVB equation used by Shah et al. (Astrophys. Space Sci. 335:529-537, 2011, doi: 10.1007/s10509-011-0766-y) is not correct. So, the numerical results that are predicted in this manuscript should not be helpful for further investigations in a plasma laboratory. For this reason, we have employed the Bernoulli's equation method to obtain the correct form of analytical solution to this equation, which is appropriate for the study of electrostatic compressive and rarefactive shocks and solitons in relativistic plasmas occurring in polar regions of pulsar.

  8. Shock

    MedlinePlus

    ... several kinds of shock. Hypovolemic shock happens when you lose a lot of blood or fluids. Causes include internal or external bleeding, dehydration, burns, and severe vomiting and/or diarrhea. Septic shock is caused by ...

  9. Abdominal Compartment Syndrome and Necrotizing Pancreatitis Following Extracorporeal Shock Wave Lithotripsy.

    PubMed

    Gupta, S; Scambia, J; Gandillon, C; Aversano, F; Batista, R

    2016-09-01

    Extracorporeal shock wave lithotripsy (ESWL) is a common procedure in the treatment of renal calculi. There have been major complications reported with ESWL such as acute pancreatitis, bower perforation, venous thrombosis, and biliary obstruction. There are few reports in the literature of necrotizing pancreatitis secondary to ESWL. We have a case report of a 29-year-old female that developed an abdominal compartment syndrome with an acute necrotizing pancreatitis hours after extracorporeal shock wave lithotripsy. PMID:27462545

  10. Complete Genome Sequence of Streptococcus mitis Strain SVGS_061 Isolated from a Neutropenic Patient with Viridans Group Streptococcal Shock Syndrome

    PubMed Central

    Petrosyan, Varduhi; Holder, Michael; Ajami, Nadim J.; Petrosino, Joseph F.; Sahasrabhojane, Pranoti; Thompson, Erika J.; Kalia, Awdhesh

    2016-01-01

    Streptococcus mitis frequently causes invasive infections in neutropenic cancer patients, with a subset of patients developing viridans group streptococcal (VGS) shock syndrome. We report here the first complete genome sequence of S. mitis strain SVGS_061, which caused VGS shock syndrome, to help elucidate the pathogenesis of severe VGS infection. PMID:27056234

  11. Toxic shock syndrome associated with TSST-1 producing coagulase-negative staphylococci.

    PubMed

    Kahler, R C; Boyce, J M; Bergdoll, M S; Lockwood, W R; Taylor, M R

    1986-11-01

    Coagulase-positive staphylococci have been isolated from more than 95% of cases of toxic shock syndrome (TSS). Toxic shock syndrome toxin-1 (TSST-1) is produced in more than 90% of cases. A case is described of recurrent TSS in which a coagulase-negative staphylococcus was isolated from the vagina and produced TSST-1. No coagulase-positive staphylococci were isolated. Coagulase-negative staphylococci should be considered as causative agents in cases of TSS. Assay for TSST-1 should be performed on coagulase-negative staphylococci obtained from the appropriate clinical sites if no coagulase-positive staphylococci are isolated.

  12. Streptococcal Toxic Shock Syndrome: Life Saving Role of Peritoneal Lavage and Drainage

    PubMed Central

    Yokoyama, Minako; Oyama, Fumie; Ito, Asami; Yokota, Megumi; Matsukura, Daisuke; Tsutsumi, Shinji; Kasai, Tomonori; Nitobe, Yohshiro; Morikawa, Akiko; Ozaki, Takashi; Yokoyama, Yoshihito

    2016-01-01

    PURPOSE We encountered a case where an infection with group A streptococcus (GAS; ie, Streptococcus pyogenes) initially caused primary peritonitis and then subsequently caused streptococcal toxic shock syndrome. The patient’s life was likely saved by an emergency laparotomy followed by extensive peritoneal lavage and drainage. CASE PRESENTATION A 40-year-old woman was admitted to the Emergency Department for lower abdominal pain and numbness in the extremities. She presented with systemic inflammatory response syndrome. An emergency laparotomy was performed, and ascites that resembled pus and general peritonitis were noted. Peritoneal lavage and drainage were performed, and GAS was isolated from peritoneal fluid. Gram staining of cervical polyp specimens revealed Gram-positive bacteria. CONCLUSIONS The patient was diagnosed with streptococcal toxic shock syndrome due to an ascending GAS infection originating from vagina. PMID:27579001

  13. Palmar-plantar hyperhidrosis occurring in a kindred with nail-patella syndrome.

    PubMed

    Pechman, K J; Bergfeld, W F

    1980-12-01

    Nail-patella syndrome (NPS) is an autosomal dominant genetic defect, which may be associated with, or closely linked to, the locus controlling palmar and plantar hyperhidrosis (HH). A clinical review of a family with NPS involving six generations was performed. Data were accumulated by personal examination and analysis of medical and family records for the trials characterizing NPS as well as the coincidence of HH. A family pedigree of each entity was constructed and the pedigree for HH was compared to the NPS pedigree. Thirty-three of sixty-eight members of the extended family were affected with NPS and nine members had HH. The NPS pedigree supported the previously known autosomal dominant mode of inheritance. The incidence of HH indicated a direct inheritance and occurred only in members affected with NPS. The pedigree provides evidence for concluding that HH occurred as a spontaneous mutation transmitted as an autosomal dominant trait closely linked to NPS or that HH represents a previous unrecognized associated disorder. PMID:7204680

  14. Heat shock proteins and chronic fatigue in primary Sjögren’s syndrome

    PubMed Central

    Bårdsen, Kjetil; Nilsen, Mari Mæland; Kvaløy, Jan Terje; Norheim, Katrine Brække; Jonsson, Grete

    2016-01-01

    Fatigue occurs frequently in patients with cancer, neurological diseases and chronic inflammatory diseases, but the biological mechanisms that lead to and regulate fatigue are largely unknown. When the innate immune system is activated, heat shock proteins (HSPs) are produced to protect cells. Some extracellular HSPs appear to recognize cellular targets in the brain, and we hypothesize that fatigue may be generated by specific HSPs signalling through neuronal or glial cells in the central nervous system. From a cohort of patients with primary Sjögren’s syndrome, 20 patients with high and 20 patients with low fatigue were selected. Fatigue was evaluated with a fatigue visual analogue scale. Plasma concentrations of HSP32, HSP60, HSP72 and HSP90α were measured and analysed to determine if there were associations with the level of fatigue. Plasma concentrations of HSP90α were significantly higher in patients with high fatigue compared with those with low fatigue, and there was a tendency to higher concentrations of HSP72 in patients with high fatigue compared with patients with low fatigue. There were no differences in concentrations of HSP32 and HSP60 between the high- and low-fatigue groups. Thus, extracellular HSPs, particularly HSP90α, may signal fatigue in chronic inflammation. This supports the hypothesis that fatigue is generated by cellular defence mechanisms. PMID:26921255

  15. Minocycline hypersensitivity syndrome with hypotension mimicking septic shock.

    PubMed

    Colvin, J H; Sheth, A P

    2001-01-01

    Minocycline is a semisynthetic tetracycline derivative that is often used in the treatment of acne vulgaris. A serious but rare adverse effect caused by minocycline therapy is a hypersensitivity syndrome (HS), consisting of fever, skin eruption, and internal organ involvement that begins within 8 weeks of therapy initiation. We report a case of minocycline HS with unique features, namely, associated hypotension, and a rebound of the cutaneous eruption upon discontinuation of systemic steroids.

  16. Toxic shock syndrome. Incidence and survival of Staphylococcus aureus in unused tampons.

    PubMed

    Skopek, A

    1982-07-24

    In a survey of 3912 unused tampons of the two leading Australian brands, all samples were found to be free from Staphylococcus aureus. Survival rates of a standard S. aureus strain and a strain isolated in the first reported Australian case of toxic shock syndrome were investigated, in parallel, in unused tampons of a brand associated with this particular case of illness. Despite the presence of nutrient in the inocula employed, the 10(6) populations of both strains were completely inactivated in 10 days. No significant difference was observed between the percentage survival of the strain isolated from a patient with toxic shock syndrome and the standard strain. In the presence of nutrient and serum, the 10(6) population of staphylococci was inactivated in 16 days.

  17. A case of osmotic demyelination syndrome occurred after the correction of severe hyponatraemia in hyperemesis gravidarum

    PubMed Central

    2014-01-01

    Background Osmotic demyelination syndrome (ODS) may be observed as a result of a rapid change in serum osmolarity, such as that induced by an overly rapid correction of serum sodium levels in hyponatraemic patients. Case presentation We describe the case of a 21-year-old woman who was hospitalized at week 10 of gestation because of severe hyperemesis. At admission the patient appeared restless and confused and severe hyponatraemia (serum sodium 107 mmol/L) and hypokalemia (serum potassium 1.1 mmol/L) were detected. Active and simultaneous correction of these imbalances led to an overly rapid increase of serum sodium levels (17 mmol/L in the first 24 hours). Isotonic saline solution was stopped and replaced by 5% dextrose solution infusion. However, the neurological alterations worsened and the radiological features were consistent with the diagnosis of extra-pontine ODS. Steroids were administered intravenously with progressive improvement of biochemical and clinical abnormalities. At the time of discharge, 20 days later, the patient was able to walk and eat autonomously with only minimal external support. Conclusions This report illustrates an unusual case of ODS, occurred after an excessive rate of correction of hyponatraemia obtained with isotonic saline infusion. Hypokaliemia and its active correction very likely played a crucial role in facilitating the onset of ODS. This interesting aspect will be explained in detail in the article. A more cautious and thoughtful correction of electrolyte alterations, would have probably prevented the onset of ODS in this patient. Physicians should be aware of the possibly fatal consequences that an exceedingly rapid change of serum osmolarity may have and should strictly follow the known safety measures in order to prevent it to occur. PMID:24725751

  18. Genetic mapping of a naturally occurring hereditary renal cancer syndrome in dogs

    PubMed Central

    Jónasdóttir, Thora J.; Mellersh, Cathryn S.; Moe, Lars; Heggebø, Ragna; Gamlem, Hans; Ostrander, Elaine A.; Lingaas, Frode

    2000-01-01

    Canine hereditary multifocal renal cystadenocarcinoma and nodular dermatofibrosis (RCND) is a rare, naturally occurring inherited cancer syndrome observed in dogs. Genetic linkage analysis of an RCND-informative pedigree has identified a linkage group flanking RCND (CHP14-C05.377-C05.414-FH2383-C05.771-[RCND-CPH18]-C02608-GLUT4-TP53-ZuBeCa6-AHT141-FH2140-FH2594) thus localizing the disease to a small region of canine chromosome 5. The closest marker, C02608, is linked to RCND with a recombination fraction (θ) of 0.016, supported by a logarithm of odds score of 16.7. C02608 and the adjacent linked markers map to a region of the canine genome corresponding to portions of human chromosomes 1p and 17p. A combination of linkage analysis and direct sequencing eliminate several likely candidate genes, including tuberous sclerosis 1 and 2 genes (TSC1 and TSC2) and the tumor suppressor gene TP53. These data suggest that RCND may be caused by a previously unidentified tumor suppressor gene and highlight the potential for canine genetics in the study of human disease predisposition. PMID:10759551

  19. Coagulation abnormalities in dengue hemorrhagic Fever: serial investigations in 167 Vietnamese children with Dengue shock syndrome.

    PubMed

    Wills, Bridget A; Oragui, Emmanuelle E; Stephens, Alick C; Daramola, Olufunmilayo A; Dung, Nguyen Minh; Loan, Ha Thi; Chau, Nguyen Vinh; Chambers, Mary; Stepniewska, Kasia; Farrar, Jeremy J; Levin, Michael

    2002-08-01

    The pathophysiological basis of hemorrhage in dengue infections remains poorly understood, despite the increasing global importance of these infections. A large prospective study of 167 Vietnamese children with dengue shock syndrome documented only minor prolongations of prothrombin and partial thromboplastin times but moderate to severe depression of plasma fibrinogen concentrations. A detailed study of 48 children revealed low plasma concentrations of the anticoagulant proteins C, S, and antithrombin III, which decreased with increasing severity of shock, probably because of capillary leakage. Concurrent increases in the levels of thrombomodulin, tissue factor, and plasminogen activator inhibitor type 1 (PAI-1) indicated increased production of these proteins. Thrombomodulin levels suggestive of endothelial activation correlated with increasing shock severity, whereas PAI-1 levels correlated with bleeding severity. Dengue virus can directly activate plasminogen in vitro. Rather than causing true disseminated intravascular coagulation, dengue infection may activate fibrinolysis primarily, degrading fibrinogen directly and prompting secondary activation of procoagulant homeostatic mechanisms.

  20. Immune reconstitution syndrome in a human immunodeficiency virus infected child due to giardiasis leading to shock.

    PubMed

    Nandy, Sneha; Shah, Ira

    2015-01-01

    Human immunodeficiency virus (HIV)-associated immune reconstitution inflammatory syndrome has been reported in association with tuberculosis, herpes zoster (shingles), Cryptococcus neoformans, Kaposi's sarcoma, Pneumocystis pneumonia, hepatitis B virus, hepatitis C virus, herpes simplex virus, Histoplasma capsulatum, human papillomavirus, and Cytomegalovirus. However, it has never been documented with giardiasis. We present a 7-year-old HIV infected girl who developed diarrhea and shock following the initiation of antiretroviral therapy, and her stool showed the presence of giardiasis. PMID:26985424

  1. Unusual staphylococcal toxic shock syndrome presenting as a scarlet-like fever.

    PubMed

    Andrey, D O; Ferry, T; Siegenthaler, N; Fletcher, C; Calmy, A; Lina, G; Emonet, S

    2015-11-01

    Diagnosis of nonmenstrual staphylococcal toxic shock syndrome (TSS) is often challenging. A female medical colleague had a rare entity, a staphylococcal pharyngitis complicated by TSS. The diagnosis was confirmed by isolation of tst-positive Staphylococcus aureus in throat culture and by identification of a specific Vβ2 expansion pattern of her T lymphocytes. Recent improvements in microbiology can be of great help for the diagnosis of nonmenstrual TSS.

  2. Toxic shock syndrome: incidence and geographic distribution from a hospital medical records reporting system.

    PubMed

    Miday, R K; Wilson, E R

    1988-05-01

    A large database of hospital records maintained by the Commission on Professional and Hospital Activities Professional Activity Study (CPHA-PAS) was used to estimate the temporal incidence and geographic distribution of toxic shock syndrome (TSS). The CPHA-PAS hospital-diagnosed incidence was 3.5 times the reported TSS incidence, with a gradual decrease over the time period 1981-83. Marked differences in the regional occurrence of cases may provide clues to the etiology of this complex disease.

  3. Unusual staphylococcal toxic shock syndrome presenting as a scarlet-like fever

    PubMed Central

    Andrey, D.O.; Ferry, T.; Siegenthaler, N.; Fletcher, C.; Calmy, A.; Lina, G.; Emonet, S.

    2015-01-01

    Diagnosis of nonmenstrual staphylococcal toxic shock syndrome (TSS) is often challenging. A female medical colleague had a rare entity, a staphylococcal pharyngitis complicated by TSS. The diagnosis was confirmed by isolation of tst-positive Staphylococcus aureus in throat culture and by identification of a specific Vβ2 expansion pattern of her T lymphocytes. Recent improvements in microbiology can be of great help for the diagnosis of nonmenstrual TSS. PMID:26543563

  4. Unusual staphylococcal toxic shock syndrome presenting as a scarlet-like fever.

    PubMed

    Andrey, D O; Ferry, T; Siegenthaler, N; Fletcher, C; Calmy, A; Lina, G; Emonet, S

    2015-11-01

    Diagnosis of nonmenstrual staphylococcal toxic shock syndrome (TSS) is often challenging. A female medical colleague had a rare entity, a staphylococcal pharyngitis complicated by TSS. The diagnosis was confirmed by isolation of tst-positive Staphylococcus aureus in throat culture and by identification of a specific Vβ2 expansion pattern of her T lymphocytes. Recent improvements in microbiology can be of great help for the diagnosis of nonmenstrual TSS. PMID:26543563

  5. Fluid replacement protection of rabbits challenged subcutaneous with toxic shock syndrome toxins.

    PubMed Central

    Lee, P K; Deringer, J R; Kreiswirth, B N; Novick, R P; Schlievert, P M

    1991-01-01

    Toxic shock syndrome toxin 1 (TSST-1) and streptococcal pyrogenic exotoxin A (SPE A) belong to a family of pyrogenic toxins produced by Staphylococcus aureus and Streptococcus pyogenes, respectively. Both toxins are responsible for causing toxic shock syndrome (TSS) and related illnesses, clinically characterized by multiorgan involvement. The most severe TSS symptom is acute hypotension and shock after the initial febrile response. In this study, we examined possible mechanisms of shock development in TSS, particularly the role of T-cell proliferation, endotoxin enhancement by toxins, and capillary leakage. American Dutch belted rabbits, with subcutaneously implanted miniosmotic pumps filled with either TSST-1 or SPE A, served as the animal model. For both TSST-1 and SPE A-treated rabbits, administration of cyclosporin A prevented toxin-induced T-cell proliferation but failed to protect the rabbits. Polymyxin B treatment of rabbits, to neutralize endogenous endotoxin, partially protected rabbits from challenge with either exotoxin; two of six rabbits survived on day 2 when treated with only TSST-1, whereas six of six animals survived after challenge with TSST-1 and polymyxin B. Similarly, with SPE A-treated rabbits, only 1 of 10 animals without polymyxin B treatment survived on day 8, but 4 of 6 rabbits survived on day 8 when given polymyxin B. Fluid replacement was successful in preventing lethality. Twelve of 14 rabbits survived when given TSST-1 with fluid, and all rabbits treated with SPE A and fluid survived. Finally, by using miniosmotic pumps, staphylococcal exfoliative toxin A and concanavalin A were administered to rabbits in an attempt to induce lethality. These two T-cell mitogens caused T-cell proliferation but failed to induce lethality in rabbits. The data suggest that toxin interactions causing vascular leakage and to some extent endotoxin enhancement are of major importance in development of hypotension and shock in TSS. It appears that T

  6. Rapid assay for detection of toxic shock syndrome toxin 1 from human sera.

    PubMed Central

    Miwa, K; Fukuyama, M; Kunitomo, T; Igarashi, H

    1994-01-01

    A noncompetitive enzyme-linked immunosorbent assay that enables the quantitation of toxic shock syndrome toxin 1 (TSST-1) to as little as 30 pg/ml and the detection of TSST-1 to 10 pg/ml in phosphate-buffered saline including 33% human serum or plasma was developed. It takes only 3 h to complete this assay after plate preparation. In this study, 64 human serum samples obtained from 30 patients with toxic shock syndrome or toxic shock syndrome-like symptoms were subjected to testing for the detection of TSST-1. With a cutoff level for TSST-1 of less than 100 pg/ml, 28 samples obtained from 12 patients were positive for TSST-1. The mean and maximum concentrations for these TSST-1-positive samples were 440 and 5,450 pg/ml, respectively. Of these 12 patients, 8 were Staphylococcus aureus culture positive, 3 were negative upon bacterial culturing, and 1 had no cultures done. PMID:8150970

  7. Clinical Audit of Gastrointestinal Conditions Occurring among Adults with Down Syndrome Attending a Specialist Clinic

    ERIC Educational Resources Information Center

    Wallace, Robyn A.

    2007-01-01

    Background: Adults with Down syndrome (DS) are predisposed to syndromic and environmental gastrointestinal conditions. Method: In a hospital-based clinic for adults with DS, a chart audit was conducted to assess the range and frequency of gastrointestinal conditions. Results: From January 2003 to March 2005, 57 patients attended the clinic,…

  8. C1-inhibitor substitution therapy in septic shock and in the vascular leak syndrome induced by high doses of interleukin-2.

    PubMed

    Hack, C E; Ogilvie, A C; Eisele, B; Eerenberg, A J; Wagstaff, J; Thijs, L G

    1993-01-01

    C1-inhibitor (C1-INH) is the major plasma inhibitor of the complement and contact systems. Activation of either system has been shown to occur in patients with septic shock and is associated with a poor outcome. Functional levels of C1-INH tend to be normal in septic patients although paradoxically this inhibitor is an acute phase protein. Moreover, levels of proteolytically inactivated C1-INH are increased in sepsis pointing to an increased turn-over. These observations suggest a relative deficiency of biologically active C1-INH in sepsis. Complement and contact activation have also been shown to occur in the vascular leak syndrome (VLS) induced by immunotherapy with the cytokine interleukin-2 (IL-2), which syndrome may be regarded as a human model for septic shock. The similarity between VLS and sepsis encompasses more than complement and contact activation since a number of other inflammatory mediators considered to play a role in the pathogenesis of septic shock, are also involved in the development of VLS. The role and the mechanisms of complement and contact activation in sepsis and in the VLS are reviewed in this paper. Initial results of intervention therapy with high doses of C1-INH in these syndromes are also reported. It is concluded that high doses of C1-INH can be safely administered to patients with septic shock or with the VLS and may attenuate complement and contact activation in these conditions. Double-blind controlled studies are needed to definitely proved these effects and to establish whether this treatment is able to reduce mortality and morbidity of these syndromes.

  9. Gastric cancer occurring in a patient with Plummer-Vinson syndrome: a case report.

    PubMed

    Kim, Ki-Han; Kim, Min-Chan; Jung, Ghap-Joong

    2005-11-28

    Plummer-Vinson syndrome (sideropenic dysphagia) is characterized by dysphagia due to an upper esophageal or hypopharyngeal web in patients with chronic iron deficiency anemia. The main cause of dysphagia is the presence of the web in the cervical esophagus, and abnormal motility of the pharynx or esophagus is also found to play a significant role in this condition. This syndrome is thought to be precancerous because squamous cell carcinoma of hypopharynx, oral cavity or esophagus takes place in 10% of those patients suffering from this malady, but it is even more unusual that Plummer-Vinson syndrome should be accompanied by gastric cancer. We have reported here a case of a 43-year-old woman with Plummer-Vinson syndrome who developed stomach cancer and recovered after a radical total gastrectomy with D2 nodal dissection.

  10. Gastric cancer occurring in a patient with Plummer-Vinson syndrome: A case report

    PubMed Central

    Kim, Ki-Han; Kim, Min-Chan; Jung, Ghap-Joong

    2005-01-01

    Plummer-Vinson syndrome (sideropenic dysphagia) is characterized by dysphagia due to an upper esophageal or hypopharyngeal web in patients with chronic iron deficiency anemia. The main cause of dysphagia is the presence of the web in the cervical esophagus, and abnormal motility of the pharynx or esophagus is also found to play a significant role in this condition. This syndrome is thought to be precancerous because squamous cell carcinoma of hypopharynx, oral cavity or esophagus takes place in 10% of those patients suffering from this malady, but it is even more unusual that Plummer-Vinson syndrome should be accompanied by gastric cancer. We have reported here a case of a 43-year-old woman with Plummer-Vinson syndrome who developed stomach cancer and recovered after a radical total gastrectomy with D2 nodal dissection. PMID:16437616

  11. Initial studies on the administration of C1-esterase inhibitor to patients with septic shock or with a vascular leak syndrome induced by interleukin-2 therapy.

    PubMed

    Hack, C E; Ogilvie, A C; Eisele, B; Jansen, P M; Wagstaff, J; Thijs, L G

    1994-01-01

    Activation of the complement and contact systems occur in patients with septic shock and is associated with a poor outcome. Activation of both systems is regulated by a common inhibitor, C1-esterase inhibitor (C1-Inh). Functional levels of C1-Inh are normal or slightly decreased in septic patients although this inhibitor is an acute phase protein. Moreover, an increased turn-over of C1-Inh in sepsis likely occurs since levels of proteolytically inactivated ("modified") C1-Inh are increased in this syndrome. One may therefore postulate that in sepsis there is a relative deficiency of C1-Inh. Here we will summarize our preliminary studies in 11 patients with septic shock, who received high doses of C1-Inh for up to 5 days. Activation of complement and contact systems also occurs in "a human model for septic shock" i.e., the vascular leak syndrome (VLS) induced by immunotherapy with the cytokine interleukin-2 (IL-2). The similarity between VLS and sepsis is not only reflected by similar patterns of complement and contact activation, but also by comparable hemodynamic and biochemical changes, and by the involvement of a number of other inflammatory mediators, such as the release of pro-inflammatory cytokines, and activation of coagulation and fibrinolysis and of neutrophils. Here we will also summarize our initial studies of the effect of C1-Inh administration to 6 patients with the VLS induced by IL-2. Our results indicate that high doses of C1-Inh can be safely administered to patients with septic shock or with the VLS, and may attenuate complement and contact activation in these conditions. Whether this therapy may reduce mortality and or morbidity of either syndrome has to be established by double-blind controlled studies.

  12. Effects of toxic shock syndrome Staphylococcus aureus, endotoxin and tampons in a mouse model.

    PubMed

    Tierno, P M; Malloy, V; Matias, J R; Hanna, B A

    1987-03-01

    Synthetic tampons and toxic shock syndrome toxin-one (TSST-1)-producing strains of Staphylococcus aureus have been linked to an increased incidence of toxic shock syndrome (TSS). While recent reports attempt to define the tampon connection as the creation of an optimal environment for the production of TSST-1, the role of other factors in disease expression in an animal model remain under investigation. To understand the role of tampons and bacteria, pools of Swiss mice were inoculated with permutations of effluents from TSS strains of S. aureus and Escherichia coli grown inside tampons. Depending on tampon brand, when all 3 factors were combined mortality ranged from 20-100%. In controls inoculated with single effluents, or effluents from growth in the presence of cotton, no deaths were observed. Likewise, when hairless mice were inoculated with exotoxin, endotoxin, and tampon leachables, mortality was 100%. In the absence of any 1 component, mortality ranged from 0-40%. Lethal toxicity can be the result of enhancement, since animal death in apparent shock was observed in all pools containing the 3 components, and in all pools containing effluents of TSS S. aureus and E. coli grown in the presence of synthetic tampons, but not in their absence. A retrospective analysis of fatal vs non-fatal TSS in humans supports the hypothesis of enhancement.

  13. A case report: locking because of cyclops syndrome occurring after partial rupture of the anterior cruciate ligament.

    PubMed

    Morizane, Kazuki; Takahashi, Toshiaki; Konishi, Fumihiko; Mori, Takahisa; Yamamoto, Haruyasu; Miura, Hiromasa

    2014-01-01

    There have been a few reports of cyclops syndrome following a partial rupture of the anterior cruciate ligament (ACL) without surgical reconstruction. We have reported for the first time a case of cyclops lesion with locking symptoms after partial rupture of the ACL. A 14-year-old girl twisted her right knee when landing after a jump while playing basketball, and locking symptoms of the knee appeared. Cyclops syndrome occurred because of a partial rupture of the posterolateral bundle of the ACL was diagnosed and removed as a lump by punch. After resection of the lesion, the locking symptom was no longer observed.

  14. Cardiogenic shock

    MedlinePlus

    Shock - cardiogenic ... electrical system of the heart (heart block) Cardiogenic shock occurs when the heart is unable to pump ... orthostatic hypotension) Weak (thready) pulse To diagnose cardiogenic shock, a catheter (tube) may be placed in the ...

  15. Intrauterine device infection causing concomitant streptococcal toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus bacteraemia.

    PubMed

    Wu, Carolyn M Yu; Noska, Amanda

    2016-01-01

    Intrauterine devices (IUDs) are rarely associated with serious infections. We report an unusual concomitant infection of group A Streptococcus (GAS) causing toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus associated with an IUD in a healthy 50-year-old patient. The IUD was subsequently removed and the patient recovered on the appropriate antibiotics. This case highlights the importance of clinicians' high index of suspicion of an IUD infection and prompt removal of the infected foreign body to obtain source control. PMID:26965406

  16. Bilateral Giant Coronary Artery Aneurysms Complicated by Acute Coronary Syndrome and Cardiogenic Shock.

    PubMed

    Chiu, Peter; Lynch, Donald; Jahanayar, Jama; Rogers, Ian S; Tremmel, Jennifer; Boyd, Jack

    2016-04-01

    Giant coronary aneurysms are rare. We present a 25-year-old woman with a known history of non-Kawasaki/nonatherosclerotic bilateral coronary aneurysms. She was transferred to our facility with acute coronary syndrome complicated by cardiogenic shock. Angiography demonstrated giant bilateral coronary aneurysms and complete occlusion of the left anterior descending (LAD) artery. Emergent coronary artery bypass grafting was performed. Coronary artery bypass grafting is the preferred approach for addressing giant coronary aneurysms. Intervention on the aneurysm varies in the literature. Aggressive revascularization is recommended in the non-Kawasaki/nonatherosclerotic aneurysm patient, and ligation should be performed in patients with thromboembolic phenomena. PMID:27000621

  17. Specific detection of the toxic shock syndrome toxin-1 gene using the polymerase chain reaction.

    PubMed

    Jaulhac, B; Prevost, G; Piemont, Y

    1991-08-01

    A rapid and specific assay for toxic shock syndrome toxin-1 gene (tst gene) detection in Staphylococcus aureus was developed using the polymerase chain reaction. A two-primer set and an oligonucleotide detection probe were synthesized. After 40 cycles of amplification, detection of a 160-bp amplified DNA fragment was carried out by agarose gel electrophoresis and Southern blot hybridization. This assay was sensitive since it was able to detect 1-10 bacteria. It was also specific since no amplification was documented with DNAs from enterotoxigenic S. aureus or Gram-negative bacteria devoid of the tst gene.

  18. A case of Lemierre's syndrome with septic shock and complicated parapneumonic effusions requiring intrapleural fibrinolysis.

    PubMed

    Croft, Daniel P; Philippo, Sean M; Prasad, Paritosh

    2015-01-01

    Lemierre's syndrome is a septic thrombophlebitis of the internal jugular vein, which can lead to severe systemic illness. We report a case of an otherwise healthy 26-year-old man who suffered from pharyngitis followed by septic shock requiring intubation and vasopressor support from Fusobacterium necrophorum bacteremia. The septic emboli to his lungs caused complicated bilateral parapneumonic effusions, which recurred after initial drainage. He required bilateral chest tubes and intrapleural tPA to successfully drain his effusions. His fever curve and overall condition improved with the resolution of his effusions and after a 33-day hospitalization, he recovered without significant disability. The severity of his illness and difficult to manage complicated parapneumonic effusions were the unique facets of this case. Using an evidence-based approach of tPA and DNase for complicated parapneumonic effusions in Lemierre's syndrome can be safe and effective. PMID:26744664

  19. Moyamoya syndrome occurred in a girl with an inactive systemic lupus erythematosus.

    PubMed

    Lee, Yun-Jin; Yeon, Gyu Min; Nam, Sang Ook; Kim, Su Yung

    2013-12-01

    We report the case of a 17-year-old Korean girl with systemic lupus erythematosus (SLE) who presented with sudden weakness of the right-sided extremities and dysarthria. Oral prednisolone was being taken to control SLE. Results of clinical and laboratory examinations did not show any evidence of antiphospholipid syndrome or thromboembolic disease nor SLE activity. Cerebral angiography showed stenosis of the left internal carotid artery and right anterior cerebral artery with accompanying collateral circulation (moyamoya vessels). After the patient underwent bypass surgery on the left side, she recovered from the neurological problems and did not experience any additional ischemic attack during the 14-month follow-up period. This case represents an unusual association between moyamoya syndrome and inactive SLE (inactive for a relatively long interval of 2 years) in a young girl.

  20. KCOT Occurring in Bilateral Maxillary Sinus in Non-Syndromic Patient

    PubMed Central

    Newaskar, Vilas; Rajmohan, Sushmita; Dashore, Dolly

    2016-01-01

    Odontogenic Keratocyst (OKC) also termed as Keratocystic Odontogenic Tumour (KCOT) (WHO 2005) is a pathology with unique behavior because of which it is under much scrutiny and continued study. The pathology usually presents itself commonly in mandible and less commonly in maxilla. The occurrence of KCOT in maxillary sinus is reported as rare and multiple occurrences are mostly associated along with the presence of Nevoid Basal Cell Carcinoma (NBCC) syndrome. Here, we present a rare case of bilateral Maxillary OKC involving maxillary sinuses, without the presence of NBCC syndrome. An interesting feature of this case is the presence of left upper third molar in ectopic position in maxillary sinus and a vertically impacted right third molar suggesting an origin from the dental lamina. PMID:27656578

  1. KCOT Occurring in Bilateral Maxillary Sinus in Non-Syndromic Patient.

    PubMed

    Newaskar, Vilas; Verma, Manish; Rajmohan, Sushmita; Dashore, Dolly

    2016-08-01

    Odontogenic Keratocyst (OKC) also termed as Keratocystic Odontogenic Tumour (KCOT) (WHO 2005) is a pathology with unique behavior because of which it is under much scrutiny and continued study. The pathology usually presents itself commonly in mandible and less commonly in maxilla. The occurrence of KCOT in maxillary sinus is reported as rare and multiple occurrences are mostly associated along with the presence of Nevoid Basal Cell Carcinoma (NBCC) syndrome. Here, we present a rare case of bilateral Maxillary OKC involving maxillary sinuses, without the presence of NBCC syndrome. An interesting feature of this case is the presence of left upper third molar in ectopic position in maxillary sinus and a vertically impacted right third molar suggesting an origin from the dental lamina. PMID:27656578

  2. Gastric cancer occurring in a patient with Plummer-Vinson syndrome: report of a case.

    PubMed

    Kitabayashi, K; Akiyama, T; Tomita, F; Saitoh, H; Kosaka, T; Kita, I; Takashima, S

    1998-01-01

    We report herein the unusual case of a 59-year-old woman with Plummer-Vinson syndrome who developed gastric cancer. The patient had a longstanding history of dysphagia and iron deficiency anemia, for which she had sporadically taken iron supplements that improved the dysphagia to some extent, but not completely. Owing to her tolerance of the dysphagia, she had not been taking iron supplements for the past 17 years. On admission, she was in fair nutritional condition and not anemic. Blood chemistry results were all normal, including the serum iron level. Gastrointestinal radiographic series demonstrated cervical esophageal webs and advanced gastric cancer. Her dysphagia was successfully treated by endoscopic bougienage through the webs, and a distal partial gastrectomy with nodal dissection was performed. Histology of the resected stomach revealed atrophic mucosal change and, by chance, an adenomatous lesion in addition to adenocarcinoma. Her postoperative course was uneventful and she is now well, without any signs of recurrence. Although Plummer-Vinson syndrome is known to be associated with upper alimentary tract cancers, gastric cancer is extremely rare. A discussion on the etiology of Plummer-Vinson syndrome and its link with potential carcinogenesis follows this case report.

  3. Protective effects of granulocyte colony-stimulating factor on endotoxin shock in mice with retrovirus-induced immunodeficiency syndrome.

    PubMed

    Toki, S; Hiromatsu, K; Aoki, Y; Makino, M; Yoshikai, Y

    1997-10-01

    Mice with retrovirus-induced murine acquired immunodeficiency syndrome (MAIDS) were hypersensitive to lipopolysaccharide (LPS)-induced lethal shock accompanied by marked elevations of systematic interleukin 1beta (IL-beta) and interferon gamma (IFN-gamma) after LPS challenge. Pretreatment with 10 microg of recombinant human granulocyte colony-stimulating factor (rhG-CSF) protected MAIDS mice from hypersensitivity to LPS-induced lethal shock and this protection was concomitant with suppression of IFN-gamma production.

  4. Clostridium sordellii as a Cause of Fatal Septic Shock in a Child with Hemolytic Uremic Syndrome

    PubMed Central

    Beyers, Rebekah; Baldwin, Michael

    2014-01-01

    Clostridium sordellii is a toxin producing ubiquitous gram-positive anaerobe, mainly associated with trauma, soft tissue skin infections, and gynecologic infection. We report a unique case of a new strain of Clostridium sordellii (not present in the Center for Disease Control (CDC) database) infection induced toxic shock syndrome in a previously healthy two-year-old male with colitis-related hemolytic uremic syndrome (HUS). The patient presented with dehydration, vomiting, and bloody diarrhea. He was transferred to the pediatric critical care unit (PICU) for initiation of peritoneal dialysis (PD). Due to increased edema and intolerance of PD, he was transitioned to hemodialysis through a femoral vascular catheter. He subsequently developed severe septic shock with persistent leukocytosis and hypotension, resulting in subsequent death. Stool culture confirmed Shiga toxin producing Escherichia coli 0157:H7. A blood culture was positively identified for Clostridium sordellii. Clostridium sordelli is rarely reported in children; to our knowledge this is the first case described in a pediatric patient with HUS. PMID:24891968

  5. Exercise-induced acute compartment syndrome in a young man, occurring after a short race

    PubMed Central

    Matar, Mousa; Vaitilingham, Siddharthan; Chalise, Shyam; Irooegbu, Nkem; Bang, Jane

    2016-01-01

    We describe a case of exercise-induced acute compartment syndrome (ACS) in a 23-year-old man who presented to his primary care physician 48 hours after he attempted to run a 5K race. He noticed searing pain in his left leg after the first half mile but had no other symptoms. He was referred to the emergency department and diagnosed with ACS, and a fasciotomy was done. A presentation of limb pain that is out of proportion to a known or suspected injury should prompt consideration of ACS. Early recognition and surgical management are essential to achieving the best possible outcome. PMID:27034546

  6. Refractory Toxic Shock-Like Syndrome from Streptococcus dysgalactiae ssp. equisimilis and Intravenous Immunoglobulin as Salvage Therapy: A Case Series.

    PubMed

    Islam, Marjan; Karter, Dennis; Altshuler, Jerry; Altshuler, Diana; Schwartz, David; Torregrossa, Gianluca

    2016-01-01

    Infections from Streptococcus dysgalactiae ssp. equisimilis (SDSE) can cause a wide variety of infections, ranging from mild cellulitis to invasive disease, such as endocarditis and streptococcal toxic shock-like syndrome (TSLS). Despite prompt and appropriate antibiotics, mortality rates associated with shock have remained exceedingly high, prompting the need for adjunctive therapy. IVIG has been proposed as a possible adjunct, given its ability to neutralize a wide variety of superantigens and modulate a dysregulated inflammatory response. We present the first reported cases of successful IVIG therapy for reversing shock in the treatment of SDSE TSLS. PMID:27597908

  7. Refractory Toxic Shock-Like Syndrome from Streptococcus dysgalactiae ssp. equisimilis and Intravenous Immunoglobulin as Salvage Therapy: A Case Series

    PubMed Central

    Karter, Dennis; Altshuler, Jerry; Altshuler, Diana; Schwartz, David; Torregrossa, Gianluca

    2016-01-01

    Infections from Streptococcus dysgalactiae ssp. equisimilis (SDSE) can cause a wide variety of infections, ranging from mild cellulitis to invasive disease, such as endocarditis and streptococcal toxic shock-like syndrome (TSLS). Despite prompt and appropriate antibiotics, mortality rates associated with shock have remained exceedingly high, prompting the need for adjunctive therapy. IVIG has been proposed as a possible adjunct, given its ability to neutralize a wide variety of superantigens and modulate a dysregulated inflammatory response. We present the first reported cases of successful IVIG therapy for reversing shock in the treatment of SDSE TSLS. PMID:27597908

  8. The use of recombinant activated factor VII for controlling life-threatening bleeding in Dengue Shock Syndrome.

    PubMed

    Chuansumrit, Ampaiwan; Tangnararatchakit, Kanchana; Lektakul, Yujinda; Pongthanapisith, Viroj; Nimjaroenniyom, Nuntaporn; Thanarattanakorn, Pattra; Wongchanchailert, Malai; Komwilaisak, Patcharee

    2004-06-01

    To report the use of recombinant activated factor VII (rFVIIa) in controlling life-threatening bleeding episodes in patients with grades III and IV Dengue Hemorrhagic Fever (DHF), also known as Dengue Shock Syndrome. Fifteen patients (seven boys, eight girls), whose median age was 8 years, were enrolled in the study. They were divided into two groups. Group 1 included nine patients, mainly grade III, waiting for platelet concentrate, and group 2 included six patients, mainly grade IV, who had already received platelet concentrate with unresponsiveness. A single dose or repeated doses of 100 microg/kg rFVIIa was/were given at intervals of 4 h according to the bleeding symptoms. The median times from the onset of bleeding to rFVIIa initiation were 6.5 and 29.8 h in groups 1 and 2, respectively. Each patient received one to three doses. An effective response was found in eight patients (53.3%), including six patients in group 1 and two patients in group 2. They had complete cessation of bleeding without recurrence for 48 h. An ineffective response was found in seven patients (46.7%) including three patients in group 1 and four patients in group 2 for which the bleeding recurred (n = 2), temporarily slowed down (n = 3), continued (n = 1) or occurred at a new site (n = 1). These included three patients in profound shock 24-48 h before referral to comprehensive treatment centers, two patients receiving ibuprofen before hospitalization, one patient with extensive volume overloading, and one patient requiring surgical intervention to ligate the torn intercostal artery and vein. The platelet concentrate was promptly transfused to stop bleeding in patients with ineffective responses. The results revealed that the earlier initiation of rFVIIa in the mainly grade III DHF in group 1 yielded a higher effective response (66.7%) than the delayed initiation in the mainly grade IV DHF in group 2 (33.3%). Moreover, patients previously receiving ibuprofen or volume expander of low

  9. Case of streptococcal toxic shock syndrome caused by rapidly progressive group A hemolytic streptococcal infection during postoperative chemotherapy for cervical cancer.

    PubMed

    Nogami, Yuya; Tsuji, Kousuke; Banno, Kouji; Umene, Kiyoko; Katakura, Satomi; Kisu, Iori; Tominaga, Eiichiro; Aoki, Daisuke

    2014-01-01

    Streptococcal toxic shock syndrome (STSS) is a severe infectious disease caused by group A hemolytic streptococcus (Streptococcus pyogenes). This condition is a serious disease that involves rapidly progressive septic shock. We experienced a case of STSS caused by primary peritonitis during treatment with paclitaxel and cisplatin (TP therapy) as postoperative chemotherapy for cervical cancer. STSS mostly develops after extremity pain, but initial influenza-like symptoms of fever, chill, myalgia and gastrointestinal symptoms may also occur. TP therapy is used to treat many cancers, including gynecological cancer, but may cause adverse reactions of neuropathy and nephrotoxicity and sometimes fever, arthralgia, myalgia, abdominal pain and general malaise. The case reported here indicates that development of STSS can be delayed after chemotherapy and that primary STSS symptoms may be overlooked because they may be viewed as adverse reactions to chemotherapy. To our knowledge, this is the first report of a case of STSS during chemotherapy. PMID:23937219

  10. Guillain-Barré syndrome: report of two rare clinical cases occurring after allergenic bone grafting in oral maxillofacial surgery

    PubMed Central

    Cicciù, Marco; Herford, Alan Scott; Bramanti, Ennio; Maiorana, Carlo

    2015-01-01

    Guillaine-Barré Syndrome (GBS), also known as post-infectious polyneuropathy or acute idiopathic polyneuritis, is an infrequent disorder of the peripheral nervous system. The cause of GBS is unknown. It has been associated in the past with microbial infections, vaccinations, surgical procedures and debilitation of the patient. The classic signs of GBS occurring in the two patients being reported here are muscle weakness, motor and sensory impairment and ascending paralysis with respiratory involvement. The documented cases involved GBS syndrome following oral and maxillofacial surgery in which allogeneic-banked freeze-dried bone have been utilized along with autogenous grafting. There were no incidents of viral infection, vaccination or the other prodromal incidents involved in these cases. It is believed that the description of these two cases would be of interest in that it may stimulate the reporting of similar anecdotal occurrences by other surgeons. Both patients fully recovered from the GBS and are presently alive and well. PMID:26261679

  11. Guillain-Barré syndrome: report of two rare clinical cases occurring after allergenic bone grafting in oral maxillofacial surgery.

    PubMed

    Cicciù, Marco; Herford, Alan Scott; Bramanti, Ennio; Maiorana, Carlo

    2015-01-01

    Guillaine-Barré Syndrome (GBS), also known as post-infectious polyneuropathy or acute idiopathic polyneuritis, is an infrequent disorder of the peripheral nervous system. The cause of GBS is unknown. It has been associated in the past with microbial infections, vaccinations, surgical procedures and debilitation of the patient. The classic signs of GBS occurring in the two patients being reported here are muscle weakness, motor and sensory impairment and ascending paralysis with respiratory involvement. The documented cases involved GBS syndrome following oral and maxillofacial surgery in which allogeneic-banked freeze-dried bone have been utilized along with autogenous grafting. There were no incidents of viral infection, vaccination or the other prodromal incidents involved in these cases. It is believed that the description of these two cases would be of interest in that it may stimulate the reporting of similar anecdotal occurrences by other surgeons. Both patients fully recovered from the GBS and are presently alive and well. PMID:26261679

  12. Ultrastructural findings in lymph nodes from pigs suffering from naturally occurring postweaning multisystemic wasting syndrome.

    PubMed

    Rodriguez-Cariño, C; Segalés, J

    2009-07-01

    The aims of this study were to evaluate ultrastructural lesions in lymph nodes from postweaning multisystemic wasting syndrome (PMWS)-affected pigs and to correlate these alterations with detection of viral-like particles (VLPs). Samples of lymph nodes were taken from 4 PMWS-affected pigs and 2 healthy animals and processed by transmission electron microscopy. Significant ultrastructural alterations were only noted in PMWS-affected pigs, mainly in histiocytes and rarely in other cell types. Histiocytes showed severe swelling and proliferation of mitochondria, and proliferation and dilation of rough endoplasmic reticulum and Golgi complex. Infected histiocytes contained large numbers of intracytoplasmic inclusion (ICI) bodies with VLPs; some histiocytes also had intranuclear inclusions (INIs). Small inclusions were surrounded by double membrane, with a granular appearance or containing paracrystalline arrays; icosahedral VLPs were 8-17 nm in diameter. Large ICIs were double-membrane bounded or not and contained VLPs usually forming paracrystalline arrays. ICIs were often found next to mitochondria with severe swelling, and also inside them. INIs were not surrounded by membranes and contained virions of 10-13 nm diameter. Lymphocyte depletion was a striking finding of lymph nodes from PMWS-affected pigs. The inclusion bodies containing VLPs referred to in the present study should be classified as viral factories, suggesting that viral replication is probably a frequent event in macrophages, in which mitochondria might play a role.

  13. Enterococcus faecalis inhibits superantigen toxic shock syndrome toxin-1-induced interleukin-8 from human vaginal epithelial cells through tetramic acids.

    PubMed

    Brosnahan, Amanda J; Merriman, Joseph A; Salgado-Pabón, Wilmara; Ford, Bradley; Schlievert, Patrick M

    2013-01-01

    The vaginal mucosa can be colonized by many bacteria including commensal organisms and potential pathogens, such as Staphylococcus aureus. Some strains of S. aureus produce the superantigen toxic shock syndrome toxin-1, which can penetrate the vaginal epithelium to cause toxic shock syndrome. We have observed that a female was mono-colonized with Enterococcus faecalis vaginally as tested in aerobic culture, even upon repeated culture for six months, suggesting this organism was negatively influencing colonization by other bacteria. In recent studies, we demonstrated an "outside-in" mechanism of cytokine signaling and consequent inflammation that facilitates the ability of potential pathogens to initiate infection from mucosal surfaces. Thus, we hypothesized that this strain of E. faecalis may make anti-inflammatory factors which block disease progression of more pathogenic organisms. E. faecalis MN1 inhibited interleukin-8 production from human vaginal epithelial cells in response to the vaginal pathogens Candida albicans, Gardnerella vaginalis, and Neisseria gonorrhoeae, as well as to toxic shock syndrome toxin-1. We further demonstrated that this organism secretes two tetramic acid compounds which appear responsible for inhibition of interleukin-8 production, as well as inhibition of T cell proliferation due to toxic shock syndrome toxin-1. Microbicides that include anti-inflammatory molecules, such as these tetramic acid compounds naturally produced by E. faecalis MN1, may be useful in prevention of diseases that develop from vaginal infections. PMID:23613823

  14. Fatal Case of Toxic Shock-Like Syndrome Due to Group C Streptococcus Associated with Superantigen Exotoxin

    PubMed Central

    Korman, Tony M.; Boers, Anthony; Gooding, Travis M.; Curtis, Nigel; Visvanathan, Kumar

    2004-01-01

    Group C streptococci have been reported to cause invasive disease similar to that classically associated with group A streptococcus (GAS). We describe a fatal case of toxic shock-like syndrome due to Streptococcus equi subsp. zooepidemicus. The causative organism did not possess any known GAS superantigen exotoxin genes but did show evidence of superantigen production. PMID:15184494

  15. Fumarate Hydratase-deficient Uterine Leiomyomas Occur in Both the Syndromic and Sporadic Settings.

    PubMed

    Harrison, Wesley J; Andrici, Juliana; Maclean, Fiona; Madadi-Ghahan, Raha; Farzin, Mahtab; Sioson, Loretta; Toon, Christopher W; Clarkson, Adele; Watson, Nicole; Pickett, Justine; Field, Michael; Crook, Ashley; Tucker, Katherine; Goodwin, Annabel; Anderson, Lyndal; Srinivasan, Bhuvana; Grossmann, Petr; Martinek, Petr; Ondič, Ondrej; Hes, Ondřej; Trpkov, Kiril; Clifton-Bligh, Roderick J; Dwight, Trisha; Gill, Anthony J

    2016-05-01

    Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome secondary to germline fumarate hydratase (FH) mutation presents with cutaneous and uterine leiomyomas, and a distinctive aggressive renal carcinoma. Identification of HLRCC patients presenting first with uterine leiomyomas may allow early intervention for renal carcinoma. We reviewed the morphology and immunohistochemical (IHC) findings in patients with uterine leiomyomas and confirmed or presumed HLRCC. IHC was also performed on a tissue microarray of unselected uterine leiomyomas and leiomyosarcomas. FH-deficient leiomyomas underwent Sanger and massively parallel sequencing on formalin-fixed paraffin-embedded tissue. All 5 patients with HLRCC had at least 1 FH-deficient leiomyoma: defined as completely negative FH staining with positive internal controls. One percent (12/1152) of unselected uterine leiomyomas but 0 of 88 leiomyosarcomas were FH deficient. FH-deficient leiomyoma patients were younger (42.7 vs. 48.8 y, P=0.024) and commonly demonstrated a distinctive hemangiopericytomatous vasculature. Other features reported to be associated with FH-deficient leiomyomas (hypercellularity, nuclear atypia, inclusion-like nucleoli, stromal edema) were inconstantly present. Somatic FH mutations were identified in 6 of 10 informative unselected FH-deficient leiomyomas. None of these mutations were found in the germline. We conclude that, while the great majority of patients with HLRCC will have FH-deficient leiomyomas, 1% of all uterine leiomyomas are FH deficient usually due to somatic inactivation. Although IHC screening for FH may have a role in confirming patients at high risk for hereditary disease before genetic testing, prospective identification of FH-deficient leiomyomas is of limited clinical benefit in screening unselected patients because of the relatively high incidence of somatic mutations.

  16. Guillain–Barré Syndrome (42 Cases) Occurring During a Zika Virus Outbreak in French Polynesia

    PubMed Central

    Watrin, Louise; Ghawché, Frédéric; Larre, Philippe; Neau, Jean-Philippe; Mathis, Stéphane; Fournier, Emmanuel

    2016-01-01

    Abstract Zika virus (transmitted by mosquitoes) reached French Polynesia for the first time in 2013, leading to an epidemic affecting 10% of the total population. So far, it has not been known to induce any neurological complications, but, a few weeks after the outbreak, an unexpectedly high number of 42 patients presented with Guillain–Barré syndrome. We report the clinical and electrophysiological characteristics of this series. Males predominated with a sex ratio of 2.82 (mean age: 46). All patients (except 2) were native Polynesian. At admission, 55% were able to walk unaided against 38% at nadir, 24% had swallowing troubles (nadir: 45%), 74% had motor weakness of the limbs (nadir: 86%) and deep tendon reflexes were diminished or not found in the vast majority of patients. Mean duration of the progressive phase and of the plateau phase was respectively 7 and 9 days. Thirty-eight percent of the patients were admitted in intensive care unit and 10 patients underwent tracheotomy. Nerve electrophysiological studies at admission showed marked distal motor conduction alterations, which had almost completely disappeared at the 4th month; this pattern was more suggestive of acute motor axonal neuropathy (AMAN) than of acute inflammatory demyelinating polyneuropathy (AIDP). Lumbar puncture showed elevated proteins in 90% of the cases, with cell count always inferior to 50/μL. This epidemic raises several questions, such as the potential existence of interactions between Zika virus and Polynesian HLA system and/or the consequences of several recombination events of this virus. This situation should call for increased vigilance, especially in countries where Aedes mosquitoes are present. PMID:27057874

  17. Guillain-Barré Syndrome (42 Cases) Occurring During a Zika Virus Outbreak in French Polynesia.

    PubMed

    Watrin, Louise; Ghawché, Frédéric; Larre, Philippe; Neau, Jean-Philippe; Mathis, Stéphane; Fournier, Emmanuel

    2016-04-01

    Zika virus (transmitted by mosquitoes) reached French Polynesia for the first time in 2013, leading to an epidemic affecting 10% of the total population. So far, it has not been known to induce any neurological complications, but, a few weeks after the outbreak, an unexpectedly high number of 42 patients presented with Guillain-Barré syndrome.We report the clinical and electrophysiological characteristics of this series. Males predominated with a sex ratio of 2.82 (mean age: 46). All patients (except 2) were native Polynesian. At admission, 55% were able to walk unaided against 38% at nadir, 24% had swallowing troubles (nadir: 45%), 74% had motor weakness of the limbs (nadir: 86%) and deep tendon reflexes were diminished or not found in the vast majority of patients. Mean duration of the progressive phase and of the plateau phase was respectively 7 and 9 days. Thirty-eight percent of the patients were admitted in intensive care unit and 10 patients underwent tracheotomy. Nerve electrophysiological studies at admission showed marked distal motor conduction alterations, which had almost completely disappeared at the 4th month; this pattern was more suggestive of acute motor axonal neuropathy (AMAN) than of acute inflammatory demyelinating polyneuropathy (AIDP). Lumbar puncture showed elevated proteins in 90% of the cases, with cell count always inferior to 50/μL.This epidemic raises several questions, such as the potential existence of interactions between Zika virus and Polynesian HLA system and/or the consequences of several recombination events of this virus. This situation should call for increased vigilance, especially in countries where Aedes mosquitoes are present.

  18. Fumarate Hydratase–deficient Uterine Leiomyomas Occur in Both the Syndromic and Sporadic Settings

    PubMed Central

    Harrison, Wesley J.; Andrici, Juliana; Maclean, Fiona; Madadi-Ghahan, Raha; Farzin, Mahtab; Sioson, Loretta; Toon, Christopher W.; Clarkson, Adele; Watson, Nicole; Pickett, Justine; Field, Michael; Crook, Ashley; Tucker, Katherine; Goodwin, Annabel; Anderson, Lyndal; Srinivasan, Bhuvana; Grossmann, Petr; Martinek, Petr; Ondič, Ondrej; Hes, Ondřej; Trpkov, Kiril; Clifton-Bligh, Roderick J.; Dwight, Trisha

    2016-01-01

    Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome secondary to germline fumarate hydratase (FH) mutation presents with cutaneous and uterine leiomyomas, and a distinctive aggressive renal carcinoma. Identification of HLRCC patients presenting first with uterine leiomyomas may allow early intervention for renal carcinoma. We reviewed the morphology and immunohistochemical (IHC) findings in patients with uterine leiomyomas and confirmed or presumed HLRCC. IHC was also performed on a tissue microarray of unselected uterine leiomyomas and leiomyosarcomas. FH-deficient leiomyomas underwent Sanger and massively parallel sequencing on formalin-fixed paraffin-embedded tissue. All 5 patients with HLRCC had at least 1 FH-deficient leiomyoma: defined as completely negative FH staining with positive internal controls. One percent (12/1152) of unselected uterine leiomyomas but 0 of 88 leiomyosarcomas were FH deficient. FH-deficient leiomyoma patients were younger (42.7 vs. 48.8 y, P=0.024) and commonly demonstrated a distinctive hemangiopericytomatous vasculature. Other features reported to be associated with FH-deficient leiomyomas (hypercellularity, nuclear atypia, inclusion-like nucleoli, stromal edema) were inconstantly present. Somatic FH mutations were identified in 6 of 10 informative unselected FH-deficient leiomyomas. None of these mutations were found in the germline. We conclude that, while the great majority of patients with HLRCC will have FH-deficient leiomyomas, 1% of all uterine leiomyomas are FH deficient usually due to somatic inactivation. Although IHC screening for FH may have a role in confirming patients at high risk for hereditary disease before genetic testing, prospective identification of FH-deficient leiomyomas is of limited clinical benefit in screening unselected patients because of the relatively high incidence of somatic mutations. PMID:26574848

  19. Fumarate Hydratase-deficient Uterine Leiomyomas Occur in Both the Syndromic and Sporadic Settings.

    PubMed

    Harrison, Wesley J; Andrici, Juliana; Maclean, Fiona; Madadi-Ghahan, Raha; Farzin, Mahtab; Sioson, Loretta; Toon, Christopher W; Clarkson, Adele; Watson, Nicole; Pickett, Justine; Field, Michael; Crook, Ashley; Tucker, Katherine; Goodwin, Annabel; Anderson, Lyndal; Srinivasan, Bhuvana; Grossmann, Petr; Martinek, Petr; Ondič, Ondrej; Hes, Ondřej; Trpkov, Kiril; Clifton-Bligh, Roderick J; Dwight, Trisha; Gill, Anthony J

    2016-05-01

    Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome secondary to germline fumarate hydratase (FH) mutation presents with cutaneous and uterine leiomyomas, and a distinctive aggressive renal carcinoma. Identification of HLRCC patients presenting first with uterine leiomyomas may allow early intervention for renal carcinoma. We reviewed the morphology and immunohistochemical (IHC) findings in patients with uterine leiomyomas and confirmed or presumed HLRCC. IHC was also performed on a tissue microarray of unselected uterine leiomyomas and leiomyosarcomas. FH-deficient leiomyomas underwent Sanger and massively parallel sequencing on formalin-fixed paraffin-embedded tissue. All 5 patients with HLRCC had at least 1 FH-deficient leiomyoma: defined as completely negative FH staining with positive internal controls. One percent (12/1152) of unselected uterine leiomyomas but 0 of 88 leiomyosarcomas were FH deficient. FH-deficient leiomyoma patients were younger (42.7 vs. 48.8 y, P=0.024) and commonly demonstrated a distinctive hemangiopericytomatous vasculature. Other features reported to be associated with FH-deficient leiomyomas (hypercellularity, nuclear atypia, inclusion-like nucleoli, stromal edema) were inconstantly present. Somatic FH mutations were identified in 6 of 10 informative unselected FH-deficient leiomyomas. None of these mutations were found in the germline. We conclude that, while the great majority of patients with HLRCC will have FH-deficient leiomyomas, 1% of all uterine leiomyomas are FH deficient usually due to somatic inactivation. Although IHC screening for FH may have a role in confirming patients at high risk for hereditary disease before genetic testing, prospective identification of FH-deficient leiomyomas is of limited clinical benefit in screening unselected patients because of the relatively high incidence of somatic mutations. PMID:26574848

  20. Dye labelled monoclonal antibody assay for detection of Toxic Shock Syndrome Toxin -1 from Staphylococcus aureus

    PubMed Central

    Javid, Khojasteh V; Foster, HA

    2011-01-01

    Objective The aim of study was to develop a rapid assay, dye labelled monoclonal antibody assay (DLMAA), using non-radioactive organic synthetic dyes for identification of Toxic Shock Syndrome Toxin-1 (TSST-1) producing strains of Staphylococcus aureus. Materials and Methods The assay protocol required only two simple steps; addition of TSST-1 antigen to a nitrocellulose membrane and then adding a colloidal dye labelled antibody (D/A) suspension detection reagent. Results The sensitivity and specificity of the assay was determined relative to positive and negative strains compared to an ELISA assay. Overall 100% agreement was found between both assays. The sensitivity for detection of TSST-1 was 30 ng. Conclusion The DLMAA did not require handling and disposal of radioactive materials. It is a rapid qualitative technique for detection of TSST-1 toxin at room temperature within a short time. PMID:22530084

  1. Postoperative toxic shock syndrome after excision of a ganglion cyst from the ankle.

    PubMed

    Strenge, K Brandon; Mangan, Douglas B; Idusuyi, O B

    2006-01-01

    Postoperative toxic shock syndrome (PTSS) after orthopedic surgery is rare, but early recognition and prompt intervention are essential to minimize morbidity and potential mortality. The diagnosis should be considered in all postoperative patients presenting with fever, hypotension, and systemic illness. The treating surgeon must have not only knowledge of the clinical entity, but also an extremely high index of suspicion, because the diagnosis can be elusive with surgical wounds appearing deceptively benign. Treatment consists of antibiotics, surgical wound debridement, and, more importantly, aggressive supportive care with intravenous fluids and intensive care surveillance. To date, the literature contains relatively few case reports of PTSS after orthopedic procedures, with even fewer cases encountered after foot and ankle surgery. This report describes a patient who developed the rare complication of PTSS after an elective ganglion cyst excision from the ankle. PMID:16818157

  2. Relatedness of Streptococcus canis from canine streptococcal toxic shock syndrome and necrotizing fasciitis.

    PubMed Central

    DeWinter, L M; Prescott, J F

    1999-01-01

    The emergence of streptococcal toxic shock syndrome (STSS) and necrotizing fasciitis (NF) in dogs caused by Streptococcus canis has been reported by our laboratory. Since clonal expansion is thought to be partially responsible for the spread of invasive strains of Streptococcus pyogenes in humans, the relatedness of 15 isolates of S. canis from canine STSS and/or NF was examined using pulsed field gel electrophoresis and biotyping; production of proteases and of a CAMP-like reaction were also examined. Only 2 of the 15 STSS and/or NF isolates were clonally related, suggesting that the emergence of canine STSS/NF is not the result of clonal expansion of one or more highly virulent strains of S. canis. All of the isolates produced proteases and demonstrated a CAMP-like reaction, which appear to be additional characteristics of S. canis. PMID:10369564

  3. Dengue haemorrhagic fever and dengue shock syndrome: are they tumour necrosis factor-mediated disorders?

    PubMed

    Yadav, M; Kamath, K R; Iyngkaran, N; Sinniah, M

    1991-12-01

    A consecutive series of 24 patients with clinical features of primary dengue infection and 22 controls (14 patients with viral fever of unknown origin and 8 healthy subjects) were assayed for serum levels of tumour necrosis factor (TNF). The acute sera of the 24 patients with clinical dengue infection were positive for dengue virus-specific IgM antibody. Clinically, 8 had dengue fever (DF), 14 dengue haemorrhagic fever (DHF) and 2 dengue shock syndrome (DSS). All 16 patients with DHF/DSS had significantly elevated serum TNF levels but the 8 DF patients had TNF levels equivalent to that in the 22 controls. A case is made for augmented TNF production having a role for the pathophysiological changes observed in DHF/DSS and mediator modulation as a possible therapeutic approach to treatment.

  4. Effect of environmental conditions on production of toxic shock syndrome toxin 1 by Staphylococcus aureus.

    PubMed Central

    Wong, A C; Bergdoll, M S

    1990-01-01

    The kinetics of toxic shock syndrome toxin 1 (TSST-1) production by Staphylococcus aureus was studied in a fermentor in which aeration rate, atmospheric composition, pH, and temperature were controlled. The toxin was synthesized at a maximal rate during the exponential phase. High bacterial populations were not necessarily accompanied by high TSST-1 yields. Aerobiosis increased TSST-1 production, but excessive aeration had an adverse effect. Addition of CO2 enhanced TSST-1 yield by increasing toxin production rate and efficiency. Cultures with no pH control made more TSST-1 than those maintained at pH 5.5 to 7.5. Maximum TSST-1 yields were obtained when cultures were supplied with air (20 cm3/min) and CO2 (5 cm3/min) via a sintered glass sparger. PMID:2108084

  5. Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device.

    PubMed

    Gollwitzer, Hans; Diehl, Peter; von Korff, Alexej; Rahlfs, Volker W; Gerdesmeyer, Ludger

    2007-01-01

    Published data describing the efficacy of extracorporeal shock wave therapy for the treatment of plantar heel pain provide conflicting results, and optimal treatment guidelines are yet to be determined. To assess the efficacy and safety of extracorporeal shockwave therapy compared with placebo in the treatment of chronic painful heel syndrome with a new electromagnetic device, we undertook a prospective, double-blind, randomized, placebo-controlled trial conducted among 40 participants who were randomly allocated to either active, focused extracorporeal shockwave therapy (0.25 mJ/mm(2)) or sham shockwave therapy. Both groups received 3 applications of 2000 shockwave impulses, each session 1 week apart. The primary outcome was the change in composite heel pain (morning pain, pain with activities of daily living, and pain upon application of pressure with a focal force meter) as quantified using a visual analog pain scale at 12 weeks after completion of the interventions compared with baseline. Secondary endpoints included changes in morning pain, pain with activities of daily living, and pain upon application of pressure with a focal force meter, as measured on a visual analog pain scale, as well as the change in the Roles and Maudsley score, at 12 weeks after the baseline measurement. Active extracorporeal shockwave therapy resulted in a 73.2% reduction in composite heel pain, and this was a 32.7% greater reduction than that achieved with placebo. The difference was not statistically significant (1-tailed Wilcoxon Mann-Whitney U test, P =.0302), but reached clinical relevance (Mann-Whitney effect size = 0.6737). In regard to the secondary outcomes, active extracorporeal shockwave therapy displayed relative superiority in comparison with the sham intervention. No relevant adverse events occurred in either intervention group. The results of the present study support the use of electromagnetically generated extracorporeal shockwave therapy for the treatment of

  6. Toxic shock syndrome toxin 1 binds to major histocompatibility complex class II molecules.

    PubMed Central

    Scholl, P; Diez, A; Mourad, W; Parsonnet, J; Geha, R S; Chatila, T

    1989-01-01

    Toxic shock syndrome toxin 1 (TSST-1) is a 22-kDa exotoxin produced by strains of Staphylococcus aureus and implicated in the pathogenesis of toxic shock syndrome. In common with other staphylococcal exotoxins, TSST-1 has diverse immunological effects. These include the induction of interleukin 2 receptor expression, interleukin 2 synthesis, proliferation of human T lymphocytes, and stimulation of interleukin 1 synthesis by human monocytes. In the present study, we demonstrate that TSST-1 binds with saturation kinetics and with a dissociation constant of 17-43 nM to a single class of binding sites on human mononuclear cells. There was a strong correlation between the number of TSST-1 binding sites and the expression of major histocompatibility complex class II molecules, and interferon-gamma induced the expression of class II molecules as well as TSST-1 binding sites on human skin-derived fibroblasts. Monoclonal antibodies to HLA-DR, but not to HLA-DP or HLA-DQ, strongly inhibited TSST-1 binding. Affinity chromatography of 125I-labeled cell membranes over TSST-1-agarose resulted in the recovery of two bands of 35 kDa and 31 kDa that comigrated, respectively, with the alpha and beta chains of HLA-DR and that could be immunoprecipitated with anti-HLA-DR monoclonal antibodies. Binding of TSST-1 was demonstrated to HLA-DR and HLA-DQ L-cell transfectants. These results indicate that major histocompatibility complex class II molecules represent the major binding site for TSST-1 on human cells. Images PMID:2542966

  7. Outbreak of dengue in Mumbai and predictive markers for dengue shock syndrome.

    PubMed

    Shah, Ira; Deshpande, G C; Tardeja, P N

    2004-10-01

    An alarming rise of dengue has been seen in Mumbai during the post-monsoon season. We undertook this prospective study in the pediatric wards and pediatric intensive care unit of B. J. Wadia Hospital for Children between 27 August 2003 and 10 October 2003 to determine the clinical features, laboratory abnormalities, and outcome of children affected with dengue and to determine the predictive markers for dengue shock syndrome. Fifty-one suspected dengue cases were tested for positivity of dengue by determination of dengue IgM antibodies by ELISA test. These positive cases were analysed for common clinical features, laboratory derangements, and outcome. Patients were subdivided into three subgroups: dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS) as per WHO classification. Predictive markers for DSS were also determined. Thirty-nine patients had a positive dengue IgM titre, 20 patients had DHF, 18 patients had DSS, and one patient had DF The mean age of presentation was 4.9 years. Fever, hepatomegaly, vomiting, bleeding tendencies, erythematous rash, thrombocytopenia, elevated liver enzymes, and deranged PT and PTT were the predominant clinical and laboratory features. Predictive markers for DSS were younger age at onset, altered sensorium, paralytic ileus, and significantly deranged PT. Patients with DSS also had a longer recovery period and required more supportive management in the form of component therapy and ionotropic support. All three patients who died belonged to the DSS subgroup with case fatality rate for DSS being 16.6 per cent. None of the patients in the DHF or DF subgroup died. Endemicity of dengue fever is on the rise in Mumbai with increased incidence among children. Appropriate investigations, strict monitoring and prompt supportive management can reduce mortality in dengue. Predictive markers of DSS can reduce the mortality if promptly treated. Also prevention of transmission by mosquito control and maintaining

  8. Differences in clinical features between children and adults with dengue hemorrhagic fever/dengue shock syndrome.

    PubMed

    Namvongsa, Vannyda; Sirivichayakul, Chukiat; Songsithichok, Sirilak; Chanthavanich, Pornthep; Chokejindachai, Watcharee; Sitcharungsi, Raweerat

    2013-09-01

    This retrospective study was conducted to assess the differences in clinical features between children and adults with dengue hemorrhagic fever/ dengue shock syndrome (DHF/DSS) admitted to Ratchaburi Hospital, Ratchaburi Province, Thailand. A total of 273 patients with DHF/DSS admitted to Ratchaburi Hospital during January 2007 to May 2008 were included in the study. The median age (range) of studied subjects was 16 years (6 months to 62 years) and the ratio of adults to children was 1.6:1. Forty-eight percent of subjects were 16-30 years old. The common signs, symptoms and clinical features were: nausea/vomiting (74.0%), a positive tourniquet test (73.0%), anorexia (67.0%), hemoconcentration (58.0%), headache (54.0%), abdominal tenderness (43.0%), myalgia (39.0%) and pleural effusion (20.0%). Children had anorexia, a positive tourniquet test, abdominal tenderness and a convalescent rash more frequently than adults. Children also had significantly more prominent plasma leakage as shown by lower serum albumin and sodium and a higher prevalence of pleural effusion, ascites and shock. Although not statistically significant, the prevalence of bleeding in children was higher than in adults but more adults needed blood transfusion. This study provides additional insight into the clinical picture of DHF/DSS in adults and children and may be beneficial for clinicians caring for these adults and children.

  9. Extracorporeal Shock Wave Therapy in Myofascial Pain Syndrome of Upper Trapezius

    PubMed Central

    Ji, Hye Min; Kim, Ho Jeong

    2012-01-01

    Objective To evaluate the effect of extracorporeal shock wave therapy (ESWT) in myofascial pain syndrome of upper trapezius with visual analogue scale (VAS) and pressure threshold by digital algometer. Method Twenty-two patients diagnosed with myofascial pain syndrome in upper trapezius were selected. They were assigned to treatment and standard care (control) groups balanced by age and sex, with eleven subjects in each group. The treated group had done four sessions of ESWT (0.056 mJ/mm2, 1,000 impulses, semiweekly) while the control group was treated by the same protocol but with different energy levels applied, 0.001 mJ/mm2. The VAS and pressure threshold were measured twice: before and after last therapy. We evaluated VAS of patients and measured the pressure threshold by using algometer. Results There were two withdrawals and the remaining 20 patients were three men and 17 women. Age was distributed with 11 patients in their twenties and 9 over 30 years old. There was no significant difference of age, sex, pre-VAS and pre-pressure threshold between 2 groups (p>0.05) found. The VAS significantly decreased from 4.91±1.76 to 2.27±1.27 in the treated group (p<0.01). The control group did not show any significant changes of VAS score. The pressure threshold significantly increased from 40.4±9.94 N to 61.2±12.16 N in the treated group (p<0.05), but there was no significant change in the control group. Conclusion ESWT in myofascial pain syndrome of upper trapezius is effective to relieve pain after four times therapies in two weeks. But further study will be required with more patients, a broader age range and more males. PMID:23185732

  10. Effect of extracorporeal shock wave therapy on the treatment of patients with carpal tunnel syndrome

    PubMed Central

    Vahdatpour, Babak; Kiyani, Abolghasem; Dehghan, Farnaz

    2016-01-01

    Background: The carpal tunnel syndrome (CTS) is the most common neuropathy. The aim of this study was to evaluate the effect of a new and noninvasive treatment including extracorporeal shock wave therapy (ESWT) in the treatment of CTS. Materials and Methods: This study is a clinical trial conducted on 60 patients with moderate CTS in selected health centers of Isfahan Medical University from November 2014 to April 2015. Patients with CTS were randomly divided into two groups. Conservative treatment including wrist splint at night for 3 months, consumption of nonsteroidal anti-inflammatory drugs for 2 weeks, and oral consumption of Vitamin B1 for a month was recommended for both groups. The first group was treated with ESWT, one session per week for 4 weeks. Focus probe with 0.05, 0.07, 0.1, and 0.15 energy and shock numbers 800, 900, 1000, and 1100 were used from the first session to the fourth, respectively. The evaluated parameters were assessed before treatment and after 3 and 6 months. Data were analyzed using SPSS version 19, Student’s t-test, and Chi-square test. Results: All parameters were significantly decreased in the ESWT group after 3 months. These results remained almost constant after 6 months compared with 3 months after treatment. However, only two parameters considerably improved after 3 months of treatment in the control group. The entire indexes in the control group implicated the regression of results in long-term period. Conclusion: It is recommended to use ESWT as a conservative treatment in patients with CTS. PMID:27563630

  11. Klebsiella pneumoniae invasive liver abscess syndrome with purulent meningitis and septic shock: A case from mainland China

    PubMed Central

    Qian, Yun; Wong, Chi-Chun; Lai, San-Chuan; Lin, Zheng-Hua; Zheng, Wei-Liang; Zhao, Hui; Pan, Kong-Han; Chen, Shu-Jie; Si, Jian-Min

    2016-01-01

    We present a rare case of invasive liver abscess syndrome due to Klebsiella pneumoniae (K. pneumoniae) with metastatic meningitis and septic shock. A previously healthy, 55-year-old female patient developed fever, liver abscess, septic shock, purulent meningitis and metastatic hydrocephalus. Upon admission, the clinical manifestations, laboratory and imaging examinations were compatible with a diagnosis of K. pneumoniae primary liver abscess. Her distal metastasis infection involved meningitis and hydrocephalus, which could flare abruptly and be life threatening. Even with early adequate drainage and antibiotic therapy, the patient’s condition deteriorated and she ultimately died. To the best of our knowledge, this is the first case of K. pneumoniae invasive liver abscess syndrome with septic meningitis reported in mainland China. Our findings reflect the need for a better understanding of the epidemiology, risk factors, complications, comorbid medical conditions and treatment of this disease. PMID:26973425

  12. Comparison of cotton and cotton/rayon tampons for effect on production of toxic shock syndrome toxin.

    PubMed

    Schlievert, P M

    1995-10-01

    Studies were done to compare tampons made solely of cotton and made of both cotton and rayon for effect on growth of Staphylococcus aureus and production of toxic shock syndrome toxin-1 (TSST-1). Under stationary in vitro conditions in which tampons were either oversaturated or 50% saturated with culture media, the same amount of or more TSST-1 was made with cotton tampons than with cotton/rayon tampons. Similarly, when tested with the tampon sac method, cotton tampons yielded the same amount of or more toxin than did the cotton/rayon tampons. Bacterial cell numbers generally paralleled toxin production. These data indicate that cotton tampons neither prevent TSST-1 production nor significantly adsorb toxin onto the fibers to make toxin unavailable to cause toxic shock syndrome, in contrast to results of a previous study.

  13. [Predictive factors of dengue shock syndrome at the children Hospital No. 1, Ho-chi-Minh City, Vietnam].

    PubMed

    Pham, T B; Nguyen, T H; Vu, T Q H; Nguyen, T L; Malvy, D

    2007-02-01

    The dengue shock syndrome (DSS) is primarily a complication of dengue haemorrhagic fever (DHF) among children in South East Asia. A case-control study was carried out at the children hospital no 1 (Ho-Chi-Minh City, Vietnam) in May-July 2005, to identify the predictive factors of the DSS among 1-15 year patients with DHE Forty consecutive admitted cases and forty controls were studied. The associated features of DSS were the 7-12 year age group and the re-infection by the dengue virus. The vaccination against the Japanese encephalitis B was not associated statistically significantly with the shock syndrome. The clinical predictors of DSS gathered an abdominal tenderness, an hepatomegaly, a lethargy, a cold extremity presentation. DSS associated laboratory features were a value of hematocrit a 50 % and a platelet cell count < or = 75,000/mm3.

  14. Combined etiology of anaphylactic cardiogenic shock: amiodarone, epinephrine, cardioverter defibrillator, left ventricular assist devices and the Kounis syndrome.

    PubMed

    Kounis, Nicholas G; Soufras, George D; Davlouros, Periklis; Tsigkas, Grigorios; Hahalis, George

    2015-01-01

    Anaphylactic shock is a life-threatening condition which needs detailed and mediculous clinical assessment and thoughtful treatment. Several causes can join forces in order to degranulate mast cells. Amiodarone which is an iodine-containing highly lipophilic benzofuran can induce allergic reactions and anaphylactic shock in sensitized patients. Epinephrine is a life saving drug, but in sulfite allergic patients it should be given with caution due its metabisulfite preservative. Metals covering cardiac defibrillators and pacemakers can act as antigens attached to serum proteins and induce allergic reactions. In anaphylactic shock, myocardial involvement due to vasospasm-induced coronary blood flow reduction manifesting as Kounis syndrome should be always considered. Clinically, combined treatment targeting the primary cause of anaphylaxis together with protection of cardiac tissue seems to be of paramount importance.

  15. Combined etiology of anaphylactic cardiogenic shock: Amiodarone, epinephrine, cardioverter defibrillator, left ventricular assist devices and the Kounis syndrome

    PubMed Central

    Kounis, Nicholas G.; Soufras, George D.; Davlouros, Periklis; Tsigkas, Grigorios; Hahalis, George

    2015-01-01

    Anaphylactic shock is a life-threatening condition which needs detailed and mediculous clinical assessment and thoughtful treatment. Several causes can join forces in order to degranulate mast cells. Amiodarone which is an iodine-containing highly lipophilic benzofuran can induce allergic reactions and anaphylactic shock in sensitized patients. Epinephrine is a life saving drug, but in sulfite allergic patients it should be given with caution due its metabisulfite preservative. Metals covering cardiac defibrillators and pacemakers can act as antigens attached to serum proteins and induce allergic reactions. In anaphylactic shock, myocardial involvement due to vasospasm-induced coronary blood flow reduction manifesting as Kounis syndrome should be always considered. Clinically, combined treatment targeting the primary cause of anaphylaxis together with protection of cardiac tissue seems to be of paramount importance. PMID:25849705

  16. Electrophysiological correlates of reinforcement learning in young people with Tourette syndrome with and without co-occurring ADHD symptoms.

    PubMed

    Shephard, Elizabeth; Jackson, Georgina M; Groom, Madeleine J

    2016-06-01

    Altered reinforcement learning is implicated in the causes of Tourette syndrome (TS) and attention-deficit/hyperactivity disorder (ADHD). TS and ADHD frequently co-occur but how this affects reinforcement learning has not been investigated. We examined the ability of young people with TS (n=18), TS+ADHD (N=17), ADHD (n=13) and typically developing controls (n=20) to learn and reverse stimulus-response (S-R) associations based on positive and negative reinforcement feedback. We used a 2 (TS-yes, TS-no)×2 (ADHD-yes, ADHD-no) factorial design to assess the effects of TS, ADHD, and their interaction on behavioural (accuracy, RT) and event-related potential (stimulus-locked P3, feedback-locked P2, feedback-related negativity, FRN) indices of learning and reversing the S-R associations. TS was associated with intact learning and reversal performance and largely typical ERP amplitudes. ADHD was associated with lower accuracy during S-R learning and impaired reversal learning (significantly reduced accuracy and a trend for smaller P3 amplitude). The results indicate that co-occurring ADHD symptoms impair reversal learning in TS+ADHD. The implications of these findings for behavioural tic therapies are discussed. PMID:27103231

  17. Electrophysiological correlates of reinforcement learning in young people with Tourette syndrome with and without co-occurring ADHD symptoms.

    PubMed

    Shephard, Elizabeth; Jackson, Georgina M; Groom, Madeleine J

    2016-06-01

    Altered reinforcement learning is implicated in the causes of Tourette syndrome (TS) and attention-deficit/hyperactivity disorder (ADHD). TS and ADHD frequently co-occur but how this affects reinforcement learning has not been investigated. We examined the ability of young people with TS (n=18), TS+ADHD (N=17), ADHD (n=13) and typically developing controls (n=20) to learn and reverse stimulus-response (S-R) associations based on positive and negative reinforcement feedback. We used a 2 (TS-yes, TS-no)×2 (ADHD-yes, ADHD-no) factorial design to assess the effects of TS, ADHD, and their interaction on behavioural (accuracy, RT) and event-related potential (stimulus-locked P3, feedback-locked P2, feedback-related negativity, FRN) indices of learning and reversing the S-R associations. TS was associated with intact learning and reversal performance and largely typical ERP amplitudes. ADHD was associated with lower accuracy during S-R learning and impaired reversal learning (significantly reduced accuracy and a trend for smaller P3 amplitude). The results indicate that co-occurring ADHD symptoms impair reversal learning in TS+ADHD. The implications of these findings for behavioural tic therapies are discussed.

  18. Churg-Strauss syndrome presenting with acute myocarditis and cardiogenic shock.

    PubMed

    Courand, Pierre-Yves; Croisille, Pierre; Khouatra, Chahéra; Cottin, Vincent; Kirkorian, Gilbert; Bonnefoy, Eric

    2012-03-01

    Churg-Strauss syndrome (CSS) is a multisystem disorder characterised by asthma, prominent peripheral blood eosinophilia, and vasculitis signs. We report the case of a 22 year-old man admitted to the intensive care unit for acute myocarditis complicated with cardiogenic shock. Eosinophilia, history of asthma, lung infiltrates, paranasal sinusitis, glomerulonephritis, and abdominal pain suggested the diagnosis of CSS. Cardiac MRI confirmed cardiac involvement with a diffuse subendocardial delayed enhancement of the left ventricular wall, and a left ventricular ejection fraction (LVEF) of 30%. Acute myocarditis was confirmed with myocardial biopsy. The patient was successfully treated with systemic corticosteroids, intravenous cyclophosphamide, vasopressor inotropes, intra-aortic balloon pump and mechanical ventilation, and was discharged 21 days later. One year after diagnosis, the patient was asymptomatic. The eosinophilic cell count was normal. Follow-up MRI at one year showed LVEF of 40% with persistent delayed enhancement. Cardiac involvement by CSS requires immediate therapy with corticosteroids and cyclophosphamide, which may allow recovery of the cardiac function. PMID:21963398

  19. The role of cytokines in activation of coagulation and fibrinolysis in dengue shock syndrome.

    PubMed

    Suharti, Catharina; van Gorp, Eric C M; Setiati, Tatty E; Dolmans, Wil M V; Djokomoeljanto, Robert J; Hack, C Erik; ten, Cate Hugo; van der Meer, Jos W M

    2002-01-01

    In a prospective clinical study of 50 patients with Dengue Shock Syndrome (DSS), we investigated the association of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), IL-1 receptor antagonist (IL-1Ra), and IL-6 with activation markers of coagulation (F1+2 and TATc) and fibrinolysis (t-PA, PAPc, and D-dimer). We found that TNF-alpha, IL-1beta and Il-1Ra, but not IL-6, concentrations were elevated in the circulation during the early stage of infection and at discharge from hospital. TNF-alpha was significantly associated with D-dimer, an activation marker of fibrinolysis (p < 0.003), but not with activation markers of coagulation. IL-1beta was significantly associated with t-PA (p < 0.03). IL-1Ra was significantly associated with F1+2, TATc (p < 0.04 and p < 0.02, respectively), whereas IL-6 was significantly associated with both, activation markers of coagulation (F1+2; p < 0.03) and fibrinolysis (PAPc; p = 0.002). Our data are in line with studies in bacterial sepsis. In severe dengue virus infection the same cytokines are involved in the onset and regulation of hemostasis.

  20. Toxic shock syndrome toxin-1, not α-toxin, mediated Bundaberg fatalities.

    PubMed

    Mueller, Elizabeth A; Merriman, Joseph A; Schlievert, Patrick M

    2015-12-01

    The 1928 Bundaberg disaster is one of the greatest vaccine tragedies in history. Of 21 children immunized with a diphtheria toxin-antitoxin preparation contaminated with Staphylococcus aureus, 18 developed life-threatening disease and 12 died within 48  h. Historically, the deaths have been attributed to α-toxin, a secreted cytotoxin produced by most S. aureus strains, yet the ability of the Bundaberg contaminant microbe to produce the toxin has never been verified. For the first time, the ability of the original strain to produce α-toxin and other virulence factors is investigated. The study investigates the genetic and regulatory loci mediating α-toxin expression by PCR and assesses production of the cytotoxin in vitro using an erythrocyte haemolysis assay. This analysis is extended to other secreted virulence factors produced by the strain, and their sufficiency to cause lethality in New Zealand white rabbits is determined. Although the strain possesses a wild-type allele for α-toxin, it must have a defective regulatory system, which is responsible for the strain's minimal α-toxin production. The strain encodes and produces staphylococcal superantigens, including toxic shock syndrome toxin-1 (TSST-1), which is sufficient to cause lethality in patients. The findings cast doubt on the belief that α-toxin is the major virulence factor responsible for the Bundaberg fatalities and point to the superantigen TSST-1 as the cause of the disaster.

  1. Spontaneous mutations in Streptococcus pyogenes isolates from streptococcal toxic shock syndrome patients play roles in virulence

    PubMed Central

    Ikebe, Tadayoshi; Matsumura, Takayuki; Nihonmatsu, Hisako; Ohya, Hitomi; Okuno, Rumi; Mitsui, Chieko; Kawahara, Ryuji; Kameyama, Mitsuhiro; Sasaki, Mari; Shimada, Naomi; Ato, Manabu; Ohnishi, Makoto

    2016-01-01

    Streptococcus pyogenes (group A Streptococcus; GAS) is a widespread human pathogen and causes streptococcal toxic shock syndrome (STSS). STSS isolates have been previously shown to have high frequency mutations in the csrS/csrR (covS/covR) and/or rgg (ropB) genes, which are negative regulators of virulence. However, these mutations were found at somewhat low frequencies in emm1-genotyped isolates, the most prevalent STSS genotype. In this study, we sought to detect causal mutations of enhanced virulence in emm1 isolates lacking mutation(s) in the csrS/csrR and rgg genes. Three mutations associated with elevated virulence were found in the sic (a virulence gene) promoter, the csrR promoter, and the rocA gene (a csrR positive regulator). In vivo contribution of the sic promoter and rocA mutations to pathogenicity and lethality was confirmed in a GAS mouse model. Frequency of the sic promoter mutation was significantly higher in STSS emm1 isolates than in non-invasive STSS isolates; the rocA gene mutation frequency was not significantly different among STSS and non-STSS isolates. STSS emm1 isolates possessed a high frequency mutation in the sic promoter. Thus, this mutation may play a role in the dynamics of virulence and STSS pathogenesis. PMID:27349341

  2. Spontaneous mutations in Streptococcus pyogenes isolates from streptococcal toxic shock syndrome patients play roles in virulence.

    PubMed

    Ikebe, Tadayoshi; Matsumura, Takayuki; Nihonmatsu, Hisako; Ohya, Hitomi; Okuno, Rumi; Mitsui, Chieko; Kawahara, Ryuji; Kameyama, Mitsuhiro; Sasaki, Mari; Shimada, Naomi; Ato, Manabu; Ohnishi, Makoto

    2016-01-01

    Streptococcus pyogenes (group A Streptococcus; GAS) is a widespread human pathogen and causes streptococcal toxic shock syndrome (STSS). STSS isolates have been previously shown to have high frequency mutations in the csrS/csrR (covS/covR) and/or rgg (ropB) genes, which are negative regulators of virulence. However, these mutations were found at somewhat low frequencies in emm1-genotyped isolates, the most prevalent STSS genotype. In this study, we sought to detect causal mutations of enhanced virulence in emm1 isolates lacking mutation(s) in the csrS/csrR and rgg genes. Three mutations associated with elevated virulence were found in the sic (a virulence gene) promoter, the csrR promoter, and the rocA gene (a csrR positive regulator). In vivo contribution of the sic promoter and rocA mutations to pathogenicity and lethality was confirmed in a GAS mouse model. Frequency of the sic promoter mutation was significantly higher in STSS emm1 isolates than in non-invasive STSS isolates; the rocA gene mutation frequency was not significantly different among STSS and non-STSS isolates. STSS emm1 isolates possessed a high frequency mutation in the sic promoter. Thus, this mutation may play a role in the dynamics of virulence and STSS pathogenesis. PMID:27349341

  3. Is shock a key element in the pathology of sudden infant death syndrome (SIDS)?

    PubMed

    Blood-Siegfried, Jane; Bowers, Margaret T; Lorimer, Marcia

    2009-10-01

    In developed countries, sudden infant death syndrome (SIDS) is the most common cause of death for infants between 1 month and 1 year of age. The etiology of SIDS is likely to be multifactorial, and current paradigms often describe three overlapping elements of risk. Those elements are a critical developmental period, a vulnerable infant, and one or more exogenous stressors. In the triple-risk model, SIDS infants are described as having an underlying vulnerability in cardiorespiratory control in the central nervous system during a critical period when autonomic control is developing. This vulnerability might affect the response to exogenous stressors, including prone sleeping position, hypoxia, and increased carbon dioxide. In the common bacterial hypothesis and fatal triangle, the focus is on the stressors. In the first, a combination of common respiratory infections can cause SIDS in an infant during a developmentally vulnerable period. This theory also includes 3 factors of vulnerability: a genetic predisposition, a vulnerable developmental age, and infectious stressors. In the fatal triangle theory, infection, inflammation, and genetics each play a role in triggering a SIDS fatality. From our work in an animal model, we have found that rat pups die from a combination of infectious insults during a critical time of development. This is exacerbated by perinatal nicotine exposure, a condition shown to alter the autonomic response in exposed offspring. We are proposing that shock and cardiovascular collapse is a key element that links these theories.

  4. Production of toxic shock syndrome toxin 1 by Staphylococcus aureus restricted to endogenous air in tampons.

    PubMed

    Reiser, R F; Hinzman, S J; Bergdoll, M S

    1987-08-01

    All types of four brands of tampons were tested in triplicate by a tampon sac method for their effect on production of toxic shock syndrome toxin 1 (TSST-1). In this method the available air is limited to that which is in the tampon sac. Tampons were weighed and inserted into dialysis sacs inoculated with a TSST-1-producing Staphylococcus aureus strain; the sacs were submerged into brain heart infusion agar, which was allowed to harden around the sacs, and were incubated for 18 h at 37 degrees C. The tampons were removed, weighed, and extracted; the CFU of staphylococci and the amount of toxin present in the extracts were determined. Glass wool was used in place of the tampons as one control, and inoculated empty sacs were used as a second control. The total CFU were consistently greater than 2 X 10(11) for the tampons and glass wool and less than or equal to 10(11) for the empty sac control. Total toxin production for all tampons tested and the glass wool was 2 to 10 times higher than the toxin produced with the empty sac control. These results indicate that tampons provide increased surface area for the staphylococci to grow and adequate oxygen for toxin production. No significant inhibition of growth of the staphylococci or TSST-1 production by any of the tampons tested was noted.

  5. An epidemic of dengue haemorrhagic fever & dengue shock syndrome in & around Vellore.

    PubMed

    Cherian, T; Ponnuraj, E; Kuruvilla, T; Kirubakaran, C; John, T J; Raghupathy, P

    1994-08-01

    This report describes an epidemic of dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) in the North Arcot Ambedkar district and the adjoining districts in Tamil Nadu and Andhra Pradesh. Nineteen children who fulfilled the clinical criteria for the diagnosis of DHF/DSS were admitted to the Christian Medical College Hospital, Vellore, during June through November, 1990. The clinical presentation was similar to that described in South-east Asian children and the case fatality rate was 26.3 per cent. Serology was confirmatory or suggestive of recent dengue virus infection in 16 children, uninterpretable in 2 and not consistent with recent dengue virus infection in 1 child. All children over 1 yr of age had very high antibody titres suggesting a secondary response whereas infants had lower titres consistent with primary response. The occurrence of recurrent epidemics in this region in the last few years with associated high case fatality emphasizes the urgent need for public health measures to curtail further epidemics.

  6. Alternate hypothesis on the pathogenesis of dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS) in dengue virus infection.

    PubMed

    Noisakran, Sansanee; Perng, Guey Chuen

    2008-04-01

    Dengue fever, caused by infection with dengue virus, is not a new disease, but recently because of its serious emerging health threats, coupled with possible dire consequences including death, it has aroused considerable medical and public health concerns worldwide. Today, dengue is considered one of the most important arthropod-borne viral diseases in humans in terms of morbidity and mortality. Globally, it is estimated that approximate 50 to 100 million new dengue virus infections occur annually. Among these, there are 200,000 to 500,000 cases of potential life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS), characterized by thrombocytopenia and increased vascular permeability. The death rate associated with the more severe form DHF/DSS is approximately 5%, predominantly in children under the age of 15. Although intensive efforts have been made to study the early clinical pathophysiology of dengue infection with the objective to identify the potential cause of DHF, results or data that have accumulated from different regions of the world involving studies of different ethnicity groups are inconsistent at present in terms of identifying a unified hypothesis for the pathogenesis of DHF/DSS. Thus, the potential mechanisms involved in the pathogenesis of DHF and DSS remain elusive. The purpose of this review is to identify alternate factors, such as innate immune parameters, hyper-thermal factors, conditioning of neutralizing antibody, concept of vector transmission, and physical status of virus in viremic patients that may play a role in the induction of DHF and DSS, which might have directly or indirectly contributed to the discrepancies that are noted in the literature reported to date. It is the hope that identification of an alternative explanation for the pathogenesis of DHF/DSS will pave the way for the institution of new strategies for the prevention of this complicated disease.

  7. Association of phenotypic and genotypic characteristics of invasive Streptococcus pyogenes isolates with clinical components of streptococcal toxic shock syndrome.

    PubMed Central

    Talkington, D F; Schwartz, B; Black, C M; Todd, J K; Elliott, J; Breiman, R F; Facklam, R R

    1993-01-01

    Sixty-two invasive Streptococcus pyogenes strains, including 32 strains isolated from patients with streptococcal toxic shock syndrome (STSS), were analyzed for the following phenotypic and genotypic characteristics: M-protein type, serum opacity factor production, protease production, the presence of streptococcal pyrogenic exotoxin (Spe) genes A, B, and C, and in vitro production of SpeA and SpeB. These characteristics were analyzed for possible associations with each other as well as with clinical components of STSS. M-type 1, the most commonly isolated M-type, was significantly associated with protease production. Protease activity was significantly associated with the clinical sign of soft tissue necrosis. M-type 1 and 3 strains from STSS patients were significantly associated with the clinical signs of shock and organ involvement as well as with SpeA production in vitro. Finally, the production of SpeA was significantly associated with the clinical component of shock and organ involvement as well as with rash. These data suggest that STSS does not make up a single syndrome but, rather, that the multiple STSS clinical criteria probably reflect different phenotypic characteristics of individual S. pyogenes isolates. PMID:8335368

  8. Streptococcal toxic shock syndrome from necrotizing soft-tissue infection of the breast caused by a mucoid type strain.

    PubMed

    Kohayagawa, Yoshitaka; Ishitobi, Natsuko; Yamamori, Yuji; Wakuri, Miho; Sano, Chiaki; Tominaga, Kiyoshi; Ikebe, Tadayoshi

    2015-02-01

    Streptococcal toxic shock syndrome is a severe infectious disease. We report a Japanese case of Streptococcal toxic shock syndrome caused by a highly mucoid strain of Streptococcus pyogenes. A 31-year old female with shock vital sign presented at a tertiary medical center. Her left breast was necrotizing and S. pyogenes was detected by Immunochromatographic rapid diagnostic kits. Intensive care, including administration of antibiotics and skin debridement, was performed. After 53 days in our hospital, she was discharged. The blood cultures and skin swab cultures all grew S. pyogenes which displayed a highly mucoid morphology on culture media. In her course of the disease, the Streptococcus strain had infected two other family members. All of the strains possessed the T1 and M1 antigens, as well as the emm1.0 gene. As for fever genes, the strains were all positive for speA, speB, and speF, but negative for speC. All of the strains exhibited and the same pattern in PFGE with the SfiI restriction enzyme. The strain might have spread in the local area by the data from the Japanese Infectious Disease Surveillance Center. Immunochromatographic rapid diagnostic kits are very useful for detecting S. pyogenes. However, they can not be used to diagnose severe streptococcul disease by highly mucoid strain alone. Careful observation of patients and colony morphology are useful methods for diagnosing severe streptococcal disease by highly mucoid strain.

  9. The Role of Heat Shock Protein 90B1 in Patients with Polycystic Ovary Syndrome.

    PubMed

    Li, Li; Mo, Hui; Zhang, Jing; Zhou, Yongxian; Peng, Xiuhong; Luo, Xiping

    2016-01-01

    Polycystic ovary syndrome (PCOS) is a heterogenetic disorder in women that is characterized by arrested follicular growth and anovulatory infertility. The altered protein expression levels in the ovarian tissues reflect the molecular defects in folliculogenesis. To identify aberrant protein expression in PCOS, we analyzed protein expression profiles in the ovarian tissues of patients with PCOS. We identified a total of 18 protein spots that were differentially expressed in PCOS compared with healthy ovarian samples. A total of 13 proteins were upregulated and 5 proteins were downregulated. The expression levels of heat shock protein 90B1 (HSP90B1) and calcium signaling activator calmodulin 1 (CALM1) were increased by at least two-fold. The expression levels of HSP90B1 and CALM1 were positively associated with ovarian cell survival and negatively associated with caspase-3 activation and apoptosis. Knock-down of HSP90B1 with siRNA attenuated ovarian cell survival and increased apoptosis. In contrast, ovarian cell survival was improved and cell apoptosis was decreased in cells over-expressing HSP90B1. These results demonstrated the pivotal role of HSP90B1 in the proliferation and survival of ovarian cells, suggesting a critical role for HSP90B1 in the pathogenesis of PCOS. We also observed a downregulation of anti-inflammatory activity-related annexin A6 (ANXA6) and tropomyosin 2 (TPM2) compared with the normal controls, which could affect cell division and folliculogenesis in PCOS. This is the first study to identify novel altered gene expression in the ovarian tissues of patients with PCOS. These findings may have significant implications for future diagnostic and treatment strategies for PCOS using molecular interventions. PMID:27046189

  10. Immunopathogenesis of dengue hemorrhagic fever and shock syndrome: role of TAP and HPA gene polymorphism.

    PubMed

    Soundravally, R; Hoti, S L

    2007-12-01

    Clinical outcomes of dengue infection such as dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS) could be attributed to host genetic factors. The transporters associated with antigen processing (TAP) genes are polymorphic genes located in the human leukocyte antigen (HLA) class II region and are essentially involved in class I antigen presentation. Therefore, these genes might grant susceptibility to severe dengue infection. Hence, the aim of the study was to type the TAP1 gene (using amplification refraction mutation system [ARMS] polymerase chain reaction [PCR]) and HPA1 and HPA2 gene polymorphism (by PCR-sequence specific primers) in different clinical spectrums of dengue infection. The study included 100 controls and 91 DF, 75 DHF, and 32 DSS patients. The results revealed that the frequencies of valine at TAP1 333 and HPA 1b at HPA1 were increased among DHF and DSS, respectively, in comparison to controls (p <0.05). The frequency of genotype TAP1 333 ILE/VAL (61.3%) was significantly higher in DHF compared with control (37%, p = 0.005) or DF (38.9%, p = 0.007) patients. A significantly greater proportion of DHF patients demonstrated HPA1a/1a and HPA 2a/2b genotypes than DF patients. DSS patients were more likely to be heterozygous at HPA1 than DHF (OR = 4.75, p = 0.003). A positive correlation existed between TAP1 333 and HPA1 in DHF (p = 0.017, r = 0.229). This first report on TAP and HPA gene polymorphism in dengue suggested that the heterozygous pattern at the TAP1 333 locus and HPA1a/1a and HPA2a/2b genotypes confer susceptibility to DHF and the HPA1a/1b genotype was determined to be a genetic risk factor for DSS.

  11. Oculo-facio-cardio-dental (OFCD) syndrome: the first Italian case of BCOR and co-occurring OTC gene deletion.

    PubMed

    Di Stefano, C; Lombardo, B; Fabbricatore, C; Munno, C; Caliendo, I; Gallo, F; Pastore, L

    2015-04-01

    Oculo-facio-cardio-dental (OFCD) syndrome is a rare genetic disorder affecting ocular, facial, dental and cardiac systems. The syndrome is an X-linked dominant trait and it might be lethal in males. This syndrome is usually caused by mutations in the BCL6 interacting co-repressor gene (BCOR). We described a female child with mild phenotype of oculo-facio-cardio-dental syndrome. Array-comparative genomic hybridization (a-CGH) analysis revealed a de novo heterozygous deletion in the Xp11.4 region of approximately 2.3 Mb, involving BCOR and ornithine carbamoyl-transferase (OTC) genes. The deletion observed was subsequently confirmed by real time PCR. In this study we report a first case with co-occurrence of BCOR and OTC genes completely deleted in OFCD syndrome.

  12. Oculo-facio-cardio-dental (OFCD) syndrome: the first Italian case of BCOR and co-occurring OTC gene deletion.

    PubMed

    Di Stefano, C; Lombardo, B; Fabbricatore, C; Munno, C; Caliendo, I; Gallo, F; Pastore, L

    2015-04-01

    Oculo-facio-cardio-dental (OFCD) syndrome is a rare genetic disorder affecting ocular, facial, dental and cardiac systems. The syndrome is an X-linked dominant trait and it might be lethal in males. This syndrome is usually caused by mutations in the BCL6 interacting co-repressor gene (BCOR). We described a female child with mild phenotype of oculo-facio-cardio-dental syndrome. Array-comparative genomic hybridization (a-CGH) analysis revealed a de novo heterozygous deletion in the Xp11.4 region of approximately 2.3 Mb, involving BCOR and ornithine carbamoyl-transferase (OTC) genes. The deletion observed was subsequently confirmed by real time PCR. In this study we report a first case with co-occurrence of BCOR and OTC genes completely deleted in OFCD syndrome. PMID:25620158

  13. Correlation of temperature and toxicity in murine studies of staphylococcal enterotoxins and toxic shock syndrome toxin 1.

    PubMed

    Stiles, B G; Campbell, Y G; Castle, R M; Grove, S A

    1999-03-01

    This study describes a quick (<12 h) assay for detecting temperature decreases in BALB/c and C57BL/6 mice injected intraperitoneally (i.p. ) with staphylococcal enterotoxin A (SEA), SEB, or SEC3 or toxic shock syndrome toxin 1 and a potentiating dose of lipopolysaccharide (LPS). Toxin-specific antisera effectively neutralized the temperature fluctuations in this model. Orally administered SEA or SEB (50 microg/animal), with or without LPS, did not have an effect on temperature or lethality. Versus wild-type mice, transgenic knockout mice lacking the p55 receptor for tumor necrosis factor (TNF) or gamma interferon were protected against an i.p. challenge of SEA plus LPS. The p75 receptor for TNF and intercellular adhesion molecule 1 have a negligible role in this toxic shock model.

  14. [Necrotizing soft tissue infection of upper extremity complicated with toxic shock syndrome--clinical presentation and treatment options].

    PubMed

    Oberhofer, Dagmar; Kucisec-Tepes, Nastja; Huljev, Dubravko

    2008-12-01

    Necrotizing soft tissue infections (NSTI) are uncommon infections associated with considerable morbidity and mortality (20%-40%). They are characterized by rapidly progressive necrosis of soft tissue that primarily involves subcutaneous fat and fascia with variable involvement of the overlying skin and muscle. Extensive soft tissue necrosis is often accompanied by systemic toxicity. Establishing the diagnosis in the early stage of the infection can be difficult, which leads to a delay in surgical treatment and a poor outcome. The principles of treatment are early and aggressive surgical debridement, broad spectrum antimicrobial therapy administered empirically and reassessed pending culture and sensitivity results, and intensive care management. We report a case of NSTI of the arm in a 64-year-old female patient caused by group A Streptococcus and Staphylococcus aureus complicated with toxic shock-like syndrome with emphasis on the pathophysiology of toxic shock-like syndrome and treatment modalities. NSTI developed 10 days after a knife cut wound of the thumb. The patient had no significant comorbidity. Treatment included aggressive surgical debridement with removal of necrotic tissue and extensive fasciotomies 24 h of admission, cardiovascular stabilization and monitoring at intensive care unit, and repeat surgical debridement at 72 h of admission. Early triple drug antimicrobial therapy included high-dose clindamycin, which inhibits protein synthesis and bacterial exotoxin production that is responsible for inflammatory response and toxic shock-like syndrome. In addition, the patient received hyperbaric oxygen therapy (8 treatments in total). The above management led to control of the infective process. Prolonged surgical wound care followed by thin split-skin grafting and placement of secondary sutures on day 36 of admission preserved the extremity with good functional and cosmetic result.

  15. Induction of nitric oxide synthase activity by toxic shock syndrome toxin 1 in a macrophage-monocyte cell line.

    PubMed Central

    Zembowicz, A; Vane, J R

    1992-01-01

    Toxic shock syndrome toxin 1 (TSST-1) is a Mr 22,000 protein produced by Staphylococcus aureus. It is thought to be the cause of toxic shock syndrome. We investigated the hypothesis that TSST-1 induces nitric oxide (NO) synthase and that the NO formed may be involved in the pathogenesis of toxic shock syndrome. We used the murine monocyte-macrophage cell line J744.2 that responds to TSST-1 and also expresses NO synthase activity upon immunological stimulation. J774.2 macrophages stimulated with TSST-1 (10-100 nM) generated nitrite, a breakdown product of NO, and induced concentration-dependent elevations of cGMP in the pig kidney epithelial cell line (LLC-PK1). This latter effect was due to the generation of L-arginine-derived NO for it was (i) abolished by oxyhemoglobin (10 microM), a scavenger of NO, or by methylene blue (10 microM), an inhibitor of NO-activated guanylate cyclase; (ii) potentiated by superoxide dismutase (100 units/ml), which prolongs the life of NO; (iii) inhibited by NG-monomethyl-L-arginine (0.3 mM), an inhibitor of NO synthase; (iv) significantly decreased when L-arginine (0.4 mM) in the medium was replaced by D-arginine (0.4 mM). Moreover, TSST-1 (100 nM) enhanced the activity of cytosolic NO synthase in J774.2 cells. Hydrocortisone (1 microM) but not indomethacin (5 micrograms/ml) or salicylic acid (5 micrograms/ml) prevented the generation of NO2- and the increases in cGMP levels in LLC-PK1 cells induced by J774.2 cells stimulated with TSST-1. The effects of hydrocortisone were partially reversed by coincubation with RU 486 (1 microM), an antagonist of glucocorticoid receptors. Thus, TSST-1 and perhaps other exotoxins produced by Gram-positive bacteria induce NO synthase and the increased NO formation may contribute to toxic shock syndrome and possibly to changes in the immune responses that accompany infection. PMID:1372433

  16. A Case Report of Churg-Strauss Syndrome Presenting With Cardiogenic Shock Treated With Extracorporeal Membrane Oxygenation.

    PubMed

    Cui, Na; Su, Longxiang; Wang, Hao; Long, Yun; Pang, Cheng; Yang, Fei; Liu, Dawei

    2015-10-01

    Churg-Strauss Syndrome (CSS) complicated with cardiogenic shock is rare. Few case reports have described successful treatment of this rare disease. However, no one has reported on the application of mechanical life support with extracorporeal membrane oxygenation (ECMO) to treat this life-threatening disease.A 36-year-old female with limb numbness for >10 days, chest tightness for 2 days, and worsening dyspnea for 5 h presented in the emergency room. Vital signs showed a low blood pressure (104/60 mm Hg), increased heart rate (158 bpm), and respiration rate (28 bpm). Laboratory tests revealed that eosinophil was significantly increased (WBC: 34.46 × 10/L, neutrophil: 7.56 × 10/L[21.9%], eosinophil: 23.84 × 10/L[69.2%]), and serum myocardial enzymes was abnormal (CK 1049U/L, CKMB-mass 145.1 μg/L, cTnI 16.24 μg/L). Myocardial injury (tachycardia with ST elevation) and poor heart function (LVEF 31%) were found by electrocardiogram and transthoracic echocardiography. On the next day, cardiogenic shock had been developed as demonstrated by deteriorating the perfusion index.Churg-Strauss Syndrome with cardiogenic shock.A series of conservative therapy with drugs such as corticosteroids, anticoagulant, antiplatelet, nitrates, calcium antagonists, inotrope, and vasopressors were initiated on the day of admission. The treatment was ineffective and a cardiogenic shock developed on the next day. Thus, ECMO was initiated immediately to stabilize circulation and perfusion. At the same time, high-dose corticosteroids combined with immunosuppressive therapy were continuously used.Symptoms of cardiogenic shock were gradually improved after ECMO treatment. Elevated values of cardiac enzymes were decreased and the dose of vasoactive drugs was reduced. Extracorporeal membrane oxygenation was discontinued after 8 days, and the patient was eventually weaned off the ventilator. The patient was discharged after 40 days treatment.Once a CSS develops into a

  17. A Case Report of Churg-Strauss Syndrome Presenting With Cardiogenic Shock Treated With Extracorporeal Membrane Oxygenation.

    PubMed

    Cui, Na; Su, Longxiang; Wang, Hao; Long, Yun; Pang, Cheng; Yang, Fei; Liu, Dawei

    2015-10-01

    Churg-Strauss Syndrome (CSS) complicated with cardiogenic shock is rare. Few case reports have described successful treatment of this rare disease. However, no one has reported on the application of mechanical life support with extracorporeal membrane oxygenation (ECMO) to treat this life-threatening disease.A 36-year-old female with limb numbness for >10 days, chest tightness for 2 days, and worsening dyspnea for 5 h presented in the emergency room. Vital signs showed a low blood pressure (104/60 mm Hg), increased heart rate (158 bpm), and respiration rate (28 bpm). Laboratory tests revealed that eosinophil was significantly increased (WBC: 34.46 × 10/L, neutrophil: 7.56 × 10/L[21.9%], eosinophil: 23.84 × 10/L[69.2%]), and serum myocardial enzymes was abnormal (CK 1049U/L, CKMB-mass 145.1 μg/L, cTnI 16.24 μg/L). Myocardial injury (tachycardia with ST elevation) and poor heart function (LVEF 31%) were found by electrocardiogram and transthoracic echocardiography. On the next day, cardiogenic shock had been developed as demonstrated by deteriorating the perfusion index.Churg-Strauss Syndrome with cardiogenic shock.A series of conservative therapy with drugs such as corticosteroids, anticoagulant, antiplatelet, nitrates, calcium antagonists, inotrope, and vasopressors were initiated on the day of admission. The treatment was ineffective and a cardiogenic shock developed on the next day. Thus, ECMO was initiated immediately to stabilize circulation and perfusion. At the same time, high-dose corticosteroids combined with immunosuppressive therapy were continuously used.Symptoms of cardiogenic shock were gradually improved after ECMO treatment. Elevated values of cardiac enzymes were decreased and the dose of vasoactive drugs was reduced. Extracorporeal membrane oxygenation was discontinued after 8 days, and the patient was eventually weaned off the ventilator. The patient was discharged after 40 days treatment.Once a CSS develops into a

  18. The Effect of Extracorporeal Shock Wave Therapy on Myofascial Pain Syndrome

    PubMed Central

    Jeon, Jong Hyun; Jung, Yun Jae; Lee, Ju Youn; Choi, Ji Soo; Mun, Jeong Hyeon; Park, Won Yong; Seo, Cheong Hoon

    2012-01-01

    Objective To investigate the effect of extracorporeal shock wave therapy (ESWT) on myofascial pain syndrome (MPS). Method Thirty patients with MPS in trapezius muscle were randomly divided into two groups, ESWT group (n=15), and trigger point injections (TPI)+transcutaneous electrical nerve stimulation (TENS) group (n=15). For a total of 3 weeks, ESWT was undertaken with 1,500 pulse each time at one week interval totaling 4,500 pulse, TPI for once a week totaling three times and TENS for five times a week totaling three weeks. Results The changes in pain threshold (lb/cm2) showed the values of 6.86±1.35 before first therapy, 11.43±0.27 after first therapy, and 12.57±0.72 after third therapy, while TPI+TENS group showed the values of 6.20±1.92 before first therapy, 8.80±0.48 after first therapy, and 9.60±2.19 after third therapy, and the changes between the groups were significantly different (p=0.045). The changes in visual analog scale were estimated to be 6.86±0.90 before first therapy, 2.86±0.90 after first therapy, and 1.86±0.69 after third therapy in case of ESWT group, whereas the figures were estimated to be 7.20±1.30 before first therapy, 4.60±0.55 after first therapy, and 2.80±0.84 after third therapy in case of TPI+TENS group, and the changes between the groups were significantly different (p=0.010). The changes in McGill pain questionnaire (p=0.816) and pain rating scale (p=0.644) between the groups were not significantly different. The changes in neck ROM were also not significantly different between the groups (p>0.05). Conclusion The ESWT in patients with MPS in trapezius muscle are as effective as TPI and TENS for the purpose of pain relief and improving cervical range of motion. PMID:23185731

  19. Effect of Radial Extracorporeal Shock Wave Therapy on Hemiplegic Shoulder Pain Syndrome

    PubMed Central

    2016-01-01

    Objective To investigate the effect of radial extracorporeal shock wave therapy (rESWT) on hemiplegic shoulder pain (HSP) syndrome. Methods In this monocentric, randomized, patient-assessor blinded, placebo-controlled trial, patients with HSP were randomly divided into the rESWT (n=17) and control (n=17) groups. Treatment was administered four times a week for 2 weeks. The visual analogue scale (VAS) score and Constant-Murley score (CS) were assessed before and after treatment, and at 2 and 4 weeks. The Modified Ashworth Scale and Fugl-Meyer Assessment scores and range of motion of the shoulder were also assessed. Results VAS scores improved post-intervention and at the 2-week and 4-week follow-up in the intervention group (p<0.05). Respective differences in VAS scores between baseline and post-intervention in the intervention and control groups were –1.69±1.90 and –0.45±0.79, respectively (p<0.05), between baseline and 2-week follow-up in the intervention and control groups were –1.60±1.74 and –0.34±0.70, respectively (p<0.05), and between baseline and 4-week follow-up in the intervention and control groups were –1.61±1.73 and –0.33±0.71, respectively (p<0.05). Baseline CS improved from 19.12±11.02 to 20.88±10.37 post-intervention and to 20.41±10.82 at the 2-week follow-up only in the intervention group (p<0.05). Conclusion rESWT consisting of eight sessions could be one of the effective and safe modalities for pain management in people with HSP. Further studies are needed to generalize and support these results in patients with HSP and a variety conditions, and to understand the mechanism of rESWT for treating HSP. PMID:27446789

  20. Investigation by syringe method of effect of tampons on production in vitro of toxic shock syndrome toxin 1 by Staphylococcus aureus.

    PubMed Central

    Lee, A C; Crass, B A; Bergdoll, M S

    1987-01-01

    A syringe method was designed to test the effect of tampons on the growth of three toxic shock syndrome-associated strains of Staphylococcus aureus and their in vitro production of toxic shock syndrome toxin 1 (TSST-1) under different conditions. Various amounts of TSST-1 were recovered from different tampons inoculated with these strains. Generally, the addition of 10% porcine blood to the growth medium, incubation in the presence of 5% CO2, or the combination of these two factors resulted in the stimulation of TSST-1 production. PMID:3793877

  1. Investigation by syringe method of effect of tampons on production in vitro of toxic shock syndrome toxin 1 by Staphylococcus aureus.

    PubMed

    Lee, A C; Crass, B A; Bergdoll, M S

    1987-01-01

    A syringe method was designed to test the effect of tampons on the growth of three toxic shock syndrome-associated strains of Staphylococcus aureus and their in vitro production of toxic shock syndrome toxin 1 (TSST-1) under different conditions. Various amounts of TSST-1 were recovered from different tampons inoculated with these strains. Generally, the addition of 10% porcine blood to the growth medium, incubation in the presence of 5% CO2, or the combination of these two factors resulted in the stimulation of TSST-1 production.

  2. Surfactants, aromatic and isoprenoid compounds, and fatty acid biosynthesis inhibitors suppress Staphylococcus aureus production of toxic shock syndrome toxin 1.

    PubMed

    McNamara, Peter J; Syverson, Rae Ellen; Milligan-Myhre, Kathy; Frolova, Olga; Schroeder, Sarah; Kidder, Joshua; Hoang, Thanh; Proctor, Richard A

    2009-05-01

    Menstrual toxic shock syndrome is a rare but potentially life-threatening illness manifest through the actions of Staphylococcus aureus toxic shock syndrome toxin 1 (TSST-1). Previous studies have shown that tampon additives can influence staphylococcal TSST-1 production. We report here on the TSST-1-suppressing activity of 34 compounds that are commonly used additives in the pharmaceutical, food, and perfume industries. Many of the tested chemicals had a minimal impact on the growth of S. aureus and yet were potent inhibitors of TSST-1 production. The TSST-1-reducing compounds included surfactants with an ether, amide, or amine linkage to their fatty acid moiety (e.g., myreth-3-myristate, Laureth-3, disodium lauroamphodiacetate, disodium lauramido monoethanolamido, sodium lauriminodipropionic acid, and triethanolamine laureth sulfate); aromatic compounds (e.g. phenylethyl and benzyl alcohols); and several isoprenoids and related compounds (e.g., terpineol and menthol). The membrane-targeting and -altering effects of the TSST-1-suppressing compounds led us to assess the activity of molecules that are known to inhibit fatty acid biosynthesis (e.g., cerulenin, triclosan, and hexachlorophene). These compounds also reduced S. aureus TSST-1 production. This study suggests that more additives than previously recognized inhibit the production of TSST-1.

  3. Local Epidermal Growth Factor Receptor Signaling Mediates the Systemic Pathogenic Effects of Staphylococcus aureus Toxic Shock Syndrome

    PubMed Central

    Gillman, Aaron N.; Stach, Christopher S.; Schlievert, Patrick M.; Peterson, Marnie L.

    2016-01-01

    Secreted factors of Staphylococcus aureus can activate host signaling from the epidermal growth factor receptor (EGFR). The superantigen toxic shock syndrome toxin-1 (TSST-1) contributes to mucosal cytokine production through a disintegrin and metalloproteinase (ADAM)-mediated shedding of EGFR ligands and subsequent EGFR activation. The secreted hemolysin, α-toxin, can also induce EGFR signaling and directly interacts with ADAM10, a sheddase of EGFR ligands. The current work explores the role of EGFR signaling in menstrual toxic shock syndrome (mTSS), a disease mediated by TSST-1. The data presented show that TSST-1 and α-toxin induce ADAM- and EGFR-dependent cytokine production from human vaginal epithelial cells. TSST-1 and α-toxin also induce cytokine production from an ex vivo porcine vaginal mucosa (PVM) model. EGFR signaling is responsible for the majority of IL-8 production from PVM in response to secreted toxins and live S. aureus. Finally, data are presented demonstrating that inhibition of EGFR signaling with the EGFR-specific tyrosine kinase inhibitor AG1478 significantly increases survival in a rabbit model of mTSS. These data indicate that EGFR signaling is critical for progression of an S. aureus exotoxin-mediated disease and may represent an attractive host target for therapeutics. PMID:27414801

  4. First Generation Gene Expression Signature for Early Prediction of Late Occurring Hematological Acute Radiation Syndrome in Baboons.

    PubMed

    Port, M; Herodin, F; Valente, M; Drouet, M; Lamkowski, A; Majewski, M; Abend, M

    2016-07-01

    We implemented a two-stage study to predict late occurring hematologic acute radiation syndrome (HARS) in a baboon model based on gene expression changes measured in peripheral blood within the first two days after irradiation. Eighteen baboons were irradiated to simulate different patterns of partial-body and total-body exposure, which corresponded to an equivalent dose of 2.5 or 5 Gy. According to changes in blood cell counts the surviving baboons (n = 17) exhibited mild (H1-2, n = 4) or more severe (H2-3, n = 13) HARS. Blood samples taken before irradiation served as unexposed control (H0, n = 17). For stage I of this study, a whole genome screen (mRNA microarrays) was performed using a portion of the samples (H0, n = 5; H1-2, n = 4; H2-3, n = 5). For stage II, using the remaining samples and the more sensitive methodology, qRT-PCR, validation was performed on candidate genes that were differentially up- or down-regulated during the first two days after irradiation. Differential gene expression was defined as significant (P < 0.05) and greater than or equal to a twofold difference above a H0 classification. From approximately 20,000 genes, on average 46% appeared to be expressed. On day 1 postirradiation for H2-3, approximately 2-3 times more genes appeared up-regulated (1,418 vs. 550) or down-regulated (1,603 vs. 735) compared to H1-2. This pattern became more pronounced at day 2 while the number of differentially expressed genes decreased. The specific genes showed an enrichment of biological processes coding for immune system processes, natural killer cell activation and immune response (P = 1 × E-06 up to 9 × E-14). Based on the P values, magnitude and sustained differential gene expression over time, we selected 89 candidate genes for validation using qRT-PCR. Ultimately, 22 genes were confirmed for identification of H1-3 classifications and seven genes for identification of H2-3 classifications using qRT-PCR. For H1-3 classifications, most genes were

  5. Systemic leukopenia, evaluation of laminar leukocyte infiltration and laminar lesions in horses with naturally occurring colic syndrome.

    PubMed

    Laskoski, Luciane Maria; Locatelli-Dittrich, Rosangela; Valadão, Carlos Augusto Araújo; Deconto, Ivan; Gonçalves, Kamila Alcala; Montiani-Ferreira, Fabiano; Brum, Juliana Sperotto; de Brito, Harald Fernando Vicente; de Sousa, Renato Silva

    2015-08-01

    The present study was aimed at identifying laminar lesions and leukocyte infiltration in hoof laminar tissue of horses with colic syndrome and its correlation with the total leukocyte count before death. Six healthy horses were used as control group (CG), and eighteen horses with lethal gastrointestinal disease were divided into two groups: leukopenic group (LG) with seven leukopenic horses, and non-leukopenic group (NLG) with 11 horses with total leukocyte count within reference range for the species. Leukocyte infiltration was examined by immunohistochemistry. Laminar lesions were observed in both LG and NLG, with no differences in severity between them. LG showed increase of the leukocyte infiltration in the hoof laminar tissue, when compared to CG and NLG. Horses with severe colic syndrome (LG and NLG) developed intense laminar lesions without clinical signs of laminitis, with increased leukocyte infiltration. However, the LG demonstrated an even higher increase of leukocyte infiltration compared to both CG and NLG.

  6. Systemic leukopenia, evaluation of laminar leukocyte infiltration and laminar lesions in horses with naturally occurring colic syndrome.

    PubMed

    Laskoski, Luciane Maria; Locatelli-Dittrich, Rosangela; Valadão, Carlos Augusto Araújo; Deconto, Ivan; Gonçalves, Kamila Alcala; Montiani-Ferreira, Fabiano; Brum, Juliana Sperotto; de Brito, Harald Fernando Vicente; de Sousa, Renato Silva

    2015-08-01

    The present study was aimed at identifying laminar lesions and leukocyte infiltration in hoof laminar tissue of horses with colic syndrome and its correlation with the total leukocyte count before death. Six healthy horses were used as control group (CG), and eighteen horses with lethal gastrointestinal disease were divided into two groups: leukopenic group (LG) with seven leukopenic horses, and non-leukopenic group (NLG) with 11 horses with total leukocyte count within reference range for the species. Leukocyte infiltration was examined by immunohistochemistry. Laminar lesions were observed in both LG and NLG, with no differences in severity between them. LG showed increase of the leukocyte infiltration in the hoof laminar tissue, when compared to CG and NLG. Horses with severe colic syndrome (LG and NLG) developed intense laminar lesions without clinical signs of laminitis, with increased leukocyte infiltration. However, the LG demonstrated an even higher increase of leukocyte infiltration compared to both CG and NLG. PMID:26267083

  7. Mild Electrical Stimulation and Heat Shock Ameliorates Progressive Proteinuria and Renal Inflammation in Mouse Model of Alport Syndrome

    PubMed Central

    Fukuda, Ryosuke; Morino-Koga, Saori; Suico, Mary Ann; Koyama, Kosuke; Sato, Takashi; Shuto, Tsuyoshi; Kai, Hirofumi

    2012-01-01

    Alport syndrome is a hereditary glomerulopathy with proteinuria and nephritis caused by defects in genes encoding type IV collagen in the glomerular basement membrane. All male and most female patients develop end-stage renal disease. Effective treatment to stop or decelerate the progression of proteinuria and nephritis is still under investigation. Here we showed that combination treatment of mild electrical stress (MES) and heat stress (HS) ameliorated progressive proteinuria and renal injury in mouse model of Alport syndrome. The expressions of kidney injury marker neutrophil gelatinase-associated lipocalin and pro-inflammatory cytokines interleukin-6, tumor necrosis factor-α and interleukin-1β were suppressed by MES+HS treatment. The anti-proteinuric effect of MES+HS treatment is mediated by podocytic activation of phosphatidylinositol 3-OH kinase (PI3K)-Akt and heat shock protein 72 (Hsp72)-dependent pathways in vitro and in vivo. The anti-inflammatory effect of MES+HS was mediated by glomerular activation of c-jun NH2-terminal kinase 1/2 (JNK1/2) and p38-dependent pathways ex vivo. Collectively, our studies show that combination treatment of MES and HS confers anti-proteinuric and anti-inflammatory effects on Alport mice likely through the activation of multiple signaling pathways including PI3K-Akt, Hsp72, JNK1/2, and p38 pathways, providing a novel candidate therapeutic strategy to decelerate the progression of patho-phenotypes in Alport syndrome. PMID:22937108

  8. Effect of steroid and high-dose immunoglobulin therapy on opsoclonus-myoclonus syndrome occurring in neuroblastoma.

    PubMed

    Veneselli, E; Conte, M; Biancheri, R; Acquaviva, A; De Bernardi, B

    1998-01-01

    The authors describe a case of an 8-month-old boy with opsoclonus-myoclonus syndrome (OMS) and coincident unresectable neuroblastoma (NB). He achieved a complete remission for NB after 6 courses of standard-dose chemotherapy without significant neurological improvement despite the use of steroids and high-dose immunoglobulin (HIG), administered separately. Only the combined treatment withthese two drugs induced a complete disappearance of neurological symptoms. On the basis of this experience, the authors suggest the association of steroids plus HIG for the treatment of OMS in patients not responsive to conventional first line therapy with steroids.

  9. Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) syndrome associated with azithromycin presenting like septic shock: a case report

    PubMed Central

    2014-01-01

    Introduction Drug reaction with eosinophilia and systemic symptoms syndrome is a potentially life-threatening cutaneous hypersensitivity reaction characterized by extensive mucocutaneous eruption, fever, hematologic abnormalities including eosinophilia and/or atypical lymphocytosis, and extensive organ involvement. The drugs most often responsible for causing drug reaction with eosinophilia and systemic symptoms syndrome are anticonvulsants, antimicrobial agents and antipyretic or anti-inflammatory analgesics. Although azithromycin is widely prescribed in clinical practice, serious cutaneous reactions from this agent have been rarely described. We report the first adult case of drug reaction with eosinophilia and systemic symptoms syndrome associated with azithromycin. Case presentation A 44-year-old previously healthy Caucasian man with history of tobacco use presented to his primary care physician with fever and productive cough. He was prescribed azithromycin, promethazine hydrochloride and dextromethorphan hydrobromide syrup. One week later, he developed a blistering erythematous rash over both hands, which over the next two weeks spread to involve nearly his entire body surface, sparing only his face. He was admitted to an outside hospital with signs of systemic inflammatory response syndrome and severe sepsis, presumably from a skin infection. Despite aggressive therapy he deteriorated, with worsening diffuse erythema, and was transferred to our institution. He developed multiple organ failure requiring ventilatory and hemodynamic support. Pertinent laboratory studies included a leukocytosis with a white blood cell count of 17.6×109/L and 47% eosinophils. A skin biopsy showed evidence of spongiotic lichenoid dermatitis with eosinophils and neutrophils, compatible with a systemic drug-induced hypersensitivity reaction. Our patient was started on high-dose steroids and showed dramatic improvement within 48 hours. Conclusions We report the first adult case of

  10. Fatal group A streptococcal necrotizing fasciitis and toxic shock syndrome in a patient with psoriasis and chronic renal impairment.

    PubMed

    Chong, Alvin H; Burrows, Nigel P

    2002-08-01

    A 78-year-old woman presented with rapid onset of skin pain which evolved into oedema, discoloration and infarction. She was diagnosed with group A beta-haemolytic streptococcus (Streptococcus pyogenes) necrotizing fasciitis and streptococcal toxic shock syndrome. The patient had a past history of psoriasis and end-stage renal impairment. Despite treatment with multiple antibiotics in an intensive care unit, the skin infarction involving the upper trunk continued to expand and the patient died within 24 hours of hospital admission. Group A streptococcus and Staphylococcus aureus were cultured from a tissue biopsy. Renal failure and compromised skin barrier function are known to predispose to invasive streptococcal infections, but necrotizing fasciitis has only rarely been reported in association with psoriasis. This case illustrates the fulminant nature of the infection.

  11. Phenotypic and genotypic characterization of dengue virus isolates differentiates dengue fever and dengue hemorrhagic fever from dengue shock syndrome.

    PubMed

    Tuiskunen, Anne; Monteil, Vanessa; Plumet, Sébastien; Boubis, Laetitia; Wahlström, Maria; Duong, Veasna; Buchy, Philippe; Lundkvist, Ake; Tolou, Hugues; Leparc-Goffart, Isabelle

    2011-11-01

    Dengue viruses (DENV) cause 50-100 million cases of acute febrile disease every year, including 500,000 reported cases of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Viral factors have been proposed to influence the severity of the disease, but markers of virulence have never been identified on DENV. Three DENV serotype-1 isolates from the 2007 epidemic in Cambodia that are derived from patients experiencing the various clinical forms of dengue were characterized both phenotypically and genetically. Phenotypic characteristics in vitro, based on replication kinetics in different cell lines and apoptosis response, grouped isolates from DF and DHF patients together, whereas the virus isolate from a DSS patient showed unique features: a lower level of replication in mammalian cells and extensive apoptosis in mosquito cells. Genomic comparison of viruses revealed six unique amino acid residues in the membrane, envelope, and in non-structural genes in the virus isolated from the DSS patient.

  12. Clinical, laboratory and radiological parameters in children with dengue fever and predictive factors for dengue shock syndrome.

    PubMed

    Chacko, Betty; Subramanian, Gayathri

    2008-04-01

    This article is a prospective study of the clinical, laboratory and radiological picture of children satisfying the case definition criteria of dengue by WHO admitted at Sri Ramachandra Medical College and Research Institute, a suburban tertiary referral centre, to determine the predictive factors for dengue shock syndrome (DSS). Data were analyzed by Chi-squared test and Student's t-test for significance after dividing the patients into two groups, those with and those without DSS for the same. Bleeding manifestations, presence of effusion on USG/X-ray, haematocrit >35%, WBC <4000/cumm, Na < or =130 meq/l, bicarbonate level of <18 mmol/l, deranged coagulation profile and serum glutamic pyruvic transaminase (SGPT) > or =40 IU were predictive of DSS.

  13. Staphylococcal enterotoxin B toxic shock syndrome induced by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA).

    PubMed

    Kashiwada, Takeru; Kikuchi, Ken; Abe, Shinji; Kato, Hidehito; Hayashi, Hiroki; Morimoto, Taisuke; Kamio, Koichiro; Usuki, Jiro; Takeda, Shinhiro; Tanaka, Keiji; Imanishi, Ken'ichi; Yagi, Junji; Azuma, Arata; Gemma, Akihiko

    2012-01-01

    We herein report a case of toxic shock syndrome (TSS) associated with the 2009 pandemic H1N1 (pH1N1) influenza virus and a community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in a 16-year-old Vietnamese girl. Staphylococcal enterotoxin B (SEB) was detected in the patient's serum, and the level of anti-SEB antibodies was found to be elevated. A flow cytometric analysis showed evidence of activated SEB-reactive Vβ3+ and Vβ12+ T cells. These data suggest that the CA-MRSA-induced activation of SEB-reactive T cells may cause TSS in patients with pH1N1 virus infection. Moreover, this is the first report describing immunological confirmation of SEB contributing directly to TSS in a patient fulfilling the diagnostic criteria of TSS.

  14. Activation of heat shock gene transcription by heat shock factor 1 involves oligomerization, acquisition of DNA-binding activity, and nuclear localization and can occur in the absence of stress.

    PubMed Central

    Sarge, K D; Murphy, S P; Morimoto, R I

    1993-01-01

    The existence of multiple heat shock factor (HSF) genes in higher eukaryotes has promoted questions regarding the functions of these HSF family members, especially with respect to the stress response. To address these questions, we have used polyclonal antisera raised against mouse HSF1 and HSF2 to examine the biochemical, physical, and functional properties of these two factors in unstressed and heat-shocked mouse and human cells. We have identified HSF1 as the mediator of stress-induced heat shock gene transcription. HSF1 displays stress-induced DNA-binding activity, oligomerization, and nuclear localization, while HSF2 does not. Also, HSF1 undergoes phosphorylation in cells exposed to heat or cadmium sulfate but not in cells treated with the amino acid analog L-azetidine-2-carboxylic acid, indicating that phosphorylation of HSF1 is not essential for its activation. Interestingly, HSF1 and HSF2 overexpressed in transfected 3T3 cells both display constitutive DNA-binding activity, oligomerization, and transcriptional activity. These results demonstrate that HSF1 can be activated in the absence of physiological stress and also provide support for a model of regulation of HSF1 and HSF2 activity by a titratable negative regulatory factor. Images PMID:8441385

  15. Cardiogenic Shock.

    PubMed

    Moskovitz, Joshua B; Levy, Zachary D; Slesinger, Todd L

    2015-08-01

    Cardiogenic shock is the leading cause of morbidity and mortality in patients presenting with acute coronary syndrome. Although early reperfusion strategies are essential to the management of these critically ill patients, additional treatment plans are often needed to stabilize and treat the patient before reperfusion may be possible. This article discusses pharmacologic and surgical interventions, their indications and contraindications, management strategies, and treatment algorithms.

  16. Cardiogenic shock and nutrition: safe?

    PubMed

    Thibault, Ronan; Pichard, Claude; Wernerman, Jan; Bendjelid, Karim

    2011-01-01

    Cardiogenic shock is a common diagnosis in patients in the intensive care unit (ICU), and is characterized by a decreased cardiac output in the presence of adequate intravascular volume associated with an inadequate tissue perfusion including a physiological reduction in the splanchnic territory. It may occur in isolation as a reflection of cardiac pathology, or it may be part of a shock syndrome involving other pathogenic mechanisms. As the use of enteral nutrition (EN) is associated with an increase in mesenteric arterial output, EN could be deleterious by overwhelming the mechanisms of mesenteric adaptation. Accordingly, EN has been suspected to increase the risk of mesenteric ischaemia, bacterial translocation and sepsis in ICU patients with cardiogenic shock. International guidelines recommend a cautious use of EN within 72 h following cardiogenic shock. Recent evidence indicates that mesenteric arterial output may decrease during parenteral nutrition administration, suggesting that parenteral nutrition could have a protective effect on splanchnic organs in ICU patients with cardiogenic shock. Contrary to former beliefs, several meta-analyses have shown that parenteral nutrition is not associated with increased mortality. Exclusive EN is associated with negative energy balance and the combination of EN with supplemental parenteral nutrition during the first days following ICU admission has been proposed to prevent negative energy balance. Such a nutritional strategy could also be beneficial for the mesenteric circulation in cardiogenic shock, and consequently may improve the clinical outcome of patients with cardiogenic shock. Clinical trials are warranted to verify these hypotheses. PMID:21086113

  17. An altered antioxidant balance occurs in Down syndrome fetal organs: implications for the "gene dosage effect" hypothesis.

    PubMed

    de Haan, J B; Susil, B; Pritchard, M; Kola, I

    2003-01-01

    Down syndrome (DS) is the congenital birth defect responsible for the greatest number of individuals with mental retardation. It arises due to trisomy of human chromosome 21 (HSA21) or part thereof. To date there have been limited studies of HSA21 gene expression in trisomy 21 conceptuses. In this study we investigate the expression of the HSA21 antioxidant gene, Cu/Zn-superoxide dismutase-1 (SOD1) in various organs of control and DS aborted conceptuses. We show that SOD1 mRNA levels are elevated in DS brain, lung, heart and thymus. DS livers show decreased SOD1 mRNA expression compared with controls. Since non-HSA21 antioxidant genes are reported to be concomitantly upregulated in certain DS tissues, we examined the expression of glutathione peroxidase-1 (GPX1) in control and DS fetal organs. Interestingly, GPX1 expression was unchanged in the majority of DS organs and decreased in DS livers. We examined the SOD1 to GPX1 mRNA ratio in individual organs, as both enzymes form part of the body's defense against oxidative stress, and because a disproportionate increase of SOD1 to GPX1 results in noxious hydroxyl radical damage. All organs investigated show an approximately 2-fold increase in the SOD1 to GPX1 mRNA ratio. We propose that it is the altered antioxidant ratio that contributes to certain aspects of the DS phenotype.

  18. Dynamic Angular Petrissage as Treatment for Axillary Web Syndrome Occurring after Surgery for Breast Cancer: a Case Report

    PubMed Central

    Lewis, Paul A.; Cunningham, Joan E.

    2016-01-01

    Background In the context of breast cancer, axillary web syndrome (AWS), also called lymphatic cording, typically presents in the weeks after axillary surgery. This painful condition, likely lymphofibrotic in origin, restricts upper extremity range of motion (ROM). There is no established treatment, although physical therapy and other approaches have been used to variable effect. This report describes treatment of a female client with AWS, who had recently undergone a unilateral simple mastectomy with sentinel node biopsy plus axillary dissection. Methods The client presented with pain upon movement (self-reported as 5 on the 0–10 Oxford Pain Scale), visible cording and restricted use of the ipsilateral upper extremity. Clinical assessment included determining the extent of AWS cording (taut, from axilla to wrist) and measuring glenohumeral joint ROM (140° flexion by goniometer). A therapeutic massage with movement protocol, termed dynamic angular petrissage, was administered over two sessions: Swedish massage combined with dynamically taking the limb through all possible angles of movement (passive ROM), controlling stretch and tension while simultaneously and segmentally applying petrissage and non-petrissage techniques to the underlying soft tissue. Careful attention was taken to not break the cord. Home care consisted of prescribed exercises performed by the patient. Results After Session One, pain was reduced (to 0/10), ROM improved (to 170° flexion), and cording was visibly reduced. After Session Two the cord was residually apparent only on hyperextension, with no ROM restrictions in glenohumeral joint flexion. Follow-up at three months revealed absence of visual or palpable evidence of cording, unrestricted glenohumeral joint ROM, and absence of movement-associated pain. Conclusion The signs and symptoms of AWS were quickly and effectively eliminated, without causing any pain or discomfort to the client. We propose that dynamic angular petrissage may be

  19. Investigation by improved syringe method of effect of tampons on production in vitro of toxic shock syndrome toxin 1 by Staphylococcus aureus.

    PubMed Central

    Wong, A C; Downs, S A

    1989-01-01

    Twenty-seven types of commercial tampons from five manufacturers were tested in a sealed-syringe method to determine their effect on the growth of Staphylococcus aureus and the production of toxic shock syndrome toxin 1. In this improvement of the syringe method, the available air is limited to that which is contained within the sealed syringe containing the tampon. The culture medium was buffered, and blood and CO2 were included in the incubation to better simulate the vaginal environment during menstruation. Variables of tampon weight, composition, air volume, and absorbency were examined for their effect on the production of toxic shock syndrome toxin 1. Generally, with the exception of brand E, toxin production in the presence of tampons was equal to or lower than that in a sealed control syringe containing air but no tampon. PMID:2808672

  20. [Pharyngo-tonsillitis and necrosing submaxillary adenitis caused by Streptococcus pyogenes associated with toxic shock syndrome in children from Mexico City].

    PubMed

    Maulén de Vázquez, I; González-Galnares, M; Ridaura-Sanz, C; Saucedo-Sánchez, A; Osnaya-Martínez, H

    1993-08-01

    We report on six previously healthy children between nine months and nine years old, who suffered streptococcal faringoamigdalitis and cervical adenitis with scarlet fever and toxic shock syndrome; four of them died in a fulminant course and two survived. These patients behave similarly to others reported from United States of America, England and Australia, and in similar way these clinical entity could be due to bacterial pyrogenic exotoxins according to the clinical fulminant course.

  1. Role of cognitive parameters in dengue hemorrhagic fever and dengue shock syndrome

    PubMed Central

    2013-01-01

    Dengue is becoming recognized as one of the most important vector-borne human diseases. It is predominant in tropical and subtropical zones but its geographical distribution is progressively expanding, making it an escalating global health problem of today. Dengue presents with spectrum of clinical manifestations, ranging from asymptomatic, undifferentiated mild fever, dengue fever (DF), to dengue hemorrhagic fever (DHF) with or without shock (DSS), a life-threatening illness characterized by plasma leakage due to increased vascular permeability. Currently, there are no antiviral modalities or vaccines available to treat and prevent dengue. Supportive care with close monitoring is the standard clinical practice. The mechanisms leading to DHF/DSS remains poorly understood. Multiple factors have been attributed to the pathological mechanism, but only a couple of these hypotheses are popular in scientific circles. The current discussion focuses on underappreciated factors, temperature, natural IgM, and endotoxin, which may be critical components playing roles in dengue pathogenesis. PMID:24305068

  2. Septic shock non-thyroidal illness syndrome causes hypothyroidism and conditions for reduced sensitivity to thyroid hormone.

    PubMed

    Castro, Isabel; Quisenberry, Leah; Calvo, Rosa-Maria; Obregon, Maria-Jesus; Lado-Abeal, Joaquin

    2013-04-01

    Non-thyroidal illness syndrome (NTIS) is part of the neuroendocrine response to stress, but the significance of this syndrome remains uncertain. The aim of this study was to investigate the effect of lipopolysaccharide (LPS)-induced NTIS on thyroid hormone (TH) levels and TH molecular targets, as well as the relationship between septic shock nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) activation and TH receptor β (THRB) gene expression at a multi-tissue level in a pig model. Prepubertal domestic pigs were given i.v. saline or LPS for 48 h. Serum and tissue TH was measured by chemiluminescence and RIA. Expression of THRs and cofactors was measured by real-time PCR, and deiodinase (DIO) activity was measured by enzyme assays. Tissue NF-kB nuclear binding activity was evaluated by EMSA. LPS-treated pigs had decreased TH levels in serum and most tissues. DIO1 expression in liver and kidney and DIO1 activity in kidney decreased after LPS. No changes in DIO2 activity were observed between groups. LPS induced an increase in hypothalamus, thyroid, and liver DIO3 activity. Among the other studied genes, monocarboxylate transporter 8 and THRB were the most commonly repressed in endotoxemic pigs. LPS-induced NF-kB activation was associated with a decrease in THRB gene expression only in frontal lobe, adrenal gland, and kidney cortex. We conclude that LPS-induced NTIS in pigs is characterized by hypothyroidism and tissue-specific reduced TH sensitivity. The role of NF-kB in regulating THRB expression during endotoxemia, if any, is restricted to a limited number of tissues.

  3. Comparative observations of fever and associated clinical hematological and blood biochemical changes after intravenous administration of staphylococcal enterotoxins B and F (toxic shock syndrome toxin-1) in goats.

    PubMed Central

    Van Miert, A S; Van Duin, C T; Schotman, A J

    1984-01-01

    The present investigation was undertaken to examine the characteristics of purified toxic shock syndrome toxin-1 (staphylococcal enterotoxin F) given intravenously to dwarf goats (dose, 0.02 to 20 micrograms kg-1). Rectal temperature, heart rate, rumen motility, plasma zinc and iron concentrations, and certain other blood biochemical and hematological values were studied and compared with the changes seen after intravenous administration of staphylococcal enterotoxin B (dose, 0.02 to 0.5 micrograms kg-1). Similar changes such as fever, tachycardia, inhibition of rumen contractions, drop in plasma zinc and iron concentrations, lymphopenia, and a decrease in serum alkaline phosphatase activity were observed. In contrast to the effects of toxic shock syndrome toxin-1, staphylococcal enterotoxin B induced colic, watery diarrhea with pseudomembranes, hemoconcentration, and a more pronounced increase in blood urea nitrogen. The results obtained demonstrate that (i) in the goat staphylococcal enterotoxin B is much more potent than toxic shock syndrome toxin-1 and (ii) the goat is a useful model to study the gastro-intestinal effects caused by staphylococcal enterotoxin B. The present finding that no clear relationship could be found between the temperature response and the alterations in zinc and iron levels in plasma support the theory that the febrile reactions and the changes in plasma trace metals are mediated by different polypeptides released by activated macrophages. PMID:6500695

  4. Vaccination with non-toxic mutant toxic shock syndrome toxin-1 induces IL-17-dependent protection against Staphylococcus aureus infection.

    PubMed

    Narita, Kouji; Hu, Dong-Liang; Asano, Krisana; Nakane, Akio

    2015-06-01

    Toxic shock syndrome toxin-1 (TSST-1) is one of superantigens produced by Staphylococcus aureus. We have previously demonstrated that vaccination with non-toxic mutant TSST-1 (mTSST-1) develops host protection to lethal S. aureus infection in mice. However, the detailed mechanism underlying this protection is necessary to elucidate because the passive transfer of antibodies against TSST-1 fails to provide complete protection against S. aureus infection. In this study, the results showed that interleukin-17A (IL-17A)-producing cells were increased in the spleen cells of mTSST-1-vaccinated mice. The main source of IL-17A in mTSST-1-vaccinated mice was T-helper 17 (Th17) cells. The protective effect of vaccination was induced when the vaccinated wild type but not IL-17A-deficient mice were challenged with S. aureus. Gene expression of chemokines, CCL2 and CXCL1, and infiltration of neutrophils and macrophages were increased in spleens and livers of vaccinated mice after infection. The IL-17A-dependent immune response was TSST-1 specific because TSST-1-deficient S. aureus failed to induce the response. The present study suggests that mTSST-1 vaccination is able to provide the IL-17A-dependent host defense against S. aureus infection which promotes chemokine-mediated infiltration of phagocytes into the infectious foci.

  5. Efficacy of Extracorporeal Shock Wave Therapy for the Treatment of Chronic Pelvic Pain Syndrome: A Randomized, Controlled Trial

    PubMed Central

    Vahdatpour, Babak; Moayednia, Amir; Emadi, Masoud; Khorami, Mohammad Hatef; Haghdani, Saeid

    2013-01-01

    Objectives. To investigate the effectiveness of extracorporeal shock wave therapy (ESWT) for symptoms alleviation in chronic pelvic pain syndrome (CPPS). Materials and Methods. 40 patients with CPPS were randomly allocated into either the treatment or sham group. In the first group, patients were treated by ESWT once a week for 4 weeks by a defined protocol. In the sham group, the same protocol was applied but with the probe being turned off. The follow-up assessments were done at 1, 2, 3, and 12 weeks by Visual Analogue Scale (VAS) for pain and NIH-developed Chronic Prostatitis Symptom Index (NIH-CPSI). Results. Pain domain scores at follow-up points in both treatment and sham groups were reduced, more so in the treatment group, which were significant at weeks 2, 3, and 12. Urinary scores became significantly different at weeks 3 and 12. Also, quality of life (QOL) and total NIH-CPSI scores at all four follow-up time points reduced more significantly in the treatment group as compared to the sham group. Noticeably, at week 12 a slight deterioration in all variables was observed compared to the first 3 weeks of the treatment period. Conclusions. our findings confirmed ESWT therapy as a safe and effective method in CPPS in short term. PMID:24000311

  6. Of cascades and perfect storms: the immunopathogenesis of dengue haemorrhagic fever-dengue shock syndrome (DHF/DSS).

    PubMed

    Pang, Tikki; Cardosa, Mary Jane; Guzman, Maria G

    2007-01-01

    The past four decades has witnessed a consolidation of the original observations made in the 1970s that dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) have an immunological basis. Following reinfection with a dengue virus of different serotype, severe disease is linked to high levels of antibody-enhanced viral replication early in illness which is followed by a cascade of memory T-cell activation and a 'storm' of inflammatory cytokines and other chemical mediators. These compounds are released mainly from T cells, monocytes/macrophages and endothelial cells, and ultimately cause an increase in vascular permeability. The consolidation of the evidence has been largely due to several important prospective sero-epidemiological studies in areas endemic for DHF/DSS, which have shown that risk of severe disease is significantly higher in secondary dengue infections. These advances have underscored the fact that DHF/DSS pathogenesis is a complex, multifactorial process involving cocirculation of various dengue virus serotypes and the interplay of host and viral factors that influence disease severity. The continued search to define risk factors in susceptible populations must be combined with the new techniques of molecular virology and innovative approaches in vaccine design to achieve the ultimate objective of developing a safe and effective vaccine. PMID:17130899

  7. Randomized comparison of oxygen mask treatment vs. nasal continuous positive airway pressure in dengue shock syndrome with acute respiratory failure.

    PubMed

    Cam, B V; Tuan, D T; Fonsmark, L; Poulsen, A; Tien, N M; Tuan, H M; Heegaard, E D

    2002-12-01

    Dengue hemorrhagic fever (DHF) is caused by dengue virus. Patients with DHF grade 3-4, termed Dengue Shock Syndrome (DSS), may develop acute respiratory failure after initial fluid resuscitation. Previously, these patients were treated with oxygen on a nasal cannula, or if necessary with tracheal intubation and mechanical ventilation. In the present prospective randomized study, we compared the effectiveness of oxygen treatment administered by a face mask vs. nasal continuous positive airway pressure (NCPAP). Morbidity, mortality, and supportive treatment was evaluated. Thirty-seven patients with DSS complicated by respiratory failure were enrolled. On admission and after 30 min of treatment, clinical and paraclinical data were obtained. Chest X-ray revealed pleural effusion in 92 per cent and showed interstitial oedema in 33 per cent. After 30 min of treatment the respiratory rate decreased significantly in the NCPAP group (p < 0.05), while SaO2 and PaO2 increased in both groups (p < 0.01). However, subsequently a significant difference of unresponsiveness to treatment between the oxygen mask group and the NCPAP group (13/19 vs. 4/18,p < 0.01) was noted. Complications of NCPAP or oxygen mask treatment were not documented. We conclude that NCPAP is useful in improving the management of acute respiratory failure in children with DHF/DSS in dengue-endemic areas.

  8. Pre- and perinatal complications in relation to Tourette syndrome and co-occurring obsessive-compulsive disorder and attention-deficit/hyperactivity disorder.

    PubMed

    Abdulkadir, Mohamed; Tischfield, Jay A; King, Robert A; Fernandez, Thomas V; Brown, Lawrence W; Cheon, Keun-Ah; Coffey, Barbara J; de Bruijn, Sebastian F T M; Elzerman, Lonneke; Garcia-Delgar, Blanca; Gilbert, Donald L; Grice, Dorothy E; Hagstrøm, Julie; Hedderly, Tammy; Heyman, Isobel; Hong, Hyun Ju; Huyser, Chaim; Ibanez-Gomez, Laura; Kim, Young Key; Kim, Young-Shin; Koh, Yun-Joo; Kook, Sodahm; Kuperman, Samuel; Lamerz, Andreas; Leventhal, Bennett; Ludolph, Andrea G; Madruga-Garrido, Marcos; Maras, Athanasios; Messchendorp, Marieke D; Mir, Pablo; Morer, Astrid; Münchau, Alexander; Murphy, Tara L; Openneer, Thaïra J C; Plessen, Kerstin J; Rath, Judith J G; Roessner, Veit; Fründt, Odette; Shin, Eun-Young; Sival, Deborah A; Song, Dong-Ho; Song, Jungeun; Stolte, Anne-Marie; Tübing, Jennifer; van den Ban, Els; Visscher, Frank; Wanderer, Sina; Woods, Martin; Zinner, Samuel H; State, Matthew W; Heiman, Gary A; Hoekstra, Pieter J; Dietrich, Andrea

    2016-11-01

    Pre- and perinatal complications have been implicated in the onset and clinical expression of Tourette syndrome albeit with considerable inconsistencies across studies. Also, little is known about their role in co-occurring obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in individuals with a tic disorder. Therefore, we aimed to investigate the role of pre- and perinatal complications in relation to the presence and symptom severity of chronic tic disorder and co-occurring OCD and ADHD using data of 1113 participants from the Tourette International Collaborative Genetics study. This study included 586 participants with a chronic tic disorder and 527 unaffected family controls. We controlled for age and sex differences by creating propensity score matched subsamples for both case-control and within-case analyses. We found that premature birth (OR = 1.72) and morning sickness requiring medical attention (OR = 2.57) were associated with the presence of a chronic tic disorder. Also, the total number of pre- and perinatal complications was higher in those with a tic disorder (OR = 1.07). Furthermore, neonatal complications were related to the presence (OR = 1.46) and severity (b = 2.27) of co-occurring OCD and also to ADHD severity (b = 1.09). Delivery complications were only related to co-occurring OCD (OR = 1.49). We conclude that early exposure to adverse situations during pregnancy is related to the presence of chronic tic disorders. Exposure at a later stage, at birth or during the first weeks of life, appears to be associated with co-occurring OCD and ADHD. PMID:27494079

  9. Pre- and perinatal complications in relation to Tourette syndrome and co-occurring obsessive-compulsive disorder and attention-deficit/hyperactivity disorder.

    PubMed

    Abdulkadir, Mohamed; Tischfield, Jay A; King, Robert A; Fernandez, Thomas V; Brown, Lawrence W; Cheon, Keun-Ah; Coffey, Barbara J; de Bruijn, Sebastian F T M; Elzerman, Lonneke; Garcia-Delgar, Blanca; Gilbert, Donald L; Grice, Dorothy E; Hagstrøm, Julie; Hedderly, Tammy; Heyman, Isobel; Hong, Hyun Ju; Huyser, Chaim; Ibanez-Gomez, Laura; Kim, Young Key; Kim, Young-Shin; Koh, Yun-Joo; Kook, Sodahm; Kuperman, Samuel; Lamerz, Andreas; Leventhal, Bennett; Ludolph, Andrea G; Madruga-Garrido, Marcos; Maras, Athanasios; Messchendorp, Marieke D; Mir, Pablo; Morer, Astrid; Münchau, Alexander; Murphy, Tara L; Openneer, Thaïra J C; Plessen, Kerstin J; Rath, Judith J G; Roessner, Veit; Fründt, Odette; Shin, Eun-Young; Sival, Deborah A; Song, Dong-Ho; Song, Jungeun; Stolte, Anne-Marie; Tübing, Jennifer; van den Ban, Els; Visscher, Frank; Wanderer, Sina; Woods, Martin; Zinner, Samuel H; State, Matthew W; Heiman, Gary A; Hoekstra, Pieter J; Dietrich, Andrea

    2016-11-01

    Pre- and perinatal complications have been implicated in the onset and clinical expression of Tourette syndrome albeit with considerable inconsistencies across studies. Also, little is known about their role in co-occurring obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in individuals with a tic disorder. Therefore, we aimed to investigate the role of pre- and perinatal complications in relation to the presence and symptom severity of chronic tic disorder and co-occurring OCD and ADHD using data of 1113 participants from the Tourette International Collaborative Genetics study. This study included 586 participants with a chronic tic disorder and 527 unaffected family controls. We controlled for age and sex differences by creating propensity score matched subsamples for both case-control and within-case analyses. We found that premature birth (OR = 1.72) and morning sickness requiring medical attention (OR = 2.57) were associated with the presence of a chronic tic disorder. Also, the total number of pre- and perinatal complications was higher in those with a tic disorder (OR = 1.07). Furthermore, neonatal complications were related to the presence (OR = 1.46) and severity (b = 2.27) of co-occurring OCD and also to ADHD severity (b = 1.09). Delivery complications were only related to co-occurring OCD (OR = 1.49). We conclude that early exposure to adverse situations during pregnancy is related to the presence of chronic tic disorders. Exposure at a later stage, at birth or during the first weeks of life, appears to be associated with co-occurring OCD and ADHD.

  10. Relevance of spontaneous fabT mutations to a streptococcal toxic shock syndrome to non-streptococcal toxic shock syndrome transition in the novel-type Streptococcus pyogenes isolates that lost a salRK.

    PubMed

    Tatsuno, Ichiro; Okada, Ryo; Matsumoto, Masakado; Hata, Nanako; Matsui, Hideyuki; Zhang, Yan; Isaka, Masanori; Hasegawa, Tadao

    2016-05-01

    Streptococcus pyogenes is a causative agent of streptococcal toxic shock syndrome (STSS). Mutations in covR/S or rgg, negative regulators, can reportedly modulate the severity of infection in this pathogen. Recently, we showed that the regions encoding the SalR-SalK, a two-component regulatory system, were deleted in some emm 1-type isolates (named as 'novel-type'). In this study, the two novel 'STSS' isolates 10-85stss and 11-171stss were more virulent than the two novel 'non-STSS' isolates 11O-2non and 11T-3non when examined using a mouse model of invasive infection. Genome-sequencing experiments using the three strains 10-85stss , 11-171stss , and 11O-2non detected only one single nucleotide polymorphism that causes a non-synonymous mutation in fabT encoding a transcriptional regulator in strain 11O-2non . Loss of fabT reduced the high level of virulence observed in the STSS isolates to that in the non-STSS isolates, and introduction of an intact fabT compensated the lower virulence of 11O-2non , suggesting that the mutation in fabT, but not in covR/S or rgg, is involved in the differential virulence among the novel-type clinical isolates. This type of non-synonymous fabT mutation was also identified in 12 non-STSS isolates (including 11O-2non and 11T-3non ), and most of those 12 isolates showed impaired FabT function.

  11. Comparison of the nucleotide sequences of 16S rRNA, 444 Ep-ank, and groESL heat shock operon genes in naturally occurring Ehrlichia equi and human granulocytic ehrlichiosis agent isolates from Northern California.

    PubMed

    Chae, J S; Foley, J E; Dumler, J S; Madigan, J E

    2000-04-01

    We examined 11 naturally occurring isolates of Ehrlichia equi in horses and two human granulocytic ehrlichiosis agent isolates in California for sequence diversity in three genes. Ehrlichia equi isolates were from Sierra (n = 6), Mendocino (n = 3), Sonoma (n = 1), and Marin (n = 1) counties, and human granulocytic ehrlichiosis (HGE) agent isolates were obtained from Humboldt county. PCR with specific primers for 16S rRNA, 444 Ep-ank and groESL heat shock operon genes successfully produced amplicons for all 13 clinical samples. The 444 Ep-ank gene of the HGE agent and E. equi isolates from northern California is different from the eastern U.S. isolates BDS and USG3. The translated amino acid sequence of the groESL heat shock operon gene fragment is identical among E. equi, the HGE agent, and E. phagocytophila, with the exception of the northern Californian equine CASOLJ isolate. Microheterogeneity was observed in the 16S rRNA gene sequences of HGE agent and E. equi isolates from northern California. These results suggest that E. equi and the HGE agent found in California are similar or identical but may differ from the isolates of equine and human origin found in the eastern United States. PMID:10747108

  12. Mathematical model describing erythrocyte sedimentation rate. Implications for blood viscosity changes in traumatic shock and crush syndrome

    PubMed Central

    Ismailov, Rovshan M; Shevchuk, Nikolai A; Khusanov, Higmat

    2005-01-01

    Background The erythrocyte sedimentation rate (ESR) is a simple and inexpensive laboratory test, which is widespread in clinical practice, for assessing the inflammatory or acute response. This work addresses the theoretical and experimental investigation of sedimentation a single and multiple particles in homogeneous and heterogeneous (multiphase) medium, as it relates to their internal structure (aggregation of solid or deformed particles). Methods The equation system has been solved numerically. To choose finite analogs of derivatives we used the schemes of directional differences. Results (1) Our model takes into account the influence of the vessel wall on group aggregation of particles in tubes as well as the effects of rotation of particles, the constraint coefficient, and viscosity of a mixture as a function of the volume fraction. (2) This model can describe ESR as a function of the velocity of adhesion of erythrocytes; (3) Determination of the ESR is best conducted at certain time intervals, i.e. in a series of periods not exceeding 5 minutes each; (4) Differential diagnosis of various diseases by means of ESR should be performed using the aforementioned timed measurement of ESR; (5) An increase in blood viscosity during trauma results from an increase in rouleaux formation and the time-course method of ESR will be useful in patients with trauma, in particular, with traumatic shock and crush syndrome. Conclusion The mathematical model created in this study used the most fundamental differential equations that have ever been derived to estimate ESR. It may further our understanding of its complex mechanism. PMID:15807888

  13. Serum Heat Shock Protein 70 Concentration in Relation to Polycystic Ovary Syndrome in a Non-Obese Chinese Population

    PubMed Central

    Xu, Mengjing; Zhang, Shun; Ghose, Bishwajit; Liu, Jun; Yao, Ping; Yan, Hong; Wang, Di; Liu, Liegang

    2013-01-01

    Background Polycystic ovary syndrome (PCOS) represents the most common cause of anovulatory infertility and affects 6-15% of women of reproductive age. However, the underlying etiology is still poorly understood. In this study, we attempted to examine the association between circulating heat shock protein 70 (Hsp70) concentrations and PCOS in a non-obese Chinese population. Methods and Results Human peripheral blood from 52 patients with PCOS and 57 healthy controls, matched for age and BMI, were analyzed. Women with PCOS were found to have significantly higher fasting insulin (FI) levels, as well as Insulin resistance index (HOMA-IR) (P < 0.05). Identically, markers of oxidative stress (malondialdehyde (MDA), 8-Hydroxy-desoxyguanosine (8-OHdG), Nitric oxide (NO)) and inflammation (tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP)) were markedly increased when compared to controls (P < 0.05). Elevated serum Hsp70 was positively correlated with IR, oxidative stress and inflammation in PCOS, even after adjustment for age, BMI and gynecologic inflammation (GI). The receiver-operating characteristic curve (ROC) analysis yielded notably different discriminative value for PCOS, with or without an addition of Hsp70 (areas under the curves were 0.884 (95% CI 0.822-0.946) vs. 0.822 (95% CI 0.744-0.900); P for difference = 0.015). Conclusions and Significance Increased serum Hsp70 levels are associated with the combination of IR, oxidative stress and low-grade chronic inflammation in PCOS individuals, which provides supportive evidence that Hsp70 plays a key role in the pathogenesis of PCOS. More consequent studies were warranted to confirm the clinical utility of circulating Hsp70, especially in diagnosis and prognosis of PCOS and its long-term health cost. PMID:23825680

  14. Emergence of Streptococcus pyogenes emm102 Causing Toxic Shock Syndrome in Southern Taiwan during 2005–2012

    PubMed Central

    Lin, Jiun-Nong; Chang, Lin-Li; Lai, Chung-Hsu; Lin, Hsi-Hsun; Chen, Yen-Hsu

    2013-01-01

    Background Streptococcal toxic shock syndrome (STSS) is an uncommon but life-threatening disease caused by Streptococcus pyogenes. Methods To understand the clinical and molecular characteristics of STSS, we analyzed clinical data and explored the emm types, superantigen genes, and pulsed-field gel electrophoresis of causative S. pyogenes isolates obtained between 2005 and 2012. Results In total, 53 patients with STSS were included in this study. The median age of the patients was 57 years (range: 9–83 years), and 81.1% were male. The most prevalent underlying disease was diabetes mellitus (45.3%). Skin and soft-tissue infection accounted for 86.8% of STSS. The overall mortality rate was 32.1%. Underlying diseases had no statistical impact on mortality. A total of 19 different emm types were identified. The most prevalent emm type was emm102 (18.9%), followed by emm11 (17%), emm1 (11.3%), emm87 (9.4%), and emm89 (7.5%). There was no statistically significant association between emm type and a fatal outcome. Among the superantigen genes, speB was the most frequently detected one (92.5%), followed by smeZ (90.6%), speG (81.1%), speC (39.6%), and speF (39.6%). The majority of emm102 strains were found to have speB, speC, speG, and smeZ. The presence of speG was negatively associated with a fatal outcome (P = 0.045). Conclusions Our surveillance revealed the emergence of uncommon emm types, particularly emm102, causing STSS in southern Taiwan. Characterization of clinical, epidemiological, and molecular characteristics of STSS will improve our understanding of this life-threatening disease. PMID:24349115

  15. Cardiogenic shock induced by Takotsubo cardiomyopathy: A new therapeutic option.

    PubMed

    Silva, Marisa Passos; Vilela, Eduardo Matos; Lopes, Ricardo Ladeiras; de Morais, Gustavo Pires; Fernandes, Paula; Santos, Lino; Dias, Adelaide; Ribeiro, Vasco Gama

    2015-11-01

    Takotsubo cardiomyopathy (TC) is characterized by the sudden onset of reversible left ventricular dysfunction, with a presentation similar to that of an acute coronary syndrome. Although cardiogenic shock is a rare occurrence in TC, if it does occur it may require the use of a left ventricular assist device. We report the use of extracorporeal life support (ECLS) in a patient with TC and refractory cardiogenic shock. With ECLS it was possible to reduce inotropic support, and a normal left ventricular ejection fraction was documented by echocardiography on day 2. This is, to our knowledge, the first reported case of TC with refractory cardiogenic shock treated with ECLS in Portugal.

  16. High-volume hemofiltration and prone ventilation in subarachnoid hemorrhage complicated by severe acute respiratory distress syndrome and refractory septic shock

    PubMed Central

    Cornejo, Rodrigo; Romero, Carlos; Ugalde, Diego; Bustos, Patricio; Diaz, Gonzalo; Galvez, Ricardo; Llanos, Osvaldo; Tobar, Eduardo

    2014-01-01

    We report the successful treatment of two patients with aneurismal subarachnoid hemorrhage complicated by severe respiratory failure and refractory septic shock using simultaneous prone position ventilation and high-volume hemofiltration. These rescue therapies allowed the patients to overcome the critical situation without associated complications and with no detrimental effects on the intracranial and cerebral perfusion pressures. Prone position ventilation is now an accepted therapy for severe acute respiratory distress syndrome, and high-volume hemofiltration is a non-conventional hemodynamic support that has several potential mechanisms for improving septic shock. In this manuscript, we briefly review these therapies and the related evidence. When other conventional treatments are insufficient for providing safe limits of oxygenation and perfusion as part of basic neuroprotective care in subarachnoid hemorrhage patients, these rescue therapies should be considered on a case-by-case basis by an experienced critical care team. PMID:25028955

  17. Understanding the Shock in "Culture Shock."

    ERIC Educational Resources Information Center

    Schnell, Jim

    "Culture shock" is the expression generally associated with the frustrations that occur when persons have difficulty functioning in a different culture or when persons are exposed to individuals from another culture. Culture shock typically occurs in a 4-stage process that can unfold over varying lengths of time: the honeymoon, crisis, resolution,…

  18. [Levosimendan for septic shock with takotsubo cardiomyopathy].

    PubMed

    Schlürmann, C-N; Reinöhl, J; Kalbhenn, J

    2016-01-01

    As a stress-induced disease, takotsubo cardiomyopathy can also occur in septic syndromes; however, the hemodynamic management is fundamentally different from the treatment approaches for classical septic cardiomyopathy, as beta mimetics can increase the heart failure symptoms in takotsubo cardiomyopathy. This article reports the case of an 82-year-old female patient who presented with acute abdomen due to adhesion ileus and takotsubo cardiomyopathy, developed severe septic shock with peritonitis and could be successfully hemodynamically stabilized with levosimendan.

  19. Guillain–Barré syndrome occurring synchronously with systemic lupus erythematosus as initial manifestation treated successfully with low-dose cyclophosphamide

    PubMed Central

    Ali, Naveed; Rampure, Ritesh; Malik, Faizan; Jafri, Syed Imran Mustafa; Amberker, Deepa

    2016-01-01

    Systemic lupus erythematous (SLE) is frequently encountered in clinical practice; a widespread immunological response can involve any organ system, sometimes leading to rare and diagnostically challenging presentations. We describe a 38-year-old female who presented with symmetric numbness and tingling of the hands and feet, and cervical pain. Imaging studies were not diagnostic of any serious underlying pathology. The patient developed ascending paresis involving lower extremities and cranial muscles (dysphagia and facial weakness). Guillain–Barré syndrome (GBS) was diagnosed on the basis of electromyography and lumbar puncture showing albuminocytologic dissociation. Intravenous immunoglobulins (IVIG) were administered for 5 days. Supported by anti-dsDNA antibody, oral ulcers, proteinuria of 0.7 g in 24 h, and neurological manifestation, she was diagnosed with lupus. After completion of IVIG, she received pulse-dose corticosteroids and one dose of low-dose cyclophosphamide. Her neurological symptoms improved and she had complete neurological recovery several months after her initial presentation. Literature search provides evidence of co-occurrence of lupus and GBS occurring mostly later in the course of the disease. However, GBS as initial manifestation of SLE is exceedingly rare and less understood. The association of GBS with lupus is important to recognize for rapid initiation of appropriate therapy and for consideration of immunosuppressive therapy which may affect the outcome. PMID:27124163

  20. Acute Radiation Hypotension in the Rabbit: a Model for the Human Radiation Shock Syndrome.

    NASA Astrophysics Data System (ADS)

    Makale, Milan Theodore

    This study has shown that total body irradiation (TBI) of immature (40 to 100 day old) rabbits leads to an acute fall in mean arterial pressure (MAP) 30 to 90 minutes after exposure, which takes no more than about three minutes, and often results in pressures which are less than 50% of the lowest pre-exposure MAP. This is termed acute cardiovascular collapse (ACC). ACC is often accompanied by ECG T-wave elevation, a sharp rise in ear temperature, labored breathing, pupillary constriction, bladder emptying, and loss of abdominal muscle tone. About 73% of 40 to 100 day rabbits exhibit ACC; the others and most older rabbits display gradual pressure reductions (deliberate hypotension) which may be profound, and which may be accompanied by the same changes associated with ACC. ACC and deliberate hypotension occurred in rabbits cannulated in the dorsal aorta, and in non-operated animals. The decline in MAP for all 40 to 100 day cannulated rabbits (deliberate and ACC responders) is 55.4%. The experiments described below only involved 40 to 100 day cannulated TBI rabbits. Heart region irradiation resulted in an average MAP decline of 29.1%, with 1/15 rabbits showing ACC. Heart shielding during TBI reduced the decline in MAP to 19%, with 1/10 rabbits experiencing ACC. These results imply that the heart region, which includes the heart, part of the lungs, neural receptors, roots of the systemic vessels, and the blood, is a sensitive target. Bilateral vagotomy reduced the decline in MAP to 24.9%, and abolished ACC. Atropine (6 mg/kg) reduced the frequency of ACC to 26%, and the decline in MAP to 41.4%. In 11/13 rabbits the voltage generated by left vagal transmission rose after TBI. The vagi appear to participate in radiation hypotension. Heart shielding together with bilateral vagotomy reduced the decline in MAP to only 9.9%, with no ACC responders. The mean right ventricular pressure (MRVP) rose after TBI in 8/10 rabbits. In animals which displayed either ACC or steep

  1. What Causes Cardiogenic Shock?

    MedlinePlus

    ... page from the NHLBI on Twitter. What Causes Cardiogenic Shock? Immediate Causes Cardiogenic shock occurs if the heart suddenly can't pump ... to the body. The most common cause of cardiogenic shock is damage to the heart muscle from a ...

  2. Temperature variability analysis using wavelets and multiscale entropy in patients with systemic inflammatory response syndrome, sepsis, and septic shock

    PubMed Central

    2012-01-01

    Background Even though temperature is a continuous quantitative variable, its measurement has been considered a snapshot of a process, indicating whether a patient is febrile or afebrile. Recently, other diagnostic techniques have been proposed for the association between different properties of the temperature curve with severity of illness in the Intensive Care Unit (ICU), based on complexity analysis of continuously monitored body temperature. In this study, we tried to assess temperature complexity in patients with systemic inflammation during a suspected ICU-acquired infection, by using wavelets transformation and multiscale entropy of temperature signals, in a cohort of mixed critically ill patients. Methods Twenty-two patients were enrolled in the study. In five, systemic inflammatory response syndrome (SIRS, group 1) developed, 10 had sepsis (group 2), and seven had septic shock (group 3). All temperature curves were studied during the first 24 hours of an inflammatory state. A wavelet transformation was applied, decomposing the signal in different frequency components (scales) that have been found to reflect neurogenic and metabolic inputs on temperature oscillations. Wavelet energy and entropy per different scales associated with complexity in specific frequency bands and multiscale entropy of the whole signal were calculated. Moreover, a clustering technique and a linear discriminant analysis (LDA) were applied for permitting pattern recognition in data sets and assessing diagnostic accuracy of different wavelet features among the three classes of patients. Results Statistically significant differences were found in wavelet entropy between patients with SIRS and groups 2 and 3, and in specific ultradian bands between SIRS and group 3, with decreased entropy in sepsis. Cluster analysis using wavelet features in specific bands revealed concrete clusters closely related with the groups in focus. LDA after wrapper-based feature selection was able to classify

  3. Cytotoxicity of lymphocytes activated by superantigen toxic-shock-syndrome toxin-1 against colorectal cancer LoVo cells.

    PubMed

    Wang, Wei; Sun, Xuejun; Lu, Le; Zheng, Jian-Bao; Tian, Yong; Wang, Wei

    2013-04-01

    Toxic-shock-syndrome toxin-1 (TSST-1), a superantigen, can stimulate T cell activation and be used for immunotherapy. In this study, we employed the carcinoembryonic antigen (CEA)-positive LoVo cells to test whether retrovirus-mediated TSST-1 expression could activate human T cells and promote cytotoxicity against tumor cells. We first generated plasmids of pLEGFP-N1-5HRE-CEAp-TSST-1-linker-CD80TM containing a fusion gene of the CEA promoter, 5 copies of the hypoxia-response elements (HRE) as an enhancer, the fragments for TSST-1, and the transmembrane domain of CD80 (CD80TM) and control pLEGFP-N1-5HRE-CEAp (without TSST-1) and generated retroviruses of 5HCTC and 5HC, respectively. After infection with 5HC and 5HCTC retroviruses to establish cell lines, the high levels of TSST-1 expression were observed on the membrane and cytoplasm of the 5HCTC-infected LoVo cells, particularly culture under a hypoxic condition, but not on CEA(-) HeLa cells. Furthermore, the TSST-1-expressing LoVo cell lysates, but not the control cell lysates, stimulated human T cell proliferation, and the co-culture of the TSST-1-expressing LoVo, but not control cells, with human peripheral blood mononuclear cells (PBMC) induced a high frequency of TNF-α- and IL-2-secreting T cells in vitro, particularly under hypoxic conditions. More importantly, co-culture of the TSST-1-expressing LoVo cells, particularly under hypoxic conditions, but not control cells, with different numbers of PBMC promoted potent cytotoxicity against LoVo cells in a dose-dependent manner in vitro. These data provide proof of the principle that selective induction of TSST1 expression in CEA(+) colorectal cancer (CRC) cells activates T cells that destroy tumor cells, particularly under a hypoxic condition. Therefore, our findings may aid in the design of new immunotherapy for the intervention of CRC at clinic.

  4. Inhaled nitric oxide in acute respiratory distress syndrome with and without septic shock requiring norepinephrine administration: a dose–response study

    PubMed Central

    Mourgeon, Eric; Puybasset, Louis; Law-Koune, Jean-Dominique; Lu, Qin; Abdennour, Lamine; Gallart, Lluis; Malassine, Patrick; Rao, GS Umamaheswara; Cluzel, Philippe; Bennani, Abdelhai; Coriat, Pierre; Rouby, Jean-Jacques

    1997-01-01

    Background: The aim of this prospective study was to assess whether the presence of septic shock could influence the dose response to inhaled nitric oxide (NO) in NO-responding patients with adult respiratory distress syndrome (ARDS). Results: Eight patients with ARDS and without septic shock (PaO2 = 95 ± 16 mmHg, PEEP = 0, FiO2 = 1.0), and eight patients with ARDS and septic shock (PaO2 = 88 ± 11 mmHg, PEEP = 0, FiO2 = 1.0) receiving exclusively norepinephrine were studied. All responded to 15 ppm inhaled NO with an increase in PaO2 of at least 40 mmHg, at FiO2 1.0 and PEEP 10 cmH2O. Inspiratory intratracheal NO concentrations were recorded continuously using a fast response time chemiluminescence apparatus. Seven inspiratory NO concentrations were randomly administered: 0.15, 0.45, 1.5, 4.5, 15, 45 and 150 ppm. In both groups, NO induced a dose-dependent decrease in mean pulmonary artery pressure (MPAP), pulmonary vascular resistance index (PVRI), and venous admixture (QVA/QT), and a dose-dependent increase in PaO2/FiO2 (P ≤ 0.012). Dose-response of MPAP and PVRI were similar in both groups with a plateau effect at 4.5 ppm. Dose-response of PaO2/FiO2 was influenced by the presence of septic shock. No plateau effect was observed in patients with septic shock and PaO2/FiO2 increased by 173 ± 37% at 150 ppm. In patients without septic shock, an 82 ± 26% increase in PaO2/FiO2 was observed with a plateau effect obtained at 15 ppm. In both groups, dose-response curves demonstrated a marked interindividual variability and in five patients pulmonary vascular effect and improvement in arterial oxygenation were dissociated. Conclusion: For similar NOinduced decreases in MPAP and PVRI in both groups, the increase in arterial oxygenation was more marked in patients with septic shock. PMID:11056694

  5. Molecular typing of toxic shock syndrome toxin-1- and Enterotoxin A-producing methicillin-sensitive Staphylococcus aureus isolates from an outbreak in a neonatal intensive care unit.

    PubMed

    Layer, Franziska; Sanchini, Andrea; Strommenger, Birgit; Cuny, Christiane; Breier, Ann-Christin; Proquitté, Hans; Bührer, Christoph; Schenkel, Karl; Bätzing-Feigenbaum, Jörg; Greutelaers, Benedikt; Nübel, Ulrich; Gastmeier, Petra; Eckmanns, Tim; Werner, Guido

    2015-10-01

    Outbreaks of Staphylococcus aureus are common in neonatal intensive care units (NICUs). Usually they are documented for methicillin-resistant strains, while reports involving methicillin-susceptible S. aureus (MSSA) strains are rare. In this study we report the epidemiological and molecular investigation of an MSSA outbreak in a NICU among preterm neonates. Infection control measures and interventions were commissioned by the Local Public Health Authority and supported by the Robert Koch Institute. To support epidemiological investigations molecular typing was done by spa-typing and Multilocus sequence typing; the relatedness of collected isolates was further elucidated by DNA SmaI-macrorestriction, microarray analysis and bacterial whole genome sequencing. A total of 213 neonates, 123 healthcare workers and 205 neonate parents were analyzed in the period November 2011 to November 2012. The outbreak strain was characterized as a MSSA spa-type t021, able to produce toxic shock syndrome toxin-1 and Enterotoxin A. We identified seventeen neonates (of which two died from toxic shock syndrome), four healthcare workers and three parents putatively involved in the outbreak. Whole-genome sequencing permitted to exclude unrelated cases from the outbreak and to discuss the role of healthcare workers as a reservoir of S. aureus on the NICU. Genome comparisons also indicated the presence of the respective clone on the ward months before the first colonized/infected neonates were detected.

  6. Molecular typing of toxic shock syndrome toxin-1- and Enterotoxin A-producing methicillin-sensitive Staphylococcus aureus isolates from an outbreak in a neonatal intensive care unit.

    PubMed

    Layer, Franziska; Sanchini, Andrea; Strommenger, Birgit; Cuny, Christiane; Breier, Ann-Christin; Proquitté, Hans; Bührer, Christoph; Schenkel, Karl; Bätzing-Feigenbaum, Jörg; Greutelaers, Benedikt; Nübel, Ulrich; Gastmeier, Petra; Eckmanns, Tim; Werner, Guido

    2015-10-01

    Outbreaks of Staphylococcus aureus are common in neonatal intensive care units (NICUs). Usually they are documented for methicillin-resistant strains, while reports involving methicillin-susceptible S. aureus (MSSA) strains are rare. In this study we report the epidemiological and molecular investigation of an MSSA outbreak in a NICU among preterm neonates. Infection control measures and interventions were commissioned by the Local Public Health Authority and supported by the Robert Koch Institute. To support epidemiological investigations molecular typing was done by spa-typing and Multilocus sequence typing; the relatedness of collected isolates was further elucidated by DNA SmaI-macrorestriction, microarray analysis and bacterial whole genome sequencing. A total of 213 neonates, 123 healthcare workers and 205 neonate parents were analyzed in the period November 2011 to November 2012. The outbreak strain was characterized as a MSSA spa-type t021, able to produce toxic shock syndrome toxin-1 and Enterotoxin A. We identified seventeen neonates (of which two died from toxic shock syndrome), four healthcare workers and three parents putatively involved in the outbreak. Whole-genome sequencing permitted to exclude unrelated cases from the outbreak and to discuss the role of healthcare workers as a reservoir of S. aureus on the NICU. Genome comparisons also indicated the presence of the respective clone on the ward months before the first colonized/infected neonates were detected. PMID:26321006

  7. Toxic Shock Syndrome

    MedlinePlus

    ... isn't strictly related to tampons. The contraceptive sponge and the diaphragm , two types of birth control ... associated with TSS (such as diaphragms and contraceptive sponges). What Do Doctors Do? TSS is a medical ...

  8. Alpha-lipoic acid prevents endotoxic shock and multiple organ dysfunction syndrome induced by endotoxemia in rats.

    PubMed

    Shen, Hsin-Hsueh; Lam, Kwok-Keung; Cheng, Pao-Yun; Kung, Ching-Wen; Chen, Shu-Ying; Lin, Pei-Chiang; Chung, Ming-Ting; Lee, Yen-Mei

    2015-04-01

    Alpha-lipoic acid (ALA), a naturally occurring disulfide derivative of octanoic acid, serves as a strong antioxidant and has been reported to possess anti-inflammatory effects. The aim of the present study is to investigate the preventive and therapeutic effects of ALA on multiple organ dysfunction syndrome (MODS) caused by endotoxemia in rats. Male Wistar rats were intravenously infused with lipopolysaccharide (LPS) (10 mg/kg) to induce endotoxemia. Alpha-lipoic acid 10, 20, or 40 mg/kg was administered intravenously 60 min before (pretreatment) LPS challenge, and ALA 40 mg/kg was administered intravenously 30 min after (posttreatment) LPS challenge. Pretreatment and posttreatment with ALA significantly improved the deleterious hemodynamic changes 8 h after LPS challenge, including hypotension and bradycardia. Alpha-lipoic acid reduced the plasma levels of glutamic pyruvic transaminase, blood urea nitrogen, lactate dehydrogenase, tumor necrosis factor-α, nitric oxide metabolites, and thrombin-antithrombin complex, which increased markedly after LPS challenge. The induction of inducible nitric oxide synthase both in the liver and the lung and vascular superoxide anion production were also significantly suppressed by ALA. Moreover, ALA significantly attenuated LPS-induced caspase-3 activation in cardiomyocytes and improved survival rate. In conclusion, ALA effectively attenuated LPS-induced acute inflammatory response and improved MODS. The antioxidant and anti-inflammatory effects of ALA may contribute to these beneficial effects. Alpha-lipoic acid might be considered as a novel therapeutic strategy in the prevention of sepsis-induced MODS and inflammatory vascular diseases.

  9. Particle Acceleration in Shock-Shock Interaction

    NASA Astrophysics Data System (ADS)

    Nakanotani, Masaru; Matsukiyo, Shuichi; Hada, Tohru

    2015-04-01

    Collisionless shock waves play a crucial role in producing high energy particles. One of the most plausible acceleration mechanisms is the first order Fermi acceleration in which non-thermal particles statistically gain energy while scattered by MHD turbulence both upstream and downstream of a shock. Indeed, X-ray emission from energetic particles accelerated at supernova remnant shocks is often observed [e.g., Uchiyama et al., 2007]. Most of the previous studies on shock acceleration assume the presence of a single shock. In space, however, two shocks frequently come close to or even collide with each other. For instance, it is observed that a CME (coronal mass ejection) driven shock collides with the earth's bow shock [Hietala et al., 2011], or interplanetary shocks pass through the heliospheric termination shock [Lu et al., 1999]. Colliding shocks are observed also in high power laser experiments [Morita et al., 2013]. It is expected that shock-shock interactions efficiently produce high energy particles. A previous work using hybrid simulation [Cargill et al., 1986] reports efficient ion acceleration when supercritical two shocks collide. In the hybrid simulation, however, the electron dynamics cannot be resolved so that electron acceleration cannot be discussed in principle. Here, we perform one-dimensional full Particle-in-Cell (PIC) simulations to examine colliding two symmetric oblique shocks and the associated electron acceleration. In particular, the following three points are discussed in detail. 1. Energetic electrons are observed upstream of the two shocks before their collision. These energetic electrons are efficiently accelerated through multiple reflections at the two shocks (Fermi acceleration). 2. The reflected electrons excite large amplitude upstream waves. Electron beam cyclotron instability [Hasegawa, 1975] and electron fire hose instability [Li et al., 2000] appear to occur. 3. The large amplitude waves can scatters energetic electrons in

  10. Why dengue haemorrhagic fever in Cuba? 1. Individual risk factors for dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS).

    PubMed

    Bravo, J R; Guzmán, M G; Kouri, G P

    1987-01-01

    During the dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) epidemic in Cuba in 1981, we identified some individual risk factors for the development of the severe clinical picture or for the fatal outcome of the disease. The percentage of secondary infection in 3 groups of patients with DHF/DSS was between 95 and 98.3 and it is concluded that secondary infection is an important, but not the only, condition for the development of DHF/DSS. An analysis of these 3 groups of patients and a fourth group of fatal cases showed that chronic diseases such as bronchial asthma, diabetes mellitus and sickle cell anaemia were additional risk factors contributing significantly to the development of DHF/DSS. The study also revealed that race was an individual risk factor, since DHF/DSS was more prevalent in white than in black persons.

  11. Molecular epidemiology of methicillin-resistant Staphylococcus aureus strains causing neonatal toxic shock syndrome-like exanthematous disease in neonatal and perinatal wards.

    PubMed

    Kikuchi, Ken; Takahashi, Naoto; Piao, Chuncheng; Totsuka, Kyoichi; Nishida, Hiroshi; Uchiyama, Takehiko

    2003-07-01

    Neonatal toxic shock syndrome-like exanthematous disease (NTED) is a new neonatal disease caused by toxic shock syndrome toxin 1 (TSST-1). We conducted a prospective surveillance study and characterized the methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from patients with NTED and compared them with the strains from patients with other MRSA infections and asymptomatic carriers. The study was performed in the neonatal intensive care unit and a general neonatal and maternal ward in the Tokyo Women's Medical University Hospital (TWMUH) from September to December 1998. Among 103 patients eligible for the study, MRSA was detected in 62 (60.2%) newborns; of these 62 newborns, 8 (12.9%) developed NTED, 1 (1.6%) had another MRSA infection, and 53 (85.5%) were asymptomatic MRSA carriers. Sixty-nine MRSA strains were obtained from the 62 newborns. DNA fingerprinting by pulsed-field gel electrophoresis showed two clusters: clone A with 8 subtypes and clone B. Sixty-seven of the 69 MRSA strains (97.1%) belonged to clone A, and type A1 was the most predominant (42 of 69 strains; 60.9%) in every neonatal and perinatal ward. All but one of the clone A strains had the TSST-1 and staphylococcal enterotoxin C genes. We also analyzed eight MRSA strains from eight NTED patients in five hospitals in Japan other than TWMUH. All the MRSA strains from NTED patients also belonged to clone A. These results suggest that a single clone that predominated in the neonatal wards of six hospitals might have caused NTED. However, the occurrence of NTED might not be dependent on the presence of an NTED-specific strain. PMID:12843033

  12. Prevalence of toxic shock syndrome toxin 1-producing Staphylococcus aureus and the presence of antibodies to this superantigen in menstruating women.

    PubMed

    Parsonnet, Jeffrey; Hansmann, Melanie A; Delaney, Mary L; Modern, Paul A; Dubois, Andrea M; Wieland-Alter, Wendy; Wissemann, Kimberly W; Wild, John E; Jones, Michaelle B; Seymour, Jon L; Onderdonk, Andrew B

    2005-09-01

    Menstrual toxic shock syndrome (mTSS) is thought to be associated with colonization with toxic shock syndrome toxin 1 (TSST-1)-producing Staphylococcus aureus in women with insufficient antibody titers. mTSS has been associated with menstruation and tampon use, and although it is rare, the effects can be life threatening. It remains of interest because of the widespread use of tampons, reported to be about 70% of women in the United States, Canada, and much of Western Europe. This comprehensive study was designed to determine S. aureus colonization and TSST-1 serum antibody titers in 3,012 menstruating women in North America between the ages of 13 and 40, particularly among age and racial groups that could not be assessed reliably in previous small studies. One out of every four subjects was found to be colonized with S. aureus in at least one of three body sites (nose, vagina, or anus), with approximately 9% colonized vaginally. Eighty-five percent of subjects had antibody titers (> or =1:32) to TSST-1, and the vast majority (81%) of teenaged subjects (13 to 18 years) had already developed antibody titers. Among carriers of toxigenic S. aureus, a significantly lower percentage of black women than of white or Hispanic women were found to have antibody titers (> or =1:32) to TSST-1 (89% versus 98% and 100%). These findings demonstrate that the majority of teenagers have antibody titers (> or =1:32) to TSST-1 and are presumed to be protected from mTSS. These findings also suggest that black women may be more susceptible to mTSS than previously thought. PMID:16145118

  13. Salmonella Typhi-Induced Septic Shock and Acute Respiratory Distress Syndrome in a Previously Healthy Teenage Patient Treated With High-Dose Dexamethasone.

    PubMed

    Ugas, Melissa Brosset; Carroll, Timothy; Kovar, Lacey; Chavez-Bueno, Susana

    2016-01-01

    Typhoid fever is commonly characterized by fever and abdominal pain. Rare complications include intestinal hemorrhage, bowel perforation, delirium, obtundation, and septic shock. Herein we describe the case of a previously healthy 16-year-old male without history of travel, diagnosed with typhoid fever complicated by septic shock and acute respiratory distress syndrome treated with high-dose dexamethasone. This case details severe complications of typhoid fever that are uncommonly seen in developed countries, and the successful response to high-dose dexamethasone as adjunct therapy. High-dose dexamethasone treatment has reportedly decreased Salmonella Typhi mortality, but controlled studies specifically performed in children are lacking, and most reports of its use are over 30 years old and all have originated in developing countries. Providers should include Salmonella Typhi in the differential diagnosis of the pediatric patient with fever, severe abdominal pain, and enteritis, and be aware of its potentially severe complications and the limited data on safety and efficacy of adjunctive therapies that can be considered in addition to antibiotics. PMID:27294165

  14. Alpha tryptase allele of Tryptase 1 (TPSAB1) gene associated with Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) in Vietnam and Philippines.

    PubMed

    Velasquez, Clara Vasquez; Roman, Arthur Dessi; Lan, Nguyen Thi Phuong; Huy, Nguyen Tien; Mercado, Edelwisa Segubre; Espino, Fe Esperanza; Perez, Ma Lucila M; Huong, Vu Thi Que; Thuy, Tran Thi; Tham, Vo Dinh; Nga, Cao Thi Phi; Ha, Tran Thi Ngoc; Bilar, Josie M; Bajaro, Jemimah Dawn P; Baello, Benilda Q; Kikuchi, Mihoko; Yasunami, Michio; Morita, Kouichi; Watanabe, Naohiro; Karbwang, Juntra; Hirayama, Kenji

    2015-05-01

    We previously reported, significantly higher levels of Chymase and Tryptase in early stage plasma of DSS patients prior to the occurrence of shock suggesting a possible role of mast cells in dengue pathogenesis. To further investigate, we analyzed CMA1 promoter SNP (rs1800875) and TPSAB1 gene alleles, which encode the Human Chymase and α- and β- tryptase 1 enzymes respectively, for susceptibility to Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) in patients from hospitals in Vietnam (Ho Chi Minh City and Vinh Long) and the Philippines. While the CMA1 promoter SNP (rs1800875) was not associated with DHF/DSS, the homozygous form of α-tryptase allele was associated with DSS patients in Vinh Long and the Philippines (OR=3.52, p<0.0001; OR=3.37, p<0.0001, respectively) and with DHF in Ho Chi Minh City (OR=2.54, p=0.0084). Also, a statistically significant association was observed when DHF and DSS were combined in Vinh Long (OR=1.5, p=0.034) and the Philippines (OR=2.36, p=0.0004); in Ho Chi Minh City when DHF and DSS were combine an association was observed, but it was not statistically significant (OR=1.5, p=0.0505). Therefore, the α-tryptase might have a possible effect on the susceptibility to severe form of Dengue infection.

  15. Molecular characterization of co-occurring Duchenne muscular dystrophy and X-linked oculo-facio-cardio-dental syndrome in a girl.

    PubMed

    Jiang, Yong-hui; Fang, Ping; Adesina, Adekunle M; Furman, Patricia; Johnston, Jennifer J; Biesecker, Leslie G; Brown, Chester W

    2009-06-01

    Duchenne muscular dystrophy is an X-linked condition at the severe end of the spectrum of dystrophinopathies. Females with dystrophin mutations are at risk for cardiomyopathy, but are usually asymptomatic during childhood. However, some girls can exhibit features of Duchenne muscular dystrophy because of skewed X-inactivation, aneuploidy, or chromosomal rearrangement. Oculo-facio-cardio-dental syndrome is a rare X-linked disorder, lethal in males, that comprises microphthalmia, congenital cataracts, congenital heart defect, canine radiculomegaly, and digital anomalies. We report on a 7-year-old girl who was referred for muscular hypotonia, with clinical features of Duchenne muscular dystrophy, including elevated serum creatine phosphokinase, pseudohypertrophy of calf muscles, and muscle weakness, which became evident at 3 years of age. In addition, she had multiple congenital anomalies including atrial septal defect, cataracts, dental and digital anomalies, a constellation that suggested the diagnosis of oculo-facio-cardio-dental syndrome, a condition caused by mutations in BCOR. Immunohistochemistry and Western blot analysis of muscle, and mutation analysis of DMD showed a maternally inherited deletion of exons 30-43, confirming the diagnosis of Duchenne muscular dystrophy. Studies of lymphocytes showed essentially complete skewing of X-inactivation. Mutation analysis of BCOR revealed a de novo frameshift mutation (c.1005delC). Thus, we report for the first time on an individual with the co-occurrence of Duchenne muscular dystrophy and oculo-facio-cardio-dental syndrome. PMID:19449433

  16. Characterisation of the Bacterial and Fungal Communities Associated with Different Lesion Sizes of Dark Spot Syndrome Occurring in the Coral Stephanocoenia intersepta

    PubMed Central

    Sweet, Michael; Burn, Deborah; Croquer, Aldo; Leary, Peter

    2013-01-01

    The number and prevalence of coral diseases/syndromes are increasing worldwide. Dark Spot Syndrome (DSS) afflicts numerous coral species and is widespread throughout the Caribbean, yet there are no known causal agents. In this study we aimed to characterise the microbial communities (bacteria and fungi) associated with DSS lesions affecting the coral Stephanocoenia intersepta using nonculture molecular techniques. Bacterial diversity of healthy tissues (H), those in advance of the lesion interface (apparently healthy AH), and three sizes of disease lesions (small, medium, and large) varied significantly (ANOSIM R  = 0.052 p<0.001), apart from the medium and large lesions, which were similar in their community profile. Four bacteria fitted into the pattern expected from potential pathogens; namely absent from H, increasing in abundance within AH, and dominant in the lesions themselves. These included ribotypes related to Corynebacterium (KC190237), Acinetobacter (KC190251), Parvularculaceae (KC19027), and Oscillatoria (KC190271). Furthermore, two Vibrio species, a genus including many proposed coral pathogens, dominated the disease lesion and were absent from H and AH tissues, making them candidates as potential pathogens for DSS. In contrast, other members of bacteria from the same genus, such as V. harveyii were present throughout all sample types, supporting previous studies where potential coral pathogens exist in healthy tissues. Fungal diversity varied significantly as well, however the main difference between diseased and healthy tissues was the dominance of one ribotype, closely related to the plant pathogen, Rhytisma acerinum, a known causal agent of tar spot on tree leaves. As the corals’ symbiotic algae have been shown to turn to a darker pigmented state in DSS (giving rise to the syndromes name), the two most likely pathogens are R. acerinum and the bacterium Oscillatoria, which has been identified as the causal agent of the colouration in Black

  17. Physics of collisionless shocks: theory and simulation

    NASA Astrophysics Data System (ADS)

    Stockem Novo, A.; Bret, A.; Fonseca, R. A.; Silva, L. O.

    2016-01-01

    Collisionless shocks occur in various fields of physics. In the context of space and astrophysics they have been investigated for many decades. However, a thorough understanding of shock formation and particle acceleration is still missing. Collisionless shocks can be distinguished into electromagnetic and electrostatic shocks. Electromagnetic shocks are of importance mainly in astrophysical environments and they are mediated by the Weibel or filamentation instability. In such shocks, charged particles gain energy by diffusive shock acceleration. Electrostatic shocks are characterized by a strong electrostatic field, which leads to electron trapping. Ions are accelerated by reflection from the electrostatic potential. Shock formation and particle acceleration will be discussed in theory and simulations.

  18. Heat shock factor 2 is a stress-responsive mediator of neuronal migration defects in models of fetal alcohol syndrome

    PubMed Central

    El Fatimy, Rachid; Miozzo, Federico; Le Mouël, Anne; Abane, Ryma; Schwendimann, Leslie; Sabéran-Djoneidi, Délara; de Thonel, Aurélie; Massaoudi, Illiasse; Paslaru, Liliana; Hashimoto-Torii, Kazue; Christians, Elisabeth; Rakic, Pasko; Gressens, Pierre; Mezger, Valérie

    2014-01-01

    Fetal alcohol spectrum disorder (FASD) is a frequent cause of mental retardation. However, the molecular mechanisms underlying brain development defects induced by maternal alcohol consumption during pregnancy are unclear. We used normal and Hsf2-deficient mice and cell systems to uncover a pivotal role for heat shock factor 2 (HSF2) in radial neuronal migration defects in the cortex, a hallmark of fetal alcohol exposure. Upon fetal alcohol exposure, HSF2 is essential for the triggering of HSF1 activation, which is accompanied by distinctive post-translational modifications, and HSF2 steers the formation of atypical alcohol-specific HSF1–HSF2 heterocomplexes. This perturbs the in vivo binding of HSF2 to heat shock elements (HSEs) in genes that control neuronal migration in normal conditions, such as p35 or the MAPs (microtubule-associated proteins, such as Dclk1 and Dcx), and alters their expression. In the absence of HSF2, migration defects as well as alterations in gene expression are reduced. Thus, HSF2, as a sensor for alcohol stress in the fetal brain, acts as a mediator of the neuronal migration defects associated with FASD. Subject Categories Development & Differentiation; Neuroscience PMID:25027850

  19. Heat shock factor 2 is a stress-responsive mediator of neuronal migration defects in models of fetal alcohol syndrome.

    PubMed

    El Fatimy, Rachid; Miozzo, Federico; Le Mouël, Anne; Abane, Ryma; Schwendimann, Leslie; Sabéran-Djoneidi, Délara; de Thonel, Aurélie; Massaoudi, Illiasse; Paslaru, Liliana; Hashimoto-Torii, Kazue; Christians, Elisabeth; Rakic, Pasko; Gressens, Pierre; Mezger, Valérie

    2014-07-15

    Fetal alcohol spectrum disorder (FASD) is a frequent cause of mental retardation. However, the molecular mechanisms underlying brain development defects induced by maternal alcohol consumption during pregnancy are unclear. We used normal and Hsf2-deficient mice and cell systems to uncover a pivotal role for heat shock factor 2 (HSF2) in radial neuronal migration defects in the cortex, a hallmark of fetal alcohol exposure. Upon fetal alcohol exposure, HSF2 is essential for the triggering of HSF1 activation, which is accompanied by distinctive post-translational modifications, and HSF2 steers the formation of atypical alcohol-specific HSF1-HSF2 heterocomplexes. This perturbs the in vivo binding of HSF2 to heat shock elements (HSEs) in genes that control neuronal migration in normal conditions, such as p35 or the MAPs (microtubule-associated proteins, such as Dclk1 and Dcx), and alters their expression. In the absence of HSF2, migration defects as well as alterations in gene expression are reduced. Thus, HSF2, as a sensor for alcohol stress in the fetal brain, acts as a mediator of the neuronal migration defects associated with FASD.

  20. Heat shock factor 2 is a stress-responsive mediator of neuronal migration defects in models of fetal alcohol syndrome.

    PubMed

    El Fatimy, Rachid; Miozzo, Federico; Le Mouël, Anne; Abane, Ryma; Schwendimann, Leslie; Sabéran-Djoneidi, Délara; de Thonel, Aurélie; Massaoudi, Illiasse; Paslaru, Liliana; Hashimoto-Torii, Kazue; Christians, Elisabeth; Rakic, Pasko; Gressens, Pierre; Mezger, Valérie

    2014-01-01

    Fetal alcohol spectrum disorder (FASD) is a frequent cause of mental retardation. However, the molecular mechanisms underlying brain development defects induced by maternal alcohol consumption during pregnancy are unclear. We used normal and Hsf2-deficient mice and cell systems to uncover a pivotal role for heat shock factor 2 (HSF2) in radial neuronal migration defects in the cortex, a hallmark of fetal alcohol exposure. Upon fetal alcohol exposure, HSF2 is essential for the triggering of HSF1 activation, which is accompanied by distinctive post-translational modifications, and HSF2 steers the formation of atypical alcohol-specific HSF1-HSF2 heterocomplexes. This perturbs the in vivo binding of HSF2 to heat shock elements (HSEs) in genes that control neuronal migration in normal conditions, such as p35 or the MAPs (microtubule-associated proteins, such as Dclk1 and Dcx), and alters their expression. In the absence of HSF2, migration defects as well as alterations in gene expression are reduced. Thus, HSF2, as a sensor for alcohol stress in the fetal brain, acts as a mediator of the neuronal migration defects associated with FASD. PMID:25027850

  1. Electron Acceleration in Shock-Shock Interaction: Simulations and Observations

    NASA Astrophysics Data System (ADS)

    Nakanotani, M.; Matsukiyo, S.; Mazelle, C. X.; Hada, T.

    2015-12-01

    Collisionless shock waves play a crucial role in producing high energy particles (cosmic rays) in space. While most of the past studies about particle acceleration assume the presence of a single shock, in space two shocks frequently come close to or even collide with each other. Hietala et al. [2011] observed the collision of an interplanetary shock and the earth's bow shock and the associated acceleration of energetic ions. The kinetic natures of a shock-shock collision has not been well understood. Only the work done by using hybrid simulation was reported by Cargill et al. [1986], in which they focus on a collision of two supercritical shocks and the resultant ion acceleration. We expect similarly that electron acceleration can also occur in shock-shock collision. To investigate the electron acceleration process in a shock-shock collision, we perform one-dimensional full particle-in-cell (PIC) simulations. In the simulation energetic electrons are observed between the two approaching shocks before colliding. These energetic electrons are efficiently accelerated through multiple reflections at the two shocks (Fermi acceleration). The reflected electrons create a temperature anisotropy and excite large amplitude waves upstream via the electron fire hose instability. The large amplitude waves can scatter the energetic electrons in pitch angle so that some of them gain large pitch angles and are easily reflected when they encounter the shocks subsequently. The reflected electrons can sustain, or probably even strengthen, them. We further discuss observational results of an interaction of interplanetary shocks and the earth's bow shock by examining mainly Cluster data. We focus on whether or not electrons are accelerated in the shock-shock interaction.

  2. Enterotoxin production by strains of Staphylococcus aureus isolated from clinical and non-clinical specimens with special reference to enterotoxin F and toxic shock syndrome.

    PubMed Central

    de Nooij, M. P.; van Leeuwen, W. J.; Notermans, S.

    1982-01-01

    Enterotoxin production by strains of Staphylococcus aureus isolated from clinical specimens of human and animal origin and from healthy human carriers was investigated. All nine patients admitted to hospital with symptoms of toxic shock syndrome (TSS) yielded enterotoxin-producing strains of S. aureus. Eight of these produced staphylococcal enterotoxin F (SEF). A significantly smaller proportion of strains (42% of 50 strains tested) isolated from other clinical specimens of hospitalized patients produced SEF. Production of SEF by strains isolated from clinical specimens of animal origin (48 strains) was not observed. Twenty-nine per cent of 24 S. aureus strains isolated from noses of hospital staff produced SEF. This result was not significantly different from that obtained from strains isolated from clinical specimens other than TSS. A similar percentage of strains isolated from healthy human carriers outside hospital produced SEF (25% of 24 strains tested). The results indicated that enterotoxin production, especially that of SEF, is associated with S. aureus isolated from patients suspected of TSS. There was no indication of an association between S. aureus isolated from other staphylococcal infections and SEF production. All strains were phage typed and 79% of the strains belonging to the international phage-group I produced SEF. All strains lysed by phage 187 were found to produce SEF. PMID:6218196

  3. Prevalence of genes for enterotoxins, toxic shock syndrome toxin 1 and exfoliative toxin among clinical isolates of Staphylococcus pseudintermedius from canine origin.

    PubMed

    Yoon, Jang W; Lee, Gi-Jong; Lee, So-Young; Park, Chul; Yoo, Jong-Hyun; Park, Hee-Myung

    2010-10-01

    A total of 74 Staphylococcus pseudintermedius strains were isolated from the 99 clinical cases of canine pyoderma or chronic otitis in our veterinary teaching hospital during May 2006-February 2008. In this study, we examined the genetic distribution of staphylococcal pyogenic toxins such as staphylococcal enterotoxins A (sea), B (seb), C (sec), D (sed), E (see), and toxic shock syndrome toxin 1 (tst) as well as the previously characterized S. intermedius exfoliative toxin (siet) among those isolates. The polymerase chain reaction analyses with the toxin gene-specific primers revealed that 18 (24.3%) of 74 S. pseudintermedius isolates carried the sec genes, but none of the sea, seb, sed, see and tst genes. Further DNA sequencing analysis of the amplified sec genes revealed that they all belonged to the canine type C staphylococcal enterotoxin (SEC(canine) ) whose superantigenic activity has been demonstrated. In addition to the sec(canine) genes, our polymerase chain reaction results showed that all the 74 isolates carried the siet gene. Since both SEC(canine) and SIET toxins are known to be biologically active, it would be interesting to investigate how those toxins are involved in the pathogenesis of the canine diseases by S. pseudintermedius such as pyoderma or chronic otitis.

  4. Staphylococcus aureus toxic shock syndrome toxin-1 (TSST-1) production and Lactobacillus species growth in a defined medium simulating vaginal secretions.

    PubMed

    Stingley, Robin L; Liu, Huanli; Mullis, Lisa B; Elkins, Christopher A; Hart, Mark E

    2014-11-01

    Lactobacillus species are commensal with the healthy vaginal environment and inhibit the growth of many pathogenic bacteria in the vaginal tract by a variety of mechanisms, such as the production of hydrogen peroxide, organic acids, and antimicrobial substances. Simulation of the vaginal environment is crucial for proper investigation of the effects of Lactobacillus species on pathogenic bacteria. In this study, we modified a medium used to simulate vaginal secretions to improve the growth of toxic shock syndrome toxin-1 (TSST-1)-producing Staphylococcus aureus clinical strains and Lactobacillus species so that interactions between these bacteria may be examined. A medium consisting of basal salts, vitamins, albumin, glycogen, mucin, urea, sodium bicarbonate, polyoxyethylene sorbitan monolaurate, and amino acids supported the growth of S. aureus and the production of TSST-1 as determined by Western analysis. Improved growth of the Lactobacillus species was seen when this same medium was supplemented with manganese chloride, sodium acetate, and an increase in glucose concentration. However, growth of S. aureus in the supplemented medium resulted in reduced levels of TSST-1. Production of TSST-1 was not detected in a medium routinely used for the growth of Lactobacillus species although S. aureus growth was not inhibited. The development of an improved genital tract secretion medium provides a more authentic environment in which to study the interactions of Lactobacillus species and vaginal pathogens, such as S. aureus.

  5. Role of air in growth and production of toxic shock syndrome toxin 1 by Staphylococcus aureus in experimental cotton and rayon tampons.

    PubMed

    Fischetti, V A; Chapman, F; Kakani, R; James, J; Grun, E; Zabriskie, J B

    1989-01-01

    Rayon and cotton fibers of the type used in the manufacture of tampons were extracted for 6 hours in isopropyl alcohol in a soxhlet apparatus to remove all finishes from the fiber surface. The fibers were used to produce experimental tampons of commercial design. Using a syringe method, the tampons were saturated with diluted staphylococci in brain-heart infusion medium and incubated at 37 degrees C. Spent medium was expressed from the tampons and analyzed for growth of staphylococci and production of toxic shock syndrome toxin 1 (TSST-1). Results revealed no statistical difference in the production of TSST-1 by cells grown in rayon or cotton. However, a significant increase in TSST-1 production was observed in tampon cultures when compared with medium controls. When similar experiments were performed with tampons saturated with nitrogen, a significant decrease in TSST-1 production was observed when compared with air-saturated tampons. The results indicate that the oxygen normally present in tampons plays a significant role in modulating the production of TSST-1.

  6. When shock waves collide

    DOE PAGESBeta

    Martinez, D.; Hartigan, P.; Frank, A.; Hansen, E.; Yirak, K.; Liao, A. S.; Graham, P.; Foster, J.; Wilde, B.; Blue, B.; et al

    2016-06-01

    Supersonic outflows from objects as varied as stellar jets, massive stars, and novae often exhibit multiple shock waves that overlap one another. When the intersection angle between two shock waves exceeds a critical value, the system reconfigures its geometry to create a normal shock known as a Mach stem where the shocks meet. Mach stems are important for interpreting emission-line images of shocked gas because a normal shock produces higher postshock temperatures, and therefore a higher-excitation spectrum than does an oblique shock. In this paper, we summarize the results of a series of numerical simulations and laboratory experiments designed tomore » quantify how Mach stems behave in supersonic plasmas that are the norm in astrophysical flows. The experiments test analytical predictions for critical angles where Mach stems should form, and quantify how Mach stems grow and decay as intersection angles between the incident shock and a surface change. While small Mach stems are destroyed by surface irregularities and subcritical angles, larger ones persist in these situations and can regrow if the intersection angle changes to become more favorable. Furthermore, the experimental and numerical results show that although Mach stems occur only over a limited range of intersection angles and size scales, within these ranges they are relatively robust, and hence are a viable explanation for variable bright knots observed in Hubble Space Telescope images at the intersections of some bow shocks in stellar jets.« less

  7. When Shock Waves Collide

    NASA Astrophysics Data System (ADS)

    Hartigan, P.; Foster, J.; Frank, A.; Hansen, E.; Yirak, K.; Liao, A. S.; Graham, P.; Wilde, B.; Blue, B.; Martinez, D.; Rosen, P.; Farley, D.; Paguio, R.

    2016-06-01

    Supersonic outflows from objects as varied as stellar jets, massive stars, and novae often exhibit multiple shock waves that overlap one another. When the intersection angle between two shock waves exceeds a critical value, the system reconfigures its geometry to create a normal shock known as a Mach stem where the shocks meet. Mach stems are important for interpreting emission-line images of shocked gas because a normal shock produces higher postshock temperatures, and therefore a higher-excitation spectrum than does an oblique shock. In this paper, we summarize the results of a series of numerical simulations and laboratory experiments designed to quantify how Mach stems behave in supersonic plasmas that are the norm in astrophysical flows. The experiments test analytical predictions for critical angles where Mach stems should form, and quantify how Mach stems grow and decay as intersection angles between the incident shock and a surface change. While small Mach stems are destroyed by surface irregularities and subcritical angles, larger ones persist in these situations and can regrow if the intersection angle changes to become more favorable. The experimental and numerical results show that although Mach stems occur only over a limited range of intersection angles and size scales, within these ranges they are relatively robust, and hence are a viable explanation for variable bright knots observed in Hubble Space Telescope images at the intersections of some bow shocks in stellar jets.

  8. Shock waves data for minerals

    NASA Technical Reports Server (NTRS)

    Ahrens, Thomas J.; Johnson, Mary L.

    1994-01-01

    Shock compression of the materials of planetary interiors yields data which upon comparison with density-pressure and density-sound velocity profiles constrain internal composition and temperature. Other important applications of shock wave data and related properties are found in the impact mechanics of terrestrial planets and solid satellites. Shock wave equation of state, shock-induced dynamic yielding and phase transitions, and shock temperature are discussed. In regions where a substantial phase change in the material does not occur, the relationship between the particle velocity, U(sub p), and the shock velocity, U(sub s), is given by U(sub s) = C(sub 0) + S U(sub p), where C(sub 0) is the shock velocity at infinitesimally small particle velocity, or the ambient pressure bulk sound velocity. Numerical values for the shock wave equation of state for minerals and related materials of the solar system are provided.

  9. Anesthesia & Down Syndrome

    MedlinePlus

    ... occur in individuals with Down syndrome than their peers without Down syndrome. An awareness of these more ... of the eyes, ears, and joints - just like peers without Down syndrome. What About Down Syndrome Is ...

  10. High prevalence of toxic shock syndrome toxin-producing epidemic methicillin-resistant Staphylococcus aureus 15 (EMRSA-15) strains in Kuwait hospitals.

    PubMed

    Udo, E E; Boswihi, S S; Al-Sweih, N

    2016-07-01

    This study characterized EMRSA-15 isolates obtained from patients in Kuwait hospitals for their genotypic relatedness, antibiotic resistance and carriage of virulence genes using pulsed-field gel electrophoresis (PFGE), coagulase serotyping, SCCmec subtyping, spa typing, multilocus sequence typing and DNA microarray. The isolates were resistant to trimethoprim (75.6%), ciprofloxacin (29.7%), erythromycin and clindamycin (24.3%), tetracycline (19.0%), and gentamicin and kanamycin (21.6%). All 37 isolates belonged to sequence type (ST) 22, coagulase type XI, three PFGE types and eight subtypes, ten spa types including t223 (51.3%), t852 (13.5%), t032 (8.1%), t790 (8.1%), t3107 (5.4%) and one each of t309, t2251, t3935, t5708 and t5983. Twenty-six isolates (70.2%) carried SCCmec IVa, eight isolates carried SCCmec IV and three isolates carried SCCmec IVh. All isolates carried agr1, cap5 and egc gene cluster (seg, sei, selm, seln, selo, and selu). tst (toxic shock syndrome toxin) was detected in 23 isolates. Eight isolates (21.6%) were positive for Panton-Valentine leukocidin (PVL). Genotypic analysis revealed that 62.1% of the isolates comprising ST22-IVa-t223 (51.3%) and ST22-IVa-t309/t2251/t3935/t5708 (10.8%) were CC22-[tst1(+)] UK EMRSA-15/Middle Eastern variant, 21.6% were CC22-PVL(+) EMRSA-15 variant and 16.2% were CC22-UK EMRSA-15/Barnim clone. These results show that the tst1 positive-ST22-IVa-t223 (Middle Eastern variant) and the CC22-PVL(+) EMRSA-15 variant were the dominant EMRSA-15 variants in Kuwait hospitals. PMID:27222714

  11. Simultaneous isolation of emm89-type Streptococcus pyogenes strains with a wild-type or mutated covS gene from a single streptococcal toxic shock syndrome patient.

    PubMed

    Masuno, Katsuaki; Okada, Ryo; Zhang, Yan; Isaka, Masanori; Tatsuno, Ichiro; Shibata, Shinichiro; Hasegawa, Tadao

    2014-04-01

    Streptococcal toxic shock syndrome (STSS) is a re-emerging infectious disease in many developed countries. Recent studies have suggested that mutations in CovRS, a two-component regulatory system in Streptococcus pyogenes, play important roles in the pathogenesis of STSS. However, in vivo evidence of the significance of CovRS in human infections has not been fully demonstrated. We investigated five S. pyogenes strains isolated simultaneously from the pharynx, sputum, knee joint, cerebrospinal fluid and blood of a single STSS patient. All were emm89-type strains, and multilocus sequence typing (MLST) analysis revealed that the strains of pharynx and blood were isogenic. The growth rates of the strains from pharynx and sputum were faster than those of the other strains. Protein profiles of the culture supernatants of strains from the pharynx and sputum were also different from those of the other strains. Sequence analyses revealed that strains from the knee joint, cerebrospinal fluid and blood contained a single nucleotide difference in the covS coding region, resulting in one amino acid change, compared with the other strains. Introduction of a plasmid containing the covS gene from the pharynx strain to the blood strain increased the production of SpeB protein. This suggests that the one amino acid alteration in CovS was relevant to pathogenesis. This report supports the idea that mutated CovS plays important roles in vivo in the dissemination of S. pyogenes from the upper respiratory tract of human to aseptic tissues such as blood and cerebrospinal fluid.

  12. Systemic inflammatory response syndrome following burns is mediated by brain natriuretic peptide/natriuretic peptide A receptor-induced shock factor 1 signaling pathway.

    PubMed

    Xu, Yang-Cheng; Luo, Cheng-Qun; Li, Xiong

    2016-10-01

    The aim of this study was to determine whether systemic inflammatory response syndrome (SIRS) in burn patients is mediated by the brain natriuretic peptide (BNP)/natriuretic peptide A receptor (NPRA)-induced heat shock factor 1 (HSF-1) signalling pathway. Mononuclear cells (MNCs) that were isolated from patients with burn injuries and SIRS mouse models and a RAW264.7 cell line were treated with normal serum or serum obtained from animals with burn injuries. In parallel, small hairpin RNAs (shRNAs) against BNP or NPRA were transfected in both cell types. Western blotting (WB) and enzyme-linked immunosorbent assay (ELISA) were used to detect protein expression and inflammatory factor levels, respectively. We found that interleukin (IL)-12, tumour necrosis factor (TNF)-α, C-reactive protein (CRP), and BNP levels were increased and IL-10 levels were decreased in the plasma and MNCs in vivo in the animal model of SIRS. Additionally, NPRA was upregulated, whereas HSF-1 was downregulated in monocytes in vivo. Treatment of RAW264.7 cells with burn serum or BNP induced IL-12, TNF-α, and CRP secretion as well as HSF-1 expression. Finally, silencing BNP with shRNA interrupted the effect of burn serum on RAW264.7 cells, and silencing NPRA blocked burn serum- and BNP-mediated changes in RAW264.7 cells. These results suggest that the interaction of NPRA with BNP secreted from circulatory MNCs as well as mononuclear macrophages leads to inflammation via HSF-1 during SIRS development following serious burn injury.

  13. Genome-Wide Expression Profiling Deciphers Host Responses Altered during Dengue Shock Syndrome and Reveals the Role of Innate Immunity in Severe Dengue

    PubMed Central

    Devignot, Stéphanie; Bergon, Aurélie; Rihet, Pascal; Ong, Sivuth; Lorn, Patrich T.; Chroeung, Norith; Ngeav, Sina; Tolou, Hugues J.; Buchy, Philippe; Couissinier-Paris, Patricia

    2010-01-01

    Background Deciphering host responses contributing to dengue shock syndrome (DSS), the life-threatening form of acute viral dengue infections, is required to improve both the differential prognosis and the treatments provided to DSS patients, a challenge for clinicians. Methodology/Principal Findings Based on a prospective study, we analyzed the genome-wide expression profiles of whole blood cells from 48 matched Cambodian children: 19 progressed to DSS while 16 and 13 presented respectively classical dengue fever (DF) or dengue hemorrhagic fever grades I/II (DHF). Using multi-way analysis of variance (ANOVA) and adjustment of p-values to control the False Discovery Rate (FDR<10%), we identified a signature of 2959 genes differentiating DSS patients from both DF and DHF, and showed a strong association of this DSS-gene signature with the dengue disease phenotype. Using a combined approach to analyse the molecular patterns associated with the DSS-gene signature, we provide an integrative overview of the transcriptional responses altered in DSS children. In particular, we show that the transcriptome of DSS children blood cells is characterized by a decreased abundance of transcripts related to T and NK lymphocyte responses and by an increased abundance of anti-inflammatory and repair/remodeling transcripts. We also show that unexpected pro-inflammatory gene patterns at the interface between innate immunity, inflammation and host lipid metabolism, known to play pathogenic roles in acute and chronic inflammatory diseases associated with systemic vascular dysfunction, are transcriptionnally active in the blood cells of DSS children. Conclusions/Significance We provide a global while non exhaustive overview of the molecular mechanisms altered in of DSS children and suggest how they may interact to lead to final vascular homeostasis breakdown. We suggest that some mechanisms identified should be considered putative therapeutic targets or biomarkers of progression to DSS

  14. Suppressive and Facilitative Effects of Shock Intensity and Interresponse Times Followed by Shock

    ERIC Educational Resources Information Center

    Everly, Jessica B.; Perone, Michael

    2012-01-01

    Although response-dependent shock often suppresses responding, response facilitation can occur. In two experiments, we examined the suppressive and facilitative effects of shock by manipulating shock intensity and the interresponse times that produced shock. Rats' lever presses were reinforced on a variable-interval 40-s schedule of food…

  15. [Cardiogenic shock].

    PubMed

    Houegnifioh, Komlanvi Kafui; Gfeller, Etienne; Garcia, Wenceslao; Ribordy, Vincent

    2014-08-13

    Cardiogenic shock, especially when it complicates a myocardial infarction, is still associated with high mortality rate. Emergency department or first care physicians are often the first providers to assess the cardiogenic shock patient, and plays thereby a key role in achieving a timely diagnosis and treatment. This review will detail the actual physiopathology understanding of the cardiogenic shock, its diagnosis and management focusing on the care within the emergency department.

  16. Turbulence in electrostatic ion acoustic shocks

    NASA Technical Reports Server (NTRS)

    Means, R. W.; Coroniti, F. V.; Wong, A. Y.; White, R. B.

    1973-01-01

    Three types of collisionless electrostatic ion acoustic shocks are investigated using a double plasma (DP) device: (1) laminar shocks; (2) small amplitude turbulent shocks in which the turbulence is confined to be upstream of the shock potential jump; and (3) large amplitude turbulent shocks in which the wave turbulence occurs throughout the shock transition. The wave turbulence is generated by ions which are reflected from the shock potential; linear theory spatial growth increments agree with experimental values. The experimental relationship between the shock Mach number and the shock potential is shown to be inconsistent with theoretical shock models which assume that the electrons are isothermal. Theoretical calculations which assume a trapped electron equation of a state and a turbulently flattened velocity distrubution function for the reflected ions yields a Mach number vs potential relationship in agreement with experiment.

  17. MRSA Clonal Complex 22 Strains Harboring Toxic Shock Syndrome Toxin (TSST-1) Are Endemic in the Primary Hospital in Gaza, Palestine

    PubMed Central

    Chen, Liang; Abdelateef, Nahed; Elamreen, Farid Abu; Ginocchio, Christine C.; Pierard, Denis; Becker, Karsten; Kreiswirth, Barry N.

    2015-01-01

    Background Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in both community and healthcare-related settings worldwide. Current knowledge regarding the epidemiology of S. aureus and MRSA in Gaza is based on a single community-based carriage study. Here we describe a cross-sectional analysis of 215 clinical isolates collected from Al-Shifa Hospital in Gaza during 2008 and 2012. Methods All isolates were characterized by spa typing, SCCmec typing, and detection of genes encoding Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin (TSST-1). Representative genotypes were also subjected to multilocus sequence typing (MLST). Antibiotic susceptibility testing was performed using VITEK2 and MicroScan. Results MRSA represented 56.3% of all S. aureus strains, and increased in frequency from 2008 (54.8%) to 2012 (58.4%). Aside from beta-lactams, resistance was observed to tetracycline, erythromycin, clindamycin, gentamicin, and fluoroquinolones. Molecular typing identified 35 spa types representing 17 MLST clonal complexes (CC), with spa 998 (Ridom t223, CC22) and spa 70 (Ridom t044, CC80) being the most prevalent. SCCmec types I, III, IV, V and VI were identified among MRSA isolates, while type II was not detected. PVL genes (lukF/S-PV) were detected in 40.0% of all isolates, while the TSST-1 gene (tst) was detected in 27.4% of all isolates, with surprisingly high frequency within CC22 (70.4%). Both PVL and TSST-1 genes were found in several isolates from 2012. Conclusions Molecular typing of clinical isolates from Gaza hospitals revealed unusually high prevalence of TSST-1 genes among CC22 MRSA, which is noteworthy given a recent community study describing widespread carriage of a CC22 MRSA clone known as the ‘Gaza strain’. While the latter did not address TSST-1, tst-positive spa 998 (Ridom t223) has been detected in several neighboring countries, and described as endemic in an Italian NICU, suggesting international spread of a

  18. Use of porcine vaginal tissue ex-vivo to model environmental effects on vaginal mucosa to toxic shock syndrome toxin-1

    SciTech Connect

    Davis, Catherine C.; Baccam, Mekhine; Mantz, Mary J.; Osborn, Thomas W.; Hill, Donna R.; Squier, Christopher A.

    2014-01-15

    Menstrual toxic shock syndrome (mTSS) is a rare, recognizable, and treatable disease that has been associated with tampon use epidemiologically. It involves a confluence of microbial risk factors (Staphylococcus aureus strains that produce the superantigen—TSST-1), as well as environmental characteristics of the vaginal ecosystem during menstruation and host susceptibility factors. This paper describes a series of experiments using the well-characterized model of porcine vaginal mucosa ex-vivo to assess the effect of these factors associated with tampon use on the permeability of the mucosa. The flux of radiolabeled TSST-1 and tritiated water ({sup 3}H{sub 2}O) through porcine vaginal mucosa was determined at various temperatures, after mechanical disruption of the epithelial surface by tape stripping, after treatment with surfactants or other compounds, and in the presence of microbial virulence factors. Elevated temperatures (42, 47 and 52 °C) did not significantly increase flux of {sup 3}H{sub 2}O. Stripping of the epithelial layers significantly increased the flux of labeled toxin in a dose-dependent manner. Addition of benzalkonium chloride (0.1 and 0.5%) and glycerol (4%) significantly increased the flux of {sup 3}H{sub 2}O but sodium lauryl sulfate at any concentration tested did not. The flux of the labeled toxin was significantly increased in the presence of benzalkonium chloride but not Pluronic® L92 and Tween 20 and significantly increased with addition of α-hemolysin but not endotoxin. These results show that the permeability of porcine vagina ex-vivo to labeled toxin or water can be used to evaluate changes to the vaginal environment and modifications in tampon materials, and thus aid in risk assessment. - Highlights: • Model assessed local effects of tampon use on vaginal mucosa. • Risks were evaluated using two tracers to assess permeability in an ex vivo model. • Mechanical damage to the epithelial surface increased tracer penetration.

  19. Dumping Syndrome

    MedlinePlus

    ... Disease Organizations​​ (PDF, 341 KB)​​​​​ Alternate Language URL Dumping Syndrome Page Content On this page: What is ... Nutrition Points to Remember Clinical Trials What is dumping syndrome? Dumping syndrome occurs when food, especially sugar, ...

  20. Down syndrome

    MedlinePlus

    Down syndrome is a genetic condition in which a person has 47 chromosomes instead of the usual 46. ... In most cases, Down syndrome occurs when there is an extra copy of chromosome 21. This form of Down syndrome is called trisomy 21. ...

  1. Multiple shock-shock interference on a cylindrical leading edge

    NASA Technical Reports Server (NTRS)

    Wieting, Allan R.

    1991-01-01

    The details of an experimental study of shock wave interference heating on a cylindrical leading edge representative of the cowl of a rectangular hypersonic engine inlet are presented. This Mach 8 study has provided the first detailed pressure and heat transfer rate distributions on a cylinder resulting from a two-dimensional shockwave interference pattern created by two incident oblique shock waves intersecting the cylinder bow shock wave. The peak heat transfer rate was 38 times the undisturbed flow stagnation point level and occurred when the two oblique shock waves coalesced prior to intersecting the cylinder bow shock wave. Development of pressure deflection diagrams identified a new interference pattern consisting of concomitant supersonic jets separated from each other by a shear layer and submerged in the subsonic region between the bow shock wave and body.

  2. Quasiperpendicular High Mach Number Shocks

    NASA Astrophysics Data System (ADS)

    Sulaiman, A. H.; Masters, A.; Dougherty, M. K.; Burgess, D.; Fujimoto, M.; Hospodarsky, G. B.

    2015-09-01

    Shock waves exist throughout the Universe and are fundamental to understanding the nature of collisionless plasmas. Reformation is a process, driven by microphysics, which typically occurs at high Mach number supercritical shocks. While ongoing studies have investigated this process extensively both theoretically and via simulations, their observations remain few and far between. In this Letter we present a study of very high Mach number shocks in a parameter space that has been poorly explored and we identify reformation using in situ magnetic field observations from the Cassini spacecraft at 10 AU. This has given us an insight into quasiperpendicular shocks across 2 orders of magnitude in Alfvén Mach number (MA ) which could potentially bridge the gap between modest terrestrial shocks and more exotic astrophysical shocks. For the first time, we show evidence for cyclic reformation controlled by specular ion reflection occurring at the predicted time scale of ˜0.3 τc , where τc is the ion gyroperiod. In addition, we experimentally reveal the relationship between reformation and MA and focus on the magnetic structure of such shocks to further show that for the same MA , a reforming shock exhibits stronger magnetic field amplification than a shock that is not reforming.

  3. Selfsimilar time dependent shock structures

    NASA Technical Reports Server (NTRS)

    Beck, R.; Drury, L. O.

    1985-01-01

    Diffusive shock acceleration as an astrophysical mechanism for accelerating charged particles has the advantage of being highly efficient. This means however that the theory is of necessity nonlinear; the reaction of the accelerated particles on the shock structure and the acceleration process must be self-consistently included in any attempt to develop a complete theory of diffusive shock acceleration. Considerable effort has been invested in attempting, at least partially, to do this and it has become clear that in general either the maximum particle energy must be restricted by introducing additional loss processes into the problem or the acceleration must be treated as a time dependent problem (Drury, 1984). It is concluded that stationary modified shock structures can only exist for strong shocks if additional loss processes limit the maximum energy a particle can attain. This is certainly possible and if it occurs the energy loss from the shock will lead to much greater shock compressions. It is however equally possible that no such processes exist and we must then ask what sort of nonstationary shock structure develops. The ame argument which excludes stationary structures also rules out periodic solutions and indeed any solution where the width of the shock remains bounded. It follows that the width of the shock must increase secularly with time and it is natural to examine the possibility of selfsimilar time dependent solutions.

  4. Cardiogenic shock.

    PubMed

    Shah, Palak; Cowger, Jennifer A

    2014-07-01

    Cardiogenic shock is the most common cause of in-hospital mortality for patients who have suffered a myocardial infarction. Mortality exceeds 50% and management is focused on a rapid diagnosis of cardiogenic shock, restoration of coronary blood flow through early revascularization, complication management, and maintenance of end-organ homeostasis. Besides revascularization, inotropes and vasodilators are potent medical therapies to assist the failing heart. Pulmonary arterial catheters are an important adjunctive tool to assess patient hemodynamics, but their use should be limited to select patients in cardiogenic shock.

  5. Basic Shock Physiology and Critical Care.

    PubMed

    Roberts, Brian K

    2016-05-01

    Veterinarians practicing emergency medicine and/or working with exotic animals must be well versed in the pathophysiology of shock because many exotic pets present with an acute crisis or an acute manifestation of a chronic process causing poor organ perfusion. This article discusses the pathophysiology of shock and the systemic inflammatory response syndrome, which may lead to organ dysfunction, organ failure, sepsis, and death. The physiology of perfusion, perfusion measurements, categories of shock, and altered function of the immune system, gastrointestinal barrier, and coagulation system are discussed. Veterinarians providing emergency care to patients with shock must also be aware of comorbidities. PMID:27131156

  6. Management of refractory cardiogenic shock.

    PubMed

    Reyentovich, Alex; Barghash, Maya H; Hochman, Judith S

    2016-08-01

    Cardiogenic shock is a life-threatening condition that occurs in response to reduced cardiac output in the presence of adequate intravascular volume and results in tissue hypoxia. Cardiogenic shock has several underlying aetiologies, with the most common being acute myocardial infarction (AMI). Refractory cardiogenic shock presents as persistent tissue hypoperfusion despite administration of adequate doses of two vasoactive medications and treatment of the underlying aetiology. Investigators of the SHOCK trial reported a long-term mortality benefit of emergency revascularization for shock complicating AMI. Since the publication of the SHOCK trial and subsequent guideline recommendations, the increase in community-based use of percutaneous coronary intervention for this condition has resulted in a significant decline in mortality. Despite these successes in the past 15 years, mortality still remains exceptionally high, particularly in patients with refractory cardiogenic shock. In this Review, we discuss the aetiology and pathophysiology of cardiogenic shock and summarize the data on the available therapeutics and their limitations. Although new mechanical circulatory support devices have been shown to improve haemodynamic variables in patients with shock complicating AMI, they did not improve clinical outcomes and are associated with high costs and complications. PMID:27356877

  7. Management of refractory cardiogenic shock.

    PubMed

    Reyentovich, Alex; Barghash, Maya H; Hochman, Judith S

    2016-08-01

    Cardiogenic shock is a life-threatening condition that occurs in response to reduced cardiac output in the presence of adequate intravascular volume and results in tissue hypoxia. Cardiogenic shock has several underlying aetiologies, with the most common being acute myocardial infarction (AMI). Refractory cardiogenic shock presents as persistent tissue hypoperfusion despite administration of adequate doses of two vasoactive medications and treatment of the underlying aetiology. Investigators of the SHOCK trial reported a long-term mortality benefit of emergency revascularization for shock complicating AMI. Since the publication of the SHOCK trial and subsequent guideline recommendations, the increase in community-based use of percutaneous coronary intervention for this condition has resulted in a significant decline in mortality. Despite these successes in the past 15 years, mortality still remains exceptionally high, particularly in patients with refractory cardiogenic shock. In this Review, we discuss the aetiology and pathophysiology of cardiogenic shock and summarize the data on the available therapeutics and their limitations. Although new mechanical circulatory support devices have been shown to improve haemodynamic variables in patients with shock complicating AMI, they did not improve clinical outcomes and are associated with high costs and complications.

  8. Is this septic shock? A rare case of distributive shock.

    PubMed

    Val-Flores, Luis Silva; Fior, Alberto; Santos, Ana; Reis, Luís; Bento, Luís

    2014-01-01

    The authors report a rare case of shock in a patient without significant clinical history, admitted to the intensive care unit for suspected septic shock. The patient was initially treated with fluid therapy without improvement. A hypothesis of systemic capillary leak syndrome was postulated following the confirmation of severe hypoalbuminemia, hypotension, and hemoconcentration--a combination of three symptoms typical of the disease. The authors discussed the differential diagnosis and also conducted a review of the diagnosis and treatment of the disease. PMID:25607273

  9. Comparative study of shock wave therapy and Laser therapy effect in elimination of symptoms among patients with myofascial pain syndrome in upper trapezius

    PubMed Central

    Taheri, Parisa; Vahdatpour, Babak; Andalib, Somayeh

    2016-01-01

    Background: The aim of this study is to compare the effects of laser therapy and shock wave therapy for symptoms treatment among patients with MPS in the upper trapezius muscle. Materials and Methods: In a clinical trial study, 46 patients were selected based on the clinical criteria and physiathrist diagnosis. Subjects were randomized into two groups as follows: Twenty individuals were assigned to exercise-medication-laser therapy group, and 26 to exercise-medication-shock wave therapy group. The pain was assessed based on visual analog scale (VAS), neck disability index (NDI), and SPADI in three stages: Before treatment, subsequently after treatment, and a month after treatment. Results: One man and 19 women, age group of 45.3 ± 7.7 years, were assigned into laser therapy group. Two men and 24 women, average age group of 42.3 ± 10.4 were assigned into shock wave therapy group. A significant difference was found among our study groups before treatment and after starting treatment for VAS, NDI, and SPDI indices, that is, two methods of treatments were effective (P < 0.001). However, among these two treatment methods, laser therapy provided higher effect on VAS and NDI as compared to the radial shock wave method (P < 0.05) in 2 weeks from starting the treatment (consequent to treatment). Conclusion: According to this study results, we can conclude that shock wave and laser therapy results on similar effect in long-term for relieve of pain and eliminating symptoms in patients with myofascial but laser provides a faster optimal results. PMID:27656607

  10. Comparative study of shock wave therapy and Laser therapy effect in elimination of symptoms among patients with myofascial pain syndrome in upper trapezius

    PubMed Central

    Taheri, Parisa; Vahdatpour, Babak; Andalib, Somayeh

    2016-01-01

    Background: The aim of this study is to compare the effects of laser therapy and shock wave therapy for symptoms treatment among patients with MPS in the upper trapezius muscle. Materials and Methods: In a clinical trial study, 46 patients were selected based on the clinical criteria and physiathrist diagnosis. Subjects were randomized into two groups as follows: Twenty individuals were assigned to exercise-medication-laser therapy group, and 26 to exercise-medication-shock wave therapy group. The pain was assessed based on visual analog scale (VAS), neck disability index (NDI), and SPADI in three stages: Before treatment, subsequently after treatment, and a month after treatment. Results: One man and 19 women, age group of 45.3 ± 7.7 years, were assigned into laser therapy group. Two men and 24 women, average age group of 42.3 ± 10.4 were assigned into shock wave therapy group. A significant difference was found among our study groups before treatment and after starting treatment for VAS, NDI, and SPDI indices, that is, two methods of treatments were effective (P < 0.001). However, among these two treatment methods, laser therapy provided higher effect on VAS and NDI as compared to the radial shock wave method (P < 0.05) in 2 weeks from starting the treatment (consequent to treatment). Conclusion: According to this study results, we can conclude that shock wave and laser therapy results on similar effect in long-term for relieve of pain and eliminating symptoms in patients with myofascial but laser provides a faster optimal results.

  11. Lessons Learned for the Resuscitation of Traumatic Hemorrhagic Shock.

    PubMed

    Spinella, Philip C; Perkins, Jeremy G; Cap, Andrew P

    2016-01-01

    The lessons learned regarding the resuscitation of traumatic hemorrhagic shock are numerous and come from a better understanding of the epidemiology, pathophysiology, and experience in this population over 10-plus years of combat operations. We have now come to better understand that the greatest benefit in survival can come from improved treatment of hemorrhage in the prehospital phase of care. We have learned that there is an endogenous coagulopathy that occurs with severe traumatic injury secondary to oxygen debt and that classic resuscitation strategies for severe bleeding based on crystalloid or colloid solutions exacerbate coagulopathy and shock for those with life-threatening hemorrhage. We have relearned that a whole blood-based resuscitation strategy, or one that at least recapitulates the functionality of whole blood, may reduce death from hemorrhage and reduce the risks of excessive crystalloid administration which include acute lung injury, abdominal compartment syndrome, cerebral edema, and anasarca. Appreciation of the importance of shock and coagulopathy management underlies the emphasis on early hemostatic resuscitation. Most importantly, we have learned that there is still much more to understand regarding the epidemiology, pathophysiology, and the resuscitation strategies required to improve outcomes for casualties with hemorrhagic shock. PMID:27215864

  12. Refeeding syndrome.

    PubMed

    Fernández López, M T; López Otero, M J; Alvarez Vázquez, P; Arias Delgado, J; Varela Correa, J J

    2009-01-01

    Refeeding syndrome is a complex syndrome that occurs as a result of reintroducing nutrition (oral, enteral or parenteral) to patients who are starved or malnourished. Patients can develop fluid-balance abnormalities, electrolyte disorders (hypophosphataemia, hypokalaemia and hypomagnesaemia), abnormal glucose metabolism and certain vitamin deficiencies. Refeeding syndrome encompasses abnormalities affecting multiple organ systems, including neurological, pulmonary, cardiac, neuromuscular and haematological functions. Pathogenic mechanisms involved in the refeeding syndrome and clinical manifestations have been reviewed. We provide suggestions for the prevention and treatment of refeeding syndrome. The most important steps are to identify patients at risk, reintroduce nutrition cautiously and correct electrolyte and vitamin deficiencies properly.

  13. [Treatment of renal vein thrombosis associated with nephrotic syndrome].

    PubMed

    Funami, M; Takaba, T; Tanaka, H; Murakami, A; Kadokura, M; Hori, G; Ishii, J

    1988-06-01

    Renal vein thrombosis is a rare entity in which true incidence is unknown. The disease occurs most frequently in patients with nephrotic syndrome, but it also can occur in the presence of other hypercoagulable state. Two cases of renal vein thrombosis with nephrotic syndrome which were treated by thrombectomy are reported here. One patient was successfully treated by renal vein and inferior vena cava thrombectomy before developing severe pulmonary embolism. The other was treated by renal vein thrombectomy by which fatal shock was able to be prevented. In those cases, immediate operation was indicated, primarily to prevent additional, possibly fatal, pulmonary embolism and also to improve perfusion of the kidney. In the hope of salvaging the kidney, thrombectomy may be the treatment of choice for acute renal vein thrombosis, complication of pulmonary embolism and inferior vena cava thrombosis, right renal vein thrombosis without collateral flow and acute renal vein thrombosis with shock.

  14. Culture shock and travelers.

    PubMed

    Stewart, L; Leggat, P A

    1998-06-01

    As travel has become easier and more affordable, the number of people traveling has risen sharply. People travel for many and varied reasons, from the business person on an overseas assignment to backpackers seeking new and exotic destinations. Others may take up residence in different regions, states or countries for family, business or political reasons. Other people are fleeing religious or political persecution. Wherever they go and for whatever reason they go, people take their culture with them. Culture, like language, is acquired innately in early childhood and is then reinforced through formal and complex informal social education into adulthood. Culture provides a framework for interpersonal and social interactions. Therefore, the contact with a new culture is often not the exciting or pleasurable experience anticipated. When immersed in a different culture, people no longer know how to act when faced with disparate value systems. Contact with the unfamiliar culture can lead to anxiety, stress, mental illness and, in extreme cases, physical illness and suicide. "Culture shock" is a term coined by the anthropologist Oberg. It is the shock of the new. It implies that the experience of the new culture is an unpleasant surprise or shock, partly because it is unexpected and partly because it can lead to a negative evaluation of one's own culture. It is also known as cross-cultural adjustment, being that period of anxiety and confusion experienced when entering a new culture. It affects people intellectually, emotionally, behaviorally and physically and is characterized by symptoms of psychological distress. Culture shock affects both adults and children. In travelers or workers who have prolonged sojourns in foreign countries, culture shock may occur not only as they enter the new culture, but also may occur on their return to their original culture. Children may also experience readjustment problems after returning from leading sheltered lives in expatriate

  15. [Obstructive shock].

    PubMed

    Pich, H; Heller, A R

    2015-05-01

    An acute obstruction of blood flow in central vessels of the systemic or pulmonary circulation causes the clinical symptoms of shock accompanied by disturbances of consciousness, centralization, oliguria, hypotension and tachycardia. In the case of an acute pulmonary embolism an intravascular occlusion results in an acute increase of the right ventricular afterload. In the case of a tension pneumothorax, an obstruction of the blood vessels supplying the heart is caused by an increase in extravascular pressure. From a hemodynamic viewpoint circulatory shock caused by obstruction is closely followed by cardiac deterioration; however, etiological and therapeutic options necessitate demarcation of cardiac from non-cardiac obstructive causes. The high dynamics of this potentially life-threatening condition is a hallmark of all types of obstructive shock. This requires an expeditious and purposeful diagnosis and a rapid and well-aimed therapy. PMID:25994928

  16. Co-Occurring Disorders

    MedlinePlus

    ... Care of You Top Ten Freshman Year Issues Alcohol, Substance Abuse and Depression Winter Break Survival Tips for College Students Implementing ... supporters and consumers in the mental health field. Alcohol and Drug Abuse, Addiction and Co-occurring Disorders: Co-occurring ... In Crisis? Call ...

  17. Sarcoidosis Occurring After Lymphoma

    PubMed Central

    London, Jonathan; Grados, Aurélie; Fermé, Christophe; Charmillon, Alexandre; Maurier, François; Deau, Bénédicte; Crickx, Etienne; Brice, Pauline; Chapelon-Abric, Catherine; Haioun, Corinne; Burroni, Barbara; Alifano, Marco; Le Jeunne, Claire; Guillevin, Loïc; Costedoat-Chalumeau, Nathalie; Schleinitz, Nicolas; Mouthon, Luc; Terrier, Benjamin

    2014-01-01

    Abstract Sarcoidosis is a granulomatous disease that most frequently affects the lungs with pulmonary infiltrates and/or bilateral hilar and mediastinal lymphadenopathy. An association of sarcoidosis and lymphoproliferative disease has previously been reported as the sarcoidosis-lymphoma syndrome. Although this syndrome is characterized by sarcoidosis preceding lymphoma, very few cases of sarcoidosis following lymphoma have been reported. We describe the clinical, biological, and radiological characteristics and outcome of 39 patients presenting with sarcoidosis following lymphoproliferative disease, including 14 previously unreported cases and 25 additional patients, after performing a literature review. Hodgkin lymphoma and non-Hodgkin lymphoma were equally represented. The median delay between lymphoma and sarcoidosis was 18 months. Only 16 patients (41%) required treatment. Sarcoidosis was of mild intensity or self-healing in most cases, and overall clinical response to sarcoidosis was excellent with complete clinical response in 91% of patients. Sarcoidosis was identified after a follow-up computerized tomography scan (CT-scan) or 18fluorodeoxyglucose-positron emission tomography/computerized tomography (18FDG-PET/CT) evaluation in 18/34 patients (53%). Sarcoidosis is therefore a differential diagnosis to consider when lymphoma relapse is suspected on a CT-scan or 18FDG-PET/CT, emphasizing the necessity to rely on histological confirmation of lymphoma relapse. PMID:25380084

  18. CULTURE SHOCK.

    ERIC Educational Resources Information Center

    WEINSTEIN, GERALD; AND OTHERS

    IN A PANEL, GEORGE BRAGLE AND NATHAN GOULD STRESS TEACHER PREPARATION TO COPE WITH THE THREATENING IMPACT OF CULTURE OR REALITY SHOCK. THEY RECOMMEND MODIFYING THE ATTITUDES OF TEACHERS BY ALTERING THEIR PERCEPTIONS, PROVIDING THEM WITH DIRECT EXPERIENCE WITH THE SOCIOCULTURAL MILIEU OF GHETTO SCHOOLS, AND REQUIRING THEM TO TAKE COURSES IN THE…

  19. Porcine Reproductive and Respiratory Syndrome Virus Replicase - Isoforms of Nonstructural Protein 2 and Interaction with Heat Shock 70kDa Protein 5

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The nsp2 replicase protein of porcine reproductive and respiratory syndrome virus (PRRSV), when expressed independently, was recently demonstrated to be processed from its precursor by the PL2 protease at or near the G**1196|G**1197 dipeptide in transfected CHO cells. The proteolytic cleavage of nsp...

  20. Suppressive and facilitative effects of shock intensity and interresponse times followed by shock.

    PubMed

    Everly, Jessica B; Perone, Michael

    2012-11-01

    Although response-dependent shock often suppresses responding, response facilitation can occur. In two experiments, we examined the suppressive and facilitative effects of shock by manipulating shock intensity and the interresponse times that produced shock. Rats' lever presses were reinforced on a variable-interval 40-s schedule of food presentation. Shock followed either long or short interresponse times. Shock intensity was raised from 0.05 mA to 0.4 mA or 0.8 mA. Overall, shock contingent on long interresponse times punished long interresponse times and increased response rates. Shock contingent on short interresponse times punished short interresponse times and decreased response rates. In Experiment 1, raising the range of interresponse times that produced shock enhanced these effects. In Experiment 2, the effects of shock intensity depended on the interresponse times that produced shock. When long interresponse times produced shock, low intensities increased response rates. High intensities decreased response rates. When short interresponse times produced shock, high shock intensities punished short interresponse times and decreased response rates more than low intensities. The results may explain why punishment procedures occasionally facilitate responding and establish parameters for future studies of punishment.

  1. Shock normal determination for multiple-ion shocks

    NASA Technical Reports Server (NTRS)

    Kessel, R. L.; Coates, A. J.; Motschmann, U.; Neubauer, F. M.

    1994-01-01

    We have adapted the single-ion Vinas and Scudder (1986) solution to the Rankine-Hugoniot (R-H) problem to a multiple-on solution. Using this technique, we can calculate a shock normal direction, shock speed, best estimate of the upstream and downstream magnetic field and plasma asymptotic states, and theta(sub Bn), the angle between the shock normal and the upstream magnetic field. We test the multi-ion solution with a theoretical case but are restricted to a perpendicular shock in order to close the multi-ion Rankine-Hugoniot equations. For this test case both single-ion and multi-ion solutions are equally valid. We examine parameter regimes to look for differences between single-ion and multi-ion solutions of the R-H equations, and we find that the largest differences occur for quasi-parallel shocks, small values of solar wind speed, large values of heavy ion density, and very strong and very weak shocks. For both the inbound and outbound crossing of comet Halley we have a slow solar wind speed, small values of water group ions and fairly weak shocks. We examine both the quasi-perpendicular inbound crossing and the quasi-parallel outbound crossing at comet Halley.

  2. Morphologic diversity of malignant neoplasms arising in preexisting spiradenoma, cylindroma, and spiradenocylindroma based on the study of 24 cases, sporadic or occurring in the setting of Brooke-Spiegler syndrome.

    PubMed

    Kazakov, Dmitry V; Zelger, Bernhard; Rütten, Arno; Vazmitel, Marina; Spagnolo, Dominic V; Kacerovska, Denisa; Vanecek, Tomas; Grossmann, Petr; Sima, Radek; Grayson, Wayne; Calonje, Eduardo; Koren, Jan; Mukensnabl, Petr; Danis, Dusan; Michal, Michal

    2009-05-01

    The authors present a series of 24 malignant neoplasms arising in preexisting benign spiradenoma (20), cylindroma (2), and spiradenocylindroma (2). Nineteen patients (12 females, 7 males; age range, 41 to 92 y) had a solitary neoplasm (size range, 2.2 to 17.5 cm; median 4 cm), whereas the remaining 5 (4 females, 1 male; age range, 66 to 72 y) manifested clinical features of Brooke-Spiegler syndrome (BSS), an autosomal dominantly inherited disease characterized by widespread, small, benign neoplasms on which background larger malignant lesions appeared. Microscopically, all cases showed the residuum of a preexisting benign neoplasm. The malignant components of the lesions were variable and could be classified into 4 main patterns, occurring alone or in combination: 1) salivary gland type basal cell adenocarcinoma-like pattern, low-grade (BCAC-LG); 2) salivary gland type basal cell adenocarcinoma-like pattern, high-grade (BCAC-HG); 3) invasive adenocarcinoma, not otherwise specified (IAC-NOS); and 4) sarcomatoid (metaplastic) carcinoma. In 1 case of IAC-NOS, an in situ adenocarcinoma was also found, presumed to have evolved from an adjacent adenomatous and atypical adenomatous component. Cases harboring a sarcomatoid carcinoma featured a malignant epithelial component composed of varying combinations of BCAC-HG, BCAC-LG, IAC-NOS, or squamous cell carcinoma, whereas the sarcomatoid component appeared as either a pleomorphic or spindle-cell sarcoma. Additionally, in 2 cases there were foci of heterologous chondrosarcomatous differentiation and in 1 case there was rhabomyosarcomatous differentiation. Of the 21 patients with available follow-up (range, 3 mo-15 y; average 4.8 y; median 3.5 y), 10 were without evidence of disease, 1 was alive with metastatic disease, 1 was alive with BSS, 3 developed local recurrences, 4 had died of disease, and 2 were dead of other causes. The histologic pattern of the malignant neoplasm correlated to some extent with the clinical course

  3. Instabilities and Structure Evolution in Radiative Shocks

    NASA Astrophysics Data System (ADS)

    Doss, F. W.; Drake, R. P.; Visco, A. J.; Kuranz, C. C.; Grosskopf, M. J.; Reighard, A. B.; Knauer, J.

    2007-11-01

    Radiative shocks, systems in which radiation transport across the shock front contributes substantially to the properties and dynamics of the shock, occur frequently in astrophysical systems, motivating our high-energy-density experiments. Recent laser-driven experiments have produced collapsed shocks by launching 10-20 μm drive disks of Be into shock tubes of Xe gas at atmospheric pressure. This method produces strongly radiative shocks at well over 100 km/sec. Experiments using x-ray pinhole radiography of collapsed radiative shocks have revealed evidence of structure evolution, perhaps through instability mechanisms. Recent experiments provided simultaneous normal and oblique data. Theoretical work related to structure growth will also be reported. This research was sponsored by the NNSA through DOE Research Grants DE-FG52-07NA28058, DE-FG52-04NA0064, and the NNSA Stewardship Science Graduate Fellowship.

  4. Magnetic field overshoots in the Venus blow shock

    SciTech Connect

    Tatrallyay, M.; Luhmann, J.G.; Russell, C.T.

    1984-01-01

    An examination of Pioneer Venus Orbiter fluxgate magnetometer data has shown that magnetic field overshoots occur not only behind quasi-perpendicular bow shocks but also behind quasi-parallel shocks. Overshoots are assocciated only with supercritical shocks. Their amplitudes increase with increasing fast Mach number. Solar wind beta has a lesser effect. The thickness of the overshoot increases with decreasing Theta-BN. The thickness of apparent overshoots detected behind 4 strong fast interplanetary shocks (M greater than M/crit) is about 3 orders of magnitude larger. Multiple crossings of the Venus bow shock were observed mainly at turbulent shocks. Their occurence is not influenced by Theta-BN. 15 references.

  5. Ruptured spinal arteriovenous malformation: Presenting as stunned myocardium and neurogenic shock

    PubMed Central

    Mehesry, Tasneem H.; Shaikh, Nissar; Malmstrom, Mohammad F.; Marcus, Marco A. E.; Khan, Adnan

    2015-01-01

    Background: Neurogenic pulmonary edema (NPE) is a clinical syndrome usually defined as an acute pulmonary edema occurring shortly after a central neurologic insult. NPE was identified 100 years ago, but it is still underappreciated in the clinical setup. NPE usually appears within minutes to hours after the injury. It has a high mortality rate if not recognized early and treated appropriately. Similarly, neurogenic shock is a known complication of spinal cord injury reported incidence is more than 20% in isolated upper cervical spinal injury. But NPE is rare to occur, and stunned myocardium (SM) is not reported in spinal arteriovenous malformation (AVM) rupture. SM is a reversible cardiomyopathy resulting in transient left ventricular dysfunction which has been described to occur in the setting of catecholamine release during situations of physiologic stress. We report a case of high spinal AVM rupture presenting as SM, NPE, and neurogenic shock. Case Description: A 32-year-old male who presented with sudden onset of pain and weakness in upper limbs. Imaging studies showed AVM rupture by imaging techniques. Initially, the patient had severe hypertension, respiratory distress requiring intubation and ventilation, then he developed hypotension, bradycardia, and asystole, which required immediate cardiopulmonary resuscitation and atropine. He remained with quadriplegia and suffered from frequent episodes of bradycardia and asystole. Conclusions: Spinal AVM rupture can present as neurogenic shock, stunned myocardium, and pulmonary edema. Early recognition of AVM rupture and prompt surgical intervention, as well as aggressive treatment of shock, may enhance recovery and decrease the long-term morbidity. PMID:26539315

  6. Chondrule destruction in nebular shocks

    SciTech Connect

    Jacquet, Emmanuel; Thompson, Christopher

    2014-12-10

    Chondrules are millimeter-sized silicate spherules ubiquitous in primitive meteorites, but whose origin remains mysterious. One of the main proposed mechanisms for producing them is melting of solids in shock waves in the gaseous protoplanetary disk. However, evidence is mounting that chondrule-forming regions were enriched in solids well above solar abundances. Given the high velocities involved in shock models, destructive collisions would be expected between differently sized grains after passage of the shock front as a result of differential drag. We investigate the probability and outcome of collisions of particles behind a one-dimensional shock using analytic methods as well as a full integration of the coupled mass, momentum, energy, and radiation equations. Destruction of protochondrules seems unavoidable for solid/gas ratios ε ≳ 0.1, and possibly even for solar abundances because of 'sandblasting' by finer dust. A flow with ε ≳ 10 requires much smaller shock velocities (∼2 versus 8 km s{sup –1}) in order to achieve chondrule-melting temperatures, and radiation trapping allows slow cooling of the shocked fragments. Initial destruction would still be extensive; although re-assembly of millimeter-sized particles would naturally occur by grain sticking afterward, the compositional heterogeneity of chondrules may be difficult to reproduce. We finally note that solids passing through small-scale bow shocks around few kilometer-sized planetesimals might experience partial melting and yet escape fragmentation.

  7. "Naturally occurring asbestos

    NASA Astrophysics Data System (ADS)

    Cagnard, F.; Lahondère, D.; Blein, O.; Lahfid, A.; Wille, G.

    2012-04-01

    The term asbestos refers to six silicate minerals from amphibole and serpentine groups. By definition, it consists in bundles of thin and flexible long fibers, with high-tensile strength, and chemical and heat resistance. In contrast to asbestos found within commercial products and mining, the specific term ''naturally occurring asbestos'' (NOA) refers to asbestiform minerals occurring within rocks or soils that can be released by human activities or weathering processes. The fact that the exposure to asbestos is related to lung pathologies is now widely demonstrated (e.g. asbestosis, mesothelioma and lung cancer). However, if health risks associated with exposure to NOA exist, they are not yet well documented. The crystallization of natural asbestos occurs in specific Mg-rich lithologies associated with peculiar structural and metamorphic conditions. By recognizing and combining such specific geologic criteria, the presence or the absence of asbestos in bedrock terrains can be reasonably predicted and maps of NOA hazard can be drawn. We present here new results of geological mapping and petrological study concerning the evaluation of the NOA hazard in the Alps and Corsica, in France. The three folds approach consists in (1) a determination of lithologies with potential NOA from a bibliographic compilation and extraction of target zones from a geological geodatabase (2) a geological mapping of the target zones followed by a petrological characterization of sampled asbestiform minerals in the laboratory (optical microscopy, TEM, SEM, and Raman spectroscopy technics), and (3) the drawing of the final map of NOA hazard, at regional-scale. Occurrence criteria can be retained as follows: 1. NOA are abundant in the internal zones of the Alps and Corsica, especially within ophiolitic complexes. Natural asbestos are mostly concentrated within ultramafic rocks but can also occur within basic lithologies such as Mg-metagabbros, metabasalts and meta-pillow-lavas, 2. Asbestos

  8. Dehydration kinetics of shocked serpentine

    NASA Technical Reports Server (NTRS)

    Tyburczy, James A.; Ahrens, Thomas J.

    1988-01-01

    Experimental rates of dehydration of shocked and unshocked serpentine were determined using a differential scanning calorimetric technique. Dehydration rates in shocked serpentine are enhanced by orders of magnitude over corresponding rates in unshocked material, even though the impact experiments were carried out under conditions that inhibited direct impact-induced devolatilization. Extrapolation to temperatures of the Martian surface indicates that dehydration of shocked material would occur 20 to 30 orders of magnitude more rapidly than for unshocked serpentine. The results indicate that impacted planetary surfaces and associated atmospheres would reach chemical equilibrium much more quickly than calculations based on unshocked material would indicate, even during the earliest, coldest stages of accretion. Furthermore, it is suggested that chemical weathering of shocked planetary surfaces by solid-gas reactions would be sufficiently rapid that true equilibrium mineral assemblages should form.

  9. Brown's syndrome.

    PubMed

    Wilson, M E; Eustis, H S; Parks, M M

    1989-01-01

    Brown's syndrome is a well-recognized clinical disorder of ocular motility manifesting most notably a restriction of active and passive elevation in adduction. The original name, "superior oblique tendon sheath syndrome," is no longer appropriate, since it has been shown that the tissue surrounding the anterior superior oblique tendon is blameless as a restrictive force. "True" and "simulated" as descriptive modifiers should also be discarded, as they relate to the disproven sheath concept. Brown's syndrome occurs as a congenital or acquired, constant or intermittent condition; the common link is restriction of free movement through the trochlea pulley mechanism. The various etiologic theories are reviewed and the spectrum of medical and surgical treatments are described and evaluated. Evidence suggests that subtypes of Brown's syndrome lie on a single continuum and that spontaneous resolution occurs in each group, probably more often than previously recognized. A simplified classification scheme is encouraged and possible future directions in Brown's syndrome research are introduced.

  10. [Definition of shock types].

    PubMed

    Adams, H A; Baumann, G; Gänsslen, A; Janssens, U; Knoefel, W; Koch, T; Marx, G; Müller-Werdan, U; Pape, H C; Prange, W; Roesner, D; Standl, T; Teske, W; Werner, G; Zander, R

    2001-11-01

    Definitions of shock types. Hypovolaemic shock is a state of insufficient perfusion of vital organs with consecutive imbalance of oxygen supply and demand due to an intravascular volume deficiency with critically impaired cardiac preload. Subtypes are haemorrhagic shock, hypovolaemic shock in the narrow sense, traumatic-haemorrhagic shock and traumatic-hypovolaemic shock. Cardiac shock is caused by a primary critical cardiac pump failure with consecutive inadequate oxygen supply of the organism. Anaphylactic shock is an acute failure of blood volume distribution (distributive shock) and caused by IgE-dependent, type-I-allergic, classical hypersensibility, or a physically, chemically, or osmotically induced IgE-independent anaphylactoid hypersensibility. The septic shock is a sepsis-induced distribution failure of the circulating blood volume in the sense of a distributive shock. The neurogenic shock is a distributive shock induced by generalized and extensive vasodilatation with consecutive hypovolaemia due to an imbalance of sympathetic and parasympathetic regulation of vascular smooth muscles. PMID:11753724

  11. Curved shock theory

    NASA Astrophysics Data System (ADS)

    Mölder, S.

    2016-07-01

    Curved shock theory (CST) is introduced, developed and applied to relate pressure gradients, streamline curvatures, vorticity and shock curvatures in flows with planar or axial symmetry. Explicit expressions are given, in an influence coefficient format, that relate post-shock pressure gradient, streamline curvature and vorticity to pre-shock gradients and shock curvature in steady flow. The effect of pre-shock flow divergence/convergence, on vorticity generation, is related to the transverse shock curvature. A novel derivation for the post-shock vorticity is presented that includes the effects of pre-shock flow non-uniformities. CST applicability to unsteady flows is discussed.

  12. “DK Crush” Technique for a Tightly Stenosed Conjoined SVG Lesion in a Patient with Acute Coronary Syndrome and Cardiogenic Shock

    PubMed Central

    Chen, Kuan-Ju; Lee, Wen-Lieng; Liu, Tsun-Jui; Chang, Wei-Chun; Wang, Kuo-Yang; Su, Chieh-Shou

    2015-01-01

    Coronary artery bifurcation disease of saphenous venous graft (SVG) is extremely rare. SVG disease remains a challenging lesion to treat because of increased morbidity and mortality with repeated coronary artery bypass graft surgery (CABG), high rates of periprocedural complications, and in-stent restenosis or occlusion requiring repeat revascularization with percutaneous coronary intervention. Herein, we present the first reported case of using the “DK crush” technique to treat an inverted Y-shaped SVG bifurcation disease in a patient with a prior CABG and new-onset acute coronary syndrome. Arising from our treatment, favorable immediate and mid-term angiographic and clinical outcomes were obtained. PMID:27122880

  13. Serotonin Syndrome

    PubMed Central

    Volpi-Abadie, Jacqueline; Kaye, Adam M.; Kaye, Alan David

    2013-01-01

    Background Serotonin syndrome is a potentially life-threatening syndrome that is precipitated by the use of serotonergic drugs and overactivation of both the peripheral and central postsynaptic 5HT-1A and, most notably, 5HT-2A receptors. This syndrome consists of a combination of mental status changes, neuromuscular hyperactivity, and autonomic hyperactivity. Serotonin syndrome can occur via the therapeutic use of serotonergic drugs alone, an intentional overdose of serotonergic drugs, or classically, as a result of a complex drug interaction between two serotonergic drugs that work by different mechanisms. A multitude of drug combinations can result in serotonin syndrome. Methods This review describes the presentation and management of serotonin syndrome and discusses the drugs and interactions that can precipitate this syndrome with the goal of making physicians more alert and aware of this potentially fatal yet preventable syndrome. Conclusion Many commonly used medications have proven to be the culprits of serotonin syndrome. Proper education and awareness about serotonin syndrome will improve the accuracy of diagnosis and promote the institution of the appropriate treatment that may prevent significant morbidity and mortality. PMID:24358002

  14. Localized shocks

    NASA Astrophysics Data System (ADS)

    Roberts, Daniel A.; Stanford, Douglas; Susskind, Leonard

    2015-03-01

    We study products of precursors of spatially local operators, , where W x ( t) = e - iHt W x e iHt . Using chaotic spin-chain numerics and gauge/gravity duality, we show that a single precursor fills a spatial region that grows linearly in t. In a lattice system, products of such operators can be represented using tensor networks. In gauge/gravity duality, they are related to Einstein-Rosen bridges supported by localized shock waves. We find a geometrical correspondence between these two descriptions, generalizing earlier work in the spatially homogeneous case.

  15. Naturally occurring insecticides.

    PubMed Central

    Soloway, S B

    1976-01-01

    Naturally occurring insecticides are abundant and varied in their effects, though but a few are articles of commerce. Even for these, pyrethrum, nicotine, rotenone, hellebore, ryania, and sabadilla, there is a paucity of information on mammalian toxicology and environmental effects. In general, these materials are characterized favorably by low acute toxicity and ready dissipation in nature. Unfavorable aspects of natural insecticides are the contained mixture of active and inactive components and the low active ingredient content on a crop yield basis pointing to a high unit cost. Natural insecticides can serve additionally as leads to unnatural mimics, of which the commercially successful synthetic pyrethroids are prime examples. The chemical nature, relationship of insecticidal activity to chemical structure, occurrence, production, and utilization, registered uses, metabolism, and insect and mammalian toxicity are reviewed. PMID:789058

  16. Mutations in the heat-shock protein A9 (HSPA9) gene cause the EVEN-PLUS syndrome of congenital malformations and skeletal dysplasia

    PubMed Central

    Royer-Bertrand, Beryl; Castillo-Taucher, Silvia; Moreno-Salinas, Rodrigo; Cho, Tae-Joon; Chae, Jong-Hee; Choi, Murim; Kim, Ok-Hwa; Dikoglu, Esra; Campos-Xavier, Belinda; Girardi, Enrico; Superti-Furga, Giulio; Bonafé, Luisa; Rivolta, Carlo; Unger, Sheila; Superti-Furga, Andrea

    2015-01-01

    We and others have reported mutations in LONP1, a gene coding for a mitochondrial chaperone and protease, as the cause of the human CODAS (cerebral, ocular, dental, auricular and skeletal) syndrome (MIM 600373). Here, we delineate a similar but distinct condition that shares the epiphyseal, vertebral and ocular changes of CODAS but also included severe microtia, nasal hypoplasia, and other malformations, and for which we propose the name of EVEN-PLUS syndrome for epiphyseal, vertebral, ear, nose, plus associated findings. In three individuals from two families, no mutation in LONP1 was found; instead, we found biallelic mutations in HSPA9, the gene that codes for mHSP70/mortalin, another highly conserved mitochondrial chaperone protein essential in mitochondrial protein import, folding, and degradation. The functional relationship between LONP1 and HSPA9 in mitochondrial protein chaperoning and the overlapping phenotypes of CODAS and EVEN-PLUS delineate a family of “mitochondrial chaperonopathies” and point to an unexplored role of mitochondrial chaperones in human embryonic morphogenesis. PMID:26598328

  17. Culture Shock as a Barrier to Intercultural Business Communication.

    ERIC Educational Resources Information Center

    Waltman, John L.

    The phenomenon of culture shock as it affects intercultural business communication is examined. The symptoms of the syndrome and its effects on the business traveler and his/her business are discussed. Flaws in current training that increase rather than reduce the impact of culture shock are explored. It is suggested that much training prepares…

  18. Shock Prevention

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The electrician pictured is installing a General Electric Ground Fault Interrupter (GFI), a device which provides protection against electrical shock in the home or in industrial facilities. Shocks due to defective wiring in home appliances or other electrical equipment can cause severe burns, even death. As a result, the National Electrical Code now requires GFIs in all new homes constructed. This particular type of GFI employs a sensing element which derives from technology acquired in space projects by SCI Systems, Inc., Huntsville, Alabama, producer of sensors for GE and other manufacturers of GFI equipment. The sensor is based on the company's experience in developing miniaturized circuitry for space telemetry and other spacecraft electrical systems; this experience enabled SCI to package interruptor circuitry in the extremely limited space available and to produce sensory devices at practicable cost. The tiny sensor measures the strength of the electrical current and detects current differentials that indicate a fault in the functioning of an electrical system. The sensing element then triggers a signal to a disconnect mechanism in the GFI, which cuts off the current in the faulty circuit.

  19. Geomagnetic avtivity triggered by interplanetary shocks: The shock impact angle as a controlling factor

    NASA Astrophysics Data System (ADS)

    Oliveira, D. M.; Raeder, J.; Tsurutani, B.; Gjerloev, J. W.

    2015-12-01

    We study the influence of interplanetary (IP) shock impact angles in the shock geoeffectiveness focusing on simulations and observations. In our simulations, we use OpenGGCM simulations to study the magnetospheric and ionospheric responses to shock impacts. Three cases are presented here: two inclined shocks, with 3.7 and 7.4 Mach numbers, and a frontal shock, whose shock normal is along the Sun-Earth line, with Mach number of 7.4. We find that, in the two inclined cases, due to the north-south asymmetry, the magnetotail is deflected southward, leading to a mild compression. The geomagnetic activity observed in the nightside ionosphere is then weak. On the other hand, in the head-on case, the magnetotail is compressed from both sides symmetrically. This compression triggers a substorm. By comparing the strong inclined shock and the frontal shock, we find that, despite the inclined shock having a larger Mach number, the frontal shock leads to a larger geomagnetic response in the nightside ionosphere. As a result, we conclude that IP shocks with similar upstream conditions, such as Mach number, can have different geoeffectiveness, depending on their shock normal orientation. In our observational study, we present a survey of IP shocks at 1 AU using Wind and ACE satellite data from Jan 1995 to Dec 2013 to study the same shock-related effects. A shock list covering one and a half solar cycle is compiled. We use data from SuperMAG, a large chain with more than 300 geomagnetic stations, to study geoeffectiveness triggered by IP shocks. The SuperMAG SML index (enhanced AL index), is used to quantify substorm strength. The jumps of the SML index triggered by shock impacts is investigated in terms of shock orientation and speed. We find that, in general, strong and almost frontal shocks are more geoeffective than inclined shocks with low speed. The highest correlations (R = 0.78) occurs for fixed shock speed and varying the shock impact angle. We attribute this result

  20. Corotating shock structures

    NASA Technical Reports Server (NTRS)

    Ogilvie, K. W.

    1972-01-01

    Consideration of observed interplanetary shocks leads to the conclusion that a corotating forward shock has not been unambiguously identified at 1 AU. A reverse shock identified in September 1967 is a likely candidate for a corotating structure.

  1. What Is Cardiogenic Shock?

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Cardiogenic Shock? Cardiogenic (kar-dee-oh-JE-nik) shock is ... treated right away. The most common cause of cardiogenic shock is damage to the heart muscle from a ...

  2. Naturally Occurring Food Toxins

    PubMed Central

    Dolan, Laurie C.; Matulka, Ray A.; Burdock, George A.

    2010-01-01

    Although many foods contain toxins as a naturally-occurring constituent or, are formed as the result of handling or processing, the incidence of adverse reactions to food is relatively low. The low incidence of adverse effects is the result of some pragmatic solutions by the US Food and Drug Administration (FDA) and other regulatory agencies through the creative use of specifications, action levels, tolerances, warning labels and prohibitions. Manufacturers have also played a role by setting limits on certain substances and developing mitigation procedures for process-induced toxins. Regardless of measures taken by regulators and food producers to protect consumers from natural food toxins, consumption of small levels of these materials is unavoidable. Although the risk for toxicity due to consumption of food toxins is fairly low, there is always the possibility of toxicity due to contamination, overconsumption, allergy or an unpredictable idiosyncratic response. The purpose of this review is to provide a toxicological and regulatory overview of some of the toxins present in some commonly consumed foods, and where possible, discuss the steps that have been taken to reduce consumer exposure, many of which are possible because of the unique process of food regulation in the United States. PMID:22069686

  3. Neonatal respiratory distress syndrome

    MedlinePlus

    Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... Neonatal RDS occurs in infants whose lungs have not yet fully ... disease is mainly caused by a lack of a slippery substance in ...

  4. Immune Reconstitution Syndrome

    MedlinePlus

    ... RECONSTITUTION SYNDROME? Some people who start antiretroviral therapy (ART) get health problems even though their HIV comes ... may occur in about 20% of people starting ART. HOW WAS THE SYNDROME IDENTIFIED? Several patients developed ...

  5. Shock-induced phase transformation in tantalum

    NASA Astrophysics Data System (ADS)

    Hsiung, Luke L.

    2010-09-01

    A TEM study of pure tantalum and tantalum-tungsten alloys explosively shocked at a peak pressure of 30 GPa is presented. While no omega phase was found in shock-recovered pure Ta and Ta-5W which mainly contain a cellular dislocation structure, a shock-induced omega phase was found in Ta-10W which contains evenly distributed dislocations with a density higher than 1 × 1012 cm - 2. The shock-induced \\alpha ~\\mathrm {(bcc)}\\rightarrow \\omega (hexagonal) transition occurs when the dynamic recovery of dislocations becomes largely suppressed in Ta-10W shocked under dynamic-pressure conditions. A dislocation-based mechanism is proposed for the shock-induced phase transformation.

  6. Punishment shock intensity and basal skin resistance.

    PubMed

    Kaufman, A

    1965-11-01

    The relationship between punishment shock intensity and basal skin resistance (BSR) was investigated in two sessions with human females selected for their ability to maintain a fairly substantial operant rate under a wide range of shock intensities. In both sessions each button-pressing response was reinforced with a counter tally. Subjects were paid one cent for each 20 counts. In session 1, punishment followed each response during alternate 4-min periods; in session 2 punishment was programmed in all 4-min periods. Shock intensities were presented randomly among the 4-min shock periods, with the restriction that the first three presentations occurred in ascending order. Operant responding showed some suppression at higher shock intensities in session 1, with substantial recovery in most subjects during session 2. Respondent behavior was characterized by greater activity at successively higher intensities, with recovery at all shock levels, especially the lowest levels, apparent during the second session.

  7. [Shock--what are the basics?].

    PubMed

    Janssens, U; Graf, J

    2004-03-01

    Shock, derived from the French "choc", is defined as a syndrome precipitated by a systemic derangement in perfusion leading to widespread cellular hypoxia and vital organ dysfunction. There is an apparently mismatch of oxygen delivery and oxygen uptake on the cellular level. Shock is associated with significant morbidity and mortality. Therefore, rational therapy should rely on the allocation to one of the four primary circulatory defects: cardiogenic, obstructive, distributive and hypovolemic shock. Compensatory mechanisms such as activation of the sympathoadrenal axis and neurohumoral mechanisms act to preserve cardiac output and perfusion of the vital organ systems. Lactate acidosis serves as a marker of critical hypoperfusion. Persistent hypoperfusion und ischemia induce a systemic inflammatory response syndrome which may lead to multiple organ dysfunction or even multiple organ failure. PMID:14997304

  8. [DRESS syndrome].

    PubMed

    Adamcová, Monika; Šturdík, Igor; Koller, Tomáš; Payer, Juraj

    2016-04-01

    DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is severe drug-induced allergic-type reaction which occurs few days to weeks after taking a drug in a predisposed patient. Organ damage, eosinophilia and skin rash are typical at presentation. Corticotherapy is often necessary in severe cases. In this report we describe a case of 56-year old female with fever, elevated liver tests and skin rash. DRESS syndrome was diagnosed and allopurinol was indentified as a causative drug. Due to possible fatal outcome, DRESS syndrome should be considered in a differential diagnosis of all patients presenting with similar signs and symptoms. PMID:27250614

  9. Shock compression of liquid hydrazine

    SciTech Connect

    Garcia, B.O.; Chavez, D.J.

    1995-01-01

    Liquid hydrazine (N{sub 2}H{sub 4}) is a propellant used by the Air Force and NASA for aerospace propulsion and power systems. Because the propellant modules that contain the hydrazine can be subject to debris impacts during their use, the shock states that can occur in the hydrazine need to be characterized to safely predict its response. Several shock compression experiments have been conducted in an attempt to investigate the detonability of liquid hydrazine; however, the experiments results disagree. Therefore, in this study, we reproduced each experiment numerically to evaluate in detail the shock wave profiles generated in the liquid hydrazine. This paper presents the results of each numerical simulation and compares the results to those obtained in experiment. We also present the methodology of our approach, which includes chemical kinetic experiments, chemical equilibrium calculations, and characterization of the equation of state of liquid hydrazine.

  10. Shock finding on a moving mesh - I. Shock statistics in non-radiative cosmological simulations

    NASA Astrophysics Data System (ADS)

    Schaal, Kevin; Springel, Volker

    2015-02-01

    Cosmological shock waves play an important role in hierarchical structure formation by dissipating and thermalizing kinetic energy of gas flows, thereby heating the Universe. Furthermore, identifying shocks in hydrodynamical simulations and measuring their Mach number accurately are critical for calculating the production of non-thermal particle components through diffusive shock acceleration. However, shocks are often significantly broadened in numerical simulations, making it challenging to implement an accurate shock finder. We here introduce a refined methodology for detecting shocks in the moving-mesh code AREPO, and show that results for shock statistics can be sensitive to implementation details. We put special emphasis on filtering against spurious shock detections due to tangential discontinuities and contacts. Both of them are omnipresent in cosmological simulations, for example in the form of shear-induced Kelvin-Helmholtz instabilities and cold fronts. As an initial application of our new implementation, we analyse shock statistics in non-radiative cosmological simulations of dark matter and baryons. We find that the bulk of energy dissipation at redshift zero occurs in shocks with Mach numbers around M≈ 2.7. Furthermore, almost 40 per cent of the thermalization is contributed by shocks in the warm hot intergalactic medium, whereas ≈60 per cent occurs in clusters, groups, and smaller haloes. Compared to previous studies, these findings revise the characterization of the most important shocks towards higher Mach numbers and lower density structures. Our results also suggest that regions with densities above and below δb = 100 should be roughly equally important for the energetics of cosmic ray acceleration through large-scale structure shocks.

  11. Radiative Shock Waves In Emerging Shocks

    NASA Astrophysics Data System (ADS)

    Drake, R. Paul; Doss, F.; Visco, A.

    2011-05-01

    In laboratory experiments we produce radiative shock waves having dense, thin shells. These shocks are similar to shocks emerging from optically thick environments in astrophysics in that they are strongly radiative with optically thick shocked layers and optically thin or intermediate downstream layers through which radiation readily escapes. Examples include shocks breaking out of a Type II supernova (SN) and the radiative reverse shock during the early phases of the SN remnant produced by a red supergiant star. We produce these shocks by driving a low-Z plasma piston (Be) at > 100 km/s into Xe gas at 1.1 atm. pressure. The shocked Xe collapses to > 20 times its initial density. Measurements of structure by radiography and temperature by several methods confirm that the shock wave is strongly radiative. We observe small-scale perturbations in the post-shock layer, modulating the shock and material interfaces. We describe a variation of the Vishniac instability theory of decelerating shocks and an analysis of associated scaling relations to account for the growth of these perturbations, identify how they scale to astrophysical systems such as SN 1993J, and consider possible future experiments. Collaborators in this work have included H.F. Robey, J.P. Hughes, C.C. Kuranz, C.M. Huntington, S.H. Glenzer, T. Doeppner, D.H. Froula, M.J. Grosskopf, and D.C. Marion ________________________________ * Supported by the US DOE NNSA under the Predictive Sci. Academic Alliance Program by grant DE-FC52-08NA28616, the Stewardship Sci. Academic Alliances program by grant DE-FG52-04NA00064, and the Nat. Laser User Facility by grant DE-FG03-00SF22021.

  12. Electron Dynamics in Perpendicular Shocks

    NASA Astrophysics Data System (ADS)

    Muschietti, L.; Roth, I.

    2003-12-01

    A full particle electromagnetic code in the Darwin approximation is used to investigate the dynamics of the electrons in a fast magnetosonic shock. We assume a perpendicular geometry where x points into the shock and the electromagnetic field structure is E=(Ex,E_y,0) and B=(0,0,Bz). The 1D3V code has open boundaries with upstream and downstream particles traversing the left and right boundaries, respectively, while the shock structure remains in the simulation box. Two shock strengths are considered, including a near critical shock with alfvenic Mach number Ma ˜ 2 and a supercritical shock with Ma ˜ 3--4. The simulation is initiated by loading the particles according to profiles modeled from conservation laws (Rankine-Hugoniot). Particles and fields are then left to evolve and, once the ion dynamics develops, a self-consistent shock structure forms. Importantly, due to the partial decoupling of ions and electrons which occurs in the magnetic ramp, the electrostatic field Ex builds up a large spike whose role is to slow down the ions. In the supercritical case a significant fraction of ions are reflected and accumulate in the foot, which leads to the process of cyclical shock reformation. We record the trajectories of selected electrons in order to analyse their behavior in the cross field structure of the ramp. We specially look for a possible ``superadiabatic heating'', a process described by previous authors [Balikhin and Gedalin (1994); Ball and Galloway (1998)]. The latter is expected to occur for extreme cases where the gradient of the electrostatic potential, which reflects the ions, is so strong that the electrons are accelerated across a large fraction of the ramp during one cyclotron gyration. The required potential difference across the ramp δ φ * depends upon its half width Δ , namely eδ φ*/mve^2≈(0.2/βe)~(Δ /λe; )2(r+1)2. Here, λ e is the electron inertia length c/ω pe and r is the compression ratio. Our study improves upon the above

  13. Cardiovascular devices; reclassification of intra-aortic balloon and control systems for acute coronary syndrome, cardiac and non-cardiac surgery, or complications of heart failure; effective date of requirement for premarket approval for intra-aortic balloon and control systems for septic shock or pulsatile flow generation. Final order.

    PubMed

    2013-12-30

    The Food and Drug Administration (FDA) is issuing a final order to reclassify intra-aortic balloon and control system (IABP) devices when indicated for acute coronary syndrome, cardiac and non-cardiac surgery, or complications of heart failure, a preamendments class III device, into class II (special controls), and to require the filing of a premarket approval application (PMA) or a notice of completion of a product development protocol (PDP) for IABPs when indicated for septic shock or pulsatile flow generation. PMID:24383147

  14. [Refeeding syndrome].

    PubMed

    Ševela, Stanislav; Novák, František; Kazda, Antonín; Brodská, Helena

    2016-01-01

    Despite being known more than 60 years, refeeding syndrome (RS) still bears many uncertainties. For example, its definition is not clear and definite, and the attitude to it varies from the complete neglect to over-prevention.The term "refeeding syndrome" refers to electrolyte and metabolic changes occurring in malnourished patients after the readministration of nutrition. These changes concern especially to phosphates and ions. Potassium, magnesium, naturism and fluids balance are involved. The changes lead to cell energetic metabolism and electric potential disturbances, with related clinical symptoms.Fully developed refeeding syndrome is quite rare; nevertheless it can be fatal for the patient. However, even its development can lead to many complications increasing the patient's morbidity and the length of stay in the hospital. Yet the refeeding syndrome is more or less predictable and if kept in mind also preventable.The aim of this article is to get the reader to know more about this metabolic phenomenon and possible attitudes towards it.

  15. Impact angle control of interplanetary shock geoeffectiveness: A statistical study

    NASA Astrophysics Data System (ADS)

    Oliveira, Denny M.; Raeder, Joachim

    2015-06-01

    We present a survey of interplanetary (IP) shocks using Wind and ACE satellite data from January 1995 to December 2013 to study how IP shock geoeffectiveness is controlled by IP shock impact angles. A shock list covering one and a half solar cycle is compiled. The yearly number of IP shocks is found to correlate well with the monthly sunspot number. We use data from SuperMAG, a large chain with more than 300 geomagnetic stations, to study geoeffectiveness triggered by IP shocks. The SuperMAG SML index, an enhanced version of the familiar AL index, is used in our statistical analysis. The jumps of the SML index triggered by IP shock impacts on the Earth's magnetosphere are investigated in terms of IP shock orientation and speed. We find that, in general, strong (high speed) and almost frontal (small impact angle) shocks are more geoeffective than inclined shocks with low speed. The strongest correlation (correlation coefficient R = 0.78) occurs for fixed IP shock speed and for varied IP shock impact angle. We attribute this result, predicted previously with simulations, to the fact that frontal shocks compress the magnetosphere symmetrically from all sides, which is a favorable condition for the release of magnetic energy stored in the magnetotail, which in turn can produce moderate to strong auroral substorms, which are then observed by ground-based magnetometers.

  16. Miniature shock tube for laser driven shocks.

    PubMed

    Busquet, Michel; Barroso, Patrice; Melse, Thierry; Bauduin, Daniel

    2010-02-01

    We describe in this paper the design of a miniature shock tube (smaller than 1 cm(3)) that can be placed in a vacuum vessel and allows transverse optical probing and longitudinal backside extreme ultraviolet emission spectroscopy in the 100-500 A range. Typical application is the study of laser launched radiative shocks, in the framework of what is called "laboratory astrophysics."

  17. Shock & Anaphylactic Shock. Learning Activity Package.

    ERIC Educational Resources Information Center

    Hime, Kirsten

    This learning activity package on shock and anaphylactic shock is one of a series of 12 titles developed for use in health occupations education programs. Materials in the package include objectives, a list of materials needed, information sheets, reviews (self evaluations) of portions of the content, and answers to reviews. These topics are…

  18. Shock Initiation of Damaged Explosives

    SciTech Connect

    Chidester, S K; Vandersall, K S; Tarver, C M

    2009-10-22

    Explosive and propellant charges are subjected to various mechanical and thermal insults that can increase their sensitivity over the course of their lifetimes. To quantify this effect, shock initiation experiments were performed on mechanically and thermally damaged LX-04 (85% HMX, 15% Viton by weight) and PBX 9502 (95% TATB, 5% Kel-F by weight) to obtain in-situ manganin pressure gauge data and run distances to detonation at various shock pressures. We report the behavior of the HMX-based explosive LX-04 that was damaged mechanically by applying a compressive load of 600 psi for 20,000 cycles, thus creating many small narrow cracks, or by cutting wedge shaped parts that were then loosely reassembled, thus creating a few large cracks. The thermally damaged LX-04 charges were heated to 190 C for long enough for the beta to delta solid - solid phase transition to occur, and then cooled to ambient temperature. Mechanically damaged LX-04 exhibited only slightly increased shock sensitivity, while thermally damaged LX-04 was much more shock sensitive. Similarly, the insensitive explosive PBX 9502 was mechanically damaged using the same two techniques. Since PBX 9502 does not undergo a solid - solid phase transition but does undergo irreversible or 'rachet' growth when thermally cycled, thermal damage to PBX 9502 was induced by this procedure. As for LX-04, the thermally damaged PBX 9502 demonstrated a greater shock sensitivity than mechanically damaged PBX 9502. The Ignition and Growth reactive flow model calculated the increased sensitivities by igniting more damaged LX-04 and PBX 9502 near the shock front based on the measured densities (porosities) of the damaged charges.

  19. Thermal shock resistance of ceramic matrix composites

    NASA Technical Reports Server (NTRS)

    Carper, D. M.; Nied, H. F.

    1993-01-01

    The experimental and analytical investigation of the thermal shock phenomena in ceramic matrix composites is detailed. The composite systems examined were oxide-based, consisting of an aluminosilicate matrix with either polycrystalline aluminosilicate or single crystal alumina fiber reinforcement. The program was divided into three technical tasks; baseline mechanical properties, thermal shock modeling, and thermal shock testing. The analytical investigation focused on the development of simple expressions for transient thermal stresses induced during thermal shock. The effect of various material parameters, including thermal conductivity, elastic modulus, and thermal expansion, were examined analytically for their effect on thermal shock performance. Using a simple maximum stress criteria for each constituent, it was observed that fiber fracture would occur only at the most extreme thermal shock conditions and that matrix fracture, splitting parallel to the reinforcing fiber, was to be expected for most practical cases. Thermal shock resistance for the two material systems was determined experimentally by subjecting plates to sudden changes in temperature on one surface while maintaining the opposite surface at a constant temperature. This temperature change was varied in severity (magnitude) and in number of shocks applied to a given sample. The results showed that for the most severe conditions examined that only surface matrix fracture was present with no observable fiber fracture. The impact of this damage on material performance was limited to the matrix dominated properties only. Specifically, compression strength was observed to decrease by as much as 50 percent from the measured baseline.

  20. PRECURSORS TO INTERSTELLAR SHOCKS OF SOLAR ORIGIN

    SciTech Connect

    Gurnett, D. A.; Kurth, W. S.; Stone, E. C.; Cummings, A. C.; Krimigis, S. M.; Decker, R. B.; Burlaga, L. F.

    2015-08-20

    On or about 2012 August 25, the Voyager 1 spacecraft crossed the heliopause into the nearby interstellar plasma. In the nearly three years that the spacecraft has been in interstellar space, three notable particle and field disturbances have been observed, each apparently associated with a shock wave propagating outward from the Sun. Here, we present a detailed analysis of the third and most impressive of these disturbances, with brief comparisons to the two previous events, both of which have been previously reported. The shock responsible for the third event was first detected on 2014 February 17 by the onset of narrowband radio emissions from the approaching shock, followed on 2014 May 13 by the abrupt appearance of intense electron plasma oscillations generated by electrons streaming outward ahead of the shock. Finally, the shock arrived on 2014 August 25, as indicated by a jump in the magnetic field strength and the plasma density. Various disturbances in the intensity and anisotropy of galactic cosmic rays were also observed ahead of the shock, some of which are believed to be caused by the reflection and acceleration of cosmic rays by the magnetic field jump at the shock, and/or by interactions with upstream plasma waves. Comparisons to the two previous weaker events show somewhat similar precursor effects, although differing in certain details. Many of these effects are very similar to those observed in the region called the “foreshock” that occurs upstream of planetary bow shocks, only on a vastly larger spatial scale.

  1. Precursors To Interstellar Shocks of Solar Origin

    NASA Astrophysics Data System (ADS)

    Gurnett, D. A.; Kurth, W. S.; Stone, E. C.; Cummings, A. C.; Krimigis, S. M.; Decker, R. B.; Ness, N. F.; Burlaga, L. F.

    2015-08-01

    On or about 2012 August 25, the Voyager 1 spacecraft crossed the heliopause into the nearby interstellar plasma. In the nearly three years that the spacecraft has been in interstellar space, three notable particle and field disturbances have been observed, each apparently associated with a shock wave propagating outward from the Sun. Here, we present a detailed analysis of the third and most impressive of these disturbances, with brief comparisons to the two previous events, both of which have been previously reported. The shock responsible for the third event was first detected on 2014 February 17 by the onset of narrowband radio emissions from the approaching shock, followed on 2014 May 13 by the abrupt appearance of intense electron plasma oscillations generated by electrons streaming outward ahead of the shock. Finally, the shock arrived on 2014 August 25, as indicated by a jump in the magnetic field strength and the plasma density. Various disturbances in the intensity and anisotropy of galactic cosmic rays were also observed ahead of the shock, some of which are believed to be caused by the reflection and acceleration of cosmic rays by the magnetic field jump at the shock, and/or by interactions with upstream plasma waves. Comparisons to the two previous weaker events show somewhat similar precursor effects, although differing in certain details. Many of these effects are very similar to those observed in the region called the “foreshock” that occurs upstream of planetary bow shocks, only on a vastly larger spatial scale.

  2. Precursors to Interstellar Shocks of Solar Origin

    NASA Astrophysics Data System (ADS)

    Gurnett, D. A.; Kurth, W. S.; Stone, E. C.; Cummings, A. C.; Krimigis, S. M.; Decker, R. B.; Ness, N. F.; Burlaga, L. F.

    2015-12-01

    On or about 2012 August 25, the Voyager 1 spacecraft crossed the heliopause into the nearby interstellar plasma. In the nearly three years that the spacecraft has been in interstellar space, three notable particle and field disturbances have been observed, each apparently associated with a shock wave propagating outward from the Sun. Here, we present a detailed analysis of the third and most impressive of these disturbances, with brief comparisons to the two previous events, both of which have been previously reported. The shock responsible for the third event was first detected on 2014 February 17 by the onset of narrowband radio emissions from the approaching shock, followed on 2014 May 13 by the abrupt appearance of intense electron plasma oscillations generated by electrons streaming outward ahead of the shock. Finally, the shock arrived on 2014 August 25, as indicated by a jump in the magnetic field strength and the plasma density. Various disturbances in the intensity and anisotropy of galactic cosmic rays were also observed ahead of the shock, some of which are believed to be caused by the reflection and acceleration of cosmic rays by the magnetic field jump at the shock, and/or by interactions with upstream plasma waves. Comparisons to the two previous weaker events show somewhat similar precursor effects, although differing in certain details. Many of these effects are very similar to those observed in the region called the "foreshock" that occurs upstream of planetary bow shocks, only on a vastly larger spatial scale.

  3. Shock experiments on maskelynite-bearing anorthosite

    NASA Technical Reports Server (NTRS)

    Lambert, P.; Grieve, R. A. F.

    1984-01-01

    A series of shock recovery experiments over 9.9-60.4 GPa have been carried out on naturally shocked anorthosite from the Mistastin impact structure in Labrador consisting primarily of diaplectic plagioclase glass or maskelynite, An(50), and pyroxene. Petrographic observations of the experimental products indicate that the component minerals and diaplectic glasses generally retained their initial character throughout, the only exception being the increase in fracturing which occurred in the 9.9 GPa shot. Reshocking at pressures higher than the initial shock tends to lower the refractive index of maskelynite. The increase in refractive index of maskelynite reshocked to pressures lower than the initial pressure is interpreted as due to shock densification of the diaplectic glass above the Hugoniot elastic limit and below the mixed phase regime. The data suggest that the low-high-low density transition of maskelynite occurs about 8 GPa below that of the crystal of corresponding composition.

  4. Neptune inbound bow shock

    NASA Technical Reports Server (NTRS)

    Szabo, Adam; Lepping, Ronald P.

    1995-01-01

    Voyager 2 crossed the inbound or upstream Neptunian bow shock at 1430 spacecraft event time on August 24 in 1989 (Belcher et al., 1989). The plasma and magnetic field measurements allow us to study the solar wind interaction with the outermost gas giant. To fully utilize all of the spacecraft observations, an improved nonlinear least squares, 'Rankine-Hugoniot' magnetohydrodynamic shock-fitting technique has been developed (Szabo, 1994). This technique is applied to the Neptunian data set. We find that the upstream bow shock normal points nearly exactly toward the Sun consistent with any reasonable large-scale model of the bow shock for a near subsolar crossing. The shock was moving outward with a speed of 14 +/- 12 km/s. The shock can be characterized as a low beta, high Mach number, strong quasi-perpendicular shock. Finally, the shock microstructure features are resolved and found to scale well with theoretical expectations.

  5. Syndromes with supernumerary teeth.

    PubMed

    Lubinsky, Mark; Kantaputra, Piranit Nik

    2016-10-01

    While most supernumerary teeth are idiopathic, they can be associated with a number of Mendelian syndromes. However, this can also be a coincidental finding, since supernumerary teeth occur in 6% or more of the normal population. To better define this relationship, we analyzed the evidence for specific associations. We excluded conditions with a single affected patient reported, supernumerary teeth adjacent to clefts or other forms of alveolar disruption (as secondary rather than primary findings), and natal teeth, which can involve premature eruption of a normal tooth. Since, the cause of supernumerary teeth shows considerable heterogeneity, certain findings are less likely to be coincidental, such as five or more supernumerary teeth in a single patient, or locations outside of the premaxilla. We found only eight genetic syndromes with strong evidence for an association: cleidocranial dysplasia; familial adenomatous polyposis; trichorhinophalangeal syndrome, type I; Rubinstein-Taybi syndrome; Nance-Horan syndrome; Opitz BBB/G syndrome; oculofaciocardiodental syndrome; and autosomal dominant Robinow syndrome. There is also suggestive evidence of an association with two uncommon disorders, Kreiborg-Pakistani syndrome (craniosynostosis and dental anomalies), and insulin-resistant diabetes mellitus with acanthosisnigricans. An association of a Mendelian disorder with a low frequency manifestation of supernumerary teeth is difficult to exclude without large numbers, but several commonly cited syndromes lacked evidence for clear association, including Hallermann-Streiff syndrome, Fabry disease, Ehlers-Danlos syndrome, Apert and Crouzon syndromes, Zimmermann-Laband syndrome, and Ellis-van Creveld syndrome. © 2016 Wiley Periodicals, Inc.

  6. Syndromes with supernumerary teeth.

    PubMed

    Lubinsky, Mark; Kantaputra, Piranit Nik

    2016-10-01

    While most supernumerary teeth are idiopathic, they can be associated with a number of Mendelian syndromes. However, this can also be a coincidental finding, since supernumerary teeth occur in 6% or more of the normal population. To better define this relationship, we analyzed the evidence for specific associations. We excluded conditions with a single affected patient reported, supernumerary teeth adjacent to clefts or other forms of alveolar disruption (as secondary rather than primary findings), and natal teeth, which can involve premature eruption of a normal tooth. Since, the cause of supernumerary teeth shows considerable heterogeneity, certain findings are less likely to be coincidental, such as five or more supernumerary teeth in a single patient, or locations outside of the premaxilla. We found only eight genetic syndromes with strong evidence for an association: cleidocranial dysplasia; familial adenomatous polyposis; trichorhinophalangeal syndrome, type I; Rubinstein-Taybi syndrome; Nance-Horan syndrome; Opitz BBB/G syndrome; oculofaciocardiodental syndrome; and autosomal dominant Robinow syndrome. There is also suggestive evidence of an association with two uncommon disorders, Kreiborg-Pakistani syndrome (craniosynostosis and dental anomalies), and insulin-resistant diabetes mellitus with acanthosisnigricans. An association of a Mendelian disorder with a low frequency manifestation of supernumerary teeth is difficult to exclude without large numbers, but several commonly cited syndromes lacked evidence for clear association, including Hallermann-Streiff syndrome, Fabry disease, Ehlers-Danlos syndrome, Apert and Crouzon syndromes, Zimmermann-Laband syndrome, and Ellis-van Creveld syndrome. © 2016 Wiley Periodicals, Inc. PMID:27250821

  7. Delayed Failure in a Shock Loaded Alumina

    SciTech Connect

    Cooper, G. A.; Millett, J. C. F.; Bourne, N. K.; Dandekar, D. P.

    2006-07-28

    Manganin stress gauges have been used to measure the lateral stress in a shock-loaded alumina. In combination with known longitudinal stresses, these have been used to determine the shear strength of this material, behind the shock front. The two-step nature of the lateral stress traces shows a slow moving front behind the main shock, behind which shear strength undergoes a significant decrease. Results also show that this front decreases markedly in velocity as the HEL is crossed, suggesting that limited plasticity occurs during inelastic deformation. Finally, comparison of measured shear strengths with other aluminas shows a high degree of agreement.

  8. Shocks generate crossover behavior in lattice avalanches.

    PubMed

    Burridge, James

    2013-11-22

    A spatial avalanche model is introduced, in which avalanches increase stability in the regions where they occur. Instability is driven globally by a driving process that contains shocks. The system is typically subcritical, but the shocks occasionally lift it into a near- or supercritical state from which it rapidly retreats due to large avalanches. These shocks leave behind a signature-a distinct power-law crossover in the avalanche size distribution. The model is inspired by landslide field data, but the principles may be applied to any system that experiences stabilizing failures, possesses a critical point, and is subject to an ongoing process of destabilization that includes occasional dramatic destabilizing events.

  9. Radio-Loud Coronal Mass Ejections without Shocks near Earth

    NASA Astrophysics Data System (ADS)

    Akiyama, S.; Gopalswamy, N.; Xie, H.; Yashiro, S.; Makela, P. A.; St Cyr, O. C.; MacDowall, R. J.; Kaiser, M. L.

    2010-12-01

    Type II radio bursts are produced by low energy electrons accelerated in shocks driven by coronal mass ejections (CMEs). One can infer shocks near the Sun, in the Interplanetary medium, and near Earth depending on the wavelength range in which the type II bursts are produced. In fact, type II bursts are good indicators of CMEs that produce solar energetic particles. If the type II burst occurs from a source on the Earth-facing side of the solar disk, it is highly likely that a shock arrives at Earth in 2-3 days and hence can be used to predict shock arrival at Earth. However, a significant fraction of CMEs producing type II bursts were not associated shocks at Earth, even though the CMEs originated close to the disk center. There are several reasons for the lack of shock at 1 AU. CMEs originating at large central meridian distances (CMDs) may be driving a shock, but the shock may not be extended sufficiently to reach to the Sun-Earth line. Another possibility is CME cannibalism because of which shocks merge and one observes a single shock at Earth. Finally, the CME-driven shock may become weak and dissipate before reaching 1 AU. We examined a set of 30 type II bursts observed by the Wind/WAVES experiment that had the solar sources very close to the disk center (within a CMD of 15 degrees), but did not have shock at Earth. We find that the near-Sun speeds of the associated CMEs average to ~600 km/s, only slightly higher than the average speed of CMEs associated with radio-quiet shocks. However, the fraction of halo CMEs is only ~28%, compared to 40% for radio-quiet shocks and 72% for all radio-loud shocks. We conclude that the disk-center radio loud CMEs with no shocks at 1 AU are generally of lower energy and they drive shocks only close to the Sun.

  10. Biomass shock pretreatment

    DOEpatents

    Holtzapple, Mark T.; Madison, Maxine Jones; Ramirez, Rocio Sierra; Deimund, Mark A.; Falls, Matthew; Dunkelman, John J.

    2014-07-01

    Methods and apparatus for treating biomass that may include introducing a biomass to a chamber; exposing the biomass in the chamber to a shock event to produce a shocked biomass; and transferring the shocked biomass from the chamber. In some aspects, the method may include pretreating the biomass with a chemical before introducing the biomass to the chamber and/or after transferring shocked biomass from the chamber.

  11. Dumping syndrome (image)

    MedlinePlus

    Dumping syndrome occurs when the contents of the stomach empty too quickly into the small intestine. The ... causing nausea, cramping, diarrhea, sweating, faintness, and palpitations. Dumping usually occurs after the consumption of too much ...

  12. Shock, Post-Shock Annealing, and Post-Annealing Shock in Ureilites

    NASA Technical Reports Server (NTRS)

    Rubin, Alan E.

    2006-01-01

    The thermal and shock histories of ureilites can be divided into four periods: 1) formation, 2) initial shock, 3) post-shock annealing, and 4) post-annealing shock. Period 1 occurred approx.4.55 Ga ago when ureilites formed by melting chondritic material. Impact events during period 2 caused silicate darkening, undulose to mosaic extinction in olivines, and the formation of diamond, lonsdaleite, and chaoite from indigenous carbonaceous material. Alkali-rich fine-grained silicates may have been introduced by impact injection into ureilites during this period. About 57% of the ureilites were unchanged after period 2. During period 3 events, impact-induced annealing caused previously mosaicized olivine grains to become aggregates of small unstrained crystals. Some ureilites experienced reduction as FeO at the edges of olivine grains reacted with C from the matrix. Annealing may also be responsible for coarsening of graphite in a few ureilites, forming euhedral-appearing, idioblastic crystals. Orthopyroxene in Meteorite Hills (MET) 78008 may have formed from pigeonite by annealing during this period. The Rb-Sr internal isochron age of approx.4.0 Ga for MET 78008 probably dates the annealing event. At this late date, impacts are the only viable heat source. About 36% of ureilites experienced period 3 events, but remained unchanged afterwards. During period 4, approx.7% of the ureilites were shocked again, as is evident in the polymict breccia, Elephant Moraine (EET) 83309. This rock contains annealed mosaicized olivine aggregates composed of small individual olivine crystals that exhibit undulose extinction. Ureilites may have formed by impact-melting chondritic material on a primitive body with heterogeneous O isotopes. Plagioclase was preferentially lost from the system due to its low impedance to shock compression. Brief melting and rapid burial minimized the escape of planetary-type noble gases from the ureilitic melts. Incomplete separation of metal from silicates

  13. [Acute respiratory distress syndrome].

    PubMed

    Estenssoro, Elisa; Dubin, Arnaldo

    2016-01-01

    Acute respiratory distress syndrome (ARDS) is an acute respiratory failure produced by an inflammatory edema secondary to increased lung capillary permeability. This causes alveolar flooding and subsequently deep hypoxemia, with intrapulmonary shunt as its most important underlying mechanism. Characteristically, this alteration is unresponsive to high FIO2 and only reverses with end-expiratory positive pressure (PEEP). Pulmonary infiltrates on CXR and CT are the hallmark, together with decreased lung compliance. ARDS always occurs within a week of exposition to a precipitating factor; most frequently pneumonia, shock, aspiration of gastric contents, sepsis, and trauma. In CT scan, the disease is frequently inhomogeneous, with gravitational infiltrates coexisting with normal-density areas and also with hyperaerated parenchyma. Mortality is high (30-60%) especially in ARDS associated with septic shock and neurocritical diseases. The cornerstone of therapy lies in the treatment of the underlying cause and in the use mechanical ventilation which, if inappropriately administered, can lead to ventilator-induced lung injury. Tidal volume = 6 ml/kg of ideal body weight to maintain an end-inspiratory (plateau) pressure = 30 cm H2O ("protective ventilation") is the only variable consistently associated with decreased mortality. Moderate-to-high PEEP levels are frequently required to treat hypoxemia, yet no specific level or titration strategy has improved outcomes. Recently, the use of early prone positioning in patients with PaO2/FIO2 = 150 was associated with increased survival. In severely hypoxemic patients, it may be necessary to use adjuvants of mechanical ventilation as recruitment maneuvers, pressure-controlled modes, neuromuscular blocking agents, and extracorporeal-membrane oxygenation. Fluid restriction appears beneficial. PMID:27576283

  14. Relative frequencies of seismic main shocks after strong shocks in Italy

    NASA Astrophysics Data System (ADS)

    Gasperini, Paolo; Lolli, Barbara; Vannucci, Gianfranco

    2016-07-01

    We analyzed a catalog of Italian earthquakes, covering 55 years of data from 1960 to 2014 with magnitudes homogeneously converted to Mw, to compute the time-dependent relative frequencies with which strong seismic shocks (4.0≤Mw<5.0), widely felt by the population, have been followed by main shocks (Mw≥5.0) that threatened the health and the properties of the persons living in the epicentral area. Assuming the stationarity of the seismic release properties, such frequencies are estimates of the probabilities of potentially destructive shocks after the occurrence of future strong shocks. We compared them with the time-independent relative frequencies of random occurrence in terms of the frequency gain that is the ratio between the time-dependent and time-independent relative frequencies. The time-dependent relative frequencies vary from less than 1% to about 20%, depending on the magnitudes of the shocks and the time windows considered (ranging from minutes to years). They remain almost constant for a few hours after the strong shock and then decrease with time logarithmically. Strong earthquakes (with Mw≥6.0) mainly occurred within two or three months of the strong shock. The frequency gains vary from about 10000 for very short time intervals to less than 10 for a time interval of two years. Only about one-third of main shocks were preceded by at least a strong shock in the previous day and about one-half in the previous month.

  15. Colliding Two Shocks: 1-D full Particle-in-Cell Simulation

    NASA Astrophysics Data System (ADS)

    Nakanotani, Masaru; Hada, T.; Matsukiyo, Shuichi; Mazelle, Christian

    2016-07-01

    Shock-shock interactions occur on various places in space and the interaction can produce high energy particles. A coronal mass ejection driven shock can collide with the Earth's bow shock [Hietala et al., 2011]. This study reported that ions are accelerated by the first Fermi acceleration between the two shocks before the collision. An electron acceleration through an interplanetary shock-Earth's bow shock interaction was also reported [Terasawa et al., 1997]. Shock-shock interactions can occur in astrophysical phenomena as well as in the heliosphere. For example, a young supernova shock can collide with the wind termination shock of a massive star if they are close to each other [Bykov et al., 2013]. Although hybrid simulations (ions and electrons treated as super-particles and mass-less fluid, respectively) were carried out to understand the kinetic nature of a shock-shock interaction [Cargill et al., 1986], hybrid simulations cannot resolve electron dynamics and non-thermal electrons. We, therefore, use one-dimensional full particle-in-cell (PIC) simulations to investigate a shock-shock interaction in which two shocks collide head-on. In a case of quasi-perpendicular shocks, electrons are accelerated by the mirror reflection between the two shocks before the collision (Fermi acceleration). On the other hand, because ions cannot go back upstream, the electron acceleration mechanism does not occur for ions. In a case of quasi-parallel shocks, ions can go back upstream and are accelerated at the shocks. The accelerated ions have great effect on the shock structure.

  16. Severe sepsis and septic shock: defining the clinical problem.

    PubMed

    Opal, Steven M

    2003-01-01

    It is generally acknowledged that severe sepsis/septic shock is a major problem in clinical medicine, yet the extent of the problem and its basic immunology remain poorly defined. The generation of accurate statistics about sepsis is confounded by the imprecise and highly variable terminology used to describe sepsis by clinicians around the world. The problem of sepsis is further complicated by the remarkably diverse spectrum of illness encompassed under the term 'sepsis'. Sepsis may range in severity from mild systemic inflammation without significant clinical consequences to multisystem failure in septic shock with an exceedingly high mortality rate. Sepsis connotes a clinical syndrome that may occur in any age group, in markedly different patient populations, and in response to a multitude of microbial pathogens from multiple different anatomical sites within the human body. A concerted effort has been made to standardize definitions of sepsis by the use of international committees and consensus opinions from panels of experts in sepsis research. While consensus definitions of sepsis have proven to be of value, the lack of uniformity in interpretation of these definitions continues to be problematic by clinicians and basic researchers alike. Recently, a new conceptual framework for understanding sepsis has been developed, called the PIRO concept (predisposition, infection, response and organ dysfunction). This has been conceptually modeled from the TNM classification (tumor size, nodal spread, metastases) which has been successfully used in defining treatment and prognostic indicators in clinical oncology. Further refinements in the definitions and predisposing factors of severe sepsis should improve the understanding and management of severe sepsis and septic shock in the near future.

  17. Analytical solutions of hypersonic type IV shock - shock interactions

    NASA Astrophysics Data System (ADS)

    Frame, Michael John

    An analytical model has been developed to predict the effects of a type IV shock interaction at high Mach numbers. This interaction occurs when an impinging oblique shock wave intersects the most normal portion of a detached bow shock. The flowfield which develops is complicated and contains an embedded jet of supersonic flow, which may be unsteady. The jet impinges on the blunt body surface causing very high pressure and heating loads. Understanding this type of interaction is vital to the designers of cowl lips and leading edges on air- breathing hypersonic vehicles. This analytical model represents the first known attempt at predicting the geometry of the interaction explicitly, without knowing beforehand the jet dimensions, including the length of the transmitted shock where the jet originates. The model uses a hyperbolic equation for the bow shock and by matching mass continuity, flow directions and pressure throughout the flowfield, a prediction of the interaction geometry can be derived. The model has been shown to agree well with the flowfield patterns and properties of experiments and CFD, but the prediction for where the peak pressure is located, and its value, can be significantly in error due to a lack of sophistication in the model of the jet fluid stagnation region. Therefore it is recommended that this region of the flowfield be modeled in more detail and more accurate experimental and CFD measurements be used for validation. However, the analytical model has been shown to be a fast and economic prediction tool, suitable for preliminary design, or for understanding the interactions effects, including the basic physics of the interaction, such as the jet unsteadiness. The model has been used to examine a wide parametric space of possible interactions, including different Mach number, impinging shock strength and location, and cylinder radius. It has also been used to examine the interaction on power-law shaped blunt bodies, a possible candidate for

  18. Dehydration of potassium alum induced by shock loading

    NASA Astrophysics Data System (ADS)

    Kishimura, H.; Imasu, Y.; Matsumoto, H.

    2014-05-01

    Potassium alum (KAl(SO4)2·12H2O) powder filled into a copper container were shock loaded up to 6.3 GPa by flyer plate impact. Recovered samples were characterized by X-ray diffraction (XRD) analysis, Raman spectroscopy, and scanning electron microscopy (SEM). XRD and Raman results of samples shocked at 4.4 GPa and below indicated that there was no sign of phase transition. In contrast, the XRD pattern of the sample shocked at 6.3 GPa was clearly different from the initial sample. Unlike previous results obtained from hydrostatic pressure experiments, an irreversible phase transition to an amorphous phase occurred under shock compression at 6.3 GPa. The morphology of the sample surface indicated the ejection of water vapor caused by shock loading. The amorphization may be attributed to the vaporization of water molecules caused by shock pressure and shock-induced heat.

  19. Shock waves in luminous early-type stars

    SciTech Connect

    Castor, J.I.

    1986-07-01

    Shock waves that occur in stellar atmospheres have their origin in some hydrodynamic instability of the atmosphere itself or of the stellar interior. In luminous early-type stars these two possibilities are represented by shocks due to an unstable radiatively-accelerated wind, and to shocks generated by the non-radial pulsations known to be present in many or most OB stars. This review is concerned with the structure and development of the shocks in these two cases, and especially with the mass loss that may be due specifically to the shocks. Pulsation-produced shocks are found to be very unfavorable for causing mass loss, owing to the great radiation efficiency that allows them to remain isothermal. The situation regarding radiatively-driven shocks remains unclear, awaiting detailed hydrodynamics calculations. 20 refs., 2 figs.

  20. Finite Time Shock Acceleration at Interplanetary Shocks

    NASA Astrophysics Data System (ADS)

    Channok, C.; Ruffolo, D.; Desai, M. I.; Mason, G. M.

    2004-05-01

    Observations of energetic ion acceleration at interplanetary shocks sometimes indicate a spectral rollover at ˜ 0.1 to 1 MeV nucl-1. This rollover is not well explained by finite shock width or thickness effects. At the same time, a typical timescale of diffusive shock acceleration is several days, implying that the process of shock acceleration at an interplanetary shock near Earth usually gives only a mild increase in energy to an existing seed particle population. This is consistent with a recent analysis of ACE observations that argues for a seed population at substantially higher energies than the solar wind. Therefore an explanation of typical spectra of interplanetary shock-accelerated ions requires a theory of finite-time shock acceleration, which for long times (or an unusually fast acceleration timescale) tends to the steady-state result of a power-law spectrum. We present analytic and numerical models of finite-time shock acceleration. For a given injection momentum p0, after a very short time there is only a small boost in momentum, at intermediate times the spectrum is a power law with a hump and steep cutoff at a critical momentum, and at longer times the critical momentum increases and the spectrum approaches the steady-state power law. The composition dependence of the critical momentum is different from that obtained for other cutoff mechanisms. The results are compared with observed spectra. Work in Thailand was supported by the Commission for Higher Education, the Rachadapisek Sompoj Fund of Chulalongkorn University, and the Thailand Research Fund. Work at the University of Maryland was supported by NASA contract NAS5-30927 and NASA grant PC 251428.

  1. Shock-implanted noble gases. II - Additional experimental studies and recognition in naturally shocked terrestrial materials

    NASA Technical Reports Server (NTRS)

    Bogard, Donald; Horz, Friedrich; Johnson, Pratt

    1989-01-01

    The process by which ambient gases can be implanted into silicates by shocks was investigated by analyzing the noble-gas content of several experimentally and naturally shocked silicate samples. The retentivity of shock-implanted gas during stepwise heating in the laboratory was defined in terms of two parameters, namely, the activation energy for diffusion and the extraction temperature at which 50 percent of the gas is released, both of which correlate with the shock pressure. The experiments indicate that, with increasing shock pressure, gas implantation occurs through an increasing production of microcracks/defects in the silicate lattice. The degree of annealing of these defects control the degree of diffusive loss of implanted gas.

  2. Application of Underwater Shock Wave Focusing to the Development of Extracorporeal Shock Wave Lithotripsy

    NASA Astrophysics Data System (ADS)

    Takayama, Kazuyoshi

    1993-05-01

    This paper describes a summary of a research project for the development of extracorporeal shock wave lithotripsy (ESWL), which has been carried out, under close collaboration between the Shock Wave Research Center of Tohoku University and the School of Medicine, Tohoku University. The ESWL is a noninvasive clinical treatment of disintegrating human calculi and one of the most peaceful applications of shock waves. Underwater spherical shock waves were generated by explosion of microexplosives. Characteristics of the underwater shock waves and of ultrasound focusing were studied by means of holographic interferometric flow visualization and polyvinyliden-difluoride (PVDF) pressure transducers. These focused pressures, when applied to clinical treatments, could effectively and noninvasively disintegrate urinary tract stones or gallbladder stones. However, despite clincal success, tissue damage occurs during ESWL treatments, and the possible mechanism of tissue damage is briefly described.

  3. Impaired Fracture Healing after Hemorrhagic Shock

    PubMed Central

    Kobbe, Philipp; Pfeifer, Roman; Campbell, Graeme C.; Tohidnezhad, Mersedeh; Bergmann, Christian; Kadyrov, Mamed; Fischer, Horst; Glüer, Christian C.; Pape, Hans-Christoph; Pufe, Thomas

    2015-01-01

    Impaired fracture healing can occur in severely injured patients with hemorrhagic shock due to decreased soft tissue perfusion after trauma. We investigated the effects of fracture healing in a standardized pressure controlled hemorrhagic shock model in mice, to test the hypothesis that bleeding is relevant in the bone healing response. Male C57/BL6 mice were subjected to a closed femoral shaft fracture stabilized by intramedullary nailing. One group was additionally subjected to pressure controlled hemorrhagic shock (HS, mean arterial pressure (MAP) of 35 mmHg for 90 minutes). Serum cytokines (IL-6, KC, MCP-1, and TNF-α) were analyzed 6 hours after shock. Fracture healing was assessed 21 days after fracture. Hemorrhagic shock is associated with a significant increase in serum inflammatory cytokines in the early phase. Histologic analysis demonstrated a significantly decreased number of osteoclasts, a decrease in bone quality, and more cartilage islands after hemorrhagic shock. μCT analysis showed a trend towards decreased bone tissue mineral density in the HS group. Mechanical testing revealed no difference in tensile failure. Our results suggest a delay in fracture healing after hemorrhagic shock. This may be due to significantly diminished osteoclast recruitment. The exact mechanisms should be studied further, particularly during earlier stages of fracture healing. PMID:26106256

  4. Structure in Radiating Shocks

    NASA Astrophysics Data System (ADS)

    Doss, Forrest

    2010-11-01

    The basic radiative shock experiment is a shock launched into a gas of high-atomic-number material at high velocities, which fulfills the conditions for radiative losses to collapse the post-shock material to over 20 times the initial gas density. This has been accomplished using the OMEGA Laser Facility by illuminating a Be ablator for 1 ns with a total of 4 kJ, launching the requisite shock, faster than 100 km/sec, into a polyimide shock tube filled with Xe. The experiments have lateral dimensions of 600 μm and axial dimensions of 2-3 mm, and are diagnosed by x-ray backlighting. Repeatable structure beyond the one-dimensional picture of a shock as a planar discontinuity was discovered in the experimental data. One form this took was that of radial boundary effects near the tube walls, extended approximately seventy microns into the system. The cause of this effect - low density wall material which is heated by radiation transport ahead of the shock, launching a new converging shock ahead of the main shock - is apparently unique to high-energy-density experiments. Another form of structure is the appearance of small-scale perturbations in the post-shock layer, modulating the shock and material interfaces and creating regions of enhanced and diminished aerial density within the layer. The authors have applied an instability theory, a variation of the Vishniac instability of decelerating shocks, to describe the growth of these perturbations. We have also applied Bayesian statistical methods to better understand the uncertainties associated with measuring shocked layer thickness in the presence of tilt. Collaborators: R. P. Drake, H. F. Robey, C. C. Kuranz, C. M. Huntington, M. J. Grosskopf, D. C. Marion.

  5. Advances in Vascular Hyporeactivity After Shock: The Mechanisms and Managements.

    PubMed

    Duan, Chenyang; Yang, Guangming; Li, Tao; Liu, Liangming

    2015-12-01

    Vascular reactivity to vasoconstrictors and vasodilators is greatly reduced after severe trauma, shock, and sepsis or multiple organ dysfunction syndrome. This reduced vascular reactivity severely interferes with the treatment of shock and other critical conditions. In particular, it interferes with the efficacy of vasoactive agents. Consequently, it is very important to elucidate the mechanisms and search for the effective treatment measures. In recent years, a lot of studies focused on the characteristics and the change rules of vascular hyporeactivity and mechanisms following shock. Also, the treatment approaches based on various mechanisms have been a hot pot these years.

  6. Condensed matter at high shock pressures

    SciTech Connect

    Nellis, W.J.; Holmes, N.C.; Mitchell, A.C.; Radousky, H.B.; Hamilton, D.

    1985-07-12

    Experimental techniques are described for shock waves in liquids: Hugoniot equation-of-state, shock temperature and emission spectroscopy, electrical conductivity, and Raman spectroscopy. Experimental data are reviewed and presented in terms of phenomena that occur at high densities and temperatures in shocked He, Ar, N/sub 2/, CO, SiO/sub 2/-aerogel, H/sub 2/O, and C/sub 6/H/sub 6/. The superconducting properties of Nb metal shocked to 100 GPa (1 Mbar) and recovered intact are discussed in terms of prospects for synthesizing novel, metastable materials. Ultrahigh pressure data for Cu is reviewed in the range 0.3 to 6TPa (3 to 60 Mbar). 56 refs., 9 figs., 1 tab.

  7. Critical point anomalies include expansion shock waves

    SciTech Connect

    Nannan, N. R.; Guardone, A.; Colonna, P.

    2014-02-15

    From first-principle fluid dynamics, complemented by a rigorous state equation accounting for critical anomalies, we discovered that expansion shock waves may occur in the vicinity of the liquid-vapor critical point in the two-phase region. Due to universality of near-critical thermodynamics, the result is valid for any common pure fluid in which molecular interactions are only short-range, namely, for so-called 3-dimensional Ising-like systems, and under the assumption of thermodynamic equilibrium. In addition to rarefaction shock waves, diverse non-classical effects are admissible, including composite compressive shock-fan-shock waves, due to the change of sign of the fundamental derivative of gasdynamics.

  8. Microcephaly syndromes.

    PubMed

    Abuelo, Dianne

    2007-09-01

    The objective of this article is to review microcephaly from a genetics point of view, especially with regard to the process of identification of syndromes in which small head circumference occurs. Microcephaly can be due to either genetic or environmental causes. It can be the only positive finding or may be part of a syndrome of congenital anomalies. The genetic etiology can be caused by autosomal dominant, autosomal recessive, or X-linked genes or various types of chromosome anomalies. Some of the gene mutations have been identified recently. Syndromic microcephaly is associated with a large number of conditions. Some can be diagnosed, or at least suspected, based on their characteristic facial dysmorphism, and others can be searched for using databases of genetic disorders.

  9. Compartment syndromes

    NASA Technical Reports Server (NTRS)

    Mubarak, S. J.; Pedowitz, R. A.; Hargens, A. R.

    1989-01-01

    The compartment syndrome is defined as a condition in which high pressure within a closed fascial space (muscle compartment) reduces capillary blood perfusion below the level necessary for tissue viability'. This condition occurs in acute and chronic (exertional) forms, and may be secondary to a variety of causes. The end-result of an extended period of elevated intramuscular pressure may be the development of irreversible tissue injury and Volkmann's contracture. The goal of treatment of the compartment syndrome is the reduction of intracompartmental pressure thus facilitating reperfusion of ischaemic tissue and this goal may be achieved by decompressive fasciotomy. Controversy exists regarding the critical pressure-time thresholds for surgical decompression and the optimal diagnostic methods of measuring intracompartmental pressures. This paper will update and review some current knowledge regarding the pathophysiology, aetiology, diagnosis, and treatment of the acute compartment syndrome.

  10. Ion heating and energy redistribution across supercritical perpendicular shocks: Application to planetary and interplanetary shocks

    NASA Astrophysics Data System (ADS)

    Yang, Z.; Liu, Y. D.; Richardson, J. D.; Parks, G. K.

    2013-12-01

    We investigate how the ion dissipative process across supercritical perpendicular shocks depends on the shock front micro-structures. At a collisionless plasma shock, the dissipation and micro-structure of the shock font are dominated by wave-particle interactions. Comparison of the ion thermalization at different kinds of shocks, e.g., planetary and interplanetary shocks, can quantify how much interaction is occurring at the shock boundary. Investigation of this problem for diverse solar wind (SW) conditions will yield important information on the dependences of the ion thermalization and energy redistribution on plasma parameters. With the aid of a successful automatic separation method [Yang et al., 2009], the incident ions at the shock can be divided into two parts: reflected (R) ions and directly transmitted (DT) ions. Corresponding heating efficiency of each population of ions at the shock can be calculated respectively. Wilkinson & Schwartz [1990] have theorized that the amount of reflected ions at perpendicular shocks depends on plasma parameters. Based on the Rankine-Hugoniot (R-H) conservation laws, they found that the fraction reflected is strongly dependent on the magnitude of the ratio of specific heat capacities γ chosen in the R-H relations. The main goal of this work is to investigate how the plasma parameters, e.g. the particle velocity distribution, the plasma beta value, seed populations, etc. (from a particle dynamic point of view), control the amount of reflected ions by using one-dimensional (1-D) full-particle-cell simulations. The simulation results may help to explain the ion heating efficiency and energy redistribution at shocks observed by Cluster, Wind, Voyager, etc.

  11. New radiative shocks experiment

    NASA Astrophysics Data System (ADS)

    Leygnac, S.; Bouquet, S.; Stehlé, C.; Benuzzi, A.; Boireau, J.-P.; Chièze, J.-P.; Grandjouan, N.; Huser, G.; Koenig, M.; Malka, V.; Merdji, H.; Michaut, C.; Thais, F.; Vinci, T.

    2002-06-01

    An experimental study of shocks with astrophysical relevance is performed with the high energy density laser of the LULI, at the Ecole Polytechnique. The peculiarity of these shocks is the strong coupling between radiation and hydrodynamics which leads to a structure governed by a radiative precursor. A new experiment has been performed this year where we have observed shocks identified as radiative shocks. We study them in various experimental configurations (several speeds and geometries of the medium where the shock propagates, allowing a quasi-planar or a quasi-spherical expansion). From the measurements it is possible to infer several features of the shock such as the speed, the electronic density, the geometrical shape and spectroscopic informations. The results will be studied with numerical simulations.

  12. Flammer syndrome

    PubMed Central

    2014-01-01

    The new term Flammer syndrome describes a phenotype characterized by the presence of primary vascular dysregulation together with a cluster of symptoms and signs that may occur in healthy people as well as people with disease. Typically, the blood vessels of the subjects with Flammer syndrome react differently to a number of stimuli, such as cold and physical or emotional stress. Nearly all organs, particularly the eye, can be involved. Although the syndrome has some advantages, such as protection against the development of atherosclerosis, Flammer syndrome also contributes to certain diseases, such as normal tension glaucoma. The syndrome occurs more often in women than in men, in slender people than in obese subjects, in people with indoor rather than outdoor jobs, and in academics than in blue collar workers. Affected subjects tend to have cold extremities, low blood pressure, prolonged sleep onset time, shifted circadian rhythm, reduced feeling of thirst, altered drug sensitivity, and increased general sensitivity, including pain sensitivity. The plasma level of endothelin-1 is slightly increased, and the gene expression in lymphocytes is changed. In the eye, the retinal vessels are stiffer and their spatial variability larger; the autoregulation of ocular blood flow is decreased. Glaucoma patients with Flammer syndrome have an increased frequency of the following: optic disc hemorrhages, activated retinal astrocytes, elevated retinal venous pressure, optic nerve compartmentalization, fluctuating diffuse visual field defects, and elevated oxidative stress. Further research should lead to a more concise definition, a precise diagnosis, and tools for recognizing people at risk. This may ultimately lead to more efficient and more personalized treatment. PMID:25075228

  13. Three-dimensional shock-shock interactions on the scramjet inlet

    SciTech Connect

    Singh, D.J.; Tiwari, S.N.; Kumar, A.

    1990-01-01

    The effects of shock impingement on the inlet of a scramjet engine are investigated numerically. The impinging shock is caused by the vehicle forebody. The interaction of this forebody shock with the inlet leading edge shock results in a very complex fully three-dimensional flowfield containing local regions of high pressure and intense heating. In the present investigation, this complex flowfield is calculated by solving the thin-layer Navier-Stokes equations using a finite-volume flux splitting technique due to van Leer. For zero or small sweep angles a Type IV interaction occurs while for moderate sweep of about 25 deg, a Type V interaction occurs. Both Type IV and Type V interactions are investigated. 25 refs.

  14. Weak shock reflection

    NASA Astrophysics Data System (ADS)

    Hunter, John K.; Brio, Moysey

    2000-05-01

    We present numerical solutions of a two-dimensional inviscid Burgers equation which provides an asymptotic description of the Mach reflection of weak shocks. In our numerical solutions, the incident, reflected, and Mach shocks meet at a triple point, and there is a supersonic patch behind the triple point, as proposed by Guderley for steady weak-shock reflection. A theoretical analysis indicates that there is an expansion fan at the triple point, in addition to the three shocks. The supersonic patch is extremely small, and this work is the first time it has been resolved.

  15. Anti-Shock Garment

    NASA Technical Reports Server (NTRS)

    1996-01-01

    Ames Research Center developed a prototype pressure suit for hemophiliac children, based on research of astronauts' physiological responses in microgravity. Zoex Corporation picked up the design and patents and developed an anti-shock garment for paramedic use. Marketed by Dyna Med, the suit reverses the effect of shock on the body's blood distribution by applying counterpressure to the legs and abdomen, returning blood to vital organs and stabilizing body pressure until the patient reaches a hospital. The DMAST (Dyna Med Anti-Shock Trousers) employ lower pressure than other shock garments, and are non-inflatable.

  16. Refeeding syndrome: a forgotten and potentially lethal entity.

    PubMed

    Aissaoui, Y; Hammi, S; Tagajdid, R; Chkoura, K; Boughalem, M

    2016-05-01

    Refeeding syndrome (RS) is defined as the fluid, electrolyte, metabolic, and clinical disturbances that occur after nutrition of patients who have been undernourished or fasting for a prolonged period. This syndrome has been recognized for several decades but is most often overlooked and underdiagnosed by health professionals. The authors report a RS in a patient subjected to prolonged fasting after being kidnapped by a criminal gang. Refeeding resulted in severe hypophosphatemia, neurological impairments, and hematologic disorders. The patient died due to septic shock with multiple organ failure secondary to aspiration pneumonia. In this case, the failure to recognize RS was decisive in the fatal outcome. Professionals must be aware of this disease to prevent and treat it properly. PMID:27412982

  17. Refeeding syndrome: a forgotten and potentially lethal entity.

    PubMed

    Aissaoui, Y; Hammi, S; Tagajdid, R; Chkoura, K; Boughalem, M

    2016-05-01

    Refeeding syndrome (RS) is defined as the fluid, electrolyte, metabolic, and clinical disturbances that occur after nutrition of patients who have been undernourished or fasting for a prolonged period. This syndrome has been recognized for several decades but is most often overlooked and underdiagnosed by health professionals. The authors report a RS in a patient subjected to prolonged fasting after being kidnapped by a criminal gang. Refeeding resulted in severe hypophosphatemia, neurological impairments, and hematologic disorders. The patient died due to septic shock with multiple organ failure secondary to aspiration pneumonia. In this case, the failure to recognize RS was decisive in the fatal outcome. Professionals must be aware of this disease to prevent and treat it properly.

  18. Shock Effects in Experimentally Shocked Samples of the H6 Chondrite Kernouve

    NASA Astrophysics Data System (ADS)

    Schmitt, R. T.; Deutsch, A.; Stoffler, D.

    1993-07-01

    extinction. In the pressure range from 10 to 20 GPa, plagioclase displays undulatory extinction. In the 35-GPa sample most of the plagioclase is transformed to maskelynite (diaplectic glass). This transformation is complete in the 60-GPa sample. The first effects of localized shock-induced melting are observed in the 35- GPa sample, where a few melt pockets occur. The 60-GPa sample shows abundant melt pockets, shock veins, and troilite injections into fractures of the silicates. Troilite of the unshocked sample is monocrystalline. In the pressure range from 10 to 20 GPa, troilite shows undulatory extinction and twinning. The 35- and 60-GPa samples contain only recrystallized troilite. This troilite is polycrystalline and consists of equant grains with 120-degree angles between grain boundaries. Shock Classification and Conclusions: Using the classification scheme of [1], the experimentally shocked Kernouve samples can be classified into the following stages: Unshocked--S1; 10 GPa--S3; 15 and 20 GPa--S4; 35 GPa--S5; and 60 GPa--S6. The transition between shock stage 3 and 4 appears to be somewhat lower than proposed by [1] and occurs in the pressure range of 10 to 15 GPa, probably near to 15 GPa.The investigation of the experimentally shocked chondrite Kernouve shows the same pressure-dependent features as observed in naturally shocked ordinary chondrites [1]. For this reason shock recovery experiments provide an important basis for a better understanding of natural shock features in ordinary chondrites. References: [1] St"ffler D. et al. (1991) GCA, 55, 3845-3867. [2] Bogard D. D. et al. (1987) GCA, 51, 2035-2044. [3] Dai C.-D. et al. (1991) Chin. Sci. Bull., 36, 1984-1988. [4] Sears D. W. et al. (1984) GCA, 48, 343-360. [5] M ller W. F. and Hornemann U. (1969) EPSL, 7, 251-264.

  19. How Is Cardiogenic Shock Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Cardiogenic Shock Treated? Cardiogenic shock is life threatening and requires emergency medical treatment. ... arrive. The first goal of emergency treatment for cardiogenic shock is to improve the flow of blood and ...

  20. [Night-eating syndrome].

    PubMed

    Takagi, S; Saitoh, S; Miki, T; Shimamoto, K

    2001-03-01

    Morning anorexia, evening hyperphagia and insomnia characterized night-eating syndrome. This syndrome is described in 1955 by Stunkard, et al. It occurred during periods of stress and was associated with a poor outcome of efforts at weight reduction. The prevalence of this syndrome was about 26% of severely obese population in US. In Japan, there is few clinical study of this syndrome. It is thought that this syndrome increases in prevalence with increasing adiposity. The behavior study showed that a coherent pattern of behavior was found in subjects with night-eating syndrome. And neuroendocrine study indicated that the leptin, which was produced from the adipocyts, related this syndrome and night eating behavior.

  1. Astrospheres and Stellar Bow shocks

    NASA Astrophysics Data System (ADS)

    Van Marle, Allard Jan

    2016-07-01

    As stars evolve, they deliver feedback to the surrounding medium in the form of stellar wind and radiation. These shape the surrounding matter, forming what is called an astrosphere, a sphere of influence in which the star dominates the morphology and composition of the surrounding medium. Astrospheres are fascinating objects. Because they are formed through the interaction between the stellar feedback and the interstellar gas, they can tell us a great deal about both. Furthermore, because they are shaped over time they provide us with a window into the past. This is of particular interest for the study of stellar evolution, because the astrosphere reflects changes in the properties of the stellar wind, which relate directly to the properties of the star. A special sub-class of astrospheres, the stellar bow shocks, occur when the progenitor star moves through the surrounding medium at supersonic speed. Because the properties of the bow shock relate directly to both the stellar wind and the interstellar medium, the shape and size of the bow shock can be used to determine these properties. Using state-of-the-art numerical codes, it is possible to simulate the interaction between the stellar wind and radiation and the interstellar medium. These results can then be compared to observations. They can also be used to predict the type of observations that are best suited to study these objects. In this fashion computational and observational astronomy can support each other in their efforts to gain a better understanding of stars and their environment.

  2. Ultrafast dynamic ellipsometry and spectroscopy of laser shocked materials

    SciTech Connect

    Bolme, Cynthia A; Mc Grane, Shawn D; Dang, Nhan C; Whitley, Von H; Moore, David S.

    2011-01-20

    Ultrafast dynamic ellipsometry is used to measure the material motion and changes in the optical refractive index of laser shock compressed materials. This diagnostic has shown us that the ultrafast laser driven shocks are the same as shocks on longer timescales and larger length scales. We have added spectroscopic diagnostics of infrared absorption, ultra-violet - visible transient absorption, and femtosecond stimulated Raman scattering to begin probing the initiation chemistry that occurs in shock reactive materials. We have also used the femtosecond stimulated Raman scattering to measure the vibrational temperature of materials using the Stokes gain to anti-Stokes loss ratio.

  3. Pathophysiology of septic shock and implications for therapy.

    PubMed

    Barron, R L

    1993-11-01

    Current knowledge about the pathophysiology of septic shock is reviewed, and biotechnology-based therapies under development are discussed. Patients with septic shock begin their clinical course with leukocytosis, fever, tachycardia, tachypnea, and organ hypoperfusion; shock ensues as immunologic and vasoactive mediators produce hypotension. There are many metabolic and cardiovascular responses, and single- or multiple-organ failure is common. Patients may experience adult respiratory distress syndrome. A multitude of endogenous and exogenous factors have been linked to the pathophysiology of sepsis and septic shock, including (1) endotoxin from gram-negative bacteria, (2) peptidoglycan and exotoxins from gram-negative bacteria, (3) endotoxin-binding proteins and receptors, (4) bactericidal proteases, (5) exotoxins from gram-positive bacteria, (6) acute-phase proteins and proteases, (7) cytokines, (8) arachidonic acid metabolites, (9) complement, (10) beta-endorphin, (11) histamine, (12) stimulation of intrinsic and extrinsic coagulation pathways and proteases, and (13) endothelium-derived factors and adhesion molecules. Molecular entities and strategies under development to combat septic shock include monoclonal antibodies to endotoxin, active immunization with lipid-A analogues, bactericidal permeability-increasing protein, interleukin inhibitors, and inhibitors of tumor necrosis factor-alpha. Successful treatment of septic shock will probably require a combination of agents, including antimicrobials. An ideal goal for biotechnology in the area of septic shock is to prevent invading pathogens from overstimulating the host's immune system and to systematically eliminate those pathogens. Biotechnology is opening new avenues to the treatment of septic shock.

  4. Shock Demagnetization of Pyrrhotite

    NASA Technical Reports Server (NTRS)

    Louzada, K. L.; Stewart, S. T.; Weiss, b. P.

    2005-01-01

    Maps of the remanent magnetic field of Mars show demagnetized zones within and around giant impact basins. It is likely that vast regions of the Martian crust were demagnetized due to a shock-induced phase change or magnetic transition of magnetic minerals in the crust. This hypothesis is supported by the fact that around the Hellas and Argyre basins, the edges of the unmagnetized zones roughly correspond with peak shock pressure contour lines of a few GPa. Although pyrrhotite is not a major carrier of magnetization in the Earth s crust, it is a common phase in Martian meteorites and may be an important carrier in the Martian crust. Understanding the effects of shock waves on magnetic minerals is critical for determining the origin of the demagnetized zones in impact basins and possibly for identifying the major magnetic carrier phases. Here we present the results of the first controlled shock demagnetization measurements on pyrrhotite. Previous experiments: Shock demagnetization

  5. On the Origin of Coronal Shocks

    NASA Astrophysics Data System (ADS)

    Nindos, Alexander; Alissandrakis, C. E.; Hillaris, A.; Caroubalos, C.

    2009-05-01

    Type II bursts represent the passage of a shock wave through the tenuous plasma of the solar corona. Their exact origin has not been unambiguously determined, although they are associated with eruptive phenomena and are identified either with a flare blast wave or with a CME forward shock or with a shock driven by the flanks of a CME. We investigate the location of the shock formation and its association with flares and/or CMEs by studying the properties of three Type II radio bursts associated with eruptions that occurred relatively close to the limb where the influence of projection effects is rather small. The Type II bursts were identified in 110-687 MHz range observations of the ARTEMIS-IV Solar Radio spectrograph and observed simultaneously with the Nancay Radioheliograph (NRH). The NRH makes images of the Sun at several fixed frequencies between 150 and 432 MHz, and our events could be mapped at two or three of its frequencies, allowing us to determine the propagation of the shocks in the low corona. The information provided by the radio data combined with observations of the associated flares and CMEs by space-borne instruments has been used to constrain the shock wave kinematics and discuss whether they were flare-ignited or CME-driven.

  6. Mechanical Properties of Shock-Damaged Rocks

    NASA Technical Reports Server (NTRS)

    He, Hongliang; Ahrens, T. J.

    1994-01-01

    Stress-strain tests were performed both on shock-damaged gabbro and limestone. The effective Young's modulus decreases with increasing initial damage parameter value, and an apparent work-softening process occurs prior to failure. To further characterize shock-induced microcracks, the longitudinal elastic wave velocity behavior of shock-damaged gabbro in the direction of compression up to failure was measured using an acoustic transmission technique under uniaxial loading. A dramatic increase in velocity was observed for the static compressive stress range of 0-50 MPa. Above that stress range, the velocity behavior of lightly damaged (D(sub 0) less than 0.1) gabbro is almost equal to unshocked gabbro. The failure strength of heavily-damaged (D(sub 0) greater than 0.1) gabbro is approx. 100-150 MPa, much lower than that of lightly damaged and unshocked gabbros (approx. 230-260 MPa). Following Nur's theory, the crack shape distribution was analyzed. The shock-induced cracks in gabbro appear to be largely thin penny-shaped cracks with c/a values below 5 x 10(exp -4). Moreover, the applicability of Ashby and Sammis's theory relating failure strength and damage parameter of shock-damaged rocks was examined and was found to yield a good estimate of the relation of shock-induced deficit in elastic modulus with the deficit in compressive strength.

  7. Refeeding syndrome.

    PubMed

    Fuentebella, Judy; Kerner, John A

    2009-10-01

    Refeeding syndrome (RFS) is the result of aggressive enteral or parenteral feeding in a malnourished patient, with hypophosphatemia being the hallmark of this phenomenon. Other metabolic abnormalities, such as hypokalemia and hypomagnesemia, may also occur, along with sodium and fluid retention. The metabolic changes that occur in RFS can be severe enough to cause cardiorespiratory failure and death. This article reviews the pathophysiology, the clinical manifestations, and the management of RFS. The key to prevention is identifying patients at risk and being aware of the potential complications involved in rapidly reintroducing feeds to a malnourished patient.

  8. Electron velocity distributions near the earth's bow shock

    NASA Technical Reports Server (NTRS)

    Feldman, W. C.; Anderson, R. C.; Bame, S. J.; Gary, S. P.; Gosling, J. T.; Mccomas, D. J.; Thomsen, M. F.; Paschmann, G.; Hoppe, M. M.

    1983-01-01

    New information is presented on the general characteristics of electron distribution functions upstream, within, and downstream of the earth's bow shock, thereby providing new insights into the instabilities in collisionless shocks. The results presented are from a survey of electron velocity distributions measured near the earth's bow shock between October 1977 and December 1978 using the Los Alamos/Garching plasma instrumentation aboard ISEE 2. A wide variety of distribution shapes is found within the different plasma regions in close proximity to the bow shock. It is found that these shapes can be classified into general types that are characteristic of three different plasma regions, namely the upstream region or electron foreshock, the shock proper where most of the heating occurs, and the downstream region or the magnetosheath. Evidence is provided that field-aligned, rather than cross-field, instabilities are the major source of electron dissipation in the earth's bow shock.

  9. Shock system of February 2, 1969. [solar wind observations

    NASA Technical Reports Server (NTRS)

    Unti, T.; Neugebauer, M.; Wu, C.-S.

    1973-01-01

    The shock system observed in the solar wind by Pioneer 9 and Ogo 5 on Feb. 2, 1969, consisted of the following major discontinuities: a forward slow shock; a forward fast shock; a tangential discontinuity at which the density dropped sharply and the flow direction changed; a tangential discontinuity at which the magnetic field strength jumped to an unusually high value; two closely spaced tangential discontinuities that bracketed a region of even greater field strength and that fronted a region of very cool, very dense, helium-enriched plasma; a reverse fast shock of low Mach number; and a second reverse fast shock of very low Mach number. The event had aspects of both corotating and flare-induced shock systems; it is suggested that the source of the disturbances was a flare occurring at or near an M region.

  10. Post myocardial infarction cardiogenic shock: a review of current therapies.

    PubMed

    Ng, Ramford; Yeghiazarians, Yerem

    2013-01-01

    Cardiogenic shock is often a devastating consequence of acute myocardial infarction (MI) and portends to significant mortality and morbidity. Despite improvements in expediting the time to treatment and enhancements in available medical therapy and reperfusion techniques, cardiogenic shock remains the most common cause of mortality following MI. Post-MI cardiogenic shock most commonly occurs as a consequence of severe left ventricular dysfunction. Right ventricular (RV) MI must also be considered. Mechanical complications including acute mitral regurgitation, ventricular septal rupture, and ventricular free-wall rupture can also lead to cardiogenic shock. Rapid diagnosis of cardiogenic shock and its underlying cause is pivotal to delivering definitive therapy. Intravenous vasoactive agents and mechanical support devices may temporize the patient's hemodynamic status until definitive therapy by percutaneous or surgical intervention can be performed. Despite prompt management, post-MI cardiogenic shock mortality remains high.

  11. Shock initiation of 1,3,3-trinitroazetidine (TNAZ)

    SciTech Connect

    Simpson, R.L.; Urtiew, P.A.; Tarver, C.M.

    1995-07-19

    The shock sensitivity of the pressed solid explosive 1,3,3-trinitroazetidine (TNAZ) was determined using the embedded manganin pressure gauge technique. At an initial pressure of 1.3 GPa, pressure buildup (exothermic reaction) was observed after ten {mu}s. At 2 GPa, TNAZ reacted rapidly and transitioned to detonation in approximately 13 mm. At 3.6 GPa, detonation occurred in less than 6 mm of shock propagation. Thus, pure TNAZ is more shock sensitive than HMX-based explosives but less shock sensitive than PETN-based explosives. The shocked TNAZ exhibited little reaction directly behind the shock front, followed by an extremely rapid reaction. This reaction caused both a detonation wave and a retonation wave in the partially decomposed TNAZ. An Ignition and Growth reactive model for TNAZ was developed to help understand this complex initiation phenomenon.

  12. Punishment and negative reinforcement of stuttering using electric shock.

    PubMed

    Martin, R; Louis, K S; Haroldson, S; Hasbrouck, J

    1975-09-01

    Five adult male stutterers were subjected to electric shock under three conditions. After stuttering frequency was stable in base rate, three subjects were (1) presented electric shock continuously, but the shock was terminated for five seconds contingent on each stuttering (escape); (2) not presented electric shock continuously, but were given a burst of shock contingent on each stuttering (punish); and (3) allowed to choose the shock condition they preferred. Two other subjects followed the same procedure, except that the order of the escape and punish conditions was reversed. The five subjects behaved differently in the various experimental conditions. For three subjects, the percentage of words stuttered changed very little in the escape condition, whereas two subjects' stuttering increased in escape. In the punish condition, the percentage of words stuttered changed very little for one subject, increased for two subjects and decreased for two subjects. Little change in stuttering behavior occurred in the preferred choice condition.

  13. Massive Organ Inflammation in Experimental and in Clinical Meningococcal Septic Shock.

    PubMed

    Hellerud, Bernt C; Olstad, Ole K; Nielsen, Erik W; Trøseid, Anne-Marie S; Skadberg, Øyvind; Thorgersen, Ebbe B; Vege, Åshild; Mollnes, Tom E; Brandtzæg, Petter

    2015-11-01

    Fulminant meningococcal sepsis is characterized by a massive growth of bacteria in the circulation, regarded as the primary inflammatory site, with no specific solid organ focus. Here we aimed to study the local inflammatory response in organs using a porcine model of fulminant meningococcal septic shock challenged with exponentially increasing doses of heat inactivated Neisseria meningitidis. The results were compared with those obtained in organs post mortem from three patients with lethal meningococcal septic shock. Nine patients with lethal pneumococcal disease and 14 patients with sudden infant death syndrome served as controls. Frozen tissue were thawed, homogenized and prepared for quantification of bacterial DNA by real-time polymerase chain reaction, and key inflammatory mediators were measured by ELISA in the pig material and by multiplex in the human material. In addition, gene expression assayed by Affymetrix gene expression profiling was performed in the pig study. The porcine model revealed a major influx of N. meningitidis in lungs, liver, spleen, and kidneys accompanied with major production of cardinal inflammatory mediators including tumor necrosis factor, interleukin (IL)-1β, IL-6, and IL-8, far exceeding the amount detected in blood. Genes encoding for these mediators revealed a similar profile. By comparing the wild-type with a lipopolysaccharide (LPS) deficient meningococcal strain, we documented that LPS was the dominant group of molecules inducing organ inflammation and was required for IL-8 production. IL-10 production was predominantly stimulated by non-LPS molecules. The massive organ inflammation in the porcine model was present in the three patients dying of meningococcal shock and differed markedly from the patients with lethal pneumococcal infections and sudden infant death syndrome. In conclusion, in meningococcal sepsis, a massive local inflammatory response occurs in specific organs.

  14. Particle acceleration at shocks in the inner heliosphere

    NASA Astrophysics Data System (ADS)

    Parker, Linda Neergaard

    This dissertation describes a study of particle acceleration at shocks via the diffusive shock acceleration mechanism. Results for particle acceleration at both quasi-parallel and quasi-perpendicular shocks are presented to address the question of whether there are sufficient particles in the solar wind thermal core, modeled as either a Maxwellian or kappa- distribution, to account for the observed accelerated spectrum. Results of accelerating the theoretical upstream distribution are compared to energetic observations at 1 AU. It is shown that the particle distribution in the solar wind thermal core is sufficient to explain the accelerated particle spectrum downstream of the shock, although the shape of the downstream distribution in some cases does not follow completely the theory of diffusive shock acceleration, indicating possible additional processes at work in the shock for these cases. Results show good to excellent agreement between the theoretical and observed spectral index for one third to one half of both quasi-parallel and quasi-perpendicular shocks studied herein. Coronal mass ejections occurring during periods of high solar activity surrounding solar maximum can produce shocks in excess of 3-8 shocks per day. During solar minimum, diffusive shock acceleration at shocks can generally be understood on the basis of single independent shocks and no other shock necessarily influences the diffusive shock acceleration mechanism. In this sense, diffusive shock acceleration during solar minimum may be regarded as Markovian. By contrast, diffusive shock acceleration of particles at periods of high solar activity (e.g. solar maximum) see frequent, closely spaced shocks that include the effects of particle acceleration at preceding and following shocks. Therefore, diffusive shock acceleration of particles at solar maximum cannot be modeled on the basis of diffusive shock acceleration as a single, independent shock and the process is essentially non-Markovian. A

  15. Syndrome by Any Other Name. . .

    ERIC Educational Resources Information Center

    Bowers, Drew

    2008-01-01

    The word "syndrome" is one of those words that has slipped into one's vocabulary with few realizing what exactly it means or all the implications it carries. The word "syndrome" can be defined as "a group of signs and symptoms that occur together and characterize a particular abnormality or condition." Typically, a syndrome will be defined by…

  16. A Journey with Klinefelter Syndrome

    ERIC Educational Resources Information Center

    Cover, Virginia Isaacs

    2006-01-01

    In this article, the author shares her experience having a son with Klinefelter Syndrome. Klinefelter Syndrome, also known as 47,XXY, is estimated to occur in 1 out of 600 males, making it the most common chromosomal disorder. Babies with Klinefelter Syndrome rarely have any physical differences that are detectable, which is the reason that so few…

  17. Naturally Occurring Radioactive Materials (NORM)

    SciTech Connect

    Gray, P.

    1997-02-01

    This paper discusses the broad problems presented by Naturally Occuring Radioactive Materials (NORM). Technologically Enhanced naturally occuring radioactive material includes any radionuclides whose physical, chemical, radiological properties or radionuclide concentration have been altered from their natural state. With regard to NORM in particular, radioactive contamination is radioactive material in an undesired location. This is a concern in a range of industries: petroleum; uranium mining; phosphorus and phosphates; fertilizers; fossil fuels; forestry products; water treatment; metal mining and processing; geothermal energy. The author discusses in more detail the problem in the petroleum industry, including the isotopes of concern, the hazards they present, the contamination which they cause, ways to dispose of contaminated materials, and regulatory issues. He points out there are three key programs to reduce legal exposure and problems due to these contaminants: waste minimization; NORM assesment (surveys); NORM compliance (training).

  18. Foliicolous microfungi occurring on Encephalartos.

    PubMed

    Crous, P W; Wood, A R; Okada, G; Groenewald, J Z

    2008-12-01

    Species of Encephalartos, commonly known as bread trees, bread palms or cycads are native to Africa; the genus encompasses more than 60 species and represents an important component of the indigenous African flora. Recently, a leaf blight disease was noted on several E. altensteinii plants growing at the foot of Table Mountain in the Kirstenbosch Botanical Gardens of South Africa. Preliminary isolations from dead and dying leaves of E. alten-steinii, E. lebomboensis and E. princeps, collected from South Africa, revealed the presence of several novel microfungi on this host. Novelties include Phaeomoniella capensis, Saccharata kirstenboschensis, Teratosphaeria altensteinii and T. encephalarti. New host records of species previously only known to occur on Proteaceae include Cladophialophora proteae and Catenulostroma microsporum, as well as a hyperparasite, Dactylaria leptosphaeriicola, occurring on ascomata of T. encephalarti. PMID:20396583

  19. Pathologic pulmonary changes in hemorrhagic shock.

    PubMed Central

    Garvey, J W; Hagstrom, J W; Veith, F J

    1975-01-01

    Fifty-seven dogs were subjected to hemorrhagic hypotension by a variety of protocols. Histologic pulmonary changes were studied using the light microscope. Of these 57 dogs, 21 had no demonstrable lesions, 8 had minimal changes, and 28 had moderate or severe lesions, all of a focal nature. No correlation was found between the presence of lesions and mean systemic arterial pressure during shock, the udration of the hemorrhagic period, the fate of the animal, preoperative hematocrits and blood volumes, mean postreinfusion arterial pressure, whether the animals were mongrels or purebred beagles, whether they were awake or sedated, whether they breathed spontaneously or were artifically ventilated, whether they had undergone previous splenectomy or not, whether hilar stripping was performed or not, and finally, whether blood was reinfused after hemorrhage or not. Thus we conclude that multiple factors may exert a harmful effect on the lung in hemorrhagic shock, and that shock probably makes the lungs more vulnerable to other injurious agents rather than there being one single pathogenetic mechanism for the pulmonary damage. The term "adult respiratory distress syndrome" rather than "shock lung" is best used for the human clinical entity since it implies a complex ettiology rather than a discrete pulmonary lesion produced by a single pathogenetic mechanism. PMID:1138638

  20. Preference for less frequent shock under fixed-interval schedules of electric-shock presentation.

    PubMed Central

    Pitts, R C; Malagodi, E F

    1991-01-01

    Lever pressing by 2 squirrel monkeys was maintained under fixed-interval 6-min and fixed-interval 2-min schedules of electric-shock presentation. Preference for these schedules was assessed during three experimental phases. In all phases, responses on one lever produced shock according to one or the other fixed-interval schedule, and responses on a second, changeover, lever switched between schedules. The opportunity to change over was presented during separate choice periods (during which the fixed-interval schedules did not operate) that followed the first through fourth shocks in each schedule. If no changeover occurred during those choice periods, a changeover automatically occurred following the fifth shock. In Phase I, durations of the choice periods were fixed. In Phase II, the choice periods equaled a proportion of their respective fixed interval. During Phase III (completed with 1 monkey) a response on the changeover lever during a given choice period reinstated the most recent fixed interval, and a failure to respond resulted in a changeover. During each of these phases, distinct preferences developed for the 6-min schedule. These results suggest that the maintenance of lever pressing by fixed-interval presentation of electric shock may not be an example of positive reinforcement, and that the response-maintaining characteristics of shock presentation may derive from other properties of the schedule. PMID:1940761

  1. Echocardiography in shock management.

    PubMed

    McLean, Anthony S

    2016-01-01

    Echocardiography is pivotal in the diagnosis and management of the shocked patient. Important characteristics in the setting of shock are that it is non-invasive and can be rapidly applied.In the acute situation a basic study often yields immediate results allowing for the initiation of therapy, while a follow-up advanced study brings the advantage of further refining the diagnosis and providing an in-depth hemodynamic assessment. Competency in basic critical care echocardiography is now regarded as a mandatory part of critical care training with clear guidelines available. The majority of pathologies found in shocked patients are readily identified using basic level 2D and M-mode echocardiography. A more comprehensive diagnosis can be achieved with advanced levels of competency, for which practice guidelines are also now available. Hemodynamic evaluation and ongoing monitoring are possible with advanced levels of competency, which includes the use of colour Doppler, spectral Doppler, and tissue Doppler imaging and occasionally the use of more recent technological advances such as 3D or speckled tracking.The four core types of shock-cardiogenic, hypovolemic, obstructive, and vasoplegic-can readily be identified by echocardiography. Even within each of the main headings contained in the shock classification, a variety of pathologies may be the cause and echocardiography will differentiate which of these is responsible. Increasingly, as a result of more complex and elderly patients, the shock may be multifactorial, such as a combination of cardiogenic and septic shock or hypovolemia and ventricular outflow obstruction.The diagnostic benefit of echocardiography in the shocked patient is obvious. The increasing prevalence of critical care physicians experienced in advanced techniques means echocardiography often supplants the need for more invasive hemodynamic assessment and monitoring in shock. PMID:27543137

  2. Imploding conical shock waves

    NASA Astrophysics Data System (ADS)

    Paton, R. T.; Skews, B. W.; Rubidge, S.; Snow, J.

    2013-07-01

    The behaviour of conical shock waves imploding axisymmetrically was first studied numerically by Hornung (J Fluid Mech 409:1-12, 2000) and this prompted a limited experimental investigation into these complex flow patterns by Skews et al. (Shock Waves 11:323-326, 2002). Modification of the simulation boundary conditions, resulting in the loss of self-similarity, was necessary to image the flow experimentally. The current tests examine the temporal evolution of these flows utilising a converging conical gap of fixed width fed by a shock wave impinging at its entrance, supported by CFD simulations. The effects of gap thickness, angle and incident shock strength were investigated. The wave initially diffracts around the outer lip of the gap shedding a vortex which, for strong incident shock cases, can contain embedded shocks. The converging shock at exit reflects on the axis of symmetry with the reflected wave propagating outwards resulting in a triple point developing on the incident wave together with the associated shear layer. This axisymmetric shear layer rolls up into a mushroom-shaped toroidal vortex ring and forward-facing jet. For strong shocks, this deforms the Mach disk to the extent of forming a second triple point with the primary shock exhibiting a double bulge. Separate features resembling the Richtmeyer-Meshkov and Kelvin-Helmholtz instabilities were noted in some tests. Aside from the incident wave curvature, the reflection patterns demonstrated correspond well with the V- and DV-types identified by Hornung although type S was not clearly seen, possibly due to the occlusion of the reflection region by the outer diffraction vortex at these early times. Some additional computational work explicitly exploring the limits of the parameter space for such systems has demonstrated the existence of a possible further reflection type, called vN-type, which is similar to the von Neumann reflection for plane waves. It is recommended that the parameter space be

  3. Ramsay Hunt syndrome

    MedlinePlus

    ... or on the mouth. It occurs when the varicella-zoster virus infects a nerve in the head. ... The varicella-zoster virus that causes Ramsay Hunt syndrome is the same virus that causes chickenpox and shingles . In ...

  4. Impingement syndrome (image)

    MedlinePlus

    ... arch of the shoulder blade, it can cause shoulder pain called impingement syndrome. The tendons become compressed, damaged, and inflamed leading to rotator cuff tendonitis. This can occur ... use of the shoulder like baseball pitching, or from an injury.

  5. Auriculotemporal Syndrome (Frey Syndrome).

    PubMed

    Motz, Kevin M; Kim, Young J

    2016-04-01

    Frey syndrome is a common sequela of parotidectomy, and although it is not frequently manifested clinically, it can cause significant morbidity for those affected. Frey syndrome results from synkinetic autonomic reinnervation by transected postganglionic parasympathetic nerve fiber within the parotid gland to the overlying sweat glands of the skin. Many surgical techniques have been proposed to prevent the development of Frey syndrome. For those who develop clinical symptoms of Frey syndrome, objective testing can be performed with a Minor starch-iodine test. Some of the current methods to prevent and treat symptomatic Frey syndrome are reviewed. PMID:26902982

  6. Shocks near Jamming

    NASA Astrophysics Data System (ADS)

    Gómez, Leopoldo R.; Turner, Ari M.; van Hecke, Martin; Vitelli, Vincenzo

    2012-02-01

    Nonlinear sound is an extreme phenomenon typically observed in solids after violent explosions. But granular media are different. Right when they jam, these fragile and disordered solids exhibit a vanishing rigidity and sound speed, so that even tiny mechanical perturbations form supersonic shocks. Here, we perform simulations in which two-dimensional jammed granular packings are dynamically compressed and demonstrate that the elementary excitations are strongly nonlinear shocks, rather than ordinary phonons. We capture the full dependence of the shock speed on pressure and impact intensity by a surprisingly simple analytical model.

  7. Anthrax-associated shock.

    PubMed

    Goldman, David L; Casadevall, Arturo

    2008-01-01

    Recent events have brought attention to the potential of Bacillus anthracis as an agent of bioterrorism. The shock like state of anthrax is invariably associated with high mortality, despite anti-microbial and supportive therapy. Multi-system dysfunction is typical, including: enhanced vascular permeability, hemorrhage and inflammation. Important questions concerning the pathophysiology of anthrax-associated shock remain unanswered, including the effects of B. anthracis infection on cardiac function. This review discusses the current state of knowledge regarding the pathophysiology of anthrax-associated shock. PMID:18508494

  8. Tourette syndrome

    MedlinePlus

    Gilles de la Tourette syndrome; Tic disorders - Tourette syndrome ... Tourette syndrome is named for Georges Gilles de la Tourette, who first described this disorder in 1885. The disorder is likely passed down through families. The syndrome may be linked to ...

  9. Shock compression and initiation behavior of FEFO

    SciTech Connect

    Simpson, R.L.; Helm, F.H.; von Holtz, E.H.

    1988-11-11

    A series of experiments were carried out on FEFO to determine the non-reactive equation of state and initiation sensitivity to one- dimensional shock loading. The material was found to be extremely insensitive requiring approximately 13.0 GPa to initiate it. Pressure records indicate that the build-up to detonation may occur within the FEFO and not at the impactor-sample interface as is often assumed. In addition, it was found that the compression vs. detonation induction time behavior between FEFO and three nitroalkanes are approximately the same although the shock pressure thresholds are quite different. 9 refs., 5 figs., 1 tab.

  10. Nonstandard Analysis and Jump Conditions for Converging Shock Waves

    NASA Technical Reports Server (NTRS)

    Baty, Roy S.; Farassat, Fereidoun; Tucker, Don H.

    2008-01-01

    Nonstandard analysis is an area of modern mathematics which studies abstract number systems containing both infinitesimal and infinite numbers. This article applies nonstandard analysis to derive jump conditions for one-dimensional, converging shock waves in a compressible, inviscid, perfect gas. It is assumed that the shock thickness occurs on an infinitesimal interval and the jump functions in the thermodynamic and fluid dynamic parameters occur smoothly across this interval. Predistributions of the Heaviside function and the Dirac delta measure are introduced to model the flow parameters across a shock wave. The equations of motion expressed in nonconservative form are then applied to derive unambiguous relationships between the jump functions for the flow parameters.

  11. Nitric oxide and septic shock. From bench to bedside.

    PubMed Central

    Kuhl, S J; Rosen, H

    1998-01-01

    Refractory hypotension with end-organ hypoperfusion is an ominous feature of inflammatory shock. In the past fifteen years, nitric oxide (a diffusible, short-lived product of arginine metabolism) has been found to be an important regulatory molecule in several areas of metabolism, including vascular tone control. Vascular endothelial cells constitutively produce low levels of nitric oxide that regulate blood pressure by mediating adjacent smooth-muscle relaxation. In an inflammatory shock state, cytokines, like interleukin-1 and tumor necrosis factor-alpha, induce a separate, high-output form of the enzyme that synthesizes nitric oxide in both endothelial and smooth-muscle cells. The ensuing high rates of nitric oxide formation result in extensive smooth-muscle relaxation, pressor refractory vasodilation, and--ultimately--shock. The concept of the pathogenesis of inflammatory shock explains many limitations of current therapies and may foster the development of new interventions to mitigate the effects of nitric oxide overproduction in this syndrome. PMID:9549416

  12. Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome).

    PubMed

    Bresler, Scott C; Padwa, Bonnie L; Granter, Scott R

    2016-06-01

    Nevoid basal cell carcinoma syndrome, or basal cell nevus syndrome (Gorlin syndrome), is a rare autosomal dominantly inherited disorder that is characterized by development of basal cell carcinomas from a young age. Other distinguishing clinical features are seen in a majority of patients, and include keratocystic odontogenic tumors (formerly odontogenic keratocysts) as well as dyskeratotic palmar and plantar pitting. A range of skeletal and other developmental abnormalities are also often seen. The disorder is caused by defects in hedgehog signaling which result in constitutive pathway activity and tumor cell proliferation. As sporadic basal cell carcinomas also commonly harbor hedgehog pathway aberrations, therapeutic agents targeting key signaling constituents have been developed and tested against advanced sporadically occurring tumors or syndromic disease, leading in 2013 to FDA approval of the first hedgehog pathway-targeted small molecule, vismodegib. The elucidation of the molecular pathogenesis of nevoid basal cell carcinoma syndrome has resulted in further understanding of the most common human malignancy. PMID:26971503

  13. Relative frequencies of seismic main shocks after strong shocks in Italy

    NASA Astrophysics Data System (ADS)

    Gasperini, Paolo; Lolli, Barbara; Vannucci, Gianfranco

    2016-10-01

    We analysed a catalogue of Italian earthquakes, covering 55 yr of data from 1960 to 2014 with magnitudes homogeneously converted to Mw, to compute the time-dependent relative frequencies with which strong seismic shocks (4.0 ≤ Mw < 5.0), widely felt by the population, have been followed by main shocks (Mw ≥ 5.0) that threatened the health and the properties of the persons living in the epicentral area. Assuming the stationarity of the seismic release properties, such frequencies are estimates of the probabilities of potentially destructive shocks after the occurrence of future strong shocks. We compared them with the time-independent relative frequencies of random occurrence in terms of the frequency gain that is the ratio between the time-dependent and time-independent relative frequencies. The time-dependent relative frequencies vary from less than 1 per cent to about 20 per cent, depending on the magnitudes of the shocks and the time windows considered (ranging from minutes to years). They remain almost constant for a few hours after the strong shock and then decrease with time logarithmically. Strong earthquakes (with Mw ≥ 6.0) mainly occurred within two or three months of the strong shock. The frequency gains vary from about 10 000 for very short time intervals to less than 10 for a time interval of 2 yr. Only about 1/3 of main shocks were preceded by at least a strong shock in the previous day and about 1/2 in the previous month.

  14. Testing bow shock models

    NASA Astrophysics Data System (ADS)

    Alrefay, Thamer; Meziane, Karim; Hamza, A. M.

    2016-07-01

    Space plasmas studies of bow shock dynamics, given the fundamental transport role and impact natural transition boundaries, have continued to attract much interest. With the overwhelming availability of data collected by various space science missions, several empirical models have been put forward to account for the location of the Earth's bow shock. Various solar wind and IMF measured parameters are used to constrain the proposed models published in the literature. For each of these empirical models, the bow shock nose velocity, at the standoff distance, is computed; each of these velocities is then compared with the observed shock speed as determined from a multipoint measurement provided by the Cluster quartet. The present study reveals to what extent the model parameters used are significant and determinant, and suggests that some empirical models are more accurate than others are.

  15. Counseling For Future Shock

    ERIC Educational Resources Information Center

    Morgan, Lewis B.

    1974-01-01

    In this article the author looks at some of the searing prophecies made by Alvin Toffler in his book Future Shock and relates them to the world of the professional counselor and the clientele the counselor attempts to serve. (Author)

  16. Collisionless parallel shocks

    NASA Technical Reports Server (NTRS)

    Khabibrakhmanov, I. KH.; Galeev, A. A.; Galinskii, V. L.

    1993-01-01

    Consideration is given to a collisionless parallel shock based on solitary-type solutions of the modified derivative nonlinear Schroedinger equation (MDNLS) for parallel Alfven waves. The standard derivative nonlinear Schroedinger equation is generalized in order to include the possible anisotropy of the plasma distribution and higher-order Korteweg-de Vies-type dispersion. Stationary solutions of MDNLS are discussed. The anisotropic nature of 'adiabatic' reflections leads to the asymmetric particle distribution in the upstream as well as in the downstream regions of the shock. As a result, nonzero heat flux appears near the front of the shock. It is shown that this causes the stochastic behavior of the nonlinear waves, which can significantly contribute to the shock thermalization.

  17. Voyager 2 in the Vicinity of the Termination Shock with Voyager 1 Well Beyond

    NASA Astrophysics Data System (ADS)

    Stone, E. C.

    2007-12-01

    Voyager 2 began observing intense inward streaming of MeV ions from the termination shock in 2005 and has recently observed plasma oscillations excited by electron beams from the shock. Such beams occur on field lines that are tangential to planetary bow shocks, and Gurnett and Kurth proposed a similar topology for oscillations observed by Voyager 1 upstream of the termination shock. This suggests that Voyager 2 is now directly connected along the magnetic field to the shock, consistent with increasing intensities of sub-MeV ions. MHD models by Opher et al. and Pogorelov et al. indicate that direct connection along the spiral magnetic field to the non-spherical shock occurs when Voyager 2 is within ~3 AU from the shock. This suggests that if the shock moves steadily inward at >30 km/s, Voyager 2 may enter the heliosheath this year at a radial distance of <85 AU. The Voyager 2 data at the shock combined with Voyager 1 data at 105 AU in the heliosheath should help address questions such as the plasma flow immediately upstream of the shock and in the heliosheath, the source of anomalous cosmic rays and their relationship to the lower energy ions from the shock, the gradients of cosmic rays in the heliosheath, the effects of transients at the shock and beyond, and the north-south asymmetries in the shock and heliosheath

  18. Attosecond shock waves.

    PubMed

    Zhokhov, P A; Zheltikov, A M

    2013-05-01

    Shock-wave formation is a generic scenario of wave dynamics known in nonlinear acoustics, fluid dynamics, astrophysics, seismology, and detonation physics. Here, we show that, in nonlinear optics, remarkably short, attosecond shock transients can be generated through a strongly coupled spatial and temporal dynamics of ultrashort light pulses, suggesting a pulse self-compression scenario whereby multigigawatt attosecond optical waveforms can be synthesized. PMID:23683197

  19. The Supernova Shock

    NASA Astrophysics Data System (ADS)

    Bethe, Hans A.

    1995-08-01

    Vigorous convection is the key to the supernova mechanism. An analytic theory is presented which parallels the computations of Herant et al. Energy is delivered by neutrinos to the convecting medium. The most important quantity is p1r3, where P1 is the density outside the shock. This can be obtained from the computations of Wilson et al., since it is not affected by the convection behind the shock. It is closely related to Mdot, the rate at which matter falls in toward the center. The outgoing shock is dominated by the Hugoniot equation; the shock cannot move out until its energy is of the order of 1 foe (= 1051 ergs). Once it moves, its velocity and energy are calculated as functions of its radius. Nucleosynthesis gives an appreciable contribution to the energy. A substantial fraction of the energy is initially stored as nuclear dissociation energy, and then released as the shock moves out. This energy cannot at present be calculated from first principles, but it can be deduced from the observed energy of SN 1987A of 1.4±0.4 foe. From the result it is shown that about one-half of the infalling material goes into the shock and one-half accretes to the neutron star.

  20. AOTV bow shock location

    NASA Technical Reports Server (NTRS)

    Desautel, D.

    1985-01-01

    Hypersonic bow-shock location and geometry are of central importance to the aerodynamics and aerothermodynamics of aeroassisted orbital transfer vehicles (AOTVs), but they are difficult to predict for a given vehicle configuration. This paper reports experimental measurements of shock standoff distance for the 70 deg cone AOTV configuration in shock-tunnel-test flows at Mach numbers of 3.8 to 7.9 and for angles of attack from 0 deg to 20 deg. The controlling parameter for hypersonic bow-shock standoff distance (for a given forebody shape) is the mean normal-shock density ratio. Values for this parameter in the tests reported are in the same range as those of the drag-brake AOTV perigee regime. Results for standoff distance are compared with those previously reported in the literature for this AOTV configuration. It is concluded that the AOTV shock standoff distance for the conical configuration, based on frustrum (base) radius, is equivalent to that of a sphere with a radius about 35 percent greater than that of the cone; the distance is, therefore, much less than reported in previous studies. Some reasons for the discrepancies between the present and previous are advanced. The smaller standoff distance determined here implies there will be less radiative heat transfer than was previously expected.

  1. PIC simulations on the termination shock: Microstructure and electron acceleration

    NASA Astrophysics Data System (ADS)

    Matsukiyo, S.; Scholer, M.

    2013-05-01

    The ability of the termination shock as a particle accelerator is totally unknown. Voyager data and recent kinetic numerical simulations revealed that the compression ratio of the termination shock is rather low due to the presence of pickup ions, i.e., the termination shock appears to be a weak shock. Nevertheless, two Voyager spacecraft observed not only high energy ions called termination shock particles, which are non-thermal but less energetic compared to the so-called anomalous cosmic rays, but also high energy electrons. In this study we focus especially on microstructure of the termination shock and the associated electron acceleration process by performing one-dimensional full particle-in-cell (PIC) simulations for a variety of parameters. For typical solar wind parameters at the termination shock, a shock potential has no sharp ramp with the spatial scale of the order of electron inertial length which is suitable for the injection of anomalous cosmic ray acceleration. Solar wind ions are not so much heated, which is consistent with Voyager spacecraft data. If a shock angle is close to 90 deg., a shock is almost time stationary or weakly breathing when a relative pickup ion density is 30%, while it becomes non-stationary if the relative pickup ion density is 20%. When the shock angle becomes oblique, a self-reformation occurs due to the interaction of solar wind ions and whistler precursors. Here, the shock angle is defined as the angle between upstream magnetic field and shock normal. For the case with relatively low beta solar wind plasma (electron beta is 0.1 and solar wind ion temperature equals to electron temperature), modified two-stream instability (MTSI) gets excited in the extended foot sustained by reflected pickup ions, and both solar wind electrons and ions are heated. If the solar wind plasma temperature gets five times higher, on the other hand, the MTSI is weakened and the pre-heating of the solar wind plasma in the extended foot is

  2. Heat shock response of murine Chlamydia trachomatis.

    PubMed Central

    Engel, J N; Pollack, J; Perara, E; Ganem, D

    1990-01-01

    We have investigated the heat shock response in the mouse pneumonitis strain of Chlamydia trachomatis. The kinetics of the chlamydial heat shock response resembled that of other procaryotes: the induction was rapid, occurring over a 5- to 10-min time period, and was regulated at the level of transcription. Immunoblot analysis and immunoprecipitations with heterologous antisera to the heat shock proteins DnaK and GroEL demonstrated that the rate of synthesis, but not the absolute amount of these two proteins, increased after heat shock. Using a general screen for genes whose mRNAs are induced by heat shock, we identified and cloned two of these. DNA sequence analysis demonstrated that one of the genes is a homolog of dnaK. Further sequence analysis of the region upstream of the dnaK gene revealed that the chlamydial homolog of the grpE gene is located just adjacent to the dnaK gene. The second locus encoded three potential nonoverlapping open reading frames. One of the open reading frames was 52% homologous to the ribosomal protein S18 of Escherichia coli and thus presumably encodes the chlamydial homolog. Interestingly, this ribosomal protein is not known to be induced by heat shock in E. coli. S1 nuclease and primer extension analyses located the start site of the dnaK transcript to the last nucleotide of the grpE coding sequence, suggesting that these two genes, although tandemly arranged, are transcribed separately. No promoter sequences resembling the E. coli consensus heat shock promoter could be identified upstream of either the C. trachomatis dnaK, grpE, or S18 gene. The induction of the dnaK and S18 mRNAs by heat shock occurred at a transcriptional level; their induction could be blocked by rifampin. The mechanisms of induction for these two loci were not the same, however; they were differentially sensitive to chloramphenicol. Whereas the induction of dnaK mRNA required de novo protein synthesis, the induction of the S18 mRNA did not. Thus, C. trachomatis

  3. Experimental shock metamorphism of maximum microcline

    NASA Technical Reports Server (NTRS)

    Robertson, P. B.

    1975-01-01

    A series of recovery experiments are conducted to study the behavior of single-crystal perthitic maximum microcline shock-loaded to a peak pressure of 417 kbar. Microcline is found to deform in a manner similar to quartz and other alkali feldspars. It is observed that shock-induced cleavages occur initially at or slightly below the Hugoniot elastic limit (60-85 kbar), that shock-induced rather than thermal disordering begins above the Hugoniot elastic limit, and that all types of planar elements form parallel to crystallographic planes of low Miller indices. When increasing pressure, it is found that bulk density, refractive indices, and birefringence of the recovered material decrease and approach diaplectic glass values, whereas disappearance and weakening of reflections in Debye-Sherrer patterns are due to disordering of the feldspar lattice.

  4. Nonlinear Interaction of the Solar Wind with Earth's Bow Shock

    NASA Astrophysics Data System (ADS)

    Parks, George; Yang, Zhongwei; Liu, Ying; Lee, Ensang; Lin, Naiguo; Fu, Suiyan; Cao, Jinbin; Canu, Patrick; Dandouras, Iannis; Reme, Henri; Goldstein, Melvyn

    2014-05-01

    The bow shock is the best-known collisionless shocks in nature. We have known from early on that the solar wind (SW) interaction with the bow shock produces gyrating and reflected particles. Some of these particles travel back into the upstream region, perturb the oncoming SW, and excite a host of nonlinear structures including hot flow anomalies, foreshock cavities and density holes. We have examined these nonlinear structures using data from 2003 when the four Cluster satellites were in a string-of-pearl configuration. We find that the nonlinear structures are evolving as they are convected with the solar wind toward Earth producing many shock-like features similar to those at the bow shock. Full 1D PIC simulation has reproduced many of the features, but the simulation requirements are different from observations. For example, the simulation shows that directly transmitted SW occurs only when the Mach number is small (sub-critical shocks). However, observations show that SW particles can penetrate the bow shock even in super-critical perpendicular shocks. This talk will discuss the new observations and simulation results with emphasis on understanding the SW dissipation mechanisms across the bow shock.

  5. Laser-shock damage of iron-based materials

    NASA Astrophysics Data System (ADS)

    Chu, Jinn P.; Banas, Grzegorz; Lawrence, Frederick V.; Rigsbee, James M.; Elsayed-Ali, Hani E.

    1993-05-01

    The effects of laser shock processing on the microstructure and mechanical properties of the manganese (1 percent C and 14 percent Mn) steels have been low carbon (0.04 wt. percent C) and Hadfield studied. Laser shock processing was performed with a 1.054 micrometers wavelength Nd-phosphate laser operating in a pulse mode (600 ps pulse length and up to 200 J energy) with power densities above 10 to the 11th power W/cm2. Shock waves were generated by volume expansion of the plasma formed when the material was laser irradiated. Maximum shock wave intensities were obtained using an energy-absorbing black paint coating without a plasma-confining overlay. Maximum modification of compressive residual stresses were achieved when laser shock processing induced deformation occurred without melting. Mechanical properties were improved through modifying the microstructure by laser shock processing. High density arrays of dislocations (greater than 10 to the 11th power/cm2) were generated in low carbon steel by high strain-rate deformation of laser shock processing, resulting in surface hardness increases of 30 to 80 percent. In austenitic Hadfield steel, laser shock processing caused extensive formation of Epsilon-hcp martensite (35 vol. percent), producing increases of 50 to 130 percent in surface hardness. The laser shock processing strengthening effect in Hadfield steel was attributed to the combined effects of the partial dislocation/stacking fault arrays and the grain refinement due to presence of the Epsilon-hcp martensite.

  6. Compaction shock dissipation in low density granular explosive

    NASA Astrophysics Data System (ADS)

    Rao, Pratap T.; Gonthier, Keith A.; Chakravarthy, Sunada

    2016-06-01

    The microstructure of granular explosives can affect dissipative heating within compaction shocks that can trigger combustion and initiate detonation. Because initiation occurs over distances that are much larger than the mean particle size, homogenized (macroscale) theories are often used to describe local thermodynamic states within and behind shocks that are regarded as the average manifestation of thermodynamic fields at the particle scale. In this paper, mesoscale modeling and simulation are used to examine how the initial packing density of granular HMX (C4H8N8O8) C4H8N8O8 having a narrow particle size distribution influences dissipation within resolved, planar compaction shocks. The model tracks the evolution of thermomechanical fields within large ensembles of particles due to pore collapse. Effective shock profiles, obtained by averaging mesoscale fields over space and time, are compared with those given by an independent macroscale compaction theory that predicts the variation in effective thermomechanical fields within shocks due to an imbalance between the solid pressure and a configurational stress. Reducing packing density is shown to reduce the dissipation rate within shocks but increase the integrated dissipated work over shock rise times, which is indicative of enhanced sensitivity. In all cases, dissipated work is related to shock pressure by a density-dependent power law, and shock rise time is related to pressure by a power law having an exponent of negative one.

  7. Ion transport in circulatory and/or septic shock

    SciTech Connect

    Sayeed, M.M.

    1987-05-01

    This review surveys investigations of membrane ion transport in animals in hemorrhagic, endotoxic, or bacteremic shock. The focus of the review is on ion transport studies in the skeletal muscle and liver. Skeletal muscle Na/sup +/-K/sup +/ transport alterations have been shown during the induction of shock via hemorrhage, endotoxin, or live Gram-negative bacteria in the rodent, canine, and primate species. These alterations include impairment of active cellular K/sup +/ accumulation, increased permeability to /sup 24/Na/sup +/ and Cl/sup -/, and membrane depolarization. The ion transport alterations in the skeletal muscle are compatible with movement of extracellular fluid into the intracellular compartment. Such fluid movements can potentially lead to decreases in circulating plasma volume and thus to circulatory deficits in shock. Studies in the liver of rats subjected to hemorrhagic or endotoxic shock indicated the failure of electrogenic Na/sup +/ pump. Although the hepatic cellular membrane permeability to Na/sup +/ relative to permeability to K/sup +/ appeared unaltered in hemorrhagic shock, endotoxic shock caused an increase in permeability to Na/sup +/. Hepatic cellular /sup 45/Ca/sup +/ regulation also appeared to be adversely affected during endotoxic shock. Alterations in hepatic Na/sup +/-K/sup +/ transport and Ca/sup +/ regulation could contribute to impairment in hepatic glucose production during shock. Although mechanisms of altered membrane ion transport during shock states remain unknown, such changes could occur prior to any substantial loss of cellular metabolic energy.

  8. Sotos syndrome.

    PubMed

    Baujat, Geneviève; Cormier-Daire, Valérie

    2007-01-01

    Sotos syndrome is an overgrowth condition characterized by cardinal features including excessive growth during childhood, macrocephaly, distinctive facial gestalt and various degrees of learning difficulty, and associated with variable minor features. The exact prevalence remains unknown but hundreds of cases have been reported. The diagnosis is usually suspected after birth because of excessive height and occipitofrontal circumference (OFC), advanced bone age, neonatal complications including hypotonia and feeding difficulties, and facial gestalt. Other inconstant clinical abnormalities include scoliosis, cardiac and genitourinary anomalies, seizures and brisk deep tendon reflexes. Variable delays in cognitive and motor development are also observed. The syndrome may also be associated with an increased risk of tumors. Mutations and deletions of the NSD1 gene (located at chromosome 5q35 and coding for a histone methyltransferase implicated in transcriptional regulation) are responsible for more than 75% of cases. FISH analysis, MLPA or multiplex quantitative PCR allow the detection of total/partial NSD1 deletions, and direct sequencing allows detection of NSD1 mutations. The large majority of NSD1 abnormalities occur de novo and there are very few familial cases. Although most cases are sporadic, several reports of autosomal dominant inheritance have been described. Germline mosaicism has never been reported and the recurrence risk for normal parents is very low (<1%). The main differential diagnoses are Weaver syndrome, Beckwith-Wiedeman syndrome, Fragile X syndrome, Simpson-Golabi-Behmel syndrome and 22qter deletion syndrome. Management is multidisciplinary. During the neonatal period, therapies are mostly symptomatic, including phototherapy in case of jaundice, treatment of the feeding difficulties and gastroesophageal reflux, and detection and treatment of hypoglycemia. General pediatric follow-up is important during the first years of life to allow detection

  9. Radio-Loud Coronal Mass Ejections Without Shocks Near Earth

    NASA Technical Reports Server (NTRS)

    Gopalswamy, N.; SaintCyr, O. C.; MacDowall, R. J.; Kaiser, M. L.; Xie, H.; Makela, P.; Akiyama, S.

    2010-01-01

    Type II radio bursts are produced by low energy electrons accelerated in shocks driven by corona) mass ejections (CMEs). One can infer shocks near the Sun, in the Interplanetary medium, and near Earth depending on the wavelength range in which the type II bursts are produced. In fact, type II bursts are good indicators of CMEs that produce solar energetic particles. If the type 11 burst occurs from a source on the Earth-facing side of the solar disk, it is highly likely that a shock arrives at Earth in 2-3 days and hence can be used to predict shock arrival at Earth. However, a significant fraction of CMEs producing type II bursts were not associated shocks at Earth, even though the CMEs originated close to the disk center. There are several reasons for the lack of shock at 1 AU. CMEs originating at large central meridian distances (CMDs) may be driving a shock, but the shock may not be extended sufficiently to reach to the Sun-Earth line. Another possibility is CME cannibalism because of which shocks merge and one observes a single shock at Earth. Finally, the CME-driven shock may become weak and dissipate before reaching 1 AU. We examined a set of 30 type II bursts observed by the Wind/WAVES experiment that had the solar sources very close to the disk center (within a CMD of 15 degrees), but did not have shock at Earth. We find that the near-Sun speeds of the associated CMEs average to approx.600 km/s, only slightly higher than the average speed of CMEs associated with radio-quiet shocks. However, the fraction of halo CMEs is only approx.28%, compared to 40% for radio-quiet shocks and 72% for all radio-loud shocks. We conclude that the disk-center radio loud CMEs with no shocks at 1 AU are generally of lower energy and they drive shocks only close to the Sun.

  10. Shock/shock interference on a transpiration cooled hemispherical model

    NASA Technical Reports Server (NTRS)

    Nowak, Robert J.; Wieting, Allan R.; Holden, Michael S.

    1990-01-01

    Experimental results are presented which show the effectiveness of transpiration cooling in reducing the peak heat flux caused by an impinging shock on a bow shock of a hemispherical model. The 12-inch diameter hemispherical transpiration model with helium coolant was tested in the Calspan 48-inch Hypersonic Shock Tunnel at nominal Mach 12.1 and freestream unit Reynolds number of 0.33 x 10 to the 6th/ft. An incident shock wave, generated by a blunt flat-plate shock generator inclined at 10 deg to the freestream, intersected the bow shock of the model to produce shock/shock interference. The stagnation heat flux without coolant or shock/shock interference was about 1.6 times a smooth surface laminar prediction due to effective roughness of the coolant ejection slots. A coolant mass flux 31 percent of the freestream mass flux reduced the stagnation heat flux to zero without shock/shock interference. However, for the same coolant mass flux and with shock/shock interference the peak heat flux was only reduced 8.3 percent, even though the total integrated heat load was reduced.

  11. Caffeine, a naturally occurring acaricide.

    PubMed

    Russell, D W; Fernández-Caldas, E; Swanson, M C; Seleznick, M J; Trudeau, W L; Lockey, R F

    1991-01-01

    Since caffeine is a plant alkaloid that has been described as a naturally occurring insecticide, its acaricidal effect on Dermatophagoides pteronyssinus (Dp) was investigated. Twelve cultures were established by adding 30 Dp to 200 mg of Tetramin fish food and brewer's yeast (8:2 ratio); six cultures were treated with 20 mg of finely ground caffeine. All 12 cultures were incubated at 75% relative humidity, 25 degrees C, and observed during 8 weeks. Live mites were then counted under a stereoscope, cultures were extracted, and supernatants were analyzed for Der p I and Der f I allergen content with a two-site monoclonal RIA. Live mite counts in untreated cultures varied from 146 to 274 (215 +/- 47.1), and in caffeine-treated cultures from 0 to 3 (1 +/- 1.2; p less than or equal to 0.0001). Der p I concentrations in untreated cultures varied from 588 to 9000 ng/gm (3138.3 +/- 2990.8 ng/gm), and in caffeine-treated cultures from 52 to 117 ng/gm (78 +/- 23.8 ng/gm; p less than or equal to 0.01). Der p I was not detected in the food media or caffeine; Der f I was not detected in any of the cultures. Results demonstrate that caffeine inhibits mite growth and allergen production.

  12. Takotsubo Cardiomyopathy (Broken-Heart Syndrome): A Short Review.

    PubMed

    Potu, Kalyan Chakravarthy; Raizada, Amol; Gedela, Maheedhar; Stys, Adam

    2016-04-01

    Takotsubo cardiomyopathy, also called "broken heart" syndrome or apical ballooning syndrome, is a reversible cardiomyopathy characterized by left ventricular dysfunction and ballooning of the left ventricular apex on imaging during systole. It predominantly occurs in post-menopausal women and is commonly associated with emotional or physical stress. Patients commonly present with chest pain and electrocardiographic evidence of ST segment elevation or T-wave-mimicking acute coronary syndrome, but with an absence of angiographic evidence of obstructive coronary disease. The exact cause is unknown, but potential contributors include catecholamine excess and sympathetic nervous system hyperactivity. There is no consensus on pharmacological treatment of takotsubo cardiomyopathy. Based on the suspected pathophysiology of the disease, adrenergic blockade using beta-blocker therapy is employed. Near complete resolution of left ventricular wall motion dyskinesis occurs in the majority of takotsubo cardiomyopathy patients within a month. Although the prognosis is generally favorable, there are reports of complications during the acute phase, including cardiogenic shock, pulmonary edema, ventricular tachycardia, apical thrombus formation, and death. This review article will briefly discuss the epidemiology, etiology, clinical features, diagnostic evaluation, and treatment of this condition. PMID:27263165

  13. Shock structure and shock heating in the Galactic central molecular zone

    NASA Astrophysics Data System (ADS)

    Ott, Jürgen; Burton, Michael; Jones, Paul; Meier, David S.

    2014-05-01

    We present maps of a large number of dense molecular gas tracers across the central molecular zone of our Galaxy. The data were taken with the CSIRO/CASS Mopra telescope in Large Projects in the 1.3 cm, 7 mm, and 3 mm wavelength regimes. Here, we focus on the brightness of the shock tracers SiO and HNCO, molecules that are liberated from dust grains under strong (SiO) and weak (HNCO) shocks. The shocks may have occurred when the gas enters the bar regions and the shock differences could be due to differences in the moving cloud masses. Based on tracers of ionizing photons, it is unlikely that the morphological differences are due to selective photo-dissociation of the molecules. We also observe direct heating of molecular gas in strongly shocked zones, with high SiO/HNCO ratios, where temperatures are determined from the transitions of ammonia. Strong shocks appear to be the most efficient heating source of molecular gas, apart from high energy emission emitted by the central supermassive black hole Sgr A* and the processes within the extreme star formation region Sgr B2.

  14. Shock wave treatment in medicine.

    PubMed

    Shrivastava, S K; Kailash

    2005-03-01

    Extracorporeal shock wave therapy in orthopedics and traumatology is still a young therapy method. Since the last few years the development of shock wave therapy has progressed rapidly. Shock waves have changed the treatment of urolithiasis substantially. Today shock waves are the first choice to treat kidney and urethral stones. Urology has long been the only medical field for shock waves in medicine. Meanwhile shock waves have been used in orthopedics and traumatology to treat insertion tendinitis, avascular necrosis of the head of femur and other necrotic bone alterations. Another field of shock wave application is the treatment of tendons, ligaments and bones on horses in veterinary medicine. In the present paper we discuss the basic theory and application of shock waves and its history in medicine. The idea behind using shock wave therapy for orthopedic diseases is the stimulation of healing in tendons, surrounding tissue and bones. PMID:15933416

  15. Large scale motions of Neptune's bow shock: Evidence for control of the shock position by the rotation phase of Neptune's magnetic field

    NASA Technical Reports Server (NTRS)

    Cairns, Iver H.; Smith, Charles W.; Kurth, William S.; Gurnett, Donald A.; Moses, Stewart L.

    1991-01-01

    The Voyager 2 spacecraft observed high levels of Langmuir waves before the inbound crossing of Neptune's bow shock, thereby signifying magnetic connection of the bow shock. The Langmuir waves occurred in multiple bursts throughout two distinct periods separated by an 85 minute absence of wave activity. The times of onsets, peaks, and disappearances of the waves were used together with the magnetic field directions and spacecraft position, to perform a 'remote-sensing' analysis of the shape and location of Neptune's bow shock prior to the inbound bow shock crossing. The bow shock is assumed to have a parabolidal shape with a nose location and flaring parameter determined independently for each wave event. The remote-sensing analysis give a shock position consistent with the time of the inbound shock crossing. The flaring parameter of the shock remains approximately constant throughout each period of wave activity but differs by a factor of 10 between the two periods. The absence of waves between two periods of wave activity coincides with a large rotation of the magnetic field and a large increase in the solar wind ram pressure' both these effects lead to magnetic disconnection of the spacecraft from shock. The planetwards motion of the shock's nose from 38.5 R(sub N) to 34.5 R(sub N) during the second time period occurred while the solar wind ram pressure remained constant to within 15 percent. This second period of planetwards motion of the shock is therefore strong evidence for Neptune's bow shock moving in response to the rotation of Neptune's oblique, tilted magnetic dipole. Normalizing the ram pressure, the remotely-sensed shock moves sunwards during the first wave period and planetwards in the second wave period. The maximum standoff distance occurs while the dipole axis is close to being perpendicular to the Sun-Neptune direction. The remote-sensing analysis provides strong evidence that the location of Neptune's bow shock is controlled by Neptune's rotation

  16. Shocks in fragile matter

    NASA Astrophysics Data System (ADS)

    Vitelli, Vincenzo

    2012-02-01

    Non-linear sound is an extreme phenomenon typically observed in solids after violent explosions. But granular media are different. Right when they unjam, these fragile and disordered solids exhibit vanishing elastic moduli and sound speed, so that even tiny mechanical perturbations form supersonic shocks. Here, we perform simulations in which two-dimensional jammed granular packings are continuously compressed, and demonstrate that the resulting excitations are strongly nonlinear shocks, rather than linear waves. We capture the full dependence of the shock speed on pressure and compression speed by a surprisingly simple analytical model. We also treat shear shocks within a simplified viscoelastic model of nearly-isostatic random networks comprised of harmonic springs. In this case, anharmonicity does not originate locally from nonlinear interactions between particles, as in granular media; instead, it emerges from the global architecture of the network. As a result, the diverging width of the shear shocks bears a nonlinear signature of the diverging isostatic length associated with the loss of rigidity in these floppy networks.

  17. LOW AMPLITUDE SINGLE AND MULTIPLE SHOCK INITIATION EXPERIMENTS AND MODELING OF LX-04

    SciTech Connect

    Vandersall, K S; Tarver, C M; Garcia, F; Chidester, S; Urtiew, P A; Forbes, J W

    2006-06-27

    Shock initiation experiments were performed on the plastic bonded explosive (PBX) LX-04 (85% HMX, 15% Viton binder) using single and multiple low amplitude shocks to obtain pressure history data for use in Ignition and Growth reactive flow modeling parameterization. A 100 mm diameter propellant driven gas gun was utilized to initiate the LX-04 explosive charges containing manganin piezoresistive pressure gauge packages placed between explosive discs. In the single shock experiments, the run distances to detonation at three shock pressures showed agreement with previously published data above 3 GPa. Even longer run distances to detonation were measured using 80 mm long by 145 mm diameter LX-04 charges impacted by low velocity projectiles from a 155 mm diameter gun. The minimum shock pressure required to cause low levels of exothermic reaction were determined for these large LX-04 charge dimensions. Multiple shocks were generated as double shocks by using a flyer plate with two materials and as reflected shocks by placing a high impedance material at the rear of the explosive charge. In both cases, the first shock pressure was not high enough to cause detonation of LX-04, and the second shock pressure, which would have been sufficient to cause detonation if generated by a single shock, failed to cause detonation. Thus LX-04 exhibited shock desensitization over a range of 0.6 to 1.4 GPa. The higher shock pressure LX-04 model was extended to accurately simulate these lower pressure and multiple shock gauge records. The shock desensitization effects observed with multiple shock compressions were partially accounted for in the model by using a critical compression corresponding to a shock pressure of 1.2 GPa. This shock desensitization effect occurs at higher pressures than those of other HMX-based PBX's containing higher HMX percentages.

  18. Extreme geomagnetic disturbances due to shocks within CMEs

    NASA Astrophysics Data System (ADS)

    Lugaz, N.; Farrugia, C. J.; Huang, C.-L.; Spence, H. E.

    2015-06-01

    We report on features of solar wind-magnetosphere coupling elicited by shocks propagating through coronal mass ejections (CMEs) by analyzing the intense geomagnetic storm of 6 August 1998. During this event, the dynamic pressure enhancement at the shock combined with a simultaneous increase in the southward component of the magnetic field resulted in a large earthward retreat of Earth's magnetopause, which remained close to geosynchronous orbit for more than 4 h. This occurred despite the fact that both shock and CME were weak and relatively slow. Another similar example of a weak shock inside a slow CME resulting in an intense geomagnetic storm is the 30 September 2012 event, which strongly depleted the outer radiation belt. We discuss the potential of shocks inside CMEs to cause large geomagnetic effects at Earth, including magnetopause shadowing.

  19. Multiple spacecraft observations of interplanetary shocks: Characteristics of the upstream ULF turbulence

    NASA Technical Reports Server (NTRS)

    Russell, C. T.; Smith, E. J.; Tsurutani, B. T.; Gosling, J. T.; Bame, S. J.

    1983-01-01

    All interplanetary shocks observed by ISEE-3 and either ISEE-1 or ISEE-2 or both in 1978 and 1979 are examined for evidence of upstream waves. In order to characterize the properties of these shocks it is necessary to determine accurate shock normals. An overdetermined set of equations were inverted to obtain shock normals, velocities and error estimates for all these shocks. Tests of the method indicate it is quite reliable. Using these normals the Mach number and angle were between the interplanetary magnetic field and the shock normal for each shock. The upstream waves were separated into two classes: whistler mode precursors which occur at low Mach numbers and upstream turbulence whose amplitude at Mach numbers greater than 1.5 is controlled by the angle of the field to the shock normal. The former waves are right hand circularly polarized and quite monochromatic. The latter waves are more linearly polarized and have a broadband featureless spectrum.

  20. Intense laser driven collision-less shock and ion acceleration in magnetized plasmas

    NASA Astrophysics Data System (ADS)

    Mima, K.; Jia, Q.; Cai, H. B.; Taguchi, T.; Nagatomo, H.; Sanz, J. R.; Honrubia, J.

    2016-05-01

    The generation of strong magnetic field with a laser driven coil has been demonstrated by many experiments. It is applicable to the magnetized fast ignition (MFI), the collision-less shock in the astrophysics and the ion shock acceleration. In this paper, the longitudinal magnetic field effect on the shock wave driven by the radiation pressure of an intense short pulse laser is investigated by theory and simulations. The transition of a laminar shock (electro static shock) to the turbulent shock (electromagnetic shock) occurs, when the external magnetic field is applied in near relativistic cut-off density plasmas. This transition leads to the enhancement of conversion of the laser energy into high energy ions. The enhancement of the conversion efficiency is important for the ion driven fast ignition and the laser driven neutron source. It is found that the total number of ions reflected by the shock increases by six time when the magnetic field is applied.

  1. Transport of Solar Wind H+ and He++ Ions across Earth’s Bow Shock

    NASA Astrophysics Data System (ADS)

    Parks, G. K.; Lee, E.; Fu, S. Y.; Kim, H. E.; Ma, Y. Q.; Yang, Z. W.; Liu, Y.; Lin, N.; Hong, J.; Canu, P.; Dandouras, I.; Rème, H.; Goldstein, M. L.

    2016-07-01

    We have investigated the dependence of mass, energy, and charge of solar wind (SW) transport across Earth’s bow shock. An examination of 111 crossings during quiet SW in both quasi-perpendicular and quasi-parallel shock regions shows that 64 crossings had various degrees of heating and thermalization of SW. We found 22 crossings where the SW speed was <400 km s‑1. The shock potential of a typical supercritical quasi-perpendicular shock estimated from deceleration of the SW and cutoff energy of electron flat top distribution is ˜50 Volts. We find that the temperatures of H+ and He++ beams that penetrate the shock can sometimes be nearly the same in the upstream and downstream regions, indicating little or no heating had occurred crossing the bow shock. None of the models predict that the SW can cross the bow shock without heating. Our observations are important constraints for new models of collisionless shocks.

  2. High-speed helicopter rotor noise - Shock waves as a potent source of sound

    NASA Technical Reports Server (NTRS)

    Farassat, F.; Lee, Yung-Jang; Tadghighi, H.; Holz, R.

    1991-01-01

    In this paper we discuss the problem of high speed rotor noise prediction. In particular, we propose that from the point of view of the acoustic analogy, shocks around rotating blades are sources of sound. We show that, although for a wing at uniform steady rectilinear motion with shocks the volume quadrupole and shock sources cancel in the far field to the order of 1/r, this cannot happen for rotating blades. In this case, some cancellation between volume quadrupoles and shock sources occurs, yet the remaining shock noise contribution is still potent. A formula for shock noise prediction is presented based on mapping the deformable shock surface to a time independent region. The resulting equation is similar to Formulation 1A of Langley. Shock noise prediction for a hovering model rotor for which experimental noise data exist is presented. The comparison of measured and predicted acoustic data shows good agreement.

  3. Free boundary problems in shock reflection/diffraction and related transonic flow problems.

    PubMed

    Chen, Gui-Qiang; Feldman, Mikhail

    2015-09-13

    Shock waves are steep wavefronts that are fundamental in nature, especially in high-speed fluid flows. When a shock hits an obstacle, or a flying body meets a shock, shock reflection/diffraction phenomena occur. In this paper, we show how several long-standing shock reflection/diffraction problems can be formulated as free boundary problems, discuss some recent progress in developing mathematical ideas, approaches and techniques for solving these problems, and present some further open problems in this direction. In particular, these shock problems include von Neumann's problem for shock reflection-diffraction by two-dimensional wedges with concave corner, Lighthill's problem for shock diffraction by two-dimensional wedges with convex corner, and Prandtl-Meyer's problem for supersonic flow impinging onto solid wedges, which are also fundamental in the mathematical theory of multidimensional conservation laws. PMID:26261363

  4. Free boundary problems in shock reflection/diffraction and related transonic flow problems

    PubMed Central

    Chen, Gui-Qiang; Feldman, Mikhail

    2015-01-01

    Shock waves are steep wavefronts that are fundamental in nature, especially in high-speed fluid flows. When a shock hits an obstacle, or a flying body meets a shock, shock reflection/diffraction phenomena occur. In this paper, we show how several long-standing shock reflection/diffraction problems can be formulated as free boundary problems, discuss some recent progress in developing mathematical ideas, approaches and techniques for solving these problems, and present some further open problems in this direction. In particular, these shock problems include von Neumann's problem for shock reflection–diffraction by two-dimensional wedges with concave corner, Lighthill's problem for shock diffraction by two-dimensional wedges with convex corner, and Prandtl-Meyer's problem for supersonic flow impinging onto solid wedges, which are also fundamental in the mathematical theory of multidimensional conservation laws. PMID:26261363

  5. Transport of Solar Wind H+ and He++ Ions across Earth’s Bow Shock

    NASA Astrophysics Data System (ADS)

    Parks, G. K.; Lee, E.; Fu, S. Y.; Kim, H. E.; Ma, Y. Q.; Yang, Z. W.; Liu, Y.; Lin, N.; Hong, J.; Canu, P.; Dandouras, I.; Rème, H.; Goldstein, M. L.

    2016-07-01

    We have investigated the dependence of mass, energy, and charge of solar wind (SW) transport across Earth’s bow shock. An examination of 111 crossings during quiet SW in both quasi-perpendicular and quasi-parallel shock regions shows that 64 crossings had various degrees of heating and thermalization of SW. We found 22 crossings where the SW speed was <400 km s-1. The shock potential of a typical supercritical quasi-perpendicular shock estimated from deceleration of the SW and cutoff energy of electron flat top distribution is ˜50 Volts. We find that the temperatures of H+ and He++ beams that penetrate the shock can sometimes be nearly the same in the upstream and downstream regions, indicating little or no heating had occurred crossing the bow shock. None of the models predict that the SW can cross the bow shock without heating. Our observations are important constraints for new models of collisionless shocks.

  6. Cushing syndrome due to adrenal tumor

    MedlinePlus

    Adrenal tumor - Cushing syndrome ... Cushing syndrome is a disorder that occurs when your body has a higher than normal level of the ... or cancerous (malignant). Noncancerous tumors that can cause ... Adrenal adenomas Micronodular hyperplasia Cancerous tumors that ...

  7. The first MEMIN shock recovery experiments at low shock pressure (5-12.5 GPa) with dry, porous sandstone

    NASA Astrophysics Data System (ADS)

    Kowitz, Astrid; Schmitt, Ralf T.; Uwe Reimold, W.; Hornemann, Ulrich

    2013-01-01

    As part of the MEMIN research program this project is focused on shock deformation experimentally generated in dry, porous Seeberger sandstone in the low shock pressure range from 5 to 12.5 GPa. Special attention is paid to the influence of porosity on progressive shock metamorphism. Shock recovery experiments were carried out with a high-explosive set-up that generates a planar shock wave, and using the shock impedance method. Cylinders of sandstone of average grain size of 0.17 mm and porosity of about 19 vol%, and containing some 96 wt% SiO2, were shock deformed. Shock effects induced with increasing shock pressure include: (1) Already at 5 GPa the entire pore space is closed; quartz grains show undulatory extinction. On average, 134 fractures per mm are observed. Dark vesicular melt (glass) of the composition of the montmorillonitic phyllosilicate component of this sandstone occurs at an average amount of 1.6 vol%. (2) At 7.5 GPa, quartz grains show weak but prominent mosaicism and the number of fractures increases to 171 per millimeter. Two additional kinds of melt, both based on phyllosilicate precursor, could be observed: a light colored, vesicular melt and a melt containing large iron particles. The total amount of melt (all types) increased in this experiment to 2.4 vol%. Raman spectroscopy confirmed the presence of shock-deformed quartz grains near the surface. (3) At 10 and 12.5 GPa, quartz grains also show weak but prominent mosaicism, the number of fractures per mm has reached a plateau value of approximately 200, and the total amount of the different melt types has increased to 4.8 vol%. Diaplectic quartz glass could be observed locally near the impacted surface. In addition, local shock effects, most likely caused by multiple shock wave reflections at sandstone-container interfaces, occur throughout the sample cylinders and include locally enhanced formation of PDF, as well as shear zones associated with cataclastic microbreccia, diaplectic quartz

  8. A case of Plummer-Vinson syndrome in childhood.

    PubMed

    Anthony, R; Sood, S; Strachan, D R; Fenwick, J D

    1999-10-01

    The Plummer-Vinson syndrome is characterized by an association of dysphagia, iron-deficiency anemia, and esophageal webs. The authors report the case of a 6 year old with Plummer-Vinson syndrome. Plummer-Vinson syndrome usually occurs in adults, rarely in adolescents, however, there have been no previous reports in the English-language literature of the syndrome occurring in childhood.

  9. TIMING OF SHOCK WAVES

    DOEpatents

    Tuck, J.L.

    1955-03-01

    This patent relates to means for ascertaining the instant of arrival of a shock wave in an exploslve charge and apparatus utilizing this means to coordinate the timing of two operations involving a short lnterval of time. A pair of spaced electrodes are inserted along the line of an explosive train with a voltage applied there-across which is insufficient to cause discharge. When it is desired to initiate operation of a device at the time the explosive shock wave reaches a particular point on the explosive line, the device having an inherent time delay, the electrodes are located ahead of the point such that the ionization of the area between the electrodes caused by the traveling explosive shock wave sends a signal to initiate operation of the device to cause it to operate at the proper time. The operated device may be photographic equipment consisting of an x-ray illuminating tube.

  10. Life Shocks and Homelessness

    PubMed Central

    Corman, Hope; Noonan, Kelly; Reichman, Nancy E.

    2014-01-01

    We exploited an exogenous health shock—namely, the birth of a child with a severe health condition—to investigate the effect of a life shock on homelessness in large cities in the United States as well as the interactive effects of the shock with housing market characteristics. We considered a traditional measure of homelessness, two measures of housing instability thought to be precursors to homelessness, and a combined measure that approximates the broadened conceptualization of homelessness under the 2009 Homeless Emergency Assistance and Rapid Transition to Housing Act (2010). We found that the shock substantially increases the likelihood of family homelessness, particularly in cities with high housing costs. The findings are consistent with the economic theory of homelessness, which posits that homelessness results from a conjunction of adverse circumstances in which housing markets and individual characteristics collide. PMID:23868747

  11. Review of the refeeding syndrome.

    PubMed

    Kraft, Michael D; Btaiche, Imad F; Sacks, Gordon S

    2005-12-01

    Refeeding syndrome describes a constellation of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished. Patients can develop fluid and electrolyte disorders, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications. We reviewed literature on refeeding syndrome and the associated electrolyte abnormalities, fluid disturbances, and associated complications. In addition to assessing scientific literature, we also considered clinical experience and judgment in developing recommendations for prevention and treatment of refeeding syndrome. The most important steps are to identify patients at risk for developing refeeding syndrome, institute nutrition support cautiously, and correct and supplement electrolyte and vitamin deficiencies to avoid refeeding syndrome. We provide suggestions for the prevention of refeeding syndrome and suggestions for treatment of electrolyte disturbances and complications in patients who develop refeeding syndrome, according to evidence in the literature, the pathophysiology of refeeding syndrome, and clinical experience and judgment.

  12. Shock destruction armor system

    DOEpatents

    Froeschner, Kenneth E.

    1993-01-01

    A shock destruction armor system is constructed and arranged to destroy the force of impact of a projectile by shock hydrodynamics. The armor system is designed to comprise a plurality of superimposed armor plates each preferably having a thickness less than five times the projectile's diameter and are preferably separated one-from-another by a distance at least equal to one-half of the projectile's diameter. The armor plates are effective to hydrodynamically and sequentially destroy the projectile. The armor system is particularly adapted for use on various military vehicles, such as tanks, aircraft and ships.

  13. MIDAS syndrome respectively MLS syndrome: A separate entity rather than a particular lyonization pattern of the gene causing Goltz syndrome

    SciTech Connect

    Muecke, J.; Happle, R.; Theile, H.

    1995-05-22

    Although it is true that MIDAS syndrome, Aicardi syndrome and Goltz syndrome show the same transmission, representing X-linked dominant traits with lethality of hemizygote male embryos, and have a number of anomalies such as defects of the eyes or brain in common, it should be noted that MIDAS syndrome and Goltz syndrome have so far never occurred as alternating phenotypes within the same family. In addition, the observation of MIDAS syndrome in a mother and her daughter lends additional support to the notion that this syndrome represents a distinct entity. 3 refs., 4 figs.

  14. Impact-shocked zircons: Discovery of shock-induced textures reflecting increasing degrees of shock metamorphism

    NASA Technical Reports Server (NTRS)

    Bohor, B. F.; Betterton, W. J.; Krogh, T. E.

    1993-01-01

    Textural effects specifically characteristic of shock metamorphism in zircons from impact environments have not been reported previously. However, planar deformation features (PDF) due to shock metamorphism are well documented in quartz and other mineral grains from these same environments. An etching technique was developed that allows scanning electron microscope (SEM) visualization of PDF and other probable shock-induced textural features, such as granular (polycrystalline) texture, in zircons from a variety of impact shock environments. These textural features in shocked zircons from K/T boundary distal ejecta form a series related to increasing degrees of shock that should correlate with proportionate resetting of the U-Pb isotopic system.

  15. Impact-shocked zircons: discovery of shock-induced textures reflecting increasing degrees of shock metamorphism

    USGS Publications Warehouse

    Bohor, B.F.; Betterton, W.J.; Krogh, T.E.

    1993-01-01

    Textural effects specifically characteristic of shock metamorphism in zircons from impact environments have not been reported previously. However, planar deformation features (PDF) due to shock metamorphism are well documented in quartz and other mineral grains from these same environments. An etching technique was developed that allows SEM visualization of PDF and other probable shock-induced textural features, such as granular (polycrystalline) texture, in zircons from a variety of impact shock environments. These textural features in shocked zircons from K/T boundary distal ejecta form a series related to increasing degrees of shock that should correlate with proportionate resetting of the UPb isotopic system. ?? 1993.

  16. Introduction to Plasma Dynamo, Reconnection and Shocks

    SciTech Connect

    Intrator, Thomas P.

    2012-08-30

    In our plasma universe, most of what we can observe is composed of ionized gas, or plasma. This plasma is a conducting fluid, which advects magnetic fields when it flows. Magnetic structure occurs from the smallest planetary to the largest cosmic scales. We introduce at a basic level some interesting features of non linear magnetohydrodynamics (MHD). For example, in our plasma universe, dynamo creates magnetic fields from gravitationally driven flow energy in an electrically conducting medium, and conversely magnetic reconnection annihilates magnetic field and accelerates particles. Shocks occur when flows move faster than the local velocity (sonic or Alfven speed) for the propagation of information. Both reconnection and shocks can accelerate particles, perhaps to gigantic energies, for example as observed with 10{sup 20} eV cosmic rays.

  17. Jadeite formation in shocked ordinary chondrites

    NASA Astrophysics Data System (ADS)

    Miyahara, Masaaki; Ozawa, Shin; Ohtani, Eiji; Kimura, Makoto; Kubo, Tomoaki; Sakai, Takeshi; Nagase, Toshiro; Nishijima, Masahiko; Hirao, Naohisa

    2013-07-01

    Albitic feldspar in shocked ordinary chondrites (Yamato 791384 L6 and Yamato 75100 H6) and albite recovered from static high-pressure and high-temperature synthetic experiments (Kubo et al., 2010) were investigated with a transmission electron microscope (TEM) subsequent to a conventional micro-Raman spectroscopy analysis to clarify albite dissociation reaction under high-pressure and high-temperature condition. When jadeite forms from albite, SiO2 phase as a residual phase of albite dissociation reaction should accompany jadeite from the stoichiometry. However, albitic feldspar in and adjacent to shock-melt veins of the shocked chondrites dissociates into jadeite+residual amorphous (or poorly-crystallized) material having varied chemical compositions between jadeite and SiO2 phase. TEM observations of albitic feldspar in the shocked chondrites and albite recovered from the static high-pressure and high-temperature synthetic experiments show that jadeite crystallization is initiated by grain refinement of albite (or albitic feldspar). Nucleation occurs along grain-boundaries or at triple-junctions of the fine-grained albite crystal assemblage. Jadeite crystal starts to grow from the nucleus through grain-boundary diffusion. Considering pressure condition recorded in the shock-melt veins of the shocked chondrites, stishovite is the most likely as a residual SiO2 phase accompanying jadeite. High-pressure and high-temperature condition induced by a dynamic event is very short. Stishovite would be hardy formed through a dynamic event due to sluggish nucleation rate of stishovite compared with that of jadeite, thus leading to induce heterogeneous and incomplete albite dissociation reaction; albite dissociates into jadeite+residual amorphous material.

  18. Hantaviruses and cardiopulmonary syndrome in South America.

    PubMed

    Figueiredo, Luiz Tadeu Moraes; Souza, William Marciel de; Ferrés, Marcela; Enria, Delia Alcira

    2014-07-17

    Hantavirus (Bunyaviridae) cardiopulmonary syndrome (HCPS) is an emerging health problem in South America due to urban growth and to the expansion of agriculture and cattle-raising areas into ecosystems containing most of the species of Sigmodontinae rodents that act as hantavirus reservoirs. About 4000 HCPS cases have been reported in South America up to 2013, associated with the following hantaviruses: Andes, Anajatuba, Araraquara (ARQV), Paranoá, Bermejo, Castelo dos Sonhos, Juquitiba, Araucária, Laguna Negra, Lechiguanas, Maripa, Oran, Rio Mamore and Tunari. The transmission of hantavirus to man occurs by contact with or through aerosols of excreta and secretions of infected rodents. Person-to-person transmission of hantavirus has also been reported in Argentina and Chile. HCPS courses with a capillary leaking syndrome produced by the hantavirus infecting lung endothelial cells and mostly with a severe inflammatory process associated with a cytokine storm. HCPS starts as a dengue-like acute febrile illness but after about 3 days progresses to respiratory failure and cardiogenic shock, leading to a high fatality rate that reaches 50% for patients infected with ARQV.

  19. Shock compression and equation of state of C60 fullerite

    NASA Astrophysics Data System (ADS)

    Milyavskiy, Vladimir; Khishchenko, Konstantin; Utkin, Alexander; Yakushev, Vladislav; Zhuk, Andrey; Fortov, Vladimir

    2007-06-01

    Recently, we have experimentally studied shock compressibility of C60 fullerite and sound velocity in shock-compressed fullerite [1]. The Hugoniot of C60 fullerite had a set of peculiarities. Appearance of a rather hard carbon phase was detected at shock pressure ˜ 9 GPa. We assume that it is a 2D-polymerized C60 phase. With increase of shock pressure, destruction of this phase and formation of a graphite-like carbon occurs. With further increase of shock pressure, the graphite- like carbon transforms to a diamond-like phase. If shock pressure is higher than ˜ 33 GPa, shock compressibility of C60 fullerite is determined by the thermodynamic properties of the diamond-like phase. The results of the shock-wave measurements were used for the description of thermodynamic properties of C60 fullerite and products of its transformations in a wide range of pressures and temperatures. A semiempirical equation of state for the simple cubic phase of C60 fullerite is proposed. The EOS we have developed for fullerite C60 provides a consistent representation of the available experimental data. The work was supported by RFBR. [1] Milyavskiy V.V., Utkin A.V., Zhuk A.Z., Yakushev V.V. and Fortov V.E. Diamond and Rel. Mat. 14 (2005) 1920.

  20. Nonstandard jump functions for radially symmetric shock waves

    SciTech Connect

    Baty, Roy S.; Tucker, Don H.; Stanescu, Dan

    2008-10-01

    Nonstandard analysis is applied to derive generalized jump functions for radially symmetric, one-dimensional, magnetogasdynamic shock waves. It is assumed that the shock wave jumps occur on infinitesimal intervals, and the jump functions for the physical parameters occur smoothly across these intervals. Locally integrable predistributions of the Heaviside function are used to model the flow variables across a shock wave. The equations of motion expressed in nonconservative form are then applied to derive unambiguous relationships between the jump functions for the physical parameters for two families of self-similar flows. It is shown that the microstructures for these families of radially symmetric, magnetogasdynamic shock waves coincide in a nonstandard sense for a specified density jump function

  1. Nonstandard jump functions for radically symmetric shock waves

    SciTech Connect

    Baty, Roy S; Tucker, Don H; Stanescu, Dan

    2008-01-01

    Nonstandard analysis is applied to derive generalized jump functions for radially symmetric, one-dimensional, magnetogasdynamic shock waves. It is assumed that the shock wave jumps occur on infinitesimal intervals and the jump functions for the physical parameters occur smoothly across these intervals. Locally integrable predistributions of the Heaviside function are used to model the flow variables across a shock wave. The equations of motion expressed in nonconservative form are then applied to derive unambiguous relationships between the jump functions for the physical parameters for two families of self-similar flows. It is shown that the microstructures for these families of radially symmetric, magnetogasdynamic shock waves coincide in a nonstandard sense for a specified density jump function.

  2. Shock-induced separation of adiabatic turbulent boundary layers in supersonic axially symmetric internal flow

    NASA Technical Reports Server (NTRS)

    Page, R. J.; Childs, M. E.

    1974-01-01

    An experimental investigation at Mach 4 of shock-induced turbulent boundary layer separation at the walls of axially symmetric flow passages is discussed, with particular emphasis placed on determining the shock strengths required for incipient separation. The shock waves were produced by interchangeable sting-mounted cones placed on the axes of the flow passages and aligned with the freestream flow. The interactions under study simulate those encountered in axially symmetric engine inlets of supersonic aircraft. Knowledges of the shock strengths required for boundary layer separation in inlets is important since for shocks of somewhat greater strength rather drastic alterations in the inlet flow field may occur.

  3. Role of molecular dynamics on descriptions of shock-front processes

    SciTech Connect

    Karo, A.M.

    1981-07-22

    By means of a computational approach based on classical molecular dynamics, we can begin to form a realistic picture of shock-induced processes occurring at the shock front and resulting from the detailed, violent motion associated with shock motion on an atomic scale. Prototype studies of phase transitions will be discussed. We will also examine the interaction of the shock front with defects, surfaces, voids, and inclusions, and across grain boundaries. We will focus on the critical question of how mechanical energy imparted to a condensed material by shock loading is converted to the activation energy required to overcome some initial energy barrier in an initiation process.

  4. Interplanetary shocks and foreshocks observed by STEREO during 2007-2010

    NASA Astrophysics Data System (ADS)

    Blanco-Cano, X.; Kajdič, P.; Aguilar-Rodríguez, E.; Russell, C. T.; Jian, L. K.; Luhmann, J. G.

    2016-02-01

    Interplanetary shocks in the heliosphere modify the solar wind through which they pass. In particular, shocks play an important role in particle acceleration. During the extended solar minimum (2007-2010) STEREO observed 65 forward shocks driven by stream interactions (SI), with magnetosonic Mach numbers Mms ≈ 1.1-4.0 and shock normal angles θBN ~ 20-87°. We analyze the waves associated with these shocks and find that the region upstream can be permeated by whistler waves (f ~ 1 Hz) and/or ultra low frequency (ULF) waves (f ~ 10-2-10-1 Hz). While whistlers appear to be generated at the shock, the origin of ULF waves is most probably associated with local kinetic ion instabilities. We find that when the Mach number (Mms) is low and the shock is quasi-perpendicular (θBN > 45°) whistler waves remain close to the shock. As Mms increases, the shock profile changes and can develop a foot and overshoot associated with ion reflection and gyration. Whistler precursors can be superposed on the foot region, so that some quasi-perpendicular shocks have characteristics of both subcritical and supercritical shocks. When the shock is quasi-parallel (θBN < 45°) a large foreshock with suprathermal ions and waves can form. Upstream, there are whistler trains at higher frequencies whose characteristics can be slightly modified probably by reflected and/or leaked ions and by almost circularly polarized waves at lower frequencies that may be locally generated by ion instabilities. In contrast with planetary bow shocks, most of the upstream waves studied here are mainly transverse and no steepening occurs. Some quasi-perpendicular shocks (45° < θBN < 60°) are preceded by ULF waves and ion foreshocks. Fluctuations downstream of quasi-parallel shocks tend to have larger amplitudes than waves in the sheath of quasi-perpendicular shocks. We compare SI-driven shock properties with those of shocks generated by interplanetary coronal mass ejections (ICMEs). During the same years

  5. A shock loss model for supersonic compressor cascades

    SciTech Connect

    Bloch, G.S.; Copenhaver, W.W.; O`Brien, W.F.

    1999-01-01

    Loss models used in compression system performance prediction codes are often developed from the study of two-dimensional cascades. In this paper, compressible fluid mechanics has been applied to the changes in shock geometry that are known to occur with back pressure for unstarted operation of supersonic compressor cascades. This physics-based engineering shock loss model is applicable to cascades with arbitrary airfoil shapes. Predictions from the present method have been compared to measurements and Navier-Stokes analyses of the L030-4 and L030-6 cascades, and very good agreement was demonstrated for unstarted operation. A clear improvement has been demonstrated over previously published shock loss models for unstarted operation, both in the accuracy of the predictions and in the range of applicability. The dramatic increase in overall loss with increasing inlet flow angle is shown to be primarily the result of increased shock loss, and much of this increase is caused by the detached bow shock. For a given Mach number, the viscous profile loss is nearly constant over the entire unstarted operating range of the cascade, unless a shock-induced boundary layer separation occurs near stall. Shock loss is much more sensitive to inlet Mach number than is viscous profile loss.

  6. Brown Syndrome

    MedlinePlus

    ... Does Brown syndrome cause eye problems besides abnormal eye movements? Some children with Brown syndrome have poor binocular ... In the congenital form of Brown syndrome, the eye movement problem is usually constant and unlikely to resolve ...

  7. Dravet Syndrome

    MedlinePlus

    ... NINDS Dravet Syndrome Information Page Synonym(s): Severe Myoclonic Epilepsy of Infancy (SMEI) Table of Contents (click to ... Dravet Syndrome? Dravet syndrome, also called severe myoclonic epilepsy of infancy (SMEI), is a severe form of ...

  8. Fahr's Syndrome

    MedlinePlus

    ... Awards Enhancing Diversity Find People About NINDS NINDS Fahr's Syndrome Information Page Synonym(s): Familial Idiopathic Basal Ganglia ... is being done? Clinical Trials Organizations What is Fahr's Syndrome? Fahr's Syndrome is a rare, genetically dominant, ...

  9. Cushing syndrome

    MedlinePlus

    Hypercortisolism; Cortisol excess ... The most common cause of Cushing syndrome is taking too much glucocorticosteroid medicine. This form of Cushing syndrome is called exogenous Cushing syndrome . Prednisone, dexamethasone, and prednisolone are ...

  10. Williams syndrome

    MedlinePlus

    Williams-Beuren syndrome ... Williams syndrome is caused by not having a copy of several genes. Parents may not have any family history of the condition. However, people with Williams syndrome have a 50% chance of passing the ...

  11. Electron plasma oscillations upstream of the solar wind termination shock.

    PubMed

    Gurnett, D A; Kurth, W S

    2005-09-23

    Electron plasma oscillations have been detected upstream of the solar wind termination shock by the plasma wave instrument on the Voyager 1 spacecraft. These waves were first observed on 11 February 2004, at a heliocentric radial distance of 91.0 astronomical units, and continued sporadically with a gradually increasing occurrence rate for nearly a year. The last event occurred on 15 December 2004, at 94.1 astronomical units, just before the spacecraft crossed the termination shock. Since then, no further electron plasma oscillations have been observed, consistent with the spacecraft having crossed the termination shock into the heliosheath.

  12. The Shock Hugoniot of the Intermetallic Compound Ni3Al

    SciTech Connect

    Knapp, I.; Millett, J. C. F.; Meziere, Y. J. E.; Gray, G. T. III; Bourne, N. K.

    2006-07-28

    The behaviour of the intermetallic compound, Ni3Al under shock loading conditions has been measured. The Hugoniot Elastic Limit occurs at ca. 530 MPa, which converts to a 1-D yield stress of 273 MPa, in agreement with quasi-static data. In contrast, the ductility at shock-induced strain-rates appears much reduced when compared to lower strain-rates. The Hugoniot in terms of shock velocity and particle velocity suggests that Ni3Al is more compressible than pure nickel. This is in agreement with the greater stiffnesses in nickel, measured using ultrasonic techniques.

  13. [The refeeding syndrome].

    PubMed

    Lambers, Wietske M; Kraaijenbrink, Bastiaan; Siegert, Carl E H

    2015-01-01

    The refeeding syndrome may occur during reintroduction of carbohydrates in malnourished patients. This syndrome is characterized by reduced plasma electrolyte levels, hypophosphataemia being most prevalent. The symptoms can vary from minor symptoms to severe neurological or cardiac symptoms. The pathophysiological mechanism comprises an increase in insulin levels, resulting in shifts of phosphate, potassium and magnesium into the intracellular environment, as well as fluid retention and relative deficiency of vitamin B1. There is growing interest in the screening and treatment of patients with malnutrition, due to which the incidence of refeeding syndrome is probably increasing. Currently, there is no single definition of this syndrome and therefore there is no solid scientific basis for screening and treatment. In this article we describe the rationale for screening and additional laboratory investigations. A prospective, controlled trial is important to define the clinical relevance of the refeeding syndrome and optimize its treatment.

  14. Maskelynite: Formation by Explosive Shock.

    PubMed

    Milton, D J; de Carli, P S

    1963-05-10

    When high pressure (250 to 300 kilobars) was applied suddenly (shock-loading) to gabbro, the plagioclase was transformed to a noncrystalline phase (maskelynite) by a solid-state reaction at a low temperature, while the proxene remained crystalline. The shock-loaded gabbro resembles meteorites of the shergottite class; this suggests that the latter formed as a result of shock. The shock-loading of gabbro at 600 to 800 kilobars raised the temperature above the melting range of the plagioclase.

  15. Teleconnected food supply shocks

    NASA Astrophysics Data System (ADS)

    Bren d'Amour, Christopher; Wenz, Leonie; Kalkuhl, Matthias; Steckel, Jan Christoph; Creutzig, Felix

    2016-03-01

    The 2008-2010 food crisis might have been a harbinger of fundamental climate-induced food crises with geopolitical implications. Heat-wave-induced yield losses in Russia and resulting export restrictions led to increases in market prices for wheat across the Middle East, likely contributing to the Arab Spring. With ongoing climate change, temperatures and temperature variability will rise, leading to higher uncertainty in yields for major nutritional crops. Here we investigate which countries are most vulnerable to teleconnected supply-shocks, i.e. where diets strongly rely on the import of wheat, maize, or rice, and where a large share of the population is living in poverty. We find that the Middle East is most sensitive to teleconnected supply shocks in wheat, Central America to supply shocks in maize, and Western Africa to supply shocks in rice. Weighing with poverty levels, Sub-Saharan Africa is most affected. Altogether, a simultaneous 10% reduction in exports of wheat, rice, and maize would reduce caloric intake of 55 million people living in poverty by about 5%. Export bans in major producing regions would put up to 200 million people below the poverty line at risk, 90% of which live in Sub-Saharan Africa. Our results suggest that a region-specific combination of national increases in agricultural productivity and diversification of trade partners and diets can effectively decrease future food security risks.

  16. A Shocking New Pump

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Hydro Dynamics, Inc. received a technical helping hand from NASA that made their Hydrosonic Pump (HPump) a reality. Marshall engineers resolved a bearing problem in the rotor of the pump and recommended new bearings, housings and mounting hardware as a solution. The resulting HPump is able to heat liquids with greater energy efficiency using shock waves to generate heat.

  17. Teleconnected food supply shocks

    NASA Astrophysics Data System (ADS)

    Bren d’Amour, Christopher; Wenz, Leonie; Kalkuhl, Matthias; Steckel, Jan Christoph; Creutzig, Felix

    2016-03-01

    The 2008–2010 food crisis might have been a harbinger of fundamental climate-induced food crises with geopolitical implications. Heat-wave-induced yield losses in Russia and resulting export restrictions led to increases in market prices for wheat across the Middle East, likely contributing to the Arab Spring. With ongoing climate change, temperatures and temperature variability will rise, leading to higher uncertainty in yields for major nutritional crops. Here we investigate which countries are most vulnerable to teleconnected supply-shocks, i.e. where diets strongly rely on the import of wheat, maize, or rice, and where a large share of the population is living in poverty. We find that the Middle East is most sensitive to teleconnected supply shocks in wheat, Central America to supply shocks in maize, and Western Africa to supply shocks in rice. Weighing with poverty levels, Sub-Saharan Africa is most affected. Altogether, a simultaneous 10% reduction in exports of wheat, rice, and maize would reduce caloric intake of 55 million people living in poverty by about 5%. Export bans in major producing regions would put up to 200 million people below the poverty line at risk, 90% of which live in Sub-Saharan Africa. Our results suggest that a region-specific combination of national increases in agricultural productivity and diversification of trade partners and diets can effectively decrease future food security risks.

  18. Shock-induced subsolidus reduction-decomposition of orthopyroxene and shock-induced melting in norite 78235

    NASA Technical Reports Server (NTRS)

    Sclar, C. B.; Bauer, J. F.

    1975-01-01

    Lunar rock 78235 is a coarse-grained igneous rock which was chipped from the top of a boulder about 1/2 m in size at Station 8 at the base of the Sculptured Hills, Taurus-Littrow Valley. The rock is a shocked coarse-grained norite with a relict subophitic texture; it is composed of about equal proportions of chromian bronzite and anorthite. Evidence is presented for the shock history of the rock. It is concluded that 78235 is a deep-seated norite of cumulate origin which has been intensely shocked. Although it may be possible to account for the observed shock-induced features by invoking a single shock event, the evidence is best explained by a history which includes at least two discrete shock events. In the first identifiable shock event much of the plagioclase was transformed to maskelynite and the associated bronzite was deformed and acquired a mosaic structure. In a later shock event, localized melting of both plagioclase pyroxene occurred.

  19. STEREO interplanetary shocks and foreshocks

    SciTech Connect

    Blanco-Cano, X.; Kajdic, P.; Aguilar-Rodriguez, E.; Russell, C. T.; Jian, L. K.; Luhmann, J. G.

    2013-06-13

    We use STEREO data to study shocks driven by stream interactions and the waves associated with them. During the years of the extended solar minimum 2007-2010, stream interaction shocks have Mach numbers between 1.1-3.8 and {theta}{sub Bn}{approx}20-86 Degree-Sign . We find a variety of waves, including whistlers and low frequency fluctuations. Upstream whistler waves may be generated at the shock and upstream ultra low frequency (ULF) waves can be driven locally by ion instabilities. The downstream wave spectra can be formed by both, locally generated perturbations, and shock transmitted waves. We find that many quasiperpendicular shocks can be accompanied by ULF wave and ion foreshocks, which is in contrast to Earth's bow shock. Fluctuations downstream of quasi-parallel shocks tend to have larger amplitudes than waves downstream of quasi-perpendicular shocks. Proton foreshocks of shocks driven by stream interactions have extensions dr {<=}0.05 AU. This is smaller than foreshock extensions for ICME driven shocks. The difference in foreshock extensions is related to the fact that ICME driven shocks are formed closer to the Sun and therefore begin to accelerate particles very early in their existence, while stream interaction shocks form at {approx}1 AU and have been producing suprathermal particles for a shorter time.

  20. Diffusive Shock Acceleration

    NASA Astrophysics Data System (ADS)

    Baring, Matthew

    2003-04-01

    The process of diffusive acceleration of charged particles in shocked plasmas is widely invoked in astrophysics to account for the ubiquitous presence of signatures of non-thermal relativistic electrons and ions in the universe. This statistical energization mechanism, manifested in turbulent media, was first posited by Enrico Fermi in 1949 to explain the observed cosmic ray population, which exhibits an almost power-law distribution in rigidity. The absence of a momentum scale is a key characteristic of diffusive shock acceleration, and astrophysical systems generally only impose scales at the injection (low energy) and loss (high energy) ends of the particle spectrum. The existence of structure in the cosmic ray spectrum (the "knee") at around 3000 TeV has promoted contentions that there are at least two origins for cosmic rays, a galactic one supplying those up to the knee, and perhaps an extragalactic one that can explain even the ultra-high energy cosmic rays (UHECRs) seen at 1-300 EeV. Accounting for the UHECRs with familiar astrophysical sites of acceleration has historically proven difficult due to the need to assume high magnetic fields in order to reduce the shortest diffusive acceleration timescale, the ion gyroperiod, to meaningful values. Yet active galaxies and gamma-ray bursts remain strong and interesting candidate sources for UHECRs, turning the theoretical focus to relativistic shocks. This review summarizes properties of diffusive shock acceleration that are salient to the issue of UHECR generation. These include spectral indices, anisotropies, acceleration efficencies and timescales, as functions of the shock speed and mean field orientation, and also the degree of field turbulence. Astrophysical sites for UHECR production are also critiqued.

  1. Weak-shock reflection factors

    SciTech Connect

    Reichenbach, H.; Kuhl, A.L.

    1993-09-07

    The purpose of this paper is to compare reflection factors for weak shocks from various surfaces, and to focus attention on some unsolved questions. Three different cases are considered: square-wave planar shock reflection from wedges; square-wave planar shock reflection from cylinders; and spherical blast wave reflection from a planar surface. We restrict ourselves to weak shocks. Shocks with a Mach number of M{sub O} < 1.56 in air or with an overpressure of {Delta}{sub PI} < 25 psi (1.66 bar) under normal ambient conditions are called weak.

  2. West syndrome in a patient with Schinzel-Giedion syndrome.

    PubMed

    Miyake, Fuyu; Kuroda, Yukiko; Naruto, Takuya; Ohashi, Ikuko; Takano, Kyoko; Kurosawa, Kenji

    2015-06-01

    Schinzel-Giedion syndrome is a rare recognizable malformation syndrome defined by characteristic facial features, profound developmental delay, severe growth failure, and multiple congenital anomalies. The causative gene of Schinzel-Giedion syndrome, SETBP1, has been identified, but limited cases have been confirmed by molecular analysis. We present a 9-month-old girl affected by West syndrome with Schinzel-Giedion syndrome. Congenital severe hydronephrosis, typical facial features, and multiple anomalies suggested a clinical diagnosis of Schinzel-Giedion syndrome. Hypsarrhythmia occurred at 7 months of age and was temporarily controlled by adrenocorticotropic hormone (ACTH) therapy during 5 weeks. SETBP1 mutational analysis showed the presence of a recurrent mutation, p.Ile871Thr. The implications in management of Schinzel-Giedion syndrome are discussed.

  3. Abrupt reflow enhances cytokine-induced proinflammatory activation of endothelial cells during simulated shock and resuscitation.

    PubMed

    Li, Ranran; Zijlstra, Jan G; Kamps, Jan A A M; van Meurs, Matijs; Molema, Grietje

    2014-10-01

    Circulatory shock and resuscitation are associated with systemic hemodynamic changes, which may contribute to the development of MODS (multiple organ dysfunction syndrome). In this study, we used an in vitro flow system to simulate the consecutive changes in blood flow as occurring during hemorrhagic shock and resuscitation in vivo. We examined the kinetic responses of different endothelial genes in human umbilical vein endothelial cells preconditioned to 20 dyne/cm unidirectional laminar shear stress for 48 h to flow cessation and abrupt reflow, respectively, as well as the effect of flow cessation and reflow on tumor necrosis factor-α (TNF-α)-induced endothelial proinflammatory activation. Endothelial CD31 and VE-cadherin were not affected by the changes in flow in the absence or presence of TNF-α. The messenger RNA levels of proinflammatory molecules E-selectin, VCAM-1 (vascular cell adhesion molecule 1), and IL-8 (interleukin 8) were significantly induced by flow cessation respectively acute reflow, whereas ICAM-1 (intercellular adhesion molecule 1) was downregulated on flow cessation and induced by subsequent acute reflow. Flow cessation also affected the Ang/Tie2 (Angiopoietin/Tie2 receptor tyrosine kinase) system by downregulating Tie2 and inducing its endothelial ligand Ang2, an effect that was further extended on acute reflow. Furthermore, the induction of proinflammatory adhesion molecules by TNF-α under flow cessation was significantly enhanced on subsequent acute reflow. This study demonstrated that flow alterations per se during shock and resuscitation contribute to endothelial activation and that these alterations interact with proinflammatory factors coexisting in vivo such as TNF-α. The abrupt reflow-related enhancement of cytokine-induced endothelial proinflammatory activation supports the concept that sudden regain of flow during resuscitation has an aggravating effect on endothelial activation, which may play a significant role in vascular

  4. Peripheral nerve hyperexcitability syndromes.

    PubMed

    Küçükali, Cem Ismail; Kürtüncü, Murat; Akçay, Halil İbrahim; Tüzün, Erdem; Öge, Ali Emre

    2015-01-01

    Peripheral nerve hyperexcitability (PNH) syndromes can be subclassified as primary and secondary. The main primary PNH syndromes are neuromyotonia, cramp-fasciculation syndrome (CFS), and Morvan's syndrome, which cause widespread symptoms and signs without the association of an evident peripheral nerve disease. Their major symptoms are muscle twitching and stiffness, which differ only in severity between neuromyotonia and CFS. Cramps, pseudomyotonia, hyperhidrosis, and some other autonomic abnormalities, as well as mild positive sensory phenomena, can be seen in several patients. Symptoms reflecting the involvement of the central nervous system occur in Morvan's syndrome. Secondary PNH syndromes are generally seen in patients with focal or diffuse diseases affecting the peripheral nervous system. The PNH-related symptoms and signs are generally found incidentally during clinical or electrodiagnostic examinations. The electrophysiological findings that are very useful in the diagnosis of PNH are myokymic and neuromyotonic discharges in needle electromyography along with some additional indicators of increased nerve fiber excitability. Based on clinicopathological and etiological associations, PNH syndromes can also be classified as immune mediated, genetic, and those caused by other miscellaneous factors. There has been an increasing awareness on the role of voltage-gated potassium channel complex autoimmunity in primary PNH pathogenesis. Then again, a long list of toxic compounds and genetic factors has also been implicated in development of PNH. The management of primary PNH syndromes comprises symptomatic treatment with anticonvulsant drugs, immune modulation if necessary, and treatment of possible associated dysimmune and/or malignant conditions. PMID:25719304

  5. What is a Shock Wave to an Explosive Molecule?

    SciTech Connect

    Tarver, C M

    2001-06-12

    An explosive molecule is a metastable chemical species that reacts exothermically given the correct stimulus. Impacting an explosive with a shock wave is a ''wake-up call'' or ''trigger'' which compresses and heats the molecule. The energy deposited by the shock wave must be distributed to the vibrational modes of the explosive molecule before chemical reaction can occur. If the shock pressure and temperature are high enough and last long enough, exothermic chemical decomposition can lead to the formation of a detonation wave. For gaseous, liquid, and perfect single crystal solid explosives, after an induction time, chemical reaction begins at or near the rear boundary of the charge. This induction time can be calculated by high pressure, high temperature transition state theory. A ''superdetonation'' wave travels through the preshocked explosive until it overtakes the initial shock wave and then slows to the steady state Chapman-Jouguet (C-J) velocity. In heterogeneous solid explosives, initiation of reaction occurs at ''hot spots'' created by shock compression. If there is a sufficient number of large and hot enough ''hot spots,'' these ignition sites grow creating a pressure pulse that overtakes the leading shock front causing detonation. Since the chemical energy is released well behind the leading shock front of a detonation wave, a mechanism is required for this energy to reinforce the leading shock front and maintain its overall constant velocity. This mechanism is the amplification of pressure wavelets in the reaction zone by the process of de-excitation of the initially highly vibrationally excited reaction product molecules. This process leads to the development of the three-dimensional structure of detonation waves observed for all explosives. In a detonation wave, the leading shock wave front becomes a ''burden'' for the explosive molecule to sustain by its chemical energy release.

  6. Appearance of heat shock proteins during the induction of multiple flagella in Naegleria gruberi.

    PubMed

    Walsh, C

    1980-04-10

    A heat shock to amebae of the amebo-flagellate Naegleria gruberi during differentiation into swimming flagellates results in the induction of heat shock proteins as well as multiple flagella. The principal heat shock proteins migrate on sodium dodecyl sulfate-polyacrylamide gels with apparent molecular weights of 96,000, 77,000, 70,000, and 68,000. These proteins are synthesized preferentially when cells at 25 degrees C are shifted to temperatures above 32 degrees C. The maximal incorporation of methionine into heat shock proteins occurs at 38.2 degrees C, the temperature at which maximal induction of multiple flagella has been reported. Synthesis of heat shock proteins requires new transcription as judged by the ability of actinomycin D to inhibit their synthesis during the first 15 min of heat shock but not thereafter. Although heat shock can induce multiple flagella only when applied during a restricted interval, heat shock proteins are induced at any time cells are shifted to 38.2 degrees C. The response to heat shock of the Naegleria heat shock proteins resembles that of Drosophila heat shock proteins, but the two groups of proteins differ in both size and number. Naegleria heat shock proteins are, however, strikingly similar in size to a group of heat-induced proteins found in chick embryo fibroblast, mouse L, and BHK cells. PMID:7358690

  7. Multipoint study of interplanetary shocks

    NASA Astrophysics Data System (ADS)

    Blanco-Cano, Xochitl; Kajdic, Primoz; Russell, Christopher T.; Aguilar-Rodriguez, Ernesto; Jian, Lan K.; Luhmann, Janet G.

    2016-04-01

    Interplanetary (IP) shocks are driven in the heliosphere by Interplanetary Coronal Mass Ejections (ICMEs) and Stream Interaction Regions (SIRs). These shocks perturb the solar wind plasma, and play an active role in the acceleration of ions to suprathermal energies. Shock fronts evolve as they move from the Sun. Their surfaces can be far from uniform and be modulated by changes in the ambient solar wind (magnetic field orientation, flow velocity), shocks rippling, and perturbations upstream and downstream from the shocks, i.e., electromagnetic waves. In this work we use multipoint observations from STEREO, WIND, and MESSENGER missions to study shock characteristics at different helio-longitudes and determine the properties of the waves near them. We also determine shock longitudinal extensions and foreshock sizes. The variations of geometry along the shock surface can result in different extensions of the wave and ion foreshocks ahead of the shocks, and in different wave modes upstream and downtream of the shocks. We find that the ion foreshock can extend up to 0.2 AU ahead of the shock, and that the upstream region with modified solar wind/waves can be very asymmetric.

  8. SELF-REGULATED SHOCKS IN MASSIVE STAR BINARY SYSTEMS

    SciTech Connect

    Parkin, E. R.; Sim, S. A. E-mail: s.sim@qub.ac.uk

    2013-04-20

    In an early-type, massive star binary system, X-ray bright shocks result from the powerful collision of stellar winds driven by radiation pressure on spectral line transitions. We examine the influence of the X-rays from the wind-wind collision shocks on the radiative driving of the stellar winds using steady-state models that include a parameterized line force with X-ray ionization dependence. Our primary result is that X-ray radiation from the shocks inhibits wind acceleration and can lead to a lower pre-shock velocity, and a correspondingly lower shocked plasma temperature, yet the intrinsic X-ray luminosity of the shocks, L{sub X}, remains largely unaltered, with the exception of a modest increase at small binary separations. Due to the feedback loop between the ionizing X-rays from the shocks and the wind driving, we term this scenario as self-regulated shocks. This effect is found to greatly increase the range of binary separations at which a wind-photosphere collision is likely to occur in systems where the momenta of the two winds are significantly different. Furthermore, the excessive levels of X-ray ionization close to the shocks completely suppress the line force, and we suggest that this may render radiative braking less effective. Comparisons of model results against observations reveal reasonable agreement in terms of log (L{sub X}/L{sub bol}). The inclusion of self-regulated shocks improves the match for kT values in roughly equal wind momenta systems, but there is a systematic offset for systems with unequal wind momenta (if considered to be a wind-photosphere collision).

  9. Shock metamorphism of deformed quartz

    NASA Technical Reports Server (NTRS)

    Gratz, Andrew J.; Christie, John; Tyburczy, James; Ahrens, Thomas; Pongratz, Peter

    1988-01-01

    The effect produced by shock loading (to peak pressures of 12 and 24) on deformed synthetic quartz containing a dislocation and abundant bubbles and small inclusions was investigated, and the relationships between preexisting dislocation density shock lamellae in the target material were examined. The resultant material was found to be inhomogeneously deformed and extremely fractured. Results of TEM examinations indicate that no change in dislocation density was caused by shock loading except in regions containing shock lamellae, where the dislocation density was lowered. The shock-induced defects tend to nucleate on and be controlled by preexisting stress concentrators; shock lamellae, glassy veins, and most curviplanar defects form in tension, presumably during release. An extremely mobile silica fluid is formed and injected into fractures during release, which forcibly removes crystalline fragments from vein walls. It is concluded that shock deformation in quartz is dominated by fracture and melting.

  10. [Syndrome of multiple organ failure].

    PubMed

    Charbonneau, P; Suisse, A

    1990-11-01

    The multiple organ failure syndrome (MOF) is a relatively new entity defined as the successive occurrence of respiratory (ARDS), hepatic, renal, myocardial, gastro-intestinal or neurological failure in patients with hyperkinetic haemodynamic and hypermetabolic states. The etiologies are: infection, septic and non-septic shock, burns and multiple injuries. The MOF syndrome is considered to be a generalised "inflammatory reaction" to tissue aggression involving a cascade of mediatory factors (TNF, interleukines...) of macrophagic, lymphocytic origin, causing multiple organ failure. The treatment depends on early correction of cellular hypoxia related to circulatory disturbances, nutritional support, anti-infective therapy and, in the near future, "control of mediator activity" (immunotherapy).

  11. Hantavirus pulmonary syndrome.

    PubMed

    Macneil, Adam; Nichol, Stuart T; Spiropoulou, Christina F

    2011-12-01

    Hantavirus pulmonary syndrome (HPS) is a severe disease characterized by a rapid onset of pulmonary edema followed by respiratory failure and cardiogenic shock. The HPS associated viruses are members of the genus Hantavirus, family Bunyaviridae. Hantaviruses have a worldwide distribution and are broadly split into the New World hantaviruses, which includes those causing HPS, and the Old World hantaviruses [including the prototype Hantaan virus (HTNV)], which are associated with a different disease, hemorrhagic fever with renal syndrome (HFRS). Sin Nombre virus (SNV) and Andes virus (ANDV) are the most common causes of HPS in North and South America, respectively. Case fatality of HPS is approximately 40%. Pathogenic New World hantaviruses infect the lung microvascular endothelium without causing any virus induced cytopathic effect. However, virus infection results in microvascular leakage, which is the hallmark of HPS. This article briefly reviews the knowledge on HPS-associated hantaviruses accumulated since their discovery, less than 20 years ago.

  12. Particle Acceleration and Nonthermal Emission in Relativistic Astrophysical Shocks

    NASA Astrophysics Data System (ADS)

    Sironi, Lorenzo

    The common observational feature of Pulsar Wind Nebulae (PWNe), gamma-ray bursts (GRBs), and AGN jets is a broad nonthermal spectrum of synchrotron and inverse Compton radiation. It is usually assumed that the emitting electrons are accelerated to a power-law distribution at relativistic shocks, via the so-called Fermi mechanism. Despite decades of research, the Fermi acceleration process is still not understood from first principles. An assessment of the micro-physics of particle acceleration in relativistic shocks is of paramount importance to unveil the properties of astrophysical nonthermal sources, and it is the subject of this dissertation. In the first part of this thesis, I explore by means of fully-kinetic first-principle particle-in-cell (PIC) simulations the properties of relativistic shocks that propagate in electron-positron and electron-proton plasmas carrying uniform magnetic fields. I find that nonthermal particle acceleration only occurs if the upstream magnetization is weak (sigma<0.001), or if the pre-shock field is nearly aligned with the shock direction of propagation (quasi-parallel shocks). Relativistic shocks in PWNe, GRBs and AGN jets are usually thought to be appreciably magnetized (sigma>0.01) and quasi-perpendicular, yet they need to be efficient particle accelerators, in order to explain the prominent nonthermal signatures of these sources. Motivated by this discrepancy, I then relax the assumption of uniform pre-shock fields, and investigate the acceleration efficiency of perpendicular shocks that propagate in high-sigma flows with alternating magnetic fields. This is the geometry expected at the termination shock of pulsar winds, but it could also be relevant for Poynting-dominated jets in GRBs and AGNs. I show by means of PIC simulations that compression of the flow at the shock will force annihilation of nearby field lines, a process known as shock-driven reconnection. Magnetic reconnection can efficiently transfer the energy of

  13. Superdiffusive shock acceleration and short acceleration times at interplanetary shocks

    NASA Astrophysics Data System (ADS)

    Perri, Silvia; Zimbardo, Gaetano

    2016-04-01

    The analysis of time profiles of particles accelerated at interplanetary shock waves has shown evidence for superdiffusive transport in the upstream region. Superdiffusive transport is characterized by a mean square displacement that grows faster than linearly in time and by non Gaussian statistics for the distribution of the particle jump lengths. In the superdiffusive framework it has been shown that particle time profiles upstream of a planar shock decay as power laws, at variance with exponential particle time profiles predicted in the case of diffusive transport. A large number of interplanetary shocks, including coronal mass ejection driven shocks, exhibit energetic particle time profiles that decay as power laws far upstream. In order to take this evidence into account, we have extended the standard theory of diffusive shock acceleration to the case of particle superdiffusive transport (superdiffusive shock acceleration). This has allowed us to derive both hard energy spectral indices and short acceleration times. This new theory has been tested for a number of interplanetary shock waves, observed by the Ulysses and the ACE spacecraft, and for the termination shock. The superdiffusive shock acceleration leads to a strong reduction of the acceleration times (even of about one order of magnitude) with respect to the diffusive shock acceleration. Thus, this new framework provides a substantial advancement in the understanding of the processes of particle acceleration and particle transport, which are among the main objectives of the new Solar Probe and Solar Orbiter space missions.

  14. Recognizing and preventing refeeding syndrome.

    PubMed

    Adkins, Susan M

    2009-01-01

    Refeeding syndrome is an uncommon but potentially fatal phenomenon that can occur in patients receiving parenteral, enteral, or oral feedings after a period of sustained malnutrition or starvation. This syndrome is characterized by hypophosphatemia, hypokalemia, and hypomagnesemia. The purpose of this article was to bring an acute awareness of refeeding syndrome to the critical care nurse. The recognition, pathogenesis, clinical manifestations, potential life threatening complications, and treatment are presented.

  15. Treatment of shock.

    PubMed

    De Backer, D

    2011-01-01

    Shock is a life-threatening condition, resulting from different causes, and leading to tissue hypoperfusion. Symptomatic therapy associates fluids and vasoactive agents. Vasopressor and inotropic adrenergic agents remain the most commonly used to correct hypotension and/or to increase cardiac output. These agents have different haemodynamic and metabolic profiles, but the relevance of these differences on outcome has long been challenged. Recent randomized trials have shaded some light on this issue. Dopamine and norepinephrine have been the most extensively studied. These trials raised major concerns on the use of dopamine, which was associated with tachycardia and increased arrhythmic events, and may be associated with an increased risk of death especially in the subgroup of patients with cardiogenic shock. The place of epinephrine is not well defined, this agent is associated with tachycardia, increased incidence of arrhythmic events, and undesired metabolic effects.

  16. SUPERDIFFUSIVE SHOCK ACCELERATION

    SciTech Connect

    Perri, S.; Zimbardo, G.

    2012-05-10

    The theory of diffusive shock acceleration is extended to the case of superdiffusive transport, i.e., when the mean square deviation grows proportionally to t{sup {alpha}}, with {alpha} > 1. Superdiffusion can be described by a statistical process called Levy random walk, in which the propagator is not a Gaussian but it exhibits power-law tails. By using the propagator appropriate for Levy random walk, it is found that the indices of energy spectra of particles are harder than those obtained where a normal diffusion is envisaged, with the spectral index decreasing with the increase of {alpha}. A new scaling for the acceleration time is also found, allowing substantially shorter times than in the case of normal diffusion. Within this framework we can explain a number of observations of flat spectra in various astrophysical and heliospheric contexts, for instance, for the Crab Nebula and the termination shock of the solar wind.

  17. Clostridium Sordellii as an Uncommon Cause of Fatal Toxic Shock Syndrome in a Postpartum 33-Year-Old Asian Woman, and the Need for Antepartum Screening for This Clostridia Species in the General Female Population.

    PubMed

    Guzzetta, Melissa; Williamson, Alex; Duong, Scott

    2016-08-01

    Clostridium sordellii (C. sordellii) is an anaerobic gram-positive rod most commonly found in the soil and sewage but also as part of the normal flora of the gastrointestinal tract and vagina of a small percentage of healthy individuals. C. sordellii infection is considered to result from childbirth, abortion, and/or gynecological procedures. Although many strains of C. sordellii are nonpathogenic, virulent toxin-producing strains exist. Infection with this organism typically manifests as a patient experiencing septic shock rapidly followed by end-organ failure. Identification of C. sordelli has been successful by traditional culture, mass spectrometry methods, and via molecular methods. Herein, we present a fatal case of C. sordellii infection of a postpartum 33-year-old Asian woman. The organism was isolated by culture and identified using matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF) technology. With the advent of rapid detection methods, antepartum screening for the fatal Clostridium species should be implemented in the general female population. PMID:27371657

  18. Septic shock in obstetrics.

    PubMed

    Knuppel, R A; Rao, P S; Cavanagh, D

    1984-03-01

    Septic shock in obstetric patients can be prevented by recognition of patients at risk and aggressive intervention in the warm-hypotensive phase. These patients must be monitored closely. Rarely will an obstetrical floor be capable of providing adequate monitoring of these patients; therefore, the patient should be transferred to an intensive care unit. Individualize therapy, but do not procrastinate in the surgical removal of the nidus of infection.

  19. Shock Classication of Ordinary Chondrites: New Data and Interpretations

    NASA Astrophysics Data System (ADS)

    Stoffler, D.; Keil, K.; Scott, E. R. D.

    1992-07-01

    Introduction. The recently proposed classification system for shocked chondrites (1) is based on a microscopic survey of 76 non-Antarctic H, L, and LL chondrites. Obviously, a larger database is highly desirable in order to confirm earlier conclusions and to allow for a statistically relevant interpretation of the data. Here, we report the shock classification of an additional 54 ordinary chondrites and summarize implications based on a total of 130 samples. New observations on shock effects. Continued studies of those shock effects in olivine and plagioclase that are indicative of the shock stages S1 - S6 as defined in (1) revealed the following: Planar deformation features in olivine, considered typical of stage S5, occur occasionally in stage S3 and are common in stage S4. In some S4 chondrites plagioclase is not partially isotropic but still birefringent coexisting with a small fraction of S3 olivines. Opaque shock veins occur not only in shock stage S3 and above (1) but have now been found in a few chondrites of shock stage S2. Thermal annealing of shock effects. Planar fractures and planar deformation features in olivine persist up to the temperatures required for recrystallization of olivine (> ca. 900 degrees C). Shock history of breccias. In a number of petrologic types 3 and 4 chondrites without recognizable (polymict) breccia texture, we found chondrules and olivine fragments with different shock histories ranging from S1 to S3. Regolith and fragmental breccias are polymict with regard to lithology and shock. The intensity of the latest shock typically varies from S1 to S4 in the breccias studied so far. Frequency distribution of shock stages. A significant difference between H and L chondrites is emerging in contrast to our previous statistics (1), whereas the conspicuous lack of shock stages S5 and S6 in type 3 and 4 chondrites is clearly confirmed (Fig. 1). Correlation between shock and noble gas content. The concentration of radiogenic argon and of

  20. [Deep vein thrombosis revealing myeloproliferative syndrome in two adolescents].

    PubMed

    Bertrand, A; Heissat, S; Caron, N; Viremouneix, L; Pracros, J-P; Javouhey, E; Lachaux, A; Mialou, V

    2014-05-01

    Deep vein thrombosis occurs in 30% of patients with essential thrombocythemia, but rarely at initial diagnosis. We report two pediatric patients with essential thrombocythemia revealed by atypical deep vein thrombosis. First, a 16-year-old girl presented Budd-Chiari syndrome revealed by a hemorrhagic shock. Clinical exam revealed isolated splenomegaly. A search for thrombophilia found a factor V Leiden homozygous mutation and a Jak2 mutation. Bone marrow biopsy confirmed the diagnosis of a myeloproliferative disorder. The second case, a 17-year-old girl, had a routine examination by her physician that revealed splenomegaly. Ultrasonography displayed thrombus in the splenic and portal vein. An isolated Jak2 mutation was found and a myeloproliferative disorder was confirmed by bone marrow biopsy. The diagnosis of myeloproliferative disorder was made in both patients presenting atypical venous thrombosis with a Jak2 mutation and confirmed by bone marrow biopsy. These initial presentations of myeloproliferative disorders are rare in childhood and possibly underdiagnosed. PMID:24709317

  1. Short- and medium-range orders in Cu46Zr54 metallic glasses under shock compression

    NASA Astrophysics Data System (ADS)

    Jian, W. R.; Yao, X. H.; Wang, L.; Tang, X. C.; Luo, S. N.

    2015-07-01

    We investigate short- and medium-range orders in Cu46Zr54 metallic glasses, as represented by icosahedra and icosahedron networks, respectively, under shock compression with molecular dynamics simulations. Complementary isothermal compression and isobaric heating simulations reveal that compression below 60 GPa gives rise to increased coordination and thus high-coordination-number Voronoi polyhedra, such as icosahedra; however, pressure-induced collapse or thermal disintegration of icosahedra (and subsequently, icosahedron networks) occurs at pressures above 60 GPa or at melting, accompanied by free volume increase. The evolutions of the short- and medium-range orders upon shock loading are the effects of compression combined with shock-induced melting. The structural changes are partially reversible for weak shocks without melting (below 60 GPa) and irreversible for strong shocks. Crystallization does not occur under isothermal or shock compression at molecular dynamics scales.

  2. ON THE EXISTENCE OF SHOCKS IN IRRADIATED EXOPLANETARY ATMOSPHERES

    SciTech Connect

    Heng, Kevin

    2012-12-10

    Supersonic flows are expected to exist in the atmospheres of irradiated exoplanets, but the question of whether shocks develop lingers. Specifically, it reduces to whether continuous flow in a closed loop may become supersonic and if some portions of the supersonic flow steepen into shocks. We first demonstrate that continuous, supersonic flow may exist in two flavors: isentropic and non-isentropic, with shocks being included in the latter class of solutions. Supersonic flow is a necessary but insufficient condition for shocks to develop. The development of a shock requires the characteristics of neighboring points in a flow to intersect. We demonstrate that the intersection of characteristics may be quantified via the knowledge of the Mach number. Finally, we examine three-dimensional simulations of hot Jovian atmospheres and demonstrate that shock formation is expected to occur mostly on the dayside hemisphere, upstream of the substellar point, because the enhanced temperatures near the substellar point provide a natural pressure barrier for the returning flow. Understanding the role of shocks in irradiated exoplanetary atmospheres is relevant to correctly modeling observables such as the peak offsets of infrared phase curves.

  3. Destruction of Interstellar Dust in Evolving Supernova Remnant Shock Waves

    NASA Technical Reports Server (NTRS)

    Slavin, Jonathan D.; Dwek, Eli; Jones, Anthony P.

    2015-01-01

    Supernova generated shock waves are responsible for most of the destruction of dust grains in the interstellar medium (ISM). Calculations of the dust destruction timescale have so far been carried out using plane parallel steady shocks, however that approximation breaks down when the destruction timescale becomes longer than that for the evolution of the supernova remnant (SNR) shock. In this paper we present new calculations of grain destruction in evolving, radiative SNRs. To facilitate comparison with the previous study by Jones et al. (1996), we adopt the same dust properties as in that paper. We find that the efficiencies of grain destruction are most divergent from those for a steady shock when the thermal history of a shocked gas parcel in the SNR differs significantly from that behind a steady shock. This occurs in shocks with velocities 200 km s(exp -1) for which the remnant is just beginning to go radiative. Assuming SNRs evolve in a warm phase dominated ISM, we find dust destruction timescales are increased by a factor of approximately 2 compared to those of Jones et al. (1996), who assumed a hot gas dominated ISM. Recent estimates of supernova rates and ISM mass lead to another factor of approximately 3 increase in the destruction timescales, resulting in a silicate grain destruction timescale of approximately 2-3 Gyr. These increases, while not able resolve the problem of the discrepant timescales for silicate grain destruction and creation, are an important step towards understanding the origin, and evolution of dust in the ISM.

  4. Shock Initiation of Energetic Materials at Different Initial Temperatures

    SciTech Connect

    Urtiew, P A; Tarver, C M

    2005-01-14

    Shock initiation is one of the most important properties of energetic materials, which must transition to detonation exactly as intended when intentionally shocked and not detonate when accidentally shocked. The development of manganin pressure gauges that are placed inside the explosive charge and record the buildup of pressure upon shock impact has greatly increased the knowledge of these reactive flows. This experimental data, together with similar data from electromagnetic particle velocity gauges, has allowed us to formulate the Ignition and Growth model of shock initiation and detonation in hydrodynamic computer codes for predictions of shock initiation scenarios that cannot be tested experimentally. An important problem in shock initiation of solid explosives is the change in sensitivity that occurs upon heating (or cooling). Experimental manganin pressure gauge records and the corresponding Ignition and Growth model calculations are presented for two solid explosives, LX-17 (92.5 % triaminotrinitrobenzene (TATB) with 7.5 % Kel-F binder) and LX-04 (85 % octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazine (HMX) with 15 % Viton binder) at several initial temperatures.

  5. Stability of shock waves in high temperature plasmas

    SciTech Connect

    Das, Madhusmita; Bhattacharya, Chandrani; Menon, S. V. G.

    2011-10-15

    The Dyakov-Kontorovich criteria for spontaneous emission of acoustic waves behind shock fronts are investigated for high temperature aluminum and beryllium plasmas. To this end, the Dyakov and critical stability parameters are calculated from Rankine-Hugoniot curves using a more realistic equation of state (EOS). The cold and ionic contributions to the EOS are obtained via scaled binding energy and mean field theory, respectively. A screened hydrogenic model, including l-splitting, is used to calculate the bound electron contribution to the electronic EOS. The free electron EOS is obtained from Fermi-Dirac statistics. Predictions of the model for ionization curves and shock Hugoniot are found to be in excellent agreement with available experimental and theoretical data. It is observed that the electronic EOS has significant effect on the stability of the planar shock front. While the shock is stable for low temperatures and pressures, instability sets in as temperature rises. The basic reason is ionization of electronic shells and consequent increase in electronic specific heat. The temperatures and densities of the unstable region correspond to those where electronic shells get ionized. With the correct modeling of bound electrons, we find that shock instability for Al occurs at a compression ratio {approx}5.4, contrary to the value {approx}3 reported in the literature. Free electrons generated in the ionization process carry energy from the shock front, thereby giving rise to spontaneously emitted waves, which decay the shock front.

  6. Transmission of Naturally Occurring Lymphoma in Macaque Monkeys

    NASA Astrophysics Data System (ADS)

    Hunt, Ronald D.; Blake, Beverly J.; Chalifoux, Laura V.; Sehgal, Prabhat K.; King, Norval W.; Letvin, Norman L.

    1983-08-01

    Spontaneously occurring rhesus monkey lymphomas were transmitted into healthy rhesus monkeys by using tumor cell suspensions. The naturally arising tumors included an immunoblastic sarcoma and an undifferentiated lymphoma. Recipient animals developed undifferentiated lymphomas, poorly differentiated lymphomas, or parenchymal lymphoproliferative abnormalities suggestive of early lesions of lymphoma. Some of these animals developed such opportunistic infections as cytomegalovirus hepatitis and cryptosporidiosis. They also showed evidence of an abnormal circulating peripheral blood mononuclear cell. These findings, all characteristic of the acquired immune deficiency syndrome (AIDS) of macaques, suggest a link between these transmissible lymphomas and AIDS in macaque monkeys.

  7. [[CARDIORENAL SYNDROMES : DEFINITION AND CLASSIFICATION].

    PubMed

    Moulin, Bruno

    2016-06-01

    Cardiorenal syndromes refer to clinical and metabolic consequences of acute and chronic heart failure or kidney disease on other organ. Recent studies have further clarified the pathophysiological mechanisms behind the different types of cardiorenal syndromes and propose a new classification. The cardiorenal syndrome type 1 corresponds to an acute heart failure (cardiogenic shock, acute decompensated congestive heart failure) which induces acute renal dysfunction. In the cardiorenal syndrome type 2 heart failure is chronic (congestive heart failure) and induces chronic kidney damages in the long-term. Whereas the renocardiac syndrome type 3 (acute) or 4 (chronic) corresponds to either acute renal failure situation (acute renal failure with tubular necrosis secondary to acute collapsus...) responsible for acute heart failure (left ventricular failure and pulmonary edema) or chronic (chronic glomerulonephritis, polycystic...) leading to chronic heart alteration (left ventricular hypertrophy, heart failure, arrhythmias). Finally, the failure of both organs can be simultaneous and secondary to a systemic or a metabolic disease (amyloidosis, diabetes) and corresponds to cardiorenal syndrome type 5. Epidemiological studies highlight the high incidence of cardiorenal syndromes type 1 and 2 and particularly the deleterious impact of renal impairment on the short and medium-term prognosis of heart failure. This classification is of essential interest for better identification of patients and help for the development of therapeutic studies. PMID:27538311

  8. Shock-Induced Phase Transitions in the Martian Meteorite Tissint: Mechanisms and Constraints on Shock Pressure

    NASA Astrophysics Data System (ADS)

    Sharp, T. G.; Hu, J.; Walton, E. L.

    2013-12-01

    Martian meteorites are important samples for understanding the origin and age of the Martian crust. All of these samples have been shocked to some degree during their ejection from Mars or earlier. Tissint, a picritic shergottite, has many high-pressure phases that have been used to constrain shock conditions and suggest a deep crustal origin [1] and to argue for multiple impact events [2]. Here we investigate the products and mechanisms of various olivine transformation reactions. Olivine in and adjacent to shock-melt veins and pockets is transformed into high-pressure minerals. In the hottest parts of the sample, olivine dissociated into 50-nm crystals of magnesiowüstite intergrown with either a pyroxene-composition glass or with low-Ca clinopyroxene. In both cases, the olivine is inferred to have transformed to silicate perovskite + magnesiowüstite during shock with subsequent breakdown of the perovskite after pressure release. Olivine along the margins of shock veins transformed into ringwoodite. Polycrystalline ringwoodite formed at the olivine-melt interface wheras coherent ringwoodite lamellae formed farther from the melt. These ringwoodite lamellae have the same topotaxial relationship to olivine as seen in static high-pressure experiments [3] and shocked meteorites [4]: (100)Ol || {111}Rw and [011]Ol || <110>Rw. The various olivine reactions can be explained by a single shock to above 24 GPa where only the highest temperatures allowed the dissociation of olivine to silicate-perovskite plus magnesiowüstite. The silicate perovskite in the melt pocket transformed to pyroxene because the melt pocket remained very hot after pressure release. At lower temperatures, the kinetically easier polymorphic transformation of olivine to metastable ringwoodite occurred. At the lowest temperatures, this reaction was facilitated by nucleation of ringwoodite lamellae on stacking faults in olivine. The variation in assemblages that we see are consistent with a single shock

  9. Effects of Interplanetary Shock Inclinations on Nightside Auroral Power Intensity

    NASA Astrophysics Data System (ADS)

    Oliveira, D. M.; Raeder, J.; Tsurutani, B. T.; Gjerloev, J. W.

    2016-02-01

    We derive fast forward interplanetary (IP) shock speeds and impact angles to study the geoeffectiveness of 461 IP shocks that occurred from January 1995 to December 2013 using ACE and Wind spacecraft data. The geomagnetic activity is inferred from the SuperMAG project data. SuperMAG is a large chain which employs more than 300 ground stations to compute enhanced versions of the traditional geomagnetic indices. The SuperMAG auroral electroject SME index, an enhanced version of the traditional AE index, is used as an auroral power (AP) indicator. AP intensity jumps triggered by shock impacts are correlated with both shock speed and impact angle. It is found that high AP intensity events typically occur when high speed IP shocks impact the Earth's magnetosphere with the shock normal almost parallel to the Sun-Earth line. This result suggests that symmetric and strong magnetospheric compression leads to favorable conditions for intense auroral power release, as shown previously by simulations and observations. Some potential mechanisms will be discussed.

  10. [Cowden syndrome can be a challenging diagnosis].

    PubMed

    Skytte, Anne-Bine; Gerdes, Anne-Marie; Bygum, Anette

    2014-01-20

    Cowden syndrome is a rare autosomal dominant overgrowth syndrome with a predisposition to cancer. The overgrowth and cancer may occur in many different tissues, which makes it a challenge to recognize it, but due to the high risk of cancer early diagnosis is important. We present the Danish screening guidelines for patients with Cowden syndrome. PMID:24629684

  11. A scarlet pimpernel for the resolution of inflammation? The role of supra-therapeutic doses of cobalamin, in the treatment of systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic or traumatic shock.

    PubMed

    Wheatley, Carmen

    2006-01-01

    Cobalamin carrier proteins,the Transcobalamins (TCS), are elevated during trauma, infections and chronic inflammatory conditions. This remains un-explained. It is proposed that such TC elevations signal a need for cobalamin central to the resolution of inflammation. Thus Cobalamin may regulate the transcription factor, NFkappaB, activation or suppression of which determines the inflammatory response and its resolution. Such regulation may involve at least 5 separate mechanisms: (i) hormone-like regulation of TNFalpha, through reduction of excess NO by cobalamin, as well as through the selective inhibition, in tandem with glutathione, of inducible nitric oxide synthase; (ii) quenching of nitric oxide radicals and reactive oxygen species, enhanced by cobalamin's glutathione sparing effect; (iii) the promotion of acetylcholine synthesis, central to the neuro-immune cholinergic anti-inflammatory pathway; (iv) the promotion of oxidative phosphorylation; (v) and a bacteriostatic role of the TCS released by neutrophil secondary granules during phagocytosis, which also appears to modulate the inflammatory response. TC elevations are dependent on NFkappaB activation, through crosstalk between NFkappaB and Sp1, another member of the helix-loop-helix protein family, which directly mediates transcription of the TCII gene. Sp1 also has binding sites on the TNFalpha and EGF gene promoters. NFkappaB may thus ensure sufficient cobalamin to determine its own eventual suppression. Cobalamin's established regulation of EGF may additionally preserve normal function of macrophages and the coagulation cascade in wound healing. By regulating NFkappaB, Cobalamin may also be the as yet unidentified mediator needed to potentiate the anti-inflammatory action of eicosanoids derived from omega-3 essential fatty acids. Moreover, animal and human clinical data suggests that high dose cobalamin may prove a promising approach to SIRS/sepsis/septic and traumatic shock. PMID:16545917

  12. Shocking signals of dark matter annihilation

    NASA Astrophysics Data System (ADS)

    Davis, Jonathan H.; Silk, Joseph; BÅ`hm, Céline; Kotera, Kumiko; Norman, Colin

    2016-05-01

    We examine whether charged particles injected by self-annihilating dark matter (DM) into regions undergoing diffuse shock acceleration can be accelerated to high energies. We consider three astrophysical sites where shock acceleration is supposed to occur, namely the Galactic center and galaxy cluster mergers. For the Milky Way, we find that the acceleration of cosmic rays injected by dark matter could lead to a bump in the cosmic ray spectrum provided that the product of the efficiency of the acceleration mechanism and the concentration of DM particles is high enough. Within the Galaxy, we find that the Fermi bubbles are a potentially more efficient accelerator than supernovae remnants. However, both could in principle accelerate electrons and protons injected by dark matter to very high energies. At the extragalactic level, the acceleration of dark matter annihilation products could be responsible for enhanced radio emission from colliding clusters.

  13. Aftershock patterns and main shock faulting

    USGS Publications Warehouse

    Mendoza, C.; Hartzell, S.H.

    1988-01-01

    We have compared aftershock patterns following several moderate to large earthquakes with the corresponding distributions of coseismic slip obtained from previous analyses of the recorded strong ground motion and teleseismic waveforms. Our results are consistent with a hypothesis of aftershock occurrence that requires a secondary redistribution of stress following primary failure on the earthquake fault. Aftershocks followng earthquakes examined in this study occur mostly outside of or near the edges of the source areas indicated by the patterns of main shock slip. The spatial distribution of aftershocks reflects either a continuation of slip in the outer regions of the areas of maximum coseismic displacement or the activation of subsidiary faults within the volume surrounding the boundaries of main shock rupture. -from Authors

  14. Shock wave structure in heterogeneous reactive media

    SciTech Connect

    Baer, M.R.

    1997-06-01

    Continuum mixture theory and mesoscale modeling are applied to describe the behavior of shock-loaded heterogeneous media. One-dimensional simulations of gas-gun experiments demonstrate that the wave features are well described by mixture theory, including reflected wave behavior and conditions where significant reaction is initiated. Detailed wave fields are resolved in numerical simulations of impact on a lattice of discrete explosive {open_quotes}crystals{close_quotes}. It is shown that rapid distortion first occurs at material contact points; the nature of the dispersive fields includes large amplitude fluctuations of stress over several particle pathlengths. Localization of energy causes {open_quotes}hot-spots{close_quotes} due to shock focusing and plastic work as material flows into interstitial regions.

  15. Remotely triggered earthquakes following moderate main shocks

    USGS Publications Warehouse

    Hough, S.E.

    2007-01-01

    Since 1992, remotely triggered earthquakes have been identified following large (M > 7) earthquakes in California as well as in other regions. These events, which occur at much greater distances than classic aftershocks, occur predominantly in active geothermal or volcanic regions, leading to theories that the earthquakes are triggered when passing seismic waves cause disruptions in magmatic or other fluid systems. In this paper, I focus on observations of remotely triggered earthquakes following moderate main shocks in diverse tectonic settings. I summarize evidence that remotely triggered earthquakes occur commonly in mid-continent and collisional zones. This evidence is derived from analysis of both historic earthquake sequences and from instrumentally recorded M5-6 earthquakes in eastern Canada. The latter analysis suggests that, while remotely triggered earthquakes do not occur pervasively following moderate earthquakes in eastern North America, a low level of triggering often does occur at distances beyond conventional aftershock zones. The inferred triggered events occur at the distances at which SmS waves are known to significantly increase ground motions. A similar result was found for 28 recent M5.3-7.1 earthquakes in California. In California, seismicity is found to increase on average to a distance of at least 200 km following moderate main shocks. This supports the conclusion that, even at distances of ???100 km, dynamic stress changes control the occurrence of triggered events. There are two explanations that can account for the occurrence of remotely triggered earthquakes in intraplate settings: (1) they occur at local zones of weakness, or (2) they occur in zones of local stress concentration. ?? 2007 The Geological Society of America.

  16. Paradoxical reaction to epinephrine induced by beta-blockers in an anaphylactic shock induced by penicillin.

    PubMed

    Goddet, Nathalie-Sybille; Descatha, Alexis; Liberge, Oliver; Dolveck, François; Boutet, Jérémie; Baer, Michel; Fletcher, Dominique; Templier, François

    2006-12-01

    Increased risk of severe and resistant anaphylactic shock is a rare and not widely known adverse effect of beta-blocker treatment. It is illustrated in a case of refractory anaphylactic shock occurring in a 47-year-old woman who received beta-blockers. Actually, beta-blockers increase the release of anaphylactic mediators, decrease the cardiovascular compensatory changes to the anaphylactic shock and promote paradoxical reflex vagotonic effects when using epinephrine.

  17. Observational test of shock drift and Fermi acceleration on a seed particle population upstream of earth's bow shock

    NASA Technical Reports Server (NTRS)

    Anagnostopoulos, G. C.; Sarris, E. T.; Krimigis, S. M.

    1988-01-01

    The efficiency of proposed shock acceleration mechanisms as they operate at the bow shock in the presence of a seed energetic particle population was examined using data from simultaneous observations of energetic solar-origin protons, carried out by the IMP 7 and 8 spacecraft in the vicinity of the quasi-parallel (dawn) and quasi-perpendicular (dusk) regions of the earth's bow shock, respectively. The results of observations (which include acceleration effects in the intensities of the energetic protons with energies as high as 4 MeV observed at the vicinity of the dusk bow shock, but no evidence for any particle acceleration at the energy equal to or above 50 keV at the dawn side of the bow shock) indicate that the acceleration of a seed particle population occurs only at the quasi-perpendicular bow shock through shock drift acceleration and that the major source of observed upstream ion populations is the leakage of magnetospheric ions of energies not less than 50 keV, rather than in situ acceleration.

  18. Antiarrhythmic Drug Therapy to Avoid Implantable Cardioverter Defibrillator Shocks

    PubMed Central

    Abboud, Jaber

    2016-01-01

    Implantable cardioverter defibrillators (ICDs) are effective in the prevention of arrhythmic sudden cardiac death. Many patients receiving an ICD are affected by heart failure and are at risk of ventricular arrhythmias, which may lead to appropriate shocks. On the other hand, in this population the incidence of atrial fibrillation, giving rise to inappropriate ICD shocks, is high. Accordingly, ICD discharges occur frequently and many patients with an ICD will need concomitant antiarrhythmic drug therapy to avoid or reduce the frequency of shocks. Therapeutic agents such as β-blockers, class I or class III antiarrhythmic drugs effectively suppress arrhythmias, but may have side-effects. Some drugs could eventually influence the function of ICDs by altering defibrillation or pacing threshold. Few prospective randomised trials are available, but current data suggest that amiodarone is most effective for prevention of appropriate or inappropriate ICD shocks. This review article summarises current knowledge regarding the antiarrhythmic management of patients with ICDs.

  19. Antiarrhythmic Drug Therapy to Avoid Implantable Cardioverter Defibrillator Shocks.

    PubMed

    Abboud, Jaber; R Ehrlich, Joachim

    2016-08-01

    Implantable cardioverter defibrillators (ICDs) are effective in the prevention of arrhythmic sudden cardiac death. Many patients receiving an ICD are affected by heart failure and are at risk of ventricular arrhythmias, which may lead to appropriate shocks. On the other hand, in this population the incidence of atrial fibrillation, giving rise to inappropriate ICD shocks, is high. Accordingly, ICD discharges occur frequently and many patients with an ICD will need concomitant antiarrhythmic drug therapy to avoid or reduce the frequency of shocks. Therapeutic agents such as β-blockers, class I or class III antiarrhythmic drugs effectively suppress arrhythmias, but may have side-effects. Some drugs could eventually influence the function of ICDs by altering defibrillation or pacing threshold. Few prospective randomised trials are available, but current data suggest that amiodarone is most effective for prevention of appropriate or inappropriate ICD shocks. This review article summarises current knowledge regarding the antiarrhythmic management of patients with ICDs. PMID:27617090

  20. The Role of Shear in Shock Initiation of Explosives

    NASA Astrophysics Data System (ADS)

    Cart, E. J.; Lee, R. J.; Gustavson, P. K.; Coffey, C. S.; Sutherland, G. T.

    2004-07-01

    This describes an experiment to test the hypothesis that the energy dissipated due to shear driven plastic deformation provides the hot spots needed for shock initiation of explosives. To develop controlled shear, sinusoidal shock wave fronts were generated and used to initiate PBXN-110 explosive charges. A threshold level was found for nearly flat shock wave fronts that did not initiate the explosive charges yet sinusoidal shock waves of lower amplitude caused initiation in the regions of maximum shear and not in the regions of minimum shear in identical explosive charges. As predicted, initiation occurred as long rows centered over the regions of maximum slope — maximum shear of the corrugated sinusoidal surface. These experiments will be discussed in detail.

  1. Explosive volcanism, shock metamorphism and the K-T boundary

    NASA Technical Reports Server (NTRS)

    Desilva, S. L.; Sharpton, V. L.

    1988-01-01

    The issue of whether shocked quartz can be produced by explosive volcanic events is important in understanding the origin of the K-T boundary constituents. Proponents of a volcanic origin for the shocked quartz at the K-T boundary cite the suggestion of Rice, that peak overpressures of 1000 kbars can be generated during explosive volcanic eruptions, and may have occurred during the May, 1980 eruption of Mt. St. Helens. Attention was previously drawn to the fact that peak overpressures during explosive eruptions are limited by the strength of the rock confining the magma chamber to less than 8 kbars even under ideal conditions. The proposed volcanic mechanisms for generating pressures sufficient to shock quartz are further examined. Theoretical arguments, field evidence and petrographic data are presented showing that explosive volcanic eruptions cannot generate shock metamorphic features of the kind seen in minerals at the K-T boundary.

  2. Antiarrhythmic Drug Therapy to Avoid Implantable Cardioverter Defibrillator Shocks

    PubMed Central

    Abboud, Jaber

    2016-01-01

    Implantable cardioverter defibrillators (ICDs) are effective in the prevention of arrhythmic sudden cardiac death. Many patients receiving an ICD are affected by heart failure and are at risk of ventricular arrhythmias, which may lead to appropriate shocks. On the other hand, in this population the incidence of atrial fibrillation, giving rise to inappropriate ICD shocks, is high. Accordingly, ICD discharges occur frequently and many patients with an ICD will need concomitant antiarrhythmic drug therapy to avoid or reduce the frequency of shocks. Therapeutic agents such as β-blockers, class I or class III antiarrhythmic drugs effectively suppress arrhythmias, but may have side-effects. Some drugs could eventually influence the function of ICDs by altering defibrillation or pacing threshold. Few prospective randomised trials are available, but current data suggest that amiodarone is most effective for prevention of appropriate or inappropriate ICD shocks. This review article summarises current knowledge regarding the antiarrhythmic management of patients with ICDs. PMID:27617090

  3. Shock Formation of Slow Magnetosonic Waves in Coronal Plumes

    NASA Technical Reports Server (NTRS)

    Cuntz, Manfred; Suess, Steven T.; Rose, M. Franklin (Technical Monitor)

    2001-01-01

    We investigate the height of shock formation in coroner plumes for slow magnetosonic waves. The models take into account plume geometric spreading, heat conduction and radiative damping. The wave parameters as well as the spreading functions of the plumes and the base magnetic field strengths are given by empirical constraints mostly from Solar and Heliospheric Observatory/Ultraviolet Coronagraph Spectrometer (SOHO/UVCS). Our models show that shock formation occurs at low coronal heights, i.e., within 1.3 solar radius, depending on the model parameters. The shock formation is calculated using the well-established wave breaking condition given by the intersection of C+ characteristics in the space-time plane. Our models show that shock heating by slow magnetosonic waves is expected to be relevant at most heights in solar coronal plumes, although slow magnetosonic waves are most likely not a solely operating energy supply mechanism.

  4. Shock Formation of Slow Magnetosonic Waves in Coronal Plumes

    NASA Technical Reports Server (NTRS)

    Cuntz, Manfred; Suess, Steve; Rose, M. Franklin (Technical Monitor)

    2000-01-01

    We investigate the height of shock formation in coronal plumes for slow magnetosonic waves. The models take into account plume geometric spreading, heat conduction, and radiative damping. The wave parameters as well as the spreading functions of the plumes and the base magnetic field strengths are given by empirical constraints mostly from Solar and Heliospheric Observatory (SOHO)/ Ultraviolet Coronograph Spectrometer (UVCS), Extreme Ultraviolet Imaging Telescope (EIT), Michelson Doppler Imager (MDI), and Large Angle Spectrometric Coronagraph (LASCO). Our models show that shock formation occurs at relatively low coronal heights, typically within 1.2 RsuN, depending on the model parameters. The shock formation is calculated using the well-established wave breaking criterion given by the intersection of C+ characteristics in the space-time plane. Our models show that shock heating by slow magnetosonic waves is expected to be relevant at most heights in solar coronal plumes, although such waves are probably not the main energy supply mechanism.

  5. Mesoscale studies of mixing in reactive materials during shock loading

    NASA Astrophysics Data System (ADS)

    Lomov, Ilya; Herbold, Eric B.; Austin, Ryan A.

    2012-03-01

    One of the requisite processes for chemical reactions between solid powder particles resulting from shock loading is that the particles undergo large deformations, exposing new surfaces while mixing with surrounding material. Reactions under shock loading occur in a reaction zone, the extent of which is defined by the interfacial surface area and the depth of the diffusion layer. The former depends on the level of hydrodynamic mixing of heterogeneous material under shock, while the latter depends on temperaturedependent species diffusion. To investigate diffusion-limited reactions at the grain scale level, mass diffusion and simple reaction kinetics depending on the interfacial surface area have been implemented in an Eulerian hydrocode GEODYN. Diffusion-reaction processes that are initiated by rapid heating of a Ni/Al nanolaminate and by shock loading of a micron-scale Ni/Al powder mixture are considered.

  6. Prospects for management of gastrointestinal injury associated with the acute radiation syndrome

    SciTech Connect

    Dubois, A.; Walker, R.I.

    1988-08-01

    The effect of total-body ionizing radiation on the digestive tract is dose-dependent and time-dependent. At low doses (1.5 Gy), one observes only a short prodromal syndrome consisting of nausea, vomiting, and gastric suppression. At doses greater than 6 Gy, the prodromal syndrome is more marked, and it is followed after a 2-5-day remission period by a subacute syndrome, characterized by diarrhea and hematochezia. This gastrointestinal syndrome is superimposed onto a radiation-induced bone marrow suppression. The combination of intestinal and hemopoietic syndromes results in dehydration, anemia, and infection, leading eventually to irreversible shock and death. The treatment of prodromal symptoms is based on the administration of antiemetics and gastrokinetics, although an effective treatment devoid of side effects is not yet available for human therapy. The treatment of the gastrointestinal subacute syndrome remains difficult and unsuccessful after exposure to total body doses greater than 8-10 Gy. Supportive therapy to prevent infection and dehydration may be effective if restoration or repopulation of the intestinal and bone marrow stem cells does occur. In addition, bone marrow transplantation may improve the prospect of treating the hemopoietic syndrome, although the experience gained in Chernobyl suggests that this treatment is difficult to apply in the case of nuclear accidents. Administration of radioprotectants before irradiation decreases damage to healthy cells, while not protecting cancerous tissues. In the future, stimulation of gastrointestinal and hemopoietic progenitor cells may be possible using cell growth regulators, but much remains to be done to improve the treatment of radiation damage to the gastrointestinal tract. 77 references.

  7. Prospects for management of gastrointestinal injury associated with the acute radiation syndrome

    SciTech Connect

    Dubois, A.; Walker, R.I.

    1988-08-01

    The effect of total-body ionizing radiation on the digestive tract is dose-dependent and time-dependent. At low doses (1.5 Gy), one observes only a short prodromal syndrome consisting of nausea, vomiting, and gastric suppression. At doses>6 Gy, the prodromal syndrome is more marked, and it is followed after a 2-5-day remission period by a subacute syndrome, characterized by diarrhea and hematochezia. This gastrointestinal syndrome is superimposed onto a radiation-induced bone marrow suppression. The combination of intestinal and hemopoietic syndromes results in dehydration, anemia, and infection, leading eventually to irreversible shock and death. The treatment of prodromal symptoms is based on the administration of antiemetics and gastrokinetics, although an effective treatment devoid of side effects is not yet available for human therapy. The treatment of the gastrointestinal subacute syndrome remains difficult and unsuccessful after exposure to total-body doses >8-10 Gy. Supportive therapy to prevent infection and dehydration may be effective if restoration or repopulation of the intestinal and bone marrow stem cells does occur. In addition, bone marrow transplantation may improve the prospect of treating the hemopoietic syndrome, although the experience gained in Chernobyl suggests that this treatment is difficult to apply in the case of nuclear accidents. Administration of radioprotectants before irradiation decreases damage to healthy cells, while not protecting cancerous tissues. In the future, stimulation of gastrointestinal and hemopoietic progenitor cells may be possible using cell growth regulators, but much remains to be done to improve the treatment of radiation damage to the gastrointestinal tract.

  8. Shocked Molecular Hydrogen in the Orion ``Bullets''

    NASA Astrophysics Data System (ADS)

    Tedds, Jonathan A.

    1997-03-01

    , the uniformity of these ratios on small-scales (these observations) and also on large scales, contradicts co mbinations of fundamentally different types of shock. However, the near constancy of this excitation with position within each individual wake is inconsistent with bow C shock models previously fitted at OMC-1, in which significantly different line ratios occur depending on the shock velocity which varies in the bow.

  9. Shock metamorphism of carbonaceous chondrites

    NASA Technical Reports Server (NTRS)

    Scott, Edward R. D.; Keil, Klaus; Stoeffler, Dieter

    1992-01-01

    Shock effects were studied in 69 carbonaceous chondrites, including CM2, CO3, CV3, ungrouped C2-C4, and CK4-6 chondrites, using optical microscopy of thin sections. It is shown that the classification scheme of Stoeffler et al. (1991) for the progressive stages of shock metamorphism in ordinary chondrites is also applicable to carbonaceous chondrites. On the basis of shock effects in olivine, the 69 carbonaceous chondrites could be assigned to four shock stage, S1 to S4. The CM2 and CO3 groups were found to be the least shocked chondrite groups, whereas the CK4-6 and CV3 were the most strongly shocked groups.

  10. Premenstrual Syndrome (PMS) Fact Sheet

    MedlinePlus

    ... PDF, 66 KB) Mental health Menstruation and the menstrual cycle What is premenstrual syndrome (PMS)? What causes PMS? ... is a group of symptoms linked to the menstrual cycle. PMS symptoms occur 1 to 2 weeks before ...

  11. Hypoplastic left heart syndrome (image)

    MedlinePlus

    Hypoplastic left heart syndrome is a congenital heart condition that occurs during the development of the heart in the ... womb. During the heart's development, parts of the left side of the heart (mitral valve, left ventricle ...

  12. Cannabinoid Hyperemesis Syndrome

    PubMed Central

    Galli, Jonathan A.; Sawaya, Ronald Andari; Friedenberg, Frank K.

    2013-01-01

    Coinciding with the increasing rates of cannabis abuse has been the recognition of a new clinical condition known as Cannabinoid Hyperemesis Syndrome. Cannabinoid Hyperemesis Syndrome is characterized by chronic cannabis use, cyclic episodes of nausea and vomiting, and frequent hot bathing. Cannabinoid Hyperemesis Syndrome occurs by an unknown mechanism. Despite the well-established anti-emetic properties of marijuana, there is increasing evidence of its paradoxical effects on the gastrointestinal tract and CNS. Tetrahydrocannabinol, cannabidiol, and cannabigerol are three cannabinoids found in the cannabis plant with opposing effects on the emesis response. The clinical course of Cannabinoid Hyperemesis Syndrome may be divided into three phases: prodromal, hyperemetic, and recovery phase. The hyperemetic phase usually ceases within 48 hours, and treatment involves supportive therapy with fluid resuscitation and anti-emetic medications. Patients often demonstrate the learned behavior of frequent hot bathing, which produces temporary cessation of nausea, vomiting, and abdominal pain. The broad differential diagnosis of nausea and vomiting often leads to delay in the diagnosis of Cannabinoid Hyperemesis Syndrome. Cyclic Vomiting Syndrome shares several similarities with CHS and the two conditions are often confused. Knowledge of the epidemiology, pathophysiology, and natural course of Cannabinoid Hyperemesis Syndrome is limited and requires further investigation. PMID:22150623

  13. Imaging Supersonic Aircraft Shock Waves

    NASA Technical Reports Server (NTRS)

    Weinstein, Leonard M.; Stacy, Kathryn; Vieira, Gerald J.; Haering, Edward A., Jr.; Bowers, Albion H.

    1997-01-01

    A schlieren imaging system that uses the sun as a light source was developed it) obtain direct flow-field images of shock waves of aircraft in flight. This system was used to study how shock waves evolve to form sonic booms. The image quality obtained was limited by several optical and mechanical factors. Converting the photographs to digital images and applying digital image-processing techniques greatly improved the final quality of the images and more clearly showed the shock structures.

  14. A comprehensive analysis of the geomagnetic storms occurred dur

    NASA Astrophysics Data System (ADS)

    Ghamry, Essam; Lethy, Ahmed; Arafa-Hamed, Tareq; Abd Elaal, Esmat

    2016-06-01

    The Geomagnetic storms are considered as one of the major natural hazards. Egyptian geomagnetic observatories observed multiple geomagnetic storms during 18 February to 2 March 2014. During this period, four interplanetary shocks successively hit the Earth's magnetosphere, leading to four geomagnetic storms. The storm onsets occurred on 18, 20, 23 and 27 February. A non-substorm Pi2 pulsation was observed on 26 February. This Pi2 pulsation was detected in Egyptian observatories (Misallat and Abu Simbel), Kakioka station in Japan and Carson City station in US with nearly identical waveforms. Van Allen Probe missions observed non-compressional Pc4 pulsations on the recovery phase of the third storm. This Pc4 event is may be likely attributed to the decay of the ring current in the recovery phase.

  15. Vorticity-production mechanisms in shock/mixing-layer interaction problems

    NASA Astrophysics Data System (ADS)

    Tritarelli, R. C.; Kleiser, L.

    2016-04-01

    In this study, we investigate analytically the importance of different vorticity-production mechanisms contributing to the shock-induced vorticity caused by the interaction of a steady oblique shock wave with a steady, planar, supersonic, laminar mixing layer. The inviscid analysis is performed under the condition of a supersonic post-shock flow, which guarantees that the shock refraction remains regular. Special attention is paid to the vorticity production induced by a change in shock strength along the shock. Our analysis subdivides the total vorticity production into its contributions due to bulk or volumetric compression, pre-shock density gradients and variable shock strength. The latter is the only contribution dependent on the shock-wave curvature. The magnitudes of these contributions are analysed for two limiting cases, i.e., the interaction of an oblique shock wave with a constant-density shear layer and the interaction with a constant-velocity mixing layer with density gradients only. Possible implications for shock/mixing-layer interactions occurring in scramjet combustors are briefly discussed.

  16. PHACE(S) syndrome.

    PubMed

    Heyer, Geoffrey L

    2015-01-01

    PHACE(S) syndrome is a neurocutaneous disorder of unknown etiology. The acronym refers to the commonest features of PHACE: posterior fossa malformations, large facial hemangiomas, cerebral arterial anomalies, cardiovascular anomalies, and eye anomalies. When ventral developmental defects such as sternal clefting or supraumbilical raphe occur, the PHACES acronym may be used. The hallmark feature of PHACE is the presence of one or more large facial infantile hemangiomas that occupy at least one facial segment. Infantile hemangiomas differ from the capillary malformation (port wine stain) of Sturge-Weber syndrome, and the arteriovenous malformation of Wyburn-Mason syndrome, distinguishing PHACE syndrome from other neurocutaneous disorders with red birthmarks. The true incidence of PHACE has not yet been established. Girls are more commonly affected than boys. Cerebral vascular anomalies are probably the most common extracutaneous feature. Given that several organ systems are involved, a multidisciplinary approach to disease surveillance and treatment is advised. PMID:26564079

  17. [Takotsubo Cardiomyopathy: Cause of a Cardiogenic Shock].

    PubMed

    Fevereiro, Maria do Carmo; Simões, Maria Inês; Lampreia, Fátima; Marcão, Isabel; Godinho, António; Lopes, Vitor

    2015-01-01

    Takotsubo cardiomyopathy, of unknown etiology, is characterized by sudden and transient systolic dysfunction of the mid-apical segments of the left ventricle without significant coronary disease, and full normalization of segmental changes. More common in middle-aged women, it is cause of differential diagnosis with acute coronary syndrome. We present the case of a 59 year old woman admitted to the emergency room with sudden chest pain and dyspnea. At presentation: acute hypotensive pulmonary edema requiring aminergic support and invasive ventilation. Blood tests showed elevated necrosis myocardial enzymes. Serial electrocardiograms: sinus rhythm with progressive inversion of the T wave through the precordial leads (v2 - v6). Control echocardiograms: overall decreased systolic function with apical akinesia, and full reversal of the changes in 2 weeks. Cardiogenic shock of unknown etiology was admitted and a coronary computed tomography angiography was performed excluding coronary heart disease, supporting the diagnosis of Takotsubo cardiomyopathy.

  18. Shock metamorphism of ordinary chondrites

    NASA Technical Reports Server (NTRS)

    Stoeffler, Dieter; Keil, Klaus; Scott, Edward R. D.

    1991-01-01

    This study proposes a revised petrographic classification of progressive stages of shock metamorphism of 26 ordinary chondrites. Six stages of shock (S1 to S6) are defined on the basis of shock effects in olivine and plagioclase as recognized by thin section microscopy, and the characteristic shock effects of each shock stage are described. It is concluded that shock effects and the sequence of progressively increasing degrees of shock metamorphosis are very similar in H, L, and LL groups. Differences in the frequency distribution of shock stages are relatively minor. It is suggested that the collisional histories of the H, L, and LL parent bodies were similar. Petrologic type-3 chondrites are deficient in stages S4 and S6 and, with increasing petrologic type, the frequency of stages S4 to S6 increases. It is suggested that the more porous and volatile-rich Type-3 chondrites are subject to melting at a lower shock pressure than the nonporous chondrites of higher petrologic type. Stage S3 is the most abundant in nearly all petrologic types.

  19. Raman spectroscopy of shocked water

    SciTech Connect

    Holmes, N.C.; Mitchell, A.C.; Nellis, W.J.; Graham, W.B.; Walrafen, G.E.

    1983-07-01

    Raman scattering has been used extensively to study the vibrational and rotational properties of molecules under a variety of conditions. Here, interest is in the behavior of water molecules shocked to high pressures and temperatures. Behind the shock front the water molecules undergo changes in bonding and the molecules may become ionized. Raman spectroscopy can be used to determine the molecular species behind the shock front. In addition, changes in Raman spectra can yield information regarding inter- and intramolecular potentials and the temperature behind the shock front.

  20. Martian bow shock - PHOBOS observations

    NASA Astrophysics Data System (ADS)

    Schwingenschuh, K.; Riedler, W.; Lichtenegger, H.; Yeroshenko, Ye.; Sauer, K.; Luhmann, J. G.; Ong, M.; Russell, C. T.

    1990-05-01

    Data obtained with the Magma magnetometer on the subsolar passes of the Phobos spacecraft during its 3 elliptic orbits reveals a turbulent bow shock with a strong foot consistent with the reflection of solar wind protons. The bow shock lies at a subsolar distance of 1.47 + or - .03 R(M). The circular orbit phase of the mission reveals a bow shock with a highly varying location. The median terminator crossing lies at 2.72 Mars radii. The location of the bow shock in the terminator plane is sensitive to neither the EUV flux nor to planetary longitude.

  1. Shock metamorphism of ordinary chondrites

    NASA Astrophysics Data System (ADS)

    Stoeffler, Dieter; Keil, Klaus; Scott, Edward R. D.

    1991-12-01

    This study proposes a revised petrographic classification of progressive stages of shock metamorphism of 26 ordinary chondrites. Six stages of shock (S1 to S6) are defined on the basis of shock effects in olivine and plagioclase as recognized by thin section microscopy, and the characteristic shock effects of each shock stage are described. It is concluded that shock effects and the sequence of progressively increasing degrees of shock metamorphosis are very similar in H, L, and LL groups. Differences in the frequency distribution of shock stages are relatively minor. It is suggested that the collisional histories of the H, L, and LL parent bodies were similar. Petrologic type-3 chondrites are deficient in stages S4 and S6 and, with increasing petrologic type, the frequency of stages S4 to S6 increases. It is suggested that the more porous and volatile-rich Type-3 chondrites are subject to melting at a lower shock pressure than the nonporous chondrites of higher petrologic type. Stage S3 is the most abundant in nearly all petrologic types.

  2. Maskelynite: Formation by Explosive Shock.

    PubMed

    Milton, D J; de Carli, P S

    1963-05-10

    When high pressure (250 to 300 kilobars) was applied suddenly (shock-loading) to gabbro, the plagioclase was transformed to a noncrystalline phase (maskelynite) by a solid-state reaction at a low temperature, while the proxene remained crystalline. The shock-loaded gabbro resembles meteorites of the shergottite class; this suggests that the latter formed as a result of shock. The shock-loading of gabbro at 600 to 800 kilobars raised the temperature above the melting range of the plagioclase. PMID:17737107

  3. Shock metamorphism in lunar samples.

    PubMed

    von Engelhardt, W; Arndt, J; Müller, W F; Stöffler, D

    1970-01-30

    Indications of shock metamorphism produced by pressures up to the megabar region have been observed in the fine material and the breccias, but very rarely in the coarser fragments of crystalline rocks. These indications are deformation structures in plagioclase and pyroxene, diaplectic plagioclase glasses, and glasses formed by shock-induced melting of lunar rocks. Two sources of shock waves have been distinguished: primary impact of meteorites and secondary impact of crater ejecta. There are two major chemical types of shock-induced melts. The differences in chemistry may be related to impact sites in mare and highland areas.

  4. Martian bow shock: Phobos observations

    SciTech Connect

    Schwingenschuh, K.; Riedler, W.; Lichtenegger, H. ); Yeroshenko, Ye. ); Sauer, K. ); Luhmann, J.G.; Ong, M.; Russell, C.T. )

    1990-05-01

    Data obtained with the MAGMA magnetometer on the subsolar passes of the Phobos spacecraft during its 3 elliptic orbits reveals a turbulent bow shock with a strong foot consistent with the reflection of solar wind protons. The bow shock lies at a subsolar distance of 1.47 {plus minus} .03 R{sub M}. The circular orbit phase of the mission reveals a bow shock with a highly varying location. The median terminator crossing lies at 2.72 Mars radii. The location of the bow shock in the terminator plane is sensitive to neither the EUV flux nor to planetary longitude.

  5. Shocks in supersonic sand.

    PubMed

    Rericha, Erin C; Bizon, Chris; Shattuck, Mark D; Swinney, Harry L

    2002-01-01

    We measure time-averaged velocity, density, and temperature fields for steady granular flow past a wedge. We find the flow to be supersonic with a speed of granular pressure disturbances (sound speed) equal to about 10% of the flow speed, and we observe shocks nearly identical to those in a supersonic gas. Molecular dynamics simulations of Newton's laws yield fields in quantitative agreement with experiment. A numerical solution of Navier-Stokes-like equations agrees with a molecular dynamics simulation for experimental conditions excluding wall friction.

  6. Characterization of Shocked Beryllium

    SciTech Connect

    Cady, Carl M; Adams, Chris D; Hull, Lawrence M; Gray III, George T; Prime, Michael B; Addessio, Francis L; Wynn, Thomas A; Brown, Eric N

    2012-08-24

    Beryllium metal has many excellent structural properties in addition to its unique radiation characteristics, including: high elastic modulus, low Poisson's ratio, low density, and high melting point. However, it suffers from several major mechanical drawbacks: 1) high anisotropy - due to its hexagonal lattice structure and its susceptibility to crystallographic texturing; 2) susceptibility to impurity-induced fracture - due to grain boundary segregation; and 3) low intrinsic ductility at ambient temperatures thereby limiting fabricability. While large ductility results from deformation under the conditions of compression, the material can exhibit a brittle behavior under tension. Furthermore, there is a brittle to ductile transition at approximately 200 C under tensile conditions. While numerous studies have investigated the low-strain-rate constitutive response of beryllium, the combined influence of high strain rate and temperature on the mechanical behavior and microstructure of beryllium has received limited attention over the last 40 years. Prior studies have focused on tensile loading behavior, or limited conditions of dynamic strain rate and/or temperature. The beryllium used in this study was Grade S200-F (Brush Wellman, Inc., Elmore, OH) material. The work focused on high strain rate deformation and examine the validity of constitutive models in deformation rate regimes, including shock, the experiments were modeled using a Lagrangian hydrocode. Two constitutive strength (plasticity) models, the Preston-Tonks-Wallace (PTW) and Mechanical Threshold Stress (MTS) models, were calibrated using the same set of quasi-static and Hopkinson bar data taken at temperatures from 77K to 873K and strain rates from 0.001/sec to 4300/sec. In spite of being calibrated on the same data, the two models give noticeably different results when compared with the measured wave profiles. These high strain rate tests were conducted using both explosive drive and a gas gun to

  7. SHOCK-EXCITED OSCILLATOR

    DOEpatents

    Creveling, R.

    1957-12-17

    S> A shock-excited quartz crystal oscillator is described. The circuit was specifically designed for application in micro-time measuring work to provide an oscillator which immediately goes into oscillation upon receipt of a trigger pulse and abruptly ceases oscillation when a second pulse is received. To achieve the instant action, the crystal has a prestressing voltage applied across it. A monostable multivibrator receives the on and off trigger pulses and discharges a pulse through the crystal to initiate or terminate oscillation instantly.

  8. The microcirculation in shock

    PubMed Central

    Matheson, N. A.

    1969-01-01

    Some aspects of blood fluidity in hypoperfusion with particular reference to the important role of the red cell are discussed. Changes in different organ beds and the internal fluidity of the red cell, which is of obvious importance in capillary flow are not considered. It is not certain to what extent the phenomena discussed are critical factors in morbidity and mortality in shock because of paucity of objective data but there are good reasons for assuming them to be of importance and for directing treatment towards their correction. The properties of Dextran 40 applicable to the therapy of disordered blood fluidity are described. PMID:5343581

  9. Chromite-plagioclase assemblages as a new shock indicator; implications for the shock and thermal histories of ordinary chondrites

    NASA Astrophysics Data System (ADS)

    Rubin, Alan E.

    2003-07-01

    Chromite in ordinary chondrites (OC) can be used as a shock indicator. A survey of 76 equilibrated H, L and LL chondrites shows that unshocked chromite grains occur in equant, subhedral and rounded morphologies surrounded by silicate or intergrown with metallic Fe-Ni and/or troilite. Some unmelted chromite grains are fractured or crushed during whole-rock brecciation. Others are transected by opaque veins; the veins form when impacts cause localized heating of metal-troilite intergrowths above the Fe-FeS eutectic (988°C), mobilization of metal-troilite melts, and penetration of the melt into fractures in chromite grains. Chromite-plagioclase assemblages occur in nearly every shock-stage S3-S6 OC; the assemblages range in size from 20-300 μm and consist of 0.2-20-μm-size euhedral, subhedral, anhedral and rounded chromite grains surrounded by plagioclase or glass of plagioclase composition. Plagioclase has a low impedance to shock compression. Heat from shock-melted plagioclase caused adjacent chromite grains to melt; chromite grains crystallized from this melt. Those chromite grains in the assemblages that are completely surrounded by plagioclase are generally richer in Al 2O 3 than unmelted, matrix chromite grains in the same meteorite. Chromite veinlets (typically 0.5-2 μm thick and 10-300 μm long) occur typically in the vicinity of chromite-plagioclase assemblages. The veinlets formed from chromite-plagioclase melts that were injected into fractures in neighboring silicate grains; chromite crystallized in the fractures and the residual plagioclase-rich melt continued to flow, eventually pooling to form plagioclase-rich melt pockets. Chromite-rich "chondrules" (consisting mainly of olivine, plagioclase-normative mesostasis, and 5-15 vol.% chromite) occur in many shocked OC and OC regolith breccias but they are absent from primitive type-3 OC. They may have formed by impact melting chromite, plagioclase and adjacent mafic silicates during higher-energy shock

  10. Chromite-Plagioclase Assemblages as a New Shock Indicator; Implications for the Shock and Thermal Histories of Ordinary Chondrites

    NASA Technical Reports Server (NTRS)

    Rubin, Alan E.

    2006-01-01

    Chromite in ordinary chondrites (OC) can be used as a shock indicator. A survey of 76 equilibrated H, L and LL chondrites shows that unshocked chromite grains occur in equant, subhedral and rounded morphologies surrounded by silicate or intergrown with metallic Fe-Ni and/or troilite. Some unmelted chromite grains are fractured or crushed during whole-rock brecciation. Others are transected by opaque veins; the veins form when impacts cause localized heating of metal-troilite intergrowths above the Fe-FeS eutectic (988 C), mobilization of metal-troilite melts, and penetration of the melt into fractures in chromite grains. Chromite-plagioclase assemblages occur in nearly every shock-stage S3-S6 OC; the assemblages range in size from 20-300 microns and consist of 0.2-20-micron-size euhedral, subhedral, anhedral and rounded chromite grains surrounded by plagioclase or glass of plagioclase composition. Plagioclase has a low impedance to shock compression. Heat from shock-melted plagioclase caused adjacent chromite grains to melt; chromite grains crystallized from this melt. Those chromite grains in the assemblages that are completely surrounded by plagioclase are generally richer in Al2O3, than unmelted, matrix chromite grains in the same meteorite. Chromite veinlets (typically 0.5-2 microns thick and 10-300 microns long) occur typically in the vicinity of chromite-plagioclase assemblages. The veinlets formed from chromite-plagioclase melts that were injected into fractures in neighboring silicate grains; chromite crystallized in the fractures and the residual plagioclase-rich melt continued to flow, eventually pooling to form plagioclase-rich melt pockets. Chromite-rich chondrules (consisting mainly of olivine, plagioclase-normative mesostasis, and 5-15 vol.% chromite) occur in many shocked OC and OC regolith breccias but they are absent from primitive type-3 OC. They may have formed by impact melting chromite, plagioclase and adjacent mafic silicates during higher

  11. Experimental shock metamorphism of the Murchison CM carbonaceous chondrite

    NASA Astrophysics Data System (ADS)

    Tomeoka, Kazushige; Yamahana, Yasuhiro; Sekine, Toshimori

    1999-11-01

    A series of shock-recovery experiments were carried out on the Murchison CM carbonaceous chondrite by using a single-stage propellant gun. The Murchison samples were shocked in nine experiments at peak pressures from 4 to 49 GPa. The recovered samples were studied in detail by using an optical microscope, a scanning electron microscope and an electron-probe microanalyzer. Chondrules are flattened in the plane of the shock front at 4 to 30 GPa. The mean aspect ratio of chondrules increases from 1.17 to 1.57 roughly in proportion to the intensity of shock pressure up to ˜25 GPa. At 25 to 30 GPa, the mean aspect ratio does not increase further, and chondrules show increasingly more random orientations and degrade their preferred orientations, and at ˜35 GPa, they are extensively disrupted. Most coarse grains of olivine and pyroxene are irregularly fractured, fracture density increases with increasing shock pressure and at ˜30 GPa almost all are thoroughly fractured with subgrains of <1 to 5 μm in size. At ˜20 GPa, subparallel fractures begin to form in the matrix in directions roughly perpendicular to the compression axis and their densities increase with pressure, especially dramatically at 25 to 30 GPa; thus, the sample is increasingly comminuted and becomes fragile. Local shock melting occurs as melt veins and pockets at 20 to 30 GPa. Fracture-filling veins of fine grains of matrix are also produced at 25 to 30 GPa. The melts and the fine grains seem to result mainly from frictional heating due to displacement along fractures. At ˜35 GPa, melting occurs pervasively throughout the matrix. The melts are mainly produced from the matrix; however, they are consistently more enriched in Fe, S, and Ca, which indicates that these elements are selectively incorporated into the melts. The melts contain tiny spherules of Fe-Ni metal, Fe sulfide, and numerous vesicles. At 49 GPa, the matrix is totally melted and coarse grains of olivine are partially melted. The melts

  12. Shock-fitted Euler solutions to shock-vortex interactions

    NASA Technical Reports Server (NTRS)

    Salas, M. E.; Zang, T. A.; Hussaini, M. Y.

    1982-01-01

    The interaction of a shock wave with a hot spot, a single vortex and a vortex street is studied within the framework of the two dimensional compressible Euler equations. The numerical results obtained by the pseudospectral method and the finite difference MacCormack method are compared. In both the methods the shock wave is fitted as a boundary of the computational domain.

  13. Finite Mach number spherical shock wave, application to shock ignition

    NASA Astrophysics Data System (ADS)

    Vallet, A.; Ribeyre, X.; Tikhonchuk, V.

    2013-08-01

    A converging and diverging spherical shock wave with a finite initial Mach number Ms0 is described by using a perturbative approach over a small parameter Ms-2. The zeroth order solution is the Guderley's self-similar solution. The first order correction to this solution accounts for the effects of the shock strength. Whereas it was constant in the Guderley's asymptotic solution, the amplification factor of the finite amplitude shock Λ(t)∝dUs/dRs now varies in time. The coefficients present in its series form are iteratively calculated so that the solution does not undergo any singular behavior apart from the position of the shock. The analytical form of the corrected solution in the vicinity of singular points provides a better physical understanding of the finite shock Mach number effects. The correction affects mainly the flow density and the pressure after the shock rebound. In application to the shock ignition scheme, it is shown that the ignition criterion is modified by more than 20% if the fuel pressure prior to the final shock is taken into account. A good agreement is obtained with hydrodynamic simulations using a Lagrangian code.

  14. Dual Mode Shock-Expansion/Reflected-Shock Tunnel

    NASA Technical Reports Server (NTRS)

    Erdos, John I.; Bakos, Robert J.; Castrogiovanni, Anthony; Rogers, R. Clayton

    1998-01-01

    NASA s HYPULSE facility at GASL has been reconfigured to permit free jet testing of the Hyper-X flowpath at flight Mach numbers of 7 and 10. Among the required changes are addition of a converging-diverging nozzle to permit operation in a reflected shock tunnel mode, a 7 ft. diameter test cabin and a 30 in. diameter contoured nozzle. However, none of these changes were allowed to interfere with rapid recovery of the prior shock-expansion tunnel mode of operation, and indeed certain changes should enhance facility usefulness and productivity in either mode. A previously-developed shock-induced detonation mode of driving the facility has been successfully applied to both reflected shock tunnel operation at Mach 10 flight conditions, with tailored interface operation, and shock-expansion tunnel operation at flight conditions corresponding to Mach numbers from 12 to 25. Tailored interface operation at Mach 7 has been achieved with an unheated helium driver. In the present paper, the rationale for a dual mode shock expansion/reflected shock tunnel is discussed, and the capabilities and limitations for each mode are outlined. The physical changes in the HYPULSE facility to achieve dual mode capability are also described. Limited calibration data obtained to date in the new reflected shock tunnel mode are presented and the anticipated flight simulation map with dual mode operation is also outlined.

  15. Finite Mach number spherical shock wave, application to shock ignition

    SciTech Connect

    Vallet, A.; Ribeyre, X.; Tikhonchuk, V.

    2013-08-15

    A converging and diverging spherical shock wave with a finite initial Mach number M{sub s0} is described by using a perturbative approach over a small parameter M{sub s}{sup −2}. The zeroth order solution is the Guderley's self-similar solution. The first order correction to this solution accounts for the effects of the shock strength. Whereas it was constant in the Guderley's asymptotic solution, the amplification factor of the finite amplitude shock Λ(t)∝dU{sub s}/dR{sub s} now varies in time. The coefficients present in its series form are iteratively calculated so that the solution does not undergo any singular behavior apart from the position of the shock. The analytical form of the corrected solution in the vicinity of singular points provides a better physical understanding of the finite shock Mach number effects. The correction affects mainly the flow density and the pressure after the shock rebound. In application to the shock ignition scheme, it is shown that the ignition criterion is modified by more than 20% if the fuel pressure prior to the final shock is taken into account. A good agreement is obtained with hydrodynamic simulations using a Lagrangian code.

  16. [Cardiac complications in a metamizole-induced type I Kounis syndrome].

    PubMed

    Juste, Jose F Martínez; Garces, Tomas Ruiz; Enguita, Rafael Gonzalez; Blasco, Pedro Cia; Trallero, Jara Altemir

    2016-01-01

    Kounis syndrome is defined as the coincidental occurrence of allergic reaction and acute coronary syndrome secondary to vasospasm. Anti-inflammatory drugs are included as one of the multiple causes. Current data available about this syndrome come from case reports. We present the case of a patient who suffered Kounis syndrome with cardiogenic shock and asystole after intravenous infusion of Metamizole, and in which no lesions were observed in coronariography.

  17. Cardiac complications in a metamizole-induced type I Kounis syndrome.

    PubMed

    Juste, Jose F Martínez; Garces, Tomas Ruiz; Enguita, Rafael Gonzalez; Blasco, Pedro Cia; Trallero, Jara Altemir

    2016-01-01

    Kounis syndrome is defined as the coincidental occurrence of allergic reaction and acute coronary syndrome secondary to vasospasm. Anti-inflammatory drugs are included as one of the multiple causes. Current data available about this syndrome come from case reports. We present the case of a patient who suffered Kounis syndrome with cardiogenic shock and asystole after intravenous infusion of Metamizole, and in which no lesions were observed in coronariography.

  18. [Cardioversion for paroxysmal supraventricular tachycardia during lung surgery in a patient with concealed Wolff-Parkinson-White syndrome].

    PubMed

    Sato, Yoshiharu; Nagata, Hirofumi; Inoda, Ayako; Miura, Hiroko; Watanabe, Yoko; Suzuki, Kenji

    2014-10-01

    We report a case of paroxysmal supraventricular tachycardia (PSVT) that occurred during video-assisted thoracoscopic (VATS) lobectomy in a patient with concealed Wolff-Parkinson-White (WPW) syndrome. A 59-year-old man with lung cancer was scheduled for VATS lobectomy under general anesthesia. After inserting a thoracic epidural catheter, general anesthesia was induced with intravenous administration of propofol. Anesthesia was maintained with inhalation of desfurane in an air/oxygen mixture and intravenous infusion of remifentanil. Recurrent PSVT occurred three times, and the last episode of PSVT continued for 50 minutes regardless of administration of antiarrhythmic drugs. Synchronized electric shock via adhesive electrode pads on the patient's chest successfully converted PSVT back to normal sinus rhythm. The remaining course and postoperative period were uneventful. An electrophysiological study performed after hospital discharge detected concealed WPW syndrome, which had contributed to the development of atrioventricular reciprocating tachycardia. Concealed WPW syndrome is a rare, but critical complication that could possibly cause lethal atrial tachyarrhythmias during the perioperative period. In the present case, cardioversion using adhesive electrode pads briefly terminated PSVT in a patient with concealed WPW syndrome.

  19. Turner Syndrome

    MedlinePlus

    Turner syndrome is a genetic disorder that affects a girl's development. The cause is a missing or ... t work properly. Other physical features typical of Turner syndrome are Short, "webbed" neck with folds of ...

  20. LEOPARD syndrome

    MedlinePlus

    LEOPARD syndrome is a very rare inherited disorder in which there are problems with the skin, face, ... LEOPARD syndrome is inherited as an autosomal dominant trait. This means the person only needs the abnormal ...